ABSTRACT
AIM: The aim of the research involved determination of reduced glutathione content in oral fluid of patients exposed to occupational vibration depending upon their dental status. MATERIALS AND METHODS: The assessment of dental status (DS) and reduced glutathione (RG) content in oral fluid (OF) was carried out in three groups of patients: control group (n=129) included the persons exposed to occupational vibration whose results of comprehensive medical examination excluded the presence of vibration disease (VD); the second group (n=63 patients with the VD stage I) and the third group (n=66 patients with VD stage II), who underwent treatment at the clinical department of the Research Institute of Occupational Hygiene and Occupational Diseases of Kharkiv National Medical University of the Ministry of Health of Ukraine. DS determination was carried out according to the method of K. M. Kosenko (Patent No. 57512, Ukraine) for in-patients and controls (during medical checkups) using the following indices: PMA, OHI-S, DMFT, with assessment of vacuum-pressory resistance of gingival capillaries (VPRC) (according to V. I. Kulazhenko) and community periodontal index of treatment needs (CPITN). RG content (activity) in OF was determined according to Garishvili. Primary data were statistically processed with the determination of accuracy by Student's test. RESULTS: Assessment of metabolic indices, which characterize the state of oxidative homeostasis enzyme chain, showed that RG content in OF depending upon VD severity reliably (p<0.05) reduced. RG content depending upon PMA intensity in patients with VD ranged from 23.5±0.8 mg/cm3 to 28.6±0.3 U/min and was reliably (p<0.05) lower in patients with VD stage I versus controls (23.2±1.0 U/min and 26.7±0.3 U/min respectively, when PMA>2.1) and also reliably lower in patients with VD stage II versus patients with VD stage I (29.9±0.9 U/min and 26.2±0.4 U/min respectively, when PMA>1.0). RG content depending upon OHI-S values in patients with VD ranged from 33.4±1.2 U/min to 24.1±1.1 U/min and was reliably (d<0.05) lower in patients with OHI-S values equal to 1.7 U and higher versus controls (24.1±1.1 U/min and 27.1±0.2 U/min, respectively) and also reliably lower in patients with VD stage II versus patients with VD stage I (27.3±0.4 U/ min and 33.4±1.2 U/min, respectively, with OHI-S≤0.6 U). A comparative analysis showed that the activity of the enzymatic protection of the periodontal membrane could be also determined by the state of hard tissues, in particular by such DS index as DFMT. The activity of RG in VD stage I was shown to be reliably (p<0.05) reduced in patients with DFMT index exceeding 15 pts (in DFMT≤10 pts RG activity was 32.2±0.4 U/min, whereas in DFMT exceeding 15 pts it was equal to 26.7±0.6 U/min). Somewhat different pattern of RG activity in OF was found in patients with VD stage II: RG activity in OF was reduced in all DFMT values in these patients and its reduction was shown to be dependent on an increase in DMFT index. In DMFT≤10 the patients with VD stage II were found to have a reliable (p<0.05) reduction in RG activity in OF versus the control group (30.1±0.3 U/ min and 23.8±0.5 U/min, respectively) and this activity was shown to be inhibited in DFMT increase (23.8±0.5 U/min with DFMT≤10 and 19.3±0.9 U/min with DFMT≥20 pts, respectively). RG content depending upon VPRC in VD patients ranged from 29.2±0.1 U/min to 29.2±0.1 U/min and was reliably (p<0.05) lower in patients with their VPRC values ≤40 sec. Assessment of RG activity in OF of VD patients with different levels of CPITN showed that RG content in persons requiring comprehensive treatment (also including prosthetic treatment; CPITN≥3.1 pts) was reliably reduced (versus corresponding groups of patients but with low CPITN values) both in VD stages I and II (24.1±1.0 U/min and 19.3±0.9 U/min, respectively). CONCLUSIONS: Increases in the rate and expression of periodontal lesions (by PMA index) depending upon the presence and severity of VD with a proper decrease in the level of RG content in OF were registered. An activation of the enzymatic chain of antioxidant protection in patients with VD under low HI values and a simultaneous inhibition of enzymatic activity under high HI values were found out. VD stage I revealed an increased RG activity versus controls (p<0.05), while VD stage II demonstrated a reliable (p<0.05) reduction of the above activity. Moreover, an unsatisfactory state of the oral cavity hygiene contributed to enzymatic protection of their periodontium in patients with VD (irrespective of its stage). Regularities were revealed, which supported the benefit of pathogenetic relationships between the state of the periodontal microcirculatory bed and enzymatic activity of OF in patients with VD. Both patients with VD and persons, who are exposed to occupational vibration, need for diagnosis of activity of enzymes in OF since, as our analysis of findings has shown, DS indices are interdependent with activity of the enzymatic chain of the antioxidant protection of OF.
