Research of microcirculatory disturbances after removal of a tooth by using the photopletismography method in atients with diabetes mellitus

Abstract

The aim of the study: to increase the efficiency of diagnosis of microcirculatory disorders in periodontal tissues after tooth extraction in patients with diabetes mellitus.
Materials and methods. Photoplethysmographic examination was carried out in Vinnitsa Regional Clinical Hospital named after N.I. Pirogov (Department of Oral and Maxillofacial Surgery). For the study, 2 groups of patients were selected: a comparison group (50 patients) – patients suffering from diabetes, who underwent tooth extraction without additional local treatment, the main group (50 patients) – patients with diabetes, who underwent tooth extraction was used ozone therapy and insertion of a extracted tooth into the well PRF. The most informative indicators describing blood vessels are as follows: anacrotic phase, photoplethysmographic index (PI), time of fast and slow blood filling, vascular tone index (PTS), peripheral resistance index (IPO), dicrotic index (GI), diastolic index (DS).
Results. At the beginning of the study, almost no microcirculatory disturbances were observed in the main group and in the comparison group. In this case, the photoplethysmographic curve had the correct form and was similar to the curve of healthy tissues. As of the 14-th day in the comparison group, the intensity of blood supply in the area of periodontal tissues was significantly increased in comparison with the main group: the photoplethysmographic index was increased 0.14±0.02 (p < 0.05), but the blood circulation rate was slower due to an increase in the duration rapid blood supply – 0.006 (in the main group – 0.002) (p < 0.05). The height of the first positive tooth of differential photoplethysmogram decreased. Vascular tone in most cases is increased – 36.95±1.09; while in the main group this indicator was 18.02±0.65 (p < 0.05).
Conclusions. Using the photoplethysmographic method allows you to accurately assess the level of blood supply in inflammatory manifestations in patients with diabetes mellitus after tooth extraction, while this method has positive properties: non-invasiveness, a high degree of sensitivity and reliability, ease of research. The use of this method in maxillofacial surgery allows you to accurately determine the effectiveness of the treatment; specify the duration of the rehabilitation period; to identify all kinds of vascular disorders in patients with diabetes mellitus; evaluate the effectiveness of local anesthesia (since anesthesia causes vasospasm; the amplitude of anesthesia can be judged by lowering the amplitude); use this method for plastic surgery and transplantology.