Introduction:
Inflammation of the denturebearing mucosa due to shear stress and functional load transfer from complete dentures is characterized by a complex interaction of proand anti-inflammatory mediators. A favourable equilibrium leads to a recovery of homeostasis, while an unfavourable balance adversely affects mucosa and the underlying bone. The present study was an assay to estimate cytokine level and its sequential expression as a biomarker of oral mucosa status after denture use.

Aim of the study:
To evaluate the cascade of expression of interleukins in patients who have been edentulous for 12-15 months and subsequently treated complete dentures.

Material and methods:
Thirty patients aged 55-65 years, edentulous for 12-15 months without any systemic affliction were selected as study participants. These patients were from remote rural areas and hence could not receive early prosthodontic treatment. They were approached by the Community Prosthodontic Outreach Initiative team and assessed for oral tissue status prior to any treatment. A biopsy specimen from the mucosa of the buccal shelf area of the mandibular alveolar ridge was taken following the standard surgical protocol and analysed for interleukin levels. Thereafter, these individuals were provided with logistic support to access prosthodontic care and complete denture rehabilitation at our Institution. Subsequent to regular denture wear, biopsy specimens from the same site were again harvested at one month, four months, seven months and eleven months following denture insertion and analysed for interleukin levels.

Results:
Interleukin-1α, 1β and -8 levels were higher than pre-treatment (baseline) levels at all the follow-ups. Expression of interleukin-4 was maximum at 1 month, declining at 4 months. Interleukin-6 expression were higher than that at baseline at all the follow ups except at 11 months. Expression of interleukin-10 level was maximum at 1 month declining by the 4th month.

Conclusions:
The limited data indicates that interleukins are produced at a higher rate after patients have been initiated into complete denture wear. mRNA expression of pro-inflammatory cytokines elevates to almost double their level of expression in the initial first few months and gradually decreases till the seventh month to reach a level lower than the initial one.