Acta Stomatologica Croatica最新文献

Objective: The removal of the root canal sealer is an important factor in nonsurgical retreatment. The aim of this study was to compare the removal of AH Plus, Well Root ST, and AH Plus Bioceramic Sealer using Protaper Universal retreatment files.

Methods: The curved mesio-buccal canals of extracted mandibular molars were prepared with the Protaper Gold file system (up to F2). Specimens were randomly divided into 3 groups and filled with the single cone technique using AH Plus, Well-Root ST, and AH Plus Bioceramic Sealer, respectively. After two weeks, the root canal filling of all specimens was removed using Protaper Universal retreatment files. All specimens were scanned using micro-CT. The remaining volume of the root canal filling was recorded in total and the coronal, middle, and apical third of each specimen.

Results: Well-Root ST and AH Plus Bioceramic Sealer groups had a higher percentage of total remaining filling material than the AH Plus group (P<0.05).

Conclusion: This study has shown that the volume of remaining root canal filling was significantly higher in the samples filled with calcium silicate-based sealers.

Objective: To assess thickness variations of thermoformed and 3D-printed clear aligners.

Materials and methods: Six different thermoplastic materials with different initial thicknesses were used for aligner thermoforming using Biostar® device (Biostar®, SCHEU-DENTAL GmbH, Iserlohn, Germany). Also, two different dental resins were used to create the printed aligners in three digitally designed thicknesses using IZZI Direct printer (3Dtech, Zagreb, Croatia). The aligners were measured using an electronic micrometer (ELECTRONIC UNIVERSAL MICROMETER, Schut Geometrical Metrology, Groningen, The Netherlands, accuracy: 0.001 mm) on a total of 20 points per aligner. Statistical analysis was performed using the JASP program (JASP, University of Amsterdam, Amsterdam, The Netherlands).

Results: The difference between the thermoformed and printed groups was statistically significant. Significant differences between different thermoformed materials and between 3D-printed materials were found. The thickness of thermoformed aligners deviated more in the upper jaw, whereas the thickness of printed aligners deviated more in the lower jaw. Both differences were statistically significant. The greatest average deviation from the initial thickness was found in Duran 0.75; Erkodur 0.6; Erkoloc-Pro 1.0; IZZI 0.5; NextDent 0.6 and NextDent A 0.6. NextDent group had the lowest deviations for all teeth of both jaws, except for upper and lower first molar where NextDent A group was more accurate.

Conclusions: Thermoformed aligners showed decreased values, while printed ones showed mostly increased values compared to the original material thickness. The highest mean deviation belonged to IZZI group, and the NextDent group had the lowest mean deviation. The thickness of both aligners was thinner at the edges compared to the thickness at cusps and fissures.

Objectives: Dental anxiety is a common problem and a great challenge for many patients, but also for dentists - the treatment of anxious patients is considered to be one of the most stressful situations for dentists. The aim of this study was to evaluate the prevalence of dental anxiety among the students of the University of Rijeka and to detect possible differences in the level of anxiety among students of different study programs.

Participants and methods: This cross-sectional study included 290 students from different faculties of the University of Rijeka (Faculty of Law, Faculty of Humanities and Social Sciences, Faculty of Engineering, Faculty of Medicine, Faculty of Dental Medicine), 73 (25.17%) male and 217 (74.83%) female students. The study was conducted online via The Modified Dental Anxiety Scale (MDAS) in 2020 and sampling was based on voluntary responses. The Student's t-test and ANOVA were used to compare differences in MDAS scores among students.

Results: There is a significant difference in dental anxiety levels between students from the Faculty of Humanities and Social Sciences and Faculty of Dental Medicine (MDAS=11.32±4.11, MDAS=8.84±3.03, p=0.01), and also between students from the Faculty of Law and Faculty of Dental Medicine (MDAS=11.47±4.64, MDAS=8.84±3.03, p <0.01).

Conclusions: This research showed that non-dental students have a higher level of dental anxiety than dental students. Sufficient knowledge of dental and oral health could potentially overcome dental fear and anxiety. Therefore, there is a need to provide additional dental education throughout the university curriculum.

Objectives: To ascertain the degree of precision and repeatability inherent in the "capture to edit" digital imaging system, namely the ColorChecker Passport Photo (X-Rite, MI, USA), and to juxtapose its performance against spectrophotometric assessments utilizing the Vita Easyshade® (Vita Zahnfabrik, H Rauter GmbH & Co. KG., Bad Sackingen, Germany) for the same set of teeth.

Materials and methods: Eighty participants aged 19-25 were included in the study; all of them were Croatian students at the School of Dental Medicine, University of Zagreb. Color measurements of the maxillary right central incisors were performed in controlled, standardized laboratory conditions. The measurements were performed on calibrated digital photographs by an experienced clinician three times in a row, and L, a, and b of CIELAB color space values were recorded. The same procedure was performed using the Vita Easyshade 5.0 spectrophotometer (Vita Zahnfabrik, Bad Säckingen, Germany) in "Tooth single" mode.

Results: The Cronbach's alpha was used as a repeatability measurement, thus revealing high consistency for both methods (α=0.94-1). Correlations were moderate (Pearson r=0.44-0.66 p<0.05). Testing confirmed that digital photography is inaccurate as spectrophotometry (p<0.05). An analysis of errors of means and their standard deviations revealed consistent discrepancies with minor deviations.

Conclusion: The "capture to edit" method showed high consistency (Cronbach's α=0.94-0.96), and it exhibits comparability in terms of variability, reliability, and repeatability when compared to spectrophotometric measurement (VitaShade 5, VitaZahnfabrik). Disparities between the methods are evident and anticipated, yet they do not follow a consistently linear pattern. The combination of repeatability and consistency renders the "capture to edit" method a valuable tool for enhanced color mapping, thus facilitating comparisons between digital images.

Objective: We aimed to assess the impact of the COVID-19 pandemic on the concern of adolescents in orthodontic treatment, and to determine whether personality traits and parental perception were predictors of adolescent patients' concerns.

Participants and methods: The sample consisted of 229 adolescent patients (57.2% female) and 223 parents (65.1% female). Questionnaires included items about the importance of infection control and concern about treatment duration and results. Their latent structure was determined using exploratory factor analysis. The Big Five Inventory was used for assessing personality traits. Predictors of patients' and parental orthodontic concern and awareness of the importance of infection control measures were tested by the hierarchical multiple regression analysis.

Results: Two factors were revealed for the patient questionnaire, Treatment concern (TC) and Awareness of the importance of measures (AM), and four factors for the parent questionnaire, Parents' treatment concern (PTC), Parents' awareness of the importance of measures (PAM), Parents' concern about the pandemic (PCP) and Parents' concern about their child with regards to the pandemic (PCC). Adolescents' personality traits were not predictors of either TC or AM. PTC was a predictor of TC (p<0.001), accounting for 28% of the variance. PAM and the patient's following of the news were predictors of AM (p≤0.022), accounting for 24% and 2% of the variance, respectively.

Conclusion: Parental concern and awareness of measures had an important role in attitudes of adolescent orthodontic patients during the COVID-19 pandemic, while personality traits did not. The clinician should put additional emphasis on communication with the parent.

Objectives: Understanding the shape and size of the sella turcica may help predict future orthodontic treatment needs related to skeletal malocclusion. This study aims to assess different morphological types of the sella turcica in lateral cephalometric radiographs and its correlation with malocclusion, as well as the relationship between gender and linear measurements of sella turcica.

Materials and methods: The lateral cephalometric radiographs of 410 volunteers (111 men and 299 women) aged 8 to 30 years were evaluated. The patients were divided into three groups based on their skeletal growth patterns (cl I, II, and III). Then the anatomical shape and linear dimensions of sella turcica were assessed. Measurements were made using Adobe Photoshop Version: 20.0.0 software, and data analysis was performed by IBM SPSS Statistics version 25.

Results: The following morphologies were observed: normal (37.8%), oblique anterior wall (9.3%), double contour of the floor (21.5%), sella turcica bridge (8.8%), irregularity (notching) in the posterior part of sella turcica (16.6%), and pyramidal shape of the dorsum sellae (6.1%). No statistically significant relationship was found between sella turcica variations and skeletal malocclusion. The correlation between female sex with the diameter (p=0.027) and depth values (p=0.035) of sella turcica was statistically significant. There was no statistically significant difference (p>0.05) in length based on gender.

Conclusion: The most morphological type reported was normal sella turcica (37.8%). Anatomical variations of sella turcica had no association with malocclusion. The most considerable depth and diameter of sella turcica were found in women.

Objective: to contribute to the validation of the Early Childhood Oral Impact Scale (ECOHIS) by studying its psychometric properties when applied to a Portuguese preschool population.

Methods: Cross-sectional study conducted with children aged between three and five-years-old. The non-probabilistic sample included two preschools in the municipality of Lisbon. Children who agreed to participate and whose guardians signed the informed consent were included. Data collection included a questionnaire, administered to the parents, and an intraoral examination of the children. The questionnaire included the Portuguese version of ECOHIS. The intraoral examination included the caries diagnosis according to the World Health Organization criteria. Discriminant validity compared the ECOHIS score between children with and without caries experience (Mann-Whitney U-test). Cohen's d was calculated to estimate the magnitude of the difference. Reliability analysis included Cronbach's α and test-retest. Construct validity was analyzed by the correlation between the ECOHIS score and dmft (Spearman's correlation). A significance level of 5% was used.

Results: The sample included 104 children (mean age 4.1 years). ECOHIS values were significantly different between children with and without caries (p=0.004). The Cohen's d was 0.84. The Cronbach's was 0.78, with no significant increase in value when eliminating any of the items. The test-retest showed significant correlation (r=0.76; p=0.01). There was a significant correlation between the ECOHIS score and caries experience (r=0.28; p=0.004).

Conclusion: The Portuguese version of the ECOHIS showed good psychometric properties, indicating that it is a reliable and valid tool to measure the impact of oral health in preschool children.

Objective: This study assesses the knowledge, practices, and attitudes of medical staff in intensive care units (ICUs) regarding oral hygiene care for critically ill, bedridden patients.

Material and methods: A cross-sectional study included 65 employees from the Intensive Care Units of the Sestre Milosrdnice Clinical Hospital Centre (CHC SM) and the Clinic for Anesthesiology and Intensive Care at the University Clinical Hospital Centre Zagreb (CHC ZG). A self-administered questionnaire was used to assess knowledge, methods, frequency, and attitudes towards oral care for mechanically ventilated patients. The data were examined through descriptive statistical methods, presented in terms of proportions (percentages). For the purpose of comparing the feedback across the two hospital centers and different educational backgrounds, the Chi-square and Fisher's exact tests were employed.

Results: Results of a survey of 65 participants (18 from CHC SM and 47 from CHC ZG) revealed a notable disparity in oral hygiene knowledge, with graduate nurses displaying the highest proportion of adequate knowledge (100%) and regular nurses showing the least (30.3%) (p<.001). Although the execution of oral care practices did not vary significantly among the groups, graduate nurses performed oral care more frequently (80% vs. baccalaureate technicians 33.33% and nurses 57.6%, three or more times a day) and demonstrated better proficiency in both mechanical (p=.005) and chemical (p<.001) biofilm management compared to their counterparts. No significant difference was observed in the delivery of oral care to orotracheally intubated patients across different educational levels (p=.127). However, a marked difference was noted in the perception of being adequately trained for such care, with nurses feeling less prepared (12.1%, p<.001). Despite these variances, all respondents recognized the importance of oral hygiene, thus showing a strong dedication to oral health care. Conclusions: This study highlights variability in ICU oral hygiene practices and points to the importance of standardized care protocols and improved training for healthcare staff.

Objective: This study aimed to evaluate the biological effects of "proanthocyanidin" (PA), and "nisin" (Ni), on dental pulp stem cells (DPSCs) and LPS-induced DPSCs as well as their antimicrobial effects against S. aureus and E. coli.

Materials and methods: After characterization of DPSCs, cytotoxicity of PA and Ni on DPSCs were evaluated using a water-soluble tetrazolium salt (WST-1). The cytokines and chemokines released by DPSCs and the expression levels of IL-6, IL-8, and TNF alpha were detected with human Cytokine Array C5 and enzyme-linked immunosorbent assay (ELİSA), respectively. The antibacterial activities of PA and Ni were tested using the drop plate method.

Results: PA at 75 μg/ml increased cell viability, decreased TNF-α expression of DPSCs, did not show any cytotoxic effects on LPS-induced DPSCs, and also showed a tendency to decrease TNF-α expression. PA at 75 μg/ml exhibited higher expressions of TIMP-2, OPG, IL-7, and IL-8 in LPS-induced DPSCs compared to DPSCs. Ni at 100 μg/ml decreased TNF-α expression in DPSCs with no cytotoxic effects. It provided increased cell viability and a downregulation trend of TNF-α expression in LPS-induced DPSCs. Both Ni and PA provided strong antibacterial effects against S. aureus. Ni at 200μg/ml had strong antibacterial effects against E. coli without affecting negatively the viability of both DPSCs and LPS-induced DPSCs and showed anti-inflammatory activity by decreasing TNF-α expression. PA provided strong antibacterial effects against E. coli at 200 μg/ml but affected DPSCs viability negatively.

Conclusion: PA and Ni at specific concentrations exhibited immunomodulatory activity on DPSCs and LPS-induced DPSCs without any cytotoxic effects and strong antibacterial effects on S. aureus.

Background: Epstein-Barr virus (EBV) is a widely disseminated herpesvirus for which antibodies have been demonstrated in over 90% of adults worldwide. After subclinical primary EBV infections, as well as after infectious mononucleosis, the virus can be shed in saliva for a prolonged period of time.

Aim: Diseases and disorders that can induce EBV salivary shedding include mental disorders and sex, connective tissue disease, multiple sclerosis, systemic lupus erythematosus, malaria and HIV infection. Since the occurrence of EBV in saliva during acute infectious diseases has not yet been systematically researched, we aimed to investigate the possible relationship between acute infectious diseases and salivary shedding of EBV.

Material and methods: This pilot cross-sectional study included consenting adults hospitalized for acute infectious conditions and their peers free of acute infectious diseases. A total of 40 patients with acute infectious diseases were enrolled, along with 41 adults free of acute infections. Peripheral venous blood samples for serodiagnosis and saliva samples for EBV PCR testing were collected from both groups. We fitted logit and general linear models to proportions and to ln (viral copy counts) to generate adjusted proportions and geometric mean values in the two groups of subjects. We used SAS for Windows 9.4.

Results: The most common acute infectious disease was COVID-19 pneumonia, followed by hemorrhagic fever with renal syndrome. Crude proportions of people with positive serological test results and those with saliva viral shedding were similar in the two groups.

Conclusions: The presented preliminary data do not indicate acute infectious conditions as a marked "contributor" in increasing salivary EBV shedding.