Клиническая медицина

Bulankina M.K., M. D. Averyanov, S. V., Bogdanov I.R., Gulyaeva O. A.

Bashkir State Medical University, Ufa, Russian Federation

Photodynamic therapy for the treatment of periodontitis

Keywords: inflammatory periodontal disease, photodynamic therapy

Abstract. The article presents information about the features and benefits of the use of photodynamic therapy in the treatment of inflammatory periodontal diseases

Epidemiological surveys conducted in recent years show a trend of increasing numbers of inflammatory periodontal diseases among the population of Russia. Improving the efficiency of conservative treatment of inflammatory periodontal diseases is one of the topical medico-social problems and challenges dentistry.

Selection of drugs for the treatment of periodontitis is extensive, but these products have side effects, do not affect all stages of pathogenesis of the disease, lead to a brief remission. Researchers suggested ways to increase the effectiveness of traditional drug therapy with new ways, combinations of various drugs or increasing their dosage is not allow to achieve the desired effect. Therefore, in modern dentistry have become increasingly important non-pharmacological treatment methods, including the effects of physical factors .

To such methods of treatment can be attributed to rapidly evolving in dentistry photodynamic therapy (PDT) that includes two components, a photosensitizer and light. Photodynamic reaction is the formation of singlet oxygen in cells that have accumulated photosensitizer (PS). Education in pathological cell singlet oxygen leads to damage and subsequent death. The rate of interaction of atomic oxygen is so high that the healthy tissue is not affected. FS a chlorine series have several advantages over other types of FS: high contrast accumulation in target tissues compared to intact tissue, high photodynamic activity when using a low-dose, low dark and light toxicity and fast elimination from the body (within 24-36 h) [1, 2]. To start the photodynamic reaction requires two main components: substance-a photosensitizer and light. A photosensitizer is a chemical compound, a molecule which under the action of light the visible spectrum is able to go into an excited (triplet) state, and when you return to the main to transfer the energy to other compounds. The role of energy acceptor is the oxygen which is always present in biological tissues. Under the action of the photosensitizer oxygen passes into the so-called singletwo form a highly active compound that can damage the cell. Interacting with proteins and other macromolecules, singlet oxygen triggers a cascade of free radical reactions that result in damaged biological structure, develop necrotic and apoptotic changes. The photosensitizer is able to selectively accumulate in the energy-deficient cells (neoplastic, microbial, damaged), which leads to the possibility of using photodynamic reaction to destroy them [3].

The main essence of photodynamic therapy is that biological objects, which include inflammatory tissue, microorganisms, cancer cells, viruses, accumulate the photosensitizer after its introduction. Then, under the influence of the energy of laser exposure in previously sensitized tissues initializes a cascade of redox reactions with the release singletno (active) and triplet (long-lived) forms of oxygen and free radicals (bicicletele), which in turn damage and destroy tumor cells, microbes, forming photocoagulation film.

Research in clinic and laboratory indicate the high antibacterial activity of photodynamic therapy with the most pronounced bactericidal activity when using such dyes, as toluidine blue, methylene blue. Many of the above parameters exceeds its analogues complex "Fotosan", in which the led generates light with a wavelength of 625-635 nm. In this range is the peak absorption of light energy by toluidine blue, on the basis of which photosensitizer "Fotosan".

Method antibacterial photodynamic therapy is showing very high degree of efficiency (over 92%) in etiopathogenetic treatment of periodontal disease in comparison with standard treatment and ozone therapy [4]. Typically, to achieve positive results requires just 1 treatment FAD, in a complicated course of the disease it can be repeated 1-2 times (the procedure is assigned a week after the first). In the result, the periodontal tissues in the area of inflammation become sterile, increases local immunity, blocked cytokinesis, and inhibited the activity of collagenase and osteoclasts resumed in varying degrees (depending on age, immune status and concomitant somatic diseases) osteoblastic process, there is a disintegration and lysis of granulation tissue and a gradual restoration of the normal periodontal pavement [5].

The advantages of using photodynamic therapy in dentistry today practice proved and undeniable: safety, absence of toxicity and resistance to repeated cycles of photodynamic therapy, the lack of adverse effects, limited use of anesthetics and, most importantly, the ability to treat without antibiotics and antiseptics. All this provides a gentle and painless treatment, comfortable conditions for patient and doctor, the acceleration of the time of treatment to achieve maximum results.

Literature:

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