Oralna higijena adolescenata u Hrvatskoj tijekom terapije fiksnim ortodontskim napravama: presječna studija

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 sredstav

The influence of exposure to social networks on perception of smile among specialists, dentists, students, and laypeople

Cilj ovoga istraživanja jest proučiti razlike u percepciji doktora i specijalista dentalne medicine, odnosno studenata i laika s obzirom na male varijacije u estetici osmijeha i proučiti koliki je utjecaj sadržaja društvenih mreža na percepciju osmijeha kod specijalista i doktora dentalne medicine, studenata i laika. U prvom dijelu istraživanja sudjelovalo je 680 ispitanika, od čega 21,7 % muškaraca i 78,83 % žena, koji su pomoću Googleova obrasca, ocjenama od 1 (najmanje atraktivno) do 10 (najatraktivnije) vrednovali fotografije lica i osmijeha, digitalno alterirane kako bi se naglasili proučavani parametri. Ispitanici su bili podijeljeni u 5 skupina: laici, studenti dentalne medicine od prve do treće godine studija, studenti dentalne medicine od četvrte do šeste godine studija, doktori dentalne medicine te specijalisti. Mjesec dana nakon ispunjavanja ankete ispitanici su podijeljeni u kontrolnu i ispitnu skupinu. Ispitna skupina pratila je profil na Instagramu- na kojem su dva puta dnevno tijekom 7 dana objavljivane fotografije lijepoga osmijeha, dok kontrolna skupina nije bila izložena istom. Po prolasku 7 dana, obje skupine ispunile su istu anketu još jednom. Nakon analize demografskih podataka, razlike u ocjenjivanju pojedine anomalije između skupina ispitanika testirane su KruskalWallisovim testom, a kako bi se uvidjelo između kojih sve skupina postoji razlika primijenio se Dunnov post hoc test. Razlike između ocjena savršene slike osmijeha i svake pojedine anomalije unutar skupina testirale su se Wilcoxonovim testom uparenih uzoraka. U drugom dijelu istraživanja usporedba ocjena anomalija između eksperimentalne i kontrolne skupine napravila se u početnoj točki mjerenja te točki mjerenja 30 dana nakon izloženosti dentalnom sadržaju na društvenoj mreži uz pomoć Mann-Whitneyjeva U-testa, a razlika u odgovorima na test između početne točke mjerenja i nakon izloženosti savršenom sadržaju na društvenim medijima unutar pojedinih skupina testirala se Wilcoxonovim testom uparenih uzoraka. Osim toga uz pomoć Mann-Whitneyjeva U-testa testirala se razlika u iznosu postotne promjene između ispitne i kontrolne skupine. Percepcija različitih parametara osmijeha razlikuje se među skupinama ispitanika, a sadržaj društvenih mreža može utjecati na percepciju osmijeha, što je najvidljivije u percepciji incizalnih ureza i samopercepciji osmijeha.Introduction: Nowadays, creating a beautiful smile is considered an art for a reason. Esthetic criteria are based on individual perception, which differs among people of different cultures, ages, education, and genders. An attractive smile should include symmetry of the central incisors, minimally visible gingiva, moderate or minimal buccal corridors, a smile arch that follows the curvature of the lower lip, and the correct shape of the gingival margin in the area of visible teeth. Although we learn to apply these principles in our daily work during our education, it is very difficult to apply them if they are not quantified and supported by scientific research. Many studies have been conducted to examine the perception of smiles in dental specialists or doctors, and laypeople. Such studies examined parameters such as displacement of the maxillary midline, mesiodistal inclination of the incisors, displacement of the mandibular midline in relation to the upper, smile arch, size of the buccal corridors, the form of the gingival margin of the maxillary anterior teeth, and visibility of the gingiva when smiling. In addition to dentofacial and dentogingival parameters, the smile evaluation should also include parameters related to the shape and size of the teeth, such as interincisal edges, incisal step, and the presence of diastemas or so called "black triangles". The perception of these among specialists, doctors of dental medicine, and laypeople differ- specialists are more critical and notice minor anomalies earlier. It is necessary to know which parameters affect the esthetics of the smile and to see the differences in the perception of it among specialists, doctors of dental medicine, students, and laypeople within our population in order to implement this scientific data in clinical work. The very experience of beauty is also influenced by media visual stimuli to which we are exposed every day. Studies involving television content have shown that watching short commercials can change women's perception of their own appearance. Social networks have become an indispensable part of our lives. Instagram is a social network replete with visual stimuli, either in the form of photos or in the form of short videos, which can influence the expectations of patients undergoing orthodontic or prosthetic treatment. Previous research shows that the content younger population is exposed to on social networks affects their demands regarding dental esthetics, and this is statistically more significant in the female population. In the existing literature, there is not enough data on the extent to which such content, placed by professional dental staff or persons who are not medically educated, affects the perception of smiles among the population. Aim: To examine the differences in the perception of doctors and specialists in dental medicine, students, and laypeople with regard to small variations in the esthetics of a smile, and to investigate the influence of social network content on the perception of a smile among specialists and doctors of dental medicine, students, and laypeople. Participants and method: In the first part of this study, 680 respondents participated, of which 21.7% were men and 78.83% were women. They evaluated photos of faces and smiles that were digitally altered to emphasize different study parameters. The respondents were divided into 5 groups: laypeople, students of dental medicine from the first to the third year of study, students of dental medicine from the fourth to the sixth year of study, doctors of dental medicine, and specialists. One month after completing the survey, the respondents were divided into a control group and an experimental group. The total number of respondents who agreed to participate in the second part of the research is 360 (174 in the experimental group, 186 in the control group). The experimental group followed an Instagram profile, on which photos of beautiful smiles were posted twice a day, for 7 days, while the control group was not exposed. After the broadcasting of images on Instagram, both groups completed the same survey a second time. After the analysis of demographic data, the differences in the assessment of a particular anomaly between the groups of subjects were tested with the Kruskal-Wallis test, and in order to see in which groups there is a difference, Dunn's post hoc test was applied. Differences between the ratings of the perfect smile image and each individual anomaly within the groups were tested by the Wilcoxon paired-samples test. In the second part of the research, a comparison of anomaly scores between the experimental and control groups was made at the initial point of measurement and at the point of measurement 30 days after exposure to dental content on the social network with the help of the Mann-Whitney U-test, while the difference in test responses between the initial point of measurement and after exposure to perfect content on social media within individual groups was tested using the Wilcoxon paired-samples test. In addition, with the help of the Mann-Whitney U-test, the difference in the amount of percentage change between the test and control groups was tested. Results: The perception of maxillary midline deviation in the amount of 2 mm, mandibular midline deviation in the amount of 3 mm, inclination of incisors, occlusal cant, reversed smile line, asymmetry of maxillary central incisors, rounded and squared incisal embrasures, nonexistent incisal step along with self-perception differs between groups of respondents. The experimental group rated the rounded incisal embrasures with lower esthetic scores compared to the control group that was not exposed to images on the social network Instagram. In those exposed to Instagram (experimental group), laypeople showed significantly greater satisfaction with their own smile after exposure to social network content, whereas no such difference was found in the control group. Conclusion: The perception of different parameters of a smile differs between groups of respondents, and the content of social media content may influence the perception of a smile, most visibly with regard to incisal embrasures and self-perception of a smile

The influence of exposure to social networks on perception of smile among specialists, dentists, students, and laypeople

Cilj ovoga istraživanja jest proučiti razlike u percepciji doktora i specijalista dentalne medicine, odnosno studenata i laika s obzirom na male varijacije u estetici osmijeha i proučiti koliki je utjecaj sadržaja društvenih mreža na percepciju osmijeha kod specijalista i doktora dentalne medicine, studenata i laika. U prvom dijelu istraživanja sudjelovalo je 680 ispitanika, od čega 21,7 % muškaraca i 78,83 % žena, koji su pomoću Googleova obrasca, ocjenama od 1 (najmanje atraktivno) do 10 (najatraktivnije) vrednovali fotografije lica i osmijeha, digitalno alterirane kako bi se naglasili proučavani parametri. Ispitanici su bili podijeljeni u 5 skupina: laici, studenti dentalne medicine od prve do treće godine studija, studenti dentalne medicine od četvrte do šeste godine studija, doktori dentalne medicine te specijalisti. Mjesec dana nakon ispunjavanja ankete ispitanici su podijeljeni u kontrolnu i ispitnu skupinu. Ispitna skupina pratila je profil na Instagramu- na kojem su dva puta dnevno tijekom 7 dana objavljivane fotografije lijepoga osmijeha, dok kontrolna skupina nije bila izložena istom. Po prolasku 7 dana, obje skupine ispunile su istu anketu još jednom. Nakon analize demografskih podataka, razlike u ocjenjivanju pojedine anomalije između skupina ispitanika testirane su KruskalWallisovim testom, a kako bi se uvidjelo između kojih sve skupina postoji razlika primijenio se Dunnov post hoc test. Razlike između ocjena savršene slike osmijeha i svake pojedine anomalije unutar skupina testirale su se Wilcoxonovim testom uparenih uzoraka. U drugom dijelu istraživanja usporedba ocjena anomalija između eksperimentalne i kontrolne skupine napravila se u početnoj točki mjerenja te točki mjerenja 30 dana nakon izloženosti dentalnom sadržaju na društvenoj mreži uz pomoć Mann-Whitneyjeva U-testa, a razlika u odgovorima na test između početne točke mjerenja i nakon izloženosti savršenom sadržaju na društvenim medijima unutar pojedinih skupina testirala se Wilcoxonovim testom uparenih uzoraka. Osim toga uz pomoć Mann-Whitneyjeva U-testa testirala se razlika u iznosu postotne promjene između ispitne i kontrolne skupine. Percepcija različitih parametara osmijeha razlikuje se među skupinama ispitanika, a sadržaj društvenih mreža može utjecati na percepciju osmijeha, što je najvidljivije u percepciji incizalnih ureza i samopercepciji osmijeha.Introduction: Nowadays, creating a beautiful smile is considered an art for a reason. Esthetic criteria are based on individual perception, which differs among people of different cultures, ages, education, and genders. An attractive smile should include symmetry of the central incisors, minimally visible gingiva, moderate or minimal buccal corridors, a smile arch that follows the curvature of the lower lip, and the correct shape of the gingival margin in the area of visible teeth. Although we learn to apply these principles in our daily work during our education, it is very difficult to apply them if they are not quantified and supported by scientific research. Many studies have been conducted to examine the perception of smiles in dental specialists or doctors, and laypeople. Such studies examined parameters such as displacement of the maxillary midline, mesiodistal inclination of the incisors, displacement of the mandibular midline in relation to the upper, smile arch, size of the buccal corridors, the form of the gingival margin of the maxillary anterior teeth, and visibility of the gingiva when smiling. In addition to dentofacial and dentogingival parameters, the smile evaluation should also include parameters related to the shape and size of the teeth, such as interincisal edges, incisal step, and the presence of diastemas or so called "black triangles". The perception of these among specialists, doctors of dental medicine, and laypeople differ- specialists are more critical and notice minor anomalies earlier. It is necessary to know which parameters affect the esthetics of the smile and to see the differences in the perception of it among specialists, doctors of dental medicine, students, and laypeople within our population in order to implement this scientific data in clinical work. The very experience of beauty is also influenced by media visual stimuli to which we are exposed every day. Studies involving television content have shown that watching short commercials can change women's perception of their own appearance. Social networks have become an indispensable part of our lives. Instagram is a social network replete with visual stimuli, either in the form of photos or in the form of short videos, which can influence the expectations of patients undergoing orthodontic or prosthetic treatment. Previous research shows that the content younger population is exposed to on social networks affects their demands regarding dental esthetics, and this is statistically more significant in the female population. In the existing literature, there is not enough data on the extent to which such content, placed by professional dental staff or persons who are not medically educated, affects the perception of smiles among the population. Aim: To examine the differences in the perception of doctors and specialists in dental medicine, students, and laypeople with regard to small variations in the esthetics of a smile, and to investigate the influence of social network content on the perception of a smile among specialists and doctors of dental medicine, students, and laypeople. Participants and method: In the first part of this study, 680 respondents participated, of which 21.7% were men and 78.83% were women. They evaluated photos of faces and smiles that were digitally altered to emphasize different study parameters. The respondents were divided into 5 groups: laypeople, students of dental medicine from the first to the third year of study, students of dental medicine from the fourth to the sixth year of study, doctors of dental medicine, and specialists. One month after completing the survey, the respondents were divided into a control group and an experimental group. The total number of respondents who agreed to participate in the second part of the research is 360 (174 in the experimental group, 186 in the control group). The experimental group followed an Instagram profile, on which photos of beautiful smiles were posted twice a day, for 7 days, while the control group was not exposed. After the broadcasting of images on Instagram, both groups completed the same survey a second time. After the analysis of demographic data, the differences in the assessment of a particular anomaly between the groups of subjects were tested with the Kruskal-Wallis test, and in order to see in which groups there is a difference, Dunn's post hoc test was applied. Differences between the ratings of the perfect smile image and each individual anomaly within the groups were tested by the Wilcoxon paired-samples test. In the second part of the research, a comparison of anomaly scores between the experimental and control groups was made at the initial point of measurement and at the point of measurement 30 days after exposure to dental content on the social network with the help of the Mann-Whitney U-test, while the difference in test responses between the initial point of measurement and after exposure to perfect content on social media within individual groups was tested using the Wilcoxon paired-samples test. In addition, with the help of the Mann-Whitney U-test, the difference in the amount of percentage change between the test and control groups was tested. Results: The perception of maxillary midline deviation in the amount of 2 mm, mandibular midline deviation in the amount of 3 mm, inclination of incisors, occlusal cant, reversed smile line, asymmetry of maxillary central incisors, rounded and squared incisal embrasures, nonexistent incisal step along with self-perception differs between groups of respondents. The experimental group rated the rounded incisal embrasures with lower esthetic scores compared to the control group that was not exposed to images on the social network Instagram. In those exposed to Instagram (experimental group), laypeople showed significantly greater satisfaction with their own smile after exposure to social network content, whereas no such difference was found in the control group. Conclusion: The perception of different parameters of a smile differs between groups of respondents, and the content of social media content may influence the perception of a smile, most visibly with regard to incisal embrasures and self-perception of a smile

The Influence of Social Network Content on the Perception of Smiles—A Randomized Controlled Trial

Background: This randomized trial’s objective was to investigate the impact of social network content on the perception of smiles among specialists, doctors, students of dental medicine, and laypeople. Method: A sample of 360 respondents was shown 7 digitally altered photographs of smiles (85.63% female, 14.37% male). Dental specialists, dentists, dental students (first to third year and fourth to sixth year), and laypeople made up the sample. Respondents were asked to rank the images on a scale of 1 to 10, starting with the least appealing and moving up to the most attractive, using a Google Form. Respondents were divided into experimental and control groups at the end of the following month by random selection. The experimental group followed an Instagram profile posting two images of beautiful smiles for seven days, while the control group received no intervention at all. Both groups then completed the same questionnaire again. The comparison of esthetic scores between the experimental and control group was performed using the Mann–Whitney U-test and the difference in test responses between the starting point of the measurement and after exposure to perfect content on social media within individual groups was tested with the Wilcoxon paired-samples test. When comparing the absolute difference of scores, the Mann–Whitney U-test and the Kruskal–Wallis test were used. Results: Respondents in the experimental group rated the rounded embrasures of the incisors with lower esthetic scores compared to the control group that was not exposed to images on the Instagram social network. In those exposed to Instagram (experimental group), laypeople showed significantly greater satisfaction with their own smile after the exposure to Instagram, whereas no such difference was present in the control group. Conclusions: The content of social networks potentially has an influence on smile perception, most visible in the perception of incisal embrasures and self-perception of smile

Utjecaj asimetričnoga položaja ruba gingive središnjih maksilarnih sjekutića na percepciju osmijeha specijalista, doktora i studenata dentalne medicine te laika

Objective: To evaluate the perceptions of altered incisor gingival position among dental specialists, dentists, dental students, and laypeople. Material and methods: Four digital smile photographs with altered gingival margin position of the right maxillary incisor (0, 1, 2, and 3 mm) were presented to a sample of 232 respondents (71.1% female; 28.9% male): 42 dental specialists, 63 dentists, 33 dental students (1 st to 3 rd year), 38 dental students (4 th to 6 th year) and 56 laypeople. The questionnaire consisted of four randomly displayed photographs, administered via Google Form, and respondents were asked to rate the images on a scale from 1 to 5, from the least attractive to the most attractive. A statistical analysis was performed using the TIBCO Statistica program (v. 13.3. 0, TIBCO Software Inc., Palo Alto, CA, USA; 2017). According to the Shapiro- Wilk’s test, the data were not distributed normally. The Kruskal-Wallis test with post hoc multiple comparisons with the Bonferroni adjustment were used to compare group esthetic scores and to determine the threshold levels of deviation at which each group was discriminated between esthetic and non-esthetic situations. Results: Median values of esthetic scores decreased in all groups as the gingival asymmetries increased. Dental professionals were significantly more critical of esthetics than laypeople in all levels of asymmetry. The greatest difference was found for 2 mm of gingival asymmetry (p=0.002). Conclusion: From the results of our study, we can conclude that the perception of gingival asymmetries in the esthetic zone of smile differs among dental specialists, doctors, students, and laypeople. Dental specialists, doctors, and clinical students were more critical of these asymmetries, while preclinical students and laypeople noticed only 2 mm or more of gingival asymmetry of central incisors.Svrha rada: Ispitati percepciju asimetričnoga položaja gingive među specijalistima, doktorima i studentima dentalne medicine te laicima. Materijali i metode: Četiri fotografije osmijeha s izmijenjenom razinom gingive desnoga središnjega gornjega sjekutića (0, 1, 2 i 3 mm) pokazane su uzorku od 232 ispitanika (71,1 % žena i 28,9 % muškaraca). Među njima su bila 42 specijalista dentalne medicine, 63 doktora dentalne medicine, 33 studenta dentalne medicine od 1. do 3. godine studija, 38 studenata dentalne medicine od 4. do 6. godine studija te 56 laika. Upitnik, u obliku Googleova obrasca, sadržavao je četiri nasumično poredane fotografije koje su ispitanici ocjenjivali ljestvicom od 1 (najmanje atraktivno) do 5 (najviše atraktivno). Statistička analiza učinjena je u programu TIBCO Statistica (v.13.3.0, TIBCO Software Inc, Palo Alto, CA, SAD; 2017). Rezultati Shapiro-Wilkova testa pokazali su da podatci ne prate normalnu razdiobu. Kruskal-Wallisov test s višestrukim post hoc testiranjima, koji su uključili i Bonferronijevu prilagodbu, primijenjeni su za usporedbu estetskih ocjena i za određivanje granice pri kojoj su određene devijacije prihvatljive ispitnim skupinama. Rezultati: S porastom iznosa gingivalne asimetrije, srednje vrijednosti estetskih bodova (ocjena) padaju u svim ispitnim skupinama. Ispitanici s dentalnim obrazovanjem bili su značajno kritičniji u ocjenjivanju svih stupnjeva asimetrije. Najveća razlika utvrđena je za asimetriju u iznosu od dva milimetra (p = 0,002). Zaključak: Rezultati studije pokazuju da se percepcija gingivalne asimetrije u estetskoj zoni osmijeha razlikuje između specijalista, doktora, studenata dentalne medicine i laika. Specijalisti, doktori i studenti dentalne medicine viših godina kritičniji su prema navedenim asimetrijama, a studenti nižih godina i laici primjećuju tek gingivalnu asimetriju središnjih sjekutića od dva milimetra