The purpose of the study was to analyze professional literature sources devoted to the influence of homocysteine on the development of vascular disorders. The role of homocysteine as a biomarker of vascular pathology is considered. Materials and methods. Bibliosemantic and analytical methods were used in the study. The analysis of the specialized literature (47 sources) was carried out using information in the scientific-metric databases MEDLINE/PubMed, Scopus and Google Scholar. Results and discussion. Homocysteinemia is a pathological condition associated with quite serious consequences for the body; the endothelium of vessels suffers mostly: systemic endothelial dysfunction develops (including disruption of the synthesis and exchange of the endothelium-relaxing factor – nitric oxide), oxidative stress, activation of platelet aggregation, hypercoagulation occurs (due to a decrease in the activity of heparin, thrombomodulin and an increase in the activity of thromboxane A2). The prevalence of hyperhomocysteinemia in Ukraine is quite high and reaches 10% among healthy adults, 2% among young people and adolescents, from 13% to 43% in patients with cardiovascular pathology. The C677T polymorphism of the methylenetetrahydrofolate reductase gene is widespread among the population of Ukraine (40.7%). Researchers believe that hyperhomocysteinemia is an independent and modifiable risk factor for vascular pathology. Conclusion. Homocysteine is recognized as one of the markers of vascular pathology. Scientists consider the activation of oxidative stress, damage to the endothelium, stimulation of the proliferation of smooth muscle cells, and pro-inflammatory effects to be the main mechanisms of vascular damage in hyperhomocysteinemia. The described pathological changes are accompanied by a violation of the regulation of vascular tone, mostly due to a decrease in the synthesis of nitric oxide. Unbalanced synthesis of nitric oxide causes and potentiates oxidative stress, the processes of atherothrombogenesis. The professional literature presents enough scientific data that convincingly prove the role of homocysteine in the development of cardiovascular and neurological pathology. However, there is a small number of studies devoted to the relationship between hyperhomocysteinemia and periodontal diseases, and the pathogenetic mechanisms of the influence of hyperhomocysteinemia on the development of vascular disorders in coronavirus disease are not fully disclosed
Aim: to evaluate the effectiveness of fibre-reinforced composite splints for lower front teeth immobilization in the scheme of complex therapy of severe periodontitis (III and IV stages) in short-term and long-term after treatment in persons with and without risk factors. Materials and methods. To reach the goal, a total of 58 patients with stage III and IV periodontitis were examined with identification of risk factors for the periodontal disease progression (smoking and diabetes). After a detailed periodontal examination, all patients were non-surgically treated for periodontitis, and mobile teeth were immobilized by fibre-reinforced composite splints. After splinting, mandatory supportive periodontal care was prescribed (every 3 months) with the dynamic monitoring of oral hygiene (PI), probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP) and the splint structure condition (cracks and fractures of the splint, violation of the marginal fit, a single tooth separation from the overall structure, chipping of the material and defects in the interdental spaces). The patients were dynamically examined before treatment, immediately after treatment (1 month) and at the long-term periods (12, 24, 36 months). Results. The splinting structure integrity was preserved in 67.24 % of patients for 3 years, and splinting defects were detected in 32.76 % of patients at different stages of the follow-up. Depending on the presence or absence of risk factors for periodontal disease, the splint structure integrity was preserved for 3 years in 18 patients (56.25 %) with associated risk factors and in 21 patients (80.77 %) without risk factors (P = 0.06). Conclusions. The use of fibre-reinforced composite splints for immobilization of lower front teeth in the scheme of complex therapy for periodontitis (III and IV stages) allowed to preserve mobile teeth and reduce values of the studied periodontal indices both immediately and in the long term after treatment in individuals with and without risk factors.
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