Relationship of HbA1c Level and Smoking to Periodontal Status in Insulin-Dependent Diabetic Patients

Svrha istraživanja bila je ispitati učinak trajanja dijabetesa melitusa (DM-a) i razine glikoliziranoga hemoglobina (HbA1c) na parodontalni status pacijenata s inzulinski ovisnim DM-om, ali i kombinirani učinak pušenja i razine glikoliziranog hemoglobina parodontalni status. Ispitanici su slučajno odabrani među pacijentima s inzulinski ovisnim DM-om, a liječe se u Zavodu za endokrinologiju Opće bolnice “Sveti Duh”. Podaci su dobiveni razgovorom, kliničkim parodontološkim pregledom te iz kartona pacijenata arhiviranih u Zavodu. Kao mjesta s parodontitisom odabrana su ona s dubinom sondiranja od 5 i više mm. Modelom Poissonove regresije izračunat je relativni rizik s 95 postotnim intervalom pouzdanosti, korigiran za dob ispitanika. Razmjerni rizik da izgubi pričvrstak kod pušača je bio 12,805, a za dubinu sondiranja 7, 99. Relativni rizik kod pušača za razinu glikoliziranog hemoglobina (HbA1c) veću od 8,5 iznosio je 10,681 (p = 0,002), a za razinu od 8,5 i manju - 8,214 (p = 0,006). Relativni rizik za gubitak pričvrska kod nepušača bio je 4,891 (p = 0,031). Kod pušača s inzulinski ovisnim DM-om i lošom glikemičkom kontrolom najveći je rizik za razvoj i progresiju parodontalne bolesti.Objective of work. The aim of the study was to investigate the effect of diabetes mellitus (DM) duration and HbA1c level on periodontal status of patients with insulin- dependent DM, as well as the combined effect of smoking and HbA1c level on periodontal status. Subjects were randomly selected from the patients with insulindependent DM that are treated at the Department of Endocrinology in the hospital “Sveti Duh”. Data was gathered by means of an interview, clinical periodontal investigation and patients’ charts from the department. Sites with probing depth of 5 mm and greater were selected as sites with periodontitis. By means of Poisson regression model a relative risk with 95% confi dence interval was computed, corrected for age of the subjects. Relative risk for attachment loss in smokers was 12.805, and for probing depth in smokers 7.99. Relative risk of the HbA1c level > 8.5 in smokers was 10.681 (p = 0.002), and 8.214 (p = 0.006) for HbA1c level ≤ 8.5. Relative risk for attachment loss in nonsmokers was 4.891 (p = 0.031). It was concluded that insulin-dependent smokers with poor glycemic control have the greatest risk for development and progression of periodontal disease

The Use of Lasers in Disinfection and Cleaning of Root Canals: a Review

Uspjeh endodontskog liječenja zuba ovisi o učinkovitoj dezinfekciji endodontskog prostora i prevenciji reinfekcije. Današnjim postupcima kemijsko-mehaničke obrade korijenskog kanala ne može se uvijek postići zadovoljavajuća dezinfekcija i zato cijeljenje periapikalnog procesa može biti otežano. Zbog velike energije lasera i specifične interakcije s biološkim tkivima posljednja se dva desetljeća istražuje njihova primjena u dezinfekciji i čišćenju korijenskog kanala zuba. Predstavljeni su rezultati dosadašnjih istraživanja o djelovanju Er:YAG-a, Er,Cr:YSGG-a, Nd:YAG-a i diodnog lasera na dentin korijenskog kanala te uklanjanje zaostalog sloja i bakterija. Objašnjena je i moguća uporaba laserske energije u aktivaciji tekućina u korijenskom kanalu i stvaranju specifičnih kavitacija i zvučnih strujanja. Na temelju rezultata dobivenih u dosadašnjim istraživanjima zaključeno je da laseri u korijenskom kanalu djeluju baktericidno. Budući da još ne mogu potpuno zamijeniti natrijev hipoklorit, preporučuju se kao dodatna dezinfekcija na kraju kemijsko-mehaničke obrade korijenskog kanala. Osim toga određeni laseri mogu iz korijenskih kanala ukloniti zaostali sloj i debris.The outcome of root canal treatment is based on efficient disinfection of the root canal system and prevention of reinfection. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure. Due to high energy content and specific characteristics of laser light, laser treatment has been proposed for cleaning and disinfecting the root canal system. This paper reviews the literature covering the effect of Er:YAG, Er,Cr:YSGG, Nd:YAG and diode laser on the root canal wall in the removal of smear layer and against intracanal bacteria. Recently, the use of laser energy to induce cavitation and acoustic streaming of intracanal irrigants has been investigated. Based on recent literature, it can be concluded that lasers have bactericidal effects. However, they still cannot replace sodium hypochlorite and should be considered as an adjunct to the current chemical root canal disinfection protocols. Certain lasers can help in removing the smear layer and debris and can modify the morphology of the root canal wall. Unfortunately, there have not been enough randomized clinical studies evaluating endodontic treatment outcome following the use of laser

Eradication of Intracanal Enterococcus Faecalis Biofilm by Passive Ultrasonic Irrigation and RinsEndo System

Svrha: Usporediti antimikrobno djelovanje triju tehnika ispiranja korijenskog kanala s obzirom na jednako vrijeme ispiranja i jednak volumen sredstva za ispiranje. Ispitanici i metode: Četrdeset i osam jednokorijenskih zuba inokulirano je 48 sati suspenzijom Enterococcus faecalisa. Preostalih šest uzoraka korišteno je za negativnu kontrolu. Trideset i šest kanala nasumično je raspoređeno u tri eksperimentalne skupine: 1. grupa: konvencionalno ispiranje brizgalicom i iglom; 2. grupa: automatsko-dinamično ispiranje (RinsEndo); 3. grupa: pasivno ultrazvučno ispiranje (PUI). U prvom protokolu korišteno je 20 ml 3-postotnoga natrijeva hipoklorita, a u drugom protokolu kanali su isprani istim tehnikama i istom otopinom tijekom 45 sekundi. Uzorci iz korijenskih kanala kultivirani su, te su izbrojene bakterijske kolonije. Rezultati: U protokolu standardiziranog volumena irigansa, sistem RinsEndo bio je učinkovitiji od PUI-ja (p 0,05). U skupini RinsEndo pronađen je najveći broj uzoraka s minimalnim brojem bakterija E. faecalis. Zaključak: Pri ispiranju korijenskih kanala istim volumenom irigansa, sistem RinsEndo učinkovitiji je od PUI-ja. RinsEndom postignuto je i najveće smanjenje bakterija u oba protokola, koristeći se najmanjom količinom irigansa te ostvarujući najdulje vrijeme djelovanja irigansa u kanalu.Aim: The aim of the study was to compare the antimicrobial efficacy of three irrigation techniques after the use of standardized volume of NaOCl and with standardized time and irrigation. Methodology: Forty-eight single rooted teeth were inoculated with an Enterococcus faecalis suspension for 24 h. The remaining six canals served as negative controls. The 36 root canals were randomly distributed into three experimental groups; group 1, conventional syringe irrigation; group 2, automateddynamic irrigation (RinsEndo); group 3, passive ultrasonic irrigation (PUI). In the first protocol, the standardized volume of 3% NaOCl (20 mL) was used and in the second protocol, and standardized irrigation time (45 seconds) was used. Samples from root canals were cultured and the colony-forming units (CFUs) were counted. Results: When the volume of the irrigant was tandardized, RinsEndo was more effective than PUI (p0.05). The RinsEndo group had the highest percentage of minimal counts of E. faecalis CFUs. Conclusions: RinsEndo was more effective than PUI only when the volume of the irrigant was standardized. However, the RinsEndo provided higher bacterial reduction in both protocols when using the least amount of the irrigant and providing longer contact time

Short-Term Antibacterial Efficacy of Three Bioceramic Root Canal Sealers Against Enterococcus Faecalis Biofilms

Ciljevi: Cilj istraživanja bio je ispitati antimikrobnu učinkovitost triju biokeramičkih materijala za punjenje korijenskog kanala na biofilm s bakterijama E. faeaclis. Materijali i metode: Bakterijski biofilm s enterekokima fekalis uzgojen je na papirnatim filtar-diskovima postavljenima na ploče s agarom. Nakon inkubacije diskovi su prekriveni s četirima različitim materijalima za punjenje korijenskih kanala: 1. jednokomponentnim biokeramičkim punilom (TotalFill BC Sealer); 2. dvokomponentnim biokeramičkim punilom (BioRoot RCS); 3. punilom proizvedenim na temelju mineralnog trioksidnog agregata (MTA Fillapex); 4. punilom proizvedenim na temelju epoksidne smole (AH Plus). Nakon kontaktnog 60-minutnog razdoblja materijali su uklonjeni, a diskovi uloženi u epruvete s puferiranom fiziološkom otopinom. Nakon serijskog razrjeđivanja, suspenzija je nasađena na ploče s agarom te su nakon 24 sata izbrojene narasle kolonije i određen njihov ukupan broj prema čimbeniku razrjeđenja. Rezultati: Nije bilo značajne razlike u antimikrobnoj učinkovitosti između TotalFill BC Sealera i AH Plusa (p = 0,386). Oba materijala pokazala su bolju antibakterijsku učinkovitost od BioRoot RCS-a i MTA Fillapexa (p < 0,001). Zaključak: Total Fill BC Sealer i AH Plus bolje antibakterijski djeluju od BioRoot RCS-a i MTA Fillapexa.Objectives: The aim of the study was to evaluate the antimicrobial efficacy of three bioceramic root canal sealers against Enterococcus faecalis (E. faecalis) biofilm. Material and methods: E. faecalis bacterial suspension was grown on filter paper discs on agar plates. After the incubation period, the discs were covered with four different root canal sealers: 1) Premixing bioceramic root canal sealer (TotalFill BC Sealer); 2) Dual component bioceramic sealer (BioRoot RCS); 3) Mineral trioxide agreggate based sealer (MTA Fillapex); 4) Epoxy resin-based selar (AH Plus). After contact time of 60 minutes, the sealers were removed, and the discs were transferred into sterile tubes containing phosphate buffered saline. After serial dilutions, the aliquots of the suspension were cultivated for 24 hours. After the incubation period, the colony forming units (CFUs) were counted. Results: There were no significant differences in antibacterial efficacy between the Total Fill BC Sealer and the AH Plus sealer (p=0.386). Both sealers showed better antibacterial efficacy compared to the BioRoot RCS and the MTA Fillapex (p<0.001). Conclusion: The Total Fill BC Sealer and AH Plus had better antibacterial efficacy than the BioRoot RCS and the MTA Fillapex sealers