Study of Dentistry in Rijeka Today and Tomorrow

Okrugle obljetnice ustanova u kojima radimo potaknu ljude kojima je stalo do onoga čime se bave da naprave raščlambu, retrospektivu, pogled u budućnost ili neki drugi oblik vrjednovanja svojega posla. Ukoliko je ustanova u kojoj se radi znanstvena, nastavna i zdravstvena, tad je osnovni problem ne ispustiti neku važnu pojedinost.The anniversary of the institution in which one works induces those interested in their work to carry out an analysis, a retrospective and to look forward to the future, or in some other way to evaluate the work in which they are engaged. If the institution in which they work is a scientific, teaching and health related institution then the main problem is to avoid leaving out any important detail

Factors influencing a patient's decision to choose the type of treatment to improve dental esthetics

Backgroung/Aim. Interest in dental esthetics has increased rapidly during the last few decades among both patients and dentists, and the creation of a natural dental appearance has become an important task in all fields of dentistry, especially in prosthodontics and restorative dentistry. The aim of this research was to investigate factors influencing a patient's decision to choose the type of treatment to improve dental esthetics. Methods. A total of 700 Caucasian subjects participated in the crosssectional study (261 men, 439 women, aged 18-86 years, mean age 46.2 ± 18.6). The study included clinical examination and a self-administrated questionnaire based on self-perceived esthetics, satisfaction with the appearance of their maxillary anterior teeth and previous dental experience. Multiple logistic regression was used in statistical analysis. Results. Hiding teeth during smile was the most important predictor for choosing fixed prosthetic restorations (OR 9.1), followed by self-perceived bad fixed prosthesis, malpositioned teeth and female gender (OR 2.9, 2.4, and 1.5, respectively). The increase in satisfaction with dental appearance and previous orthodontic therapy reduced chances for seeking prosthetic therapy (each OR 0.4). The significant predictors for bleaching choosing were hiding teeth during smiling, already done bleaching, female gender, lower levels of satisfaction with dental appearance and the absence of the previous orthodontic therapy (OR 5.8, 2.4, 1.8, 0.5 and 0.4, respecitively). Hiding teeth during smile, self-perceived malposition and crowding, and lower levels of satisfaction, were significant predictors for choosing orthodontic treatment (OR 3.1, 2.4, 2.2 and 0.6, respectively). None of current dental statuses was statistically significant predictor for choosing prosthodontic, bleeching nor orthodontic therapy. Conclusion. The psychological elements and female gender are the main predictors of seeking dental therapy. Understanding the prevalence of dissatisfaction with the present esthetics and desired treatments to improve esthetics can be a guide for strategies for intervention to improve esthetics

Function of the Stomatognathic System in Patients with Posttraumatic Stress Disorder

Svrha ovoga istraživanja bila je utvrditi zastupljenost temporomandibularnih disfunkcija (TMD) u veterana Domovinskoga rata koji boluju od posttraumatskog stresnog poremećaja (PTSP). Ispitivanu je skupinu činilo 100 ispitanika muškoga spola, sudionika rata s dijagnozom PTSP-a, a kontrolnu je skupinu činilo 94 ispitanika iste dobi i spola koji nisu sudjelovali u ratu i u kojih je psihijatrijskom dijagnostikom isključen PTSP. Istraživanje se sastojalo od anamnestičog i kliničkoga pregleda Anamnestičko ispitivanje provedeno je upitnikom u kojem su ispitanici odgovarali na postavljena pitanja izborom da−ne odgovora. Kliničkim je pregledom procijenjeno stanje čeljusnih zglobova (zvukovi, osjetljivost i bol prigodom palpacije čeljusnoga zgloba ) i žvačnih mišića (osjetljivost i bol prigodom palpacije žvačnih mišića), te je utvrđena funkcijska sposobnost stomatognatoga sustava (maksimalno otvaranje, maksimalna laterotruzijska kretnja u desno i lijevo, te maksimalna protruzija uz registraciju možebitne pojave boli ili zvuka). Statistički znatna razlika utvrđena je u gotovo svim mjerenim parametrima. Oboljeli od PTSP-a mnogo češće imaju subjektivne simptome i kliničke znakove TMD-a. 82% oboljelih od PTSP-a imalo je najmanje jedan simptom, a 98% najmanje jedan znak disfunkcija u usporedbi s 23,91% odnosno 50% ispitanika kontrolne skupine. Najčešći znak u objema skupinama bio je zvuk u temporomandibularnom zglobu (TMZ), i to u 64% ispitanika s PTSP om i 17,31% ispitanika kontrolne skupine. Statistički znatna razlika postoji i u granicama maksimalno mogućih kretnji jer ispitanici s PTSP-om znatno češće imaju ograničene kretnje otvaranja, desne i lijeve laterotruzije i protruzije. Najveće razlike među skupinama jesu u vezi s parametrima boli. 52% ispitanika s PTSP-om imalo je bolne TMZ-ove, a 91% imalo je bolnu najmanje jednu mšićnu lokaciju. Može se zaključiti da postoji povezanost između PTSP-a i TMD-a.The aim of this study was to determine the incidence of temporomandibular dysfunction (TMD) in veterans of the War for Independence, who suffer from posttraumatic stress disorder (PTSD. The examined group consisted of 100 male subjects with a diagnosis of PTSD, who had participated in the war, and a control group of 94 subjects of the same age and sex who had not participated in the war and in whom psychiatric diagnosis excluded PTSD. The study consisted of case history data and a medical examination. The examination included a questionnaire in which subjects answered questions with yes−no answers. During the medical examination the condition of the jaw joints (sounds, sensitivity and pain during palpation of the jaw joint) and mastication muscles (sensitivity and pain during palpation of the masticatory muscles) was assessed and the functional ability of the stomatognathic system determined (maximal opening, maximal laterotrusion movement left and right and maximal protrusion with registration of eventual occurrence of pain or sound). Statistically significant difference was determined in almost all measured parameters. The subjects with PTSD had subjective symptoms and clinical signs of temporomandibular disfunction (TMD) significantly more frequently. Eighty-two percent (82%) of those with PTSD had at least one symptom and 98% at least one sign of dysfunction, compared with 23.91% and 50% respectively of the subjects in the control group. The most frequent sign in both groups was sound in the temporomandibular joint (TMJ), which occurred in 64% of subjects with PTSD and 17.3% of subjects in the control group. Statistically significant difference was also found in the limitation of maximal possible movements, i.e. the subjects with PTSD had significantly more often restricted movements in opening, left and right laterality and protrusion. The greatest differences between the groups related to parameters of pain. Namely, 52% of subjects with PTSD had painful TMJ and 91% had at least one painful muscular location. It can be concluded that correlation exists between PTSD and TMJ

Oral Health Status and Temporomandibular Disorders in Multiple Sclerosis Patients

Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system. Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia, sensory neuropathy of the trigeminal nerve and facial palsy. The aim of this study was to determine the oral health status, the frequency of subjective symptoms and temporomandibular disorders (TMD) subtype according to Research diagnostic criteria for temporomandibular disorders (RDC/TMD) among MS patients. Examinees in this study were 50 patients suffering from MS, who were at least once treated during their disease in the Clinic Hospital Center, Rijeka, Clinic for Neurology. All examinees had to meet the diagnostic criteria for clinically and laboratory confirmed MS, according to Poser. The results show the difference in mean DMFT (decayed, missing, filled teeth) between MS and the control group. The number of decayed and missing teeth was higher, but the number of filled teeth was significantly lower in MS group. Eighty-two per cent of the subjects with MS had a least one symptom of dysfunction compared with 24% of the subjects in the healthy control group. In the present study, pain, the pain during mouth opening, the difficulty with mouth opening and temporomandibular joint (TMJ) sounds were more commonly reported in the MS group than in the control group. This study shows a statistically significant excess of dental caries and temporomandibular disorders among MS patients compared with the control group. These results suggest that MS is a possible etiological factor in temporomandibular disorders

Effect of Oral Parafunction on the Occurrence of Clinical Signs and Symptoms of Temporomandibular Dysfunction in a Rijeka Population

Cilj ovoga istraživanja bio je dobiti podatke o pojavnosti kliničkih znakova i simptoma temporomandibularne disfunkcije u riječkoj populaciji te pronaći međusobnu povezanost između pojedinih znakova i simptoma. Istraživanje je obuhvatilo 408 osoba od 18-85 godina podijeljenih u 3 grupe po dobi i spolu. Upotrijebljen je anamnestičko-dijagnostički upitnik koji su ispunjavali ispitanici. Klinički pregled izvođen je prema preporuci Okesona. Dobili smo sljedeće frekvencije pojedinih znakova i simptoma: • noćni bruksizam ima 17% žena i 14 % muškaraca • dnevni bruksizam ima 34% žena i 30% muškaraca • pojavu zvukova u TMZ-u prigodom kretnji ima 26% žena i 25% muškaraca • glavobolje češće od jedanput u mjesecu ima 34% žena i 19% muškaraca • pacijenti s bruksizmom imaju u 37% češću glavobolju od jedanput u mjesecu, 35% bol vratnih mišića i 33% pojavu zvukova u TMZ-u prigodom kretnji čeljusti • pacijenti bez bruksizma imaju u 41% glavobolje, 28% bol vratnih mišića i 24% pojave zvukova TMZ-a. Možemo zaključiti da su subjektivne bolnosti češće u žena te da dnevni i noćni bruksizam uzrokuju povećanu bolnost vratnih mišića i povećano postojanje zvukova u TMZ-u pri čeljusnim kretnjama.The aim of this investigation was to obtain data on the incidence of clinical signs and symptoms of temporomandibular dysfunction in the Rijeka population and to ascertain possible mutual correlation between particular signs and symptoms. The investigation included 408 subjects, 164 men and 242 women aged 18-85 years. After completing a questionnaire a clinical examination was performed of all subjects. The following frequency of particular signs and symptoms were determined: • Bruxism during the night in 17% women and 14% men. • Bruxism during the day in 34% women and 30% men. • Sounds in the temporomandibular joint (TMJ) during movement in 26% women and 25% men. • Headaches more often than once in a month in 34% women and 19% men. Of the patients with bruxism 37% experience headaches more frequently than once in a month, 35% pain in neck muscles and 33% sounds in the TMJ during mandibular movement. Of the patients without bruxism 41% experience headaches, 28% pain in neck muscles and 24% sounds in the TMJ. For statistical analysis χ2 test and odds ratio (OR) were used. Data were analysed by computer programmes Med Calc and Statistics for Windows. Statistically significant difference was found for the frequency of certain signs and symptoms of temporomandibular dysfunction (TMD) in the group of women. No statistically significant difference was found between oral parafunction and signs and symptoms of TMD. It can be concluded that day and night bruxism caused increased pain in the neck muscles and that the increased occurrence of sounds in the TMJ during mandibular movement was more frequent in women, although this was not statistically significant

Detection of Salivary Interleukin 2 and Interleukin 6 in Patients With Burning Mouth Syndrome

The etiology of BMS remains unknown. Role of various cytokines has been implicated in the development of BMS. The aim of this study was to evaluate levels of salivary IL-2 and IL-6 in patients with BMS, compared with age-matched healthy volunteers (control group). Whole saliva from 30 patients with BMS, age range 55–65, was tested for the presence of IL-6 and IL-2 by enzyme immunoassay. Control group consisted of 30 healthy participants, aged 55–65 years. Saliva IL-2 concentrations in BMS were significantly increased in patients compared to healthy subjects: mean 34.1 ± 9.7 versus 7.3 ± 3.0 pg/mL; P < .001. Patients with BMS had significantly higher concentrations of IL-6 compared to control: mean 30.8 ± 5.6 versus 5.2 ± 2.8 pg/mL; P < .001. In patients with BMS, IL-2 and IL-6 levels in saliva are elevated, correlating with the severity of illness