Mirjana Apostolovic

Chronic gingivitis: the prevalence of periodontopathogens and therapy efficiency

The purpose of this study was to determine the level of gingival inflammation and the prevalence of periodontopathogenic microorganisms in adolescents with chronic gingivitis, as well as to compare the effectiveness of two approaches in gingivitis treatment-basic therapy alone and basic therapy + adjunctive low-level laser therapy (LLLT). After periodontal evaluation, the content of gingival pockets of 140 adolescents with gingivitis was analyzed by multiplex PCR for the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythensis and P. intermedia. Subsequent to bacteria detection, the examinees were divided into two groups with homogenous clinical and microbiological characteristics. Group A was subjected to basic gingivitis therapy, and group B underwent basic therapy along with adjunctive LLLT. A statistically significant difference between the values of plaque-index (PI) and sulcus bleeding index (SBI) before and after therapy was confirmed in both groups (p < 0.001), though more pronounced in group B. Following therapy, the incidence of periodontopathogenic microorganisms decreased considerably. The best result was obtained in P. gingivalis eradication by combined therapy (p = 0.003). The presence of periodontopathogens in adolescents with gingivitis should be regarded as a sign for dentists to foster more effective oral health programs. LLLT appears to be beneficial as adjuvant to basic therapy.

The importance of health education in prevention of oral health in children

UNLABELLED HEALTH EDUCATION: The aim of education is to impart knowledge on the causes of disease and decay of the teeth and periodontium, on the ways and possibilities of disease prevention and adequate treatment; to point out to the necessity of proper nutrition, regular and proper oral hygiene, proper use of fluoride products as well as to the significance of regular check-ups with a dentist. NUTRITION Frequent intake of carbohydrates leads to a higher prevalence of caries. Taking into consideration that it is neither obtainable nor recommendable to completely eliminate glucoses from the nutrition components, it is necessary to advice parents and children to take glucose (if possible) only along with the regular meal when the saliva flow is increased. ORAL HYGIENE In order to establish oral hygiene as an important prophylactic measure influencing successful protection of oral health of the whole population, it is necessary to inform as many people as possible about oral hygiene effectiveness and its necessity in preventing oral and dental diseases; to develop the habits of regular oral hygiene maintenance in the youngest children as well as to refer them to the use of most adequate paraphernalia and agents for performing the daily oral hygiene procedures. FLUORIDE PROPHYLAXIS Undoubtedly, fluoride is currently the most efficient agent for the prevention of dental pathology. The anticaries efficacy of fluoride is a consequence of the cumulative effect of several different mechanisms. They can occur on the dental surface or directly influence the mineral phase in the enamel. Each dental hygiene preventive program must include the content about the use of fluoride as the basic prophylactic measure. It is recommended to be the sum of the combined effect of systemic (endogenic) and local (exogenic) application. CONCLUSION Regarding high prevalence of caries in children, the issue of prophylaxis is of great significance and current interest. In that respect, health education should point out to the significance of proper nutrition, regular oral hygiene and fluoride prophylaxis, all aimed at preventing dental diseases. It is certain that parents must take an active part in these activities both as educators and controllers of the proposed measures.

Cytomorphometric and clinical investigation of the gingiva before and after low-level laser therapy of gingivitis in children

Gingival epithelial cells are the first physical barrier against periodontal pathogenic microorganisms. Bacterial products may penetrate the epithelium and directly disturb its integrity. We investigated the clinical and cytomorphological status of the gingiva in children with gingivitis before and after low-level laser therapy. The study enrolled 130 children divided into three groups: group 1 comprised 50 children with chronic catarrhal gingivitis who received basic treatment, group 2 comprised 50 children with chronic catarrhal gingivitis who received low-level laser treatment in addition to basic treatment, and group 3 comprised 30 children with healthy gingiva as controls. Oral hygiene and the status of the gingiva were assessed using the appropriate indexes before and after treatment. Inflammation of the gingiva was monitored by cytomorphometric evaluation. Cytomorphometric analysis revealed a statistically significant difference (p < 0.001) in the size of the nuclei of the stratified squamous epithelial cells of the gingiva before and after treatment in chronic catarrhal gingivitis. Evaluation using clinical parameters showed that treatment of gingivitis with basic treatment was successful. Cytomorphometric analysis showed that after basic treatment the nuclei of the stratified squamous epithelial cells of the gingiva were reduced in size, although not to the size found in healthy gingiva. However, after adjuvant low-level laser therapy, the size of the nuclei of the stratified squamous epithelial cells in the gingiva matched the size of the nuclei in the cells in healthy gingiva.

Remineralization of demineralized enamel around orthodontic braces

Introduction. Decaltification on the teeth around the orthodontic braces can be reduced with adequate oral hygiene and use of fluorides. Aim. The aim of this study was to examine, using scanning electron microscopy, the ultrastructural changes on enamel surface after the treatment with different fluoride preparations. Methods. Orthodontic braces were placed on 30 dental samples (premolars) extracted for orthodontic reasons and orthodontic braces fixed with Fuji Ortho LC. The teeth were divided into three groups with 10 teeth each. First group was the control one, without treatment with fluoride solutions. Second group consisted of teeth samples treated with Fluorogal (0.05% F), every day for 1 minute in the period of 6 months. Third group consisted of teeth samples treated 5 minutes daily with GC Tooth Mousse in the period of 6 months. The teeth were placed in artificial saliva in the period of 6 months. Afterwards, the samples were prepared for scanning electron microscopy, SEM (JEOL JSM 5300) using the technique of sputtering in a vacuum evaporator. Enamel surface was analyzed in order to identify micromorphologic structural changes on the places where braces had been previously fixated. Results. The results indicated that SEM analysis detected the highest remineralization potential in the tooth samples exposed daily to low doses of fluoride. Conclusion. Remineralization of demineralized enamel was present in both experimental groups of teeth, being more intense in the group treated with Fluorogal solution.

Presence and role of noncollagenous proteins in dentin: Dentin siaolproten, bone sialoprotein and osteopontin

Dentin, as a specific hard tooth tissue is very rich in organic materials, representing approximately 20% of its weight and 33% of its volume. The basic organic component of dentin is collagen. However, the noncollagenous organic content of dentin has not been sufficiently studied. Dentin and its complex ultrastructure, molecular content and biochemical process, playing the main role in dentinogenesis, still haven’t been fully explained, which presents a real scientific challenge. Protein separation was done with sodium dodecil sulfate poliacrilamid gel electrophoresis (SDS PAGE) technique in which polipeptides are separated by the differences in their molecular masses.Electrophoretic analysis of proteins is very important in basic research of proteins family which are organic constituents of the dentin tissue. Research results revealed significant presence of dentin sialoprotein, bone sialo protein and osteopontin in analized samples of dentin. Dentin sialoptotein (DSP) is one of the specific proteins in dentin, and its produced by secretory activity of mature odontoblasts. It also represents a reliable phenotype marker of odontoblasts. The fact that dentin sialoprotein is specific for dentin and cannot be found in any other tissue implicate sits unique, critical and key-roll in dentinogenesis. Bone sialoprotein (BSP) and osteopontin, revealed in this research, are not specific for dentin. They are produced both by odontoblasts and osteoblasts. Bone sialoprotein may have a function in the initiation of the crystal hydroxiapatite growth in mineralized tissues. Osteopontin and alkaline phosphatase could be the markers of the odontoblast differentiation. Upon analyzing the characteristics of the presented nonspecific proteins, the necessity of their presence during the process of dentinogenesis can be stated as a conclusion to this research.