CLINICAL AND DIAGNOSTIC SIGNIFICANCE OF DEFENSINS IN THE DEVELOPMENT OF DENTAL CARIES AND CHRONIC CATARRHAL GINGIVITIS IN CHILDREN WITH SPECIAL NEEDS

Abstract

Introduction. Determination of defensin concentration in oral fluid is a promising diagnostic criterion for assessing the risk of dental caries and periodontal inflammatory diseases, as well as a potential marker of the effectiveness of preventive and therapeutic interventions. The aim of the study was to evaluate the diagnostic potential of defensins in dental caries and chronic catarrhal gingivitis in children with special needs over time. Materials and methods. Sixty-six children aged 7 to 18 years were examined and divided into two groups: the main group (n = 31) consisted of children with special needs who had clinical signs of hard dental tissue lesions and inflammatory periodontal diseases, and the comparison group (n = 35) included age-matched children without systemic developmental disorders and with a healthy oral cavity. Children in the main group underwent professional oral hygiene and dental treatment; the oral mucosa was treated with a sorbent solution (Enterosgel) and an anti-inflammatory agent (Stomatofyt A-spray), while a calcium-containing gel was applied to hard dental tissues along with oral administration of calcium citrate. Defensin levels in oral fluid were determined using an enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using MS Excel and the licensed statistical software Biostat. Results. It was found that children with special needs had significantly lower levels of α-defensins in oral fluid prior to treatment compared with the comparison group. After the implementation of therapeutic and preventive measures, a significant increase in α-defensin concentrations in oral fluid was observed in the main group at 6 and 12 months of follow-up (p < 0.05). The most pronounced positive dynamics of α-defensin levels were observed in older children (13–18 years) and in children with mild to moderate cognitive impairment, which may be associated with better adaptation of local immune defense mechanisms and more effective oral hygiene practices. Conclusions. Correlation analysis revealed statistically significant positive relationships between age and post-treatment α-defensin levels (r = 0.54–0.74; p < 0.05), as well as a negative correlation between the severity of cognitive impairment and α-defensin concentration in oral fluid (r = −0.71; p < 0.05).