Association between local and systemic factors in patients with burning mouth syndrome

Cilj: Ispitati povezanost sindroma pekućih usta (SPU) te lokalnih i sustavnih čimbeni- ka. Ispitanici i metode: U istraživanju je sudjelovalo 314 ispitanika koji su podijeljeni u SPU skupinu (n = 164) i kontrolnu skupinu (n = 150). Istraživanje je provedeno pomoću ankete kojom smo ispitivali pojavnost lokalnih i sustavnih čimbenika koji utječu na pojavnost SPU-a između skupina. Anketa se sastojala od 14 upita: demografski podatci, uzimanje lijekova, alergije, sustavne bolesti ili poremećaji koji mogu biti u podlozi SPU-a, pušenje te lokalni čimbenici. Zatim je izmjerena količina izlučene sline, uzeti su brisovi na Candidu, izmjeren je galvanizam te je ispitivano postojanje parafunkcijskih navika. Komparativne statističke analize ispitivanih čimbenika između skupina učinjene su Hi kvadrat testom, Fischer egzaktnim te- stom ili t-testom za razlike između proporcija. Rezultati: Utvrđena je značajno veća pojavnost navedenih čimbenika u SPU skupini u odnosu na kontrolnu skupinu: alergije na inhalacijske alergene, postmenopauza, pozitivan nalaz H. pylori/GERB/gastritis, lokalna trauma živca ili neurološka oboljenja, parafunkcije, kserostomija, kandidijaza, galvanizam te terapija antihipertenzivima. Pušenje je značajno zastupljenije u kontrolnoj skupini. Zaključak: U radu s pacijentima koji pate od sekundarnog SPU-a liječnik dentalne medicine treba obratiti posebnu pozornost na prisutnost kandidijaze, galvanizma i parafunkcijskih navika te na gastroenterološke probleme.Aim: To evaluate the prevalence of Burning mouth syndrome (BMS) and to determine local and systemic factors associated with its presence. Patients and methods: 314 patients were divided in BMS group (n = 164) and control group (n = 150). Research was conducted using a questionnaire assaying the prevalence of local and systemic factors associated with BMS between BMS group and control group. The questionnaire involved 14 enquires: demographic data, drugs, allergies, systemic illness or disorders that may be in the back- ground of BMS, smoking and local factors. Total salivary flow rates were determined, smears to identify the presence of Candida were taken, oral galvanism was measured and the presence of parafunctional habits was determined. Comparative statistical analyses of scanned factors among groups were performed using Hi square test, Fischer’s exact test or t-test for the difference between proportions. Results: Significantly higher prevalence in the SPU group was found for: allergies, postmenopause, positive finding of H. pylori / GERD / gastri- tis, local nerve trauma or neurologic disease, parafunctional habits, xerostomia, candidiasis, galvanism and antihypertensive therapy. Smoking was significantly more common in control group. Conclusions: Treating the patients with secondary BMS dentists should pay special attention to the presence of candidyasis, galvanism, parafunctional habits and gastroenterological problems

Development and Validation of a Questionnaire Measuring Attitudes towards e-learning among University Students

Cilj: Tijekom posljednjeg desetljeća provode se mnoga istraživanja koja analiziraju čimbenike utjecaja na e-učenje; između ostalog, informatičke vještine korisnika, pristup internetu i stav studenata prema e-učenju. Većina studija stav ispituje utvrđujući svrhu i učestalost uporabe računala, dok neke mjere stav studenata upitnikom, a da pritom nisu određene mjerne osobine upitnika. Stoga je cilj ovog rada bio oblikovati upitnik za mjerenje stava studenata prema e-učenju te odrediti njegove psihometrijske osobine. Metode: Istraživanje je bilo provedeno od listopada 2010. godine do listopada 2011. godine. Ispitano je 308 ispitanika (106 studenta i 202 studentice) s Medicinskog i Tehničkog fakulteta Sveučilišta u Rijeci. Za nastanak prve inačice upitnika oblikovano je 40 tvrdnji (čestica). Iz relevantne znanstvene literature odabrane su 22 tvrdnje, a na osnovi vlastitih znanja i iskustva preostalih 18. Dva stručnjaka koja se bave izradom i validacijom upitnika i dva stručnjaka u području e-učenja pregledala su svih 40 tvrdnji te uklonila tvrdnje sa sličnim ili nejasnim značenjima. Preostale su 24 tvrdnje na kojima je učinjena eksploratorna faktorska analiza tipa analize glavnih komponenata. Rezultati: Utvrđena su dva faktora: faktor I – pozitivan stav prema e-učenju (10 čestica), faktor II – negativan stav prema e-učenju (12 čestica). Korelacija između faktora iznosila je 0,67. Pouzdanost upitnika bila je vrlo visoka (a = 0,87). Završna inačica upitnika sastojala se od 22 čestice kojima se opisuje pozitivan i negativan aspekt prema e-učenju. Studenti su iskazali visoko pozitivan stav prema e-učenju (87 ± 10 od mogućih 110). Zaključak: Oblikovan je upitnik s dobrim psihometrijskim osobinama koji će u daljnjim istraživanja predstavljati standardni alat za mjerenje stava studenata prema e-učenju.Aim: In the last decade many survey studies have analyzed factors that influenced e-learning such as computer skills, access to the Internet and attitudes towards e-learning. Some surveys were developed for broader studies and different contents while others lack psychometric properties testing. The aim of this study was to construct and examine the psychometric properties of a questionnaire measuring students’ attitudes towards e-learning. Methods: Research was conducted from October 2010 to October 2011. Participants were 308 undergraduate students (106 men and 202 women) from the School of Medicine and the School of Engineering at the University of Rijeka, Croatia. In the first version of the questionnaire, we generated 40 statements (items). Twenty-two statements were based on relevant scientific literature, whereas the remaining 18 statements were developed on the basis of our own knowledge and experience. Two experts in questionnaire construction and validation and two experts in e-learning reviewed independently all the statements and removed those with similar or ambiguous meaning. The remaining 24 statements were chosen for the validation. Factor analysis was used to find the factor structure of the questionnaire and to measure construct validity. Results: The final version of the questionnaire consisted of 22 items. The Principal Component Analysis (PCA) determined two factors: factor I – positive attitudes towards e-learning (10 items) and factor II – negative attitudes towards e-learning (12 items). Correlation between factors was 0.67. The reliability of the questionnaire was high (a=0.87). Participants had positive attitudes towards e-learning with a mean score ± standard deviation of 87±10 out of maximum 110. Conclusion: The instrument proved to have good psychometric properties and it can be used for future studies assessing attitudes towards e-learning

A review on the current status of retinal prostheses (bionic eye)

Argus® II prva je retinalna proteza odobrena za liječenje slijepih pacijenata koji boluju od retinalne pigmentoze. Godine 2011. primila je oznaku CE-a (engl. European Committee) te 2013. odobrenje FDA-a (engl. Food and Drug Administration). Retinalna proteza pruža stabilnu, sigurnu i dugotrajnu retinalnu stimulaciju. Poboljšanje vida s retinalnim protezama ovisi o poboljšanju vidne rezolucije, razvoju točnog neuralnog obrasca za obradu slike i poboljšanju biološke kompatibilnosti uređaja kako bi se osigurala dugotrajnost. Jednom tema narodne predaje i znanstvene fantastike, ideja povratka vida slijepim osobama danas se približava realnosti.Argus® II, the first retinal prosthesis is approved for the treatment of patients with retinal pigmentosis. 2011 has received the CE (European Committee) designation and 2013 FDA (Food and Drug Administration) Approval. Retinal prosthesis provides a stable, safe and long-lasting retinal stimulation. The improvement of vision with retinal prosthesis depends on the improvement of the visual resolution, development of the correct neural form for imaging and improvement of the biological compatibility of the device to ensure durability. Once the theme of folklore and science fiction, the idea of returning sight to blind people today is approaching reality

A review on the current status of retinal prostheses (bionic eye)

Argus® II prva je retinalna proteza odobrena za liječenje slijepih pacijenata koji boluju od retinalne pigmentoze. Godine 2011. primila je oznaku CE-a (engl. European Committee) te 2013. odobrenje FDA-a (engl. Food and Drug Administration). Retinalna proteza pruža stabilnu, sigurnu i dugotrajnu retinalnu stimulaciju. Poboljšanje vida s retinalnim protezama ovisi o poboljšanju vidne rezolucije, razvoju točnog neuralnog obrasca za obradu slike i poboljšanju biološke kompatibilnosti uređaja kako bi se osigurala dugotrajnost. Jednom tema narodne predaje i znanstvene fantastike, ideja povratka vida slijepim osobama danas se približava realnosti.Argus® II, the first retinal prosthesis is approved for the treatment of patients with retinal pigmentosis. 2011 has received the CE (European Committee) designation and 2013 FDA (Food and Drug Administration) Approval. Retinal prosthesis provides a stable, safe and long-lasting retinal stimulation. The improvement of vision with retinal prosthesis depends on the improvement of the visual resolution, development of the correct neural form for imaging and improvement of the biological compatibility of the device to ensure durability. Once the theme of folklore and science fiction, the idea of returning sight to blind people today is approaching reality

Child Perceptions Questionnaire in Croatia: Two Domains for Measuring Oral Health

Cilj: Provesti međukulturnu prilagodbu i testiranje psihometrijskih svojstava Upitnika o dječjoj percepciji (engl. Child Perceptions Questionnaire – CPQ), kratke inačice od osam čestica za dob od 11 do 14 godina: regresijske (engl. Regression Short Form – RSF:8) i čestične (engl. Item Short Form–ISF:8). Materijali i metode: Uzorak je obuhvatio 237 ortodontskih pacijenata u dobi od 11 do 14 godina na dvjema sveučilišnim stomatološkim klinikama u Hrvatskoj. Procijenjena je strukturna i konstruktna valjanost, pouzdanost i prikladnost. Intraoralni pregled uključivao je procjenu intenziteta karijesa i malokluzije. Rezultati: Dvije dimenzije, umjesto prvotno predloženih četiriju, prikladnije su za procjenu kvalitete života povezane s oralnim zdravljem (engl. Oral Health-Related Quality of Life – OHRQoL) s oba instrumenta – ISF:8 i RSF:8 (60,05 % i 52,24 % varijance; α = 0,56 – 0,85). Oralni simptomi i funkcionalna ograničenja originalnog instrumenta grupirani su u jednu dimenziju koja definira oralnu funkciju, a emocionalno i društveno blagostanje dimenzija je psihosocijalnog blagostanja. Instrumenti mogu otkriti razlike između osoba s niskim i visokim intenzitetom karijesa te malokluzije. Stabilni su kada nema promjena oralnih uvjeta, a u stanju su detektirati razlike uzrokovane korekcijom malokluzije ortodontskom terapijom (p < 0,05). Zaključak: CPQ od osam čestica ima dobra psihometrijska svojstva, no u Hrvatskoj su prikladnije dvije umjesto četiri dimenzije za procjenu OHRQoL-a u dobi između 11 i 14 godina.Objective: To perform cross-cultural adaptation and to test psychometric properties of the 8-item CPQ in 11-14 year-olds: stepwise-regression (RSF:8) and item-impact (ISF:8) short-forms. Materials and Methods: The sample included 237 orthodontic patients aged 11-14 at two University Dental Clinics in Croatia. Structural and construct validity, reliability and responsiveness were assessed. Intraoral examination included an assessment of dental caries and malocclusion severity. Results: Two domains instead of originally suggested four are more appropriate for the assessment of oral healthrelated quality of life (OHRQoL) in both ISF:8 and RSF:8 (60.05% and 52.24% variance; α=0.56-0.85). Oral symptoms and functional limitations from the original instrument were grouped in one dimension that defines oral function, while emotional and social well-being were grouped in a dimension of psychosocial well-being. Instruments are able to detect differences between subjects with low and high caries and malocclusion severity. They were stable when there were no changes in oral conditions, while it was possible to detect differences induced by correction of malocclusion following orthodontic treatment (p<0.05). Conclusion: Both 8-item CPQ demonstrated good psychometric properties but pointed to the fact that two domains instead of four are more appropriate for the assessment of OHRQoL in 11-14 year-olds

Effects of Visual Stimuli from Media on the Perception of Dentofacial Esthetics

Cilj: Autori studije istražili su mogu li televizijske reklame mijenjati percepciju vlastite dentofacijalne privlačnosti te je li taj proces pod utjecajem osobina ličnosti.Materijal i metode: Uzorak su činila 83 ispitanika u dobi od 19 do 27 godina. Eksperimentalna skupina (N = 42) gledala je reklame u kojima su sudjelovali poznati mladi ljudi s visokom estetikom osmijeha, svijetlim zubima i bez vidljivih malokluzija, a kontrolnoj skupini (N = 41) prezentirane su neutralne reklame (bez ljudi ili vidljivih zuba). Percepcija estetike vlastita lica i osmijeha te njezini psihološki učinci procijenjeni su mjesec dana prije gledanja reklama te odmah nakon toga. Procijenjeni su i intenzitet malokluzije ispitanika te osobine ličnosti (ekstraverzija, savjesnost, ugodnost, neuroticizam, intelekt, samopoštovanje i perfekcionizam).Rezultati: U svojem drugom iskazu ispitanici su imali tendenciju navoditi manje psihosocijalnih utjecaja uz male razlike (prosječno u rasponu od 0 do 3 skalarna boda) te manje značajne promjene u aktivnoj skupini negoli u neutralnoj (2 od 7 vs. 5 od 7 aspekata). Vrsta vizualnog podražaja bila je značajan prediktor samo promjene koja se odnosi na psihološki utjecaj dentalne estetike (p = 0,045; r = 0,221). Intelekt je kao supresor oblikovao percepciju estetike osmijeha nakon gledanja reklama s naglašenim lijepim osmijesima (ΔR 2 = 0,076; p = 0,005; ukupni model R 2 = 0,347; p = 0,033). Kod osoba s većim intelektom je povećanje intenziteta samoopažene malokluzije izazvalo manji pad psihološkog utjecaja dentalne estetike u usporedbi s onima s manjim intelektom.Zaključak: Psihosocijalni utjecaji malokluzije nisu stabilni i imaju tendenciju smanjivati se tijekom vremena. No, izlaganje visokoj estetici osmijeha drugih ljudi može kočiti taj proces kod osoba s većom malokluzijom i većim intelektom.Objectives: The study explored whether television commercials change the perception of one’s own dentofacial attractiveness and to identify if it is influenced by personality traits. Material and methods: The sample included 83 participants, aged 19-27 years. The experimental group (N=42) watched commercials portraying famous young individuals with high smile esthetics, bright teeth and no visible malocclusions, while the control group (N=41) watched neutral commercials (without people or visible teeth). The perception of subjects` own orofacial esthetics and its psychosocial effects were assessed a month before the exposure and immediately after it. The subjects` malocclusion severity and personality characteristics (extraversion, conscientiousness, agreeableness, neuroticism, in-tellect, self-esteem and perfectionism) were assessed. Results: In their second report, respondents were inclined to report less psychosocial impacts with small differences (ranging from 0-3 scalar points on average) and less significant in the active group compared to neutral group (2 out of 7 vs. 5 out of 7 aspects). Types of visual stimuli were a significant predictor only of changes pertaining to psychological impact of dental esthetics (p=0.045; r=0.221). The intellect moderated perception of smile esthetics, after having been exposed to commercials, accentuated beautiful smiles as a suppressor (ΔR 2 =0.076; p=0.005; total model R 2 =0.347; p=0.033). In subjects with higher cognitive abilities, an increase in the self-perceived malocclusion level induced a smaller decrease in psychological impact of dental esthetics as compared to those with lower intellect. Conclusion: Psychosocial influences of malocclusion are not stable and tend to decrease during time. However, the exposure to a high smile esthetic of other individuals can inhibit that process in persons with more severe mallocclusion and higher cognitive abilities

Purtscher’s retinopathy: case report

Cilj: Cilj rada je prikazati slučaj Purtscherove retinopatije, rijetke hemoragijske i vazookluzivne vaskulopatije koju obilježava nagli značajni pad vida povezan s teškom traumom glave bez značajne ozljede oka. Može se javiti i u sklopu nekih netraumatskih stanja i tada se naziva retinopatija slična Purtcherovoj. U većini slučajeva javlja se bilateralno, dok je rjeđa unilateralna pojava. Budući da još uvijek ne postoje službene smjernice za liječenje Purtscherove retinopatije, ona svakako predstavlja izazov za kliničare. Prikaz slučaja: 28-godišnji muškarac požalio se na izrazito pogoršanje vida lijevog oka dva dana nakon traume glave zadobivene pri padu s motocikla. Detaljnim oftalmološkim pregledom ustanovljen je uredan nalaz očne pozadine desnog oka, dok su lijevo ustanovljene promjene papile vidnog živca, te krvarenja i blijede, jasno ograničene zone retine (Purtscherove mrlje) te pamučasti eksudati. Idući korak uključivao je kompjutoriziranu tomografiju orbita, optičku koherentnu tomografiju makula i vidnog živca, fluoresceinsku angiografiju i perimetriju te je postavljena konačna dijagnoza Purtscherove retinopatije, a u konzultaciji s neurokirurgom uvedena je pulsna terapija metilprednizolonom. Gotovo potpun oporavak vida i promjena na očnoj pozadini postignut je za 3 mjeseca. Zaključci: Purtscherova retinopatija razmjerno je rijetka bolest, a jednostrano pojavljivanje još je i rjeđe. Nema egzaktnih smjernica za liječenje ove bolesti, naime, neki autori navode poboljšanje nakon terapije metilprednizolonom, a neki su zabilježili i određeni stupanj oporavka bez liječenja. Svakako je potrebno sistematsko praćenje slučajeva koji se pojave te razmjena iskustava u svrhu preciznijeg određivanja adekvatne, eventualno i nove terapije.Aim: To present a case of Purtscher\u27s retinopathy, rare haemorrhagic and vasoocclusive vasculopathy characterized by sudden blindness associated with severe head trauma with non-ocular trauma. It can occur in the complete absence of trauma and the term Purtscher-like retinopathy is used. In most cases it occurs bilaterally, less common unilateral occurence. Since there are still no official guidelines for Purtscher\u27s retinopathy treatment, it represents a challenge. Case report: A 28-year-old male patient who had head trauma secondary to motorcycle accident was referred to our Clinic two days after the trauma for left unilateral visual loss. The patient underwent a detailed ophthalmological examination with no remarkable signs on the right eye and changes of optic nerve head and retinal hemorrhages, multiple white retinal patches (Purtscher\u27s flecken) and cotton wool spots on the left eye. The next step including orbital computerized tomography , macular and optic nervae head optic coherent tomography, fluorescein angiography and perimetry was performed and the patient was finally diagnosed as Purtscher\u27s retinopathy. After consultation with neurosurgeon the patient was treated with pulse methylprednisolone. Almost complete recovery of vision and retinal changes was achieved in 3 months. Conclusions: Purtscher retinopathy is a relatively rare disease; unilateral appearance is less common. There are no exact guidelines for the treatment, some authors cite improvement after therapy with methyl-prednisolone, and some have recorded a certain degree of recovery without treatment. It is necessary to monitor systematically the cases that arise and exchange experiences for the purpose of more precise determination of adequate, possibly new, therapies

PREDICTORS OF ORTHODONTIC TREATMENT DEMAND IN EARLY ADOLESCENCE

Cilj istraživanja bio je ispitati odnose između intenziteta malokluzije, narušenosti kvalitete života, stava roditelja o potrebi za ortodontskim liječenjem vlastitog djeteta te zahtjeva za ortodontskim liječenjem mlađih adolescenata u Hrvatskoj. Dodatno, provesti validaciju četiri skraćene inačice Upitnika percepcije djece koji mjeri psihosocijalne utjecaje i oralne funkcije. Uzorak je činilo 287 ispitanika (55% ženskog spola) dobi 11-14 godina. Psihometrijske karakteristike Upitnika percepcije djece analizirane su provjerom valjanosti, pouzdanosti i prikladnosti. Regresijskom analizom istražen je odnos intenziteta malokluzije, spola, narušenosti kvalitete života, stava roditelja o potrebi za ortodontskim liječenjem svog djeteta i zahtjeva za liječenjem mlađih adolescenata. Upitnik percepcije djece pokazao je zadovoljavajuću valjanost, pouzdanost i prikladnost, regresijske i kraće inačice bolju nego čestične i dulje. Stav roditelja te narušeno emocionalno blagostanje smanjuju direktni linearni odnos stupnja malokluzije i zahtjeva za liječenjem djelujući kao paralelni medijatori (B=0,12-0,33; p<0,001). Oralni simptomi, ograničenja funkcije i društveno blagostanje nisu odrednice zahtjeva. S porastom psiholoških utjecaja malokluzije i stava roditelja o potrebi za liječenjem raste zahtjev. Izgled za zahtjevom adolescenta za ortodontskim liječenjem povećava se 3,1 puta ako roditelj ima pozitivan stav o potrebi za njegovim liječenjem (95% CI 1,5-6,2; p=0,002), 2,7 puta kod visokog intenziteta malokluzije (95% CI 1,3-5,6; p=0,007) te 1,4 puta za svaki skalarni bod narušenosti emocionalnog blagostanja (95% CI 1,2-1,7; p<0,001). Izgled za zahtjevom adolescenta dobi 11-12 godina povećava se 7,7 puta kod pozitivnog stava roditelja (95% CI 2,4-25,1; p=0,001), dok se u dobi 13-14 godina povećava za 4,5 puta kod izraženije malokluzije (95% CI 1,5-12,9; p=0,006). Postoji visoka varijabilnost razine želje za ortodontskim liječenjem mlađih adolescenata te na nju utječe više posredničkih čimbenika, najmanje stupanj malokluzije. Adolescenti koji osjećaju sram zbog malokluzije te čiji roditelji imaju pozitivan stav o potrebi za liječenjem imat će veći zahtjev. Uloga roditelja je značajnija u ranijoj dobi kada bi mogli biti i važan čimbenik suradljivosti tijekom terapijeObjectives were to explore relationship between malocclusion severity, impaired quality of life, parental perception of their child's treatment need and orthodontic treatment demand of young adolescents in Croatia. To validate 4 short-forms of Child Perceptions Questionnaire which measures psychosocial influences and oral functions. A total of 287 subjects (55% female) 11-14 year-olds participated. Psychometric characteristics of Child Perceptions Questionnaire were analyzed for validity, reliability and responsiveness. Regression analysis was used to explore relationship between malocclusion severity, gender, impaired quality of life, parental perception of their child's treatment need and treatment demands in young adolescents. Child Perceptions Questionnaire demonstrated satisfactory validity, reliability and responsiveness, regression and shorter versions better than item and longer ones. Parental attitude and impaired emotional well-being diminish direct linear relationship between malocclusion severity and treatment demand acting as parallel mediators (B=0.12-0.33; p<0.001). Oral symptoms, functional limitations and social well-being are not determinants of treatment demand. With the increase in psychological influences of malocclusion and the parental attitude, demand increases. The odds for treatment demand increases 3.1 times with higher parental attitude of treatment need (95% CI 1.5-6.2; p=0.002), 2.7 times with malocclusion severity (95% CI 1.3-5.6; p=0.007) and 1.4 times for a scalar point of impaired emotional well-being (95% CI 1.2-1.7; p<0.001). The odds of demanding treatmant in 11-12 year-olds increases 7.7 times if the parent has a high attitude (95% CI 2.4-25.1; p=0.001), and in 13-14 year-olds it increases by 4.5 times with a high degree of malocclusion (95% CI 1.5-12.9; p=0.006). There is a high variability of adolescents' orthodontic treatment demand. It is influenced by several mediators, least of all malocclusion severity. Adolescents who feel ashamed due to their malocclusion and whose parents have a high perception of treatment need will have higher demand. The role of parents is more significant at an earlier age when they could be important factor in compliance during therapy

PREDICTORS OF ORTHODONTIC TREATMENT DEMAND IN EARLY ADOLESCENCE

Cilj istraživanja bio je ispitati odnose između intenziteta malokluzije, narušenosti kvalitete života, stava roditelja o potrebi za ortodontskim liječenjem vlastitog djeteta te zahtjeva za ortodontskim liječenjem mlađih adolescenata u Hrvatskoj. Dodatno, provesti validaciju četiri skraćene inačice Upitnika percepcije djece koji mjeri psihosocijalne utjecaje i oralne funkcije. Uzorak je činilo 287 ispitanika (55% ženskog spola) dobi 11-14 godina. Psihometrijske karakteristike Upitnika percepcije djece analizirane su provjerom valjanosti, pouzdanosti i prikladnosti. Regresijskom analizom istražen je odnos intenziteta malokluzije, spola, narušenosti kvalitete života, stava roditelja o potrebi za ortodontskim liječenjem svog djeteta i zahtjeva za liječenjem mlađih adolescenata. Upitnik percepcije djece pokazao je zadovoljavajuću valjanost, pouzdanost i prikladnost, regresijske i kraće inačice bolju nego čestične i dulje. Stav roditelja te narušeno emocionalno blagostanje smanjuju direktni linearni odnos stupnja malokluzije i zahtjeva za liječenjem djelujući kao paralelni medijatori (B=0,12-0,33; p<0,001). Oralni simptomi, ograničenja funkcije i društveno blagostanje nisu odrednice zahtjeva. S porastom psiholoških utjecaja malokluzije i stava roditelja o potrebi za liječenjem raste zahtjev. Izgled za zahtjevom adolescenta za ortodontskim liječenjem povećava se 3,1 puta ako roditelj ima pozitivan stav o potrebi za njegovim liječenjem (95% CI 1,5-6,2; p=0,002), 2,7 puta kod visokog intenziteta malokluzije (95% CI 1,3-5,6; p=0,007) te 1,4 puta za svaki skalarni bod narušenosti emocionalnog blagostanja (95% CI 1,2-1,7; p<0,001). Izgled za zahtjevom adolescenta dobi 11-12 godina povećava se 7,7 puta kod pozitivnog stava roditelja (95% CI 2,4-25,1; p=0,001), dok se u dobi 13-14 godina povećava za 4,5 puta kod izraženije malokluzije (95% CI 1,5-12,9; p=0,006). Postoji visoka varijabilnost razine želje za ortodontskim liječenjem mlađih adolescenata te na nju utječe više posredničkih čimbenika, najmanje stupanj malokluzije. Adolescenti koji osjećaju sram zbog malokluzije te čiji roditelji imaju pozitivan stav o potrebi za liječenjem imat će veći zahtjev. Uloga roditelja je značajnija u ranijoj dobi kada bi mogli biti i važan čimbenik suradljivosti tijekom terapijeObjectives were to explore relationship between malocclusion severity, impaired quality of life, parental perception of their child's treatment need and orthodontic treatment demand of young adolescents in Croatia. To validate 4 short-forms of Child Perceptions Questionnaire which measures psychosocial influences and oral functions. A total of 287 subjects (55% female) 11-14 year-olds participated. Psychometric characteristics of Child Perceptions Questionnaire were analyzed for validity, reliability and responsiveness. Regression analysis was used to explore relationship between malocclusion severity, gender, impaired quality of life, parental perception of their child's treatment need and treatment demands in young adolescents. Child Perceptions Questionnaire demonstrated satisfactory validity, reliability and responsiveness, regression and shorter versions better than item and longer ones. Parental attitude and impaired emotional well-being diminish direct linear relationship between malocclusion severity and treatment demand acting as parallel mediators (B=0.12-0.33; p<0.001). Oral symptoms, functional limitations and social well-being are not determinants of treatment demand. With the increase in psychological influences of malocclusion and the parental attitude, demand increases. The odds for treatment demand increases 3.1 times with higher parental attitude of treatment need (95% CI 1.5-6.2; p=0.002), 2.7 times with malocclusion severity (95% CI 1.3-5.6; p=0.007) and 1.4 times for a scalar point of impaired emotional well-being (95% CI 1.2-1.7; p<0.001). The odds of demanding treatmant in 11-12 year-olds increases 7.7 times if the parent has a high attitude (95% CI 2.4-25.1; p=0.001), and in 13-14 year-olds it increases by 4.5 times with a high degree of malocclusion (95% CI 1.5-12.9; p=0.006). There is a high variability of adolescents' orthodontic treatment demand. It is influenced by several mediators, least of all malocclusion severity. Adolescents who feel ashamed due to their malocclusion and whose parents have a high perception of treatment need will have higher demand. The role of parents is more significant at an earlier age when they could be important factor in compliance during therapy

Rana ortodontska terapija malokluzija progenijskog kompleksa

Skeletna klasa III najčešće se pojavljuje kao kombinacija različitog stupnja nedovoljnog rasta maksile i pretjeranog rasta mandibule. Rana ortodontska terapija skeletnih malokluzija klase III provodi se u periodu rane mješovite denticije, kada cirkummaksilarne suture još nisu okoštale pa je moguće ostvariti anteriorni pomak maksile. Cilj rada bio je utvrditi učinak rane terapije skeletnih malokluzija klase III napravom za forsiranu ekspanziju maksile hyrax vijkom i obraznom ortopedskom maskom. Istraživanje je bilo prospektivno. U istraživanju je sudjelovalo 8 ispitanika s dijagnozom skeletne klase III kojima je provedena terapija napravom za forsiranu ekspanziju maksile i obraznom maskom u periodu rane mješovite denticije. Terapija obraznom maskom trajala je 12 mjeseci. Učinak rane terapije analiziran je usporedbom latero-lateralnih kefalograma snimljenih prije terapije i po završetku terapije. Praćen je ukupno 21 parametar koji se odnosi na skeletne i dentoalveolarne strukture. U statističkoj analizi korišten je Wilcoxonov test uz razinu značajnosti P<0.05. Terapija je rezultirala značajnim povećanjem u vrijednostima kuta maksilarnog prognatizma (P=0,036) i kuta skeletne klase (P=0,025) te pregriza (P=0,018). Promjene u ostalim mjerenim skeletnim i dentoalveolarnim varijablama nisu bile statistički značajne. Terapija je imala tendenciju povećanja vertikalne dimenzije lica, protruzije gornjih sjekutića, retruzije donjih sjekutića i produbljivanja zagriza. Rana terapija malokluzija klase III napravom za forsiranu ekspanziju maksile s hyrax vijkom i obraznom ortopedskom maskom producirala je značajni anteriorni skeletni pomak maksile uz manje izraženu dentoalveolarnu kompenzaciju i povećanje vertikalne dimenzije lica.Skeletal class III malocclusion are often presented as a combination of insufficient growth of the upper jaw and excessive growth of the lower jaw. Early treatment of skeletal class III malocclusion is applied during the early mixed dentition, when circummaxillary sutures still have not completed their ossification and anterior movement of the maxilla can be achieved. The aim of this research was to determine the effectiveness of the early treatmnet of skeletal class III malocclusion with maxillary expansion and face mask therapy. Prospective research has been performed. A total of 8 patients with skeletal class III malocclusion were treated with maxillary expansion and face mask therapy during the period of early mixed dentition. Face mask therapy lasted 12 months. Effectiveness of the early treatmnet was evaluated by comparison of the values of cephalometric variables measured before and after therapy. A total of 21 cephalometric variables concering skeletal and dentoalveolar structures were measured. Statistic analysis were performed using Wilcoxon test, with significance set at a P value < 0,05. Therapy resulted with significant increase of the angle of maxillary protrusion (P=0,036), significant increase of the angle of skeletal class (P=0,025) and significant increase of over-jet (P=0,018). Changes of the values of other skeletal and dentoalveolar variables were not statistically significant. Tendencies toward the increase of the vertical dimension of the face, protrusion of the upper incisors, retrusion of the lower incisors and toward the increase of over-bite were observed. Early treatment of skeletal class III malocclusion with maxillary expansion and face mask therapy produced significant skeletal anterior translation of maxilla with less noticed dentoalveolar compensations and increase of the vertical facial dimension