Utjecaj prehrambenih navika na stupanj oralne higijene u djece

The objective of this study was to determine whether there was a correlation between children’s oral hygiene and dietary habits, and whether this relationship changed through different age groups. Additionally, we analysed changes in dietary habits and oral hygiene index by age groups. A total of 102 children aged between 0 and 18 years participated in the study, with approximately the same ratio of female and male respondents. Children were divided into three groups according to age: preschool age children (0 to 6 years), young school-age children (7 to 10 years) and older school-age children (11 to 18 years). Two short questionnaires were prepared and participants could select only one answer to the question asked. The questionnaire on oral hygiene consisted of six questions, and the questionnaire on dietary habits of children of seven questions. In order to replace questioned parameters with one variable, we formed two variables, dietary habits (DH) and oral hygiene index (OHI). The score was calculated based on the responses from the questionnaire and children were classified into the group with either good or poor oral hygiene and in the group with either good or poor dietary habits. The results of this study showed a statistically significant difference in oral hygiene index among different age groups; it was highest in children of the youngest age (up to 6 years), and lower in children in the other two age groups. Analysis of age and dietary habits of children was related to the existence of statistically significant effects of age on dietary habits, with one becoming worse with age. No statistically significant correlation was found between the oral hygiene index and dietary habits of children. In addition, the correlation of oral hygiene and dietary habits was not connected with the age of children.Cilj ovog istraživanja bio je utvrditi postoji li povezanost stupnja oralne higijene djece s njihovim prehrambenim navikama te mijenja li se taj odnos kroz različite dobne skupine. Uz navedeno, analizirane su promjene prehrambenih navika djece prema njihovoj dobi i stupnja oralne higijene po dobnim skupinama ispitanika. U istraživanju je anketirano ukupno 102-je ispitanika u dobi između 0 i 18 godina, pri čemu je omjer ženskih i muških ispitanika bio približno jednak. Na temelju dobi ispitanici su razdijeljeni u tri skupine; djeca predškolske dobi (0 do 6 godina), djeca mlađe školske dobi (7 do 10 godina) i ona starije školske dobi (11 do 18 godina). Pripremljena su dva kratka upitnika u kojima je bilo potrebno odabrati jedan od ponuđenih odgovora na postavljeno pitanje. Upitnik o oralnoj higijeni sastojao se od šest pitanja, a upitnik o prehrambenim navikama djece sadržavao je sedam pitanja. Kako bi više parametara ispitanih u svakom upitniku bilo zamijenjeno samo jednom varijablom, formirane su dvije varijable, prehrambene navike (DH) i indeks oralne higijene (OHI). Na temelju bodovanja odgovora iz upitnika ispitanici su svrstani u skupinu s dobrom ili lošom oralnom higijenom te u skupinu s dobrim ili lošim prehrambenim navikama. Rezultatima istraživanja potvrđeno je postojanje statistički značajne razlike u stupnju oralne higijene djece različitih dobnih skupina: najviša je kod djece u najmlađoj dobnoj skupini, do 6 godina, dok je niža kod djece mlađe i starije školske dobi. Analizom povezanosti dobi i prehrambenih navika djece uočeno je postojanje statistički značajnog utjecaja dobi na prehrambene navike, pri čemu one postaju lošije s porastom dobi. Statistički značajna povezanost OHI i prehrambenih navika djece nije utvrđena. Uz navedeno, povezanost oralne higijene i prehrambenih navika ne ovisi o dobnoj skupini

KARCINOM DOJKE I IMUNOSUPRESIJA U PRIMATELJA BUBREŽNOG PRESATKA: PREGLED LITERATURE

Breast cancer is the most common neoplasm and the fi fth cause of death among females. The etiology and pathogenesis of this malignancy are multifactorial. The occurrence of neoplasms in solid organ recipients treated with immunosuppressive drugs is 2 to 3 times higher than in the general population. Females with kidney transplants are also in the at-risk population. The aim of this article is to review recent literature on immunosuppression and the effect it has on breast cancer prevalence in kidney transplant recipients; to discuss the proposed pathologic mechanisms of breast cancer owing to concurrent immunosuppressive treatments; and to review breast cancer screening recommendations for kidney transplant recipients. To attain relevant literature, we conducted literature search using PubMed databases, see PRISMA Diagram (Figure 1). The following MeSH Terms were used in the search: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; "immunosuppression”; and “cancer”. We reviewed a total of 409 articles after having applied exclusion criteria. These articles included randomized controlled trials, reviews, and systematic reviews. Importantly, we also utilized references from other review/primary research articles to attain additional relevant information previously not captured from our initial research. Breast cancer is the third leading malignant cause of death in Croatia, preceding lung and colorectal carcinoma. Generally, breast cancer develops due to a combination of hormonal, genetic and age-related factors. However, a signifi cant risk factor and critical motif in carcinogenesis is immunosuppression. Carcinogenic environmental factors, disturbed function of the immune system due to chronic use of immunosuppressive drugs, and genetic make-up infl uence the process of carcinogenesis in transplant patients. Immunosuppression reduces immunosurveillance that predisposes patients to increased viral oncogenesis and general carcinogenesis causing cancer to be the second most frequent cause of death in post-kidney transplant patients. Particularly, kidney transplant recipients are prone to carcinogenesis due to lifelong immunosuppressive regimens. Importantly, differences in cancer risk depend on the kidney recipient\u27s cancer type. Certain malignancies, such as breast cancer, are not affected by immunosuppression as their relative risk is comparable to that of the general population. Due to the limited number of articles addressing post-transplant breast cancer (PTBC), we present here a comprehensive review of the topic, current understanding of its pathophysiology, and the role of screening in its diagnosis, treatment and overall management. The risk of developing PTBC in kidney transplant recipients is not increased when compared to the general population. It appears that the development of breast cancer in kidney transplant recipients is unrelated to transplantation immunosuppressive regimen and is mostly associated with aging and independent risk factors that can lead by themselves to kidney transplantation such as diabetes mellitus. Due to screening programs, PTBC is usually diagnosed early. However, if PTBC is diagnosed in advanced grades, it is associated with signifi cantly increased mortality risk. Therefore, it is recommended that patients be screened periodically compared to their age- and gender-matched counterparts from the general population. Notably, this is an area of ongoing research and requires further investigation. Due to the rarity of PTBC and scarce resources on the topic, most guidelines are extrapolated from the general population and are not corresponding to the minimal risk of developing PTBC. Similarly, treatment guidelines are inferred from the general population and do not account for the particular considerations in these patients such as graft survival, graft rejection, nephrotoxic chemotherapeutic drugs, and concurrent administration of immunosuppression. It is worth mentioning that the heterogeneity of results discussed in our review is perhaps due to differing immunosuppressive regimens, type of organ transplantation, concomitant comorbidities, length of follow-up, and screening protocols used. To draw clear guidelines tailored for this population, further investigation into the mechanisms of disease is warranted, with prolonged follow-up time in patients on differing immunosuppressive regimens to allow for subsequent comparison.Rak dojke najčešća je novotvorina i peti uzrok smrti žena. Etiologija i patogeneza ovoga zloćudnog tumora su multifaktorske. Pojava neoplazma u primatelja solidnih organa liječenih imunosupresivnim lijekovima je 2 do 3 puta veća nego u općoj populaciji. U rizičnoj populaciji su i žene s presađenim bubregom. Cilj ovoga pregleda literature je istražiti povezanost pojavnosti karcinoma dojke u primatelja bubrežnog presatka i imunosupresivnih režima, opisati njihovu ulogu u tom procesu te istražiti trenutne preporuke probira za rano otkrivanje karcinoma dojke u toj populaciji. Kako bismo pristupili potrebnoj literaturi koristili smo bazu podataka PubMed-a. MeSH pojmovi uporabljeni za pretragu baze literature su bili: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; “immunosuppression” i “cancer”. Nakon primjene kriterija isključenja ukupno je pregledano 409 članaka. Članci su uključivali randomizirana kontrolna istraživanja, preglede i sustavne preglede literature. Uporabljene su i reference s drugih pregleda literature kako bi se pribavile dodatne relevantne informacije koje potencijalno nisu bile dohvaćene pri inicijalnoj pretrazi. Karcinom dojke najdijagnosticiraniji je karcinom i ujedno peti vodeći uzrok smrti žena u svijetu. Karcinom dojke je na trećem mjestu liste malignih uzročnika smrti, odmah iza karcinoma pluća i kolorektalnog karcinoma. Karcinom dojke je uzrokovan kombinacijom hormonskih i genetskih čimbenika te čimbenika vezanih uz starenje. Značajan čimbenik procesa kancerogeneze je imunosupresija, što potvrđuje dva do tri puta češća pojavnost malignih bolesti u populaciji primatelja transplantiranih organa. Kronična imunosupresivna terapija, okolišni čimbenici (izlaganje sunčevu zračenju) i genetički zapisi pojedinaca utječu na proces razvoja malignih bolesti u primatelja transplantiranih organa. Imunosupresivni lijekovi smanjuju imuni nadzor, što pospješuje proces virusne onkogeneze te opće karcinogeneze. Primatelji bubrežnog presatka skloniji su razvoju karcinoma upravo zbog doživotne imunosupresivne terapije pa je karcinom drugi uzročnik smrtnosti kod te populacije. Od iznimne važnosti je spomenuti da razlike u procijenjenom riziku razvoja karcinoma ovise upravo o vrsti karcinoma. Pokazalo se da imunosupresija ne utječe na određene maligne bolesti poput karcinoma dojke, jer je njihov relativni rizik usporediv s onim u općoj populaciji. Zbog ograničenog broja radova koji se bave tematikom karcinoma dojke nakon transplantacije bubrega ovom prigodom predstavljamo sveobuhvatan pregled dosadašnje literature, trenutnog razumijevanja patofi ziologije bolesti, uloge probira u- njenoj dijagnozi i liječenju. Opsežnim pregledom literature došli smo do zaključka da rizik razvoja karcinoma dojke nakon transplantacije u primatelja bubrežnog presatka nije povećan u usporedbi s općom populacijom. Iz pregledanih radova proizlazi zaključak da razvoj karcinoma dojke u primatelja bubrežnog presatka nije povezan s post-transplantacijskim imunosupresivnim režimom te je uglavnom povezan sa starenjem i neovisnim čimbenicima rizika koji sami po sebi mogu dovesti do transplantacije bubrega, kao što je dijabetes melitus. Zbog programa probira za rano otkrivanje karcinoma post-transplantacijski karcinom dojke obično se dijagnosticira rano. Međutim, ako ga se dijagnosticira u uznapredovalim stadijima povezan je sa značajno lošijim ishodom i povećanom razinom smrtnosti u usporedbi s općom populacijom. Preporuka je da se probir bolesnika provodi zajedno s općom populacijom koja odgovara dobi i spolu bolesnika s presatkom, uz naglasak na individualni pristup svakom bolesniku. Iznimno je važno napomenuti da je ovo područje medicine koje zahtijeva daljnje istraživanje. Zbog rijetkosti post-transplantacijskog karcinoma dojke i oskudnih resursa na tu tematiku većina smjernica ekstrapolirana je iz opće populacije i ne odgovara minimalnom riziku od razvoja te bolesti. Slično tome, smjernice za liječenje izvedene su iz podataka opće populacije i ne uzimaju u obzir posebna razmatranja kod populacije pacijenata s bubrežnim presatkom kao: održavanje funkcionalnog presatka, odbacivanje presatka, nefrotoksične kemoterapijske lijekove i istodobnu primjenu imunosupresivnih lijekova. Potrebno je spomenuti da je heterogenost rezultata o kojima se raspravlja u našem pregledu literature posljedica različitih vrsta imunosupresivnih režima, transplantiranih organa, pridruženih bolesti, duljine praćenja bolesnika i programa probira. Kako bi se defi nirale jasne smjernice prilagođene ovoj populaciji, potrebno je daljnje istraživanje mehanizama nastanka bolesti, uz produljeno vrijeme praćenja pacijenata na različitim imunosupresivnim režimima kako bi se omogućila naknadna usporedba

KARCINOM DOJKE I IMUNOSUPRESIJA U PRIMATELJA BUBREŽNOG PRESATKA: PREGLED LITERATURE

Breast cancer is the most common neoplasm and the fi fth cause of death among females. The etiology and pathogenesis of this malignancy are multifactorial. The occurrence of neoplasms in solid organ recipients treated with immunosuppressive drugs is 2 to 3 times higher than in the general population. Females with kidney transplants are also in the at-risk population. The aim of this article is to review recent literature on immunosuppression and the effect it has on breast cancer prevalence in kidney transplant recipients; to discuss the proposed pathologic mechanisms of breast cancer owing to concurrent immunosuppressive treatments; and to review breast cancer screening recommendations for kidney transplant recipients. To attain relevant literature, we conducted literature search using PubMed databases, see PRISMA Diagram (Figure 1). The following MeSH Terms were used in the search: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; "immunosuppression”; and “cancer”. We reviewed a total of 409 articles after having applied exclusion criteria. These articles included randomized controlled trials, reviews, and systematic reviews. Importantly, we also utilized references from other review/primary research articles to attain additional relevant information previously not captured from our initial research. Breast cancer is the third leading malignant cause of death in Croatia, preceding lung and colorectal carcinoma. Generally, breast cancer develops due to a combination of hormonal, genetic and age-related factors. However, a signifi cant risk factor and critical motif in carcinogenesis is immunosuppression. Carcinogenic environmental factors, disturbed function of the immune system due to chronic use of immunosuppressive drugs, and genetic make-up infl uence the process of carcinogenesis in transplant patients. Immunosuppression reduces immunosurveillance that predisposes patients to increased viral oncogenesis and general carcinogenesis causing cancer to be the second most frequent cause of death in post-kidney transplant patients. Particularly, kidney transplant recipients are prone to carcinogenesis due to lifelong immunosuppressive regimens. Importantly, differences in cancer risk depend on the kidney recipient\u27s cancer type. Certain malignancies, such as breast cancer, are not affected by immunosuppression as their relative risk is comparable to that of the general population. Due to the limited number of articles addressing post-transplant breast cancer (PTBC), we present here a comprehensive review of the topic, current understanding of its pathophysiology, and the role of screening in its diagnosis, treatment and overall management. The risk of developing PTBC in kidney transplant recipients is not increased when compared to the general population. It appears that the development of breast cancer in kidney transplant recipients is unrelated to transplantation immunosuppressive regimen and is mostly associated with aging and independent risk factors that can lead by themselves to kidney transplantation such as diabetes mellitus. Due to screening programs, PTBC is usually diagnosed early. However, if PTBC is diagnosed in advanced grades, it is associated with signifi cantly increased mortality risk. Therefore, it is recommended that patients be screened periodically compared to their age- and gender-matched counterparts from the general population. Notably, this is an area of ongoing research and requires further investigation. Due to the rarity of PTBC and scarce resources on the topic, most guidelines are extrapolated from the general population and are not corresponding to the minimal risk of developing PTBC. Similarly, treatment guidelines are inferred from the general population and do not account for the particular considerations in these patients such as graft survival, graft rejection, nephrotoxic chemotherapeutic drugs, and concurrent administration of immunosuppression. It is worth mentioning that the heterogeneity of results discussed in our review is perhaps due to differing immunosuppressive regimens, type of organ transplantation, concomitant comorbidities, length of follow-up, and screening protocols used. To draw clear guidelines tailored for this population, further investigation into the mechanisms of disease is warranted, with prolonged follow-up time in patients on differing immunosuppressive regimens to allow for subsequent comparison.Rak dojke najčešća je novotvorina i peti uzrok smrti žena. Etiologija i patogeneza ovoga zloćudnog tumora su multifaktorske. Pojava neoplazma u primatelja solidnih organa liječenih imunosupresivnim lijekovima je 2 do 3 puta veća nego u općoj populaciji. U rizičnoj populaciji su i žene s presađenim bubregom. Cilj ovoga pregleda literature je istražiti povezanost pojavnosti karcinoma dojke u primatelja bubrežnog presatka i imunosupresivnih režima, opisati njihovu ulogu u tom procesu te istražiti trenutne preporuke probira za rano otkrivanje karcinoma dojke u toj populaciji. Kako bismo pristupili potrebnoj literaturi koristili smo bazu podataka PubMed-a. MeSH pojmovi uporabljeni za pretragu baze literature su bili: “breast cancer”; “risk factors”; “cancer screening”; “kidney transplantation”; “immunosuppression” i “cancer”. Nakon primjene kriterija isključenja ukupno je pregledano 409 članaka. Članci su uključivali randomizirana kontrolna istraživanja, preglede i sustavne preglede literature. Uporabljene su i reference s drugih pregleda literature kako bi se pribavile dodatne relevantne informacije koje potencijalno nisu bile dohvaćene pri inicijalnoj pretrazi. Karcinom dojke najdijagnosticiraniji je karcinom i ujedno peti vodeći uzrok smrti žena u svijetu. Karcinom dojke je na trećem mjestu liste malignih uzročnika smrti, odmah iza karcinoma pluća i kolorektalnog karcinoma. Karcinom dojke je uzrokovan kombinacijom hormonskih i genetskih čimbenika te čimbenika vezanih uz starenje. Značajan čimbenik procesa kancerogeneze je imunosupresija, što potvrđuje dva do tri puta češća pojavnost malignih bolesti u populaciji primatelja transplantiranih organa. Kronična imunosupresivna terapija, okolišni čimbenici (izlaganje sunčevu zračenju) i genetički zapisi pojedinaca utječu na proces razvoja malignih bolesti u primatelja transplantiranih organa. Imunosupresivni lijekovi smanjuju imuni nadzor, što pospješuje proces virusne onkogeneze te opće karcinogeneze. Primatelji bubrežnog presatka skloniji su razvoju karcinoma upravo zbog doživotne imunosupresivne terapije pa je karcinom drugi uzročnik smrtnosti kod te populacije. Od iznimne važnosti je spomenuti da razlike u procijenjenom riziku razvoja karcinoma ovise upravo o vrsti karcinoma. Pokazalo se da imunosupresija ne utječe na određene maligne bolesti poput karcinoma dojke, jer je njihov relativni rizik usporediv s onim u općoj populaciji. Zbog ograničenog broja radova koji se bave tematikom karcinoma dojke nakon transplantacije bubrega ovom prigodom predstavljamo sveobuhvatan pregled dosadašnje literature, trenutnog razumijevanja patofi ziologije bolesti, uloge probira u- njenoj dijagnozi i liječenju. Opsežnim pregledom literature došli smo do zaključka da rizik razvoja karcinoma dojke nakon transplantacije u primatelja bubrežnog presatka nije povećan u usporedbi s općom populacijom. Iz pregledanih radova proizlazi zaključak da razvoj karcinoma dojke u primatelja bubrežnog presatka nije povezan s post-transplantacijskim imunosupresivnim režimom te je uglavnom povezan sa starenjem i neovisnim čimbenicima rizika koji sami po sebi mogu dovesti do transplantacije bubrega, kao što je dijabetes melitus. Zbog programa probira za rano otkrivanje karcinoma post-transplantacijski karcinom dojke obično se dijagnosticira rano. Međutim, ako ga se dijagnosticira u uznapredovalim stadijima povezan je sa značajno lošijim ishodom i povećanom razinom smrtnosti u usporedbi s općom populacijom. Preporuka je da se probir bolesnika provodi zajedno s općom populacijom koja odgovara dobi i spolu bolesnika s presatkom, uz naglasak na individualni pristup svakom bolesniku. Iznimno je važno napomenuti da je ovo područje medicine koje zahtijeva daljnje istraživanje. Zbog rijetkosti post-transplantacijskog karcinoma dojke i oskudnih resursa na tu tematiku većina smjernica ekstrapolirana je iz opće populacije i ne odgovara minimalnom riziku od razvoja te bolesti. Slično tome, smjernice za liječenje izvedene su iz podataka opće populacije i ne uzimaju u obzir posebna razmatranja kod populacije pacijenata s bubrežnim presatkom kao: održavanje funkcionalnog presatka, odbacivanje presatka, nefrotoksične kemoterapijske lijekove i istodobnu primjenu imunosupresivnih lijekova. Potrebno je spomenuti da je heterogenost rezultata o kojima se raspravlja u našem pregledu literature posljedica različitih vrsta imunosupresivnih režima, transplantiranih organa, pridruženih bolesti, duljine praćenja bolesnika i programa probira. Kako bi se defi nirale jasne smjernice prilagođene ovoj populaciji, potrebno je daljnje istraživanje mehanizama nastanka bolesti, uz produljeno vrijeme praćenja pacijenata na različitim imunosupresivnim režimima kako bi se omogućila naknadna usporedba

Laser treatment of deciduous teeth

Smatra se da je korištenje lasera u terapiji novorođenčadi i male djece, uključujući i pacijente s posebnim potrebama, učinkovito prilikom restaurativnih zahvata i terapije mekih tkiva. Uporaba različitih vrsta lasera prilikom terapije pojedinih tkiva ovisi o načinu interakcije tkiva s laserskom svjetlošću i željenom učinku u svrhu liječenja. Terapija laserom ima pozitivan antimikrobni učinak i po- voljno utječe na mineralizaciju cakline. Nd:YAG laser povećava otpornost cakline na demineralizaciju što ga čini vrijednom terapij- skom mogućnosti u kombinaciji s fluoridacijom zuba. Laseri se mogu koristiti u širem spektru vitalnih i avitalnih preparacija pulpe mliječnih zuba uključujući prekrivanje pulpe, pulpotomiju i pulpektomiju. Upotreba lasera u dentalnoj medicini ima posebnu važ- nost u radu s djecom. Svojom preciznošću i selektivnošću laseri omogućuju minimalno invazivnu preparaciju tvrdih zubnih tkiva. Također, predstavljaju manju opasnost za termičke ozljede tkiva prilikom preparacije u usporedbi s klasičnim tehnikama preparacije. Zbog manjeg kontakta terapijskog pomagala i tkiva smanjena je bol i vibracije prilikom preparacije. Time se postiže bolja suradlji- vost pacijenata zbog smanjene dentalne anksioznosti i fobije u djece. Veća ugoda pacijenta je postignuta i analgetičkim učinkom erbijevog lasera, zbog nepostojanja potrebe za uporabom lokalnih anestetika prilikom zahvata. U ovom radu predstavljeno je pro- vedeno kliničko istraživanje na 120 pacijenata u dobi 5 – 8 godina. Sudionici ispitivanja bili su podjeljeni u dvije skupine na kojima su se proveli postupci tradicionalne pulpotomije i pulpotomije diodnim laserom. Rezultati istraživanja potvrdili su kliničku vrijednost primjene diodnih lasera u dječjoj i preventivnoj dentalnoj medicini.The use of lasers in the treatment of infants and children, including patients with special needs, is considered to be effective in restor- ative procedures and soft tissue therapy. The use of different types of lasers in the therapy of individual tissues depends on the way the tissues interact with laser light and the desired effect for the purpose of treatment. Laser therapy has a positive antimicrobial effect and has a beneficial effect on enamel mineralization. Nd: YAG laser increases the resistance of enamel to demineralization which makes it a valuable therapeutic option in combination with tooth fluoridation. Lasers can be used in a wide range of vital and avital preparations of deciduous teeth pulp including pulp cuping, pulpotomy and pulpectomy. The use of lasers in dentistry is of particular importance in working with children. Lasers enable minimally invasive preparation of hard dental tissues with their preci- sion and selectivity. They also pose a lower risk of thermal tissue injuries during preparation compared to classical preparation tech- niques. Due to less contact between the therapeutic aid and tissue, pain and vibration during preparation are reduced. This achieves better patient compliance due to reduced dental anxiety and phobia in children. Greater patient comfort was achieved by the anal- gesic effect of erbium laser, due to the elimination of the need to use local anesthetics during the procedure. This paper presents a clinical study conducted on 120 patients aged 5 - 8 years. The participants were divided into two groups in which traditional pulpotomy and diode laser pulpotomy procedures were performed. The results of this study confirmed the clinical value of the use of diode lasers in pediatric and preventive dentistry

Ortostatika i kronična venska insuficijencija u hrvatskih stomatologa

The purpose of the study was to point to occupational exposure of dental medicine doctors in Croatia and to the effect of static performance on developing venous disease. The study included 120 subjects, 60 of them doctors of dental medicine and 60 from other professions. The study was focused on finding a way to upgrade preventive measures against developing chronic venous insufficiency and the quality of life of dental medicine doctors. Study subjects underwent verbal testing (questionnaire), clinical examination and ultrasonography (color Doppler).U radu se ukazuje na utjecaj profesionalne izloženosti doktora dentalne medicine u Hrvatskoj te na statičko opterećenje u odnosu na razvoj bolesti venskog sustava. Istraživanje je obuhvatilo 120 ispitanika, od toga 60 doktora dentalne medicine i 60 ispitanika drugih struka. Cilj istraživanja ponajprije je unaprjeđenje preventivnih mjera kojima bi se spriječio razvoj kronične venske insuficijencije, ali i poboljšanje kvalitete života naših ispitanika. Ispitanici su podvrgnuti usmenom anketiranju (anketni upitnik), kliničkom pregledu te ultrazvučnoj dijagnostici (obojeni Doppler)

Clinical evaluation of 980 nm diode laser application for pulpotomy of primary teeth

Svrha istraživanja bila je usporediti kliničku upotrebu lasera za pulpotomiju mliječnih zuba s klasičnom metodom vitalne pulpotomije te utjecaj materijala za definitivni ispun na konačni ishod postupka. Provedeno je kliničko istraživanje u trajanju od 2 godine u kojem je sudjelovalo 120 pacijenata u dobi 5 – 8 godina na Zavodu za dječju stomatologiju Stomatološkog fakulteta Sveučilišta u Zagrebu. Pacijenti su bili podijeljeni randomiziranim odabirom u dvije skupine. U prvoj skupini bilo je 60 ispitanika gdje se koristila metoda vitalne pulpotomije čeličnim svrdlom ili ekskavatorom u lokalnoj anesteziji. U drugoj skupini provodila se devitalizacija korištenjem diodnog lasera valne duljine 980 nm u lokalnoj anesteziji. U obje skupine za prekrivanje korijenskog dijela pulpe koristio se Biodentin. Svaka je skupina randomizirano podijeljena u dvije podskupine prema vrsti materijala za definitivni ispun (kompozitni materijal i stakleno ionomerni cement). Kontrolni pregledi provodili su se nakon 6 mj., 12 mj. i 24 mj. od prvog zahvata. Planirani period istraživanja bio je 2 godine. Kriteriji uspješnosti liječenja su: zub bez simptoma, bez promjene boje, bez periapikalnih promjena, bez gubitka parodontnog pričvrstka, uredan radiološki nalaz i funkcija u okluziji do prirodne eksfolijacije. Kvaliteta ispuna evaluira se USPHS (United States Public Health Service) kriterijima. Statističkom obradom podataka kolerirao se postupak pulpotomije s ishodom liječenja te vrsta materijala za trajni ispun s ishodom liječenja. U obje skupine kontroliralo se stanje okolnih mekih tkiva endodontski liječenih mliječnih zuba unutar dvije godine.Since the first successful laser application in dentistry in 1965 indications for the use of different types of lasers are all wider (1). One of the areas the endodontic treatment of primary teeth is successfully applied, with 980 nm wavelength diode lasers suitable for the pulpotomy procedure (2). Although some studies show the benefits of laser compared to the conventional method of clinical studies are lacking. The material for a definitive filling of endodontically treated primary teeth can also affect the outcome of the therapy. Therefore, the purpose of this observation was to compare the clinical use of the pulpotomy laser with the classic vital pulpotomy method and the influence of the material for definitive filling for the final outcome of the procedure. A clinical study was conducted over a period of 2 years, involving 120 patients at the age of 5-8 years at the Department of Pediatric Dentistry at the Faculty of Dental Medicine of the University of Zagreb. Patients were divided by randomized selection into two groups. In the first group there was 60 examinees where the vital pulpotomy method was used with a carbid drill or an excavatron in local anesthesia. In the second group devitalization was carried out using a 980 nm wavelength diode laser in local anesthesia. Biodent was used in both groups to cover the root portion of the pulp. Each group was randomly divided into two subgroups according to the type of material for the final filling (composite material and glass ionomer cement). Checkups were conducted after 6 months, 12 months and 24 months from the first procedure. Before the preliminary procedure and during the control examinations, clinical examination and X-ray analysis of treated teeth was performed. Clinical examinationl included: intraoral and extraoral visual examination, percussion and palpation. The X-ray analysis was conducted to show the continuity of the hard lamina and the existence of periapical lesions in the area involving the support of the treated tooth, the surrounding tissue of the adjacent two teeth, and the condition of the permanent tooth embryo. The planned research period was 2 years. Criteria for the success of the treatment were: a tooth without any symptoms without color change, without periapical changes, without loss of periodontal attachment, neat radiological findings and functions in occlusion to natural exfoliation. Filling quality were evaluated by USPHS (United States Public Health Service) criteria. Statistical data processing were done in choleration to the pulpotomy process with the treatment outcome and the kind of permanent fill material with the treatment outcome. Both groups controled the condition of soft tissue endodontically treated primary teeth within two years

Clinical evaluation of 980 nm diode laser application for pulpotomy of primary teeth

Svrha istraživanja bila je usporediti kliničku upotrebu lasera za pulpotomiju mliječnih zuba s klasičnom metodom vitalne pulpotomije te utjecaj materijala za definitivni ispun na konačni ishod postupka. Provedeno je kliničko istraživanje u trajanju od 2 godine u kojem je sudjelovalo 120 pacijenata u dobi 5 – 8 godina na Zavodu za dječju stomatologiju Stomatološkog fakulteta Sveučilišta u Zagrebu. Pacijenti su bili podijeljeni randomiziranim odabirom u dvije skupine. U prvoj skupini bilo je 60 ispitanika gdje se koristila metoda vitalne pulpotomije čeličnim svrdlom ili ekskavatorom u lokalnoj anesteziji. U drugoj skupini provodila se devitalizacija korištenjem diodnog lasera valne duljine 980 nm u lokalnoj anesteziji. U obje skupine za prekrivanje korijenskog dijela pulpe koristio se Biodentin. Svaka je skupina randomizirano podijeljena u dvije podskupine prema vrsti materijala za definitivni ispun (kompozitni materijal i stakleno ionomerni cement). Kontrolni pregledi provodili su se nakon 6 mj., 12 mj. i 24 mj. od prvog zahvata. Planirani period istraživanja bio je 2 godine. Kriteriji uspješnosti liječenja su: zub bez simptoma, bez promjene boje, bez periapikalnih promjena, bez gubitka parodontnog pričvrstka, uredan radiološki nalaz i funkcija u okluziji do prirodne eksfolijacije. Kvaliteta ispuna evaluira se USPHS (United States Public Health Service) kriterijima. Statističkom obradom podataka kolerirao se postupak pulpotomije s ishodom liječenja te vrsta materijala za trajni ispun s ishodom liječenja. U obje skupine kontroliralo se stanje okolnih mekih tkiva endodontski liječenih mliječnih zuba unutar dvije godine.Since the first successful laser application in dentistry in 1965 indications for the use of different types of lasers are all wider (1). One of the areas the endodontic treatment of primary teeth is successfully applied, with 980 nm wavelength diode lasers suitable for the pulpotomy procedure (2). Although some studies show the benefits of laser compared to the conventional method of clinical studies are lacking. The material for a definitive filling of endodontically treated primary teeth can also affect the outcome of the therapy. Therefore, the purpose of this observation was to compare the clinical use of the pulpotomy laser with the classic vital pulpotomy method and the influence of the material for definitive filling for the final outcome of the procedure. A clinical study was conducted over a period of 2 years, involving 120 patients at the age of 5-8 years at the Department of Pediatric Dentistry at the Faculty of Dental Medicine of the University of Zagreb. Patients were divided by randomized selection into two groups. In the first group there was 60 examinees where the vital pulpotomy method was used with a carbid drill or an excavatron in local anesthesia. In the second group devitalization was carried out using a 980 nm wavelength diode laser in local anesthesia. Biodent was used in both groups to cover the root portion of the pulp. Each group was randomly divided into two subgroups according to the type of material for the final filling (composite material and glass ionomer cement). Checkups were conducted after 6 months, 12 months and 24 months from the first procedure. Before the preliminary procedure and during the control examinations, clinical examination and X-ray analysis of treated teeth was performed. Clinical examinationl included: intraoral and extraoral visual examination, percussion and palpation. The X-ray analysis was conducted to show the continuity of the hard lamina and the existence of periapical lesions in the area involving the support of the treated tooth, the surrounding tissue of the adjacent two teeth, and the condition of the permanent tooth embryo. The planned research period was 2 years. Criteria for the success of the treatment were: a tooth without any symptoms without color change, without periapical changes, without loss of periodontal attachment, neat radiological findings and functions in occlusion to natural exfoliation. Filling quality were evaluated by USPHS (United States Public Health Service) criteria. Statistical data processing were done in choleration to the pulpotomy process with the treatment outcome and the kind of permanent fill material with the treatment outcome. Both groups controled the condition of soft tissue endodontically treated primary teeth within two years

Should the Application of Diode Laser Completely Replace Conventional Pulpotomy of Primary Teeth?

Nowadays, the use of lasers in dental medicine has become an effective approach for numerous restorative and soft tissue therapeutic procedures. The use of different types of lasers depends on how the tissue interacts with the laser light and the purpose of treatment. Although some studies show the benefits of laser pulpotomy compared to the conventional method of pulpotomy, clinical studies are lacking. Moreover, the material used for a definitive restoration of endodontically treated primary teeth can also affect the outcome of the therapy. Therefore, this prospective study aimed to compare the clinical use of the diode laser and the conventional method of vital pulpotomy, as well as the influence of the material chosen for a definitive restoration for the outcome of the procedure. Patients were divided into two groups: conventional pulpotomy and 980 nm diode laser. Each group was then divided into two subgroups according to the type of material for the final restoration. By comparing the success of the therapy according to clinical parameters depending on the material of the final restoration, the advantage of the composite material compared to the glass ionomer cement was noticed at 6 months checkup (p = 0.045). A strong positive correlation between the quality of the final restoration according to the United States Public Health Service (USPHS) criteria and the success of the clinical parameters was found in all investigated time points. There is no statistically significant difference between the diode laser and the conventional pulpotomy, however, the choice and quality of the final restoration significantly contribute to the outcome of therapy