Electromyographic Evaluation of the Influence of Denture Adhesive on Retention and Stability of Complete Dentures

Improving retention and stability of complete dentures is of considerable interest in prosthetic dentistry. Approaches to this problem over the years have included overdentures, implants and denture adhesives. Although denture adhesives are widely used, there are few quantitative data on the effects of an adhesive on denture retention and stability during normal functional activities. The purpose of this investigation was to study the influence of denture adhesive on the surface EMG activity of the masticatory muscles in a sample of complete denture wearers. In this study 6 denture wearers were investigated. Surface EMG recordings were obtained from left and right anterior temporal and masseter muscle and from the sub-mandibular group in the region of the anterior belly of the digastric muscle on the left and right side. Data were recorded during standardized jaw positions that included clenching in the position of maximal intercuspation of teeth (at 100%, 50% and 25% of the maximum activity), lateral eccentric positions, maximal lateral eccentric positions, protrusion, maximal protrusion and wide opening. The results demonstrated higher digastric muscle activity in protrusion with the teeth at an edge-toedge position after the use of adhesive (p0.05). This investigation demonstrated that patients were able to produce greater levels of muscle activity in protrusive and laterotrusive positions with the use of adhesive

The Prevalence of Candida Albicans in Institutionalized Geriatric Denture Wearers

The aim of this prospective study was to record the presence of Candida albicans yeast in a geriatric population, and to compare the results between denture wearers and non-wearers, in order to evaluate the role of dentures as a factor influencing Candida growth. We performed an oral examination on 217 institutionalized elderly people living in the hospice "Sv. Josip" in Zagreb, recorded data regarding oral health and collected detailed information on denture wearing status. Furthermore, we performed oral smears for Candida cultures, cultivated on Sabouraud\u27s dextrose agar (“Emmon\u27s”) at 37°C for 48 hrs and counted the Candida colonies. Collected data were stored in the database created for this purpose in "Microsoft Access 2000". The number of Candida colonies from denture wearers and non-wearers were compared (Man-Whitney U test, p<0.05), and the obtained results are discussed

Periotron as a Modern Sialometric Method in Xerostomia Diagnosis and Treatment Monitoring

Periotron (Oraflow, Plainview, SAD), mjerač mikrokoličine vlažnosti, elektronički je instrument napravljen za mjerenje gingivne tekućine, eksudata parodontnoga džepa, lučenja sline i debljine filma sline. U mjerenju se rabe različiti papirni mediji za sakupljanje uzorka. Ti se mediji (Periopaper strips, PeroCol strips, Sialopaper strips) stave na željeno mjesto u ustima i ostave tijekom određenog vremena, nakon čega se odloži između elektroda Periotrona. Poseban oblog elektroda omogućuje im da djeluju kao 2 ploče kondenzatora, čime mjeri submikrolitarske količine oralnih fluida i prikazuje numerički podatak na zaslonu od tekućega kristala. Unošenjem podataka dobivenih prethodnom kalibracijom instrumenta u program Periotron Professional software for Windows izradimo baždarnu krivulju iz koje interpolacijom izračunamo realni volumen tekućine.Napravili smo jednostruko slijepu placebo-kontroliranu studiju u svrhu procjene mogućega postojanja dugoročnog učinka polikarpin-hidroklorida (PHK) na lučenje sline u bolesnika s kserostomijom. Dvanaest bolesnika s kserostomijom uključeno je u ispitivanje. Držali smo se strogih uključnih kriterija u svezi s mogućim nuspojavama i kontraindikacijama. Šest bolesnika je podučeno da uzimaju peroralno 5 mg PHK (po 5 kapi otopine, Pilokarpin 2% Pliva, Zagreb, Hrvatska) 3 puta na dan tijekom 7 dana. Drugih 6 bolesnika (placebo skupina) uzimalo je po 5 kapi dekspantenol (D-panthenol, Ljekarne Zagreb, Hrvatska) 3 puta na dan tijekom 7 dana. Lučenje malih slinovnica mjereno je na donjoj usni i na nepcu s pomoću Periotrona, a ukupna slina je sakupljana u baždarene epruvete. Mjerenja su se ponavljala svaki tjedan. Svaki je ispitanik ipunio Oral Health Impact profile (OHIP) upitnik prije i nakon 7 tjedana uzimanja ordiniranog sredstva u svrhu procjene utjecaja oralnog zdravlja na život bolesnika. Nakon 7 tjedana bolesnicima iz placebo skupine ordiniran ja PHK, ali nije bilo vidljive potrebe za ordiniranjem placeba onima koji su prije uzimali PHK budući da u toj skupini nije bilo poboljšanja salivacije. U bolesnika placebo skupine niti nakon uzimanja PHK nije bilo poboljšanja salivacije. Nalazi OHIP-a nisu pokazali statistički znatnu razliku nakon 7 tjedana liječenja. Jedan bolesnik iz placebo skupine (dok je još uzimao placebo), kao i 1 ispitanik iz PHK skupine, odustali su iz ispitivanja zbog navodnih nuspojava. Peroralna upotreba PHK ne uzrokuje dugoročno poboljšanje salivacije nego vjerojatno samo trenutačno i kratkotrajno poboljšanje. Sudeći prema rezultatima Periotrona i nalazu ukupne sline, naši podatci dokazuju kako PHK ne može dugotrajnom upotrebom “izliječiti” kserostomiju, to jest da nema produljenog ili kumulativnog učinka u stimulaciji salivacije.The Periotron micro-moisture meter (Oraflow, Plainview, USA) is an electronic instrument that has been designed for gingival vrevicular fluid (GCF), periodontal pocket fluid (PPF), salivary flow and saliva thickness measurments, by using a variety of paper collection strips. Collection strips (Periopaper strips, PerioCol strips, Sialopaper strips) are applied to the oral tissues of interest for a certain period of time, after which the are inserted between Periotron electrodes. The special insulation coating on the electrodes enables them to work as two plates of a capacitor, being able to measure submicroliter quantities of oral fluids. Periotron displays the numerical output on LCD. By inputting data obtained during prior calibration process into Periotron professional software for Windows, we design a standard curve, from which we interpolate actual fluid volume. We have designed a single blind placebo controlled study to evaluate possible presence of long-term effect of pilocarpine-hydrocloride (PHC) on salivary flow rate in patients with xerostomia. 12 patients suffering from xerostomia underwent this trial. We used strict inclusion criteria regarding the possible side effects. Six patients were instructed to self-administer 5 mh of PHC (5 drops of solution, Pilokarpin 2%, pliva Zagreb, Croatia), three times a day, for 7 days. Another 6 patients (placebo group) were instructed to take 5 dexapanthenol drops (D panthenol, Ljekarne Zagreb, Zagreb, croatia), 3 times a day for 7 weeks. The flow rate of minor salivary glands was measured on the lower lip and palate by means of Periotron and whole saliva was collected in calibrated test tubes. mesurements were repeated once a week. Each patient filled in an extensive Oral Health Impact Profile questionnaire (OHIP) at te baseline and after completion of PHC treatment to monitor oral health influence on patients lives. After 7 weeks of treatment the placebo group was swiched to PHC, but there no apparent need for switching pilocarpine group to placebo, because we found no improvement in salivary flow rate after 7 weeks of treatment. in the group previously taking placebo, there was also no improvement in salivary flow rate after taking PHC. OHIP findings were calculated and showed no statistically significnt improvement after 7 weeks of PHC administration. One patient from the pilocarpine group and one from palcebo group ( while taking placebo) reported side effects and discontinuited the trial. oral administration of PHC does not seem to produce log-term salivary flow rate increase, but rther immediate and shortr lasting improvement. Judging by Periotron and whole saliva scores, our results showed that PHC is not able to “cure” xerostomia after prolonged administration, i.e. there is no residual effect in salivary gland simulation once the drug is discontinued and eliminated

Opiorphin in burning mouth syndrome patients: a case-control study

Objectives Opiorphin is a pentapeptide isolated from human saliva that suppresses pain from chemically induced inflammation and acute physical pain. Burning mouth syndrome (BMS) is a chronic condition of a burning sensation in the mouth, where no underlying dental or medical cause can be identified. We aimed to measure the level of opiorphin in whole unstimulated (UWS) and stimulated (SWS) saliva of patients with BMS. Materials and methods Originally developed and validated LC-MS/MS method was used for opiorphin quantification. Samples were obtained from 29 BMS patients and 29 age- and sex-matched controls. Results The average concentration of opiorphin in UWS and SWS in the BMS group was 8.13 ± 6.45 and 5.82 ± 3.59 ng/ml, respectively. Opiorphin in BMS patients’ UWS was significantly higher, compared to the control group (t = 2.5898; p = 0.0122). SWS opiorphin levels were higher, but not significantly, in BMS patients than in controls. Conclusions Our results indicate that higher quantities of salivary opiorphin in BMS may be a consequence of chronic pain, but we cannot exclude that they occur as a result of emotional and behavioral imbalances possibly associated with BMS. To our knowledge, this is the first original article measuring opiorphin in a pain disorder. Clinical relevance Opiorphin may be a measurable biomarker for chronic pain, which could help in objectifying otherwise exclusively a subjective experience. Increased opiorphin could serve as a universal objective indicator of painful conditions. Since opiorphin may also reflect emotional and socio-relational imbalances occurring with BMS, it could as well represent a biomarker for BMS. Knowledge on opiorphin’s involvement in pain pathways could contribute to developing new clinical diagnostic methods for BMS

Burning mouth syndrome as the initial sign of multiple myeloma

AbstractA 79-year-old women was referred to our Department with burning symptoms in the whole oral cavity together with clinically healthy appearence of the oral mucosa. Hematological tests as well as bone marrow biopsy revealed diagnosis of plasmocytoma. The aim of our case report was to underline the importance of hematological screening in patients with burning mouth syndrome

Non-Aromatic Naphthalane: A Future Remedy For Oral Mucosal Lesions

Svrha je ovoga rada prikazati podatke dobivene iz nekoliko eksperimentata koje su proveli autori u vezi sa sastavom posebne frakcije Hrvatske nafte, nazvane “NeAromatskim - Visoko Steranskim (NAVS) naftalanom, te njezinim izraženim protutupalnim djelovanjem i djelovanjem na kontrolu stanične proliferacije. NAVS je dobiven iz nafte vrlo bogate steranima, koja se desetljećima uspješno upotrebljava u liječenju psorijaze (Naftalan, Ivanić Grad, Hrvatska). Proizvodi se gotovo potpunim uklanjanjem policikličkih aromata (od kojih su neki kancerogeni), čime se dobiva potpuno bezbojno ulje ugodnoga mirisa. Prigodom postupka dearomatizaije sterani su održani i čak koncentrirani, kako je i dokazano plinskom kromatografijom i vezanim sustavom plinske kromatografije i spektrometrije masa. Ti su geogeni sterani molekularnom strukturom srodni bioaktivnim spojevima, npr. kortikosteroidima i vitaminu D. Zbog tih strukturnih sličnosti, moguće je objasniti dobru učinkovitost u liječenju psorijaze NAVS-om, u čemu su rezultati obećavajući. Tijekom liječenja NAVS-om nije bilo nikakvih promjena hematoloških niti biokemijskih nalaza. In vitro studije dokazuju izraženu dozno-ovisnu inhibiciju proliferacije stanica planocelularnoga karcinoma SCC VII, ali ne i inhibiciju nemalignih fibroblasta L929, pokazujući time selektivnost u kontroli staničnoga rasta. In vivo rezultati pokazuju znatno usporavanje rasta malignoga tumora. Uzrok tome, osim u samoj kontroli proliferacije tumorskih stanica, autori također vide i u sprječavanju neoangiogeneze (poput onom vitamina D), koje još treba dokazati imunohitokemijskim studijama. Planiraju se dodatna istraživanja i razvija se animalni model oralnog planocelularnoga karcinoma u svrhu budućeg uvođenja NAVS-a u liječenje različitih bolesti oralne sluznice budući da je NAVS i učinkovit i vrlo upotrebljiv zbog superiornih organoleptičnih svojstava.The purpose of this lecture is to summarize data obtained from several experiments conducted by authors, regarding the composition of special Croatian petrol fraction reffered to as “Non Aromatic- Very rich in Steranes” (NAVS) naphthalane, as well as its potent-inflammatory and cellular growth controlling effect. NAVS is derived from ordinary brown naphthalane, particulaly rich in steranes, that has been famous for decades in the treatment of psoriasis vulgaris (Naftalan, Ivanić Grad, Croatia). NAVS was prepared by removing virtually all of its original polycyclic aromatic content (some of them are carcinogenic), which resulted in completely colourless transparent oil with a pleasant scent. Steranes were preserved and concentrated during the de-aromatisation process, as was proven by means of GC and GC-MS. These geogenic steranes have molecular skeletons analogous to bioactive compounds, such as corticosteroids and vitamin D. Due to these structure similarities, we can explain the beneficial affects in treating psoriatic patients with NAVS, which yielded promising results. NAVS treatment did not affect either haematological or biochemical findings. Further studies established In vitro dose dependant inhibition of planocellular carcinoma (SCC VII) cell proliferation, withhout interfering with nonmalignant fibroblast (L929) cells, thus showing selectivity in cell proliferation control. In vivo results showed marked delay in tumour growth. A rationale for that, besides cell proliferation control, authors see also in the antineoangiogenetic activity of NAVS (similar to vitamin D), wich is yet to bi proved through immunohistochemical studies. Future studies are planned and oral planocellular carsinoma animal models are being developed in order to introduce NAVS in the treatment of different conditions of oral mucosa, because the preparation is not only effective, but also highly applicable in oral tissues, due to its superior organoleptic properties

Consensus Report : 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis

Unrecognized oral manifestations of Langerhans cell histiocytosis which progressed to systemic disease

SummaryA 2.5 years old boy was referred to the Department of oral medicine because of substantial erythema and ulcerations on palatal, buccal and alveolar regions. Unfortunately, it took two subsequent visits to our Department in six-months intervals, and re-evaluation at Pediatric oncology clinic where diagnosis of Langerhans cell histiocytosis (LCH) was finally established. At that stage, disease already progressed to multisystem life-threatening presentation, requiring aggressive treatment. Therefore, this case is a reminder of the possibility of occurrence of this rare disease in the oral cavity which might manifest itself in multiple presentations thus easily leading to the misdiagnosis and therefore it could be easily overlooked by dentists

Salivary interleukin-6 and tumor necrosis factor-α in patients with recurrent aphthous ulceration

Background: Recurrent apthous ulceration (RAU) is a well known oral disease which seems to be mediated principally by the immune system. However, it is still a matter of debate which part of the immune system is implicated in its pathogenesis as a reaction to the still unknown antigen. The aim of this study was to evaluate salivary cytokines, interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Methods: In 26 patients with minor RAU, age range of 23-49 years (mean 27.3 years), during both the acute phase and remission and in 26 healthy controls, age range of 22-64 years (mean 30.1 years), salivary IL-6 and TNF-α levels were determined by use of enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed by use of descriptive statistics. Results: Significant differences in salivary TNF-α between healthy controls and patients with acute RAU and during the remission period were found (P < 0.001) as well as between patients with acute RAU and those during the remission period (P < 0.001). No differences in salivary IL-6 between all three groups could be found. Conclusions: We might conclude that elevated salivary TNF-α levels during acute RAU and especially during the remission period are of importance in RAU, whereas salivary IL-6 levels seem not to play a role in the RAU disease