The role of cytokines, chemokines and growth factors in extraction socket healing

Abstract

Relevance. Reparative processes in the extraction socket include hemostasis, inflammation, proliferation and tissue remodelling. These processes are caused by mediators which determine interactions in the immunoregulatory, cytokine network. After the tooth extraction, pro- and anti-inflammatory mediators are unbalanced. The number of macrophages, lymphocytes, neutrophils releasing lysosomal enzymes increases in the surrounding tissues, and it leads to cleaning of the extraction socket from the damaged tissues and microorganisms. The growth factors are of great importance for reparative processes. The level of cytokines, chemokines and growth factors in biological fluids is the assessment criterium of various physiological and pathological processes and effectiveness of the treatment procedures. Purpose – to assess the activity of the wound healing processes by studying the level of cytokines/ chemokines and growth factors in the extraction socket. Materials and methods. The data received on examination of 40 patients was used in the study. 20 of the patients had their teeth extracted for chronic periodontitis and the socket healing was studied by clinical and laboratory findings (seven mediators of immunoregulatory processes were studied). The comparison group consisted of 20 subjects without periodontal pathology. Results. Clinical data, typical for the normal socket healing, are characterized by the certain content of immunoregulatory mediators (IL1β and IL6 – proinflammatory cytokines, IL8 and MCP1 – chemokines, RAIL1 – anti-inflammatory cytokine, VEGF and TGFβ1- growth factors). The content of proinflammatory cytokines and chemokines was detected to increase in the socket on the first day after the extraction, which indicates the activity of the local inflammatory process. The level of RAIL 1 and VEGF and TGFβ1 growth factors increases in the extraction socket five days later. Conclusion. The post-surgical activity of the inflammatory and regenerative processes in the tissues is revealed by the level of cytokines/ chemokines on the first day after surgery and the level of growth factors and RAIL1 in the socket discharge on the fifth day after surgery.