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Habibova Nazira Nasullaevna, Bukhara Medical Institute, Scientific applicant E-mail: nilu74@list.ru
CHARACTERISTIC FEATURES OF FREE-RADICAL PROCESSES AND ANTIOXIDANT PROTECTION IN THE ORAL CAVITY DURING CHRONIC RECURRENT APHTHOUS STOMATITIS
Abstract: The study and assessment of the state of free radical processes and antioxidant defense in saliva in patients with chronic recurrent aphthous stomatitis. It was established that these patients are characterized by a high frequency of diseases of the digestive system, nervous system, allergic diseases and blood diseases. This disease is accompanied by impaired antioxidant protection in the oral cavity, which is manifested by an increase in the content of primary (hydroperoxides) and secondary (MDA) lipid peroxidation products, a decrease in the antioxidant activity of saliva, which correlate with the duration of the disease.
Keywords: chronic recurrent aphthous stomatitis, lipid peroxidation, antioxidant protection, oral cavity, saliva.
Chronic recurrent aphthous stomatitis (CRAS) is consid- HRAS (main group), among them 46 women (57.5 ± 5.5%) ered to be one of the most frequent diseases of the oral mucosa [1; 11]. This disease accounted for 5% of all pathologies of the oral mucosa.
It revealed that about 20% of the world's population suffers from aphthae in this or that period of life. The age of most patients ranged from 20 to 40 years, until puberty suffer equally often people of both sexes, but women predominate among adults [6; 10].
The etiology and pathogenesis of CRAS is still not completely installed. It is known that a significant role in the pathogenesis of chronic inflammatory processes belongs mi-crobiocenosis of oral mucosa [2; 5]. It proved its participation in the metabolism, synthesis of vitamins, and the formation of immune regulation and the nonspecific resistance of the organism [7; 9].
The role of gastrointestinal pathology and pathogenesis of liver diseases in CRAS show clinical and experimental results [3]. Widely discussed issue of allergic genesis of the disease [4; 8].
It is known that disorders of the immune status and free-radical processes can affect the course and prognosis of chronic diseases of the oral mucosa [10; 11].
At the same time, the state of free-radical processes and antioxidant protection oral mucosa in the parameters of saliva in this pathology remains poorly understood. In this regard, the study of pathogenetic mechanisms of recurrence CRAS is an urgent task of modern dentistry.
Aim of the study. Learn the assessment and free-radical processes and antioxidant protection in the saliva of patients with chronic recurrent aphthous stomatitis.
Material and method. To achieve this goal we have been involved for research 418 patients with dental pathology. From this category in 80 patients (19.1 ± 1.9%) were diagnosed with
and 34 men (42.5 ± 5.5%) aged 18 to 49 years. The reference group consisted of 20 apparently healthy patients of the same age, including 11 women (55.0 ± 11.1%) men and 9(45.0 ± 11.1%). The average age of onset was generally 33.0 ± 3.7 years, and disease duration 4.5 ± 3.7 years. Studies have been conducted over the period from 2015 to 2017.
HRAS diagnosis was based on anamnesis data and characteristic clinical picture of the disease. Particular attention was paid to the state of the oral cavity: the presence of decayed teeth, sharp edges of teeth of amalgam fillings, prostheses made of dissimilar metals was evaluated quality prosthetic and orthodontic devices.
The level of caries activity was assessed by the method of PA Leus (1990), the oral hygiene condition determined by an index OHI-S (DI-S) by Green JC, Vermillion JR (1964). Estimates of the prevalence and intensity of periodontal tissue destruction of periodontal index performed Russel A. (1956). Patients CRAS more pronounced and widespread tissue damage was found periodontal - periodontal index 4.65 ± 0.09 against 2.25 ± 0.06 points in the control group.
Along with the traditional general clinical and dental practices, to establish the pathogenic mechanisms of CRAS conducted special laboratory studies unstimulated mixed saliva - determining the intensity of lipid peroxidation, antioxidant protection. Determination of the intensity of lipid peroxidation was carried out at a concentration of hydro peroxides according to the method Gavrilova V B. et al. (1983), malonic dial dehyde (MDA) and total antioxidant activity is not stimulated by the method of mixed saliva Klebanova G. I. et al. (1985) with using spectrofluorimetrical method.
Statistical analysis of the results was carried out using the methods of variation statistics on a personal computer using «Excel» applications.
Medical science
Results. It is shown that is typical for patients CRAS signifi-cantlyhigh level duplexfamilyhistoryofmedical illnesses (78.8 ± ± 4.6%, n = 63) compared with the control group (45.0 ± 11.1%, n = 9).
Significant differences from control are identified and the frequency of digestive diseases (87.5 ± 3.7%, n = 70 vs. 45.0 ± ± 11.1%, n = 9), nervous system (73.8 ± 4.9%, n = 59 vs. 25.0 ± ± 9.7%, n = 5), diseases of the endocrine system (51.3 ± 5.6%, n = 41 vs. 25.0 ± 9.7%, n = 5) allergic diseases (40.0 ± 5.5%, n = 32 vs. 5.0 ± 4.8%, n = 5), blood diseases and blood-forming organs (75.0 ± 4.8%, n = 60 vs. 5.0 ± 4.8%, n = 5).
Patients CRAS various degrees of oral mucosa dysbacteriosis noted in 77 (96.3 ± 2.1%) cases. CRAS most common cause of exacerbation of allergic reactions (41.3 ± 5.5%, n = 33), infectious diseases (37.5 ± 5.4%, n = 30), recurrent chronic diseases (35.0 ± 5.3%, n = 28) and high stress situations (40.0 ± 5.5%, n = 32).
In the biochemical study of mixed saliva in patients CRAS were found changes of selected indicators of free radical oxidation. For patients CRAS was characterized by a significant increase in compared with the control group (p < 0.05) the content of the primary products of lipid peroxidation (LPO) - hydro peroxides (2.16 ± 0.03 U/ml vs 1.18 ± 0.01 U/ ml.) and secondary - MDA (1.27 ± 0.13 nmol/ml.pl vs 0.24 ± ±.01 nmol/ml.pl.). Antioxidant activity of saliva was reduced to 58.8 ± 0.05% in the main group and 15.0 ± 0.05% in the control group (p < 0.05). As for the concentration of hydro peroxide, the fair they were seen us rise. Average values exceed similar data in the control group (1.45 ± 0.03 rl.unit / ml vs 1.35 ± 0.03 r.unit / ml), but these differences were not a valid character (p> 0.05). Analysis ofthe mean values ofsaliva antioxidant activity according to their clinical groups showed a significant decrease.
Of particular interest was the comparison of lipid per-oxidation and antioxidant protection indicators with disease duration. Installations intensive growth of the MDA level in saliva with increasing duration of the disease. Thus, if the duration is less than 1 HRAS, the average value of the indicator MDA (0.39 ± 0.01 nmoles/ml.pl.) Differ slightly from those in the control group (0.27 ± 0.01 nmoles/ml.pl). then even when disease duration from 1 to 3 years parameters (0.68 ± ± 0.02 nmoles/ml.pl.) exceed the values of the control group at 2-fold (p < 0.05), 3 to 5 years (1.31 ± 0.11 nmoles/ml.pl.) in 4-fold (p < 0.001), over 5 years (1.38 ± 0.11 nmoles/ml.pl.) in 6.8-fold (p < 0.001).
Increasing the concentration of hydro peroxide with increasing duration of the disease occurred less intensively. When the disease duration of less than 1 year old, and 1 year
to 3 years averages hydro peroxides (respectively 1.47 ± 0.04 and 1.41 ± 0.03 rl.unit/ml) did not differ from those in the control group (1.35 ± 0.03 rl.unit/ml). In patients with a longer history of disease hydro peroxide concentration in saliva was significantly higher than in controls and patients with less prescription disease (p <0.05). Thus, in patients with disease duration from 3 to 5 years, it was 2.31 ± 0.09 relative units/ml, and for a duration of more than 5 years 3.05 ± 0.1 relative units /ml, 1.6 and 2.2 times, respectively, higher than in the control group (p <0.001).
It should be noted, that was obtained by close, direct correlation parameters and MDA hydro peroxide duration of CRAS.
The dynamics of antioxidant activity of saliva in patients with CRAC with an increase in the duration of the disease was characterized by a tendency to decrease. In patients with a disease duration of less than 3 years antioxidant activity differed little from those in the control group (29.4 ± 0.05%) less than 1 year, respectively 27.7 ± 0.3% and from 1 to 3 years 35.8 ± ± 0.07%. With further increase in the duration of disease (more than 3 years) indicated a greater reduction in anti-oxidant activity: more than 3 to 5 years 27.2 ± 0.06% and 5 children 26.8 ± 0.12%. These changes were unreliable nature (p > 0.05), but in determining the correlation indicators the antioxidant activity of disease duration was an inverse relationship with very high correlation coefficient - p = 0.909.
It should be noted on the dependence of the activity of free-radical processes in patients CRAS the predominance of a particular type of oral microflora. The most pronounced changes were observed LPO in the presence of Klebsiella and fungal flora.
Thus, patients with marked disorders CRAS free-radical processes in the oral cavity are characterized by an increase in the intensity of POL process, and depression of the antioxi-dant system. The level of lipid peroxidation and ant oxidative defense saliva depends on the duration of the disease and the composition microflora in the oral mucosa.
Conclusions 1. It is found that for patients with chronic recurrent aphthous stomatitis characterized by significant levels of duplex family history of medical conditions, the high frequency of comorbidity such as the digestive diseases, nervous system, allergic diseases and diseases of the blood.
2. Chronic recurrent aphthous stomatitis accompanied by disturbances of antioxidant protection in the oral cavity, which is manifested by increased content of LPO products - primary (hydro peroxides) and secondary (MDA) products, reduced saliva antioxidant activity that correlate with disease duration.
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