Diabetes in the context of dental treatment in an interdisciplinary approach

Instroduction:  Diabetes, including its numerous complications, is one of fundamental challenges of modern medicine. Over the years, many types of this disease have been appointed, differing in both etiological background and method of treatment. Dentists, when providing dental care to a patient burdened with diabetes, should pay special attention to the first symptoms reported by the patient as well as manifested in the oral cavity and surrounding tissues, e.g. in the form of xerostomia, hypertrophy of the salivary glands, changes on mucous membranes, impeded healing, or difficulties in combating local inflammation and infections, as well as in the form of physiological microflora disorders. Aim of the study: The aim of the study is to emphasize the need for controlling diabetes for the sake of general and oral health. Materials and methods: Our work is mainly based on the articles published in PubMed, websites or medical books. We were looking for keywords such as ‘diabetes’, ‘dental treatment’, ‘symptoms of diabetes’ or ‘oral cavity diseases’. Results: Diabetes is often manifested by changes in the oral cavity, as evidenced by numerous scientific studies presented in the bibliography. Controlling the disease helps to eliminate lowering quality-of-life general symptoms and oral lesions. Conclusions: Faced with the challenges of modern medicine, the dentist is obliged to inform the patient about the diagnostic and therapeutic possibilities of both diabetes itself and its symptoms occurring in the oral cavity and then take all steps to ensure that the patient's condition is stabilised

The analysis of the oral hygiene habits among Polish children

Introduction: The frequency of dental caries among Polish children is higher than in surrounding high development countries at comparable latitude. To reduce the prevalence of the carries required is sufficient level knowledge and oral regimen maintaining habits among both - children and their parents. This article is a questionnaire-based analysis of oral hygiene practice among school-aged children. Material and methods: The single-choice survey was performed on 76 children between 7 and 16 years old, living in the Upper Silesia region of Silesian Voivodeship in Poland. Responders have been divided into three groups (group A - 7-9 years old children, group B - 10-12 years old, group C - over 13 years old). Questionnaire for groups A and B contained 14 questions, while one for children from group C - 12. Results: The results of the survey indicate insufficient intentness of children in processes of keeping proper hygiene in the oral cavity and lacking involvement of parents in the control of oral hygiene of children. The overhead translates into in the future for increased caries presence among Polish children

Interpretative Phenomenological Analysis for the Comparison of Polish and Foreign Dentistry Students’ Concerns during the Covid-19 Pandemic

Introduction: At the beginning of 2020, the worldwide infection of coronavirus (SARS-CoV-2) changed many aspects of human lives. The controlled lockdown was not only an obligatory lifestyle change to communities across the globe, but it was also an emotional struggle. The aim of the presented study was to identify and compare the main difficulties that final-year students (both Polish and foreigners) of Dentistry, Faculty of Medical Sciences in Zabrze Medical University of Silesia had to cope with during the first wave of the pandemic. Application of the biographical method in the form of essays written was done. Authors discussed the following issues: possible losses and benefits subjectively felt by individuals due to the COVID-19 pandemic, adaptation to online type of studying, students’ opinions regarding change of habits, and psychological impact of the lockdown. Students’ responses varied between groups in the aspect of what they considered as the biggest struggle of the pandemic time period. Adaptation to e-learning was easier for the group of foreign students. The Polish group considered it as a serious stress factor. Foreigners were much more worried about not being able to help their families in comparison to Polish students. Polish students’ fear was related to the fear of virus transmission to their older relatives. Both groups were aware of how serious the situation was and of the possible impact of lack of practical classes on their future internships. As benefits of that situation, both groups listed development of new hobbies and increased sport activities. The Polish group emphasized improvement of interpersonal bonds during the lockdown in their families. The main conclusion proved an awareness of the seriousness of the situation in which students of medical, especially dental faculties found themselves. Concerns were related to the form of further studies and the possibility of taking up employment after graduation. Polish students declared more intense concerns about e-learning and remote study than foreign-language students who were more familiar with this form of communication. A particularly valuable form of teaching for students may be increased numbers of online consultations, since even though they cannot replace practical classes, they may still be helpful in explaining doubts and simply “being there”. Encouraging young people to discover constructive benefits of the pandemic can also be one of a task-oriented strategies of help

Oral cavity status of long-term hemodialized patients vs. their socio-economic status

BackgroundThe chronic kidney disease, blood hypertension and diabetes are recognized as civilization diseases that affect more and more people. The probability of encountering a patient suffering from these diseases is increasing. As such, it appears crucial to better understand the specific dental needs of such groups of patients. The aim of the work was to assess the oral hygiene status and the needs of patients suffering from the end-stage chronic kidney disease, arterial hypertension or/and diabetes.Material and MethodsTwo hundred and twenty eight patients were included in the research. One hundred and eighty patients were hemodialized in Diaverum dialysis stations and 48 patients were from the Conservative Dentistry with Endodontics Clinic of the Academic Centre of Dentistry in Bytom, Silesian Medical University in Katowice, and from the Dentistry Division of the Arnika Clinic in Zabrze, and were not not diagnosed with any of the diseases mentioned. The research scheme was divided into 3 parts, consisting of an analysis of the general health socio-economic status, a survey and an assessment of oral health.ResultsThe patients who were not suffering from any of the discussed diseases were more aware of how to properly perform hygienic procedures. Most of the patients from both the control and examined groups were not using any rinsing solutions. A higher percentage of patients in the control group was using dental floss, changing their toothbrush every 3 months and brushing their teeth for ≥2 min. The Aproximal Plaque Index and the Oral Hygiene Index-Simplified values in the control group were significantly lower in comparison to the examined group.ConclusionsThe socio-economic status of hemodialized patients was low, which in most cases was a result of the difficulties in starting a job. Due to the lower standards of life, the neglect of oral hygiene maintenance and its consequences could be observed

Periodontal Treatment Needs of Hemodialized Patients

End-stage renal failure is the reason for complications in many systems and organs, and the applied pharmacotherapy often causes the deepening of already existing pathologies within the oral cavity, such as: caries, periodontal diseases, mucosal lesions or reduced saliva secretion. Reduced saliva secretion results in an increased accumulation of dental plaque, its mineralization and prolonged retention, which leads to the development of gingival and periodontal inflammation. There is some evidence that chronic kidney diseases are influenced by periodontal health. The aim of the work was to evaluate the dental needs by the usage of clinical assessment of periodontal tissues of patients suffering from end-stage chronic kidney disease, arterial hypertension or/and diabetes mellitus. Material and methods: 228 patients underwent the research. 180 patients were hemodialized in Diaverum dialysis stations (42 of them were diagnosed with end stage chronic disease, 79 with the end stage chronic disease and arterial hypertension, 16 with end stage chronic kidney disease and diabetes, 43 with end-stage chronic disease, arterial hypertension and diabetes) and 48 patients of the Conservative Dentistry with Endodontics Clinic of Academic Centre of Dentistry of Silesian Medical University in Bytom and patients of the dentistry division of Arnika Clinic in Zabrze not diagnosed with any of the aforementioned diseases. The scheme of the research comprised 2 parts: analysis of the general health and assessment of the periodontal status which contain the following indices: Periodontal Probing Depth (PPD), Clinical Attachment Lost (CAL), Bleeding Index or Bleeding on Probing Index (BI or BOP), Community Periodontal Index for Treatment Needs (CPITN). Results: Significantly lower percentage of patients with healthy periodontal tissues and higher percentage with periodontal pockets deeper than 3.5 mm and the loss of trainers connective of 5 mm or higher were in the examined group. The values of the bleeding index were significantly lower in control group. The analysis of the CPITN index indicates higher percentage of patients qualified as CPI 1 or 2 in the control group while in the examined one most of the patients turned out to require specialist periodontal treatment. Conclusions: there is a direct relationship between periodontal status and end-stage renal disease which typically includes other chronical civilization ailments. It is important to develop a scheme for the easy and rapid examination of periodontal status, to determine the treatment needs in this area, which will allow precise assignment of long-term dialyzed patients to the range of prophylactic and therapeutic procedures

The Radiological Assessment of Root Features and Periodontal Structures in Endodontically Treated Teeth Subjected to Forces Generated by Fixed Orthodontic Appliances. A Prospective, Clinical Cohort Study

The various side effects of orthodontic treatment with fixed orthodontic appliances (FOAs) and their impact on apical and periodontal structures have been widely reported. However, the existing data is not yet conclusive. Aims and objectives: To investigate the status of roots and periodontium in endodontically treated teeth that have undergone orthodontic treatment with the use of FOAs and to evaluate their impact on apical/periodontal structures. Material and methods: The prospective clinical cohort study initially involved 69 participants aged 16–40, without underlying systemic conditions, who received orthodontic treatment with ligatureless FOA systems due to different types of mild and moderate malocclusions. To meet the required criteria, 88 teeth in 34 patients were assessed clinically and radiologically. Participants had at least one tooth treated endodontically while the corresponding tooth from the same anatomical group on the opposite side was vital and intact (a ‘split-mouth’ approach). Four cohorts were allocated: Group IA consisted of 15 teeth, treated utilising the principles of modern endodontics, that were subjected to orthodontic forces no less than six months after completing the root canal obturation. Group I consisted of 13 similarly endodontically treated teeth, which commenced orthodontic treatment at least six months after the completed endodontic therapy. Group II contained 16 teeth treated by conventional endodontic methods and the control group, Group III, contained 44 clinically and radiologically intact teeth (incisors and premolars) with vital and sound dental pulp. The response of apical and periodontal structures to FOAs was determined by data collected from intraoral periapical radiographs taken within the course of five consecutive appointments during the orthodontic treatment. Results: No statistically significant differences were observed in susceptibility to FOA-induced external apical root resorption (EARR) between combined Groups IA + IB and II. An association was, however, demonstrated, between the occurrence of EARR and the degree of expansion of the periodontal ligament (PDL) space, regardless the method of root canal treatment. Cumulative data revealed a positive correlation between the width of the PDL space and the stage of FOA treatment (the third and the fourth appointment). The subtle changes in radiological length of roots have been observed (min 0 mm/max 0.38 mm), particularly between the second and third appointment in Group II (p < 0.05). Conclusions: The standard orthodontic therapy with FOAs is a safe option with predictable outcome for persons who have recently received endodontic therapy. The anterior teeth, predominantly incisors, were more susceptible to minimal EARR than premolars, which suggests that the rate of EARR occurrence may depend upon the original morphology of the apical portion of the root. The use of additional orthodontic forces increases the risk of EARR and is associated with a higher incidence of radiologically detected PDL space widening

Oral Mucosa Status and Saliva Parameters of Multimorbid Adult Patients Diagnosed with End-Stage Chronic Kidney Disease

There has been an increasing number of patients diagnosed with chronic diseases. Many of those diseases determine changes in patients’ social and even professional life. The aim of the present work was to analyze saliva and oral mucosa parameters in adult patients diagnosed with chronic diseases. A total of 228 patients took part in the research. A total of 180 patients were hemodialyzed in Diaverum dialysis stations, and there were 48 patients from the Conservative Dentistry with Endodontics Clinic of the Academic Centre of Dentistry of Silesian Medical University in Bytom and patients from the dentistry division of the Arnika Clinic in Zabrze not diagnosed with any such diseases. Selected saliva parameters (secretion, pH and buffer capacity) and mucosa status were examined. In order to obtain information regarding xerostomia, patients were given a questionnaire. Patients assigned to the control group rarely used water to make swallowing easier or used candies to lessen the feeling of oral cavity dryness. They also rarely suffered from eye dryness. The feeling of dryness also did not influence their social life. The amount of produced saliva was higher in the control group. There was a significantly lower percentage of patients with a low buffer capacity of saliva. There were no differences in terms of saliva pH values between the two groups of patients. A significantly lower number of patients were diagnosed with ecchymosis, candidiasis, scrotal tongue and mechanical damages. Patients diagnosed with chronic diseases need to be provided with long-term care

Magnetic Resonance Imaging for Assessment of Endodontic Instruments’ Precision during “L-Shaped” Model Root Canals Preparation

The purpose of the mechanical root canal preparation is to clean it and give it the right shape. The preparation should be carried out in a way that maintains the original curvature and initial orientation of the apical end. Insufficient root canal preparation may prevent effective chemical decontamination and obturation to the full working length. The study aims to evaluate the shaping ability and effectiveness of the NiTi rotary and reciprocating endodontic instruments, compared to standard hand files using magnetic resonance imaging based on spin echo. Material and methods: A comparative study of severely curved root canals’ shaping abilities using three NiTi systems and K-type hand files was performed, with 40 training “endo-blocks” presenting with “L-shaped” canal. The root canal topography and geometry “before” and “after” mechanical preparation obtained by the magnetic resonance imaging based on the spin echo was used. The main measurement was made using the RARE sequence, with slice thickness reduced to 100 micrometers. In order to improve the signal-to-noise ratio, NA = 25 was used. To minimize the measurement time, the field of view was limited to a cuboid 17 × 16 × 3 mm, with a resolution of 33 × 31 × 100 micrometers. Each 3D image consisted of 512 × 512 × 30 voxels. The imaging plane has been selected in such a way as to fully illustrate the course of curvature of the model root canal. For TR = 5 s and effective TE = 36 ms, TA was 1.5 h. Measurements were performed twice, before and after the preparation of endo-blocs with a selected type of endodontic tools. Results: The use of rotary NiTi instruments caused a substantial alteration in the curvature topography and angle of the canals and change in the curvature length. The substantial discrepancy was observed during the preparation of simulated root canals with the reciprocating instruments and the use of WaveOne files led to the largest volume variation. No dependence between the amount of material removed and the measured intracanal side was observed when NiTi instruments were used. Preparation with hand K-type files revealed a relationship between the measuring side and the amount of material removed, with the lower values obtained for the canals’ internal curvatures. Conclusions: All the studied endodontic instruments allow a safe preparation of curved root canals in simulating in vivo conditions. The abbreviation of original root canals topography does not seem to be significantly altered following mechanical preparation of simulated, severely curved root canals. The spin echo-based magnetic resonance imaging technique can be utilized for visualization of the internal topography of the root’s canals in vitro before and after their mechanical preparation in in vitro conditions. In the future, magnetic resonance microscopy may become a diagnostic tool supporting the work of a clinician

Interakcja metali badana we włosach dzieci zamieszkałych na terenach przemysłowym i rolniczym

Introduction. Different biological samples (blood, gallstone, teeth, hair) serve as a biomarker of exposure to metals for many years. This method appeared to be useful not only in clinical medicine, but also in the studies on the environment. Aim. The study is to compare the amount of selected metals in children’s hair residing in industrial and rural areas. Material and methods. Research of occurrence of 12 metals in children’s hair at the age of 7, 10 and 14 living in an industrial (Nowy Bytom town ) and a rural (Strumień town) areas has been presented. Determination of Pb, Cd, Ni, Co Na, K, Mg, Zn, Cu, Mn, Fe and Ca was carried out by atomic absorption spectrophotometry (AAS) using a spectrometer Perkin- Elmer 400. Results. In the case of seven-year old children, regardless of gender a common mechanism of co-occurrence was noticed for manganese and calcium, manganese and magnesium, calcium and magnesium, sodium and potassium. Apart from the correlation of metals for the seven-year-old-children mentioned, in case of ten-year old children, an additional correlation between calcium and zinc appears. Conclusion: The amount of some metals in the hair with the diversified possibility of interaction between the metals themselves and their relation to gender and age of children revealed different environmental exposure.Wstęp. Materiał biologiczny (krew, złogi pęcherzyka żółciowego, zęby, włosy) służy od lat jako biomarker ekspozycji na metale. Metoda ta okazała się być przydatna nie tylko w medycynie klinicznej ale również w badaniach nad środowiskiem. Cel pracy. Porównanie zawartości wybranych metali we włosach dzieci zamieszkałych na terenach przemysłowym i rolniczym. Materiał i metody. Zaprezentowano wyniki występowania 12 metali we włosach dzieci w wieku lat 7, 10 i 14, zamieszkujących tereny przemysłowy (Nowy Bytom) i rolniczy (Strumień). W celu dokonania oznaczeń Pb, Cd, Ni, Co, Na, K, Mg, Zn, Cu, Mn, Fe i Ca zastosowano absorpcyjną spektrometrię atomową. Wykorzystano spektrometr Perkin-Elmer 400. Wyniki. W przypadku dzieci 7- i 10-letnich dostrzeżono mechanizmy współwystępowania bez względu na płeć dla Mn i Ca, Mg i Mn, Ca i Mg, Na i K. Przy czym u dzieci 10 letnich dodatkowo wystąpiła współzależność pomiędzy Ca i Zn. Wnioski. Zawartość niektórych metali we włosach dzieci determinowana jest różną ekspozycją środowiskową, płcią i wiekiem badanych. Możliwa jest interakcja pomiędzy różnymi metalami

The Influence of Gender and Year of Study on Stress Levels and Coping Strategies among Polish Dental

Background and objectives: Stress is a common term used to describe various adverse psychological conditions. Students in the dentistry field face many negative psychological outcomes. The core factors for stress among dental students are related to their training course and social contacts with peers. This research aimed to assess the stress of dental students depending on their gender and study year. Materials and methods: We used the Perceived Stress Scale (PSS-10) and Mini-COPE questionnaire. The surveys were conducted among 446 dental students (320 women and 126 men) at the Faculty of Medical Sciences of the Medical University of Silesia in Katowice. Results: For the second-year and fifth-year students, the differences in scores were statistically significant, while in both cases, men had significantly lower values on the analysed scale. The results of the Kruskal-Wallis test indicated significantly lower values on the PSS-10 scale for the third-year and fourth-year students than in first-year students. The performed statistical analysis of the data obtained from the Mini-COPE questionnaire showed significant differences between men and women in individual years of study. In the first year, women chose more often the strategies related to turning to religion (p = 0.007), seeking emotional support (p = 0.046), seeking instrumental support (p = 0.045) and dealing with something else (p = 0.029) in coping with stress than men. Conclusions: The highest level of stress was found among first-year dental students. Moreover, women were characterised with higher stress levels than men. Men more often use psychoactive substances and resort to a sense of humour to cope with stress. On the other hand, women turn to religion, seek instrumental and emotional support