Вплив профілактичного комплексу на стан тканин пародонта у дітей регіонів із різним умістом фтору в питній воді

Abstract

За підсумками обстеження 120 дітей (60 - основна група, 60 - референтна група) у віці 6 років, які проживають у місцевості із різним умістом фтору в питній воді виявлено, що флюороз має перебіг на фоні погіршення стану тканин пародонта. Профілактичний комплекс, який вміщує препарат «Остеовіт» і зубну пасту «Новый жемчуг кальций» у регіоні з підвищеним умістом фтору в питній воді більш ефективний, ніж той, що передбачає пероральне вживання таблеток гліцерофосфату кальцію, полівітаміни «Ревіт» та аплікації глюконату кальцію; По результатам обследования 120 детей (60 - основная группа, 60 - референтная группа) в возрасте 6 лет, проживающих в местности с разным содержанием фтора в питьевой воде выявлено, что флюороз протекает на фоне ухудшения показателей состояния тканей пародонта. Профилактический комплекс, который содержит препарат «Остеовит» и зубную пасту «Новый жемчуг кальций» в регионе с повышенным содержанием фтора в питьевой воде более эффективный, чем тот, который предусматривает приём внутрь таблеток глицерофосфата кальция, поливитаминов «Ревит» и аппликации глюконата кальция; Increased fluoride exposure has negative effect on human tissues and organs. Fluoride activates neutrophil superoxide generation and weakens antioxidant system in blood and periodontal tissues, stimulates production of prostaglandins and thereby exacerbates the inflammatory response in gingivitis and periodontitis. Periodontal immature tissues are sensible to hurt factors; pathological changes in periodontal tissues strengthen with low hygienic level. Recent studies have shown that periodontal indexes worsen with severity of fluorosis. Thus, fluorosis prevention is actual problem in areas with high content of fluoride in drinking water Purpose of research was to analyze changes of the periodontal tissues state in children who live in areas with different content of fluoride in drinking water under influence of treatment-prevention complexes (Poltava — optimal fluoride content, Shishaki — high). 120 children aged 6 years were examined: 60 children from Poltava, 60 children from Shishaki. Dental fluorosis was estimated with WHO classification. Children from both regions were divided on two groups - base and referent. The base group took treatment-prevention complex with «Osteovit» and cleaning teeth by «Novyi zhemchug calcii». The referent group took glycerophosphate calcium, polyvitamins «Revit» tablets, and gluconate calcium topically. All children took hygienic education, tooth cleaning method was standard, treatment of all carious teeth, orthodontic treatment if they need; sanitary-educative work is provided for parents. Recommendations were made for child’s tooth brush: medium softness, brush head is corresponded to child age. Gum’s inflammation was estimated with PMA index proposed by Masser and modified Parma (1960). Probability of differences between data was assessed by Student’s - Fischer t criterion. The children from Shishaki had prevalence of periodontal diseases 87,94 ± 2,74%, which is significantly higher (P<0,001) than index in children from Poltava, — 48,92 ± 1,84%. Prevalence of periodontal disease increases with severity of fluorosis. Light degree of gingivitis prevailed in children from Poltava (96,13 ± 1,01%). Rate of children with light degree of gingivitis decreased in Shishaki (79,03 ± 3,66%), while rate of children with moderate degree of gingivitis increased (20,97 ± 3,66%). Initially PMA in base and referent groups wasn’t considerably different (p>0,5). After first prevention course PMA improved in both groups. PMA decreased in base group in Poltava from 4,31 ± 0,91% to 1,44 ± 0,51% (p<0,01) and from 4,86 ± 0,71% to 2,92 ± 0,46% (p<0,05) in referent group. In Shishaki PMA changes were higher: from 9,35 ± 0,90 to 4,40 ± 0,49% (p<0,001) in base group and from 9,44 ± 1,07 to 5,98 ± 0,59% (p<0,01) in referent group. After 6 months PMA was better than at first examination, but worse than after prevention course. PMA in base group in Poltava was 2,22 ± 0,47% and 3,80 ± 0,54% in referent group, in Shishaki 5,28 ± 0,48% in base group and 6,90 ± 0,55% - in referent group. After 12 months PMA in base group in Poltava was 1,62 ± 0,25% and 3,47 ± 0,50% in referent group, in Shishaki 4,45 ± 0,38% in base group and 6,16 ± 0,68% - in referent group. Thus, it is necessary to prescribe prevention complex 2 times a year for long effect. PMA was reliable better in base group (p<0,05) then in referent group for whole observation period. Prevention complex with «Osteovit» and cleaning teeth by «Novyi zhemchug calcii» in region with high content of fluoride in drinking water was more effective than glycerophosphate calcium, polyvitamins «Revit» tablets, and gluconate calcium topically. Taking all these aspects into consideration, it can be concluded that in the coming future examination the other periodontal indexes will be a very helpful tool for different treatment-prevention means efficacy monitoring.