Josip Kranjčić

Human Papillomavirus in the Lesions of the Oral Mucosa According to Topography

Background The association between human papillomavirus (HPV) types and oral lesions has been shown in many studies. Considering the significance that HPV has in the development of malignant and potentially malignant disorders of the oral mucosa, the purpose of this study was to investigate the prevalence of HPV DNA in different oral lesions. In addition, we wanted to elucidate whether the HPV infection is associated predominantly with either the lesion or a particular anatomic site of the oral cavity. Methodology/Principal Findings The study included 246 subjects with different oral lesions, and 73 subjects with apparently healthy oral mucosa (controls). The oral lesions were classified according to their surface morphology and clinical diagnosis. The epithelial cells were collected with a cytobrush from different topographic sites in the oral cavity of the oral lesions and controls. The presence of HPV DNA was evaluated by consensus and type-specific primer-directed polymerase chain reaction. The HPV positivity was detected in 17.7% of oral lesions, significantly more than in apparently healthy mucosa (6.8%), with a higher presence in benign proliferative mucosal lesions (18.6%). High-risk HPV types were predominantly found in potentially malignant oral disorders (HPV16 in 4.3% and HPV31 in 3.4%), while benign proliferative lesions as well as healthy oral mucosa contained mainly undetermined HPV type (13.6 and 6.8%, respectively). Conclusions/Significance The distribution of positive HPV findings on the oral mucosa seems to be more associated with a particular anatomical site than the diagnosis itself. Samples taken from the vermilion border, labial commissures, and hard palate were most often HPV positive. Thus, topography plays a role in HPV prevalence findings in oral lesions. Because of the higher prevalence of the high-risk HPV types in potentially malignant oral disorders, these lesions need to be continuously controlled and treated.

Differences in articular-eminence inclination between medieval and contemporary human populations

The articular-eminence inclination is an important element in the biomechanics of the temporomandibular joint and the entire masticatory system; however, very little is known about this inclination in archaeological human populations. Therefore, the aim of this study was to determine the values of, in addition to the differences between, the articular-eminence inclination in medieval and contemporary human populations. The study was carried out on two dry skull groups. The first group consisted of 14 dry skulls from the medieval culture group Bijelo Brdo (BB) of East Croatia, and the other consisted of 137 recent dry skulls from the osteologic collection of the Institute of Anatomy (IA) in Zagreb. All BB skulls were dentulous, whereas the IA skulls were divided into dentulous and edentulous groups. The articular-eminence inclination was measured in relation to the Frankfurt horizontal plane on digital images of the skulls two lateral views using AutoCAD computer software. The mean value of the articular-eminence inclination in the BB sample group (49.57°) was lower, with a statistical significance (p<0.01), than those of the IA dentulous (61.56°), the IA edentulous (62.54°), and all the combined IA (61.99°) specimens. Because the values of the articular-eminence inclination can vary a lot with reference to the number of specimens and the different methods used for measuring, the obtained values yield only orientational information. Further investigations including a larger number of medieval specimens are needed to confirm the results obtained from this study.

Oral Health-Related Quality of Life in Different Types of Mandibular Implant Overdentures in Function Longer Than 3 Years.

PURPOSE The aim of this study was to evaluate the oral health-related quality of life (OHRQoL) of patients treated with three different types of mandibular implant overdentures (IOD) after at least 3 years in function. MATERIALS AND METHODS A total of 122 patients treated with mini implant (50), locator (56), or bar (16) mandibular IODs participated. Modified plaque (PI) and gingival (GI) indices were also assessed. RESULTS Older patients and patients with mini mandibular IODs were the most satisfied with their OHRQoL. The bar overdenture presented the worst PI and GI results. CONCLUSION The mini mandibular overdenture patients were assessed with a better OHRQoL than those with bar and locator IODs.

Treatment Outcomes Based on Patients’ Self-Reported Measures after Receiving New Clasp or Precision Attachment-Retained Removable Partial Dentures

PURPOSE To evaluate effects of a treatment taking into consideration esthetics, chewing, and oral health-related quality of life (OHRQoL) of two tooth replacement strategies for maxillary partially edentulous patients with clasp (C-RPD) and precision attachment (PA-RPD) retained removable partial dentures (RPD). MATERIALS AND METHODS The study included 150 patients (72 men, 78 women) who received maxillary RPDs; 88 patients received clasp and 62 patients received precision attachment retained RPDs. Patients completed three questionnaires before treatment and again 3 months after treatment: the Orofacial Esthetic Scale (OES), the Oral Health Impact Profile (OHIP-14), and the Chewing Function Questionnaire (CFQ). Statistical analysis comprised descriptive statistics, paired t-test, and two-factor ANOVA. RESULTS Both RPD treatments yielded better after-treatment summary scores when compared with the baseline scores (p < 0.01); however, better results were obtained in the PA-RPD group. Gender, as a single factor, did not yield significant effects; mutual interaction of retention type and gender yielded significant effects. The PA-RPD female group assessed esthetics, chewing function, and OHRQoL significantly better than males, and significantly worse than males in the C-RPD group. The covariate baseline scores yielded statistically significant effects; patients with worse pretreatment condition benefited more from both therapies. CONCLUSIONS Treatment outcomes were better in the PA-RPD group than the C-RPDs. Women showed greater concern for the treatment outcomes; their rates were significantly better than in male patients in the PA-RPD group; however, when their satisfaction was lower, their rates were significantly worse than in male patients (in the C-RPD group).

A two-step (altered cast) impression technique in the prosthetic rehabilitation of a patient after a maxillectomy: a clinical report.

This clinical report describes the prosthetic rehabilitation complicated by trismus (as a consequence of surgery and radiation therapy) of a patient with an acquired maxillary defect, after surgical removal of the right maxillary sinus tumor. The patient was restored with a partial removable dental prosthesis with a hollow bulb obturator to obtain orofacial rehabilitation and defect obturation. Precise obturation requires an accurate impression of the resection defect. A 2-step impression was performed because of trismus. A primary maxillary impression was made with an irreversible hydrocolloid, while a secondary (altered cast) impression was made with a silicone material by using the obturator cast framework as a tray. In that way an altered cast was produced. Subsequently, an obturator prosthesis was processed with a conventional technique.

Short-term Postoperative Pain and Swelling Associated with Mini and Standard-Size Implants in the Same Patients

PURPOSE To assess short-term postoperative pain and swelling after insertion of mini dental implants (MDI) and standard-size implants (SSI) in the same patients at different times. MATERIALS AND METHODS A convenience sample of 42 patients (22 females, 20 males; 58 to 73 years old) participated. Half of the participants received MDIs first, and the other half received SSIs first. Self-perceived pain and swelling at 1, 3, 5, 7, and 10 days postoperative were assessed using a 0-10 visual analog scale. RESULTS AND CONCLUSION Flapless MDI insertion led to significantly less intense postoperative pain, less intake of analgesics, and almost no swelling compared to SSI insertion.

Differences in skeletal components of temporomandibular joint of an early medieval and contemporary Croatian population obtained by different methods

The temporomandibular joint (TMJ) is one of the most complex joints in the human body. The anatomical configuration of the TMJ allows for a large range of mandibular movements as well as transmission of masticatory forces and loads to the skull base. The measurements of the TMJs anatomical structures and their interpretations contribute to the understanding of how pathological changes, tooth loss, and the type of diet (changing throughout human history) can affect biomechanical conditions of the masticatory system and the TMJ. The human TMJ and its constituent parts are still the subject of extensive investigation and comparisons of measurement methods are being made in order to determine the most precise and suitable measurement methods. The aim of this study has been to examine the morphology of skeletal components of TMJ of an early medieval population (EMP) in Croatia and to compare measured values with TMJ values of the contemporary Croatian population (CP) using various methods of measurement. The study was performed on 30 EMP specimens - human dry skulls, aged from 18 to 55 years, and 30 CP human dry skulls, aged from 18 to 65 years. Only fully preserved specimens (in measured areas) were included. The articular eminence (AE) inclination was measured in relation to the Frankfurt horizontal using two methods. Also, the AE height (glenoid fossa depth) and the length of the curved line - highest to the lowest point of the AE were measured. Measurements were performed on lateral skull photographs, panoramic radiographs and lateral cephalograms using VistaMetrix software on skull images. The results were statistically analyzed using SPSS statistical software. No statistically significant differences were obtained for AE parameters between the EMP and CP populations independent of age and gender. However, statistically significant (p<0.05) differences were revealed when comparing results of three different measuring methods. It could not be determined which of the used measurement methods is the most accurate due to the different results obtained as well as the presence of possible shortcomings and limitations of the various methods (measuring points are difficult to determine and/or they are not clearly observed in the investigated images to be precisely marked and measured; distortion and magnification of structures on radiographic images are present). Therefore, due to the limitations of this study, the obtained results could serve only as orienting information.

Articular eminence inclination in medieval and contemporary Croatian population

Articular eminence inclination (AEI) of the temporomandibular joint leads the mandible in its movements. Therefore, the aim of the present study was to determine AEI values in medieval (MP) and recent (RP) Croatian population. The study was carried out on two groups of specimens: first group with 30 MP human dry skulls, while the other, serving as control group consisted of 137 dry skulls. The AEI was measured on lateral digital skull images as the angle between the best fi t line drawn along the posterior wall of the articular eminence and the Frankfurt horizontal plane. No statistically significant (p>0.05) differences between the left and right side AEI were found between MP skulls and RP skulls. The mean value of MP AEI was 45.5˚, with a range of 20.9˚-64˚. The mean RP AEI value was steeper (61.99˚), with a range of 30˚-94˚. Difference between the mean MP and RP AEI values was statistically significant (p<0.05). Values of AEI vary a lot. Nonsignificant differences between the left and right side AEI confirmed the natural left-right side asymmetry. The values of AEI differ between the RP and MP groups, most probably due to different type of food consumption in medieval time, and consequently different masticatory loads and forces.