DIAGNOSTIC SIGNIFICANCE OF ACUTE PHASE REACTANTS IN THE ORAL FLUID IN PREGNANT WOMEN SUFFERING FROM DENTAL DISEASES

Aim. To determine the diagnostic significance of acute phase reactants in mild and moderate dental caries and chronic generalized periodontitis (CGP) in the course of pregnancy.

Materials and methods. 97 pregnant women aged from 18 to 35 were examined. Group 1 (n=35) consisted of pregnant women suffering from dental caries, group 2 (n=31) consisted of pregnant women suffering from mild and moderate CGP, and a control group (n=31) – pregnant women with physiological pregnancy and without dental pathology. The results of the laboratory assessment of oral fluid in 32 healthy nonpregnant female donors aged from 18 to 30 were taken into account. In the oral fluid, the concentration of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) was evaluated using a solidphase immunoenzyme method. The content of C-reactive protein (CRP) in the oral fluid was characterized by a precipitation reaction with a diagnostic serum. Laboratory studies were performed in all the trimesters of pregnancy: I – 8-12 weeks, II – 13-27 weeks, III – 28-40 weeks of gestation.

Results. Only in pregnant women of the group 2, the content of CRP in the oral fluid systematically increased from the 1st to 3rd trimester in the dynamics of the gestational period. During all three trimesters the patients of the 2nd group suffering from moderate CGP demonstrated higher levels of CRP in the oral fluid than the patients with mild CGP. Patients of the control group and group 1 in the course of pregnancy, the level of TNF-α in the oral fluid did not change, and IL-6 consistently grew up. During all pregnancy periods, the level of TNF-α in the oral fluid was higher in group 2 than in the control group and group 1. Especially significant this difference was in the 3rd trimester. Compared to the control group, in patients of group 2 the content of IL-6 in the oral fluid increased 3,5 times in the first trimester (p<0,05), 4 times in the second trimester (p<0,05) and 6 times in the third trimester (p<0,05). Correlation analysis of the concentration of CRP, IL-6 and TNF-α in the oral fluid of pregnant women with mild and moderate CGP, on the one hand, and the PMA index, on the other, revealed a close direct relationship between the indices. In the control group and group 1, the association between the acute phase reactants, the proinflammatory mediators and the CFR index, the PMA index was weak and statistically insignificant.

Conclusion. During pregnancy the concentration of IL-6 in the oral fluid increases from the first to the third trimester. In pregnant women with dental caries, the determination of CRP, IL-6 and TNF-α in oral fluid is not of diagnostic significance for the characteristics of the activity of carious lesions of teeth. The increased content of CRP, proinflammatory mediators IL-6 and TNF-α in the oral fluid of pregnant women with CGP reflects the severity of the dental disease, which allows obtaining additional assessment criteria for characterizing the disease. 

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