STUDY OF CHANGES IN REGULATORS OF MINERAL HOMEOSTASIS IN THE ORAL FLUID OF VEGETARIAN CHILDREN WITH CARIES AND PERIODONTITIS DURING THERAPEUTIC AND PREVENTIVE MEASURES

Abstract

Dental caries and initial inflammatory lesions of periodontal tissues in adolescent children are an urgent problem in pediatric dentistry, especially under conditions of specific dietary patterns, in particular vegetarian nutrition. Insufficient dietary balance in terms of proteins, vitamins, and mineral components may affect the condition of hard dental tissues, the activity of remineralization processes, local nonspecific resistance, and the course of inflammatory changes in periodontal tissues. In this context, the assessment of biochemical markers of oral fluid, particularly the activity of acid and alkaline phosphatases, is of considerable importance, as these enzymes reflect the relationship between demineralization, resorptive, and remineralization processes. The purpose of the study was to dynamically evaluate the effectiveness of a therapeutic and preventive complex in relation to the activity of acid and alkaline phosphatases in the oral fluid of vegetarian children with caries and initial periodontitis. Materials and methods. Biochemical studies of oral fluid were performed in 25 vegetarian children aged 12–15 years with dental caries and initial periodontitis. The patients were divided into two groups: a comparison group, in which oral cavity sanitation and professional oral hygiene were performed, and a main group, in which a therapeutic and preventive complex was additionally administered at the beginning of treatment and after 6 months. In unstimulated oral fluid, acid phosphatase activity was determined as a marker of resorptive and destructive processes, and alkaline phosphatase activity was determined as a marker of osteoblastic and remineralization activity. The mineralization index was calculated as the ratio of alkaline phosphatase activity to acid phosphatase activity. Statistical processing of the results was performed using STATISTICA 6.1 software; differences were considered statistically significant at p<0.01. Research results. At baseline, a significant 3.4-fold increase in acid phosphatase activity and a 40.1–42.7% decrease in alkaline phosphatase activity compared with reference values were established in both groups of vegetarian children with caries and initial periodontitis. In the comparison group, basic therapy did not ensure stable normalization of the studied parameters: acid phosphatase activity at 6 and 12 months corresponded to the baseline level, while alkaline phosphatase activity remained reduced. In the main group, the use of the therapeutic and preventive complex contributed to a significant decrease in acid phosphatase activity after 3, 6, and 12 months, as well as to a marked increase in alkaline phosphatase activity, which reached reference values after 6 and 12 months. The mineralization index in children of the main group increased more markedly than in the comparison group, indicating restoration of the balance between demineralization and remineralization processes. Conclusions. The use of the developed therapeutic and preventive complex in vegetarian children with caries and initial periodontitis contributes to the normalization of acid and alkaline phosphatase activity in oral fluid, reduction of resorptive and inflammatory manifestations, activation of remineralization processes, and improvement of the mineralization index. The obtained results confirm the feasibility of using a comprehensive approach in the prevention and treatment of dental diseases in children adhering to a vegetarian diet.