CC BY
23
DOI 10.26724/2079-8334-2019-4-70-22-25 UDC 616.314-083:159.9-053.7
S.N. Vadzyuk. Yu.V. Boliiik. M. A. I.ucliyiiskyi I. Horbachevsky lernopil Stale Medical I Diversity. lernopil
INFLUENCE OF PSYCHOPHYSIOLOGICAL FEATURES ON THE CONDITION OF TEETH HARD TISSUES AND PERIODONTIUM IN YOUNG SUBJECTS
e-mail: boliuk@tdmu.edu.ua
The article presents data on the correlation between the indices of assessment of soft teeth deposits, dental calculus, the state of teeth hard tissues, periodontium and psychophysiological characteristics in subjects aged 18-23 with periodontopathology. The significant influence of the amount of dental calculus and retention factors on the intensity of the inflammatory process in periodontal tissues was revealed. However, the dependence of these local factors and values of the Schiller-Pisarev test and the papillary-marginal-alveolar index from the oral hygiene state has not been determined. In addition, data on the relationship between the intensity of inflammation and the indicators for evaluating the signs of neurotic depression, asthenia, aggressiveness and frustration were obtained.
Keywords: caries, periodontium, oral hygiene, dental calculus, psychophysiological features.
The work is a fragment of the research project «Psychophysiological features of young people with different condition ofperiodontium and hard tissues of teeth», state registration No. 0116U00792.
The issue of the etiology and pathogenesis of various oral cavity diseases remains open. One of the major theories about the causes or triggers of the development of teeth hard tissues and periodontal pathology is the impact of certain local factors. The quality and level of oral hygiene and the presence of retention points contributing to the accumulation of dental deposits, the development of pathogenic microenvironment and damage to periodontal tissues are among them [0, 0].
However, the integrity of the human body where all the parts are interconnected and can affect each other should not be forgotten [0]. Therefore, the most common thought about the risks of dental diseases development is the theory of the combination of various factors effects [0, 0]. Psychophysiological features of the individual are among the factors that are currently being studied, in particular, temperament and certain reactive conditions, indicating adaptation or maladaptation to the environment (anxiety, frustration, aggression, rigidity, neurotic conditions).
Some sources show the relationship between psychophysiological features and periodontal status in children [0]. Other authors cover this issue for people of working age, but only for some psychological characteristics [0, 0]. However, the correlation of these parameters with the pathology of periodontal tissues and teeth was not yet sufficiently investigated.
The purpose of the work was to study the relationship between the indices of teeth hard tissues, periodontium condition and local factors in individuals aged 18-23 years, and also to determine the relationship between pathology of periodontal tissues and teeth and psychophysiological features in this age group.
Material and methods. A group that included 36 young people aged 18-23 with periodontal lesions was formed according to the results of the dental examination. The dental examination included anamnesis, oral examination, and the determination of the caries intensity index (CII), the hygienic indices by Silness-Loe (SL, 1964) and K. Stallard (HI, 1969), the dental calculus index (DCI), the dental calculus intensity index (DCII) and retention index (RI) [0]. The periodontal tissues condition was assessed using the test by Schiller and Pysarev (SP), papillary-marginal-alveolar index in Parma modification (PMA 1960) and the papillary bleeding index by Muhlemann-Saxer (PBI, 1975) [0]. Determination of psychophysiological features was conducted using various indicators: extraversion and neuroticism according to the Eysenck's Personality Inventory (EPI, 1963) [0], well-being, activity, mood according to the methodology by V. Doskin and N. Lavrentieva [0], anxiety, frustration, aggression, rigidity in the method of self-esteem of mental condition by H. Eysenck [0], reactive and personal anxiety according to the scale of C. Spielberger and Yu. Khanin [0], anxiety, neurotic depression, asthenia, hysterical response, obsessive-phobic and vegetative disorders according to the clinical questionnaire for identifying and assessment of neurotic conditions [0].
The statistical analysis of the data was carried out using the StatPlus 6 licensed software statistic package using the Spearman rank correlation coefficient.
Results of the study and their discussion. The analysis of the results did not show the significant correlation between the values of CII, hygienic indices and psychophysiological characteristics of the subjects. A moderate direct relationship was found between figures of the levels of practically all dental indices, as illustrated in table 1.
However, no significant correlation was found between the index of dental calculus and the SL and HI. Although there was a significant direct correlation between the DCII and the SL, no such correlation was found between the DCII and the Stallard HI. This indicates a weak effect of oral hygiene on tartar amount, and also suggests that in young people with periodontal disease, calculus formation is more dependent on factors other than hygienic levels. For HI by Stallard, a certain relationship was observed only with SL. In addition, there is also no
© S.N. Vadzyuk, Yu.V. Boliuk, 2019 22
links between the values of the soft plaque index SL and RI, as well as the PMA. That is, no significant impact of the hygienic status of the oral cavity on the intensity of the inflammatory process in the periodontal tissues was detected. At the same time, the moderate dependence of the PMA index on DCI, DCII and RI was shown.
Table 1
Correlation between indices of dental status evaluation
SL HI DCI DCII RI SP PMA
SL - r=0.523 *p=0.001 r=0.259 p=0.127 r=0.371 *p=0.027 r=0.141 p=0.413 r=0.356 *p=0.033 r=0.326 p=0.052
HI r=0.523 *p=0.001 - r=0.318 p=0.059 r=0.296 p=0.079 r=0.113 p=0.513 r=0.175 p=0.308 r=0.255 p=0.134
DCI r =0.259 p=0.127 r=0.318 p=0.059 - r=0.851 *p=0.000 r=0.650 *p=0.000 r=0.351 *p=0.036 r=0.368 *p=0.027
DCII r=0.371 *p=0.027 r=0.296 p=0.079 r=0.851 *p=0.000 - r=0.645 *p=0.000 r=0.373 *p=0.025 r=0.520 *p=0.001
RI r=0.141 p=0.413 r=0.113 p=0.513 r=0.650 *p=0.000 r=0.645 *p=0.000 - r=0.502 *p=0.002 r=0.573 *p=0.000
SP r=0.356 *p=0.033 r=0.175 p=0.308 r=0.351 *p=0.036 r=0.373 *p=0.025 r=0.502 *p=0.002 - r=0.645 *p=0.000
PMA r=0.326 p=0.052 r=0.255 p=0.134 r=0.368 *p=0.027 r=0.520 *p=0.001 r=0.573 *p=0.000 r=0.645 *p=0.000 -
PBI r=0.337 *p=0.045 r=0.234 p=0.170 r=0.360 *p=0.031 r=0.478 *p=0.003 r=0.626 *p=0.000 r=0.691 *p=0.000 r=0.659 *p=0.000
- significant correlation
However, according to Chereda, the hygienic status of the oral cavity among those aged 19-29 had been significantly worse in individuals with gingivitis than in healthy people. The author also demonstrates the impact of dysbiotic shifts in the gingival biofilm and increase of the oral fluid viscosity and surface tension on the development of caries and gingivitis. This may explain the difference in results [0]. Dutch scientists' results confirm as our study the lack of correlation between bleeding indices and plaque index. They explain it with a different period of time that had passed since brushing teeth in each examinee, although they do not deny that gingivitis and bleeding can be caused by other factors, except plaque, for instance, harmful habits and genetics [0]. Our research also proves the correlation between the psychophysiological features of young people and the intensity of the inflammation in periodontal tissues. Among these psychophysiological characteristics there are signs of neurotic depression, asthenia, aggression and frustration, belonging to the disorders of adaptation. According to Mendelevich, depressive conditions are accompanied by a decrease in mood, inability to find a way out of a particular situation and even suicidal thoughts [0]. Asthenia is manifested by irritability, emotional lability, decreased ability to work, physical weakness, sleepiness and sleep disorders. According to Selye's works, asthenia is a manifestation of depletion of the organism [0]. Frustration is a mental condition due to objective (or subjective, perceived as objective) difficulties in achieving a goal or solving a problem. Frustration is always a painful experience of failure or contradiction that can not be solved. It is accompanied by a range of negative emotions: anger, irritation, guilt, etc. Frustration is possible only when the degree of dissatisfaction is higher than one can withstand [0]. Aggression manifests itself by direct and open confrontation with the environment [0].
The inverse correlation of moderate strength was detected between the values of the SP and the values of the neurotic depression and asthenia scale (r=-0.337, p=0.044 and r=-0.382, p=0.022, respectively). This indicates that the lower (more negative) values of the maladaptive states are, the higher the SP scores are registered. Therefore, with increasing signs of neurotic depression and asthenia, the degree of inflammatory process in periodontal tissues goes up (fig. 1-2).
SP = 1 4Z3-0,0206'x
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Fig. 1. Correlation between values of neurotic depression and SP.
Fig. 2. Correlation between asthenia levels and SP.
In addition, a direct moderate relationship between PMA and aggression (r=0.378, p=0.019) was
observed (fig. 3).
PMA (%) =2.154+1,0Q93+x Scatterplot of PBI against (tpycrpaqw
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Frustration
Fig. 3. Correlation between values of aggression and PMA. Fig. 4. Correlation between frustration levels and PBI.
A direct correlation of moderate strength was found between the frustration level and PBI (r=0.375, p=0.024) which is illustrated in fig. 4.
It follows that in persons with high levels of aggression and frustration there is a high probability of development of more intense manifestations of the inflammatory process in periodontal tissues. Other authors had investigated the effect of emotional instability on the development of dental diseases. They had found that more than half of young people with caries and gingivitis had been emotionally unstable [0]. Also, the growth in manifestations of periodontal tissue pathology in children with increased level of frustration and anxiety had been proved [0]. The obtained data may serve to further exploration of the relationship between psychophysiological characteristics and dental status indicators in young people, in particular with periodontal tissue diseases.
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No significant correlation between the state of oral hygiene and the intensity of the inflammatory process in periodontal tissues has been detected in 18-23 years old subjects with a periodontal disease. A direct relationship between the indices of dental calculus, the intensity of dental calculus, the retention index and the value of the papillary-marginal-alveolar index has been found in this group of individuals. A direct correlation between the estimates of periodontal indices and psychological characteristics such as neurotic depression, asthenia, aggression and frustration has been also determined. These proves the impact of these parameters on the predisposition to periodontal tissues diseases.
Uefeiviiu-s
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ВПЛИВ ПСИХОФ1З1ОЛОГ1ЧНИХ ВЛИЯНИЕ ПСИХОФИЗИОЛОГИЧЕСКИХ
ОСОБЛИВОСТЕЙ НА СТАН ТВЕРДИХ ОСОБЕННОСТЕЙ НА СОСТОЯНИЕ ТВЕРДЫХ
ТКАНИН ЗУБ1В ТА ПАРОДОНТА ТКАНЕЙ ЗУБОВ И ПАРОДОНТА
В ОС1Б МОЛОДОГО В1КУ У ЛИЦ МОЛОДОГО ВОЗРАСТА
Вадзюк С.Н., Болюк Ю.В., Лучинський М.А. Вадзюк С.Н., Болюк Ю.В., Лучинский М.А.
У статт наведеш данi про кореляцiйнi зв'язки мiж В статье приведены данные о корреляционных связях
показниками шдексно'1 оцшки м'яких зубних вiдкладень, между показателями индексной оценки мягких зубных
зубного каменю, стану твердих тканин зубiв та пародонта отложений, зубного камня, состояния твердых тканей зубов и
i психофiзiологiчними характеристиками в оЫб 18-23 пародонта и психофизиологическими характеристиками у лиц
роюв iз пародонтопатолопею. Виявлено iстотний вплив 18-23 лет с пародонтопатологией. Обнаружено существенное
юлькосп зубного каменю та ретенцшних чинниюв на влияние количества зубного камня и ретенционных факторов
iнтенсивнiсть запального процесу в тканинах пародонта. на интенсивность воспалительного процесса в тканях
Проте не визначено залежност цих мюцевих факторiв та пародонта. Однако не определено зависимости этих местных
значень проби Шиллера-Писарева i патлярно- факторов и значений пробы Шиллера-Писарева и папиллярно-
маргшально-альвеолярного шдексу вщ стану ппени маргинально-альвеолярного индекса от состояния гигиены
ротово'1 порожнини. ^м того, отримано данi про зв'язок полости рта. Кроме того, получены данные о связи между
мiж штенсившстю запалення та показниками оцшки интенсивностью воспаления и показателями оценки признаков
ознак невротично'1 депреси, астени, агресивностi та невротической депрессии, астении, агрессивности и
фрустраци. фрустрации.
Ключовi слова: карiес, пародонт, гiгiена ротово'1 Ключевые слова: кариес, пародонт, гигиена
порожнини, зубний камшь, психофiзiологiчнi полости рта, зубной камень, психофизиологические
особливоси. особенности.
Стаття надшшла 26.02.2019 р. Рецензент Ткаченко П.1.
DOI 10.26724/2079-8334-2019-4-70-25-29 УДК 616-089.86:340.624-1:617.55
А.В. Верба, М.Д. 'Же, мбм1, I.. I. Богуш, А.М. Галушка2, 1.1. Дошат.
Шмськовим ме шчмий к шмчмим пен i р Цен i ральног о рег тму, Иммимя 1 Шммиш.киМ нлнома, м.мим медичмим умм-.ерсиич Î4. М.I.Пирогова, liiiiiiinisi 21 оловме глмськово-мешчме умраг.-иммя, К'иТв
ДОСВ1Д РЕКОНСТРУКТИВНО-В1ДНОВНИХ Х1РУРГ1ЧНИХ ВТРУЧАНЬ У ПАЦ1еНТ1В З1 СТОМАМИ П1СЛЯ ВОГНЕПАЛЬНИХ ПОРАНЕНЬ ЖИВОТА
e-mail: m.d.zheliba@gmail.com
Метою роботи було вивчити характер сучасних бойових травм живота та подшитися досвщом реконструктивно-вiдновних хiрургiчних втручань у пацieнтiв 3i стомами. Проведено аналiз медичних документiв 15 поранених у живщ яким були накладен розвантажувальнi стоми. Пiсля усунення загрози для життя 1'м були виконаш реконструктивнi хiрургiчнi втручання, яю полягали у лiквiдацiï стоми та накладенш рiзних типiв товстокишкових анастомозiв. Пiсляоперацiйнi ускладнення з боку хiрургiчного втручання виникли у 7 пащенив: зовнiшня тонкокишкова нориця i гостра кишкова непрохiднiсть - по 1 випадку, нагноення рани у 5. Летальних наслщюв не було. Реконструктивш хiрургiчнi втручання у пацiентiв 3i стомами виконуються у складних техшчних умовах з великою кiлькiстю тсляоперацшних ускладнень.
Ключов1 слова: бойова травма живота, колостома, реконструктивно-вщновш onepaijiï.
Робота е фрагментом НДР «Профшактика та комплексне л^вання тсляоперацшних ускладнень, гншно-запальних захворювань, вогнепальних пошкоджень», № державно1 реестраци 0116U6354.
Щд час бойових дш на сход1 Украши осколков! поранення отримали 61,6% поранених, мшно-вибухов1 - 27%, кульов1 - 9,1% [9]. Сучасна бойова травма характеризуеться множинними i поеднаними пошкодженнями оргашв грудноï i черевноï порожнин, голови, тулуба, кшщвок, травматичним шоком, смертельною кровотечею, вираженими морфофункщональними змшами в уражених тканинах. До найбшьш тяжких ушкоджень належать поранення живота, як у структур1 бойовоï травми займають четверту позищю тсля поранень кшщвок, голови, грудей i становлять вщ 6,6 до 9% [1, 3, 5]. Вогнепальш поранення живота, як найбшьш важка категор1я бойовоï травми, супроводжуеться високою шсляоперацшною летальнютю (12-75%) та великою частотою ускладнень (54-81%). Розвиток ускладнень значною м1рою залежить вщ тривалосп i иерюду стабшзацп життево важливих функцш оргашзму, вибору обсягу х1рурпчного втручання,
© А.В. Верба, М.Д. Жешба, 2019
