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RESULTS MORPHOLOGICAL AND MORFOMETRICHSEKOGO RESEARCHES

Group of preparations of patients with bisfosfonatnym an osteonecrosis

At histological research in the given group attracted attention, that the material has been presented sekvestrirovannoj by the osteal tissue which feature were signs rezorbtsii on festonchatomu to type.

Osteal beams basically it is sharp istoncheny, contain empty lacunas, the surface is corroded. Pasting lines not the frequent have an accurate correct drawing. mezhbalochnoe the space basically is filled by a cellular and fabric detritis without cellular elements (the Drawing 43).

Fig. 43. Gistotopogramma a sequester of an osteal tissue. A surface of a bone with signs festonchatoj rezorbtsii, pasting lines carry regular character. Colouring a hematoxylin and eosine. х50.

Frequently in intertrabecular space it is free (the Drawing 44) on a surface istonchennyh osteal trabekul becomes perceptible growth of colonies aktinomitsetov.

Fig. 44. Gistotopogramma an osteal sequester. Growth of colonies aktinomitsetov in intertrabecular space among a fabric detritis is specified by a finger. Colouring a hematoxylin and eosine. х50.

In some cases colonies aktinomitsetov settled down on an osteal tissue, being attached to it, forming continuous "coverlets". Under such "coverlets" rezorbtsija an osteal tissue was minimum or was absent at all (the Drawing 45).

Fig. 45. Gistotopogramma an osteal sequester. Growth of colonies aktinomitsetov on a bone surface. Places absence rezorbtsii in a place of an attachment of a colony. Colouring a hematoxylin and eosine. х50.

In some cases among mezhbalochnogo spaces the quaggy fibrous connecting tissue was found out. With low infiltration basically plasmocytes, rare neutrophils. The centres of osteoblastic activity on a surface devitalizirovannyh osteal fragments were not found out (the Drawing 46).

Fig. 46. Gistotopogramma an osteal sequester. A quaggy fibrous connecting tissue with infiltration by plasmocytes (it is specified by marksmen). Colouring a hematoxylin and eosine. х50.

At morfometricheskom research it is taped (Table 18), that the median of the index characterising rezorbtsiju, «Activity rezorbtsii» makes 96,14 % that testifies that practically all surface of a bone is involved in rezorbtsiju.

Table 18

The Morfometrichesky indicators received at the analysis of tissue specimens of patients with bisfosfonatnym by an osteonecrosis

Thus, prominent features of osteal sequesters at patients with bisfosfonatnym an osteonecrosis of jaws were:

1. High rezorbtsija an osteal matrix on festonchatomu to type;

2. Absence of signs of neogenesis;

3. An actinomycosis, with absence of signs rezorbtsii under the colonies located on a surface of osteal beams;

4. Correct structure and a sharpness of lines of pasting.


Group of preparations of patients with an osteonecrosis of a jaw against narcotic dependence

At histological research in the given group attracted attention, that the material has been presented partially sekvestrirovannoj by the osteal tissue which feature were signs rezorbtsii on festonchatomu to type.

Osteal beams basically it is sharp istoncheny, contain as empty lacunas in sites of a full sequestration, and the centres presented retikulofibroznoj by an osteal tissue with osteocytes and with adjournment of ossiform structures, and in those and other cases all surface is corroded rezorbtsionnym by process on festonchatomu to type. Abaissement of osteocytes from lacunas in yet not generated and not a mature osteal tissue is often found out. Pasting lines frequent, have indistinct, areguljarnyj a drawing. mezhbalochnoe the space basically is filled by a reticular connecting tissue with an edema, on a surface trabekul low quantity of inactive osteoblasts and a considerable quantity of the osteoclasts, full sequesters contain in mezhbalochnom space a detritis and an inflammatory infiltrate, basically presented by neutrophils (the Drawing 47, 48).

Fig. 47. Gistotopogramma an osteal sequester with high regenerative activity, high rezorbtsiej novoobrazujushchejsja bones. Colouring a hematoxylin and eosine. х50.

Fig. 48. Gistotopogramma an osteal sequester. High degree festonchatoj rezorbtsii, frequent the wrong form of a line of pasting. mezhbalochnoe the space is filled by pus and a detritis (it is specified by a finger). Colouring a hematoxylin and eosine. х50.

At morfometricheskom research high indexes of a bone formation, against sharp depression of an index of osteal balance that testifies a simultaneous active osteogenesis and destruction with prevalence of destruction still live bones (Table 19) were defined.

Table 19

The Morfometrichesky indicators received at the analysis of tissue specimens of patients with an osteonecrosis of a jaw against reception of narcotic preparations

Thus, prominent features of osteal sequesters at patients with an osteonecrosis of a jaw against reception of narcotic preparations were:

1. High rezorbtsija an osteal matrix on festonchatomu to type;

2. High regenerative activity - an unripe osteal tissue with osteoblasts with the lowered activity;

3. Rezorbtsija again generated unripe (retikulofibroznoj) an osteal tissue on festonchatomu to type;

4. Pasting lines frequent, not regular, the wrong form.


Group of preparations of patients with a dontogenous osteomyelitis

At histological research in the given group attracted attention, that the material has been presented partially sekvestrirovannoj by an osteal tissue and the osteal sequesters which feature were insignificant signs rezorbtsii on festonchatomu and to smooth type. Osteal beams of a sufficient thickness, contain empty lacunas in sites of a full sequestration, and not numerous centres presented retikulofibroznoj by an osteal tissue with osteocytes and with adjournment of ossiform structures without signs festonchatoj rezorbtsii by individual sites of the smooth. Pasting lines not the frequent have an accurate correct drawing. mezhbalochnoe the space in a sequester basically is filled by a cellular and fabric detritis with blood and neutrophils (the Drawing 49, 50).

Fig. 49. Gistotopogramma an osteal sequester. Beams of a normal thickness, smooth and festonchataja rezorbtsija, in mezhbalochnom space an inflammatory exsudate (it is specified by a finger). A hematoxylin and eosine. х50.

Fig. 50. Gistotopogramma an osteal sequester with a neogenesis site (it is specified by a finger), small surfaces basically smooth rezorbtsii and a poor inflammatory infiltrate. Colouring a hematoxylin and eosine. х50.

Thus, the given group had characteristic lines of a dontogenous osteomyelitis with a sequestration and regional replaceable neogenesis.

At morfometricheskom research against a necrosis of an osteal tissue active processes of an osteogenesis that was expressed in high digits of an index of osteal balance (Table 20) became perceptible.

Table 20

The Morfometrichesky indicators received at the analysis of tissue specimens of patients with a dontogenous osteomyelitis


3.4.

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Scientific source ZASLAVSKAYA NATALIA ALEKSANDROVNA. OPTIMIZATION of PREVENTIVE MAINTENANCE And TREATMENT BISFOSFONATNYH of OSTEONECROSES of JAWS At PATIENTS WITH MALIGNANT NEOPLASMS. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

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