EVALUATION OF THE TREATMENT EFFECTIVENESS OF ACUTE ODONTOGENIC PERIOSTITIS IN CHILDREN WITH DIFFUSE NON-TOXIC GOITER ACCORDING TO THE INDICATORS OF PROOXIDANT-ANTIOXIDANT HOMEOSTASIS OF ORAL FLUID

The purpose – to assess the effectiveness of an improved method of treating acute odontogenic periostitis in children with diffuse toxic goiter by the degree of normalization of prooxidant- antioxidant relationships in oral fluid. Material and methods. 38 children suffering from acute odontogenic periostitis with concomitant diffuse nontoxic goiter were examined and treated. Children were divided into two groups: the main group – 20 children with acute odontogenic periostitis and diffuse nontoxic goiter, in whom an improved treatment method was used, and the group of comparison – 18 children with acute odontogenic periostitis and diffuse nontoxic goiter, who received a generally accepted treatment method. The control indicators for comparison were the results of 30 healthy children of the same age who did not have acute odontogenic periostitis and concomitant endocrine pathology. The effectiveness of treatment was assessed by the degree of normalization of the intensity of lipid peroxidation in the oral fluid of children of both groups (by determining the content of diene conjugates (DC) and malonaldehyde) and the antioxidant capacity of the oral fluid (by the activity of catalase, superoxide dismutase (SOD), the content of HS groups, reduced glutathione (GSH), the activity of glutathione peroxidase, glutathione transferase, glutathione reductase). The degree of probability of differences was assessed statistically: in the case of normal distribution of both samples by the Student- Fisher test, in other cases – by the U-Wilcoxon test for independent samples and by the T-Wilcoxon test for dependent samples using the STATISTICA 6.1 program. Results. In the oral fluid of children with acute odontogenic periostitis against a background of diffuse nontoxic goiter, a shift of prooxidant- antioxidant homeostasis towards the enhancement of free radical processes was detected due to the intensity of lipid peroxidation increase (a significant increase in the content of DC and malonaldehyde) against the background of a significant depression of the activity of antioxidant enzymes (catalase and SOD) with a simultaneous decrease in the content of HS groups, reduced glutathione, activity of glutathione reductase, and glutathione transferase. A month after the end of treatment, the content of diene conjugates in the oral fluid of children of both groups significantly approached to the control indicator, remaining higher than the control values, and the content of malonaldehyde in children of the main group normalized, while in the comparison group it only approached the control; in children of both groups, a significant increase in the activity of catalase, SOD, and most indices of the glutathione system was established. However, these changes were more significant in children of the main group: they had normalization of SOD activity, and the content of HS groups, reduced glutathione and glutathione reductase activity significantly exceeded the corresponding indicators in children of the comparison group. Conclusions. 1. In the oral fluid of children with acute odontogenic periostitis combined with diffuse non-toxic goiter, an increased intensity of lipid peroxidation is determined against the background of the antioxidant system deficiency. 2. The improved method of complex therapy of acute odontogenic periostitis complicated by diffuse non-toxic goiter demonstrates a more powerful inhibition of lipoperoxidation processes and a more significant increase in antioxidant protection, which indicates its higher therapeutic efficacy.