Ультраструктурні зміни слизової оболонки ясен пацієнтів із хронічним генералізованим пародонтитом та ішемічною хворобою серця

Abstract

Abstract. Coronary artery disease (CAD), which is based on atherosclerotic lesions of vessels and systemic hemodynamic disorders, can cause profound metabolic and functional disorders in periodontal tissues, including the hemomicrocirculatory bed. The purpose. With the use of electron microscopy method of study to complement the scientific data on the structure of the gingival mucous membrane , in particular the epithelial layer, cells and cellular elements, stromal structures and hemocapillaries of the connective tissue of the gums in patients with CGP and CAD. Materials and methods. Electron microscopy study was performed in 10 patients (mean age 54.2±5.3 years) with CGP initial-I, II degree and CAD. The material for the study were gingival biopsy samples fixed in the 2 % solution of osmium tetroxide in 0.1 M phosphate buffer. Ultrathin slices were obtained with the ultramicrotome УМТП-3М and studied using the electronic microscope УЭМВ-100К. Results. Study of the ultrathin slices of the gingival mucous membrane in patients with CGP and CAD revealed changes which are typical for tissue hypoxia. Disorders of local blood circulation are primarily associated with narrowing of the hemocapillaries or their dilation. It was observed the violation of the blood rheological properties in these microvessels, which were manifested by the erythrocyte hyperaggregation in the lumens of hemocapillaries and plasma hypercoagulation. It was revealed the changes in the epithelial layer of the connective tissue of the gums, in particular, an increase in the area of penetration of the basement membrane into the main substance of connective tissue, changes in the shape and intracellular structures of cells of the spinous and granular layers, disintegration of intercellular desmosomes. The presence of disorganized unmyelinated nerve fibers indicates the local dysfunction of the autonomic nerve fibers of the gingival mucous membrane. Conclusions. Electron microscopy study revealed ultrastructural changes in the gingival mucous membrane in patients with CGP and CAD, which are the result of hypoxia in periodontal tissues. Key words: ultrastructure, gingiva, hemocapillaries, hypoxia, generalized periodontitis, coronary artery disease.