Komparativna analiza kliničkog i mikrobiološkog nalaza kod pacijenata sa proteznim stomatitisom

Abstract

Protezni stomatitis je često oboljenje kod pacijenata koji koriste totalne zubne proteze. Uglavnom protezni stomatitis nije praćen simptomima i pacijenti nisu svesni prisutnog oboljenja. Etiologija proteznog stomatitisa je multifaktorijalna. Kao dominantan faktor ističe se infekcija gljivama roda Candida. Totalne zubne proteze podležu kolonizaciji i formiranju biofilma Candida spp. Protezni plak (biofilm) je sličan dentalnom plaku i služi kao rezervoar potencijalno infektivnih mikroorganizama. Mikroorganizmi iz proteznog plaka, (najviše Candida spp.) su odgovorni za nastanak proteznog stomatitisa. Kontinuirano gutanje mikroorganizama iz proteznog plaka izlaže pacijente riziku od neočekivane infekcije. ajčešća izolovana vrsta gljive na protezama je C. albicans. Prisutni su opšti i lokalni kontributivni faktori. Lokalni faktori su: lezije oralne sluzokože uzrokovane neadekvatnim protezama, neprekidno nošenje zubne proteze, smanjen protok pljuvačke, loša higijena zubne proteze, vrsta materijala od koga je izrađena proteza, starost proteze, slaba retencija proteze, neizbalansirana okluzija. Opšti faktori su: diabetes mellitus, pušenje, dugotrajna primena antibiotika i kortikosteroida, radio i hemoterapija, faktori ishrane – nedostatak vitamina B12, folata i gvožđa, psihotropni lekovi, hiposalivatori. Cilj ovog istraživanja je bio da se pouzdano dijagnostikuje i odredi učestalost proteznog stomatitisa gljivične etiologije i ispita antifungalna aktivnost etarskih ulja. Za potrebe ovog istraživanja dizajniran je poseban upitnik, koji sadrži generalije, medicinsku i stomatološku istoriju i podatke dobijene kliničkim pregledom. Klinički pregled se sastojao od inspekcije usne duplje, na osnovu koga se dijagnostikovala inflamacija mekih tkiva, kao i stepen i lokacija inflamacije. Analizom postojećeg stanja totalne zubne proteze u ustima pacijenta utvrđivan je stepen retencije zubne proteze, očuvanost vertikalne dimenzije okluzije i okluzalni odnosi sa antagonistima. Deo istraživanja je sproveden u laboratoriji...

Denture stomatitis is a common disease in patients with dentures. Generally, denture stomatitis is not followed by any symptoms and patients are usually not aware of the disease. Etiology of denture stotmatitis is multifactorial. As a dominant factor is the fungal infection by Candida spp. Complete dentures are susceptible to colonization and biofilm formation of Candida spp. Denture plaque (biofilm) is similar to a dental plaque and it is a reservoir of potential infective microorganisms. Microorganisms in denture plaque, (mostly Candida spp.) are responsible for the emergence of denture stomatitis. A continual swallowing of microorganism from denture plaque exposes patients to a risk of unexpected infection. The most common isolated species of fungus on dentures is C. albicans. There are some general and local contributory factors. The local factors are: trauma of oral mucosa caused by inadequate dentures, continuous dentures wearing, reduced saliva flow, bad dentures hygiene, type of the material dentures are made of, detures’age, poor dentures retention, unbalanced occlusion. The general factors are: diabetes mellitus, smoking, long antibiotics and corticosteroids application and radio or chemotherapy, diet factors, - lack of vitamin B12, foliates and iron, psychotropic medications and hyposalivators. The aim of this research has been to diagnose and designate a frequency of denture stomatitis of fungal etiology and examine antifungal activities of essential oils. For the needs of this research there has been designed a special questionnaire which contains .personal data, medical and stomatological history and data obtained by clinical examination. Clinical examination consisted of inspection of oral cavity on the basis of which a soft tissue inflammation has been diagnosed as well as a degree and location of the inflammation. Analysing the present state of complete dentures in patients’ mouth there has been established a degree of denture retention, preservation of vertical dimension of occlusion and occlusal relations with antagonists...