Оценка клинико-функционального состояния полости рта при дисбиозе и рациональные подходы в стоматологическом-ортопедическом лечении

Abstract

Background. The study emphasizes the dependence of quantitative and qualitative characteristics of oral microbial colonization on exogenous and endogenous factors, as well as on the design and number of dental prostheses (DPs). The significance of factors influencing oral microbiota alterations and the development of oral dysbiosis among the elderly population of Andijan city was demonstrated. To characterize clinical manifestations of dysbiosis in elderly individuals, the oral “microbial landscape” was evaluated, including species composition, microbial counts, and colonization characteristics associated with dental pathology.
The purpose of the study. To develop scientifically grounded principles for the rational management of dental pathologies through diagnosis of oral dysbiosis types and normalization of oral microbiocenosis under local climatic and regional environmental conditions.
Materials and methods. The study included 155 patients (68 males and 87 females) aged 18–60 years who attended dental clinics in Andijan. The main group comprised 95 patients with oral dysbiosis (41 males — 43.15%; 54 females — 56.84%; mean age 49 years). According to established diagnostic criteria, dysbiosis severity was classified as: Grade I — 22 patients (23.15%); Grade II — 36 patients (37.89%); Grade III — 37 patients (38.94%). The control group consisted of 60 clinically healthy individuals (27 males and 33 females; mean age 37 years) without periodontal or oral mucosal pathology, included to determine regional reference values of oral microbiota. Depending on the number and structure of dental prostheses, patients were divided into diagnostic groups: Group I — up to three crowns (n=22); Group II — more than three crowns (n=36); Group III — dental prostheses made from more than two types of metal alloys (n=37). For dysbiosis correction, dill (Anethum graveolens) was used in fresh form and as an herbal infusion. Clinical, functional, and laboratory assessments were performed before treatment and after 14, 60, and 90 days.
Results. In healthy adults of Andijan city, oral microbiota values were within the following ranges: Lactobacillus — 10³–10⁴; Streptococcus spp. — 10⁵–10⁸; Str. pyogenes — not detected; Leptotrichia — 10²–10⁴; Staphylococcus spp. — 10²–10⁴; Candida spp. — 10²–10³; Enterobacteriaceae — 10–10²; Corynebacterium — <10²; Bacteroides — <10³; Veillonella — 10³–10⁸; Fusobacterium — 10³–10⁴; Staphylococcus aureus — not detected; Neisseria — 10⁵–10⁷. Oral dysbiosis was characterized by: Grade I — reduction of resident microbiota; Grade II — alterations in both resident and opportunistic microbiota; Grade III — marked increase in Candida spp. fungi. The number and material diversity of removable prostheses significantly influenced microbiota composition. The positive effect of dill (Anethum graveolens) on improving oral hygiene and microbiocenosis was substantiated.
Conclusion. A classification of clinical manifestations of oral dysbiosis (Grades I–III) was developed. Regional reference values of oral microbiota for the Andijan population were established. The importance of prosthesis quantity, material composition, and oral hygiene status in the development of pathological processes was demonstrated. The therapeutic and preventive efficacy of Anethum graveolens was scientifically justified.