THE ROLE OF TRAUMATIC NODES IN THE MAINTENANCE OF PERIODONTAL INFLAMMATION IN PATIENTS WITH GENERALIZED PERIODONTITIS, CHRONIC COURSE

Abstract

Objective. To conduct a comparative analysis between the clinical examination of patients with generalized periodontitis of the initial-first degree of chronic course and radiological changes in the areas of interdental membranes, taking into account the existing traumatic nodes. Materials and methods. The study was conducted in 60 patients living in the city of Kyiv and Kyiv region, aged 20 to 40 years, of whom 20 were in the control group. The patients were diagnosed with generalized periodontitis, initial – I degree, chronic course. The condition of periodontal tissues and the need for their treatment were assessed according to the structure of the CPITN index according to WHO criteria. As an indicator of antimicrobial protection in periodontal pockets, the functional activity of neutrophilic granulocytes in local foci of chronic inflammation was studied in comparison with the same indicators in the localization of traumatic nodes. The bactericidal activity of neutrophilocytes was studied by the content of non-enzymatic cationic proteins according to the method of V.E. Pigarevsky. Particular attention was paid to the comparative analysis of clinical manifestations of the inflammatory process in the periodontium, taking into account local irritants of periodontal tissues, traumatic nodes and occlusion. The state of bone tissue was assessed by orthopantomography and 3D computed tomography. The results of the examination in general revealed the need for hygienic interventions in 70.89 % of the examined patients, and the need for complex treatment in 47.18 %, where the depth of periodontal pockets up to 3-4 mm in four sextants was found in up to 65 %. At the same time, the bactericidal activity of neutrophilocytes is 1.3-1.4 times reduced in the areas of periodontal pockets and, compared to traumatic nodes, more than 2 times intracellular and 3 times extracellular. In addition, analog methods (orthopantomography) do not fully demonstrate changes in the structure of bone tissue in comparison with digital methods of 3D computed tomography of alveolar processes, interdental membranes in patients with generalized periodontitis of the initial – I degree, chronic course, accompanied by traumatic occlusion.