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”

Influence of orthopedic treatment with using endosseous implants on indexes of acid-resistant inhibitors of mixed saliva

Although the success of dental implantology still noticed big procent (10% to 18%) of postoperative complications , associated with traumatization,wound damage and aseptic inflammation(periimplantitis),that leads to implant rejection, that's way it prevention is important medico-social problem.

It should be noted,that the balance in system of proteinase inhibitors reflects the physiological condition of the body,it separate systems.Changes in it balance is the typical manifestation of the body's reaction,leading to damage at the molecular ,cellular and system levels.Change of inhibitory balance showing the severity of pathological process.

The purpose of our investigation is to determine the level of acid-resistant inhibitors of mixed saliva in orthopedic patients as criterion of compatibility assessment of implant's material and different types of non-removable dentures on adaptation processes in prosthetics by different types of non-removable constructions with relying on implants.

During investigation we used preparation “Erbisol“-immunomodulator, reparant and adaptogen- to prevent possible complication and to accelerate the adaptation after prosthesis.This preparation contains low molecular weight “signal” fragments of membrane glycoproteins,that carry on the function of “markers of the physiological condition of the cells”,which activate the immune system in pathological disturbance of homeostasis .

Preparations of class Erbisol effect only on disbalanced systems ,damaged organs and tissues and stay indifferent to the healthy organism , without side effects.In our observations were selected 45 people,whom were performed detal implantation by two-stage methodology.According to objectives of investigation patients were devided in two essential groups.In first group(28 people) were patients,who used metal-ceramic crowns ,based on cobalt-chromium alloys for prosthetics.The second group( 17 people) of patients used metal-free ceramic prosthesis.To obtain objective results we selected for first and second group the patients with similar age ,character of surgery,number of placed implants.Each group was subdivided into 2 subgroups:subgroup A-with no any additional therapeutic measures;subgroup B- patients were given an injection of preparation “Erbisol” in buttocks 1ml,for 10 days after non-removable dentures fixation.Were examined 15 people as a control group,which not suffering from dental pathology.

To determine the level of acid-resistant inhibitors in saliva the samples were processing for acid-resistant proteins precipitation.For this 1 ml of saliva mixed with 1 ml of 0,05 M Na acetate buffer(pH-1,4) and heated in a water bath at 60 oC in 20 minutes.After cooling the sample was neutralized by adding 0,3 ml of 0,1 n NaOH Solution.The further definition was performed by of V.F.Nartikova and T.S.Paskhina method.The method based on determination of inhibition BAEE-esterase activity of trypsin by saliva.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

Per 1 inhibitor unit is taken as much amounts of inhibor,which inhibits the formation of 1 mk mole BA for minute.

As a result of conducted investigation of the level of mixed saliva acid-resistant inhibitors in orthopedic patients with different types of non-removable dentures, based on implants ,is noticed the growth of indices by month after prosthetics,which not depend from type of prosthesis.The most fast recovery of indexes ARI,by month of observation,observed in 2 group,where used metal-free ceramic prosthesis.The use of immunomodulator and adaptogen “Erbisol” contributed the more fast normalization of the level ARI indexes:in first group , where used metal-ceramic prosthesis – by 5 month,in second group ,where used metal-free ceramic prosthesis – by 3 month.