CALCIUM-PHOSPHORUS EXCHANGE AND BONE METABOLISM IN GENERALIZED PERIODONTITIS, WHICH OCCURS ON THE BACKGROUND OF RHEUMATOID ARTHRITIS IN PATIENT, WHO LIVE IN ENVIRONMENTALLY UNFAVORABLE TERRITORIES

Kovalyshyn H. V., Rozhko M. M.

DENTISTRY

Scentific article

Object and methods. A biochemical research was performed on 123 patients, including 70 patients with RA in remission with GP of the I and II degree of development. Two groups of patients with RA were formed: group I – 35 patients who live in environmentally unfavorable areas and group II – 35 patients who live in environmentally favorable areas. From patients with GP without concomitant somatic pathology, group III was formed – 35 people. Each of the groups, depending on the severity of GP was divided into subgroups: A – GP of the I degree; B – GP of the II degree of severity. The control group consisted of 18 healthy individuals with intact periodontium (K). The diagnosis of periodontal tissue diseases was established according to the classification by MF Danilevsky (1994). Patients of groups I, II and III underwent comprehensive treatment. Topically prescribed: rinsing the oral cavity with a solution of “Furasol” applications on the gums with the drug “Holisal”. For general treatment, patients of all groups received “Osteogenon”, “E 200-Zentiva”. Enterosorbent “Enterosgel” was additionally prescribed for patients of group I. Alkaline and acid phosphatase activity were determined using standard «SPL» kits. The concentration of total, ionized calcium and inorganic phosphorus was determined with reagents from «Simko LTD». The obtained results were statistically processed using computer programs Microsoft Excel and Statistica 7. Research results and their discussion. Analysis of the obtained results before treatment showed a decrease in calcium, phosphorus, LF activity and an increase in CF activity in the oral fluid in all subgroups of patients with GP. In GP of the II degree of severity, these deviations were more significant than in I degree. Among those examined with the II degree of severity of GP, the highest activity of CF was detected in the IB subgroup, which is 2.74 times significantly higher than the result of the control group (*p<0.001). The greatest decrease in LF activity in oral fluid is observed in the IIB subgroup, namely 2.28 times the value of the healthy group (*p<0.001). Calcium and phosphorus levels in the IB subgroup were the lowest. In particular, the level of calcium in the IB subgroup was 1.63 times, and the level of phosphorus 1.68 times lower compared with the healthy group (*p<0.001). After conducted comprehensive treatment in patients of all subgroups normalization of bone metabolism. However, the approximation of the researched indicators to the results of the healthy group after 6 months was mostly noted. Conclusions. The negative impact of concomitant somatic pathology and unfavorable environmental situation on bone metabolism in patients with GP has been established, which is confirmed by significantly higher acid phosphatase activity, lower concentration of calcium, phosphorus and LF in the oral fluid of such patients compared with patients of groups II and III. After conducted treatment, normalization of bone metabolism and calcium-phosphorus metabolism is observed during all observation periods, which is confirmed by an increase in calcium, phosphorus, increased alkaline phosphatase activity and decreased acid phosphatase activity in the oral fluid.

generalized periodontitis, calcium-phosphorus metabolism, bone metabolism, rheumatoid arthritis, environmentally unfavorable areas.

1. Ostapyak IZ. Osoblyvosti kliniko-biokhimichnoyi kartyny u khvorykh na heneralizovanyy parodonty pid vplyvom ekozabrudnennya solyamy vazhkykh metaliv. Halytskyy likarskyy visnyk. 2008;15(2):58-60. [in Ukrainian].
2. Popovych ZB, Rozhko MM, Solovey SI, Bodnaruk YuB, Kukurudz NI. Problemy dovkillya i stan stomatolohichnoho zdorovya IvanoFrankivskoyi oblasti. Profilaktychna dytyacha stomatolohiya. 2014;1:74-7. [in Ukrainian].
3. Agayeva DF. Vliyaniye vrednykh khimicheskikh primesey vozdukha na nekotoryye pokazateli sostoyaniya polosti rta. Gigiyena i sanitariya. 2011;2:48-51. [in Russiаn].
4. Skrypnikova TP, Neyko NV. Kistkovyy metabolizm i kaltsiy-fosfornyy obmin pry heneralizovanomu parodontyti, shcho perebihaye na foni revmatoyidnoho artrytu. Halytskyy likarskyy visnyk. 2000;(7)3:109-12. [in Ukrainian].
5. Bilozetskyy II. Suchasni uyavlennya pro vzayemozvyazky heneralizovanoho parodontytu, revmatoyidnoho artrytu y osteoporozu. Problemy osteolohiyi. 2015;2(8):51-63. [in Ukrainian].
6. Bilozetskyy II, Hrymalyuk NV, Slaba US, Zarudna OI, Makhovska OS, Lehka LL, ta in. Chastota i osoblyvosti urazhennya parodonta u patsiyentiv z revmatoyidnym artrytom. Halytskyy likarskyy visnyk. 2014;4:6-9. [in Ukrainian].
7. Kuznyak NB, Boytsanyuk SI, Sukhovolets IO. Vykorystannya biokhimichnykh markeriv kistkovoho metabolizmu v stomatolohiyi. Klinichna stomatolohiya. 2015;1:99-104. [in Ukrainian].
8. Vavilova TP, Pashkova GS, Grinin VM. Issledovaniya rastvorimogo osteoklastaktiviruyushchevogo faktora i osteoprotegirina v smeshannoy slyune patsiyentov s parodontitom. Rossiyskiy stomatologicheskiy zhurnal. 2010;2:11-3. [in Russian].
9. Vavilova TP, Shtrunov LN, Shishkin SV. Ispolzovaniye pokazateley slyuny v otsenke sostoyaniya tkaney parodonta. Rossiyskiy stomatologicheskiy zhurnal. 2010;1:10-3. [in Russian].
10. Gavrilyuk LA, Shevchenko NV, Spiney AF. Aktivnost glutationzavisimykh enzimov slyuny bolnykh parodontitom. Klinicheskaya laboratornaya diagnostika. 2008;7:22-5. [in Russian].
11. Drok VO. Vyvchennya pokaznykiv metabolizmu kistkovoyi tkanyny u patsiyentiv iz zuboshchelepnymy anomaliyamy ta osteopenichnym syndromom. Visnyk problem biolohiyi i medytsyny. 2015;2(119):79-82. [in Ukrainian].
12. Boychuk OH. Doslidzhennya aktyvnosti markeriv kistkovoho metabolizmu u vahitnykh zhinok, khvorykh na heneralizovanyy parodontyt, na tli zalizodefitsytnoyi anemiyi. Ukrayinskyy zhurnal medytsyny, biolohiyi ta sportu. 2019;5(14):198-202. [in Ukrainian].
13. Kaminska MV, Rozhko MM, Erstenyuk AM. Metabolichni porushennya v orhanakh rotovoyi porozhnyny za umov poyednanoyi diyi ksenobiotykiv ta korektsiya vyyavlenykh porushen. Science and Education a New Dimension. Natural and Technical Sciences, VII(25), Issue: 206. 2019;15-19. [in Ukrainian].
14. Pyasetska LV, Luchynskyy MV, Vadzyuk SN. Dynamika pokaznykiv okremykh fermentiv rotovoyi ridyny pry zakhvoryuvannyakh tkanyn parodontu u osib z riznymy klinichnymy variantamy reaktsiy psykhofiziolohichnoyi dezadaptatsiyiyi. Visnyk problem biolohiyi i medytsyny. 2018;3(145):378-81. [in Ukrainian].
15. Haydin AM, Dyakiv VO, Chikova IV. Ekolohichni problemy hirnychopromyslovykh kompleksiv. Naukovo-tekhnichnyy zhurnal. 2014;2(10):101-7. [in Ukrainian].
16. Savchuk LYa, Semchuk YaM. Dzherela ekolohichnoyi nebezpeky khimichnykh pidpryyemstv m. Kalusha. Naukovo-tekhnichnyy zhurnal. 2014;2(10):107-13. [in Ukrainian].
17. Veligoriya IY. Aktivnost’ fosfataz v slyune u lits, podvergshikhsya vozdeystviyu ioniziruyushchey radiatsii i stressa. Vísnik stomatologíí̈ . 1999;2:12-3. [in Russian].
18. Melnychuk AS, Kashivska RS, Melnychuk HM. Rezultaty kompleksnoho likuvannya heneralizovanoho parodontytu z vykorystannyam preparativ na osnovi ekstraktu hinkho biloby ta oseyin-hidroksyapatytnoho kompleksu. Klinichna stomatolohiya. 2015;2:50-6. [in Ukrainian].
19. Lychkovska OL, Melnychuk HM. Vplyv kompleksnoho likuvannya iz zastosuvannyam metodu fotoaktyvovanoyi dezinfektsiyi parodontalnykh kyshen u khvorykh na heneralizovanyy parodontyt na deyaki biokhimichni pokaznyky. Innovatsiyiyi v stomatolohiyi. 2017;1:2-7. [in Ukrainian].
20. Zubachyk VM, Fedun IR. Biokhimichni pokaznyky rotovoyi ridyny u narkozalezhnykh khvorykh na khronichnyy heneralizovanyy parodontyt. Klinichna stomatolohiya. 2017;2:9-14. [in Ukrainian].
21. Anshukova OI. Strukturno-funktsionalni osoblyvosti stanu tkanyn parodonta u patsiyentiv z prohresuyuchoyu osteorezorbtsiyeyu alveolyarnoyi kistky. Odeskyy medychnyy zhurnal. 2005;2(88):52-6. [in Ukrainian].
22. Plavyuk LYu, Herelyuk VI, Neyko NV, Stasyuk NO. Kliniko-biokhimichna kharakterystyka Sa-R mettolizmu u khvorykh na heneralizovanyy parodontyt iz suputnim osteoporozom. Halytskyy likarskyy visnyk. 2009;16(4):72-5. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 3 (157), 2020 year, 326-331 pages, index UDK 616.314-71+616.31+616.314.18-002.4+616.72-002.77+502.1+616-08

10.29254/2077-4214-2020-3-157-326-331