上颌牙槽突骨组织结构和血管化的组织形态学评价

IF 0.6 Archiv EuroMedica Pub Date : 2023-06-27 DOI:10.35630/2023/13/3.308
D. Domenyuk, O. Sumkina, Natalya Mikutskaya, T. Kochkonyan, A. Markovsky, Dmitry Matsukatov, Yuri Harutyunyan, O. Ivanyuta, S. Domenyuk
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引用次数: 0

摘要

基础医学和应用医学中最相关的优先领域的扩展,以及现代牙科和颌面重建外科的进步,需要深入了解上颌牙槽突骨组织的形态和功能状态,并了解下颌牙槽部分,从而允许选择用于颌面病理的合理治疗策略。上颌牙槽突微结构学、血管结构学以及牙根不同层次的牙周膜排列的定性特征,额骨和远端骨组织的组织学和形态计量学研究,以及上颌中切牙和第一磨牙的上颌段。组织学研究结果表明,上颌牙槽突的微结构特征是板层骨由彼此紧密相邻的板组成。骨板在前部的方向是纵向的,而在远端的方向是沿着哈维尔管周围的同心圆。上颌牙槽突的血管结构以管状结构为特征,管状结构主要垂直于骨表面,有许多吻合。上颌牙槽突血管系统的形态计量学分析显示,在额部,每1mm2的血管数量为22.41±1.76-22.87±2.08;远端段−23.94±1.88-25.02±2.69(p≤0.01);前部血管的平均直径为25.34±2.45微米-26.06±3.17微米,远端为-25.72±2.31微米-26.14±2.93微米(p≤0.05);前部的平均壁厚为1.43±0.09微米-1.48±0.12微米,远端的平均壁厚度为-1.50±0.11微米-1.54±0.14微米(p≤0.01)。上颌中切牙在根牙龈部分水平的前庭表面以及根尖水平的口腔表面被发现是牙周膜压迫区,而齿根-牙龈水平的口腔表面和根尖水平的前庭表面是牙周膜拉伸的区域。在第一上颌磨牙的根-牙龈水平,内侧和前庭表面是牙周膜压迫区,而口腔和远端表面是牙周膜拉伸区。定量评估显示,中切牙牙周膜和第一上颌磨牙的结构元素在牙周膜压迫区具有松散的结缔组织,其特定区域占主导地位;然而,在咀嚼应力作用下,牙周膜拉伸区主要存在致密结缔组织的特定区域。通过对中切牙和第一上颌磨牙的牙周膜微血管床的定量分析获得的数据表明,压迫区的血管面积远远超过拉伸区的血管区域。在上颌的切牙-上颌段和臼齿-上颌段经历生物力学应力的情况下,牙周膜形态将在整个牙根中发生变化,这似乎是相当合理的,这取决于压缩和拉伸区域的定位。
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HISTOMORPHOMETRIC ASSESSMENT OF ARCHITECTONICS AND VASCULARIZATION IN MAXILLARY ALVEOLAR PROCESS BONE TISSUE
The expansion of the most relevant priority fields in fundamental and applied medicine, along with the progress in modern dentistry and reconstructive maxillofacial surgery, requires in-depth understanding of the morphological and functional status of the maxillary alveolar process bone tissue and knowledge of the mandibular alveolar part, thus allowing selecting a reasonable treatment tactics for maxillofacial pathologies. Qualitative features of maxillary alveolar process microarchitectonics, angioarchitectonics, as well as the periodontal ligament arrangement at various levels of the teeth roots, histological and morphometric studies of bone tissue in the frontal and distal sections, as well as the maxillary segments of the maxillary medial incisors and the first molars were studied in 5 certified male cadavers with preserved dentition. The histological findings show, that the microarchitectonics of the maxillary alveolar process features a lamellar bone consists of plates that are adjacent tightly to each other. The bone plates orientation in the frontal section is longitudinal, while in the distal part it is along concentric circles located around the Haversian canals. The angioarchitectonics of the maxillary alveolar process features tubular structures, which run mainly perpendicular to the bone surface, with numerous anastomoses. As the morphometric analysis of the maxillary alveolar process vascular system shows, in the frontal section the number of vessels per 1 mm2 is 22.41± 1.76 - 22.87± 2.08; in the distal section − 23.94± 1.88 - 25.02±2.69 (p≤0.01); the average diameter of vessels in the frontal section is 25.34±2.45 microns – 26.06 ±3.17 microns, in the distal section − 25.72±2.31 microns – 26.14± 2.93 microns (p≤0.05); the average wall thickness in the frontal section is 1.43± 0.09 microns - 1.48± 0.12 microns, in the distal section − 1.50± 0.11 microns – 1.54± 0.14 microns (p≤ 0.01). The vestibular surface of the maxillary medial incisors at the level of the root gingival part, as well as the oral surface at the root apical level have been found to be zones of periodontal ligament compression, while the oral surface at the root gingival level and the vestibular surface at the root apical level – zones of the periodontal ligament stretching. At the root gingival level of the first maxillary molars, the medial and vestibular surfaces are zones of the periodontal ligament compression, whereas the oral and the distal surfaces stand as the zones of the periodontal ligament stretching. As a quantitative assessment showed, the structural elements of the medial incisors periodontal ligament, and the first maxillary molars had loose connective tissue – taken by its specific area – prevailing in the periodontal ligament compression zone; the specific area of dense connective tissue, though, was found to be prevailing at the periodontal ligament stretching zone under chewing stress. The data obtained through a quantitative analysis of the periodontal ligament microvascular bed of the medial incisors, and the first maxillary molars, reveal that the area with blood vessels in the compression zones by far exceeds the area of blood vessels in the stretching zones. It appears rather reasonable that in case of a biomechanical stress experienced by the incisor-maxillary and molar-maxillary segments of the upper jaw, the periodontal ligament morphology will change throughout the root, depending on the compression and stretching zone localization.
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来源期刊
Archiv EuroMedica
Archiv EuroMedica MEDICINE, GENERAL & INTERNAL-
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83.30%
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