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 УДК 611311:613.84

Однією з найактуальніших проблем сучасності - тютюнопаління, що є причиною багатьох тяжких захворювань. Дослідження останніх років свідчать, що динаміка розповсюдженості тютюнопаління в Україні загрозливо зростає – нині палять 62% чоловіків та 16 % жінок. У сучасній стоматології достатньо висвітлена проблема пов’язана зі згубним впливом тютюнового диму, а також встановлений прямий причинно-наслідковий зв’язок між тютюнопалінням та поширеністю і тяжкістю перебігу захворювань тканин та органів порожнини рота.

У тютюнових продуктах виявлено карієс-переважаючі субстанції, концентрація яких залежить від виду тютюну, умов зберігання, наявності ароматичних домішок для поліпшення смаку. Встановлено, що у курців агрегація тромбоцитів прискорюється внаслідок впливу нікотину на синтез простацикліну в судинах, яка спричиняє порушення мікроциркуляції в тканинах пародонту подібне до того, як це спостерігається при пародонтиті.

Клінічно доведений зв’язок тривалості тютюнопаління зі збільшенням втрати кісткової тканини, (майже в чотири рази), більшою втратою прикріплення пародонту (у 2,5-3,5 рази), більшою рецесією ясен і формуванням пародонтальної кишені у порівнянні з некурцями. Навіть якщо курець ретельно дотримується правил гігієни порожнини рота його пародонтальний статус гірший порівняно тими, що не мають нікотинової залежності.

В останні роки, у зв’язку з проведеними чисельними клінічними дослідженнями, які підтвердили вплив тютюнопаління на організм людини в цілому, провідні тютюнові компанії докладають великі зусилля для розробки менш шкідливих нікотиновмісних продуктів для здоров’я населення. До них належать електронні сигарети та системи нагрівання тютюну. Досі тривають дослідження щодо їх впливу на здоров’я людини. І жодне не має доказової відповіді, включно з міжнародними організаціями.


Ключові слова: карієс, захворювання пародонту, індексна оцінка, системи нагрівання тютюну GLO та IQOS. 

 УДК 616.314.13/.14:613.83]-056.8-08

Результати аналізу поширеності вживання наркотиків у 2018–2019 рр. вказують, що ситуація погіршилася, поширеність наркоманії в Україні має тенденцію до зростання. Вживання наркотичних речовин призводить до чималої кількості негативних змін у різних органах і системах організму (нефропатії, респіраторні захворювання, цироз печінки, захворювання серцево-судинної системи (інфекційний ендокардит), хірургічна патологія (некротизувальні фасціїти), вірусні гепатити, ВІЛ/ СНІД, туберкульоз), а також до психічних і поведінкових порушень. Мета роботи – на підставі аналізу фахової літератури дослідити вплив наркотичних речовин і способу життя, що формується при наркозалежності, на патологію порожнини рота та особливості надання стоматологічної допомоги наркозалежним хворим. 

УДК 616.314.9-002:616.7]-018.2-053.4

Abstract. Аssociation between incidence of caries of temporary teeth and pathology of the musculoskeletal system 
in preschool children, considering biochemical markers of connective tissue metabolism. Bodnaruk N.I.,  Smolyar N.I., Chukhray N.L., Mashkarinets O.O., Gan I.V. The aim is study biochemical markers of connective tissue  metabolism in children with musculoskeletal disorders and their association with dental caries of temporary teeth. There  were examined 232 children at the age of 5 (202 children with musculoskeletal disorders and 30 conditionally healthy  children without somatic pathology). Among children with musculoskeletal disorders 68 (33.66%) had flat feet, 59  (29.21%) – postural impairment and 75 (37.13%) – combined pathology of the musculoskeletal sestem. For further  research, the children were divided into three groups, 30 people in each. Group І included children with pathology of the musculoskeletal system, dental caries, without oxyproline in urine; group ІІ – with pathology of the musculoskeletal  system, dental caries and oxyproline in urine; group ІІІ – with dental caries and without oxyproline in urine. Urinary excretion of glycosaminoglycans using a nephelometric test with cetylpyridinium chloride was determined. The concentration of creatinine in urine was measured in units of weight in the formation of a chromogenic complex of a solution of picric acid with creatinine in an alkaline medium. Dental status was assessed in terms of caries prevalence, deft index and severity of dental caries. The prevalence of caries of temporary teeth in 5-years old children with musculoskeletal disorders was on average 90.6±2.05%, deft index ─ 6.62±0.20, being significantly higher than in children without somatic pathology (respectively 70.83±4.45% and 5.15±0.34, р<0.001). Oxyprolin was detected only in the urine of children with combined pathology of musculoskeletal system (on average 3.53±0.11 units). The excretion rates of glycosaminoglycans in children with pathology of the musculoskeletal system, dental caries and oxyproline in urine (gr.ІІ) were two times higher than the reference range (415.37±15,09 CPCh units / 1 g creatinine, р<0.001). In the absence of oxyproline in urine, both in somatically healthy children (gr. ІІІ) and in children with pathology of the musculoskeletal system (gr. І), the levels of excretion of glycosoaminoglycans were within the reference range (respectively 198.83±10.71 and 203.87±12.52 CPCh units / 1 g creatinine. The levels of daily excretion of creatinine were within the normal range in children of gr. ІІІ (1.17±0.13 g/day; in children of gr. І they were 2.85 times lower (0.41±0.05 g/day, p<0.001); in children of gr. ІІ – 6.5 times lower (0.18±0.02 g/day р<0.001). In children of gr. ІІ, a negative correlation was found between the levels of creatinine and oxyproline (τ= -0.68, p<0.05). The absence of oxyproline in the urine of children of gr. І and ІІІ indicates the absence of collagen decay in their bodies. In children with pathology of the musculoskeletal system against the background of undifferentiated connective tissue dysplasia (gr. ІІ), a strong, positive correlation was found between the deft index and levels of urinary excretion of oxyproline (τ= +0.77, p<0.05) and glycosaminoglycans (τ= +0.90, p<0.05), which indicates that the development of dental caries depends on the severity of the pathology of the musculoskeletal system.

The purpose of the study was to investigate the influence of concomitant somatic pathology on periodontal tissues. Materials and methods. 104 patients, aged 28–46 years, with diseases of periodontal tissues, who had somatic pathology, were involved in the study. The examined persons were divided into groups: 35 persons (group 1) with pathology of the hepatobiliary system, 37 persons (group 2) with pathology of the gastrointestinal tract, and 32 persons (group 3) with pathology of the cardiovascular system. The comparison group included 30 people with periodontal tissue diseases without somatic pathology. To determine the depth and prevalence of the inflammatory process of the gums the Svrakov’s number indicator was used. Oral hygiene was assessed according to the Silness-Loe and Stallard indices. The papillary-marginal-alveolar index (C. Parma, 1960) was determined to assess the severity of gum inflammation. Bleeding gums were assessed by the gum’s papilla bleeding index according to Muhllemann. Statistical processing of the research results was carried out with a computer program for variational and statistical analysis of medical and biological research data “GraphPad Prism 5”.
Results and discussion. Patients with diseases of periodontal tissues against the background of somatic pathology had the highest percentage of chronic generalized periodontitis of the II degree, in contrast patients of the comparison group had the highest percentage of chronic generalized periodontitis of the initial – I degree. Svrakov’s number in patients with periodontal disease against the background of somatic pathology significantly (р ˂0.05) exceeded the indicators of patients of the comparison group. At the same time, there is no significant difference between the results of groups 1, 2 and 3.
The highest values of the indexes of Silness-Loe and Stallard were recorded in patients with the cardiovascular system pathology, which significantly (p<0.05) exceeded the data in the comparison group, but did not significantly differ from the results of patients with pathology of hepatobiliary system and gastrointestinal tract. The papillary-marginal-alveolar index data were the highest in patients with hepatobiliary system pathology (64.25 ± 8.19%), which significantly (p<0.05) exceeded the results of the comparison group and in individuals of groups 2 and 3.The highest indicator of the bleeding index is 1.98 ± 0.22 points in patients of the 1st group, which significantly exceeds the indicators in the group of people without somatic pathology and in the group of patients with pathology of gastrointestinal tract and cardiovascular system. Conclusion. The conducted studies show that the presence of somatic pathology contributes to the development of periodontal tissue diseases, and certainly aggravates their course, which is proven by the results of the index assessment.
Keywords: periodontitis, somatic pathology, periodontal indices.

Аssociation between incidence of caries of temporary teeth and pathology of the musculoskeletal system in preschool children, considering biochemical markers of connective tissue metabolism. Bodnaruk N.I., Smolyar N.I., Chukhray N.L., Mashkarinets O.O., Gan I.V. The aim is study biochemical markers of connective tissue metabolism in children with musculoskeletal disorders and their association with dental caries of temporary teeth. There were examined 232 children at the age of 5 (202 children with musculoskeletal disorders and 30 conditionally healthy children without somatic pathology). Among children with musculoskeletal disorders 68 (33.66%) had flat feet, 59 (29.21%) – postural impairment and 75 (37.13%) – combined pathology of the musculoskeletal sestem. For further research, the children were divided into three groups, 30 people in each. Group І included children with pathology of the musculoskeletal system, dental caries, without oxyproline in urine; group ІІ – with pathology of the musculoskeletal system, dental caries and oxyproline in urine; group ІІІ – with dental caries and without oxyproline in urine. Urinary excretion of glycosaminoglycans using a nephelometric test with cetylpyridinium chloride was determined. The concentration of creatinine in urine was measured in units of weight in the formation of a chromogenic complex of a solution of picric acid with creatinine in an alkaline medium. Dental status was assessed in terms of caries prevalence, deft index and severity of dental caries. The prevalence of caries of temporary teeth in 5-years old children with musculoskeletal disorders was on average 90.6±2.05%, deft index ─ 6.62±0.20, being significantly higher than in children without somatic pathology (respectively 70.83±4.45% and 5.15±0.34, р<0.001). Oxyprolin was detected only in the urine of children with combined pathology of musculoskeletal system (on average 3.53±0.11 units). The excretion rates of glycosaminoglycans in children with pathology of the musculoskeletal system, dental caries and oxyproline in urine (gr.ІІ) were two times higher than the reference range (415.37±15,09 CPCh units / 1 g creatinine, р<0.001). In theabsence of oxyproline in urine, both in somatically healthy children (gr. ІІІ) and in children with pathology of the musculoskeletal system (gr. І), the levels of excretion of glycosoaminoglycans were within the reference range (respectively 198.83±10.71 and 203.87±12.52 CPCh units / 1 g creatinine. The levels of daily excretion of creatinine were within the normal range in children of gr. ІІІ (1.17±0.13 g/day; in children of gr. І they were 2.85 times lower (0.41±0.05 g/day, p<0.001); in children of gr. ІІ – 6.5 times lower (0.18±0.02 g/day р<0.001). In children of gr. ІІ, a negative correlation was found between the levels of creatinine and oxyproline (τ= -0.68, p<0.05). The absence of oxyproline in the urine of children of gr. І and ІІІ indicates the absence of collagen decay in their bodies. In children with pathology of the musculoskeletal system against the background of undifferentiated connective tissue dysplasia (gr. ІІ), a strong, positive correlation was found between the deft index and levels of urinary excretion of oxyproline (τ= +0.77, p<0.05) and glycosaminoglycans (τ= +0.90, p<0.05), which indicates that the development of dental caries depends on the severity of the pathology of the musculoskeletal system.