PHOTODYNAMIC THERAPY WITH METHYLENE BLUE IN CHILDREN WITH CEREBRAL PARALYSIS

Abstract

Children with cerebral palsy suffer from dental diseases almost three times more often than healthy children. Risk factors that cause the development of dental diseases in children with CP include low rates of unstimulated salivation rate, acidity, increased saliva osmolarity and total protein concentration, which indicates a violation of hydration. The above factors contribute to the formation of acquired pellicles and biofilms due to increased bacterial agglutination. Ultimately, this contributes to the accelerated formation of plaque. There is a tendency to increase the concentration of hemoglobin and reduce the degree of oxygenation of oxyhemoglobin and, as a result, to increase the active forms of oxygen and nitrogen, which, in turn, have a toxic effect and lead to cell death. Photodynamic therapy (PDT) using photosensitizers (FS) improves blood filling and the degree of oxygenation in periodontal tissues, and also allows the elimination of bacterial biofilm. At the same time, opto-spectral diagnostics painlessly in the monitoring mode allows to identify and fix tissue areas with low hemoglobin oxygenation rates for precision photodynamic effects. PDT is a method used as a therapy for oral diseases of various origins, such as cancer, precancerous diseases, caries, periodontitis and gingivitis. Initially, methylene blue was the first dye used in medicine as an antiseptic, as well as the first tested and approved photosensitizer for antimicrobial photodynamic therapy. The use of photodynamic therapy with methylene blue as a photosensitizer can allow to deactivate inflammation and completely destroy bacteria in the biofilm, which will contribute to the functional normalization of gum tissue and restore oxygenation in the microcirculatory bed. The advantages of this method are antibacterial, anti-inflammatory and wound healing effects. The article presents the literature data on photodynamic therapy with the use of methylene blue in children, on the methodology and results of the use of this treatment technique in practice.