Uticaj tipa materijala za plombiranje zuba na koncentraciju interleukina 9 u uzorcima gingivalne sulkusne tečnosti
Sažetak
Uvod/Cilj. Jedan broj citokina i limfokina (IL1ß, ENA78, IL6, TNFα, IL8 I S100A8) izlučuje se tokom upale zubne pulpe. Analiza gingivalne sulkusne tečnosti (gingival crevicular fluid – GCF) omogućava neinvazivno proučavanje opšteg odgovora pacijenta na lokalne promene u usnoj duplji. Iako nivoi GCF mogu da odražavaju stanje upale kako u zubnoj pulpi, tako i u gingivi susednog zuba, uzorci GCF zuba bez značajnijeg gingivitisa mogli bi se tumačiti kao pokazatelji procesa u pulpi. Cilj ovog istraživanja bio je da se ispitaju nivoi IL9 u GCF kod pacijenata sa zubnim karijesom i da se utvrdi eventualni uticaj različitih materijala za zubne ispune na lokalnu proizvodnju IL9. Metode. U studiju je bilo uključeno 90 pacijenata, starih od 18 do 70 godina, uz primenu kriterijuma za uključivanje/isključivanje za prospektivne kliničke studije. Od ukupno šest materijala za punjenje pripremljenih kaviteta, tri je korišćeno za privremenu i tri za trajnu ispunu. Prema težini zubnog ispuna, pacijenti su bili podeljeni na tri grupe: oni sa ispunama lakšim od 0,50 g, sa ispunama od 0,50 do 1,00 g i sa ispunama težim od 1,00 g. Uzorci su uzimani iz gingivalnog sulkusa primenom tehnike filter papira. Korišćeni klinički parametri bili su indeks krvarenja, plak indeks (Silness-Lou, 0–3), gingivalni indeks (0–3) i dubina gingivalnog sulkusa. Koncentracije citokina određene su komercijalnim citomiksom. Rezultati. Težina zubne ispune ukazivala je na tendenciju opadanja vrednosti IL9, što je značilo da je veće oštećenje zuba, sa zubnom ispunom težom od 1,00 g, praćeno nižom koncentracijom IL9 u GCF. Vrednosti IL9 bile su u korelaciji sa stepenom gingivalnog indeksa i dubinom gingivalnog sulkusa, pogotovu u poodmaklom gingivitisu i izraženijim anatomskim promenama ivica zuba. Različite ispune izazivale su različite lokalne sekrecije IL9. Cink-polikarbonatni cement i amalgamska ispuna izazvale su značajan i dugotrajan pad nivoa lokalnog IL9, dok je primena tetrik-evocerama i GMA-BISK znatno povisila nivoe IL9. Zaključak. Rezultati dobijeni u ovoj studiji ukazuju da se IL9 u GCF može koristiti kao mera za reakciju odontoblasta na veličinu karijesa. Tip zubne ispune može da promeni biološku funkciju ćelija gingive i pulpe. Rezultati ove studije, takođe, ukazuju i na to da neke vrste ispuna mogu čak da ubrzaju zarastanje rane modulacijom aktivnosti makrofaga.
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