| 1. |
- Bratel, John, 1953, et al.
(author)
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The frequency of different T-cell receptor V-families in oral lichen planus and lichenoid contact lesions: an immunohistochemical study.
- 1998
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In: Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. - 0904-2512. ; 27:9, s. 415-9
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Journal article (peer-reviewed)abstract
- Oral lichen planus (OLP) and lichenoid contact lesions (CL) are recognized as different pathological conditions of the oral mucosa. Cutaneous delayed-type hypersensitivity to mercury displayed by patients with CL but not by OLP patients supports the concept of different etiological mechanisms behind the two lesions. It is not possible to reveal this difference by histopathological assessments, and differences in clinical appearances are at present the only way to discriminate between the two conditions. It has recently been observed that T cells in OLP lesions express T-cell receptors (TCR) belonging to the Vbeta3 family in a higher frequency than expected from a random distribution, suggesting an involvement of superantigens as an etiologic factor behind this condition. In an effort to discriminate more clearly between OLP and CL, and to provide clues to the etiological mechanisms behind the two lesions, the TCR V-family distributions in the inflammatory infiltrates of OLP and CL were compared. Biopsies were taken from 10 patients with manifest OLP and 10 patients with CL. Frozen sections were incubated with antibodies against TCR Vbeta3, Valpha2 and Vbeta5a utilizing a standard immunoperoxidase technique. The frequency of Vbeta3.1 (clone 8F10) was calculated as 7%, and for Valpha2 less than 3%, and the results did not reveal any differences between OLP and CL regarding the frequencies of T-cell V-families. Thus, it was not possible to discriminate between OLP and CL by immunohistochemistry staining for different V families.
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| 2. |
- Bratel, John, 1953, et al.
(author)
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Anamnestic findings from patients with recurrent aphthous stomatitis
- 2014
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In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 38:3, s. 143-149
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Journal article (peer-reviewed)abstract
- Recurrent aphthous stomatitis (RAS) is a common oral disorder with a prevalence varying between 5% and 66%. RAS appears in three forms; minor, major and herpetiform. The aetiology is unknown.The aim of this study was to evaluate associations between specific anamnestic information and different types of recurrent aphthous stomatitis (RAS). A group of 177 patients (mean age=42.8 years; SD=14.3; range 17-79 years) participated. Data were collected from a structured interview, consisting of 22 questions. Information about i) health status and medication, ii) predisposing factors, iii) RAS experience, iv) previous treatment methods and v) brand of toothpaste was collected. Sixty-eight per cent of the patients were healthy and 44% of the patients were not taking any medication. Forty-one per cent of the patients did not have any apprehension of the reason for their RAS, while stress (15.8%) was the most common apprehended aetiological factor. Sixty-two per cent had one to three minor ulcers at one time. Forty-eight per cent reported having had a major aphthous ulcer at least once.The most frequent symptom reported was pain (53.7%), followed by a smarting sensation (18.6%) and tenderness (4%). The most common treatment for RAS was Zendium™ toothpaste/mouthrinse (28%), followed by corticosteroids (25%). Fifty-four per cent of the patients experienced no relief from the treatment. When toothpaste habits were investigated, Zendium™ was used by 32% of the patients and toothpaste containing sodium-lauryl-sulfatase was used by 32%. There was no positive correlation between the use of Zendium™ toothpaste and the relief of symptoms or the size, number or frequency of the aphthous ulcers. Sixty-four per cent of the patients had never smoked, while 7% were smokers. No positive correlation was found when age, gender, allergy, medication and smoking were correlated to the frequency, number and size of the aphthous ulcers. In conclusion, we found that the aetiology behind RAS is still unclear and probably multifactorial. Standard treatment methods like Zendium™ should perhaps be questioned and this study did not find any support for smoking as a "protective" factor, i.e. having less likelihood of experiencing major problems from RAS.
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| 3. |
- Bratel, John, 1953, et al.
(author)
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The effect of LongoVital on recurrent aphthous stomatitis in a controlled clinical trial.
- 2005
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In: Oral health & preventive dentistry. - 1602-1622. ; 3:1, s. 3-8
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study was to evaluate the effect of daily intake of LongoVital (LV) (herbal vitamin tablets) in the prevention of RAS. MATERIALS AND METHODS: A group of 78 consecutively referred patients was enrolled to a three-months pretreatment period. Fifty subjects were then randomly allocated to an LV-group (n = 25) or a placebo group (N = 25). A double blind, stratified-randomised clinical case-control study was performed during six months. Number and size of the ulcers were registered by the patients using a standardized chart. The degree of discomfort was recorded on a 100 mm horizontal visual analogue scale (VAS-scale). RESULTS: The three-months pretreatment period revealed that the most dominant symptoms were pain (78%) followed by burning sensation (18%). No significant differences between the two groups were found during this period when a comparison was made at the end of the study. After the intervention period the number of aphthous ulcers/month decreased significantly in the LV-group (p = 0.02). The number of days in pain/month were also reduced (p < 0.001). If a 50% reduction of number of aphthous ulcers and days in pain were considered as clinically relevant, no statistical significant differences were found between the groups. CONCLUSION: Thus, no strong evidence was found that justified a recommendation of LV as a general drug for treatment of RAS.
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| 4. |
- Bratel, John, 1953, et al.
(author)
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Treatment of oral infections prior to heart valve surgery does not improve long-term survival
- 2011
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In: Swedish Dental Journal. - 0039-6745. ; 35:2, s. 49-55
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Journal article (peer-reviewed)abstract
- The objective was to evaluate the importance of preoperative elimination of oral infections and oral health for survival after heart valve surgery In a group of patients (n=149; treatment group, GP group), oral health was examined and dental treatment was performed 3-6 months prior to heart valve surgery. In a second group (n=103; control group, SP group), oral health was examined postoperatively, but patients did not receive dental treatment prior to surgery. Sixteen years after heart valve surgery was performed, morbidity endpoint data were obtained. Differences in survival between the two groups and the influence of differences in oral health were analyzed. Fewer patients survived in the study group (37%) compared with the control group (45%). Mean survival was 122.9 months in the GP group compared with 143.3 months in the SP group, including time to death and those alive at the endpoint (p=0.018). A positive relationship was found between the number of teeth and survival, with RR = 0.98 (95% CI 0962-0.996 (p=0.016)).The deaths from heart valve disease were 18% in the GP group and 7% in the SP group (chi2=3.65, df=1, p=0.56). At the long-term follow-up,the results of the present study show,that it was not possible to demonstrate that dental treatment before heart valve surgery improved survival. Therefore, the need for extensive dental treatment prior to heart valve surgery may be reconsidered.
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| 5. |
- Schander, Kerstin, et al.
(author)
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Oral infections and their influence on medical rehabilitation in kidney transplant patients.
- 2009
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In: Swedish dental journal. - 0347-9994. ; 33:3, s. 97-103
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Journal article (peer-reviewed)abstract
- Infections seem to be the most common life-threatening complication of long-term immunosuppressive therapy following organ transplantation. Although sparse scientific evidence, potential oral infections are considered to contribute to these complications. The aim of this study was to examine whether there is an association between oral infections and rejections after kidney transplantation. A group of 46 kidney transplant candidates was enrolled. The patients were examined clinically and radiographically for dental caries, periodontal disease, mucosal lesions/infections, and general oral health problems. Examinations were conducted the day before transplantation, and one year post transplantation. Fifteen (32.6%) patients developed acute rejections during the first year. Six of these patients (40%) presented with oral opportunistic infections (candida or herpes infections of the oral mucosa). The number of dental infections and semi-impacted teeth were low. When rejections were related to probing pocket depths (PPDs) > or = 4 mm and apical lesions together, statistical significance was not reached (p=0.075, OR=3.17 [0.87; 11.55]). Similar results were obtained when PPDs > or = 4 mm, apical lesions, semi-impacted teeth, and opportunistic mucosal infections were compared to rejections. The results of the present study do not support that opportunistic oral mucosal infections or dental-related infections seem to increase the risk of rejection in kidney transplanted patients.
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| 6. |
- Öhman, David, et al.
(author)
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Partially erupted third molars as a potential source of infection in patients receiving peripheral stem cell transplantation for malignant diseases: a retrospective study
- 2010
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In: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 118:1, s. 53-58
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Journal article (peer-reviewed)abstract
- Forty-four patients with malignant diseases for which they received peripheral stem cell transplant therapy (PSCT) were retrospectively studied regarding local and systemic infection originating from around partially erupted third molars (PEMs). Twenty-two patients had one or more PEMs, while 22 patients had none. Data were retrieved from medical and dental records. Systemic and local signs of infection and treatment were assessed. We recorded the number of transplanted CD34(+) blood stem cells, days with white blood cell counts < 0.5 x 10(9) l(-1), days until engraftment, maximum level of C-reactive protein (CRP), days with fever, positive blood cultures, days taking antibiotics, days drinking < 0.5 l, days of total parenteral nutrition, days receiving intravenously administered analgesics, and number of admission days. No statistically significant difference was detected between patients with PEMs and those without PEMs regarding any of the studied parameters. Of patients with PEMs, 36% (8 of 22) developed local infections around PEMs during the PSCT period. The study indicates that PEMs pose no significant risk of causing systemic infection in patients receiving PSCT for malignant diseases but increase the risk of developing a local infection, justifying close supervision and early treatment in cases of local infection during PSCT treatment.
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