ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES AT THE DEPARTMENT OF PEDIATRIC SURGERY, UNIVERSITY HOSPITAL SPLIT BETWEEN 2006-2016

Cilj istraživanja: Incidencija ozljeda meniska je u porastu u pedijatrijskoj populaciji. Postoje snažni dokazi da meniscektomija u djece pospješuje razvoj osteoartritisa koljena, pa su se tako u proteklih dvadeset godina tehnike popravka ruptura meniska razvile u smjeru očuvanja tkiva i funkcije meniska. Cilj ovog istraživanja je bio analizirati epidemiološke, demografske, kliničke karakteristike i ishod bolesnika operiranih zbog ozljeda meniska te unutar ispitanika usporediti dvije skupine bolesnika operiranih različitim tehnikama popravka meniska. Ispitanici i metode: Ispitanici su svi bolesnici operirani u Zavodu za dječju kirurgiju KBC Split zbog ozlijede meniska od 1. siječnja 2006. do 1. lipnja 2016. godine. Svakom ispitaniku analizirani su sljedeći parametri: dob, spol, mehanizam nastanka ozlijede, lateralizacija ozlijede i meniska, anatomska lokalizacija ozljede i pridružene ozlijede. Ispitanicima koji su podvrgnuti tehnikama popravka meniska analizirani su još i vrsta kirurške tehnike popravka meniska, vrijeme trajanja operacije, duljina hospitalizacije, rezultati subjektivne evaluacije 4 tjedna nakon operacije putem Lysholm i IKDC upitnika te komplikacije nakon operacije. Rezultati: istraživanje je obuhvatilo 102 bolesnika operiranih zbog ozlijede meniska. Od ukupnog broja bolesnika u 24 bolesnika je učinjena resekcija meniska, u 36 bolesnika „shaving“ meniska, 21 bolesnik operiran je tehnikom postavljanja šavova i 21 bolesnik operiran fiksacijom meniska strelicama. Dječaci su češće operirani od djevojčica u odnosu 2:1, a prosječna dob operiranih je bila 16 godina. Medijalni menisk (62%) i desno koljeno (58%) su češće zahvaćeni ozljedom. Najčešća anatomska lokalizacija ozljede meniska su prednji rog (36%) i tijelo meniska (36%), a među ozljedama srednjeg djela meniska, najčešća je ozljeda po tipu „Bucket-handle“ (84%). Sport (87%) ima najvišu incidenciju kao uzrok ozljede meniska, a nogomet (33%) je najčešći među sportovima. Između skupine bolesnika operiranih tehnikom postavljanja šavova i tehnikom fiksacije meniska strelicama nije bilo značajne razlike između promatranih ishoda liječenja, osim za anatomsku lokalizaciju ozljede (p=0.035). Medijani operacijskog vremena u skupinama bolesnika operiranih tehnikama popravka meniska bili su 62.5 i 70 minuta (p=0.184). Medijan duljine hospitalizacije bio je 3 dana za obje skupine (p=0.951). Medijan vrijednosti Lysholm ljestvice za promatrane skupine bio je 86.5 i 84.5 (p=0.651) i IKDC ljestvice 81.05 i 81.6 (p=0.986). Zaključci: Poznavajući štetne učinke meniscektomije, tehnika popravka meniska je dugoročnije bolji odabir i trebala bi se provoditi kad god je to moguće. Obje tehnike (tehnika postavljanja šavova i tehnike fiksacije meniska strelicama) su sigurne i uspješne u liječenju ruptura meniska u djece, bez značajnijih komplikacija te s dobrim dugoročnim rezultatima.Objectives and background: Incidence of meniscal lesions is increasing in the pediatric population. There is strong evidence that meniscectomy in pediatric patients induces the development of premature osteoarthritis, so given the harmful impact of meniscectomy, meniscal repair is attempted whenever possible. The aim of this study was to analyze epidemiologic, demographic, clinical characteristics, outcomes in patients with arthroscopic management of meniscal injuries and to compare two groups of patients that have undergone different techniques of meniscal repair. Patients and Methods: From January 2006 until June 2016 case records of 102 patients who underwent arthroscopic management of meniscal injuries were retrospectively reviewed. Each patient was analyzed for following parameters: age, gender, mechanisms of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and the results of follow-up (Lysholm and IKDC score). Results: The study included 102 patients who underwent arthroscopic management of meniscal injuries. There were 24 patients with meniscal resection, 36 patients with meniscus „shaving“, 21 patient with suture technique and 21 patient with meniscal dart technique. The male to female ratio was 2:1 and mean age was 16. Medial meniscus (62%) and right leg (58) were predominantly injured. The anterior segment was involved in 36% cases, the middle segment in 36% cases and among middle segment injuries there were 84% bucket-handle tears. Mechanisms of injury included sports-related accidents in 89% of the cases and football (33%) had the highest incidence among sports. In patients that underwent meniscal repair, statistically significant differences regarding clinical outcomes were not found, but differences between groups were found in anatomic injury localization (p=0.035). Median of operation time was 62.5 and 70 minutes for two groups (p=0.184), median of hospital stay was 3 days for both groups (p=0.951), median of Lysholm score was 86.5 and 84.5 (p=0.651) and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Conclusions: Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support routine arthroscopic repair of meniscal tears, since the suture technique as the meniscal dart techniques are safe and successful in meniscal repair, with good long-term results and without important complications

ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES AT THE DEPARTMENT OF PEDIATRIC SURGERY, UNIVERSITY HOSPITAL SPLIT BETWEEN 2006-2016

Cilj istraživanja: Incidencija ozljeda meniska je u porastu u pedijatrijskoj populaciji. Postoje snažni dokazi da meniscektomija u djece pospješuje razvoj osteoartritisa koljena, pa su se tako u proteklih dvadeset godina tehnike popravka ruptura meniska razvile u smjeru očuvanja tkiva i funkcije meniska. Cilj ovog istraživanja je bio analizirati epidemiološke, demografske, kliničke karakteristike i ishod bolesnika operiranih zbog ozljeda meniska te unutar ispitanika usporediti dvije skupine bolesnika operiranih različitim tehnikama popravka meniska. Ispitanici i metode: Ispitanici su svi bolesnici operirani u Zavodu za dječju kirurgiju KBC Split zbog ozlijede meniska od 1. siječnja 2006. do 1. lipnja 2016. godine. Svakom ispitaniku analizirani su sljedeći parametri: dob, spol, mehanizam nastanka ozlijede, lateralizacija ozlijede i meniska, anatomska lokalizacija ozljede i pridružene ozlijede. Ispitanicima koji su podvrgnuti tehnikama popravka meniska analizirani su još i vrsta kirurške tehnike popravka meniska, vrijeme trajanja operacije, duljina hospitalizacije, rezultati subjektivne evaluacije 4 tjedna nakon operacije putem Lysholm i IKDC upitnika te komplikacije nakon operacije. Rezultati: istraživanje je obuhvatilo 102 bolesnika operiranih zbog ozlijede meniska. Od ukupnog broja bolesnika u 24 bolesnika je učinjena resekcija meniska, u 36 bolesnika „shaving“ meniska, 21 bolesnik operiran je tehnikom postavljanja šavova i 21 bolesnik operiran fiksacijom meniska strelicama. Dječaci su češće operirani od djevojčica u odnosu 2:1, a prosječna dob operiranih je bila 16 godina. Medijalni menisk (62%) i desno koljeno (58%) su češće zahvaćeni ozljedom. Najčešća anatomska lokalizacija ozljede meniska su prednji rog (36%) i tijelo meniska (36%), a među ozljedama srednjeg djela meniska, najčešća je ozljeda po tipu „Bucket-handle“ (84%). Sport (87%) ima najvišu incidenciju kao uzrok ozljede meniska, a nogomet (33%) je najčešći među sportovima. Između skupine bolesnika operiranih tehnikom postavljanja šavova i tehnikom fiksacije meniska strelicama nije bilo značajne razlike između promatranih ishoda liječenja, osim za anatomsku lokalizaciju ozljede (p=0.035). Medijani operacijskog vremena u skupinama bolesnika operiranih tehnikama popravka meniska bili su 62.5 i 70 minuta (p=0.184). Medijan duljine hospitalizacije bio je 3 dana za obje skupine (p=0.951). Medijan vrijednosti Lysholm ljestvice za promatrane skupine bio je 86.5 i 84.5 (p=0.651) i IKDC ljestvice 81.05 i 81.6 (p=0.986). Zaključci: Poznavajući štetne učinke meniscektomije, tehnika popravka meniska je dugoročnije bolji odabir i trebala bi se provoditi kad god je to moguće. Obje tehnike (tehnika postavljanja šavova i tehnike fiksacije meniska strelicama) su sigurne i uspješne u liječenju ruptura meniska u djece, bez značajnijih komplikacija te s dobrim dugoročnim rezultatima.Objectives and background: Incidence of meniscal lesions is increasing in the pediatric population. There is strong evidence that meniscectomy in pediatric patients induces the development of premature osteoarthritis, so given the harmful impact of meniscectomy, meniscal repair is attempted whenever possible. The aim of this study was to analyze epidemiologic, demographic, clinical characteristics, outcomes in patients with arthroscopic management of meniscal injuries and to compare two groups of patients that have undergone different techniques of meniscal repair. Patients and Methods: From January 2006 until June 2016 case records of 102 patients who underwent arthroscopic management of meniscal injuries were retrospectively reviewed. Each patient was analyzed for following parameters: age, gender, mechanisms of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and the results of follow-up (Lysholm and IKDC score). Results: The study included 102 patients who underwent arthroscopic management of meniscal injuries. There were 24 patients with meniscal resection, 36 patients with meniscus „shaving“, 21 patient with suture technique and 21 patient with meniscal dart technique. The male to female ratio was 2:1 and mean age was 16. Medial meniscus (62%) and right leg (58) were predominantly injured. The anterior segment was involved in 36% cases, the middle segment in 36% cases and among middle segment injuries there were 84% bucket-handle tears. Mechanisms of injury included sports-related accidents in 89% of the cases and football (33%) had the highest incidence among sports. In patients that underwent meniscal repair, statistically significant differences regarding clinical outcomes were not found, but differences between groups were found in anatomic injury localization (p=0.035). Median of operation time was 62.5 and 70 minutes for two groups (p=0.184), median of hospital stay was 3 days for both groups (p=0.951), median of Lysholm score was 86.5 and 84.5 (p=0.651) and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Conclusions: Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support routine arthroscopic repair of meniscal tears, since the suture technique as the meniscal dart techniques are safe and successful in meniscal repair, with good long-term results and without important complications

Artroskopsko liječenje ozljeda meniska u adolescenata: usporedba tehnike šivanja izvana-unutra i meniskealnih strelica

The aim of this study was to evaluate clinical and subjective outcomes of the meniscal dart technique in patients having undergone arthroscopic meniscal repair by comparing it with the outside-in suturing technique. From January 2006 until June 2017, case records of 37 patients having undergone arthroscopic meniscal repair were retrospectively reviewed. The patients were divided into two groups based on the technique used for meniscal repair, as follows: 18 patients in suture technique group and 19 patients in meniscal dart group. Each patient was analyzed for the following parameters: age, gender, mechanism of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and results of follow-up (Lysholm and International Knee Documentation Committee (IKDC) score). There were no statistically significant differences between the groups according to clinical outcomes except for anatomic injury localization (p=0.035). Median of operation time was 62.5 min in suture technique group and 70 min in meniscal dart group (p=0.184); median of hospital stay was 2 days for both groups (p=0.951); median of Lysholm score was 86.5 and 84.5 (p=0.651); and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support arthroscopic repair of meniscal tears, since both the suture technique and the meniscal dart technique are safe and successful in meniscal repair in children, with good long-term results and without important complications.Cilj ovoga istraživanja je bio analizirati kliničke i subjektivne ishode liječenja u bolesnika operiranih zbog ozljeda meniska te usporediti dvije skupine bolesnika operiranih različitim tehnikama popravka meniska. Od siječnja 2006. do lipnja 2017. godine u studiju je uključeno 37 bolesnika koji su liječeni artroskopski zbog rupture meniska. Bolesnici su podijeljeni u dvije skupine ovisno o vrsti kirurškog zahvata: jednu skupinu skupinu činilo je 18 bolesnika u kojih je meniskus šivan tehnikom postavljanja šavova, a drugu 19 bolesnika u kojih su upotrebljene strelice za fiksaciju meniska. Svakom ispitaniku analizirani su sljedeći parametri: dob, spol, mehanizam nastanka ozljede, lateralizacija ozljede i meniska, anatomska lokalizacija ozljede i pridružene ozljede. Ispitanicima koji su podvrgnuti tehnikama popravka meniska analizirani su još i vrsta kirurške tehnike popravka meniska, rezultati subjektivne evaluacije 4 tjedna nakon operacije putem upitnika Lysholm i IKDC (International Knee Documentation Committee) te komplikacije nakon operacije. Između skupina bolesnika operiranih tehnikom postavljanja šavova i tehnikom fiksacije meniska strelicama nije bilo značajne razlike u promatranim ishodima liječenja, osim za anatomsku lokalizaciju ozljede (p=0,035). Medijani operacijskog vremena u skupini bolesnika operiranih tehnikom postavljanja šavova iznosio je 62,5 min, dok je u skupini fiksacije meniska strelicama medijan operacijskog vremena iznosio 70 minuta (p=0,184). Medijan duljine hospitalizacije bio je 2 dana za obje skupine (p=0,951). Medijan vrijednosti ljestvice Lysholm za promatrane skupine bio je 86,5 i 84,5 (p=0,651), a ljestvice IKDC 81,05 i 81,6 (p=0,986). Poznavajući štetne učinke meniskektomije, tehnika popravka meniska je dugoročnije bolji odabir i trebala bi se provoditi kadgod je to moguće. Obje tehnike (tehnika postavljanja šavova i tehnika fiksacije meniska strelicama) su sigurne i uspješne u liječenju ruptura meniska u djece, bez značajnijih komplikacija te s dobrim dugoročnim rezultatima

Procjena genotoksičnosti i citotoksičnosti dentalnih implantata na gingivnim epitelnim stanicama

Objectives: Although titanium-based implants are considered bioinert, it has been found that they are subject to corrosion and wear. This study aimed to evaluate the cytotoxic and genotoxic potential of two implant systems in gingival epithelial cells. Material and methods: Gingival swabs were taken three times from 91 subjects. The first swab was taken before dental implant placement, the second swab 90 days after dental implant placement and the third swab 21 days following the healing abutment placement. DNA damage was analyzed using the micronucleus test. Tested dental implants with corresponding healing abutments were Ankylos and Dentium SuperLine. Results: Of all scored forms of cytogenetic damage in gingival cells of individuals after implementation of tested dental implant systems, only an increase in the number of binucleated cells (P ≤ 0.001) was significant in contrast to control values for both tested implant systems, 90 days after dental implant placement and 21 days following the healing abutment placement. Conclusion: It may be concluded that there are no titanium-based implant dependent cytogenetic damage in gingival epithelial cells. A slight increase in cytogenetic damage has been observed but it is of no biological relevance and might be associated with healing abutment induced effect.Cilj istraživanja: Iako se titanijevi dentalni implantati smatraju bioinertnima, potvrđeno je da su podložni koroziji i trošenju. Cilj ovog istraživanja jest procjena citotoksičnoga i genotoksičnoga potencijala dviju vrsta implantoloških sustava na gingivnim epitelnim stanicama. Materijal i metode: Uzorci oljuštenih gingivnih stanica uzeti su od 91 ispitanika u trima razdobljima. Prvi bris uzet je prije postavljanja implantata, drugi 90 dana poslije njegove ugradnje, a treći 21 dan poslije postavljanja nadogradnje za oblikovanje gingive, tj. gingivnoga formera. Oštećenje DNK procijenjeno o je mikronukleusnim testom. Ispitivani dentalni implantati s gingivnim formerima bili su Ankylos i Dentium SuperLine. Rezultati: Dobiveni rezultati pokazuju da se poslije postavljanja obiju vrsta ispitivanih dentalnih implantata (Ankylos i Dentium) znatno povećava broj binuklearnih stanica (P ≤ 0,001) u odnosu prema početnim vrijednostima i to 90 dana poslije postavljanja implantata i 21 dan poslije postavljanja gingivnoga formera. Zaključak: Na temelju dobivenih rezultata može se zaključiti da titanijevi dentalni implantati nakon postavljanja ne izazivaju citotoksične i genotoksične učinke na gingivnim stanicama. Uočeni blagi učinci ne mogu se smatrati biološki relevantnima

ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES AT THE DEPARTMENT OF PEDIATRIC SURGERY, UNIVERSITY HOSPITAL SPLIT BETWEEN 2006-2016

Cilj istraživanja: Incidencija ozljeda meniska je u porastu u pedijatrijskoj populaciji. Postoje snažni dokazi da meniscektomija u djece pospješuje razvoj osteoartritisa koljena, pa su se tako u proteklih dvadeset godina tehnike popravka ruptura meniska razvile u smjeru očuvanja tkiva i funkcije meniska. Cilj ovog istraživanja je bio analizirati epidemiološke, demografske, kliničke karakteristike i ishod bolesnika operiranih zbog ozljeda meniska te unutar ispitanika usporediti dvije skupine bolesnika operiranih različitim tehnikama popravka meniska. Ispitanici i metode: Ispitanici su svi bolesnici operirani u Zavodu za dječju kirurgiju KBC Split zbog ozlijede meniska od 1. siječnja 2006. do 1. lipnja 2016. godine. Svakom ispitaniku analizirani su sljedeći parametri: dob, spol, mehanizam nastanka ozlijede, lateralizacija ozlijede i meniska, anatomska lokalizacija ozljede i pridružene ozlijede. Ispitanicima koji su podvrgnuti tehnikama popravka meniska analizirani su još i vrsta kirurške tehnike popravka meniska, vrijeme trajanja operacije, duljina hospitalizacije, rezultati subjektivne evaluacije 4 tjedna nakon operacije putem Lysholm i IKDC upitnika te komplikacije nakon operacije. Rezultati: istraživanje je obuhvatilo 102 bolesnika operiranih zbog ozlijede meniska. Od ukupnog broja bolesnika u 24 bolesnika je učinjena resekcija meniska, u 36 bolesnika „shaving“ meniska, 21 bolesnik operiran je tehnikom postavljanja šavova i 21 bolesnik operiran fiksacijom meniska strelicama. Dječaci su češće operirani od djevojčica u odnosu 2:1, a prosječna dob operiranih je bila 16 godina. Medijalni menisk (62%) i desno koljeno (58%) su češće zahvaćeni ozljedom. Najčešća anatomska lokalizacija ozljede meniska su prednji rog (36%) i tijelo meniska (36%), a među ozljedama srednjeg djela meniska, najčešća je ozljeda po tipu „Bucket-handle“ (84%). Sport (87%) ima najvišu incidenciju kao uzrok ozljede meniska, a nogomet (33%) je najčešći među sportovima. Između skupine bolesnika operiranih tehnikom postavljanja šavova i tehnikom fiksacije meniska strelicama nije bilo značajne razlike između promatranih ishoda liječenja, osim za anatomsku lokalizaciju ozljede (p=0.035). Medijani operacijskog vremena u skupinama bolesnika operiranih tehnikama popravka meniska bili su 62.5 i 70 minuta (p=0.184). Medijan duljine hospitalizacije bio je 3 dana za obje skupine (p=0.951). Medijan vrijednosti Lysholm ljestvice za promatrane skupine bio je 86.5 i 84.5 (p=0.651) i IKDC ljestvice 81.05 i 81.6 (p=0.986). Zaključci: Poznavajući štetne učinke meniscektomije, tehnika popravka meniska je dugoročnije bolji odabir i trebala bi se provoditi kad god je to moguće. Obje tehnike (tehnika postavljanja šavova i tehnike fiksacije meniska strelicama) su sigurne i uspješne u liječenju ruptura meniska u djece, bez značajnijih komplikacija te s dobrim dugoročnim rezultatima.Objectives and background: Incidence of meniscal lesions is increasing in the pediatric population. There is strong evidence that meniscectomy in pediatric patients induces the development of premature osteoarthritis, so given the harmful impact of meniscectomy, meniscal repair is attempted whenever possible. The aim of this study was to analyze epidemiologic, demographic, clinical characteristics, outcomes in patients with arthroscopic management of meniscal injuries and to compare two groups of patients that have undergone different techniques of meniscal repair. Patients and Methods: From January 2006 until June 2016 case records of 102 patients who underwent arthroscopic management of meniscal injuries were retrospectively reviewed. Each patient was analyzed for following parameters: age, gender, mechanisms of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and the results of follow-up (Lysholm and IKDC score). Results: The study included 102 patients who underwent arthroscopic management of meniscal injuries. There were 24 patients with meniscal resection, 36 patients with meniscus „shaving“, 21 patient with suture technique and 21 patient with meniscal dart technique. The male to female ratio was 2:1 and mean age was 16. Medial meniscus (62%) and right leg (58) were predominantly injured. The anterior segment was involved in 36% cases, the middle segment in 36% cases and among middle segment injuries there were 84% bucket-handle tears. Mechanisms of injury included sports-related accidents in 89% of the cases and football (33%) had the highest incidence among sports. In patients that underwent meniscal repair, statistically significant differences regarding clinical outcomes were not found, but differences between groups were found in anatomic injury localization (p=0.035). Median of operation time was 62.5 and 70 minutes for two groups (p=0.184), median of hospital stay was 3 days for both groups (p=0.951), median of Lysholm score was 86.5 and 84.5 (p=0.651) and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Conclusions: Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support routine arthroscopic repair of meniscal tears, since the suture technique as the meniscal dart techniques are safe and successful in meniscal repair, with good long-term results and without important complications

Assessment of damage to the buccal cells of the oral cavity caused by fluoride

Ciljevi: Glavni cilj istraživanja je procijeniti potencijalni citotoksični i genotoksični učinak kombiniranog korištenja fluoridiranih zubnih pasta i tekućine za ispiranje usne šupljine s fluoridom mjerenjem pojavnosti mikronukleusa i ostalih jezgrinih anomalija u stanicama bukalne sluznice mikronukleus testom. Sporedni ciljevi su procijeniti potencijalni citotoksični i genotoksični učinak zubnih pasta s različitim koncentracija fluorida na pojavnost mikronukleusa i ostalih jezgrinih anomalija u stanicama bukalne sluznice mikronukleus testom te ispitati znanja, stavove i ponašanje ispitanika prema oralnom zdravlju. Materijali i metode: Ovo prospektivno, dvostruko slijepo, paralelno randomizirano kliničko ispitivanje provedeno je pomoću analize bukalnog mikronukleusnog citoma (BMCyt analiza). Četrdeset i jedan ispitanik nasumično je raspoređen u dvije skupine. Svi su ispitanici koristili iste vrste pasta za zube 12 tjedana, dizajniranih izričito za ovu studiju (bez fluorida, 1050 ppm NaF, odnosno 1450 ppm NaF; svaka kroz 4 tjedna). Istovremeno, tijekom tri mjeseca istraživanja, jedna skupina koristila je tekućini za ispiranje usta s fluoridom (450 ppm NaF), a druga bez fluorida. Uzorak bukalne sluznice uzet je prije uporabe testiranih proizvoda te nakon 4, 8 i 12 tjedana njihove uporabe. Anketni upitnik o znanjima, stavovima i ponašanju sadržavao je 11 pitanja o znanju, 8 o stavovima i 7 o ponašanju prema oralnom zdravlju. Rezultati: Učestalost mikronukleusa i većina drugih bodovanih parametara iz BMCyt testa nije pokazala statistički značajne razlike unutar i između ispitivanih skupina. Uspoređujući dvije skupine, samo je statistički značajno povećanje broja stanica s jezgrinim pupoljcima (p = 0,048) i karioreksom (p = 0,020) nakon 4 tjedna korištenja primijećeno u skupini koja je koristila tekućinu za ispiranje usta s fluoridom. Znanja, stavovi i ponašanje prema oralnom zdravlju također ne pokazuju značajnija odstupanja od točnih odgovora i pozitivnog stava te ponašanja, a za bolje riješen upitnik o znanjima, stavovima i ponašanju prema oralnom zdravlju značajni negativni prediktori su iznadprosječni socio-ekonomski status (OR = 0,023; 95 % CI 0,0007 - 0,794; p = 0,036) i visoka stručna sprema (OR = 0,010; 95 % CI 0,0002 - 0,515; p = 0,021). Zaključak: Na temelju rezultata može se zaključiti da istovremena primjena fluoridirane zubne paste i fluoridirane tekućine za usta ne dovodi do citotoksičnog i genotoksičnog oštećenja stanica bukalne sluznice. Na broj stanica s kariolizom utječe konzumacija mesa, a na broj stanica s karioreksom utječe muški spol. Za bolje riješen upitnik o znanjima, stavovima i ponašanju prema oralnom zdravlju značajni negativni prediktori su iznadprosječni socio - ekonomski status i visoka stručna sprema.Objectives: The main objective is to evaluate the potential cytotoxic and genotoxic effect of the combined use of fluoridated toothpastes and mouthwashes with fluoride by measuring the occurrence of micronuclei and other nuclear anomalies in the cells of the buccal mucosa using the micronucleus test. Secondary objectives are to assess the potential cytotoxic and genotoxic effect of toothpastes with different concentrations of fluoride on the occurrence of micronuclei and other nuclear anomalies in the cells of the buccal mucosa using the micronucleus test, and to examine the knowledge, attitudes and behavior towards the oral health. Materials and methods: This prospective, double-blinded parallel randomized clinical trial was conducted using a buccal micronucleus cytome assay (BMCyt assay). Forty-one participants were randomly assigned to the two groups. All participants have been using the same kinds of toothpaste for 12 weeks, designed explicitly for this study (non-fluoride, 1050 ppm NaF, and 1450 ppm NaF each for four weeks, respectively). Simultaneously, during the three months of the research, one group used mouthwash with fluoride (450 ppm NaF) and another without fluoride. The buccal mucosal sampling was taken before using the tested products and after 4, 8, and 12 weeks of their use. The survey questionnaire on knowledge, attitudes and behavior had 11 questions on knowledge, 8 on attitudes and 7 on behavior towards oral health. Results: The frequency of micronuclei and the majority of other scored end-points from the BMCyt assay showed no statistically significant differences within and between the studied groups. Comparing two groups only statistically significant increase in the number of cells with nuclear buds (p = 0,048) and karyorrhexis (p = 0,020) at four weeks of usage were observed in the group that used mouthwash with fluoride. Knowledge, attitudes and behavior towards the oral health also does not show significant deviations from correct answers and positive attitude and behavior, and for the better-solved questionnaire on knowledge, attitudes and behavior towards oral health, significant negative predictors are above-average socio-economic status (OR = 0,023; 95 % CI 0,0007 - 0,794; p = 0,036) and higher education grade (OR = 0,010; 95 % CI 0,0002 - 0,515; p = 0,021). Conclusion: Based on the results, it can be concluded that simultaneous application of fluoridated toothpaste and fluoride mouthwash does not lead to cytotoxic or genotoxic damage in buccal mucosal cells. The number of cells with karyolysis is affected by meat consumption, and the number of cells with karyorrhexis is affected by male gender. For the better-solved questionnaire on knowledge, attitudes and behavior towards oral health, significant negative predictors are above-average socio-economic status and high professional education

Assessment of damage to the buccal cells of the oral cavity caused by fluoride

Ciljevi: Glavni cilj istraživanja je procijeniti potencijalni citotoksični i genotoksični učinak kombiniranog korištenja fluoridiranih zubnih pasta i tekućine za ispiranje usne šupljine s fluoridom mjerenjem pojavnosti mikronukleusa i ostalih jezgrinih anomalija u stanicama bukalne sluznice mikronukleus testom. Sporedni ciljevi su procijeniti potencijalni citotoksični i genotoksični učinak zubnih pasta s različitim koncentracija fluorida na pojavnost mikronukleusa i ostalih jezgrinih anomalija u stanicama bukalne sluznice mikronukleus testom te ispitati znanja, stavove i ponašanje ispitanika prema oralnom zdravlju. Materijali i metode: Ovo prospektivno, dvostruko slijepo, paralelno randomizirano kliničko ispitivanje provedeno je pomoću analize bukalnog mikronukleusnog citoma (BMCyt analiza). Četrdeset i jedan ispitanik nasumično je raspoređen u dvije skupine. Svi su ispitanici koristili iste vrste pasta za zube 12 tjedana, dizajniranih izričito za ovu studiju (bez fluorida, 1050 ppm NaF, odnosno 1450 ppm NaF; svaka kroz 4 tjedna). Istovremeno, tijekom tri mjeseca istraživanja, jedna skupina koristila je tekućini za ispiranje usta s fluoridom (450 ppm NaF), a druga bez fluorida. Uzorak bukalne sluznice uzet je prije uporabe testiranih proizvoda te nakon 4, 8 i 12 tjedana njihove uporabe. Anketni upitnik o znanjima, stavovima i ponašanju sadržavao je 11 pitanja o znanju, 8 o stavovima i 7 o ponašanju prema oralnom zdravlju. Rezultati: Učestalost mikronukleusa i većina drugih bodovanih parametara iz BMCyt testa nije pokazala statistički značajne razlike unutar i između ispitivanih skupina. Uspoređujući dvije skupine, samo je statistički značajno povećanje broja stanica s jezgrinim pupoljcima (p = 0,048) i karioreksom (p = 0,020) nakon 4 tjedna korištenja primijećeno u skupini koja je koristila tekućinu za ispiranje usta s fluoridom. Znanja, stavovi i ponašanje prema oralnom zdravlju također ne pokazuju značajnija odstupanja od točnih odgovora i pozitivnog stava te ponašanja, a za bolje riješen upitnik o znanjima, stavovima i ponašanju prema oralnom zdravlju značajni negativni prediktori su iznadprosječni socio-ekonomski status (OR = 0,023; 95 % CI 0,0007 - 0,794; p = 0,036) i visoka stručna sprema (OR = 0,010; 95 % CI 0,0002 - 0,515; p = 0,021). Zaključak: Na temelju rezultata može se zaključiti da istovremena primjena fluoridirane zubne paste i fluoridirane tekućine za usta ne dovodi do citotoksičnog i genotoksičnog oštećenja stanica bukalne sluznice. Na broj stanica s kariolizom utječe konzumacija mesa, a na broj stanica s karioreksom utječe muški spol. Za bolje riješen upitnik o znanjima, stavovima i ponašanju prema oralnom zdravlju značajni negativni prediktori su iznadprosječni socio - ekonomski status i visoka stručna sprema.Objectives: The main objective is to evaluate the potential cytotoxic and genotoxic effect of the combined use of fluoridated toothpastes and mouthwashes with fluoride by measuring the occurrence of micronuclei and other nuclear anomalies in the cells of the buccal mucosa using the micronucleus test. Secondary objectives are to assess the potential cytotoxic and genotoxic effect of toothpastes with different concentrations of fluoride on the occurrence of micronuclei and other nuclear anomalies in the cells of the buccal mucosa using the micronucleus test, and to examine the knowledge, attitudes and behavior towards the oral health. Materials and methods: This prospective, double-blinded parallel randomized clinical trial was conducted using a buccal micronucleus cytome assay (BMCyt assay). Forty-one participants were randomly assigned to the two groups. All participants have been using the same kinds of toothpaste for 12 weeks, designed explicitly for this study (non-fluoride, 1050 ppm NaF, and 1450 ppm NaF each for four weeks, respectively). Simultaneously, during the three months of the research, one group used mouthwash with fluoride (450 ppm NaF) and another without fluoride. The buccal mucosal sampling was taken before using the tested products and after 4, 8, and 12 weeks of their use. The survey questionnaire on knowledge, attitudes and behavior had 11 questions on knowledge, 8 on attitudes and 7 on behavior towards oral health. Results: The frequency of micronuclei and the majority of other scored end-points from the BMCyt assay showed no statistically significant differences within and between the studied groups. Comparing two groups only statistically significant increase in the number of cells with nuclear buds (p = 0,048) and karyorrhexis (p = 0,020) at four weeks of usage were observed in the group that used mouthwash with fluoride. Knowledge, attitudes and behavior towards the oral health also does not show significant deviations from correct answers and positive attitude and behavior, and for the better-solved questionnaire on knowledge, attitudes and behavior towards oral health, significant negative predictors are above-average socio-economic status (OR = 0,023; 95 % CI 0,0007 - 0,794; p = 0,036) and higher education grade (OR = 0,010; 95 % CI 0,0002 - 0,515; p = 0,021). Conclusion: Based on the results, it can be concluded that simultaneous application of fluoridated toothpaste and fluoride mouthwash does not lead to cytotoxic or genotoxic damage in buccal mucosal cells. The number of cells with karyolysis is affected by meat consumption, and the number of cells with karyorrhexis is affected by male gender. For the better-solved questionnaire on knowledge, attitudes and behavior towards oral health, significant negative predictors are above-average socio-economic status and high professional education

Clinical Prospective Assessment of Genotoxic and Cytotoxic Effects of Fluoride Toothpaste and Mouthwash in Buccal Mucosal Cells

Background: Fluorides are an essential component of oral hygiene products used to prevent dental decay. Therefore, a question arises about the potential harms of joint use of fluoridated toothpaste and mouthwashes regarding the increased amount of fluoride in the oral mucosa. Methods: This prospective, double-blinded parallel randomized clinical trial was conducted using a buccal micronucleus cytome assay (BMCyt assay). Forty-one participants were randomly assigned to the two groups. All participants used the same kinds of toothpaste for 12 weeks, designed explicitly for this study (non-fluoride, 1050 ppm F, and 1450 ppm F each for 4 weeks). Simultaneously, during the 3 months of the research, one group used mouthwash with fluoride (450 ppm) and another without fluoride. The buccal mucosal sampling was taken before using the tested products and after 4, 8, and 12 weeks of their use. Results: The frequency of micronuclei and the majority of other scored endpoints from the BMCyt assay showed no statistically significant differences within and between the studied groups. Comparing two groups, only statistically significant increases in the number of cells with nuclear buds (p = 0.048) and karyorrhexis (p = 0.020) at four weeks of usage were observed in the group that used mouthwash with fluoride. Conclusion: On the basis of the results, it can be concluded that simultaneous application of fluoridated toothpaste and fluoride mouthwash does not lead to cytogenetic damage in buccal mucosal cells

Oromaxillofacial Surgery: Both a Treatment and a Possible Cause of Obstructive Sleep Apnea—A Narrative Review

Obstructive sleep apnea (OSA) is a chronic, sleep-related breathing disorder. It is characterized by a nocturnal periodic decrease or complete stop in airflow due to partial or total collapse of the oropharyngeal tract. Surgical treatment of OSA is constantly evolving and improving, especially with the implementation of new technologies, and this is needed because of the very heterogeneous reasons for OSA due to the multiple sites of potential airway obstruction. Moreover, all of these surgical methods have advantages and disadvantages; hence, patients should be approached individually, and surgical therapies should be chosen carefully. Furthermore, while it is well-established that oromaxillofacial surgery (OMFS) provides various surgical modalities for treating OSA both in adults and children, a new aspect is emerging regarding the possibility that some of the surgeries from the OMFS domain are also causing OSA. The latest studies are suggesting that surgical treatment in the head and neck region for causes other than OSA could possibly have a major impact on the emergence of newly developed OSA, and this issue is still very scarcely mentioned in the literature. Both oncology, traumatology, and orthognathic surgeries could be potential risk factors for developing OSA. This is an important subject, and this review will focus on both the possibilities of OMFS treatments for OSA and on the OMFS treatments for other causes that could possibly be triggering OSA

Temporomandibular Disorder Prevalence and Its Association with Lifestyle Habits in Biomedicine Students—A Cross-Sectional Study

This study aimed to examine the frequency of temporomandibular disorder among biomedical students and relate its occurrence to lifestyle habits. A cross-sectional collection of data was carried out and included a total of 676 examinees through a questionnaire that had 73 questions: general information and lifestyle habits, the Fonseca Anamnestic index (FAI), the Jaw Function Limitation Scale (JFLS), and the Perceived Stress Questionnaire (PSQ). The statistical analyses between three or more groups were conducted using the one-way analysis of variance (ANOVA) with post hoc Scheffé test or Kruskal–Wallis test with post hoc Dunn’s test for quantitative variables. The comparison of qualitative variables was conducted using the Chi-square test, while the correlations were determined using Spearman’s correlation test. The analysis showed that a higher frequency of moderate or severe TMD was observed in subjects who were smokers (p p < 0.001). Furthermore, a positive correlation between the amount of stress and the severity of TMD was found. Our study implies that students of biomedical studies have an increased risk for TMD and that there is a link with their lifestyle habits