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Objective: To investigate the impact of fixed orthodontic treatment on adolescents’ oral hygiene behavior and to examine their food consuption during fixed orthodontic treatment, as well as their motivation to maintain oral hygiene. Materials and methods: This research was carried out in a form of a survey questionnaire consisting of 23 questions. The sample comprised 170 adolescent patients aged from 11 to 19 who underwent the fixed orthodontic treatment at the Orthodontic Clinic of the Zagreb University Hospital Centre. Results: The orthodontic appliance did not interfere with the patients’ maintenance of oral hygiene, but it made the consumption of certain foods more difficult. Most adolescents brushed their teeth twice a day, using medium-soft brushes (35%). Regarding additional oral hygiene aids, 72.4% of the respondents used interdental brushes, more than 50% of the respondents used antiseptic mouthwashes for mouth rinsing, whereas only 31.2% of the tested population used dental floss (4.1% of which daily). The respondents were highly motivated to maintain oral hygiene by their orthodontists (96.5%), but only a small number of the respondents were informed about the importance of an adequate diet while undergoing a fixed orthodontic treatment. Conclusion: Orthodontists should provide their patients with detailed instructions on hygiene maintenance and adequate diet during orthodontic treatment to minimize negative side effects of the fixed orthodontic treatment. Patients should be motivated upon each follow-up examination and encouraged to use as many oral hygiene aids in their daily routines as possible., Svrha rada: Željelo se ispitati kakav je utjecaj fiksne ortodontske terapije na konzumaciju hrane i održavanje oralne higijene kod adolescenata te njihova motiviranost za njezino održavanje. Materijal i metode: U tu je svrhu provedeno istraživanje u obliku anketnog upitnika od 23 pitanja, a sudjelovalo je 170 pacijenata adolescentne dobi od 11 do 19 godina koji su bili na terapiji fiksnim metalnim or-todontskim napravama u Klinici za ortodonciju Kliničkoga bolničkoga centra Zagreb. Rezultati: Istraživanje je pokazalo da ortodontska naprava ne smeta pacijentima u održavanju oralne higijene, ali im otežava konzumaciju određenih namirnica. Najveći broj adolescenata zube pere dva puta na dan i koristi se srednje mekanom četkicom (35 %). Od pomoćnih sredstava 72,4 % ispitanika upotrebljava interdentalne četkice za zube, više od 50 % koristi se antiseptičkom vodicom za ispiranje usne šupljine. Zubnim koncem koristi se tek 31,2 % ispitane populacije (od kojih samo 4,1 % svakodnevno). Ispitanike su uglavnom na održavanje oralne higijene motivirali njihovi ortodonti (96,5 %), ali samo mali dio ispitanika upućen je u važnost pravilne prehrane tijekom fiksne ortodontske terapije. Zaključak: Ortodonti svojim pacijentima trebaju davati detaljne upute o održavanju higijene te o pravilnoj prehrani za trajanja ortodontske terapije kako bi se minimalizirale negativne nuspojave fiksne ortodontske terapije. Pacijenti se trebaju motivirati tijekom svakoga kontrolnog pregleda te poticati da se u svakodnevnoj rutini koriste sa što više pomoćnih sredstava

Objectives: This study aimed to evaluate the levels of TNF-alpha, PGE., RANKL, RANK, OPG, the markers of periimplant bone toss in peri-implant crevicutar fluid obtained around standard and extra short implants. Moreover, the levels of putative oral pathogens were investigated in the submucosal biofilm samples. Material and Methods: The implants were divided into two groups according to their Lengths: standard (>= 8 mm) and extra short (4 mm). A total of 60 implants were researched in 30 patients. The probing depth (PD), clinical attachment level (CAL), presence of bleeding on probing (BOP), 3-year survival rate (CSR), and bone toss (BL) were measured. Results: No statistically significant difference was found in the values of PD, CAL, BOP, CSR, and BL between the groups (P> 0.05). Total amounts of PGE,, RANKL, RANK, OPG, and RANKL/OPG were not statistically significantly different between the groups (P> 0.05). The abundance of F. nucleatum, T. forsythia, P. intermedia, P. gingivalis, S. oralis and T. denticola was compared between the groups and the results were not statistically significant (P> 0.05). Conclusion: The results of this study suggested that PGE(2), TNF-alpha, RANKL, RANK, OPG, and RANKL/OPG in PICF, as well as microbiological parameters in submucosal biofilms, were similar between standard (>= 8 mm) and extra short (4 mm) implants. Therefore, the implant length does not seem to influence the bone loss, levels of osteoimmunological and microbiological markers in the peri-implant tissues and survival rates.

The bifid mandibular canal (BMC) is an anatomical variation with reported prevalence ranging from 0.08 to 65%. Identifying anatomical variations of mandibular canal is very important in order to prevent possible complications during oral surgical and other dental procedures. Objectives: The aim of this study was to determine the prevalence and to classify the morphology of BMCs using digital panoramic radiographs. Material and methods: A retrospective study was conducted that included 1008 digital panoramic radiographs (412 female and 596 male) used to identify the type of BMC. Panoramic radiographs were analyzed by three oral surgeons and one dentist, and BMCs were classified into six different types, 4 types according to Langlais et al. (types 1-4), and two new types (types 5 and 6) described by authors. Results: The prevalence of BMC was 4.66% (n=47), with no significant differences in gender between BMC types (P=0.947; χ2=0.74). The prevalence of type 1 BMC was 0.79 % (n=8), type 2 2.08 % (n=21), type 3 0.30 % (n=3), type 4 0% (n=0), type 5 0.89 % (n=9) and type 6 0.60% (n=6). Conclusion: This study revealed a relatively high prevalence of BMCs among Zagreb citizens. Furthermore, two new types of BMCs were described. These results stress the importance of a careful and thorough radiographic analysis prior to each invasive procedure in the mandible., Dvostruki mandibularni kanal (DMK) anatomska je varijacija s učestalošću u rasponu od 0,08 do 65 %. Njegovo uočavanje iznimno je važno kako bi se prevenirale moguće komplikacije tijekom oralnokirurških i drugih dentalnih zahvata. Svrha: Cilj istraživanja bio je ustanoviti morfološke klasifikacije i učestalost dvostrukoga mandibularnog kanala koristeći se ortopantomogramskim snimkama. Materijali i metode: Obavljena je retrospektivna analiza 1008 digitalnih ortopantomograma (412 od žena i 596 od muškaraca) kako bi se identificirao tip i učestalost DMK-a. Tri oralna kirurga i jedan stomatolog analizirali su ortopantomogramske snimke i dvostruki mandibularni kanal klasificirali su u šest različitih tipova – četiri prema Langlaisu i suradnicima (tipovi 1 4) i dva nova (tip 5 i 6) koje su opisali autori ovoga istraživanja. Rezultati : Učestalost DMK bila je 4,66 % (n = 47), bez statistički značajne razlike prema spolovima (P = 0,947; χ2= 0,74). Učestalost tipa 1 iznosila je 0,79 % (n = 8), tipa 2 bila je 2,08 % (n = 21), tipa 3 – 0,30 % (n = 3), tipa 4 – 0 % (n = 0), tipa 5 – 0,89 % (n = 9) i tipa 6 – 0,60 % (n = 6). Zaključak: U ovom istraživanju utvrdili smo razmjerno visoku učestalost DMK-a među stanovnicima Zagreba. Nadalje, opisana su i dva nova tipa. Rezultati istraživanja pokazuju koliko je važna temeljita i temeljita analiza ortopantomograma prije svakoga invazivnog zahvata na donjoj čeljusti.

Objective: To review the frequency and management of post-discharge complications in patients who underwent dental treatment in general anesthesia (GA) in a day-care surgery setting and identify the factors that increase the risk for these complications. Material and methods: Anonymous questionnaire was sent to parents/caregivers of patients who underwent full mouth restoration in GA at our institution between 1 st January 2017 and 31 st July 2019. Demographic and clinical data of patients as well as the data about the occurrence and management of complications were collected. Results: Sixty-six parents/caregivers (30.5%) responded to the questionnaire. Most frequent complications were drowsiness and pain in 40(60.6%) patients. Complications were managed by parents or caregivers with conservative measures at home in 57(91.9%) cases. Phone consultation with dentist was required in 5(8.1%) cases. One patient (1.6%) was readmitted. Younger age and diagnosis were associated with increased risk for drowsiness. Conclusion: Post discharge complications of dental treatment in GA in a day-care service are common and they can be managed by parent/caregiver with conservative measures at home. The rate of readmission is low. Dental treatment in GA in a day-care service is a safe procedure that can be performed with acceptable risk in carefully selected patients., Svrha rada: Ispitati učestalost i liječenje komplikacija nakon otpusta pacijenata koji su bili podvrgnuti stomatološkom liječenju u općoj anesteziji (OA) u sustavu jednodnevne kirurgije i identificirati čimbenike koji povećavaju rizik od navedenih komplikacija.Ispitanici i postupci: Anonimni upitnik poslan je roditeljima/skrbnicima pacijenata koji su bili podvrgnuti stomatološkoj sanaciji u OA u našoj ustanovi između 1. siječnja 2017. i 31. srpnja 2019. Prikupljeni su demografski i klinički podatci o pacijentima te podatci o pojavi komplikacija i njihovu liječenju. Rezultati: Na upitnik je odgovorilo 66 roditelja/skrbnika (30,5 %). Najčešće komplikacije bile su ošamućenost i bol koje su se pojavile kod 40 pacijenata (60,6 %). Liječene su konzervativnim mjerama kod kuće u 57 slučajeva (91,9 %). Telefonska konzultacija sa stomatologom bila je potrebna u pet slučajeva (8,1 %). Jedan pacijent (1,6 %) bio je ponovo primljen u bolnicu. Mlađa dob i dijagnoza bile su povezane s povećanim rizikom od ošamućenosti. Zaključak: Komplikacije stomatološkog liječenja u općoj anesteziji poslije otpusta iz jednodnevne kirurgije su česte, no roditelji/skrbnici mogu ih u većini slučajeva liječiti konzervativnim mjerama kod kuće. Postotak ponovnih prijama u bolnicu je nizak. Stomatološko liječenje u OA u sustavu jednodnevne kirurgije siguran je zahvat koji se može obaviti uz prihvatljiv rizik ako se pacijenti pomno odaberu.

Aim: The main purpose of this study was to assess the genotoxic and cytotoxic effect of fissure sealants on buccal epithelial cells. Material and methods: The study was conducted on 45 patients (27 girls and 18 boys), seven to 16 years of age (age mean 12.09 ± 2.20). Buccal swabs were collected before (T0), seven (T1), 30 (T2) and 90 days (T3) consequently after fissure sealant placement (Heli-oseal F®, Equia Fil®, Constic®). Patients or legal guardians filled in the questionnaire regarding the demographic data (age, gender), dietary habits, health status, medication usage, and recent X-ray exposure. DNA damage was analyzed using the micronucleus test. Results: Statistically significant difference in the number of buccal cells with condensed chromatin was found between T0 (time before fissure sealant placement) and T3 (90 days after fissure sealant placement) period for Helioseal F® (P = 0.025). For the other two analyzed materials, no difference was observed during the tested period. There was no difference between materials in the same sampling time. Conclusion: Apart from an increase in cells with condensed chromatin 90 days after the placement of Helioseal F®, no other nuclear abnormalities were observed for tested fissure sealants. Although these sealants have now largely been used, it is of high importance that their biocompatibility is checked continuously, especially in in vivo clinical studies, Cilj: Glavni cilj studije bila je procjena genotoksičnog i citotoksičnog učinka materijala za pečaćenje na epitelne stanice bukalne sluznice. Materijal i metode: U istraživanju je sudjelovalo 45 pacijenata (27 djevojčica i 18 dječaka) u dobi između 7 i 16 godina (srednja dob 12,09 ± 2,20). Brisevi bukalne sluznice uzeti su prije postupka (T0) te sedam (T1), 30 (T2) i 90 dana (T3) poslije postavljanja materi-jala za pečaćenje (Helioseal F®, Equia Fil®, Constic®). Pacijenti i/ili njihovi zakoniti skrbnici ispunili su upitnik o demografskim podatcima (dob, spol), prehrambenim navikama, zdravstvenom statusu, korištenju lijekova i nedavnoj izloženosti rendgenskom zračenju. Rezultati: Zabilježena je statistički značajna razlika u broju epitelnih stanica bukalne sluznice s kondenziranim kromatinom između vre-mena T0 (prije postavljanja materijala za pečaćenje) i T3 (90 dana poslije postavljanja materijala za pečaćenje) za materijal Helioseal F® (P = 0,025). Za druga dva analizirana materijala nije zabilježe-na statistički značajna razlika tijekom istraživanja. Nije zabilježena statistički značajna razlika među materijalima u istom vremenu uzorkovanja. Zaključak: Osim porasta u broju stanica s kondenziranim kromatinom 90 dana nakon postavljanja materijala Helioseal F®, za testirane materijale nije zabilje-žena ni jedna druga morfološka promjena jezgre. Iako se navedeni materijali za pečaćenje svakod-nevno primjenjuju, iznimno je važno kontinuirano provjeravati njihovu biokompatibilnost, posebno u kliničkim studijamain vivo.

Background: To analyze craniofacial growth during adolescence from the ages of 12 to 21 years and its relation to late mandibular incisor crowding. Methods: The study included 61 orthodontically untreated subjects (49% males). Lateral cephalograms were used to assess the jaw growth and inclination of the incisors. Little’s Irregularity Index and the anterior mandibular dental arch depth of mandibular dentition were measured. Results: A reduction of the skeletal class angle (ANB) was observed in both genders, although it was significant only in males (η2=0.188; p=0.015). The growth of the mandible was more prominent compared to that of the maxilla, and it was more prominent in males than in females. The skeletal vertical dimension, however, demonstrated a significant reduction in both genders (η2=0.527-0.593, p, Cilj: Analizirati kraniofacijalni rast tijekom adolescencije u dobi od 12. do 21. godine i njegovu povezanost s kasnom zbijenošću mandibularnih sjekutića.Metode: U studiji je sudjelovao 61 ortodontski netretirani ispitanik (49 % muškaraca). Za procjenu rasta čeljusti i nagiba sjekutića korišteni je laterolateralni kefalogram. Izmjereni su Littleov indeks nepravilnosti i prednja dužina donjega zubnog luka.Rezultati: Uočeno je smanjenje kuta skeletne klase (ANB) kod oba spola, iako značajno samo kod muškaraca (η2 = 0,188; p = 0,015). Mandibula je rasla više od maksile i to više kod muškaraca negoli kod žena. No, skeletna vertikalna dimenzija pokazala je značajno smanjenje u oba spola (η2 = 0,527 – 0,593, p < 0,001). Mandibularni sjekutići imali su tendenciju retroinklinacije u oba spola, a maksilarni su bili skloni proklinaciji kod muškaraca te blažoj retroinklinaciji kod žena. Primijećeno je smanjenje prednje dužine donjega zubnog luka u oba spola (η2 = 0,259; p < 0,05). Povećanje nepravilnosti sjekutića u prosjeku je iznosilo 1,8 ± 1,7 mm (95 % CI 1,3 – 2,2; η2 = 0,520; p < 0,001), a uočeno je u oba spola. Logistička regresija otkrila je da su manji sagitalni rast maksile (povećanje kuta SNA ≤ 2°) i smanjenje konveksiteta sagitalnoga međučeljusnog odnosa (smanjenje ANB ≥ 1°) bili značajni prediktori nastanka zbijenosti (Δ Littleov indeks nepravilnosti ≥ 1 mm) dajući omjere izgleda od 4,9 i 4,8. Zaključci: Diferencijalni rast maksile i mandibule povezan je s pojavom kasne zbijenosti mandibularnih sjekutića uglavnom zbog manje količine sagitalnoga rasta maksile u odnosu na mandibulu.

Aim: To analyze the influence of different surface pretreatments of zirconium dioxide reinforced lithium disilicate ceramics on the shear bond strength of self-adhesive resin cement. Materials and methods: Eighty-four zirconium reinforced lithium disilicate disc Vita suprinity (Vita Zahnfabrick, Bad Säckingen, Germany) 14x12x2 mm specimens were fabricated according to the manufacturer’s recommendations. The specimens were embedded in acrylic resin blocks and randomly divided in seven groups (n=12/each) accorrding to the treatment: Group 1- 10% hydrofluoric acid; Group 2- silane; Group 3- hydrofluoric and silane; Group 4- sandblasting with silane; Group 5- Er: YAG laser+ silane; Group 6- Nd: YAG laser + silane; and the control group, in which the specimens were not treated. Round shape composite discs (Filtek Bulk fill, 3M ESPE, St.Paul, Minnesota, USA) with 3.5 mm diameter, were made for shear bond strength testing, and then cemented to the ceramic sample surface using composite cement (RelyX U200 Automix, 3M ESPE, Neuss, Germany). After cementing the composite disc on the sample, the samples were subjected to shear bond strength test of 10 N with a “stress rate” of 1 MPa / s. To determine the nature of the fracture (adhesive, cohesive or adhesivecohesive), the broken samples were examined under a stereomicroscope. The ANOVA test and the Tukey test were used to compare the values of the bond strength characteristics between different types of materials. All tests were performed with a significance level of α = 0.05. Results: There was a significant difference in the shear bond strength of self-adhesive cement to dental lithium-disilicate ceramics reinforced with zirconium dioxide after different preparation protocols (p, Cilj: Analizirati utjecaj različitih površinskih obrada litij-disilikatne keramike ojačane cirkonijevim dioksidom na veznu čvrstoću samoadherirajućega smolastoga cementa. Materijali i metode: Osamdeset i četiri litij-disilikatna uzorka diska Vita suprinity (Vita Zahnfabrick, Bad Säckingen, Njemačka) ojačana cirkonijevim dioksidom, veličine 14 x 12 x 2 mm, proizvedena su prema preporukama proizvođača. Uzorci su inkorporirani u akrilatne blokove i podijeljeni prema vrsti površinskog tretmana u sedam skupina (n = 12 / svaka): skupina 1. – 10-postotna fluorovodična kiselina; skupina 2. – silanizacija; skupina 3. – fluorovodična kiselina i silanizacija; skupina 4. – pjeskarenje i silanizacija; skupina 5. – Er: YAG laser + silanizacija; skupina 6. – Nd: YAG laser + silanizacija; kontrolna skupina u kojoj uzorci nisu obrađivani. Za testiranje smične čvrstoće napravljeni su diskovi od kompozita (Filtek Bulk fill, 3M ESPE, St.Paul, Minnesota, SAD) okruglog oblika promjera 3,5 mm, te su pričvršćeni na površinu keramičkog uzorka kompozitnim cementom (RelyX U200 Automix, 3M ESPE, Neuss, Njemačka). Nakon cementiranja kompozitnog diska na uzorak, uzorci su podvrgnuti testu snage smične sile od 10 N uz stress rate od 1 MPa/s. Kako bi se ustanovila priroda loma (adhezivni, kohezivni ili adhezivno/kohezivni), slomljeni uzorci pregledani su pod stereomikroskopom. Za usporedbu vrijednosti obilježja snage vezivanja između različitih vrsta materijala korišteni su ANOVA i Tukeyev test. Svim testovima razina značajnosti bila je α = 0,05. Rezultati: Značajna je razlika u veznoj čvrstoći samoadherirajućega cementa na dentalnu litij-disilikatnu keramiku ojačanu cirkonijevim dioksidom nakon različitih protokola pripreme (p < 0,05). Zabilježena je značajno veća snaga vezivanja nakon tretmana litij-disilikatne keramike ojačane cirkonijevim dioksidom postupkom silanizacije, pjeskarenja + silanizacije i Nd:YAG laserom + silanizacija u odnosu prema kontrolnoj skupini. Postoji statistički značajno veća vezna čvrstoća samoadherirajućega cementa nakon predtretmana litij-disilikatne keramike laserom Nd:YAG + silanizacijom u usporedbi s laserom Er:YAG + silanizacijom (p < 0,05). U kontrolnoj skupini i u skupini pjeskarenje + silanizacija te u skupinama s laserom prevladava adhezivni lom, a u ostalima mješoviti. Zaključak: Uzimajući u obzir ograničenja ovog istraživanja, Nd: Yag lasersko zračenje u kombinaciji sa silanizacijom moglo bi se koristiti kao predtretman u svrhu osiguravanja bolje čvrstoće vezivanja samoadherirajućega smolastoga cementa i litij-disilikatne keramike ojačane cirkonijevim dioksidom.

Objectives: To evaluate different intervals of exposure to staining solutions and artificial aging on translucency parameter (TP 00) of CAD-CAM materials. Material and Methods: One millimeter thick square-shaped specimens (N = 288) were cut from Cerasmart (CS), IPS e.max (IE), Lava Ultimate (LU), Shofu HC (SH), Vita Enamic (VE), and Vita Suprinity (VS) and were divided into laboratory and chairside polishing. Reflection wavelength spectra, CIE D65 standard illuminant, 2 ° standard observer, SCI, UV included, SAV aperture, 6 mm diameter, were recorded at 10 nm sensitivity against white and black calibration tiles using a benchtop spectrophotometer. Subsequently, they were converted into CIEDE 2000 TP 00. After baseline measurements (T0), the specimens were divided as follows (n = 8): staining in coffee (C) and wine (W), for 60 (T1) and 120 hours (T2), and accelerated artificial aging (A). Artificial aging (ISO 4892-2 standard) was performed in two cycles of 150 KJ/m 2, for T1 and T2, respectively. TP measurements were repeated at T1 and T2. Data of TP 00 retention were submitted to analysis of variance and Fisher’s PLSD multiple comparison test (α=0.05). Results: Fisher’s PLSD critical differences among materials, time intervals and staining/aging were 0.16, 0.11 and 0.11, respectively. SH showed the highest TP 00 followed by LU > CS > IE = VS > VE. For all time intervals, the lowest TP 00 retention was observed with C. W, and A presented similar values. Conclusions: Translucency Parameter was material, time and staining/aging-dependent material. In majority of cases, it decreased upon staining/aging., Svrha rada: Procijeniti utjecaj različitih intervala izloženosti otopinama za bojenje i umjetnom starenju na parameter translucencije (TP 00) CAD/CAM materijala.Materijal i metode: Uzorci kvadratnog oblika debljine 1 mm (N = 288) izrezani su iz blokova Cerasmart (CS), IPS e.max (IE), Lava Ultimate (LU), Shofu HC (SH), Vita Enamic (VE) i Vita Suprinity ( VS) te su razvrstani u skupine u kojima je provedeno poliranje ili u laboratoriju ili u ordinaciji. Mjereni su referentnim spektrofotometrom spektri valne duljine refleksije (standardno osvjetljenje CIE D65, standardni promatrač od 2°, SCI, uključen UV, otvor SAV, promjer 6 mm) pri osjetljivosti od 10 nm na bijelim i crnim kalibracijskim pločicama i pretvoreni u CIEDE 2000 TP 00 . Nakon početnih mjerenja (T0) uzorci su podijeljeni na sljedeći način (n = 8): bojenje u kavi (C) i vinu (W) 60 (T1) i 120 sati (T2) te ubrzano umjetno starenje (A) . Umjetno starenje (ISO 4892-2 standard) obavljeno je u dvama ciklusima od 150 KJ/m2, za T1, odnosno T2. Mjerenja TP-a ponovljena su nakon T1 i T2. Podatci o TP 00 podvrgnuti su analizi varijance Fisherovim PLSD- testom višestruke usporedbe (α = 0,05).Rezultati: Kritične razlike Fisherova PLSD-testa između materijala, vremenskih intervala i bojenja/starenja bile su 0,16, 0,11, odnosno 0,11. SH je imao najviši TP 00 , a zatim slijede LU > CS > IE = VS > VE. Za sve intervale zabilježeno je najmanje zadržavanje TP 00 kod C-a. Slične vrijednosti imali su W i A. Zaključci: Parametar translucencije ovisio je o materijalu, vremenu i bojenju/starenju. U većini slučajeva smanjio se nakon bojenja/starenja.

Objectives The development and placement of translucent zirconia ceramics on the dental materials market is in full swing. This research aimed to investigate how aging protocols affect the microstructure, color parameters and translucency of a new-generation monolithic zirconia ceramic. Material and methods Translucent zirconia ceramics KATANA-Zirconia STML with different surface treatments (as sintered - control, glazed, polished) was tested using two aging protocols (hydrothermal degradation in autoclave at 134 °C and 2 bars for three hours, chemical degradation in four-percent acetic acid at 80 °C for 16 hours) in order to examine phase composition using X-ray diffraction analysis and ΔE, ΔL and ΔC color parameters through spectrophotometry. The translucency parameter (TP) was calculated using parameters L*, a* and b* on a black and white surface. Results Regardless of the surface treatment, aging protocols did not cause a tetragonal-to-monoclinic phase transformation, although hydrothermal degradation in the autoclave transformed the hybrid tetragonal-cubic structure of all specimens to a tetragonal one. All polished and glazed specimens during chemical degradation demonstrated a significant color change ΔE. Lightness ΔL significantly changed in polished specimens aged in the autoclave. In all specimens, ΔC underwent a change manifested through statistically insignificant yellowing. None of the aging protocols altered the translucency of specimens. Conclusions Aging, regardless of the final surface treatment, did not manifest a monoclinic phase in the specimens. A tetragonal-cubic microstructure dominates. Unlike polishing, glazing the surface of translucent zirconia ceramics contributed to minor changes in color, lightness and chromaticity. The translucency of translucent zirconia ceramics remains stable regardless of aging and surface treatment.

Objectives: The aim of the study was to assess discomfort and anxiety of dental students caused by the COVID-19 pandemic crisis and to assess quality of the study during the crisis, as well as to compare subjective experiences and attitudes of preclinical and clinical students towards lectures and practicals during the first and the second lockdown at the School of Dental Medicine, University of Zagreb. Methods: This research was conducted using online questionnaires. The questionnaires were compiled by students for a presentation at the Brescia Colloquium 2020. The participants were integrated undergraduate and graduate dental students from the School of Dental Medicine, University of Zagreb. The questionnaires were completed by students during March 2020 and during February 2021 and were anonymous. For the statistical analysis of the data, the software package SPSS 20 (IBM Corp., Armonk, New York, USA) was used. Descriptive statistical analysis was used to determine the basic statistical parameters (frequencies, median, mod, minimum and maximum values). The significance of the differences among the tested groups was assessed by the Chi-Square or the Fisher's Exact Tests. Results: All dental students experienced some discomfort and were worried about the future competence. No gender differences were found (p>0.05). Preclinical students were less motivated than clinical students (p

Objectives: This study was performed to determine the values of the articular eminence inclination (AEI), the articular eminence height (AEH), and the length of the articular eminence curved line (AEL) among American prehistoric and contemporary populations. Materials and methods: The study was carried out on 120 human dry skulls divided into 4 groups: Illinois group (IP), Kentucky group (KP), African Americans group (AAP) and American Caucasians group (ACP). Each group comprised 30 human dry skulls. Measurements of AEI (by two methods), AEH and AEL were performed using computer software on 5 sagittal sections through silicone molds of the articular eminence. The obtained results were statistically analyzed at significance level of p < 0.05. Results: No statistically significant differences of AEI, AEH and AEL values were obtained among American populations (IP, KP, AAP, ACP) neither by body side, sex and age (p > 0.05). The mean AEI M1 values ranged from 31.56° to 38.72°, the mean AEI M2 values ranged from 44.14° to 58.37°, the mean AEH ranged from 5.82 to 6.86 mm, and the mean AEL values ranged from 11.57 to 12.73 mm. Conclusions: AEI, AEH, AEL values are variables, but they did not differ significantly among American populations. Left-right differences as the result of natural body asymmetry were not statistically significant. Sex and age did not significantly affect the articular eminence morphology., Svrha rada: Istraživanje je provedeno kako bi se dobile vrijednosti nagiba stražnjega zida zglobne kvržice (AEI), visine zglobne kvržice (AEH) i duljine zakrivljene linije od najviše do najniže točke na zglobnoj kvržici (AEL) između američkih povijesnih i suvremenih populacija. Materijal i metode: Istraživanje je obavljeno na 120 ljudskih lubanja podijeljenih u četiri skupine: Illinois (IP), Kentucky (KP), američki crnci (AAP) i američki bijelci (ACP). U svakoj je bilo po 30 lubanja. Mjerenje AEI (dvije metode), AEH i AEL vrijednosti provedeno je s pomoću računalnog programa na pet rezova kroz si-likonske otiske zglobne kvržice. Rezultati su statistički obrađeni i analizirani na razini značajnosti od p < 0,05. Rezultati: Nema statistički značajnih razlika u AEI, AEH i AEL vrijednostima između američkih populacija (IP, KP, AAP, ACP) ni s obzirom na stranu tijela, spol i dob (p > 0,05). Srednje AEI M1 vrijed-nosti bile su od 31,56° do 38,72°, srednje AEI M2 vrijednosti od 44,14° do 58,37°, srednje AEH vrijed-nosti od 5,82 do 6,86 mm, a srednje AEL vrijednosti od 11,57 do 12,73 mm. Zaključak: AEI, AEH, AEL vrijednosti su varijabilne, ali bez statistički značajnih razlika između američkih populacija. Razlike s obzirom na stranu tijela, kao rezultat prirodne asimetrije tijela, nisu bile statistički značajne. Spol i dob nisu značajno utjecali na morfologiju zglobne kvržice.

Objectives: To assess dentists’ level of knowledge and practice concerning antibiotic usage in endodontics using the European Society of Endodontology position statement as a reference. Material and Methods: A cross-sectional study was conducted in the form of an electronic questionnaire consisting of 23 questions, including dentists’ demographic and professional characteristics, attitudes as well as experiences regarding antibiotics in endodontics. Data were evaluated by the Mann-Whit-ney test or the Kruskal Wallis 1-way ANOVA, α = 5%. Results: The overall mean self-reported knowl-edge of antibiotics usage in endodontics was 11.7±2.5 points, out of a maximum possible score of 23. The factors associated with a higher knowledge were: age (P≤0.001), clinical experience (P≤0.001), specialist training (P=0.008), and adherence to the guidance on the use of systemic antibiotics in endodontics (P=0.006). Dentists who specialized in endodontics (16.1±2.2) achieved higher levels of knowledge. Conclusion: Knowledge on antibiotic usage in endodontics among dentists in Croatia is insufficient. There is a need for continuing education on the use of antibiotics among general dentists., Ciljevi: Procijeniti razinu znanja i iskustva stomatologa o primjeni antibiotika u endodonciji koristeći se kao referencijom konsenzusom Europskoga endodontološkoga društva. Materijal i metode: Ovo presječno istraživanje provedeno je na temelju elektroničkoga upitnika sastavljenoga od 23 pitanja, uključujući demografske i profesionalne značajke doktora dentalne medicine, njihova stajališta i iskustva u vezi s korištenjem antibiotika u endodonciji. Podatci su analizirani Mann-Whitneyjevim testom ili Kruskal-Wallisovim jednosmjernim ANOVA testom – α = 5 %. Rezultati: Ukupna prosječna vrijednost znanja doktora dentalne medicine iznosila je 11,7 ± 2,5 bodova, od najviše mogućih 23. Čimbenici povezani s višim znanjem bili su dob (P ≤ 0,001), kliničko iskustvo (P ≤ 0,001), specijalističko usavršavanje (P = 0,008) te poštovanje smjernica o primjeni sistemskih antibiotika u endodonciji (P = 0,006). Doktori dentalne medicine koji su specijalizirali endodonciju (16,1 ± 2,2) postigli su višu razinu znanja. Zaključak: Znanje o primjeni antibiotika u endodonciji među doktorima dentalne medicine u Republici Hrvatskoj je nedostatno. Potrebna je stalna edukacija o upotrebi antibiotika među populacijom općih doktora dentalne medicine.

Introduction: Hydrophilicity of dental impression materials is crucial for obtaining an accurate impression and necessary for the production of a well-fitting cast restoration. The most common technique for evaluation of hydrophilicity is a contact angle measurement. The aim of the present in vitro study was to compare the water contact angles of four groups of elastomeric impression materials, before and during setting. Material and methods: Flattened specimens (n=10) of tested impression materials were prepared by the use of a Teflon mold with specific dimensions. A 5μl droplet of deionized water fell on the specimen, and photos were taken using a Nikon D3200 DSLR camera and a 105 mm macro lens (Nikorr, Nikon) in specific time points. Results: The CAD/CAM material showed the highest contact angle measurements. The light body polyvinylsiloxane (PVS) material 1, polyether and vinylsiloxanether material showed comparable contact angle measurements especially at the initial time point. A statistically significant reduction of contact angles was reported during setup time for all PVS, PE and vinylsiloxanether materials, while the most expressed reduction of contact angle measurements, and thus the most significant increase of hydrophilicity were reported for light wash PVS material 2. Conclusions: The CAD/CAM impression material showed the most hydrophobic behavior. PVS materials showed excellent hydrophilicity. Polyether and polyvinyloxanether impression materials presented lower contact angle measurements, and thus superior hydrophilicity, compared with other tested materials initially and during setting. All tested impression materials presented a stepwise development of hydrophilicity during the setting stage., Uvod: Hidrofilnost otisnih materijala ključna je za preciznost otiska i prijeko potrebna za izradu nadomjestka s dobrim dosjedom. Najčešća tehnika za njezinu procjenu jest mjerenje kontaktnog kuta. Cilj ovoga istraživanja in vitro bio je usporediti kontaktne kutove vode u četirima skupinama elastomernih otisnih materijala, prije vezivanja i tijekom vezivanja. Materijali i metode: Spljošteni uzorci (n = 10) ispitanih otisnih materijala pripremljeni su u teflonskom kalupu specifičnih dimenzija. Kapljica deionizirane vode od 5 μL kapnuta je na uzorak, a fotografije su snimljene fotoaparatom Nikon D3200 DSLR i 105 mm makroobjektivom (Nikorr, Nikon) u određenim vremenskim točkama. Rezultati: CAD/CAM materijal imao je najveći kontaktni kut. Rijetki materijali polivinilsiloksan (PVS) 1, polieter i vinilsiloksaneter imali su usporedive mjere kontaktnoga kuta, posebno u početnoj vremenskoj točki. Statistički značajno smanjenje kontaktnih kutova zabilježeno je tijekom postavljanja za sve PVS-ove, PE-ove i vinilsiloksan, a najizraženije smanjenje, pa time i najznačajnije povećanje hidrofilnosti, zabilježeno za rijedak PVS 2. Zaključci: CAD/CAM otisni materijal imao je najhidrofobnija svojstva. PVS materijali imali su izvrsnu hidrofilnost. Polieterski i poliviniloksaneterski otisni materijali imali su manji kontaktni kut, pa tako i veću hidrofilnost u usporedbi s drugim ispitivanim materijalima na početku vezivanja i tijekom toga postupka. Svi ispitani otisni materijali postupno su razvijali hidrofilnost tijekom faze vezivanja.

Objective: To assess whether there are differences in skeletal maturation among subjects with horizontal, vertical, and neutral facial growth patterns. Material and methods: The study was performed on 48 latero-lateral craniographs of patients with horizontal, 48 with vertical and 50 with neutral growth patterns aged 12 to 18 years. Eight variables from the Zagreb 82 MOD, Bracchetti and Accord analysis, were selected for measuring angular and linear parameters on latero-lateral craniographs. The assessment of skeletal maturation was done by using the CVMS method. Results: Sta-tistical analysis showed significant differences in skeletal maturity (p 0.05) in skeletal maturity among subjects with ver-tical growth patterns compared with horizontal and neutral. In terms of stages of skeletal maturity, patients with a horizontal and neutral growth pattern in the younger group were on average in the fourth stage, and those with a vertical growth pattern in the third stage. In the older group, patients with a horizontal and neutral growth pattern were on average in the fifth stage of skeletal maturity and those with a vertical growth pattern in the fourth stage. Conclusion: According to the growth pat-tern, patients differ in the stage of skeletal maturity., Svrha rada: Odrediti postoji li razlika u stupnju skeletne zrelosti između pacijenata s horizontalnim, vertikalnim i neutralnim obrascem vertikalnoga rasta lica. Materijal i metoda: U istraživanju je korišteno 48 laterolateralnih kraniograma pacijenata u dobi od 12 do 18 godina s horizontalnim obrascem vertikalnoga rasta lica, 48 s vertikalnim i 50 s neutralnim. Za procjenu obrasca korišteno je osam varijabli iz MOD analize Zagreb 82, a za određivanje stupnja skeletne maturacije metoda prema Baccettiju i Accordu. Rezultati: Statistička analiza pokazala je značajne razlike u stupnju skelet-ne zrelosti (p < 0,001) između pacijenata s horizontalnim i vertikalnim obrascem rasta te između onih s neutralnim i vertikalnim (p < 0,05). Između pacijenata s horizontalnim i neutralnim rastom nije bilo statistički značajne razlike. Unutar mlađe dobne skupine (12 – 15 godina) ustanovljena je statistički značajna razlika (p < 0,05) između pacijenata s horizontalnim i vertikalnim obrascem rasta. U starijoj skupini (16 – 18 godina) pronađena je statistički značajna razlika (p > 0,05) u stupnju skeletne zrelosti kod pacijenata s vertikalnim obrascem rasta u odnosu prema onima s horizontalnim i neutralnim. Pacijenti s horizontalnim i neutralnim obrascem rasta unutar mlađe dobne skupine bili su najčešće u četvrtom stupnju skeletne zrelosti, a oni s vertikalnim u trećem. Unutar starije dobne skupine, pacijenti s horizontalnim i neutralnim obrascem rasta najčešće su bili u petom stupnju, a oni s vertikalnim u četvrtom stupnju skeletne zrelosti. Zaključak: S obzirom na obrazac rasta, pacijenti se razlikuju u stupnju skeletne zrelosti.

Objective: Enamel remineralizing effects of theobromine have received much attention from the clinicians. The aim of this study was to investigate the caries preventive effect of theobromine containing toothpaste on children with early childhood caries (ECC). Materials & Methods: Salivary pH, buffering capacity and frequency of Streptococcus mutans (SM) levels were measured. Each child was assigned either fluoridated or theobromine containing toothpaste. The changes were analyzed using Laser Fluorescence system. Statistical analyses were performed. Results: We included 13 children (mean age 4.25) with 145 teeth in the fluoridated toothpaste (Colgate Kids toothpaste) group; 13 children (mean age 4.46) with 115 teeth in theobromine containing toothpaste (Theodent TM Kids toothpaste) group. Both toothpastes demonstrated enamel remineralization and were effective in increasing the buffering capacity and pH (p < 0.05). A statistically significant decrease in S. mutans levels was found in both toothpaste groups (p, Svrha rada: Učinci teobromina na remineralizaciju cakline privukli su pozornost kliničara. Cilj ovog istraživanja bio je istražiti karijesprotektivni učinak paste za zube koja sadržava teobromin na karijes u ranoj dječjoj dobi. Materijal i metode: Izmjereni su pH sline, puferski kapacitet i razina bakterija Streptococcus mutans. Svakom djetetu dodijeljena je zubna pasta s fluorom ili teobrominom. Promjene su analizirane s pomoću laserskoga fluorescentnog sustava. Obavljene su statističke analize. Rezultati: U skupinu s fluoriranom zubnom pastom (Colgate Kids) bilo je uključeno 13 djece (prosječna dob 4,25) sa 145 zuba; u skupini sa zubnom pastom koja sadržava teobromin (TheodentT-MKids) sudjelovalo je 13 djece (prosječna dob 4,46) sa 115 zuba. Obje zubne paste potaknule su remineralizaciju cakline i učinkovito su povećale puferski kapacitet i pH (p < 0,05). U objema skupinama ustanovljeno je statistički značajno smanjenje razine S. mutans (p < 0,05). Zaključak: Obje zubne paste imale su statistički značajan učinak na remineralizaciju cakline. Budući da su kod teobromina zabilježene dodatne prednosti poput povećanja pH sline i smanjenja razine S. mutans, paste za zube koje sadržavaju teobromin mogu se smatrati učinkovitim sredstvom za remineralizacije bijelih mrlja i mogu se upotrebljavati u prevenciji ranih lezija cakline.

Background According to available scientific references and textbooks, there are contradictory views concerning the etiology of signs and symptoms of TMD. Objectives The aim of this study was to determine a correlation between the incidence of signs and symptoms of TMD in children aged 12-18 who do not wear a fixed orthodontic appliance and the incidence of signs and symptoms of TMD in children who wear a fixed orthodontic appliance. Material and methods The total number of 120 subjects were included in this survey and divided into two groups. There were 60 respondents in the experimental group that consisted of 30 boys and 30 girls with different types of malocclusion, who were treated with a fixed orthodontic straight wire technique. The remaining 60 respondents, which was a group that also consisted of 30 boys and 30 girls, were patients with neutroclusion. Results The results of the study have shown that the TMJ clicking sound symptom, the most common symptom of TMD, occurs with almost equal prevalence in both groups of respondents; specifically, 56.4% in orthodontic patients, and 46.6% in the control group respondents. A statistically significantly higher percentage of female respondents in both groups have experienced headache problems (p Conclusion On the basis of the statistics obtained as a result of this research, we can come to the conclusion that there is no correlation between the fixed orthodontic treatment and the development of signs and symptoms of TMD.

Objectives: To compare the frequency of apical periodontitis (AP) in non-endodontically treated teeth restored with full coverage crowns, amalgam and resin composite fillings, and to disclose the association of type and quality of coronal restoration with periapical disease. Material and methods: The cross-sectional study involved 597 subjects who attended the Dental Clinic of the Clinical Hospital Centre, Rijeka, Croatia for the first time. Data were collected by means of a clinical and radiological survey. The following data were recorded for all permanently restored non-endodontically treated teeth: the type, the quality of coronal restoration according to clinical and radiographic criteria for marginal integrity as well as the recurrent caries presence, periapical status and marginal bone loss. Chi-square tests were used to analyze the difference in periapical status regarding the type and the quality of restoration. The multivariate logistic regression analysis was used to assess the effect of explanatory tooth-specific variables on periapical status. Results: There was no significant difference in the proportion of AP with regards to the type and material of adequate quality coronal restorations (χ 2 =5.000, P=0.082). The regression analysis revealed significant positive associations with outcome variable (AP) for crowns (OR=3.39; P, Cilj: Svrha studije bila je usporediti učestalost apikalnog parodontitisa (AP) u endodontski neliječenim zubima koji su restaurirani potpunim krunicama te amalgamskim i smolastim kompozitnim ispunima. Također je istraživana povezanost vrste i kvalitete koronarne restauracije s prisutnošću periapikalne bolesti. Materijali i postupci: Presječno istraživanje obuhvatilo je 597 ispitanika koji su prvi put posjetili Kliniku za dentalnu medicinu Kliničkoga bolničkog centra Rijeka. Podatci su prikupljeni kliničkim i radiološkim pregledom. Za sve trajno restaurirane endodontski neliječene zube analizirani su vrsta, kvaliteta koronarne restauracije prema kliničkim i radiološkim kriterijima za rubnu cjelovitost restauracije i prisutnost rekurentnog karijesa, periapikalni status te gubitak marginalne kosti. Hi-kvadrat testovi primijenjeni su u analizi razlike periapikalnog statusa s obzirom na vrstu i kvalitetu restauracije. Multivarijantna logistička regresijska analiza obavljena je u procjeni utjecaja prediktorskih dentalnih varijabli na periapikalni status. Rezultati: Nije dokazana značajna razlika u proporciji AP-a s obzirom na vrstu i materijal koronarne restauracije odgovarajuće kvalitete (χ 2 = 5,000, P = 0,082 ). Regresijskom analizom otkrivena je značajna pozitivna povezanost s ishodišnom varijablom (AP) za krunice (OR = 3,39; P < 0,001), rekurentni karijes (OR = 4,67; P < 0,001) i pretkutnjake (OR = 1,73; P = 0,002). Zaključak: Ako su restauracije primjerene kvalitete, nema razlike u periapikalnom statusu endodontski neliječenih zuba s obzirom na vrstu i materijal korišten za koronarne restauracije.

Objectives: The aim of this research was to evaluate the effect of long-term use of three intracanal medicaments on the radicular dentin microhardness and fracture resistance. Material and methods: A chemomechanical preparation was done using the Protaper rotary instruments up to F3. The teeth were stored in an incubator at 37°C at 100% humidity and were categorized in three groups by random allocation, namely: Triple Antibiotic Paste (TAP), Calcium hydroxide paste (Apexcal) and Ledermix. Following medicament application, the access openings of all teeth were sealed with 4 mm thickness of cavit. The samples were stored for periods of 1 week, 1 month and 3months. Two dentin cylinders measuring 5mm and 3mm were obtained from each sample. The cervical third was used for fracture resistance and the middle third was used for micro hardness evaluation. The microhardness testing was done using a Knoop microhardness tester, and the fracture resistance testing was done using the universal testing machine. Results: Calcium hydroxide showed maximally negative effect on the physical properties of radicular dentin compared to TAP (p= 0.0100 at one month and Ledermix (p=0.0001 at one month ). With an increase in the application time, there was an increased deterioration in the physical properties of radicular dentin. Conclusion: Long-term placement of calcium hydroxide, Triple Antibiotic Paste, and Ledermix (p= 0.0001at 3 months) significantly affects the microhardness and fracture resistance of radicular dentin.

Aim. Optimization of an endodontic retreatment by performing the following tasks, including the selection of an optimal and safe solvent.Materials and methods. In order to choose the most suitable solvent for the problem, an experiment was conducted with clove, mint, eucalyptus, orange, and grapefruit oils. The surface tension coefficient was measured by the Rebinder apparatus. In order to justify the choice of an effective essential oil, as well as the dissolving ability and the absence of solvent and debris after irrigation with sodium hypochlorite in the root canal, a tube-shaped electron scanning microscopy was performed.Results. Grapefruit oil has the most dissolving activity (p < 0.05). In addition to the solubility of the filler and siller, grapefruit essential oil is able to dissolve the smear layer.Conclusion. Optimization of the endodontic retreatment with root canals previously filled with gutta-percha, is possible using essential oils, however, a grapefruit oil is the most effective.

Objective: Many authors have tried to face the anatomical limitations resulting from maxillary bone atrophy. Up to five millimeters bone height, the lateral sinus floor elevation is the most commonly used and validated strategy to achieve the prosthetic rehabilitation. However, the disadvantages of this technique are its invasiveness and delayed rehabilitation. The aim of this paper was to assess 5 years clinical outcome of implants placed with a technique that allows the percrestal sinus floor elevation and the immediate implant placement. Materials and Methods: 30 transcrestal sinus floor elevations with immediate implant placement were performed in severely atrophic maxillae. Implant survival, marginal bone level variation, harvested bone height variation and periodontal indices were assessed. Results: After a five year follow up none of the thirty implants were lost. The mean value of vertical harvested bone loss was 5%. The mean crestal bone loss was -0.33 mm (Standard Deviation (SD) 0.11 mm). The mean value of periodontal indices was respectively: PD 1.22 mm (SD 0.72 mm), PI 17.47% (SD 15.01 mm), BOP 9, 87 %.,( SD 19.17 mm). Conclusion: The results obtained are comparable with success criteria in implant rehabilitation. The reported technique proved to be successful in the population observed, with minimal trauma and reduced invasiveness., Svrha rada: Mnogi su se autori pokušali suočiti s anatomskim ograničenjima koja nastaju zbog atrofije maksilarne kosti. Do visine kosti od pet milimetara lateralno podizanje dna sinusa najčešće je korištena i potvrđena strategija za protetičku rehabilitaciju. No nedostatci te tehnike su invazivnost i odgođena rehabilitacija. Cilj ovoga rada bio je procijeniti petogodišnji klinički ishod ugrađenih implantata tehnikom koja omogućuje perkrestalno podizanje dna sinusa i imedijatnu ugradnju implantata. Materijali i metode: Obavljeno je 30 transkrestalnih podizanja dna sinusa s imedijatnom ugradnjom implantata u vrlo atrofiranu maksilu. Procijenjeni su preživljavanje implantata, varijacija razine marginalne kosti te varijacija visine kosti i parodontoloških indeksa. Rezultati: Nakon petogodišnjeg praćenja ni jedan od trideset implantata nije bio izgubljen. Srednja vrijednost vertikalnog gubitka kosti iznosila je 5 %. Srednji gubitak krestalne kosti bio je -0,33 mm [standardna devijacija (SD) 0,11 mm]. Srednja vrijednost parodontoloških indeksa bila je: PD 1,22 mm (SD 0,72 mm), PI 17,47 % (SD 15,01 mm), BOP 9, 87 %, (SD 19,17 mm). Zaključak: Dobiveni rezultati usporedivi su s kriterijima uspješnosti u implantološkoj rehabilitaciji. Prikazana tehnika pokazala se uspješnom u promatranoj populaciji, uz minimalne traume i smanjenu invazivnost.

Aim:Prevention of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis requires the cooperation of physicians and dentists. We investigated the knowledge, experience, and behaviour related to medical and dental cooperation for MRONJ prevention in patients with osteoporosis between physicians and dentists practising in the Shiga prefecture., Materials and methods:We conducted a cross-sectional study to investigate the cooperation between practising physicians and dentists for preventing osteonecrosis of the jaw (ONJ) in patients with osteoporosis using 2 separate questionnaires from July 28, 2018, to February 3, 2019, in Shiga prefecture, Japan., Results:Of 461 dentists who were sent the questionnaires at their dental clinics, 307 (67%) responded via fax. Of 846 physicians who were sent the questionnaire at their clinics, 378 (45%) responded via fax. Of these, 268 (32%) were finally analysed because 110 (13%) physicians had never treated patients with osteoporosis; 50% dentists and 24% physicians were familiar with the MRONJ position paper in Japan, and 39% dentists and 9% physicians had encountered MRONJ in their clinical practice. A total of 30% physicians had requested oral health care by a dentist before administering bone-modifying agents (BMA) therapy. The knowledge and experience of MRONJ differed between doctors and dentists., Conclusion:The behaviour of doctors and dentists was insufficient to enable medical and dental cooperation for the prevention of MRONJ in patients with osteoporosis. The lack of cooperation between physicians and dentists during osteoporosis treatment in the Shiga prefecture in Japan is documented in this study.

Objectives Porous titanium is used for the reconstruction of large bone defects due to its excellent mechanical strength. The quality of osseointegration of implants placed in bone reconstructed with porous titanium is unknown. The purpose of this in vivo study was to evaluate the osseointegration of implants at sites reconstructed using porous titanium. Material and Methods Hollow porous titanium (Ti) (outer-diameter 6 mm, inner-diameter 2 mm, length 4 mm, 85% porosity) and similar-sized porous hydroxyapatite (porous HA: 75% porosity) samples were prepared and implanted in 6 New Zealand white rabbit femurs. Four weeks later, an implant bed was created to receive a Ti implant (diameter 2 mm, length 4 mm). An implant placed at a pristine bone site served as the control. Four weeks later, histological and histomorphometric evaluations of the test and control sites were conducted. Results Osseointegration was observed in all groups. There was no significant difference in the bone formation ratio and bone-implant contact (BIC) ratio across all groups for the whole area. At the cancellous bone area of the bone defect, superior bone formation ratio and BIC ratio were observed with porous Ti and porous HA compared to the control (bone formation ratio: control 1.8 [SD 3]%, HA 23 [SD 3]%, Ti 23.6 [SD 5]%; BIC ratio: control 5.4 [SD 5.3]%, HA 28.9 [SD 10.7]%, Ti 41.6 [SD 14]%). Porous Ti demonstrated good osteoconduction and osseointegration abilities, similar to porous HA. Conclusions To our knowledge, this is the first report of implant treatment after preliminary bone reconstruction using a titanium biomaterial. Porous titanium is a suitable material for bone reconstruction before implant treatment in load-bearing areas that allow subsequent prosthetic treatment.

Objectives The aim of this retrospective study was to evaluate the morphology of the olfactory fossa in the Turkish population using cone-beam computed tomography according to Keros classification and to investigate the effect of age, gender and nasal septum deviation on the olfactory fossa. Material and Methods Olfactory fossa (OF) were analysed in coronal sections on cone-beam computed tomography images of 385 individuals. Nasal floor (NF), medial ethmoid roof point (MERP), cribriform plate (CP) heights, CP depth and width, OF width, lateral lamella-cribriform plate angle (LLCPA), and nasal septum deviation angle (NSDA) were measured. Keros and Gera classifications were made according to the measurements. Results According to the Keros classification, 137 of 770 OFs were type I (17.8%), 554 (71.9%) were type II, and 79 (10.3%) were type III. The most common combination was Keros type II and Gera type II (45.6%). There was a positive correlation between CP depth and LLCP angle, NF, MERP and CP heights (P ≤ 0.05). NF, MERP, and CP heights, CP depth and LLCP angle were statistically significant differences according to Keros classification (P ≤ 0.05). Only the right LLCP angle showed a statistically significant difference according to the NSD sides (P = 0.014). Conclusions The study shows that the lateral lamella-cribriform plate angle increases as the cribriform plate depth increases. This result suggests that it may moderate the risk during endoscopic sinus surgery. Also, according to the nasal septum deviation sides, the dimensions of the olfactory fossa did not change significantly, except for the lateral lamella-cribriform plate angle.

Objectives The aim of this experimental animal study was to evaluate the effects of systemic propranolol on new bone formation in peri-implant bone defects. Material and Methods Implant slots were created 4mm long and 2.5 mm wide. After the titanium implants were placed in the sockets, 2 mm defects were created in the neck of the implants. Bone grafts were placed in these defects. Then the rats were randomly divided into three equal groups: control (n = 8), propranolol dose-1 (PRP-1) (n = 8), and propranolol dose-2 (PRP-2) (n = 8) groups. In the control group, the rats received no further treatment during the eight-week experimental period after the surgery. The rats in the PRP-1 and PRP-2 groups were given 5 mg/kg and 10 mg/kg propranolol, respectively, every three days for the eight-week experimental period after the surgery. At the end of the experimental period, the rats were euthanized. Blood serum was collected for biochemical analysis, and the implants and surrounding bone tissues were used for the histological analysis. Results There were no significant differences in the histological analysis results and the biochemical parameters (alkaline phosphatase, calcium, creatinine and phosphorus) of the groups (P > 0.05). Also, in the test groups, there was numerically but not statistically more new bone formation detected compared with the controls. Conclusions Within the limitations of this study, propranolol did not affect the new bone formation in peri-implant defects.

Saliva is the major contributor for the protein composition of the acquired enamel pellicle (AEP), a bacteria-free organic layer formed by the selective adsorption of salivary proteins on the surface of the enamel. However, the amount of proteins that can be recovered is even smaller under in vitro condition, due to the absence of continuous salivary flow. Objective This study developed an in vitro AEP protocol for proteomics analysis using a new formation technique with different collection solutions. Methodology 432 bovine enamel specimens were prepared (4x4 mm) and divided into four groups (n=108). Unstimulated saliva was provided by nine subjects. The new AEP formation technique was based on saliva resupply by a new one every 30 min within 120 minutes at 37ºC under agitation. AEP was collected using an electrode filter paper soaked in the collection solutions according with the group: 1) 3% citric acid (CA); 2) 0.5% sodium dodecyl sulfate (SDS); 3) CA followed by SDS (CA+SDS); 4) SDS followed by CA (SDS+CA). The pellicles collected were processed for analysis through LC-ESI-MS/MS technique. Results A total of 55 proteins were identified. The total numbers of proteins identified in each group were 40, 21, 28 and 41 for the groups CA, SDS, CA+SDS and SDS+CA, respectively. Twenty-three typical AEP proteins were identified in all groups, but Mucin was only found in CA and CA+SDS, while three types of PRP were not found in the SDS group. Moreover, a typical enamel protein, Enamelin, was identified in the CA+SDS group only. Conclusion The new technique of the in vitro AEP formation through saliva replacement was essential for a higher number of the proteins identified. In addition, considering practicality, quantity and quality of identified proteins, citric acid seems to be the best solution to be used for collection of AEP proteins.

Objectives Estimating blood loss is an important factor in several surgical procedures. The accuracy of blood loss measurements in situations where blood is mixed with saliva and saline is however uncertain. The purpose of this laboratory study was to ascertain if blood loss measurements in mixtures of blood, saline, and saliva are reliable and could be applicable in a clinical setting. Material and Methods Venous blood and resting saliva were collected from six volunteers. Saliva, saline, and combinations thereof were mixed with blood to obtain different concentrations. A portable spectrophotometer was first used to measure the haemoglobin concentration in undiluted venous blood followed by measurements of the haemoglobin concentration after each dilution. To examine the strength of linear relationships, linear regression and Pearson correlations were used. Results The measurements of haemoglobin concentrations in mixtures of blood, saline, and saliva were proven to be accurate for haemoglobin measurements > 0.3 g/dl (correlation = 0.986 to 1). For haemoglobin measurements < 0.3 g/dl, a small increase in haemoglobin values were reported, which was directly associated to the saliva concentration in the solution (correlation = 0.983 to 1). This interference of saliva was significantly eliminated by diluting the samples with saline, mimicking the clinical situation. Conclusions The results suggest that a portable spectrophotometer can be used clinically to preoperatively measure the haemoglobin value of a venous blood sample and postoperatively measure the haemoglobin value of the collected liquids, including shed blood, thereby achieving a highly accurate method of measuring blood loss during oral and maxillofacial surgery.

Objectives The purpose of this retrospective study was to compare the pre- and post-treatment values of patients treated with monoblock and twin-block appliances with the values of the skeletal Class I individuals. Material and Methods The initial lateral cephalometric radiographs of the pubertal untreated skeletal class I patients and cephalometric radiographs of 60 (30 monoblock, 30 twin-block) patients before and after the functional treatment were included in the study. Skeletal, dental, and soft tissue measurements were performed by a single researcher using Dolphin Imaging software version 11.95 (Dolphin Imaging, Chatsworth, CA, USA). Paired t-test was used for statistical evaluation and P < 0.05 was considered statistically significant. Results In both monoblock and twin-block groups, there was a statistically significant increase in the measurements of the lower jaw and the vertical direction values (sella nasion B point (SNB), pogonion nasion perpendicular, Y-axis, sella nasion-gonion gnathion, palatal-mandibular angle, anterior facial height, mandibular length P < 0.05); however, in the Twin-block group, the lower jaw was found to be displaced more forward (change for twin-block; SNB = 2.35, Wits appraisal = -4.77). The most measurements of the twin-block treated group were similar to the control group. Conclusions Both functional appliances have been identified to be useful in achieving treatment targets; however, with twin-block, results closer to ideal values are obtained.

OBJECTIVES: The aims of the present case-control study were to compare craniofacial morphology, airway minimum cross-sectional area and airway volume between patients with hypermobile Ehlers-Danlos syndrome and healthy controls.MATERIAL AND METHODS: The sample comprised 18 hypermobile Ehlers-Danlos syndrome (hEDS) patients (16 females, 2 males, mean age 34.1 [SD 10.35] years), clinically diagnosed and genetically tested in order to exclude other types of EDS, and 16 controls (14 females, 2 males, mean age 37.9 [SD 10.87] years) with neutral occlusion and normal craniofacial morphology. Craniofacial morphology was assessed on lateral cephalograms. Minimum cross-sectional area and upper airway volume were assessed on cone-beam computed tomography and analysed by standard and well-validated methods. Differences were tested by logistic regression analysis adjusted for age, gender and body mass index (BMI).RESULTS: No significant differences in craniofacial morphology were found between hEDS patients and controls. Airway minimum cross-sectional area (P = 0.019) and airway volume (P = 0.044) were significantly smaller in hEDS patients compared to controls. When adjusted for age, gender and BMI no significant differences were found. However, minimum cross-sectional area was almost significant (P = 0.077).CONCLUSIONS: The craniofacial morphology and airway dimensions of hypermobile Ehlers-Danlos syndrome patients were comparable to controls, with a tendency towards a smaller minimum cross-sectional area in the hypermobile Ehlers-Danlos syndrome group. The results may prove valuable for understanding the effect of hypermobile Ehlers-Danlos syndrome on craniofacial morphology and the upper airways.

Objective of Work: Wrong-site tooth extraction (WSTE) is the most common serious patient safety incident in dentistry. Safety checklists have significantly reduced wrong-site surgery, although their benefit is unproven in primary care dentistry. Our quality improvement project developed and implemented a checklist optimised for oral surgery procedures in primary care to reduce WSTE risk. Material and Methods: Local best practice for tooth extraction record-keeping (LBP), using national guidelines and standards was devised. We then retrospectively audited tooth extraction record-keeping against LBP. Deficiencies in current record-keeping practice were identified and used to design a checklist aimed at improving compliance. We provided a computerised safety checklist compliant with LBP to eleven clinicians at three general dental clinics within our region. The checklist included a preoperative safety check, a pause to re-confirm the surgical site and a post-operative record-keeping proforma. The checklist was linked to our record-keeping software for use during tooth extraction. We audited checklist completion and compliance with LBP fortnightly for ten weeks. Results: The introduction of a safety checklist resulted in increased compliance with LBP for tooth extraction record keeping. At week ten, 67% of records contained the computerised safety checklist. This resulted in a 50% increase in overall compliance with LBP for tooth extraction compared to baseline. Conclusions: A computerised safety checklist for tooth extraction in primary care has potential to improve patient safety by adopting measures to prevent WSTE and standardising communication between clinicians. Checklists in general practice should be encouraged., Svrha rada: Vađenje pogrešnoga zuba najčešći je ozbiljni incident u dentalnoj medicini. Sigurnosni kontrolni popisi znatno su smanjili učestalost takve pogreške iako u primarnoj stomatološkoj praksi nije dokazano ima li od njih koristi. U sklopu našeg projekta o poboljšanju kvalitete razvijen je i im-plementiran kontrolni popis prilagođen oralnim kirurškim zahvatima u primarnoj zaštiti kako bi se smanjio rizik od vađenja pogrešnoga zuba.Materijal i metode: Koristeći se nacionalnim smjernicama i standardima osmišljena je najbolja lokalna praksa za evidenciju vađenja zuba. Zatim je retrospe-ktivno revidirana evidencija o vađenju zuba. Uočeni su nedostatci u dosadašnjoj praksi vođenja evi-dencije što je iskorišteno za izradu kontrolnoga popisa sa svrhom poboljšanja usklađenosti. Jedan-aest kliničara u trima općim stomatološkim klinikama u našoj regiji dobilo je digitalni kontrolni popis u skladu s najboljom lokalnom praksom. Sadržavao je preoperativnu sigurnosnu provjeru, stanku za ponovnu potvrdu mjesta vađenja i postoperativnu evidenciju. Kontrolni popis bio je povezan s našim softverom za vođenje evidencije koji se upotrebljava tijekom vađenja zuba. Deset tjedana svakih pet-naest dana provjeravala se ispunjenost kontrolnih popisa i usklađenost s najboljom lokalnom prak-som. Rezultati: Primjena sigurnosnoga kontrolnoga popisa rezultirala je povećanom usklađenošću s najboljom lokalnom praksom za vođenje evidencije o vađenju zuba. U desetom tjednu 67 % zapisa sadržavalo je digitalnu sigurnosnu kontrolnu listu. To je rezultiralo povećanjem ukupne usklađenosti s najboljom lokalnom praksom vađenja zuba za 50 % u odnosu prema početnoj vrijednosti. Zaključ-ci: Digitalnim sigurnosnim kontrolnim popisom za vađenje zuba u primarnoj zdravstvenoj zaštiti mo-že se poboljšati sigurnost pacijenata ako se usvoje mjere za sprječavanje vađenja pogrešnoga zuba i standardizira komunikacija između kliničara. Treba poticati kontrolne liste u općoj praksi.

Objectives Millions of people worldwide are affected by diseases or injuries which lead to bone/tooth loss and defects. While such clinical situations are daily practice in most of the hospitals, the widely used treatment methods still have disadvantages. Therefore, this field of medicine is actively searching new tissue regeneration techniques, one of which could be stem cell secretome. Thus, the purpose of this research study was to perform the detail proteomic analysis of periosteum-derived mesenchymal stem cells secretome in order to evaluate if it is capable to induce osteo-regenerative process. Material and Methods Periosteum-derived mesenchymal stem cells (PMSCs) were extracted from adult male New Zealand White rabbits. Cells were characterised by evaluating their differentiation potential. After characterisation PMSCs secretomes were collected and their proteomic analysis was performed. Results PMSCs were extracted from adult male New Zealand White rabbits. In order to characterise the extracted PMSCs, they were differentiated in the directions which mainly describes MSC multipotency - osteogenic, myogenic and adipogenic. A total of 146 proteins were detected. After characterisation PMSCs secretomes were collected and their proteomic analysis was performed. The resulting protein composition indicates the ability to promote bone regeneration to fully mature bone. Conclusions Bioactive molecules detected in periosteum-derived mesenchymal stem cells secretome initiates the processes required for the formation of a fully functional bone.

Introduction: Varnish fluoride has the ability to prevent enamel demineralization. De-waxed shellac that mostly used for fruits coating, now is applied as varnish fluoride materials. This de-waxed shellac is quite potential since the product can be found from Indonesian sources. The research aims to describe the toxicity effect of varnish fluoride made of de-waxed shellac by measuring the viability of the fibroblast cells. Methods: The research method that was used in this study is in vitro experimental method, which using the tooth that had been smeared with varnish fluoride contacted with fibroblast cells REF (Rat Embryonic Fibroblast) for 4, 8, and 24 hours. The toxicity effect of varnish fluoride was then measured by cell viability. Results The results show that the average cells viability on 4 hours contacted tooth was 88%, while average cells viability on 8 hours contacted tooth was 74%, and lastly the average cells viability on 24 hours contacted tooth was 63%. Conclusion: The conclusion of this preliminary study on cells viability based on toxicity effect of varnish fluoride made from Indonesian de-waxed shellac are different based on contacted time.Keywords: Cell viability, toxicity effect, varnish fluoride, Indonesian de-waxed shellac

Objectives The diagnostic role and correlation between phosphatase and tensin homologue and alpha-smooth muscle actin in oral submucous fibrosis and oral squamous cell carcinoma with concomitant oral submucous fibrosis was analysed by this case control study. The mechanism by which phosphatase and tensin homologue controls myofibroblast expression was also evaluated. Material and Methods Overall, 10 normal mucosa, 30 oral submucous fibrosis (OSF) and 30 oral squamous cell carcinoma (OSCC) with OSF were stained immunohistochemically with phosphatase and tensin homologue (PTEN) and alpha-smooth muscle actin (α-SMA). Percentage positivity, pattern of expression was statistically compared using Pearson’s Chi-square and Fischer exact tests. The correlation between markers was analysed using Spearman correlation. Results OSF and OSCC affected males predominantly with majority below 40 years and above 40 years of age respectively. Percentage of PTEN positive cells was statistically significant with gender (P = 0.024) and α-SMA distribution of pattern showed a significant correlation with habits (P = 0.018). A significant decrease in nuclear PTEN positivity (P < 0.001) and a gradual increase in α-SMA cytoplasmic expression was noted from NM to OSF and OSCC. A statistically significant weak inverse correlation existed between PTEN and α-SMA. Conclusions A reduced phosphatase and tensin homologue expression in oral submucous fibrosis makes it more prone for malignant transformation. An increase in stromal desmoplasia modifies differentiation, invasive and proliferative capacity of tumour cells. As phosphatase and tensin homologue functions through P-Akt pathway, P-Akt with phosphatase and tensin homologue could be a therapeutic target.

Objectives Digital radiography is an increasingly used technology in Lithuania. However, there is no published information about using cone-beam computed tomography. The aims of this cross-sectional study performed in Lithuania were (1) to obtain information about the prevalence and accessibility of digital radiography and cone-beam computed tomography usage, and (2) to estimate dental practitioners’ knowledge about this diagnostic method and their need for education. Material and Methods Questionnaires consisting of 31 questions were distributed during the 2019 International Dentist Congress in Lithuania. Results This study analyses the data obtained from 248 respondents. Most of the clinicians use digital radiographic methods in their practice. The institutions usually have a digital dental X-ray machine, less often a digital panoramic X-ray machine, and least often a cone-beam computed tomography (CBCT) unit. Most dental practitioners performed 1 to 10 CBCT scans per month for adult patients and the most frequent reason for its use was implantation planning. Of the practitioners, 81.7% would like to improve their CBCT knowledge and skills. Conclusions The number of digital X-ray machines has increased throughout the last decade. Lithuanian dental practitioners do not excessively use cone-beam computed tomography. Some concerns were raised regarding respondents’ knowledge about exposure factors and this diagnostic method’s performance for paediatric patients. Additional training should be provided to Lithuanian dental specialists.

Objectives: The aim of this clinical study was to compare tooth sensitivity scores and color change values before and 1 day following whitening treatments using different concentrations of whitening agents for in-office and at-home procedures. Materials and methods: A total of 60 participants divided into 3 groups were included in this study. A whitening procedure was carried out in groups using 40% hydrogen peroxide (HP) in in-office treatment, 16% and 10% carbamide peroxide (CP), respectively. Participants rated their tooth sensitivity at the baseline and 1 day following the treatment. The CIElab values were recorded and color differences were calculated. Results: Within each of the whitening treatments, the tooth sensitivity scores significantly increased following the procedure (p, Cilj: Cilj ove kliničke studije bio je usporediti rezultate osjetljivosti zuba i vrijednosti promjene boje prije izbjeljivanja u ordinaciji i kod kuće različitim koncentracijama sredstava za izbjeljivanje i jedan dan poslije. Materijal i metode: U istraživanje je bilo uključeno ukupno 60 sudionika podijeljenih u tri skupine. Postupak izbjeljivanja proveden je 40-postotnim vodikovim peroksidom (HP) za izbjeljivanje u ordinaciji, te 16-postotnim, odnosno 10-postotnim karbamidnim peroksidom (CP) za postupak kod kuće. Sudionici su ocijenili osjetljivost zuba na početku postupka izbjeljivanja i dan poslije završetka. Rezultati: Pri svakom postupku izbjeljivanja rezultati za osjetljivost zuba značajno su se povećali nakon zahvata (p < 0,05). Najveći porast zabilježen je za postupak u ordinaciji 40-postotnim HP-om, a najmanja osjetljivost zabilježena je za izbjeljivanje kod kuće 10-postotnim CP-om (p < 0,05). Najveća promjena boje nakon postupka izbjeljivanja uočena je u skupini za izbjeljivanje u ordinaciji (40-postotni HP) (3.3) i značajno se razlikovala od izbjeljivanja 16-postotnim i 10-postotnim CP-om kod kuće čija je razlika u boji bila 2,0 (p < 0,05). Zaključak: Nakon postupka izbjeljivanja najmanju osjetljivost zuba prouzročilo je sredstvo za izbjeljivanje kod kuće s niskom koncentracijom CP-a u usporedbi s višim koncentracijama CP-a za kućno izbjeljivanje i HP-a za izbjeljivanje u ordinaciji, s istom učinkovitošću u promjeni boje kao i sredstvo s visokim koncentratom CP-a. U slučaju da je blaga osjetljivost zuba prijavljena prije početka postupka, bilo bi dobro obaviti izbjeljivanje 10-postotnim CP-om.

Objective: The aim of the study was to investigate the maternal-child S. mutans infection, mutual interaction and potential risk factors altering this interaction. Material and methods: A total of 160 mothers who were paired with their children were recruited. Saliva from mothers and children was collected and S. mutans categorized levels were analyzed. A questionnaire was used to collect maternal and child conventional caries risk factors. A proportional odds regression model was used to investigate whether the level of infection of mothers would similarly affect the level of infection of their children, thus adjusting for other risk factors. Results: The average age of mothers was 28.1 years and children had a median age of 5.1 months. Paired mother-child S. mutans crossclassification into non-infected and infected subjects showed no agreement in mutual contamination. Maternal in-fection of the child was highest when the mother was infected with 10 >3 S. mutans/ml of saliva. The results obtained by the regression model showed that none of the potential risk factors influenced the level of infection in the child. Conclusion: Mothers with a high S. mutans level increase the risk of S. mutans acquisition for her five- month- old child but no evidence was found that other maternal/ child factors may influence this., Svrha: Cilj je bio istražiti infekciju kod majke i djeteta bakterijom S. mutans, međusobnu interakciju i moguće čimbenike rizika koji mijenjaju tu interakciju.Materijali i metode: U istraživanju je ukupno sudjelovalo 160 majki sa svojom djecom. Prikupljena je njihova slina te su analizirane kategorizirane razine S. mutans. Upotrijebljen je upitnik za prikupljanje čimbenika rizika za nastanak karijesa kod majke i djeteta. Model proporcionalne regresije vjerojatnosti korišten je za istraživanje hoće li razina infekcije kod majki na sličan način utjecati na razinu zaraze njihove djece, čime se prilagođavaju dru-gi čimbenici rizika. Rezultati: Prosječna dob majki bila je 28,1 godina, a djece 5,1 mjesec. Uparena klasifikacija majke i djeteta u nezaražene i zaražene ispitanike bakterijom S. mutans nije pokazala slaganje u međusobnoj kontaminaciji. Majčinska infekcija djeteta bila je najveća kada je majka bila zaražena s 10 >3 S. mutans/mL sline. Rezultati dobiveni regresijskim modelom pokazali su da ni jedan od potencijalnih čimbenika rizika nije utjecao na razinu infekcije kod djeteta. Zaključak: Majke s visokom razinom S. mutans povećavaju rizik od prijenosa te bakterije na svoju petomjesečnu djecu, ali nisu pronađeni dokazi da na to mogu utjecati drugi čimbenici povezani s majkom/djetetom.

Introduction: Radiotherapy is used to treat neo plasmatic lesions and the common side effects of this process are pain, swelling and sensitivity of mucous membranes in domain of radiation, reduced salivation, caries, and periodontal disease and, in total, low life quality. The purpose of this research was to estimate the outcome of direct irradiation on physical and surface characteristics of hard dental tissues. Material and methods: Twenty, caries free third molars were involved in the research. Prior to different submission protocols, tooth halves were randomly assigned to subject and control groups by using a draw method. The first group (n=20) was submitted to conventional irradiation protocol (2 Gy for 35 days), second group (n=20) was submitted to one powerful, exploratory dose of 70 Gy. Each sample served as its own control. Radiation was performed with a linear accelerator radiotherapy unit. The surface microhardness and roughness were measured at the beginning (initially), and upon completion of irradiation procedure. The average change in microhardness and roughness after different treatments was compared by t-test for independent samples. Normality was tested by the Shapiro-Wilk test. Results: Significant differences were found after the standard radiation protocol and the exploratory dose of 70 Gy, with decreased mean microhardness and increased mean roughness (p, Uvod: Radioterapija se primjenjuje u liječenju neoplazmatskih lezija, a uobičajene nuspojave u tom procesu obično su bol, oteklina i osjetljivost sluznice u području zračenja, smanjeno izlučivanje sline, karijes, parodontna bolest i smanjena kvaliteta života. Svrha ovog istraživanja bila je procijeniti učinak izravnoga zračenja na fizičke i površinske karakteristike tvrdih zubnih tkiva. Materijali i metode: Istraživanje je provedeno na 20 trećih kutnjaka bez karijesa. Prije primjene različitih protokola zračenja, polovine zuba raspoređene su u ispitnu i kontrolnu skupinu metodom nasumičnog izvlačenja. Prva skupina (n = 20) podvrgnuta je konvencionalnom protokolu zračenja (2 Gy tijekom 35 dana), druga skupina (n = 20) bila je izložena jednoj snažnoj, eksperimentalnoj dozi od 70 greja (Gy). Svaki uzorak služio je kao vlastita kontrola. Zračenje je provedeno radioterapijskom jedinicom linearnog akceleratora. Mikrotvrdoća i hrapavost površine mjerene su na početku (početna) i na kraju postupka zračenja. Prosječna promjena mikrotvrdoće i hrapavosti nakon različitih tretmana uspoređena je t-testom za nezavisne uzorke. Normalnost je testirana Shapiro-Wilkovim testom. Rezultati: Uočene su značajne razlike nakon standardnoga protokola zračenja i eksperimentalne doze od 70 greja, uz smanjenu prosječnu mikrotvrdoću i povećanu prosječnu hrapavost (p < 0,001) obaju tvrdih zubnih tkiva. Mikrotvrdoća i hrapavost površine cakline i dentina nisu se značajno razlikovale s obzirom na različite protokole zračenja. Zaključak: Standardni protokol zračenja glave i vrata može oštetiti caklinu i dentin, uz smanjenu mikrotvrdoću i povećanu hrapavost površine bez obzira na korišteni protokol zračenja.

Objectives: The aim of this study was to evaluate the influence of artificial ageing on the retention force of original semipermanent cements, as well as the possibility of using conventional cements for semipermanent cementation with adequate modification of the cementing protocol. Material and methods: Forty CoCrMo alloy crowns were divided in four groups (each group n=10) and fixed with two semipermanent cements (resin-based and glass ionomer-based cements) and one conventional (zinc phosphate), using conventional and modified cementation techniques on titanium abutments. The samples were stored in humid conditions for 24 hours at 37°C and subjected to thermocycling (500 cycles) and mechanical cyclic loading (7 days, 3, 6, 9 and 12 months function simulation). The cast crowns were removed and the retention force was recorded. Results: The highest initial retention force measured was for zinc-phosphate cement - conventional cementing (198,00±61,90 N), followed in descending order by zinc-phosphate cement - modified cementing technique (152,00±45,42 N), long term temporary cement – GC Fuji Temp LT (57,70±20,40 N), and semipermanent cement - Te-lio CS Cem Implant (56,10±18,68 N). After 12 months, the highest retention force measured was for zinc-phosphate cement - conventional cementing (88, 90±14, 45 N), followed by zinc-phosphate cement – modified cementing (48, 15±14,41N), semipermanent cement GC Fuji Temp LT (16,55±3,88 N) and Telio CS Cem Implant (15,55±5,52 N). Conclusions: Zinc-phosphate cement - modified cementing technique and original semipermanent cements can be recommended for conditional permanent cementing of implant supported crowns. Clinical relevance: The use of semipermanent cements and zinc-phosphate cement - modified cementing technique provides a predictable retrievability of implant-supported crowns., Cilj: Željelo se ispitati kakav je utjecaj umjetnoga starenja na retencijsku silu originalnih (polutrajnih) semipermanentnih cemenata i mogućnost upotrebe konvencionalnih cemenata za polutrajno pričvršćivanje, uz odgovarajuću prilagodbu protokola cementiranja. Materijal i metode: U četiri skupine raspoređeno je 40 krunica izrađenih od Co-Cr-Mo legure (svaka skupina n = 10) i fiksiranih dvama polutrajnim cementima (cementi na bazi smola i staklenoionomera) i jednim konvencionalnim (cink-fosfatni cement), učvršćene konvencionalnom i prilagođenom tehnikom cementiranja na titanijevim nadogradnjama (engl. abutment). Uzorci su bili 24 sata pohranjeni u vlažnim uvjetima na temperaturi od 37 °C nakon čega su podvrgnuti termocikliranju (500 ciklusa) i mehaničkim cikličnim opterećenjima (simulacija 7 dana, 1, 3, 6, 9 i 12 mjeseci u funkciji). Krunice su uklonjene i zabilježena je retencijska sila. Rezultati: Najvišu inicijalnu retencijsku silu pokazao je cink-fosfatni cement – konvencionalno cementiranje (198,00 ± 61,90 N), a slijede ga u silaznom nizu cink-fosfatni cement – prilagođena tehnika cementiranja (152,00 ± 45,42 N), dugotrajni privremeni cement – GC Fuji LT (57,70 ± 20,40 N) i semipermanentni cement Telio CS (56,10 ± 18,68 N). Poslije 12 mjeseci najviša retencijska sila izmjerena je za cink-fosfatni cement – konvencionalno cementiranje (88, 90 ± 14,45 N), a slijede cink-fosfatni cement – prilagođena tehnika cementiranja (48,15 ± 14,41 N) te semipermanentni cementi GC Fuji Temp LT (16,55 ± 3,88 N) i Telio CS Cem Implant (15,55 ± 5,52 N). Zaključak: Cink-fosfatni cement – prilagođena tehnika cementiranja i originalni polutrajni cementi (semipermanentni) mogu se preporučiti za uvjetno trajno cementiranje krunica postavljenih na implantate jer omogućuje optimalnu mogućnost uklanjanja krunica postavljenih na implantate.

Aim: This study aimed to test the applicability of the methods proposed by Olze et al. (2012) and Timme et al. for dental age estimation in Brazilian subadults and adults. Material and methods: Panoramic radiographs of 503 individuals aged between 20 and 70 years were analyzed. The mean chronological age of males and females of the sample was 29.04 and 29.97 years, receptively. Secondary dentin formation, cementum apposition, periodontal recession, and attrition of teeth #34, #35, #44 and #45 teeth were assessed as parameters to be calculated in the formulae designed by Olze et al. and Timme et al. Results: In males, the mean estimated age by the Olze method was 28.97 ± 2.86 years, while in females it was 27.85 ± 2.70 years. The Timme method estimated mean age for males of 32.54 ± 5.32 years and for females 33.09 ± 5.16 years. Low coefficients of determination (r 2 ) for the application of tooth-specific formulae of both methods suggest that estimated and chronological ages were not properly associated. Conclusion: The outcomes of this study indicate that the Olze and Timme methods may be limited for forensic applications in Brazilian subadults and adults. Country-specific statistical adjustments might be useful for improvements in practice, Cilj: Željela se ispitati primjenjivost metoda koje su predložili Olze i suradnici (2012.) i Timme i su-radnici za procjenu dobi zuba brazilskih adolescenata i odraslih. Materijal i metode: Analizirane su panoramske rendgenske snimke 503 osoba u dobi od 20 do 70 godina. Prosječna kronološka dob muškaraca i žena u uzorku bila je receptivno 29,04 i 29,97 godina. Sekundarni dentin, apozicija ce-menta, parodontna recesija i trošenje zuba #34, #35, #44 i #45 ocijenjeni su kao parametri koje treba izračunati u formulama koje su osmislili Olze i suradnici i Timme i suradnici. Rezultati: Kod muškaraca je srednja dob procijenjena Olzeovom metodom bila 28,97 ± 2,86 godina, a kod žena je iznosila 27,85 ± 2,70 godina. Timmeovom metodom procijenjena je srednja dob za muškarce od 32,54 ± 5,32 godine, a za žene 33,09 ± 5,16 godina. Niski koeficijenti determinacije (r 2 ) za primjenu formula specifičnih za zube u objema metodama sugeriraju da procijenjena i kronološka dob nisu pravilno povezane. Zaključak: Rezultati ove studije pokazuju da Olzeova i Timmeova metoda mo-gu biti ograničene kad je riječ o forenzičkoj primjeni kod brazilskih adolescenata i odraslih osoba. Statističke prilagodbe za pojedine zemlje mogle bi biti korisne za poboljšanja u praksi.

Objective: Permanent teeth trauma is most frequent in children aged 7-9 years, and the primary school teachers (PSTs) are often the first to notice it. The aim of this study was to evaluate the competence in tooth avulsion clinical issues and knowledge on dental trauma of PSTs, as they can occasionally take on the role of school nurses. Material and Methods: Questionnaires were handed to 312 PSTs from 24 randomly selected primary schools in Zagreb, Croatia. An algorithm was designed for PST competence assessment. Results: Response rate amounted to 81.37% (N=255). Only 3.14% (N=8) of the PSTs would replant the permanent tooth properly and only 43.92% of them (N=112) would immediately take the child to a doctor of dental medicine. Dry tissue, as a transport medium for an avulsed tooth, was chosen by 50.20% (N=128) of the respondents. Altogether, 4.71% (N=12) of PSTs were graded as competent in case of child’s tooth avulsion. Conclusion: These results provided significant implications for school health, showed the educators’ serious lack of knowledge in cases of dental trauma and stressed a need for continuous education of PSTs on the topic., Cilj: Trauma trajne denticije najčešća je kod djece u dobi od 7 do 9 godina te su učitelji prvi koji je uočavaju. Avulzija je potpuno izbijanje zuba iz zubne alveole i najteži je oblik dentalne traume. S obzirom na to da učitelji osnovnih škola u takvim slučajevima najčešće preuzimaju ulogu školske medicinske sestre, svrha istraživanja bila je procijeniti njihovu sposobnost pri zbrinjavanju te znanje o avulziji zuba. Materijal i metode: Uručeno je 312 anketnih upitnika učiteljima iz 24 nasumično odabrane osnovne škole u Zagrebu. Izrađen je algoritam za procjenu sposobnosti zbrinjavanja djeteta. Rezultati: Odziv ispitanika iznosio je 81,37 % (N = 255). Samo 3,14 % učitelja ispravno bi replantiralo trajni zub, a 49,92 % odvelo bi učenika u najkraćem roku doktoru dentalne medicine. Polovina ispitanika (50,2 %; N = 128) spremila bi izbijeni zub u rupčić. Sveukupno je samo 4,71 % ispitanika (N = 12) ocijenjeno sposobnima za zbrinjavanje avulzije trajnoga zuba kod djece. Zaključak: Rezultati istraživanja otkrili su nedostatke u organizaciji školskog zdravstva, ozbiljan nedostatak znanja učitelja osnovnih škola te upozorili na nužnost kontinuirane izobrazbe učitelja kad je riječ o toj temi.

Objectives: To evaluate the effectiveness of two pit and fissure sealants (PFS) in reducing the incidence of dental caries in schoolchildren. Material and Methods: A randomized split-mouth experimental design was used in a sample of 140 subjects assigned to two groups. The sealants used were Clinpro©3M and BeautiSealant©Shofu placed in first permanent molars (FPMs). Each sealant was compared to molars in the controls to determine effectiveness over a period of 6 months. The study had a 12.9% loss to follow-up. No statistically significant differences (p>0.05) were observed for sex, age, baseline dmft, or type of sealants. Nonparametric tests were used for statistical analysis. Results: Average dmft index at baseline was 4.10±3.16. Lower incidence of caries was observed in FPMs with pit and fissure sealants (p, Svrha rada: Procjena učinkovitosti smola za pečaćenje jamica i fisura (PFS) u smanjenju učestalosti zubnog karijesa kod školaraca. Materijali i metode: Primijenjen je randomizirani eksperimentalni dizajn s podijeljenim ustima u uzorku od 140 ispitanika raspoređenih u dvije skupine. Korištene su smole za pečaćenje Clinpro ©3M i BeautiSealant © Shofu koje su aplicirane na prve trajne kutnjake (FPM). Sve smole uspoređene su s kutnjacima na kontrolnoj strani kako bi se ustanovila učinkovitost tijekom 6 mjeseci. U istraživanju je postotak ispitanika koji su odustali od praćenja iznosio 12,9 %. Nisu uočene statistički značajne razlike (p > 0,05) za spol, dob, početni DMFT ili vrstu smole. Za statističku analizu upotrijebljeni su neparametrijski testovi. Rezultati : Prosječni DMFT indeks bio je na početku 4,10 ± 3,16. Manja incidencija karijesa zabilježena je na zapečaćenim prvim trajnim kutnjacima (p < 0,01), bez obzira na vrstu smole. Kada su smole ostale intaktne, incidencija karijesa bila je manja u usporedbi s djelomično ili potpuno nestalim pečatima, no razlika je bila statistički značajna samo za prve trajne kutnjake 16. Incidencija karijesa bila je veća kod zuba zapečaćenih smolom BeautiSealant u usporedbi sa smolom Clinpro, ali je statistički značajna bila samo kod prvih trajnih kutnjaka 16, 36 i 46 (p < 0,05). Incidencija karijesa bila je veća u slučajevima s višim početnim DMFT-om, ali je statistički značajna samo za prve trajne kutnjake 26 i 36. Relativni rizik od karijesa bio je niži kod zapečaćenih zuba (p < 0,01). Zaključak: Smole za pečaćenje fisura i jamica učinkovite su u prevenciji karijesa tijekom šestomjesečnog razdoblja praćenja školske djece od 6 do 8 godina, bez obzira na vrstu smole. Smola s većom učinkovitošću, kad je riječ o prevenciji i retenciji, bio je Clinpro © 3M.

Aim: The aim of the study is to evaluate and compare the apical seal obtained with Biodentine after conditioning of root end with three different solutions (HEBP, chitosan, and ethylenediaminetetraacetic acid [EDTA]). Materials and Method: Forty-eight maxillary incisors were selected and decoronated. Instrumentation was done with protaper rotary files up to F4 file and obturated with AH plus sealer (Dentsply, Germany) and Protaper gutta-percha cone using lateral condensation technique. The apical part of each root was resected at 90° to the long axis of the root for 3 mm, and retrograde cavity preparation was done in standardized dimensions. The teeth were randomly divided into four groups with 12 samples in each group and later subjected to a standard regimen of 3 ml of respective solutions for 5 min: Group I – 18% HEBP, Group II – 0.2% chitosan, Group III – 17% EDTA, Group IV – saline (control). All teeth were then restored with Biodentine (Septodont, USA). Samples were coated with two coats of nail varnish except in the apical 3 mm which will be immersed in 5 ml of 2% methylene blue dye and stored in incubator for 72 h. The nail varnish will be removed later, and the teeth will be immersed in 35% nitric acid for 72 h. The solutions were then filtered using a fine-grit filter paper and centrifuged at 2000 rpm for 1 min. The solutions thus collected will be used to determine absorbency in ultraviolet-visible spectrophotometer. Results: The mean values of absorbance were greatest for Group IV (saline) followed by Group III (17% EDTA), Group II (0.2% chitosan), and Group I (18% HEBP). Group IV (saline) and Group III (17% EDTA) have got statistically significant difference with all the other groups. Group II has got statistically significant difference with all the other groups except Group I. Conclusion: Within the limitations of the study, it was concluded that irrigation with newer agents significantly influenced the sealing ability of biodentine. Root-end irrigation with 18% HEBP and 0.2% chitosan showed the least microleakage when compared to 17% EDTA.