FREQUENCY OF PRESENCE OF PERIODONTOPATHOGENIC BACTERIA IN THE PERIODONTAL POCKETS.

The study is aimd at detection the pathogenic markers: Aggregatibacter actinomycetemcomit, Porphyromonas Gingivalis, Prevotella Intermedia, Tannerella Forsythia and Treponema Denticola, identify their types, qualitative content and encounter frequency in periodontal pockets of the patients with generalized periodontitis, stage II (A or B level), before and after treatment with mechanical forms of therapy - Ultrasound, Vector or Laser Therapy . The material has been studied by using Micro-Ident biological method based on DNA-Strip technology. The surveyed 25 patients (women - 75% and men - 25%), 20 to 60 years of age, were divided into the three groups: group I treatment with Ultrasound scaler (n=9), group II treatment with Ultrasound Scaler and Diode laser (n=8), group III treatment with Ultrasound Scaler and Vector Sistem (n=8). All five strain before treatment were detected in 3 (12.5%) cases, none of the strain were detected in 1 patient (4%); among the rest 21 patients (87.5%) the following associations of different microorganisms were detected: P.G., P.I, T.F., T.D. - in 20.8% of patients, P.G., T.F., T.D. - 12.5%; A.A., P.G., P.I., T.F. - 4.16%; P.G., P.I., T.F.-33.28%; P.I., T.F., T.D. - 4.16%; A.A., P.G., T.F., T.D. - 12.5%; P.I., T.F. - 4.16%; P.G., P.I., T.D. - 4.16%. After evaluating the effectiveness of the treatment, based on Ultrasound system, Vector system, Diode laser and the complex picture of clinical and laboratory examinations in patients with generalized periodontitis, stage II, A or B level, a significant improvement in clinical conditions was observed. The microbiological study of Aggregatibacter Actinomycetemcomit (AA), Porphyromonas Gingivalis (PG), Prevotella Intermidia (PI), Tannerella Forsythia (BF), Treponema Denticola (TD) showed a complete elimination of qualitative and quantitative data after Vector therapy, but no reliable elimination of bacteria was observed after ultrasound and laser therapies. After treatment all five strain were detected in 1 (4%) case, 4 strain A.A., P.G., T.F., T.D. in 1 (4%) case, P.G.,P.I.,T.F.,T.D. - 2 (8%) case, 3 strain P.G., P.I., T.F in 3 (12.5%) case, 2 strain P.G., T.F - 1 strain (4%) and 1 T.F in 2 (8%).

[Parodontitis pathogenetic factors, their interaction and effects].

Induced by microbial intervention oxidative stress causes electronic transport disorder in gingival cells mitochondrias as well as decrease of energogenesis and increase of lipoperoxidation. In oral cavity local immunity is decreased in parodontitis, that is related with immunoglobulin A deficiency and lysozyme activity decrease. Against this background, microbial factors damaging effect on periodont is intensified. In parodontitis the free nitric oxide (NO) content decrease in gingival tissues and its appearance in saliva is related with transformation of NO into toxic peroxinitrite, that on its turn enhances oxidation, parodontal injury, cell degra dation and necrosis. Nitrooxide defficiency in gingival mucosal cells is characterized by decreased protein P-53 expression and terminal differentiation disorder of the cells. Mitochodria related energogenesis disorder in gums causes inhibition of their cell regeneration, which together with apoptotic changes is characterized with parodontal tissue destruction and depletion.

The psychological aspects of burning mouth syndrome.

It should be emphasized that at the present stage there is no consensus achieved regarding the etiopathogenesis of BMS. Almost all researchers point to lots of factors, simultaneously participating in genesis and development of BMS and at the same time most of them agreed on one - psychological factors play a crucial role in formation and maintenance of painful sensations. The aim of the study was the identification of psychological or psychiatric deviations (changes) among the patients with BMS to perform an adequate differentiated therapy. Clinico-psychological examination (dentist, neurologist, psychiatrist) was carried out in 39 patients from 46 to 70 years of age. Among them women - 36 and men - 3. To identify clinical types of BMS a classification of P.J. Lamey (1996) was used and as a result, depression, insomnia, cancerophobia, severe neurologic disorders, phobic syndrome were revealed. Three main categories - a chronic somatoform dysfunction (23 cases), chronic vegetative disorders (8), and chronic pain phenomenon (12) were identified. Only in one case was revealed a paranoid syndrome. Alongside with the well-known scheme of treatment (antidepressants, anticonvulsants, or neuroleptics) Psychotherapy was conducted, while EEG-feed back (Biofeed back, Neurofeed back) method was used for the first time. A number of important decisions were made the most important of which are the following: BMS - must be regarded as a psychosomatic problem rather than a psychiatric disorder. In addition to psychotherapy, using of EEG - feedback method greatly improved patients' condition and in 4 cases BMS clinical manifestations were evened-out completely.

[Oral cavity features in patients suffering from osteogenesis imperfecta].

Osteogenesis Imperfecta (OI) is a rare hereditary connective tissue disorder. This pathology is characterized by disruption of biosynthesis of Type I collagen, and production of limited amount of defective and imperfect collagens. This causes decrease in bone mass of human body, bones become fragile and brittle, resulting in unreasonable multiple fractures. Reportedly, number of patients with OI ranges between 32-38 in Georgia. However, exact number of patients, including children and their parents, is unknown. Dentinogenesis Imperfecta (DI; DGI) and skeletal malocclusion occupy special place in varied spectrum of OI clinical symptoms. We studied 14 patients: 9 women (64.3%), 5 men (35.7%) and divided them in three age groups: I - 2.5-6 years - period of primary dentition (28.6%), II - 6-14 years - period of changing teeth dentition (35.7%) and III - above 14 years - period of permanent dentition (35.7%). 28.5% of screened patients had one of the symptoms of DI, such as tooth discoloration. Discoloration of primary teeth was revealed in 4 patients (primary dentition). Another symptom of DI, such as early abrasion, was detected in 5 patients i.e. 35.71%. This was divided in the following manner: I age group - 3 cases, II and III age groups - 1-1 cases. It was also observed that early abrasion of primary teeth prevails over permanent. One of DI's radiographic symptoms, such as peculiar form of teeth crown and root, was revealed in 21.4% or in 3 patients, 2 of whom had bulbous crown, and the third one deformed (curved) root. Peculiar characteristics of DI, such as increased constriction of the coronal-radicular junction, obliterated pulp chamber, short and narrow roots, were not observed in the patients examined. Interesting characteristic of DI, such as periapical destruction of intact tooth root, was revealed in the form of bone defect in 7.1% of those examined (1 patient). Therefore, out of examined 14 patients with OI - DI had 6 patients or 42.85% of cases. Also, interesting observation was revealed - DI is more common in primary teeth (66.66%) than in permanent (33.33%). Radiographic examination - orthopantomography - revealed secondary osteoporosis of jaw bones in 100% of cases. Mucous tissue of examined patients is within normal range. Among examined patients, 1 case of adenty, 1 case of retention and 1 case of overcomplex tooth were revealed. According to current literature, it is unknown whether there is a lgical relationship between adenty, retention, overcomplex teeth and OI. This will be defined by future research.

[Markers of periodontal diseases and sensitivity to taromentine in patients with aggressive periodontitis].

The aim of the research was to study sensitivity of specific microorganisms from the periodontal pockets of patients with rapidly progressive periodontal disease to Taromentine. 95 patients aged 21 to 35 years (50 women (52,6+/-33,62) and 45 men (47,36+/-3,62)) with rapidly progressive form of periodontal desease were observed. Porphiromonas gingivalis was identifide in 83 out of 95 patients (87,36+/-2,06). Prevotella intermedia - in 31 patients (32,6+/-2,750); Actinobacillus actinomycetemcomitans - in 23 patients (24,2+/-2,050); Bacteroides forsythus - in 19 patients (20,0+/-2,360); Treponema denticola - in 16 patients (16,84+/-2,190); Candida - in 11 patients (11,57+/-1,80). The sensitivity of all cultures to Taromentine was investigated: 134 (77,9+/-1,89) out of 183 identified markers demonstrated sensitivity to Taromentine. Demostrated sensitivity to Taromentine: 64 (37,2+/-1,06) out of 83 identified cultures of Porphiromonas gingivalis, 24 (13,95+/-1,85) out of 31 identified cultures of Prevotela intermedia, 18 (10,47+/-1,05) out of 23 identified cultures of Actinobacillus actinomycetemcomitans, 15 (8,7+/-1,86) out of 19 identified cultures of Bacteroides forsythus, and 13 (7,84+/-1,09) out of 16 identified cultures of Treponema denticola. Totally 38 (22,1+/-1,59) out of 172 identified periodontal markers demonstrated resistence to Taromentine. The results of analysis showed that Taromentine could be recommended in complex treatment of periodontal diseases.

[Comparative estimation of laser devices in complex treatment of oral cavity mucous membrane diseases].

The aim of the study was to compare laser devices "Optodan" and portative laser "Baure" in complex treatment of oral cavity mucous membrane diseases. We studied 90 patients: 54 female (60,0+/-0,77%) and 36 (30,0+/-0,7%) men from 18 to 45 years old. All patients had different forms of oral mucosal diseases: Stomatitis aphtosa chronica recidiva had 36 patients (28,9+/-0,9%); Erythema exudativum multiforme - 10 patients (6,7+/-1,5%), Candidosis angulitis - 26 patients (17,8+/-1,46%), Lichen ruber planus ulceroza - 4 patients (4,44+/-1,03%), Trauma mechanicum acutium - 12 patients (11,06+/-2,8%), Stomatitis herpetica - 28 patients (31,1+/-1,48%). All the patients were practically healthy and had no contraindications for physiotherapy. Before treatment to all patients had been recommended means of individual hygiene and several recommendations. The patients were divided into two groups. Every group consisted of 45 patients. 13 patients with Stomatitis aphtosa chronica recidiva, 14 - Stomatitis herpetica, 3 - Erythema exudativum multiforme, 8 - Candidosis angulitis, 2 - Lichen ruber planus ulceroza, 5 - Trauma mechanicum acutium. All the patients underwent symptomatic treatment according to the form and gravity of disease. Patients in a first group in addition had laserotherapy with a laser device "Optodan". Patients in a second group underwent laserotherapy with a portative device (Baurer). The positive results were achieved in both groups, though the first group patients mentioned considerable reduce of pain right after procedures. Our research proved the high effectiveness of laserotherapy in complex treatment of oral cavity mucous membrane diseases. Treatment with device "Optodan" is the most preferable.

[Etiologic factors in development of inflammatory diseases (cheilitis) of the lips].

Last years the number of patients affected with lips' pathologies has been significantly increased that could be caused by different exogenic (chemical, biological, pharmacological and toxic substances etc.) and endogenic factors. Therefore, considering the above-mentioned etiologic factors, the aim of our study was identification and differentiation of different types of Cheilitis and basing on the study of their pathogenesis, to perform differential diagnostics and to systematize them. In certain cases, cheilitis appeared to be the early manifestations of diseases of different organs or organ systems on lips, laying the great responsibility on the Doctor-Stomatologists, who together with the other appropriate specialists is obliged to perform diagnostics of general (background) diseases in time; to make differential diagnostics and to plan the further and target therapy.

[Holisal in the complex treatment of periodontal disease].

The aim of our research was to evaluate efficiency of medicine Cholisal in complex treatment of periodontitis. During the research 36 patients with periodontitis (from 18 to 36 years old) were examined and treated. The patients were divided into 3 groups according to severity of periodontitis. Each group included 12 patients. For studying the efficiency of treatment both objective and subjective data was used. In case of mild severity of disease clinical indices were: HI=2,1+/-0,75; Ghi=1,4+/-0,67; Gi=1,7+/-0,78, PI=0,8+/-0,34. In case of moderate severity of disease clinical indices were: HI=2,57+/-1,02; GHI=2,18+/-0,81; GI=1,95+/-0,8, PI=3,9+/-1,1. In case of severe disease - HI=3,9+/-1,25, GHI=2,5+/-0,8, GI=2,9+/-1,2, PI=7,8+/-1,62. Clinical study has shown that Cholisal enables successful treatment of periodontitis. It has prolonged, antiinflamatory, deodorant and analgesic effect. Our investigation revealed that xolisale can be recommended in complex treatment of periodontal disease.

[Content and metabilism of nitric oxide in substrates of oral cavity and their role in pathogenesis of periodontite disease].

Content and metabolism of free NO in saliva, fluids of periodontal pockets and gingival tissue has been investigated by EPR (electron paramagnetic resonance) method with the use of nitric oxide spin-trap in patients suffering from periodontitis. It was found that increased generation of nitric oxide at early stages of periodontitis is of protective nature. However, at serious disorders of mitochondrial respiration and exaggerated formation of generators of reactive oxygen, nitric oxide converts into citotoxic peroxinitrite leading to destruction of parodontal tissue; part of free nitric oxide produces FeSNO, which in turn, supports and decreases content of free NO in gingival tissue. As a result, decreases local antimicrobial protection, hemocirculation, tissue nutrition, progresses inflammation. Periodontitis decreases local immunity due to NO deficiency in gingival tissue. Reduced content of NO in gingival tissue decreases regeneration ability of cells, which in turn, leads to deterioration on gingival tissue.

[Antibacterial nature of medicinal ointments, based on Georgian mineral waters in treatment of generalized periodontitis].

The goal of the work was to determine antibacterial nature of the medicinal ointments (N1 - "Achtala"; N2 - "Sairme", N3 - "Tschaltubo", N4 "Amagleba") based on Georgian mineral waters and containing bio-active extracts. The goal of the work was to determine antibacterial nature of the medicinal ointments (N1 - "Achtala"; N2 - "Sairme", N3 - "Tschaltubo", N4 "Amagleba") based on Georgian mineral waters and containing bio-active extracts. The investigation was done in purpose to determine microbial structure of oral cavity of the 80 patients with chronic generalized periodontitis, as a result was confirmed, that microbial structure of these patients was rather heterogeneous and is presented by different aerobe, microaerophil and anaerobe microbial flora. The sensitivity, resistance, of isolated microorganisms, was studied to modern groups of antibiotics. Results of investigations are: high antibacterial activities of ointments, prepared on mineral waters of Georgia. So, it can be recommended for usage in treatment schedule for patients with chronic generalized periodontitis.

[Role of various etiologic factors in the development of burning mouth syndrome].

Burning mouth syndrome (BMS) has been comparatively recently isolated as the separate nosologic diagnosis. This disease is characterized by the feeling of burning, dryness, numbness, pricking and seldom by pain in the tongue or mouth cavity area (palate, lips, alveoli) without any changes in mucous membrane. Absence of visible causes of the disease complicates its treatment and makes the patients to address the physicians of various profiles, often without any result. All the above stated made the authors to define the etiologic factors of various clinical versions of BMS and to carry out their differential diagnostics along with the development of pathogenetic therapy of BMS. 30 women of 40 to 70 year of age were examined. According to the anamnesis, BMS was developing gradually and in most cases it was associated with the aggravation of the existing disease (hypertension, diabetes mellitus, aggravation of climacteric state) or with deterioration of psycho-emotional sphere due to conflicting situation. The carried out studies enabled the authors to select and divide patients with BMS into groups according to clinical values and the etiologic factors. In most cases diverse clinical versions of the burning mouth syndrome are cause-and-effect expressions of various somatic diseases, the timely determination and adequate therapy of which give the best results in the struggle against BMS.

[Employment of the laser apparatus SL-30 in complex treatment of chronic recurrent herpetic stomatitis].

The purpose of the study was the estimation of complex treatment effectiveness of chronic recurrent herpetic stomatitis using portable laser device "Beurer" (Germany). Fifty patients 17 till 55 years of age were investigated. Among them 28 were women and 22 were men. They were divided into two groups. All patients were treated by standard algorithm according to the severity of the disease. In the patients from the second group laser therapy by means of SL-30, 15-30 min per day was administered. After the completion of the course of treatment positive therapeutic effect has been achieved in all patients from the second group. Disappearance of the subjective symptoms and the initiation of the reparative-regenerative processes has occurred much faster in this group which gave us an opportunity to reduce the number of sessions by 5-6 in comparison with the first group. Thus, it was shown that the use of apparatus SL-30 in complex treatment of the chronic recurrent herpetic stomatitis increases the efficiency of the treatment.