[Microcirculation impairment in periodontal tissues in patients with chronic generalized periodontitis combined with metabolic syndrome]

[Evaluation of the clinical effectiveness of the use of a navigational surgical template in the vestibuloplasty protocol in patients with periodontal diseases]

THE AIM OF THE STUDY

Was to evaluate the clinical effectiveness of the use of a navigational surgical template in the vestibuloplasty protocol in patients with periodontal diseases.

MATERIALS AND METHODS

There were 48 people selected to participate in the study and randomly divided into 2 equal groups. The patients of the main group underwent vestibuloplasty procedure using a free gingival graft modeled using the developed protocol and a navigational surgical template. Patients in the control group underwent a similar operation using classical technology. The study assessed postoperative pain, the index of early wound healing, Doppler fluometry of the transplanted flap and flap morphometric measurements.

RESULTS

The results of all conducted studies confirmed the effectiveness of the developed clinical protocol.

CONCLUSION

According to objective and subjective assessments, the use of a surgical navigation template can reduce the time and invasiveness of vestibuloplasty surgery, make it more comfortable for the patient and get a more predictable clinical result.

Evaluation of Microcirculation, Cytokine Profile, and Local Antioxidant Protection Indices in Periodontal Health, and Stage II, Stage III Periodontitis

Periodontitis, initiated by the subgingival biofilm and modified by the individual’s inflammatory/immune response, has been associated with vascular dysfunction. To analyze microcirculation indices in periodontal tissues and determine the activity of the enzymatic component of antioxidant defense and humoral immunity factors, a single-blind non-invasive clinical trial was realized. Forty subjects, aged from 30 to 65 years, with moderate to severe chronic periodontitis (chronic generalized periodontitis, CGP) vs. 40 subjects as periodontally healthy were recruited. Information such as capillary diameter, capillary blood flow velocity, concentration of pro- and anti-inflammatory cytokines in serum, vascular endothelial growth factor, and enzymatic component of antioxidant protection were taken. The revealed microcirculatory dysfunctions in patients with CGP clearly demonstrate the progressive disorder of periodontal tissue perfusion and oxygenation, the presence of increased vascular permeability and functional failure of the microvascular system in the lesion. Cytokine profile of CGP patients’ blood serum demonstrated a significant increase of interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), IL-4 levels as well as statistically significant decrease of IL-1ra, IL-10 concentration. Participants with CGP demonstrated a dominant superiority of IgM and IgG levels. In conclusion, these results contribute to a better understanding of potential correlation between microvascular changes and local and systemic markers of inflammation.

[Hypoxia-dependent transcriptional control of activity of destructive inflammatory and malignant periodontium changes]

The aim of the study was to evaluate the diagnostic value of determining the level of hypoxia-inducible factor-1α (HIF-1α) in the gingival fluid in patients with chronic generalized periodontitis (CGP) and exacerbation of inflammatory periodontal diseases in patients with cancer of the oral mucosa (OM). A clinical study was carried out with the participation of 60 patients with CGP (group 1) and 22 patients with cancer of OM (group 2) of the T1-2N0M0 stage, as well as 15 healthy individuals with no revealed periodontal pathology. CGP patients, depending on the depth of periodontal pockets (PC), were divided into two subgroups - with a mild degree (PC depth up to 3.5 mm) and an average degree (PC depth from 4 to 6 mm). Group 2 patients were also divided into two subgroups - with exacerbation of CGP (n=12) and patients with no complications (n=10). The content of HIF-1α in the gingival fluid was determined by enzyme immunoassay. The results of the study made it possible to establish that in patients of group 1, the concentration of HIF-1α in inflammatory exudate increased by 2.4 times (p<0.001) compared with the control group. The concentration of HIF-1α in the contents of periodontal pockets in patients with CGP depended on the severity of the disease: with mild CGP, it did not differ from the control group, and with moderate CGP it was 3.15 times higher (p<0.001). In patients with cancer of OM, the concentration of HIF-1α in the gingival fluid did not depend on the presence of inflammatory periodontal lesions and was determined by a multiple increase in the biomarker level (7.5 times) due to the development of a malignant process in the oral cavity. Therefore, monitoring the concentration of HIF-1α in the gingival fluid is informative in patients with CGP in assessing the severity of periodontal conditions, as well as in differential diagnosis with malignant formations of the oral cavity.