Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации9253Conference ProceedingsIdentification of the relationship between the development of aphthous stomatitis and concomitant diseases in childrenLidokhovaOlesia Vladimirovna<p>Candidate of Biological Sciences, Associate Professor, Department of Pathological Physiology</p>Lidohova@rambler.ruPodoprigoraDmitry Vladimirovich<p>Student of the Institute of Dentistry</p>gora76@mail.ruKretsuVeronica Anatolievna<p>Student of the Institute of Dentistry</p>nika.kretsu@bk.ruKoretskayaInessa Vladimirovna<p>Candidate of Medical Sciences, Associate Professor</p>anmorozov@vrngmu.ruVoronezh State Medical University named after N.N. BurdenkoVoronezh State Medical University named after N. N. Burdenko1904202413S13033052501202410042024Copyright © 2024, Lidokhova O.V., Podoprigora D.V., Kretsu V.A., Koretskaya I.V.2024<p>Modern medicine identifies several theories of the occurrence of stomatitis, each of which has its own grounds and provisions. However, most scientists agree that the infectious-allergic factor is leading in the pathogenesis of aphthous stomatitis. This factor manifests itself in a change in the reactivity of the body and its increased sensitivity to staphylococci, streptococci and other microorganisms that are usually present in the oral cavity. With certain disorders, these microorganisms become pathogenic, causing inflammatory processes.</p> <p>Aphthous stomatitis can have acute, chronic and recurrent forms. Foreign authors distinguish three main manifestations of chronic recurrent stomatitis: small aphthae (up to 10 mm in diameter), large aphthae (more than 1 cm in diameter) and herpetiform ulcers multiple round-shaped aphthae, ranging in size from 1 to 3 mm, distributed throughout the oral mucosa.</p> <p>This article discusses issues related to the etiology and pathogenesis of aphthous stomatitis in children, depending on the concomitant pathology. The study is based on a retrospective and prospective analysis of the results of the examination of 120 children aged 3 to 8 years with various forms of stomatitis. The study was conducted at Voronezh Regional Children's Clinical Hospital No. 2. The most common concomitant pathology turned out to be allergic reactions of various origins. It was also revealed that aphthous stomatitis was most severe in children with oral acidosis, especially in those who sought medical help in the late stages of the disease.</p>aphthous stomatitisconcomitant pathologyoral mucosaафтозный стоматитсопутствующая патологияслизистая оболочка полости рта<p>Relevance. Aphthous stomatitis is an inflammation of the mucous membrane of the oral cavity, characterized by a violation of the surface layer of the mucous membrane and the appearance of aphth (erosions). The disease is accompanied by severe soreness, burning sensation, enlarged lymph nodes, and in rare cases proceeds with the development of fever. Aphthae that have arisen in the oral cavity heal and disappear without a trace within 7-10 days [1]. The etiology of this disease is well known: heredity; infectious diseases such as chickenpox, infectious laryngitis; diseases of the digestive tract (viral hepatitis, gastric ulcer); lack of vitamins and nutrients due to poor nutrition; allergens; prolonged stress; viruses, including the herpes virus [2]. The mechanism of development of the disease is simple and includes two main factors: a decrease in the function of the immune system and, as a result, the development of pathogenic microflora, and the effect of damaging factors on the mucous membrane and the penetration of infection into the oral cavity. There are several theories of the occurrence of stomatitis, but most scientists agree that the key factor in the pathogenesis of aphthous stomatitis is an infectious and allergic component. This factor manifests itself in a change in the reactivity of the body and increased sensitivity to microorganisms usually present in the oral cavity, which can lead to the development of inflammatory processes [3].Acute aphthous stomatitis is characterized by the formation of ulcers and redness in the oral cavity with swelling and swelling of the mucous membrane. Symptoms include acute pain when eating, enlarged lymph nodes, fever, weakness and fatigue. Chronic aphthous stomatitis, associated with the inability of the immune system to fully resist the acute form of stomatitis, is usually associated with a decrease in immunity caused by various pathologies such as gastrointestinal diseases and chronic inflammatory diseases of the nasopharynx. Treatment of this form requires a longer time, and relapses may occur after recovery [4]. Foreign authors [5, 6] identify three main manifestations of chronic recurrent stomatitis: Small afty (afty Mikulich). The most common form (frequency of occurrence 70-85%). As a rule, small aphthae are located on the mucous membrane of the lips, cheeks, bottom of the mouth, on the tip and lower surface of the tongue. Their size is no more than 10 mm in diameter. Large aphthae (necrotic periadenitis of the oral mucosa, or Setton's disease). They exceed 1 cm in diameter. Soft palate and pharynx are mainly affected, they occur in 10-15% of patients suffering from HRA. Herpetiform ulcers are multiple roundshaped aphthae, ranging in size from 1 to 3 mm, scattered throughout the mucous membrane of the mouth. They are quite rare 5-10% of all cases of HRAS.</p> <p>Диагностика афтозного стоматита основана на оценке клинической картины и сборе информации от пациента. Врач должен знать, как давно проявились первые симптомы, какова их интенсивность, возникали ли подобные случаи ранее, существуют ли какие-либо признаки аллергических реакций [7]. Также нужно выяснить, были ли аналогичные проблемы со здоровьем у ближайших родственников. Кроме того, значение имеет количество и размеры афт, а также состояние слизистой полости рта после их заживления и исчезновения. В ряде случаев применяется лабораторная диагностика: берётся мазок из полости рта с целью выявить возбудителя, точно поставить диагноз и подобрать лечебную тактику [8, 9].The aim of the work was to study clinical, anamnestic and laboratory data on stomatitis in children to identify the relationship between the development of aphthous stomatitis and concomitant pathology in children. Materials and methods of research. The study was conducted on the basis of Voronezh Regional Children's Clinical Hospital No. 2 and is based on a retrospective and prospective analysis of the examination results of 120 children aged 3 to 8 years with various forms of stomatitis. The results of the study. During the study, the frequency of concomitant pathology was established, chronic tonsillitis was detected in 4 (3.33%) children, atopic dermatitis in 10 (8.33%) patients, bronchial asthma in 16 (13.33%) people, chronic rhinopharyngitis in 10 (8.33%) patients, respiratory affective seizures in 1 (0.84%) of the child. In the course of the work, a connection with harmful habits of a local nature was revealed, the most pronounced harmful habit onychophagy was observed in 6 (5%) children. Allergic pathology was detected in 30 (25%) children. Food allergies 15 (12.5%) patients, allergic rhinitis and allergy to animal hair were detected in equal numbers, in 6 (5%) patients, an allergic reaction to medicines was established in 3 (2.5%) of the examined children. Changes in the level of acid-base balance of the oral cavity in children with stomatitis of various etiologies were determined, deviations from the norm were detected in 58 (48.3%) patients.Acidosis was detected in 2 (1.66%) children diagnosed with allergic stomatitis, in 3 (2.49%) children with traumatic stomatitis, in 11 (9.16) with fungal stomatitis (candidiasis), in 28 (23.33%) children diagnosed with acute viral stomatitis (herpetic), in 13 (10.83%) when diagnosed with chronic viral stomatitis with a recurrent course of herpetic etiology. It was revealed that 84 patients (70%) of the child seek qualified dental care in the late stages of the disease (the second and third categories in terms of the area of lesions of the disease), which prolongs the disease. Conclusion. The results of the study emphasize the relationship of concomitant pathology and local bad habits with the development of stomatitis in children. Deviations from the norm in the acid-base balance of the oral cavity in children with various etiologies of stomatitis were also revealed. Late medical treatment in the vast majority of patients can lead to a prolonged course of the disease.</p> <p></p>1.1. Кузьменкова, А. В. Клинико-анамнестические и лабораторные данные при стоматитах у детей / А. В. Кузьменкова, Е. Г. Асирян // Стоматолог. – 2020. – Том 39, № 4. – С. 42-47.2.2. Чижевский, И. В. Клиника и диагностика осложненных форм острого герпетического стоматита у детей / И. В. Чижевский, Е. В. Дегтяренко, И. Д. Ермакова // Стоматология славянских государств : сборник трудов ХIV Международной научно-практической конференции, 8-12 ноября 2021 г. – Белгород, 2021. – С. 319-322.3.3. Анализ этиопатогенетических и клинических особенностей течения хронического рецидивирующего афтозного стоматита у детей с ревматическими заболеваниями / А. А. Скакодубал, Н. А. Геппе, О. И. Адмакин [и др.] // Российский вестник перинатологии и педиатрии. – 2019. – Том 64, № 4. – С. 76-82.4.4. Скакодуб, А. А. Междисциплинарное взаимодействие при диагностике и лечении хронического рецидивирующего афтозного стоматита у детей с различной соматической патологией / А. А. Скакодуб, А. Д. Мамедов, Ю. А. Козлитина // Современная стоматология: от традиций к инновациям : материалы международной научно-практической конференции, Тверь, 15-16 ноября 2018 г. – Москва, 2018. – С. 350-352.5.5. Koberová, R. Recurrent Aphthous Stomatitis in Children: A Practical Guideline for Paediatric Practitioners / R. Koberová, V. Merglová, V. Radochová. – DOI 10.14712/18059694.2020.56 // Acta Medica (Hradec Kralove). – 2020. – Volume 63, № 4. – P. 145-149.6.6. Recent advances in the aetiology of recurrent aphthous stomatitis (RAS) / Z. Wang, H. Cao, J. Xiong [et al.]. – DOI 10.1136/postgradmedj-2020-139421 // Postgraduate Medical Journal. – 2022. – Volume 98, № 1155. – P. 57-66.7.7. Структура соматической патологии у детей с афтозным стоматитом / Г. М. Акмалова, С. В. Чуйкин, Н. Д. Чернышева, С. Ф. Назмиева // Проблемы стоматологии. – 2020. – Том 16, № 1. – С. 93-97.8.8. Изучение особенностей оральной микробиоты у детей с афтозным стоматитом / Г. Р. Маннапова, О. С. Гилева, Г. М. Акмалова [и др.] // Проблемы медицинской микологии. – 2022. – Том 24, № 2. – С. 99-100.9.9. Характеристика микрофлоры полости рта у детей с хроническим рецидивирующим афтозным стоматитом / С. В. Чуйкин, Г. М. Акмалова, И. А. Мирсаяпова [и др.] // Стоматология детского возраста и профилактика. – 2018. – Том 17, № 2 (65). – С. 29-31.