Course Of Periodontitis Research Articles

ОСОБЕННОСТИ СОСТОЯНИЯ ЗУБОВ И ПАРОДОНТА У ЖЕНЩИН ПОЖИЛОГО ВОЗРАСТА С САХАРНЫМ ДИАБЕТОМ И ОСТЕОПОРОЗОМ

Subject. The subject of this research is the dental health status and related diabetes mellitus and osteoporosis.
 Objective. The objective of this research is to determine specific characteristics of defeat teeth and periodontal tissues, as well the clinical course of periodontitis in elderly patients with diabetes mellitus and osteoporosis.
 Methodology. In a clinical examination of elderly women (aged 55–65) with periodontal inflammation and during their follow-ups at the stage of supporting therapy, three groups were formed (each with 20 subjects). The first group consisted of patients with Type II diabetes mellitus and osteoporosis; the second group consisted of osteoporotic patients; the third (reference) group consisted of patients who were the same age and considered themselves practically healthy at case control studies with follow-ups and periodontal inflammation in remission. 
 Results and discussion. DMFT index was 19.6 ± 2.35 for the patients in the first group, 1.31 times lower for the patients in the second group and 1.38 times lower for the patients in the third group. Russel’s periodontal index was 3.5 ± 0.8 in the first group, 1.46 times lower in the second group and 1.84 lower in the third group. 
 Conclusion. The research found the direct correlation between defeat teeth and more aggressive periodontitis in the patients with Type II diabetes mellitus and osteoporosis. Specific characteristics of defeat teeth are determined by higher Green-Vermillion oral hygiene indices, higher caries intensity with specific prevalence of “D” in both DMFT and DMFS indices. Increasing saliva viscosity decreases patient adaptation and adversely impacts on the organs of the oral cavity in the group of women with Type II diabetes mellitus and osteoporosis.

Berry as an adjunct to nonsurgical periodontal therapy: A clinical trial.

Periodontal disease, a persistent inflammatory condition affecting the tissues around the teeth, is brought on by an imbalance between dental biofilm and the host's reaction, with the potential for tooth loss. Periodontal disease has been linked to an excess of free radicals induced by oxidative stress or antioxidant deficiency. There is a notable oxidative process early in the course of periodontal disease, especially in periodontitis. The objective of the study is to assess if berry supplements can be used as a supplement to nonsurgical periodontal therapy. Forty individuals with chronic periodontitis in total were divided into two groups for this study. Group A received scaling and root planing (SRP), whereas Group B received SRP plus berry supplements. At baseline and on the 28th day, both groups had their probing pocket depth (PPD) and clinical attachment level (CAL) assessed. After then, the data from both time periods were compared. The SPSS software was used to examine the data (Version 23.0). Using an unpaired t-test, the mean PPD and CAL values were compared between the groups. The mean PPD in Group A decreased on day 28 from 4.18 ± 0.12 to 3.06 ± 0.02 while in Group B reduced from 4.21 ± 0.13 to 2.05 ± 0.08. The CAL in Group A improved from 5.05 ± 0.09 to 3.04 ± 0.11 and in Group B from 4.52 ± 0.17 to 2.02 ± 0.08. There was evidence of a statistically significant difference between two groups in terms of mean pocket depth and clinical attachment degree (P < 0.05). Therefore, berries may be an effective treatment for chronic periodontitis when used in conjunction with SRP.

TLR9 Mediates Periodontal Aging by Fostering Senescence and Inflammaging

TLR9 is a critical nucleic acid sensing receptor in mediating periodontitis and periodontitis-associated comorbidities. Emerging evidence implicates TLR9 as a key sensor during aging, although its participation in periodontal aging is unexplored. Here, we investigated whether TLR9-mediated host responses can promote key hallmarks of aging, inflammaging, and senescence, in the course of periodontitis using a multipronged approach comprising clinical and preclinical studies. In a case-control model, we found increased TLR9 gene expression in gingival tissues of older (≥55 y) subjects with periodontitis compared to older healthy subjects as well as those who are younger (<55 y old) with and without the disease. Mechanistically, this finding was supported by an in vivo model in which wild-type (WT) and TLR9–/– mice were followed for 8 to 10 wk (young) and 18 to 22 mo (aged). In this longitudinal model, aged WT mice developed severe alveolar bone resorption when compared to their younger counterpart, whereas aged TLR9–/– animals presented insignificant bone loss when compared to the younger groups. In parallel, a boosted inflammaging milieu exhibiting higher expression of inflammatory/osteoclast mediators (Il-6, Rankl, Cxcl8) and danger signals (S100A8, S100A9) was noted in gingival tissues of aged WT mice compared to the those of aged TLR9–/– mice. Consistently, WT aged mice displayed an increase in prosenescence balance as measured by p16 INK4a /p19 ARF ratio compared to the younger groups and aged TLR9–/– animals. Ex vivo experiments with bone marrow–derived macrophages primed by TLR9 ligand (ODN 1668) further corroborated in vivo and clinical data and showed enhanced inflammatory-senescence circuit followed by increased osteoclast differentiation. Together, these findings reveal first systematic evidence implicating TLR9 as one of the drivers of periodontitis during aging and functioning by boosting a deleterious inflammaging/senescence environment. This finding calls for further investigations to determine whether targeting TLR9 will improve periodontal health in an aging population.

Effect of switching from cigarette smoking to the use of the tobacco heating system on periodontitis treatment outcome: Periodontal parameter results from a multicenter Japanese study

ObjectivesWe conducted a 6-month randomized clinical study to evaluate the impact of exposure to the aerosol of the Tobacco Heating System (THS), a smoke-free alternative to cigarettes, on changes in periodontal parameters after scaling and root planing (SRP) for periodontitis in subjects who were either continuing to smoke cigarettes or had switched to THS.Material and methodsSmokers with generalized periodontitis were randomized to continue smoking cigarettes or switch to THS use. They underwent SRP for up to 8 weeks, with dental assessments conducted at baseline and at 3 and 6 months after the first treatment.ResultsAfter SRP treatment, all groups showed improvements in the mean full-mouth probing depth (PD), full-mouth clinical attachment level (CAL), gingival inflammation score, plaque control record (PCR), and bleeding on probing (BoP). There were no statistically significant intergroup differences. However, as compared to smokers, THS users showed a trend toward more favorable outcomes in BoP, PCR, and PD improvement at sites with higher initial PD (≥7 mm).ConclusionsOur results indicate that SRP improves the course of periodontitis similarly in cigarette smokers and THS users. The beneficial effects of this treatment might mask the favorable changes that may occur upon modifying one of the several periodontitis risk factors, such as cigarette smoking.Clinical trial registrationClinicalTrials.gov, identifer: NCT03364751.

An examination of the risk of periodontitis for nonfatal cardiovascular diseases on the basis of a large insurance claims database.

Although many studies have reported a higher risk of atherosclerotic cardiovascular diseases (ACVD) in people with periodontitis (PD), this has been tested in a few large-scale population-based studies with a longitudinal design. The aim of this study was to investigate whether people with PD status have an increased risk of a nonfatal ACVD event compared to people without PD status. A cohort of 1.2 million participants from a healthcare insurance claims database was studied longitudinally for a period of 8 years. PD status was derived from PD-related insurance claims and ACVD status from ACVD-related insurance claims. Person-time at risk (PTAR) was calculated from the start of follow-up (01 January 2007) for participants with and without PD status until ACVD or event-free censoring (31 December 2014). Time-dependent Cox proportional hazard models were used to calculate the hazard ratio (HR) and to adjust for shared risk factors (age, sex, socioeconomic position and diabetes mellitus). The prevalence of PD was 20.1%, and the cumulative incidence of nonfatal ACVD events was 7.5%. The univariable and multivariable analyses revealed a limited risk of ACVD for participants with PD status (HR: 1.12; 95% CI 1.10-1.14, HR: 1.06; 95% CI 1.04-1.08, respectively). A subgroup analysis of participants ≤35 and > 35 years of age showed that those ≤35 years of age with PD status had a higher ACVD risk (univariable HR: 1.20; 95% CI 1.05-1.37, multivariable HR: 1.21; 95% CI 1.05-1.39). ACVD risk was not increased in participants >35 years of age with PD status (univariable HR: 0.92; 95% CI 0.91-0.94, multivariable HR: 0.96; 95% CI 0.94-0.98). This study based on a healthcare insurance cohort shows that PD can hardly be regarded as a risk factor for nonfatal ACVD. The increased risk is of minor size, and therefore, the proposed role of PD in the development of ACVD events should be reconsidered. Possibly PD plays a role as a risk factor in younger people due to overlapping genetic risk factors of ACVD and a more aggressive course of PD.

Дослідження фізико-хімічних властивостей ротової рідини у працівників промислових виробництв із шкідливими чинниками

The purpose of the study was to investigate the physical and chemical properties of oral fluid in industrial workers with harmful factors. Materials and methods. To conduct this study 2 groups were formed. The main group (81 people) includes workers of three industrial productions of Ivano-Frankivsk region: workers of chemical production, glass production and workers of agro-industrial complex. The control group consisted of 60 administrative and support staff of these industries, who did not come into contact with industrial hazards. The age of the subjects was 25-55 years. Work experience at the factory was from 0.5 to 15 years. The rate of salivation, viscosity and acidity of the oral fluid were studied. Results and discussion. Already in the first year of work in the conditions of harmful production the rate of secretion of mixed saliva in the subjects of the main group was lower compared to the control, but the recorded figure of 0.540.01ml/min was within the generally accepted norm. With work experience of 1-5 years, the secretion rate of mixed saliva in the main group decreased to 0.440.02 ml/min, which is by 1.2 times lower than that with work experience of up to one year and by 1.6 times lower compared to the control. With work experience of 5-10 years, the rate of salivation in the main group increased slightly to 0.470.01 ml/min, remaining significantly lower compared to the control. The lowest salivation rate is 0.390.02 ml/min, recorded in employees with more than 10 years of experience, which is by 1.4 times lower than in the case of experience up to 1 year and by 1.5 times lower than in the control. With the increase in work experience in the main group, there was a progressive increase in the viscosity of oral fluid, the maximum value of which is 2.180.19 MPas, found in people with work experience over 10 years, which is by 1.6 times higher than indicators of the group with experience up to 1 year and by 1.6 times higher than the value of the control group. With the increase of work experience in the subjects of the main group, a decrease in the pH of oral fluid from 6.750.09 with experience up to one year to 6.34  0.03 with experience over 10 years. The pH of oral fluid in subjects with more than one year of experience was lower both compared to 1 year of experience and compared to the control. The obtained data allowed to establish the following changes in the studied parameters: the rate of salivation on average was 0.440.02 ml/min, which is lower compared to the control group (0.730.01 ml/min) by 1.7 times. The mean value of the viscosity of the oral fluid (1.820.07 MPaS) was also significantly higher than the same in the control (1.330.03 MPaS) by 1.3 times. When determining the concentration of hydrogen ions in the oral fluid of the main group, the average pH value was 6.490.05, which is by 1.04 times lower than the value of 6.770.05 in the control group. Conclusion. The results of the study revealed changes in the oral homeostasis of industrial workers exposed to occupational pathogens: a decrease in salivation may indicate a violation of the secretory function of the salivary glands under the influence of harmful factors, which naturally affects increased saliva viscosity. The predominance of acidosis in the oral cavity and the reduction of the protective properties of saliva is an important factor in creating a periodontal situation in the oral cavity of workers and aggravating the course of periodontal disease in this category of the population. The analysis of the received data allows to assume that periodontopathogenic influence of a complex of harmful production factors of industrial production is realized largely due to change of properties of oral fluid of workers

ОСОБЕННОСТИ СОСТОЯНИЯ ОРГАНОВ ПОЛОСТИ РТА У ЖЕНЩИН В ПОСТМЕНОПАУЗЕ

The article analyzes the features of the clinical course of periodontitis in elderly patients with vitamin D deficiency. It revealed a direct correlation between indicators of dental and periodontal status in postmenopausal patients with vitamin D deficiency and the need to take into account the importance of vitamin D in the diagnosis and complex therapy of periodontitis in the studied participants.

IMPACT OF LIPID PEROXIDATION ON COLLAGEN FIBRIL DEGRADATION IN EXPERIMENTAL PERIODONTITIS

Lipid peroxidation analysis and identification of the main damage predictors lead to introduction of new diagnostic and treatment technologies into medical practice.&#x0D; The aim of the study was to evaluate the activity of free radical damage processes and identify their association with collagen metabolism disorders in the disease dynamics in experimental periodontitis.&#x0D; Materials and Methods. An experimental study was carried out on 60 white non-linear rats. A rat model of periodontitis was reproduced according to K.D. Shkolnaya and V.G. Atrushkevich method (Patent RU No. 2625295, December 07, 2017). The overall activity of free radical oxidation and antioxidant potential was assessed according to biochemiluminescence parameters. Lipid peroxidation activity was assessed according to the parameters of primary and secondary peroxidation products. Collagen metabolism was assessed by P.N. Sharaev method.&#x0D; Results. The rat model of periodontitis demonstrated a high level of free radical oxidation parameters. At the same time decrease in the antioxidant potential was observed throughout the experiment. It proved a significant inhibition of the antioxidant system ability to neutralize bioradical oxidation reactions. The resulting free radicals caused the collagen destruction, which formed the frame of the periodontal connective tissue structures. It was confirmed by hydroxyproline increase due to its free and peptide-bound fractions throughout the experiment. Finally, an increase in protein-bound hydroxyproline was determined against the background of high levels of free hydroxyproline, which was explained by the formation of pathological granulations and fibrillar collagen with an inferior short-chain structure.&#x0D; Conclusion. Chronic periodontitis is characterized by disturbances in the bioradical balance followed by the oxidative stress development, which induces the dystrophy of periodontal collagen structures. The data obtained substantiate the use of collagen peroxidation and metabolism markers as diagnostic criteria to predict the course of periodontitis, and also prove the importance of antioxidants.

Дослідження цитокінового спектру ротової рідини хворих із генералізованим пародонтитом на тлі метаболічного синдрому

The purpose of the study was to study the state of cytokine regulation of oral fluid in patients with generalized periodontitis and metabolic syndrome. Materials and methods. For this study, 3 groups of surveys were formed. The main group included 30 people with generalized periodontitis on the background of metabolic syndrome; 30 people with generalized periodontitis, without somatic pathology, formed a comparison group. The obtained results were compared with the data of 20 practically healthy individuals with intact periodontium who were included in the control group. The content of pro-inflammatory cytokines IL-1β, IL-6, TNF-α and anti-inflammatory cytokines IL-4, TGF-β1 in the oral fluid of the study groups was determined by solid-phase enzyme-linked immunosorbent assay. Results and discussion. According to the research, on average, the highest levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) were observed in patients with periodontal disease on the background of metabolic syndrome. We investigated increase in the concentration of proinflammatory IL-1β. The average value of IL-6 in the oral fluid of patients with metabolic syndrome exceeded this figure in persons not burdened with somatic pathology by 1.3 times, the difference with healthy individuals was more significant: the indicators differed by 2 times. That can be considered an immune response to the inflammatory process in periodontal tissues. The next stage is the beginning of the cytokine cascade, which is characterized by increased production of IL-6 and TNF-α – inducers of acute phase protein synthesis. TNF-α causes an increase in the number of free radicals and can lead to intensification of apoptosis. Due to the fact that anti-inflammatory IL-4 blocks the induced expression of pro-inflammatory IL-6 and TNF-α, a decrease in its level in oral fluid can be considered an unfavorable factor in the course of inflammatory-dystrophic periodontal lesions in patients with syndrome X. Given that TGF-β1 is an immunosuppressive factor, a decrease in its concentration indicates a deficiency of local factors of immune protection in patients with periodontal disease on the background of metabolic syndrome. Conclusion. Patients with metabolic syndrome and periodontal disease have significant disorders of cytokine regulation, which are complicated by age: expression of proinflammatory IL-1β, IL-6, TNF-α on the background of reduced anti-inflammatory cytokines IL-4 and TGF-β1. Such changes in cytokine homeostasis indicate chronic inflammation, insufficient efficiency of regenerative processes in tooth-retaining tissues, and, as a consequence, lead to a more severe course of periodontal disease in people with metabolic syndrome

Candida spp. and Actinomyces spp. infections as a probable reason for resistance to periodontal therapy

Relevance. Resistance of periodontal diseases to conservative therapy may constitute up to 7% of all clinical cases and may be due to specific pathogens. Active infection caused by Candida spp. and bacterial infection (formerly known as mycosis) caused by Actinomyces spp. are possible clinical options. Both the absence of described specific clinical manifestations and pathogen variety, ability to morphological transformation and similar unconventional approaches to microbiological diagnosis determine the continuity of the pathological process. At the same time, both the available scientific literature and our clinical work evidenced the detection of a diagnostically significant quantity of Candida spp. and Actinomyces spp. in pockets of patients with a worse response to periodontal therapy. However, most available studies used non-morphological diagnostic methods, which are hard to interpret assess ing the effect of the infectious process on the course of periodontitis. Possible options include the following: from significant etiological reasons, aggravating factors, background process or marker of systemic or local disorders to the dysbiosis caused by antibacterial therapy.Propose. To draw the attention of dental practitioners to the peculiarities of the course of the infectious process in patients with resistance to periodontal therapy.Conclusion. The paper presents specific characteristics of differential diagnosis, risk group assessment, comprehensive approach to local and systemic therapy based on the data from modern literature, our analytics and particular clinical cases.

Perio Tools: A Journey from Inaccuracy to Precision- A Mini Review

Background: In the 21st century dentistry has not only reached an epitome of great inventions but also has established a great milestone in achieving efficiency, efficacy and technological advancement. Technology has not only helped dentistry to grow in its value but also has encouraged the dentists to introduce less traumatic procedures. The course of periodontal disease is obvious by the sporadic and intermittent pattern of disease activity and inactivity showing random or alternate exacerbation and remission. Although microbes were considered to be the primary etiology, they were insufficient to cause a disease all by themselves, environmental, systemic and host response were also a part of the etiotrophic factors. Hence, to understand these complexities various assessment tools and advanced diagnostic aids were developed and introduced in practice. The various chair side diagnostic aids include Advanced Periodontal probes, Advanced radiographic diagnosis, Advanced microbial analysis, advanced immunodiagnostic techniques and molecular biological assays, Advanced biomarker identification and genetic testing and Advanced Chair side diagnostic kits. This manuscript reviews the advancement in the recent chair side diagnostic kits which are frequently studied and relied upon.

CLINICAL AND RADIOGRAPHIC MANIFESTATIONS OF GENERALIZED PERIODONTITIS IN PATIENTS ON THE BACKGROUND OF THE DAMAGE OF CERVICAL INTERVERTEBRAL DISCS

Introduction. In recent years, more and more attention has been paid to the study of the relationship between inflammatory processes in the periodontium and somatic diseases. Systemic processes, in particular, dystrophic lesions of the spine are known to have a significant role, leading to profound changes in the internal environment of the body and structural lesions of the periodontal tissues. The peculiarities of the clinical course of periodontal disease in patients with predominant damage of the cervical intervertebral discs are insufficiently described in the literature and remain relevant. The aim of this work was to study the features of clinical and radiographic indicators of periodontal tissues condition in patients with concomitant lesions of the intervertebral discs of the cervical spine. Materials and methods. Clinical and X-ray examination of 74 patients with the damage of cervical intervertebral discs was carried out: 48 persons of late mature age with stage I chronic generalized periodontitis and 26 elderly patients with stage II–III chronic generalized periodontitis. 40 patients of similar age groups and identical periodontal lesions without comorbidities comprised the control group. Research results. When comparing the clinical symptoms of chronic generalized periodontitis in groups of patients with damage of the intervertebral discs of the cervical spine and without somatic pathology, we revealed: increasing the depth of periodontal pockets and recession of the gums by 12.6% and 34.2% in late mature age subjects and by 10.2% and 16.2% in the elderly; the bleeding index by 19.4% in late mature age subjects and by 38.3% in the elderly; the intensity of exudation from periodontal pockets by 30.3% and 13.5%, respectively, with a high significant difference (p &lt; 0.001). The indicators of furcation in the horizontal and vertical directions according to Tarnow–Fletcher and Hamp, respectively, were also worse in patients with damage of the cervical intervertebral discs. In addition, there was a decrease in the percentage of patients with an initial degree of bone resorption and an increase – with a high degree of bone loss. Conclusions. The clinical and radiographic study of patients revealed a negative impact of dystrophic lesions of the cervical spine on the clinical course of periodontal diseases, its deepening and burdening.

Особливості кверцетину та його вплив на зміни у тканинах пародонта у дітей, які проживають в екологічно забруднених регіонах Прикарпаття

Goal. Improving the effectiveness of treatment of patients with chronic catarrhal gingivitis living in ecologically favorable conditions and in ecologically polluted regions of Prykarpattia, by adding to the complex therapy of quercetin and chlorhexidine dent. The results of research by a number of scientists indicate that the use of quercetin in complex therapy helps to restore the antioxidant system, improve oxygen uptake by tissues and peripheral circulation, improve the rheological properties of the patient's blood. These properties of the drug were used by us in research. Research methods. We studied changes in periodontal tissues in children living in ecologically favorable conditions and in ecologically polluted regions of Prykarpattia, conducted a comparative description of periodontal changes and proposed a treatment plan for patients with chronic catarrhal gingivitis supplemented with chlorhexidine dent and quercetin. We examined 60 children with chronic catarrhal gingivitis living in the contaminated areas of Prykarpattia (Burshtyn) and 15 people with intact periodontium living in environmentally stable conditions. All patients underwent a full range of therapeutic measures, taking into account the removal of dental plaque and rehabilitation of the oral cavity. In 1 group of patients (30 people) patients were treated with chlorhexidine, calendula and chamomile infusion and 1 % mefenamine paste. Patients of group 2 (30 people) – the drug quercetin on the mucous membrane of the gums under the individual gingival cap and chlorhexidine dent in the form of oral baths. For the purpose of comparative characterization of the two groups, an index assessment of the condition of periodontal tissues and a study of rheographic parameters of periodontal tissues were performed. Scientific novelty. At the present stage used drugs chlorhexidine dent 0.12 % and quercetin for the treatment of periodontal diseases in children living in environmentally unfavorable conditions, studied the state of hemodynamics in periodontal tissues, studied rheographic parameters and their dynamics under the influence of treatment and prevention complex in children with chronic catarrhal gingivitis and evaluated the effectiveness of the developed treatment and prevention complex in children with chronic catarrhal gingivitis living in environmentally unfavorable conditions. Conclusion. The results of the study did not show a significant difference between clinical and laboratory parameters in patients 1 and 2 groups before treatment (p &gt; 0.05), but they differed significantly from those in the comparison group (p &lt; 0.05), which points out that unfavorable environmental living conditions have an impact on the course of periodontal disease in children. We found a significant difference in the blood supply to periodontal tissues in patients with chronic catarrhal gingivitis compared with (p &lt; 0.05). The results of the study showed that the use of quercetin and 0.12 % chlorhexidine solution in the complex treatment of patients with chronic catarrhal gingivitis provided a significant improvement in clinical and laboratory characteristics of periodontal tissues in children living in different environmental conditions, and stabilized these indicators in long-term observation.The use of the proposed treatment regimen for patients with chronic catarrhal gingivitis stimulates metabolic processes in periodontal tissues, reduces cyanosis, edema of periodontal tissues according to the results of rheography of periodontal tissues. After treatment, we observe the normalization of the rheological characteristics of the gums, which indicates an improvement in blood circulation in periodontal tissues in these patients (normalization of qualitative and quantitative characteristics of rheograms). Key words: chronic catarrhal gingivitis, ecologically polluted areas, chlorhexidine, quercetin, reorganic changes of periodontium.

Особливості синдрому взаємообтяження за коморбідності пептичної виразки шлунка, ДПК та захворювань тканин пародонту у осіб із незнімними зубними протезами

The comorbid course of peptic ulcer of the stomach, duodenum and periodontal disease indicates common pathogenetic mechanisms of their development and progression. However, researchers do not always take into consideration the influence of dentures, including fixed ones, made of different materials on the course of these diseases. The aim of the study was to investigate the features of the clinical course of periodontal disease in patients with peptic ulcer in the presence of dental prosthetics and without it. To solve the goal and objectives, a study of periodontal tissue in 177 patients with peptic ulcer was performed. Patients were divided into 4 groups depending on the presence of dentures and their structural material: 1st group consisted of 43 people without dentures, 2nd group consisted of 65 people, who had fixed metal dentures: stamped and solid structures, 3rd group – 42 patients with fixed metal-ceramic dentures, and 4th group – 27 people with fixed ceramic dentures. The control group consisted of 20 healthy individuals of the appropriate age. Statistical processing of the material was performed using modern methods of variation statistics. It was found that the prevalence of periodontal disease in patients with peptic ulcer of the stomach and duodenum without dentures and in the presence of fixed dentures differed by 13.8 % (p&lt;0.05). Among the groups of patients with fixed dentures, the highest prevalence of chronic generalized periodontitis of I and II stages of severity was found in the group of patients with fixed metal dentures (60.0% and 29.2%, respectively), which was higher in patients with fixed ceramic dentures in 1.6 times and 2.6 times, respectively (p&lt;0.05). The presence of metal-containing dentures in the oral cavity also adversely affected the course of peptic ulcer of the stomach and duodenum, as it contributed to the development of larger ulcerative defects than in the group without dentures (p&lt;0.05).

EFFECT OF QUERСETIN AND CHLORHEXIDINE-DENT ON CHANGES IN PERIODONTIC TISSUES IN CHILDREN LIVING IN ENVIRONMENTALLY POLLUTED REGIONS OF PRECARPATHIAN REGIONS

The aim of the research is to increase the effectiveness of treatment of patients with chronic catarrhal gingivitis living in ecologically favorable conditions and in ecologically polluted regions of Precarpathian, by adding to the complex therapy of quercetin and chlorhexidine dent. The results of research by a number of scientists indicate that the use of quercetin in complex therapy helps to restore the antioxidant system, improve oxygen uptake by tissues and peripheral circulation, improve the rheological properties of the patient's blood. These properties of the drug were used by us in the research.&#x0D; We studied changes in periodontal tissues in children living in ecologically favorable conditions and in ecologically polluted regions of Precarpathian, conducted a comparative characterization of changes in periodontium and proposed a treatment plan for patients with chronic catarrhal gingivitis, supplemented with chlorhexidine dent and quercetin.&#x0D; We examined 60 children with chronic catarrhal gingivitis living in the contaminated areas of Precarpathian (Burshtyn) and 15 people with intact periodontium living in environmentally stable conditions. All patients underwent a full range of treatment measures, taking into account the removal of dental plaque and rehabilitation of the oral cavity. In 1 group of patients (30 people) patients were treated with chlorhexidine, calendula and chamomile infusion and 1% mefenamine paste. Patients of group 2 (30 people) - the drug quercetin on the mucous membrane of the gums under the individual gingival cap and chlorhexidine dent in the form of oral baths.&#x0D; In order to compare the two groups, an index assessment of the condition of periodontal tissues and a study of rheographic parameters of periodontal tissues were performed.&#x0D; The results of the research did not show a significant difference between clinical and laboratory parameters in patients 1 and 2 groups before treatment (p&gt; 0.05), but they differed significantly from those in the comparison group (p &lt;0.05), which indicates the fact that unfavorable environmental living conditions have an impact on the course of periodontal disease in children. We obtained a significant difference in the blood supply to periodontal tissues in patients with chronic catarrhal gingivitis compared with (p &lt;0.05). The results of the research showed that the use of quercetin and 0.12% chlorhexidine solution in the complex treatment of patients with chronic catarrhal gingivitis provided a significant improvement in clinical parameters and laboratory characteristics of periodontal tissues in children living in different environmental conditions, and provided stabilization of these indicators in long-term observation. The use of the proposed scheme of treatment of patients with chronic catarrhal gingivitis stimulates metabolic processes in periodontal tissues, reduces cyanosis, edema of periodontal tissues according to the results of rheography of periodontal tissues. After treatment, we observe the normalization of the rheological characteristics of the gums, which indicates an improvement in blood circulation in the periodontal tissues in these patients (normalization of qualitative and quantitative characteristics of rheograms).

Clinical and laboratory rationale for the effectiveness of transcranial electrostimulation in the treatment of chronic generalized periodontitis in elderly patients

Relevance. Immunomodulation is becoming increasingly relevant in geriatric dentistry. The administration of this therapy cannot be empirical and requires the study of the corresponding immunological parameters. The study of the gingival crevicular fluid composition allows evaluating not only the immune system ageing processes and their influence on the periodontitis course but the effectiveness of the treatment. The study aimed to evaluate the effectiveness of transcranial electrostimulation (TES) for the treatment of periodontitis in elderly patients and to prove the value of gingival crevicular fluid laboratory testing during immunomodulatory therapy. Materials and methods. We conducted a clinical, prospective, controlled, randomized, unblinded, comparative study. We examined two groups of periodontal patients (68 subjects), aged 60-74, and equally treated them. But the patients in the second group additionally received transcranial electrostimulation (TES). The research included the follow-up assessment of IL-1β, TNF-α, IL-10, sIgA and LDH in the crevicular fluid and periodontal index reduction: SBI and PMA (%), before the treatment and on the 7th, 14th, 21st and 30th day.Results. The study established that the periodontal treatment scheme, which includes TES (immunomodulation), is more clinically effective than conventional treatment. There were statistically significant differences in the clinical and laboratory parameters between the 1st and the 2nd patient groups after the 14th day (p &lt; 0,05). On the 30th day of observation, the described trend persisted: the parameters of crevicular fluid in both groups continued to decrease. Moreover, their mean values were significantly lower in the 2nd group than in the 1st. The level of IL-1β (pg/ml) was 16.9 ± 0.33 and 18.8 ± 0.38;TNF-α (pg/ml): 11.9 ± 0.37 and 14.4 ± 0.4; IL-10 (pg/ml): 11.0 ± 0.35 and 12.9 ± 0.36, respectively (p &lt; 0.05).Conclusion. In elderly patients, TES (as a part of a comprehensive treatment) is more effective clinically than the conventional periodontal treatment alone. In geriatric dentistry, it is of primary importance to test gingival crevicular fluid composition and properties in a laboratory and to select the most significant immunological and biochemical components: IL-1β, TNF-α, IL-10, sIgA, LDH. It allows a periodontist to confirm the changes in the manifestations of periodontitis in the elderly patients and to verify the clinical effectiveness of immunomodulation.

Prevalence and Structure of Periodontal Disease and Oral Cavity Condition in Patients with Coronary Heart Disease (Prospective Cohort Study).

PurposeTo study the incidence and structure of periodontal disease in elderly Moscow residents suffering from permanent coronary heart disease, as well as examine the oral cavity and tooth structure in patients with generalized periodontitis and coronary heart disease.Patients and MethodsStage 1 (studying the incidence and structure of periodontal diseases) enrolled 330 patients over 50 years old: Group 1 consisted of 180 patients (102 males and 78 females) with stable coronary heart disease; Group 2 consisted of 150 dental patients (90 males and 60 females) with periodontal pathology without associated coronary heart disease. Stage 2 enrolled 216 patients with generalized periodontitis (studying features of the generalized periodontitis course depending on the coronary heart disease presence): Group 1 consisted of 145 patients with coronary heart disease and generalized periodontitis (79 males and 66 females), Group 2 consisted of 71 patients with generalized periodontitis but without coronary heart disease (40 males and 31 females).ResultsIt has been established that 172 (95.6%) patients with coronary heart disease had periodontal disease with a predominance of generalized periodontitis in its structure, present in 145 (84.3%) people with coronary heart disease. A more severe clinical course distinguishes generalized periodontitis in patients with coronary heart disease than those without comorbid coronary heart disease. Moreover, it is characterized by a higher mean number of tooth loss (6.21±0.16 vs 4.83±0.12 teeth, p <0.05), more teeth defects (54.69±2.25% vs 21.15±1.27%, p <0.05), higher caries intensity level (11.07±0.32 vs 8.55±0.41, p < 0,05), clinical attachment loss (5.76±0.09 mm vs 4.85±0.10 mm, p < 0.05), and greater depth of periodontal pockets (4.80±0.17 mm vs 3.64±0.21 mm, p < 0.05).ConclusionCoronary heart disease is a favorable prerequisite for the development and progression of periodontal pathology.

The influence of thyroid pathology on the course of periodontal disease in children and ways to correct it (Review)

Iodine deficiency diseases constitute an important medical and social problem, since a significant part of the territory of Ukraine is characterized by biogeochemical indicators of low iodine content in the environment, which is the cause of hypothyroidism development. At the same time, there are many other factors that can trigger the thyroid disorders in children. Epidemiological studies carried out in the Carpathian region have shown that iodine deficiency of varying degrees is specific to this area. Professor M.M. Kovalev's in-depth study of the causes of goitre in Bukovyna showed that along with iodine deficiency, macro- and micronutrient deficiencies associated with certain regions play an important role. Iodine deficiency promotes goitrogenesis and decreases the secretory capacity of the thyroid gland. As a result of reduced intrathyroid iodine in the gland, diiodothyrosine synthesis decreases and monoiodothyrosine increases, the hormone ratio increases due to an increase in the more biologically active triiodothyronine. This compensates for the euthyroid state against the background iodine deficiency. An adaptive manifestation of iodine deficiency is goitre, considered being the main sign of iodine deficiency; as iodine deficiency or thyroid hormone requirements increase, goiter size increases and more severe forms of thyroopathology develop. Iodine deficiency is common in many countries of the world. The analysis of the research data has shown the multifactorial nature of the etiology and pathogenesis of periodontal diseases in children, as well as the significant impact of thyroid disorders on the condition of the human dentition. In this regard, the study of cause-effect relationships between the initial manifestations of thyroid pathology and periodontal tissue changes in children seems relevant and promising in terms of improving methods of diagnosis, prevention and treatment. Keywords: periodontium, diffuse non-toxic goitre, children.

The effect of various modifiers on the course of periodontitis

The purpose of the work is to establish the degree of influence of various modifiers on the course of chronic generalized periodontitis. We examined 83 periodontal patients. During the examination, in addition to the obligatory volume, data on somatic burden and dependence on smoking were included with the determination of the number of cigarettes smoked per day. Bleeding of the gums was determined in the area of all teeth. To determine the rate of progression of periodontitis on the basis of orthopantomogram data, an indirect indicator was calculated — the decrease in the alveolar bone in relation to the patient's age. It was established by the research that the modeling of periodontitis, with an identical hygienic state of the oral cavity of patients, is affected by concomitant somatic pathology, especially diabetes mellitus, making the course of periodontitis worse; and also a bad habit — smoking, which contributes to more pronounced vascular changes in the periodontium in patients with clinical manifestations of periodontitis. Recommendations are given to take into account the concomitant pathology of internal organs and the degree of dependence of patients on tobacco smoking when planning periodontal treatment, in order to correct these risk factors and motivate the patient to cooperate with a doctor.

The influence of gingival biotypes on periodontal health: A cross-sectional study in a tertiary care center

Dimensional characteristic of gingiva is a predisposing factor for initiation and course of periodontal diseases and conditions. Knowledge about variations of gingival biotype among subjects is a prognostic determinant in Periodontics.The purpose of the study was to determine the prevalence of gingival biotypes and to evaluate its influence on various periodontal health parameters.Among the patients who reported to the out-patient section, a cross-sectional study was done on those who satisfied the inclusion criteria.Gingival thickness was measured on six anterior teeth of maxillary and mandibular arch using no.15 endodontic spreader and digital caliper by a single examiner on 112 subjects. Another examiner recorded the clinical parameters pertaining to periodontal health. Subjects with gingival thickness 1.5mm were categorized to thin and those with 2mm into thick gingival biotype.Difference in mean values of quantitative variables was tested by Mann Whitney U test. Bivariate correlation was assessed by Pearson correlation. Multiple linear regression models were developed for modified gingival index and interproximal attachment loss.Prevalence of thin and thick gingival biotype was 48.21% and 39.28% respectively. Mean gingival thickness observed was 1.49±0.59mm. Mean score of all clinical parameters were significantly higher in thin gingival biotype. Gingival biotype had a negative correlation with modified gingival index and interproximal attachment scores.Thicker gingival biotype can be considered to have a protective effect against the development of periodontal pathology.