Features of cellular mechanisms affecting the pathogenesis and course of chronic catarrhal gingivitis

Aim. To investigate the cellular mechanisms of chronic catarrhal gingivitis to develop the appropriate treatment schemes based on the analysis of obtained data.

Methods. 57 patients aged 16 to 22 years were observed and divided into the control group (18 subjects with the intact periodontium with no orthopedic constructions) and the study group of patients with chronic catarrhal gingivitis (39 subjects, group 1). The degree of gingival inflammation was evaluated by papillo-marginal alveolar index as well as by gingival bleeding index. In addition, laboratory parameters were measured: spontaneous nitroblue tetrazolium test and zymosan-stimulated nitroblue tetrazolium test. Leukocyte-modulating activity of oral fluid was determined by measurement of luminol-dependent chemiluminescence. The activity of lysosomal enzymes - acid deoxyribonuclease and acid phosphatase - was determined in whole oral fluid, supernatant fraction of oral fluid and in sediment, obtained by centrifugation. Antioxidant activity was determined in whole oral fluid by biochemiluminescent method with hydrogen peroxide.

Results. The performed investigations demonstrated that the development of chronic catarrhal gingivitis is accompanied by a sharp increase of the number of neutrophils and macrophages with a significant increase of their functional activity. At the same time, more than two-fold increase of the activity of lysosomal enzymes, lysosomal membrane labilization and release of enzymes outside the organelles and cells were observed, that indicated the increase of destructive potential in chronic catarrhal gingivitis. Use of indometacin in the complex treatment of chronic catarrhal gingivitis contributed to normalization of clinical parameters, increased neutrophil functional activity and enhanced their functional reserve, reduced the activity of phlogogenic factors and normalized the antioxidant activity of oral fluid. Pro- and anti-inflammatory factors secreted into the oral cavity during inflammatory periodontal diseases collectively have leukocyte-modulating activity.

Conclusion. The obtained data indicate the important role of both high oxygen-dependent and oxygen-independent biocidal activity of neutrophils and macrophages in the pathogenesis and clinical course of chronic catarrhal gingivitis.