Literature data indicates that measurement of certain salivary constituents might serve as a useful diagnostic/prognostic tool in the patients with oral squamous cell carcinoma (OSCC). In 24 patients ...with OSCC (60 +/- 2.5 yrs) and in 24 controls (24 +/- 3.7 yrs) we have determined levels of salivary magnesium, calcium, copper, chloride, phosphate, potassium, sodium, total proteins and amylase. Sodium, potassium and chloride were determined by indirect potentiometry whereas copper, magnesium and phosphate were determined by atomic absorption spectrophotometry. Total proteins were determined by pyrogalol colorimetric method. Amylase levels were determined by continued colorimetric method. Statistical analysis was performed by use of chi2 test and Spearman's correlation test. The results of this study indicate that the concentrations of sodium and chloride were significantly elevated in patients with OSCC when compared to the controls. However, level of total protein was significantly decreased when compared to the healthy controls. Furthermore, there was a negative correlation between alcohol consumption and total protein concentration in patients with oral carcinoma. We might conclude that in patients with OSCC increased salivary sodium and chloride might reflect their overall dehydration status due to alcohol consumption rather than consequence of OSCC itself.
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 approximal 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.
The aim of study was to compare salivary and serum concentrations of interleukin 1 beta (IL-1β), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in patients with oral leukoplakia, oral ...cancer and healthy controls.
Eighty eight patients (28 with oral cancer, 29 leukoplakia, and 31 healthy controls) were included in this study. Cytokine concentrations were measured by commercial enzyme linked immunoassay.
Salivary IL-1β and IL-6 were significantly higher in oral cancer patients than in patients with leukoplakia and control group (p<0.05). No differences in concentrations of salivary TNF-α between either of the groups were observed. Serum concentrations of IL-1β were below level of detection in all but two participants. No significant differences between the groups were observed in serum concentrations of IL-6. Serum TNF-α was significantly higher in control subjects than in oral cancer patients.
Patients with oral cancer have elevated levels of inflammatory cytokines in their saliva. Whether this elevation can be used for monitoring the malignant transformation of oral leukoplakia remains to be answered by further follow up studies.
The aim of this study was to evaluate smoking habits, the level of knowledge and attitudes towards smoking, as well as the role of dental professionals in prevention of smoking among students of the ...School of Dental Medicine, University of Zagreb and compare them to attitudes of practicing Croatian dentists.
The study was carried out among 1
and 6
year dental students at the School of Dental Medicine, University of Zagreb and dentists employed in primary practice throughout Croatia. A total of 159 subjects (51 1
and 53 6
year dental students and 55 dentists) participated in the study.
The prevalence of smoking was highest among 6
year dental students (39, 6%). It slightly decreased among dentists (34, 5%), while least smokers were found among first year dental students (7, 8%). The majority of dental student smokers expressed a desire to stop smoking (66, 7% of 1
year dental student smokers and 76% of 6
year dental student smokers), while less than half of dentist smokers had the desire to stop - only 45, 8% of them. Dental students of the 1
and 6
year of the study showed a statistically significantly higher level of desire for education about harmful smoking effects and patients counselling to quit smoking compared to dentists. The data gathered in this study indicate that it is necessary to increase awareness among dental professionals about harmful effects of smoking on oral and general health. Also, their awareness about the central role of healthcare workers as promoters of a healthy lifestyle among patients should be raised.
Oral squamous cell carcinoma (OSCC) constitutes 3 percent of all cancers with predominant occurrence in middle aged and elderly males. Tumour recurrence worsens disease prognosis and decreases ...quality of life in patients with OSCC. Proinflammatory cytokines such as interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α) have been suggested to play a certain role in variety of tumours. The aim of this study was to investigate the relationship of pretreatment serum IL-6 and TNF-α levels on tumour recurrence in patients with OSCC in order to identify potential biomarkers for the early detection of disease recurrence.
The patients with newly diagnosed OSCC were treated and followed from the first visit from November 2006 until January 2008. Serum IL-6 and TNF-α concentrations were measured. The records of the patients were re-examined in July 2012 and data were recorded about cancer characteristics and tumour recurrence. Disease free survival was analyzed by Kaplan-Meier survival curves, log rank test and Cox proportional hazards regression.
Serum IL-6 was shown as an independent risk factor for tumour recurrence.
Pretreatment serum IL-6 concentration may be a useful biomarker for identification of OSCC patients with increased risk of the disease recurrence.
We report a rare case of a patient who was referred to the Department of Oral medicine in Zagreb, Croatia. The patient was 20 years old, otherwise healthy and not taking any medication. She presented ...with irregular erosions partially covered with pseudomembranes that involved both lips and retrocomissural mucosa. Discrete erosion was also noticed on her lower lingual gingiva in the area 42. She reported a propolis solution self-medication for treatment of recurrent aphthous ulcers. After ten days of propolis application, lip and oral lesions developed. Patch test to propolis was proven. We highlight the fact that some folk medicine medications, such as propolis, although being known for many decades to be helpful in various conditions, in some individuals might lead to unwanted side-effects due to its antigenic potential. Additionally, every colleague, during the differential diagnosis of the oral lesions must bear in mind unwanted reactions to folk medicine products.
A 40-year-old female patient was admitted to the Department of Oral Medicine due to oral ulcerations. Oral ulcerations were present on vestibular mucosa above teeth 21,22,25 and 26 and were 1 cm in ...diameter, and also around teeth 45 and 46. The patient had prolonged neutropenia due to therapy-related myelodysplastic syndrome that progressed to therapy-related acute myeloid leukemia. Initially, the patient was successfully treated with polychemotherapy for non-Hodgkin lymphoma. Unfortunately, many toxic complications ensued, such as peripheral neuropathy, dilated cardiomyopathy and therapy-related myelodysplastic syndrome/therapy-related acute myeloid leukemia. The onset of therapy-related myelodysplastic syndrome was less than six months after initiation of chemotherapy treatment, which was rather early, but cytogenetic changes (monosomy 5 and 7) were consistent with the diagnosis. Upon admission to our Department, microbiological swabs were obtained and were all negative, while x-ray finding showed that ulcerations did not have dental cause. Biopsy was not obtained as the patient had severe neutropenia and thrombocytopenia. While viral and fungal swabs were negative, Stenotrophomonas maltophilia was cultured from the oral cavity. Thus, differential diagnoses are listed in this report. Neutropenic ulcerations did not heal albeit extensive medicamentous oral and systemic treatments were applied and the patient died. Key words: Leukemia, myeloid, acute; Gingivitis, necrotizing, ulcerative; Case reports Bolesnica u dobi od 40 godina primljena je na Zavod za oralnu medicinu zbog oralnih ulceracija. Oralne ulceracije promjera 1 cm bile su prisutne na vestibularnoj sluznici iznad zuba 21, 22, 25 i 26, a takoder i oko zuba 45 i 46. Bolesnica je imala produljenu neutropeniju uslijed mijelodisplasticnog sindroma povezanog s terapijom, koji je progredirao u akutnu mijeloidnu leukemiju povezanu s terapijom. U pocetku je bolesnica uspjesno lijecena polikemoterapijom za non-Hodgkinov limfom. Nazalost, uslijedile su mnoge toksicne komplikacije poput periferne neuropatije, prosirene kardiomiopatije i mijelodisplasticnog sindroma povezanog s terapijom/akutne mijeloidne leukemije povezane s terapijom. Terapijski mijelodisplasticni sindrom pojavio se u manje od sest mjeseci nakon zapocinjanja lijecenja kemoterapijom, sto je bilo prilicno rano, ali su citogenetske promjene (monosomija 5 i 7) bile u skladu s dijagnozom. Nakon dolaska na nas Zavod ucinjeni su mikrobioloski brisevi i svi su bili negativni, a rendgenski nalaz je iskljucio odontogenu etiologiju ulceracija. Biopsija nije ucinjena, jer je bolesnica imala tesku neutropeniju i trombocitopeniju. Iako su virusni i gljivicni brisevi bili negativni, Stenotrophomonas maltophilia izolirana je iz usne supljine. Stoga su u ovom prikazu navedene razlicite dijagnoze. Unatoc ekstenzivnim oralnim i sistemskim tretmanima neutropenicne ulceracije nisu zacijelile, a bolesnica je preminula. Kljucne rijeci: Leukemija, mijeloidna, akutna; Gingivitis, ulcerativni; Prikazi slucaja
Objectives: Burning mouth syndrome (BMS) is a disorder which is described as burning sensation of the oral mucosa without pathological changes. Most of the patients have some underlying stressful ...conditions. Stress induces an increase in secretion of different endocrine glands resulting in higher levels of glucocorticoids. One of the options for treatment of BMS includes low level laser therapy (LLLT). The aim of this research was to determine salivary Cortisol levels and intensity of burning symptoms in BMS patients before and after LLLT. Material and Methods: Twenty-three participants were allocated by randomization in two groups: 12 patients in the study group and 11 patients in the placebo group. Cortisol levels in all patients were analyzed from the sample of saliva collected without stimulation. In both groups, the LLLT was performed once a day for ten consecutive days (excluding weekend) with Ga-AI-As light-emitting diode type of laser, with a wavelength of 685nm. In the control group, LLLT was done with inactive laser probe which was only emitting audio signal. The intensity of burning symptoms was measured by a visual analogue scale (VAS). The VAS and unstimulated saliva were measured at baseline and on the last day of the LLLT. A quantitative analysis of saliva was performed using competitive commercial ELISA-kit. Results: VAS scores and salivary Cortisol levels were significantly lower in both groups after LLLT. Conclusions: LLLT can be useful in patients with BMS for reducing burning symptoms and salivary Cortisol level. Future studies on a larger number of patients should clarify whether the positive results are an outcome of laser effectiveness or of placebo effect. Key words Burning Mouth Syndrome; Saliva; Hydrocortisone; Low-Level Light Therapy Uvod: Sindrom pekucih usta (SPU) poremecaj je obiljezen simptomima zarenja sluznice usta bez vidljivih patoloskih promjena. Vecina bolesnika ima u podlozi odredeno stresno stanje. Stres potice izlucivanje razlicitih endokrinih zlijezda, sto rezultira i povisenom razinom glukokortikoidnih hormona. Jedna od opcija u lijecenju SPU-a ukljucuje i niskoenergijski laser. Cilj: Svrha ovog istrazivanja bila je utvrditi razinu kortizola u slini i jakost simptoma zarenja kod bolesnika sa SPU-om prije lijecenja niskoenergijskim laserom i poslije tog postupka. Materijali i metode: U dvije skupine slucajnim je odabirom podijeljeno dvadeset i troje ispitanika--dvanaestero je bilo u ispitnoj i jedanaestero u placebo skupini. Svakomu od njih odredena je razina kortizola u nestimuliranoj slini. U obje se skupine lijecenje niskoenergijskim laserom provodilo jedanput na dan tijekom deset dana (iskljucujuci vikend) diodnim tipom lasera Ga-AI-As valne duljine 685 nm. U kontrolnoj skupini lijecenje je obavljeno inaktivnom sondom lasera odasiljajuci samo zvucni signal. Intenzitet simptoma zarenja mjeren jes pomocu vizualno analogne ljestvice (VAS-a). VAS i nestimulirana slina mjereni su na pocetku istrazivanja i posljednjeg dana lijecenja niskoenergijskim laserom. Analiza sline obavljena je komercijalnim kitom EUSA.Rezultati: U obje skupine su VAS bodovi i razina kortizola u slini bili znacajno nizi nakon lijecenja niskoenergijskim laserom. Zakljucak: Niskoenergijski laser moze bolesnicima sa SPU-om smanjiti jakost zarenja i razinu kortizola u slini. Buduce studije na vecem broju ispitanika trebale bi razjasniti je li pozitivan ucinak rezultat ucinkovitosti lasera ili je placebo efekt. Kljucne rijeci sindrom pekucih usta; slina; kortizol; lijecenje niskoenergijskim laserom
The aim of this clinical study was to compare low-level laser therapy (LLLT) switched on and switched off in the treatment of burning mouth syndrome (BMS). BMS is a debilitating condition for ...patients and highly demanding for physicians, characterized by burning symptoms in the oral cavity. Despite extensive research, so far only cognitive behavioral therapy and clonazepam have been proven successful for its treatment in randomized controlled trials. Forty-four patients with BMS were randomly assigned to the study laser group (LLLT) or the sham laser group. LLLT was performed with the GaAlAs laser (830 nm) used in non-contact mode on the site in the mouth where burning symptoms were present; study patients received 10 sessions (10 days). Each participant filled out the visual analog scale (VAS) and oral health impact on the quality of life scale (OHIP-CRO 14) before and after either therapy protocol. There were no significant differences between the groups before and after LLLT (switched on and off) in the quality of life (OHIP CRO 14 scores) (p>0.05). There was significant decrease in pain symptoms (VAS) in both LLLT switched on and LLLT switched off groups (p<0.05). Both LLLT switched on and switched off decreased pain symptoms (VAS) in patients with BMS; however, neither LLLT switched off or switched on improved the OHIP-CRO 14 scores.Key words: Low-Level Light Therapy; Burning Mouth Syndrome; Cognitive Therapy; Quality of LifeCilj ovoga istrazivanja je bio usporediti ucinkovitost niskoenergetskog lasera koji je bio ukljucen i iskljucen u bolesnika sa sindromom pekucih usta (SPU). SPU je stanje koje iscrpljuje bolesnike, zahtjevno je za lijecenje, a ocituje se simptomima zarenja u usnoj supljini. Usprkos brojnim istrazivanjima do sada su se kognitivna bihejvioralna terapija i klonazepam jedini pokazali kao uspjesan nacin lijecenja SPU u randomiziranim kontroliranim istrazivanjima. Cetrdeset i cetiri bolesnika s SPU su podijeljeni u skupinu koja je lijecena upaljenim laserom i u skupinu koja je lijecena ugasenim laserom. Lijecenje laserom je provedeno uz pomoc lasera GaAlAs (830 nm) koji je koristen u nekontaktnom nacinu rada na mjestu gdje su u ustima bili prisutni simptomi zarenja, a sudionici su dobili po deset terapija (deset dana). Svaki sudionik je prije i poslije istrazivanja odredio stupanj boli na vizualnoj analognoj ljestvici (VAS) te ispunio upitnik o utjecaju oralnog zdravlja na kvalitetu zivota (OHIP-CRO 14). Nije bilo znacajnih razlika izmedu skupina prije i nakon lijecenja laserom (upaljen i ugasen) u utjecaju oralnog zdravlja na kvalitetu zivota (OHIP CRO 14) (p>0,05). Utvrdeno je znacajno smanjenje simptoma boli (VAS) u objema skupinama lijecenim laserom (upaljen i ugasen) (p<0,05). Upaljen i ugasen laser je doveo do smanjenja simptoma boli u bolesnika s SPU, doduse, niti jedan nacin lijecenja laserom (upaljen ili ugasen) nije doveo do poboljsanja rezultata utjecaja oralnog zdravlja na kvalitetu zivota.Kljucne rijeci: niskorazinska laserska terapija; sindrom pekucih usta; kognitivna terapija; kvaliteta zivota
Adenoid cystic carcinoma is a less commonly diagnosed cancer that may affect the major or minor salivary glands. We present a 70 year old male patient who was admitted to the Department of Oral ...Medicine, School of Dental Medicine in Zagreb, Croatia due to pain in the right maxilla. In this case we report a case of the patient with unilateral pain in the maxilla &eye which lead to the diagnosis of adenoid cystic cancer without any visible oral lesions. Key words Carcinoma, Adenoid Cystic; Salivary Gland Neoplasms; Unilateral Pain in the Maxilla & Eye Adenoidni cisticni karcinom rjede je dijagnosticirani tumor koji moze zahvatiti velike i male zlijezde slinovnice. Prikazan je slucaj 70-godisnjeg bolesnika koji je upucen u Zavod za oralnu medicinu Stomatoloskog fakulteta u Zagrebu zbog boli u desnoj strani gornje celjusti. U ovom slucaju opisujemo kako jednostrana ostra bol u gornjoj celjusti i oku moze ukazivati na dijagnozu adenoidnog cisticnog karcinoma, iako bolesnik nema u usnoj supljini vidljivih promjena. Kljucne rijeci adenoidni cisticni karcinom; tumori zlijezda slinovnica; jednostrana bol gornje celjusti i oka
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