Custom Thermoformed Trays in the Treatment of Denture Stomatitis

Svrha je istraživanja ispitati djelotvornost mikonazolskog gela primijenjenog pomoću individualne termoplastične udlage kao prekonoćnog držača lijeka u liječenju protetskog palatitisa, u usporedbi s klasičnom primjenom lijeka koju je propisao proizvođač. Sudjelovala su 44 nositelja mobilnih stomatoloških gornjih nadomjestaka s dijagnosticiranim protetskim palatitisom. Ispitna skupina (n = 22) liječena je 2-postotnim gelom mikonazolima, a nanosio se tijekom noći u individualnu udlagu. Kontrolna skupina (n = 22) liječena je unošenjem 2,5 ml istog lijeka u usta četiri puta na dan. Određivali su se intenzitet upale i infi ciranosti. Provedeni su sljedeći klinički testovi: intenzitet upale prema Newtonu, veličina eritematoznih lezija na sluznici nepca ispod ležišta nadomjestka, digitalna termometrija sluznice i bris za kulturu Candida albicans. Zabilježeni su i podaci o starosti, higijeni proteze i nosi li pacijent protezu tijekom noći. Rezultati su pokazali bržu i potpuniju sanaciju protetskog palatitisa u ispitnoj skupini bolesnika u odnosu prema kontrolnoj. U ispitnoj skupini zapažena je i veća redukcija kolonija kulture Candida albicans, što upućuje na njihovu djelotvorniju eliminaciju iz usta primjenom lijeka novom metodom. Ta metoda dodatno potiče bolesnika da slijedi upute o terapiji i higijeni nadomjestka. Individualna udlaga kao okluzijski zavoj pokazala se djelotvornijom i bolesniku ugodnijom od liječenja klasično ordiniranim antimikotikom, što bi klinički moglo biti vrlo važno u liječenju protetskog palatitisa.The aim of this study was to evaluate the effect of miconazole gel delivered on a custom thermoformed tray as an overnight drug holder appliance in denture stomatitis treatment, in comparison with classic application as recommended by manufacturer. The investigation included 44 upper denture wearers, diagnosed with denture stomatitis. The experimental group (n = 22) applied 2% miconazole gel in custom tray for overnight wear. The control group (n = 22) applied 2,5 ml of the same drug 4 times a day in their mouth. Intensity of infl ammation and infection was evaluated. The clinical tests that were used were: infl ammation intensity according to Newton, extent of palatal mucosal erythematous surface below denture, digital thermometry, and swabs for Candida albicans cultures. Oldness and hygiene status of dentures were recorded, as well as habit of overnight denture wearing. The investigation revealed that denture stomatitis healed faster and better in the experimental group compared to control group. Greater Candida albicans culture colony count reduction was observed in experimental group, which suggests more effi cient elimination of Candida albicans from the mouth with novel method. This method motivates patients to adhere to treatment and appliance hygiene instructions. Custom splint as occlusive drug delivery showed to be more effective and more convenient for the patients than the same antimicotic drug, classically delivered, which might be clinically relevant in treatment of denture stomatitis

Effects of 10% Carbamide Peroxide Teeth Whitening System on Periodontal Health

Svrha rada bila je istražiti utjecaj sredstva za izbjeljivanje zuba s 10 %-tnim karbamidnim peroksidom (VivaStyle, Ivoclar Vivadent, Schaan, Liechtenstein) na zdravlje parodonta. U studiju je bilo uključeno 10 ispitanika u dobi od 22 do 29 godina, s klinički zdravim parodontnim tkivima, a željeli su promijeniti nijansu boje zuba. Tijekom 12 dana njihovi su zubi bili svaki dan podvrgnuti jednosatnom tretmanu 10 %-tnim karbamidnim peroksidom. Svi su morali tijekom postupka voditi dnevnik mogućih nelagoda. Na početku - šestog i dvanaestog dana - kod svih ispitanika izmjerene su vrijednosti API-a i PBI-a te su im zubi fotografi rani u zagrizu. Svi su zubi postupkom izbijeljeni barem za jednu nijansu. Tijekom tretmana nije bilo promjena ni u akumulaciji plaka, ni u upali gingive. Taj postupak nema nikakva utjecaja na zdravlje parodonta.The aim of this study was to examine the effects of a 10% carbamide peroxide bleaching gel (VivaStyle, Ivoclar Vivadent, Schaan, Liechtenstein) on periodontal health. Ten participants, 22 to 29 years of age, with clinically healthy periodontal tissues and a wish to change the shade of their teeth, participated in this study. Subjects were treated with 10% carbamide peroxide for one hour daily during 12 days. The volunteers were instructed to keep a diary of possible disturbances during the teeth whitening procedure. At baseline, on 6th and on 12th day API score and PBI score were measured and clinical photograph of teeth in intercuspidation relation was taken. All teeth demonstrated change of at least one shade. There was no change in either plaque accumulation, or gingival inflammation during the teeth whitening procedure. This teeth whitening procedure seems not to have any influence on the periodontal health

Oralne promjene kod pedijatrijskih bolesnika s poremećajima u jedenju

Numerous oral changes develop as a result of dysfunctional eating behavior in patients with eating disorders (ED). The aim of this study was to evaluate the correlation among oral manifestations, age, disease duration and nutritional status in pediatric patients with ED. The study included 50 female ED patients, median age 14 (range 10-18) years and median disease duration 9 (range 1-42) months. Nutritional status was expressed as z-score for body mass index (BMI). Mean BMI z-score was -2.10±1.64. The most commonly observed oral findings were dental plaque, marginal gingivitis, morsicatio, dental calculus, caries, pharyngeal erythema, exfoliative cheilitis and angular cheilitis. Dental plaque and pharyngeal erythema were correlated with shorter disease duration (p=0.048; p=0.040), while frictional keratosis of tongue was correlated with longer disease duration (0.011). Linea alba and pain in the temporomandibular joint were associated with younger age (p=0.012; p=0.024), and tooth impression on tongue with lower degree of nutrition (p=0.030). This study showed that there was a link among oral manifestations, age, disease duration and degree of nutritional disorder, although further investigations comparing the groups of ED patients with different age, disease duration and nutritional status would give better, concrete and precise conclusions.Poremećen odnos prema jelu u sklopu poremećaja u jedenju rezultira brojnim promjenama u usnoj šupljini. Cilj ovog istraživanja je bio utvrditi postoji li korelacija između pojavnosti promjena u usnoj šupljini, dobi, duljine trajanja poremećaja te stupnja uhranjenosti u pedijatrijskih bolesnika s poremećajima u jedenju. U istraživanju je sudjelovalo 50 bolesnica s poremećajem u jedenju prosječne dobi od 14 (raspon 10-18) godina i prosječnog trajanja bolesti od 9 (raspon 1-14) mjeseci. Stupanj uhranjenosti izražen je standardnom devijacijom indeksa tjelesne mase (ITM z-vrijednost). Srednja ITM z-vrijednost bila je -2,10±1,64. Najčešće promjene u usnoj šupljini bile su zubni plak, marginalni gingivitis, morsikacije, kamenac, karijes, eritem farinksa, eksfolijativni heilitis i angularni heilitis. Zubni plak i eritem farinksa bili su povezani s kraćim trajanjem poremećaja (p=0,048; p=0,040), a frikcijska keratoza jezika s duljim trajanjem poremećaja (0,011). Linea alba i bolovi u temporomandibularnom zglobu su bili povezani s mlađom dobi (p=0,012; p=0,024), a impresije zubi na jeziku s nižim stupnjem uhranjenosti (p=0,030). Ovo istraživanje je pokazalo da postoji povezanost između promjena u usnoj šupljini, dobi, trajanja poremećaja i stupnja uhranjenosti, no daljnja istraživanja koja će uspoređivati skupine bolesnika različite dobi, trajanja bolesti i različitog stupnja uhranjenosti dat će bolje, konkretnije i preciznije zaključke

Gingival Necrosis Caused by an Ill-Fitting Denture

U ovom prikazu opisali smo slučaj 80-godišnjeg pacijenta koji je bio upućen u Zavod za oralnu medicinu Stomatološkog fakulteta u Zagrebu zbog gingivalnog ulkusa prisutnog osam dana. Na kliničkom pregledu uočena je eksponirana kost na bezubom alveolarnom grebenu u području molara s desne strane mandibule veličine 0,8 cm u promjeru. Inače, pacijent je svakodnevno uzimao doksazosin jer je imao teškoća s urinarnim traktom te ipatropij-bromid zbog respiratornih tegoba. Donju djelomičnu protezu nije promijenio već šest godina. Na početku je, točnije prva tri dana, bio liječen parodontnim zavojem (Resopack, HagenWerken, Njemačka) uz preporuku da ne nosi protezu, no nakon tri dana klinički pregled nije pokazao poboljšanje stanja. Zato smo se odlučili na liječenje topikalnim kortikosteroidom (betametazon) i oralnim antiseptikom (klorheksidin-diglukonat) tri puta na dan. Nakon tri tjedna lezija je zacijelila. Naveden je popis mogućih čimbenika koji mogu rezultirati nastankom ulkusa gingive.We present a case of an 80-year-old male who was referred to the Department of Oral Medicine, School of Dental Medicine University of Zagreb, Croatia due to gingival ulcer which was present for eight days. Clinical examination has revealed exposed bone on the toothless alveolar ridge in the lower molar region on the right side of 0.8 cm in diameter. Otherwise, the patient was taking doxazosin due to urinary problems and ipatropium bromide due to respiratory problems. The patient wore a 6-year-old partial lower denture. He was initially treated with periodontal bandage (Resopack, HagenWerken, Germany) for the first three days and was instructed not to wear the denture; however, no benefit could be seen. Therefore, we added a local corticosteroid (betamethasone) and an oral antiseptic (chlorhexidine digluconate) applied three times a day. After 3 weeks the lesion healed. A list of possible causative factors regarding gingival ulcers is included

Effects of Low-Level Laser Treatment on Mouth Dryness

Mouth dryness (MD) is usually followed by inadequate mechanical cleaning of the mouth and decrease in the levels of salivary antimicrobial proteins (including secretory immunoglobulin A (sIgA)). It is accompanied by difficulties during speaking and food swallowing, with an unpleasant taste, burning sensations in the mouth and higher susceptibility to oral diseases. Low-level laser treatment (LLLT) can intensify cell metabolism and its application on salivary glands could improve salivation. The purpose of this study was to evaluate the effects of LLLT on salivation of patients suffering from MD. The study included 17 patients with MD. Their major salivary glands were treated with low intensity laser BTL2000 on 10 occasions. The whole unstimulated and stimulated saliva quantities were measured just before the 1st, after the 10th and thirty days following the last (10th) treatment. In the samples of unstimulated saliva concentrations of sIgA were estimated by using ELISA method and its quantity in the time unit was calculated. The visual analogue scale (VAS) score was used to assess burning and/or pain intensity at these three time points. Statistical tests revealed significant salivation improvement quantitatively and qualitatively, i.e. increase in the quantity of saliva and sIgA. VAS score was also significantly improved and no side effects were observed. Conclusions: According to the results of this study, application of LLLT to xerostomic patients’ major salivary glands stimulates them to produce more saliva with better antimicrobial characteristics and improves the difficulties that are associated with MD. This simple non-invasive method could be used in everyday clinical practice for the treatment of MD

Sindrom pekućih usta – goruća enigma

Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by an intraoral burning sensation and an absence of oral mucosal lesions and disturbances in laboratory findings. Burning symptoms usually affect the anterior two-thirds of the tongue, its lateral borders, hard palate and labial mucosa, but other oral cavity sites may also be affected. Taste alterations and a decrease in the salivary flow rate frequently accompany the burning symptoms. This condition mostly affects peri- and postmenopausal women. To date, the etiology of BMS remains unclear. This unknown etiology means that no appropriate treatment is currently available. A large number of the treatments and medications have been tried for BMS, but treatment management remains unsatisfactory in some patients. The purpose of this article is to present current knowledge on the treatment of BMS.Sindrom pekućih usta (SPU) kronično je bolno stanje koje je karakterizirano osjećajem žarenja u usnoj šupljini bez vidljivih promjena na sluznici i poremećaja u laboratorijskim nalazima. Simptomi žarenja obično zahvaćaju prednje 2/3 trećine i lateralne površine jezika, tvrdo nepce, labijalnu sluznicu, ali može biti zahvaćena bilo koja regija u usnoj šupljini. Simptomi žarenja obično su praćeni promjenom osjeta okusa te smanjenim lučenjem sline. Ovo stanje najviše pogađa žene u peri- i postmenopauzi. S obzirom na to da je etiologija SPU-a nepoznata, ne postoji niti odgovarajuće liječenje. Dostupno je više različitih terapija i lijekova za SPU, međutim, liječenje kod pojedinih pacijenata i dalje je bezuspješno. Svrha ovog rada je prikazati trenutno znanje o liječenju SPU-a

Psychological status and recurrent aphthous ulceration [Psihološki status i rekurentne aftozne ulceracije]

Recurrent aphthous ulceration (RAU) are a disease of an unknown etiology and mediated through T-cell lymphocytes. Evidence suggests that RAU is connected with chronic bowel disease, haematinic deficiencies, AIDS, food hypersensitivity and severe stress. The aim of this study was to determine whether differences in anxiety and depression could be seen in patients with RAU during acute phase and remision period and in comparison to the healthy controls. There were 30 patients with RAU (age range 36.27 +/- 15.308) and 30 controls aged 29.83 +/- 9.082. Every participant with RAU fullfilled STAI and Beck Depression Inventory II test during acute phase and during remission period as well as controls. Statistical analysis was performed by use of descriptive statistics and t-test. There are no differences in the level of depression and stress between the two phases of the RAU (acute versus remission period) as well as in comparison to the controls. Patients with acute RAU are more anxious than patients with RAU during remission period. We might conclude that psychological disturbances do not preceed the development of RAU and that the patients with acute RAU are more anxious when compared to the condition when they do not have RAU due to the discomfort they experience

Sialochemistry in Patients with Oral Lichen Planus

Svrha: Zna se da određeni sastojci sline mogu biti poremećeni kod bolesnika koji pate od oralnoga lichen planusa (OLP-a), no rezultati objavljenih istraživanja nisu konzistentni. Svrha ovog istraživanja bila je odrediti koncentraciju salivarnih analita u sklopu salivarnih enzima koji održavaju integritet oralnih sluznica, a on je oštećen kod oboljelih od oralnoga lichen planusa. Ispitanici i postupci: Skupini od 25 bolesnika s OLP-om (73±1,4 godine) i 24 kontrolna ispitanika (24±3,7 godina) određeni su u slini ukupni proteini, amilaza, magnezij, kalcij, bakar, klorid, fosfat i kalij. Ukupni proteini određeni su kolorimetrijskom metodom uz pirogalol. Natrij, kalij i klorid izmjereni su indirektnom potenciometrijom, bakar i magnezij atomskom apsorpcijskom spektrofotometrijom, a fosfat kolorimetrijskom uz pomoć molibdata. Statistička analiza obavljena je uz pomoć χ2 testa, Mann–Whitneyeva U-testa, analizom kovarijance i Spearmanovom korelacijom. Rezultati: Znatno povišene vrijednosti salivarnog klorida pronađene su kod oboljelih od OLP-a u odnosu prema sudionicima u kontrolnoj skupini (p=0,025). Nakon toga, kada su dobiveni rezultati prilagođeni s obzirom na količinu izlučene sline, ustanovljene su povišene vrijednosti salivarnog kalija, natrija, klorida i ukupnih proteina kod oboljelih od oralnoga lichen planusa u odnosu prema kontrolnoj skupini (p=0,622; p=0,504; p=0,00; p=0,586). Koncentracija salivarnih analita nije bila povezana s pušenjem. Zaključak: Povišene vrijednosti salivarnog natrija, kalija i klorida vjerojatno su posljedica velikih razlika u količini izlučene sline između oboljelih od OLP-a i sudionika u kontrolnoj skupini i ne upućuju na pojačanu antimikrobnu aktivnost kod bolesnika s OLP-om.Objective: It is well known that certain salivary constituents might be disturbed in patients suffering from oral lichen planus (OLP), however, the results of the published studies are inconsistent. The aim of this study was to assess the concentrations of salivary analytes because most of them are part of salivary enzymes which maintain integrity of the oral mucosa which is compromised in OLP patients. Materials and Methods: In 25 patients with OLP (73±1.4 yrs) and in the 24 controls (24±3.7yrs) levels of total proteins, amylase, salivary magnesium, calcium, copper, chloride, phosphate, potassium and sodium were determined. Total proteins were determined by pyrogalol colorimetric method. Amylase levels were determined by continued colorimetric method. Salivary sodium, potassium and chloride were determined by indirect potentiometry whereas salivary copper and magnesium were determined by atomic absorption spectrophotometry whereas phosphates were determined by colorimetric method with use of molybdate. Statistical analysis was performed by use of χ2 test, Mann Whitney U test analysis of covariance and Spearman´s correlation. Results: Significantly higher concentration of salivary chloride was detected in OLP patients in comparison to the controls (p=0.025). Furthermore, when the obtained results for salivary analytes were adjusted with respect to the salivary flow rate, increased levels of salivary potassium, sodium, chloride and total proteins were found in patients with OLP when compared to the controls (p=0.622; p=0.504; p=0.600; p=0.586). Concentrations of salivary analytes were not affected by smoking habit. Conclusions: Increased levels of salivary sodium, potassium and chloride are probably a result of significant differences in salivary flow rate between patients with OLP and controls and do not indicate increased salivary antimicrobial activity