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A fogászati implantáció elterjedésével előtérbe kerülnek az implantációval kapcsolatos szövődmények vizsgálatai. Azegyik gyakori szövődmény az implantátum körüli szöveteket érintő gyulladás. Ennek kialakulásában számos tényezőjátszik szerepet, többek közt az általános egészségi állapotot befolyásoló betegségek, például a cukorbetegség, hiperlipidémiaés egyéb szisztémás betegségek [1]. Kutatásunk célja a vérvizsgálat – mint az implantációt megelőző szűrővizsgálat– effektivitásának felmérése és alkalmazása a periimplantáris gyulladások prevenciójában.Vizsgálataink során 33 beteg teljes fogászati státusz felvételét és nagy rutinlabor eredményeit vetettünk össze. Azadatokat Microsoft Excel (Remond, Washington, Egyesült Államok) program segítségével értékeltük. A vizsgált betegek81,8%-a szenvedett részleges foghiányban, közülük 66,7%-nál volt parodontális csontelváltozás diagnosztizálhatóorthopantomogram felvétel alapján. A betegpopuláció 21,2%-ának volt magas az éhomi vércukorszintje, 51,5%-nak pedigmegnövekedett a vérzsír értéke. Emellett megvizsgáltuk a parodontális érintettség és a laboreltérések együttes előfordulásigyakoriságát is. Magas vércukorszint és a parodontális érintettség a betegek 6,1%-ánál, parodontális érintettségés a magas gyulladásos paraméter a betegek 21,2%-ánál volt egyszerre megfigyelhető. A periimplantáris gyulladásokkialakulásának egyik rizikófaktora a nem vagy rosszul kezelt cukorbetegség. A hiperlipidémia negatívan befolyásoljaa periimplantáris szövetek lokális immunreakcióit és az implantáció hosszútávú sikerességét befolyásoló csontintegrációt.Bármely általános rizikófaktor, parodontális érintettséggel együtt fokozott kockázatot jelent az implantáció során,ezáltal fontos szerepe van ezeknél a pácienseknél a rizikóanalízisnek és a rendszeres kontrollvizsgálatnak. A Fogászatiés Szájsebészeti Oktató Intézet álláspontja szerint a vérvizsgálat már az implantációt megelőzően alkalmas az általánosrizikófaktorok kiszűrésére.

A fogorvosi beavatkozásokkal járó stressz, a hosszabb kezelési idő és a fogorvosi anesztézia széleskörű alkalmazásavalószínűleg megnöveli a rendelői rosszullétek számát is. A rosszullétek prevalenciája a fogorvosi rendelőkben 19–67%között mozog. A szakirodalom rendelőnként átlag évi 2–20 rosszullétet említ. A leggyakoribb, ellátásra szoruló eseményaz összeesés, ájulás volt, és a leggyakoribb rosszulléteket a cukorbetegségből eredő hypoglikémiás roham, az allergiásreakció és a vérnyomáskiugrás okozta. A fogorvos feladata az életet veszélyeztető állapotok elhárítása, ami a szakirodalmiadatok szerint az összes rosszullétek 8-10%-a. A megfelelő beavatkozáshoz szükséges, hogy minden rendelőbenkészüljön „riadóterv” a rosszullétek ellátásra, világosan megjelölve az orvos és az asszisztencia feladatát. A rendelőfelszerelésére a jogszabály tárgyi feltételeket is megjelölt, ezeket azonban érdemes a fogorvosi rendelő lehetőségeinekfényében újragondolni. Ezért a szerzők javaslatot tesznek a szükséges gyógyszerek összeállítására, valamint a szükségeseszközök beszerzésére. A tárgyi feltételek mellett elengedhetetlen az orvosi elsősegélynyújtás naprakész tudása.Erre a meglevő tankönyv és a gyakori posztgraduális képzés lehetőséget ad, ami nemzetközi összehasonlításbanis kiemelkedően jónak mondható.

Summary: Purpose: We performed a dental survey of epilepsy patients to examine their oral health by statistical means and to provide a guide for the dental treatment of these patients. Methods: We first set up four “dental” subgroups of epilepsy patients, based on the types of seizures, seizure frequency, and mental state. One hundred one patients underwent a survey concerning their dental, medical, and epilepsy histories, followed by a dental examination. Indexes quantifying oral hygiene, the number and condition of the remaining teeth, periodontium, and the degree of prosthetic treatment were measured. An age-matched control group of general (nonepilepsy) population underwent an identical dental examination. Statistical comparison was performed between the patient and the control groups and between subgroups of epilepsy patients. Results: In almost all aspects of oral health and dental status, patients with epilepsy showed a significantly worse condition compared with the control group. Comparison of the subgroups of epilepsy patients revealed that the most severe findings concern patients who have poorly controlled epilepsy, especially those who have frequent generalized tonic‐clonic seizures. Conclusions: The observed difference probably results from a combination of factors such as the effect of the seizures themselves, socioeconomic conditions, and the negative attitude of dentists. We recommend that the planning of dental treatment of such patients should start with the assessment of their disease and determination of the “dental” subgroup to which they belong. For each subgroup, specific recommendations for interventions are given. Key Words: Epilepsy—Oral health—Dental— Periodontal—Prosthetic. It is a general impression that patients with epilepsy tend to have poorer oral health and receive less adequate dental treatment in comparison with the general (nonepilepsy) population (1‐4). We have set out to take a survey of oral health and dental status of patients with epilepsy in comparison with the nonepilepsy population. To our knowledge, only one such survey has been published (3), which was, however, uncontrolled. Others concentrated on only the periodontal status in relation to antiepileptic medication (AEDs) (5,6). Our aim was to test statistically whether these patients did indeed have poorer oral health compared with that of the nonepilepsy population, and if so, to cast light on the possible reasons and measures to be taken to avoid it. Oral health is an important aspect of quality of life, and every effort should therefore be made to improve oral health, especially in a group of people already disadvantageously affected by their disease. Epilepsy patients are a heterogeneous group, comprising patients with a wide variety of etiologies, seizure types

The aim of this study was to investigate the later oral consequences of chemotherapy on the oral health of children with emphasis on the cariological status and the major and minor salivary gland function.Thirty-eight 12-year-old children (mean age 12.3 ± 0.58 years) who underwent chemotherapy were evaluated after 5 years of treatment. Forty age- and sex-matched healthy children with similar socioeconomic backgrounds served as controls. Subjects' cariological status was explained by the number of decayed, filled, missing permanent teeth (DMF-T), and unstimulated and stimulated whole saliva flow rates were measured by the spitting method. Palatal saliva flow rate using a Periotron meter (Oraflow Inc., Plainview, NY) and salivary buffer capacity using CRT buffer (Ivoclar Vivadent AG, Schaan, Lichtenstein) were also investigated.Children who underwent chemotherapy had significantly more decayed teeth than healthy controls (3.97 ± 3.58 vs 0.84 ± 1.75, respectively, p0.001). Recipients of chemotherapy had significantly lower stimulated whole saliva flow rate (0.84 ± 0.35 vs 1.13 ± 0.46 ml/min, p0.05) compared to the controls. Palatal saliva flow rate was at the same time significantly higher in the test group compared to the controls (1.64 ± 0.87 vs 0.46 ± 0.32 ml/min/cm(2), respectively, p0.001). High levels of buffer capacity of the saliva could be detected in a significantly higher prevalence in the patient group compared to the controls (high: 81.6% vs 40%).According to these results, chemotherapy in children might result in a decreased stimulated whole saliva flow rate, hyposalivation, and, consequently, increased caries risk. Although these processes might be compensated to a limited extend by the increased minor saliva flow rate, resulting in a higher buffer capacity, nutrition and oral hygiene control of children obtaining cancer therapy is essential in the preservation of the oral tissues.

The aim of this study was to investigate the long-term effects of chemotherapy on the dental and gingival health and dental disturbance parameters of children cancer survivors.Thirty-eight children (mean age 12.2 ± 0.5 years) who underwent chemotherapy at 4.29 ± 1.71 years of age formed the study group. Forty age- and gender-matched healthy children with a similar socioeconomic background served as controls. Subjects' caries status (number of decayed, missing, or filled permanent teeth [DMF-T]) was recorded according to World Health Organization criteria. Subjects' periodontal status was recorded according to the community periodontal index system. Radiographic dental examination was used to analyze dental malformations.DMF-T, D-T (number of decayed permanent teeth), and F-T (number of filled permanent teeth) were significantly higher in the study group compared to the controls (4.61 ± 3.71, 3.97 ± 4.45, respectively, and 0.58 ± 0.14 vs. 2.21 ± 1.01, 0.84 ± 1.82, and 1.18 ±1.07, respectively. The most frequent dental disturbances were root malformation (52.6%) and agenesis (47.4%).According to our examination dental status of long-term survivors is worse than in controls. Hence proper oral hygiene for children cancer survivors (CCS) is critical. In order to meet the need for dental care in CCS health authorities are encouraged to revitalize the dental services Long-term follow-up of CCS is necessary to monitor their dental growth and oral health.

Epilepsy is a chronic disease that can affect oral health and prosthodontic status in different ways. However, epilepsy is a condition of various etiologies and seizure types, and different patients may have differing needs in prosthodontic care.The purpose of this study was to examine the prosthodontic status of patients with epilepsy to determine if the disease has any effect on prosthodontic treatment and to obtain information regarding the level of prosthodontic care. This information was used to provide recommendations for the prosthodontic treatment of patients with epilepsy.One hundred one epileptic patients were examined, interviewed, and compared with 101 age-matched control (nonepileptic) subjects of the general population. Epileptic patients were recruited at an epilepsy outpatient clinic. The only exclusion criterion was a mental handicap severe enough to exclude cooperation of the patient during a dental examination. Control subjects were recruited at a community radiographic chest-screening clinic. Epileptic patients were first grouped according to dental risk factors and dental manageability. Dental classification of patients with epilepsy considered the frequency and type of seizures, as seizures may damage the teeth and dental prostheses. The number of missing teeth, the ratio of missing and replaced teeth, and the number of fixed and removable partial dentures and complete dentures, and the characteristics (material, degree of abrasion, and age) of the dentures was determined by dental examination. Finally, the state of oral mucosa and the number of seizure-related injuries was noted. Statistical comparison of the patient and the control group was performed, using the 2-tailed t -test for continuous variables and the chi-squared test or Fisher's exact test for categorical variables (alpha=.05).The number of missing teeth was significantly higher in the epilepsy group than in the control group (P =.021). The ratio of replaced and missing teeth was lower in the epileptic group (P.01), indicating inadequate prosthodontic care. There was also a significant difference in the age of the fixed prostheses (P =.0016), being lower in the epilepsy group, and in the material of fixed prostheses (P =.033), metal-ceramic being more common in the control group. More epileptic patients were edentulous than control subjects (8 versus 3) and the average age at the time of examination was younger (48 versus 57 years). Seizure-related injuries were reported by 11% of patients, all belonging to the subgroup of patients with frequent generalized tonic-clonic seizures.Patients with epilepsy have an increased risk for loosing teeth and, furthermore, the prosthodontic status of epilepsy patients was not as optimal as compared with the control group. Seizure-related injuries to prostheses are also an issue, but only in those suffering from frequent generalized tonic-clonic seizures. Therefore, the large majority of patients can and should receive prosthodontic treatment without restrictions. For a smaller group of patients, however, certain restrictions apply, to prevent potentially dangerous seizure-related complications.

Background: The aim of this prospective study is to investigate the long-term effects of chemotherapy on the oral health of children with a primary focus on salivary gland function.