Epidemiologija and etiologija pločastog karcinoma glave i vrata

Introduction: It was expected at least in Western countries that incidence of head and neck cancers (HNSCC) should become lower due to the propaganda against smoking. However, the expected decrease in HNSCC was not achieved in many countries. Tobacco and alcohol consumption are known as a major risk factors for development of HNSCC. It is well known that 15-20% of HNSCC are linked to HPV infection, however, some authors reported coexistence with other viruses as well. In the Eastern countries paan (betel nut), ghutka, that have been also linked to the development HNSCC. However, lately HNSCC have been linked to the low vegetable and fruit intake, vitamin defi ciencies, coinfection with other viruses, certain genetic syndromes and occupational exposure. Therefore, the aim of this study is to review recent literature regarding epidemiology and other risk factors in the development of HNSCC. Methods: Pubmed was searched in the past two years in order to fi nd out novelties regarding epidemiology and aetiology for HNSCC and 34 papers were included. Results and Conclusion: The results of this review paper show that smoking is a major contributing factor especially with alcohol both being dosed and time dependent in the development of HNSCC. Unhealthy diet, decrease in vitamin intake especially folate, C and E vitamin and occupational exposure were seen in the diseased. In about one fourth of the patients infection with HPV has been noticed, and in some coinfection with other viruses such as Epstein Barr, cytomegalovirus and HIV. Obviously genetic predisposition exists but also correlation with certain genetic syndromes such as Fanconi’s anaemia and Bloom syndrome.Uvod: Očekivalo se barem u Zapadnim zemljama kako će incidencija karcinoma glave i vrata biti manja uslijed propagande protiv pušenja. Ipak, očekivano smanjenje u incidenciji karcinoma glave i vrata nije postignuto u mnogim zemljama. Pušenje i konzumacija alkohola su glavni faktori rizika za nastanak karcinoma glave i vrata. Dobro je poznato da je 15-20% karcinoma glave i vrata povezao s HPV infekcijom, doduše, neki autori su izvijestili i o koegzistenciji s drugim virusima također. U istočnim zemljama paan (betel nut), ghutka su također povezani s nastankom carcinoma glave i vrata. Ipak, nedavno je karcinom glave i vrata povezan s rijetkim unosom povrća i voća, defi citom vitamina, koinfekcijom s drugim virusima, određenim genetskim sindromima i radnim okolišem. Stoga je cilj ovog istraživanja bio pregledati noviju literature s obzirom na epidemiologiju i druge rizične faktore u nastanku karcinoma glave i vrata. Metode: Pubmed je pretražen u zadnje dvije godine kako bi se ustanovilo novosti vezane uz epidemiologiju i etiologiju karcinoma glave i vrata te su 34 rada uključena. Rezultati i zaključci: Rezultati ovog preglednog rada pokazuju kako je pušenje najvažniji faktor koji doprinosi nastanku karcinoma glave i vrata uz konzumiranje alkohola, a što ovisi o dozi i vremenu izloženosti. Nezdrava prehrana,smanjeni unos vitamina, posebice folata, C i E vitamina i radni okoliš se ustanove u oboljelih. U oko četvrtine pacijenata je ustanovljena infekcija s HPV virusom, a u nekih i koinfekcija s drugim virusima poput Epstein Barrovog, citomegalovirusa i HIV-a. Očito genetska predispozicija postoji ali i korelacija sa određenim genetskim sindromima poput Fankonijeve anemije i Bloomovog sindroma

Orofacial Pain of Non-Odontogenic Cause-Retrospective Study on 100 Patients Referred to the Primary Dental Health Care

Dijagnoza orofacijalne boli je esencijalna i često nedovoljno cijenjena sastavnica stomatološke prakse. Svrha ovoga retrospektivnog ispitivanja bila je ustanoviti uzroke, navesti dijagnostičke postupke i kliničke manifestacije neodontogene orofacijalne boli u 100 pacijenata koji su upućeni u primarnu stomatološku zaštitu. U naših bolesnika bol se je najčešće javljala u maksili, zatim mandibuli, uhu i TMZ-u. Upala je kod većine bila prateći simptom. Karakter boli opisan je kao duboka, jednostrana, tupa, izdrživa i pulsirajuća bol. 44 pacijenta su navela stres i podjedanko su raspoređeni po spolu. Prosječno trajanje simptoma prije dolaska stomatologu bilo je 4,23 mjeseca. Prosječno trajanje boli jednom kad bi počela bilo je 8 sati. Najčešći uzroci neodontogene boli su bili maligni tumori usne šupljine, bolesti TMZ-a i trigeminalna neuralgija.The diagnosis of orofacial pain is an essential and frequently undervalued component of dental practice. The aim of this retrospective study was to report causes, diagnostic procedures applied and clinical manifestations of non-odontogenic orofacial pain in patients referred to primary dental care. In our patients, pain most frequently occurred in the maxilla, followed by the mandible, ear and temporomandibular joint (TMJ). Out of the accompanying symptoms, inflammation was reported in most of the patients. The character of the pain was described as deep, unilateral, dull, bearable, and pulsing. Forty-four patients reported stress with equal distribution according to the gender of patients. The average duration of pain before seeking the professional help of a dentist was 4.23 months. The average duration of pain once it had started was 8 hours. Most frequent causes of non-odontogenic pain in our patients were malignant tumors in the oral cavity, followed by TMJ disorders and trigeminal neuralgia

Epidemiologija and etiologija pločastog karcinoma glave i vrata

Introduction: It was expected at least in Western countries that incidence of head and neck cancers (HNSCC) should become lower due to the propaganda against smoking. However, the expected decrease in HNSCC was not achieved in many countries. Tobacco and alcohol consumption are known as a major risk factors for development of HNSCC. It is well known that 15-20% of HNSCC are linked to HPV infection, however, some authors reported coexistence with other viruses as well. In the Eastern countries paan (betel nut), ghutka, that have been also linked to the development HNSCC. However, lately HNSCC have been linked to the low vegetable and fruit intake, vitamin defi ciencies, coinfection with other viruses, certain genetic syndromes and occupational exposure. Therefore, the aim of this study is to review recent literature regarding epidemiology and other risk factors in the development of HNSCC. Methods: Pubmed was searched in the past two years in order to fi nd out novelties regarding epidemiology and aetiology for HNSCC and 34 papers were included. Results and Conclusion: The results of this review paper show that smoking is a major contributing factor especially with alcohol both being dosed and time dependent in the development of HNSCC. Unhealthy diet, decrease in vitamin intake especially folate, C and E vitamin and occupational exposure were seen in the diseased. In about one fourth of the patients infection with HPV has been noticed, and in some coinfection with other viruses such as Epstein Barr, cytomegalovirus and HIV. Obviously genetic predisposition exists but also correlation with certain genetic syndromes such as Fanconi’s anaemia and Bloom syndrome.Uvod: Očekivalo se barem u Zapadnim zemljama kako će incidencija karcinoma glave i vrata biti manja uslijed propagande protiv pušenja. Ipak, očekivano smanjenje u incidenciji karcinoma glave i vrata nije postignuto u mnogim zemljama. Pušenje i konzumacija alkohola su glavni faktori rizika za nastanak karcinoma glave i vrata. Dobro je poznato da je 15-20% karcinoma glave i vrata povezao s HPV infekcijom, doduše, neki autori su izvijestili i o koegzistenciji s drugim virusima također. U istočnim zemljama paan (betel nut), ghutka su također povezani s nastankom carcinoma glave i vrata. Ipak, nedavno je karcinom glave i vrata povezan s rijetkim unosom povrća i voća, defi citom vitamina, koinfekcijom s drugim virusima, određenim genetskim sindromima i radnim okolišem. Stoga je cilj ovog istraživanja bio pregledati noviju literature s obzirom na epidemiologiju i druge rizične faktore u nastanku karcinoma glave i vrata. Metode: Pubmed je pretražen u zadnje dvije godine kako bi se ustanovilo novosti vezane uz epidemiologiju i etiologiju karcinoma glave i vrata te su 34 rada uključena. Rezultati i zaključci: Rezultati ovog preglednog rada pokazuju kako je pušenje najvažniji faktor koji doprinosi nastanku karcinoma glave i vrata uz konzumiranje alkohola, a što ovisi o dozi i vremenu izloženosti. Nezdrava prehrana,smanjeni unos vitamina, posebice folata, C i E vitamina i radni okoliš se ustanove u oboljelih. U oko četvrtine pacijenata je ustanovljena infekcija s HPV virusom, a u nekih i koinfekcija s drugim virusima poput Epstein Barrovog, citomegalovirusa i HIV-a. Očito genetska predispozicija postoji ali i korelacija sa određenim genetskim sindromima poput Fankonijeve anemije i Bloomovog sindroma

Stimulation of Saliva in Physiological Conditions by C-Vitamins and Chewing gum

U 20 žena i 20 muškaraca, studenata 5. godine stomatologije, sa zdravim oralnim sluznicama i saniranim zubima, kvantificirana je nestimulirana i stimulirana slina. Prvim mjerenjem, koje je provedeno tako da su je izbacivali u epruvetu (0,1 skala) tijekom 5 minuta, određena je nestimulirana slina. Sedam dana poslije mjerena je stimulirana slina pošto su studenti pili vodenu otopinu askrobinske kiseline (lg na 1 del), te skupljali slinu u epruvetu tijekom 5 minuta. Mjerenjem nakon 14 dana dobivena je stimulirana slina pošto su 1 minutu žvakali žvakaću gumu “Orbit ”, te izbacivali slinu u epruvetu tijekom 5 minuta. Svrha istraživanja bila je odrediti razlike u količini nestimulirane i stimulirane sline, ovisnost sekrecije sline o vrsti stimulacije, razlike u količini sline prema spolu. Rezultati pokazuju da su vrijednosti nestimulirane sline manje od vrijednosti stimulirane, C-vitamin povećava sekreciju za 35%, a “Orbit” za 70%. Muškarci izlučuju veće količine nestimulirane sline i stimulirane C-vitaminom i “Orbitom” u odnosu na prema ženama i to u omjeru 1:1,5.Zvakača se guma preporučuje u sijalometrijske i terapijske svrhe lokalne stimulacije.Stimulated and unstimulated saliva was quantified in 20 female and 20 male 5th year students of dentistry with healthy oral mucoous membranes and treated teeth. In the first measuring unstimulated saliva was determined by collecting in a test tube (0.1 scale) during 5 minutes. Stimulated saliva was measured 7 days later after drinking a water solution o f asorbic acid (Ig to ldcl), and collecting in a test tube during 5 minutes. After 14 days stimulated saliva was measured after chweing uOrbit” chewing gum for one minute and collecting in a test tube during 5 minutes. The aim o f the investigation was to determine the difference in the amount o f stimulated and unstimulated saliva; dependence o f saliva secretion on the type o f stimulation, and the difference in the amount o f saliva according to sex. The results show that the values o f unstimualted saliva are lower than the values o f stimulated saliva, and the C-vitamin increases secretion by 35%, and “Orbit” chewing gum by 70%. Male students excreted a greater quantity o f unstimulated saliva and saliva stimulated by C-vitamin and “Orbit” compored to the female students (ratio 1:1.5).Chewing gum is recommended for the purpose of sialographic and therapeutic local stimulation

Xerostomia: an Update

Kserostomija može znatno utjecati na oralno zdravlje i kvalitetu života. Mnogobrojne nove terapije stalno se razvijaju i vrjednuju, ali općenito i dalje se teško liječe bolesti žlijezda slinovnica smještenih u podlozi. Važno je kod svih bolesnika s dugotrajnom kserostomijom obaviti pretrage koje će otkriti uzrok i bolesnicima omogućiti odgovarajuću profesionalnu oralnu njegu.Xerostomia can have a significant adverse effect upon oral health and quality of life. A variety of new therapies are continuously being developed and assessed, but in general the treatment of the underlying salivary gland disease remains difficult. It is important, however, that all patients with long-standing xerostomia are appropriately investigated to establish the underlying aetiology, and to receive professional oral health care

Mandibular osteonecrosis due to the pulpal-periodontal syndrome: a case report and review of the literature

OBJECTIVE: Ishemic bone disease has multifactorial etiologies. Cronic dental infections should be eliminated to prevent osteonecrosis of the jaw. ----- CASE REPORT: We report an unusual case of osteonecrosis due to the pulpal-peridontal syndrome and subsequent pulp necrosis. A case of 38 year old woman who presented with exposed bone, 8 mm in diameter, in the lingual area of the right lower third molar. The patient was otherwise healthy and was not taking any medications. A detailed medical history showed no previous diseases. Patient denied any type of local trauma. A complete blood count showed no abnormalities. The panoramic radiograph revealed a deep periodontal pocket between teeth 47 and 48. The CBCT revealed a deep periodontal pocket between molars and bone sequestrum of the lingual plate. Topical treatment consisted of adhesive periodontal dressing based on the cellulose and bethamethasone oitnment together with orabase, without improvement. Therefore, peroral amoxycillin was prescribed for a week. Since there was no improvement, the third molar was removed as well as necrotic bone; the alveolar bone was remodelled and sutures were placed. After suturing, the whole area was covered using intraoral resorbable bandage. Microbial swab of the wound aspirate did not reveal polymorphonuclears or the presence of microorganisms. Microbial swab of the biopsy specimen of the necrotic bone particle and sequestrum showed a large amount of gram-positive coccae, however, polymorphonuclears were not found. Histopathological analysis revealed acute chronic inflammation. One week after the surgery, the area healed completely. ----- CONCLUSION: This case highlights the fact that in some patients bone exposure might develop due to the pulpal-periodontal syndrome i.e. pulp necrosis

Quantity of Salivary Immunoglobulin A, Lysozyme and Magnesium in Patients with Burning Mouth Syndrome and Xerostomia

Nedavne studije izvješćuju o povezanosti između sindroma pečenja usta te količine i sastava sline. Svrha našeg ispitivanja bila je ustanoviti količinu salivarnog imunoglobulina A, lizozima i magnezija u nestimuliranoj i stimuliranoj ukupnoj slini bolesnika sa sindromom pečenja usta (SPU) i kserostomijom. Uzorci sline dobiveni su sijalometrijom. Salivarni IgA je određen radijalnom imunodifuzijom po Manziniju, količina lizozima po metodi Osserman i Lowlor, a magnezij je određen atomskom apsorpcijskom spektrofotometrijom. Količina sIgA i lizozima bila je znatno snižena u stimuliranoj ukupnoj slini bolesnika sa SPU i kserostomijom u usporedbi s nestimuliranom (p<0,001). Količina magnezija nije se mijenjala s obzirom na stimulaciju sline. Rezultati našeg ispitivanja pokazuju da količina sline ima utjecaja na sastav sline te da zajedno mogu biti jedan od mnogobrojnih etioloških čimbenika u nastanku simptoma sindroma pečenja usta.Recent studies suggest a connection between burning mouth syndrome (BMS) and the quantitiy and quality of saliva. The aim of our study was to determine quantities of salivary immunoglobulin A (sIgA), lysozyme and magnesium in unstimulated and stimulated saliva of patients with burning mouth syndrome and xerostomia. Salivary samples were obtained by sialometry. Salivary immunoglobulin A was determined by radial immunodiffusion according to Manzini, lysozyme levels were obtained according to Osserman and Lowlor, and magnesium was determined using atomic absorbance spectrophotometry. Levels of sIgA were decreased in stimulated whole saliva of patients with BMS and xerostomia when compared to those in unstimulated saliva (p<0.001). Lysozyme levels were also lower in stimulated whole saliva in such patients when compared to the levels in unstimulated saliva (p<0.001). Magnesium levels remain unchanged with regard to the salivary stimulation. The results of our study indicate that the quantity and quality of saliva could have an impact on symptoms of burning mouth syndrome

Evaluation of Periodontal Status in HIV Infected Persons in Croatia

A number of periodontal changes have been associated with human immunodeficiency virus (HIV) infection, however our knowledge of the epidemiology, microbiology, host response and natural history of these conditions remains limited. Therefore, the aim of our study was the assessment of possible differences in periodontal status of HIV infected subjects when compared with healthy controls matched for age, gender and smoking habit in Croatian population. Assessment included measurement of plaque accumulation using aproximal plaque index, measurement of gingival inflammation by use of sulcus bleeding index, pocket depth, gingival recession as well as the number of decayed, missing and filled teeth in 25 HIV infected subjects (age range 22–61, X=40.8 years) in comparison with 25 healthy controls (age range 20–62, X=40.9 years). Statistical analysis was performed by use of descriptive statistics and Mann-Whitney U test showed significantly increased level of inflammation of the marginal gingiva in HIV infected subjects when compared to the controls (p<0.002). Significantly increased mean values of periodontal pockets (p<0.002) and the deepest periodontal pocket (p<0.003) were also observed when HIV infected subjects were compared to the healthy controls. In HIV infected subjects there was significant increase in the number of decayed, missing and decrease in the number of filled teeth (p<0.002; p<0.002; p<0.009, respectively). The results of this study once again highlight the need for more prevalent periodontal check-ups and treatments in HIV infected subjects

Connection Between the Course of Neurodermitis and Oral Focus Finding

U radu je opisan slučaj bolesnice koja boluje od neurodermitisa i u koje je potvrđen nalaz oralnoga fokusa. Pogoršanje tijeka neurodermitisa koincidiralo je s otkrićem oralnoga fokusa, a nakon eliminacije oralnoga fokusa stanje neurodermitisa se je poboljšalo.A case of a patient suffering from neurodermitis, and with a finding of oral focus is described. The worsening of neurodermitis was concomitant with a finding of oral focus. After elimination of the focus, neurodermitis regressed from the severe form

White Sponge Nevus

Opisan je slučaj 45-godišnje žene koja obostrano na obraznoj sluznici ima bijele hiperkeratotične promjene. Anamnestički podatci, klinički nalaz te biopsijski nalaz u usnoj šupljini upućuju na dijagnozu bijelog spužvastog nevusa.A 45-year old woman was referred to our Department with bilateral white lesions on the buccal mucosa. Detailed medical history, clinical appearance including a histopathologic finding revealed a diagnosis of white sponge nevus