Procena obrasca rasta i odnosa cervikalnih i kraniofacijalnih struktura

Ontogenesis represents unique qualitative and quantitative change of an organism, and it is process of somatic, functional and reproductive development of each individual from the time of fertilization to the organism’s mature form. Growth refers to a positive change in size of body over a period of time as a result of cellular proliferation and extracellular matrix secretion. Change of analyzed growth parameters over a period of time represents the characteristic growth pattern. The exact assessment of physical development of organs of human body and growth pattern of each individual is important for determination of extreme values under their standard norms or their deviation, and for diagnostic and therapeutically purposes. Changes in craniofacial system from birth to maturity are very characteristic. A lot of previous studies had shown the existence of correlation between growth and development of craniofacial and cervical structures. It has been shown that posture of cervical vertebra is influenced by several factors including: ethnicity, sex, age, constitution of the body, craniofacial morphology and orthodontic therapy. Based on previous research in our population there are no available data of growth and development parameters of craniofacial and cervical system, especially related to different age, sex and skeletal classes of patients. Additionally, influence of craniofacial parameters on growth and development of component of cervical system has not been thoroughly investigated. AIMS. This study aimed to determine the standard norms of parameters of craniofacial and cervical system in patients of our population with different age, sex and skeletal classes. The additional aims were to determine the correlation between craniofacial and cervical parameters and skeletal maturity of patients in our population based on morphological characteristics of cervical vertebra. MATERIAL AND METHODS. This retrospective study consisted of 540 patients of Clinic of orthodontics, School of dental medicine, University of Belgrade, both sex, divided in 3 skeletal classes according to Angle classification and in 9 age groups: I – 7.00-8.06, II – 8.07-10.00, III – 10.01-11.06, IV – 11.07-13.00, V – 13.01-14.06, VI – 14.07-16.00, VII – 16.01-17.06, VIII – 17.07-19.00 and IX – older than 19 years...Ontogenetsko razviće obuhvata jedinstven niz kvalitativnih i kvantitativnih promena organizma, te predstavlja proces sveukupnog somatskog (anatomsko–morfološkog), funkci-onalnog i reproduktivnog formiranja svake individue od njenog začeća do pune polne zrelosti. Rast je porast mase i veličine organizma koji nastaje kao posledica povećanja broja ćelija proliferacijom, rastom ćelija i sekrecijom ekstracelularnog matriksa. Promena vrednosti analiziranih parametara rasta u odreĎenim vremenskim intervalima predstavlja karakterističan obrazac rasta. Tačna procena fiziološkog razvoja pojedinih organskih sistema i obrazac rasta svake individue vaţni su radi odreĎivanja ekstremnih vrednosti unutar fizioloških varijacija ili njihovog odstupanja, te postavljanja pravilne dijagnoze i sprovoĎenja adekvatne terapije. Promene u predelu kraniofacijalnog sistema od roĎenja do odraslog doba su izrazite i veoma upadljive. Mnogobrojna istraţivanja su pokazala da postoji povezanost izmeĎu rasta i razvoja kraniofacijalnih i cervikalnih struktura. Pokazano je da na poloţaj vratnog dela kičmenog stuba utiču mnogobrojni faktori poput: etničke pripadnosti, pola, uzrasta, konstitucije, kraniofacijalne morfologije, kao i ortodontska terapija. Sa aspekta procene obrasca rasta, u dosadašnjim istraţivanjima još uvek nisu analizirani parametri rasta i razvoja kranio-facijalnog i cervikalnog sistema u našoj populaciji u odnosu na različite uzraste i pol pa-cijenata, kao i različite skeletne klase. Dodatno, nedovoljno je ispitan uticaj kraniofacijalnih parametara na rast i razvoj komponenti cervikalnog segmenta kičmenog stuba. CILJ ISTRAŢIVANJA. Ovo istraţivanje je imalo za cilj da odredi vrednosti kranio-facijalnih parametara i parametara cervikalnog dela kičmenog stuba na ispitivanom uzorku pacijenata različite starosti, pola i skeletnih klasa. TakoĎe, cilj je bio i da se utvrdi postojanje meĎusobnog odnosa izmeĎu kraniofacijalnih i cervikalnih parametara u ispitivanoj populaciji pacijenata, kao i da se odredi skeletna zrelost pacijenata na osnovu morfoloških karakteristika cervikalnog dela kičmenog stuba. MATERIJAL I METOD. U retrospektivno istraţivanje uključeno je ukupno 540 pacijenata Klinike za ortopediju vilica Stomatološkog fakulteta Univerziteta u Beogradu, oba pola, podeljenih u tri skeletne klase, u skladu sa Angle-ovom klasifikacijom, i u devet starosnih grupa: I – 7.00-8.06, II – 8.07-10.00, III – 10.01-11.06, IV – 11.07-13.00, V – 13.01-14.06, 3 VI – 14.07-16.00, VII – 16.01-17.06, VIII – 17.07-19.00 i IX – stariji od 19 godina..

Assesment of growth pattern and relationship between cervical and craniofacial structures

Ontogenetsko razviće obuhvata jedinstven niz kvalitativnih i kvantitativnih promena organizma, te predstavlja proces sveukupnog somatskog (anatomsko–morfološkog), funkci-onalnog i reproduktivnog formiranja svake individue od njenog začeća do pune polne zrelosti. Rast je porast mase i veličine organizma koji nastaje kao posledica povećanja broja ćelija proliferacijom, rastom ćelija i sekrecijom ekstracelularnog matriksa. Promena vrednosti analiziranih parametara rasta u odreĎenim vremenskim intervalima predstavlja karakterističan obrazac rasta. Tačna procena fiziološkog razvoja pojedinih organskih sistema i obrazac rasta svake individue vaţni su radi odreĎivanja ekstremnih vrednosti unutar fizioloških varijacija ili njihovog odstupanja, te postavljanja pravilne dijagnoze i sprovoĎenja adekvatne terapije. Promene u predelu kraniofacijalnog sistema od roĎenja do odraslog doba su izrazite i veoma upadljive. Mnogobrojna istraţivanja su pokazala da postoji povezanost izmeĎu rasta i razvoja kraniofacijalnih i cervikalnih struktura. Pokazano je da na poloţaj vratnog dela kičmenog stuba utiču mnogobrojni faktori poput: etničke pripadnosti, pola, uzrasta, konstitucije, kraniofacijalne morfologije, kao i ortodontska terapija. Sa aspekta procene obrasca rasta, u dosadašnjim istraţivanjima još uvek nisu analizirani parametri rasta i razvoja kranio-facijalnog i cervikalnog sistema u našoj populaciji u odnosu na različite uzraste i pol pa-cijenata, kao i različite skeletne klase. Dodatno, nedovoljno je ispitan uticaj kraniofacijalnih parametara na rast i razvoj komponenti cervikalnog segmenta kičmenog stuba. CILJ ISTRAŢIVANJA. Ovo istraţivanje je imalo za cilj da odredi vrednosti kranio-facijalnih parametara i parametara cervikalnog dela kičmenog stuba na ispitivanom uzorku pacijenata različite starosti, pola i skeletnih klasa. TakoĎe, cilj je bio i da se utvrdi postojanje meĎusobnog odnosa izmeĎu kraniofacijalnih i cervikalnih parametara u ispitivanoj populaciji pacijenata, kao i da se odredi skeletna zrelost pacijenata na osnovu morfoloških karakteristika cervikalnog dela kičmenog stuba. MATERIJAL I METOD. U retrospektivno istraţivanje uključeno je ukupno 540 pacijenata Klinike za ortopediju vilica Stomatološkog fakulteta Univerziteta u Beogradu, oba pola, podeljenih u tri skeletne klase, u skladu sa Angle-ovom klasifikacijom, i u devet starosnih grupa: I – 7.00-8.06, II – 8.07-10.00, III – 10.01-11.06, IV – 11.07-13.00, V – 13.01-14.06, 3 VI – 14.07-16.00, VII – 16.01-17.06, VIII – 17.07-19.00 i IX – stariji od 19 godina...Ontogenesis represents unique qualitative and quantitative change of an organism, and it is process of somatic, functional and reproductive development of each individual from the time of fertilization to the organism’s mature form. Growth refers to a positive change in size of body over a period of time as a result of cellular proliferation and extracellular matrix secretion. Change of analyzed growth parameters over a period of time represents the characteristic growth pattern. The exact assessment of physical development of organs of human body and growth pattern of each individual is important for determination of extreme values under their standard norms or their deviation, and for diagnostic and therapeutically purposes. Changes in craniofacial system from birth to maturity are very characteristic. A lot of previous studies had shown the existence of correlation between growth and development of craniofacial and cervical structures. It has been shown that posture of cervical vertebra is influenced by several factors including: ethnicity, sex, age, constitution of the body, craniofacial morphology and orthodontic therapy. Based on previous research in our population there are no available data of growth and development parameters of craniofacial and cervical system, especially related to different age, sex and skeletal classes of patients. Additionally, influence of craniofacial parameters on growth and development of component of cervical system has not been thoroughly investigated. AIMS. This study aimed to determine the standard norms of parameters of craniofacial and cervical system in patients of our population with different age, sex and skeletal classes. The additional aims were to determine the correlation between craniofacial and cervical parameters and skeletal maturity of patients in our population based on morphological characteristics of cervical vertebra. MATERIAL AND METHODS. This retrospective study consisted of 540 patients of Clinic of orthodontics, School of dental medicine, University of Belgrade, both sex, divided in 3 skeletal classes according to Angle classification and in 9 age groups: I – 7.00-8.06, II – 8.07-10.00, III – 10.01-11.06, IV – 11.07-13.00, V – 13.01-14.06, VI – 14.07-16.00, VII – 16.01-17.06, VIII – 17.07-19.00 and IX – older than 19 years..

Primena ibuprofena u suzbijanju postoperacionog bola u stomatologiji

Postoperative pain is common complication after daily dental care. Non-steroidal anti-inflammatory drugs are among most widely prescribed analgesics for management of postoperative pain. The analgesic effect of a non-steroidal antiinflammatory drug (NSAID) is related to its ability to inhibit prostaglandin synthesis. Ibuprofen (2-proprionic acid derivate) was discovered in the 1960s as a representative of NSAIDs. It is a peripherally acting analgesic with a potent anti-inflammatory action. An extensive retrospective analysis of randomized clinical trials conducted over the last 40 years demonstrated that ibuprofen is effective in moderate to severe postoperative pain for different indications in dentistry. In comparison to other NSAIDs, ibuprofen is characterized by its efficiency, safety and good tolerance. The aim of this article was to present the most important pharmacological and therapeutic characteristics and side effects of ibuprofen used for postoperative pain treatment in dentistry.Bol koji se javi nakon hirurške intervencije je vrlo česta komplikacija u svakodnevnoj stomatološkoj praksi. U suzbijanju (lečenju) postoperacionog bola najčešće se prepisuju nesteroidni antiinflamatorni lekovi (NSAIL). Njihov analgetski efekat se zasniva, pre svega, na sprečavanju sinteze prostaglandina. Ibuprofen (derivat 2-propionske kiseline) je predstavnik velike grupe NSAIL, a otkriven je 1960. godine. Ovaj analgetik deluje na periferne nervne završetke s izrazitim protivupalnim efektom. Opsežna retrospektivna analiza randomiziranih kliničkih istraživanja u proteklih 40 godina pokazala je da je ibuprofen efikasan u suzbijanju umerenog i izraženog postoperacionog bola kod različitih indikacija. Osim efikasnosti, ibuprofen se odlikuje dobrom podnošljivošću i sigurnošću u poređenju sa drugim NSAIL. Cilj ovog rada bio je da se ukaže na najznačajnije farmakološke i terapeutske odlike, kao i neželjena dejstva ibuprofena u lečenju postoperacionog bola pri različitim indikacijama u stomatologiji

Promene krivine vratne kičme i morfologije cervikalnih pršljenova u različitim uzrastima i mogućnost procene skeletne zrelosti

Introduction During growth, proportions of craniofacial and cervical structures are changed. Craniofacial and cervicovertebral structures are morphologically and functionally connected, but their each other's influence is still unknown. Objective The aim of this study was to determine the changes in cervical lordosis and cervicovertebral morphology in different age periods and the possibility of estimating skeletal maturity, based on the percentage of anterior cervical vertebrae body height sum in the total anterior C2-C5 height. Methods The study included lateral radiographs of 120 patients of both sexes, divided into three different age groups: eight, 12-13 and 17-18 years of age. Five craniofacial and 15 cervical parameters were measured and analyzed. Results The results showed significant correlation between cervical lordosis angle and age, gender, anterior and posterior body height of C3, C4, C5, anterior C4-C5 and posterior C2-C3, C3-C4, C4-C5 intervertebral space, anterior body height of C2-C5. Overall values of all cervical body heights were more present in the total height of the spine in females, while all intervertebral spaces were more present in males. The percentage of anterior and posterior C2, C3, C4, C5 body height sum compared to total C2-C5 height increases with age. Conclusion The cervical lordosis becomes more curved and vertebral bodies occupy more space in females, while intervertebral spaces occupy more in males. Skeletal maturity could be estimated following vertebral percentage distribution in the total anterior C2-C5 part.Uvod Tokom rasta proporcije kraniofacijalnih i cervikovertebralnih struktura se menjaju. Ove strukture su morfološki i funkcionalno povezane, ali je njihov međusobni uticaj i dalje nepoznat. Cilj rada Cilj ove studije je bio da se uoče promene krivine vratne kičme i morfologije vratnih pršljenova u različitim uzrasnim grupama, kao i mogućnost procene skeletne zrelosti zasnovane na procentualnoj zastupljenosti zbira prednjih visina vratnih pršljenova C2, C3, C4 i C5 u ukupnoj dužini prednje visine kičme od C2 do C5. Metode rada Studija je obuhvatila 120 ispitanika oba pola koji su svrstani u tri starosne grupe: 8, 12-13 i 17-18 godina. Pet kranijalnih i 15 cervikalnih parametara je mereno i analizirano. Rezultati Rezultati su pokazali statistički značajnu korelaciju između zakrivljenosti vratne kičme i godina, pola, prednje i zadnje visine tela pršljena C2, C3, C4, prednjeg C4-C5 i zadnjeg C2-C3, C3-C4, C4-C5 međupršljenskog prostora. Prosečne vrednosti visine tela vratnih pršljenova procentualno su bile češće kod ispitanica, a svi međupršljenski prostori kod osoba muškog pola. Procenat zbira prednje i zadnje visine pršljena C2, C3, C4 i C5 povećavao se sa godinama. Zaključak Krivina vratne kičme postaje zakrivljenija i tela pršljenova zauzimaju više prostora kod žena, a međupršljenski prostor više kod muškaraca. Procena skeletne zrelosti bi mogla da se prati na osnovu procentualne zastupljenosti visine tela pršljena u ukupnoj dužini prednjeg dela kičme (C2-C5)

Radiographic assessment of lower third molar eruption in different anteroposterior skeletal patterns and age-related groups

Objective: To analyze radiographic predictors for lower third molar eruption among subjects with different anteroposterior skeletal relations and of different age groups. Materials and Methods: In total, 300 lower third molars were recorded on diagnostic digital orthopantomograms (DPTs) and lateral cephalograms (LCs). The radiographs were grouped according to sagittal intermaxillary angle (ANB), subject age, and level of lower third molar eruption. The DPT was used to analyze retromolar space, mesiodistal crown width, space/width ratio, third and second molar angulation (alpha, gamma), third molar inclination (beta), and gonion angle. The LC was used to determine ANB, angles of maxillar and mandibular prognathism (SNA, SNB), mandibular plane angle (SN/MP), and mandibular lengths. A logistic regression model was created using the statistically significant predictors. Results: The logistic regression analysis revealed a statistically significant impact of 6 angle and distance between gonion and gnathion (Go-On) on the level of lower third molar eruption (P lt .001 and P lt .015, respectively). The retromolar space was significantly increased in the adult subgroup for all skeletal classes. The lower third molar impaction rate was significantly higher in the adult subgroup with the Class II (62.3%) compared with Class III subjects (31.7%; P lt .013). Conclusion: The most favorable values of linear and angular predictors of mandibular third molar eruption were measured in Class III subjects. For valid estimation of mandibular third molar eruption, certain linear and angular measures (beta angle, Go-On), as well as the size of the retromolar space, need to be considered

Patients’ trust in the health care system and physiotherapists

Introduction: The assessment of the health-care system by its beneficiaries is based on evaluation of the public perception in regards to the performance of healthcare workers, the functioning of the health system, the effectiveness of health policy measures, and a number of other components. The aim of this study was to determine patients’ trust in the work of physiotherapists and the health-care system; determine the quality of communication between the patient and the physiotherapist and determine the quality of cooperation between healthcare workers in the provision of health services.Methods: The study is descriptive, conducted in five cities: Banja Luka, Bihać, Herceg Novi, Nikšić, and Podujevo. The confidence in health-care questionnaire developed by Calnan and Sanford (2004) was used as a research instrument, containing six areas of research: Attitude toward the patient, Health policy and patient care, Professionalism and expertise, Quality of health care, Communication and information, and Quality of cooperation.Results: The mean age of the subjects was 41 years, 24 females and 26 males. Subjects expressed the greatest satisfaction on subscales I - Attitude toward the patient (27.44 ± 3.59 out of 30) and IV - Quality of health care (36.60 ± 4.19 out of 40), which represents 91.5% of the possible maximum. This is followed by subscale V - Communication and information (20.8 ± 3.17 out of 25) corresponding to 83.2% of the possible maximum, followed by subscale III - Professionalism and expertise (15.68 ± 3.29 out of 20) which represents 78.4% of the possible maximum. Subjects showed the least satisfaction on subscales II - Health policy and patient care (16.94 ± 5.56 out of 25), which represents 67.8% of the possible maximum, and subscales VI - Quality of cooperation (9.94 ± 0.42 out of 15) which corresponds to 66.3% of the possible maximum.Conclusions: The research showed a high degree of satisfaction of subjects in various fields, which indicates a high degree of confidence in the work of physiotherapists and the health-care system. Research on a larger sample in needed for creation and implementation of the guidelines in the strategic documents of the countries in the region and for improvement of health policies and patient care

Relationship between the vertical craniofacial disproportions and the cervicovertebral morphology in adult subjects

Introduction. Orthodontic diagnosis includes the interpretation of the relations between the craniofacial and cervical system, given the potential impact of the irregularities from one system to another. Objective. The aim of this study was to examine morphological characteristics of the cervical spine, depending on the parameters of the vertical craniofacial growth and gender in adult subjects. Methods. The sample comprised lateral cephalograms of 120 subjects with different vertical facial growth, aged 17.5-35 years. Measured parameters were the following: anterior and posterior vertebral body height (ABHC2-C5, PBHC2-C5), anterior and posterior intervertebral space (AISC2-C5, PISC2-C5), distance between vertebrae and point sella (SC2, SC3, SC4), pterygomaxillare (PmC2), gonion (GoC2) and basion (BaC4); cervical spine angulation (OPT/CVT) and inclination (OPT/HOR, CVT/HOR). Results. Results showed that subjects with anterior facial growth rotation have greater values for BaC4, OPT/HOR, CVT/HOR, OPT/CVT, anterior and posterior vertebral body heights and intervertebral spaces, and lower values for GoC2 and PmC2. Higher values in males were found for anterior and posterior vertebral body heights, distances SC2, SC3, SC4, and BaC4. In females, the greater values were found for GoC2 and ОРТ/СVT. Conclusion. Subjects with anterior facial growth rotation have greater cervical spine inclination and angulation, higher cervical vertebrae and intervertebral spaces, longer upper cervical spines and shorter distances GoC2 and PmC2. Males show smaller cervical column curvature, but higher cervical vertebrae and greater length of the upper cervical spine

The third molars for indicating legal adult age in Montenegro

Aim: From a medico-legal and penalty point of view, it is essential to conclude if an individual is a minor or an adult (18 years of age). Methods based on the third molar development have been used for this purpose. The present article aims to verify the Nolla's stages of mineralization of the third molars and a third molar maturity index (I-3M) which is based on the measures of the projections of open apices normalized by their height in the sample of Montenegrins. Method and sample: The sample consisted of 683 panoramic radiographs (324 males and 359 females) between 13 and 24 years of age. The specific mineralization stages of Nolla and the cut-off value of I-3M lt 0.08 was used to discriminate adults and minors. Results: The best performance in discriminating adults and minors was for I-3M lt 0.08 followed by the Nolla stage 9. For I-3M lt 0.08 the results demonstrated high sensitivity of 0.92 and 0.82 and specificity of 0.94 and 0.96 in males and females, respectively. The proportions of correctly classified individuals were 0.93 in males and 0.89 in females. The Nolla stage 9 demonstrated the sensitivity of 0.95 and 0.85 and the specificity of 0.84 and 0.90 in males and females, respectively. The proportions of correctly classified individuals were 0.90 in males and 0.87 in females. Conclusion: The suggested value of I-3M lt 0.08 followed by Nolla stage 9 can be used to discriminate adults from minors with high specificity