EXAMINATION INDICES OF THE STATE OF THE VEGETATIVE NERVOUS SYSTEM IN CASE OF PERIODONTAL DISEASES IN THE PATIENTS WITH AFFECTED CERVICAL INTERVERTEBRAL DISCS

Rationale of the topic. There is a certain stable dependence between the state of periodontal tissues and general somatic diseases. In modern concepts of pathogenesis of the inflammatory and inflammatory-dystrophic periodontal diseases much attention is paid to the vegetative-vascular disorders. It is known that affection of cervical intervertebral discs is accompanied by affection of the vegetative nervous system. At present the evaluation of vegetative dysfunction manifestations according to A. Vein and determination of its regulatory mechanisms according to Kerdo and Hildebrant has become widespread. However, the use of these simple, safe and informative methods in the patients with periodontal diseases is not sufficiently covered in the special literature. Objective of this research: to study the state of the vegetative nervous system in case of periodontal diseases in the patients with affected cervical intervertebral discs. Materials and methods. To achieve the stated objective the dental examination of 74 patients with periodontal diseases and affected cervical intervertebral discs (ACID) and 40 apparently healthy persons of the control group aged from 36 up to 72 years was performed. 48 patients of the main group and 26 persons of the control group made up a group of the 2nd period of the maturity age, 26 patients and 14 persons, respectively, of the elderly age. Disorders of the vegetative nervous system were determined using the Vein Questionnaire for detection of vegetative changes. To evaluate the outcoming vegetative tone the Kerdo vegetation index (VI) was calculated. To analyze the intersystem cardiorespiratory correlation the Hildebrant ratio (correlation between the heart rate and the respiratory rate, per 1 minute) was calculated. Results of the study. In the patients with affected periodontal tissues and CID the significant increase of vegetative manifestations and high frequency of vegetative dysfunctions could be observed with the confidence level of 99-99,9%, as compared to apparently healthy people. That gave evidence of the vegetative regulation disorder of homeostasis and homeokinesis of the examined patients. In the vegetative innervation of the cardiovascular system of the persons of the 2nd period of the mature and elderly age the sympathetic tone prevailed over the parasympathetic one (in the patients' groups – 4,2 and 4,3 times as much, in the control groups – 1,6 and 1,5 times as much) that proved the diffuse and generalized effect of the influence and stressed the role of the so-called premorbid background (pathology of the cervical intervertebral discs) in the development of periodontal diseases. The revealed significant deviations in the intersystem correlations according to the Hildebrant ratio in case of periodontal diseases in the patients with ACID proved a high level of inconsistency in the activity of the visceral systems: the heart and respiratory ones. The revealed sympathicotonia in the groups of patients (in 60,4 and 65,4% of observations, respectively) proved prevailing of the sympathetic influences on the heart over such influences on the respiratory tract

DOPPLER SONOGRAPHY RESULTS OF HEMODYNAMICS OF EXTRACRANIAL REGION OF BRACHIOCEPHALIC VESSELS IN CASES OF PERIODONTAL TISSUES DISEASES IN PATIENTS WITH THE LESIONS OF INTERVERBAL DISCS OF THE CERVICAL SPINE

Rationale. Diseases of periodontal tissues belong to polyetiological diseases with continual growth in the presence of accompanying somatic pathology, including lesions of intervertebral discs of the cervical spine. The development of osteochondrosis of the cervical spine causes the disturbance of autonomic regulation of blood vessels, leading to circulatory failure and development of secondary vascular disorders not only in the system of vertebrobasilar but carotid territory. Therefore, dopplerographic method of vessels examination due to harmlessness, noninvasiveness and high information content is relevant. The objective of our research is to study hemodynamic state of extracranial regions of brachiocephalic vessels in patients with generalized periodontitis on the background of lesions of intervertebral discs of the cervical spine. Materials and methods. To achieve this objective we conducted ultrasound examination of 74 patients of II middle age period with generalized periodontitis at initial - I degree (48 - with an accompanying lesion of the intervertebral discs of the cervical spine, 26 - without comorbidity) and 40 patients of elderly age period with the generalized periodontitis of II-III degree (26 - against the background of degenerative diseases of the cervical spine, 14 - without them), and 26 healthy individuals of II adulthood period and 14 of years old which made up the control group. (Duplex scanning of extracranial regions of brachiocephalic vessels (external carotid and vertebral arteries and internal jugular veins) was performed using ultrasound scanner of company ESAOTE CARIS PLUS (Italy) with a linear array transducer with the frequency of 3,5-10MHts. Research results. Significant reduction of peak systolic and end diastolic blood flow velocity in the vertebral arteries of patients with chronic generalized periodontitis on the background of lesions of the cervical intervertebral discs of the cervical spine compared with the same healthy individuals without general somatic diseases indicatied about the disturbance of backbone hemodynamics due to narrowing of the canal lumen in cases of degenerative diseases of the spine column. Determined more evident hemodynamic changes of the vertebral artery in elderly patients indicate the deepening of degenerative processes in the intervertebral discs of the cervical spine with age that contribute to the progression of lesions of periodontal tissues. Determined hemodynamic complications of in the system of blood supply of external carotid artery (significant reduction of maximum systolic blood flow velocity and Purselo index) are more evident in cases of lesions of the intervertebral discs of the cervical spine showed the negative impact of spine comorbidity, caused by its vegetative-vascular disorders. We have found out a slight, nonsignificant increase in the diameter of internal jugular vein. It pointed to the absence of significant disorders of venous hemodynamics and available developed system of collateral venous blood outflow. Conclusion. In patients with chronic generalized periodontitis found out significant changes of key qualitative and quantitative hemodynamic parameters of extracranial regions of arteries, more evident in cases of compatible lesions of the intervertebral discs of the cervical spine and increased age of patients. This showed the negative impact of spine comorbidity on the clinical course of periodontal diseases

DOPPLER SONOGRAPHY RESULTS OF HEMODYNAMICS OF EXTRACRANIAL REGION OF BRACHIOCEPHALIC VESSELS IN CASES OF PERIODONTAL TISSUES DISEASES IN PATIENTS WITH THE LESIONS OF INTERVERBAL DISCS OF THE CERVICAL SPINE

Rationale. Diseases of periodontal tissues belong to polyetiological diseases with continual growth in the presence of accompanying somatic pathology, including lesions of intervertebral discs of the cervical spine. The development of osteochondrosis of the cervical spine causes the disturbance of autonomic regulation of blood vessels, leading to circulatory failure and development of secondary vascular disorders not only in the system of vertebrobasilar but carotid territory. Therefore, dopplerographic method of vessels examination due to harmlessness, noninvasiveness and high information content is relevant. The objective of our research is to study hemodynamic state of extracranial regions of brachiocephalic vessels in patients with generalized periodontitis on the background of lesions of intervertebral discs of the cervical spine. Materials and methods. To achieve this objective we conducted ultrasound examination of 74 patients of II middle age period with generalized periodontitis at initial - I degree (48 - with an accompanying lesion of the intervertebral discs of the cervical spine, 26 - without comorbidity) and 40 patients of elderly age period with the generalized periodontitis of II-III degree (26 - against the background of degenerative diseases of the cervical spine, 14 - without them), and 26 healthy individuals of II adulthood period and 14 of years old which made up the control group. (Duplex scanning of extracranial regions of brachiocephalic vessels (external carotid and vertebral arteries and internal jugular veins) was performed using ultrasound scanner of company ESAOTE CARIS PLUS (Italy) with a linear array transducer with the frequency of 3,5-10MHts. Research results. Significant reduction of peak systolic and end diastolic blood flow velocity in the vertebral arteries of patients with chronic generalized periodontitis on the background of lesions of the cervical intervertebral discs of the cervical spine was compared with the same healthy individuals without general somatic diseases It was indicated about the disturbance of backbone hemodynamics due to narrowing of the canal lumen in cases of degenerative diseases of the spine column. More evident hemodynamic changes of the vertebral artery in elderly patients that indicate the deepening of degenerative processes in the intervertebral discs of the cervical spine with age which contribute to the progression of lesions of periodontal tissues was determined. Hemodynamic complications of in the system of blood supply of external carotid artery (significant reduction of maximum systolic blood flow velocity and Purselo index) are more evident in cases of lesions of the intervertebral discs of the cervical spine was showed the negative impact of spine comorbidity, it was caused by its vegetative-vascular disorders. We have found out a slight, nonsignificant increase in the diameter of internal jugular vein. It pointed to the absence of significant disorders of venous hemodynamics and available developed system of collateral venous blood outflow. Conclusion. In patients with chronic generalized periodontitis found out significant changes of key qualitative and quantitative hemodynamic parameters of extracranial regions of arteries, more evident in cases of compatible lesions of the intervertebral discs of the cervical spine and increased age of patients. The negative impact of spine comorbidity on the clinical course of periodontal diseases was showed