EVALUATION OF THE REMOVABLE PROSTHETIC DENTURES DURABILITY

Cilj istraživanja: Cilj ovog istraživanja bio je ispitati kolika je prosječna trajnost mobilnih proteza u našoj populaciji i doznati koji su najčešći razlozi zamjene istih. Materijali i metode: U istraživanju je sudjelovalo 100 pacijenata s područja grada Splita i okolice, dobi između 49 i 86 godina, od čega 61 žena i 39 muškaraca. Prilikom dolaska po novu protezu pacijenti su popunjavali upitnik s podacima vezanim za svoje stare proteze. Upitnik se sastojao od devet pitanja o dobi, spolu, materijalu od koje je izrađena protezna baza, vrsti proteze, čeljusti u kojoj se proteza nalazi, starosti proteze, ordinaciji i gradu u kojoj je izrađena te razlogu zamjene. Rezultati: Rezultati su pokazali da nema statističke povezanosti između uporabne trajnosti proteza i činjenice da su izrađene od strane specijalista protetike. Trajnost proteza izrađenih u specijaliste stomatološke protetike bila je prosječno 8,9 ± 5,6 godina, a onih izrađenih u općeg stomatologa prosječno 9,25 ± 4,4 godine, što nije bilo statistički značajno (P = 0,732). Trajnost akrilatnih protetskih nadomjestaka bila je statistički značajno duža u odnosu na prosječnu trajnost metalnih protetskih nadomjestaka (10,4 ± 6,2 godine vs. 8,1 ± 3,9 godina, P = 0,032). Najčešći razlog zamjene djelomičnih proteza bio je izvađen zub (27,4 %), a potpunih nestabilnost (44,9 %). Zaključak: Temeljem rezultata ovog istraživanja može se zaključiti da su mobilni protetski nadomjesci s metalnom bazom trajniji od onih s akrilatnom bazom, a mobilni protetski nadomjesci koje je izradio specijalist stomatološke protetike nisu trajniji su od onih izrađenih od strane općeg doktora dentalne medicine. Najčešći razlog zamjene mobilnih protetskih nadomjestaka je nestabilnost.Objectives: The aim of this study was to examine the average durability of removable prosthetic dentures in our population and find out what are the most common reasons for replacing them. Material and Methods: The study included 100 patients from Split and surrounding area between 49 and 86 years old, of which 61 women and 39 men. During the examination or the impression taking, patients completed a questionnaire related to their old dentures. Data were divided into 9 categories according to age, sex, prosthesis material, prosthesis type, jaw in which the prosthesis was located, age of prosthesis, a dental office where the old denture was made, the city where it was made, and the reason of the replacement. Results: The results showed there was no statistical difference between durability of prosthetic dentures and the fact that they were made by a specialist of prosthetic dentistry. Durability of removable dentures made by the specialist of prosthetic dentistry was average 8.9 ± 5.6 years, and those dentures made by the general dentist 9.25 ± 4.4 years, which was not statistically significant (P = 0.732). The durability of acrylic removable dentures was significantly longer than of metal removable dentures (10.4 ± 6.2 years vs. 8.1 ± 3.9 years, P = 0.032). The main reason for the replacement of old partial removable dentures was tooth extraction (27.4 %), while the reason for the replacement of old total removable dentures was instability (44.9 %). Conclusion: Based on the results of this study we can conclude that metal removable prosthetic dentures have longer durability than those with acrylic base, while removable prosthetic dentures made by the specialist did not show longer durability than those made by the general dentist. The most frequent reason for the replacement of the denture was instability

EVALUATION OF THE REMOVABLE PROSTHETIC DENTURES DURABILITY

Cilj istraživanja: Cilj ovog istraživanja bio je ispitati kolika je prosječna trajnost mobilnih proteza u našoj populaciji i doznati koji su najčešći razlozi zamjene istih. Materijali i metode: U istraživanju je sudjelovalo 100 pacijenata s područja grada Splita i okolice, dobi između 49 i 86 godina, od čega 61 žena i 39 muškaraca. Prilikom dolaska po novu protezu pacijenti su popunjavali upitnik s podacima vezanim za svoje stare proteze. Upitnik se sastojao od devet pitanja o dobi, spolu, materijalu od koje je izrađena protezna baza, vrsti proteze, čeljusti u kojoj se proteza nalazi, starosti proteze, ordinaciji i gradu u kojoj je izrađena te razlogu zamjene. Rezultati: Rezultati su pokazali da nema statističke povezanosti između uporabne trajnosti proteza i činjenice da su izrađene od strane specijalista protetike. Trajnost proteza izrađenih u specijaliste stomatološke protetike bila je prosječno 8,9 ± 5,6 godina, a onih izrađenih u općeg stomatologa prosječno 9,25 ± 4,4 godine, što nije bilo statistički značajno (P = 0,732). Trajnost akrilatnih protetskih nadomjestaka bila je statistički značajno duža u odnosu na prosječnu trajnost metalnih protetskih nadomjestaka (10,4 ± 6,2 godine vs. 8,1 ± 3,9 godina, P = 0,032). Najčešći razlog zamjene djelomičnih proteza bio je izvađen zub (27,4 %), a potpunih nestabilnost (44,9 %). Zaključak: Temeljem rezultata ovog istraživanja može se zaključiti da su mobilni protetski nadomjesci s metalnom bazom trajniji od onih s akrilatnom bazom, a mobilni protetski nadomjesci koje je izradio specijalist stomatološke protetike nisu trajniji su od onih izrađenih od strane općeg doktora dentalne medicine. Najčešći razlog zamjene mobilnih protetskih nadomjestaka je nestabilnost.Objectives: The aim of this study was to examine the average durability of removable prosthetic dentures in our population and find out what are the most common reasons for replacing them. Material and Methods: The study included 100 patients from Split and surrounding area between 49 and 86 years old, of which 61 women and 39 men. During the examination or the impression taking, patients completed a questionnaire related to their old dentures. Data were divided into 9 categories according to age, sex, prosthesis material, prosthesis type, jaw in which the prosthesis was located, age of prosthesis, a dental office where the old denture was made, the city where it was made, and the reason of the replacement. Results: The results showed there was no statistical difference between durability of prosthetic dentures and the fact that they were made by a specialist of prosthetic dentistry. Durability of removable dentures made by the specialist of prosthetic dentistry was average 8.9 ± 5.6 years, and those dentures made by the general dentist 9.25 ± 4.4 years, which was not statistically significant (P = 0.732). The durability of acrylic removable dentures was significantly longer than of metal removable dentures (10.4 ± 6.2 years vs. 8.1 ± 3.9 years, P = 0.032). The main reason for the replacement of old partial removable dentures was tooth extraction (27.4 %), while the reason for the replacement of old total removable dentures was instability (44.9 %). Conclusion: Based on the results of this study we can conclude that metal removable prosthetic dentures have longer durability than those with acrylic base, while removable prosthetic dentures made by the specialist did not show longer durability than those made by the general dentist. The most frequent reason for the replacement of the denture was instability

KOREKCIJA CISTOKELE SINTETSKOM MREŽICOM TRANSOBTURATORNIM PRISTUPOM (PERIGEE SISTEM)

Objectives. Our first short-term results of transobturator mesh interposition (Perigee System) for the correction of cystoceles are presented. Methods. This is our initial study on 22 women with cystocele > Grade 2 who underwent the Perigee procedure in our Center between January 2006 and March 2007. In 15 cases lateral cystocele defect was ¬diagnosed, whereas other 7 patients had central anterior vaginal wall defect. All patients were assessed by POP-Q staging. Results. The anatomical and functional reconstruction of anterior vaginal wall was achieved in all patients. Preoperatively, mean POP-Q Aa value was +1.1 (± 0.3) and Ba value was + 1.9 (± 1.3) . No major intraoperative or immediate postoperative complications were observed. One and three months postoperatively, mean POP-Q Aa value was – 2.9 (± 0.21) and – 2.82 (± 0.1) respectively and Ba was –2.85 (± 0.4) and – 2.8 (± 0.23) respectively. Patients’ satisfaction and the imposing short-time surgical outcome were achieved in all cases after three months follow-up. Conclusion. We consider Perigee procedure to be highly efficacious, minimally invasive and easy technique for correction of anterior vaginal wall defects.Cilj rada. Prikazati preliminarne rezultate transobturatornog pristupa korekcije cistocela metodom Perigee. Metode. 22 bolesnice s cistocelom drugog stupnja podvrgnute su u našoj ustanovi metodi Perigee u vremenskom razdoblju između sječnja 2006. i ožujka 2007. godine. U 15 bolesnica dijagnosticirano je lateralno paravaginalno oštećenje, dok je u 7 bolesnica verificirano centralno oštećenje prednje vaginale stijenke. Rezultati. Anatomska i funkcionalna korekcija prednje vaginalne stijenke ovom metodom postignuta je kod svih bolesnica. Preoperativno, srednja vrijednost POP-Q Aa točke bila je +1.1 (± 0.3) a Ba točle + 1.9 (± 1.3). Nije bilo intraoperativnih ni perioperativnih komplikacija zahvata. Jedan i tri mjeseca nakon zahvata, srednja vrijednost točke POP-Q Aa bila je – 2.9 (± 0.21) i – 2.82 (± 0.1) dok je srednja vrijednost točke Ba bila –2.85 (± 0.4) i – 2.8 (± 0.23). Zaključak. Smatramo da je Perigee metoda jednostavna, ¬neinvazivna i učinkovita metoda korekcije defekata svih tipova cistokela

Učinak porođaja i epiziotomije na nastanak inkontinencije mokraće u žena: pregled literature

Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed mediolaterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine mediolateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased. The role of episiotomy in development of pelvic floor dysfunction remains quite unclear. Due to the mentioned reason, restricted episiotomy approach should be accepted. The origin of stress incontinence during pregnancy is controversial and not definitely scientifically proven. Pregnancy per se and older age at first delivery may have impact on the onset of pelvic floor dysfunction. Urinary incontinence in pregnancy increases the risk of later urinary incontinence, both postpartum and later in life. Vaginal delivery is just one of the potential risk factors for development of urinary incontinence. Mechanical pressure by fetus on the pelvic floor structures, limited denervation of the pelvic floor and soft tissue damage during delivery are some of explanations for the onset of stress urinary incontinence. On the other hand, cesarean delivery might not be protective against emergence of urinary incontinence. Further research in this field is needed.Epiziotomija je porodnička operacija u kojoj se incizijom širi predvorje vagine tijekom drugog porođajnog doba. Epiziotomija se intenzivno koristila uz postupno povećanje stope u prvoj polovici 20. stoljeća kao mediolateralni urez međice na svim prvorodiljama s idejom zaštite glave fetusa od traume i zdjeličnog dna od ozljeda. U posljednje vrijeme objavljeni su radovi koji tvrde da epiziotomija nema prije navedene koristi, odnosno da rutinska mediolateralna epiziotomija ne štiti od pojave stresne inkontinencije mokraće nakon vaginalnog porođaja, dok je rizik od pojave analne inkontinencije povećan. Uloga epiziotomije u razvoju disfunkcije zdjeličnog dna ostaje prilično nejasna. Zbog navedenih razloga restriktivni pristup uporabi epiziotomije bi trebao biti prihvaćen. Uzrok stresne inkontinencije tijekom trudnoće je proturječan i nije definitivno znanstveno dokazan. Trudnoća sama po sebi i starija dob pri prvom porođaju mogu imati utjecaj na nastanak disfunkcije zdjeličnog dna. Također pojava inkontinencije mokraće u trudnoći povećava rizik za nastanak inkontinencije mokraće poslije porođaja i u ostatku života. Vaginalni porođaj je samo jedan od potencijalnih čimbenika rizika za razvoj inkontinencije mokraće. Mehanički pritisak fetusa na zdjelično dno, ograničena denervacija zdjeličnih struktura i oštećenja mekih tkiva tijekom porođaja su neka od objašnjenja za pojavu stresne inkontinencije mokraće. Porođaj carskim rezom vjerojatno ne štiti od pojave inkontinencije mokraće. Sve upućuje na to da su daljnja istraživanja u ovom području neophodna

Efficacy of Sling Procedures for Treatment of Female Stress Urinary Incontinence

The aim of this study was to determine the efficacy and surgical outcome of the sling procedures in stress incontinent women in comparison to conventional anterior colporrhaphy. Total of 56 patients with stress urinary incontinence (SUI) were treated with sling procedure between November 2011 and March 2013, 39/56 (69.6%) with suprapubic arc (SPARC) and 17/56 (30.4%) with MiniArc method. During the same period total of 49 patients with SUI were treated with traditional anterior colporrhaphy according to Bagović method as the control group. All patients were prospectively clinically assessed over a period of 3, 6 and 12 months after surgery. The objective cure rate after the follow-up was 92.9% (52/56) in observed group of patients and 79.6% (39/49) in control group and improvement was occurred in rest of 5.4% (3/56) and 18.4% (9/49), respectively (p<0.05). The overall complications rate was significantly lower in the observed group of patients than in the control group, 12.5% (7/56) vs. 28.6% (14/49), (p<0.05). In the sling group was postoperatively noticed slightly higher rate of urinary incontinence, but in the colporrhaphy group was emphasized rate of urinary retention. Only one from the each group of patients failed the surgical procedure and required additional correction for SUI. The mean operating time for SPARC and MiniArc procedure was 19±7 and 9±5 minutes, respectively (p<0.0001). Mean duration of hospitalization was significantly shorter in the sling group of patients (2.6±1.0, range 2-7) days than in the control group of (9.6±1.8, range 6-18), (p<0.001<0.0001). According to presented results, sling is a highly effective method in patients with SUI with low incidence of perioperative complications, promising long-term results and high patient\u27s satisfaction

Fetal Macrosomia in Pregnant Women with Gestational Diabetes

The aim of the study was to determine the frequency of fetal macrosomia in newborns from mothers with gestational diabetes mellitus (GDM) and healthy mothers, as well as determining the influence of fetal growth on pregnancy termination, on complications in pregnancy, during delivery and puerperium and on neonatal complications. In the study were included 351 pregnant women with GDM, as well as control group of 1502 healthy pregnant women. Newborns of mothers with GDM had significantly higher birth weight and length, ponderal index >2.85 was more frequent, they were macrosomic and hypertrophic (disproportional and proportional), had smaller Apgar score and more frequent neonatal complications (p<0.05). Fetal macrosomia and fetal hypertrophy alone or, particularly, connected with disproportional fetal growth, but disproportional hypotrophy as well, had significantly influence on greater frequency of delivery and puerperal complications, delivery completion with Cesarean section and neonatal complications in pregnant women with GDM

Fetal Macrosomia in Pregnant Women with Gestational Diabetes

The aim of the study was to determine the frequency of fetal macrosomia in newborns from mothers with gestational diabetes mellitus (GDM) and healthy mothers, as well as determining the influence of fetal growth on pregnancy termination, on complications in pregnancy, during delivery and puerperium and on neonatal complications. In the study were included 351 pregnant women with GDM, as well as control group of 1502 healthy pregnant women. Newborns of mothers with GDM had significantly higher birth weight and length, ponderal index >2.85 was more frequent, they were macrosomic and hypertrophic (disproportional and proportional), had smaller Apgar score and more frequent neonatal complications (p<0.05). Fetal macrosomia and fetal hypertrophy alone or, particularly, connected with disproportional fetal growth, but disproportional hypotrophy as well, had significantly influence on greater frequency of delivery and puerperal complications, delivery completion with Cesarean section and neonatal complications in pregnant women with GDM

Asymmetric Neonatal Crying: Microdeletion, Infection or Birth Injury? - A Case Report

Asymmetric neonatal crying is a rare minor congenital abnormality caused by unilateral agenesis or hypoplasia of depressor anguli oris muscle and depressor labii inferioris muscle. It is either an isolated clinical finding or one of the clinical findings included in several malformation syndromes linked to a microdeletion within a chromosomal region 22q11.2. Some malformations in that region are associated with serious cardiovascular anomalies. Nowadays, standard diagnostic techniques for detecting aberrations within the chromosomal region 22q11.2 are fluorescence in situ hybridization (FISH) and multiplex ligation probe amplification (MLPA). This short report describes an eutrophic female newborn whose both lip corners are symmetrically positioned while at rest; while crying, left lip corner and left half of the lower lip are falling. She also has partial bilateral syndactyly between second and third toe, open foramen ovale and by ultrasound detected hyperechogenic region in the thalamus and brain parenchyme. Aiming to investigate etiopathogenesis of the newborn asymmetric crying and accompanying minor abnormalities, we have tried to verify or exclude: microdeletion syndrome, TORCH infection and birth injury. Recognising such a paresis soon after the delivery is of great importance and can be helpful in detecting other accompanying anomalies, especially cardiovascular anomalies

Expression of Matrix Metalloproteinase-1 in Uterosacral Ligaments Tissue of Women with Genital Prolapse

Collagen metabolism is altered in the pelvic organ tissues of women with genital prolapse. The aim of this study was to compare collagen metabolism by measuring matrix metalloproteinase – 1 (MMP – 1) expression in uterosacral ligament tissues of postmenopausal women with and without genital prolapse. Uterosacral ligament tissues were obtained at the time of abdominal or vaginal surgery from twenty-four patients with pelvic organ prolapse (POP) and 21 women who underwent gynecologic surgery for benign indications. The tissue samples were analyzed by immunohistochemistry. There were no differences in age, BMI and parity between two groups. The patients with genital prolapse demonstrated significantly higher occurences of MMP – 1 expression compared to controls. These findings indicate that increased MMP – 1 expression in uterosacral ligaments is associated with genital prolapse. Our data are consistent with the theory that increased collagen breakdown may play an important role in the onset and development of pelvic organ prolapse (POP)

PLACENTNI ČIMBENIK RASTA U MAJČINOJ I UMBILIKALNOJ KRVI TRUDNICA OBOLJELIH OD DIJABETESA TIPA-1 I ZDRAVIH TRUDNICA

Vascular endothelial growth factor (VEGF) and placental growth factor (PlGF) are key factors in physiological and pathological conditions of pregnancy. We investigated whether serum levels of PlGF in mother’s and umbilical blood are different between healthy pregnant women and pregnant women suffering from type-1 diabetes mellitus. We performed a prospective study of 44 pregnant women with type 1 diabetes who did not have diabetic complications and of 34 healthy pregnant women of the adequate age and parity and the normal pregnancy course. Venous blood samples were collected from 8th weeks of pregnancy during the whole pregnancy, in distance from 4 weeks. Results are expressed as means±standard deviations. Statistical analysis was performed using ANOVA, Student t-test, linear regression, and non-parametrical Mann-Whitney U test. PlGF level in diabetic and healthy pregnant women from the 8th till the 15th week of pregnancy is comparatively low (23.16±4.94 pg/mL : 21.68 ±4.91 pg/mL), and after the 15th week of pregnancy it increases fast till the 31st week of pregnancy when the value is the highest (440.77±173.03 pg/ml : 390.41±138.07 pg/mL). After the 31st week of pregnancy there is a decrease of PlGF levels. Comparing PlGF values between the research groups in defined weeks of pregnancy no statistically significant difference was found. PlGF values in serum of healthy and diabetic pregnant women do not differ in same weeks of pregnancy. PlGF values in mother’s and fetal serum immediately after the birth are a bit lower (but not statistically significant) in diabetic pregnant women in relation to a control group. A statistically significant correlation coefficient was found between PlGF level and a newborns weight and between PlGF and placenta weight. A statistically significant correlation coefficient was found between PlGF level of mother’s blood and umbilical vein.Vaskularni endotelni čimbenik rasta (VEGF) i placentarni čimbenik rasta (PlGF) su ključni čimbenici u fiziološkim i patološkim trudnoćama. Cilj istraživanja je bio naći razliku razina PlGF-a u majčinoj i umbilikalnoj krvi između zdravih trudnica i onih koje boluju od dijabetsa tipa-1. Učinjeno je prospektivno istraživanje u 44 trudnice s dijabetesom tipa-1 i u 34 zdrave trudnice. Trudnice su bile istih dobnih skupina, pariteta i urednog tijeka trudnoće. Venska krv trudnica je skupljana od 8. tjedna trudnoće tijekom cijele trudnoće u vremenskim razmacima od 4 tjedna. Rezultati su prikazani srednjim vrijednostima ± standardne devijacije, a statistička analiza je učinjena sljedećim testovima: ANOVA, Student-t testom, linearnom regresijom i Mann-Whitneyevim U testom. Razina PlGF-a u dijabetičnih i zdravih trudnica je bila podjednako niska u vremenskom razdoblju od 8. do 15. tjedna trudnoće (23,16±4,94 pg/mL : 21,68±4,91 pg/mL), a nakon 15. tjedna dolazi do naglog povišenja razine sve do 31. tjedna trudnoće kada su vrijednosti bile i najviše (440,77±173,03 pg/ml : 390,41±138,07 pg/mL). Nakon 31. tjedna trudnoće dolazi do sniženja vrijednosti PlGF-a. Uspoređujući vrijednosti PlGF-a između istraživanih skupina u istim tjednima trudnoće nije nađena statistički znakovita razlika. Neposredno nakon poroda razina PlGF-a u majčinom i fetalnom serumu je bila nešto niža, ali ne i statistički znakovito niža u dijabetičnih trudnica u odnosu na zdrave trudnice. Nađene su statistički značajne korelacije između razina PlGF-a i porodne težine, između PlGF-a i težine placente i između razina PlGF-a seruma majke i seruma umbilikalne vene