Diseased Teeth as a Focus - A Delusion or Reality?

U stomatološkoj praksi smanjen je interes da se infektivni fo kusi na zubima povezuju s poremećenim općim zdravstvenim stanjem i/ili reumatološkim tegobama. Zbog toga je u ovome radu prikazano dvoje bolesnika u kojih se temeljitom obradom došlo do zaključka da je streptokokna afekacija zubi bila uzrokom znatnih reumatskih poteškoća. Iznosi se podatak da od ukupne množine reumatoloških bolesnika 10% otpada na reaktivni artritis koji se može povezati s latentnim ili manifestnim infektivnim zarišitem u organizmu uključujući u njih bolesne zube. Nove spozanje govore u prilog činjenici da se atralgije i/ili artritisi pojavljuju kao imunološki odgovor samo u predisponiranih bolesnika, pri čemu je važno postojanje HLA B-27 antigena. Utvrđeno je da streptokoki skupine A i G mogu izazvati porast antistreptolizinskog titra (AST), a infekcija stafilokokima porast antistafilolizinskog titra (ASTA). Ako se isključe drugi fo kusi, takav imunološki odgovor organizma upućuje na mogućnost da postoji granulom zuba. U tome slučaju sanacija zuba može imati povoljan učinak.There is a decrease of interest in dental practice to relate dental infective foci to general condition disturbances and/or rheumatic difficulties. For that reason, we report on two patients, in whom careful medical treatment was followed by streptococcal land staphylococcal dental affection responsible for their rheumatic difficulties. The information is presented that 10% of all rheumatics have reactive arthritis which may be related to latent of manifest infective foci in the body, including diseased teeth. Some new concepts indicate that arthralgias and/or arthritis arise from immune response in predisposed patients only, the presence of HLA-B27 antigen being of considerable importance. It has been demonstrated that staphylococcal and group A and G streptococcal infection can increase the titer of antistaphylolysin (ASTA) and antistreptolysin (ASO) antibodies, respectively. It all other foci are excluded, such immune response indicates the possible presence of tooth root abscess. In this case, proper dental treatment may have a positive effect