STUDY OF THE KINETICS AND ACTIVITY OF SALIVARY ALPHA-AMYLASE IN PEDIATRIC PATIENTS WITH STREPTOCOCCUS MUTANS-ASSOCIATED CHRONIC GINGIVITIS AND ITS ROLE IN TOOTH DECAY.
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BACKGROUND AND AIM: Chronic gingivitis in children heightens caries risk, yet the mechanistic links between salivary dysfunction, systemic inflammation, and Streptococcus mutans-driven cariogenesis remain unclear. This study explores salivary α-amylase activity and kinetics, inflammatory biomarkers, and S. mutans virulence factors in pediatric chronic gingivitis to uncover pathways fueling caries progression. METHODS: A case-control study comprised 80 individuals aged 7 to 14 years (40 with chronic gingivitis and 40 healthy controls). Salivary and serum samples were assessed for matrix metalloproteinase-8 (MMP-8), procalcitonin (PCT), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), α-amylase activity, and pH. The selective culture, microtiter plate assays, and the CNPG3 substrate were used to measure S. mutans load, biofilm growth, lactic acid production, glucosyltransferase B (GTF-B) levels, and α-amylase kinetics at pH 6.2 and 7.2. RESULTS: The gingivitis group displayed significantly elevated salivary MMP-8 (37.41±3.47 vs. 3.35±0.41 ng/mL), serum PCT (5.53±0.39 vs. 0.067±0.004 ng/mL), TNF-α (16.82±0.71 vs. 6.28±0.41 pg/mL), and IL-6 (12.36±0.89 vs. 2.56±0.25 pg/mL; all p<0.0001), alongside reduced α-amylase activity (26.76±1.00 vs. 53.83±3.16 U/mL, p<0.001) and pH (6.24±0.043 vs. 7.27±0.032, p<0.0001). α-Amylase kinetics showed lower Vmax and higher Km. S. mutans counts, biofilm biomass, lactic acid, and GTF-B levels were markedly higher in gingivitis patients, particularly at pH 6.2 (p<0.0001). CONCLUSION: Chronic gingivitis creates a cariogenic environment due to systemic inflammation, reduced salivary function, and increased S. mutans virulence. We require early treatment methods and biomarker confirmation.