Ultrasound refers to physical factors that can have a multi-sided therapeutic effect in periodontitis. In therapeutic doses, it affects a variety of local tissue reactions, stimulates compensatory, restorative, protective and adaptive mechanisms. For ultrasound therapy modern industry offers two types of devices that are able to generate ultrasonic vibrations in a wide frequency range: low frequency (2040 kHz) and high frequency (more than 800 kHz).The comparative study of the use of low-frequency and high-frequency ultrasound therapy in the complex of therapeutic measures for periodontitis is now of great scientific and practical interest.

BACKGROUND: One of the most popular antibacterial drugs used in periodontology is Metrogil Denta gel. In recent years, it is most often prescribed as a means of local antibacterial therapy. However, there is practically no information about the use of Metrogil Denta gel ultraphonophoresis in the treatment of periodontal tissue diseases. Therefore, the development of the Metrogil Denta gel ultraphonophoresis technique and the study of its effectiveness in inflammatory periodontal diseases has significant theoretical and practical interest. AIM: This study aimed to explore the influence of various methods of using Metrogyl Denta gel on the microbiota of the periodontal pockets in periodontitis. MATERIALS AND METHODS: In the first group (main), composed of 20 patients with a diagnosis of moderate periodontitis, the treatment procedures included high-frequency ultrasound and application of antibacterial preparation of Metrogyl Denta gel for the periodontal tissue (ultraphonophoresis of Metrogyl Denta gel). In the second group (control), composed of 20 patients with a diagnosis of moderate periodontitis, phonophoresis was not prescribed, and Metrogyl Denta gel was applied into the surface of the gums of the upper and lower jaw two times a day for 10 days. RESULTS: Contents of the pathological periodontal pockets were examined twice: first after dental plaque removal in patients with periodontitis of the main and control groups and then after 10 ultraphonophoresis procedures using Metrogyl Denta gel as a contact medium in the study group or after 10 days of Metrogyl Denta gel applications in the control group. Data analysis revealed that ultraphonophoresis of Metrogyl Denta gel has a more pronounced antibacterial effect in comparison with the injection of this drug. CONCLUSIONS: The combined effect of high-frequency ultrasound and Metrogyl Denta gel makes it possible to create a drug reserve in the periodontal tissues.

As a result of the study, it was found that the removal of dental plaque using low-frequency ultrasound and ozonized contact medium in chronic generalized catarrhal gingivitis of young people can significantly improve the state of microbiocenosis of the gingival sulcus. The preservation of the main resident species is noted, occasional transient species disappear and the frequency of isolation of aggressive representatives of beta-hemolytic streptococci and periodontopathogenic species decreases. When using ozonated water for the removal of dental deposits, the efficiency of eradication of the microbiota of the gingival sulcus, especially of representatives of aggressive species, is higher than when removing dental deposits without the use of ozonated water.

The study is devoted to identifying the frequency of detection of galvanic couple of metal structures in various of the oral mucosal diseases. A high difference in the electrochemical potentials of metal structures in the mouth, exceeding 50 mV, was observed in 33% of patients with glossalgia, while in precancerous diseases, such as erosive and ulcerative form of lichen planus, verrucous form of leukoplakia, limited hyperkeratosis of the mucous membrane, galvanic couple with a high difference in electrochemical potentials were found in 78–87% of cases. Due to the high frequency of detection of metal structures with a high difference of electrochemical potentials in patients with oral mucosal diseases, the study to detect galvanic couples of metal structures should be introduced in the list of mandatory measures in the examination.

The dental status of 148 patients aged 18 to 22 years. All students who were diagnosed with generalized catarrhal gingivitis (46) were carried out removal of dental plaque with ozonation of the environment. The results of clinical studies indicate the high efficiency of the use of the removal of dental plaque using low-frequency ultrasound using an ozonized contact medium in the treatment of chronic generalized catarrhal gingivitis. The treatment carried out using this method contributed to the elimination of inflammation, the normalization of blood circulation in the gums. 3 months after the treatment, the achieved effect was preserved, which was confirmed by the data of clinical and functional research methods. Despite a slight increase in inflammation in the gums and a deterioration in microcirculation indicators, even a year after treatment, the indicators characterizing the degree of inflammatory and microcirculatory disorders in the gums retained significant differences compared to the values obtained before the treatment.

Metronidazole-based preparations are widespread in periodontal practice among those with antibacterial action. However, recently, reports are increasing about the resistance of pathogenic microorganisms to metronidazole. The treatment of this problem is facilitated by the combined effect of metronidazole and physical therapeutic factors, which can ensure the delivery of the antimicrobial agent to periodontal tissues and its deposition. The efficacy of Metrogil Dent gel ultraphonophoresis with low-frequency ultrasound and Metrogil electrophoresis in the treatment of periodontitis has been proven. However, no information is available in the literature about the comparative effectiveness of ultraphonophoresis and electrophoresis of metronidazole-based preparations in the complex treatment of periodontitis, which is of scientific and practical interest.