Abstract

Background. Analysis of oral fluid parameters in patients with inflammatory periodontal diseases and juvenile idiopathic arthritis (JIA) may help to identify new markers in gingivitis diagnostics.
Aim: to investigate the levels of acid and alkaline phosphatases, immunoglobulins of class A, M, G in oral fluid and the value of the mineralization index in adolescents with JIA, depending on the basic medical support of the disease, JIA subtype, the state of individual oral hygiene and the intensity of gingival inflammation.
Materials and methods. 80 children aged 10 to 17 years with JIA and 20 adolescents without comorbidities were included in the research. Basic dental examination with plaque staining, assessment of inflammation severity using the PMA index, and oral fluid sampling to determine acid and alkaline phosphatase activity, mineralization index, and Ig A, M, and G titers were performed. The participants were classified into five categories depending on: presence or absence of JIA, type of basic pharmacological therapy (patients whose treatment regimen includes methotrexate (MTX) at a dosage of ≤15 mg (n = 43), greater than 15 mg (n = 18), or a combination of MTX and adalimumab (n = 19) and the control group (n=20)), JIA subtype (polyarticular RF+ (n = 29) and RF- (n = 10), undifferentiated (n = 5), oligoarticular (n = 24), enthesitis-associated (n = 12), and comparison group (n = 20)), level of individual oral hygiene based on the PHP index values (excellent (n = 3), good (n = 28), satisfactory (n = 37) and poor (n = 12)), and level of gingival inflammation according to the value of the PMA index (mild gingivitis (n = 52) and moderate (n = 28)) (the last two classifications were applied only to patients with JIA).
Results. The presence of JIA, its subtype, and the pharmacological treatment do not affect the activity of acid and alkaline phosphatase, the value of the mineralization index, IgA and M titers, but they do affect the IgG titer: patients with JIA, those undergoing treatment with MTX ≤15 mg and adalimumab, and those with oligoarticular JIA had higher IgG titers compared to the control group by 1.57, 1.6 and 1.8 times, respectively. No influence of gingival inflammation severity or individual oral hygiene status on the analyzed indicators was found among patients with JIA.
Conclusion. The identified patterns contribute to the expansion of existing knowledge on the course of inflammatory periodontal diseases in the context of JIA and may serve as a basis for developing targeted dental prevention programs for this patient group