Microecology of the mucous membrane of the alveolar ridges in the period of adaptation to complete dentures

Анотація

Introduction. The oral cavity is an open ecosystem for various microorganisms and is one of the most populated biotopes of human. Removable dental prosthesis creates favorable conditions for the breeding of various microorganisms, including fungi. Stomatitis of dentition (SOD) refers to a group of the most frequent pathologies of the mucous membranes of the oral cavity inflammatory character, due to the presence of the patient's dental prosthesis. For the prevention of SOD due to removable prostheses are used proper hygiene of dental prostheses, manufacture of technologically optimal designs of dentures, the shielding of the prosthesis and the use of cushioning materials. In this regard, the aim of this work was to study the dynamics characteristics of the microbiota of the mucous membranes of the oral cavity when performing prosthetic rehabilitation of patients with complete removable acrylic dentures with the use of adhesive and without its use. Materials and methods. The formation of the clinical groups of the patients occurred according to the following criteria: the study group comprised 23 patients with complete edentulous upper and lower jaw, which produced full removable laminar dentures on the upper and lower jaw, which used water-resistant adhesive based on polyvinylacetate and carboxymethilcellulose (cushions and/or cream "Fittydent") according to the instructions of the manufacturer, the control group consisted of 12 patients with complete edentulous upper and lower jaw, which produced full removable laminar dentures on the upper and lower jaw, in the period of adaptation to removable dentures has not applied the adhesive to improve the fixation of dentures. Microbiological examination of patients was carried out in dynamics before developing the prosthesis, after a week and after a month's stay of the prosthesis in the oral cavity. Results and discussion. Microbiological studies included determination of the qualitative and quantitative composition of the biocenosis. It is established that the microflora of the alveolar ridge in patients with edentulous consisted of associations of yeasts from 2-5 representatives of the microbial world. It is established that in patients of the experimental group on the 7th day of withdrawal 3-component microbial associations has decreased in 1.3 times, whereas the 4-component associations were recorded in 1.4 times more often compared with the initial period of observation. For patients with adhesive frequency of detection of 2-component microbial associations 30-the day of the research was 1.3 times higher than prior to the setting of the prosthesis. Identify 5 component associations for 30-the day, has decreased in 2 times. In patients without adhesive (control group) 4-component microbial associations in the mouth after a week of adaptation to the prosthesis were detected in 1.6 times, and 30 days – in 2 times more often than to prosthetics. The weight 5 component associations through the week remained at the initial level, while after 30 days has increased in 1,5 times.The structure microbiocenosis the mucous of the oral cavity patients with edentulism are represented 13 genera of bacteria and morilioid fungi of the genus Candida, allocated in secondary amounts by lg (2,5±0,19)to lg (5,4±0,17) CFU/g. When adhesive between denture base and mucosa of the alveolar ridge frequency of withdrawal and the density of microbial colonization in the adaptation period were not statistically different. But the density of the microbial population among the control group increased 1.5 times for Enterococcus spp, 1.4 for the Klebsiella spp and 1.6 times for yeast fungi Candida spp. Found a significant decrease in microbial density of the representatives of the resident microflora in 1.4 times for Neisseria spp, 1.6-fold for Lactobacillus spp (p<0.05).

Conclusion. The results of these studies indicate significant changes of qualitative and quantitative structure of microbiocenosis of oral cavity in patients with edentulous representatives Moraxella spp, Klebsiella spp and E. coli Comparison of frequency of discharge and the density of microbial colonization showed persistence in a given habitat representatives of 13 genera of bacteria and yeast fungi of the genus Candida in medium quantities from lg (2,5±0,19) lg to (5,4±0,17) CFU/g. For patients who used adhesive (fixative cream and/or cushions Fittydent) on the basis of carboxymethilcellulose and polivinilatsetat in the period of adaptation to removable prosthesis characteristic was reduced in 2 times revealing the 5 component associations on 30 the day. Frequency of withdrawal and the density of microbial colonization of the experimental group were not statistically different. Among patients in the control group increased the density of microbial colonization for Enterococcus spp, Klebsiella spp and yeasts of Candida spp. Found a significant decrease in microbial density of the representatives of the resident microflora in 1.4 times for Neisseria spp, 1.6-fold for Lactobacillus spp. Identified microbiological characteristics dictate the need for inclusion in the treatment of patients with edentulous circuit correction of microbiocenosis of the oral cavity, with the use of the funds are directed anti-inflammatory action and ensure the restoration and preservation of normal biocenosis of the specified biotope.