Urszula Kaczmarek

Selected antibacterial factors in the saliva of diabetic patients

OBJECTIVE Diabetes mellitus leads to many systemic complications, including changes in the morphology, function of the salivary glands, and the composition of saliva. DESIGN The study comprised a randomly selected 156 adults, of both genders, aged from 21 to 79, out of which patients with diabetes type 1 and 2, and healthy subjects forming two control age- and gender matched to the ill subjects. In unstimulated mixed saliva, total protein, peroxidase, myeloperoxidase and immunoglobulin A were measured as well as salivary flow rate. The periodontal condition was assessed with the use of GI, mSBI and PSR index. The obtained data were analysed with the use of U Mann-Whitneys test, Spearmans rang correlation and Chi-square test at a significant level of p < 0.05 with use of Statistica 9.0 software. RESULTS Type 1 diabetics in comparison to healthy age and gender matched control group had a lower salivary flow rate (p < 0.01), a higher content of total protein (p < 0.01), myeloperoxidase (p < 0.001) and immunoglobulin A (p < 0.001). Similarly, type 2 diabetics in comparison to control subjects had a higher level of total protein concentration (p < 0.01), myeloperoxidase (p < 0.05) and immunoglobulin A (p < 0.001). We also found worse periodontal condition. CONCLUSION Within the limitation of the study it may be stated that diabetes type 1 and 2 can cause abnormalities in salivary glands function resulting in the diminishing of salivary flow rate and the increase in total protein content. Higher levels of myeloperoxidase and IgA in the saliva can be linked to worse periodontal condition in the diabetic patients.

Salivary lactate dehydrogenase and aminotransferases in diabetic patients.

AbstractDiabetes mellitus (DM) is a group of metabolic diseases resulting from impaired insulin secretion and/or action. DM is characterized by hyperglycemia that can lead to the dysfunction or damage of organs, including the salivary glands.The aim of this study was to compare the levels of salivary lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in diabetic patients.The study was approved by the Bioethics Committee of Wroclaw Medical University (Poland). The study comprised 90 adults of both sexes, aged 21 to 57 years. The patients were divided into 3 groups: type 1 diabetics (D1), type 2 diabetics (D2), and a healthy control group (C). Each group consisted of 30 age- and sex-matched subjects. Total protein (P, by Lowry method), LDH, AST, ALT (with Alpha Diagnostics kits), and salivary flow rate were measured in unstimulated mixed saliva. The level of glycosylated hemoglobin (HbA1c) was measured with DCA 2000 Reagent Kit. The obtained data were analyzed using the Mann–Whitney U test and the Spearman rank at a significance level of P < 0.05 with the use of STATISTICA 9.0 software.In comparison with C, D1 presented a significantly higher activity of LDH (P < 0.001), AST (P < 0.001), and ALT (P < 0.01), whereas D2 indicated higher levels of LDH (P < 0.001) and ALT (P < 0.05) compared with C. Comparing D1 to D2, approximately 3-fold higher activity of AST (P < 0.01) and approximately 4.5-fold higher activity of ALT (P < 0.01) was observed.Higher levels of salivary LDH, AST, and ALT in D1 compared with D2 and C confirm that salivary glands of D1 might be attributed to autoimmunological damage associated with the pathomechanism of DM.

Validation of the Polish Version of the Oral Health Impact Profile-14

BACKGROUND The Oral Health Impact Profile-14 (OHIP-14) is an example of a specific questionnaire used for assessing the quality of life in relation to oral health. OBJECTIVES The aim of this study was to validate the Polish version of the original English Short-Form OHIP-14 questionnaire. MATERIAL AND METHODS The Polish version of the OHIP-14 instrument had been prepared in accordance with generally accepted standards. The main study was conducted among a group of 150 subjects of both genders, aged from 35 to 91 who were randomly selected. Statistical analysis was made by STATISTICA software using the Cronbach alpha reliability test, Mann-Whitney U test, multiple comparison post-hoc test - LSD and Spearman`s correlation coefficient. RESULTS The total OHIP-14 score was 8.72 ± 13.39, out of which the highest value was for item 4 (uncomfortable to eat 0.89 ± 1.19). The value of the alpha Cronbach coefficient was above 0.9 for all 14 items of the OHIP-14 instrument indicating excellent internal consistency. Positive relationships between all items of the matrix of the inter-items correlation coefficients were found. The value of coefficients ranged from 0.56 to 0.90 at a significance level of p < 0.01. Construct validity was supported by the fact that oral health condition was correlated with total OHIP score. It was observed that there is a correlation between the quality of life evaluated with the OHIP-14 test and dental condition, dental needs, wearing removable dentures and self-assessment of general health and oral health condition. CONCLUSIONS The obtained data indicated the reliability and validity of OHIP-14 instrument for the assessment of oral health-related quality of life for in Polish adult population.

Application of Chitosan and Propolis in Endodontic Treatment: A Review

Chitosan and propolis are natural substances that can be commonly found in the environment. Chitosan is one of the several cationic polysaccharides found in nature. It is a natural biopolymer transformed from chitin which is a product of crustacean shells. Propolis is produced by honeybees through mixing the secretions of their hypopharyngeal glands with the digested product of resins collected from plants. Due to their excellent chemical and biological properties, chitosan and propolis arouse keen interest in dental science, including endodontics. There are various possibilities for applying propolis and chitosan based medicaments in endodontic treatment of root canals, and what is particularly emphasized is their potential effectiveness against resistant microorganisms such as E. faecalis and C. albicans, as well as biocompatible to the periapical tissues in comparison with the most commonly used agents. They aim at microflora which is difficult to eliminate, and their medicinal properties, including anti-inflammatory, antifungal and antiseptic properties, make them suitable for use in endodontic treatment. Due to the potential side effects of commonly used synthetic drugs and other safety related reasons, natural alternatives for endodontic usage are continuously explored and tested. The paper presents the possibilities of applying propolis and chitosan in endodontic treatment on the basis of chosen articles published in recent years.

Dental Caries Level and Sugar Consumption in 12-Year-Old Children from Poland.

BACKGROUND The frequent and high consumption of sugar products, particularly sucrose, is one of the causative factors of dental caries. Meta-analyses assessing the relationship between sugar intake and dental caries revealed that a restricted sugar intake to less than 10% of the daily energy intake results in substantial health benefits. Sugar consumption in Poland is 2-fold higher than recommended by the WHO. As change in dietary habits is slow, knowledge of whether a gradual reduction of sugar consumption influences beneficially the dental condition is important. OBJECTIVES Assessment of the relationship between caries experience and sugar consumption in 12-year-old children. MATERIAL AND METHODS The data obtained from the Statistical Agricultural Yearbooks of the Central Statistical Office in Poland regarding the average yearly sugar intake by a person in the years 1995-2013, and caries prevalence (frequency and DMFT) resulting from the national epidemiological studies of the 12-year-old children conducted by the Ministry of Health in those years were analyzed. The data was analyzed by linear regression. Regression function parameters and coefficients of determination were assessed for a possible link between sugar consumption and dental caries frequency and severity was expressed as DMFT value. RESULTS The mean yearly sugar intake by a statistical Pole ranged from 43.6 kg (2002) to 35.3 kg (2006). Despite a slight trend to lower the sugar consumption, its mean intake in 1995 and 2013 was the same (41.9 kg). Caries frequency and DMFT decreased in 2012 compared to 1995 from 90.5% to 79.6% and from 4.3 to 3.53 kg in 2012, respectively. The increased sugar intake by 1 kg/year caused the increase of caries frequency by 1% and DMFT value by 0.2. CONCLUSIONS Even a relatively low decrease in sugar consumption can exert some beneficial influence on the dental condition in adolescents, particularly upon the severity of caries.

Caries pattern in three-year old preschool children

Background. Analysis of the results of epidemiological studies of Polish children showed that caries in children can occur very early, and their incidence and intensity increase with age. According to an epidemiological study, 53.8% children at the age of 3 reported an average of 2.4 tooth decay. There is insufficient information about the intensity of decay, the pattern of caries in primary dentition and the treatment undertaken in the group of 3-years-old children with tooth decay.

Genetic Aspects of Dental Caries

Dental caries still remain one of the most prevalent infectious diseases, affecting populations and individuals unequivocally. It is observed that people with similar behavioral risk present different caries rates. Susceptibility to caries results from both the host and environmental factors that complement each other and may result in increased incidence of caries or greater resistance to it. Numerous studies of twins, families and animal models initiated in the early decades of the previous century provided strong evidence for the genetic component of dental caries development. The succeeding research, identifying specific genes and genetic markers and confirming the genetic correlation of dental caries, explained the reasons behind the greater susceptibility to caries in some diseases like Epidermolysis bullosa. Many inherited determinants are well established. The most recognizable are the structure of the hard dental tissue, tooth morphology including depth of occlusal fissures and surface characteristic of the enamel, time of eruption, alignment of the teeth in dental arches, flow rate of the saliva and its constituents, immunologic response to cariogenic microorganisms in oral cavity. An important role is also played by inherited thresholds for tastes and smells, which affect taste preferences and thus dietary habits and activity of specific enzymes participating in regulation processes on various stages of development and subsequent physiologic functioning of the organism. The knowledge of genetic basis of caries will enable us to identify high-risk groups and provide them with targeted screening, preventive measures and interventional strategies (Dent. Med. Probl. 2016, 53, 3, 413–418).

Comparison of the Efficiency of Dental Plaque Removal with the Use of Soft Manual Toothbrushes

Background. Efficient dental plaque removal is essential in preventing dental caries and periodontal diseases. The selection of toothbrushes and a tooth brushing techniques depends on the oral health of a given patient, their manual skills and personal preferences. Patient’s age, manual dexterity, susceptibility to decay, occurrence of noncarious lesions, and the periodontal state should be taken into consideration when choosing a toothbrush. Objectives. The aim of this study was to compare the efficiency of dental plaque removal with the use of two soft toothbrushes of different head shapes. Material and Methods. The study involved 50 people, including 32 women and 18 men at a mean age of 23. The subjects were divided into two groups and they were assigned Colgate® Slim SoftTM (group I) and CuraproxTM Soft (group II) toothbrushes. Dental plaque was assessed in all patients with the use of the Navy Plaque Index (RMNPI) modified by Rustogi et al., before and after a 2-min-long tooth brushing. In addition, the respondents carried out a subjective evaluation of the comfort of tooth brushing. Results. In the group I, the 2-min-long tooth brushing was reported to more efficiently remove dental plaque from the approximal area (52.0% vs. 42.0%), as well as from the total surface (57.0% vs. 53.0%), in comparison with the Dent. Med. Probl. 2016, 53, 1, 83–88 DOI: 10.17219/dmp/60348

Oral Health and Quality of Life in Old Age: A Cross-Sectional Pilot Project in Germany and Poland

BACKGROUND The process of ageing influences all dimensions of social life and personal well-being, but the influence of health on different dimensions of quality of life (QoL) among the elderly is rarely examined. OBJECTIVES The aim of the pilot study is to test the feasibility of a comprehensive study design to evaluate general and dental health as well as QoL in a bi-national sample. In addition, this pilot study should allow for the exploration of potential interactions between QoL, socioeconomic, health and oral health variables. MATERIAL AND METHODS Individuals aged 64 years and older (n = 100) from university dental clinics of the Wroclaw Medical University, Poland (n = 50) and of the University Hospital in Dresden, Germany (n = 50) were examined. The oral health status of participants was assessed by clinical examination. Socio-demographic, environmental and general health status were evaluated during the medical interview. General quality of life (GQoL) was assessed by an overall question with a visual analogue scale (VAS) from -5 (worst) to +5 (best). Health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) were measured with the EQ-5D and OHIP-14 questionnaires. Statistical analyses comprised Pearsons c2 test, Wilcoxon test, linear regression model for statistical analysis and different multivariate linear regression analyses. RESULTS For the GQoL-VAS-Score the results for QoL measurements were 1.22 ± 2.62 (x± SD), for EQ-5D-Score 7.45 ± 2.25 (x± SD), and for OHIP-14-ADD-Score 11.04 ± 13.56 (x± SD). Differences between Polish and German populations were observed. CONCLUSIONS The study design proved to be feasible for a senior population. The overall GQoL question, EQ-5D and OHIP-14 were regarded as appropriate instruments. Subjective and objective (oral) health measures showed differences between Germany and Poland. For methodological reasons, these differences are not generalizable, but of value for study hypotheses in larger samples.

The Impact of Selected Fluoridated Toothpastes on Dental Erosion in Profilometric Measurement.

BACKGROUND Some fluoridated toothpastes, available commercially, are described to have a protective effect against dental erosion. OBJECTIVES To evaluate the influence of the selected marketed toothpastes on the human enamel exposed to acid beverages. MATERIAL AND METHODS Enamel specimens from extracted human teeth were prepared (n = 40). Specimens were randomly divided into 10 experimental groups, 4 specimens each, which were subjected to acid challenge for 10 min using orange juice (pH 3.79) or Pepsi Cola (pH 2.58) and then immersed for 2 min into a slurry of five marketed toothpastes with distilled water (1 : 3 w/w). The tested toothpastes contained 1450 or 5000 ppm fluoride, CPP-ACP with 900 ppm fluoride, 1450 ppm fluoride with potassium nitrate 5%, all of them as sodium fluoride, and 700 ppm fluoride as amine and sodium fluoride with 3500 ppm SnCl2. Enamel roughness (Ra parameter) by contact profilometer at baseline and after exposure onto soft drinks and slurry was measured. RESULTS Exposure to both beverages caused a similar increase of enamel surface roughness. After the specimens immersion into slurries of toothpastes with 1450 or 5000 ppm fluoride, 1450 ppm fluoride with potassium nitrate 5% and CPP-ACP with 900 ppm fluoride the significant decrease of Ra values were found, reaching the baseline values. However, toothpaste with 700 ppm fluoride and 3500 ppm SnCl2 did not cause any fall in Ra value, probably due to other mechanism of action. CONCLUSIONS Within the limitation of the study we can conclude that the sodium fluoride toothpastes are able to restore the surface profile of enamel exposed shortly to acidic soft drinks.