The dissertation presents a theoretical foundation and practical solution to the current problem of dentistry - improving the treatment and prevention of generalized periodontitis in young people with comorbid obesity by developing methods of pathogenetically directed drug correction of metabolic changes.
The work is devoted to increasing the effectiveness of complex differentiated personalized treatment of patients with generalized periodontal diseases, in particular, generalized periodontitis (GP), associated with obesity. The severity of comorbid pathology is determined by a wide range of clinical manifestations and severity of somatic and dental diseases, untimely diagnosis and correction of which lead to the consequences of primary functional changes in the neuroendocrine regulation system are persistent organic changes in the periodontium with subsequent loss or deterioration of functional and structural elements of the periodontal complex, especially in young people.
Questions that are open for research are determination of predictors of development of GPD in obese, specification of degree of correlation between the chain of pathological changes in the periodontium, the severity of their manifestations depending on BMI/degree of obesity and comorbid diseases.
The study was performed as a fragment of the SRW of the Department of Dentistry of Bogomolets NMU, according to the plan of the Ministry of Health of Ukraine: "Scientific foundation of optimization of early diagnosis, treatment and prevention of major dental diseases in young people" (№ state registration 0115U000907) and "Scientific foundation of early diagnosis of generalized periodontal diseases of chronic and acute course" (№ state registration 0118U100471). The respondent is a co-performer of the aforecited researches.
The aim of the work is to increase the effectiveness of prevention and treatment of generalized periodontitis in obese patients by pathogenetic foundation of drug correction methods including the identified changes of inflammatory mediators, prooxidant-antioxidant homeostasis of patients and features of comorbid pathology.
Study objectives:
1. To establish the clinical and nosological structure, prevalence and features of periodontal disease in obese patients, including comorbid pathology.
2. Investigate medical, social and general clinical predictors of generalized periodontitis in obese patients.
3. To analyze the disorders of lipid, carbohydrate metabolism, intensity of nitrosative and oxidative stress and markers of endothelial dysfunction in patients with GP with comorbid obesity, including the clinical features of periodontal disease and the degree of obesity.
4. To determine changes in the adipokines profile and proinflammatory cytokines, expression of antimicrobial peptides of oral fluid and the level of endogenous intoxication in patients with GP with comorbid obesity.
5. To substantiate and develop a system of pathogenetically directed measures for the algorithm of diagnosis, treatment and prevention of GP, associated with obesity, including the identified systemic metabolic changes.
6. To determine the clinical effectiveness of the developed treatment-and-prophylactic measures with using drugs of pathogenetically directed action, to develop practical recommendations with their introduction into clinical practice.
The design of this study was approved by the Commission of Bioethical Expertise and Ethics of Scientific Research at Bogomolets National Medical University.
Including the aim and the content of the planned objectives, the following research methods were used: clinical, instrumental (radiological), biochemical, laboratory and statistical.
