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A comprehensive examination of the dental health of student youth in the city of Samarkand was carried out. The study was carried out between the Higher Educational Institutions. The total number is 574 students. The following universities participated: (Samarkand Medical Institute (SamMI) and Samarkand State University (SamGU)) among which there were 193 students of the 1st year, 175 people of the 2nd year, 206 students of the 3rd year, respectively. The prevalence of dental caries, which was 91.87±1.30%. The intensity of the carious process was 5.31 ± 0.14 teeth with 8.34 ± 0.26 surfaces, signs of periodontal tissue diseases were revealed with an intensity of 3.88 ± 0.06 segments. Dental anomalies and deformities were recorded in 53.05±2.37% of students

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Relevance. Students of higher educational institutions (HEIs) constitute a special social stratum of the population, united by a certain age, specific learning conditions and lifestyle. Mastering the sciences requires from young people a huge expenditure of energy, psycho-emotional stress, physical effort, mobilization of body reserves.Student youth is one of the main reserves of highly qualified specialists for various sectors of the national economy [1]. Modern students will have to implement the most important social functions of society in the future: professional, labor, reproductive, intellectual and moral, etc [2]. Expensive mass medical examinations are carried out to determine the state of health in different countries, meanwhile, an important criterion is self-assessment of health, the determination of which is relatively easy to perform among various categories of the population [3]. The Health Survey Questionnaire developed in accordance with the 8020 program to assess oral health, associated lifestyle, general health and quality of life of the population, was used in Japan and some other countries of the world, but in Russia such studies have not been previously conducted In connection with the foregoing [4]. The use of sociological research methods to study the problem of the relationship between the dental and general health of students is an important and relevant area of scientific research[5]. Material and methods of the study. To accomplish the set tasks we have examined 574 students of Samarkand higher educational institutions (Samarkand Medical Institute (SMI) and Samarkand State University (SSU)) among which first-year students 193, second-year students -175 and third-year students 206 respectively. The average age was 21.4±1.2 years. The prevalence of all detected diseases was expressed as a percentage of persons suffering from these diseases [6]. Examination of oral mucosa and soft tissues included examination of skin and lip border (diseases of lips and SOPR - K13), character of their occlusion; mucosa of lips, cheeks and mouth vestibule; frenulum of lips and tongue, mucosal bands; gingival margin; tongue mucosa (tongue diseases - K14), floor of mouth, hard and soft palate [7]. The incidence of dental caries was assessed by its prevalence and intensity. The caries prevalence was expressed as the percentage of people with the disease. The caries incidence rate (KPI) was considered as an integrated value of all variants of dental caries - the number of teeth affected by caries, its complications, fillings and extractions [8]. Registration of the obtained data was carried out in the developed "Card for the assessment of the dental status". The following indices were used to assess the state of periodontal tissues: gingival bleeding index (Muchlemann - Cowell), gingival index GI, as well as CPI index reflecting the need for treatment of periodontal diseases [9]. Oral hygiene status (as a major risk factor for dental diseases) was assessed according to the simplified OHI-S scale, the international classification of Dean N.T. was used to assess the presence of dental fluorosis. According to this classification, the following forms of dental fluorosis were distinguished: The Dental Aesthetic Index (DAI) was used to determine the need for orthodontic treatment. It assessed the position of the teeth and the condition of the bite in the sagittal, vertical and transversal directions [10]. To identify the need for restorative treatment of teeth, we used the index of destruction of the occlusal surface of the teeth - the DAI of Milikevich V.Yu. [10]. The entire occlusal surface area of a tooth was taken as a unit. To determine the fracture index, the surface area of the cavity or filling was subtracted from unity, i.e., the entire occlusal surface area. Results of the study. The out-of-oral examination carried out on 574 students (430 male and 144 female) studying in Samarkand higher educational institutions (Samarkand Medical Institute (SamMI) and Samarkand State University (SamSU) showed the absence of marked pathology. On detection of complaints, external examination and palpation of the temporomandibular joint, it was found that 132 (22.80±1.99%) students had pathology in articulatory function of the TMJ (Fig. 1). It was expressed in the presence of pain, clicking and crunching in the joints, restricted mouth opening, zigzag shift of the lower jaw to the left or right, asynchronous movement of the heads of the TMJ. The prevalence of pathology in articulatory function of the temporomandibular joint in SamMI students was slightly higher (24,22±2,87%) than in SamSU students (21,36±2,76%, p>0,05). State of the mucous membrane and soft tissues of the oral cavity. The prevalence of different types of pathology of oral mucosa and soft tissues of Samarkand students was 30.66±2.19% (176 students) (Pic 1). Most frequently there were 107 (18.64±1.85%) inflammatory changes of gingival margin, followed by 61 (10.63±1.45%) tongue surface changes (desquamative glossitis or geographical tongue) and 38 (6.62±1.18%) students who had affected red vermilion of lips (meteoric cheilitis). Examination of the SOPR revealed isolated cases of CPAS (4 persons -0.7%). We did not find pronounced pathology in the location and attachment of the frenulum of the lips, tongue and mucosal bands in the subjects. Comparison of examination findings revealed that prevalence of oral mucosa and soft tissue diseases among SamMI students was 2.1 times lower than among students of SamSU (19.73% and 41.82% respectively, p<0.05). Inflammatory changes of gingival margin were found 3.4 times less frequently among SamMI students than among SamSU students (8.52% and 29.09%, respectively), changes on the dorsal surface of the tongue were 2.3 times less frequently (6.28% and 14.55%, respectively, p<0.05). Prevalence and intensity of dental caries Each student had on the average little more than 5 teeth affected by caries (5.31±0.14), the rate of carious lesions on CPU(n) surfaces was 8.34±0.26 (Table 1). Table 1 - Intensity of dental caries and surfaces in students of Samarkand State Medical Institute and Samarkand State University (M±m) Indicators Intensity of injury Samarkand State Medical Institute Samarkand State University Structure of the dental lesion index KPU(h) 5,49 ±0,20 5,12 ±0,18 C(h) 1,11 ± 0,08 1,56 ± 0,09* P(h) 4,26 ± 0,17 3,43 ±0,16* U(h) 0,12 ±0,01 0,13 ±0,02 Structure of the dental surface lesion index KPU(n) 8,32 ± 0,37 8,37 ±0,37 C(n) 1,63 ±0,13 2,65 ±0,18* P(n) 6,09 ± 0,27 5,09 ± 0,25* U(n) 0,61 ±0,07 0,64 ± 0,08 Note: * - differences between the indicators are significant (p<0.05). The analysis of the index structure revealed the high proportion of "filled teeth" (72,5%), the proportion of "decayed teeth" was 25,24%, "extracted teeth" - 2,26%. In the vast majority of cases (75.73±2.04% of all affected teeth) caries process, occurred in the group of molars (Table 2). The level of dental care for Samarkand university students was 74.82±2.06%, which corresponds to a satisfactory value. To determine the need for various types of restorative therapy, we used Milikevich V.Y.'s IROPZ index. Depending on the degree of destruction, all teeth to be treated were divided into three groups. The EDEPI equal to 0,2-0,5 was observed in 43 % of teeth, indicating their moderate destruction and possibility of restoration of dental defects by means of fillings and restorations. 35% of the teeth had an MRPI of 0.6-0.7, indicating more severe damage, no possibility of repair by filling, and the need for crowns. A CRPI of 0.8-0.9 was observed in 22% of teeth, indicating significant damage and indicating the need for dental restoration with cast inlays or post and cuspidectomy, followed by crowning. The incidence of each index group IROPZ included approximately equal numbers of students from both institutions, with girls characterised by an IROPZ of 0.36±0.07 and boys 0.43±0.08. Table 2 - Prevalence of dental caries by dental group of Samarkand State Medical Institute and Samarkand State University (M±m, %) Prevalence of dental caries HEI Samarkand State Medical Institute (n=289) Samarkand State University (n=285) Molars 73,96 ±2,94 77,71 ±2,81 Upper jaw molars 31,84±3,12 30,46 ±3,10 Lower jaw molars 42,12 ±3,31 47,25 ±3,37 Premolars 14,61 ±2,37 10,92 ±2,10 Premolars upper jaw 11,18 ±2,12 7,28 ±1,75 Lower premolars 3,43 ±1,22 3,64 ±1,26 Incisors and canines 11,43 ±2,13 11,37 ±2,14 Incisors and canines of upper jaw 10,29 ±2,03 10,75 ±2,09 The incisors and canines of the lower jaw 1,14 ±0,71 0,62 ±0,53 Non-carious damages of hard tooth tissues have been met in 56,44±2,36 % of examined students, some degrees of dental fluorosis have been observed in 30,93±2,20 %, the share of stains and hypoplasia of enamel was 16,93±1,78 %, the signs of pathological erasure were revealed in 3,61±0,89 %, and cliniform defects - in 4,97±1,03 % (Table 3). Table 3 - Prevalence of non-carious dental lesions of Samarkand university students (M±m, %) Non-carious dental lesions Prevalence Dental fluorosis 30,93 ±2,20 Forms of dental fluorosis Doubtful 32,12 ±3,99 Very weak 20,44 ± 3,45 Weak 29,20 ±3,88 Moderate 16,07 ±3,14 Severe 2,19 ±1,25 Stained and hypoplasic enamel 16,93 ±1,78 Abnormal abrasion 3,61 ±0,89 Wedge-shaped defects 4,97 ±1,03 Gingivitis was detected in 364 (63.41%) students examined, clinically characterised as catarrhal in 306 (84.07%) students and hypertrophic in 59 (16.21%) students. According to gingivitis index (GI) in 55,77% (203 persons) of cases mild inflammation of gingiva (slight hyperemia and swelling), in 40,11% (146 students) - moderate inflammation (more pronounced hyperemia and swelling, bleeding when probing), in 4,12% (12 persons) - severe inflammation (intense hyperemia and swelling, spontaneous bleeding). Bleeding gingival inflammation was assessed with the Muchlemann index, which showed bleeding in 310 (54%) subjects, bleeding at the slightest gingival probing and while eating in 104 (18,12%) students. Evaluation of the results of study of periodontal tissues condition among Samarkand State University students has shown their high prevalence (97,49±0,78%) and intensity (3,88±0,06) among students (table 4). The prevalence of periodontal disease signs among students of SamSU was 99.55±0.45%, with average intensity of lesions - four segments per examinee (4.10±0.08), which was 5% and 12%, respectively, higher than in students of SamMI (p<0.05). Tartar was most common among medical students and its prevalence was 78.65±3.07%. Tartar was diagnosed in almost 2 sextants. Among signs of periodontal tissue lesions, tartar was also frequently observed among SamSU students (65.45±3.21%), with an intensity of 1.55±0.08 sextant, but this lesion sign was found reliably less frequently than among medical students. The average hygiene index in SamMI youth was 1.92±0.07, which corresponds to a satisfactory level of oral hygiene. The average value of hygiene index in SamSU students (2.05±0.05) did not differ significantly from that of SamMI students. However, there were significant differences in plaque index (1.51±0.03 and 1.25±0.03, respectively) and calculus index (0.54±0.03 and 0.67±0.04, respectively) (Table 5). Table 4 - Prevalence and intensity of periodontal tissue of periodontal tissues of Samarkand students (M±m) Indicators Samarkand State Medical Institute) Samarkand State University Prevalence (%) medium 94,94 ±1,64 99,55 ±0,45* bleeding 15,17 ±2,69 28,64 ±3,05* stone 78,65 ±3,07 65,45 ±3,21* pocket 1,12 ±0,79 5,45 ±1,53* Intensity (sextants) medium 3,61 ±0,10 4,10±0,08* bleeding 1,63 ±0,09 2,50 ± 0,08* stone 1,97 ±0,10 1,55 ±0,08* pocket 0,01 ±0,00 0,05 ±0,01* Note: * - Differences between signs between groups are significant (p<0.05). Table 5 Oral hygiene status of Samarkand university students (M±m) Indicators Values Secondary SamMI SamSU Hygiene index average 2,00 ±0,04 1,92 ±0,07 2,05 ±0,05 plaque 1,40 ±0,02 1,25 ±0,03 1,51 ±0,03* stone 0,60 ±0,02 0,67 ±0,04 0,54 ±0,03 * Oral hygiene level (%) good 22,79 ±2,17 29,41 ±3,68 18,18 ±2,60* satisfactory- 64,34 ±2,48 58,82 ±3,98 68,18 ±3,14 good 12,87 ±1,73 11,76 ±2,60 13,64 ±2,31 Note:* - differences between the groups are significant (p<0.05). Prevalence of dental and maxillary system disorders The dental system disorders were found in every second student of Samarkand (53,05±2,37%) (tab. 6). We registered bite pathology in 16.48±1.76% of all examined students. Among the students having bite pathology, prognathic jaw ratio was the most frequent - 64,38±5,60%; prevalence of deep bite was 17,81±1,82%; equally frequent (6,85±2,96%) open and cross bites were observed; in single cases prognathism was registered (4,11±2,32%). Dental anomalies occurred in 75.40±2.05% of the students. Anomalies of individual teeth were found least frequently (8.13±1.39%). Table 6 - Frequency of different types of dental anomalies among Samarkand university students (M±m) Nosology Prevalence Disorders of the maxillary system 53,05 ±2,37 Bite anomalies 16,48 ±1,76 Types of anomaly Prognathia 64,38 ±5,60 Prognathia 4,11 ±2,32 Crossbite 6,85 ±2,96 Deep bite 17,81 ±1,82 Open bite 6,85 ±2,96 Dental anomalies 75,40 ±2,05 Anomalies of individual teeth 8,13 ±1,39 Our study showed that 193 (33.62±2.25%) students had an aesthetic DAI of less than 25, indicating no or very little bite problems. In these cases, there is little or no need for treatment. DAI values of 26-30 were found in 92 (16.03±1.21%) young people, indicating a clear bite disturbance, they are recommended to consult an orthodontist and treatment as indicated. In 63 (10.98±1.35%), the DAI index value was 31-35, indicating a pronounced bite disorder and the need for orthodontic treatment. In 28 (4.88±0.19%) young men and women the aesthetic index values exceeded 36, which reflects very severe bite disturbances and an unconditional need for treatment. Conclusions. The prevalence of dental caries among students of Samarkand higher educational institutions is 91,87±1,30% and intensity of carious process is 5,31±0,14 tooth at 8,34±0,26 surface. Non-carious damages of hard tissues of teeth are ascertained at 56,44±2,36 % on a background of satisfactory level of stomatological help to students. 97,49±0,78 % of Samarkand university students have revealed signs of periodontal tissues diseases with intensity of 3,88±0,06 segments, and 30,70±2,19 % of students have stated pathology of mucous membrane and soft tissues of oral cavity. Oral hygiene of Samarkand university students is at satisfactory level, and good level of hygiene of medical students is 1,6 times higher than that of Samarkand State University students. Dental-alveolar anomalies and deformities were found in 53.05±2.37% of students, and articulatory dysfunctions of temporomandibular joints were found in 22.80±1.99% of students. There is a direct correlation between the prevalence and intensity of major dental diseases and risk factors such as poor oral hygiene, tobacco smoking and alcohol consumption.

About the authors

L. E Khasanova

Samarkand State Medical University

Department of Oral Surgery and Dental Implantology

F. A Ismatov

Samarkand State Medical University

Department of Oral Surgery and Dental Implantology


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