The effect of removable acrylic dental prostheses on immune homeostasis of the oral mucosa depending on the applied materials and structures

Abstract

Aim. To pathogenetically substantiate the effectiveness of performing prosthetic appliances of the dentition defects and predicting the results of occlusal rehabilitation of patients with pathology of the dental system based on the analysis of immune homeostasis of the oral mucosa. Methods. Examined were 39 people with secondary partial (I and II class according to Kennedy) and complete lack of teeth aged from 25 to 85 years, for whom removable acrylic dentures were manufactured. The control group included 18 people aged 20-85 years with abnormal dentition, requiring preliminary surgical preparation for prosthetics. Three age groups were identified: 20-40 years (first group), 40-60 years (second group), aged 60 and above (third group). Conducted was a morphological study of prosthetic bed biopsies obtained after 3, 6 and 12 months after returning the prostheses with immunohistochemical determination of markers for CD68, CD204, and CD163, with high specificity for dendritic cells, mast cells and macrophages, respectively, providing the immune homeostasis of the oral mucosa. For identification of intraepithelial lymphocytes determined was the expression of CD4 and CD8. In order to evaluate the intensity of regeneration of epithelial cells determined was the expression of the Ki-67 marker. Results. In the individuals of the first and second age groups noted was the predominance of dendritic, mast cells, CD4+ and CD8+. In patients of the third group the dynamics of the content of CD68+ and CD163+ cells in the mucosa of the prosthetic bed was less pronounced. A direct strong correlation relationship between the proliferation index and the number of CD68+, CD204+, CD4+, CD8+ cells, which provide the immune homeostasis of the oral mucosa in these patients, was established. A direct strong correlation relationship between the clinical changes in the oral cavity in the process of usage of the removable dentures and the absolute number of lymphocytes and dendritic cells in the inflammatory infiltrate was established. Revealed were the dynamics of changes in mitotic activity of keratinocytes in the process of usage of the removable dentures and the correlation of these parameters with the terms of use of the prostheses. Conclusion. The changes of the immune homeostasis parameters of the oral mucosa with this type of prosthesis can be considered a basis for pathogenetic substantiation of treatment and predicting the outcomes of occlusal rehabilitation of dental patients.