The purpose of the study was to determine the metalloproteinase 9 level for the differential diagnosis of periodontitis’ various forms at the stage of disease manifestation by morphometric evaluation of its expression in biopsy. Material and methods. Biopsy material of the gums of 70 patients was analyzed. There were control groups (n=7), rapidlly progressive (n=19), chronic simplex (n=9) and chronic complex (n=35) periodontitis. Morphometric and statistical analysis of metalloproteinase 9 expression were performed using AperioImageScopev12.0 and Statistica 10.0, p <0.05. Results and discussion. Metalloproteinase 9 expression was detected in all the research clinical cases like cytoplasmic and membrane staining of epithelial cells, inflammatory infiltrate cells and fibroblast of the gingival lamina in the control group such as the groups of patients with signs of periodontitis. A direct relationship was found between the positivity (ρ = 0.71) and intensity (ρ = 0.82) of the epithelial and stromal expression of metalloproteinase 9, as well as the involvement of the epithelial component into the inflammation process, including its erosion. The highest variability with a maximum positivity of metalloproteinase 9 expression up to 66% was found in the group of patients with chronic complex periodontitis, it decreased to 38% and 34% in the groups of rapidlly progressive and chronic simplex periodontitis (p˂0.001) and did not exceed 0.5% in the control group. Moreover, the expression area of metalloproteinase 9 did not have statistically significant differences in the group of patients with rapidly progressive periodontitis, with that in the group of chronic simpleх periodontitis, but it was significantly smaller than in the group of chronic complex periodontitis. Analysis of the expression intensity of metalloproteinase 9 “hot points” of the sites revealed significantly higher intensity number in the groups of rapidly progressive and chronic complex periodontitis (which were comparabled in this parameter, p=0.60) compared with chronic simplex periodontitis (p = 0.014 and p =0.045). Conclusion. The expression area of metalloproteinase 9 (which was in the group of chronic complex periodontitis has significantly higher rates with comparable expression intensity) is the most informative indicator for determinination of the course of periodontitis at the stage of disease manifestation and for the differential diagnosis of rapidly progressive periodontitis with chronic complex periodontitis. The expression intensity of metalloproteinase 9 (which has significantly lower rates in the group of chronic simplex periodontitis with comparable expression of the marker area) is a key indicator for the chronic simplex periodontitis.

Keywords: periodontitis, matrix metalloproteinase 9, immunohistochemistry, expression, prognosis

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