ASSESSING THE EFFECTIVENESS OF INTEGRATED TREATMENT IN ADOLESCENTS WITH CHRONIC CATARRHAL GINGIVITIS LIVING IN ENVIRONMENTALLY COMPROMISED AREAS
Authors: Malko N.V. , Bandrivskyi Yu.L. 
Published: December 2024

The challenging ecological situation in Western Ukraine, coupled with natural geochemical factors such as deficiencies in fluorine and iodine, contributes to the deterioration of children's somatic and dental health. This underscores the urgent need to develop comprehensive treatment and preventive strategies to mitigate pathological processes in periodontal tissues and enhance treatment outcomes.
Purpose: The study aimed to evaluate the effectiveness of treating chronic catarrhal gingivitis in children residing in environmentally polluted areas with iodine and fluorine deficiencies (the cities of Yavoriv and Zhydachiv). The study observed children aged 12–15, comprising 59 participants in the main group and 42 in the control group (from the city of Lviv, considered an ecologically clean region). Children in the main group were treated according to a specialized protocol developed for the study, while those in the control group received treatment per the Ministry of Health of Ukraine's protocols for “Therapeutic Dentistry”.
Methods. The treatment regimen for chronic catarrhal gingivitis in the main group included: local measures such as Professional oral hygiene, traditional anti-inflammatory agents (tinctures of chamomile, St. John’s wort, calendula), applications of “Holisal” gel on the gingival surface, use of “Lacalut Aktiv Herbal” toothpaste and “Lacalut Aktiv” mouthwash; systemic treatment including “Kinder Biovital Lecithin” gel to enhance immune system function, “Ascorutin” to reduce capillary fragility and permeability.
This multifaceted approach aimed to address both local and systemic factors influencing periodontal health in children from ecologically compromised regions.
Results and discussion. The evaluation of the immediate results of the treatment was carried out visually, taking into account the change in clinical symptoms (on 5-6 days) and with the help of periodontal and hygienic indices, immunological indicators. Periodontal status was assessed by papillary-marginal alveolar indices, communal periodontal index and gingival bleeding index. Oral hygiene was assessed by the Fedorov-Volodkina index. In order to assess the adaptive capabilities of the body and determine the risk factors for periodontal tissue lesions, the content of leukocytes in the oral fluid of children was evaluated.
In the initial period of the treatment course, we found a decrease in the values ​​of periodontal indices in both the main and control groups. On the 5-6th day after the start of treatment of chronic catarrhal gingivitis, the value of the papillary-marginal alveolar index in the main group was 20.16±1.95% that was significantly lower compared to the control group, 33.21±1.82%. Following the treatment, a decrease in the bleeding index was found in the children of the main group accounting 0.94±0.11 points versus 1.42±0.15 points in the control group.
Analyzing the changes in the communal periodontal index, a more significant decrease was found in the children of the main group (1.09±0.15 points) compared to the control group (1.39±0.16 points).
Along with the normalization of the clinical condition of the periodontal tissues in children with chronic catarrhal gingivitis who were under our observation, an improvement in oral hygiene was noted, which, in our opinion, can be due to the implementation of professional hygiene, quality control of tooth brushing, as well as conversations on hygiene education with children and their parents. This is confirmed by indicators of the hygienic index of Fedorov-Volodkina.
Since local immunity is a sensitive indicator of the effect of external and internal environmental factors, we determined the concentration of leukocytes in the oral fluid 5-6 days after the treatment of chronic catarrhal gingivitis.
It is worth noting that after treatment for 5-6 days, the number of leukocytes in the oral fluid of children with chronic catarrhal gingivitis in the study groups significantly decreased. Thus, in the children of the main group, the number of leukocytes was 205.14±4.28 × 106 /l and 220.40±4.21 × 106 /l in the control group, which was significantly lower than the corresponding values ​​before treatment (р<0 ,01).
Thus, the study results have demonstrated the described treatment course can significantly normalize and improve the condition of periodontal tissues and oral hygiene in the children of the main group with chronic catarrhal gingivitis that is confirmed by oral hygiene indices and laboratory findings.