JAW BONES MICROARCHITECTONICS AND MORPHOLOGY IN PATIENTS WITH DIABETES MELLITUS

Abstract

The study, while aiming to study the microarchitectonics and morphology of the mandible alveolar part at dentition defects in 24 males (aged – 50-65; with type 2 diabetes mellitus going through the compensation stage following the correction of bone remodeling imbalance), and 19 healthy persons belonging to the same age group, implied analyzing 3D cross-sections of the adentia zone (through cone-beam computed tomograms), along with bone tissue biopsy histological examination, obtained from the projection area of dental implants. All patients had their biochemical features of bone metabolism within the reference values, the volume of the bone tissue at the missing teeth area was classified as Category A and B (by C.E. Mich, K.B.M. Judy, 1987), while the densitometry value at the lumbar spine and femoral neck (based on T-criterion) fell within the normal value (> -1SD). The X-ray and histological studies carried out in the studied groups, identified no significant differences in the quantitative and qualitative parameters of the mandibular alveolar part within the area of missing teeth. The morphology of the lower jaws alveolar part at the adentia area in healthy patients, which was represented by strongly interconnected trabeculae, single elements of adipose tissue in peritrabecular spaces, small resorption lacunae on the beam surface, few bonding lines, a depleted pool of osteogenic cells observed in the endossal layer – all these point at an age-related decrease in the intensity of reparation processes, as well as at a decreasing rate of bone tissue remodeling and development. The histological specifics of the mandibular alveolar part at the dentition defects in patients with type 2 diabetes, after pharmacological correction of the bone remodeling imbalance by way of interconnected trabeculae, local elements of adipose tissue against red bone marrow, a significant number of activated osteoblasts and inactive flattened osteogenic cell elements, enhanced activity of osteoblastic differon cells, as well as zones of the developing weakly mineralized osteoid, serve proof to an increase in the intensity of bone tissue metabolic processes, the predominance of the bone development phase over resorption and active osteogenesis. The results of X-ray and morphological studies show that in order to bring bone remodeling back to normal and reduce the risk of postoperative complications at the dental implantation in patients with compensated type 2 diabetes prior to dental rehabilitation, a good choice would imply carrying out pathogenetic pharmacological correction using groups of drugs capable of reducing bone resorption and enhancing bone development.