[The relationship between inflammatory periodontal diseases and cardiovascular diseases]

[Soluble forms of adhesive molecules in blood serum as a marker of endothelial dysfunction in chronic generalized parodontitis.]

An important factor in the pathogenesis of chronic inflammation in periodontitis is endothelial dysfunction (ED). Adhesion molecules are markers of impaired barrier function, adhesive properties and vascular permeability. The study of the concentration of soluble adhesion molecules is very promising in the diagnosis of ED. The purpose of this research was to study changes in the concentration of soluble forms of adhesive molecules of the selectin family and the immunoglobulin superfamily when used as markers of systemic manifestations of ED in the dynamics of the treatment of chronic generalized periodontitis (CP) using surgical and therapeutic schemes. 60 patients with CP (33 women and 27 men) and 20 clinically healthy volunteers (10 men and 10 women) were examined. The state of the endothelium was assessed by the content in the serum of soluble forms of adhesive molecules - sP- and sE-selectins, intercellular adhesive molecules of type 1 (sICAM-1), vascular molecules of cell adhesion of type 1 (VCAM-1) by ELISA. The short-term results of non-surgical treatment of CP are more effective in correction of vascular wall adhesive properties disorders compared with surgical treatment. Conservative treatment of chronic hepatitis C effectively adjusted the blood content of adherent endothelium molecules in women than in men. The long-term results of applying this scheme were characterized by partial preservation of a positive effect on the adhesive properties of the endothelium, however, long-term results were inferior to short-term ones. Surgical treatment of CP in women in the early postoperative period was accompanied by reactive impairment of the adhesive properties of the endothelium. The long-term results of this treatment regimen testified to its greater effectiveness. In women, the effectiveness of treatment of CP in restoring the adhesive properties of the endothelium was higher than in men. The results obtained allow us to conclude that the systemic manifestations of ED in CP were characterized by an increase in the concentration in the blood of soluble forms of adhesion molecules. The dynamics of the concentration of adhesive molecules during the treatment of СР testified to the dependence of the sex of patients on the effectiveness of the influence of therapeutic and surgical treatment regimens on the systemic manifestations of ED.

[Oral health as a factor of primary prevention of postinfectious complications]

OBJECTIVE

The purpose of the study is to substantiate the need and importance of early diagnosis and treatment of oral lesions in infectious diseases (ID) by dentists.

MATERIAL AND METHODS

A retrospective analysis of the provision of dental care in multi-specialty hospitals to 780 patients with infectious pathology: herpetic infections (HI) - 320 people (41.03%); ARVI - 160 people (20.51%); acute enteric infections (AEI) - 300 people (38.46%). The diagnosis of the disease was established by infectious diseases doctors. The etiology of ID was confirmed using PCR and IFA.

RESULTS

The prevalence of caries is 98.5%, the CPEs index is 10.26±0.04. In 84.1% of patient's oral hygiene was unsatisfactory. In the acute period of ID in HI, ARVI and AEI oral mucosa (OM) lesions were detected in 75.89% of cases: stomatitis (81.75%), gingivitis (69.76%), glossitis (35.98%), cheilitis (23.31%). Incidence of OM lesions in ID: catarrhal stomatitis - HI - 52.8%, ARVI - 64.1%, AEI - 67.9%; catarrhal gingivitis: in patients with HI, it is 1.7 times less frequent than in patients with AEI (p<0.001), and in ARVI - 1.6 times more often than in patients with HI (p<0.001). Cheilitis: HI - 25.9%, ARVI - 18.3%, AEI - 23.7%; catarrhal glossitis: AEI - 65.1%, ARVI - 23.2%, HI - 17.0%; candidiasis of the oral mucosal and tongue: HI - 11.1%, ARVI - 27.5%, AEI - 26.9%. A direct relationship between the lesions of OM and the severity of the course of HI, ARVI and AEI was established.

CONCLUSION

Thus, dental pathology in infectious patients is pathogenetically determined by combined and interrelated disorders of the functional state of each organ of the oral cavity, the dental system and the body as a whole. Due to the relatively short duration of inpatient treatment for acute ID, priority should be given to the prevention of postinfectious complications of oral mucosal diseases.

Hirudotherapy in treatment of chronic generalised periodontitis

Chronic generalized periodontitis (CGP) is a disease associated with low susceptibility to the therapeutic protocols applied; practitioners tend to characterize it as a disease presenting certain difficulties. Therefore, the search for drugs and methods capable of increasing the efficacy of CGP therapy is an ongoing process. Additional problems, which have to do with either with antibiotic resistance or increased sensitivity to drugs, also occur quite often. This study aimed to assess the possibility of applying hirudotherapy in the context of conservative treatment of CGP. 50 patients with CGP without somatic pathology were examined and treated. The participants were divided into two groups (n = 25), all group members of about the same age. At the first stage, the treatment followed the accepted standard: professional oral hygiene procedures, antimicrobial and anti-inflammatory drugs, demonstration of proper personal oral hygiene routines. Then, first group went through a monthlong hirudotherapy course that consisted of 6 to 8 individual procedures. Second group was observed throughout this period with the aim to control the level of their compliance with the oral hygiene routines they were trained. Having analyzed the results, we found that hirudotherapy was more effective than what was prescribed to the second (control) group. The papillary marginal alveolar index (PMA), which reflects the severity of inflammation and gum bleeding, decreased significantly in the first group, where medicinal leeches were used: in the patients with severe CGP it went down by 6%, in those with moderately severe CGP the index decreased by 24% and the participants whose CGP was only light had the PMA go down by 2%. Thus, we have demonstrated the efficacy of hirudotherapy in the context of conservative CGP treatment, which allows recommending this method for inclusion into clinical practice.