Dentalni strah u djece s ponovljenom traumom zuba

Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years. Subjects in both age groups were divided into subroups without dental trauma, with one dental trauma and with repeated dental trauma. The validated Children’s Fear Survey Schedule – Dental Subscale was used on fear assessment. Results showed that only 12.2% of children without trauma, 33.3% with one trauma and 51.7% with repeated trauma were not afraid of injection. Older children had a significantly lower fear of injections, touch of an unknown person, choking, going to the hospital and people in white uniforms. Dentist was not the cause of fear in 65.5% of patients with repeated trauma. With each repeated injury of teeth, the degree of their fear of dental treatment was lower.Ozljede zubi su ozbiljno kliničko stanje. Neka djeca doživljavaju dentalne traume samo jednom, dok su druga sklonija ozljedama i ponavljanju trauma zubi. Ponovljene traume zuba javljaju se u 19,4% do 30% bolesnika. Bol i trauma zuba su najčešći razlozi straha i tjeskobe. Glavni cilj ovoga istraživanja bio je ispitati kako zubna trauma utječe na pojavu i razvoj dentalnog straha. Istraživanje je provedeno na slučajnom uzorku od 147 ispitanika (88 djevojčica i 59 dječaka) u dobi od 5-8 i 9-12 godina. Ispitanici u obje dobne skupine podijeljeni su u tri poskupine: bez dentalne traume, s jednom dentalnom traumom i s ponovljenom dentalnom traumom. U procjeni straha korišten je validirani test Children’s Fear Survey Schedule – Dental Subscale test. Starija djeca su imala značajno niži stupanj straha od injekcija, dodira nepoznate osobe, gušenja, odlaska u bolnicu i ljudi u bijelim uniformama. Strah od stomatologa nije imalo 65,5% djece s ponovljenom traumom. Samo 12,2% djece bez trauma, 33,3% s jednom i 51,7% s ponovljenom traumom se ne boje injekcije. Sa svakom ponovljenom ozljedom zuba stupanj njihovog straha od stomatološkog liječenja je manji

Učinkovitost liječenja niskoenergetskim laserom u sindromu pekućih usta – probno istraživanje

The aim of this clinical study was to compare low-level laser therapy (LLLT) switched on and switched off in the treatment of burning mouth syndrome (BMS). BMS is a debilitating condition for patients and highly demanding for physicians, characterized by burning symptoms in the oral cavity. Despite extensive research, so far only cognitive behavioral therapy and clonazepam have been proven successful for its treatment in randomized controlled trials. Forty-four patients with BMS were randomly assigned to the study laser group (LLLT) or the sham laser group. LLLT was performed with the GaAlAs laser (830 nm) used in non-contact mode on the site in the mouth where burning symptoms were present; study patients received 10 sessions (10 days). Each participant fi lled out the visual analog scale (VAS) and oral health impact on the quality of life scale (OHIP-CRO 14) before and after either therapy protocol. Th ere were no signifi cant diff erences between the groups before and after LLLT (switched on and off ) in the quality of life (OHIP CRO 14 scores) (p>0.05). There was signifi cant decrease in pain symptoms (VAS) in both LLLT switched on and LLLT switched off groups (p0,05). Utvrđeno je značajno smanjenje simptoma boli (VAS) u objema skupinama liječenim laserom (upaljen i ugašen) (p<0,05). Upaljen i ugašen laser je doveo do smanjenja simptoma boli u bolesnika s SPU, doduše, niti jedan način liječenja laserom (upaljen ili ugašen) nije doveo do poboljšanja rezultata utjecaja oralnog zdravlja na kvalitetu života

Utjecaj lokalnih i sistemskih čimbenika na neuspjeh dentalnih implantata - analiza 670 pacijenata s 1260 implantata

The etiopathogenesis of dental implant failure is multifactorial and may include numerous local and systemic factors, however, studies including both local and systemic factors are still lacking. Therefore, the aim of this study was to evaluate whether periodontal disease, oral hygiene index, i.e. bleeding on probing (BOP), full mouth plaque index (FMPI), smoking, systemic diseases, as well as implant characteristics (length and diameter) affect failure of implant-prosthodontic therapy. Data on 670 patients were retrieved in whom 1260 dental implants had been placed and followedup for at least five to ten years. Categorical data were analyzed by the χ2-test, whereas Mann-Whitney test was used for continuous variables (age, BOP and FMPI). The values of p<0.05 were considered significant. The effect of local and systemic factors on the success of implant-prosthodontic therapy was assessed by multiple logistic regression analysis. Forty-five (6.7%) patients had systemic diseases, of which diabetes mellitus was most common, followed by atherosclerosis, diabetes and atherosclerosis, diabetes mellitus type 1, lymphoma, and hepatitis C. One-third (33.4%) of the patients were smokers. Periodontal disease was present in 170 patients, while 500 patients were without periodontal disease. Nine implants were lost during the period of five years. There were no differences regarding the type of implant or type of connection to the prosthetic suprastructure. However, most of these patients had a periodontal disease. There were no significant differences in dental implant failure rates between smokers and non-smokers or between patients with and without systemic diseases. Furthermore, the results of this study showed that implant type (straight vs. tapered) and type of connection with prosthodontic appliance (cemented or screw retained) did not affect BOP and FMPI. In smokers, significant improvement of BOP and FMPI was noticed. Initially, smokers had a significantly worse BOP (0.0037) when compared to non-smokers; however, there were no differences regarding FMPI (p=0.4218) between the two groups. In patients with periodontal disease, improvement of BOP and FMPI was seen at 5-year follow-up and no significant differences were found when compared to patients without periodontal disease. There were no significant differences in BOP and FMPI between patients with and without diabetes at 5-year follow-up. Atherosclerosis had a significant negative effect on BOP, but not on FMPI at 5-year follow-up. It is concluded that periodontal disease had a significant impact on the implant-prosthodontic therapy.Etiopatogeneza neuspjeha vezanog uz implantoprotetsku terapiju je multifaktorijalna i može uključivati brojne lokalne i sistemske čimbenike, iako još uvijek nedostaju istraživanja na tu temu. Stoga je cilj ovoga istraživanja bio ustanoviti utječe li prisutnost prijašnje parodontne bolesti, stupanj oralne higijene odnosno krvarenje pri sondiranju (KPS) i plak cijele usne šupljine (PCUŠ), pušenje, sistemske bolesti, kao i same značajke dentalnih implantata (veličina, tip) na neuspjeh implantoprotetske terapije. Analizirani su podaci za 670 pacijenata kojima je ugrađeno 1260 dentalnih implantata i koji su praćeni tijekom najmanje pet godina. U statističkoj obradi primijenjen je program Medcalc. Kategorički podatci obrađivani su χ2-testom. Kontinuirane varijable (dob, KPS, PCUŠ) nisu bile normalnih distribucija te su stoga analizirane neparametrijskim Mann-Whitneyjevim U testom. Vrijednosti p<0,05 smatrane su značajnima. Rezultati ovoga istraživanja su pokazali kako je 9 implantata bilo izgubljeno, pri čemu nije bilo značajne razlike u tipu implantata ili načinu pričvršćenja protetske suprastrukture. Ipak, zanimljivo je da je većina pacijenata imala parodontnu bolest. Nadalje, nije bilo značajne razlike između pušača i nepušača u odnosu na gubitak implantata. Nije bilo značajnih razlika s obzirom na sistemske bolesti ovih bolesnika. Nadalje, rezultati ovoga istraživanja su pokazali kako tip implantata (konični odnosno cilindrični) i vrsta fiksacije protetskog nadomjestka na implantat (cementirani ili vijkom fiksirani) nije imao značajnog utjecaja na KPS ili PCUŠ. Kod pušača koji su ujedno imali i značajno lošije inicijalno stanje KPS (0,0037) od onih koji nisu pušili, u svim slučajevima došlo je do poboljšanja KPS i PCUŠ, no za PCUŠ to nije bilo značajno (p=0,4218). U bolesnika s parodontnom bolesti došlo je do poboljšanja KPS i PCUŠ nakon 60 mjeseci praćenja te nije bilo razlika u odnosu na osobe koje nisu imale bolest parodonta. Također, nije bilo značajnih razlika u KPS ili PCUŠ između osoba s dijabetesom i onih bez dijabetesa nakon petogodišnjeg praćenja. Ateroskleroza je imala značajan negativan utjecaj na KPS, ali ne i na PCUŠ, nakon pet godina praćenja. Može se zaključiti kako je jedino parodontitis imao značajan utjecaj na neuspjeh implantoprotetske terapije

Oralni lihen panus i oralna lihenoidna reakcija - novosti

Oral lichen planus (OLP) and oral lichenoid reaction (OLR) are clinically and histopathologically similar diseases. Whereas OLP is a consequence of T cell mediated autoinflammatory process to a still unknown antigen, OLR might be caused by drugs, dental restorative materials and dental plaque. Pubmed was searched and 24 publications published over the last three years regarding etiology, diagnosis and malignant alteration were included in this study. Patients with OLR who have amalgam fillings near lesions should have them replaced, i.e. when possible they should be referred to patch test, as well as when drug-induced OLR are suspected. OLR lesions induced by drugs should disappear when the offending drug has been discontinued. Histology finding in OLR consists of more eosinophils, plasma cells and granulocytes in comparison to OLP lesions. Furthermore, OLP lesions showed more p53, bcl-2 and COX-2 positivity when compared to OLR. OLP is characterized by infiltration, atrophic epithelium, rete pegs and Max Joseph spaces, while deep infiltration into connective tissue and hyperkeratosis were the criteria for making the diagnosis of OLR. The number of degranulated mastocytes in the reticular layer, as well as the number of capillaries was higher in OLR in comparison to OLP. It seems that OLR are more prone to malignant alteration in comparison to OLP.Oralni lihen planus (OLP) i oralna lihenoidna reakcija (OLR) su dvije klinički i patohistološki slične bolesti. OLP je posljedica autoimunog procesa koji je posredovan T limfocitima na još uvijek nepoznati antigen, a OLR može biti uzrokovana lijekovima, dentalnim materijalima i dentalnim plakom. Cilj je ovoga preglednog rada bio istražiti Pubmed te su uključena 24 rada koja su publicirana u posljednje tri godine, a s obzirom na etiologiju, dijagnostiku i malignu alteraciju ovih bolesti. Oboljeli od OLR koji u blizini lezija imaju amalgame trebaju ih zamijeniti kompozitnim ispunima, odnosno kad je moguće treba ih uputiti na patch test, kao i onda kada se sumnja da je OLR uzrokovana lijekovima. OLR uzrokovane lijekovima trebale bi se povući kada osoba prestane uzimati suspektni lijek. Patohistološki nalaz u OLR se sastoji od više eozinofila, plazma stanica i granulocita u usporedbi s lezijama kod OLP. Nadalje, lezije OLP imaju više pozitivnih nalaza p53, bcl-2 i COX-2 u usporedbi s lezijama OLR. OLP obilježava infiltracija, atrofični epitel, zupci pile i Max Josephovi prostori, dok OLR karakterizira dublja infiltracija u vezivno tkivo i hiperkeratoza. Broj degranuliranih mastocita u retikularnom sloju, kao i broj kapilara je veći u OLR u usporedbi s OLP. Čini se kako su OLR sklonije malignoj alteraciji u odnosu na OLP

Presentation of DMF Index in Croatia and Europe

Karijes je najčešća oralna bolest svih dobnih skupina i glavni je uzročnik gubitka zuba. Iako je u svijetu zabilježen pad u njegovoj prevalenciji, u mnogim zemljama i dalje je glavni oralnozdravstveni problem. Svrha: Ovim se radom željelo prikazati kretanje vrijednosti KEP/kep indeksa u Hrvatskoj i usporediti ga s europskim zemljama te predstaviti planove usmjerene prema promicanju oralnoga zdravlja i smanjenju prevalencije karijesa. Materijal i metode: Podatci o KEP indeksu prikupljeni su pretraživanjem internetskih baza podataka od 1985. do 2015. godine. Rezultati: Hrvatska se ubraja u europske zemlje s visokim KEP indeksom među dvanaestogodišnjacima (4, 18). Iskustva zemalja s malim KEP-om pokazala su da je karijes moguće kontrolirati edukacijom i preventivnim aktivnostima, što u konačnici rezultira smanjenjem sveukupnih financijskih troškova na individualnoj i nacionalnoj razini te poboljšanjem općega zdravlja i kvalitete života. Zaključak: Praćenje i nadzor oralnoga zdravlja, odnosno dentalnog karijesa, zahtijeva u sustavu bolje prikupljanje podataka o njegovoj prevalenciji, utvrđivanje multifaktorijalnih uzroka u njegovu nastanku te provedbu nacionalnih preventivnih programa.Dental caries is the most common oral disease affecting all age groups and a major cause of tooth loss. Although a decrease in the prevalence of dental caries has been marked across the globe, in many countries it has remained a major oral-health problem. Aim: The objective of this paper was to show the trends in the DMF index in Croatia, compare it with European countries and present further courses of action oriented towards promotion of oral health and decrease in caries prevalence. Material and Methods: The DMF index databases have been generated based on online database searches for the period from 1985 to 2015. Results: Croatia is one of European countries with a high DMF index relating to 12-year old children (4.18). The experience of countries with a low DMF index has shown that dental caries can be controlled through education and prevention activities, which eventually lead to diminished financial costs, at individual and national level, improving overall health and quality of life. Conclusion: Tracking and monitoring of oral health i.e. dental caries need to be improved in terms of creation of data base systems on the prevalence of dental caries, determining multi-factorial causes of its occurrence and with respect to the implementation of national oral-health prevention programs

Stanje uhranjenosti i kvaliteta prehrane u bolesnika s nealkoholnom bolešću masne jetre

Non-alcoholic fatty liver disease (NAFLD) is becoming a major health burden with increasing prevalence worldwide due to its close association with the epidemic of obesity. Currently there is no standardized pharmacological treatment, and the only proven effective therapeutic strategy is lifestyle modification, therefore it is important to determine the potential dietary targets for the prevention and treatment of NAFLD. We assessed nutritional status in 30 patients diagnosed with NAFLD using anthropometric parameters, hand grip strength, and lifestyle and dietetic parameters (physical activity, NRS2002 form and three-day food diary). The mean body mass index was 29.62±4.61 kg/m2, yielding 86.67% of obese or overweight patients. Physical activity results indicat-ed poorly active subjects. Excessive energy intake was recorded in 27.78% of patients. The mean in-take of macronutrients was as follows: 15.5% of proteins, 42.3% of carbohydrates and 42.2% of fat, with ­deficient micronutrient intake of calcium, magnesium, iron, zinc, and vitamins A, B1 and B2. The ­results showed that the quality of nutrition in study subjects was not accordant to current rec-ommendations and that they consumed a high proportion of fat, especially saturated fatty acids, along with low micronutrient intake. The results obtained might point to the importance of unbalanced diet as a contributing factor in NAFLD development.Nealkoholna bolest masne jetre (NAFLD) postaje velik zdravstveni problem s povećanom učestalosti u svijetu zbog bliske povezanosti s epidemijom pretilosti. Kako zasad ne postoji standardizirano farmakološko liječenje i jedina dokazana učinkovita terapijska strategija je promjena načina života, važno je odrediti potencijalne prehrambne ciljeve za prevenciju i liječenje NAFLD. Procijenili smo nutritivni status 30 bolesnika s dijagnosticiranim NAFLD primjenom antropometrijskih parametara, mjerenjem snage ruke dinamometrom i dijetetskim parametrima (tjelesna aktivnost, upitnik NRS 2002 i tro­dnevni dnevnik prehrane). Srednja vrijednost indeksa tjelesne mase bila je 29,62±4,61 kg/m2 s 86,67% bolesnika koji su bili prekomjerne tjelesne mase ili pretili. Rezultati tjelesne aktivnosti pokazuju da su ispitanici bili slabo aktivni. Prekomjerni energetski unos u odnosu na dnevne potrebe imalo je 27,78% bolesnika. Prosječan dnevni unos makronutrijenata je iznosio: 15,5% proteina, 42,3% ugljikohidrata i 42,2% masti s nedostatnim unosom sljedećih mikronutrijenata: kalcij, magnezij, ­željezo, cink, vitamini A, B1 i B2. Rezultati istraživanja pokazuju da kvaliteta prehrane naših ispitanika nije bila u skladu s aktualnim preporukama i da su konzumirali velike količine masti, pogotovo zasićenih masnih kiselina s niskim unosom ­mikronutrijenata. Dobiveni rezulatati bi mogli ukazati na ulogu nepravilne prehrane kao važnog čimbenika razvoja NAFLD-a

Visoka učestalost neliječene i nedovoljno liječene deficijencije i insuficijencije vitamina D u bolesnika s upalnim bolestima crijeva

Inflammatory bowel disease (IBD) patients with vitamin D deficiency show an increased risk of hospital admission, surgery, and loss of response to biologic therapy while high vitamin D levels are identified as a protective factor. Our goal was to investigate the prevalence of untreated and undertreated vitamin D deficiency and factors associated with vitamin D deficiency. In this cross-sectional study, we measured serum vitamin D in a random sample of Caucasian IBD patients. Vitamin D deficiency was defined as <50 nmol/L and insufficiency as 50-75 nmol/L. Supplementation was defined as taking 800-2000 IU vitamin D daily. Untreated patients were defined as not taking supplementation and undertreated group as receiving supplementation but showing vitamin D deficiency or insufficiency despite treatment. Our study included 185 IBD patients, i.e. 126 (68.1%) with Crohn’s disease (CD) and 59 (31.9%) with ulcerative colitis (UC). Overall, 108 (58.4%) patients had vitamin D deficiency and 60 (32.4%) patients vitamin D insufficiency. There were 16 (14.8%) and 11 (18.3%) treated patients in vitamin D deficiency and vitamin D insufficiency group, respectively. The rate of untreated patients was 81.7% (n=49) in vitamin D deficiency group and 85.2% (n=92) in vitamin D insufficiency group. Tumor necrosis factor alpha inhibitors were associated with higher serum vitamin D levels in CD and UC, and ileal involvement, ileal and ileocolonic resection with lower levels. In conclusion, not only is vitamin D deficiency common in IBD patients but the proportion of untreated and undertreated patients is considerably high. We suggest regular monitoring of vitamin D levels in IBD patients regardless of receiving vitamin D supplementation therapy.Bolesnici s upalnim bolestima crijeva (inflammatory bowel disease, IBD) i manjkom vitamina D su pod povećanim rizikom hospitalizacije, operacije i gubitka odgovora na biološku terapiju, dok visoke serumske razine vitamina D predstavljaju zaštitni čimbenik. Cilj ove studije bio je istražiti učestalost neliječenih i nedovoljno liječenih bolesnika s IBD i manjkom vitamina D te čimbenike rizika. U ovoj presječnoj studiji mjerene su serumske razine vitamina D u slučajnom uzorku bolesnika s IBD bijele rase. Deficijencija je definirana kao razine <50 nmol/L, a insuficijencija kao 50-75 nmol/L. Nadoknada vitamina D je definirana kao uzimanje 800-2000 IJ vitamina D na dan. Neliječeni bolesnici su oni bez nadoknade, a nedovoljno liječeni oni s deficijencijom ili insuficijencijom usprkos nadoknadi. Uključeno je ukupno 185 bolesnika s IBD, tj. 126 (68,1%) s Crohnovom bolešću i 59 (31,9%) s ulceroznim kolitisom. Ukupno je 108 (58,4%) bolesnika imalo deficijenciju, a 60 (32,4%) insuficijenciju. Udio liječenih bolesnika s deficijencijom i insuficijencijom vitamina D iznosio je 14,8% (n=16) i 18,3% (n=11). Udio neliječenih s deficijencijom iznosio je 81,7% (n=49), a s insuficijencijom 85,2% (n=92). Terapija inhibitorima faktora tumorske nekroze alfa bila je povezana s višim razinama vitamina D. Niže razine vitamina D su zabilježene kod bolesnika s upalom u području ileuma i resekcijom ileuma ili ileokolona. U zaključku, niske serumske razine vitamina D su česta pojava kod bolesnika s IBD, a dodatno je udio neliječenih i nedovoljno liječenih također visok. Naša preporuka je kontinuirano praćenje razina vitamina D u serumu svih bolesnika s IBD uključujući i one na nadoknadi vitaminom D

Duboke infekcije vrata

Duboke infekcije vrata su infekcije koje mogu obuhvatiti nekoliko vratnih prostora. Danas su rjeđe u odnosu na preantibiotsko doba, a najčešći uzroci su širenje infekcije od zuba, žlijezda slinovnica, krajnika, trauma ili je pak uzrok infekcije strano tijelo. Klinička slika često ne mora biti tipična, te dijagnostički postupak i liječenje ponekad predstavljaju izazov za kliničare, a od velikog su značaja zbog moguće brze progresije i razvoja životno ugrožavajućih komplikacija. Cilj ovih smjernica za kliničku praksu je pomoći liječnicima u ujednačavanju pristupa bolesnicima s dubokim infekcijama vrata. Opisani su relevantni uzroci, dijagnostički i terapijski postupak. One uzimaju u obzir dokaze iz više izvornih znanstvenih članaka iz dostupne medicinske literature, oslanjajući se pri tome na naše dugogodišnje iskustvo

NEW TECHNIQUES AND PROSPECTS IN INVASIVE TREATMENT IN VERTEBROLOGY

U članku su obrađene novosti i perspektive u invazivnom liječenju u vertebrologiji s naglaskom na interventne i poluinvazivne postupke te minimalno invazivnu kirurgiju u liječenju hernije intervertebralnog diska slabinske kralježnice. Osim toga opisane su novosti u neuroablativnim postupcima u liječenju križobolje, fiksaciji kralježnice i operativnom liječenju skolioza. Članak se osvrće i na metode koje se još ne primjenjuju kod nas, a koje dosta obećavaju kao što su rekonstrukcije nukleusa pulpozusa transplantacijom autolognih hondrocita, a prikazane su najnovije spoznaje u kirurgiji vratne kralježnice. Upozoreno je na uspješnost svake pojedine kirurške metode liječenja. Osim što je informativan, zajedno s odgovarajućim člankom o patofiziologiji spinalne boli, magnetskoj rezonanciji i konzervativnom liječenju ovaj tematski članak o najnovijim spoznajama u tom području može pomoći u pristupu bolesnicima.In this article authors outline new techniques and prospects in invasive treatment in vertebrology with emphasis on interventional and semi invasive procedures and minimally invasive surgery for lumbar disc herniation. They describe new approaches in neuroablative procedures for back pain treatment, in spinal fixation and in surgical treatment of scoliosis. Authors also report methods of great expectations which are not yet in use in our clinical practice but are promising like reconstruction of nucleus pulposus by autologous chondrocytes transplantation. New methods in cervical spine surgery are also discussed. The efficacy of each surgical method is pointed out. Apart from being informative, together with the corresponding article on patophysiology, magnetic resonance imaging and conservative treatment, these articles considering recent developments can be used as an aid in decision making when approaching these patients

NEW TECHNIQUES AND PROSPECTS IN INVASIVE TREATMENT IN VERTEBROLOGY

U članku su obrađene novosti i perspektive u invazivnom liječenju u vertebrologiji s naglaskom na interventne i poluinvazivne postupke te minimalno invazivnu kirurgiju u liječenju hernije intervertebralnog diska slabinske kralježnice. Osim toga opisane su novosti u neuroablativnim postupcima u liječenju križobolje, fiksaciji kralježnice i operativnom liječenju skolioza. Članak se osvrće i na metode koje se još ne primjenjuju kod nas, a koje dosta obećavaju kao što su rekonstrukcije nukleusa pulpozusa transplantacijom autolognih hondrocita, a prikazane su najnovije spoznaje u kirurgiji vratne kralježnice. Upozoreno je na uspješnost svake pojedine kirurške metode liječenja. Osim što je informativan, zajedno s odgovarajućim člankom o patofiziologiji spinalne boli, magnetskoj rezonanciji i konzervativnom liječenju ovaj tematski članak o najnovijim spoznajama u tom području može pomoći u pristupu bolesnicima.In this article authors outline new techniques and prospects in invasive treatment in vertebrology with emphasis on interventional and semi invasive procedures and minimally invasive surgery for lumbar disc herniation. They describe new approaches in neuroablative procedures for back pain treatment, in spinal fixation and in surgical treatment of scoliosis. Authors also report methods of great expectations which are not yet in use in our clinical practice but are promising like reconstruction of nucleus pulposus by autologous chondrocytes transplantation. New methods in cervical spine surgery are also discussed. The efficacy of each surgical method is pointed out. Apart from being informative, together with the corresponding article on patophysiology, magnetic resonance imaging and conservative treatment, these articles considering recent developments can be used as an aid in decision making when approaching these patients