Bacterial morphotypes in periodontal pockets of diabetic patients

Cilj ovog rada je ispitati postotak mikrobnih morfotipova u uzorcima subgingivnog plaka u bolesnika sa šećernom bolesti i to metodom mikroskopa s tamnim poljem. U tu svrhu ispitana su 31 bolesnika sa šećernom bolesti Tipa I ili Tipa II, a komparativna skupina sastojala se od 22 sistemski zdrava ispitanika s parodontnom bolesti. Ispitanici u obje grupe su imali duboke parodontne džepove na mjestima uzimanja uzoraka (X = 6.0 vs 6.3), a slične kliničke vrijednosti imali su i za upalu gingive (Gl) i plak indeks (Pl). Veći postotak džepova sa supuracijom imali su bolesnici sa šećernom bolesti. Dobiveni nalazi ukazuju da je prosječni postotak spiroheta veoma sličan u obje grupe ispitanika (48,3 vs 48,1) kao i postotak štapića (30.2 vs 29.8). Prosječan postotak pokretnih štapića bio je veći u ispitanika sa šećernom bolesti (9.6 vs 5.5, P < 0.001), ali je postotak koka bio značajno veći u sistemski zdravih ispitanika (7.6 vs 4.0, P < 0.001). Unatoč određenim ograničenima koje pruža tehnika mikroskopa s tamnim poljem može se zaključiti da u subgingivnoj flori bolesnika sa šećernom bolesti postoje patogeniji mikrobni morfotipovi nego u sistemski zdravoj skupini.The aim of this study was to assess the percentage of microbial morphotypes in samples of subgingival plaque taken from diabetic patients, using a darkfield microscope technique. The group consisted of 31 patienssuffering from type I or type II diabetes, and a comparative group comprised of 22 systemically normal subjects with a periodontal disease. The subjects of both groups had deep periodontal pockets at the sites of sampling (X = 6.0 vs. 6.3) and they were also found to have similar clinical values for both gingivitis (Gl) and plaque index (PI). The percentag of pockets with suppuration was higher in patients with diabetes mellitus. The findings obtained indicated the mean percentage of spirochaetes to be very similar in the two groups examined (48.3 vs. 48.1), and so was the percentage of rods (30.2 vs. 29. 8). The mean percentage of motile rods was higher in diabetic patients (9.6 vs. 5.5; P < 0.001), but the percentage of cocci was significantly higher in systemically healthy subjects (7.6 vs. 4.0; P < 0.001). In spite of limitation s posed by a techniqe of darkfield microscope, a conclusion is suggested that in the subingival flora of patients suffering from diabetes mellitus some more pathogenic microbial morphotypes are present as compared to the control group of subjects

The incidence of the fusion of the roots in permanent molars

U radu su prikazani rezultati ispitivanja učestalosti srastanja korjenova molarnih zubi na temelju analize ortopantomograma na skupini od 119 pacijenata oba spola. Ukupno je pregledano 889 molara i to u 448 u gornjoj i 441 u donjoj čeljusti. Ispitivanje ukazuje da prosječno 30,8% molara ima sraštene korjenove a učestalost je nešto veća u gornjoj (40,5%) nego u donjoj (40,1%) čeljusti. Fuzija korjenova na rendgenu se najčešće opaža na trećim gornjim molarima (70,5%), zatim na drugim gornjim (47,8%) a najrjeđe na prvim donjim molarima. Rezultati također pokazuju da postoji izrazita simetričnost u pojavi fuzije u obje čeljusti kod svih ispitanikaThe incidence of the fusion of the roots of molar teeth was studied by analyzing the orthopantomograms of 119 patients of both sexes. A total of 889 molars, i.e. 448 in the upper and 441 in the lower jaw, were examined. As many as 30.8% of the molars were found to have fused radices. The incidence was slightly higher in the upper (40.5%) than in the lower jaw (40.1%). X-ray of the teeth moist often revealed root fusion in the third upper molars (70.5%), then in the second upper molars (47.8%) and the least frequently in the first lower molar teeth. The results also point to a marked similarity in the appearance of fusion in both jaws in all examines

Nonsurgical therapy of parodontal diseases

nekirurške terapije i komparativnim rezultatima kirurške i nekirurške terapije parodontnih bolesti. Ističe se da se nekirurškom terapijom postižu vrlo uspješni rezultati, obzirom na kliničko stanje, položaj i održanje pričvrstka kao i inaktivnost parodontne lezije. Komparativni rezultati ukazuju da se nekirurškom terapijom parodontnih džepova postižu jednako uspješni klinički rezultati kao kao i kirurškim tretmanom. Histološki nalazi također ukazuju da cjeljenje tkiva nakon nekirurške terapije rezultira u stvaranju epitelne adhezije na tretiranom korijenu zuba kao i nakon kirurških zahvata. Za kratkotrajne kao i dugotrajne efekte nekirurške terapije, najvažnije je striktno održavanje oralne higijene kao i redovna profilaksa. Na kraju se ističe da su unatoč vrlo povoljnim kliničkim rezultatima, potrebne još dodatne studije, posebno one koje će evaiuirati rezultate nekirurške terapije u području oštećenih furkacija višekorijenskih zubi.The author evaluate the clinical effect of nonsurgical therapy and compare the results of surgery with non-surgical therapy of parodontal diseases. Very successful results have been achieved with nonsurgical therapy in certain clinical stages of gingiva, for the positioning and maintenance of the level of the attachment, and for inactive parodontal lesions. The comparative results show that nonsurgical therapy of parodontal pockets has the same clinical results as surgical treatment. Histological findings, likewise, indicate that epithelial adhesions develop on treated roots of teeth after nonsurgical therapy as they do after surgery. Oral hygiene and prophylaxis are extremely important for maintaing both a short and long — term effect of nonsurgical therapy. Finally, the author point out that in spite of very favorable clinical results, further studies, especially those which evaluate the effects of nonsurgical therapy on impaired furcation of multirooted teeth, are necessary

The significance of the width of keratinized gingiva for the periodontal health

U radu se iznose rezultati dosadašnjih studija o ulozi širine keratinizirane gingive na zdravlje parodontnih tkiva. Ističe se, da su razvijene brojne kirurške metode za proširenje uske zone keratinizirane gingive s ciljem da se dobije »adekvatna« zona marginalne i pričvrsne gingive, što će omogućiti održavanje gingivnog zdravlja. Suvremene znanstvene studije ukazuju da je moguće održanje zdravlja gingive i u područjima s minimalnom zonom keratizirane gingive, ako postoji redovna oralna higijena. Područja s uskom zonom keratizirane gingive nisu podložnija nakupljanju plaka, a ako je plak prisutan, klinički simptomi upale jednako su izraženi bez obzira na širinu keratizirane gingive. Histološki je ustanovljeno da u prisutnosti plaka dento-giingivno spojište s uskom zonom pričvrsne gingive ima jednaku sposobnost upalnog odgovora na metaboličke produkte plaka kao i u područjima sa širokom zonom pričvrsne gingive. Bazirajući na dosadašnjim kliničkim i eksperimentalnim rezultatima znanstvenih studija, čini se da širina keratizirane gingive nema onakav utjecaj za održanje gingivnog zdravlja kako se prije smatralo, i da opsežni mukogingivni zahvati nemaju kliničkog i znanstvenog opravdanja.The author presents the results from recent studies of the influence of the width of keratinized gingiva on periodontal tissue health. Many clinical procedures have been developed to increase the narrow area of keratinized gingiva for the purpose of obtaining on »adequate« zone of marginal and attached gingiva to help maintain gingival health. Modern scientific studies indicate, however, that it is possible to maintain gingival health even in areas with minimal keratinized if oral hygiene is meticulous. The narrow zone of keratinized gingiva is not subject of more plaque accumulattion compared with areas with normal zone of keratinized gingiva. Clinical symptoms of inflammatioin are equally present regardless of the width of keratinized gingiva. It was histologically shown that when plaque is present, the dento-gingival junction in the narrow zone of attached gingiva has the same ability as the wide zone of attached gingiva for an inflammatory response to the metabolic product of plaque. Based on present clinical and experimental results, the width of keratinized gingiva does not specifically help maintain gingiva health, and comprehensive mucogingival procedures are often neither clinically nor scientifically justified

Clinical evaluation of periodontal disease

Klinička procjena parodontnih tkiiva omogućuje egzaktno dijagnosticiranje parodontnih bolesti i evaluaciju terapijskih zahvata na oboljelom parodontu. U radu se iznosi pregled postojećih kliničkih metoda za kliničku evaluaciju parodontnih bolesti i ukazuje na važnost i mogućnosti svake postojeće metode. Ističe se, da unatoč brojnim modifikacijama i unaprijeđenjima, sadašnje kliničke metode pružaju često subjektivnu sliku stanja parodontnih tkiva, što otežava preciznu dijagnostiku kao i komparativne studije o efektima različitih teraipijskih metoda u parodontnoj terapiji. Stoga se razvoj preciznih, osjetljivih i reproducibilnih kliničkih metoda nameće kao jedan od prioritetnih ciljeva u parodoritnm istraživanjima.Clinical studies of periodontal tissue enable the precise diagnosis of periodontal diseases and the evaluation of therapeutic procedures for the diseased periodontium. The author review existing clinical procedures for evaluating periodontal diseases and stress the importance and possibilities of each particular method. In spite of the numerous modifications and advancements, present clinical procedures often provide a subjective picture of the status of periodontal tissue, hindering therefore a precise diagnosis and a comparative study on the effect of different therapeutic methods in periodontal therapy. For this reason, the development of accurate, sensitive and reproducible clinical procedures as a leading goal in periodontal investigations is stressed

Assessment of gingival fluid during the periodontal pocket healing

Svrha ovog ispitivanja je bila odrediti odnos između gingivne tekućine (GT) i nekih kliničkih parametara za vrijeme cjeljenja parodontnih tkiva. Gingivna tekućina, klinička dubina parodontnih džepova, klinička razina pričvrstka, krvarenje na sondiranje parodontnih džepova, krv na papirnom štapiću iz parodontnog džepa i postotak plaka su bili određeni u 198 aproksimalnih džepova kod 13 pacijenata s uznapredovalom parodontnom bolešću. Klinički parametri mjereni su prije te 3 i 6 mjeseci nakon poliranja korjena i uputa u oralnu higijenu. Gingivna tekućina i krv sakupljani su s endo-papirnim štapićem i mjereni do najbližeg 0.5 mm. Dubina parodontnih džepova i krvarenje na sondiranje određivano je elektronskom na pritisak osjetljivom sondom sa silom od 50 gr. Prosječna dubina parodontnih džepova prije tretmana iznosila je 5.6 ± 1.8 mm, a iznos gingivne tekućine je bio 6.6 ± 3.7 mm (koeficijent korelacije r = 0.55 p < 0.001). Tri i šest mjeseci nakon tretmana značajno se smanjila klinička dubina parodontnih džepova i količina gingivne tekućine, ali je i dalje postojala statistički značajna korelacija između ova dva parametra (poslije 3 mjeseca r = 0.33 p < 0.01, i poslije 6 mjeseci r = 0.31 p < < 0.01). Iznos gingivne tekućine također je bio viši u mjestima gdje je postojalo krvarenje na sondiranje, a slični su rezultati dobiveni i za mjesta gdje se dobilo krv na papirnom štapiću. Rezultati također ukazuju da mjesta gdje je postojao koronarni pomak razine pričvrstka pokazuju značajno više redukcije gingivne tekućine i dubine parodontnog džepa nego mjesta gdje postoji gubitak pričvrstka. Ovi podaci ukazuju da postoji pozitivna korelacija između gingivne tekućine i drugih kliničkih parametara za vrijeme cjeljenja parodontnih tkiva u uznapredovaloj parodontnoj bolesti.The purpose of this study was to determine the relationship between gingival fluid (GF) and some clinical parameters during the periodontal pocket healing. GF, probing pocket depth (PPD) attachment level (AL), bleeding on probing (BL), bleeding on paper point (BLP) and plaque score were obtained from 198 interproximal pockets of 13 patients with advanced periodontal disease. Clinical parameters were measured prior to and 3 and 6 months after root planning. GF and BLP were collected by endo-paper point, and measured to the nearest 0.5 mm. Pre-treatment PPD was 5.6 ± 1.8 mm and amount of GF was 6.6 ± 3.7 mm (corr. coeff. r = 0.55 p < 0.001). 3 and 6 months after treatment significant reduction of PPD and GF were obtained but significant correlation between these parameters exist, (at 3months r = 0.33 p < 0.04, and at 6 months r = 0.31 p < 0.01). Amount of GF was higher also in the sites demonstrating BLP at initial and 3 and 6 month examination (p < 0.001). Similar results were obtained for sites demonstrating BL. The results proved also that sites showing gain of AL demonstrated significantly more reduction of GF and PPD comparing the sites demonstrating loss of AL Such data indicate that positive correlation between GF and other clinical parameters exist during periodontal pocket healing in advanced periodontal disease

Zaitgemösse Erkentnisse über die Bildung und Zusammensetzung der Shcleimhautflüssigkeit

Gingivna tekućina je upalni eksudat porijeklom iz seruma, a nastaje kao rezultat upalnih procesa u parodontu. Količina i sastav tog eksudata ovisi o permeabilnosti epitela i malih krvnih žila gingive, ali i o patološkom stanju tkiva kroz koje taj eksudat prolazi do parodontnog džepa. Autor iznosi pregled brojnih biokemiijskih supstancija u gingivnoj tekućini i upućuje na njihovu moguću ulogu u biokemijsko-patogenetskim procesima koji se zbivaju u parodontu i njihovu moguću ulogu u obrani marginalnog parodonta.Gingival fluid is an inflammatory exudate originating from serum, which is due to inflammatory processes in the periodontal tissue. The quantity and structure of this exudate depends on the permeability of the epithelium and small, blood vessels in gingiva, as well as on the pathological condition of the-tissue through which this exudate passes to the periodontal pocket. The author describes, a number of biochemical substances in gingival fluid, and their possible role in biochemical-pathogenetical processes occurring in the periodontal tissue and their possible role in the defence of the marginal periodontal tissue.Die Gingivaflüssigkeit ist ein entzündliches Exudat aus dem Serum stammend, als Resultat von entzündlichen Prozessen im Parodont. Die Menge und Zusammensetzung dieses Exudats hängt von der Durchlässigkeit des Epithels und kleinerer Gefässe der Schleimhaut ab, aber auch vom pathologischen Zustand der Gewebe welche dieses Exudat am Wege zur parodonta len Tasche durchläuft. Der Autor zählt die zahlreichen biochemischen Substanzen in der Schleimhautflüssigkeit, auf, und führt ihre biochemisch-pathogenetische Rollen die sich im Parodont abspielen, an. Ihre potentielle Rolle in der Abwehr des marginalen Parodonts wird ebenfalls erwähnt

Razvoj infrastrukture prostornih podataka u Hrvatskoj uz nacionalni i regionalni pristup

Although still not a member State of the European Union, Croatia has recognized in the spatial data infrastructure a concept that can significantly incite the modernization and effectiveness of the State administration, and create preconditions for the accelerated economic growth. Given this fact, Croatia has defined, after preparations which lasted several years, the legal framework for the national spatial data infrastructure establishment by adopting the Law on State Survey and Real Property Cadastre in 2007. During the adoption of this Law, great attention was paid to it being in line with the EU INSPIRE Directive (European Union, 2007) that was being adopted at the time, so the adopted provisions were fully compatible with the INSPIRE provisions. Regarding the model that Croatia has chosen in the establishment of its National Spatial Data Infrastructure (NSDI), the role of the State Geodetic Administration (SGA), the Croatian National Mapping and Cadastre Agency (NMCA), is significant. The SGA acts as a coordination body for the NSDI establishment, giving technical support to the NSDI bodies. One of the obligations is the establishment of a metadata catalogue through the national geoportal. Significant activities have been undertaken in the field of raising the awareness. The most important studies describing the manner of the NSDI establishment and current national as well as European situation have been translated into Croatian language and distributed to more than 1,000 NSDI stakeholders. Several workshops have been organised in order to transfer the best practices from the countries that have achieved big progress in this field. In parallel with the national activities, Croatia, or rather the SGA, has recognized that the spatial data infrastructure (SDI) development cannot be based on isolated national activities connected exclusively to the INSPIRE Directive but that the Croatian spatial data infrastructure development activities must be part of the development of the regional and European spatial data infrastructure (ESDI). In this context, Croatia has recognized South-Eastern Europe as a region sharing many similarities, whether with regards to the historical legacy, development degree, current development directions, reform activities or the SDI development stage, although it should be pointed out that there are also differences. Given the above-mentioned similarities, Croatia has instigated the regional cooperation linked to the development of both national and regional SDI’s. Concrete achievements on this road are the establishment of the regional cooperation between cadastral organization, launching of the annual regional conference on the cadastre and preparation of the first regional SDI project entitled INSPIRATION – Spatial Data Infrastructure in the Western Balkans (Inspiration project). At the European level, the SGA is member of EuroGeographics, European organisation whose purpose is the improvement of the ESDI development, including topographic information, cadastre and land information. This paper describes the role and activities of the SGA in the SDI establishment at the national, regional and European level.Iako još nije članica Europske unije, Hrvatska je u infrastrukturi prostornih podataka prepoznala koncept koji može u značajnoj mjeri pospješiti modernizaciju i učinkovitost državne uprave i stvoriti pretpostavke za ubrzani razvoj gospodarstva. Upravo zbog te činjenice Hrvatska je nakon višegodišnjih priprema, donošenjem Zakona o državnoj izmjeri i katastru nekretnina 2007. godine, definirala zakonodavni okvir uspostave nacionalne infrastrukture prostornih informacija. Prilikom usvajanja toga Zakona velika je pozornost posvećena usklađenosti s INSPIRE direktivom EU (European Union 2007) koja je tada bila u donošenju, tako da su usvojene odredbe u potpunosti usklađene s odredbama INSPIRE-a. Pri izboru modela koji je Hrvatska izabrala pri uspostavljanju nacionalne infrasturkture prostornih podataka (NIPP) značajna je bila uloga Državne geodetske uprave (DGU). DGU je koordinacijsko tijelo za uspostavu NIPP-a koje daje tehničku podrušku tijelima NIPP-a. Jedan od zadataka je također uspostava kataloga metapodataka kroz nacionalni geoportal. Značajne aktivnosti učinjene su na polju podizanja svijesti. Najvažnije studije koje opisuju način uspostave NIPP-a, kao i sadašnju nacionalnu i europsku situaciju prevedene su na hrvatski jezik i disdtribuirane na više od 1000 adresa. Organizirano je nekoliko radionica kako bi se prenijelo najbolje primjere iz prakse iz zemalja koje su napravile velike korake na tom polju. Paralelno s nacionalnim aktivnostima Hrvatska je, uz pomoć DGU, prepoznala da se razvoj infrastrukture postorrnih podataka (IPP) ne može temeljiti na izoliranim nacionalnim aktivnostima s isključivom povezanošću na INSPIRE direktivu, već aktivnosti izgradnje hrvatske infrastrukture prostornih podataka moraju biti dio izgradnje regionalne i europske infrastrukture prostornih podatka (EIPP). U tom kontekstu je Hrvatska prepoznala jugoistočnu Europu kao regiju s kojom dijeli mnoge sličnosti, bilo da je riječ o povijesnom nasljeđu, stupnju razvijenosti, aktualnim pravcima razvoja i reformskim aktivnostima i stanju razvoja IPP-a, iako treba istaknuti da postoje i razlike. Upravo zbog navedenih sličnosti, Hrvatska je potaknula uspostavu regionalne suradnje na izgradnji kako nacionalnih, tako i regionalnog IPP-a, s ciljem da se zajedničkim naporom svih zemalja sudionica ubrza izgradnja takvog IPP-a. Konkretna postignuća na tom putu su uspostava regionalne suradnje katastarskih organizacija, pokretanje godišnje Regionalne konferencije o katastru i priprema prvog regionalnog IPP projekta nazvanog INSPIRATION – SDI in the Western Balkan (projekt Inspiration). Na europskoj razini DGU je članica EuroGeographicsa, europske organizacije čija je svrha poboljšanje razvoja EIPP-a, uključujući topografske informacije, katastar i zemljišne informacije. U ovome se radu opisuje uloga DGU pri uspostavi IPP-a na nacionalnoj, regionalnoj i europskoj razini