Correlation between the degree of dental crowding, the level of oral hygiene, and the concentration of statherin protein in oral fluid

   Background. Dental crowding is one of the most common dentofacial anomalies in children and adolescents, occurring in 35–65 % of school-age children. This pathology creates conditions for increased plaque formation in areas difficult to access for hygiene, increasing the risk of dental caries and inflammatory periodontal diseases. The relevance of this study is due to the need to develop effective strategies for oral hygiene care in children with dental crowding, taking into account age characteristics, severity of the anomaly, and level of manual skills development.

   Objective. To improve the level of oral hygiene in children aged 6–12 years with dental crowding by developing an algorithm for optimizing individual oral hygiene, taking into account the concentration of statherin protein in oral fluid as a marker of mineral metabolism.

   Materials and methods. A study was conducted of 60 children aged 6–12 years (32 boys and 28 girls), divided into two age groups: 6–8 years (n = 30) and 9–12 years (n = 30). Subgroups were identified in each group according to the degree of dental crowding (mild, moderate, severe). Green – Vermillion hygiene indices (OHI-S), bleeding index (PBI), and papillary-marginal-alveolar index (PMA) were determined. In 30 children, the concentration of statherin protein in oral fluid was determined by enzyme immunoassay (ELISA). The effectiveness of three types of tooth-brushes (manual with flat bristle field, manual with multi-level bristle field, electric) was evaluated after single brushing and after 1 and 3 months of use. Statistical processing was performed using Statistica 12.0.

   Results. The prevalence of dental crowding was 68.3% (41/60), with a tendency to increase with age (63.3 % in the 6–8 years group and 73.3 % in the 9–12 years group). A strong direct correlation was established between the degree of crowding and OHI-S values (r = 0.72, p < 0.01). Mean PMA values significantly increased with increasing severity of crowding: 14.8 ± 2.3 % (no crowding), 23.5 ± 3.1 % (mild), 31.7 ± 3.8 % (moderate), 42.5 ± 4.7 % (severe) (p < 0.05). Statherin concentration was significantly higher in children with crowding (3.2 ± 0.4 mmol/L in the 6-8 years group and 3.9 ± 0.5 mmol/L in the 9-12 years group) compared to children without pathology (2.7 ± 0.3 and 3.0 ± 0.3 mmol/L, respectively) (p < 0.05). In children aged 6-8 years, manual brushes with multi-level bristle field and electric brushes showed comparable effectiveness (plaque reduction 68.4 ± 5.2 % and 70.8 ± 6.1 %), surpassing manual brushes with flat field (52.6 ± 4.7 %, p < 0.05). In the 9–12 years group, electric brushes were most effective (75.3 ± 5.8 %), surpassing manual brushes with multi-level (64.2 ± 5.0 %, p < 0.05) and flat (50.1 ± 4.5 %, p < 0.01) fields. When using electric brushes for 3 months, a significant decrease in statherin concentration was noted (by 22.5 ± 3.8 % in the 6–8 years group and by 28.7 ± 4.2 % in the 9–12 years group, p < 0.05).

   Conclusion. A correlation has been established between the degree of dental crowding and the level of oral hygiene. The concentration of statherin protein in oral fluid can serve as a risk marker and compensatory mechanism in dental crowding. A comprehensive algorithm for selecting oral hygiene products has been developed, taking into account age, degree of crowding, and level of manual skills.

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