Background: The aim of this research was to determine the functional state of regional blood flow in young people with varying degrees of anatomical and functional disorders of periodontal tissues. Methods and Results: One hundred and thirty-five young patients with varying degrees of anatomical and functional disorders of periodontal tissues (AFDP) and 52 controls with intact periodontium were examined. All patients with AFDP were divided into three groups: Group 1 included 33 patients in the compensation stage (low degree of periodontal risk, intact periodontium, no clinical symptoms, pale pink gums, no bleeding on probing, dentogingival attachment is not disturbed); Group 2 included 38 patients in the sub-compensation stage (average degree of periodontal risk, disorders of the mucogingival complex, without clinical symptoms); and 64 patients in the decompensation stage (high degree of periodontal risk, disorders of the mucogingival complex, the presence of clinical symptoms, individual or combined signs of periodontal pathology, gingival recession (Class I and II according to Miller's classification). We studied the regional blood flow of periodontal tissues, which was assessed by an ultrasound Doppler graph in a non-invasive way. The parameters of linear (PSV, peak systolic velocity) and volumetric (Qs, maximum systolic volume velocity) velocities of blood flow, as well as the parameters of the wall vascularization (PI, pulsation index; RI, resistance index). Results: The PSV increased statistically significantly with a load compared to rest in the control and sub-compensation groups and decreased in the decompensation group with a load, compared to the rest condition. The PSV increased relative to the control in the subcompensation and decompensation groups in rest and under load. The Qs indicator showed a similar trend in the groups. Qs significantly increased under load, compared to the rest condition in the control, compensation, and subcompensation groups, and decreased in the decompensation group. The Qs values, in comparison with the control, increased in the subcompensation and decompensation groups in the rest condition and under load. The PI increased with the load relative to the rest condition in the control, compensation, and decompensation group. At the same time, PI decreased under the load, compared to the rest condition, in the subcompensation group. In comparison with the control, the PI values decreased in the subcompensation and decompensation groups in the rest condition and under load. The RI significantly changed only in the subcompensation group under load, compared to the rest condition. Only RI values decreased significantly in the subcompensation group under load, compared to the control. Conclusion: The use of Doppler ultrasonography in assessing the state of regional blood flow of periodontal tissues is a highly informative and non-invasive method. The velocity characteristics (linear and volumetric velocities) of blood flow are important diagnostic indicators, allowing the most rapid and reliable assessment of the degree of anatomical and functional disorders of periodontal tissues.
Subject. Anatomical and functional disorders of the mucogingival complex. Objectives. To evaluate microcirculatory, clinical and radiological changes in periodontal tissues in various variants of mucogingival complex disorders. Methodology. The study was conducted at the Department of Therapeutic Dentistry of ASMU. In the course of the study, 80 patients (49 women, 31 men) aged 18 to 35 years were examined with a ratio of dentition close to orthognathic bite in the presence of maximum occlusion. Three groups were formed depending on the anatomical and functional state of the mucogingival complex. In the clinical part of the study, an objective assessment of the condition of periodontal tissues was carried out on the basis of a dental examination with a comprehensive analysis of the periodontal status. The X-ray examination included the analysis and description of cone-beam computed tomograms for patients of clinical groups. To assess microcirculation in periodontal tissues, the method of ultrasonic Dopplerography with functional probe breakdown was used. Results. In the studied groups, the level of oral hygiene was characterized as good, and the indicators of hygiene indices did not differ significantly, periodontal indices indicated the absence or minimal degree of inflammation in periodontal tissues. Carrying out a functional tension test made it possible to divide patients into subgroups according to the type of reaction: normal, compensated, subcompensated, decompensated. According to the results of the study of CBCT in the comparison group, pathological changes in the bone tissue of the alveolar process of the studied areas were not recorded, in patients of the first clinical group, in most cases (80.2%), pathological changes in the bone tissue of the alveolar process were not observed, in the rest (19.8%), a low level of alveolar bone was noted. In patients of the second clinical group, the phenomena of osteoporosis and an increase in the distance from the dental enamel-cement border to the edge of the outer cortical plate were recorded. Conclusions. X-ray changes in bone tissue most often corresponded to the already existing clinical symptoms of periodontal tissue damage against the background of mucogingival pathology. The predictors of prenosological diagnosis in anatomical and functional disorders of the mucogingival complex were changes in microcirculation indicators.
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