Silvana Jukić Krmek

Prevalence of apical periodontitis and quality of root canal fillings in population of Zagreb, Croatia: a cross-sectional study.

Aim To determine the prevalence of apical periodontitis and assess the quality of endodontic fillings in the population of the city of Zagreb, Croatia. Methods A total of 1462 orthopantomograms from new patients at 6 different dental practices was analyzed during 2006 and 2007. The presence of periapical lesions was determined by using the periapical index score (PAI). The quality of endodontic fillings was assessed according to the filling length and homogeinicity. Data were analyzed using t test and ANOVA with Scheffe post-hoc test. Results There were 75.9% of participants with endodontically treated teeth and 8.5% of all teeth were endodontically treated. Only 34.2% of endodontically treated roots had adequate root canal filling length, while 36.2% of root canal fillings had homogenous appearance. From the total number of teeth with intracanal post, 17.5% had no visible root canal filling. Using PAI 3 as a threshold value for apical periodontitis, periapical lesions were detected in 8.5% of teeth. Adequate quality of root canal fillings was associated with a lower prevalence of periapical lesions. Conclusion We found a large proportion of endodontically treated teeth with apical periodontitis and a correlation between the quality of endodontic filling and the prevalence of periapical lesions. This all suggests that it is necessary to improve the quality of endodontic treatment in order to reduce the incidence and prevalence of apical periodontitis.

Ablative potential of the erbium-doped yttrium aluminium garnet laser and conventional handpieces: a comparative study.

OBJECTIVES To compare the ability of the Variable Square Pulse technology (VSP-technology)-based erbium-doped yttrium aluminium garnet (Er:YAG) laser working in maximum speed (MAX) mode (1000 mJ, 300 micros, 20 Hz) and the high-speed handpiece to ablate enamel, to compare the ability of for the VSP-technology-based Er:YAG laser working in MAX mode and the low-speed handpiece to ablate dentin, and to analyze in vitro effects of Er:YAG ablation of enamel and dentine surfaces using scanning electron microscopy (SEM). BACKGROUND DATA A VSP-technology-based Er:YAG laser operating in MAX mode should be appropriate for achieving the maximum ablating speed in hard dental tissues. MATERIALS AND METHODS The experiment was conducted on extracted, cleaned, sterilized human molar teeth. Cavity preparations were made in hard dental tissues using the VSP-technology Er:YAG laser in MAX mode, in enamel using the high-speed handpiece, and in dentin using the low-speed handpiece at different time intervals. A laser triangulation profilometer was used to determine cavity volumes. The cavity surfaces of five specimens were examined using SEM. RESULTS The Er:YAG laser removed a volume of enamel that was 3.3 times as large as that removed by the high-speed handpiece in the same period of time. In dentin, the Er:YAG laser removed 8 to 18 times as much volume as the steel bur in the same period of time. The Er:YAG ablation rate in dentin was faster than in enamel. SEM of laser prepared cavities showed a well-defined surface, free of the smear layer. CONCLUSIONS The VSP-technology-based Er:YAG laser, working in MAX mode, is more efficient than mechanical drills for enamel and dentin ablation.

The Temperature Changes in the Pulp Chamber During Cavity Preparation with the Er:YAG Laser Using a Very Short Pulse

OBJECTIVE The aim of this study was to examine the temperature changes in the pulp chamber during cavity preparation with the Er:YAG laser (2940 nm) with a very short pulse (VSP). MATERIALS AND METHODS Nine groups of 10 intact molars each were used. One root of each sample was amputated and a thermocouple was inserted into the chamber. Class V cavity preparation in enamel was performed, and then preparation was performed in dentine. The enamel was lased with 400, 360, and 320 mJ in contact mode using a VSP with a duration of 100 microsec. The diameter of the fiber tip was 950 microm. Frequencies of 10, 12, and 15 Hz were used, and the total time of irradiation was 10 sec. The dentine was irradiated with 340, 280, and 200 mJ at 10, 8, and 5 Hz for 7 sec. Cooling was done with a water spray (73 psi and 50 mL/min). The differences were tested by MANOVA and the Bonferroni post hoc test. RESULTS The highest rise in temperature in the pulp was achieved after enamel irradiation with 400 mJ and 15 Hz (1.99 +/- 0.28 degrees C), and the lowest was after irradiation with 320 mJ and 10 Hz (0.70 +/- 0.18 degrees C). In dentine the highest temperature increase was achieved with 340 mJ and 10 Hz (1.37 +/- 0.42 degrees C), and the lowest was with 200 mJ and 5 Hz (0.43 +/- 0.18 degrees C). Two-way analysis of both enamel and dentine showed that the influence of energy on temperature increase was stronger than that of frequency. CONCLUSION Cavity preparation with an Er:YAG laser using VSP mode in vitro did not cause significant increases in temperature in the pulp chamber of human molars.

Caries prevalence and periodontal status in 18th century population of Požega-Croatia

OBJECTIVE The aim was to examine dental and periodontal status of adult Croatian 18th century population and compare the results with available literature data. MATERIALS AND METHODS 104 specimens from the crypt of Požega cathedral were grouped into three female and three male groups according to age. Caries was determined by visual inspection and dental probe. Ante and post mortem teeth losses were recorded. Periodontal status was determined according to the length of exposed tooth root from alveolar crest to cemento-enamel junction. The presence of dehiscences and fenestrations was recorded on facial and oral plate of alveolar bone. RESULTS The whole sample exhibited ante- and post mortem teeth loss of 19.57% and 24.91%, respectively. The teeth most frequently lost postmortem were incisors. The canines were best preserved. The frequency of caries in both jaws was the highest in molars (26.63% in maxilla and 28.10% in mandible), whilst central incisors exhibited the least carious lesions (11.59 and 1.92%). The most frequently affected surfaces were occlusal, then proximal and facio-oral. The percentage of teeth with either moderate or considerable bone loss was higher in females. The frequency of considerable bone loss increased significantly with age. The frequency of dehiscences was 3.11%. It was higher in maxilla than in the mandible. The frequency of fenestrations was 5.65% and it was significantly higher in maxilla. CONCLUSIONS The results demonstrate poor oral health amongst 18th century population of continental Croatia, exhibiting high antemortem teeth loss, high periodontal disease frequency and occlusal and proximal caries frequency.

Proteomics profiling of keratocystic odontogenic tumours reveals AIDA as novel biomarker candidate

BACKGROUND Keratocystic odontogenic tumour (KCOT) is a benign, yet aggressive odontogenic tumour. Herein, proteome analysis of KCOT lesions in comparison with control patient-matched tissue unaffected by the disease and with inflammatory odontogenic cysts, namely radicular cysts is presented. METHODS For the proteomics profiling, two complementary proteomics techniques MALDI-MS/MS and LC-ESI-MS/MS were employed. Potential candidate biomarkers were validated by immunohistochemistry. RESULTS More than 43 proteins were found to be differentially expressed or up-regulated in KCOT lesions in comparison with patient-matched unaffected oral mucosa. These proteins bear important biological functions and are involved in cell proliferation, cytoskeletal re-organization, transcription, cellular motility and apoptosis. In particular, a number of differentially expressed proteins participate in autocrine regulation and signalization within JNK and p38 MAPK signalling pathways. CONCLUSIONS Immunohistochemical validation of chosen putative biomarkers revealed axin interaction partner and dorsalization-antagonist (AIDA), known as a protein that blocks activation of JNK signalling pathway, as a differential biomarker for KCOT lesions on an independent cohort of KCOT tissue samples in comparison with most prevalent intra-oseal lesions inflammatory odontogenic cysts.

The Oral Status of Adult Population in the Croatian Town of Knin: a Cross Sectional Study

THE AIM Epidemiologic studies in many countries show uneven distribution of oral diseases (primarily caries) within the population. This is why more studies are oriented towards specific regions or subpopulations instead of large scale national surveys. The major purpose of this cross sectional study was to obtain relevant data about the oral status of the population of Knin and its surroundings according to the WHO criteria. SUBJECTS AND METHODS The study included 414 participants aged between 18 and 65. The recorded variables included general anamnestic data, extraoral status, oral mucosa status, temporomandibular joint status, dental, periodontal and prosthetic status, and the need for dental restoration. The comparison between different groups regarding age, gender, educational level and origin was made. RESULTS DMFT index was 17.3 - with on average 1.7 caries, 6.2 fillings, and 9.4 teeth extracted. SiC index equaled 26.4. The difference was significant regarding the level of education and age (p<0.001). The percentages of individuals with the highest CPI scores from 0-4 were 27.3, 16.9, 36.5, 16.4 and 2.9%, respectively. The difference between the age groups in CPI scores was statistically significant, while the differences according to the gender and origin were not significant (p=0.001). CONCLUSION The population of Knin and the surrounding area exhibited very bad oral status which can be attributed to the consequences of the war in the 1990-ies, the economic transition, and the lack of national program for oral health promotion.

In vitro assessment of the accuracy of three electronic apex locators

Aim of this in vitro study was to compare accuracy of three electronic apex locators (EALs) (ES-02, ES-03 and ProPex) in root canals of extracted human teeth utilizing two meter readings and different conditions of root canals (RC). RC lengths of 46 single-rooted teeth were visually determined using a K-file # 15. Teeth and labial connector were then embedded in alginate. Two sets of measurements were performed for each device - root canal condition combination (dry root canal, 2.5% NaOCl, 17% EDTA, RC prep, Glyde) according to readings “-0.5” and “0.0”. The differences were evaluated using descriptive and nonparametric statistics. The mean difference between real and measured values at meter reading “0.0” was 0.10 mm with ProPex, 0.31 mm with ES-02 and 0.71 mm with ES-03. At meter reading “-0.5“ that difference was 0.28 mm with ProPex, 0.41 mm with ES-02 and 0.87 mm with ES-03. In vitro testing showed ProPex to be the most accurate EAL in most of combinations, followed by ES-02, and ES-03 (p<0.05). Most accurate measurements were performed in canal conditions as follows: dry canals, Glyde, Rc-Prep, NaOCl and EDTA solutions (p<0.05). ProPex was the most accurate at meter reading “0.0”. At reading “-0.5” ES-02 and ProPex were equal, whereas ES-03 was the least accurate. All tested EALs should be used with meter reading “0.0” as a reference because it is more accurate than using the meter reading “-0.5” (p<0.001).