ASSESSMENT OF DENTAL AND PERIODONTAL TISSUES BASED ON CLINICAL PARAMETERS AND LABORATORY INDICATORS OF PHOSPHORUS-CALCIUM METABOLISM IN MIXED SALIVA IN CHILDREN WITH HYPOPHOSPHATASIA

Relevance. Evaluation of mineral metabolism markers in mixed saliva may be a non-invasive method for diagnosing potential disorders and developing strategies for the prevention and treatment of dental diseases in children with hypophosphatasia (HPP). Objective: To determine the content of vitamin D, osteocalcin (OCC), osteoprotegerin (OPT), bone-specific alkaline phosphatase (BSAP), and parathyroid hormone (PTH) in mixed saliva and to study their relationships with some clinical parameters of dental status in children with HPP. Materials and Methods. Twenty children with HPP, aged 6–17 years, and 20 healthy children of the same age were examined. Caries intensity and structural and functional caries resistance of enamel in permanent teeth were assessed using the KPU index and the TER test, respectively; periodontal tissue condition was determined using the PMA index. The content of vitamin D, TBPC, OPT, and IAP were determined using enzyme-linked immunosorbent assay (ELISA). Results. Clinical evaluation of key dental parameters in children with HPP and healthy children revealed insufficient oral hygiene associated with an increase in caries in permanent teeth and the presence of moderate gingivitis. In the laboratory phase of the study, a statistically significant difference (2-fold) in the mixed saliva of children with HPP was found in a two-fold decrease in IAP secretion. Reduced levels of vitamin D concentration and OPT minute secretion in mixed saliva in children with HPP are associated with the development of caries in permanent teeth and soft tissue inflammation. Conclusions. The identified changes in biochemical parameters (IBP, vitamin D, OPT, and OPT) in mixed saliva allow us to recommend them as markers for identifying the risk of impaired formation and mineralization of dental and periodontal tissues in children with hypophosphatasia.