[Diagnostic possibilities of laboratory assessment of cathepsin K activity in gingival and peri-implant fluid under normal conditions and periimplantitis]. / Diagnosticheskie vozmozhnosti laboratornoi otsenki aktivnosti katepsina K v desnevoi i periimplantatsionnoi zhidkosti v norme i pri periimplantite.

OBJECTIVE: The aim of the work was to develop a non-invasive laboratory method for local control of the severity of osteo-destructive processes in the bone tissue of the jaws after dental implantation. MATERIALS AND METHODS: The study comprised 75 individuals aged 18 to 65. The main group included 40 patients with a diagnosis of dental periimplantitis (ICD K 10.2). A comparison group (n=20) included patients after dental implantation without postoperative complications. The control group (n=25) consisted of individuals without dental pathology. Cathepsin K (CTSK) (Human) ELISA Kit (Cloud-Clone Corp., USA) was used to determine the concentration of cathepsin K by the enzyme immunoassay in the gingival or peri-implant fluid. RESULTS: The concentration of cathepsin K in the gingival fluid in the patients of the control group was 1.7±0.3 pmol/l, in the comparison group the concentration of the studied biomarker corresponded to 2.3±0.4 pmol/l. In the main group, the concentration of cathepsin K in the exudate of peri-implantation pockets increased 2.8 times (p<0.05) and corresponded to 4.9±0.5 pmol/l. The concentration of cathepsin K in the gingival fluid normally did not depend on age and gender, which increased the independence of the osteomarker for characterizing the osteoresorbent process in the peri-implantation area. After dental implantation, an excess of cathepsin K concentration above the level of 2.7 pmol/l with a diagnostic sensitivity of 82.5% and a specificity of 83.7% suggests a high risk of developing peri-implantitis. CONCLUSION: The concentration of cathepsin K may be seen as valuable marker for local inflammatory and destructive processes in the contents of the peri-implantation area.

[Diagnostic value of biomarkers of bone metabolism in the gingival fluid in inflammatory-destructive and tumor oral pathology]. / Informativnost' otsenki biomarkerov kostnogo metabolizma v desnevoi zhidkosti pri vospalitel'no-destruktivnoi i opukholevoi patologii v polosti rta.

OBJECTIVE: The aim of the work was to determine the informativeness of the assessment of biochemical markers in the gingival fluid with destructive bone changes in the peri-implantation area, primary tumor lesion of the alveolar processes of the jaws and metastatic destruction of the jaw bone tissue in cancer of the large salivary glands. The study included 51 patients aged 30 to 75 years of both sexes. Depending on the genesis of destruction of the bone tissue of the lower jaw, three groups of patients were identified. Group 1 - 20 patients with peri-implantitis. Group 2 - 22 patients diagnosed with cancer of the oral floor mucosa (ICD C04) with erosion of the cortical bone or dental socket by a primary tumor. Group 3 - 9 patients with adenocarcinoma of the large salivary glands with metastatic lesions of the lower jaw. 15 people were practically healthy persons without periodontal pathology. The test material was gingival fluid or exudate from peri-implantation pockets. The content of cathepsin K, tartrate-resistant acid phosphatase (TAP) was determined by the enzyme immunoassay, and the bone fraction of alkaline phosphatase (BAP) was determined by the kinetic method. RESULTS: As a result, it was found that in group 1 in the exudate of the peri-implantation sulcus, the content of cathepsin K increased in comparison with the control by 2.5 times (p<0.05), TAP by 1.6 times (p<0.05). in groups 1 and 2, there was a moderate increase in the production of activated osteoblasts of KAP. In cancer of the mucous membrane of the floor of the mouth, a tenfold increase in the concentration of cathepsin K and TAP in the gingival fluid was observed. With metastatic lesions of the jaw in patients with adenocarcinoma of the large salivary glands, along with a multiple increase in the concentration of cathepsin K and TAP in the gingival fluid, there was a twenty-fold increase in the bone formation marker BAP, which indicated a mixed type of metastases and was a differential diagnostic criterion for metastatic lesion of bone tissue in comparison with the primary metastatic lesion of bone tissue. CONCLUSION: Thus, biochemical markers are sensitive indicators of remodeling of bone tissue both in local inflammatory and destructive processes in peri-implantitis and in primary and metastatic tumor lesions of the jaws.

[Osteoimmunological aspects of periodontal inflammatory destructive changes at periimplantitis, chronic periodontitis and oncological diseases of the oral cavity]. / Osobennosti osteoimmunologicheskikh aspektov osteorezorbtsii pri periimplantite, khronicheskom parodontite i rake al'veolyarnogo otrostka i al'veolyarnoi chasti chelyustei.

THE AIM OF THE STUDY: Was to analyze possible correlation between the concentration of the pro-inflammatory cytokine interleukin-6 and the activation marker of osteoclasts cathepsin K in the gingival fluid during osteoresorption of inflammatory (periimplantitis, chronic generalized periodontitis) and malignant oncological origin (malignant neoplasm of gums). MATERIALS AND METHODS: The study comprised 87 individuals of both sexes aged 30 to 60: 20 patients (group 1) with periimplantitis, 30 people with chronic generalized periodontitis (CGP) (group 2), 22 patients with squamous cell carcinoma of the upper and lower alveolar bone gingiva (group 3), 15 healthy individuals without periodontal disease. RESULTS: The concentration of interleukin-6 (IL-6) and cathepsin K was determined in the gingival fluid by enzyme-linked immunosorbent assay. The examination revealed that during CGP and peri-implantitis the accumulation of IL-6 in the contents of periodontal and peri-implantation pockets was a pathogenetic factor for the activation of osteoclasts and their secretion of proteolytic enzymes osteoresorption. In cancer the increase of cathepsin K expression was a lot higher than the accumulation of IL-6 in the gingival fluid reducing the dependence of the activation of osteoclasts on the local accumulation of pro-inflammatory cytokines. Conclusion. To formulate the prognosis of progressive bone loss in patients with peri-implantitis it is necessary to control the concentration of IL-6 and cathepsin K in the peri-implantation pocket, in case of CGP the concentration of IL-6 in the exudate of the periodontal pocket and in patients with cancer of the alveolar processes the content of cathepsin K of gingival fluid.