Acta Stomatologica Croatica最新文献

Objectives: Numerous indices have been used to grade the severity of gingival overgrowth which led to suspicion regarding the results concerning its prevalence and pathogenicity. The aim of this study was to assess the concordance of three different gingival overgrowth indices, which were used widely in previous studies, and check their reliability and reproducibility.

Material and methods: A total of 30 full-mouth plaster casts and 90 intra-oral photographs collected from 30 patients diagnosed with gingival overgrowth were included in our study. Three trained examiners performed measurements twice on plaster casts using gingival hyperplasia index (A index) and hyperplastic index (B index). Intraoral photographs were assessed also twice using (C index).

Results: Concordance of intra-examiner and inter-examiner reliability of the recorded measurements was carried out for each index using weighted kappa (K), with a confidence interval of 95%. The A index revealed intra-examiner total kappa values between 0.724-0.876 for horizontal measurement and 0.512-0.823 for vertical measurement, and inter-examiner total kappa values between 0.255-0.626 horizontally and 0.235-0.279 vertically. The B index presented intra-examiner total kappa values between 0.587-0.868 horizontally and 0.653-0.855 vertically; and inter-examiner total kappa values between 0.393-0.595 and 0.372-0.635 for horizontal and vertical measurements, respectively. The C index achieved the highest intra-examiner concordance with total kappa values between 0.758-0.855 and inter-examiner total kappa values between 0.716-0.804.

Conclusions: The C index evaluated through intraoral photographs is considered the most reliable and applicable method to be utilized. The C index is suggested to be used in large scale populations with its definite detailed criteria.

Objective: Bioceramic-based sealers, in combination with bioceramic-coated gutta-perchas, have become more commonly used in root canal obturation. The present study aimed to assess the influence of laser-assisted dentin conditioning compared with conventional conditioning protocols on the push-out bond strength (PBS) of a bioceramic-based root canal filling.

Material and methods: Sixty extracted mandibular premolars with one root canal were instrumented with EndoSequence rotary files up to size 40/0.04. Four types of dentin conditioning protocols were used: 1) 5.25% NaOCl (control), 2) 17% EDTA+5.25% NaOCl, 3) Diode laser-agitated 17% EDTA+5.25% NaOCl, 4) Er,Cr:YSGG laser irradiation+5.25% NaOCl. Teeth were obturated using the single-cone technique with EndoSequence BC sealer+BC points (EBCF). After having obtained 1-mm-thick horizontal slices from the apical, middle and coronal root thirds, push-out test was carried out, and failure modes were determined. The data were analyzed by two-way analysis of variance and Tukey's test with a significance level of p<0.05.

Results: The apical segments showed the highest PBS in all groups (p<0.05). In the apical segments, EDTA+NaOCl and diode laser agitated EDTA increased the PBS compared to the control (p=0.0001) and Er, Cr: YSGG laser (p=0.011 and p=0.027, respectively) groups. Both laser-used groups revealed significantly higher PBS values in the middle and coronal segments than EDTA+NaOCl (p<0.05). The bond failure was predominantly cohesive without any significant difference among the groups (p>0.05).

Conclusions: Laser-assisted dentin conditioning had distinct effects on the PBS of the EBCF at different root segments. Although Er, Cr: YSGG was ineffective in the apical segments, generally, laser-assisted dentin conditioning affected PBS more favorably than conventional irrigation groups, with a more pronounced effect in the diode laser-agitated EDTA group.

Objectives: The study aimed to determine the relationship between the mandibular asymmetry index according to Kjellberg between patients with painful unilateral anterior disc displacement (DD) and asymptomatic volunteers without disc displacement. Vertical measurements were performed on a panoramic single-image radiograph, and the disc status was confirmed by magnetic resonance imaging (MRI).

Material and methods: Two groups of subjects were retrospectively selected, 40 patients (the overall mean age was 35.5 years; 75% female) with temporomandibular disorder symptoms confirmed by RDC/TMD axis I and manual functional analysis. Unilateral DD was determined by MRI. A comparative group of asymptomatic volunteers (20 dental students with a mean age of 23.4 years; 72% female) had the physiological position of the disc determined by MRI. The vertical asymmetry of the condyle was determined by the method of Kjellberg et al. The symmetry of the gonial angle of the mandible was also measured.

Results: A comparison of the mean of the asymmetry index between patients (average 90.89±7.08%) and asymptomatic volunteers (mean 95.86±4.44%) showed a statistically significant difference (p=0.0029). There was no difference (p=0.088) in gonial angle symmetry between the patients (mean 96.48±2.96°) and the asymptomatic volunteers (mean 97.52±2.31°). The distribution of the presence of individual DD diagnoses (partial and total displacement with reduction, displacement without reduction) in patients diagnosed with asymmetry of the mandible was without statistical significance (p>0.05).

Conclusion: This study actually points to the asymmetry of the mandible as a potential morphological risk of anterior DD.

Objective: Due to the consideration that oral/dental health is an important part of general health, well-being, and an individual's quality of life, the need for appropriate instruments assessing oral health-related quality of life is emphasized. This study aimed to evaluate the psychometric properties of the Oral health-related quality of life questionnaire consisting of 14 questions among the Macedonian language-speaking adults (OHIP-MAC 14).

Material and methods: A total of 270 adults participated in the study. The reliability of the questionnaire was examined by testing the internal consistency and reproducibility (test-retest). The responsiveness of the instrument was tested by computing the pre-intervention and post-intervention OHIP-14 scores using the paired t-test followed by the determination of the effect-size. The two aspects of the construct validity were evaluated: concurrent validity and discriminative validity.

Results: A concurrent validity analysis confirmed that the instrument performed well. Discriminative validity also confirmed good psychometric properties (P<0.01). The ICC statistics and the Cronbach alpha coefficients indicated the appropriate reliability of the instrument for the included groups of participants. The responsiveness of the questionnaire was also acceptable (P<0.01) demonstrating the large effect-size of 1.43.

Conclusion: The OHIP 14 MAC showed acceptable psychometric properties and can be recommended as a valuable instrument in assessments of the Oral health-related quality of life in the Republic of North Macedonia.

Objectives: Due to the emphasis on the protective and antimicrobial role of Nitric Oxide against gastrointestinal diseases, investigating its relationship with dental caries is a right topic. Therefore, this research has investigated the amount of saliva Nitric Oxide in different volumes of DMFT indicator in adults.

Material and methods: In this descriptive- analytical cross-sectional study, 80 participants (20-35 years old), without a history of systemic disease and drug use participated as research samples, (53.8% of the participants in the study were women). Participants were selected from patients who had visited dental Department. The participants were divided in four groups based on DMFT (DMFT=0, 1≤DMFT≤3, 3

Results: A significant relationship between DMFT and age was identified. At different levels of DMFT, significant relationship between DMFT and sex was not found. In different groups of DMFT, no significant relationship between Nitric Oxide and DMFT exist.

Conclusion: The level of Nitric Oxide saliva was not affected by the amount of DMFT.

Introduction: Antiresorptive drugs (AR) have been used for many years in the treatment of various bone conditions such as osteoporosis, osteopenia, Paget's disease, bone metastases, multiple myeloma and the associated malignant hypercalcemia. As a side effect of AR therapy, medication-related osteonecrosis of the jaw, which affects the mandible more commonly than the maxilla, (MRONJ) has become an increased risk regarding patients' health and quality of life. The incidence of osteonecrosis has increased significantly in the last few years. One of the main methods of the disease prevention is the education of patients and doctors of dental medicine (DDMs). This is evidenced by the national program of information and prevention of antiresorptive therapy side effects, which was also the impetus for this study.

Purpose: This study aims to test the knowledge of DDMSs on AR, especially on bisphosphonate (BF) therapy, MRONJ as well as on the risk factors of the disease itself.

Material and methods: 458 DDMs from the Republic of Croatia participated in the survey and responded by an anonymous questionnaire to questions about the knowledge of AR/BF and the risk of MRONJ.

Results: The results showed that 36.68% of DDMs do not know that MRONJ is the main complication of AR/BF therapy. The results are significantly different in terms of academic degree, specialization, workplace, and work experience. 60.26% of respondents do not know the main indications for AR/BF use, 53.26% do not know the factors affecting the onset of the disease, and 42.58% do not know which therapy is not recommended for patients on AR/BF therapy. 93.89% of respondents expressed the desire to educate on this issue. This current study was carried out to further investigate the pilot study findings which was conducted in the year 2015, but it had a significantly lower number of participants.

Conclusion: This research suggests that further education of DDMS on this topic is necessary to prevent or to start early treatment of MRONJ.

Objectives: Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day's busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well.

Aims: To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers.

Methods: The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits.

Results: ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%); dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children's parents (CI=10.55%, RI=10.80%, TI=12.98%).

Conclusion: Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.

Objectives: Molar crown wear is often used in bioarchaeological research as a proxy for age at death. However, a small number of researchers have used premolars or compared the application of different methods of relative age estimation.

Material and methods: Using a sample of 197 previously extracted maxillary first premolars from US dental patients, we considered three protocols for estimating age: the Bang and Ramm/Liversidge and Molleson (BRLM) age estimate method, occlusal topographic analysis, and the Smith system of macrowear scoring. A previous study utilizing the Bang and Ramm method yielded an age estimate range of 9.4 to 10.8 years for the sample.

Results: Our analyses showed no associations between occlusal topography parameters (occlusal slope, relief, or faceting) and BRLM age estimates, but some concordance was found between Smith scoring and BRLM ages estimates and between Smith scoring and occlusal topography parameters.

Conclusion: The results of the present study suggest that relationships between gross tooth wear, tooth shape, and dental age estimates are complex, and available methods should be considered together to gain a more comprehensive understanding of how teeth change their shape with wear throughout the lifecourse.

Objective: The increasing significance of medicolegal evaluation following maxillofacial traumatic events constitutes a complex issue. This clinical research aimed to assess the current etiology of oral and maxillofacial injuries in Portuguese population.

Material and methods: An epidemiological clinical observational study was conducted in Centro Hospitalar Lisboa Norte on a sample of 384 subjects diagnosed with oral and maxillofacial trauma, between 2018 and 2020. Data were collected through clinical reports and analyzed using SPSS version 27.

Results: Women and men were nearly identical in the number and distribution, with 49.5% females and 50.5% males. In 2020, there was a decrease in the number of traumatic incidents compared to other years. Falls or accidental descents were found to be the most common cause of injury, accounting for 44.3%, followed by assaults accounting for 24.7%. A total of 84 subjects exhibited soft tissue injuries related to periodontal region. The upper central incisors (174) were the most frequently affected teeth with uncomplicated fractures, and the predominant form of treatment was the administration of pain medication.

Conclusion: A correlation between falls or accidental descents, female subjects, and advancing age, as well as between assaults, male subjects, and adults, has been established. Falls or accidental descents and assault were the predominant etiologies, and the year 2020 exhibited a decrease in the incidents of traumatic events.

Objectives: Smokers with periodontitis are therapeutically challenging. Azithromycin (AZM) may be used as an adjunct to periodontal treatment. The aim of this randomized, double-blind, controlled clinical study was to determine the effect of azithromycin in shallow, moderate, and deep pocket depths in smokers when combined with non-surgical periodontal treatment.

Material and methods: Forty-nine patients who smoked at least 20 cigarettes per day for more than 5 years were included in the study; however only 40 completed it. The number of teeth, plaque index (PI), gingival index (GI), PPD, CAL, bleeding on probing (BOP) and gingival recession were recorded at baseline and months 1, 3 and 6. The pocket depths (PD) were grouped as shallow, moderate, and deep. Twenty-four patients assigned to the AZM+ (test) group received AZM (500 mg tablets) once a day for 3 days, beginning on the first day of SRP.

Results: The decline in the total number of pockets in all groups was statistically significant from baseline to 1^st, baseline to 3^rd, baseline to 6^th; and from 1^st to 3^rd and 1^st to 6^th months. There was a statistically significant increase in the number of shallow pockets between baseline and 3^rd, baseline and 6^th; and 1^st and 6^th months (p=0.000) for both groups.

Conclusion: Antibiotic administration significantly increased the number of shallow pockets at all time points. However, larger scale controlled clinical studies are needed to verify the efficiency of AZM in smoker periodontitis patients.