PERIODONTAL STATUS OF PATIENTS WITH DIFFERENT ATTITUDES TO PERIODONTITIS TREATMENT COMPLIANCE

Background.Adherence to periodontal therapy can positively or negatively affect the onset or progression of periodontal disease. Irregular maintenance therapy leads to higher rates of periodontitis recurrence compared to patients who regularly adhere to the treatment regimen. Aim: To establish the relationship between periodontal status and patients' compliance with the treatment of generalised periodontitis and to find out the possible causes of its violation. Materials and methods. The state of periodontal tissues of 104 patients with generalised periodontitis of II degree of severity, chronic course at the age of 35-44 years was examined by conventional methods. The Schiller-Pisarev test, Svrakov iodine number, periodontal pocket depth, PMA index, comprehensive periodontal index, gingival bleeding, and Fedorov-Volodkina hygiene index were determined at the first visit, 3, 6, 9, and 12 months later. Basic and maintenance periodontal therapy was performed. All patients filled out a questionnaire developed by us at each follow-up visit. Results. In 3 months after the baseline treatment, the condition of periodontal tissues was significantly better, with statistically significant improvement in all indicators. After 6 months, the periodontal condition worsened. In 11 out of 58 patients (19%), there was an exacerbation of the inflammatory process, but most periodontal status indicators were better than at the initial examination. After 9 months, deterioration of periodontal tissues was noted by all indicators, they did not have a statistically significant difference with the indicators at the initial examination, before basic periodontal therapy. In 14 out of 80 patients (17.5%) there was an exacerbation of the inflammatory process. After 12 months, the periodontal status was significantly worse than before and almost approached the level at the initial examination. Exacerbation of the inflammatory process in periodontal tissues was recorded in 23 of 94 (24.5%) patients. The regularity of patients' visits for maintenance periodontal therapy was extremely unsatisfactory. Thus, after basic periodontal therapy, 34 (32.7%) out of 104 patients came for maintenance therapy in 3 months, 58 (55.8%) in 6 months, 80 (85.1%) in 9 months, and 94 (90.4%) in 12 months. The results of the survey on the first set of questions show that all patients were given information about their disease, treatment and recommendations for oral hygiene care. However, from 3.4% to 15% of patients did not understand or partially understood the information about their disease. The doctor's information on periodontitis treatment was partly understood by 15-17.6% of patients. The doctor's recommendations for oral hygiene care were not understood or partially understood by 2.5-4.3% of patients. The analysis of answers to the second set of questions showed that 41.4% to 63.8% of patients did not keep their scheduled visits to the doctor, 3.4-29.4% did not fulfill or partially fulfill their doctor's prescriptions, and 10.3-14.9% partially adhered to oral hygiene care. Conclusions. Thus, patients' failure to comply with the treatment of generalised periodontitis leads to a deterioration in their periodontal status. The reasons for the violation of compliance with periodontitis treatment may be factors caused by the actions of both the doctor and the patient.