Dubravka Negovetić Vranić

Heat-treated glass ionomer cement fissure sealants: retention after 1 year follow-up

OBJECTIVE The aim of this study was to assess the retention rate of glass ionomer cement (GIC) fissure sealants heated during setting time. METHODS One hundred and twelve teeth with well-delineated fissure morphology were sealed with composite resin and GIC. Composite resin (Helioseal F, Vivadent) was used in control group A (56 teeth). GIC (Fuji VII, GC) was applied using split-mouth design with conditioning in group B (26 teeth) and without surface conditioning in group C (30 teeth). GIC was heated with external heat source (Elipar Trilight, Espe) for 40 s during the setting time according to the manufacturers instructions. Fissure sealants were evaluated 1 year after clinical service. RESULTS Retention rate in group A was 80.4% after 1 year of clinical service. Group B showed retention rate of 30.8%, and group C of 26.7%. Two new caries lesions were detected in groups B and C. Significant differences in retention between the composite group and GIC groups were obtained by Kruskal-Wallis and Mann-Whitney tests. CONCLUSION It could be concluded that retention rate of GIC sealing treated with heat during setting time was significantly lower than retention of conventional composite resin. The heating procedure during setting of GIC sealants cannot be recommended as routine treatment in clinical practice.

General dentists’ awareness of how to cope with medical emergencies in paediatric dental patients

BACKGROUND General dentists (GDs) should be aware of the symptoms, signs, diagnoses and treatment of medical emergencies in paediatric patients. AIM To evaluate the knowledge of GDs in coping with medical emergencies, and to identify whether they are confident to diagnose and treat medical emergencies in paediatric patients. DESIGN The questionnaire was conducted immediately before the beginning of national dental meetings and continuing education seminars in Croatia, attended by the GDs, in order to obtain a representative sample. RESULTS Of a total of 498 GDs who returned the questionnaire with valid data, 51.2% reported that a medical history was regularly taken. A high proportion (81.3%) of the GDs had never received any basic life support (BLS) training and education for paediatric patients during their undergraduate studies. After graduation, this value rose to 86.1% of GDs. However, more than two-thirds (68.7%) had experienced some emergency situation in their practice. The most frequent emergency was vasovagal syncope (83.6%) and the most rare was cardiac arrest (8.2%). One-fifth (20.5%) of GDs experienced some emergency but could not make a diagnosis. The more BLS training undergone by a GD, the more self-confident s/he felt in an emergency situation. CONCLUSIONS Most GDs have a lack of knowledge to cope with medical emergencies in paediatric patients, and do not feel confident to diagnose and treat emergency situations in children. It is suggested that adequate training and education should be provided for all GDs to address this shortcoming.

Medical emergencies in Pediatric Dentistry

Medical emergencies that are life threatening can occur in dental practice. Complications may arise because of an underlying disease or a reaction to medication. Reactions to medications may be allergic and toxic. The most common reactions are toxic reactions to local anesthetics, whereas allergies occur mainly as a consequence of the application of antibiotics, usually penicillin. In response to stress, vasovagal syncope typically occurs. Other causes may be related to an underlying disease-specific pathology (such as acute asthma attack, diabetic ketoacidosis, hypoglycemia, or seizures) or accidents (aspiration of a foreign body causing obstruction of the respiratory system). For all the above conditions, guidelines have been established that need to be known. If complications occur or necessary measures are not taken, it can lead to cardiac and respiratory arrest. Therefore, cardiopulmonary resuscitation is needed. All procedures and dosages should be adapted to the age of the child.

Clinical and patient reported outcomes of bleaching effectiveness

Abstract Objective: The objective of this study is to evaluate clinical and patient reported outcomes of different bleaching products. Materials and methods: Thirty participants were randomly divided into three bleaching groups (n = 10). Bleaching was performed with high concentrations of hydrogen peroxide (HP) – Boost (40%) and Dash (30%), and with prefabricated splints Bite&White (6% HP). Tooth colour was measured before, immediately after, and 1 and 6 months after the bleaching by using classical shade guide and spectrophotometer. Tooth hypersensitivity was self-rated by patients on the Wong-Baker’s face scale. Patient satisfaction was evaluated on a 7-point Likert-type scales that measured perceived performance and importance of different characteristics of bleaching treatment. Results: All products were effective in teeth colour change (ΔE > 3.3), which was significantly higher for Boost (p = .016) and Dash (p = .024) than Bite&White treatment. Perception of hypersensitivity was the highest in Boost group, followed by Dash and Bite&White treatment. Most of the patients were satisfied with final tooth colour, length and comfort during treatment, but were dissatisfied with the stability of bleached tooth colour. Conclusion: Materials with the higher concentrations of bleaching agent demonstrated greater bleaching effectiveness than at-home bleaching product, but also a greater hypersensitivity. Lengthening the treatment process, but achieving a more stable tooth colour may improve the perceived value of a bleaching service.

Uporaba antiseptika u dječjoj stomatologiji

Svrha ovog rada je pregled antiseptika i definiranje znacenja stomatoloskih antiseptika u kontroli i eliminaciji mikroorganizama kao sastavnog dijela prevencije i terapije bolesti zuba i parodonta u djecjoj stomatologiji. Dosad su poznate karakteristike i mehanizam djelovanja pojedinih antiseptika te je doprinos rada predstaviti indikacije za njihovu primjenu u svakodnevnom radu stomatologa, osobito u djecjoj i preventivnoj dentalnoj medicini

Erosive Drinks Impact on Fluoride Potential Change and Ph Value of Artificial Saliva In Vitro

Dental erosion is defined as the chemical removal of minerals from the hard dental tissue [1,2]. Erosion can be caused by intrinsic or extrinsic factors. Intrinsic factor is gastro-esophageal cause and extrinsic factor is diet [1-3]. Dental erosion is a significant oral health problem in European and Middle-Eastern countries [4]. The results obtained by measurement on a potentiometric titrator and pH meter allow categorization of erosive drinks according to their harmful / potentially positive effect. From the measurements it is possible to read the minimum and maximum potential of fluoride ions. The potential value is inversely proportional to the concentration of ions.

Guidelines for teeth fluoridation with respect to fluoride concentration in Primorsko-goranska county

Objective: The purpose of this study was to investigate the fluoride concentration in drinking water in the Primorsko-goranska county (PGC) and to provide the guidelines for teeth fluoridation of respective area. Methods: Data on the fluoride concentration in drinking water in the PGC were examined by the Department of Environmental Health of the Teaching Institute of Public Health in Primorsko-goranska county. The fluoride concentration in the drinking water was measured by using ion chromatography technique. Public water supply in PGC is organized through 9 particular water supply systems. A high percentage of 96% of the population is connected to the public water supply, which is considerably higher than 74% representing the average estimation for the total country. Results: The average concentration of fluoride in the main water sources of the PGC was assessed for a 5-year period (2007-2011: Rijeka 0.010 mg F-/l, Opatija 0.020 mg F-/l, Crikvenica - Novi Vinodolski (CR-NV) 0.007 mg F-/l, Delnice 0.029 mg F-/l, Vrbovsko 0.038 mg F-/l, Cabar 0.031 mg F-/l, Krk 0.044 mg F-/l, Cres – Losinj (CR-LO) 0.054 mg F-/l, Rab 0.090 mg F-/l. PGC public water supply systems do not include artificial fluoridation of the drinking water. Concentration of fluorides in the drinking water is considered low and ranges from the detected limit of <0.002 mg F-/l in Opatija to 0.220 mg F-/l in Rab, representing the overall average value of 0.034 mg F-/l. Conclusion: Considering the amount of fluorides in the drinking water, teeth fluoridation can be safely accomplished by individually adjusted doses of other fluoride agents.

Disanje na usta kao uzrok orofacijalnih anomalija

Covjek dise na usta kada nije u mogucnosti disati na nos. Najcesci razlog je opstrukcijea nosa ili gornjih disnih putova koja može biti uzrokovana upalom sluznice nosa, kronicnom infekcijom, alergijom ili mehanickom opstrukcijom. Utjecaj nazorespiratorne opstrukcije na ortodontski status i facijalni rast je kontroverzna tema o kojoj se raspravlja dugi niz godina. S obzirom da su ova stanja cesta u djecjoj dobi, tj. za vrijeme intenzivnog rasta i razvoja, promjene koje nastaju izmjenom obrasca disanja (od normalnog disanja na nos prema disanju na usta) utjecu i na razvoj orofacijalne regije. To su dokazala mnoga istraživanja, u kojima su uocene promjene u pojavnosti malokluzija Angle klase II, zagriza u frontalnom i lateralnom dijelu zubnog niza, te nesrazmjera u rastu gornje i donje celjusti. Analizom pregledane literature može se uociti da se opstrukcija disanja na nos adenoidom ili tonzilama javlja kod velikog broja ispitanika. Velika vecina orofacijalnih anomalija javlja se zbog nemogucnosti disanja na nos uslijed opstrukcije adenoidom U slucajevima otklanjanja smetnji koje su uzrokovane hipertrofijom tonzila i adenoida (tonzilektomijom i/ili adenotomijom), uoceno je smanjenje intenziteta prisutne anomalije te ponovno uspostavljanje disanja na usta. Suradnjom pedijatara, otorinolaringologa, alergologa i lijecnika dentalne medicine djecjeg stomatologa i ortodonta, pravovremenim uocavanjem i odstranjivanjem povecanih nepcanih tonzila i adenoida, te ranom ortodontskom terapijom, moguce je obrazac nepravilnog rasta vratiti na normalu temeljem ponovnog uspostavljanja disanja na nos.