Mechanisms of age-related changes in the morphology of the pulp system of the first lower molars

Abstract

To study the coupling of age-related systemic changes in inflammation-mediated apoptosis with the features of the anatomy of the pulp system of the first mandibular molars in patients with chronic pulpitis and periodontitis. The study included 55 patients of both sexes from 18 to 75 years of age in three age groups - young (18-44 years) (n=17), middle (45-59 years) (n=18), elderly (60-74 years) (n=20) with indications for endodontic treatment. Diagnostic measures were supplemented with New Tom 3G cone-beam tomography. The concentration of anitapoptotic protein Bcl-XL and tumor necrosis factor-a (TNF-a) was determined in the blood, and the level of the nuclear transcription factor NF-KB subunit p65 was determined in the lysates of mononuclear cells. As a result of the analysis of the sections, significant obliteration of the pulp was revealed throughout and an increase in the frequency of occurrence of slit-shaped channels in the distal root of the first molar of the mandible in elderly patients. The pathogenetic factors leading to a change in the morphology of the pulp system include old age and an imbalance in the system of anti-inflammatory cytokine transcription mechanisms, which contributes to increased apoptosis and the protracted nature of inflammation.