Зміни функціональної активності пульпи на кислотне подразнення у дітей із флюорозом

Abstract

За підсумками обстеження 120 дітей ( 60 - мали дуже слабкий та слабкий ступінь флюорозу зубів, 60 - слабкий та помірний) у віці 6 років, які проживають у місцевості із різним умістом фтору в питній воді виявлено, що з підвищенням ступеня флюорозу зубів знижується захисна реакція пульпи на кислотний подразник. Навіть за однакових ступенів флюорозу зубів ці показники мають гірші значення в регіонах із підвищеним умістом фтору в питній воді; По результатам обследования 120 детей (60 - имели очень слабую и слабую степень флюороза, 60 - слабую и умеренную степень флюороза) в возрасте 6 лет, проживающих в местности с разным содержанием фтора в питьевой воде выявлено, что с повышением степени флюороза зубов снижается защитная реакция пульпы на кислотный раздражитель. Даже при одинаковых степенях флюороза эти показатели имеют меньшие значения в регионах с повышенным содержанием фтора в питьевой воде; Dental fluorosis is actual problem for different region's of Ukraine. Problem of fluoride is especially actual for Poltava's region because of it is endemic region with this microelement. Studies have shown the presence of a specific reaction of the pulp to acid stimulus to the tooth surface, which leads to rapid changes in electrical impedance of the structure of the enamel-dentin depending on the stages of formation of a root and tooth enamel maturation (Denga О. V., 1995). It was found that caries protective functional activity of the pulp either absent or greatly reduced for fluorosis (Horochivsky V. N, 2002). The aim of the study was to detect changes in functional activity of the pulp to acid irritation enamel, depending on the severity of dental fluorosis in children residing in areas with different content of fluoride in drinking water. 120 children aged 6 years were examined, who lived in areas with different content of fluoride in drinking water (Poltava - optimal; Shyshaki - high). Manifestations of dental fluorosis were assessed by classification I. J. Muller. Caries protective functional activity of the pulp of teeth (CPFAP) was evaluated using a method based on reducing permeability of enamel to alternating current after the acid putting (Denga О. V., 1995). We determined the ratio of increase of electrical impedance of enamel-dentin structure Z2 to the value of impedance Z1, which is measured to the action of acid on the tooth: A = Z2/Z1. Electrical impedance of teeth measured in vivo with the alternating current at a frequency of 1000 Hz using RLC-bridge type E5030. To assess the validity of the results using the Student's- Fisher criterion t. Results. Poltava’s children were found less pronounced degree of dental fiuorosis than in Shyshaki where found severe forms of dental fluorosis. It was found that the middle form of fluorosis (68,8 ± 4,14%) prevalences in children living in areas with a high content of fluoride, as very easy fluorosis (63,1 ± 2,06%) prevalences in children living in areas with an optimal fluoride in drinking water. The pulp reaction to acids was significantly (p<0. 001) higher (29,98 ± 0,36 kOhm) in Poltava's children than children in Shyshaki (22,83 ± 0,39 kOhm) for the primary examination. After the action of acid on tooth enamel the pulp reaction is also more pronounced in Poltava’s children - 39,73 ± 0,31 kOhm than in children from the region with a high content of fluoride in drinking water, - 17,7 ± 0,43 kOhm (p< 0.001). Index A 1.7 times is more impor¬tant in Poltava’s children than children from Shyshaky. Pulp response to (30,32 ± 0,51) and after exposure to acid (40,36 ± 0,27), as well as the value of A (1.33) have significantly higher rates in Poltava's children with very easy fluorosis, than in children with easy dental fluorosis (Z1 = 27,9 ± 0,48 kOhm; Z2 = 36,6 ± 0,72 kOhm, A = 1.31) (pCO.001). Children from Shyshaki with low degree of dental fluorosis also have a more pronounced reaction of the pulp to acid stimuli than children with moderate dental fluorosis. Conclusion. For the same degree of fluorosis the pulp reaction before and after exposure to acid more pronounced in Poltava’s children than in children from Shyshaki (P <0,001). Thus, protective reaction of the pulp to acid stimulus reduced with increasing degree of dental fluorosis. These figures have the worst values in areas with high fluoride content in drinking water even for identical degrees of dental fluorosis. It advisable to study the effect of various medical facilities on condition caries protective functional activity of the pulp of teeth affected by fluorosis in future.