Roganov G.G., Bobkova S.A., Kushnir K.G.

Crimea state medical university named after S. I. Georgievsky

The influence of fixed dentures based on implants on enzymatic activity of peripheral blood

Nowadays accumulated the significant dental science and practice experience in orthopedic rehabilitation of the patients by dental implants use. Together with positive results of implantation the are different complications in use this method. The majority of dental implants made of titanium. The titanium is final alternative, that used in dentistry in the occurrence of allergic reactions to metal. This metal attracted the attention of due to it great biocompatibility and stability. But despite of listed unique properties can not be excluded the development of adverse electrochemical reactions in use some stomatological alloys in prostheses based on titanium. In oral cavity the metal implants can cause an electrochemical reaction. We can not consider the oral cavity separately from the whole body, so the electrochemical reactions between implant and dental prostheses can lead to disbalance of neutrophils of peripheral blood. The most important problem becomes the factor of doubt of different metal alloys different by composition and chemical nature , which present in the oral cavity.

The purpose of our investigation is studying the cytochemical indexes of neutrophils of peripheral blood as a criterion of estimation the processes of adaptation during the prosthetics by different types of fixed dentures based on implants.

Material and methods

The object of our investigation was peripheral blood of patients , which

was conducted dental implantation by two-stage method with next prosthetics by different fixed dentures. For our investigation examinated 86 people(42 women and 46 men) at the age of 21-54. The patients were divided to 2 groups: first group included 63 patients, which were fixed metal ceramic prostheses based on cobalt chromium alloy “Dutseraloy” after carried out implantation. The second group included – 23 patients, which were manufactured the free metal ceramic prostheses based on implants. Each group was subdivided to 2 subgroups: subgroup A - with no additional therapeutic procedures;subgroup B - the patients after fixed dentures installation had injection of “Erbisol” in the buttock 1 ml everyday for 10 days. Besides, were examinated 15 almost healthy people as a control group.

Blood collection for investigation carried out on 1,2,3,4,5,6 months after prosthetics.Interest was study of dehydrogenase activity – enzymes of Krebs cycle and glycolysis: succinate dehydrogenase and lactate dehydrogenase, value of which considered by us as not specific indicator of tissue damage.

Results of investigation and discussion

The analysis of the cytochemical activity of neutrophils of peripheral blood in othopedic patients with using different types of fixed prostheses based on implants has showed , that in 1 and 2 groups of investigation by 1 month observed statistically not significant (p>0,05) decrease of aerobic glycolysis and increase of anaerobic glycolysis in relation to control.

By 2 month observed significant decrease of aerobic glycolysis in all groups.(indicators of succinate dehydrogenase in groups: 1A- up 22,4 %,1B- up 24,2%,2A- up 19,4%,2B- up 16,3% in realation to control and increase of indicators of lactate dehydrogenase , that indicates about increase of anaerobic glycolysis, in 1A – up 17,3%, in 1B – up 17,7, in 2A – up 18,2, in 2B – up 16,3%(p<0,05).

By 3 month observed progressive changes in enzymatic activity in all groups of observation , especially in 1A group.

In next 5-6 months of obsevation the cytochemical activity of neutrophils of peripheral blood approaching normal.

The carried out observation of cytochemical activity of neutrophils of peripheral blood in orthopedic patients with different types of fixed prostheses based on implants showed , that after fixation independently of type of prostheses observed decrease of aerobic glycolysis and increase of anaerobic glycolysis. Using preparation Erbisol allowed greatly reduce terms of adaptation after carried out prosthetics in all groups.

Conclusions:

1. The carrying out of orthopedic treatment by fixed prostheses based on titanium implants leads to change the cytochemical activity of neutrophils of peripheral blood: the decrease of succinate dehydrogenase activity and increase of lactate dehydrogenase activity.

2. The terms of adaptation after carried out prosthetics are different in investigated groups : the minimal – by use the free metal ceramic prostheses (3-4 months), by use the metal ceramic prostheses – 5-6 months.

3. The use immunomodulator Erbisol significantly reduces the terms of adaptation the organism after prosthetics.