Features of morphological changes of peridont tissues in patients with β-thalassemia major

Abstract

Relevance of the research topic.Β-thalassemia major is a hereditary blood disease, the functional manifestation of which is the defciency of synthesis of the β hemoglobin chain, leading to the occurrence of severe hypochromic anemia in the frst two years of postnatal development. Treatment of the disease requires a lifelong transfusion, which leads to the iron overload disorder. The development of hemosiderosis contributes to the chronization of inflammatory processes and cellular modifcation of organs and tissues, including the oral cavity. Inevitable metabolic disorders that occur during β-thalassemia prevents the full functional participation of macro- and microelements in metabolic processes in the periodontium, which is necessary for collagen modifcation.Purpose.The aim of the study is to identify the features of morphological changes in the gingival mucous membrane in patients with β-thalassemia major with generalized gingivitis in remission stage in order to determine potential points of application of additional corrective therapy. Materials and methods. The study included 12 patients with β-thalassemia major (the average age of the subjects was 15 ± 0.1 years). Dental examination was carried out in accordance with the recommendations of the WHO, 1990. Araldite-Epon blocks were formed according to the generally accepted method. The production of semi- (1-2 microns) and ultrathin (35-70 nm) sections were obtained using a Leica EM UC7 ultramicrotome (Germany). Semi-thin sections (1-2 μm) were stained by trichrome staining according to F. D'Amico (2005). Viewing of stained and unstainted ultrathin sections was performed on an JEM-1400 electron microscope (Japan) at an accelerating voltage of 80-120 kV.Results.Periodontal modifcation in the remission stage of catarrhal-sclerosing gingivitis in patients with β – thalassemia major is morphologically marked by disorganization of the connective tissue with destruction of the collagen structures and defciency of the presence of immunocompetent cells in its matrix. Elements of dense connective tissue spread from the papillary part of the lamina propria, where elements of loose connective tissue are usually located. The accumulation of immunocompetent cells in the composition of the connective tissue and in the vascular elements's lumen (both blood and lymphatic) of the lamina propria is not detected.Summary.An inflammatory periodontal disease in patients with β-thalassemia major is characterized by marked disorganization of the connective tissue, which requires therapy aimed to develop a correction of mineral metabolism, antioxidant protection and activate the mechanisms of anti-infective protection of the periodontal tissues.