Zoran Pesic

Effect of Periodontal Treatment on Lipoproteins Levels in Plasma in Patients with Periodontitis

Objectives: Recent epidemiological studies have shown that individuals with periodontitis have a significantly increased risk of developing coronary heart disease. In addition to conventional risk factors, dyslipidemia may be associated with this increased risk. Methods: We measured concentration of lipids in patients with moderate to severe periodontitis before and 3, 6 and 12 months after local periodontal treatment. A total of 50 participants with periodontitis and 25 participants without periodontitis were included in the analyses. Lipoproteins were measured by using serological analyses of the Central Biochemical Laboratory in Clinical Center in Nis. Periodontal health indicators included the plaque index, gingival bleeding index, and periodontal disease status (defined by pocket depth and attachment loss). Patients were non-surgically treated with mechanical debridement of calculus once a week for 1 month. Results: The results show a significant relation between indicators of poor periodontal status and serum level lipoproteins. Periodontal therapy resulted in a significant reduction of local inflammation and tissue destruction as reflected in reduced pocket depth and reduced bleeding indices. The levels of lipoproteins after therapy seemed to be lower than those reported before treatment in patients with periodontitis compared with healthy ones. Lipoproteins were significantly decreased after treatment (P < 0.005) except high-density lipoprotein cholesterol which was not significantly reduced (P > 0.05). Conclusion: This pilot study shows that periodontal disease significantly affects the serum levels of lipoproteins and suggests that following successful periodontal treatment decreases serum lipid concentration. This study suggests also that lipoproteins are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.

[Macroglossia and Beckwith-Wiedemann syndrome].

INTRODUCTION In 1963 Beckwith presented a report on the first patient with extreme cytomegaly of adrenal cortex, hyperplasia of kidneys and pancreas and Leydig cell hyperplasia. Wiedemann completed description of the new syndrome by adding umbilical hernia and macroglossia. The diagnosis is made based on the clinical signs of omphalocele or some other umbilical deformity, macroglossia, congenital asymmetry, visceromegaly (liver, pancreas, and kidneys). CASE OUTLINE A 16-month-old male child was admitted for examination because of macroglossia. He underwent examination on several occasions by an endocrinologist due to recurrent hypoglycaemic crisis. The patient was observed by a paediatric neurophysicatrist for disorders of mental development. Hypoglycaemia, muscular hypotonia of the anterior abdominal wall with umbilical hernia and macroglossia were observed by clinical examination. Inratraoral examination revealed macroglossia with microstomia, suckling and swallowing difficulties, hypotonia of the perioral muscles with increased salivation. It was therefore decided to perform surgical reduction of the prominent tongue and develop good condition for nutrition, speech function and the development of orofacial system. CONCLUSION The diagnosis of macroglossia is based on subjective clinical criteria such as the morphology and amount of protrusion of the tongue, difficulty in articulating sounds, breathing, and hypersalivation. Some authors have suggested that the tongue size may be analyzed radiographically with a cephalogram. Treatment of macroglossia is controversial because of the absence of objective clinical criteria.

Morphometric analysis of the stylohyoid complex

PurposeStylohyoid complex is anatomical structure predisposed to numerous individual variations. These may result in its extreme elongation, medial deviation and finally Eagle’s syndrome occurrence. The aim of this study was to measure the length, angulation, evaluate morphological variations of stylohyoid complex by computed tomography and, subsequently, relate obtained data to the gender and the age of the evaluated cases.Materials and methodsThe material included CT scans of stylohyoid complexes of 282 individuals. The entire length, maximal thickness, and angulation of the stylohyoid complexes in the coronal, transverse, and sagittal planes were measured.ResultsAccording to their morphology, orientation and length, stylohyoid complexes were classified into six morphological types. Elongated, bent, segmented, and segmented with attached stylohyoid ligament for the lesser horns of the hyoid bone stylohyoid complex types were characterized by significantly greater length, while pseudoarticulated type was characterized by significantly lower length in relation to normal stylohyoid complex type. The elongated type was additionally significantly thicker and with significantly lower value of medial angle in transverse plain than the normal stylohyoid complex type. Elongated, bent, and segmented types were significantly more frequent in males than in females. Furthermore, the frequency of the elongated stylohyoid complex type increased, whereas normal and pseudoarticulated types decreased with age.ConclusionsIn conclusion, elongated and more medially deviated stylohyoid complexes are more frequent in males than in females. Their more frequent presence in the older age groups indirectly connects this phenomenon with the aging process.

Trauma of the Frontal Region Is Influenced by the Volume of Frontal Sinuses. A Finite Element Study

Anatomy of frontal sinuses varies individually, from differences in volume and shape to a rare case when the sinuses are absent. However, there are scarce data related to influence of these variations on impact generated fracture pattern. Therefore, the aim of this study was to analyse the influence of frontal sinus volume on the stress distribution and fracture pattern in the frontal region. The study included four representative Finite Element models of the skull. Reference model was built on the basis of computed tomography scans of a human head with normally developed frontal sinuses. By modifying the reference model, three additional models were generated: a model without sinuses, with hypoplasic, and with hyperplasic sinuses. A 7.7 kN force was applied perpendicularly to the forehead of each model, in order to simulate a frontal impact. The results demonstrated that the distribution of impact stress in frontal region depends on the frontal sinus volume. The anterior sinus wall showed the highest fragility in case with hyperplasic sinuses, whereas posterior wall/inner plate showed more fragility in cases with hypoplasic and undeveloped sinuses. Well-developed frontal sinuses might, through absorption of the impact energy by anterior wall, protect the posterior wall and intracranial contents.

Rare Disease: Lobar Holoprosencephaly With a Median Cleft Lip—Case Report

Holoprosencephaly is a complex malformation of the brain associated with the median facial defects. Variability of the clinical picture is the characteristic of this anomaly. In most cases, the degree of severity of the facial anomaly correlates with the degree of damage to the brain. This article aims to present a rare case of child with a milder form of brain anomaly combined with a severe form of facial anomaly. The article also presents the application of a feeding stimulator to improve the childs quality of life. The anomaly was diagnosed by postnatal sonography of the brain, magnetic resonance imaging of the endocranium, and three-dimensional computed tomography of the craniofacial skeleton.

Biomaterials in Dentistry—Implantology and Guided Bone Regeneration

The use of biomaterials and implant therapy in dentistry is becoming a more popular and acceptable procedure for the replacement of both single and multiple teeth. Procedures have evolved for maintaining and regenerating bone to provide an optimal environment for subsequent implant placement. Both guided bone regeneration and implantology have applications in dentistry for increasing the width and height of the alveolar ridge in areas with insufficient alveolar bone in jaws, as well as repairing and maintaining bone defects around the teeth. The application of these techniques involves the use of a wide range of materials, including autogenous bone grafts, allografts, xenografts, alloplasts, bone-promoting factors, resorbable/nonresorbable barrier membranes, and implants used either alone or in a variety of combinations. The methods of guided bone regeneration utilize biological materials or synthetic specimens. Furthermore, insight into the future development of membrane fabrication, as well as platelet-rich fibrin membranes, will strongly influence the development of guided bone regeneration. This article describes a series of six patients treated with guided bone regeneration using bovine bone mineral, a resorbable collagen membrane, a growth factor, platelet-rich plasma, and an implant placed with a minimum follow-up period of eighteen months.

Place and role of titanium mesh in reconstruction of the frontal bone after trauma

Adresa autora: Srbislav Pajić, Centar za zbrinjavanje urgentnih stanja i neurotraume Urgentnog centra KSC Pasterova 2, 11 000 Beograd, Srbija. E-mail: nevus-ng@hotmail.com Rad primljen: 16. 03. 2017. Rad prihvaćen: 11. 04. 2017. Elektronska verzija objavljena: 22. 05. 2017. www.tmg.org.rs UDK 616.216.2-089.844 ISSN 0350-2899. God. 42, br. 1 (2017), str. 5-11. 616.715-001.5-089.844 COBISS.SR-ID 234133772

Mucocele in the submandibular salivary gland: Case report and literature review

(1) CENTAR ZA ZBRINJAVANJE URGENTNIH STANJA I NEUROTRAUME URGENTNOG CENTRA KSC, (2) KLINIKA ZA OTORINOLARINGOLOGIJU I MAKSILOFACIJALNU HIRURGIJU, KLINIČKI CENTAR CRNE GORE, (3) STOMATOLOŠKI FAKULTET U BEOGRADU, CENTAR ZA RADIOLOŠKU DIJAGNOSTIKU, (4) MEDICINSKI FAKULTET PODGORICA, DOM ZDRAVLJA PODGORICA, (5) MEDICINSKI FAKULTET U NIŠU, (6) MEDICINSKI FAKULTET U NIŠU, KLINIKA ZA MAKSILOFACIJALNU HIRURGIJU

Immunohistochemical and karyometric similarities and differences of salivary gland tumors between pleomorphic adenoma, basal cell adenoma and polymorphous low grade adenocarcinoma

Uvod: Tumori pljuvačnih žlezda su veoma retke neoplazme. S obzirom na njihovu patohistološku sliku, ovi tumori predstavljaju veoma veliki dijagnostički izazov. Cilj: istaživanja je diferencijacija ova tri tipa tumora primenom imunohistohemijske i morfometrijske analize, kao i određivanje visine Ki67 proliferativnog indeksa. Materijal i metode: Istraživanje je obuhvatilo 44 tumora, 20 pleomorfnih adenoma, 12 adenoma bazalnih ćelija i 12 polimorfnih adenokarcinoma niskog gradusa. Analizirana je ekspresija Ki67, p53 i HER-2 antigena, kao markera proliferacije. U sklopu diferencijalne dijagnostike, analizirana je ekspresija CEA, EMA, GFAP, p63, vimentina, CK14, α-SMA, S-100 protein i WT1 antigena. Morfometrijska analiza vršena je u softverskom paketu „ImageJ” verzija 1.43u. Rezultati: Neoplastične ćelije u pleomorfnom adenomu su pokazale jaku ekspresiju GFAP, p63, WT1, vimentin i S100. U grupi od dvanaest polimorfnih adenokarcinoma niskog gradusa prisutna je difuzna ekspresija CK14, S100, vimentin i EMA su bili apsolutno eksprimirani, dok je αSMA bio negativan. Adenom bazalnih ćelija pokazuje pozitivnost na S-100, CEA, p63 i vimentin. Analizom vrednosti proliferativnog Ki67 indeksa ustanovljena je statistički značajna razlika u grupi pleomorfnog adenoma, što se dovodi u vezu sa čestim recidiviranjem. Morfometrijskom analizom se uočavaju veće vrednosti u grupi polimorfnog adenokarcinoma niskog gradusa, ali su statistički značajne razlike nađene samo za Feretov dijametar i integrisanu optičku gustinu u odnosu na pleomorfni adenom (p<0,05). U grupi adenoma bazalnih ćelija tumorske ćelije su pokazale statistički veće vrednosti za integrisanu optičku gustinu u odnosu na pleomorfni adenom (p<0,001). Zaključak: Za diferencijalnu dijagnozu tumora pljuvačnih žlezda, pored osnovne mikromorfološke, neophodna je i imunohistohemijska i morfometrijska analiza.

Closure of persistent oro-nasal fistula with removable obturator denture

Introduction. Cleft lip and cleft palate are relatively common congenital deformities. Patients with clefts require multidisciplinary treatment approach and a team which may include a maxillofacial surgeon, orthodontist, speech therapist, pediatrician, prosthetician, psychologist, as well as the relevant experts who may be of help in restoring the function of the orofacial system. Case report. The paper describes a case of prosthetic rehabilitation of an edentulous female patient with oronasal fistula, after multiple surgical interventions performed in various medical institutions in order to treat her cleft primary and secondary palate. Conclusion. Well planned prosthetic treatment of adult patients with cleft palate and total edentulousness can produce satisfactory results in view of both function and esthetics.