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The aims were: evaluation of the correlation between the Dental Aesthetic Index (DAI) and Index of Complexity, Outcome and Need (ICON); the assessment of orthodontic treatment need for schoolchildren in a population with two indices, separately for schoolchildren with mixed and permanent dentition; the estimation of the population share that could not receive orthodontic treatment because of the presence of caries and/or gingivitis.

The aim was to explore the predictive value of objective treatment need, impaired quality of life, and parental influence on orthodontic treatment demand in preadolescents and adolescents. A secondary goal was to validate 16-item Child Perceptions Questionnaire for the 11-14 year age group (CPQ11-14): item-impact and stepwise-regression short-forms. A convenience sample of 287 participants (55% female) was used for validation. Internal consistency, test-retest reliability, and convergent validity were evaluated. Predictors of treatment demand were explored in 197 orthodontic patients: 93 preadolescents (51% females), 104 adolescents (55% females). Hierarchical linear regression and multilevel logistic regression models were used to explore the predictive power of age, gender, objective treatment need, impaired quality of life and parental influence on treatment demand. CPQ11-14 regression short-form had acceptable psychometric properties. Significant linear predictors of treatment demand were impaired emotional well-being (EW) (β = 0.335, p = 0.002), parental influence (β = 0.221, p = 0.002), and malocclusion severity (β = 0.152, p = 0.025). In logistic regression, parental influence was revealed as the most important predictor of treatment demand in preadolescents, OR = 7.7 (95% confidence interval CI 2.4-25.1; p = 0.001); objective treatment need in adolescents, OR = 4.5 (95% CI 1.5-12.9; p = 0.006). The increase of impairment in EW by one scalar point increased treatment demand by 1.4 (95% CI 1.1-1.9; p = 0.017) in preadolescents; 1.3 (95% CI 1.0-1.7; p = 0.021) in adolescents. Greater parental agreement and motivation for treatment could result in higher preadolescents' cooperation. Orthodontic treatment in adolescents might be more effective with the patient-oriented approach.

Aim: Aim of article was to compare the shear bond strength of indirectly and directly bonded orthodontic brackets., Materials and Methods: The experimental in vitro study included 60 maxillary and mandibular premolars. Teeth were mounted on cold-cure acrylic blocks for each tooth separately and divided into two groups: directly bonded brackets (30 teeth) and indirectly bonded brackets (30 teeth). Brackets (Discovery, Roth 0.022", Dentaurum, Ispringen, Germany) were bonded using Transbond XT (3M Unitek, Monrovia, CA, USA) in direct method, while in indirect technique, a combination of Transbond XT and Sondhi Rapid Set (3M Unitek, Monrovia, CA, USA) was used. The shear bond strength and adhesive remnant index (ARI) were evaluated. The in vivo study included 30 subjects - 15 with indirectly bonded brackets and 15 with directly bonded brackets. Survival rate was assessed during the period of 6 months., Results: No statistically significant difference in the shear bond strength was found in direct (7.48±1.61 MPa) and indirect labial bonding methods (7.8.2±1.61 MPa). Both methods produced very similar amount of adhesive remnant on tooth surface (median = 1; interquartile range 1-2). There were no significant differences in bracket survival rate between methods., Conclusion: Regarding the shear bond strength, adhesive remnant on tooth surface, and survival rate, both indirect and direct methods of orthodontic bracket bonding seem to be equally valuable methods in clinical practice.

Introduction: We aimed to determine whether appliance type affects changes in maximum voluntary bite force (MVBF) and the number of occlusal contacts (NOC) during retention, controlling for sex, age, and body mass index., Methods: The sample comprised 176 examinees (70 male, 106 female) aged 14 to 20 years: 30 had maxillary and mandibular Essix retainers, 30 had wrap-around retainers, and 30 had a combination of fixed mandibular canine-to-canine retainers bonded on each tooth separately (double twisted, 0.254 mm in diameter, stainless steel ligature wire) and Essix retainer in the maxillary arch; 86 with normal occlusion were not treated. MVBF and the NOC were measured immediately after removal of preadjusted edgewise appliances (Roth prescription), 6 weeks after that, and after the next 4 weeks., Results: Increases in MVBF and the NOC were demonstrated, but subjects with 2 Essix retainers showed lower values than did the others. Changes were related to type of appliance, sex, and age (P <0.05) but not to body mass index. The increase in NOC occurred faster than the increase of MVBF, more and sooner with the wrap-around retainer and in male subjects than with the Essix and in female subjects. MVBF and NOC nearly reached the values of the control subjects., Conclusions: Settling of the occlusion depends on appliance type: it takes longer in female patients and with Essix in both dental arches than with the other tested appliances., (Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

This study investigated the relationships between the stages of calcification of teeth and cervical vertebral maturation. The sample consisted of 295 subjects (129 male and 166 female), mean age 13.36 ± 2.65 (range 7-18) years. Dental age was evaluated from panoramic radiographs according to the method of Demirjian. Cervical vertebral maturation was determined on lateral cephalometric radiographs using cervical vertebrae maturation stages (CVS). For assessing the relationship between cervical vertebral and dental maturation, percentage distributions of the stages of calcification for each studied tooth were calculated. Only in the first CVS stage, boys and girls were of the same age. In all other stages (CVS 2-CVS 6) girls were by 0.98 (range 0.23-1.86) younger than boys. Gender differences in the mineralization pattern were also observed. It was found that dental maturation was finished earlier in female subjects. The highest correlation coefficient between dental and skeletal maturity was found for second premolars. Mineralization pattern of second premolars could be considered as a guideline for prediction of the pubertal growth spurt. Dental maturation stages might be clinically useful as a reliable indicator of facial growth.

The purpose of this study was to estimate unmet orthodontic treatment needs of adolescents in Zagreb, Croatia, compare normative and self-perceived need and investigate factors influencing the reason why untreated subjects with severe malocclusions have not been treated before. One thousand and forty-two non-orthodontically treated subjects in age groups of 12 and 18 years, from sixteen randomly selected public schools in Zagreb, Croatia were examined. The Dental Aesthetic Index, Aesthetic Component of Index of Orthodontic Treatment Need and a questionnaire concerning self-perceived orthodontic treatment need, perception of aesthetics, function, behaviors and socioeconomic status were used. Around one third of untreated adolescent population had an objective need, less than 20 percent had aesthetic need, and self-perceived need was reported in one third of population. Associations and agreements between objective, aesthetic and self-perceived need were weak (r = 0.27-0.48; p < 0.001 and κ in range from 0.05 (p > 0.05) to 0.32 (p < 0.05), respectively). Satisfaction with personal dental appearance and awareness of malocclusion were better related in persons with no treatment need or minor need (r = 0.53-0.59) than in those with major need (r = 0.31-0.40). Multiple logistic regression analyses confirmed that objective, aesthetic and self-perceived needs were better related between themselves than to socio-economic status of subjects, function, activities of daily living and oral health-related behaviors. It appears that self-perceived treatment need has low role in predicting objective need, but relation between satisfaction and awareness of malocclusion could be one of basic factors in process of making decision to go for treatment and maybe could serve in predicting patient's compliance.

Adequate oral care in intubated patients may reduce occurrence of ventilator-associated pneumonia. The purpose of this study was to explore knowledge, attitudes, and oral care practice in Croatian intensive care units and influencing factors. Nurses' knowledge is insufficient; however, most of them reported positive attitude toward the importance of oral care. Performed oral hygiene measures are mostly inappropriate. There is a need to improve the knowledge of ventilator-associated pneumonia and oral care., (Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Objective: To determine the effect of different bracket designs (conventional brackets and self-ligating brackets) on periodontal clinical parameters and periodontal pathogens in subgingival plaque., Material and Methods: The following inclusion criteria were used: requirement of orthodontic treatment plan starting with alignment and leveling, good general health, healthy periodontium, no antibiotic therapy in the previous 6 months before the beginning of the study, and no smoking. The study sample totaled 38 patients (13 male, 25 female; mean age, 14.6 ± 2.0 years). Patients were divided into two groups with random distribution of brackets. Recording of clinical parameters was done before the placement of the orthodontic appliance (T0) and at 6 weeks (T1), 12 weeks (T2), and 18 weeks (T3) after full bonding of orthodontic appliances. Periodontal pathogens of subgingival microflora were detected at T3 using a commercially available polymerase chain reaction test (micro-Dent test) that contains probes for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola., Results: There was a statistically significant higher prevalence of A actinomycetemcomitans in patients with conventional brackets than in patients with self-ligating brackets, but there was no statistically significant difference for other putative periodontal pathogens. The two different types of brackets did not show statistically significant differences in periodontal clinical parameters., Conclusion: Bracket design does not seem to have a strong influence on periodontal clinical parameters and periodontal pathogens in subgingival plaque. The correlation between some periodontal pathogens and clinical periodontal parameters was weak.

Objective: To evaluate the antimicrobial effect of different frequencies of brushing with fluoride toothpaste on the levels of salivary mutans streptococci and lactobacilli in children undergoing fixed orthodontic treatment., Methods: The study included 22 patients scheduled for fixed orthodontic therapy distributed between 2 groups with different hygiene regimes. All the subjects received identical braces, bands, and brackets bonded with the same material. Stimulated saliva samples were obtained before placement of the appliance and at 6, 12, and 18 weeks during the therapy. Saliva samples were cultured on selective microbial agar for the detection of microorganisms., Results: Salivary mutans streptococci were significantly suppressed throughout the experimental period in the group that brushed 4 times a day as compared to the group that brushed twice a day. Salivary lactobacilli were not significantly affected by the frequency of brushing with 0.32% sodium fluoride (NaF) toothpaste., Conclusions: The use of 0.32% NaF-containing toothpaste more than 3 times a day has effective antimicrobial activity on mutans streptococci but not lactobacilli in the saliva of children with fixed orthodontic appliances.

Aim: To determine the prevalence of apical periodontitis and assess the quality of endodontic fillings in the population of the city of Zagreb, Croatia., Methods: A total of 1462 orthopantomograms from new patients at 6 different dental practices was analyzed during 2006 and 2007. The presence of periapical lesions was determined by using the periapical index score (PAI). The quality of endodontic fillings was assessed according to the filling length and homogenicity. Data were analyzed using t test and ANOVA with Scheffe post-hoc test., Results: There were 75.9% of participants with endodontically treated teeth and 8.5% of all teeth were endodontically treated. Only 34.2% of endodontically treated roots had adequate root canal filling length, while 36.2% of root canal fillings had homogenous appearance. From the total number of teeth with intracanal post, 17.5% had no visible root canal filling. Using PAI 3 as a threshold value for apical periodontitis, periapical lesions were detected in 8.5% of teeth. Adequate quality of root canal fillings was associated with a lower prevalence of periapical lesions., Conclusion: We found a large proportion of endodontically treated teeth with apical periodontitis and a correlation between the quality of endodontic filling and the prevalence of periapical lesions. This all suggests that it is necessary to improve the quality of endodontic treatment in order to reduce the incidence and prevalence of apical periodontitis.

Introduction: The form and the size of a dental arch are products of the configuration and the naturally established balance of the jaw, alveolar bone, and muscles. We investigated which arch dimensions mostly discriminate particular dentoalveolar classes and sexes., Methods: Plaster dental casts were collected from 137 white adolescent subjects (71 girls, 66 boys) aged between 15 and 18 years (mean, 16.0 ± 1.2 years) with Class I (43 subjects: 24 girls, 19 boys), Class II (50 subjects: 28 girls, 22 boys), and Class III (44 subjects: 19 girls, 25 boys) malocclusions. Casts were scanned with the ATOS II SO (small objects) scanner (GOM mbH, Braunschweig, Germany) and measured with ATOS Viewer software (version 6.0.2; GOM mbH)., Results: The major discriminating factors of the particular dentoalveolar classes are the mandibular canine width/depth ratio and the maxillary molar width/depth ratio, which explain 82.8% of the total variability (P <0.001). Class III subjects with the widest and shallowest frontal segment of the mandibular arch and the posterior segment of maxillary arch are clearly distinguished from Class II subjects whose abovementioned segments are the deepest and narrowest. Class I subjects are more similar to Class II than to Class III subjects. The most homogenous are Class III subjects, with 61.1% of them correctly classified, followed by Class II (57.8%) and Class I (52.4%). Sex differences are significant in linear measurements, but not in ratios., Conclusions: Variability of dental arch dimensions and forms is a common characteristic of all dentoalveolar classes. Maxillary arch form is more distinguishing in the posterior segment, and mandibular arch form is more distinguishing in the anterior segment. Class III patients have the most detectable arch form, and Class I the least detectable arch form., (Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Objective: To determine the physiologic changes of salivary flow rate, pH, and buffer capacity and the levels of Streptococcus mutans and Lactobacillus spp in patients undergoing fixed orthodontic treatment., Materials and Methods: The study included 23 patients scheduled for fixed orthodontic therapy. All subjects received equal braces, bands, and brackets, bonded with the same material. Stimulated saliva samples were taken before placement of the appliance, and at weeks 6, 12, and 18 during the therapy. Salivary flow rate and salivary pH were measured, and the salivary buffer capacity was determined. Saliva samples were cultivated on selective microbial agar for microorganism detection., Results: A significant (P < .05) increase in stimulated salivary flow rate and salivary pH was found. The salivary levels of S mutans and Lactobacillus spp also inscreased significantly (P < .05), and the major peak was at week 12 of fixed orthodontic therapy., Conclusion: The 6th to 12th week of orthodontic therapy is the period of the most intensive intraoral growth of S mutans and Lactobacillus spp and a time of very intensive salivary functions and physiologic response.

The aims of this investigation were to determine whether stabilization of maximum voluntary bite force (MVBF) occurs between 15 and 18 years of age in subjects with a normal occlusion, and to assess the influence of gender, body mass index (BMI), morphological occlusion, and jaw function measured by the number of occlusal contacts, overjet, overbite, maximal mouth opening, mandibular deflection during opening, sagittal slide between the retruded contact position and the intercuspal position, and number of dental restorations. The sample comprised 60 Caucasian subjects aged 15 (15 males and 15 females) and 18 (14 males and 16 females) years with a neutral occlusion, balanced facial profile, and absence of a previous orthodontic history. Bite force measurements were undertaken using a portable occlusal force gauge on both the left and the right sides of the jaw in the first molar region during maximal clenching. Two independent samples t-tests and multiple regression were used for statistical analysis. MVBFs were age and gender related (P<0.05). Males showed a significant increase in bite force between 15 and 18 years of age (P=0.002), but gender differences were significant only in the 18-year-olds (P=0.003). In subjects with a neutral occlusion, MVBF could best be predicted using multiple regression from age and gender. The regression model accounted for 31.3 percent of the variance in MVBF (P=0.031), with gender contributing 17.9 percent and age 7.9 percent. Morphological occlusion, jaw function, and BMI explained the remaining 5.5 percent of variance. While controlling for all other parameters, the independent contribution of gender to the prediction of MVBF was 16.2 percent, age 6 percent, number of occlusal contacts 3.2 percent, and BMI 1.3 percent.

Introduction: Improved facial esthetics can be fully achievable only if facial preferences of the treated group are known. We hypothesized that facial profile perception and preferences could be influenced by orthodontic treatment., Methods: Differences in facial profile preferences between children with and without an orthodontic history were investigated in a sample of 1626 children aged 12 to 19 years (mean age, 14.8 ± 2.2 years) from 24 public schools in Zagreb, Croatia, randomly selected by using a cluster sampling procedure. Eight profile distortions for each sex, morphed by a digital imaging technique, were used for estimation. Analysis of variance (ANOVA), Bonferroni, and 2 independent sample t tests were used to compare the preferences of the groups., Results: A straight profile was the most favored in both sexes, regardless of previous orthodontic history. A bimaxillary alveolar protrusive profile with thicker lips was preferred among the female profiles, and a bimaxillary retrusive profile with flat lips and a prominent chin was preferred among the male profiles. Orthodontic history and personal facial profile had little effect, and sex had a slightly greater influence on personal facial profile preferences., Conclusions: It seems that orthodontic therapy has no clinically relevant influence on facial profile preferences. Depending on the patient's sex, orthodontists should have different criteria for treating borderline patients with bimaxillary dentoalveolar protrusion and mandibular prognathism., (Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Objective: To test the hypothesis that no differences exist in dental arch dimensions between dentoalveolar Classes I, II, and III, and between male and female subjects, as measured on virtual three-dimensional (3D) models., Materials and Methods: Samples included randomly selected plaster dental casts of 137 white patients (43 Class I, 50 Class II, and 44 Class III) from the Department of Orthodontics, School of Dental Medicine, University of Zagreb, Croatia. Dental models were scanned and digitized using ATOS II SO ("Small Objects") scanning technology (GOM mbH, Braunschweig, Germany). Eight linear and two proportional measurements were calculated for both upper and lower dental arches., Results: In men, a significant difference in the upper dental arch was present in the incisor region, and in the lower dental arch, differences were found in intercanine and intermolar widths (P < .05). Significant differences were noted between male groups in the upper molar depth dimension (P = .022) and in the lower molar and canine depth dimensions (P < .05). Class III males had the greatest lower molar and canine width/depth ratios and the smallest lower canine depth/molar depth ratio. Class III women had wider and shorter mandibular arches when compared with Class I and Class II females., Conclusion: The hypothesis was rejected. The dimensions of the dental arches are related to gender and to dentoalveolar class. Class I and II subjects have similar dimensions of maxillary dental arch, but Class II subjects have a transverse deficit in the mandible. In Class III subjects, the maxillary dental arch is insufficient in transverse and sagittal dimensions, and the mandibular arch dominates in the transverse but not in the sagittal dimension.

Summary: Patients' and parents' perception of malocclusion are important in determining orthodontic treatment demand, motivation, and cooperation. The aim of this study was to investigate differences in perception of treatment need in currently orthodontically treated, previously treated, and untreated subjects. The sample comprised 3196 children and adolescents (1593 males and 1603 females) aged 8-19 years (mean age 13.0 +/- 3.6 years) from 24 randomly selected public schools in Zagreb, Croatia. Objective treatment need was assessed clinically using the Dental Aesthetic Index (DAI). Subjective treatment need was estimated separately by an orthodontic resident, the child/adolescent and his/her parent using the Standardized Continuum of Aesthetic Need (SCAN) procedure. The children/adolescents completed a questionnaire that had five questions with five-point Likert-type scale answers concerning satisfaction with dental appearance, importance of teeth for facial appearance, and malocclusion-related quality of life. Spearman correlation and logistic regression were used for statistical analysis. Associations between objective and subjective orthodontic treatment need were weak but statistically significant (Rho from 0.20 to 0.50; P < 0.05). Malocclusion-related quality of life was poorly associated with treatment need. Satisfaction with tooth appearance showed the most frequent statistically significant correlation (Rho from -0.14 to -0.35; P < 0.05), while importance of aligned teeth for facial appearance and social contacts had the weakest correlation with treatment need. Perception of treatment need was greater in previously treated subjects. Parents' perception had a low predictive value. The findings of this study show that malocclusion has more impact on emotional well-being than on function or social contacts.

This study is concentrated on the lower face profile, the emphasis being given to the lips and chin area which have been analysed by various proportions. A sample consisted of 110 subjects (52 males and 58 females) with good soft tissue profile, dental class I and Caucasian type. All the records were taken in the natural head position (NHP) and all measurements were performed using the computer and by the same operator. Using the photographs of the facial profile, seven vertical measurements were taken and seven indices used to determine the relationships between measurements of the lower third of the face, lower lip, chin and upper lip. Almost all the vertical profile measurements were greater in males than in females. The only variables with no gender differences were lower (Li-Sto) and upper vermilion heights (Ls-Sto). The largest portion of the lower face was occupied by the chin and the smallest by the lower lip height in both genders. All indices were greater in females except (IND7) representing chin/lower third of the face proportion, which was greater in males. Some acknowledged aesthetic guidelines must be followed when determining orthodontic plan for optimal aesthetics. The proportional relationships found in our sample are a valuable contribution and might serve as a template for vertical facial analysis of the lower face in this patient population.

The aim of this study was to determine the development of the mandibular third molar and its relation to chronological age. The evaluated material consisted of 979 orthopantomograms of patients of Croatian Caucasian origin aged between 5.7 and 14.6 years. Third molar developmental stages were evaluated according to the stages proposed by Nolla. The frequencies of different stages of mineralization and the mean value of the mineralization of the mandibular third molars with regard to age, gender, and size of the mandible were determined and the coefficient of correlation determined between the age of the subject and the stage of development of the mandibular molars. Statistically significant correlation was determined between mineralization of the mandibular third molar and chronological age of the subjects (boys, mandibular left third molar r = 0.779, right third molar r = 0.793; girls, mandibular left third molar r = 0.746, right third molar r = 0.725). It can be concluded that the accuracy of age estimation based on Nolla's method is applicable for Croatian children.

The aim of this study was to determine the presence of third molar germs in patients with Class II/2 and Class III malocclusions. The study comprised 146 examinees from Zagreb and Istria. Examinees with Class II/2 malocclusions amounted to 77 and those with Class III 69. With regard to development of dentition the examinees were divided into two groups: Group I subjects with early mixed dentition (23 subjects with Class II/2 and 21 subjects with Class III), and Group II subjects with late mixed dentition (54 subjects with Class II/2 and 48 subjects with Class III). Assessments were made from panoramic radiographs and lateral cephalograms. The Pearson chi2-test and Fisher's exact test was used to determine statistical significance in differences. Assessments showed that third molar germs were present significantly more often in the upper jaw in Class II/2 (58% vs. 44%) and in the lower jaw in Class III (83% vs. 69%). In subjects with Class II/2 all third molar germs were present statistically more often in late mixed dentition, which was also determined for maxillary third molar germs in Class III. The presence of mandibular third molar germs in Class III examinees was almost equal in both periods of mixed dentitions. The study confirmed correlation between the presence of third molar germs and sagital maxillomandibular relationship and encourages investigation of the differences in calcifications of all permanent teeth in such malocclusions.

The aim of the study was to establish a mathematical classification of normal soft tissue profile by cluster analysis based on linear and angular photogrammetric measurements.The sample consisted of 110 subjects, 52 males (mean age, 28.7 y) and 58 females (mean age, 25.7 y), with good and balanced soft tissue profile and dental class 1 occlusal relationship and were white. The measurements were made with standardized photographic records taken in natural head position.The 39 soft tissue variables (27 linear and 12 angular) were classified according to similarity by cluster analysis. Males and females were separated in an effort to identify representative values for each group. The squared Euclidean distance was used for distance measurement, and the Ward method was used for cluster analysis. Measurement variables for cluster analysis were standardized using z score. Four recognizable types of soft tissue profiles were obtained in both sexes, which differ mostly with regard to the position of the lips and prominence of the chin. This study found a highly significant sex dimorphism in the soft tissue profile, presenting that the form difference is both a size and a shape difference between male and female soft tissue profiles. The lower third of the face expressed most of the sex differences.

Objective: To examine the effects of three different parameters-pH value, type of archwire, and length of immersion-on release of metal ions from orthodontic appliances., Materials and Methods: Simulated fixed orthodontic appliances that corresponded to one-half of the maxillary arch were immersed in artificial saliva of different pH values (6.75 +/- 0.15 and 3.5 +/- 0.15) during a 28-day period. Three types of archwires were used: stainless steel (SS), nickel-titanium (NiTi), and thermo NiTi. The quantity of metal ions was determined with the use of a high-resolution mass spectrophotometer (HR-ICP/MS)., Results: The release of six different metal ions was observed: titanium (Ti), chromium (Cr), nickel (Ni), iron (Fe), copper (Cu), and zinc (Zn). Repeated measures statistical analysis of variance (ANOVA) was used. Results showed that (1) the appliances released measurable quantities of all ions examined; (2) the change in pH had a very strong effect (up to 100-fold) on the release of ions; and (3) the release of ions was dependent on wire composition, but it was not proportional to the content of metal in the wire. The largest number of ions was released during the first week of appliance immersion., Conclusion: Levels of released ions are sufficient to cause delayed allergic reactions. This must be taken into account when type of archwire is selected, especially in patients with hypersensitivity or compromised oral hygiene.

The aim of this study was to assess the differences in eruption of permanent teeth (C, P1, P2 and M2) in a group of children with and without malocclusion. A sample of 1758 children (921 boys and 837 girls), aged 8-13 was randomly selected. The subjects were grouped by chronological age (11 groups) and by presence of malocclusion. Statistically significant differences were found for both, upper and lower canines in the age group 11 (p<0.01). Statistically significant difference was found in the age group 8.5 for upper first (p<0.05), upper second premolars (p<0.01) in the age group 10, and the lower second premolars in the age group 11 (p<0.05). Premature loss of deciduous teeth caused early eruption of succedaneus permanent teeth, possibly leading to development of a malocclusion.

Purpose: The purpose of this study was to examine the correlation between variables that determine the position of the third molar (M3) and correlation between the pattern of facial growth and examined variables., Materials and Methods: Material for the study consisted of 130 panoramic radiographs and lateral radiographs of subjects' heads in whom orthodontic therapy had been started. Analysis of the position of the mandibular M3 and its relation to the bone and other teeth were determined by 4 variables: evaluation of the space for both M3, spatial relation between the second molar and M3, vertical position of the M3 in relation to the alveolar ridge, and inclination of the germ of the M3., Results: In boys, significant correlation was determined on the right side of the jaw, between the retromolar area and the vertical position of M3. Significant correlation was determined in girls, between the retromolar area and the vertical position of M3 on both sides, retromolar area and M3 inclination on the left side, and retromolar area and spatial relation of M3 on the right side. Analysis of correlation between facial growth pattern and 4 variables that determinate the position of M3 showed positive correlation only for the lower right M3 inclination in subjects with anterior facial rotation., Conclusion: The present study showed that the amount of retromolar space for the position of the M3 is not a sign of its normal development. No significant differences were determined between the position of M3 and type of facial growth.

This study was carried out on 40 lateral cephalograms of Croatian subjects aged 12 to 15 years with dental and skeletal class I. The purpose of this investigation was to determine the means and standard deviations of the soft tissue parameters in the sample of Croatian population exhibiting dental and skeletal class I and to find the correlations between investigated parameters. The investigation included a total of 11 variables of which 4 were angular and 7 linear. Linear and angular measurements were made to the nearest 0.5 mm or 0.5 degree with dial calipers and a standard protractor with 0.5 degree increments. Data from this investigation could serve to determine the norms of 11 soft tissue variables for Croatian population with dental and skeletal class I, and to define craniofacial morphology of the soft tissue profile in patients with normal occlusion. Significant correlations were found between thickness of upper and lower lip, and between the distance of upper and lower lip to the Ricketts esthetic line, and Holdaway angle.

An aesthetically pleasing and balanced face is one of the objectives of orthodontic treatment. An understanding of the soft tissues and their normal ranges enables a treatment plan to be formulated to normalize the facial traits for a given individual. The aim of this study was to evaluate the variables defining the soft tissue facial profile of a Croatian (Caucasian) sample, by means of angular measurements typically used for aesthetic treatment goals. Additionally, gender differences were tested. The soft tissue facial profiles of 110 dental students (52 males and 58 females) between 23 and 28 years of age at the University of Zagreb, Croatia, with a dental Class I occlusal relationship and harmonious soft tissue profile were studied by means of standardized photographs taken in the natural head position (NHP). To compare males and females, a Student's t-test was used. The reliability of the method was analysed using Dahlberg's formula. There were distinct gender differences. All angles were larger in females: nasofrontal (G-N-Nd, females = 139.11 degrees; males 136.38 degrees; P = 0.030), nasolabial (Cm-Sn-Ls, females = 109.39 degrees; males = 105.42 degrees; P = 0.018), mentolabial (Li-Sm-Pg, females = 134.5 degrees; males = 129.26 degrees; P = 0.019), and nasal tip angle (N-Prn-Cm, female = 84.12 degrees; male = 79.85; P = 0.001). The greatest variability was found for mentolabial angle. The findings demonstrate a distinct profile trait for female Croatian patients compared with male subjects.

One hundred and ten subjects (52 males and 58 females) between 23-28 years of age with dental Class I occlusal relationship, good soft tissue profile, and Caucasian ethnicity were selected from the population of dental students at the University of Zagreb, Croatia. The soft tissue facial profiles were digitally analyzed using linear (11 vertical and 14 horizontal) measurements made with standardized photographic records, taken in natural head position, to determine average soft tissue facial profile for males and females. The application of Student t-test showed gender dimorphism in most parameters of the labial, nasal. and chin areas. Almost all vertical variables were larger in the males, except the length of the nasal tip, which was larger in females. In the height of the vermilion, no gender dimorphism was observed. The females exhibited shallower labial sulci than the males and their chins were at least as prominent as those of the males. This study showed that male chins are not absolutely more prominent than female chins, but only appear to be such because their labial sulci are deeper.

The purpose of this study was to investigate dental arch changes that occurred during the mixed dentition in 30 normal occlusion children. Two analyses were done. The first one was at the age of early mixed dentition and the second at the age of late mixed dentition. Most width variables were greater in the males, and depth variables greater in the female subjects. A directionally larger left side of the maxilla and right side of the mandible were observed. Our findings indicate that most arch width dimensions are established in the early mixed dentition. We conclude that the period between the early and late mixed dentition is suitable for environmental factors to disrupt the ideal symmetrical developmental pattern because more growth and developmental changes occur after a relatively stabile period of deciduous dentition.

The finite element method is a useful technique for measuring structural stress and for movement analyses. The objective of this investigation was to get a more accurate estimation of tooth movement depending on application point when a tipping orthodontic force is applied. The three-dimensional model of un upper canine, consisting of 4,000 hexahedron elements with 2,367 nodes was obtained. Horizontal, orally directed 1N tipping orthodontic force was applied to the model on five different levels of the tooth crown. The three-dimensional mathematical finite element model is useful in analyzing the tooth movement in response to orthodontic forces. The tipping tooth movement is greater if the force is applied closer to its neck, or more gingivally.

After orthodontic brackets debonding, the remaining resin has to be removed. The purpose of this study was to determine the most efficient method as well as to introduce a new method of composite removal. The study was carried out on a sample of 30 premolars, extracted for orthodontic purposes. Brackets had been bonded using the Ortho One Bisco composite resin. After the removal of brackets, samples were randomly divided into three groups of ten. Composite remnants in the first group were removed using the Band Driver (KaVo). For the second group, the tungsten carbide bur (Komet) was applied. In the third group, composite remnants were removed manually, using adhesive removing pliers (ORMCO). The samples were analysed using a light-stereomicroscope (Olympus). Photomicrographs were examined and the ARI (Adhesive Remnant Index) was calculated. Post Hoc tests (Scheffe, Tukey) indicated a statistically significant difference between groups 1 and 2 as well as between groups 1 and 3. The tungsten carbide bur was found to be the most efficient instrument for composite remnant removal.

This paper presents a preliminary orofacial analysis of a subadult population of Hvar, a Croatian island in the Adriatic. Its population represents one of the last genetic isolates in Europe and has therefore been the object of intensive crossdisciplinary research over the last 30 years. We focussed on the coefficient of endogamy on the one hand and malocclusal-related caries on the other hand, and expected differences in the latter between subgroups of the population. We analyzed 224 dental casts from children all over the island and found multiple caries in approximal surfaces in 55 percent of the children, but no significant differences between the subpopulations. Instead, significantly more caries affection was found in the boys than in the girls. The percentage of general caries affection is fairly high, even when compared to other isolated populations; it may be due to environmental influence. This would be consistent with the other results, which have putatively been caused by complex environmental influences and not solely by genetic components.

In contemporary orthodontic treatment, the extraction of a premolar is frequently indicated, followed by canine retraction with bodily movement. The main problem is how to prevent the mesial movement of first molars (loss of anchorage) and loss of the space obtained by extraction. The aim of the study was to evaluate the anchorage capacity of posterior teeth using SW (straight wire) appliances after extraction of first premolars and to determine Goshgarian transpalatal arch as anchorage reinforcement. All experiments were recorded by video-camera, and the analogue signal has been digitized and saved on PC. Computer animation visualised the direction and the amount of tooth movement. Very significant loss of anchorage was found (in the control experiment), when molars and premolars were reinforced. No significant difference between the active and non-active transpalatal arch has been perceived in the sense of lateral anchorage stabilization.

CADIA can only be performed on geometrically standardized images converted in Al equivalents. The aim of this study was to develop the ability of the new CADIA software to quantify bone density on dental radiographs without previous standardization. A total of 36 examines with periradicular lesions were treated surgically, the defects were filled with Hydroxylapatite and followed up for 1, 6, and 12 months. Before and after surgery the operated areas were clinically evaluated using intraoral radiographs, tooth mobility index and relapses. Clinical results revealed satisfactory bone healing in 27 cases and relapses in 9 cases. The radiographs were then digitized with a high resolution CCD camera. Densitometric analysis was done in 10 points at the edge of the bone defect. Correction of geometric and brightness distortions was done with mathematical manipulation from three referral points positioned at the same place on each radiograph. Density values observed no bone loss in 23 cases and loss of bone in 13 cases. The differences between clinical evaluation and CADIA were not statistically significant.

The aim of this study was to determine the prevalence of third molars in children in Istria aged 7 to 18. The study was performed on 2350 panoramic radiographs of children in Istria that have been analysed and then divided into 7 age groups. Each of these groups consisted of the same number of boys and girls. It has been found that the development of third molars starts earlier in the mandible, and that before the age of 12 there are more third molars in the mandible than in the maxilla (p < 0.01). Nine-year old girls have statistically significantly more third molars than the boys of that age, but twelve year old boys have more than the girls. The differences in the prevalence of third molars between the jaw sides was statistically significant only for mandibles of twelve year old girls. Hypodontia of third molars has been found in 4.5% of boys and 5.8% of girls aged 14 to 18.

The aim of the present study was to determine whether changes in the endocrinologic status occur in patients with progressive forms of periodontal disease and, if so, what their role is. For this purpose the function of hypophysis, concentration of pituitary and accessory gland hormones, parathormone, calcium, phosphorous, glucose and lipids in blood were determined. The study was carried out in 77 subjects, 37 patients with advanced periodontal disease, and 40 control subjects with normal periodontium. Blood glucose was significantly lower in the study group (p < 0.01%) which was surprising, since increased glucose values are known to favor the development of periodontal disease. Growth hormone was significantly lower in the study group (p < 0.01%). Concentrations of parathormone calcium and phosphorous were also lower in the study group. Among sex hormones, only estradiol was found to have a significantly lower value in the study group (p = 0.92%). Although the values of nearly all hormones were within the reference range, the within-group analysis showed significant differences for some hormones. In general, these results were lower in subjects with advanced periodontal disease.

The aims of this study were to determine if there is an increased incidence of respiratory diseases in patients with Angle Class II/1 skeletal intermaxillary relationship in comparison to eugnathic patients and if there is a difference of body height and weight between them. The sample consisted of 60 eugnathic subjects and 88 subjects with Class II/1. Girls were examined at an age of 6, 7, 8, 10, 13 and 14 and boys at an age of 7, 8, 9, 11, 14 and 15. All subjects underwent an orthodontic and medical examination in these time intervals. Data about their respiratory diseases as well as those about their height and weight were taken from their medical files in school dispensaries and were statistically analyzed. No statistically significant differences with regard to the frequency of respiratory diseases were found between eugnathic subjects and those with Class II/1. In almost all investigated time intervals subjects with Class II/1 were statistically significantly higher than the eugnathic subjects, but only in the 8-years old male group with Class II/1 the subjects were heavier than others. The results of this study suggest that patients with Class II/1 either have a faster growth pattern or belong to an asthenic constitution type.

The aim of this study was to establish prevalence of hypodontia in the twin sample and to assess the degree of its heritability. A study was performed in a sample of 96 twin pairs, 38 pairs being monozygotic (MZ) and 58 pairs dizygotic (DZ), from north-west Croatia. The sample included 25.82% of all twins born in the region during a ten-year period. The twin zygosity was determined according to the WHO recommendations (1996). A revised Holzinger's index (Hc') according to Allen was applied to calculate the degree of heritability. Hypodontia was found in 22 out of the total of 192 twins analyzed (11.5%). Among 96 pairs of twins, hypodontia was observed in 17 pairs (7 MZ and 10 DZ pairs). Among the MZ, 4 pairs were found to be concordant for hypodontia, among the DZ one pair only. The heritability index was 0825. A prevalence of hypodontia in twins observed in this study is significantly higher than in the general population. A high index of heritability (Hc' = 0.825) points to a high genetic determination.