CLINICAL EFFICACY OF SYNBIOTICS IN COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS
For today periodontal lesions of varying severity is quite common pathology has growing nature of the flow, and in people over 35 years, are observed in three of the four investigated [6-8]. Periodontitis is caused by a common factor (reduced resistance, concomitant diseases of internal organs and systems) and local (presence of dental plaque infected periodontal pockets) [2,7]. Along with careful implementation of the rules of oral hygiene, elimination of risk factors (normalization of occlusal contacts, prosthetics), regular visits to the dentist, decisive in the treatment of periodontitis and gingivitis is to restore bacterial homeostasis [1, 4, 9].
This refers to probiotic flora that normally is suppressed as a result of the predominance of more aggressive on cultural properties of microorganisms, so and irrational antibiotic therapy, leading to dysbiotic phenomena [3,7, 11]. Considering this, the use of proand prebiotics (synbiotic medications) in dentistry is a promising direction, but their parenteral use is limited by necessity of individual selection of bacterial strains and determination dose-dependent effect. Therefore, the aim of our study was to study the clinical effectiveness of local use drug "Baktulin" in the treatment of patients with inflammatory processes in the periodontium.
The article presents the results of a clinical trial of topical application synbiotic drug "Baktulin" in the form of applications crushed to powder consistency tablets with a small amount of distilled water in 12-14 days and 6 months after combined treatment. A decrease of the degree of inflammation by Schiller-Pisarev test, reducing the depth of periodontal pockets, a quantitative indication of ACA and the periodontal index in patients both immediately after treatment and in long-term period (6 months) after the application of synbiotics "Baktulin" in complex treatment of periodontitis.
On clinical examination in accordance with the study protocol have agreed 124 patients with inflammation in periodontium, they were divided into two groups: primary (61 ) and control ( 63). To patients in the control group was performed traditional treatment according to indications, and to patients of the main group additionally localy was applied drug " Baktulin " as applications crushed to a powder consistency tablets with a small amount of distilled water. In each group, a clinical examination of the tissues was carried out with the consent of periodontal patients on the same day , ie before treatment , after treatment and at 6 months after treatment. Assessment of oral hygiene was performed using hygiene index according to Fedorov - Volodkina . The intensity and prevalence of inflammation in periodontium evaluated by Schiller - Pisarev . To quantify the inflammatory process used by PMA index S. Parma [ 10] , for the clinical assessment of periodontal status - periodontal index AL Russel [ 11]. By examination of periodontal pockets was measured their depth using a graduated probe or trowel with millimeter divisions . Differential diagnosis of pathological periodontal and gingival pockets was performed using formalin tests  , tooth mobility - with D.A.Entinim , state of alveolar bone of the jaws - using in- traoral radiographs and contact ortopantomogrammu.
After treatment in the study group was observed earlier and more clearly defined normalization of clinical indicators, and during long-term observations of periodontal status indicators in the study group were also better than in the control group without the use of " Baktulin ." Patients of the main group after treatment improved health , disappeared halitosis , decreased bleeding , swelling, pain and itching in the gums . Despite improvement in the periodontal tissues in patients of the control group after treatment remained minor bleeding and itching in gums.
Therapeutic efficacy of synbiotic "Baktulin" in complex treatment of periodontitis confirmed decrease in the degree of inflammation breakdown Schiller - Pisarev, decreasing depth of periodontal pockets, a quantitative indicator ACA and periodontal index in patients with both immediately after treatment and maintains a positive trend in the long term after 6 months treatment.
2. Зв’язок захворювань пародонту з загальносоматичною патологією (огляд літератури) / [О.М. Немеш, З.М. Гонта, І.В. Шилівський, А.П. Скалат] // Новини стоматології. – 2006. – № 2 (47). – С. 34–37.
3. Зубачик В.М. Вплив прота синбіотикотерапії на імунологічний захист порожнини рота хворих на генералізований пародонтит / В.М.Зубачик, М.В. Лісничук // Вісник стоматології. – 2009. – № 1. – С. 44–52.
4. Кухарская О.Г. Микробиологический баланс полости рта у больных пародонтитом / О.Г. Кухарская, М.Д. Король // Український стоматологічний альманах. – 2007. – № 1. – С. 58–61.
5. Ланкин Т.Ф. Биометрия / Т.Ф.Ланкин. – М. : Высшая школа, 1990. – 352 с.
6. Леонтьев В.К. Здоровые зубы и качество жизни / В.К. Леонтьев // Стоматология. – 2000. – № 5. – С. 10–13.
7. Максименко П.Т. Медикаментозная патология в стоматологии / П.Т.Максименко. – Полтава, 2001. – 138 с.
8. Мащенко И.С. Болезни пародонта / И.С. Мащенко. – Днепропетровск : КОЛО, 2003. – 272 с.
9. Федоров Ю.А. Оценка очищающего действия зубных гигиенических средств и качества ухода за полостью рта / Ю.А. Федоров, В.В. Володкина // Терапевтическая и ортопедическая стоматология. – К. : Здоров’я, 1971. – Вып. 1. – С. 117–119.
10. Parma C. Parodontopathien / C. Parma. – I.A. Verlag, Leibzig, 1960. – 203 s.
11. Roberts F.A. Beneficial bacteria of the periodontium / F.A. Roberts, R.P. Darveau // Periodontology. – 2002. – Vol. 30. – P. 40–50.
12. Russel A.L. A system of classification and scoring for prevalence surveys of periodontal disease / Russel A.L. // J. Dent. Res. – 1956. – Vol. 36. – P. 922-925.