- SourceAvailable from: Kiro Ivanovski[Show abstract] [Hide abstract] ABSTRACT: To determine the correlation between the concentration of the collagenase MMP-1 in the inflammatory gingival bounding tissue in patients with a chronic form of periodontal disease with the clinical parameters. 32 patients with a chronic form of periodontal disease were followed, according to the criteria set by AAP 1999. The index of dental plaque Silness-Loe was clinically followed, the index of gingival inflammation Loe-Silness, the index of clinical attachment loss and the Miller-Pelzer index of bone resorption. For setting the concentrations of MMP-1, the quantitative enzyme method was used, with the commercial set Colorimetic SensoLyte MMP-1 ELISA Kit. We found the presence of a positive correlation between IDP and the examined MMP-1 (r =0.55). Importantly, a positive correlation was present between IGI and MMP-1 (r =0.77). The loss of attachment and resorption of the alveolar bone were strongly correlated with the concentrations of MMP-1 (r=0.83 and r=0.76). The microorganisms from the biofilm initiate the production of the collagenase MMPs-1 and their concentrations rise with the development of the inflammatory processes, leading to the loss of attachment and resorption of the alveolar bone.
- [Show abstract] [Hide abstract] ABSTRACT: The insufficient data for the associations between hypochromic anemia as an etiological factor and pathogenetic events responsible for the clinical manifestation of burning mouth syndrome was the greatest motivation for us to show the biochemical events found in the oral mucosa due to iron deficiency, through cytological analysis of the tongue epithelium (keratinisation, parakeratosis, degenerated epithelial cells, acanthosis and mitotic activity). Cytomorphological analysis was done in 30 patients with burning mouth syndrome and hypochromic anemia in the experimental group. For comparation of the results, the same analysis was done in 30 patients of the control group, as well, with burning mouth syndrome, but without hypochromic anemia. The prepared slides were cytomorphologicly analyzed with light (optical) microscope under immersion. Among the patients with hypochromic anemia and burning mouth syndrome, some cylotogical changes in the tongue epithelium were found. Besides impaired keratinisation and presence of degenerated epithelial cells, some reduction in the tongue epithelium thickness, acanthosis and mitotic activity were found, as well. Our point is that these findings are due to reduced oxygenation of the oral mucosa, as a result of impaired biochemical and metabolic processes in the body that appear in hypochromic anemia. On the basis of the results from the cytological analysis, it can be concluded that the iron deficiency-induced hypoxia, which is a reason for number of systemic changes (biochemical, metabolic etc.) is the main reason for subjective and objective changes in the oral cavity in patients with burning mouth syndrome and hypochromic anemia to appear, as well.
- [Show abstract] [Hide abstract] ABSTRACT: To determine the quantitative and qualitative characteristics of the saliva of patients treated with antihypertensive medications. 60 subjects, aged 30-70 were included whereby an experimental group involved 30 patients at antihypertensive drugs. In control group (30) subjects didn't receive any medications. Unstimulated saliva was collected of all participants according Navazesh recommendations. A biochemical analyzer INTEGRA 400-Roche was used to determine total salivary proteins, urea, albumin, calcium, sodium and potassium levels in saliva. Computer programs Statistica 7.1 and SPSS 17 were used. The amount of unstimulated saliva was significantly decreased in experimental group. Increased saliva amounts of K + , Na + and urea were noted in this group. The total proteins were insignificantly increased, while the amounts of Ca 2+ and albumin did not differ significantly between the two groups. Antihypertensive medications significantly influence the salivary composition which can cause disruption of the oral homeostasis.
Conference Paper: EFFECTIVENESS OF ANTIMICROBIAL SOLUTIONS IN MAINTAINING TOOTHBRUSHES[Show abstract] [Hide abstract] ABSTRACT: Introduction: Toothbrushes are characterized as an environment for microbial transport, retention and growth, and highly contaminated toothbrushes can be reason of local and systemic diseases.
- [Show abstract] [Hide abstract] ABSTRACT: (Full text is available at http://www.manu.edu.mk/prilozi). Examination of the composition of saliva in patients with diabetes may be useful for understanding why oral manifestations occur and how they should be treated. The purpose of this study was to determine the degree of severity of xerostomia, salivary concentrations of glucose and urea in patients with insulin-dependent diabetes, and to determine the correlation between xerostomia and salivary glucose levels. For the realization of this goal, the study included 60 patients of both sexes aged 30-70 years. The sample was divided into two groups. The first, experimental, group consisted of 30 patients who had insulin-dependent diabetes mellitus. The control group consisted of 30 subjects who were not suffering from diabetes. To determine the degree of severity of xerostomia among all respondents a questionnaire recommended by Carda was used. From all patients in both the control and experimental group, total saliva was collected for 10 minutes for biochemical analysis in accordance with the recommendations of Navazesh. Salivary glucose was determined by using the enzymatic method with a hexokinase (mmol/l), and salivary urea by using the kinetic method with urease and glutamate dehydrogenase (mmol/l). Varying degrees of xerostomia were noticed in 80% of the experimental group and only 10% of the control group. In diabetics, we found significantly higher levels of urea (2.36 mmol/l) and glucose (0.022 mmol/l) in the saliva compared with the values of these parameters (1.48 mmol/l, 0017 mmol/l) in the control group. Based on these results, we concluded that diabetes is a disease that causes xerostomia and there is a significant correlation between the degree of xerostomia and the salivary level of glucose. Key words: diabetes, saliva, urea, glucose.
- [Show abstract] [Hide abstract] ABSTRACT: Objective: To determine the dynamics of correlation between PGE2 and COX-2 presence in gingival tissue of patients with periodontitis, before and after therapy. Material and Methods: 80 gingival papilla biopsy samples were obtained from 80 subjects. Twenty subjects did not present clinical signs of periodontal disease (negative control). From 20 patients diagnosed with chronic advanced periodontitis after collection of clinical parameters (GI, BI and PI) were taken papilla biopsies. This experimental group received SRP on a single quadrant/day for 4 consecutive days. On day 5 all quadrants were rescaled. Papilla biopsies were obtained from subjects at the end of treatment protocols. Samples were stored at-80°C and evaluated by RT-PCR for levels of COX-2 gene expression, and by EIA for PGE2 presence. Results: In the control group, there is weak positive correlation between COX-2 and PGE2 which probably confirms that COX-2 plays a crucial role in the production of prostaglandins in the periodontal le-sions. In the group before the therapy is clearly a strong positive correlation between PGE2 and COX-2, which reflects the inflammatory events in the gingival tissue, and the dominant use of COX-2 pathway in prostaglandin synthesis locally in vivo. After treatment persists negligible positive correlation between the COX-2 gene expression and PGE2, which represents a confirmation of the instability in the periodontal tissue complex, and still present an inflammatory reaction in the immediate post therapy period. Conclusion: Immunoregulatory mechanisms, as well as increased production of inflammatory mediators are implicated in mechanisms of tissue destruction associated with periodontal disease. Clarification of tissue dynamics of inflammatory parameters (PGE2, COX-2) can be a diagnostic marker of periodontal disease, but also a marker of therapeutic success
Article: Periodontal disease and root caries[Show abstract] [Hide abstract] ABSTRACT: Introduction. Root caries is a problem of great importance among the adult population. Aim. The purpose of our research was to review the prevalence of the root caries in patients with periodontal disease and to develop preventive methods for managing this problem in adults. Methods. The information was collected at the Department of Periodontology and Oral Medicine from patients with periodontal disease at the age of 35 and above. The data on root carries were collected from 150 subjects who have retained their teeth. All retained teeth were examined for caries presence and evaluated as healthy teeth with caries or restoration, irrespective of the presence of recession on root surfaces. The analysis was made according to the case and root surface, with special analysis of the root surfaces with caries and root surfaces with caries and restoration. Results. We statistically defined the rate of prevalence of root surfaces with caries and root surfaces with caries and restoration. The rate of prevalence of root surfaces with caries was 38%; the rate of prevalence of root surfaces with caries or restoration was 52,6%; the middle amount of surfaces with caries was 1.6 per patient; the mean value obtained the presence of root caries 1,6% per patients, while the mean value obtained for root caries and restoration amounted to 1,8% middle amount of surfaces with caries or restoration was 1,8 per patient. The percentage of root surfaces with caries associated with recession was 68,5%. The percentage of root surfaces with caries associated with inflammation was 31,5%. Conclusion. The results point to the seriousness of the problem in the mature population and the need of preventive and treatment methods for both conditions, periodontal disease and root caries.
- [Show abstract] [Hide abstract] ABSTRACT: This study sought to evaluate the effect of low-level laser treatment combined with scaling and root planing (SRP) on gingival tissue levels of TNF-alpha in subjects with periodontal disease. Eighty gingival papilla biopsy samples were obtained from 60 patients diagnosed with chronic advanced periodontitis; randomly assigned to three treatment groups (n = 20), as well as 20 subjects with no periodontal disease (group A). Group B received SRP on a single quadrant/day for four consecutive days. On day 5, all quadrants were rescaled. Groups C and D received the same treatment as group B plus laser application with the low-level diode laser (630-670 nm, 1.875 J/cm(2)) for five and ten consecutive days, respectively. Papilla biopsies were obtained from subjects and evaluated by ELISA for levels of TNF-alpha. The values in the control group were 5.2 ± 3.21 pg/mg and baseline values for the examined groups were 46.01 ± 16.69. Significantly decreased level of TNF-alpha for groups C and D was found after treatment, while group B demonstrated reduction of TNF-alpha of 31.34%. The results of this study show suppression of TNF-alpha in gingival tissue after low-level laser treatment as adjunct to SRP. Data may suggest beneficial anti-inflammatory effects of the laser treatment when used as adjunctive periodontal treatment.
- [Show abstract] [Hide abstract] ABSTRACT: This study assessed the effects of low-level laser treatment in combination with scaling and root planing (SRP) in patients with periodontitis. Sixty subjects with chronic advanced periodontitis were assigned randomly to three treatment groups (n = 20) after collecting gingival clinical parameters. Group A received SRP on a single quadrant per day for four consecutive days; on the fifth day, all quadrants were rescaled. Group B received the same treatment as Group A, followed by laser application for five days. Group C received the same treatment as Group B but the laser treatment was administered for a total of 10 days. For Groups B and C, a low-level diode laser (630 to 670 nm) was used. The plaque index, gingival index, and sulcular bleeding index were recorded for all groups. For all clinical parameters, all three groups reported statistically significant differences (p < 0.005) compared to baseline data. Compared to Group A, Groups B and C showed statistically significant improvement for all clinical parameters. These findings suggest that a low-level diode laser can have a beneficial effect for treating inflammatory chronic advanced periodontitis.
- [Show abstract] [Hide abstract] ABSTRACT: The aim of this study is to compare the effectiveness of low-level laser irradiation to traditional topical fluoride treatment for treatment choices of dentinal hypersensitivity following scaling and root planing. The experimental group (15 patients) was treated with low-energy-level diode laser at each site of dentinal hypersensitivity following scaling and root planning. The control group (15 patients) received topical fluoride treatment (protective varnish for desensitization). All the patients were treated at baseline visit, and then at day 2 and 4 after the initial treatment; the pain was subjectively assessed by the patients as strong, medium, medium low, low, or no pain. Total absence of the dental hypersensitivity was reported in 26.66% of the examined group even after the second visit, compared to the control group where complete resolution of the hypersensitivity was not present after the second visit in any of the treated cases. Complete absence of pain was achieved in 86.6% of patients treated with laser and only in 26.6% in the fluoride treated group, after the third visit. Based on our findings, we conclude that low-energy biostimulative laser treatment can be successfully used for treatment of dental hypersensitivity following scaling and root planing.
- [Show abstract] [Hide abstract] ABSTRACT: Laser therapy is a standard therapeutic procedure, with unambiguous indications and contraindications. Among the reasons for this are: positive clinical experiences, scientifically verified objective changes in tissue equilibrium caused by laser, and above all, better understanding of the mechanisms of laser effects. Clinical and experimental experience shows that laser therapy has its greatest effects on cells/tissue/organs affected by a generally deteriorated condition with the ph value lower than normal. Biostimulation has been demonstrated with doses of laser emission from as low as 0,001 J/cm to 10 J/cm , with cytostatic effect above 240 J/cm . There were no macroscopic and microscopic damages to the tissue when recommended doses were used, which confirmed the safety of laser therapy. There are many indications for the laser use in oral pathology and periodontology, such as cheilitis exfoliativa sicca, gingivitis, gingivitis desquamativa, and periodontitis. Taking into consideration the effects of the laser treatment, such as activation of microcirculation, production of new capillaries and thickening of the capillary net, anti-inflammatory, analgesic effect, stimulated growth and regeneration of cells, and accelerated bone consolidation, following the need for incorporating non-invasive methods for minimizing the pain and discomfort either during or after dental treatment, we consider that the use of biostimulation laser therapy is an excellent treatment option.
- [Show abstract] [Hide abstract] ABSTRACT: Focal infection can be defined as infections occurring in different locations of the human body and which are caused by microorganisms (or their products) inhabiting the oral cavity. The oral cavity is the site of many infectious and inflammatory disease , which has recently been associated with systemic diseases. Dental procedures (tooth extraction, endodontic treatment, root polishing etc), including periodontal therapy, can provoke the entrance of oral microorganisms of dental plaque into the blood flow and lymphatic system. This bacteriemia is short-term but in the conditions of weakened defense mechanisms, the risk of these bacteria is increased. In these cases, bacterial attacks on tissues and organs, after a while, lead to their multiplications and the origin of oral focal infections. Some diseases, such as infective endocarditis, infections of head and neck, respiratory infections, diseases of gastrointestinal tract, skin diseases, bone diseases and premature birth, occur as the consequence of the transmission of microbes fromdental foci. Many recent researches also list a periodontal disease as a risk factor. Chronic periodontitis is probably the most prevalent and potentially has the strongest epidemiological and plausible mechanistic associations with these systemic diseases.
- [Show abstract] [Hide abstract] ABSTRACT: Oral lichen planus (OLP) is an oral lesion with an enigmatic etiology. To explore the possibility of psycho-somatization, we evaluated the psychological personality profiles of OLP patients. Twenty patients with reticular; 20 with erosive form of OLP, and 25 controls were tested with the psychological Minnesota Multiphasic Personality Inventory (MMPI)-202 test. Eight clinical scales (hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania) as well as cortisol level, CD3, CD4, CD8, and CD16 markers by group were compared. Psychosomatization was evaluated by the use of internalization ratio (IR) Index. A characteristic MMPI profile was noted in the OLP groups with high IR index value. Significant differences among the groups were detected for cortisol, CD4, CD8, and CD16 counts. Mean values for hypochondriasis, depression, and hysteria were all significantly different with significantly higher mean scores for both reticular and erosive OLP subjects compared with controls. Prolonged emotive stress in many OLP patients may lead to psychosomatization and may contribute to the initiation and clinical expression of this oral disorder. Clinical significance: If additional research involving a larger and more diverse sample of patients confirms these findings, clinical trials will be needed to determine whether adjunctive psychological intervention provides a benefit in treating patients with OLP.