THE PREVALENCE AND INTENSITY OF CARIES IN CHILDREN WITH HODGKIN'S DISEASE, IT WAS EXAMINED AT DIFFERENT PERIODS OF THEM MANIFESTATION
Total of children with malignant lymphomas has increased for last 15 years. Advances in the treatment regimens, including multiagent chemotherapy and radiation therapy, have greatly increased the chances of survival and achieving remission at 98% patients for first 4 years. The pediatric dentist plays an important role in the prevention, stabilization, and treatment of oral and dental problems that can compromise the child’s health and quality of life during, and follow up of the cancer treatment.
Aim of study was to determine the incidence of dental caries in 45 lympogranulomatosis children at different phases of disease.
Matherials and methods. A total of 45 patients of both sexes in the age group of 5-15 years who have lymphogranulomatosis (LG) were examined. 152 healthy age-and-sex-matched children were completed for the control group. Children were divided into groups by age: preschool (5-6 years), young primary school (7-11 years), secondary school (12-15 years) [Usov В.І., 1991]. Patients were categorized mainly into three groups. The group I consisted of patients after initial examination with lymphogranulomatosis (LG I). The group II - patients with lymphogranulomatosis after one-month of initial chemotherapy(LG II). The group III - patients who have a constant remission period (more than 6 months till 5 years).
The dental caries indexes DMF, dm(f) used for determination of caries intensity and prevalence. The assessment of the caries level in each age group was carried out according to WHO recommendations accordant with the scale: very low – if the DMF is 0,0 - 1,1scores; low - 1.2 - 2.6 scores ; middle - 2.7 - 4.4scores; high – 4.5 – 6.5scores; very high – 6.6 and above.
We conducted a structural analysis of the constituent elements of the caries intensity index in permanent teeth (DMF) and dmf in primary teeth, which was estimated in absolute value and as a percentage. The prevalence and intensity, complications of caries were evaluated. Statistical analyses were done by Student's-Fisher's method.
The 5-15 years old patients with Hodgkin’s disease were examined and determined the trustworthy increase the level of caries prevalence and intensity, quantity of it complications in primary and permanent teeth (p <0.05). We have not found the trustworthy differences between indicators LGM group (I) and LGM (II).
The prevalence of caries in children of group LGM I in primary teeth was 80,0 ± 9,3%, intensity is 2,23 ± 0,55 and in the control group - 57 9 ± 3,4% and 1,21 ± 0,08 respectively (p <0.05). The percentage of caries complications in temporary teeth was 35,0 ± 10,6% and intensity of caries complications is 0,7 ± 0,25, which is significantly differentiated with indices in the control group (p <0.05). The prevalence of caries process in permanent teeth was 45,0 ± 11,1%, that’s higher than in control group in 3.0 once (p <0.05). The intensity of caries in permanent teeth was 1,1 ± 0,36, and the comparison group is 0,17 ± 0,035 (p <0.05).
The 5-15 years old patients with LGM (group LGM III) in constant remission period have a caries prevalence and intensity in permanent and temporary teeth significantly higher than in children of control group (p <0.05).
We determined the relation between manifestation of different clinic period LGM and severity of caries and it complication. The higher caries indices were exposed in the patients with LGM (group LGM III) in constant remission period.
There are reviewed structure of consist elements caries indices DMF and df for the detail analysis study of caries process in primary and permanent teeth.
So, our clinical researches confirmed higher percentage of caries lesions and teeth extraction and lower percent of filling teeth in the patients with LGM comparatively with control group (р<0,05).
The result of poor oral hygiene and only limited emergency dental treatment during polychemotherapy (LGM II group) caused the high percentage of caries complications and teeth extraction in deciduous and permanent teeth in constant remission of disease.
Conclusion. The clinical studying of caries process in patients with LGM during different manifestation period of disease has determined the terms of preventive measures prescription and directing for increase the dental hard tissues resistance and reduces the frequency of caries complications in children with LGM.
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