Background/Aim: Oral cancer is one of the ten most common cancers in the world, recently positioned as a sixth one, unfortunately with poor prognosis after treatment because of the late diagnostics in advanced stages of the disease. Aim of this study was to present the basic criteria in assessment the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the conventional oral examination (COE) as the easiest and most acceptable procedure in detection of the early changes of the suspicious oral tissue changes compared to the diagnostic gold standard – tissue biopsy in two different groups of examinees.
Material and Methods: Sixty patients divided into two study groups (one with potentially malignant oral lesions and a second consisted of clinically suspicious oral cancer lesions) were examined with COE and subjected to histopathological confirmation - tissue biopsy. All examined patients underwent the diagnostic protocol by the American Joint Commission on Cancer, selected under certain inclusion and exclusion criteria.
Results: Sensitivity of COE in the group of examinees with oral potentially malignant lesions is 83.33%, its specificity is 20.83%, the positive predictive value is 20.83% and the negative predictive value is 83.33%. The accuracy of the COE method is 33.33%. The sensitivity, in the group of patients with oral cancer is 96.43%, specificity is 0%, the positive predictive value is 93.10% and the negative predictive value is 0%. The accuracy of this method is 90%.
Conclusions: The accuracy reaches a value over 90% for the group with lesions with highly suspected malignant potential – oral cancer, and sets the thesis that COE as screening method for oral cancer or premalignant tissue changes is more valuable for the patients with advanced oral epithelial changes, but is recommended to be combined with some other type of screening procedure in order to gain relevant results applicable in the everyday clinical practice.
Recurrent aphthous stomatitis (RAS) is a quite frequent, painful, ulcerative disease that affects the lining of the oral cavity and has an unknown etiology. The aim of this article is to examine the impact of the medication proaftol on epithelization speed and severity of pain in patients with RAS. In this randomized, double-blind, placebo-controlled study respondents were divided into two groups where one group was treated with proaftol spray and the other with a placebo. Aphthae considered for treatment had a diameter of 5-6 mm. The participants were given instruction on the use of the spray, two sprayings on the place of the aphtae 3-4 times a day. We examined two parameters in the symptomatology of RAS-lesion size (mm) and pain intensity (noted on four subjective levels: 0-no pain, 1-discomfort, 2-moderate pain, 3-severe pain). These parameters were noted on the baseline, the third, the fifth and the eighth days of examination.
Results: A significant faster reduction of the dimension of aphthous ulcers in patients treated with proaftol 3rd day p < 0.001, 5th day p < 0.0006, 8th day full epithelization in the control group. The magnitude of pain in the experimental compared with the control group on 3rd, 5th and 8th day was also significantly reduced: p < 0.0001, p < 0.007, p < 0.007 respectively.
Conclusion: The use of proaftol positively influences the rate of epithelization and reduction of subjective feeling of pain in patients with RAS. The action of propolis should be the goal of studies with a larger number of subjects.
Introduction. Kidney disease is associated with many abnormalities in the oral health status as well as with alterations in salivary flow and composition. The aim of this study was to evaluate and to correlate oral clinical findings, salivary flow (SF) and salivary pH values in patients with chronic kidney disease (CKD) not yet on hemodyalisis treatment, those undergoing hemodialysis and in kidney transplant recipients.
Methods. In a cross-sectional study 90 patients were included. The cohort was composed of three groups: 30 patients with CKD (serum creatinine values under 120 μmol/L-group 1), 30 patients with CKD on hemodialysis (group 2) and 30 kidney transplanted patients (group 3). The control group consisted of 20 healthy individuals. Oral symptoms, signs and lesions: salivary volume, salivary pH and SF of stimulated and unstimulated saliva were evaluated.
Results. Among patients with CKD without dialysis treatment inverse relationship was found between uremic fetor, unpleasant taste and unstimulated SF and also between xerostomia and stimulated SF. Negative correlation between thirst and unstimulated salivary flow was found in both groups, patients with CKD on dialysis and kidney transplant group. Furthermore, in kidney-transplant patients a negative correlation was found between petechiae and SF, while in group of patients with CKD on hemodialysis the same negative correlation was registered between uremic fetor and stimulated SF.
Conclusions. Salivary flow was significantly lower in hemodialysis patients, while the highest was in the kidney-transplant recipients accompanied with improvement in the other oral clinical findings observed in our study.
Aim:To determine whether there is an immunogenic connection and antigen difference between the HLA antigens in the erosive (EOLP) and reticular (ROLP) oral lichen planus.
Materials and Method: 73 patients with ROLP and EOLP have been tested. Typing of the HLA antigens has been made for locus A and B. The typing of the HLA was conducted with the use of microlymphocyto toxic test by Terasaki. The reading of the findings has been conducted with an inverse microscope. When a reaction has 4 points it is considered to be positive.
Results: The most frequently typified antigens in ROLP from locus A are HLA А2 (57.57%) and А3 (33.33)%, and for locus B 21.21%. In EOLP it is А9 (8888%). In locus B a connection has been found with HLA B8 (77.77%). The statistical analysis with the ×2 test has shown that the carriers of HLA A9 display a relative risk (RR) of 3.65 and ×2=20.72. Consequently, there is high static importance for locus A p<0,001. For locus B, In EOLP for HLA B8, RR=6. 7 ×2=37.64 and p<0,001. ROLP has shown association with HLA A3, where RR=2. 31 and ×2 =9.14 and p<0.05.
Conclusions: In ROLP A3 antigen and in EOLP A9 and A8 may be considered as carriers with proneness to OLP.
Background/Aim: to examine the connection of H. Pylori in saliva and biopsy material with oral lesions.
Material and Methods: Sixty patients with dyspeptic complaints were followed up at the Clinic for Gastroenterology at University Medical Clinical Centre in Skopje, divided into two groups: first group consisted of 30 patients without presence of H. pylori, and the second group with 30 subjects and presence of H. pylori. The presence or absence of H. pylori has been ascertained after endoscopic examination-gastroscopy, and implemented urease test (CLO-test). All patients were clinically followed in order to determinate mouth burning, recurrent aphthous stomatitis (RAS), acid taste and lingual papillary hyperplasia according to Cohen and Proctor. The presence of H. pylori in saliva has been ascertained before endoscopic examination, after chewing Orbit gum without sugar for 1 min using by Pronto dry test. Determination of H. pylori in biopsy material has been ascertained by rapid urease test (RUT).
Results: At 30 patients with dyspeptic complaints and presence of Helicobacter pylori, 16 patients (53,33%) had lingual papillary hyperplasia, acid taste, burning mouth and recurrent aphthous stomatitis (RAS). At 4 patients (13,33%) was confirmed acid taste, and also at 4 patients (13,33%) burning mouth. At 2 patients (6,67%) was confirmed lingual papillary hyperplasia, burning mouth, and recurrent aphthous stomatitis (RAS). At the same time, at 2 patients (6,67%) was confirmed burning mouth, and recurrent aphthous stomatitis (RAS), until at 1 patient (3,33%) lingual papillary hyperplasia, as at 1 patient (3,33%) lingual papillary hyperplasia and acid taste. At patients without presence of Helicobacter pylori but with dyspeptic complaints, was confirmed burning mouth in 14 patients (46,67%), lingual papillary hyperplasia, burning mouth, and acid taste in 7 patients (23,33%); in 3 patients (10,00) lingual papillary hyperplasia, burning mouth, and in 2 patients (6,67%) was confirmed recurrent aphthous stomatitis (RAS). Acid taste was registered in 2 patients (6,67%), and also lingual papillary hyperplasia in 2 patients (6,67%). There was a significant differences in clinical aspect between the patients with and without presence of H. pylori, for p< 0,01(p= 0,002); Pearson Chi-square= 20,10 и and p<0,05(p= 0,01).
Conclusions: H. pylori in saliva and biopsy material detected with CLO test are reason for oral lesions at patients with dyspeptic complaints who have the presence of H. pylori.
Aim: To examine the role of IgA, CIC and component C3 as indicators of humoral immune response in the etiopathogenesis of oral erosive lichen planus (OELP).
Material and method: The study comprised 19 patients with OELP whose samples of blood, saliva and tissue were obtained after carefully taken medical history and clinical examination. Samples of oral mucosa were taken from the site of lesion, i.e. exclusively from buccal mucosa (1 cm in width and length), and from the deep epithelium as well as a segment from the lamina propria. Determination of immunoglobulins in serum and saliva, and determination of component C3, was done using the micro-elisa technique by Rook & Cameron, Engvall and Ulman. Determination of CIC in serum and mixed saliva was done with the PEG (polyethylene glycol) method. Determination of immunoglobulin A and component C3 in biopsy material was done with direct immunofluorescence.
Results: Levels of immunoglobulin A in serum in OELP during exacerbation were decreased (1.04 ± 0.49 gr/l) and during remission increased (5.92 ± 0.62) in comparison with the control group (p < 0.001). Levels of CIC during exacerbation and remission were increased (p < 0.001), and component C3 levels were increased in both examined phases in the examined group compared with the control group (p < 0.05). Deposits of IgA were registered in one (5.88%) patient with OELP and component C3 was registered in 3 (17.64%) patients.
Conclusion: Changes in IgA values, as well as CIC and component C3, may correlate with changes in oral mucosa emphasizing the role of humoral immune response in the pathogenesis of oral lichen planus.