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CHARACTERIZATION OF CLINICAL AND IMMUNOLOGICAL
PARAMETERS OF PATIENTS WITH CHRONIC FORMS OF PULPITIS
WITH PAINFUL SYMPTOMS
Buriyeva Nafosat Askarali qizi
https://doi.org/10.5281/zenodo.13831914
Annotation
. Despite the long study of odontogenic facial pain, the clinical
and pathophysiologic features of atypical facial pain in pulpitis have not yet been
elucidated. Such a study would allow dentists to consider pulpitis pain not only
as a symptom of dental disease, but also as a systemic syndrome that affects the
nervous system, the patient's psyche, his ability to work and quality of life.
Purpose of the study:
to investigate the complex of clinical and
immunologic parameters in patients with pulpitis.
Materials and methods of research.
107 patients with facial pain caused by
dental pulp inflammation aged from 18 to 64 years were examined. The average
age was 36±1.2 years. The bulk of the examined patients (87.9%) were aged
from 20 to 49 years, fewer patients were aged under 20 years (3.7%) and after
50 years (8.4%). Facial pain was most often detected on the right side - in 60,7%
of cases.
Methods of immunologic research.
They included determination of the
level of antibodies to myeloperoxidase (MPO) and antibodies to myelin basic
protein (MBP) in blood serum by means of immunofemoral analysis (ELISA).For
this purpose test-systems of “Navina” company (Russia) were used. The content
of myeloperoxidase was determined using monospecific polyclonal antibodies in
solid-phase enzyme-linked immunosorbent assay.
The obtained data were subjected to statistical processing on a computer with a
Pentium-IV processor using Microsoft Office Excel-2003 software package,
including the use of built-in functions of statistical processing.
Results of the clinical study
All 47 patients with pain symptom examined by us needed oral cavity
sanation. The hygienic state of the oral cavity was assessed in all patients using
the Fedorov-Volodkina hygienic index.
In all patients the leading complaint was pain symptom of different duration,
localization and intensity. With the progression of inflammatory/process in the
pulp of teeth the pain increased, became aching and excruciating, localized in the
area of projection of the affected dental plexus. The pain covered the tooth,
gingiva and alveolar process. In most cases (53.7%) the upper dental plexus was
affected. On the background of aching pains, in 19.6% of patients there was an
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attack-like intensification of pains lasting from several seconds to 1 minute.
Painful paroxysms occurred with different frequency: from 3 - 4 times a day
to 5 - 7 attacks per hour. Pain localization corresponded to the affected dental
plexus. Pain was most often localized in molars (61.1%) and premolars (36.1%),
less often in canines (0.9%) and incisors (1.9%).
Results of the immunologic study.
Immunologic studies revealed a significant
increase in immunologic parameters in patients with atypical facial pain
compared to the comparison group. The difference amounted to 6.2 times.
The established increase of antidiv titers to myeloperoxidase in patients with
dental neuralgia indicates the presence of systemic vasculitis in them, as these
antibodies are one of the markers of inflammatory damage of small vessels.
Dental neuralgia was the result of systemic vascular process, proceeding by the
type of vasculitis, caused by allergy to infectious-allergic factors.
Conclusions:
Inflammation in the pulp of teeth in the examined patients
accompanies not only the pain symptom, but also disorders on the part of the
immune, nervous system, manifested in 42.1% of patients with the syndrome of
vegeto-vascular dystonia, 24.3% - focal lesions of the brain, combined with
dental plexopathy
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Diagnostic possibilities of magnetic stimulation in facial nerve lesions
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