Profilaktik tibbiyot va salomlatlik
–
Профилактическая
медицина
и
здоровье
–
Preventive Medicine
and Health
Journal home page:
https://inscience.uz/index.php/preventive-medicine
The incidence and structure of dental pathology in
children with chronic viral hepatitis C
Sevara MATKULIEVA
1
, Khabiba ISAKHODJAEVA
2
, Ilkhom KHAMIDOV
3
Tashkent State Dental Institute
ARTICLE INFO
ABSTRACT
Article history:
Received September 2022
Received in revised form
10 October 2022
Accepted 25 November 2022
Available online
15 December 2022
The main purpose is to develop a complex of therapeutic
measures for various lesions of the oral mucosa in children with
chronic viral hepatitis C and solve the tasks and achieve the
goals of the study, general clinical, biochemical, immunological,
microbiological, virological, dental and statistical research
methods were used in the work. The study was conducted in the
period from 2018 to 2021. Data collection was carried out on
the basis of the Republican Specialized Scientific and Practical
Medical Center of Pediatrics of the Ministry of Health of the
Republic of Uzbekistan (Department of Chronic Hepatitis. The
head of the department is Academician of the Academy of
Sciences of the Republic of Uzbekistan Inoyatova F.I.), as well as
on the basis of the pediatric dental clinic of the Tashkent State
Dental Institute. The main group of patients was formed,
including 112 children with HCV and pathology of COPD.
Results: The analysis showed that the proposed method of
treatment had a significantly positive effect on the condition of
the oral mucosa in children with hepatitis C.
2181-3663
/©
2022 in Science LLC.
https://doi.org/10.47689/2181-3663-vol1-iss1-pp34
This is an open-access article under the Attribution 4.0 International
(CC BY 4.0) license (
https://creativecommons.org/licenses/by/4.0/deed.ru
Keywords:
children,
oral mucosa,
chronic viral hepatitis,
virological,
pathology.
Bolalarda surunkali virusli gepatit Sda tilning shakli va
rangi o'zgarishining xususiyatlari
ANNOTATSIYA
Kalit so‘zlar
:
bolalar,
o
g‘
iz b
o‘
shli
g‘
i shilliq qavati,
Surunkali virusli gepatit S bilan o
g‘
rigan bolalarda o
g‘
iz
b
o‘
shli
g‘i shilliq qavatining turli xil shikastlanishlariни
dsavolash uchun terapevtik chora-tadbirlar kompleksini ishlab
1
Assistant, Department of Prevention of Dental Diseases, Tashkent State Dental Institute.
2
Senior Lecturer, Department of Prevention of Dental Diseases, Tashkent State Dental Institute.
3
Assistant, Department of Prevention of Dental Diseases, Tashkent State Dental Institute.
Profilaktik tibbiyot va salomlatlik
–
Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
–
1
№
1 (2022) / ISSN 2181-3663
35
surunkali virusli gepatit,
virusologik,
patologiya.
chiqish. Tadqiqot maqsadi va vazifalaridan kelib chiqib umumiy
klinik, biokimyoviy, immunologik, mikrobiologik, virusologik,
stomatologik va statistik tadqiqot usullaridan foydalanilgan.
Tadqiqot 2018-yildan 2021-yilgacha b
o‘
lgan davrda
o‘
tkazildi.
Ma
’
lumotlar t
o‘
plash
O‘
zbekiston Respublikasi So
g‘
liqni saqlash
vazirligi Respublika ixtisoslashtirilgan pediatriya ilmiy-amaliy
tibbiyot markazi (gepatologiya b
o‘
limi) negizida amalga
oshirildi, shuningdek, Toshkent davlat stomatologiya instituti
bolalar stomatologiya klinikasi negizida. Bemorlarning asosiy
guruhi, shu jumladan HCV va KOAH patologiyasi b
o‘
lgan
112 bola tashkil etildi. Natijalar: Tahlil shuni k
o‘
rsatdiki, tavsiya
etilgan davolash usuli gepatit C bilan o
g‘
rigan bolalarda o
g‘
iz
b
o‘
shli
g‘
i shilliq qavatining holatiga sezilarli darajada ijobiy
ta
’
sir k
o‘
rsatdi.
Особенности изменений формы и цвета языка при
хроническом вирусным гепатите С у детей
АННОТАЦИЯ
Ключевые слова:
дети,
слизистая оболочка
полости рта,
хронический вирусный
гепатит,
вирусологическая,
патология.
Разработать комплекс лечебных мероприятий при
различных поражениях слизистой оболочки полости рта у
детей с хроническим вирусным гепатитом С. Для решения
задач и достижения целей проводились исследования
общеклинические,
биохимические,
иммунологические,
микробиологические, вирусологические, стоматологические
и статистические. В работе использовались методы
исследования. Исследование
проводилось в период с 2018 по
2021 годы. Сбор данных осуществлялся на базе
Республиканского
специализированного
научно
-
практического медицинского центра педиатрии МЗ РУз
(отделение хронических гепатитов. Зав. кафедрой является
академик АН РУз Иноятова
Ф.И.), а также на базе
детской стоматологической поликлиники Ташкентского
государственного
стоматологического
института.
Сформирована основная группа больных, включающая
112 детей с ВГС и патологией ХОБЛ. Результаты: Анализ
показал, что предложенный способ
лечения оказал
достоверное положительное влияние на состояние
слизистой оболочки полости рта у детей с гепатитом С.
THE PURPOSE OF THE STUDY
To develop a set of therapeutic measures for various lesions of the oral mucosa in
children with chronic viral hepatitis C. Material and methods.
The main group of patients was formed, including 112 children with HCV and OM
pathology. The data of 50 children with OM pathology without HCV markers were used as
a comparison group. The groups of patients were comparable by gender, no statistical
differences were found (p>0.05). Boys predominated in both groups (66% in the main
Profilaktik tibbiyot va salomlatlik
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Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
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№
1 (2022) / ISSN 2181-3663
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group and 62% in the control group). In the main group, the proportion of girls was 34%,
in the control group
–
38%. The main group was dominated by children aged 7-14 years
and 14-18 years (27.7% and 68.7%, respectively). In the control group, younger children
were more often registered. There were significantly fewer adolescent children
(14-18 years old)
–
2% (p<0.001). All children included in this study underwent a
comprehensive examination, including an assessment of the state of liver function,
determination of immunological and virological markers of chronic hepatitis C, as well as a
comprehensive dental examination, including, in addition to standard dental examination
indicators, microbiological and immunological examinations of the oral fluid.
We analyzed the frequency of dental pathology recorded in children with chronic
hepatitis C, depending on the CHC genotype. The data obtained are presented in Figure 1.1.
From the data in Figure 4.9. it can be seen that there were no significant
differences in the frequency of registration of various dental nosologies. At the same
time, it should be noted that in our study there were very significant differences between
the number of patients with different virus genotypes.
Thus, there were only 2 patients with genotype 2, 10 children with genotype 3,
while genotype 1b was detected in 100 children. In this regard, our results cannot fully
reflect the dependence of the frequency of development of various types of dental
disorders in children with chronic hepatitis C depending on the virus genotype.
We analyzed the frequency of development of dental pathology depending on the
activity of the process in the liver. The results obtained are shown in Figure 1.1.
It can be seen from the diagram data that in patients with a high degree of activity
of the pathological process in the liver, the frequency of registration of all nosological
types of pathology of the oral mucosa was significantly higher compared to patients with
moderate and minimal degree of activity of chronic hepatitis C.
28,3
50
4
0
5
20
15,1
20
10
7,1
10
68,7
80
87,8
90
0
10
20
30
40
50
60
70
80
90
100
1genotype
3 genotype
aphtosus stomatitis
herpangina
acute candidasis stomatitis
хр гиперпл кандидоз
afta Bednara
syndrome Shegrene
географ язык
xerostomiya
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RESEARCH RESULTS
With chronic hepatitis C, xerophthalmia and geographic stomatitis were detected
significantly more often (p<0.001) (90.2% and 69.6%, respectively), and a number of
diseases were recorded that were not observed in the control group, namely, herpangina
(0.9%), Bednar
’s afta (0.9%), Sjögren’
s syndrome (5.4%).
The first study reporting an association between salivary gland disease and
hepatitis C was published in 1992 and showed that 57% of patients with chronic liver
disease associated with HCV had characteristic histological changes in the salivary glands
(Haddad J.
, 1992). Subsequent studies have shown that, in contrast to Sjögren’
s
syndrome, the lymphocytic infiltration in HCV patients was pericapillary rather than
periductal, without destruction of the salivary gland ducts, and that the lymphocytic
capillaritis resembled the early stage of the disease (Pawlotsky J.M., 1994.).
Further studies have shown conflicting results, but up to 80% of HCV-infected
individuals may have salivary gland pathology (Henderson L., 2001; Ferreiro M.C., 2002),
often presenting with histological evidence of mild sialadenitis.
According to our data, chronic viral and fungal lesions of the oral mucosa
(recurrent herpetic stomatitis and chronic hyperplastic candidiasis) were also more
typical for the group of children with chronic hepatitis C (p<0.05). This was also pointed
out by a number of researchers (Coates E.A., 2000; Henderson L., 2001).
Calculation of the odds ratio (OR) showed that in children with CHC the probability
of developing xerostomia is 82.6 times higher than in children without markers of CHC,
geographic stomatitis
–
26.4 times, chronic hyperplastic candidiasis
–
3 times and
recurrent herpetic stomatitis
–
2.2 times.
We analyzed the dental status of 112 children with chronic viral hepatitis C.
The data of 50 children without CVHC markers, randomly selected when applying for
dental care, served as a control group. All children underwent a comprehensive dental
examination.
30
23,2
50
2
1,8
66,7
2
10,7
16,7
14
16,1
100
0
1,8
0
0
10,7
66,7
72
66,1
83,3
88
87,5
83,3
0
20
40
60
80
100
120
minimal
moderate
highth
xerostomiya
geographicai tongue
syndrome Shegren
Afta Bednar
chronic herpetic stomatitis
acute candidiasis stomatitis
herpangina
aphtosus stomatitis
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When assessing the number of teeth in children at the time of observation, there
were some differences in the observation groups. So, in the main group, the average
number of teeth was 28 (24-30), while in the control group there were fewer
–
24 (20-26) (p<0.01). This is due to the fact that in the control group the proportion of
young children was somewhat higher.
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