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189
PREVENTION OF PERIODONTAL TISSUE DISEASES ASSOCIATED
WITH CANDIDIASIS.
Kazakova N.N.
https://orcid.org/0000-0002-9434-540X
Коmilov K.O.
https://orcid.org/0009-0008-6196-7406
https://doi.org/10.5281/zenodo.17001542
Abstract.
Oral candidiasis is an inflammatory process that occurs due to
infection of the div with Candida fungi. Usually, the fungus is activated when
the div's defenses are reduced. Often, candidiasis affects small children, who
often have relapses of the disease. The risk group includes smokers, men over
60, women of all ages. In recent years, the number of patients with candidiasis
has increased significantly. The main reason for this trend is the irrational and
uncontrolled use of antibiotics, which reduce the div's immune functions and
disrupt the balance of microflora.
Key words.
Assimilation process, immunological markers, periodontal
tissue diseases, immunohistochemical study, etiopathogenetic picture.
Oral candidiasis is an inflammatory process that occurs due to infection of
the div with Candida fungi. Usually, the fungus is activated when the div's
protective functions are reduced. Candidiasis often affects small children, who
often have relapses of the disease. In modern dentistry, this is a clinical and
functional characteristic of diseases that develop as a result of caries; a complex
of dental and physiotherapeutic interventions for gum lesions; somatic
treatment of patients notes literature; methods of disease prevention based on
disorders of the respiratory system leading to disorders in the functioning of the
respiratory system are proposed; methods of disease prevention leading to
disorders in the functioning of the respiratory system are proposed [1,5].
In our country, targeted and practical measures are being implemented to
reform the healthcare system and bring it into line with international standards,
and effective methods of prevention, early diagnosis and comprehensive
treatment of diseases of the oral mucosa are being developed. In this regard, the
following tasks have been set: increasing the efficiency, quality and accessibility
of medical care, as well as the formation of a system of medical standardization,
the introduction of high-tech diagnostic and treatment methods. As a result of
solving these problems, the introduction into practice of improving the
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treatment and prevention of periodontal diseases is one of the current scientific
directions [2,4].
Opportunistic yeast-like fungi of the genus Candida are quite common on
the oral mucosa [5, 6]. It has also been proven that they are isolated from the
contents of the gingival sulcus and periodontal pocket, which leads to a change
in the clinical picture of periodontitis, resistance to traditional therapy and an
increase in the frequency of relapses [3, 7].
Candida have different sensitivity to the antifungal and antiseptic drugs
used, which reduces the effectiveness of therapy for inflammatory periodontal
diseases [4]. Etiotropic therapy for periodontitis involves the destruction of
bacterial biofilm, for which mechanical and antibacterial methods of action are
used. Since the structure of the biofilm does not allow drugs to penetrate into
the plaque, antibiotics are used in treatment as a support, and not as a
replacement for professional hygiene. Ultrasonic devices have properties that
perfectly meet the requirements of periodontal therapy. Due to the cavitation
effect, ultrasonic waves in a humid environment have an antimicrobial effect,
and the rinsing solution removes a lot of bacteria from periodontal pockets. In
everyday dental practice, it has long been possible to carry out effective and at
the same time gentle therapy of periodontal diseases using the Vector
ultrasound system (Durr Dental) [1, 2].
The clinical case demonstrates the treatment of Candida-associated
periodontitis using modern ultrasound technologies. Patient G., 49, came for
consultation to the Department of Therapeutic Dentistry of the ASMU. He
complained of discomfort in the gums, bleeding, tooth mobility and discharge
from periodontal pockets when pressing on the gums. From the anamnesis it
was found out that he has been suffering from periodontitis for more than 5
years, and is constantly undergoing treatment by a periodontist. The disease
worsens every six months, for which he receives a course of conservative
treatment, including antibiotics. After the therapy, he notes a slight
improvement. External examination was unremarkable, regional lymph nodes
were enlarged, painless on palpation, the oral mucosa was pale pink, without
visible pathological changes, moderately moist. The mucous membrane of the
gum is stagnant-hyperemic (PMA 58%), soft plaque and tartar deposits were
observed, OHI-S according to Green-Vermilion was 1.6 points. Also, pronounced
bleeding was noted (SBI 70%) during probing of the gingival sulcus, which
corresponds to grade III of the PBI index.
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When pressing on the gum, scanty whitish-turbid discharge from
periodontal pockets of a non-purulent nature was detected (Fig. 1b). The depth
of periodontal pockets was from 4 to 6 mm, furcation defects of class I, tooth
mobility of degree II. The patient was given a clinical diagnosis: generalized
periodontitis of moderate severity, chronic course. The preliminary diagnosis
was confirmed radiologically: the orthopantomogram showed uneven
resorption of the interdental septa and a decrease in their height by 1/3 of the
root length, the cortical plate at the apices is not determined. A smear was taken
from the patient's periodontal pockets and from the oral mucosa for microflora
and determination of sensitivity to antibacterial drugs. The analysis showed that
no growth of pathogenic microflora was detected on the mucosa, and the
opportunistic microflora was within acceptable limits. Fungi Candida albicans
were isolated from periodontal pockets in an etiologically significant
concentration of >104.
The patient underwent professional oral hygiene and was prescribed
general and local antifungal therapy according to sensitivity: fluconazole 100 mg
per day orally and Clotrimazole cream on the gum for 14 days. No significant
clinical improvement was observed after treatment. Complaints of discomfort in
the gums, their bleeding and tooth mobility persisted. Repeated microbiological
testing showed a high content of Candida albicans in a smear from periodontal
pockets. The further treatment plan, against the background of a repeated
course of antifungal drugs, included Vector therapy, based on the effect of
ultrasound through a hydroxyapatite suspension shell on the bacterial film of
the periodontal pocket. Using thin nozzles adapted for work in deep pockets,
deposits were removed and the root surface was well polished. The curettage
procedure caused virtually no discomfort. The next day, the patient noted an
improvement: bleeding significantly decreased, a feeling of a "clean mouth"
appeared.
After 2 weeks, examination revealed signs of process stabilization: the gums
were pink, bleeding slightly in some areas (SBI 9%), probing of the gingival
sulcus revealed grade I of the PBI index, mobility of 0 - grade I. Repeated
analysis of microflora for yeast-like fungi from periodontal pockets after 3
months was negative. Remission was observed for a year. Achieving a stable
clinical condition of the periodontium in this patient indicates the effectiveness
of using ultrasound therapy in the complex treatment of Candida-associated
periodontitis. The presented clinical case confirms the need for additional
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microbiological treatment in case of failure of standard treatment regimens and
the inclusion of modern technologies in the plan.
References:
1. Gorodko M., Burklin T., Raetske P., Ratka Kruger P. Klinicheskie issledovaniya
efektivnosti novogo ultrazenkovogo pribora dlya parodontoterapii //
Parodontologie, 2003, 14/2; 143-159.
2. Jinovsky F. Painless therapy of parodonta // Klinicheskaya stomatologiya,
2003. – №1. - S. 48-50.
3. Melekhov S.V. Rol drojjepodobnyx gribov roda Candida v razvitii patologii
parodonta / S.V. Melekhov // Maestro. 2007. – #2. - S. 72-75.
4. Sergeev A. Yu. Candida / A.Yu.Sergeev, Yu.V.Sergeev. M.: Triada-X, 2001. – 472
p.
5. Shumsky A.V. Candida disease / A.V. Shumsky, V.A. Zheleznyak. - Samara,
2008. - 199 p.
6. Shumsky A.V. Anti-fungal and immunomodulating lymphotropic therapy for
candidiasis of the mucous membrane lining / A.V.Shumsky, M.M.Pojaritskaya,
E.V.Yurchenko // Dentistry. 1996. - T. 75, No. 4. -S. 17-20.
7. Jarvensivu A. Candida yeasts in chronic periodontitis tissues and subgingival
microbial biofilms in vivo / A. Jarvensivu et al. // Oral. Dis. 2004. – Vol. 10, №2. –
P. 106-12.
