Changes in Salivary Parameters of Oral Immunity after Biologic Therapy for Inflammatory Bowel Disease

We previously observed that inflammatory bowel disease (IBD) may compromise oral host defense, as assessed by decreased salivary levels of immunoglobulin A (IgA) and myeloperoxidase (MPO). Biologic therapy with inhibitors of cytokines or adhesion molecules is increasingly used for patients with IBD. Little is known, however, about how this treatment modality affects the release and properties of saliva. Here, we aimed to determine how biologic therapy in patients who had not responded to previous standard treatment with conventional drugs affected the salivary concentration of IgA and MPO. To this end, unstimulated whole mixed saliva was collected before treatment or after 10–12 weeks of therapy from 27 patients with Crohn’s disease (CD) and 24 patients with ulcerative colitis (UC). After the induction phase of therapy with biologics, salivary levels of IgA and MPO increased significantly in UC, but not in CD patients. These increases were approximately 8-fold and 6-fold, for IgA and MPO, respectively. Moreover, these effects occurred in UC patients who responded successfully to therapy, but not in those who failed to improve. Furthermore, the relative increases in salivary IgA and MPO correlated with the relative decrease in UC severity, as assessed by the Mayo scale. These data indicate that the successful therapy with biologics in UC patients results also in improved oral host defense. However, it remains to be determined why such an effect does not occur during therapy for CD.

The study of the calcium and phosphorus metabolism impact on the development of demineralized enamel areas in adolescents

Relevance. The article presents the current data on the impact of calcium and phosphorus metabolism on the development of demineralized enamel areas in adolescents. The level of vitamin D3, osteocalcin, bone alkaline phosphatase isoenzyme and parathyroid hormone (PTH) in mixed saliva appeared to reflect the risk of the cariogenic situation in the oral cavity and the risk of enamel demineralization development, which are relevant in pediatric dentistry. Purpose – to reveal the relationship between the localized enamel demineralization and the calcium and phosphorus metabolism in teenagers.Materials and methods. In 45 adolescents, the study examined the vulnerability of hard dental tissues, including initial lesions and the mixed saliva mineral metabolism in teenagers. We formed the following groups to study the caries intensity level. Group 1 consisted of 12 adolescents with a DMF index of 3.8. 11 adolescents comprised group 2 and 11 adolescents – group 3 with DMF indices of 4.9 and 6.8, respectively; group 4 contained adolescents without caries.Results. The analysis of caries intensity and permanent enamel demineralization areas in adolescents and the main markers of mixed saliva mineralization revealed a correlation between the activity of the initial carious lesions and the calcium and phosphate metabolism.Conclusions. Evaluating the principal markers of calcium and phosphorus metabolism is relevant for the risk assessment of the cariogenic situation or enamel demineralization development in adolescents and preventive treatment planning.

Potential Salivary Markers for Differential Diagnosis of Crohn’s Disease and Ulcerative Colitis

The properties of the saliva of patients with inflammatory bowel disease (IBD) are poorly recognized. Likewise, the diagnostic potential of saliva for differentiating various forms of IBD is largely unexplored. Therefore, we compared the concentrations of several parameters in unstimulated whole mixed saliva collected in a standardized manner from patients with active IBD unresponsive to conventional therapy. The samples were received from 27 patients with Crohn’s disease (CD), 24 patients with ulcerative colitis (UC), and 51 healthy individuals. Compared to the controls, the salivary concentrations of S100A8/calprotectin, myeloperoxidase, and IgA were significantly decreased in both CD and UC patients. In addition, patients with UC had decreased levels of TNF-R1 and decreased catalase activity. Interestingly, the concentrations of myeloperoxidase and TNF-R1 showed a high differentiation potential for CD and UC (AUC = 0.690 and 0.672, respectively). All these findings are discussed in the context of host defense in the oral cavity, patients’ prior treatment regimens, and smoking habits.

Orthodontic treatment with clear aligners and enamel remineralization in adolescents

Relevance. The effectiveness of the new remineralizing agent PRESIDENT®PROFI REM "MINERALS GEL" was assessed at different stages of clear aligner orthodontic treatment in adolescents with reduced enamel resistance.Materials and methods. PRESIDENT®PROFI REM "MINERALS GEL" was evaluated in a one-month open, single center, non-comparative study where 20 adolescents took part (mean age 14.9 ± 1.1 years).Results. OHI-S decreased by 24.75%, PMA and ERT reduced by 44.33% and 17.11% respectively, after one month of the orthodontic treatment with clear aligners and simultaneous use of the remineralizing gel. The pH in the mixed saliva increased from 6.97 ± 0.16 to 7.69 ± 0.11, calcium went up by 48.5%, and the total antioxidant activity decreased by 29.36% (according to the mixed saliva biochemical parameters). The OHIP-14 questionnaire revealed that the quality of life decreased in 75% of adolescent patients during the orthodontic treatment with aligners due to "communication problems". The quality of life was significantly higher during the aligner treatment with simultaneous remineralizing therapy than during the conventional treatment with fixed appliances (4.25 ± 0.86 points in the aligner group versus 7.05 ± 1.16 points – the brackets group).Conclusions. The remineralizing gel PRESIDENT®PROFI REM "MINERALS GEL" has an anti-plaque and mineralizing effect. The quality of life is significantly higher during the clear aligner treatment with simultaneous remineralizing therapy than during the conventional treatment with fixed appliances.

Saliva as new analytical object for D-dimer level determination

The amount of D-dimer in the mixed saliva of healthy individuals and patients with comorbidities has been investigated. It has been established that the level of D-dimer in saliva increases with age regardless of pathology. The highest values were found in patients with erosive gastritis.

BIOLOGICAL MARKERS OF MMP-8 (MATRIX METALLOPROTEINASE 8) AND TIMP-1 (TISSUE INHIBITOR OF METALLOPROTEINASES 1) IN THE ORAL FLUID IN VARIOUS FORMS OF LICHEN PLANUS AND THEIR ROLE IN ASSESSING THE CLINICAL COURSE OF THE DISEASE

Early detection of tumor transformation of lichen planus presents a real challenge, since squamous cell carcinoma can develop both from unchanged epithelium, and against the background of inflammatory or precancerous lesions. Another aspect of untimely diagnosis is the unfavorable long-term prognosis of lichen planus, so after complex treatment, 50% of patients have a relapse: 80% — within 2 years and 20% — within 4 years. The aim of this study was to analyze the levels of MMP-8, TIMP-1 and their ratio of MP-8/TIMP-1 in the oral fluid of patients with varied forms of lichen planus. We examined and treated 24 women (35–70 years old). 14 women with oral lichen planus of the mucosa in a typical form were assigned to Group 1; 10 patients with an exudative-hyperemic form - Group 2. Concentrations of the biological markers MMP-8 and TIMP-1 were determined in the oral fluid before and after treatment. Results of the study showed that to assess the severity of oral lichen planus it is essential to evaluate concentration ratio of biological markers MMP-8/TIMP-1 in mixed saliva. Dynamic changes in MMP-8/TIMP-1 levels should be monitored at least once in a quarter.

ACTIVITY OF FREE RADICAL PROCESSES IN MIXED SALIVA OF PATIENTS WITH RECURRENT UPPER RESPIRATORY TRACT INFECTIONS

The study conducted a comprehensive assessment of the state of the pro-/antioxidant mixed saliva system of 64 healthy individuals and 85 patients with recurrent upper respiratory tract infections RIURT. At the same time, the determination of the parameters of pro-/antioxidant systems was carried out using two methods (photometric: the content of lipid peroxidation products and the level of ceruloplasmin and luminal-dependent chemiluminescence (LDHL) was determined, which allows assessing the complex interaction of two systems - prooxidants and antioxidants). Studies have demonstrated that most patients with RIURT during remission on individual components of prooxidants (diene conjugates, ketodienes, Schiff bases;), as well as saliva antioxidant (ADS: ceruloplasmin) levels were elevated compared to controls. At the same time, the LDHL saliva parameters did not go beyond the reference interval, although they were changed relative to the median of the control group. This allows us to consider the observed fluctuations as a balance in the system of pro- and antioxidants.

Dynamics of clinical and immunological parameters in the integrated management of endo-­periodontal lesions, including laser therapy

Aim. To determine the dynamics of clinical changes and indicators of local immunity in integrating the diode laser into the treatment of the endo-periodontal lesion. Methods. We performed a prospective study of 110 patients of both sexes aged 2555 years with endo-periodontal lesions. The patients were randomized into two groups the main group (n=54), whose received root canal treatment and periodontal pockets with a diode laser in addition to standard therapy, which included endodontic and periodontal treatment, and control group (n=56), whose patients received only standard treatment. The GreenVermillion oral hygiene index and Russells periodontal index, as well as the levels of immunoglobulin (Ig) A, tumor necrosis factor-alpha (TNF-alpha) and cytokine interleukin-10 (IL-10) in the mixed saliva of patients, were determined during the study. Quantitative data were described using median, lower and upper quartiles. These data were visualized using boxplots. The MannWhitney U test was used to compare differences between an independent set of quantitative data. Differences were considered significant at a confidence level of p 0.05. Results. The median oral hygiene index decreased from 2.9 to 1.0 (p 0.001) in the main group and from 2.9 to 1.6 (p 0.001) in the control group. The median Russell's periodontal index decreased from 3.38 to 1.3 (p 0.001) in the main group and from 3.95 to 2.0 (p 0.001) in the control group. The median immunoglobulin A content decreased from 5.25 to 3.13 mg/L (p 0.001) in the main group and from 5.23 to 4.21 mg/L (p 0.001) in the control group. The tumor necrosis factor-alpha level decreased from 16.65 pg/ml in the main group and 18.28 pg/ml in the control group to 3.96 and 8.44 pg/ml (p 0.001), respectively. The median cytokine interleukin-10 levels increased from 0.83 to 2.94 pg/ml (p 0.001) in the main group and from 1.29 to 2.13 pg/ml (p 0.001) in the control group. Conclusion. The use of a diode laser in the treatment of endo-periodontal lesions has a positive effect on the dynamics of clinical and immunological parameters, as evidenced by a statistically significant decrease in clinical indices, as well as the normalization of the immunoglobulin A and cytokine levels in mixed saliva.

Mineralizing potential of mixed saliva and the course of dental caries in children and adolescents with endocrine and musculoskeletal disorders

The features of microcrystallization and the mineralizing potential of mixed saliva, the intensity of caries in children and adolescents with endocrine pathology and pathology of the musculoskeletal system at the age of 9–10, 12–13 and 16–17 years have been studied, the relationship between the intensity of dental caries and the mineralizing potential of saliva has been revealed. The study of saliva in patients with endocrine pathology showed a low saliva mineralizing potential, crystals of type II and III were found, with a predominance of type III. The lowest mineralizing potential of saliva is observed at the age of 12–13 years. The carious process progresses with age and the subcompensated degree of activity prevails. The study of mixed saliva in patients with pathology of the musculoskeletal system showed a low mineralizing potential, crystals of types II and III were encountered, with a predominance of type III. The lowest mineralizing potential of saliva is observed at the age of 12–13 years. The carious process stabilizes over time and compensated degrees of activity prevail. The examinees with endocrine and musculoskeletal pathologies have reduced salivary mineralizing potential, high rates of intensity and degree of caries activity. In patients with endocrine pathology, indicators are worse than in patients with musculoskeletal pathology. The age of 12–13 is critical.

CLINICAL AND LABORATORIAL RESEARCH IN PHYSICAL-CHEMICAL CHARACTERISTICS OF NEW TOOTHPASTE WITH HYALURON-TI FORTE COMPLEX

Subject. Physical-chemical characteristics of the toothpaste Dentaswiss Extra Whitening and structural and optical parameters of mixed saliva before and after volunteer brushing. Objectives. To evaluate physical-chemical characteristics of the new therapeutic and prophylactic toothpaste Dentaswiss Extra Whitening together with changes in structural and optical parameters of the effected mixed saliva. Methodology. The composition and properties of the new therapeutic and prophylactic toothpaste Dentaswiss Extra Whitening are studied based on the results of physical and chemical analysis of three aqueous solutions (prepared with different concentrations) by measuring pH value, calcium ion concentration, electrical conductivity and surface tension. The study involved 32 student volunteers of both sexes (men — 11, women — 21) from the Ural State Medical University Faculty of Dentistry between the ages of 21 to 23 who were comprehensively examined including structural and optical parameters of mixed saliva before and after brushing. Results. The average pH value is 7.91±0.01, the increased calcium ion (Са2+) level is found up to 2.25 mmol/l in all three aqueous suspensions (р≤0.05). Electrical conductivity of suspensions is found to be increased and surface tension is found to be reduced uniformly with the increase in mass fraction (р≤0.05). Conclusion. The study of physical-chemical characteristics of the toothpaste Dentaswiss Extra showed positive changes in pH values, electrical conductivity and surface tension promoting the increased remineralizing properties of mixed saliva (р≤0.05).