Assessment of oral tissue status and selected parameters of mixed saliva in children with hypophosphatemic rickets

Relevance. Genetically determined metabolic disorders and the resulting hypomineralization of dental and periodontal tissues may increase the risk of inflammation and structural damage in the oral tissues of children with hypophosphatemic rickets (HR).

Materials and methods. The study involved 46 children aged 6–17 years, including 29 diagnosed with hypophosphatemic rickets (HR) and 17 practically healthy controls. Oral hygiene was assessed using the Fedorov–Volodkina Hygiene Index and the Simplified Oral Hygiene Index (OHI-S) by Green and Vermillion. The severity of dental caries and its complications in primary and permanent teeth was evaluated using the dft/DMFT and pufa/PUFA indices, respectively. Periodontal status was assessed using the PMA index, while gingival sulcus bleeding was evaluated using the Sulcus Bleeding Index (SBI). Levels of monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), procalcitonin (PCT), and D-dimer in mixed saliva were measured using solid-phase enzyme-linked immunosorbent assay (ELISA) kits (Vector-Best, Russia).

Results. Children with HR exhibited unsatisfactory oral hygiene and moderate periodontal inflammation. The pufa/PUFA index was 7.6 times higher in this group compared to healthy controls. These clinical findings were accompanied by significant differences in salivary biochemical parameters, including elevated levels of MCP-1, VEGF, PCT, and D-dimer. A positive correlation was observed between MCP-1 and PCT, as well as between MCP-1 and VEGF (r = 0.49 and r = 0.59, respectively; p < 0.05), suggesting a potential prognostic role of these biomarkers in the development of oral inflammation in children with HR.

Conclusion. Children with hypophosphatemic rickets showed clear signs of periodontal inflammation. The detection of MCP-1, VEGF, and D-dimer in mixed saliva highlights their diagnostic potential as markers of inflammatory activity in the oral cavity in this patient population.

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