С целью комплексного анализа состояния фосфорнокальциевого обмена у детей, страдающих кариесом, обследованы 104 пациента 7-14 лет с компенсированной и субкомпенсированной формами заболевания (основная группа) и 20 здоровых детей с интактными зубами (контрольная группа). Материалом исследования служили сыворотка крови и слюна. У детей с кариесом в целом зафиксировано статистически значимое повышение секреции остеокальцина, но при активном множественном кариесе определено относительное снижение его продукции, что в совокупности с другими метаболическими нарушениями свидетельствует об истощении защитнокомпенсаторных механизмов. Нарушение кальций-фосфорного баланса обусловливает расстройство минерализации эмали и снижает резистентность тканей зуба к неблагоприятным воздействиям ротовой жидкости. Включение в терапию детей с субкомпенсированным кариесом комбинированного препарата кальция приводило к статистически значимому увеличению в крови общего и ионизированного кальция и 25-гидроксивитамина D3, а также к нормализации локального содержания кальция и его соотношения с фосфором.
Background. The WHO has included teeth caries in the six illnesses of the present which prophylaxis is the most actual problem of a medical science and public health services. Methods. For the purpose of the complex analysis of the condition of phosphor-calcium exchange at children with caries the examination of 104 patients of 7-14 years old with compensated and subcompensated disease forms (the basic group) and 20 healthy children with intact teeth (control group) was done. The research material was the blood serum and mixed non-stimulated saliva in which the concentration of the general and ionized calcium and inorganic phosphate were estimated. In blood serum also the level of calcitonin, osteocalcin, parat hormone and 25-hydroxy vitamin D3 was calculated. Results. In blood serum of all patients the maintenance of the general calcium and phosphorus was within reference limits. However at children with caries requiring therapy the relative insufficiency of the general calcium and statistically significant decrease in the ratio of the ionized calcium and inorganic phosphorus are revealed. The concentration of the ionized calcium in saliva was significantly higher at children requiring sanitation of teeth. At them considerable change of the ratio “calcium: phosphorus” is found. At all children with caries the hyperproduction of osteocalcin and decreased level of 25-hydroxy vitamin D3, the direct moderate correlation between calcitonin level and 25-hydroxy vitamin D3 is revealed. At complex treatment by calcium and vitamin D3 in 6 months there was statistically significant increase in blood of the general and ionized calcium and 25-hydroxy vitamin D3 and also normalized the local level of calcium and its ratio to phosphorus. Conclusions. Infringement in calcium-phosphoric balance leads to the mineralization lesion of enamel and reduces the resistance of the tooth tissues to adverse influence of the oral liquid. Treatment of children with subcompensated caries of the combined calcium preparation leads to the normalization of phosphor-calcium exchange.
The authors declare that there are no conflicts of interest present.