CC BY
7ЗАГАЛЬНА ХАРАКТЕРИСТИКА ХВОРИХ НА ГЕНЕРАЛ1ЗОВАНИЙ КАТАРАЛЬНИЙ Г1НГ1В1Т ТА АНАЛ1З ПОЧАТКОВОГО СТАНУ ЗА ПОКАЗНИКАМИ КЛ1Н1ЧНИХ ДОСЛ1ДЖЕНЬ
Шостенко А.А.
Вищий державний навчальний заклад Украти «Буковинський державний медичний унгверситет»
GENERAL CHARACTERISTICS OF PATIENTS WITH GENERALIZED CATARRAL GINGIVITIS AND ANALYSIS OF THE INITIAL CONDITION ACCORDING TO CLINICAL TRIAL INDICATORS
Shostenko A.
HSEE "Bukovinian state medical university", department of pediatric dentistry, assistant DOI: 10.5281/zenodo.6616152
Анотащя
У стати наведеш отримаш результата дослщження клiнiчних показник1в ротово! порожнини у 82 хво-рих на генералiзований катаральний гiнгiвiт з хрошчним та загостреним перебiгом до проведення лжу-вально-профшактичних заходав. Об'ективний стан порожнини рота та ясен встановлювали на основi наступ-них теспв: спрощеного iндексу гiгieни (OHI - S), iндексу кровоточивостi Мюллемана, Коуела, патлярно-маргiнально-альвеолярного iндексу (РМА).
Abstract
The article presents the results of the study of clinical indicators of the oral cavity in 82 patients with generalized catarrhal gingivitis with chronic and acute course before treatment and prevention. The objective condition of the oral cavity and gums was determined on the basis of the following tests: Simplified Hygiene Index (OHI -S), Mulleman Bleeding Index, Cowell Index, Papillary-Marginal-Alveolar Index (PMA).
Ключовi слова: катаральний пнпвгт, пародонт, запалення,
Keywords: catarrhal gingivitis, periodontium, inflammation.
One of the most relevant and unresolved in modern dentistry is the problem of the prevalence of generalized catarrhal gingivitis, especially in young people. Significant concern is the increase in the number of cases of long-term disease with frequent exacerbations on the background of insufficiently effective treatment [1,2].
Numerous studies on this problem have been conducted [2,3,4,5], but still many fundamental issues of etiology and pathogenesis remain unresolved, which slows down the development of adequate and highly effective treatments for the disease.
The aim of the study was to assess the clinical condition of the oral cavity in patients with generalized catarrhal gingivitis at the stages of chronic and exacerbated course before treatment and prevention measures.
Materials and methods. There were 82 patients with generalized catarrhal gingivitis under observation. All patients underwent examinations, which included collecting complaints and medical history, determining the duration of the disease, the frequency of exacerbations of inflammation in the gums, the features of previous treatment and its effectiveness, visual and instrumental assessment of dental status. Determined dental formula, occlusion, the condition of the hard tissues of
the tooth, the presence of dental plaque and their consistency, the condition of the mucous membrane of the gums (bleeding, redness, swelling, and cyanosis). The objective condition of the oral cavity and gums was determined based on the dynamics of the following tests: simplified index of oral hygiene (OHI - S) by Green J. C., Vermillion J. R. (1960); Muehlemann's hemorrhage index (Muehlemann H., 1971), as modified by Cowell (Cowell I., 1975); papillary-marginal-alveolar index (Parma, 1960). The paper used standard digital or-thopantomography, followed by a study on a personal computer to objectively assess the condition of the bone tissue of the alveolar processes in the area between the alveolar septa. The paper used standard digital or-thopantomography, followed by a study on a personal computer to objectively assess the condition of the bone tissue of the alveolar processes in the area between the alveolar septa. Research results and their discussion.
This study is based on clinical follow-up of 82 patients with generalized catarrhal gingivitis. Depending on the clinical manifestation, they were divided into two groups: 1st - group - 33 patients with chronic generalized catarrhal gingivitis; 2nd - group - 49 patients with acute disease. The groups were formed identically by age and sex. Age characteristics and sex of the observed are presented in table. 1.
Distribution of subjects by age and sex.
Table 1.
Clinical Groups Sex Age
Male Female 18-20 y.o 21-25 y.o 26-30 y.o Average age
I group (n = 33) 15 (45,5%) 18 (54,5%) 16 (48,5%) 10 (30,3%) 7 (21,2%) 24,9±1,2
II group (n = 49) 23 (46,9%) 26 (53,1%) 25 (51,0%) 14 (28,6%) 10 (20,4%) 25,8±1,1
As can be seen from the presented data, patients of groups I and II by age and sex did not differ significantly from each other.
During the collection of anamnesis, approximately the same duration of generalized catarrhal gingivitis was found in patients of both groups, which at the time of inclusion in the study averaged 2.7 ± 0.4 years and 2.4 ± 0.3 years (p> 0.05) . Previously, 90.2% of patients received professional care, while the vast majority of people (78.4%) treatment was limited to professional hygienic interventions (removal of dental plaque, irrigation and rinsing the mouth with chlorhexidine-con-taining products). The effect of such measures was short-lived. It should be noted that the study groups included only those individuals who do not have violations of clinical and radiological integrity of the gingival junction, the inflammatory process in gum tissue was generalized, spread to both jaws, capturing the interdental and marginal part of the gums, gingival depth furrows did not exceed 1-2 mm. However, the initial severity of the main signs of the disease in representatives of groups I and II had significant differences. The most common complaints for the former were only complaints of bleeding gums, which are aggravated by
brushing teeth and eating solid foods. Objectively revealed hyperemia of the gingival papillae, slight swelling and bleeding gums in the teeth on both the lower and upper jaw. The maximum accumulation of soft plaque and tartar was found on the cervical surfaces of the front teeth of the mandible. The average value of the hygiene index averaged 1.6 ± 0.09, which indicated unsatisfactory oral hygiene. Confirmed the presence of chronic inflammatory process in the tissues of the gums in patients of group I, the average value of the indices: PMA - 27.3 ± 0.4%, IR - 1.8 ± 0.5 (Table 2). The most common complaints in patients of group II were discomfort in the mouth, pain and bleeding gums. Intense pain was found in 4 (8.2%) patients, moderate in 36 (73.5%) and mild in 9 (18.3%). Diffuse hyperemia and edema of the gingival papillae were visually determined, in most cases (59.2%) there was involuntary bleeding gums, pain on palpation, which indicated an active manifestation of the inflammatory reaction in the soft periodontal tissues. It was found that the acute inflammatory process in 85.7% of patients of group II was generalized, in others its localization was observed mainly in the area of the front teeth of the lower and upper jaw.
Table 2.
Initial indicators of hygiene index (ONI-S), Muehlemann index (IR) and papillary - marginal - alveolar index
Survey groups Periodontal indices
OHI - S (nu) IK (nu) PMA (%)
I group 1,6±0,09 1,8±0,5 27,3±1,2
II group 2,32±0,05* 2,47±0,19* 78,9±0,6*
Note: * p<0.05 - reliability in relation to the indicators of group I.
The hygienic index in the analyzed patients averaged 2.38 ± 0.05 and indicated an insufficient state of oral hygiene. High indices: bleeding - 2.47 ± 0.19 and PMA - 78.9 ± 0.6 reflected the high activity of chronic exacerbated inflammatory process in the gum tissue in patients of the analyzed group (see table 3). Thus, at the initial stage of the study it was found that the clinical symptoms and averages of paraclinical tests in patients of group I corresponded to chronic, and in group II -acute inflammatory process in the gum tissue. At the same time, in most people (about 20% of cases) individual gingival indices in patients had a wide range of fluctuations and did not depend on the clinical manifestation of generalized catarrhal gingivitis, which complicated the objective assessment of the inflammatory process in this pathology. This is especially important at the time of transition from chronic to acute inflammation. Insufficient information of generally accepted clinical indicators of the severity of inflammation in the tissues of the gums, led us to search for simple and ac-
cessible laboratory criteria that could be used in the differential diagnosis of generalized catarrhal gingivitis with chronic and acute.
References
1. Belousov NN. Prichiny shirokogo rasprostraneniya tyazhelykh form vospalitelnykh zabolevaniya parodonta. Parodontologiya. 2005; 3(36): 26-29.
2. Tsepov LM, Nikolayev AI, Mikheyeva YeA. Diagnostika, lecheniye i profilaktika zabolevaniy parodonta. M.: MedPress. 2008:272.
3. Michikawa M. Periodontal disease. Nihon Rinsho. 2014;72(4):744-748.
4. Hujoel P, Zina L, Cunha-Cruz J, Lopez R. Specific infections as the etiology of destructive periodontal disease: a systematic review. J. Oral Sci. 2013;121:2-6.
5. Cochran DL. Inflammation and bone loss in periodontal disease.J. Periodontal. 2008;79:1569-1576.
6. Antomonov M.Yu. Matematicheskaya obrabotka i analiz mediko-biologicheskikh dannykh / M.Yu. Antomonov // K.: Firma malogo druku, 2006.- 508 s.
