Dental Prosthetic Status and Prosthetic Needs of Institutionalized Elderly Population in Long-Term Residence in Skopje, Republic of N. Macedonia

Aim: Taking into consideration the poor oral health among the institutionalized elderly people the aim of this study was established: to determine the prosthetic status of the institutionalized elderly in the department "Mother Teresa", nursing home for long-term care in Skopje, Republic of Macedonia. Materials and Methods: Total number of 73 patients older than 65 years were examined. Research was conducted in the period from April to July 2018. Throughout the dental history we were noting whether the examined subjects wear prosthetic devices and whether they have problems with them. Also, the examinees were asked what are their dominant dental treatment needs. A thorough examination determined the presence and need of prosthetic appliances. Oral hygiene assessment of the prosthetic devices was done. Results: The study revealed that less than half of the participants wear prosthetic devices (exactly 42.7%). A large percentage from the participants who have prosthetic devices (64.5%) were complaining of difficulties associated with wearing dentures. Most of the examined elderly participants (53.23%) need various prosthetic treatments Total anodontia was registered in 47.95% of the surveyed elderly. Conclusion: The need for dental interventions is high, because the use of prostheses is quite low. Numerous problems associated with the use of prosthetic devices were noted. High prevalence of bimaxillary total anodontia and absence of prosthetic devices despite their unavoidable need is characteristic of institutionalized elderly. Also, unsatisfactory hygiene of prosthetic devices was noticed in our study. Keywords: Dental Prosthetic Status; Prosthetic Need; Geriatric Dentistry; Edentulous; Gerodontolog

Компаративна анализа на системите на материовигиланца во Македонија, САД, ЕУ, Јапонија и Кина и нивната улога во јавното здравство

Materiovigilance is a system applied for the purpose of detecting, gathering, monitoring, assessing and responding to new data on safety of medicinal products and related to the use of medical device related to possible incidents during use. The aim of this paper was to show the characteristics of the system of materiovigilance in the Republic of Macedonia compared to four other jurisdictions (US, EU, Japan and China), the recognition of the advantages and disadvantages of the systems and their impact on public health. Material and methods: For the realization of the aim of the study, we conducted an analysis of data published on the web pages of regulatory authorities related to the existing legal framework and review of the literature available on the network for scientists and researchers ResearchGate. General dialectical method as well as legal methods (dogmatic and normative method) were used in this study in order to determine the content, the meaning and the importance of the legal norms which regulate the system of materiovigilance. Results: The five systems of materiovigilance have several features that include monitoring of adverse events caused by medical device that have been granted a marketing authorization. Globally, these systems provide different, shared responsibility of all stakeholders. Thus, the scope of responsibilities of producers is significantly higher in Japan and China, opposed to the EU and Macedonia, where the responsibility is passed on to distributors, health professionals and other for-profit entities. United States is in the middle between these two extreme systems of materiovigilance, where the FDA has the responsibility to protect the public health forecasting responsibilities to the industry. Conclusion: There are significant variations in the regulation system of materiovigilance in the Republic of Macedonia and the analyzed legal systems. To date, there is no empirical evidence that one system is better than another, but it is indisputable that each system has its advantages and disadvantages regarding the protection of public health. Within the analyzed systems of materiovigilance three best practices can be seen that contribute to the improvement of public health: transparency, repeating the examination of medical device and central versus local control. Материовигиланца претставува систем кој се применува за откривање, собирање, следење, процена и обезбедување на соодветност на новите податоци за безбедност на медицинското средство поврзано со можните инциденти од употребата. Целта на овој труд е да се прикажат карактеристиките на системот на материовигиланца во Република Македонија, и тие да се споредат со други четири правни системи (САД, ЕУ, Јапонија и НР Кина), да се воочат предностите и недостатоците на системите и нивното влијание врз јавното здравство. Материјал и методи: За реализација на поставената цел извршивме анализа на податоците објавени на web страниците на регулаторните тела кои се однесуваат на важечката правна рамка, како и преглед на литературата достапна во-академската мрежа ResearchGate. Во овој труд го користевме општиот дијалектички метод, како и правните методи (догматски и нормативен метод) со цел утврдување на содржината, смислата и значењето на правните норми со кои се регулира системот на материовигиланца. Резултати: Петте системи на материовигиланца имаат неколку карактеристики кои вклучуваат следење на несаканите настани предизвикани од медицински средства кои имаат одобрение за ставање во промет. На глобално ниво, овие системи предвидуваат различна, поделена одговорност на засегнатите страни. Така, обемот на одговорности на производителите е значително поголем во Јапонија и Кина, за разлика од Европската Унија и Македонија, каде одговорноста е пренесена на дистрибутерите, здравствените работници и другите профитни субјекти. САД се наоѓа во средина помеѓу овие два екстремни система на материовигиланца, при што FDA има надлежност да го штити јавното здравје, предвидувајќи обврски за индустријата. Заклучок: Постојат значителни варијации во регулирањето на системот на материовигиланца во Република Македонија и анализираните правни системи. До денес, нема емпириски докази дека еден систем е подобар во однос на друг, но несомнено е дека секој систем има свои предности и недостатоци во врска со заштитата на јавното здравје. Во рамките на анализираните системи на материовигиланца може да се забележат трите најдобри практики кои придонесуваат за унапредување на јавното здравје: транспарентност, повторување на испитување на медицинското средство и централна наспроти локална контрола

Laser analgesic during orthodontic therapy

Introduction: Most of the patients feel pain 4 hours after the arch applying, gaining the highest level after 24 hours and its lowering in the next few days. Literature reports show that the fear of pain is a very important reason for discouraging the patient to agree for this kind of orthodontic treatment The aim of this study was to evaluate the effectiveness of the biostimulative laser treatment in pain reduction in patients with fixed orthodontic appliances. Materials and methods. Fifteen patients were treated with low energy level biostimulative diode laser, used 2 minutes per quadrant immediately after placement of fixed orthodontic appliances and in the following four days. The control group of 15 patients received analgesic therapy for period of five days. The pain was assessed subjectively as strong, medium or no pain. The pain disappeared in 20% of the subjects in the examined group after the first day, while in 60% and 26.6% of the subjects medium and isolated pain was still present at day 2 and 3, respectively. Results. The pain disappeared in all the patients treated with laser at day 5. In the control group, strong pain was present in all the subjects the first day, decreasing to 60% of strong pain and 20% medium pain the second day. After day three, the control group demonstrated medium localized pain in 40% of the cases, which dropped to 26.6% after the fourth day, suggesting delayed pain reduction, compared to the laser treated group. Conclusion. Our results suggest that the low energy laser treatment can successfully be used for pain reduction during the initial discomfort period after placing fixed orthodontic appliances

Morphological characteristics of the lip grooves in citizens of the Republic of North Macedonia determined by Cheiloscopy

Introduction: Cheiloscopy is defined as the study of the sulci labiorum, known as "lip prints". Aim of the study: The aim of this study was to determine the morphological characteristics of the lip grooves in the three dominant nationalities in the Republic of North Macedonia (Macedonians, Albanians, Roma) and to compare the obtained results with the morphological characteristics of the lip grooves in three other populations from different geographical regions. Material and methods: In this research, we included 150 examinees aged 25-50 years and divided them into three groups: Macedonians (50), Albanians (50) and Roma (50). The lip prints were taken using microscopic slides and detected using the dactyloscopic powder and brush method. We used the Suzuki and Tsuchihashi classification to typify the lip prints. Results: The most common type of lip grooves in the population of the Republic of North Macedonia was the type II grooves. There was no significant difference in the presence of different types of lip grooves in the four quadrants between males and females, nor between Macedonians, Albanians and Roma. The comparative analysis showed that populations from different geographical areas had different anthropological and morphological characteristics of the lip grooves. Conclusion: Type II lip grooves are the most common in the population of the Republic of North Macedonia and there is no statistically significant difference between the prevalence of different types of lip grooves in the three nationalities in this study. Considering the large number of factors that can affect the quality of the lip print, we recommend that a swab should always be taken before collecting the lip print in order to attempt to extract DNA material from the found trace

DMFT Index among Institutionalized Elderly

Introduction. Poor oral health among elderly is most common dental problem nowadays, especially among the institutionalized persons. Aim. To detect DMFT index among the institutionalized elderly. Material and Method. Oral examination was made to make adequate evaluation. A total number of 70 subjects were evaluated. DMFT index has been detected only with dental mirror and probe, without using additional instruments and methods. Results. Average value of DMFT index in our survey was 24.84 ± 4.56 (with Confidence interval from 23.77 to 25.89). M-component was dominant - 21.56 ± 7.79 (with Confidence interval from 15.74 to 23.38). D-component indicated by carious teeth and persistent roots had value 2.60 ± 3.54 (with Confidence interval from 1.77 to 3.42). Mean value of teeth with definitive fillings (F-component of DMFT index) was 0.34 ± 1.42 (with Confidence interval from 0.33 to 1.01). Conclusion. DMFT index among the institutionalized elderly had one of the biggest values in the literature. M-component was dominant and indicator of the absence of many teeth. Therefore it is of great importance to prepare adequate protocol for oral health care among the institutionalized elderly. Keywords: Gerodontology; Institutionalized Elderly; DMFT Inde

Subjective assessment for dental treatment needs among institutionalized elderly

Background: Among the adult population the need for dental care and certain preventive measures can be enhanced, especially among the oldest one. Among residents in long-term care institutions, in most cases in the oral cavity only a few teeth are left,and most of them have need of treatment. The goal was to evaluate the subjective need for dental treatment among institutionalized elderly. Material and method- this research was conducted in the "Mother Teresa" department, within the PHI Gerontology Institute "XIII-th of November" Skopje. All 73 institutionalized persons older than 65 years were examined. Adequate survey with appropriate questions subjective assessment for need of dental treatment was made among the institutionalized elderly. Results: 61.64% of respondents gave his subjective opinion that have need for dental intervention, while the remaining 38.36% from the institutionalized elderly people had no need for dental interventions. In terms of what kind of interventions, most needed treatment subjectively considered by the subject were different prosthetic activities (53.23%). Only one form the examined persons (1.61%) subjectively noted the need for treatment of gingival and periodontal diseases or need for checkup. Conclusion- The need for dental interventions among institutionalized elderly is high, with a predominance of different prosthetic interventions

The presence of subjective feelings of xerostomia in the institutionalized elderly

Introduction: The presence of subjective feelings of dry mouth is the most common oral problem in the institutionalized elderly. Purpose: to assess the subjective presence of xerostomia in the institutionalized elderly. Materials and method: Seventy individuals, older than 65 years and institutionalized in a particular nursing home, were evaluated. The subjective presence of xerstomia was determined. To determine the level of expressiveness of xerostomia, a questionnaire recommended by Carda et al was used. Results: 62.8% of the subjects believed that they had subjective feelings of xerostomia. The majority of the subjects, around 40%, had mild (xerostomia1), while around 25% of the subjects had severe xerostomia (xerostomia 3). Conclusion: Xerostomia is highly prevalent in the institutionalized elderly. Moreover, there is a high percentage of institutionalized elderly people who use drugs that may cause xerostomia. Key words: xerostomia, the institutionalized elderly, dry mout

Оптимално орално здравје кај возрасната популација на територија на Република Македонија.

Преку анкета, авторите на овој труд се обиделе да направат проценка на тоталната и парцијалната беззабност кај возрасната популација на Република Македонија, дефинирана како лица постари од 35 години. Исто така преку оваа анкета авторите се обиделе да испитаат колкав е процентот на лица кои го задоволуваат критериумот за оптимално орално здравје. Опфатени се 2367 испитаници од сите делови на Република Македонија. Резултатите покажале дека 23,62 % од испитаниците поседувале тотална беззабност, парцијална беззабност е забележана кај 66,79 % од испитаниците. Критериумот оптимално орално здравје (најмалку 20 заби во усната празнина), според авторите го задоволуваат само 38,10 % од испитуваната популација

Root caries among institutionalized elderly

Background-cervical caries or root caries is one of the most common types of caries among the elderly, especially among the institutionalized elderly. Due process of apical migration of epithelial attachment and present gingival recession, primary site of this type of caries occurrence is cervical region. Goal- to determine the prevalence of cervical caries among institutionalized elderly. Material and method- this research was conducted in the "Mother Teresa" department, within the PHI Gerontology Institute "XIII- th of November" Skopje. All of the institutionalized persons (total number - 73 subjects) older than 65 years were examined. Clinical examination was performed and the prevalence of root caries among respondents was determined. Results- The research indicates that the examined institutionalized people older than 65 years in which there were natural teeth, prevalence of root caries was 54.05%. The average number of root caries defects was 1,16 ± 1,4. Among the overall examined population the presence of root caries of teeth was 26.03%. Root caries is more common in the lower jaw (the frontal teeth mostly - 34.14%) than on the upper jaw. According to the processed data in this examination tooth which is usually encompassed from root caries is left lower canine. In only one patient (1.74% of the) was observed definitive restoration of the root caries. Conclusion- institutionalized elderly showed a high prevalence of root caries, with only a low number of carious lesions which are repaired with definitive filling