Association between salivary alkaline phosphatase and inflammatory periodontal diseases among adolescents in the European North of Russia

The high prevalence of periodontal inflammatory diseases (PID) among adolescents underscores the need to develop simple, non-invasive methods for their timely detection. Oral fluid is considered a promising diagnostic substrate, enabling the assessment of various biomarkers, particularly alkaline phosphatase (ALP), which is involved in inflammatory and reparative processes in periodontal tissues. However, there is a paucity of studies analyzing the diagnostic significance of this enzyme. Objective. To investigate the association between salivary ALP levels and clinical signs of PID in individuals aged 15–17 years permanently residing in the European North of Russia. In a cross-sectional study, participants (n = 439) residing in the Nenets Autonomous Okrug (n = 171), the Komi Republic (n = 146), and Murmansk Oblast (n = 121) underwent a dental examination with recording of periodontal parameters (bleeding, dental deposits, presence of periodontitis) and provided mixed saliva samples for subsequent determination of ALP activity. Data analysis was performed using Poisson regression models; unadjusted and adjusted (for sex, age, and place of residence) relative risks were calculated, and linear trends were assessed across quartiles of ALP distribution. Results: а direct statistically significant association was observed between enzyme concentration and the number of sextants exhibiting bleeding in the multivariable regression model, p for trend = 0.037. No statistically significant association was found between ALP levels and the likelihood of detecting periodontitis (p for trend = 0.404) or dental calculus (p = 0.521). Our results suggest that elevated ALP levels in the oral fluid of adolescents are associated with a greater prevalence of gingival bleeding. This suggests that this parameter may serve as a potential indicator of the severity and extent of generalized inflammation in periodontal tissues, although it is not specific for a diagnosis of periodontitis. Further prospective studies are required to definitively establish the clinical and diagnostic utility of ALP and to justify its application in routine clinical practice.

1. Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global Prevalence of Periodontal Disease and Lack of Its Surveillance // Scientific World Journal. 202;28.2146160.

2. Shetty S, Al-Bayati S, Said M, Eid H. Salivary alkaline phosphatase and oral health: A review // Ital J Dent Med. 2017:55–58.

3. Todorovic T, Dozic I, Vicente-Barrero M, Ljuskovic B, Pejovic J, Marjanovic M, Knezevic M. Salivary enzymes and periodontal disease // Med Oral Patol Oral Cir Bucal. 2006;11:115–119.

4. Dabra S, Singh P. Evaluating the levels of salivary alkaline and acid phosphatase activities as biochemical markers for periodontal disease: A case series // Dent Res J (Isfahan). 2012;9(1):41–45.

5. Razi M.A., Qamar S., Singhal A., Mahajan A., Siddiqui S., Mohina Minz R.S. Role of natural salivary defenses in the maintenance of healthy oral microbiota in children and adolescents // J Family Med Prim Care. 2020;9(3):1603–1607.

6. Malhotra R., Grover V., Kapoor A., Kapur R. Alkaline phosphatase as a periodontal disease marker // Indian J Dent Res. 2010;21(4):531–536.