THE STATE OF BONE METABOLISM IN PATIENTS WITH GENERALIZED PERIODONTITIS IN DIABETIC OSTEOPATHY

Abstract

Diagnosis of the state of bone metabolism in patients with generalized periodontitis burdened with type 2 diabetes is an important step in the complex of treatment and prevention measures for this pathology. The purpose of the study was to create evidence-diagnostic criteria for assessing and predicting the severity of the course of generalized periodontitis in diabetic osteopathy based on the study of the variability of bone remodeling. Research material and methods. In order to select homogeneous groups, a clinical and radiological examination of 166 patients with generalized periodontitis, associated and not associated with type 2 diabetes, was conducted. The age of the patients was in the range of 30-50 years (on average 42.5+- 2.34 years). Among them there were 99 (59.6 %) women and 67 (40.4 %) men. The degree of severity of generalized periodontitis was verified according to generally accepted clinical and radiological criteria outlined in modern and domestic classifications: 76 (45.8 %) patients had chronic generalized periodontitis and 90 (54.2 %) had chronic rapidly progressive periodontitis. The control group consisted of 19 almost healthy voluntary donors of similar age (on average 41.5+-2.7 years) and sex without endocrine pathology, with healthy periodontium and intact teeth. Research results and their discussion. Evaluation of the Hounsfield index and markers of bone metabolism in different groups of patients with generalized periodontitis in type 2 diabetes with average statistical analysis showed that they are directly correlated with the severity and the course of generalized periodontitis, the stage of compensation, the severity and duration of diabetes. Conclusions. The peculiarity of the clinical course of generalized periodontitis in type 2 diabetes mellitus, burdened by diabetic osteoporosis, is caused and manifested by a decrease in the bone structures of the periodontium in the processes of osteosynthesis and an increase in the intensity of bone resorption. A feature of the manifestation of rapidly progressive and chronic generalized periodontitis in diabetic osteopathy and without systemic pathology is the increase, independent of the clinical picture of the disease, of signs of osteoporosis activation and a decrease in osteosynthesis. To verify the activity of osteosynthesis and bone resorption in periodontal tissues, the following have predictive value: diagnosis of different directionality and intensity of bone remodeling based on the levels of quantitative content in blood serum of the levels of markers of bone metabolism.