The thesis presents a theoretical generalization and solution of an urgent issue of modern stomatology consisting in scientific substantiation of the ways for prevention and treatment of complications after tooth extraction due to orthodontic indications considering microbe, immune and antioxidant background of the patient’s organism.
The laboratory findings demonstrated that protective components of the oral fluid of children experiencing complications after tooth extraction due to orthodontic indications are characterized by reduced lysozyme activity – 34,81-48,42 % (р<0,05), reduced level of sIgA – 2,86-16,67 % together with increase of IgА content – 4,76-9,52 % and IgG – 15,15-24,24 % in comparison with the parameters of children who do not have any complications during the postoperative period.
The cytokine profile of the oral fluid of orthodontic patients indicates 9,06 % and 24,46 % increase of IL-1β and IL-4 respectively under conditions of development of postoperative complications in somatically healthy children and 16,56 % increase of IL-1β level and 26,25 % decrease of IL-4 under conditions of development of postoperative complications in children suffering from diffuse simple goiter, which is a precondition and evidence of intensification of inflammatory reactions in the maxillofacial tissues during the period of wound healing.
The prooxidant-antioxidant system of the oral fluid of children under conditions of the surgical stage of orthodontic treatment was found to be characterized by an increased level of Malone aldehyde 36,96-64,73 % up (р<0,05), diene conjugates – 53,42-90,41 % (р<0,05), reduced catalase activity 2,02-2,72 times as much (р<0,05), superoxide dismutase – 1,44-1,98 times (р<0,05), glutathione peroxidase – 1,37-1,69 times (р<0,05), decreased level of НS-groups 1,9-2,21 times (р<0,05), G-SН – 2,64-4,21 times (р<0,05) in comparison with patients without complications.
The therapeutic-preventive complex was developed and tested in order to prevent post-extraction complications in orthodontic patients, which assumes correction of protective mechanisms on the systemic level and local effect on the microscopic flora of the oral cavity. Effectiveness of the suggested method is clinically evidenced by the absence of any complications from the side of the maxillofacial area tissues at the surgical stage of orthodontic treatment as well as 20,75 % (р<0,05) decrease of the general microbe amount, the amount of pathogenic and opportunistic bacteria 2,09 times, Str. mutans – three fold less, and with simultaneous increase of lactic bacilli 2,33 times and complete absence of Candida fungi. The protective mechanisms of the oral fluid of patients improved: 20,51 % (р<0,05) increase of lysozyme activity, 6,25 % increase of sIgA level with21,23 % (р<0,05) decrease of IL-4 concentration, 46,41 % (р<0,05) increase of catalase activity, SOD – 15,52 %, level of НS-groups –24,59 % (р<0,05), G-SH – 60,89 % (р<0,05), glutathione peroxidase inactivity – 14,07 % and reduced function of glutathione reductase –15,20 %.
Scientific novelty of the research. The research supplemented the current scientific data concerning local and general risk factors promoting development of complications in children after tooth extraction due to orthodontic indications.
A detailed analysis of the oral cavity microbial flora was performed for the first time including the prooxidant-antioxidant system and protective components of the oral fluid in children at the surgical stage of orthodontic treatment. Prognostic diagnostic criteria of post-extraction complications are determined. The data obtained enabled to develop the method of prevention and treatment of complications after tooth extraction due to orthodontic indications including pharmacological composition of the vitamin-mineral, immune modulating and probiotic medicines.
