Acta Stomatologica Croatica最新文献

Objective: The aim of the study was to evaluate the surface areas and volumes of HyFlex EDM (HEDM) nickel-titanium (NiTi) files before and after multiple uses in mandibular molar root canal preparation.

Materials and methods: Twelve HEDM files with sizes of 10/.05 and 25/.08 were evaluated by micro-CT before and after a single use or multiple uses in root canal preparation. The mesiobuccal and mesiolingual root canals of thirty-six human mandibular molar teeth were instrumented using twelve 10/.05 (300 rpm and 1.8 Ncm) and twelve 25/.085 Ncm) HEDM files according to the manufacturer's recommendation. HEDM files were evaluated using micro-CT at four different timelines: 1) Intact file, 2) After instrumentation of one canal, 3) After instrumentation of two canals, and 4) After instrumentation of three canals. Each group's volume and surface area were analyzed by applying Friedman's test. Each group comparison was assessed using the Wilcoxon signed-rank test with Bonferroni correction.

Results: Intact HEDM 10/.05 and HEDM 25/.08 files showed significantly larger volumes and surface areas compared to the used instruments (p < 0.05).

Conclusions: A significant decrease in the volume and surface area of the NiTi files was observed as the number of uses increased regardless of the file group. These findings emphasize the importance for clinicians to understand the structural changes in HEDM files during repeated use to ensure safe instrument reuse and prevent endodontic treatment failure.

Objective: to analyze a single-visit endodontic treatment together with root canal detection practices in Croatia and investigate their relationship with reported postoperative pain, medication prescription, magnifying devices, rubber dam, radiographical checks before the procedure, cone-beam computed tomography (CBCT) and engine-driven instrumentation.

Materials and methods: A structured questionnaire was distributed via email to all Croatian dental practitioners, with 819 responses analyzed corresponding to an estimated 27% response rate. Statistical analyses included descriptive analysis and regression modelling.

Results: Among Croatian practitioners, 27.9% frequently performed single-visit endodontic treatments. Male practitioners, practitioners with continuous education and ample experience, endodontic specialists, and those working in polyclinics or academic settings were more likely to adopt this approach. It correlated positively also with the use of advanced diagnostic and treatment tools (e.g., magnification devices, rubber dam, CBCT) and a reduction in antibiotic prescription. However, it was associated with increased reported analgesic prescription and a larger number of reported vertical tooth fractures. Practitioners reported less frequently using single-visit endodontic treatments for multi-rooted teeth and those with associated sinus tracts or periradicular lesions. Furthermore, practitioners more often performing single-visit endodontic treatment rate themselves better in finding additional canals, which is positively influenced by usage of radiography and magnification devices. In addition, continuous education has a positive effect on the root-finding abilities, but it decreases with years of their clinical experience.

Conclusions: Single-visit endodontic treatment practice in Croatia is influenced by practitioner education, experience, and access to advanced equipment. While it offers benefits such as reduced antibiotic prescription, clinical attention and further research is needed to address potentially associated complications such as vertical tooth fractures and reliance on analgesics. Root finding abilities are positively influenced by continuous education. These findings underscore the role of education and resources in optimizing endodontic outcomes.

Objectives: The aim of this study was to evaluate epidemiological data on pemphigus vulgaris and pemphigoid, with special focus on characteristics, clinical manifestations, and treatment approaches.

Materials and methods: This study includes patients who have been diagnosed with pemphigus vulgaris or pemphigoid at the Dermatology Service of the Santa Maria Local Health Unit between the years 2013 and 2022. The statistical software IBM SPSS® version 29, with Clopper-Pearson 95% confidence intervals (CI) was used for proportions.

Results: The total number of patients included in this study is 99 patients with pemphigus vulgaris (49 females, 50 males) and 227 with pemphigoid patients (108 females, 119 males). Patients who have been treated for pemphigus vulgaris, the most prescribed medicine were corticosteroids, followed by the second most prescribed, drugs which were immunosuppressants. Additionally rituximab was used in 21 patients. The interval of the disease was 304 days; with an interval of no symptom disease was 415 days for relapsed patients. Similarly, for pemphigoid, the primary treatment used was with corticosteroids, which were also used for the main treatment, in many cases it was combined with other medicines, such as: antihistamines, antibiotics, and immunosuppressants. The average cure time was 148 days, with 32.0% of patients claiming they experienced relapse.

Conclusion: To conclude, we observed that corticosteroids, particularly prednisolone, remain still the most important pharmacological treatment for pemphigus vulgaris and pemphigoid. However, rituximab is an effective pharmacological alternative for pemphigus, while the use of clobetasol propionate is increasing and becoming as one of the preferred treatments for pemphigoid.

Objective: To analyze the color stability of Bulk-fill resins immersed in chicha morada and light-cured at different distances (0 mm, 2 mm and 4 mm).

Methods: This in vitro experimental study included a total of 216 Bulk-fill resin discs. The specimens were distributed into nine groups of 24 discs based on the type of resin (3M ESPE^® Filtek™ Bulk Fill^®, Ivoclar^® Tetric N-Ceram Bulk Fill^® and FGM^® Opus Bulk-fill APS^®), light-curing distances (0, 2 and 4 mm) and staining solution (control with distilled water and Naturalle^® chicha morada). Color measurements were taken 24 hours after fabrication and immersion in distilled water and Naturalle^® chicha morada at 24 hours, 1 week and 3 weeks.

Results: Light-curing distances affected the color stability of the resins with 3M ESPE^® and Ivoclar^®, ^thus exhibiting significant color changes at all evaluated time points when immersed in chicha morada. For the Delta (ΔE) value 3M ESPE^® and Ivoclar^® resin discs immersed in chicha morada showed significant changes at 24 hours 1 week and 3 weeks (p = .001, p = .000 and p = .000; and p = .000 p = .000 and p = .000 respectively). However, FGM^® resin discs exhibited significant changes only at 24 hours and 1 week (p = .000 and p = .001). FGM^® showed better color stability compared to 3M ESPE^® and Ivoclar^® at 3 weeks of immersion in chicha morada. All three commercial brands showed a significant decrease in the "L" value as immersion time in chicha morada increased.

Conclusions: The study concluded that FGM^® demonstrated better chromatic stability over time compared to 3M ESPE^® and Ivoclar^® Ceram, which exhibited significant color changes influenced by immersion duration and photopolymerization distance.

Objectives: There are two types of keratinized cystic lesions arising in the jaw - developmental cysts of odontogenic origin (odontogenic keratocyst - OKC and orthokeratinized odontogenic cyst - OOC) and epidermoid cyst (EC) of undetermined origin. These lesions have overlapping histopathological features and their treatment depends on the correct diagnosis. The aim of our study was to determine diagnostically relevant differences between these cysts and to establish criteria for diagnosing intraosseous EC.

Materials and methods: An immunohistochemical analysis comprised of various cytokeratins, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), epithelial cell adhesion molecules family member BerEP4, apoptosis-related markers bcl-2 and calretinin, stem cell marker CD44, tumor suppressor gene p63 and proliferation activity marker Ki-67 was performed on 25 OKCs, 8 OOCs and 11 ECs.

Results: CK5/6 was positive in all layers of both OKCs and OOCs, but only in the basal layer of all ECs. CK8/18 and CK19 revealed strong basal and suprabasal positivity in all OKCs, weak basal positivity in OOCs, and negative expression in all ECs. BerEP4 and Bcl-2 revealed positivity in all OKCs while being negative in OOCs and ECs.

Conclusions: The results of our study suggest that BerEP4 and Bcl-2 positivity may be useful in distinguishing between OKCs and the other keratinized jaw cysts. Orthokeratinized lesions within the jaw should be defined as OOCs, while intraosseal EC should be diagnosed only if immunohistochemical staining points to ectodermal origin, thus suggesting congenital or post-traumatic inclusion of the oral epithelium.

Objective: To examine the association between snoring, a primary symptom of obstructive sleeps apnea (OSA) and patients' age, sex, and anthropometric characteristics. The goal is to support dental medicine doctors in identifying individuals at increased risk of OSA.

Materials and methods: This retrospective cross-sectional clinical study included 795 participants. Data were collected on age, sex, and anthropometric measurements. Participants also completed the STOP questionnaire and the Epworth Sleepiness Scale. Overnight polysomnography was performed at the Clinical Hospital Center Split and the University of Split School of Medicine between 2018 and 2023.

Results: Participants who reported snoring were significantly heavier (96.5 ± 20.5 kg vs. 84.6 ± 19.3 kg) and had a higher BMI (31.3 ± 10.9 kg/m² vs. 27.2 ± 5.1 kg/m²) than those without snoring. They also had larger neck (41.5 ± 6.0 cm vs. 38.8 ± 4.5 cm), waist (107.8 ± 15.4 cm vs. 96.9 ± 15.4 cm), and hip (110.7 ± 12.3 cm vs. 106.0 ± 11.0 cm) circumferences (P < 0.001 for all). These participants also reported greater daytime sleepiness (Epworth Sleepiness Scale: 7.8 ± 4.9 vs. 5.9 ± 4.2; P < 0.001) and had significantly higher AHI values (32.8 ± 26.1 vs. 15.1 ± 17.5; P < 0.001), indicating more severe OSA.

Conclusion: Snoring is significantly associated with higher body mass, increased BMI, larger body circumferences, greater daytime sleepiness, and more severe OSA. It may serve as a useful clinical marker for dentists when identifying patients at elevated risk for OSA. Among the examined variables, BMI, AHI, and age were significant predictors of snoring, while sex did not show a statistically significant influence.

Background: The complex anatomy of root canals in primary teeth makes root canal treatment and canal filling difficult. Root canal filling materials should meet the basic requirements for hermetic filling in terms of their physicochemical properties, such as radiopacity and viscosity, which might be affected by heat.

Objectives: The aim of this study was to investigate the effect of different temperatures on the filling quality and hermetic obturation ability of primary root canal filling pastes.

Materials and methods: Primary root canal filling pastes containing calcium hydroxide with barium sulphate and calcium hydroxide with iodoform were heated to four different temperatures (4°C, 23°C, 39°C and 55°C). After instrumentation, 80 endodontic blocks were filled with the heat-treated sealers. Digital radiographs were taken and analysed. The results were analyzed using Tukey's HSD, two-way Robust ANOVA, and the Bonferroni test for multiple comparisons.

Results: The results of this study, the obturation radiopacity values of calcium hydroxide paste containing barium sulphate showed significant differences at different temperature values. Paste at 4°C showed significantly higher radiopacity (p<0.001). Paste at 55°C showed both significantly higher radiopacity (p<0.001), and the total unfilled area values obtained at 55°C was found to be significantly lower than the other temperatures (p=0.025).

Conclusion: It was observed that the preheating process had a positive effect both on the filling quality and hermetic obturation capacity of primary root canal sealants at high temperatures.

Background: A comprehensive understanding of the anatomy and pathology of the maxillary sinus is paramount for precise diagnosis and effective planning of dental interventions. Cone Beam Computed Tomography (CBCT) offers enhanced visualization of sinus structures, thus facilitating the identification of anatomical variations and pathological conditions which are critical for surgical and dental treatment strategies.

Materials and methods: This retrospective descriptive study analyzed 200 CBCT scans, comprising 400 maxillary sinuses from patients treated at the Faculty of Dentistry University of Sarajevo. The study assessed sinus dimensions, volumes, anatomical features, their relationships with adjacent anatomical structures, and the occurrence of pathological alterations. Furthermore, the patient's gender and dental status were studied in relation to these features. The sinus measurements were performed with Sidexis 4 software (Dentsply Sirona, Germany), which is intended for precise linear measurements in three orthogonal planes.

Results: Significant differences were found in sinus width between patients with full dentition and those with partial or complete edentulism (p<0.01). Male participants exhibited larger mean sinus dimensions compared to females in all dimensions. The maxillary sinus floor was inferior to the nasal floor in 91.5% of cases. Various types of sinus membrane abnormalities were observed, with normal membrane thickness in 53.75% of cases. Sinus septa were most frequently located on the roof of the sinus, and their frequency varied significantly among patients with different dentition statuses. The study also identified 274 Haller cells and documented several pathological changes, with mucosal thickening exceeding 3 mm being the most common alteration.

Conclusion: This radiographic study of Bosnian and Herzegovian population revealed significant anatomical variations and pathological changes in maxillary sinuses, thus emphasizing the importance of careful preoperative evaluation using CBCT for surgical planning in the posterior maxillary area. The findings highlight gender-based differences in sinus volumes, the impact of dentition status on sinus anatomy, and the prevalence of various pathological conditions, thus contributing to valuable insights in the field of maxillofacial radiology.

Objectives: The group of spondyloarthritis (SpA) disorders shares common clinical manifestations, including internal derangement (ID) of temporomandibular joint (TMJ). This study aimed to investigate SpA activity in patients with ID of TMJ.

Materials and methods: We assessed 200 patients with neck pain using the Assessment of Spondyloarthritis International Society (ASAS) criteria. TMJ was examined using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD protocol). Patients with SpA were divided into three groups: symptomatic ID of TMJ, asymptomatic ID of TMJ, or healthy TMJ (controls). Activity of SpA was evaluated using the Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Disease Activity Index in Psoriatic Arthritis (DAPSA), patients' self-estimated SpA activity, difficulties in performing daily activities, pain intensity (visual analogue scale) and laboratory parameters.

Results: Patients with symptomatic and asymptomatic ID showed statistically significantly increased ASDAS, anti-streptolysin titer, patients' self-estimated axial pain and activity of SpA, and decreased hematocrit than the control. Patients with symptomatic ID also had statistically significant earlier onset of SpA, along with increased BASDAI and DAPSA, total body pain, difficulties in performing daily activities, platelet count, and serum alpha-amylase but lower hemoglobin concentration than controls. Patients with asymptomatic ID had higher frequencies of exacerbated axial SpA and sacroiliac joint ankylosis compared to the control.

Conclusion: All patients with SpA and ID showed increased axial disease activity.

Objectives: Dental agenesis refers to the absence of one or more teeth, occurring in both primary and permanent dentitions. It can result in several complications, impacting functional aspects of the dentition, such as chewing and speech. This study aimed to evaluate the prevalence of agenesis of permanent incisors, premolars, and third molars in patients aged 8-18. The prevalences were compared according to age, gender, and the regions they live in.

Material and methods: This study was conducted in the Central Anatolia and Mediterranean regions of Turkey. It included data from 593 patients, 304 females and 289 males. The study involved a retrospective evaluation of the patients' orthopantomographic images. Descriptive statistics were employed for the analysis.

Results: In the study, the prevalence of incisor agenesis among all patients was 2.4%. Premolar agenesis was found in 3.9% of patients, with the mandibular second premolar being the most commonly missing premolar (missing in 19 patients). The prevalence of third molar agenesis was 19.9% (118 patients). Incisor and premolar agenesis were more common in the Central Anatolia region than the Mediterranean region, whereas third molar agenesis was more prevalent in the Mediterranean region. In both regions, the left mandibular premolar was the most frequently missing premolar tooth, and the left maxillary third molar was the most frequently missing third molar tooth.

Conclusion: This study presents a thorough analysis of the prevalence and distribution of tooth agenesis, with a particular focus on incisors, premolars, and third molars. The results emphasize the necessity of considering gender differences and specific tooth locations in the diagnostic and therapeutic approaches to tooth agenesis.