Реологічні властивості ротової рідини та її мінералізуючий потенціал у осіб з генералізованим пародонтитом на тлі уражень шлунково-кишкового тракту

Abstract

The purpose of the study was to investigate the rheological properties of oral fluid and its mineralizing potential in persons with generalized periodontitis on the background of lesions of the gastrointestinal tract. Material and methods. The rheological properties of oral fluid and its mineralizing potential were studied in 100 patients (main group) and 50 patients (comparative group). The overall functional activity of the salivary glands was assessed by the rate of secretion of mixed saliva. Oral fluid was collected for 15 minutes by spitting into graduated test tubes. The rate of salivation (ml / min) was the total volume of saliva collected divided by the time of oral fluid collection. The viscosity of oral fluid was determined using an Oswald viscometer with a capillary length of 10.0 cm and a diameter of 0.4 mm. The surface tension of saliva was determined by the method of T. L. Redinova. In the oral fluid of patients examined the calcium content by the method of A. V. Karakamov and inorganic phosphate by the method of D. F. Boltz [10]. The research was performed in compliance with the basic provisions of the "Rules of ethical principles of scientific medical research with human participation", approved by the Declaration of Helsinki (1964-2013), ICH GCP (1996), EEC Directive № 609 (dated 24.11.1986), orders of the Ministry of Health of Ukraine № 690 dated 23.09.2009, № 944 dated 14.12.2009, № 616 dated 03.08.2012. Each patient signed an informed consent to participate in the study, and all measures were taken to ensure the anonymity of patients. To assess the probability of the obtained results of the study used a variational-statistical method of analysis using Microsoft Excel. Statistical calculation of the results of clinical and laboratory studies was carried out according to conventional methods. Results and discussion. In recent years, a number of researchers have tried to systematize the internal pathology associated with periodontal disease. In foreign literature, a number of priority somatic risk factors for generalized periodontitis, in particular gastrointestinal diseases, have been formulated. In patients with generalized periodontitis on the background of gastrointestinal pathology, an increase in oral viscosity was studied. Oral viscosity along with poor oral hygiene, and decreased local immunity may serve as an additional factor in increasing the formation of plaque, which contributes to the intensification of inflammatory and dystrophic periodontal diseases in this contingent of patients. Increasing the rate of salivation in patients of the main group can be considered as an adaptive-compensatory response of the salivary glands to changes in oral homeostasis. The decrease in the mineralizing potential of the oral fluid according to the surface tension, calcium, phosphorus content and their ratio indicates a decrease in the resistance of the oral fluid and demineralization of the enamel, which leads to deterioration of dental status in patients. It should be noted that in patients with generalized periodontitis on the background of gastrointestinal lesions, the imbalance of the analyzed indicators was more pronounced in almost healthy people with inflammatory-dystrophic diseases of periodontal tissues. In Helicobacter pylori-positive patients of both groups of the study, a decrease in the rheological properties of oral fluid was determined, which indicated more pronounced changes in oral fluid homeostasis compared with the data obtained in Helicobacter pylori-negative patients. Conclusion. The study showed that in Helicobacter pylori-positive patients of the main group the imbalance of physico-biochemical, rheological and remineralizing parameters of oral fluid were more pronounced than in Helicobacter pylori-negative patients of the main group and in Helicobacter pylori-positive patients of the comparison group