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IMMUNOLOGICAL ASSESSMENT OF THE STRESS RESPONSE IN PATIENTS WITH INFLAMMATORY POSTPROTHETIC COMPLICATIONS
Abstract
Post-prosthetic complications during dental implantation are accompanied by pain symptoms leading to disorders of the psychoemotional state. All this influences the behavior of patients. In addition, psychoemotional stress is often a factor of provocation and persistence of the complications. The presence of a stress state in the identified pathology, as well as the influence of various therapies on the treatment of post-prosthetic complications, is reflected in the dynamics of changes in the concentrations of both catecholamines (epinephrine, norepinephrine) and glucocorticoids (cortisol) — hormones of the medulla and the adrenal cortex. The aim: to conduct an immunological analysis of the stress response in patients with postprosthetic complications during dental implantation. Materials and methods: The study was performed in 120 patients with post-prosthetic complications during dental implantation before and during treatment: Group I (control) — 30 patients treated with the conventional therapy; group II — 30 patients treated with ozone therapy in addition to the conventional therapy; group III — 30 patients treated with transcranial electrical stimulation in addition to the conventional therapy; Group IV — 30 patients treated with a combination of conventional therapy, ozone therapy and transcranial electrical stimulation. The concentration of epinephrine, norepinephrine, cortisol, alkaline phosphatase, and the Garkavi index were evaluated. Results: The change in these indicators after the treatment indicates the normalization of the level of the studied enzymes — markers of bone homeostasis, which is confirmed by an improvement in the clinical picture in the oral cavity. Conclusion: changes in immunological parameters objectively reflect the psychoemotional state of patients. The nature of changes in the hormonal stress response to the treatment of post-prosthetic complications indicates the effectiveness of the therapeutic regimens used, and, as a result, a decrease in both pain symptoms and psychoemotional stress.
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The relevance of the research topic. Morpho-functional changes in peripheral circulation established in type 1 diabetes mellitus correlate with changes in central hemodynamics, allowing the use of microcirculation indicators as diagnostic and prognostic criteria for assessing the degree of functional vascular disorders.
Purpose – identifcation of microcirculation features of the blood by the method of laser Doppler flowmetry in children with different experience of type 1 diabetes in key age categories.
Methods. The study included 67 children with type 1 diabetes mellitus aged 12-15 years with an experience of the disease from six months to ten years. The comparison group consisted of 38 healthy children. The state of the microvasculature was assessed by laser Doppler flowmetry using a laser analyzer for capillary blood flow LAKK-OP.
Results. In children with an experience of type 1 diabetes of less than two years, microcirculation disorders in periodontal tissues correspond to the hyperemic form, accompanied by increased perfusion, a decrease in the amplitude of low-frequency oscillations, increased heart rate, high blood flling, and blood flow bypass. For children with an endocrinopathy experience of more than three years, microcirculation disorders correspond to a stagnant form, combined with a decrease in perfusion due to stagnation of blood in the venular link, endothelial domination with suppression of neurogenic and cardiac fluctuations, low effciency and redistribution of blood flow in favor of the nutritive link.
Summary. With the increase in experience, the degree of compensation of type 1 diabetes, the progression of diabetic microangiopathy, it is advisable to designate two stages of development of microcirculatory disorders. Early - compensatory with active adaptation, including neurogenic and endothelial regulation mechanisms. Late - decompensation with passive adaptation, supporting the effectiveness of microcirculation due to myogenic control of regulation, shunting and increasing the rate of blood outflow.
Relevance. The high prevalence of microvascular complications in children with type I diabetes mellitus (DM) has a serious impact on the quality of life and can result in a lower working capacity and early disability. The negative effect of the drug therapy, inability to fully comply with the acceptable age-related safety limits, specific metabolism and pharmacokinetic features in childhood – all these reveals the need to improve the patterns for comprehensive treatment of periodontal diseases in children with type I diabetes.The purpose was to explain the clinical and functional effectiveness of the combined enzyme and magnet & laser therapy in comprehensive treatment of the periodontal microcirculatory disorders in children suffering from type I diabetes. Materials and methods. The study involved 97 children diagnosed with type I diabetes, aged 12-17 y.o., with the present disease history from 6 months to 12 years. The microcirculation was assessed by laser Doppler flowmetry. Microcirculatory disorder correction was performed by a local exposure to a running low-frequency pulsed magnetic field combined with enzyme therapy. Results. The dynamic magnetic therapy has proven to increase the effectiveness of capillary blood flow in children with early signs of vascular congestion and hyperemia, while Phlogenzym, a polyenzyme formulation, needs to be added in cases of vascular congestion and ischemia. Conclusion. The effectiveness of physiotherapeutic and pharmacological effect of Phlogenzym along with the dynamic magnetic therapy shows that it can be recommended as an alternative to the conventional anti-inflammatory, antiseptic and antibiotic therapy during the pre-surgical treatment and post-surgical follow-up care as well as at the maintenance phase, both in an inpatient and outpatient setting.
Relevance . Psychoemotional stress is referred to as a disease of civilizations. When the psychophysiological state of a person is disturbed, all resources are directed to compensating for the pathological situation. With depletion and the development of adaptive capabilities, various disorders of microhemodynamics arise.
Materials and methods . In this article, psychoemotional stress is considered as a pathogenic factor in the development of post-prosthetic complications at a dental appointment. Using laser Doppler flowmetry, a comparative analysis of microcirculatory changes in the oral cavity in patients with inflammation of the peri-implant tissue was carried out.
Results . Previously, all people had a violation of the psychophysiological state. The control group consisted of healthy people. It is proved that in the comparison group microcirculatory changes occur with the development of arterial hyperemia. In this case, hyperemia was revealed by the ratio of the contribution of pulse and respiratory fluxmotions.
Conclusion . Thus, it can be assumed that it is psychoemotional stress that is the primary factor in the development of the inflammatory response in the oral cavity. What should be taken into account at the orthopedic appointment when drawing up a treatment plan for such patients.
Relevance. Morpho-functional changes in peripheral circulation established in type 1 diabetes mellitus correlate with changes in central hemodynamics, allowing the use of microcirculation indicators as diagnostic and prognostic criteria for assessing the degree of functional vascular disorders. Identifcation of microcirculation features of the blood by the method of laser Doppler flowmetry in children with different experience of type 1 diabetes in key age categories.
Materials and methods. The study included 67 children with type 1 diabetes mellitus aged 12-15 years with an experience of the disease from six months to ten years. The comparison group consisted of 38 healthy children. The state of the microvasculature was assessed by laser Doppler flowmetry using a laser analyzer for capillary blood flow LAKK-OP.
Results. In children with an experience of type 1 diabetes of less than two years, microcirculation disorders in periodontal tissues correspond to the hyperemic form, accompanied by increased perfusion, a decrease in the amplitude of low-frequency oscillations, increased heart rate, high blood flling, and blood flow bypass. For children with an endocrinopathy experience of more than three years, microcirculation disorders correspond to a stagnant form, combined with a decrease in perfusion due to stagnation of blood in the venular link, endothelial domination with suppression of neurogenic and cardiac fluctuations, low efciency and redistribution of blood flow in favor of the nutritive link.
Conclusions. With the increase in experience, the degree of compensation of type 1 diabetes, the progression of diabetic microangiopathy, it is advisable to designate two stages of development of microcirculatory disorders. Early – compensatory with active adaptation, including neurogenic and endothelial regulation mechanisms. Late – decompensation with passive adaptation, supporting the effectiveness of microcirculation due to myogenic control of regulation, shunting and increasing the rate of blood outflow.
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