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Scleromyxedema is a skin disorder, which is considered very rare. Its symptoms are mucin accumulation in the patients’ skin, which is also called mucinosis. It causes papular and sclerodermoid bumps. Also, people affected by this disease have increased production of fibroblasts in the absence of a thyroid disorder. Another symptom includes monoclonal gammopathy, which is shown as abnormal protein existence in the person’s blood. This disease has no standard treatment. All patients should have their life quality improved by any means possible. These ses are extremely challenging for most of the treatments, that are being made by a dentist, because the patient is unable to open his mouth wide enough, so that standard dental manipulations can be made. A 60-year-old patient was presented with Scleromyxedema to our clinic. He was unable to open his mouth by more than 1,7 centimeters, which is considered a very narrow mouth opening. Patients face muscles were rigid, especially – musculus orbicularis oris and musculus masseter. Any attempts to open the mouth by more than 1,7 centimeters resulted with ruptures in patients mouth corners. Intra-oral Examination revealed 2 teeth left in the lower jaw, and no teeth in the upper jaw. Patient was in need of masticatory function rehabilitation, phonetics and aesthetics improvement. Such case requires special procedures and specific adaptation, compared to a standard edentulous patients’ treatment. In this case report, we review all the intra oral procedures, which should be modified accordingly to this rare case. Clinicians should be informed of such rare diseases and should be able to diagnose and treat them accordingly.

A 56 year old man presented with one-sided cleft palate, affecting alveolar ridge in the upper left canine region. Patient was unable to eat and drink without having the food fall out through his mouths opening into his nose. During first visit, patient underwent x-ray analysis to identify how deeply the bone damage has affected his maxilla. It revealed deep bone penetration, connecting the base of the nose with the mouth. We suggested one of the most effective methods for treating these types of cases – a removable partial denture, which was made to work as an obturator at the same time, closing the space, which causes difficulties to the patient. This case report represents a rare presentation and treatment of cleft palate by using removable partial dentures (RPDs) to close the gap, connecting the patient’s mouth with the nose structures.

BACKGROUND The present study aimed to evaluate whether non-surgical treatment interferes with clinical parameters and local patterns of osteo-immunoinflammatory mediators (IL-17 and TNF-alpha) and matrix metalloproteinase-8 (MMP-8) that are found in peri-implant crevicular fluid (PICF) and biofilms during the progression of peri-implant mucositis. MATERIAL AND METHODS We selected 30 patients with peri-implant caused mucositis before (MP) and after treatment (TP) and 30 healthy people (HP) for the analysis of IL-17, TNF-alpha cytokine, and MMP-8 production in PICF and for analysis of colonization dynamics of periodontopathogenic bacteria in supra- and subgingival plaque samples. The levels of IL-17 and MMP-8 concentrations in samples were assayed by enzymatic immunosorbent assay (ELISA) and TNF-alpha levels were determined by enzyme amplified sensitivity immunoassay (EASIA) method in PICF. The micro-IDent test was used to detect 11 species of periodontopathogenic bacteria in subgingival biofilm. RESULTS We found significantly (P

Periodontal pathologies are highly widespread throughout the world. Epidemiological studies have shown that as much as 1% of the population is suffering from periodontal disease. In recent years, there has been a growing number of studies linking these diseases with autoimmune diseases, especially with rheumatoid arthritis. This literature review evaluates changes in the relationship between periodontal pathologies caused by the bacterium Porphyromonas gingivalis and rheumatoid arthritis. The systematic review of the literature was performed according to the PRISMA analysis protocol. The review was performed with articles from the PubMed database. Searched articles were not older than 5 years. Only full texts and research performed with people were selected. A total of 56 results were received. A review and analysis of their full texts have been carried out and 10 articles were selected according to the established criteria. They were analyzed and results were presented. The results obtained from the literature were based on the influence of Porphyromonas gingivalis on the pathogenesis of rheumatoid arthritis. In the literature, the activity of this bacterium is explained by the analysis of its enzyme peptidylarginine deiminase and its principle of action. Studies have also been found to prove the presence of Porphyromonas gingivalis not only in the oral cavity but its DNA is also found in synovial fluid and plasma. In the researched articles, direct links between Porphyromonas gingivalis and rheumatoid arthritis have led doctors to draw attention to patients' oral hygiene and the condition of parodentium, as this may be the cause of autoimmune lesions. Treatment of periodontal disease will not only help maintain a healthy oral cavity but prevent the spread of bacteria to the surrounding tissues.

BACKGROUND The purpose of the present research is to analyze the effect of polyphenols and flavonoids substrat (PFS) from plants Calendula officinalis, Salvia fruticosa, Achillea millefolium, and propolis as immunomodulatory in the production of interleukin (IL)-1ss and IL-10 in peripheral blood leukocytes medium (PBLM) in patients who were diagnosed with mucositis of peri-implant tissue compared to patients with healthy implant tissue. It was hypothesized that IL-1ss and IL-10 contribute to the inflammation processes noticed in the diseases of peri-implant tissues. MATERIAL AND METHODS Sixty non-smoking patients were included in this study: patients with healthy implants (HP group) and patients with peri-implant mucositis (MP group). Peri-mucositis was diagnosed by radiologic and clinical examination. The PBLM from MP were treated with PFS at various concentrations. The levels of IL-10 and IL-1ss excreted by the PBLM stimulated and unstimulated with viable Porphyromonas gingivalis test-tube were committed by the enzyme amplified immunoassay sensitivity method. RESULTS Unstimulated and stimulated PBLM and treatment with 5.0 mg/mL or 10.0 mg/mL of PFS in the MP group produced significantly higher levels IL-10 (P

BACKGROUND: Various studies have shown that non-surgical periodontal treatment is correlated with reduction in clinical parameters and plasma levels of inflammatory markers. The aim of this study was to evaluate the effect of long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide as maintenance therapy followed by non-surgical periodontal treatment on clinical parameters, plasma levels of inflammatory markers, and morphological changes in gingival tissues of patients with periodontitis. MATERIAL AND METHODS: In total, 43 patients with chronic periodontitis were randomly allocated to long-term maintenance therapy. The patients’ periodontal status was assessed using clinical parameters of approximal plaque index, modified gingival index, bleeding index, pocket probing depth, and plasma levels of inflammatory markers (high-sensitivity C-reactive protein and white blood cell count) at baseline and after 1, 2, and 3 years. The morphological status of gingival tissues (immediately after supragingival irrigation) was assessed microscopically. RESULTS: Complete data were obtained on 34 patients. A highly statistically significant and consistent reduction was observed in all long-term clinical parameters and plasma levels of inflammatory markers. Morphological data showed abundant spherical bubbles in gingival tissues. CONCLUSIONS: 1. The present study showed that non-surgical periodontal treatment with long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide improved clinical periodontal status and plasma levels of inflammatory markers and may be a promising method in periodontology. 2. We found that supragingival irrigation with aerosolized 0.5% hydrogen peroxide created large numbers of spherical bubbles in gingival tissues.

Candida albicans is the most prevalent human fungal pathogen, that is component of the commensal microbial flora of the mouth. Under certain conditions, C. albicans can cause severe diseases, septicaemia, and death. The mass of infections made by this pathogen are connected with biofilm growth. This survey highlights the pathogenicity mechanisms of C. albicans and how this may lead to the induction of a protective immune response. The survey is based on the most recent and important literature available from the Medline database.

The aim of this review was to evaluate the most common complications in implant prosthodontics with porcelain-fused-to-metal crowns, to evaluate the influence of biomechanical properties on fractures and cracks of veneered porcelain, and to compare the effects of crowns with different connections on soft tissues.A search of literature in the English language between 2009 and 2015 was conducted using the following databases: Medline via PubMed, Science Direct, Wiley online library, TaylorFrancis, and Cochrane library. In total, 10 studies that met the inclusion criteria were found.Four investigations showed that technical complications more often occurred in screw-retained prostheses, although two studies concluded that cement-retained crowns were also susceptible to technical complications. Two investigations showed that the deeper the abutment margin was subgingivally, the more excess cement was left in the peri-implant sulcus. Four studies concluded that cement-retained prostheses were more susceptible to biological complications, but two investigations also showed that biological complications were observed in tissues adjacent to screw-retained crowns.The research of literature data for the last five years showed that screw-retained crowns demonstrated more failures such as porcelain cracks and fractures or screw loosening, while cement-retained crowns caused more severe biological complications such as peri-implant soft tissue inflammation or pathological bone resorption.

Background: The aim of the study was to analyze how metabolic control of type 1 diabetes is related to clinical and micro- biological periodontal parameters. Material/Methods: The study involved 56 subjects aged from 19 to 50 years divided into 2 groups: healthy subjects (the H group), and diabetic (type 1 diabetes) patients with chronic untreated generalized periodontitis (the DM group). The gly- cosylated hemoglobin value (HbA1c) was determined using the UniCel DxC 800 SYNCHRON System (Beckman Coulter, USA), and the concentration in blood was measured by the turbidimetric immunoinhibition method. A molecular genetic assay (Micro-IDent plus, Germany) was used to detect periodontopathogenic bacteria in plaque samples. Periodontitis was confirmed by clinical and radiological examination. Results: Fusobacterium nucleatum, Capnocytophaga species, and Eikenella corrodens were the most frequently found bacteria in dental plaque samples (77.8%, 66.7%, and 33.4%, respectively), whereas Aggregatibacter actinomy- cetemcomitans was identified 40.7% less frequently in the DM group than in the H group. The strongest rela - tionship was observed between the presence of 2 periodontal pathogens - F. nucleatum and Capnocytophaga spp. - and poorer metabolic control in type 1 diabetes patients (HbA1c) and all clinical parameters of periodon- tal pathology. Conclusions: Periodontal disease was more evident in type 1 diabetic patients, and the prevalence of periodontitis was great- ly increased in subjects with poorer metabolic control.

In the present study, we investigated the relation between clinical parameters and levels of interleukin (IL) -4 and -5, and tumour necrosis factor-α (TNF-α) in the leukocyte incubation medium (LIM) obtained from 26 patients with chronic periodontitis (P) and 26 control group subjects (C). The levels of cytokines IL-4 and IL -5 produced by the LIM stimulated with non-opsonised E. coli were determined using the Enzyme-Linked Immunosorbent Assay (ELISA) method and the levels of TNF-α were evaluated by applying Enzyme Amplified Sensitivity Immunoassay (EASIA). TNF-α levels in stimulated LIM were strongly positively correlated with clinical parameters such as the pocket probing depths (PPD), the clinical attachment level (CAL), the bleeding on probing (BOP) and oral hygiene index (OHI), whereas the IL-4 and IL-5 levels in the analogous medium were strongly negatively correlated with the clinical parameters. IL-4 and IL-5 levels in stimulated LIM of P group patients were significantly lower, whereas TNF-α levels were significantly higher than that in analogous medium of C group subjects. These differences were associated with the severity of periodontal disease.

BACKGROUND This study evaluated the survival of the most prevalent oral bacteria and fungi (Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, and Candida albicans) in dental casts, and compared changes in the amounts of these microorganisms at different time intervals to determine how long dental casts may pose threat to the health of dental personnel and patients. MATERIAL AND METHODS When manufacturing the casts, regular water was replaced with sterile distilled water, where suspensions of the studied bacteria or the fungus at certain concentrations were prepared. When the dental casts were fully set (solidified), plaster shavings were examined immediately after the contact of the studied microorganism with the plaster, as well as after 1, 2, 24, 48, 72, 96, and 120 hours. Following that, we measured how the amount of the studied bacteria and fungi in 1 gram of the plaster changed within the studied period of time. RESULTS Klebsiella pneumoniae survived in plaster for up to 4 days, and the reduction in the number of these bacteria became statistically significant after 1 day (p

BACKGROUND Levels of pro-inflammatory cytokine (IL-1β) released by peripheral blood leukocyte medium (PBLM), isolated from chronic periodontitis patients (P) before therapy and matched to controls, were determined in the presence or absence of non-opsonized Escherichia coli and Staphylococcus aureus. MATERIAL AND METHODS In this investigation, 26 patients with untreated, severe, generalized, chronic periodontitis and 26 healthy subjects (H) were enrolled. Periodontal status was assessed by measuring bleeding on probing (BOP), clinical attachment loss (CAL), probing pocket depth (PPD), and Ramfjord index (PDI). The levels of IL-1β (µg/ml) were assayed by a standard Immunoenzymetric Assay Diasource IL-1β ELISA kit in PBLM. RESULTS Our study showed that the values of IL-1β levels in PBLM of the P group (stimulated with non-opsonized E. coli and S. aureus) were significantly higher than in the analogous medium of H group subjects (P

Opportunistic oral fungal infections have spred, especially in denture wearers. Denture stomatitis is a common inflammatory reaction, multifactorial etiology, which is usually associated with Candida species, particularly Candida albicans, due to its high virulence, ability to adhere and form biofilms on oral cavity tissues and denture surfaces. This article highlights the pathogenesis, clinical presentation, and management strategies of Candida-associated denture stomatitis commonly encountered in dental practice.

Background. The aim of the study was to investigate the immunomodulating effect of s-1,3/1,6 glucan from yeast on the production of interleukin-4 (IL-4), interleukin-5 (IL-5) in a medium of peripheral venous blood leukocytes from patients with periodontitis. Material/Methods. The study was performed using venous blood of 22 patients, aged 20 to 45 years, suffering from untreated severe chronic generalized periodontitis confirmed by clinical and radiological examination, and 22 periodontally healthy subjects. The effects of s-1,3/1,6 glucan on the production of the cytokines IL-4 (pg/ml) and IL-5 (pg/ml) levels by unstimulated and stimulated leukocyte incubation medium with unopsonized E. coli were determined using the Enzymes Linked Immunosorbent Assay (ELISA) method. Results. We found that the incubation medium of stimulated leukocytes by unopsonized E. coli and treated with 0.2 mg and 0.4 mg of s -1,3/1,6-glucan of patients with periodontitis produced significantly higher (P

The aim of the simulation was to find the forcing laws, which provide the close-to reality mastication motions of the components of the system and to investigate the contact zones, interaction forces and their action points as they vary in time. The loss of one or few elements of the mastication system can be restored without significant violations of the overall function provided the general correlations among the mastication system elements, which were influenced during the evolutionary development, have been determined in advance.We present an approach based on the computer simulation of mastication biomechanics on the basis of finite element (FE) models. They were generated by using the data acquired with both optical and CT scanning systems, which enabled to obtain highly accurate three-dimensional geometrical models of all hard parts of the mastication system of a real dead goat. The surfaces of dental arcs of upper and lower jaws mechanically interacting one against another have been used as the main parts of the model.Using FE models we discovered that mastication forces are correlated directly between dental arches and TMJ surfaces. Factors influencing geometry of dental arches results a destroy jaw function.In the course of this analysis the mastication system of a goat has been considered as a representative of the ruminant individual and enabled to demonstrate the mechanics of the mastication process with insights for evaluation of the similarities and differences against the human mastication.

PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment.

Outcomes of mandibular fractures were stated as frequent reason of temporomandibular joint dysfunctions. The objective of this study was to evaluate dynamical changes of occlusion and articulation during treatment of mandibular angle fractures. 12 subjects with mandibular angle fractures underwent analysis of occlusion and articulation in all stages of healing. Findings of investigations were presented in Posselt's and intercondylar axis diagrams, occlusiograms and relative force vs. time graphs. Comparison of results in first day, 1, 3 and 6 months after trauma showed that despite typical process of fragments healing and good fixation but with insufficiently balanced occlusion and posttraumatic discoordination of muscle activity first signs of TMJ articular discs dysfunction were found. Our results confirm the concept that early rehabilitation of mandibular function and occlusion are essential to prevent developing functional disorders of TMJ.

The Early Childhood Oral Health Impact Scale (ECOHIS) is a parent--assessed oral health related quality of life measure developed to assess the impact of oral health problems on preschool children.The aim of this study was to develop a Lithuanian version of the ECOHIS and evaluate its validity and reliability among preschool children in Lithuania.A lithuanian version of ECOHIS (L-ECOHIS) was developed through a forward-backword translation. A cross-sectional study was performed to assess discriminant and convergent validity and internal consistency. Data was collected from 130 parents of 0-5 year-old children visiting the dental department. A subsample of parents filled the questionnaire again to assess the test-retest reliability.Cronbach's alpha for the instrument was 0.869. Item-total correlation coefficients ranged from 0.389 to 0.797. Scores of the child and family sections were significantly correlated (P0.001). The scale scores indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health and problem-based dental attendance. The intra-class correlation coefficient was 0.98.The L-ECOHIS is a valid and reliable measure to assess OHRQoL of 0-5 year-old children with Lithuanian speaking parents.

BACKGROUND. Mini dental implants (MDI) and small diameter implants (SDI) have been extensively used as temporary or orthodontic anchorage; however there have been studies that proved their availability as a mean for long term prosthodontics. Our aim was to review the indications, advantages of MDI and SDI, and their long-term survival. METHODS. Computerized searches were conducted for clinical studies between year 2000 and 2011 that involved either implants with 3.3 mm diameter or less, used in prosthodontics; or provided a follow up of MDI or SDI duration of at least 4 months following implant placement including survival rate data. All studies about implants used in orthodontics were excluded. The range of available MDI and SDI has been found in cataloges of the companies: 3M ESPE IMTEC, Bicon Dental, Zimmer, Implant Direct, Intra lock, Hiossen, Simpler Implant, KAT Implants, OCO Biomedical, American Dental Implant. RESULTS. 41 studies meeting the above criteria were selected, 22 out of them reviewed survival rates of MDI and SDI. The follow up duration varried from 4 months to 8 years with survival rates between 91.17 and 100%. Nevertheless, the companies showed a big variety of MDI and SDI provided in the market for long term prostheses. CONCLUSIONS. Implants with small diameters can be used successfully in a variety of clinical situations. Less surgical time, less postoperative pain, ability of direct loading after surgery with no harm to bone and cost effectiveness are the advantages. The reduced surface implants require correct treatment planning so that the loading force would not cause bone loss or implant failure. MDI and SDI show high survival rates, but special cautions for bone quality and good oral hygiene should be maintained.

The aims were to overview healing of extraction socket, recommendations for atraumatic tooth extraction, possibilities of post extraction socket bone and soft tissues preservation, augmentation.A search was done in Pubmed on key words in English from 1962 to December 2011. Additionally, last decades different scientific publications, books from reference list were assessed for appropriate review if relevant.There was made intraalveolar and extraalveolar postextractional socket healing overview. There was established the importance and effectiveness of atraumatic tooth extraction and subsequent postextractional socket augmentation in limited hard and soft tissue defects. There are many different methods, techniques, periods, materials in regard to the review. It is difficult to compare the data and to give the priority to one.

Objective. The aim of the study was to establish the dynamics of β-glucuronidase activity in subjects suffering from type 1 diabetes and chronic untreated generalized periodontitis, subjects suffering from chronic untreated generalized periodontitis only, and control subjects not suffering from generic diseases with healthy periodontal tissue. Material and Methods. The study involved 165 19–50-year-old subjects who were divided into three groups: healthy subjects (n=55), subjects with chronic untreated generalized periodontitis (n=55), and subjects with type 1 diabetes and chronic untreated generalized periodontitis (n=55). Neutrophilic leukocytes of peripheral venous blood were exposed to bacterial stimuli: opsonized zymosan, nonopsonized Staphylococcus aureus, and prodigiosan. The activity of β-glucuronidase was determined by the spectrofluorimetry method. Results. The diagnostic value of changes in β-glucuronidase activity of neutrophilic leukocytes markedly increased in all study groups after stimulation of neutrophilic leukocytes by opsonized zymosan, nonopsonized Staphylococcus aureus, and prodigiosan as compared to control media not exposed to any stimulus (P

The aim of this study was to investigate associations between the immune component of the oral cavity, lysozyme, in gingival crevicular fluid and unstimulated saliva, and colonization dynamics of periodontopathogenic bacteria from supra- and subgingival plaque samples in patients with gingivitis or periodontitis.Lysozyme in crevicular fluid and unstimulated saliva, and bacteria in supra- and subgingival plaque samples were assessed in 84 samples from 28 patients with gingivitis, 96 samples from 32 patients with periodontitis, and 72 samples from 24 donors with intact periodontium and free of internal disease. Lysozyme activity was determined spectrophotometrically. The micro-IDent plus assay was used to detect 6 periodontopathogenic bacteria plaque samples.Lysozyme activity in crevicular fluid in the gingivitis and periodontitis groups was significantly greater than that in the donor group, but lysozyme activity in unstimulated saliva was less than that in the donor group. Peptostreptococcus micros, Fusobacterium periodontium and Campylobacter rectus were predominant in subgingival plaque samples in the periodontitis group compared to the donor group (P0.001), and Eubacterium nodatum and Eikenella corrodens were predominant in the gingivitis group compared to the donor group (P0.001).Lysozyme activity in crevicular fluid and in unstimulated saliva correlated with periodontal pocket depth in donors and in patients with gingivitis or periodontitis (specificity and sensitivity were both 100%). These findings indicate that infection with P. micros, F. periodontium, E. nodatum, E. corrodens, and C. rectus may be an important indicator of inflammatory periodontal disease development.

Aim of study was to examine periodontal status among 20 44 year old patients and to study the secretory function of peripheral venous blood neutrophilic leukocytes (NL) exposed to various antigens and alkaline phosphatase (AP) activity in gingival crevicular fluid (GCF) in patients suffering from gingivitis and periodontitis. Clinically were determined Russell's periodontal index (PI). Secretory function of NL affected by opsonized zymosane, non-opsonized E. coli was examined in 77 patients with gingivitis and periodontitis, and in 35 donors, free of internal diseases, by means of beta-glucuronidase (beta-GD), lysozyme (LZ). NL secreted higher levels of beta-GD in incubation medium in patients with periodontitis (por = 0.001) subject to degree of periodontal lesion. NL affected by various antigens secreted higher levels of LZ into non-cellular matrix in patients with gingivitis and periodontitis comparing to control environment in analogous groups. Data obtained from this study suggest that in patients with periodontitis response of NL to bacterial stimuli is specific and subject to the degree of periodontal lesion. Our study showed a significant difference of AP activity in GCF subject to pocket depth and degree of periodontal lesion. Once NL are exposed to corpuscules prone to phagocytosis, an increase in secretion of beta-GD and LZ can be explained by overall increase in secretion of NL lysosomic enzymes, thus disclosing the mechanism of inflammatory periodontal tissue damage.