Promene biohemijskog sastava salive kod dijabetičara

Introduction: Diabetic patients, beside numerous acute and chronic complications, often have oral manifestations of the disease. Aim: The aim of the study was to establish changes in saliva of diabetic patients in relation to healthy population in order to use saliva in the disease monitoring, as well as the changes depending on the type of diabetes. Materials and methods: The study comprised 52 adult patients of both sexes and at the age between 18 and 79 with Diabetes mellitus type 1 and 2 who were treated at the Institute for endocrinology, diabetes and metabolic disorders of the Clinical center of Serbia. The control group consisted of 67 volunteers from Belgrade, students at the School of Dentistry, aged between 19 and 24. The whole of unstimulated and stimulated saliva was collected and biochemical parameters (glucose, total proteins, albumin, sodium and potassium) were determined by methods commonly used for serum. Results: The results showed that salivary potassium level was increased in saliva of diabetic patients, that of sodium and total proteins was decreased, and glucose and albumin did not show changes compared to the control group. Concentrations of total proteins and potassium were higher in patients with DM type 2, and sodium was higher in DM type 1 (p = 0.05). Conclusion: Diabetic patients often have changes in biochemical composition of saliva.Uvod: Kod obolelih od Diabetes mellitus-a (DM), pored brojnih akutnih i hroničnih komplikacija, dolazi i do poremećaja oralne homeostaze. Cilj: Cilj rada bio je da se utvrde promene u biohemijskom sastavu salive dijabetesnih bolesnika u odnosu na zdravu populaciju radi eventualnog korišćenja salive u praćenju toka bolesti, odnosno da se utvrde promene u salivi u odnosu na tip dijabetesa. Materijal i metode: Istraživanje je obuhvatilo 52 odrasla pacijenta oba pola, uzrasta 18-79 godina, obolelih od DM - tip 1 i tip 2, lečenih na Institutu za endokrinologiju, dijabetes i bolesti metabolizma Kliničkog centra Srbije. Kontrolnu grupu činilo je 67 dobrovoljaca iz Beograda, studenata Stomatološkog fakulteta u Beogradu, uzrasta 19-24 godine. Sakupljana je ukupna nestimulisana i stimulisana saliva, a biohemijski parametri (glukoza, ukupni proteini, albumin, natrijum i kalijum) određeni su referentnim metodama za serum. Rezultati: Dobijeni rezultati su pokazali da je u salivi obolelih od dijabetesa koncentracija kalijuma povišena, koncentracija natrijuma i ukupnih proteina snižena, a glukoze i albumina nepromenjena u odnosu na kontrolnu grupu. Koncentracije proteina i kalijuma više su kod obolelih od DM tip 2 nego kod DM tip 1, a koncentracija natrijuma viša je kod DM tip 1 (p = 0.05). Zaključak: Biohemijski sastav salive je ukazao na promene kod dijabetesnih bolesnika

Stanje tkiva periodoncijuma kod bolesnika sa dijabetesom melitusom u populaciji Beograda

Background/Aim. Diabetes mellitus (DM) as a complex metabolic disease influences functioning of numerous organs. Therefore, frequent diabetic complication is chronic periodontitis. The aim of the study was to investigate the influence of various risk factors, like age, sex, duration of DM, oral hygiene, on oral manifestations of diabetes. Methods. The group of diabetics included 52 adult patients, 18-79-year of age, both sexes (33 females, 19 males) out of which 35 patients were with diabetes mellitus type I and 17 with type II. Mean age of the patients was 54.6 years and the mean duration of diabetes was 11.1 years. The controls consited of 67 volunteers from the city of Belgrade, 19-24-year of age, both sexes (47 females, 20 males) with no paradonthopathy and non-systemic diseases. Estimation of periodontal status of the patients was performed by measuring dental plaque index, gingival index and periodontal pockets' depth. Results. The results suggest an increased incidence and severity of periodontitis in diabetic patients. It was established that duration of diabetes, patients' age and bad oral hygiene had a negative influence on status of remained teeth in diabetics, while the sex had no influence on parameters monitored. Conclusion. Indices of oral hygiene level and periodontal status (dental plaque index, gingival index and periodontal pockets' depth) were significantly worsened in patients with diabetes. Negative influence on remained teeth had patients' age (>50 years), duration of diabetes (> 20 years) and bad oral hygiene. About half of the patients had a total or partial bridge suggesting that periodontitis is significant complication of diabetes mellitus.Uvod/Cilj. Diabetes mellitus (DM) kao oboljenje u čijoj osnovi jeste metabolički poremećaj odražava se na funkcionisanje brojnih organa. Stoga, česte manifestacije dijabetesa predstavljaju i gingivitis i parodontopatija. Cilj rada bio je da se ispita uticaj različitih faktora (pol, starost, trajanje DM, higijena usta i zuba) na oralne manifestacije dijabetesa. Metode. Ispitana je grupa bolesnika obolelih od DM i kontrolna grupa zdravih osoba. Grupu ispitanika činila su 52 odrasla bolesnika, starosti 18-79 godina, oba pola (33 žene i 19 muškaraca), obolela od dijabetesa melitusa tip 1 (35 ispitanika) i tip 2 (17 ispitanika), lečena u Institutu za endokrinologiju, dijabetes i bolesti metabolizma Kliničkog centra Srbije. Srednja starost ispitanika bila je 54,6 godina, a srednje trajanje dijabetesa 11,1 godina. Kontrolna grupa formirana je od 67 dobrovoljaca iz Beograda, studenata Stomatološkog fakulteta Univerziteta u Beogradu, starosti 19-24 godine, oba pola (47 ženskih i 20 muških), bez parodontopatije i sistemskih bolesti. Status periodoncijuma bolesnika definisan je na osnovu merenja indeksa plaka, gingivnog indeksa i dubine periodontnih džepova. Rezultati. Dobijeni rezultati ukazuju na povećanu učestalost i težinu parodontopatije kod bolesnika sa dijabetesom. Utvrđeno je da značajan negativni uticaj na stanje preostalih zuba kod bolesnika sa dijabetesom imaju dužina trajanja bolesti, starost bolesnika i loša oralna higijena, dok je pol bez uticaja na posmatrane promene. Zaključak. Pokazatelji nivoa oralne higijene i stanje periodontnog tkiva (indeks dentalnog plaka, gingivni indeks, dubina periodontnih džepova) značajno su pogoršani kod dijabetesnih bolesnika. Negativan uticaj na broj preostalih zuba imaju starost (> 50 godina), dužina trajanja dijabetesa (> 20 godina) i loša oralna higijena. Polovinu ispitanih bolesnika zbog gubitka svih ili velikog broja zuba nosi parcijalnu ili totalnu protezu, što pokazuje da je parodontopatija značajna komplikacija DM

Mogućnosti upotrebe pljuvačke kao dijagnostičke tečnosti u stomatologiji

Saliva is a secretion of the salivary and mucous glands and is of major importance in the maintainance of oral health. Over the last few decades, saliva has been evaluated as a diagnostic fluid in medicine for determining systemic disease markers as well as for monitoring numerous drugs, narcotics, and hormones. The biochemical analysis of saliva is particularly important in dentistry. The estimation of the risk of appearance and diagnosis of disease, monitoring of disease progression, evaluation of therapy efficacy for caries, periodontitis, premalignant and malignant oral lesions, as well as infectious diseases of the oral cavity, can be assessed by analyzing different constituent: of saliva, individuals at risk of caries can be identified using test: that determine saliva flow rate, saliva buffer capacity, and colonization of the oral cavity by cariogenic bacteria. Today, these rapid and simple diagnostic tests are used routinely in caries risk determination. The study and use of saliva-based diagnostics have increased over the last few decades. Clinical testing of saliva shows much promise. However, there is a need for much additional research in this area, before the true clinical value of saliva as a diagnostic fluid in dentistry can be determined.Pljuvačka je sekret pljuvačnih i mukoznih žlezda koji je značajan za održavanje oralnog zdravlja. Poslednjih decenija sve više se razmatra mogućnost njene primene kao zamena krvi, odnosno krvnom serumu i plazme, radi dokazivanja pokazatelja sistemskih oboljenja, kao i za nadgledanje primene lekova, droga i hormona. Analiziranje biohemijskog sastava pljuvačke posebno je značajno u stomatologiji za procenu rizika nastanka, praćenja toka bolesti i kontrole rezultata primenjenog lečenja zubnog karijesa, parodontopatije, oralnih karcinoma i infektivnih oboljenja usne duplje. U proceni rizika nastanka karijesa na zubima rutinski se izvode ispitivanja kojima se određuju količina izlučene pljuvačke, njen puferski kapacitet i stepen kolonizacije usne duplje kariogenim vrstama bakterija. Jednostavnost izvođenja ovih ispitivanja omogućava da ih u stomatološkoj ordinaciji primenjuje lekar praktičar, što predstavlja veliku pomoć u proceni rizika za nastanak zubnog karijesa. Zbog bliskog kontakta s oralnim tkivima, pljuvačka sadrži brojne biohemijske pokazatelje patoloških procesa lokalizovanih u ovim tkivima (enzimi, imunoglobulini, ostali proteini, fenotipski pokazatelji). Ispitivanje pomenutih pokazatelja je značajno kao dopuna kliničkom dijagnostikovanju ukoliko ono ne pruža dovoljno informacija

Parodontalni status i biohemijske promene u salivi obolelih od dijabetes melitusa

Diabetes mellitus is often accompanied by periodontitis of different grades and biochemical changes in saliva. Evaluation of periodontal status is performed by measuring dental plaque index, gingival index and periodontal pockets depth. Whole saliva levels of glucose and electrolytes are measured by usual methods for serum. The results reveal that there are no statistically significant changes in saliva glucose levels in diabetic and/or periodontitis patients in relation to healthy population; potassium level is increased in saliva of both experimental groups in relation to controls, and sodium level is decreased. Plaque index, gingival index and periodontal pocket depth are increased in diabetic patients, and tooth loss increases in patients over 50 years of age.Dijabetes melitus često je praćen parodontopatijom različitog stepena i promenama u biohemijskom sastavu salive. Parodontalni status pacijenata definisan je na osnovu merenja plak indeksa, gingivalnog indeksa i dubine parodontalnih džepova. Koncentracija glukoze i elektrolita u mešovitoj salivi određene su metodama koje se koriste za ova određivanja u serumu Dobijeni rezultati ukazuju da nema statistički značajne razlike u koncentraciji glukoze u salivi obolelih od dijabetesa i/ili parodontopatije u odnosu na zdravu populaciju. Koncentracija kalijuma u salivi povišena je kod obe eksperimentalne grupe u odnosu na kontrolnu, dok je koncentracija natrijuma u salivi snižena. Prosečne vrednosti plak indeksa, gingivalnog indeksa i dubine parodontalnih džepova povećane su kod dijabetesnih bolesnika, a posle pedesete godine je kod ovih osoba izražena i povećana učestalost gubitka zuba usled parodontopatije

Odnos glikoproteinskih frakcija mešovite pljuvačke i starenje

Whole saliva of persons with different stages of periodontal disease was compared with saliva of patients of different ages, but in terminal stage of periodontal disease. Separation of protein fractions was made by IEF on Servalyt plates. Protein fractions over pHi 8,3 decreased in patients with periodontal disease as well as in older patients.Sva elektroforetska ispitivanja pokazala su da je proteinski sastav pljuvačke i stanje parooncijuma u zavisnoj vezi od starosti ispitanika. Posebno se to odnosi na glikoproteinski sastav pljuvačke, koji naročito varira sa starošću organizma. Poznato je da sa starenjem pljuvačka gubi serozne karakteristike, dok je mukusni sekret mnogo zastupljeniji. Takođe promene glikoproteinskih karakteristika mogu ukazati i na enzimske i zaštitne imunoglobulinske promené. Na to ukazuje skraćenje dužine oblasti elektroforegrama u kojima se nalaze bazne proteinske komponente velikih molekulskih masa Mr>60.000, koje odgovaraju globulinskoj i imunoglobulinskoj oblasti razdvajanja. Ispitivanja pojedinačnih uzoraka mešovite pljuvačke pokazuju, u saglasnosti sa stanjem parodontalnih tkiva i godinama starosti a uprkos individualnim razlikama, ujednačen proteinski sastav. Međutim, da bi se mogao izvesti zaključak o proteinskom statusu u stanju svakog stadijuma oboljenja parodoncijuma u vezi sa starenjem ispitanika, primenom pool-ovih uzoraka odstranjuje se svaka individualna razlika koja može ovim postupcima nastati. Sve promené ogledaju se u povećanju zastupljenosti proteinskih frakcija manjih molekulskih masa (Mr lt 60.000), na račun degradacije onih sa većim relativnim molekulskim masama (Mr>60.000). Smanjenje zastupljenosti frakcija glikoproteina baznih karakteristika naročito izostanak lizozima (pHi=10,65), i to na račun frakcija glikoproteina kiselih karakteristika, kao stoje utvrđeno izoelektričnim fokusiranjem, ukazuje na neželjene promené nastale ne samo napredovanjem parodontalnog oboljenja, već i uporedo sa starenjem organizma. Saglasno sa promenama proteinskih frakcija mešovite pljuvačke sa napredovanjem oboljenja parodoncijuma i starenjem organizma u in vivo uslovima, nastaju promené proteinskog sastava mešovite pljuvačke i u in vitro uslovima - "starenjem" zdravog uzorka stajanjem u epruveti duže vreme (1-10 dana) u puferu za uzorak. Moguće objašnjenje svih ovih promena je da se, uprkos stalnom obnavljanju pljuvačke u usnoj duplji, promené proteinskog sastava mogu pripisati razvoju oboljenja parodoncijuma, kao i starenju organizma, jer razvoj bolesti obično nastaje sa godinama (izuzetak je juvenilna parodontopatija). Na ovu pretpostavku ukazuju i destruktivne promené proteina velikih molekulskih masa nastale stajanjem zdravog uzorka mešovite pljuvačke duže vreme u puferu za uzorak

Changes in the biochemical composition of saliva in diabetic patients

Introduction: Diabetic patients, beside numerous acute and chronic complications, often have oral manifestations of the disease. Aim: The aim of the study was to establish changes in saliva of diabetic patients in relation to healthy population in order to use saliva in the disease monitoring, as well as the changes depending on the type of diabetes. Materials and methods: The study comprised 52 adult patients of both sexes and at the age between 18 and 79 with Diabetes mellitus type 1 and 2 who were treated at the Institute for endocrinology, diabetes and metabolic disorders of the Clinical center of Serbia. The control group consisted of 67 volunteers from Belgrade, students at the School of Dentistry, aged between 19 and 24. The whole of unstimulated and stimulated saliva was collected and biochemical parameters (glucose, total proteins, albumin, sodium and potassium) were determined by methods commonly used for serum. Results: The results showed that salivary potassium level was increased in saliva of diabetic patients, that of sodium and total proteins was decreased, and glucose and albumin did not show changes compared to the control group. Concentrations of total proteins and potassium were higher in patients with DM type 2, and sodium was higher in DM type 1 (p = 0.05). Conclusion: Diabetic patients often have changes in biochemical composition of saliva

Use of saliva as a diagnostic fluid in dentistry

Saliva is a secretion of the salivary and mucous glands and is of major importance in the maintainance of oral health. Over the last few decades, saliva has been evaluated as a diagnostic fluid in medicine for determining systemic disease markers as well as for monitoring numerous drugs, narcotics, and hormones. The biochemical analysis of saliva is particularly important in dentistry. The estimation of the risk of appearance and diagnosis of disease, monitoring of disease progression, evaluation of therapy efficacy for caries, periodontitis, premalignant and malignant oral lesions, as well as infectious diseases of the oral cavity, can be assessed by analyzing different constituent: of saliva, individuals at risk of caries can be identified using test: that determine saliva flow rate, saliva buffer capacity, and colonization of the oral cavity by cariogenic bacteria. Today, these rapid and simple diagnostic tests are used routinely in caries risk determination. The study and use of saliva-based diagnostics have increased over the last few decades. Clinical testing of saliva shows much promise. However, there is a need for much additional research in this area, before the true clinical value of saliva as a diagnostic fluid in dentistry can be determined