Abstract

Systemic sclerosis (SSc) can lead to pathological changes in the maxillofacial region, contributing to the violation of the microbiocenosis of the oral cavity with a predominance of pathogenic microflora.Objective: to study the composition of the oral microflora in patients with SSc. Patients and methods. The composition of the oral microflora was studied in 50 patients with SSc. The control group consisted of 50 subjects without rheumatic diseases. To assess the intensity of dental caries and the level of oral hygiene we used dental indices: the index of caries intensity (Decayed, Missing, and Filled Teeth (DMFT) and the hygienic index (OHI-S).Results and discussion. Microbiological examination in patients with SSc revealed pathogenic Staphylococcus aureus and Candida albicans > 10-6 CFU in equal percentage of cases (18.9%), which was significantly more frequent than in the control group (p=0.049). In the oral cavity in SSc, there were no representatives of normal microflora (lactobacilli). In patients with SSc, the DMFT index was 17.8±7.1 on average, and OHI-S – 2.3±0.7, which corresponds to a very high level of caries intensity and low indicators of oral hygiene, respectively. When analyzing the microflora of the oral cavity in 90% of cases, a dysbiotic shift of the 3rd degree was stated.Conclusion. It can hypothesized that the qualitative and quantitative composition of the microflora of the oral cavity affects the development and severity of inflammatory and destructive pathology of the periodontal and oral mucosa. It is necessary to develop and implement an adapted personal hygiene regimen, including cleansing of the tongue and administration of local probiotics, which, as part of complex therapy, can improve the results of SSc treatment.

Highlights

  • The composition of the oral microflora was studied in 50 patients with SSc

  • The control group consisted of 50 subjects without rheumatic diseases

  • In the oral cavity in SSc, there were no representatives of normal microflora

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Summary

Introduction

Однако множество факторов (возраст, курение, наличие хронических соматических заболеваний, в том числе ИВРЗ, прием лекарственных препаратов, включая иммунодепрессанты) может приводить к изменению микрофлоры полости рта [4,5,6]. ССД может вызывать широкий ряд патологических состояний челюстно-лицевой области (например, сужение ротовой щели из-за уплотнения окружающих тканей), которые негативно отражаются на качестве жизни больного и существенно затрудняют гигиену полости рта, способствуя изменению ее микробиоценоза с преобладанием патогенной микрофлоры [9,10,11]. Простого и неинвазивного метода определения качественного и количественного состава микрофлоры полости рта [12,13,14,15,16], можно диагностировать имеющиеся нарушения и осуществить их персонализированную коррекцию.

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