Jelena Krunic

Caries prevalence in adolescents in Eastern Bosnia: Foča municipality

Caries is the most frequent oral disease in all age groups. Aim: The aim of this study was to determine dental status and caries prevalence in adolescents in the Eastern Bosnian region, in Foca municipality Materials and methods: The study comprised 300 pupils of secondary schools, of both sexes and aged between 15 and 18 in Foca municipality. Dental check-up was conducted by a single dentist using daylight, dental mirror and dental probe. Caries prevalence was analyzed using the DMFT index. Results: Results showed that the dominant components of DMFT were filled (51.7%) and decayed teeth (36.8%) while extracted teeth were least frequent (11.8). Initial caries was observed most frequently in upper (48%) and lower (39.7%) molars and least frequently in lower anterior teeth (8.4%). Deep caries lesions were most often found in upper (35,7%) and lower (33.3%) molars and rarely in lower anterior teeth (3.3%). Conclusion: Adolescents in Eastern Bosnia (Foca municipality) have great number of carious and unrestored teeth and, therefore, the implementation of primary dental healthcare system is necessary as well as looking for a solution to this problem.

Limited Jaw Movements and Somatization (But Not Pain) May Play a Role in Salivary Flow in Female Patients with Temporomandibular Disorders

AIMS To explore the unstimulated salivary flow rate and subjective feeling of oral dryness in young adult women with temporomandibular disorders (TMD) and their relation to the presence of chronic pain, depression, somatization, and limited mandibular mobility. METHODS Unstimulated whole saliva flow rate and presence of oral dryness were determined in 45 women with TMD and 30 healthy controls. The Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD, chronic pain, depression, somatization, and mandibular mobility. Factors with P < .05 in the bivariate analysis were included in multivariate modeling. RESULTS The TMD patients showed significantly diminished unstimulated salivary flow (P = .010) in comparison to controls, but there was no difference in subjective oral dryness. Within the TMD group, patients with mandibular hypomobility and free from somatization exhibited significantly lower salivary output (P = .037; P = .015, respectively). No relationship between salivary flow and depression or TMD pain was observed. Multivariate linear regression identified somatization as the single variable contributing to salivary flow (P = .044) in the TMD patients. CONCLUSION The present study shows a relationship between TMD and lower salivary flow but no evidence of a relationship between TMD and subjective oral dryness in young adult women. Somatization was the single variable to emerge from the evaluation of potential factors contributing to salivary output in TMD patients.

Pulp Sensitivity: Influence of Sex, Psychosocial Variables, COMT Gene, and Chronic Facial Pain

Introduction: The purpose of this study was to evaluate the associations of variability in pulp sensitivity with sex, psychosocial variables, the gene that encodes for the enzyme catechol‐O‐methyltransferase (COMT), and chronic painful conditions (temporomandibular disorders [TMDs]). Methods: The study was composed of 97 subjects (68 women and 29 men aged 20–44 years). The electric (electric pulp tester) and cold (refrigerant spray) stimuli were performed on mandibular lateral incisors. The results were expressed as pain threshold values for electric pulp stimulation (0–80 units) and as pain intensity scores (visual numeric scale from 0–10) for cold stimulation. The Research Diagnostic Criteria for TMD were used to assess TMD, depression, and somatization. DNA extracted from peripheral blood was genotyped for 3 COMT polymorphisms (rs4680, rs6269, and rs165774) using the real‐time TaqMan method. Multivariate linear regression was used to investigate the joint effect of the predictor variables (clinical and genetic) on pulp sensitivity (dependent variables). Results: Threshold responses to electric stimuli were related to female sex (P < .01) and the homozygous GG genotype for the rs165774 polymorphism (P < .05). Pain intensity to cold stimuli was higher in TMD patients (P < .01) and tended to be higher in women. Multivariate linear regression identified sex and the rs165774 COMT polymorphism as the determinants of electric pain sensitivity, whereas TMD accounts for the variability in the cold response. Conclusions: Our findings indicate that sex/a COMT gene variant and TMD as a chronic painful condition may contribute to individual variation in electric and cold pulp sensitivity, respectively.

Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal

ObjectivesTo evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).Materials and methodsAntibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively.ResultsOzone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp.ConclusionsAntibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility.Clinical relevanceOzone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.

Oral Alterations in Diabetes Mellitus

Summary Diabetes mellitus is one of the most common chronic diseases which continue to increase in number and significance. It presents the third most prevalent condition among medically compromised patients referring for dental treatment. Diabetes mellitus has been defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Hyperglycemia leads to widespread multisystem damage which has an effect on oral tissue. The present article summarizes current knowledge regarding the association between diabetes mellitus and oral and dental health.

Validation of the Child Oral Impact on Daily Performance index among schoolchildren in Bosnia and Herzegovina: A pilot study

Introduction. The aim of this study was to translate the Child Oral Impact on Daily Performance index into Serbian language and to evaluate its reliability in practice. Material and Methods. Following internationally established methods, adaptation of the Child Oral Impact on Daily Performance index for children and adolescents in the Serbian speaking areas consisted of three steps: forward translation of the Child Oral Impact on Daily Performance index, backward translation, and a pilot study. Results. A pilot study included 42 participants (21 males and 21 females), mean age of 12.0 ± 1.01 years. All items showed a corrected item-total correlation coefficient above >0.20 and the standardized Cronbachs alpha coefficient was 0.80. All correlation coefficient values were positive. The prevalence of oral health impact measured by the Child Oral Impact on Daily Performance index was relatively high and 54.8% of the participants reported at least one oral impact on the daily performance in the last 3 months. The most common activities affected were eating (38.1%) and cleaning the teeth (16.7%). Conclusion. The Serbian version of the Child Oral Impact on Daily Performance index is suitable for use in everyday practice and it provides useful information in the evaluation of oral health-related quality of life. The prevalence of oral impacts was high with the most prevalent impact referring to eating. Further clinical research, including larger number of participants, is required for exact verification of the Child Oral Impact on Daily Performance index.

Dental Status and Prosthetic Rehabilitation in Elderly Population in Relation to Socioeconomic Factors in Republika Srpska

Summary : Introduction The aim of this study was to determine dental status and prosthetic rehabilitation in elderly population in relation to socioeconomic factors in Republika Srpska. Material and Methods The study included 262 subjects (133 males and 129 females) aged 65-74 years. Dental status was assessed using DMFT index and its components (D - decayed, M - extracted, F - filled tooth) and analysed in relation to socioeconomic factors: gender, level of education and monthly income. Prosthetic restorations were recorded for both jaws in accordance with criteria of the World Health Organisation. Results The mean DMFT was 27.2. Females had the highest DMFT index score (29.1) while highly educated subjects had the lowest score (22.7). The mean number of missing teeth was 22.7. There were 28.2% edentulous respondents. Significant difference in the number of edentulous persons was recorded in relation to gender, education and monthly income. In total, 16.8% of subjects had functional dentition (≥20 natural teeth). 48.5% and 32.1% of elderly respondents were found to have at least one form of prosthetic restoration in upper and lower jaw, respectively. Complete dentures were the most common prosthetic restorations. Conclusion Socioeconomic factors influenced dental status in elderly population. Removable dentures were more common restorations compared to crowns and bridges.

Maksilarni drugi molar sa pet korijenskih kanala – prikaz bolesnika

Uvod. Osnovni cilj endodontske terapije je adekvatna obrada i opturacija cjelokupnog kanalnog sistema. Nekompletna instrumentacija i ciscenje kanala, neadekvatna opturacija i zaboravljeni kanali najcesci su razlozi neuspjeha endodontske terapije. Stoga je poznavanje morfologije korijenskog sistema zuba od velikog znacaja i može da smanji neuspjeh endodontske terapije uzokovane nekompletnom kanalnom preparacijom i opturacijom. Cilj rada je da se prikaže endodontska terapija maksilarnog drugog molara sa dva palatinalna korijena i pet korijenskih kanala. Prikaz bolesnika. U radu je prikazan maksilarni drugi molar sa cetiri korijena kod pacijenta starosti 27 godina. Poslije klinickog ispitivanja i analize radiograma, uoceno je postojanje dva palatinalna korijena. Sprovedena je endodontska terapija u dvije posjete. Poslije zavrsene intrakanalne medikacije u trajanju od 15 dana, kanali su opturisani gutaperka poenima i silerom. Zakljucak. Prikaz istice važnost dobrog poznavanja kanalne morfologije i ukazuje da anatomske abnormalnosti treba uvijek uzeti u obzir kada se sprovodi endodontsko lijecenje.

Dental status in adults of the municipality of Foča

Introduction. Dental caries has been one of the oldest but still one of the most common oral diseases in humans. Even though it has been almost eradicated in developed countries due to increased fluoride use, adoption of proper oral hygiene habits and systematic implementation of preventive programs, caries remained one of leading oral diseases in developing countries. Epidemiological data about the prevalence of caries is very important for prediction of need for dental care, number of dental care providers as well as financial aspect. The aim of this study was to determine dental status and indicate dental treatment need in adults of the municipality of Foca, Republika Srpska (Bosnia and Herzegovina). Material and Methods. The study included 244 randomly selected residents (131 males and 113 females) from the municipality of Foca which were divided into three age groups: 20-29, 30-39 and 40-49 years. Dental status and need for dental treatment were determined in accordance to the criteria and methodology of the World Health Organization. Results. Mean value of DMFT index was 12.7 for the first age group, 16.4 for the second and 20.5 for the third age group of respondents. Dominant components in the first group were restored and carious teeth while in the third age group number of extracted teeth dominated. Also, in the third age group of respondents need for one and two or more surfaces fillings was significantly lower (p<0.01), but need for removable dentures was significantly higher (p<0.01) as compared to other two groups. Conclusion. These results indicated high value of DMFT index in adult population of the municipality of Foca.