ЕФЕКТИВНІСТЬ ПРОВЕДЕННЯ ФОТОДИНАМІЧНОЇ ТЕРАПІЇ У ПАЦІЄНТІВ ІЗ ХРОНІЧНИМ ГЕНЕРАЛІЗОВАНИМ ПАРОДОНТИТОМ ТА ЦУКРОВИМ ДІАБЕТОМ 2-ГО ТИПУ НА ФОНІ ПЕРЕНЕСЕНОЇ КОРОНАВІРУСНОЇ ХВОРОБИ

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Abstract
The coronavirus disease (COVID-19) has become one of the greatest challenges of the 21st century, as its rapid spread since its emergence in December 2019 has led to alarming morbidity and mortality rates worldwide. It has been documented that the majority of patients infected with COVID-19 are asymptomatic or have mild symptoms; approximately 14 % are estimated to develop severe disease. In these cases, factors such as advanced age and the presence of comorbidities, including type 2 diabetes mellitus and periodontitis, have been identified as significant risk factors for disease progression to more severe clinical manifestations and even death. Type 2 diabetes mellitus is the most common clinical form of diabetes and is characterized by a set of interrelated biochemical and pathophysiological changes. Several studies have shown a bidirectional relationship between periodontitis and T2DM, indicating that patients with T2DM are more likely to develop periodontal disease. In turn, the presence of periodontitis in patients with T2DM is associated with poor glycemic control, indicating a mutual pathological interaction that may worsen the clinical course of both conditions. These data emphasize the need for further analysis of the interaction between these pathologies in order to understand their joint impact on the clinical course of the disease and improve comprehensive treatment strategies for patients with these comorbidities. We investigated the effectiveness of photodynamic therapy in the treatment of generalized periodontitis in patients with compensated type 2 diabetes mellitus and previous coronavirus disease. 70 patients with the above diagnosis were divided into two groups and, according to the division, an improved and generally accepted treatment method was performed. The improved method included photodynamic therapy. The control group included 31 somatically healthy patients. To control the initial state of periodontal tissues and the dynamics of treatment, an index assessment was used before treatment, after 3 and 6 months: periodontal probing depth (PPD), periodontal index (PI) proposed by Russel, Green-Vermillion oral hygiene index (GVHI), papillary-marginal-alveolar index (PMA) in the Parma modification, and the community periodontal index for treatment need (CPITN) were assessed. After 3 months, a significant decrease in PPD was observed in group A by 1.59 times, in group B by 1.5 times (p˂0.001), after 6 months by 2.21, 1.88 times, respectively (p˂0.001). PI indicators significantly decreased in group A by 1.32 and 1.37 times, in group B – by 1.18, 1.26 times after 3 and 6 months, respectively (p˂0.001). GVHI indicators decreased after 3 months by 2.27 and 1.77 times, after 6 months – by 5.1 and 4.55 times in groups A and B, respectively (p˂0.001). PMA index indicators significantly decreased after 3 months by 1.36 times in group A (p˂0.001), in group B – by 1.21 times (p˂0.01). After 6 months, a significant decrease was observed in groups A and B, respectively (p˂0.001). CPITN index values significantly decreased in group A by 2.41 and 7.3 times, in group B by 1.98 and 6.24 times after 3 and 6 months, respectively (p˂0.001). Our study indicates that photodynamic therapy in patients with generalized periodontitis with type 2 diabetes mellitus and previous coronavirus disease is quite effective, since this observation group received the best average indicators in dynamics.

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