[Characteristics, diagnosis and treatment of the most common bacterial diseases of the oral cavity]. / A szájüreg leggyakoribb bakteriális eredetu kórképeinek jellegzetességei, diagnosztikája és kezelése.

Billions of microorganisms can be found in the oral cavity, from which bacteria are the most frequent. More than 600 bacterial species can be isolated. Most of them are harmless, moreover, some species prove themselves to be specifically useful. However, in the case of a weakened immune status or inappropriate oral hygiene, they may cause many types of soft and hard tissue disorders. Caries and periodontal diseases are the most common bacterial diseases of the oral cavity. In both cases, the dental biofilm gives rise to the disorder, which is caused by the insufficient oral hygiene. Dental caries are mainly caused by cariogenic streptococci and lactobacilli. In the case of serious periodontal diseases, anaerob parodonto-pathogen microorganisms play the major role. Untreated caries may result in the necrosis of the pulp, which can cause an inflammation expanding towards the parodontium. This can be characterized as a focal infection, like the untreated periodontal pockets. Dental foci may have lots of systemic consequences such as cardiovascular diseases, diabetes, pneumonia, arthritis, preterm birth and alopecia areata. When these diseases occur, dental foci should always be considered. The professional plaque control and chlorhexidine rinsing before the proposed surgeries have an outstanding role in the prevention of ventilator-associated pneumonia. Oral cancer is multicausal; more and more researchers are analyzing the role of certain bacteria in the carcinogenesis of oral cancer. In addition to the mentioned clinical aspects, we are planning to describe the relatively rare, but diverse and diagnostically challenging bacterial soft tissue disorders in another publication. Orv Hetil. 2019; 160(19): 739-746.

[The association between maternal periodontal health and adverse pregnancy outcomes]. / A várandós no parodontalis egészségi állapota és a terhességi komplikációk közötti kapcsolat.

Data from epidemiological and clinical studies published in the past two decades indicate certain association between periodontal disease and increased risk for preterm birth or low birth weight. Although the strength of those observed associations is weak, periodontitis today is considered as one of the potentially modifiable risk factors for adverse pregnancy outcomes. The aims of the publication are to summarize the epidemiological and clinical evidence for the impact of periodontal disease on adverse pregnancy outcomes and to make an attempt to overview the potential biological mechanism behind this association. The majority of epidemiological and clinical studies found certain negative effect of poor maternal periodontal condition on the incidence of low birth weight, preterm birth, pre-eclampsy, restricted foetal growth or even stillbirth. Two possible biological pathways have so far been identified: 1) the direct dissemination of the periodontal pathogens or their toxic by-products which reach the foetal-placental unit, and 2) an indirect mechanism when the circulating systemic inflammatory mediators induced by the periodontal inflammation can provoke secondary inflammation and foetal damage in the amnion. The periodontal therapy applied during the second or third trimesters has not been proven to reduce the incidence of any adverse pregnancy outcomes in pregnant women. A much more prophylaxis-oriented approach in periodontal treatment is needed. The adequate periodontal therapy should be completed before the conception to provide benefit to the pregnant women and also the new born baby. Orv Hetil. 2018; 159(25): 999-1007.

[Effect of the treatment of periodontal disease on the outcome of pregnancy]. / Fogágybetegség kezelésének hatása a terhesség kimenetelére.

INTRODUCTION: Correlations between periodontitis and its effects on the outcome of pregnancies are actually more focused topics. Maternal motivation for a good oral hygiene and preventive dental treatment must be highlighted tasks during pregnancy care. AIM: The authors analysed the effect of the preventive dental treatment during pregnancy and its obstetrical effects. METHOD: In a prospective randomised study, including pregnant women observed for threatening preterm deliveries, patients with dental examination (n = 71) were compared with patients undergoing dental treatment at the same time (n = 79). STATISTICAL ANALYSIS: Univariate comparisons for categorical variables were assessed by χ2 tests and independent Student's t-tests for continuous variables. ORs were compared with Mantel-Haenszel tests. Multivariable logistic regression was performed to evaluate the factors determining the poor periodontal parameters and gingivitis separately. The two-tailed statistical significance level was set at 5%. RESULTS: In the dental treatment group, the neonatal birth weight was significantly higher than in the non-treated group, in case of patients with periodontitis (2990 ± 582.3 g vs 2568.1 ± 699.1 g, p = 0.005). Also the average age at delivery was significantly higher in the treated vs non-treated groups (37.3 ± 1.9 vs 36.0 ± 2.9 weeks, p = 0.027), and the treatment had a beneficial effect on the prolongation of pregnancy, with a higher level of significance in the gingivitis group vs patients with periodontitis groups (p = 0.02 vs p = 0.043). CONCLUSIONS: Dental treatment of expecting women has a beneficial effect on the prolongation of pregnancy by decreasing the rate of prematurity and perinatal complications. Orv Hetil. 2018; 159(24): 978-984.