Stress and Salivary Glands.

Salivary glands produce a bicarbonate-rich fluid containing digestive and protective proteins and other components to be delivered into the gastrointestinal tract. Its function is under strict control of the autonomic nervous system. Salivary electrolyte and fluid secretion are primarily controlled by parasympathetic activity, while protein secretion is primaily triggered by sympathetic stimulation. Stress activates the hypothalamic - pituitary - adrenal axis. The peripheral limb of this axis is the efferent sympathetic/adrenomedullary system. Stress reaction, even if it is sustained for long, does not cause obvious damage to salivary glands. However, stress induces dramatic changes in the constituents of secreted saliva. Since salivary protein secretion is strongly dependent on sympathetic control, changes in saliva can be utilized as sensitive stress indicators. Some of the secreted compounds are known for their protective effect in the mouth and the gut, while others may just pass through the glands from blood plasma because of their chemical nature and the presence of transcellular salivary transporting systems. Indeed, most compounds that appear in blood circulation can also be identified in saliva, although at different concentrations. This work overviews the presently recognized salivary stress biosensors, such as amylase, cortisol, heat shock proteins and other compounds. It also demonstrates that saliva is widely recognised as a diagnostic tool for early and sensitive discovery of salivary and systemic conditions and disorders. At present it may be too early to introduce most of these biomarkers in daily routine diagnostic applications, but advances in salivary biomarker standardisation should permit their wide-range utilization in the future including safe, reliable and non-invasive estimation of acute and chronic stress levels in patients.

Alteration of consciousness via diverse photo-acoustic stimulatory patterns. Phenomenology and effect on salivary flow rate, alpha-amylase and total protein levels.

Long-term photo-acoustic stimulation is used for the induction of altered states of consciousness for both therapeutic and experimental purposes. Long-term photo-acoustic stimulation also leads to changes in the composition of saliva which have a key contribution to the efficiency of this technique in easing mucosal symptoms of oral psychosomatic patients. The aim of this study is to find out whether there is any cumulative effect of repeated stimulation and whether there are any detectable differences between diverse stimulatory patterns of long lasting photo-acoustic stimulation on the phenomenology of the appearing trance state and on salivary secretion. There was significant cumulative effect in relation with the appearance of day dreaming as phenomenological parameter, and in relation with protein output and amylase/protein ratio as salivary parameter. Pattern specific effect was detectable in relation with salivary flow rate only. Although our results clearly indicate the existence of certain cumulative and stimulation-pattern specific effects of repeated photo-acoustic stimulation, the absolute values of all these effects were relatively small in this study. Therefore, in spite of their theoretical importance there are no direct clinical consequences of these findings. However, our data do not exclude at all the possibility that repeated stimulation with other stimulatory parameters may lead to more pronounced effects. Further studies are needed to make clear conclusion in this respect.

Molecular mechanisms of taste recognition: considerations about the role of saliva.

The gustatory system plays a critical role in determining food preferences and food intake, in addition to nutritive, energy and electrolyte balance. Fine tuning of the gustatory system is also crucial in this respect. The exact mechanisms that fine tune taste sensitivity are as of yet poorly defined, but it is clear that various effects of saliva on taste recognition are also involved. Specifically those metabolic polypeptides present in the saliva that were classically considered to be gut and appetite hormones (i.e., leptin, ghrelin, insulin, neuropeptide Y, peptide YY) were considered to play a pivotal role. Besides these, data clearly indicate the major role of several other salivary proteins, such as salivary carbonic anhydrase (gustin), proline-rich proteins, cystatins, alpha-amylases, histatins, salivary albumin and mucins. Other proteins like glucagon-like peptide-1, salivary immunoglobulin-A, zinc-α-2-glycoprotein, salivary lactoperoxidase, salivary prolactin-inducible protein and salivary molecular chaperone HSP70/HSPAs were also expected to play an important role. Furthermore, factors including salivary flow rate, buffer capacity and ionic composition of saliva should also be considered. In this paper, the current state of research related to the above and the overall emerging field of taste-related salivary research alongside basic principles of taste perception is reviewed.

Clinical Management of BCLP With a Severe Hypoplastic and Retruded Premaxilla.

Bilateral cleft lip and palate with a severe hypoplastic and backward rotated premaxilla and lack of soft tissues is a rare congenital facial deformity. No treatment protocol for this type of cleft is widely accepted. In patient with bilateral cleft lip and palate, the premaxilla was protracted by nasoalveolar molding before lip surgery. The nasal tip was elevated and the columella lengthened by nasal components incorporated into the palatal guidance plate. After 4 months of nasoalveolar molding, surgery could be performed without complications. Postoperative use of a guidance plate prevented relapse of the premaxillary segment, the nasal conformers maintained the nostril form.

Management of prominent premaxilla in bilateral cleft lip and alveolus.

Our aim was to describe the early management protocol of the prominent premaxilla in bilateral cleft lip and alveolus and its rationale, as used in the Cleft Centre at the 1st Department of Pediatrics and at the Department of Pedodontics and Orthodontics at the Semmelweis University Budapest. The non-surgical and surgical procedures included lip taping, nasoalveolar molding, lip adhesion and definitive one-stage lip closure. With this treatment sequence, arch management was satisfactory and at the time of the definitive lip closure the position of the premaxilla did not interfere with adequate surgical repair.

Orofacial characteristics of adolescents with diagnosed spinal disorders.

The objective of the current epidemiological study is to show the correlation of various postural abnormalities and spinal deformities and the clinically identifiable dentofacial anomalies by orthodontic examination. Twenty-three children with Scheuermann's disease [mean age: 14 years 8 months; standard deviation (SD): 1 year 8 months] and 28 with scoliosis (mean age: 14 years 7 months; SD: 2 years 3 months) participated in the study. Standardized orthodontic screening protocols were used to map the occlusal relations in the sagittal, vertical, and horizontal dimensions; the space relations of the maxillary and mandibular frontal segment; the temporomandibular joint (TMJ) status; and the facial asymmetries. Statistically significant differences (p<0.05) were found between the values of the examined groups of patients for the following measurements: incisal overjet and overbite, upper and lower midline deviation, mandibular frontal spacing, TMJ pathological symptoms and functional characteristics, and frequency of facial asymmetries. A large percentage of patients with pre-pubertal developments of spinal deformities have various dentofacial anomalies. The majority of these anomalies are present in patients with Scheuermann's disease. Early treatment of the malocclusions closely correlated to postural disorders should minimize the progression of the dentofacial anomalies, making necessary performing orthodontic screening of these patients as early as possible.

Salivary defense proteins: their network and role in innate and acquired oral immunity.

There are numerous defense proteins present in the saliva. Although some of these molecules are present in rather low concentrations, their effects are additive and/or synergistic, resulting in an efficient molecular defense network of the oral cavity. Moreover, local concentrations of these proteins near the mucosal surfaces (mucosal transudate), periodontal sulcus (gingival crevicular fluid) and oral wounds and ulcers (transudate) may be much greater, and in many cases reinforced by immune and/or inflammatory reactions of the oral mucosa. Some defense proteins, like salivary immunoglobulins and salivary chaperokine HSP70/HSPAs (70 kDa heat shock proteins), are involved in both innate and acquired immunity. Cationic peptides and other defense proteins like lysozyme, bactericidal/permeability increasing protein (BPI), BPI-like proteins, PLUNC (palate lung and nasal epithelial clone) proteins, salivary amylase, cystatins, prolin-rich proteins, mucins, peroxidases, statherin and others are primarily responsible for innate immunity. In this paper, this complex system and function of the salivary defense proteins will be reviewed.

A broadband and high throughput single-monochromator Raman spectrometer: application for single-wall carbon nanotubes.

We present a high sensitivity single-monochromator Raman spectrometer which allows operation with a tunable laser source. The instrument is based on the modification of a commercial Raman spectrometer; such instruments operate with interference Rayleigh filters which also act as laser mirrors and are usually considered as inherently narrow band. In our design, the two tasks are separated and the filter can be freely rotated without much effect on the light alignment. Since rotation shifts the filter passband, this modification allows tunable operation with efficient stray light filtering down to 150 cm(-1). The design is optimized for single-wall carbon nanotubes, for which the performance is demonstrated using a tunable dye laser source. The spectrometer thus combines the high sensitivity with the broadband characteristics of usual triple monochromator systems.

[Treatment options of missing teeth resulting from hypodontia. Literature overview I]. / A hypodontia következtében létrejött foghiány ellátásának lehetôségei. Irodalmi áttekintés I.

Nowadays there is an increased need to identify genetic polimorphisms, the underlying genetic factors of hypodontia. This article aims to describe the genetic components of hypodontia, the most frequent congenital tooth development disorder, as well as its interdisciplinary treatment. Congenitally missing teeth may cause serious emotional and physical problems particularly during adolescence. To prevent this, the early diagnosis and the development of definitive treatment plan are vital. In this work the interdisciplinary management involving a dental team plays a crucial role. The most important first step in hypodontia management is to decide whether to apply space closure or space opening when making room for fixed restorations and implants.

[Treatment options of missing teeth resulting from hypodontia. Literature overview II]. / A hypodontia következtében létrejött foghiány ellátásának lehetoségei. Lrodalmi attekintés II.

Congenital hypodontia may cause serious emotional and physical problems which can become particularly grave during adolescence. This article highlights the importance of early diagnosis and the prevention of the progress of the state, and discusses a variety of definitive treatment plans. The aim of restorative dentistry is to restore function, improve appearance and prevent complications caused by hypodontia. When developing a treatment plan, first the severity of hypodontia, the number of missing teeth, and some other factors have to be considered. This can be followed by the treatment, which involves an interdisciplinary dental team.

Attitude toward death: does it influence dental fear?

The possible influence of fear of death and attitude toward death were studied related to dental anxiety in Hungarian elementary and secondary school subjects (n = 277; 114 males, 163 females; age between 8 and 18 years). Dental fear and anxiety scores were DAS: 10.8 +/- 3.6; DFS: 40.6 +/- 15.6; STAI-S: 38.0 +/- 11.0; STAI-T: 40.3 +/- 10.0. Lester's Attitude Toward Death Scale scores were 6.3 +/- 1.3. Girls scored higher on DAS, STAI-S, and STAI-T scales (P < or = 0.05). Age influenced STAI-S, STAI-T, and Lester's Scale scores (P < or = 0.05). Lester's Scale scores influenced the expectations of the subjects about the dental fear of their surrounding people (parents, brother, sister, friends) (P < or = 0.05). A percentage of 7.22 of the subjects indicated a rather strong connection between dental fear and fear of death. These subjects had significantly higher dental fear and anxiety scores as compared to others (P < or = 0.01). Death-related content was found in 4.3% of drawings and in 10.5% of free associations (couplings) related to teeth (in 12.6% either in drawings or in couplings). The appearance of death-related content was higher with higher age, and higher expected dental fear of surrounding people (P < or = 0.01). Our data indicate a detectable influence of fear of death on dental fear, especially in subjects with higher dental fear scores.

Prevalence of hypodontia and hyperdontia in paedodontic and orthodontic patients in Budapest.

Various publications have reported the prevalence of accessory teeth to be between 1 and 3%. In contrast, hypodontia has a much higher prevalence. In the current work, the authors studied OP radiographs on 2,219 patients aged 6 to 18 years who presented at the Department of Paedodontics and Orthodontics at Semmelweis University in Budapest (patients with systemic disease were excluded). The examined radiographs revealed a prevalence of accessory teeth of 1.53%. The sequence of prevalence was as follows: mesiodens > second incisor > first incisor. 77.5% of the accessory teeth were located in the upper jaw, with 97.5% of those being present in the incisor region. Hypodontia was detected in 326 patients (14.69%); missing wisdom germs were not considered. The sequence of prevalence of missing germ was as follows: upper second incisor > lower second premolar > upper second premolar > lower first incisor. Hypodontia in the molar region was observed in 15 cases (0.68%). The prevalence of oligodontia was 1.04%.

[Dental fear scores of 12-19-year-old school children of the Hungarian minority in Transylvania]. / Adatok a határon túli magyarság fogászati félelem értékeiro1 12-19 éves korcsoportban.

In this study 549 school children of the Hungarian minority in Transylvania were investigated (n=549, 342 female, 207 male, age between: 12-19 years). Mean dental fear scores were high: DAS: 12.6 +/- 3.3, DFS: 50.6 +/- 25.1. Girls scored significantly higher (p< or =0.01) in both scales. Scores increased between age of 12 and 16 confluently in both scales (DAS, DFS; p< or =0.05). There was a strong Pearson's correlation between DAS and DFS scales: (r= 0.70; p< or =0.01), and a somewhat lower correlation between these scales and the general anxiety scores. Mean DBS score (n = 203 only) was: 44.9 +/- 10.2.

[Psychology and psychosomatics of the orthodontic treatment]. / Pszichológia és pszichoszomatika a fogszabályozásban irodalmi áttekintés.

Psychosomatic problems related to orthodontic treatment are a special group of oral psychosomatic disorders. The most frequent complaints are related to aesthetics and occlusion. Most of the patients are children, adolescence or young adults, with special emotional problems. Authors reviewed the most important knowledge related to this specific field, but some general aspects of oral psychosomatics are also discussed.

[Background data about the dental fear scores of Hungarian secondary school students]. / Adatok budapesti középiskolások fogászati kezeléssel kapcsolatos félelmeinek hátterérol.

Free association (coupling) of 139 Hungarian secondary school students (90 females, 49 males, age between 14-18 yr.) about their teeth was collected. Dental fear (DAS, DFS) and general anxiety scores were measured. Typical dental events (i.e.: simple and traumatising dental treatments, etc.) were coupled by the participants in 36,7% of the cases. Functions and importance of the teeth and oral hygiene were described in 7,2% of the cases. Simple, grotesque, or magical stories and tales about teeth were found in 16,5% of the cases. No answer was found in 39,6% of the cases. Highest dental fear and general anxiety scores were found in the group coupled traumatising dental treatment. Age had no influence on the sense of the association (coupling).

[Lexicologic parameters of free association (coupling) about teeth of Hungarian primary school children. An initial study]. / Fogakkal kapcsolatos történetek szótani alapparamétereinek vizsgálata általános iskolás (8-15 éves) korcsoportban.

Free association (coupling) of 97 Hungarian primary school children (age: 8-15 yrs, 44 male, 53 female) about their teeth was collected and analysed related to lexicologic parameters, as a pilot to establish further investigations. In some cases significant (p < or = 0.05) differences within the groups related to several topics were detected in the case of the length of the text and in the case of the distribution of etymons (root of word). Gender significantly influenced the length of the text as well. Some effect of dental fear and anxiety on the length of the text, and on the etymon's distribution may also be possible. The analysis of the most frequently used words indicated some coupling of pain and fear, and the importance of the mother in how the children see dental life events.

[Background data about the high dental fear scores of Hungarian 8-15-year-old primary school children]. / Adatok általános iskolás (8-15 éves) gyermekek fogászati kezeléssel kapcsolatos félelmeinek hátterérol.

Free associations (coupling) of 139 Hungarian primary school children about their teeth was collected. Dental fear (DAS, DFS) and general anxiety scores were measured. Typical dental events (i.e.: loss of deciduous teeth, simple and traumatising dental treatments, tooth fractures) were coupled by the participants in 41.0% of the cases. Functions and importance of the teeth and oral hygiene were described in 20.1% of the cases. Simple, grotesque, or magical stories and tales about teeth were found in 8.6% of the cases. No answer was given in 30.2% of the cases. Highest dental fear and general anxiety scores were found in the group coupled traumatising dental treatment. Traumatising loss of deciduous teeth was caused by the dentist or by the father of the child, and was associated with higher dental fear and general anxiety comparing to simple loss of deciduous teeth. Higher dental fear and general anxiety scores were found in the group coupled functions and importance of the teeth comparing to the group coupled simple, grotesque, or magical stories and tales, or the group giving no answer.

[Epidemiologic study of dental fear in school children 8-15 years of age]. / Fogászati kezeléstöl való félelem epidemiológiai vizsgálata általános iskolás (8-15 éves) korcsoportban.

Authors investigated the dental fear scores (DAS, DFS) of 139 primary school children in Budapest, Hungary (72 females, 67 males, ages between 8-15 years). Sex and age had no effect on the scales. Mean dental fear scores were high (DAS: 10.7 +/- 3.7, DFS: 40.4 +/- 15.3). A strong correlation between DAS and DFS, and somewhat lower correlation between these scales and the general anxiety scales were demonstrated. Children's evaluation of the dental fear of the family and relations strongly correlated with dental fear and moderately with general anxiety. The results indicate that, dental fear is influenced by dental fear of family and relations, and general anxiety, but much less influenced by other demographic variables (i.e. age, sex) in primary-school children.