Factors related to the efficiency of treatment of advanced periodontitis
| dc.contributor.author | Pähkla, Ene-Renate | |
| dc.date.accessioned | 2011-02-28T08:00:31Z | |
| dc.date.available | 2011-02-28T08:00:31Z | |
| dc.date.issued | 2011-02-28 | |
| dc.description | Väitekirja elektrooniline versioon ei sisalda publikatsioone. | et |
| dc.description.abstract | Parodontiit on krooniline infektsioosne haigus, mis haarab iget ja hammast toetavat luud ning ravimata jätmisel lõppeb hamba väljalangemisega. Doktoritöö eesmärk oli saada uusi teadmisi parodontiidi ravi efektiivsuse kohta. Selleks pöörasime tähelepanu mittekirurgilise ravi edukuse mikrobiaalsele hindamisele. Meie uuring näitas, et patsientidele, kelle haigus ei allu rutiinsele mehhaanilisele ravile, on näidustatud igemetasku mikrofloora laboratoorne uurimine. Saadud tulemused kinnitasid, et patsiendi põhine igemetasku mikrofloora määramine on adekvaatse haiguse diagnostika ja individuaalselt sobiva antbiootilise ravi edukuse aluseks. Süsteemseid antibiootikume ordineeritakse patsientidele, kelle haigus ei allu esmasele mehaanilisele ravile. Meie uuring kinnitas, et metronidasool tungib hästi igemevao vedelikku ja sülge. Metronidasooli jaotumine igemevao vedelikus on sarnane ravimi jaotumisega teistes hea verevarustusega kudedes nagu näiteks lihaskude. Seetõttu saab parodontiidi ravis rakendada kõiki metronidasooli kohta käivaid farmakokineetilisi teadmisi. See teadmine aitab kaasa sobiva antimikrobiaalse ravi manustamise viisi valikule. Multivariatiivsete analüüside tulemused näitavad, et haiguse levimus on oluliselt suurem suitsetajatel.Raske generaliseerunud parodontiidi korral osutus mittekirurgiline ravi kombineeritud mikrobioloogilisel analüüsil põhineva süsteemse antibiootikumiraviga üldiselt efektiivseks, kuid suitsetamine halvendas oluliselt parodontiidi ravitulemusi Parodontiidi ravi on kompleksne, patsiendile toob kaasa olulisi väljaminekuid ja ka ebamugavusi. Seetõttu on oluline paremaks haiguse ärahoidmiseks varakult tuvastada riskipatsiendid. Uuringu tulemusena leidsime, et haigete emade lapsed on vastuvõtlikumad igemehaigustele. Tegime kindlaks, et ema igemehaigus omab prognostilist väärtust laste ja noorukite igemete seisundile. Kuna varakult alanud haigus seostub halvema prognoosiga, on spetsiifilise profülaktika vajadus parodontiidihaigete perekonnaliikmetel kõrge. Antud uurimistöö võib olla suhteliselt odava ja lihtsasti realiseeritava riskipatsientide väljaselekteerimise meetodi loomise aluseks. | et |
| dc.description.abstract | Periodontitis is a chronic infectious disease that affects bone and tissue supporting the teeth that if left untreated can result in tooth loss. The purpose of the current doctoral thesis is to gain new knowledge’s about the efficiency of treatment of advanced periodontitis. For that reason it focuses on a microbiological assessment of the microbiological success of non-surgical treatment. We concluded that microbial testing may provide guidance in choosing a specific antibiotic agent mainly in periodontal cases that do not respond to initial therapy. Successful diagnosis and treatment of periodontitis should be based on individual microbiological examination. Systematic antibiotics are prescribed to those patients whose disease does not respond to primary treatment. Our research confirmed that metronidazole efficiently penetrates into the gingival crevice fluid and saliva. The distribution of metronidazole in gingival crevice fluid is similar to distribution of the drug in other well vascularized tissues. Therefore, the general pharmacokinetic data of metronidazole, which have been established in numerous trials, can be also applied in the treatment of periodontal disease. This data provides clinicians with an assurance in choosing the proper route of administration for the antimicrobial agent. The results obtained indicate that the distribution of the disease is significantly higher in smokers. The combination of nonsurgical and systemic antibiotic treatment is effective in the treatment of generalized severe chronic periodontitis. However, smoking habits adversely affect the results of combined treatment. The treatment of periodontitis is complex and incurs substantial expense and discomfort. Therefore it is important to identify patients at higher risk in advance to help prevent the disease. As a result of research, we found that the children of diseased mothers are more susceptible to periodontal diseases. Whereas disease appearing at an early age is associated with a poorer prognosis, the need for specific prophylactics is greater in children of affected mothers. This particular research might serve as the basis for developing an inexpensive and easily accomplishable method for selecting patients at higher risk. | en |
| dc.identifier.isbn | 978–9949–19–592–3 (trükis) | |
| dc.identifier.isbn | 978–9949–19–593–0 (PDF) | |
| dc.identifier.issn | 1024–395X | |
| dc.identifier.uri | http://hdl.handle.net/10062/16553 | |
| dc.language.iso | en | et |
| dc.relation.ispartofseries | Dissertationes medicinae Universitatis Tartuensis;182 | |
| dc.subject | dissertatsioonid | et |
| dc.subject | meditsiin | et |
| dc.subject | parodontiit | et |
| dc.subject | igemehaigused | et |
| dc.subject | antibiootikumid | et |
| dc.subject | stomatoloogia | et |
| dc.subject | mikrobioloogia | et |
| dc.subject.other | dissertatsioonid | et |
| dc.subject.other | ETD | en |
| dc.subject.other | dissertation | en |
| dc.subject.other | väitekiri | et |
| dc.title | Factors related to the efficiency of treatment of advanced periodontitis | en |
| dc.title.alternative | Parodontiidi ravi efektiivsust mõjutavad tegurid | et |
| dc.type | Thesis | en |