Patologìâ (Aug 2024)
Influence of diabetes on the character of changes of resorption and repair processes in the parodontium and mandibular tissues after tooth extraction
Abstract
Today, diabetes mellitus (DM) represents a problem on which the attention of endocrinologists, general practitioners, and dentists is focused. Early pathological changes, which manifest themselves in the oral cavity, determine the relevance and social significance of this pathology, because dentists are usually the first to diagnose disorders of carbohydrate metabolism based on the results of the analysis of specific complaints and typical clinical symptoms of damage to the mucous membrane and periodontal tissues. The aim of the work is to find out the pathogenetic characteristics of the reparative component of the post-extraction alveolar socket depending on the time after tooth extraction in experimental diabetes. Materials and methods. In total, 120 sexually mature (age 8–10 months) male Wistar rats, divided into 8 groups of 15 animals each, were used for research. Complex immunohistological, radiographic and biochemical studies were used for the purpose of detailed analysis of the features of the course and mechanisms of development of complications after tooth extraction against the background of DM. In order to assess the state of the innate link of local immunity, the specifics of the course of repair processes at different times of the post-extraction period, the levels of cell proliferation (by expression of Ki-67) and the concentration and content of CD68-positive macrophages in the mucous membrane were determined immunohistochemically. In order to determine the state of the bone tissue of the dental and jaw apparatus and the levels of mineralization of the hard tissues of the molars in the animals of the experimental groups, radiovisiographic images of the right half-mandible were analyzed with determination of the radiographic density. Results. Analysis of proliferative-reparative relationships showed almost no macrophages and very low proliferative activity in the intact periodontium, on the other hand, in DM, initial significant diffuse infiltration by CD68-immunopositive cells with high levels of Ki-67 expression was found. Analysis of X-ray images of the half-mandible revealed that induced DM in rats, even without prior surgical intervention, led to the intensification of resorption processes in bone tissue, which was evidenced by a decrease in radiographic density in the root region of the 1st molar and intraalveolar bone membranes of all three lower molars. Conclusions. In the intact periodontium, there are almost no CD68-immunopositive macrophages and very low proliferation activity in the periodontal soft tissues. In experimental diabetes, on the contrary, initial significant diffuse infiltration by CD68-immunopositive macrophages with high proliferative activity of most fibroblasts is determined. Induced diabetes in rats, even without prior surgical intervention, leads to increased resorption processes in the bone tissue of the mandible and long-term prolongation of the inflammatory process after tooth extraction.
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