DYNAMICS OF INDICATORS OF THE GLUTATHIONE SYSTEM AND GLUTATHION-DEPENDENT ENZYMES OF ORAL FLUID IN CHILDREN WITH CHRONIC CATARAL GINGIVITIS AND DIABETES MELLITUS

The aim of the study – to increase the eff ectiveness of chronic catarrhal gingivitistreatment in children with diabetes mellitus by determining and correcting the indicatorsof the glutathione system of oral fl uid.Material and methods. Group I (control) included 22 children who had clinically healthyperiodontal tissues, Group II included 18 children with chronic catarrhal gingivitis (CHG)without concomitant somatic pathology, Group III included 25 children with diabetesmellitus (DM) and CHG who received traditional treatment for gingivitis, Group IV included 25 children with DM who received antioxidant therapy in addition to traditional treatment for gingivitis. Children of groups II and III were treated with CHG according to the protocols of the Ministry of Health of Ukraine for the provision of medical care in the specialty «Children’s Therapeutic Dentistry», children of group IV were additionally prescribed oral administration of the complex drug «Quertuline» in the form of tablets, drops «Imupret» and the multivitamin drug «Pikovit» for 20 days. Local irrigation of the oral cavity with a solution of dental elixir «Exodent» was prescribed. The activity of reduced glutathione, glutathione peroxidase, glutathione reductase, glutathione transferase was determined in the oral fl uid of children before and after treatment. The eff ectiveness of CHG treatment was assessed by comparing the initial indicators (I examination) with the indicators immediately after its completion (II examination), after 1 (III examination), 3 (IV examination) and 6 months (V examination). The condition of periodontal tissues was assessed by the papillary- marginal-alveolar index. The material for the study was the oral fl uid of children.Results. In children with CHG against a background of diabetes, the indicators of glutathione reductase (8.24±0.44 nmol/min mg protein), glutathione transferase (127.23±2.49 nmol/min mg protein), reduced glutathione (4.08±0.20 kmol/mg protein) are generally lower compared to the indicators of children with CHG without somatic pathology (13.62±0.19 nmol/min mg protein, 161.37±4.85 nmol/min mg protein, 6.21±0.09 nmol/mg protein, respectively) (p<0.05). After the completion of the treatment proposed by us, there was an increase in all studied indicators of the functional state of the glutathione system, with the exception of glutathione peroxidase, which indicates increased antioxidant protection.Conclusions. The use of the therapeutic and prophylactic complex proposed by us, which, in addition to traditional treatment, involves the use of antioxidants, led to an improvement in the indicators of reduced glutathione and glutathione- dependent enzymes (glutathione reductase, glutathione transferase) and the maintenance of their values at a suffi ciently high level for 6 months after the treatment, which, in turn, leads to a decrease in the indicators of the papillary- marginal-alveolar index and a decrease in gingival bleeding in the studied patients.