The State of the Local Cytokine Status and Its Pathogenetic Significance with Secondary and Residual Palatal Deformities after Uranoplasty in Children

Abstract

Providing qualified care to patients with congenital cleft of the upper lip and palate (CСLP), accompanied by dentoalveolar anomalies and nasal deformities is one of the most difficult tasks of modern dentistry and maxillofacial surgery. According to various authors, complications after reconstructive operations range from 8 to 32% (4,5,8,13,14). With this pathology, the quality of the postoperative scar depends on the general condition of the body, the nature of the disease, the experience of the surgeon, the type of suture material and many other factors. Any kind of surgical intervention in the dental-jaw system causes disturbances in microcirculation, as well as in the blood circulation of tissues around the wound, which leads to an inflammatory reaction. Even with the initial wound healing, accompanied by a decrease in blood supply, the scar forms and matures more slowly, and its quality becomes worse. The interest to the problem of postoperative wound healing is explained by the fact that inflammation plays a leading role in the course of any wound process, which determines the path along which wound healing will go. Considering the medical and social significance of the problem of healing postoperative wounds in the tissues of the maxillofacial area, the development of methods aimed at optimizing the healing process of postoperative wounds, reducing the number of complications and improving the appearance of scars remains an urgent problem in surgical dentistry. It has recently been proven that one of the factors influencing wound healing is cellular interaction and adequate work of cells and cytokines. Consequently, the regeneration of the tissues of the oral cavity depends on adequate cellular cooperation. Growth factors play an important role in the development of scars. Growth factors are polypeptides that release various activated cells at the site of injury. They stimulate cell proliferation and chemoattraction of new cells. The variety of clinical manifestations after various types and techniques of uranoplasty, in particular the emerging secondary (SD) (postoperative) and residual defects (RD) of the palate in children, as well as the difficulties of their treatment, make it relevant and necessary to further study their pathogenesis and improve the methods of treatment.

The aim of our research was to assess the state of the local cytokine status and its pathogenetic significance in secondary and residual palatal deformities after uranoplasty in children.