Bobkova S.A., Kazinina E.N., Makarenko V.N., Kazinin V.G.

Chair of Dentistry (Postgraduate Education Division, head prof. RomanenkoI.G.)

SI “Crimea State Medical University named after S. I. Georgievsky”

The indexes of antitripsine activity of mixed saliva after implants installation in orthopedic patient with somatic pathology

The analysis of national and world publications have shown, that in spite of the large number of studies,still insufficiently examined problems, associated with development of early inflammatory complications in periimplantational soft tissues of supporting zones of orthopedic constructions, and it influence on prosthetics beginning terms, especially in patients with background somatic pathology. Clinical success of orthopedic treatment of patients,with using dental implants is possible only in case of effective surrounding tissue structures rehabilitation and partly depends on morphofunctional condition and reactivity of surrounding soft tissues. According to several authors, among the affections of internal organs, the gastrointestinal tract pathology causes the largest changes in the oral cavity, and not only by the fact that these diseases are often diagnosed in the population, but also because of the close anatomical and functional association with the oral cavity.

Based on the above information, the purpose of our investigation is exploration of enzymatic activity of mixed saliva in orthopedic patients,having stomach and duodenal ulcers , after endosseous implants installation. The subject of our investigation was mixed saliva of patients,who underwent dental imlantation. For our investigation were examined 87 patients(37 female patients and 50 male patients)aged 21-64 years. Selecting the patients,we took into account the general condition of body,past and associated illness,anatomical and physiological condition of the oral cavity.

The patients were divided into 3 groups:the first group includes orthopedic patients with no somatic pathology - 20 patients;second group – orthopedic patients with somatic pathology( stomach and duodenal ulcers)- 27 patients;third group compose 25 patients,requiring orthopedic care and with somatic pathology,which were given 1 ml of IM injection of immunomodulator “Erbisol” during the first 30 days after implantation every other day.Besides, examined 15 almost healthy people(norm) as a control group,which not suffering from dental pathology.Orthopedic treatment were performed by two-stage methodology of implantation ,using helical endosseous implants «U-Impl»

During investigation we used preparation “Erbisol“-immunomodulator, reparant and adaptogen.Anti-tryptic activity of saliva determined by V.F.Nartikova and T.S.Paskhina method.Activity calculation was providing using formula:

(ΔDk - ΔDo)×2,73×2,3/0,5=(ΔDk - ΔDo)×12,558 IU/ml

Where

ΔDk , ΔDo - increase of optical density in the test and control samples for 1 min

2,73 - optical density conversion factor to 1 мкmole (Benzoyl-Arginine),conforming of formation 1 mkM BA in 1 ml of probe

0,5 - the amount of taken saliva for analysis

2,3 - dilution factor of saliva.The acid-resistant inhibitors activity was expressed in IU/ml.

Analysis of enzymatic activity of mixed saliva in orthopedic patients after implants installation showed, that in all three groups by 1 month noticed statistically significant increase of mixed saliva enzymatic activity against to control (p<0,05).In the next three months after implantation noticed cascade increase of enzymatic activity in all observed groups, but the most obviously expressed was in the second group, where were examined orthopedic patients with somatic diseases(peptic and duodenal ulcer) and, where antitrypsin activity of mixed saliva was 195.14 ± 15.24 IU/ml, which was about 34,5% (p<0,01) higher than the control results.

By 6 month after implants installation the patients of 1 group(orthopedic patients with no somatic pathology)and of 3 group(orthopedic patients with somatic pathology,which were treated by preparation “Erbisol”),observed the normalization of enzymatic activity of mixed saliva,indexes of it were acquired statistically insignificant character(p>0,05),but by this time of observation the ATA of saliva in patient of 2 group remained at a high level and was 171,82 ±10,78 IU/ml,which was about 18,4% higher than the control(p<0,05)

In this way,the conducted analysis of enzymatic activity of mixed saliva showed,the process of implantation has significant increase of mixed saliva antitrypsin activity.The somatic pathology leads to more long enzymatic disbalance.

Conclusions:

1.Installation of endosseous implants has significant and statistically significant increase of ATA by 1 month.

2.The patients with somatic pathology(stomach and duodenal ulsers) have more pronounced and long changes of the mixed saliva enzymatic activity.

3.Using immunomodulator “Erbisol” as corrective therapy considerably accelerates processes of reparation.