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8MEDICAL SCIENCES
HARACTERISTICS OF TREATMENT AND PREVENTION MEASURES USED IN THE CASE OF INFLAMMATORY DISEASES OF PERIODONTAL TISSUES AND THYROPATHOLOGY
Kitsak T.
PhD, Associate Professor at the Department of Pediatric Dentistry, Bukovynian State Medical University, Chernivtsi, Ukraine
Abstract
Dental morbidity in children, despite numerous preventive measures, remains very high today. The occurrence and severity of periodontal tissue disease vary widely in Ukraine and other countries, and depend on age [110].
Today, inflammatory diseases of periodontal tissues are considered as a reaction of the organism to the imbalance between the microbial agent and the protective systems of the oral cavity under the influence of various exo- and endogenous factors.
Keywords: periodontium, diffuse non-toxic goitre, children.
A review of the research data has shown that the scientific pursuit for the treatment of periodontal disease in children is aimed at 30eneralize the treatment of CCG in children by means of a combined pathogenic therapy [1].
A complex of therapeutic measures for children with CCG living in environmentally unfavourable and fluorine- and iodine-deficient conditions was developed, including professional oral hygiene, traditional anti-inflammatories, Holisal gel applications, the use of Lakalut® 30enera herbal toothpaste and Lakalut® 30en-era mouthwash. For general treatment, Kinder Biovital Lecithin Gel to enhance immune system function and Ascorutin to reduce capillary permeability and fragility were suggested [2].
E.T. Supieva (1996) suggests that children in endemic goitre areas should be treated with local remin-eralising agents and iodine-containing toothpastes [3].
A differentiated approach to solving the problem of treatment and prevention of dental diseases in children with DNG was implemented by A.P. Rozhko [4].To this end, she developed a staged therapeutic and preventive complex, including elimination of iodine deficiency (Iodine-active), enhancement of immunity, regulation of thyroid hormonal activity (Selenium-active), use of adaptogens and antioxidants (Lecithin, Bi-otrit), remineralising agents (R.O.C.S. rinse and toothpaste) and osteogenesis stimulating agents (Calcicor), and anti-inflammatory agents (Lysodent). This enabled the author to obtain the prophylactic efficacy of 55,3 % against caries and to significantly improve oral hygiene and periodontal indices in the patients.
According to the research data [5], in case of per-iodontal tissue diseases in children with DNG, it is advisable to correct macro- and microelement metabolism, if possible, systemically and locally. For this purpose, R.O.C.S. Bionica healing and prophylactic toothpaste with the active fractions of thyme and kelp, and R.O.C.S.-School mouthwash containing kelp extract, xylitol, calcium and magnesium should be used. The use of Teraflex in the complex treatment of CCG in the conditions of DNZ results in the restoration of the dentoalveolar structures built of the connective tissue.
In children with thyreopathology, mouthwashes with a 1-2% Achilles salt solution are recommended to increase the protective properties and remineralising function of the oral fluid [6].
N.V. Bidenko [7] recommends a combination of measures, including dietary adjustments, preventive examinations, the use of remineralising solutions, and rinsing the mouth with Diuciphonum, which greatly potentiate the benefits of caries and gingivitis treatment in children with diffuse euthyroid goitre.
According to A.B. Sarafanova [8], 30eneral-ized30ed iodine prophylaxis should be given as part of the treatment package to improve CCG management in young patients with thyroid hyperplasia.
It has been found that the combined use of Diplen-F film, Calcinova granulate and Iotrin in children with concomitant hypoplasia against the background of hypothyroidism improves local immunity [9].
K.A. Kolesnyk [10] recommends that in the course of orthodontic treatment of children with DNG, a complex of preparations with adaptogenic, osteotropic and prebiotic effects be used to restore microcirculation in the periodontal tissues.
In children affected by chronic thyroiditis, the use of a common regimen for the treatment and prevention of dental caries and gingivitis, including remineralis-ing, antimicrobial and immunocorrective agents (Belagel Ca/P, Paragel) is recommended [11].
To manage 30eneralized periodontitis in adolescents with thyreopathology, treatment and prophylactic measures with Erbisol have been recommended, which demonstrated a positive effect and elimination of the inflammatory process in the periodontal tissues [12].
In pubertal children, the treatment of CCG with the use of Echiposol oral gel, Colgate® Herbal Healing toothpaste and Colgate® Plax Total Herbal Rinse has proven effective [13].
Diseases of periodontal tissues caused by endocrine-immune pathology associated with iodine deficiency are effectively treated with Iodis-calendula and Iodis-concentrate in combination with Calcium-D3 Ny-comed, which helps to 30eneraliz thyroid function and improve bone tissue metabolic parameters [16].
In patients affected by chronic 30eneralized periodontitis against the background of primary hypothy-roidism, the immunomodulator Galavit, organosilicon
gel-based magnetophoretic compositions, Alloplant graft and autoplasma combinations are recommended [9].
Antioxidants in the complex of medical therapy for patients with concomitant thyroid pathology significantly increase the effectiveness of treatment and stabilize the pathological process in periodontal tissues.
According to the research data [14], patients affected by chronic 31eneralized periodontitis with concomitant thyreopathology should be given a full range of preventive and curative measures, including the use of Elam-Dent iodine- containing toothpaste, at least four times a year.
To 31eneraliz bone metabolism in 31eneralized periodontitis with concomitant thyroid pathology, the use of Calcium-D3 Nicomed and Fitor is recommended [15].
A treatment and prophylactic scheme for perio-dontal disease on the background of primary hypothy-roidism, which includes the combined use of the antiseptic Holisal and the immunomodulatory complex Im-munovel, was developed and introduced into dental practice with regard to the basic periodontal therapy and the correction of thyroid pathology [11].
Thus, practical dentistry has developed many approaches to the treatment and prevention of periodontal diseases in concomitant thyroid pathology in children and adults. However, the issues of improvement of treatment and prophylactic measures with regard to individual factors of the child's body and regional peculiarities remain topical. In particular, the study and correction of immunological changes and oral glycopro-tein level abnormalities in children with CCG against the background of DNG are required, and that will constitute the subject of the study in our work.
The analysis of the research data has shown the multifactorial nature of the etiology and pathogenesis of periodontal diseases in children, as well as the significant impact of thyroid disorders on the condition of the human dentition. In this regard, the study of cause-effect relationships between the initial manifestations of thyroid pathology and periodontal tissue changes in children seems relevant and promising in terms of improving methods of diagnosis, prevention and treatment.
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