BOHOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE.
STATE INSTITUTION «INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE», KYIV, UKRAINE.
Wiad Lek. 2021;74(3 cz 1):441-449.
The aim is to determine the clinical and morphological dependencies, which are important for diagnostics, treatment and prediction of outcomes of pathological processes in the region of the LTM with complicated eruption, as based on the study of histopathological changes of paradental tissue (mucous membrane, walls of retromolar pocket, alveolar bone tissue).
Materials and methods: The materials of the study were 34 biopsy specimens of pathologically altered soft tissue and parodontium obtained as a result of pericoronectomy, extraction of the LTM and other surgical interferences performed based on the relevant indications in 28 patients in the region of the LTM with complicated eruption. Morphological and statistical research methods were used.
Results: The local pathological processes, which chronologically precede the destructive changes in the hard tissue of a tooth (caries), are developed in patients of both genders with complicated LTM eruption in soft tissue of parodontium and the adjacent bone tissue of the alveolar wall in the majority of cases. As per biopsy examinations, the frequency of the main pathological processes in paradental tissue in case of complicated LTM eruption varies from 25 to 60 % of the number of biopsy specimens and occurs in various combinations in patients with different values of clinical parameters. The correlation relationships between the patients' clinical data and the morphological parameters of damage to paradental tissue are weak, multidirectional and uncertain in the majority of combinations (considering the available number of biopsy specimens studied). The close certain positive dependence between the damage of the squamous epithelium and the inflammation activity in the lamina propria mucosae, covering the tooth: in the vast majority of cases, the presence of damaged epithelium (within the biopsy specimen) is associated with the inflammation of high activity, was established as based on correlation relationships between the morphological parameters of damage to paradental tissue.
Conclusions: The found pathological changes and the correlations justify surgical tactics on paradental soft and osseous tissues that are directed on the LTM sparing.
本研究旨在探讨伴有复杂萌出的 LTM 区牙周组织（黏膜、磨牙后间隙壁、牙槽骨组织）的组织病理学变化，以确定对诊断、治疗和预测病理性过程结局具有重要意义的临床和形态学相关性。
研究材料为 28 例伴有复杂萌出的 LTM 区患者的 34 个经牙周切除术、LTM 拔出和其他基于相关适应证的手术干预后获得的病理性改变的软组织和牙周组织活检标本。采用形态学和统计学研究方法。
在伴有复杂 LTM 萌出的患者中，在硬组织发生破坏性改变（龋齿）之前，局部病理过程主要发生在牙周软组织和牙槽骨壁的相邻骨组织中。根据活检检查，伴有复杂 LTM 萌出时牙周组织的主要病理过程在活检标本中的频率从 25%到 60%不等，并且在具有不同临床参数值的患者中以不同的组合发生。患者临床数据与牙周组织形态学损伤参数之间的相关关系在大多数组合中（考虑到研究的活检标本数量有限）较弱、多方向且不确定。在覆盖牙齿的黏膜固有层中，鳞状上皮损伤与炎症活动之间存在密切的正相关关系：在绝大多数情况下，损伤的上皮（在活检标本内）与高活性炎症相关，这是基于牙周组织损伤的形态学参数之间的相关关系确定的。
发现的病理变化和相关性证明了针对 LTM 保留的牙周软组织和骨组织的手术策略是合理的。
