A randomized trial of improving the effectiveness of physiotherapy treatment of patients with type 2 diabetes mellitus with periodontal-periodontal pathology

Abstract

BACKGROUND: The severity of chronic periodontitis and related dental complications (gingival pockets accompanied by bleeding gums, pain, tooth mobility, inflammation of the gums, suppuration) in patients with type 2 diabetes mellitus are largely determined by blood sugar parameters, which indicates the importance of modeling treatment to increase efficiency and reduce risks, forming a high medical and social problem.

AIM: was to evaluate the prospects and efficacy of physiotherapeutic treatment, including intracanale laser exposure in the form of radiation with a wavelength of 810 nm in combination with transchannel galvanophoresis of copper-calcium hydroxide, in patients with type 2 diabetes with periodontal periodontitis.

MATERIAL AND METHODS: The materials of a retrospective study including 89 patients with type 2 diabetes mellitus with periodontal periodontitis were analyzed. Patients of the first group (Comparison I ― 17 people) received laser exposure intracanally. Patients of the second group (Comparison II ― 18 people) received galvanophoresis with copper-calcium hydroxide transcanally with an active anode. Patients of the third group (Comparison III ― 18 people) received galvanophoresis with copper-calcium hydroxide transcanally from the active Cathode. Patients of the main group (Main I ― 18 people) received complex therapy in the form of laser exposure intracanally and galvanophoresis with copper-calcium hydroxide transcanally from the active Cathode. Patients of the main group (Main II ― 18 people) received complex therapy in the form of laser exposure intracanally and galvanophoresis with copper-calcium hydroxide transcanally with an active anode. The control was carried out on patients without physiotherapeutic treatment, including long-term indicators.

RESULTS: During dental treatment, all patients with type 2 diabetes had a laboratory-confirmed blood glucose level of 7.5±1.9 mg% (p <0.05). The hygienic index of Fedorov–Volodkina ― 5.3±0.3 points. In 86.5% of patients, supra- and subgingival tartar was detected and in 35.9% of them ― the formation of periodontal pockets with bright red granulations, which required very careful treatment. It has been established that the depot-phoresis with an active cathode provides high anti-inflammatory and analgesic results with mono-exposure. In 29.4% of patients after intracanal monolaser exposure, high anti-inflammatory effects were established, which were accompanied by a decrease in the hygiene index, the index of inflammation, which was lower than after complex laser electrophoresis.

CONCLUSION: The use of depot-foresis with an active cathode provides higher anti-inflammatory and analgesic results in relation to the apex-foresis of copper-calcium hydroxide (active anode), which, in our opinion, is based on an increase in the activity of physico-chemical reactions of metabolic orientation in the alkaline environment of the oral cavity.

Keywords

depot-phoresis / apex-foresis / diabetes mellitus type 2 / periodontitis / laser radiation

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