Preventive Dentistry in Bosnian Private Dental Practices

Svrha istraživanja bila je ispitati stajališta, praksu i znanje općih stomatologa (GDPa) o primarnim preventivnim mjerama - profesionalnoj topikalnoj fluoridaciji, uputama za oralnu higijenu, uputama o prehrani te pečaćenju fisura - u liječenju pacijenata u ordinacijama. Zato je posebno pripremljen upitnik o preventivnoj stomatologiji poslan na adrese 57 privatnih stomatoloških ordinacija u sarajevskom kantonu (Bosna i Hercegovina), a vraćeno je 46 (80,7 %) ispunjenih. Svi ispitanici tvrdili su da primjenjuju neku od preventivnih mjera, ali samo 26 % napisalo je da se koriste svim preporučenim mjerama. Jedina mjera koju primjenjuju svi opći stomatolozi upute su za oralnu higijenu – 83 % njih topikalno primjenjuje fluoride, a rijetko 40,4 %. Većina redovito daje pacijentima upute o prehrani, a čak 15 % to uopće ne čini. Pečaćenje fisura primjenjuje 72 % ispitanih stomatologa. Svi ispitani znaju temeljna načela preventivne stomatologije, ali im ne posvećuju dovoljno pozornosti. Jedina preventivna mjera koju svi provode, upute su o oralnoj higijeni, a to čine uglavnom verbalno kao mini-predavanja. Profesionalna topikalna primjena fluorida obavlja se na djeci rutinski u stomatološkim ordinacijama. Najčešći savjet o prehrani je naputak da se što rjeđe jedu slastice i piju zaslađeni napici.The aim of this research was to investigate the private general dental practitioners’ (GDPs) attitudes, practice and knowledge to primary preventive measures (professional topical fluoridation, oral hygiene instructions, dietary advice and fissure sealing) in treating patients in their practices. Specially designed questionnaire concerning GDP’s attitudes, practice and knowledge of preventive dentistry related questions, was distributed to 57 private dental practices in Canton Sarajevo area, Bosnia and Herzegovina. There were 46 (80.7%) completed and returned questionnaires. All of the respondents claimed to have applied some sort of preventive measures in treating their patients, but only 26% of GDPs said they had used all of the recommended measures. The only preventive measure that all of GDPs reported using was giving oral hygiene advice/instruction; 83% of dentists applied topical fluoride, 40.4 % of which admitted to practicing it rarely. Most GDPs give diet counseling to patients regularly while some 15% of them don’t practice this at all. Seventy two per cent of dentists used fissure sealants. Surveyed dentists were familiar with basic principles of preventive dentistry, but they did not give enough importance to it in overall treatment of patients. The only preventive measure delivered by all general dental practitioners was oral health advice/instructions, usually given verbally in a form of mini-lectures. Professional topical fluoridation was performed generally on children, mostly on routine basis in dental practices. The most often given dietary advice was about decreasing total intake of sugary foods and drinks

Results of Paleostomatological Analysis of Material From the Cave Near Gornji Vakuf (South-West Bosnia)

Among explored speleological objects near the Krupa village, close to Gornji Vakuf, the most interesting cave from paleocultural aspect, is the cave named “Cave number 5”. In the internal part of that cave, besides ceramic fragments and one metal needle, rich anthropological material have been found, compounds of numerous humans bones and teeth. Anato-morphological analysis of the one part of material showed that this site is a prehistoric crypt with remains of at least 13 people. Radiocarbon 14C bone analysiss results showed that those people lived 2765 ± 75 before presence. The fact that anthropological material includes some remains which belonged to children shows some characteristics of burial culture of that period on area of Uskoplje. This cave crypt is the one of the biggest on this region. Paleostomatological analysis of teeth and jaw fragments gave us clear evidence about therapeutic interventions performed in this period. X-rays analysis showed presence of the metal body inside the bone in one mandibular fragment. It’s supposed that this metal is broken part of instrument used for tooth extraction

Učinci pentadekapeptida BPC 157, L-NAME i L-arginina na serijski prijelom rebara u štakora

Introduction: Rib fractures, in particular serial fractures (3 or more fractured ribs ipsilateral) have serious consequences on the human body and quality of life and represent an important medical and socioeconomic problem. Aim: To determine the effects of pentadecapeptide BPC 157, L-arginin and L-NAME on healing of serial rib fracture in rats. Materials and methods: After intraperitoneal anesthesia, in male Winstar albino rats was performed the vertical transection of 8-10 ribs of right hemithorax at the lateral edge of the paravertebral muscles. The pentadecapeptide BPC 157 was administered intraperitoneal or orally.It was applied intraperitoneal (doses of 10 μg/kg and 10 ng/kg) immediately following a surgical procedure and then once daily and the last application 24 h before sacrifice. Orally (0.16 μg/ml and 0.16 ng/ml, a total of 12 ml/day) was applied in drinking water, from waking up to the animal sacrifice. In order to test the interaction with the NO system, L-NAME (5 mg/kg/day i.p.) and/or L-arginin (100 mg/kg/day i.p.) were administered alone or with BPC 157 to specific animal groups. The control groups were treated with 0.9% NaCl i.p. or with pure drinking water p.o. The daily clinical status of the animal (respiration frequency, chest movement) was observed, and on 20th day, during the first sacrifice interval, aortic blood was taken to analyze the acid-base status and the calcium and phosphate serum levels. At the same time, the local finding was verified in the sense of the formation of endothoracic fascia and scar, and then the right hemitorax was taken for further radiographic and histological analysis. After 60 days, the animals were sacrificed for biomechanical testing. Results: Animals treated with BPC 157 did not show pathological alterations in acid-base status. Calcium and phosphate serum levels were normal in all animal groups. BPC 157 alone or in combination with L-arginin and/or L-NAME leads to earlier healing of the rib fracture and increased creations of callus without scarring and adhesions at the place of fracture, as confirmed by radiographic and histological analysis. Biomechanical testing has shown that bone tissue of animals treated with BPC 157 on the site of fractures is stronger. Conclusion: The pentadecapeptide BPC 157 leads to earlier healing of fractured ribs and formation of stronger bones at the site of the fractures, and this is the effect of interacting with the NO system. The positive effect of pentadecapeptida BPC 157 is achieved regardless of the way of administration (oral or intraperitoneal) and the administered dose (10 μg or 10 ng)

Influence of drug and alcohol addiction on oral hygiene

Ovisnost o alkoholu i drogi raširena je pojava u općoj populaciji koja doseže globalne razmjere. Unatoč brojnim preventivnim postupcima i programima, nažalost, broj ovisnika raste iz godine u godinu. Ovisnost ograničava normalno funkcioniranje pojedinca i njegove okoline te se manifestira i oralno i sustavno na tijelu svakog ovisnika. Oralna higijena je važan segment i sastavni dio sveukupne higijene pojedinca. Razlike u održavanju oralne higijene između ovisnika o alkoholu i ovisnika o drogama, su minimalne. Dentalna higijena se opisuje kao izuzetno loša, uz posljedično loše oralno zdravlje. Zanemarivanje oralne higijene rezultira povišenjem rizika za određena patološka stanja. Tako se u ovisnika redovito nalaze: povišena prevalencija karijesa, diskoloracije zuba, oboljenja parodonta uz razvoj gingivitisa i parodontitisa te halitoza. Kako je ovisnost o alkoholu i drogama raširena pojava, velika je vjerojatnost da će se svaki doktor dentalne medicine u svom radnom vijeku susresti s određenim brojem pacijenata koji au aktualni ili bivši ovisnici. Važno je da stomatolog ima potrebna znanja o ovisnostima, kako bi ih mogao prepoznati. Također je bitno da ovisnike informira o važnosti oralnog zdravlja, motivira ih i daje upute o pravilnom provođenju oralne higijene.Alcohol and drug addiction is a widespread phenomenon among the general population that reaches global proportions. Despite numerous preventive approaches and programs, unfortunately the number of addicts is increasing each year. Addiction limits the normal functioning of an individual and his or her environment, as it manifests itself both orally and systematically on each addict's body. Oral hygiene is an important segment and an integral part of an individual's overall hygiene. There are minimal differences in oral hygiene maintenance between alcohol and drug addicts. Their oral hygiene is considered extremely bad and its consequence is a poor oral health. There is a higher risk for certain pathological conditions due to oral hygiene negligence. Therefore, addicts suffer regularly from: high caries prevalence, tooth staining, periodontal disease, including gingivitis and periodontitis and halitosis. If we take into account that abuse of alcohol and illegal drugs is a widespread phenomenon, it is highly probable that each doctor of dental medicine will encounter, in his or her working life, a certain number of patients who are current or former addicts. The dentist must have the necessary knowledge of addictions in order to recognize them. Furthermore, the dentist must inform the addicts about the importance of oral health, motivate them and should provide them with proper oral hygiene instructions

Synchronous caecal small-cell neuroendocrine carcinoma and adenocarcinoma of the rectum

Neuroendokrini karcinom malih stanica debeloga crijeva rijedak je entitet s najčešće lošom prognozom. Osamdesetogodišnja žena podvrgnuta je operaciji debeloga crijeva zbog sinkronog tumora rektuma i cekuma. Patohistološka analiza tumora cekuma pokazala je trabekularne i čvrste nakupine, relativno uniformne male do srednje velike epitelne stanice, oskudne citoplazme, a u vezivnom tkivu bilo je dosta mitoza s većim područjima nekroze. Imunohistokemija je bila pozitivna na kromogranin A. Tumor je dijagnosticiran kao neuroendokrini karcinom malih stanica cekuma. Osim toga, tumor rektuma pokazao je mikroskopske nalaze u skladu s IIA stadijem adenokarcinoma. Imunohistokemijski panel pokazao je da je tumor bio negativan na neuroendokrine markere. Nije bilo kliničkoga nalaza koji ukazuje na pojačanu sekreciju hormona. Metastaze karcinoma nisu nađene. Provedena je postoperativna kemoterapija. Pacijentica je i dalje živa, dobrog općega stanja, bez znakova progresije tumora.Small-cell neuroendocrine colon carcinoma is a rare entity with a usually poor prognosis. An 80-year-old female had colon cancer surgery due to synchronous tumour of the rectum and caecum. Pathohystological analysis of the caecal tumour showed trabecular and solid clusters, relatively uniformed small to middle sized epithelial cells, deficient cytoplasm and there were a great number of mitosis with larger areas of necrosis in the connective tissue. The immunohistochemistry was positive for chromogranin A. The caecal tumour was diagnosed as a small-cell neuroendocrine carcinoma. In addition, the rectal tumour showed microscopic findings consistent with stage IIA adenocarcinoma. The immunohistochemical panel showed that the tumour was negative for neuroendocrine markers. There were no clinical findings suggestive of hormone hypersecretion. Cancer metastases were not found. Postoperative chemotherapy was applied. The patient is still alive, in good general condition and with no signs of tumour progression

Uporaba piezoelektričnog svojstva u poboljšanju kvalitete instrumenata i sigurnosti bolesnika u laparoskopskoj kirurgiji

The piezoelectric properties of some natural crystals and polymers can also be used in surgery. For this purpose, a prototype of an endoscopic instrument was constructed with piezoelectric material attached to its working end with the aim of recognizing pulsating blood vessels during laparoscopic surgery. To test the properties of the new instrument in laboratory conditions, simulated blood circulation was used with the possibility of changing pressure and frequency. The instrument was tested in the pressure range of 40-180 mm Hg at constant frequency of 72/min and frequency range of 36-130 beats per minute at constant pressure of 120 mm Hg. Test results showed that the instrument with certainty recognized a pulsating “blood vessel” in the expected pressure ranges and at different blood pump frequencies. Given the piezoelectric material’s very small dimensions and flexible form, it can be installed at the working end of most standard laparoscopic instruments and thus significantly increase certainty in the recognition of arteries during surgery, which would reduce the possibility of their injury or accidental ligation.Piezoelektrična svojstva nekih prirodnih kristala i nekih polimera moguće je koristiti i u kirurgiji. U tu svrhu konstruiran je prototip endoskopskog instrumenta na čijem je radnom dijelu ugrađen piezoelektrični materijal s ciljem prepoznavanja pulzirajućih krvnih žila tijekom laparoskopskih operacija. Za ispitivanje svojstava novoga instrumenta u laboratorijskim uvjetima korišten je simulirani krvotok s mogućnošću mijenjanja tlaka i frekvencije. Rad instrumenta je ispitivan u rasponu tlakova 40-180 mm Hg uz konstantnu frekvenciju 72/min, te u rasponu frekvencija 36-130 otkucaja u minuti uz konstantan tlak 120 mm Hg. Rezultati ispitivanja pokazuju da instrument sa sigurnošću prepoznaje pulzirajuću „krvnu žilu“ u očekivanom rasponu tlakova i pri različitim frekvencijama rada krvne pumpe. S obzirom na to da se radi o vrlo malim dimenzijama i prilagodljivim oblicima piezoelektričkog materijala, moguće ga je postaviti na radni dio većine standardnih laparoskopskih instrumenata i time značajno povećati sigurnost prepoznavanja arterija tijekom operacijskog zahvata, što bi smanjilo mogućnost njihove ozljede ili slučajnog podvezivanja