自发性牙周炎手术治疗后创面骨组织形态计量指标伴机体反应性不同功能状态

IF 0.1 Q4 MEDICINE, GENERAL & INTERNAL
Y. Yarov
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引用次数: 0

摘要

在牙周手术中,利用血小板富集血浆、定向组织再生技术、应用各种骨塑材料等先进技术得到广泛应用。尽管取得了毋庸置疑的成就,但仍存在术后并发症的风险。本研究的目的是研究自发性牙周炎伴机体正常、高或低反应性手术治疗后伤口愈合阶段的强度和持续时间。材料和方法。本研究选用Wistar大鼠90只,体重270±58克,年龄11-12月龄,自发性牙周炎的非线性成年白色雄性大鼠。根据动物机体的反应状态,这些动物被分成三组。所有动物均行牙周组织手术,三组各一半行皮瓣手术,另一半行骨成形术(Kolapan-L、Hypro-sorb F),用形态计量学方法测定微循环床、结缔组织和骨肉芽组织、骨小梁、骨髓腔、多形核白细胞、淋巴细胞、巨噬细胞、浆细胞的比重。对自发性牙周炎伴机体活动不正常的动物的骨创面制剂进行形态计量学研究,可以确定创面过程中的以下愈合阶段:退行性炎症变化(第10天),修复过程增加(第20天)和活跃的再生(第30天)。在高反应性和低反应性的情况下,伤口愈合阶段的强度和持续时间不同。在高反应的情况下,粒细胞-巨噬细胞反应表达较多,持续时间也较长,直至第20天,因此到第30天才能观察到再生的迹象。低反应时,粒细胞反应出现较晚(仅在第20天),持续时间较长,第30天出现活跃再生迹象。无论伤口中是否存在骨成形性材料,所识别的模式都会发生。在无活性的情况下,伤口处理阶段的强度和时间是最优的。在反应受损(高或低)的情况下,细胞期强度(增加或减少)和期(加速或减慢)的改变导致骨创面愈合延迟,即观察到一个复杂的过程。它证明了开发靶向药物纠正方法的可行性和必要性,以将身体反应性受损的伤口过程阶段转变为典型的正常作用阶段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Morphometric indicators of wound bone tissue condition after surgical treatment of spontaneous periodontitis accompanied by different functional state of organism reactivity
In periodontal surgery, advanced technologies such as the use of platelet-enriched plasma, the technique of directed tissue regeneration, applying various osteoplastic materials are widely spread. Despite the undoubted achievements, there is a risk of postoperative complications. The aim of the work was to study the intensity and duration of the wound healing phases after surgical treatment of spontaneous periodontitis accompanied by normo-, hyper- or hyporeactivity of the body by bone morphometry. Materials and methods. Wistar rats were selected for the study ‒ 90 nonlinear white adult male rats weighing 270 ± 58 grams, aged 11–12 months with spontaneous periodontitis. The animals were divided into three equal groups depending on the condition of their organism reactivity. All the animals underwent surgery on the periodontium: one half of the animals in each of the three groups underwent flap operations, the other – flap operations with osteoplasty (Kolapan-L, Hypro-sorb F). The specific weight of microhemocirculatory bed, connective tissue and bone granulation tissue, bone trabeculae, bone marrow cavities, polymorphonuclear leukocytes, lymphocytes, macrophages, plasma cells was studied by a morphometric method. Results. Morphometric study of bone wound preparations from animals with spontaneous periodontitis accompanied by normoreactivity of the body has allowed to identify the following phases of healing during the wound process: degenerative-inflammatory changes (the 10th day), an increase in reparative processes (the 20th day) and active regeneration (the 30th day). In cases of hyper- and hyporeactivity, the intensity and duration of the wound healing phases differed. In case of hyperreaction, the granulocyte-macrophage reaction was more expressed and lasted longer until the 20th day, therefore later, only on the 30th day, the signs of regeneration could be observed. In case of hyporeaction, the granulocyte reaction appeared later (only on the 20th day) and lasted longer, signs of active regeneration were noticed later, on the 30th day. The identified patterns occurred regardless of the absence or presence of osteoplastic material in a wound. Conclusions. In case of normoreactivity, the intensity and timing of the wound process phases were optimal. In case of impaired (hyper- and hypo-) reactions, altered intensity of the cellular phase (increased or decreased) and terms (accelerated or slowed down) resulted in delayed bone wound healing, that is, a complicated course was observed. It justifies the feasibility and necessity of developing methods of targeted drug correction for transforming the wound process phases with impaired body reactivity into those that are typical of normoreaction.
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Zaporozhye Medical Journal
Zaporozhye Medical Journal MEDICINE, GENERAL & INTERNAL-
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