Comparison of Fluoride Ion Release from Fluoride Gel in Various Solvents

Cilj: U istraživanjuse željela odrediti koncentracija fluorida u različitim otapalima i usporediti je s de-klariranom koncentracijom fluorida.Materijal i metode: Gel koji sadržava aminofluorid i natrijevfluorid uspoređen je s gelom samo s natrijevim fluoridom. Otapala korištena u ovom istraživanju bila su destilirana voda, redestilirana voda, voda iz slavine, 0,9-postotna otopina natrijeva klorida i umjet-na slina. Količina fluoridnih iona (F -) određena je fluor-selektivnom elektrodom. Korišteni su ANOVA i post hoc Tukeyjev test. Razina značajnosti bila je α = 5 %.Rezultati: Razlike izmeđuotpuštanja F –iona u različitim otapalima bile su statistički značajne (p < 0,05). Koncentracija F –iona izmjerena u otopinama redistilirane vode obaju gelova bila je viša od deklariranih koncentracija. Zabilježena je značajna razlika u otpuštanju fluorida između otopina gela koje su sadržavale samo natrijev fluorid. Oslobađanje fluoridnih iona bilo je značajno različito u otopinama kombiniranoga fluoridnog gela. Zaključak: Aminofluoridi ne stupaju u interakciju s drugim ionima u otopini, a otpuštanje F –iona iz natrijeva fluorida mijenja se kada su u istoj otopini i drugi ioni. Aminofluoridi učinkovitije dostavljaju F –ione za prevenciju karijesa.Objective: The aim of this study was to determine the concentration of fluoride ions present in var-ious solvent solutions and compare it to the label amount of fluoride concentration. Material and methods: The gel containing amine fluoride and sodium fluoride was compared to gel containing sodium fluoride only. The solvents used in this study were distilled water, redistilled water, tap water, 0.9% sodium chloride solution and the artificial saliva. The amount of fluoride ion (F -) was determined by the use of fluoride ion-selective electrode. The ANOVA and the Post hoc Tukey’s test were used. The significance level was α = 5%. Results: The differences between F –ion release in various solvents were statistically significant (p < 0.05). The F –ion concentrations measured in both gels’ redistilled water solutions were higher than the label concentration. There was a significant difference in fluo-ride ion release in sodium fluoride only gel solutions. Fluoride ion release was significantly different in combined fluoride gel solutions. Conclusions: Amine fluorides do not interact with other ions pres-ent in the solution, whereas F –ion release from sodium fluoride alters when other ions are dissolved in the same solution. Amine fluorides deliver F -ions for caries prevention more efficientl

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

Auto-Medication of Analgesics by Dental Patients

Uklanjanje boli jedan je od glavnih izazova stomatološke prakse. Akutna bol značajka je većine odontogenih boli i često je povezana sa samoupotrebom analgetika. No samoliječenje stvara rizik uzimanja prekomjerne doze lijeka, preduge upotrebe, klinički znatnih interakcija s već pripisanim lijekovima, te polipragmazije i mogućih štetnih učinaka. Početno zbivanje kod većine bolnih stanja jest bolni podražaj koji izaziva destrukciju tkiva, sintezu i otpuštanje bikemijskih medijatora koji sudjeluju u nastanku boli. Za ublažavanje boli najčešće se rabe analgeticiantipiretici, nesteroidni (NES) lijekovi koji djeluju na periferiji. Oni inhibiraju biokemijske medijatore boli. Svi NES analgetici izazivaju kvalitativno slične neželjene učinke, uzimaju se kroz usta i lako su dostupni u ljekarnama bez recepta - u slobodnoj prodaji. Svrha ovoga rada bila je odrediti čestoću samoliječenja analgeticima stomatoloških bolesnika s akutnom boli. 32 bolesnika sa zuboboljom u dobi od 19 do 73 godine, prosječne dobi 32,5 godine i oba spola, ispitana su o intenzitetu boli prije liječenja i o uporabi lijekova. 68% bolesnika opisalo je svoju bol kao jaku, 21,9% kao umjerenu i 10,1% kao neugodni osjećaj. Rezultati su pokazali da je 99,6% bolesnika samo uzelo lijek za neposredno otklanjanje bolova. Najčešće uzeti analgetici jesu: kombinacija analgetika- antipiretika (propifenazon+paracetamol+kofein+kodein) u 33% i dikofenak (Voltaren) u 29,1%, zatim metamizol u 21,8, aspirin u 13% i ibuprofen u 3,1% slučajeva. 56% bolesnika lijekove je nabavilo kod ljekarnika, a 44 % iz kućne zalihe. Bolesnici (87,5%) su dobro obaviješteni o mogućim neželjenim učincima i toksičnosti NES analgetika. Neželjene učinke opisalo je 21,8% bolesnika, većinom kao gastrointestinalne simptome: mučnina i želučana bol. To je u skladu s dobro opisanim nuspojavama NESanalgetika, koje su najvjerojatnije rezultat inhibicije ciklooksigenaza i znatan uzrok bolesti.Pain is one of the major challenges in dental care. The most common types of odontogenic pain are characterised as acute pain which is frequently associated with selfmedication with analgesics. However , there is a risk with self-medication such as the use of excessive drug dosage, prolonged duration of use, clinically significant interactions with prescription medicines and polypharmacy and possible side effects. The initial event for most painful conditions is a noxious stimulus that results in tissue destruction, the synthesis and the release of biochemical mediators involved in the pain process. Peripherally acting nonsteroid analgesic-antipyretic drugs /NSAIDs/ are the most commonly used analgesics. They inhibit these biochemical mediators of pain. All NSAIDs share a qualitatively similar side ellect profile, the oral route of administration and all of them are freely available to the general public without prescription over the counter drugs (OTC). The aim of this study was to determine the incidence of auto medication with analgesics among dental patients with acute pain. 32 patients aged from 19 to 73 years, (32.5) of both sexes and with odontalgia were interviewed personally regarding the intensity of their pre-treatment pain and the use of medications. 68% of patients described their pain as severe, 21.9% as moderate pin and 10.1% as unpleasant sensation. The results showed that 99.6% of the patients self-medicated a drug for the immediate relief of toothache. The most frequently self-medicated analgesics were: analgesic-atipyretic combined formulations (propiphenazon + paracetamol + coffeine + codeine) in 33% and diclofenac (Voltaren) in 29.1%, the metamizol in 21.8%, aspirin in 13% and ibuprofen in 3.1%. Selfmedicated drugs came from the pharmacist in 56% patients and 44% from the family stock. Patients (87.5%) were well informed about possible side effects and toxicity of NSAIDs. Adverse effects during therapy was reported by 21.8% patients, mainly as gastrointestinal symptoms: nausea and gastric pain. This is in egreement with the wel documented NSAIDs side effects which are presumably the result of inhibiting cyclooxygenases and a significant cause of morbidity

The Effect of Salivary Calcium and Fluoride Toothpaste on the Formation of KOH-Soluble Fluoride: In Vitro Study

Svrha: Svrha ovoga preliminarnog istraživanja in vitro bila je procijeniti učinak sline pušača (pretpostavlja se da sadržava veću koncentraciju kalcija) u kombinaciji s fluornom pastom za zube na ugradnju alkalno topljivih fluorida na površinu cakline. Materijali i metode: Sa svakoga od 14 ekstrahiranih impaktiranih umnjaka odrezana su četiri caklinska bloka koji su nakon toga nasumičnim odabirom svrstani u četiri skupine. Uzorci nestimulirane sline prikupljeni su od dvojice dobrovoljca istoga spola i dobi – jedan je bio pušač, a drugi nepušač. Dva uzorka iz skupine A i B mućkala su se pet minuta u slini (A – u slini pušača, B – u slini nepušača), a zatim tri minute u smjesi paste za zube i deionizirane vode (1 : 3). Uzorci iz skupina C nisu bili tretirani slinom nego su se mućkali samo u smjesi paste za zube i deionizirane vode. Tretman je ponovljen poslije šest sati. Jedna od skupina (D) poslužila je kao kontrolna. Rezultati: Koncentracija kalcija u slini pušača bila je veća negoli u slini nepušača. Ugradnja alkalno topljivih fluorida na površinu cakline u skupini A bila je statistički značajno veća nego u ostalim dvjema tretiranim skupinama (B i C). Ugradnja alkalno topljivih fluorida na površinu cakline u sve tri skupine koje su bile tretirane slinom i zubnom pastom bila je statistički značajno veća negoli u kontrolnoj skupini. Zaključak: Rezultati pokazuju da slina pušača, koja je imala veću koncentraciju kalcija, povećava ugradnju alkalno topljivih fluorida na površinu cakline, što nas potiče da provedemo opsežniju studiju.Objective: The aim of this in vitro preliminary study was to assess the effect of smokers’ saliva (assuming their higher calcium concentration) in combination with fluoridated toothpaste on the enamel uptake of alkali-soluble (KOH-soluble) fluoride. Materials and methods: Four enamel slabs were cut from each of 14 impacted third molars and randomly assigned into 4 groups. Unstimulated saliva samples were collected from two age and sex matched volunteers. One of the samples was taken from a heavy smoker and the other sample was taken from a non-smoker. Two groups (A and B) were shaken in saliva (A in smoker’s saliva, B in nonsmoker’s saliva) for 5 min and then shaken for 3 min in a toothpaste/deionized water slurry (1:3 w/w). One of the groups (group C) received no saliva treatment and was only shaken in toothpaste slurry for 3 min. The treatment was repeated after a 6-hour period. One of the groups (D) served as a control group with no treatment. Results: Calcium concentration in the smoker’s saliva was higher than in the nonsmoker’s saliva. The enamel uptake of KOH-soluble fluoride in group A was significantly higher than that in the other two treatment groups, B and C. The enamel uptake of KOH-soluble fluoride in all 3 groups was statistically different from that in the control group. Conclusion: These results demonstrate that saliva collected from a heavy smoker, which had higher salivary calcium concentration, enhances enamel uptake of alkali-soluble fluoride and encourages us to conduct a large-scale study

Fluoride-Releasing Restorative Materials: the Effect of a Resinous Coat on Ion Release

Svrha rada: Cilj istraživanja bio je utvrditi učinak dvaju dentinsko adhezijskih sustava i staklenoionomerne smole na količinu otpuštenih fluoridnih iona i promjenu pH tijekom 168 dana. Materijali i metode: U istraživanju su korištena četiri restaurativna materijala: giomer Beautifil II, alkasitni kompozitni materijal Cention, konvencionalni kompozit Filtek Z 250 i konvencionalni staklenoionomerni cement Fuji IX Extra. Svjetlosno polimerizirani kompozitni uzorci premazani su G-aenial Bondom i adhezivom Clearfil Universal Bond Quick. Na uzorke sa staklenoionomernim cementom nanesen je premaz GC Fuji Coat LC. Uzorci bez premaza korišteni su kao referencije. Mjerenja količine otpuštenih fluoridnih iona i pH vrijednosti provedena su u sljedećim vremenskim intervalima: 1 sat, 24 sata, 2 dana, 7 dana, 28 dana, 84 dana i 168 dana. Rezultati: Kumulativne količine otpuštenih fluoridnih iona poslije 168 dana povećale su se na nepremazanim uzorcima sljedećim redoslijedom: Filtek Z 250 < Beautifil II < Cention < Fuji IX Extra. Kompoziti premazani Clearfil Universal Bond Quickom otpuštali su manju količinu fluoridnih iona od nepremazanih uzoraka, a kumulativne vrijednosti dosegnute nakon 168 dana povećavale su se sljedećim redoslijedom: Filtek Z 250 < Beautifil II < Cention. Kompoziti premazani G-aenial Bondom također su otpuštali manje količine fluoridnih iona u usporedbi s nepremazanim uzorcima – kumulativne vrijednosti povećavale su se sljedećim redoslijedom: Filtek Z 250 < Beautifil II < Cention. Kompoziti premazani G-aenial Bondom u svim su skupinama pokazivali pH vrijednosti u kiselom rasponu (4,4 – 5,7) u intervalima od jednoga i 24 sata. Zaključak: Količina otpuštenih fluoridnih iona varirala je među ispitivanim restaurativnim materijalima i ovisila je o upotrebi dentinskog adhezijskog sustava i premaza. Vrijednosti pH varirale su između materijala, tretmana i vremenskih intervala.Objective: To determine the effect of two adhesive systems and a glass ionomer coating resin on fluoride release and concurrent pH changes over a period of 168 days. Material and methods: Four restorative materials were investigated: a giomer Beautiful II, an “alkasite” material Cention, a conventional composite Filtek Z250, and a glass ionomer cement Fuji IX Extra. Light-cured composite specimens were coated using G-aenial Bond and Clearfil Universal Bond Quick. Glass ionomer specimens were coated using GC Fuji Coat LC. Uncoated specimens were used as references. Quantitative fluoride release and pH changes were measured after 1 h, 24 h, 2 days, 7 days, 28 days, 84 days, and 168 days. Results: The cumulative fluoride release after 168 days increased for uncoated specimens in the following order: Filtek Z250 < Beautifil II < Cention < Fuji IX Extra. A comparatively lower fluoride release was measured for the composites coated with Clearfil Universal Bond Quick, with cumulative values after 168 days increasing in the following order: Filtek Z250 < Beautifil II < Cention. The composites coated with G-aenial Bond showed lower fluoride release compared to the uncoated specimens, with cumulative values increasing in the following order: Filtek Z250 < Beautifil II < Cention. The composites coated with G-aenial Bond showed pH values in the acidic range (4.4-5.7) after 1 h and 24 h. Conclusion: Fluoride release varied among the investigated restorative materials and depended on the use of dental adhesives and coatings. The pH of all materials, coating types and time points varied

Antibiotic Administration Along with Endodontic Therapy in the Republic of Croatia: a Pilot Study

Cilj: Željelo se procijeniti vrstu i učestalost primjene antibiotika tijekom endodontskih zahvata u Republici Hrvatskoj te procijeniti stajalište liječnika dentalne medicine o endodontskom liječenju pacijenata rizičnih za nastanak bakterijskog endokarditisa.Materijal i metode: Podatci su skupljeni ispunjavanjem anketnih upitnika. Rezultati: Među liječnicima koji su odgovorili na anketna pitanja njih 8,4 % istaknulo je da propisuje antibiotike često, a 91,6 % nikada, vrlo rijetko ili rijetko. Većina njih (41 %) ordinirala je antibiotike jedanput ili dva puta na mjesec, 32,5 % jedanput ili dva puta u nekoliko mjeseci, a 20,5 % jedanput ili dva puta na tjedan. Najčešće korišteni antibiotik bio je penicilin s klavulanskom kiselinom. Zatim, 26,2 % liječnika propisivalo je antibiotike za gangrenu pulpe, 51,2 % za lokalizirani akutni apikalni parodontitis bez otekline, 85 % za celulitis, 75 % za povišenu tjelesnu temperaturu i povećane limfne čvorove, 16,9 % za zub s fistulom i 94,1 % za profilaksu bakterijskog endokarditisa. Prema rezultatima studije 54,4 % stomatologa nije propisivalo antibiotike bez intervencije na osjetljivom zubu, 76 % često je, gotovo uvijek, ili uvijek prihvatilo endodontsko liječenje bolesnika kojima je bila potrebna antibiotska profilaksa zbog sprječavanja infektivnog endokarditisa, a 96,7% sudionika odgovorilo je da zna za nedavne upute o antibiotskoj profilaksi.Zaključak: Rezultati upozoravaju na neprimjerenu uporabu antibiotika u praksi na temelju odgovora 83 doktora dentalne medicine, s obzirom na učestalost primjene i indikacije. Najčešće korišteni antibiotik bio je penicilin s klavulanskom kiselinom. Visok postotak anketiranih odgovorio je da su im poznate recentne upute o antibiotskoj profilaksi te da obavljaju endodontske zahvate i pacijentima rizičnima za razvoj bakterijskog endokarditisa. Potrebna je ciljana trajna edukacija doktora dentalne medicine u Republici Hrvatskoj.Objective: To evaluate the type and the frequency of antibiotic prescribing along with endodontic therapy in Croatia. The aim is, also, to assess the attitudes of Croatian doctors towards endodontic treatment of patients at risk of developing bacterial endocarditis. Material and methods: Data were collected by a survey questionnaire. Results:8.4% of the examined practitioners stated that they prescribe antibiotics often, and 91.6% of them stated that they prescribed them never/ very rarely/rarely. Most of them (41%) prescribe antibiotics once or twice a month, 32.5% once or twice in several months and 20.5% once or twice a week. The most commonly used antibiotic was penicillin with clavulanic acid. Also, 26.2% of examined practitioners prescribed antibiotics for gangrene pulp, 51.2% of them for localized acute apical periodontitis without swelling, 85% of them for cellulitis, 75% of them for fever and enlarged lymph nodes, 16.9% of them for tooth with fistula and 94.1% of them for prophylaxis of infectious endocarditis. According to the results of study, 54.4% of dental practitioners did not prescribe antibiotics without intervention on susceptible tooth; 76% of participants often/almost always/ always accepted endodontic treatment of patients requiring antibiotic prophylaxis to prevent infectious endocarditis, and 96.7% of participants indicated they were familiar with recent instructions for antibiotic prophylaxis. Conclusion: These findings point to inappropriate use of antibiotics in the practice of 83 dental practitioners questioned regarding the frequency of administration and indications. The most commonly used antibiotic was penicillin with clavulanic acid. A high percentage of surveyed practitioners stated that they were familiar with recent instructions for antibiotic prophylaxis. They also stated that they performed endodontic procedures on patients who were at risk of bacterial endocarditis. There is a noticeable need for targeted continuing education of dental practitioners in the Republic of Croatia

Use of antiseptics in pediatric dentistry

Svrha ovog rada je pregled antiseptika i defi niranje značenja stomatoloških antiseptika u kontroli i eliminaciji mikroorganizama kao sastavnog dijela prevencije i terapije bolesti zuba i parodonta u dječjoj stomatologiji. Dosad su poznate karakteristike i mehanizam djelovanja pojedinih antiseptika te je doprinos rada predstaviti indikacije za njihovu primjenu u svakodnevnom radu stomatologa, osobito u dječjoj i preventivnoj dentalnoj medicini.The purpose of this article is to review the use of antiseptics and defi ne the meaning of dental antiseptics in the control and elimination of microorganisms as an integral part of prevention and treatment of plaque diseases in pediatric dentistry. Also, the article describes the known characteristics and mechanism of action of some antiseptics, contributing to current indications for their use in pediatric and preventive dentistry

Znanje i stajališta doktora dentalne medicine u Hrvatskoj o propisivanju antibiotika u endodonciji: presječno istraživanje

Objectives: To assess dentists’ level of knowledge and practice concerning antibiotic usage in endodontics using the European Society of Endodontology position statement as a reference. Material and Methods: A cross-sectional study was conducted in the form of an electronic questionnaire consisting of 23 questions, including dentists’ demographic and professional characteristics, attitudes as well as experiences regarding antibiotics in endodontics. Data were evaluated by the Mann-Whit-ney test or the Kruskal Wallis 1-way ANOVA, α = 5%. Results: The overall mean self-reported knowl-edge of antibiotics usage in endodontics was 11.7±2.5 points, out of a maximum possible score of 23. The factors associated with a higher knowledge were: age (P≤0.001), clinical experience (P≤0.001), specialist training (P=0.008), and adherence to the guidance on the use of systemic antibiotics in endodontics (P=0.006). Dentists who specialized in endodontics (16.1±2.2) achieved higher levels of knowledge. Conclusion: Knowledge on antibiotic usage in endodontics among dentists in Croatia is insufficient. There is a need for continuing education on the use of antibiotics among general dentists.Ciljevi: Procijeniti razinu znanja i iskustva stomatologa o primjeni antibiotika u endodonciji koristeći se kao referencijom konsenzusom Europskoga endodontološkoga društva. Materijal i metode: Ovo presječno istraživanje provedeno je na temelju elektroničkoga upitnika sastavljenoga od 23 pitanja, uključujući demografske i profesionalne značajke doktora dentalne medicine, njihova stajališta i iskustva u vezi s korištenjem antibiotika u endodonciji. Podatci su analizirani Mann-Whitneyjevim testom ili Kruskal-Wallisovim jednosmjernim ANOVA testom – α = 5 %. Rezultati: Ukupna prosječna vrijednost znanja doktora dentalne medicine iznosila je 11,7 ± 2,5 bodova, od najviše mogućih 23. Čimbenici povezani s višim znanjem bili su dob (P ≤ 0,001), kliničko iskustvo (P ≤ 0,001), specijalističko usavršavanje (P = 0,008) te poštovanje smjernica o primjeni sistemskih antibiotika u endodonciji (P = 0,006). Doktori dentalne medicine koji su specijalizirali endodonciju (16,1 ± 2,2) postigli su višu razinu znanja. Zaključak: Znanje o primjeni antibiotika u endodonciji među doktorima dentalne medicine u Republici Hrvatskoj je nedostatno. Potrebna je stalna edukacija o upotrebi antibiotika među populacijom općih doktora dentalne medicine