Oral Cavity Of Patients Research Articles

PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Background: Despite innovations in orthopedic dentistry, the manufacture of removable dentures belongs to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. According to the WHO, one-fifth of the world s population suffers or has suffered various candidiasis forms at least once. The worldwide increase in the incidence of the disease is primarily related to the fact that this infection is opportunistic, more than half of the world s population is a carrier of fungi of this kind, i.e., in most cases, it is an endogenous infection, which makes candidiasis different from other opportunistic mycoses. Aims: The purpose of this study was to study the prevalence of candidiasis in patients using removable dentures and to evaluate the effectiveness and prevention of candidiasis treatment. Methods: 100 patients with oral candidiasis of various age groups from 45 to 65 years were observed. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Results and Discussion: Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis-60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. Conclusions: The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

Condition of the oral cavity in patients who have had a viral infection COVID-19

Coronavirus COVID-19 is the cause of severe respiratory pathology and is a dangerous disease, proceeding in various clinical forms with varying degrees severity. This scientific paper presents a literature review of the latest collected data on the course of the novel coronavirus infection COVID-19 and its manifestations in the oral cavity during illness and after convalescence. The transmission routes of the disease and the main symptoms are also described. All healthcare systems in the world have been tasked with prompt diagnosis of coronavirus infection, specialized medical care and rehabilitation. In COVID 19 (SARS-CoV-2), changes in OOM are not the primary cause, but are manifested as a result of drug treatment and disease progression, despite the fact that the oral cavity is one of the sources of entry gate for infection.

Oral lichenoid contact lesions related to dental metal allergy may resolve after allergen removal

Background/ purposeDistinguishing oral lichenoid contact lesions (OLCLs) from oral lichen planus (OLP) is challenging. This study aimed to identify clinicopathological findings to distinguish OLCLs from OLP, and to evaluate the effectiveness of removing metal allergens in the treatment of OLCLs. Materials and methodsThis study retrospectively evaluated 30 patients diagnosed with OLCLs, and 30 age- and sex-matched OLP patients. We also evaluated the effectiveness of removing dental metal containing positive metal allergen, confirmed by skin patch test and metal component analysis in patients with OLCLs. ResultsPalladium and gold were the most common patch test-positive metals observed in the oral cavity of patients with OLCLs. The patients with OLCLs were more likely to present with white type lesions in the buccal mucosa and gingiva than were the patients with OLP (p = 0.030, 0.009, respectively). Overall, 50.0% of patients with OLCLs failed to meet the histopathological diagnostic criteria of OLP. Twenty-three of 24 (95.8%) patients with OLCLs showed a complete or partial improvement after the removal of dental metal. ConclusionThe present findings suggest the importance of a skin patch test and metal component analysis to confirm suspected OLCLs related to dental metal allergy, as these lesions may improve with the removal of the allergy-inducing metal.

Candida species biotypes and polyclonality of potentially virulent Candida albicans isolated from oral cavity of patients with orofacial clefts.

This study evaluated the incidence of Candida species, and the genetic diversity and virulence of C. albicans of the oral cavity from patients with cleft lip and palate (CLP). Oral samples were investigated by microbiological and species-specific PCR methods. The genetic diversity of C. albicans was established using isoenzyme markers, Nei's statistics, and clustering analysis. Hydrolytic enzymes (SAPs and PLs) were analyzed in vitro. Oral colonization by Candida species was observed in 29 patients with CLP (65.9%), and C. albicans was highly prevalent. SAP and PL activities were observed in 100% and 51.9% of isolates, respectively. High genetic diversity and patterns of monoclonal and polyclonal oral colonization by C. albicans were observed among patients with CLP. Two major polymorphic taxa (A and B) and other minor polymorphic taxa (C to J) were identified. Only one of the 16 clusters (taxon A) harbored strains from patients with and without CLP, whereas other clusters harbored strains exclusively from CLP patients. The anatomical conditions of the oral cavity of patients with CLP contribute to the high incidence of Candida species (C. albicans, C. krusei, C. tropicalis, and/or Candida spp.). Data suggest high genetic diversity of potentially virulent C. albicans strains in the oral cavity of CLP patients. Microbiological niches in orofacial clefts can contribute to the emergence of a relative clinical genotypic identity of C. albicans. However, orofacial rehabilitation centers can contribute to the direct and indirect sources of transmission and propagation of Candida species.

Impact of High-Altitude Hypoxia on Early Osseointegration With Bioactive Titanium.

Nowadays, the bone osseointegration in different environments is comparable, but the mechanism is unclear. This study aimed to investigate the osseointegration of different bioactive titanium surfaces under normoxic or high-altitude hypoxic environments. Titanium implants were subjected to one of two surface treatments: (1) sanding, blasting, and acid etching to obtain a rough surface, or (2) extensive polishing to obtain a smooth surface. Changes in the morphology, proliferation, and protein expression of osteoblasts on the rough and smooth surfaces were examined, and bone formation was studied through western blotting and animal-based experiments. Our findings found that a hypoxic environment and rough titanium implant surface promoted the osteogenic differentiation of osteoblasts and activated the JAK1/STAT1/HIF-1α pathway in vitro. The animal study revealed that following implant insertion in tibia of rabbit, bone repair at high altitudes was slower than that at low altitudes (i.e., in plains) after 2weeks; however, bone formation did not differ significantly after 4weeks. The results of our study showed that: (1) The altitude hypoxia environment would affect the early osseointegration of titanium implants while titanium implants with rough surfaces can mitigate the effects of this hypoxic environment on osseointegration, (2) the mechanism may be related to the activation of JAK1/STAT1/HIF-1α pathway, and (3) our results suggest the osteogenesis of titanium implants, such as oral implants, is closely related to the oxygen environment. Clinical doctors, especially dentists, should pay attention to the influence of hypoxia on early osseointegration in patients with high altitude. For example, it is better to choose an implant system with rough implant surface in the oral cavity of patients with tooth loss at high altitude.

Клинико-патогенетические особенности суставного синдрома при ревматоидном артрите с коморбидным пародонтитом

Актуальность. Накопление бактерий в полости рта больных ревматоидным артритом (РА) повышает частоту развития поражений тканей пародонта, но существует и обратная связь обоих заболеваний, когда коморбидный пародонтит способствует возникновению РА. Эндотоксемия, вызванная пародонтитом, может повышать чувствительность больных РА к аутоантигенам, участвовать в патогенетических построениях обоих заболеваний. РА и пародонтит имеют сходную остеоклазию, аллельные гены и общий дисбаланс состояния цитокиновой сети. Цель и задачи исследования: изучить у больных РА частоту и характер течения коморбидного хронического генерализованного пародонтита, определить его этиологические факторы, оценить степень влияния на клинические и рентгеносонографические признаки суставного синдрома. Материалы и методы. Под наблюдением находились 173 больных РА в возрасте 18–76 лет (в среднем 46 лет), среди которых было 20,8 % мужчин и 79,2 % женщин. Продолжительность от первой манифестации заболевания составила в среднем 10 лет. Частота серопозитивности РА по ревматоидному фактору в крови составила 74,6 %, а по антителам к цитруллиновому циклическому пептиду — 72,8 %. І, ІІ и ІІІ степени активности болезни соответственно констатированы в 26,0; 43,9 и 30,1 % случаев, а соотношение I, II, III и IV стадий патологического процесса составило 1 : 6 : 5 : 3. Для оценки количества аэробных и факультативно-анаэробных микроорганизмов, вегетирующих на слизистой оболочке десен, использовалась методика стерильных бумажных дисков. Проводили клиническое, рентгенологическое и ультразвуковое исследование суставов, изучение биохимических, иммуноферментных и физико-химических показателей крови и смывов полости рта, определение интегральных тяжестей течения основной и коморбидной патологии. Результаты. Хронический генерализованный пародонтит диагностирован у 45,7 % от числа больных РА (соотношение мужчин и женщин 1 : 4), развитие которого было тесно связано с активностью и стадией суставного синдрома, наличием системного остеопороза, серопозитивностью заболевания по ревматоидному фактору и антителам к циклическому цитруллиновому пептиду, причем в этиологии пародонтита первостепенное значение отводится моракселлам, псевдомонам, стафилококкам, стрептококкам, бактериоидам, эубактериям, фузобактериям, пропионибактериям и сарцинам, а в его патогенезе — интерлейкину-1β, при этом сама патология полости рта участвует в патогенетических построениях остеопороза, поражений верхнечелюстных, лучезапястных и коленных суставов, в формировании артрокальцинатов и развитии синдрома Шегрена. Выводы. Полученные данные диктуют необходимость разработки новых подходов к медицинской технологии индивидуальной патогенетической терапии РА с учетом наличия и этиологии коморбидного пародонтита, выделения критериев, позволяющих оценивать активность патологического процесса, прогнозировать характер течения болезни и эффективность лечебных мероприятий.

Clinical evaluation of complex treatment and prevention of generalized periodontitis in patients with type I diabetes mellitus with cardiomyopathy

Annotation. Diabetes mellitus is an acute problem, as evidenced by the large number of people suffering from this disease, and the tendency to significantly increase the incidence rate. The most serious complications of diabetes include cardiomyopathy, the pathogenetic aspects of which are being actively studied. Widespread inflammatory-dystrophic periodontal disease and an increase in the proportion of generalized periodontitis in patients with diabetes mellitus complicated by cardiomyopathy, makes the problem of effective treatment and prevention of this pathology among the most relevant. The purpose of the study: clinical evaluation of complex treatment and prevention of generalized periodontitis in patients with type I diabetes mellitus with cardiomyopathy according to the developed algorithm. Comprehensive treatment and prevention measures were performed in 127 patients with generalized periodontitis on the background of type I diabetes mellitus with cardiomyopathy, of which 82 patients were the main group, where treatment was carried out using our proposed treatment and prevention algorithm. The control group, in which treatment was carried out according to protocol methods, consisted of 45 patients. Clinical visual examination and determination of paraclinical indices were performed on day 30 after treatment. Statistical calculation of digital values was performed on a Pentium II computer using the statistical software package “Statgraphic 2.3” and “Microsoft Excel 2000”, the significance of changes was evaluated by t-test. As a result of the research it was found that on average, 30 days after treatment, in the main group where we used the proposed pharmacotherapy, “normalization” of periodontal tissues was studied in 26.83 % of patients, “improvement” – in 30.49 % of patients’ treatment was ineffective in 42.68 % of patients, with a reliability of p>0.05. In patients of the control group, where traditional treatment and prevention measures were used to treat generalized periodontitis, on average, “normalization” of periodontal tissue was recorded in 17.78 % of patients, “improvement” of periodontal tissue was found in 28.89 % of patients. Treatment was ineffective in 53.33 % of patients. Thus, as a result of research, it can be argued that in patients with generalized periodontitis on the background of type I diabetes mellitus complicated by cardiomyopathy, whose treatment was carried out using our treatment and prevention algorithm, which included local measures and general appointments, significantly improved periodontal tissues, as confirmed by clinical observation. In the control group, where traditional treatment regimens were used, the treatment of generalized periodontitis was ineffective. In further studies, it is planned to study the microbiome of the oral cavity in patients with generalized periodontitis on the background of type I diabetes mellitus complicated by cardiomyopathy.

Algorithm of diagnosis and treatment of patients with distal occlusion in the period of replacement bite

The purpose of the work is to establish the degree of influence of various modifiers on the course of chronic generalized periodontitis. We examined 83 periodontal patients. During the examination, in addition to the obligatory volume, data on somatic burden and dependence on smoking were included with the determination of the number of cigarettes smoked per day. Bleeding of the gums was determined in the area of all teeth. To determine the rate of progression of periodontitis on the basis of orthopantomogram data, an indirect indicator was calculated — the decrease in the alveolar bone in relation to the patient's age. It was established by the research that the modeling of periodontitis, with an identical hygienic state of the oral cavity of patients, is affected by concomitant somatic pathology, especially diabetes mellitus, making the course of periodontitis worse; and also a bad habit — smoking, which contributes to more pronounced vascular changes in the periodontium in patients with clinical manifestations of periodontitis. Recommendations are given to take into account the concomitant pathology of internal organs and the degree of dependence of patients on tobacco smoking when planning periodontal treatment, in order to correct these risk factors and motivate the patient to cooperate with a doctor.

ХАРАКТЕРИСТИКА КЛИНИЧЕСКИХ И МИКРОБИОЛОГИЧЕСКИХ ПОКАЗАТЕЛЕЙ ПОЛОСТИ РТА У ПАЦИЕНТОВ С ПАРОДОНТИТОМ И ГИПОТИРЕОЗОМ НА ФОНЕ КЛИНИЧЕСКОЙ ТЕРАПИИ С ПРИМЕНЕНИЕМ СИНБИОТИКА

Subject. Microbial landscape of the oral cavity is a highly sensitive systemic indicator reacting to changes in different body organs and systems by qualitative and quantitative shifts. The unique ability of microbiocenosis of the oral cavity to self-regulate and maintain the ecological balance creates a personal health profile of an individual and assumes that a timely correction of microbiocenosis shall be added to required treatment patterns for various dental and somatic diseases. This approach ensures the protective effect of growth of opportunistic pathogenic bacteria improving quality of therapy and patient recovery time. Objectives. To study dynamics of clinical and microbiological changes in the oral cavity in patients with periodontitis and hypothyroidism on the background of complex therapy with inclusion of synbiotic Maxilac. Materials and methods. Based in the Ural State Medical University Department of Therapeutic Dentistry and Propedeutics of Dental Decease, the study of oral microbiology was carried out on 50 generalized moderate periodontitis patients aged 44 to 59 years during the period from 2017 to 2021. The average age of the subjects was 50.50±3.5 years. Two groups were formed: the main group (30 patients with “primary hypothyroidism” receiving hormone therapy) and the comparison group (20 patients). The patients in the main group were prescribed general therapy by the endocrinologist based on the phase, stage and the severity of the disease. During examination all patients underwent the complex clinical and laboratory evaluation before treatment, in its course and after it, as well they were subjected to full mouth debridement and the course of the complex periodontal therapy in accordance with clinical recommendations. Microbiota was corrected by active ingredient probiotic (lyophilized probiotic bacteria) — 4.5*109 CFU (colony-forming unit): Lactobacillus elveticus, lactis, rhamnosus, plantarum, casei; Bifidobacterium longum, breve, bifidum; Sreptococcus thermophilus. Results. The study of microbiocenosis of the oral cavity of patients with primary hypothyroidism demonstrated changes in species and the number of microorganisms in the oral cavity. Conclusions. Timely diagnostics and correction of disbiotic changes included in the dental treatment protocol will allow to select the most appropriate dental treatment strategy.

Advantages of using toothpaste containing propolis and plant oils for gingivitis prevention and oral cavity hygiene in cleft lip/palate patients

BackgroundThe anti-inflammatory and antibacterial action of preparations used during oral hygiene procedures is particularly important in patients with oral cleft. Few reports have been published assessing the influence of natural products on the state of the oral cavity in patients with oral cleft. The aim of this study was to assess the effect of toothpaste containing Polish propolis and plant oils on oral cavity health in patients with oral cleft treated orthodontically. Materials and methodsA total of 50 patients aged 9–16 years old (20 females, 23 males) were selected and randomly assigned into two groups. Group (A) received toothpaste with Polish propolis, tea tree oil, menthol, and rosemary oil. Group (B) received toothpaste without active ingredients (placebo). A baseline assessment was followed by an oral hygiene index (OHI, debris OHI-D, and calculus OHI-C component) and gingival bleeding index (GBI) after 35 days. The methodology of the oral condition assessment included the presence of cleft malformation as a dysmorphic of the anterior maxilla segment. ResultsIn group A, improvement in oral cavity hygiene assessed for incisors and molars was found (OHI-T p = 0.011). For the gingival condition, a decrease in the gingival bleeding index - total (GBI-T p = 0.002), as well as for the incisors (GBI-I p = 0.007) and molars (GBI-M p = 0.017) was found. ConclusionsThis research confirms the biological effectiveness of toothpaste with Polish propolis and plant oils. These results may be clinically useful for improving preventative oral care and for control of oral infectious diseases during orthodontic treatment in patients with oral cleft.

The newly synthesized thiazole derivatives as potential antifungal compounds against Candida albicans

Recently, the occurrence of candidiasis has increased dramatically, especially in immunocompromised patients. Additionally, their treatment is often ineffective due to the resistance of yeasts to antimycotics. Therefore, there is a need to search for new antifungals. A series of nine newly synthesized thiazole derivatives containing the cyclopropane system, showing promising activity against Candida spp., has been further investigated. We decided to verify their antifungal activity towards clinical Candida albicans isolated from the oral cavity of patients with hematological malignancies and investigate the mode of action on fungal cell, the effect of combination with the selected antimycotics, toxicity to erythrocytes, and lipophilicity. These studies were performed by the broth microdilution method, test with sorbitol and ergosterol, checkerboard technique, erythrocyte lysis assay, and reversed phase thin-layer chromatography, respectively. All derivatives showed very strong activity (similar and even higher than nystatin) against all C. albicans isolates with minimal inhibitory concentration (MIC) = 0.008–7.81 µg/mL Their mechanism of action may be related to action within the fungal cell wall structure and/or within the cell membrane. The interactions between the derivatives and the selected antimycotics (nystatin, chlorhexidine, and thymol) showed additive effect only in the case of combination some of them and thymol. The erythrocyte lysis assay confirmed the low cytotoxicity of these compounds as compared to nystatin. The high lipophilicity of the derivatives was related with their high antifungal activity. The present studies confirm that the studied thiazole derivatives containing the cyclopropane system appear to be a very promising group of compounds in treatment of infections caused by C. albicans. However, this requires further studies in vivo.Key points• The newly thiazoles showed high antifungal activity and some of them — additive effect in combination with thymol.• Their mode of action may be related with the influence on the structure of the fungal cell wall and/or the cell membrane.• The low cytotoxicity against erythrocytes and high lipophilicity of these derivatives are their additional good properties.Graphical abstract

What is the survival rate of deciduous molars in cases with agenesis of premolar successors? A systematic review.

To systematically review the literature on the survival rate of deciduous molars in cases of agenesis of premolar successors. Four electronic databases and partial grey literature were searched up to November 2020. The PECOS eligibility criteria included (P) second deciduous molar (E) exposed to agenesis of a premolar successor (O) evaluated by the survival rate in the oral cavity, infraocclusion, and root resorption through (S) observational studies. Risk of bias (RoB) was assessed using the checklists from the Joanna Briggs Institute and the level of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) tool. Three studies were included: one with low, one with moderate, and one with high RoB. Synthesis methods included the frequency of persistent deciduous second molars during the follow-up. Approximately 82% to 89% remained in the oral cavity after 5 to 13 years. The incidence of root resorption was 11%, and the infraocclusion was 1 mm. The level of evidence was considered low for each outcome. There was considerable RoB regarding the observational studies and a need for clinical and radiographic monitoring of the deciduous molars. Maintaining a deciduous molar in the oral cavity in patients with agenesis of the premolar successor is a viable clinical choice since 82% to 89% of the retained molars evaluated were in good condition over a follow-up ranging from 5 to 13 years. Infraocclusion and root resorption did not seem to increase considerably. The level of evidence was considered low for each outcome.

Results of assessment of oral acid-base balance in patients with mandibular fractures combined with periodontal pathology

Aim. To estimate the condition of acid-main balance of oral cavity in patients with fracture of the mandible in combination with parodontal pathology.Material and methods. 40 patients with fractures of the mandible in combination with parodontal pathology were observed in the study. They were divided into three groups. Patients of the first group had a fracture of the mandible in combination with chronic periodontitis. Patients of the second group had fractures of the mandible and chronic gingivitis. Patients of the third group had no bone-traumatic damages and parodontal pathology.Results and discussion. The activity of the parodontal microflora of the oral cavity in patients with the bone trauma of the mandible in combination with periodontitis is higher and characterizes the quick response component of the acid-main balance regulation in the oral cavity.Conclusion. Lingual raid is the main reservoir of oral microflora and its role under existing bone-traumatic damage on the background of parodontal pathology in maintaining microbiocenosis not only increases but also becomes the factor of destabilization regenerators processes at fracture of the mandible.

Циркуляція антибіотикорезистентних ізолятів бактерій родини Enterobacteriaceae у системі людина – водні екосистеми

The rapid development of resistance of microorganisms to antimicrobial drugs has led to the spread of antibiotic-resistant bacteria and their genetic determinants of resistance in the environment. It has led to the emergence of a new threat to human health, the precondition of which is the entry of resistance genes to the human body through the food chain. Modern systems of treatment plants are not capable of complete purification of water from genetic determinants, the largest source of which is known to be hospital effluents and domestic wastewater. In the context of this problem, the study of the influence of ecological resist on the development of antibiotic resistance in the human body becomes very important. The purpose of the study was to determine the relationships between the migration of antibiotic-resistant microorganisms in the system human-aquatic ecosystem. Materials and methods. To achieve the purpose, a number of microbiological studies were performed, which included the isolation of microbial isolates from water samples of the Uzh River (Ukraine), surface waters of which are a source of drinking and domestic water supply, and clinical samples from the oral cavity of patients with inflammatory periodontal diseases. Identified isolates were tested for sensitivity to antibiotics of different groups. Results and discussion. During the research experiment, bacteria of the Enterobacteriaceae family were isolated from the oral cavity of 64 patients with inflammatory diseases of periodontal tissues, the species diversity of which was represented by the following species: Escherihia coli, Enterobacter cloacae, Citrobacter freundii, Klebsiella rhinoskleromatis, Hafnia alvei. According to the study, members of the Enterobacteriaceae family isolated from water samples showed significant resistance to antibiotics of natural origin, such as tetracycline, amipicillin and gentamicin, as well as to beta-lactams and second-generation macrolides. Conclusion. According to the results of the study, the samples of water and oral cavity were dominated by the same spectrum of gram-negative microorganisms belonging to the genera Enterobacter, Citrobacter, Escherichia and characterized by a high degree of resistance to tetracyclines, macrolides and unprotected beta-lactam antibiotics. The formation of such an antibiotic resistance in ecological and clinical samples may indicate probable migration routes of antibiotic-resistant microorganisms and genetic determinants of stability in the system human-aquatic ecosystem. There is a need for further research to study the prevalence of antibiotic-resistant microorganisms in the environment and the development of appropriate regulations governing the conduct of sanitary and epidemiological control over the spread of microorganisms with multiple resistance in the environment

Prevalence of different fungal species in Saliva and Swab samples of patients undergoing Radiotherapy for Oral Cancer

Oral cancer is one of the leading causes of morbidity and mortality globally. There is a lack of studies on the growth of different Candida species in swab pre and post-radiotherapy. Hence, this study aimed to determine different Candida species in the oral cavity of patients who undergo radiotherapy. The study included 50 patients with oral cancer scheduled to undergo radiotherapy. Both saliva and swab samples were collected from all the patients before and after two- and six weeks of starting the radiotherapy. Similar inoculation was performed using the salivary swabs and incubated aerobically at 37°C for 48h. After 48h, culture plates were removed from the incubator and observed for the growth of different fungal species based on the color of the colonies. The culture of samples from patients with oral cancer resulted in the growth of 68% of Candida species in saliva and 44% in swab before initiating radiation. Unlike baseline findings, Candida albicans were identified in a higher number in swab samples (44%) than saliva (24%) post two weeks of radiotherapy. All saliva samples were positive to candida species, in which Candida albicans shows high prevalence (24%). After six weeks of radiotherapy, in the swab, 30% of samples were positive for Candida albicans, and 18% of samples were positive for non-albicans species. Before radiotherapy, at two weeks and six weeks of radiotherapy, saliva samples showed a higher prevalence of Candidal species compared to swab samples. The combination of other Candida species was also higher in saliva samples compared to swab samples during radiotherapy.

Oddziaływanie olejku rozmarynowego (Rosmarini aetheroleum) na grzyby drożdżopodobne

Introduction. The plants have been used as herbs and medicines for thousands of years. Rosemary (Rosmarinus officinalis L.) from Lamiaceae family is cultivated all over the world. The rosemary herb contains flavonoids, carnosic acid, caffeic acid and its esters (rosmarinic acid), referred to as Labiatae tannins, essential oil (borneol, 1,8-cineol, borneol acetate, ?- and ?-pinene, camphor, ?-myrcene, camphene, geraniol, citronellol, linalool, p-cymene, ?-terpinene, ?-phellandrene, verbenone) and phytosterols. The compounds present in the extracts and essential oil have antimicrobial, antioxidant, antitumor and antidiabetic properties, protect against gastric and duodenal ulcers and prevent dementia in the elderly peoples. Aim. The aim of the research was to determine the activity of rosemary oil (Semifarm, Gdańsk) against yeast-like fungi of the genus Candida. Material and methods. 31 strains of yeast-like fungi isolated from the oral cavity of patients with candidosis and 9 reference strains were tested. The susceptibility (MIC) was determined by the method of serial dilution in Sabouraud agar. The suspension containing 10 5 CFU/drop was transferred using a Steers apparatus upon the agar medium with the appropriate concentration of rosemary oil (15.0; 10.0; 7.5; 5.0 and 2.5 mg/ml) and on the medium without the addition of oil (strain growth control). Incubation was carried out for 24-48 hours in aerobic conditions at 37°C. The lowest concentration of rosemary oil, which completely inhibited the growth of the tested yeast-like fungi strains, was assumed as MIC. Results. The growth of all tested yeast-like strains was inhibited by oil concentrations of 7.5-15.0 mg/ml. The most sensitive to rosemary oil were strains of the species C. utilis (MIC = 7.5 mg/ml), C. guilliermondii and C. kefyr (MIC 7.5-10.0 mg/ml), and the least sensitive species were C. tropicalis. C. krusei and C. lusitaniae strains were more resistant (MIC = 15 mg/ml). Conclusions. Candida strains showed moderate sensitivity to rosemary oil. The oil was most active against yeast-like fungi strains from the species of C. utilis, C. guilliermondii and C. kefyr. The strains of C. krusei and C. lusitaniae showed the lowest sensitivity to the oil.

Dental Education in the Time of COVID-19 Pandemic: Challenges and Recommendations

Moving within the second wave of the coronavirus (COVID-19) pandemic, dental education delivery has been profoundly affected by this crisis, so has the structure, evaluation, and future of dental education. Both pre-clinical and clinical dental education have experienced challenges ranging from fully online educational content to limited dental training for senior dental students. This crisis appears to be a tipping point that produced confusion in dental teaching especially clinical sciences. Although medical institutions immediately started to adapt to the unexpected COVID-19 crisis, dental and oral health educational services are profoundly impaired due to the dental team's propinquity to the patient and the aerosols generated during routine dental therapeutic procedures. Dental students unlike other medical students are considered to be at the highest risk due to the nature of their clinical training that includes working in the oral cavity of patients using aerosol-generating equipment. Some dental schools have taken the leadership and documented their modifications during this pandemic; however, there is a serious need for further investigation and wide range screening of the situation in the dental schools during the COVID-19 crisis. The aim of this mini-review is to present these challenges and how academic dental institutions have implemented strategies to overcome them.

The Use of Commercially Available Non-Medical Grade USB Cameras for Physician Guided ENT Out-Patient Self-Examination During the COVID-19 Pandemic

ABSTRACT
 Objective: To describe the use of commercially available, non-medical grade USB cameras in a non-contact examination of simple cases involving the ears, nose and oral cavity of patients during the COVID-19 pandemic
 Methods:
 Design: Instrument innovation
 Setting: Tertiary Government Training Hospital
 Participants: Patients who consulted at the ENT-HNS outpatient department
 during the COVID-19 pandemic.
 Results: Commercially available USB cameras were able to provide basic visualization of the ears, nose and oral cavity. The non-medical grade USB cameras captured lower quality images when compared to the medical grade endoscopes but provided enough visualization to aid in the examination and diagnosis of simple cases. There was a learning curve in using the set-up but patients were able to adjust well, taking an average time of 2.7 minutes to complete the examination.
 Conclusion: Non-medical grade USB cameras may play a role in aiding otolaryngologists in examining simple cases during the COVID-19 pandemic. Integration of this system into current examination practices may offer an extra layer of protection for otolaryngologists and patients alike. However, the use of these instruments as part of regular ENT practice may be controversial and will need further study.

Potential Pathogenicity of Candida Species Isolated from Oral Cavity of Patients with Diabetes Mellitus.

Introduction In the recent decade, the increased immunocompromised population such as diabetic patients makes a high incidence of invasive Candida infections. Diabetes mellitus is the most common endocrine metabolic disorder, and diabetic patients are more susceptible to oral candidiasis infection. Candidiasis is an opportunistic fungal infection caused by many species of Candida. Secretion of exoenzymes plays an important role in the virulence and pathogenesis of Candida species. The aim of this study was to evaluate the potential role of phospholipase, esterase, and hemolytic activity of Candida species isolated from oral cavity lesions of diabetic patients. Methods A total of 108 Candida species including 75 Candida albicans and 33 non-Candida albicans species were recovered from the oral cavity of diabetic patients included in our study. Egg yolk agar, Tween 80 opacity medium, and blood agar plate assays were used for determining phospholipase, esterase, and hemolytic activities, respectively. Results Candida albicans species had the most exoenzyme activity in comparison to non-albicans isolates. Candida albicans isolates showed 97.3%, 100%, and 77.3% phospholipase, hemolysin, and esterase activities, respectively. The difference between Candida albicans and non-Candida albicans was significant in phospholipase (P < 0.001) and hemolytic activity (P = 0.027), but not significant in esterase activity (P = 0.076). Conclusion This study showed that most of the isolates had different enzymatic patterns, and Candida albicans isolates had the most exoenzyme activity. So due to the potential effects of these enzymes in pathogenesis and virulence effects of Candida species, we can conclude that the severity of extracellular enzymes may play a role in the severity of signs and symptoms of Candida oral cavity infections in diabetic patients.

PREPARATION FOR PALATOPLASTY SURGERY WITH AN ACRYLIC FEEDING OBTURATOR: A CASE REPORT

ABSTRACTBackground: Clefts on the lips and palate are common cases to be found frequently in the field of dentistry. This gap connects the oral cavity and the nasal cavity so that it interferes with the nutritional intake in patients. The age and size of the oral cavity in patients become particular challenges for prosthetic rehabilitation. Another challenge lies at the impression procedure, because it is an essential part in the making of obturator. Objective: To provide information on the management of patient with cleft palate using feeding obturator from acrylic material. Case: A 13-months-old male patient arrived at Prof. Soedomo Gadjah Mada University Dental Hospital with his parents and was seeking for prosthetic therapy to cover the cleft on his palate because it had been muddling with food and beverage intake. Patient had undergone cheiloplasty surgery and further arranged for palatoplasty procedure. Intraoral examination exhibited a cleft extended from hard palate, soft palate, and uvula. Case management: Upper jaw impression was performed for individual tray fabrication, followed by impression procedure in an upright straight position until the patient bawled. The impression result was casted to construct an obturator using acrylic heat cure material. Fitting surface was covered with soft liner. Treatment result showed that the obturator was retentive, stable and able to assist the nutritional intake in patient. Conclusion: Acrylic feeding obturator can recover the condition in patient with cleft palate and improve nutritional intake as well as body weight to prepare patient for palatoplasty surgery.Keywords: Cleft Palate, Feeding Plate, Obturator