MONITOROWANIE SKUTECZNOŚCI LECZENIA PRÓCHNICY ZĘBÓW MLECZNYCH U DZIECI W OBWODZIE POŁTAWSKIM

Olha V. Sheshukova, Valentina P. Trufanova, Tetiana V. Polishchuk, Kateryna S. Kazakova, Sofiya S. Bauman, Natalia A. Lyakhova, Iryna M. Tkachenko

The Higher State Educational Establishment of Ukraine“Ukrainian Medical Stomatological Academy”, Ukraine, Poltava

Abstract

Introduction: Dental caries is still a major health care problem not only in Ukraine but throughout the world. Complicated dental caries currently ranks the leading position among the oral diseases in children.

The aim of this study is to carry out a analysis of the epidemiology of dental caries and its complications, and to evaluate the efficiency of the caries treatment for temporary teeth among the children of Poltava oblast over the last decade based on the data of the annual reports.

Materials and methods: We have studied the figures reflecting the epidemiology of dental caries and its complications in Poltava oblast over the past ten years obtained through the analysis of the annual reports on the quantitative and qualitative indicators of paediatric dental service.

Review: According to the annual reports from the districts, the number of cases of temporary teeth treatment for complicated caries did not change significantly when comparing the relevant data of 2007 and 2017. When carrying out the comparative analysis of annual reports for 2007 and 2017 by the indicator of the share of complicated caries, attention should be focused on the average increase of the value from 30.4% in 2007 to 35.9% in 2017.

Conclusions: The analysis of annual reports for 2007 and 2017 through Poltava oblast points out the low efficiency of dental caries management in the children’s temporary teeth. As a result, outcomes of the dental caries treatment and caries complications in the children’s temporary teeth are assessed as unsatisfactory both in the preventive and the therapeutic aspects.

Wiad Lek 2018, 71, 3 cz. II, -767

 

Introduction

Dental caries is still a major health care problem not only in Ukraine but throughout the world. Caries is known as the most prevalent chronic disease among children and occurs five times more often than asthma, four times more often than obesity, and twenty times more often than diabetes. Leading experts in cariology consider that dental caries is a disease that can never be eliminated due to the complex interaction of cultural, social, behavioural, nutritional and biological risk factors triggering the diseases and contributing into its progression [1,2].

Complicated dental caries currently ranks the leading position among the oral diseases in children. Failures to invest in preventive dental care have led to deplorable consequences. The high prevalence of complicated caries affecting both temporal and permanent teeth indicates an inadequate efficiency in managing the diseases including approaches and measures of caries prevention and treatment, which sometimes are far from been perfect [3,4,5, 6].

Unfortunately, parents hardly realize the importance of regular oral cavity sanation in keeping oral health of their children that in many instances results in the occurrence of unsatisfactory or sometimes even severe consequences. Left untreated, chronic caries of temporary teeth and its complication, periodontitis first of all, often serve as sources of chronic intoxication of the child’s body and impact the general health by triggering inflammation or keeping it in other body organs and systems. Such diseases as endocarditis, rheumatoid arthritis, nephritis, tonsillitis can be associated with caries progression as evidenced in relevant reports [7, 8].

Consequences caused by local inflammation in the periodontal structures of a temporary tooth are very serious as well starting from enamel hypoplasia up to the death of the dental germ of a permanent tooth and the formation of odontogenic cyst with subsequent complicated osteomyelitis of a jaw bone, and as a result – delayed growth of the jaw, occurrence of a variety of orthodontic problems [9].

To elaborate the regional programs in order to enhance the efficiency of measures in caries prevention, it is necessary to assess the prevalence and the severity of dental caries, i. e. characteristics of caries epidemiology typical for a particular region, common caries complications and to evaluate the effectiveness of the treatment of complicated and uncomplicated forms of dental caries.

The Aim

The aim of this study is to carry out a detailed analysis of the epidemiology of dental caries and its complications, and to evaluate the efficiency of the caries treatment for temporary teeth among the children of Poltava oblast over the last decade based on the data of the annual reports provided by the municipal dental settings throughout the Poltava oblast.

Materials and methods

We have studied the figures reflecting the epidemiology of dental caries and its complications in Poltava oblast over the past ten years (2007 – 2017) obtained through the analysis of the annual reports on the quantitative and qualitative indicators of paediatric dental service performance provided by the municipal dental settings throughout the oblast.

The following indicators were taken as representative characteristics and then scrutinized:

1. Prevalence and intensity of dental caries in temporary teeth among 6-year-old children;

2. The proportion of complicated caries: this indicator is calculated as a ratio between the number of the teeth with complicated caries, i.e. the sum of the teeth filled to arrest complicated caries and teeth removed (missing) due to the same reason, and the number of temporary teeth filled due to uncomplicated caries.

3. The ratio between teeth, which have been treated due to uncomplicated caries and the teeth with complicated caries;

4. The ratio between the teeth restored due to complicated caries and the teeth extracted for the same reason.

The Indicators mentioned above were calculated for each district (rayon), for cities where there are specialized dental clinics (Poltava, Kremenchuk, Horinshni Plavni) and for the Poltava oblast in general. The comparison of the findings was based on the analysis of annual reports for 2007 and 2017 years.

Review and discussion

The study of the data presented in the annual reports has revealed that in 2007 the prevalence of dental caries among 6-year-old children in Poltava oblast made up 66.0%, and up to 2017 it went up 65.6%, with the intensity of 2.3 ± 0.22 and 2,2 ± 0.21, respectively, i.e., the indices did not differ significantly. At the same time, in some districts, the prevalence of dental caries among the children in this age group reached over 80% (Table I).

The most dramatic situation was found out in Khorol and Orzhytsia districts, and in the city of Horishni Plavni.

The high values of the indicators of complicated caries shown in the (Table II) require a particular attention to. According to the annual reports from the districts, the number of cases of temporary teeth treatment for complicated caries did not change significantly when comparing the relevant data of 2007 and 2017 (19858 and 19735 teeth, respectively). However, the number of complicated caries in temporary teeth registered in some cities and districts of the oblast has almost doubled. For example, in Poltava, in 2007, a number of 2669 temporary teeth were reported to have been treated for complicated caries, while in 2017 this number went up to 4336 teeth that points out the progression of complicated caries. A similar situation is observed in the city of Kremenchuk, where in 2007, according to the reports, 2791 temporary teeth with complicated caries were treated, while in 2017 this number reached 4216 teeth, and in the city of Horynshni Plavni, where in 2007, 413 teeth were reported as cured, while in 2017 this figure rose to 923 teeth. In Hlobyne district this figure doubled from 771 teeth in 2007 to 1420 teeth in 2017. Thus, we can conclude that there is a tendency towards twofold increase in the number of temporary teeth treated for complicated caries in 2017 compared with 2007 that is the evidence of growing prevalence and intensity of dental caries.

However, in Poltava oblast, according to the analysis conducted, there are districts that have been found out to report the significantly reduced number of temporary teeth, which have been treated for complicated dental caries. Thus, in Myrhorod and Shyshaky districts this figure changed nearly fivefold – from 1442 to 292 teeth and from 111 to 29 respectively, in Gadyach district it decreased approximately twofold, from 690 to 314 teeth, the same tendency was observed in Kobeliaky district – from 693 to 343 teeth, in the city of Poltava from 859 to 402 teeth; in Lubny district this figure lowered from 1219 to 879 teeth, and in Pyryatyn district – from 1732 to 699 teeth.

We suggest this dynamics in the treatment of complicated caries in temporary teeth may be explained by the expansion of the network of private dental offices, which did not submit their reporting. On the other hand, in some districts over the past 10 years, the positions of paediatric dentists were reduced therefore parents had to seek for dental care in the nearest cities.

Complicated dental caries of temporary teeth is the commonest cause of an outpatient surgical operation – tooth extraction. Although over the past decade, the number of temporary teeth extracted due to complicated caries somewhat increased (by 1328 teeth, from 11288 to 12616 teeth respectively). It has been determined that in 2007 in the city of Poltava complicated caries was the primary cause for extracting 3583 temporary teeth, and in 2017 6293 teeth were extracted for the same reasons that is almost twice as much. Nearly the same situation has been revealed in the Hlobyne district (from 460 to 716 temporary teeth removed), Semenivka district (from 195 to 274 teeth removed), and in Reshetylivka district the number of teeth extracted for the reasons of complicated caries increased in four times, from 186 teeth in 2007 to 827 teeth in 2017.

At the same time, there are districts, where we registered the decrease in the number of teeth extracted for complicated caries, among them the city of Horishni Plavni, where the number of teeth extracted dropped from 633 to 112 teeth, Lubny district, where 55 teeth were reported to be extracted in 2007 versus none in 2017, Mashivka district, where the number of teeth extracted went down from 173 to 54, the city of Poltava (from 175 teeth to 74 teeth) and Myrhorod district, which demonstrated seven-fold drop from 758 teeth in 2007 to 102 teeth in 2017.

The main indicator characterizing the quality of caries treatment is the share of the cases of complicated caries: this indicator shows the ratio between the number of teeth with complicated forms of caries, i.e. the sum of the number of temporary teeth filled due to complicated caries and teeth extracted for the same reason, and the number of temporary teeth filled due caries. We consider this indicator is relevant to clearly demonstrate the effectiveness of the caries treatment performed in a particular dental setting: the lower the percentage of the indicator, the less number of children with caries complications asked for dental treatment, and, accordingly, the larger number of children has escaped complicated caries.

Data for 2007 show that the relative indicator of the share of complicated is an average 30.4% throughout Poltava oblast (Table III).

Based of the analysis of the indices demonstrating the share of complicated caries, we divided all the districts into 3 groups: 12 districts had the indicators of the share of complicated forms of caries less than the average value (the city of Poltava – 23.9, Karlivka district – 11.7, Kozelshchyna district – 23.9, Kremenchuk district – 20.2%, Lubny district – 20.8%, Novi-Sanzhary district – 14.5%, Poltava district – 19.6%, Reshetylivka district – 28.3%, Semenivka district – 18.1%, Khorol district – 21.5%, Chutove district – 10.5%; Shishaky district – 27.8%;); 4 districts with the indicators close to the average values and 12 districts with indicators that significantly exceed the average values (the city of Kremenchuk – 50.9%, Velika Bahachka district – 119.9%, Hrebinka district – 38.2%, Dykanka district – 53.4%, Kobeliaky district – 43.1%, Kotelva district – 43.6%, Lokhvytsa district – 46.4%, Mashivka district – 40.9%, Myrgorod district – 40.9%, Orzhytsia districts – 64.3%, Pyriatyn district – 50.7%, Chornukhy district – 43.6%).

The prevalence of caries complications among the diseases of hard tissues in temporary teeth indicates the low efficiency of the secondary prevention and the untimely sanitation of the oral cavity in preschoolers. Therefore, we classified the districts where this indicator exceeded the average values, as unfavourable in terms of providing paediatric dental care. It should be noted that in some districts this indicator overstepped the average values in several times. The indices obtained in Orzhytsya district (64.3%), were more than twice as much as the average, and in the Velyka Bahachka district (119.9%) this indicator exceeded the average values in four times. That is, the number of restoration cases of complicated forms of caries exaggerates the number of temporary teeth with uncomplicated caries.

When carrying out the comparative analysis of annual reports for 2007 and 2017 by the indicator of the share of complicated caries, attention should be focused on the average increase of the value from 30.4% in 2007 to 35.9% in 2017. Significant exceeding of the indicator over the average value in 2017 in Hlobyne, Kotelva, Reshytylivka and Khorol districts should compel dental professionals’ attention as the situation in these districts has considerably deteriorated compared with 2007 that is regarded as a warning and requires in-depth analysis of the problems and implementing the effective approaches to improve the efforts in providing paediatric dental care in these district.

For more detailed analysis of the treatment efficiency for temporary teeth, we calculated the ration between the teeth with uncomplicated caries, which had been treated for uncomplicated caries and teeth treated for complicated caries: the mean indicator for Poltava oblast was 5.2: 1 in 2007 and 4.6: 1 in 2017. We also found out a number of the districts in which this indicator was significantly lower than the average values in 2007 (the city of Kremenchuk – 3,7: 1, Gadyach district – 2,9: 1, Hrebinka district – 2,8: 1, Dykanka district – 3, 5: 1, Kobeliaky district – 3,3: 1, Kotelva district – 2,7: 1, Lokhvitsa district – 2,8: 1, Myrhorod district – 3,7: 1, Orzhitsia district – 2,3: 1, Pyriatyn district – 2,2: 1 and Chornukhy district – 2.3: 1). No particular changes were found in these districts in 2017, but only in Reshetylivka and Hlobyne districts the situation dramatically deteriorated and the number of cases of complicated caries became higher than the mean value through Poltava oblast.

The analysis of the ratio between temporary teeth treated for complicated caries and teeth extracted for the same reason demonstrated the identical tendency. In the city of Kremenchuk and Dykanka, Zinkiv, Mashivka, Chutove and Novi Sanzhary districts, this indicator is approaching 1:1 (Table IV). This is regarded as a threatening situation for preserving temporary teeth until the period of their physiological replacement with permanent descendants that can lead to the development of dento-facial disorders.

Conclusions

The analysis of annual reports for 2007 and 2017 through Poltava oblast points out the low efficiency of dental caries management in the children’s temporary teeth. As a result, outcomes of the dental caries treatment and caries complications in the children’s temporary teeth are assessed as unsatisfactory both in the preventive and the therapeutic aspects. In a decade, i.e. in 2017, the relative indicator of the proportion of complicated forms of dental caries somewhat increased and made up at average 35.9% in the oblast.

The study has revealed the simultaneous increase in the share of complicated caries and exceeding the ratio of temporary teeth removed due to dental caries over the teeth with complicated caries that have been treated with therapeutic techniques. Taken together, these data, in our opinion, indicate inadequate attention to the oral cavity sanation in children. The decline in the efficiency of primary prevention and oral cavity sanation in preschoolers and junior schoolchildren may be likely due to lack of funding and the scarcity of paediatric dentists in many districts of the oblast. Such a state of affairs requires immediate boosting of both primary and secondary measures in order to prevent dental diseases among the children that must be the first priority for the paediatric dental care services through Poltava oblast.

References

1. E. D. Beltrán-Aguilar, L. K. Barker, M. T. Canto et al. Surveillance for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis. United States, 1988–1994 and 1999–2002 MMWR. Surveillance Summaries, 2005, Vol. 54 (03):1–44.

2. O. V. Klitynska,  Y.Y. Kostenko, V.R. Gurando. Determination of criteria early caries diagnostics in children of different ethnic groups domiciled in biogeochemical deficiency of fluorine and iodine. Journal of Stomatology. 2016. Vol. 70 (1), Issue 1: 51-56.

3. Sheshukova O.V Pokaznyky yakosti likuvannia uskladnen kariiesu tymchasovykh zubiv u ditei Poltavskoi oblasti. Visnyk stomatolohii, 2005, Spetsialnyi vypusk 2:113 – 115.

4. Oral Health in America:A Report of the US Surgeon General. US Department of Health and Human Services; National Institute of Dental and Craniofacial Research; US Public Health Service. Washington, Sept. 2000.

5. O.V. Sheshukova, V.P. Trufanova. Pokaznyky stomatolohichnoho zdorovia ditei u rehioni z vysokym umistom ftoru v pytnii vodi. Ukrainskyi stomatolohichnyi almanakh, 2005.5:42 – 44.

6. Natalia A. Lyakhova, Svetlana S. Kasinets. The preexposure prophylaxis of stomatological diseases among the population of Ukraine in the practice of the family doctor and the pediatrician. Wiadomości Lekarskie 2017, tom LXX, 3 cz I:470-473

7. A.V.Mitronin. I.D.Ponyakina. Izucheniye vliyaniya khronicheskogo apikalnogo periodontita na sostoyaniye organizma patsiyenta. Stomatologiya, 2007.6:26 – 29.

8. D.F. Kinane, G.D. Lowe. How periodontal disease may contribute to cardiovascular disease. Periodontology, 2000, Vol.23: 121 –126.

9. Sheshukova O.V. Vplyv khronichnoho zapalennia periodonta tymchasovoho zubu na rezorbtsiiu yoho koreniv. Ukrainskyi stomatolohichnyi almanakh. – 2005,6(56): 51 –53.

ADDRESS FOR CORRESPONDENCE

Valentina P. Trufanova

Shevchnka st. 23, 36011, Poltava, Ukraine

tel: +380505910092

e-mail: trufanovav4@gmail.com

Received: 06.03.2018

Accepted: 14.05.2018

Table I. Affection of temporary teeth with dental caries in 6-year-old children of Poltava oblast

District

Caries prevalence, %

Caries intensity, (dft)

2007

2017

2007

2017

1

The city of Poltava

61,3

62,5

1,9

1,3

2

The city of Kremenchuk

78,0

62,5

3,2

2,5

3

The city of Horishni Plavni

71,0

83,0

2,6

1,7

4

Velyka Bahachka D.

32,0

36,0

2,3

2,6

5

Hadiach D.

74,0

72,4

1,9

2,1

6

Hlobyne

72,0

72,1

2,5

2,6

7

Hrebinka

72,8

73,0

2,1

2,3

8

Dykanka

49,0

56,0

1,8

2,3

9

Zinkiv

69,0

69,0

2,0

2,1

10

Karlivka

64,0

66,0

2,4

2,1

11

Kobeliaky

46,1

52,3

1,8

2,4

12

Kozelshchyna

73,0

72,0

2,4

2,5

13

Kotelva

72,0

72,0

2,0

2,3

14

Kremenchuk

77,0

78,4

2,5

2,3

15

Lokhvytsia

57,0

58,0

2,4

2,4

16

Lubny

49,3

56,8

2,9

2,7

17

Mashivka

76,0

75,0

2,0

2,1

18

Myrhorod

57,0

53,2

1,9

1,9

19

Novi Sanzhary

53,0

53,0

2,6

2,4

20

Orzhytsia

82,0

75,0

2,3

2,0

21

Pyriatyn

68,0

57,1

1,2

2,2

22

Poltava

67,0

68,0

2,5

2,1

23

Reshetylivka

63,8

64,2

3,1

3,2

24

Semenivka

72,4

76,0

2,4

2,4

25

Khorol

86,0

84,0

2,5

2,1

26

Chornukhy

72,0

68,2

2,4

2,3

27

Chutove

73,0

72,0

2,4

2,4

28

Shyshaky

58,0

50,0

1,8

1,8

Total

 

66,0

65,6

2,3

2,2

Table II. Affection of temporary teeth with complicated forms of dental caries in children of Poltava oblast

Districts

Teeth have been treated for complicated caries, n

Teeth have been extracted for complicated caries, n,

2007

2017

2007

2017

1

The city of Poltava

2669

4336

3583

6293

2

The city of Kremenchuk

2791

4216

2541

1976

3

The city of Horishni Plavni

413

923

633

112

4

Velyka Bahachka

210

322

37

22

5

Hadiach d.

690

314

31

48

6

Hlobyne d.

771

1420

460

716

7

Hrebinka d.

136

140

11

13

8

Dykanka d.

204

119

180

111

9

Zinkiv d.

738

490

469

452

10

Karlivka d.

288

375

123

201

11

Kobeliaky d.

693

343

305

220

12

Kozelshchyna d.

342

457

110

76

13

Kotelva d.

480

705

78

56

14

Kremenchuk d.

805

874

307

218

15

Lokhvytsia d.

398

550

121

91

16

Lubny d

1219

879

55

17

Mashivka d.

215

146

173

54

18

Myrhorod d.

1442

292

758

102

19

Novi Sanzhary d.

183

154

85

116

20

Orzhytsia d.

113

168

56

16

21

Pyriatyn d.

1732

699

191

119

22

Poltava d.

859

402

175

74

23

Reshetylivka d.

423

353

186

827

24

Semenivka d.

325

547

195

274

25

Khorol d.

266

233

321

312

26

Chornukhy d.

291

147

27

27

Chutove d.

167

102

62

80

28

Shyshaky d.

111

29

42

8

Total

 

19858

19735

11288

12616

Table III. Indicators of the efficiency of the treatment of complicated caries in temporary teeth among the children of Poltava oblast

Districts

Teeth treated in 2007, n

Teeth treated in 2017, n

Total

Caries

Complicated caries

Ratio

Total

Caries

Complicated caries

Ratio

1

The city of Poltava

28792

26123

6252

23,9

32144

27808

10629

38,2

2

The city of Kremenchuk

13263

10472

5332

50,9

19019

14803

6192

41,8

3

The city of Horishni Plavni

3635

3222

1046

32,5

6696

5773

1035

17,9

4

Velyka Bahachka

2084

1874

2247

119,9

1678

1356

344

25,4

5

Hadiach d.

2031

1971

721

36,6

1349

1035

362

34,9

6

Hlobyned.

4630

3859

1231

31,9

3602

2182

2136

97,9

7

Hrebinka d.

521

385

147

38,2

502

362

153

42,3

8

Dykanka d.

923

719

384

53,4

377

258

130

50,4

9

Zinkiv d.

4121

3383

1207

35,7

2451

1961

942

48,0

10

Karlivka

3799

3511

411

11,7

1777

1402

576

41,1

11

Kobeliaky d.

3009

2316

998

43,1

1616

1273

563

44,2

12

Kozelshchyna d.

2229

1887

452

23,9

2327

1870

533

28,5

13

Kotelva d.

1760

1280

558

43,6

1717

992

761

76,7

14

Kremenchuk d.

6305

5500

1112

20,2

6161

5287

1092

20,7

15

Lokhvytsia d.

1516

1118

519

46,4

1698

1148

641

55,8

16

Lubny d.

7352

6133

1274

20,8

6051

5172

879

16,9

17

Mashivka d.

1149

934

388

41,5

848

702

200

28,5

18

Myrhorod d.

6824

5382

2200

40,9

2949

2357

394

16,7

19

Novi Sanzhary d.

2036

1853

268

14,5

1952

1798

270

15,0

20

Orzhytsia d.

376

263

169

64,3

519

351

184

52,4

21

Pyriatyn d.

5526

3794

1923

50,7

2217

1518

818

53,9

22

Poltava d.

6143

5284

1034

19,6

4610

4208

476

11,3

23

Reshetylivka d.

2572

2149

609

28,3

1675

1322

1180

89,3

24

Semenivka d.

3205

2880

520

18,1

2813

2266

821

36,2

25

Khorol d.

2995

2729

587

21,5

1175

942

545

57,9

26

Chornukhy d.

958

667

291

43,6

937

790

174

22,0

27

Chutove d.

2343

2176

229

10,5

960

858

182

2,1

28

Shyshaky d.

661

550

153

27,8

468

439

37

8,4

Total

 

122272

102414

31146

30,4

20505

90233

32351

35,9

Table IV. Analysis of the treatment efficiency for complicated and uncomplicated caries of temporary teeth in children of Poltava oblast

Districts

Ratio between teeth, which have been treated for uncomplicated caries and teeth treated for complicated caries

Ratio between teeth, have been treated for complicated caries and teeth extracted due to complicated caries

2007

2017

2007

2017

1

The city of Poltava

9,8:1

6,4:1

7,5:1

6,9:1

2

The city of Kremenchuk

3,7:1

3,5:1

1,1 :1

2,1:1

3

The city of Horishni Plavni

7,8:1

6,3:1

6,5:1

8,2:1

4

Velyka Bahachka d.

8,9:1

4,2:1

5,7:1

14,6:1

5

Hadiach d.

2,9:1

3,3:1

22,3:1

6,5:1

6

Hlobyne d.

5,0:1

1,5:1

1,7:1

1,9:1

7

Hrebinka d.

2,8:1

2,6:1

12,4:1

10,9:1

8

Dykanka d.

3,5:1

2,2:1

1,1:1

1,1:1

9

Zinkiv d.

4,6:1

4,0:1

1,6:1

1,1:1

10

Karlivka d.

1,2:1

3,7:1

2,3:1

1,9:1

11

Kobeliaky d.

3,3:1

3,7:1

2,3:1

1,6:1

12

Kozelshchyna d.

5,5:1

4,1:1

3,1:1

6,0:1

13

Kotelva d.

2,7:1

1,4:1

6,2:1

1,3:1

14

Kremenchuk d.

6,8:1

6,0:1

2,6:1

4,0:1

15

Lokhvytsia d.

2,8:1

2,1:1

3,3:1

6,0:1

16

Lubny d.

5,0:1

5,9:1

22,2:1

17

Mashivka d.

4,3:1

4,8:1

1,2:1

2,7:1

18

Myrhorod d.

3,7:1

8,1:1

1,9:1

2,9:1

19

Novi Sanzhary d.

10,1:1

11,7:1

2,2:1

1,3:1

20

Orzhytsia d.

2,3:1

2,1:1

2,0:1

10,5:1

21

Pyriatyn d.

2,2:1

2,2:1

9,1:1

5,9:1

22

Poltava d.

6,2:1

10,5:1

4,9:1

5,4:1

23

Reshetylivka d.

5,1:1

3,7:1

2,3:1

4,3 :1

24

Semenivka d.

8,9:1

4,1:1

1,7:1

1,9:1

25

Khorol d.

10,3:1

4,0:1

8,3:1

7,5:1

26

Chornukhy d.

2,3:1

5,4:1

5,4:1

27

Chutove d.

13,0:1

8,4:1

2,7:1

1,3:1

28

Shyshaky d.

4,9 :1

15,1 :1

2,6:1

3,6:1

Total

 

5,2:1

4,6:1

1,8:1

1,6:1