DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY, LVIV, UKRAINE.
5TH MILITARY HOSPITAL WITH POLYCLINIC IN CRACOW, CRACOW, POLAND.
Wiad Lek. 2023;76(8):1748-1753. doi: 10.36740/WLek202308107.
The aim: of our work was investigation of dystrophy in periodontal tissues and an attempt to establish the correlation between dystrophy in the periodontium and presence of intestinal disbacteriosis.
Materials and methods: Clinical-radiological examination was carried out in 146 patients with generalized periodontal pathology at the age from 26 to 59 years old. Among them in 92 persons generalized periodontitis was diagnosed and in 54 - periodontosis. The first stage of heaviness of the pathological process in the periodontium was revealed in 50 patients with generalized periodontitis and 28 persons with periodontosis. Other patients suffered from heavier forms of periodontal pathology (II and III stages), 42 persons with generalized periodontitis and 28 persons with periodontosis accordingly. Bacteriological analysis of feces for disbacteriosis was carried out in all patients.
Results: Changes in the physiological contour of the gums (that is macro relief of marginal periodontium) were found in the majority of examined patients. Because of the development of pathological gingival contour and recession of the gums, 72,5% of examined patients suffered from root denudation and different pathological conditions of roots cement structure - pigmentation, demineralization, wedge-shaped defects, caries. According to our clinical investigations it was found out that in majority of patients (83%) both inflammatory and dystophic changes were present, only 17% of patients had purely atrophic process in the periodontium without inflammation. In patients with GP and periodontosis, in whom dystrophic changes were accompanied by inflammation, clinical appearance was more expressed with redness, bleeding and suppuration from the pockets, thus hiding dystrophic signs.
Conclusions: According to clinical and radiological findings numerous dystrophic changes were found in all structures of the periodontium and teeth of patients with periodontosis and generalized periodontitis. Changes intensify in disease progressing into the II-III stages. In patients with periodontosis clinical- radio¬logical peculiarities of dystrophy were revealed in early stages of disease progression, while in generalized periodontitis dystrophic changes become apparent in late stages of disease. The presence of colon disbacteriosis was established in patients with periodontosis and generalized periodontitis. Disbacteriosis intensifies when diseases progress into II-III stages of heaviness. These data indicates to possible correlation between the development of dystrophic changes in periodontal tissues and the presence of intestinal disbacteriosis.
我们的工作旨在研究牙周组织的营养不良,并试图建立牙周营养不良与肠道菌群失调之间的相关性。
对 146 名年龄在 26 至 59 岁之间患有广泛性牙周病的患者进行了临床-影像学检查。其中,92 人被诊断为广泛性牙周炎,54 人被诊断为牙周病。在 50 名患有广泛性牙周炎和 28 名患有牙周病的患者中发现了牙周组织病变的第一阶段加重。其他患者患有更严重的牙周病(II 期和 III 期),其中 42 名患有广泛性牙周炎和 28 名患有牙周病。对所有患者进行粪便细菌分析以检查菌群失调。
在大多数接受检查的患者中发现了牙龈生理轮廓的变化(即边缘牙周的宏观轮廓)。由于病理性牙龈轮廓的发展和牙龈退缩,72.5%的患者出现了牙根暴露和不同的牙根牙骨质结构病理状况——色素沉着、脱矿、楔形缺损、龋齿。根据我们的临床研究发现,在大多数患者(83%)中,既有炎症性变化,也有营养不良性变化,只有 17%的患者在牙周组织中仅有非炎症性的单纯萎缩性过程。在患有 GP 和牙周病的患者中,营养不良性变化伴随着炎症,临床表现更为明显,表现为牙龈红肿、出血和脓肿,从而掩盖了营养不良的迹象。
根据临床和影像学检查结果,在患有牙周病和广泛性牙周炎的患者的牙周组织和牙齿的所有结构中都发现了许多营养不良性变化。随着疾病进展到 II-III 期,这些变化会加剧。在患有牙周病的患者中,在疾病进展的早期阶段就发现了临床-放射学特有的营养不良性变化,而在广泛性牙周炎中,营养不良性变化则在疾病的晚期阶段才变得明显。在患有牙周病和广泛性牙周炎的患者中都存在结肠菌群失调。随着疾病进展到 II-III 期加重,菌群失调也会加剧。这些数据表明,牙周组织营养不良的发展与肠道菌群失调之间可能存在相关性。