PRACA ORYGINALNA

ORIGINAL ARTICLE

Rheological, immunological and microbiological parameter dynamics after dental implantation

ZMIANA PARAMTERÓW REOLOGICZNYCH, IMMUNOLOGICZNYCH ORAZ MIKROBIOLOGICZNYCH PO ZAŁOŻENIU IMPLANTU STOMATOLOGICZNEGO

Yuriy Yu. Yarov

Donetsk national medical university, Kramatorsk, Ukraine

Abstract

Introduction: It has been proven that the oral hygiene is determined by the quantitative and qualitative composition of the bacterial biofilm, by the local immunity, and the rheological properties of the oral fluid.

The aim of this study was to observe the dynamics of these parameters in the short term postoperative period after dental implantation in patients with a different state of periodontal tissues, depending on maintenance therapy.

Materials and methods: 124 healthy people, aged 18 to 34, were examined. Depending on the follow-up maintenance therapy after dental implantation, patients were divided into two equal study groups: patients of the main group received the proposed differentiated maintenance therapy, the volume and multiplicity of which were determined by the initial oral hygiene state; patients of the control group underwent traditional treatment. Patients with healthy periodontium comprised a comparison group. Using the digital drop shape, the viscosity coefficient b2 was determined. Identification of the biofilm’s microorganisms was carried out with aerobic and anaerobic cultivation techniques. The presence of immunoglobulin SIgA in the oral liquid was determined by Manchini’s radial immunodiffusion method.

Results: In the main group, the viscosity coefficient b2 and the content of SIgA immunoglobulin in the oral fluid were significantly higher than in the control group (p <0.05). The proposed maintenance therapy led to the restoration of the species domination of the probiotic microflora, proportional to the healthy periodontium both in the frequency of selection, and the level of insemination. The indicated dynamics of these parameters leads to a probable decrease of the Green-Vermillion HI (p<0,05).

Conclusions: Proposed maintenance therapy leads to a probable improvement of the oral hygiene state based on Green-Vermillion HI, caused by the normalization of the surfactant properties of the oral liquid, biofilm’s ratio of microbial associations, and local oral hygiene.

Key words: oral hygiene, dental implants, maintenance therapy

Wiad Lek 2019, 72, 2, 216-223

Introduction

The hygienic state of the oral cavity significantly influences the healing processes in postoperative wounds after dental implantation, and in the future it also influences the osteointegration of the implant [1-3]. Multiple experimental and clinical studies prove that oral hygiene is largely determined by the quantitative and qualitative composition of the bacterial biofilm, by the local immunity, and the rheological properties of the oral fluid [4-6]. Therefore, identification of abnormalities in these indicators after dental implantation is of practical interest, since it allows for their adjustment with appropriate targeted medical therapy [7]. This is important to maintain a satisfactory oral hygiene at a stable level, as a main component of preventing complications after dental implantation. As more and more people make choices in favor of dental implants each year, the number of patients with complications is expectedly on the rise, with the most common of complications being periimplantitis [8,9]. The prevalence of this complication reaches 12-43% for the majority of implantation systems [10]. The requirement of successful implantation surgery in the immediate and long-term implant functioning becomes even more urgent in patients with inflammatory diseases of periodontal tissues [11].

The aim

Aim of this study was to observe the dynamics of these parameters in the short term postoperative period after dental implantation in patients with a different state of periodontal tissues, depending on maintenance therapy.

Materials and methods

A total of 124 somatically healthy people (54 men and 70 women) aged 18 to 34 years old were examined, among them: 25 persons with healthy periodontium, 35 patients with chronic catarrhal gingivitis (CCG), 30 patients with generalized periodontitis (GP) of the I degree, 34 patients with GP of the II degree of severity. Subsequently, all patients underwent a prescribed dental implant surgery. CCG and GP were diagnosed on the basis of data from clinical examination, radiography, periodontal indexes and tests in accordance with the International Classification of Diseases ICD-10. Oral hygiene state was determined using the total hygienic index of Green-Vermillion (OHI-S) (Green, Vermillion, 1960). Oral fluid was taken for rheological and immunological tests; a dental biofilm was taken by standard method for microbiological testing; for microbiological – a biofilm tooth extraction according to the standard method. Rheological test included using the digital drop shape analyzer, with which the viscosity coefficient b2 was determined. The b2 coefficient is an indicator that has the strongest correlation with the Green-Vermillion index. Microbiological studies included detection and identification of microorganisms from a biofilm using aerobic and anaerobic cultivation techniques by seeding clinical material from a transport swab into special nutritional environment. The results of the quantitative study of the microflora – the level of insemination – were expressed in colony-forming units per 1 ml of clinical material (CFU/ml). To evaluate the state of local oral immunity and periodontium tissue, the content of immunoglobulin SIgA in the oral fluid was studied. Detection was performed using Manchini Radial Immunodiffusion.

Depending on further maintenance therapy, patients were divided into two study groups: the main (62 persons) – recieved the proposed differentiated maintenance therapy, the volume and multiplicity of which were determined by the initial hygienic state of the oral cavity; control (62 persons) – received traditional maintenance therapy. Since the medicamental therapy post implantation surgery was not indicated for patients with a healthy periodontium (25 people), they comprised a comparison group. The groups were randomized by sex, age, the nature of concomitant pathology, the state of periodontal tissues, and the type of dental defect. Reducing the amount of probiotic bacteria in a biofilm in patients with chronic catarrhal gingivitis with “unsatisfactory” hygienic conditions makes it advisable to use local probiotics – drugs containing “good” microflora. The presence of aerobic-anaerobic-fungal associations with predominance of parodontopathogens and yeast fungi as part of a biofilm in patients with generalized periodontitis defines the tactics of rational antimicrobial therapy – local application of antifungal and antibacterial remedies of a wide spectrum of action. Given the wider range of parodonotopathogens in biofilm and higher values of CFU in 1 ml of clinical material in patients with GP with the progression of the pathological process: at the first degree of severity, antimicrobial therapy after implantation was performed for two weeks, with the second degree of severity – during three weeks. The revealed heterogeneous nature of the differences in the studied parameters of local immunity – the expressed intensity of the parameters studied in patients with generalized periodontitis of the I degree and a decrease in a number of indicators (lysozyme, β-lysine and immunoglobulin A) with GP II degree – indicate the expediency of using drugs with immunomodulatory action.

Results and Discussion

The results of the dynamics of the level of oral hygiene by Green-Vermillion HI showed that in patients of main groups with a different state of periodontal tissues (CCG and GP of the I, II degree of severity) after dental implantation, there is a probable decrease in this indicator compared with the control (p < 0,05). In this case, the Green-Vermillion HI in the main groups was, respectively, in CCG patients 1,32 times lower, GP of the I degree – 1,58 times lower, GP II-degree – 1,53 times lower compared with control. This dynamic was stable during the entire term of observation up to 3 months. It should be noted that the level of oral hygiene in patients who received the proposed drug therapy in the postoperative period was comparable to such in healthy periodontium.

The evaluation of changes in the surfactant properties of the oral liquid in patients with chronic catarrhal gingivitis after dental implantation was carried out according to the dynamics of the viscosity coefficient (b2), which, according to the previous data, has the strongest correlation with Green-Vermillion HI. As can be seen from Table I, the use of a probiotic drug according to the proposed scheme in the postoperative period leads to a significant increase in the viscosity (b2) at all observation periods, on average 1,71 times compared with the control (p <0,05 ).

The revealed dynamics of the b2 indicate the sensitivity of the viscous component of the complex viscoelastic module to the proposed drug treatment. This effect can be explained by the normalization of the amount of lactobacilli that produce lactic acid, which, by increasing salivation, change the viscosity of the oral fluid. The values of this coefficient in the main group were proportional to those with healthy periodontium (comparison group) and were in the range from -2,20 ± 0,21 to -2,38 ± 0,32 mN/m (p > 0,05).

Results of evaluation of the frequency of detection and the level of insemination of the biofilm in patients with chronic catarrhal gingivitis after dental implantation are presented in Table II.

As can be seen from this table, in main group’s patients with CCG we can observe a resumption of species dominance of the probiotic microflora in the biofilm, proportional to the frequency of detection and the level of insemination with such in a healthy periodontium. At the same time, in the control, the number of lactobacilli in the clinical material was reduced compared with the main group by 10 times. Periodontal pathogenic anaerobic bacteria in the biofilm were not detected in any patient. Based on the findings of the microbiological study, it can be concluded that the proposed maintenance drug therapy has a normalizing effect on the microbial association of biofilm in patients with chronic catarrhal gingivitis after dental implantation.

The nature of changes in the state of local oral immunity in patients with chronic catarrhal gingivitis after dental implantation is judged by the dynamics of secretory IgA level in the oral liquid (Table III).

As can be seen from this table, the level of secretory IgA in patients with CCG in the postoperative period during the entire observation period (from 1 week after removal of seams to 3 months) in the control was on average 1,16 times higher than in the main group (p <0,05). The revealed differences in the investigated index in the mouth fluid towards its increase indicates the tension of local immunity of the oral cavity in patients in the control group. At the same time, the level of secretory IgA in patients who, additionally after the operation of dental implantation received the proposed treatment, was proportional to such in a healthy periodontium and was in range from 0,302 ± 0,020 to 0,338 ± 0,027 g/l (p > 0,05). This means that the prescribed probiotic, increasing the number of probiotic bacteria, has a stimulating effect on the indicators of local immunity of the oral cavity – leading them to normal values. Changes in the surfactant properties of oral fluid in patients with GP of the I degree in the immediate period after dental implantation were studied via the observation of dynamics of the viscosity coefficient (b2).

As can be seen from Table IV, the use of the proposed drug therapy in addition to the traditional scheme of postoperative management of patients, changes the rheological properties of the oral fluid, resulting in a probable increase in the viscosity coefficient (b2) in all terms of observation, on average, 2,08 times higher compared with control (p < 0.05). At the same time, the value of the investigated parameter in the main group was in the range from -2,42 ± 0,28 to -2,30 ± 0,28 mN/m, in control: from -5,08±0,32 to -4,76 ± 0,30 mN/m. The revealed differences in the b2 indicate a significant sensitivity of the viscous component of the complex viscoelastic module to the proposed drug combination. It should be noted that the values of this coefficient in the main group were comparable with those in healthy periodontium (p > 0,05).

Results of microbiological research in patients with generalized periodontitis of the I degree of severity after dental implantation are presented in Table V.

As can be seen from this table, in the main group there is a species dominance of lactobacilli and optional aerobes is proportional to the frequency of detection, and the level of insemination with such in a healthy periodontium throughout the monitoring period. At the same time, in patients of the control group the presence of aerobic-anaerobic-fungal associations was observed due to the expansion of the spectrum of identified gram-positive and gram-negative anaerobic periodontal pathogens, namely: Peptostreptcoccus, Prevotella, Porphyromonas. Based on the data obtained from microbiological studies it can be concluded that, in addition to the traditional therapy, the proposed combination of drugs provides the evident antifungal and antimicrobial activity in relation to the pathogenic microflora of a biofilm in patients with generalized periodontitis of the I degree of severity after dental implantation by reducing the frequency of detection and the level of insemination of periodontal tissues by parodontopathogens and fungi. The established antimicrobial efficacy of the proposed combination is related to both direct damage of lipid membranes of microorganisms and fungi under the action of antimicrobial drug, and with an indirect antimicrobial effect of an immunomodulatory drug.

The nature of changes in local oral immunity in patients with generalized periodontitis of the I degree of severity after dental implantation was judged by the dynamics of secretory IgA level in the oral liquid as the parameter most correlated with the level of hygiene by Green-Vermillion HI.

As shown in Table VI, the level of secretory IgA in the oral liquid of the GP of the I degree of severity patients in the postoperative period during the observation period from the 1st week after removal of seams to 3 months in the control were significantly higher than in the main group and were in the range from 0,432 ± 0,026 to 0,438 ± 0,024 g/l (p <0,05). The determined differences of the investigated index in the direction of increase indicate the pronounced tension of local oral immunity in patients of the control group. At the same time, the level of secretory IgA in patients who, after the operation, according to the proposed scheme, received appropriate drug therapy, were comparable with those with healthy periodontium and were observed in the range from 0,327 ± 0,022 to 0,342 ± 0,028 g / l (p> 0,05), which is, on average, 1,30 times less than in the control. The determined differences in the values of the investigated index indicate the expressed immunomodulatory properties of the proposed medical treatment that can stimulate local protective mechanisms by increasing the production of the antimicrobial factor – secretory IgA, which provides an indirect antimicrobial action in relation to parodontopathogens of the oral cavity.

The dynamics of the viscosity coefficient in the oral liquid in patients with generalized periodontitis of the II degree of severity after dental implantation is presented in Table VII.

As can be seen from the table, the use of antimicrobial, antifungal and immunomodulatory drugs according to the proposed scheme in the postoperative period changes the rheological properties of the oral fluid, which leads to a probable increase in the viscosity (b2) value, starting from the 1st week after the seams are removed and in all further observation time up to 3 months, on average, 2,45 times higher compared with control (p < 0,05). In this case, the value of the studied parameter in the main group was in the range from -2,58 ± 0,31 to -2,39 ± 0,28 mN/m, in: from -6,12 ±0,30 to -5,94 ±0,27 mN/m. The revealed differences of the b2 coefficient indicate an even more significant sensitivity of the viscous component of the complex viscoelastic module to the proposed drug combination as the periodontal tissue pathology progresses. It should be noted that the values of this coefficient in the main group were proportional to those in healthy periodontium (p > 0,05).

The results of microbiological research in patients with generalized periodontitis of the II degree of severity in the immediate period of observation after dental implantation are presented in Table VIII.

As can be seen from this table, patients of the main group have a predominant probiotic microflora and optional aerobes, which by the frequency of detection and the level of insemination is comparable with such in a healthy periodontium throughout the observation period, starting from the 1st week after withdrawal seams and for all subsequent terms up to 3 months. In control, the presence of aerobic-anaerobic-fungal associations with dominance of optional and obligate anaerobes and yeast fungi was noted. This is due, firstly, to the further expansion of the spectrum of identified periodontal pathogens, namely Actinomyces, Klebsiella, Capnocytophaga, Bacteroidas, and secondly, due to an increase in the frequency of detection and level of insemination with anaerobes and fungi. Based on the findings of the microbiological study, it can be concluded that the proposed maintenance therapy with the combination of antimicrobial and immunomodulatory drugs, has a pronounced antimicrobial action in relation to the pathogenic microflora of biofilm in patients with generalized periodontitis of the II degree of severity in the immediate period after dental implantation. This is due to a decrease in the frequency of detection and level of insemination of periodontal tissues with parodontopathogens and fungi.

The character of changes in the state of local oral immunity in patients with generalized periodontitis of the II degree of severity after dental implantation was judged by the dynamics of secretory IgA level in the oral liquid, as the parameter that most closely correlates with the level of hygiene by the Green-Vermillion index.

As can be seen from Table IX, the level of secretory IgA in this category of patients in the postoperative period during the observation period from the 1st week after removal of seams to 3 months in the control were significantly higher than in the main group, on average, by 1,31 times (ranged from 0,446 ± 0,024 to 0,452 ± 0,023 g/l (p < 0,05). The differences of the investigated index in the oral liquid in the direction of an even greater increase compared to that of the GP of the 1st degree testify to the more pronounced tension of local immunity of the oral cavity with the GP of the II degree (control group). In this case, the level of secretory IgA in patients who received additional therapy after the surgery according to the proposed scheme, were proportional to those in healthy periodontium and were in the range of 0,337 ± 0,026 to 0,354 ± 0,028 g/l (p > 0,05). The determined differences in the values of the investigated index indicate the expressed immunomodulatory properties of the proposed drug treatment, which stimulates local protective mechanisms by increasing the detection of an antimicrobial factor – secretory IgA, which has a pronounced mediated antimicrobial action in relation to the parodontopagic microflora of the oral cavity.

Our research confirms the fact that, firstly, the hygienic state of the oral cavity is determined by the quantitative and qualitative composition of the biofilm, the state of local immunity and the rheological properties of the oral fluid, and, secondly, the use of the proposed maintenance treatment after dental implantation leads to the normalization of surfactant properties of the oral fluid, the ratio of microbial associations of biofilms and indices of local immunity. We have proved that the indicated dynamics of the investigated parameters leads to a probable decrease in Green-Vermillion HI (p<0,05). A number of researchers have proven the role of oral hygiene in the postoperative period [12]. However, we propose a differential approach to the prescription of drugs depending on the initial level of hygiene and, accordingly, the state of periodontal tissues.

Conclusion

An analysis of the dynamics of rheological, immunological and microbiological parameters in patients with a different state of periodontal tissues (chronic catarrhal gingivitis, generalized periodontitis of the I and II degrees of severity) after dental implantation testifies to the effectiveness of the proposed maintenance therapy in the immediate follow-up periods of the 1st week after the seams are removed for up to 3 months. The application of the proposed drugs according to the scheme leads to optimization of the terms of postoperative wound healing, a probable improvement of the hygienic state of the oral cavity by Green-Vermillion HI due to the normalization of the surfactant properties of the oral fluid, the normalization of the ratio of microbial associations of the biofilm and indices of local immunity of the oral cavity.

References

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2. Yarov Yu.Yu, Silenko Yu. Dvornik V, Kuts P. Podderzhivayucchee lechenie posle dentalnoy implantatsii [Supportive treatment after dental implantation]. Ukrainskii stomatologichnii аlmanax. 2014;5-6:71-74. (In Ukranian).

3. Novitskiy V. B. Efektivnist ratsionalnoyi gigieni porozhnini rota ta zastosuvannya osteotropnih zasobiv v period osteointegratsiyi dentalnih implantativ [Effectiveness of rational and hygienic empty company and osteotropic zasosuvannya during the period of osseointegration of dental implants] Visnik stomatologiyi. 2006;3:59 – 62. (In Ukranian)

4. Gemmel E, Marshal R, Seymour G. Cytokines and prostaglandins in immune homeostasis and tissue destruction in periodontal disease. Periodontol. 2000. 2007;Vol. 14:112 – 143.

5. Maschenko I. S, Gudaryan A, Shirinkin S. Kompleksnaya otsenka faktorov riska razvitiya retsidivov dentalnyih periimplantitov v ramkah vtorichnoy profilaktiki [Comprehensive assessment of risk factors for recurrence of dental periimplantitis as part of secondary prevention]. Visnik stomatologiyi. 2013;1:66 – 73. (In Ukranian)

6. Borisenko A. V, Smolyar V. Zmini mikroflori porozhnini rota na etapah implantatsiyi [changes in the microflora of the empty company during the implantation stages]. Visnik stomatologiyi. 2013;4:50-53. (In Ukranian)

7. Sidelnikov P. V. Gigiena polosti rta na etapah implantatsii [Oral hygiene at the stages of implantation]. Sovremennaya stomatologiya. 2002;1:81 – 83. (In Russian)

8. Labunets V.A. Rasprostranennost, intensivnost, struktura, tendentsii razvitiya malyih vklyuchennyih defektov zubnyih ryadov u lits molodogo vozrasta i ih oslozhneniy [Prevalence, intensity, structure, development trends of small included dentition defects in young people and their complications]. Visnik stomatologiyi. 2013;1:93 – 100. (In Russian)

9. Paraskevich V. L. Dentalnaya implantologiya: Osnovyi teorii i praktiki [
Dental Implantology: Fundamentals of Theory and Practice]. OOO »Yunipress», 2002:368 s. (In Russian)

10. Shvarts F., Beker Yu. Periimplantit: etiologiya, diagnostika i lechenie.
[Periimplantitis: etiology, diagnosis and treatment]. M.:GalDent, 2014:282s. (In Russian)

11. Borisenko A. V, Tivonenko L, Ahrameeva N. Zavisimost mezhdu sostavom mikrofloryi parodontalnyih karmanov i harakterom techeniya generalizovannogo parodontita [The relationship between the composition of the microflora of periodontal pockets and the nature of the flow of generalized periodontitis]. Sovremennaya stomatologiya. 2005; 3 (31):50 – 52. (In Russian)

12. Ugrin M. M, Bronska Yu, Ugrin O. Rol profesiynoyi gigieni u pidtrimuyuchiy terapiyi na riznih etapah implantoproteznoyi reabilitatsiyi patsientiv ta osnovni vimogi do spetsialista. [The role of professional hygiene and pediatric therapy in the early stages of implant prosthesis and patient rehabilitation is basic to specialist]. ImplantologIya. ParodontologIya. OsteologIya. 2008;2 (10):13 -20. (In Ukranian)

The work is a fragment of the research initiative of the Department of Stomatology №2, Donetsk National Medical University «To develop supportive treatment of patients after dental implantation, depending on the level of oral hygiene». State registration number 0116U004191.

Source of funding: own funds.

Conflict of interest:

The Author declare no conflict of interest.

CORRESPONDING AUTHOR

Yuriy Yu. Yarov

Donetsk National Medical University

Mashonobudivnikov Boulevard, 39,

84404 Kramatorsk, Ukraine

tel: +380506204307

e-mail: Kaf.stomatologii2@ukr.net

Received: 02.10.2018

Accepted: 27.01.2019

Table І. Dynamics of the viscosity coefficient (b2) of the oral liquid in patients with chronic catarrhal gingivitis in the immediate observation period(М±SE, mN/m)

Research groups

1st

week

2nd

week

3d

week

After

2 months

After

3 months

Main group

(n= 18)

-2,38 ± 0,32*

-2,32 ± 0,30*

-2,29 ± 0.27*

-2,28 ± 0,29*

-2,32 ± 0,30*

Control

(n= 17)

-4,18 ± 0,30^

-3,92 ± 0,29^

-3,96 ± 0,32^

-3,89 ± 0,33^

-3,90 ± 0,28^

Comparison

(n= 25)

-2,26 ± 0,24

-2,20 ± 0,21

-2,23 ± 0,20

-2,21 ± 0,21

-2,22 ± 0,23

Note: *-p < 0,05 compared with control; ^-p < 0,05- compared with the comparison group

Table ІІ. Dynamics of the detection frequency and the level of insemination of the biofilm in patients with chronic catarrhal gingivitis after the removal of seams in the immediate obsevation terms (abs.units/CFU/ml)

Genus of isolated microorganisms

1st

Week

2nd

week

3d

week

After

2 months

After

3 months

Main group (n=18)

Staph.

16/104-108

16/104-108

16/104-108

16/104-108

16/104-108

Strept.

18/104-108

18/104-108

18/104-108

18/104-108

18/104-108

Lactobac.

18/107

18/107

18/107

18/107

18/107

Enterobacter

1/104

2/104,108

2/104,108

1/104

1/104

Fusobacter.

2/106,108

2/106,108

2/106,108

2/106,108

2/106,108

Candida

4/106-108

4/106-108

4/106-108

4/106-108

4/106-108

Control group (n=17)

Staph.

14/104-108

13/104-108

13/104-108

13/104-108

13/104-108

Strept.

15/104-108

15/104-108

15/104-108

15/104-108

15/104-108

Lactobac.

17/106

17/106

17/106

17/106

17/106

Entero

bacter

1/104

2/104,108

2/104,108

1/104

1/104

Fusobac.

2/106,108

2/106,108

2/106,108

2/106,108

2/106,108

Candida

4/106-108

5/106-108

5/106-108

4/106-108

4/106-108

Comparison group (n=25)

Staph.

23/104-107

23/104-107

23/104-107

24/104-107

24/104-107

Strept.

25/104-107

25/104-107

25/104-107

25/104-107

25/104-107

Lactobac.

25/107

25/107

25/107

25/107

25/107

Entero

bacter

3/103-105

3/103-105

3/103-105

2/103,105

3/103-105

Fusobac.

2/106,108

2/106,108

2/106,108

3/106-108

2/106,108

Candida

4/106-107

4/106-107

4/106-107

4/106-107

4/106-107

Table ІІІ. Dynamics of secretory IgA level in the oral liquid in patients with chronic catarrhal gingivitis after the removal of seams in the immediate observation period (М±SE, g/l)

Research groups

1st

week

2nd

week

3d

week

After

2 months

After

3 months

Main group (n= 18)

0,338 ±

0,027*

0,332 ±

0,024*

0,329 ±

0,022*

0,328 ±

0,020*

0,332 ±

0,023*

Control (n= 17)

0,398 ±

0,030^

0,392 ±

0,029^

0,386 ±

0,026^

0,378 ±

0,027^

0,379 ±

0,028^

Comparison (n= 25)

0,324 ±

0,022

0,320 ±

0,021

0,323 ±

0,020

0,308 ±

0,018

0,302 ±

0,020

Note: *-p < 0,05 compared with control; ^-p < 0,05- compared with the comparison group

Table ІV. Dynamics of the viscosity coefficient (b2) of the oral liquid in patients with generalized periodontitis of the I degree of severity after the removal of seams in the immediate observation period (М±SE, mN/m)

Research groups

1st

week

2nd

week

3d

week

After

2 months

After

3 months

Main group (n= 15)

-2,42 ±

0,28*

-2,38 ±

0,30*

-2,30 ±

0,28*

-2,32 ±

0,32*

-2,34 ±

0,26*

Control (n= 15)

-5,08 ±

0,32^

-4,92 ±

0,30^

-4,95 ±

0,32^

-4.76 ±

0,30^

-4,80 ±

0,29^

Comparison (n= 25)

-2,26 ±

0,24

-2,20 ±

0,21

-2,23 ±

0,20

-2,21 ±

0,21

-2,22 ±

0,23

Note: *-p < 0,05 compared with control; ^-p < 0,05- compared with the comparison group

Table V. Dynamics of the detection frequency and the level of insemination of the biofilm in patients with generalized periodontitis of the I degree of severity after the removal of seams in the immediate observation period (abs.units/CFU/ml)

Genus of isolated microorganisms

1st

week

2nd

week

3d

week

After

2 months

After

3 months

Main group (n=15)

Staph.

12/104-108

12/104-108

12/104-108

12/104-108

12/104-108

Strept.

15/104-108

15/104-108

15/104-108

15/104-108

15/104-108

Lactobac.

15/107

15/107

15/107

15/107

15/107

Enterobacter

2/104,108

2/104,108

2/104,108

2/104,108

2/104,108

Fusobacter.

3/106-108

3/106-108

3/106-108

2/106,108

2/106,108

Candida

4/106-108

4/106-108

4/106-108

4/106-108

4/106-108

Control group (n=15)

Staph.

7/104-108

7/104-108

7/104-108

8/104-108

8/104-108

Strept.

8/104-108

8/104-108

8/104-108

8/104-108

8/104-108

Lactobac.

15/105

15/105

15/105

15/105

15/105

Entero

bacter

1/104

2/104,108

2/104,108

1/104

1/104

Fusobac.

6/106-108

6/106-108

6/106-108

6/106-108

6/106-108

Candida

7/106-108

7/106-108

7/106-108

7/106-108

7/106-108

Peptostr.

2/102,107

2/102,107

2/102,107

3/102-107

3/102-107

Prevotella

2/102,108

2/102,108

2/102,108

3/102-108

3/102-108

Porphyr.

1/106

1/106

1/106

1/106

1/106

Comparison group (n=25)

Staph.

23/104-107

23/104-107

23/104-107

24/104-107

24/104-107

Strept.

25/104-107

25/104-107

25/104-107

25/104-107

25/104-107

Lactobac.

25/107

25/107

25/107

25/107

25/107

Entero

bacter

3/103-105

3/103-105

3/103-105

2/103,105

3/103-105

Fusobac.

2/106,108

2/106,108

2/106,108

3/106-108

2/106,108

Candida

4/106-107

4/106-107

4/106-107

4/106-107

4/106-107

Table VІІІ. Dynamics of the detection frequency and the level of insemination of the biofilm in patients with generalized periodontitis of the II degree of severity after the removal of seams in the immediate observation period (abs.units/CFU/ml)

Genus of isolated microorganisms

1st

week

2nd

week

3d

week

After

2 months

After

3 months

Main group (n=17)

Staph.

14/104-108

14/104-108

14/104-108

14/104-108

14/104-108

Strept.

17/104-108

17/104-108

17/104-108

17/104-108

17/104-108

Lactobac.

17/107

17/107

17/107

17/107

17/107

Enterobacter

3/104-108

3/104-108

3/104-108

3/104-108

3/104-108

Fusobacter.

1/106

1/106

1/106

1/106

1/106

Candida

3/106-108

3/106-108

3/106-108

3/106-108

3/106-108

Control group (n=17)

Staph.

8/104-108

8/104-108

8/104-108

8/104-108

8/104-108

Strept.

3/104-108

3/104-108

3/104-108

3/104-108

3/104-108

Lactobac.

17/104

17/104

17/104

17/104

17/104

Entero

bacter

2/104,108

2/104,108

2/104,108

2/104,108

2/104,108

Fusobac.

9/106-108

9/106-108

9/106-108

9/106-108

9/106-108

Candida

8/106-108

8/106-108

8/106-108

8/106-108

8/106-108

Peptostr.

3/102-107

3/102-107

3/102-107

3/102-107

3/102-107

Prevotella

4/102-108

4/102-108

4/102-108

4/102-108

4/102-108

Porphyr.

3/106-108

3/106-108

3/106-108

3/106-108

3/106-108

Actinom.

1/107

1/107

1/107

1/107

1/107

Pseudom.

2/105,107

2/105,107

2/105,107

2/105,107

2/105,107

Klebsiell.

2/104,107

2/104,107

2/104,107

2/104,107

2/104,107

Capnocyt.

7/107-108

7/107-108

7/107-108

7/107-108

7/107-108

Bacteroid

1/106

1/106

1/106

1/106

1/106

Comparison group (n=25)

Staph.

23/104-107

23/104-107

23/104-107

24/104-107

24/104-107

Strept.

25/104-107

25/104-107

25/104-107

25/104-107

25/104-107

Lactobac.

25/107

25/107

25/107

25/107

25/107

Entero

bacter

3/103-105

3/103-105

3/103-105

2/103,105

3/103-105

Fusobac.

2/106,108

2/106,108

2/106,108

3/106-108

2/106,108

Candida

4/106-107

4/106-107

4/106-107

4/106-107

4/106-107