Longitudinal immunological analysis of gingival crevicular fluid during treatment of aggressive periodontitis

Abstract

Relevance . Aggressive periodontitis is increasingly encountered in clinical practice. Treatment of this condition is challenging for dental practitioners because it is characterized by progressive alveolar bone loss, while the clinical presentation does not always correspond to the radiographic findings. Cytokines are among the biomarkers that may be used to assess treatment response. Objective . To evaluate the efficacy of a combination treatment protocol in patients with periodontitis characterized by rapid progression using immunological analysis of gingival crevicular fluid. Materials and methods . The study included 64 young adults diagnosed with periodontitis (ICD-10 code K05.39), who underwent comprehensive clinical examination and were divided into two treatment groups. Group 1 comprised 31 patients treated according to the conventional protocol. Group 2 comprised 33 patients whose treatment regimen included topical applications of a bischofite-containing gel and injections of Cortexil into the marginal and attached gingiva. Results . Both treatment approaches were effective, although the course of healing differed between the groups. By day 3, patients in Group 2 demonstrated statistically significant improvements in immunological parameters relative to both baseline and Group 1. On day 7, the IL-1β/IL-4 ratio was 3.4 ± 0.1 in Group 1 and 3.1 ± 0.1 in Group 2, indicating a predominance of regenerative processes over inflammatory activity and a reduced risk of a protracted disease course. Conclusion . The combined use of Cortexil injections and topical applications of a bischofite-based gel was the most effective treatment approach in patients with aggressive periodontitis. The two agents had complementary and synergistic effects. However, serial monitoring and long-term follow-up at 1–2 years after treatment initiation are warranted to assess treatment efficacy.