PERIODONTITIS IN HEMATOLOGICAL DISEASES

ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 1304 PERIODONTITIS IN HEMATOLOGICAL DISEASES Muhitdinova F.G’. Tashkent State Medical University Abstract Chronic periodontitis is a multifactorial inflammatory disease in which microbial biofilm and host immune response interact to determine disease onset and progression. Although dental plaque is the primary etiological factor, the clinical severity of periodontitis varies considerably among individuals, suggesting differences in microbial composition and host susceptibility. The aim of this study was to evaluate clinical and microbiological characteristics of chronic periodontitis according to disease severity and to analyze their relationship with periodontal tissue destruction. A total of 141 patients diagnosed with chronic periodontitis were examined and stratified into mild, moderate, and severe forms based on clinical and radiographic criteria. Periodontal parameters including gingival inflammation, bleeding on probing, probing pocket depth, clinical attachment loss, and alveolar bone resorption were assessed. Subgingival samples were collected for microbiological analysis to identify aerobic and anaerobic microorganisms associated with periodontal inflammation. Patients with mild chronic periodontitis predominantly exhibited moderate gingival inflammation and shallow periodontal pockets, whereas moderate and severe forms were characterized by increased pocket depth, clinical attachment loss, and radiographic bone destruction. Microbiological analysis demonstrated a progressive shift from predominantly aerobic flora in mild disease to anaerobic pathogenic microorganisms in severe periodontitis. The highest prevalence of anaerobic bacteria was observed in patients with severe disease, often accompanied by mixed microbial associations. These findings indicate that clinical severity of chronic periodontitis is closely associated with qualitative and quantitative changes in periodontal microflora. Understanding these relationships may improve risk assessment and contribute to more targeted periodontal treatment strategies. Keywords chronic periodontitis; periodontal microflora; anaerobic bacteria; disease severity; periodontal pockets; clinical characteristics 1. Introduction Chronic periodontitis is one of the most common inflammatory diseases of the oral cavity and remains a leading cause of tooth loss in adults. The disease is initiated by microbial dental plaque; however, the clinical manifestations and rate of progression differ significantly among affected individuals. Periodontal tissue destruction results from a complex interaction between pathogenic microorganisms and the host immune-inflammatory response. While bacteria provide the initial stimulus, tissue damage is largely mediated by inflammatory mechanisms triggered by the host. Numerous studies have demonstrated that changes in the composition of subgingival microflora are associated with disease progression. The transition from predominantly aerobic to anaerobic microbial communities is considered a key factor in the development of destructive periodontal lesions. ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 1305 Despite extensive research, the relationship between specific clinical manifestations of chronic periodontitis and microbiological findings remains incompletely understood, particularly in relation to disease severity. Population-specific studies are essential to clarify these associations and improve clinical decision-making. The aim of the present study was to assess clinical and microbiological characteristics of chronic periodontitis across different severity levels and to evaluate their association with periodontal tissue destruction. 2. Materials and Methods 2.1. Study Population The study included 141 patients diagnosed with chronic periodontitis who received treatment at dental clinics affiliated with higher medical institutions in Tashkent. All participants were examined according to standardized clinical protocols. Patients were classified into mild, moderate, and severe chronic periodontitis groups based on clinical and radiographic findings. 2.2. Clinical Periodontal Examination Clinical examination included assessment of gingival inflammation, bleeding on probing, probing pocket depth, clinical attachment loss, and tooth mobility. Radiographic evaluation was performed to assess alveolar bone resorption. Disease severity was determined according to the extent of periodontal tissue destruction. 2.3. Microbiological Assessment Subgingival samples were collected from periodontal pockets using sterile instruments. Microbiological analysis was performed to identify aerobic and anaerobic microorganisms associated with periodontal inflammation. The frequency and distribution of detected microorganisms were analyzed in relation to disease severity. 2.4. Statistical Analysis Descriptive statistical methods were used to summarize clinical and microbiological data. Associations between disease severity and microbiological findings were evaluated using comparative statistical analysis. A p-value < 0.05 was considered statistically significant. 3. Results 3.1. Clinical Findings Patients with mild chronic periodontitis exhibited mild to moderate gingival inflammation, minimal bleeding on probing, and periodontal pocket depths generally not exceeding 4.5 mm. Radiographic examination revealed initial alveolar bone changes. In patients with moderate chronic periodontitis, gingival inflammation was more pronounced, accompanied by increased bleeding on probing, deeper periodontal pockets, and moderate clinical attachment loss. Radiographic findings demonstrated partial alveolar bone resorption. Severe chronic periodontitis was characterized by extensive gingival inflammation, frequent bleeding, deep periodontal pockets exceeding 6 mm, marked clinical attachment loss, tooth mobility, and significant alveolar bone destruction evident on radiographs. 3.2. Microbiological Findings Microbiological analysis revealed distinct differences in subgingival microflora among severity groups. In mild chronic periodontitis, aerobic and facultative anaerobic microorganisms predominated. ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-12 1306 In moderate disease, a mixed microbial profile was observed, with increased detection of anaerobic bacteria. In severe chronic periodontitis, anaerobic pathogenic microorganisms were identified in the majority of cases, often forming complex microbial associations. The prevalence of anaerobic microflora increased progressively with disease severity, indicating a strong association between microbial composition and periodontal tissue destruction. 4. Discussion The results of this study demonstrate a clear relationship between clinical severity of chronic periodontitis and changes in periodontal microflora. The observed shift from predominantly aerobic microorganisms in mild disease to anaerobic pathogenic bacteria in severe periodontitis supports the concept of microbial succession during disease progression. These findings emphasize that periodontal destruction is not solely dependent on bacterial presence but also on the ecological balance within the subgingival environment. Anaerobic bacteria appear to play a critical role in sustaining chronic inflammation and promoting tissue breakdown. Understanding the association between clinical parameters and microbiological characteristics may facilitate more accurate disease staging and support individualized periodontal treatment strategies. 5. Conclusions Clinical severity of chronic periodontitis is closely associated with qualitative and quantitative changes in periodontal microflora. The progression of the disease is characterized by a shift toward anaerobic pathogenic microorganisms, accompanied by increased periodontal tissue destruction. These findings highlight the importance of integrating clinical and microbiological assessments in the diagnosis and management of chronic periodontitis. References 1. Budtz-Jørgensen, E.; Lombardi, T. 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