Food-Borne Transmission of Tick-Borne Encephalitis Virus-Spread, Consequences, and Prophylaxis.

Tick-borne encephalitis (TBE) is the most common viral neurological disease in Eurasia. It is usually transmitted via tick bites but can also occur through ingestion of TBEV-infected milk and dairy products. The present paper summarises the knowledge of the food-borne TBEV transmission and presents methods for the prevention of its spread. The incidence of milk-borne TBE outbreaks is recorded in central, eastern, and north-eastern Europe, where Ixodes ricinus, Ixodes persulcatus, and/or Dermacentor reticulatus ticks, i.e., the main vectors of TBEV, occur abundantly. The growing occurrence range and population size of these ticks increases the risk of infection of dairy animals, i.e., goats, sheep, and cows, with viruses transmitted by these ticks. Consumers of unpasteurised milk and dairy products purchased from local farms located in TBE endemic areas are the most vulnerable to alimentary TBEV infections. Familial infections with these viruses are frequently recorded, mainly in children. Food-transmitted TBE can be monophasic or biphasic, and some of its neurological and psychiatric symptoms may persist in patients for a long time. Alimentary TBEV infections can be effectively prevented by consumption of pasteurised milk and the use of TBEV vaccines. It is recommended that milk and dairy products should be checked for the presence of TBE viruses prior to distribution. Protection of dairy animals against tick attacks and education of humans regarding the epidemiology and prophylaxis of TBE are equally important.

Finding Better Ways to Perform Graftless Full Rehabilitation of a Compromised Maxilla: New Platform-Switched Zygomatic Implants Placed Extra-Sinus Improve Prosthetic Restoration-A Preliminary Study of 25 Cases and 85 Implants.

Standard treatment for full rehabilitation of compromised maxillae with regular implants includes sinus elevation grafting, a minimum of two to three surgeries, and a minimum treatment time of 9 to 15 months. Zygomatic implants are a viable alternative. However, prosthetic restorations have been compromised due to abutments emerging on the palate. The purpose of this study was to find ways that abutments will emerge on the ridge (occlusal surface). The presented results show it can be done if zygomatic implants are placed in the sinus wall (extra-sinus) and use an internal, conical connection with platform-switching and 45-degree abutments. Thus, marginal tissue prognosis and primary stability may also be improved by adding coronal threads to an implant design. These improvements, if confirmed in longer follow-ups and further studies, may encourage more graftless rehabilitations of severely compromised maxillae, reducing the number of surgeries and overall treatment time.

Evaluation of circulating CD34+ stem cells in peripheral venous blood in patients with varying degrees of periodontal disease.

INTRODUCTION: Periodontal disease presents a challenge for modern medicine, and research on the use of stem cells as a treatment is currently underway. MATERIAL AND METHODS: The study included 45 patients who were given a thorough physical examination. Additionally, an evaluation of their medical history of the disease, degree of progression of periodontal disease, and the level of CRP in the blood was carried out. Patients were divided into 4 groups: 4 patients were in the first group with no periodontal disease, 8 patients in the second group with a moderate level, 20 patients in the third group with an advanced level, and 13 patients in the fourth group were toothless. For each group, the use of stem cells as a treatment of antibody-labeled CD34+ stem cells, lymphocytes, and leukocytes was conducted. RESULTS: A statistically significant positive correlation was observed in CD34+ stem cells in proportion to lymphocytes in the moderate (0.80), in the advanced (0.75), and in the toothless groups (0.70). The ratio of CD34+ stem cells to leukocytes was statistically significant in the toothless group (0.92) and in the advanced group (0.91). A statistically significant increase was noted in the level of CRP in the previously mentioned groups of patients, and the highest concentration of CD34+ stem cells in the advanced group. CONCLUSIONS: The highest concentration of CD34+ cells was observed in the group of patients with advanced periodontal disease.

The inflammation link between periodontal disease and coronary atherosclerosis in patients with acute coronary syndromes: case-control study.

BACKGROUND: Coronary atherosclerosis and periodontal disease, due to their prevalence, are a serious epidemiological problem. Pathophysiological evidence points to their possible common inflammatory etiopathological background. The aim of the study was to analyze the relationship between the presence and severity of periodontitis, systemic inflammation and selected parameters of myocardial injury and heart function in patients with acute myocardial infarction. METHODS: The study group consisted of 71 patients 54.22 (7.05)-year-old hospitalized due to acute myocardial infarction. The patients underwent a coronary angiographic examination and echocardiography. The following laboratory parameters were determined: blood morphology, high sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), fibrinogen, troponin I, creatine kinase myocardial band (CK-MB), brain natriuretic peptide (BNP), lipidogram, glucose, creatinine, glomerular filtration rate (GFR), thyroid stymulating hormone (TSH), glycated hemoglobin (HbA1c). Dental assessment of the patients was performed and the following indicators were included: the number of teeth preserved, approximal plaque index (API), bleeding on probing (BoP), pocket depth (PD), the number of bleeding periodontal pockets ≥ 4 mm in depth (NoPD ≥ 4 mm), the percentage of bleeding periodontal pockets ≥ 4 mm in depth (%PD ≥ 4 mm), clinical attachment loss (CAL). The control consisted of 40 patients 52 (± 8.43)-year-old without a history of coronary heart disease. These patients were subjected to a periodontal examination using the above parameters and classification methods. The following statistical tests were implemented: Shapiro-Wilk test, Levene's test, Mann Whitney's U analysis, Univariate Analysis of Variance (ANOVA); the post-hoc analysis was performed with the use of Tukey's honest significant difference test (HSD), Kruskal-Wallis's non-parametric test, Spearman's rank correlation, logistic regression analysis, linear regression analysis and ROC analysis. RESULTS: The BoP (bleeding on probing) significantly correlated with fibrynogen (R-0.36; p-0.006). All indices regarding the pocket depth correlated significantly with the number of leukocytes: PD (R-0.27; p-0.02), NoPD ≥ 4 mm (R-0.28, p-0.02), %PD ≥ 4 mm (R-0.27; p-0.02). PD (R-0.28; p-0.01) and NoPD ≥ 4 mm (R-0.24; p-0.04) were also associated significantly with the level of hsCRP. The BoP is correlated closely with the levels of BNP (R-0.29, p-0.02). The multifactorial analysis showed that significant predictors of myocardial infarction are API and BoP. The analysis showed that API and BoP are important predictors of troponin levels. Linear regression analysis showed that only CAL is a significant predictor of BNP. CONCLUSIONS: Patients with acute myocardial infarction have worse periodontal status compared to people without coronary heart disease. Greater severity of periodontitis, plaque accumulation and bleeding on probing are associated with acute myocardial infarction. Periodontitis is a risk factor for myocardial infarction and also affects the degree of post-infarction left ventricular damage, which means that there is an inflammatory link between these two diseases.

Tunnel technique with enamel matrix derivative in addition to subepithelial connective tissue graft compared with connective tissue graft alone for the treatment of multiple gingival recessions: a randomized clinical trial.

OBJECTIVES: The aim of this study was to compare outcomes of the modified coronally advanced tunnel technique (MCAT) combined with subepithelial connective tissue graft (SCTG) with or without enamel matrix derivative (EMD), in the treatment of gingival recession types 1 and 2. MATERIALS AND METHODS: A total of 20 patients with 150 multiple gingival recessions (GR) were included in the study. On one side, MCAT was combined with SCTG and EMD (tests), whereas MCAT with SCTG was applied on the contralateral side (controls). Clinical parameters were measured at baseline and 6 months after surgery. Visual analog scales (VAS) and questionnaires were used to assess patient-reported outcomes and the root coverage esthetic score (RES) for professional esthetic evaluation. RESULTS: MCAT+SCTG+EMD was not superior with regard to root coverage. At 6 months, average root coverage (ARC) was 87.4% for SCTG+EMD-treated and 90.9% for SCTG-treated defects (p = 0.4170). Complete root coverage (CRC) was observed in 86.7% (tests) and 85.3% (controls) of the cases (p = 0.9872). Significantly less pain was reported using VAS (p = 0.0342) post-operatively in the SCTG+EMD group. Professional assessment of esthetic outcomes using RES showed a significant difference (9.25 versus 8.71, p = 0.0103) in favor of the test group. CONCLUSIONS: Both treatment modalities were equally effective in treatment of multiple GR and led to similar improvements in clinical parameters. However, the application of EMD as an adjunct resulted in less post-operative pain and better professionally assessed esthetic outcomes. CLINICAL RELEVANCE: Patients' early morbidity and 6-month esthetic outcomes following GR coverage with MCAT might be influenced by means of EMD utilization.

Platform switch hybrid zygoma implants improve prosthetics and marginal bone protection after extra-sinus placement.

PURPOSE: The aim of our studdy is clinical evaluation of Platform switch hybrid zygoma implants. MATERIALS AND METHODS: 117 zygomatic implants were followed up during this time. They included 55 Brånemark System zygoma implants, 38 Noris implants, and 24 novel iRES hybrid implants with platform switch. RESULTS: Bone quality and quantity are the prerequisite for successful implant treatment. Zygomatic implants are intended for patients with severely resorbed maxilla that cannot accommodate conventional implants without prior extensive bone grafting. Such regenerative procedures, like sinus lifts, prolong implant rehabilitation to several months (12-18). Furthermore, extensive grafts are less predictable showing varying degrees of graft resorption. Zygoma implants enable full, often immediate, reconstruction of the upper dental arch without the need for sinus lift treatment. The original zygoma protocol runs the implants through the sinus, requires general anesthesia, and positions the prosthetic platform of the implants on the palate, which makes prosthesis cumbersome. It also induces risk for post-op sinusitis. Extra-sinus approach with novel zygoma hybrid implants bypasses sinuses and positions the implant prosthetic platform on the crest allowing for same good prosthetics as on conventional dental implants. Furthermore, crestal threads and a platform-switch, of the novel zygoma design, increase implant anchorage and minimize marginal bone loss. The study presents evolution of zygoma implant rehabilitation protocol and zygoma implant design in our clinical practice over 15 years (2004-2019). CONCLUSION: Extra-sinus zygomatic implant placement lowers the risk of post-op sinusitis and makes procedure possible to be done in local anesthesia.

Extra-Sinus Zygomatic Implants to Avoid Chronic Sinusitis and Prosthetic Arch Malposition: 12 Years of Experience.

This report retrospectively at the 12-year follow-up results of the treatment and rehabilitation of edentulous maxillae, applying extra-sinus zygomatic implants alone or in combination with intra-sinus zygomatic implants. We recruited 22 patients with 35 zygomatic Brånemark system implants; 24 implants in the standard Brånemark protocol through the sinus and 11 extra-sinus implants outside the sinus. Additionally, 147 regular implants were placed. The minimum follow-up period was 50 months to a maximum of 152 months. The zygoma survival rate after 12 years was 97.15%. Chronic sinusitis occurred in 11.42% of patients. We lost 1 (2.85%) zygomatic implant placed through the sinus and none of those in the extra-sinus position. The survival rate of the regular implants was 93.87%. Chronic sinusitis occurred in 4 patients (11.42%) who received zygomatic implants using standard protocol through the sinus. None of the extra-sinus zygoma patients developed sinusitis. Peri-implantitis was detected with only 3 zygomatic implants. In the original P-I Brånemark zygoma protocol the implants were passing through the sinus, which resulted in chronic sinusitis in some patients and malposition of the prosthetic platform toward the palate. These complications can be avoided by the extra-sinus placement of zygoma implants as demonstrated in this study.

Evaluation of Metalloproteinase-8 Levels in Crevicular Fluid of Patients with Healthy Implants or Periodontitis.

Evaluation of periodontal and peri-implant tissue condition is mainly based on clinical examination and imaging diagnostics. Some data imply that Metalloproteinase-8 (MMP-8) level examination in peri-implant sulcular fluid (PISF) might be useful for evaluating the condition of peri-implant tissues and monitoring a development of peri-implant inflammation, including both mucositis and peri-implantitis. Hence, in this study, we decided to evaluate the level of MMP-8 in PISF obtained from patients without clinical symptoms of mucositis or peri-implantitis and compare it with MMP-8 level in gingival crevicular fluid (GCF) obtained from patients with healthy periodontium and those with varying severity of periodontitis. A total of 189 subjects were included in the study, and GCF/PISF samples were analysed for MMP-8 level by ELISA test. We documented that MMP-8 level in PISF obtained from patients without symptoms of mucositis or peri-implantitis was significantly higher not only than in GCF of periodontally healthy patients but also, which seems to be very interesting, than in GCF of patients with varying degrees of periodontal inflammation, consistent with earlier studies. Our observation might imply that monitoring of MMP-8 level in PISF could help to diagnose mucositis/peri-implantitis in an early stage, prior to clinical manifestations, which may allow for quick start of appropriate therapy.

Correlation between the state of periodontal tissues and selected risk factors for periodontitis and myocardial infarction.

BACKGROUND: The current level of knowledge indicates a relationship between periodontitis and diabetes and/or cardiovascular diseases (CVD). Periodontitis can be not only a risk factor for these diseases, but also a condition modifying other primary risk factors associated with the occurrence of cardiovascular complications (lipid disorders, arterial hypertension, etc.) or diabetes. OBJECTIVES: The aim of the study was an analysis of the correlation between the state of periodontal tissues and selected risk factors for myocardial infarction (MI) in patients after recent myocardial infarction. MATERIAL AND METHODS: The study included 417 patients (92 women, 325 men) hospitalized due to recent MI. The inclusion criteria were MI history and age below 70 years. The state of periodontal tissues (plaque index, bleeding on probing, pocket depth and clinical attachment loss, CPI index) and selected risk factors for periodontitis and CVD were recorded. RESULTS: An analysis of the results showed no statistically significant correlation between the depth, the number, percentage of periodontal pockets and the average clinical attachment level on one hand and BMI on the other hand. Whereas a statistically significant correlation was observed between tobacco smoking and the degree of severity of periodontal diseases measured by the average pocket depth, the number and percentage of pockets above 4 mm and the average clinical attachment loss, as well as between hypertension and the state of oral hygiene and between diabetes and the number of preserved teeth and the number of pockets above 4 mm. CONCLUSIONS: The degree of severity of periodontal disease can impact hypertension and diabetes, which could potentially influence the occurrence and course of CVD.

The side-effects of head and neck tumors radiotherapy.

Radiotherapy of head and neck tumours causes numerous complications in the oral cavity. The most frequent side effects are: mucositis, osteoradionecrosis, hypogeusia or dysgeusia, xerostomia, dental caries, dentinal hypersensitivity. It is recomended to prevent, reduce or relieve these complications in the oral cavity.

[The influence of breathing mode on the oral cavity]. / Wplyw toru oddechowego na jame ustna.

Nose breathing is one of the key factors in the proper development and functioning of the oral cavity. The air passing through the nasal cavity is warmed and humidified while dust and other particulate matter is removed. It is also important as far as bone formation is concerned. The obstruction or congestions of the upper respiratory tract may negatively affect the correct and most optimal (nasal) respiratory tract. The switch from nasal to mouth breathing may lead to serious clinical consequences. Children with the clinical diagnosis of mouth breathing are usually pale, apathetic and they lack concentration and often get tired. Disorders resulting from hypoxy may also be the reason from sleep disturbances, such as frequent waking-up, nocturia, difficulties falling aslee. The main clinical manifestations of mouth breathing appear in the craniofacial structures. Mouth breathers frequently suffer from dental malocclusions and craniofacial bone abnormalities. Chronic muscle tension around the oral cavity could result in the widening of cranio-vertebral angle, posterior position of mandibula and narrow maxillary arch. Among dental alterations the most common are class II malocclusion (total or partial) with the protrusion of the anterior teeth, cross bite (unilateral or bilateral), anterior open bite and primary crowded teeth. Apart from malocclusion, chronic gingivitis, periodontitis, candida infections and halitosis are frequently present in mouth--breathing patients.

[Alcohol dependence syndrome--symptoms in the oral cavity]. / Nastepstwa uzaleznienia od alkoholuobserwowane w jamie ustnej.

Alcohol dependence syndrome is defined as a cluster of physiological, behavioural and cognitive phenomena in which the use of a psychoactive substance takes on a much higher priority for a given individual than other behaviours that once had greater value. In European Union the problem of the addiction affects about 5% of men and 1% of women each year. Long lasting alcohol abuse is detrimental to the whole body, including the oral cavity. The observable changes are usually caused by a convergent impact of a number of factors. The changes differ depending on the chemical features of the consumed substance, the life style adopted - as a consequence of the addiction, simultaneous addiction to nicotine, and finally on the medical treatment applied at different stages of the disease. Pathological changes may occur in all structures in oral cavity (teeth, periodontium, tongue, mucose membrane and salivary glands). Individuals addicted to alcohol revealed high percentage of carious losses and chemical damage enamel and dentine and inflammatory changes of the periapical area of teeth. Presence of these changes is linked unfortunately with low indicator of treatment. There is independence between alcohol addiction and damage of periodontium (clinical attachment level and pocket depth). Results of alcohol abuse may be also double-sided, painless, noninflammatory and non-malignant swelling on salivary glands (sialosis). Alcohol is said to be the risk factor for development of flat-epithelial cancer of the oral cavity. The most frequent localization of cancerous changes is the bottom of the oral cavity and the side of the tongue.

Incidence of abnormalities in temporomandibular joints in a population of 1,100 urban and rural patients lacking teeth and other parafunctions in 2003-2008. An international problem.

INTRODUCTION AND OBJECTIVE: A hectic lifestyle and everyday stress are direct causes of parafunctions. The objective of the presented study was to examine the relation of sleep disorders, distant pain symptoms, symptoms of pathological tooth wear in rural and urban patients with parafunctions. MATERIALS AND METHODS: The patient group consisted of 836 women and 274 men aged 9-82, and divided into groups taking into account the following criteria: number of patients in certain age groups, number of women and men, place of residence, presence of missing teeth problem, presence of occlusal and non-occlusal parafunctions, symptoms of tooth wear, distant pain symptoms, and sleep disorders. RESULTS: 354 (31.89%) of the patients came from the rural environment. Distant pain symptoms were more frequent in patients performing parafunctions than in those who did not perform parafunctions (n = 1110, RR = 1.10, CI = from 1.04 to 1.16). Sleep disorders were more frequent in patients performing parafunctions than in those who do not perform parafunctions (n = 1110, RR = 1.06, CI = from 1.00 to 1.12). Symptoms of pathological tooth wear were more frequent in patients performing parafunctions than in those who did not perform parafunctions (n = 1110, RR = 1.08, CI = from 1.02 to 1.13). CONCLUSIONS: It is extremely important (as it is international problem) to introduce prophylactic care to prevent the occurrence of parafunctional activity in patients from the rural environment. Parafunctions, therefore, should be taken into account in the diagnosing procedure of such disorders and pathological symptoms as pathological tooth wear, sleep disorders, cervicalgia, neck myalgia, shoulder girdle myalgia, and dorsalgia.

Correlation between eye and ear symptoms and lack of teeth, bruxism and other parafunctions in a population of 1006 patients in 2003-2008.

INTRODUCTION: Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. MATERIAL AND METHODS: The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. RESULTS: Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. CONCLUSIONS: The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes.

[The influence of tobacco smoking on the state of dentition and the effect of the chronic periodontitis conservative treatment in periodontology clinic patients at the Chair and Department of Periodontology of the Medical University in Lublin]. / Wplyw palenia papierosów na stan przyzebia i efekty leczenia zachowawczego przewleklego zapalenia przyzebia u pacjentów Poradni Periodontologicznej przy Katedrze i Zakladzie Periodontologii UM w Lublinie.

Tobacco smoking is a serious health and social problem. The aim of the study was investigation of the influence of tobacco smoking on the state of dentition and effects of conservative treatment of the chronic, moderately advanced periodontitis by comparison of API, SBI, PPD and CAL indices before and after the treatment in smoking and non-smoking patients. Smokers group consisted of 30 people aged 30-48 including 15 men and 15 women who had smoked for more than 10 years, with the intensity of smoking of more than 10 cigarettes a day. The control group constituted 30 non-smoking people aged 30-50; 15 men and 15 women. The SBI index of bleeding from periodontal pockets in smokers is essentially statistically lower than in non-smokers, with similar hygiene indices. Shallowing of periodontal pockets depth (PPD) after the treatment is smaller than in smokers. Reconstruction of alveolodental ligament measured with CAL index in smokers seems to be smaller than in non-smokers.

Comparison of the effectiveness of the conservative treatment of the periodontal pockets with or without the use of laser biostimulation.

The use of laser therapy as the agent reinforcing conventional treatment of the periodontal diseases becomes more and more common. In the physiotherapy of the periodontal diseases the biostimulating, laser is eagerly used because of its action which accelerates the healing of wounds and also because of its antioedematous, anti-inflammatory and analgesic action. The aim of work was the evaluation of the influence of laser biostimulation on the change of the periodontological pockets depth after the routine conservative periodontological treatment with additional use of laser biostimulation and without it for two groups of pockets: above and below 5 mm. In six patients having periodontitis 613 sites were submitted to the statistic analysis (290 treated conservatively only, including 251 with the depth 2-5 mm and 39 above 5 mm as well as 323 with the use of laser therapy including 297 shallow pockets and 26 deep ones). The initial values of API, SBI, PPD and their changes in the course of the treatment were registered. During each control appointment the patients subjectively estimated periodontal pain occurrence. In both studied groups statistically essential decrease of the evaluated parameters was obtained. Reinforcing the conventional treatment with laser biostimulation shortens its duration and leads to the elimination of pain faster than with the use of conservative treatment only. The changes of the PPD index among the successive examinations were statistically essentially higher in the therapy with the use of laser, especially in relation to deep pockets.

The use of HA-Biocer in the complex treatment of aggressive periodontal diseases.

The aim of the work was clinical and radiological evaluation of the HA-Biocer implant material in the complex conservative and surgical treatment of the advanced changes in marginal periodontium. Highly statistically important reduction of the attachment loss CAL and pockets depth PPD were obtained.

The application of Bio-Oss and Bio-Gide as implant materials in the complex treatment of aggressive periodontitis.

In the presented study the results of the complex conservative and surgical periodontological treatment using Bio-Oss implant material and the regenerative Bio-Gide collagen membrane by Geistlich company were subjected to clinical and radiological evaluation. The measure depth of the periodontal pockets PPD was subjected to evaluation, the level of the epithelial attachment CAL and the defect of bone of the alveolar process were observed on radiograms. In all patients the state of oral cavity hygiene was examined using the index of API bacterial plaque and the percent of SBI index of bleeding gingiva. The analysis of the examined parameters concerned the period before surgeries and 8 to 12 months after the surgeries of the guided tissue regeneration. On the basis of the conducted research and the statistic analysis, the reduction of the periodontal pockets depth and the reconstruction of the attachment.

Use of Emdogain enamel matrix proteins in the surgical treatment of aggressive periodontitis.

One of the ways of treating of the aggressive forms of periodontitis is the method of guided tissue regeneration using enamel matrix proteins included in Emdogain preparation. The aim of work was clinical evaluation of the complex treatment of those periodontolyses using the above mentioned material as the implant material. 35 intrabony pockets were operated in 11 patients aged 17-50. The treatment results were described with the use of clinical indices of API and SBI, indices of pockets depth PPD and the loss of the attachment CAL indices before and within the period of 8 to 12 months after the surgeries. The values of the examined features were submitted to statistical analysis using Shapiro-Wilks and Wilcoxon's tests. The treatment that was applied led to extremely statistically significant improvement of the examined parameters.