CHRONIC GINGIVITIS IN PUBERTAL PATIENTS BASED ON CLINICAL AND MORPHOLOGICAL PARAMETERS
Keywords:
chronic catarrhal gingivitis, puberty, periodontopathogens, gingival morphology, cytokines, sIgA, oxidative stress, microcirculationAbstract
Chronic catarrhal gingivitis in pubertal patients is one of the most common forms of inflammatory periodontal diseases and is characterized by pronounced clinical-morphological and immunobiochemical changes. The pubertal period is accompanied by hormonal restructuring of the body, leading to increased vascular permeability, enhanced angiogenesis, and changes in the reactivity of gingival tissues to microbial biofilm.
The aim of this work was a systematic analysis of clinical, morphological, microbiological, and immunological indicators of chronic gingivitis in adolescents based on modern scientific literature data.
As a result of the analysis, it was established that in pubertal patients chronic gingivitis is accompanied by increased inflammation indices (PMA, SBI), acanthosis and parakeratosis of the epithelium, lymphoplasmacytic infiltration of the lamina propria of the mucous membrane, dilation of microcirculatory vessels, and hemodynamic disturbances. The oral microbiocenosis is dominated by anaerobic periodontopathogens (Porphyromonas gingivalis, Prevotella intermedia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum), which activate pro-inflammatory cytokine cascades.
Immunological studies reveal a decrease in the level of secretory IgA, an imbalance in cytokine regulation (IL-1β, IL-6, TNF-α), a decrease in the phagocytic activity of neutrophils, and activation of lipid peroxidation processes accompanied by an increase in the concentration of malondialdehyde and modified albumin. Microcirculatory disorders detected by laser Doppler flowmetry aggravate tissue hypoxia and maintain chronic inflammation.
Thus, chronic gingivitis in puberty is a polyetiological disease, the formation of which is обусловлено взаимодействием microbial, hormonal, and immunological factors. Clinical and morphological indicators correlate with the severity of immunobiochemical disorders, which substantiates the need for a comprehensive pathogenetic approach to the diagnosis and treatment of this pathology.
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