Komparativno ispitivanje lokalnog terapijskog dejstva probiotika, aktivnog kiseonika i klindamicin gela kod pacijenata sa hroničnom parodontopatijom

Abstract

The aim of the study, which was conducted as a clinical prospective study, was to determine the effectiveness of basic periodontal therapy, local application of probiotics, active oxygen and clindamycin gel after basic periodontal disease therapy in subjects with chronic periodontitis. Different approaches to the treatment of chronic periodontitis have been compared. In addition to basic (causal) therapy, which is the "gold standard" in the treatment of chronic periodontitis, probiotic, active oxygen and clindamycin gel therapy was used. All subjects underwent a detailed clinical examination and accurate anamnestic data were taken. The dental examination revealed a chronic form of periodontitis in all subjects, which was confirmed by radiological examination. Clinical parameters were determined before therapy, on the seventh day and 30 days after therapy. Subgingival specimens were collected before basic therapy and after 30 days to identify the following bacterial species: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis and Treponema denticola. The results were compared by clinical examination (oral hygiene indices, gingival and periodontal index) and polymerase chain reaction (PCR) by the method for testing periodontopathogenic bacteria. The study involved 160 respondents divided into 4 groups. The first group consisted of 40 subjects with chronic periodontitis who received only basic therapy (control group). The second group consisted of 40 subjects with chronic periodontitis who were treated with probiotic bacteria, Probiotic® (Ivančić and sons, Hemofarm Stada group, Vršac) in the periodontal pocket for 5 days. The third group consisted of 40 subjects with chronic periodontitis who, after basic therapy, received active oxygen therapy in liquid form (Deverra, Farm DOO, Lebane) in the periodontal pocket for 5 days. The fourth group of subjects, a total of 40, with a chronic form of periodontitis, received basic periodontal therapy, after which clindamycin gel (clindamycin hydrochloride gel 2%) was applied topically to the periodontal pocket, once. The clinical trial showed better results in groups II, III and IV compared to the first control group of subjects in whom only basic periodontal therapy was used. After therapy, a reduction in the presence of the following bacterial species was found: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythensis and Treponema denticola (p <0.001). Based on this clinical trial, it can be concluded that the combined basic therapy and local application of probiotics and active oxygen gave better results compared to the control group in which only basic therapy was used.