Dimitrije Mirkovic

Univerzitet u Svrljigu, Nisch, Central Serbia, Serbia

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Publications (11)3.53 Total impact

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    ABSTRACT: Objective: To evaluate the effect of periodontal treatment on gingival overgrowth in a group of renal transplant patients. Subjects and Methods: Twenty-five renal transplant recipients receiving immunosuppressive therapy with cyclosporine A (CsA) were randomly assigned to 2 groups. Group 1 (n = 15) included patients who had been specifically referred to a dental clinic to prevent gingival overgrowth and were given full periodontal therapy. Group 2 (n = 10) was comprised of patients who did not receive any professional periodontal cleaning. Patients from both groups were examined to determine their periodontal status before and after 3, 6 and 12 months in terms of their plaque index, gingival index and gingival overgrowth. During the examination, their overall health was stable. Results: For group 1, the scores were 1.89 (baseline), 0.98 (6 months) and 0.56 (12 months), and hence there were significant reductions (p = 0.0001). The gingival indices were 1.71 (baseline), 0.76 (6 months) and 0.35 (12 months), and the reductions were also significant (p = 0.0001). A significant association was observed between poor oral hygiene and the degree of gingival overgrowth. The 1-year post-treatment follow-up showed that patients in group 1 did not develop gingival overgrowth due to the use of CsA as group 2 did without prior periodontal therapy. Conclusion: Oral hygiene status was the most important variable related to the development and degree of gingival overgrowth due to the use of CsA. © 2013 S. Karger AG, Basel.
    Medical Principles and Practice 12/2013; · 0.96 Impact Factor
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    A Pejcic, D Kojovic, D Mirkovic, I Minic
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    ABSTRACT: Periodontal regeneration is considered to be biologically possible but clinically unpredictable. In periodontitis, inflammation manifests clinically as loss of supporting periodontal tissues and regeneration of damaged tissue is the main goal of treatment. For decades, periodontists have sought to repair the damage through a variety of surgical procedures, and use of grafting materials and growth factors, and of barrier membranes. Reports have emerged that demonstrate which populations of adult stem cells reside in the periodontal ligaments of humans and other animals. This opens the way for new cell-based therapies for periodontal regeneration. This review provides an overview of adult human stem cells and their potential use in periodontal regeneration.
    Balkan Journal of Medical Genetics 06/2013; 16(1):7-12. · 0.08 Impact Factor
  • A Pejcic, D Kojovic, D Mirkovic
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    ABSTRACT: Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. In the oral cavity, the most common sites for piercings are the tongue and lower lip. Pain, swelling and infection are the most serious consequences associated with this procedure. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. Other adverse outcomes include mucosal or gingival trauma, increased salivary flow, and interference with speech, mastication and swallowing. This article presents case reports on lip and tongue piercings and literature review highlights of this procedure. Special attention is given to complications and dental implications associated with such a practice.
    The West Indian medical journal 11/2012; 61(8):838-43. · 0.32 Impact Factor
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    ABSTRACT: Odeljenje za parodontologiju i oralnu medicinu, Medicinski fakultet, Univerzitet u Nišu, Niš, Srbija Apstrakt Uvod/Cilj. Parodontopatija je lokalni inflamatorni proces koji obuhvata destrukciju parodontalnog tkiva prouzroko-vanu bakterijskim insultom. Paradontopatija se karakteriše i sistemskim inflamacijskim odgovorom domaćina, koji deli-mično može dovesti do povećanog rizika od sistemskih oboljenja, uključujući i poremećeni metabolizam lipida. S druge strane, mnogi ljudi u svetu imaju hiperlipidemiju, koja je poznata kao faktor rizika od ateroskleroze. Cilj ovog rada bio je da se utvrdi veza između parodontalnog oboljenja i nivoa lipida u krvi. Metode. U istraživanje je bilo uključeno 50 pacijenata sa parodontopatijom koji nisu imali akutni ko-ronarni ispad u istoriji bolesti. Zdravu, grupu bez parodon-topatije (grupa za upoređivanje) činilo je 25 ispitanika. Svi ispitanici su parodontološki pregledani i napravljena im je istoriija bolesti. Mereni su indeks dentalnog plaka, dubina parodontalnog džepa, gingivalni indeks, indeks krvarenja i nivo epitelnog pripoja. Uzorci krvi uzimani su radi određi-vanja nivoa ukupnog holesterola, triglicerida, "dobrog" i "lošeg" holesterola. Rezultati. Utvrđeno je da su kod osoba sa paradontopatijom srednji nivoi holesterola (6,09 ± 1,61 mmol/L), triglicerida (2,19 ± 1,67 mmol/L) i LDL holeste-rola (4,09 ± 1,40 mmol/L) znatno viši, a nivo HDL holeste-rola (1,43 ± 0,51 mmol/L) niži u odnosu na osobe bez pa-rodontopatije (4,86 ± 1,37; 1,14 ± 0,71; 3,18 ± 0,64; 1,53 ± 0,32 mmol/L, respektivno). Ova studija je pokazala da po-stoji značajna veza između parodontalnog oboljenja i nivoa lipida u krvi kod ispitivane populacije. Zaključak. Nalazi ove studije pokazuju razliku u koncentraciji ukupnog hole-sterola, triglicerida, HDL i LDL holesterola u krvnom se-rumu između osoba sa zdravim parodontom i onih sa paro-dontopatijom. Rezultati ukazuju na to da parodontopatija može biti faktor rizika i da može doprineti patogenezi atero-skleroze i kardiovaskularnih oboljenja. Međutim, potrebne su dalje studije za potvrdu pretpostavke da parodontalno oboljenje može biti faktor rizika od pojave kardiovaskular-nih oboljenja. Ključne reči: periodontalne bolesti; rizik, procena; hiperlipidemija; faktori rizika; trigliceridi; lipoproteini, hdl holesterol; lipoproteini, ldl holesterol; periodontalni indeks. Abstract Background/Aim. Periodontitis is a local inflammatory process mediating destruction of periodontal tissues trig-gered by bacterial insult. However, this disease is also char-acterized by systemic inflammatory host responses that may contrbute, in part, to the recently reported increased risk for systemic diseases, including an altered lipid metabolism. On the other hand, many people in the world are affected by hyperlipidemia, which is a known risk faktor for atheroscle-rosis. The aim of this study was to determine the relation-ship between periodontal disease and blood lipid levels. Methods. A total of 50 patients with periodontitis included in this study had no documented history of recent acute coronary events. The healthy, non-periodontal subjects (comparison group) comprised 25 subjects. All the patients were periodontology examined and completed a medical history. Dental plaque index, probing depth, gingival index bleeding on probing and clinical attechment levels were re-corded. Blood samples were taken on admission for meas-urements of serum total cholesterol, triglycerides, hight den-sity lipoprotein cholesterol (HDL-cholesterol), and low den-sity lipoprotein cholesterol (LDL-cholesterol). Results. The obtained results showed that mean levels of cholesterol (6.09 ± 1.61 mmol/L), triglycerdes (2.19+1.67mmol/l) and LDL cholesterol (4.09 ± 1.40 mmol/L) in individuals with periodontitis were higer, and levels od HDL (1.43 ± 0.51 mmol/L) was lower than those of individuals without peri-odontitis (4.86 ± 1.37; 1.14 ± 0.71; 3.18 ± 0.64; 1.53 ± 0.32 mmol/L, respectively). Conclusion. This study confirms a significant relationship between periodontal disease, re-gardless its intensity, and blood lipid levels in the studied population. The results imply that periodontitis may be a risk factor and may contribute to the pathogenesis of ath-erosclerosis and cardiovascular diseases (CVD). However, future prospective randomized studies have to determine whether periodontal disease is a risk factor for the oc-curence of CVD.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 09/2012; 69(1):1-10. · 0.21 Impact Factor
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    ABSTRACT: Periodontitis is a local inflammatory process mediating destruction of periodontal tissues triggered by bacterial insult. However, this disease is also characterized by systemic inflammatory host responses that may contrbute, in part, to the recently reported increased risk for systemic diseases, including an altered lipid metabolism. On the other hand, many people in the world are affected by hyperlipidemia, which is a known risk faktor for atherosclerosis. The aim of this study was to determine the relationship between periodontal disease and blood lipid levels. A total of 50 patients with periodontitis included in this study had no documented history of recent acute coronary events. The healthy, non-periodontal subjects (comparison group) comprised 25 subjects. All the patients were periodontology examined and completed a medical history. Dental plaque index, probing depth, gingival index bleeding on probing and clinical attechment levels were recorded. Blood samples were taken on admission for measurements of serum total cholesterol, triglycerides, hight density lipoprotein cholesterol (HDL-cholesterol), and low density lipoprotein cholesterol (LDL-cholesterol). The obtained results showed that mean levels of cholesterol (6.09 +/- 1.61 mmol/L), triglycerdes (2.19 +/- 1.67 mmol/l) and LDL cholesterol (4.09 +/- 1.40 mmol/L) in individuals with periodontitis were higer, and levels od HDL (1.43 +/- 0.51 mmol/L) was lower than those of individuals without periodontitis (4.86 +/- 1.37; 1.14 +/- 0.71; 3.18 +/- 0.64; 1.53 +/- 0.32 mmol/L, respectively). This study confirms a significant relationship between periodontal disease, regardless its intensity, and blood lipid levels in the studied population. The results imply that periodontitis may be a risk factor and may contribute to the pathogenesis of atherosclerosis and cardiovascular diseases (CVD). However, future prospective randomized studies have to determine whether periodontal disease is a risk factor for the occurence of CVD.
    Vojnosanitetski pregled. Military-medical and pharmaceutical review 09/2012; 69(9):771-7. · 0.21 Impact Factor
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    ABSTRACT: Recent epidemiological studies have shown that individuals with periodontitis have a significantly increased risk of developing coronary heart disease. In addition to conventional risk factors, dyslipidemia may be associated with this increased risk. We measured concentration of lipids in patients with moderate to severe periodontitis before and 3, 6 and 12 months after local periodontal treatment. A total of 50 participants with periodontitis and 25 participants without periodontitis were included in the analyses. Lipoproteins were measured by using serological analyses of the Central Biochemical Laboratory in Clinical Center in Nis. Periodontal health indicators included the plaque index, gingival bleeding index, and periodontal disease status (defined by pocket depth and attachment loss). Patients were non-surgically treated with mechanical debridement of calculus once a week for 1 month. The results show a significant relation between indicators of poor periodontal status and serum level lipoproteins. Periodontal therapy resulted in a significant reduction of local inflammation and tissue destruction as reflected in reduced pocket depth and reduced bleeding indices. The levels of lipoproteins after therapy seemed to be lower than those reported before treatment in patients with periodontitis compared with healthy ones. Lipoproteins were significantly decreased after treatment (P < 0.005) except high-density lipoprotein cholesterol which was not significantly reduced (P > 0.05). This pilot study shows that periodontal disease significantly affects the serum levels of lipoproteins and suggests that following successful periodontal treatment decreases serum lipid concentration. This study suggests also that lipoproteins are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.
    Southern medical journal 08/2011; 104(8):547-52. · 0.92 Impact Factor
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    ABSTRACT: Periodontal disease is considered to be an inflammatory disorder that is related to the accumulation of oral microbial biofilm and the host response to this accumulation. The host reaction to gingival microorganisms is characterized in part by increase in the polymorphonuclear leukocyte counts, which is one of the most important steps in host defense. Exaggerated leukocytes and neutrophils of host response are a very important component in the pathogenesis of periodontal disease. The purpose of this study was to investigate the relationship between white blood cell count and periodontal disease in subjects with moderate and severe periodontitis and in control subjects with healthy periodontal tissues. Leukocytes for the present study were obtained from peripheral venous blood of 50 patients with moderate periodontitis, 50 patients with severe periodontitis and 25 healthy subjects. The clinical parameters of periodontitis including plaque index, bleeding on probing and gingival index were determined in all study subjects. In both moderate and severe periodontitis, the results indicated a significantly higher count ofneutrophils (P < 0.001), as well as of both lymphocytes and total leukocytes (P < 0.05). The values of clinical parameters (plaque index, gingival index and bleeding on probing) also showed significant between-group differences (P < 0.005 and P < 0.001, respectively). It is possible that there is a significant relationship between total leukocyte count, neutrophil count and different forms of periodontal disease.
    Acta clinica Croatica 06/2011; 50(2):159-67. · 0.28 Impact Factor
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    ABSTRACT: Objective: The host reaction to gingival microorganisms in periodontitis is characterized in part by increasing of polymorphonuclear leukocytes counts, which is one of the most important steps in host defense The purpose of this study was to investigate the relationship between the white blood cell count and periodontal disease among the subjects with moderate and severe periodontitis and in the control subjects with healthy periodontal tissues. Methods: The leukocytes for the present investigation were obtained from peripheral venous blood of 15 patients with moderate periodontitis and of 15 patients with severe periodontitis and 15 healthy subjects. The clinical parameters of periodontitis - plaque index, bleeding on probing and gingival index were determined among all subjects in this study. Results: In both moderate and severe periodontitis, the results indicated that the neutrophils had a significantly higher count p<0.001) among the groups. The results also indicated that there was no significance in the lymphocytes counts and total leukocytes counts (p0.05) among the groups. The values of clinical parameters (plaque index, gingival index, bleeding of brobing) indicated a significant difference (p<0.005, p<0.001) among the groups. Conclusion: It is possible that there was a significant relationship between the total leukocytes count, neutrophil count and the different forms of periodontitis
    Acta clinica Croatica 02/2011; 50(2):159-167. · 0.28 Impact Factor
  • Ana Pejcic, Dimitrije Mirkovic
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    ABSTRACT: Background: Periodontitis is an inflammatory disease of the supportive tissue of teeth caused by specific microorganisms. Periodontitis is a typical example of a chronic inflammatory reaction which cannot develop without an associated inflammation, since it is always attended by gingivitis with marked inflammation. The aim of the paper is to show the anti-inflammatory effects on gingiva by combined therapy (conservative therapy complemented with laser therapy). Material and methods: A total of 34 patients were examined who had been diagnosed with chronic periodontitis. In the experimental group 17 patients were treated using conservative methods (scaling and root planing) followed by a low level laser therapy (LLLT) with a Scorpion-SM-405-7A system (OPTIKA-LASER; Sofia, Bulgaria), and the patients of the control group (n = 17) were treated only with scaling and root planing (SRP). Clinical measurements included probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL), as well as supragingival plaque measurements (PL) and gingival crevicular fluid (GCF) measurements in pockets and were undertaken before therapy (baseline), and three and six months, respectively after the therapy had been completed. Results: All the subjects in each group completed all phases of the study. Six months after the therapy, the average PPD, CAL and CGF reduction in the experimental group with LLLT was significantly greater (p < 0.05) than for the patients receiving only conservative therapy. The reduction in CAL and GCF at the treated sites was greater than at the SRP sites, although the difference was statistically significant for the six month visit only (p < 0.05). In the group using only conservative therapy, histological findings of gingivae showed a reduction in the number of inflammatory cells and partial stroma collagenization, while histological findings in gingivae after the laser therapy indicated completely regenerated gingival tissue with few inflammatory cells as well as marked collagen tissue homogenization. Conclusion: Based on the results obtained, it can be concluded that the use ofLLLTas an adjunct procedure in the conservative treatment of periodontitis is very successful in reducing gingival tissue inflammation.
    Medical Laser Application 01/2011; 26(1):27-34.
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    Ana Pejcic, Dragan Grujicic, Dimitrije Mirkovic
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    ABSTRACT: Determining the causative factors of periodontal abscess continues to tax the diagnostic skills of clinicians. This case report describes a complication of periodontal disease affecting the vestibular site of the mandibular first molar presenting with features of a periodontal abscess. Treatment options are varied, the most predictable surgical treatment. In this case, the surgical therapy of periodontal abscess was done.
    Advances in Medical and Dental science. 03/2009; 3(2):56-59.
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    ABSTRACT: Background Smoking patients show a reduction of inflammatory clinical signs that might be associated with local vasoconstriction and an increased gingival epithelial thickness. The purpose of this work was to evaluate the S-thickness of the marginal gingival oral epithelium in smokers and non-smokers. Methods Twelve biopsies were obtained from three different groups. Group I: non-smokers with gingivitis, group II smokers, and group III health persons without any periodontal disease. These biopsies were histologically processed, serially sectioned at 5 µm, and underwent evaluation of the major epithelial thickness, the epithelial base thickness, and the external and internal epithelial perimeters. Differences between the groups were analyzed using ANOVA test. The criteria for statistical significance were at the probablity level p < 0.05. Results A greater epithelial thickness was observed in smokers. Conclusion The increased epithelium thickness can contribute to the reduction of inflammatory clinical signs in the gingival tissue.
    Central European Journal of Medicine 7(6). · 0.26 Impact Factor