Influence of Certain Nutritional Products On Periodontal Status

Material and Method: 60 patients within the age range of 35-65 years were included. The selection of the respondents was made by a simple random method.  As a criterion in the research sample, the depth of the periodontal pockets was taken into account, which was from 3 to 5 mm, according to which a selection was made.  Chronic periodontal disease with a clinically manifest stage was diagnosed in all patients. Each of the respondents had the opportunity to estimate the frequency of personal consumption of 6 selected food items (vegetables, fast food, fish, meat, fruits, and desserts) by choosing one of three possible answers (never, infrequently and often consumed). For the clinical part of the study, 4 parameters were measured, namely: GI-gingival inflammation, PI-plaque index, PPD-depth of periodontal pockets, and CAL-clinical loss of attachment. The findings were statistically processed. Results: For the male and female respondents, the average age was 39.8 ± 5.3 with min/pop of 30/53 years and 41.2 ± 6.3 with min / pop of 32/55 years, respectively. The analysis showed that, for p> 0.05, the frequency of consumption of vegetables significantly decreased, and the consumption of fast food insignificantly increased the values of the four clinical parameters (GI, PI, PPD, CAL). Conclusion: Consumption of fish, meat, and vegetables reduces the values of clinical parameters (PI, GI, PPD, CAL). This is in contrast to fast food and dessert which indicated an increase in the values of PPD and CAL

Free Gingival Graft versus Mucograft: Histological Evaluation

INTRODUCTION: The correction of the gingival recession is of esthetical and functional significance, but the tissue regeneration can only be confirmed by a histological examination.AIM: This study aims to make a comparison between the free gingival graft and the autograft.MATERIAL AND METHODS: This study included 24 patients with single and multiple gingival recessions. Twelve patients were treated with a free gingival graft and the other twelve with a micrograft. Six months after the surgical procedure, a micro-punch biopsy of the transplantation area was performed. The tissue was histologically evaluated, graded in 4 categories: immature, mature, fragmented and edematous collagen tissue. The elastic fibres were also examined and graded in three categories: with a normal structure, fragmented rare and fragmented multiplied.RESULTS: Regarding the type of collagen tissue that was present, there was a significant difference between the two groups of patients, with a larger number of patients treated with a micrograft showing a presence of mature tissue, compared to the patients treated with a free gingival graft. A larger number of patients in both of the groups displayed elastic fibres with a rare fragmented structure; 33.3% of the patients showed a normal structure; 50% demonstrated a normal structure.CONCLUSION: The patients treated with a free gingival graft showed a larger presence of fragmented collagen tissue and fragmented elastic fibres, whereas a mature tissue was predominantly present in the surgical area where a Geistlich Mucograft was placed

Diagnostic dilemmas in the most common oral lesions and diseases

Objectives: The diagnosis and treatment of lesions of the oral cavity are an integral part of oral health care, hence the early detection and treatment of these lesions will greatly improve the quality of life of patients and the survival rate in cases of oral cancers. Aim: To present the most common oral changes and lesions, their clinical characteristics and differential diagnostic possibilities, to avoid mistakes and ensure an accurate diagnosis. Methods: research was done exploring specialized databases PubMed, MEDLINE, EBSCO, Science Direct, and Scopus for the period 2010-2023, by use of MeSH terms: pigmented oral lesions, diffuse and bilateral pigmented lesions, focal pigmented lesions, differential diagnosis. Results: The most common oral manifestations were categorized in groups as follows: localized (intravascular, extravasated blood, melanocytic, tattoo) and generalized (hereditary, with systemic diseases, physiologic and medications associated). Conclusions: To minimize wrong diagnoses and achieve more accurate ones, it is necessary to consider the main complaints of patients, medical and dental history, and clinical manifestation, not excluding paraclinical examinations. Laboratory tests, and in many cases histopathological examination, which is known as the gold standard in the diagnosis of oral pathology, are used to confirm the clinical diagnosis. Keywords: oral cavity lesions, pigmented lesions, differential diagnosis

The role of cannabis oil (kanoil) in the treatment of pain in oral mucositis

To monitoring the effect of Kanoil oil on patient’s pain treated with radiotherapy because of malignancies on the head and neck. Materials and method: 25 patients with malignancies of the head and neck were hospitalized at the Clinic for Radiotherapy and Oncology. All subjects underwent radiotherapy with daily dose of 2 Gy for 6-7 weeks. Lesions in their mouth were treated with Kanoil 7% CBD (700 mg CBD / 10 ml) whose manufacturer is Replek, Skopje, same treatment for all of them, regardeless of age and gender. Treatment of lesions was done according to the technique of split–mouth study. The Visual analogue scale (VAS) was used to assess the pain. In this scale through numerical values from 0-10 is the determined the intensity of the pain, where 0 means no pain, and 10 the most possible pain. The intensity of the pain is determined in three stages: at zero time, day 10 and 1 month after application of Kanoil. Results: After 10 days and 1 month using Kanoil is noticed that the pain intensity is slowly going down. The lowest intensity of pain is recorded after 1 month of treatment. Comparing the obtained findings, there was recorded a significant difference between the non-examined and the examined side (p≤0,001). Conclusion: Kanoil has a positive effect of pain reduction, with the greatest effect after 1 month of treatment. The application of this oil improves chewing, swallowing, speech and quality of life and helps this individuals to have better social life

Use of Biomaterials for Periodontal Regeneration: A Review

BACKGROUND: Management of bone periodontal defects, destruction, and loss of the alveolar bone is considered a challenge for modern periodontal regeneration and implant dentistry. Numerous of biomaterials are being used in periodontal regenerative treatment. AIM: This study aims to know the characteristics of biomaterials and their efficiency in periodontal surgical treatment as regenerative therapy. METHODS: A systematic review of the literature considering reviews, clinical studies, original papers, and articles from electronic data has been used. RESULTS: Different biomaterials such as Straumann® Emdogain®, Geistlich Bio-Oss®, MIS 4MATRIX – Bone Graft, Platelet-rich fibrin (PRF), Mis Bone-4MATRIX, and PRF are being used for periodontal regeneration treatment, hence revealing more effective outcomes when combined. PRP together with conventional grafting procedures may be a beneficial treatment approach, guided tissue regeneration with bioabsorbable membranes in combination with Bio-Oss are stable on a long-term basis. CONCLUSION: Biomaterials being used in periodontal surgical treatment have the different regenerative ability. The combined use of biomaterials might result in a better clinical outcome. There are also a number of other biomaterials used to treat periodontal regeneration, but generally all have the same ability and the same molecular structure as highlighted in this literature review

Submucous cleft palate presenting with a micro cleft of the uvula

Introduction: The comprehensive treatment of clefts as deformities implies a detailed understanding of the anatomical complexity of the condition and maintaining a delicate balance between the intervention that would be chosen as an appropriate treatment and the further growth of the child. Observance of coordinated and appropriate care from the infantile period until adolescence allows us an ideal outcome for each patient. For this purpose, it is necessary for the surgeons to have previous experience and to be involved throughout the entire process of treating the condition. The classification of clefts is based on the involvement of the primary palate whereby if involved the cleft can be determined as unilateral, bilateral, complete (total), or incomplete (partial). In the secondary palate, the division is made in relation to the incisive foramen where the cleft can be anterior or posterior; in addition, it can also be unilateral, bilateral, complete, and incomplete. As a separate and distinct entity, there is a submucous cleft palate considered to be the most subtle type of all palate clefts. Case presentation: In the presentation, we will present a case of rare unilateral submucous cleft palate accompanied by uvular micro cleft. Keywords: Cleft, lip, palate, submucous cleft, deformity, anomalies

Interpositional grafting procedure in ridge defects reconstruction

Numerous surgical grafting procedures designed to reconstruct a partially toothless ridge or ridge defects have been described in the literature over the years. Aim: The procedures can be grouped according to the means used to increase the ridge such as soft and hard tissue augmentation procedures. To illustrate the different approaches to utilizing soft tissue augmentation, the following procedures will be discussed: Pedicle graft, Roll graft and Free graft procedures (Pouch graft, Interposition graft and Onlay graft procedure). Material and method: In interposition graft procedures, there is no need to remove the epithelium from the surface of the donor tissue. If augmentation is required in both buccolingual and apico-coronary direction, part of the graft must be placed above the surface of the tissue around the recipient site. Some of the grafted connective tissue surfaces will be exposed in the oral cavity. “Envelope” or partial thickness flap with relaxing incisions, is prepared on the vestibular surface of the defective area. An appropriate donor site is selected at the palate or in the area of the maxillary tubercle, and a free epithelial connective tissue graft is harvested. A temporary bridge is positioned to serve as a reference when estimating the amount of tissue needed to fill the defect. Results: The newly formed granulation tissue during healing will make a border between the graft and the adjacent tissue, smooth and properly epithelialized. Edema, which occurs postoperatively, will help contour the ridge. Conclusion: Class III ridge defects are a major challenge for the dentists, as the ridge needs to be enlarged in both vertical and horizontal dimensions. The combined procedures can be used successfully in such situation. Key words: interposition grafting, ridge augmentation, connective tissue graf

Oral signs of adverse drug reactions

BACKGROUND: Adverse reactions to drugs are common and may have a variety of clinical presentations in the oral cavity. They are harmful and unintended responses to a medical product. As newer therapeutic agents are approved, it is likely that more adverse drug events will be encountered. The extent of adverse drug reactions is unknown; however, because a lot of them are asymptomatic, many are believed to go unnoticed. Their pathogenesis, especially of the mucosal reactions, is largely unknown and appears to involve complex interactions between the drug, other medications, the patient’s underlying disease, genetics and lifestyle factors. AIM: to describe the most common adverse drug reactions that dentists may encounter in daily clinical practice. MATERIALS AND METHODS: research was done exploring specialized databases PubMed, MEDLINE, EBSCO, Science Direct, and Scopus for the period 2010-2023, by use of MeSH terms: adverse drug reaction, drug-induced reactions, oral manifestation. RESULTS. The most common oral manifestations were categorized into groups as follows: saliva and salivary gland involvement, soft tissue alterations, hard tissue damage, and non-specific oral conditions. CONCLUSIONS: Knowledge of adverse drug-induced oral effects helps dental professionals to better diagnose oral disease, administer drugs, and improve patient compliance during drug therapy which may foster a more rational use of drugs. Keywords: oral cavity, adverse drug reactions, oral signs

Differential diagnostic in the common ulcerated oral lesions and diseases

Background: The oral cavity is a complex region in the head and neck area where a wide range of changes, conditions and lesions of the oral mucosa are encountered that can cause diagnostic dilemmas for dentists. A diverse range of cysts, benign and malignant tumors of the salivary glands, precancers, as well as odontogenic and non-odontogenic neoplasms, can often be overlooked or misdiagnosed. Aim: to present the most common ulcerated oral lesions, their clinical characteristics and differential diagnostic possibilities, in order to avoid mistakes and ensure an accurate diagnosis. Methods: research was done exploring specialized databases PubMed, MEDLINE, EBSCO, Science Direct, Scopus for the period 2010-2023, by use of MeSH terms: oral tumor, oral neoplasms, differential diagnosis. Results. The most common ulcerated oral manifestations were categorized in groups as follows: benign (epithelial, mesenchymal, salivary gland); cysts; and malignant (squamous, verrucous, melanoma, salivary gland adenocarcinoma) Conclusions: The diagnosis and treatment of lesions of the oral cavity are an integral part of oral health care, hence the early detection and treatment of these lesions will greatly improve the quality of life of patients and the survival rate in cases of oral cancers. Laboratory tests, and in many cases histopathological examination, which is known as the gold standard in the diagnosis of oral pathology, are used to confirm the clinical diagnosis. Keywords: oral ulcerated lesions, oral neoplasms, malignant tumors, differential diagnosis

Comparison of root surface roughness induced by hand and ultrasonic instrumentation on treated molars: an in vitro study

Objective: To compare the effects of hand and ultrasonic instrumentation on root surface of treated molars. Materials and Methods: 20 molars extracted from orthodontic reasons were followed in vitro. After extraction, the teeth are washed with distilled water, kept at room temperature in phosphate buffer solution pH 7,0. At mesial and distal cervical third of the roots were formed parallel grooves using carbide borer .The first groove is made 3 mm over enamel-cement junction(ECJ) of the crown, and the second is 3 mm under ECJ (in apical direction).This zone is treated in two ways: manually treated samples (hand instrumentation) using Gracey curettes 5-6 (Gracey; Hu-Friedy, Chicago, IL, USA), and ultrasound treated (KAVO, SONIC flex 2000 , number 5 - 6; frequency 6000 Hz). After 48 hours, samples were examined by scanning electron microscope, SEM model VEGA3LMU. Samples were examined with magnification ranging from 17 x to 300 x. Additional SEM micrographs with magnification higher than 300x were taken for detailed examination. The presence of fissures and cracks in 1mm² are calculated with mathematical formula. Results: Presence of fissures on root surface (cement) of molars treated with hand instrumentation for Z = -5,41 and p <0,001 (p = 0,000) is significantly lower compared to the presence of fissures on root ssurface (cement) of molars treated with ultrasonic instrumentation. Conclusion: Manual instrumentation is safer in the treatment of root surfaces, as opposed to applied ultrasound instrumentation, causing numerous and wide fissures in molars. Keywords: root surface, scaling and root planning, ultrasonic instrumentation, manual instrumentatio