IMPROVEMENT OF DENTAL TREATMENT OF HARD TISSUES IN WOMEN DURING LACTATION.

ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 176 IMPROVEMENT OF DENTAL TREATMENT OF HARD TISSUES IN WOMEN DURING LACTATION. Dildora Rikhsieva2 PhD Department of Hospital Prosthetic Dentistry, Tashkent State Medical University [email protected] ABSTRACT A comparative assessment of the use of therapeutic and prophylactic gels showed the predominance of positive changes in patients of groups 2 and 3, which justifies the inclusion of these funds in the complex of individual oral hygiene in this group of patients. According to the results of a clinical and laboratory study conducted before and after therapeutic and preventive measures (through 3, 6, 12 months) established the clinical efficacy of RemIon for the treatment and prevention of enamel caries in the stain stage. The results of the study confirm the effectiveness of our proposed method for the prevention and treatment of enamel caries in women in the first year of lactation. A personal approach to the choice of means for the prevention and treatment of enamel caries improves the effectiveness of dental care and prevents the progression of the demineralization process in lactating women. Keywords: mineralization of teeth, Remion gel, Rocs Medical Minerals gel, TER test. INTRODUCTION Lactation acts as an endogenous stressor induced by the implementation of the reproductive function of the female body. It is evident that the manifestation of shifts in the body associated with pregnancy, childbirth, and breastfeeding should primarily affect systems and functions under maximum load. Among such vulnerable functions is the dentoalveolar system, the condition of which is influenced by numerous exogenous and endogenous factors, including those ensuring fetal development and the formation of organs and tissues (1,6). Researchers have established that 68.0% of pregnant women are diagnosed with dental caries, and in cases of toxicosis, the incidence rises to 79.0%. Children born to such women exhibit an increased frequency of caries. These women often suffer from primary gingivitis. Cases of exacerbation of chronic gingivitis and periodontitis are also observed (1). According to some researchers, extrastomatological pathological conditions during pregnancy may intensify the caries process (2,3). An analysis of the literature and clinical practice indicates that dentists often face the challenge of selecting appropriate treatment methods for various clinical situations. The lack of timely, noninvasive treatment for focal demineralization leads to the progression of the pathological process, requiring surgical excision of affected tissues followed by restoration using various materials, which significantly increases the cost of dental care. Addressing this issue necessitates studying the effectiveness of modern dental therapeutic and preventive agents, timely diagnosis of focal demineralization, and the development of a new domestic agent based on nano-hydroxyapatite—providing effective and predictable treatment for preventing the progression of the pathological process (4,5). Materials and Methods The study included 60 female patients, who were divided into 3 groups according to the treatment received: ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 177 1. Group 1 – 20 patients, control group: breastfeeding women who underwent professional dental cleaning at 3, 6, and 12 months over the course of a year. 2. Group 2 – 20 patients, comparison group: women who received treatment with R.O.C.S. Medical Minerals gel over the course of a year. 3. Group 3 – 20 patients, main group: women who received treatment with the domestic RemIon gel over the course of a year. Within each group, based on the OHI-S index, two subgroups were identified: 1. Subgroup 1 – patients with good or satisfactory oral hygiene (0–1.6 points). 2. Subgroup 2 – patients with unsatisfactory or poor oral hygiene (1.7 points and above). During the study, dynamic monitoring of the patients was conducted to assess the effectiveness of the treatment at 3, 6, and 12 months. Results After 3 months, patients in Group 1 reported aesthetic defects in the cervical region of the teeth (11– 55%). Six of them experienced hypersensitivity, mainly to cold, and 30% of patients had gum recession. The TER test in Group 1 showed an average increase of 15.4%. In Group 2, complaints of high sensitivity decreased. The TER test results decreased by 22.65% in subgroup 2a (patients with good or satisfactory oral hygiene) and by 11.4% in subgroup 2b (patients with unsatisfactory or poor oral hygiene). In Group 3, there was a sharp decrease in complaints of high sensitivity. TER test results in subgroup 3a (good and satisfactory hygiene) decreased by 25.19%, and in subgroup 3b (unsatisfactory or poor hygiene) by 13.2% (Figure 1). Figure 1. Dynamics of clinical signs at the 3rd month of the study At the follow-up examination of patients in the first group after 6 months, an increase in complaints by 34.17% was recorded. The esthetic appearance of the teeth worsened due to an increase in multiple chalky spots in the cervical region, accompanied by complaints of defects in the hard dental tissues, indicating the progression of enamel caries from the "white spot" stage to superficial caries. Clinical examination also revealed an increase in wedge-shaped defects and the presence of hypersensitivity. Six months after vital staining, the indicators in the first group increased by 12.5%, whereas in the second group, by the 6th month of the treatment dynamics, complaints about esthetic defects ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 178 decreased on average by 35.6%. Patients reported that the spots became less pronounced, the appearance of the teeth improved, and hypersensitivity to thermal and chemical stimuli was absent. The results of the TER test in patients with good and satisfactory oral hygiene decreased by 24.37% in group 1, while in group 2, it decreased by 14.6%. In patients of the third group, complaints decreased by 38.7%. The TER test results in patients with good and satisfactory hygiene decreased by 27.45%, and in those with poor hygiene, by 15.4% (Figure 2). Figure 2. Dynamics of clinical signs at the 6th month of the study At the follow-up examination of patients in the first group at the 12th month of the study, an increase in aesthetic complaints was observed due to the progression of caries from the "white spot" stage to deeper dental tissues as superficial caries. The main complaints of patients were bleeding (46%), increased dental plaque formation (34%), and heightened tooth sensitivity to thermal and chemical stimuli (31%). In the second group of patients, 12 months after treatment, there was a decrease in the frequency of complaints regarding esthetic defects. In the first subgroup of the group, complaints decreased by 33.4%, and in the second subgroup by 27.8%. TER test results decreased by 26.12% in the first subgroup and by 15.1% in the second subgroup. In the third group of patients, treated according to our proposed protocol, a significant reduction in complaints was observed, on average by 38.73%. TER test results decreased by 29.68% in subgroup 3a and by 17.8% in subgroup 3b (Figure 3). ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 179 Figure 3. Dynamics of clinical signs at the 12th month of the study Discussion: According to the TER test results, groups 2 and 3 showed dynamic improvement in values, which is directly associated with the treatment performed. Based on these data, we can conclude that the agents used in our study have a pronounced remineralizing effect in the prevention of caries in patients with good and satisfactory oral hygiene. The TER test score in the second group of patients was 3.2 points, while in the third group it was 2.9 points (p < 0.05). In the control group without treatment, the TER test score was 6.2 points, which is 2.1 and 1.9 times worse than in groups 2 and 3, respectively. These results confirm the effectiveness of the applied treatment in women during lactation with good and satisfactory oral hygiene. Conclusions: The clinical and laboratory data substantiate the effectiveness of the domestic gel RemIon for remineralizing therapy in the prevention and treatment of enamel caries at the "white spot" stage. The TER test score in the second group was 3.2 points, and in the third group, 2.9 points (p < 0.05). In the control group without treatment, the score was 6.2 points, which is 2.1 and 1.9 times worse than in groups 2 and 3. These findings confirm the efficacy of the applied treatment in women during lactation with good and satisfactory oral hygiene. REFERENCES: 1. 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