RESUMEN
In addition to palpation tests, dynamic/static tests have been proposed to complement temporomandibular disorders (TMD) patients' evaluation in the clinical setting. The aim of this study was to assess the intra- and inter-observer reliability of the palpation tests and of the dynamic/static tests, and to determine whether those tests would yield comparable outcomes in terms of pain diagnoses. Ninety-eight (N = 98) consecutive adult patients were examined during 2 clinical sessions by 2 independent examiners, based on muscle and joint palpation techniques described in the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). They also underwent dynamic/static tests. The intra-observer reliability of palpation tests was generally poor, with fair-to-good to excellent ICC values only for the superior masseter and intra-oral sites. The inter-observer reliability of palpation was fair-to-good for muscles, but it was poor for the TMJ lateral pole. Both intra- and inter-observer reliability for the dynamic/static tests varied from fair-to-good to excellent. The intra-observer reliability for muscle pain diagnoses based on palpation tests was between poor and fair-to-good, whereas the inter-observer reliability was excellent. The intra-observer reliability for pain diagnoses based on dynamic/static tests was fair-to-good, and the inter-observer reliability varied from fair-to-good to excellent. CONCLUSIONS: Some features of the dynamic/static tests make them potentially more useful than palpation tests for selected clinical purposes, such as discriminating between joint and muscle pain as well as monitoring symptoms course. Thus, findings from this investigation suggest that both tests should be included in the TMD diagnostic algorithms.
Asunto(s)
Diagnóstico Bucal , Dolor Facial/diagnóstico , Palpación/métodos , Disco de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/diagnóstico , Adulto , Dolor Facial/fisiopatología , Femenino , Humanos , Masculino , Variaciones Dependientes del Observador , Evaluación de Resultado en la Atención de Salud , Dimensión del Dolor , Rango del Movimiento Articular , Reproducibilidad de los Resultados , Trastornos de la Articulación Temporomandibular/fisiopatologíaRESUMEN
The significance of teaching dental subjects to medical students as well as medicine to dental students is considered. The authors' experience in teaching dentistry to medical students in English at the University of Krakow is described.
Asunto(s)
Educación en Odontología , Lenguaje , Estudiantes de Medicina , Curriculum , Humanos , Polonia , UniversidadesRESUMEN
The present study aimed at researching the synergistic effect between an ectopic bone substitute and surrounding muscle tissue. To describe this effect, changes of insulin like growth factors (IGF1, IGF2), myostatin (GDF8) and vascular endothelial growth factor (VEGF) mRNA content of 12 Wistar-King rats musculus latissimus dorsi with implanted poly-3-hydroxybutyrate (PHB) scaffold were examined after 6 and 12 weeks. At each time interval six rats were killed and implants and surrounding tissues prepared for genetic evaluation. Eight rats without any implants served as controls. RNA was extracted from homogenized muscle tissue and reverse transcribed. Changes in mRNA content were measured by Real-Time PCR using specific primers for IGF1, IGF2, GDF8 and VEGF. Comparing the level of VEGF mRNA in muscle after 6 and 12 weeks to the controls, we could assess a significant increase of VEGF gene expression (p<0.05) whereas the level of mRNA expression was higher after 6 than after 12 weeks of treatment. Expression of IGF1 gene was also significantly increased as compared to the controls over the observed period of time (p<0.05). In the case of the IGF2 gene, the expression was significantly elevated after 6 weeks (p<0.05), but not significantly increased after 12 weeks (p>0.05). We observed a significantly decreased GDF8 gene expression (p<0.05) both after retrieval of implants after 6 as well as after 12 weeks. Moreover, mRNA level of GDF8 after 6 and 12 weeks were comparable the same. Our results show that PHB implants in rat musculus latissimus dorsi interact with the surrounding muscle tissue. This interaction works itself on growth potential of the muscle.
Asunto(s)
Adaptación Fisiológica/efectos de los fármacos , Sustitutos de Huesos/farmacología , Hidroxibutiratos/farmacología , Músculo Esquelético/metabolismo , Poliésteres/farmacología , Cicatrización de Heridas/efectos de los fármacos , Adaptación Fisiológica/fisiología , Animales , Factor I del Crecimiento Similar a la Insulina/efectos de los fármacos , Factor I del Crecimiento Similar a la Insulina/genética , Factor I del Crecimiento Similar a la Insulina/metabolismo , Factor II del Crecimiento Similar a la Insulina/efectos de los fármacos , Factor II del Crecimiento Similar a la Insulina/genética , Factor II del Crecimiento Similar a la Insulina/metabolismo , Masculino , Miostatina/efectos de los fármacos , Miostatina/genética , Miostatina/metabolismo , Osificación Heterotópica/metabolismo , Osteogénesis/fisiología , Prohibitinas , ARN Mensajero/análisis , Distribución Aleatoria , Ratas , Ingeniería de Tejidos , Andamios del Tejido , Factor A de Crecimiento Endotelial Vascular/efectos de los fármacos , Factor A de Crecimiento Endotelial Vascular/genética , Factor A de Crecimiento Endotelial Vascular/metabolismo , Cicatrización de Heridas/fisiologíaRESUMEN
Neuromuscular blocking drugs (NMBD) can inhibit not only nicotinic but also muscarinic (M) receptors and thereby affect not only skeletal but also smooth muscle (SM) tone. A selective postjunctional muscarinic inhibition would relax, while prejunctional inhibition of muscarinic M2 receptor might hasten SM contraction thereby increasing the risk of bronchospasm. In rat tracheal rings in vitro we evaluated the effects of cumulative concentrations of some NMBD and M receptor blocking agents for their effects on tracheal smooth muscle (TSM) tone pre-contracted with carbachol (CARB; 5 x 10(-7)M or 10(-6)M), pilocarpine (PILO; 5 x 10(-6)M), or by electrical field stimulation. The NMBDs produced relaxation in the preparations precontracted with CARB or PILO. The order of potency after CARB (10(-6)M) was (EC(50)): 4-DAMP (9.8) >atropine (9.2) >methoctramine (6.4) >pancuronium (6.0) >mivacurium (5.8) >cisatracurium (5.6) >gallamine (5.2) >rocuronium (4.8) >succinylcholine (2.9); NMBDs also partially prevented contraction elicited by the electrical field stimulation. We demonstrated that the clinically used NMBD that were examined produced rat TSM relaxation, probably by predominantly blocking postjunctional muscarinic receptors.
Asunto(s)
Tono Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos , Fármacos Neuromusculares/farmacología , Tráquea/efectos de los fármacos , Animales , Relación Dosis-Respuesta a Droga , Tono Muscular/fisiología , Músculo Liso/fisiología , Ratas , Ratas Endogámicas Lew , Tráquea/fisiologíaRESUMEN
H. pylori is an important factor in the pathogenesis of numerous diseases including gastro-intestinal, metabolic and vascular disorders. Therefore, identification of individuals at risk of this infection remains of critical importance. Dentists and dental professionals may be at increased risk due to the contact with oral cavity of patients with the presence of H. pylori in the oral cavity where it may serve as reservoir for gastric infections and participate in the pathogenesis oral mucosal lesions and ulceration. However, evidence regarding the occurrence of H. pylori infections and colonization in dentists is conflicting, but has been based mainly on serological studies, which carry significant limitations. Therefore, we attempted to characterize H. pylori infection in practising dentists in relation to the duration of their work as dental professionals. Moreover, apart from seropositivity, which was used by majority of previous studies, we have performed urea-breath test (UBT), which has been shown to represent active H. pylori infection in stomach as well as the H. pylori culture from the oral cavity. We found that while the occurrence of either gastric or oral H. pylori in dentists is not greater than in general population, it seems that in male dentists there is a greater risk of gastric H. pylori infection. Moreover, we found a relationship between the length of dentist occupation with the presence of H. pylori in gingival sulcus. In conclusion, while overall occurrence of H. pylori in dentists did not differ from that reported for stomach or oral cavity in general population, there was an increased occurrence of H. pylori in male dentists and the presence of this germ in the oral cavity appears to be related to the length of professional exposure.
Asunto(s)
Odontólogos , Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Exposición Profesional/efectos adversos , Recuento de Colonia Microbiana/métodos , Femenino , Infecciones por Helicobacter/microbiología , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Boca/microbiología , Prevalencia , Factores Sexuales , Factores de TiempoRESUMEN
In the design of biomaterials for therapeutic application the evaluation of cellular/tissue responses play a key role. In this study, the in vivo bone-regenerative capacity and resorption of granular BONITmatrix and a paste-like bone substitution material on the basis of BONITmatrix were investigated in a rat cranial defect model. The results obtained with both biomaterials were compared to each other. For these, the paste-like composite and the granular BONITmatrix were implanted in adult male WOK-W rats, the skulls were harvested after eight weeks, and histopathological examinated. The comparison of the both tested biomaterials showed that the paste-like composite is much better to handle, the resorption of the material and the ossification process is much faster than those of granular BONITmatrix. The amount of newly formed bone was also measured and more bone formation was found in bone defects filled with the paste-like composite compared to those with granular BONITmatrix. The present study showed that both biomaterials could stimulate bone regeneration, but the paste-like composite leads in comparison to granular BONITmatrix to an accelerated more comprehensive bone regeneration.
Asunto(s)
Regeneración Ósea/efectos de los fármacos , Sustitutos de Huesos/administración & dosificación , Fosfatos de Calcio/administración & dosificación , Dióxido de Silicio/administración & dosificación , Cráneo/efectos de los fármacos , Cráneo/patología , Animales , Regeneración Ósea/fisiología , Evaluación Preclínica de Medicamentos/métodos , Masculino , Osteogénesis/efectos de los fármacos , Osteogénesis/fisiología , Ratas , Cráneo/citología , Resultado del TratamientoRESUMEN
The objective of the study was to evaluate the degree of temperature change in the bone, directly adjacent to the implant site during the abutment part of one-piece implants, during procedures involving different cutting techniques. Three different one-piece implants: Osteoplant, Nobel Direct, Q-implant were cut with air-turbine burs after insertion in fresh pig ribs. Tests were performed with a variety of cooling techniques including air and air-liquid coolant. Implants were cut on the occlusal and axial surfaces of the abutment part. The temperature changes were evaluated using thermocouple type K during and after cutting procedures. It was found that regardless of the cutting technique, the temperature of the bone always increased during the cutting procedure. The critical temperature threshold Delta T=10 degrees C (47 degrees C) was always exceeded, when only the air coolant was used, although when the air-water spray coolant was utilized during the cutting procedure, it prevented the temperature to exceed this critical level. The extent of thermal changes in the bone depends on the cutting technique. Constant air-water cooling during the cutting procedure is a recommended technique in order to avoid overheating the implant-bone interface. The dry cutting technique, using only an air coolant, should be avoided as it can induce sufficiently high thermal damage in the bone adjacent to the implant, which leads to compromise of the osteointegration process.
Asunto(s)
Trasplante Óseo/métodos , Implantes Dentales , Boca/fisiología , Termografía/métodos , Animales , Temperatura Corporal/fisiología , Trasplante Óseo/instrumentación , Boca/cirugía , Osteotomía/instrumentación , Osteotomía/métodos , Porcinos , Termografía/instrumentaciónRESUMEN
Our previous studies demonstrated that the use of acrylic based prosthesis in edentulous patients had a direct impact on the increased incidence of oral mycosis and further episodes of mycosis in the digestive tract. This dependency is associated with formation of a space between the surface of the prostheses and adhering mucosal membrane, where a specific micro environment is being formed, which - as stated - creates a superior breeding ground mainly for microorganisms of the genus Candida.
Asunto(s)
Candidiasis , Prótesis Dental de Soporte Implantado/microbiología , Dentadura Completa/microbiología , Esofagitis , Mucosa Bucal/microbiología , Acrilatos , Adulto , Anciano , Antifúngicos/administración & dosificación , Antifúngicos/uso terapéutico , Candida albicans/efectos de los fármacos , Candida albicans/aislamiento & purificación , Candidiasis/microbiología , Candidiasis/prevención & control , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/microbiología , Candidiasis Bucal/prevención & control , Esofagitis/microbiología , Esofagitis/prevención & control , Humanos , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Hueso Paladar/microbiología , Resultado del TratamientoRESUMEN
The development of cancer is associated with high oxidative stress and at the same time with immune system activation. Tumors develop efficient mechanisms of protection against the immune response, which allow them to escape the immune surveillance. Simultaneously, key events in the process of carcinogenesis are related to oxidative stress. The relationship between the two remains unknown. Novel understanding of oxidative stress shows that discrete changes of activities of certain enzyme systems such as NADPH oxidases or nitric oxide synthases may be more important than the overall balance of production and removal of reactive oxygen species. Such imbalance of nitric oxide and superoxide production could modify inflammation and immune regulation. We studied superoxide anion production (by lucigenin enhanced chemiluminescence - 5 microM), NADPH oxidase activity and nitric oxide synthase (NOS) dysfunction. In parallel mRNA expression of immunomodulatory markers such as FoxP3 (T regulatory cell marker), CCR6 (mucosal homing effector T cell marker) and CD85j (NK cell/CD8 T cell Ig-like MHC class I inhibitory receptor) was determined. Basal superoxide production and NADPH oxidase activity are increased in oral squamous cell carcinoma. Tumor superoxide production was inhibited by NADPH oxidase inhibitor apocynin and by NOS inhibitor L-NAME. This indicates, for the first time, that oral squamous cell carcinoma is characterized by dysregulated nitric oxide synthase, which apart from increased NADPH oxidase activity contributes to oxidative stress and may be related to the immuno-pathology of these tumors. Studied tumors were infiltrated by CCR6+, but showed lower expression of both CD85j and FoxP3 mRNA. Finally, the CD85j mRNA expression was inversely correlated to oxidative stress parameters. These preliminary studies indicate that tumor oxidative stress, related to NADPH oxidase activity and NOS activity could be related to immune responses to cancer, thus therapeutic modification of oxidative stress, which could include the correction of NOS dysfunction, could facilitate immune surveillance.
Asunto(s)
Carcinoma de Células Escamosas/fisiopatología , Neoplasias de la Boca/fisiopatología , NADPH Oxidasas/metabolismo , Óxido Nítrico Sintasa/metabolismo , Antígenos CD/metabolismo , Factores de Transcripción Forkhead/metabolismo , Expresión Génica , Humanos , Técnicas In Vitro , Receptor Leucocitario Tipo Inmunoglobulina B1 , Estrés Oxidativo , ARN Mensajero/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Receptores CCR6/metabolismo , Receptores Inmunológicos/metabolismo , Superóxidos/metabolismoRESUMEN
The role of the oral cavity in the pathogenesis of diseases of various systems such as the gastro-intestinal tract (GIT), cardiovascular and immune systems has been recently evaluated. While initially the oral cavity was considered to be mainly a source of various bacteria, their toxins and antigens, recent studies showed that it may also be a location of oxidative stress and periodontal inflammation. Accordingly, this review focuses on the involvement of melatonin (MT) in oxidative stress diseases of oral cavity as well as on potential therapeutic implications of MT in dental disorders, especially in periodontal inflammation. MT is generated and released by pineal gland and by entero-endocrine (EE) cells located in the GIT. The pattern of MT secretion from the pineal gland is controlled by an endogenous circadian timing system that conveys information about the light/dark cycle to various organs of the body, thereby organizing its seasonal and circadian rhythms. The secretion of MT from the EE cells of GIT is related mainly to feeding periods. MT is a non-toxic highly lipophilic indole, and this feature facilitates its penetration through cell membranes and its compartments. However, the most important effect of MT seems to result from its potent antioxidant, immuno-modulatory, protective and anti-cancer properties. It stimulates synthesis of type I collagen fibers and promotes bone formation. Thus, MT could be used therapeutically for instance, locally, in the oral cavity damage of mechanical, bacterial, fungal or viral origin, in post-surgical wounds caused by tooth extractions and other oral surgeries and, in helping bone formation in various auto-immunological disorders such as Sjorgen syndrome, in periodontal diseases, and in oral cancers.
Asunto(s)
Melatonina/fisiología , Enfermedades de la Boca/fisiopatología , Estrés Oxidativo/fisiología , Antioxidantes/fisiología , Humanos , Inflamación/fisiopatología , Melatonina/metabolismo , Enfermedades Periodontales/fisiopatologíaRESUMEN
There are numerous studies suggesting that inflammation of the oral cavity caused by bacteria or fungi is accompanied by gastric inflammation. This is particularly relevant in patients using complete dentures. Since the presence of H. pylori in the oral cavity can be easily discovered by bacteria culture and that in the stomach by (13)C urea breath test (UBT) and histology of gastric endoscopic biopsy samples it is reasonably to state that the majority of the patients show the presence of bacterium in oral cavity and active gastric H. pylori infection. When comparing, however, the bacteria culture originating from the oral mucosa to those from the gastric mucosa, employing molecular biology examination, such as polymerase chain reaction (PCR), we found that the oral bacteria and those originating from stomach are completely different, suggesting that H. pylori may be present only transiently in oral cavity and does not play major role in gastric H. pylori infection. Thus, oral cavity does not serve as bacterial reservoir to infect gastric mucosa. Most important finding of our study is that patients with recognized inflammation in the oral cavity in the form of stomatitis prothetica hyperplasica both fibrosa as well as papillaris showed in nearly 100% gastric H. pylori infection, usually without the presence of the same bacterium in the oral cavity, suggesting that gastric H. pylori infection affects oral mucosa at distance by some, as yet, unknown mechanism.
Asunto(s)
Infecciones por Helicobacter/microbiología , Helicobacter pylori/aislamiento & purificación , Boca/microbiología , Estómago/microbiología , Adulto , Anciano , ADN Bacteriano/genética , Placa Dental/microbiología , Dentaduras , Infecciones por Helicobacter/genética , Helicobacter pylori/genética , Humanos , Masculino , Persona de Mediana Edad , Saliva/microbiologíaRESUMEN
Helicobacter pylori (H. pylori) is an important gastrointestinal pathogen associated with gastritis as well as gastric or duodenal ulcers and gastric cancer. The oral cavity has been considered as a potential reservoir for the gastric infection and reinfection. The objective of our studies was to evaluate the influence of oral H. pylori for the stomach infection and the release of gut hormones affecting food intake such as ghrelin and gastric secretion such as gastrin. Additionally, the contribution of H. pylori in the periodontal disease has been examined. H. pylori infection in stomach was assessed by (13)C- Urease Breath Test and presence of the bacteria in oral cavity by culture. The periodontal status was measured by pockets depth with the periodontal probe. We estimated the serum level of IgG anti-H. pylori, anti-VacA, anti-CagA, ghrelin, gastrin, TNF-alpha and IL-8 in blood and the level of IgA anti-H. pylori in saliva. The presence of H. pylori in oral cavity was detected in 54.1% of examined individuals, whereas the H. pylori gastric infection in tested group was found in 51% cases. However, the correlation analysis between those two groups of patients involving together about 100 subjects showed that within the group of patients with positive gastric H. pylori infection only 45.1% did not show the presence of H. pylori in saliva and 43.1% showed no H. pylori in supragingival plaque. In line of these findings patients who did not have gastric H. pylori infection, 53.2% showed presence of H. pylori in saliva and 42.9% in supragingival plaques. Serum level of ghrelin and gastrin in subjects with oral H. pylori inoculation but without gastric H. pylori infection were not significantly different from those without the presence of this germ in oral cavity. In contrast, gastric H. pylori infection resulted in significant reduction in serum ghrelin levels and significant elevation of gastrin as compared to those who were gastric H. pylori negative. We concluded that oral H. pylori alone does not seem to serve as bacterium sanctuary for gastric H. pylori infection and, unlike gastric infection, it fails to affect serum levels of hormones stimulating appetitive behaviour such as ghrelin and gastric acid secretion such as gastrin.
Asunto(s)
Reservorios de Enfermedades , Dispepsia/microbiología , Infecciones por Helicobacter/fisiopatología , Boca/microbiología , Gastropatías/microbiología , Adulto , Factores de Edad , Pruebas Respiratorias , Placa Dental/microbiología , Femenino , Gastrinas/sangre , Gastrinas/metabolismo , Ghrelina/sangre , Ghrelina/metabolismo , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/inmunología , Helicobacter pylori/inmunología , Helicobacter pylori/aislamiento & purificación , Humanos , Persona de Mediana Edad , Enfermedades Periodontales/microbiología , Prevalencia , Saliva/microbiologíaRESUMEN
UNLABELLED: Helicobacter pylori is a gram-negative, microaerophilic rod-shaped bacteria that lives beneath the gastric mucous layer, on the surface of epithelial cells. Stomach infection with this organism causes inflammation of the gastric mucosa, which can lead to gastritis, duodenal or gastric ulcer and even in rare cases to gastric carcinoma or MALT lymphoma. Approximately 50% of the world's population is believed to be infected with H. pylori. Most infections is probably acquired in childhood, but the exact route of transmission is unknown. It has been speculated that dental plaque might harbour Helicobacter pylori and, therefore, might be a source of gastric infection. In order to address this issue we studied the relationships between oral and gastric infections with H. pylori in 100 subjects. METHODS: Gastric H. pylori infection was determined by (13)C-urea breath test (UBT) and the presence of the bacteria in oral cavity was monitored by the culture from the saliva and from dental plaque. RESULTS: H. pylori was found in the stomach in 51% of studied individuals, while oral H. pylori was found in 54% (in saliva) and in 48.3% (in gingival pockets), the difference was not statistical significant (p=NS). Interestingly, anti-Hp IgA was found in 84% of studied individuals. No relationship was found between the presence of the bacteria in the oral cavity and the H. pylori gastric infection. 54.9% of subjects with stomach infection showed concomitant presence of H. pylori in saliva. 52.3% of examined subjects with negative UBT-test revealed the presence of H. pylori in culture from the saliva. The X(2) value of relationship between UBT and culture H pylori in saliva was 0.029 (p=0.9). Similarly, no relationship was found between the presence of H. pylori in the stomach and in the dental plaque (X2=0.6); p=0.4). As expected, the presence of H. pylori in the dental plaque was significantly correlated with the presence of bacteria in the saliva (X2=18.4; p=0.0002). We also compared the presence of H. pylori in the saliva of patients with and without teeth. The cultured H. pylori was found in 63.7% of patients without teeth and in 52.9% of patients with teeth. This indicates that the presence of teeth does not seem to affect the occurrence of H. pylori in saliva. We conclude that oral activity contamination with of H. pylori occurs at similar degree to that in the stomach. However, there was no significant correlation between the occurrence of H. pylori in the stomach and in the oral cavity indicating that other factors, like susceptibility to infection due to acid environment in the stomach may be the major factor in gastric infection with that bacteria, while oral cavity may serve only as transient food-related contamination without clear relation to gastric infection.