DIAGNOSTIC AND PROGNOSTIC VALUE OF MOLECULAR BIOCHEMICAL MARKERS IN PATIENTS WITH PERIODONTAL TISSUE DISORDERS AND DENTAL DEFECTS
About the author:
Romaniuk V. M., Vozniy O. V., Pavlov S. V
Type of article:
Chronic generalized periodontitis is one of the most common chronic diseases in the world. Periodontal diseases include a wide range of inflammatory reactions that affect the retaining structures of the teeth, which ultimately leads to their loss. With the help of various laboratory methods of studying the composition of oral fluid, it is possible to determine the activity of substances involved in cellular metabolism in inflammatory diseases of the oral cavity. The study of medical literature has confirmed considerable pathogenic role of some biomolecules, namely of matrix metalloproteinases of lactoferrin and cathelicidin, in the development of periodontium tissue diseases. It is these molecular markers that are given considerable attention in the development of protocols for laboratory screening of oral diseases. The purpose of the present research was to estimate prognostically valid criteria at planning implantological and prosthetic treatment of patients with periodontium tissues disorders and defects of dental arches.80 patients aged 18 to 65 years were selected for the present study. Among them, 20 healthy patients comprised observational group, and 60 patients with periodontium tissues diseases formed treatment group. There were 19 patients with first-degree periodontitis, 27 patients with second-degree periodontitis and 14 patients with thirddegree periodontitis and defects of dental arches. The study of oral hygiene using the Green Vermilion Index (OHI-S) showed that in patients with first-degree periodontitis exceeded the norm by 2 times, with second and third-degree periodontitis exceeded the norm by 3 and 4 times, respectively. The value of the PMA index in patients with first-degree periodontitis was 54%, which is 6 times higher than in the control group. In patients with second-degree periodontitis, this figure was 66% in patients with third-degree periodontitis – 81%. SBI in patients with first-degree periodontitis value averaged 13%, in patients with second-degree periodontitis, this figure was 35%, in patients with third-degree periodontitis – 69%. Level of MMP-8 in oral cavity fluid increased directly depending on periodontitis degree. At first-degree periodontitis, values of MMP-8 increased 3 times in comparison with the observation group (0,47±0,08 ng/ml). Values at second- and third-degree periodontitis increased 4 and 7 times correspondingly. The increase of MMP-8 level in the oral cavity indicates the destruction of connective tissue that points at the intensity of inflammation processes of oral cavity mucous membranes and at the necessity in periodontological treatment. Values of LL-37 were estimated in inversed relation to MMP-8, i.e. they decreased according to periodontitis degree. At first-degree periodontitis, values of cathelicidin decreased 2 times in comparison with the observation group (3,77±0,10 ng/ ml). Values at second- and third-degree periodontitis decreased 5 and 12 times correspondingly. Received findings demonstrate the decrease of antimicrobial activity both against Gram-positive and against Gram-negative bacteria. The deficiency of LL-37 in the oral fluid points at the direction of pathological manifestations and reflects the level of periodontium tissues inflammation. Values of Lactoferrin increased directly depending on periodontitis degree. At first-degree periodontitis, values of lactoferrin increased 2 times in comparison with the observation group (44,02±2,60 ng/ml). Values at second- and third-degree periodontitis increase 5 and 8 times correspondingly. These findings prove the decrease of tissue immunity in the oral cavity. It was discovered that values of lactoferrin and MMP-8 demonstrate direct correlational dependence which indicates the activity of inflammation processes in periodontium tissues. Values of lactoferrin and cathelicidin demonstrate inversed correlational dependence. Estimation of level of biomarkers in oral cavity fluid is a prospective diagnostic method which is minimally invasive, does not require specific qualification of a dentist, and gives an opportunity to estimate the present state of denture base tissues, which allows rational planning of prosthetic rehabilitation of dental patients and controlling the process of adaptation.
biological markers, periodontal diseases, diagnosis.
- Malyj DYu. Epidemiologiya zahvoryuvan` parodonta: vikovyj aspekt. Ukrayins`kyj naukovo-medychnyj molodizhnyj zhurnal. 2013;4:41-3. [in Ukrainian].
- Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017 Jun 22;3:17038. DOI: 10.1038/ nrdp.2017.38
- Ramirez JH, Parra B, Gutierrez S, Arce RM, Jaramillo A, Ariza Y, Contreras A. Biomarkers of cardiovascular disease are increased in untreated chronic periodontitis: a case control study. Aust. Dent. J. 2014;59(1):29-36.
- Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012;55(1):21-31.
- Brennan DS, Spencer AJ, Roberts-Thomson KF. Quality of life and disability weights associated with periodontal disease. J. Dent. Res. 2007;86(8):713-7.
- Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, et al. Primary prevention of periodontitis: managing gingivitis. J. Clin. Periodontol. 2015;42(16):71-6.
- Slots J. Periodontology: past, present, perspectives. Periodontol. 2013;62(1):7-19.
- Trindade F, Oppenheim FG, Helmerhorst EJ, Amado F, Gomes PS, Vitorino R. Uncovering the molecular networks in periodontitis. Proteomics Clin. 2014;8(9-10):748-61.
- Castro CE, Koss MA, Lopez ME. Biochemical markers of the periodontal ligament. Med. Oral. 2003;8(5):322-8.
- Kudo C, Naruishi K, Maeda H, Abiko Y, Hino T, Iwata M, et al. Assessment of the plasma/serum IgG test to screen for periodontitis. J. Dent. Res. 2012;91(12):1190-5.
- Kim HD, Sukhbaatar M, Shin M, Ahn YB, Yoo WS. Validation of periodontitis screening model using sociodemographic, systemic, and molecular information in a Korean population. J. Periodontol. 2014;85(12):1676-83.
- Barros SP, Williams R, Offenbacher S, Morelli T. Gingival crevicular fluid as a source of biomarkers for periodontitis. Periodontol. 2016;70(1):53-64.
- Pfaffe T, Cooper-White J, Beyerlein P, Kostner K, Punyadeera C. Diagnostic potential of saliva: current state and future applications. Clin. Chem. 2011;57(5):675-87.
- Tabeta K, Hosojima M, Nakajima M, Miyauchi S, Miyazawa H, Takahashi N, et al. Increased serum PCSK9, a potential biomarker to screen for periodontitis, and decreased total bilirubin associated with probing depth in a Japanese community survey. J. Periodontal Res. 2018;53(3):446-56.
- Ingman T. Matrix metalloproteinases and their inhibitors in gingival crevicular fluid and saliva of periodontitis patients. J. Clin. Periodontol. 1996;23:1127-32.
- Birkedal-Hansen H. Role of matrix metalloproteinases in human periodontal diseases. J. Periodontol. 1993;64:474-84.
- Lin Zhang, MSc, RN, Xiue Li, RN, Hong Yan, RN, Lei Huang. Salivary matrix metalloproteinase (MMP)-8 as a biomarker for periodontitis A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) [Internet]. 2018 Jan;97(3):e9642. Published online 2018 Jan 19. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779768. DOI: 10.1097/MD.0000000000009642
- Kushlinskii NE, Solovykh EA, Karaоglanova TB, Bayar U, Gershtein ES, Troshin AA, et al. Content of matrix metalloproteinase-8 and matrix metalloproteinase-9 in oral fluid of patients with chronic generalized periodontitis. Bull Exp Biol Med. 2011 Dec;152(2):240-4. DOI: 10.1007/s10517-011-1498-2
- Figueredo CM. The short-term effectiveness of non-surgical treatment in reducing protease activity in gingival crevicular fluid from chronic periodontitis patients. J. Clin. Periodontol. 2004;31:615-9.
- Neiminen A. The effect of treatment on the activity of salivary proteases and glycosidases in adults, with advanced periodontitis. J. Periodontol. 1993;64:297-301.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 365-369 pages, index UDK 616.314.17-018+616.314.2]-037-07:577.112