Diagnostic value of microbiome biomarkers of the periodonite microbiome in patients with the association of chronic periodontitis and diabetes mellitus type 2

The place of high-tech methods of molecular biology in clinical laboratory diagnostics of various diseases and the development of a system of biomarkers as an important component of diagnostic research is currently attracting the closest attention of the scientific community. In this paper, an attempt is made to use high-tech metagenomic analysis to solve problems that arise due to the high frequency of association of periodontal diseases with systemic pathology, in particular, with type 2 diabetes mellitus. The aim of the study was to determine the taxonomic and metabolic features of the microbiome of periodontal tissues in periodontal diseases associated with type 2 diabetes mellitus, as a model of the ratio of local and systemic effects of periodontal pathogenic bacteria. The study included 16S shotgun sequencing of bacterial DNA as part of biological material from periodontal pockets/dentoalveolar furrows of 46 people - 15 patients with chronic periodontitis associated with type 2 diabetes mellitus, 15 patients with chronic periodontitis unrelated to systemic pathology, as well as 16 healthy people in the control group, followed by bioinformatic processing of the data obtained. The obtained data allowed us to establish the taxonomic features of the periodontal microbiome in the association of chronic periodontitis with type 2 diabetes mellitus, which included the predominance of representatives of the families Prevotellaceae and Spirochaetaceae in its composition. The features of metabolic processes in periodontal tissues with the participation of the microbiome were also revealed, which consisted in an increase in the exchange of cysteine and methionine against the background of a decrease in the metabolism of pyrimidine, methane, sphingolipids, and the synthesis of fatty acids, which are of diagnostic value in assessing the condition of patients with type 2 diabetes mellitus.

Ceramids as biomarkers of chronic periodontitis associated with type 2 diabetes

Relevance . The association of chronic periodontitis with type 2 diabetes mellitus is one of the most frequent manifestations of systemic effects that are etiologically associated with periodontopathogenic bacteria in the biofilm of the gingival sulcus. In this regard, the study of the metabolic mechanisms leading to such systemic effects and serving their markers is an urgent problem. Aim . Study of the features of sphingolipid/ceramide metabolism, both produced by etiologically significant microflora, and present in periodontal tissues of patients on the example of the association of chronic periodontitis with type 2 diabetes. Materials and methods . The observation groups included 58 patients with chronic periodontitis in association with type 2 diabetes, 39 patients with chronic periodontitis without concomitant systemic pathology, and 27 conditionally healthy people. All the examined patients underwent molecular genetic studies of the taxonomic and metabolic profiles of the dental sulcus/ periodontal pockets microbiota using 16S sequencing and evaluation of phosphorylated ceramides in saliva by the activity of the ceramid kinase enzyme. Results . It was found that in the Association of chronic periodontitis with type 2 diabetes mellitus, there are features of the taxonomic composition of the dental sulcus/periodontal pockets microbiota, which are combined with a decrease in sphingolipid metabolism. In addition, in these patients, depending on the duration of diabetes mellitus, there was an increasing drop in the saliva of ceramide kinase, which determines the phosphorylation of sphingolipids/ceramides. Conclusion . In the Association of chronic periodontitis with type 2 diabetes mellitus, the systemic effects of the dental sulcus/ periodontal pockets microbiota are manifested by a decrease in sphingolipid metabolism, including a decrease in ceramide kinase in periodontal tissues, which can serve as a marker of the combined pathological process.

[Filifactor alocis and its role in the etiology of chronic periodontitis]

The review is devoted to the analysis of modern ideas about the role of bacteria Filifactor alocis in the etiology of chronic periodontitis. The study of these bacteria, discovered in 1985, is complicated by the difficulty of their detection with cultural methods. According to modern researches, the bacteria F.alocis with good reason can be included in the red complex of periodontal pathogens as the most important pathogens of chronic periodontitis. F.alocis is a synergist of such a key pathogen Porphyromonas gingivalis, as well as a frequent satellite of Fusobacterium nucleatum and, somewhat less frequently, Aggregatibacter actinomycetemcomitans. F.alocis is practically not found in healthy people (except for smokers), with a high frequency accompanies the aggressive course of periodontal disease, and also recorded in endodontitis. Due to the ability to participate in the metabolism of arginine, expressed protease activity, a wide range of virulence factors, F.alocis not only colonizes the periodontal tissues, but also significantly affects the formation of the community of periodontal microorganisms (including viruses), contributing to their invasion of epithelial tissues. F. alocis has a number of unique properties, including resistance to oxidative stress conditions in the home defeat, induction of apoptosis of epithelial cells, extracellular matrix degradation of periodontal tissues, activation of proinflammatory cytokines formulation in sites of its presence, suppression of protective reactions of neutrophilic granulocytes, inhibition of the process of complement activation.

"Shielding" of Cytokine Induction by the Periodontal Microbiome in Patients with Periodontitis Associated with Type 2 Diabetes Mellitus

Periodontal diseases, especially those with polymicrobial etiology, are often associated with type 2 diabetes mellitus, proceeding more severely and affecting the course of diabetes mellitus. Recently, this feature has been associated with the ability of periodontopathogen microflora to cause not only a local infectious process in the oral cavity, but also to interact with the human immune system and induce various systemic effects. We investigated changes in the salivary cytokine profile of patients with chronic periodontitis, associated and not associated with type 2 diabetes mellitus. We observed a statistically significant decrease of MCP-1/CCL2, GM-CSF, IL-5, IL-6, and IFN-γ in the saliva of patients with chronic periodontitis associated with type 2 diabetes mellitus in comparison with patients with chronic periodontitis only. All of these cytokines are associated with macrophage activation. These data are an important contribution to the elucidation of the mechanism of periodontopathogens involvement in the manifestation of the systemic effects of type 2 diabetes.

[Control of primary adhesion of microorganisms and formation of biofilms on stomatological materials used for transdental implantation in dental stabilizing operations.]

Transdental implantation is an effective way to restore the lost biomechanical properties of a resected or amputated tooth. The choice of structural materials for the implant is the most important stage of treatment, in relation to the adhesion of aggressive microbiota to them. To characterize the adhesion of microorganisms of periodontopathogenic and cariogenic groups in vitro to experimental samples of zirconium dioxide and titanium alloys using cultural and electronic microscopic methods of adhesion evaluation as the first stage of biofilm formation. Samples for the experiment were prepared in the form of a tablet of standard form, on which the test strains were applied in an amount of 106CFU/ml. After shaking the unattached cells with ultrasound, they were seeded into dense nutrient medium to determine their number. In total, 14 strains of perodontopathogenic and cariogenic groups (including 3 reference strains) were used in the experiment. Scanning electron microscopy was used to visualize the adhesion of microorganisms. The results of the adhesion test to titanium nickelide and zirconium dioxide showed a significant reduction in adhesion for all microorganism species. In all variants (with all strains) the adhesion values to titanium nickelide and zirconium dioxide were statistically significantly lower than when using samples from a traditional titanium alloy. In scanning electron microscopy, single cells of test strains of perodontopathogenic microorganisms were determined on zirconium dioxide samples, while a considerable number of cells and the initial phase of biofilm formation were observed on the compared structural materials. Zirconium dioxide can be considered as an optimal choice material for the manufacture of transdental implants, which, in terms of its technological characteristics and low adhesion characteristics of microbes, is superior to the traditionally used titanium alloys.

Metagenomic Analysis of Gingival Sulcus Microbiota and Pathogenesis of Periodontitis Associated with Type 2 Diabetes Mellitus

Biofilm of the gingival sulcus from 22 patients with type 2 diabetes mellitus and periodontitis, 30 patients with periodontitis not complicated by diabetes mellitus (reference group), and 22 healthy volunteers without signs of gingival disease (control group) was studied by quantitative PCR. Quantitative analysis for the content of P. gingivalis, T. forsythia, A. ctinomycetemcomitans, T. denticola, P. intermedia, F. nucleatum/periodonticum, and P. endodontalis in the dental plaque was performed with a Dentoscreen kit. The presence of other bacterial groups was verified by metagenomic sequencing of the 16S rRNA gene to evaluate some specific features of the etiological factor for periodontitis in type 2 diabetes mellitus. Specimens of the Porphiromonadaceae and Fusobacteriaceae families were characterized by an extremely high incidence in combined pathology. The amount of Sphingobacteriaceae bacteria in the biofilm was shown to decrease significantly during periodontitis. Metagenomic analysis confirmed the pathogenic role of microbiota in combined pathology, as well as the hypothesis on a possible influence of periodontitis on the course and development of type 2 diabetes mellitus.

PREVALENCE OF GENETIC MARKERS OF RESISTANCE TO ANTIBIOTICS IN BIOFILM-FORMING STRAINS OF OBLIGATE AND ELECTIVE ANAEROBES

AIM

Comparative study of frequency of detection of genetic markers of resistance to antibiotics forming in anaerobic bacteria under the conditions of mixed biofilms in a clinical setting and comparison of data of phenotypic and genotypic methods of study.

MATERIALS AND METHODS

66 strains of bacteria forming biofilm with PCR detection of antibiotics were studied: Streptococcus sanguinis, Streptococcus salivarius, Staphylococcus aureus, Staphylococcus epi- dermidis, Enterococcusfaecalis, Klebsiellapneumoniae, Pseudomonas aeruginosa and anaero- bic pathogens - Porphyromonasgingivalis, Tannerella forsythia, Parvinonas micra, Prevotella intermedia. Modelling of microbial biofilms in vitro and scanning electron microscopy were carried out.

RESULTS

The studied strains of resident and pathogenic microbiota were established to have genes that code resistance to P-lactam antibiotics; carbapenems, macrolides, tetra- cyclines. Genetic markers of resistance to P-lactam antibiotics (STX-M 14 MECA - cepha- losporines), including carbapenems.(VIM and NDM, but not Oxa-48), glycopeptides (VanA and VanB), macrolides (ERM), tetracycline (Tet) and QNRB plasmids (fluoroquinolones) were detected in strains by PCR.

CONCLUSION

The most frequently used preparations in dental practice - metronidazole and lincomycin (for the last 20 - 30 years) have shown the highest number of resistant strains - 52.3 and 22.7%, respectively. The frequency of detection of genetic markers of resistance to other studied preparations did not exceed 2.5 - 11.4%. Minimal quantity of resistant strains of anaerobic bacteria was detected for carbapenems and fluoroquinolones.

[The use of self-adapting system files (SAF) for controlling microbial biofilms of root canals in the treatment of apical periodontitis]

The aim of this study was to conduct a clinical and laboratory study and evaluate the effectiveness of endodontic root canal treatment using a self-adapting files system (SAF) in the complex treatment of patients with chronic apical periodontitis. 3% sodium hypochlorite solution was used as irrigation agent in all groups which included 20 patients treated with conventional manual tools, 21 patients receiving treatment with ultrasonic activation of irrigant and 26 patients treated with SAF system. Root canal biofilm structure was studied by scanning electron microscopy (SEM) using a Quantum 3D microscope (USA). Clinical efficiency of the root canal treatment was assessed by complications frequency a year after treatment. SEM revealed the presence of high levels of microbial contamination of dentine tubules in the apical portion of the tooth. In standard method group the percentage of re-treatment and surgery was higher than in the studied groups. Use of SAF irrigation system was associated with a decrease in the number of identified pathogens. However, the study revealed high resistance of Enterococcus spp., Porphyromonas gingivalis, Candida albicans to all types of endodontic treatment, so the improvement of methods of root canal microbial biofilms removing need to be continued.

[The application of scanning electronic microscopy and bio-reactor for evaluating eradication of microbial bio-film of root channels under endodontic treatment.]

According to the results of endodontic treatment of chronic forms of odontotis and periodontitis the rate of complications continues to be high - from 32% to 50% that os related to characteristics of microbial bio-film. The studies of this object in root canals and methods of eradication of bio-films are at their initial stage. The purpose of study is to provide a laboratory substantiation and evaluation of efficacy of complex effect of ultrasound processing and photo-activating disinfection of root of tooth in case of chronic forms of odontotis and periodontitis and also evaluation of endodontic treatment using scanning electronic microscopy. The micro-flora of root canals was examined using bacteriological method (4 bacterial and 2 fungous clinical isolates). The effect of ultrasound processing in complex with the system, photo-activating disinfection on micro-flora of root canal was evaluated using a bio-reactor. The analysis of bio-films of system of root canals of tooth in patients with chronic forms of odontotis (52 patients) and periodontitis (16 patients) are implemented using scanning electronic microscopy. The established availability of abundant microbial bio-film in orifices of dentinal tubules and obturation of dentinal tubules in particular cases. The features of formation of curves of growth of population of bacteria of oral micro-flora (Porphyromonas gingivalis; Fusobacterium nucleatum; Streptococcus sanguinis; Streptococcus mutans; Candida albicans; Candida krusei) as a result of complex effect of photo-dynamic activation and ultrasound as compared with control without such. The complex effect inhibits growth of microbial populations of oral bacteria and fungi species Candida.

[EXPERIMENTAL RATIONALE OF ENDODONTIC THERAPY OF CHRONIC FORMS OF PULPITIS- AND PERIODONTITIS USING PHOTO-ACTIVATED DISINFECTION AND ULTRASOUND TREATMENT]

AIM

Laboratory rationale of application of a complex effect of ultrasound treatment, and photo-activated disinfection in experiments in vitro using strains of anaerobic and microaerophilic microorganisms isolated from patients with chronic forms of pulpitis and periodontitis.

MATERIALS AND METHODS

Microbiologic study of root canal was carried out using a bacteriologic method (2 species of obligatory-anaerobic and 2 -microaerophilic streptococci). Evaluation of the effect of ultrasound treatment in a complexwith a system of photo-activated disinfection on microflora of root canal was carried out using a bioreactor. Study of biofilms of the root canal system of a tooth in patients with chronic forms of pulpitis (52 individuals) and periodontitis (16 individuals) were carried out using scanning electron microscopy.

RESULTS

The presence of an ample microbial bio- film in the ostiums of dentinal canaliculi and obturation of dentinal canaliculi in certain cases was established. Features of formation of growth curves for bacterial populations of oral microflora (Porphyromonasgingivalis, Fusobacterium nucleatum, Streptococcussanguinis, Streptococcus mutans) were described in the experimental part of the study as a result of a complex effect of photody- namic activation and ultrasound compared with control lacking those.

CONCLUSION

The data obtained allow to conclude that complex effect significantly suppresses the growth or microbial populations of oral bacteria.

Clinical-microbiological research of action ozone therapy and light-emetting diode radiation of red range (630 nanometers) on microflora of the hole extracted toothatalveolitis and limited osteomyelitis of jaws

As a result of cliniko-microbiological research the data testifying to substantial improvement of efficiency of antimicrobictherape at inclusion in a complex of medical actions at alveolitis and the limited osteomyelitis of a jow ozone therapy in a combination with a light-emettinf diode irradiation of the hole extracted teeth red ( 630 nanometers) are obtained by light.

[THE MOLECULAR TECHNIQUES OF DIAGNOSTIC OF GINGIVITIS AND PERIODONTITIS IN HIV-INFECTED PATIENTS]

The examination was carried out in the Moscow clinical infectious hospital No 2 concerning 102 patients with verified diagnosis "AIDS-infection" and seropositive according results of detection of anti-HIV-antibodies in blood serum. The study was organized to analyze rate ofcolonization of gums with virulent anaerobic bacteria in HIV-infected (polymerase chain reaction) and antibodies to HIV in gingival fluid (enzyme-linked immunosorbent assay). It is established that in HIV-infected patients, in scrape from gingival sulcus dominate anaerobic bacteria P. gigngivalis and A. ctinomycetemcomitans and in case of periodontitis--P. gingivalis and T. forsythia. The received data permits recommending the test-system "Multident-5" for polymerase chain reaction diagnostic. The reagents kit "Calypte®HIV-1/2"--for enzyme-linked immunosorbent assay gingival fluid. The results of polymerase chain reaction and enzyme-linked immunosorbent assay have no impact of concomitant stomatological (periodontitis, gingivitis) and somatic pathology.

[STUDY OF COLONIZATION PROCESSES AND PERSISTENCE OF MICROORGANISMS IN ARTIFICIAL MATERIALS FOR MEDICAL USE]

AIM

Study processes of microbial colonization and persistence of microorganisms in polymer materials for medical use.

MATERIALS AND METHODS

Samples (1 x 1 cm plates) of polymer plastics for production of removable dental prosthesis based on polyurethane and acryl were used, that were incubated with clinical isolates of Pseudomonas aeuruginosa, Staphylococcus aureus in Luria-Bertani broth nutrient media for 24, 48 hours and 7, 14 days and for 1, 5 and 3 months at a temperature of 37 degrees C. Dynamics of interaction process of microorganisms with polymer materials were studied using scanning electron microscope Quanta 200 3D (FEI Company, USA). The samples were fixated after incubation with 10% of neutral formaldehyde, dehydration with alcohols or acetone, typical for SEM, was not carried out, that allowed to conserve the native structure of the samples, including exo-cell matrix of biofilms.

RESULTS

Electron-microscopical data on stages of interaction of bacteria with the surface of medical plastics were obtained. Biofilms were shown to be formed on abiotic surfaces and biodestructive changes of plastics appeared. A question on the possibility of prolonged persistence of pathogenic for human microorganisms in artificial prosthesis is discussed.

CONCLUSION

The developed experimental model of formation of biofilm on abiotic surfaces could be the basis for carrying out studies directed on the fight with biofilms, by using SEM.

[Features of adhesion of anaerobic periodontopathogenic bacteria and Candida albicans fungi to experimental samples of basis dental plastic depending on surface roughness and polishing method]

AIM

Study the main surface parameters of milled polyacrylic materials using atomic force microscopy and primary microbial adhesion of periodontopathogenic group bacteria and Candida albicans fungi taking into consideration the method of sample polishing.

MATERIALS AND METHODS

Studied samples: mill-treated without polishing (control); ergobox polished; polished in dental laboratory conditions; polished by a rubber brush in dentists' office. Microbial strains belonging to periodontopathogenic species (clinical isolates) that had been isolated from periodontal pockets of periodontitis patients: Porphyromonas gingivalis, Fusobacterium nucleatum, Streptococcus sanguis, C. albicans fungi were used for modelling experiments of primary adhesion of microbes to the material samples.

RESULTS

S. sanguis had the highest degree of adhesion to polymer after milling, P. gingivalis, C. albicans--medium, F. nucleatum--low. A significant reduction of adhesion is observed during polishing in dental laboratory conditions or ergobox, less significant--during polishing in dental office.

CONCLUSION

The data obtained allow to make a conclusion that the samples from polymer materials for preparation of prosthesis basis have varying degree of intensity of microbial adhesion of members of periodontopathogenic microflora and C. albicans fungi that depends on the polishing method, that accordingly determined the differences in colonization resistance against formation of microbial biofilm during polymer use in clinical conditions. . ,

[PCR rationale for use of oral cephalosporins by oral surgery procedures]

The article presents the experience of PCR detection of DNA of pathogenic germs inducing odontogenic inflammation. Pus samples of 48 patients aged 18 to 68 years undergoing oral surgery because of apical periodontal lesions and pericoronitis. The results showed microorganisms associations revealed by PCR are sensitive to III generation cephalosporins. Effective oral regimen included 400 mg Ceftibuten once daily. The PCR results thus served as a rationale for use of oral cephalosporins by oral surgery procedures proved by clinical and immunological data in postoperative period.

[Feasibility and assessment of combined anti-inflammatory, antibacterial and immunocorrective treatment in periodontal disease]

The article presents the experience of using medical dressings of combined action based on antibiotic Spiramycin and antiseptic Triclosan. Investigation and treatment of 79 patients with moderate chronic periodontitis proved the given drug formulation to be highly clinically effective for local treatment of periodontal disease.

[Gingival fluid cytokine profile in patients after dental implantation and by periimplantitis]

The study included 32 patients with complications which have developed 3 months to 14 years after dental implants placement. ELISA method was used to assess cytokines content in various sites of tooth alignment in patients with Herpesviridae and periodontopathogenics bacteria associated periimplantitis. The results prove the necessity for Herpesviridae and selected bacteria monitoring after dental implantation.

[Preventive antibacterial treatment in oral bone augmentation procedures]

The paper contains clinical and microbiological base for the use of Ceftibuten for prevention of inflammatory complications after bone augmentation and dental implant placement.

[Expression of cytokines in dentogingival sulcus in patients after dental implantation and during development of peri-implantitis]

AIM

Determination of cytokine content in various areas of dentition in patients with peri-implantitis associated with parodontopathogenic bacteria species of I and II order.

MATERIALS AND METHODS

32 patients with complications that developed in 3 months to 14 years after installation of intraosteal dental implants were examined. Content of cytokines in various areas of dentition was determined by using solid phase enzyme immunoassay in patients with developed peri-implantitis associated with parodontopathogenic bacteria species of I and II order. Multiplex polymerase chain reaction was used for determination of parodontopathogenic bacteria marker DNA.

RESULTS

Marker DNA of I order parodontopathogenic bacteria - Aggregatibacter (Actinobacillus) actinomycetemcomitans, Tannerella forsythia (Bacteroides forsythus), Porphyromonas gingivalis in peri-implantation tissues during implant rejection was detected with 34.4 - 75% frequency while II order (Prevotella intermedia, Treponema denticola, Parvimonas micros (Peptostreptococcus micros), Fusobacterium nucleatum/periodonticum etc.) - with significantly lower frequency. Total concentration of IL- 1beta, IL-4, IL-6, IL-8, TNFalpha, IL- 17A and INFgamma in contents of pathological pocket in the area of implants and the levels of each of them were significantly higher than in the contents of parodontal pockets, areas with stable implants and gingival fluid from areas with healthy teeth. Total interleukin content in the contents of pathological pockets in the area of rejected implants was significantly higher than in other studied areas. In the exudate of parodontal pockets of the preserved teeth it was 2.4 times lower, in the area of stable implants - 4.6 times lower, and in the areas with healthy teeth - 4.8 times lower than with rejected implants (p<0.05).

CONCLUSION

The results of the study conducted allow to make a conclusion regard- ing reasonability of monitoring during dental implantation of parodontopathogenic microorganism strains and local cytokine response of the host organism with the objective of rational prophylaxis and therapy of inflammatory complications.

[Biofilm formation on temporary dentures: correlation of primary adhesion, coaggregation and colonization]

Forty-six patients (20 male and 26 female, age 45-76) with temporary dental prosthesis were followed-up both clinically and microbiologically. The results of quantitative and qualitative assessment proved biofilm formed on acrylic resin to be potentially more aggressive because of high incidence and significant number of virulent germs as well as yeast-like Candida fungal. Laboratory polished polyurethane samples showed much lower colonization by virulent germs and Candida fungal. After biofilm stabilization PCR revealed twice-fold less incidence of virulent germs on polyurethane when compared to other tested materials.

[Comprehensive microbiological and molecular-biological control of using laser technologies in ambulatory surgical practice]

Results of comparative use of different type lasers for surgical treatment of patients with medium severity level of periodontitis were presented: group 1--erbium laser "Waterlaser Millennium" (41 people); group 2--diode laser "LS-0,97 - IRE-Polyus" (25 people); group 3--carbon dioxide laser "СО2-laser LST - 20/01 Lantset" (21 people). Patients of the comparative group undergone a traditional surgical curettage (30 people). A PCR-diagnostic was made to all patients that were sent to ambulatory surgical treatment. It revealed carriage of 1 to 4 types of periodontium pathogenic bacteria that present ed threat from the point of view of infectious complications development in the postoperative period. After using laser technologies an increase of periodontium pathogenic species eradication frequency was registered (А. actinomycetemcomitans, T. forsithia, P. gingivalis, P. intermedia, T. denticola): up to 60, 58 and 60%--for erbium, diode and carbon dioxide correspondingly.

[Polymorphism of IL1α and IL1β genes and bacterial invasion in patients with chronic generalized periodontitis]

Researchers studied polymorphism of IL-1α and IL-1β genes among patients of different ages with severe chronic generalized periodontitis and people with healthy periodontium. The study demonstrated a correlation between high frequency of genetic polymorphism in IL-1α -899 and IL-1β +3953 loci and development of severe periodontitis among patients less than 35 years of age, as well as markers of P. intermedia, T. denticola, HSV1 and EBV in periodontal pocket.

[Study of virus content of Herpes viridae family in parotid secretion of patients with inflammatory-dystrophic diseases of salivary glands]

The study is devoted to disclose the interrelation between Herpes viridae family carriage and inflammatory-dystrophic diseases of salivary glands (SG). It was shown that inflammatory and dystrophic diseases of SG in observed patients run on the background of latent and active chronic herpes-virus infection. In the case the frequency of disclosure and content of antibodies to nuclear protein of Epstein-Barr virus in the peripheral blood serum in patients with different inflammatory and dystrophic SG diseases were statistically significantly higher and antibodies to simple 1st type virus and cytomegalovirus lower than in patients with different types of maxillofacial region pathology without SG involvement. The immediate contamination of parotid secretion by virus of Herpes viridae family was detected with the help of polymerase chain reaction in 18% of patients with SG diseases.

[The allelic polymorhism of IL-1alpha and IL-beta genes in patients with chronic inflammatory periodontal diseases]

The researchers studied the polymorphism of IL-1alpha and Il-beta genes in patients of different ages with severe chronic generalized periodontitis and people with healthy periodontium. They used molecular and genetic techniques such as polymerase chain reaction and reverse hybridization with Geno Type PRT reagents (Germany). The study demonstrated a correlation between high frequency of genetic polymorphism in IL-1A -899 and IL-1B +3953 loci and the development of severe periodontitis in patients less than 35 years of age, and a possibility of using this parameter in complex assessment of patients with periodontal diseases. The research suggests that Geno TypeR PRT test system should be recommended for evaluation of patients with a high risk of aggressive periodontal diseases, as well as patients with therapy-resistant periodontitis.

[Use of molecular genetic systems for diagnostics of inflammatory diseases of oral mucosa and periodontium]

Structure of bacterial microflora of periodontal pocket using classical cultural and molecular genetic methods (PCR and RT-PCR assays) was studied in patients with chronic generalized severe or intermediate periodontitis in acute phase and in healthy subjects. Structure of viral and fungal microflora using PCR or ELISA assays was studied also. Markers of Gram-negative bacteria (B. forsithus, T. denticola, A. actinomicetemcommitans, P. intermedia and P. gingivalis) were detected with different rates. Rate of detection of pigment-forming P. intermedia and P. gingivalis was significantly higher when PCR assay was used compared with traditional bacteriologic method. Detection rate of Candida albicans DNA in tooth-gingival fluid was virtually not different from one when cultural method was used. PCR assay is recommended as laboratory method for detection of DNA of microorganisms associated with inflammatory diseases of oral mucosa and periodontium.

[Evaluation of antibacterial activity of apex-phoresis]

Effects of apex-phoresis on dental root canal microflora were studied and optimal dosage parameters were determined. Microbiological study in vitro has established that optimal antibacterial effect was achieved with the apex-phoresis dosage in the range between 2.5-5 mA/min. Study of the effects of apex-phoresis on dental root canal microflora in vivo disclosed its high antibacterial activity both in cases of pulpitis and destructive forms of chronic periodontitis. For the first time the data are confirmed by molecular-genetic method of detection of hard to cultivate virulent anaerobic bacteria. The results of the study allow to recommend apex-phoresis for wide use in clinical practice as an effective way to sterilize difficult to traverse dental root canals.

[Development and use of periodontal dressing of collagen and Lactobacillus casei 37 cell suspension in combined treatment of periodontal disease of inflammatory origin (a microbiological study)]

Periodontal dressing consisting of collagen and Lactobacillus casei 37 cell suspension (cell concentration 108 cells/ml) was created and used in combined treatment of patients with chronic generalized parodontitis. Efficacy of the developed isolation was explained by a considerable decrease of the number and frequency of isolation of aggressive microbial representatives (pigment synthesizing Bacteroids, Actinomyces and Str. intermedius) in periodontal pockets and also Fungus (Candida albicans). This periodontal dressing provided remission up to 10-12 months.

[Efficiency of combined action of a chemical disinfectant and plasma sterilization on stomatological instruments and casts]

The efficiency of combined treatment of dentures by argon plasma and chemical disinfectant Ocadez is compared using anaerobic culturing of oral bacteria and polymerase chain reaction with hepatitis B, C, and D virus primers. Different protocols of processing dental instruments and casts directly after dentist's manipulations with outpatients were tried and model experiments with hepatitis viruses were carried out. The optimal protocol of plasma sterilization is as follows: 10 min at 86-90 degrees C after treatment with Ocadez or 15 min without additional chemical treatment.

[Microbiological validation of the choice of basic plastic for removable dentures]

Adhesion of obligate and facultative anaerobic bacteria, favoring the development of oral inflammatory diseases, including the cariesogenic and periodontogenic bacteria and Candida albicans fungi, isolated from patients with periodontitis, to 13 basic materials used in removable denture making, was studied. The adhesion of all bacteria (Streptococcus sanguis, Prevotella melangogenica, Fusobacterium nucleatum, Corynebacterium xerosis) and fungi to hot polymerization basic materials was the maximum. The most perspective basic plastic for clinical use (preserving intact oral microbiocenosis and preventing stomatitis induced by denture wearing) are cold polymerization materials, such as Redont-03, Dentoplast Breden, Leocryl, and UHF polymerization materials Acron GC, AKR-MV, and Etakril-02.

[Clinical and laboratory studies of bacterial adhesion to validate the choice of material for making provisional dentures for patients with periodontal diseases]

Adhesion of bacteria favoring the development of oral inflammations, including cariesogenic and periodontopathogenic (Actinobacillus actinomycetemcommitans, Streptococcus sanguis, Fusobacterium nucleatum, Staphylococcus warneri) and yeast fungi (Candida albicans), to 13 materials used for making provisional dentures was studied. Adhesion of all the studied bacteria and fungi to Russian material Esterfil Foto was the minimum. Clinical use of this material in patients with chronic generalized periodontitis showed that it was well tolerated and the treatment led to improvement of oral microbiocenosis.

[Ozone therapy in treatment of local sluggish suppurative inflammation of maxillofacial soft tissues]

Combined local and general ozone therapy was used in 30 patients with local sluggish pyoinflammatory diseases of the maxillofacial soft tissues. The results were compared to those in 33 patients administered no ozone therapy. Ozone therapy decreased the duration of treatment more than 2-fold due to antibacterial effect and stimulation of nonspecific and immunological reactivity. Lack of obvious contraindications and selective activity and universal immunocorrective effect recommend ozone therapy for wide use in this patient population irrespective of the type of inflammatory reaction.

[Dynamics of immune status in patients with phlegmons of the maxillofacial area during endolymphatic antibiotic therapy]]

Studies of immunotropic effects of ampicillin, gentamicin sulfate, lincomycin, and rifampicin SV used in endolymphatic therapy of patients with maxillofacial phlegmons demonstrated a pronounced immunomodulating effect of rifampicin SV in polygluquine. The immunomodulating effect of lincomycin was lower, and that of ampicillin virtually null. Gentamicin sulfate suppressed some parameters of the immune status.

Interaction peculiarities between microbial cenosis and local immunity of periodontium of humans under extreme conditions

The investigations were directed at finding out the peculiarities of both periodontal microflora and local immunity under extreme conditions (spaceflight, saturation diving, antiorthostatic hypokinesia). The obtained results revealed different kinds of interactions amongst which saturation diving resulted in the most severe decrease of commensale microflora level, decrease of local immunity and appearance of periodontal pathogens.

[The clinico-microbiological evaluation of the efficacy of using new drug forms of chlorhexidine--Corsodyl and Eludril--for the prevention of infectious complications in operations for endosseous implantation]

Prevention of infectious inflammatory complications of intraosseous implantation is a pressing problem. Chlorohexidine dosage forms Corsodyl and Eludril were used for this purpose. In the control group, furacillin was used. Microbiological studies showed that instillations of Corsodyl and Eludril solutions during the postoperative period did not modify normal oral microflora and led to disappearance of the most aggressive anaerobic bacteria in 1-3 days. These drugs are more effective that Listerine, and they are recommended for prevention of infectious inflammatory complications after intraosseous implantation.