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13МЕДИЦИНСКИЕ НАУКИ
MUCOSAL IMMUNOLOGICAL INDICES AFTER LASER CORRECTION OF DENTAL STATUS IN WOMEN IN THE EARLY POSTPARTUM PERIOD Kulikova N.G.1, Tkachenko A.S.2
'Kulikova Natalia Gennadievna - Doctor Physical Therapist of the Highest Qualification Category, Doctor of Medical Sciences, Professor, PROGRAM OF CARBOXYTHERAPY REHABILITATION CENTER "VICTORIA";
2Tkachenko Albina Sergeevna - Competitor of a Scientific Degree of Candidate of Medical Sciences,
Head of Laboratory, DEPARTMENT OF PHYSICAL THERAPY FPC MI, FEDERAL STATE UNIVERSITY PEOPLE'S FRIENDSHIP UNIVERSITY OF RUSSIA,
MOSCOW
Abstract: the article shows the results of the clinical examination of women with dental diseases in the early postpartum period (to 6 months) before/after use in the laser therapy with the drug "Mouthspray BioXtra", which allowed to reduce the risk of dental complications of 84.7% and improve the local mucosal immunity (p<0.0').
Laser therapy with the drug "Mouthspray BioXtra" in conjunction with dental treatment provides high levels of efficiency with respect to the correction of mucosal immunity in the shortest time (3-4 days), indicating a high orientation of the complex etiopathogenetic treatment.
The article presents the materials of the examination and treatment of women 20-35 years in the early postpartum period (to 6 months) with periodontal disease. In the study, PCR diagnostics, which allowed to obtain the molecular-genetic parameters of saliva (immune complexes, the composition of the microflora of the oral cavity) before/after laser therapy with helium drug "Mouthspray BioXtra" on the background of the dental treatment ofperiodontal disease.
The aim of this study was to evaluate PCR immune parameters of oral fluid in women in the early postpartum period with the dental pathology before/after application of laser therapy with helium-inflammatory drug "Mouthspray BioXtra.
Keywords: women's in growing baby period, parodontosis, molecular genetics PZR- immunology indicators in oral liquid, low-intensive laser radiation "BioXtra Mouthspray " preparation.
ICMJE № 22
Introduction.
Dental health is a component of the overall health of the population, without preserving which it is impossible to maintain the quality of life at a high level [1-2]. It is proved that the key regulators of immunological homeostasis are endogenous hormones. In this regard, women who underwent the ancestral stress in the postpartum period to note the increase of many diseases, including dental, with the development of the structural and inflammatory changes in periodontal tissues. The latter is largely due to dysbiotic shifts and mucosal immune imbalance due to hormonal changes in the body [1; 2]. Dysbiotic disorders in the oral cavity accompanied by an increase in the number of microbial and immunological abnormalities in oral fluid, which is especially problematic for women's health nursing-mothers with dental pathology in the absence of treatment during pregnancy [1-2;5].
The aim of the study was scientific substantiation of application of laser therapy in women in early postpartum period (to 6 months) for correction of immunological mucosal changes in the oral fluid.
Organization and research methods. The study was conducted in the laboratory of the Department of therapy of PFUR, Moscow. The study included 92 women in the early postpartum period (to 6 months). The distribution of women in the comparison groups were as follows: in the first group (31 persons) - performed dental treatment and manipulation of irradiation of low-intensity laser radiation on parodontale fabric and pockets from the apparatus AALST-01 "Optodan"; in the second group (31 persons) - performed dental procedures and literatures "Mouthspray BioXtra" parodontale fabric and pockets from the apparatus AALST-01 "Optodan"; in the third group (30 people) - dental treatment by a preparation "Mouthspray BioXtra" without the use of physiotherapeutic factors.
Intervention. To obtain results for complex orthodontic treatment and laser therapy used in the research process, the technique of laser therapy based on previously conducted studies about dental and physiotherapy immunological correction [4-5]. The course of laser therapy were performed at low-
intensity infrared laser apparatus "Pattern" with a wavelength of 0.89 mcm, a pulse frequency of 1.5 to 2.0 Hz, pulse power of 3.5-4.5 Vt. We and the total energy exposure is not above 3.0 and 5.0 gc Time exposition effects on the tonsils on both sides did not exceed 1 min. (for 30 sec. each); the exposure effect on the projection of the thymus gland and oral mucosa in the field of orthodontic exposure was 1.5-to 2.0 min. (total - no more than 3 minutes). The duration of treatment averaged 8 -10 procedures, 3 months before the course of laser exposure in patients were off all drug.
Research methods. Microbiological analysis of fluid from the oral cavity was performed using anaerobic culturing techniques (quantitative sectoral sowing environment designed for the cultivation of bacteria of the oral cavity). The results of a quantitative study of microflora was calculated in colony forming units - CFU/ml (CFU) and CFU lg. Molecular genetic method (PCR) using test set ident (NPF "Genlab", Russia) were highly specific molecular biological marker assessment of parodontopathogenic (Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia). Scoring of the results of dental treatment on indices of inflammation were performed as a dentist-researcher. The subjective complaints of women were evaluated according to expert scale. Pulsatory index (PI) were investigated using the device Hitachi EUB 7500A Ultra Scanner Model: EZU-MT27-S1 SN: KE 15263910 ("Hitachi", Japan) and a LSK. facials by the method of Doppler ultrasound scanning [3].
The collected material was processed by methods of mathematical statistics using the standard software Statistic 7.0, which allowed us to obtain data on the average age of women in each comparison group and its standard error; the average error parameters relative indices (P%); the parameters of the reliability of differences (t-test coefficients t; Mann-Whitney (U) of Kolmogorov-Smirnov (KS).
Main results. The research suggests that at 30.1±0.3% of women in the early postpartum period revealed different dysbiotic violations, the severity of which correlated with the severity of parodontale-tissue lesions, developing, 27.5% in the 3-d trimester of pregnancy and 72.5% of women in the early postpartum period. According to our data the severity of dysbiotic disorders in the oral cavity correlated with the levels of IgG (R= - 0,022), which was significantly above the normal values and 53.4±11.3% higher than that of women who had a dental health during pregnancy (p<0,01). Considering that the immunoglobulins IgG serum is relatively independent of the system and have the unique ability to suppress microbial aggression in the oral cavity, exerting antiviral effect, correction of mucosal immune parameters after comprehensive dental treatment with the use of laser, confirms the high efficiency and pathogenetic directed of the developed method of complex treatment (table. 1).
Table 1. Indices of mucosal immunity in women with a dental pathology in the early postpartum period
before/after treatment
indicator 1 rp n=31 P 2. rp n=31 P 3. rp n=30 P
IA r/n 0,15± 0,005 0,11± 0,002 0,000 0,12± 0,003 0,04±0,0 01 0,00 0 0,14± 0,001 0,06± 0,003* 0,00 0
IG r/n 0,1± 0,01 0,1± 0,02 0,000 0,15± 0,01 0,06±0,0 14** 0,00 0 0,15± 0,01 0,07± 0,018* 0,00 0
Protein r/n 1,24± 0,41 1,13± 0,3 0,000 1,24± 0,41 0,94±0,3 ** 0,00 0 1,24± 0,41 0,99± 0,3* 0,00 0
Note: the significance of differences between parameters before and after treatment in the comparison groups -* p<0,05; **p<0.01; ***p<0.001.
Our findings do not contradict the statements of experts, that local mucosal immunity in the oral fluid provides antimicrobial protection and regeneration of the mucous membranes of the oral cavity, helps to eliminate dysbiotic disorders and activates the activity of lysozyme, complement and secretory immune globulins [2]. Tabular material assures that mucosal immunological parameters in women with periodontal disease in the early postpartum period significantly correction using laser therapy with the drug "BioXtra Mouthspray" 3 times faster (p<0.05), compared to the same indicators in women of the comparison groups. According to our data, laser therapy with the drug "Mouthspray BioXtra" provides increased levels of cytokines and macrophages, enhance the elimination of inflammatory and dysbiotic pathogen from the periodontal tissues and allows the pharmacological load as soon as possible to enhance the regeneration of damaged tissue and correction of mucosal immunity.
Comprehensive dental treatment, including laser therapy with the drug "Mouthspray BioXtra" provides a quick and efficient elimination of clinical symptoms of inflammatory-dystrophic periodontal disease. According to our data in inflammatory form of periodontal disease laser therapy with the drug "Mouthspray BioXtra" eliminates clinical symptoms in 3-4 days and normalizes microcirculation in periodontal tissues, as evidenced by the microcirculatory parameters after a Doppler ultrasound. facialis (table 2).
Table 2. Doppler ultrasonography of the surveyed womena month after treatment
Indicators of micro hemodynamics a. facialis
Index pulsatory (SP) 1-h gr. (31 h) 2-h gr. (31 h) 3-h gr. (30 h)
2,80 3,2 2,57
Linear blood flow velocity (BFV) 72,12 73,44 71,44
Index inert resistance (IR) 0,90 0,99 0,78
According Doppler ultrasound observed significant increase in speed performance in a. facialis in all investigated women. However, in women of the 2-d group on the background of complex dental treatment and laser therapy with the drug "Mouthspray BioXtra" noted earlier, the effects of decrease in indices of inflammation and bleeding, and eliminating dysbiotic shifts in the oral cavity in comparison with the surveyed group's comparison. The women of 2-d group revealed a significant reduction of bleeding index (IR) in a week, whereas in the 1st group IR decreased after 2 weeks and the 3-d group is after 1 month ^<0,05). The incidences of subjective complaints (bleeding, bad breath, swelling prudently fabrics, etc.) in patients from the 1-d group decreased by 68,5±0,5% after 7-8 days (p<0,01), in the 2-d group (after laser therapy with the drug "Mouthspray BioXtra") - 92,5±0,82% in 3-4 days (p<0,001), against 43,5±0,4% of the patients from the 3-d group treated without the use of physiotherapeutic factors, where they observed a significant improvement after 2-weeks.
Thus, laser therapy with the drug "Mouthspray BioXtra in the shortest possible time from the start of treatment provides a significantly more effective anti-inflammatory and anti-microbial correction, stimulation of microcirculation and metabolic processes in the damaged tissues of the periodontium, increased mucosal immunity in women in early postpartum period. Conclusions.
Pharmaco-physiotherapeutic method of laser treatment of periodontal disease in women in the early postpartum period, better than the previously studied methods of dental treatment provide correction of mucosal immunological changes in the oral fluid and improves the indices of dental health in women on a background of extremely low pharmacological load on the newborn.
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