Clinical and Laboratory Efficiency of Treatment of Women With Periodontal Diseases on the Background of Bacterial Vaginosis

Abstract

Introduction. There is currently no tactic for dental examination and treatment of women suffering from bacterial vaginosis (BV), although chronic catarrhal gingivitis, periodontitis of initial and first degree of severity in patients with this pathology has been proven. The frequency of detection of BV in modern women aged 18-45 is 67-89%. The main pathogens of BV are Gardnerella vaginalis and Atopobium vaginae.
 Aim. To determine clinical and laboratory effectiveness of the treatment scheme for women with periodontal diseases on the background of bacterial vaginosis.
 Materials and methods. Diagnosis of BV was established by an obstetrician-gynaecologist based on the Amsel criteria. 54 women aged 18-45 were examined. The examined women were divided into two groups, depending on the intended scheme of integrated treatment. Determination of the degree of inflammation of the periodontal period was carried out according to the PMA indices (modified by S. Parma), KPI by Leus. The quality control of the treatment was performed by PCR method, the presence of Gardnerella vaginalis and Atopobium vagina, the amino test of oral liquid, the quantitative activity of alpha amylase and the concentration of sIgA in saliva. Representatives of the first control group (26 women) were prescribed the common course of treatment, namely: local treatment therapy (oral baths of the solution of the medicine “Stomatophyte” after morning and evening hygiene procedures, application of “Mergagil-denta” (7 days); general therapy (metronidazole 250 mg every 8 hours for every 7 days, probiotic “Symbiter acidophilic concentrate” for 21 days). Women of the second experimental group (28 patients) were treated according to the scheme we patented. Their local treatment included: oral baths with the medicine “Stomatophyte” after morning and evening hygiene procedures (7 days), tablets for resuscitation “Lizak” for 1 tab. every 6 hours (5 days), application of “Metrogil-denta” for 20 minutes twice a day. After using “Stomatophyte” (10 days), use “Symbiter omega” for 21 days in silicone caps for the night after the completion of the use of “Metrogil-Denta”. General medicines for patients in the 2nd group: clindamycin 150 mg every 6 hours (7 days), probiotic “Symbiter acidophilic concentrate” per unit (21 days). Evaluation of the treatment results was carried out 14 days, 3, 6 and 12 months after the end of the course treatment.
 Results. In the examined two groups, there was a disorder in the condition of periodontal tissues. In women of the first group chronic catarrhal gingivitis was registered in 11.5%, chronic generalized periodontitis of initial degree - in 57.69%, chronic generalized periodontitis - in 30.77%; in patients of the 2nd group – in 10.71%, 64.29% and 25% respectively. None of the 54 patients had clinically intact periodontal disease. The PMA and Leish KPI indices in women of the 1st group after the treatment did not have a significant difference with the initial results, while the rates of patients in the second group decreased significantly, indicating a decrease in inflammation in the periodontal tissues. The concentration of sIgA after the end of the treatment course was higher in women of the 2nd group, which suggests a higher efficacy of the proposed method of treatment.
 Conclusions. Comparing the conventional and patented treatment regimen, it has been determined that traditional treatment is significantly less effective. Clinical methods of examination are insufficient to control the quality of treatment of women with BV and manifestations of periodontal disease, since a specific microflora appears in the oral cavity of this contingent of patients. In order to objectify clinical results, it is advisable to use a study of local immunity factors, such as saliva alpha-amylase and sIgA. To control the presence of IB pathogens as an express method, an amino test should be used, and in the case of its positive result, PCR should be used to detect Gardnerella vaginalis and Atopobium vaginae.