Kuzniak B. Prevention of Periodontal Tissue Diseases in Adolescents

t was established that the main risk factors for the development of gingivitis in adolescents living in Chernivtsi are unsatisfactory oral hygiene (OHIS index over 2.0 points), the presence of hard dental deposits and harmful eating habits. A significant influence of nutritional and somatic factors was revealed: 47.3% of children eat without a clear system, 29.1% have concomitant somatic diseases that aggravate the course of gingivitis. A decrease in the quality of the diet (less consumption of dairy products) negatively affects the metabolic background and increases the risk of developing periodontal pathology. A feature of the clinical course of chronic catarrhal gingivitis in children living in Chernivtsi is a pronounced symptom of bleeding. When examining and determining the PMA index in children aged 12 years, less pronounced signs of the inflammatory process are recorded than in children aged 15 years; Changes in the state of periodontal tissues with increasing severity of the disease were the same in different age groups. An imbalance of the prooxidant-antioxidant system and the dominance of peroxidation processes over antioxidant protection processes was established, which is one of the pathogenetic mechanisms of the formation of the inflammatory process in the gums: the level of malonaldehyde was (236.42±15.30) μmol/mg protein, diene conjugates (1.42±0.85) μmol/mg, catalase activity was (7.65±0.34) μmol/min×mg protein, superoxide dismutase – (0.63±0.017) U/min×mg protein. In children with chronic catarrhal gingivitis, a decrease in lysozyme activity by 21.29%, sIgA level to (0.28±0.01) g/l, as well as an imbalance in the cytokine profile: an increase in pro-inflammatory IL1β and a decrease in anti-inflammatory IL4 were found. This indicates a weakening of local humoral protective factors and the formation of conditions for the chronicity of the inflammatory process. The development of CGH in children is accompanied by a pronounced imbalance of protein-carbohydrate components of the oral fluid, namely a decrease in the total glycoprotein content to (0.08±0.002) mg/ml against the background of an increase in the total protein level to (5.62±0.24) g/l. The transformation of the fractional profile of glycoproteins consists in an intensive increase in the levels of hexosamines to (0.68±0.04) mmol/l, sialic acids – (0.26±0.02) mmol/l and fucose – (0.51±0.03) mmol/l. Strong and moderate reliable correlations between the studied clinical and paraclinical indicators were found, which indicates a significant influence of the insufficiency of local mechanisms of oral fluid protection on the formation and progression of periodontal tissue pathology in children. Based on comprehensive clinical and laboratory examinations of children in the observation groups, a method for the prevention and treatment of chronic catarrhal gingivitis was theoretically substantiated and practically developed. For the first time, a complex of pharmacological measures aimed at the correction of chronic catarrhal gingivitis was proposed, which, in addition to the generally accepted therapeutic and preventive measures, provides for the additional appointment of a local probiotic preparation and an oral vitamin-mineral complex. The proposed therapeutic and preventive complex, which included professional hygiene, the probiotic "BioGaia ProDentis", and the vitamin preparation "AlfaVit Shkolyar", proved highly effective: the PMA index decreased from 37.11 to 1.13%, the number of healthy sextants increased from (2.22±0.14) to (6.12±0.02). Long-term results confirmed a stable decrease in the clinical manifestations of gingivitis and an improvement in the indicators of local immune protection.