Anti-inflammatory systemic pharmacotherapy of periodontitis (a literature review)
A search was conducted in the databases Scopus, Web of Science, MedLine, The Cochrane Library. Periodontal disease is the main cause of tooth loss. Periodontitis is an inflammatory dise-ase caused by a specific microflora and leads to the progressive destruction of the ligaments of the tooth and alveolar bone. This is accompanied by the formation of the gums recession, the formation of periodontal pockets, both separately and mutually. Periodontitis is observed in 9–85 % of children, 70–90 % of adolescents, more than half of adults. Activation of inflammation in the periodontium is inextricably linked with systemic processes in the body, which are accompanied by an inflammatory response, and therefore perio-dontitis is a concomitant factor in coronary heart disease and cerebrovascular disease/ischemic stroke, adversely affects the digestive, cardiovascular, endocrine and other systems. Uncontrolled inflammatory response of the body in the conditions of microbial biofilm, which is tightly adjacent to the tooth surface, leads to the destruction of periodontal tissues, bone loss. If the acute inflammation subsides in time, preventing destruction without the complete return of tissues to homeostasis, it leads to damage caused by neutrophils and chronic inflammation. Systemic anti-inflammatory therapy with the use of non-selective nonsteroidal anti-inflammatory drugs is an important direction of periodontitis therapy, which reduces the intensity of inflammation, minimizes the destruction of periodontal tissues, limits the resource of nutrients for pathogenic microorganisms, prevents resorption of alveolar bone. For the prevention of gastropathy, it is advisable to use a synthetic analogue of prostaglandin E2 misoprostol in the complex therapy. The mana-gement of drug interaction should be used when prescribing nonsteroidal anti-inflammatory drugs to a patient taking sulfonylureas, warfarin, antihypertensive drugs, and the like.