Aim of the study: The aim of this study is to determine the values of salivary enzyme biomarkers (alkaline phosphatase – ALP, aspartate aminotransferase – AST and lactate dehydrogenase – LDH) in subjects with healthy and diseased periodontium and to investigate the possibility of using these salivary enzymes as diagnostic and prognostic markers. Methods: We collected saliva with the spitting method from all examinees in the morning, using the recommendations provided by Navazesh. The values of the enzymes in saliva were determined spectro-photometrically, with the following methods: ALP-IFCC, AST-IFCC, LDH-PYRUVATE. IGI Silness-Löe was used to determine the presence of gingival inflammation, and to determine the presence of clinically manifest periodontitis, we determined the clinical loss of periodontal attachment with a graduated periodontal probe. For statistical purposes, we used the method of ANOVA Chi Square and Student’s t-test. Results: The difference in the average salivary AST and LDH values between the first and the second group, as well between the first and third group is statistically significant (p < 0.000). The difference in the average salivary AST and LDH values between the examinees with gingivitis and the examinees with clinically manifest periodontal disease is statistically insignificant (p < 0.485101 for AST, p < 0.816665 for LDH). The difference in the average salivary levels of ALP between the three groups is statistically significant (p < 0.000). Conclusion: The salivary levels of AST, LDH, and ALP can be used as diagnostic markers, while ALP can also be used as a prognostic marker for periodontal disease.
The therapy of erosive lichen planus (ELP) has been particular problem in the treatment of oral lesions. This case of ELP in male patient 29 years old was treated with topic application of the NBF gingival gel, three times a day after meal, previously rinsed with Clorhexidine gluconate 0.12%. After 5 days of treatment, initial improvements were recorded, and after two weeks of application of the NBF gingival gel we observed significant improvement. Clinical monitoring after the fifth day showed mild epithelialization of the eroded mucosa, yet still present erythematous base of the lesion. After the second week the erythema area was significantly reduced and the eroded surfaces of the mucosa were minimal, measured less than 0.5 mm. After the third week there were no erosions to detect on the oral mucosa, yet still present vague redness, which completely pulled after the fourth week. Treatment ended after the fifth week when the topical application of the NBF gingival gel was terminated, and therapy was done, and clinically achieved effects remained stable even after the third month of the treatment. Topic application of the NBF gingival gel with ELP patients showed positive clinical effects in relatively short time period.
BACKGROUND: The advanced periodontal disease is characterised by a strongly pronounced loss of attachment and reduction of the alveolar bone support, which leads to luxation, migration of the teeth, functional discomfort and poor facial aesthetics. CASE PRESENTATION: The aim of this paper is to present the case of a 26-year-old female patient, registered at the Clinic of Periodontology with highly expressed gingivitis, unsatisfactory periodontal status, presence of diastemas between the frontal teeth and attachment loss of 5-6 millimetres in different areas. We conducted a thorough classic periodontal treatment, as well as training for proper maintenance of oral hygiene, with frequent professional oral-prophylactic sessions, complemented with orthodontic treatment. Fixed orthodontic appliances were installed, and mild forces were applied for gradual levelling of the teeth, with constant control of the periodontal status. After 20 months of treatment, the patient was in retention. CONCLUSION: Orthodontic therapy of periodontally-affected teeth can begin only after exhaustive administration of a periodontal treatment. Orthodontic treatment as an addition to the periodontal restoration must be gradual with mild forces for an optimal dental response, thus helping to improve function, facial aesthetics and psychological confidence of adult patients.
Primary purpose of restorative dentistry is to preserve pulp vitality. Besides calcium hydroxide, the application of calcium silicate cements as a material for direct pulp capping has become used recently. The aim of our study was to investigate the influence of materials for direct and indirect pulp capping on the bond strength of composite restorations using two different self etch dentin adhesives. The test was performed on 60 intact molars extracted for periodontal or orthodontic reasons. The prepared samples were divided into the two groups and three subgroups depending on the adhesive and pulp cupping material. Two different calcium silicate based materials were used for pulp cupping. One step and two steps self etch dentin adhesive was applied to prepared specimens depending on the group and with the help of a specially made metal mold set up a composite post. The share bond strength was assessed using a universal testing machine. The results showed significant difference in the share bond strength between the samples treated with TheraCal LC and Biodentine with TheraCal LC being superior to Biodentine.
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