Fogorvosi szemle, 2006 (99. évfolyam, 1-6. szám)

2006-12-01 / 6. szám

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FOGORVOSI SZEMLE ■ 99. évf. 6. sz. 2006.

The erythromycin is the most popular member of the macrolide group of antibiotics, and it is the first choice in dentistry for treating penicillin-allergic patients. The spectrum of activity of the clindamycin is similar to that of eritromycin, but it has partial cross-resistance. Formerly the tetracyclines were one of the most widely used antibiotic groups owing to their very broad spectrum of activity and infrequent side effects. Their usefulness has decreased as a result of increasing bacterial resistance. The metronidazole has anaerobic activity, which makes it exceedingly effective against strict anaerobes and some protozoa, so this drug can be the first to be introduced to treat protozoal infections. In serious, generalized infections the carbapenems (imipenem and meropenem) are the first choice in dentistry.

Antifungal therapy: In contrast to the wide range of antibacterial agents, the number of effective antifungals are limited, because selective toxicity is much more difficult to achieve in eukaryotic fungal cells, which share similar features with human eukaryotic cells. Polyenes (nystatin) and the azoles (fluconazole) are the most commonly used antifungals in dentistry. Antiviral therapy: Few antiviral drugs with proven clinical efficiency are available, in contrast to great range of successful antibacterial agents. The shortage of antivirals is mainly due to the difficulty of interfering with the viral activity within the cell without damaging the host. Aciclovir is an efficient, highly selective antiviral agent, which blocks viral DNA production at a concentration of some thousand times less than that required to inhibit host cell DNA production.

INFLUENCE OF ER:YAG LASER IN PERIODONTAL REGENERATION

HORVATH, A., WINDISCH, P., GERA, I.

Department of Periodontology, Semmelweis University, Budapest, Hungary

Background and aim: Lasers are increasingly used in dentistry nowadays. In periodontal field the erbiumdoped: yttrium, aluminium, garnet (Er:YAG) laser seems to be the most promising. Several studies have reported its efficiency in calculus removal, root surface conditioning and potential antimicrobial effect that may lead to biocompatible surface for tissue reattachment. However, there is a controversy among various studies regarding to the dimension of its benefit added to conventional therapy. The aim of this preliminary study was to observe the possible effect of Er:YAG laser when used in guided tissue regeneration (GTR) therapy. Material and method: Deep periodontal pockets scheduled for GTR treatment of four volunteer patients of our department were treated. All patients underwent oral hygienic program ind. SRP at least two weeks

before operation. Prior to and 6 months following surgery standardized radiographs were taken and clinical parameters of gingival recession (GR), probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP), tooth mobility (MOB) were measured. Following full thickness flap elevation in local anaesthesia, the major part of granulation tissue was removed with Gracey curettes. Subsequently debridement and removal of remaining granulation tissue were carried out utilizing Er:YAG laser (KEY®, wavelength 2940 nm, 160 mJ/pulse, 10 Hz). Then the intrabony defects were filled with natural bone mineral and covered by resorbable collagen membrane.

Results: No adverse event was observed and less discomfort as usual was reported during maintenance and 6 months healing period. The results have demonstrated GR increase from 1.7 ± 1.2 to 3.1 ±2.1 mm, while PD and CAL were both reduced from 8.6 ± 2.3 to

3.8 ± 0.9 mm and from 10.3 ± 2.9 to 6.9 ± 2.2 mm on average, respectively. BoP changed from the mean of 75% to 38% and MOB was not evaluated because of splinting the teeth.

Conclusion: Within the limits of the present preliminary study, it may be concluded that the use of Er:YAG laser doesn’t impede the outcome of GTR therapy, which encourages us to perform further histological and randomized controlled trial.

THE IMPORTANCE OF THE STOMATO-ONCOLOGICAL EXAMINATION IN DENTAL PRAXIS

KATONA, J., KATONA, I.

St. János Hospital, Budapest, Hungary

Since the enactment of Section 2 (1) of Act LXXXIII of 1997 on obligatory health insurance, the stomato-oncological examination of the patients is obligatory for each Hungarian dentist.

Based on the statistics, the number of malignant growth of the oral cavity diseases is continuously growing. By now the number of cases in Hungary are the highest in the world.

In spite of the current arrangements, the huge number of malignant growths of the oral cavity shows no signs of improvement.

For the improvement of the statistics it is necessary: to give the stomato-oncological examination more prominence, to recognize and filter out cases at an early stage, to send the patient to oncological centers, and start the treatment without further delay.

The results of stomato-oncological examinations of dental patients between December 1, 2005 and July 31, 2006 are summarized. Out of the total number of 1240 screened patients 9 cases presented premalignant lesions. Because of the little number of cases ex-