Yu. S. Harutyunyan

The global issue of diabetes mellitus (DM), which is a serious burden faced by the healthcare systems and economies in many countries, has been increasing steadily in the recent decades. The fast pace of DM growth and prevalence, as well as associated complications (macro- and microangiopathy, neuropathy, nephropathy, impaired vision), high economic costs and social damage, high disability and mortality rates entailed by this disease take constant improvement of the respective diagnostics, prevention and treatment approaches. Dental manifestations of DM are diagnosed in most patients and reveal themselves through demineralized hard dental tissues, high intensity of dental caries and its prevalence, as well as the prevalence of periodontal diseases and issues affecting the oral mucosa. Our research included 60 male Wistar stock rats, all divided into two groups: the comparison group with no DM (n=10) and the main group with induced DM (n=50). DM modeling was done by a single intraperitoneal injection of streptozotocin (dosage – 65 mg/kg). The main group lab animals were removed from the experiment on Days 8, 16, 24, 32 and 60 under anesthesia by decapitation. All the histological and morphometric changes observed in the dental tissues were recorded in the ImadgeJ software package using a Leica DM2500 hardware and software set. The studied sections were used to evaluate the thickness of enamel, dentin, predentin, cement, pulp, the dentin tubule diameter, as well as the density of odontoblasts and ameloblasts. On Day 60 into the experiment, the following changes were identified in relation to the hard dental tissues: regarding the enamel − demineralization, disintegration of the interprism substance; deformed enamel prisms; erosion-type defects developing; regarding the dentin − expanded dentin tubules, vacuole dystrophy of odontoblasts, accumulating edematous fluid under the odontoblast layer, deformation and atrophy of odontoblasts; regarding the cement – layer thinning, cementolysis, cavities developing. Quantitative evaluation of rat dental tissues on Day 60, if compared with intact animals, revealed a multidirectional dynamics in the morphometric values. There was a statistically significant (p≤0.05) decrease in the enamel thickness identified (from 31.06±2.17 microns to 18.19±1.36 microns), in predentin (from 25.19±1.48 microns to 20.93±1.16 microns), in cement (from 37.28±2.04 microns to 31.04±1.46 microns), in the dentin tubule diameter (from 1.82±0.14 microns to 1.56±0.13 microns), as well as in the density of odontoblasts (from 7683.24±319.76 units/mm2 to 7312.61±256.19 units/mm2) along with a statistically reliable (p ≤0.05) increase in the thickness of dentin (from 96.54±3.39 microns to 105.11± 3.16 microns), pulp (from 107.43± 4.12 microns to 120.38±5.26 microns), as well as in the ameloblast density (from 6471.39± 272.18 units/mm2 to 6849.06±253.84 units/mm2). The outcomes expand the understanding of the structural changes affecting rat dental tissues at various times through modeling of Type 1 diabetes, as well as results could be used for developing pharmacological correction methods aiming at the reduction of the pathology intensity.

HISTOMORPHOMETRIC ASSESSMENT OF ARCHITECTONICS AND VASCULARIZATION IN MAXILLARY ALVEOLAR PROCESS BONE TISSUE - Archiv-EuroMedica

Relevance. Detection of maxillofacial pathomorphological changes in children with connective tissue dysplasia (CTD) allows identifying the nature and severity of disorders, as well as it serves the basis for selecting the best treatment options in view of the pathogenetic features. The purpose is to improve the diagnosis of periodontal diseases in children with CTD based on x-ray morphometric indices of the lower jaw and peripheral skeleton ultrasound osteodensitometry.Materials and methods. 92 children with varying CTD severity, and 43 healthy children, underwent cone-beam computed tomogram examination with a further analysis of their X-ray morphometric (quantitative, qualitative) values and the lower jaw optical density indices. Besides, the status of the peripheral skeleton bone tissue was also determined through quantitative ultrasonic densitometry.Results. Quantitative X-ray morphometric indices in healthy children and children with CTD revealed strong positive correlation with the Z-criterion of osteodensitometry, offering an objective reflection of the bone tissue status in the peripheral skeleton.Conclusion. CTD progression in children correlates with the bone structure destruction intensity in the maxillofacial area, an increase in chronic productive inflammation, a decrease in the bone density, bone tissue fibrous transformation, a decrease in the thickness of cortical, and fiber-dissociation in closing, plates, of the lower jaw, prevalence of mid- and fine-meshed bone pattern, disturbed spatial orientation and thinning of bone trabeculae, as well as the development of pathologies in the periodontium.

Relevance. The high prevalence of dysplastic disorders involving connective tissue, and its negative effecton the development of dentoalveolar anomalies, carious and non-carious lesions of the teeth, periodontopathy, temporomandibular joint issues in the child population, lay the basis for improving diagnostics algorithms. Enhancing the already available standards is of greatest importance for children at the initial stages of diagnostics when evaluating the external signs of dysplastic disorders.Purpose – improving diagnostics algorithms for connective tissue dysplasia (CTD) in children in primary dental care facilities based on the evaluation of external phenotype signs and maxillofacial morphological features.Materials and methods. Depending on the external phenotype manifestations severity, as well as on laboratory, clinical and instrumental signs, the 92 children with CTD were divided into groups with mild, moderate and severe degrees of undifferentiated dysplasia. Gnathometric and biometric examinations of the maxillofacial area were performed through traditional methods, whereas the diagnosis was set following the generally accepted classifications. The diagnosis confirmation implied evaluation through cone beam computed imaging.Results. The nature and the intensity of morphofunctional disorders in the craniofacial structures (“small” stigmas) depend on the severity of connective tissue dysplastic disorders.Conclusions. The change direction vector in the facial and brain parts of cranium in children with CTD is aimed at increasing hypoplastic tendencies and dolichocephalia, proof to that being the following constitutional and morphological features: the prevalence of the vertical type of face skeleton growth over the horizontal and neutral ones; a convex face profile with a disproportionate general heights of the face skeleton; reduction of latitudinal with an increase in altitude facial parameters; a narrow short branch of the lower jaw; the upper jaw displaced downwards and forward; a decrease in the size of the apical basis of the lower dentition, the lower jaw body, as well as the height and width of the lower jaw branches.