Changes in oral microflora and neutrophil netosis activity in patients with lower esophageal sphincter insufficiency

Abstract

The aim of the study is to investigate the features of changes in oral microbiota and neutrophil netosis activity (an antimicrobial mechanism of neutrophils) in patients, using acrylic and polycarbonate prostheses on the background of the lower esophageal sphincter insufficiency.
Materials and methods.
A total of 57 patients (19 men, 38 women) aged 58—79 years (mean age 68.4±5.3 years) using complete removable dentures made of polymethyl methacrylate and polycarbonate with lower esophageal sphincter insufficiency were examined. pH measurement of oral fluid was performed, and the quantitative composition of microflora was studied using polymerase chain reaction. The presence of extracellular neutrophil traps was determined by the Feulgen reaction with Schiff’s reagent on DNA.
Results.
In the context of lower esophageal sphincter insufficiency, a shift in the pH of oral fluid is observed, which contributes to an increase in the number of enterobacteria, leptotrichia, fungi of the genus Candida, rod-shaped (Fusobacterium spp. and Prevotella spp.) and coccal (Streptococcus spp., Peptostreptococcus spp., Veillonella spp.) flora. In the biological material from patients with acrylic dentures, these microorganisms are detected in abundant quantities (>105 CFU/ml), while in those with polycarbonate dentures, they are found at a lower titer (102—105 CFU/ml).
Conclusion.
Among individuals using removable dentures made of polycarbonate with normal tone of the lower esophageal sphincter, single neutrophils capable of netosis with expression of extracellular neutrophil traps are found on the mucous membrane of the alveolar process, palate, and alveolar part of the mandible. In patients using polymethyl methacrylate-based dentures, regardless of the presence or absence of lower esophageal sphincter insufficiency, no neutrophils were detected.