Wiesław Hędzelek

Candida-associated denture stomatitis in type 2 diabetes mellitus.

OBJECTIVE To describe the clinical appearance of Candida-associated denture stomatitis (DS) in subjects with type 2 diabetes (T2DM). The relationships between the types of DS, oral complaints and associated conditions were assessed in terms of glycemic control as determined by glycated hemoglobin (HbA1c) measurements. MATERIALS AND METHODS Demographic and clinical data were obtained from questionnaires and oral examinations of 110 edentulous patients with T2DM and 50 control subjects. RESULTS Type II DS commonly occurred in diabetics (57.3% vs 30%; p=0.002) together with DS related oral complaints (60.9% vs 24%; p<0.001) compared with controls. Burning sensation of the mouth (BS) was the most common complaint. Dryness of the oral mucosa (DOM) (50.9% vs 6%; p<0.001), angular cheilitis (26.4% vs 8%; p=0.01) and glossitis (27.3% vs 6%; p=0.003) occurred more frequently in diabetics. Oral complaints and associated conditions of DS coincided with elevated HbA1c levels (p<0.001). Diabetics with extensive type of inflammation had higher HbA1c levels than type I/III DS subjects (p<0.001). CONCLUSIONS Diffuse type of inflammation was associated with T2DM. BS and DOM were the most common oral complaints. Inadequately controlled diabetes with Candida-associated DS was linked to a high incidence of an extensive type of inflammation, oral complaints and associated conditions.

Evaluation of Mandibular Movement Functions Using Instrumental Ultrasound System

PURPOSE The article deals with routinely performed instrumental temporomandibular joint (TMJ) examinations and interpretation of findings obtained from the Arcus Digma ultrasound device in individuals with or without clinical symptoms of temporomandibular disorders (TMD). The aim of this study was to analyze mandibular movement functions and the relationship between incisors and condylar movement parameters during jaw opening, which may be helpful for clinical evaluation in these patients. MATERIALS AND METHODS The study group consisted of 84 young students with no dental problems and other serious acute or chronic diseases in the medical history; the students were examined both clinically and with the Arcus Digma ultrasound device. RESULTS Helkimo Di = I was the most common score in 49 participants, and Helkimo Di = II in a significantly (p < 0.01, Di = I vs. Di = II) smaller number of participants. Medical history revealed symptoms of unilateral mastication in 15 participants and a statistically significant increased (p < 0.02, participants with symptoms of unilateral mastication vs. asymptomatic) condylar range of motion parameter during retrusion. Also a significant decrease (p < 0.03, participants with symptoms of unilateral mastication vs. asymptomatic) of the incisal and condylar ranges of motion during mouth opening was found. Limitation of mouth opening, defined as a decrease of inter-incisal distance, appeared in 19 participants (22.6%) and in 25 participants (29.8%) measured instrumentally with the Arcus Digma device. A comparison of instrumental result examinations of the right and left TMJs showed positive correlations of the range of mandible opening movement with the Posselt opening movement (r = 0.75) and opening/closing movements with the Posselt closing movements (r = 0.70). A correlation was demonstrated (r = 0.81) between the condylar range of motion studied on the left and on the right TMJ during mandible opening movement. Correlations were also found between opening-closing movements and the condylar range of motion of the left TMJ, and between the opening-closing movement and the condylar range of motion of the right TMJ during the opening movement. CONCLUSIONS According to the results of this study with instrumental Arcus Digma ultrasound device measurements of mandibular movements, data were provided on irregularities in TMJ function not detected in participants with or without clinical symptoms of TMD.

Photofunctionalization of Titanium: An Alternative Explanation of Its Chemical-Physical Mechanism.

Objectives To demonstrate that titanium implant surfaces as little as 4 weeks from production are contaminated by atmospheric hydrocarbons. This phenomenon, also known as biological ageing can be reversed by UVC irradiation technically known as photofunctionalization. To propose a new model from our experimental evidence to explain how the changes in chemical structure of the surface will affect the adsorption of amino acids on the titanium surface enhancing osteointegration. Methods In our study XPS and AES were used to analyze the effects of UVC irradiation (photofunctionalization) in reversing biological ageing of titanium. SEM was used to analyze any possible effects on the topography of the surface. Results UVC irradiation was able to reverse biological ageing of titanium by greatly reducing the amount of carbon contamination present on the implant surface by up to 4 times, while the topography of the surface was not affected. UVC photon energy reduces surface H2O and increases TiOH with many –OH groups being produced. These groups explain the super-hydrophilic effect from photofunctionalization when these groups come into contact with water. Significance Photofunctionalization has proven to be a valid method to reduce the amount of hydrocarbon contamination on titanium dental implants and improve biological results. The chemisorption mechanisms of amino acids, in our study, are dictated by the chemical structure and electric state present on the surface, but only in the presence of an also favourable geometrical composition at the atomical level.

Relations between the results of complex clinical and neurophysiological examinations in patients with temporomandibular disorders symptoms

Abstract Objective: Reinvestigation of clinical importance of surface electromyography recordings (sEMG) from the masticatory, neck and shoulder girdle muscles in patients with various clinically detected temporomandibular disorders (TMDs). Methods: Fifty women with myalgia diagnosis of Axis I DC/TMD and the same number of healthy female volunteers were studied clinically and neurophysiologically by means of sEMG. Results: Unilateral more than bilateral complex symptoms of TMDs were related to the non-neurogenic masticatory rather than neck and shoulder girdle muscles dysfunctions at rest. A strong negative correlation between masticatory muscles activity at rest and during maximal contraction was found (rs = −0.778), mainly in the masseter muscle. Conclusion: sEMG is a suitable tool for prosthodontists because it provides objective results on the stomatognathic system muscles function. Pain and other temporomandibular symptoms detected mostly unilaterally significantly increase muscle tension of the masticatory muscles and diminish muscle motor units recruitment during maximal contraction. Effects may spread to the neck and shoulder girdle muscles.

Hydroxyapatite coating on titanium endosseous implants for improved osseointegration: Physical and chemical considerations

BACKGROUND For many years, hydroxyapatite (HA) has been used as a bioactive endosseous dental implant coating to improve osseointegration. As such, the coating needs to be of high purity, adequate thickness, crystalline, and of a certain roughness in order to stimulate rapid fixation and form a strong bond between the host bone and the implant. There are a number of ways of preparing the HA coating, resulting in various coating properties. Herein, we report the preparation of the HA coating using a direct electrochemical method without the need for subsequent heat treatment. OBJECTIVES The aim of this study was to investigate the physicochemical properties of the HP coating, deposited on titanium implants by a modified electrochemical method. MATERIAL AND METHODS The coating was characterized in terms of surface chemical composition, structure, morphology, coating thickness and roughness. RESULTS The coating was found to be composed of homogenous HA with Ca/P and Ca/O ratios of 1.62 and 0.35, respectively. No other forms of calcium phosphate were detected. The degree of crystallinity of HA was 92.4%. The surface roughness was moderate (Sa = 1.04 μm) with the coating thickness of 2-3 μm. The scanning electron microscopy (SEM) analysis revealed a uniform, integrated layer of rod-like HA crystals with the longitudinal axes parallel to the implant surface. CONCLUSIONS The coating reported herein was found to have potentially favorable chemical and physical characteristics fostering osseointegration.

Photofunctionalization of dental zirconia oxide: Surface modification to improve bio-integration preserving crystal stability

The use of zirconium oxide in dental implantology is rapidly increasing as it is regarded as being more aesthetical and biologically friendly than titanium oxide. The interaction of titanium oxide with cells and proteins has proven to be significantly affected by the inevitable atmospheric hydrocarbon contamination, defined as biological ageing. The latter has proven to be effectively reversed by UVC irradiation. Crystal structures of both Zr and Ti oxides are very similar, thus also ZrO2 is prone to contamination by hydrocarbons. In the present study we have characterized the chemical-physical changes occurring to ZrO2 after UVC irradiation. Firstly a reduction by 3-fold of carbon present on its surface. XRD analysis has indicated that UVC irradiation treatment does not affect the crystalline structure of ZrO2, suggesting that it is possible to improve cell attachment on the surface without sacrificing the mechanical strength of the material. In addition a chemical model of interaction of cell surface proteins with the almost carbon free ZrO2 surface obtainable after UVC irradiation is proposed, pointing to the important role likely played by integrins and RGD sequences originating in soluble proteins adsorbed at the cell/ZrO2 interface. Hence in clinical practice UVC photofunctionalization could improve the soft tissue seal around dental implants functioning as a valid barrier between implant and peri-implant bone, thereby improving the long-term success of implants.

Overdentures and overlay dentures in therapy of patients in the developmental age – review of the literature

Streszczenie Leczenie protetyczne dzieci z anodoncją lub ciężką oligodoncją wymaga długotrwałej i wysoce skomplikowanej rehabilitacji. Dla prawidłowego przebiegu leczenia konieczna jest znajomość mechanizmów rozwoju i wzrostu twarzoczaszki. Wcześnie rozpoczęta rehabilitacja ma na celu odbudowę nieprawidłowo wykształconych tkanek i zapewnienie prawidłowego rozwoju i funkcjonowania układu stomatognatycznego. Stosowane uzupełnienia nie mogą hamować wzrostu kości i powinny być okresowo wymieniane. Prowadzona terapia powinna polegać na współpracy lekarza protetyka z ortodontą, chirurgiem stomatologicznym, periodontologiem i pedodontą. Ponadto jest niezwykle istotna z punktu widzenia rozwoju psychospołecznego młodych pacjentów, poprzez znaczną poprawę komfortu życia. Celem pracy było przedstawienie, na podstawie piśmiennictwa, nowoczesnych możliwości rehabilitacji protetycznej pacjentów w wieku rozwojowym z zaburzeniami morfologiczno-czynnościowymi układu stomatognatycznego, przy zastosowaniu ruchomych protez typu overdenture i overley denture. Uzupełnienia te mają u dzieci charakter tymczaLeczenie pacjentów w wieku rozwojowym z zastosowaniem protez typu overdenture i overlay denture – przegląd piśmiennictwa

Temporomandibular disorders in adolescents with headache

BACKGROUND Headache is a common complaint in all age groups and is a frequent cause of medical consultations and hospitalization. OBJECTIVES The aim of this study was to evaluate the prevalence of bite and non-bite parafunctions as well as the signs and symptoms of temporomandibular disorder (TMD) in adolescents presenting with primary headaches. MATERIAL AND METHODS Parents of adolescents presented with headaches to the Department of Developmental Neurology within a 12-month period were asked to complete a questionnaire developed by the authors of this study. Of the 1000 patients evaluated, 19 females and 21 males, aged 13 to 17 years, met the inclusion criterion - a confirmed clinical diagnosis of migraine or a tension headache according to the International Classification of Headache Disorders, 2nd edition. The diagnostic algorithm of the study group consisted of a full medical history, an assessment of the occurrence of bite habits and a physical examination based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). RESULTS Bite and non-bite parafunctions were found in 36 of the study group patients. A significant difference (p = 0.0003) between the number of bite parafunctions and non-bite parafunctions was found in females but not in males. However, bite parafunctions were more frequent in boys compared to girls (p = 0.01). CONCLUSIONS Our findings suggest that it may be useful for pediatricians and neurologists to include TMD dysfunctions as a part of a standard examination of adolescents presenting with persistent headaches.

Assessment of the impact of acrylic resin complete dentures on saliva secretion in patients with type 2 diabetes

Streszczenie Wstęp. Cukrzyca to choroba metaboliczna z szeregiem objawów ogólnoustrojowych manifestująca się w jamie ustnej. Cel pracy. Celem pracy była ocena wpływu użytkowania akrylowych protez całkowitych na wydzielanie śliny u pacjentów z cukrzycą typu 2. Materiał i metody. Zbadano 60 osób, które podzielono na dwie grupy. Grupę badaną stanowiło 30 pacjentów z całkowitymi protezami akrylowymi, a grupę kontrolną 30 pacjentów bez uzupełnień protetycznych. W badaniu porównano ilość wydzielanej śliny (u-SFR, s-SFR, test lusterkowy) oraz zbadano subiektywne odczucia pacjentów dotyczące suchości jamy ustnej (test Foxa). Wyniki. Badanie wykazało różnice w wydzielaniu śliny spoczynkowej i stymulowanej pomiędzy grupą kontrolną a badaną. W grupie badanej ilość Ocena wpływu użytkowania całkowitych protez akrylowych na wydzielanie śliny u pacjentów z cukrzycą typu 2*

The analysis of primary and secondary stability of implants with modified surfaces based on Osstell Mentor and Periotest S comparison: An animal study

Streszczenie Cel pracy. Celem pracy była ocena w badaniach in vivo procesu osteointegracji wszczepów tytanowych o modyfikowanych powierzchniach aktywnych, na podstawie instrumentalnej analizy stabilizacji pierwotnej i wtórnej. Materiał i metoda. Na potrzeby eksperymentu wyprodukowano ze stopu tytanu TiAl6V4 typ ELI wszczepy śródkostne Osteoplant (Fundacja Uniwersytetu Medycznego, Poznań, Polska) o czterech typach powierzchni: maszynowej (MA); piaskowanej tlenkiem glinu (Al2O3); piaskowanej materiałami resorbowalnymi (RBM) i o powierzchni złożonej: piaskowane a następnie trawione mieszaniną kwasów (SAE). Eksperyment badawczy przeprowadzono na królikach rasy nowozelandzkiej białej. W grupie 18 królików wszczepiono sumarycznie 72 implanty o modyfikowanych powierzchniach aktywnych (MA, Al2O3, RBM, SAE). Każde zwierzę otrzymało 4 wszczepy o 4 różnych powierzchniach, po 2 w każdą z kości piszczelowych. Zwierzęta Analiza stabilizacji pierwotnej i wtórnej modyfikowanych wszczepów tytanowych w badaniach porównawczych Osstell Mentor i Periotest S na modelu zwierzęcym