Parodontalna bolest (parodontopatija) je hronična inflamatorna bolest u čiju patogenezu su uključene različite ćelije urođenog i stečenog imuniteta, među kojima i makrofagi. Makrofagi su profesionalni fagociti čija je osnovna uloga ingestija i destrukcija mikroorganizama. Pored fagocitoze, ove ćelije su angažovane u produkciji proinflamatornih citokina i u prezentaciji antigena T-ćelijama, te se smatraju ključnim ćelijama urođenog imunskog odgovora. U našem istraživanju praćena je gustina i distribucija makrofaga u zdravoj i inflamiranoj gingive sa ciljem da se proceni njihov značaj u patogenezi parodontopatije. Materijal su činile gingivalne biopsije 96 pacijenata svrstanih u 4 grupe: zdrava gingiva, gingivitis, početna parodontopatija i uznapredovala parodontopatija. Za identifikaciju makrofaga korišćena je imunohistohemijska tehnika bojenja zasnovana na upotrebi monoklonskog antitela anti-CD68. Prema našem istraživanju gustina makrofaga je veća u gingivitisu i parodontopatiji u odnosu na zdravu gingivu. Između gingivitisa i parodontopatije nije nađena značajna razlika u gustini makrofaga. Grupisanje makrofaga u blizini delimično liziranih kolagenih vlakana u parodontopatiji ukazuje na njihovu kolagenolitičku aktivnost. Povećanje broja makrofaga u inflamiranoj gingivi može se dovesti u vezu i sa resorpcijom kosti jer se ove ćelije mogu diferencirati u osteoklaste.

Collagen is a major constituent of the gingival extracellular matrix, which crucially affects the histoarchitecture of the gingival tissue. Collagen type I dominates the gingival tissue, while type II, III and IV are present to a lesser extent. Changes in distribution and density occur in the inflamed gingiva. The aim of the study was to examine the organization and density of the collagen in healthy and inflamed gingiva. The material for the study consisted of the gingival biopsies performed in 96 patients aged from 13 to 70 years. The gingival specimens were classified into 4 groups: healthy gingiva, gingivitis, moderate periodontal disease and severe periodontal disease. The samples of the gingival tissues were stained by the method of Van Gieson’s Stain, while the VD of the collagen was measured bz the use of multipurpose testing system M42. In healthy gingival collagen are thick and receptive to color. In gingivitis collagen is mostly preserved structure, but reduced volume; in the periodontitis collagen bundles are reduced, short, thin, disorganized, often fragmented and less susceptibility to color. In healthy gingiva collagen fibers occupy 58.6 ± 5.1% of the volume of lamina propria; in gingivitis significantly lower (44.2 ± 6.2%); in moderate periodontitis 32.7 ± 8.5% and in the progressed periodontitis only 28.7 ± 9.7%. Based on our results, we concluded that in periodontal disease occurs collagenolysis. Quantitative evaluation of gingival collagen volume density may reflect the clinical severity of periodontal disease.

Diabetes mellitus is one of the most common non-communicable chronic diseases, which is the combined action of genetic factors, environmental factors and lifestyle. Specific conditions occur in the oral cavity in the course of diabetes that cause changes in all oral tissues with different symptoms and signs. Increased salivary glucose level is followed by increased accumulation of dental plaque and decreased resistance to noxious agents. The most common oral manifestations in diabetic patients include higher prevalence of periodontal desease, burning mouth syndrome, disruption in salivary flow, opportunistic infections, higher prevalence of denture stomatitis, oral lichen planus, fissured tongue, angular cheilitis etc. Dental interventions in patients with well-controlled diabetes are not different from those applied to nondiabetic patients. Regular monitoring of these patients is required because of the complications that can occur.

Parodontopatija predstavlja inflamantornu reakciju na gram-negativne anaerobne bakterijske infektivne agense koja pogađa potporni aparat zuba, uključujući gingivu, parodontalni ligament, cement i alveolarnu kost. Cilj istraživanja bio je da se utvrdi kvantitativno-kvalitativni sastav mokroorganizama subgingivalnog plaka kod pacijenata obolelih od hronične i agresivne parodontopatije PCR metodom (eng. Polimerase Chain Reaction), a zatim proceni povezanost različitih stepena inflamacije i destrukcije tkiva parodoncijuma sa prisustvom i koncetracijom ovih mikroorganizama. Ispitivanjem je obuhvaćeno 70 pacijenata starosti od 16 do 65 godina. Utvrđivanje mikroorganizama u subgingivalnom plaku, određen je PCR metodom. U cilju postavljanja dijagnoze i određivanja stepena destrukcije parodontalnog tkiva, bili su korišćeni standardni epidemiološki kriterijumi: plak indeks (Silness-Löe), gingivalni indeks (Lӧe-Silness), SBI indeks (Mühleman-Son) i PDDZ. Prisustvo parodontopatogena u subgingivalnom plaku pokazalo je statističku vezu sa kliničkim parametrima težine parodontopatije i inflamacije gingive. Nalaz Porphyromonas gingivalis i Actinobacillus actinomycetemcomitans je bio statistički značajno češći kod pacijenata sa srednje teškom i teškom formom parodontopatije u odnosu na prosečnu dubinu parodontalnih džepova. Detekcija P.g. i A.a. je bila statistički značajno češća kod osoba sa umerenom i intezivnom inflamacijom gingive. Kvantitativno-kvalitativni sastav mikroorganizama subgingivalnog plaka ima direktan uticaj na inflamatorno-destruktivne procese u parodontalnim tkivima.

Health of soft oral tissue and periodontium in biggest measure depends as well of oral hygiene. It exists the positive correlation between oral hygiena and periodontal condition. Many systemic disease, as blood disease, change reactivity of organism and also peridontium, and directly take influence at course and difficulty of periodontitis.

Vital extirpation is microsurgical intervention.Wellknowing of internal morpfology of pulp cavity and with patience, carefull and precise work is possible to extirpate, dilatate and fil in both distal and mesial root of down molars,even if in mesial root exists two canal (buccal and lingual) what is the ruosh aften finding. Vital extirpation is very frequenthy used method in the treatment of multi-root teeth.It is more requested intervention tlak usnal once,but patients mane less visits at the dentist and the results one good enongh. So, one session method isacceptable as from medical point of view but endodontic too.

The nature of herpes simplex virus as infective agens, which can grow in number, only in live cells, and fact that many herpes virus infections of oral tissue have atypic and asymptomatic course, makes their diagnosis more difficult and complicate from infections caused by other microorganisms. The aim of this investigation were to established cytological findings oral lesions of primary and recurrent herpes infections.