INFLUENCE OF OCCLUSION DISORDERS ON BONE METABOLISM IN PATIENTS WITH GENERALIZED PERIODONTITIS

Malynovskyi V. G.

DENTISTRY

Scentific article

Despite the large number of studies, the role of occlusive disorders in the pathogenesis of periodontitis remains not completely clear. So the aim of this study was to determine the level of biochemical markers of bone metabolism in patients with generalized periodontitis with diagnosed occlusive imbalance. The object and methods of research. 128 patients with generalized periodontitis of the I-II degree, chronic course, age 35-55 years, were examined. The occlusion diagnosis was performed by means of the T-Scan III company “Tekscan” (USA) for the various types of occlusion. Besides, markers of bone metabolism, such as tartrate-resistant acid phosphatase (TRAP) in serum, concentration of β-CrossLaps in urine, concentration of C-terminal propeptide procolagen type I (CICP) in plasma, bone alkaline phosphatase (BAP) in serum and osteocalcin were studied. Additionally, indicators of mineral metabolism – the concentration of parathyroid hormone in serum and the concentration of total calcium and total inorganic phosphorus in blood – were studied. Results and their discussion. According to the results of computer diagnostics, only 15.6 ± 3.2 % of patients had an occlusive balance. An acceptable balance of 60% – 40% was observed at 18.8 ± 3.4 %. While in the remaining 65.6 ± 4.2 %, occlusive imbalance was recorded, resulting in a functional overload of the teeth on the corresponding side of the jaws. The difference between all studied parameters received for patients with generalized periodontitis, in whom the occlusion balance was diagnosed, and those, where the disorders of occlusive relations were defined, were not established (p> 0,05), that indicates the similarity of metabolic processes in bone tissue in these groups of patients. At the same time, the presence of occlusive disorders led to an increase in the level of TRAP and β-CrossLaps, which indicates an increase in the activity of resorptive processes in the bone tissue (p <0,05). In turn, the level of markers of bone formation in patients with generalized periodontitis with diagnosed occlusive imbalance decreased in comparison with cases of occlusion norm (p <0,05). Otherwise, the mineral metabolism indices in the bone tissue did not differ according to the state of occlusion balance (p> 0.05). In our opinion, this is due to the localization of destructive processes only in the tissues of periodontal disease, as a consequence of the inflammatory process in the gums. The strongest direct correlation was observed between occlusal disorders and markers of bone resorption. Somewhat lower feedback correlation was registered for bone formation indicators. Conclusions. The obtained results indicate that occlusive imbalance affects the nature of the destructive process in periodontal bone tissue in patients with generalized periodontitis. The registered increase in the level of bone resorption markers against the background of decreasing bone formation indicators confirms the role of occlusive trauma in the pathogenesis of disease. However, the absence of strong correlation between the level of occlusive imbalance and the values of biochemical markers of bone metabolism indicates the secondary role of occlusive disorders in the development of the disease, that is, their ability to somewhat worsen the course of destruction in the alveolar bone, but the inability to activate the pathological process initially. Prospects for further research. According to the obtained data, occlusive disorders are one of the factors that determine the course of generalized periodontitis, in particular, activating resorptive processes in the bone tissue and suppressing bone formation. Therefore, it is promising to search for measures of effective functional diagnosis and occlusion correction, which will significantly improve the long-term prognosis of complex treatment of the disease.

generalized periodontitis, occlusive disorders, bone metabolism

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«Bulletin of problems biology and medicine» Issue 4 part 1 (146), 2018 year, 294-297 pages, index UDK 616.314.17-002-031.81: 616.71-007.23: 616.314.2

10.29254/2077-4214-2018-4-1-146-294-297