Cytokine imbalance as a factor of postoperative complications of third mandibular molar extraction

Background. Tooth extraction is considered the most frequently performed operation in surgical dentistry, which can often cause inflammatory complications. Modern research has come a long way in terms of developing methods for the prevention, diagnosis and treatment of these complications, but the search for their early laboratory markers remains an urgent task to this day.

The aim of the study. To determine prognostic laboratory criteria for the development of local inflammatory complications of third mandibular molar extraction.

Methods. The study included 35 people who underwent extraction of a third mandibular (semi-impacted) molar. Before the surgery, immediately after the surgery, 1, 2, 3 and 4 days after the surgery, we assessed the objective status of the patients and collected oral fluid from the oral cavity, in which we determined the concentrations of cytokines using enzyme-linked immunosorbent assay. After the surgery, patients were divided into a control group and a group with complications with determination of their cytokine status.

Results. Immediately after the surgery, patients from the group with complications, compared with patients from the control group, had significantly higher levels of proinflammatory cytokines – interleukin (IL) 1, IL-8 and comparable levels of tumor necrosis factor α and anti-inflammatory cytokines IL-4 and IL-10. Integral cytokine indices in both groups showed a sharp shift towards pro-inflammatory direction in patients with complications. This fact determines the protracted or progressive nature of the inflammatory process after the surgery.

Conclusion. Determining the level of individual cytokines and cytokine indices in the oral fluid after the extraction of a third mandibular molar allows us to identify early markers for the chronicity of the inflammatory process, to predict its further course and to take appropriate measures to prevent the development of expected complications.

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