Subject. Some features of the clinical picture, hygienic and microbiological state of the oral cavity, acidity and free-radical oxidation of the oral fluid in patients with recurrent aphthates on the background of acid-dependent diseases of the gastrointestinal tract are considered. The aim is to assess the relationship between clinical and laboratory parameters in patients with recurrent oral aphthae associated with acid-dependent diseases of the gastrointestinal tract. Methodology. A comprehensive clinical and laboratory examination of 58 young people with revealed recurrent aphthae of the oral cavity against the background of acid-dependent diseases of the gastrointestinal tract was carried out. The level of oral hygiene was assessed using the ONI-s index, the state of free-radical oxidation of the oral fluid - the "Chemilumimer-003" device, individual representatives of the normal flora were identified by inoculating the contents from the surface of aphthous elements on special differential diagnostic media of the HiCrome series. The acidity of the oral fluid was determined using a universal indicator litmus paper pH-1-14, short-term intragastric pHmetry was performed directly during fibrogastroduodenoscopy. Results. In 46.4 % of those examined, recurrent aphthae were found on the oral mucosa. In persons with chronic gastritis and duodenitis, the frequency of recurrences once a year was 37.9 %, 2-3 times a year ― 62.0, with the presence of chronic pancreatitis against the background of hyperacid gastric secretion ― 44.8 and 55.2, respectively. In patients with recurrent aphthae, a low level of oral hygiene, a violation of its microbiome, and a change in the acidity of the oral fluid were revealed. Conclusions. The presence of recurrent aphthae complicates individual oral hygiene, because accompanied by severe pain and paresthetic symptoms. This is manifested by an increase in the ONI-S index and a disturbance in the state of the normobiome in the form of an increase in the growth of resident microflora against the background of changes in the acidity of the oral fluid. Chemiluminescence indices correlate with the hygienic state of the oral cavity, qualitative changes in the normobiota and pH of the oral fluid in the studied clinical groups.
The purpose of the study is to evaluation of peculiarities of complaints, symptoms and clinical manifestations of typical asymptomatic (L43.80) and erosive-ulcerative (L43.82) forms of lichen planus (LP), its manifestations on the oral mucosa, depending on the age and sex of patients. Material and methods. In the present study, 111 patients with OLP were divided into a main clinical group with erosive-ulcerative form of OLP (L43.82, n = 86) and a comparison group with typical asymptomatic form of OLP (L43.80, n = 25) based on the complex of dental examination and simple randomization method. Mann–Whitney and chi-square tests, including Yates' correction, were used to assess the statistical significance of differences between the groups. Results. Patients with the typical asymptomatic form of OLP (L43.80) often had grayish-white, flat papules up to 2 mm in diameter on the unchanged mucosa of the cheeks and dorsal surface of the tongue in the absence of complaints. In the erosive and ulcerative form (L43.82) of OLP, the complaints of pain, intensifying at intake of hard, spicy and hot food, feeling of tightness, roughness, burning, slight dryness prevailed, papules, erosions of irregular or polygonal ulcers were simultaneously observed on swollen, hyperemic mucosa of cheeks, corners of mouth and lateral surface of tongue. The studied pathology prevailed in 81.98% of cases in persons of young working age. Depending on the form of OLP, the intensity of caries according to the CPU index corresponds to a high or very high degree of caries process, the state of oral hygiene according to the OHI-S index of poor or poor hygiene, the inflammatory process in periodontal tissues according to the PMA index of mild or medium degree of inflammation (p < 0.001). Conclusion: thus, the identified features of complaints, symptoms and manifestations of oral mucosal lichen planus should be taken into account by general practitioners when conducting outpatient appointments.
Subject. The results of a comprehensive microbiological study of the state of the normobioma of the oral cavity in individuals with recurrent aphthae of the oral cavity against the background of acid-dependent diseases of the gastrointestinal tract are considered. The goal is to determine the diagnostic significance of individual representatives of the oral normobioma in patients with recurrent aphthae of the oral cavity against the background of acid-dependent diseases of the gastrointestinal tract. Methodology. The study involved 83 patients who were divided into two main and control groups depending on the clinical manifestations of recurrent aphthae of the oral cavity on the background of hypersecretory syndrome. Results. The results of the study showed that in patients of the first and second main groups, in which the manifestations of recurrent aphthae in the oral cavity were accompanied by diseases of the gastrointestinal tract with hypersecretory syndrome, the frequency of allocation of staphylococcal flora was 1.3—1.5 times higher compared to control (p≤0.05), an increase in the proportion of S. aureus — 2.5 times. The detection frequency of S. epidermidis in the control and both clinical groups was 28.0, 27.6 and 31.0 % of cases, respectively, the proportion of hemolytic forms in the control group was 4.0 %, in the first 10.3 % (an increase of 2 5 times), in the second — 17.2 % (4.3 times). The observed changes in the species composition may indicate dysbiosis in the oral cavity, caused not only by the presence of recurrent aphthae, but also by acid-dependent diseases of the gastrointestinal tract. Conclusions. In recurrent aphthae of the oral cavity in patients with acid-dependent diseases of the gastrointestinal tract in the microbiome of the oral cavity against the background of reduced titers of lactobacilli, an increase in representatives of Staphylococcus spp., Enterococcus spp is most often observed. and Candida spp. (1.2 times average), Enterococcus spp. (1.4 times), Staphylococcus spp. and Enterobacteriaceae spp. (1.2 times), Actinobacillus spp. (1.1 times).
The work presents the results of assessing the spread of pathology of hard tissues of teeth and periodontal in patients with chronic inflammatory bowel diseases (IBD). Objective. Assessment of the intensity and spread of pathology of dental hard tissues and inflammatory periodontal diseases in patients with Crohn's disease (CD) and chronic ulcerative colitis (CUC). Materials and methods. A comprehensive clinical and dental examination of 70 patients with CD and CUC was carried out. The complex of dental examination included the analysis of complaints, anamnesis, assessment of the condition of hard tissues of teeth, periodontal tissues. Assessment of the intensity level of nociceptive pain was carried out using a visual analog scale (VAS). Results and discussion. As a result of the clinical examination, a high prevalence of caries (K02) was revealed in CD and CUC, respectively, in 97.2% and 91.4% of cases, high and very high intensity of the carious process according to the CP index ≥ 10. With CD, the symptom of hyperesthesia, increased erasure of mixed teeth and wedge-shaped defects were most often observed in 100, 77.14 and 60.0% of cases, in 68.57% chronic periodontitis prevails (K05.3), with CD, the symptom of hyperesthesia (K03.80) and increased tooth erasure (K03.0) were 1.2 times less common) (p < 0.05), chronic gingivitis prevails in 62.85% (K05.10). The level of intensity of the pain symptom for patients with CD and CUC corresponds to the VAS scale from moderate to significant (p < 0.001). Results. As a result of a comprehensive dental examination of patients with CD and CUC, a high prevalence and intensity of caries and non-carious dental hard tissue lesions, inflammatory periodontal diseases, the level of dental care in persons with CD and CUC is insufficient. Conclusion. The connection of dental status with clinical manifestations of chronic inflammatory bowel diseases is beyond doubt. The ambiguity of the etiology and pathogenesis of CD and CUC as well as the significant similarity of their clinical manifestations, dictate the need for an integrated approach to the development of methods for diagnosing pathology of hard tissues of teeth and periodontal and assessing their clinical features.
Objective. This paper presents a comparative analysis of the effect of various diode lasers in the complex of local treatment of patients with recurrent oral aphthae on the background of inflammatory diseases of the digestive tract. Materials and methods. An examination and a complex of local treatment were carried out, as well as dynamic observation of 58 patients aged 25 to 45 years with the presence of aphthous rashes on the mucous membrane of the vestibulum and the oral cavity itself. The patients participating in the study were divided into 2 study groups. To relieve inflammation, diode lasers with different power and wavelength were used, as well as applications of various means with anti-inflammatory, antimicrobial, increasing epithelialization and regeneration of the mucous membrane in the area of the aphthous element. The estimation of the level of intensity of nociceptive pain level was assessed based on the data of the visual analog pain scale (VAS). Results and discussion. During the clinical observation of 1–5–7 days, the effect of a diode laser, regardless of the wavelength and intensity of radiation, contributed to a decrease in the intensity of inflammation, an increase in the rate of mucosal epithelialization and a leveling of the intensity of the pain level. A decrease in the intensity of pain was observed on average by 3.0 ± 0.8 and 3.5 ± 0.5 days, complete epithelialization of aphthous elements and leveling of all complaints was observed by 4.9 ± 0.4 and 4.7 ± 0.4 days of local treatment. Conclusions. The inclusion of various types of diode lasers in the scheme of local treatment of aphthous stomatitis in combination with applications are highly effective methods and contributes not only to the qualitative relief of pain, inflammation, but also contributes to the acceleration of epithelialization and regeneration of the mucous membrane in this group of patients. Summary. The effect of diode lasers and applications of powdered platelet autologous plasma, benzydamine hydrochloride and hyaluronidase 64 MU lyophilizate and Ora-Aid self-adhesive patch have high clinical efficacy in the complex of local treatment of recurrent ulcerative stomatitis against the background of inflammatory diseases of the digestive tract with symptoms of gastroesophageal reflux disease and chronic inflammatory bowel diseases.
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