RU2367959C1 - Laboratory saliva-composition diagnostic technique for oral diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to the laboratory diagnostic techniques for oral diseases based on the ultimate saliva composition. To implement the technique, a patient's saliva is analysed for the content of sodium, potassium, calcium and phosphorus. The ratios Ca/P and Na/K are calculated, and if Ca/P is less than 0.3, and Na/K is less than 0.2, dental caries is diagnosed. If the value Ca/P is less than 0.3, and Na/K exceeds 0.2, odontolith process is diagnosed. The values Ca/P exceeding 0.3 enables to consider oral health status as normal.

EFFECT: provides detection of persons with caries and odontolith risk within dental examination on the basis of laboratory estimation of oral health status.

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Description

The invention relates to medicine, in particular to dentistry, and is intended to identify at a dental appointment persons with a risk of caries and stone formation in the oral cavity based on a laboratory assessment of the condition of the oral cavity.

The condition of the organs of the oral cavity to a large extent depends on the composition and properties of the surrounding fluid, namely saliva. Saliva plays a crucial role in maintaining the physiological balance of the processes of mineralization and demineralization in tooth enamel. In the oral cavity, saliva is present as a thin film of liquid on various surfaces. Human saliva can serve as a source of information about the general condition of the body. Studies of the oral fluid under physiological conditions of the oral cavity are very important in order to identify integrated parameters and establish their critical values to prevent the occurrence of pathological changes. The study of oral fluid in close interaction with adverse factors is currently an urgent problem of dentistry, it is associated with questions of prenosological diagnosis, prognosis and individual prevention of diseases of the oral cavity. Currently available methods for diagnosing pathological changes in the oral cavity are to a certain extent complicated, time-consuming and not sufficiently informative. Therefore, it is important to search for simple, informative, accessible methods for the rapid diagnosis of dental diseases, based on the analysis of changes in the physicochemical parameters of saliva.

Known methods for diagnosing a number of diseases for the study of oral fluid: odontogenic osteoflegmon and adenoflegmon (RF patent 2230327, IPC G01N 33/84), acute odontogenic osteomyelitis (RF application 2002113510, IPC G01N 33/84); desquamative glossitis on the content of norepinephrine (RF application 2004132590, IPC G01N 33/48), inflammation in the respiratory system (RF patent 2140080, IPC G01N 33/487), chronic gastroduodenitis and functional dyspepsia in children (RF patent 2270610, IPC A61B 10 / 00, G01N 33/483). Methods are also known for predicting the course of diseases by a number of parameters of the oral fluid, in particular inflammatory diseases (RF patent 2286572, IPC G01N 33/52) and diseases accompanied by disturbance of the microflora of the oral cavity (RF patent 2229130, IPC G01N 33/48). All these methods make it possible to diagnose an organism’s disease by a number of specific parameters of the oral fluid, which often requires the development and implementation of new analysis methods. Moreover, the above methods are not applicable for the diagnosis and prevention of diseases of the oral cavity.

Closest to the claimed method is a method for diagnosing caries in adolescents by the content of calcium and chloride in saliva (RF application 2004131801, IPC G01N 33/48).

This method is used to diagnose and determine the criteria for the development of caries in relation to the calcium content in saliva to the chloride content, with values of 0.4-0.5 and higher, caries is diagnosed.

This method does not provide the ability to simultaneously diagnose a number of diseases (caries and stone formation in the oral cavity) and identify criteria for the normal state of the oral cavity of a person.

The objective of the invention is to develop a laboratory method for the early diagnosis of diseases of the oral cavity (dental caries and stone formation) by the elemental composition of saliva and to identify a predisposition to these diseases, including in cases where there are no clinical signs of manifestation of the corresponding diseases of the oral cavity.

The specified technical result is achieved by the fact that in the method of laboratory diagnosis of diseases of the oral cavity by the elemental composition of saliva, based on the determination of saliva parameters and the ratio of their concentrations, the content of sodium, potassium, calcium and phosphorus in the saliva of the subject is determined, and the ratios Ca / P and Na / are calculated K and with Ca / P values less than 0.3 and Na / K less than 0.2, dental caries is diagnosed; with Ca / P values less than 0.3 and Na / K greater than 0.2, the process of stone formation in the oral cavity is diagnosed; with Ca / P values greater than 0.3, a conclusion is drawn about the normal state of the oral cavity.

The method is as follows.

The following studies were performed to determine the parameters of the oral fluid. The study material was the saliva of 90 patients. Saliva was taken in the morning, on an empty stomach, before brushing your teeth in a sterile test tube with a tight-fitting lid. The collected saliva was centrifuged for 10 minutes at a speed of 3000 rpm in a laboratory medical centrifuge OPL-8. The elemental composition of oral fluid samples was determined by the method of atomic emission spectral analysis with inductively coupled plasma [Thompson M., Walsh D.N. Inductively coupled plasma spectrometric analysis guide. - M .: Nedra, 1988. - 174 p.]. Validation of the obtained results was carried out according to the methods adapted in dentistry for the study of oral fluid [Pitaeva AN, Korshunov AP, Distel V.A. and other Physico-chemical methods for the study of mixed saliva in clinical and experimental dentistry (study guide). - Omsk. 2001. - 71 p.].

The study identified three groups of people:

1) group 1 - patients with dental caries (30%).

2) group 2 - patients with dental deposits in the oral cavity (40%).

3) group 3 - control group (30%).

The group of persons resistant to diseases, taken as a comparison, was composed of people with the same somatic status of “practically healthy,” as well as those without periodontal and oral mucosa diseases.

The next stage of the study included the determination of the elemental composition of the oral fluid in the studied diseases. Table 1 shows the laboratory parameters of the oral fluid of the studied groups of patients (selectively 5 people from each group).

Table 1. The elemental composition of the oral fluid of patients Group Calcium,
g / l Phosphorus,
g / l Sodium, g / l Potassium,
g / l Ca / R Na / K Diagnosis 1-1 16.15 291.45 120.8 1194 0.055 <0.3 0.101 <0.2 Caries 1-2 45.29 196.62 164.5 852.2 0.230 <0.3 0.193 <0.2 Caries 1-3 24.15 142.61 152.8 913.8 0.169 <0.3 0.167 <0.2 Caries 1-4 26.75 235.58 141.9 1199 0.114 <0.3 0.118 <0.2 Caries 1-5 13.17 132.34 125.7 723.1 0.099 <0.3 0.174 <0.2 Caries 2-1 20.27 143.66 164.4 685.9 0.141 <0.3 0.240> 0.2 Stones 2-2 18.02 123.96 311.8 838.2 0.145 <0.3 0.372> 0.2 Stones 2-3 12.93 131.8 166.5 642.8 0.098 <0.3 0.259> 0.2 Stones 2-4 42.05 284.19 339.8 1354 0.148 <0.3 0.251> 0.2 Stones 2-5 39.39 414.07 318.3 732 0.095 <0.3 0.435> 0.2 Stones 3-1 51,20 110.13 130,4 428.2 0.465> 0.3 0,305 Norm 3-2 69.47 156.46 132.8 573.4 0.444> 0.3 0.232 Norm 3-3 55.15 122.19 187.7 566.1 0.451> 0.3 0.332 Norm 3-4 45.31 134.20 119.2 562.1 0.338> 0.3 0.212 Norm 3-5 59.73 195.29 318 995.2 0.306> 0.3 0.320 Norm Note. The first digit is the group number, the second is the patient number.

To derive diagnostic parameters for each group, confidence intervals were calculated (Table 2).

Table 2. Characterization of the elemental composition of the oral fluid in the studied groups of diseases Element Group 3 (control) Group 2 (stone formation in the oral cavity) Group 1 (dental caries) Calcium, g / l 54.9 ± 8.1 19.2 ± 13.1 25.5 ± 12.3 Phosphorus, g / l 145.3 ± 35.8 170.0 ± 32.6 216.1 ± 62.8 Sodium, g / l 131.6 ± 30.7 301.4 ± 94.3 147.5 ± 22.3 Potassium, g / l 569.8 ± 193.6 723.1 ± 78.7 1023.1 ± 245.3

A laboratory study of the oral fluid is an important material indicating significant differences in the physicochemical properties of the oral fluid and its elemental composition, which is the basis of the laboratory differential diagnosis of individual laboratory symptoms corresponding to a particular pathology.

As can be seen from the above data (Tables 1, 2), when various diseases of the oral cavity occur, a significant deviation of the parameters of the oral fluid from the norm occurs. So, with the formation of tartar, the content of calcium ions decreases, but the content of phosphorus and electrolyte components — sodium and potassium ions — increase. In the presence of caries, the same changes are observed, however, the sodium content remains normal.

Since the concentrations of calcium, phosphorus, sodium, and potassium in the studied groups changed in opposite directions, it became possible to increase the significance of the differences by calculating the ratios of the studied parameters: Ca / P and Na / K (Table 3).

Table 3. The values of the coefficients Ca / P, Na / K for the studied groups of diseases Coefficient Control group Stone formation in the oral cavity Tooth decay Ca / R 0.391 ± 0.082 0.120 ± 0.026 0.141 ± 0.047 Na / K 0.268 ± 0.098 0.340 ± 0.122 0.161 ± 0.038

Thus, using the Ca / P ratio, we can distinguish groups of patients with caries and stone formation in the oral cavity by a significant deviation of the parameters from the norm (Ca / P <0.3). The Na / K ratio can be used to separate the groups of patients with caries and stone formation among themselves: when the coefficient value is less than 0.2, the patient has a significant risk of dental caries; with a value of more than 0.2 - the risk of calculus formation.

Claims (1)

A method for laboratory diagnosis of diseases of the oral cavity by the elemental composition of saliva, based on measuring saliva parameters and determining the concentration ratio, characterized in that the content of sodium, potassium, calcium and phosphorus in the saliva of the subject is determined, and Ca / P and Na / K ratios are calculated and at values Ca / P less than 0.3 and Na / K less than 0.2 diagnose dental caries; with Ca / P values less than 0.3 and Na / K greater than 0.2, the process of stone formation in the oral cavity is diagnosed; with Ca / P values greater than 0.3, a conclusion is drawn about the normal state of the oral cavity.