Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria

Rapidly progressing generalized perio­dontitis (RPGP) still remains an extremely important medical problem, despite certain achievements in solving most of the issues of etiology, pathogenesis and treatment. The study included 102 patients with rapidly progressing periodontitis of I-II and II-III de...

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Main Authors: A.A. Gudaryan, I.S. Maschenko, A.S. Dorogina, S.V. Shyrinkin
Format: Article
Language:English
Published: Dnipro State Medical University 2020-12-01
Series:Medičnì Perspektivi
Subjects:
Online Access:http://journals.uran.ua/index.php/2307-0404/article/view/221409
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author A.A. Gudaryan
I.S. Maschenko
A.S. Dorogina
S.V. Shyrinkin
author_facet A.A. Gudaryan
I.S. Maschenko
A.S. Dorogina
S.V. Shyrinkin
author_sort A.A. Gudaryan
collection DOAJ
description Rapidly progressing generalized perio­dontitis (RPGP) still remains an extremely important medical problem, despite certain achievements in solving most of the issues of etiology, pathogenesis and treatment. The study included 102 patients with rapidly progressing periodontitis of I-II and II-III degrees of severity, with ineffective and inconsistent results of previous treatment who were examined and treated in the clinic of the Department of Surgical Dentistry, Periodontics and Implantology of the SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine». On the basis of the diagnostic and therapeutic measures carried out, it was established that, in patients with rapidly progressing generalized periodontitis, the formation of various drug sensitivity in periodontopathogenic microorganisms to protocol antibacterial therapy is closely associated with immunological protocol diseases. The presence of drug-resistant bacteria in the periodontal tissues is combined with a more pronounced immunodeficiency in the mechanisms of systemic and local protection than when the lesions are colonized by drug-sensitive periodontal microorganisms. The revealed features of immunity disorders in patients with RPGP with drug-resistant infection to conventional antibiotic therapy are manifested by a decrease in CD3+ lymphocytes, cells with cytostatic activity (CD4+, CD16+) expressing receptors for the activation of lymphocytes CD25+, HLA-DR and apoptosis CD95+), against the background of a slight increase in CD20+, CD116+, CD54+, significant inhibition of the synthesis of SIgA, IgM, α-INF, γ-INF; a pronounced increase in the production of pro-inflammatory cytokines IL-1β and TNF-α. The need for a differentiated approach in the correction of immunological disorders in patients with RPGP depending on the detected sensitivity and resistance of periodontal pathogenic bacteria to the protocol generally accepted antibacterial therapy has been clearly proved; this provides a faster relief of the infectious and inflammatory process (on average on 3.6±0.2 day) in more than 90% of cases, normalization of the parameters of immunological reactivity in 93.3% of the observed and stable clinical remission of the disease.
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spelling doaj.art-c1c6d3107fc6410e9c3b6ce8980610262022-12-21T17:23:23ZengDnipro State Medical UniversityMedičnì Perspektivi2307-04042020-12-0125413814610.26641/2307-0404.2020.4.221409221409Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteriaA.A. Gudaryan0I.S. Maschenko1A.S. Dorogina2S.V. Shyrinkin3SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Oral Surgery, implantology and Periodontology department V. Vernadsky str., 9, Dnipro, 49044SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Oral Surgery, implantology and Periodontology department V. Vernadsky str., 9, Dnipro, 49044SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Oral Surgery, implantology and Periodontology department V. Vernadsky str., 9, Dnipro, 49044SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Oral Surgery, implantology and Periodontology department V. Vernadsky str., 9, Dnipro, 49044Rapidly progressing generalized perio­dontitis (RPGP) still remains an extremely important medical problem, despite certain achievements in solving most of the issues of etiology, pathogenesis and treatment. The study included 102 patients with rapidly progressing periodontitis of I-II and II-III degrees of severity, with ineffective and inconsistent results of previous treatment who were examined and treated in the clinic of the Department of Surgical Dentistry, Periodontics and Implantology of the SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine». On the basis of the diagnostic and therapeutic measures carried out, it was established that, in patients with rapidly progressing generalized periodontitis, the formation of various drug sensitivity in periodontopathogenic microorganisms to protocol antibacterial therapy is closely associated with immunological protocol diseases. The presence of drug-resistant bacteria in the periodontal tissues is combined with a more pronounced immunodeficiency in the mechanisms of systemic and local protection than when the lesions are colonized by drug-sensitive periodontal microorganisms. The revealed features of immunity disorders in patients with RPGP with drug-resistant infection to conventional antibiotic therapy are manifested by a decrease in CD3+ lymphocytes, cells with cytostatic activity (CD4+, CD16+) expressing receptors for the activation of lymphocytes CD25+, HLA-DR and apoptosis CD95+), against the background of a slight increase in CD20+, CD116+, CD54+, significant inhibition of the synthesis of SIgA, IgM, α-INF, γ-INF; a pronounced increase in the production of pro-inflammatory cytokines IL-1β and TNF-α. The need for a differentiated approach in the correction of immunological disorders in patients with RPGP depending on the detected sensitivity and resistance of periodontal pathogenic bacteria to the protocol generally accepted antibacterial therapy has been clearly proved; this provides a faster relief of the infectious and inflammatory process (on average on 3.6±0.2 day) in more than 90% of cases, normalization of the parameters of immunological reactivity in 93.3% of the observed and stable clinical remission of the disease.http://journals.uran.ua/index.php/2307-0404/article/view/221409rapidly progressive generalized periodontitis, infectious and inflammatory process, drug-resistant microflora, immunity
spellingShingle A.A. Gudaryan
I.S. Maschenko
A.S. Dorogina
S.V. Shyrinkin
Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
Medičnì Perspektivi
rapidly progressive generalized periodontitis, infectious and inflammatory process, drug-resistant microflora, immunity
title Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
title_full Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
title_fullStr Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
title_full_unstemmed Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
title_short Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
title_sort justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria
topic rapidly progressive generalized periodontitis, infectious and inflammatory process, drug-resistant microflora, immunity
url http://journals.uran.ua/index.php/2307-0404/article/view/221409
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AT ismaschenko justificationsfordifferentiatedapproachincorrectionofsomechangesoftheimmunologicdisordersinpatientswithrapidlyprogressinggeneralizedparodontitiswithdifferentdrugsusceptibilityoftheparodontalbacteria
AT asdorogina justificationsfordifferentiatedapproachincorrectionofsomechangesoftheimmunologicdisordersinpatientswithrapidlyprogressinggeneralizedparodontitiswithdifferentdrugsusceptibilityoftheparodontalbacteria
AT svshyrinkin justificationsfordifferentiatedapproachincorrectionofsomechangesoftheimmunologicdisordersinpatientswithrapidlyprogressinggeneralizedparodontitiswithdifferentdrugsusceptibilityoftheparodontalbacteria