Márk Antal

Width ratios in the anterior maxillary region in a Hungarian population: Addition to the golden proportion debate

STATEMENT OF PROBLEM In the last 2 decades, several studies have questioned the application of the rule of golden proportion in dentistry. PURPOSE The purpose of this study was to test the rule of golden proportion for the maxillary anterior region in a population of young, healthy people with excellent oral hygiene at the Faculty of Dentistry of the University of Szeged. MATERIAL AND METHODS One hundred and nine participants (36 male, 73 female) were examined, 41 of whom had previously worn orthodontic appliances. A Canon 450D camera, Canon 100 mm Macro lens, and a Sigma 140 DG ring flash were used for digital documentation. The accreditation photography protocol of the American Academy of Cosmetic Dentistry was applied to standardize the images. The width of the teeth from the frontal view was measured digitally. Tooth dimension data were collected and the Mann-Whitney U test was performed (α=.05). RESULTS The relative width of the central incisors, lateral incisors, and canines was 1.6:1:0.85 on both sides. The ratios were not influenced by either sex or previous orthodontic treatment. CONCLUSIONS The results demonstrated that, because of the difference in canines in this population, the golden proportion in its original form was not valid for the maxillary anterior region. Orthodontic treatment does not change the dentition toward the golden proportion. The results suggest that the rule of golden proportion should not be used for treatment planning without observing individual modifying factors.

Smoking as a permissive factor of periodontal disease in psoriasis

Background Population-based studies have identified smoking as a pathogenetic factor in chronic periodontitis. At the same time, chronic periodontal disease has also been found to occur more often in persons suffering from psoriasis than in controls with no psoriasis. It is known that smoking aggravates both periodontal disease and psoriasis, but so far it has not been investigated how smoking influences the occurrence and severity of periodontal disease in psoriasis. Methods A hospital-based study was conducted to investigate this question. The study population consisted of 82 psoriasis patients and 89 controls. All patients received a full-mouth periodontal examination, and a published classification based on bleeding on probing, clinical attachment level and probing depth was utilized for staging. Both patients and controls were divided into smoker and non-smoker groups, and the resulting groups were compared in terms of periodontal status. Beyond the descriptive statistics, odds ratios were computed. Results Psoriasis in itself increased the likelihood of severe periodontal disease to 4.373 (OR, as compared to non-smoker controls, p<0.05), while smoking increased it to 24.278 (OR, as compared to non-smoker controls, p<0.001) in the studied population. In other words, the risk of severe periodontal disease in psoriasis turned out to be six times higher in smokers than in non-smokers. Conclusions The results of this study corroborate those of other studies regarding the link between psoriasis and periodontal disease, but they also seem to reveal a powerful detrimental effect of smoking on the periodontal health of psoriasis patients, whereby the authors propose that smoking may have a permissive effect on the development of severe periodontal disease in psoriasis.

Reconstruction of a Large Upper Lip Defect with Severe Associated Injuries by the Combination of the Kazanjian and Abbé Flaps

Upper lip defects caused by animal bites can result in serious oral and facial functional compromise. The management of such large defects in a way that an optimal functional and cosmetic outcome is reached remains a major reconstructive challenge. We present the upper lip reconstrucion of a 57-year-old woman who was attacked by her dog. The attack caused severe scalp and facial injuries, including a large upper lip defect. After initial trauma treatment, the lip defect was reconstructed by the combination of the Kazanjian and Abbe flaps. No venous circulation defect, wound healing problems or other complications were detected. After three months, sensory function of the area returned, and after 6 months the movements of the lip were satisfactory, the patient was able to pucker the lips, open the mouth and to eat. Beyond that, a cosmetically acceptable outcome was reached, so that the psychosocial reintegration of the patient was not at risk.We propose that combination of the Kazanjian and Abbe flaps offers an excellent alternative for the reconstruction of wide or total lip resections.

A video feedback-based tobacco cessation counselling course for undergraduates-preliminary results.

BACKGROUND Hungary has one of the highest rates of tobacco use and decayed, missing and filled teeth in Europe, and the number of lung cancer-related deaths per annum is amongst the highest globally. As it is estimated that the rate of smokers who see their dentist or physician annually is about 70%, to involve all healthcare providers in tobacco intervention seems to be a promising strategy to reduce tobacco use in countries like Hungary. Such an intervention should obviously include the dental health team. It has already been suggested by experts on this topic that instruction in tobacco use prevention and cessation counselling for dental professionals and students of dentistry should be included in under- and postgraduate curricula. OBJECTIVES To present a novel, video feedback-based undergraduate cessation counselling programme, which has recently been introduced to the dental curriculum at the Faculty of Dentistry, Szeged, Hungary. METHODS Applying a problem-based learning approach, the programme consists of three main activities: a small-group interactive training session led by a faculty member, where students learn about the basic science and clinical aspects of tobacco use, including counselling skills; student interactions with professional actors (i.e. standardised patients) simulating real-life dental situations, which are recorded for post hoc evaluation; and finally an evaluation of the recorded performance of each student, with the participation of the actor, the student and a faculty member. RESULTS With the help of this new approach, students had the chance to learn about and develop a deeper understanding of tobacco-related professional dental communication in realistic, case-based dental scenarios. Students have reported increased confidence in tobacco counselling after having participated in this programme. Furthermore, this method appears to be an ideal tool for the evaluation of both verbal and non-verbal tobacco counselling skills. CONCLUSION To our knowledge, we are the first to have applied video feedback combined with behavioural modification methods in the teaching of tobacco cessation counselling. We conclude that teaching method can help dentists better understand smokers, gain confidence in tobacco cessation counselling and become more effective promoters of a smoke-free lifestyle. In addition, this method can be easily adapted to other healthcare educational settings, including other oral health training programmes.

In vitro efficacy of different irrigating solutions against polymicrobial human root canal bacterial biofilms

The purpose of this in vitro study was to compare the antimicrobial efficacy of five different irrigating solutions against complex polymicrobial bacterial biofilms harvested from root canals to model actual endodontic irrigation as closely as possible, and to test the efficacy of these irrigants in these conditions. Two multi-species in vitro biofilms were generated from bacterial samples taken from patients presenting with acute pulpitis. The microbial composition of these samples was characteristic of the disease. The biofilms were incubated with 1000 p.p.m. Solumium Dental (ClO(2)), 0.2% chlorhexidine (CHX), 5.25% sodium-hypochlorite (NaOCl), 5.25% Neomagnol, 10% iodine and phosphate buffered saline (PBS) as control. After the microbiological preparation of the samples, colony forming units (CFU) were counted. NaOCl, iodine and Neomagnol were the most effective, whilst CHXand Solumium appeared to be less effective against these specific biofilms. The efficacy of the most effective agents differed according to biofilm and application time. All irrigants were efficient to some extent, but NaOCl proved to be the most efficient, while chlorine dioxide (ClO(2)) yielded the poorest results in these circumstances. The efficacy of NaOCl was already well-known, but our results also point out that iodine could have an important role in endodontic irrigation.

An observation on the severity of periodontal disease in past cigarette smokers suffering from rheumatoid arthritis- evidence for a long-term effect of cigarette smoke exposure?

BackgroundRheumatoid arthritis (RA) and cigarette smoking are both risk factors for periodontal disease (PD). Previous research suggests that systemic inflammatory conditions and cigarette smoking may act in synergy, and their co-occurrence leads to a much higher risk of developing severe stage PD than what the combination of their individual risks would suggest. We originally sought to test this in the case of RA, but it turned out that the majority of our patients were former smokers, who smoked for prolonged periods in the past. For that reason, we decided to shift our focus toward the possible effects of past chronic cigarette smoke exposure.MethodsThe data of 73 RA patients and 77 healthy controls were analyzed. The participants received a full-mouth periodontal examination to determine their periodontal status. Rheumatological indices and data on past tobacco use were also recorded. Both the patient and the control groups were divided into former smoker and non-smoker subgroups for the analyses. Non-smoker controls were used as the reference group.ResultsIn the control group, smoking in history increased the odds of developing both the moderate and the severe stages of PD, but the change was not statistically significant. RA significantly, increased the odds of developing both stages in itself, but the highest odds were seen in the former smoker RA group.ConclusionBased on this surprising observation of ours, we hypothesize that chronic cigarette smoke might bring about permanent changes in the periodontal tissues, leading to their hypersensitivity to inflammatory challenges.

A dohányzás hatása a fej-nyak régió daganata miatt sebészi terápiában részesült betegek protetikai rehabilitációt követő életminőség-javulására

INTRODUCTION It is known that the quality of life (QoL) of patients surgically treated for head and neck cancer (HNC) is significantly enhanced by rehabilitation. It is also known that some of these patients will not quit smoking. AIM To assess if smoking hampers rehabilitation-related QoL enhancement after surgery. METHOD Applying the H&N 35 questionnaire of EORTC, we assessed the QoL of 38 smoking and non-smoking patients who underwent surgical therapy for HNC and subsequent rehabilitation. QoL was assessed after surgery (after the healing period) and 6 months after rehabilitation. RESULTS While the QoL enhancement of nonsmokers was significant in almost all aspects, that of smoking patients did not reach the level of significance on a number of scales. The results suggest that smoking does not hamper rehabilitation directly, rather, it prevents rehabilitation from exerting its beneficial effects through its own effects. CONCLUSIONS Smoking is a factor that measurably acts against the efforts to enhance the QoL of the surgically treated HNC patient. Therefore, it is essential that emphasis is put on smoking cessation right from the cancer diagnosis also for this reason. Orv. Hetil., 2017, 158(5), 172-177.Absztrakt: Bevezetes: Ismert, hogy a fej-nyak daganat miatt műteten atesett betegek rehabilitacioja atfogoan es szignifikansan javitja ezeknek a betegeknek az eletminőseget. Celkitűzes: Celunk volt felmerni, hogy a műtetet es a rehabilitaciot kovető eletminőseg-javulasban van-e elteres a dohanyzo es nem dohanyzo betegeknel. Modszer: Az EORTC H&N 35 kerdőiv segitsegevel ket alkalommal mertuk fel 38, fej-nyaki tumor miatt operalt (dohanyzo es nem dohanyzo), majd sajat osztalyunkon rehabilitalt beteg eletminőseget, előszor a műtet utan (a gyogyulast kovetően), majd a rehabilitacio utani hat honapos kontroll alkalmaval. Eredmenyek: A dohanyzo betegek eletminőseg-javulasa szamos aspektusban elmaradt a nem dohanyzoketol. Az eredmenyek alapjan a dohanyzas nem kozvetlenul hat a rehabilitacio sikeressegere, hanem onallo hatasai folytan akadalyozza meg, hogy a rehabilitacio kifejtse atfogo eletminőseg-javito hatasat. Kovetkeztetesek: A tanulmany korlatait is figyelembe veve levonhato az a kovetkeztetes, hogy a fej-...

Erratum: Smoking as a permissive factor of periodontal disease in psoriasis (PLoS ONE (2014) 9:3 (e92333) DOI: 10.1371/journal.pone.0092333)

Citation: The PLOS ONE Staff (2014) Correction: Smoking as a Permissive Factor of Periodontal Disease in Psoriasis. PLoS ONE 9(10): e110975. doi:10.1371/journal. pone.0110975 Published October 8, 2014 Copyright: 2014 The PLOS ONE Staff. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.