Features of reactive changes in the cellular composition of the gums in the dynamics of clinical observations, depending on the type of odontopreparation for cermet structures

Abstract

The study of the effect of odontopreparation under the cermet structures on the morphofunctional changes in the tooth tissues makes it possible to characterize the features of the preparation of the teeth for this type of structures in order to maintain the viability and functioning of their pulp. The issues of reactive changes in the gums depending on the type of odontopreparation and the predictability of the long-term results of prosthetics, taking into account the individualized approach in the age aspect, remain insufficiently studied.

The aim of the study – to optimize approaches to odontopreparation under full cermet structures with the creation of a ledge and without it, proceeding from the patterns of morphological changes in the cellular composition of the gums in conditions of various types of odontopreparation.

Materials and Methods. Causal relationships between various types of odontopreparation and the course of the process of gums cellular composition differentiation on the 45th day of clinical observations that arise as a result of orthopedic treatment with full metal-ceramic structures. The material was collected from patients from the surface of the marginal part of the gum by scraping, using a crescent trowel on day 45 of clinical observations. The collected material was applied to a sterile objective glass, fixed by dry fixation at room temperature, under open-air conditions, followed by Romanovsky-Gimsa staining.

Rresults and Discussion. The study of cellular gum composition in the area of the prepared teeth of patients of both clinical groups of observations on the 45th day after odontopreparation, based on scientific data on the renewal of the epithelium of the oral mucosa, which for gums is 41–57 days, according to V. L.  Bykov. In the cellular composition of the gums of patients of the first group, intermediate epithelial cells predominated, if surface cells and horny scales are present. Intermediate cells had a centrally located rounded nucleus, an azure-positive cytoplasm and an elongated form, implanted plasmolemma. Intermediate cells with the phenomena of cytopathology. Segmented nucleated leukocytes with clearly segmented nuclei and their individual young forms. The heterogeneity of myeloid cells, as a response to the high activity of the inflammatory process, indicates the differentiation of leukocytes. A powerful microbial composition subsequently initiates necrobiotic processes in epithelial cells, and segmented neutrophils. Along with this, due to phagocytosis, the cytoplasm of segmented neutrophilic leukocytes is destroyed, the so-called incomplete phagocytosis. Cellular gum composition in the region of the prepared vital teeth of patients of the second group, represented by multilayered flat epithelium. Interim epithelial cells predominated, provided that surface cells and horny scales were present. Available single representatives of rod-like flora and intermediate basophilic epithelial cells are predominantly cubic or polygonal, with azur-positive granules in the cytoplasm. The nucleus is round, sometimes oval.

Cellular gum composition in the region of the prepared endodonticaly treated teeth in the patients of both groups is represented by multilayered flat epithelium with intermediate surface cells and horny scales. Single lymphocytes and segmental leukocytes were visualized. One of the definite differences in the qualitative rearrangement of the cells of both groups’ individuals was the appearance of epithelial cells in the cellular structure, with signs of irritation in the form of a sharp basophilia, homogenization and vacuolization of the cytoplasm as a manifestation of a dystrophic process. Taking into account the fact that in the scraping cells of the inflammatory reaction are rare gingival changes in this term of observations should be stated as those that arose because of epithelium differentiation violation accordingly as a compensatory adaptive response to periodontal fibrosis and, to a lesser extent, as a response to odontopreparation.

Conclusions. The results of a complex cytological study indicate that the above tinctorial features of gingival epitheliocytes in the cellular composition of patients in both groups of clinical observations reflect the functioning of the protective mechanisms of gum tissue in norm and provide their homeostasis.