The Hodgkin’s disease (lymphogranulomatosis, LGM) stands at the top of the list among malignant lymphomas in children. The highest rate of it occurrence coincides with childhood. LGM is most common at 4-6 and 12-14 years. The scope of scientific clinical research on odontoand parodontopathology is limited among pediatric population. The quantitative and qualitative composition of plaque, its thickness and area is primary pathogenic chain. In turn, unsatisfactory oral hygiene contributes to the development of decay and periodontal and oral mucosal disease in children with LGM.
Our research aims to study the oral hygienic condition in patients with LGM during different clinical stages of the underlying disease. In order to reduce the toxic effect of LGM treatment, rational oral hygiene preventive measures shall be implemented.
Matherials and methods. A total of 45 patients of both sexes in the 5-15 year age group diagnozed with lymphogranulomatosis (LGM) were examined. 243 healthy age-and-sex-matched children were included in the control group. The patients with lymphogranulomatosis (LGM I) were examined after the initial diagnosis. Group II (LGM II) consisted of patients who had completed the first polychemestry treatment cycle. Group III (LGM III) included patients who had a constant remission period (from over 6 months to 5 years).
The oral hygienic condition was studied using the Pahomov’s hygienic index, the simplified oral hygiene index (OHI-S by Greene and Vermilion), the PHP hygiene hygiene efficiency index (Podshadley, Haley, 1968), the modified Turesky index (1970), and API surfaces [6]. The data was statistically analyzed using Student's-Fisher's method.
The Pahomov's hygienic index (PHI) in children aged 5-15 with LGM was quite different in the main and control groups (p<0.05). The score of PHI was 2.3 ± 0.05 (p<0.05) in patient group with LGM (LGM I). The Pahomov's hygienic index had increased in the children aged 5-15 diagnozed with LGM. The Pahomov’s index values from the second (LGM II) and third (LGM III) examinations were found to be quite different when compared to the control group of children of the same age (p<0.05). This PHI value was 3.39 ± 0.11 (very poor) after the second examination (LGM II) and was at 2.7 ± 0.10 (poor) during the third examination (LGM II). The satisfactory and unsatisfactory oral hygiene conditions according to the Pahomov’s index were observed in 5-15 year old children with LGM.
The satisfactory and unsatisfactory oral hygiene conditions have been established using the Pahomov’s index, Green-Vermilion, Tureski, PHP, API in 5-15 year old children with LGM. The children might have completely given up on tooth brushing due to increased trauma and bleeding gums.
Soft plaque is often responsible for dental decay in primary and permanent teeth in children and periodontal diseases. The analysis of the individual oral hygiene condition determined poor level of hygiene skill in patients with LGM compared to somatically healthy children. Hygienic condition and care depend on age, clinical stage of the underlying disease, the course of pathological complications in hard dental and soft oral tissues.
Conclusion. Our clinical study established a poor oral hygiene condition by using different groups of dental hygiene indicators in patients with LGM. This condition particularly worsens during chemotherapy, which causes significant changes in periodontal, oral mucous and hard dental tissues. Children have low awareness of oral cavity care requirements or the specifics of selecting hygiene supplies and facilities. In those cases, the dental examination was required for raising awareness and providing oral hygiene control which was carried out among patients at different stages of the Hodgkin’s disease and it remission. Therefore, adopting such measures would provide an opportunity to increase the resistance of hard dental and periodontal tissues.
Hodgkin's disease in childhood. Histopathologic classification in relation to age and sex