Мікроцирукуляторні зміни в пульпі зуба при парадонтиті

Abstract

В даній статті приведені дані щодо динаміки мікроциркуляторних змін в судинах пульпи при хронічному генералізованому пародонтиті ІІ та ІІІ ступеню тяжкості. Авторами проводилося з морфологічне дослідження пульпи інтактних зубів, а також зубів, видалених з приводу пародонтиту за медичними та ортопедичними показаннями. Отримані результати свідчили, що при пародонтиті виникають порушення транспорту крові в судинах всіх ланок МЦР пульпи. Це вказує на те, що стан пульпи відіграє значну роль в протіканні та розв’язку пародонтитного процесу; В данной статье приведены данные о динамике микроциркуляторных изменений в сосудах пульпы при хроническом генерализованном пародонтите II и III степени тяжести. Авторами проводилось морфологическое исследование пульпы интактных зубов, а также зубов, удаленных по поводу пародонтита по медицинским и ортопедическим показаниям. Полученные результаты свидетельствовали, что при пародонтите возникали нарушения транспорта крови в сосудах всех звеньев МЦР пульпы зубов. Это указывает на то, что состояние пульпы играет значительную роль в течении и исходе пародонтитного процесса; Diseases of periodontal tissues represents one of the most common and complicated pathologies of maxillo-facial region. According to the WHO, functional disorders of the maxilla-facial system caused by teeth loss on the background of periodontal diseases are diagnosed 5 times more often than because of the caries complications. Itsimportance is determined by the fact that the number of persons with generalized periodontitis steadily increases and this pathology loses its age limits. Review of literature on this problem allows us to conclude that among main factors of pathogenesis of this pathology is a dirsorder in the vascular system of the periodontal complex. Some authors draw our attention on the relationship between microcirculatory disorders in periodontal tissues and in teeth pulp. The purpose of our research was to study dynamics of microcirculatory changes in pulp vessels in the case of periodontitis. Object and methods of research. We examined 19 patients aged 35-45 years with diagnosed chronic generalizedperiodontitis of II and III stage of severity. The stomatological status of 7 practically healthy people of the same age was also determined in order to form the control group. For patients in all groups, we applied clinical and special research methods. Moreover, a morphological study of intact tooth pulp as well as teeth removed because of chronic generalized periodontitis according to medical and prosthetic indications was performed. Results and discussions. Performed optical researches have allowed to reveal changes in all structural elements of micro-circular system of tooth pulp on the background of periodontitis. The dynamics of microcirculatory changes in the arterial chain of the microcirculatory system of tooth pulp on thebackground of periodontitis could be visualized as follows: inflammatory hyperemia → metabolic disorders → vascular constriction → stasis → plasmatic soaking of the vascular wall → sclerosis, hyalinosis and destruction of the vascular wall. The dynamics of microcirculatory changes in the dental pulp capillaries on the background of periodontitis could be visualised as follows: inflammatory hyperemia → metabolic disturbances → the appearance of “leakage locuses”, destruction of the wall → diapedesis, interstitial edema → increase of interstitial pressure → collapsion of capillaries` walls. The dynamics of microcirculatory changes in the venular section of tooth pulp on the background of periodontitis can be visualized as follows: inflammatory hyperemia → metabolic disorders → uneven dilation of blood vessels →blood flow decrease → disturbance of the rheological properties of circulating blood, formation of “leakage locuses”→ increase of vascular wall permeability → interstitial edema, diapedesis → increase of interstitial pressure →vasoconstriction. Conclusion. Thus, in the case of periodontitis appears a disturbance of blood transport in vessels of all parts of the microcirculatory system of tooth pulp. It should be indicated that the pulp condition plays a significant role in the appearance and development of the periodontal process.