CLINICAL AND MORPHOFUNCTIONAL CHANGES IN THE ORAL MUCOSA IN NEWBORNS AFTER DENTAL TREATMENT OF CANDIDAL INFECTION

Abstract

Oral mucosal candidiasis is one of the most common infectious and inflammatory pathologies of the neonatal period and maintains high clinical significance in modern pediatrics and pediatric dentistry [1, 2]. According to domestic and foreign authors, the incidence of oropharyngeal candidiasis in newborns varies from 20 to 40%, which is due to a combination of anatomical, physiological and immunological features of early postnatal development [3, 9]. The oral mucosa of newborns is characterized by morphological immaturity, high permeability of the epithelial barrier, insufficient keratinization and functional failure of local defense mechanisms [1, 4]. These features create favorable conditions for the adhesion and invasion of Candida fungi, which, under conditions of reduced resistance of the mucous membrane, quickly pass from a saprophytic state to a pathogenic one [8, 9]. The development of candidal infection is accompanied by pronounced clinical and morphological changes in the oral mucosa, including inflammatory infiltration, dystrophic and desquamative changes in the epithelium, impaired cellular regeneration processes and a decrease in the barrier function of the mucosa [2, 4]. In newborns, these changes are of particular clinical significance, since they lead to a violation of the sucking reflex, a decrease in nutritional status, the formation of pain syndrome and an increased risk of secondary infection [9]. Despite the availability of modern antifungal drugs and developed treatment regimens, in clinical practice the main attention is usually paid to the elimination of the clinical manifestations of candidal infection, whereas the structural and functional restoration of the oral mucosa after treatment remains insufficiently studied [3, 8]. The available scientific literature is dominated by studies devoted to the evaluation of the clinical effectiveness of therapy, while data on the dynamics of morphofunctional changes in the mucous membrane in newborns are fragmentary [4, 7]. The study of the morphofunctional state of the oral mucosa in the neonatal period is particularly relevant, since this stage of ontogenesis is characterized by high tissue plasticity and intensive epithelial differentiation processes [1, 2]. Disruption of these processes against the background of infectious and inflammatory lesions can have an adverse effect on the further formation of the orofacial region and the resistance of the mucosa to infectious agents in subsequent age periods [6].

In this regard, conducting a comprehensive clinical and morphofunctional analysis of the oral mucosa in newborns after dental treatment for candidal infection is scientifically sound and timely. The data obtained will allow us to objectively assess the effectiveness of the treatment, expand our understanding of the mechanisms of epithelial restoration in the early neonatal period, and substantiate the need for a comprehensive dental approach in the care of this patient population [3, 5].

Thus, the high prevalence of candidal infection in newborns, the severity of morphofunctional disorders of the oral mucosa, as well as insufficient study of the processes of its restoration after dental treatment determine the relevance of this study and its significance for practical dentistry and neonatology.