The influence of mouth breathing on skeletal and dental features of splanchnocranium.

OBJECTIVE: This study was performed to investigate changes in dentofacial characteristics associated with mouth breathing (MB) and adenoidectomy. BACKGROUND: MB is considered to be an etiological factor of malocclusion. Adenoidectomy is supposed to have the ability to prevent the development of dentofacial deformities. METHODS: This retrospective study included 123 patients, namely 57 nose breathers, 19 former mouth breathers, who have undergone adenoidectomy, and 47 mouth breathers. The groups were compared according to their skeletal and dental characteristics. The measurements of each individual were obtained from lateral cephalograms and dental casts. The comparison was done using one-way ANOVA, Bonferroni post-hoc, Mann-Whitney U and Kruskal-Wallis tests. The statistically significant difference was defined as p<0.05. RESULTS: The MB group showed an increase in ArGoMe (p=0.02) angle. No difference was found in the sagittal parameters among the groups. Upper dental arch compression was positively correlated with MB(p=0.00), even in adenoidectomy cases (p=0.01). CONCLUSION: MB alters the vertical and transverse growth of the craniofacial complex. It is associated with longer lower anterior facial height and decreased maxillary intermolar distance. However, it does not influence the sagittal parameters. Airway clearance via adenoidectomy promotes the normalization of vertical parameters (Tab. 1, Fig. 2, Ref. 20).

Relations between markers of cardiac remodelling and left ventricular collagen in an isoproterenol-induced heart damage model.

There is a great urgency of detecting and monitoring myocardial fibrosis in clinical practice with the aim to improve and personalize therapy against cardiac remodelling. Hence, the aim of this study was to describe alterations in and show potential correlations between the structural characteristics and the molecular and biochemical markers of cardiac remodelling on a model of isoproterenol-induced heart failure. Two groups of 3-month-old male Wistar rats (n = 8 per group) were sacrificed after four weeks of treatment: control (placebo), ISO (5 mg/kg/day intraperitoneally). Chronic ISO treatment led to heart failure (HF) characterized by significant reduction of systolic blood pressure (SBP) accompanied by an increase in left ventricular weight (LVW) along with increased collagen content in the LV. The collagen content correlated negatively with SBP (R = -0.776, P < 0.001) and positively with LVW (R = 0.796, P < 0.001), with Col1a1 (0.83; P < 0.001) and Acta2 (0.73; P < 0.01). Moreover, the mRNA expression of fibrotic remodelling indicator, i.e. TGF-ß1 tended to increase, while the level of fibrinolysis markers (MCP-1, TIMP-2, MMP) were unchanged. The plasma markers of collagen, procollagen I C-terminal propeptide (PICP) was 37.34 ± 7.10 pg/mL in control and was reduced by 42% (P < 0.05) in the ISO group and procollagen III N-terminal propeptide (PIIINP) was 1216.7 ± 191.0 pg/mL in control and was decreased by 66% (P < 0.05) in the ISO group. Surprisingly, there was no positive correlation between plasma markers of collagen, i.e. PICP and PIIINP and collagen content or molecular markers of collagen. However, both PICP and PIIINP correlated with BW (R = 0.712, resp. 0.803, P < 0.001), which was significantly reduced (by 25%, P < 0.05) in the ISO group. In conclusion, we assume that the collagen content of the left ventricle does not need unavoidably correlate with plasma markers of collagen, which might be affected by confounding factors in heart failure, such as loss of body weight, presumably associated with a catabolic condition.

The influence of cranio-cervical rehabilitation in patients with myofascial temporomandibular pain disorders.

OBJECTIVE: The aim of the study was to prove the causality between the craniocervical dysfunction and myofascial pain in the head and neck and to demonstrate the clinical value and usefulness of physiotherapy as one of the therapeutic options for myofascial pain. METHODS: The group of patients diagnosed with myofascial dysfunctional pain syndrome contained 98 patients out of which 79 patients (81 %) were females and 19 patients (19 %) were males. The majority of the patients were aged between 26 and 35 years; the total age range was 14-77 years with the average of 38 years. Observed patients were subdivided into three groups. Standard therapeutic methods aimed at the temporomandibular joint were provided to the patients of the first group. The second group of the patients received therapy aimed at cervical muscles only. Complex rehabilitation was applied in the third group of patients. The most frequent method used in the evaluation of chronic musculoskeletal pain in clinical studies is the visual analogue scale (VAS). RESULTS: According to our results, all three groups of patients saw an improvement in pain perception, but the overall subjective remission of painful sensations in the third group took place in as many as 88 % of patients. In this group, there was a significant decrease in the tenderness of trigger points in the trapezius and sternocleidomastoid muscles. CONCLUSION: It was proved that a combination of simple relaxing and stretching exercises of cervical muscles with a standard method used in the therapy of masticatory muscles is significantly more efficient (Fig. 5, Ref. 18).

Human race as indicator of 3D planning of soft tissue of face and multidisciplinary approach.

OBJECTIVE: The aim of this study was to determine the optimal parameters for 3D soft tissue planning for ortognatic treatment by gender and increases the effectiveness of multidisciplinary cooperation. METHODS: Craniofacial parameters which were analysed: nose breadth (al-al), bi-entocanthion breadth (en-en), bi-zygomatic breadth (zy-zy), bi-gonial breadth (go-go), total facial height (n-gn), mouth breadth (ch-ch), morphologic face height (sn-gn), upper-lip height (Ls-Stm), lower-lip height (Stm-Li) and pupils - mid-face (right). The statistically significant level was determined at p values < 0.05. RESULTS: We have determined the optimal parameters of chosen proportions for men and women as the common goal for ortodontist and maxilofacial surgeon. The gender and age influenced the variability of following parameters: bi-gonial breadth, total facial height and morphologic face height. CONCLUSION: The soft tissue values for craniofacial parameters can be used to identify the surgical-orthodontic goal for patient - europoid race. Due to the immigration and the mix of races it is necessary to take this fact into account (Tab. 3, Fig. 1, Ref. 41).

Prevalence of dental caries in dentistry students.

The study evaluates dental caries prevalence in dentistry students. They represent a sample of individuals with good dental status, socio-economical level and access to dental care. The values of teeth number with decay and filling and values of surfaces of teeth with decay and filling indices in group with lower caries incidence give the information as to what could be achieved by systemic care and prevention of dental caries in whole population (Tab. 4. Ref. 25).

Role of human papilloma virus infection and oral-genital contact in oral cancer ethiopathogenesis.

Head and neck squamous cell carcinoma and especially oropharyngeal squamous cell carcinoma is a very significant cause of morbidity and mortality. The majors risk factors of these tumors are tobacco smoking, chewing and alcohol consumption. But there is a group, non-drinking and non-smoking, patients with oropharyngeal squamous cell carcinoma. In these patients may be oral-genital contact and human papillomavirus infection the major risk factor for oral carcinogenesis. Aim of this review is to point out this fact in correlation with clinical studies and clinical conclusion for medical practice (Fig. 1, Ref. 32).

Mesenchymal stem cells - a promising perspective in the orofacial cleft surgery.

Autologous bone grafts provide the golden standard for closure of oronasal fistulas in the cleft palate. Augmentation may be performed also by homografts and various xenogenic or alloplastic materials to prevent morbidity at the donor site but they may cause many problems (transmission of infections, immune response etc.). All the mentioned approaches also often reveal recurrences of the fistulas and prolong suffering of the cleft patients. Combination of mesenchymal stem cells (MSCs) and so called "platelet gel" seems to be a perspective method in this way. The platelet gel contains hydroxyapatite particles mixed with platelet rich plasma coagulated under effect of the calcium ions. The MSCs from the pelvic bone marrow aspirate are cultivated on a scaffold (collagen membrane) for 3-4 weeks before placement into the cleft defect. The method provides promising results in the alveolar clefts. Authors document a successful case of the secondary surgery in 25-year-old man with the unilateral complete cleft (Fig. 5, Ref. 10).

Vertical distraction osteogenesis of frontal segment and platelet-rich plasma in the edentulous mandible.

In patients with atrophy of the alveolar ridge of classes V and VI according to Cawood and Howell, the distraction osteogenesis (DO) is the only possibility of reconstruction connected with subsequent dental implants. This method was introduced by Ilizarov (1989), a Russian doctor. In the past few years, the distraction devices have undergone several changes and technical improvements. The usage of platelet-rich plasma (PRP) and autologous bone-platelet gel (ABPG) serving as the source of growth factors is considered a significant progress. The increase in the level of growth factors leads to new bone formation and in soft tissues enhances the healing around the bone and bone wound, lowers the risk of postoperative complications such as pain, swelling and bleeding as well as enables fast placement of implants (Ref. 19).

Sjögren´s syndrome in present.

Sjögren´s syndrome is a systemic autoimmune disease characterized by a reduced function of exocrine glands, mainly salivary and lacrimal glands based on chronic plasmocellular infiltration. Syndrome includes affection of glands in gastrointestinal system, respiratory apparatus, skin, and vaginal mucosa. I tis described separately as a primary Sjögren´s syndrome or together with other inflammatory rheumatic diseases as a secondary Sjögren´s syndrome. Advanced diagnostic is based mainly on serologic examinations. Treatment of patients reflects the form of Sjögren´s syndrome. Despite recent knowledge the treatment is rather symptomatic than causal (Ref. 12).

The use of optical magnifying devices in periradicular microsurgery.

Microsurgery is a more precise modification of present procedures with less operative trauma and improved healing. The basic risk with traditional periradicular surgery arises from potential damage to major vessels or nerve bundles. These potential problems can be fixed using optical magnifying tools such as dental operating microscopes and endoscopes. Instruments have been also designed to take the full advantage of increased visibility. The higher magnification and illumination is favorable in all phases of periradicular surgery. The article focuses mainly on the advantages of optical magnifying devices by root-end resection (Tab. 1, Ref. 22).

Root-end resection.

AIM: The aim of the retrospective clinical study was to analyse a complex of patients who underwent a root end resection in the Department of Dentistry and Maxillofacial Surgery, Comenius University, St. Elisabeth Hospital, Bratislava, Slovakia between January 2006 and December 2009 on the small surgery court. PATIENTS: A total number of 285 patients who underwent root end resection. METHODS: Factors examined include sex, patients age structure, total number of resected teeth and their position in upper or lower jaw and the 10 most resected teeth. RESULTS: From 285 patients 103 (36.14 %) were males and 182 (63.86 %) were females. A total number of 378 root end resections was performed, 55 (14.55 %) in the lower jaw and 323 (85.45 %) in the upper jaw. The most resected teeth are from the first and second quadrant. CONCLUSION: There is a decrease trend by the number of patients who underwent root end resection and teeth which were resected in the timeline between 2006-2009. This process is positive and matches the worldwide trend, by making better and successfull endodontic treatment which results in healing of periapical pathology without the need of root end resection (Tab. 2, Fig. 2, Ref. 20). Full Text in PDF www.elis.sk.

Digital and manual cephalometric analysis.

OBJECTIVES: To compare the manual and digital cephalometric analyses and to research a new procedure of analog cephalogram digitalization. METHODS: 40 repeated measurements were used to evaluate the reproducibility and reliability of both methods. The analog x-ray was CHIRALUX2, the digital camera used was Canon PowerShot G5 and the digital tracing was done by Dolphin imaging version 10. The sample dispersion has been evaluated for each of the monitored cephalometric variables (SNA, SNB, ANB, PP/ML, inter-incisal angle and Wits). The difference of sample dispersion was tested (Morgan-Pitman). Four doctors processed 100 random analog cephalograms in total and evaluated them in a way established by Bland and Altman. RESULTS AND CONCLUSION: Validity and reproducibility of analyses carried out manually and digitally is in high mutual correlation and therefore the software analysis can fully substitute the manual method. The dispersion of values in repeated measurements was higher in manual method and therefore we consider the digital method more accurate (Fig. 4, Tab. 1, Ref. 15). Full Text (Free, PDF) www.bmj.sk.

The WEB 2.0 induced paradigm shift in the e-learning and the role of crowdsourcing in dental education.

OBJECTIVES: Authors evaluated the effect of the WEB 2.0 environment on dental education and estimated the difference in retention of knowledge by cephalometric analysis in orthodontics between conventional education and off-line e-learning. BACKGROUND: Five years of experience with complex web-based e-learning system allowed the evaluation by retrospective analysis and on-line questionnaire. RESULTS: The results revealed the current trends in on-line behavior of students based on the WEB 2.0 innovative technologies like Ajax. Results confirmed an increasing number of resources with a rising frequency of e-learning materials. CONCLUSION: The study confirmed that e-learning of the same subject is more efficient in immediate examination after the lecture with even better results after 12 and 24 months against the control group (Tab. 3, Fig. 1, Ref. 26).

Recurrent malignant epitheloid schwannoma of the lower lip.

The authors describe a case of recurrent malignant epitheloid schwannoma of the lower lip. Histologically, the tumor was composed of fibroblast-like spindle cells in compact fascicles and areas of epitheloid growth, combined with demonstration of S-100, GFAP and NF positivity, which is characteristic for this type of tumor. The therapy consisted of a combination of surgery and radiotherapy and the patient was followed-up since the disease was diagnosed. A local re-operation had to follow the first surgical intervention consisting of a radical excision of tumor in the lower lip together with suprahyoid neck dissection six months later. After the first operation, the patient received a radiation therapy with a total dosage of 12 Gy in seven fractions to the tumor area of the lower lip. After the second operation, an external radiotherapy with total dosage of 50 Gy was applied. Despite the complex intensive therapy, the patient died of metastases into lungs, liver and spine 37 months after the initiation of the therapy (Fig. 2, Ref. 17). Full Text (Free, PDF) www.bmj.sk.

Squamous cell carcinoma of the oral cavity.

OBJECTIVES: A number of treatment modalities are available in the management of oral cavity cancer. These are surgery (operation OP), irradiation (radiotherapy RT), chemotherapy (CHT), or complex therapy performed as a combination of the later three methods with various survival rates. A multidisciplinary team approach in every individual case is required. BACKGROUND AND METHODS: Authors analysed retrospectively a group of 622 patients (553 men, 69 women), mean age 58.6 years (range 23-88 years) hospitalised in the Department of Oral and Maxillofacial Surgery, Faculty Hospital and Faculty of Medicine Comenius University in Bratislava within the years 1992-2001 with primary untreated histologically confirmed squamous cell carcinoma of oral cavity (beside cancer of the lip and salivary glands). Gender, age, location and TNM staging of the disease, clinical and histopathological evaluations of the neck lymph nodes and relationship to the treatment modalities were recorded. The authors compared some parameters of the results obtained during their previous study within the years 1977-1986 (453 patients). RESULTS: The number of cases with squamous cell carcinoma of oral cavity increased by 37.31% in total as well as that of cases with advanced disease, especially stage IV (318 patients = 56.6%) increased by 7.6%. In the studied group there occurred cases that were clinically falsely negative by NO (11.04%) as well as falsely positive by N1 (39.1%) when examined by palpation of lymph nodes. The overall 5-year survival rate remained at the same level (55.4 %), the early and late stages did not change the survival rate at the 5th year (I = 75.1%, II = 69.9%, III = 47.5%, IV = 25.1%). Regarding the complexity of treatment, the best 5-year survival rates showed the complex three-modal therapy (CHT + OP + RT = 23.5%), comparing to the dual (OP + RT or CHT + RT = 19.4%) and mono-modal therapy (OP or RT alone = 17.2%). In the complex therapy, the mean disease-free interval improved (30.2 vs 39.4 months) due to a change in the sequence of therapy modalities. CONCLUSION: The increase in the number of cases with advanced disease has a warning trend. The reasons of this trend remain unclear. In spite of the fact that the overal 5-year survival was found not to improve, the quality of life regarding the mean disease-free interval in the group of patients under the complex treatment is considered to be a positive result (Tab. 3, Fig. 4, Ref. 27). Full Text (Free, PDF) www.bmj.sk.

[Logistics in the pharmaceutical service]. / Logistika v lekárenstve.

The conception of the field of pharmaceutical service defines pharmaceutical service as the basic part of pharmacy, the principal task of which is to provide pharmaceutical care as an inseparable part of providing health care. It represents a set of professional activities of the pharmacist oriented to securing human and veterinary pharmaceutical products and health care products and to optimising effective, safe and quality pharmacotherapy. Technically, pharmaceutical service is an applied discipline, as it makes use of knowledge gained in other pharmaceutical, medical, psychological, social, and economic sciences. Because of its interdisciplinary character it is necessary to extend the theory of pharmaceutical service in such a way so that it may reflect all aspects of its sphere of activity. One of the possibilities is to define the pharmacy premises as an independent functional unit which operates on the basis of valid legal standards in such a way that on the one hand it secures the provision of health (pharmaceutical) care, and on the other hand it maintains its cost-effectiveness. To keep the quality of care of the patient and the economic aspect in balance, it is necessary to define the term pharmaceutical logistics also under the conditions of Slovak (Czech) pharmacy as early satisfaction of the requirements of the patient (client) in the pharmacy premises, which means that the appropriate pharmaceutical product or health care product and the appropriate information must be at the right time in the required amount and required quality in the right place.

[Patient-oriented advice on pharmaceuticals and its position on pregraduate education of pharmacists]. / Informacná cinnost o liecivách a liekoch a jej miesto v pregraduálnej výucbe farmaceutov.

Patient-oriented information on pharmaceuticals has gradually become the dominant activity of the pharmacist in the community pharmacy. It is therefore necessary to devote sufficient attention to the quality of patient oriented advice already in the course of the pregraduate education of pharmacists so that new graduates who start practising may be prepared both theoretically and practically to cope with the requirements they encounter when working with pharmaceuticals and patients under the contemporary conditions. This paper aimed to monitor the present state of instruction of undergraduates as far as the items of information given to patients are concerned. The results of the study propose to the instructor possible ways of motivating and guiding the undergraduates to the correct approach of the use of information given to patients are concerned. The results of the study propose to the instructor possible ways of motivating and guiding the undergraduates to the correct approach of the use of information on pharmaceuticals as well as the methods items of employng these items of information on dispensing.