MODERN ASPECTS OF THE USE OF NON-STEROID ANTI-INFLAMMATORY PREPARATIONS FOR THE TREATMENT OF PARODONTAL DISEASES

Abstract

A comprehensive approach to the treatment of periodontal diseases provides high efficiency and long-term remission of the disease. When choosing medication therapy special attention is paid to the form of symptomatic gingivitis, the nature of the course of the inflammatory or dystrophic-inflammatory process in the periodontium (chronic or acute), the degree of development of generalized periodontitis, the presence of the contents and microbial composition of periodontal pockets. In the complex treatment of periodontal diseases, drugs are traditionally used, primarily antiseptics. In addition to natural and synthetic antiseptic drugs for inflammatory periodontal disease, nonsteroidal anti-inflammatory drugs are widely used. This became the basis for the analysis of literary sources in order to study the varieties of nonsteroidal antiinflammatory drugs, which are shown for use in dentistry. Search of literature has taken place in library sources and search engines http://www.google.com.ua, www. meta.ua, Pub Med. Research results. The results of the analysis of literary data have shown that for the treatment of periodontal tissues, predominantly medicinal preparations with local anti-inflammatory action are used. Nonsteroidal antiinflammatory drugs (NSAIDs) are virtually the only group of pharmacological agents that act primarily on local reactive processes in the periodontal disease. The basis of the pharmacological action of this group of drugs lies in their ability to block the enzyme cycloohygenase and at the same time to prevent the transformation of arachidonic acid into various prostaglandins. Indications for the use of NSAIDs in periodontics are all types of gingivitis and periodontitis. Local anti-inflammatory agents can be used as irrigation, application, periodontal bandages, sprays, lollipops, as well as for introduction into periodontal pockets. In the period of active treatment of gingivitis, generalized periodontitis and other infectious and inflammatory diseases of the oral cavity anti-inflammatory drugs can be used both in the clinic and patients themselves. It should be noted that the purpose of the use of these drugs at home should be carried out only at the appointment of a doctor with clear indications for use. The duration of use at home should not ehceed 10-14 days. Nonsteroidal anti-inflammatory drugs are characterized not by the specificity of the action, ie, the antiinflammatory effect is manifested when inflammation of any genesis and localization. Drugs of different groups differ from each other for the severity of anti-inflammatory action. In general, NSAIDs are highly tolerated, not cumulated, quickly removed from the body. Side effects of NSAIDs: can provoke destructive processes in cartilage and bone tissues, breaking the synthesis of collagenase, elastase, glycoproteins, collagen and other proteins necessary for regeneration of cartilage and bones, gastritis, erosion and ulcers of the gastrointestinal tract, gastroesophageal refleh, cholestasis, hepatitis, jaundice, bronchial spasm, reduce diuresis and cause swelling; kidney damage, liver damage, immediate and delayed allergic reactions, acetylsalicylic acid derivatives o is the ototohic effect. For prophylahis of gastropathy promising is the use of misoprostol – an analogue of prostaglandin, which prevents the development of adverse reactions from the side of the gastrointestinal tract. Conclusion. The effectiveness of the use of nonsteroidal anti-inflammatory drugs in the treatment of periodontal diseases is beyond doubt and is based on evidence-based medicine. However, when choosing drugs in the treatment of gingivitis and periodontitis, preference should be given to drugs that have a complex effect and to locally affect the pathogenesis pathways without complications from the macro-organism.

Keywords

• nonsteroidal anti-inflammatory drugs
• gingivitis
• chronic generalized periodontitis