Prevalence of Sjögren's syndrome in patients with dry mouth in the region of Central Hungary.

OBJECTIVE: One-third of the Hungarian population suffers from xerostomia. Since there is no evidence of the actual prevalence of Sjögren's syndrome (SS) in Hungary, this study aimed to evaluate the same. MATERIALS AND METHODS: Data were collected from the Faculty of Dentistry, Semmelweis University from 2008 to 2015. A diagnosis of SS was established based on the American College of Rheumatology and European League Against Rheumatism criteria. RESULTS: Of the 1076 patients examined with sicca symptoms, 188 patients had confirmed SS. Primary SS (pSS) was diagnosed in 135 patients and secondary SS (sSS) was confirmed in 53 patients. According to the available statistical records of the public health service of Hungary, there were an average of 16 (0.0014%, 5-26) newly diagnosed SS cases in the entire population and 141 SS patient-practitioner consultations (49-232) per 100,000 inhabitants in the country over the past 10 years (based on the past 10 years: 2011-2020). CONCLUSION: Results revealed that approximately 1/5th-1/6th of patients with sicca symptoms have SS, among whom 72% and 285 have pSS and sSS, respectively. Global Hungarian records simultaneously revealed that the number of both new diagnoses and doctor-SS patient encounters has significantly decreased (by 50%) yearly over the last decade.

Is temporomandibular joint involvement more frequent in patients with epilepsy? A clinical study.

STATEMENT OF PROBLEM: Epileptic seizures may affect the stomatognathic system via transmission of an increased load to the dentition and the temporomandibular joint (TMJ), resulting in temporomandibular joint dysfunction (TMD). PURPOSE: The purpose of this clinical study was to assess whether TMD was more prevalent in patients with epilepsy than in those without epilepsy. MATERIAL AND METHODS: A total of 107 participants diagnosed with epilepsy and 100 healthy controls were enrolled in the study. Those with epilepsy were divided according to their dental manageability into 3 subgroups: mild group, moderate group, and severe group. Following general, dental, and TMJ-related history, the range of maximal mouth opening (MMO), laterotrusion, possible deviation and deflection, and presence of crepitation and clicking was recorded, as suggested by the diagnostic criteria for temporomandibular diseases (DC/TMD). Pressure pain threshold (PPT) was also measured by using a pressure algometer on 3 points bilaterally. RESULTS: Incidence of TMJ complaints was not significantly different between the control (30%) and the group diagnosed with epilepsy (33%); however, the number of complaints experienced was significantly higher in the epilepsy group (C: 3%, E: 16% had 3 or more complaints; P<.001). Joint clicking was significantly more prevalent in the entire epilepsy group (P=.012) and in the mild group (P=.004) than in controls. Crepitation and joint pain were not significantly more common in the epilepsy group. Maximal mouth opening, laterotrusion, and the ratio of restricted mouth opening did not differ significantly in the epilepsy group. Deflection occurred significantly more often in the epilepsy subgroups (mild and moderate groups; P<.001), and the extent of deflection was also significantly higher in all the epilepsy subgroups (P<.001) than in controls. Regarding the pressure pain threshold, significant difference was observed in the severe group at the left masseter muscle points M1 (P=.046) and M2 (P=.028) compared with controls. CONCLUSIONS: All parameters typical of TMD could be found frequently in patients with epilepsy. Because of the seizures and the consequent joint overload, the TMJ involvement was more common or more serious in those diagnosed with epilepsy. Outcomes of this study support the assumption that epilepsy is a risk factor for the development of TMD.

[Delusional Parasitosis associated with diabetes mellitus treated in outpatient care during COVID-19 pandemic - case report].

The presenile dermatozoic delusion, subsequently referred to as Ekbom's syndrome and delusional parasitosis is a rare chronic condition, having an undetermined etiology and rising challenging treatment approaches. The diagnosis of delusional parasitosis can be presumed on the basis of the clinical history, but it is important to thoroughly assess the existence of an underlying systemic disorder or unrecognized skin disorder. A skin examination must be performed to rule out an infestation or a skin disorder. We present a 63-year-old diabetic woman with a high level of resilience towards the psychiatric treatment for whom we successfully offered outpatient psychiatric and dermatological assistance during the pandemic COVID-19. The trigger for a successful treatment scheme in outpatient care in a case of delusional parasitosis was the close and trustful relationship between the patient and the doctor. Different pharmacological treatments were approached and adjusted according to the patient adherence and the objective result (quetiapine XR, duloxetine, risperidone, olanzapine, and lamotrigine along with chronic disease treatment and wound management). Having a mutual agreed objective criteria for the treatment outcome, and creating a throughout examination scheme with frequent medical checks, increased the patient adherence to the treatment.

Effects of substrate, ceramic thickness, translucency, and cement shade on the color of CAD/CAM lithium-disilicate crowns.

OBJECTIVE: The aim of this in vitro study was to evaluate the effects of substrate colors, different levels of ceramic thickness and translucency, and cement shades on the color difference from a reference color of lithium-disilicate crowns. MATERIALS AND METHODS: A premolar tooth preparation was made on a study model for 1.0 and 1.5 mm thick full-ceramic crowns. Digital impressions were taken (3Shape TRIOS) and crowns designed in a CAD program (DentalDesigner). Shade A1 crowns were milled (Everest, Kavo) from high-translucency (HT) and low-translucency IPS e.max (Ivoclar Vivadent) blocks. Twelve substrates were made of different colors and materials (Natural Die Material, Co-Cr, zirconia, and gold-colored alloy). Three different shades of try-in pastes were used to simulate the effect of cements (Variolink Esthetic try-in paste; Ivoclar). Shade measurement was done three times for each crown by a spectrophotometer (VITA Easyshade Advance); averages were compared to a reference crown (A1, HT, 1.5 mm, ND2 abutment, neutral try-in paste) with ΔE00 (CIEDE2000, according to the CIE latest standard) calculated. RESULTS: All the examined parameters influenced the ΔE00 of the crowns. The weakest effect was exerted by the try-in paste. CONCLUSIONS: All examined parameters influenced the final color of e.max CAD lithium-disilicate ceramic crowns. CLINICAL SIGNIFICANCE: Matching the shade of ceramic crowns to the natural tooth color is a great challenge in dentistry. To meet patients' increasing esthetical expectations, CAD/CAM methods are very popular for full-ceramic crowns. However, several factors such as the shade of the abutment, luting cement color, ceramic thickness, and translucency may influence the final color. Our objective was to measure the optical effect of these factors on the final shade of CAD/CAM lithium-disilicate ceramic crowns.

Oral Health Status of Stroke Patients Related to Residual Symptoms: A Case-Control Epidemiological Study in Hungary.

PURPOSE: Stroke is a leading cause of death in developed countries. Recently, its connection with oral health has been a focus of the medical literature. The aim of this study was therefore to statistically examine the oral health of subjects who previously suffered from stroke and provide a guide for the dental treatment of these patients. MATERIALS AND METHODS: Stroke patients at least one year after the stroke episode and age- and sex-matched healthy controls were examined: dental and medical stroke histories were recorded, followed by a detailed orofacial examination. A categorisation into three 'dental' subgroups of stroke patients was carried out based on their residual symptoms, the functional deficiency of limbs, and chewing and swallowing difficulties. Indices quantifying oral hygiene (OHI-S), dental status explained by the number of decayed, missing, and filled teeth (DMFT), periodontal status (CAL, CPITN, Mühlemann index), and the status of prosthetic treatment (prosthetic index) were assessed. Statistical comparison was performed between the patient and age- and sex-matched control subjects, as well as between subgroups of stroke patients. RESULTS: One hundred two stroke patients and 98 healthy age- and sex-matched control subjects were examined. The oral health and dental status of stroke patients was worse compared with the control group. Stroke patients had significantly more decayed (2.3 ± 3 vs1.1 ± 1.8; p = 0.01) and missing (19.3 ± 9.5 vs 15.5 ± 9.3; p = 0.005) teeth, but significantly fewer filled (3.6 ± 4.7 vs 7.7 ± 5.6; p < 0.001) teeth than did the healthy controls. In stroke patients, clinical attachment loss (CAL) was double that of the control group (p < 0.001). A comparison between the subgroups of stroke patients revealed that the most severe findings were in patients who had chewing and swallowing disabilities. DISCUSSION: According to these results, the combination of risk factors of stroke, residual neurological signs after stroke, and poorer socioeconomic conditions results in poor oral hygiene, poor dental and periodontal conditions, and a lower prosthetic index. Special care and attention should be given to the oral hygiene and dental treatment of such patients, to enable good nourishment.

[Effect of a gel-type denture adhesive on unstimulated whole saliva and minor salivary gland flow rates and on subjective orofacial sicca symptoms]. / A mufogsorragasztó hatása a nyugalmi kevert és a kis nyálmirigyek szekréciójára, valamint a szájszárazság érzetére teljes lemezes fogpótlást viselokben.

INTRODUCTION AND AIM: To determine whether the continuous use of gel-type denture adhesives influence the unstimulated whole saliva, the palatal and labial saliva flow rates, and to assess the possible changes of subjective orofacial sicca symptoms. METHOD: 28 maxillary complete denture wearing patients (average age: 70 ± 10 years) were investigated. A gel-type denture adhesive was administered to the patients for regular use during the 3 weeks of examination. A questionnaire of 16 questions was used to evaluate subjective orofacial sicca symptoms. Unstimulated whole saliva was determined by the spitting method, palatal and labial saliva flow rates were measured by the Periotron® device with filter paper discs at the initial, first, second and third weeks. STATISTICAL ANALYSIS: The following tests were used: subjective values - χ2-test; flow rates - ANOVA, paired Student's t-test. RESULTS: According to the questionnaire, the ratio or severity of xerostomia did not change. A significant increase in the subjective feeling of "saliva thickness" could be detected (p = 0.027), but the other subjective parameters remained unchanged. Palatal saliva flow rates decreased significantly by week 3 (week 0: 4.21 ± 3.96 µl/cm2/min; week 3: 2.21 ± 2.30 µl/cm2/min; p = 0.024). On the other hand, there was no significant change in the unstimulated whole saliva (week 0: 0.37 ± 0.36 ml/min; week 3: 0.39 ± 0.35 ml/min) and labial saliva (week 0: 3.99 ± 3.75 µl/cm2/min; week 3: 2.58 ± 3.39 µl/cm2/min) flow rates. CONCLUSIONS: The regular use of denture adhesives did not influence xerostomia and the majority of subjective orofacial sicca symptoms, but may cause a subjective feeling of "increased saliva thickness" and reduce palatal minor salivary gland flow rates among complete maxillary denture wearers. Orv Hetil. 2018; 159(40): 1637-1644.

Late effects of multiagent chemotherapy on salivary secretion in children cancer survivors.

OBJECTIVE: The aim of this study was to investigate the later oral consequences of chemotherapy on the oral health of children with emphasis on the cariological status and the major and minor salivary gland function. METHOD: Thirty-eight 12-year-old children (mean age 12.3 ± 0.58 years) who underwent chemotherapy were evaluated after 5 years of treatment. Forty age- and sex-matched healthy children with similar socioeconomic backgrounds served as controls. Subjects' cariological status was explained by the number of decayed, filled, missing permanent teeth (DMF-T), and unstimulated and stimulated whole saliva flow rates were measured by the spitting method. Palatal saliva flow rate using a Periotron meter (Oraflow Inc., Plainview, NY) and salivary buffer capacity using CRT buffer (Ivoclar Vivadent AG, Schaan, Lichtenstein) were also investigated. RESULTS: Children who underwent chemotherapy had significantly more decayed teeth than healthy controls (3.97 ± 3.58 vs 0.84 ± 1.75, respectively, p < 0.001). Recipients of chemotherapy had significantly lower stimulated whole saliva flow rate (0.84 ± 0.35 vs 1.13 ± 0.46 ml/min, p < 0.05) compared to the controls. Palatal saliva flow rate was at the same time significantly higher in the test group compared to the controls (1.64 ± 0.87 vs 0.46 ± 0.32 ml/min/cm(2), respectively, p < 0.001). High levels of buffer capacity of the saliva could be detected in a significantly higher prevalence in the patient group compared to the controls (high: 81.6% vs 40%). CONCLUSIONS: According to these results, chemotherapy in children might result in a decreased stimulated whole saliva flow rate, hyposalivation, and, consequently, increased caries risk. Although these processes might be compensated to a limited extend by the increased minor saliva flow rate, resulting in a higher buffer capacity, nutrition and oral hygiene control of children obtaining cancer therapy is essential in the preservation of the oral tissues.

Anatomical changes in the structure of the temporomandibular joint caused by complete edentulousness.

BACKGROUND: The posterior slope of the articular eminence of completely edentulous patients compared to patients with maintained occlusion shows significant flattening. OBJECTIVE: The aim of this present study was to reveal a possible correlation between edentulousness and the flattening of the eminence and to find out whether this deformation is connected to age. MATERIAL AND METHODS: Thirty patients were examined in three groups, each consisting of 10 persons (group I: 18- to 25-year-old patients with maintained occlusion, group II: patients over 60 with maintained occlusion, group III: edentulous patients over 60). The three groups were compared according to dental status, age, sex and side. Measurements were carried out on orthopantomographic images taken with Kodak 8000 Digital Panoramic System. The angle of the posterior slope of the articular eminence relative to the Frankfort plane was measured on both sides. Data were analysed statistically with the one-way anova test (α = 0.05). RESULTS: The highest values were measured in group I (right side: 39.8 ± 5.4°, left side: 43.0 ± 5.9°), values were somewhat lower in group II (right side: 38.9 ± 4.7°, left side: 39.5 ± 7.4°) and were the lowest in group III, which was significantly lower on both sides than the results of group I and group II (right side: 29.8 ± 6.0°, left side: 31.9 ± 5.2°, p < 0.01). The correlation coefficient between age and the flattening of the eminence in group I, II and III was 0.23, 0.35 and 0.92, respectively. CONCLUSION: The flattening of the articular eminence could be correlated with age; however, the rate of deformation is significantly higher in completely edentulous patients than in patients with maintained occlusion.

[The dental aspects of public health in Hungary. Review article]. / Magyarország népegészségügyi helyzetének fogorvosi vonatkozásai. Osszefoglaló közlemény.

Despite great improvements in the oral health status of the population, public health and dental public health continue to be a major problem in society. A number of epidemiologic studies revealed the importance of the social, behavioral and environmental factors contributing to inequalities in the maintenance and restoration of oral health. Dental public health is the science and art of preventing oral diseases, promoting oral health and improving the quality of life through the organized efforts of the public. The aim of the authors was to provide an overview about the development and the functions of the Hungarian public health and dental public health system, its associations with international dental public health organizations and about the present dental public health status of the Hungarian population. According to WHO pathfinder studies, the Hungarian population has a usual cariologic and periodontal status in Europe, but a number of WHO statistical analyses reveal the sad situation regarding the high frequency of oral malignancies in our country. The social support system is given, the tasks are in front of us, and Hungary intends to follow the oral health strategies of the WHO for 2020 in order to improve the dental public health status of the nation, but it is necessary to declare that not only behavioral but also political decisions are necessary for that goal.

[Flow rate of minor salivary glands in elderly patients wearing complete dentures]. / Idoskorú, teljes fogpótlást viselok kisnyálmirigy szekréciójának vizsgálata.

Minor salivary glands show diverse levels of secretion in different regions of the oral cavity. The smallest production can be measured at the palatal glands, the highest in the buccal and the lingual glands. The labial glands show an intermediate value between the palatal and the buccal flow rate. According to the literature, secretion of the minor salivary glands decreases with age, yet only few data are available regarding the influence of removable dentures on the flow rate. The aim of this study was to assess the influence of complete dentures on the palatal, the labial and the whole saliva flow rate on elderly patients. A further aim was to compare the results obtained by the two measuring methods (weighing method and the PERIOTRON method), used to determine the flow rates of the minor salivary glands. According to the results of this study neither whole resting saliva flow rate nor the flow rate of the minor salivary glands (palatal, buccal) was influenced by long term removable denture wearing (denture wearers and controls -- weighing method: palatal: right side 2.4 +/- 3.3 microl/min/cm2, left side 1 +/- 3.8 microl/min/cm2 and labial: 1.4 +/- 2.6 microl/min/cm2; controls: right side 3.7 +/- 5.2 microl/min/cm2, left side 1.4 +/- 2.5 microl/min/cm2 and labial 1.8 +/- 3.9 microl/min/cm whole resting saliva flow: 0.32 +/- 0.26 ml/min and 0.29 +/- 0.24 ml/min respectively) (The data of denture wearers and controls -- PERIOTRON method: palatal right side 4 +/- 4.6 microl/min/cm2, palatal left side 3.5 +/- 3.6 microl/min/cm2 and labial 0.9 +/- 0.6 microl/min/cm2; controls: palatal right side 2.2 +/- 3.1 microl/min/cm2, palatal left side 1.8 +/- 1.8 microl/min/cm2 and labial 1.9 +/- 3 microl/min/cm2). Authors could not show difference between the weighing method and the PERIOTRON method applied in the measurement of the saliva flow rate of the minor glands.

[Frequency of oral candidiasis in stem cell transplant patients]. / Oropharyngeális candidiasis elofordulása ossejtátültetett betegeknél.

This study included 80 persons with haematological malignancies receiving stem cell transplantation (SCT) who were followed up for a period of 24 months. Authors focused on the patients' oral health state and on the correlation between the fungal colonisation of the oral cavity and the unstimulated whole saliva flow rate, before and after the stem cell transplantation. Carious teeth could be detected in 20 out of the 80 persons, although all of them were examined and treated by their dentists before taking part in the SCT program. Fungal colonization could be shown in 16 patients before the conditioning phase and in 19 subjects during the aplasia phase of SCT. Hyposalivation (unstimulated whole saliva flow rate < or = 0.1 mI/min) was detected in 28 patients. In conclusion there was a higher incidence of Candida albicans and other fungal colonization in SCT patients suffering from hyposalivation than in those of normal saliva flow rate.

Bioactive Constituents and Antioxidant Activity of Some Carpathian Basin honeys.

Unifloral honeys have a high commercial value and should undergo a strict quality control before marketing. This study aimed at determining floral origin, polyphenolic compounds and antioxidant activity in 7 samples marketed as lavender and thyme honeys. The samples were subjected to pollen analysis to confirm their botanical origin. Coupled chromatographic techniques (HPLC-DAD-ESI-MS) were optimized for the separation and identification of polyphenolic compounds. The antioxidant properties of the samples were determined by spectrophotometric methods. Pollen profile analysis revealed that only 3 out of 5 alleged lavender honeys contained a low percentage (0.6-1.5) of lavender pollen; and there were only traces (0.1-0.6%) of thyme pollen in the alleged thyme honeys. Polyphenolic constituents did not allow for the clear separation of honey samples, revealing no marker compounds previously associated with lavender and thyme honeys. All samples contained large amounts of chlorogenic acid, chrysin, hesperetin, kaempferol and p-coumaric acid; as well as abscisic acid, a plant hormone known to be present in floral nectar and honey. Our results suggest that only one of five alleged lavender honeys and neither of the two alleged thyme honeys are true unifloral honeys. However, they can still provide various health benefits, such as being good sources of antioxidants. There was no relationship between the antioxidant activity and the uni- or multifloral character of the honey samples. Total phenolic content and antioxidant activity was the lowest in the honey sample with lavender and the highest in one of the alleged lavender honeys. Our findings highlight the importance of microscopical and phytochemical analyses of honeys before marketing, to ensure satisfactory quality for customers.

Ebola virus disease: Awareness among dental students in Hungary.

INTRODUCTION: The Ebola epidemic has claimed thousands of lives in Africa, and there has been a mounting pressure on the healthcare systems around the globe to prepare for the showing up of patients infected with this virus. Junior clinicians are at the forefront of medical teams, often coming into contact with patients first, during clerking and admissions. This study assesses the level of knowledge of Ebola virus disease (EVD) among dental students at Semmelweis University, Budapest, Hungary. MATERIALS AND METHODS: A cross-sectional survey of 257 dental students was carried out across five different courses. Each of the students was asked to fill out a detailed questionnaire comprising of 11 questions, to assess their knowledge about signs and symptoms, investigations, management, and sequelae of the virus and the outbreak. FINDINGS: This study highlighted that there is an overall lack of knowledge about critical aspects of EVD among dental students. We found that the participating students scored less than 60% for 8 of the 11 questions, including those assessing their recognition and subsequent management of EVD. CONCLUSION: These results are concerning and the medical universities and dental schools need to act fast to prepare the Hungary's dental (and medical) students and junior doctors for an inevitable influx of infected patients.

[Oral symptoms of immunologic disorders. Part I. Systemic autoimmune diseases]. / Immunológiai kórképek fogorvosi vonatkozásai I. Szisztémás autoimmun betegségek.

Polysystemic autoimmune diseases often cause orofacial and stomatognathic symptoms. Inflammation of the temporomandibular joint only rarely and slightly reduces the range of mouth opening (rheumatoid arthritis), which is much more restricted in systemic sclerosis due to fibrosis of perioral soft tissues. Weakness of masticatory and pharyngeal muscles in idiopathic inflammatory myopathies results in dysphagia and dystonia. Ulcerations, petechiae, teleangiectasia, and lichenoid lesions are the characteristic symptoms of oral mucosal involvement, but drugs used in systemic treatment can also cause very similar side effects. Salivary gland hypofunction (Sjögren's syndrome) is common, and in addition to the subjective complaints, leads to objective pathologic alterations such as oral mycotic infections, purulent sialadenitis, and increased caries prevalence. The side effects of steroid administration should be taken into account also during dental treatments. Regular dental follow-up and treatment is a basic part of the complex care of these patients in order to diagnose and cure oral abnormalities and salivary gland hypofunction in time. Impairment of hand functions (rheumatoid arthritis, scleroderma) reduces the oral hygienic activity and therefore special devices, local antiseptics and local fluoride preparations are necessary.

[Mixed and palatal salivary secretion in denture-wearing healthy people and in patients with Sjogren syndrome]. / A kevert és a palatinális nyálszekréció vizsgálata teljes fogpótlást viseló egészséges és Sjögren-szindrómában szenvedó személyeken.

Denture retention is related to forces necessary to completely remove the denture from its basal seat. The liquid-joint model for explaining denture retention is accepted by most of the authors. According to this model retentive force is a function of saliva surface tension, liquid film thickness, surface of contact and the liquid-denture contact angle. Based upon the literature, mucosa covered with the least amount of saliva exists at the area of the palate and the upper lip, consequently at the area of the upper denture retention. Dryness is dependent on the volume of saliva present on the oral mucous membranes and the rate of its evaporation of them. However, the hard palate contains few minor glands and it is an area of high evaporation. Based on the above mentioned facts, patients with xerostomia might have problems with the stability of the complete dentures. To verify it, authors investigated 24 healthy people and 11 patients with Sjögren's syndrome (SS). Further aim of the authors was to determine how the new dentures influence the whole resting and the palatal saliva flow rate. According to the results whole resting saliva flow rate is decreased in SS because of the focal inflammation of the salivary glands, but surprisingly the palatal secretion rate does not change in SS related to the initial values of the healthy people. Although every patient had xerostomia (WRS < or = 0.1 ml/min), none of them complained about denture instability. Based upon this study, authors agree with the statement of the literature, that palatal mucous saliva can help to stabilize the maxillary denture. Results suggest that whole resting and palatal saliva flow rates are not influenced by the placement of new dentures in healthy complete denture wearers.

[Study of the effects of alkali metals on some virulence characteristics of Candida albicans]. / Alkálifémek hatásának vizsgálata Candida albicans néhány, virulenciával összefüggó tulajdonságára.

The effects of the alkali metals sodium, potassium and lithium on the growth and on certain virulence factors (adhesion, cell-surface hydrophobicity and the germinating ability) of Candida albicans were investigated. It can be concluded that high concentrations of alkali metals possessed an inhibitory effect on the growth of the Candida cells and preincubation in the presence of alkali metals had a negative effect on all the virulence factors studied. It is worth emphasizing that the changes induced during the preincubation persisted even when the high concentrations of the alkali metals were removed from the cell suspension. However, even at high concentrations of sodium or potassium a considerable growth of Candida cells could be measured. Data also showed that although alkali metals could significantly decrease certain virulence traits of the fungus they could not totally inhibit either the adhesion or the germ tube formation potential of the cells. Thus, in spite of the high salt concentrations Candida cells may represent a health hazard in such habitats.

Frequency and location of traumatic ulcerations following placement of complete dentures.

PURPOSE: To determine the location of mucosal injuries that appear following placement of complete dentures, as well as the number of adjustments necessary to achieve patient comfort. The frequency of mucosal injuries in female and male patients and their connection with clinical anatomic features were also investigated. MATERIALS AND METHODS: Sixty-one completely edentulous healthy patients who wore dentures (47 women and 14 men) took part in the study; 122 newly fabricated complete maxillary and mandibular dentures were investigated. All patients were seen for a 1-week adjustment appointment. Areas where signs of denture-induced mucosal injuries appeared were marked on an anatomic illustration. The follow-up period was in 1-week increments as deemed necessary by the patient. Associations between variables were analyzed with analysis of variance. Results were recorded as mean + SD. Statistical significance was set at P < or = .05. RESULTS: Eighty-seven percent of the dentures required adjustment at week 1, 50% at week 2, and only 7% at week 3. No patients required a further visit. Most frequently injured maxillary areas were the vestibular sulcus (41%), maxillary tuberosity (21%), and hamular notch (12%). In the mandible, the most frequently injured areas were the retromylohyoid area (17%), lingual sulcus (14%), and vestibular sulcus (13%). Denture-induced irritations were detected in a higher ratio in the mandible (P < .001), especially in male denture wearers at the first adjustment (P < .05). Men had a higher ratio of lesions at the region of the maxillary vestibular sulcus between the labial and buccal frenum and at the mandibular vestibular sulcus of the buccal shelf region (P < .001). CONCLUSIONS: Denture-induced irritations appeared most often in the vestibular sulcus of the maxilla and mandible, indicating that it is necessary to evaluate the area of the facial seal of the prosthesis by applying a medium- or a heavy-pressure indicator paste to the borders, and to make adjustments at the delivery stage and subsequent adjustment appointments. Denture placement must not be the final patient-clinician encounter when treating with complete dentures. Denture adjustments are very important clinical phases of denture fabrication and essential in patient care.

Evaluation of oral manifestations and masticatory force in patients with polymyositis and dermatomyositis.

BACKGROUND: The polymyositis (PM) and dermatomyositis (DM) complex encompasses a heterogeneous group of acquired autoimmune skeletal muscle diseases called idiopathic inflammatory myopathies (IIM). Despite their histological and immunopathological differences, the end result of the affected muscles in all of these entities is the triad of chronic inflammation, fibrosis and the loss of muscle fibres. The aim of this study was to perform a complete analysis of the orofacial abnormalities in 34 patients with PM and DM. METHODS: Evaluation of subjective oral symptoms, measurement of whole resting saliva flow rate (WS) with the 'spitting method', a visual investigation of the oral soft tissue alterations, light- and electron microscopic analysis of the symptoms of capillary abnormalities or signs of focal infiltration in labial biopsy specimens were carried out. The number of decayed, missing and filled teeth (DMF-T) according to the WHO recommendations (1997), the periodontal probing depth (PPD), the plaque index (PI; Silness-Löe) and the gingival index (GI; Löe-Silness) were determined. For comparison with healthy controls the masticatory force (MF) and the force of the upper extremities' flexors were measured with a specially developed device. The SPSS version 11.0 for Windows software program, two-tailed Student's t-test and Mann-Whitney test were used to statistically analyse all data. Values were considered to be significant if P level was < or = 0.05. RESULTS: Nine patients complained of subjective xerostomia, 11 showed the signs of salivary hypofunction (WS < or = 0.1 ml/min). The most prominent symptom of the oral mucosa and perioral tissues was the presence of telangiectasia, detected in seven cases. Fibrosis of the minor salivary glands was found in 12 patients, interstitial-perivascular infiltration was detected in eight cases, periductal infiltration in one case. The findings on dental and periodontal conditions indicate, that the patients with IIM diseases had significantly higher DMF-T scores (24.06 +/- 7.04 vs. 19.54 +/- 8.93, respectively; P = 0.002), they had less remaining teeth in average (15 vs. 20; P = 0.002), compared with the control group. Their oral hygiene was significantly worse (PI was 1.46 +/- 0.75 and 0.73 +/- 0.54, P = 0.001). GI was significantly higher in the patients (1.27 +/- 0.60 and 0.66 +/- 0.56, respectively, P = 0.0003), although we could not demonstrate any difference in the severity of the periodontal destruction between patients and controls. Masticatory force was significantly weaker in the first molar region on both sides in the patient group (309 +/- 213 N and 113 +/- 146 N, P = 0.0016 for the right side; 315 +/- 239 N and 123 +/- 76 N, P = 0.009 for the left side), but only the left hands showed to be weaker in the patient group (77 +/- 27 N and 59 +/- 20 N, P = 0.04). CONCLUSION: In conclusion, the present study showed that, patients with IIM diseases have hyposalivation and mucosal alterations, mainly in the form of telangiectasia. They have increased prevalence of dental caries, which may be secondary to the hyposalivation. The masticatory and the upper extremity flexor forces indicate that the weakness of the masticatory muscles can manifest earlier than that of the arms.

Incidence of oropharyngeal candidosis in stem cell transplant (SCT) patients.

Eighty persons with haematological malignancies receiving stem cell transplantation (SCT) were examined over a 24 months period. Hyposalivation, a common complaint in patients treated by intensive chemotherapy and radiotherapy can predispose to oral candidal colonisation as well. This study was focused on correlation between the fungal colonisation of the oral cavity and the total unstimulated saliva flow rate of 80 patients with haematological malignancies before and after stem cell transplantation and in addition, on their oral health state. Despite the fact that prior to being involved in the transplantation programme, the patients were subjected to dental examination and decayed teeth were found in 20 out of 80 patients (25%). From the 2233 different oropharyngeal specimens fungi were isolated before conditioning from 16 patients (20%), and during aplasia from 19 patients (23.7%). Objective xerostomia (unstimulated total saliva flow rate < or = 0.1 ml/min) was detected in 28 patients (35%). Stem cell transplant patients with pretransplant mouth dryness had higher incidence of Candida albicans and other fungal colonisation than those with normal saliva secretion.