Jaw Bones Microarchitectonics and Morphology in Patients With Diabetes Mellitus

The expansion of the most relevant priority fields in fundamental and applied medicine, along with the progress in modern dentistry and reconstructive maxillofacial surgery, requires in-depth understanding of the morphological and functional status of the maxillary alveolar process bone tissue and knowledge of the mandibular alveolar part, thus allowing selecting a reasonable treatment tactics for maxillofacial pathologies. Qualitative features of maxillary alveolar process microarchitectonics, angioarchitectonics, as well as the periodontal ligament arrangement at various levels of the teeth roots, histological and morphometric studies of bone tissue in the frontal and distal sections, as well as the maxillary segments of the maxillary medial incisors and the first molars were studied in 5 certified male cadavers with preserved dentition. The histological findings show, that the microarchitectonics of the maxillary alveolar process features a lamellar bone consists of plates that are adjacent tightly to each other. The bone plates orientation in the frontal section is longitudinal, while in the distal part it is along concentric circles located around the Haversian canals. The angioarchitectonics of the maxillary alveolar process features tubular structures, which run mainly perpendicular to the bone surface, with numerous anastomoses. As the morphometric analysis of the maxillary alveolar process vascular system shows, in the frontal section the number of vessels per 1 mm2 is 22.41± 1.76 - 22.87± 2.08; in the distal section − 23.94± 1.88 - 25.02±2.69 (p≤0.01); the average diameter of vessels in the frontal section is 25.34±2.45 microns – 26.06 ±3.17 microns, in the distal section − 25.72±2.31 microns – 26.14± 2.93 microns (p≤0.05); the average wall thickness in the frontal section is 1.43± 0.09 microns - 1.48± 0.12 microns, in the distal section − 1.50± 0.11 microns – 1.54± 0.14 microns (p≤ 0.01). The vestibular surface of the maxillary medial incisors at the level of the root gingival part, as well as the oral surface at the root apical level have been found to be zones of periodontal ligament compression, while the oral surface at the root gingival level and the vestibular surface at the root apical level – zones of the periodontal ligament stretching. At the root gingival level of the first maxillary molars, the medial and vestibular surfaces are zones of the periodontal ligament compression, whereas the oral and the distal surfaces stand as the zones of the periodontal ligament stretching. As a quantitative assessment showed, the structural elements of the medial incisors periodontal ligament, and the first maxillary molars had loose connective tissue – taken by its specific area – prevailing in the periodontal ligament compression zone; the specific area of dense connective tissue, though, was found to be prevailing at the periodontal ligament stretching zone under chewing stress. The data obtained through a quantitative analysis of the periodontal ligament microvascular bed of the medial incisors, and the first maxillary molars, reveal that the area with blood vessels in the compression zones by far exceeds the area of blood vessels in the stretching zones. It appears rather reasonable that in case of a biomechanical stress experienced by the incisor-maxillary and molar-maxillary segments of the upper jaw, the periodontal ligament morphology will change throughout the root, depending on the compression and stretching zone localization.

Section: Introductionmentioning

confidence: 99%

Histomorphometric Assessment of Architectonics and Vascularization in Maxillary Alveolar Process Bone Tissue

Domenyuk,

Sumkina,

Mikutskaya

et al. 2023

“…Advances in cell biology, regenerative medicine and materials science have turned intraosseous dental implantation into a modern high-tech field in both dentistry and maxillofacial surgery, which has attracted various experts to unite their efforts thus aiming at solving issues related to comprehensive rehabilitation of patients with serious -from the functional point of view -defects and deformities of the face bones, as well as various adentias. A decrease in the alveolar ridge mass caused by progressive bone atrophy affects possible intraosseous implantation due to a high risk of damage that may be caused to the mandibular nerve, the fundus perforation, and a ruptured maxillary sinus mucosa [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Histological and Morphometric Studies of Bone Tissue Autografts From Intraoral and Extraoral Donor Zones

Domenyuk¹,

Sumkina²,

Дмитриенко³

et al. 2023

Major research carried out in modern dentistry and maxillofacial surgery is commonly focused on long-term and stable results for implant rehabilitation of jaw defects and deformities in patients with bone and soft tissue losses at the site of planned implantation. Various osteoplastic materials, donor or the patient’s own bone, tissue-engineering and cellular products are common in clinical medicine, since guided regeneration can help not only recover the volume of bone tissue once lost, yet also ensure an outcome acceptable from both functional and aesthetic view. Guided bone regeneration employs methods of regenerative medicine and tissue engineering, with transplantation of native bone tissue and cell transplants, as well as various osteoplastic materials with osteoinductive and osteoconductive properties. In order to compare the structure of intact bone tissue obtained from intraoral and extraoral donor zones, histological and morphometric studies of bone autografts in 4 certified male cadavers with intact dentition were carried out. The results of histological studies in bone tissue autografts from intraoral and extraoral donor zones revealed that the highest density of bone rods could be observed in biopsies taken from the mandible outer oblique line area and chin symphysis. Whereas the lowest rate of the said factor we observed in the biopsies obtained from the iliac crest area. The highest rate of the inter-rod girder space was found in the area of the iliac crest, and the minimal – in biopsies from the parietal bone. The highest bone vascularization level was identified at the iliac crest and the parietal bone, while its lowest levels were seen in biopsies taken from the area of the mandible outer oblique line. The density of cellular elements was found to be highest at the iliac crest. The lowest density level was registered in biopsies from the area of the mandible outer oblique line. The high rates of cellular elements in autografts from the iliac crest area can be accounted for by the predominance of spongy substance over cortical, while in bone biopsies taken from the mandible outer oblique line, chin symphysis, maxillary tuberosity and parietal bone, the share of cellular elements failed to exceed 27% within the total data set. This points at the predominance of cortical rather than spongy substance. In reconstructive bone plastic surgery for augmentation of the maxillary alveolar process and the mandible alveolar part with significant atrophy, it is reasonable to use autogenous transplants taken from intraoral donor zones. The autogenous transplants have cortical morphology and embryological origin similar to the jaw bones. Bone blocks from the donor zones of the mandible outer oblique line, the chin symphysis and the maxillary tuberosity have the highest density of the bone cortical substance and the duly sufficient amount of spongy substance.

“…Improving histological and histomorphometric approaches and techniques allow expanding the potential of experimental study focusing on hard dental tissues, despite the issues related to their morphological and crystal chemical structure, the small size of the elements, high mineralization and complexity of the structure [29][30][31][32][33]. There is a need for joint efforts taken by specialists involved in various fields of medical knowledge, both clinical and morphological, in order to develop new principles and approaches to preventing, diagnosing and treating hard dental tissue pathologies in Type 1 diabetes [34][35][36][37][38][39][40][41].…”

Section: Introductionmentioning

confidence: 99%

Morphological Features of Dental Tissues in Streptozotocin-Induced Diabetes Mellitus Model

Domenyuk,

Ostrovskaya,

Eremin

et al. 2023

The global issue of diabetes mellitus (DM), which is a serious burden faced by the healthcare systems and economies in many countries, has been increasing steadily in the recent decades. The fast pace of DM growth and prevalence, as well as associated complications (macro- and microangiopathy, neuropathy, nephropathy, impaired vision), high economic costs and social damage, high disability and mortality rates entailed by this disease take constant improvement of the respective diagnostics, prevention and treatment approaches. Dental manifestations of DM are diagnosed in most patients and reveal themselves through demineralized hard dental tissues, high intensity of dental caries and its prevalence, as well as the prevalence of periodontal diseases and issues affecting the oral mucosa. Our research included 60 male Wistar stock rats, all divided into two groups: the comparison group with no DM (n=10) and the main group with induced DM (n=50). DM modeling was done by a single intraperitoneal injection of streptozotocin (dosage – 65 mg/kg). The main group lab animals were removed from the experiment on Days 8, 16, 24, 32 and 60 under anesthesia by decapitation. All the histological and morphometric changes observed in the dental tissues were recorded in the ImadgeJ software package using a Leica DM2500 hardware and software set. The studied sections were used to evaluate the thickness of enamel, dentin, predentin, cement, pulp, the dentin tubule diameter, as well as the density of odontoblasts and ameloblasts. On Day 60 into the experiment, the following changes were identified in relation to the hard dental tissues: regarding the enamel − demineralization, disintegration of the interprism substance; deformed enamel prisms; erosion-type defects developing; regarding the dentin − expanded dentin tubules, vacuole dystrophy of odontoblasts, accumulating edematous fluid under the odontoblast layer, deformation and atrophy of odontoblasts; regarding the cement – layer thinning, cementolysis, cavities developing. Quantitative evaluation of rat dental tissues on Day 60, if compared with intact animals, revealed a multidirectional dynamics in the morphometric values. There was a statistically significant (p≤0.05) decrease in the enamel thickness identified (from 31.06±2.17 microns to 18.19±1.36 microns), in predentin (from 25.19±1.48 microns to 20.93±1.16 microns), in cement (from 37.28±2.04 microns to 31.04±1.46 microns), in the dentin tubule diameter (from 1.82±0.14 microns to 1.56±0.13 microns), as well as in the density of odontoblasts (from 7683.24±319.76 units/mm2 to 7312.61±256.19 units/mm2) along with a statistically reliable (p ≤0.05) increase in the thickness of dentin (from 96.54±3.39 microns to 105.11± 3.16 microns), pulp (from 107.43± 4.12 microns to 120.38±5.26 microns), as well as in the ameloblast density (from 6471.39± 272.18 units/mm2 to 6849.06±253.84 units/mm2). The outcomes expand the understanding of the structural changes affecting rat dental tissues at various times through modeling of Type 1 diabetes, as well as results could be used for developing pharmacological correction methods aiming at the reduction of the pathology intensity.