DYNAMICS OF ANTIOXIDANT ENZYME ACTIVITY AND MALONIC DIALDEHYDE LEVEL IN TRE ORAL FLUID OF PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS AND RHEUMATOID ARTHRITIS WHO LIVE IN ECOLOGICALLY UNFAVORABLE AREA UNDER THE INFLUENCE OF COMPLEX TREATMENT

Inflammatory-destructive changes in periodontal tissues are more common in patients with concomitant somatic diseases and due to adverse environmental factors. This necessitates the development of new treatments aimed at eliminating the etiopathogenetic factors of generalized periodontitis development. The aim to study the indicators changes in antioxidant protection and malonic dialdehyde (MDA) levels in the oral fluid in patients with GP and rheumatoid arthritis (RA) who live in environmentally unfavorable areas and assess-ment of the dynamics of changes in the studied indicators in the oral fluid under the influence of comprehensive treat-ment. Materials and methods. 105 patients with GP of the I-II degree of development were examined and treated, of which 70 patients were with RA. Depending on the ecological living conditions of patients with RA was divided into two groups: group I (n=35) – live in environmentally unfavorable areas; group II (n=35) – live in environmentally fa-vorable areas. Group III (n=35) was formed by patients with GP without concomitant pathology. Each of the groups, depending on the severity of GP was divided into subgroups: A – GP of the I degree; B – GP of the II degree of severity. The control group consisted of 18 virtually healthy individuals with intact periodontium and preserved dentition (H). The state of the prooxidant system of the oral cavity was determined by the level of MDA. To study the state of the antioxidant defense system (AOS), the activity of superoxide dismutase (SOD) and catalase was determined. Research results. Determining the level of MDA in oral fluid in all subgroups of patients with GP and RA and without concomitant pathology revealed an increase in this indicator before treatment. It increased most significantly in the IB subgroup to 1.19±0.02 nmol/l and in the IA subgroup to 1.16±0.01 nmol/l, compared with 0.34±0.17 nmol/l in healthy individuals. (*pIB-3<0.001, *pIA-3<0.001), which exceeded it by 3.5 and 3.4 times, respectively, which may be due to the negative impact of the environment. During all follow-up periods after conducted treatment, the level of MDA decreased and most closely approached the rate of healthy individuals after 6 months. However, before treatment, depletion of the antioxidant system was detected in all subgroups, as evidenced by the weakening of the AOS. In particular, in the IB subgroup there is the greatest decrease in the activity of SOD to 35.6±0.56%, compared with the group of healthy individuals 49.06±0.03% (p<0.001) and catalase to 4.42±0.03 с.u along with healthy – 6.64±0.01 c.u (p<0.001). The activity of certain antioxidant protection enzymes tends to increase after a comprehensive treatment in all subgroups after 6 months. And in the IB subgroup the activity of SOD after 6 months was 44.77±0.35%, catalase 6.29±0.0 3c.u. Conclusions. As a result of complex treatment there was normalization of the AOS system, which is manifest-ed by increased activity SOD and catalase in the oral fluid, as well as a decrease in MDA. This indicates a decrease in inflammation process and the effectiveness of our treatment and prevention complex on the antioxidant system, which provided remission GP in these patients.