Diagnostic value of molecular biomarkers in evaluating dental implantation results in middle-aged and elderly patients

In the context of an aging population, there is an increasing need for dental implantation in middle-aged and elderly patients with partial tooth loss. Despite the high clinical effectiveness of dental implantation, which is reflected in the high frequency of implant survival in long-term follow-up, the development of periimplant inflammatory complications remains a relevant clinical issue. This problem is particularly relevant for elderly patients, who are characterized by age-related changes in inflammatory regulation, angiogenesis, and the epithelial barrier, which can negatively affect the processes of implant osteointegration and the condition of periimplant tissues. The aim of the study is to evaluate the diagnostic significance of molecular markers of inflammation (COX-1, COX-2, COX-3), angiogenesis (VEGF, VEGFR) and epithelial adhesion (claudin-1, E-cadherin) as tools for early diagnosis and prediction of clinical outcomes of dental implantation in middle-aged and elderly patients. The study included 184 patients divided into two groups - middle-aged and elderly. The biomaterial was buccal epithelium, the expression of molecules was determined before implantation and 6 months later by immunocytochemistry. In middle-aged patients, 6 months after implantation, there was a decrease in COX-1 expression by 33,6%, COX-2 by 47% and COX-3 by 40%, as well as a more than twofold increase in the levels of VEGF and VEGFR (p<0,05). In elderly patients, the decrease in COX-2 and COX-3 expression was less pronounced (17 and 14%, respectively), with insufficient angiogenic response and a significant decrease in claudin-1 and E-cadherin (p<0,01). Age is an independent modifying factor for the outcomes of implantation. A panel of biomarkers, including COX-1,2,3, VEGF, VEGFR, claudin-1 and E-cadherin, can be used for early stratification of the risk of complications and formation of personalized clinical and preventive approaches in dental implantation.