Postexposition prophylaxis for hepatotropic viruses (HBV and HCV) and human immunodeficiency virus (HIV)

A serious occupational risk of transmitting viral infections caused by hepatotropic viruses, such as hepatitis B virus (HBV) and hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is present in dental practice. The risk of exposure to blood and a variety of pathogenic agents is significantly higher in health care workers. The aim of this study was to present the guidelines in the case of risk contact with potentially infectious material containing hepatotropic viruses (HBV and HCV) and HIV in dental practice. As those viruses cause serious infections, immediately after the exposure (up to 24 hours) it is necessary to visit the referent institution for Postexposition Prophylaxis (PEP) implementation. Complete dental team should be familiar with PEP protocol. PEP should be administered by specialist of infectious diseases who assesses the degree of risk contact. Because of possibly serious complications due to infection by hepatotropic viruses, all health workers should received a vaccine against HBV. Instructions regarding the control testing and counseling are provided by a physician who prescribed PEP. A health worker in Serbia can contact Clinic for Infectious Diseases in Belgrade, Novi Sad and Nis, if PEP is needed

Kako prepoznati pacijenta zaraženog HIV-om u stomatološkoj ordinaciji

The human immunodeficiency virus (HIV) belongs to the family of retroviruses, the subfamily of lentiviruses and can be found in all body fluids. Virus concentration in body fluids determines the way of HIV transmission (through sexual contact, blood and blood products, vertical transmission). The results from literature indicate that, among the first manifestations of HIV, there are gingival and periodontal changes. Besides, certain number of opportunistic infections start and manifest themselves in the oral cavity. The aim of this paper was to present the most frequent changes in the oral cavity, such as: HIV gingivitis, HIV periodontitis, Candidiasis (pseudomembranous, erythematous, hyperplastic and agular cheilitis), hairy leukoplakia, HSV1 and Kaposi sarcoma.Virus humane imunodeficijencije (HIV), pripada familiji retrovirusa iz podfamilije lentivirusa i nalazi se u svim telesnim tečnostima (ekskretima i sekretima) u osoba sa HIV infekcijom. Koncentracija virusa u telesnim tečnostima determiniše način prenošenja HIV-a (seksualnim kontaktom, preko krvi i krvnih produkata, vertikalnom transmisijom). Podaci iz literature ukazuju na činjenicu da među prvim manifestacijama HIV infekcije dolazi do promene na gingivi i parodoncijumu, a osim toga, određeni broj oportunističkih infekcija počinje i manifestuje se u usnoj duplji. Cilj ovog rada je bio da predstavi najčešće promene u usnoj duplji osoba sa HIV infekcijom kao što su: HIV gingivitis, HIV parodontitis, kandidijaza (pseudomembranozna, eritemska, hiperplastična i angulusni heilitis), čupasta leukoplakija, HSV i Kapošijev sarkom

Heliobacter pylori u dentalnom plaku kod pacijenata sa oboljenjem želuca i duodenuma

The discovery of Helicobacter pylori (H. pylori) bacteria in 1982 (by Warren and Marshall) begins a new historical era in gastroenterology. Discovery of gramnegative bacteria has led to the revolution of the pathogenesis of ulcer disease, cancer alone, primary gastric lymphoma low-grade malignancy (MALT - lymphoma), and treatment of ulcer disease. Literature data on colonisation of H. pylori in dental plaque and in gastric mucosa at the same time in patients with gastric disorders are contradictory. Taking into account the prevalence of H. pylori infections, increasing resistance to therapy, and the potential existence of a reservoir within the oral cavity, the importance of understanding the relationship between the bacteria that inhabit the stomach and those in dental plaque imposes itself. The impact of dentists on the possibilities of prevention and treatment is very important, but on the other hand insufficiently explored. The main objective of this doctoral thesis was to determine the correlation of findings of H. pylori in the stomach and H. pylori in dental plaque in patients with disorders related to the upper part of the digestive tract as well as the correlation of these findings after the applied therapy in patients with confirmed presence of H. pylori in the stomach. The study was designed as a prospective study. The study comprised 158 patients divided into two groups. The first, target, group consisted of 118 patients with problems related to the upper part of the digestive tract and in which endoscopic diagnostics was indicated for identification of H. pylori. The second, control, group consisted of 40 patients who did not have any problems related to the upper part of the digestive tract. In the target group patients were subjected to esophagogastroduodenoscopy, and cuts of gastric mucosa were taken for histopathological analysis, rapid urease test and culture of bacteria...Otkrićem bakterije Helicobacter pylori (H. pylori) 1982. godine (Warren i Marshal), počinje novo istorijsko razdoblje u gastroenterologiji. Otkriće ove gram negativne bakterije dovelo je do revolucije patogeneze ulkusne bolesti, karcinoma i primarnog limfoma želuca niskog stepena malignosti (MALT-limfom), te lečenja ulkusne bolest. Literaturni podaci o istovremenoj kolonizaciji H. pylori u dentalnom plaku i sluzokoži želuca kod pacijenata sa gastričnim smetnjama su vrlo kontradiktorni. Uzimajući u obzir rasprostranjenost H. pylori infekcije, rastuću otpornost na terapiju, kao i postojanje potencijalnih rezervora unutar usne duplje, značaj razumevanja odnosa između bakterija koje naseljavaju želudac i onih u dentalnom plaku se sam nameće. Uticaj stomatologa na mogućnosti prevencije i terapije je veoma značajan, a sa druge strane nedovoljno istražen. Osnovni cilj ove doktorske disertacije je bio određivanje korelacije nalaza H. pylori u želucu i H. pylori u dentalnom plaku u pacijenata sa tegobama koje se odnose na gornji deo digestivnog trakta kao i korelacije istih nalaza nakon primenjene terapije kod pacijenata kod kojih je potvrđeno prisustvo H. pylori u želucu. Istraživanje je dizajnirano kao prospektivna studija. U studiji je učestvovalo 158 pacijenata podeljenih u dve grupe. Prvu ciljnu grupu činilo je 118 pacijenata sa tegobama koje se odnose na gornji deo digestivnog trakta i u kojih je bila indikovana endoskopska dijagnostika radi identifikacije H. pylori. Drugu kontrolnu grupu činilo je 40 pacijenata koji nisu imali nikakve tegobe vezane za gornji deo digestivnog trakta. Pacijentima ciljne grupe, podvrgnutim ezofagogastroduodenoskopiji, uzimani su isečci želudačne sluznice za patohistološku analizu, brzi ureaza test i bakterijsku kulturu. Neposredno pred ezofagogastroduodenoskopiju određivan je indeks dentalnog plaka..

Helicobacter pylori in dental plaque in patients with gastric and duodenal disease

Otkrićem bakterije Helicobacter pylori (H. pylori) 1982. godine (Warren i Marshal), počinje novo istorijsko razdoblje u gastroenterologiji. Otkriće ove gram negativne bakterije dovelo je do revolucije patogeneze ulkusne bolesti, karcinoma i primarnog limfoma želuca niskog stepena malignosti (MALT-limfom), te lečenja ulkusne bolest. Literaturni podaci o istovremenoj kolonizaciji H. pylori u dentalnom plaku i sluzokoži želuca kod pacijenata sa gastričnim smetnjama su vrlo kontradiktorni. Uzimajući u obzir rasprostranjenost H. pylori infekcije, rastuću otpornost na terapiju, kao i postojanje potencijalnih rezervora unutar usne duplje, značaj razumevanja odnosa između bakterija koje naseljavaju želudac i onih u dentalnom plaku se sam nameće. Uticaj stomatologa na mogućnosti prevencije i terapije je veoma značajan, a sa druge strane nedovoljno istražen. Osnovni cilj ove doktorske disertacije je bio određivanje korelacije nalaza H. pylori u želucu i H. pylori u dentalnom plaku u pacijenata sa tegobama koje se odnose na gornji deo digestivnog trakta kao i korelacije istih nalaza nakon primenjene terapije kod pacijenata kod kojih je potvrđeno prisustvo H. pylori u želucu. Istraživanje je dizajnirano kao prospektivna studija. U studiji je učestvovalo 158 pacijenata podeljenih u dve grupe. Prvu ciljnu grupu činilo je 118 pacijenata sa tegobama koje se odnose na gornji deo digestivnog trakta i u kojih je bila indikovana endoskopska dijagnostika radi identifikacije H. pylori. Drugu kontrolnu grupu činilo je 40 pacijenata koji nisu imali nikakve tegobe vezane za gornji deo digestivnog trakta. Pacijentima ciljne grupe, podvrgnutim ezofagogastroduodenoskopiji, uzimani su isečci želudačne sluznice za patohistološku analizu, brzi ureaza test i bakterijsku kulturu. Neposredno pred ezofagogastroduodenoskopiju određivan je indeks dentalnog plaka...The discovery of Helicobacter pylori (H. pylori) bacteria in 1982 (by Warren and Marshall) begins a new historical era in gastroenterology. Discovery of gramnegative bacteria has led to the revolution of the pathogenesis of ulcer disease, cancer alone, primary gastric lymphoma low-grade malignancy (MALT - lymphoma), and treatment of ulcer disease. Literature data on colonisation of H. pylori in dental plaque and in gastric mucosa at the same time in patients with gastric disorders are contradictory. Taking into account the prevalence of H. pylori infections, increasing resistance to therapy, and the potential existence of a reservoir within the oral cavity, the importance of understanding the relationship between the bacteria that inhabit the stomach and those in dental plaque imposes itself. The impact of dentists on the possibilities of prevention and treatment is very important, but on the other hand insufficiently explored. The main objective of this doctoral thesis was to determine the correlation of findings of H. pylori in the stomach and H. pylori in dental plaque in patients with disorders related to the upper part of the digestive tract as well as the correlation of these findings after the applied therapy in patients with confirmed presence of H. pylori in the stomach. The study was designed as a prospective study. The study comprised 158 patients divided into two groups. The first, target, group consisted of 118 patients with problems related to the upper part of the digestive tract and in which endoscopic diagnostics was indicated for identification of H. pylori. The second, control, group consisted of 40 patients who did not have any problems related to the upper part of the digestive tract. In the target group patients were subjected to esophagogastroduodenoscopy, and cuts of gastric mucosa were taken for histopathological analysis, rapid urease test and culture of bacteria..

Eradikacija Helicobacter pylori kod bolesnika bez gastričkih simptoma koji imaju rekurentni aftozni stomatitis - pilot studija

Background/Aim. Helicobacter (H.) pylori is a widespread bacterium and its involvement in pathogenesis of gastric diseases is well-known. However, H. pylori role in etiology of other histologically similar conditions, especially recurrent aphthous stomatitis (RAS) is still controversial. Research regarding H. pylori and its association with RAS, as well as the treatment options were always conducted on patients with diagnosed gastric problems. The aim of this study was to determine whether H. pylori is present in the oral cavity of patients suffering from RAS but without any symptoms or medical history of gastric disease. Methods. A total of 15 patients with RAS participated in the study. None of the participants suffered from any gastrointestinal disorders. Two dental plaque samples from each participant were collected. The first was analyzed using rapid urease test and the second one was put in transport medium and sent for cultivation. The sensitivity of H. pylori to antibiotics was established using disk diffusion method of sensitivity testing for every patient individually and adequate therapy was prescribed. Results. Before the treatment the mean annual recurrence rate of RAS was 8.1 ± 2.1, with the average number of lesions being 3.9 ± 1.9. During the 12-month observation period after the eradication therapy, none of the patients reported recurrence of aphthous lesions. The treatment was successful in all cases. Conclusion. This study shows that RAS can be effectively treated by successful eradication of oral H. pylori, and that RAS could be possibly considered as an early warning sign of potential gastric infection by H. pilory.Uvod/Cilj. Helicobacter (H.) pylori je široko rasprostanjena bakterija i njen uticaj na nastanak gastričkih oboljenja vrlo dobro je dokumentovan. Međutim, uloga H. pylori u patogenezi histološki sličnih oboljenja, posebno rekurentnog aftoznog stomatitisa (RAS), nije dovoljno istražena. Dosadašnje studije, u kojima je ispitivana veza između H. pylori i RAS, kao i moguće terapijske opcije, bile su usmerene ka bolesnicima sa prethodno dijagnostikovanim gastričkim smetnjama. Cilj ovog istraživanja bio je da se utvrdi da li je H. pylori prisutan u usnoj duplji i kod bolesnika bez simptoma i istorije gastričkih oboljenja koji pate od RAS. Metode. U studiji je učestvovalo 15 bolesnika koji pate od RAS. Bolesnici nisu imali smetnje vezane za gornji deo digestivnog trakta. Po dva uzorka dentalnog plaka prikupljena su od svakog bolesnika. Jedan plak je ispitivan uz pomoć brzog ureaza testa, dok je drugi stavljen u transportni medijum i poslat na kultivaciju. Osetljivost H. pylori na antibiotike određivana je uz pomoć antibiograma za svakog bolesnika posebno i, u skladu sa rezultatima, prepisivana je odgovarajuća terapija. Rezultati. Pre lečenja prosečan broj epizoda RAS tokom godine iznosio je 8,1 ± 2,1, sa prosečno 3,9 ± 1,9 aftoznih lezija. Tokom 12-mesečnog perioda nakon eradikacione terapije, ni kod jednog bolesnika nije došlo do ponovne pojave afti. Terapija je bila uspešna kod svih bolesnika. Zaključak. Rezultati ovog istraživanja pokazuju da se RAS može uspešno lečiti eradikacijom H. pylori i da se sama pojava RAS može posmatrati kao rano upozorenje na moguću gastričku infekciju

Klinička efikasnost miksture natrijum-perborata i vodonik-peroksida za intrakoronarno izbeljivanje depulpisanih zuba

Introduction/Objective the aim was to evaluate initial efficiency of sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture for intracoronal non-vital teeth bleaching ("walking bleach" technique). Methods Forty patients with discolored teeth were included in the study. Based on their history and clinical examination, causes of discoloration were classified as necrotic pulp, "endo-sealer" or unknown. The "walking bleach" technique was performed by applying sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture intracoronally to cavity dentin walls. The mixture was renewed in seven-day intervals. Tooth color was assessed visually before, during, and after the procedure using the Vita Classical shade guide (Vita Zahnfabrik, Bad Säckingen, Germany). Numerical values or shade guide units (SGU) were assigned to Vita shade tabs on a bright-dark scale. Analysis of variance, t-test, correlation and regression analysis were used to analyze the data (p lt 0.05). Results on average, 26 ± 9 days or 3-4 appointments were required for intracoronal bleaching to achieve the desired or best possible shade. Better clinical efficiency was found in the necrotic pulp group (17 ± 6 days; 8 ± 3 SGU) than in the "endo-sealer" group (42 ± 13 days; 4 ± 2 SGU) (p lt 0.05). Age significantly influenced bleaching efficiency (p lt 0.05). There was no significant correlation between bleaching efficiency and initial shade (p > 0.05). Conclusion Intracoronal, non-vital teeth bleaching ("walking bleach" technique) using sodium perborate (tetrahydrate) and 30% hydrogen peroxide mixture showed satisfactory clinical efficiency. Discoloration caused by pulp necrosis was treated more efficiently than that caused by endodontic sealers. Younger age had a positive effect and discoloration intensity had no effect on bleaching efficiency.Cilj Cilj ovog rada je da ispita inicijalnu kliničku efikasnost miksture natrijum-perborata (tetrahidrata) i 30% vodonik-peroksida za intrakoronarno izbeljivanje depulpisanih zuba (,,šetajuća" tehnika). Metode U studiju je bilo uključeno 40 pacijenata sa prebojenim zubima. Na bazi anamneze i kliničkog pregleda, uzroci diskoloracije su klasifikovani kao "nekrotična pulpa", ,,endo-siler" ili ,,nepoznat". U intervalima od sedam dana mikstura natrijum-perborata i 30% vodonik-peroksida aplikovana je intrakoronarno na dentinske zidove kaviteta. Boja zuba je procenjivana vizuelnom metodom pre, tokom i posle tretmana primenom ključa boja Vita Classic (Vita Zahnfabrik, Nemačka). Numerička vrednost (jedinica nijanse) dodeljena je svakoj nijansi ključa Vita pomoću svetlo-tamne skale. Analiza varijanse, t-test, korelaciona i regresiona analiza su korišćene za statističku obradu podataka (p lt 0,05). Rezultati Prosečno 26 ± 9 dana ili 3-4 posete su bile neophodne da se intrakoronarnim izbeljivanjem postignu željena ili najsvetlija moguća nijansa. Bolja klinička efikasnost izbeljivanja zabeležena je u grupi ,,nekrotična pulpa" (17 ± 6 dana; 8 ± 3 nijansi) nego u grupi ,,endo-siler" (42 ± 13 dana; 4 ± 2 nijanse) (p lt 0,05). Uzrast pacijenta je značajno uticao na efikasnost izbeljivanja (p lt 0,05). Nije utvrđena značajna povezanost između efikasnosti izbeljivanja i početne nijanse (p > 0,05). Zaključak Intrakoronarno izbeljivanje depulpisanih zuba odnosno "šetajuća" tehnika izbeljivanja primenom miksture natrijum-perborata (tetrahidrata) i 30% vodonik-peroksida pokazala je zadovoljavajuću kliničku efikasnost. Diskoloracija usled nekroze pulpe je uspešnije izbeljena nego diskoloracija izazvana endodontskim pastama. Efikasnije izbeljivanje je zabeleženo kod mlađih pacijenata, dok intenzitet početne diskoloracije nije značajno uticao na efikasnost izbeljivanja

RELATEDNESS OF PERSONALITY DIMENSIONS AND READING HABITS OF HIGH SCHOOL STUDENTS

Cilj je ovoga rada istražiti povezanost osobina ličnosti prema velepetoromu modelu, ekstraverzije, emocionalne stabilnosti, ugodnosti, savjesnosti te intelekta, s čitalačkim navikama srednjoškolaca jedne strukovne srednje škole iz Osijeka te ispitati mogućnost predviđanja količine čitanja na temelju dimenzija ličnosti, uz kontrolu utjecaja spola, dobi i školskoga uspjeha. Prikazani rezultati dio su opsežnijega istraživanja provedenoga u sklopu istraživanja o predrasudama i stavovima. Ukupno 103 sudionika, u dobi od 14 do 20 godina, ispunila su kratki upitnik o navikama čitanja te IPIP 50 inventar ličnosti. Upitnik o navikama čitanja omogućio nam je uvid u to koliko sudionici procjenjuju,u usporedbi s drugim učenicima u školi, da često čitaju knjige, koliko uživaju u čitanju vijesti te koliko uživaju u čitanju knjiga. Rezultati pokazuju kako postoji umjerena, ali bitna pozitivna povezanost između procijenjene učestalosti čitanja knjiga, kao i procjene užitka u čitanju knjiga s dimenzijom intelekta (r=.347, p<.01te r=.276, p<.05). Preostale dimenzije ličnosti nisu bitno povezane s navikama čitanja. Nadalje, na temelju osobina ličnosti, uz kontrolu spola, dobi i školskoga uspjeha, moguće je predvidjeti oko 20 % varijance količine čitanja, pri čemu je od dimenzija ličnosti jedini važan prediktor intelekt.The purpose of this research is to investigate the relationship of personality dimension defined by the Big Five personality model: extraversion, emotional stability, agreeableness, consciousness and intellect, with reading habits among Croatian high school students from the city of Osijek region. Furthermore, we wanted to investigate the ability to predict reading quantity based on personality dimensions, with the contribution of factors such as age, gender and school success. The results displayed are a part of a larger study on prejudice and attitudes. A total of 103 participants, aged from 14 to 20 years, filled in a short questionnaire about how much, compared to other pupils from their school, they read books, enjoy reading news and how many books they read in a year. Also, they completed a short version of IPIP 50 personality questionnaire. Results show a significant positive correlation between how much the participants read and how much they enjoy reading books with the intellect personality dimension (r=.347, p<.01 and r=.276, p<.05 respectively). Other personality dimensions showed no significant correlations with reading variables. In hierarchical regression analyses, after controlling for the effect of age, gender and school success, the Big Five model of personality was able to predict around 20 % of variance of reading quantity, with the intellect being the only significant predictor

Temperature changes in the pulp chamber induced by polymerization of resin-based dental restoratives following simulated direct pulp capping

The objective of this study was to measure temperature changes in the pulp chamber induced by polymerization of resin-based dental restoratives following a simulated procedure of direct pulp capping. Class I cavities with a microperforation at the pulp horn were prepared in extracted human molar teeth. The complete procedure of direct pulp capping and cavity restoration was performed with the root part of extracted teeth fixed in a water bath at 37 degrees C. Mineral trioxide aggregate, bioactive dentin substitute or calcium-hydroxide paste were used as pulp capping materials. Cavities were restored with a light-cured or chemically-cured resin-modified glass ionomer, universal adhesive and a bulk-fill composite, cured with a high-intensity LED unit. Pulp capping materials caused a slight temperature decrease. Lower temperature increase was recorded during light-curing of the glass ionomer liner after direct capping with mineral trioxide aggregate and calcium-hydroxide than that recorded for the bioactive dentin substitute. Adhesive light-curing increased temperature in all groups with higher mean temperatures in groups with chemically-cured as compared to those for the light-cured glass ionomer liner. Direct pulp capping with mineral trioxide aggregate or calcium-hydroxide followed by the light-cured resin-modified glass ionomer liner and a bonded bulk-fill composite restoration induced temperature changes below the potentially adverse threshold of 42.5 degrees C

Prevention of viral infection transmission in dental practice

The risk of transmission of viral infections in dentistry has caused great public fear both among patients and dentists. This is primarily related to the human immunodeficiency virus (HIV) and hepatitis viruses (HBV and HCV), which can cause many complications. This problem is particularly important in dental practice where the appropriate protection during all dental procedures is required. The application of preventive measures against blood-borne infections (HIV, HBV and HCV) may prevent transmission of these infectious agents during dental intervention. The aim of this study was to emphasize possible ways of transmission and advise prevention and protection measures against HIV, HBV and HCV infections in dental practice