Features of the clinical manifestation of generalized parodontal diseases in patients with anorexia nervosa

Abstract

Generalized parodontal diseases (GPD) are one of the most common dental diseases, which occupy a significant place in the structure of human diseases, reaching 60–90%. This is due to the complexity of understanding the etio-pathogenetic mechanisms of the development GPD and the high association of them with a number of diseases of the internal organs and systems with common points of contact between interdependence and mutual influence, in particular with anorexia nervosa (AN). Recently, the incidence of AN has increased significantly and poses a serious state, social, psychological and medical problem. There are serious changes on the axis hypothalamus — pituitary — amygdala, genital and thyroid glands, which cause a decrease in thyroid hormone metabolism, cause hypoestrogenia, hypogonadism, secondary hyperparathyroidism due to AN. Objective. To establish the features of the configuration of generalized pаrodontal diseases and their clinical manifestations in the format of basic characteristics of anorexia nervosa statistical methods were used. Objects were 75 patients with GPD, with AN, aged 18–36 years (average age 26 ± 3.8) — the main group (M), and 60 patients with GPD without signs of anorexia of the same age — comparison group (C). For a detailed analysis of the clinical manifestations of GPD in patients with AN, all patients in the main (M) and comparative (C) groups were divided into several subgroups. M1 subgroup — patients with various forms of gingivitis. The M2 subgroup was presented with patients with generalized parodontitis (GP) with AN as the basic pathology. The comparative (C) group consisted of two subgroups (C1), (C2) with different forms of gingivitis and GP, respectively. Results. A high incidence of GPD up to 100% was diagnosed, including both independent parodontal soft tissue disease and all components of the parodontal complex, which had characteristic of all age groups and varied with patient age, duration of AN and its stages. Among the independent forms of gingivitis, the most common was chronic catarrhal marginal gingivitis (86.7 ± 8.8%), with some cases of exacerbation on the background of the overwhelming absence of complaints with single manifestations of aggravation, complexity of psychological alliance. GP was predominantly I–II degree, with chronic course prevailing over other forms of GPD (80 ± 4.6%). Radiographically, in all patients, regardless of the severity of GP, there was an extension of the parodontal cleft and osteoporosis of the bone component of the parodontal complex, horizontal type of resorption. Advantages and priorities of different segments of parodontal complex lesions in patients with AN were not observed. For all patients with GP, a high degree of tissue sensitization to the bone antigen, characterizing significant changes in the bone component of the parodontal complex with AN, was finalized. Conclusion. Thus, direct correlation and interdependence of generalized parodontal diseases in the format of basic characteristics of anorexia nervosa were established.