Динаміка показників білкового обміну ротової рідини після комплексного лікування генералізованого пародонтиту у осіб молодого віку на тлі первинного гіпотиреозу

Abstract

The purpose of the study was to evaluate the effectiveness of complex treatment of generalized periodontitis in young people with primary hypothyroidism based on protein metabolism indicators of the oral fluid. Materials and methods. Complex treatment of chronic generalized periodontitis was carried out in 110 patients aged 25–44, who were divided into treatment groups: the main group – 55 patients with hypothyroidism, in whom the developed treatment and prevention complex was used; and the comparison group, which included 55 patients with hypothyroidism, where the treatment was carried out according to the “Protocols of the Ministry of Health of Ukraine for the provision of medical care” in the specialty “Therapeutic dentistry”. The activity of elastase, collagenase, and the content of hydroxyproline in the oral fluid of individuals in the treatment groups were evaluated. Results and discussion. 1 month after comprehensive treatment of generalized periodontitis, the activity of the proteolytic destructive enzyme elastase in the oral fluid of the main group significantly decreased by 3.3 times: from 1.14 ± 0.12 μkat/l to 0.35 ± 0.06 μkat/l, p<0.01. Collagenase activity also decreased by 1.7 times from the digital value of 0.50 ± 0.06 mmol/l to 0.29 ± 0.04 mmol/l, p<0.01. In the current period of observation, in the main group, on the other hand, an increase by 1.4 times in the level of protein-bound hydroxyproline in the oral fluid was observed: from 3.03 ± 0.22 μg/ml to 4.25 ± 0.54 μg/ml, p<0.01. In the main group, 6 months after using the proposed therapeutic and preventive scheme, the stabilization of the indicated indicators was confirmed: the activity of elastase in the oral fluid was 0.36 ± 0.06 μkat/l, the activity of collagenase was equal to 0.32 ± 0.05 mmol/l, the level of protein-bound hydroxyproline in oral fluid was within laboratory norms – 4.16 ± 0.52 μg/ml, p<0.01. 12 months after the treatment of generalized periodontitis in young people with hypothyroidism, who were treated according to the developed scheme, all indicators of protein metabolism of the oral fluid were within the reference range. In patients of the comparison group, positive dynamics of indicators of protein metabolism of oral fluid were observed only in the near term of observation, in the distant terms, the indicated indicators were at the lower limit of the margin and were significantly lower than the initial values before treatment. Conclusion. In young people with hypothyroidism, after comprehensive treatment of generalized periodontitis according to the developed scheme, a decrease in the activity of the destructive enzymes elastase and collagenase and an increase in the concentration of protein-bound hydroxyproline in the oral fluid were observed, which indicates the predominance of the synthetic phase over the catabolic phase in collagen metabolism