Stanje oralnog zdravlja u dece obolele od dijabetesa melitusa tip 1 u Crnoj Gori
The state of oral health in children with diabetess mellitus type 1 in Montenegro
Докторанд
Đuričković, Mirjana N.Ментор
Vulićević, ZoranЧланови комисије
Ivanović, MirjanaJovičić, Olivera
Samardžić, Mira
Метаподаци
Приказ свих података о дисертацијиСажетак
Uvod: Šećerna bolest se zbog svoje velike rasprostranjenosti, komplikacija do kojih dovodi
i relativno skupe i kompleksne terapije, sasvim opravdano smatra ozbiljnim zdravstvenim
problemom. Dijabetes mellitus je najčešći endokrini poremećaj kod dece. Osim retkih
izuzetaka deca najčešće obolevaju od insulin zavisnog dijabetesa (tip I). Posebno je
značajan efekat ove bolesti na oralno zdravlje, a koji se odnosi na tkiva parodoncijuma i
karijes zuba. Promene na parodoncijumu variraju od gingivitisa do teških formi
parodontopatija. Kod obolelih je primećena sklonost ka gubitku pripojnog epitela i
nastanku parodontalnih džepova kao i nešto brža destrukcija alveolarne kosti. Obolenja
parodoncijuma su 1993.g. identifikovana kao šesta komplikacija dijabetesa, a 1997.g. su
uvrštena kao jedno od patoloških stanja dijagnostifikovanih kod ovih bolesnika ( Expert
Commitet on the Diagnosis and Classification of Diabetes Mellitus ). Crna Gora ima
najveću incidenciju dijabetes mellitusa tipa 1 na Balk...anu kod dece ispod 14 g., i u stalnom
je porastu.
Ciljevi istraživanja. Glavni cilj istraživanja je utvrđivanje stanja oralnog zdravlja dece
obolele od dijabetes mellitus-a tip I u Crnoj Gori, a koji se odnosi na: utvrđivanje
rasprostranjenosti karijesa stalnih zuba, strukture KEP-a, stanja oralne higijene, salivarnog i
mikrobiološkog statusa obolele i zdrave dece, utvrđivanje stepena metaboličke kontrole na
sve predhodno navedene parametre kod obolele dece i na kraju, na osnovu dobijenih
rezultata, predložiti plan preventivnih mera, kojim bi se omogućilo unapređenje oralnog
zdravlja kod dece obolele od šećerne bolesti.
Materijal i metodologija istraživanja.U istraživanje je bilo uključeno 177 pacijenata
uzrasta 10 -15 godina, oba pola podeljenih u dve grupe. Prvu grupu D, njih 87, činila su
deca obolela od dijabetes mellitus-a tip I. Drugu, kontrolnu grupu K, njih 90, predstavljala
su zdrava deca. U istraživanje su bila uključena samo ona deca čiji su roditelji svojim
potpisom dali saglasnost. Sva deca koja su učestvovala u istraživanju pregledana su
standardnim stomatološkim dijagnostičkim sredstvima na suvim zubima, pri veštačkom
osvetljenju na stomatološkoj stolici. Status zuba je registrovan pomoću Klein Palmerovog
siastema u skladu sa kriterijumima i metodologijom SZO. Za određivanje oralne hgijene
primenjivan je Plak Indeks po Silness-Loe-u i Indeks zubnog kamenca po Green-u, a za
kliničku procenu stanja gingive primenjivan je Loe-Silness-ov indeks. Procena stanja
parodoncijuma registrovana je primenom CPI Indeksom (Community Periodontal Index) i
merenjem nivoa pripojnog epitela (NPE). Salivarni status je podrazumevao količinu izlučene stimulisane pljuvačke i puferski kapacitet pacijenata koji je određivan gotovim
fabričkim testovima Dentobuff Strip Sistem (Orion Diagnostica, Espoo, Finland)...
Introduction: Diabetes is due to its high prevalence, complications that may occur
relatively expensive and complex therapies, quite rightly considered a serious health
problem. Diabetes mellitus is the most common endocrine disorder in children. Apart from
rare exceptions, children frequently suffer from insulin-dependent diabetes (Type I). An
especially important aspect is the effect of the disease on oral health, which refers to the
periodontal tissues and tooth decay. Changes in periodontal tissues range from gingivitis to
severe forms of periodontal disease. These changes are observed in patients with a tendency
to loss of epithelial attachment and the development of periodontal pockets and a slightly
faster destruction of the alveolar bone. Periodontal diseases, which occurred in 1993, are
identified as the sixth complication of diabetes, and periodontal diseases in 1997 are
included as one of the pathological conditions in these patients diagnosed (Expert
Committee on the Diagno...sis and Classification of Diabetes Mellitus). Montenegro has the
highest incidence of Type I diabetes mellitus in the Balkans in children under the age of 14
years and this is constantly growing.
The objectives of the research:The main aim of this study was to determine the oral health
status of children with diabetes mellitus type I in Montenegro, which is related to:
establishment of permanent tooth caries, the structure of the EPC, the state of oral hygiene,
salivary and microbiological status of patients and healthy controls, determining the degree
of metabolic control on all previously mentioned parameters in infants and in the end.
Based on the results, a proposed plan of preventative measures would allow improvement
of oral health in children with diabetes.
Materials and methods:This study includes 177 patients aged 10 -15 years, of both sexes
which were divided into two groups. The first group D, consists 87 subjects, made up of
children with diabetes mellitus type I. Second, the control group K, contains 90 subjects,
was represented by healthy children. The study involved only those children whose parents
have signed their consent. All the children who participated in the study were examined by
standard dental diagnostic tool to dry the teeth, the artificial light in the dental chair. Status
tooth is registered with Klein Palmer’s system according to WHO criteria and
methodology. To determine the oral hygiene applied plaque index by Silness-Loe-index
and the dental calculus on the Green, a clinical assessment of the gum was applied by Loe-
Silness's index. Assessment of periodontal disease was registered using the CPI (Community Periodontal Index) and by measuring levels of epithelial attachment (DEA)...