The Effect of Chemical Degradation and Polishing on the Gloss of Composite Dental Materials.

This aim of this study was to investigate surface gloss changes of different composite dental materials after chemical degradation or polishing. Five different composites were used (Evetric, GrandioSO, Admira Fusion, Filtek Z550, Dynamic Plus). The gloss of the tested material was measured with a glossmeter before and after chemical degradation in different acidic beverages. Statistical analysis was performed using a t-test for dependent samples, ANOVA, and a post hoc test. For comparison between groups, a level of significance was set at 0.05. Initial gloss values ranged from 51 to 93 at baseline to 32 to 81 after chemical degradation. The highest values were obtained for Dynamic Plus (93.5 GU) and GrandioSO (77.8 GU), followed by Admira Fusion (82 GU) and Filtek Z550 (70.5 GU). Evetric showed the lowest initial gloss values. After acidic exposures, the gloss measurements revealed different patterns of surface degradation. The results showed that the gloss of the samples decreased with time regardless of the treatment. The interaction between chemical-erosive beverages and the composite could lead to a decrease in the surface gloss of the composite restoration. The nanohybrid composite showed less gloss changes under acidic conditions, suggesting that it is more suitable for anterior restorations.

Are Mini Dental Implants Suitable for Support of Crowns or Small Bridges in the Mandibular Incisor Region? A 5-year Longitudinal Study.

PURPOSE: It has not been previously studied whether 1-piece category 1 narrow dental implants (≤2.5 mm wide) can successfully support crowns or small bridges. The purpose of this study was to evaluate the long-term benefits of the fixed-type mini dental implants (MDIs) for replacement of mandibular incisors. MATERIALS AND METHODS: In a prospective cohort study, fixed-type 1-piece MDIs, replacing single or multiple mandibular incisors, supporting metal-ceramic single crowns (unsplinted group), or splinted crowns/small bridges (splinted group) were observed over the period of 5 years. The primary predictor was the splinting status. The primary outcome variables were peri-implant marginal bone level (MBL) change, success, and survival rates (assessed as per Pisa Consensus Conference). The secondary outcomes were dental patient-reported outcome measures (dPROMs) and oral hygiene assessment. Descriptive statistics, Chi-squared test, t-test, Mann-Whitney and Wilcoxon tests, Kaplan-Meier survival analysis, log-rank (Mantel-Cox) comparison, Cox proportional hazard analyses adjusting for number of implants, Spearman correlation, and repeated measures were used for data analysis. RESULTS: From 44 participants (mean age 56.02 ± 5.72 years), 40 completed the 5-year study: 23 in the splinted and 17 in unsplinted group. Three subjects did not respond, while 1 MDI failed (third year) in the unsplinted group. Mean marginal bone level (MBL) change in both groups was small; however, it increased over time (-0.22 ± 0.38 mm after 1 year; -0.54 ± 0.56 mm after 5 years; P < .05). After 5 years mean MBL change was -0.59 ± 0.71 mm in the unsplinted and -0.50 ± 0.41 mm in the splinted group (P > .05). Survival analysis revealed no significant difference between the unsplinted (85.7% success, 4.8% failures, and 9.5% satisfactory survivals) and splinted group (93.4% success and 6.6% satisfactory survivals) (P > .05). The group affiliation (unsplinted vs splinted) and number of implants were not significant predictors of MDI failure or survival rates (P > .05). Significant improvement in dPROMs after rehabilitation remained unchanged over 5 years (P > .05). Modified plaque index significantly increased over time, correlating with the MBL loss. CONCLUSION: MDIs supporting crowns and/or small bridges in the mandibular incisor region showed small rates of marginal bone loss, acceptable success, and survival rates and improved dPROMs over a 5-year observation period.

Dental Treatment for Special Needs Patients Under General Anaesthesia: A 14-year Experience from South Bosnia and Herzegovina.

We conducted a retrospective analysis of records of special needs patients (SNPs) who received dental treatment under orotracheal-intubation general anaesthesia (OIGA) at Caritas Centre St. Family in Mostar, Bosnia and Herzegovina during the 14-year period from January 2005 to December 2018. Of the 7,085 SNPs who received dental treatment, 1,220 (17.2%) received dental treatment under OIGA: 829 (67.9%) males and 391 (32.1%) females. The patients' mean age was 18.3±10.9 years (747 paediatric and 473 adult patients). Mental retardation and psychiatric problems were the most common medical conditions (81.22%). The most common indication for dental treatment under OIGA was behaviour management (87.21%), and 81% of the patients had an urgent need for treatment. Many of the patients had restorative treatment (3,833) and tooth extractions (3,681). From 2011 onwards, the number of tooth extractions decreased significantly. Annual trends revealed a rapid increase of patients every year. The mean dental treatment duration was 95.3±12.1 min; the mean time under OIGA was 98±8.5 min. No serious adverse effects occurred. There was increase of annual trend of SNP in OIGA. The number of extractions decreased while the number of preventive and restorative dental treatments increased.

Spatio-Temporal Expression Pattern of Ki-67, pRB, MMP-9 and Bax in Human Secondary Palate Development.

We analyzed the immunohistochemical expression of Ki-67, pRb, Bax, and MMP-9 during the human secondary palate formation (7th to 12th developmental weeks (DWs). The most significant proliferation was observed in the seventh DW with 32% of Ki-67-positive cells in the epithelium, while loose ectomesenchyme condensations (lec) and loose non-condensing ectomesenchyme (lnc) had only 18 and 11%, respectively (Kruskal-Wallis, p < 0.001), and diminished afterwards. Contrarily, pRb-positive cells were mostly located in the lnc (67%), with significant difference in comparison to epithelium and lec in all investigated periods (Kruskal-Wallis, p < 0.001). Ki-67- and pRb-positive cells co-expressed occasionally in all investigated periods. MMP-9 displayed a strong expression pattern with the highest number of positive cells during the seventh DW in the epithelium, with significant difference in comparison to lec and lnc (Kruskal-Wallis, p < 0.0001). The ninth DW is particularly important for the Bax expression, especially in the epithelium (84%), in comparison to lec (58%) and lnc (47%) (Kruskal-Wallis, p < 0.001). The co-expression of Bax and MMP-9 was seen only in the epithelium during seventh and ninth DWs. Our study indicates the parallel persistence of proliferation (Ki-67, pRb) and remodeling (MMP-9) that enables growth and apoptotic activity (Bax) that enable the removal of the epithelial cells at the fusion point during secondary palate formation.

Attitudes of dental practitioners towards antimicrobial therapy in Croatia and Bosnia and Herzegovina.

INTRODUCTION: The objective of this study was to assess perceptions and attitudes amongst dental practitioners in relation to antibiotic usage and antibiotic resistance. METHODS: Self-administered questionnaire was given to dental practitioners employed in south Croatia, west Herzegovina and Sarajevo, Bosnia and Herzegovina (N = 115). RESULTS: 81.7% of respondents agreed the usage of antimicrobials is frequently uncritical and unnecessary. 83.5% of dental practitioners reported that they have used guidelines in their practice; however, only 9 out of 115 stated valid guidelines. One-third of the respondents agreed or were undecided that the usage of antimicrobials in every oral inflammatory process treatment is justified. Furthermore, 13% was undecided and 26% agreed that pregnant women and breastfeeding women should not use any antimicrobials. However, three quarters of respondents considered they had satisfactory knowledge on antimicrobials. DISCUSSION: The respondents considered they had satisfactory knowledge on antimicrobials, which was in contrast to the knowledge shown, but also expressed the need for additional education. Therefore, adequate measures include the creation of the local guidelines, their implementation, and updating the practitioners' knowledge on antibiotic use and resistance through continuous educational courses.

Acceptance of Orthodontic Therapy according to the Aesthetic Component of the Index of Orthodontic Treatment Need among Schoolchildren - a Cross-Sectional Study.

OBJECTIVE: Orthodontic anomalies with impaired facial aesthetics and disturbed oral functions have a major effect on emotional and social development. It is necessary to determine the degree of acceptance of treatment. This study includes an evaluation of the Index of Orthodontic Treatment Need (IOTN) according to the Aesthetic Component (AC) of dental health in schoolchildren. METHODS: The research included 300 schoolchildren (150 girls, 150 boys) with an age range from 12 to 15 years. An evaluation of the need for orthodontic treatment according to the AC consisted of a ten-grade scale illustrated with a sequence of ten intraoral photographs showing different degrees of acceptability of dental appearance. Results were expressed as absolute and relative frequencies. The Chi-square test (in the absence of the expected frequencies of Fisher's Exact test) was used for testing the significance of differences. Cohen's kappa statistic measure was used for measuring the agreement between the children and dentists. RESULTS: There is a significant substantial agreement between children and dentists in assessing the need for orthodontic treatment. Differences in assessment of the degree of orthodontic anomalies by the doctor of dental medicine with respect to boys and girls, are negligible, and statistical analysis did not show any significant difference. Analysis of the need for orthodontic treatment with respect to the age of the children showed a significant difference. CONCLUSION: The need for orthodontic treatment is more pronounced in older children, and there is no difference between boys and girl.

The prevalence of orthodontic treatment needs of school children in northern Herzegovina.

OBJECTIVE: The study was conducted to evaluate the Index of Orthodontic Treatment Need based on the Dental Health Component (DHC). MATERIALS AND METHODS: 300 students aged 12-15 years were included in this study. The examinations were performed in two elementary schools in the municipality of Prozor-Rama, using standard dental instruments. Children were ranked into five grades according to the DHC. RESULTS: Only 12% of children were found not to have a need for orthodontic treatment. Of the others, 45.33% had a great, and 10% a very great need for orthodontic treatment. The rest of the children were found to have a need for minor or moderate orthodontic treatment. Slightly more girls than boys had a great or a very great need for treatment, although the difference by gender was not statistically significant. Analysis of the level of need by age of children showed no significant difference; children with a great need of orthodontic treatment prevailed in all age groups. About 85% of children with a great and a very great need for orthodontic treatment would agree to orthodontic treatment, while the rate of non-acceptance was about 5%. CONCLUSION: The high rate of need for orthodontic treatment in the examined students is explained by the lack of programs for this type of health care, the insufficient number of qualified orthodontic specialists, and the very low percentage of allocations from the state budget for oral health.

Dental fear and anxiety in older children: an association with parental dental anxiety and effective pain coping strategies.

An association between dental fear and anxiety (DFA) has been confirmed for children younger than 8 years, but this association in older children is less clear. The aim of this study was to fill this knowledge gap by studying DFA in older children and their parents with validated measures. This cross-sectional study, conducted at Community Health Centre Mostar, Bosnia and Herzegovina, included 114 children and their parents. DFA, coping, and sociodemographic variables were studied using Corah Dental Anxiety Questionnaire (CDAS), Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS), Dental Cope Questionnaire, and sociodemographic questionnaire. Maternal CDAS scores had significant positive correlation with child DFA measured with CFSS-DS (r=0.35, P<0.001) and CDAS (r=0.32, P<0.001). Fathers' CDAS scores were not associated with child CFSS-DS, but showed a moderate correlation with child CDAS (r=0.19, P<0.05). There were no significant differences in children's fear and anxiety based on age, sex, or socioeconomic variables. Children used internal coping strategies most frequently and external coping strategies were rated by the children as the most effective. We did not find differences in number and type of effective coping strategies in children with high DFA compared with children with low DFA. In conclusion, there is evidence of the coexistence of dental fear in parents and older children. These findings may help to devise interventions that will prevent or alleviate children's DFA.