Pylypiuk O. Substantiation of complex preventive measures and treatment of dental caries in children with juvenile rheumatoid arthritis.

Thesis research is devoted to the efficiency improvement of treatment and prevention of dental caries in children with JRA by means of the development of a therapeutic and prophylactic complex on the basis of the study of local homeostatic changes, violations of mineral metabolism and its regulators and their experimentally substantiated correction. As a result of the research, we have determined the negative effect of JRA on the intensity and activity of carious lesions of teeth. Besides, we have studied the importance of changes in the components of phosphorous-calcium metabolism and their regulators in serum and local damaging factors in the development of dental caries in children with JRA. The experimental model of JRA confirmed the influence of autoimmune disease on the state of solid dental tissues and substantiated a complex method of treatment and preventive measures of carious lesions of teeth and proved its high efficiency. On the basis of clinical, morphological, biochemical and immuno-enzymatic studies, we have developed a method of complex treatment and preventive measures of dental caries in children with JRA, including targeted therapy and non-medicated treatment of autoimmune disease, the use of modern technology for the treatment of initial caries of teeth (microinvasive technique), correction of mineral metabolism and vitamin balance, restoration of acid-base balance and normalization of the hygienic state of the oral cavity. The use of this complex for the children of the main group of prepubertal age allowed to reduce the growth of the caries of permanent teeth in one year by 62,6%, in two years – 70,7%, temporary teeth - respectively by 57,8 and 65,4%. In one year this index made 64,9% for permanent teeth of teenagers, in two years of observation – 69,5%.