Efficacy of Optimized Remineralizing Therapy in Post-Covid-19 Patients: Evaluation of Results

Abstract

Data from Ukrainian researchers confirm that the prevalence of dental caries, even among young people, remains too high, reaching 95-98%. Fortunately, dental caries is reversible in the early stages of the disease, and it is possible to slow down the demineralization of enamel and dentin by inhibiting the formation of biofilm and the action of protective factors of saliva. The most interesting macronutrients that attracted our attention during the study were calcium and phosphorus, which play a key role in the mineralizing function of saliva and are the main structural elements of enamel hydroxyapatites. The results of our study indicate that the enamel mineralization processes are disturbed in patients with COVID-19. To correct the identified disorders and prevent the occurrence and development of carious lesions, we applied an improved algorithm of prophylaxis of dental enamel diseases using remineralizing therapy. Objective: to evaluate the effectiveness of the optimized method of remineralization by studying the dynamics of dental parameters in patients after 6 and 12 months. Materials and methods. To achieve this goal, 84 patients were monitored and divided into two equivalent groups: the main group, which included 42 patients who used our proposed preventive method, and the comparison group, which also consisted of 42 patients who were prescribed conventional preventive measures. Research results and discussion. The results obtained after one year of observation of patients with COVID-19 showed significant effectiveness of our proposed method. The increase in caries intensity in the main group after 6 months was 0.39±0.06, and after 12 months 0.44±0.06, while the corresponding index of the comparison group was higher both after 6 months (0.58±0.07) and after 12 months (0.78±0.05). Decrease in caries intensity allowed to establish a significant improvement in oral health in patients in all subgroups. The most significant values were observed after 12 months (66.67%, 37.18%, 28.21% for each subgroup, respectively). The study of oral hygiene using the OHI-S index showed the following results: after 12 months, the patients of the first and second subgroups had corresponding values of 0.67±0.05 and 0.69±0.06, which, according to the interpretation, referred to good hygiene; the patients of the third subgroup were distinguished by the transition to satisfactory hygiene (1.17±0.09) from the initial data of unsatisfactory hygiene (2.46±0.08). Evaluation of enamel resistance according to the TER test revealed a significant migration of indicators towards high and medium resistance: it should be noted that enamel caries resistance in patients with a history of severe form underwent significant changes and decreased to 6.48±0.24 points (from baseline 8.63±0.38), while in patients diagnosed with mild to moderate severity was 2.52±0.19 points (from baseline 4.15±0.22) and 4.68±0.25 (from baseline 6.29±0.31). Conclusions. The results of the analysis of patients' examination during one year of Tooth Mousse gel application for the prevention of dental caries with the use of individual mouth guards confirm the effectiveness of the conducted measures among patients with COVID-19 of different severity.