Acta Stomatologica Croatica最新文献

The article presents a case of a young female patient who sought help due to myofascial pain followed by a sudden occlusal change (anterior open bite (AOB)) that occurred shortly after the administration of a soft night guard that had been previously provided by a general dentist. Palpation of the masseter and temporal muscles elicited the presence of familiar pain. After magnetic resonance imaging of temporomandibular joints, which ruled out disc displacement, the final diagnosis was myalgia. Since the patient had myalgia and malocclusion, the therapy included treatment of both conditions. Temporomandibular disorders (TMDs) management included a combination of kinesiotherapy, pharmacotherapy, and a stabilization splint. After TMD symptoms had resolved, the patient underwent an orthodontic evaluation. Cephalometric analysis revealed skeletal class II, retrognathic face, convex profile, and normal vertical growth pattern. Orthodontic treatment included a fixed appliance with vertical intermaxillary elastics. After 19 months of treatment, both sides achieved acceptable occlusion with Class I. Since the patient had myalgia and severe malocclusion, it was important to follow a systematic diagnostic and therapeutic workflow. Although it is impossible to establish a relationship between TMD symptoms and orthodontic therapy, patients who have TMD symptoms should have their pain resolved through a conservative treatment protocol before commencement of orthodontic treatment. The beginning of orthodontic therapy comes into consideration only when the TMD pain resolves.

Objective: To assess the potential correlation between clinical peri-implant parameters and the presence of Porphyromonas gingivalis in different peri-implant conditions.

Material and methods: The study included 30 patients from the Department of Periodontology and Oral Medicine divided into three equal groups, defined according to the following diagnoses: peri-implantitis (PI), peri-implant mucositis (PM), and peri-implant health (HI). Clinical parameters such as peri-implant probing depth (PPD), bleeding on probing (BOP), suppuration on probing (SUP), and plaque index (PI) were recorded. The samples of peri-implant crevicular fluid were collected and relative levels of Porphyromonas gingivalis were analyzed using Real-Time PCR (Reverse transcriptase - real-time polymerase chain reaction).

Results: The mean patient age was 51.33 ± 12.61 years. The mean value for Porphyromonas ginigvalis relative level was higher in the PI group (14.80 ±31.51) compared to PM and HI group (0.48 ± 1.34 and 0.06 ± 0.12, respectively). This parameter significantly differed between PI and HI (p=0.012), as well as PI and PM (p=0.049). The mean whole mouth probing pocket depth (PPD) in the PI group (4.02mm ± 0.77mm) was also significantly greater compared to the other two groups (3.39mm ± 0.52mm in PM and 1.97mm ± 0.54mm in the HI group. The SUP in the PI (mean value of 18%) group was more frequent than in PM (mean value of 14%) while the SUP was not detected in the HI group. The correlation between clinical parameters and relative levels of Porphyromonas gingivalis was not significant.

Conclusions: The findings of this research indicate higher relative levels of Porphyromonas gingivalis in peri-implant lesions, especially in peri-implantitis.

Objective: To compare the effectiveness of reciprocating instruments in removing gutta-percha and bioactive-based (BioRoot RCS and MTA Fillapex) and epoxy resin-based (AH Plus) sealers from root canals based on filling residues and the time required for root canal revision.

Material and methods: Root canals of 90 teeth were instrumented with Reciproc R40. All root canals were obturated using the single-cone technique with Reciproc R40 gutta-percha and with one of the selected sealers. Samples with oval, straight canals were used and randomly divided into three groups: (i) filled with AH Plus sealer and gutta-percha (n=30); (ii) filled with MTA Fillapex and gutta-percha (n=30); (iii) filled with BioRoot RCS and gutta-percha (n=30). Each group was divided into two subgroups (n=15) according to the retreatment instrument used (Reciproc M-Wire R25/R40 or Reciproc blue RB25/RB40). Root canals were longitudinally split and analyzed with a stereomicroscope at 15 × magnifications in the coronal, middle, and apical third. Computational analyses were performed with the Image J software. Data were compared using the Kruskal-Wallis test and Mann-Whitney U test.

Results: While no statistically significant differences in the residual material surface were found for Reciproc Blue, Reciproc M-Wire showed significantly higher residual material surface for AH Plus and MTA Fillapex compared to BioRoot RCS. For AH plus. Residual material surface was significantly lower for Reciproc Blue than for Reciproc M-Wire. In contrast, BioRoot RCS showed a significantly higher residual material surface for Reciproc Blue.

Conclusions: Calcium silicate-containing sealers were more retrievable compared to AH Plus, with fewer sealer remnants and shorter retreatment time. Retreatment with Reciproc M-Wire instruments was superior to Reciproc blue instruments in retreatment of BioRoot RCS. However, none of the sealers were removed completely.

Objective: The aim of this study was to examine the satisfaction of parents and caregivers of patients who underwent dental treatment in general anesthesia (GA) in a day-care surgery setting.

Material and methods: Anonymous questionnaire was sent to parents/caregivers of patients who underwent full mouth restoration in GA. The survey consisted of 4 parts: general data, data about procedure, satisfaction with various aspects of care and the perception of parents/caregivers about the condition of their child in relation to the time before dental treatment in GA.

Results: 66 parents/caregivers (30.5%) responded to the questionnaire. Overall satisfaction with the treatment was high (4.69). Respondents expressed the highest degree of satisfaction with communication with nurses (4.92), and the lowest with the waiting time for the procedure (3.89). Parents/caregivers of patients who reported difficulty eating expressed significantly lower overall satisfaction than the subjects whose children did not report difficulty eating. Also, the more treatments the patients underwent, the lower was the overall satisfaction than of those subjects whose children were never treated in such a manner before.

Conclusions: Since patient satisfaction has a beneficial impact on treatment outcome and adherence to preventive recommendations, all health care providers should strive to achieve it.

Objective: Effective tools and methods are applied during root canal retreatment to eliminate root canal obturation materials and preserve the initial root canal anatomy. The present study compared the efficacy of Reciproc, Neoniti, ProTaper, and Hedstrom files in the retreatment of curved root canals.

Material and methods: In the present in vitro study, 100 root canals with 25‒45º curvatures were used. After the samples were initially prepared and examined by CBCT, the root canals were obturated with gutta-percha and randomly assigned to four groups (n=25). A retreatment was carried out in each group with NeoNiTi, ProTaper, Reciproc, and Hedstrom files. CBCT examinations were carried out again under the same conditions. The samples were evaluated at 3-, 6-, and 9-mm distances from the apex on the first and the second CBCT image for root canal transportation and remaining gutta-percha in the root canals. The time required for retreating each canal in each sample was recorded. One-way ANOVA and corresponding non-parametric tests were applied for data analysis.

Results: The root canal transportation in the NeoNiTi group was lower than that in the other groups and significantly different from the ProTaper group (P<0.05). There was a remaining gutta-percha after retreatments in all the four groups, which was not statistically significant (P>0.05).

Conclusion: Despite the fact that the NeoNiTi file produced less transportation than other file systems evaluated in the retreatment of curved root canals, all the files were very effective at the clinically acceptable levels.

Objectives: The aim of the study was to evaluate the attitude and perspectives of dental students of four Croatian universities towards online learning during the COVID-19 pandemic.

Material and methods: An anonymous internet-based survey was administered to undergraduate dental medicine students at the Universities of Zagreb, Rijeka, Split and Osijek. The 29-item questionnaire collected data on students' demographics, online learning organization and management, and perception of online classes.

Results: Five hundred and four participants (85.1% female) took part in the survey. The majority of the participants (63.5%) were from the University of Zagreb. 39.6% of students reported agreement regarding online learning satisfaction. Individual university satisfaction ratings on overall online learning were: Osijek 3.69, Zagreb 3.22, Split 3.05 and Rijeka 2.64. Most students considered that lectures (82.9%) and seminars (78.9%) could be successfully delivered in an online learning format. The online learning format cannot successfully deliver laboratory, preclinical, clinical practicals or clinical clerkship, as agreed by more than 80% of the total student sample. 60% of students consider online learning a valuable alternative to face-to-face instruction.

Conclusion: Online learning was highly praised for educational formats such as lectures and seminars, and was considered a useful substitute for conventional learning. Conventional practical courses cannot be substituted with online learning. Overall perspective about online learning was mixed among the students of four universities. The findings of the present study can serve to help individual universities address the shortcomings and reinforce the strengths of their OL programs.

Objectives: The aim of the study was to examine the impact of rapid high-intensity polymerization on water sorption and solubility of a new generation of bulk-fill composite materials.

Material and methods: Five materials were tested: a conventional composite Filtek Z250 (3M, St. Paul, USA) and four bulk-fill composites, Filtek One Bulk Fill (3M), Tetric PowerFill (Ivoclar Vivadent, Schaan, Liechtenstein), Tetric PowerFlow (Ivoclar Vivadent), SDR Plus (Dentsply, Konstanz, Germany). Composite specimens with a 9-mm diameter and a 2-mm height (n = 6) were polymerized with a high-intensity curing unit (Bluephase® PowerCure, Ivoclar Vivadent). The control group was polymerized for a total of 40 s on both sides (1193 mW / cm²) and 3s group for 3 s on one side (3053 mW/cm²). Water sorption and solubility were measured by ISO 4049 method up to 30 days of immersion. The results were statistically analyzed using one-way ANOVA with Tukey post-hoc correction. Different polymerization protocols for the same material were compared by t-test (p <0.05).

Results: The 3s polymerization protocol increased the solubility of all materials. Filtek One Bulk Fill showed the highest water sorption and solubility values, and Tetric PowerFlow proved to be a stable material with low values of tested parameters. During immersion, a saturation of specimens was achieved in low-viscosity bulk-fill composites within two weeks, while in other materials it was not achieved within 30 days, or more, following the immersion.

Conclusions: Rapid polymerization caused an increase in solubility, which could affect the biocompatibility of the investigated materials not intended for the 3s curing. SDR Plus and Filtek One Bulk Fill should not be polymerized with rapid high-intensity curing due to increased solubility that exceeds ISO 4049:2009 limits.

Objectives: Oral health in children is additionally burdened with the presence of dental fear and anxiety (DFA). These clinical psychologic entities in their progressive stages inevitably lead to avoidance of dental appointments, which makes prevention and therapy of oral diseases more difficult. Upon the onset of DFA in general, as one of the emotional outcomes of stress in a dental office, most children patients could define the specific stressors that were most intense for them, which could predict the presence of DFA.

Aim: To examine the predictors of DFA presence in 9-12-year-old children, and investigate how they could explain the DFA occurrence in study participants.

Material and methods: The sample consisted of 200 children aged from 9 to 12 years. The DFA presence was determined by the modified version of the CFSS-DS scale. The child's behavior in the dental office during the treatment was evaluated by the trained observer using Venham anxiety and behavior rating scales. Socioeconomic status, characteristics of dental office visits, and previous caries experience were also analyzed.

Results: The main DFA predictors were related to invasive dental treatments, where the behavior during dental treatment was the most accurate expression of the DFA appearance.

Conclusions: Invasive dental procedures are the main stressful factor for DFA occurrence. Predisposing factors could strengthen the DFA occurrence.

Background: The Dunning-Kruger effect (cognitive bias) is a psychological phenomenon that implies that individuals with a lack of knowledge and skills have an unrealistically optimistic image of their abilities compared to others.

Purpose: The study aimed to examine the presence of the Dunning-Kruger effect in fifth (final) year dental undergraduate students at Gulf Medical University, UAE, in clinical domains related to pediatric dentistry.

Methods: A longitudinal cohort study was conducted at Gulf Medical University, College of Dentistry, to evaluate cognitive bias among 5th-year dental students at GMU in the competency domains of communication, diagnosis, and clinical skills in Pediatric dentistry.

Results: Overall, compared to the level of confidence of students in September, there was a decline in the level of confidence in January. With an increase in time, the percentage shifted to a higher level in May across all domains.

Conclusion: Characteristic patterns of fluctuations in students' self-confidence during clinical exposure are observed. The research results prove that the Dunning-Kruger effect, the cognitive bias of the perception pattern, is present in the examined group of dental students.

Introduction: Over the last decade, the criminal justice system among the European countries deals with a new group of people, the undocumented people. In the criminal field, most of the suspected claimed to be under the minor legal age according to the type of crime. The government of each European country is committed to protecting the children and vulnerable people. There are serious safety concerns since adults falsely claim to be minors and legal systems oppose to such claims. In this study, we have used different age assessment methods and some of them without accuracy.

Objective: To meet the general considerations we developed a study using the current dental age assessment methods. Hence, for the Portuguese population, this study aims to validate the European regression formula between the ages of 6 and 15 years of age; to estimate the cut-off point for the age of 12 years, and to compare the quantitative approach of European regression formula with Demirjian's qualitative approach for age estimation.

Material and methods: 483 orthopantomograms were analysed using the European formula and Demirjian scoring stages. A new method, Model 2, was designed to better suit the Portuguese population.

Results: The European formula: average age underestimation of 4.88 for the third quadrant and 4.04 months for the fourth quadrant; and a mean absolute error (MAE) of 10.93 and 10.68 months respectively. Demirjian method: average overestimation of 8.70 months, MAE of 12.85 months. In Model 2: MAE of 9.37 months for the third quadrant, and 9.28 months for the fourth quadrant. Both European formula and Demirjian method had an area under ROC curves results above 0.93. Discrepancy of sensitivity between methods for the specific cut-off point: 11.48. The results obtained in this study can be extrapolated to 87.33% of the Portuguese population.

Conclusions: The European regression formula can be applied for the Portuguese population, and seems to be more accurate than Demirjian's methodology in this population. Nevertheless, both European regression formula and Demirjian method present similarly suitable results in the classification of 12 years of age, although there is a noticeable discrepancy favouring the European regression formula. The European Formula when applied for criminal age assessment, independently of population, is mandatory to indicate to the judicial institutions, the sensitivity of the results.