Substantiation of the use of digital methods for assessing the dental status of the oral cavity in normal and pathological conditions

BACKGROUND: Diseases and processes of microbial nature in the oral cavity, such as caries, the hygienic condition of the oral cavity, and its biotopes, in terms of their diagnosis and sanogenetic therapy, are still an important concern in dentistry. The present ad oculum methods are subjective and have a 200%–400% error.

AIM: To conduct pathogenetic and clinical substantiation using an objective digital express method of Raman-fluorescence diagnostics to assess the dental status of the oral cavity in situ in patients with cardiac arrhythmia who are taking anticoagulants.

MATERIALS AND METHODS: One hundred fifty people aged 35 to 55 yr with cardiac arrhythmia on the background of taking anticoagulants or without them (in a comparative aspect) were examined using a hardware and software complex of the “InSpectrM” type. The patients were divided into two groups. Before and after controlled and/or uncontrolled oral hygiene treatment, the indicators of oral homeostasis at the metabolic, morphometric, functional, and clinical levels were assessed in each group using both the digital method and the classical ad oculum method. Aerobicity/anaerobicity of tissues, type of metabolism, saliva volume and index of microbial contamination of saliva, digitized Schiller–Pisarev sample, index of oxygenation, mineralization, and periodontal and hygienic indices were determined and presented in the form of a pie chart to assess the visibility of the results in their relationship. The observation was carried out for 6 months.

RESULTS: It is shown that the proposed digital express Raman-fluorescent technology for assessing the dental status of the oral cavity eliminates the presence of errors ranging from 200% to 400% when measuring the hygienic status of the oral cavity ad oculum and enables the acquisition of results in the relationship of all elements of oral homeostasis, which is confirmed both experimentally and clinically. It is shown that the hygienic condition of the oral cavity is close to the norm indicators in patients taking anticoagulants with controlled hygienic treatment than in patients with noncontrolled hygienic treatment (p <0.05). At the same time, all of the indicators evaluated had a positive dynamics at p <0.05. The need for remineralizing therapy after each hygienic treatment of hard tooth tissues is substantiated. It is evident that for a complex hygiene assessment, it is required to use the Raman-fluorescent diagnostics method and separate ad oculum methods (periodontal index, the index of bleeding), which complement each other in interrelation.

CONCLUSION: Based on the studies presented, it is shown that the Raman-fluorescent digital diagnostics method allows for simultaneous and multifactorial digital online assessment of the totality of all indicators of the dental status of the oral cavity in patients with cardiac arrhythmia while taking anticoagulants at the metabolic, morphometric, functional, and clinical levels.