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    Dnistranskiy V. I.

    FEATURES OF LOCAL IMMUNITY AT DIFFERENT METHODS OF TREATMENT OF CHRONIC DESTRUCTIVE APICAL PERIODONTITIS


    About the author: Dnistranskiy V. I.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation Local immunity of the oral cavity characterizes secretory immunoglobulin A, which prevents the attachment and penetration of bacteria and viruses through the epithelium, linking pathogens that enter the biological fluids and neutralizes viruses penetrated inside epithelial cells. In addition, an enzyme that plays a leading role in natural nonspecific immunity is lysozyme. The aim of the study was the comparative evaluation of the state of local immunity at different methods of treatment of chronic destructive apical periodontitis. The study was conducted with the participation of 62 patients (33 men and 29 women) with chronic destructive apical periodontitis, which were divided into two groups. Patients of the first group (19 persons) were treated apical periodontitis according to the traditional methods. The main group consisted of 42 patients divided into two subgroups (2A and 2B), which was treated apical periodontitis improved by our method. In subgroup 2a treatment of apical periodontitis was conducted according to the traditional scheme with the addition processing of the root canal liquids for deep fluoridation. In subgroup 2b treatment was carried out according to the scheme of the first sub-group with the addition of ultrasonic agitation of siler directly in the root canal. All patients were identified indicators of oral hygiene (HI, CFE), periapical-alveolar index (PAI) immediately after treatment and 6 months after treatment, the content of secretory immunoglobulin A (Ig A) and lysozyme (before treatment and one week after treatment). The results of the assessment of the oral cavity of patients with the use of indexes of the CFE and the HI showed that all patients had poor hygienic condition of their mouths and high lesion with dental caries. It is established that all the three used method of treatment of chronic destructive apical periodontitis lead to a significant (p<0.05) reduction and normalization of local immunity of the oral cavity 7 days after treatment (sIgA content is reduced by an average 2.3-3.0 times; of lysozyme 1.4-1.9 times). Analysis of the configuration of factor structures built on the basis of the investigated parameters, before treatment and after different types of treatment allowed to establish that the measure of the success of regeneration (PAI) after traditional treatment depends on the oral hygiene (HI) and sIgA content; after treatment according to the traditional scheme with the addition processing of the root canal liquids for deep fluoridation PAI depends only on the state of oral hygiene, but after treatment according to the traditional scheme with the addition processing of the root canal liquids for deep fluoridation and ultrasonic agitation of siler directly in the root canal PAI depends on the performance of local immunity of the oral cavity. On the basis of correlation analysis it is shown that in all the investigated groups of patients there is a positive relationship between the PAI immediately after treatment and in a remote period, and in the first group it is the strongest (r=0,9), in subgroup 2a it is weaker (r=0,8) and in the subgroup 2b it is the weakest (r=0,6), which may indicate a decline in the influence of the initial condition on the result of regeneration at the treatment of chronic destructive apical periodontitis using ultrasonic agitation of siler. The most effective method of treatment of chronic destructive apical periodontitis is a method that uses deep fluoridation of the root canal with liquids as well as ultrasonic agitation of siler directly in the root canal, which is confirmed by the results of correlation and factor analysis.
    Tags chronic destructive apical periodontitis, local immunity, immunoglobulin, lysozyme
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    Publication of the article «World of Medicine and Biology» №2(50) 2 part 2015 year, 042-048 pages, index UDK 612.017.1: 616.314.17-008.1-002.2-08-035