RESUMO
OBJECTIVE: to determine the severity of gingivitis in children with teeth formation disorders - residents of the ter-ritories contaminated with radionuclides as a result of Chornobyl Nuclear Power Plant (ChNPP) accident. MATERIALS AND METHODS: The object of the study is 1470 children aged 6-14 years with dental malformations, 528 amomg them are residents of areas contaminated with radionuclides as a result of the ChNPP with the identified types of disorders of teeth formation (DTF) (systemic enamel hypoplasia (SEH) and molar-incisor hypomineralization (MIH)), and different stages of the severity of gingivitis. RESULTS: Determining of the degree of severity of gingivitis in children with DTF indicates the presence of its lesion of a moderate degree of the severity with a prevalence in persons with SEH or MIH and chronic diseases of internal organs suffered after the ChNPP accident. CONCLUSIONS: In irradiated children with DTF, an average degree of severity of gingivitis was established (Ð ÐÐ = (43.03 ± 19.64) %, p > 0.001), which may be due to the effect of a complex of negative factors, in particular the influence of low doses of ionizing radiation, the peculiarities of the social status of the examined persons (imbalanced nutrition), unsatisfactory oral hygiene. In children suffered after the ChNPP accident with SEH, the indicators of the PMA index were reliable (p > 0.05) higher compared to individuals with MIH, which indicates a more pronounced degree of periodont damage. Revealed damage to periodont, in particular gingivitis, in children with DTF residents of the contaminated territories, probably caused by the action of a complex of negative environmental factors, in particular the influence of low doses of ionizing radiation, and the peculiarities of the social status of children, which requires a comprehensive approach to the prevention of complications of defects of hard tissues of the teeth.
Assuntos
Acidente Nuclear de Chernobyl , Gengivite , Humanos , Criança , Radioisótopos , Prevalência , Radiação Ionizante , Gengivite/epidemiologia , Gengivite/etiologiaRESUMO
OBJECTIVE: assessment of dental caries intensity in children with disturbances in tooth formation living in radiologically contaminated territories as a result of the Chornobyl NPP accident. MATERIALS AND METHODS: Children aged 6-14 years old (n = 1470) suffering from disturbances in tooth formation(DTF) with the residents of radiologically contaminated territories (n = 528) among them were enrolled in the study.The DTF subtypes were assayed, namely the systemic enamel hypoplasia (SEH) and molar incisor hypomineralisation(MIH). Personal radiation history was recorded. Intensity of caries and caries of surfaces in the mixed (i.e. transitional) occlusion (df+DMF, dfs+DMFS coefficients) and permanent occlusion (DMF, DMFS coefficients) was identified. RESULTS: Caries intensity in the exposed children suffering DTF with mixed and permanent dental occlusion was sig-nificantly higher vs. either in children exposed to ionizing radiation with no DTF or in the control group (Ñ < 0.001,Ñ < 0.001 and Ñ < 0.05, Ñ < 0.001 correspondingly). The highest caries intensity of the permanent teeth was revealedin the residents of contaminated territories suffering SEH (6.95 ± 2.3) vs. cases of MIH (5.68 ± 1.97) as a result ofnonsymmetrical teeth involvement. CONCLUSIONS: The highest values of df+DMF, dfs+DMFS coefficients were diagnosed in children with a mixed dentalocclusion aged 6-14 years old living on territories contaminated as a result of the ChNPP accident as compared tothe not exposed subjects and control group (7.2 ± 2.07 and 8.98 ± 2.4, Ñ < 0.001). A very high intensity of cariesand surface caries of permanent teeth (DMF = 6.79 ± 2.34, DMFS = 8.69 ± 2.75, Ñ < 0.001) was established in children exposed to ionizing radiation and suffering DTF. Such a high intensity may be due to the impact of a set of negative factors including the ionizing radiation in low doses and peculiarities of economic component of social sta-tus of study subjects, namely the unbalanced diet. In case of permanent occlusion the intensity of caries and cariesof tooth of in children survived after the ChNPP accident and suffering SEH was significantly (Ñ < 0.05) higher compared to the persons suffering MIH.
Assuntos
Acidente Nuclear de Chernobyl , Cárie Dentária/fisiopatologia , Odontogênese/efeitos da radiação , Exposição à Radiação/efeitos adversos , Radiação Ionizante , Adolescente , Criança , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Ucrânia/epidemiologiaRESUMO
BACKGROUND: Odontological effects of ionizing radiation (IR) as a result of radiotherapy, the consequences of accidents at nuclear power plants and industry, individual occupational exposure, etc. deserve significant attention interns of radiation medicine and radiation safety. OBJECTIVE: to analyze and summarize clinical and experimental data on the odontological radiation effects. OBJECT: the pathological changes in the hard tissues of teeth, pulp, periodontium, mucousmembranes of the mouth and jaws due to exposure to IR. METHOD: search in the PubMed / MEDLINE, Google Scholarabstract medical and biological databases, scientific libraries of the relevant sources of scientific information. RESULTS: Radiobiological effects of IR due to its direct and indirect action are manifested throughout the period ofodontogenesis and formation of the facial skeleton. Experimental and clinical data (in children and adults) indicatethe increased risk of dental caries, reduction of pain threshold and vascularization of tooth pulp along with its fibrosis and atrophy, periodontal dysfunction, which predispose to a high probability of tooth loss. Abnormalities in theactivity of osteoblasts and cementoblasts of dental periosteum and osteoblasts of alveolar process in combinationwith circulatory disorders due to endothelial cell death, hyalinization, thrombosis and vascular obliteration increasethe risk of jaw osteoradionecrosis. Children who have undergone a prenatal exposure to IR as a result of theChornobyl NPP accident have a premature change of teeth. Deterioration of periodontal tissues and early development of acute and complicated dental caries are typical for children and adults affected by the Chornobyl disaster. CONCLUSIONS: Summarized data on the effects of radiation exposure under different conditions on teeth primordia(i.e. immature teeth), their formation and eruption in experimental and clinical settings, as well as on the odontological radiation effects in adults are summarized. Condition of the teeth in the Chornobyl NPP accident survivorsis described. Understanding and taking into account the radiobiological odontological effects is necessary in thelight of planning, preparing, and conducting local radiation therapy and developing the standards of radiation safety and measures to protect professionals and the public in the event of possible radiation accidents at the nuclearpower plants and industry facilities.
Assuntos
Acidente Nuclear de Chernobyl , Cárie Dentária/patologia , Osteorradionecrose/patologia , Exposição à Radiação/efeitos adversos , Lesões por Radiação/patologia , Perda de Dente/patologia , Cárie Dentária/etiologia , Cárie Dentária/terapia , Cemento Dentário/patologia , Cemento Dentário/efeitos da radiação , Polpa Dentária/patologia , Polpa Dentária/efeitos da radiação , Células Endoteliais/patologia , Células Endoteliais/efeitos da radiação , Humanos , Arcada Osseodentária/patologia , Arcada Osseodentária/efeitos da radiação , Mucosa Bucal/patologia , Mucosa Bucal/efeitos da radiação , Odontogênese/efeitos da radiação , Osteoblastos/patologia , Osteoblastos/efeitos da radiação , Osteorradionecrose/etiologia , Osteorradionecrose/terapia , Periodonto/patologia , Periodonto/efeitos da radiação , Doses de Radiação , Lesões por Radiação/etiologia , Lesões por Radiação/terapia , Radiação Ionizante , Dente/patologia , Dente/efeitos da radiação , Perda de Dente/etiologia , Perda de Dente/prevenção & controleRESUMO
OBJECTIVE: evaluation of oral hygiene to enhance the prophylaxis of complications specifically of dental caries inchildren with disturbances in tooth formation (DTF) who live on radiologically contaminated territories after theChornobyl NPP (ChNPP) accident. MATERIALS AND METHODS: Children aged 6-14 years (n = 1470) with DTF were the study subjects examined in 2012-2016. Among them there were (n = 528) residents of the zones III and IV of radiological contamination after theChNPP accident with 137Cs soil contamination density 1-15 Ci/km2. The effective radiation dose in them was notexceeding 1 mSv/year. The Green-Vermillion and Silness-Loe oral hygiene indices were assesses within clinicalexamination methods. RESULTS: The worth oral hygiene was revealed in children having got the DTF, compensated chronic diseases oforgans and systems, and in those with burdened radiation history. The Green-Vermilion and Silness-Loe indices were1.7 ± 0.51 and 1.65 ± 0.46 respectively. CONCLUSIONS: A significant deterioration in oral hygiene confirmed by the highest values of the Green-Vermillion index (1.7 ± 0.51; p < 0.001 - «unsatisfactory oral hygiene¼ criterion) and Silness-Loe index (1.65 ± 0.46; p < 0.001 -«poor oral hygiene¼ criterion) was found in children with DTF aged 6-14 years being residents of contaminated areasas a result of the Chernobyl accident. The revealed deterioration may be due to a set of negative factors, includingthe impact of ionizing radiation in low doses and peculiarities of social status. Results of the questioning of surveyed pediatric contingents both having got an DTF and with no defects of the hard tissues of teeth indicate aninsufficient level of knowledge and skills in hygienic care of oral cavity regardless of the area of residence.Development of a set of measures to prevent the DTF complications in children should be carried out taking intoaccount the state of oral hygiene, level of knowledge and skills in oral care, and include the use of hygiene products, namely toothpastes and anti-caries mouthwashes.
Assuntos
Acidente Nuclear de Chernobyl , Cárie Dentária/patologia , Hipoplasia do Esmalte Dentário/patologia , Higiene Bucal , Exposição à Radiação/efeitos adversos , Desmineralização do Dente/patologia , Adolescente , Radioisótopos de Césio/análise , Criança , Cárie Dentária/diagnóstico , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Hipoplasia do Esmalte Dentário/diagnóstico , Hipoplasia do Esmalte Dentário/epidemiologia , Hipoplasia do Esmalte Dentário/etiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Radiação Ionizante , Poluentes Radioativos do Solo , Desmineralização do Dente/diagnóstico , Desmineralização do Dente/epidemiologia , Desmineralização do Dente/etiologia , Ucrânia/epidemiologiaRESUMO
OBJECTIVE: To advance the efficiency of tooth caries prevention in children with enamel hypoplasia through a com plex intervention focused at amelioration of oral hygiene, secretory immunoglobulin A (sIgA) level, and mineral con tent of oral fluid. MATERIALS AND METHODS: Hypoplasia of permanent teeth enamel was the target of research. State of oral cavity hygiene, sIgA, total calcium and orthophosphate content in oral fluid were the research subject. Enamel vital stain ing, transillumination, immunoenzymometric and photometric techniques were applied. Indices of oral cavity hygiene: simplified oral hygiene index (OHI S) by Green and Vermillion (1964) and Silness Loe (1964, 1967) plaque index were the assayed. Assessment of oral cavity hygiene and assay of sIgA, calcium and orthophosphate content in oral fluid were held in 43 children 6-14 years old (n=21, Group 1; n=22, Group 2) with a systemic enamel hypoplasia and underlying diffuse non toxic (euthyroid) goiter. All children were born from the ChNPP accident clean up work ers and evacuees from territories of mandatory resettlement. Children in the Group 1 were prescribed a set of preven tive interventions including recommendations on choice of the oral care tools and teaching the standard dental cleaning skills. Children in the Group 2 additionally used the remineralizing gel with calcium, phosphorus, magnesium and xylitol (Sanction of the State Sanitary and Epidemiological Service of Ukraine # 05.03.02 03/9351 from 07.02.2014). RESULTS: State of oral cavity hygiene in children of the both study groups was assayed by a "dissatisfactory" criteri on according to the OHI S by Green and Vermillion and by a "poor" criterion according to the Silness Loe plaque index. Upon application of preventive intervrntions the state of oral cavity hygiene improved in children of Group 1 and Group 2: there was a significant decrease of OHI S by Green and Vermillion (p=0.0001) and Silness Loe plaque index (p=0.0003). Administration of remineralizing gel resulted in a significant increase of calcium (Ñ = 0.0008) and orthophosphate (Ñ = 0.001) content in oral fluid. No substantial change in sIgA concentration was found in both groups. CONCLUSION: Implementation of the preventive intervention tools including preparation with remineralizing effect promoted the amelioration of oral hygiene, increased content of mineral constituents in oral fluid, however with no effect on sIgA level.