PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

Despite innovations in orthopedic dentistry, removable dentures belong 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. It was observed 100 patients with oral candidiasis of various age groups from 45 to 65 years. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis in 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. 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.

Clinical diagnostic dilemma: Oral verruciform xanthoma

Verruciform xanthoma is a specific but not so common, papillary growth typically occurring on the oral mucosa of middle-aged persons. It is a unique entity and has found to be incident in 0.025-0.05% of all cases reported as per the literature study. One such case of 75 days duration was successfully managed with complete local surgical excision. The surgical site was monitored for one year postoperatively with no signs of recurrence or other postoperative complications. Clinical perspective, histopathological highlights and differential interpretation is discussed in this article with an in-depth review of the literature. It is important to consider this rare entity in the differential diagnosis of lesions involving oral mucosa as its clinical and histological features overlap with several other lesions.

Armed to the Teeth—The Oral Mucosa Immunity System and Microbiota

The oral cavity is inhabited by a wide spectrum of microbial species, and their colonization is mostly based on commensalism. These microbes are part of the normal oral flora, but there are also opportunistic species that can cause oral and systemic diseases. Although there is a strong exposure to various microorganisms, the oral mucosa reduces the colonization of microorganisms with high rotation and secretion of various types of cytokines and antimicrobial proteins such as defensins. In some circumstances, the imbalance between normal oral flora and pathogenic flora may lead to a change in the ratio of commensalism to parasitism. Healthy oral mucosa has many important functions. Thanks to its integrity, it is impermeable to most microorganisms and constitutes a mechanical barrier against their penetration into tissues. Our study aims to present the role and composition of the oral cavity microbiota as well as defense mechanisms within the oral mucosa which allow for maintaining a balance between such numerous species of microorganisms. We highlight the specific aspects of the oral mucosa protecting barrier and discuss up-to-date information on the immune cell system that ensures microbiota balance. This study presents the latest data on specific tissue stimuli in the regulation of the immune system with particular emphasis on the resistance of the gingival barrier. Despite advances in understanding the mechanisms regulating the balance on the microorganism/host axis, more research is still needed on how the combination of these diverse signals is involved in the regulation of immunity at the oral mucosa barrier.

Site-specific adaptation mechanisms of an oral pathobiont in the oral and gut mucosae

Periodontal inflammation leads to oral dysbiosis with the expansion of oral pathobionts. Besides the pathogenic role of oral pathobionts during periodontal inflammation, studies have revealed that oral pathobionts contribute to diseases in distant organs beyond the oral mucosa. For example, the oral pathobiont Klebsiella aerogenes, which accumulates in the oral mucosa during periodontitis in mice, can exacerbate colitis when it ectopically colonizes the gastrointestinal tract. However, the precise mechanisms by which oral pathobionts establish their colonization in extra-oral mucosal sites remains incompletely understood. We performed high-throughput in vivo genetic screening to identify fitness genes required for the adaptation of the oral pathobiont K. aerogenes to different mucosal sites – the oral and gut mucosae – in the steady state and during inflammation. In addition, the global transcriptome of K. aerogenes in different environments was analyzed. We determined that K. aerogenes employs genes related to iron acquisition and chaperone usher pili, which are encoded on a newly identified genomic locus named “locus of colonization in the inflamed gut” (LIG), for adaptation in the gut mucosa, particularly during inflammation. In contrast, the LIG virulence factors are not required for K. aerogenes to adapt to the oral mucosa. Thus, oral pathobionts likely exploit distinct adaptation mechanisms in their ectopically colonized intestinal niche as compared to their original niche.

Changes in the microcirculation of the oral mucosa in post-COVID-19 patients not receiving anti-coagulant therapy

Introduction. The outbreak of a new coronavirus infection has become a challenge for the global health system. The COVID-19 infection is directly related to various disorders of the cardiovascular system, including the microcirculatory bed, caused by thrombotic events and deteriorations of blood rheology. Aims. The paper reports on the results of a study of Doppler sonographic parameters changes in patients with a novel coronavirus infection over the past 6 months. Materials and methods. We assessed the oral mucosa microcirculation in three segments using the high-frequency ultrasound dopple-rography. Results. We recorded the linear and volumetric blood flow rates and the Gosling and Purselo indexes in the course of our work. When comparing the obtained average statistical parameters of blood flow velocity, the linear and volumetric blood flow rates in patients of both groups were found to be lain in the same range and the mean values of Vas, Vam, Qas were equal. The mean values of the Purselo resistance index were closer to 1,0 in patients with COVID-19, and the values of the Gosling pulsation index (PI) were on average 53.3 % higher than in the control group. Conclusion. We evaluated the screening capabilities and potential of high-frequency ultrasound dopplerography for use in patients of different age groups and different somatic status.

Oral cavity infection by the SARS-CoV-2: emphasizing the essence of masking and peptide therapeutics

The SARS-CoV-2 has infected many people globally with the ravaging COVID-19; a disease, which has become challenging for every aspect of modern healthcare. The saliva and oral mucosa are sites of high risk for increased viral loads, and aside from the usual epithelial functions like lining and protection, the oral mucosa is also specialized for crucial functions, such as secretion, mastication, sensory perception, and taste perception. The human ACE2 receptor has been extensively studied for its essential role in the regulation of blood pressure homeostasis. However, scRNA-Seq studies have revealed high expression levels of the protein in keratinized epithelial surfaces of the oral cavity. The SARS-CoV-2 have access to the host’s body by binding to the ACE2 receptor, leading to the cleavage and major conformational changes in the viral spike glycoprotein for the release of its nucleocapsid into the cellular cytoplasm. This proteolytic cleavage is carried out by the TMPRSS2 and cathepsin L. In this study, we harnessed the information from the binding interface of TMPRSS2 and PAI-1 (a protease inhibitor known to inhibit the TMPRSS2 and several other proteases) to design a potential therapeutic peptide for the inhibition of the TMPRSS2, while also emphasizing the need for preventive masking.

Denture Acrylic Resin Material with Antibacterial and Protein-Repelling Properties for the Prevention of Denture Stomatitis

Denture stomatitis is a multifactorial pathological condition of the oral mucosa that affects up to 72% of denture wearers. It is commonly seen on the palatal mucosa and characterized by erythema on the oral mucosa that are in contact with the denture surface. The aim of this study was to incorporate 2-methacryloyloxyethyl phosphorylcholine (MPC) and dimethylaminohexadecyl methacrylate (DMAHDM) into a high impact polymethylmethacrylate heat-cured denture base acrylic resin as a potential treatment for denture stomatitis. We used a comparative study design to examine the effect of incorporating MPC as a protein repellent agent and DMAHDM as an antifungal agent to prevent the adherence of Candida albicans to the denture base material. The dual incorporation of MPC and DMAHDM reduced C. albicans biofilm colony-forming unit by two orders of magnitude when compared to the control group devoid of the bioactive agents. Although the addition of MPC and DMAHDM alone or in combination significantly reduced the flexural strength of the material, they showed reduced roughness values when compared to control groups. This new denture acrylic resin provides the benefit of enhancing C. albicans biofilm elimination through dual mechanisms of action, which could potentially reduce the prevalence of denture stomatitis.

Atypical Peripheral Ossifying Fibroma of the Mandible

Peripheral ossifying fibroma (POF) is a benign localized lesion originating from gingival and alveolar oral mucosa. Its origin can be cells of periodontal ligament. The lesions usually develop in women in their twenties. POF is a complex clinical and histological diagnosis due to its shared characteristics with many other conditions. In this paper, we presented a case of an atypical peripheral ossifying fibroma (POF) in the left lateral part of the mandible in a 70-year-old male patient who had two semicircular bridges supported on four implants in the upper and lower jaws. A review of CBCT and orthopedic imaging showed no visible intraosseous changes. Histological analysis revealed the diagnosis of POF. The case in question is interesting, as elaborated on in the discussion section of this paper because POF is usually found in female patients aged between 20 and 30 years.