Recent consideration on diagnosis and therapy of gingival desquamative lesions: Case report

The purpose of the studywas to present a case of desquamative gingivitis and indicate to diagnosis and therapy od desquamative lesions of gingivae. The case of desquamative gingivitis in 75 year old patient is shown. Despite pathohistological and immunofluorescent analyses having been done, the origin of the disease could not have been established at first. The undertaken therapy gave limited results. The patient did not show up for the check up for 2,5 years. When he finally came, the clinical situation was the same as the first examination. The bioptic material gave positive results. Continuous linear deposits of IgG and IgA along the basement membrane were found. The histopathological diagnosis presentes a pemphigoid. Metilprednisolon 40mg per day was prescribed, with gradual dicrease of the dose, along with tetracycline 4x250mg per day. Therapy lasted for six and a half months. Changes on the gingivae completely retreated after three months

Oxidative/anti-oxidative effects of colloidal silver ions and chlorhexidine in saliva and gingival fluid of periodontal patients

Background/Aim. Chronic periodontitis is an inflammatory disease. Oxidative stress is an important factor in periodontitis progress, hence examining the antioxidative properties of antiseptics, such as chlorhexidine (CHX) and silver ions solution (SSI), is a beneficial biomarker in estimating the recovery of tissue impairment during periodontal disease treatment. Methods. This clinical trial was conducted on the control group referred to healthy volunteers and individuals with periodontal disease, divided into two subgroups: before and after applying antiseptic treatments (CHX or SSI). Measurements of oxidative/antioxidative parameters were addressed to determine thiobarbituric acid products (TBARS) concentration and total superoxide dismutase (tSOD) activity in saliva and gingival crevicular fluid (GCF) of periodontal patients. Results. TBARS concentration was increased in saliva before the CHX treatment compared to the periodontal group after the CHX treatment, as well as before both CHX and SSI antiseptic treatment in CGF, compared to controls and periodontal groups after the treatment. Patients before SSI treatment had increased tSOD activity in saliva compared to the control group treated with SSI, as well as compared to patients after the SSI treatment. Additionally, tSOD activity was increased in GCF in patients with periodontitis before antiseptic treatment (CHX, SSI) compared to the control or the group of patients after the appropriate treatment. Conclusion. Our results revealed elevated lipid peroxidation in CGF, which reflected the promotion of oxidative stress during periodontal inflammation. The study suggests that antiseptics with antioxidant properties may reduce tissue damage initiated by periodontal disease. Moreover, the determination of oxidative/antioxidative parameters can be important for diagnosing, monitoring, and prognosis of the clinical state of periodontal patients

Comparison of cefixime and amoxicillin plus metronidazole in the treatment of chronic periodontitis

Introduction/Aim. Despite significant advances in current medicine and improvement of overall health education, chronic periodontitis is still a widespread disease. Losing teeth is the most serious complication of this particular illness. The aim of this study was to examine patients with chronic periodontitis in order to evaluate the efficacy of non-surgical therapy and combination of amoxicillin and metronidazole compared with cefixime, which has not been so far used for the treatment of this disease. Methods. Adult patients with chronic periodontitis (n = 90) underwent non-surgical periodontal treatment (zero-day) and then randomly divided into three groups. The group I served as a control, the group II was additionally treated with the combination of amoxicillin and metronidazole (for 7 days), while the group III was treated with cefixime (also for 7 days). To assess the condition of periodontium before and seven days after the therapy, four clinical parameters were used: gingival index (GI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL). Results. On the day 7 after the beginning of the therapy, we found that all the three groups of patients had statistically significant clinical improvement of three parameters: GI, BOP and PD, but not of the CAL. However, the improvement of PD was only statistically, but not clinically significant. The improvement in the control group of patients on the day 7 was 19% in BOP and 28% in GI; this improvement was statistically highly significant after the addition of amoxicillin plus metronodazole (71% in BOP and 77% in GI) or cefixime (62% in BOP and 82% in GI). Compared to the combination of amoxicillin and metronidazole, cefixim was statistically significantly more effective for GI (p < 0.05), while for the other three clinical parameters their effects were equal. Conclusion. The conjunction of amoxicillin plus metronidazole or cefixime to the causal treatment of patients with chronic periodontitis led to statistically significant improvement in efficacy in relation to GI and BOP parameters, while cefixime was statistically significantly more efficient than the combination of amoxicillin and metronidazole for GI

Dental treatment of oral complications during radiation therapy of head and neck cancer

Radiation therapy is often used as primary or adjuvant therapy for malignancy of the oropharyngeal region. Inflammatory changes of the oral mucosa resulting from the direct effect of radiation therapy, are defined as Radiation Mucositis (RM). As a consequence of irradiation, patients have xerostomia, pain, difficulty in chewing and swallowing, dental caries, oral microbial changes, chronic esophagitis, periodontitis, osteoradionecrosis. To eliminate or decrease discomfort in oral cavity, the use of various mouth rinses is recommended for compromised patients. These solutions should reduce pain, promote reepithelialization of soft tissue lesions, normalize the pH of oral fluids. They should be nontoxic, and to have acceptable taste. In the modern practice of head and neck oncology, dentists are essential members of the team. Their contribution is essential in improvement of the patients' quality of life

Assessment of the periodontal health and community periodontal index in the army of Serbia

Background/Aim. Promotion of oral health in military population is not only a significant component of general health, but also of the military readiness and represents the strategic orientation of each country. The basic task of military dentistry is to provide oral health of military personnel and to enable their operational readiness at the optimal level. The aim of the study was to assess the periodontal condition in Serbian military population using the community periodontal index of treatment needs (CPITN), and the influence of general life habits and local risk factors on periodontal health. Methods. This prospective cross-sectional pilot study was conducted on 101 examinees at the mean age of 38.94 ± 11.63 years who had dental check-ups at the Dental Clinic of the Military Medical Academy in Belgrade. All the categories of military personnel aged 20-64 years were divided into five groups. The frequency distribution of general and local factors on periodontal health, oral hygiene index, and the assessment of the mean number of sextants by CPITN compared to age were examined. Results. The examinees at the age of 51-60 years had the best oral hygiene index (0.95 ± 0.65), whereas the oldest population had the worst (1.63 ± 0.42). Only one person (5.6%) at the age group of 51-60 years had a completely healthy periodontium. Observed in relation to the age groups, the mean values of sextants increased linearly, but in general population, the most frequent CPITN categories were in sextant with the periodontal pockets 4-5 mm (score 3). Conclusions. Compared to the results from other countries shown by the World Health Organization, the periodontal condition in our examinees is below the average. The appropriate preventive program preparation and its implementation are needed, including primarily the appropriate training on oral hygiene, as well as education based on periodontal disease prevention and treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175014

Adjunctive effect of the colloidal silver ions solution in the treatment of chronic periodontal disease: A preliminary clinical study

Background/Aim. Bacteria play the most important role in the development of periodontitis and chlorhexidine (CHX) is a “gold standard” in its treatment. Silver ions are also strong antiseptics, being used in dentistry for a long time. Therefore, the aim of this study was to compare the efficacy of CHX and colloidal silver ions solution (SSI) in the treatment of patients with chronic periodontitis. The additional aim was to ascertain silver ions, tolerability and efficacy comparing to CHX. Methods. Twenty-nine examinees of both sexes (the average age 50.6) participated in this study and were divided into two groups. The patients in the first group (n = 15) suffering from a generalized moderate chronic periodontitis, after scaling and root planning (SRP), were treated by rinsing of periodontal pockets with 0.2% solution of CHX. The patients of the second group (n = 14), in addition to the treatment of periodontal pockets, were treated with a 5 mg/mL colloidal SSI. Results. During the periodontal treatment, the mean values of all clinical parameters (except clinical attachment loss – CAL), in the both groups of patients were statistically significantly lower (p < 0.001) in relation to the initial values. The greater reduction of periodontal bleeching on probing (BOP) depth after one month was found in the SSI treated group (0.97 mm) in relation to the CHX group (0.65 mm). The local application of CHX and SSI led to statistically significant reduction of gingival parameters (gingival index – GI and BOP) in the groups after the treatment (GI for 0.65 and 0.87; BOP for 0.31 and 0.33, respectively). Conclusion. The results of our study showed that colloidal SSI was at least equally effective in the treatment of patients with periodontal disease as the solution of CHX. Additionally, the SSI is simple for use which speaks in favor of its more extensive use in dentistry including chronic periodontal disease

Gingivitis and periodontitis in children and adolescents suffering from type 1 diabetes mellitus

[Projekat Ministarstva nauke Republike Srbije, br. III41008, 175075

Oral health of 20 to 64 years old military insured's measured by DMFT index: A pilot study

Objective: The aim of this study was to determine the oral health status, as well as influence of general and local factors that may affect the level of oral health. Patients and methods: We have done a prospective cross-sectional pilot study (observational type) with 52 examinees (32 men and 20 women), mean age 40.4±12.7 years. We analyzed all categories of military insured's between 20 and 64 years of age. They were divided into three age groups: 20-34, 35-44 and 45-64 years. The study was conducted in the Department of Military Health Care, Pancevo, Serbia. Results: There were 25 examinees (48.1%) between 20 and 34 years of age. Majority of the examinees used simple sugars (90.4%) and fizzy drinks (63.5%) in their diet at least once a week. Majority of the examinees did not use mouthwashes (76.9%), interproximal brushes (86.5%) or dental floss (73.1%). Examinees who did not use dental floss, had significantly higher decayed, missing and filled teeth index (DMFT index) (U=130; p=0.05). About half of the examinees experienced bleeding from gums during tooth brushing (24; 46.2%). Majority of the examinees had bad teeth brushing technique (82.7%). The average value of DMFT index in all examinees was 15.69±4.80, and there was no significant difference between the age groups (F=1.945; p=0.154). However, there were significant differences between the age groups in missing teeth (F=9.700; p=0.000). The highest average value of missing teeth was in the group of 35-44 years olds (6.56±3.88). Conclusions: Although there was high level of awareness among the examinees about the influence of oral health to general health, majority of them had high value of the DMFT index