PECULIARITIES OF TREATMENT OF CHANGES IN PERIODONTAL TISSUES IN CHILDREN LIVING IN POLLUTED PRECARPATHIAN REGIONS
Authors: Rozhko M. M. , Pavlishin M. V. 
Published: October 2021

Today special attention to the influence of environmental factors on the condition of the dental-maxillary system and periodontal tissues in children is paid. Scientists have proved that environmentally unfavorable conditions also change the immunological reactivity of the body, form violations of the immune status, and changes in the local immunity in the oral cavity stimulate the development of pathogenic microflora.
Our research is devoted to the study of changes in periodontal tissues in children living in ecologically favorable conditions and in ecologically polluted Precarpathian regions, a comparative characterization of changes in periodontium, a treatment plan for chronic catarrhal gingivitis, supplemented with chlorhexidine dentin and quercetin. According to the results of many researches, 0.12% chlorhexidine solution provides a pronounced antimicrobial effect on pathogenic microflora; and under the action of quercetin there is a stabilization of the antioxidant system, improvement of peripheral blood circulation, improvement of rheological properties of the patient's blood.
We examined 60 patients with chronic catarrhal gingivitis living in environmentally stable conditions (Ivano-Frankivsk) (1 group), 15 people with intact periodontium and 60 children with chronic catarrhal gingivitis living in contaminated Precarpathian regions (Burshtyn) (group 2). All patients were treated with a set of therapeutic measures, which are recommended for the conventional treatment of patients with chronic catarrhal gingivitis. In groups 1a and 2a, patients were treated with chlorhexidine, calendula and chamomile infusion and 1% mefenamine paste. In groups 1b and 2b we applied a quercetin gel on the mucous membrane of the patient’s gums under an individual dental-gingival cap.
For the purpose of comparative characterization of the two groups, an index assessment of the condition of periodontal tissues, study of rheographic parameters of periodontal tissues and radiographic characteristics of jaw bone tissue were performed.
The results of the research showed a significant difference between clinical and laboratory parameters in patients with chronic catarrhal gingivitis living in environmentally friendly conditions compared with persons living permanently in ecologically polluted Precarpathian regions (p <0.05 ). In people living in ecologically polluted areas there is a pronounced cyanosis of the gums and mild diffuse cyanosis of the oral mucosa, high rates of bleeding gums. Scientists believe that the main mechanisms of pathogenetic effects on periodontal tissues are transmitted infectious and toxic diseases, trophic and metabolic disorders, changes in neurohumoral regulation, vitamin imbalance in the body, immune disorders, hypoxia, oxidative stress, disorders of plastic processes in any tissues of the body, the mucous membrane of the oral cavity.
We proved that the use of the proposed treatment regimen for chronic catarrhal gingivitis (groups 1b and 2b) shows a significantly higher effectiveness over the treatment of basic therapy in groups 1a and 2a. This treatment stimulates metabolic processes in periodontal tissues, reduces cyanosis, edema of periodontal tissues, eliminates inflammatory phenomena in periodontal tissues. The results show that the use of quercetin and 0.12% chlorhexidine solution in the complex treatment of patients with chronic catarrhal gingivitis provides a significant improvement in clinical parameters and laboratory characteristics of periodontal tissues in children living in different environmental conditions.