Assessment of clinical and morphological changes in the oral organs and tissues in post-menopause women

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Назарова N., & Исломова N. (2022). Assessment of clinical and morphological changes in the oral organs and tissues in post-menopause women. in Library, 22(1), 60–67. извлечено от https://inlibrary.uz/index.php/archive/article/view/8735
Нодира Назарова, Самаркандский государственный медицинский университет

професор кафедры стоматологии факультета последипломного образования, Узбекистан

Нилуфар Исломова, Самаркандский государственный медицинский университет

ассистент кафедры ортопедической стоматологии

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Аннотация

During menopause, irreversible changes in the hormonal function of the ovaries occur, the concentration of estrogens decreases. It is during this period that a progressive increase in various diseases is noted [8]. The study of the dental status in menopausal women has proven the existence of a relationship between a decrease in estrogen concentration and a sharp increase in dental diseases [4]. Because the oral mucosa and salivary glands contain estrogen receptors, changes in hormonal levels can be seen directly in the mouth. Leimola-Virtanen et al confirmed the presence of estrogen mRNA and immunoreactive protein in the oral mucosa and salivary glands, which also confirms its biological role [11]. Thus, the climacteric period is characterized by a disorder of metabolism and function in the tissues of the oral cavity [6]. As a result, tooth loss, periodontal disease, increased bone resorption of the alveolar processes are observed.

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A

BSTRACT

During menopause, irreversible changes in the hormonal function of the ovaries occur, the concentration
of estrogens decreases.

It is during this period that a progressive increase in various diseases is noted [8]. The study of the dental

status in menopausal women has proven the existence of a relationship between a decrease in estrogen

concentration and a sharp increase in dental diseases [4]. Because the oral mucosa and salivary glands

contain estrogen receptors, changes in hormonal levels can be seen directly in the mouth. Leimola-Virtanen

et al confirmed the presence of estrogen mRNA and immunoreactive protein in the oral mucosa and

salivary glands, which also confirms its biological role [11].
Thus, the climacteric period is characterized by a disorder of metabolism and function in the tissues of the

oral cavity [6]. As a result, tooth loss, periodontal disease, increased bone resorption of the alveolar

processes are observed.

Journal

Website:

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s.org/journals/index.ph
p/fmspj

Copyright:

Original

content from this work
may be used under the
terms of the creative
commons

attributes

4.0 licence.

Research Article

ASSESSMENT OF CLINICAL AND MORPHOLOGICAL CHANGES
IN THE ORAL ORGANS AND TISSUES IN POST-MENOPAUSE
WOMEN

Submission Date:

May

10, 2022,

Accepted Date:

May 20

, 2022,

Published Date:

May

30, 2022

Crossref doi:

https://doi.org/10.37547/medical-fmspj-02-05-08

Nazarova Nodira Sharipovna

Associate Professor, Department of Dentistry, Faculty of Postgraduate Education, Uzbekistan

Islomova Nilufar Bustanovna

Assistant of the Department of Orthopedic Dentistry, Samarkand State Medical University, Uzbekistan


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K

EYWORDS

Menopause, generalized periodontitis, postmenopausal period, diseases of the oral mucosa.

I

NTRODUCTION

The purpose of the study

: to study the clinical

and

microbiological

manifestations

and

mechanisms of development of dental diseases in

postmenopausal women.

M

ATERIAL AND METHODS

We examined 40 postmenopausal women with

various diseases of the oral cavity. The control

group of patients were women who are not in the

postmenopausal period with dental diseases.

R

ESULTS AND DISCUSSIONS

All participants of the study underwent a
comprehensive examination: hygienic and

periodontal indices (OHI-S hygiene index, PI

periodontal index), pH of mixed saliva was

measured, sialometry was performed according

to the method of M.M. Pozharitskaya, studied the

microflora of the oral cavity by PCR (polymerase

chain reaction).

When collecting anamnesis, it was revealed that

most often women of group I complained of

bleeding gums (13.3%) and bad breath (6.7%).

Group II patients complained of bleeding gums

(66%), bad breath (43.9%), exposure of the roots
of the teeth (15.3%), tooth mobility (16.1%), and

40% of women had complaints of dry mouth.

While 26.7% of postmenopausal women taking

HRT complained of bleeding gums, 18.1%

complained of dry mouth and bad breath.

According to the results of the survey,

postmenopausal women taking HRT 2.3 times

less complained of bleeding gums (27.7%) and

dry mouth (17.1%) compared with women not
taking HRT (63%; 40% respectively). 18.1% of

women taking HRT noted bad breath, which is 2.5

times less than women not taking HRT (43.9%),

but 3 times more than in the control group (5.8%

). Postmenopausal women, regardless of whether

they take HRT or not, were 3 times more likely to

have a white coating on the tongue (18.1%,


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15.3%, respectively) than women in the control

group (6.7%). Burning sensation in the oral cavity

was noted by 5.7% of women in group II and 3.9%

in group III.

Attention was also paid to the TMJ, noting the

symmetry of the face and movements of the

mandible when opening the mouth, pain when

moving the mandible, and the range of vertical
and lateral movements of the mandible. In 22.6%

of group I 49, in 40% of group II and 45.7% of

group III women, a deviation was observed,

manifested by a displacement of the lower jaw to

the side at the beginning and a return to the

midline in the middle of opening the mouth by 2

mm. None of the subjects had limited range of
vertical and lateral movements. 2.9% - group I,

14.3% - group II and 11.5% - group III sometimes

noted clicks during the movement of the lower

jaw.

When examining the oral cavity, such non-carious

lesions of the teeth as erosion were noted, which

were detected in 2.8% of women in group II.

Wedge-shaped defects were noted in 17.1% of

group I, 54.3% of group II and 62.8% of group III
women. Pathological tooth wear was detected in

17.1% of group II and 14.2% of group III women,

but there were no significant differences between

the groups (p > 0.05).

The

clinical

examination

included

the

determination of the KPU index, the OHI-S

hygiene index, the periodontal index PI, the

measurement of the pH of the mixed saliva,

sialometry, and the assessment of the microflora

of the oral cavity by PCR (polymerase chain

reaction).

In the study of the intensity of tooth decay by

caries, it was found that in group I, the average
value of the KPU index = 13.58 ± 6.35 (moderate

level of caries intensity), in group II, KPU = 18.8 ±

6.17 (very high level of caries intensity) , and in

group III, the KPU index = 16.45±6.2 (high level of

caries intensity).

When examining the level of oral hygiene, it was

found that the OHI-S hygiene index, which takes

into account both the amount of plaque and

tartar, in group I was 1.83 ± 1.1, in group II - 2.89
± 0.89, in group III - 3.24±1.6. A statistically

significant difference was found between groups

I and II, groups II and III (p < 0.05), and between

groups I and III there were no significant

differences in relation to the values of group

parameters (p > 0.05).


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To determine the severity of periodontal disease,

the periodontal index PI was used, which showed

that its value in women who do not take HRT is

2.31±1.29, which corresponds to the average

degree of periodontal pathology and is 2 times

more than in women taking HRT and 5 times
more than in the control group. In women taking

HRT, the value of the periodontal index PI is

1.16±0.75, which corresponds to the initial and

mild degree of periodontal pathology, and in the

control group - 0.46±0.56.

An objective examination of patients showed

increased saliva viscosity, combined with

foaminess in 51.4% of women not taking HRT,

and in 25.7% of women taking HRT.

Sialometry according to the method of M.M.

Pozharitskaya allows you to determine the
amount of mixed unstimulated saliva. The

greatest hyposalivation in the oral cavity was

observed in women not taking HRT, and the

average for the group was 2.1 ± 0.28 ml at a rate

of 4.1 ml.

In the study of the pH of mixed saliva in women in

group I, the average value reached 7.04±0.35, in

group II, pH=6.48±0.33, and in group III, the

average pH=6.94±0.36.

Analysis of samples of the contents of periodontal

pockets showed that A. actinomycetemcomitans,

a gram-negative non-motile facultative anaerobic

coccobacillus, was found in 22.9% of women in

group I, 51.4% in group II and 37.1% in group III.

It was found that A. actinomycetemcomitans
occurs 1.4 times more often in women who do not

take HRT compared to women taking it and 2.2

times more often than in the control group. At the

same time, a significant difference (p < 0.05) is

observed only between groups I and II.

The frequency of occurrence of T. denticola,

which is able to organize associations with other

bacteria, especially with P. gingivalis and T.

forsythia, is 37.1% in group I, 54.3% in group II
and 51.4% in group III, but no significant

difference (p > 0.05) between groups was found.

T. forsythia, which most strongly promotes cell

apoptosis, was found in 51.4% in group I, in 80%

in group II, and in 45.7% in group III. A significant

difference was found between groups I and II, II

and III. Periodontopathogen P. gingivalis, as the
most aggressive bacterium, was found in 11.4% of

women in group I, 77.1% in group II and 28.6% in

group III, respectively. It was shown that P.

gingivalis occurs 6.7 times more often in group II


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than in group I and 2.7 times more often than in

group III.

P. intermedia was found in 11.3% of women in

group I, in 74.3% in group II and in 25.7% in

group III, respectively. P. intermedia is 6.6 times

more common in group II than in group I and 2.9

times more common than in group III. At the same

time, there is a significant difference between P.
gingivalis and P. intermedia (p < 0.05) between

groups I and II, II and III. There was no significant

difference between the qualitative composition of

the microflora of periodontal pockets in groups I

and III (control and the group of women taking

HRT) (p> 0.05).

Most often, in women not taking HRT, P.

gingivalis, P. intermedia, and T. forsythia were

detected, in contrast to women taking HRT. A.
actinomycetemcomitans and T. denticola as part

of the subgingival microflora were found

regardless of the use of HRT and were detected in

a smaller number of patients.

The study also revealed Epstein-Barr virus in

11.4% of women in group I, 20% in group II and

17.1% in group III. Herpes simplex virus was

found in 17.1% of the women of group I, 25.7% of

group II and 28.6% of group III. Candida albicans

was found in 5.7% of women of group I, 25.7% of

group II and 20% of group III, and a significant

difference was found between groups I and II, II

and III (p < 0.05).

In all patients of the control group, in whom a

periodontopathogen was detected, the amount

was relatively low and did not exceed 105

units/ml.

Spearman's rank correlation method was used to

identify the relationship between the degree of

clinical indicators and the composition of the

microflora of periodontal pockets.

The relationship between an increased number of
A. actinomycetemcomitans in the contents of the

periodontal pocket with a low level of oral

hygiene according to the OHI-S index

(r=0.503027) and with the severity of

periodontitis (r=0.505208) was revealed. A

negative correlation was observed with the pH of

the mixed saliva (r=-0.456773).

T. denticola

No correlation was found between the amount of

T. denticola in periodontal pockets and clinical

parameters.

P. gingivalis


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)

OCLC

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METADATA

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6.986















































Publisher:

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The content of P. gingivalis moderately correlated

with the level of oral hygiene (r=0.469771). A

negative relationship between the content of P.

gingivalis and the pH of mixed saliva (r=-

0.491576) was revealed.

T. forsythia

The amount of T. forsythia in the contents of

periodontal pockets moderately correlated with

the level of oral hygiene (r=0.376309), and to a

greater extent with the severity of periodontitis

(r=0.552702). A negative correlation was also

found with the pH of the mixed saliva.

P. intermedia

The level of P. intermedia depended on the

severity of periodontitis (r=0.416681).

According to the results of the study, a

statistically significant relationship was revealed
between oral hygiene and the severity of

periodontitis with the quantitative composition

of periodontopathogens of group II (p < 0.05).

Findings

. Thus, the greater sensitivity of the

above indices is associated with the peculiarities

of the pathogenesis of menopause, namely with

estrogen deficiency. The content of estrogen

receptors on the oral mucosa plays a direct role in

the development of dental diseases [9]. During

menopause, the angioprotective effect of

estrogens weakens, followed by damage to the

structures of the hemomicrocirculatory bed. Also

during this period, the production of osteoclasts

increases, the production of osteoblasts
decreases, the absorption of calcium in the

intestine decreases, the lack of vitamin D, which

leads to increased bone resorption.

Due to estrogen deficiency, there is a decrease in

intestinal absorption of calcium in the div,

which in turn leads to disturbances in the

regulation of calcium-phosphate metabolism and

increased calcium release not only into the blood

serum, but also into saliva [6]. Therefore, a high
concentration of calcium in the saliva of

menopausal women can lead to faster plaque

mineralization and, consequently, to an increase

in stone formation, which has a direct impact on

the progression of gingivitis and periodontitis

[9;1]. Thus, the pathogenesis of menopause

affects the state of all structures of the oral cavity.

R

EFERENCES

1.

Аlisher

Berdikulovich

Norbutaev,

Mukhiddin Kamariddinovich Shamsiev,

Nodira Sharipovna Nazarova. Clinical and


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I

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05

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60-67

SJIF

I

MPACT

FACTOR

(2021:

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)

(2022:

5.605

)

OCLC

1272874727

METADATA

IF

6.986















































Publisher:

Frontline Journals

functional changes in hard tissues of teeth

in рatients with hemophilia. The American

journal of

medical sciences and

pharmaceutical research Volume 2 Issue

12, 2020, Р 29-34

2.

Rizayev Jasur Alimdjanovich, Nazarova
Nodira Sharipovna. Assessment of

changes in the condition of periodontal

tissues in workers exposed to exposure to

epoxy resin. The American journal of

medical sciences and pharmaceutical

research №2 Р 14-17. 2020.

3.

Zhasur

Alimdzhanovich

Rizaev,

Rahimberdiev Rustam Abdunosirovich,

Nazarova Nodira Sharipovna. Ways to

improve the organization of dental

services for chemical industry workers.

The American journal of medical sciences

and pharmaceutical research. Volume 2

Issue 12, 2020, Р 35-39.

4.

Nazarova

Nodira

Sharipovna,

Rakhmberdiev Rustam Abdunosirovich,

Bakirov

Asadullo

Abdikodirovich,

Sultonov Odiljon Raimovich. The intensity

of dental caries in workers is harmful

industry. The American journal of medical

sciences

and

pharmaceutical

research.Volume 03 Issue 07-2021, P-68-

72.

5.

Rustam

Rakhmberdiev,

Gulchekhra

Musaeva, Nodira Nazarova. Ways to

improve the organization of dental care for

workers in the chemical industry. Society
and innovations. Volume 01 Issue 1-2021,

P 139-144.

6.

Nazarova N.SH, Musayeva G.A, Ravshanov

I.R. Evaluation of Effectiveness of

Combined Oral and Dental Therapy in

Tobacco Growers. Journal of Research in

Medical and Dental Science 2021, Volume
9, Issue 8, Page No: 241-246.

7.

Rustem Hayaliev, Sabir Nurkhodjaev,

Nodira Nazarova, Jasur Rizayev, Rustam

Rahimberdiyev, Tatyana Timokhina, Ivan

Petrov. Interdisciplinary Approach of

Biomedical

Engineering

in

the

Development of Technical Devices for
Medical Research. Journal of Biomimetics,

Biomaterials and Biomedical Engineering

Submitted: 2021-05, Vol. 53, pp 85-92

Accepted: 2021-05-11.

8.

Alisher Norbutaev, Nodira Nazarova.

Assessment of the results of the level of

oligopeptides of average molecular mass
in the oral fluid of employees in the


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FRONTLINE MEDICAL SCIENCES AND PHARMACEUTICAL JOURNAL
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VOLUME

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I

SSUE

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Pages:

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SJIF

I

MPACT

FACTOR

(2021:

5.14

)

(2022:

5.605

)

OCLC

1272874727

METADATA

IF

6.986















































Publisher:

Frontline Journals

production of ammonium and nitrate

saltpeter. Frontline medical sciences and

pharmaceutical journal 1(8): 2021, 24-34.

9.

Rizayev Jasur Alimjanovich, Nazarova

Nodira

Sharipovna,

Nasreddinova

Maxzuna Taxsinovna. (2021). Improving
The Treatment Of Paradontic Diseases

With The Help Of Immunomodulating And

Probiotic Drugs. The American Journal of

Medical Sciences and Pharmaceutical

Research, 3(08), 44–50.

10.

Rizayev Jasur Alimdjanovich, Nazarova

Nodira Sharipovna. Assessment of
changes in the condition of periodontal

tissues in workers exposed to exposure to

epoxy resin. The American journal of

medical sciences and pharmaceutical

research 2019, №2 Р 14-17.

11.

Ризаев Ж.А., Назарова Н.Ш. Состояние

местного иммунитета полости рта при
хроническом

генерализованном

парадонтите.

Вестник

науки

и

образования 2020. № 14 (92).Часть 4. С

35-40.

12.

Alisher Norbutaev, Nodira Nazarova.

Ammiak va nitrat selitrasi ishlab

chiqarishda

ishlaydiganlar

og‘iz

suyuqligida o‘rta molekulyar og‘irlikdagi

oligopeptidlar darajasining natijalarini

baholash . Society and innovations. 25

October 2021, Р. 168-176.

Библиографические ссылки

Alisher Berdikulovich Norbutaev, Mukhiddin Kamariddinovich Shamsiev, Nodira Sharipovna Nazarova. Clinical and functional changes in hard tissues of teeth in patients with hemophilia. The American journal of medical sciences and pharmaceutical research Volume 2 Issue 12, 2020, P 29-34

Rizayev Jasur Alimdjanovich, Nazarova Nodira Sharipovna. Assessment of changes in the condition of periodontal tissues in workers exposed to exposure to epoxy resin. The American journal of medical sciences and pharmaceutical research №2 P 14-17. 2020.

Zhasur Alimdzhanovich Rizaev, Rahimberdiev Rustam Abdunosirovich, Nazarova Nodira Sharipovna. Ways to improve the organization of dental services for chemical industry workers. The American journal of medical sciences and pharmaceutical research. Volume 2 Issue 12, 2020, P 35-39.

Nazarova Nodira Sharipovna, Rakhmberdiev Rustam Abdunosirovich, Bakirov Asadullo Abdikodirovich, Sultonov Odiljon Raimovich. The intensity of dental caries in workers is harmful industry. The American journal of medical sciences and pharmaceutical research.Volume 03 Issue 07-2021, P-68-72.

Rustam Rakhmberdiev, Gulchekhra Musaeva, Nodira Nazarova. Ways to improve the organization of dental care for workers in the chemical industry. Society and innovations. Volume 01 Issue 1-2021, P 139-144.

Nazarova N.SH, Musayeva G.A, Ravshanov I.R. Evaluation of Effectiveness of Combined Oral and Dental Therapy in Tobacco Growers. Journal of Research in Medical and Dental Science 2021, Volume 9, Issue 8, Page No: 241-246.

Rustem Hayaliev, Sabir Nurkhodjaev, Nodira Nazarova, Jasur Rizayev, Rustam Rahimberdiyev, Tatyana Timokhina, Ivan Petrov. Interdisciplinary Approach of Biomedical Engineering in the Development of Technical Devices for Medical Research. Journal of Biomimetics, Biomaterials and Biomedical Engineering Submitted: 2021-05, Vol. 53, pp 85-92 Accepted: 2021-05-11.

Alisher Norbutaev, Nodira Nazarova. Assessment of the results of the level of oligopeptides of average molecular mass in the oral fluid of employees in the production of ammonium and nitrate saltpeter. Frontline medical sciences and pharmaceutical journal 1(8): 2021, 24-34.

Rizayev Jasur Alimjanovich, Nazarova Nodira Sharipovna, Nasreddinova Maxzuna Taxsinovna. (2021). Improving The Treatment Of Paradontic Diseases With The Help Of Immunomodulating And Probiotic Drugs. The American Journal of Medical Sciences and Pharmaceutical Research, 3(08), 44-50.

Rizayev Jasur Alimdjanovich, Nazarova Nodira Sharipovna. Assessment of changes in the condition of periodontal tissues in workers exposed to exposure to epoxy resin. The American journal of medical sciences and pharmaceutical research 2019, №2 P 14-17.

Ризаев Ж.А., Назарова Н.Ш. Состояние местного иммунитета полости рта при хроническом генерализованном парадонтите. Вестник науки и образования 2020. № 14 (92).Часть 4. С 35-40.

Alisher Norbutaev, Nodira Nazarova. Ammiak va nitrat selitrasi ishlab chiqarishda ishlaydiganlar og'iz suyuqligida o'rta molekulyar og'irlikdagi oligopeptidlar darajasining natijalarini baholash . Society and innovations. 25 October 2021, P. 168-176.

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