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Analysis of Oral Health and Quality of Life of Groups of Patients with Type 2 Pjaee, 17 (6) (2020) Diabetes and Chronic Kidney Disease

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Analysis of Oral Health and Quality of Life of Groups of Patients with Type 2 Pjaee, 17 (6) (2020) Diabetes and Chronic Kidney Disease ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 PJAEE, 17 (6) (2020) DIABETES AND CHRONIC KIDNEY DISEASE. ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 DIABETES AND CHRONIC KIDNEY DISEASE. Umid Golibovich Nusratov Assistant of the Department of Orthopedic Dentistry and Orthodontics, Bukhara State Medical Institute,Uzbekistan. [email protected] Umid Golibovich Nusratov, ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 DIABETES AND CHRONIC KIDNEY DISEASE.-Palarch’s Journal Of Archaeology Of Egypt/Egyptology 17(6),ISSN 1567-214x Abstract: Recent advances in the study of the mechanisms of development of type 2 diabetes have contributed to the development of fundamentally new views on the genesis of the disease and its complications. Our goal is a comparative analysis of the assessment of quality of life in patients with type 2 diabetes mellitus complicated by chronic kidney disease after the use of orthopedic dental treatment. Analysis of questionnaires showed that the quality of life of patients with partial absence of teeth was reduced to a varying degree in all groups of patients. Summarizing the results of the study, we can conclude that the correct deontological approach using the developed recommendations for the collection of anamnesis will facilitate understanding by the dentist of the algorithms and methods of treating the patient and help to improve the quality of prosthetics and further rehabilitation. Key words: diabetes, Dental diseases, kidney disease, orthopedic dentistry, Tongue plaque. Introduction In recent years, the role of chronic inflammation in the development and progression of atherosclerosis, obesity, metabolic syndrome, insulin resistance has been actively discussed.3 Diabetic neuropathy complicates the course of diabetes in 60-90% and is dangerous for the development of diabetic foot syndrome. A statement of diabetic nephropathy in 41% of patients with type 2 diabetes is associated with a risk of developing renal failure 10 years after the start of the process. Diabetic nephropathy in 5-10% of cases leads to terminal renal failure, which in the structure of mortality of patients with type 2 diabetes is 1.5-3%. Transformation of the microalbuminuric stage of diabetic nephropathy into proteinuric occurs in 20–40% of cases over a ten-year period. 2 A high frequency of lesions of the oral organs (up to 90%) in diabetes is due to damage to the microvascular system, bone resorption, and a decrease in local immune responses. Inflammatory periodontal diseases that occur against the background of somatic pathology have a long chronic course, often resistant to treatment, and, despite the improvement of diagnostic methods, a wide arsenal of 14385 ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 PJAEE, 17 (6) (2020) DIABETES AND CHRONIC KIDNEY DISEASE. conservative and surgical methods of treatment and increased attention to prevention, remain a significant problem in modern dentistry.4-8 Dental diseases have a significant impact on the social and psychological adaptation of the nephrological patient in society. Patients suffering from kidney disease, mainly people of a young, able-bodied age, leading an active social life (work, travel, etc.), therefore the state of the oral cavity affects many components of their quality of life. 1, 2, 5 In this regard, the prevention and treatment of somatic disease of type 2 diabetes with chronic kidney disease occupy an important place in dentistry and are clearly interpreted as an epidemiologically significant direction in the development of a preventive strategy in patients.9 Significant changes in the analyzed parameters justify the importance of their control at the stages of orthopedic dental rehabilitation during orthopedic dental treatment, especially in patients with concomitant general pathology. Purpose Comparative analysis of assessing the quality of life of patients with type 2 diabetes mellitus complicated by chronic kidney disease after applying orthopedic dental treatment. Material and methods Scientific research was conducted at the departments and clinics of orthopedic dentistry of the Bukhara State Medical Institute and the Tashkent State Dental Institute. We examined 90 patients with partial secondary adentia, men - 39 (43%) women - 51 (57%). A comprehensive diagnosis of type 2 diabetes was established by endocrinologists in accordance with WHO clinical and laboratory criteria. (1999). Figure 1. Patient distribution by gender and age 25 20 15 Men 10 Women 5 0 40 45 50 55 60 years and more As can be seen in figure 1. The average age of the examined group was 55.0 ± 9.5 years. men - 36 (40%) women - 54 (60%). All patients were divided into three groups. The first group consisted of 30 patients with type 2 diabetes mellitus without chronic kidney disease, the second - 30 patients with chronic kidney disease. The third group (30) is the control group. The clinical and hygienic examination included the study of the anamnesis of life, disease, general and local dental status of the patient. General clinical methods were used: interrogation, examination Questioning of patients with type 2 diabetes mellitus with chronic kidney 14386 ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 PJAEE, 17 (6) (2020) DIABETES AND CHRONIC KIDNEY DISEASE. disease and dentition defects and periodontal diseases was carried out using a specially designed (Questionnaire 1.) questionnaire, which was filled directly by the dentist when collecting an anamnesis. Questionnaire 1. Specially designed questionnaire, which was filled directly by the dentist when collecting an anamnesis Symptomatic indicators 1 Dry oral cavity (xerostomia) 2 Bad breath (halitosis) 3 Gum soreness 4 Soreness of the tongue and oral mucosa (stomalgia) 5 Burning in the mouth and tongue 6 Taste perversion 7 Metallic taste in the mouth 8 Gum bleeding 9 Tongue plaque 10 Soft deposits on the teeth 11 Hard deposits on the teeth Pathology of periodontal and oral mucosa 12 Uremic plaque 13 Cheilitis 14 Secondary Adentia • full • partial 15 Angulite 16 Chronic generalized periodontitis • moderate severity • severe 17 Gingivitis 18 Сhronic recurrent aphthous stomatitis 19 Lichen 20 Fungal stomatitis 14387 ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 PJAEE, 17 (6) (2020) DIABETES AND CHRONIC KIDNEY DISEASE. 21 Bacterial stomatitis Tooth pathology 22 Hyperesthesia 23 Carious lesions 24 Pathological mobility 25 Pathological abrasion An additional survey of patients with type 2 diabetes mellitus with chronic kidney disease and dentition defects and periodontal diseases was performed using the Oral Health Impact Profile-14 (OHIP-14) quality of life dental questionnaire. The main questions of the OHIP-14 questionnaire relate to the identification of difficulties in pronouncing words, pain in the mouth, a decrease in vital interests, a taste for food, difficulties in eating, constraints in communicating with people, and difficulties in working due to problems with teeth and the mucous membrane of the cavity mouth or dentures. The index is an objective measurement tool that allows you to evaluate dental health in terms of its impact on quality of life. Defects of dentitions of the III, IV classes according to Kennedy and their combination were localized both on the lower and on the upper jaw. All patients had periodontal disease. Testing of patients was carried out: at the initial examination; after the pre-prosthetic sanitation of the oral cavity in the amount of tooth extraction, dental treatment and periodontium; after applying orthopedic treatment with partial fixed dentures. To assess the effect on the mucous membrane of removable prostheses, a number of laboratory microbiological and immunological studies were undertaken. The antiseptic drug LOROBEN was tested in patients to normalize the function of the oral mucosa, prevent inflammatory processes, prevent dysbiotic changes and quickly adapt the applied prostheses in the oral cavity during prosthetics. Patients were divided into the following groups according to orthopedic treatment; - The first group included 13 patients with type 2 diabetes and CKD (control group) who received conventional treatment; - The second group included 17 patients with type 2 diabetes and CKD (the main group) using LOROBEN; Patients in the main group were recommended to rinse the oral cavity with the prepared LOROBEN solution diluted (according to the instructions) with boiled or distilled water, after meals and before bedtime, 3-4 times a day. Pre-prosthetic rehabilitation preparation took (with varying severity of pathology) from one week to 1 month. After rehabilitation measures, prosthetics were carried out for one to two weeks. Results At the stage of clinical and hygienic examination, studying the general and local dental status of patients, symptoms of various types of diseases, such as chronic mechanical trauma, recurrent aphthous stomatitis, leukoplakia, candidiasis, desquamative glossitis, exfoliative, were revealed in patients suffering from type 2 diabetes, complicated by CKD severe cheilitis, gingivitis and periodontitis. The condition was exacerbated by foci of chronic diseases on the background of uremic 14388 ANALYSIS OF ORAL HEALTH AND QUALITY OF LIFE OF GROUPS OF PATIENTS WITH TYPE 2 PJAEE, 17 (6) (2020) DIABETES AND CHRONIC KIDNEY DISEASE. intoxication and progressive renal dysfunction. The decrease
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