EFFECT OF THE THERAPEUTIC-PREVENTIVE COMPLEX ON РН AND ORAL FLUID MINERALIZING POTENTIAL IN CHILDREN EXAMINED WITH CHRONIC CATARRHAL GINGIVITIS AND DIABETES MELLITUS

The conducted study is indicative of changes in pH value and mineralizing potential of the oral fluid in children with chronic catarrhal gingivitis. Special attention should be paid to patients with diabetes mellitus who have reliably lower indices than those somatically healthy. Administration of our therapeu-tic-preventive complex made it possible to improve the indices examined and maintain them on an appropriate level during 6 months. Abstract. Objective of the research was to study рН and oral fluid mineralizing potential of the children examined with chronic catarrhal gingivitis and diabetes mellitus after administration of our therapeutic-preventive complex suggested including oral complex preparation “Quertulin”, drops “IMUPRET”, polyvita-mins “Pikovit” and local irrigation of the oral cavity with the solution of the mouthwash “Exodent”. Administration of our therapeutic-preventive complex produced a positive effect on the oral cavity homeostasis and made it possible to improve the indices examined and maintain them on an appropriate level during 6 months. mineralizing potential of the oral fluid, treatment, prevention.


Introduction
Due to a wide spread and advanced course both among adults and children diseases of the periodontal tissue are an urgent issue of modern stomatology. Numerous factors influence upon their occurrence and course including homeostasis changes of the oral cavity and diabetes mellitus which is rather common among children. The medium surrounding the gums is an important for maintenance of their healthy condition and function. Oral fluid plays a crucial role in this process, and its content can be corrected by means of therapeuticpreventive complexes [1][2][3][4][5][6][7]. Scientists pay a considerable attention to the development and implementation of various methods of prevention and treatment of inflammatory diseases of the periodontal tissues influencing on different chains of their etiology and pathogenesis [8][9][10][11][12][13].
Objective of our research was to study pH value and oral fluid mineralizing potential of the children examined with chronic catarrhal gingivitis and diabetes mellitus after administration of our therapeutic-preventive complex suggested.

Subjects and methods
Stomatological status of 50 children suffering from diabetes mellitus and chronic catarrhal gingivitis (CCG) at the age 12-16 years (2, 3 groups 25 children in each) was examined [14] and they were treated. 18 children (1 group of control) of the same age with CCG and without somatic pathology available were examined and treated as well. The children from 1 and 2 groups were treated according to the protocols of the Ministry of Health of Ukraine on giving stomatological aid. Group 3, the main one, including 25 children with CCG and comorbid diabetes mellitus received oral complex preparation "Quertulin" in the form of tablets in the dose of 1 tablet three times a day, drops "IMUPRET" in the dose of 25 drops three times a day, and polyvitamin "Pikovit" in the dose of 1 tablet once a day after meals till complete resorption in the oral cavity during 20 days. Solution of the mouthwash "Exodent" was indicated for local irrigation of the oral cavity (1 teaspoon per ¼ glass of water after each meals and tooth brushing during 1-2 minutes). The results were compared with those of somatically and stomatologically healthy children.
Professional oral hygiene, oral cavity sanation (if necessary), teaching children the methods of tooth brushing, the use of dental floss, selection of individual means for oral hygiene were carried out in all the groups before treatment.
The effect of treatment of CCG was assessed by means of comparison of the primary indices (I check-up) with the indices on completion of treatment immediately (II check-up), one month (III check-up), three months (IV check-up) and six months (V check-up) later.
Oral fluid pH value was determined in all the children examined by means of litmus paper with calibrated color scale (5,6-8,0) from the set of the pharmacological preparation "Uralith" (Germany).
Student's method was applied for statistical processing. The results were considered reliable with р<0,05.

Results and discussion
The index of children with diabetes mellitus and chronic catarrhal gingivitis (2 and 3 groups) differed reliably from that of healthy ones and those with chronic catarrhal gingivitis without diabetes mellitus (1 group) (р<0,05). The best index was found in healthy children without chronic catarrhal gingivitis. pH value of the oral fluid of children from the groups of observation before the therapeutic-preventive measures were initiated had been different: the best one was registered in group 1, and the worst -in the group 3.
Further examination of pH value of the oral fluid is indicative of a positive effect of our treatment produced on homeostasis of the oral cavity of children in all the groups of observation ( Table 1). The patients from group 1 with chronic catarrhal gingivitis demonstrated the best pH value during the whole period of observation in comparison with other groups of the study. The value increased reliably compared to the first examination after the course of treatment according to the standard method, and it decreased inconsiderably during the following examinations, but 6 months later it was higher than the index before the treatment. pH value improved and remained on a rather high level during the whole period of study in children with changes in the periodontal tissues and diabetes mellitus (groups 2 and 3). More substantial results were registered in children who received our complex of treatment (р<0,05). Meanwhile, during I check-up better pH value was found in the 2 group of children (р<0,05). Our suggested therapeutic-preventive complex produces a long effect on the oral cavity homeostasis and regulates pH value of the oral fluid. A similar tendency was found in the study of a mineralizing potential of the oral fluid (Table 2). During examination of children before the therapeutic-preventive measures were initiated certain indices had been found to be different depending on the state of the periodontal tissues and general pathology available. The lowest index was found in children with chronic catarrhal gingivitis and diabetes mellitus, and the best one -in healthy children. The teenagers suffering from chronic catarrhal gingivitis but were somatically healthy had a mineraliz-ing potential of the oral fluid reliably different from that in the 2 and 3 groups (children with chronic catarrhal gingivitis and diabetes mellitus).
The index increased on completion of the treatment. 1, 3 and 6 months later after the therapeuticpreventive complex was administered the mineralizing potential decreased, but it remained higher than that before the course of treatment. The most substantial and prolonged results were registered in children who received the therapeutic-preventive complex containing antioxidants (group 3). The conducted study is indicative of changes in pH value and mineralizing potential of the oral fluid in children with chronic catarrhal gingivitis. Special attention should be paid to patients with diabetes mellitus who have reliably lower indices than those somatically healthy. Administration of our therapeutic-preventive complex made it possible to improve the indices examined and maintain them on an appropriate level during 6 months.

Стаття надійшла:
19.03.2022 р. Summary Abstract. Objective of the research was to study рН and oral fluid mineralizing potential of the children examined with chronic catarrhal gingivitis and diabetes mellitus after administration of our therapeuticpreventive complex suggested including oral complex preparation "Quertulin", drops "IMUPRET", polyvitamins "Pikovit" and local irrigation of the oral cavity with the solution of the mouthwash "Exodent". Administration of our therapeutic-preventive complex produced a positive effect on the oral cavity homeostasis and made it possible to improve the indices examined and maintain them on an appropriate level during 6 months.
Key words: children, gingivitis, diabetes mellitus, pH value of the oral fluid, mineralizing potential of the oral fluid, treatment, prevention.