Microflora of the oral cavity in patients with xerostomia.

OBJECTIVE: The aim of this study was to evaluate the dependence of the condition of the microflora of the oral cavity on the etiology of xerostomia, patients' sex, age, degree of hyposalivation, and duration of the sense of dryness. MATERIAL AND METHODS: A total of 64 patients with complaints of oral dryness referred to the Clinic of Oral and Dental Diseases, Hospital of Lithuanian University of Health Sciences, for consultation during the period from 2003 to 2005 were selected for the study. The etiological factors of xerostomia were as follows: radiotherapy (PRT) to the maxillofacial area, Sjögren's syndrome (SS), and xerogenic medications, tricyclic antidepressants (TCAs). RESULTS: There were 50 women and 14 men. Their mean age was 60.5 ± 1.6 years. All the patients in the PRT group had high counts of Candida spp. as compared with percentages of patients in the TCA and SS groups (100% vs. 66.7% and 56.2%, P<0.05). Patients' age and sex in different etiology groups had no significant impact on the condition of their oral microflora. There were equal percentages of patients with deficient and normal salivation in the TCA group (44% in both the groups; P<0.01). All the patients in the PRT group had pronounced hyposalivation (P<0.002). A significantly greater percentage of patients with severely reduced salivation had high counts of Lactobacillus spp. (P<0.01). Significantly greater percentages of patients with the clinical duration of xerostomia of up to 6 months had high counts of Lactobacillus spp. and Candida spp. colonies. CONCLUSIONS: In patients with xerostomia, the condition of the microflora of the oral cavity and impairment of major salivary gland function varied according to the etiology of the disease. The level of hyposalivation and the duration of xerostomia were found to have a significant impact on the microflora of the oral cavity.

Aspects of xerostomia prevalence and treatment among rheumatic inpatients.

OBJECTIVES: The aim of the study was to evaluate the prevalence of xerostomia among inpatients with rheumatic disorders at the Hospital of Kaunas University of Medicine (HKUM) and its association with age, sex, and xerophthalmia. Determining adequate treatment for xerostomia was also important, because untreated xerostomia may become aggravated and thus significantly impair patient's quality of life. MATERIAL AND METHODS: The authors designed a special questionnaire for conducting all study-related enquiries. Patients for this study were selected according to their case records ranging from 1998 to 2004. In total, there were 483 cases chosen based on prevalent rheumatic diseases, which were most conducive to xerostomia. RESULTS: The results showed no significant evidence that the prevalence of xerostomia increased with age. Also, women were more susceptible to rheumatic diseases than men (W:M = 10:1) and are more likely to be affected by xerostomia and xerophthalmia (W:M = 2.5:1). A significant correlation was found between xerostomia and xerophthalmia. Only 17.7% of xerostomia-positive patients were treated for xerostomia, in comparison with xerophthalmia-positive patients who were treated for xerophthalmia in 84.8% of cases. It was shown that the modalities of treatment administered for xerostomia were neither sufficient nor up-to-date according to current recommendations found in medical literature. CONCLUSIONS: Xerostomia is closely correlated with xerophthalmia in rheumatic diseases. Xerostomia is more prevalent in older segments of population, especially in women, but we failed to prove statistical significance of older age in prevalence of sicca symptoms. Treatment administered to rheumatic patients for xerostomia in the HKUM is neither sufficient nor adequate.

The relationship between blood serum lipids and periodontal condition.

THE AIM OF THE STUDY: the study analyzed he relationship between blood serum lipids and periodontal condition, as well as the relationship between the left ventricular mass index and the condition of periodontium. The study included 261 subjects--140 women and 121 men. Mean age of the subjects was 38 years. The condition of periodontal tissues during the study was evaluated with the help of the CPITN index (Community Periodontal Index of Treatment Needs). The study was performed at Kaunas University of Medicine (KMU) Clinic of Dental and Oral Diseases. Laboratory blood lipid studies were performed at the laboratory of the Hospital of Kaunas University of Medicine (HKUM). The studies included the determination of the total blood cholesterol level, triglyceride level, HDL cholesterol level, and LDL cholesterol level (mmol/l). Patients with hypertension (102 patients) underwent ultrasound examination of the heart at KMU Clinic of Cardiology. On the basis of the findings of the ultrasound study, left ventricular mass index (g/m(2)) was calculated. The findings of our study showed that there was no difference in the blood serum concentration of total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol between people with healthy periodontium and those with gingivitis or periodontitis. Mean rank of the left ventricular mass index in subjects with healthy periodontium or gingivitis (CPITN codes 0, 1, 2) was 48.3, and in subjects with periodontitis (CPITN codes 3, 4) - 61.36 (p<0.05).

Morphometric analysis of pulpal myelinated nerve fibers in human teeth with chronic periodontitis and root sensitivity.

BACKGROUND: The reasons why root sensitivity occurs in some periodontally diseased teeth are still unknown. It is possible that root sensitivity may be related to changes of intradental myelinated nerve fibers, which are responsible for dentine sensitivity. OBJECTIVE: The aim of this study was to define the pattern of myelinated nerve fiber changes in the pulps of teeth with and without root sensitivity in the presence of chronic periodontitis. MATERIALS AND METHODS: A total of 33 cross-sectioned human dental pulp specimens were collected from noncarious, intact, permanent teeth sensitive to electric and thermal (cold) stimulus (10 hypersensitive teeth with chronic periodontitis (HTPP group), 15 nonsensitive teeth with chronic periodontitis (NTPP group), and 8 nonsensitive teeth with healthy periodontium (control group)). The morphometric parameters were estimated using light microscopy and image-analyzing computer program Image-Pro Plus. RESULTS: The means of myelinated nerve fiber density, fiber and axon diameter, area, perimeter, length, width, g ratio, index of circularity, and myelin sheath thickness in NTPP group significantly differed from HTPP group and the control group teeth (p<0.001). The great reduction in the density of myelinated nerve fibers in NTPP group was accompanied by unequal decrease in the number of very large-diameter myelinated nerve fibers. The mean values of morphometric parameters of all myelinated nerve fibers in HTPP group were almost the same as those in the control teeth, and no significant difference was observed. CONCLUSION: The findings of the present study suggest that the reason for enhanced root sensitivity has likely nothing to do with changes of the innervation of myelinated nerves in the dental pulp. While, decreased sensitivity of periodontally diseased teeth may be related to the degeneration of myelinated nerve fibers in the pulp.

Oxidative function of neutrophils in periodontitis patients with type 1 diabetes mellitus.

BACKGROUND: The involvement of reactive oxygen species in periodontal diseases is unclear. The aim of the present study was to explore the oxidative function of neutrophilic leukocytes of the peripheral venous blood in patients with severe periodontitis and type 1 diabetes mellitus and in the control subjects with healthy periodontal tissues and without systemic diseases. MATERIALS AND METHODS: The leukocytes for the present investigation were obtained from peripheral venous blood of 38 patients with severe periodontitis and type 1 diabetes mellitus and 27 control subjects. The maximal luminol-dependent chemiluminescence and peak time values of neutrophils stimulated with non-opsonized Escherichia coli ATCC 25922 and Staphylococcus aureus 256 were measured. RESULTS: The maximal luminol-dependent chemiluminescence of neutrophils in patients with severe periodontitis, stimulated with non-opsonized Escherichia coli and Staphylococcus aureus, is mainly lower than that in the control group subjects (p < 0.001). Luminol-dependent chemiluminescence of neutrophils reached its maximal value at the same time in both the diseased and the healthy patients. CONCLUSION: In periodontitis, local non-opsonized bacteria might stimulate neutrophilic leukocytes to release oxygen species. However, these cells in patients with periodontitis are characterized by a lower intensity of luminol-dependent chemiluminescence (p < 0.001) compared to analogous findings in people with healthy periodontal tissues. This might indicate insufficient microbicidal activity of these cells in patients with periodontitis.

Clinical effectiveness of dentin sealer in treating dental root sensitivity following periodontal surgery.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a commercially available light-cured, resin-based dentin sealer in the treatment of postoperative sensitivity of roots with gingival recession of different extent. MATERIALS AND METHODS: The study was a case control, randomized, blind design. A total of 62 patients with the presence of chronic periodontitis, who required periodontal surgery, participated in this study. All recipients underwent flap operation. After the periodontal surgery 641 teeth were selected for the study. The pain intensity was determined by using visual analogue scale (VAS). The extent of gingival recession was measured using William's periodontal probe. After recording the initial baseline VAS scores, the patients were randomly divided into two groups according to the materials used in the study. The resin-based dentin sealer in the test group was applied following the manufacture's recommendations. Water was used in the control (placebo) group. Hypersensitivity measurements on VAS were repeated 5 minutes, 7 and 30 days after the application of the materials. RESULTS: It was observed that the efficacy of the desensitizing material differed from placebo. The dentin sealer effectively reduced the root sensitivity. The statistically significant (p<0.001) decrease in the intensity of root sensitivity after the application of materials was noted in test and control groups. However, the difference in the reduction of pain intensity between the groups was significant and remained such throughout the study period. The root sensitivity on the day 7 and 30 in both groups showed little change compared to the measurements made right after the application of the materials. No significant difference in measurements of pain intensity in the presence of different extent of gingival recession was noted in none of the groups. CONCLUSION: The results of the study showed that dentin sealer used provided quick and effective reduction in root sensitivity after the surgery and its desensitizing effect lasted beyond 30 days.

[Xerostomia: clinic, etiology, diagnosis and treatment]. / Burnos sausumas: klinika, etiologija, diagnoze ir gydymas.

The aim of this article is to review the problem of xerostomia considering its clinical, etiological, diagnostic and treatment features, basing on the today's tutorials and scientific articles found in databases on the Internet. Recent epidemiologic data on the prevalence of xerostomia in different countries are introduced. There are analyzed the main aspects of clinical manifestations of xerostomia, according to the different etiology analyzed. The most common etiological factors causing xerostomia, especially the main three of them: radiation therapy, Sjögren's syndrome, and drugs, are pointed out. The most popular and accepted clinical and laboratory assays for measuring and evaluating the function of salivary glands are represented. Attention is paid to xerostomia as substantiation of the separate diagnosis and its role in diagnosing other diseases. The concept of possible treatment modalities and prognosis are discussed. The main and most common problems concerning xerostomia are revealed.

Smoking and other factors influencing the oral health of Lithuanian Army recruits.

The aim of our research was to determine the prevalence of smoking among Lithuanian army recruits and how smoking and other factors affect oral health. The findings of our research showed that 70% of recruits smoke. The analysis of the research findings showed that smoking had a negative effect on oral hygiene. Especially smoking was harmful with respect to periodontal tissues. The periodontal lesions were more prevalent and severe among recruits who smoked. Smokers had a higher Community Periodontal Index of Treatment Needs index than nonsmokers. The analysis of the research findings showed that the state of oral health was related to other factors, such as oral hygiene, age, and education. It was determined that the oral hygiene of males living in the countryside and having poorer education was worse than that of males living in the city. Their status of periodontal tissues was worse, and they had more decayed and untreated teeth. The findings of the logistical regression analysis showed that poor education and living in the country, irregular tooth brushing, poor oral hygiene, and smoking were the most important factors related to a great number of untreated decayed tooth surfaces.

The influence of microvascular complications caused by diabetes mellitus on the inflammatory pathology of periodontal tissues.

The aim of our study was to analyze inflammatory pathology of periodontal tissues in patients with diabetes mellitus, and the relationship of this pathology with other complications caused by diabetes mellitus. In our study, we evaluated 126 people aged 16-53 years (42 males and 84 females) with diabetes mellitus admitted to the Clinic of Endocrinology of the Hospital of Kaunas University of Medicine (HKUM). The condition of periodontal tissues was evaluated according to the World Health organization (WHO) CPITN index. Oral hygiene was evaluated using a simplified oral hygiene index (OHI-S) according to Green-Vermillion. Out of 126 subjects with diabetes mellitus, periodontitis was detected in 96 patients (36 males and 60 females) (CPITN index 2-5). Gingivitis was found in 27 subjects (CPITN index 1). Only 2.4% of the studied patients had healthy periodontal tissues. The study analyzed complications of other organs (neuropathy, and nephropathy and retinopathy) caused by diabetes mellitus. The obtained findings showed that microvascular complications were diagnosed more frequently in the presence of more severe inflammatory pathology of periodontal tissues. Retinopathy was diagnosed in patients with CPITN index 2.8+/-0.1, while patients with CPITN index 1.8+/-0.3 had no retinopathy. Neuropathy was more common among patients whose CPITN index was 2.9+/-0.1, while the condition was absent in cases where the CPITN index was 1.8+/-0.2. Comparable results were yielded by the studies of nephropathies in relation with changes in periodontium. Nephropathy was diagnosed in patients whose CPITN index was 3.0+/-0.1, and was not found in patients with CPITN index 2.1+/-0.2. The generalization of the obtained study data allows for stating that a more detailed analysis of factors causing complications of diabetes mellitus will also allow for a more profound understanding of the etiopathogenetic mechanisms that cause inflammatory pathology of periodontal tissues.