Inflammatory Processes In Periodontal Tissues Research Articles

CHARACTERISTICS OF CYTOKINE PROFILE OF ORAL FLUID IN PATIENTS WITH CHRONIC SIMPLE MARGINAL GINGIVITIS

Biomarkers of inflammation can be used as indicators for monitoring the treatment of periodontal diseases, as well as for finding the safest and most effective drugs with different mechanisms of action. The concentration of biomarkers in saliva was determined by enzyme immunoassay and chemiluminescent analysis. The obtained results reflect the degree of activity of inflammatory processes in periodontal tissues that occur in gingivitis and reveal an imbalance in the processes of free radical oxidation and antioxidant protection of the oral cavity.

MODERN SCIENTIFIC VIEW ON THE OPTIMIZATION OF TREATMENT OF PERIODONTAL DISEASES

The article presents a retrospective review of professional domestic and foreign literature on modern aspects of treatment of inflammatory periodontal diseases, including vector therapy, plasmalifting, which can be used in various forms of this pathology. Periodontal diseases are one of the most pressing problems of dentistry, which has not only general but also great social significance, due to the high prevalence, intensity of the process, the subsequent formation of chronic odontogenic foci of infection, tooth loss at a young age and adverse effects on the body. Treatment of periodontal disease is a complex and lengthy process that includes general methods of influencing the pathophysiological processes occurring in the body, both local - therapeutic, orthopedic and surgical measures. Before planning treatment, the dentist should determine the patient's medical and dental history, conduct clinical and radiological examinations, determine the degree of loss of the alveolar ridge, functional disorders of the dental system and the possibility of their correction. Depending on this, determine the plan of treatment and rehabilitation measures, the sequence of medical interventions. The main task of periodontal treatment is to optimize the conditions for maintaining a healthy dentition and restoring its physiological functions. The difficulty of treating inflammatory periodontal diseases is that known and standard methods (antibacterial therapy and courses of local therapy) do not always give a positive result and a long period of remission. Therefore, to improve the quality of medical care for patients with periodontal pathology, it is necessary to introduce new innovative methods of treatment in dental practice. Given the patterns of pathophysiological processes occurring in periodontal tissues and bone tissue of the alveolar process, to date, several stages of treatment and rehabilitation measures have been proposed. The first stage is the elimination of the pathogenic action of microbial factors and inflammatory processes in periodontal tissues. Microbial invasion and the inflammatory reaction of periodontal tissues caused by it activate the processes of osteoclastical bone resorption. The task of the second stage of treatment and rehabilitation measures is to restore the physiological structure of gums and bone by normalizing metabolic processes in periodontal tissues, reducing the activity of resorption processes and stimulating reparative osteogenesis in the bone tissue of the alveolar process and the body in general, surgical treatment. At the third stage of treatment and rehabilitation measures, teeth with a significant degree of atrophy of the alveolar process are removed, which cannot be used for prosthetics. To restore the integrity of the dentition, even distribution of masticatory load, appropriate prosthetics are performed. The use of the latest methods contributes to the effective treatment of periodontal disease in the early stages, stabilization of the process at deeper stages, in some cases helps to avoid surgery.

The anti-inflammatory and osteoinductive effect of Simvastatin, possibilities of its use for treatment of periodontal diseases

The successful use of surgical and medical methods for the treatment of jawbone restoration has been convincingly confirmed in clinical practice. At the same time, technologies for potentiating the osteoinductive properties of osteoplastic materials to restore bone volume continue to develop. The inclusion of statins in the composition of osteoplastic materials alone or in combination with MSCs is one of the new and promising areas of regenerative action. Objectives — collection and analysis of scientific data on the influence of SMV on the differentiation of MSCs, the participation of SMV in inflammatory processes in periodontal tissues, the search for prospects for the use of SMV as a component of complex therapy of periodontal diseases. Materials and methods. The research of data has been carried out on the databases: PubMed.com, ScienceDirect.com, eLibrary.ru, by the following key words: “simvastatin” AND “periodontitis”, “simvastatin” AND “stromal mesenchymal cells” over the time period from 2014 to 2020; the articles have been selected on the basis of a number of experimental works. Results. The main cellular and genetic ways of implementing the work of SMV in relation to MSCs and periodontal diseases were emphasized, the correlation between the dose-dependent use of SMV with the differentiation of MSCs and the severity of the inflammatory response in periodontal diseases was revealed. Conclusion. SMV is a promising tool for periodontal diseases both at the inflammatory and rehabilitation stages.

The degree of influence of the types of selected microcultures from subgingival zone on diferent nosological forms of periodontal diseases in young people

The development and course of periodontal disease in young people is characterized by sluggish clinical symptoms, and at the initial stage are asymptomatic, which greatly complicates its timely diagnosis. Therefore, it is especially important to find methods of early diagnosis and prediction of periodontal disease, which will allow for a rational comprehensive prevention. Among the causes of periodontal disease, the main role belongs to the microorganisms of dental plaque, which has important diagnostic value.The aim of the study. To investigate the composition of mixed microcultures of subgingival plaque bacteria in young people with different nosological forms of periodontal disease and to assess the degree of influence of microbial factors on the development of periodontal diseases.Materials and methods. The state of microbiocenosis in the subgingival zone in 104 people with periodontal disease and in 94 people with intact periodontal tissues were studied. To assess the severity of the influence of the types of selected microcultures of the subgingival zone on the development and progression of periodontal disease in young people, the method of alternative sequential analysis of Wald and Bayes’s formula was used.Results. With the development of the inflammatory process in periodontal tissues in most cases revealed cultures characterized by the presence of polymorphic gram-negative bacteria that developed, fixed on the solid phase, and in the liquid phase contained coccal microflora (53.01±5.48 %). During the development of generalized periodontitis, an increasing number of microcultures with a predominance of gram-negative microflora with pronounced adhesive properties was detected, which led to the development of these microcultures on the solid phase (61,9±10,6 %). The calculation of prognostic coefficients showed that the presence of microcultures that developed in the planktonic phase, but contained gram-negative rod-shaped bacteria and cocci were highly important in terms of the development of periodontal disease (+7.46).Conclusions. With the development of the pathological process in periodontal tissues, the state of the microflora changed in the direction of increasing gram-negative polymorphic microflora with pronounced adhesive properties that are capable of aggregation (up to 53.01 % in patients with catarrhal gingivitis, up to 90,48 % – with generalized periodontitis). The result of calculation of the severity of isolated types of microcultures from subgingival zone on the development and progression of periodontal disease in young people showed that the presence of microcultures that developed in the planktonic phase, but contained gram-negative rod-shaped bacteria and cocci were highly important in terms of the development of periodontal disease

РОЛЬ ЛЕЙКОЦИТАРНЫХ ПРОТЕИНАЗ В ПАТОГЕНЕЗЕ ВОСПАЛИТЕЛЬНЫХ ЗАБОЛЕВАНИЙ ПАРОДОНТА

Subject. Despite the constant efforts of practicing physicians and scientists, the prevalence proportion of inflammatory and destructive periodontal diseases in the world is not subsiding. Previously scientists have examined several different theories on the development of pathological conditions in periodontal tissues, ranging problems from the neurotrophic theory of occurrence to the effect of occlusion injury on periodontal tissues. Theories dealing with the influence of specific and non-specific bacterial plaque have also been studied. None of the theories has become reasonable and single valued. It is believed that the mechanism of the development of the disease is complex, autoimmune, damaging primarily collagen, elastic fibers of the capillary endothelium, gingival ligament and bone tissue. Over the past decade, it has been proven that inflammation in periodontal tissues is initiated and proceeds in response to the introduction of pathogenic bacteria. However, it can be said that not all patients develop an inflammatory response to bacterial invasion. The second important factor in the development and progression of the inflammatory-destructive process is the immune response of a particular individual. Scientists have noted the influence of the non-microbial factor and have come to the conclusion that in the surrounding tissues of the inflamed area there are not only enzymes secreted by bacteria, but also leukocyte proteinases, which in turn are mediators of the tissue destruction. Purpose ― to examine the role of leukocyte proteinases in the pathogenesis of inflammatory periodontal diseases. Methodology. The number of indigenous and foreign literature sources dealing with the study of the role of leukocyte proteinases in the development and maintenance of a destructive inflammatory process has been reviewed by us. Conclusion. The role of the aggressive destructive effect of leukocyte proteinases on periodontal tissues has been analyzed. Leukocyte proteinases are mediators of progressive destruction of connective tissue and can be used as markers to assess the severity of the course and predict the development of the inflammatory process in periodontal tissues.

Cytokines differently define the immunomodulation of mesenchymal stem cells isolated from the periodontal ligament

Background & Aim Periodontal ligament derived mesenchymal stem cells (hPDLSCs) fulfil the minimal criteria of the International Society for Cellular Therapy (ISCT) for mesenchymal stem/stromal cells. In periodontal tissues these cells play a crucial role in tissue homeostasis and regeneration. The in vivo function of hPDLSCs is mainly executed by their immunomodulatory properties and is reciprocally affected by inflammatory cytokines which are secreted by immune cells. Such inflammatory cytokines are interferon (IFN)-γ, tumor necrosis factor (TNF)-α and interleukin (IL)-1β, which trigger various signaling pathways and consequently may regulate immunomodulatory activities of hPDLSCs differently. The effect of these cytokines on hPDLSCs’ immunomodulation was not directly compared, so far. Methods, Results & Conclusion Hence, we directly compared in an indirect in vitro co-culture model the effect of IFN-γ, TNF-α or IL-1β treated primary hPDLSCs on CD4+ T lymphocyte proliferation. Further, the expression levels of the immunomodulatory factors indoleamine-2,3-dioxygenase-1 (IDO-1), programmed cell death 1 ligand 1 (PD-L1), programmed cell death 1 ligand 2 (PD-L2), TNF-inducible gene 6 protein (TSG-6) and prostaglandin E2 (PGE2) in cytokine treated hPDLSCs were directly compared. Additionally, IDO-1, PD-L1 and prostaglandin-endoperoxide synthase 2 (PTGS-2) were inhibited pharmacologically to compare their effects on CD4+ T lymphocyte proliferation under different cytokine conditions. CD4+ T lymphocyte proliferation was significantly decreased by hPDLSCs. This effect was intensified in the presence of IL-1β and IFN-γ but not by TNF-α. IFN-γ treated hPDLSCs showed a significantly stronger inhibition of CD4+ T lymphocyte proliferation than by IL-1β treated hPDLSCs. All three inflammatory cytokines showed significant different effects on the production of immunomodulatory factors in hPDLSCs. IDO-1, PD-L1 and PD-L2 expression levels were strongest increased by IFN-γ, PTGS-2 levels mainly by IL-1β and TSG-6 by IL-1β and TNF-α to a similar extent. Additionally, pharmacological inhibition of IDO-1, PD-L1 and PTGS-2 reversed the suppression of CD4+ T lymphocyte proliferation to different extent depending on the present cytokine. This study shows that cytokines variously activate immunomodulatory mechanisms of hPDLSCs probably due to boosting the production of different immunomodulatory factors. This may be involved in fine-tuning local inflammatory processes in periodontal tissues.

ORAL CARE AND CHOICE OF MEDICINES FOR TREATING GINGIVITIS AND PERIODONTITIS IN CHILDREN WITH TYPE 1 DIABETES MELLITUS

The anatomical and physiological characteristics of a growing organism require a specific approach to the prevention and treatment of periodontal diseases. Not enough attention is paid toward improving the oral health of children suffering from diabetes mellitus, as well as therapeutic and prophylactic measures aimed at preserving teeth and preventing exacerbations of the inflammatory process in periodontal tissues. The results of clinical studies indicate a high prevalence of dental diseases in patients with type I diabetes mellitus; there are not enough reliable results of such indicators depending on the age and duration of this endocrine pathology, diabetic complications, hypoglycemic therapy taking into account metabolic control. Diagnosis of periodontal diseases is complicated by the peculiarities of the child’s psychological perception, caused by age-specific characteristics and the influence of common manifestations of inflammatory diseases. Children of primary school age often demonstrate increased motor activity, a hyperergic reaction even to minor negative feelings, the difficulty of adequate behaviour in an unfamiliar environment and a correct assessment of what is happening, being stressed due to the presence of many phobias associated with doctors and medical manipulations, communicative difficulties caused by staying in the spotlight, meeting new people, talking with adults. Teaching children must necessarily be accompanied by educating parents, since within limited time interval of dental appointment a doctor does not have the opportunity to fully monitor and consolidate the knowledge and skills the child has received, and this responsibility falls on parents. In this case, some attention should be paid to issues of skills, motivation as well as on the importance dental care aspects for the development of the dentofacial system, since in the vast majority of cases, parents are not enough aware on these issues. In addition to educating and fostering the motivation, it is necessary to control the level of knowledge, the frequency and quality of tooth brushing. For young children, it is necessary to do complete cleaning up the chewing group of teeth due to the low level of children’s manual skills.

SINGLE-NUCLEOTIDE POLYMORPHISMS OF THE ESR1 [RS 2234693], IL-1 [RS1143627], RANKL [RS9594738] AND [RS9594759] GENES AS POSSIBLE RISK MARKERS FOR VARIOUS VARIANTS OF THE COURSE OF PERIODONTAL DISEASE IN PATIENTS BORN MACROSOMIC

The article is concerned with the research for genetic predictors of periodontal tissue diseases in individuals born to macosomіс.
 Purpose of this study is to identify the association between the polymorphic variants of the CYP19A1 [rs2414096, rs936306], ESR1 [rs2234693, rs9340799], IL-1b [rs1143627], IL-6 [rs1800796], IL-10 [rs1800896], RANKL [rs9597575] and VDR [rs 1544410, rs10735810] genes and the formation of periodontal tissue disorders with a predominance of inflammatory (periodontitis) or dystrophic (paradontosis) flow patterns in of Kharkiv and the population of adjacent district who were born by macrosomic delivery.
 Object and Methods. The molecular genetic method was used to examine 81 persons of different ages (from 18 to 55 years old) who live in the Kharkiv and adjacent districts (Ukraine). The participants in the study were divided into 3 groups. The pathological changes in periodontal tissues were recorded by the classification of periodontal diseases (M.F. Danylevskyi, 1994).
 The macrosomic-at-birth participants who were diagnosed with chronic periodontitis (of the initial, first, or second degree) were assigned to the general group with a predominance of inflammatory processes in periodontal tissues. The macrosomic-at-birth participants who were diagnosed with parodontosis (of the initial, first or second degree), were assigned to the general group with a predominance of dystrophic processes in periodontal tissues. The comparison group consisted of the individuals with a conventionally healthy periodontium.
 The DNA was isolated from the buccal epithelium. The genotyping of SNP was carried out by Real-Time PCR.
 Conclusions. 1. The risk of dystrophically-inflammatory diseases of periodontal tissues with prevalence of both dystrophic (parodontosis) and inflammatory (periodontitis) flow patterns is associated with variants of the IL-1b gene: [rs1143627] (an over-dominant model of inheritance) in individuals born macrosomic. 2. The protective effect during periodontal tissue diseases with a tendency to inflammatory course was associated with the ESR gene variants [rs 2234693] (recessive model of inheritance) and IL-1b [rs1143627] (dominant and multiplicative model of inheritance). 3. A more pronounced effect of the IL-1b gene variant: [rs1143627] on the development of processes with a tendency to inflammatory course in the periodontal tissues (additive, dominant, over-dominant and multiplicative models of inheritance versus over-dominant model of the tendency to dystrophic flow) was recorded. 4. The risk of developing of pathological processes in periodontal tissues with a tendency to a dystrophic course rather than to an inflammatory course, associated with the RANKL [rs9594738] gene variants (dominant and multiplicative models of inheritance) and RANKL [rs9594759] variant (dominant model of inheritance). 5. Analysis of variants of the ESR1 [rs 2234693], IL-1b [rs1143627] and RANKL [rs9594738], [rs95944738], [rs95944738] gene variants is proposed to be used for DNA diagnostics at the preclinical stage of the disease in order to highlight the risk group for the development of periodontal tissue disorders and increase the effectiveness of personalized preventive measures in individuals born macrosomic.

PERIODONT TISSUES STATUS AND FEATURES OF CLINICAL COURSE OF APICAL PERIODONTITIS OF PERMANENT TEETH WITH DISORDERS OF ROOT FORMATION AS A RESULT OF INJURY

Relevance. In childhood, traumatic tooth injuries are often found. Pulp necrosis occurs in 34,2 % of injured teeth, this causes damage to the periapical tissues. The post-traumatic complications (odontogenic cysts, periodontitis) in teeth with incomplete root formation often lead to a halt in root development. Chronic nidus of infection can be the cause of the somatic pathology development. This makes the early clinical and radiological diagnosis of post-traumatic complications important.
 Objective of the work is to study the clinical features of the post-traumatic periodontitis of permanent teeth with incomplete root formation of the tooth and to assess the condition of periodontal tissues in permanent teeth with impaired root formation as a result of trauma based on data from clinical and radiological studies.
 Materials and methods. On follow-up there were 17 children 9-15 years old with post-traumatic periodontitis of permanent teeth with incomplete formation of the root of the tooth. When making the diagnosis, we relied on data from clinical and radiological studies.
 Results. Most children complained of an aesthetic defect. 9 children (52,9 %) after an acute tooth injury did not seek the help of a dentist, аfter treatment of 8 children, dynamic observation was not conducted. In 76 % (13 teeth) periodontitis is diagnosed in teeth with a crown fracture within the enamel, enamel and dentin.
 It has been established that chronic granulating periodontitis is the most common form among destructive forms of periodontitis (12 teeth – 70,6%). Exacerbation of chronic granulating periodontitis diagnosed in 5 teeth. We did not ascertain chronic granulomatous periodontitis in teeth with incomplete root formation. The prevalence of the granulating form of chronic periodontitis in children is due to the histomorphological features of periodontal disease in childhood.
 8 children, among the examined had a bite pathology – protrusion of the teeth of the front of the jaw (5 children) and a distal deep bite (3 children). In 71% of lesions, destructive forms of periodontitis were most often diagnosed in the maxillary incisors.
 Conclusion. Untimely seeking help and the lack of dynamic monitoring of injured teeth are the main reasons for the development of post-traumatic periodontitis. The clinical course of periodontitis is peculiar – chronic granulating periodontitis predominates, the inflammatory process in periodontal tissues in childhood is characterized by rapidly progressive destruction of bone tissue. Malocclusion can be a risk factor for tooth injuries.

THE INTENSITY OF CHRONIC CATARRHAL GINGIVITIS IN CHILDREN DEPENDING ON THE AGE

The aim: To determine the degree of severity of the inflammatory process in periodontal tissues of children living in different ecological conditions. Materials and methods: With the purpose of estimation of the condition of periodontal tissues the epidemiology examination of 642 children that live on territory with the high level of pollution and natural deficit of iodine and fluorine was conducted. Results: The study found that the increase of age of examined children causes the decrease of percentage of easy degree of severity of chronic catarrhal gingivitis, giving way to the advanced forms of the disease, and this process was more pronounced in children living in ecologically polluted region. In children-inhabitants of ecologically clean region easy degree of severity of chronic catarrhal gingivitis met more often than their peers living in environmentally polluted region. At the same time, average and heavy degree of severity of chronic catarrhal gingivitis in children living in ecologically contaminated region met more often than their peers, inhabitants of ecologically clean region. Conclusions. It was found that with increasing age of the examined children decreases the percentage of chronic catarrhal gingivitis of moderate severity.

Dynamics of crystallogenic properties of the oral fluid and periodontal status when using toothpaste with fluoride

Within 6 weeks a group of students was observed, which was divided into 2 subgroups depending on the activity of the carious process and with characteristic changes in crystalloscopy of the oral fluid. Clinical trials of parodontax anti-inflammatory toothpaste with fluorine were conducted. The properties declared by the manufacturer were evaluated using clinical, biochemical, laboratory studies, and criteria-based assessment of crystalloscopic features of the oral fluid. The study revealed a statistically significant correlation of the cleaning ability of the hygiene product and crystalloscopic properties of saliva and changes in the clinical picture of chronic catarrhal gingivitis. With the inclusion of a comprehensive anti-inflammatory toothpaste containing fluorine and natural herbal extracts, a shift in the acid-base balance of the oral fluid to the alkaline side was recorded. The improvement in the oral hygiene indices and the resolution of inflammatory processes in periodontal tissues prove the efficacy of comprehensive treatment of chronic gingivitis including parodontax toothpaste.

AN INFLUENCE OF INFLAMMATORY DISEASES OF GASTROINTESTINAL TRACT ON PARODONTIUM IN CHILDREN

Diseases of gastrointestinal tract refer to the most widespread patholigical conditions of infancy and constant 25,5-31,3% from general mirbidity. Inflammatory diseases of gastrointestinal tract are often accompined with damage of dentofacial system. Oral cavity is the first element of gastrointestinal tract, so even the smallest changes can have manifestations on oral mucosa, periodontal tissues, teeth of children. Microflora in oral cavity and endogenic and pathogenic factors can give an opportunity to define dental diseases in children with diseases of gastrointestinal tract to diseases of systemic factors of etiology and pathogenesis. The aim is to analyze data about correction between oral cavity disorders with diseases of different regions of gastrointestinal tract in order to determine further developments of possible preventive measures, which will prevent the development of damage. The problem of periodontal tissues in children is one of the main issue for modern dentistry. Scientific investigations proved that initial changes during catarrhal gingivitis without timely treatment causes severe forms of parodontitis. Low level of oral hygiene is the main factor of plaque formation, which has high potential for pathogenic factor and it can seen as the main factor of inflammatory process of periodontal tissues. Transcription factors are factors present in cytoplasm of main cells and during activation they are transported in the nucleus to regulate the manufacturing of Inflammatory mediators. However, there are a lot of Information about inflammatory mediators of periodontal tissues damage, but nowadays the role of transcription factors has not studied yet. Nuclear factor-kappa B(NF-kB) and signal arrangaments and transcription activators 3(STAT3) are two main factors of transcription, involved in chronic Inflammatory diseases. But their significance in periodontal tissues, pathogenesis has not studied. Researches proved, that cytokines are trigger of inflammatory process in periodontal tissues and precusors of patholigical changes. Cytokines are primary line of activation of immune response, determine the efficacy and type of immune reaction on infectious and non-infectious agents, regulate inflammatory immune reactions. Having analyzed different scientific sources, it has been defined, that nuclear factor of transcription NF-kB and its manifestations during periodontal tissues inflammation in children has not practically studied.

ДИНАМИКА КЛИНИЧЕСКИХ И ИММУНОЛОГИЧЕСКИХ ПОКАЗАТЕЛЕЙ ПРИ КОМПЛЕКСНОМ ЛЕЧЕНИИ КАНДИДА-АССОЦИИРОВАННОГО ПАРОДОНТИТА

Subject. The problem of complex treatment of candida-associated periodontitis is considered. The authors propose a two-component probiotic, which, due to antagonistic activity regarding periodontal pathogenic infection and fungi of the genus Candida, leads to the relief of the inflammatory process, positive dynamics and stabilization of immunological parameters.
 The aim ― to evaluate the dynamics of clinical and immunological parameters in the complex treatment of candida-associated periodontitis with an average degree of quantitative seeding of periodontal pockets using a two-component probiotic.
 Methodology. A clinical and laboratory examination of three groups (I, II, III) of patients with Candida-associated periodontitis with an average degree of quantitative contamination of periodontal pockets (> 3 <6 CFU / ml) was carried out. Patients I groups were prescribed the well-known complex treatment including an antimycotic drug, patients II groups included a two-component probiotic locally in the treatment complex, and patients III groups locally and per os. The state of the oral mucosa was assessed, PMA, PI, OHI - S were determined, and indicators of cellular and humoral immunity were examined.
 Results. The study made it possible to establish that the inclusion of a two-component probiotic in the complex of treatment of candida-associated periodontitis with an average degree of quantitative contamination of periodontal pockets with fungi of the genus Candida contributes to the relief of the inflammatory process, an increase in phagocytosis, the metabolic activity of neutrophils, the concentration of immunoglobulins A, lysozyme levels, and a decrease in the concentration of immunoglobulins. G, positive dynamics of other indicators of immunity and their stabilization.
 Conclusions. The inclusion of a two-component probiotic from two strains in the complex treatment of chronic hepatitis C associated with fungi of the genus Candida contributes to the rapid relief of the inflammatory process in periodontal tissues, positive dynamics and stabilization of cellular and humoral immunity parameters.

Effeciency of Initial-I Stage Generalized Periodontitis Treatment Among Medical University Students According to Indicators of Oral Cavity Prooxidant-antioxidant System

Periodontal diseases are one of the most important problems in dentistry, due to its very high dissemination. Inflammatory processes in periodontal tissues are more common among young people, which, in the future, without adequate treatment lead to irreversible changes in structure of cellular bone. This causes development of new effective therapeutic complexes aimed at eliminating etiopathogenetic factors development of periodontal tissues inflammatory diseases and the targeted influence on the pathological processes in these tissues.
 The objective of the study was to analyze the efficiency of suggested initial-I stage generalized periodontitis treatment among second-year students of medical university.
 Materials and methods. To achieve this goal, we examined and treated 50 students with initial-I stage of generalized periodontitis without somatic pathology, which were divided into two groups, depending on treatment method. First group included 25 students who received advanced treatment; second group included 25 students, who received usual treatment. Control group consisted of 20 clinically healthy students. The state of oral cavity prooxidant-antioxidant system was determined by the level of malone dialdehyde (MDA), diene conjugates (DK), superoxide dismutase (SOD) activity, glutathione-S-transferase (G-ST), and the activity of glutathione peroxidase (GPO).
 Results and discussion. Periodontal diseases, namely, initial-I stage of GP, are accompanied by an imbalance of oral cavity prooxidant-antioxidant system indicators. This is confirmed by an increase number of MDA and DK (p<0.001), and a decrease in SOD, G-ST, GPO (p<0.001) compared to clinically healthy students.
 Conclusions. The results of GP treatment in first group were significantly better in relation to the second one (p<0.05), indicating the effectiveness of the proposed advanced treatment of initial-I stage of GP.

Найближчі результати лікування загостреного перебігу генералізованого пародонтита у хворих з переважанням парасимпатичної нервової системи

Objectives. The exacerbated course of generalized periodontitis has certain features of clinical course and, accordingly, complex treatment. In the emergence of an exacerbated course of periodontal disease, the general condition of the patient's organism is of particular importance. Taking this into account, a medicamental treatment scheme for the exacerbated course of generalized periodontitis in patients with a predominant parasym pathetic autonomic nervous system was proposed.Aim. The determination of the nearest results of clinical efficacy of the proposed complex treatment of patients with exacerbated course of generalized periodontitis in the presence of parasympathetic nervous system predominance. Materials and methods. Clinical investigation was conducted on groups of 60 patients with exacerbated course of generalized periodontitis and prevalence of the parasympathetic nervous system. Medicamental treatment of 40 patients was performed using proposed sedation composition. Patients were conducted a comprehensive examination of periodontal tissue before treatment and after treatment. To evaluate the clinical efficacy of treatment used Schiller-Pisarev test (1962), the index of PMA by C. Parma (1961), hygienic index OHI-S (1964), the vacuum test by Kulazhenko (1961).Results. As a result of the investigation it was found that the usage of the proposed sedation composition in the complex therapy of patients with exacerbated course of generalized periodontitis can effectively inhibit the dystrophic inflammatory process in periodontal tissues. This confirms by the decline in the index PMA, increase the time of formation of hematoma during the vacuum tests on Kulazhenko, improving oral hygiene.Conclusions. Usage of the proposed sedation composition increases the effectiveness of treatment of exacerbated course of generalized periodontitis in patients with predominance of the parasympathetic nervous system.Key words: exacerbated course of generalized periodontitis, patients with predominance of the parasympathetic nervous system, sedation composition.

Salivary interleukin 6, interleukin 8, interleukin 17A, and tumour necrosis factor α levels in patients with periodontitis and rheumatoid arthritis.

IntroductionRheumatoid arthritis (RA) and periodontitis share risk factors and inflammatory pathways that could be related to cytokines, such as interleukin (IL)-6, IL-8, IL-17A, and tumour necrosis factor-α (TNF-α). The aim of this study was to compare periodontal status and salivary levels of selected cytokines between patients diagnosed with RA and periodontitis. RA patients were assessed for the potential influence of anti-rheumatic therapy.Material and methodsOne hundred and six patients were enrolled in a cross-sectional study. Medical assessment and periodontal examination were performed in 35 patients with chronic periodontitis, in 35 patients with RA and chronic periodontitis, and in 36 controls. Unstimulated whole saliva samples were analysed for IL-6, IL-8, IL-17A, and TNF-α.ResultsSignificant differences in biomarkers and periodontal parameters were found among groups. Study groups exhibited higher mean pocket depth (PD), number of PD > 4 mm, and mean clinical attachment loss, when compared with controls. The RA group had lower bleeding on probing index and PD, but higher values of plaque indices than the periodontitis group. Concentration of evaluated cytokines were higher in the RA and periodontitis groups, compared with controls. The periodontitis group showed also higher levels of IL-6, IL-17A, and TNF-α in comparison to RA. RA patients were treated with disease-modifying anti-rheumatic drugs (DMARDs) and glucocorticosteroids.ConclusionsSalivary levels of IL-6, IL-8, IL-17A, and TNF-α can be affected by periodontitis, RA, and presumably DMARDs. DMARD therapy appears to reduce destructive and inflammatory processes in periodontal tissues because lower values of PD, BOP, and salivary levels of IL-6, IL-17A, and TNF-α were found in RA.

КЛИНИКО-РЕНТГЕНОЛОГИЧЕСКИЕ ПОКАЗАТЕЛИ ПОРАЖЕНИЯ ПАРОДОНТА И ПЕРИАПИКАЛЬНЫХ ТКАНЕЙ ЭНДОДОНТИЧЕСКИ ЛЕЧЕННОГО ЗУБА У ПАЦИЕНТОВ С ЭНДОДОНТО-ПАРОДОНТАЛЬНЫМИ ОСЛОЖНЕНИЯМИ

Objective: Explore the clinical and X-ray indicators of periodontal and periapical tissue lesions in patients with combined endodontic-periodontal pathology. Methods: The results of endocanal treatment of 65 teeth with 82 foci of periapical destruction in the form of bone resorption, periodontal slit expansion, and inflammation of marginal-alveolar gum are presented in 78 patients with combined endodontic-periodontal pathology between the ages of 20 and 50 years and older. Depending on the diameter of the periapical resorption and the severity of the inflammatory process in periodontal tissues, the patients were divided into three groups: the group I – 45 patients who were found to be foci of periapical destruction with a diameter of 1 to 3 mm, and diagnosed a mild course of endodontic-periodontal pathology of a combined nature; II group – 19 patients with bone hotspots resorptions of periapical arrangement with a diameter of 3 to 5 mm and the presence of combined endodontic-periodontal pathology of moderate severity. Patients of group I and II received a combination of complete endodontic treatment with antioxidants, calcium containing and antimicrobial drugs as well as professional oral hygiene. 14 patients with foci of periapical destruction with a diameter of 1 to 5 mm and the presence of periodontal pathology of different severity of stages included into group III. These patients received complete endodontic treatment only. Results: A reliable decrease in the size of the foci near the upper grade of resorption in patients of the first group occurred 12 months after endodontic treatment. With full endodontic treatment, the area of the focal point of destruction in the periapical tissues decreased by 4.8 times, and the restoration of bone tissue in the form of a reduction in the area of resorption 60.0±3.5% of cases. Periodontological index was significantly reduced, which indicates a decrease in inflammatory phenomena in periodontal tissues. Conclusion: After high-quality endodontic treatment, a reliable decrease in the diameter of the resorption focus and an increase in the rate of periapical reparative processes were found. During the 12 months of observation, the complete restoration of bone tissue in the periapical area with focal points of destruction from 1 to 2 mm was noted in 67.3% of cases, in the diameter of the foci 3-4 mm – in 37.6% of observations, and in the case of 5 mm – in 25.3% of cases. Keywords: Endodontic, periodontic, resorption, periapical focus, endodontic-periodontal pathology, endodontic treatment.

Оцінка інтенсивності запальних процесів у тканинах пародонта в пацієнтів із рецесією ясен залежно від віку та біотипу пародонта

Summary. Prevention and treatment of periodontal diseases remains one of the most important tasks of modern dentistry in connection with their high prevalence among all age groups of the population. Recently, much attention has been paid to the study of gum recession, as one of the clinical forms of periodontal disease. The paper presents data on paraclinical indexes in patients with gum recession, depending on age and biotype of periodontal disease. The aim of the study – to evaluate the intensification of inflammatory processes in periodontal tissues in patients with gum recession, depending on age and periodontal biotype using paraclinical indices. Materials and Methods. The article presents a comparative assessment of the intensity of inflammatory processes in periodontal tissues, depending on age and periodontal biotype in 204 somatically healthy patients who had a recession of the gums caused by different etiological factors. Results and Discussion. As a result of our research, it was found that with increasing age, there was a clear tendency to increase the indexes of all paraclinical indexes analyzed by us. Also, attention was drawn to the fact that the carriers of biotype periodontal A1-Thin S flow of inflammatory processes proceeded more pronounced and more intense.Conclusions. In persons with recession gum, the intensification of inflammatory processes in periodontal tissues increased with age, but depended on the periodontal biotype.Conclusions. In persons with recession gum, the intensification of inflammatory processes in periodontal tissues increased with age, but depended on the periodontal biotype.

Зміни показників ротової рідини дітей дошкільного віку з гінгівітом під впливом лікувально-профілактичних заходів

Summary. The significant prevalence of inflammatory processes in periodontal tissues of children of different ages indicates insufficient effectiveness of preventive and therapeutic measures. Children of preschool age need special attention in the choice of therapeutic and prophylactic means.The aim of the study – a comparative evaluation of traditional treatment of children aged from 3–5 years with chronic catarrhal gingivitis with therapy with the use of anti-inflammatory gel with neovitin.Materials and Methods. 47 children with chronic catarrhal gingivitis were taken for dispensary observation and divided into groups: the main (23 children) and the comparative (24 children). All children underwent conventional therapy according to the protocols of medical care – basic therapy. In the main group, for a month, pathogenetic agents were used – an anti-inflammatory gel with neovitin, hygiene products were recommended. In the comparative group for local therapy, a 3 % hydrogen peroxide solution was used to rinse the oral cavity (during the first week of treatment) – Rotokan, a therapeutic and prophylactic toothpaste. Control examinations and examination with the definition of the hygienic state of the oral cavity using the hygienic index of Yu. A. Fedorov and V. V. Volodkina, the prevalence and intensity of the inflammatory process in the gums were assessed using the Schiller-Pisarev test and the PMA index, the oral fluid index (formation of oxyradical, urease activity, pH, viscosity, lysozyme content, degree of dysbiosis).Results and Discussion. After the treatment, elimination of gum inflammation in patients of the main group was accompanied by a 2.8-fold decrease in the PMA index; GI – 1.6 times. The reduction in the period of treatment of children was revealed in the application of the proposed treatment regimen. The effectiveness of the treatment was confirmed by a decrease in the formation of oxyradicals immediately after treatment by 15.67 % and 10.98 % (p<0.05), a decrease in urease activity was observed in 8.43 % and 5.47 %; the viscosity of the oral fluid decreased by 54.51 % and 50.51 % (p<0.05), the incidence of dysbiosis decreased by 22.49 % (p<0.05) and 10.36 % in children of the primary and comparative groups, respectively. After 0.5 years, the lysozyme content in the oral fluid of children increased by 21.12 % and 7.09 % (p<0.05), the pH increased by 1.39 % and 0.25 % (p>0.05) in children of the primary and comparative groups, respectively.Conclusions. The use of the proposed therapy with gel with neovitin contributed to the best results of treatment: a decrease in the degree of gingival inflammation by the PMA index by 2.8 times, a decrease in the number of visits to a doctor by 1.1, improvement of the oral fluid of children, and, to a greater extent, six months after the performed treatment.

Індексна оцінка стану тканин пародонта у осіб молодого віку з хронічним катаральним гінгівітом на тлі скупчення зубів

Summary. Today it is known that among maxillodental abnormalities crowded teeth have a leading position and often accompanied by periodontal diseases, lesions of the hard dental tissues, functional disorders of maxillodental system and psycho-emotional disorders of patients is a relevant problem in dentistry. The researchers ascertained the fact of increasing the activity of the course of periodontal disease in patients with maxillodental abnormalities.The aim of the study – to estimate the intensification of inflammatory processes in periodontal tissues of young individuals with crowding of the teeth using periodontal indices.Materials and Methods. The article presents the comparative estimation of the intensity of inflammatory processes in periodontal tissues from 104 people in the age of 18−35 years with chronic catarrhal gingivitis (CCG) on the background of crowding of teeth (main group) and 33 people with CCG without orthodontic pathology (comparison group). For the estimation of the state of periodontal tissues the indexes PMA, bleeding gums and СPI were used. The obtained data were worked out statistically. Results Discussion. It is set on the results of studies that in dependence on the degree of severity of CCG and with increase of the age of examined increases the intensity of inflammatory processes in tissues of teeth-restraint apparatus in both study groups, but in patients with CCG on the background of crowding of teeth this tendency was more pronounced. The average value of the PMA index by its criteria of index revealed to gingivitis of the average severity in the main and comparison groups of the study. With the increase of age of patients in both study groups the increase of the index of bleeding was set. In patients with crowding teeth the values of CPI index exceeded the values of the index in individuals without orthodontic pathology.Conclusions. In patients with crowded teeth on the background of chronic catarrhal gingivitis the intensification of inflammatory processes in periodontal tissues increased with age and depended on the severity of chronic catarrhal gingivitis and was higher than in patients without orthodontic pathology.