Uticaj karijesa i zubnih ispuna na nivoe IL-1 β i TNF-α u gingivalnoj tečnosti
Sažetak
Uvod/Cilj. U duhu personalizovane medicine, određivanje biomarkera za karijes u pljuvački i gingivalnoj crevikularnoj tečnosti (gingival creviculr fluid – GCF) privlači veliko interesovanje u novijim stomatološkim istraživanjima. Koncentracija citokina u GCF reflektuje procese u zubnim strukturama. U smislu interpretacije njihovih koncentracija, treba uzeti u obzir uticaj položaja zuba i obim karijesne destrukcije. Nivoi IL-1β i TNF-α u GCF mogu poslužiti kao indikator zapaljenskog odgovora na biomaterijale koji se koriste za zubne ispune. Cilj rada bio je određivanje proinflamatornih citokina IL-1 β i TNF-α u GCF poreklom od karijesom zahvaćenih i intaktnih zuba i njihovo korelisanje sa obimom karijesa, položajem zuba i različitim zubnim ispunima. Metode. Uzorci GCF sakupljeni su od 90 parodontološki zdravih osoba koji su imali najmanje jedan zub sa proksimalnim karijesom i jedan intaktni zub, na početku terapije, kao i 7 i 30 dana nakon terapije. Profil biomarkera ispitivan je u odnosu na obim karijesnih lezija: površne (C2), pulpitis (C3), gangrena (C4) i karijes korena (C5), veličinu defekta i vrstu biomaterijala. Rezultati. Obim karijesnih lezija značajno je bio udružen sa IL-1β, čije su koncentracije bile najniže u grupi gangrenoznih zuba (C4) i površnog karijesa (C2). Trideset dana nakon terapije grupa C5 pokazala je najviše vrednosti IL-1β. Različiti materijali za zubne ispune pokazali su različiti profil citokina u GCF. CPC je uzrokovao porast IL-1β kod više od 70% bolesnika. Obim karijesne lezije nije pokazao značajnu korelaciju sa merenim citokinima, dok su veći defekti bili udruženi sa povećanjem srednjih vrednosti citokina. U pogledu položaja zuba, IL-1β je pokazivao najviše vrednosti kod karijesom zahvaćenih očnjaka i drugih molara, dok je TNF-α imao najveće vrednosti kod očnjaka. Nakon terapije, povećanje koncentracije citokina je utvrđeno kod očnjaka (IL-1β i TNF-α), prvog i drugog molara (IL-1β). Zaključak. Intenzitet zapaljenja zubnih struktura se direktno reflektovao na koncentraciju IL-1β i TNF-α. Zubni ispuni su značajno uticali na nivoe IL-1β i TNF-α u odnosu na vrstu korišćenog biomaterijala. Profil merenih citokina je varirao u odnosu na različiti položaj zuba, pri čemu su očnjaci i molari pokazali najviše vrednosti. Uočeni porast merenih pro-inflamatornih citokina u odsustvu klinički manifestne patologije može ukazivati na reparatorne efekte.
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