The Pattern of Antibiotic Prescribing by Dental Practitioners in Zagreb, Croatia.

BACKGROUND: Bacterial resistance is considered a consequence of misuse or overuse of antibiotics. Dentistry significantly contributes to this increasing public health problem. The aim of this cross-sectional study was to examine the pattern of antibiotics prescribed by Croatian dentists in Zagreb area. METHODS: Out of 220 Doctors of Dental Medicine (DMDs) from Zagreb 110 responded to survey. Prior to the research an ethical approval was obtained. Participants were directly contacted. The questionnaire consisted of two parts: general data on DMDs and the part concerning indications, duration, type and dosage of antibiotic therapy. Data were processed using MS Excel and SPSS for Windows, Version 17.0. Statistical significance was tested by Fisher's exact test, chi-square test, Mann-Whitney U test and Spearman's rank correlation at the level of statistical significance p<0.05. RESULTS: During the period of two months, the doctors prescribed antibiotics to 1,500 patients, 690 (46%) were men and 810 (54%) women. The most often prescribed antibiotics were penicillin (72.5% of patients), represented mostly by amoxicillin in combination with clavulanic acid (57.6%). The most common indication for the prescribed antibiotics was periapical or periodontal abscess (44%). Definite clinical indication (71.2%) was stated as the most common reason for antibiotic prescription. Antibiotic therapy usually lasted 7 days (62.9%). The doctors prescribed daily doses of antibiotics according to the instructions for the use of specific drugs. CONCLUSION: The examined subjects prescribe antibiotics according to the curriculum taught at the School of Dental Medicine for majority of types, doses and duration of the treatments, although antibiotics over-prescription in cases without medical indication was observed. The national guidelines on antibiotic regimens are required in order to reduce unnecessary antibiotic use.

Caries prevalence and periodontal status in 18th century population of Pozega-Croatia.

OBJECTIVE: The aim was to examine dental and periodontal status of adult Croatian 18th century population and compare the results with available literature data. MATERIALS AND METHODS: 104 specimens from the crypt of Pozega cathedral were grouped into three female and three male groups according to age. Caries was determined by visual inspection and dental probe. Ante and post mortem teeth losses were recorded. Periodontal status was determined according to the length of exposed tooth root from alveolar crest to cemento-enamel junction. The presence of dehiscences and fenestrations was recorded on facial and oral plate of alveolar bone. RESULTS: The whole sample exhibited ante- and post mortem teeth loss of 19.57% and 24.91%, respectively. The teeth most frequently lost postmortem were incisors. The canines were best preserved. The frequency of caries in both jaws was the highest in molars (26.63% in maxilla and 28.10% in mandible), whilst central incisors exhibited the least carious lesions (11.59 and 1.92%). The most frequently affected surfaces were occlusal, then proximal and facio-oral. The percentage of teeth with either moderate or considerable bone loss was higher in females. The frequency of considerable bone loss increased significantly with age. The frequency of dehiscences was 3.11%. It was higher in maxilla than in the mandible. The frequency of fenestrations was 5.65% and it was significantly higher in maxilla. CONCLUSIONS: The results demonstrate poor oral health amongst 18th century population of continental Croatia, exhibiting high antemortem teeth loss, high periodontal disease frequency and occlusal and proximal caries frequency.

[Antibacterial effect of the materials for the root canal filling, bases and material for the cavity fillings]. / Antibakterijski ucinak materijala za punjenje korijenskih kanala, podloge i ispune kaviteta.

AIM: To assess antimicrobial effects of the materials used in the endodontic treatment of the teeth. METHODS: The following root-canal fillings were examined: Ketac Endo, AH Plus, Diaket, and gutta-percha, by means of the agar diffusion test. As for the base materials, Zink Oxide/Eugenol cement, glass-ionomere cements Fuji II LC Improved, Ketac Cem, and phosphate cement and Harvard cement were investigated. Finally, of the materials for final cavity filling, amalgam, Ketac Molar and Fuji II LC Improved were tested. In the present research, the following bacteria were applied: Streptococcus mutans, Streptotoccus mitis, Lactobacillus species, Staphylococcus aureus, Enterococcusfaecalis, and polymicrobial suspention. For each individual bacterium tested, material samples were placed on the inoculated plates of blood-agar. RESULTS: Antibacterial effects were confirmed in the following materials: root-canal fillings--Diaket, AH Plus, Ketac Endo; bases--Zink Oxide/Eugenol cement, phosphat cement and Harvard cement. No antibacterial effect was established in: amalgam, gutta-percha, Fuji II LC Improved, Ketac Cem and Ketac Molar. Diaket showed a statistically more significant antibacterial effect in comparison with AH Plus, Ketac Endo, and gutta-percha (P(s.mitis) < 0.05; P(s.mutans) < 0.05; p(lactobacillus) < 0.05; p(enterococcus) < 0.05; P(staphilococcus) < 0.05; p(polymicrobial) < 0.05); of the base materials, however, a somewhat stronger antimicrobial effect was found in phosphate cement, Harvard cement, and Zink Oxide/Eugenol (ZnOE) (p < 0.05) as compared with Fuji II LC Improved and Ketac Cem. CONCLUSION: According to the results of this study, and considering the fact that all cavity-filling materials failed to show any antimicrobial effect at all, when choosing the materials for root-canal fillings, and for bases, advantage should be given to those with the manifested strongest antibacterial effect, namely Diaket and phosphate cement.

A three-dimensional evaluation of microleakage of class V cavities prepared by the very short pulse mode of the erbium:yttrium-aluminium-garnet laser.

The aim of this study was to evaluate microleakage along resin restoration in cavities prepared with an erbium:yttrium-aluminium-garnet (Er:YAG) laser, with and without acid etching, and to compare it with that in diamond-drilled cavities. Thirty intact molars were divided into three equal groups. In the teeth in group I, class V cavities were prepared with a diamond drill. Cavities in groups II and III were prepared with an Er:YAG laser (400 mJ/15 Hz for enamel and 250 mJ/10 Hz for dentine). The cavities in groups I and II were acid-etched and adhesive and flowable composite were applied to all cavities. The specimens were first immersed in dye for 24 h and then in 5% nitric acid for 72 h for softening. The fillings were extracted and photographed through a dissecting microscope. The leakage area was measured with specially designed software. The Kruskal-Wallis test showed that the best ranking was group II [mean range (m.r.) = 27.46], followed by group I (m.r. = 33.48) and, lastly, group III (m.r. = 45.15). The differences between groups I and III (P = 0.023) and between groups II and III were statistically significant (P = 0.080). The least microleakage was found in those cavities prepared by Er:YAG laser and subsequently acid-etched, whereas the most leakage was in the lased cavities that had not been etched; the traditional diamond-drilled acid-etched cavities produced medium leakage.

The temperature changes in the pulp chamber during cavity preparation with the Er:YAG laser using a very short pulse.

OBJECTIVE: The aim of this study was to examine the temperature changes in the pulp chamber during cavity preparation with the Er:YAG laser (2940 nm) with a very short pulse (VSP). MATERIALS AND METHODS: Nine groups of 10 intact molars each were used. One root of each sample was amputated and a thermocouple was inserted into the chamber. Class V cavity preparation in enamel was performed, and then preparation was performed in dentine. The enamel was lased with 400, 360, and 320 mJ in contact mode using a VSP with a duration of 100 microsec. The diameter of the fiber tip was 950 microm. Frequencies of 10, 12, and 15 Hz were used, and the total time of irradiation was 10 sec. The dentine was irradiated with 340, 280, and 200 mJ at 10, 8, and 5 Hz for 7 sec. Cooling was done with a water spray (73 psi and 50 mL/min). The differences were tested by MANOVA and the Bonferroni post hoc test. RESULTS: The highest rise in temperature in the pulp was achieved after enamel irradiation with 400 mJ and 15 Hz (1.99 +/- 0.28 degrees C), and the lowest was after irradiation with 320 mJ and 10 Hz (0.70 +/- 0.18 degrees C). In dentine the highest temperature increase was achieved with 340 mJ and 10 Hz (1.37 +/- 0.42 degrees C), and the lowest was with 200 mJ and 5 Hz (0.43 +/- 0.18 degrees C). Two-way analysis of both enamel and dentine showed that the influence of energy on temperature increase was stronger than that of frequency. CONCLUSION: Cavity preparation with an Er:YAG laser using VSP mode in vitro did not cause significant increases in temperature in the pulp chamber of human molars.