Oral Fluid Of Patients Research Articles

The effect of oral cavity condition on expression of saliva biomarkers in patients with oral mucosa pathology

Introduction. Despite visual accessibility of the elements of tumor lesions in the oral mucosa, patients with this pathology rarely seek medical help. Regeneration of the mucosa is a long process taking varying time depending on the location of the lesions. Asymptomatic tumor process leads to its diagnosis at late stages.Aim. To develop clinical and proteomic approach to diagnosis of malignancies of the oral mucosa at the stage of out-patient dentist appointment.Clinical observations. Examples of extended clinical, dental and immunoenzymatic monitoring in patients with elements of tumor lesions of the oral mucosa with long-term course are presented.Conclusion. The use of extended clinical, dental and immunoenzymatic analysis of oral fluid in patients with elements of tumor lesions of the oral mucosa allows to diagnose this pathology early.

Cytokine profile of oral fluid in case of traumatic fractures of the lower jaw and the presence of third molars in patients` oral cavity

Objective. To analyze the level of cytokines in the oral fluid of patients with traumatic fractures of the mandible in the presence of third molars, to establish the influence of the latter on the oral cavity homeostasis, to determine the most informative indicators. Materials and methods. 82 people aged 18–60 years took part in the study, they were divided into 3 groups. Group 1 contained 43 patients with mandibular fracture and having more than two third molars. Group 2 consisted of 18 patients with mandibular fracture, without third molars. Group 3 included 21 people without a fracture of the mandible, who had more than two-thirds of the molars. Group 4 (control) contained the data of somatically and dentally healthy individuals, borrowed from special literature. The levels of IL-1β, IL-6, IL-8, and TNF-a in OF were determined using standard enzyme immunoassay kits. The data were processed statistically. Results. A comparison of the indicators of groups 1 and 3 revealed a significant increase in the level of IL-6 z = 4.15 (H = 20.43; p = 0.0001) and the level of IL-8 z = 3.08 (H = 12.29; p = 0.0064) in patients with a jaw fracture. A considerable increase in IL-8 levels was determined in the individuals from group 2 compared with group 3 – z = 2.74 (H = 12.29; p = 0.0064). The comparison of groups 1 and 4 in terms of TNF-a showed a tendency to a significant difference of z = 1.60 (H = 4.65; p = 0.19), and the data of group 2 in comparison with group 4 were significantly higher than z = 1.97 (H = 4.65; p = 0.19). Comparing the results of groups 3 and 4 with each other we revealed a considerable difference of z = 1.75 (H = 4.65; p = 0.19). Conclusion. The profile of cytokines level in the OF indicates that the presence of third molars in the oral cavity in mandibular fractures affects the homeostasis of the oral cavity negatively, which is the reason for expanding the indications for their removal in order to prevent infectious and inflammatory complications.

Results of biochemical and histological studies after restoration of bone defects using cellular technologies in dental patients

Objective of the research was to find out the effectiveness of the use of osteoplastic materials based on the multipotent mesenchymal stromal cells of the adipose tissue during surgical treatment for restoration of bone defects in dental patients. The clinical material included examination of 79 patients who underwent replacement of bone defects of the alveolar processes and/or an alveolar part of the appropriate jaw by means of different osteoplastic materials and their combinations or without their application (the control group). Acid phosphatase activity in the oral fluid of patients was determined by means of the unified “end point” method. Alkaline phosphatase activity in the oral fluid was determined using a set of reagents produced by the company “Filisit-Diagnostika” (Ukraine). Oral fluid mineralization index (MI) of patients was calculated according to the ratio of enzymatic activity of alkaline phosphatase (ALP) to acid phosphatase (AP) according to the formula: MI=ALP/AP. Histological material was taken at the stage of installation of a dental implant. It was established that the use of a composition based on multipotent mesenchymal stromal cells of adipose tissue, platelet-enriched blood plasma and bone tissue substitute containing hydroxyapatite contributes to the improvement of regenerative processes in the bone tissue of the jaws, which is confirmed by a 28.68% decrease in acid phosphatase activity, an increase by 25, 97% of alkaline phosphatase activity in the oral fluid of group B patients and, accordingly, a 77.08% increase in the ratio of alkaline to acid phosphatase. According to the results of histological studies and phase-contrast microscopy, after 6-8 months of observation, in patients of group B, the areas of jaw defects were filled with newly formed bone tissue, identical to native bone, and the resulting trepanobioptas had the structure of cancellous bone with osteoblastic elements forming a chain around osteoid tissue. Having analyzed the results of biochemical and histological studies it was established that application of an osteoplastic composition based on the multipotent mesenchymal stromal cells of the adipose tissue, bone tissue substitute with hydroxyapatite and platelet-rich plasma allows restoration of bone defects of the alveolar processes and an alveolar part of the appropriate jaw in shorter terms. The method is an optimal alternative to traditional osteoplastic materials to be used in modern dental practice and dental implantation.

Bactericidal Activity Changes in Saliva During Post-Covid

In the post-covid period, changes occur in the oral cavity, which may be caused by the action of a new coronavirus infection. Studies show that the virus can negatively affect the cells of the oral mucosa, which in turn leads to a decrease in local immunity. The lack of protective factors makes the body more vulnerable to the virus and can lead to complications. The aim of the study is to analyze changes in the parameters of immunoglobulins in oral fluid of patients before and after a new coronavirus infection. The literature analysis was carried using the following scientometric databases: PubMed, Scopus, Google Academy, Rospatent, RSCI. This article describes changes in the composition of saliva and a decrease in its amount in the post-covoid period and provides links to 39 scientific publications. Literature analysis showed that, in the post-covid period, changes in the parameters of secretory IgA, salivation rate of saliva and lysozyme activity occur in saliva and oral fluid.

VALUE OF BONE REMODELLING MARKERS IN MANDIBULAR FRACTURE PATIENTS BY GENDER AND BONE MINERAL DENSITY

Numerous studies have shown that fractures of the mandible are the most common injuries of the facial skeleton. The high incidence of such fractures is due to the anatomical and physiological characteristics of the mandible, as well as a variety of local and general causes. Disturbances in the structural-functional properties of bone tissue can occur as a result of internal and external influences and provide a favorable background for the development of fractures in various locations, including the mandible. A large number of regulatory factors of a nervous, humoral and immune nature, the presence of inflammation as an obligatory (first) phase of reparative regeneration after bone damage, dictate the need for an in-depth study of the structuralfunctional state of bone tissue in patients with traumatic injuries of the mandible, through the improvement of diagnostic and therapeutic methods. The aim of the study is to analyze the levels of bone remodeling markers in the oral fluid of patients with traumatic lesions of the mandible according to sex and BMD status compared with those of practically healthy control subjects (without general somatic and dental diseases). Materials and methods. The study is based on the results of laboratory tests on 151 people (main group) with mandibular fractures and 30 people (control group) without general somatic and dental diseases. The study included patients of both sexes aged 18-44 years: 92 (60,93%) male and 59 (39,07%) female patients. The levels of total calcium (Ca) and inorganic phosphorus (P) in the oral fluid were determined by photometric methods using commercial kits from «Filisit-Diagnostics» (Ukraine). The activity of alkaline phosphatase and acid phosphatase in oral fluid was determined by the kinetic method with n-nitrophenol phosphate. Oxyproline excretion was determined in daily urine using the Cobas test system (Roshe Diagnostics, Germany). Statistical processing of the study results was performed using Microsoft Excel and Statistics software packages for the statistical analysis of biomedical research data. Results and discussion. As a result of the studies, it was found that in men with osteoporosis, the levels of P in oral fluid were not significantly different from those in the control group, p>0,05. At the same time, the remaining values of bone remodeling markers in biological fluids were characterized by a pronounced imbalance, namely an increase in Ca content by 92,85%, p<0,01, p1<0,05, Ca/P ratio by 2,8 times, p, p1<0,01, AP activity by 89,48%, p<0,01, p1>0,05, ALP by 56,34%, p<0,05, p1>0,05, and urinary hydroxyproline level by 54,09%, p, p1<0,01, compared with the same data in the control group. In women with osteoporotic mandibular fractures, the values of all the parameters studied were significantly different from those of the control group. Thus, we found an increase in the oral fluid content of Ca – by 102,38%, p, p1<0,05, Ca/P ratio – by 3,5 times, p, p1<0,01, AP activity – by 99,06%, p, p1<0,01, ALP – by 65,15%, p, p1<0,01 against a decrease in the value of P – by 42,31%, p, p1<0,05, compared to the data of the control group. At the same time, in this subgroup of women there was an increase in urinary hydroxyproline by 58,26%, p, p1<0,01, compared to the data in the control group. Conclusions. Thus, analysis of bone remodeling marker levels showed that in patients with mandibular fractures due to destruction of the bone matrix as a result of trauma, there was an increase in osteoresorption activity that depended on the structural-functional state of the patients' bone tissue and was more pronounced in women.

INDEX ASSESSMENT OF THE STATE OF THE ORAL CAVITY IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX DISEASE

It has been established that diseases of the gastrointestinal tract, namely gastroesophageal reflux disease, affect the oral cavity. It should be noted that GERD is one of the most common diseases of the digestive tract in the world. The close relationship of the oral cavity, due to the similarity of functions, the common blood supply, innervation, and the morphological structure of the gastrointestinal tract leads to a violation of immunological reactivity, physical and chemical changes in saliva. SORP is a powerful receptor field that perceives the receptor influences of the whole organism. Numerous studies by clinicians confirm that 75% of patients with ENT pathologies are examined for gastrointestinal tract diseases. With increased acidity of gastric juice, there is hypersalivation, hypertrophy of the filiform papillae of the tongue in combination with foci of desquamation, pallor and swelling of the mucous membrane of the oral cavity, catarrhal gingivitis. With reduced acidity of gastric juice, there is a large number of plaques on the tongue, atrophy of filiform papillae, decreased salivation, dry lips, and angular cheilitis are observed. This is due to the weakening of the pharyngeal and cardinal valves of the stomach, as a result of which the contents of the stomach with its secretory component are thrown into the oral cavity, thereby affecting the taste buds. The index evaluation of the state of the oral cavity based on the index of plaque on the back of the tongue, the index of oral hygiene -OHI-S, the determination of the acidity of the oral fluid in patients with GERD indicates a dependence on the level of acidity of gastric juice. Gastroesophageal reflux disease negatively affects oral hygiene, the acid-alkaline balance of oral fluid, which leads to the formation of pathological processes in the oral cavity. Homeostasis of the oral cavity is maintained due to the acid-alkaline balance, the main indicator of which is the pH of the oral fluid. Oral fluid is considered an integral environment of the human body, therefore metabolic processes affect its composition.
 Aim. To study the indexes of the state of the oral cavity according to the indicators: index of plaque on the tongue according to (WTS); pH of oral fluid; hygiene index - OHI-S.
 Materials and methods. To achieve the goal, 60 patients aged 25 to 55 years were examined. Of them, 30 are practically healthy people, 30 are patients with gastroesophageal reflux disease (of which 15 have increased acidity of gastric juice, and 15 have been examined with reduced acidity). IN THE RESEARCH PROCESS, WE STUDY INDICATORS index of plaque on the tongue according to (WTS); pH of oral fluid; hygiene index - OHI-S.
 Results. At the initial examination, plaque (W.T.C INDEX) was noted in patients with GERD. Thus, in the main group, the preference for a thick plaque on the back of the tongue was noted. Evaluating the state of oral hygiene (according to the Green-Vermillion index), it should be noted that, in general, hygiene was satisfactory in the main group of the examination. With increased acidity of gastric juice, at the age of 25-35, the satisfactory condition of the oral cavity according to the Green-Vermillion index was noted and was 1.4±0.1, and the group of female patients of the same category had an unsatisfactory state of oral hygiene and was 1.76±0 ,06. With low acidity, the hygienic index of the oral cavity in men aged 25-35 years was 1.3±0.1 and was satisfactory, while in women of the same age it was 2.0±0.4, which was unsatisfactory. Thus, in the 2nd group of women with reduced acidity aged 45-55 years, the indicator was 2.7±0.2, and in men of the same age, it was 2.3±0.3. Thus, when studying the pH of oral fluid in the main group, we noticed that the lower the pH level, the more acidic the environment. The acid-alkaline balance of the oral fluid is important for metabolism. Normally, the acidity of a person varies from 6.8-7.4 pH, and with a high rate of salivation it can reach 7.8 pH. With gastroesophageal reflux, which reaches the oral cavity, a decrease in the pH of saliva leads to pathological changes in the mucous membrane.
 Conclusion. So, the studied indices make it possible to assess the hygienic condition of the oral cavity, acid-alkaline balance in accordance with the level of acidity of gastric juice in GERD.

IMMUNOLOGICAL ANALYSIS OF ORAL FLUID IN PATIENTS WITH GENERALIZED PERIODONTITIS

The objective of this study is to conduct an immunological analysis of oral fluid, specifically focusing on determining the interleukin status among patients with generalized periodontitis and underlying metabolic syndrome. Materials and methods. For immunological studies, 3 groups were formed: main group, comparative and control groups. The main group included 30 individuals with generalized periodontitis and metabolic syndrome, the comparison group included 30 people with generalized periodontitis without somatic pathology; 20 healthy individuals with intact periodontium made up the control group. The content of pro-inflammatory cytokines IL-1β, IL-6, TNF-α and anti-inflammatory cytokines IL-4, TGF-β1 in the oral fluid of the subjects of the examination groups was determined by the method of solid-phase enzyme immunoassay using reagents of the company "Simko" (Ukraine).
 Results. According to average values obtained, the highest levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) were found in individuals with periodontal pathology and metabolic syndrome. The value of the IL-1β content in the oral fluid of the main group was 1.1 times higher than the similar indicator of the comparison group, and 1.4 times higher than the indicator of the control group. The mean IL-6 content in the oral fluid of patients with metabolic syndrome was 1.3 times higher compared to individuals without the systemic disease. Interestingly, the disparity was more pronounced in healthy individuals, with IL-6 levels differing by 2 times.
 Conclusion. Patients with metabolic syndrome and periodontal pathology have significant disturbances in cytokine regulation. Cytokines are key factors in the formation of a local inflammatory reaction, therefore, an increase in the concentration of pro-inflammatory IL-1 β can be considered an immune response to the inflammatory process in periodontal tissues.

Pharmacological correction of the activity of bone remodelling markers in the oral fluid of patients with generalised periodontitis depending on blood type

This article presents the data on the effectiveness of the treatment complex we developed on the activity of bone remodelling markers in the oral fluid during the treatment of generalized periodontitis, depending on the blood group. The use of our proposed drugs of general and local action in patients with generalized periodontitis of different blood groups allowed to reduce the average content of TRACP in the oral fluid by 18.25%, while increasing the level of BSALP by 27.64% in comparison with the corresponding data before treatment, p, р1<0.05, 0.01, which indicates the predominance of bone remodelling processes over osteoresorption processes in patients of the main group. The tactics of treatment of patients with generalized periodontitis of different blood groups, which we propose, is more effective than the conventional therapy and contributes to a faster achievement of remission of generalized periodontitis.

Indicators of Mineral Metabolism in the Oral Fluid in Patients with Gastroesophageal Reflux Disease

Disruption of the digestive system in the gastrointestinal tract, namely in gastroesophageal reflux disease, leads to the development of pathological processes in the oral cavity, changing the homeostasis of the viscoelastic gel layer of the esophageal mucosa. Thus, it has been proven that there are reflex connections between the receptor apparatus of the esophageal mucosa and the efferent nerve fibers of the salivary glands, which can be disrupted in GERD. Therefore, saliva is involved in providing effective protection of the esophagus. As a result, the content of mineral components changes significantly: in particular, the level of calcium and enzyme composition.
 Aim to study the indicators of mineral metabolism: the content of calcium, alkaline, and acid phosphatases in mixed saliva in patients with gastroesophageal reflux disease.
 Methods 60 patients of various ages who underwent inpatient treatment at the IFNMU University Clinic were examined, where pH-metry was performed to determine acidity. The main group consisted of patients diagnosed with GERD, with decreased and increased acidity. The content of indicators of mineral metabolism in saliva was determined as follows: calcium (Ca) - photometric method with arsenase -111; acid phosphatase (AC) was determined by the Hillman method, alkaline phosphatase (AL) by hydrolysis of p-nitrophenyl phosphate at pH -10.4, release of p-nitrophenol and phosphate. The norm of indicators of mineral metabolism was established on 30 practically healthy volunteers. Statistical processing of data was carried out using the Microsoft Excel program by calculating the arithmetic mean.
 Conclusions thus, the results obtained indicate that in GERD there is a violation of mineral metabolism in the oral fluid. The oral fluid is the first to come into contact with the reflux agent. This leads to a violation of saliva neutralization, so the study of saliva mineral composition can be considered as an early diagnostic marker for gastroesophageal reflux disease.

Assessment of the pH value of the acid-base balance of
 the oral fluid in patients before the application of orthodontic
 devices, after three and six months of treatment
 with removable and non-removable equipment made of
 different materials

Hardware orthodontic treatment with intraoral devices
 made of various materials can contribute to the development
 of an imbalance of a number of chemical elements in the
 body, as well as their redistribution in the oral fluid. These
 changes affect the metabolic processes of both essential
 (vital) and toxic trace elements that can accumulate in the
 body, as well as affect the hydrogen pH of the oral fluid.
 Research objective. To investigate the hydrogen index of
 acid-base balance of oral fluid in patients before and during
 orthodontic treatment with various equipment in
 dynamics.

Cytokine profile of oral fluid in patients with food allergy associated with atopic dermatitis and psoriasis

The world is experiencing a rapid increase in the prevalence of allergic and autoimmune diseases. It is known that allergic inflammation is most often systemic, involving various organs and systems in the pathological process, such as the skin, respiratory and gastrointestinal tract with the development of dermatorespiratory, dermato-intestinal and other manifestations. The study of the features of the cytokine profile in oral fluid (saliva) deserves special attention, since these characteristics reflect not only local, but also systemic disorders. Of particular relevance is the study of local cytokine regulation of intercellular interactions in food allergies. Our objective was to study the concentration of IL-4, IL-10, IFNγ, secretory IgA in salivary fluid, the concentrations of total immunoglobulin E and eosinophilic cationic protein in blood serum of the patients with atopic dermatitis and psoriasis with concomitant food allergies.The study included patients with atopic dermatitis (AD, group 1, n = 20), psoriasis with concomitant food allergy (PS, group 2, n = 27), psoriasis without concomitant allergies (PS, comparison group 3, n = 23). Quantitative assessment of the cytokine concentrations (IL-4, IL-10, IFNγ, sIgA) in salivary fluid was carried out by enzyme-linked immunosorbent assay. Concentrations of total immunoglobulin E and eosinophilic cationic protein in blood serum were determined by indirect immunofluorescence. The obtained results were processed using the Statistica 8.0 applied software.In groups of patients with atopic dermatitis (Group 1) and psoriasis with concomitant food allergy (Group 2), we have noted a statistically significant increase of salivary IL-4 and IL-10, as well as of total immunoglobulin E concentrations in blood serum as compared with a group of patients with psoriasis without concomitant allergies (group 3), and with control group. When studying concentrations of IFNγ in saliva, no statistically significant intergroup differences were found. The concentration of sIgA in saliva was significantly higher in the groups of patients with atopic dermatitis and psoriasis accompanied by food allergies in comparison with control group and the group of psoriatic patients without food allergies (group 3).The cytokine profile of saliva is characterized by unidirectional changes in food allergy. Skin seems to be the shock organ in this condition, regardless of nosological form of the disease (atopic dermatitis or psoriasis). Salivary fluid is an easily accessible material when assessing the state of mucosal immunity in food allergies.

ANALYSIS OF MICROBIOCENOSIS OF ORAL FLUID IN PATIENTS WITH DEFECTS OF DENTITION, ZAKARPATTIA REGION RESIDENTS

Dental diseases are among the most frequent diseases of the human body. The microflora of the oral cavity is specific, unlike the microflora of other cavities both in composition, quantity, and functions. The resident microflora will play an important role both in maintaining the normal physiological state of the oral cavity and in the development of dental diseases.
 The aim of the study is to establish insemination with clinically significant microorganisms of oral fluid in patients with defects of dentition, Zakarpattia region residents.
 The species and quantitative composition of microbiocenosis of the oral fluid of 282 (94 men and 188 women) patients with dentition defects, residents of the Zakarpattia region, confirms the formation and progression of inflammatory and inflammatory-dystrophic changes in the periodontal tissues.
 In patients with bilateral end defects according to Kennedy, the predominance of anaerobic microflora was determined in the form of Klebsiella pneumonia (108), Prevotella spp. (7×105), Enterobacter spp. (102), Porphyromonas spp. (5×105), Staphylococcus epidermidis (104) and Staphylococcus aureus (1,2×103), Streptococcus pneumonia (108), Streptococcus viridans (103), Enterobacter spp. (102) and opportunistic microorganisms Candida albicans (104).
 Among patients with unilateral end defects according to Kennedy, Enterococcus faecalis was defined. (103), Staphylococcus epidermidis (102–103) and Staphylococcus aureus (105), Streptococcus pneumonia (105–107), Streptococcus viridans (102–5×105), Stahylococcus haemolyticus (102), Candida albicans (5×102) and Escherichia coli coli (109).
 In patients with included defects in the lateral areas according to Kennedy, there were cultured Klebsiella pneumonia (101–3.5×106), Prevotella spp. (4-5×101), Enterococcus faecalis (107), Peptostreptococcus micros (3.5×103–5×103), Staphylococcus haemolyticus (101–105) and Staphylococcus aureus (101–105), Streptococcus pneumonia (106–108 ), Streptococcus pyogenes (105–109), Candida albicans (102), Escherichia coli (107), Sarcina spp. (103) and Citrobacter spp. (104).
 Microbiocenosis of the oral fluid of the fourth clinical group with included defects in the frontal areas according to Kennedy is presented Lactobacillus acidophilus (108-1011), Streptococcu mitis (108-1011), Bifidobacterium (108-1010), Streptococcus salivarius (1081010), Streptococcus mutans (107-109), Streptococcus pneumonia (104 –108), Streptococcus sanguis (105–107).
 Therefore, in patients with dentition defects, the microflora of the oral fluid confirms the formation of inflammatory and inflammatory-dystrophic processes in the periodontal tissue due to the prevalence of anaerobic flora, while in the presence of inclusions in the frontal area, the prevalence of normal obligate microflora is diagnosed.

Immunoglobulin A response to SARS-CoV-2-N-protein potentially persists in oral fluids of patients with periodontitis six months after mRNA vaccine administration

Few studies have investigated the mucosal immune response after BNT162b2-booster vaccination in individuals with periodontitis. In this study, we evaluated the persistence of IgA anti-SARS-CoV-2-N-protein in saliva and gingival crevicular fluid (GCF) of patients with periodontitis for at least six months post BNT162b2 vaccine booster. We included patients with moderate (n = 7) and severe (n = 7) periodontitis and participants without periodontitis (n = 7) as controls. The Bradford method measured the protein concentrations in the samples, and an enzyme-linked immunosorbent assay of the SARS-CoV-2 N protein was performed to analyze the targeted IgA level. For the tested SARS-CoV-2 antigen (N-protein), IgA levels in saliva and GCF showed a strong and significant correlation. Therefore, in patients with moderate or severe periodontitis, saliva and GCF can provide information regarding the IgA response against SARS-CoV-2-N-protein. The neutralizing activity of IgA against SARS-CoV-2 was not investigated in this study, necessitating further research.

Microvesicles and neutrophil aggression factors in the pathogenesis of chronic periodontitis

Background. It is known that the number of polymorphonuclear leukocytes increases with the development of periodontitis. However, their role in the pathogenesis of chronic periodontitis has not been fully defined.
 Aim. To study the pathogenetic role of polymorphonuclear leukocytes in the development of chronic periodontitis, realized by microvesicles and aggression factors (metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2).
 Material and methods. 30 patients aged 30 to 50 years with a diagnosis of chronic generalized periodontitis of moderate severity (K05.3) and no severe somatic pathology were under observation. The comparison group included 20 people with no inflammatory diseases in the oral cavity, comparable with the main group in terms of gender, age, nationality, and the presence of bad habits. Using a standard set of indices, the state of periodontal tissues was assessed, and all examined patients underwent X-ray examination. In the oral fluid of the examined, the total number of microvesicles and their phenotype, the concentration of matrix metalloproteinases-2 and -9, myeloperoxidase, calprotectin, lipocaine 2 were determined. The parameters were determined using a flow cytometer. Descriptive statistics are represented by the median and interquartile range (25th and 75th percentiles). Two independent sample sets were compared using the MannWhitney test. Correlation analysis was carried out according to the Spearman method.
 Results. The total number of microvesicles in the oral fluid in patients with chronic periodontitis was 11 times higher than in healthy volunteers (p=0.00001). More than a third of them had neutrophil markers. The levels of neutrophil aggression factors were also higher in patients with periodontitis and correlated with the value of the periodontal index, the depth of the periodontal pocket, bleeding index, indicators of periodontal health. Thus, a strong positive relationship was found between the total number of microvesicles and the value of the periodontal index (r=0.675), the depth of the periodontal pocket (r=0.763), the bleeding index (r=0.704); the number of neutrophilic microvesicles and indicators of periodontal health r=0.816, r=0.837 and r=0.776, respectively. The content of metalloproteinase-2 correlated with the depth of the periodontal pocket (r=0.754), bleeding index (r=0.811), papillary-marginal-alveolar index (r=0.675).
 Conclusion. Neutrophils contribute to the pathogenesis of chronic periodontitis through the secretion of aggression factors: metalloproteinases, myeloperoxidase, calprotectin, lipocaine 2, and microvesicles.

Functional activity of the oral endothelium in persons, with chronic periodontitis during treatment with plasmolifting

Chronic periodontitis as an osteoimmune disease of the oral cavity is accompanied by a change in the functional activity of endotheliocytes. Moreover, abnormal vascularization exacerbates periodontal inflammation, as it promotes the transmigration of a larger number of immunocompetent cells, the influx of inflammatory mediators and cytokines.The aim of our work was to study the functional activity of the endothelium of the vessels of the oral cavity in persons suffering from chronic periodontitis in the treatment of plasmolifting.Materials and methods. Under observation were 30 patients diagnosed with chronic generalized periodontitis of moderate severity at the age of 35 (32.50; 40.00) years, with no severe somatic pathology (main group). The comparison group included 20 people aged 38 (34.00; 45.00) years with no inflammatory diseases in the oral cavity. All patients underwent local anti-inflammatory therapy and sanitation of periodontal pockets, correction of occlusal contacts, curettage, plasma lifting. Oral fluid concentration of soluble adhesion molecules ICAM-1 and VCAM-1, endothelin-1, qualitative and quantitative composition of microflora were determined.Results. After the treatment with plasmolifting, a noticeable relief of the activity of the inflammatory process was observed. In patients with chronic periodontitis, Porphyromonas gingivalis was found in 100 % of cases in a titer of 5.73 (4.9; 6.7) lg (gEq/sample), in 62.5 % – Prevotella intermedia in a titer of 4.5 (3.0; 5.5) lg (gEq/sample). Against the background of therapy, decrease of the occurrence of the microorganism and of the number of microorganisms was observed. The concentration of the soluble form of VCAM-1 in the oral fluid of patients with chronic periodontitis exceeded the values of the control group by 38.3 times (p = 0.000001), and ICAM-1 – by 18.1 times (p = 0.00001). Against the background of plasmolifting therapy, the level of the studied substances decreased, but exceeded the control values by 25.2 and 6.4 times, respectively. The content of endothelin in the oral fluid in patients with periodontitis exceeded the values of healthy individuals by 40.7 % (p = 0.003), during therapy its values decreased, but did not reach the level of healthy volunteers (p = 0.04).

The condition of the oral fluid in patients under conditions of long-term chronic stress

Objective — to evaluate some qualitative and quantitative parameters of mixed saliva in patients at risk of metabolic‑associated diseases and military personnel under the conditions of the armed conflict in Ukraine.
 Materials and methods. The study involved patients who were included in three groups: the main group (27 individuals at risk of metabolic diseases), comparison group (19 military personnel) and control group (10 somatically healthy individuals). The survey has been performed with the use of questionnaire to assess dryness in the oral cavity, issues of changes in oral hygiene during the last year. To investigate some qualitative and quantitative parameters of unstimulated saliva, fasting oral fluid was collected in the morning. Salivation rate, oral fluid viscosity, and type of microcrystallization were studied using standard techniques.
 Results. Prevalence of persons, in whom the nature of nutrition and individual care of the oral cavity had changed, was established in all investigated groups. The study of the salivation rate revealed a significant decrease in salivation in patients of the main group and comparison groups vs the control group. The lowest secretion level was defined in patients with a risk of metabolic‑associated diseases, whose oral fluid viscosity had the highest values. The most favorable type I of crystallization prevailed only in patients of the control group, it was rare in the main group, whereas in the group of military personnel it was not found, and type II was defined in 26.3% of subjects. Negative changes in the normal life against the background of hostilities resulted in the deterioration in the physical indicators of salivation in both main and comparison groups.
 Conclusions. Long‑term chronic stress causes changes in the qualitative and quantitative composition of oral fluid. The study of microcrystallization of the mixed saliva can be used as a non‑invasive diagnostic method for detecting stress as one of the risk factors for premature aging in patients at risk of metabolic‑associated diseases.

Dynamics of free radical processes in the oral fluid of patients with chronic recurrent aphthous stomatitis at the first stage of therapy

Chronic recurrent aphthous stomatitis (CRAS) is a disease of the oral mucosa, characterized by the appearance of specific round aphthous forms with hyperemic corolla, covered with grayish-yellow plaque against the background of inflamed mucous membrane, which violates the oxidative homeostasis of oral fluid and the body as a whole.The aim of our study was to reveal the dynamics of free radical processes in oral fluid of patients with chronic recurrent aphthous stomatitis on the background of the first stage of antiseptic therapy with analgesics in order to determine the optimal treatment tactics for this condition. In order to achieve the set objective we had to solve the following tasks: to evaluate the functional activity of free radical processes in the oral liquid of patients with CPAS on the background of antiseptics (chlorhexidine, octenisept, furacilin, myramistine) and anaesthetic (Camistad gel) application for 7 days.Materials and Methods. During the study the oral fluid of 120 people diagnosed with CPPS was studied, divided into 4 groups equally: Group 1 – control, patients used the antiseptic chlorhexidine for gargling; Group 2 – patients with CPPS therapy with octenisept; Group 3 – patients with CPPS therapy with furacilin; Group 4 – patients with CPPS therapy with miramistine. For pain relief, patients in all groups used Kamistad gel. Analysis of free radical processes in oral fluid of patients was carried out before the study and on the 7th day of therapy by determining products of oxidative modification of biomolecules on the basis of quantitative evaluation of stained complex with thiobarbituric acid (TBA), maximal flash (MVHL) and area (PCL) of H2O2-induced luminol-dependent chemiluminescence using LT-01 chemiluminometer ("Horos" "Joint Venture Soviet-Swedish Company"). Concentration of diene conjugates and malonic dialdehyde was also determined to estimate enzymatic part of oxidative homeostasis.Results of the study. Results of the researches permit to conclude that at chronic recurrent aphthous stomatitis enzymatic activity of an oral liquid changes. According to the presented data the initial values of concentration of TBK-RP, maximal flash of oral chemiluminescence, area of oral chemiluminescence and concentration of MDA and DC in the control group and three experimental groups reliably differ from the data received on the 7th day of the research. Significant decrease of the studied indexes of oral liquid testifies to the efficiency of the first stage of therapy of aphthous stomatitis by antiseptic preparations and decrease of intensity of oxidative processes in oral liquid. Of all the proposed antiseptics the best efficiency is demonstrated by octenisept, reliably worse are chlorhexidine and myramistine and the least effective in the therapy of CPAS is furacilin.Conclusions: treatment of CPAS with Octenisept in combination with Camistad gel is the most effective in restoration of the disturbed oxilite.

Biophysical indicators of the mucous membrane of the oral cavity, the microcirculatory channel and the oral fluid in patients with lichen ruber planus

Annotation. The work aims to conduct a biophysical assessment of the charge state of the buccal epithelium cells (BEC), the microcirculatory channel of the oral mucosa and oral fluid in patients with the erosive-ulcerative form of lichen planus. The problem is relevant due to the increasing number of lichen planus patients, the uncertain etiology of the disease, and the ongoing struggle to find treatment solutions. 11 patients aged 50-60 years with lichen planus (erosive-ulcerative form) were examined. All patients underwent a study of the charge state of the buccal epithelium cells. Buccal cell samples were collected on an empty stomach after rinsing the oral cavity with water, applying a gentle swabbing technique. A spectrocolorimeter of type “Pulsar” was used to assess the condition of the microcapillary channel of the oral mucosa. In addition, in patients with lichen planus, the stability of the pH of the oral fluid (ΔpH) was evaluated as one of the indicators of the level of non-specific resistance in the body and the oral cavity in particular. Five 1ml samples of oral fluid were taken from each patient to calculate the value of ΔpH, where pH value was determined using an ionometer immediately after sampling. An average value of ΔрН and the confidence interval of deviations (ΔрН) from the average value were calculated, taking into account the Student coefficient for five measurements and a confidence probability of 0.95. The results obtained from biophysical studies show a significant decrease in all studied indicators. The percentage of mobile nuclei in patients with the erosive-ulcerative form of lichen planus of the oral mucosa is two times lower than in healthy people of the same age. At the same time, the plasmalemma and nuclei displacement amplitudes, as well as their ratio, were reduced compared to the norm, which indicates a decrease in their charge and deterioration of the physiological state of cells and the body as a whole. We found that individuals with lichen planus exhibit a decreased efficiency of functional reactions in the oral cavity tissues, which requires the development and implementation of effective treatment and prevention measures.

Experimental and clinical study of the concentrations of chemical elements in oral fluid from prostheses and implants

BACKGROUND: Electrochemical reactions can occur in the mouth of patients with prostheses made of metal alloys. The phenomena of galvanism reflect the hidden process of corrosion of structural alloys in oral fluid, which makes it necessary to analyze the chemical contents of prostheses under clinical conditions in patients with implants and experimental conditions.
 AIM: Comparative analysis of the trace element content in the oral fluid from prostheses in implants in the clinic and an experiment.
 MATERIALS AND METHODS: National Research Technological University MISIS analyzed artificial saliva after prostheses were in contact with grade 4 and grade 5 implants for 3 months. Titanium, cobalt, chromium, aluminum, vanadium, molybdenum, tungsten, manganese, nickel, and iron were determined by spectrometry. The same chemical elements were analyzed using an identical spectrometric method in 32 patients with fixed dentures on implants.
 RESULTS: Under the experimental conditions, nine trace elements were found in the container around one grade 4 implant with a crown, including titanium (0.4 g/l), cobalt (3.8 g/l), chromium (0.5 g/l), aluminum (2.6 g/l), vanadium (0.6 g/l), molybdenum (1.5 g/l), tungsten (3.0 g/l), manganese (0.9 g/l), nickel (0.5 g/l), and iron (0.6 g/l). The grade 5 implant was characterized by a greater degree of diffusion of aluminum, nickel, and manganese into artificial saliva. Mass spectrometry of the oral fluid in patients with dental implants revealed more trace elements than experimental data. The difference in the concentration of microelements from the prostheses under clinical conditions and in the experiment ranged from 0 to 128 times the minimum.
 CONCLUSION: Fixing experimental prostheses on implants for 3 months in artificial saliva was accompanied by the diffusion of microelements from the prostheses and implants into the environment, particularly cobalt, aluminum, and vanadium. Prostheses on implants with a lower titanium content are characterized by a greater degree of diffusion of aluminum, cobalt, nickel, and manganese. More significant diffusion of microelements occurred from the prostheses into the saliva under clinical conditions, according to the spectrometric data.

STUDY OF IMMUNE-INFLAMMATORY RESPONSE CHANGES IN ORAL FLUID IN PATIENTS WITH DISEASES OF PERIODONTAL TISSUES IN COMBINATION WITH GENERAL SOMATIC PATHOLOGY.

The aim: To determine the concentration of markers of the immune-inflammatory response (IL-1β, IL-10, IL-1β / IL-10, hsCRP) in oral fluid in patients with diseases of periodontal tissues in combination with general somatic pathology. Materials and methods: The study was conducted at Danylo Halytsky Lviv National Medical University, Department of therapeutic dentistry FPGE, Lviv, Ukraine. The patients were divided into two groups: the main group - 144 patients (with periodontal tissue diseases on the background of general somatic pathology) and the control group - 30 somatically and dentally healthy persons, in whose oral fluid was determined the concentration of IL-1β, IL-10, hsCRP by the enzyme immunoassay method. Results: As a result of our research, it was found that in people with periodontal tissue diseases, against the background of general somatic pathology, there is an activation of the immune-inflammatory response, which aggravates the course of general somatic and dental diseases in this contingent of patients. Conclusions: Therefore, in patients with periodontal tissue diseases on the background of somatic diseases, a significant increase in the level of the pro-in-flammatory cytokine IL-1β and hsCRP was determined against the background of a decrease in the anti-inflammatory cytokine IL-10 in the oral fluid compared to the values in the control group.