Introduction. Parodontal tissues diseases occupy a leading place among dental affections, and the treatment of generalized parodontitis (GP) is one of the most difficult problems in modern dentistry, the solution of which scientists continue to work around the world. There are very few publications devoted to the pathogenetic features of the course and treatment of GP in patients with anorexia nervosa (AN), which, in our opinion, is a serious drawback, because AN, as an aggressive disease, in recent years worries all medical, social and public institutions not only due to its rapid and increased prevalence among both young and adults, but also due to significant, often irreversible changes induced in all internal organs and systems that create direct conditions for the involvement of the parodontal complex in the pathological process and tissues. Objective. To establish the cooperative role of oxidative stress and 25 hydroxyvit D, 25- (OH) D in the pathogenesis of generalized parodontitis in patients with anorexia nervosa and its place in planning the algorithm for the treatment of both generalized parodontitis and anorexia nervosa. Materials and methods. Clinic, radiological, immunological, analytical and statistical methods were used. With informed consent, 60 patients with GP I-II degree, chronic course associated with anorexia nervosa, restrictive form (mean age 26±3.8 years) – the main group (O) – were examined. The comparison group (C1) included 45 patients with GP I-II degree, chronic course, who did not have eating disorders, while another comparison group (C2) included 35 patients with AN without generalized parodontal disease. The control group consisted of 30 subjects of similar age and sex, without clinical signs of parodontal disease. Persons with diseases of internal organs and systems, including the osteoarticular apparatus, were excluded. Results and discussion. The amount of unsaturated fatty acids was reduced 2 times, due to polyunsaturated fatty acids (PUFA), the level of PUFA was significantly reduced 2 times compared to the control – 3 times reduction of linoleic fatty acid (C 18: 2), linolenic fatty acid (C 18:3) 2 times, and an insignificant increase in arachidonic fatty acid (C 20: 4) compared with the control, which, in our opinion, reflects the violation of the oxidative-antioxidant balance, being a marker of stress as an indicator of endogenous intoxication in patients with GP I- II degree, chronic course and AN. The most significant decrease in the degree of security of the body 25 hydroxyvit D, 25- (OH) D was observed in the main (GP+AN) and comparative group (C2) (patients with AN-GP), where the average degree of security was 14.0±0.5 ng/mol and 12.5±0.7 ng/mol, respectively while, in the comparative (C1) – GP-AN and control groups, this value was 30.0±1.2 ng/mol and 41.0±1.4 ng/mol, respectively. The pronounced oxidative-antioxidant stress and reduced level of vitamin D3 in patients with GP I-II degree, chronic course with AN and their cooperative interaction allowed us to develop and propose an algorithm and evaluate the results of comprehensive treatment in patients with GP I- II degree, chronic course with AN, restrictive form. Conclusions. The cooperative role of oxidative stress and 25 hydroxyvit D, 25- (OH) D in the pathogenesis of generalized parodontitis in patients with anorexia nervosa and its place in planning the algorithm for the treatment of generalized parodontitis and anorexia nervosa were established.
Keywords:- anorexia nervosa
- generalized parodontal diseases
- generalized parodontitis
- hypersensibilisation
- osteoporosis