ORAL HYGIENE STATUS IN THE TREATMENT OF TOOTH DISLOCATION IN CHILDREN

Abstract

The article discusses the issues of determining the state of oral hygiene as a factor of regeneration in children before and during immobilization of injured teeth. Since traumatic dental injuries are the most common lesions of hard tissues of non-carious origin in children of all ages, they usually require emergency medical care and can lead to irreversible changes in the tooth pulp and periodontal tissues, adversely affect the further development and growth of teeth and jaws. One of the key stages of treatment is immobilization of damaged teeth by splinting. However, the success of regeneration of injured structures depends on careful hygiene in the area of splinted teeth, since the accumulation of dental biofilm can lead to the development of secondary complications. For the study, we selected 110 children with traumatic incomplete dislocations of permanent teeth and formed a group of 103 patients who met the inclusion criteria. The aim of the work was to determine the state of oral hygiene in children with incomplete dislocation of permanent teeth during and after their immobilization. Materials and methods of the study. Clinical examination of patients included an objective assessment of the hygienic state of the oral cavity during and after immobilization of injured teeth. For this purpose, the modified hygienic indices of O’Leary and Fedorov-Volodkina were used. All data obtained through clinical examination and index assessment of the oral cavity were entered into the “Card for examination and management of a patient with dental trauma” developed by us. Statistical calculations of the obtained study results were carried out using the author’s MedStat package and the EZR statistical package v. 1.35, as well as in the IBM SPSS Statistics software environment. Results and discussion. The recruitment of patients who met the inclusion criteria was carried out conveniently at the clinical bases of the Department of Surgical Dentistry and Maxillofacial Surgery of childhood the Bogomolets National Medical University. Clinical groups of patients were formed taking into account the local status by the number of teeth surrounding the injured tooth and the state of root formation. By gender, among 103 children, 64 were boys and 39 were girls, with a boy/girl ratio of 1.64:1. The average age of patients in the study groups was 10.15 years (range 5–17 years; median 10; standard deviation 3.26). The indicators of oral hygiene did not differ in the study groups on the 7th and 14th day by gender and local status, however, slight differences were identified by age. Thus, the indicators of IPV in the 3rd study group (6–8 years) were recorded at the level of 3,2 р., and IOL – at the level of 35 %, while in the other study groups, IPV – 2,8–3,0 р., and IOL – 30–32 %. We attribute such differences to the fact that younger children pay less attention to the quality of oral hygiene, and also protect injured teeth from unpleasant or painful sensations during tooth brushing. In the control group, on the 7th day after immobilization, the indicators of IPV were 4,9 р., and IOL – 54 %, and no differences were identified by gender, age, and local status. On the 14th day of the study, the IPV in the control group was 5,0 р., and the IOL was 63 %, which indicated a deterioration in oral hygiene over time in children with tooth immobilization with a smooth splint-bracket. Conclusions. It has been proven that immobilization of permanent teeth with a wire-photopolymer splint in children with incomplete dislocations allows to significantly improve the hygienic condition of the oral cavity (by 2 times) during and after immobilization.