CLINICAL CHARACTERISTIC OF STATE OF HARD TISSUES OF TEETH IN CHILDREN AND ADOLESCENTS WITH DYSTROPHIC EPIDERMOLYSIS BULLOSA

Savychuk N. O., Sorochenko N. O., Piankova O. V

DENTISTRY

Scentific article

The article describes results of the dental examination of 41 patients from 2 to 18 years old with dystrophic epidermolysis bullosa (DEB) for studying the state of hard tissues of teeth. Object and methods of the research. To assess the state of hard tissues of teeth in 41 children and adolescents with DEB which applied for a consultation at the Children’s City Center of the treatment and prevention of diseases of oral mucosa and periodontal of the Children’s Clinical Hospital №9 in Kyiv. All patients were divided into 3 groups by age. The I group (from 2 to 5 years old) included 9 children, the II group (from 6 to 12 years old) included 12 children, the III group (from 13 to 18 years old) included 20 adolescents. Study and assessment of hard tissues of teeth were conducted according to WHO recommendations (1998). In the I group the study included determination of the prevalence of dental caries of deciduous teeth (in %), intensity of caries of deciduous teeth according to the DFT index and the DFS index. In the II group the study included determination of the prevalence of dental caries of deciduous and permanent teeth (in %), intensity of caries of deciduous teeth according to the DFT index and the DFS index and intensity of caries of permanent teeth according to the DMFT index and DMFS index. In the III group the study included determination of the prevalence of dental caries of permanent teeth (in %), intensity of caries of permanent teeth according to the DMFT index and the DMFS index. Activity of caries process was evaluated according to the recommendations of T.F. Vinogradova (1978). To determine the state of oral hygiene was used hygienic index Fedorov-Volodkina (1971). The survey of patients and their parents was conducted to identify compliant behavior in relation to dental treatment. Results of the research. In the I group of patients the prevalence of caries was 56%. The intensity of caries of deciduous teeth according to the DFT index was 4,67±2,4, which corresponded to the high level. The intensity of caries surfaces according to the DFS index was 5,2±2,66. There were filled teeth not registered. Compensated form of caries prevails and was diagnosted in 67%. Decompensated form of caries was registered in 22%. Subcompensated form of caries was diagnosted in 11%. Complicated caries was registered in 33%. A case of imperfect amelogenesis was diagnosed. Enamel hypoplasia was registered in 11%. In the II group of patients the prevalence of caries was 100%. The intensity of caries of deciduous and permanent teeth according to the DFT+DMFT index was 6,08±1,08, which corresponded to the high level. The intensity of caries surfaces according to the DFS+DMFS index was 9,5±2,1. We haven’t revealed filled teeth and extracted permanent teeth in the II group of patients. Compensated form of caries was diagnosted in 42%. Decompensated form of caries was registered in 25%. Subcompensated form of caries was diagnosted in 33%. Complicated caries was registered in 50%. Enamel hypoplasia was diagnosted in 16%. In the III group of patients the prevalence of caries was 100%. The intensity of caries according to the DMFT index was 9,85±1,63, which corresponded to the high level. The intensity of caries of surfaces according to the DMFS index was 20,7±4,88. Number of extracted permanent teeth was 1,2±0,37. Decompensated form of caries was diagnosted in 45%. Compensated form of caries was registered in 30%. Subcompensated form of caries was diagnosted in 25%. Complicated caries in permanent teeth was registered in 20%. Enamel hypoplasia was diagnosted in 15%. Results of the study of the state of oral hygiene in the I group show that the level of oral hygiene was satisfactory in 45%, was unsatisfactory in 11%, was poor in 11%, was very poor in 33% of patients. The average index of FedorovVolodkina was 2.98+0.41 points. In the II group the level of oral hygiene was satisfactory in 25%, was poor in 58%, was very poor in 17% of patients. The average index of Fedorov-Volodkina was 2.95+0.22 points. The examination for the purpose of studying of oral hygiene in the III group showed that satisfactory level of hygiene was fixed in 30%, unsatisfactory level was fixed in 15%, poor level was fixed in 40%, very poor level was fixed in 15% of patients. The average index of Fedorov-Volodkina was 2.74+0.2 points. Patients with DEB have low compliance to dental treatment and low motivation for oral hygiene. Conclusions. Data of dental examination of children with DEB indicates that prevalence of dental caries in the period of temporary occlusion is medium, in the period of the replaceable and permanent occlusion is high. Intensity of dental caries is high in all periods of occlusion. The negative tendency of the carious process to decompensate is traced. Most of patients have poor oral hygiene. The efficiency of dental care to patients with DEBis low. This contingent of patients needs of dispensary observation of a pediatric dentist and a complex of therapeutic and preventive measures considering the general anamnesis, specificity of predictors of caries and low compliance of patients to dental treatment

dystrophic epidermolysis bullosa, caries intensity, prevalence of caries, oral hygiene, oral mucosa, index, prevention

1. Savichuk NO, Trubka IA, Kornienko LV, Marchenko OA. Sovremennye podkhody preventivnoy terapii kariesa zubov. Dent Art. 2013;2:67-74. [in Russian].
2. Khomenko LO, redaktor. Terapevtychna stomatolohiia dytiachoho viku. Т.1. Karies zubiv ta yogo uskladnennia. Kyiv: Knyga plius; 2014. 432 s. [in Ukrainian].
3. Fain J-D, Hinter H, redaktor. Bullyeznyy epidermoliz. Moskva: Praktika; 2014. s. 169-85. [in Russian].
4. Savychuk NO, Sorochenko NO. Proiavy spadkovoho bulloznoho epidermolizu v porozhnyni rota u ditei. Zbirnyk naukovykh prats spivrobitnykiv NMAPO imeni P.L. Shupyka. 2015;24(4):403-11. [in Ukrainian].
5. Savychuk NO, Derevianko LA, Sorochenko NO, Hedeon IV. Vypadok dystrofichnoho bulloznoho epidermolizu z urazhenniam slyzovoi obolonky porozhnyny rota. Sovremennaya stomatologiya. 2016;1:50-2. [in Ukrainian].
6. Parushetti AD, Agrawal JM, Nanjannawar LG, Agrawal MS. Oral manifestations of epidermolysis bullosa dystrophica: a rare genetic disease. BMJ case reports. [Internet] 2013 [cited 2013 Jan 23]; 2013: Р. bcr2012007963. DOI: 10.1136/bcr-2012-007963
7. Wright JT. Oral manifestations in the epidermolysis bullosa spectrum. Dermatologic clinics. 2010;28(1):159-64. Available from: https://doi.org/10.1016/j.det.2009.10.022
8. Umemoto H. Type VII collagen deficiency causes defective tooth enamel formation due to poor differentiation of ameloblasts. The American journal of pathology. 2012;181(5):1659-71. Available from: https://doi.org/10.1016/j.ajpath.2012.07.018
9. Savychuk NO, Sorochenko NO, Piankova OV. Chinnyky ryzyku rozvytku stomatolohichnykh zakhvoriuvan u ditei z dystrofichnym bulloznym epidermolizom. East European Scientific Journal. 2016;8(2):102-4. [in Ukrainian].
10. Sorochenko NO. Faktory ryzyku rozvytku kariesu u ditei iz retsesyvnym dystrofichnym bulloznym epidermolizom. Khyst. 2016;18:528. [in Ukrainian].
11. Čolović A, Jovičić O, Stevanović R, Ivanović M. Oral health status in children with inherited dystrophic epidermolysis bullosa. Vojnosanitetski pregled. 2017;74(7):644-51.
12. Javed AP. Occurrence of epidermolysis bullosa along with Amelogenesis imperfecta in female patient of India. Dental research journal. 2013;10(6):813-6.
13. Nagarajan SK, Shetty P. Epidermolysis Bullosa associated with Enamel Hypoplasia, Multiple Missing Teeth and Mitral Regurgitation – A Case Review. International Journal of Health and Rehabilitation Sciences (IJHRS). 2013;2(3):165-72.
14. Chaplieva EM. Psikhofiziologicheskie osobennosti lits molodogo vozrasta s razlichnym urovnem motivatsii k stomatologicheskim lechebnoprofilakticheskim meropriyatiyam [dysertatsiya]. Volgograd: Volgogradskiy gos. med. un-t; 2008. 26 s. [in Russian].

«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 344-348 pages, index UDK 616.314:616.311:616.529.1]-053.5

10.29254/2077-4214-2018-4-2-147-344-348