The thesis deals with solving an urgent problem of pediatric dentistry as to increase the effectiveness of treatment of chronic catarrhal gingivitis (CCG) in children with insulin - dependent diabetes mellitus by studying the clinical and paraclinical signs of the disease to determine the prooxidant - antioxidant system of the oral cavity.
The results of examination of the periodontal tissues in children with diabetes found a significantly higher prevalence of periodontal disease compared with somatically healthy children. CCG predominated in the structure of periodontal tissue diseases. CCG was most commonly diagnosed in children with diabetes less than 5 years of age and in children with suboptimal glycemic control. There is a close relationship between oral hygiene, bleeding gums and the severity of HCG and the duration and severity of diabetes. The values of the Green - Vermillion index in children with a history of severe HCG and diabetes for more than 5 years were 1.5 times higher than in children with diabetes less than 5 years and corresponded to poor and unsatisfactory oral hygiene. At the level of glycemic control with BPH and the duration of diabetes over 5 years, the values of the Green - Vermillion index exceeded the same 1,3 times (2,42±0,29) points) against (1,87±0,15) points) in children SOGK and corresponded to unsatisfactory level of oral hygiene in both cases. The obtained results of the questionnaire indicate an insufficient level of sanitary and hygienic knowledge among the respondents, which is directly proportionally reflected in the index indicators of oral hygiene.
The course of chronic catarrhal gingivitis is associated with deterioration in the rate of salivation, pH, viscosity, mineralizing potential of oral fluid in the examined children, especially in children with the duration of the diabetes mellitus over 5 years.
There was a significant difference in OMP, DC, ADS, total protein, HS group, ceruloplasmin, SOD activity, catalase of oral fluid in children різних груп спостереження.
In children with chronic catarrhal gingivitis on the background of diabetes mellitus glucose-6-phosphate dehydrogenase (6,43±0,06 nmol / min mg protein), glutathione peroxidase (459,28±3,44 nmol/min mg protein)), glutathione reductase (8,04±0,08 nmol/min mg of protein), glutathione transferase (116,69±2,49 nmol/min mg of protein), reduced glutathione (4,01±0,11 kmol/mg protein) deteriorate compared with children with chronic catarrhal gingivitis without somatic pathology (10,68±0,16 nmol/min mg protein, 396,15±5,70 nmol/min mg protein, 13,62±0,19 nmol/min mg protein, 161,37±4,85 nmol/min mg of protein, 6,2±0,09 kmol/mg protein, respectively) (p<0,05).
The suggested treatment and prevention complex involves: oral administration of a complex biologically active supplement "Kvertulin" 1 tablet 3 times a day after meals until complete absorption in the oral cavity for 20 days, drops "Imupret" 25 drops 3 times a day, and multivitamin complex "Pikovit" in the form of tablets 1 tablet once a day after meals until complete absorption in the oral cavity, topically administered irrigation of the oral cavity with the solution of dental elixir "Exodent" (1 teaspoon per ¼ cup of water after each meal and brushing teeth for 1-2 minutes) for three weeks, and as an individual hygiene recommend a toothbrush of medium hardness with therapeutic paste "Colgate Total 12" (2 times a day), which increases the resistance of the periodontal tissues in children with chronic catarrhal gingivitis and diabetes mellitus.
Developed and implemented in clinical practice treatment and prevention complex helped to improve oral hygiene, salivation rate, viscosity, pH, mineralizing potential of oral fluid, normalized the state of prooxidant-antioxidant system (OMB, DC, MDA, general group ceruloplasmin, SOD activity, catalase, glucose-6-phosphate dehydrogenase, glutathione peroxidase, glutathione reductase, glutathione transferase, reduced glutathione), which resulted in gums bleeding in patients and reduction of the PMA index of 63,3%.
