Abstract
Given that the dental status of drug addicts is burdened with numerous diseases of the tissues and organs of the oral cavity, the issues of developing an optimal scheme of therapeutic tactics for the purpose of restoring their trophic and balance of the oral microflora against opioid background remain relevant in modern periodontology. The aim of the study was to investigate the ultrastructure of periodontal tissues with experimental two-week opioid action and after its abolition for four weeks under conditions of complex medical corrective action. The study material was white male rats (22) of reproductive age (4.5-6 months), Wistar line, with an average body weight of 200 g. The animals were injected with nalbuphine for two weeks, the dose was 0.212 mg/kg and its subsequent withdrawal for four weeks. In order to correct pathological changes arising from the action of opioids in periodontal tissues, pentoxifylline and the antibiotic ceftriaxone were used. Pentoxifylline was administered intramuscularly daily for four weeks after opioid withdrawal (3-6 weeks) at a dose of 2.857 mg/kg. Ceftriaxone was administered once for 11 days at the end of the experiment (5-6 weeks) at a dose equivalent to rat (2.857 mg/kg). Periodontal tissue sampling was performed in the area of the papilla, followed by ultrastructural examination. Submicroscopically found that the structural components of the periodontium have minor changes, their organization is close to normal. The ultrastructure of all sections of the epithelial lining of the mucosa is characterized by a layered arrangement of cells. In epitheliocytes, part of the nuclei has invaginations of the nuclear membrane, indicating their functional activity, clear outlines of compact nucleolus and plasmalemma. In the cytoplasm, most organelles are virtually unchanged, in the mitochondria there are cristae, clearly identified tonofilaments, desmosomal contacts and the basement membrane. Plasmalemma contours are clear, the intercellular contacts are preserved, and the individual intercellular regions appear thickened. The periodontium is represented by well-ordered collagen fiber bundles, the cellular components are unchanged. The detected submicroscopic structure of fibroblasts indicates their synthetic activity aimed at updating the intercellular substance of connective tissue. Electron microscopic studies of the hemocapillaries of the mucous membrane of the gums of animals of this group showed that in their wide lumens there are formed blood elements, mainly erythrocytes. The nuclei of the endothelial cells have an ellipsoidal shape, small invasions of nuclear membrane, clear nuclear membranes, organelles are few. Perivascular spaces without signs of edema. Venules are unaltered, have wide lumens, cytoplasmic portions of endothelial cells are not wide, their nuclear parts protrude into the lumen, the basement membrane is thickened in places. Thus, sub-microscopically established that when canceling opioid analgesic and drug correction at the end of the two-week action of opioid there are signs of positive dynamics in the structural components of periodontium, which is explained by the pathogenic reasonableness of pentoxifylline when disturbed by the opioid analgesia and by medication of the opioid analgesia and medication. effect on the ultrastructural and functional organization of periodontal tissues.
Highlights
Uncontrolled or deliberate misuse of opioid medications in chronic pain is a determining risk of patient addiction, leading to the development of withdrawal syndrome and high overdose death rates [3, 10]
Diseases of the organs and tissues of the oral cavity are most commonly found in drug addicts, whose dental status is burdened with numerous diseases of the tissues of the tooth and mucous membrane of the oral cavity [18, 19, 23]
The course of periodontitis in the chronic process develops against the background of inhibition of phagocytic protection, where the immune response does not depend on the severity of pathomorphological changes, and the function of macrophages when interacting with bacterial flora can cause excessive production of toxic substances that damage the periodontal tissues [18]
Summary
Uncontrolled or deliberate misuse of opioid medications in chronic pain is a determining risk of patient addiction, leading to the development of withdrawal syndrome and high overdose death rates [3, 10]. The course of periodontitis in the chronic process develops against the background of inhibition of phagocytic protection, where the immune response does not depend on the severity of pathomorphological changes, and the function of macrophages when interacting with bacterial flora can cause excessive production of toxic substances that damage the periodontal tissues [18]. Since we cannot study periodontal tissues in patients in dynamics at different timing of opioid exposure, the experimental study allows us to simulate the pathological process in periodontal animals and to apply a complex medication correction of the destructive changes that occur during opioid exposure. The aim of the study was to investigate periodontal tissue biopsy specimens under the experimental action of opioid for two weeks and after its four-week withdrawal under conditions of complex medical corrective action at the ultrastructural level
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