The aim of this study was to investigate the effect of low-level laser irradiation on the secretory function of salivary glands in 34 patients with xerostomia (dry mouth).
Xerostomia, a common ...complaint of oral dryness within the elderly population, is caused by a reduction in normal salivary secretion due to different causes. Treatment is aimed at increasing salivary flow, although in most cases it remains palliative.
In this study, laser light from a pulsed Ga-As laser operating at 904 nm was applied bilaterally on each salivary gland area: extraorally on the parotid and submandibular gland areas and intraorally on the sublingual gland area. The operational probe distance from the irradiated area was 0.5 cm resulting in an irradiance of 246 mW/cm(2). The exposure time was 120 sec per daily treatment during 10 consecutive days. The average energy density per exposure was 29.5 J/cm(2). The control group consisted of 16 patients who were treated with 15 mL of a 2% citric acid solution applied as a mouth rinse for 30 sec.
The average difference in the amount of salivation (dQ-sal, mL/min) before and after laser therapy increased linearly from dQ-sal = 0.05 mL/min on the first day, up to dQ-sal = 0.13 mL/min on the last (10th) day of therapy. In the control group, the average dQ-sal initially demonstrated a gradual increase, with a reversal of the trend toward the end of the therapy period and eventually yielding no correlation between the duration of therapy and dQ-sal.
The results of our study indicate that the effects of low-level laser therapy on salivary glands are not only stimulating, but also regenerative to a degree since the glandular response to the same amount of applied laser energy increased linearly over time.
Objectives Current recommendations for safe and effective dental management are less than optimal for some medical conditions because of limited evidence, conflicting conclusions, or both. This ...review (1) compiled and evaluated dental management recommendations for select medical conditions; (2) summarized recommendations and their assigned levels of evidence; (3) identified areas of conflict, ambiguity, or both; and (4) identified issues that warrant future research, enhanced consensus statements, or both. Study Design Systematic literature searches were performed for guideline publications, systematic and narrative reviews, and opinion documents containing recommendations for (1) medication-related osteonecrosis of the jaw (MRONJ); (2) cardiovascular diseases (CVDs); (3) prosthetic joints (PJs); and (4) systemic steroid therapy (SST). Results The search yielded the following numbers of publications that met the inclusion criteria: MRONJ – 116; CVDs – 54; prosthetic joints – 39; and systemic steroids – 12. Conclusions Very few of the compiled recommendations were assigned or linked to levels of evidence by their authors. Key conclusions include the following: MRONJ–expert recommendations trend toward proceeding with dental treatment with little to no modification in osteoporotic patients on bisphosphonates; CVDs–current recommendations are primarily directed to general surgery and applied to dentistry; PJs–routine antibiotic prophylaxis is not indicated for dental treatment; and SST–steroid supplementation is not indicated for most patients undergoing dental procedures under local anesthesia.
Summary
Drug-induced lesions of oral mucosa are well-established side effect of different commonly used drugs. A female patient under treatment for hypertension with an angiotensin-converting enzyme ...inhibitor (ACE inhibitor), lisinopril, developed blisters and ulcerations on oral mucosa 3 weeks after lisinopril intake. Due to clinical finding drug-induced pemphigus was considered. However, direct and indirect immunofluorescence analysis revealed no autoantibodies that are commonly present in pemphigus while histological study suggested allergic reaction. Lisinopril was discontinued from further therapy and after a month after her first arrival patient has experienced complete remission of the disease. This case raises the question, whether the term pemphigus in drug-induced reactions could be used when immunopathological criteria for pemphigus are not fulfilled.
Given long-term effect on oral tissues due to contact with dental appliances, the biocompatibility studies of casting alloys are of great importance. It has been previously documented that metal ...dental appliances, due to corrosion, might induce genotoxic and mutagenic effects in cells. Therefore, the aim of presented study was to examine the genotoxicity of two dental casting alloys (Co-Cr-Mo and Ni-Cr) commonly used in fixed and removable prosthodontic appliances that are in contact with the oral epithelium for 5 years or more. For that purpose, 55 age-matched subjects were included in the study; 30 wearers of prosthodontic appliances and 25 controls. Buccal cells of oral mucosa were collected and processed for further analysis. The cell viability has been assessed by trypan blue exclusion test, while genotoxic effect of metal ions on DNA in oral mucosa cells was studied by use of alkaline comet assay. Results have shown significantly higher comet assay parameters (tail length and percentage DNA in the tail) in the group wearing metal appliances. Both subjects with Co-Cr-Mo alloy and Ni-Cr alloy showed significantly higher comet assay parameters when compared with controls. It has been confirmed that metal ions released by the two base metal dental casting alloys examined in this study, might be responsible for DNA damage of oral mucosa cells. Therefore, the results of this study emphasize the importance of the in vivo evaluation of dental materials with respect to their genotoxicity, which is of major importance to ensure long-term biocompatibility.
It has been documented in vitro and in vivo that metal dental appliances release metal ions due to corrosion. Dentists must choose among many dental casting alloys available, often without knowledge ...of their biological properties and effect on oral mucosa. The aim of this study was to measure metal content of nickel (Ni) and chromium (Cr) in whole saliva of 85 patients with and without metal dental appliances. Unstimulated whole saliva was collected and analyzed by using electrothermal atomic absorption spectrometry. History data, subjective complaints and objective findings on oral mucosa were recorded. The concentration of metal ions was investigated in correlation to burning mouth syndrome, erythema of oral mucosa, pH and smoking habit. Results showed a higher Ni concentration in patients with metal restorations, especially wearers of predominantly base metal appliances. The concentration of Cr showed no difference between patient groups. Although burning mouth syndrome was more frequent in the group with dental casting alloys, there was no correlation between higher Ni and Cr concentrations and burning mouth syndrome. Erythema of oral mucosa was a common finding in study patients, but did not correlate with salivary Ni and Cr ion concentrations. Salivary Ni and Cr concentrations were not related to either pH or smoking habit.
Oral mucosal lesions during orthodontic treatment BARICEVIC, MARINKA; MRAVAK-STIPETIC, MARINKA; MAJSTOROVIC, MARTINA ...
International journal of paediatric dentistry,
March 2011, Letnik:
21, Številka:
2
Journal Article
Recenzirano
Background
Oral mucosal lesions can result from irritation caused by orthodontic appliances or malocclusion, but their frequency is not known.
Aim
To examine the frequency of oral mucosal lesions in ...wearers of orthodontic appliances in comparison to children with malocclusion.
Design
This study comprised 111 subjects: 60 wearers of orthodontic appliances and 51 controls (aged between 6 and 18 years). Type and severity of mucosal lesions, their topography, gingival inflammation, and oral hygiene status were determined by using clinical indices.
Results
Mucosal lesions were more present in wearers of orthodontic appliances than in children with malocclusion. Gingival inflammation, erosion, ulceration, and contusion were the most common findings in orthodontic patients. The severity of gingival inflammation was in correlation with oral hygiene status; the poorer oral hygiene, the more severe gingival inflammation was. Better oral hygiene status was found in children during orthodontic treatment than in children with malocclusion.
Conclusions
Orthodontic treatment carries a higher risk of mucosal lesions and implies greater awareness of better oral hygiene as shown by the results of this study. Oral hygiene instructions and early treatment of oral lesions are important considerations in better patient’s motivation, treatment planning, and successful outcome.
The aim of this study was to investigate the role of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) in detecting latent tuberculosis in immunocompromised patients before introducing tumor necrosis ...factor (TNF-α) antagonists. The study included 300 subjects of similar age. The study group comprised of 150 QuantiFERON (QFT) positive subjects with rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis and psoriatic arthritis, while control group comprised of 150 QFT negative respondents with the same diseases. Exhaustive medical history was documented for all patients. Screening tests were performed including QFT-GIT, tuberculin skin test (TST), chest radiography and detection of Mycobacterium tuberculosisin sputum culture 2 times. A positive QFT-GIT test result, regardless of TST result, was considered as an indication for latent tuberculosis infection (LTBI) treatment. Results of this study showed good correlation between the conclusive results of QFT-GIT and TST. All study group patients had normal clinical findings, normal radiologic findings and negative results of sputum microbiological analysis during the course of prophylaxis and after its completion and during the course of biological therapy. Conversion of positive QFT-GIT test to negative was observed in 4% of study group patients, while QFT negative respondents remained negative. There was a statistically significant positive correlation between QFTGIT, TST results and patient age, smoking habit and contact with tuberculosis. Study results showed that along with good clinical evaluation and detailed medical history, it is important to conduct testing in order to avoid disease progression or unnecessary isoniazid prophylaxis.
The aim of this retrospective study was to determine the frequency and malignant transformation rate of oral lichen planus and leukoplakia in a large group of oral medicine patients. Study included ...12 508 patients who were referred between 1998 and 2007 to the Department of Oral Medicine. The frequency of OLP was 4.30%, leukoplakia 1.11%, and combined diagnoses 0.14%. In primary biopsies dysplasia was found in 12.96% of patients with leukoplakia and not in one with OLP and combined lesions. The highest frequency of leukoplakia was found in smokers. Women were found as predominant sufferers of both diseases and their combination. During the observed period often years malignant transformation of OLP was not detected, unlike leukoplakia where it was 0.64%. The frequency of OLP and leukoplakia in our study are comparable to other similar studies. The highest frequency of malignant transformation was observed in those patients who did not respond to our invitation to regular check-up. It is therefore neccessary to perform a detailed examination of the oral cavity in these patients and to raise patients awareness of the disease and the importance of regular follow-up.
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