RU2286579C2 - Method for predicting titanium nickelide implantation consistency - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves studying whole blood state by applying radiofluorescence analysis approach with synchrotronic radiation, determining quantities of microelements like Se, Zn, Cu and Mn in whole blood. Early and late implantation consistency is to be predicted, when detecting 20% selenium concentration fall, zinc concentration twice as low at the third day in early postimplantation period relative to reference values, and 40% zinc concentration fall, copper concentration increase 1.3 times as high and manganese concentration increase 1.5 times as high at the fourteenth day, and 40% zinc concentration fall at the sixtieth day, and manganese concentration increase twice as high at the one hundred twentieth day in late postimplantation period when having correspondence to the reference values. Intact animal group indices and microelements concentrations in other periods are taken as the reference values.

EFFECT: high reliability and accuracy of prognosis.

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Description

The invention relates to medicine, namely to dentistry and other fields of medicine using titanium nickelide for implantation, in particular to methods for predicting the course of the post-implantation period, the viability and long-term success of titanium nickelide implantation.

Known methods for laboratory and instrumental assessment of the functional state of the implant: determination of bone density (densitometry), ultrasound diagnostics, study of gingival fluid, study of microcirculation of the mucous membrane of the alveolar process and gums in the area of the implant, gnatodynamometry, functional tests, etc. The value of these methods is not in doubt , however, they are difficult to access for wide clinical practice (Babushkin E.V. Restoration of dentition defects with prostheses based on composition of materials in patients with diabetes mellitus. Abstract of thesis ... Candidate of Medical Sciences - Novosibirsk, 1999. - 28 pp .; Pozdeev AI Reconstruction of the integrity of the dentition using porous implants for diabetes mellitus. . ... Candidate of Medical Sciences. - Novosibirsk. 1999. - 17 p .; Perova MD, 1999; Kuznetsov E.K., Ivanov S.Yu., Tsarev V.N. et al. Efficiency Assessment the use of antibacterial drugs rovamycin and lincomycin for the prevention of inflammatory complications of intraosseous implantation surgery // New in dentistry. - 2001. - No. 9 (99). - S.90-94; Perova M.D. On the issue of prevention of destruction of near-implant tissue structures // New in dentistry. - 1996. - No. 2 (72), special issue. - S.33-41; Paraskevich V.L. Diagnosis of regional jaw osteoporosis during implant planning // Russian Dental Journal. - 2000. - No. 2. - S.33-35; Matveeva A.I., Gvetadze R.Sh., Dronov D.A. et al. Development of clinical diagnostic and prophylaxis methods in dental implantology // Russian Dental Journal. - 2000. - No. 2. - S.9-10). The disadvantage of these methods is their local effect on the existing focus of changes in peri-implant tissues, which often complicates the course of the postoperative period, as well as their lack of impact on the pathogenetic links of the implant rejection process.

There is a method of studying the metabolism of lymphocytes of regional lymph nodes during implantation of titanium nickelide (Loginov A.G. Structural and functional organization of the regional lymph node during dental implantation. Abstract of thesis ... Candidate of Medical Sciences. - Novosibirsk. 1998. - 18 p. .). For this, we used cytochemical indicators of the enzymatic activity of the most important intracellular metabolic processes: lactate dehydrogenase (LDH), which catalyzes the final stage of glycolysis - the reverse reaction of pyruvate reduction into lactate and succinate dehydrogenase (LDH), which catalyzes the succinate oxidation reaction in the Krebs cycle. Indicators were studied on the 14th and 30th days after implantation. The method is informative, however, it concerns only one side of the energy metabolism of the lymphocyte. These two indicators are not enough to fully assess the energy status of a lymphocyte, which is a structural-morphological unit of the immune system; not enough to fully compose a prognostic scenario and reliably predict and plan the course of the post-implantation period.

A known method for predicting the effectiveness of implantation of titanium nickelide (decision on the grant of a patent according to application No. 2002129551/15 (031151)), which is based on the assessment of the dynamics of the post-implantation period in terms of blood, in particular lymphocytes. The method is effective, however, concerns only the energy metabolism of lymphocytes and does not take into account the antioxidant status - one of the central units involved in the molecular mechanisms of nonspecific resistance with destabilizing factors for intraosseous implantation.

Closest to the claimed method relates to the study of metabolism in the cells of the mucosal-periosteal flap and bone of the alveolar bone, manifested, in particular, by the generalization of lipid peroxidation of cytoplasmic membranes and impaired body functions: immune, antioxidant, proteolytic (Ivanov S.Yu., Sharapov G .N. Kalashnikova O.Yu. et al. Prediction of complications of dental implantation in terms of lipid peroxidation and glutathione metabolism // New in Dentistry. - 1999. - No. 2 (99). - .74-78). The study addressed the issues of predicting the complications of dental implantation in terms of lipid peroxidation and glutathione metabolism. Antioxidant defense was studied: the activity of superoxide dismutase in the mucoperiosteal flap and serum (R. Friid, 1975), catalase K (E.K.Dubinina, 1988), glutathione metabolism: the level of total glutathione (M.E. Anderson, 1985). reduced and oxidized glutathione (Little, 1981), activity of glutagion reductase GR (A.Werdel, 1981).

It has been established that in patients who have a change in the lipid peroxidation system and glutathione system, implant rejection is possible before implantation surgery. A correlation was found between the increased concentration of diene conjugate, malondialdehyde, Schiff base, peroxide hemolysis of erythrocyte membranes in blood serum and a mucoperiosteal flap in the preoperative period and the occurrence of inflammation reactions in peri-implant tissues in the early postoperative period.

The increase in the level of oxidized forms of glutathione in 1.5-2 times leads to disruption of the functioning of all antiradical systems. With an increase in lipid peroxidation products (LPO) up to 1.5 times on the 3-7th day of the postoperative period, it is possible to compensate for the functioning of antiradical systems and the reversibility of the implant rejection reaction. A 2-fold increase in the concentration of lipid peroxidation products indicates the irreversibility (decompensation) of the implant rejection reaction that has begun. If changes in the LP and the functioning of glutathione systems are detected in the preoperative period, general and antioxidant therapy is necessary. The method is informative, although not without its inaccuracies, since it does not reflect all aspects of the functioning of glutathione systems. The methods used to determine lipid peroxidation products make it possible to record intermediate and final products of peroxidation reactions. At each point in time, the content of diene conjugates and lipid peroxides is a stationary concentration of compounds, the result of two simultaneously occurring processes: formation and decomposition. As a result of this, the data obtained cannot be unambiguously interpreted: an increase in the content of lipid peroxides, for example, can result either from an increase in the rate of their formation, or vice versa, from a decrease in the rate of decay. Another disadvantage of this method of forecasting is invasiveness: biopsy samples were taken from the area of implantation to analyze the mucoperiosteal flap.

The objective of the invention is to increase the reliability of early and remote prediction of the results of intraosseous implantation based on the evaluation of antioxidant metabolism by microelement composition of whole blood.

When solving this problem, there is a positive therapeutic effect. The method allows to predict the course of the post-implantation period, to identify the link, which can be corrected if necessary, thereby achieving long-term success of implantation, improving the quality of treatment by stabilizing clinical and laboratory tests, correct diagnosis and targeted treatment, early non-invasive diagnosis of functional disorders can serve as the basis for approaches to individual correction of dysmicroelementosis in the post-implantation period, allows to prevent The possibility of the transition of negative processes in the body from the stages of functional deviations to persistent health disorders (implant rejection) reveals the connection of metals with a change in valency (trace elements) with free radical oxidation processes in the body due to its significant role in the formation of prenosological and pathological conditions. Determination of the antioxidant status of an organism by microelement analysis of whole blood using an X-ray fluorescence method using synchrotron radiation (XRD) gives stable and correct results that allow you to determine the onset of decompensatory processes associated with any sex before detecting functional disorders at the body level. The restructuring of antioxidant enzymes is interconnected with the periods of implantation, which allows a long-term prognosis of the patient’s body after implantation and a forecast of the effectiveness of implantation, allows you to identify the link that needs to be adjusted. It should be noted that microelement analysis can be used to examine the health and quality of life of a patient under implantation conditions. The development of the RFA-SI method showed the following advantages: high sensitivity, small volume and weight of the studied sample, panoramic measurement, non-destructive measurement procedure, expressness of obtaining the result, the ability to measure the surface and volume distribution of elements, the ability to organize mass automated elemental analysis for applied purposes, in including in biology and medicine.

As criteria for predicting the viability of implantation, a decrease or increase in the content of trace elements of whole blood Se, Zn, Cu, Mn was used at different times after endosseous implantation of titanium nickelide. At the same time, the “reference point”, the control indicators were the results of the values of the trace elements Se, Zn, Cu, Mn in whole blood (μg / g dry weight) of the intact group.

Se enters the catalytic center of glutathione peroxidase, its concentration reflects the cell's need for an enzyme whose activity responds to any external and internal stimuli. The biological role of glutathione peroxidase is to protect the cell membrane structures from the damaging effects of reactive oxygen species and lipid peroxidation products during the pathological process. Glutathione peroxidase is an active antioxidant and a regulator of oxidation - antioxidation processes.

The change in selenium concentration depends on the stage of the post-implantation period: in the early post-implantation period - a significant decrease in concentration (by 20% for 3 days) and the correspondence of selenium concentration to control values at all other times

The complex of microelements Zn, Cu, Mn protects the genome from lipid peroxidation products and prevents cells from programmed death. Zn - protects cells from oxidative stress; in the early post-implantation period, its concentration decreases by 2 times on the 3rd day and by 40% on the 14th day; in the late postimplantation period on day 60, the zinc concentration decreases by 40% relative to the control value.

Cu - indicates the degree of antioxidant protection; an increase on the 14th day of the concentration by 1.3 times relative to the control value indicates a sufficiently powerful cell defense.

Mn - is directly related to the immune system and the protection of cell membranes. An increase in the concentration of manganese relative to the control value is noted 1.5 times on the 14th day and 2 times on 120 days.

The problem is solved due to the fact that they investigate the state of whole blood by X-ray fluorescence analysis using synchrotron radiation, determine the number of trace elements Se, Zn, Cu, Mn in whole blood and when a decrease in concentration is detected in the early postimplantation period on day 3 of selenium on 20% and zinc 2 times, on day 14 - a decrease in zinc by 40% and an increase in copper by 1.3 times and manganese by 1.5 times, and in the late post-implantation period - a decrease in zinc by 40% on day 60 and an increase in m rgantsa for 120 hours in accordance with the 2-fold control values, which are used as indicators of intact group of animals, the concentration of trace elements in all other periods predict early and long consistency implantation.

The method is as follows. After endosseous implantation, venous blood is sampled for microelement analysis using an X-ray fluorescence method using synchrotron radiation (RFA SI). The study of whole blood was performed at the RFA SI VEPP-3 station of the International Center for Synchrotron Radiation of the I. I. Budker INP SB RAS. Control results were the values of the intact group. Sample preparation and analysis was carried out in accordance with the IAEA recommendations, “Methodological recommendations on spectral methods for the determination of trace elements in environmental objects and biomaterials during hygienic studies”, approved. USSR Academy of Medical Sciences 03.20.86, guidelines approved by the Ministry of Health of the USSR 11/28/1988 "Screening methods for identifying high risk groups among workers in contact with toxic chemical elements", guidelines approved by the Ministry of Health of the Russian Federation No. 25/10-3416-97-32 from 07/30/1997 "Comprehensive hygienic assessment of the degree of tension of the medical and environmental situation in various territories due to toxicants polluting the living environment of the population."

Blood is taken in the morning, taking into account the biological rhythms of changes in the lymphoid organs during the day. Blood volume is 2 ml, immediately after sampling, the blood is placed in a disposable tube (laboratory glass) with a known weight (with an accuracy of 5 mg), the filled tube is weighed on a balance (torsion bar) with an accuracy of 5 mg; blood is dried in an oven. The trace element analysis is determined in the early - on the 3rd and 14th days and late - on the 60th and 120th days - the post-implantation periods. Based on experimental studies, the optimal terms for the study of the microelement composition of whole blood were determined (Appendix). If in the early post-implantation period a decrease of 20% and zinc by 2% relative to the control values of the concentration of selenium on the 3rd day is detected, 2 times lower on the 14th day, zinc decreases by 40% and copper increases by 1.3 times and manganese by 1.5 times, and in the late post-implantation period — reduction of zinc by 40% on day 60 and a 2-fold increase in manganese by day 120, in accordance with control values, which are used as indicators of the intact group of animals, trace elements concentration in all other periods, early and distant conditions are predicted nost implantation.

application

The content of trace elements in whole blood (μg / g dry weight) of the intact group and during endossal implantation of titanium nickelide TH-10 (M ± m)

day Se Zn Cu Mn intact TiNi intact TiNi intact TiNi intact TiNi 3 1.46 ± 0.02 1.12 ± 0.04 * 29.2 ± 1.22 14.2 ± 0.52 * 3.85 ± 0.25 3.17 ± 0.09 6.36 ± 0.28 9.93 ± 0.19 * 7 1.54 ± 0.16 1.24 ± 0.09 27.1 ± 0.29 25.5 ± 1.33 4.25 ± 0.47 4.88 ± 0.76 5.26 ± 0.16 5.48 ± 0.29 fourteen 1.22 ± 0.05 1.39 ± 0.07 25.3 ± 1.33 16.6 ± 0.76 * 3.42 ± 0.26 4.72 ± 0.11 * 5.5 ± 0.41 7.64 ± 0.21 * thirty 1.8 ± 0.25 1.8 ± 0.16 26.0 ± 1.76 31.2 ± 1.02 7.99 ± 1.22 5.49 ± 1.08 4.82 ± 0.39 6.47 ± 0.46 60 1.61 ± 0.04 1.38 ± 0.07 33.4 ± 0.03 18.1 ± 0.62 * 4.33 ± 0.33 4.9 ± 0.11 6.5 ± 0.21 7.34 ± 0.18 120 1.59 ± 0.05 1.38 ± 0.76 22.4 ± 1.77 17.2 ± 0.58 4.43 ± 0.5 4.39 ± 0.19 6.42 ± 0.26 13.4 ± 0.95 * * - the difference is significant in comparison with the initial value at p <0.05

Claims (1)

A method for predicting the viability of titanium nickelide implantation in an experiment by evaluating the antioxidant system of the body, characterized in that the state of whole blood is examined by X-ray fluorescence analysis using synchrotron radiation, the number of trace elements Se, Zn, Cu, Mn in whole blood is determined and if it is detected in the early postimplantation period decrease relative to the control concentration values on day 3 of selenium by 20% and zinc by 2 times, on day 14 - decrease in zinc by 40% and increase in copper by 1.3 times a and manganese 1.5 times, and in the late post-implantation period - a decrease in zinc by 40% on day 60 and an increase in manganese on day 120 by 2 times, according to control values, which are used as indicators of the intact group of animals, the concentration of trace elements in all the remaining dates predict the early and long-term viability of implantation.