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Literaturni podaci upućuju na to da neplodne pacijentice imaju lošiji parodontni status, što može biti uzrok komplikacijama začeća. Matriksna metaloproteinaza 8 (MMP-8) je enzim u slini koji je izravno povezan s parodontnom upalom. Cilj ove studije bio je validacija ordinacijskog testa koji detektira aktivni oblik MMP8 (aMMP8) iz ispirka usne šupljine u populaciji žena s neobjašnjivom neplodnošću u usporedbi s plodnim ženama odgovarajuće dobi s i bez parodontitisa. Pretpostavljali smo da će neplodne žene imati lošiji parodontni status i veći broj pozitivnih aMMP-8 testova u usporedbi s plodnim ženama. Istraživanje je uključilo 50 zdravih žena s urednim ovulacijskim ciklusima u dobi od 25-45 godina i strogo definiranom neobjašnjivom (idiopatskom) neplodnošću i 50 zdravih žena s urednim ovulacijskim ciklusima iste dobi koje su zatrudnjele i rodile prirodnim putem. Svim sudionicama napravljen je klinički parodontološki pregled i ordinacijski test na aMMP-8 iz ispirka usne šupljine. Polovici pacijentica u svakoj skupini dijagnosticiran je parodontitis, dok je druga polovica bila bez parodontitisa. Osjetljivost i specifičnost testa za otkrivanje parodontitisa iznosila je 84% i 72% u skupini neplodnih, 88% i 68% u skupini plodnih pacijentica te 86% i 70% u ukupnoj populaciji pacijentica. Neplodne pacijentice s parodontitisom imale su manje uznapredovali parodontitis od kontrolne skupine, iako ta razlika nije bila statistički značajna. Rezultati su pokazali da su neplodne bolesnice imale bolji parodontni status i manje uznapredovali parodontitis od plodnih žena iste dobi te da osjetljivost i specifičnost testa rastu sa stupnjem uznapredovalosti parodontitisa. Testom se može razmjerno dobro identificirati pacijentice s parodontitisom, ali je, s obzirom na naše rezultate, korist od tog testiranja u obradi i liječenju idiopatske neplodnosti upitna. Aim: Literature data suggest that infertile patients present worse periodontal status, which may be a factor that complicates conception. Matrix metalloproteinase 8 (MMP-8) is an enzyme in saliva that is directly related to periodontal inflammation. The aim of our study was to validate a chairside mouth rinse test for detection of active form of MMP8 (aMMP8) in a population of women with unexplained infertility compared to age-matched fertile women, with and without periodontitis. Our hypothesis was that infertile women will have worse periodontal health and more positive MMP8 tests, compared to fertile women. Materials and methods: The study included 50 healthy norm-ovulatory females ages 25-45 with strictly defined unexplained infertility, and 50 healthy norm-ovulatory women at the same age who have conceived and delivered naturally. All participants underwent clinical periodontal examination and a chairside aMMP-8 oral rinse test. One half of the participants in each group was diagnosed with periodontitis, while the other half was without periodontitis. Results: The sensitivity and specificity of the test for the detection of periodontitis in the group of infertile patients was 88% and 68%, in the group of fertile patients 84% and 72% and 86% and 70% in the total patient population. Infertile patients with periodontitis had less advanced periodontitis than the control group, although the difference was not statistically significant. Conclusion: Our results have shown that infertile patients had better periodontal status and less advanced periodontitis than fertile women of the same age. Sensitivity and specificity of the test increase with the degree of progression of periodontitis. Patients with periodontitis can be relatively well identified, but based on our results, the benefit of this test in the treatment of idiopathic infertility is questionable.

Leukoplakija je bijela mrlja ili plak koji se ni klinički ni histološki ne može okarakterizirati kao neka druga lezija i nije povezana ni s jednim fizikalnim ili kemijskim uzročnim faktorom, osim upotrebe duhana. Dosadašnji načini liječenja poput ekscizije skalpelom, lokalne ili sistemske primjene retinoida i nekih lasera u manjem ili većem broju slučajeva dovode do recidiva leukoplakije. Iz tog razloga postoji potreba za pronalaskom učinkovitijih metoda liječenja oralne leukoplakije. Stoga je svrha ovog istraživanja bila odrediti učinkovitosti visokoenergetskih ablativnih lasera u liječenju oralne leukoplakije. Nadalje, svrha je bila međusobno usporediti i procijeniti subjektivne i objektivne postoperativne parametre za dva različita ispitivana ablativna lasera, erbij, itrij, aluminij, garnet laser (Er:YAG) i erbij, kromij dopiran s itrijem, skandijem, galijem, garnetom laser (Er,Cr:YSGG). U istraživanju su sudjelovala 54 ispitanika, od čega 16 muškaraca i 38 žena. Nasumičnim odabirom ispitanici su bili razvrstani u jednu od dvije ispitivane skupine. U prvoj skupini pacijentima se leukoplakična lezija uklanjala visokoenergetskim ablativnim laserom Er:YAG, a pacijentima u drugoj skupini visokoenergetskim ablativnim Er,Cr:YSGG laserom. Pacijentima je prije početka liječenja utvrđena veličina leukoplakične lezije, izmjerena u milimetrima. Kriterij za procjenu učinkovitosti lasera bila je pojava recidiva leukoplakije u razdoblju praćenja od jedne godine i šest mjeseci. Rezultati su pokazali da postoji statistički značajna razlika u lokalizaciji pojave lezija između muškaraca i žena. Kod muškaraca lezija se najčešće nalazila na obrazu, dok se kod žena javljala u retromolarnom području i području mekog nepca. Kod muškaraca je bila utvrđena češća pojava recidiva nego kod žena. Lezije liječene Er:Cr:YSGG laserom nakon prve terapije pokazale su manje recidiva nego lezije liječene Er:YAG laserom, te su ispitanici imali nižu razinu postoperativne boli i veću kvalitetu života nakon liječenja Er:Cr:YSGG laserom. Iz navedenih rezultata može se zaključiti da je Er;Cr:YSGG laser učinkovitiji i prihvatljiviji za liječenje oralne leukoplakije nego Er:YAG laser. Aim: The aim of this study was to determine the most effective non-invasive surgical therapy in the treatment of oral leukoplakia by means of high energy ablative lasers. In addition, the aim was to compare the efficacy of ablative lasers and to evaluate subjective and objective postoperative parameters (healing, postoperative pain, quality of life, recurrence), all for the purpose of identifying the optimal laser and precision settings of lasers for clinical use in order to achieve a successful treatment of oral leucoplakias. Previous treatment methods such as scalpel excision, topical or systemic administration of retinoids and some lasers in a smaller or larger number of cases lead to recurrence of leukoplakia. For this reason, there is a need for finding more effective methods of treating oral leukoplakia. Therefore, the purpose of this study was to determine the efficacy of high energy ablative lasers in the treatment of oral leukoplakia. Furthermore, the purpose was to compare and evaluate subjective and objective postoperative parameters for two different ablative lasers such as erbium, yttrium, aluminum, garnet (Er: YAG) and erbium, chromium doped with yttrium, scandium, gallium, and garnet laser (Er: Cr: YSGG). Materials and methods: The study involved 54 subjects, of whom 16 men and 38 women. By random selection, the subjects were classified into one of the two study groups. In the first group of patients, the leukoplakic lesion was removed by high energy ablation laser Er: YAG and patients in the second group were treated by use of high energy ablative Er, Cr: YSGG laser. At the very beginning, the size of the leukoplakic lesion was measured in millimeters. The criterion for laser efficacy estimate was the recurrence of leukoplakic lesion during the one-year and six-month follow-up period. For the statistical analysis of the data, the Fisher's exact test was used for comparing discrete characteristics and the multivariate variance analysis (MANOVA) with three classification variables for comparing continuous characteristics. The Pearson correlation coefficient was used as the correlation measure. The analysis was made using the SAS statistical package on the Windows platform. Values of less than 0.05 were considered significant (p

Liječenje bezubosti s dentalnim implantatima je danas uobičajeno u većini zemalja zapadnog svijeta. Procjenjuje se kako je uspješnost takova liječenja iznimno velika, iako postoji i dalje potreba za istraživanjima na velikom broju bolesnika kojima su postavljeni implantati, a u kojih bi se promatrali lokalni i sistemski čimbenici koji dovode do neuspjeha ovog načina liječenja. Stoga je cilj ovog istraživanja bio ustanoviti je li prisutnost prijašnje parodontalne bolesti, stupanj oralne higijene odnosno krvarenje pri sondiranju (KPS) i plak cijele usne šupljine (PCUS), pušenje, sistemske bolesti kao i same karakteristike postavljenih dentalnih implantata (veličina, tip) utječu na neuspjeh implant-protetske terapije. Analizirani su podaci od 670 bolesnika kojima je ugrađeno 1260 dentalnih implantata i koji su praćeni tijekom pet godina najmanje. Za statističku obradu korišten je Medcalc (v11.4). Kategorički podatci obrađivani su hi-kvadrat testom (Chi-square). Kontinuirane varijable (dob, KPS, PCUS) nisu bile normalnih distribucija te su stoga bile analizirane neparametrijskim Mann-Whitney U testovima. P vrijednosti manje od 0,05 smatrane su značajnima. Rezultati ovog istraživanja su pokazali kako je 9 implantata bilo izgubljeno pri čemu nije bilo znakovite razlike u tipu implantata ili načinu pričvršćenja suprastrukture. Ipak, zanimljivo je da je većina tih bolesnika imala parodontnu bolest. Nadalje nije bilo znakovite razlike između pušača i nepušača vezano uz gubitak implantata.Nije bilo znakovitih razlika s obzirom na sistemske bolesti ovih bolesnika. Nadalje, rezultati ovog istraživanja su pokazali kako tip implantata (konični odnosno cilindrični) i vrsta vezivanja suprastrukture na implantat (cementirani ili vijak) nisu imali znakovitog utjecaja na KPS ili PCUŠ. Kod pušača je u svim slučajevima došlo do značajnog poboljšanja KPS i PCUŠ, a koji su ujedno imali i značajno lošije inicijalno KPS stanje (0,0037) od onih koji nisu pušili, no za PCUŠ nije bilo značajnosti (p=0,4218). U bolesnika s parodontalnom bolesti došlo je do poboljšanja KPS i PCUŠ nakon 60 mjeseci praćenja te nije bilo razlika u odnosu na osobe koje nisu imale parodontozu. Također, nije bilo značajnih razlika niti u KPS ili PCUS između osoba s dijabetesom i onih bez dijabetesa nakon petogodišnjeg praćenja. Ateroskleroza je imala znakovit negativan utjecaj na KPS ali ne i na PCUŠ nakon pet godina praćenja. Možemo zaključiti kako je jedino parodontitis imao znakovit utjecaj na neuspjeh implanto-protetskog liječenja. Background and objectives: The treatment of edentulousness with dental implants is usual a procedure in most of the western countries. From the published data it is well known that previous data upon periodontal disease and smoking might lead to the more frequent failure of implanto-prosthetic therapy. Systemic diseases such as diabetes mellitus, atherosclerosis, cardiovascular disorders, thyroid disease, osteoporosis, chemotherapy and radiotherapy in the head and neck area have been proposed as a factors that might contribute to the failure of implanto-prosthetic therapy. Furthermore, implant characteristics such as type, diameter and length of implant as well as its connection with prosthetic suprastructure (screw retained or cemented one) migh influence the success of implanto-prosthetic therapy. Also, surgical technique and placement in the upper or lower jaw might additionally influence the success of impalnto-prosthetic therapy. It is estimated that such a treatment is highly successful, although there is still a need for studies which would include local and systemic factors on big populations in order to detect potential failures. The aim of this study was to analyze whether the previous presence of periodontal disease, oral hygiene status i.e. bleeding on probing (BOP) and full mouth plaque index (FMPI), smoking, systemic diseases as well as implant characteristics (type, length, shape) and type of connection with prosthetic suprastructure affect implant-prosthetic failure. Methods: Data from 670 patients were retrieved in whom 1260 dental implants were installed and who were followed in the course of at least five to ten years. All patients were treated in the private clinic in Zagreb by one experienced clinican. In every participant anamnestic data regarding age, gender, smoking habit, previous data upon periodontal disease, systemic diseases such as diabetes mellitus, atherosclerosis etc. were registered. In every patient, type of implant (lenght, diameter and shape) was registered as well as place in the bone where was installed as well as type of retention of the prosthetic suprastructure (cemented/screw retained). Plaq index of the full mouth was assesed together with bleeding on probing. The participants were called for recall after five years in order to determine whether periimplantitis was present or unsuccesful osseointegration nas occurred. Data were analysed using Medcalc (v11.4). Categorical data were analysed by the Chi-square test. Continued variables (age, BOP, FMPI) were not normally distributed, therefore the non-paramteric Mann-Whitney test was used. P values lower than 0.05 were significant. The influence of local and systemic factors on the success of implanto-prosthetic therapy was assesed by multiple logistic regression analysis. Loss of implants was dependent variable while age, smoking, previous data upon periodontal disease, type, length and diameter of implants, type of retention with prosthetic suprastructure and systemic diseases were independent variables. Results: Forty five patients had systemic diseases 45 pacijenata (6.7%), and diabetes mellitus was the most common one among them (n=35), followed by atherosclerosi (n=8), diabetes and atherosclerosis (n=5), diabetes mellitus type 1 (n=3), lymphoma (n=1) and hepatitis C (n=1). One third of the patients were smokers (33.4%). Most of the patients were 41-60 years old, mean age 53.9%. All patients were treated during the period of the year 2008 till the year 2012. therefore the obtained data could be retrieved for at least five years. One hundred and 70 patients had periodontal disease, while 500 patients were without periodontal disease. Of 670 patients, 628 patients had only one procedure. The number of installed implants was one in 333 patients, i.e. more than one in 337 patients. Nine implants were lost during the period of five years. There were no differences regarding the type of implant or type of connection to prosthetic suprastructure. However, most of these patients had a periodontal disease. There were no significant differences in dental implant failure between smokers and non-smokers and between patients with systemic diseases and those without systemic diseases. Furthermore, the results of this study showed that implant type (straight vs tapered) and type of connection with prosthetic suprastructure (cemented or screw retained) did not affect BOP and FMPI. In smokers, significant improvement of BOP and FMPI was noticed. Initially, the smokers had significantly worse BOP (0,0037) when compared to the non-smokers, however, there were no differences regarding FMPI (p=0,4218) between the two groups. In patients with periodontal disease, an improvement of BOP and FMPI was seen after 5 years of followup and no significant differences were found when compared to patients without periodontal disease. There were no signficant differences in BOP and FMPI between patients with diabetes and those without diabetes after five years of follow-up. Atherosclerosis had a negatively significant effect of BOP, but without FMPI after five years of follow-up. Conclusion: We might conclude that periodontal disease had significant impact on the implant-prosthetic therapy.

Objectives: The aim of this study was to determine the prevalence and type of human papillomavirus (HPV) in various oral lesions in comparison to control healthy oral mucosa, and the dynamic of HPV infection course (persistence, change of HPV type and clearance). Material and Methods: The study comprised 426 consented subjects, of which 343 patients with different oral lesions and 83 controls with apparently healthy oral mucosa, referred for oral examination in the period from 2000 to 2015. The diagnoses of oral lesions were established according to clinical criteria and confirmed by histopathology. Oral cytobrush samples were collected from oral lesions and healthy mucosa from different topographic sites and the HPV types were determined by polymerase chain reaction (PCR). The presence of HPV DNA was evaluated by consensus and type-specific (TS) primer-directed PCR. A subset of samples was analysed for the presence of both alpha and beta genus HPV types. Results: Out of 426 specimens, 144 (41.98%) from oral lesions and 15 (18.07%) controls were positive for HPV DNA; 22.3% of all tested samples contained beta-HPV type and 15.02% alpha-PV type. The highest prevalence of beta-HPV and high risk (HR) HPV (alpha-HPV) types were found in benign and premalignant oral lesions, while HR-HPVs were found in a small number of control samples. In 38 subjects sampling was performed more than twice, in average 2.29 times, with time distance between sampling of 5.8 months. Twenty-six of these 38 patients were continuously HPV negative, five had transient infection, five acquired a new HPV infection, one had persistent HPV infection, and one had initially co-infection with different HPV types followed with new one during which initial oral lesion became malignant. The topographic distribution of the alpha-PV and beta-PV types showed affinity for the anterior part of the oral cavity and particular risk localization. Conclusion: Positive finding of HPV in all age groups and on healthy oral mucosa, high prevalence of HPV types in oral premalignant and proliferative lesions, affinity for risk localization in the oral cavity, unpredictable dynamic course and change of HPV type indicates the need for regular oral assessment and HPV control in patients with initially positive findings on oral mucosa. Cilj istraživanja bio je ispitati prevalenciju i tip humanog papiloma virusa (HPV) u različitim oralnim lezijama u usporedbi s kontrolnom, naizgled zdravom sluznicom i dinamiku tijeka HPV infekcije u ustima (ustrajnost, promjenu tipa HPV i prolaznost infekcije). Ispitanici i postupci: U ispitivanju je sudjelovalo 426 ispitanika, od kojih 343 bolesnika s različitim oralnim lezijama i 83 kontrolnih s naizgled zdravom sluznicom koji su upućeni na pregled usne šupljine u razdoblju od 2000. do 2015.godine. Svi ispitanici dali su svoj informirani pristanak prije uključivanja u ovo istraživanje. Dijagnoze oralnih lezija postavljene su na temelju kliničkih kriterija i potvrđene histopatološkom analizom. Citološki obrisci uzeti su citološkom četkicom s oralnih lezija i zdrave sluznice s topografski različitih mjesta sluznice, a HPV je dokazan lančanom reakcijom polimerazom (PCR). Prisutnost HPV DNA dokazana je PCR-om sa zajedničkim i tip-specifičnim početnicama. Određeni dio uzoraka bio je testiran na tipove HPV-a iz roda alfa i beta. Rezultati: U svih 426 testiranih uzoraka, HPV DNA dokazana je u 144 (41,98%) uzoraka s oralnih lezija i 15 (18,07%) kontrolnih; 22,3% ispitanih uzoraka sadržavalo je tip HPV iz roda beta, a 15,02% tip HPV iz roda alfa. Najveća prevalencija beta-HPV i visokorizičnih (HR) HPV tipova (alfa-HPV) pronađeni su u benignim i premalignim oralnim lezijama, a visokorizični HPV tipovi pronađeni su i u malom broju kontrolnih uzoraka. U 38 ispitanika uzorkovanje je provedeno više od dva puta, u prosjeku 2.29 puta, u vremenskom razmaku od prosječno 5,8 mjeseci. Dvadesetšest od 38 ispitanika bilo je stalno negativno na HPV, u pet je dokazana prolazna infekcija, pet je steklo novu infekciju HPV-om, jedan ispitanik imao je stalnu infekciju HPV-om, a jedan je tijekom praćenja početno dokazanu koinfekciju s različitim tipovima HPV-a i stekao novu s HPV tipom visokog rizika tijekom koje je inicijalna premaligna lezija sluznice postala zloćudna. Analiza topografske distribucije alfa-HPV i beta-HPV tipova na oralnoj sluznici pokazala je afinitet virusa za sluznicu prednjeg dijela usne šupljine i osobito za rizične lokalizacije. Zaključak: Pozitivan nalaz HPV-a u svim dobnim skupinama i na zdravoj sluznici te visoka prevalencija HPV tipova u oralnim premalignim i proliferativnim lezijama kao i afinitet za rizične lokalizacije te nepredvidljiv dinamičan tijek uz promjene tipa HPV-a upućuju na potrebu kontrole na HPV u kliničkoj stomatološkoj praksi kod inicijalno pozitivnog nalaza.

Objectives: The aim of this study was to determine the prevalence and type of human papillomavirus (HPV) in various oral lesions in comparison to control healthy oral mucosa, and the dynamic of HPV infection course (persistence, change of HPV type and clearance). Material and Methods: The study comprised 426 consented subjects, of which 343 patients with different oral lesions and 83 controls with apparently healthy oral mucosa, referred for oral examination in the period from 2000 to 2015. The diagnoses of oral lesions were established according to clinical criteria and confirmed by histopathology. Oral cytobrush samples were collected from oral lesions and healthy mucosa from different topographic sites and the HPV types were determined by polymerase chain reaction (PCR). The presence of HPV DNA was evaluated by consensus and type-specific (TS) primer-directed PCR. A subset of samples was analysed for the presence of both alpha and beta genus HPV types. Results: Out of 426 specimens, 144 (41.98%) from oral lesions and 15 (18.07%) controls were positive for HPV DNA; 22.3% of all tested samples contained beta-HPV type and 15.02% alpha-PV type. The highest prevalence of beta-HPV and high risk (HR) HPV (alpha-HPV) types were found in benign and premalignant oral lesions, while HR-HPVs were found in a small number of control samples. In 38 subjects sampling was performed more than twice, in average 2.29 times, with time distance between sampling of 5.8 months. Twenty-six of these 38 patients were continuously HPV negative, five had transient infection, five acquired a new HPV infection, one had persistent HPV infection, and one had initially co-infection with different HPV types followed with new one during which initial oral lesion became malignant. The topographic distribution of the alpha-PV and beta-PV types showed affinity for the anterior part of the oral cavity and particular risk localization. Conclusion: Positive finding of HPV in all age groups and on healthy oral mucosa, high prevalence of HPV types in oral premalignant and proliferative lesions, affinity for risk localization in the oral cavity, unpredictable dynamic course and change of HPV type indicates the need for regular oral assessment and HPV control in patients with initially positive findings on oral mucosa. Cilj istraživanja bio je ispitati prevalenciju i tip humanog papiloma virusa (HPV) u različitim oralnim lezijama u usporedbi s kontrolnom, naizgled zdravom sluznicom i dinamiku tijeka HPV infekcije u ustima (ustrajnost, promjenu tipa HPV i prolaznost infekcije). Ispitanici i postupci: U ispitivanju je sudjelovalo 426 ispitanika, od kojih 343 bolesnika s različitim oralnim lezijama i 83 kontrolnih s naizgled zdravom sluznicom koji su upućeni na pregled usne šupljine u razdoblju od 2000. do 2015. godine. Svi ispitanici dali su svoj informirani pristanak prije uključivanja u ovo istraživanje. Dijagnoze oralnih lezija postavljene su na temelju kliničkih kriterija i potvrđene histopatološkom analizom. Citološki obrisci uzeti su citološkom četkicom s oralnih lezija i zdrave sluznice s topografski različitih mjesta sluznice, a HPV je dokazan lančanom reakcijom polimerazom (PCR). Prisutnost HPV DNA dokazana je PCR-om sa zajedničkim i tip-specifičnim početnicama. Određeni dio uzoraka bio je testiran na tipove HPV-a iz roda alfa i beta. Rezultati: U svih 426 testiranih uzoraka, HPV DNA dokazana je u 144 (41,98%) uzoraka s oralnih lezija i 15 (18,07%) kontrolnih; 22,3% ispitanih uzoraka sadržavalo je tip HPV iz roda beta, a 15,02% tip HPV iz roda alfa. Najveća prevalencija beta-HPV i visokorizičnih (HR) HPV tipova (alfa-HPV) pronađeni su u benignim i premalignim oralnim lezijama, a visokorizični HPV tipovi pronađeni su i u malom broju kontrolnih uzoraka. U 38 ispitanika uzorkovanje je provedeno više od dva puta, u prosjeku 2.29 puta, u vremenskom razmaku od prosječno 5,8 mjeseci. Dvadesetšest od 38 ispitanika bilo je stalno negativno na HPV, u pet je dokazana prolazna infekcija, pet je steklo novu infekciju HPV-om, jedan ispitanik imao je stalnu infekciju HPV-om, a jedan je tijekom praćenja početno dokazanu koinfekciju s različitim tipovima HPV-a i stekao novu s HPV tipom visokog rizika tijekom koje je inicijalna premaligna lezija sluznice postala zloćudna. Analiza topografske distribucije alfa-HPV i beta-HPV tipova na oralnoj sluznici pokazala je afinitet virusa za sluznicu prednjeg dijela usne šupljine i osobito za rizične lokalizacije. Zaključak: Pozitivan nalaz HPV-a u svim dobnim skupinama i na zdravoj sluznici te visoka prevalencija HPV tipova u oralnim premalignim i proliferativnim lezijama kao i afinitet za rizične lokalizacije te nepredvidljiv dinamičan tijek uz promjene tipa HPV-a upućuju na potrebu kontrole na HPV u kliničkoj stomatološkoj praksi kod inicijalno pozitivnog nalaza.

Rad ne sadrži sažetak na hrvatskom jeziku. Background and objectives: Hyposalivation is a state of reduced secretion of saliva which can be caused by drugs, by radiation to the head and neck in order to treat head and neck cancers, and can occur in some systemic diseases such as Sjogren's syndrome, etc. Hyposalivation is a very annoying symptom for patients as it is constantly present, thus preventing speech, chewing and swallowing. In addition to these, there is a stronger tendency to develop caries, gingivitis and candidiasis due to lack of saliva. In the literature around the world there are various local and systemic preparations to facilitate the symptoms of dry mouth in patients, although each of them has advantages and disadvantages. The aim of this study was to compare the efficacy of acupuncture, low level laser therapy (LLLT) and water in 67 patients with hyposalivation caused by drugs. Methods: Before therapies each participant filled out a questionnaire on the quality of life in the Croatian language (OHIP-14 CRO) and the amount of saliva was measured by simple method of ejecting saliva into calibrated tubes for 5 minutes in the morning between 8 and 11 A.M. Both procedures were repeated after the completion of each therapy. Low Level Laser Therapy (GaAlAs, 830 nm wavelength; dose 1,80 J/cm2; power 35 mW, area 4 cm2, frequency 5,20 Hz, pulse 800 ms; period 1 ms) was carried out every working day in the course of 14 days and each session lasted 15 minutes on the skin area above the major salivary glands in 28 patients. In 16 participants of the control group, LLLT was conducted with laser device which was switched off. Acupuncture was performed by use of needles (0,16x10mm) inserted on the following points; Shen Man, Point Zero, Autonomic Point, Thirst Point, Salivary Gland F on both ears while the participants were sitting for 30 minutes at the acupuncturist. After the participants got press needles (0,16x1,4 mm) on one ear at the points Shen Men and Thirst Point till the next session. Second acupuncture session was one week after the first one and the remaining three every seven days. Statistical analysis was performed by use of Student t test for dependent and independent samples. Results: The results of this study have shown that acupuncture was superior in comparison to the LLLT and switched off LLLT on the basis of increased salivary flow rate and the quality of life questionnaire. LLLT increased salivary flow rate, however, there was no significant improvement in scores of the quality of life questionnaire. LLLT, when switched off, did not increase salivary flow rate nor OHIP-CRO scores significantly. Conclusion: We might conclude that salivary gland stimulation by use of acupuncture increased salivary flow rate in patients with drug-induced hyposalivation as well as improved scores of OHIPCRO. Switched on LLLT also increased salivary flow rate in these patients, however OHIP CRO scores were not signifiantly different. Switched of LLLT neither increased salivary flow rate nor improved OHIP-CRO scores.

Sindrom pekućih usta (SPU) je kronični oralni symptom karakteriziran osjećajem pečenja u osoba koje imaju klinički zdrav izgled oralne sluznice. Čini se da je u podlozi neuropatološki poremećaj. Nadalje, postoji manjak randomiziranih kontroliranih istraživanja s obzirom na postojeće liječenje ovog sindroma. U ispitivanje je bilo uključeno 60 bolesnika (6 muškaraca i 54 žene) sa sindromom primarnog sindroma pekućih usta kao i 20 kontrolnih ispitanika koje su liječeni na Klinici za neurologiju zbog tegoba od strane slabinske kralježnice. Ispitanici su nakon postavljanja dijagnoze sindroma pekućih usta, podijeljeni u tri skupine po dvadeset ispitanika kod kojih će se primijeniti terapija klonazepamom, terapija akupunkturom i grupa ispitanika bez terapije (kontrolna skupina). Ispitanici su prije dobivanja bilo koje od terapija (klonazepam, akupunktura, kontrolna skupina) ispunili upitnike VAS, Lanssova skala, MoCa, SF-36, Hamiltonova skala, Beckova skala. Iste upitnike su ispunili i nakon završetka bilo koje od terapija. Svrha istraživanja je bila: ustanoviti učinkovitost akupunkture i klonazepama u oboljelih od sindroma pekućih usta a na temelju rezultata skala (LANSS, VAS, MoCa, SF-36, Beck i Hamilton), te neurološke poremećaje u oboljelih od sindroma pekućih usta. Rezultati ovog istraživanja pokazuju kako je liječenje akupunkturom i kloazepamom dovelo do značajne regresije boli, kao i do regresije anksiodepresivnih tegoba i poboljšanja kvalitete života, dok kod kognitivnih funkcija nije došlo do značajnijih promjena. U rezultatima vidnih evociranih potencijala nije nađeno značajnijih odstupanja od normale, analizom tremora također nije nađeno značajnijih odstupanja od normalnih vrijednosti. Zabilježena je statistički značajna pojavnost disfunkcije u EMNG-u refleksu treptaja uz promjenu habituacije R2 komponente i pozitivnu R3 komponentu, također je u vrijednostima V-R latence u BAERU zabilježeno produljenje latence što ukazuje na disfunkciju u inervacijskom području n trigeminusa. Iz istraživanja se dade zaključiti kako su akupuntkura i klonazepam učinkoviti u liječenju sindroma pekućih usta. Background and objectives: Burning mouth syndrome (BMS) is a chronic oral symptom with burning sensation and clinically healthy appearance of the oral mucosa. Recently, neuropathological basis has been provided to support this concept. Furthermore, there is a lack of randomized controlled studies regarding applied therapies. Therefore, the aim of this study was to compare the effectiveness of acupuncture and clonazepam in patients with burning mouth syndrome measured by the following scales (LANSS, VAS, MoCa, SF-36, Beck i Hamilton), to determine a correlation between temporomandibular disturbances and BMS as well as to establish a correlation between neurological disturbances and BMS. Methods: This study included 60 patients with BMS (6 men and 54 women) and 20 controls with low back painful disturbances. BMS patients were randomly divided into three groups: 20 patients who took clonazepam, 20 patients who underwent acupuncture treatment and 20 subjects without any therapies. Prior to and after any therapies the subjects were asked to rate pain severity on the following scales: VAS, LANSS, MoCa, SF-36, Hamilton, and Beck. The analysis of temporomandibular disturbances was made by clinical examination and x-ray. Neurological tests included brain evoked auditory and eye potentials (BAEP), electromyoneurography of the blink reflex. Statistical analysis was performed by use of Student t test and logistic regression analysis. P values lower than 0.05 were considered significant. Results: The results of this study showed that both acupuncture and clonazepam led to a significant elimination of pain as well as anxio-depressive symptoms and, also, to improvement in quality of life in BMS patients. However, there was no improvement in cognitive function. There was no significant assignation in evoked eye potentials as well as in tremor analysis. There was a significant dysfunction seen electromyographically of the blink reflex with changed habituation of R2 component and positive R3 component as well as an increased V-R latency in BAEP, which implies a dysfunction of the innervation area of the trigeminal nerve. Conclusion: Acupuncture and clonazepam are similarly effective for patients with burning mouth syndrome.

Uvod Zadnje desetljeće u istraţivanju tumorskih biomarkera obiljeţile su globalne metode analize (genomika, transkriptomika i proteomika) s ciljem pronalaska novih čimbenika uključenih u zloćudnu preobrazbu stanica. Cilj U ovom istraţivanju provedeno je proteomsko profiliranje tkiva oralne sluznice pacijenata s potencijalno zloćudnim (oralni lihen planus) i zloćudnim promjenama oralne sluznice (karcinom pločastih stanica glave i vrata) te bez promjena na oralnoj sluznici, kako bi se istraţili novi potencijalni biomarkeri koji bi poboljšali ranu dijagnostiku i terapiju potencijalno zloćudnih i zloćudnih lezija. Materijali i metode Za analizu proteoma u istraţivanim lezijama korištena je metoda masene spektrometrije, a pojedini markeri validirani su metodom Western blot. Nadalje, s obzirom kako je poznato da inzulinu slični čimbenici rasta i njihovi receptori igraju vaţnu ulogu u rastu normalnih somatskih stanica, ciljano su istraţeni status ekspresije proteina inzulinu sličnih čimbenika rasta 2 i njegovog receptora, IGF2/IGF2R, u istim uzorcima te uzorcima leukoplakija metodom imunohistokemije. Rezultati i zaključak Analiza diferencijalno eksprimiranih proteina promjenama zahvaćenih tkiva u odnosu na kontrolna tkiva (nezahvaćena oralna sluznica istih pacijenata i zdrava oralna sluznica) ukazala je na ulogu proteina izvanstaničnog matriksa u razvoju oralnih lezija, osobito proteina lumikana u oralnom karcinomu usne šupljine. Većina diferencijalno eksprimiranih proteina u promijenjenoj sluznici pacijenata s lihenom uključena je u citoskeletne promjene, keratinizaciju, morfogenezu i staničnu signalizaciju. Imunohistokemijska analiza izraţenosti IGF2 i IGF2R pokazalo je značajnu razliku u postotku ekspresije IGF2 i intenzitetu ekspresije IGF2R u populaciji zdravih u odnosu na pacijente s lihenom, leukoplakijom i karcinomom glave i vrata. Introduction Global analysis methods (genomics, transcriptomics and proteomics) have marked the last decade, trying to identify new factors involved in malignant cell transformation. Aim A proteomic profiling of oral mucosa tissue of patients with potentially malignant (oral lichen planus) or malignant oral lesions (squamous cell carcinoma) and patients without oral changes has been conducted to explore new potential biomarkers which would enhance making of an early diagnosis and treatment of potentially malignant and malignant lesions. Materials and methods Proteomic analysis of these lesions was made using mass spectrometry, and some markers identified by mass spectrometry were validated by Western blotting. Furthermore, since insulin-like growth factors and their receptors are thought to play an important role in the growth of normal somatic cells, the expression status of the insulin-like growth factor 2 and its receptor, IGF2/IGF2R, have been explored in the same type of lesions and also in specimens of oral leukoplakia, using immunohistochemistry. Results and conclusion The analysis of differentially expressed proteins in changed tissues compared to control tissues (oral mucosa without changes of the same patient and healthy tissue) pointed to a crucial role of extracellular matrix proteins in development of oral lesions, especially an important role for lumican in oral cancer. Most of the differentially expressed proteins in altered mucosa of patients with oral lichen planus have been included in cytoskeletal changes, keratinization, morphogenesis and cell signaling. Immunohistochemical analysis of IGF2 and IGF2R expression has determined a significant difference in expression percentage of IGF2 and the expression intensity of IGF2R in a population of healthy patients compared to the patients with lesions of oral lichen planus, leukoplakia and head and neck carcinoma.

Cilj Cilj istraživanja je bio ispitati učestalost celijakije u oboljelih od oralnoga lihen planusa (OLP) u odnosu na osobe sa zdravom sluznicom usne šupljine. Materijal i metode U serumima 89 pacijenata s OLP-om i 89 osoba sa zdravom sluznicom usne šupljine određena je razina protutijela na tkivnu transglutaminazu (anti-tTG) i na glijadin (AGA). Kod svih pacijenata učinjena je i HLA-tipizacija. U pacijenata s pozitivnim protutijelima učinjena je biopsija dvanaesnika kako bi se patohistološkim nalazom potvrdila dijagnoza celijakije. Rezultati Celijakija je dijagnosticirana u 12 pacijenata (13,48%) s oralnim lihen planusom. Statistički značajna razlika između dva različita oblika OLP-a, retikularnog i erozivnog, pokazala se za IgA tTG (P=0,008). Učestalost HLA DQ2 i DQ8 bila je veća u oboljelih od OLP-a nego u kontrolnoj skupini. Zaključak Učestalost celijakije veća je u oboljelih od OLP-a u odnosu na osobe sa zdravom sluznicom usne šupljine te u odnosu na opću populaciju. IgA tTG bi mogao biti vrijedan dijagnostički marker u probiru na celijakiju u oboljelih od OLP-a., Objective The aim of this study was to investigate the prevalence of celiac disease (CD) in patients with oral lichen planus (OLP) compared to healthy controls. Materials and methods Tissue transglutaminase antibodies (anti-tTG) and antibodies against gliadin (AGA) were measured in the sera from 89 OLP patients and 89 healthy controls, who also underwent human leukocyte antigen (HLA) typing. The duodenal biopsy was performed in patients with positive serology to confirm the diagnosis of CD. Results CD was diagnosed in 12 OLP patients (13,48%). A statistically significant difference among the forms of oral lichen was observed for the IgA tTG (P=0,008). Higher frequencies of HLA DQ2 and DQ8 were found in OLP patients compared to the control group. Conclusion The prevalence of CD was higher in patients with OLP than in the control group and in the general population. IgA tTG is a valuable diagnostic tool that can be used for screening CD in patients with OLP.

Uvod: NAVS Nearomatski visokosteranski naftalan prirodno je mineralno ulje dobiveno složenim nizom postupaka separacije i rafinacije čime je očuvana steranska struktura NAVS-a kojoj se pripisuju ljekovita svojstva. Svrha istraživanja bila je ispitati učinkovitost NAVS-a u liječenju oralnog lihena planusa (OLP) i rekurentnih aftoznih ulceracija (RAU) te potvrditi sigurnost njegove primjene. Materijali i metode: Istraživanje je provedeno kao randomizirana dvostruko-slijepa studija na pedeset i sedam ispitanika (30 OLP, 27 RAU). Primjena NAVS-a 3x dnevno tijekom 28 dana provedena je u ispitnoj skupini, a 0,05% betametazon dipropionata u kontrolnoj skupini. Klinički intenzitet bolesti (REU) bilježen je u ispitanika s OLP-om. Broj i promjer lezija u bolesnika s RAU bilježen je na 0., 3. i 5. dan. Intenzitet boli i nelagode procjenjivan je korištenjem vizualne analogne skale (VAS) i upitnikom OHIP-14, prije i nakon liječenja. Rezultati: Veće smanjenje REU zabilježeno je u NAVS skupini (NAVS 67,21%, betametazon 66,30%), iako ne statistički značajno (p=0,4421). Nije bilo statistički značajne razlike u smanjenju OHIP-14 između NAVS (74,38%) i betametazon skupine (67,55%) (p=0,8191). Smanjenje VAS-a za NAVS iznosilo je 96,29%, a za betametazon 93,66% (p=0,3722). Nije bilo statistički značajne razlike između skupina u smanjenju broja (3. dan p=0,48; 5. dan p=0,75) i veličine lezija (3. dan p=0,40; 5. dan p=0,83) u ispitanika s RAU. Zabilježeno je smanjenje VAS-a i OHIP-14 u obje skupine ispitanika 8. dana po završenoj terapiji, međutim razlika nije bila statistički značajna (VAS p=0,59; OHIP-14 p=0,69). Zaključak: NAVS je uspješno smanjio kliničke znakove i simptome OLP-a, te broj, veličinu lezija i simptome u bolesnika s RAU. Introduction: "Non-aromatic Very rich in Steranes" (NAVS) naphtalan is a natural mineral oil, produced by various methods of separation, with a preserved sterane structure which has healing properties. The purpose of this study was to evaluate the effectiveness of NAVS in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). Material and Methods: A randomized, double-blind trial was designed. Fifty seven patients (30 OLP, 27 RAS) were randomized into two groups to receive NAVS or 0,05%-betamethasone dipropionate in adhesive paste 3x daily for 28 days. The severity of the OLP lesions (REU) was objectively scored. The number and the diameter of RAS lesions were assessed on days 0, 3 and 5. The intensity of the pain/discomfort was determined using a visual analogue scale (VAS) and OHIP-14-questionnaire before and after the therapy. Results: Greater REU reduction was observed in NAVS group (NAVS 67,21%, betamethasone 66,30%), although it was not statistically significant (p=0,4421). No statistically significant differences in the reduction of the OHIP-14 between NAVS (74,38%) and betamethasone group (67,55%) were observed (p=0,8191). VAS reduction for NAVS was 96,29% and for betamethasone 93,66% (p=0,3722). There were no statistically significant differences between the two groups in reduction of number (day 3. p=0,48; day 5. p=0,75) and lesion diameter (day 3. p=0,40; day 5. p=0,83) in RAS patients. VAS and OHIP-14 reduction was observed in both groups 8 days after the completion of therapy, but the difference was not statistically significant (RAS p=00,59; OHIP-14 p=0,69). Conclusion: NAVS has successfully reduced the clinical signs and symptoms of OLP. It has reduced the number, diameter and symptoms in patients with RAS.