Американский Научный Журнал DENTAL MORBIDITY AND BIOCHEMICAL INDICATORS OF ORAL FLUID IN CHILDREN SUFFERING WITH CEREBRAL PARALYSIS

Annotation. Parents and medical specialists face the fact that for every 1000 children born, there are from 1 to 2–3 cases of giving birth to a child with cerebral palsy syndrome. Congenital malformations of the central nervous system are characterized by the multiplicity and combination of functional disorders. The maxillofacial region does not remain isolated from secondary changes in the morphological structure of bones, and damage to organs and tissues of the oral cavity becomes an integral part of cerebral palsy syndromes. As a result of damage to the musculoskeletal system, speech, and mental sphere, children cannot independently carry out rational oral care, therefore, they need constant care, and they certainly need help in taking measures to improve their oral cavity [1-4]. Скачать в формате PDF
14 American Scientific Journal № ( 31) / 20 19
губы и неба в регионе с экотоксикантами //
Проблемы стоматологии. 2019. Т. 15. № 2. С. 89 -96.
17. Чуйкин С.В., Викторов С.В., Чуйкин О.С.
Применение генетических маркеров в
прогнозировании стоматологических заболеваний.
Моно графия. -LambertSaarbruchen, 2013. -361с.
18. Чуйкин С.В., Топольницкий О.З., Персин
Л.С. Врожденная расщелина верхней губы и нёба.
Монография. -LambertSaarbruchen, 2012. -593с.
19. Состояние слизистой оболочки полости
рта при заболеваниях внутренних органов/Чуйкин
С.В., Макушева Н.В., Акатьева Г.Г., Акмалова
Г.М., Афлаханова Г.Р., Егорова Е.Г., С неткова Т.В.,
Чуйкин О.С., Чуйкин О .С. и др.; под ред. Чуйкин
С.В. 1 -е изд. Уфа: ООО "Печатный домъ", 2016.

DENTAL MORBIDITY AND BIOCHEMICAL INDICAT ORS OF ORAL FLUID IN CHILDREN
SUFFERING WITH CEREB RAL PARALYSIS

Morozova Natalia Sergeevna
Kashtanova Maria Sergeevna
Moscow State Medical University named after I.M. Sechenov

Annotation . Parents and medical specialists face the fact that for every 1000 children born, there a re from 1
to 2 –3 cases of giving birth to a child with cerebral palsy syndrome. Congenital malformations of th e central
nervous system are characterized by the multiplicity and combination of functional disorders. The maxillofacial
region does not remain i solated from secondary changes in the morphological structure of bones, and damage to
organs and tissues of th e oral cavity becomes an integral part of cerebral palsy syndromes. As a result of damage
to the musculoskeletal system, speech, and mental sphere , children cannot independently carry out rational oral
care, therefore, they need constant care, and they cer tainly need help in taking measures to improve their oral
cavity [1 -4].
Key words : cerebral palsy, dental morbidity, biochemical parameters.

Re levance. Cerebral palsy is one of the most
common diseases worldwide, leading to childhood
disabilities due to impaired motor development. It
occurs due to brain damage during the period of
intrauterine development, childbirth and newborn,
manifested by mo tor disorders (paresis, paralysis,
hyperkinesia, impaired coordination). Given the
development of not only the motor, but also the
intellectual, psycho -speech and emotional spheres, the
following forms of this disease are distinguished:
double hemiplegia, spastic diplegia, hemiparetic form,
hyperkinetic form, atonic -astatic form [5 -13]. The Ural
zone, which include s the Republic of Bashkortostan, is
considered the most unfavorable in terms of child
disability. The reason for the high prevalence of
childhood disability is the high concentration of
industrial enterprises in this territory. In cerebral palsy,
cerebral structures responsible for voluntary
movements are particularly affected. A motor defect is
disabling not only because of the insufficiency or
absence of certain skills, but also because it is a
constant traumatic factor [14 -17]. In addition, most
children with cerebral palsy suffer from mental and
speech changes. Thus, with cerebral pathology, the
most important functions for a person suffer:
move ment, speech, psyche. Congenital malformations
of the central nervous system are characterized by the
multiplic ity and combination of functional disorders.
The maxillofacial region does not remain isolated from
secondary changes in the morphological struct ure of
the bones, and damage to organs and tissues of the oral
cavity becomes an integral part of cerebral pals y
syndromes. As a result of damage to the
musculoskeletal system, speech, and mental sphere,
children cannot independently carry out rational ora l
care and need constant care. Since children are easily
vulnerable to a disease such as cerebral palsy [18 -19] ,
dental measures should be carried out taking into
account the specifics of neuromuscular pathology [1].
Prevention and treatment of dental dise ases of such
children should be of high quality and effective [3].
The aim of our study is to assess the state of the
oral cavity in children with cerebral palsy, studying the
kinematic viscosity and biochemical parameters of the
saliva of children.
Materi als and research methods. We conducted a
clinical examination of children aged 12 -15 years with
a diagnosis of cerebral palsy of various forms (1 group
- 40 people) and healthy children without neurological
pathology (2 control group - 20 people). Children with
cerebral pathology were examined on the basis of the
State Educational Institution “Ufa Special Boarding
School No. 13”. External examination, examination of
the oral cavity, assessment of oral hygiene was carried
out visually and using a standard de ntal tool kit. To
study the hygienic status, we applied the methods of
Fedorov - Volodkina, Schiller - Pisarev tests, PMA and
Green - Vermilion index. The quality of oral hygiene in
patients was evaluated before conducting hygiene
lessons, at the end and a fter a month of controlled
brushing. The oral fluid was collected in the morning
on an empty stomach, and the o ral fluid was collected
in 4.0 ml glass tubes. To determine the kinematic
viscosity of saliva, a VPZh -4 capillary viscometer was
used. Colorimetr ic determination of protein in saliva
was carried out using the BELOK -PGK -NOVO reagent
kit. When the protein in teracts with pyrogallol red and
sodium molybdate, a colored complex forms, the color
intensity of which is proportional to the protein
concentrat ion in the sample. The photometric
determination of calcium in saliva was determined
using a set of reagents CA LCIUM -NOVO. In an acidic

American Scientific Journal № ( 31) / 2019 15

environment, calcium ions interact with the Arsenazo
111 indicator reagent to form a raspberry complex, the
color intens ity of which is directly proportional to the
calcium content in the sample. The photometric
determination of ma gnesium in saliva was determined
using the MAGNIUM -NOVO reagent kit. In an
alkaline medium, magnesium ions interact with the
xylidyl blue indicat or reagent to form a colored
complex, the color intensity of which is directly
proportional to the magnesium co ntent in the sample.
The photometric determination of phosphorus in saliva
was determined using a set of reagents FOSFOR -
NOVO. Inorganic phosphor us in the reaction with
ammonium molybdenum acid in an acidic medium in
the presence of a detergent forms a col orless phosphor -
molybdenum complex. The optical density of the
complex formed is directly proportional to the
concentration of phosphorus in the sample. The level of
TBA -active products in saliva was determined using a
set of reagents TBA -AGAT. Lipid perox idation
products form a colored complex with thiobarbituric
acid (TBA), extracted with butanol. In the observed
groups, an analysis was made of c hanges in the level of
protein, TBA -active products, trace elements (calcium,
magnesium, phosphorus), and the k inematic viscosity
of saliva. The calculations were carried out according
to the corresponding formulas.
The results of the study and their discu ssion. In
most children and adolescents with cerebral pathology
revealed violations of the maxillofacial region [5].
Speech and breathing impairment was recorded by us
in 80.4% of children with all forms of cerebral palsy.
Mouth breathing prevailed in chil dren with
hemiparesis, mixed breathing prevailed in children
with hyperkinesis and diplegia. Dysfunction of
swa llowing and chewing was detected in all examined
children. 86.3% of children had weakness of the
circular muscle of the mouth. With cerebral pals y, it can
be difficult for children to keep their lips closed and
regularly swallow saliva, so salivation in ch ildren is
plentiful. Of bad habits, biting of the lips, cheeks,
laying of the tongue between the teeth, and also finger
sucking were most often e ncountered. Anomalies in the
structure of the frenulum of the lips and tongue were
found in 47.4%. All types of tooth and dentition
anomalies were revealed, in children with spastic
diplegia - 85.5%, atonic -astatic form of the disease -
88.5%, hemiplegic f orm - 60.2%. Among malocclusion
abnormalities, the prognathic ratio of the jaws in
combination with a deep bite was most often observed,
and less often, open and cross types of bite. Carious
lesions of the hard tissues of the teeth were most often
found on the proximal surfaces of the upper and lower
milk molars (in 57.14% of cases in children of the 1st
group and 16.2% in children of the 2nd group), as well
as cervical caries of the upper incisors (in 60% of cases
- 1 group, 12.5% - 2 group). Carious cav ities in children
with cerebral palsy were extensive (in 29.6% of cases),
pigmented dentin was easily removed b y an excavator.
Among non -carious lesions of hard tooth tissues,
enamel hypoplasia (32.05%) was most often observed
in children with central nervous system pathology; in
healthy children, it was less common (4.2%). Mostly
milk teeth were affected, the reas on for which was the
poor hygiene of the oral cavity due to imperfection of
manual skills. In 26.92% of cases in children with
cerebral palsy, pathological abrasion of hard tissues of
teeth was observed, an intensive decrease in hard
tissues in all teeth w as observed in 3.97% of children
with hyperkinetic form of cerebral palsy. In children of
the control group, this type of pathology did not occur.
Periodontal diseases were also noted, the most common
of which was chronic catarrhal gingivitis - 94.4% in
children with cerebral palsy, 16% in healthy children.
During the survey among children with cerebral
pathology, it turned out that 80% of children with
cerebral palsy do not know how to brush their teeth
correctly. The indices of the studied indices before
classes exceeded the norm by 2.5 times, after classes by
2.0 times, after 1 month by 1.5 times. In children of the
control group, indicators before classes were 0.5%,
after 0.3%, after 1 month 0.15%. Oral conditions
evaluated using hygiene indices were uns atisfactory.
This difference in indicators is directly related to the
fact that most children with cerebral palsy do not follow
oral hygiene due to constant hand hyperkinesia and
intellectual deficiency. After examining the oral fluid,
it was determined th at in children with central nervous
system disease, the average calcium in children with
cerebral pathology in the oral fluid is 1.92 mmol / l, and
in children without central nervous system pathology,
1.22 mmol / l. The average level of phosphorus in the
oral fluid in the 1st study group is 5.18 mmol / L, in the
2nd group - 4.8 mmol / L. The average oral fluid
magnesium in children with central nervous system
disease is 1.43 mmol / L, and in healthy children 0.34
mmol / L. The average oral protein protein of the test
group is 1.16 g / l, the control group is 1.08 g / l. The
level of TBA -active products in the oral fluid of the first
group was 0.420 μmol / L, of the second group - 0.164
μmol / L. The kinematic viscosity of saliva in children
with cerebral pa lsy is 1.300 mm² / sec, in healthy
children - 0.901 mm² / sec.
Findings. Based on the data obtained, one can
judge about the high prevalence of dental diseases
among children suffering from cerebral palsy, about a
change in the biochemical parameters of or al fluid and
kinematic viscosity upward. Our data will be used to
justify the choice of means and methods for the
prevention and treatment of dental diseases in children
with cerebral palsy.

Bibliography:
1. Chuykin S.V., Akmalova G.M. Features of
hematosali vary barrier in lichen planus of the oral
mucosa// В сборнике : The Second European
Conference on Biology and Medical Sciences
Proceedings of the Conference. Mazilescu V. (Ed.).
2014. С. 48 -50.
2. Chuykin S.V., Akmalova G.M., Chuykin O.S.,
Makusheva N.V., Aphla khanova G.R. The concept of
blood -tissue barries in denistry //Journal of
Pharmaceutical Sciences and Research. 2017. №Т. 9.
№ 4. С. 415 -419.
3. Чуйкин С.В., Штанько М.И. Влияние
возрастных изменений критериев

16 American Scientific Journal № ( 31) / 20 19
стоматологического здоровья на качество жизни
пац иентов пожилого и старческого возраста.
Институт стоматологии. 2013. № 2 (59). С. 18 -19.
4. Чуйкин С.В., Аверьянов С.В. Оказание
ортодонтической помощи детям Республики
Башкортостан Ортодонтия 2004. № 2. С. 46 -48.
5. The role of mineral elements in the
pathogene sis of lichen planus of the oral mucosa
/Chuykin S.V., Akmalova G.M., Chuykin O.S.,
Makusheva N.V., Akatyeva G.G.//Research Journal of
Pharmaceutical, Biological and Chemical Sciences.
2016. Т. 7. № 6. С. 704 -710.
6. Чуйкин С.В., Акмалова Г.М., Чернышева
Н.Д. Особенности клинического течения красного
плоского лишая с локализацией на слизистой
оболочке полости рта//Клиническая дерматология
и венерология. 2015. Т. 14. № 3. С. 72 -75.
7. Чуйкин С.В., Малышева Г.В., Воложин
А.И. Гематосаливарный барьер при
стрессиндуц ированных изменениях в пародонте
под влиянием ритмических гипотермических
воздействий//Уральский медицинский журнал,
2008. -№10. (50). -С. 30 -33.
8. Чуйкин С.В., Акмалова Г.М., Штанько
М.И. Состояние селективной проницаемости
гематосаливарного барьера у лиц р азличных
возрастных групп //Уральский медицинский
журнал. 2014. № 5 (119). С. 82 -84 .
9. Чуйкин С.В., Камилов Ф.Х., Галеева Р.Р.
Изучение физико -химических показателей ротовой
жидкости у детей с детским церебральным
параличом. Стоматология детского возраста и
профилактика. 2014. Т. 13. № 2 (49). С. 12 -14 .
10. Чуйкин С.В., Плечев В.В., Макушева Н.В.,
Бузаев И.В. Значение стоматологического
обследования в диагностике атеросклеротических
стенозов сонных артерий// Медицинский вестник
Башкортостана. 2010. Т. 5. № 6. С. 51 -54.
11. Чуйкин С.В., Давлетшин Н.А., Викторова
Т.В., Шайхутдинова. Д.И. Этиология, патогенез,
клиника и профилактика врожденной расщелины
верхней губы и неба. Уфа, 2007 .
12. Галеева Р.Р., Чуйкин С.В. Клинические
результаты стоматологического обследования
дет ей с детским церебральным параличом
//Уральский медицинский журнал, 2014. - № 3
(117) . - С. 36 -38.
13. Чуйкин С.В., Штанько М.И. Некоторые
физико -химические и биохимические п оказатели
ротовой жидкости у лиц пожилого и старческого
возраста//Институт стоматолог ии. 2013. № 2 (59).
С. 72 -73.
14. Акатьева Г.Г., Чуйкин С.В., Снеткова Т.В.,
Гаянова А.З., Байбурина Э.К. Оценка
гигиенических знаний школьников по уходу за
полостью рта // в сборнике: «Материалы
одиннадцатого сибирского конгресса "
Стоматология и челюстно - лицевая хирургия» с
международным участием Всероссийского
симпозиума" Новые технологи и в стоматологии "
2016. С. 10 -12.
15. Чуйкин С.В., Джумартов Н.Н., Чуйкин
О.С., Кучук К. Н., Гринь Э.А., Чуйкин Г.Л.,
Муратов А.М., Гильманов М.В. Клинико -
анатомические формы врожденной расщелины
губы и неба в регионе с экотоксикантами. //
Проблемы стоматолог ии. 2019. Т. 15. № 3. С. 127 -
132.
16. Чуйкин С.В., Давлетшин Н.А., Чуйкин
О.С., Кучук К.Н ., Джумартов Н.Н., Гринь Э.А.,
Гильманов М.В., Муратов А.М. Алгоритм
реабилитации дет ей с врожденной расщелиной
губы и неба в регионе с экотоксикантами //
Проблемы стомат ологии. 2019. Т. 15. № 2. С. 89 -96.
17. Чуйкин С.В., Викторов С.В., Чуйкин О.С.
Применени е генетических маркеров в
прогнозировании стоматологических заболеваний.
Монография. -LambertSaarbruchen, 2013. -361с.
18. Чуйкин С.В., Топольницкий О.З., Персин
Л.С. Врожденная расщелина верхней губы и нёба.
Монография. -LambertSaarbruchen, 2012. -593с.
19. Состоя ние слизистой оболочки полости
рта при заболеваниях внутренних органов/Чуйкин
С.В., М акушева Н.В., Акатьева Г.Г., Акмалова
Г.М., Афлаханова Г.Р., Егорова Е.Г., Снеткова Т .В.,
Чуйкин О.С., Чуйкин О.С. и др.; под ред. Чуйкин
С.В. 1 -е изд. Уфа: ООО "Печатный домъ", 2016.