Zaporožskij Medicinskij Žurnal (May 2023)
Morphometric indicators of wound bone tissue condition after surgical treatment of spontaneous periodontitis accompanied by different functional state of organism reactivity
Abstract
In periodontal surgery, advanced technologies such as the use of platelet-enriched plasma, the technique of directed tissue regeneration, applying various osteoplastic materials are widely spread. Despite the undoubted achievements, there is a risk of postoperative complications. The aim of the work was to study the intensity and duration of the wound healing phases after surgical treatment of spontaneous periodontitis accompanied by normo-, hyper- or hyporeactivity of the body by bone morphometry. Materials and methods. Wistar rats were selected for the study ‒ 90 nonlinear white adult male rats weighing 270 ± 58 grams, aged 11–12 months with spontaneous periodontitis. The animals were divided into three equal groups depending on the condition of their organism reactivity. All the animals underwent surgery on the periodontium: one half of the animals in each of the three groups underwent flap operations, the other – flap operations with osteoplasty (Kolapan-L, Hypro-sorb F). The specific weight of microhemocirculatory bed, connective tissue and bone granulation tissue, bone trabeculae, bone marrow cavities, polymorphonuclear leukocytes, lymphocytes, macrophages, plasma cells was studied by a morphometric method. Results. Morphometric study of bone wound preparations from animals with spontaneous periodontitis accompanied by normoreactivity of the body has allowed to identify the following phases of healing during the wound process: degenerative-inflammatory changes (the 10th day), an increase in reparative processes (the 20th day) and active regeneration (the 30th day). In cases of hyper- and hyporeactivity, the intensity and duration of the wound healing phases differed. In case of hyperreaction, the granulocyte-macrophage reaction was more expressed and lasted longer until the 20th day, therefore later, only on the 30th day, the signs of regeneration could be observed. In case of hyporeaction, the granulocyte reaction appeared later (only on the 20th day) and lasted longer, signs of active regeneration were noticed later, on the 30th day. The identified patterns occurred regardless of the absence or presence of osteoplastic material in a wound. Conclusions. In case of normoreactivity, the intensity and timing of the wound process phases were optimal. In case of impaired (hyper- and hypo-) reactions, altered intensity of the cellular phase (increased or decreased) and terms (accelerated or slowed down) resulted in delayed bone wound healing, that is, a complicated course was observed. It justifies the feasibility and necessity of developing methods of targeted drug correction for transforming the wound process phases with impaired body reactivity into those that are typical of normoreaction.
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