• M. Cholovskyi Ukrainian Medical Dental Academy (Poltava)
Keywords: physiological change, morphology, mucous membrane, upper jaw


Physiological eruption of teeth indicates the proper development of the child. According to modern literature, in many countries around the world there is an increase in the frequency of dental anomalies with a violation of the eruption of teeth. Influence on the child's body of negative factors of both local and general nature causes the formation of this orthodontic. It is scientifically substantiated that there is a strong correlation between the number of erupted teeth – maxilaris anomalies. This means that the greater the prevalence of orthodontic pathology, the fewer erupted permanent teeth.

Our complex analysis of micropreparations in patients with palatal and vestibularly retained canines of the upper jaw, showed changes in the microcirculatory tract with decreasing vascular density, dyscirculatory disorders, which further causes the formation of zones of ischemia, foci of initiation of necrobiotic changes. According to our data, more pronounced dystrophic and sclerotic processes were detected during vestibular placement of retained canines; instead, the processes of compensation and adjustment were less pronounced.Objective of the study: to determine the morphological features of the structure of the gums from the vestibular and palatal surfaces during the physiological change of canines.

Object and research methods. For the subsequent solution of the tasks stipulated by the purpose of the work, 15 people aged 10 to 12 years with a physiological change in the canines of the upper jaw were included in the scientific work.

Microscopic examination of the palatine parts of the gums revealed that the mucous membrane of the latter had a typical structure. Stratified squamous epithelium with expressive differentiation into basal, prickly granular and stratum corneum was visualized along the entire length. The formation of acanthotic epithelial cords took place in almost all cases. The latter buried deep in the lamina propria of the mucous membrane, periodically forming bizarre reticular structures. In the described epithelial complexes, an increase in the number of mitotic figures took place, indicating an increased proliferative activity of the epithelium.

The study of the features of the morphological structure of the gums during the change of temporary canines suggests that signs of inflammation prevail in the mucous membrane, which are more pronounced in the vestibular areas.

The study of the mucous membrane of the vestibular edge of the gums revealed almost everywhere acanthotic foci of multilayered squamous epithelium. Quite often there was a hypertrophy of an epithelial layer due to increase in cell rows of a prickly layer. Quite often in epitheliocytes of a prickly layer cells with the phenomena of a hydropic dystrophy as evidenced by detection in perinuclear space of epitheliocytes of transparent, average sizes of a vacuole were found.

In 7 cases, we found inflammatory changes in our own plate, the nature of which differed slightly from those described above. Thus, inflammatory infiltration was everywhere either diffuse or large-focal in nature and spread significantly deeper into its own plate of the mucous membrane. Among the cellular elements of the inflammatory infiltrate, neutrophilic leukocytes were quite often found, which indicate the active phase of the inflammatory process. Sclerotic changes similar to those described above were also detected by us in 5 cases.

Comparison of data on the structure of the vestibular and palatal areas of the gums found that in the papillary layer of the lamina propria of the gingival mucosa of the vestibular area there were signs of inflammation, which were more pronounced compared to the palatine. The higher level of signs of inflammation of the vestibular area can be explained by the peculiarities of the physiological eruption of the canines - more vestibular. It is known that a key role in the development of various symptoms of teething belongs to pro-inflammatory cytokines. The obtained data on the features of the morphological structure of the gums under conditions of physiological changes in canines can serve as qualitative indicators in the diagnosis of the state of the mucous membrane over the crowns of impacted teeth and will allow clinicians to rethink clinical approaches and determine the justification for the volume complex of surgical and orthodontic treatment of this dentoalveolar anomaly.


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