Effects of low-level laser treatment on mouth dryness.

UNLABELLED: Mouth dryness (MD) is usually followed by inadequate mechanical cleaning of the mouth and decrease in the levels of salivary antimicrobial proteins (including secretory immunoglobulin A (sIgA)). It is accompanied by difficulties during speaking and food swallowing, with an unpleasant taste, burning sensations in the mouth and higher susceptibility to oral diseases. Low-level laser treatment (LLLT) can intensify cell metabolism and its application on salivary glands could improve salivation. The purpose of this study was to evaluate the effects of LLLT on salivation of patients suffering from MD. The study included 17 patients with MD. Their major salivary glands were treated with low intensity laser BTL2000 on 10 occasions. The whole unstimulated and stimulated saliva quantities were measured just before the 1st, after the 10th and thirty days following the last (10th) treatment. In the samples of unstimulated saliva concentrations of sIgA were estimated by using ELISA method and its quantity in the time unit was calculated. The visual analogue scale (VAS) score was used to assess burning and/or pain intensity at these three time points. Statistical tests revealed significant salivation improvement quantitatively and qualitatively, i.e. increase in the quantity of saliva and sIgA. VAS score was also significantly improved and no side effects were observed. CONCLUSIONS: According to the results of this study, application of LLLT to xerostomic patients' major salivary glands stimulates them to produce more saliva with better antimicrobial characteristics and improves the difficulties that are associated with MD. This simple non-invasive method could be used in everyday clinical practice for the treatment of MD.

Serum immunoglobulins IgG, IgA and IgM in patients with oral lichen ruber.

The aim of this study was to determine level of serum IgA, IgG and IgM in patients with OLR as indicators of humoral immunity which might reflect cell-mediated immunity. This study was conducted on 30 patients (age 60.17 +/- 11.75) with clinically and histopathologically confirmed diagnosis of OLR and 30 healthy controls (age 56.16 +/- 11.82) Determination of serum IgA, IgG and IgM was performed by use of standard laser nephelometry in both patients and controls. Statistical analysis was done using Mann-Whitney U test and the level of significance was determined as p values lower than 0.05. Serum IgA and IgM in patients with OLR were significantly increased in comparison to the control group, while serum IgG levels were higher in patients with OLR but they did not reach significance. We might conclude that elevated levels of serum IgA and IgM show that humoral immunity is implicated in the pathogenesis of OLR.

[Recurrent aphthous ulcerations: analysis of predisposing factors in 68 patients]. / Rekurentne aftozne ulceracije: analiza predisponirajucih cimbenika u 68 bolesnika.

Recurrent aphthous ulcerations (RAU) are the most common oral ulcerative disease, affecting 10% to 20% of the population. Local, systemic, genetic, immunological and microbial factors may play a role in the etiology of RAU, but the pathogenesis of the disease still remains unknown. In this study we have investigated correlation between RAU and anemia, dispeptic difficulties, Helicobacter pylori infection and immunological disorders in 68 patients age range 5-73 years, mean age 38.8 years, from the Department of Oral Medicine, School of Dental Medicine, University of Zagreb with diagnosed RAU in the year 2003. The diagnosis of RAU was based on clinical criteria. Anemia was diagnosed using routine laboratory tests and the diagnosis of H. pylori infection was made based on serologic or urea breath test. The results of this study show that RAU are more frequent in women and that they often occur in patients with dispeptic difficulties. It should be emphasized that in patients with RAU after the exclusion of hematological deficiencies (iron, folic acid and vitamin B12) gastrointestinal examination and H. pylori testing should be performed, due to high percentage of RAU disappearance after H. pylori eradication therapy.

The significance of salivary and serum interleukin 6 and basic fibroblast growth factor levels in patients with Sjögren's syndrome.

Role of various cytokines have been implicated in the development and perpetuation of Sjogren's syndrome (SS), but no specific cytokine could be determined as a major contributor to the SS. Salivary and serum interleukin 6 (IL-6) levels have been studied previously in patients with SS, but data upon salivary and serum basic fibroblast growth factor (bFGF) in SS are lacking. The aim of this study was to evaluate levels of salivary and serum IL-6 and bFGF in 18 patients with SS, age range 32-79, mean 54.05 years. Control group consisted of 23 healthy participants, mean age 25 years. Serum IL-6 and bFGF levels were not significantly different between patients with SS and healthy controls. Elevated levels of salivary IL-6 and bFGF in patients with SS when compared to the healthy controls were found (p<0.001). We might speculate that higher levels of salivary IL-6 and bFGF in patients with SS might originate from local production probably having source in the salivary glands.

Tissue expression of proliferative antigens (PCNA and Ki-67) in oral lichen ruber related to clinical status.

The aim of this study was to determine the expression intensity of PCNA and Ki-67 tissue antigens related to pathologically modified oral mucosa in OLR lesions, and to determine the reaction intensity of these antigens in individual clinical forms, i.e. lichen ruber planus (LRP) and lichen ruber erosivus (LRE) comparing the reaction intensity with the inflammation grade and the degree of hyperkeratosis in lesions of 30 patients. Control group included patients (n = 15) with oral leukoplakia simplex. Tissue antigens were observed by immunohistochemical analysis using APAAP and LSAB methods. The reaction on tested tissue antigens was focal positive and of mosaic type. The reaction of the PCNA antigen was intensely high in OLR lesions regardless on the clinical form of the lesion. The reaction intensity positively correlated with the inflammation grade and the degree of hyperkeratosis in lesions. The reaction on Ki-67 tissue antigen ranged from low to moderately high intensity. Intensely high reaction was observed in lesions of lichen ruber erosivus. The reaction positively correlated with the inflammation grade and the degree of hyperkeratosis in lesions. Observed modified reaction of analyzed tissue antigens related with individual clinical forms of OLR might be the indicator of transformed nature of these lesions.

Changes in the tissue expression of the C-erbB-2 oncogen in the oral lichen ruber.

The aim of this study was to determine the expression intensity of c-erbB-2 antigen in oral lichen planus and erosive form of oral lichen in 30 patients, and to compare the obtained results with the inflammation intensity i.e. hyperkeratosis. The examination of expression intensity of c-erbB-2 antigen was conducted through immunohistochemical analysis by APAAP method. Obtained reaction of examined tissue antigen was positive in individual or in group cells of spinous epithelium layer and mosaically expressed. The reaction was negative in basal cell epithelium layer. Strong intensity reaction was observed in intercellular bridges of spinous cells layer. In control group, the reaction was of uniform strong intensity in all epithelium layers. The reaction was not dependent on the inflammation intensity in lesions but it was positively correlated with their degree of hyperkeratosis. Changed expression of c-erbB-2 antigen in OLR lesions reveals the possibility of potential malignant transformation of these lesions.

[Mouth dryness (xerostomia)--causes, diagnosis and therapy]. / Suhoca usta (kserostomija)--uzroci, dijagnostika i lijecenje.

Xerostomia or dry mouth is a state of decreased salivary flow rate in the oral cavity, i.e. symptom which could be caused by various systemic diseases and states, as well as iatrogenically. The importance of recognizing xerostomia results in better conditions in the oral cavity, because loss of saliva manifests itself in frequent infections in the oral cavity, rampant caries, especially of the cervical parts of the teeth, inflammation of the major salivary glands, various unspecific symptoms as well as decreased ability to speak and eat.