IMPACT OF GASTROINTESTINAL TRACT DISEASES ON CARIES DEVELOPMENT, PROGRESSION, AND THE EFFECTIVENESS OF ORTHOPEDIC PROSTHETIC TREATMENT

The relevance of the study is due to growing evidence of a close relationship between gastrointestinal pathology and the development of dental diseases, including caries and complications of removable and fixed prosthetics. The aim of the study is to systematize and analyze the scientific literature on modern views on the influence of gastrointestinal pathology on the development and course of caries, as well as on removable and fixed prosthetics with orthopedic structures. The literature review was carried out by searching the PubMed, Web of Science, Scopus and Google Scholar databases using MeSH terms. The results of the analysis indicate that the main pathophysiological mechanism of the negative impact of gastrointestinal pathology is a change in the acid-base balance and composition of saliva, which leads to enamel demineralization, reduced adhesion of dental materials, increased risk of secondary caries, prosthetic stomatitis and candidiasis. Gastroesophageal reflux is associated with frequent episodes of acid exposure of enamel and the formation of erosions, Helicobacter pylori-associated gastritis reduces the buffer capacity of saliva and impairs its antibacterial properties, and chronic inflammatory bowel diseases cause a decrease in the bioavailability of calcium and other trace elements. It has been established that such changes significantly affect the success of denture fixation, the stability of orthopedic structures and the frequency of complications in the post-prosthetic period. The findings confirm the need for an interdisciplinary approach to treatment, which includes a preliminary gastroenterological examination, determination of saliva pH and composition, remineralizing therapy, and the use of materials with increased resistance to acid action. Prospects for further research include conducting multicenter clinical trials to develop unified international recommendations for orthopedic treatment of patients with concomitant gastrointestinal pathologies.