PhD, associate professor Nikonov A.Y.,
student Garbuz O.M., student Sergiyenko M.O.
Kharkiv national medical university
RESEARCH IN THE DYNAMICS OF MORPHOLOGICAL SIGNS OF GUM
INFLAMMATION BY USING METAL ORTHOPEDIC DENTAL
CONSTRUCTIONS
To assess the condition of the oral mucosa it is necessary to carry out a complex
morphological analysis in patients with intolerance to dental constructions [1,2].
Morphological research should be an important step of dental examination when carrying
out difficult orthopedic manipulations. Understanding of the nature and severity of the
pathological process, as well as of the emerging compensatory-adaptive and regenerative
reactions determines the need for a morphological examination of the oral mucosa [3,4].
The purpose of our research was to study regularities and pathologic features of the
pathomorphological reorganization of the mucous membrane of the prosthetic bed by using
metal orthopedic dental constructions.
The biopsy material of the mucous membrane of the prosthetic bed in the area of
metal bridge-like denture was used for this pathomorphological research. A group of
patients was assembled with regards to the problems of this research. It was assembled of
fifteen dental patients from 29 to 46 years old. In the oral cavities these patients had
orthopedic metal constructions made of stainless steel with nitride-titanic covering.
In order to obtain objective properties of the processes in the mucosa of the gum we
took specimens in the pathological focus and on its boundary with healthy tissue under
local anaesthesia. The gathering of specimens was carried out at about the same time – 10
o’clock, dimensions of the biopsies did not exceed 1 mm3, and morphological
examinations were carried out [5].
Results of the research. Histological changes in the mucosa of the gums of the
patients from the experimental group were polymorphic and were visualized by signs of
long traumatic inflammation, emergence of parakeratosis, keratosis, hyperkeratosis and
acanthosis. The result of the incurred changes is disorder of normal regenerative processes
with epithelial barrier damage.
First of all, it should be noted that in the underepithelial tissue of the mucous
membrane of the gum, both in papillary and reticulate layers, diffusion infiltration mainly
by lymphocytes, plasmatic cells, fibrocytes and fibroblasts is found. The vessels of the
reticulate layer are sharply widened with parietal location of erythrocytes and appearance
of fibrous connecting tissues around them coloured in red according to Van-Gizon.
In some of the histological preparations a moderately expressed proliferation of the
epithelium of basal parts is observed. As a result of this process, the nuclei of the cells
become rod-shaped, elongated and contain heterochromatin. The variety of morphological
changes is characterized by a combination of keratosis and acanthosis, where slight
discomplexation of the nuclei of the epithelial basal layer and its focal proliferation is
detected. Opposite proccesses in the form of atrophy of the epithelial layer with areas of
keratinization and densely cellular lymphohistiocytic infiltration takes place in rare cases.
Conclusions. Thus, on the basis of the abovementioned, we can make the following
conclusions. Longtime presence of a metal orthopedic non-removable bridge-like denture
with nitride-titanic covering in the oral cavity causes chronic inflammation in the area of
the prosthetic bed; it leads to keratosis of the mucous membrane. In turn, the presence of
acanthosis and keratosis in the mucosa is usually accompanied by persisting inflammation
with occurrences of dysplastic processes of the mucous membrane of the gums with an
associated reduction of regenerative processes in the surface epithelium, which is
consistent with our previous studies [6].
ЛИТЕРАТУРА
1. Леоненко П.В. Дифференциально–диагностические критерии клинических
форм непереносимости сплавов металлов зубных протезов / П. В. Леоненко //
Современная стоматология. – 2003. – № 1. – С. 104-108.
2. Марков
Б.П.
Комплексный
подход
к
проблеме
индивидуальной
непереносимости стоматологических конструкций из различных материалов /
[Марков Б. П., Козин В. Н., Джириков Ю. А. и др.] // Стоматология. – 2003. –
№ 3. – С. 47-51.
3. Мельников О.Ф. Состояние местного иммунитета в ротовой части глотки у
лиц с зубными протезами из различных материалов / Мельников О. Ф., Флис
П. С., Бобокал А. Н. // Журнал вушних, носових і горлових хвороб. – 2003. – №
3. – С. 24-26.
4. Prtoumeno E. Corrosion susceptibility and nickel release of nickel titanium wires
during clinical application / [Prtoumeno E., Kislyuk M., Hoederath H. et all] // J. of
Orofacial Orthopedics. – 2008. – Vol. 69 (6). – P. 411-423.74.
5. Пирс Э. Гистохимия / Пирс Э. // М.: Иностранная литература. – 1962. – 962с
6. Ніконов А.Ю. Клінічний досвід використання золотого гальванопокриття
зубних протезів / А. Ю. Ніконов // Укр. мед. альманах. – 2005. – Т. 8, № 2. – С.
105-107.