STUDY OF MARKERS OF IMMUNE-INFLAMMATORY RESPONSE AND ENDOTHELIAL FUNCTION OF PERIODONTAL TISSUES AFTER TREATMENT IN PATIENTS WITH CPITN>2

Abstract

Despite the achievements of modern medicine, the systemic approach in the treatment and prevention of periodontal diseases is rather limited in clinical dentistry and their genesis is interpreted from local positions. Often, the commonality of the leading mechanisms that initiate the development of pathological processes in various organs and tissues of the body is not taken into account. It is erroneous to assess pathological changes in the organs of the oral cavity as secondary, ie complications of diseases of other body systems. Today, the question of the influence of immunе-inflammatory and pressor neurohumoral disorders, the state of endothelial function on the development and progression of periodontal diseases in patients with cardiovascular, neurological, gastroenterological and rheumatic pathology remains insufficiently studied. Optimization of the use of new treatment schemes will allow not only to effectively control the course of diseases of the tooth-retaining tissues, but also to influence the key links in the development of periodontal tissue lesions on the background of somatic pathology. The aim of the study: on the basis of laboratory data to investigate the effectiveness of polypeptide drugs in patients with inflammatory diseases of periodontal tissues on the background of somatic pathology. Object and methods of research. Treatment was performed on 136 persons with inflammatory and inflammatory-dystrophic diseases of periodontal tissues, which were divided into 2 groups: the main – 75 patients treated with our method and control – 61 persons in whom the curation of periodontal pathology was carried out according to conventional protocols. Determination of levels of interleukin – 1β, interleukin-10, hs-CRA in oral fluid was performed by enzyme-linked immunosorbent assay. Studies of the level of final nitrogen metabolites were performed according to the method based on the reduction of nitrates to nitrites with their determination by reaction using Gris reagent. The research was carried out in compliance with the basic provisions of the «Rules of ethical principles of scientific medical research with human participation», approved by the Declaration of Helsinki (1964- 2013), ICH GCP (1996), EEC Directive № 609 (from 24.11.1986), orders of the Ministry of Health of Ukraine № 690 dated 23.09.2009, № 944 dated 14.12.2009, № 616 dated 03.08.2012. Each patient signed an informed consent to participate in the study, and all measures were taken to ensure the anonymity of patients. Statistical processing of the obtained results was performed on a personal computer using the licensed programs «Microsoft Excel» and «Statistica». Research results. After 1 year of research in the main group, as a result of the application of our proposed method, we investigated the significant improvement and stabilization of these markers of the immune-inflammatory response. Thus, we investigated the decrease in oral fluid levels of IL-1ß – by 42.20 %, the ratio of IL-1ß / IL-10 – by 60.63 %, hs-CRA – by 41.58 %, p <0.01, against the background of increasing the content of IL-10 – by 46.70 %, p <0,05. Also objectified positive dynamics of values of markers of endothelial dysfunction, which was due to an increase in oral fluid concentrations of NO2 – by 69.93 %, NO3 – by 66.17 % and the total value of NO2 + NO3 – by 65.97 %, p <0.05. Conclusions. The effectiveness of the treatment using our proposed method contributed to a significant improvement in a number of studied immunological and biochemical parameters of oral fluid.

Keywords

• immune-inflammatory response
• endothelial function
• periodontal tissue diseases
• somatic diseases