STATE OF LOCAL IMMUNITY OF THE MOUTH CAVITY IN CHILDREN WITH INFLAMMATORY PERIODONTAL DISEASES ON THE BACKGROUND OF TUBERCULOSIS

Abstract

One of the urgent problems of dentistry continues to be the prevalence of inflammatory periodontal diseases, which rank second in frequency among all dental diseases, and their prevalence increases with age. The main etiological factor in the development of inflammation in periodontal tissues is qualitative and quantitative changes in the microflora of the oral cavity, which leads to the activation of periodontopathogenic microorganisms. But to a greater extent than periodontal pathogens, the progression of periodontal diseases is influenced by systemic factors, which in 85 % of cases are concomitant and activate the pathological process in the periodontium. A significant role in the chain of pathological mechanisms in periodontal diseases is played by the immune system, the violation of which indicators contribute to the emergence and development of the inflammatory process, which makes it necessary to study the indicators of local immunity in children with inflammatory periodontal diseases against the background of tuberculosis for timely implementation of preventive measures and treatment of inflammatory processes in the periodontium. The aim of the study. Study of the state of the main indicators of local immunity of the oral cavity in children with inflammatory periodontal diseases against the background of respiratory tuberculosis. Research material and methods. To study indicators of immunological reactivity of oral fluid, the examination was conducted in 67 children aged 7, 12, and 15 years with inflammatory periodontal diseases on the background of respiratory tuberculosis (main group). The control group consisted of 43 healthy children of a similar age with clinically healthy periodontal tissues. The immunological examination included the determination of the level of pro- and anti-inflammatory cytokines, the concentration of immunoglobulins of different classes and lysozyme in the children's oral fluid. Scientific novelty. It was established that the state of local immunity of the oral cavity in children with inflammatory periodontal diseases on the background of tuberculosis was manifested by an increase with age of the pro-inflammatory interleukin IL-1ß from 56.1±1.7 pg/ml in 7-year-olds to 140. ±1.74 pg/ml in 15-year-olds and a decrease in the level of IL-4 ‒ from 28.7±0.3 pg/ml in 7-year-olds to 20.6±0.6 pg/ml in 15-year-olds. The content of sIgA and IgA underwent a decreasing trend, and the content of IgG increased from 0.554±0.014 g/l in 7-year-olds to 0.822±0.016 g/l in 15-year-old children, which can be considered as a possible factor of prolonging inflammation and evidence violation of the relationship between the secretory and humoral links of local immunity. The level of Lz in oral fluid decreased – from 23.42±1.14 μg/l in 7-year-olds to 14.43±1.12 μg/l in 15-year-olds. Conclusions. The results of the conducted studies show that in children with inflammatory periodontal diseases against the background of respiratory tuberculosis, there is a tension in the indicators of the secretory immunity of the oral cavity, which is manifested by an imbalance of interleukins and immunoglobulins of different classes. A decrease in sIgA and IgA and an increase in IgG can be considered as factors of prolongation of the inflammatory process in the periodontium, which may indicate a negative effect of respiratory tuberculosis on the state of indicators of local immunity of the oral cavity of children with inflammatory periodontal diseases.