CHANGES IN ORAL FLUID DYSBIOSIS DEGREE IN CHILDREN WITH ENDEMIC DENTAL FLUOROSIS DURING COMPREHENSIVE ORTHODONTIC TREATMENT

Abstract

The combination of endemic dental fluorosis and orthodontic pathology requires assessment of the relationship between microbial burden and local antimicrobial defence. Oral fluid dysbiosis degree, determined using the enzymatic method proposed by A.P. Levytskyi, is an integrated biochemical measure of this relationship. The purpose of the study was to assess changes in oral fluid dysbiosis degree in children with endemic dental fluorosis receiving a therapeutic and preventive complex during orthodontic treatment. Materials and methods. The study involved 25 children aged 6–7 years, including 13 in the main group and 12 in the comparison group. All children underwent dental treatment and professional oral hygiene; the main group additionally received a therapeutic and preventive complex. Dysbiosis degree was calculated as the ratio of relative urease activity to relative lysozyme activity at baseline, before bracket placement, and at 1, 6 and 12 months after placement. Results are presented as mean ± standard error. Research results. Baseline dysbiosis degree was 5.83 ± 0.28 arbitrary units in the comparison group and 5.85 ± 0.23 arbitrary units in the main group, compared with a reference value of 1.0 ± 0.10 arbitrary units (p < 0.001). Before bracket placement, the index decreased by 24.2% (p₁ < 0.002) and 49.9% (p₁ < 0.001), respectively. At 1, 6 and 12 months, values in the main group were 1.47 ± 0.11, 0.99 ± 0.07 and 1.21 ± 0.10 arbitrary units, respectively. Corresponding values in the comparison group were 3.3, 5.3 and 5.2 times as high (p₂ < 0.001). At 6 and 12 months, no statistically significant differences from the reference level were found. Conclusions. Additional administration of the therapeutic and preventive complex was associated with a marked and sustained reduction in oral fluid dysbiosis degree. At 6 and 12 months, the index approached the reference level, indicating favourable changes in the relationship between the microbial component and local antimicrobial defence