Severinova S.K., Kushnir K.G., Lavrovskaya O.M., Kolbasina L.P

Department Prosthetic of Dentistry (Head prof. Zhadko S.I)

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

Indexes of enzymatic activity in case of endosteal implants’ installation

Despite on the dental implantology successes there is still a big percent of postoperative complications (from 10% to 18%) connected with traumatization, injury alteration and aseptic inflammation (periimplantitis) leading to implant failure, that’s why prophylactic of these complications is an important medical-social task.

It ought to be remarked that proteinases’ inhibitors system balance represents of physiological state of the whole body and its systems. Their balance changing is the typical manifestation of organism reaction leading to damage on the molecular, cellular and system levels. The changing of inhibitor potential represents the severity level of pathological process.

The target of our research is the measuring of the acid-resistant mixed saliva inhibitors in prosthetic patients as the estimation criterion of implants materials’ and different fixed prosthesis’ compatibility on the adaptation processes after the prosthetics with different types of fixed implant-supported prostheses.

During the carrying out of the research for the prophylactic of possible complications and adaptation terms acceleration after the prosthetics we’ve used “Erbisolum” medicine – the immunomodulator, restorer and adaptogen. This medicine consists of low-molecular “signal” membrane glycoprotein’s’ fragments, which act as the “cellular physiological state markers” which activate immune system during the homeostasis’s failures. Erbisolum-type medicines act only on the imbalanced systems, affected organs and tissues, and they are almost indifferent to healthy organism without inducing of any side reactions. During the investigation 45 persons, whom was carried out the two-stage implant procedure were selected for carrying out of investigation. The patients were divided on two main groups according with the tasks of investigation. The first group of 28 persons was composed of those whom were made the prosthetic appliance with PFM prosthesis based on cobalt-chrome alloy. The second group of 17 persons was composed of those patients whom were made the prosthetic appliance with the usage of nonmetal ceramic dental prostheses. For the getting of more objective data the combination of patients in both groups is approximately similar in age, character of surgical procedure and number of installed implants. Inside the investigated groups were segregated 2 subdivisions (subdivision A without any additional therapeutic measures and subdivision B, which were everyday intramuscular injected in gluteus with 1 ml single-dose of the “Erbisolum” with the 10 days duration of therapeutic course). 15 persons without any dental pathology were examined as the control group.

For the measuring of saliva’s acid-resistant inhibitors (ARI) level samples of saliva first were purificated for acid-intolerant proteins’ sedimentation. For this 1 ml of saliva was mixed with I ml 0,05 M of sodium-acetate buffer (pH – 1,4) and heated on water-bath at 60⁰C for 20 minutes. After cooling the sample was neutralized with 0,3 ml 0,1 M NaOH solution. Further determination was taken using V.F. Narticova’s and T.S. Paschina’s method. The method is based on measuring of saliva’s suppression of BAEE-estherase activity of trypsin. Activity calculation was taken by formula:

(ΔDk – ΔDo)x2,73x2,3/0,5 =(ΔDk – ΔDo)x12,558 IU/ml

Where:

ΔDk, ΔDo – extinction increase in 1 minute in experimental and in control groups;

2,73 – coefficient of extinction conversion in BA mcM (benzoil-agrynine), equal to1 mcM of BA formation in 1 ml of sample;

0,5 – amount of saliva taken for analyses;

2,3 – saliva’s dilution factor. ARI activity is measured in IU/ml.

For 1 inhibition unit (IU) is taken such an amount of inhibitor which slows or stops the formation of 1 BA mcM per 1 minute.

As the result of taken investigation of mixed saliva ARI level’s exponent with different types of fixed implant-supported prostheses the growth of exponents is marked in 3 month after prosthetic care independently of prosthesis’ type. The most fast restoration of ARI exponents (4 months) was marked in the second group where nonmetal ceramic dental prostheses where used. Using on the “Erbisolum” immunomodifier aids to faster normalization of ARI exponent levels: up to 5 months in first group where PFM prostheses were used and up to 3 month in second group where nonmetal ceramic dental prostheses were used.