Assessment of the Salivary Concentrations of Selected Immunological Components in Adult Patients in the Late Period after Allogeneic Hematopoietic Stem Cell Transplantation-A Translational Study.

(1) The aim of the study was to analyze the salivary concentrations of lysozyme, lactoferrin, and sIgA antibodies in adult patients in the late period after allogeneic stem cell transplantation (alloHSCT). The relationship between these concentrations and the salivary secretion rate and the time elapsed after alloHSCT was investigated. The relationship between the concentrations of lysozyme, lactoferrin, and sIgA and the titer of the cariogenic bacteria S. mutans and L. acidophilus was assessed. (2) The study included 54 individuals, aged 19 to 67 (SD = 40.06 ± 11.82; Me = 39.5), who were 3 to 96 months after alloHSCT. The concentrations of lysozyme, lactoferrin, and sIgA were assessed in mixed whole resting saliva (WRS) and mixed whole stimulated saliva (WSS). (3) The majority of patients had very low or low concentrations of the studied salivary components (WRS-lysozyme: 52, lactoferrin: 36, sIgA: 49 patients; WSS-lysozyme: 51, lactoferrin: 25, sIgA: 51 patients). The levels of lactoferrin in both WRS and WSS were statistically significantly higher in the alloHSCT group than in the control group (CG) (alloHSCT patients-WRS: M = 40.18 µg/mL; WSS: M = 27.33 µg/mL; CG-WRS: M = 17.58 µg/mL; WSS: 10.69 µg/mL). No statistically significant correlations were observed between lysozyme, lactoferrin, and sIgA concentrations and the time after alloHSCT. In the group of patients after alloHSCT a negative correlation was found between the resting salivary flow rate and the concentration of lactoferrin and sIgA. The stimulated salivary flow rate correlated negatively with lactoferrin and sIgA concentrations. Additionally, the number of S. mutans colonies correlated positively with the concentration of lysozyme and sIgA. (4) The concentrations of non-specific and specific immunological factors in the saliva of patients after alloHSCT may differ when compared to healthy adults; however, the abovementioned differences did not change with the time after transplantation.

Effects of Interleukin-1 Genotype on the Clinical Efficacy of Non-Surgical Periodontal Treatment of Polish Patients with Periodontitis.

(1) Background: Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth-supporting apparatus. The aim of the study was to evaluate the efficacy of basic periodontal treatment depending on the interleukin-1 genotype in adult Poles. (2) Methods: Sixty subjects aged 39-64 years were examined. At initial presentation (T1), at 6-8 weeks (T2), and 16-18 weeks (T3) after treatment completion, the following percentages were recorded: surfaces with plaque, pockets bleeding, pocket depth, and change in the attachment level. During the T1 examination, the genotype for IL-1 was determined using the GenoType® PST test. (3) Results: Thirty subjects had genotype IL+ and the other thirty were IL-. During the T1 examination no significant differences were observed between patients. The study showed an increase of all the tested clinical parameters after 6-8 weeks. This increase continued up to the T3 examination. A significant reduction in the percentage of plaque surfaces after 6-8 weeks was observed, which was sustained after 16-18 weeks for both genotypes. For both genotypes, a significant decrease in the percentage of bleeding pockets was observed at the T2 examination, which persisted through until examination T3. For both studied genotypes, after 6-8 weeks, a significant shallowing of pockets was observed. In patients with the IL- genotype, a further significant shallowing of pockets was observed after 16-18 weeks. A significant reconstruction of epithelial attachment was observed between the T1 and T2 examinations, averaging 0.55 mm in patients with the IL+ genotype, and 0.77 in patients with the IL- genotype. (4) Conclusions: The results of our study show that the IL-1 genotype, may be one of the factors affecting the healing process after non-surgical periodontal treatment in adult Poles.

Association between IL-1 Gene Polymorphisms and Stage III Grade B Periodontitis in Polish Population.

Periodontitis is a chronic multifactorial inflammatory disease originating from microbial, environmental and genetic factors. The present study aimed to find an association of genetic polymorphisms at IL-1A-889 and IL-1B+3953 loci in Polish patients with stage III grade B periodontitis and periodontally healthy subjects. Fifty patients with stage III grade B periodontitis (tests) and thirty-five periodontally healthy controls were included in the study. To determine IL-1A and IL-1B gene polymorphisms, buccal swab-derived DNA obtained by means of the GenoType PST test was used. There were no statistically significant differences regarding the prevalence of IL-1A-889 or IL-1B+3953 alleles between groups. The frequencies of different IL-1A-889 genotypes did not differ significantly between groups. The IL-1B+3953 C/T genotype was significantly more predominant in periodontitis patients than in controls, whereas C/C genotype prevalence was significantly lower in the test group. Complex genotypes consisting of at least one IL-1A-889 and IL-1B+3953 T allele occurred significantly more frequently in subjects with periodontitis. Stage III grade B periodontitis may be associated with the IL-1B+3953 T allele and composite IL-1 polymorphism. Reduced susceptibility to periodontal disease was present in IL-1A-889 and IL-1B+3953 C/C homozygotic patients.

Assessing Fluorosis Incidence in Areas with Low Fluoride Content in the Drinking Water, Fluorotic Enamel Architecture, and Composition Alterations.

There is currently no consensus among researchers on the optimal level of fluoride for human growth and health. As drinking water is not the sole source of fluoride for humans, and fluoride can be found in many food sources, this work aimed to determine the incidence and severity of dental fluorosis in Poland, in areas where a low fluoride content characterizes the drinking water, and to assess the impact of fluoride on the enamel composition and microstructure. The dental examination involved 696 patients (aged 15−25 years) who had since birth lived in areas where the fluoride concentration in drinking water did not exceed 0.25 mg/L. The severity of the condition was evaluated using the Dean's Index. Both healthy teeth and teeth with varying degrees of fluorosis underwent laboratory tests designed to assess the total protein and fluoride content of the enamel. Protein amount was assessed spectrophotometrically while the level of fluoride ions was measured by DX-120 ion chromatography. The clinical study revealed 89 cases (12.8%) of dental fluorosis of varying severity. The enamel of teeth with mild and moderate fluorosis contained a significantly higher protein (p-value < 0.001 and 0.002, respectively) and fluoride level (p < 0.001) than those with no clinical signs of fluorosis. SEM images showed irregularities in the structure of the fluorotic enamel. An excessive fluoride level during amelogenesis leads to adverse changes in the chemical composition of tooth enamel and its structure. Moreover, dental fluorosis present in areas where drinking water is low in fluorides indicates a need to monitor the supply of fluoride from other possible sources, regardless of its content in the water.

Level of Anxiety Caused by the Coronavirus (COVID-19) Pandemic among Dentists in Poland.

Background and Objectives: The early information on both the speed and high morbidity rate and, above all, mortality triggered the symptoms of COVID-19-related panic and anxiety. Dentists were listed in the top five professions with the highest risk of transmission of the virus. The aim of the present study was to investigate the correlation between the fear level of COVID-19 and sociodemographic variables in Polish dentists. Materials and Methods: A cross-sectional study was conducted via an online survey questionnaire with seven statements in the COVID-19 Fear Scale (FCV-19S). The online questionnaire was completed by 356 dentists. The SPSS and PQStat were used to analyze, validate, and assess correlations and logistic regression. Results: In the studied population of dentists, the perceived level of anxiety associated with COVID-19 should be considered relatively low. When the respondents had children, lived with the elderly, or looked after them, the observed level of anxiety was higher, and physical symptoms, such as sweating palms and increased heart rate, occurred. Conclusions: Studies concerning the anxiety level related to COVID-19 carried out among Polish dentists ascertained that the tested level of anxiety among dentists was relatively low. The COVID-19 Fear Scale (FCV-19S) adjusted to the Polish language requirements is a reliable tool that can be used effectively for analyzing the impact of any pandemic on the Polish-speaking population.

Late Post-Operative Occurrence of Dentin Hypersensitivity in Adult Patients Following Allogeneic Hematopoietic Stem Cell Transplantation-A Preliminary Report.

Allogeneic hematopoietic stem cell transplantation (alloHSCT) is one of the most commonly performed transplantation procedures nowadays. Despite the significant progress made in the treatment, alloHSCT is still associated with numerous complications also affecting the oral cavity. One of them is dentin hypersensitivity (DH)-a sharp, short-term pain that occurs when stimuli act on exposed dentin. Various authors point out that DH may result in a significantly lower quality of life, among other things by impeding the consumption of food as well as causing difficulties in daily oral hygiene. The aim of the study was a preliminary analysis of the incidence rate and severity of DH pain in adult patients during late period after alloHSCT. The impact of chronic graft-versus-host disease (cGvHD) and time after alloHCT were also considered. A total of 80 patients were examined. cGvHD was identified in 52 participants. The incidence rate and severity of DH pain was assessed on the basis of a questionnaire and a clinical examination. DH pain appeared a serious problem in late period after alloHSCT regardless of post-transplant time. DH primarily affected cGvHD patients. The prevention-treatment protocol for DH should be developed for this group.

Oral health of adult patients undergoing hematopoietic cell transplantation. Pre-transplant assessment and care.

Hematopoietic cell transplantation (HCT) is now one of the frequent procedures used for treatment of malignant and non-malignant blood diseases, autoimmune disorders, and certain solid tumors. Despite improvements of therapeutic protocols, HCT still carries a high risk of non-relapse mortality due to early and late complications. Side effects of the therapy regimen frequently occur in the oral cavity and often significantly decrease the patients' quality of life. The complications may result from or may be exacerbated by improper oral preparation of the patient before transplantation. Therefore, it is mandatory that all patients referred to HCT undergo thorough dental examination and receive appropriate treatment before the procedure. It is also very important to develop an individual post-transplantation oral care protocol with special concerns to oral hygiene before implementation of the conditioning. This paper presents a review of dental management methods intended for patients before HCT proposed in literature as well as recommendations based on the experience of the Department of Comprehensive Dental Care and the Department of Conservative Dentistry of Warsaw Medical University and the Warsaw Institute of Hematology and Blood Transfusion. The article pays special attention to the problem of potential foci of infection and bleeding. It also presents protocol of oral hygiene in post-transplantation period, used by patients of Warsaw Medical University and Institute of Hematology and Blood Transfusion.

Prevalence of erosive lesions with respect to risk factors in a young adult population in Poland-a cross-sectional study.

OBJECTIVE: The study was conducted to investigate the prevalence of erosive lesions and related risk factors in the population of 18-year-old young adults in Poland. MATERIALS AND METHODS: Calibrated examiners measured erosive tooth wear according to Basic Erosive Wear Examination (BEWE) scoring system in 1869 patients and assessed the impact of risk factors with a questionnaire. RESULTS: Erosion was present in 42.3% of the patients. Early damage to the enamel was the most frequent finding (BEWE 1)-28.9%. More advanced lesions (BEWE 2) were observed in 12% of the patients. Advanced damage to the teeth (BEWE 3) was diagnosed rarely-1.4% of the examined population. Acidic diet, hygienic habits, and medical conditions such as asthma, eating disorders, and esophageal reflux showed statistical significance, as associated with erosion in the examined population. CONCLUSIONS: The present study indicates that dental erosion is a common oral disease in the 18-year-old population with prevalence of frequency and intensity in males. However, on the basis of observations carried out in recent years, it may be assumed that the prevalence of this type of lesion is increasing. CLINICAL RELEVANCE: Present findings support other longitudinal studies toward evaluation of the BEWE system as a valuable standard for assessing erosive and related risk factors among different populations.

[Epidemiological study of prevalence and risk factors for dental erosions among Polish young adults]. / Badania nad wystepowaniem erozji zebów i czynników ryzyka w populacji mlodych doroslych w Polsce.

UNLABELLED: Dental erosion for many years has been a pathology of secondary interest to dental public health authorities, but this point of view is changing. In recent years the occurrence and severity of erosive tooth wear seems to have increased. Various studies have shown that the prevalence of erosive tooth wear has particularly increased among younger population. AIM: Across-sectional oral health survey of randomly selected sample of 1886, 18-year old adults was carried out in Poland. Tooth wear was diagnosed according to BEWE index. Information about general health, oral hygiene habits, dietary habits, were gathered in a questionnaire. MATERIALS AND METHODS: Across-sectional oral health survey of randomly selected sample of 1886, 18-year old adults was carried out in Poland. Tooth wear was diagnosed according to BEWE index. Information about general health, oral hygiene habits, dietary habits, were gathered in a questionnaire. RESULTS: Out of 1886 young adults 42% had signs of dental erosion. Early damage to the enamel (BEWE 1) was diagnosed in 28.9% patients. More advanced lesions (BEWE 2) were observed in 12% of patients and the highest score (BEWE 3) was diagnosed in 1.4% of the examined population. About 85,7% of the population answered "I feel healthy", 2,7% had gastroesophageal reflux disease, 8,5% allergy, 2,7% asthma, 2,7% eating disorders. CONCLUSIONS: The present study indicate that the dental erosion is common oral disease in 18-year old population in Poland with prevalence of frequency and intensity in males. Acidic diet, hygienic habits and medical conditions such as asthma, eating disorders and esophageal reflux showed statistical significance, as associated with erosive in examined population. In this young adult sample 13,4% had signs of advanced tooth wear which may increase clinical problems in the future.

[Tooth erosion - a multidisciplinary approach]. / Erozje zebów - problem interdyscyplinarny.

During the last decades, an increasingly greater interest in dental erosion has been observed in clinical dental practice, in dental public health and in dental research because prevalence of erosive tooth wear is still increasing especially in young age group of population. Erosive tooth wear is a multifactorial etiology process characterized by progressive loss of hard dental tissue. It is defined as the exogenous and/or endogenous acids dissolution of the dental tissue, without bacterial involvement. In the development of dental erosive wear, interactions are required which include chemical, biological, behavioral, diet, time, socioeconomic, knowledge, education, and general health factors. Examples of risk groups could be patients with eating disorders, like anorexia nervosa or bulimia nervosa, gastroesophageal reflux disease, chronic alcohol abuse or dependence. Special nutrition habits groups with high consumption of soft or sport drinks, special diets like vegetarian, vegan or raw food diet, the regular intake of drugs, medications and food supplements can also increase the risk for dental erosion. Comprehensive knowledge of the different risk and protective factors is a perquisite for initiating adequate preventive measures.

Prevalence of dental erosion in young adults aged 18 years in Poland.

AIM: The aim of this study was to assess the prevalence of tooth wear in young adults in Poland. METHODS: A total of 1,886 persons aged 18 years, selected on a basis of multistage sampling, were examined within the Nationwide Dental Health Monitoring Programme. Previously calibrated dentists measured tooth wear using the BEWE-scoring system (Basic Erosive Wear Examination). RESULTS: Out of 1,886 young adults, 42.2% presented the signs of dental erosion. Considered the severity of erosion, it was graded as 1, 2 and 3 in 28.9%, 11.9% and 1.5% of 18-year-olds, respectively. CONCLUSIONS: Results of clinical assessment of dental erosion in 18-year-old young adults revealed that erosive tooth wear is an important problem in this age group. Of them, 13.4% had signs of advanced tooth wear which may lead to serious clinical problems in the future.

[Current attitudes to the elimination of infection foci from the oral cavity of adult patients qualified for allogeneic hematopoietic stem cell transplantation]. / Aktualne poglady dotyczace usuwania ognisk rakazenia z jamy ustnej doroslych pacjentów zakwalifikowanych do allotransplantacji macierzystych komórek krwiotwórczych.

Oral cavity is often the source of local and/or general complications in patients treated by allogeneic hematopoietic stem cell transplantation (alloHSCT). According to the literature dental treatment of an adult patient prior to transplantation is based on empiric protocols elaborated by oncological clinics for their individual needs. Suggested rules often differs between each other. I this article we present different attitude to the important problem of either removing or leaving the potential dentogenic foci of infection. The analysis of the literature suggest that the most appropriate procedure is to eliminate all potential and existing sources of infection before transplantation, as long as it is possible by the amount of time remaining before beginning the conditioning chemo/radiotherapy and by the general condition of a patient. In another case dental treatment should be postponed until the posttransplantation period.

Saliva secretion and abnormal moistening of oral mucosa after bone marrow transplantation.

Haematopoietic Stem Cell Transplantation (HSCT) is one of the methods to treat neoplasmatic blood diseases. This treatment is cause of several complications, some of which affecting the oral cavity. Patients who had undergone the treatment frequently experienced oral dryness some time thereafter. The aim of the study was to compare the level of moistening of the oral mucosa with the rate of secretion of the stimulated and non-stimulated saliva at various times after the patient underwent the bone marrow transplant. The study involved 46 patients 18 women and 28 men, aged 19 to 54 (mean 38.3 +/- 10.5 years), between 100 days and 6 years following the HSCT (mean 18.7 +/- 15.7 months). In each of the patients the over all look and moistening of the oral mucosa, as well as the rate of secretion of stimulated and non-stimulated saliva were assessed. Most of the HSCT patients had abnormal moistening of oral mucosa. Those with normal moistening exhibited average rates of both stimulated and non-stimulated saliva secretion significantly higher than patients with abnormal moistening of oral mucosa.