Lavrovskaya O.M., Severinova S.K., Kushnir K.G., Kazinin V.G. Crimea State Medical University named after S. I. Georgievsky

“Cytomorfometriya of tissue of paradontium at orthopaedic treatment of patients slipshod dental rows with support on implants.”

Cytomorfometricheskiy method of research of parodontal'nykh tissues. Fence of material, his research was carried out on the method of Grigor'yana A.S. with the further counting of index of parodontal destruction - IPD on developed by us to the author method of cytomorfometricheskogo method of estimation of destruction of parodontal and periodontal tissues.

Cytomorfometricheskiy a research method was conducted on imprints, to taken from a language or cheek surface in area of adjoining of gum to the neck of implant (area of interface), office worker by support for prosthetic appliance. Imprints took from a periodontal furrow in 4 hours after cleaning of teeth. For the receipt of imprints used a target is a wedge-shaped fragment of elastic - eraser with the size of his narrow part no more than 1 mm. Targets were kept in double-dish, inundated 50 % by solution of ethyl spirit. Before taking of imprints a target was dried out the stream of air from an air pistol after easily entered in a periodontal furrow, densely pinning an internal cheek to the surface of implant, and external - to the symmetric area of gum.

Imprints were inflicted on fat free subject glass. On glass the number of protocol of cytological research is specified, glass was marked out glazier on quadrants, mark-to-market in accordance with the areas of fence of imprints: "I" is an implant, "D" is gum. On every glass of fence there are imprints, taken from an area 1-2 implant, for 3-4 imprints in every quadrant. Glass was dried out and painted on the method of Romanovskogo - Gimza. Dye of Romanovskogo - Gimzy consists of methylene dark blue, eosin and azure, due to what he paints the elements of microorganism and hemocytes in different colors. Before treatment of preparation dye was conducted water (pH 7, 0-7, 2) in 10-20 times. Painting painted 20-25 minutes at 37 in a moist chamber (closed double-dish with a water-wet filter on a day). After painting was washed in running water, dried on air and probed at oily immersion.

Calculation of index of periodontal destruction (IPD) - on an author method, to developed by us - it is suggested to conduct the count of amount of epithelial cages (regardless of their degree and maturity ) and amount of neutrophils in sight:

- cytological preparations were studied under a microscope - the count of cages was conducted in 2 th basic cellular populations of cytograms: epithelial and connective tissue;

- selecting fields is arbitrary, but the fields should be 3-5, not less;

-when calculating the epithelial cells of the set of their total number in the field of view regardless of the degree of maturity , then make a counting the cells and connective tissue cells, namely neutrophils.

Results of research

Noted that the impressions of periodontal tissues and in the norm there are fagiruyuschye cells, but in inflammatory processes in the background expressed exfoliation of the ratio of epithelial cells and the connective tissue is changing in the direction of increasing connective tissue dramatically changed in the direction of increased connective tissue mainly at the expense of neutrophils (neutrophil chemotaxis).

Next, the authors' methodology developed by us was calculated index periodontal destruction (IPD) by:

IPD= (e1/n1)+(e2/n2)+(e3n3)

Where:

e - the total number of epithelial cells in the field of view,

n – number of neutrophils in sight,

1, 2, 3 - visual field

Index periodontal destruction expressed in units. Based on our observations of the average value of the index of periodontal destruction in various states mucosa have the following ranges:

- at the state standards - IPD -12,09-15,03

- at the weak expression of inflammation - IPD -15,04-22,05

- at the moderate inflammation - IPD -22.06 and more.

Also, we performed a correlation analysis of index values of periodontal destruction (IPD) in other groups of patients with different types of fixed prostheses made of various materials (Group 1 - metal-prosthetic group 2 metal-free ceramic prosthesis). The purpose of the correlation analysis - to provide some information about getting one variable with another variable. Result’s correlation analysis on 2-3 and 4-5 months of observations have shown that between the first and the two groups of observations (as a sub - without the use of the drug "Erbisol" and in groups B - with the use of this drug), there is a strong positive relationship.

When follow-up was observed positive dynamics of reduction of bleeding gums, reducing the signs of inflammation.