Pantus A. Development of new methods of osteoplasty of jaws using bioframeworks

Українська версія

Thesis for the degree of Doctor of Science (DSc)

State registration number

0521U101856

Applicant for

Specialization

  • 14.01.22 - Стоматологія

24-09-2021

Specialized Academic Board

Д 20.601.01

Ivano-Frankivsk national medical university

Essay

chronic generalized periodontitis of the II and III degree and 90 patients with radicular cysts of the jaws. An experimental study was also performed on 60 animals (rabbits). The theoretical substantiation and practical decision of an actual scientific problem concerning increase of quality of restoration of jaw bone tissues by application of matrix materials on the basis of biopolymer microfibers are performed in the dissertation work. The clinical condition of periodontal tissues and existing radicular cysts was assessed. A new technological approach for obtaining biopolymer microfiber non-woven matrices from thermoplastic biopolymers based on polycaprolactone and polylactide was developed. The identity of the chemical composition of the obtained biopolymer microfiber non-woven matrices based on polycaprolactone and polylactide with the primary material was determined. The microstructure and morphometric peculiarities of microfibers from the obtained microfiber biopolymer non-woven matrices depending on the polymer concentration were studied. The percentage of microfibers of a certain thickness in the obtained microfiber biopolymer non-woven matrices depending on the polymer concentration was investigated. The possibility of releasing an impregnated antibiotic and antibiotic-sorbing ability of the obtained microfiber biopolymer non-woven matrices has been studied. The morphological and morphometric peculiarities of the soft tissues structure in the area of subcutaneous implantation of biopolymer microfiber matrix in animal experiments were studied. Immunohistochemical peculiarities of bone tissue structure in the area of biopolymer microfiber matrix implantation in animal experiments were investigated. The efficiency of biopolymer microfiber non-woven matrices in jaw bone grafting in patients with chronic generalized periodontitis was studied. The effectiveness of biopolymer microfiber non-woven matrices in bone grafting in patients with radicular cysts of the upper and lower jaws was also studied. There were used the following research methods: method of microscopic analysis of microfibers; method of spectroscopy to determine the identity of the chemical structure of the obtained biopolymer microfibers with the primary material; microbiological methods to determine the antibiotic-sorbent capacity of the obtained microfiber biopolymer non-woven matrices; histological, morphometric and immunohistochemical methods for assessment of the structure of soft tissues and bone tissue in the area of implantation of biopolymer microfiber matrix; clinical methods (survey, examination, palpation) and X-ray methods (cone-beam computed tomography, spiral computed tomography) to study the condition of the periodontium and bone tissue in the area radicular cysts of the jaws and the effectiveness of treatment; biochemical methods; statistical methods to determine the probability of the results obtained. During the performance of microscopic studies of the obtained fibrous matrices it was revealed a relationship between the increase in the concentration of polymer in the sucrose melt and the increase in the percentage of thicker microfibers (13,04-25,95 %). Microbiological analysis of the antibiotic-sorbent capacity of the obtained microfiber biopolymer non-woven matrices determined that impregnated into polymer matrices lincomycin is characterized by less stability during storage 39,8 % (р<0,01) than cefazolin 35,2 % (р<0,01). The concentrations of antibiotics in the eluent of the studied samples were as close as possible to the control values during storage of impregnated matrix materials for a period not exceeding 5 days. The results of morphometric and immunohistochemical studies of bone tissue in the experiment during the implantation of the fibrous matrix, showed an increase in reparative osteogenesis, manifested by an increase in osteoid areas (34,38 %) and increased expression of osteoinductive proteins: osteocalcin (117,09±2,64) and osteopontin (135,27±2,84) in the early period (the 1-3 month) with the following intensification of mineralization and compaction of bone tissue during the 4-5 months of the experiment. The developed method of bone grafting using biopolymer microfiber matrix in combination with bone-plastic material in the form of a gel, contributed to the formation of bone tissue, both in the area of periapical defects in patients with odontogenic jaw cysts and in the area of marginal defects in patients with chronic generalized periodontitis, confirmed by the computed tomography data. Key words: chronic generalized periodontitis, cysts of the jaws, microfiber biopolymer matrix, Immunohistochemical analysis, bone tissue. Branch-Medicine.

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