Kustro T. Optimization of prevention and treatment of generalized periodontal diseases associated with gluten-related disorders

This scientific work presents a theoretical substantiation and practical solution to the actual problem of dentistry – increasing the effectiveness of treatment and prevention of generalized periodontal disease in young people with gluten-related disorders by developing methods of pathogenetically directed drug correction of detected changes in metabolism. Periodontal disease is one of the most common dental diseases in the world. According to the Global Burden of Disease (GBD), between 1990 and 2010, the prevalence of this disease increased from 11.2% to 57.3%. It is known that periodontal disease is multifactorial in etiology and pathogenesis, with immunological, biochemical, structural and other pathological changes playing a role. A number of authors associate periodontal lesions with various chronic diseases, with special attention paid to diseases of the gastrointestinal tract and the musculoskeletal, endocrine and cardiovascular systems, etc. One of the most relevant problems is the relationship of pathological processes developing in different systems of the body. Every year, there is an increase in the prevalence of disorders associated with gluten intolerance. According to the modern nomenclature, the following forms of gluten-related disorders are considered: autoimmune diseases (celiac, gluten ataxia, dermatitis herpetiformis), allergies (food or respiratory) and nonautoimmune gluten intolerance. Celiac disease (gluten enteropathy) is an autoimmune disease that affects the small intestine of genetically predisposed individuals due to the consumption of cereal protein – gluten. According to analysis of the results of multicenter statistical studies conducted in Europe, celiac disease was diagnosed in 1% of the population (with some difference across countries), which indicates the globalization of the disease and the great social significance of this pathology. Every year there is a rapid increase in its prevalence. Both genetic and exogenous factors play a significant role in this multifactorial disease. In some cases, its diagnosis is complex, since it is associated with an atypical course of the disease or the predominance of extraintestinal symptoms. Patients with this disease often experience pathological changes that can be detected in the oral cavity. Most often, researchers’ attention is focused on manifestations of celiac disease in the oral cavity: lesions of the hard tissues of the teeth and mucous membrane. Thus, modern sources of scientific literature rarely examine the relationship of periodontal lesions and diseases associated with gluten intolerance (GI). The study of periodontal lesions against the background of gluten intolerance is important, because the coexistence of these pathologies causes mutual encumbrance and requires a detailed study of the characteristics of clinical manifestations, improvement of treatment methods and the development of personalized prevention methods, which make the topic of this dissertation particularly relevant.