中脑调节和臭氧疗法复合应用时种植体周围炎患者体内氧化应激标记物和细胞因子含量的动态变化

Madina R. Balayeva, S. Nagornev, A. Remizova
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引用次数: 0

摘要

背景:种植牙后炎症并发症的显著发生率决定了有必要通过制定预防和治疗种植体周围疾病的综合方案,并将其纳入现代牙科康复理念,来寻求更有效的解决方案。目的:研究种植体周围炎患者在使用中脑调节、臭氧疗法及其组合疗法进行综合治疗期间的氧化应激模式、促炎和抗炎细胞因子水平。材料与方法:根据 S.A. Jovanovic 标准,该研究有 116 名 I 级和 II 级种植体周围炎患者参与。通过简单的固定随机方法(基于计算机程序生成的随机数),所有患者被分为四组。第一组(对照组,人数=28)接受标准牙科治疗,包括专业口腔卫生和局部使用消毒剂。第二组(对比组 1,人数=29)除接受标准治疗外,还接受臭氧治疗,即用臭氧浓度为 2.5-5.5 mcg/ml 的臭氧生理溶液对种植体周围进行 15 分钟的冲洗。第三组(对比组 2,n=30)在标准治疗的基础上辅以中胚层调节疗法。第四组(主要组,人数=29)的患者在接受标准治疗的同时,还接受了复合治疗,包括臭氧疗法和间脑调节的疗程应用。治疗结束后,通过氧化应激标志物的动态变化以及促炎和抗炎细胞因子的含量对治疗结果进行评估。随机分组的临床疗效评估基于口腔卫生指数、乳头出血和乳头-边缘-牙槽指数以及种植体稳定性系数的测定。结果:使用不同的治疗方案会导致过氧化代谢模式和细胞因子状态发生变化,其强度各不相同。对照组患者的矫正活性最小。在使用治疗性物理因子进行标准治疗的同时,估计参数的动态变化更为明显,其方向表明脂肪过氧化系统和细胞因子炎症机制趋于正常。估计参数的最大变化出现在主要组别中,该组在标准疗法的基础上辅以中脑调节和臭氧疗法的复合应用。这表现在酶的抗氧化活性增强,脂肪过氧化产物的水平降低到健康组的水平,以及在具有抗炎作用的介质水平上升的背景下,促炎因子的水平下降。结论:获得的结果令人信服地证明了在中脑调节和臭氧的复合应用过程中观察到的明显协同作用,其特点是产生最大的矫正效果,旨在恢复种植体周围区域的促炎和抗氧化平衡,减少细胞因子机制的炎症活动。通过分析所发现的生化参数与种植体周围炎患者牙齿状况指数指标之间的相关性,可以将某些促进和抗氧化系统指标以及细胞因子状况视为决定治疗效果预后的生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dynamics of oxidative stress markers and cytokine content in patients with peri-implantitis at complex application of mesodiencephalic modulation and ozone therapy
BACKGROUND: Significant prevalence of inflammatory complications after dental implantation determines the necessity to search for a more effective solution of this problem with the formation of a comprehensive program of prevention and treatment of peri-implant diseases and its integration into the modern concept of dental rehabilitation. AIM: Study of oxidative stress patterns, level of pro- and anti-inflammatory cytokines in patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination. MATERIALS AND METHODS: The study was carried out with participation of 116 patients with peri-implantitis of I and II classes according to S.A. Jovanovic. By means of simple fixed randomization (based on random numbers generation by computer program) all patients were divided into 4 groups. The first group (control group, n=28) received standard dental therapy, including professional oral hygiene and local application of antiseptic agents. In the second group (comparison group 1, n=29) in addition to the standard therapy the course ozone therapy was carried out, for which the peri-implant zone was irrigated with ozonized physiological solution with ozone concentration 2.5–5.5 mcg/ml for 15 min. In the third group (comparison group 2, n=30) the standard treatment was supplemented with the course application of mesodiencephalic modulation. Patients of the fourth group (main group, n=29) along with the standard treatment received complex treatment including course application of ozone therapy and mesodiencephalic modulation. The results were evaluated after the end of therapy by the dynamics of oxidative stress markers and the content of pro- and anti-inflammatory cytokines. The assessment of clinical efficacy in randomized groups was based on the determination of oral hygiene indexes, papilla bleeding and papillo-marginal-alveolar index, as well as the implant stability coefficient. RESULTS: The use of different therapy schemes caused changes in the patterns of peroxidation metabolism and cytokine status, the intensity of which had different character. In the least degree the corrective activity was revealed in the control group of patients. Supplementation of standard treatment with therapeutic physical factors was accompanied by more pronounced dynamics of the estimated parameters, the direction of which indicated normalization of the lipoperoxidation system and cytokine mechanism of inflammation. Maximum changes of the estimated parameters were revealed in the main group, where the standard therapy was supplemented with a course complex application of mesodiencephalic modulation and ozone therapy. This was manifested in the strengthening of antioxidant activity of enzymes and reduction of the level of lipoperoxidation products to the level of the healthy group, as well as regression of the level of proinflammatory factors against the background of an increase in the level of mediator with anti-inflammatory effect. CONCLUSION: The obtained results convincingly prove the pronounced synergetic interaction observed at course complex application of mesodiencephalic modulation and ozone, characterized by the development of maximum corrective effect aimed at the restoration of pro- and antioxidant equilibrium and reduction of cytokine mechanism activity of inflammation in peri-implant zone. The analysis of the revealed correlations of the biochemical parameters with the index indicators of the dental status of the patients with peri-implantitis allows to consider some indicators of the pro- and antioxidant system and cytokine status as biomarkers determining the prognosis of the treatment efficiency.
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