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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 measures 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., Uvod/Cilj. Bulozna epidermoliza je grupa retkih, genetski predisponiranih bolesti vezivnog tkiva koja se karakteriše formiranjem bula (mehurova) u koži i mukoznim membranama. Cilj rada bio je da se ispita stanje oralnog zdravlja dece obolele od distrofične bulozne epidermolize, kao i nivo znanja i mišljenje roditelja o primeni preventivnih mera i kvalitetu stomatološke zaštite obolele dece. Metode. U studiju je bilo uključeno 17 bolesnika sa distrofičnom buloznom epidermolizom iz Srbije i odgovarajuća kontrolna grupa. Stanje zuba ustanovljeno je Klein Palmerovim indeksom karijesnih, ekstrakovanih plombiranih zuba - KEP indeksom. Stanje oralne higijene analizirano je indeksima oralne higijene (pojednostavljeni plak indeks i indeks zubnog kamenca po Green-Vermillionu). Stanje gingive je na osnovu inspekcije ocenjivano kao zdrava gingiva ili gingivitis, u zavisnosti od toga da li su joj bili promenjeni boja, oblik, veličina ili struktura. Stanje oralne sluzokože evidentirano je na osnovu inspekcije usana, jezika, poda usne duplje, vestibuluma, plika i frenuluma, kao i mekog i tvrdog nepca. Nivo znanja i utisci roditelja o primeni preventivnih mera i kvalitetu stomatološke zaštite dece obolele od bolozne epidermolize, ispitivani su kroz dva upitnika specijalno dizajnirana za potrebe ove studije. Rezultati. U obe denticije bilo je najviše karijesno obolelih zuba. Za mlečnu denticiju prosečan modifikovani plak indeks iznosio je 1,4 ± 1,14, a modifikovani kalkulus indeks 0,7 ± 1. U stalnoj denticiji vrednosti prosečnog plak indesa i kalkulus indeksa redom su bile 2 ± 0,4 i 1,6 ± 0,6. Utvrđena je statistički značajna razlika u procentualnoj zastupljenosti karijesnih, ekstrahovanih i plombiranih zuba stalne denticije između dece obolele od bulozne epidermolize i kontrolne grupe, kao i za vrednosti plak i kalkulus indeksa. Najčešće promene oralne sluzokože bile su mikrostomija (76,5%) i ankiloglosija (88,2%). Zaključak. Odsustvo protokolarne saradnje između ordinirajućeg lekara i stomatologa, kao i nedovoljna informisanost roditelja, glavni su razlozi lošeg stanja oralnog zdravlja. Primena preventivnih mera je od najvećeg značaja kako bi se sprečio nastanak komplikacija koje je teško sanirati kod ove grupe bolesnika.

Introduction: Diabetes is due to its high prevalence, complications that may occur relatively expensive and complex therapies, quite rightly considered a serious health problem. Diabetes mellitus is the most common endocrine disorder in children. Apart from rare exceptions, children frequently suffer from insulin-dependent diabetes (Type I). An especially important aspect is the effect of the disease on oral health, which refers to the periodontal tissues and tooth decay. Changes in periodontal tissues range from gingivitis to severe forms of periodontal disease. These changes are observed in patients with a tendency to loss of epithelial attachment and the development of periodontal pockets and a slightly faster destruction of the alveolar bone. Periodontal diseases, which occurred in 1993, are identified as the sixth complication of diabetes, and periodontal diseases in 1997 are included as one of the pathological conditions in these patients diagnosed (Expert Committee on the Diagnosis and Classification of Diabetes Mellitus). Montenegro has the highest incidence of Type I diabetes mellitus in the Balkans in children under the age of 14 years and this is constantly growing. The objectives of the research:The main aim of this study was to determine the oral health status of children with diabetes mellitus type I in Montenegro, which is related to: establishment of permanent tooth caries, the structure of the EPC, the state of oral hygiene, salivary and microbiological status of patients and healthy controls, determining the degree of metabolic control on all previously mentioned parameters in infants and in the end. Based on the results, a proposed plan of preventative measures would allow improvement of oral health in children with diabetes. Materials and methods:This study includes 177 patients aged 10 -15 years, of both sexes which were divided into two groups. The first group D, consists 87 subjects, made up of children with diabetes mellitus type I. Second, the control group K, contains 90 subjects, was represented by healthy children. The study involved only those children whose parents have signed their consent. All the children who participated in the study were examined by standard dental diagnostic tool to dry the teeth, the artificial light in the dental chair. Status tooth is registered with Klein Palmer’s system according to WHO criteria and methodology. To determine the oral hygiene applied plaque index by Silness-Loe-index and the dental calculus on the Green, a clinical assessment of the gum was applied by Loe- Silness's index. Assessment of periodontal disease was registered using the CPI (Community Periodontal Index) and by measuring levels of epithelial attachment (DEA)..., Uvod: Šećerna bolest se zbog svoje velike rasprostranjenosti, komplikacija do kojih dovodi i relativno skupe i kompleksne terapije, sasvim opravdano smatra ozbiljnim zdravstvenim problemom. Dijabetes mellitus je najčešći endokrini poremećaj kod dece. Osim retkih izuzetaka deca najčešće obolevaju od insulin zavisnog dijabetesa (tip I). Posebno je značajan efekat ove bolesti na oralno zdravlje, a koji se odnosi na tkiva parodoncijuma i karijes zuba. Promene na parodoncijumu variraju od gingivitisa do teških formi parodontopatija. Kod obolelih je primećena sklonost ka gubitku pripojnog epitela i nastanku parodontalnih džepova kao i nešto brža destrukcija alveolarne kosti. Obolenja parodoncijuma su 1993.g. identifikovana kao šesta komplikacija dijabetesa, a 1997.g. su uvrštena kao jedno od patoloških stanja dijagnostifikovanih kod ovih bolesnika ( Expert Commitet on the Diagnosis and Classification of Diabetes Mellitus ). Crna Gora ima najveću incidenciju dijabetes mellitusa tipa 1 na Balkanu kod dece ispod 14 g., i u stalnom je porastu. Ciljevi istraživanja. Glavni cilj istraživanja je utvrđivanje stanja oralnog zdravlja dece obolele od dijabetes mellitus-a tip I u Crnoj Gori, a koji se odnosi na: utvrđivanje rasprostranjenosti karijesa stalnih zuba, strukture KEP-a, stanja oralne higijene, salivarnog i mikrobiološkog statusa obolele i zdrave dece, utvrđivanje stepena metaboličke kontrole na sve predhodno navedene parametre kod obolele dece i na kraju, na osnovu dobijenih rezultata, predložiti plan preventivnih mera, kojim bi se omogućilo unapređenje oralnog zdravlja kod dece obolele od šećerne bolesti. Materijal i metodologija istraživanja.U istraživanje je bilo uključeno 177 pacijenata uzrasta 10 -15 godina, oba pola podeljenih u dve grupe. Prvu grupu D, njih 87, činila su deca obolela od dijabetes mellitus-a tip I. Drugu, kontrolnu grupu K, njih 90, predstavljala su zdrava deca. U istraživanje su bila uključena samo ona deca čiji su roditelji svojim potpisom dali saglasnost. Sva deca koja su učestvovala u istraživanju pregledana su standardnim stomatološkim dijagnostičkim sredstvima na suvim zubima, pri veštačkom osvetljenju na stomatološkoj stolici. Status zuba je registrovan pomoću Klein Palmerovog siastema u skladu sa kriterijumima i metodologijom SZO. Za određivanje oralne hgijene primenjivan je Plak Indeks po Silness-Loe-u i Indeks zubnog kamenca po Green-u, a za kliničku procenu stanja gingive primenjivan je Loe-Silness-ov indeks. Procena stanja parodoncijuma registrovana je primenom CPI Indeksom (Community Periodontal Index) i merenjem nivoa pripojnog epitela (NPE). Salivarni status je podrazumevao količinu izlučene stimulisane pljuvačke i puferski kapacitet pacijenata koji je određivan gotovim fabričkim testovima Dentobuff Strip Sistem (Orion Diagnostica, Espoo, Finland)...

Uvod: Šećerna bolest se zbog svoje velike rasprostranjenosti, komplikacija do kojih dovodi i relativno skupe i kompleksne terapije, sasvim opravdano smatra ozbiljnim zdravstvenim problemom. Dijabetes mellitus je najčešći endokrini poremećaj kod dece. Osim retkih izuzetaka deca najčešće obolevaju od insulin zavisnog dijabetesa (tip I). Posebno je značajan efekat ove bolesti na oralno zdravlje, a koji se odnosi na tkiva parodoncijuma i karijes zuba. Promene na parodoncijumu variraju od gingivitisa do teških formi parodontopatija. Kod obolelih je primećena sklonost ka gubitku pripojnog epitela i nastanku parodontalnih džepova kao i nešto brža destrukcija alveolarne kosti. Obolenja parodoncijuma su 1993.g. identifikovana kao šesta komplikacija dijabetesa, a 1997.g. su uvrštena kao jedno od patoloških stanja dijagnostifikovanih kod ovih bolesnika ( Expert Commitet on the Diagnosis and Classification of Diabetes Mellitus ). Crna Gora ima najveću incidenciju dijabetes mellitusa tipa 1 na Balkanu kod dece ispod 14 g., i u stalnom je porastu. Ciljevi istraživanja. Glavni cilj istraživanja je utvrđivanje stanja oralnog zdravlja dece obolele od dijabetes mellitus-a tip I u Crnoj Gori, a koji se odnosi na: utvrđivanje rasprostranjenosti karijesa stalnih zuba, strukture KEP-a, stanja oralne higijene, salivarnog i mikrobiološkog statusa obolele i zdrave dece, utvrđivanje stepena metaboličke kontrole na sve predhodno navedene parametre kod obolele dece i na kraju, na osnovu dobijenih rezultata, predložiti plan preventivnih mera, kojim bi se omogućilo unapređenje oralnog zdravlja kod dece obolele od šećerne bolesti. Materijal i metodologija istraživanja.U istraživanje je bilo uključeno 177 pacijenata uzrasta 10 -15 godina, oba pola podeljenih u dve grupe. Prvu grupu D, njih 87, činila su deca obolela od dijabetes mellitus-a tip I. Drugu, kontrolnu grupu K, njih 90, predstavljala su zdrava deca. U istraživanje su bila uključena samo ona deca čiji su roditelji svojim potpisom dali saglasnost. Sva deca koja su učestvovala u istraživanju pregledana su standardnim stomatološkim dijagnostičkim sredstvima na suvim zubima, pri veštačkom osvetljenju na stomatološkoj stolici. Status zuba je registrovan pomoću Klein Palmerovog siastema u skladu sa kriterijumima i metodologijom SZO. Za određivanje oralne hgijene primenjivan je Plak Indeks po Silness-Loe-u i Indeks zubnog kamenca po Green-u, a za kliničku procenu stanja gingive primenjivan je Loe-Silness-ov indeks. Procena stanja parodoncijuma registrovana je primenom CPI Indeksom (Community Periodontal Index) i merenjem nivoa pripojnog epitela (NPE). Salivarni status je podrazumevao količinu izlučene stimulisane pljuvačke i puferski kapacitet pacijenata koji je određivan gotovim fabričkim testovima Dentobuff Strip Sistem (Orion Diagnostica, Espoo, Finland)... Introduction: Diabetes is due to its high prevalence, complications that may occur relatively expensive and complex therapies, quite rightly considered a serious health problem. Diabetes mellitus is the most common endocrine disorder in children. Apart from rare exceptions, children frequently suffer from insulin-dependent diabetes (Type I). An especially important aspect is the effect of the disease on oral health, which refers to the periodontal tissues and tooth decay. Changes in periodontal tissues range from gingivitis to severe forms of periodontal disease. These changes are observed in patients with a tendency to loss of epithelial attachment and the development of periodontal pockets and a slightly faster destruction of the alveolar bone. Periodontal diseases, which occurred in 1993, are identified as the sixth complication of diabetes, and periodontal diseases in 1997 are included as one of the pathological conditions in these patients diagnosed (Expert Committee on the Diagnosis and Classification of Diabetes Mellitus). Montenegro has the highest incidence of Type I diabetes mellitus in the Balkans in children under the age of 14 years and this is constantly growing. The objectives of the research:The main aim of this study was to determine the oral health status of children with diabetes mellitus type I in Montenegro, which is related to: establishment of permanent tooth caries, the structure of the EPC, the state of oral hygiene, salivary and microbiological status of patients and healthy controls, determining the degree of metabolic control on all previously mentioned parameters in infants and in the end. Based on the results, a proposed plan of preventative measures would allow improvement of oral health in children with diabetes. Materials and methods:This study includes 177 patients aged 10 -15 years, of both sexes which were divided into two groups. The first group D, consists 87 subjects, made up of children with diabetes mellitus type I. Second, the control group K, contains 90 subjects, was represented by healthy children. The study involved only those children whose parents have signed their consent. All the children who participated in the study were examined by standard dental diagnostic tool to dry the teeth, the artificial light in the dental chair. Status tooth is registered with Klein Palmer’s system according to WHO criteria and methodology. To determine the oral hygiene applied plaque index by Silness-Loe-index and the dental calculus on the Green, a clinical assessment of the gum was applied by Loe- Silness's index. Assessment of periodontal disease was registered using the CPI (Community Periodontal Index) and by measuring levels of epithelial attachment (DEA)...