Diagnostic value of biomarkers of bone metabolism in the gingival fluid in inflammatory-destructive and tumor oral pathology

Abstract

The aim of the work was to determine the informativeness of the assessment of biochemical markers in the gingival fluid with destructive bone changes in the peri-implantation area, primary tumor lesion of the alveolar processes of the jaws and metastatic destruction of the jaw bone tissue in cancer of the large salivary glands. The study included 51 patients aged 30 to 75 years of both sexes. Depending on the genesis of destruction of the bone tissue of the lower jaw, three groups of patients were identified. Group 1 - 20 patients with peri-implantitis. Group 2 - 22 patients diagnosed with cancer of the oral floor mucosa (ICD C04) with erosion of the cortical bone or dental socket by a primary tumor. Group 3 - 9 patients with adenocarcinoma of the large salivary glands with metastatic lesions of the lower jaw. 15 people were practically healthy persons without periodontal pathology. The test material was gingival fluid or exudate from peri-implantation pockets. The content of cathepsin K, tartrate-resistant acid phosphatase (TAP) was determined by the enzyme immunoassay, and the bone fraction of alkaline phosphatase (BAP) was determined by the kinetic method. As a result, it was found that in group 1 in the exudate of the peri-implantation sulcus, the content of cathepsin K increased in comparison with the control by 2.5 times (p<0.05), TAP by 1.6 times (p<0.05). in groups 1 and 2, there was a moderate increase in the production of activated osteoblasts of KAP. In cancer of the mucous membrane of the floor of the mouth, a tenfold increase in the concentration of cathepsin K and TAP in the gingival fluid was observed. With metastatic lesions of the jaw in patients with adenocarcinoma of the large salivary glands, along with a multiple increase in the concentration of cathepsin K and TAP in the gingival fluid, there was a twenty-fold increase in the bone formation marker BAP, which indicated a mixed type of metastases and was a differential diagnostic criterion for metastatic lesion of bone tissue in comparison with the primary metastatic lesion of bone tissue. Thus, biochemical markers are sensitive indicators of remodeling of bone tissue both in local inflammatory and destructive processes in peri-implantitis and in primary and metastatic tumor lesions of the jaws.