Клінічні, імунологічні та метаболічні особливості загостреного і швидко прогресуючого варіантів генералізованого пародонтита

Abstract

Summary. Generalized periodontitis is one of the most common and complex problems of modern dentistry. According to the WHO, its incidence corrects with age: in the group of individuals from 35 to 44 years, the prevalence of this pathology reaches more than 50 %, in people older than 65–78%, which leads to tooth loss in 40 % of cases. The complexity of the problem lies in the fact that generalized periodontitis is a multifactorial disease, which is characterized by a chronic course with a periodic exacerbation of the inflammatory process in periodontal disease. The progression of destructive phenomena in periodontal tissues depends on many reasons, the role of which from the moment of description and to this day remains the subject of debate and debate. The aim of this study is to assess the pathogenetic significance of disorders of the local components of the immune system, cytokine profile, processes of radical and antioxidant status, and features of bone remodeling in patients with aggressive generalized periodontitis. The work is based on the results of comprehensive clinical and laboratory studies of 123 patients with different course of generalized periodontitis. The study used generally accepted clinical, paraclinical and laboratory research methods, supplemented by dental volumetric tomography. The subjects were divided into 2 groups: I – with an aggravated course (62 people), II – with an aggressive (rapidly progressing) course of the disease (61 people), the control group consisted of 20 healthy volunteers. Studies have shown that exacerbated and rapidly progressing chronic generalized periodontitis is manifested by the same type of clinical symptoms and the same state of gingival and periodontal indices. In individuals with a high rate of destruction of periodontal bone structures, the activity of the inflammatory-destructive process and the rate of loss of periodontal bone tissue are caused by functional disorders of varying strengths: the state of local secretory immunity, the processes of free radical oxidation and the antioxidant defense system, changes in the cytokine profile, and is also found bone remodeling dysfunction due to increased processes of bone resorption and decreased bone formation. The need is substantiated, along with anamnestic data, to take into account the degree of increase in the levels of proinflammatory cytokines IL-1β and TNF-α, as well as features of bone metabolism and osteoparotic processes detected using dental volumetric tomography.