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Background/Aim. Open pelvic fractures are devastating, rare injuries with high mortality. Leading causes of mortality are the following: hemorrhage, infection, and associated injuries. The aim of this study was to point out methods of treating these injuries and a great number of prognostic mortality factors. Methods. In the period from January 2011 to December 2015, 221 patients with pelvis ring fractures were treated at three large clinical centers in Serbia, of which 13 (5%) patients had an open fracture type. We have classified pelvic ring fractures according to the Young-Burgess classification. We have classified injuries according to Gustilo at I, II, and III degrees, and the location of the wound according to Faringer classification was distributed in zone I, II, and III. Urogenital and intra-abdominal injuries were monitored, and the severity of injuries was determined according to Severity Score Injury (ISS) and Trauma Score (TS). Results. There were 6 (46%) women and 7 (54%) men with an average age of 41 year (13–76). Injuries from traffic trauma were dominant. The most common causes of pelvic ring fracture were anteroposterior compression – 6 (46%), lateral compression – 4 (31%), and vertical force in 3 (23%) patients. Dominant injuries were types I and II according to Gustilo and zone I according to the Faringer classification. There were 6 (46%) patients with urogenital injuries and the same number with intra-abdominal injuries, of which 3 (23%) patients had been treated with colon resection and diversion. Due to abundant hemorrhage and hypovolemic shock, two patients died, and another one died after three days due to sepsis and multisystem organ failure. Conclusion. Open pelvic fractures have a high mortality rate due to: hemorrhage, infection, associated abdominal and genitourinary tract injuries, ISS > 25, TS < 8, and the age of patients > 65 years.

Background/Aim. Dystrophic epidermolysis bullosa (DEB) is characterized by distinct systemic and skin changes, as well as numerous oral manifestations. The aim of the study was to examine oral and perioral soft tissues and oral functions in DEB patients by monitoring changes over a period of one year. Methods. Twenty-four patients (1 month to 36 years old) were clinically examined initially (T0), after 6 months (T6), and after 12 months (T12). Appearance and localization of perioral and oral bullae and scars, maximum mouth opening, reduced vestibule depth, absence of lingual papillae and palatal rugae, and restricted tongue movement due to scarring were monitored. The values of maximum mouth opening at the initial examination were compared to those measured in the healthy con-trol group of the same age. The age of patients and differences between the dominant and recessive subtypes of DEB were analyzed. Results. The average maximum mouth opening was significantly lower in DEB patients compared to healthy individuals. Oral and perioral bullae and scars, microstomia, and reduced vestibule depth were very common, with no statistically significant difference among T0, T6, and T12. The prevalence of restricted tongue movement due to scarring and the absence of lingual papillae and palatal rugae increased significantly over one year. Patients with microstomia, vestibule depth, and restricted tongue movement due to scarring were significantly older than patients without these characteristics. Lingual papillae and palatal rugae were more frequently absent in recessive than dominant DEB. Conclusion. DEB causes significant changes in oral and perioral soft tissues and oral functions impairment.

Background/Aim. Asthma is a chronic inflammatory lung disorder. The effect of asthma drugs on oral health is still the subject of debate among researchers in dentistry. The aim of this study was t o e valuate dental status in asthmatic children and evaluate the possible effect of drugs treating asthma on dental health. Methods. Study participants were divided into two groups: the asthma (AG) and the non-asthma (NAG) group. Based on the symptoms of asthma and the possibility for effective control of the disease, the AG group was divided into two subgroups. The oral examination of the teeth was per-formed using a probe and mouth mirror under artificial light in accordance with the recommendations of the World Health Organization. Saliva analysis was carried out by the GC Saliva-Check Buffer, according to the manufacturer's instructions. Results. The study included 136 children aged 6 to 16 years (10.5 ± 3.3). The mean of decayed, missing, and filled teeth (dmft/DMFT) of the children in the AG group (6.0 ± 4.0/3.3 ± 4.4) was higher than in the NAG group (4.8 ± 4.4/2.5 ± 3.4), but significant differences were not observed between the groups. Salivary pH values were found to be similar in both groups, but the quantity and buffering capacity of the stimulated saliva were found to be significantly lower in the AG group (p < 0.001 and p < 0.05, respectively). Conclusion. Although the prevalence of dental caries in the AG group was similar to that of the NAG group in this study, decreased quantity and buffering capacity of the stimulated saliva in the A G group may contribute to higher values of dental caries in asthmatic children in the future.

Background/Aim. Dental caries represents a health problem of all ages, but it is especially significant in the earliest age of children. Early childhood caries can develop immediately after the eruption of deciduous teeth, resulting in many complications, such as tooth extraction, which is reflected in the quality of life and health. Early childhood caries is influenced by a large number of predictors. Considering that the data on predictors for the development of deciduous teeth caries are scarce, the aim of this paper was to determine the prevalence of deciduous teeth caries and detect the predictors for the development of early childhood caries. Methods. Our survey included 117 children of both genders, aged 3 to 6 years, from the territory of Kosovska Mitrovica and Zvečan. All respondents, including children and parents, were surveyed, and thus general data was obtained. A dental examination was performed on all children. The current state of dental health was inserted into special research cards that were in line with the recommendations of the World Health Organization. Those predictors of dental health level that were statistically significant in models of univariate ordinal logistic regression at the significance level of 0.05 were included in the model of multivariate ordinal logistic regression. Results. According to the full structure, there were 49.6% of boys and 50.4% of girls. Healthy teeth were present in 25 (21.4%) children, 19 had reversible changes (16.2%), while 73 (62.4%) children had irreversible carious changes on teeth. The most important detected predictors were sweets consummation, sleeping with a baby bottle, 6 and more meals per day, frequent usage of medical syrups, child’s daily tooth-brushing frequency, child’s independent toothbrushing frequency, usage of non-fluoride toothpaste, a lack of professional fluoride application, and mouth breathing. Conclusion. This research contributed to the detection of a large number of predictors that are most important for the development of early childhood caries. In order to reduce the risk of caries development, it is necessary to act in more spheres. This certainly requires planning and implementing preventive dental programs.

Introduction/Objective. The aim of this paper is to point out the prevalence and severity of oral diseases in patients in the period before and after the transplantation of solid organs and hematopoietic stem cells. Methods. MEDLINE literature search was done via PubMed. Results. The development and improvement of transplantation medicine in specialized centers lead to an increasing number of patients, both adults and children, with transplanted solid organs and hematopoietic stem cells. Despite the success of therapy, numerous changes and complications can be observed on other organs in patients undergoing transplantation of solid organs and hematopoietic stem cells in the pre- and post-transplant phase. Systemic diseases and conditions related to organ and cell transplantation, which are accompanied by numerous oral manifestations. The most common oral changes are gingival enlargement, desquamation of the oral epithelium, very painful ulcerations, polypoid and granulomatous changes in the oral mucosa, hard dental tissues with frequent complications, developmental anomalies of teeth in younger children, and in the later stage also the occurrence of oral cancer. After transplantation of solid organs, hematopoietic changes in the oral cavity and other organs occur depending on the patient’s post-transplantation period as well as on the applied immunosuppressive therapy. Conclusion. Oral changes development before and after transplantation of solid organs and hematopoietic stem cells point to the importance of timely and competent cooperation between the dentist and the doctor who treats the underlying disease.

Background/Aim. Radiology is a crucial part of dentists’ everyday practice. It plays a vital role in diagnosis, treatment planning and the follow-up care of patients. The aim of this study was to evaluate the knowledge of dentists in Serbia concerning the use of radiology in pediatric dentistry. Methods. In total, 252 dentists from across Serbia participated in the study. A questionnaire was created in order to examine dentists’ knowledge about the use of radiology in pediatric dentistry. The questionnaire consisted of 39 questions. All questions were analyzed in SPSS 24 statistical software. Results. According to the results, 42.1% of dentists worked in private practice, 17.8% at University clinics and 40.1% in National Health Services. Out of total 252 respondents, only 82 (32.5%) had an x-ray unit. A total of 199 (79%) dentists replied they would diagnose early caries lesions only by inspection, but 30 (11.9%) dentists said they would make a diagnosis by doing both the inspection and taking a radiograph. The results show that 187 (74.2%) respondents said that they did not make an OPG for every patient. When asked about the disposal of radiological waste, 84.3% of dentists did not answer the question. Conclusion. Attempts should be made in order to upgrade and update Serbian dentists overall knowledge about the use of radiology in pediatric dentistry.

Introduction/Aim. The interest in oral health quality and the tendency to evaluate, provide, improve and compare it, are constantly improving. The main aim of this research was to examine the effectiveness of health education programme to change habits, attitudes and behaviours of dental students. Methods. The research was conducted at the Faculty of Dentistry in Pančevo. The first stage was related to the survey, the measurement of oral health status and the implementation of targeted health education. The second stage was conducted after the health education intervention, as a survey of attitudinal and behavioural changes and clinical measurement of oral health change. The sample consisted of 65 first-year and 54 fourth-year students, a total of 119 students. The following were defined as research instruments: the research record, questionnaires [the original questionnaire, Hiroshima University Dental Behavioural Inventory (HU-DBI) questionnaire] and health education intervention for modelling factors that determine attitudes and behaviours related to oral health. The Decayed-missing-filled (DMF) index was used to evaluate oral health and hard dental tissue conditions. Results. At the beginning of the research we asked the students: “Do you think your mouth and teeth condition is good?” Contrary to our expectations, 15.4% of the first-year students and 37% of the fourth-year students did not know the answer, or thought they had a problem. 80% of the first-year and 85.2% of the fourth-year students had positive attitude about the statement that once in six months they should go to the dentist for a check-up. 7.7% of the first-year students did not remember the last time they had visited a dentist. The implemented health education intervention led, to some ex-tent, to changes in habits, attitudes and behaviours of students related to oral health. Conclusions. Students of dental medicine do not have sufficiently clear attitudes and safe behaviour regarding oral health. Targeted health education intervention represents the method of choice to take care of one’s own health.

Introduction. Osteogenesis imperfecta is a rare heritable connective tissue disorder characterized by increased fragility of the bony tissue. The incidence of orofacial alterations associated with osteogenesis imperfecta is variable and includes dentinogenesis imperfecta, malocclusions, hypoplasia of the jaws, delayed dental development and structural abnormalities of the teeth. Case outline. A 22-year-old female was referred to the Clinic for Pediatric and Preventive Dentistry for dental treatment. Enlarged head, triangular-shaped face, mandibular prognathism with excessive maxillary hypoplasia, lowered vertical occlusal dimension were present features. The intraoral findings included dentinogenesis imperfecta with Kennedy’s class IV in the upper jaw and class II in the lower jaw. Panoramic radiograph revealed abnormalities in the crown and root shape, obliteration of the pulp chamber and severe deficiency of alveolar bone mass. Overall treatment involved five phases: I – preventive and prophylactic treatment, II – direct restauration of five teeth with glass ionomer cement, III – extraction of severely damaged teeth, IV – prosthodontic rehabilitation with removable partial dentures, V – maintenance and follow-up phase. Conclusion. Low prevalence and wide variety of signs and symptoms make dental treatment of osteogenesis imperfecta overly complex and challenging. Nevertheless, it is essential to improve craniofacial and dental function along with facial aesthetic.

Introduction. Recurrent aphthous stomatitis (RAS) is a relatively common oral mucosal lesion of unclear etiology. It occurs in otherwise healthy people, but also in various infectious and non-infectious diseases, including celiac disease (CD). We present an obese adolescent with RAS as the only clinical sign of CD. Case outline. An adolescent aged 15 2/12 years come with very pronounced RAS in previous five months. He had no other difficulties. The patient was obese from the age of 12. Other data were without peculiarities. On admission he was 165 cm tall (P25), obese (BMI 27 kg/m2), in the final stage of puberty, with stretch marks in the distal areas of the abdomen, thighs and gluteus and very pronounced pain-sensitive aphthae in the buccal and labial mucosa accompanied by swelling of the lips and perioral region. Except for lower serum iron levels (8 μmol/l), routine laboratory blood tests were within the reference range. The serological test for CD was positive (antibodies to tissue transglutaminase IgA 78.5 U/ml, anti-endomysial antibodies IgA positive). Endoscopy revealed reflux esophagitis, without any other pathological findings. Stereomicroscopic and pathohistological analysis of the duodenal mucosa samples showed mild destructive enteropathy (Marsh IIIa). Pathohistological examination of the gastric mucosa revealed grade I-II lymphocytic gastritis. The urease test for Helicobacter pylori was negative. A gluten-free diet resulted in the withdrawal of aphthous stomatitis and no recurrence later. Conclusion. Within the differential diagnostic analysis of the RAS causes, CD should also be considered. Additionally, obesity does not exclude the presence of CD.

Introduction Separation of instruments in the root canal is one of the challenges in endodontic treatment. More specifically, nickel-titanium (NiTi) rotary instruments usually separate without previous deformation. The aim of this pilot study was to assess the effect of torsional stress on endodontic NiTi rotary instruments separation in simulated clinical conditions. Materials and methods Research was conducted on a sample of 20 human teeth in laboratory conditions. Experimental procedure consisted of determining canal curvatures for each root on digital radiographs and root canal treatment using endodontic NiTi rotary instruments. Out of 20 teeth (60 canals), two groups were formed with similar root canal curvatures (10 pairs of teeth) and instrumented using NiTi rotary instrument with or without torque control. Results Wilcoxon matched pair test showed no statistically significant difference in average number of instruments use with or without torque control (p>0.05). Conclusion Even though there is no statistical significance in instrument separation when instruments were used with or without torque, there is tendency to experience sudden fracture of instruments after work without torsional control even after only few uses in clinical work.

Background/Aim. Epidermolysis bullosa is a group of rare, genetic connective tissue diseases that cause blisters in the skin and mucosal membranes. The aim of this study was to evaluate the oral health status of patients with epidermolysis bullosa dystrophica and level of knowledge and opinion of parents about the implementation of preventive measaures and quality of dental care of affected children. Methods. This study included a group of 17 patients from Serbia suffering from dystrophic epidermolysis bullosa and matched control group. Dental caries status was assessed using the Klein-Palmer index. Oral hygiene status was verified with oral hygiene indices, simplified plaque index, and calculus index as described by Green and Vermillion. The gingiva was assessed as healthy or inflamed (gingivitis) on the basis of any changes in color, shape, size and surface texture. The condition of oral mucosa has been registered on the basis of inspection of the lips, tongue, a floor of the mouth, mouth vestibule and palate. The level of knowledge and the impressions of parents about the application of preventive measures were investigated through two questionnaires specifically designed for this study. Results. In both dentitions, there was the highest percentage of caries teeth. In primary dentition average value of the modified plaque index was 1.4 ± 1.14 and modified calculus was 0.7 ± 1. On permanent teeth average plaque index was 2 ± 0.4, and average calculus 1.6 ± 0.6. Statistically, significant higher values were found in permanent dentition in percentage distribution of decayed, missing, filled teeth and also for plaque and calculus indices between affected children and the control group. Most common findings on mucosa were microstomia (76.5%) and ankyloglossia (88.2%). Conclusion. The absence of protocol between the treating physician and the dentist and not sufficiently informed parents are leading to inadequate dental care. The implementation of preventive measures is of most importance to decrease the risk of severe complications that are difficult to be managed.

Goal of contemporary dentistry is to decrease the patient’s discomfort during treatment. Dentists aim to achieve maximum with the newly developed dental materials as well as with new cavity preparation techniques in the shortest time span. Since the development of the first constructed borer (drilling machine) for caries removal, the preparation techniques have considerably changed. The progress of dental materials as well as the cavity preparation techniques has led us to contemporary carbide tungsten and diamond borers that are used with obligatory water cooling. The innovation within this field represents newly developed polymer borers that can detect the difference between carious lesions and healthy tooth structure. In this way the cavity preparation may be performed without damaging dental healthy tissue. This is possible owing to their hardness which is lower than the hardness of intact dentin. Polymer borer preparation is painless with less vibration, while the increase in temperature is negligible. Lasers have been used in clinical dentistry since 1980s so it can be said that they represent a new technology. The function of lasers is based on ablation which requires water. Erbium lasers have shown the highest potential with their ability to produce effective ablation of hard dental tissues. Laser application in dentistry requires special training as well as some protective measures. Laser advantages, compared to traditional preparation techniques, involve the absence of vibration, painless preparation, possibility of preparation without anesthetic and easier patient’s adjustment to dental intervention which is of importance, especially in pediatric dentistry. [Projekat Ministarstva nauke Republike Srbije, br. 46009]

Speed, and vehicles themselves, affect the level of service and road safety, quality of life, noise from traffic, the environment, health, air pollution, emission of carbon dioxide, global warming, the economy and consumption of non-renewable energy such as oil. Therefore, the speed management of the traffic of multiple significance and that should be primarily to provide effective and economical conditions of the modern and preventive protection of human life as the greatest treasure and then the material resources. The way to accomplish this is by using various (different) measures such as: appropriate planning and projecting roads and streets, speed control, the legislation, enforcement, campaigns, education, advanced technologies (ITS).

Oral manifestations are often present in all types of leukaemia, and are particularly severe in children. Oral diseases may result as complications of aggressive cytotoxic therapy. On the other hand, oral diseases that are already present in the oral cavity could be aggravating the patient’s general condition and lead to serious life-threatening infections. The aim of this paper was to highlight the importance of preventive measures in maintaining oral health, as well the measures for controlling oral disorders onset during the course of illness and applied therapy in children with acute leukaemia. All preventive measures that include proper, regular hygiene and intervention depend on the patient’s haematological status and general health condition, and are performed with the consultation and approval of the haematologists-in-charge. The preventive program can be implicated in three stages; before the beginning of cytotoxic therapy, during active cytotoxic therapy and after cytotoxic therapy. Having in mind that oral disease can influence general treatment in children with acute leukaemia dramatically, developing protocols on the implementation of all measures of oral prevention and treatment is mandatory.

Acute leukaemia is the most common form of chilhood cancer. The aim of this paper was to underline the importance of oral manifestations in children with acute leukaemia. The disease and its treatment can directly or indirectly affect oral health. Oral manifestations are gingival inflammation and enlargement. Leukaemic cells are capable of infiltrating the gingiva and the deeper periodontal tissues which leads to ulceration and infection of oral tissues. Gingival bleeding is a common sign in patients with leukaemia. Symptoms include local lymphadenopathy, mucous membrane Petechiae and ecchymoses. Cytotoxic drugs have direct effects like mucositis, involving atrophy, desquamation and ulceration of the mucosa, with increasing the risk for local and systemic infections. Leukaemia can directly influence dental care and dental treatment, while oral lesions may have life-threatening consequences. Knowledge and skills among dentists may also not be adequate to treat children with acute leukaemia. It is therefore imperative that all stomatologists be aware of dental problems that occur in leukaemia in order to be able to effectively carry out appropriate measures to mitigate these problems.

Cerebral palsy is one of the commonest children's physical handicaps with frequency of 1.5-3/1000. Beside many other disturbances, these children may have serious disorders caused by dental diseases. Concerning this fact, the objective of our study was to examine children with cerebral palsy in our country and determine condition of dental health and suggest adequate protective measures. A total of 116 children, 3-18 years old, with cerebral palsy were examined and the results were compared to the control group of healthy children of the same age. Among healthy children, 7-10 years old, 66.3% had healthy parodontium, while none of children with cerebral palsy had healthy parodontium. Children, 11-14 years old with cerebral palsy had higher percentage of untreated caries, but lower percentage of filled teeth (18.7%) compared to healthy children (55.0%). Children, 15-18 years old with cerebral palsy had significantly higher percentage of extracted teeth (10.6%) than healthy children (4.1%) and more often orthodontic anomalies (70.6%), compared to healthy children (46.9%). Results of these study indicate that children with cerebral palsy need special and planned dental care.