Diagnostic informativeness of laboratory control of the severity of inflammatory and osteodestructive processes in periodontium

Aim. To offer a set of laboratory tests and to assess its informativeness in characterizing the severity of inflammatory and osteodestructive processes in periodontium.

Methods. At the first stage of the study, two groups were formed: the study group (clinical, n=95) and the control group (relatively healthy individuals, n=31). Further, depending on the clinical situation, the clinical group was divided into subgroups. Subgroup 1 (n=40) included patients with catarrhal and ulcerative gingivitis, subgroup 2 (n=32) with mild chronic generalized periodontitis and subgroup 3 (n=33) with moderate chronic generalized periodontitis. In patients’ gingival fluid or in the contents of periodontal pockets, the concentration of tumor necrosis factor-α, osteotropic mediators (soluble receptor activator of nuclear factor-κB ligand and osteoprotegerin) were determined by the immunoassay method.

Results. In patients with chronic generalized periodontitis, as well as with increase of severity of periodontal lesions, in the gingival fluid the concentration of tumor necrosis factor-α and soluble receptor activator of nuclear factor-κB ligand increases and the content of osteoprotegerin decreases. The change in the concentration of osteotropic mediators in the fluid from periodontal pockets occurred prior to osteolysis in the periodontium. The widest range of statistically significant correlations with periodontal indices was established for the concentration of tumor necrosis factor-α in the contents of the gingival sulcus with the depth of periodontal pockets (R=0.79; р <0.0001) and periodontal attachment loss (R=0.83; р <0.0001), as well as for soluble receptor activator of nuclear factor-κB ligand with the depth of periodontal pockets (R=0.75; р <0.0001) and periodontal attachment loss (R=0.87; р <0.0001).

Conclusion. In patients with mild chronic generalized periodontitis, a decrease in the concentration of osteoprotegerin (p <0.05) and increase in the content of soluble receptor activator of nuclear factor-κB ligand (р <0.05) in the gingival fluid relative to the norm requires active radiological monitoring of bone resorption.