Treatment of aggressive (rapidly progressing) generalized periodontitis using systemic enzyme therapy in combination with osteoinductive medicines
Keywords:generalized periodontitis, aggressive periodontitis, systemic enzyme therapy, Wobenzym, recombinant morphogenetic protein, rhBMP-2, treatment of periodontitis
AbstractThe modern treatment strategy for various forms of generalized periodontitis includes the use of a wide arsenal of drugs, which in turn leads to an excessive drug load on the body, this actualizes the search and use of drugs that have a systemic effect. The aim of the study is to develop and study the effectiveness of the use of systemic enzyme therapy in the treatment of aggressive (rapidly progressing) generalized periodontitis. The work is based on the results of comprehensive clinical and laboratory studies of 61 patients with an aggressive form of generalized periodontitis, without concomitant pathologies (30 main groups and 31 comparison groups). A control group consisted of 20 healthy donor volunteers. We used standard clinical, paraclinical, laboratory diagnostic methods, supplemented by dental volumetric tomography. In patients of both observation groups, standard protocol therapy was used, in the comparison group supplemented pathogenic therapy, and in the main group – multienzyme drug (Wobenzym) and rhBMP-2 injections. A comparative analysis of clinical, paraclinical, and laboratory studies has shown that the use of systemic enzyme therapy supplemented with recombinant morphogenetic protein (rhBMP-2) in patients with aggressive (rapidly progressing) generalized periodontitis is comparable to that of standard polymedicine therapy supplemented with pathogenic therapy, and leads to a faster control (average 13.7±0.7 days) of an active inflammatory and destructive process, normalization of indices of local humoral immunity, cytokine profile, free radical oxidation and antioxidant defense system, achievement of clinical and radiological remission in more than 90% of patients.
Antomonov M. [Mathematical processing and analysis of biomedical data]. 2nd ed. Kyiv: MIC «Medinform». 2018. p. 579. Russian. ISBN 978-966-409-202-6
Gudaryan А, Kuznyak N, Dronik I. [Clinical and laboratory efficacy of systemic enzyme therapy in patients with chronic generalized periodontitis complicated by purulent foci in soft periodontal tissues]. Medicni perspektivi. 2017;XXII(2):104-10. Russian. doi: https://doi.org/10.26641/2307-0404.2017.2.109843
Zabolotnyi TD, Bandrivskii JuL, Dyryk VT. [The state of local and systemic immunity in patients with different course of generalized periodontitis]. Stomatologiya. 2016;95(6):23-25. Russian. doi: https://doi.org/10.17116/stomat201695623-25
Miklyaev SV, Leonova OM, Glazev VK, et al. [Study of the quality of life in patients suffering from chronic inflammatory periodontal diseases]. Vestnik Tambov University: Natural and technical sciences. 2017;22(1):187-92. Russian. doi: https://doi.org/10.20310/1810-0198-2017-22-1-187-192
Ushnitsky ID, Ivanova AA, Pinelis IS, Yurkevich AV, Mikhalchenko DV. [Modern etiological and pathogenetic aspects of inflammatory destructive processes of periodontal tissues]. Endodontics Today. 2019;17(4):46-49. Russian. doi: https://doi.org/10.36377/1683-2981-2019-17-4-46-49
Ulitovskii SB, Alekseeva ES. [Periodontal diseases: hygienic aspects of an integrated approach to treatment]. Medecinskii alfavit. 2019;2(11):22-26. Russian. doi: https://doi.org/10.33667/2078-5631-2019-2-11(386)-22-26
Bartold PM, Van Dyke TE. An appraisal of the role of specific bacteria in the initial pathogenesis of periodontitis. J Clin Periodontol. 2019;46:6-11. doi: https://doi.org/10.1111/jcpe.13046
Cirino CCDS, Vale HFD, Casati MZ, Sallum EA, Casarin RCV, Sallum AW. Clinical and Microbiological Evaluation of Surgical and Nonsurgical Treatment of Aggressive Periodontitis. Braz Dent J. 2019;30(6):577-86. doi: https://doi.org/10.1590/0103-6440201902930
Marzin T, Lorkowski G, Reule C, et al. Effects of a systemic enzyme therapy in healthy active adults after exhaustive eccentric exercise: a randomised, two-stage, double-blinded, placebo-controlled trial. BMJ Open Sport Exerc Med. 2017;2(1):e000191. 2017 Mar 12. doi: https://doi.org/10.1136/bmjsem-2016-000191
Llanos AH, Silva CGB, Ichimura KT, et al. Impact of aggressive periodontitis and chronic periodontitis on oral health-related quality of life. Braz Oral Res. 2018;32:e006. doi: https://doi.org/10.1590/1807-3107bor-2018.vol32.0006"
Kinane D, Stathopoulou P, Papapanou P. Periodontal diseases. Nat Rev Dis. 2017;3:17038. doi: https://doi.org/10.1038/nrdp.2017.38
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