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For the first time the effects of different sampling periods and their interaction with five major autochthonous Croatian Istrian olive cultivars and the Italian cultivar ‘Leccino’ on the quantity and composition of olive leaf phenolic compounds and mineral nutrients were investigated. For that purpose, olive leaves were sampled in two collecting periods, in October and March, coinciding with the harvesting and pruning periods, respectively. All selected cultivars had a higher oleuropein leaf content in the pruning collecting period, with the highest levels noted for the ‘Leccino’ and ‘Buža’ cultivars. Cultivar significantly affected almost all the investigated phenols, with higher concentrations of these valuable compounds in the pruning than in the harvesting period. Differences observed in leaf mineral composition were closely related to the differences in phenolic profiles and were significantly affected by genotype. Some of the studied mineral nutrients, such as P, Cu and B, were found to be significantly correlated with the most abundant olive leaf phenolic compounds, oleuropein and verbascoside.

Introduction: Candida species (Candida spp.) is a part of the normal flora in the oral cavity. Candida may cause various forms of infections, from superficial to systemic conditions. With the increasing use of antifungal agents and a growing number of resistant strains, many researchers are working to find new potential herbal therapeutics that may be a safer alternative in treatment. Among natural products, Olive leaf extract (OLE) is a promising therapeutic tool for the treatment of oral infections due to its antimicrobial activity against a large number of pathogenic microorganisms. Aim: The aim of this study was to determine the antifungal activity of OLE against clinical isolates of Candida spp. Materials and Methods: Using the disc diffusion method, we tested the sensitivity of 15 clinical oral isolates of Candida spp. (11 C.albicans, 3 C. krusei, and 1 C. tropicalis) to four concentrations of OLE (7.5 µg/µL, 15 µg/µL, 30 µg/ µL and 60 µg/µL). Results: All tested concentrations of OLE showed a statistically significantly higher antifungal effect against Candida spp. compared to the control (DMSO). There was a concentration- dependent effect of OLE on the tested samples. Concentrations of 60 µg/µl and 30 µg/µl had statistically significantly higher antifungal activity compared to concentrations of 15 µg/µl and 7.5 µg/µl and a concentration of 30 µg/µl compared to the lowest tested concentration of 7.5 µg/µl. Conclusion: OLE could be a potential drug in the treatment of oral diseases caused by Candida.

Purpose P2Y2 receptors (P2Y2Rs) are among the various receptors that play an important role in nociception. The goal of this research was to investigate possible P2Y2R expression changes in the trigeminal ganglion (TRG) in bilateral masseter muscle (MM) hypersensitivity following unilateral MM inflammation. The impact of unilateral intramasseteric administration of P2Y2R antagonist on bilateral MM hypersensitivity was also explored. Materials and methods Bilateral MM hypersensitivity was provoked by unilateral intramasseteric injection of complete Freund's adjuvant (CFA). The head withdrawal threshold (HWT) was assessed bilaterally 4 days later. Bilateral TRG and MM isolation were followed, and quantitative real-time polymerase chain reaction (qRT-PCR) and histopathological analysis were carried out on these tissues, respectively. The involvement of P2Y2Rs in nocifensive behavior was evaluated by administering two doses of P2Y2R antagonist AR-C118925 (0.2 or 1 mg/100 μL) in inflamed MM 4 days post-CFA administration. Bilateral HWT was assessed at different time points following antagonist injection. Results qRT-PCR analysis demonstrated P2Y2R up-regulation in TRG ipsilateral to the site of CFA administration. Compared to the controls, both doses of AR-C118925 injected ipsilateral to the TRG increased the bilateral HWT at 30, 60, 90, and 120 minutes after antagonist administration. Conclusion The findings suggest that P2Y2Rs may affect MM inflammatory hypersensitivity owing to its up-regulation in the TRG in MM inflammatory pain states.

Petra Tariba Knežević,1,2 Robert Vukman,1,2 Mia Uhač,3 Davor Illeš,4 Daniela Kovačević Pavičić,1,2 Sunčana Simonić-Kocijan1,2 1Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia; 2Department of Prosthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia; 3Department of Orthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia; 4Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, CroatiaCorrespondence: Sunčana Simonić-KocijanDepartment of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, Rijeka 51000, CroatiaTel +385 51 345 633Fax +385 51 345 630Email suncanask@uniri.hrPurpose: P2Y2 receptors (P2Y2Rs) are among the various receptors that play an important role in nociception. The goal of this research was to investigate possible P2Y2R expression changes in the trigeminal ganglion (TRG) in bilateral masseter muscle (MM) hypersensitivity following unilateral MM inflammation. The impact of unilateral intramasseteric administration of P2Y2R antagonist on bilateral MM hypersensitivity was also explored.Materials and Methods: Bilateral MM hypersensitivity was provoked by unilateral intramasseteric injection of complete Freund’s adjuvant (CFA). The head withdrawal threshold (HWT) was assessed bilaterally 4 days later. Bilateral TRG and MM isolation were followed, and quantitative real-time polymerase chain reaction (qRT-PCR) and histopathological analysis were carried out on these tissues, respectively. The involvement of P2Y2Rs in nocifensive behavior was evaluated by administering two doses of P2Y2R antagonist AR-C118925 (0.2 or 1 mg/100 μL) in inflamed MM 4 days post-CFA administration. Bilateral HWT was assessed at different time points following antagonist injection.Results: qRT-PCR analysis demonstrated P2Y2R up-regulation in TRG ipsilateral to the site of CFA administration. Compared to the controls, both doses of AR-C118925 injected ipsilateral to the TRG increased the bilateral HWT at 30, 60, 90, and 120 minutes after antagonist administration.Conclusion: The findings suggest that P2Y2Rs may affect MM inflammatory hypersensitivity owing to its up-regulation in the TRG in MM inflammatory pain states.Keywords: facial pain, masticatory muscles, temporomandibular disorders, trigeminal ganglion

Petra Tariba Knežević,1,2 Robert Vukman,1,2 Mia Uhač,3 Davor Illeš,4 Daniela Kovačević Pavičić,1,2 Sunčana Simonić-Kocijan1,2 1Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia; 2Department of Prosthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia; 3Department of Orthodontics, Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia; 4Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, CroatiaCorrespondence: Sunčana Simonić-KocijanDepartment of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, Rijeka 51000, CroatiaTel +385 51 345 633Fax +385 51 345 630Email suncanask@uniri.hrPurpose: P2Y2 receptors (P2Y2Rs) are among the various receptors that play an important role in nociception. The goal of this research was to investigate possible P2Y2R expression changes in the trigeminal ganglion (TRG) in bilateral masseter muscle (MM) hypersensitivity following unilateral MM inflammation. The impact of unilateral intramasseteric administration of P2Y2R antagonist on bilateral MM hypersensitivity was also explored.Materials and Methods: Bilateral MM hypersensitivity was provoked by unilateral intramasseteric injection of complete Freund’s adjuvant (CFA). The head withdrawal threshold (HWT) was assessed bilaterally 4 days later. Bilateral TRG and MM isolation were followed, and quantitative real-time polymerase chain reaction (qRT-PCR) and histopathological analysis were carried out on these tissues, respectively. The involvement of P2Y2Rs in nocifensive behavior was evaluated by administering two doses of P2Y2R antagonist AR-C118925 (0.2 or 1 mg/100 μL) in inflamed MM 4 days post-CFA administration. Bilateral HWT was assessed at different time points following antagonist injection.Results: qRT-PCR analysis demonstrated P2Y2R up-regulation in TRG ipsilateral to the site of CFA administration. Compared to the controls, both doses of AR-C118925 injected ipsilateral to the TRG increased the bilateral HWT at 30, 60, 90, and 120 minutes after antagonist administration.Conclusion: The findings suggest that P2Y2Rs may affect MM inflammatory hypersensitivity owing to its up-regulation in the TRG in MM inflammatory pain states.Keywords: facial pain, masticatory muscles, temporomandibular disorders, trigeminal ganglion

By definition, the term “collision lesion” refers to two or more tumors coinciding in the same anatomic position or visceral organ. Collision lesions coexisting on the same skin location are defined as collision skin lesions (CSLs). Although this term implies a conflict between the tumors, this is not the case. CSLs appear to be rare, but still pose a significant diagnostic problem in everyday clinical practice and clinicians should be aware of their existence. The aim of this study was to elucidate the problem of CSLs in clinical practice, with an emphasis on classification of CSLs according to position dependence, tumor histogenesis, etiology, and possible lesion combinations in CSLs, as well as diagnostic possibilities. According to our results, accurate clinical diagnosis could be only rarely reached, requiring lesion excision and pathohistological confirmation of CSLs. Considering the fact that tumors in CSLs can be partially or completely overlying or can even be positioned one within the other, the existence of two or more tumors is extremely difficult to detect.

Cilj: Modificiranje oblika i veličine mikrodontnih bočnih sjekutića u gornjoj čeljusti kompozitnim ljuskama izrađenim injekcijskom tehnikom. Materijali i metode: 45-godišnji pacijent dolazi u ordinaciju dentalne medicine sa željom preoblikovanja zuba u estetskoj zoni. Kao temeljni problem navodi oblik i veličinu gornjih bočnih sjekutića koji, zbog odstupanja od estetskih ideala, narušavaju harmoniju osmijeha. Pacijentov preduvjet za početak liječenja bio je korištenje minimalno- invazivnih tehnika za dobivanje što poštednijih restauracija, stoga su pacijentu predložene dvije terapijske opcije: (1) izrada non-prep keramičkih ljuski te (2) izrada kompozitnih ljuski injekcijskom tehnikom, pri čemu se pacijent odlučio za drugu opciju. Prvi korak uključio je skeniranje maksilarnog i mandibularnog zubnog luka te međučeljusnih odnosa (Trios 4, 3Shape, Kopenhagen, Danska). Dentalni tehničar je zatim digitalnim planiranjem na osnovi skena pripremio navoštavanje, uz dodavanje morfologije labijalnih ploha bočnih sjekutića u sam dizajn wax-up-a. Nakon konzultacija s pacijentom i konačnog odabira oblika zuba, tehničar je navošteni model isprintao pomoću 3D printera (P30+, Straumann Group, Zurich, Švicarska). Uporabom prozirnog čvrstog silikona napravljen je transparentni silikonski ključ koji je poslužio za prijenos navoštenog predloška na površine zuba neodgovarajućih oblika i veličine. Prije jetkanja površine bočnih sjekutića, središnji sjekutići i očnjaci zaštićeni su teflonskom trakom kako bi se spriječio nanos kiseline, adheziva i kompozita na površinu susjednih zuba. Nakon jetkanja i nanošenja adheziva, tekući kompozit (G-ænial Universal Injectable, GC Corporation, Tokyo, Japan) je apliciran kroz kanal na silikonskom ključu lociran u području incizalnog brida bočnog sjekutića te je polimeriziran preko prozirnog silikona. Polimerizaciju je slijedilo završno poliranje i finiranje čime je postignut konačan izgled nadoknade. Rezultati: Kompozitnim restauracijama izrađenim injekcijskom tehnikom postignut je zadovoljavajući estetski rezultat, a pritom su poštovane pacijentove želje izražene prije početka liječenja. Zaključak: Iako su slučajevi u kojima se minimalno-invazivno želi ispraviti nezadovoljavajuća morfologija bočnih sjekutića indikacija za izradu non-prep keramičkih ljuski, poboljšanja fizičkih, mehaničkih i optičkih svojstava suvremenih kompozita te prihvatljivost iz financijskog aspekta, predvidljivosti ponovljivost ove tehnike opravdavaju upotrebu u ovom terapijskom postupku.

Kao jedna od najvažnijih mediteranskih voćnih vrsta, maslina (Olea europaea L.) je poznata kao bogat izvor fenola i drugih nutritivno važnih spojeva. Proteklih godina na Institutu za poljoprivredu i turizam provedena su brojna istraživanja vezana uz utjecaj ishrane masline na fenolne komponente lista ili maslinovog ulja.Temeljem odabranog seta podataka prikazanih u ovom radu, sorta 'Istarska bjelica' pokazala je najveću koncentraciju oleuropeina u listu i ukupnih fenola u maslinovom ulju. U hidroponskom pokusu smanjena razina magnezija u hranivoj otopini povećala je, a niska razina mangana, cinka i bakra smanjila koncentraciju ukupnih fenola u listu masline sorte 'Istarska bjelica'. Folijarna gnojidba sumporom imala je pozitivan učinak na količinu ulja po stablu u rodnoj godini neovisno o proučavanoj sorti.

Zubne proteze mobilni su protetski nadomjestci kojima se nadoknađu ju izvađeni zubi i resorbirana kost čeljusti. Za razliku od krunica i mostova koji su fiksni (trajno fiksirani), protetske nadomjestke, proteze pacijent može (i mora) samostalno vaditi iz usta ponajprije radi održavanja oralne higijene

Oral infections caused by Candida species are becoming more common, which may be related to an increase in the number of immunologically compromised patients as well as favorable conditions in the oral cavity that often include removable prosthetic appliances. The purpose of this study was to determine the presence of a particular Candida species in patients with PMMA and Cr-Co prosthetic appliances, as well as the salivary flow rate, and oral signs and symptoms. This investigation included a total of 120 subjects with different kinds of removable dentures. A sample of concentrated oral rinse was collected from all subjects in order to detect Candida colonization and identify the Candida species, a quantum of salivation was measured, and subjects were examined clinically. Candida spp. was predominant among the subjects who were denture wearers (p &lt, 0.0001). In all subjects, the most frequently detected species was C.albicans. A statistically significant difference was found between the prevalence of C.albicans (p &lt, 0.001) and C.krusei (p &lt, 0.001) in denture wearers. Subjects with PMMA-based removable prosthetic appliances mostly demonstrated a significant decrease in salivation (p &lt, 0.001), an increase in burning sensations (p &lt, 0.001), and dry mouth (p &lt, 0.001) compared to the subjects who wore partial dentures with Co–Cr metallic frameworks. Red oral lesions were more frequently found among the subjects with partial dentures with Co–Cr metallic frameworks (p &lt, 0.001). Regardless of the material used for the denture, patients must be regularly checked by their dentists in order to prevent the development of oral lesions.

Uvod: Candida species (Candida spp.) je predstavnik fiziološke flore usne šupljine. Candida albicans je najzastupljenija, a od ostalih vrsta javljaju se Candida tropicalis, Candida glabrata, Candida parapsilosis, Candida krusei i Candida pseudotropicalis. Pacijenti s protetskim nadomjescima imaju veću predispoziciju kolonizacije usne šupljine Candidom spp. zbog razlike u površini materijala i stupnju poroznosti u uvjetima u usnoj šupljini. Cilj je ispitati utjecaj polimetil-metakrilata (PMMA) i kobalt krom (Co-Cr) legure na zastupljenost različitih vrsta Candida spp. u usnoj šupljini. Materijali i metode: Sudjelovalo je 120 ispitanika podijeljenih u tri skupine: Ispitanici s mobilnim protetskim nadomjestkom od polimetil- metakrilata PMMA ; ispitanici s mobilnim protetskim nadomjestkom s lijevanom metalnom bazom od kobalt- krom (Co-Cr) legure i ispitanici bez ikakvog protetskog nadomjestka (kontrolna skupina). Svakom ispitaniku uzet je uzorak usne šupljine metodom koncentriranog ispiranja. Uzorak je nasađen na CHROMagar Candida koji identificira pet vrsta Candide (C. albicans, C. Krusei, C. glabrata, C. tropicalis, Candida druge vrste) i inkubiran na 37°C/48h. Rezultati: Candida albicans je najzastupljenija vrsta u sve tri skupine. Značajno je više prisutno C. albicans (P

The color of teeth in dental medicine significantly affects the overall aesthetics of the teeth and face. Color perception depends on many factors, such as human factor, lighting, environment, background color, and other optical phenomena. Choosing the color in dental medicine is most often done visually using the factory-made color shade guide that are based on the tone of color, saturation or brightness. Colors from the prefabricated shade guide are compared to the color of the dental arch of the patient. Such a color assessment mode is very subjective and the selected color is difficult to reproduce. Therefore, objective and instrumental methods of determining the color were created using different devices such as digital cameras, a colorimeter and a spectrophotometer. Tooth color selected by these methods give results that are quantified, objectified, easily repeatable and reproduced in dental laboratory.

Psorijaza se ubraja u psihosomatske bolesti. Stresogeno odnosno traumatsko iskustvo smatra se jednim od čimbenika rizika za pojavu psorijaze odnosno pogoršanja same bolesti. Cilj ovoga rada bio je ispitati učestalost stresogenih odnosno traumatskih iskustava u dječjoj i adolescentnoj dobi u oboljelih od psorijaze kao i obilježja stresora koji su prethodili pojavi ili pogoršanju bolesti. Osim toga cilj je ispitati razlike kod oboljelih od tipa I (pojava bolesti prije 40-te godine) i tipa II (pojava bolesti nakon 40-te godine) psorijaze te ispitati težinu kliničke slike psorijaze (prema psoriasis area and severity indexu – PASI) u odnosu na stresogena odnosno traumatska iskustva. Ispitivanje je provedeno na skupini oboljelih od psorijaze (N=100) u odnosu na kontrolnu skupinu (N=101). Primijenjeni su slijedeći instrumenti: Upitnik sociodemografskih podataka ; Trauma antecedentni upitnik (Trauma Antecedents Questionnaire – TAQ), Ljestvica životnih događaja (Thoma Holmes i Richard Rahe, 1967.) te je učinjen klinički pregled od strane dermatologa kako bi se utvrdila težina kliničke slike i tip psorijaze. Ovim istraživanjem utvrđeno je da su oboljeli od psorijaze imali manje pozitivnih iskustava tijekom školske dobi i adolescencije u odnosu na kontrolnu skupinu. Također, u skupini oboljelih od psorijaze više je negativnih iskustava tijekom života u odnosu na kontrolnu skupinu. Nije nađena statistički značajna povezanost težine kliničke slike psorijaze u odnosu na stresogena/traumatska iskustva. Nije nađena razlika između oboljelih od psorijaze i kontrolne skupine u broju stresora doživljenih unutar 6 mjeseci, ali je nađen viši stupanj uznemirenja kod ispitanika oboljelih od psorijaze. Zaključak: Osobe oboljele od psorijaze češće su doživjele stresogena/traumatska iskustva tijekom školske dobi, adolescencije kao i tijekom odrasle dobi u odnosu na osobe koje ne boluju od psorijaze. Iako nisu doživjeli više nedavnih stresora u odnosu na zdrave ispitanike stupanj uznemirenosti je veći. Može se pretpostaviti da su oboljeli od psorijaze osjetljiviji na stresore.

Aim To determine the relationship between bilateral allodynia induced by masseter muscle inflammation and P2X3 receptor expression changes in trigeminal ganglia (TRG) and the influence of intramasseteric P2X3 antagonist administration on bilateral masseter allodynia. Methods To induce bilateral allodynia, rats received a unilateral injection of complete Freund’s adjuvant (CFA) into the masseter muscle. Bilateral head withdrawal threshold (HWT) was measured 4 days later. Behavioral measurements were followed by bilateral masseter muscle and TRG dissection. Masseter tissue was evaluated histopathologically and TRG tissue was analyzed for P2X3 receptor mRNA expression by using quantitative real-time polymerase chain reaction (PCR) analysis. To assess the P2X3 receptor involvement in nocifensive behavior, two doses (6 and 60 μg/50 μL) of selective P2X3 antagonist A-317491 were administrated into the inflamed masseter muscle 4 days after the CFA injection. Bilateral HWT was measured at 15-, 30-, 60-, and 120-minute time points after A-317491 administration. Results HWT was bilaterally reduced after the CFA injection (P < 0.001). Intramasseteric inflammation was confirmed ipsilaterally to the CFA injection. Quantitative real-time PCR analysis demonstrated enhanced P2X3 expression in TRG ipsilaterally to CFA administration (P < 0.01). In comparison with controls, the dose of 6 μg of A-317491 significantly increased bilateral HWT at 15-, 30-, and 60-minute time points after the A-317491 administration (P < 0.001), whereas the dose of 60 μg of A-317491 was efficient at all time points ipsilaterally (P = 0.004) and at 15-, 30-, and 60- minute time points contralaterally (P < 0.001). Conclusion Unilateral masseter inflammation can induce bilateral allodynia in rats. The study provided evidence that P2X3 receptors can functionally influence masseter muscle allodynia and suggested that P2X3 receptors expressed in TRG neurons are involved in masseter inflammatory pain conditions.

Uvod: Svrha ovoga istraživanja bila je procijeniti ponovljivost položaja centrične relacije kod pacijenata s dislokacijom diska s redukcijom. Materijali i metode: U ispitnoj skupini bilo je 30 ispitanika s utvrđenom dislokacijom diska s redukcijom u desnom i lijevom zglobu ili u oba. Kontrolna skupina sastojala se od 12 sudionika bez znakova i simptoma temporomandibularnih poremećaja. Koristeći se metodom vođenja brade s prednjim deprogramatorom, učinjena su tri registrata centrične relacije za svakog ispitanika i to tijekom jednog posjeta. Elektroničkim ultrazvučnim mjernim uređajem snimljen je položaj lijevoga i desnoga kondila kod svakog dobivenog registrata centrične relacije. Podatci su analizirani računalom. Izmjerena je udaljenost kondila dobivena kod različitih registrata centrične relacije (anteroposteriorne, vertikalne, transverzalne i linearne vrijednosti) te su podatci statistički analizirani t i F testom. Rezultati: Nije utvrđena statistički značajna razlika između ispitne i kontrolne skupine. Kod dvije trećine ispitanika kondilni je položaj tijekom ponavljanja određivanja centrične relacije bio unutar promjera od 0,3 milimetra. Za više od 90 posto ispitanika to je područje bilo unutar 0,4 milimetra. Zaključak: Ne postoji razlika u ponovljivosti centrične relacije između pacijenata s dislokacijom diska s redukcijom i onih sa zdravim temporomandibularnim zglobom (p > 0,05). Kada se radi registrat centrične relacije na pacijentu s dislokacijom diska s redukcijom, prije toga nije potrebna terapija udlagom, dovoljne su standardne mjere opreza. Dobiveni rezultati moraju se interpretirati unutar ispitne skupine, bez povezivanja s drugim skupinama temporomandibularnih poremećaja., Objective: The aim of this study was to investigate reproducibility of the position of centric relation in patients with disc displacement with reduction. Materials and methods: The test group included 30 subjects, diagnosed with disc displacement with reduction in right, left or both joints. The control group included 12 individuals with no signs and symptoms of temporomandibular disorders. Using chin point guidance with a jig, centric relation record was made three times by every participant, in a single session. Left and right condylar position for each centric relation record was determined and recorded using the electronic ultrasonic measuring device. The data were transferred to the computer, processed and analyzed. Condylar distances between centric relation records were measured (anteroposterior, vertical, transversal and linear values), and the data were statistically analyzed using the t and the F tests. Results: No statically significant difference was found between the test and the control groups. Two thirds of study participants demonstrated condylar position of the repeated centric relation recording within the area of 0.3 mm in diameter. For more than 90% of participants that area was within 0.4 mm. Conclusions: There is no difference in reproducibility of the centric relation between patients with disc displacement with reduction and healthy temporomandibular joint individuals (p>0.05). When doing centric relation record on a patient with disc displacement with reduction there is no need for previous splint therapy and standard precautions are acceptable. The obtained results must be interpreted within the experimental group, and not projected on the other groups of temporomandibular disorders.

Boja zuba u dentalnoj medicini značajno utječe na doživljaj cjelokupne estetike zubi i lica. Percepcija boje ovisi o mnogim čimbenicima, kao što su ljudski faktor, osvjetljenje, okolina, boja pozadine i drugi optički fenomeni. Odabir boje u dentalnoj medicini najčešće se vrši vizualno pomoću tvorničkih ključeva boja koji se temelje na tonu boje, zasićenosti ili svjetlini. Boje iz ključa se uspoređuju s bojom zubnog niza pacijenta. Takav način odabira boje vrlo je subjektivan te je tako odabranu boju teško reproducirati. Iz tog razloga kreirane su objektivne, instrumentalne metode određivanja boje pomoću različitih uređaja kao što su digitalne kamere, kolorimetar i spektrofotometar. Boja zuba odabrana ovim metodama daje rezultate koji su kvantificirani, objektivizirani, lako ponovljivi i reproducirani u dentalnom laboratoriju., The color of teeth in dental medicine significantly affects the overall aesthetics of the teeth and face. Color perception depends on many factors, such as human factor, lighting, environment, background color, and other optical phenomena. Choosing the color in dental medicine is most often done visually using the factory-made color shade guide that are based on the tone of color, saturation or brightness. Colors from the prefabricated shade guide are compared to the color of the dental arch of the patient. Such a color assessment mode is very subjective and the selected color is difficult to reproduce. Therefore, objective and instrumental methods of determining the color were created using different devices such as digital cameras, a colorimeter and a spectrophotometer. Tooth color selected by these methods give results that are quantified, objectified, easily repeatable and reproduced in dental laboratory.

Uvod: Svrha ovoga istraživanja bila je procijeniti ponovljivost položaja centrične relacije kod pacijenata s dislokacijom diska s redukcijom. Materijali i metode: U ispitnoj skupini bilo je 30 ispitanika s utvrđenom dislokacijom diska s redukcijom u desnom i lijevom zglobu ili u oba. Kontrolna skupina sastojala se od 12 sudionika bez znakova i simptoma temporomandibularnih poremećaja. Koristeći se metodom vođenja brade s prednjim deprogramatorom, učinjena su tri registrata centrične relacije za svakog ispitanika i to tijekom jednog posjeta. Elektroničkim ultrazvučnim mjernim uređajem snimljen je položaj lijevoga i desnoga kondila kod svakog dobivenog registrata centrične relacije. Podatci su analizirani računalom. Izmjerena je udaljenost kondila dobivena kod različitih registrata centrične relacije (anteroposteriorne, vertikalne, transverzalne i linearne vrijednosti) te su podatci statistički analizirani t i F testom. Rezultati: Nije utvrđena statistički značajna razlika između ispitne i kontrolne skupine. Kod dvije trećine ispitanika kondilni je položaj tijekom ponavljanja određivanja centrične relacije bio unutar promjera od 0,3 milimetra. Za više od 90 posto ispitanika to je područje bilo unutar 0,4 milimetra. Zaključak: Ne postoji razlika u ponovljivosti centrične relacije između pacijenata s dislokacijom diska s redukcijom i onih sa zdravim temporomandibularnim zglobom (p > 0,05). Kada se radi registrat centrične relacije na pacijentu s dislokacijom diska s redukcijom, prije toga nije potrebna terapija udlagom, dovoljne su standardne mjere opreza. Dobiveni rezultati moraju se interpretirati unutar ispitne skupine, bez povezivanja s drugim skupinama temporomandibularnih poremećaja., Objective: The aim of this study was to investigate reproducibility of the position of centric relation in patients with disc displacement with reduction. Materials and methods: The test group included 30 subjects, diagnosed with disc displacement with reduction in right, left or both joints. The control group included 12 individuals with no signs and symptoms of temporomandibular disorders. Using chin point guidance with a jig, centric relation record was made three times by every participant, in a single session. Left and right condylar position for each centric relation record was determined and recorded using the electronic ultrasonic measuring device. The data were transferred to the computer, processed and analyzed. Condylar distances between centric relation records were measured (anteroposterior, vertical, transversal and linear values), and the data were statistically analyzed using the t and the F tests. Results: No statically significant difference was found between the test and the control groups. Two thirds of study participants demonstrated condylar position of the repeated centric relation recording within the area of 0.3 mm in diameter. For more than 90% of participants that area was within 0.4 mm. Conclusions: There is no difference in reproducibility of the centric relation between patients with disc displacement with reduction and healthy temporomandibular joint individuals (p>0.05). When doing centric relation record on a patient with disc displacement with reduction there is no need for previous splint therapy and standard precautions are acceptable. The obtained results must be interpreted within the experimental group, and not projected on the other groups of temporomandibular disorders.

24-godišnji pacijent došao je u ordinaciju dentalne medicine zbog traumatske ozlijede zuba i mekih tkiva zadobivenih udarcem laktom. Kliničkim i radiografskim pregledom utvrdio se nekomplicirani lom krune zuba 11 i 21 uz laceraciju oralne sluznice. Pacijent se bavio kontaktnim sportom te je imao visoke estetske zahtjeve. Razmatranjem informacija dobivenih anamnezom i kliničkim pregledom, utvrđeno je da restaurativna terapija nije preporučljiva, te je odabrano minimalno invazivno protetsko zbrinjavanje atipičnim potpuno keramičkim nadomjescima kojima se nadoknađuju isključivo izgubljeni dijelove zuba. Nakon neuspjeha prvobitne terapije, pristupilo se izradi ljuski koje su u konačnici u potpunosti estetski i funkcijski zadovoljavali pacijentove potrebe.

Linear immunoglobulin A bullous dermatosis (LABD) is a rare autoimmune blistering skin disease characterized by deposition of IgA autoantibodies along the basement membrane zone (BMZ). Although LABD is most often idiopathic, it can be triggered by infections and drugs, or occur in association with other autoimmune diseases, lymphoproliferative disorders and internal malignancies. Acquired hemophilia A (AHA) is a rare and potentially life- threatening coagulation deficiency caused by the production of anti-factor VIII autoantibodies. Similarly to LABD, it has been associated with malignancies, drugs, or other autoimmune diseases. A 57-year-old male patient presented with sudden onset of pruritic vesicles and bullae distributed on the upper trunk, proximal extremities, axillary vaults and inguinal folds. Lesions were partially distributed in herpetiform fashion, resembling “cluster of jewels” or in annular and polycyclic arrangement creating the “string of beads sign”. There were also multiple erosions and vesicles on the oral mucosa and bilateral conjunctivitis. Histopathological findings of lesional skin showed subepidermal blister and a dermal infiltrate rich in neutrophils and eosinophils. Direct immunofluorescence analysis showed linear deposits of IgG and IgA, and focal granular deposits of C3 along the BMZ. Indirect immunofluorescence, ELISA for IgG antibodies against BP 180, Desmoglein 1 and 3, ANA and ENA screen were all negative. A diagnosis of LABD was made, and based on the patient history of recent introduction of perindopril, moxonidine and amlodipine, it was presumed to be drug-induced. A relatively rapid remission was achieved within a month, after discontinuation of the incriminated drugs and a course of systemic glucocorticoids. However, as the erosions healed, the patient developed melena and widespread suffusions, accompanied by tingling sensation and pain. Laboratory analyses revealed significantly prolonged activated partial thromboplastin time, a decrease of factor VIII activity and the presence of factor VIII inhibitors, findings indicative of AHA. Neither a combination of glucocorticoids and cyclophosphamide, nor intravenous immunoglobulin therapy demonstrated sufficient clinical response. Clinical and laboratory remission was finally achieved with rituximab. The coincidence of autoimmune bullous diseases and AHA is very rare, and to the best of our knowledge, this is the second reported case of AHA occurring in association with LABD. References: 1. Makita S et al. Acquired hemophilia associated with autoimmune bullous diseases: a report of two cases and a review of the literature. Intern Med. 2013 ; 52(7):807-10. 2. Arakaki O et al. Case of linear immunoglobulin A bullous dermatosis associated with acquired hemophilia. J Dermatol 2008 ; 35(7):437-46. 3. Filipczak A et al. Coexistence of pemphigus foliaceus and acquired hemophilia A: A case report. J Dermatol 2015 ; 42(6):638-41. 4. Qiu X et al. Acquired hemophilia associated with bullous pemphigoid: a case report. Int J Clin Exp Pathol 2012 ; 5(1):102-4.

Glavni ciljevi protetske rehabilitacije bezubih i djelomično ozubljenih pacijenata je uspostavljanje funkcije i estetike stomatognatog sustava. Djelomično ozubljene osobe imaju niz mogućih protetskih rješenja. Jedno od često korištenih su fiksno-mobilni kombinirani radovi retinirani preciznim pričvrstcima. Precizni pričvrstak je definiran kao retencijsko i stabilizacijsko sredstvo djelomične proteze koji omogućuje pravilan prijenos žvačnih i izvanžvačnih sila. U ovom radu navedene su indikacije i prednosti takvog načina zbrinjavanja djelomične bezubosti kao i njihovi nedostatci. Prikazane su podjele pričvrstaka i indikacije za uporabu istih. Nakon svega, prikazan je klinički slučaj rješavanja djelomične bezubosti izradom fiksno- mobilnog kombiniranog rada retiniranog ekstrakoronarnim preciznim pričvrstcima.

Uvod: Temporomandibularni poremećaj (TMP) je muskoloskeletalni poremećaj koji obuhvaća niz kliničkih stanja karakteriziranih promjenama žvačne muskulature, temporomandibularnih zglobova (TMZ) i pridruženih struktura. Najčešći prisutan simptom je bol lokalizirana u žvačnim mišićima. Etiologija mišićne boli nije u potpunosti razjašnjena. Cilj istraživanja bio je ispitati utjecaj kroničnog stresa, okluzijske interferencije te njihovog zajedničkog djelovanja na bol maseteričnog mišića. Također, cilj je bio utvrditi utjecaj ispitivanih čimbenika na sistemsku i lokalnu razinu interleukina-6 (IL-6) te utvrditi moguću povezanost razine IL-6 s mišićnom boli. Cilj je bio utvrditi doprinos kroničnog stresa, okluzijske interferencije, razine IL-6 u tkivu i plazmi na bol maseteričnog mišića te utvrditi doprinos kroničnog stresa i okluzijske interferencije na razinu IL-6 u plazmi i tkivu maseteričnog mišića. Materijali i metode: U eksperimentalnom radu korišteno je 50 muških Wistar štakora. Životinje su podijeljene u pet skupina od 10 štakora. Skupine sačinjavaju: skupina izložena kroničnom stresu; skupina izložena okluzijskoj interferenciji; skupina izložena kroničnom stresu i okluzijskoj interferenciji; kontrolna skupina slobodna od kroničnog stresa i okluzijske interferencije i apsolutna kontrola koju formiraju životinje slobodne od bilo kakve procedure ili dobivanja ikakve tvari. Životinje su bile podvrgnute eksperimentu 56 dana. Zadnjeg eksperimentalnog dana životinjama se procjenjivala mišićna bol nakon čega su žrtvovane, te su sakupljeni uzorci krvi i masetera, iz kojih su enzimskim imunotestom određivane vrijednosti IL-6. Rezultati: Životinje izložene zajedničkom učinku okluzijske interferencije i kroničnog stresa pokazuju statistički značajno veću reakciju na bolni podražaj u usporedbi s kontrolnom skupinom (p=0,023). Također, utvrđena je značajno viša razina IL-6 maseteričnog mišića u skupini izloženoj zajedničkom učinku okluzijske interferencije i kroničnog stresa u usporedbi s kontrolnom skupinom (p=0,012). Utvrđena je pozitivna korelacija između razine IL-6 maseteričnog mišića i boli (r = 0,62; p, Introduction: Temporomandibular disorder (TMD) is a musculoskeletal disorder that involves various clinical conditions of masticatory muscles, temporomandibular joints and accompanied tissues. The most prominent symptom is pain in masticatory muscles. The etiology of TMD is poorly understood. Objectives of this study were to examine the individual effect of chronic stress and occlusal interference, as well as their combined influence on masseter muscle pain. The study also aimed to investigate influence of proposed etiological factors on systemic and local level of interleukine-6 (IL-6) and to find possible correlation between IL-6 and muscle pain. The aim was to estimate the contribution of chronic stress, occlusal interference and IL-6 levels on masseter muscle pain and to estimate contribution of chronic stress and occlusal interference on IL-6 levels. Material and methods: Experiments were performed on 50 male Wistar rats. Animals were divided in five groups of 10 rats. Groups were as follow: chronic stressed group, group with occlusal interference, group with both chronic stress and occlusal interference, control group free of chronic stress and occlusal interference and absolute control group free of experimental procedures and formalin injection. Experimental procedure, for all animals, lasted 56 days. On last experimental day muscle pain was evaluated. Animals were decapitated and blood and tissue samples were collected to determine IL-6 levels. Results: Animals submitted to combination of occlusal interference and chronic stress showed statistically significant difference of nociceptive behavioral response comparing to the control group (p=0,023). Also, tissue level of IL-6 in group of animals submitted to both occlusal interference and chronic stress were significantly higher than in the control group (p=0,012). A positive correlation between the tissue IL-6 level and the masseter muscle pain was established (r=0,62; p

Introduction: Lichen planus is a papulosquamous, inflammatory dermatosis, whose pathogenesis is primarily mediated by cytotoxic mechanisms. Activated cytotoxic cells, such as cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells, release pro- apoptotic proteins from previously synthesized cytotoxic granules, stored in their cytoplasms. Granulysin (GNLY) is a proinflammatory, pro-apoptotic molecule expressed in those granules. After leaving the granules, GNLY has possibility of provoking irreparable cell damage, finally causing target cell death. Heretofore, there are few reports regarding the role of granulysin in lichen planus and no previously published data of granulysin blood expression in patients with exanthematous lichen planus. Material/methods: We collected peripheral blood samples of patients with exanthematous lichen planus and from healthy controls (10 participants per group). GNLY expression was evaluated in the total lymphocyte population, by direct immunofluorescence staining followed by flow cytometry analyses. Results: The objective of our study was to investigate GNLY+ cells in blood lymphocyte population of lichen planus patients and healthy controls. Whereas we formerly performed an investigation of GNLY tissue expression and proved upregulation of GNLY+ cells in lesional papules of lichen planus, our present study revealed overexpressed levels of GNLY+ cells within peripheral blood lymphocytes of patients with exanthematous lichen planus, primely within CD3+CD8+, CD3- CD56+ and CD3+CD56+ cells. The percentage of GNLY+ cells between the patient group and a group of healthy controls differed significantly (p

Introduction & Objectives Psoriasis is a chronic inflammatory skin disease mediated by T lymphocytes, while NK and NKT cells are also implicated in its pathogenesis. Granulysin (GNLY) is a pro-apoptotic molecule expressed in the cytoplasmic granules of cytotoxic immune cells. Activated cytotoxic cells such as cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells cause target cell cytolysis by exocytosis of these granules and their contents. Until now, there are few reports regarding the role of granulysin in psoriasis and no data of granulysin blood expression in psoriatic patients. Material & Methods We obtained peripheral blood samples of patients with mild psoriasis, patients with severe psoriasis and healthy controls (10 patients per group). GNLY expression was evaluated in the total lymphocyte population, by direct immunofluorescence staining followed by flow cytometry analyses. Results The objective of our study was to investigate GNLY+ cells in blood lymphocyte population of psoriatic patients and healthy controls. While our previous study showed significantly increased numbers of GNLY+ cells in psoriatic plaques, our present research revealed elevated levels of GNLY+ cells within peripheral blood lymphoctes of psoriatic patients, primely within CD3+CD8+, CD3+CD56+ and CD3- CD56+ cells. The percentage of GNLY+ cells significantly differed between groups of patients with mild and severe psoriasis as well as in group of healthy controls. Conclusions A significant upregulation of GNLY-expressing peripheral blood lymphocytes, especially cytotoxic T cells, NK and NKT cells, has been observed in psoriatic patients in contrast of its level in healthy controls. GNLY-mediated cytotoxicity of peripheral blood lymphocytes considerably differed depending on disease severity. This observation indicates a possible important role of this cytolytic molecule in psoriasis pathogenesis.

Case report.

Pain in masticatory muscles is among the most prominent symptoms of temperomandibular disorders (TMDs) that have diverse and complex etiology. A common complaint of TMD is that unilateral pain of craniofacial muscle can cause a widespread of bilateral pain sensation, although the underlying mechanism remains unknown. To investigate whether unilateral inflammation of masseter muscle can cause a bilateral allodynia, we generated masseter muscle inflammation induced by unilateral injection of complete Freund's adjuvant (CFA) in rats, and measured the bilateral head withdrawal threshold at different time points using a von Frey anesthesiometer. After behavioral assessment, both right and left trigeminal ganglia (TRG) were dissected and examined for histopathology and transient receptor potential vanilloid 1 (TRPV1) mRNA expression using quantitative real-time PCR analysis. A significant increase in TRPV1 mRNA expression occurred in TRG ipsilateral to CFA injected masseter muscle, whereas no significant alteration in TRPV1 occurred in the contralateral TRG. Interestingly, central injection of TRPV1 antagonist 5-iodoresiniferatoxin into the hippocampus significantly attenuated the head withdrawal response of both CFA injected and non-CFA injected contralateral masseter muscle. Our findings show that unilateral inflammation of masseter muscle is capable of inducing bilateral allodynia in rats. Upregulation of TRPV1 at the TRG level is due to nociception caused by inflammation, whereas contralateral nocifensive behavior in masticatory muscle nociception is likely mediated by central TRPV1, pointing to the involvement of altered information processing in higher centers.

53-godišnja žena zaprima se radi dodatne obrade i liječenja psorijaziformnih kožnih promjena praćenih svrbežom i eritematozno- smećkastih infiltrata na donjim ekstremitetima. Od 1996. godine do 2016. godine, klinička slika, učinjene patohistološke i laboratorijske analize, upućuju na nekoliko različitih dijagnoza uz visoke vrijednosti IgE-a u krvi i eozinofilne infiltrate u histološkim nalazima. Bolesnica je prethodno liječena ciklosporinom, metotreksatom i azatioprinom, koji su zbog izraženih nuspojava ukinuti iz daljnje terapije. Također je provedeno nekoliko ciklusa PUVA terapije, no bez značajnijeg učinka. Značajno ali kratkotrajno poboljšanje kliničke slike nastupilo je nakon primjene srednjih doza metilprednizolona. Pri kliničkom pregledu, vide se suha, ekcematiformna, ljuskava žarišta na trupu i pretežno gornjim udovima te jasno ograničeni crveno-smeđi plakovi s nekoliko manjih erozija na donjim udovima. Na dorzumima obje šake i potkoljenicama uočavaju se brojne prurigo papule i nodulusi. Na dlanovima i tabanima prisutan je blagi eritem i ljuskanje uz poneku ragadu. Nokti su na stopalima hiperkeratotični. Tijekom hospitalizacije odgovarajućom se obradom isključi parazitološka infekcija i paraneoplastični sindrom. U laboratorijskim nalazima uočen je povišen titar BP180 IgG 148 RU/ml, BP230 IgG>200 RU/ml, ANA 1:640 uz IgE 7561 kIU/L dok su ostali nalazi bili u granicama referentnih vrijednosti. Patohistološka analiza bioptata induriranih plakova potvrdila je dijagnozu lipoidne nekrobioze, a preostale višestruke biopsije ukazale su na vjerojatnu dijagnozu vulgarne psorijaze uz istovremeni neobičan nalaz intraepidermalnih eozinofila, koji je međutim indikativan za prebuloznu fazu buloznog pemfigoida. Direktna i indirektna imunofluorescentna pretraga pokazale su IgG depozite u zoni bazalne membrane te u manjoj mjeri i među keratinocitima, a na «salt-split skin» uzorku nađeni su depoziti IgG na epidermalnoj strani. Negativnim nalazom imunofluorescentne pretrage na urotelu i ELISA pretrage na envoplakin, isključena je dijagnoza paraneoplastičnog pemfigusa. Uz topičku kortikosteroidnu terapiju tijekom ljetnih mjeseci nastupa izraženo poboljšanje kliničke slike, stoga se uvođenje sustavne terapije planira kod nastupa pogoršanja bolesti.

The final years of the current decade (2000- 2010), which were dedicated to bone and joint diseases by the World Health Organization, are the right time to pay attention to musculoskeletal diseases of the orofacial system. A basic concept related to TMDs is the attempt to include musculoskeletal disorders of the stomatognathic system into the functional schematics of disorders appearing elsewhere in the body. Apart from the general knowledge on ageing, undergraduate dental students should be taught about anticipating needs, planning and implementing treatment and the subsequent care of the elderly prosthodontic patients. The clinical picture of TMJ functional disturbances may range from physiological variability of joint structures functioning (sometimes painless joint sound) to painful condition with pronounced clinical signs of TMJ disorder

INTRODUCTION & OBJECTIVES: Psoriasis and lichen planus are inflammatory skin diseases mediated by T lymphocytes. Killer lymphocytes, including cytotoxic T lymphocytes and natural killer cells, synthetize cytotoxic granules loaded with pro-apoptotic and pore-forming proteins. Such molecules cause physical damage of target cells and have critical role in infection and regulation of autoimmunity. Perforin-2/macrophage-expressed protein 1 is a novel pore-forming protein family member recognized by its potent bactericidal ability. We aimed to evaluate the presence of perforin-2 in the skin, both in physiological (healthy skin) as well as in inflammatory conditions. For the latter, two distinct skin pathologies were chosen ; lichen planus, a prototype disease mediated by apoptotic cell death of keratinocytes and psoriasis as one of the most common chronic inflammatory skin diseases. MATERIAL & METHODS: Immunohistochemistry for perforin-2 was performed in biopsy samples from lesional and non-lesional skin of patients with psoriasis and cutaneous lichen planus and in skin of healthy controls (5 patients per group). RESULTS: We found increased perforin-2 expression in psoriatic and lichen planus lesional skin in comparison with both non-lesional and healthy skin. The vast majority of perforin-2 positive cells were observed in dermal compartment of psoriatic and lichen planus lesional skin. Based on morphology, at least part of perforin-2 positive cells were macrophages. CONCLUSIONS: Perforin-2 expression is upregulated in psoriatic and lichen planus lesional skin. Further analysis is warranted in order to characterize the cell populations expressing the protein as well as its potential role in the pathogenesis of these and other inflammatory skin diseases.

Recent data suggest that childhood and adulthood stressors may play a significant role in the development of an autoimmune disease. The present study explores the relationship between psoriatic arthritis (PsA) and positive and negative life events during childhood and adulthood in psoriatic patients. Forty-five patients with psoriatic arthritis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences [Traumatic Antecedents Questionnaire (TAQ)]. The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The patients with psoriatic arthritis exhibited lower mean scores of total positive experiences during late childhood (latency) as compared to the control group. Negative experiences during four developmental periods appeared more frequently in patients with psoriatic arthritis than in the controls. The most frequently reported negative experiences were neglect, emotional abuse, physical abuse, sexual abuse, alcohol/drug abuse and other traumas. The present findings add evidence to the relationship between retrospectively reported childhood experiences and psoriatic arthritis. Furthermore, a high amount of reported emotional and physical abuse occurs in patients with psoriatic arthritis during latency and adolescence.

doi: 10.1111/j.1741-2358.2011.00543.x Influences of age and maxillary anterior teeth status on patient’s satisfaction with dental appearance and tooth colour Objectives: To study the impact of age, gender, tooth colour and maxillary anterior teeth status on patient’s satisfaction with their dental appearance. Material and methods: A total of 259 Caucasian subjects participated in the study (119 men, mean age 56 years; 140 women, mean age 61 years) divided into three age groups (young 0.05). Conclusions: Satisfaction with the appearance of the maxillary anterior teeth differed both between individuals of different age and different dental status.

It is well known that several psychiatric disorders may be related to childhood psychological trauma. Recent studies have associated childhood exposure to trauma to some skin diseases. Our study aimed at exploring whether psoriasis is related to the reported positive and negative traumatic life events in different age intervals beginning from early childhood to adulthood. Furthermore, we investigated differences between psoriatics with early and late onset according to traumatic experiences in different age intervals. Also, we investigated the possible correlation of traumatic experiences with the disease severity. One hundred patients with psoriasis and 101 controls (patients with skin conditions considered to be "non-psychosomatic") were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The severity of psoriasis was estimated according to the Psoriasis Area and Severity Index (PASI), a standardized measuring instrument. The amount of positive experiences did not differ significantly among groups, except for safety scores that were higher in controls compared with both psoriatic groups (early and late onset). On the other side, negative traumatic experiences appeared more frequently in patients with psoriasis during all developmental periods. We found no correlation between severity of psoriasis and traumatic experiences. The present study demonstrates an increased history of childhood and adulthood negative traumatic experiences in patients with psoriasis compared to the control group. Our findings suggest a relationship between retrospectively reported negative traumatic experiences and psoriasis.

Psoriasis is a chronic papulosquamous skin disease, histologically characterized by epidermal hyperproliferation and dermal infiltration of inflammatory cells. The majority of T lymphocytes infiltrating dermis are CD4+ T lymphocytes secreting type 1 and type 17 cytokines. These cytokines are responsible for triggering keratinocyte proliferation as well as chemokine secretion and subsequent migration of other inflammatory cells in the skin. Contrarily, lymphocytes that accumulate in epidermis are mainly CD8+ T lymphocytes. According to the recent findings, these cells can also secrete type 1 and type 17 cytokines. However, it is demonstrated so far that epidermal CD8+ T lymphocytes contain higher amounts of cytolytic molecules, such as perforin, granzyme B and granulysin whose role in psoriasis pathogenesis is still unknown. Therefore, in this article we hypothesize the active involvement of cell mediated cytotoxicity in killing the proliferating keratinocytes as a mechanism of potential self-defense and possible brake in psoriatic plaque formation, maintaining skin homeostasis.

The purpose of this investigation was to study sagittal condylar inclination values within a uniform sample (Angle class I occlusion) using ‘articulator-related registration’ and Camper’s plane as a reference plane. The study was performed on a sample of 58 Angle class I subjects (mean age 25.1, SD 3.1). Measurements were performed with an ultrasonic jaw tracking device with six degrees of freedom. After a paraocclusal tray was fixed in the mouth, each subject had to make three protrusive movements and three right and left laterotrusive movements. From protrusive movements the software of the device automatically calculated the left and the right sagittal condylar inclination values used for setting of the articulator. The mean sagittal condylar inclination value was 41.0° (SD 10.5) for the right joint and 40.7° (SD 9.8) for the left joint. The maximum value was 65.0° for the right and 68.6° for the left joint, and the minimum value was 13.7° for the right and 21.7° for the left joint. The results of this study suggested the average articulator setting for sagittal condylar inclination for fully dentate adult subjects to be 40° in relation to Camper’s plane. This is especially important for the articulators that are set up in relation to Camper’s plane., Cilj istraživanja bio je proučavanje vrijednosti kuta nagiba kondilne staze unutar jednoličnog uzorka (klasa I. po Angleu) koristeći registraciju definiranu artikulatorom i Camperovu ravninu kao referentnu ravninu. Istraživanje je provedeno na uzorku od 58 ispitanika (prosjek godina 25,1; SD 3,1). Mjerenja su izvedena pomoću ultrazvučnog uređaja za snimanje kretnji donje čeljusti na temelju šest stupnjeva slobode. Nakon što se pričvrstila paraokluzijska žlica svaki ispitanik je izveo po tri kretnje protruzije, lijeve i desne laterotruzije. Iz protruzijske kretnje program uređaja je automatski izračunao vrijednosti lijevog i desnog kuta nagiba kondilne staze koje se koriste za individualizaciju artikulatora. Prosječna vrijednost kuta nagiba kondilne staze iznosila je 41,0° (SD 10,5) za desni zglob i 40,7° (SD 9,8) za lijevi zglob. Maksimalna vrijednost iznosila je 65,0° za desni i 68,6° za lijevi zglob, dok je minimalna vrijednost iznosila 13,7° za desni i 21,7° za lijevi zglob. Rezultati ovoga istraživanja sugeriraju vrijednost kuta nagiba kondilne staze od 40° prema Camperovoj ravnini kod namještanja artikulatora prema prosječnim vrijednostima kod potpuno ozubljenih pacijenata. To pogotovo vrijedi za artikulatore vrijednosti kojih se postavljaju u odnosu na Camperovu ravninu.

INTRODUCTION & OBJECTIVES: Melanoma is one of the most frequently occurring neoplasms worldwide, with up to 2.1% of the population being diagnosed at some point during their lifetime. Nodular melanomas are relatively common, but melanomas greater than 10 cm in size are rarely seen in practice. We present a clinically impressive and rarely encountered scenario of a rapidly progressing giant melanoma in a young adult. MATERIAL & METHODS: A single case report is presented. RESULTS: A 33-year old Caucasian male in good previous health presented with a 2-month history of a rapidly growing tumour on his left thigh. As reported by the patient, the tumour originated from a mole that was present since early childhood. He also complained of inexplicable weight loss, intermittent pain irradiating throughout his body, as well as recent onset of cough and a low-grade fever. On examination, a protruding fungoid mass measuring approximately 12x10x2 cm was evident on the upper portion of the patient’s left thigh. It was centrally necrotic and ulcerated, malodourous, with evidence of recent bleeding. The left inguinal region had multiple enlarged, firm and densely packed lymph nodes. In line with the patient’s history of a previous mole at the tumour site, malignant melanoma was initially suspected, however due to the impressive size, ulceration, rapid growth and lack of pigment traces, differential diagnosis included lymphoma and sarcoma. After wide surgical excision and ipsilateral lymph node dissection, histopathology confirmed a diagnosis of nodular melanoma with Breslow thickness of 20 mm, ulceration, 5 mitoses per square mm, lymphatic invasion, BRAF V600K mutation and multiple nodal macrometastases. Within 3 weeks of surgery, the patient developed right-sided muscle weakness and was diagnosed with multiple brain, liver and lung metastases. He was initially subjected to palliative radiotherapy of the central nervous system however a final management plan was not feasible because the patient deceased shortly thereafter. CONCLUSIONS: This case illustrates a rare presentation of nodular melanoma with an uncommonly large, fungating tumour and extremely rapid disease progression. Such thick melanomas are usually encountered in elderly patients due to fear of disease or self- negligence but our case highlights that we should consider giant melanoma in the differential diagnosis of large skin tumours even in young adults. Unfortunately, this specific group of patients has a significantly higher probability of developing early metastases and curative treatment is rarely possible. Therefore, to prevent such ominous prognosis, patient education and preventive skin examinations should be the mainstay of early recognition of melanoma.

We are presenting a female patient with multiple chronic, mostly autoimmune diseases, vitilgo, psoriasis and morphea. She has also diabetes and arterial hypertension. Our patient was xposed to may traumatic experiences during childhood and adolescence. We explored negative life experiences that had happened before the appearence of psoriasis and vitiligo. Recent studies suggest that multiple traumatic life events during childhood and adolescence in combination with genetic background could increase the vulnerabity for developing some autoimmune diseases. Therefore, for the tratment of these patients, interdisciplinary approach is needed. That includes the participation of the dermatologist and a psychiatrist- psychotherapist.

This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). The number of self-reported pain and number of painful sites were correlated with the level of depression. More self-reported pain and painful sites were recorded in the group of war veterans with PTSD as compared with either war veterans without PTSD or healthy men. Furthermore, PTSD patients mostly suffered from severe depression. There was a statistically significant positive correlation between all investigated pain parameters and level of depression. As the most important finding, the present study demonstrated chronic head, face and neck pain to be related to depression in PTSD patients.

Pemphigus vulgaris is a rare, chronic autoimmune bullous disease that was achieving mortality of about 75% before therapy onset. In our two patients with resistant pemphigus vulgaris it was necessary to apply a variety of therapeutic modalities for the effective disease management.

Psoriasis and lichen planus are papulosquamous, T-cell-mediated inflammatory dermatoses. Granulysin is an antimicrobial and cytolytic peptide expressed in the cytoplasmic granules of activated natural killer (NK) cells and cytotoxic T lymphocytes (CTLs). CTLs and NK cells mediate cytolysis by various mechanisms but mainly by granule exocytosis which triggers cell apoptosis. Until now, there are very few reports regarding the role of granulysin in psoriasis and lichen planus. Immunohistochemistry was conducted in biopsy specimens from lesional and non-lesional skin of patients with psoriasis and cutaneous lichen planus and in skin of healthy controls (10 patients per group). Significant increase of granulysin expression was found in psoriatic and lichen planus lesional skin opposing to both non- lesional and healthy skin. Differences were observed in dermal and epidermal granulysin expression of psoriatic and lichen planus lesional skin. The majority of granulysin-positive cells, in both diseases, were located in the inflammatory infiltrate of upper dermis and they were principally more plentiful in lichen planus dermal compartement. In lichen planus granulysin-positive cells were noticed mainly in basal parts of epidermis, whereas in psoriasis they were present throughout the whole epidermis. Granulysin expression is notably upregulated in the lesional dermis of patients with psoriasis and lichen planus encouraging a substantial role of this cytolytic molecule in the pathogenesis of both diseases.

P2X3 receptor influence masseter muscle pain.

The influence of hyperbaric oxygen (HBO) treatment on the activities of superoxide dismutase (SOD) and Na + ,K + -ATPase was determined during different time periods of reperfusion in rats exposed to global cerebral ischemia. Ischemic animals were either sacrificed or exposed to the first HBO treatment 2, 24, 48 or 168 h after ischemic insult (for SOD activities measurement) or immediately, 0.5, 1, 2, 6, 24, 48, 72 or 168 h after ischemic procedure (for Na + ,K + -ATPase activities measurement). Hyperbaric oxygenation procedure was repeated for seven consecutive days. The results of presented experiments demonstrated the statistically significant increase in the hippocampal SOD activity 24 and 48 h after global cerebral ischemia followed by a decrease in the enzymatic activity 168 h after ischemic insult. In the ischemic rats treated with HBO the level of hippocampal SOD activity was significantly higher after 168 h of reperfusion in comparison to the ischemic, non HBO-treated animals. In addition, it was found that global cerebral ischemia induced a statistically significant decrease of the hippocampal Na + ,K + -ATPase activity starting from 1 to 168 h of reperfusion. Maximal enzymatic inhibition was obtained 24 h after the ischemic damage. Decline in Na + ,K + -ATPase activity was prevented in the animals exposed to HBO treatment within the first 24 h of reperfusion. Our results suggest that global cerebral ischemia induces significant alterations in the hippocampal SOD and Na + ,K + -ATPase activities during different periods of reperfusion. Enhanced SOD activity and preserved Na + ,K + -ATPase activity within particular periods of reperfusion, could be indicators of a possible benefitial role of HBO treatment in severe brain ischemia.

The anticonvulsant effects of the dihydropyridine calcium channel blockers nifedipine, nicardipine and nimodipine were studied on experimental seizures induced by intra-hippocampal injection of kainic acid (KA) in chloralhydrate anesthetized Wistar rats. The rats were anesthetized and placed in a stereotaxic apparatus. After midline incision four screw electrodes were placed over the left and right frontal and parietal cortex and KA was injected into left dorsal hippocampus via 5-microliter Hamilton microsyringe. The changes in electroencephalograph (EEG) activity and EEG power spectra were recorded in basal conditions and 5, 10, 15, 30 and 60 min following KA injection. KA-induced excitatory changes in the surface EEG activity were associated with the marked increase in EEG power spectra in the frequency range from 14.5-22 Hz. Pretreatment with nifedipine, nicardipine and nimodipine revealed that they exerted certain differences in their anticonvulsant properties. Nimodipine significantly delayed the onset of seizures and prevented the KA-induced changes in EEG and in EEG power spectra in all recorded channels and in a dose dependent manner. Nifedipine exerted significant anticonvulsant effect only in channel four, while nicardipine was ineffective. Our results suggest that anticonvulsant action of some dihydropyridine calcium channel blockers, especially nimodipine may be in part independent of its antagonism on L-type voltage-gated calcium (Ca(2+)) channels.

The aim of this study was to investigate possible therapeutic approach to neuronal damage caused by status epilepticus. The effects of the L-type voltage-sensitive calcium channel blockers (nimodipine, nicardipine) and NMDA blockers (ifenprodil and MK-801) on the brain free fatty acid (FFA) level and glutathione peroxidase (GPX) activity in rats with lithium and pilocarpine (LiPi) - induced status epilepticus were examined. Vehicle or various doses of calcium channel and NMDA blockers had been injected i.p. 30 min after the pilocarpine application. Tested doses of nicardipine and MK-801 did not influence the increase in the brain FFA level. Nimodipine and ifenprodil revealed a tendency to reduce FFA level. The inhibition of L-type voltage-sensitive Ca2+ channels or NMDA receptor - associated channels was not sufficient for significant attenuation of an increase in the rat brain FFA content and a decrease GPX activity associated with LiPi - induced status epilepticus. Individual compounds have shown to prevent FFA increase, suggesting some alternative or additional mechanism of action. The prevention of FFA accumulation was not followed by the prevention of GPX decrease indicating the activation of non FFA-related mechanisms of cell damage.

Cilj: Dentalna estetika, kao nova grana dentalne medicine, postaje sve bitnija u modernom društvu. Ljudi su sve više svjesni svog izgleda, kao i novih materijala i tehnologija u dentalnoj medicini. Svrha ovog istraživanja bila je procijeniti utječe li dob na zadovoljstvo dentalnom estetikom. Ispitanici i metode: U istraživanju je sudjelovalo 700 odraslih osoba (261 muškarac i 439 žena, prosjek 46,2 ± 18,6 godina, medijan 45). Oni su ispunjavali upitnik o zadovoljstvu trenutnim estetskim dentalnim statusom, kao što su zadovoljstvo izgledom, bojom, oblikom i postavom gornjih prednjih zuba. Odgovori su uspoređeni s trenutnim statusom (tip restaurativnog ili protetskoga rada), bojom, veličinom i oblikom gornjih prednjih zuba. Rezultati: Pearsonova korelacija ukazuje da ne postoji statistički značajna povezanost između dobi i zadovoljstva svojim zubima niti na pojedinačnim aspektima niti na generalnoj razini. Zaključak: Iako smo očekivali da će stariji ispitanici biti zadovoljniji izgledom svojih zuba od mlađih, to se nije dogodilo. Vjerojatno je, pospješen medijskim pritiskom, dentalni izgled podjednako važan i mlađim i starijim osobama., Aim: Dental aesthetic as a new part of dental medicine is becoming more important in modern society. People are becoming more conscious of their looks, as well as new materials and techniques in dental medicine. The aim of this study was to assess whether age affects the satisfaction of dental aesthetics. Methods: The study population consisted of 700 adults (261 men and 439 women; mean age 46.2 ± 18.6 years, median 45). They completed a questionnaire regarding satisfaction with current dental esthetics issues, such as satisfaction with tooth appearance, color, shape and alignment of maxillary anterior teeth. The answers were compared with the current status (type of the restorative or prosthetic appliance), color, size and the shape of the maxillary anterior teeth. Results: The Pearson correlation showed that there were no statistically significant differences between age and satisfaction with dental aesthetic. Conclusion: Even we expected that the older participants would be more satisfied with dental aesthetics than younger, it did not happen. Probably due to media pressure, dental appearance is equally important for young and old participants.

Iako okluzijski ili mišićno-skeletalni odnos čeljusti ne mora zadovoljavati definiciju kliničkog koncepta optimalne ili idealne okluzije, tkiva žvačnog sustava moraju biti u stabilnoj i funkcionalnoj ravnoteži. Kada je funkcijska ravnoteža narušena, okluzijska shema se mora nanovo uspostaviti. Ovo je prikaz 28-godišnje pacijentice koja se žali na loše sanirane zube u lateralnom segmentu, stiskanje zubi tijekom noći te napetost u području maseteričnog i temporalnog mišića u jutarnjim satima. Kliničkim pregledom utvrđeni su neadekvatni ispuni, loše izbalansirana okluzija, sniženje vertikalne dimenzije okluzije u oba lateralna segmenta, Angle klasa II te nedostatak kontakata u frontalnoj regiji zbog izraženog horizontalnog pregriza. Nakon detaljne analize u artikulatoru, predloženi terapijski plan obuhvaća minimalno podizanje vertikalne dimenzije okluzije koja će biti dovoljna za smještaj funkcijski i estetski zadovoljavajućih nadomjestaka u lateralnim segmentima. Kako bi se očuvalo što više tvrdog zubnog tkiva te kako bi se adhezivnim cementiranjem kompenzirala eventualna nedovoljna visina kliničkih kruna i unaprijedila retencija nadomjestaka, slučaj prikazuje izradu nadomjestaka iz bezmetalne keramike.

Cilj: Nezadovoljstvo izgledom prednjih zuba jedan je od čestih razloga posjeta pacijenata ordinaciji dentalne medicine. Izradom ljuski od litijeve disilikatne staklokeramike omogućava se zbrinjavanje prednjeg segmenta koje uz maksimalno očuvanje zubnog tkiva osigurava visokoestetske zahtjeve. Prikaz slučaja: 28-godišnji pacijent došao je u specijalističku ordinaciju stomatološke protetike nezadovoljan izgledom gornjih prednjih zuba. Pacijentu su planirane i izrađene ljuske iz litijeve disilikatne IPS e.max press staklokeramike metodom tlačenja. Zaključak: Odabirom litijeve disilikatne IPS e.max press keramike omogućena je izrada izuzetno otpornih protetskih nadomjestaka minimalnih debljina te visoke estetike uz maksimalno očuvanje zubnog tkiva., Aim: In many cases, patients visit dental offices unsatisfied with the aesthetic appearance of the upper anterior teeth. Lithium disilicate glass ceramic veneers used in the anterior region provide high aesthetics with maximum conservation of the tooth structure. Case report: A 28 years old patient was unhappy with his upper frontal teeth. The lithium disilicate IPS e.max Press ceramic veneers using a hot pressing technique was planned and fabricated for the patient. Conclusion: Lithium disilicate IPS e.max Press ceramics provide the production of extremely resistant and highly aesthetic prosthetic appliances allowing minimal thickness of the bonded porcelain restorations in the anterior dentition and maximum conservation of the tooth structure.

Terapijske mogućnosti u liječenju bolesnika s umjereno teškim ili teškim oblikom psorijaze odnedavno su proširene lijekovima iz skupine čimbenika nekroze tumora-alfa te antagonistom interleukina 12/23. Zbog svoje izrazito visoke učinkovitosti, ovi lijekovi predstavljaju svojevrsnu revoluciju u liječenju psorijaze, no trebamo biti svjesni i rizika od najrazličitijih nuspojava koje mogu pratiti njihovu primjenu. Pritom ponajprije treba istaknuti umanjen imunološki odgovor prema infektivnim uzročnicima i tumorima, ali i cijeli spektar kožnih nuspojava nepoznatog mehanizma nastanka. U sklopu izlaganja iznijet ćemo pregled nuspojava ove skupine lijekova temeljem literaturnih podataka uz prikaz naših iskustava u posljednjih 6 godina. Većina naših bolesnika nije imala nuspojava tijekom terapije ili su one bile blage, poput pojačanog znojenja, rinitisa ili cistitisa te nisu bile razlogom za prekid terapije. Među težim nuspojavama koje su zahtjevale privremeni ili trajni prekid primjene lijeka prevladavale su infekcije. Najteža nuspojava s kojom smo se susreli bio je nastup sindroma stafilokoknog ljuštenja kože u odraslog bolesnika tijekom liječenja infliksimabom s posljedičnim gubitkom učinkovitosti te potrebom uvođenja drugog biološkog lijeka.

Cilj: Nezadovoljstvo izgledom prednjih zuba jedan je od čestih razloga posjeta pacijenata ordinaciji dentalne medicine. Izradom ljuski od litijeve disilikatne staklokeramike omogućava se zbrinjavanje prednjeg segmenta koje uz maksimalno očuvanje zubnog tkiva osigurava visokoestetske zahtjeve. Prikaz slučaja: 28-godišnji pacijent došao je u specijalističku ordinaciju stomatološke protetike nezadovoljan izgledom gornjih prednjih zuba. Pacijentu su planirane i izrađene ljuske iz litijeve disilikatne IPS e.max press staklokeramike metodom tlačenja. Zaključak: Odabirom litijeve disilikatne IPS e.max press keramike omogućena je izrada izuzetno otpornih protetskih nadomjestaka minimalnih debljina te visoke estetike uz maksimalno očuvanje zubnog tkiva., Aim: In many cases, patients visit dental offices unsatisfied with the aesthetic appearance of the upper anterior teeth. Lithium disilicate glass ceramic veneers used in the anterior region provide high aesthetics with maximum conservation of the tooth structure. Case report: A 28 years old patient was unhappy with his upper frontal teeth. The lithium disilicate IPS e.max Press ceramic veneers using a hot pressing technique was planned and fabricated for the patient. Conclusion: Lithium disilicate IPS e.max Press ceramics provide the production of extremely resistant and highly aesthetic prosthetic appliances allowing minimal thickness of the bonded porcelain restorations in the anterior dentition and maximum conservation of the tooth structure.

Stomatognati sustav prilagođen je funkciji žvakanja, gutanja i govora. Međutim, određene aktivnosti stomatognatog sustava odvijaju se bez svrhe i nazivaju se parafunkcijama. Parafunkcijske aktivnosti javljaju se kod velikog broja osoba i mogu dovesti do simptoma i znakova poremećaja stomatognatog sustava, obuhvaćajući promjene zuba, temporomandibularnih zglobova, potpornog aparata zuba, žvačne muskulature te udaljenih organskih sustava. Pravodobno otkrivanje simptoma i znakova oštećenja stomatognatog sustava te rano dijagnosticiranje parafunkcijskih aktivnosti preduvjet su prevencije ozbiljnih oštećenja sustava.