Diabetes mellitus (DM) takes one of the leading positions in the world. Since this disease is a consequence of insulin deficiency and results in metabolic disorders of all types of substances, this leads to the defeat of various organs and systems and, first of all, the vascular bed. During a short period of time, there is an increase in morphological changes of arterioles and capillaries, as well as the progression of metabolic and structural disorders in gum epithelium in patients with diabetes mellitus. According to the observations of many authors, in patients with diabetes there is almost always a dental pathology, which is precisely caused by this disease. The high incidence of oral lesions (up to 90%) in patients with diabetes is due to changes in the microvascular system, resorption of bone tissue, and decreased local immune responses. It leads to the decrease in periodontal endurance, while the usual chewing load becomes traumatic for supporting teeth. Consequently, periodontitis in individuals with diabetes has a unique morphological structure, characterized by disorders of the microcirculatory bed, bone destruction of the dentofacial system and directly depends on the severity of the disease and age. DM is not only a risk factor for the development of periodontal diseases, their further progression, but it also increases with the presence of inflammatory processes in the tissues of the periodontal complex. The purpose of our study is to examine the pathogenetic dependence of the pathology of the endocrine system with morphological changes in alveolar process and changes in indices of calcium phosphorus metabolism. Materials and methods. The experiment was conducted on white laboratory rats weighing 160-180 g, which were kept on a standard diet under vivarium conditions. Animals from the experimental and control groups were removed from the experiment 90 days after the start. The material of the research was lower jaws, which were obtained during the slaughter of animals of the control and experimental groups. When determining the number of osteocytes and osteoclasts, a calculation was made in five fields of view of one sample and the average value was calculated. The study of rats’ blood serum was carried out according to standard methods for calcium, phosphorus, total and bone alkaline phosphatase testing. Results and discussion. Having compared the characteristics of periodontal tissues which are in norm and with diabetic periodontopathy, we detected significant changes, namely: there was a predominance of demineralization processes over remineralization, which subsequently caused lacunar resorption. Changes in the cellular composition of alveolar process with diabetes on the 30th day were statistically insignificant. On the 60th and 90th day of the study there was a statistically significant decrease in the number of osteocytes and an increase in the number of osteoclasts. Analysing the obtained results of biochemical indices of blood serum of rats, it was established that the quantitative composition of alkaline general and bone phosphatase, calcium and phosphorus in experimental diabetes has changed. The increase in total alkaline phosphatase indicates the presence of biochemical changes in bone tissue. Conclusions. The depletion of adaptive periodontal forces in diabetes mellitus is potentiated under the influence of three main pathogenetic links: hyalinosis, amyloidosis and glucose formation of proteins on the background of calcium and phosphorus metabolism.
Keywords: diabetes mellitus, periodontium, bone
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