THERAPEUTIC ACTION ORAL GEL WITH HYALURONICACID AND QUERCETIN ON THE ORAL CAVITY FORPATIENTS WITH GINGIVITIS

Abstract

Introduction. The problem of the treatment of inflammatory periodontal diseases (IPD) is urgent
worldwide now. Among periodontal diseases, gingivitis is the most common form of periodontal tissue
destruction.
Inflammation processes in gums often reflect the decrease of the barrier and protective functions of
their epithelial layer by disrupting tight intercellular contacts, which promotes the penetration of
pathogenic agents, toxins and the spread of bacteria. Considering the fact that the basis of intercellular
matrix consists of hyaluronic acid, which causes manifestation of many functions of connective tissues,
it gives possibility to use its parodontally protective properties and reduce bacterial invasion by
stabilizing intercellular substance. The pathogenetic link of free radical oxidation with the development
of gingivitis defines the usage of antioxidants and angioprotectors. The usage of quercetin, which is
capable of suppressing the activity of hyaluronidase and reducing fabric penetration in combination with
hyaluronic acid is perspectively alternative method of treating gingivitis.
The purpose of the given paper – to improve the efficiency of treatment of chronic catarrhal gingivitis
by combining the usage of hyaluronic acid and quercetin on the basis of the experimentally and
clinically received data.
Methods. The object of the study was the saliva (oral fluid) in 40 patients with chronic catarrhal
gingivitis (HCG) and 12 healthy volunteers. Examination of patients was carried out at the Department
of dentistry Kharkiv national medical University and Kharkov city dental clinic № 7. The subjects were
selected aged 18-35 without malocclusions, without background pathology of internal organs and
systems. The severity HCG was determined by the level of bleeding gums, redness and cyanosis,
edema and flattening of the gingival papillae objective of periodontal indices. The therapeutic effect of
hyaluronic acid gel and of the drug Circulin (quercetin + inulin + calcium citrate) was assessed by
biochemical markers of inflammation (elastase, MDA), dysbiosis (urease, lysozyme) and the antioxidant
system (catalase) was determined in saliva.
Statistical processing of results was performed using software package SPSS SigmaStart 3.0, the
probability of differences between samples was determined by t-student's criterion. Data was
considered significant at the significance level of 0.95, i.e., p<0.05.
Results. For the first time, the possibility and effectiveness of usage of combined therapeutic action
of HA and quercetin in clinical conditions are established that is proved by a decrease in elastase
activity by 34.5%, MDA - 30%, urease - 62%, the degree of dysbiosis - by 81.5%, an increase in activity
lysozyme - 100%, catalase - by 46.1%, IPA – by 108,6% in the oral fluid of patients.
Conclusions. In the given paper for the first time in the conditions of experimental simulation of
periodontal pathologies in rats the effect of hyaluronic acid, quercetin, and their combinations are
studied at the levels of biochemical markers of inflammation and amount of hyaluronic acid in the
periodontal tissues.

Scientific data on changes in biochemical markers of inflammation and count of HA in periodontal
tissues are expanded and complemented depending on the external pathogens and the time of their
exposure.
For the first time in various experimental models of gingivitis the possibility and efficacy of parallel
use of HA and quercetin in complex treatment of CCG are demonstrated.