Bobkova S.A., Kushnir K.G., Lavrovskaya O.M., Kolbasina L.P
Chair of Dentistry (Postgraduate Education Division)
SI “Crimea State Medical University named after S. I. Georgievsky”
Cytochemical criterions of periphery
blood activity in case of prosthetic patients’ somatic pathology
Despite on the dental implantology
successes there are still some questions connected with prophylactics of
inflammatory complications in periimplantic tissues. For successful result of
treatment and prolongation of fixed implant-supported prostheses’ useful
lifetime, well-timed control under the condition of round-implant tissues in
the patients with gastric and duodenal ulcer disease is necessary because
according to results of multiple researches changes in GIT are the start point
of many dental diseases. Among the lesions of inner organs the lesions of GIT
causes the biggest changes in mouth cavity. The clinical success of patients’
prosthetic treatment using dental implants is possible only upon condition of
round tissue structures’ effective rehabilitation and depends particularly from
morphofunctional condition and reactivity of supporting soft tissues. On the
assumption of above mentioned the target of our investigation is the carrying
out of neutrophils cytochemical analyzes in peripheral blood in the prosthetic
patients after interosseal implants installation against gastric and duodenal
ulcer disease.
The material of our investigation is
the peripheral blood of patients after dental implantation. For the carrying
out of investigation 87 patients (37 women and 50 men) in the age from 21 to 64
years were examined. Selecting the patients we keep in mind their general
state, past and concomitant
diseases, anatomico-physiological state of mouth cavity. Patients were divided
on 3 groups: first group consisted of 20 prosthetic patients without somatic
pathology, second group consisted of 27 prosthetic patients with somatic
pathology (gastric and duodenal ulcer disease) and the third group from the 25
patients with background disease requiring prosthetic help, which were every
other day injected with 1 ml single-dose of the “Erbisolum”. Also15 persons
without any dental pathology were examined as the control group (norm). During carrying out of the investigation
we’ve used “Erbisolum” medicine – the immunomodulator, restorer and
adaptogen. Peripheral blood sampling
for investigation was made on the first, third, sixth and twelfth month after
implants’ installing.
The studying of lactic dehydrogenase
(LDH) and succinate dehydrogenase (SDH) activity represents big interest,
because their level and activity is considered to be heterospecific criteria of
cell damage. For the calculation of blood enzymes activity we’ve used Astaldi
method based on medium cytochemical level (MCL) calculation by formula:
MCL =
where:
x – number of cells in one smear
with certain level of enzymatic activity from 100 of viewed neutrophils;
1,2,3,4 – level of activity;
100 – number of viewed neutrophils
in one smear.
Thereby there were distinguished 4
levels of activity (fourth stage – neutrophil is fully covered by formazan
granules, third stage – ¾ of
activity, second stage – ½ of activity and first stage – ¼ of
activity).
Cytochemical exponents analyze in
periphery blood neutrophils in prosthetic patients after an implant
installation showed that in all the three groups statically significant
decreasing of aerobic oxidation in relation to control group (p<0,05) and
growth of anaerobic glycolysis was marked after
the first month of investigation. To the third month of investigation
significant decreasing of aerobic oxidation in periphery blood neutrophils was
marked in all groups but it was the most expressed in second group where MCL of
SDH was 1,34±0,05 c.u which was on 27,5% lower than in control group
(p<0,01), thereat LDH activity (anaerobic glycolysis) showed reverse
conformity, it was increased on 25,9% (p<0,01) and it was 2,87±0,15 c.u. To
the sixth month of investigations in first group (prosthetic patients without
somatic pathology) and in the third group (prosthetic patients with somatic
pathology and “Erbisolum” immunomodifier usage) was observed the normalization
of neutrophils’ cytochemical activity, where they’ve got statically
insignificant character in relation to control group (p>0,05). However by
this time cytochemical imbalance in second patients’ group was on the high
level and was statically significant and approaching of cytochemical exponents
to control level in this group was marked only after six month of investigations.
Carried out investigations of
periphery blood neutrophils cytochemical activity in prosthetic patients after
dental implantation showed that implant installation by itself is accompanied
by decreasing of aerobic oxidation and growth of anaerobic glycolysis. Somatic
pathology presence leads to more significant cytochemical imbalance.
Conclusions:
1. Implants installation is an
energy-consuming and traumatic process by itself what is shown by statically
significant decreasing of aerobic oxidation (SDH) and growth of anaerobic
glycolysis (LDH).
2. Presence of background disease in
prosthetic patients (gastric and duodenal ulcer disease) is manifested by more
overt changing of periphery blood neutrophils cytochemical activity and
significantly slows down reparation processes.
3. “Erbisolum” immunomodifier usage
increases reparation processes and accelerates adaptation processes after
implants’ installation.