Acta Stomatologica Croatica最新文献

Objectives: This study aimed to determine the effect of time span between exposing the enamel to calcium lactate and sodium fluoride and of a demineralized surface on the uptake of alkali-soluble fluorides.

Materials and methods: A total of 20 non-carious human wisdom teeth, were used. First 10 teeth, were cut into four slabs each and allocated to one of four groups: two treatment groups A) Calcium lactate followed by sodium fluoride with minimal delay (just drying between the two treatments); B) Calcium lactate followed by sodium fluoride with a delay of one hour; one of two control groups C) Sodium fluoride, as the positive control; D) Negative control group without treatment. The other 10 teeth were used for the second part of the research, each tooth was cut into 4 slabs and divided into one of two groups - the first group underwent two weeks of demineralization liquid treatment, the second group, as a control, underwent two weeks in deionized water. After two weeks, all slabs were treated with calcium lactate and followed with sodium fluoride 226ppm F-.Enamel fluoride uptake was determined by the fluoride extraction method by Caslavska and analyzed using a fluoride ion-specific electrode.

Results: Enamel fluoride uptake showed no statistical difference regarding various durations of treatment between exposing enamel slabs to calcium lactate and sodium fluoride, as well as demineralization of the surface of the enamel.

Conclusions: Time span between exposing enamel to calcium lactate and sodium fluoride and the demineralization process did not significantly affect the enamel uptake of alkali-soluble fluorides.

Objective: The aim of this study was to investigate the stress distribution and force direction in Nobel Active implants and their crowns under varying implant angulations using finite element analysis.

Materials and methods: A three-dimensional finite element analysis was conducted using Nobel Active implants with zirconia crowns. Implants were modelled at 0°, 5°, and 10° angulations. Vertical loads of 300 N were applied to simulate masticatory forces. Stress distribution (von Mises stress) and force directions (DX, DY, DZ) were analyzed across the crown, implant body, and hard bone.

Results: Increased implant angulation amplified stress across all regions. The crown exhibited stress levels of 51.72 MPa (0°), 52.12 MPa (5°), and 54.26 MPa (10°). The implant body showed stress ranging from 44.3 MPa (0°) to 64.59 MPa (10°). Hard bone stress increased from 21.84 MPa (0°) to 37.37 MPa (10°). Force directions showed the highest displacement in the DY axis, increasing from 0.0107 mm (0°) to 0.0156 mm (10°).

Conclusion: Implant angulation significantly influences stress distribution and force dynamics. Higher angulation increases stress in the crown, implant body, and hard bone while amplifying vertical and anteroposterior forces. These findings emphasize the importance of precise angulation planning and material selection to optimize implant performance and longevity.

Objective: This scoping review aimed to map the knowledge, perceptions, and attitudes of dental professionals and students regarding MIH.

Materials and methods: A systematic search was conducted in the electronic databases MEDLINE/PubMed, Scopus, Web of Science, and Embase up to May 2023. A search in the OpenGrey database for grey literature was also performed. The reference lists of potentially eligible studies were checked to ensure that all relevant studies were analyzed. Scientific papers were considered eligible if they met the specified inclusion criteria: (1) focused on MIH; (2) assessed the knowledge/perception/attitudes of oral health professionals. Scientific papers were deemed ineligible if they met any of the following exclusion criteria: (1) lacking data on the knowledge/perception/attitudes regarding MIH among dental health professionals and students; (2) being a literature review/expert opinion/systematic review/case report.

Results: 207 potentially eligible studies were identified, and 35 studies were included. A clear distinction emerged between qualified dental professionals and students regarding knowledge, attitudes, and management of MIH. Globally, variability was evident: Australia/New Zealand demonstrated strong protocols, China/Chile reported substantial gaps, and the UK showed mixed performance. Treatment preferences differed, with Saudi Arabia favoring stainless steel crowns/composite resin and Malaysia using glass ionomer cement/composite resin.

Conclusion: Knowledge, attitudes, and management of MIH differ significantly across professional levels and countries. Specialists and general dentists show greater confidence in diagnosing and treating MIH than students, though variations exist within both groups. The systematic review protocol was registered in OSF platform (doi: 10.17605/OSF.IO/NHMV2).

Objectives: The primary objective of this study was to examine the potential association between glutathione S-transferases (GSTT1/GSTM1) deletion polymorphisms and the development of apical periodontitis (AP) in a population of patients at two university centers: the Faculty of Medicine at the University of Banja Luka in Bosnia and Herzegovina and the School of Dental Medicine at the University of Belgrade in Serbia.

Materials and methods: The study involved 200 patients with AP in the experimental and 250 healthy individuals without AP in the control group. As a source of genomic DNA, sterile buccal swabs were taken from each patient. Genotyping of GSTM1 and GSTT1 deletion polymorphisms was conducted using multiplex Polymerase Chain Reaction (PCR). The risk of AP development with regard to the genotypes was evaluated based on odds ratios (ORs) and 95% confidence intervals (CIs) that were calculated via unconditional logistic regression.

Results: There were significant differences in demographic characteristics between the investigated groups (p = 0.446, p = 0.154, respectively). GSTM1 and GSTT1 deletions were associated with a 3.05-fold and 5.69-fold risk (OR = 3.05, 95% CI = 2.07-4.49, OR = 5.69, 95% CI = 3.66-8.86, p < 0.001, p < 0.001, respectively) for the AP development. The co-occurrence of both deletions posed a significantly higher risk for AP development (OR = 52.76. 95% CI = 18.20-152.94, P < 0.001).

Conclusions: The carriers of null GSTT, null GSTM, and double null GSTT/GSTM genotypes are more susceptible to AP development in the populations examined at the two centers.

Objectives: This study aimed to evaluate the relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms and various oral health outcomes in children, including dental trauma, plaque accumulation, gingivitis, endodontic treatment, and molar incisor hypomineralization (MIH).

Materials and methods: Eighty children (42 boys and 38 girls) aged 3 to 17 years participated in the study. Caregivers completed a standardized ADHD diagnostic tool (ADHDT) assessing inattention, hyperactivity, and impulsivity. Each child underwent a comprehensive oral examination to assess the presence of plaque, gingivitis, dental trauma, endodontically treated teeth, and MIH.

Results: No statistically significant associations were observed between ADHD symptoms and the presence of plaque, gingivitis, endodontic treatment, or MIH. However, a significant association was found between higher hyperactivity and impulsivity scores and increased incidence of dental trauma. Inattention symptoms did not demonstrate a significant relationship with any of the oral health indicators.

Conclusions: Children exhibiting higher levels of hyperactivity and impulsivity may be at increased risk for dental trauma. These findings highlight the importance of integrating behavioral assessments into pediatric dental care to better identify and manage children who may be more vulnerable to oral injuries.

Objective: This study aimed to evaluate parental knowledge, behaviors, and sociodemographic predictors influencing children's oral hygiene practices, dental visitation patterns, and dental fear in Croatia.

Materials and methods: A cross-sectional study involving 100 parents of children aged 0-7 years was conducted at the Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb. A structured, validated questionnaire assessed parental knowledge, dietary habits, brushing frequency, fluoride use, dental visit reasons and frequency, and child dental fear. Statistical analyses included chi-square tests, ANOVA, Spearman correlations, and logistic regression to identify predictors of inadequate oral hygiene, irregular dental attendance, and dental fear.

Results: Only 68% of children brushed their teeth twice a day; 66% consumed sweets daily, and 33.3% drank sweetened beverages daily. Logistic regression revealed that brushing once per day or less-classified as inadequate brushing-was significantly predicted by daily consumption of snacks (OR = 2.91, p = 0.025) and low parental oral health knowledge (OR = 2.58, p = 0.043). Irregular dental visits were more likely in children with a history of dental pain (OR=3.42, p=0.019). Child dental fear (41.4%) was predicted by previous trauma (OR=26.4, p=0.001), frequent check-ups (OR=27.4, p=0.009), and parental education (OR=10.0, p=0.049), while trauma management knowledge was protective (OR=0.067, p=0.002). Fluoridated toothpaste use was positively associated with regular dental attendance.

Conclusions: Children's oral health behaviors and fear are significantly influenced by parental knowledge, education, dietary patterns, and trauma experiences. Educational interventions targeting caregivers, particularly regarding trauma response and oral hygiene, are warranted to improve pediatric oral health outcomes.

Background: Methods that use lateral teleradiography for sex estimation need to be discussed considering their feasibility and applicability in forensic cases.

Purpose: The aim of this study was to conduct a systematic review about the use of lateral teleradiography for sex estimation in adults.

Methods: A search was conducted on Embase, PubMed/MEDLINE, Scopus, Lilacs, Scielo, and Web of Science databases. The search results were exported to Rayyan (https://www.rayyan.ai/). Subsequently, two independent reviewers applied eligibility criteria to select studies related to the topic, resulting in nine studies. Regarding the risk of bias, the checklist recommended by The Joanna Briggs Institute was applied. The risk of bias in all selected studies was considered low.

Results: However, a meta-analysis could not be performed, as there was no standardization in the way the data were presented. Regarding the included studies, it was noted that the samples came from six countries and that the studies presented methodological discrepancies regarding the measurements used in the analyses. As a result, the accuracy rates varied from 56.3% to 99.0%.

Conclusion: It is concluded that lateral cephalometric radiography can support sex estimation in adults, especially in settings with limited resources. However, due to variations in measurement methods and landmarks across studies, future research should adopt standardized and more rigorous methodologies to strengthen its scientific validity.

Objectives: This study evaluated the cytotoxicity of different thermoplastic materials and the impact of thermoforming on their cytotoxicity.

Materials and methods: Four 3D thermoplastic materials were tested before and after thermoforming: Zendura A (Bay Materials), Zendura FLX (Bay Materials), Erkoloc-pro (Erkodent), and CA Pro + (Scheu Dental). The samples were stored in artificial saliva and incubated at 37 °C for 14 days to simulate conditions in the oral cavity during one stage of clear aligner treatment. Then, the saliva was diluted with a complete culture medium at three concentrations: c1=10%, c2=20% and c3=30%. Cytotoxic activities of the materials were evaluated after incubation for 4h, 24h, 48h, and 72h by using the CCK-8 assay on human oral fibroblast cells (Innoprot, REF: P10868).

Results: The mean measured values of metabolically active cells below 70% of the control were for c3 of non-thermoformed Zendura A and Erkoloc-pro, and thermoformed Zendura A, after 72-hour incubation. The analysis showed differences between non-thermoformed: Zendura A and Erkoloc-pro and Zendura FLX and CA Pro +, thermoformed: Zendura A and CA Pro +, and Zendura FLX and CA Pro + at certain conditions. Differences between concentrations (c2 vs. c3 and c1 vs. c3) in the non-thermoformed group were found. There were no statistically significant differences in cytotoxicity between non-thermoformed and thermoformed groups.

Conclusions: Cytotoxicity was observed in non-thermoformed and thermoformed materials, with significant differences between concentrations of the same material. However, the thermoforming process did not impact the cytotoxicity of clear aligner materials.

Objectives: The aim of this study was to evaluate the bond strength of a new endodontic filling material containing added bioactive glass in comparison to a conventional polydimethylsiloxane-based material.

Materials and methods: Fourteen single-rooted teeth were chemo mechanically prepared, divided into two test groups and filled with the test material. The samples were embedded in acrylic resin and sectioned into 1 mm thick slices using a diamond saw. An average of 8 samples was obtained from each tooth (GuttaFlow2 n=37, GuttaFlow bioseal n= 34). The force required to fracture each individual sample was measured using the 'push out' test method. The Kolmogorov-Smirnov test assessed the 'bonding strength' distribution, and the Mann-Whitney U test compared bonding strength differences between the filling material groups.

Results: The Mann-Whitney U test showed no statistically significant difference between the two tested groups (P > 0.05).

Conclusion: No statistically significant differences in bond strength between tested materials were observed.

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.