Periodontal diseases constitute an important medical and social problem due to their high prevalence, propensity to progression, and the formation of a complex of pathological changes which lead to breach the main protective functions of periodontium and loss of teeth. Current problems of modern dentistry are studying of the periodontal tissues state in pregnant women who has some somatic pathology. Iron deficiency anemia is frequent complication of pregnancy which ranks the first place among all complications within this period (IDA). Disorders of bone metabolism should recognize as one of the central mechanisms in pathogenesis of periodontitis. The enzymes which involved in the regulation of phosphorus-calcium metabolism and have a direct effect on the bone resorption and regeneration processes include acid and alkaline phosphatase. The aim of our research was to study the changes in the activity of acid and alkaline phosphatase in serum blood and saliva of pregnant women with generalized periodontitis and iron deficiency anemia. Biochemical studies were performed on serum blood and saliva which were taken from 42 pregnant women with generalized periodontitis of the initial and I severity and iron deficiency anemia (main group) and 34 pregnant women with generalized periodontitis of the initial and I severity without iron deficiency anemia (comparison group). The obtained data testify that compensated bone resorption processes are taking place in the periodontal tissues as result of effect IDA on them. The level of alkaline phosphatase in serum blood had a moderate tendency to decrease with the development of generalized periodontitis in pregnant women of the comparison group as opposed to women of the main group where the decrease level of alkaline phosphatase in biological fluids declined acutely. The level of alkaline phosphatase in the blood serum of women with initial severity of generalized periodontitis who have physiological course of pregnancy approached the upper margin of norm (184.15 ± 8.26 U / L) and was 2.7 times higher than that in pregnant women who have anemia (68.28 ± 4.01 U / L) which was within the lower boundary of the norm. The level of alkaline phosphatase in blood serum of both groups at I severity of generalized periodontitis was significantly lowered: 46.19 ± 2.91 U / L in the main group and 120.34 ± 6.35 U / L in the comparison group, that may indicate about an increase inflammation and destructive process in periodontium. The content of alkaline phosphatase in saliva of pregnant women from main group was 2.4 times lower than in the comparator group (11.12 ± 1.33 U / L against 26.48 ± 2.23 U / L). The level of alkaline phosphatase in the saliva of the persons with the generalized periodontitis of the I severity in the main group decreased to 7.53 ± 1.24 U / L that was 2 times less than in the comparison group (15.52 ± 1.98 U / L). The acid phosphatase activity in the blood serum of the main group and comparative group tended to increase. The level of acid phosphatase in the blood serum of the main group at the initial stage severity was close to the upper boundary of the norm with a value of 4.05 ± 0.34 U/ L. This indicator of the comparison group was in the average range of the average static norm (2.14 ± 0.18 U / L) and was in 1.9 times lower than in the main group. The content of acid phosphatase in saliva of the women with the initial severity of generalized periodontitis from the main group was 22.15 ± 1.46 U / L, and exceeded the normal more then 1.7 times higher than that was in women of the comparison group (13.36 ± 1.15 U / L). The level of acid phosphatase in the saliva significantly increased to 25.31 ± 1.61 U / L in women with complicated pregnancy with the increase in the phenomena of generalized periodontitis that was indicating predominance of bone resorption processes in the periodontium within the effect of iron deficiency anemia. As a conclusion, significant changes the levels of activity of markers of bone metabolism in pregnant women with anemia were observed such as: active reduction of alkaline phosphatase and increase of acidic phosphatase in biological fluids (blood serum and saliva) of pregnant women that gives grounds to assert about the negative influence of iron deficiency anemia the processes of bone remodeling in pregnant women with generalized periodontitis.
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