Thesis presents a theoretical generalization and a new solution for the current problem of modern dentistry - creating a system of diagnostic measures for detecting periodontal disease in young people (18-25 years old) by studying potential risk markers on the biochemical and molecular-genetic levels.
Based on an in-depth study of the role of biochemical and molecular-genetic mechanisms of pathological changes in periodontal tissues of young people (18-25 years old), 4 variants of molecular-genetic profiles with changes in nitric oxide, interleukin-4, interleukin-1β and tumor necrosis factor-α were identified, which became the basis for the development of a new method for predicting the development and early diagnosis of gingivitis and early stages of periodontitis at the stage of pre-disease with the introduction of a new algorithm with personalized control of periodontal status.
At I stage of the study, 170,754 medical cards of young people (18-25 years old) for the period 2011-2016 were analyzed, with the definition of the average annual periodontal morbidity at the level of 0,18%, while as a result of an objective periodontal examination of 155 students of the same age were diagnosed with periodontal disease in 73.55%.
At II stage of the study, to determine the features of the clinical course of periodontal disease in young people, a specialized periodontal examination (PMA index, PP depth, loss of epithelial attachment, bleeding gums, tooth mobility, OHI-S index) of 155 people (18-25 years old) was conducted with division into groups: I - persons with intact periodontium; II - persons with catarrhal gingivitis; III - persons with generalized periodontitis of initial, I degree. To determine the role of possible risk factors (gender, smoking, hypodynamics, dietary preferences) in the development of periodontal disease, each subject filled out a questionnaire.
In order to determine the biochemical phenotype and study the molecular-genetic profile, after obtaining informed consent, 80 people (24 males and 56 females) were selected and divided into groups: I (21) - intact periodontium; II (22) - chronic catarrhal gingivitis; III (37) - generalized periodontitis of initial, I degree. To determine the biochemical phenotype, in the examined three groups on an empty stomach without stimulation at the same morning hours, oral fluid was taken to determine interleukins (IL-1β, IL-4), TNF-α and nitrite content. To study the molecular-genetic profile, the buccal epithelium was removed simultaneously with the help of buccal brushes, followed by freezing of the samples at a temperature of -20°C. To determine the marker genes for periodontal disease from the buccal epithelium, genomic DNA was isolated with subsequent analysis by polymerase chain reaction (PCR) of polymorphic variants of ACE gene: I/I, I/D, D/D; of TNF-α gene: G308G, G308A, A308A; of eNOS gene: G894G, G894T, T894T.
At the final stage, in order to test a new algorithm of medical examination with personalized control of periodontal status, a clinical observation lasting 12 months was performed (checkpoints: 3, 6 and 12 months) for 40 young people with different polymorphic variants of the studied genes.
