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.
The oral mucosa is a mechanical barrier against the penetration and colonization of microorganisms. Oral homeostasis is maintained by congenital and adaptive systems in conjunction with normal oral flora and an intact oral mucosa. Components contributing to the defense of the oral cavity include the salivary glands, innate antimicrobial proteins of saliva, plasma proteins, circulating white blood cells, keratinocyte products of the oral mucosa, and gingival crevicular fluid. General disturbances in the level of immunoglobulins in the human body may be manifested as pathological lesions in the oral mucosa. Symptoms of immunoglobulin-related general diseases such as mucous membrane pemphigoid (MMP), pemphigus vulgaris (PV), linear IgA bullous dermatosis (LABD), Epidermolysis Bullosa Aquisita (EBA), and Hyper-IgE syndrome (HIES) may appear in the oral cavity. In this review, authors present selected diseases associated with immunoglobulins in which the lesions appear in the oral cavity. Early detection and treatment of autoimmune diseases, sometimes showing a severe evolution (e.g., PV), allow the control of their dissemination and involvement of skin or other body organs. Immunoglobulin disorders with oral manifestations are not common, but knowledge, differentiation and diagnosis are essential for proper treatment.
A number of systemic diseases including hematological disorders have manifestations in the oral cavity region. These manifestations may often represent early signs of the underlying hematopoietic disease and occur frequently in leukemia. Despite the fact that leukemia has long been known to be associated with oral health deterioration, the available literature on this topic consists mostly of case reports, without data to conclude these. The aim of the study was to assess dentition state in leukemic patients during one cycle of chemotherapy and its correlation with blood parameters. The study included 102 adults treated because of leukemia at the Clinic of Haemato-Oncology and Bone Marrow Transplantation at the university hospital in Lublin, Poland. The sample group consisted of 51 women and 51 men aged 22 to 72 (54.07 ± 10.33) with following diagnoses: Acute myelogenous leukemia (AML)—55 patients (53.92%), Chronic lymphocytic leukemia (CLL)—17 patients (16.67%), Acute lymphoblastic leukemia (ALL)—16 patients (15.69%), Chronic myelogenous leukemia (CML)—10 patients (9.80%), Acute promyelocytic leukemia (APL) —3 patients (2.94%), Chronic hairy cell leukemia (HCL)—1 patient (0.98%). DMFT index was used to assess dentition state. After the cycle of chemotherapy, their dentition state changed in terms of decayed, missing and filled teeth and correlated with hematological parameters. Adult patients with leukemia have high dental treatment needs, and high number of missing teeth; thus, a comprehensive and fast dental treatment is necessary to avoid systemic complications and ensure better quality of life.
The oral cavity is the place where the first symptoms of systemic diseases may appear. Leukemia is the malignancy of the hematopoietic system in which abnormal leukocytes are produced in the bone marrow and these cells spread to the peripheral blood. It is classified clinically on the basis of the duration and nature of the disease (acute or chronic), the type of cell involved (myeloid, lymphoid, or monocytes), and a rise in the number of abnormal cells in the blood. The study aimed to assess and compare the oral hygiene and periodontium status based on the indices in leukemic patients before and after one cycle of chemotherapy and whether the therapy had an impact on the change of these parameters. Dental indices used in clinical diagnostics were calculated: API (approximal plaque index), SBI (sulcus bleeding index), and CPI (community periodontal index). The research project was conducted at the Clinic of Hematooncology and Bone Marrow Transplantation of the Independent Public Clinical Hospital No. 1 in Lublin. The target population consisted of 102 adults with leukemia who were over 18 years of age. The time since diagnosis of the disease ranged from 1 to 10 years. The data were evaluated in the Statistica 12 software with the respective tests. In the majority of patients, both before and after chemotherapy, improper oral hygiene and severe generalized periodontitis were confirmed. The cycle of chemotherapy that was used did not correlate with the change of patients’ oral hygiene and periodontium state. Unsatisfactory oral hygiene and periodontal health has to be addressed with urgent dental treatment to avoid systemic complications in leukemic patients.
The aim of the study was to evaluate the toxicity of triclosan in the Danio rerio model and mammalian cells, as well as to assess its antimicrobial and antibiofilm activity against selected bacterial pathogens. Triclosan toxicity was assessed in Danio rerio embryos in accordance with OECD Test Guideline 236: Fish Embryo Acute Toxicity (FET) Test. Cytotoxicity was evaluated in vitro using the MTT assay on human dermal fibroblasts (BJ) and rat cardiomyoblasts (H9c2). Antimicrobial activity was assessed via broth microdilution method following EUCAST guidelines and antibiofilm effects were evaluated through minimum biofilm inhibitory concentration (MBIC) assays for each tested strain. Triclosan exhibited toxicity towards Danio rerio, reducing their survival rate, heart rate, and locomotor activity. In vitro tests revealed cytotoxicity (LC50 = 28.44 μg/mL for BJ cells and 25.36 μg/mL for H9c2 cells). Antimicrobial tests demonstrated MIC values ranging from 0.24 μg/mL (Lactobacillus acidophilus) to 3.9 μg/mL (Enterococcus faecalis), with corresponding MBC values up to 7.8 μg/mL. MBIC values ranged from 0.03 to 0.12 μg/mL, confirming potent antibiofilm activity. Triclosan demonstrates high antimicrobial efficacy and inhibits bacterial biofilm formation. However, its toxicity towards aquatic organisms, including Danio rerio, and its cytotoxic effects on mammalian cells raise concerns.
Background. Gingival recessions are common mucogingival deformities and conditions around teeth, which are described as the apical migration of tissues in the relation to the cementoenamel junction. One of the types of graft materials used to treat these recessions is the collagen graft material. The aim of this pilot study was to evaluate the effectiveness of the use of the collagen matrix combined with the coronally advanced flap surgery method to cover dental recessions, after a 12 month follow-up period. Methods. The following parameters were assessed in 20 patients, with 38 single or multiple Miller class I or II gingival recessions: depth of the recession—RD; width of the recession—RW; height of the keratinized tissue—HKT; and thickness of the keratinized gingivae—GT. The percentage of the root coverage after 12 months was also calculated. Results. There was a significant difference in the RD and RW values before and after the procedure. On average, the RD decreased by 3.39 mm, and the RW by 3.87 mm. Moreover, the values of the GT and HKT, before and after the treatment, significantly increased by 0.98 mm and 1.13 mm, respectively. The partial root coverage was 43.48%, and the total root coverage was 56.52%. Conclusion. The use of the collagen matrix with a split thickness gingival flap to cover the gingival recessions is a predictable and effective method when the clinician carefully follows the recommendation of the producer, which was confirmed in a 1 year follow-up with good clinical results.