Bilozetskyі I. Clinical and pathogenetic mechanisms of relationship of generalized periodontitis in patients with rheumatoid arthritis.

The thesis is dedicated to improving the detection of periodontal lesions in patients with rheumatoid arthritis by studying the clinical and pathogenetic features of generalized periodontitis progression. Based on examination of 115 patients were studied in depth clinical and dental x-ray indicators and markers of inflammatory activity, changes in proinflammatory cytokine - TNF-alfa in blood and saliva, bone mineral density, and the adequacy of basic osteotropic therapy depending on the generalized periodontitis in patients with rheumatoid arthritis. The structure and main trigger factors of periodontal lesions and progression in patients with rheumatoid arthritis. The basic factors of severe outcome of generalized periodontitis and the main criterion of rheumatoid arthritis and periodontal pathology; and prediction of progression of generalized periodontitis in patients with rheumatoid arthritis, which is the presence of postmenopausal course seropositive rheumatoid arthritis antibodies to cyclic citrullinated peptide levels increased TNF-alfa in blood and saliva, decreased bone mineral density (osteoporosis and osteopenia) the use of corticosteroids, inadequate basic and osteotropic therapy. It is proved that the use of standard therapy, significantly improves the condition of GP and leads to periodontal stabilization of GP in 46.8 % of patients with an initial treatment of RA and 71.4 %, subject to the appointment of RA treatment in accordance with the activity of the process and the level of BMD. By creating a mathematical model of unfavorable generalized periodontitis in rheumatoid arthritis improved tactics of patients with generalized periodontitis for early diagnosis and prevention of the progression of periodontal lesions.