Taxonomic composition and population level of the prosthetic bed mucosa microbiota at the dental arch defects in patients made prosthetic appliance with partial denture Текст научной статьи по специальности «Клиническая медицина»

DOI 10.26724/2079-8334-2019-4-70-128-133 UDC 616.314-76-008.87:579

Z.R. Ozhogan, MM Yasinskyi1, R.A. Levandovskyi1, RY. Bulyk1 j Ivano-Frankivsk National Medical University 'IISEI'.I of I kraine "Bukovinian Male Medical I nixersily"

TAXONOMIC COMPOSITION AND POPULATION LEVEL OF THE PROSTHETIC BED MUCOSA MICROBIOTA AT THE DENTAL ARCH DEFECTS IN PATIENTS MADE PROSTHETIC APPLIANCE WITH PARTIAL DENTURE

e-mail: khvilovyyyy@gmail.com

The article considers the taxonomic composition and the population level of the oral cavity mucous membrane microbiota and changes in their characteristics, after dental prosthetic rehabilitation with partial dentures. In patients with partial loss of teeth, made a prosthetic appliance for the teeth with conventional removable dentures, the taxonomic composition of microbiota changes in the gum mucosa due to the biotope contamination with opportunistic S. aureus and yeast-like fungi of the Candida genus, S. haemolyticus, K. pneumoniae, enterobacteria (E.coli , K.pneumoniae, E.cloacae), B.catarralis, M.lacunata and due to partial elimination of S. sialivarius, S.sanguis, S. mutans, S. mitis from the biotom. In 78.72% of patients, microorganisms isolated and identified from the surface of the prosthetic bed, are in associations that consist of 2 (31.70% cases), 3 (8.51%) and 4 (8.51 %) taxons. The most numerous associations consisting of 2 taxons were: S. aureus and M. lacunata; S. aureus and N. flavescens; S. haemolyticus and B.catarrhalis as well as C. albicans and S. epidermidis. In the biotope (surface of the prosthetic bed gums mucous membrane), these patients made a prosthetic appliance for the teeth with partial removable plate dentures, the population level is reduced in S. salivarius, S. sanguis, S. mutans, S. mitis and significantly increases in opportunistic staphylococci (S. aureus, S. haemolyties, S. epidermidis), S. pyogenes, enterobacteria (E. coli, K. pneumoniae, E. clocacae), B.catarrhalis. Microorganisms (S. aureus and C. albicans) reach a high population level, and it also grows in S. haemoliticus, S. epidermidis, S. pyogenes, E. coli, E. cloacae, K. pneumoniae.

Keywords: partial removable dentures, taxonomic composition, population level.

The work is a fragment of the research project "Multidisciplinary approach to the diagnosis, treatment and prevention of major dental diseases with preservation of tissue regenerative properties and restoration of the anatomical structures prosthetic properties in the inhabitants of Northern Bukovina", state registration No. 0116U002929.

Replacement of dental defects occupies a significant place in the clinic of orthopedic dentistry. Among the main causes of the teeth loss caries and its complications can be identified, as well as inflammatory and dystrophic-inflammatory diseases of periodontal tissues, traumas. Solving this problem by mounting partial removable dentures has clear indications, namely: loss of teeth in the presence of the end ones, included and combined defects in the dentition. However, the prosthetics with these structures has many disadvantages, one of the main is the change in the oral cavity microflora and the decrease in the reactivity of the prosthetic bed mucous membrane tissues at the point of contact with both the elements of the removable prosthesis and the entire oral cavity [1-3, 5].

Isolation and identification of microorganisms associations from the prosthetic bed tissues, comparing these indices to the oral cavity microflora of practically healthy patients is an important diagnostic method for treatment and preventing clinical manifestations of the adaptation disorders in patients with partial removable prostheses [4, 8]. It is also important to establish dynamic changes in the oral mucosa microbiota in patients with defects in dentition before and after the prosthetics.

The purpose of the study was to establish the tachonomic composition, population level and microecological parameters of the prosthetic bed mucous membrane microbiota in patients made a prosthetic appliance with partial removable dentures.

Materials and methods. Microbiological (bacteriological and mycotic) examination of gum mucus secretion in patients with partial loss of teeth has been performed.

The control group consisted of 50 patients (23 men and 27 women) who had no problems adapting to removable denture during the last 6 months and did not have any infectious and noncommunicable diseases.

In the patients and practically healthy people (the control group) oral fluid and the prosthetic bed mucous membrane secretion were sampled with sterile cotton swabs. After sampling the material, the sterile cotton swab was squeezed to the wall of a sterile centrifuge tube to the volume of not less than 0.5 ml. The material was added with the ten fold volume of the buffer solution and the material was diluted 1: 10 (10-1). A titration mixture was prepared of the main material, diluted to the amount of 10-1 to 10-7. From each dilution, 0.01 ml of the mixture was collected and plated on the sectors with the best medium for each taxon, grinding the material with sterile glass spatulas. All inoculations were incubated in a thermostat at the temperature of 37° C, and for yeast-like fungi - 23° C. Staphylococci and enterococci were tested on egg yolk-salt agar, streptococci - on nutrient media containing blood or serum. Isolation and identification of Candida yeast-like fungi species were carried out on sabouraud medium [1, 6]. Enterobacteria were

© Z.R. Ozhogan, MM Yasinskyi, 2019

grown and identified on differential diagnostic media by Endo, Levin, Ploskirev. The total number of aerobic microorganisms and their hemolytic properties were determined by plating the material on 5% meat infusion agar.

An ecological method was used to reveal the mechanisms of contamination and colonization of biota by microorganisms, which permitted to determine the features of coexistence in representatives of the "microorganism - microbiota" ecological system and the ability to dynamic changes of the gum mucosa microbiota in patients with partial loss of teeth. Dominance typology was carried out based on the constancy index determined. To characterize the microbiocenosis diversity of the gums mucous membrane, the Margalef species richness index and the Whittaker species diversity index were calculated [3, 9].

To determine the dominance degree for a certain microorganism species on the gum mucusa of patients with partial loss of teeth, the species-domination indices by Simpson and Berger-Parker were calculated.

The results obtained were processed using the MYSTAT 2 (USA) software. The reliability of the data for independent samples was calculated by means of the Student's t-criterion (with the distribution of arrays close to normal). The difference is considered reliable for P <0.05.

Results of the study and their discussion. Results of the study on the taxonomic composition of the gum mucus surface microbiota in patients with partial loss of teeth are given in table 1. In practically healthy people, the main microbiota of the gum mucosa surface is represented by Streptococus salivarius. An additional microbiota is represented by S. sanguis. Other microorganisms, presented by the constancy index, the incidence frequency, the Margalef species richness index and the Whittaker species diversity index, and the Simpson and Berger-Parker species domination index are detected as occasional microorganisms in the biota (table 1).

Table 1

Taxonomy composition of oral cavity microbiota

Microbiota taxons Patients with partial secondary adentia (n=47) Practically healthy people (n=50) p

Strains isolated Constancy index (%) Incidence frequency Margaleff species richness index Whittaker species diversity index Species domination index Strains isolated Constancy index (%) Incidence frequency Margaleff species richness index Whittaker species diversity index Species domination index

Simpson Berger-Parker Simpson Berger-Parker

S.aureus 18 38.30 0.18 0.173 3.55 0.184 0.032 - - - - - - - -

S.epidermidis 6 12.77 0.06 0.051 1.18 0.061 0.003 7 14.00 0.06 0.055 1.68 0.064 0.004 >0.05

S.haemolytics 8 17.02 0.08 0.071 1.58 0.082 0.006 2 4.00 0.02 0.009 0.48 0.018 - <0.05

S.pyogenus 8 17.02 0.08 0.071 1.58 0.082 0.006 5 10.00 0.05 0.037 1.20 0.046 0.002 >0.05

S.salivarius 2 4.56 0.02 0.010 0.39 0.020 - 47 94.00 0.43 0.469 11.30 0.431 0.184 <0.01

S.sanguis 3 6.38 0.03 0.020 0.59 0.031 0.001 12 24.00 0.11 0.101 2.88 0.110 0.011 <0.05

S.mutans 2 4,56 0.02 0.010 0.39 0.020 - 8 16.00 0.07 0.064 1.92 0.073 0.005 >0.05

S.mitry 2 4,56 0.02 0.010 0.39 0.020 - 7 14.00 0.96 0.055 1.68 0.064 0.004 >0.05

E.coli 7 14.89 0.07 0.061 1.38 0.071 0.004 2 4.00 0.02 0.009 0.48 0.018 - >0.05

K.pneumoniae 4 8.51 0.04 0.031 0.79 0.041 0.001 1 2.00 0.01 - 0.24 0.009 - -

E.cloacae 2 4.56 0.02 0.010 0.39 0.020 - 1 2.00 0.01 - 0.24 0.009 - -

Acinetobacter 5 10.64 0.05 0.041 0.99 0.051 0.002 5 10.00 0.05 0.037 1.20 0.046 0.002 >0.05

B.catarrhalis 9 19.15 0.09 0.082 1.78 0.092 0.008 1 2.00 0.01 - 0.24 0.009 - -

N.pneumoniae 7 14.89 0.07 0.061 1.38 0.071 0.004 6 12.00 0.06 0.046 1.44 0.055 0.003 >0.05

M.lacunata 7 14.89 0.07 0.061 1.38 0.071 0.004 4 8.00 0.04 0.028 0.96 0.037 0.001 >0.05

C.albicans 8 17.02 0.08 0.071 1.58 0.082 0.006 - - - - - - - -

In patients with partial loss of teeth, the listed ecological indices, S. aureus is often found and is the leading causative agent of the inflammatory process. Infrequent are S. epidermis, S. hemolyticus, S. pyogenus, E. coli, Acinetobacter spp., B. sattaralis, N. flavescens, M.lacunata and C. albicans.

In 47 patients, 26 strains of microorganisms belonging to 16 different taxonomic groups have been isolated and identified, which, according to the Margaleff species richness index and the Whittaker species diversity index, testifies to the fact that in the biotope, after partial loss of teeth, spatial, nutritional and other conditions are created for development of microbiota in associative groups.

Taxonomic composition destabilization on the population level of microecological indices of the "macroorganism - microbiota" ecosystem of the prosthetic bed mucous membrane in patients with the dental arch defects with partial removable dentures is associated with disorders of each taxon dominance both in the

biotope and in the macroorganism - microbiota ecosystem. This reduces the dominance level, participation in self-regulation and relationships in the ecosystem of autochthonous obligate and facultative bacteria (bacteria of the Lactobacillus genus, Bacteroides, S. Salivarius, S. sanguis, S. mitry, S. mutans, S. epidermidis) and promotes growth of opportunistic (S.anginosus, S. Pyogenus, S.faecalis, S. Haemolytics, E. Coli, K. Pneumonia, P. aeruginosa, C. Albicens) microorganisms that become the leading agents of the inflammatory process.

An integral part of bacterial and micrologic examination is the sensitivity determination of isolated and identified bacteria strains or microscopic fungi to antimicrobials. This contributes to the development of targeted antibiotic therapy, which ensures the efficacy of treatment in patients. The condition for efficient etiotropic therapy is isolation and identification of opportunistic microorganisms from the surface of the prosthetic bed mucous membrane in patients with the dental arch defects with partial removable dentures and determination of their sensitivity to antimicrobials.

Table 2 shows the results of the quantitative characteristics determination for the association of opportunistic microorganisms on the surface of the prosthetic bed mucous membrane in patients with partial loss of teeth.

Table 2

Quantitative associations of opportunistic microorganisms on the surface of the prosthetic bed mucous membrane in patients with partial secondary adentia

Indices Number of patients examined Microorganisms associations, including 13 taxons

Patients examined 47 2 taxons 10 3 taxons 20 4 taxons- 5 taxons -

Percentage of patients 100 21.28 61.70 8.51 8.5

Isolated and identified taxons 96 10 58 12 16

Percentage of taxons 100 10.42 60.42 12.5 16.66

It was shown that on gum mucosa in most patients (78.72%) with partial loss of teeth, there persist microorganisms' associations consisting of 2, 3, and 4 microorganism species belonging to different taxonomic groups. Therefore, the inflammatory processes on the gum mucous membrane in patients with partial loss of teeth, are caused by associations of opportunistic microorganisms having a variety of species interrelations. The results determining qualitative characteristics and opportunistic microorganisms associations on the surface of the gum mucosa in patients with partial loss of teeth are presented in table 3.

Table 3

Qualitative characteristics of the gingival mucosa opportunistic microflora in partial secondary adentia

Taxons Abs %

I. Opportunistics microorganisms monocultures

S.pyogenes 4 8.51

S.aureus 3 6.38

E.coli 2 4.26

B.catarrhalis 1 2.13

II. Associations including 2 taxons

S.aureus+ M.lacunata 5 10.64

S.aureus+ N.flavescens 4 8.51

S.haemolyticus+ B.catarrhalis 5 10.64

S.epidermidis+ C.albicans 5 10.64

S.pyogenes+ Acinetobacter spp 2 4.26

S.pyogenes+ K.pneumoniae 2 4.26

E.coli+S.mutans 2 4.26

E.coli+S.mitis 2 4.26

S. aureus+S. sangui s 1 2.13

B.catarrhalis+ E.cloacae 1 2.13

III. Associations including 3 taxons

S.aureus+ M.lacunata+ K.pneumoniae 1 2.13

S.haemolyticus+ C.albicans+ N.flavescens 1 2.13

S.haemolyticus+ B.catarrhalis+ S.aureus 1 2.13

E.coli+ C.albicans+Actinobacter spp. 1 2.13

IV. Associations including 4 taxons

S.epidermidis+ B.catarrhalis+ E.cloacae+S.sanguis 1 2.13

S.aureus+ C.albicans+N.flavescens+ Actinobacter spp. 1 2.13

S.aureus+ S.salivarius+ S.sanguis+ K.pneumoniae 1 2.13

S.haemolyticus+ M.lacunata+ S.salivarius+ Actinobacter spp. 1 2.13

It was observed that only in 10 patients with partial loss of teeth (8, 51%) monoculture was detected on the gum mucosa, more frequently it was the monoculture of S. pyogenes. In most patients, associations consisting of 2 taxons were revealed. Associations of S. aureus and N. lacunata; S. hemolyticus and B. Catarralis, association of S. epidermidis and C. albicans was detected in five (10.64%) patients. Other associations, consisting of 2, 3 and 4 taxons, were observed significantly less frequently. It is known that in each microbes association of a certain taxon in the biotope, the best spatial and nutrient conditions for their existence, growth and reproduction are created. Individual microorganisms of this biotope have the advantage of growing and reproduction and reach a high population level, becoming the leading agents (factors) of the pathological process in the biotope. To establish this characteristic in the associations, we have studied the population level of each taxon that forms an association on the gum mucosa in patients with partial loss of teeth. (table 4).

Table 4

Population level

M.O. Patients (n=47) Practically healthy people (n=50) P

PL b lgCFU/ml M±m KKfl K3 PL. b lgCFU/ml M±m KKfl K3

S.aureus 6.11±0.34 46.16 0.22 0 - - -

S.epidermidis 5.18±0.27 13.05 0.06 4.34±0.27 14.61 0.063 < 0.05

S.haemolytics 6.09±0.29 20.44 0.10 3.78±0.19 3.63 0.018 < 0.01

S.pyogenus spp. 7.21±0.35 24.20 0.11 3.27±0.17 7.86 0.04 < 0.01

S.salivarius 4.76±0.21 4.28 0.02 7.67±0.41 173.31 0.743 < 0.01

S.sanguis 4.27±0.18 5.37 0.03 5.11±0.31 29.48 0.135 < 0.05

S.mutans 4.31±0.16 3.88 0.02 5.09±0.18 19.58 0.086 < 0.05

S.mitry 4.02±0.17 3.62 0.02 5..7±0.22 18.07 0.077 < 0.05

E.coli 5.27±0.23 15.48 0.07 3.30±0.17 3.17 0.016 < 0.01

K.pneumoniae 4.29±0.18 7.20 0.03 3.00 1.44 0.007 -

E.cloacae 4.78±0.27 4.30 0.02 3.00 1.44 0.007 -

Actinobacter spp. 5.21±0.33 10.93 0.05 4.17±0.12 10.02 0.050 < 0.05

B.catarralis 5.93±0.41 22.40 0.11 3.00 1.44 0.007 -

N.flavescens 4.56±0.31 13.39 0.06 3.62±0.11 10.44 0.052 < 0.05

M.lacunata 4.18±0.17 12.28 0.06 3.47±0.16 6.67 0.033 < 0.05

C.albicens 4.97±0.29 16.68 0.08 0 - - -

It was established that the highest population level in the gum mucosa secretion of patients with partial secondary loss of teeth was found in S. pyogenes. Somewhat lower level was observed in staphylococci, colibacilli, acinetobacteria, branhamella, and others.

In patients with partial tooth loss the population level of S. pyogenes on the mucosa grows by 2.2 times, B. catarrhalis - by 97.67%, Actinobacter - by 94.94%, S. hemolyticus - by 61.11%, E. Coli - 59.70%, E. cloacae - 59.33%, S. epidermidis - 49.35%, K. pneumoniae - 43.0%, N. flavescens - 25.60%, M. lacunata - by 20.46%. Microorganisms contaminating the surface of the prosthetic bed mucous membrane - S. aureus and C. albicans - reach the high population level, S. salivarius grows by 61.13%, S. mitris - by 33.58%, S. mutans - by 18.10%, S. sanguis - by 14.67%. Thus, in patients with partial loss of teeth, the concentration of autochthonous obligatory and facultative for the biotom streptococci is reducing on the gum mucosa (S. sallivarius, S. sanguis, S. mutans, S. mytri), but the population level of S. pyogenus S., epidermidis, S. haemoliticus, enterobacteria (E. coli, K. pneumoniae, E. cloacae), Acinetobacter, B.cattaralis, N.flavescens, N..lacunata and yeast-like fungi of the Candida genus. Standard clinical and laboratory studies, such as determination of oral hygiene indices, correction of partial removable denture are important auxiliary methods for accelerating adaptation of patients with partial secondary adentia to removable dentures [6, 8]. Microbiological studies permit practitioners to correct rehabilitation therapy, by means of methods having a pronounced effect against certain taxa of microorganisms, and combination of microbiological study with knowledge of the of blood cells composition, by means of leukocyte indices permits to determine the adaptation zones and the most favourable moment to influence the patient's body with medicinal products of local or general action [1].

Further studies on antibiotic resistance and the microbial taxa sensitivity to local antiseptics are necessary to develop a complete plan for rehabilitation of patients after prosthetics. Studies on the development and implementation of improvements to the existing partial removable dentures will also be relevant, with the purpose of preventing infectious and inflammatory processes that make it impossible to use the prosthesis, impair the quality of life in patients and their trust towards the dentist orthopedic doctor

by introduction of prolonged action drugs in the oral cavity of patients [1, 9]. It will be important to study the dynamics of microbiota changes when using different designs of removable dentures, during the period of patients' adaptation to them [3, 4].

1. In patients with partial loss of teeth, made a prosthetic appliance with conventional removable dentures, the taxonomic composition of microbiota changes on the gum mucosa due to contamination of the habitat with opportunistic S. aureus and yeast-like fungi of the Candida genus, S. haemolyticus, K. pneumoniae, enterobacteria (E .coli, K. pneumoniae, E. cloacae), B. catarralis, M. lacunata and partial elimination of S. sialivarius, S.sanguis, S. mutans, S. mitis from the biotom.

2. Microorganisms isolated and identified from the surface of the prosthetic bed in 78.72% of patients were in associations that consisted of 2 (in 31.70% of cases), 3 (8.51%) and 4 (8.51%) taxons. The most numerous associations consisting of 2 taxons were: S. aureus and M. lacunata; S. aureus and N. flavescens; S. haemolyticus and B.catarrhalis; C. albicans and S. epidermidis.

3. In the biotope (the surface of the prosthetic bed gums mucous membrane) of these patients made a prosthetic appliance with partial removable plate dentures, the population level is reduced in S. salivarius, S. sanguis, S. mutans, S .mitis and significantly increases in opportunistic staphylococci (S. aureus, S. haemolyties, S. epidermidis), S. pyogenes, enterobacteria (E. coli, K. pneumoniae, E. clocacae), B. catarrhalis. Microorganisms (S. aureus and C. albicans) reach a high population level, and it also increases in S. haemoliticus, S .epidermidis, S. pyogenes, E. coli, E. cloacae, K .pneumoniae.

Prospects for further research lie in studying the possibilities for stabilizing the taxonomic composition and population level of the prosthetic bed mucous membrane microbiota in the patients made a prosthetic appliance with partial removable dentures.

1. Lewandowsky RA. Vydovyi sklad i populiatsiinyi riven mikroflory rotovoyi porozhnyny liudei zi skladnoyu shchelepno-lytsevoyu patolohiyeyu pry korystuvanni riznymy vydamy proteziv ta yiyi chutlyvist do antyseptychnykh preparativ in vitro. Clinical and Experimental Pathology. 2014; 13(1):69-74. [in Ukrainian]

2. Safarov AM. Mikrobnaya obsemenennost polosti rta pri noshenii syemnykh zubnykh protezov na osnove razlichnykh materialov. Sovremennaya stomatologiya. 2010; 2:103-5. [in Russian]

3. Sokolova II, Skidan KV, Voropaeva LV, Tomilina TV, German SI, Slinko YuA, i dr. Mikroflora polosti rta, disbakterioz i puti ego korrektsii probiotikami. Eksperymenalna i klinichna medytsyna. 2010; 2:64-9. [in Russian]

4. Tsarev VN, redaktor. Mikrobiologiya, virusologiya i immunologiya polosti rta: uchebnik. Moscow: GJeOTAR-Media; 2013. 576 p. [in Russian]

5. Kilian M, Chapple IL, Hannig M, Marsh PD, Meuric V, Pedersen AM, et al. The oral microbiome - an update for oral healthcare professionals. British Dental J [Internet]. 2016; [cited 2018 Sep 11]; 221(10):657-66. Available from: https://www.nature.com/articles/sj.bdj.2016.865 doi: 10.1038/sj.bdj.2016.865.

6. Pietiäinen M, Liljestrand JM, Kopra E, Pussinen PJ. Mediators between oral dysbiosis and cardiovascular diseases. Eur J Oral Sci [Internet]. 2018; [cited 2018 Sep 11]; 126(1): 26-36.: Available from https://onlinelibrary.wiley.com.

7. Vesty A, Biswas K, Taylor MW, Gear K, Douglas RG. Evaluating the Impact of DNA Extraction Method on the Representation of Human Oral Bacterial and Fungal Communities. PloS One [Internet]. 2017; [cited 2018 Sep 11]; 12(1):e0169877. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169877 doi: 10.1371/journal.pone.0169877.

8. Zhang M, Zheng Y, Li Y, Jiang H, Huang Y, Du M. Acid-resistant genes of oral plaque microbiome from the functional metagenomics. J Oral Microbiol [Internet]. 2018; [cited 2018 Aug 29]; 10(1):1424-455. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5795652/ doi: 10. 1080/20002297.2018.1424455.

9. Zheng X, He J, Wang L, Zhou S, Peng X, Huang S, Zheng L, et al. Ecological Effect of Arginine on Oral Microbiota. Scientific Reports [Internet]. 2017; [cited 2018 Aug 29]; 7:7206. Available from: https://www.nature.com/articles/s41598-017-07042-w doi: 10.1038 / s41598-017-07042-w.

iY<|k|>;iiii

ТАКСОНОМ1ЧНИЙ СКЛАД I ПОПУЛЯЦ1ЙНИЙ Р1ВЕНЬ М1КРОБ1ОТИ СЛИЗОВО1 ОБОЛОНКИ ПРОТЕЗНОГО ЛОЖА ПРИ ДЕФЕКТАХ ЗУБНИХ РЯД1В У ПАЩ€НТ1В, ЗАПРОТЕЗОВАНИХ ЧАСТКОВИМИ ЗН1МНИМИ

ПРОТЕЗАМИ Ожоган З.Р., Ясшський М.М., Левандовський Р.А., Булик Р.Й.

У статп розглянуто таксономiчний склад i популяцшний рiвень мкробюти слизово! оболонки ротово! порожнини i змши !х характеристик, тсля протезування частковими зшмними протезами. У пащенив з частковою втратою зубiв, запротезованих звичайними зшмними протезами, на слизовш оболонщ ясен змшюеться таксономiчний склад мкробюти за рахунок контамшацп бютопу умовно патогенними

ТАКСОНОМИЧЕСКИЙ СОСТАВ И ПОПУЛЯЦИОННОЙ УРОВЕНЬ МИКРОБИОТЫ СЛИЗИСТОЙ ОБОЛОЧКИ ПРОТЕЗНОГО ЛОЖА ПРИ ДЕФЕКТАХ ЗУБНЫХ РЯДОВ У ПАЦИЕНТОВ ЗАПРОТЕЗИРОВАНИХ ЧАСТИЧНЫМИ СЪЕМНЫМИ ПРОТЕЗАМИ Ожоган З.Р., Ясинский Н.Н., Левандовский Р.А., Булык Р. И.

В статье рассмотрены таксономический состав и популяционный уровень микробиоты слизистой оболочки ротовой полости и изменения их характеристик, после протезирования частичными съемными протезами. У пациентов с частичной потерей зубов, запротезированных обычными съемными протезами, на слизистой оболочке десен меняется таксономический состав микробиоты за счет контаминации биотопа условно патогенными S. aureus и

S. aureus i дрiжджоподiбними грибами ряду Candida, S. haemolyticus, K. pneumoniae, ентеробактерiями (E. coli, K. pneumoniae, E. cloacae), B. catarralis, M. lacunata i частково'' елiмiнацiï з бюти S. salivarius, S. sanguis, S. mutans, S. mitis. Видшеш та щентифковаш з поверхш протезного ложа мкрооргашзми в 78,72% пащентсв знаходяться в асощащях, якi складаються з 2-х (в 31,70% випадюв), 3-х (8,51%) i 4-х (8,51 %) таксонiв. Найбiльш численнi асоцiацiï, що складаються з 2-х таксошв були: S. aureus i M. lacunata; S. aureus i N. flavescens; S. haemolyticus i B.catarrhalis i C. albicans i S. epidermidis. У бютот (поверхш слизово'' оболонки ясен протезного ложа) цих пащентсв, запротезованих частковими зшмними пластинковими протезами, популяцшний рiвень знижуеться у S. salivarius, S. sanguis, S. mutans, S. mitis i ютотно тдвищуеться в умовно патогенних стафюлокоюв (S. aureus, S. haemolyties, S. epidermidis), S. pyogenes, ентеробактерш (E. coli, K. pneumoniae, E. clocacae), B. catarrhalis. Мкрооргашзми (S. aureus i C. alb^ns) досягають високого популяцшного рiвня, також вiн тдвищуеться у S. haemoliticus, S. epidermidis, S. pyogenes, E. coli, E. cloacae, K. pneumoniae.

Ключовi слова: частковi знiмнi протези, таксономiчний склад, популяцiйний рiвень.

Стаття надшшла 27.03.2019 р.

дрожжеподобными грибами ряда Candida, S. haemolyticus, K. pneumoniae, энтеробактериями (E. coli, K . pneumoniae, E. cloacae), B. catarralis, M. lacunata и частичной элиминации из биоты S. salivarius, S. sanguis, S. mutans, S. mitis. Выделенные и идентифицированные с поверхности протезного ложа микроорганизмы в 78,72% пациентов находятся в ассоциациях, которые состоят из 2-х (в 31,70% случаев), 3-х (8,51%) и 4-х (8,51 %) таксонов. Наиболее многочисленные ассоциации, состоящие из 2-х таксонов были: S. aureus и M. lacunata; S. aureus и N. flavescens; S. haemolyticus i B.catarrhalis и C. albicans i S. epidermidis. В биотопе (поверхности слизистой оболочки десны протезного ложа) этих пациентов, запротезированных частичными съемными пластиночными протезами, популяционный уровень снижается у S. salivarius, S. sanguis, S. mutans, S. mitis и существенно повышается у условно патогенных стафиолококков (S. aureus, S. haemolyties, S. epidermidis), S. pyogenes, энтеробактерий (E. coli, K. pneumoniae, E. clocacae), B. catarrhalis. Микроорганизмы (S. aureus i C. alb^ns) достигают высокого популяционного уровня, также он повышается у S. haemoliticus, S. epidermidis, S. pyogenes, E. coli, E. cloacae, K. pneumoniae.

Ключевые слова: частичные съемные протезы, таксономический состав, популяционный уровень.

Рецензент Аветиков Д. С.

DOI 10.26724/2079-8334-2019-4-70-133-137 УДК 616.12-008.331.1:616-005.4:616.89-008.46-08

II.Ю. Осовська. Б.В. Шеремет. II.В. Ку ¡ьмшюг.а. А.О. I аврм. мок. 1.1. К'мя'.ькова1 liiiiiiiiiii.K'iiM мап1омальммм медмчммй унп'.ерсиич iM. M.I. I lupin ова. Шмшмш

'Харькмич.кмМ мам1омальммм ме ичимм у мми-риме!. Хармв

КОМПЛЕКС 1НСТРУМЕНТАЛЬНИХ ПОКАЗНИК1В, АСОЦ1ЙОВАНИХ

З ПЕРЕДГ1ПЕРТРОФ16Ю Л1ВОГО ШЛУНОЧКА У МОЛОДИХ ЗДОРОВИХ ОС1Б

e-mail: osovskayanatalia@gmail.com

Обстежено 78 здорових oci6 25,3±0,6 роюв. За допомогою множиино! лiнiйноi регресп визначеш незалежнi предиктори виникнення концентричного ремоделювання лiвoгo шлуночка (пеpедгiпеpтpoфii). Найбiльш шформативним предикторами у нормотензивних молодих оЫб виявилося зростання швидкoстi pанiшньoгo тдйому систoлiчнoгo аpтеpiальнoгo тиску бiльше шж 14 мм рт. ст., при наявносп якого в 9,5 pазiв зростае вipoгiднiсть розвитку ремоделювання серця. При поеднанш даного показнику з шдексом часу систoлiчнoгo аpтеpiальнoгo тиску бшьше нiж 11%, ваpiабельнiстю систoлiчнoгo аpтеpiальнoгo тиску бiльше нiж 8 мм рт. ст. та наявшстю в стpуктуpi лiвoгo шлуночка аномально! хорди, шанс дiагнoстики концентричного ремоделювання зростае в 11-15 pазiв. Використання сукупносп даних паpаметpiв в piзних поеднаннях покращуе ранню дiагнoстику ураження серця при вщсутносп скарг та класичних кpитеpiiв дiагнoстики серцево-судинних захворювань, в першу чергу, масковану аpтеpiальну гiпеpтензiю.

Ключовi слова: предиктори концентричного ремоделювання лiвoгo шлуночка, мoлoдi здopoвi особи, артер1альна гшертегая.

Робота е фрагментом НДР «Структурно-функцюналъний стан серця i нирок та ятстъ життя na^eHmie i3 хрошчною серцевою недостаттстю, оnmимiзaцiя лжування», № державно'1 реестраци 0115U007129 та «Меmaболiчнi фактори ризику, серцево-судинне ремоделювання та функцюналъний стан нирок у хворих з серцево-судинною namологieю. Можливосmi фaрмaкологiчноi корекци», № державно1 реестраци 0119U101849.

В даний час одне з провщних мюць в кардюлогй займае вивчення серцево-судинного ремоделювання при будь-якш серцево-судиннш та коморбщнш патологи. Ремоделювання л1вого шлуночка - симптомокомплекс, що характеризуеться змшою маси, об'ему та форми л1вого шлуночка (ЛШ) за рахунок гшертрофн кардюмюципв, гшерплазп штерстищальних клггин та ендотелда, що призводить до порушення функцюнальних властивостей мюкарда. Концентричне ремоделювання л1вого шлуночка (КРЛШ) не е ознакою ступеня артер1ально! гшертенз1ю або стадй гшертошчно! хвороби. Лише шдвищення маси мюкарда е ознакою гшертрофн л1вого шлуночка. КРЛШ - це «передгшертроф1я», ознака, що вказуе на компенсаторну реакщю оргашзму на будь-який фактор або комплекс фактор1в, що спричиняють гемодинам1чне навантаження на мюкард. КРЛШ безперечно е компенсаторним мехашзмом адаптацй серця до тдвищеного навантаження та незалежним предиктором розвитку серцево-судинних ускладнень у хворих з артер1альною

© Н.Ю. Осовська, Б.В. Шеремета, 2019