Hrvoje Jurić

The effect of two different bracket types on the salivary levels of S mutans and S sobrinus in the early phase of orthodontic treatment

OBJECTIVE To determine the difference in the levels of Streptococcus mutans and S sobrinus in stimulated saliva in orthodontic patients with different bracket types (stainless steel and esthetic brackets) using polymerase chain reaction and cultivation method. MATERIALS AND METHODS Thirty-two patients, aged 13 to 30 years, were selected following these criteria: 1) orthodontic treatment indication, 2) systemic health, and 3) no tobacco and antibiotic consummation for three months prior to the commencement of the study. Patients were divided into two groups according to the bracket type; 16 patients formed the conventional bracket group (stainless steel brackets), and 16 patients formed the esthetic bracket group (plastic brackets). The levels of S mutans and S sobrinus in stimulated whole saliva samples were collected prior to fixed orthodontic appliance placement (T1) and 12 weeks after placement (T2), as were the Decayed, Missing, and Filled Surface Index (DMFS) and Oral Hygiene Index-Simplified (OHI-S). Mann-Whitney, Wilcoxon, and chi-square tests were used for statistical analysis. RESULTS Statistical analysis (chi-square test) showed no difference in S mutans and S sobrinus counts among patients with different brackets at either T1 or T2. There was no difference in total bacteria counts after fixed orthodontic appliance placement. CONCLUSION The number of colony-forming units of S mutans and S sobrinus in stimulated saliva samples does not seem to be significantly different between patients with stainless steel brackets and patients with plastic brackets.

Current possibilities in occlusal caries management.

UNLABELLED Dental caries is a multifactorial disease that affects most populations throughout the world and it is still the primary cause of oral pain and tooth loss. The occlusal surfaces of posterior teeth are the most vulnerable sites for dental caries due to their anatomy. Therefore, the aim of the following article is to summarize current knowledge on occlusal caries development and the possibilities of its prevention. Although the overall caries rate today has fallen for populations in industrialized countries, the rate of occlusal surface caries has not decreased. This may be explained with fact that topically applied fluorides and their mode of action prevent caries better on smooth than on occlusal surfaces. As we know, tooth decay of first permanent molars causes a great deal of different short and long term difficulties for patients. Therefore, there is a continuous need for implementation of programs for caries prevention in permanent teeth. Nowadays, we like to treat our patients by minimally invasive methods. A very important step in our effective preventive treatment is sealing pits and fissures as a cornerstone of occlusal caries management. Reliable assessment of caries activity is also very important for defining treatment needs and plans. A very important decision, which should be made during occlusal caries management, is the selection of restorative material according to the treatment plan. CONCLUSION Current possibilities in occlusal caries prevention and management are very effective. Therefore, dentists today do not have any excuse for avoiding the philosophy of Minimally Invasive Dentistry, especially when we talk about caries management of occlusal surfaces in permanent molars.

The Reliability and Validity of the Three Modified Versions of the Children’s Fear Survey Schedule-Dental Subscale of 9-12 Year Old Children in a Clinical Setting in Bosnia and Herzegovina

OBJECTIVE This study sought to obtain a comprehensive, reliable and valid instrument for evaluation of the presence of dental fear and anxiety (DFA) in children, through evaluation of the reliability and validity of three modified versions of the Childrens Fear Survey Schedule-Dental Subscale (CFSS-DS). MATERIALS AND METHODS The study sample comprised children aged 9, 10, 11 and 12 years. The first sample group (200 patients) filled in a modified version of the CFSSDS scale, the second sample group (100 patients) filled in a short form of the Dental Fear Survey Schedule, and the third sample group (100 patients) filled in a short version of the CFSS-DS scale, prior to dental treatment, respectively. In order to determine test-retest reliability, the 184 patients from the first sample group filled in the modified version of the CFSS-DS scale again, prior to their next scheduled dental appointment. RESULTS The modified version of the CFSS-DS scale had the best internal consistency reliability (α=0.907), as well as validity results, compared to the other two instruments used. Test-retest reliability was moderate (Intraclass correlation coefficient: 0.58). CONCLUSIONS Of the three psychometric instruments used for evaluation of DFA presence in children, the modified version of the CFSS-DS scale showed the most clinically adequate reliability and validity values. This study thus provides a new psychometric instrument that should be considered for clinical use in evaluation of DFA presence in 9-12 year-olds, in a clinical setting sample type of children.

THE FOOTHOLDS OF AN INTEGRATIVE BIOETHICS IN THE WORK OF VAN RENSSELAER POTTER

Regardless of the still persistent tendencies to narrow the concept of bioethics down to (bio)medical or even clinical bioethics, it is clear that today’s bioethics integrates discussions of a much wider range of issues – from bio-medical to global-ecological. The broadening of the field of bioethics is the result of the insight that the issues of the techno-scientific era humanity faces are interwoven with the issues that regard other living beings and nature as a whole. This insight into the interweavement of the issues involved (and the interweavement of the relationships themselves within the living world) has brought about the networking of various sciences, professions and non-scientific views, which we know under the names of multi-, inter- and trans-disciplinarity, and pluriperspectivism. However, bioethics should not be satisfied with a mere mechanical gathering of various disciplinal views and worldviews, but should aspire after real integration, the shaping of a unified platform for discussion of the ethical problems regarding life in all its forms, shapes, degrees, stages and manifestations. Developing the starting premises of this platform is the task of “integrative bioethics”. In order to do so, taking account of the work of Van Rensselaer Potter cannot be avoided, since his idea of bioethics and the development of his bioethical thought extensively coincide with what bioethics generally means, as well as with its historical transformations: from the moment he coined the term ‘bioethics’, through having founded so-called “bridge bioethics” to the reformulation and expansion of the contents of bioethics into so-called “global bioethics”. The aim of this paper is to examine the extent to which Potter’s work can serve as a stimulus and be the foothold of the goal to establish bioethics as integrative bioethics.

The Relationship Between Dental Trauma, Anxiety and Aggression Behavior in 7 to14 Year old Children in Kosovo

BACKGROUND AND AIM Dental fear has a negative impact on the treatment outcomes. The aim of this study was to evaluate dental anxiety among children with different measurement scales, with the aim of getting more precise and thorough estimations, as well as correlation between anxiety scale and aggression scale in children with/or without dental trauma. MATERIAL AND METHODS The study population include 254 childrens experience with dental trauma (59.1% male), and 251 children without dental trauma (46.6% male), between 7 and 14 years old, and their respective parents were evaluated during 2015-2016. Psychometric measures used for this purpose included several questionnaires. The result was tested with the X2 test, Students t-test, one-way ANOVA, and Pearsons correlation coefficient. The Cronbach alpha was used to check the reliability and validity of the measures. The predetermined significance levels were set at 0.05. RESULTS All used test has satisfactory reliability and validity of the scale. The mean anxiety score was significantly higher in children with dental trauma. The children with dental trauma had a higher mean aggression scale (OAS). The girls had significantly higher mean anxiety score than boys in all used questionnaires. The mean aggression score was significantly higher for boys than girls in both compared groups (p<0.001). The Odds of the aggressive behavior in children with dental trauma decrease for 0.95 when the value of the mean DVSS-SV scale is increased by one units, and increase for 1.04 when the means anxiety score increased by one units. CONCLUSION The mean anxiety score was significantly higher in children with dental trauma, as well as the girls and children who are more afraid of medical interventions (CMFQ). Also the children with dental trauma, and boys had a higher mean aggression scale (OAS).
Significant correlation was found between dental anxiety level and aggressive behavior of childrens. The odds of the aggressive behavior increased with increasing of mean score of each anxiety measurement scale, but not significantly, except for S-DAI score.

Oral Health of Down Syndrome Children in Bosnia and Herzegovina

Introduction: The objective of this study was to determine the oral health condition Down syndrome (DS) children in Bosnia and Herzegovina, by analizing oral health of Down syndrome individuals in two largest regions, Sarajevo and Tuzla Canton. Patients and Methods: Caries and oral health status of Down syndrome children aged 6-18 years were examined and assessed according WHO 1997 criteria. DS individuals were divided in to four age groups: I (0-6 yrs); II (7-12 yrs); III (13-18 yrs). Results: The mean dmft/DMFT index for age group I is (6,40±6,05); II (2,05±2,04) and III (10,30±6,80). The analysis of oral hygiene of Down syndrome children by using the debris index, it was found that 43,9% have very good oral hygiene, 33,3% respondents have good oral hygiene, 15,8% were with poor oral hygiene, while the very poor hygiene had 7% subjects. By using Pearson’s correlation to the value of DMFT, debris index and age of examinees with Down syndrome, it is established a statistically significant positive correlation between analyzed variables. Values of CPI index according to age groups were as follows: I (0,1); II (0,17) and III group (0,4).

Oral Health of Down Syndrome Adults in Bosnia and Herzegovina.

Introduction: The objective of this study was to determine the oral health condition Down syndrome (DS) adults in Bosnia and Herzegovina, by analyzing oral health of Down syndrome individuals in two largest regions, Sarajevo and Tuzla Canton. Patients and Methods: Caries and oral health status of 33 Down syndrome adults aged 19-45 years were examined and assessed according WHO 1997 criteria. Results: The mean DMFT index is 15,96±8,08. The analysis of oral hygiene of Down syndrome children by using the debris index, is found that 42,4% have very good oral hygiene, 21,2% respondents have good oral hygiene, 27,3% are with poor oral hygiene, while the very poor hygiene have 9,1% subjects. The Value of CPI index is 0,82.

Causes and prevalence of dental and oral soft tissue injuries in school children in Zagreb, Croatia

Cilj ovog istraživanja je bio istražiti etiologiju i vrste traumatskih ozljeda stalnih zuba kao i prisutnost ozljeda mekih tkiva oralne regije među skolskom djecom u Zagrebu, Hrvatska. Retrospektivno istraživanje provedeno je na Odjelu djecje stomatologije Stomatoloskog fakulteta Sveucilista u Zagrebu služeci se dokumentacijom 319-ero bolesnika (203 djecaka i 116 djevojcica) u dobi od sedam do 16 godina s ozljedama trajnih zuba između veljace 2009. i sijecnja 2013. Trauma je zapažena na 542 trajna zuba, sto nam pokazuje da je broj ozlijeđenih trajnih zuba 1, 7 po djetetu. Vecina djece s ozljedom zuba je u dobi od devet godina. Gornji sredisnji sjekutici su najcesce zahvaceni zubi (81%), zatim slijede gornji lateralni sjekutici, dok su najmanje zahvaceni donji sredisnji sjekutici. Traumatske dentalne ozljede koje zahvacaju tvrda zubna tkiva i pulpu dva su puta cesca od ozljeda parodontnog tkiva. Najcesce promatrana traumatska dentalna ozljeda tvrdoga zubnog tkiva i pulpe je fraktura cakline i dentina bez izloženosti pulpe, a subluksacija je najcesca vrsta parodontne ozljede tkiva. Najcesci uzrok ozljede zuba je pad, a vecina se ozljeda dogodila u skoli. Od bolesnika koji su primili terapiju 132-je (41, 4%) ih je imalo ozljede mekog tkiva oralne regije. Uspoređujuci djecu s ozljedama zuba i mekih tkiva i onu s ozljedama zuba bez ozljeda mekih tkiva, postoji statisticki znacajna razlika u vremenu dolaska (P<0, 01).

Oral Health Changes during Early Phase of Orthodontic Treatment

The aim of the study was to assess the influence of fixed orthodontic appliance on Streptococcus (S.) mutans and S. sobrinus counts in orthodontic patients with regard to their previous caries experience (Decayed, Missing and Filled Teeth (DMFT) index) during the first 12 weeks of orthodontic treatment. Twenty-two patients that satisfied inclusion criteria (healthy systemic and periodontal condition, avoidance of antibiotic therapy and antiseptic mouthwashes in the past three months) were included. All clinical measurements took place prior to and 12 weeks after fixed orthodontic appliance placement, in the following order: 1) stimulated saliva flow (SS); 2) Simplified Oral Hygiene Index (OHI-S); and 3) DMFT. The method of polymerase chain reaction (PCR) was used to detect the presence of S. mutans and S. sobrinus at T1 and T2. T-test showed significant increase in DMFT index and SS between T1 and T2. Results also indicated significant improvement in OHI-S index. By use of the PCR method, S. mutans was detected in two patients at T1. At T2, two more patients had S. mutans, but the increase was not statistically significant. Using the same method, S. sobrinus was detected only in two patients at T2. In conclusion, fixed orthodontic appliances did not induce statistically significant changes in caries microflora even in the presence of enhanced oral hygiene habits.