Relevance. According to the WHO scale, mucositis of 3-4 degrees is a severe injury among patients receiving high-dose radiation and chemotherapy for the head and neck region, the frequency of which reaches 85%. Dental treatment of such patients is extremely important, more often it is symptomatic and is aimed at improving their well-being and limiting the spread of the process, particularly oral mucositis. The aim of this study was to increase the effectiveness of the prevention of oral mucositis in patients with COR cancer against the background of systemic chemoradiation treatment. Material and methods. We examined 89 patients with a diagnosis of oral mucosa cancer (C00-C06, C10, C13, C14) according to ICD-10) II and III stages (T2-3, N0-1, M0), aged from 55 to 67 years, who received chemo-radiation therapy for the head and neck area. To rate immune status, in particular the mechanisms of regulation of protective reactions at the local level, patients with mucositis in the oral fluid were examined and it was determined by the content of pro-inflammatory and anti-inflammatory interleukins (IL), the concentration of cytokines in saliva was determined by ELISA. Depending on the method of treatment, patients were divided into two groups: comparison (traditional treatment) and main (developed method). Results. The concentration of proinflammatory IL-1b in the saliva of patients before starting treatment averaged 126.14 ± 45.01 pg/ml and anti-inflammatory IL-10 at 94.96 ± 44.20 pg/ml. Laetrile has a short-term local effect, which slightly affects the cytokine profile of saliva, the concentration of IL-1 increases by the 5th day, and IL-10 decreases 2.2 times. The concentration of cytokines before treatment was 64.55 ± 22.85 pg/ml and tended to gradually increase by the 7th day. For IL-10, the values were also low. Thus, a significant individual difference in the content of these cytokines was revealed, reflecting the sensitivity to both radiation and local therapy.
The article discusses etiological factors, pathogenesis, features of clinical manifestations, optimization of diagnosis, treatment and prevention of exudative erythema multiforme of the oral cavity. Currently, such pathological changes in the oral cavity are insufficiently studied and remain relevant in modern dentistry. Promising approaches to the successful treatment of this disease involve the implementation of additional examination and joint treatment with related specialists. Numerous studies of domestic and foreign authors demonstrate that special attention is paid to the prevention of re-morbidity of exudative erythema multiforme, aimed at preventing the occurrence of lesions of the oral mucosa.
Background — Radiation and chemotherapy of cancer cause complications that drastically reduce the quality of life. This requires the search for effective therapeutic agents for the mucositis treatment. We investigated the effects of amygdalin as a trophic external agent for post-radiation and post-chemotherapeutic oral mucositides. The study objectives were to conduct an immunomorphological analysis using an experimental model of iatrogenic mucositis, and to evaluate the effectiveness of amygdalin as cyanide with probable protective chemical properties in mucositis correction. Material and Methods — Our studies were performed on 40 male white rats. Radiation therapy was simulated by irradiating animals with a cranial dose of 6 Gy. Then an intraperitoneal injection of cisplatin was performed. On day 7, a biopsy was taken (model control), and animals were treated for 14 days with a mixture of 0.02% nitrofurazone, Desensitin® gel, Suprasorb® and amygdalin, after which a biopsy was taken again (therapy control). Results — Immunomorphological studies revealed dystrophic structural changes due to the progress of tissue hypoxia and the launch of Fas-dependent apoptosis in tissues. Using treatment with amygdalin by activating hypoxia-inducible factor (HIF) stimulates the macrophage population to remodel the stroma of the submucosal layer. In addition to activating the cellular components of local immunity, a therapeutic anti-apoptotic effect has been established. Conclusion — The method of mucositis correction by amygdalin is effective, which is confirmed by increased proliferation and decreased apoptosis due to revascularization and hypoxia reduction.
The aim of the study was to investigate the needs of children of various Crimean regions in orthodontic care. The epidemiological survey involved 125 children under the age of 12 years old living in the regions of Crimea with different levels of medical and social conditions (Alushta, Simferopol, Lenin and the Krasnogvardeisky district). The two-component IOTN index was used in investigation. Children of regional municipal areas showed higher severity of malocclusion and the need in orthodontic care than their urban peers (p<0.01 for Pearson χ criterion). A large part of the surveyed demonstrated a low motivation to receive orthodontic treatment according to aesthetic component of IOTN index. It was determined a strong correlation between of dental status values of the IOTN index and the number of orthodontists in the region, as well as the average strength of connection between the objective component of the index and ecological potential of the territory. It was revealed a moderate linkage between the indicators of the subjective component and the region of residence of the child. Thus, it is necessary to develop and implement programs of prevention of dentofacial anomalies in children with regard for regional peculiarities.
Relevance. One of the main causes of periodontitis is oral dysbiosis, in which changes in the quantitative and qualitative composition of the microflora occur, the systems of interaction between the microorganism and the microbiota are disturbed, and immunity is reduced. Is to study the comparative anti-disbiotic efcacy of various immunobiological preparations in patients with chronic apical periodontitis against the background of oral dysbiosis.Materials and methods. The study included 66 patients who were divided into 2 groups: comparisons (n = 34) and main (n = 32). Each group was divided into three subgroups depending on the degree of dysbiosis of the oral cavity according to the method of A.P. Levitsky (2007): determination of the ratio of the relative activities of urease and saliva lysozyme. All patients underwent traditional endodontic treatment and oral hygiene with parallel correction of oral microbiocenosis through the use of a complex of immunomodulatory drugs to patients of the main group.Results. In chronic apical periodontitis, urease activity was signifcantly increased, and in those examined with grade II-III dysbiosis almost 2 times compared with patients with grade I severity of clinical manifestations. The proposed treatment reduced the activity of urease in patients in all three subgroups of both groups (main and comparison). The results indicate a signifcant decrease in the activity of lysozyme in all patients more than 2 times. Conducted traditional treatment (comparison group) increased activity, but did not lead to a recovery in the rate of healthy individuals. The use of immunomodulatory drugs allowed to increase the level of lysozyme to the indicators of the control group.Conclusions. The inclusion of immunobiological preparations in the complex therapy of chronic apical periodontitis against the background of oral dysbiosis eliminates the dysbiotic phenomena in the oral cavity and has a therapeutic effect on destructive processes in the periapical tissues that are difcult to treat and often recur.
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