Terapijska učinkovitost klindamicin gela kao dodatak bazičnoj terapiji kronične parodontopatije

Clindamycin, a lincosamide antibiotic, has been under-recognized as an antimicrobial agent for use in dentistry. The aim of the present work was to evaluate clinical efficacy of 2% clindamycin gel in addition to the basic mechanical periodontal therapy. At baseline, scaling and root planing (SRP) was performed at all 50 subjects (control group and test group). Clindamycin gel was applied after SRP only in the test group. Clinical measurements including periodontal pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP) and plaque index (PI) were done at baseline, and at 3 and 6 months after treatment. Compared to baseline, the PPD and CAL values significantly decreased in the test group (p<0.05) and were statistically lower (p<0.05) compared to control group. PPD reduction of 2.42 mm was obtained in the test group and could be generally considered as clinically significant. A PPD reduction greater than 2 mm indicated that clindamycin gel could be used efficiently as an adjunct to SRP. Also, between-group difference in BOP and PI scores was statistically significant 6 months after treatment. In conclusion, the application of clindamycin gel in combination with SRP enhanced the efficacy of non surgical periodontal therapy in reducing pocket depth and improving attachment levels in chronic periodontitis subjects and had additional benefits over mechanical therapy alone.Klindamicin, linkozamidni antibiotik, je u širokoj upotrebi u stomatologiji. Cilj ovoga rada je bio procijeniti kliničku učinkovitost 2% klindamicin gela kao dodatne terapije bazičnoj terapiji kronične parodontopatije. Bazična terapija provedena je u svih 50 pacijenata (kontrolna skupina i ispitna skupina). Klindamicin gel je primijenjen nakon bazične terapije parodontopatije samo u ispitnoj skupini. Praćeni su sljedeći klinički parametri: dubina parodontalnog džepa (DPDZ), razina pripojnog epitela (NPE), indeks krvarenja (Ikr), plak indeks (PI). Mjerenje indeksa provedeno je prilikom prve terapije te tri i šest mjeseci nakon tretmana. DPDZ i NPE vrijednosti su bile značajno smanjene u ispitnoj skupini (p<0,05) i bile su statističke niže u odnosu na kontrolnu skupinu (p<0,05). Smanjenje dubine parodontalnog džepa za 2,42 mm zabilježeno je u ispitnoj skupini i može se smatrati klinički značajnim. Ovo smanjenje pokazuje da klindamicin gel ima terapijski učinak kao dodatak bazičnoj terapiji u liječenju kronične parodontopatije. Također je evidentirana statistička razlika između skupina u Ikr i PI šest mjeseci nakon terapije. Zaključuje se da primjena klindamicin gela u kombinaciji s bazičnom terapijom parodontopatije povećava učinkovitost nekirurške terapije

ORAL MANIFESTATIONS OF THE LICHEN PLANUS

The Lichen planus is frequent dermatosis that only attack mucus with no skin manifestation. Its only location can be only upon oral mucus.The aim of the paper is to examine the oral localization incidence in all its key variants.From March, 1999, to December, 2002, 35 patients were examined, namely, 28 women and 7 men of 19 to 63 years of age. Of 6 variants of the Lichen planus oral manifestations 17 had an erosive-ulcerous form, 13 had a reticular one and 5 patients had an atrophic form.The erosive-ulcerous form that was dominant in the last few years in its clinic variants was diagnosed upon the byccal mucus, gingiva, tongue, hard palate, lips and mouth cavity floor.This form requires an adequate therapy regarding its chronic nature as well as frequent check-ups due to the possibility of the "lichen dysplasia". Similar treatment is required with the atrophic form while the reticular variant requires occasional controls with no specific therapy except for the one referring to everyday maintenance of good oral hygiene, caries elimination and periodontal diseases along with the hygienic-diet regime

Analysis of enzyme activity and the level of malondialdehyde in the saliva of children with gingivitis

Introduction/Aim. By analyzing activity of some of the enzymes normally present in the saliva and the level of malondialdehyde in gingivitis, it is possible to estimate the functional condition of parodontium, and the examined parameters can be considered as biochemical markers of its functional condition. The aim of this paper was to examine activity of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, lactate dehydrogenase and the level of malondialdehyde in the saliva of children affected with gingivitis, as well as the values of the mentioned parameters in relation to the level of the inflammation of gingiva. Methods. The research included 120 children at the age of 12.2 with permanent dentition. Löe and Silness gingival index was used to estimate the condition of gingiva, based on which the children were classified into four groups: the children with healthy gingiva (the control groups), the children with mild, moderate and severe inflammation of gingiva (the study group). Enzymes of the saliva were determined by the use of original tests and measured by the autoanalyser (Bio Systems A25, Spain). A modified method with tiobarbituric acid was used to determine malondialdehyde in nonstimulated mixed saliva. Results. The results of the examined enzyme activity and the level of malondialdehyde in the saliva of the study groups showed statistically considerably higher values for the level of malondialdehyde (p &lt; 0.001), for the activity of aspartate aminotransferase and gamma glutamyl transferase (p &lt; 0.01), as well as for alanine aminotransferase (p &lt; 0.05) in comparison with the control group, whereas the activity of lactate dehydrogenase did not show a statistically significant increase. In relation to the level of the inflammation of gingiva, the results of the examination of the enzyme activity in the study groups showed statistically significantly higher values in the group with severe inflammation in comparison with those with mild, as well as the moderate inflammatory, except for the gamma glutamyl transferase, and in the group with moderate inflammation compared to that with the mild one, except for alanine aminotransferase. The results of the examination of the level of malondialdehyde in the saliva of the study groups did not show a statistically significantly increase in relation to the level of the inflammation of gingiva. Conclusion. There is a higher level of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase and lactate dehydrogenase enzyme activity together with the higher level of malondialdehyde in the saliva of children with gingivitis in comparison with the activity of the same enzymes and the level of malondialdehyde in the saliva of children without gingivitis. The activity of the examined enzymes in the saliva of children with gingivitis increases in relation to the intensity of the pathological process, whereas the level of malondialdehyde shows no significant difference in relation to the level of the inflammation of gingiva