Livia Cigić

The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus

BACKGROUND In spite of all the efforts, recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) still have unexplained etiology. The role of anxiety, depression, and psychological stress in occurrence and intensity of symptoms in RAS and OLP patients has been investigated in this study. METHODS A total of 110 patients with RAS in the acute phase and 112 patients with OLP also in acute phase participated in this study. All patients filled out questionnaires related to the primary disease (RAS/OLP) after which they took the following psychological tests: Beck Depression Inventory (BDI), The State-Trait Anxiety Inventory (STAI), and Ways of Coping Questionnaire (WCQ). RESULTS According to multiple regression analysis, in patients with RAS, the highest correlation was found between results of the pain intensity and STAI test (β= 0.66; p < 0.000). In the patients with OLP, the highest correlation was found between the level of hyperkeratosis and WCQ test (β = 0.53; P < 0.000), inflammation and results of BDI test (β = 0.33; P < 0.002), and results of dynia test and STAI test (β = 0.31; P < 0.004). CONCLUSIONS In this study, a high correlation between anxiety, depression, and psychological stress with symptoms of RAS and OLP has been observed.

Analysis of expression patterns of IGF-1, caspase-3 and HSP-70 in developing human tooth germs

AIMS To analyze expression patterns of IGF-1, caspase-3 and HSP-70 in human incisor and canine tooth germs during the late bud, cap and bell stages of odontogenesis. MATERIALS AND METHODS Head areas or parts of jaw containing teeth from 10 human fetuses aged between 9th and 20th developmental weeks were immunohistochemically analyzed using IGF-1, active caspase-3 and HSP-70 markers. Semi-quantitative analysis of each markers expression pattern was also performed. RESULTS During the analyzed period, IGF-1 and HSP-70 were mostly expressed in enamel organ. As development progressed, expression of IGF-1 and HSP-70 became more confined to differentiating tissues in the future cusp tip area, as well as in highly proliferating cervical loops. Few apoptotic bodies highly positive to active caspase-3 were observed in enamel organ and dental papilla from the cap stage onward. However, both enamel epithelia moderately expressed active caspase-3 throughout the investigated period. CONCLUSIONS Expression patterns of IGF-1, active caspase-3 and HSP-70 imply importance of these factors for early human tooth development. IGF-1 and HSP-70 have versatile functions in control of proliferation, differentiation and anti-apoptotic protection of epithelial parts of human enamel organ. Active caspase-3 is partially involved in formation and apoptotic removal of primary enamel knot, although present findings might reflect its ability to perform other non-death functions such as differentiation of hard dental tissues secreting cells and guidance of ingrowth of proliferating cervical loops.

Involvement of IGF-2, IGF-1R, IGF-2R and PTEN in development of human tooth germ – an immunohistochemical study

ABSTRACT Insulin-Like Growth Factor 2 (IGF-2) is a peptide hormone essential for prenatal growth and development. IGF-2 exerts its mitogenic effects via Insulin-Like Growth Factor 1 Receptor (IGF-1R), and is eliminated by binding to Insulin-Like Growth Receptor 2 (IGF-2R). IGF-2 is also negatively regulated by Phosphatase and Tensin Homolog (PTEN), a phosphatase mutated in various tumors. Not much is known about the interplay between these factors during human odontogenesis. In this study, expression patterns of IGF-2, IGF-1R, IGF-2R and PTEN were analyzed by double immunofluorescence in incisor human tooth germs during the foetal period of development between the 7th and 20th gestational week. Throughout the investigated period, IGF-2 was mostly expressed in enamel organ, whereas mild to moderate expression of PTEN could be seen in dental papilla and parts of enamel organ. Expression of IGF-1R was ubiquitous and displayed strong intensity throughout the entire enamel organ. In contrast, expression of IGF-2R had rather erratic pattern in enamel organ and dental papilla alike. Expression patterns of IGF-2, IGF-1R, IGF-2R and PTEN in highly proliferative cervical loops, as well as in differentiating pre-ameloblasts and pre-odontoblasts of cusp tip region during the early and late bell stages when enamel organ acquires definitive shape, indicate importance of these factors in crown morphogenesis of human incisor. Taken together, our data suggest the involvement of IGF-2, IGF-1R, IGF-2R and PTEN in temporo-spatial patterning of basic cellular processes (proliferation, differentiation) during normal tooth development. They are also relevant for improving knowledge of molecular basis of human odontogenesis.

The prevalence of celiac disease in patients with geographic tongue.

BACKGROUND Geographic tongue (GT) is a benign inflammatory condition usually involving the dorsal surface and lateral borders of the tongue. Numerous etiological factors of GT have been suggested, including immunological factors; genetic; atopic or allergic predisposition; emotional stress; and hormonal disturbances. GT may also coexist as one of the possible manifestations of celiac disease (CD). Therefore, the aim of this study was to investigate the prevalence of CD, positive serologic tests for CD screening, and HLA-DQ presence in patients with GT. METHODS Tissue transglutaminase antibodies (anti-tTG), antibodies against gliadin (AGA), and human leukocyte antigen (HLA) typing were assessed for 60 GT patients and 60 healthy control subjects. The duodenal biopsy was performed in patients with positive serologic tests. RESULTS We found that 9 (15%) GT patients were positive for IgA tTG, and in those patients histological changes consistent with CD were confirmed by duodenal biopsy. Only two of them reported the presence of gastrointestinal symptoms. There were statistically significant differences between the GT patients and control group for immunoglobulin (Ig) A tTG (P = 0.03), IgG tTG (P = 0.04), IgA AGA (P = 0.04), and IgG AGA (P = 0.02). CONCLUSION The results of our study demonstrated the increased prevalence of CD in patients with GT. Therefore, the clinical oral examination should be considered a diagnostic tool, especially in atypical or silent forms of CD, since it may contribute to provide an early diagnosis.

Antimicrobial efficacy of probiotic-containing toothpastes: an in vitro evaluation

Aim To evaluate, in vitro antimicrobial ability of two probiotic toothpastes (one containing Lactobacillus paracasei, other containing Lactobacillus acidophilus) and one toothpaste without probiotic separately, and in a combination with two different mouthrinses (one containing essential oils and the other containing hexitidine). Methods Antimicrobial susceptibility was checked by using the ditch method and Clinical Laboratory Standard Institute (CLSI) guidelines. Two different toothpastes with probiotic, toothpaste without probiotic and two different mouthrinses were tested against the following selected microorganisms: Candida albicans, Candida tropicalis, Enterococcus faecalis, Streptococcus salivarius and Staphylococcus aureus. Kruskal-Wallis test and MannWhitney U test were used for the statistical analysis (p≤ 0.05). Results Probiotic toothpastes had better inhibitory effect than toothpaste without probiotic in the case of Candida albicans (p=0.043) and Streptococcus salivarius (p=0.043). In all cases, toothpastes had stronger inhibition capacity than mouthrinses (p≤0.05). Conclusion Probiotic toothpastes, as a relatively new concept in the prevention of oral infectious diseases such as caries and periodontal disease, can contribute to the prevention of oral infectious diseases.

The role of parental anxiety, depression and psychological stress level on the development of early-childhood caries in children

BACKGROUND It is important to understand how the psychological status of parents affects oral health in children. AIM This study aimed to assess the level of depression, anxiety, and stress of parents whose children have early-childhood caries. DESIGN The study included 235 children and their parents who visited the Dental clinic at the School of Medicine of the University of Split between October 2016 and July 2017. The dental status of each child was recorded, while parents filled out the Depression Anxiety Stress Scale questionnaire and the questionnaire related to the demographic characteristics, questions related to childs habits of the tooth brushing, eating sweets. RESULTS Multiple regression analysis showed that the incidence of active caries in the children was statistically significantly related not only to the level of parent depression (β = -0.289; P = 0.040) but also the level of anxiety (β = 0.186; P = 0.038) and stress (β = -0.120; P = 0.036). The dmft index in the examined children was negatively significant associated with the parental level of depression (β = -0.305; P = 0.032). CONCLUSION Considering the results of our research it is essential to emphasize the need for better health education of parents.

Different Protocols of Photobiomodulation Therapy of Hyposalivation

OBJECTIVE Photobiomodulation (PBM) therapy has proved to be effective for a wide range of oral pathologies including oral dryness, but the literature still lacks reports of clinical trials and protocols. The purpose of our study was to evaluate the effects of different wavelengths of PBM on salivation in patients suffering from hyposalivation aiming at determination of optimal treatment protocol. MATERIALS AND METHODS This study included 30 patients whose major salivary glands were treated with low-intensity diode laser BTL2000 (Medical Technologies, s.r.o., Czech Republic) during 10 consecutive days. Patients were randomly assigned into two groups, each of 15 patients, and treated with PBM of 830 nm and PBM of 685 nm, respectively. The whole unstimulated and stimulated saliva quantities were measured each day during 10 days, before and after laser treatment, and at 10th day after treatment was ended. RESULTS Results have shown that the laser treatment significantly improves salivation (p < 0.0001) in both groups after 10 days treatment. The salivation also remains improved 10 days after the end of treatment. The patients treated with PBM of 830 nm have had continuously higher values of quantity of saliva. CONCLUSIONS Our results have shown that both laser wavelengths were effective in increasing salivary flow rate, and the improvement in salivation was statistically significant. The effect of treatment could be observed 10 days after the completion of treatment, thus providing evidence not only of stimulative effect but also indicating regenerative potential of PBM therapy.