Investigating the impact of kallikrein 4 gene polymorphism on caries severity and development in divers age groups of pregnant women during caries prevention

Abstract

Relevance. The progression of caries during pregnancy is significantly influenced by the resistance of dental tissues against demineralization. The degree of resistance in dental enamel is influenced by its genetic determinants, encompassing structural and morphological properties. The kallikrein 4 (KLK4) gene plays a pivotal role as a primary enzyme in dental enamel formation. Consequently, evaluating the effectiveness of various preventive measures on dental enamel necessitates consideration of KLK4 gene mutations.Material and methods. An examination was conducted on a cohort of 322 pregnant women. Key indices assessed included OHI-S, DMF, DMFs, ∆DMF, and ∆DMFs. Oral fluid analysis encompassed parameters such as Ca, P, Ca/P-molar ratio, рН, Ca2+, pK+, pNa+. The sediment of oral fluid was examined for ∆рН and ∆Ca. DNA sample was isolated from venous blood obtained from the participants.Results. The G/G polymorphism of the KLK4 gene at positions G2664153A and G2142А did not exhibit a statistically significant association with an increase in the ∆DMFs index during caries prevention, a finding consistent across both discussed tools for exogenous caries prevention in this study. In case of heterozygous KLK4 G/A polymorphism with the dominant G allele, the application of Enamel Sealing Liquid showed a tendency towards higher ∆DMF and ∆DMFs indices over a 12-month follow-up period. When pregnant patients with heterozygous dominant G allele mutations were treated with the triple-component calcium-fluorine-phosphate-containing gel, there were no observed elevations in these indices. The amplified production of KLK4 A/A polymorphism was associated with a statistically significant rise in ∆DMF and ∆DMFs indices, accompanied by alterations in certain oral fluid parameters. These changes included reduced active calcium levels and Ca/P molar ratio, along with elevated levels of phosphates and electrolytes. Enhanced demineralizing activity was observed in the oral fluid sediment.Conclusion. The effectiveness of caries prevention tools during pregnancy is contingent upon the genotypic diversity of KLK4 gene polymorphism at the G2664153A and G2142А mutation points.