The Development of Dental Medicine in Croatia

Suvremena stomatologija vuče korijen znanstvene medicinske grane od godine 1728., tj. otkako je objavljeno djelo Pierrea Faucharda pod naslovom “Le chirurgien dentiste où traité des dents”. Bolesti usne šupljine, osobito bolesti zuba, pratilje su čovjekova života od njegovih početaka. Isto su tako stara i nastojanja da se liječe bolesti usta i zuba. Stomatologija u Hrvatskoj razvijala se na usporediv način kao i u drugim europskim zemljama, a prema društvenim i materijalnim prilikama u nas. Primorski gradovi imali su još od 13. stoljeća u službi stalne liječnike fizike, kirurge, ljekarnike i brijače (niže kirurge), a Dubrovnik godine 1777. prvi osniva i zubno-liječničku službu kao zasebnu granu opće zdravstvene zaštite. U kopnenome dijelu Hrvatske stomatologija se razvija kasnije, te krajem 18. stoljeća i početkom 19. stoljeća, npr. u Zagrebu, ima osoba koje se isključivo bave zubarstvom, a u 19. stoljeću imenuju se i gradski zubari. Djelovanje školovanih stomatologa, u to doba pretežno stranaca, pojedinačno je, samostalno i temelji se na zaradi. Javna stomatološka služba brže se razvijala od dvadesetih godina prošloga stoljeća (školske, gradske, državne poliklinike). U velikim središtima (Osijeku, Splitu, Rijeci i Zagrebu) utemeljene su poliklinike, a samo u Zagrebu Stomatološka klinika (1931.). Specijalizacije pojedinih stomatoloških grana u Hrvatskoj počinju od 1959. godine, a bile su samo dvije. Danas bi doktor stomatologije mogao specijalzirati osam grana. K tome treba dodati i potrebu trajnog usavršavanja, koja je utkana u sadašnji Zakon o zdravstvu. Raširenost bolesti usta, usne šupljine, zuba i čeljusti u Hrvatskoj velika je. Početkom 1979. godine u Hrvatskoj se uvodi Međunarodna klasifikacija bolesti u stomatologiji (MKBS) za određene bolesti (karijes zuba, parodontopatije, ortodontske anomalije, zloćudne tumore usta, rascjepe usta i nepca...). Stomatološko školstvo začeto je osnutkom Katedre za stomatologiju i zubarstvo na Medicinskom fakultetu u Zagrebu godine 1922. s prvim nastavnikom Eduardom Radoševićem. Stomatološka klinika, premda osnovana 1931. godine, stvarno je otvorena 1939. u novoizgrađenoj zgradi na Širokom brijegu na Šalati, s predstojnikom Ivom Čuparom koji ju je vodio tri sljedeća desetljeća. U Splitu je 1945. bila osnovana Viša zubarska škola, istovrsna i u Zagrebu 1947., te 1948. godine Odontološki odsjek na Medicinskom fakultetu u Zagrebu, koji je 1962. prerastao u samostalni Stomatološki fakultet Sveučilišta u Zagrebu Prvi dekan Fakulteta bi je Živko Bolf. Stomatološki studij na Rijeci utemeljen je u sklopu Medicinskog fakulteta 1973. godine. Znanstvenoistraživačka djelatnost u stomatologiji može se pratiti više od sto godina. U početku su to bili pojedinci, a danas je s porastom množine istraživača stvorena kritična masa za osnutak Centra za interdisciplinarnu djelatnost u stomatologiji. Pisana riječ traje već desetljećima u časopisima (Folia stomatologica, na žalost prestao izlaziti 1950. godine, Acta Stomatologica Croatica; u novije vrijeme Hrvatski stomatološki vjesnik), te brojnim skriptama, priručnicima, udžbenicima i u novije vrijeme internetskim stranicama. Društvena organiziranost struke krenula je godine 1903. osnutkom Zadruge hrvatskih stomatologa, a danas imamo Hrvatsko stomatološko društvo i niz specijalističkih društava u sklopu Hrvatskoga liječničkog zbora, te od 1995. Hrvatsku stomatološku komoru. Nakon osnutka samostalnog Stomatološkog fakulteta u Zagrebu (1962.) bitno je poboljšana struktura visokoškolovanih kadrova u stomatologiji u Hrvatskoj, a šezdesetih i sedamdesetih godina prošloga stoljeća nastao je i veći “izvoz” stomatologa u europske zemlje (npr. SR Njemačku, Švicarsku). Danas se, na žalost, još uvijek ne možemo pohvaliti bitnim smanjenjem rasta zubnoga karijesa i njegovih posljedica u hrvatskom pučanstvu.The roots of modern dental medicine, as a scientific medical branch, go back to 1728, when Pierre Fauchard published his paper entitled “Le chirurgien dentists où traité des dents”. Diseases of the oral cavity, particularly diseases of the teeth, have plagued man from his very beginning, as have attempts to treat diseases of the mouth and teeth. Dental medicine in Croatia developed in a similar way to other European countries, and in accordance with the social and material conditions in the country. As early as the 13th century coastal towns had services with permanent physicians physics, surgeons, pharmacists and barbers (lower surgeons). In 1777 Dubrovnik was first to establish a dental-medical service as a separate branch of general health protection. Dental medicine developed later in the interior of Croatia. For example, in Zagreb at the end of the 18th century and beginning of the 19th century one could come across people engaged exclusively in dentistry, and in the 19th century a town dentist was appointed. At that time foreigners carried out the work of educated dentists, and it was individual, independent and based on profit. With effect from the 1920s the public service of dental medicine rapidly developed (school, town and national polyclinics). In large centres (Osijek, Split, Rijeka and Zagreb) polyclinics were founded, and in Zagreb, in 1931, a Dental Clinic. In 1959, it was possible to specialise in two branches of dental medicine in Croatia. Today dentists can specialise in eight branches. The need for permanent training should be stressed, which is included in the Law on Health. The prevalence of diseases of the mouth, oral cavity, teeth and jaws in Croatia is high. At the beginning of 1979 International Classification of Disease in Dental Medicine (ICDD) was introduced in Croatia for a determined number of diseases (dental caries, periodontopathy, orthodontic anomalies, malignant tumours of the mouth, cleft palate ...) Education in dental medicine commenced in 1922 with the establishment of the Department of Dental Medicine and Dentistry at the Medical School in Zagreb, with the first teacher, Eduard Radoπević. Although founded in 1931 the Dental Clinic actually opened in 1939 in a newly erected building at Široki brijeg, Šalata, with Ivo Čupar as Head. He was Head of the Dental Clinic for thirty years. In 1945 the Higher Dental School was founded in Split and in 1947 a similar school in Zagreb. In 1948 the Odontological Section was established at the School of Medicine in Zagreb, which later became the independent School of Dental Medicine University of Zagreb in 1962. The first Dean of the School was Živko Bolf. In 1973 the study of dental medicine was established within the framework of the Medical Faculty in Rijeka. Scientific-research in dental medicine has continued for more than 100 years. Initially by individuals, today the increased number of investigators has created a critical mass for the establishment of a Centre for Interdisciplinary Activity in Dental Medicine. The written word has been present for decades in journals (Folia stomatologica, which sadly ceased to be published in 1950, Acta Stomatologica Croatia, with effect from 1966 and the Croatian Dental Herald since1993) and in numerous scripts, manuals, textbooks and more recently the Internet pages. The social organisation of the profession started in 1903 with the founding of the Society of Croatian Dentists. Today we have the Croatian Dental Society and several specialist societies within the framework of the Croatian Medical Association, and with effect from 1995 the Croatian Dental Chamber. Following the founding of the independent School of Dental Medicine in Zagreb in 1962 the structure of highly educated staff in dental medicine improved in Croatia, and during the 1960s and 1970s there was a significant “export” of dentists to European countries (e.g. Federal Republic of Germany, Switzerland). Today, unfortunately, we still cannot claim a significant reduction in dental caries and its consequences in the population of Croatia

Faculty of Medicine and Dentistry University of Western Australia

Početkom prosinca 2002. godine posjetio sam Stomatološki fakultet u Perthu u Zapadnoj Australiji. Grad Perth osnovan je godine 1829. i leži na ušću rijeke Swan na obali Indijskoga oceana. Grad danas ima oko 1.200.000 tisuća stanovnika, koji zapravo žive u nizu satelitskih gradova, i gospodarsko je i administrativno središte Države Zapadne Australije, koja ukupno ima oko 2.200.000 tisuća stanovnika. Preko trideset tisuća su Hrvati ili njihovi potomci, koji su najvećim dijelom podrijetlom iz Dalmacije, s otoka ili iz Dalmatinske zagore. Medicinski i stomatološki fakultet Sveučilišta Zapadne Australije u Perthu, u kojem inače djeljuje ukupno pet sveučilišta, jedinstvena je ustanova od 1. siječnja 1994. godine. Stomatološki fakultet, izvorno Fakultet stomatološke znanosti, utemeljen je godine 1946., a Medicinski fakultet 1956. i oba su u sastavu Sveučilišta Zapadne Australije.At the beginning of December 2002 I visited the School of Dentistry in Perth, Western Australia. The town of Perth was founded in 1829 and lies on the mouth of the river Swan on the coast of the Indian Ocean. Today the town has around 1.200.000 inhabitants, who live in several satellite towns. Economically it is the administrative centre for the State of Western Australia, which has approximately 2.200.000 inhabitants. More than 30.000 of them are Croats or their descendants, and most originate from Dalmatia, the islands or from the Dalmatian hinterland. The Faculty of Medicine and Dentistry of the University of Western Australia in Perth, which encompasses five universities, became an integrated institution on 1st January 1994. The School of Dentistry, originally the School of Dental Science, was established in 1946, and the School of Medicine in 1956. Both are included in the structure of the University of Western Australia

The Comparison of Molar Traits in Krapina Hominids and Contemporary Humans

Svrha ovoga istraživanja bila je utvrditi morfološke značajke okluzalnih ploha trajnih molara u krapinskoga hominida (KH) te dobivene rezultate usporediti s nalazima današnje populacije koja je činila kontrolnu skupinu (KS). Klasifikacija značajki okluzalnih ploha molara određena je prema standardima za karakterizaciju morfoloških varijanti trajnih zuba po ASU (Arizona State University) - Dentoantropološki sustav Državnog sveučilišta u Arizoni). Ukupno je obrađeno 77 molara KH, od toga 34 gornja i 43 donja. U KS ukupno je obrađeno 4836 molara, od toga 2548 gornjih i 2288 donjih. Raščlambom okluzalnih ploha molara utvrđeno je : u trećih i drugih gornjih molara KS smanjenje čestoće distolingvalne kvržice; nestankom ili redukcijom veličine distolingvalne kvržice nastala je promjena obrisa okluzalne plohe iz romboidnog u trokutast, te gubitka H-sustava brazdi, koji je znatno češći nalaz u KH (p < 0,05). Na prvome gornjem molaru nađeno je najmanje razlika između dviju promatranih skupina. Samo po obilježju Carabellijevo svojstvo nađena je znatna razlika u zastupljenosti i to s većom čestoćom u KH (p < 0,01). U donjih molara (M1, M2, M3) KS utvrđena je smanjena čestoća distalne kvržice (p < 0,01). Na M3 i M2 u objema promatranim skupinama najzastupljeniji crtež brazdi je oblika +. Oblik X postoji samo u KS. Na M1 dominantan crtež brazdi u objema skupinama je oblika Y. Na osnovi navedenih rezultata može se zaključiti da je u današnjega čovjeka na molarima nastala redukcija broja kvržica i promjena oblika okluzalnih ploha, što je dovelo do smanjenja ukupne žvačne površine zuba. Kako je prema stajalištima antropologa crtež brazdi oblika Y najkonzervativniji, a oblik X najrazvijeniji, može se zaključiti da je M1 najkonzervativniji i da u evolutivnom smislu nije postignuo gotovo nikakav napredak. U M2 dominantan crtež brazdi je oblika +. Kako crtež brazdi oblika + predstavlja razvojni međuoblik i može se uzeti kao najviši evolutivni stadij oblika Y, tj. kao početak oblika X, taj zub glede evolutivnih procesa spada u prijelaznu razvojnu fazu. Oblik X na M2 nađen je samo u KS, što potvrđuje da je u evolutivnom smislu taj zub postignuo znatan napredak u odnosu prema KH. Dominantan crtež brazdi na M3 u objema skupinama je oblika +. Crtež brazdi X nije nađen ni na jednome M3 u KH, za razliku od KS gdje crtež brazdi X postoji u preko četvrtine zuba. Takav nalaz upućuje na zaključak da je od svih donjih molara KS u evolutivnom smislu M3 dosegnuo najvišu razvojnu razinu.The aim of this study was to investigate morphological characteristics of occlusal surfaces of permanent molars in Krapina hominid (KH) and to compare them with the findings in the modern population (control group, CG). ASU (Arizona State University Dentoanthropological System) standards for the characterization of morphological variants of permanent molars were used for classification of occlusal molar surface characteristics. A total number of 77 KH molars, among them 34 upper and 43 lower, as wel as 4836 CG molars, among them 2548 upper and 2288 lower ones was analysed. The analysis of occlusal molar surfaces revealed a lower incidence of distolingual cusps in CG third and second upper molars. The disappearance of reduction in size of distolingual cusp resulted in a change in occlusal surface contour from rhomboid to triangular and H-shaped grooves were lost; these characteristics were more grequently present in KH (p < 0.05). The least difference was found in the first upper molar; the only significant difference was the Carabelli trait, present significantlly more frequently in KH (p < 0.01). In lower KH molars (M1, M2, M3) the incidence of distal cusp was reduced (p < 0.01). In both study groups the most frequent groove shape in M3 and M2 was + shape. X-shape was seen only in CG. The predominanat groove shape in M1 was Y-shape in both study groups. Based on these results, it may be concluded that the number of cusps was reduced ond the shape of occlusal surface was changed in modern humans, leading to a reduction in the tital masticatory surface. Since Y-shape is considered most conservative and X-shape considered the most advanced by athropologist, we conclude that M1 remained the most conservative and did not undergo any progression in tooth evolution. The dominant groove shape in M2 was +shape. Since the +shaped groove is considered intermediate stage the highest evolutionary stage of Y-shape, i.e. the initial stage in X-shape formation, this tooth can be considered the transitional stage in tooth evolutionary development. X-shape was found only in CG, indicating the significant advancement in tooth evolutionary development in comparisom with KH. The dominant groove shape in M3 was +shape in both study groups. X-shape was not found in any of KH M3 in contrast to CG, where it was found in more than one fourth of teeth. This finding indicates that M3 reached the highest developmental stage among all lower molars in CG

Characteristics of the Occlusal Surfaces of Lower Molars in a Sample of the Croatian Population

Svrha ovoga istraživanja bila je utvrditi značajke okluzalnih ploha donjih molara na uzorku hrvatske populacije. Klasifikacija značajki okluzalnih ploha molara određena je prema standardima za karakterizaciju morfoloških varijanti trajnih zuba po ASU (Arizona State University - Dentoantropološki sustav Državnoga sveučilišta u Arizoni). Na temelju dobivenih rezultata oblika brazdi u donjih molara, glede evolutivnog procesa kod tih zuba, može se zaključiti da je prvi donji molar najkonzervativniji. Kod drugoga donjeg molara znakovita je pojava visoke čestoće oblika +. Kako se oblik + može uzeti kao najviši evolucijski stadij konzervativnog oblika Y, ili pak kao početak najrazvijenijeg oblika X, za drugi donji molar može se reći da je u prijelaznome stadiju, s tim što je s postignutom evolucijskom razinom svakako bliži donjemu trećem molaru. Treći donji molar dosegnuo je najviši razvojni oblik u oblikovanju okluzalne plohe donjih molara.The aim of this study was to determine the characteristics of the occlusal surfaces of lower molars in a sample of the Croatian population. Classification of the characteristics of the occlusal surface of molars was determined according to the standards for characterisation of morphological variants of permanent teeth, of ASU (Arizona State University - Dentoanthropological System of the State University of Arizona). On the basis of the obtained results of the shape of grooves in lower molars, with regard to the evolutive process in these teeth, it can be concluded that the first lower molar is the most conservative. The high frequency of + shape was significant in the second lower molar. As + shape can be taken as the highest evolutive stage of the conservative Y shape, i.e. the beginning of the most developed X shape, the second lower molar can be said to be in the transitive stage, and thus with its attained evolutive level it is definitely closer to the lower third molar. The third molar reached the highest developmental shape in the formation of the occlusal surfaces of lower molars

Miroslav Suvin (30.5.1899 - 30.5.1999)

Uz stotu obljetnicu rođenja prof. dr. Miroslava Suvina prisjetit ćemo se jednoga burnog i vrlo sadržajnog razvoja stomatologije u Hrvatskoj. Miroslav Suvin rodio se je u Zagrebu 30. svibnja 1899. godine. Osnovno i srednje školovanje završio je u rodnom gradu, a studij opće medicine na Medicinskom fakultetu Sveučilišta u Beču 1923. godine. Nakon završena obvezatnog jednogodišnjeg liječničkog staža, koji je obavio u zagrebačkim bolnicama pretežito u Zakladnoj bolnici, jednu godinu specijalizirao je neurologiju i psihijatriju na Sveučilišnoj klinici u Beču. Osobitu pozornost privukla mu je psihoanaliza i psihoterapija. Prvi znanstveni radovi posvećeni su upravo tim temama i objavljeni su u "Störungen des Trieb - Affektlebens", Band 6 (Urban und Schwarzenberg, Wien, 1927.). Kako je M. Suvin zaključio da u psihoanalizi maha uzimaju ekstremistička stajališta, s kojima se nije slagao, prekinuo je specijalizaciju iz neurologije i psihijatrije te prešao na specijalizaciju stomatologije, također u Beču.With the hundredth anniversary of the birth of Prof. Miroslav Suvin we recall a period of exciting and important development of dental medicine in Croatia. Miroslav Suvin was born in Zagreb on 30th May 1899. He finished primary and middle school in Zagreb and the study of general medicine at the School of Medicine University of Vienna in 1923. After completing obligatory medical practice in Zagreb hospitals, mainly in the Endowment Hospital (Zakladna Bolnica), he completed one year of specialisation in neurology and psychiatry in the University Clinic in Vienna. He was particularly interested in psychoanalysis and psychotherapy. Thus, his first scientific papers were on those themes and were published in "Störungen des Trieb - Affektlebens", Band 6 (Urban and Schwarzenberg, Vienna, 1927). As M. Suvin concluded that extremist attitudes were prevalent in psychoanalysis, with which he did not agree, he discontinued specialisation in neurology and psychiatry and began specialisation in dental medicine, also in Vienna

65 ans d\u27existence de l\u27association des stomatologistes croates

Autor objavljuje podatke o događajima koji su prethodili osnivanju Zadruge hrvatskih stomatologa u Zagrebu i o jednom razdoblju djelovanja Zadruge. Rad predstavlja dio uvodnih istraživanja razvoja stomatološke medicine u ovim krajevima, pa ga samo kao takvog treba shvatiti.In dieser Arbeit schildert der Autor die Geschehnisse, welche der Gründung der Genossenschaft kroatischer Stomatologen in Zagreb vorausgegingen, sowie auch einen Teil der Wirkungsperiode der Genossenschaft. Die Arbeit stellt eine Einführung in Forschungen über die Entwicklung der Stomatologie in diesen Gegenden dar und soll daher als solche aufgefasst werden.Dans ce travail l\u27auteur donne des details sur les evenements qui on precede la fondation de l\u27Assaciation des stomatologistes croates et sur une periode d\u27activite de cette association. Ce travail represente une partie de recherches introductoires du developpement de medecine stomatologique dans ces regions et il faut le considerer de cette maniere seulement