Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating. The study on RAS remains relevant over many years and continues to be a priority in modern dentistry. The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention. Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions. This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention. Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity. Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.
The aim of the work is to study the Klotho protein concentration in the oral fluid of patients exposed to work-related harmful factors and to reveal correlations with the content of bone tissue and vitamin D metabolism markers. Materials and methods. The study group consisted of 126 patients with generalized periodontitis of initial (n = 8), I (n = 32), II (n = 68) and III (n = 18) degree of severity, chronic course, working in hazardous conditions of the “Dniprospetsstal” plant in Zaporizhzhia. The comparison group consisted of 32 periodontitis patients of initial (n = 5), I (n = 10), II (n = 11) and III (n = 6) degree of severity without exposure to work-related harmful factors. The control group included 20 otherwise healthy individuals aged 19–25 years without signs of periodontal diseases. The levels of vitamin D, VDBP, MMP-8 and osteocalcin were determined by enzyme-linked immunosorbent assays, the concentration of soluble Klotho was detected by the enzyme-linked ImmunoChem-2100 immunosorbent assay. Results. It was found, that in the study group of patients working in hazardous work-related conditions, the decrease in oral fluid Klotho protein concentration was greater, than in the comparison group of patients with periodontal diseases, but not exposed to work-related hazardous conditions. The indicator of Klotho protein is an early marker of the periodontal disease progression and varies inversely with the severity of periodontitis, starting in the early stages of the disease. The correlation coefficient between the level of Klotho protein and the degree of the disease severity in the comparison group patients was γ = -0.957, P < 0.05 and γ = -0.906, P < 0.05 – in the study group. In the patients with periodontal diseases, there was a decrease in the Klotho protein concentration with a parallel increase in the marker of bone tissue destruction - MMP-8, and a decrease in the marker of remodeling – osteocalcin, as compared to the controls. The decrease in Klotho protein concentration occurred with vitamin D deficiency and worsened with the vitamin D-binding protein reduction. Conclusions. The Klotho protein is the early, sensitive and specific diagnostic biomarker in dental diseases, and its measurement can be used as a predictor of inflammatory periodontal disease and its complications. The Klotho protein is one of the main regulators of bone metabolic processes.
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