Oral fluids and auxiliary diagnostic techniques in autoimmune and neuropathic disorders of the oral cavity. Local and systemic implications. Fluidi orali e tecniche ausiliarie diagnostiche nei disordini autoimmuni e neuropatici del cavo orale. Implicazioni locali e sistemiche.

Abstract

In this dissertation different features of oral fluids were analyzed in order to verify whether saliva and/or the crevicular fluid may be helpful in diagnosing underlying pathologies, monitorizing systemic diseases activity or contributing to a better understanding of idiopathic oral pathologies. - In the first study, saliva was quantitatively analyzed through the spitting method in a group of patients affected by the most common idiopathic psychosomatic disorder of the oral cavity, known as Burning Mouth Syndrome. This study showed how saliva is a complex fluid, and that the central nervous system and emotional attitudes are very strong influencing agents on the oral health. - In the second study, 35 patients affected by Oral Lichen Planus, an autoimmune disorder, were recruite. Salivary fluid and crevicular fluid samples were collected to measure the presence of Human ß2-defensin, an antimicrobial peptide involved in immunomodulatory functions. It was observed that HBD-2 could become a very important index to measure the disease’s activity and its evolution in the future. - In the third study it was demonstrated that periodontal pockets and saliva contain Helicobacter pylori and that oral hygiene is useful in preventing the formation of a reservoir of microorganisms involved in gastritis and gastric cancer. - In the fourth study, a total group of 34 patients affected by Rheumatoid Arthritis were examined and several links between rheumatic factors and periodontal indices were found. In the end, a total number of 240 patients were recruited in this experimental work and each study contributed to new topics in the research on saliva and crevicular fluid as potential diagnostic tools for oral pathologies and systemic diseases