Sándor Márton

ASSOCIATIONS BETWEEN MICROBIOLOGICAL AND SALIVARY CARIES ACTIVITY TESTS AND CARIES EXPERIENCE IN HUNGARIAN ADOLESCENTS

The aim of the study was to assess caries prevalence in connection with salivary caries–related findings in 349 14– to 16–year–old Hungarian adolescents living in two different cities. DMFT, DMFS means, stimulated salivary flow, buffer capacity, mutans streptococci, lactobacilli and candida counts in saliva were determined. The ratio of caries–free adolescents was 4.6% in the total population sample, DMFT mean values were 7.24±4.86, DMFS means 10.50±8.35. Mean secretion rate of stimulated saliva was 0.84±0.50; a low buffer capacity was found in 6.3% of the examined children. The ratio of carriers of mutans streptococci, lactobacilli and yeasts in saliva was 89.7, 73.9 and 47.7%, respectively. DMFT and DMFS values as well as mutans streptococci and candida counts were lower in the capital than in the other city. Statistically significant correlations were found between DMFT, DMFS mean values, and salivary microbiological counts.

Status of Complementary and Alternative Medicine in European Medical Schools

Background: The aim of this study was to investigate whether Complementary and Alternative Medicine (CAM) education is part of the regular medical curriculum in European universities and whether it correlates with the public demand for CAM methods. Materials and Methods: Using the World Directory of Medical Schools, 265 medical faculties in EU countries were contacted via e-mail or regular post and asked to fill out a questionnaire of 7 questions concerning CAM education in their establishments. Results: Only 40% of the responding universities were offering some form of CAM training. We could not show any correlation between the public demand for CAM methods and the availability of CAM training in medical universities. Conclusions: The growing popularity of CAM makes it very important for physicians to gain information on these methods and techniques, thus better incorporation of CAM education into the regular medical curriculum is needed in all European medical faculties.

Effect of Amine Fluoride Toothpaste and Gel in High Risk Groups of Hungarian Adolescents: Results of a Longitudinal Study

The aim of the study was to establish a preventive program with the combined use of amine fluoride toothpaste and gel in groups of adolescents living in different locations in Hungary. Caries and oral hygiene examinations were performed at the beginning of the study and repeated after 1 and 2 years. The adolescents were divided into 3 groups: 1 control and 2 test groups. The control group continued its usual oral care habits. One of the test groups received Elmex toothpaste for unsupervised home use daily and Elmex gel for use once a week, and the other test group received Elmex toothpaste and only placebo gel. The combined use of amine fluoride-containing toothpaste and gel provided a significant reduction in DMFS mean values (38% including white spot lesions, 34% not including white spot lesions, p < 0.05) and in visible plaque index values (18%, p < 0.05) compared to the control group.

Dental caries experience in a Hungarian police student population.

The aim of this study was to assess the caries experience of Hungarian police students and to evaluate its relationship with nutrition, oral hygiene habits, behavioural and social factors. This representative cross-sectional epidemiological survey was conducted in a dental office of the Miskolc Law Enforcement Secondary School in Hungary in 2008. Altogether 792 Hungarian police student volunteers (male/female ratio was 90.3/9.7%, age: 20.4 ± 1.3 years, mean ± SD) participated in the study. Caries experience was measured using World Health Organization criteria and a validated questionnaire was used to collect social and oral health behaviour data. The DMFT number was 10.3 ± 5.7 (mean ± SD). Significant relationships were found between the DMFT value and the education of fathers, frequency of dental attendance, and use of dental floss (p < 0.05). D and T components of caries prevalence showed significant relationships with the frequency of dental attendance, while from the components the FT value showed statistically significant relationships with the education of fathers and the MT component with the use of dental floss (p < 0.05). Based on the results of this survey, strategies aiming at effective caries-preventive programmes should be established in police student populations ensuring the official basic requirements on their health condition and suitability for subsequent service. The published information can be used as a base for new strategies, and allows the evaluation of the effects of a carefully planned and implemented health care system.

Changes in gingival blood flow during orthodontic treatment

The aim of the study was to investigate the changes in gingival blood flow due to orthodontic forces. Eleven volunteers, with the maxillary canine in an ectopic position were tested. A Laser Doppler Flowmeter (LDF) with a gingival probe was used, registering both the blood flow and temperature of the gingivae. After baseline measurement, a fixed orthodontic appliance was bonded. Measurements were repeated monthly, after activation of the appliance. The study lasted 6 months. The baseline value was 338.7 ± 201.56 P.U. [Perfusion Unit (mean ± S.D.)] which decreased to 218.9 ± 74.83 P.U. (p < 0.05) after two months and the final value of 363.9 ± 194.86 P.U was not significantly different from that initially (p > 0.5). The results showed that application of a force of 75 g resulted in a decrease in gingival blood flow up to 50%, but this returned to previous values after a few months. The study supports this measurement technique as a useful tool for monitoring gingival blood flow in long-term studies as well.

Outcome of antiepileptic drug treatment of 1282 patients with epilepsy, their pharmacovigilance reports and concomitant medication on CNS in an East-Hungarian adult database

OBJECTIVE The aim of this study was to determine the outcome of antiepileptic drug (AED) treatment based on seizure freedom, pharmacovigilance reports and effects of concomitant medication on the central nervous system (CNS) of adult epileptic patients registered in the East-Hungarian Epilepsy Database. METHODS Prospective cross-sectional database was compiled from outpatient files between 1992 and 2011. RESULTS The majority of 1282 treated patients were on monotherapy 894 patients (70%), 286 (22%) on bitherapy and 102 (8%) on polytherapy. Of all treated patients, seizure freedom was achieved by 603 (47%). Among the seizure free patients 464 (77%) were on monotherapy, 115 (19%) on bitherapy and only 24 (4%) on polytherapy. The overall rate of adverse drug reactions (ADRs) was 16.2%. From patients on AED, 279 (22%) took concomitant drugs acting on the CNS. In a logistic regression model, other CNS-related drugs and a number of prescribed antiepileptic drugs had a significant influence on the desired outcome of seizure freedom. On comparing the Proportional Reporting Ratio and 95%CI of older and newer AEDs, no significant superiority of newer AEDs was detected. CONCLUSION Careful drug selection for epileptic patients must be highlighted in order to improve outcome, reduce ADRs and improve patient compliance.

Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

Predictors of Long-term Outcome after Intravenous or Intra-arterial Recombinant Tissue Plasminogen Activator Treatment in the Eastern Hungarian Thrombolysis Database

BACKGROUND This prospective single-center study aimed to identify features determining long-term outcome after thrombolysis in a Central European stroke population. METHODS Between 1 January, 2004, and 31 December, 2010, 415 patients were treated with recombinant tissue plasminogen activator at the Department of Neurology, University of Debrecen. Stroke severity by the National Institute of Health Stroke Scale score (NIHSSS) and imaging findings by the Alberta Stroke Programme Early Computed Tomography score (ASPECTS) were evaluated on admission and 1 day later. The modified Rankin Scale (mRS) at 3 months and case fatality at 1 year were evaluated. Independent predictors of outcome were identified by multivariate testing. RESULTS Data of 369 patients were analyzed. Median NIHSSS was 12 (interquartile range [IQR], 8-17) on admission and 10 (IQR, 5-16) at 24 hours. Arterial occlusion was found in 55%. Symptomatic intracerebral hemorrhage (SICH) was detected in 3.8%. Outcome was significantly worse, and SICH was more frequent in intra-arterially treated patients. At 3 months, one third of the patients were independent (mRS ≤ 2), and 23% were dead. At 1 year 2 of 3 patients were alive. Significant independent predictors of disability at 3 months were 24-hour NIHSSS, admission ASPECTS, admission glucose level, and treatment modality. Only the 24-hour NIHSSS was a significant predictor of case fatality at 1 year. CONCLUSIONS Although short-term outcome was similar, the 3-month and 1-year outcomes were worse than data from previous reports. A more efficient health care program should be implemented after stroke to maintain the favorable effect of thrombolysis in the long term.

PS-119 Effect of anticoagulation and antiplatelet therapy on the incidence of intracranial bleeding after thrombolysis in patients with acute ischaemic stroke – a pharmacoepidemiological approach

Background The rt-PA is an effective therapy in patients with acute ischaemic stroke. Well known complication of the treatment is intracranial bleeding (haemorrhagic transformation, or parenchymal haemorrhage) which can hinder the improvement and can be lethal. Purpose Identifying the effect of anticoagulants and antiplatelet drugs, taken before the stroke, on the intracranial haemorrhage rate after rt-PA treatment. Material and methods The Debrecen Thrombolysis Database was used. Between the 1st of January 2004 and the 31st of December 2010, 415 patients were treated with rt-PA at the Department of Neurology, University of Debrecen. For the analysis 370 patients’ data was used, who fulfilled the protocol. Odds ratio (OR) and Relative risk (RR) were calculated. ResultsAbstract PS-119 Table 1 Group Patient’s number Intracranial bleeding No intracranial bleeding Mean dose of administered rt-PA (mg) Anticoagulants users* (A) 40 8 (20%) 32 66.83 Antiplatelet drugs users (B) 32 3 (9.4%) 29 66.59 No previous therapy (C) 298 43 (14.4%) 255 62.87 * The INR (International Normalised Ratio) value before thrombolysis was below 1.7. Comparing groups A and C: ORanticoagulants = 1.48; 95% CI = 0.64–3.43; p = 0.358 and RRanticoagulants = 1.386; 95% CI = 0.70–2.73; p = 0.346 are in the group which was pre-treated with anticoagulants. Among antiplatelet drugs users (B versus C) ORantiplatelet drugs = 0.61; 95% CI = 0.17–2.1; p = 0.437 and RRantiplatelet drugs = 0.649; 95% CI = 0.21–1.97; p = 0.447 were found. If those taking anticoagulants and antiplatelet drugs were compared (A vs. B) ORanticoagulants/antiplatelet drugs = 2.41; 95% CI = 0.58–9.98; p = 0.223 and RRanticoagulants/antiplatelet drugs = 2.13; 95% CI = 0.61–7.39; p = 0.232. Conclusion There was a non-significant trend that may suggest that antiplatelet therapy before stoke reduces the risk of intracranial bleeding, anticoagulant therapy increases it despite the acceptable INR level. Findings have to be confirmed on larger patient population. References and/or acknowledgements No conflict of interest.

Links between oral health and personality at a law enforcement school

One of the territories of dental psychosomatics is the link between personality characterisctics and dental status. The aim of the present study was to survey the relationship between temperament and character factors and dental status in police students. It can be hypothesized, that some temperament factors can increase the risk for dental health problems. After dental screening 792 police students completed the Temperament and Character Inventory (TCI) devised by Cloninger. 57.5% of students rated their own teeth as being in good or very good condition, and only 2.8% as bad condition. In persons rating their dental status as “good”, the average DMFT was 9.23±5.01 (mean±S.D.). In students assessing their own oral health as bad, TCI results showed that a higher percentage of students displayed extravagance, impulsiveness, disorderliness than the overall population. Among the students with good self-assessment but bad teeth, there was a higher percentage of students displaying passivity, low assertiveness, and introversion. The temperament and character factors may have negative consequences for students in an institution which exposes them to high stress level. It may be useful to screen these students using subjective health questionnaires in order to permit more effective efforts to positive health behaviour.