scholarly journals CLINICAL AND LABORATORY EFFICIENCY OF TREATMENT OF WOMEN WITH PERIODONTAL DISEASES ON THE BACKGROUND OF BACTERIAL VAGINOSIS

2018 ◽  
pp. 35-39
Author(s):  
A.D. Shulzhenko ◽  
T.O. Petrushanko ◽  
M.V. Mykytiuk

Introduction. There is currently no tactic for dental examination and treatment of women suffering from bacterial vaginosis (BV), although chronic catarrhal gingivitis, periodontitis of initial and first degree of severity in patients with this pathology has been proven. The frequency of detection of BV in modern women aged 18-45 is 67-89%. The main pathogens of BV are Gardnerella vaginalis and Atopobium vaginae. Aim. To determine clinical and laboratory effectiveness of the treatment scheme for women with periodontal diseases on the background of bacterial vaginosis. Materials and methods. Diagnosis of BV was established by an obstetrician-gynaecologist based on the Amsel criteria. 54 women aged 18-45 were examined. The examined women were divided into two groups, depending on the intended scheme of integrated treatment. Determination of the degree of inflammation of the periodontal period was carried out according to the PMA indices (modified by S. Parma), KPI by Leus. The quality control of the treatment was performed by PCR method, the presence of Gardnerella vaginalis and Atopobium vagina, the amino test of oral liquid, the quantitative activity of alpha amylase and the concentration of sIgA in saliva. Representatives of the first control group (26 women) were prescribed the common course of treatment, namely: local treatment therapy (oral baths of the solution of the medicine “Stomatophyte” after morning and evening hygiene procedures, application of “Mergagil-denta” (7 days); general therapy (metronidazole 250 mg every 8 hours for every 7 days, probiotic “Symbiter acidophilic concentrate” for 21 days). Women of the second experimental group (28 patients) were treated according to the scheme we patented. Their local treatment included: oral baths with the medicine “Stomatophyte” after morning and evening hygiene procedures (7 days), tablets for resuscitation “Lizak” for 1 tab. every 6 hours (5 days), application of “Metrogil-denta” for 20 minutes twice a day. After using “Stomatophyte” (10 days), use “Symbiter omega” for 21 days in silicone caps for the night after the completion of the use of “Metrogil-Denta”. General medicines for patients in the 2nd group: clindamycin 150 mg every 6 hours (7 days), probiotic “Symbiter acidophilic concentrate” per unit (21 days). Evaluation of the treatment results was carried out 14 days, 3, 6 and 12 months after the end of the course treatment. Results. In the examined two groups, there was a disorder in the condition of periodontal tissues. In women of the first group chronic catarrhal gingivitis was registered in 11.5%, chronic generalized periodontitis of initial degree - in 57.69%, chronic generalized periodontitis - in 30.77%; in patients of the 2nd group – in 10.71%, 64.29% and 25% respectively. None of the 54 patients had clinically intact periodontal disease. The PMA and Leish KPI indices in women of the 1st group after the treatment did not have a significant difference with the initial results, while the rates of patients in the second group decreased significantly, indicating a decrease in inflammation in the periodontal tissues. The concentration of sIgA after the end of the treatment course was higher in women of the 2nd group, which suggests a higher efficacy of the proposed method of treatment. Conclusions. Comparing the conventional and patented treatment regimen, it has been determined that traditional treatment is significantly less effective. Clinical methods of examination are insufficient to control the quality of treatment of women with BV and manifestations of periodontal disease, since a specific microflora appears in the oral cavity of this contingent of patients. In order to objectify clinical results, it is advisable to use a study of local immunity factors, such as saliva alpha-amylase and sIgA. To control the presence of IB pathogens as an express method, an amino test should be used, and in the case of its positive result, PCR should be used to detect Gardnerella vaginalis and Atopobium vaginae.

2020 ◽  
pp. 21-24
Author(s):  
A.D. Krutikova

Patients with bacterial vaginosis are diagnosed with chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases, such as chronic catarrhal gingivitis, periodontitis of initial and first severity. The aim of the study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. Materials and methods. 28 heterosexual couples aged 18-45 years took part in the survey. Clinical dental examination was performed at the time of treatment and 3 months after completion of treatment. Green-Vermilion indices, RMA (in Parma modification), complex periodontal index according to Leus (KPI), Svrakov's number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included: "Fluconazole" 50 mg 1 time per day (7 days), "Clindamycin" 150 mg every 6 hours (5 days), starting from the 3rd day of antibiotics - probiotic "Symbiter acidophilus concentrated "(21 days), Calcium-D3-Nycomed 1 tab. during dinner 30 days. Local treatment included: oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures (7 days), application of "Metrogil-dent" on the gums (7 days), the drug "Lizak" 1 tab. keep in the mouth until complete dissolution every 6 hours (5 days), after the use of "Stomatophyte" and "Metrogil - dent" - application of "Symbiter omega" on the gums in silicone caps at night (21 days). Results. In women, chronic generalized catarrhal gingivitis was detected in 10.71%, chronic generalized periodontitis of the initial degree in 64.29% and chronic generalized periodontitis of the I degree in 25%. In men who are carriers of pathogens of BV, chronic generalized catarrhal gingivitis was found in 7.14%, chronic generalized periodontitis of the initial degree in 60.71% and chronic generalized periodontitis in grade 32.1. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive objective dynamics of dental status. Thus, after 3 months of clinical and laboratory observations, there were no complaints, the state of oral hygiene improved significantly. If before the treatment the Green-Vermilion index in general in women with BV was 1.323 ± 0.035 points, then after 3 months it was equal to 1.032 ± 0.021. A similar dynamics was determined in men: from the starting index of 1.336 ± 0.041, the Green-Vermilion index decreased to 1.048 ± 0.036. 3 months after treatment, the PMA of patients decreased by 49.03%, in men - by 51.95%, no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant . According to the KPI index, women had a significant difference between baseline and post-treatment outcomes of 1.98 points, while men had a score of 2.01 points. No significant difference was found between the results of groups I and II both before and after treatment. A similar positive dynamics characterizes the indicator - Srakov's number, according to this indicator before treatment and after differences between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. Before treatment and after the detection rate in the oral cavity, Gardnerella vaginalis and Atopobium vaginae did not have a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after treatment in the middle and second groups. Thus, Gardnerella vaginalis was detected less by 67.87% and 61.59%, Atopobium vaginae - by 65.79% and 58.65% in women and men, respectively. Conclusions. The developed and patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory phenomena, improves oral hygiene, and is suitable for the treatment of women with this comorbidity and for the treatment of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens corresponded to the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who were their sexual partners, which once again confirms the equal effectiveness of treatment for both gender groups.


Author(s):  
A. D. Krutikova

Patients with bacterial vaginosis are often diagnosed as having chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases including chronic catarrhal gingivitis, mild and moderate periodontitis. The aim of this study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. The study included 28 heterosexual couples aged 18-45. Clinical dental check-up was performed during the treatment and in 3 months after the treatment completion. Green-Vermilion indices, РMA (in Parma modification), complex periodontal index (CPI) according to Leus, Svrakov's iodine number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included "Fluconazole" in a dose of 50 mg once a day for 7 days, "Clindamycin" in a dose of 150 mg every 6 hours for 5 days, probiotic "Symbiter acidophilus concentrated" was prescribed to be taken starting from the 3rd day of antibiotic therapy for 21 days, and Calcium-D3-Nycomed (1 tab. during dinner for 30 days). Local treatment included oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures for 7 days, "Metrogil-dent" ointment for gum application for 7 days, the chewing drug "Lizak" (1 tab. every 6 hours for 5 days), "Symbiter omega" in silicone caps for gum application overnight following the for 21 days. Chronic generalized catarrhal gingivitis was detected in 10.71% of women, mild chronic generalized periodontitis – in 64.29% and moderate chronic generalized periodontitis – in 25% of the women. In men who were carriers of pathogens of bacterial vaginosis, chronic generalized catarrhal gingivitis was found in 7.14% of individuals, mild chronic generalized periodontitis – in 60.71% and moderate chronic generalized periodontitis – in 32 male subjects. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive evidence-based dynamics of dental status. 3 months after clinical and laboratory observations, no complaints were presented and the oral hygiene status improved significantly. Before the treatment, the Green-Vermilion index mean values in women with bacterial vaginosis were 1.323 ± 0.035; by the end of 3 month therapy they equalled to 1.032 ± 0.021. A similar dynamics was seen in the men: from the initial index values of 1.336 ± 0.041, the Green-Vermilion index lowered to 1.048 ± 0.036. By the end of 3 month therapy, the PMA decreased by 49.03% in women and by 51.95% in men; no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant. The analysis of the СPI index values demonstrated the women had a significant difference between baseline and post-treatment outcomes of 1.98 scores, while the men had 2.01 scores. No significant difference was found between the findings of groups I and II both before and after the therapy. A similar positive dynamics was confirmed by the Svrakov's iodine number indicator and according to this indicator obtained before and after the therapy, difference between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. The detection Gardnerella vaginalis and Atopobium vaginae in the oral cavity before and after the therapy did not demonstrate a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after the therapy. Gardnerella vaginalis was detected by 67.87% and 61.59% less, Atopobium vaginae – by 65.79% and 58.65% less in the women and men, respectively. This patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory manifestations, improves oral hygiene, and is effective for the treatment of women with this comorbidity and for the therapy of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens reflects the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who are their sexual partners that confirms the effectiveness of the therapy for both gender groups.


Author(s):  
A.D. Krutikova

Numerous studies have proved that periodontal pathology is an issue that requires a comprehensive and multidisciplinary approach in diagnosis, treatment and prevention, as most periodontal diseases are syndromic manifestations of somatic and psycho-somatic diseases, but there are little data on the periodontal status in patients with disturbance of the genital microflora. The aim of the study was to provide the grounds for the tactics of dental examination of child-bearing women with bacterial vaginosis and their sexual partners and to compare the results of different sex groups. Materials and methods. 28 heterosexual couples aged 18-45 years were examined. Objective periodontal examination included the calculation of Green-Vermilion oral hygiene index, papillary-marginal-alveolar index, complex periodontal index by P.A. Leus, Svrakov's iodine number. Amino test of oral fluid, assessment of oral fluid pH, identification of bacterial vaginosis pathogens, and in particular, Gardnerella vaginalis and Atopobium vaginae, in the oral cavity of the patients by polymerase chain reaction-diagnostics and bacterioscopically. Results. Chronic generalized catarrhal gingivitis was detected in 10.71% of the women, chronic generalized periodontitis in the initial stage was found out in 64.29% of the women, and chronic generalized periodontitis of the first degree in 25% of the female patients. Men, who were carriers of bacterial vaginosis, chronic generalized catarrhal gingivitis, made up 7.14%; chronic generalized periodontitis in the initial stage was found in 60.71% of the men and chronic generalized periodontitis was found in 32.14%. The values ​​of periodontal indices did not really differ between the indicators of different sex groups. Amino tests of the oral fluid in the women and men showed a positive result those points out the presence of volatile amines. The oral fluid pH is reduced in patients of both groups that indicate an inflammatory process in the oral cavity. All the patients have "key cells", which are exfoliated epitheliocytes with Atopobium vaginae and Gardnerella vaginalis adhered to them. This is one of the main markers of bacterial vaginosis. Conclusions. Summing up the results of the performed clinical and laboratory observations, it should be noted that when collecting the history of bearing aged women, the dentist should pay attention to the presence of diseases of the genital tract, and in particular, bacterial vaginosis. To detect inflammatory and inflammatory-dystrophic periodontal diseases in women of childbearing age, amino tests of oral fluid not only in women but also in their sexual partners for rapid diagnosis of pathogens such as bacterial vaginosis and vaginal vaginal vagina can be very informative.


Author(s):  
A.D. Krutikova

At present, the issue of cross-contamination and cross-infection between the oral cavity and other body sites has not sufficiently studied yet and requires the elaboration of clinical protocols for diagnosis infectious diseases, which the dentists can rely on in their practice. We consider it necessary to highlight the issue of cross-infection between the oral cavity and vagina in women with bacterial vaginosis. This gynaecologic diagnosis draws much attention of healthcare professionals due to its prevalence, the frequency of relapses and the specificity of the microflora causing pathology. The purpose of the work was to characterize the diagnostic value of the amino test of oral fluid as an express method for detecting bacterial vaginosis in the oral cavity. Materials and methods. 106 women of child-bearing age without marked somatic and orthodontic pathologies were examined. Patients were divided into 3 groups depending on their gynaecological status. I group included 25 women with the 1st and 2nd degree of vaginal purity; II group involved 27 individuals – carriers of Gardnerella vaginalis; the third group included 54 women with a confirmed diagnosis of bacterial vaginosis, who were divided into 2 subgroups depending on the prescribed treatment. 26 women who received standard treatment and supportive therapy made up III-A subgroup; 28 patients who received the treatment and preventive therapy aimed at eliminating atypical microflora in the oral cavity and preventing relapse, constituted III-B subgroup. The examination was carried out before starting therapy and in 6 and 12 months following the therapy. The amino-test of oral fluid that we patented is designed for express diagnosis of mixed saliva for the presence of volatile amine of isonitrile produced by bacteria Gardnerella vaginalis and Atopobium vaginae associated with bacterial vaginosis. To confirm the results of the amino test of the oral fluid, a PCR-diagnosis for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity was performed. Results. In women with bacterial vaginosis (group III), chronic catarrhal gingivitis was diagnosed in 12.96%, chronic generalized periodontitis of initial severity was found in 25.93% of the patients studied, chronic generalized periodontitis I severity degree was diagnosed in 61.11% of the patients; clinically intact periodontitis was not registered. Comparing the results of the amino test of oral fluid at all stages of the observation with the results of PCR-diagnosis of Gardnerella vaginalis and Atopobium vaginae, we have found out that the patients of groups I demonstrated complete conformity to the results obtained in the group II: the absence of these microorganisms in the oral cavity was confirmed by negative results of amino test. In the group III-A examined, the percentage of the positive amine test was directly proportional to the changes in the detection of Atopobium vaginae in the oral cavity: before the treatment, this microorganism was detected in 84.6% of the amino test, at the beginning of the survey it was 76.9%; in 6 months following the therapy, the PCR decreased by 26.9%, while the result of the amino test dropped by 34.6%; in a year the detection of Atopobium vaginae increased by 42.3% and the percentage of positive test increased by 34.6%. In groups III-B, direct correlation of the changes in the results of the Gardnerella vaginalis PCR and the amino-test of oral fluid were noted. The primary findings of Gardnerella vaginalis and the positive amine test of women in this group made up 67.9% and 75% respectively. In 6 months, the percentage of Gardnerella vaginalis detection was reduced by 39.3% and by 53.6%, the positive oral test in the oral cavity decreased; in one year, Gardnerella vaginalis was found to be 14.3% less frequent in the patients of group III-B, and the registration of the positive amino test decreased by 7.1%. The obtained data make it possible to suggest the informativeness of the amino test of oral fluid as an express method for detecting bacterial vaginosis agents in the oral cavity, such as Gardnerella vaginalis and Atopobium vaginae, to use this method in the diagnosis of concomitant diseases of periodontal tissues and to prescribe treatment, taking into account the presence of oral microbes from atypical representatives who are resistant to traditional treatment regimens.


2019 ◽  
Vol 23 (3-4) ◽  
pp. 17-21
Author(s):  
T.O. Petrushanko ◽  
A.D. Krutikova ◽  
E.I. Krutikova

The lack of clear dental screening strategy for women with bacterial vaginosis (BV) leads to inadequate treatment planning, since atypical triggering factors are not considered, despite the given evidence for the presence of chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases in patients with BV. The analysis of the oral fluid, especially its protective properties, is crucial in the noninvasive diagnostics. In this regard, alpha-amylase and secretory IgA (sIgA) are noteworthy. The aim of the research. The paper was aimed at verification of the diagnostic value of the assessment of the outcomes of the recent treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women of reproductive age with bacterial vaginosis by determining the changes in the kinetic activity of alpha- amylase and sIgA concentration. Material and Methods. 50 women of reproductive age have been examined. The subjects were assigned into groups according to their gynecological status: Group I (control) (n=10) included women with the I and II degree of purity of the vagina Group II (n=10) included carriers of Gardnerella vaginalis without diagnosed bacterial vaginosis ; Group ІІІ-A (n=15) included women with verified diagnosis of BV who received conventional treatment; Group IІІ-B (n=15) included women with BV, who received treatment using our patented treatment regimen that takes into account the presence of specific BV-microflora found in the oral cavity in this group of subjects. In the oral cavity the results of the amino-test of the oral fluid were analyzed and kinetic activity of alpha-amylase and sIgA concentration was determined. The presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity was determined by the polymerase chain reaction (PCR) method. Results. The sIgA level of women with BV was by 30-45% lower as compared to the value of patients without BV. Concentration of oral sIgA in both groups of women was restored after treatment, but the results of the III-A and III-B groups after treatment significantly differed (the result of sIgA in subjects of Group III-B was by 1.33 times higher than the value of Group III-A), indicating the higher efficacy of the proposed treatment regimen, which takes into account the presence of etiological agents of BV in the oral cavity. The results of the amino test of oral fluid were positive in patients of Group III-A before treatment in 73.3%, after treatment only in 53.3%, while in the subjects of Group III-B the initial result was 80%; after treatment, a decrease to 20% was registered. Conclusions. The diagnostic value of the applied laboratory methods for examination of local resistance in women is sufficient for mass use as a control of the results in periodontal treatment of patients with inflammatory and inflammatory-dystrophic periodontal diseases concomitant with bacterial vaginosis.


2016 ◽  
Vol 144 (1-2) ◽  
pp. 10-14 ◽  
Author(s):  
Gavrilo Brajovic ◽  
Branka Popovic ◽  
Miljan Puletic ◽  
Marija Kostic ◽  
Jelena Milasin

Introduction. Periodontal diseases are associated with the presence of elevated levels of bacteria within the gingival crevice. Objective. The aim of this study was to evaluate a total amount of bacteria in subgingival plaque samples in patients with a periodontal disease. Methods. A quantitative evaluation of total bacteria amount using quantitative real-time polymerase chain reaction (qRT-PCR) was performed on 20 samples of patients with ulceronecrotic periodontitis and on 10 samples of healthy subjects. The estimation of total bacterial amount was based on gene copy number for 16S rRNA that was determined by comparing to Ct values / gene copy number of the standard curve. Results. A statistically significant difference between average gene copy number of total bacteria in periodontal patients (2.55.107) and healthy control (2.37.106) was found (p=0.01). Also, a trend of higher numbers of the gene copy in deeper periodontal lesions (>7 mm) was confirmed by a positive value of coefficient of correlation (r=0.073). Conclusion. The quantitative estimation of total bacteria based on gene copy number could be an important additional tool in diagnosing periodontitis.


Author(s):  
G. A. Loban ◽  
T. O. Petrushanko ◽  
V. V. Chereda ◽  
M. O. Faustova ◽  
M. M. Ananieva ◽  
...  

Background. Periodontal tissues inflammatory diseases are widespread among young people. Objective. This study was aimed at elaborating the method to assess risks of periodontal inflammatory diseases and determining its efficacy depending on the state of dental tissues, gum tissues and sex.          Methods. The study included 182 students (93 men, 89 women) aged 19-29: 22 individuals had no lesions of hard dental tissues and no signs of periodontal disease; 51 individuals were found to have DMF index <6; 52 individuals – DMF index ≥6; 57 individuals were diagnosed with chronic catarrhal gingivitis. Primary groups were formed in autumn; re-examination was carried in spring. The research participants were assessed for detection of risks of periodontal inflammatory disease by the method developes by the authors (Patent UA 54041). Results. The study revealed that the risk of development of preiodontitis increases in individuals with high caries and gingivitis intensity. In spring, more individuals suffer from microbial imbalance in in the composition of gingival sulcus fluid and decrease in the mean stability coefficient value that indicates an increased risk of inflammatory periodontal disease development. Women were less likely to experience seasonal dysbiotic changes in the gingival sulcus fluid composition compared with men. Conclusions. The method suggested for assessment of the risk of periodontal inflammatory diseases is of high informativeness. It allows clinicians detecting early pre-nosological signs of oral microbiocenosis imbalance that enhances the effectiveness of early diagnosis of inflammatory periodontal diseases.


2018 ◽  
Vol 32 (4) ◽  
Author(s):  
Giorgio Dirani ◽  
Silvia Zannoli ◽  
Maria Federica Pedna ◽  
Francesco Congestrì ◽  
Patrizia Farabegoli ◽  
...  

Background and aims. Bacterial vaginosis (BV) is one the more frequently identified genital syndrome among childbearing aged women. The basic condition that generates this condition is a modification in the vaginal microbiota. The aim of this paper is to briefly review the current status of the art of BV and to report the results of a pilot study performed with an innovative PCR based technique. Materials and Methods. 36 samples of vaginal fluid routinely submitted for the diagnosis of BV to the Unit of Microbiology – GRHL were comparatively evaluated by standard techniques and with the HP-Vaginiti e Vaginosi NLM kit that simultaneously detects in a quantitative way specific DNA from Candida (albicans, glabrata; krusei, tropicalis), Gardnerella vaginalis, Lactobacillus spp. and Atopobium vaginae. Results and conclusions. Candida spp. has been identified in 8 samples with culture and in 15 with the molecular test. 29 G. vaginalis were found by PCR whereas only in 7 samples a specific prescription for this microbe was present (of which 4 positive). A. vaginae has been identified in 20 samples by the molecular approach and Lactobacillus spp. was identified in 19 samples (by culture) and in 32 by PCR. The overall diagnosis of BV was made in 9 patients by standard techniques and in 7 by applying the molecular approach. (Cohen’s kappa test: 0,84). The findings of this study clearly demonstrate that the joint use of the routine culture- based techniques with the multiplex PCR methods amplifies by far the sensitivity of the overall diagnostic workflow of BV.


2018 ◽  
pp. 54-59
Author(s):  
N.N. Saveleva ◽  
I.I. Sokolova ◽  
S.I. German ◽  
T.V. Tomilina

The review of the scientific literature is devoted to the topical issues of studying the etiology of periodontal diseases, which are one of the most common and complex pathologies of the maxillofacial region. Analysis of recent studies proves a stable relationship between the development of periodontal diseases and disorders in the immune system, the neurohumoral system, metabolic disorders, genetic predisposition, and so on. The article presents the data obtained in the course of studying the literature on the role of disorders in the functioning of individual organs (gastrointestinal tract, liver, lungs, heart, and urinary system) in the development of chronic periodontal diseases. The article notes that the anatomical and physiological proximity of the periodontal and digestive tract tissues, the generality of innervation and humoral regulation create prerequisites for the involvement of periodontal disease in the pathological process in diseases of the gastrointestinal tract. One of the main etiological factors in the development of inflammatory diseases of the gastrointestinal tract and periodontium is Helicobacter pylori, which is found in the loci of the oral cavity: in the oral and gingival fluid, on the mucous membrane of the tongue and cheeks, and in the periodontal pockets. It is pointed out that the liver also occupies a special place in the development of periodontal diseases, which is explained by the performance of its significant functions for the human body: regulatory, metabolic, antitoxic and other. There is evidence that the pathology of periodontal disease plays a leading role in the structure of dental diseases in patients with chronic obstructive pulmonary diseases, which is clinically manifested by symptoms of generalized periodontitis of the І-ІІ degrees of development and its complications - partial or complete secondary adentia, and with tooth preservation - defects in dental series and violations of occlusion, function, aesthetics. Scientists suggest a general biological mechanism for the development of generalized periodontitis and cardiovascular diseases, linking the development of periodontal diseases in patients with cardiovascular pathology with microcirculatory disorders. The dependence of the severity of inflammatory changes in the periodontal tissues on the disturbances of salt metabolism in urolithiasis is proved. The data obtained indicate that diseases of the internal organs contribute to the structural damage of periodontal tissues and they are a risk factor for periodontal diseases, which necessitate the presence of not only theoretical knowledge and practical skills in dentistry, but also their awareness of the features and clinical manifestations of somatic pathology. An urgent and justified step in the treatment of periodontal diseases is also the involvement in the process of rendering complex dental care to internist doctors capable of quickly and qualitatively assessment the condition of the internal organs and the basic systems of the patient's body.


2019 ◽  
Vol 23 (1-2) ◽  
pp. 17-21
Author(s):  
M. Skrypnyk ◽  
T. Petrushanko ◽  
T. Kryvoruchko ◽  
K. Neporada

Obesity prevalence has significantly increased especially in young adults, which is caused by a particular lifestyle, food quality and dietary behavior. Obesity leads to development of huge array of comorbid conditions such as arterial hypertonia, heart stroke, arthritis and other diseases. We conducted standard clinical examination of oral cavity of 154 young patients (18-21 years old) – all of them were students of Ukrainian Medical Stomatological Academy. It has been determined that the majority of patients with BMI >30 kg/cm2 have aggravated family heredity, in 66,2% cases one parent of obese students had obesity and 32,43% patients have both parents with obesity that is significantly higher compared with persons with normal BMI and overweight. There was a high prevalence of periodontal diseases about 74% and carious lesions of teeth - 97.4% among young people despite the age and contingent of examined patients - medical students. In patients with BMI >30 kg/cm2 prevalence of generalized forms of gingivitis and periodontitis was by three times higher compared with individuals with normal BMI. The values of oral hygienic indexes were poor in all examined groups, but their values were slightly lower in patients with normal BMI than in those with overweight and obesity. The prevalence of inflammatory changes in gums was higher in persons with obesity: all of them had a mild degree of lesions in periodontal tissues. Inflammatory processes in the gums were the most intense in patients with the second degree of obesity. According to the results of the study, the presence of the first and the second degree of obesity should be considered as a risk factor triggering periodontal tissues diseases. For persons with BMI >30 kg/cm2 with periodontal disease measures for the secondary prevention of inflammatory and inflammatory dystrophic periodontal diseases should be carried out and in persons without periodontal disease on the background of obesity measures primary prevention should be done.


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