The dynamics of cytokine concentrations in the mixed saliva of patients with mild chronic periodontitis and concomitant peri-implantitis

Relevance. Saliva, which contains a wide spectrum of biomarkers, is a promising material for the non-invasive diagnosis and monitoring of the progression of these oral diseases. Objective. Based on the results of an enzyme-linked immunosorbent assay (ELISA) of unstimulated whole saliva, determine the relationship between the levels of pro-inflammatory and anti-inflammatory cytokines and the presence of mild chronic generalized periodontitis in combination with peri-implantitis. Materials and methods. The study utilized unstimulated whole saliva samples collected by the spitting method from patients with periodontitis and peri-implantitis before treatment, as well as 30 and 60 days after it. The treatment included professional hygiene and antibacterial therapy (metronidazole topically and/or systemically administered). The concentrations of cytokines (TNF-α, IL-1β, IL-6, IL-4, IL-10) and VEGF-A were determined by solid-phase enzyme-linked immunosorbent assay (ELISA) using commercial reagent kits. Results. Studies have shown that the salivary cytokine profile changes significantly in inflammatory diseases of the periodontium and around implants. In patients with periodontitis alone, a significant increase in TNF-α and IL-1β levels was recorded before treatment, which decreased after therapy. In the group with combined pathology (periodontitis and peri-implantitis), a more complex picture was revealed: initially, reduced levels of IL-1β, IL-6, IL-10, and VEGF-A were observed. After treatment, the dynamics of various cytokines were divergent; for example, by day 60, the level of IL-1β had increased, while the concentrations of IL-4, IL-6, and IL-10, on the contrary, had decreased significantly. Conclusions . It has been established that the salivary cytokine profile is a sensitive marker reflecting the activity of the inflammatory process in periodontitis and peri-implantitis. Differences in the immune response were identified between isolated periodontitis and its combination with peri-implantitis, indicating peculiarities in the pathogenesis of the combined pathology. Monitoring the levels of cytokines in saliva can be useful for assessing the effectiveness of the treatment and the disease dynamics.