State of Periodontal Tissues during the Treatment and Recovery of Patients with Inflammatory Diseases of Maxillofacial Area

Grygorova А. О.

DENTISTRY

Scentific article

The purpose of research was aimed at study of periodontal tissues condition during the treatment and recovery of patients with inflammatory diseases of maxillofacial area (MFA). Materials and Methods. Dental status of 147 patients with odontogenous inflammatory diseases (ID) of MFA has been studied at the stages of its perioperative monitoring. Dental status (DS) have been estimated according to the following indices: papillary- marginal-alveolar (PMA) index, oral hygiene index (ОНІ-S), index of zonal vacuum- pressing persistence of gingival capillaries (ZVPC) at the stages of monitoring. Results and Discussion. The analysis of PMA index values during clinical monitoring of patients with MFA ID showed that the frequency and manifestation of inflammatory process in periodontal tissues varied from stage to stage. In the pre-surgical period (74,1 ± 3,6) % of patients required medioprophylactic management related to sys- temic treatment and sanitation of periodontal tissues. In the postsurgical period the frequency of occurrences of severe gingivitis significantly (р 0,05) increased. In the late postsurgical period the ratio of patients with РМА values up to 1,0 p significantly decreased; the ratio of patients with moderate lesion of parodentium (from 74,1 ± 3,6) % to (66,7 ± 3,9) %, р 0,05) significantly decreased, too, and the ratio of patients with severe gingivitis was almost 4 times as high. Dynamic analysis of state of oral health according to ОНІ-S values showed the significant (р 0,05) decrease in number of patients with ОНІ-S values within (0,7ч1,6) units since the early postsurgical period (60,0 ± 4,0) %, and (73,5 ± 2,5) % in pre-surgical period. The increase of ratio of patients with “boundary” values of oral health indices has been revealed: number of patients with values within (1,7ч2,5) units in the remote postsurgical period signifi- cantly (р 0,001) increased. It has been ascertained that ,depending on the period of clinical monitoring, the ratio of patients with refer- ence degrees of ZVPC was increasing from (51,7 ± 4,1) % at the Stage I to (76,2 ± 3,5) % at the Stage ІV of clinical monitoring; however, even in the remote postsurgical period about one third of patients (23,8 ± 3,5) % is hemody- namically characterized by microcirculatory disorders. In pre-surgical period microcirculatory disorders have been revealed in (48,3 ± 4,1) % of patients, including manifested disorders (VZPC 49 sec) in 28,9 % of patients. The similar tendency was also admitted in early postsurgical period: reference values were observed in (55,1 ± 4,1) % of patients, manifested parodentium microcirculation disorders were observed in 27,2 % of patients with inflam- matory disease of MFA. In the late postsurgical period the ratio of patients with reference ZVPC degrees up to (70,1 ± 3,8) %, р 0,05, significantly increased. In the remote postsurgical period the tendency to positive changes of parodentium microcirculation has been preserved; however, (23,8 ± 3,5) % of patients demonstrated low indices of VZPC, and critically low values have been detected in 12,7 % of patients. Conclusions. At the stages of treatment patients with MFA ID require active sanogenetic approach and systemic treatment related to perioperative protection of parodentium; the amount of such measures are defined, at least, by the stage of treatment. The significant changes of indices of dental status of patients with inflammatory diseases of MFA are characterized by: in the early period by the absence of changes of DS indices; in the late postsurgical pe- riod the increase of need in parodentium treatment due to oral health and parodentium microcirculation worsening, as well as increasing РМА, has been registered; in the remote postsurgical period increase of РМА index has been registered against the background of DS changes, mentioned above. Perspectives of further research are connected with the enhancement of treatment -and -recovery (rehabilitation) management, considering the revealed mechanisms and risk factors for parodentium pathology development at pre-hospital, during hospital and post-hospital stages of medical care provision for patients with MFA ID.

dental status, odontogenous inflammatory diseases, maxillofacial area, clinical monitoring

«Bulletin of problems biology and medicine» Issue 4 part 1 (113), 2014 year, 349-354 pages, index UDK 616. 31:[616. 176. 8+617. 52]-001-036-07-08-084-092