RESUMEN
UNLABELLED: During healing following tooth extraction, inflammation and the immune response within the extraction socket are related to bone resorption. OBJECTIVE: We sought to identify how the alloplastic material used for socket preservation affects the immune responses and osteoclastic activity within extraction sockets. MATERIAL AND METHODS: Using a porcine model, we extracted teeth and grafted biphasic calcium phosphate into the extraction sockets. We then performed a peptide analysis with samples of gingival tissue from adjacent to the sockets and compared the extraction only (EO) and extraction with socket preservation (SP) groups. We also used real-time polymerase chain reaction (PCR) to evaluate the expression level of immunoglobulins, chemokines and other factors related to osteoclastogenesis. Differences between the groups were analyzed for statistical significance using paired t tests. RESULTS: Levels of IgM, IgG and IGL expression were higher in the EO group than in the SP group 1 week post-extraction, as were the levels of CCL3, CCL5, CXCL2, IFN-γ and TNF-α expression (p < 0.05). In addition, receptor activator of nuclear factor kappa-B ligand (RANKL) was also significantly upregulated in the EO group (p < 0.05), as were IL-1ß, IL-6 and IL-8 (p < 0.05). CONCLUSIONS: These results suggest that the beneficial effect of socket preservation can be explained by suppression of immune responses and inflammation.
Asunto(s)
Pérdida de Hueso Alveolar/inmunología , Citocinas/análisis , Encía/inmunología , Inmunoglobulinas/análisis , Osteoclastos/inmunología , Extracción Dental , Alveolo Dental/inmunología , Animales , Sustitutos de Huesos/farmacología , Citocinas/genética , Encía/efectos de los fármacos , Inmunoglobulinas/genética , Osteoclastos/efectos de los fármacos , Osteogénesis/efectos de los fármacos , Osteogénesis/inmunología , Reacción en Cadena en Tiempo Real de la Polimerasa , Porcinos , Porcinos Enanos , Factores de Tiempo , Alveolo Dental/cirugía , Cicatrización de Heridas/efectos de los fármacos , Cicatrización de Heridas/inmunologíaRESUMEN
The aim of the present study was to perform a biochemical, histological, and histomorphometrical evaluation of the mechanisms involved in tissue repair in rats subjected to submandibulectomy-induced hyposialia, 24, 48, and 72 hours of post-tooth extraction. We studied the correlation between the lack of submandibular saliva and the modulation of inflammatory mediators involved in tissue repair, such as prostaglandin E2 , nitric oxide (NO), and tumor necrosis factor alpha (TNF-α). Rats with hyposialia showed a delay in socket healing, slow replacement of the clot with granulation tissue, and fewer cells and collagen fibers, concomitant with a longer inflammatory process, as compared to controls. The lack of saliva induced by submandibulectomy modified the levels of prostaglandin E2 , NO, and TNF-α, and tissue response in the early stages of wound healing compared to controls, and could thus determine alterations in later osteogenic response. Our results allow concluding that hyposialia modulates the parameters of inflammation studied here, and that it is essential for optimal healing. Therefore, these findings provide evidence for the importance of submandibular saliva to final bone socket healing.