Український стоматологічний альманах (Mar 2016)
DOPPLER SONOGRAPHY RESULTS OF HEMODYNAMICS OF EXTRACRANIAL REGION OF BRACHIOCEPHALIC VESSELS IN CASES OF PERIODONTAL TISSUES DISEASES IN PATIENTS WITH THE LESIONS OF INTERVERBAL DISCS OF THE CERVICAL SPINE
Abstract
Rationale. Diseases of periodontal tissues belong to polyetiological diseases with continual growth in the presence of accompanying somatic pathology, including lesions of intervertebral discs of the cervical spine. The development of osteochondrosis of the cervical spine causes the disturbance of autonomic regulation of blood vessels, leading to circulatory failure and development of secondary vascular disorders not only in the system of vertebrobasilar but carotid territory. Therefore, dopplerographic method of vessels examination due to harmlessness, noninvasiveness and high information content is relevant. The objective of our research is to study hemodynamic state of extracranial regions of brachiocephalic vessels in patients with generalized periodontitis on the background of lesions of intervertebral discs of the cervical spine. Materials and methods. To achieve this objective we conducted ultrasound examination of 74 patients of II middle age period with generalized periodontitis at initial - I degree (48 - with an accompanying lesion of the intervertebral discs of the cervical spine, 26 - without comorbidity) and 40 patients of elderly age period with the generalized periodontitis of II-III degree (26 - against the background of degenerative diseases of the cervical spine, 14 - without them), and 26 healthy individuals of II adulthood period and 14 of years old which made up the control group. (Duplex scanning of extracranial regions of brachiocephalic vessels (external carotid and vertebral arteries and internal jugular veins) was performed using ultrasound scanner of company ESAOTE CARIS PLUS (Italy) with a linear array transducer with the frequency of 3,5-10MHts. Research results. Significant reduction of peak systolic and end diastolic blood flow velocity in the vertebral arteries of patients with chronic generalized periodontitis on the background of lesions of the cervical intervertebral discs of the cervical spine was compared with the same healthy individuals without general somatic diseases It was indicated about the disturbance of backbone hemodynamics due to narrowing of the canal lumen in cases of degenerative diseases of the spine column. More evident hemodynamic changes of the vertebral artery in elderly patients that indicate the deepening of degenerative processes in the intervertebral discs of the cervical spine with age which contribute to the progression of lesions of periodontal tissues was determined. Hemodynamic complications of in the system of blood supply of external carotid artery (significant reduction of maximum systolic blood flow velocity and Purselo index) are more evident in cases of lesions of the intervertebral discs of the cervical spine was showed the negative impact of spine comorbidity, it was caused by its vegetative-vascular disorders. We have found out a slight, nonsignificant increase in the diameter of internal jugular vein. It pointed to the absence of significant disorders of venous hemodynamics and available developed system of collateral venous blood outflow. Conclusion. In patients with chronic generalized periodontitis found out significant changes of key qualitative and quantitative hemodynamic parameters of extracranial regions of arteries, more evident in cases of compatible lesions of the intervertebral discs of the cervical spine and increased age of patients. The negative impact of spine comorbidity on the clinical course of periodontal diseases was showed.
