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PERIODONTAL THERAPY USING ANTIBIOTICS AND PHYTOTHERAPY:
CLINICAL EFFICACY AND DIAGNOSTIC ANALYSIS
Mohinur Anvarjonova, Zilolakhon Chalaboyeva
Kokand University, Andijan Branch, Andijan, Uzbekistan.
E-mail:
Chalaboyevazilola559@gmail.com
Tel; + 998903837471
Annotation:
This manuscript presents a comprehensive analysis of inflammatory
periodontal diseases, examining their prevalence, etiopathogenetic mechanisms, clinical
forms, and therapeutic approaches. Drawing on epidemiological data from both global and
Uzbek populations, it details age-related disease distribution, diagnostic tools (CPITN index,
Shiller–Pisarev test, Kulajenko vacuum test), and modern treatment strategies. A clinical
study involving 40 patients was conducted. Results indicate that “Glikodent” demonstrates
high efficacy in early-stage periodontal inflammation, while antibiotic therapy proves
effective in advanced disease. Accurate assessment through diagnostic indices enabled
individualized treatment planning, underscoring the importance of a specific, multimodal
approach. The study concludes that early diagnosis and innovative, combined treatment
protocols significantly enhance clinical outcomes.
Keywords.
Periodontal disease, gingivitis, periodontitis, Shiller–Pisarev test, Glikodent,
antibiotic therapy, oral hygiene, dental prevention, clinical diagnostics.
Introduction.
In recent years, inflammatory periodontal diseases have emerged as the most
prevalent oral health pathology. According to the World Health Organization (WHO), these
conditions affect 60–90% of adults aged 35–44. Severe forms can result in tooth loss and
systemic disorders such as cardiovascular disease, endocrine dysfunction (notably in
diabetic patients), and immune system impairment. In Uzbekistan, similar trends are
observed, with 40–97% prevalence among children and adolescents. Consequently, early
detection, accurate diagnosis, and effective interventions remain pivotal priorities in
dentistry.
Prior studies in morphology, immunology, and microbiology have identified inflammatory
and dystrophic changes as primary pathogenic mechanisms. Researchers including
Muehleman, Mazor, Saburova, and Kulajenko have demonstrated correlations between
periodontal disease prevalence and demographic factors such as age, sex, and geography.
Notably, Saburova reported a two-and-a-half-fold increase in periodontal disorders in
mountainous regions compared to plains.
In Uzbekistan, data show 40% prevalence among 5-year-olds and up to 95% in individuals
aged 25–45, highlighting the need for early-stage detection and treatment innovations.
Recent molecular biology research underscores the trophic and regenerative roles of sulfated
glycosaminoglycans (sGAGs) in periodontal tissue repair. The novel preparation
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“
Glikodent”, composed of chlorhexidine, sulfated glycosaminoglycans, and mint extract,
has attracted scientific and clinical interest as a promising intervention.
Objective:
To investigate clinical and morphological characteristics of inflammatory
periodontal diseases, analyze etiopathogenetic factors, and develop effective prevention and
treatment strategies.
Aims:
1.
Classify clinical forms of periodontal disease (gingivitis, periodontitis,
periodontosis).
2.
Identify local and systemic etiological and pathogenic factors.
3.
Apply modern diagnostics (CPITN index, Shiller–Pisarev, Kulajenko).
4.
Evaluate the clinical efficacy of the new “Glikodent” formulation.
5.
Assess treatment effectiveness of antibiotic and natural preparations in complex
therapy.
6.
Develop prevention and prophylactic guidelines.
Materials and Methods.
A total of 40 patients (varying ages, both sexes) with clinical
evidence of periodontal disease were enrolled.
Clinical evaluation included assessment of: dental plaque, bleeding on probing, pocket depth,
and tooth mobility—using the CPITN index.
Laboratory diagnostics involved:
Shiller–Pisarev test for glycogen accumulation in gingival mucosa, indicating inflammation,
Kulajenko vacuum test to assess capillary fragility of the gingiva.
Therapeutic interventions were applied as follows:
Group 1 (n=20): Antibiotic therapy
Systemic: Amoxicillin + Metronidazole, Doxycycline
Local: Arestin, PerioChip
Group 2 (n=20): Natural remedies
Chlorhexidine 0.12% mouthwash, saline rinse, Aloe vera gel, ginger extract, tea tree oil, and
green tea
Glikodent local therapy
: A combination mouthwash containing cholorhexidine, sulfated
GAGs, and mint extract. Patient status was monitored before and after therapy, with data
collected on clinical parameters and diagnostic index changes.
Results. Antibiotic Therapy (Group 1)
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Patients presented with severe periodontitis (pocket depth ≥6 mm) and alveolar bone
resorption.
After 14 days: 80% showed marked reductions in inflammation, pain, suppuration, and
bleeding.
CPITN scores: 75% of patients improved from scores of 3–4 down to 1–2.
Radiographs demonstrated cessation of bone loss and early signs of tissue repair.
Antibiotics proved highly effective against anaerobic pathogens but are recommended
alongside mechanical debridement (scaling and root planing).
Potential systemic side effects warrant restricted and monitored use.
Natural Remedies (Group 2)
Patients had mild-to-moderate periodontitis (CPITN 1–3).
60% achieved significant reduction in gingival bleeding, mainly attributed to chlorhexidine,
saline, and Aloe vera.
Ginger extract and tea tree oil contributed to noticeable decreases in edema and oral malodor.
By day 7–10, majority reported pain relief and improved oral hygiene compliance.
Natural remedies provide a safe and patient-friendly alternative for early disease, though not
sufficient for advanced cases.
Glikodent Therapy
Of 20 patients, 17 (85%) experienced significant symptom relief within 5–7 days:
Pain ↓ (85%), bleeding ↓ (80%), malodor ↓ (75%).
Clinical evaluation demonstrated improved gingival tissue tone, color, and resilience.
Glikodent is effective as part of a combined regimen, showing fast-acting anti-inflammatory
and antiseptic effects without notable adverse reactions.
Table 1.
Clinical indicators before and after treatment in study groups
Parameter
Group
1:
Antibiotics
Group
2:
Natural
Remedies
Glikodent-
treated
CPITN (baseline)
3.5
2.5
2.8
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Parameter
Group
1:
Antibiotics
Group
2:
Natural
Remedies
Glikodent-
treated
CPITN (post-treatment)
1.5
1.2
1.3
Gingival bleeding (%)
80%
60%
20%
Edema (gingival swelling)
(%)
85%
65%
25%
Pain presence (%)
90%
50%
15%
Discussion.
The findings demonstrate that antibiotic therapy is the most effective
intervention for advanced periodontal disease, especially when combined with mechanical
debridement. Conversely, natural remedies provide a viable, well-tolerated option for mild
and moderate cases, ideal for long-term maintenance. The innovative Glikodent formulation
shows promise as an adjunctive agent, combining anti-inflammatory, regenerative, and
antiseptic benefits, making it a beneficial addition to combined treatment regimens.
Conclusions and Recommendations:
1.
Early detection and accurate staging via CPITN and adjunctive laboratory tests
enhance periodontal treatment outcomes.
2.
Advanced periodontitis requires systemic antibiotics alongside professional dental
cleaning for optimal results.
3.
Natural therapies are effective alternatives in less severe cases and support
preventive care.
4.
Glikodent is recommended as a local adjunct in periodontal therapy due to its rapid
symptom relief and high tolerability.
5.
Educational campaigns in oral hygiene, especially at the community level, are
essential to reduce disease burden.
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