Clinical and immunological monitoring of gingival fluid cytokines in patients with perimplantitis during photodynamic therapy

The effect of FDT on the processes of mucosal immunity, in particular, the cytokine profile, remains practically unstudied.

Objective: clinical and immunological assessment of the effectiveness of FDT in the complex treatment of periimplantitis at the initial stage of the relief of the inflammatory process.

Materials and research methods. The study included patients who contacted the dental institutions of the Republic of Dagestan and the clinic of the Department of Surgical Dentistry of Moscow State Medical University aged 20 to 49 years with a diagnosis of periimplantitis, a total of 61 people. 33 patients received the ABT (the main group 1), 28 patients received the PDT (the main group 2). The control group consisted of 76 patients with stable implants without signs of inflammation or periodontitis (intact periodontium). The concentration of cytokines TNF, IL-1β, IL-6, and IL-17A in the oral fluid was determined by ELISA twice using the INFINITE F50 analyzer (TECAN, Austria) and test systems (Vector-Best, Novosibirsk, Russia). Results. Differences in the state of the cytokine profile in ABT (amoxicillin / sodium clavulanate at 825/125 mg 2 times a day for 7 days) and PDT (FotoSan 350 apparatus, photosensitizer toluidine blue: 4 sessions every 1 day for 40 sec) were found. The maximum cytokine response was observed in the evaluation of IL-1β (137–139 pg/ml) and IL-17A (161–172 pg/ml). After 1 month, statistically significant differences were revealed between the groups of patients with periimplantitis receiving different treatment options. The level of TNF-α decreased by 2.5 times and corresponded to the norm in the case of PDT, but with ABT it remained significantly higher, although we also observed a downward trend. The level of IL-17A showed a statistically significant decrease in PDT, while in ABT, the decrease was not significant. 3 months after treatment, complete normalization of the levels of TNF-α, IL-6 and IL-17A was observed in both compared groups, with the exception of IL-1β, which remained elevated: 8.6 times with PDT and 25 times with ABT.

Conclusion. The cytokine profile of gingival fluid in periimplantitis is an important diagnostic marker for the severity of inflammation, which can confirm the presence of periimplantitis and predict the course. The content of IL-1β and IL-17 A reflects the severity of the process. Restoring normal levels of IL-1β is slower than IL-17 A.

1. Аверьянов С. В., Гуляева О. А. Повышение эффективности консервативного лечения воспалительных осложнений после дентальной имплантации. Стоматология. 2017 (96) № 6-2:20-20.

2. Андреева В. В., Галиева Э. И. Диагностика и лечение периимплантита. Актуальные вопросы стоматологии. 2018:10–14.

3. Балмасов Р. С., Дюмеев Р. М., Галиева Э. И. Лечение и профилактика периимплантита. Актуальные вопросы стоматологии. 2018:29–32.

4. Лабутова А. В. и др. Нозологический статус хронического периимплантита: синдром или болезнь? Пародонтология. 2019 (24) № 4:15–21.

5. Кузнецов К.В. Оптимизация подготовки пациентов к амбулаторным хирургическим операциям и контроль эффективности лечения в послеоперационном периоде. Автореф. дисс. к.м.н. М., МГМСУ. 2019, 24с.

6. Николаева Е.Н., Царев В.Н., Панин А.М., Чувилкин В.И., Ипполитов Е.В., Хитаришвили М.В., Царева Т.В. Экспрессия цитокинов в зубодесневой борозде у больных периимплантитами. Dental Forum. 2012. № 2. С. 5–9.

7. Царев В.Н. Микробиология, вирусология, иммунология полости рта. М.: ГЭОТАР-Медиа, 2019, 720с. DOI: 10-33029-9704-5055-0-MVI-2019-1-720 -ISBN 978-5-9704-5055-0.

8. Янушевич О.О., Ахмедов Г.Д., Панин А.М., Арутюнов С.Д., Царев В.Н. Микро- экология полости рта и инфекционно-воспалительные осложнения в хирургической стоматологии (монография). М.: Практическая медицина, 2019. 192с.

9. Kröger A. et al. The severity of human peri-implantitis lesions correlates with the level of submucosal microbial dysbiosis. Journal of clinical periodontology. 2018 (45) №12:1498-1509.

10. Kumar P. S. et al. Pyrosequencing reveals unique microbial signatures associated with healthy and failing dental implants. Journal of clinical periodontology. 2012(39) №5:425-433.

11. Ипполитов Е.В., Азизова А.С., Ахмедов Г.Д., Коробова Е.В. Различия цитокинового ответа у жителей Дагестана и московского региона при развитии хронического пародонтита. Медицинский алфавит. Стоматология. 2012. Т. 4. № 19. С. 25-29.