Inzuvatova K.P., Guyter O.S. Analysis of the interconnection between the quantitative indicators of various cytokines in the oral fluid and the local inflammatory process at the stage of orthopedic rehabilitation of patients with postoperative jaw defects. Head and neck. Russian Journal. 2022;10(4):68–747
The literature review is devoted to the actual problem of orthopaedic rehabilitation of patients with postoperative jaw defects. Any surgical intervention in the maxillofacial region involves the appearance of a long-term healing wound, the restoration of which in many clinical cases is complicated by the inflammatory process. Resection of the upper jaw in particular leads to the loss of a significant volume of adjacent tissues. Morphological restructuring, repair of tissues of the acquired jaw defect is inextricably linked with the inflammatory reaction, biochemical changes in the vascular wall and the influence of orthopedic construction in this zone. The leading link in the development of syntropy of chronic inflammation is a violation of cytokine regulation. Cytokines are biologically active proteins produced by many different cells of the immune system. They are responsible for the immune response in the process of inflammation. There is a launch of the cytokine cascade, including, on the one hand, pro-inflammatory cytokines, and on the other — anti-inflammatory mediators. The balance between the two groups determines the nature of the course and the outcome of repair in the zone of the acquired defect. Most of both pro- and anti-inflammatory cytokines are present not only in the peripheral blood, but also in saliva. Among the large number of biomarkers, in our opinion, the most significant in the development of the local inflammatory reaction are: pro-inflammatory (IL-1, IL-8, VEGF, TNF-α) and anti-inflammatory (IL-4, IL-10, TGF-β). Determining the concentration of only one group of pro-inflammatory cytokines without taking into account anti- inflammatory, does not give a complete picture of cytokine balance disorders. The quantitative assessment of the combination of markers of the two groups is the correct diagnostic indicator of local immune disorders and their pathological relationship with the effect of a replacement prosthesis in patients with postoperative jaw defects. This is promising for the development of preventive diagnostic methods, a comprehensive assessment of the dental status of patients with acquired jaw defects and the justification of new approaches to therapeutic and preventive measures. Biochemical changes and changes in the functional state of the vascular endothelium ultimately cause morphological features in the regeneration zone. Understanding and consolidation of the key mechanisms of inflammation, repair and angiogenesis will allow us to build a rational tactic for resolving postoperative inflammatory complications in the area of acquired jaw defect in patients using replacement orthopaedic structures. Ideas about the change in markers of inflammation, vascular reaction and the influence of the structural material of the prosthesis on the process of repairing the acquired defect have not been studied enough. The aim of this review is to clarify the pathogenetic mechanisms of inflammation that reveal the role of cytokine regulation, as well as to develop available diagnostic methods for detecting hidden chronic inflammatory processes in the area of acquired jaw defect during the period of adaptation to replacement prostheses. Timely impact to on which will reduce the number of complications and improve the quality of orthopaedic rehabilitation of patients.
Key words: oral fluid, inflammation, cytokines, orthopedic rehabilitation, acquired defect, biomarker replacing prosthesi
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study