Кількісний склад мікрофлори у хворих з гальванозом, що користуються незнімними ортопедичними конструкціями

Abstract

Резюме. Проведеними дослідженнями РЧ-ПЛР встановлено зміни мікробіоценозу ротової порожнини і встановлена домінуюча група мікрофлори у розвитку дисбіозу у пацієнтів з гальванозом, що користуються незнімними ортопедичними конструкціями із неблагородних сплавів. У хворих гальванозом, що користуються металевими ортопедичними конструкціями нами встановлена домінуюча група мікрофлори: Gardner ella+Prevotela+Perphiromonas spp., Streptococcus spp., Eubacterium spp. У хворих гальванозом з металокерамічними конструкціями домінуюча мікрофлора була наступна: Eubacterium spp. і Gardnerella+Prevotela+P erphiromonas spp. Це може служити діагностичним критерієм при розвитку дисбіозу у хворих з гальванозом.

. Проведенными исследованиями рВ- Пцр установлены изменения микробиоценоза ротовой полости и установлена доминирующая группа микрофлоры в развитии дисбиоза в пациентов, которые пользуются несъемными ортопедическими конструкциями из неблагородных сплавов. У больных гальванозом, которые пользуются металлическими ортопедическими конструкциями нами установлена доминирующая группа микрофлоры: Gardnerella+Prevotela+Perphiromonas spp., Streptococcus spp., Eubacterium spp. У больных гальванозом с металлокерамическими конструкциями доминирующая микрофлора была следующей: Eubacterium spp. и Gardnerella+Prevotela+Perphiromonas spp. Это может служить диагностическим критерием при развитии дисбиоза у больных с гальванозом.

Oral cavity diseases, caused by galvanic potentials because of metal inclusions in a mouth (fixed denture constructions, amalgam dental fillings, metal pins, etc.), occupy a significant place in prosthodontics. The aim is to study in real time the oral microbiota in galvanis patients who use dentures made of different materials. To achieve our goal, clinical and laboratory examination of 28 patients (12 male and 16 female), aged 35 to 55 years old, were performed. Patients were examined in the traditional way, which included oral cavity clinical examination and periodontal status. Under our examination there were 28 galvanis patients who use fixed dentures made of the base metals alloys. Persons with dental crowns, bridges and consoles made of stainless steel, cobalt-chrome, nickel-chrome and other metal alloys were considered patients with metal inclusions. 9 healthy people of the same age but without metal inclusions (amalgam dental filling and metal dentures) with sanified oral cavity were in the control group. To determine the bacteria in plaque from the area adjacent to the gingiva, a plaque sample was studied. Microbiological tests were performed by the multiplex real time polymerase chain reaction (PCR) method using reagents complex «Femoflor 8». After successful amplification the results were recorded by detecting amplifier DT-322 («DNA – Technology», Russia), the program calculated the number of gene copies in terms of cycle indicator; quantitative results were expressed in common logarithms. We determined the total bacterial mass, quantitative relationships: Lactobacterium spp., Total Enterobacterium spp., Streptococcacea spp., Gardnerella spp., Prevotella spp., Porphyromonas spp., Eubacteridacea spp., Micoplasma (hominis + genitalium), and Candida spp. Statistical analysis of the data was performed using the standard software package «STATISTICA 6. 0 for Windows» (StatSoft Inc., USA). It was determined that most galvanis patients had figures often characterized by large potential difference – 14 patients had measurements from 120 to 150 mV, 10 patients – from 150 to 240 mV, and 1 patient – 400 mV. 50. 4% of galvanis patients had galvanis symptoms being developed during the first year of dentures using, mainly due to the appearance of dissimilar metals units in the oral cavity; when using dentures for two years the figures were 18. 5%, respectively; and for more than 5 years – 30. 1%; respectively. Galvanis symptoms development was mainly caused by a significant increase of metal dentures electric corrosion because of the worn dentures and oral cavity potential difference growth. Patients without galvanis symptoms used dentures from 3 to 5 years (41. 9%) and more than 5 years (48. 1%). Real Time PCR results allowed establishing the dental plaque microbiota quantitative characteristics, which are listed in Table 1. The statistical data have allowed concluding that in case galvanis the quantitative total bacterial mass, Lactobacillus spp., Enterobacteriaceae, Gardnerella vaginalis / Prevotella bivia / Porphyromonas spp. in the gingival plaque sample was significantly higher than figures under physiological conditions, and therefore can serve as criteria for the dysbiosis diagnosing. Real Time PCR studies revealed a microflora Gardnerella+Prevotela+Perphiromonas spp., Streptococcus spp., Eubacterium spp dominant group among the galvanis patients who use metal dentures. The galvanis patients, who use metal-ceramic structures, had the dominant microflora as follows: Eubacterium spp. and Gardnerella+Prevote la+Perphiromonas spp. This can serve as a diagnostic criterion for the dysbiosis development in galvanis patients. These results lead to the need for preventive and therapeutic interventions for galvanis patients, to correct dysbiosis.