ATTITUDES TOWARDS AND HABITS IN ORAL HEALTH OF ADOLESCENTS IN HERZEGOVINA.

The aim of the study was to determine attitudes towards and habits in oral health of adolescents in Herzegovina, as well as to evaluate the possible differences in habits among individuals of different adolescent categories. The study included 120 participants (35 male and 85 female) divided into three adolescent categories, as follows: early (11-14 years of age), middle (15-18 years) and late (19-21 years) adolescence, from the Herzegovina-Neretva Canton, who presented for dental examination. All participants completed the socio-demographic questionnaire and standardized Hiroshima University Dental Behavioral Inventory (HU-DBI). The answers provided by study adolescents in the HU-DBI showed statistically significant differences among particular age groups, i.e. between early and middle adolescence in items 7 (p=0.046) and 15 (p=0.007); between middle and late adolescence in items 8 (p=0.021), 11 (p=0.04) and 12 (p=0.027); and between middle and late adolescence in item 11 (p=0.032). Respondents in middle adolescence had poorer oral hygiene attitudes than those in early and late adolescence. In order to improve the oral hygiene habits of adolescents in Herzegovina, it is necessary to put emphasis on continuous education about oral hygiene habits during their secondary education.

Dental Medicine and Psychiatry: The Need for Collaboration and Bridging the Professional Gap.

Dental health and mental health are strongly associated. Neglecting either of them can negatively influence on the other and induce many health and communication problems. Association between oral/dental health, self-esteem, quality of life and holistic health has been recognized for a long time. There has been increasing interest in dental health among patients with major mental disorders as well as in mental states and problems among patients with orodental disorders. Despite of huge progress in the field of dentistry psychiatric patients have had poor oral/dental health. Patients with major mental disorders have quite number of the risk factors for oral disease and consequently poorer dental health, but oral/dental problems and diseases are commonly overlooked or neglected. Bad or inappropriate dental care is related to the patients' amotivation, ignorance, fears, low economic status, stigmas and negative attitudes by the medical professionals. It is important to stress that dental diseases in psychiatric patients deserve the same attention as other comorbid somatic diseases. In this review we accentuate the need for more collaboration in order to bridge the professional gap between dentistry and psychiatry.

The Connection between Socioeconomic Inequalities and the Appearance of the Toothlessness in Mostar.

BACKGROUND: To determine the existence of the toothlessness within the patients in the area of Mostar. The aim is to determine the topography of toothlessness within the population of Mostar, according to Kennedy classification. The aim is to connect measures of socioeconomic status with the appearance of the toothlessness. To develop a model that includes a form of toothlessness and the socioeconomic status of the patients in Mostar. SUBJECTS AND METHODS: The study was conducted at the Health Center in Mostar and the Regional Medical Center in Mostar. The research was cross-sectional study. It included 800 patients who regularlyoccurred to the dental ambulance because of the toothlessness and because of the prosthodontics treatment. The measurement was conducted by the dentist based on the anonymous research cardboard at the first examination of the patient. The dentist will determine the topography of the toothlessness according to Kennedy classification and the etiology of the toothlessness. RESULTS: In the total sample of respondents, the toothlessness was significantly higher represented (P<0.001). The manifestation of thetoothlessness was significantly higher among temporary employees and the retirees (P<0.001). In the total sample, toothlessness affected the sociological status of a higher percentage of the respondents (P<0.001). CONCLUSION: In our study, in a total sample of respondents, toothlessness was significantly higher represented (90% of respondents). The influence on the sociological status of the patient is most visible in the groups with the lower material status.

Determinants of the COVID-19 Pandemic in the West Herzegovina Canton.

A study of COVID-19 infected patients was conducted regarding to organic and psychological characteristics. The findings of the study indicate that in the period of the pandemic in 2020, a total of 78 infection cases were confirmed in West Herzegovina Canton. Of the total number of infected, 55.1% are women and 44.9% are men. Of the infected population, 16.7% were hospitalized. By monitoring the COVID-19 disease in West Herzegovina Canton, we conclude how all manifestations of the disease were represented, from asymptomatic, through mild respiratory to the most severe clinical picture with fatal outcomes. The mortality rate in West Herzegovina Canton is 5.1%. The study showed that a total of 28.2% of COVID-19 positive patients before infecting with virus, were most likely to suffer from hypertension, diabetes and malignancies. Furthermore, it is important to emphasize that a total of 71.9% of those infected are without underlying diseases. Also, the results indicate that people with COVID-19 in addition to the characteristic symptoms of the disease (fever, fatigue, cough, etc.) had certain mental ailments such as decreased general mood, increased anxiety, panic attacks, acute stress disorder and others.

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.

Frequency of sweet and salty snack consumption among children in relation to their mothers' education level.

Aim To investigate the frequency of consumption of sweet and salty snacks among children aged 2-18 years in relation to their mothers' education level. Methods A descriptive epidemiological study was conducted in five dental practices at the School of Medicine of the University of Mostar from May to October 2022. The data were collected from medical records. Results: Out of a total of 477 children, 172 (36.1%) had mothers with a high school education, while 305 (63.9%) had mothers with a university degree. In the group of preschool children (aged 2-6 years), there were 42 mothers with high school education and 105 with university degree. In the group of school children (age 7-18 years) there were 130 mothers with high school education and 200 with university degree. The difference in the consumption of sweetened beverages among children of mothers with high school and university was not statistically significant. Similar results were found for the consumption of salty snacks, lollipops, caramels and candies. The frequency of the consumption of biscuits, chocolate and cakes (several times a day) was statistically significantly higher among the children of mothers with high school education (p=0.04), especially among school children. Eating habits of children, regardless of the level of education of their mothers, differed significantly only in the consumption of lollipops, caramels, and candies (p=0.03), which were consumed once a day by 79 (63.7%) schoolchildren and 45 (36.3%) of pre-schoolers. Conclusion A higher level of education among mothers does not necessarily equate to proper nutritional knowledge.

Fusion of Unerupted Mesiodens with a Regular Maxillary Central Incisor: a Diagnostic and Therapeutic Challenge.

The mesiodens is the most frequent type of supernumerary tooth which can appear in the maxillary midline area. The etiology of mesiodentes is not fully understood. This report shows a case of incomplete fusion of an unerupted mesiodens with a permanent maxillary central incisor, aligned in the dental arch. Intraoral and radiographic examinations indicated fusion of the crown and cervical part of the root of the supernumerary tooth with the permanent incisor. The clinical situation was further complicated by the presence of another supernumerary tooth located palatally. The treatment approach has included two phase surgical therapy to extract the supernumerary teeth. Early diagnosis and appropriate surgical treatment of mesiodentes are important to decrease the risk of clinical complications. Pre-operative 3D imaging is strongly advisable since it allows accurate data to be obtained, and reduces the extent of surgery and the possibility of procedural complications. In most cases, a multidisciplinary collaboration is necessary for precise diagnosis and predictable treatment outcome.

Comparison of different surgical procedures on the stability of dental implants in posterior maxilla: A randomized clinical study.

BACKGROUND: Stability of a dental implant is very important when planning immediate loading and design of a final restoration. The aim of this study was to compare the primary and the secondary stability of dental implants inserted by three different surgical techniques: conventional (standard) technique using a sequence of drills for implant bed preparation, osteotome technique using tapered hand instruments for creating implant sites by condensing the bone and guided flapless implant surgery with surgical templates. MATERIAL AND METHODS: The study included 150 patients (80 males and 70 females), 46-71 years old, who required implant supported fixed partial dentures in the posterior maxilla of D3 or D4 bone density. Patients were randomly assigned into one of the three surgical insertion technique groups. All patients received tapered implants of the same manufacturer of the same length and two different widths (3.3 × 11.5 mm or 4.2 × 11.5 mm). Primary and secondary implant stability were measured by means of resonance frequency analysis (RFA) at the time of implant placement and 5 months after surgery using the Ostell ISQ device (Osstell AB, Sampgatan, Goteborg, Sweden). Statistical analysis included one-sample Kolmogorov Smirnov test, descriptive statistics, multivariate analysis (Bonferoni post-hoc tests) and paired t-tests. RESULTS: Patients in the osteotome group exhibited higher primary stability (P < 0.01) than in the conventional and surgically guided flapless groups. There were no significant differences in the secondary stability (p > 0.05). Wider implants presented higher ISQ values (P<0.01). CONCLUSION: The osteotome technique led to the highest implant primary stability, therefore it can be recommended when immediate loading is planned or for one-piece implant insertion.

Follicular jaw cysts.

The aim of this study was to examine the occurrence, localization, size, ways of diagnosing and treatment of a foIlicular jaw cyst. Assessment of the patients' motives and their earlier health status was recorded, as well as their postoperative clinical course. Most of the patients were admitted because of pain, swelling, trismus, or other difficulties associated with cyst formation. Follicular cysts with persisting primary predecessor had an asymptomatic development, and were discovered after orthodontic examination or by chance. In most cases pathohistological finding and description of the formation have coincided with each other (p < 0.05). Cysts of different sizes were treated by different surgical approaches, most commonly alveolotomy and cystectomy in small cysts, while alveolotomy and cystectomy with suction or iodine tampon in large cysts. Cooperation of a dentist, an oral surgeon, a pathologist, and other specialists can lead to early diagnose and prevention of further growth of a follicular jaw cyst, thus preventing substantial bone damage.

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.

Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia.

Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time spent outdoors, physical activity (PA), and body mass index (as predictors) with the 25(OH)D level (outcome) in healthy preschool children. The participants were preschoolers (all 5⁻6 years of age) from southern Croatia. All the participants were tested during their mandatory medical examination 6⁻7 months prior to school enrollment. The PA was obtained using the preschool-age physical activity questionnaire (Pre-PAQ), which categorizes PA into five levels (from sedentary to vigorous PA). The prevalence of 25(OH)D deficiency was high: 58% of the children had 25(OH)D levels of <50 nmol/L (deficiency), and an additional 29% had an insufficient level of 25(OH)D (50⁻75 nmol/L). Boys had higher levels of 25(OH)D than girls. A multinomial regression using 25(OH)D categories as the outcome and a sufficient level (>75 nmol/L) as the reference value identified gender as the only significant predictor of 25(OH)D status, with boys being at lower risk for 25(OH)D deficiency than girls. These results showed a high prevalence of 25(OH)D deficiency in preschoolers from the southern part of Croatia, which is additionally alarming based on the geographical position of the studied region (42° N) and its high number of sunshine hours (>2600 h per year). Future studies examining other potential correlates of 25(OH)D in the region are warranted.

Prevalence of periodontal diseases in North Herzegovina.

AIM: To investigate effects of smoking on periodontal tissue and the occurrence of periodontal disease in the population of North Herzegovina. METHODS: The study included 800 persons of 20-49 years of age (400 smokers and 400 non-smokers), inhabitants of Prozor-Rama Municipality, Bosnia and Herzegovina. Periodontal condition assessment was made by the Community Periodontal Index of Treatment Needs index (CPITN) at representative teeth: 16, 17, 21, 26, 27, 36, 37, 31, 46, and 47.Statistically significant difference between non-smokers and smokers was tested by χ2 test with the level of significance set at p=0.05. RESULTS: The prevalence of healthy periodontal tissues was lower in smokers than in non-smokers, 25 (6.3%)and 36 (9%), respectively. The prevalence of gingival bleeding, calculus, shallow and deep periodontal pockets was higher in smokers than in non-smokers, although it was not significant. There was a risk between occurrence of deep periodontal pockets and smoking (RR=2). A total of 64 (8%)participants neededonly instructions on proper oral hygiene, 654 (81.8%) prophylaxis and initial treatment,while 21 (2.6%) needed complex periodontal treatment. CONCLUSION: Obtained results indicate a high need of preventive measures and the improvement of oral health in the population of North Herzegovina.