Vol. 8, No 1, 2001 pp. 35 - 38
UC 611.3
OSTEOPOROSIS IN PROSTHETIC PATIENTS
- A QUANTITATIVE PATHOHISTOLOGICAL ANALYSIS
Zorica Ajduković1, Dragutin Stanković1, Dragan
Mihailović2, Aleksandar Dimić3
1Clinic of Stomatology, 2Institute of Pathology,
3Institute for Prevention, Treatment and Rehabilitation
of Rheumatic and Cardiovascular Diseases "Niška Banja", University of Niš
Summary. The objective of this study was to define a rela-tion between
the histological structure of the alveolar bone and periodontal disease,
on the one hand, and osteo-porosis of different etiopatho-genesis on the
other, as well as to propose an adequate stomato-prosthetic therapy.
The female patients, divided into age groups, underwent a procedure
aimed at determining the level of interdependence between the degree of
osteoporosis and the corresponding form of periodontopathy, which was done
on the basis of anamneses, data from the case history, clinical check-ups
and secondary diagnostic methods.
During the extraction of the teeth according to the plan of therapy,
the samples of the al-veolar bone were taken and decalcified, colored by
the routine HE method and analyzed by image analyzer. The following changes
have been detected: poorly calcified parts of the cortical bone, thinned
bone lamellae and widened Haversian system which indicates poor bone activity,
i.e. a greater activity of osteo-clasts as compared to osteoblasts.
Six months after the de-fined internist's therapy (alpha-calcidol,
etidronate, plus compensatory hormonal therapy) and a corresponding stomato-pros-thetic
therapy with PMD (par-tial mobile dentures), the samples of the alveolar
bone were taken again and pre-pared in the same way. It was micro-scopically
found that the Haversian system was not widened and the cement lines were
noticeable, which indicated bone tissue recovery and prevalence of anabolic
proc-esses.
In conclusion, it is emphasized that cumulative effects of internist's
and stomato-prosthetic therapies improve the osteoblastic activity enabling
prevalence of anabolic processes which improves the quality of the said
tissues and provides grounds for a more suc-cessful prosthetic therapy.
Key words: Osteoporosis, dentistry, mandible, image analysis
OSTEOPOROZA KOD PROTETIČKIH PACIJENATA
- PATOHISTOLOŠKI NALAZI (PRELIMINARNA STUDIJA)
Kratak sadržaj: Cilj ovog istraživanja je utvrđivanje odnosa histološke
građe alveolarne kosti i oboljenja periodoncijuma, s jedne strane, i osteoporoze
različite etiopatogeneze, s druge strane, kao i predlog adekvatne stomatološko-protetičke
terapije.
Kod bolesnica su definisane uzrastne grupe na osnovu anamneze, podataka
iz istorije bolesti, kliničkog pregleda i pomoćnih dijagnostičkih metoda;
utvrđena je međuzavistnost između stepena osteoporoze i odgovarajućeg oblika
parodontopatije.
U toku terapijski predviđene ekstrakcije zuba uzimani su uzorci alveolarne
kosti mandibule, i zatim dekalcifikovani, bojeni hematoksilin-eozin (HE)
metodom i analizirani pod svetlosnim mikroskopom uz pomoć sistema za analizu
slike.
Zapažene su sledeće promene: slabo kalcifikovani delovi kortikalne
kosti, istanjenje koštanih lamela, proširen Havers-ov sistem. Sve ovo ukazuje
da je kost slabo aktivna, tj. da je veća aktivnost osteoklasta u odnosu
na osteoblaste.
Šest meseci posle definisane internističke terapije (alphacalcidol,
etidronat, phosphamax, odgovarajuća supstituciona hormonska terapija) i
odgovarajuće stomatološko-protetičke terapije parcijalnom mobilnom zubnom
protezom (PMZP) ponovo su uzeti uzorci alveolarne kosti i obrađeni na prethodno
opisani način. Histološki je uvrđeno da Havers-ov sistem nije proširen
i zapažene su cementne linije, što govori u prilog nadoknade koštanog tkiva,
odnosno proces anabolizma.
Usaglašenom internističkom i stomatološko-protetičkom terapijom poboljšava
se aktivnost osteoblasta i pojačava anabolizam kosti, što podiže kvalitet
koštanog tkiva i stvara preduslove za uspešniju protetičku terapiju.
Ključne reči: Osteoporoza, proteza, donja vilica, analiza slike
