Relevance. Periodontitis remains one of the most common dental pathologies, in which the connective tissue between the bone of the socket, where the tooth is located, and the cementum of its root is affected [1, p. 257]. In the general structure of dental pathology, the specific weight of periodontitis ranges from 40-75% and is recorded mainly in people of mature age - 35-44 years [2, p. 75; 3, p. 502; 4, p. 457;]. A fairly frequent clinical variant of periodontitis is chronic granulating periodontitis (CGP), which is characterized by active progressive inflammation in the periodontium and adjacent bone tissue, with simultaneous growth of granulation tissue, which replaces the periodontium, and the pathological process extends beyond the periodontal gap [1, p. 258].
Chronic inflammation in the periodontium is accompanied by the destruction of bone tissue, in the resorption of which matrix metalloproteinases participate, in particular matrix metalloproteinase-1 (MMP-1), which destroys type I collagen localized in the periodontal tissue [5, p. 440].
Determination of the quantitative content of MMP-1 in the blood of patients with periodontitis can significantly improve the diagnosis of chronic inflammation in the periodontium and deepen our knowledge about the pathogenesis of this disease.
The aim of the study was to study the quantitative content of MMP-1 in the blood serum of adult men with chronic granulating periodontitis in the dynamics of the disease.
Materials and methods. 27 men aged 33-42 years (mean age – 33.5±1.2 years), patients with chronic obstructive pulmonary disease were examined. The indicated contingent of patients formed the main group. Blood from these patients was taken from the cubital vein, in the dynamics of the disease, namely: in the phase of exacerbation of the disease and in the phase of convalescence (on the 1st, 3rd, 6th and 9th month after therapeutic treatment). During the examination period, exacerbation of concomitant chronic pathology of the nervous and endocrine systems, internal organs and musculoskeletal system in patients with manifestations of chronic obstructive pulmonary disease was absent.
The control group consisted of 23 practically healthy men aged 31 to 43 years (mean age – 34.4±1.3 years), in whom no periodontal lesions, as well as acute or chronic pathology of the nervous and endocrine systems, internal organs and musculoskeletal system were detected during the examination.
The material for the laboratory study was venous blood serum, which was taken from the vein of the control group once in the morning on an empty stomach, and in patients with chronic hepatitis B according to the research algorithm, in the acute stage of chronic hepatitis B and at the 1st, 3rd, 6th and 9th month after treatment. Blood serum was stored at -20°C in a cryostat before laboratory study.
MMP-1 activity was determined by solid-phase enzyme-linked immunosorbent assay using standard Human MMP-1 (total) test systems (R&D Diagnostics Inc., USA) on an automatic enzyme-linked immunosorbent assay complex “GBG Star Fax 2100” manufactured by “Awareness Technology Inc.” (USA).
Statistical analysis of the study results was performed using parametric methods.
Results and discussion. It was found that in the control group (conditionally healthy individuals) the quantitative content of MMP-1 in the blood serum was 15.8±0.5 pg/ml, which was taken as the reference norm.
On the contrary, in the group of patients with CGP, the quantitative content of MMP-1 in the phase of exacerbation of the disease was significantly increased and reached an average of 46.8±2.3 pg/ml (the degree of exceeding the reference norm by 2.96 times, p<0.001).
After conducting a laboratory study of the quantitative content of MMP-1 in the phase of exacerbation of CGP, all patients underwent endodontic sanitation of the focus of inflammation in the causal tooth.
The quantitative content of MMP-1 in the blood serum of the treated patients after 1 month was on average 27.4±1.2 pg/ml, which was 1.74 times less than the similar indicator in the acute phase of CGP (p<0.01), but was 1.73 times more than the reference norm (p<0.01), which indicated the incomplete completion of the inflammatory process.
3 months after endodontic sanitation of the causal tooth, the quantitative composition of MMP-1 in the blood serum of the main group of patients decreased to 22.0±1.3 pg/ml, which was 2.13 times lower than in the acute phase of CGP (p<0.001), 1.25 times lower than in the remission phase after 1 month (p<0.01), but exceeded the reference norm by 1.39 times (p<0.01).
6 months after endodontic treatment of the causative tooth, the quantitative composition of MMP-1 in the blood serum of the subjects of the main group decreased to 16.2±0.9 pg/ml, which was 2.89 times lower than in the acute phase of CGP (p<0.001), as well as 1.68 and 1.36 times lower than in the remission phase after 1 and 3 months, respectively (p<0.01 for both comparisons). Compared to the reference norm, the registered concentration of MMP-1 in the main group had no statistical difference.
At the 9th month after endodontic treatment of the causative tooth, the quantitative composition of MMP-1 in the blood serum of the subjects of the main group was 19.5±1.3 pg/ml, which exceeded the reference norm by 1.23 times (p<0.05).
Thus, MMP-1 activity in blood serum can be a diagnostic criterion that characterizes the activity of the inflammatory process in the periodontium.
Conclusions.
1. Chronic granulating periodontitis in the acute phase is accompanied by a significant increase in the quantitative content of matrix metalloproteinase-1 (MMP-1) in the blood serum of patients.
2. In the remission phase, after endodontic sanitation of the causal tooth, the quantitative content of MMP-1 in the blood serum decreases and reaches the norm by the 6th-9th month after endodontic treatment.
Literature
1. Dental diseases: therapeutic dentistry / A.V. Borisenko, M.Yu. Antonenko, L.V. Lynovytska and others; edited by A.V. Borisenko. – K.: Medicine, 2017. – 664 p.
2. Nazir M.A. Prevalence of periodontal disease, its association with systemic diseases and prevention. International Journal of Health Sciences. 2017. Vol. 11. Issue 2. P. 72–80.
3. Righolt A.J., Jevdjevic M., Marcenes W., Listl S. Global-, Regional-, and Country-Level Economic Impacts of Dental Diseases in 2015. Journal of Dental Research. 2018. Vol. 97. Issue 5. P. 501–507.
4. Tonetti M.S., Jepsen S., Jin L., Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. Journal of Clinical Periodontology. 2017. Vol. 44. Issue 5. P. 456–462.
5. Cavalla F., Hernandez-Rios P., Sorsa T., et al. Matrix metalloproteinases as regulators of periodontal inflammation. International Journal of Molecular Sciences. 2017. Vol. 18. Issue 2. P. 440.
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