Psychological Functioning of Women Diagnosed with Lichen Planus and Other Diseases of the Oral Cavity-Explorative Study.

The role of psychosocial factors in the development of changes in lichen planus and other diseases of the oral cavity has been implicated, but is still understudied. Therefore, the aim of our study was to describe the specific profile of psychological functioning of patients with these diseases, including the role of temperamental traits, action-oriented personality components, and self-esteem. In total, 94 adult women participated in the study: (1) with lichen planus (LP; n = 46; Mage = 54.80, SD = 12.53), (2) with other oral conditions (n = 25; Mage = 34.76, SD = 16.03), (3) without chronic disease (n = 24; Mage = 40.96, SD = 13.33). The following questionnaires were used: ZKA-PQ/SF, Polish Adaptive and Maladaptive Perfectionism Questionnaire, ACS-90, PROCOS, and MSEI. Results indicated no significant differences in temperament dimensions between studied groups. However, women diagnosed with LP presented lower levels of maladaptive perfectionism and social support than healthy women. Furthermore, women with LP also obtained lower scores for social resourcefulness and higher scores for moral self-approval than healthy women. Summarizing, patients with LP often use compensatory mechanisms that negatively affect their social functioning; thus diagnostic/therapeutic programs directed towards those group should be holistic, including psychologists and psychiatrists who support patients' psychological well-being.

Biocompatibility of Subperiosteal Dental Implants: Effects of Differently Treated Titanium Surfaces on the Expression of ECM-Related Genes in Gingival Fibroblasts.

INTRODUCTION: Titanium alloys currently are the most used material for the manufacture of dental endosseous implants. However, in partially or totally edentulous patients, varying degrees of maxillary bone resorption usually occur, making the application of these devices difficult or even impossible. In these cases, a suitable alternative is offered by subperiosteal implants, whose use is undergoing a revival of interest following the introduction of novel, computer-assisted manufacturing techniques. Several procedures have been developed for the modification of titanium surfaces so to improve their biocompatibility and integration with bone. Information is, however, still incomplete as far as the most convenient surface modifications to apply with subperiosteal implants, in which an integration with soft mucosal tissues is just as important. OBJECTIVES: The present study aimed at evaluating whether different treatments of titanium surfaces can produce different effects on the viability, attachment, and differentiation of gingival fibroblasts, i.e., the cell type mainly involved in osteointegration as well as the healing of soft tissues injured by surgical procedures, in order to verify whether any of the treatments are preferable under these respects. METHODOLOGY: The human immortalized gingival fibroblast (CRL-4061 line) were cultured in the presence of titanium specimens previously treated with five different procedures for surface modification: (i) raw machined (Ti-1); (ii) electropolished (Ti-2); (iii) sand-blasted acid-etched (Ti-3); (iv) Al Ti Color™ proprietary procedure (Ti-4); and (v) anodized (Ti-5). At different times of incubation, viability and proliferation of cells, was determined along with the changes in the expression patterns of ECM-related genes involved in fibroblast attachment and differentiation: vinculin, fibronectin, collagen type I-alpha 1 chain, focal adhesion kinase, integrin ß-1, and N-cadherin. Three different experiments were carried out for each experimental point. The release from fibroblasts of endothelin-1 was also analyzed as a marker of inflammatory response. The proliferation and migration of fibroblasts were evaluated by scratch tests. RESULTS: None of the five types of titanium surface tested significantly affected the fibroblasts' viability and proliferation. The release of endothelin-1 was also not significantly affected by any of the specimens. On the other hand, all titanium specimens significantly stimulated the expression of ECM-related genes at varying degrees. The proliferation and migration abilities of fibroblasts were also significantly stimulated by all types of titanium surface, with a higher-to-lower efficiency in the order: Ti-3 > Ti-4 > Ti-5 > Ti-2 > Ti-1, thus identifying sandblasting acid-etching as the most convenient treatment. CONCLUSIONS: Our observations suggest that the titanium alloys used for manufacturing subperiosteal dental implants do not produce cytotoxic or proinflammatory effects on gingival fibroblasts, and that sandblasting acid-etching may be the surface treatment of choice as to stimulate the differentiation of gingival fibroblasts in the direction of attachment and migration, i.e., the features allegedly associated with a more efficient implant osteointegration, wound healing, and connective tissue seal formation.

Positive Effects of UV-Photofunctionalization of Titanium Oxide Surfaces on the Survival and Differentiation of Osteogenic Precursor Cells-An In Vitro Study.

INTRODUCTION: The UVC-irradiation ("UV-photofunctionalization") of titanium dental implants has proved to be capable of removing carbon contamination and restoring the ability of titanium surfaces to attract cells involved in the process of osteointegration, thus significantly enhancing the biocompatibility of implants and favoring the post-operative healing process. To what extent the effect of UVC irradiation is dependent on the type or the topography of titanium used, is still not sufficiently established. OBJECTIVE: The present study was aimed at analyzing the effects of UV-photofunctionalization on the TiO2 topography, as well as on the gene expression patterns and the biological activity of osteogenic cells, i.e., osteogenic precursors cultured in vitro in the presence of different titanium specimens. METHODOLOGY: The analysis of the surface roughness was performed by atomic force microscopy (AFM) on machined surface grade 2, and sand-blasted/acid-etched surface grades 2 and 4 titanium specimens. The expression of the genes related with the process of healing and osteogenesis was studied in the MC3T3-E1 pre-osteoblastic murine cells, as well as in MSC murine stem cells, before and after exposure to differently treated TiO2 surfaces. RESULTS: The AFM determinations showed that the surface topographies of titanium after the sand-blasting and acid-etching procedures, look very similar, independently of the grade of titanium. The UVC-irradiation of the TiO2 surface was found to induce an increase in the cell survival, attachment and proliferation, which was positively correlated with an increased expression of the osteogenesis-related genes Runx2 and alkaline phosphatase (ALP). CONCLUSION: Overall, our findings expand and further support the current view that UV-photofunctionalization can indeed restore biocompatibility and osteointegration of TiO2 implants, and suggest that this at least in part occurs through a stimulation of the osteogenic differentiation of the precursor cells.

The prevalence of contact hypersensitivity in patients with oral lichen planus.

Introduction: Oral lichen planus (OLP) is a chronic autoimmune inflammatory disease with an unknown aetiology and a higher prevalence in women. Oral lichenoid lesions both clinically and histologically resemble oral lichen planus and are often associated with contact allergy to dental materials. Aim: To investigate the prevalence of delayed hypersensitivity reactions in patients with OLP and to identify the most common allergens that may exacerbate the disease. Material and methods: Twenty patients diagnosed with OLP and undergoing treatment in the Gerodontology and Oral Pathology Department of the Poznan University of Medical Sciences were enrolled in the study. The subjects underwent a detailed oral examination consisting of anamnesis and a clinical evaluation by a qualified dentist, while an assessment of the skin and skin appendages was carried out by a dermatologist. Patch testing was performed using the Polish Baseline Series and Dental Screening Series. Results: Fifty percent of the examined patients displayed positive patch test reactions. A total of 18 allergic reactions were revealed, but only four appeared during the first test. The most common allergens were found to be nickel, gold, and a fragrance mix. Only 1 patient had a positive reaction to more than three allergens. Conclusions: There seems to be a high contact reaction rate in patients with oral lichen planus, which is not related to contact with synthetic dental materials. However, further investigations on a larger population with the introduction of additional tests administered 7 days after exposure are required to confirm the effects of delayed hypersensitivity reactions on patients with OLP exacerbation.

Periodontal status and the incidence of selected bacterial pathogens in periodontal pockets and vascular walls in patients with atherosclerosis and abdominal aortic aneurysms.

The aim of the study was to examine the periodontal status of patients with atherosclerosis and abdominal aortic aneurysms. The occurrence of 5 periodontopathogens was evaluated in periodontal pockets and atheromatous plaques together with specimens from pathologically changed vascular walls of aortic aneurysms. The study comprised 39 patients who qualified for vascular surgeries. Patients with periodontitis and concomitant atherosclerosis or aneurysms were enrolled in the study. Periodontal indices were evaluated, and subgingival plaque samples were examined together with atheromatous plaques or specimens from vascular walls to identify, by polymerase chain reaction (PCR), the following periodontopathogens: Porphyromonas gingivalis, Tanarella forsythia, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Treponema denticola. The majority of patients had chronic severe generalized periodontitis in stages III and IV. Laboratory investigations showed the occurrence of one or more of the five targeted periodontopathogens in 94.6% of the periodontal pockets examined. Of the examined periodontopathogens, only Porphyromonas gingivalis was confirmed in 1 atheromatous plaque sample collected from the wall of an aortic aneurysm. Therefore, the occurrence of this bacterium in these vessels was considered to be occasional in patients with chronic periodontitis.

Comparison of two optical devices used for artificial tooth color selection.

BACKGROUND: Correct color assessment and the selection of the color of the prosthetic restoration are important aspects of prosthetic treatment, which significantly affect the success of the treatment. OBJECTIVES: The aim of this study was to compare 2 commercial devices used for tooth color selection. MATERIAL AND METHODS: The color of maxillary right central incisors and right canines was assessed in a group 100 patients aged 22-40 years (25.11 ±3.24 years), using the Easyshade® spectrophotometer and the ShadeStar® colorimeter. Two visual shade guides were used as references for the tests - VITA VITAPAN® Classical and VITA 3D­Master. The 2 instruments and the 2 visual shade guides were assessed in terms of agreement in tooth color selection. RESULTS: There were statistically significant differences between the 2 instruments in terms of agreement in tooth color selection as well as between the 2 shade guides. The VITA VITAPAN Classical shade guide was shown to be more accurate in tooth color selection than VITA 3D­Master. There was agreement between the Easyshade spectrophotometer and ShadeStar colorimeter measurements for incisors in 49% of cases with the VITA VITAPAN Classical shade guide and in 22% of cases with VITA 3D­Master. In the comparative analysis of the Easyshade and ShadeStar devices with regard to the measurements performed on canines there was 52% agreement for the VITA VITAPAN Classical shade guide and 32% agreement for VITA 3D­Master. CONCLUSIONS: The VITA VITAPAN Classical system demonstrated superior agreement in shade selection as compared to the VITA 3D­Master system. A low degree of agreement between the optical devices used in the selection of the color of artificial teeth may indicate optical differences between devices from different manufacturers.

Oral health status of psoriatic patients managed with modern biological therapy.

Introduction: Psoriasis is a chronic multifactorial dermatosis with an autoimmune and genetic background, with characteristic periods of remission and exacerbation, affecting up to 3% of the population; it is currently regarded as a systemic disease. Aim: To investigate the oral health status, including oral mucosal lesion frequency and prosthetic treatment requirements, in psoriatic patients managed with biological therapies. Material and methods: Forty-two patients diagnosed with psoriasis and managed with biologics were enrolled in this study. All subjects completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The disease severity was assessed using the Psoriasis Area and Severity Index (PASI) scale and a DLQI questionnaire. To evaluate the oral health status, the following techniques were used: Approximal Plaque Index (API), the Community Periodontal Index (CPI), and the Decayed, Missing, and Filled Teeth (DMFT) index. The oral mucosa evaluation was based on the clinical appearance, location, and morphology of the lesions. Results: The most common oral lesions in patients with psoriasis were found to be fissured tongue and white coated tongue. Thirteen patients (31%) presented with clinically healthy oral mucosa. Type II (diffuse type) denture stomatitis (DS) was most common amongst psoriatic patients wearing acrylic removable dentures. Most of the subjects required prosthetic treatment (57.1 %) and the removal of calculus (40.5%); however, no one required surgical treatment. Conclusions: Fissured tongue seemed to be associated with skin lesions in psoriatic patients managed with biological therapies. The need for dental treatment was observed in 71.4% of the patients, with most subjects requiring prosthetic treatment. The study indicated that the diffuse type of DS occurred amongst subjects with psoriasis, who were wearers of acrylic removable dentures.

The effectiveness of topical forms of dexamethasone in the treatment of oral lichen planus- A systematic review.

The goal of this systematic review was to assess the efficacy of dexamethasone compared to other treatments in oral lichen planus (OLP). The literature search used the following inclusion criteria: randomized controlled trials (RCT) comparing dexamethasone and other treatment strategies in patients with OLP. The outcome measures included relief of symptoms, decrement of erosive area size, and changes in quality of life. A computer and manual search was performed in Pubmed, Web of Science, and Cochrane Library up to January 31, 2021. The risk of bias was measured with the Revised Cochrane risk-of-bias tool for randomized trials. Eight trials with 131 study participants and 132 controls were identified. The following interventions were compared dexamethasone mouthwash, and 5% methylene blue-mediated photodynamic therapy, low-level laser therapy, amlexanox, clobetasol mouthwash, ketoconazole with amitriptyline, and thalidomide 1% paste. The therapeutic outcomes were more advantageous for dexamethasone in comparison with photodynamic therapy (PDT) (2 RCT) and low-level laser therapy (LLLT). Comparable effects were observed for dexamethasone, amlexanox, thalidomide, and PDT (1 RCT). Clobetasol showed more effective action than dexamethasone. Given the small sample sizes, heterogeneity and the few studies included, there is limited evidence to support the selection of treatment for OLP.

A Comparison of Biomechanical Properties of Implant-Retained Overdenture Based on Precision Attachment Type.

This paper aims to compare, in vitro, the biomechanical properties of an overdenture retained by two bar-retained implants and an overdenture retained by two bar-retained implants with ball attachments. An edentulous mandible model was prepared for the study based on the FRASACO mold with two implants. In the first system, the "rider" type (PRECI-HORIX, CEKA) retention structure and the complete mandibular denture with the matrix were made. In the second system, the "rider" type retention suprastructure was also used. In the distal part, (CEKA) clips were placed symmetrically, and a complete mandibular denture, together with the matrix on the bar, and the clip patrices were made. A numerical model was developed for each system where all elements were positioned and related to geometric relations, as in reality. The FEA analysis (finite element analysis) was carried out for seven types of loads: with vertical forces of 20, 50, and 100 N and oblique forces of 20 and 50 N acting on individual teeth of the denture, namely central incisor, canine, and first molar. Displacements, stresses, and deformations within the systems were investigated. Maximum denture displacement in the first system was 0.7 mm. Maximum bar stress amounted to 27.528 MPa, and implant stress to 23.16 MPa. Maximum denture displacement in the second system was 0.6 mm. Maximum bar stress amounted to 578.6 MPa, that of clips was 136.99 MPa, and that of implants was 51.418 MPa. Clips cause smaller displacement of the overdenture when it is loaded but generate higher stress within the precision elements and implants compared to a denture retained only by a bar. Regardless of the shape of the precision element, small deformations occur that mainly affect the mucosa and the matrix.

Oral mucositis in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation in relation to the conditioning used prior to transplantation.

This study was designed to investigate the frequency and severity of oral mucositis in patients with acute myeloid leukemia after allogeneic hematopoietic cell transplantation, in relation to the type of conditioning used. Eighty patients diagnosed with acute myeloid leukemia were assigned to two groups based on the conditioning regimen used before transplantation. The intensity of oral inflammatory lesions induced by chemotherapy (oral mucositis) was evaluated according to a 5-point scale recommended by World Health Organization. Oral mucosa was investigated in all patients before the transplantation and during two subsequent stages of the post-transplantation procedure in relation to the conditioning regimen used. Mucositis in the oral cavity was observed in the majority of patients (66%) in the first week after transplantation, whereas the largest percentage of patients suffering oral lesions (74%) occurred in the second week after transplantation. A significantly higher percentage of patients with mucositis was observed in the group which underwent myeloablation therapy (74% of MAC and 50% of RIC patients in the first week; 83% of MAC and 53% of RIC patients in the second examination).The severity of mucositis after transplantation was higher in the MAC patients compared to the RIC patients. The highest mean value of the mucositis index was recorded in the second week in the MAC group (1.59). In AML sufferers receiving allo-HSCT, oral mucositis is a significant complication of the transplantation. This condition is more frequent and more severe in patients after treatment with myeloablation therapy.

Beta-defensin 1 gene polymorphisms in the pathologies of the oral cavity-Data from meta-analysis: Association only with rs1047031 not with rs1800972, rs1799946, and rs11362.

OBJECTIVES: The purpose of this meta-analysis was to reveal a potential association of the four functional polymorphisms in human Beta-defensin 1 (DEFB1) gene: rs1047031(c*5G > A) at 3'UTR and rs11362 (-20 G > A), rs1800972(-44 C > G), and rs1799946 (-52 G > A) at 5'UTR with the risk of common oral cavity pathologies that included periodontitis, caries, lichen planus, and recurrent aphthous stomatitis. METHODS: The relevant studies were obtained by the two researchers from PubMed, Scopus, and Web of Science up to April 29, 2020. The manual search of the reference lists was also performed. Studies on DEFB1 gene polymorphisms and oral cavity disorders, using the case-control genetic association analysis approach, and published as full texts in English were included. To assess the association strength, odds ratios (ORs) with their 95% confidence intervals (CIs) were extracted. RESULTS: Thirteen publications met the inclusion criteria and were incorporated in this meta-analysis. Statistically significant values of the association tests were found only for the rs1047031 polymorphism. Allele distribution in the rs1047031 polymorphism was significantly associated with susceptibility to oral cavity pathologies (adjusted P value = 0.003). The rare variant allele carriers had a significantly higher risk for oral disasters under recessive (CC vs CT + TT), and CC vs CT models. No significant correlations between rs11362, rs1800972, and rs1799946 and the risk of oral pathologies were revealed. CONCLUSIONS: Significant association between rs1047031 polymorphism and risk of oral pathologies has been found, and therefore, we suggest to include this polymorphism in future research concerning the genetic background of the oral cavity diseases.

Oral mucosal lesions in psoriatic patients based on disease severity and treatment approach.

BACKGROUND: This observational case-control study was designed to investigate the frequency of oral lesions in psoriatic patients and to identify an association between mucosal involvement, the severity of the disease, and a form of treatment. METHODS: One hundred twenty-seven patients diagnosed with psoriasis were enrolled in this study from November 2018 to September 2019. The oral mucosa evaluation was based on the clinical appearance, location, and morphology of the lesions. All patients completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The severity of skin involvement was assessed using the Psoriasis Area and Severity Index (PASI) scale. RESULTS: The most common oral lesions in patients with psoriasis were found to be fissured (FT), white coated (CT), and geographic tongue (GT). A significantly lower prevalence of GT was evident in the group managed with a new class of biological drugs and smokers. There appeared to be no association between the oral manifestation and the PASI score. FT appeared significantly more often in patients that experienced an extremely large effect of psoriasis on their quality of life as determined by the DLQI questionnaire and smokers. Only 25% of patients presented normal oral mucosa. CONCLUSIONS: Tongue lesions seem to be associated with skin psoriasis regardless of the treatment. The severity of the disease, according to the PASI scale, does not influence mucosal involvement. The type of treatment may affect the prevalence of oral lesions. Further investigations are required to confirm the influence of biological therapies on mucosal improvement.

Effect of artificial saliva on the mechanical properties of a polymer material reinforced with fiber, used in esthetic tooth restorations.

BACKGROUND: The oral environment can negatively affect the physical properties of fiber-reinforced composite (FRC) materials, which can lead to the deterioration of mechanical stability and reduce the span of their clinical usefulness. OBJECTIVES: The aim of this study was to determine the influence of artificial saliva on the selected mechanical properties of FRC. MATERIAL AND METHODS: The core of the polymer material selected for the study was a bundle of ultrahighmolecular-weight polyethylene (UHMWPE) fibers. Fourteen samples were stored in an incubator at 37°C, in 20 mL of artificial saliva solution, and weighed on days 1 and 28. At the same time, mechanical tests were performed, including the measurements of Young's modulus, tensile stress, maximum tensile force, and tensile deformation. RESULTS: The analysis of basic statistics together with the results of the Shapiro-Wilk test and the distribution of Spearman's rho coefficient showed a strong negative relationship between the pair of variables - tensile deformation and the sorption of synthetic saliva. The results related to Young's modulus of elasticity and tensile stress were not statistically significant. CONCLUSIONS: Water penetration into the space between the fibers does not adversely affect the mechanical properties of the material tested. In the static tensile test, high and desired mechanical strength was observed, which may justify the effective use of this type of material in clinical practice and may be a good alternative to prosthetic restorations, whose retention is obtained only through a mechanical connection with the abutment tooth.

Evaluation of the efficacy of treatment modalities in burning mouth syndrome-A systematic review.

OBJECTIVES: Burning mouth syndrome (BMS) is a medical entity characterised by a spontaneous sensation of burning, numbness or pain of the oral mucosa in the absence of clinical symptoms. The goal of this systematic review was to assess the efficacy of various current treatments for BMS. METHODS: The literature search used the following inclusion criteria: randomised controlled trials (RCTs) which compared one or more treatment strategies for patients with primary/idiopathic BMS with a placebo group describing all types of interventions. The primary and secondary outcome measures included: relief of pain/burning sensations, changes in psychosocial factors and feeling of sensation of dryness. A computer and manual search was performed in Pubmed, Web of Science and Cochrane Library up to 5 November 2019 and updated on 28 June 2020. The risk of bias was measured with the Cochrane Collaboration tool. RESULTS: Thirty RCTs which included 727 study participants and 589 controls were identified. The following interventions were introduced: dietary supplements, anticonvulsants, benzodiazepines, antidepressants, analgesics, topical agents, electromagnetic radiation or induction, physical barriers and psychological therapies. The most successful therapeutic outcomes were observed for clonazepam tested in 3 RCTs, where significant pain reduction appeared after both topical and systemic application. Evident pain reduction was also reported for tongue protectors and capsaicin in 2 separate studies. DISCUSSION: Short follow-up periods, low numbers of participants, variability of the metrics used in the evaluation of the results and heterogeneous study design were the main limitations of the reviewed studies. Based on our analysis, clonazepam appears to be the most effective treatment option for BMS.

Low-level laser therapy in the treatment of recurrent aphthous stomatitis and oral lichen planus: a literature review.

Recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) present inflammatory, recurrent diseases of the oral mucosa with not fully understood aetiology. Despite numerous attempts to discover an effective treatment for RAS and OLP, the current main treatment strategies are largely confined to the reduction of symptoms. Low-level laser therapy (LLLT) is of interest as a novel treatment modality. The aim of the paper was to discuss the mechanism of action and the biological effects of LLLT and to critically review and summarize recent clinical reports on the management of RAS and OLP. Most of the studies demonstrated the beneficial effect of LLLT in accelerating the healing process and pain reduction. However, the results should be interpreted with caution due to the limited number of studies available and empirical design using various irradiation parameters.

Evaluation of human osteoblast metabolic activity in modified titanium-conditioned medium.

To evaluate human osteoblast metabolic activity cultured in medium conditioned with commercially pure titanium after surface treatments with alumina or ceramic grit-blasting followed by acid etching. Commercially available, pure Grade 4 titanium disks were used and subjected to seven different surface modifications: (1) machined (MA)-used as the control group; (2) blasted with Al2O3 (Al2O3); (3) blasted with sintered ceramic (HAS); (4) blasted with non-sintered ceramics (HA); (5) blasted with Al2O3 and etched with HCl/H2SO4 (Al2O3 DE); (6) blasted with sintered ceramic and etched with HCl/H2SO4 (HAS DE), and (7) blasted with non-sintered ceramic and etched with HCl/H2SO4 (HA DE). A samples roughness evaluation test was carried out with an interference microscope, and energy-dispersive X-ray spectroscopy was performed to evaluate the presence of aluminum, phosphorus, and calcium deposited during the titanium surface treatment along with carbon contaminants acquired by the surface during processing. A culture medium conditioned with the respective samples was prepared in five dilutions, and its effect on human osteoblast cell viability was evaluated using the relative viability of cells. Human osteoblast metabolic activity was found to be the most intensive for the Al2O3 DE sample. The lowest activity was observed for the HAS DE. The material's cytocompatibility depended on both the surface roughness and its chemical composition. Etching had a dual effect on cell activity, depending on the chemical composition of the titanium surface after blasting.

Effects of different light sources on tooth shade selection.

BACKGROUND: Differences in lighting conditions can make matching the shade of a single porcelain tooth to the natural adjacent teeth very challenging. OBJECTIVES: The purpose of the study was to examine visual shade selection under 3 different light sources - natural daylight, a dental operating light and a color-corrected light. MATERIAL AND METHODS: The visual assessment was based on a comparison between a shade guide and the target tooth. One observer with normal color vision was asked to visually match the color of the maxillary central right incisor and the maxillary right canine in a group of 100 subjects, aged 22-40 years. Two shade guides were used - VITA Vitapan Classical® and VITA 3D Master® - in natural daylight as well as under an operating light and a handheld light (Demetron Shade Light®). The VITA Easyshade® spectrophotometer was used to evaluate the results of the visual shade selection method. RESULTS: Significant differences were found between the effects of using the shade guide systems (p < 0.05) and light sources (p < 0.05). Overall, the use of the Vitapan Classical shade guide significantly improved the correlation between visual matching and the spectrophotometer readings. CONCLUSIONS: Within the limitations of this study, the Vitapan Classical shade guide demonstrated superior agreement in shade selection as compared to the 3D Master shade guide. The Demetron Shade Light was proven to be a useful device for the color matching of artificial teeth in prosthodontic treatment. Visual tooth color matching is a subjective method and it produces the best results under a color-matching light.

Scarlet fever - a diagnostic challenge for dentists and physicians: A report of 2 cases with diverse symptoms.

Scarlet fever is an infectious disease caused by group A streptococcal bacteria, transmitted mainly through direct contact with the saliva and nasal fluids of infected people. It may also arise from streptococcal wound infections or burns. The disease most commonly affects children aged 5-15 years and manifests as a sore throat, fever and a sandpaper-like, papular skin rash. Due to the evident involvement of the oral structures, the awareness of the symptoms of scarlet fever is essential for dentists in order to avoid the spread of this highly contagious disease in crowded places, such as kindergartens and schools. As no vaccine is available to prevent scarlet fever, the early diagnosis and treatment of this condition are important in reducing the risk of developing local and systemic complications, which include acute rheumatic fever, glomerulonephritis, bacteremia, pneumonia, endocarditis, and meningitis. In this report, 2 cases of scarlet fever are described in unrelated children with diverse symptoms, and diagnostic and therapeutic strategies are discussed.

Low-level laser therapy (LLLT) in the treatment of recurrent aphthous stomatitis (RAS) - a promising treatment option: A report of two cases.

Recurrent aphthous stomatitis (RAS) is a chronic, ulcerative condition of the oral mucosa that affects 10-25% of the population. The etiopathogenesis of the disease is not fully understood, although a polygenic mode of inheritance and immunological dysregulation have been suggested in several studies. The contribution of numerous predisposing factors, such as a deficiency of iron, vitamin B12 or folic acid, trauma, emotional stress, endocrine disturbances, or allergy, have also been considered. So far, no causative treatment for RAS has been developed; instead, topical and systemic drugs are used to reduce pain and inflammation, and to lengthen the period of remission. Low-level laser therapy (LLLT) is a non-invasive and atraumatic therapeutic method that involves the local application of a high-density, monochromatic, narrow-band light source. With the use of the appropriate power and wavelength, the therapy brings anti-inflammatory and analgesic results, and wound healing is promoted. Several reports on the beneficial effects of LLLT in RAS have been presented recently. This report describes 2 cases of adult patients with RAS treated with LLLT to relieve pain and promote the healing of the ulcers. The clinical presentations with the signs and symptoms are discussed and illustrated, along with the treatment algorithms and outcomes.