DEVELOPMENT OF CLINICAL INNOVATIVE TECHNOLOGIES AND THEIR IMPLEMENTATION IN DENTAL PRACTICE
DOI:
https://doi.org/10.32689/2663-0672-2022-2-6Keywords:
stomatology, oral cavity, periodontitis, microbiome, pathogenic microorganisms, antibiotics, prebioticsAbstract
Introduction. The complexity of the pathology and insufficient effectiveness of dental treatment of inflammatory processes in the oral cavity determines the relevance of the study of the oral microbiome. Analysis of recent research and publications. Data from scientific literature sources confirm the leading role of various types of microorganisms in the etiology and pathogenesis of inflammatory diseases of the oral cavity, the microbiome of which is a complex biomarker of its diseases. Formulation of the purpose of the research. The purpose of the research: a scientific solution to the problem of providing dental care to the population by applying modern technologies of individualized approaches to diagnosis, treatment and normalization of the microbiome of the oral cavity. Research materials and methods. The methodological basis of the study was a holistic understanding of the human body and definition of the concept of health as a unity of physical, psychological and social well-being. The following methods of scientific research were used: analytical (analysis of data sources of scientific literature on the problem of dental treatment of inflammatory processes in the oral cavity); clinical and laboratory diagnostics (for examination of dental patients, evaluation of the microbiological status of the oral cavity and determination of the levels of individual sensitivity to antibacterial drugs); medical and statistical (for statistical processing of research results). In the course of the study, a clinical examination and dental treatment of 67 patients with inflammatory processes of the oral cavity were carried out (22 patients with chronic periodontitis of a mild degree of severity, 24 of moderate degree and 21 of severe degree). Research results. The conducted study showed that when using antibiotic therapy in accordance with the established sensitivity of pathogenic microorganisms to drugs, as well as in the case of combining this therapeutic scenario with accompanying probiotic therapy, the results of treatment of patients with a severe degree of chronic periodontitis were statistically significantly (p<0.05) better than in cases of using basic periodontal drug therapy or its combination only with the empirical accompanying prescription of antibiotics. Discussion of research results. In the course of the conducted clinical study, a statistically significant (р≦0.05) advantage of the implementation of personalized therapy algorithm approaches was revealed, which, in addition to basic periodontal interventions, also included accompanying antibiotic therapy in accordance with the indicators of a previous study of the sensitivity of microorganisms to various forms of antimicrobial drugs, and its combination with auxiliary probiotic therapy. Conclusions and prospects for further research. The effectiveness of the developed algorithm of a personalized approach to dental treatment, which includes the isolation of the pathogen, its identification, establishment of antibiotic sensitivity, normalization of the microbiome of the oral cavity and control of treatment, has been proven. Statistically reliable (р≤0.05) the predominant success rate of treatment of all forms of severity (mild, moderate, severe) of chronic periodontitis when implementing the proposed approaches of personalized medicine in dentistry with the use of antibiotic therapy in accordance with the established sensitivity of pathogenic microorganisms to drugs, as well as in the case of a combination of this therapeutic scenario with accompanying probiotic therapy. Prospects for further research will be aimed at finding innovative approaches to dental interventions in therapeutic dentistry and orthodontics.
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