Abstract To evaluate applicability of Demirjian and Willems methods for calculating dental age of children in the Former Yugoslav Republic of Macedonia we analyzed panoramic radiographs of 966 ...children (485 female and 481 male, aged 6–13 years) treated at the University and Community Dental Clinics in Skopje using four Demirjian methods and a Willems method for determining dental ages. Intra-rater and inter-rater agreement of mineralization stages were 0.86 and 0.82, respectively. All methods significantly overestimated dental age when compared to the chronological age ( p < 0.001). In males, the lowest overestimation was shown using Willems method (0.52 ± 0.87 years), followed by Demirjian methods from 1976 using PM1 , PM2 , M1 , M2 teeth (0.69 ± 0.92 years) and using I2 , PM1 , PM2 , M2 teeth (0.80 ± 0.98 years). The greatest overestimation were shown using Demirjian methods using 7 teeth from 1976 (0.92 ± 0.99 years) and method from 1973 (1.06 ± 1.07 years). In females, the lowest overestimation was shown using Willems method (0.33 ± 0.83 years) than the Demirjian method using PM1 , PM2 , M1 , M2 teeth (1.00 ± 1.01 years), following methods from 1976 using 7 teeth (1.03 ± 1.01 years) and I2 , PM1 , PM2 , M2 teeth (1.12 ± 0.96 years). The greatest overestimation was for method from 1973 using 7 teeth (1.17 ± 0.98 years). Willems method was the most accurate while Demirjian's methods for dental age calculation are not suitable on children from the Former Yugoslav Republic of Macedonia.
Objective
To analyze the correlations of saliva production and pH value with disease activity, disease severity, and oral health-related quality of life in patients with diffuse cutaneous systemic ...sclerosis (dcSSc) without concomitant Sjögren’s syndrome (SS) or SS-related antibodies.
Methods
This cross-sectional study included 28 patients with dcSSc and matching healthy controls. Sialometric assessment and caries status were compared between the two groups. Clinical and laboratory parameters were used to evaluate disease severity, in accordance with the Medsger Severity Scale.
Results
In patients with dsSSc, reduced saliva production and higher pH value were associated with disease activity and severity; moreover, caries status was correlated with SSc disease characteristics, including disease duration and disease severity. Oral health-related quality of life was negatively correlated with mean salivary flow rate.
Conclusions
These findings contradict the existing notion that reduced saliva production in patients with SSc is linked to SS-related antibodies or caused by underlying SS. In addition, patients with dcSSc exhibit elevated risk of cardiovascular disease and invasive dental treatment has been shown to enhance the rates of stroke and heart attack in the general population; therefore, oral health is particularly important in patients with SSc.
Objective
This study was performed to identify a possible association of the clinical parameters of systemic sclerosis (SSc) and the socioeconomic status (SES) with oral health-related quality of ...life (OHrQoL) as measured by the Oral Health Impact Profile 49 (OHIP 49), taking into account the effect of educational level (as a proxy of SES) on oral health.
Methods
Subjects were recruited from the Croatian SSc Center of Excellence cohort. Detailed dental and clinical examinations were performed according to standardized protocols. The associations of OHrQoL with disease characteristics and socioeconomic status were examined.
Results
Thirty-one consecutive patients with SSc were enrolled (29 women; mean age, 56.45 ± 13.60 years). OHIP 49 scores were significantly correlated with disease activity and severity. Furthermore, OHrQoL was positively correlated with skin involvement as evaluated by the modified Rodnan skin score. Impaired OHrQoL was positively correlated with the severity of general, skin, gastrointestinal, and joint/tendon involvement. The OHIP 49 score differed between patients who were positive and negative for anti-topoisomerase I antibody. Higher OHIP 49 scores were detected in patients with lower SES (primary school educational level).
Conclusion
Collaboration between rheumatologists and dental professionals is required to improve dental care and oral health outcomes of SSc.
Data on oral lesions of coronavirus disease (COVID-19) are conflicting, and there are few evidence-based data on oral lesions directly caused by severe acute respiratory syndrome coronavirus 2 ...(SARS-CoV-2). The aim of this case series and literature review is to determine the prevalence of oral lesions associated with COVID-19 in outpatients and identify oral manifestations that are likely associated with COVID-19. We present 15 patients that came for their first specialist examination to the Oral Medicine Outpatient Clinic, Dental Clinic, Split, Croatia between November 2020 and January 2024. Their medical and dental history was taken following CARE guidelines. The prevalence of oral lesions associated with SARS-CoV-2 was 1.42% during the 4-year follow-up period. The most common oral lesions were nonspecific erosions, stomatitis, salivary flow disorders (xerostomia, oligosialia), salivary gland diseases (sialadenitis, chronic sialadenitis), candidiasis, pigmentation, aphthae, burning mouth syndrome, and geographic and fissured tongue. The mean latency period was 25.1 days. The site most commonly affected was the tongue (61.5%). Oral lesions associated with COVID-19 occurred in middle-aged patients, with an equal distribution by sex. They presented in a mild form and did not correlate with the severity of the clinical picture of COVID-19.
Background
In spite of all the efforts, recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) still have unexplained etiology.
The role of anxiety, depression, and psychological stress in ...occurrence and intensity of symptoms in RAS and OLP patients has been investigated in this study.
Methods
A total of 110 patients with RAS in the acute phase and 112 patients with OLP also in acute phase participated in this study. All patients filled out questionnaires related to the primary disease (RAS/OLP) after which they took the following psychological tests: Beck Depression Inventory (BDI), The State‐Trait Anxiety Inventory (STAI), and Ways of Coping Questionnaire (WCQ).
Results
According to multiple regression analysis, in patients with RAS, the highest correlation was found between results of the pain intensity and STAI test (β= 0.66; p < 0.000). In the patients with OLP, the highest correlation was found between the level of hyperkeratosis and WCQ test (β = 0.53; P < 0.000), inflammation and results of BDI test (β = 0.33; P < 0.002), and results of dynia test and STAI test (β = 0.31; P < 0.004).
Conclusions
In this study, a high correlation between anxiety, depression, and psychological stress with symptoms of RAS and OLP has been observed.
The aim of our study was to assess the relationship between the concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and the psychological profile of patients with oral lichen ...planus (OLP) and primary burning mouth syndrome (BMS). A total of 160 subjects participated in this case–control study: 60 patients with OLP; 60 patients with primary BMS; and 40 control subjects. Unstimulated whole saliva (UWS) was collected between 9 and 10 a.m. Salivary biomarkers were analyzed by enzyme-linked immunosorbent assays (ELISAs). Psychological assessment was evaluated with the Depression, Anxiety, and Stress Scale (DASS-21). The patients with primary BMS had higher salivary cortisol concentrations and α-amylase activity (0.52 vs. 0.44 µg/dL; 160,531 vs. 145,804 U/L; one-way analysis of variance (ANOVA) with post hoc Scheffe test) compared with patients with OLP. The patients with primary BMS had statistically significant higher scores for depression, anxiety, and stress compared with patients with OLP and control subjects (p < 0.001, Kruskal–Wallis test). There was a strong positive correlation between anxiety and depression, stress and depression, and stress and anxiety in patients with OLP and BMS (p < 0.001 and p < 0.001, respectively; Spearman’s correlation). There was a good positive correlation between symptom intensity (pain/burning) and psychological profile (depression, anxiety, stress) in patients with primary BMS (r = 0.373, p = 0.003; r = 0.515, p < 0.001; r = 0.365, p = 0.004, respectively; Spearman’s correlation). This case–control study is the first to compare the psychoendocrinological profile of patients with two different oral diseases. The patients with BMS showed a higher concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and a stronger association with mental disorders compared with patients with OLP. However, an interdisciplinary psychoneuroimmunological approach is equally important in both patient groups (OLP and BMS), regardless of whether mental disorders are the cause or the consequence.
To determine salivary flow rate, oral and periodontal status, oral health-related quality of life (OHRQoL), objective and subjective indexes, and serum antibody reactivity in patients with primary ...Sjögren's disease (pSD). Thirty-one patients with pSD and 31 control subjects participated in this cross-sectional, single-center study. The unstimulated whole salivary flow rate (UWSFR) and stimulated whole salivary flow rate (SWSFR), salivary pH, DMFT index (DMFT = D-decayed, M-missing, F-filled tooth), periodontal pocket depth (PPD), clinical attachment level (CAL), interincisal distance, OHRQoL, objective European League Against Rheumatism (EULAR) SS Disease Activity Index (ESSDAI) and subjective (EULAR SS Patient Reported Index (ESSPRI), 6-items-VAS-SS (Visual Analog Scale), Profile of Fatigue) indexes were analyzed. The patients with pSD had a blood sample taken in the morning between 7 and 10 a.m. for comprehensive laboratory analysis. Patients with pSD had statistically significant lower UWSFR (0.20 vs. 0.90 mL/min) and SWSFR (0.56 vs. 1.64 mL/min) values compared with control subjects (
< 0.001, Mann-Withney U test). Salivary pH value of pSD patients was significantly lower compared with control subjects (6.00 vs. 7.00;
< 0.001, Mann-Whitney U test). The mean DMFT index of patients with pSD compared to control subjects was not statistically significant (23.74 ± 7.28 vs. 20.77 ± 5.73;
= 0.08,
-test). Interincisal distance was significantly decreased in the pSD group compared with control subjects (43.80 ± 0.38 vs. 47.60 ± 0.50;
= 0.003,
-test). The prevalence of periodontitis was similar in patients with pSD and control subjects (83.9% vs. 77.4%;
= 0.35, λ
test). The mean Oral Health Impact Profile (OHIP-49) total score was statistically significantly higher in pSD patients compared with control subjects (32.00 vs. 8.00;
< 0.001, Mann-Whitney U test). Patients with pSD have decreased salivary flow and salivary pH, poor oral health, decreased interincisal distance, high prevalence of periodontitis, and worse OHRQoL. These findings highlight the need for a multidisciplinary approach to the management of patients with pSD that includes physical and psychological aspects of the disease.
Determination of salivary flow rate and oral status in patients with primary Sjögren's Syndrome (pSS) and diffuse cutaneous systemic sclerosis (dcSSc) and comparison with control subjects. Thirty-one ...pSS patients, 28 dcSSc patients, and 28 control subjects participated in this single-center, cross-sectional study. Unstimulated whole salivary flow rate (UWSFR) and stimulated whole salivary flow rate (SWSFR), salivary pH, DMFT index (D-decayed, M-missing, F-filled tooth), periodontal pocket depth (PPD), clinical attachment level (CAL), interincisal distance, and OHRQoL (oral health-related quality of life) were analyzed in all three groups of subjects. Primary SS and dcSSc patients had statistically significant lower values of UWSFR (0.20; 0.38 vs. 0.91 mL/min) and SWSFR (0.56; 0.70 vs. 1.64 mL/min) compared with control subjects (
< 0.001, Kruskal-Wallis test). Salivary pH values were statistically significantly lower in pSS and dcSSc patients compared with control subjects (6.00; 6.25 vs. 7.00, respectively) (
< 0.001, Kruskal-Wallis test). The DMFT index of dcSSc patients was higher (28.50) and statistically significant compared to control subjects (20.00) (
= 0.01). The prevalence of periodontitis was the same in pSS and dcSSc patients and control subjects (
= 0.384). Primary SS and dcSSc patients had a statistically significant decreased interincisal distance compared to control subjects (43.80; 38.00 vs. 48.00) (
= 0.003 and
< 0.001, respectively). Primary SS and dcSSc patients show decreased UWSFR and SWSFR, salivary pH values closer to an acidic medium, higher DMFT index, higher prevalence of periodontitis, decreased interincisal distance, and poorer OHRQoL, i.e., poor oral and periodontal health.
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