CHANGES OF ORAL MICROBIOCENOSIS IN PERIODONTAL DISEASES IN SETTINGS OF CHRONIC HEPATITIS C

Sichkoriz H. A.

DENTISTRY

Scentific article

The presence of liver diseases creates conditions for negative effects of both endogenous periodontopathogenic factors and microflora of the oral cavity on periodontal tissues. In the settings of chronic hepatitis C (CHC), stable changes of microbiocenosis are formed, which can often become a trigger for the development of periodontal diseases (PD) or complicate their course. In patients with PD, the development of local inflammatory response is also associated with an increase in the infection load of viral-microbial associations together with changes in the immune status of the organism and the formation of a secondary immunodeficiency, which develops in CHC. Therefore, the aim of our researchwas to study the rate of inoculated microorganisms from gingival sulci and periodontal pockets in patients with PD in the settings of CHC, as well as to study the characteristics of the microbiocenosis under study, depending on the diagnosed periodontal pathology. The object and methods of study. We conducted a study of the rate of inoculated microorganisms from gingival sulci and periodontal pockets in 68 patients with PD in the settings of CHC (study group) and 27 patients with PD without concomitant pathology in their history (control group). To determine the microbial status in CHC patients depending on the periodontal diagnosis, the rate of inoculated microorganisms was determined in 20 people with chronic catarrhal gingivitis (CCG) and 48 patients with generalized periodontitis (GP). The material for the study was the content of gingival sulci and periodontal pockets. 5% blood agar, egg yolk high salt agar culture medium, sugar broth, chocolate agar, Endo agar, milk agar, Wilson-Blair medium and Schaedler Agar, Sabouraud agar with amikacin, 5 % rabbit citrated plasma and HIS-selective medium were used to plate bacteria and study their properties. Identification of isolated strains of microorganisms was carried out according to morphological, cultural and biochemical properties. Statistical data were computed using the Statistica 8.0 software. Study results and discussion.Most of the microorganisms were inoculated at a higher rate in patients of the study group compared with the control group. Less frequent in patients of the study group were S. saprophyticus, G. stomatococcus and G. lactobacillus (p>0.05). The appearance of a large number of enterobacteria in the material from gingival sulci and periodontal pockets suggests a significant shift in the microflora of the oral cavity from grampositive to gram-negative and forming a dysbiotic state of III-IV degree in PD, which is especially pronounced during hepatic damage by the hepatitis C virus. Significant spread of fungi of the genus Candida confirms development of dysbacteriosis of the oral cavity in PD in the settings of CHC. The rate of most microorganisms inoculated in the study group was higher in patients with GP, in comparison with patients with CCG. Statistically significant in patients with GP, compared to patients with CCG, was higher rate of the following: α-hemolytic streptococci (64.58±6.90% vs. 35.00±10.94%, p<0.05), F. Enterobacteriaceae bacteria (87.50±4.77% vs. 65.00±10.94%, p<0.05), G. Bacteroides, Porphyromonas, Prevotella, Fusobacterium bacteria (85.42±5.09% vs. 55.00±11.41%, p<0.05), and G. Candida fungi (93.75±3.49% vs. 70.00±10.51%, p<0.05). Nonhaemolytic G. streptococcus, G. lactobacillus and S. saprophyticus were inoculated more often in patients with CCG. However, the only statistically significant difference was between the values of the rate, with which S. saprophyticus was inoculated (65.00±10.94% in CCG patients vs. 33.33±6.80% in patients with GP of І-ІІ stage, p<0.05). Conclusion.The conducted studies indicate that the combined course of CHC and PD is accompanied by significant disturbances in microbiocenosis of the gingival sulci and periodontal pockets, which manifests itself in the severe increase in the significance of opportunistic pathogens, an increasing number of anaerobic periodontal pathogens, pyogenic gram-positive cocci and representatives of the transient microflora. The latter confirms that certain types of microorganisms act as etiological trigger in affecting periodontal tissues. Reduction in the rate the normal microflora is inoculated and the appearance of pathogenic and opportunistic flora reflects the formation of a local immunodeficiency state that occurs in the settings of CHC

chronic hepatitis C, periodontal disease, chronic catarrhal gingivitis, generalized periodontitis, opportunistic microflora, microbiocenosis

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«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 348-352 pages, index UDK 616.311.2+616.314.17+616.314.19)-002-06:616.36-002.17]-02:616.31-008.87

10.29254/2077-4214-2018-4-2-147-348-352