The bone regeneration after the injury is of particular importance in view of the social and economic relevance related to the need for a long and costly treatment and medical rehabilitation. In recent years, the autologous platelet concentrates were widely used for the tissue regeneration in clinical practice. However, there is not enough information regarding the effectiveness and the possibility of using platelet-enriched plasma for the long tubular bones fractures in people suffering from chronic hyperglycemia or diabetes mellitus type ІІ in the scientific literature. The purpose of our work was to study the microscopic and ultrastructural features of reparative osteogenesis under the influence of chronic hyperglycemia and the correction of chronic hyperglycemia influence on the processes of reparative osteogenesis by platelet-rich blood plasma. Material and methods. The study was conducted on 80 white laboratory rats: a group of animals with chronic hyperglycemia of the body (40 rats), the group of animals with chronic hyperglycemia and the application of platelet-enriched plasma (40 rats). The chronic hyperglycemia was simulated by single intraperitoneal administration of streptozotocin (40 mg/kg) and nicotinic acid (1 mg/kg). After the administration of streptozotocin, the animals had the usual dietary intake for 60 days. On the 60th day after the model reproduction in animals of the control group and the group with chronic hyperglycemia of the body, the hole was formed using a portable dental sterile boron in the middle third of the tibia diaphysis. The platelet-rich plasma was prepared from the blood taken from lateral tail vein. The resulting solution was injected into the wounds of animals. The studies were performed on the 3rd, 7th, 14th and 30th day after trauma. The sections were stained with hematoxylin-eosin and methylene blue. The light microscopy was performed using an Olympus BH-2 microscope (Japan), scanning electron microscopy was performed using a microscopy "REM 102". Results and discussion. On the 3rd day of reparative osteogenesis, the defect was filled with macrophages, leukocytes, a fibrin and bone detritus residues in the rats with the modeled chronic hyperglycemia and the application of platelet-enriched plasma. On the 7th day of the study, the residual signs of inflammation were observed in the defect as well as the osteoblasts and osteoclasts have appeared. On the 7th day of the experiment, the bone detritus residues were not observed and at the same time there was a sharp proliferation of connective tissue and its ordering and formation in osteoid beams. The area of connective tissue with the large number of sinusoidal capillaries and without any signs of osteogenic beams was found in the middle of defect. On the 21th day, the mineralization of the formed new connective tissue beams was observed but the mentioned process was of a local character as in the previous case. In the central section of the defect, the formation of bone trabeculae was at the initial stage. It was only noted that ordering of the connective tissue around the capillaries and the alignment of osteoblasts along the connective tissue cords. Conclusion. The application of platelet-rich plasma allowed correcting the negative influence of chronic hyperglycemia on the process of reparative osteogenesis. The area of defect was cleaned from inflammatory infiltrate and the osteogenic beams were formed quicker. The reparative osteogenesis proceeded as an osteoplastic diferon.
Keywords: reparative osteogenesis, chronic hyperglycemia, platelet-rich plasma
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