Sonja Pezelj-Ribarić

Detection of Tumor Necrosis Factor α in Normal and Inflamed Human Dental Pulps

Abstract Background The aim of this study was to determine concentrations of tumor necrosis factor-α (TNF-α) in normal, painful, and asymptomatic human dental pulps. Methods Pulps were obtained from three groups of teeth, including healthy teeth, asymptomatic teeth with caries and/or large restoration, and symptomatic teeth with clinical diagnosis of irreversible pulpitis. Pulpal tissues were collected, prepared, and analyzed for TNF-α concentration by ELISA technique. Results Nonparametric Kruskal-Wallis test revealed significant differences between TNF-α concentration in normal samples (64.01 ± 53.12 pg/g) and irreversible symptomatic pulpal tissue (1,962.99 ± 1,288.75 pg/g), between irreversible symptomatic and asymptomatic (1,120.09 ± 649.72 pg/g), and between normal and irreversible asymptomatic pulpal tissue ( p = 0.000). Conclusions TNF-α may be an objective marker for determining extent of pulpal inflammation associated with irreversible pulpitis.

Tumor Necrosis Factor-Alpha in Peripical Tissue Exudates of Teeth with Apical Periodontitis

Aim. The aim of this study was to determine tumor necrosis factor-alpha (TNF-α) levels in periapical exudates and to evaluate their relationship with radiological findings. Methodology. Periapical exudates were collected from root canals of 60 single-rooted teeth using absorbent paper points. TNF-α levels were determined by enzyme-linked immunosorbent assays. The samples were divided into three groups according to the periapical radiolucent area. Results. Nonparametric Kruskal-Wallis test revealed significant differences between TNF-α concentrations in control group (40, 57±28, 15 pg/mL) and group with larger radiolucent areas (2365, 79±582, 95 pg/mL), as well as between control and canals with small radiolucent areas (507, 66±278, 97) (P<.05). Conclusions. The levels of TNF-α increase significantly in teeth with periapical pathosis, from smaller to bigger lesions. This research and its results have shown that objective analysis of the TNF-α levels enables establishment of a relationship between different concentrations of TNF-α and different radiological changes.

Salivary levels of tumor necrosis factor-alpha in oral lichen planus.

OBJECTIVE: Oral lichen planus (OLP) is chronic inflammatory disease of the oral mucosa, presenting in various clinical forms. The etiology of OLP is still unknown but mounting evidence points to the immunologic basis of this disorder. AIM: Our study was undertaken to quantify the salivary levels of pro-inflammatory tumor necrosis factor-alpha (TNF-alpha) in the reticular and the erosive/atrophic forms of OLP, compared with age-matched healthy control volunteers. SUBJECTS AND METHODS: Whole saliva from 40 patients with active lesions of OLP, as well as from 20 healthy persons, was investigated for the presence of TNF-alpha by enzyme immunoassay. RESULTS: Salivary TNF-alpha levels were significantly increased in patients with OLP in comparison with healthy subjects. The presence of TNF-alpha showed positive correlation to clinical forms of OLP, being significantly higher in the erosive/atrophic type than in the reticular type of disease. CONCLUSION: Saliva provides an ideal medium for the detection of pro-inflammatory markers of the oral cavity. In patients with OLP, TNF-alpha levels in saliva are elevated, correlating with the severity of illness. Salivary TNF-alpha analysis may be a useful diagnostic tool and a potential prognostic marker in OLP.

Detection of salivary interleukin 2 and interleukin 6 in patients with burning mouth syndrome.

The etiology of BMS remains unknown. Role of various cytokines has been implicated in the development of BMS. The aim of this study was to evaluate levels of salivary IL-2 and IL-6 in patients with BMS, compared with age-matched healthy volunteers (control group). Whole saliva from 30 patients with BMS, age range 55–65, was tested for the presence of IL-6 and IL-2 by enzyme immunoassay. Control group consisted of 30 healthy participants, aged 55–65 years. Saliva IL-2 concentrations in BMS were significantly increased in patients compared to healthy subjects: mean 34.1 ± 9.7 versus 7.3 ± 3.0 pg/mL; P < .001. Patients with BMS had significantly higher concentrations of IL-6 compared to control: mean 30.8 ± 5.6 versus 5.2 ± 2.8 pg/mL; P < .001. In patients with BMS, IL-2 and IL-6 levels in saliva are elevated, correlating with the severity of illness.

Tumor Necrosis Factor-Alpha and Interleukin 6 in Human Periapical Lesions

Aim. The aim of this study was to evaluate the presence of the cytokines tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in human periapical lesions. Subjects and methods. Samples were obtained from three groups of teeth: symptomatic teeth, asymptomatic lesions, and uninflamed periradicular tissues as a control. Results. TNF-alpha levels were significantly increased in symptomatic lesions compared to control. Group with asymptomatic lesions had significantly higher concentrations compared to control. There were no significant differences in TNF-alpha levels between symptomatic and asymptomatic lesions. In group with symptomatic lesions, IL-6 levels were significantly higher than in group with asymptomatic lesions. The IL-6 levels in symptomatic group also showed significantly higher concentration in comparison with control group. In asymptomatic group, the IL-6 level had significantly higher concentrations compared to control. Conclusion. These results indicate that symptomatic lesions represent an immunologically active stage of disease, and asymptomatic lesions are the point from which the process advances toward healing.

Oral sensorial complaints, salivary flow rate and mucosal lesions in the institutionalized elderly.

The aims of this study were to determine the prevalence of oral sensorial complaints, salivary flow rate and oral mucosal lesions in the institutionalized and non-institutionalized elderly. The study included 280 institutionalized and 61 non- institutionalized elderly people. Dry mouth, burning mouth sensations, taste disturbances, salivary flow rate and oral mucosal lesions were assessed and compared between groups. A greater number of the institutionalized elderly had dry mouth (P = 0.001) and taste disturbance (P = 0.035) compared to non-institutionalized elderly. The institutionalized elderly also had significantly lower salivary flow rate (P < 0.0001). Positive correlation was found between salivary flow rate and perception of dry mouth in the institutionalized elderly (r(s) = 0.26; P < 0.05), as well as in the non-institutionalized elderly (r(s) = 0.35; P < 0.05). Moreover, positive correlation was observed between salivary flow rate and the sensation of burning mouth in the institutionalized elderly (r(s) = 0.13; P < 0.05) and non-institutionalized elderly (r(s) = 0.31; P < 0.05). The number of institutionalized elderly people with oral mucosal diseases was higher compared with non-institutionalized ones (P = 0.01). The most common oral mucosal lesions in both groups were related to wearing dentures. It can be concluded that the institutionalized elderly are significantly affected with oral sensorial complaints, including dry mouth and taste disturbance, as well as decreased salivary flow rate and oral mucosal diseases compared with the non-institutionalized elderly.

Salivary Levels of TNF-α and IL-6 in Patients with Denture Stomatitis Before and After Laser Phototherapy

OBJECTIVE The aim of this study was to monitor therapeutic response by determining the level of proinflammatory cytokines TNF-alpha and IL-6 in whole unstimulated saliva in patients with denture stomatitis (DS), before and after laser phototherapy (LPT). BACKGROUND DS is an inflammatory condition that occurs in subjects who wear dentures, and it is a common oral mucosal lesion. A potential noninvasive treatment for DS patients is LPT. MATERIALS AND METHODS A sample consisting of 40 consecutive subjects was selected on a voluntary basis from patients who presented for the diagnosis and treatment of DS at the Oral Medicine Unit of the Medical Faculty at the University of Rijeka. A clinical examination was performed according to the standard clinical criteria. Lesions described as palatal inflammation were diagnosed as Newton type II denture stomatitis. The patients were randomly assigned to either an experimental group (20 patients receiving real LPT) or a control group (20 patients receiving inactive/placebo laser treatment). In order to determine the salivary levels of TNF-alpha and IL-6, ELISA (Sigma Immunochemicals, St Louis, MO) was performed. RESULTS Following treatment with LPT for 4 wk, the levels of TNF-alpha and IL-6 decreased significantly (p < 0.001) and were significantly different from controls (p < 0.001). CONCLUSION The results of this study suggest that LPT may be an efficacious choice of therapy.

Coronally advanced flap alone or with connective tissue graft in the treatment of single gingival recession defects: a long-term randomized clinical trial.

BACKGROUND Numerous surgical approaches for the treatment of single gingival recession (GR) defects are documented in the literature. The aim of this 5-year, split mouth-design, randomized clinical trial was to evaluate the effectiveness of coronally advanced flap (CAF) alone versus CAF with connective tissue graft (CAF+CTG) in the treatment of single Miller Class I and II GR defects. METHODS Thirty-seven patients with 114 bilateral, single Miller Class I and II GR defects were treated with CAF on one side of the mouth and CAF+CTG on the other side. Clinical measurements (GR length [REC], keratinized tissue width [KT], complete root coverage [CRC], and percentage of root coverage [PRC]) were evaluated before surgery and after 6, 12, 24, and 60 months. RESULTS There was a significant reduction of REC and increase of KT after surgery in both groups. CAF+CTG showed significantly better results for all evaluated clinical parameters in all observed follow-up periods. Miller Class I defects showed better results in terms of REC, CRC, and PRC, whereas Miller Class II showed better results in KT, both in favor of CAF+CTG. Miller Class I defects showed better results than Miller Class II GR defects regardless of the surgical procedure used. CONCLUSIONS Both surgical procedures were effective in the treatment of single Miller Class I and II GR defects. The CAF+CTG procedure provided better long-term outcomes (60 months postoperatively) than CAF alone. Long-term stability of the gingival margin is less predictable for Miller Class II GR defects compared to those of Class I.

Difference in the periapical status of endodontically treated teeth between the samples of Croatian and Austrian adult patients

Aim To compare the periapical status of endodontically treated teeth between Austrian and Croatian adult patients and determine its relation to age, sex, position of teeth, and length of root canal filling. Methods The study was conducted from 2007 to 2009 at two university dental clinics and included 163 Croatian (412 teeth) and 101 Austrian (430 teeth) patients. We assessed the periapical status of endodontically treated teeth by using the periapical index system and determined its relation to age, sex, position of teeth, and length of root canal filling. Results Austrian patients had a greater number of diseased endodontically treated teeth than Croatian patients (P = 0.001). In the age group 31-40 years, Austrian patients had apical periodontitis significantly more often (22.1% vs 12.2%, P < 0.001) than Croatian patients. In relation to sex and position of teeth, no significant difference was found between the two groups. In Croatian patients, apical periodontitis was significantly more often present in molar than premolar (46.2% vs 29.7%, P = 0.022) and front teeth (46.2% vs 24.1%, P < 0.001). In Austrian patients, apical periodontitis was significantly more often present in molar and premolar than front teeth (molar-front teeth: 38.2% vs 25.5%, P = 0.011; premolar-front teeth: 36.3% vs 25.5%, P = 0.029). Croatian and Austrian patients significantly differed in the number of adequately filled and underfilled teeth with AP (both P<0.001). Conclusion Apical periodontitis was significantly more present in endodontically treated teeth in Austrian patients. The difference in the periapical status between Croatian and Austrian patients was most related to age and length of root canal filling.

Association between oral lichenoid reactions and amalgam restorations

Background  The aim of this study was to perform a clinical assessment of the association between oral lichenoid reactions (OLR) and amalgam restorations and to determine the salivary concentrations of interleukin‐6 (IL‐6) and IL‐8 before and after replacement of the amalgam restorations.