The dissertation is devoted to the clinical, experimental, and pathogenetic substantiation of a therapeutic and preventive complex for dental caries and inflammatory periodontal diseases in children aged 6–7 years with chronic gastrointestinal disorders.
A comprehensive dental examination was conducted in 55 children aged 6–7 years from Odesa presenting with dental caries and inflammatory periodontal diseases associated with chronic gastrointestinal pathology. It was established that these children had a less favorable oral health status compared to children without concomitant pathology. In particular, the DMFT index was 2.7 times higher, the “decayed” component was 5.7 times higher, and the “filled” component was 2.1 times higher. The PMA index increased 4.1-fold, while the gingival bleeding index exceeded the values observed in children without concomitant pathology by more than three times, indicating more pronounced inflammatory changes in periodontal tissues.
Molecular genetic studies were performed to investigate polymorphisms of the EDN1, EGFR, TGF-β1, and TNF genes. Associations between certain genetic variants and caries experience, periodontal status, and oral hygiene indices were identified, suggesting their potential role as markers of individual susceptibility to dental diseases in children with chronic gastrointestinal disorders.
Experimental studies in rats demonstrated that a cariogenic diet combined with peroxide-induced periodontitis resulted in complex disturbances of the dentoalveolar system, including the development of dental caries, progression of carious lesions, suppression of the mineralizing function of the dental pulp, activation of inflammation, oxidative stress, oral dysbiosis, and resorptive processes in the jaw bone. The proposed therapeutic and preventive complex, including Minerol, Inos K2+D3+Ca, and Biotrit-Denta phytogel, reduced the number and depth of carious lesions, decreased alveolar bone atrophy, normalized phosphatase activity, and reduced inflammation, lipid peroxidation, and dysbiotic disturbances.
In the clinical part of the study, administration of the therapeutic and preventive complex to children aged 6–7 years with dental caries and inflammatory periodontal diseases associated with chronic gastrointestinal pathology provided a caries-preventive effect of 40.4% over a two-year follow-up period. The increase in the DMFT index was 0.59 in the main group compared with 0.99 in the comparison group. Significant improvements in periodontal status were observed: the PMA index decreased by 40.1%, the gingival bleeding index by 56.5%, and the Schiller–Pisarev test by 61.1%. Improvements were also recorded in the Silness–Löe and Stallard oral hygiene indices.
Biochemical analysis of oral fluid revealed a reduction in lipid peroxidation intensity, increased catalase and lysozyme activity, and decreased elastase and urease activity, as well as a reduction in the degree of oral dysbiosis. Biophysical studies confirmed stabilization of oral fluid pH, reduction of gingival inflammation, and improvement of the functional state of the gingival microcirculatory bed.
The obtained results confirm the pathogenetic validity and clinical efficacy of the developed therapeutic and preventive complex in children with dental caries and inflammatory periodontal diseases associated with chronic gastrointestinal disorders.
