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Cilj istraživanja: Ispitati učestalost patoloških lezija oralne sluznice, suspektnih potencijalno malignih oralnih lezija te lezija suspektnih na oralni karcinom u osoba koje su se odazvale pregledu u svrhu ranog otkrivanja oralnog karcinoma prilikom obilježavanja Svjetskog tjedna svjesnosti o karcinomu usne šupljine, glave i vrata u travnju 2022. i 2023. godine u ambulanti za oralnu medicinu KBC-a Split. Materijali i metode: U istraživanju je dobrovoljno sudjelovalo 440 ispitanika koji su se odazvali na preventivni pregled u svrhu ranog otkrivanja oralnog karcinoma u sklopu organiziranog Dana otvorenih vrata. Raspon dobi ispitanika je od 18 do 93 godine. Svim ispitanicima uzeta je detaljna anamneza. Prilikom neinvazivnog kliničkog pregleda usne šupljine zabilježeni su podatci o stanju oralne sluznice te o vrsti lezije koja je pronađena. Pacijenti kojima su pronađene patološke promjene u usnoj šupljini upućeni su na daljnju specijalističku obradu. Oni ispitanici kod kojih je pronađena lezija suspektna na karcinom upućeni su na maksilofacijalnu kirurgiju kako bi se napravila biopsija i patohistološka analiza lezije. Rezultati: U istraživanju je sudjelovalo 208 (47,3 %) muškaraca i 232 (52,7 %) žene. Srednja vrijednost dobi iznosila je 62,8 dok je medijan bio 66 godina. Pronađenih prekanceroza bilo je ukupno 32 (7,3%). Od toga su 23 (5,2 %) klinička nalaza imponirala erozivnim formama oralnoga lihen planusa. Sedam (1,6 %) patoloških promjena bilo je suspektno na karcinom. Na pitanje o svakodnevnoj konzumaciji alkohola 112 (25,5 %) ih je odgovorilo potvrdno, dok se 104 (23,6 %) izjasnilo kao pušači. Zaključci: Patološka promjena koja je suspektna na karcinom pronađena je u sedam ispitanika od pregledanih 440. U ovome istraživanju pronađeno je ukupno 117 patoloških promjena sluznice, od čega su 32 okarakterizirane kao potencijalno maligna lezija. Najčešće pronađena potencijalno maligna lezija bio je erozivni oblik oralnog lihen planusa. Ukupno su 104 ispitanika zahtijevala dodatni specijalistički pregled, što je za većinu bio pregled specijalista oralne medicine. Od sedmero ispitanika kod kojih je pronađena lezija suspektna na karcinom njih četvero negira konzumaciju alkohola i duhanskih proizvoda., Objectives: To examine the frequency of pathological lesions of the oral mucosa, suspected potentially malignant oral lesions and lesions suspicious for oral cancer in persons who responded to the examination for early detection of oral cancer during the promoting of the Oral, Head and Neck Cancer Awareness Week in April 2022 and 2023. in the clinic for oral medicine of the University Hospital of Split. Materials and methods: 440 subjects, who responded to a preventive examination for early detection of oral cancer as part of the organized Open Day, voluntarily participated in the research. The age range of the respondents is from 18 to 93 years. A detailed medical history was taken from all subjects. During the non-invasive clinical examination of the oral cavity, data on the condition of the oral mucosa and the type of lesion that was found were recorded. Patients who were found to have a pathological lesion of the oral cavity were referred for further specialist treatment. Subjects who were found to have a lesion suspicious of cancer were referred to the clinic for maxillofacial surgery in order to perform a biopsy and pathohistological analysis of the lesion. Results: 208 (47.3%) men and 232 (52.7%) women participated in the research. The mean age was 62.8, while the median was 66 years. A total of 32 (7.3%) precancerous lesions were found. Of these, 23 (5.2%) had clinical findings of erosive forms of oral lichen planus. Seven (1.6%) pathological changes were associated with oral cancer. When asked about daily alcohol consumption, 112 (25.5%) answered yes, while 104 (23.6%) declared themselves as smokers. Conclusion: A pathological change suspicious of cancer was found in seven subjects out of 440 examined. In this study, a total of 117 pathological changes of the mucous membrane were found, of which 32 were characterized as potentially malignant lesions. The most frequently found potentially malignant lesion was the erosive form of oral lichen planus. A total of 104 respondents required an additional specialist examination, which for the majority was an examination by an oral medicine specialist. Of the seven subjects in whom a lesion suspicious of cancer was found, four of them denied the consumption of alcohol and tobacco products.

Cilj istraživanja: Usporediti učinkovitost primjene plazme bogate faktorima rasta (PRGF) kao potencijalne metode liječenja erozivnog oralnog lichen planusa (EOLP) s topikalnom primjenom kortikosteroida koja predstavlja trenutni zlatni standard u liječenju ove bolesti. Materijali i metode: U studiju su bili uključeni pacijenti kojima je biopsijom potvrđena dijagnoza EOLP-a. Pacijenti koji su zadovoljili sve kriterije i odlučili sudjelovati, potpisali su suglasnost. Istraživanje smo proveli kao split- mouth kontroliranu studiju. U jednoj polovici usne šupljine primijenili smo PRGF, a u drugoj kortikosteroid kao zlatni stanard u terapiji. Randomizaciju smo proveli metodom slučajnog odabira. Radili smo četiri aplikacije svakih sedam dana kroz četiri tjedna zaredom te potom kontrolne preglede u četiri vremenske točke (7, 30, 60 i 90 dana nakon zadnje aplikacije). Prilikom svakog posjeta određivali smo veličinu lezija, radili kliničke fotografije prije svake primjene te zatražili pacijenta da ocijeni subjektivne simptome boli i pečenja za svaku stranu usne šupljine prema VAS-i. Također, pacijenti su ispunili OHIP-14 upitnik pri prvoj aplikaciji te prvoj i četvrtoj kontrolnoj posjeti. Rezultati: Ova split-mouth studija je provedena na 15 ispitanika. Uspoređivane su razine boli i pečenja za svaku grupu pojedinačno te između grupa. Dokazano je kako između grupa nema statistički značajne razlike dok je unutar grupa dokazana statistički značajna razlika između dolazaka. Veličina lezija se u obje grupe kontinuirano smanjivala te je također dokazano kako nema statistički značajne razlike između grupa. Dinamika OHIP-14 zbira kontinuriano se smanjivala između triju točaka mjerenja. Zaključci: Primjena PRGF- a kao i kortikosteroida dovela je do značajnog smanjenja boli, pečenja i veličine lezija kao i do poboljšanja kvalitete života. Dokazano je kako nema statistički značajne razlike između grupa te nisu zabilježene nikakve nuspojave nakon terapijske aplikacije PRGF-a. Potrebna su daljnja istraživanja kako bi se potvrdili dobiveni rezultati, ali PRGF se može razmatrati kao alternativna metoda u liječenju EOLP- a., Research objective: Comparing the efficacy of using growth factor rich plasma (PRGF) as a potential method for treating erosive oral lichen planus (EOLP) to the topical use of corticosteroids, which is the current gold standard when it comes to treating this disease. Materials and methods: This study included patients with biopsy- confirmed EOLP diagnosis. Patients that fit all of the criteria and decided to participate in the study signed the consent forms. The research was conducted as a split-mouth control study. One half of the oral cavity was treated using PRGF, and the other used corticosteroids which is the golden standard in therapy. Randomization was conducted by the random selection method. The therapy was applied four times, every seven days over the course of four weeks, with control examinations at four different points in time (7, 30, 60 and 90 days after the last application). During each of the visits, we determined the size of the lesions, made clinical photographs before each application, and asked the patients to grade their subjective pain symptoms and burning sensation using the VAS (visual analog scale) for each side of the oral cavity. Patients also filled out the OHIP-14 questionnaire before the first application and during the first and fourth control visit. Results: This split-mouth study has been conducted on 15 patients by comparing different levels of pain and the burning sensation for each group individually and among different groups. It has been proven that there are no statistically significant differences between the groups but there are statistically significant differences between different sessions inside the same group. In both groups, lesion size had been continuously decreasing and it was proven that there were no statistically significant differences between the groups. The dynamics of OHIP-14 sum had been continuously decreasing between the three measurement points. Conclusion: Using the PRGF method, as well as the use of corticosteroids brought a significant decrease of pain levels and the burning sensation, decrease in lesion size and an improved quality of life. It was proven that there are no statistically significant difference between the groups and there was no noted side effects after the therapeutic application of PRGF. Additional research is needed to confirm the results, but the PRGF can be considered as an alternative method in treating EOLP.

Cilj: Glavni cilj istraživanja je bio usporediti aktivnost SAA-e u bolesnika s OLP-om u odnosu na zdrave kontrolne ispitanike. Ostali ciljevi bili su odrediti najčešće lokalizacije OLP-a, razinu depresije, anksioznosti, stresa te kvalitetu života kod svih ispitanika. Dodatni ciljevi su bili odrediti duljinu trajanja bolesti i intenzitet simptoma (bol/pečenje) u oboljelih, te usporediti sve navedene parametre između ispitne i kontrolne skupine te unutar samih skupina. Materijali i metode: U istraživanju je sudjelovalo ukupno 50 ispitanika podijeljenih u dvije skupine. Ispitnu skupinu (N=30) su činili bolesnici s potvrđenom dijagnozom OLP-a. Kontrolna skupina se sastojala od 20 ispitanika. Bolesnicima s OLP-om je zabilježen oblik bolesti (neerozivni, erozivni), duljina trajanja bolesti (mjeseci), intenzitet simptoma (VAS ljestvica). Svim ispitanicima je izmjerena aktivnost SAA-e (kinetičkom kolorimetrijskom metodom), određen psihološki profil (DASS-21) i kvaliteta života (OHIP-CRO14). Rezultati: Nije uočena statistički značajna razlika aktivnosti SAA-e u bolesnika s OLP-om u odnosu na zdrave kontrolne ispitanike (P = 0,314). Najčešće lokalizacije OLP-a su bile sluznica obraza desno (SZO19) i sluznica obraza lijevo (SZO20). Pokazana je dobra pozitivna statistički značajna korelacija kvalitete života (ukupno) s intenzitetom simptoma (r = 0,584, P < 0,001) i depresijom (r = 0,651, P < 0,001), anksioznosti (r = 0,653, P < 0,001), stresom (r = 0,578, P < 0,001). Pokazana je statistički značajna razlika subsklale OHIPCRO14 fizička bol između bolesnika s erozivnim oblikom OLP-a u odnosu na neerozivni (2,7±2,3 naspram 0,8±1,3, P = 0,012). Zaključak: Bolesnici s OLP-om pokazuju znatno više vrijednosti depresije, anksioznosti, stresa u odnosu na kontrolne ispitanike. Naše istraživanje je pokazalo snažnu povezanost psihičkih poremećaja i kvalitete života u bolesnika s OLP-om. Možemo zaključiti da je interdisciplinarni psihoneuroimunološki pristup nužan u bolesnika s OLP-om neovisno jesu li psihički poremećaji dio etiološkog mehanizma bolesti ili su njegova posljedica., Objectives: The main objective of the study was to compare the activity of SAA in patients with OLP compared with control subjects. Other objectives were to determine the most common topography of OLP, the level of depression, anxiety, stress, and quality of life in all subjects. Specific objectives were to determine the disease duration and the intensity of symptoms (pain/burning) in patients with OLP and to compare all the above parameters between the test and control groups and within the groups themselves. Materials and Methods: A total of 50 subjects, divided into two groups, participated in the cross-sectional study. The test group (N=30) consisted of patients diagnosed with OLP. The control group consisted of 20 subjects. In the patients with OLP, the form of the disease (nonerosive, erosive), the disease duration (months), the intensity of the symptoms (VAS scale) were recorded. In all subjects, SAA activity (using the kinetic colorimetric method), psychological profile (DASS-21) and quality of life (OHIP-CRO14) were determined. Results: There was no statistically significant difference in SAA activity in patients with OLP compared to control subjects (P = 0.314). The most frequent topography of OLP were the mucosa of the right cheek (SZO19) and the mucosa of the left cheek (SZO20). There was a good positive statistically significant correlation of quality of life (total) with symptom intensity (r = 0.584, P < 0.001) and depression (r = 0.651, P < 0.001), anxiety (r = 0.653, P < 0.001), stress (r = 0.578, P < 0.001). There was a statistically significant difference in the OHIP-CRO14 physical pain subscale between patients with an erosive form of OLP compared to a non-erosive form (2.7±2.3 vs. 0.8±1.3, P = 0.012). Conclusion: Patients with OLP had significantly higher scores for depression, anxiety, and stress compared with control subjects. Our cross-sectional study showed a strong association between mental disorders and quality of life in patients with OLP. We can conclude that an interdisciplinary psychoneuroimmunological approach is necessary in patients with OLP, regardless of whether mental disorders are part of the etiological mechanism of the disease or its consequence.

Ciljevi: Glavni cilj ovog istraživanja bio je utvrditi učestalost bolesti štitnjače kod pacijenata sa oralnim lichen ruberom. Specifični ciljevi bili su utvrditi učestalost povišenih vrijednosti TSH, T3 i T4 te učestalost pozitivnog nalaza antiTPO i antiTg kod osoba s oralnim lichen ruberom. Materijali, metode i ustroj istraživanja: Uzete su anamneze pacijenata te su po potrebi su učinjene serološke pretrage (TSH, T3, T4, antiTPO i antiTG). Rezultati: Bolest štitnjače pronađena je kod više od polovice pacijenata s dijagnosticiranim OLR-om. Povišena serumska vrijednost TSH pronađena je kod 22,7% pacijenata. Parametar je bio povišen kod polovice slučajeva kad bolest štitnjače nije dijagnosticirana. Vrijednost T3 bila je povišena kod 18,2% pacijenata te manje od polovice (40%) onih bez dijagnosticirane bolesti štitnjače. Serumske razine T4 unutar referentnog intervala uz povišene vrijednosti TSH mogu upućivati na subklinički hipotireoidizam. Serumske vrijednosti protutijela antiTPO i antiTG bile su pozitivne kod 13,6% pacijenata. Iste su iste bile pozitivne kod 30% pacijenata koji nisu imali dijagnosticiranu bolest štitnjače. Zaključci: Bolest štitnjače pronađena je kod više od polovice pacijenata s dijagnosticiranim oralnim lichen ruberom. Povišena serumska vrijednost hormona TSH i T3 pronađena je kod dijela pacijenata s ORL-om i oko polovice istih bez prethodne dijagnoze bolesti štitnjače. Serumske razine T4 unutar referentnog intervala uz povišene vrijednosti TSH mogu upućivati na subklinički hipotireoidizam. Serumske vrijednosti protutijela antiTPO i antiTG bile su pozitivne kod manjeg broja pacijenata i oko trećine pacijenata koji nisu imali dijagnosticiranu bolest štitnjače., Objectives: The main aim of this study was to determine the frequency of thyroid gland disease in patients with oral lichen ruber. Specific aims were to determine the frequency of elevated levels TSH, T3, T4 and the frequency of positive antibody tests for TPOAb and TgAb in patients with oral lichen ruber. Materials, methods and organization of research: Patients' anamnesis were taken and serological tests were made if needed. Results: Thyroid disease was found in more than half of patients with diagnosed oral lichen ruber. Elevated TSH serum level was found in 22,7% of patients. Parameter was raised in half cases when ORL hasn't been diagnosed. T3 level was raised in 18,2% of patients and in less then half (40%) of them without diagnosed thyroid disease. Serum levels of T4 in reference interval with elevated TSH levels can refer to subclinical hypothyroidism. TPOAb and TgAb serum levels were positive in 13,6% patients. The same were positive in 30% patients without diagnosed thyroid disease. Conclusions: Thyroid disease was found in more than half of patients with diagnosed oral lichen ruber. Elevated serum levels of TSH and T3 were found in some of the patients and half of the same without previous thyroid disease diagnosis. Serum levels of T4 in reference interval with elevated TSH levels can refer to subclinical hypothyroidism. TPOAb and TgAb serum levels were positive in a smaller number of patients and about a third of patients that were not diagnosed with thyroid disease.

Literaturni podaci upućuju na to da neplodne pacijentice imaju lošiji parodontni status, što može biti uzrok komplikacijama začeća. Matriksna metaloproteinaza 8 (MMP-8) je enzim u slini koji je izravno povezan s parodontnom upalom. Cilj ove studije bio je validacija ordinacijskog testa koji detektira aktivni oblik MMP8 (aMMP8) iz ispirka usne šupljine u populaciji žena s neobjašnjivom neplodnošću u usporedbi s plodnim ženama odgovarajuće dobi s i bez parodontitisa. Pretpostavljali smo da će neplodne žene imati lošiji parodontni status i veći broj pozitivnih aMMP-8 testova u usporedbi s plodnim ženama. Istraživanje je uključilo 50 zdravih žena s urednim ovulacijskim ciklusima u dobi od 25-45 godina i strogo definiranom neobjašnjivom (idiopatskom) neplodnošću i 50 zdravih žena s urednim ovulacijskim ciklusima iste dobi koje su zatrudnjele i rodile prirodnim putem. Svim sudionicama napravljen je klinički parodontološki pregled i ordinacijski test na aMMP-8 iz ispirka usne šupljine. Polovici pacijentica u svakoj skupini dijagnosticiran je parodontitis, dok je druga polovica bila bez parodontitisa. Osjetljivost i specifičnost testa za otkrivanje parodontitisa iznosila je 84% i 72% u skupini neplodnih, 88% i 68% u skupini plodnih pacijentica te 86% i 70% u ukupnoj populaciji pacijentica. Neplodne pacijentice s parodontitisom imale su manje uznapredovali parodontitis od kontrolne skupine, iako ta razlika nije bila statistički značajna. Rezultati su pokazali da su neplodne bolesnice imale bolji parodontni status i manje uznapredovali parodontitis od plodnih žena iste dobi te da osjetljivost i specifičnost testa rastu sa stupnjem uznapredovalosti parodontitisa. Testom se može razmjerno dobro identificirati pacijentice s parodontitisom, ali je, s obzirom na naše rezultate, korist od tog testiranja u obradi i liječenju idiopatske neplodnosti upitna. Aim: Literature data suggest that infertile patients present worse periodontal status, which may be a factor that complicates conception. Matrix metalloproteinase 8 (MMP-8) is an enzyme in saliva that is directly related to periodontal inflammation. The aim of our study was to validate a chairside mouth rinse test for detection of active form of MMP8 (aMMP8) in a population of women with unexplained infertility compared to age-matched fertile women, with and without periodontitis. Our hypothesis was that infertile women will have worse periodontal health and more positive MMP8 tests, compared to fertile women. Materials and methods: The study included 50 healthy norm-ovulatory females ages 25-45 with strictly defined unexplained infertility, and 50 healthy norm-ovulatory women at the same age who have conceived and delivered naturally. All participants underwent clinical periodontal examination and a chairside aMMP-8 oral rinse test. One half of the participants in each group was diagnosed with periodontitis, while the other half was without periodontitis. Results: The sensitivity and specificity of the test for the detection of periodontitis in the group of infertile patients was 88% and 68%, in the group of fertile patients 84% and 72% and 86% and 70% in the total patient population. Infertile patients with periodontitis had less advanced periodontitis than the control group, although the difference was not statistically significant. Conclusion: Our results have shown that infertile patients had better periodontal status and less advanced periodontitis than fertile women of the same age. Sensitivity and specificity of the test increase with the degree of progression of periodontitis. Patients with periodontitis can be relatively well identified, but based on our results, the benefit of this test in the treatment of idiopathic infertility is questionable.

Oralna leukoplakija (OL) je potencijalno zloćudna lezija sluznice usne šupljine kod koje postoji povećan rizik za zloćudnu transformaciju u odnosu na zdravu sluznicu. Razumijevanje procesa karcinogeneze i razvoj molekularne biologije doveo je do otkrivanja novih molekularnih biomarkera poput Ki67 i CD44 koji bi mogli pomoći u ranom otkivanju tumora te njihovom liječenju. Cilj ovog retrospektivnog presječnog istraživanja je imunohistokemijski utvrditi izraženost CD44 i Ki67 u OL te usporediti dobivene podatke s izraženosti CD44 i Ki67 u oralnom planocelularnom karcinomu (OPK) i zdravoj oralnoj sluznici, kako bi se iz obrazaca njihovih pojavnosti pretpostavila uključenost u patološke događaje, a što bi moguće indiciralo potrebu za prospektivnim studijama koje uključuju i ishode. Analizirano je 30 uzoraka sluznice usne šupljine s dijagnozom OL, 30 uzoraka sluznice usne šupljine s dijagnozom OPK i 20 uzoraka sluznice usne šupljine bez patohistoloških promjena. Imunohistokemijska analiza za protutijela vodila se LSAB metodom kao vizualizacijskim sistemom na Dako TechMate TM Horizon (Dako, Copenhagen, Danska) automatiziranom stroju za imunohistokemijsko bojenje. Zabilježena je značajna razlika između ispitivanih skupina u odnosu na izraženost CD44 u epitelu kao i u odnosu na izraženost Ki67 u epitelu. Statistički značajna razlika zabilježena je između ispitivanih skupina u odnosu na imunohistokemijsku izraženost CD44 u upalnom infiltratu, dok je značajna razlika s obzirom na izraženost Ki67 u upalnom infiltratu zabilježena između skupine OPK i OL te OPK i zdrave sluznice, ali ne i između OL i zdrave sluznice. Pozitivna korelacija zabilježena je između upale detektirane na hematoksilin eozinskom preparatu (HE) i Ki67 u upalnom infiltratu u skupini OL. Značajne i pozitivne korelacije zabilježene su i s CD44 i u epitelu i u upalnom infiltratu iste skupine. Nije zabilježena značajna korelacija između upale HE i ispitivanih molekularnih biljega u skupini OPK. Značajna pozitivna korelacija zabilježena je između CD44 u upalnom infiltratu s CD44 i Ki67 u epitelu, ali samo u skupini OL, dok za OPK nije bilo značajne povezanosti. Povećana imunohistokemijska izraženost biljega CD44 i Ki67 u OL upućuje na potrebu provođenja novih opsežnijih studija koje bi omogućile kliničarima dodatne mogućnosti praćenja i predviđanja ponašanja pojedinih lezija. INTRODUCTION: Oral leukoplakia (OL) is a potentially malignant lesion of the oral mucosa in which there is an increased risk of malignant transformation compared to healthy mucosa. Today, many clinical, histopathological, and molecular factors are used as potential predictors of malignant transformation. Overall, conventional histopathological assessment remains the golden standard to determine malignancy in such cases. However, the assessment of dysplasia is subjective and for an accurate histopathological assessment experience is necessary. Understanding the process of carcinogenesis and the development of molecular biology has led to the discovery of new molecular biomarkers such as Ki67 and CD44 that could help in the early detection of tumors and their treatment. AIM OF THE RESEARCH: The aim of the research to immunohistochemically determine the presence of CD44 and Ki67 in OL and to compare the obtained data with the presence of CD44 and Ki67 in the oral squamous cell carcinoma (OSCC) and healthy oral mucosa. METHODS: 30 samples of oral mucosa diagnosed with OL, 30 samples of oral mucosa diagnosed with OSCC and 20 samples of oral mucosa without pathohistological changes analyzed. Sections of paraffin blocks and primary monoclonal antibodies to Ki67 (MO A-HU Ki67, clone MIB-1, 1: 150, DAKO) and to CD44 (MO A-HU CD44, clone DF 1485, 1:50, DAKO) used for immunohistochemical analysis. Immunohistochemical analysis for antibodies performed using the LSAB method as a visualization system on a Dako TechMateTM Horizon (Dako, Copenhagen, Denmark) automated machine for immunohistochemical staining. RESULTS: In the group diagnosed with OSCC, significantly more men compared to the OL groups and healthy oral mucosa were detected. The OSCC group was the oldest with a median age of 66.5 (IQR 52.2–72.0) years. A significant difference was noticed considering the presence of inflammation between the OL and OSCC group in regard to healthy mucosa, while no difference between the OL and OSCC group were observed. The inflammatory infiltrate described on hemalaun eosin (HE) in the stroma correlated with the presence of Ki67 in the inflammatory infiltrate in the stroma. Significant difference between the examined groups in relation to the presence of CD44 in the epithelium as well as in relation to the presence of Ki67 in the epithelium were observed. A statistically significant difference between the examined groups in relation to the CD44 in inflammatory infiltrate was observed, while a significant difference in terms of Ki67 in inflammatory infiltrate between OSCC and OL and OSCC and healthy mucosa, but not between OL and healthy mucosa were detected. A positive correlation between HE and Ki67 in the inflammatory infiltrate in the OL group were observed. Significant and positive correlations between HE inflammatory infiltrate and CD44 both in the epithelium and in the inflammatory infiltrate of the same group were observed. No significant correlation between HE inflammation and the examined molecular markers in the OSCC group was observed. A significant positive correlation between CD44 in inflammatory infiltrate with CD44 and Ki67 in the epithelium was observed, but only in the OL group, whereas no significant connection for OSCC was observed. CONCLUSION: An increased immunohistochemical presence of CD44 and Ki67 markers in OL suggests the need for new more extensive studies that would provide clinicians additional options for monitoring and predicting the behavior of individual lesions.

Cilj istraživanja: Cilj ove studije bio je odrediti točnost biopsije malih labijalnih žlijezda slinovnica u dijagnozi SS. Specifični ciljevi istraživanja bili su: utvrditi postoji li korelacija FS-a s anti-SSA (Ro), anti-SSB (La), anti-SSA+SSB protutijelima, Qs i Qss, odrediti i usporediti vrijednosti Qs i Qss u obje skupine ispitanika te usporediti korisnost Qs i Qss u obje skupine ispitanika. Materijali i metode: Istraživanje je provedeno na 37 ispitanika. Ispitanici su podijeljeni u dvije skupine. Ispitnu skupina se sastojala od 15 pacijenata s dijagnozom SS-a, dok je kontrolna skupina od 22 pacijenata uključivala one pacijente koji nisu zadovoljavali ACR/EULAR dijagnostičke kriterije. Rezultati: Izračunata osjetljivost, specifičnost i točnost biopsije MLŽS iznosili su 86,7 %, 100 % i 94,6 %. Nadalje, rezultati pokazuju statistički značajnu povezanost FS-a i ANA (P = 0,002). Također je Pearsonovom korelacijom pokazana slaba, negativna i statistički neznačajna korelacija Qs (r = -0,058, P = 0,731) i Qss (r = -0,022, P = 0,899) obzirom na FS. Dobiveni rezultati ukazuju na veću korisnost Qss u odnosu na Qs u dijagnostici SS-a. Zaključak: Iako biopsija MLŽS ima veliku dijagnostičku vrijednost u dijagnozi SS-a te pokazuje veliku točnost, ona nije uvijek točna. Za točnije rezultate potrebna je standardizacija histopatološke interpretacije., Objectives: This study aimed to determine the accuracy of minor salivary gland biopsy in diagnosing Sjögren syndrome. The specific purposes of the research were to determine whether FS correlates with anti-SSA (Ro), anti-SSB (La), anti-SSA+SSB, Qs and Qss, and to determine and compare the usefulness of Qs and Qss in both groups of respondents. Materials and methods: The research was conducted on 37 subjects. The respondents were divided into two groups. The test group consisted of 15 patients diagnosed with SS, while the control group of 22 patients included those patients who did not meet the ACR/EULAR diagnostic criteria. Results: The calculated sensitivity, specificity and accuracy of minor salivary gland biopsy were 86.7%, 100% and 94.6%. Furthermore, the results obtained by the Fisher exact test show a statistically significant association between FS and ANA (P = 0.002). Also, Pearson's correlation showed a weak, negative, statistically insignificant correlation between Qs (r = -0.058, P = 0.731 and Qss (r = -0.022, P = 0.899) to FS. Obtained results indicate greater usefulness of Qss compared to Qs in diagnosing SS. Conclusion: Although minor salivary gland biopsy has a significant diagnostic value in the diagnosis of SS and shows excellent accuracy, it is not always accurate. Standardization of histopathological interpretation is needed for more accurate results.

Transplantacija bubrega najučinkovitija je metoda nadomještanja bubrežne funkcije. Napredovanjem transplantacijske medicine i imunosupresivne terapije sve je bolja prognoza preživljenja bolesnika s presađenim bubregom. Posljedično se povećava i broj takvih pacijenata koji će tražiti stomatološku pomoć. Stomatolozi imaju aktivnu ulogu u pripremi pacijenata za transplantaciju, kao i u liječenju i praćenju pacijenata dugoročno nakon transplantacije. Zbog visoke imunosupresije nakon transplantacije, znatno je povećana podložnost infekcijama, reducirana obrana od njih i povećana opasnost od sistemskog širenja, stoga oralni fokusi za ove bolesnike mogu biti fatalni. Cilj je transplantaciji pristupiti sa zdravom oralnom šupljinom. Imajući na umu sve komplikacije kronične bubrežne bolesti i hemodijalize koje mogu utjecati na zahvate u oralnoj šupljini, stomatolog se konzultira s nadležnim specijalistom. Dogovaraju se mjere opreza vezane uz krvarenje, potencijalna primjena antibiotske profilakse te koje lijekove i u kojoj dozi primijeniti. Potrebno je dijagnosticirati i liječiti sve oralne bolesti, a naročito one koje bi mogle rezultirati infekcijom ili potrebom za oralno kirurškim zahvatom neposredno nakon transplantacije kada su pacijenti najugroženiji. Šest mjeseci nakon transplantacije pacijenti primaju najviše doze imunosupresivnih lijekova jer su pod višim rizikom od odbacivanja transplantata, također su češće su ostale komplikacije i skloni su infekcijama. Stoga je uloga stomatologa u ovom razdoblju palijativne i preventivne naravi, ne radi se ništa elektivno, a hitni zahvati obavljaju se u bolničkim uvjetima nakon konzultacije s nadležnim liječnikom. Kada se pacijentovo stanje stabilizira, stomatološki zahvati mogu se sigurno obavljati. U dogovoru s timom koji vodi pacijenta u posttransplantacijskom razdoblju definira se potreba za antibiotskom profilaksom, nadomjesnom kortikosteroidnom terapijom, hematološkim testovima i ostalim modifikacijama liječenja ovisnih o pacijentovu općem stanju. Pacijenti se uključuju u aktivni recall program i naručuju svakih tri do šest mjeseci kako bi se na vrijeme dijagnosticirale i liječile sve promjene. Na svakom pregledu pacijentu se ponavljaju upute u oralnu higijenu, pregledava kompletna oralna šupljina i traže znakovi infekcije ili maligniteta. Kidney transplantation is the most effective method of replacing kidney function. With the advancement of transplantation medicine and immunosuppressive therapy, the survival prognosis of kidney transplant patients is getting better. As a result, the number of such patients who will seek dental care is also increasing. Dentists play an active role in the preparation of patients for transplantation as well as in the treatment and monitoring of patients in the long term after transplantation. Due to high immunosuppression after transplantation, the susceptibility to infections is significantly increased, the defense against them is reduced and the risk of systemic spread is enlarged, therefore oral foci can be fatal for these patients. The main aim is to approach the transplantation with a healthy oral cavity. Bearing in mind all the complications of chronic kidney disease and hemodialysis that can affect procedures in the oral cavity, the dentist consults with a competent specialist. Precautions related to bleeding, the potential use of antibiotic prophylaxis and which drugs to use and in what dose are agreed upon. It is necessary to diagnose and treat all oral diseases, especially those which could result in infection or the need for oral surgery immediately after transplantation, when patients are most vulnerable. During the period of 6 months after transplantation, patients receive the highest doses of immunosuppressive drugs because they are at a higher risk of transplant rejection, other complications are also more common and they are prone to infections. Therefore, the dentist's role in this period is of a palliative and preventive nature, nothing elective is done and emergency procedures are performed in hospital conditions after consultation with the competent doctor. When the patient's condition is stabilized, dental procedures can be performed safely. In agreement with the team managing the patient in the post-transplant period, the need for antibiotic prophylaxis, additional corticosteroid therapy, hematological tests and other treatment modifications depending on the patient's general condition are defined. Patients are included in the active recall program with appointments every 3 to 6 months in order to diagnose and treat any changes in time. At each examination, the patient is given repeated oral hygiene instructions, the entire oral cavity is examined and signs of infection or malignancy are looked for.

Uvod i cilj rada: Oralni mukozitis (OM) upala je koju prate bolne ulceracije u usnoj šupljini narušavajući tako njezinu funkciju i onemogućujući osnovne radnje poput konzumiranja hrane, gutanja i govora. Javlja se u više od 95 % pacijenata zaraženih u području glave i vrata i jedna je od najteže podnošljivih nuspojava. Obično se javlja na kraju prvog tjedna radioterapije (RT) i traje nekoliko tjedana nakon prestanka terapije. Intenzitet OM-a ponekad može dovesti do prekida radioterapije. Cilj ovog istraživanja jest utvrditi pojavnost i karakteristike OM-a kod pacijenata s karcinomom glave i vrata liječenih zračenjem, kao i uključenost stomatologa/specijalista oralne medicine u liječenju takvih pacijenata. Ispitanici i postupci: Za potrebe ove studije kreiran je anketni upitnik s pitanjima koja se posredno ili neposredno odnose na problematiku OM-a. Upitnik je ispunilo 30 pacijenata s anamnezom karcinoma glave i vrata koji su bili zračeni s ili bez adjuvantne kemoterapije. Rezultati: Oralni mukozitis razvilo je 22 pacijenta. Najveći broj pacijenata razvilo je treći stupanj OM-a, odnosno, mogli su konzumirati samo tekuću hranu. Najviše pacijenata razvilo ga je unutar deset dana od početka radioterapije/kemoradioterapije. Kod najvećeg broja ispitanika OM je trajao dva tjedna nakon prekida kemoterapije/radioterapije. Deset pacijenata liječilo ga je prema uputama specijalista oralne medicine, osmero prema uputama specijalista nadležnog za osnovnu bolest, a četvero ga uopće nije liječilo. Najčešće korišten lijek je gel na bazi polivinil pirolidona (Gelclair). Zaključak: Iako je OM najčešća neželjena nuspojava zračenja i kemoterapije u pacijenata s karcinomom glave i vrata, stomatolozi i specijalisti oralne medicine kao najbolji poznavatelji prevencije i liječenja OM-a i dalje nisu dovoljno zastupljeni u uobičajenu sastavu onkološkog tima. Introduction and aim of the work: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area and is one of the most difficult to tolerate side effects. OM represents inflammation accompanied by painful ulcerations in the oral cavity, disrupting its function and preventing basic functions such as eating, swallowing, and speaking. It occurs at the end of the first week of RT and lasts for several weeks after stopping. The intensity of OM can sometimes lead to the interruption of RT. The aim of this thesis was to determine the occurrence and characteristics of OM in patients with head and neck cancer, as well as the involvement of dentists/oral medicine specialists in the treatment of such patients. Respondents and procedures: For the purposes of this thesis, a unique survey questionnaire was created with questions that are directly or indirectly related to the issue of OM. The questionnaire was completed by 30 patients with a history of head and neck cancer who were irradiated and/or receiving chemotherapy. Results: 22 patients developed OM. The largest number of patients developed the third degree of OM, that is, they could only consume liquid food. The largest number of patients developed OM up to ten days after the start of radiotherapy/chemoradiotherapy. In the largest number of subjects, OM lasted for two weeks after cessation of radiotherapy/chemotherapy. Ten patients were treated by OM according to the instructions of an oral medicine specialist, eight according to the instructions of a specialist responsible for the underlying disease, and four were not treated by OM at all. The most commonly used agent is a gel based on polyvinyl pyrrolidone (Gelclair). Conclusion: Although OM is the most common unwanted side effect of radiation and chemotherapy in head and neck cancer, dentists and oral medicine specialists, as the best experts in the prevention and treatment of OM, are still not sufficiently involved in the oncology team.

Pemfigus i pemfigoid su potencijalno smrtonosne autoimune bulozne bolesti koje mogu zahvatiti sluznice i kožu. Dijagnoza se postavlja na temelju laboratorijskih i histoloških pretraga, kliničkog pregleda te anamneze. Patohistološki je pemfigus obilježen akantolizom tj. pucanjem međustaničnih veza (dezmosoma) koje se nalaze u trnastom sloju epitela zbog stvaranja antitijela usmjerenih prema tim spojevima. Posljedica toga je nastanak intraepitelnog mjehura. Kod pemfigoida su protutijela usmjerena protiv hemidezmosoma, multiproteinskih kompleksa koji se nalaze duž bazalne membrane i spajaju epitel s vezivom, te je prisutan nalaz subepitelnog mjehura. Nakon pucanja mjehura nastaju erozije, lezije koje se mogu inficirati ukoliko nije ordinirana lokalna i/ili sustavna terapija koja smanjuje upalu i imunološku reakciju, ublažava simptome i potiče epitelizaciju sluznice. Zlatni standard za detekciju bolesti je direktna imunofluorescencija koja se provodi uzimanjem uzorka iz nepromijenjenog perilezijskog tkiva. Kako bi se potvrdila dijagnoza ovih autoimunih bolesti tkivo ne smije biti razoreno te mora sadržavati u sebi depozite imunoglobulina G i/ili C3 komponentu komplementa na odgovarajućoj lokalizaciji, ovisno o tome koji je ciljni antigen. Uz patohistološku analizu i direktnu imunofluorescenciju tkiva moguće je koristiti indirektnu imunofluorescenciju za praćenje tijeka bolesti te ELISA-u (engl. enzyme-linked immunosorbent assay), visoko osjetljivi i specifični imunoenzimski test. Pravodobna dijagnostika te odgovarajuća terapija uvelike utječe na prognozu i krajnji ishod bolesti. Primarno liječenje pemfigusa su sistemski kortikosteroidi u kombinaciji s adjuvantnim imunosupresivima ili rituksimab (anti-CD20 monoklonalno antitijelo) dok se u teškim slučajevima mogu primijeniti i intravenski imunoglobulini i plazmafereza. Liječenje pemfigoida obično uključuje topikalnu primjenu sredstva za ublažavanje bolova s protuupalnim djelovanjem, a za tu svrhu odlični su lokalni kortikosteroidi. Mogu se propisati i pomoćni imunosupresivni lijekovi. Novije metode liječenja i jasnije razumijevanje patogeneze bolesti poboljšali su prognozu pemfigusa/pemfigoida te smanjili mortalitet. Pemphigus and pemphigoid are potentially fatal autoimmune diseases with blisters that affect mucocutaneous surfaces and skin. The diagnosis is made on the basis of laboratory and histopathological tests, clinical examination and medical history. Histopathologically, pemphigus is characterized by acantholysis i.e. the breaking of intercellular connections (desmosomes) located in the spinous layer of the epithelium due to the formation of antibodies directed towards these connections. The consequence of these events is the formation of an intraepithelial blister. In pemphigoid the antibodies are directed against hemidesmosomes, multiprotein complexes that are located along the basement membrane and connect the epithelium with the connective tissue. There is a finding of a subepithelial blister. After the bursting of the blisters, erosions occur, lesions that can become infected if supportive antiseptic therapy with agents that stimulate epithelialization of the mucous membrane has not been conducted. The gold standard for the detection of the disease is direct immunofluorescence, which is performed by taking a sample from the unchanged perilesional tissue. In order to confirm the diagnosis of these autoimmune diseases, the tissue must not be necrotic and must contain deposits of immunoglobulin G and/or the C3 component of complement in the appropriate localization, depending on which antigen is affected. In addition to pathohistological analysis and direct immunofluorescence of the tissue, it is possible to use indirect immunofluorescence to monitor the course of the disease and ELISA, enzyme-linked immunosorbent assay, a highly sensitive and specific immunoenzymatic test. Timely diagnosis and appropriate therapy greatly influence the prognosis and the final outcome of the disease. The primary treatment of pemphigus are systemic corticosteroids in combination with adjuvant immunosuppressants or rituximab (anti-CD20 monoclonal antibody), while in severe cases intravenous immunoglobulins and plasmapheresis can also be used. Treatment of pemphigoid usually involves the topical application of a pain reliever with an anti-inflammatory effect, and topical corticosteroids are excellent for this purpose. Auxiliary immunosuppressive drugs may also be prescribed. Newer treatment methods and a clearer understanding of the pathogenesis of the disease have improved the prognosis of pemphigus/pemphigoid and reduced mortality.

Cilj istraživanja: Cilj ovog istraživanja bio je ispitati iskustva njegovateljica i medicinskih sestara koje su zaposlene u domovima za starije i nemoćne osobe o načinima provođenja oralne higijene u štićenika koji to nisu u mogućnosti učiniti sami, kao i procjeniti potrebu njegovatelja za dodatnim edukacijama. Metode: U razdoblju od ožujka do lipnja 2022. godine je provodeno istraživanje u kojem je sudjelovalo 50 ispitanica koje su zaposlene u domovima za starije i nemoćne osobe. Istraživanje je provedeno korištenjem izrađenog upitnika koji je bio podijeljen po domovima za starije i nemoćne u papirnatom formatu. Anketni upitnik se sastojao od dva dijela. Prvi dio upitnika se sastojao od pitanja s jednim točnim odgovorom koja su se odnosila na opće podatke kako što su spol, dob, zanimanje, godine radnog staža. U drugom dijelu upitnika ponuđene su izjavne tvrdnje kojima se procjenjuje educiranost njegovateljica i medicinskih sestara o oralnom zdravlju, te kako oralno zdravlje može imati utjecaj na opće zdravlje i obrnuto. U ovom dijelu upitnika je korištena Likertova skala s vrijednostim od 1 do 5. Provođenje istraživanja je odobrilo Etičko povjerenstvo Medicinskog fakulteta u Splitu. Rezultati: U ovom istraživanju su svi ispitanici bili ženskog spola. 30 njih su bile njegovateljice, dok su ostale bile medicinske sestre. 80% ispitanica je u sklopu svog obrazovanja ili zaposlenja prošla obuko o oralnoj zdravstvenoj njezi. Gotovo sve ispitanice pomažu u provođenju oralne higijene štićenicima koji to nisu u mogućnosti sami učiniti. Najčešće to čine jedan ili dva puta dnevno i 72% ih pri tome čisti jezik. 84% ispitanica koriste gaze koje su natopljenje antiseptikom i to rade u slučajevima kako štićenici nemaju zube ili ako ne mogu jako otvoriti usta. Međutim, ipak 2% njih to radi kada štićenici imaju neke ranice u ustima. Svi štićenici pružaju otpor prilikom provođenja oralne higijene, neki uvijek ,a neki ponekad. Isto tako, svi nose proteze koje tijekom noći skidanju i pohranjuju ih u posudi uronjene u vodu. Samo 58% ispitanica svaki dan čiste proteze štićenicima, dok 38% njih to rade povremeno. Većina štićenika odlazi na preglede kod stomatologa samo po potrebi (bol, klimavost, krvarenje), a 16% ih odlazi redovito, odnosno 2 puta godišnje. Gotovo sve ispitanice smatraju da ranice koje ne cijele u usnoj šupljini mogu potencijalno biti prekanceroze, kao i da je oralno zdravlje povezano s kvalitetom okusa, žvakanja i gutanja. Zadovoljavajuća je i razina znanja vezana za utjecaj oralnih bolesti na sistemnske poremećaje i obrnuto. Lošiji rezulatati ovog istraživanja se uočavaju kod pitanja i tvrdnji koje se odnose na komorbiditete starijih osoba i povezanost oralne njege s aspiracijskom pneumonijom, gdje polovica ispitanica smatra kako nema povezanosti. Nadalje, ipak se 82% ispitanica slaže kako je upala pluća vodeći uzrok smrti kod starijih osoba. Veliki postotak ispitanica smatra da su im potrebne dodatne edukacije o oralnom zdravlju. 74% ispitanica ne zna da se stečena pneumonija može prevenirati mehaničkim čišćenjem, korištenjem antiseptika i redovitom stomatološkom njegom. Zaključak: Temeljem ovog istraživanja vidljivo je da većina njegovateljica i medicinskih sestara ima zadovoljavajući nivo znanja vezan za pravilno provođenje oralne higijene kod starijih i nemoćnih osoba. Oralnu higijenu vjerojatno provode na ispravan način, ali ne i onoliko učestalo koliko bi trebalo. Smatraju da je oralno zdravlje važno i da ima utjecaj na opće zdravlje. Većina ispitanica pokazuje zainteresiranost za dodatno educiranje o metodama za očuvanje oralnog zdravlja., Objectives: The goal of this research was to examine the experiences of caregivers and nurses who are employed in homes for the elderly and infirm regarding ways of performing oral hygiene in residents who are unable to do it themselves, as well as to assess the caregivers' need for additional education. Materials and metods: In the period from March to June 2022, a survey was conducted in which 50 respondents who worked in homes for the elderly and infirm participated. The research was conducted using a questionnaire that was distributed to homes for the elderly and infirm in paper format. The questionnaire consisted of two parts. The first part of the questionnaire consisted of questions with one correct answer that related to general information such as gender, age, occupation, years of work experience. In the second part of the questionnaire, statements were offered that assess the education of caregivers and nurses about oral health, and how oral health can have an impact on general health and vice versa. In this part of the questionnaire, a Likert scale with a value of 1 to 5 was used. The conduct of the research was approved by the Ethics Committee of the University of Split School of Medicine. Results: In this research, all respondents were female. 30 of them were caregivers, while the rest were nurses. 80% of the respondents received oral health care training as part of their education or employment. Almost all of the respondents help in the implementation of oral hygiene for residents who are not able to do it themselves. Most often, they do it once or twice a day and 72% of them clean their tongue. 84% of the respondents use gauze soaked with an antiseptic and they do this in cases where residents have no teeth or if they cannot open their mouths wide. However, 2% of them still do it when residents have some sores in their mouths. All residents resist oral hygiene, some always and some sometimes. Likewise, everyone wears prostheses, which they remove during the night and store them in a container immersed in water. Only 58% of the respondents clean their residents' dentures every day, while 38% of them do it occasionally. Most of the residents go to the dentist only when necessary (pain, unsteadiness, bleeding), and 16% of them go regularly, that is, twice a year. Almost all respondents believe that non-healing sores in the oral cavity can potentially be precancerous, as well as that oral health is related to the quality of taste, chewing and swallowing. The level of knowledge related to the impact of oral diseases on systemic disorders and vice versa is also satisfactory. Worse results of this research can be seen with questions and statements related to comorbidities of the elderly and the connection between oral care and aspiration pneumonia, where half of the respondents believe that there is no connection. Furthermore, 82% of respondents agree that pneumonia is the leading cause of death in the elderly. A large percentage of respondents believe that they need additional education about oral health. 74% of respondents do not know that acquired pneumonia can be prevented by mechanical cleaning, using antiseptics and regular dental care. Conclusion: Based on this research, it is evident that the majority of caregivers and nurses have a satisfactory level of knowledge related to the proper implementation of oral hygiene in the elderly and infirm. Oral hygiene is probably performed correctly, but not as often as it should be. They believe that oral health is important and has an impact on general health. Most of the respondents showed an interest in additional education on methods for preserving oral health.

Cilj istraživanja: Cilj ovog istraživanja bio je procijeniti stavove i iskustva medicinskih sestara o mjerama provođenja oralne higijene u hospitaliziranih pacijenata. Materijali i metode: Intervjui su provedeni u svrhu istraživanja za izradu diplomskog rada. Vođeni su od strane E.K., ženske osobe i studentice 6. godine dentalne medicine te od asistentice na fakultetu i liječnice. Intervjui su provedeni preko internetske platforme Zoom, uključujući audio i video zapis. U istraživanju je sudjelovalo 7 ispitanika. Samo trajanje intervjua variralo je između 15 i 45 minuta. Rezultati: U provedenom istraživanju ispitanici su govorili o postojanju svijesti o važnosti oralne higijene. Naime, kod ispitanika uočena je percepcija važnosti oralne higijene. Govoreći o protokolima za provođenje oralne higijene kod hospitaliziranih bolesnika, uočeno je znanje o postojanju istih, ali i nedostatak znanja kod određenih ispitanika. Prijašnja edukacija, u vidu spominjanja važnosti provođenja OH tokom školovanja, nije na zavidnom nivou. Nedostatak materijala, vremena i osoblja predstavlja veliki problem i izazov većini ispitanika. Većina ispitanika zbrinjava mobilne proteze prilikom njege hospitaiziranog pacijenta. Zaključak: Na temelju prikupljenih informacije, ustanovljeno je da u svih ispitivanih medicinskih sestara postoje stavovi o važnosti oralne higijene u hospitaliziranih pacijenata. Također da postoji praksa provođenja oralne higijene različitim materijalima, metodama, opremom i frekvencijom u hospitaliziranih pacijenata. Uočeno je da postoje prepreke u implementaciji oralne higijene u skladu s dostupnim smjernicama, prvenstveno u vidu manjka vremena, osoblja i opreme. Također istraživani su i čimbenici koji bi mogli pomoći u provedbi odgovarajuće oralne higijene, primarno u vidu poboljšanje edukacije te novih smjernica i protokola kako bi se njega bolesnika dovela na veći nivo., The aim of the research: The aim of this research was to evaluate the attitudes and experiences of nurses regarding measures of oral hygiene in hospitalized patients. Materials and methods: The interviews were conducted for the purpose of research for the preparation of a diploma thesis. They were led by E.K., a female student in her 6th year of dental medicine, and by a faculty assistant and a doctor. The interviews were conducted via the internet platform Zoom, including audio and video recordings. 7 respondents participated in the research. The duration of the interview itself varied between 15 and 45 minutes. Results: In the conducted research, respondents spoke about the existence of awareness of the importance of oral hygiene. Namely, the respondents perceived the importance of oral hygiene. Speaking about the protocols for performing oral hygiene in hospitalized patients, knowledge of their existence, but also a lack of knowledge among certain respondents, was observed. Previous education, in the form of mention of the importance of implementing OH during schooling, is not at an enviable level. The lack of materials, time and personnel is a big problem and challenge for most respondents. Most respondents take care of mobile prostheses when caring for a hospitalized patient. Conclusion: Based on the collected information, it was established that all the examined nurses have opinions about the importance of oral hygiene in hospitalized patients. Also that there is a practice of conducting oral hygiene with different materials, methods, equipment and frequency in hospitalized patients. It was observed that there are obstacles in the implementation of oral hygiene in accordance with the available guidelines, primarily in the form of a lack of time, personnel and equipment. Factors that could help in the implementation of adequate oral hygiene were also investigated, primarily in terms of improving education and new guidelines and protocols in order to bring patient care to a higher level.

Cilj istraživanja: Cilj ovoga istraživanja je ispitati oralno-higijenske navike i kvalitetu života u odnosu na oralno zdravlje studenata prve i pete godine dentalne medicine. Materijali i metode: U istraživanju je sudjelovalo 57 studenata dentalne medicine, odnosno dvije skupine od kojih je jedna bila prva godina dentalne medicine, a druga peta godina dentalne medicine. Ispitanicima su zabilježeni dob, spol, navike pušenja, broj godišnjih odlazaka doktoru dentalne medicine te kotištenje sredstava za održavanje oralne higijene. Uz navedene parametre studenti su ispunili Oral Health Impact Profile upitnik (OHIP-14) te im je izmjeren KEP indeks. Rezultati: Anamnestičkim upitnikom utvrđeno je kako ispitanici nisu u velikom broju bili pušači te su odlazili na redovne kontrole kod doktora dentalne medicine. Studenti pete godine su imali veću akumulaciju plaka, što se pokazalo i kao statistički značajan podatak (P < 0,001). Oralno-higijenske navike u obje skupine studenata pokazale su se kao odlične, odnosno velika većina je navela kako pere zube više od dva puta dnevno. Od svih ponuđenih dodatnih sredstava za održavanje oralne higijene, svi studenti koriste barem jedan. Na prvoj godini to je zubni konac, dok studenti pete godine osim konca koristi i interdentalne četkice, što se pokazalo statistički značajno (P = 0,004). U većoj mjeri koriste i vodice za ispiranje usta (P = 0,038), a prijavili su i češće profesionalno uklanjanje naslaga od studenata na prvoj godini (P = 0,015). Studenti prve i pete godine razlikovali su se i prema KEP indeksu (P = 0,017), odnosno, studenti pete godine imali su veću vrijednost KEP indeksa. Studenti pete godine imali su više saniranih zubi (P < 0,001) te više ekstrahiranih zubi (P = 0,014), dok su studenti prve godine imali veći broj intaktnih zubi. Ispunjavanjem OHIP-14 upitnika nisu se pokazale statistički značajne razlike, odnosno, obje skupine imaju visoku kvalitetu života vezanu za oralno zdravlje. Zaključak: Rezultati ovog istraživanja pokazuju kako postoje razlike u oralno-higijenskim navikama studenata prve i pete godine dentalne medicine. Također, razlika postoji i u KEP indeksu koji se mjerio u sklopu ovog istraživanja, dok u kvaliteti života u odnosu na oralno zdravlje nismo pronašli razlike među ispitivanim skupinama., Objectives: The aim of this study was to examine oral-hygiene habits and quality of life in relation to the oral health of first and fifth year dental students. Materials and methods: The study involved 57 dental students, ie two groups, one of which was the first year of dental medicine and the other the fifth year of dental medicine. Respondents were recorded age, gender, smoking habits, number of annual visits to the dentist and means for maintaining oral hygiene. In addition to the above parameters, students completed the Oral Health Impact Profile Questionnaire (OHIP-14) and their KEP index was measured. Results: The anamnestic questionnaire determined that a large number of respondents were non smokers and went for regular check-ups with dentists. Fifth-year students had a higher accumulation of plaque, which proved to be a statistically significant data (P < 0,001). Oral hygiene habits in both groups of students proved to be excellent, ie the vast majority stated that they brush their teeth more than twice a day. Of all the additional oral hygiene products offered, all students use at least one. In the first year it is dental floss, while the fifth year students use interdental brushes in addition to floss, which proved to be statistically significant (P = 0,004) and to a greater extent they also use mouthwashes (P = 0,038) and are more frequent with professional removal of deposits from the first year of students (P = 0,015). First and fifth year students also differed according to the KEP index (P = 0,017), ie fifth year students had a higher value of the KEP index. Fifth-year students had more filled teeth (P < 0,001) and more extracted teeth (P = 0,014), while the first year had a higher number of sound teeth. Completion of the OHIP-14 questionnaire did not show statistically significant differences, ie both groups have a high quality of life related to oral health. Conclusion: The results of this research show that there are differences in the oral hygiene habits of first and fifth year dental students. There is also a difference in the KEP index measured in this study, while we did not find statistically significant differences in quality of life compared to oral health.

Ciljevi: Glavni cilj ovog istraživanja bio je ispitati postoji li razlika u pojavnosti patoloških promjena na sluznici usne šupljine u trudnica u odnosu na žene koje nisu trudne. Metode i materijali: Anamnestički su se od ispitanica (N = 48) uzimali podaci o tome puše li, imaju li kronične bolesti i subjektivne simptome u usnoj šupljini. Napravljen je klinički pregled, sijalometrija i izmjeren pH sline. Ispitnu skupinu su činile 24 trudnice, a kontrolnu skupinu 24 žene reproduktivne dobi koje nisu trudne. Rezultati: Rezultati su potvrdili statistički značajnu razliku u količini izlučene sline tijekom pet minuta (P = 0,000) i pH vrijednosti sline (P = 0,000) između trudnica i kontrola. Također je utvrđena statistički značajna razlika u ispitnoj skupini prije i tijekom trudnoće u učestalosti subjektivnih simptoma u usnoj šupljini (P = 0,012), suhoći usne šupljine (P = 0,028) i broju dijagnoza (P = 0,000). Zaključci: Trudnice imaju smanjenu salivaciju i niži pH u odnosu na žene reproduktivne dobi koje nisu trudne. Tijekom trudnoće je došlo do povećanja učestalosti simptoma u usnoj šupljini, porasta suhoće usne šupljine i povećane učestalosti pojave patoloških promjena na sluznice usne šupljine u odnosu na vrijeme prije trudnoće. Svakako bi trebalo provesti više istraživanja na ovu temu, obuhvatiti veći broj ispitanica i pratiti ispitnu skupinu prije, tijekom i nakon trudnoće., Objectives: The aims of this study were to invastigate whether there is a difference in the incidence of oral mucosal changes in pregnant women compared to non – pregnant women of reproductive age. Materials and Methods: Patient madical data (pregnant and non – pregnant subjects) was collected from the subjects (N = 48) on whether they smoke, whether they have chronic disease and subjective symptoms in the oral cavity. A clinical examination, sialometry and pH value of saliva were measured. The study group consisted of 24 pregnant women and the control group consisted of 24 non – pregnant women of reproductive age. Results: The results confirmed a statistically significant difference in saliva secreted during 5 minutes (P = 0,000) and pH values (P = 0,000) between pregnant and non – pregnant subjects. A statistically significant difference was also found in the study group before and during pregnancy in the frequency of symptoms in the oral cavity (P = 0,012), mouth dryness (P = 0,028 ) and number od diagnoses (P = 0,000). Conclusion: Pregnant subjects have lower salivary flow and lower pH value compared to non – pregnant women of reproductive age. During pregnancy, there was an increase in the frequency of symptoms in the oral cavity, an increse in the dryness of the oral cavity and an increase in the frequency of pathological changes in the oral mocosa compered to time before pregnancy. Certainly, more research should be conducted on this topic, a larger number of test subjects should be included and the study group should be monitored before, during and after pregnancy.

Mukozitis je bolna, ulcerozna upala koja nastaje uslijed citotoksičnog učinka kemoterapije i radioterapije na epitelne stanice sluznice te zahvaća sluznicu gastrointestinalnog sustava, kojem pripada i sluznica usta i ždrijela. Prezentira se najčešće kao eritem, atrofija ili ulceracija sluznice. Pojavljuje se u gotovo svih pacijenata koji primaju terapiju zračenjem u području glave i vrata, u 20 do 40 % pacijenata na kemoterapiji te 60 do 85 % bolesnika koji idu na transplantaciju hematopoetskih matičnih stanica. Mukozitis se razvija nekoliko dana nakon početka terapije, najčešće između prvog i drugog tjedna, prisutan je dok traje terapija te prestaje dva do četiri tjedna nakon završetka terapije. Podatci iz literature pokazuju da je 19 % pacijenata liječenih kemoterapijom i zračenjem u području glave i vrata hospitalizirano uslijed razvoja teškog oblika oralnog mukozitisa. Posljedično, odgađa se antineoplastična terapija dok ne nastupi poboljšanje stanja, smanjena je kvaliteta života, lošija prognoza osnovne bolesti i rastu troškovi liječenja pacijenta. Ključno je informirati pacijenta o ovoj mogućoj nuspojavi terapije karcinoma i o dostupnim načinima liječenja koji će olakšati simptome i omogućiti neprekinuto provođenje liječenja osnovne bolesti, za optimalan terapijski učinak. Mucositis is a painful, ulcerative inflammation that occurs due to the cytotoxic effect of chemotherapy and radiotherapy on the epithelial cells of the mucosa and affects the mucosa of the gastrointestinal system, which includes the mucous membranes of the mouth and throat. It is most commonly presented as erythema, atrophy, or ulceration of the mucosa. It occurs in almost all patients receiving radiation therapy of the head and neck, in 20-40% of patients on chemotherapy and 60-85% of patients undergoing hematopoietic stem cell transplantation. Mucositis develops a few days after the start of therapy, usually between the first and second week, lasts the entire duration of the therapy and stops two to four weeks after the end of therapy. Data from the literature show that 19% of patients treated with chemotherapy and radiation of the head and neck area were hospitalized due to the development of severe oral mucositis. Consequently, antineoplastic therapy delayed until the condition improves. The quality of life is reduced; poorer prognosis of the underlying disease is given, and the cost of treating the patient increased. It is crucial to inform the patient on this possible side effect of cancer therapy and on the available treatments that will alleviate the symptoms and allow continuous treatment of the underlying disease, for optimal therapeutic effect.

Osteonekroza čeljusti odnosi se na odumiranje koštanog dijela čeljusti, a uzrokovana je raznim stanjima. Možemo ju podijeliti na medikamentoznu osteonekrozu čeljusti, osteoradionekrozu, traumatsku, netraumatsku i spontanu osteonekrozu. Medikamentozna osteonekroza uzrokovana je antiresorptivnim ili antiangiogenim lijekovima. Nastanak ovakvog stanja posljedica je uzajamnog djelovanja lijekova, mikrobiološke kontaminacije i lokalne traume. Glavni je klinički pokazatelj kost koja je eksponirana dulje od osam tjedana, ali može doći i do otekline mekih tkiva, ograničene gnojne upale ili fistule. Terapija osteonekroze dijeli se na konzervativnu koja je usmjerena na podizanje kvalitete pacijentova života te na kiruršku kojom se odstranjuje dio nekrotične kosti. Osteoradionekroza teška je komplikacija zračenja koja se javlja kod pacijenata oboljelih od raka glave i vrata. Definira se kao područje eksponirane kosti koje ne cijeli dulje od tri mjeseca nakon zračenja, a nema znakova primarnog tumora, recidiva ili metastaza. Klinički uz eksponiranu kost mogu se javiti i ulceracije te nekroza kože ili mukoze. Čimbenici rizika za razvoj osteonekroze su: trauma (vađenje zuba), lokalizacija tumora, ukupna doza zračenja, površina ozračene kosti, oralna higijena i drugi. Konzervativno liječenje uključuje oralnu njegu samu ili u kombinaciji s ultrazvukom ili hiperbaričnom oksigenacijom. Kirurško zbrinjavanje uključuje resekciju nekrotične kosti i mekog tkiva s raznim vrstama rekonstrukcije. U manjem broju slučajeva osteonekroza se javlja i zbog drugih stanja, a uzroke možemo podjeliti na traumatske i netraumatske. U traumatske ubrajamo osteonekrozu nastalu uslijed termičkog, mehaničkog ili kemijskog oštećenja, dok u netraumatsku ubrajamo osteonekrozu nastalu uslijed infekcije (bakterijska, virusna, gljivična, infekcijski osteomijelitis), stečene i kongenitalne bolesti te djelovanja raznih supstanci. Uloga stomatologa u prevenciji razvoja osteonekroze izuzetno je bitna. Pravovremenom sanacijom pacijenata koji su upućeni na zračenje ili prije početka uzimanja antiresorptivne ili antiangiogene terapije moguće je spriječiti razvoj osteonekroze i time značajno poboljšati kvalitetu života ovakvim pacijentima Osteonecrosis of the jaw refers to the disruption of the bone tissue of the mandible and it is caused by various conditions. We can categorize it as medication- related osteonecrosis of the jaw, osteoradionecrosis, trauma- induced, nontraumatic and spontaneous osteonecrosis. Medication- related osteonecrosis is caused by antiresorptive or antiangiogenic medication. The simultaneous impact of said medication, microbiological contamination and local trauma can cause the onset of this condition. The main clinical indicator is an exposed bone, which is present for more than 8 weeks, but soft tissue swelling, limited purulent inflammation and fistulae may also occur. Osteonecrosis treatment can be conservative, which is directed at raising the quality of the patient's life or surgical, which refers to the removal of the part of necrotic bone. Osteoradionecrosis is a severe complication of radiation which occurs in patients suffering from head and neck cancer. It is defined as the area of exposed bone which does not heal for more than three months after the radiation treatment and has no signs of primary tumor, relapses or metastasis. Clinically, other than exposed bone, ulcerations and skin necrosis or mucosae may also occur. Developmental risk factors for osteonecrosis are: trauma (tooth extraction), tumor localization, total radiation dose, irradiated bone surface, oral hygiene and others. Conservative treatment includes oral care alone or combined with ultrasound or hyperbaric oxygenation. Surgical treatment includes resection of the necrotic bone and soft tissue with various types of reconstruction. In the minority of cases, osteonecrosis may be caused by other conditions and those cases can be trauma induced or nontraumatic. Trauma induced includes osteonecrosis resulting from thermal, mechanical or chemical damage, while nontraumatic cases include osteonecrosis caused by infections (bacterial, viral, fungal, infectious osteomyelitis), acquired and congenital diseases and the impact of various substances. The dentists' role in osteonecrosis prevention is extremely important. With timely remediation of patients referred for radiation or before exposure to antiresorptive/ antiangiogenic treatment, it's possible to prevent the development of osteonecrosis and thereby significantly improve the quality of life for such patients.

Oral submucous fibrosis (OSF) is a chronic progressive condition affecting the oral cavity, oropharynx and upper third of the oesophagus. It is a potentially malignant disorder. The authors collated and analysed the existing literature to establish the overall malignant transformation rate (MTR). A retrospective analysis of medical and dental scientific literature using online indexed databases was conducted for the period 1956 to 2021. The quality of the enrolled studies was assessed by the Newcastle-Ottawa Scale (NOS). A meta-analysis using a random effects model of a single proportion was performed along with statistical tests for heterogeneity. The overall proportion of malignancy across all studies was 0.06 (95% CI, 0.02–0.10), indicating an overall 6% risk of malignant transformation across all studies and cohorts. Sub-group analyses revealed strong differences in proportion of malignancy according to ethnicity/cohort ; Chinese = 0.02 (95% CI 0.01–0.02), Taiwanese = 0.06 (95% CI, 0.03– 0.10), Indian = 0.08 (95% CI, 0.03–0.14) and Pakistani = 0.27 (95% CI 0.25–0.29). Overall, the MTR was 6% ; however, wide heterogeneity of the included studies was noted. Geographic variations in MTR were noted but were not statistically significant. Further studies are required to analyse the difference between cohort groups.

Oral squamous cell carcinoma (OSCC) is frequently diagnosed in the advanced stages. The purpose of this paper is to determine the salivary values of SCCA1, SCCA2 and TROP2 in patients with T1N0M0 OSCC and to compare them with the values obtained from healthy individuals. Unstimulated (UWS) and stimulated (SWS) saliva was sampled from 29 patients with T1N0M0 OSCC and 29 sex- and age-matched healthy individuals. Statistical difference was observed in SCCA1 and SCCA2 levels both in UWS and SWS samples. TROP2 was not measurable in most of the salivary samples. Both SCCA1 and SCCA2 could represent potential biomarkers for the early-stage OSCC. Research on a larger sample and biomarker validation is needed to assess the clinical potential of SCCA1 and SCCA2 in the OSCC early diagnostics.

Zeolites and zeolitic imidazolate frameworks (ZIFs) are widely studied as drug carrying nanoplatforms to enhance the specificity and efficacy of traditional anticancer drugs. At present, there is no other systematic review that assesses the potency of zeolites/ZIFs as anticancer drug carriers. Due to the porous nature and inherent pH-sensitive properties of zeolites/ZIFs, the compounds can entrap and selectively release anticancer drugs into the acidic tumor microenvironment. Therefore, it is valuable to provide a comprehensive overview of available evidence on the topic to identify the benefits of the compound as well as potential gaps in knowledge. The purpose of this study was to evaluate the potential therapeutic applications of zeolites/ZIFs as drug delivery systems delivering doxorubicin (DOX), 5-fluorouracil (5-FU), curcumin, cisplatin, and miR-34a. Following PRISMA guidelines, an exhaustive search of PubMed, Scopus, Embase, and Web of Science was conducted. No language or time limitations were used up to 25th August 2021. Only full text articles were selected that pertained to the usage of zeolites/ZIFs in delivering anticancer drugs. Initially, 1279 studies were identified, of which 572 duplicate records were excluded. After screening for the title, abstract, and full texts, 53 articles remained and were included in the qualitative synthesis. An Inter-Rater Reliability (IRR) test, which included a percent user agreement and reliability percent, was conducted for the 53 articles. The included studies suggest that anticancer drug-incorporated zeolites/ZIFs can be used as alternative treatment options to enhance the efficacy of cancer treatment by mitigating the drawbacks of drugs under conventional treatment.

Ciljevi: Glavni cilj istraživanja bio je istražiti i analizirati korelaciju nalaza ambulantnog testa vitalnog bojanja toluidinskim modrilom i patohistološkog nalaza lezije oralne sluznice na Katedri za Oralnu medicinu i parodontologiju Medicinskog fakulteta te u ambulanti za oralnu medicinu Odjela za dentalnu medicinu Zavoda za maksilofacijalnu kirurgiju KBC-Split. Materijali i metode: U istraživanju je dobrovoljno sudjelovalo 30 ispitanika s patološkom promjenom na sluznici usne šupljine kojima je uzeta detaljna anamneza i napravljen klinički pregled od strane specijalista oralne medicine. Nakon kliničkog pregleda pristupilo se bojanju suspektne lezije sluznice usne šupljine toluidinskim modrilom i biopsiji lezije za patohistološku analizu. Podaci su uneseni u proračunske tablice te je napravljena deskriptivna statistika. Rezultati: Od ukupno 30 ispitanika, dijagnoza OLP-a je potvrđena u njih 10 ispitanika (33%), kao i dijagnoza leukoplakije. Aktinički cheilitis imalo je pet ispitanika (17%), dok je kod dva ispitanika (7%) potvrđen planocelularni karcinom. Pozitivan nalaz toluidinskog testa imalo je ukupno pet (17%) ispitanika. Svih pet patoloških lezija koje su imale pozitivan toluidinski test su bile odmah klinički suspektne na malignitet. U dva ispitanika (6,5%) patohistološkom analizom utvrđena je displazija epitela, dok je u također dva ispitanika (6,5%) utvrđen planocelularni karcinom. U jednog je ispitanika s OLP-om toluidinski test bio pozitivan, dok patohistološka analiza nije ukazala na postojanje displazije epitela. Zaključci: Temeljem dobivenih rezultata može se potvrditi pozitivna korelacija ambulantnog testa vitalnog bojanja toluidinom i patohistološkog nalaza bioptirane suspektne lezije. Toluidinski test koristimo u diferencijalnoj dijagnostici oralnih lezija i ulceracija različitih etiologija prema zloćudnim promjenama u ustima. Prednosti ovog testa su sposobnost definiranja područja koja mogu biti zloćudna ili abnormalna. Vitalno bojenje pomaže u procjeni opsega potencijalno zloćudne lezije za eksciziju, naročito kada se radi o difuznim, velikim lezijama ili multilokularnim lezijama. Nažalost, ovaj test nije 100% specifičan. Iako nijedan od dodatnih dijagnostičkih testova ne može u potpunosti zamijeniti biopsiju tkiva i patohistološku analizu, toluidinski test se ipak pokazao kao vrijedan dodatni dijagnostički alat u slučaju potencijalno premalignih i malignih lezija usne šupljine., Objectives: The main objective of the research was to establish and analyse the correlation between the findings of the ambulatory test of vital toluidine blue staining and the pathohistological findings of oral mucosal lesions at the Chair of Oral Medicine and Periodontology of the School of Medicine and at the outpatient clinic for oral medicine of the Division for Dental Medicine of the Department of Maxillo-facial Surgery of the University Hospital of Split. Materials and methods: The total of 30 patients with a pathological change in the oral mucosa participated in the research on a voluntary basis. Oral medicine specialists obtained a detailed medical history of the patients and performed a clinical examination. After the clinical examination, staining of a suspected lesion of the oral mucosa with toluidine blue and biopsy of the lesion for pathohistological analysis were performed. The data were entered into spreadsheets and descriptive statistics was conducted. Results: Out of the total number of 30 respondents, the diagnosis of OLP, as well as the diagnosis of leukoplakia, were confirmed in 10 respondents (33%). A total of five respondents (17%) had cheilitis actinica, while squamous cell carcinoma was confirmed in two respondents (7%). A total of five respondents (17%) tested positive for toluidine blue stain. All five pathological lesions that tested positive for toluidine blue stain were immediately clinically suspected of malignancy. Epithelial dysplasia was detected in two respondents (6.5%) by means of pathohistological analysis, while squamous cell carcinoma was detected in two respondents (6.5%). The toluidine blue stain test was positive in one respondent with OLP, while pathohistological analysis did not indicate the presence of epithelial dysplasia. Findings: Based on the obtained results, a positive correlation between the ambulatory test of vital toluidine blue staining and pathohistological finfing of the biopsied suspicious lesions can be confirmed. The toluidine blue stain test is used in the differential diagnosis of oral lesions and ulcerations of various etiologies according to malignant changes in the mouth. The advantages of this test are the ability to define areas that may be malignant or abnormal. Vital staining helps assess the extent of a potentially malignant lesion for excision, especially when it comes to diffuse, large lesions, or multilocular lesions. Unfortunately, this test is not 100% specific. Although none of the additional diagnostic tests can completely replace tissue biopsy and pathohistological analysis, the toluidine blue stain test has nevertheless proved to be a valuable additional diagnostic tool in the case of potentially premalignant and malignant oral lesions.

Cilj: Glavni cilj ovog istraživanja bio je ispitati stavove i znanja studenata četvrte, pete i šeste godine studija Dentalne medicine u Splitu o antikoagulantnim lijekovima. Specifični ciljevi ovog istraživanja bili su ispitati poznaju li studenti dentalne medicine interakcije antikoagulantnih lijekova, koliko su informirani o mogućim štetnim posljedicama nepoznavanja antikoagulantne terapije u dentalnoj medicini te utvrditi postoji li potreba za dodatnom edukacijom studenata dentalne medicine o antikoagulantnim lijekovima. Materijali i metode: Istraživanje je temeljeno na anonimnoj anketi koja je provedena među studentima četvrte, pete i šeste godine studija Dentalne medicine u Splitu. Istraživanje je temeljeno na online upitniku putem Google forms obrasca (Prilog), a provođenje istraživanja odobrilo je Etičko povjerenstvo Medicinskog fakulteta u Splitu. Ukupno je sudjelovalo 67 ispitanika, a upitnik se sastojao od tri dijela i 40 pitanja. U prvom dijelu upitnika ispitanici su popunjavali osobne podatke, u drugom dijelu izrazili stavove o liječenju u budućoj kliničkoj praksi, dok se u trećem ispitalo znanje o antikoagulantnim lijekovima. Podaci su obrađeni u programskom paketu STATISTICA 11. Rezultati: Studenti svih triju godina pokazali su ispodprosječno do prosječno znanje o antikoagulantnim lijekovima, uz iznimku nekoliko pitanja s odličnim rezultatima. Samo 20,9 % ispitanika je prepoznalo sve ponuđene antikoagulanse. Ispitanici su imali odlične rezultate na pitanjima o varfarinu i INR-u za pacijente na terapiji istim, no čak 46,3 % ispitanika bi tražilo pogrešan i nepotreban test kod pacijenata na NOAK-ima. Nadalje, samo 40,3 % ispitanika je znalo točan odgovor kada nastaviti terapiju u slučaju prekidanja terapije dabigatranom što također potvrđuje slabije znanje kada se radi o NOAK-ima. Znanja o interakciji lijekova s antikoagulansima se razlikuju ovisno o pitanju. Najviše studenata (67,2 %) je prepoznalo nistatin kao antimikotik izbora kod pacijenata na terapiji varfarinom, a tek nešto više od polovice ispitanika (55,2 %) paracetamol kao analgetik izbora uz antikoagulantnu terapiju. Samo 59,7 % studenata se složilo da je korištenje antibiotika jednokratno za profilaksu sigurno kod pacijenata na antikoagulantnoj terapiji, dok čak 43,3 % studenata misli da je kod pacijenata na dualnoj antitrombocitnoj terapijji potrebno ukinuti jedan od lijekova 24 sata prije ekstrakcije. Najbolje znanje ispitanici su pokazali u zadnjoj skupini pitanja gdje su spajali ponuđene terapije s procijenjenim rizikom krvarenja te je raspon točnih odgovora za tu skupinu pitanja bio od 38,8 % do 98,5 % (66,1±22,4 %) s medijanom vrijednošću 65,7 % . Zaključak: Temeljem rezultata ovog istraživanja pokazalo se kako većina studenata nema dovoljno znanja o antikoagulantnim lijekovima te da ne postoji značajna razlika u znanju ovisno o godini studija. Loše znanje o smjernicama, interakcijama te posljedicama prekidanja antikoagulantne terapije upućuje na potrebu za dodatnom edukacijom i ažuriranim smjernicama na ovu temu., Objectives: The main aim of this study was to assess knowledge and attitudes of fourth, fifth and sixth year dental students at the University of Split School of Medicine about anticoagulants. The specific aims of this study were to determine whether dental students know the interactions of anticoagulants, possible harmful consequences of interruption of anticoagulant therapy and to assess the need for additional education of dental students about anticoagulants. Materials and Methods: This study has been carried out using an anonymous questionnaire among students of fourth, fifth and sixth year of integrated dental study of the School of Medicine in Split. The study was based on an online questionnaire via Google forms and has been approved by the Ethics Committee of the Medical School in Split. A total of 67 students participated and the questionnaire consisted of three parts and 40 questions. In the first part, the respondents filled in personal data, in the second part they expressed their attitudes about treatment in future clinical practice, and in the third part, the knowledge about anticoagulant therapy was examined. The gathered data were processed in the software package STATISTICA 11.0. Results: Students of all three years showed below-average to average knowledge of anticoagulant therapy, with the exception of a few questions with excellent results. Only 20.9 % of participants recognized all the anticoagulants offered. Students had excellent results on questions about warfarin and INR for patients on the same therapy, but as many as 46.3 % of students would order a wrong and unnecessary test in patients on NOACs. Furthermore, only 40.3 % of participants knew when to continue therapy in case of discontinuation of dabigatran therapy, which also confirms poorer knowledge when it comes to NOACs. Knowledge of drug interaction with anticoagulants varies depending on the issue. 67.2 % of students recognized nystatin as the antifungal of choice in patients on warfarin therapy, and just over half of the students (55.2 %) recognized paracetamol as the analgetic of choice with anticoagulant therapy. Only 59.7 % of students agreed that the use of a single antibiotic dose for prophylaxis is safe in patients on anticoagulant therapy, while as many as 43.3 % of students think that patients on dual antiplatelet therapy should discontinue one of the drugs 24 hours before extraction. Participants showed the best knowledge in the last group of questions where they combined the offered therapies with the estimated risk of bleeding and the range of correct answers for this group of questions ranged from 38.8 % to 98.5 % (66.1 ± 22.4 %) with a median worth 65.7 % . Conclusion: Based on the results of this study, it was shown that most students do not have enough knowledge about anticoagulant therapy and that there is no significant difference in knowledge depending on the year of study. Poor knowledge of the guidelines, interactions, and the consequences of discontinuation of anticoagulant therapy, suggests the need for additional education and updated guidelines on this topic.

Dirofilariasis is an endemic infestation in tropical and subtropical countries caused by about 40 different species. It rarely occurs in the oral cavity and is mostly presented as mucosal and submucosal nodules. Differential diagnoses include lipoma, mucocele, and pleomorphic adenoma. We report a rare case of oral dirofilariasis mimicking mucocele in a 41-year-old male patient from Croatia without an epidemiological history of travelling outside the country. He came in because of non-painful lower lip swelling that had lasted for two months. The parasite was surgically removed from the lesion. This is the first reported case of oral dirofilariasis in Croatia. It is important to point out this rare diagnosis in order to make dentists aware of the possibility of the presence of such an infestation in common lesions of the oral mucosa.

Background: The objective of this study was to determine the most effective treatment option for burning mouth syndrome. Methods: Informative treatment alone, B vitamin injections, oral cavity probiotics, and low-level laser therapy were evaluated and compared. The study included new patients diagnosed with burning mouth syndrome, who were randomly allocated into one of four treatment groups. The primary outcome was improvement in patient’s quality of life as determined by a self-perceived Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire before and after therapy. The secondary outcome was determination of mucosal symptom intensity according to visual analog scale (VAS) grading from 0 to 10. Data were submitted to statistical analysis. Results: A total of 62 patients completed the study. Oral cavity probiotics and LLLT scores for OHIP-14 resulted in a statistically significant difference before and after therapy. Standardized effect sizes between OHIP scores before and after treatment were the greatest for patients who had received oral cavity probiotics. Conclusions: Oral cavity probiotics and LLLT were the most effective treatment for improvement in quality of life. Further investigation on a larger group of patients is required.