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 Quality, Benefits and Differentiation of Aluminium Single Serve Portion Capsules for Drinks

Aluminium capsules can be used as the final packaging for any type of powdered foods, such as tea or vitamin and similar hot drinks. Aluminium represents a 100% barrier, is impermeable, extends the shelf life of the final product, is recyclable and an alternative to plastic. A wide range of individualized products, including the capsule as attractive single-use possibility, made it possible to satisfy the preferences and expectations of consumers. Currently two main materials for single serve portion coffee capsules are in use: aluminium and/or plastic based

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 Quality, Benefits and Differentiation of Aluminium Single Serve Portion Capsules for Drinks

Aluminium capsules can be used as the final packaging for any type of powdered foods, such as tea or vitamin and similar hot drinks. Aluminium represents a 100% barrier, is impermeable, extends the shelf life of the final product, is recyclable and an alternative to plastic. A wide range of individualized products, including the capsule as attractive single-use possibility, made it possible to satisfy the preferences and expectations of consumers. Currently two main materials for single serve portion coffee capsules are in use: aluminium and/or plastic based

The Influence of Gender and Age on the Values of Linear Radiomorphometric Indices Measured on the Lower Border of the Mandible

Osteopeniju ili gubitak kosti, kao prvi simptom osteoporoze, moguće je dijagnosticirati radiografski - na rendgenskoj slici vidljiva je smanjena gustoća kosti, a na ortopantomogramu moguće je izmjeriti debljinu kosti, stanjenost kortikalnoga dijela kosti, poroznost ili promjene u trabekulama spongioznoga dijela koštane strukture. Svrha ovog istraživanja bila je izmjeriti mentalni, antegonionalni i gonionalni radiomorfometrijski indeks čeljusti na 200 ortopantomograma, uzimajući u obzir dob i spol ispitanika. Tri indeksa: debljina kortikalnoga dijela kosti na gonionu (GI), antegonionu (AI) i u projekciji mentalnoga foramena (MI) mjerena su obostrano na donjemu rubu čeljusti na 200 ortopantomograma. Pouzdanost mjerenja dvaju ispitivača (p=0,89 za studenta stomatologije; p=0,93 za stomatologa) i podudarnost njihovih mjerenja (k=0,81) bila je zadovoljavajuća. Rezultati istraživanja pokazuju znatnu razliku između izmjerenih vrijednosti GI-a na lijevoj i na desnoj strani čeljusti (p<0,001). U muških pacijenata pronađene su statistički znatno više izmjerene vrijednosti MI-a u usporedbi sa ženama, a u žena starijih od 65 godina pronađena je znatno niža vrijednost AI-a u odnosu prema ženama mlađima od 65 godina. Na temelju dobivenih rezultata ovog istraživanja moguće je zaključiti da je ortopantomogram koristan kao vrlo jednostavna metoda procjene kakvoće čeljusne kosti u pacijenata u svrhu planiranja budućeg stomatološkog tretmana.Osteopenia (bone loss, first symptom of osteoporosis) can be identified radiographically - by a reduction in radiopacity of bone measuring the bone density or by observation of thinned cortices, porosity of the cortices, or changes in trabecular pattern on dental panoramic radiographs (DPRs). The objective of this study was to measure mental, antegonial and gonial radiomorphometric indices of the mandible on 200 DPRs taking into account age and gender of the participants. Three indices: cortical width at the gonion (GI), antegonion (AI) and below the mental foramen (MI) were measured at the lower border of the mandible, bilaterally on 200 DPRs. The reliability of the measurements (p= 0.89 for a dental student, p=0.93 for a dentist) and agreement between the observers (= 0.81) were satisfactory. The results of the study revealed significant difference between GI measured on the left and right side of the mandible (p<0.001). Male patients demonstrated significantly higher measured values for MI than female patients (p<0.001), and finally, female patients older than 65 years showed significantly lower measured AI values than those younger than 65 years. Based on the results of this study, we conclude that the DPR is useful as a simple method of screening patients for evaluation of mandibular bone quality prior to dental treatment

Reasons for Extraction of Permanent Teeth in Urban and Rural Populations of Croatia

The survey aimed to determine the reasons for extraction of permanent teeth by general dental practitioners in urban and rural population of the Senj region, Adriatic coast, Croatia. During a two-year period (1998–9), a total of 2006 teeth were extracted in both regions, in patients aged 15+. The causes were defined as follows: (1) decay or root without a crown (radix relicta), (2) periodontal disease, (3) endodontic or periapical diseases and (4) other reasons – orthodontics/prosthodontics and dental trauma. The statistical Chi-square-test was used to determine the significant difference between the populations and the sexes. Dental caries was the most frequent cause for extraction (over 50%), followed by endodontic and periapical diseases (23%) as the result of untreated caries and at the end periodontal disease (21%). Urban population more often lose teeth due to periodontal disease (22.75%) than rural (18.93%, p<0.05). Similarly, this is more frequent in the urban male population (25.61%) than the female urban population (20%, p<0.05). In rural areas, people more often lost teeth as a result of endodontic and periapical disease (25.85%) than in the urban locations (19.07%, p<0.01) and this is more frequent in women from rural areas (28.37%) than the rural men (22.44%, p<0.05). Periodontal disease was not the main cause of tooth loss in either the rural or the urban population. Dental caries and its sequel remain the most important challenge for the dental service. It also reveals the inadequacy of dental services. Education of both the population and the general dental practitioners must be conducted in order to improve oral hygiene and to insist on conservative rather than extraction therapy

Razlozi za ekstrakcije kod vojnog osoblja i civila tijekom rata u Hrvatskoj

The aim of the study was to identify the reasons for tooth extraction in military personnel and civilian population during the war in Croatia. Data were obtained from dental records of a military dental clinic located on the frontline and compared with records of a dental clinic in the nearby town of Senj. Subjects were divided into three age groups (18-29, 30-39 and 40-49 years) according to the International Classification of Diseases. On statistical analysis, χ2-test was used. Civilians had a higher rate of tooth extraction due to decay or periodontal disease, whereas military personnel had more teeth extracted due to trauma and endodontal or periapical disease (p<0.05 both). In the military population, there were no significant differences either between the left and right side of the mouth, or between the maxillary and mandibular teeth. In the military personnel, the main causes of tooth loss were negligence and lack of time for complex therapy (endodontic, periodontic or prosthodontic treatment). There is the need of appropriate education of both military personnel and military dentists.Cilj studije bio je utvrditi razloge za vađenje zuba među vojnim osobljem i civilima tijekom rata u Hrvatskoj. Podaci iz vojne zubne ambulante smještene na prvoj bojišnici uspoređeni su s podacima ambulante iz obližnjega grada Senja. Ispitanici su podijeljeni u tri dobne skupine (18-29, 30-39 i 40-49 godina) prema Međunarodnoj klasifikaciji bolesti. U statističkoj analizi primijenjen je χ2-test. Kod civilne populacije prevladavalo je vađenje zuba zbog kvarenja ili parodontne bolesti, dok je kod vojnog osoblja više zuba izvađeno zbog traume te zbog endodontne i periapikalne bolesti (p<0,05 oboje). Kod vojne populacije nije bilo statistički značajne razlike između lijeve i desne strane usne šupljine, kao ni između zuba gornje i donje čeljusti. Kod vojne populacije glavni uzroci gubitka zuba su zapuštenost zuba i nedostatno vrijeme za sveobuhvatnu terapiju (endodontsko, parodontno ili protetsko liječenje). Utvrđena je potreba obrazovanja kako vojnog osoblja tako i vojnih stomatologa

Effectiveness of Different Preventive Procedures in the Control of Some Caries Risk Factors

Procjena rizika kad je riječ o karijesu važan je klinički postupak koji na više načina olakšava primjenu preventivnih postupaka u cijeloj populaciji. Kako bi se identificirali pojedinci s visokim rizikom za nove karijesne lezije, potrebno je primijeniti najučinkovitiji preventivni protokol. Svrha istraživanja bila je ispitati vrijednosti određenih postupaka u prevenciji karijesa u situaciji in vivo. Pet skupina ispitanika, svaka s osamnaestero djece u dobi od 4 do 5 i od 10 do 12 godina (n=90), podvrgnuto je različitim preventivnim postupcima (otopina aminfluorida, profesionalna profilaktička pasta, žvakaća guma s ksilitolom i fluoridom, otopina klorheksidina i klorheksidinski gel). Tijekom dva mjeseca obavljeno je pet mjerenja, a procjenjivale su se sljedeće varijable: broj bakterija Streptococcus mutans (SM) i lactobacill (LB), indeks oralne higijene (OHI), količina stimulirane sline i puferski kapacitet. Na kraju je najbolji rezultat u redukciji broja bakterija postigla primjena paste Proxyt i svakodnevno žvakanje žvakaće gume (p<0,001). Kod pacijenata kod kojih se koristila ta preventivna metoda broj SM-a pao je za jednu klasu, a broj LB-a na manje od 104, nakon dva mjeseca od početka istraživanja. Rezultati pokazuju da je profesionalno čišćenje zuba i svakodnevna upotreba žvakaće gume s ksilitolom i fluoridom učinkovit protokol za kontrolu najvažnijih čimbenika rizika i prediktora karijesa.Caries risk assessment is a valuable clinical procedure that in many ways alleviates implementation of preventive procedures in the entire population. When high-risk individuals for new caries lesions are identified the most effective preventive protocol should be applied. The aim of this study was to investigate the caries preventive values of certain preventive procedures in in vivo conditions. Five groups of subjects, each with 18 children aged from 4-5 and 10-12 years (n=90) were treated with different preventive procedures (aminfluoride solution, professional prophylactic paste, chewing gum containing xylitol and fluoride, chlorhexidine solution, chlorhexidine gel). During a period of two months five measurements were performed and the following variables evaluated: the number of Streptococcus mutans (SM) and lactobacilli (LB), oral hygiene index (OHI), the amount of stimulated saliva and buffer capacity. At the end of the study the best result in the reduction of the number of bacteria was achieved by the application of Proxyt paste and daily use of chewing gum, (p<0.001). In patients treated with this preventive procedure the number of SM was reduced by 1 class and LB to <104 after two months of study. The results obtained indicate that professional teeth cleaning and use of chewing gum with xylitol and fluorides on daily basis can be very effective protocol for controlling most important caries risk factors or predictors

Influence of Smoking on the Periodontal Status of Adolescents

Mnoga su istraživanja potvrdila da je pušenje jedan od najvažniji čimbenika rizika za nastanak, progresiju i uspješnu terapiju parodontalne bolesti. No samo je nekoliko istraživanja provedeno da bi se utvrdio utjecaj pušenja na mlađu populaciju. Poznato je da je težina parodontalne bolesti izravno povezana s dnevnom količinom cigareta, ali i s godinama pušenja. Potrebno je prepoznati prve znakove negativna utjecaja kako bi se moglo djelovati. Svrha ovoga istraživanja bila je odrediti postotak pušača među učenicima, utvrditi ima li razlike u parodontalnom statusu pušača i nepušača, te ustanoviti utjecaj pušenja na gubitak pričvrstka. Istraživanje je provedeno na 517 srednjoškolskih učenika. Uzimani su podatci o dobi, mjestu stanovanja. socijalnom statustu, navici pušenja, navici pušenja roditelja, navikama oralne higijene i posjeta stomatologu. Parodontalni se je status prikupljao s pomoću CPI i LA indeksa. 34,6% ispitanika bili su redoviti pušači. Dob u kojoj srednjoškolci počinju pušiti sve je niža. Oni koji sada imaju 16 godina počeli su pušiti s 14, ali oni koji sada imaju 14 i 15 godina počeli su pušiti s 12. Djeca kojima roditelji puše imaju dvostruko veću vjerojatnost da i sami postanu pušači, u usporedbi s onom djecom kojoj roditelji ne puše. Krvarenje je češće u pušača (4,61) nego nepušača (4,19) (p=0,001).Pušači imaju znatno više sekstanata s kamencem (1,47) nego nepušači (0,88) (p<0,001). Gubitak pričvrstka znatno je veći u pušača (1,68) nego nepušača (,59) (p<0,001). Količina popušenih cigareta ima velik utjecaj na gubitak pričvtstka. Godišnji gubitak pričvrstka u redovitih i jakih pušača iznosi 0,07 mm. Navike oralne higijene ne razlikuju se između pušača i nepušača, ali učenici s lošom oralnom higijenom imaju veći gubitak pričvrstka. Pušenje utječe na parodontalnu bolest, čak i u mladoj populaciji. Zato je prijeko potrebno obavijestiti mlade pušače o negativnim posljedicama te navike.Different studies have proven that smoking is one of the most important risk factors for the occurrence, progression and successual therapy of periodontal disease. However, only few studies have been conducted to prove the influence of smoking in a younger population. As we know that the severity of periodontal disease is directly associated with the amount of daily smoked cigarettes and also with the duration of smoking, it is important to find out when the first signs of negative influence appear so that we can act appropriately. The aim of this study was to determine if the periodontal status of smokers and non-smokers has differences, and to establish the influence of smoking habits on loss of attachment.The study was conducted on 517 highschool students. For each examinee data was taken concerning their age, place of residence, social status, smoking habits, smoking habits of their parents, oral hygiene habits and attendance to a dentist. The periodontal status was measured by the CPI and LA indices. Among the examines 34.6% were regular smokers. Students who are now 16 started to smoke when they were 14, but students who are now 14 and 15 started at age of 12. Children whose parents smoke had a two-fold increase of becoming smokers themselves, compared to children whose parents did not smoke. Bleeding was more frequent in non-smokers (4.61), than in smokers (4.19) (p=0,001). Smokers had significantly more sextants with calculus (1.47) than nonsmokers (0.88) (p<0,001). Loss of attachment was significantly greater in smokers (1.68) than in non-smokers (1.59) (p<0.001). The amount of smoked cigarettes had a great influence on loss of attachment. The annual loss of attachment in regular and intensive smokers measured 0.07 mm. Oral hygiene habits did not differ between smokers and non-smokers, but students with poor oral hygiene habits had greater attachment loss. Smoking has an influence on periodontal health even in this young age population, therefore it is necessary to inform young smokers about the negative cosequencese that smoking has

Advances in the Relationship between Periodontitis and Systemic Diseases

Novija istraživanja neprijeporno potvrđuju da postoji klinički relevantan međusobni utjecaj između parodontitisa i određenih sustavnih bolesti, to jest stanja važnih i za stomatologa u svakodnevnoj praksi i za liječnika opće medicine. Ovaj članak daje najnovije obavijesti o utjecaju parodontnih bolesti u sustavnim bolestima koje uključuju kardiovaskularne bolesti i aterosklerozu, diabetes mellitus, respiratorne bolesti i nepoželjne ishode trudnoće. Također obrađuje utjecaj dijabetesa i pušenja u parodontnim tkivima.New investigations have definitely acknowledged a clinically relevant two-way relationship between periodontitis and certain systemic diseases and conditions which are significant for the dentist in daily practice, and for a physician as well. This review article yields the most up-to-date information on the role of periodontal disease in systemic diseases that include cardiovascular diseases and atherosclerosis, diabetes mellitusm respiratory diseases and unfavorable pregnancy outcomes. It debates the role of diabetes and smoking in the periodontal tissues