COMPARISON of CYTOKINE, IMMUNOGLOBULINE and OSTEOPROTEGERIN LEVELS of PATIENTS with NON-CARIOUS CERVICAL LESIONS BEFORE and AFTER TREATMENT with FLOWABLE RESIN COMPOSITES
Project no. 360 · Status: Kapanmış · 2018
Summary
OBJECTIVES: In the treatment of non-carious root surface lesions (abfraction), flowable resin composites, which are routinely applied in the clinic, before and after restorative treatments, cytokines (interleukins), which are indicators of inflammation in the gingival crevicular fluid (GCF), and immunoglobulins, which are accepted as criteria for infection. and to evaluate the levels of osteoprotegerin (OPG) enzyme levels and the success of composite restorations according to USPHS (Ryge) criteria. MATERIALS & METHODS: The lesions in the teeth of 30 patients, who were systemically healthy and non-smoking, who had at least three (3) different teeth with non-carious chole lesions (abfraction) on the root surface, between the ages of 25-50, were restored with three different flowable composites. The working groups were formed as follows: a) Self-adhering flowable composite (Vertise Flow, Kerr Corp, Orange Co. CA, USA), b) Fluoride releasing flowable composite (Nexcomp Flow, Meta BioMED, Seoul, S. Korea) c) Traditional microhybrid flowable composite (Nova Compo SF, Imicryl, Konya, Turkey). The pre-treatment dental and systemic anamnesis of the patients were recorded, their symptoms before, after the treatment, at the 1st week, 1st and 6th months, the clinical evaluation of the restorations were scored according to USPHS criteria, during these processes, gingival crevicular fluid (GCF) from the patients' relevant teeth periodontal papers (Periopaper, OraFlow Inc. USA) and the levels of IL-1, IL-1ß, IL-10, IgA, IgM and OPG in DOS were determined by ELISA (enzyme linked immunosorbent assay) method. The data obtained were analyzed by Pearson correlation test and one-way analysis of variance-ANOVA test (p= 0.05). RESULTS: GCF volume was increased mostly in conventional microhybrid flowable composite (SF) (1.34±0.09 µl). While the titer of interleukin was increased in all groups after restoration process, the higher increases were observed in IL-1 and IL-1ß titres in the fluoride-releasing flowable composite (NF) group (170.78 pg/ml and 39.35 pg/ml). IL-10 was increased mostly in self-adhering flowable composite (VF) group (14.33±0.85 pg/ml). While IgA levels varied partially among all groups (p>0.05), IgM levels were elevated after restoration process but returned to normal on the 28th day (p<0.05). OPG levels were increased over time in all groups (p<0.05). In considering the effects of restorations on cytokine and immunoglobulin values, Vertise Flow (VF) was found to be the most successful restoration material (p<0.05). Fluoride-releasing flowable composite (NF) is determined to be the least successful material in most of the USPHS criteria, while the materials that fail only in the marginal adaptation criteria are self-adhering flowable composite (VF) and traditional microhybrid flowable composite (SF) (p<0.05). Marginal discoloration criterion has also been observed as in the same restorations that have failed and renewed due to marginal adaptation. Partial enamel demineralization next to restoration margins was observed only in one case in group VF and two cases in both group NF and SF (p>0.05). All of the groups scored as alpha (1) for this reason. Nova Compo (SF) has been found to be the most successful restoration material considering USPHS criteria (p>0.05). CONCLUSION: When flowable composites are used in the treatment of cervical lesions, they cause localized inflammation in the surrounding periodontal tissues and GCF due to their monomer composition. This inflammation returns to normal in 1-6 months depending on the type of material used. The use of flowable composites stand alone in cervical areas that carry occlusal stress and susceptible to abrasion may cause failures such as marginal adaptation and discoloration. Flowable composites that contain 4-META and MDP are one of the materials that can be used safely in these areas.