Clinical and Radiological Analysis of Periodontal Structures in Anatomical and Functional Disorders of the Mucogingival Complex

Abstract

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.