Znanstvene novosti u stomatologiji News in Dental Sciences

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Znanstvene novosti u stomatologiji
News in Dental Sciences
Restaurativna dentalna medicina
Restorative dental medicine
Usporedba snage svezivanja dentinskih adheziva 5. 6. i 7. generacije
na koronarni dentin i dno pulpne komore pokazala je kako osim sastava
dentinskog adheziva i supstrat vezanja ima važnu ulogu. Adhezija je kod
svih sustava bila jača na koronarni dentin nego na dno pulpne komore. Također, „sve u jednom“ sustav imao je najmanju snagu veze i na koronarni
dentin i na dno pulpne komore (1).
U usporedbi dva caklinsko – dentinska adhezijska sustava s antibakterijskim djelovanjem korištenjem metode s agar gelom i metode modela
zuba, Clearfil protect bond je pokazao antibakterijsko djelovanje međutim
ono je izostalo kod Prime & bond NT adheziva. Također se pokazalo kako je model zuba također prikladna metoda u istraživanju antibakterijske
aktivnosti materijala (2).
Staklo temeljeno na cink-boron-germaniju pokazalo je povoljan učinak na fizikalno-kemijska svojstva nekonvencionalnih staklenoionomernih
cementa. Ovakvi bi cementi mogli pronaći svoje mjesto i izvan stomatoloških indikacija, posebno u domeni ortopedije i maksilofacijalne kirurgije (3).
Kod tretmana intrakanalnih kolčića vodikovim peroksidom prije cementiranja postoji opasnost od negativnog djelovanja kisikovih radikala
na polimerizaciju kompozitnog cementa. Međutim, pokazalo sa kako ovaj
postupak, uz uporabu odgovarajućih antioksidansa, kod konvencionalnih
kompozitnih cementa može povećati snagu veze (4).
U pregledu literature o utjecaju hemostatskih sredstava na snagu svezivanja caklinsko- dentinskih adhezijskih sustava pokazalo se kako imaju negativan utjecaj zbog mijenjanja površine tvrdih zubnih tkiva (dentin). Pri
tome su samojetkajući sustavi bili osjetljiviji od jetkajuće-ispirućih. Uporaba EDTA kroz 60 sekundi ili jetkanje kaviteta ortofosfornom kiselinom
kroz 15 sekundi te ispiranje poništavali su djelovanje hemostatika. Zbog različite metodologije nisu bile moguće izravne usporedbe studija (5).
Kompoziti punjeni s mezoporoznim nanočesticama silike obogaćene klorheksidinom pokazali su dugotrajnu i kontinuiranu antibakterijsku
aktivnost protiv S. Mutansa i L. Casei. Pri tome nije došlo do degradacije
mehaničkih svojstava kompozitnog materijala uz očuvanje glatkoće i sjaja
površine. Za razliku od toga, kompoziti s izravno umiješanim klorheksidinom su pokazali neravnomjerno otpuštanje klorheksidina uz degrtadaciju
površine i mehaničkih svojstava (6).
U istraživanju otpuštanja fluora iz staklenih ionomera nakon tretmana natrij fluoridnim ili zakiseljenim fosfat- fluoridnim gelom pokazalo se
kako konvencionalni visoko-viskozni stakleni ionomeri otpuštaju značajno više fluorida nakon tretmana. Također, tretman kiselim gelom fosfatfluorida doveo je do većeg posljedičnog otpuštanja fluorida (7).
U istraživanu remineralizacije dentina, kalcij silikatni cement pokazao se boljim od konvencionalnog staklenog ionomera. U detekciji stupnja remineralizacije koristilo se tetraciklinsko obilježavanja uz fluorescentnu mikroskopiju (8).
U istraživanju učinka visoke koncentracija sredstva (35% vodikov peroksid) za izbjeljivanje na mikropunjene, mikrohibridne i nanohibridne
kompozitne materijale pokazalo se kako izbjeljivanje ozbiljno povećava
hrapavost površine materijala sve tri skupine materijala (9).
Pokazalo se kako kompozitni ispuni s primjenom tekućeg kompozita
kao prvog sloja nisu imali prednosti pred kompozitnim ispunima bez laminiranja tekućim kompozitnim materijalom. Međutim, potrebno je provesti dodatne studije kod sendvič tehnike s korištenjem staklenog ionomera (10).
Comparison of 5th, 6 th and 7 th generation of dental adhesives’ bonding strength to the coronary dentine and pulp chamber floor demonstrated that beside the composition of the dental adhesive a substrate properties
also play important role in bonding strength. Adhesion was stronger to the
coronal dentine than on the pulp floor in all adhesive groups. Also, “all in
one” 7 th generation system yielded lowest bonding strength on both, coronal and pulpal floor dentine (1).
Comparison of the antibacterial activity of two dental adhesives
showed that Clearfil protect bond had a significant antibacterial activity
while Prime&bond NT had a low level of antibacterial activity. It was also
demonstrated that the tooth cavity model can be used as a valid method
for the antibacterial activity of dental materials (2).
Zinc - boron - germanium based glass positively influenced physical
and chemical properties of unconventional glass ionomer cements. These
modified cements may be used in non - dental applications, i.e. maxillofacial surgery or orthopaedic surgery domains owing to their properties (3).
Intracanal fiberglass post treatment using a hydrogen peroxide may
lead to a problematic polymerization of the resin cements. However, it
was demonstrated that this procedure together with usage of antioxidants
may actually lead to the increased bonding strength if conventional resin
cements are used (4).
Systematic review on haemostatic agents’ influence on the bonding
strength revealed they lower bonding strength due to dental tissue surface
modification (dentine especially). Self etch adhesives were more affected
than etch and rinse systems. Cavity treatment with 17% EDTA during 60
seconds or etching a cavity during 15 seconds with water spray rinsing reversed this negative effect. Comparison between studies was difficult due
to differences in the study designs (5).
Composites filled with mesoporous silica nanofiller enriched with
chlorhexidine demonstrated prolonged and continuous antibacterial activity against S. Mutans and L. Casei without change in mechanical properties and absence of surface degradation and gloss. However, composites
with directly mixed chlorhexidine showed imbalanced release of chlorhexidine with surface gloss and mechanical properties degradation, which is
yet another example of succesfully integrating nanotechnology into dental composites (6).
Research on fluoride release from glass ionomer cements treated with
sodium fluoride gel or acidulated phosphate fluoride gel revealed that
highly viscous glass ionomers released higher amounts of fluorides after
the treatment. Also, acidulated phosphate fluoride gel caused larger increase in the release of fluoride ions (7).
Calcium silicate cement was found superior to the conventional glass
ionomer in the remineralization of the dentine in vitro. Tetracycline markers with fluorescent microscopy was used in the study (8).
High concentration bleaching gel (35% hydrogen peroxide) was demonstrated to cause serious increase in the surface roughness of microfilled,
microhybrid and nanohybrid composite materials in vitro (9).
Composite fillings with flowable composite demonstrated no advantages when compared to fillings without flowable liner. However, a long
term studies are necessary when glass ionomer - composite lamination
technique is considered (10).
www.ascro.hr
Literatura
1. Deepa VL, Damaraju B, Priyadharsini BI, Subbarao
VV, Raju KR. Comparative Evaluation of Microshear Bond Strength of 5(th), 6(th) and 7(th) Generation Bonding Agents to Coronal Dentin Versus Dentin at Floor of Pulp Chamber: An In vitro
Study. J Int Oral Health. 2014 Sep;6(5):72-6.
PubMed PMID: 25395797; PubMed Central PMCID: PMC4229834.
2.Deshpande P, Nainan MT, Metta KK, Shivanna
V, Ravi R, Prashanth BR. The Comparative Evaluation of Antibacterial Activity of Methacryloxydodecyl Pyridinium Bromide and Non-methacry-
loxydodecyl Pyridinium Bromide Dentin Bonding
Systems Using Two Different Techniques: An In vitro Study. J Int Oral Health. 2014 Sep;6(5):60-5.
PubMed PMID: 25395795; PubMed Central PMCID: PMC4229832.
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ic agents on dentin and enamel surfaces and dental bonding: A systematic review. J Am Dent Assoc. 2014 Nov;145(11):1120-8. doi:10.14219/
jada.2014.84. PubMed PMID: 25359643.
6. Zhang JF, Wu R, Fan Y, Liao S, Wang Y,
Wen ZT, Xu X. Antibacterial dental composites with chlorhexidine and mesoporous silica. J Dent Res. 2014 Dec;93(12):1283-9.
doi:10.1177/0022034514555143. Epub 2014 Oct
15. PubMed PMID: 25319365.
7.Ghajari MF, Torabzadeh H, Safavi N, Sohrabi A, Ardakani FF. Fluoride release from three
glass ionomers after exposure to sodium fluoride
and acidulated phosphate fluoride gels. Dent Res
J (Isfahan). 2014 Sep;11(5):604-609. PubMed
PMID: 25426154; PubMed Central PMCID:
PMC4241616.
8.Atmeh AR, Chong EZ, Richard G, Boyde A, Festy F, Watson TF. Calcium silicate cement-induced
remineralisation of totally demineralised dentine in
comparison with glass ionomer cement: tetracycline
labelling and two-photon fluorescence microscopy.
J Microsc. 2014 Nov 24. doi: 10.1111/jmi.12197.
[Epub ahead of print] PubMed PMID: 25421432.
9.Moro AF, Prado M, Simao RA, Dias KR. Surface roughness of different composite resins subject to in-office bleaching. Gen Dent. 2014 NovDec;62(6):e20-3. PubMed PMID: 25369396.
10.Nguyen K, Sathorn C, Wong R, Burrow M. Clinical performance of laminate and non-laminate resin composite restorations: a systematic review. Aust
Dent J. 2014 Nov 17. doi: 10.1111/adj.12252.
[Epub ahead of print] PubMed PMID: 25404178.
Endodoncija
Endodontics
Terapijski potpomognuto održanje vitaliteta zubne pulpe predstavlja
ultrakonzervativnu metodu endodontskog liječenja. U studiji koja je obuhvatila ovakvo liječenje kod 94 zuba zahvaćena ireverzibilnim pulpitisom
izvedeni su zahvati indirektnog prekrivanja pulpe, direktnog prekrivanja
pulpe, minimalne pulpotomije i koronarne/potpune pulpotomije uz korištenje cementa obogaćenog kalcijem. Samo je 1 zub iz skupine gdje je provedeno direktno prekrivanje pulpe pokazao klinički/radiološki neuspjeh (1).
U studiji učinkovitosti bijelog i sivog mineral trioksid agregata (MTA)
te bijelog i sivog portland cementa u direktnom prekrivanju pulpe kod pasa pokazalo se kako su se svi materijali pokazali prikladnima u ovoj indikaciji. Iako nije bilo statistički značajne razlike među navedenim materijala,
najizraženije upalne promjene uz pojačanu vaskularizaciju i smanjeno odlaganje veziva primjećeni su kod bijelog MTA (2).
In vitro studija brtvljenja endodontskih cementa pokazala je veće curenje kod cementa temeljenog na MTA (Fillapex) nego kod cementa temeljenog na epoksidnoj smoli (AH 26), pri čemu su uzorci oba cementa
pokazali i statistički značajnu razliku u odnosu na kontrolnu skupinu (3).
Mjerenje količine bakterijske DNA u perikardijalnoj tekućini pri obdukcijama (n=22) pokazala je kako ozbiljnost koronarne arterijske bolesti
izravno korelira s količinom bakterijske DNA. Identificirani su endodontski i parodontološki patogeni. Pri tome ovakvi rezultati govore u prilog
i mogućnosti kliničke primjene testa na oralne (endodontske i parodontološke) patogene u procjeni ozbiljnosti koronarne arterijske bolesti (4).
Usporedba učinkovitosti reciprocirajućih sustava Wave One i ReciProc u reviziji endodontskog punjenja s rotirajućim sustavom ProTaper
Universal pokazala je kako nema razlike među njima u učinkovitosti smanjenja količine endodtoksina i bakterijskog optertećenja, čime je odabir
sustava pitanje izbora kliničara (5).
U studiji ekstruzije detritusa i irigacijske tekućine tijekom strojne
obrade korijenskog kanala pomoću Reciproc, OneShape i ProTaper sustava pokazalo se kako Reciproc dovodi do najviše a OneShape do najmanje ekstruzije detritusa, dok je ProTaper uzrokovao najmanje ekstruzije irigansa (6).
Dodavanje fentanila otopini lidokain-adrenalina nije pokazalo prednosti pred anestezijom samo s lidokain-adrenalinom kod ireverzibilnog
pulpitisa maksilarnih zubi. Trajanje i intenzitet infiltracijske anestezije nisu se statistički značajno razlikovali između ove dvije skupine (7).
Simulacija apikalne resorpcije tijekom ortodontske terapije nije negativno djelovala na točnost određivanja radne duljine korištenjem apeks
lokatora Apit i Root ZX. Nije bilo statistižki značajne razlike niti između apeks lokatora niti između zubi sa ili bez simulirane resorpcije apikalnog područja (8).
Studija utjecaja različitih otopina na ciklički zamor reciprocirajućih i
rotirajućih endodontskih instrumenata pokazala je kako uranjanje u natrijev hipoklorit nema utjecaja. Međutim, trominutno uranjanje u 17%tnu
otopinu EDTA imalo je pozitivan utjecaj na otpornost instrumenata cikličkom zamoru. Prisutnost surfaktanata nije imalo utjecaja osim ukoliko
se radilo o dodavanju NaOCl otopini i Reciproc sustavu (9).
Sustavna analiza protokola pri regenerativnoj endodontskoj terapiji
pokazala je visoku varijabilnost i razlike u pojedinim protokolima, pri čemu
se radi nemogućnosti klasifikacije otežava i njihova klinička primjena (10).
Pulp vitality preservation therapy represents an ultra-conservative
endodontic treatment approach. In a study with 94 teeth with irreversible pulpitis a minimal intervention endodontic treatment was performed
(direct pulp capping, indirect pulp capping, minimal pulpectomy or coronal pulpectomy) and a calcium enriched cement was used. Only one tooth
showed clinical/radiological failure during the recall period (1).
Study on white and grey mineral trioxide aggregate (MTA) and white
and grey Portland cement direct pulp capping efficacy revealed no significant differences between materials. However, majority of inflammatory
changes, increased vascularization and lowered connective tissue deposition was linked to the usage of the white MTA (2).
In vitro study of endodontic sealers revealed increased bacterial leakage in case of the MTA based sealer (Fillapex) when compared to an epoxy
resin cement (AH 26). Both cements showed increased bacterial leakage
when compared to a control (3).
Measurements on quantity of the bacterial DNA in the pericardial
fluid during an autopsy (n=22) revealed strong correlation between intensity of the coronary artery disease and quantity of bacterial DNA. Endodontic and periodontal pathogens were identified. These results indicate
a possibility of clinical usage of this type of test in order to asses the severity of coronary arterial disease (4).
Comparison of Wave One and Reciproc reciprocating systems with
rotary system Pro Taper universal revealed no differences in in endotoxin
quantity and bacterial load reduction (5).
Study on debris and irrigation fluid extrusion during Reciproc, OneShape and ProTaper system revealed that Reciproc extruded the most debris apically, while OneShape extruded the least amount of debris. However, ProTaper extruded the least quantity of irrigant (6).
Fentanyl addition to a lidocain-epinephrine aesthetic solution showed
no advantage when compared to lidocaine-epinephrine alone in anaesthesia of teeth with irreversible pulpitis maxilla. Namely, intensity and duration of the anaesthesia was comparable in both groups (7).
Results of the root canal length measurements obtained using Apit
and Root ZX endometers in vitro on teeth with simulated apical resorption due to orthodontic therapy were comparable to those obtained on
teeth without simulated resorption. These apex locators represent a valid
instrument even in case of apical resorptions (8).
Study on reciprocating or rotating nickel-titanium instrument immersion in different solutions on torsional fatigue resistance revealed that
3 minute immersion in 17% EDTA significantly increases torsional resistance of instruments. Surfactant addition had no effect except in case of
sodium hypochlorite and Reciproc system combination (9).
System review of regenerative endodontic therapy protocols revealed
high variability and differences between protocols, making their usage,
classification and clinical reproducibility difficult (10).
Jurica Matijević
[email protected]
www.ascro.hr
3. Zhang X, Werner-Zwanziger U, Boyd D. Composition-structure-property relationships for non-classical ionomer cements formulated with zinc-boron
germanium-based glasses. J Biomater Appl. 2014
Nov 12. pii: 0885328214557906. [Epub ahead of
print] PubMed PMID: 25391445.
4.Khoroushi M, Mazaheri H, Tarighi P, Samimi P,
Khalighinejad N. Effect of antioxidants on pushout bond strength of hydrogen peroxide treated
glass fiber posts bonded with two types of resin cement. Restor Dent Endod. 2014 Nov;39(4):303-9.
doi:10.5395/rde.2014.39.4.303. Epub 2014 Sep 2.
PubMed PMID:25383350; PubMed Central PMCID: PMC4223101.
5.de Oliveira Bernades K, Hilgert LA, Ribeiro AP,
Garcia FC, Pereira PN. The influence of hemostat-
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Literatura
www.ascro.hr
1. Asgary S, Fazlyab M, Sabbagh S, Eghbal MJ. Outcomes of different vital pulp therapy techniques on
symptomatic permanent teeth: a case series. Iran
Endod J. 2014 Fall;9(4):295-300. Epub 2014 Oct
7. PubMed PMID: 25386213; PubMed Central
PMCID: PMC4224770.
2.Bidar M, Naghavi N, Mohtasham N, Sheik-Nezami M, Fallahrastegar A, Afkhami F, Attaran Mashhadi N, Nargesi I. Mineral trioxide aggregate and
portland cement for direct pulp capping in dog:
a histopathological evaluation. J Dent Res Dent
Clin Dent Prospects. 2014 Summer;8(3):134-40.
doi: 10.5681/joddd.2014.025. Epub 2014 Sep 17.
PubMed PMID: 25346831; PubMed Central PMCID: PMC4206754.
3.Razavian H, Barekatain B, Shadmehr E, Khatami
M, Bagheri F, Heidari F. Bacterial leakage in root
canals filled with resin-based and mineral trioxide
aggregate-based sealers. Dent Res J (Isfahan). 2014
Sep;11(5):599-603. PubMed PMID: 25426153;
PubMed Central PMCID: PMC4241615.
4.Louhelainen AM, Aho J, Tuomisto S, Aittonie-
mi J, Vuento R, Karhunen PJ, Pessi T. Oral bacterial DNA findings in pericardial fluid. J Oral Microbiol. 2014 Nov 19;6:25835. doi: 10.3402/jom.
v6.25835. eCollection 2014. PubMed PMID:
25412607.
5.Martinho FC, Freitas LF, Nascimento GG, Fernandes AM, Leite FR, Gomes AP, Camões IC. Endodontic retreatment: clinical comparison of reciprocating systems versus rotary system in disinfecting
root canals. Clin Oral Investig. 2014 Nov 21.
[Epub ahead of print] PubMed PMID: 25411081.
6. Küçükyilmaz E, Savas S, Saygili G, Uysal B. Assessment of apically extruded debris and irrigant produced by different nickel-titanium instrument systems. Braz Oral Res. 2014;29(1):1-6. Epub 2014
Nov 11. PubMed PMID: 25387860.
7. Mehrvarzfar P, Pourhashemi A, Khodaei F, Bohlouli B, Sarkarat F, KalantarMotamedi M, Layegh Nejad MK, Zamaheni S. The effect of adding fentanyl to epinephrine-containing lidocaine on
the anesthesia of maxillary teeth with irreversible pulpitis: a randomized clinical trial. Iran En-
dod J. 2014 Fall;9(4):290-4. Epub 2014 Oct 7.
PubMed PMID: 25386212; PubMed Central
PMCID:PMC4224769.
8.Angerame D, De Biasi M, Marigo L, Castagnola R, Somma F, Castaldo A. Influence of simulated apical resorption following orthodontic treatment on working length determination: an in vitro
study. Eur J Paediatr Dent. 2014 Sep;15(3):288-92.
PubMed PMID: 25306146.
9.Pedullà E, Franciosi G, Ounsi HF, Tricarico M,
Rapisarda E, Grandini S. Cyclic fatigue resistance
of nickel-titanium instruments after immersion
in irrigant solutions with or without surfactants. J
Endod. 2014 Aug;40(8):1245-9. doi: 10.1016/j.
joen.2014.02.005. Epub 2014 Mar 28. PubMed
PMID: 25069942.
10.Kontakiotis EG, Filippatos CG, Tzanetakis GN,
Agrafioti A. RegenerativeEndodontic Therapy: A Data Analysis of Clinical Protocols. J Endod. 2014 Oct 7.pii: S0099-2399(14)00785-7.
doi: 10.1016/j.joen.2014.08.003. [Epub ahead ofprint] Review. PubMed PMID: 25301351.
Protetika
Prosthodontics
Shahmiri i sur. pomoću metode konačnih elemenata pokazali su da
distalni položaj opterećenja batrljka (naspram mezijalnog) poboljšava distribuciju opterećanja unutar metalnog skeleta i akrilata kod proteze poduprte implantatima (1).
De Oliveira Junior i sur. proučavali su utjecaj dva ljepila na žvačnu
efikasnost kod nosioca potpunih proteza. Korištenje ljepila je poboljšalo
žvačnu efikasnost, te nije pronađena razlika između vrsta korištenih ljepila (2).
Poznata je važnost mjesta zubnog dodira i nagiba zubnih kvržica na
raspodjelu stresa unutar zuba. Liu i sur. pomoću metode konačnih elelmenata utvrdili su na gornjim pretkutnjacima s preostalom vestibularnom
stijenkom dentina veći lokalni stres na korijenu zuba. Promjena mjesta
zubnog dodira i smanjivanje inklinacije vestibularne kvržice može smanjiti
lokalni stres unutar zuba (3).
Melis i Di Giosia proučavali su utjecaj genetike na etiologiju temporomandibularnih poremećaja. Mnogi polimorfizmi gena pokazali su se povezanim s višim ili nižim rizikom temporomandibularnih poremećaja (4).
Bruksizam i opstruktivna apneja kod spavanja se često mogu vidjeti
kod djece. Ferreira i sur. su pokazali povezanost bruksizma i opstruktivne
apneje kod spavanja kod djece (5).
Torabi i sur. proučavali su kondilne inklinacije pomoću Cadiax Compact II sustava i intraoralnim registratima. Sve proučavane mjere su pokazale statistički značajnu razliku između Cadiax Compact II i intraoralnih
registrata (6).
Maryod i sur. istraživali su imedijatno i rano opterećenje mini implantata kod pokrovnih proteza. I imedijatno i rano opterećenje su pokazali zadovoljavajuće rezultate. Ipak, rano opterećenje mini implantata se preferira kod pokrovne proteze na mini implantatima (7).
Mehanička svojstva akrilata za proteze mogu se mjenjati pod utjecajem raznih pića i vodica za ispiranje usta. U istraživanju Goiatoa i sur. Coca Cola i vino su najviše utjecali na smanjivanje tvrdoće akrilata (8).
Sripetchdanond i Leevailoj proučavali su trošenje zubne cakline na
monolitni cirkonij, staklo keramiku i kompozit. Monolitni cirkonij i kompozit su rezultirali manjim trošenjem zubne cakline u odnosu na staklo keramiku (9).
Pregledom literature, Afrashtehfar i Qadeer zaključili su da kompjutorska analiza okluzije predstavlja bolju opciju u odnosu na druge, nedigitalne načine analize okluzije (10).
Shahmiri et al found that moving the position of the occlusal rest
from the mesial to distal side of the abutment teeth improved the stress
distribution in the metal framework and acrylic resin denture base structures (1).
De Oliveira Junior et al. studied masticatory performance of complete denture wearers after using two adhesives. The use of denture adhesive improved the masticatory performance of conventional complete denture wearers, and there was no difference between different adhesives (2).
Site of occlusal contact and cusp inclination affect stress distribution.
Liu et al. used the finite elements analysis to demonstrate that maxillary
premolars with only facial dentin remaining show higher local stress on
root dentin. Altering the load position and reducing the facial cusp inclination can reduce local stresses (3).
Melis and Di Giosia studied the role of genetic factors in the etiology
of temporomandibular disorders. Many gene polymorphisms were shown
to be associated with a higher or lower risk of temporomandibular dysfunction (4).
Sleep bruxism and obstructive sleep apnea syndrome are often observed in children. Ferreira et al. showed that sleep bruxism is associated
with obstructive sleep apnea syndrome (5).
Torabi et al. investigated condylar inclinations using Cadiax Compact II and intraoral registrations. The results showed that the differences between Cadiax and intraoral records were statistically significant for all
measurements (6).
Maryod et al. investigated immediate versus early loading of miniimplants supporting mandibular overdentures. immediate and early loading protocols showed good clinical results. Early loading of mini-implants
supporting a mandibular overdenture appears to be preferable to immediate loading (7).
The mechanical properties of acrylic resins used in intraoral prostheses
may be altered by exposure to beverages and mouthwashes. Goiato et al.
showed that acrylic specimens immersed in cola or wine experienced the
greatest decrease in microhardness (8).
Sripetchdanond and Leevailoj investigated wear of human enamel opposing monolithic zirconia, glass ceramic, and composite resin. Monolithic zirconia and composite resin resulted in less wear depth to human
enamel compared with glass ceramic and enamel (9).
Afrashtehfar and Qadeer showed in the sistematic review that computerized occlusal analysis is better occlusal indicator when compared with
other non-digital convention indicators (10).
Literatura
1.Shahmiri R, Das R, Aarts JM, Bennani V. Finite
element analysis of an implant-assisted removable
partial denture during bilateral loading: Occlusal
rests position. J Prosthet Dent 2014 [Epub ahead of
print].
2. de Oliveira Junior NM, Rodriguez LS, Mendoza
Marin DO, Paleari AG, Pero AC, Compagnoni MA.
Masticatory performance of complete denture wearers after using two adhesives: A crossover randomized
clinical trial. J Prosthet Dent [Epub ahead of print].
3. Liu S, Liu Y, Xu J, Rong Q, Pan S. Influence of occlusal contact and cusp inclination on the biomechanical character of a maxillary premolar: A finite
element analysis. J Prosthet Dent [Epub ahead of
print].
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4. Melis M, Giosia MD. The role of genetic factors in
the etiology of temporomandibular disorders: a review. Cranio 2014 [Epub ahead of print].
5.Ferreira NM, Dos Santos JF, Dos Santos MB,
Marchini L. Sleep bruxism associated with obstructive sleep apnea syndrome in children. Cranio 2014
[Epub ahead of print].
6.Torabi K, Pour SR, Ahangari AH, Ghodsi S. A
Clinical Comparative Study of Cadiax Compact II
and Intraoral Records Using Wax and Addition Silicone. Int J Prosthodont 2014;27:541-543.
7. Maryod WH, Ali SM, Shawky AF. Immediate versus early loading of mini-implants supporting mandibular overdentures: a preliminary 3-year clinical
outcome report. Int J Prosthodont 2014;27:553560.
8. Goiato MC, Dos Santos DM, Andreotti AM, Nobrega AS, Moreno A, Haddad MF et al. Effect of
beverages and mouthwashes on the hardness of
polymers used in intraoral prostheses. J Prosthodont 2014;23:559-564.
9.Sripetchdanond J, Leevailoj C. Wear of human
enamel opposing monolithic zirconia, glass ceramic, and composite resin: An in vitro study. J Prosthet
Dent [Epub ahead of print].
10.Afrashtehfar KI, Qadeer S. Computerized occlusal
analysis as an alternative occlusal indicator. Cranio
2014. [Epub ahead of print].
Dr.sc. Samir Čimić
Dječja i preventivna dentalna medicina
Paediatric and preventive dentistry
1. Prihvaćanje pečaćenja fisura iz perspektive djeteta
Cilj je bio tražiti dječje mišljenje o prihvatljivosti pečaćenja fisura
kompozitnom smolom. Procjena usluga pomoću upitnika usmjerenog
djetetu, izdanog potencijalnom uzorku od dolazećih bolničkih pacijenata.
Upitnici su izdani djeci, u dobi od 3-16 godina, odmah nakon pečaćenja
fisura smolom u Zavodu za Dječju stomatologiju u Sheffieldu. Sudionici
su koristili trodjelnu ljestvicu lica za pozitivne, neutralne i negativne odgovore, uređenu po Likertovoj ljestvici s minimalnim tekstom, kako bi ocijenili svoje liječenje i zadovoljstvo posjete stomatologu. Rezultati su pokazali
da se ispunilo dvjesto upitnika. Sveukupno, 96% (n = 191) bilježi pozitivan ili neutralan odgovor za jednostavnost koju je nosio postupak, kod većine djece s pozitivnim stavom o ponavljanju pečaćenja fisura (66%; n =
132). Daljnja analiza pokazala je da djeca koja su prethodno pečatili fisure, lakše to prihvaćaju nego oni koji ih pečate po prvi put (p <0,05, hi-kvadrat test). Gotovo polovica svih sudionika je neodlučna o ukusu i osjećaju
(46%; n = 92 i 55%; n = 110 respektivno). Velika većina djece bila je zadovoljna objašnjavanjem njihovih stomatologa. Zaključak je bio da je većini sudionika pečaćenje fisura prihvatljiv postupak, uz poboljšano prihvaćanje pacijenata s većim iskustvom (1).
1. Acceptability of fissure sealants from the child’s perspective Aim was to seek children’s opinions about the acceptability of resin
fissure sealant placement. Service evaluation using a child-centred questionnaire issued to a prospective sample of consecutive hospital patients.
Questionnaires were issued to children, aged 3 to 16 years, immediately after resin fissure sealant placement in the Paediatric Dentistry Department
in Sheffield. Participants used a three-point faces scale for positive, neutral and negative responses, arranged as a Likert scale with minimal text,
to rate their treatment experiences and satisfaction with the dental visit.
Results showed that two hundred questionnaires were returned. Overall,
96% (n = 191) recorded a positive or neutral response for the ease at which
they coped with the procedure, with most children positive about having
fissure sealants placed again (66%; n = 132). Further analysis demonstrated that children who had fissure sealants on a previous occasion found
them easier than those having them for the first time (p <0.05, chi-squared
test). Almost half of all participants where ambivalent about the taste and
feeling (46%; n = 92 and 55%; n = 110 respectively). The vast majority of
children were satisfied with the explanations provided by their operator.
Conclusion was that most participants found having resin fissure sealants
placed an overall acceptable procedure, with patient acceptance improving
with increased treatment experience (1).
3. Uspjeh punjenja korijenskih kanala ozoniranim uljem cink oksida u
mliječnim kutnjacima: Preliminarni rezultati
Cilj je bio procijeniti uspješnost mješavine ozoniziranog ulja i cinkovog oksida kao materijala za punjenje korijena mliječnih kutnjaka. U potencijalno randomiziranom kliničkom istraživanju je sudjelovalo 60 bolesnih mliječnih donjih kutnjaka koji su bili jednako podijeljeni u studijske
grupe (Ozonizirana ulja-ZnO) i kontrolnu skupinu (cink oksid-eugenol).
Postupak pulpotomije je proveden, a djeca su praćena u redovitim intervalima. Sva su djeca bila dostupna za ocjenjivanje na kraju 12 mjesečnog razdoblja. Zubi su procijenjena na uspjeh ili neuspjeh na temelju kliničkih i
radioloških kriterija od strane nasumičnog stomatologa. Razmjerne vrijednosti uspoređene su pomoću χ2 testa. Rezultati su bili da klinička i radi-
2. Biodentine™ material characteristics and clinical applications:
A review of the literature Biodentine™ is a new version of calcium silicate-based inorganic cement. The aim of this review is to provide a detailed analysis of the physical and biological properties of Biodentine™ and to compare these properties with those of other tricalcium silicate cements vs. mineral trioxide
aggregate (MTA) and Bioaggregate™ (Bioaggregate). A comprehensive systematic literature search for all publications to date was performed on 20th
November 2013 by two independent reviewers in Medline (PubMed),
Embase, Web of Science, CENTRAL (Cochrane), SIGLE, SciELO, Scopus, Lilacs and clinicaltrials.gov using the search terms Biodentine, “tricalcium silicate”, Ca3SiO5, “dentine substitute”, “dentin substitute” and
RD 94. In addition to the electronic search, hand searches and reference
searches were performed to include articles published in journals that were
not indexed in Medline. Randomised control trials (RCT), case control
studies, case series, case reports, in vitro studies, animal studies and short
communications in English language were considered for this review.
Conclusion was that considering the superior physical and biologic properties, Biodentine™ could be an efficient alternative to MTA to be used in
a variety of clinical applications. There appears to be a wide range of clinical applications where Biodentine™ could be used in the field of endodontics, dental traumatology, restorative dentistry and pediatric dentistry. Although it seems to be good clinical practice, currently there is little clinical
evidence to support all potential indications (2).
3. Success of root fillings with zinc oxide-ozonated oil in primary molars:
Preliminary results Aim was to evaluate the success rate of mixture of ozonated oil and
zinc oxide as a primary teeth root filling material. Prospective randomised
clinical study included 60 infected primary mandibular molars which were
equally divided into study group (ozonated oil-ZnO) and control group
(zinc oxide-eugenol). Pulpectomy procedure was performed and the children were followed at regular intervals. All the children were available for
evaluation at the end of 12 months. The teeth were evaluated for success
www.ascro.hr
2. Karakteristike Biodentine™ materijala i klinička primjena:
Pregled literature
Biodentine™ je nova verzija kalcijev silikatnog anorganskog cementa.
Cilj ovog pregleda je pružiti detaljnu analizu fizikalnih i bioloških svojstava Biodentine™ i usporediti ta svojstva s onima ostalih trikalcijev silikatnim cementima, nasuprot, Mineral Trioksid Agregata (MTA) i Bioaggregate™. Sveobuhvatna sustavna potraga literature za sva izdanja do sada, je
provedena 20 studenog 2013 od strane dva neovisna recenzenta u Medline (PubMed), Embase, Web of Science, CENTRAL (Cochrane), SIGLE,
SciELO, Scopus, Lilacs i clinicaltrials.gov pomoću termina u tražilici: Biodentine, “trikalcijev silikata”, Ca3SiO5, “dentin zamjena” i RD 94. Uz
elektronsko pretraživanje, ručna pretraga i pretraga literature provedene
su kako bi uključile članake objavlje u časopisima koji nisu indeksirani u
Medline. Randomizirana kontrolna liječenja (RCT), kontrolna studija slučaja, izvješće slučaja, in vitro studije, studije na životinjama i kratka komunikacija na engleskom jeziku bili su uzeti u obzir za ovaj pregled. Zaključak
je bio da je s obzirom na vrhunske fizičke i biološke osobine, Biodentine ™
može biti učinkovita alternativa MTA koji se koristi u različitim kliničkim
aplikacijama. Čini se da postoji širok spektar kliničke primjene gdje bi se
Biodentine™ mogao koristiti u području endodoncije, dentalne traumatologije, restorativne stomatologije i dječje stomatologije. Iako se čini da je
dobra klinička praksa, trenutno je malo kliničkih dokaza koji podupiru sve
potencijalne indikacije (2).
316
ološka procjena sugerira da zubi punjeni ozoniziranim uljem cink oksida,
pokazali dobar postotak uspješnosti (93.3%) u odnosu na cink oksid eugenol (63,3%). Međutim, statistički značajna varijacija (p = 0,408) nije opažena između skupina. Zaključak je bio da je Ozonizirano ulje-ZnO pokazalo dobar klinički i radiološki uspjeh nakon 12 mjeseci praćenja i može se
smatrati alternativnim punilom kanala mliječnih zuba (3).
4. Propušteni kanal...poziv iz entomolarnog korijena
Sveobuhvatno razumijevanje korijena i morfologije korijenskih kanala mliječnih zuba je važno za uspješno endodontsko liječenje. Prekobrojan
korijen je razvojna anomalija koja može zahvatiti bilo koji zub. Dodatni
korijen situiran lingvalno (radix entomolaris) ili bukalno (radix paramolaris) može se zateći u donjih kutnjaka ipak; bilateralni dodatni korijen u
karioznim donjim kutnjacima je rijetkost. Ovom izvješću je cilj opisati dijagnozu, značaj i liječenje dodatnih korijena u karioznim donjim kutnjacima u perspektivi moderne kliničke dječje endodoncije (4).
5. Upotreba mini dentalnih implantata u djece s ektodermalnom
displazijom: Praćenje tri slučaja
Ektodermalna displazija je nasljedna genodermatoza karakterizirana
prirođenim manama ektodermalnih struktura, koje uzrokuju malformacije zuba i anomalije. Implantologija je postala prihvaćena u tim slučajevima. Međutim, slučajevi često kompliciraju smanjenom veličinom alveolarnog grebena, što čini umetanje konvencionalnih implantata teškim bez
presađivanja kosti. Smanjeni promjer mini implantata i njihova jednostavnost umetanja pružaju zanimljivo rješenje za mobilni ili fiksni nadomjestak. Cilj ovog rada je prikazati tri slučaja djece (11-12 godina) s ektodermalnom displazijom kod kojih su se koristili mini implantati za podršku
proteza. U prvom slučaju, dva mini-implantata su umetnuta u prednjem
dijelu mandibule za stabilizaciju mobilne proteze (2 godišnje praćenje). U
druga dva slučaja, mini-implantati su umetnuti u gornje i donje čeljusti za
nadomjestak prednjih zuba s fiksnom protetikom. Pacijenti su pozvani na
praćenje svakih 6 mjeseci: u drugom slučaju praćenje je trajalo četiri godine u donjoj čeljusti i 2 godine u gornjoj čeljusti; U trećem slučaju, 2 godine u gornjoj čeljusti i 1 godina u čeljusti. Zaključak je bio da je uporaba mini implantata u djece s ektodermalnom displazijom može poboljšati
estetiku i funkcionalni i psihosocijalni razvoj (5).
www.ascro.hr
6. Stupanj konverzije kompozitnih materijala polimeriziranih na bazi
LED lampe s dvostrukim ili jednostrukim vrhom
Tu je nedostatak podataka o polimerizaciji kompozitnih materijala
koji se koriste u dječjoj stomatologiji, koristeći LED lampu s dvostrukim
vrhom. Cilj je bio procijeniti stupanj konverzije kompozitnih materijala sa
LED lampom s dvostrukim ili jednostrukim vrhom. Uzorci Vit-l-escence (Ultradent) i Herculite XRV Ultra (Kerr), te smole za pečaćenje fisura
Delton Clear i Delton Opaque (Dentsply) su aplicirane (n = 3 po grupi)
i polimerizirane s bilo kojom od dve LED lampe s dvostrukim (Bluephase ® G2, Ivoclar ili Valo, Ultradent) ili jednostrukim vrhom (bluephase®,
Ivoclar). Tekuća kromatografija visoke performanse i nuklearna magnetska rezonantna spektroskopija su korištene kako bi potvrdili prisutnost ili
odsutnost inicijatora osim kamforkinona. Stupanj konverzije je određen
pomoću mikro-Raman spektroskopije. Podaci su analizirani korištenjem
općeg linearnog modela ANOVA; α = 0.05. Rezultati su pokazali da je
Herculite XRV Ultra, u kombinaciji sa LED lampom s jednostrukim vrhom dao veće vrijednosti stupnja konverzije nego bilo koji od dve LED
lampe s dvostrukim vrhom (P <0,05). Obe pečatne smole pokazale su veći stupanj konverzije u usporedbi s dva kompozitna materijala (P <0,05);
stupanj konverzije na dnu prozirne pečatne smole veće je od neprozirne
pečatne smole (P <0,05). 2,4,6-trimethylbenzoyl difenilfosfinoksida (Lucirin® TPO) pronađeno je samo u Vit-l-escence. Zaključak je bio da LED
lampa s dvostrukim vrhom ne može biti najprikladnija za polimeriziranje
ne-Lucirin® TPO materijale. Prozirne pečatne smole pokazale su bolju polimerizaciju kroz materijal i možda su prikladnije od neprozirnih verzija u
dubokim fisurama (6).
7. Uloga obiteljskih navika kod ranog dječjeg karijesa
Ciljevi ovog istraživanja bili su istražiti odnos između obiteljskih navika i ranog dječjeg karijesa. Daljnji ciljevi su (i) istražiti da li oralna higijena
može utjecati kod mogućih veza između obiteljskih navika i ranog dječjeg
karijesa te (ii) istražiti je li obiteljske navike mogu posredovati u odnosu između sociodemografskih čimbenika i ranog dječjeg karijesa. Slučajni uzorak od 630 djece, 5 do 6 godina starosti je regrutirano iz šest velikih dječ-
or failure based on clinical and radiographic criteria by a blinded investigator. The proportional values were compared using χ 2 test. Results were
that clinical and radiographic evaluation suggested that teeth obturated
with ozonated oil-zinc oxide demonstrated good success rate (93.3 %) as
compared to zinc oxide eugenol (63.3 %). However, no statistically significant variation (p = 0.408) was observed between the groups. Conclusion
was that ozonated oil-ZnO demonstrated a good clinical and radiographic
success at 12 months follow-up and it can be considered as an alternative
obturating material in infected primary teeth (3).
4. Missed canal...call from radix entomolaris A comprehensive understanding of root and root canal morphology
of primary teeth is valuable for successful endodontic therapy. A supernumerary root is a developmental anomaly which can affect any tooth. An
extra root placed lingually (radix entomolaris) or buccally (radix paramolaris) can be seen in mandibular molars nonetheless; bilateral association
of an additional root in deciduous mandibular molars is rare. This report
aimed to describe the diagnosis, significance and management of an extra
root in deciduous mandibular molars bilaterally in perspective of modern
clinical paediatric endodontics (4).
5. Use of mini dental implants in ectodermal dysplasia children: Followup of three cases Ectodermal dysplasia is a hereditary genodermatosis characterised by
a congenital defect of ectodermal structures, causing tooth malformations
and anomalies. Implantology has become accepted in these subjects. However cases are often complicated by a reduction in the size of the alveolar
process, making the insertion of conventional implants difficult without
bone grafting. The reduced diameter of mini-implants and their ease of insertion provide an interesting solution in supporting removable or fixed
prosthesis. The purpose of this paper is to report the follow-up of three cases of children (11-12 year-old) with ectodermal dysplasia in which miniimplants were used to support the prostheses. In the first case, two miniimplants were inserted into the anterior part of the mandible for stabilising
a removable denture (2 years follow-up). In the other two cases, miniimplants were inserted in the maxilla and mandible to replace missing
front teeth with fixed prostheses. Patients were called for follow-up every
6 months: in the second case follow-up lasted 4 years in the mandible and
2 years in the maxilla; in the third case, 2 years in the maxilla and 1 year
in the mandible. Conclusion was that the use of mini-implants in children
with ectodermal dysplasia can enhance aesthetics, and functional and psychosocial development (5).
6. Degree of conversion of resin-based materials cured with dual-peak or
single-peak LED light-curing units There is a lack of data on polymerization of resin-based materials
(RBMs) used in paediatric dentistry, using dual-peak light-emitting diode
(LED) light-curing units (LCUs). Aim was to evaluate the degree of conversion (DC) of RBMs cured with dual-peak or single-peak LED LCUs.
Samples of Vit-l-escence (Ultradent) and Herculite XRV Ultra (Kerr)
and fissure sealants Delton Clear and Delton Opaque (Dentsply) were
prepared (n = 3 per group) and cured with either one of two dual-peak
LCUs (bluephase® G2; Ivoclar Vivadent or Valo; Ultradent) or a singlepeak (bluephase®; Ivoclar Vivadent). High-performance liquid chromatography and nuclear magnetic resonance spectroscopy were used to confirm
the presence or absence of initiators other than camphorquinone. The DC
was determined using micro-Raman spectroscopy. Data were analysed using general linear model anova; α = 0.05. Results were that with Herculite XRV Ultra, the single-peak LCU gave higher DC values than either of
the two dual-peak LCUs (P < 0.05). Both fissure sealants showed higher
DC compared with the two RBMs (P < 0.05); the DC at the bottom of
the clear sealant was greater than the opaque sealant, (P < 0.05). 2,4,6-trimethylbenzoyl diphenylphosphine oxide (Lucirin® TPO) was found only
in Vit-l-escence. Conclusion was that dual-peak LED LCUs may not be
best suited for curing non-Lucirin® TPO-containing materials. A clear sealant showed a better cure throughout the material and may be more appropriate than opaque versions in deep fissures (6).
7. The role of family functioning in childhood dental caries
Objectives of this study were to investigate the relationship between
family functioning and childhood dental caries. Further objectives were (i)
to explore whether oral hygiene behaviours could account for a possible
317
8. Roditeljsko prihvaćanje tehnika upravljanja ponašanja koja se koriste
u dječjoj stomatologiji i njihov odnos spram dentalne anksioznosti i
iskustva roditelja
Cilj ovog istraživanja bio je ispitati prihvaćanje od strane roditelja devet tehnika upravljanja ponašanja i povezanosti s nekoliko mogućih čimbenika. Nakon etičkog odobrenja, 106 roditelja čija djeca imaju od 3 do
12 godina su bila primljena na liječenje na sveučilišnoj stomatološkoj klinici, te 123 roditelja djece iz privatne ordinacije pristalo je sudjelovati. Nakon što je pokazan video s devet tehnika upravljanja ponašanja, roditelji
su ocijenili prihvaćanje svake tehnike na skali 0-10. Oni su zatim zamoljeni da ispune upitnik o demografiji, njihovog prethodnog stomatološkog
iskustva i dentalne anksioznosti (modificirana skala dentalne anksioznosti). Rezultati su pokazali da je najbolje prihvaćena tehnika reci-pokažiučini (9,76 ± 0,69), nakon čega slijedi tehnika roditeljske prisutnosti/odsutnosti (PPA) (7,83 ± 3,06) i inhalacijska sedacija dušikovim oksidulom
(7,09 ± 3,02). Najmanje prihvaćene tehnike su pasivne suzdržanosti (4,21
± 3,84) i opće anestezije (4,21 ± 4,02). Nisu pronađene korelacije između prihvaćanja bilo koje pojedinačne tehnike upravljanja i roditeljske dobi, spola, dohodka, obrazovanja, stomatološkog iskustva i dentalne anksioznosti ili djetetove dobi, spola i stomatološkog iskustva. Roditelji čija su
djeca bila liječena na Sveučilišnoj klinici imali su niži dohodak i obrazovnu
razinu, i ocijenila su pasivnu suzdržanost, oralni sedaciju i opća anestezija
više od onih iz privatne prakse. Kada su roditelji bili posebno upitani birati između opće anestezije te bilo koje aktivne ili pasivne tehnike, rukom
preko usta i kontrole glasa tehnika, 10% je dalo prednost općoj anesteziji,
a ti roditelji su prikazali statistički značajno negativnije stomatološke iskustvo, ali ne i veću stomatološku anksioznost. Zaključak je da ne postoji povezanost između stomatološkog iskustva roditelja te dentalne anksioznosti
i prihvaćanja neke posebne tehnike upravljanja ponašanja. Međutim, roditelji s negativnim stomatološkim iskustvom bi radije opću anesteziju nad
bilo kojim aktivnim ili pasivnim metodama i tehnikom kontrole glasa (8).
9. Istraživanje o zdravlju zuba djece s pretilosti: analiza dentalne erozije i
statusa karijesa
Cilj je bio istražiti jesu li djeca s pretilošću iskusila više erozije i karijesa od djece s normalnom težinom. Ova studija uključila je djecu u dobi od
7-15 godina. Istraživanje i kontrolna skupina su sastavljena od 32 djece s
BMI > 98. centile i 32 zdrave djece s normalnim BMI-za-dob. Indeks erozije po O’Sullivan i WHO karijes indeks bili korišteni u ispitivanju erozije
i karijesa, respektivno. Potaknuta brzina protoka sline, puferski kapacitet,
Streptococcus mutans i Lactobacillus broji (CFU / ml) su bili ocijenjeni.
Upitnik je bio zadužen prikupiti informacije sudionika o demografskoj
pozadini, povijesti oralnog zdravlja i navika, te korištenja skrbi stomatološke usluge. Rezultati su pokazali da djeca s pretilošću će vjerojatno imati
više eroziju nego zdrava djeca (p <0,001), te imati više erozije u smislu težine (p <0.0001) i zahvaćenih područja (p <0,0001), ali ne u broju zahvaćenih površina (p = 0,167). Stražnji zubi će biti vjerojatno manje pogođeni erozijom od prednjih zubi (OR 0,32, 95% CI 0,012 - 0,082). Spol nije
imao učinak na eroziju. Nije bilo statistički značajne razlike u KEP indek-
association between family functioning dimensions and childhood dental
caries and (ii) to explore whether family functioning could mediate the relationship between sociodemographic factors and childhood dental caries.
A random sample of 630 5-to 6-year-old children was recruited from six
large paediatric dental centres in the Netherlands. Children’s dmft scores
were extracted from personal dental records. A parental questionnaire and
the Gezinsvragenlijst (translation: Family Questionnaire) were used to collect data on sociodemographic characteristics, oral hygiene behaviours and
family functioning. Family functioning was assessed on five dimensions:
responsiveness, communication, organization, partner-relation and social
network. Associations with dmft were analysed using multilevel modelling. Results were that bivariate analysis showed that children from normal functioning families on the dimensions responsiveness, communication, organization and social network had significantly lower dmft scores
compared with children from dysfunctional families. Poorer family functioning on all dimensions was associated with an increased likelihood of
engaging in less favourable oral hygiene behaviours. Children with lower
educated mothers, immigrant children and children of higher birth order
were more likely to come from poorer functioning families. In multivariate analysis, organization remained a significant predictor of dmft after adjusting for the other family functioning dimensions and the mother’s education level, but it lost statistical significance after adjustment for oral
hygiene behaviours. Conclusion was that a relationship between family
functioning and childhood dental caries was found, which may have operated via oral hygiene behaviours. Family functioning modestly explained
socioeconomic inequalities in child oral health. Organization appeared to
be the most important dimension of family functioning that influenced
children’s caries experience (7).
8. Parental acceptance of behaviour-management techniques used in
paediatric dentistry and its relation to parental dental anxiety and
experience
The aim of this study was to examine the acceptance by Greek parents
of nine behaviour-management techniques and its association with several possible confounding factors. Following ethical approval, 106 parents
whose 3- to 12-year-old children had been receiving treatment in a university postgraduate paediatric dental clinic, and 123 parents of children
from a private paediatric dental practice agreed to participate. After being
shown a video with nine behavior-management techniques, parents rated
the acceptance of each technique on a 0–10 scale. They were then asked
to complete a questionnaire about demographics, their previous dental experience and dental anxiety (modified Corah dental anxiety scale). Results
showed that the best accepted technique was tell–show–do (9.76 ± 0.69),
followed by parental presence/absence (PPA) technique (7.83 ± 3.06)
and nitrous oxide inhalation sedation (7.09 ± 3.02). The least accepted techniques were passive restraint (4.21 ± 3.84) and general anesthesia
(4.21 ± 4.02). No correlations were found between acceptance of any individual management technique and parental age, gender, income, education, dental experience and dental anxiety or the child’s age, gender and
dental experience. Parents whose children had been treated at the University clinic had lower income and educational levels, and rated passive restraint, oral sedation and general anesthesia higher than those from the
private practice. When the parents were specifically asked to choose between general anesthesia over any of the active or passive restraint, handover-mouth and voice control techniques, 10 % preferred general anesthesia, and these parents reported statistically significant more negative dental
experience but not higher dental anxiety. Conclusion was that there was
no correlation between parental dental experience and dental anxiety and
the acceptance of any specific behavior-management technique. However, parents with negative dental experience would prefer general anaesthesia over any of active or passive restraint, hand-over-mouth and voice control techniques (8).
9. An investigation into the dental health of children with obesity: An
analysis of dental erosion and caries status
The aim was to investigate whether children with obesity experienced
more erosion and caries than children with normal weight. This study involved children aged 7-15 years. The study and control group comprised
32 children with BMI > 98th centile and 32 healthy children with normal
BMI-for-age, respectively. O’Sullivan Erosion Index and WHO Caries In-
www.ascro.hr
jih zubnih centara u Nizozemskoj. Dječji KEP indeks je uzet iz dentalne
kartoteke. Roditeljski i obiteljski upitnik su korišteni za prikupljanje podataka o sociodemografskim obilježjima, oralnoj higijeni i obiteljskim navikama. Obiteljske navike su procijenjene na pet kategorija: odaziv, komunikacijske, organizacijske, partner-relaciji i društvene mreže. KEP indeks
je analiziran pomoću višerazinskog modeliranja. Rezultati su pokazali da
su djeca iz obitelji s normalnim obiteljskim navikama na dimenzije odaziv,
komunikacije, organizacije i društvene mreže imali su značajno niže KEP
rezultate u usporedbi s djecom iz disfunkcionalnih obitelji. Siromašnije
obiteljske navike na svim dimenzijama su bile povezane s povećanim vjerojatnostima u slabiju oralnu higijenu. Djeca s manje obrazovanim majkama, useljenička djeca i djeca višeg reda rođenja češće dolaze iz obitelji sa siromašnijim navikama. U multivarijatnim analizama, organizacija je ostala
značajan prediktor KEP indeksa nakon prilagodbe za drugim obiteljskim
navikama te razinu obrazovanja majke, ali je izgubila statističku značajnost
nakon prilagodbe za oralnu higijenu. Zaključak je bio da je pronađena veza između obiteljskih navika i ranog dječjeg karijesa, što se može korigirati preko oralne higijene. Obiteljske skromne navike objasnile su socioekonomske nejednakosti u oralnom zdravlju djece. Čini se da je organizacija
najvažnija dimenzija obiteljskih navika koja je utjecala na karijes djece (7).
318
su, profilu sline ili odgovorima upitnika među skupinama. Zaključak bi
bio da djeca s pretilošću mogu imati visok rizik od dentalne erozije, ali nije
nužno da imaju veći rizik od karijesa od djece s normalnom težinom (9).
10. Učinci voćnih pića na eroziju cakline
Ovom prospektivno, randomiziranom in vitro istraživanju bio je cilj
ispitati pH i titraciju kiselosti voćnih pića i procijeniti učinak tih pića na
eroziju cakline. Pedeset površina cakline su bila podijeljena u pet skupina koje su bile raspoređene u skupine uzoraka: Innocent® smoothie jagode i banane (SB), Innocent® smoothie mango i voće (MP) i Dijetna Coca Cola. Destilirana deionizirana voda (DD) je korištena kao negativna
kontrola i limunska kiselina 0.3% kao pozitivna kontrola. Sve površine su
podvrgnute 21-dnevnom pH cikličnom režimu koji uključuje 2 min od
uranjanja, pet puta dnevno s odgovarajućim razdobljima remineralizacije
između. Mjerenje demineralizacije površine procijenjena je pomoću profilometrije. Nezavisni uzorak t testovi su korišteni za usporedbu aritmetičkih sredina. Rezultati su pokazali da titracijska kiselost za oba testa voćnih
pića su 3,5 do 4 puta veća nego što je potrebno kako bi neutralizirala dijetnu Colu i 0,3%tnu limunsku kiselinu. PH SB, MP voćnih pića i Dijetne
Cole je utvrđena na 3,73, 3,59 i 2,95. MP voćno piće je izazvao najveći gubitka površine te slijedi Dijetna Cola. Kod oba voćna soka je utvrđeno da
uzrokuju značajan gubitak površine. MP voćni napitak rezultirao je znatno većem gubitku u odnosu na površinu MB voćnog napitka i 3%tne limunske kiseline. Zaključak je bio da su testirani voćni sokovi kiseli i imaju
visoku titraciju kiselosti. Oni proizvode značajnu eroziju cakline in vitro.
Rezultati ovog istraživanja ukazuju na to da treba povećati svijest o erozijskim učincima voćnih napitaka pogotovo što se čini da je njihova potrošnja u porastu (10).
Literatura
1.Morgan AG, Madahar AK, Deery C. Acceptability of fissure sealants from the child’s perspective.
Br Dent J 2014; 217(1):34-35. Doi: 10.1038/
sj.bdj.2014.553 Scopus
2. Rajasekharan S, Martens LC, Cauwels RGEC, Verbeeck RMH. Biodentine material characteristics
and clinical applications: A review of the literature.
Eur Arch Paediatr Dent 2014; 15(3):147-158. Doi:
10.1007/s40368-014-0114-3 Scopus
3.Chandra SP, Chandrasekhar R, Uloopi KS, Vinay
C, Kumar NM. Success of root fillings with zinc oxide-ozonated oil in primary molars: Preliminary results. Eur Arch Paediatr Dent 2014; 15(3):191-195.
Doi: 10.1007/s40368-013-0094-8 Scopus
4.Patil A, Shigli A, Tamagond SB, Pushpalatha C.
Missed canal...call from radix entomolaris. BMJ
dex were used in the examination of erosion and caries, respectively. Stimulated salivary flow rate, buffering capacity, Streptococcus mutans and lactobacilli counts (CFU/ml) were evaluated. A cross-sectional questionnaire
survey was employed to collect information on participant’s demographic
background, oral health history and habits, and utilisation of dental care
services. Results showed that children with obesity were more likely to
have erosion than healthy children (p < 0.001), and had more erosion in
terms of severity (p < 0.0001) and area affected (p < 0.0001), but not in
the number of surfaces affected (p = 0.167). Posterior teeth were less likely than anterior teeth to be affected by erosion (OR 0.32, 95 % CI 0.0120.082). Gender had no effect on erosion. There were no statistically significant differences in the DMFT, saliva profiles or questionnaire responses
between the groups. Conclusions was that children with obesity may have
high risk of dental erosion, but do not necessarily have higher risk of dental caries than children with normal weight (9).
10. The effects of fruit smoothies on enamel erosion This prospective, randomized in vitro study was to investigate the pH
and titrable acidity of fruit smoothie drinks and to assess the effect of these
drinks on enamel erosion. Fifty enamel slabs were divided into five groups
which were allocated to the sample solutions groups: Innocent® smoothie strawberries and bananas (SB), Innocent® smoothie mangoes and passion fruit (MP) and Diet Coke. Distilled deionised water (DD) was used
as negative control and citric acid 0.3 % as positive control. All the slabs
were subjected to a 21-day pH cycling regime involving 2 min of immersions, five times a day with appropriate remineralization periods in between. Measurement of surface loss was assessed using profilometry. Independent sample t tests were used to compare mean. Results showed that
the titratable acidity for both test smoothies were 3.5-4 times more than
that needed to neutralise Diet Coke and citric acid 0.3 %. The pH of SB,
MP smoothie and Diet Coke was found to be 3.73, 3.59 and 2.95, respectively. MP smoothie caused the greatest amount of surface loss followed
by Diet Coke. Both smoothies were found to cause significant surface loss.
MP smoothie resulted in significantly higher surface loss compared with
MB smoothie and citric acid 3 %. Conclusion was that the smoothies tested were acidic and had high titratable acidity. They produced a significant erosion of enamel in vitro. The results of this study suggest that there
should be increased awareness of the erosive effects of smoothies especially
as their consumption seems to be on the increase (10).
Case Reports 2014 March 13th; Article number
202204. Doi: 10.1136/bcr-2013-202204 Scopus
5.Sfeir E, Nassif N, Moukarzel C. Use of mini dental implants in ectodermal dysplasia children: Follow-up of three cases. Eur J Paediatr Dent 2014;
15(1):207-212. PubMed ID: 25101504
6. Lucey SM, Santini A, Roebuck EM. Degree of conversion of resin-based materials cured with dualpeak or single-peak LED light-curing units. Int J
Paediatr Dent 2014; Article in Press. Doi: 10.1111/
ipd.12104 Scopus
7.Duijster D, Verrips GHW, Van Loveren C. The
role of family functioning in childhood dental
caries. Community Dent Oral Epidemiol 2014;
42(3):193-205. Doi: 10.1111/cdoe.12079 Scopus
8. Boka V, Arapostathis K, Vretos N, Kotsanos N. Pa-
rental acceptance of behaviour-management techniques used in paediatric dentistry and its relation
to parental dental anxiety and experience. Eur Arch
Paediatr Dent 2014; 15(5):333-339. Doi: 10.1007/
s40368-014-0119-y Scopus
9. Tong HJ, Rudolf MCJ, Muyombwe T, Duggal MS,
Balmer R. An investigation into the dental health
of children with obesity: An analysis of dental erosion and caries status. Eur Arch Paediatr Dent 2014;
15(3):203-210. Doi: 10.1007/s40368-013-0100-1
Scopus
10.Tahmassebi JF, Kandiah P, Sukeri S. The effects of
fruit smoothies on enamel erosion. Eur Arch Paediatr Dent 2014; 15(3):175-181. Doi: 10.1007/
s40368-013-0080-1 Scopus
www.ascro.hr
Dr.sc. Tomislav Škrinjarić
Parodontologija
Periodontology
Promatrana je moguća povezanost određenih kliničkih parametara
parodontitisa i sistemnih biomarkera za koronarnu bolest srca. Na uzroku od 317 pacijenata s parodontitisom i koronarnom bolesti srca koja ja
angiografski dokazana te bez drugih sistemskih bolesti, klinički parametar krvarenje pri sondiranu (eng. bleeding on probing, BOP) pokazao je
snažnu povezanost s prisutnom sistemnom razinom C-reaktivnog proteina (CRP). Ova povezanost upućuje na mogući značajni doprinos lokalne
parodontne upale na sistemnu upalu (1).
Kako bi procijenili parodontni status i gubitak zubi kod pacijenata s
novodijagnosticiranim pred-dijabetesom ili dijabetes melitusom pregleda-
The study assessed the possible association between certain clinical
periodontal parameters and systemic biomarkers for coronary heart disease. In patients with periodontitis and proven coronary heart disease and
no other systemic diseases (n=317) bleeding on probing showed a strong
association with the present systemic levels of C-reactive protein (CRP).
This association possibly reflects the potential significance of the local periodontal inflammatory burden for systemic inflammation (1).
A total of 1097 subjects with previously undiagnosed diabetes were
measured to assess the periodontal status and number of missing teeth in
patients with newly identified pre-diabetes or diabetes mellitus. Patients
no je 1097 ispitanika kojima prethodno nije dijagnosticiran dijabetes. Kod
pacijenata s prethodno neprepoznatim pred-dijabetesom uočena je parodontna destrukcija koja se inače vidi kod pacijenata koji se nalaze između
normoglikemije i dijabetes melitusa. Ovaj nalaz naglašava povezanost oralnog nalaza i disglikemije te upućuje kako parodontna bolest i gubitak zubi
mogu biti rane komplikacije dijabetes melitusa (2).
Nacionalni centar za statistiku u Švedskoj omogućio je pristup podacima kako bi se istražio odnos između stope pušenja i prevalencije parodonte bolesti u periodu od 1970. do 2010. Dobno standardizirana stopa
pušenja u Švedskoj pala je s 44% u 1970. na 15% u 2010. Paralelno s padom pušenja procijenjena prevalencija parodontne bolesti pala je s 26%
na 12%. Procijenjena prevalencija parodontne bolesti usko je povezana sa
stvarno promijenom u stopi pušenja. Kako stopa pušenja opada, tako će i
prevalencija parodontne bolesti opadati (3).
U istraživanju usporedbe dva regenerativna kirurška tretmana kod terapije periimplantitisa kroz 5 godina praćena su 25 pacijenata. Prva grupa
je liječenja koštanim nadomjesnim materijalom i resorbirajućom membranom (13 pacijenata s 23 implantata), a druga grupa je liječena samo koštanim nadomjesnim materijalom (12 pacijenata s 22 implantata). Kroz 5
godina obje grupe pokazuju klinički i radiološki poboljšanje, ni jedan implantat nije izgubljen zbog periimplantitisa. Oba terapijska postupka rezultirala su stabilnim stanjem te se može zaključiti da dodatna upotreba
membrane ne poboljšava ishod (4).
Kako bi istražili povezanost parodontitisa i preeklampsije kod nepušača u prospektivnu studiju uključene su 283 trudnice između 21. i 24. gestacijskog tjedna, 67 trudnica je bilo s parodontitisom te 216 bez. Od toga
kod 13 trudnica dijagnosticirana je preeklampsija. Ustanovljena je značajna povezanost između parodontitisa i pojave preeklampsije kod trudnica
koje nisu nikad bili pušači (5).
Da bi se odredio utjecaj nekirurške mehaničke parodontološke terapije na upalne markere koji se odnose na rizik za kardiovaskularne bolesti,
64 pacijenata s uznapredovanim kroničnim parodontitisom podijeljeni su
u dvije skupine, ispitivanu skupinu (n=32) na kojoj je provedena terapija i
kontrolnu skupinu (n=32) kod koje je odgođena terapija, odnosno terapija
nije provedena 6 mjeseci dok nije završena studija. Nekirurška parodontološka terapija bila je učinkovita u smanjenju razine sistemnih upalnih markera te je poboljšala lipidni profil kod osoba s uznapredovanim kroničnim
parodontitisom (6).
Titan koji se koristi u stomatologiji može korodirati zbog elektrokemijske interakcije u okruženju usne šupljine. Sam proces korozije može
promijeniti površinu materijala pa je postavljena hipoteza da tako promijenjena titanska površina može povećati prianjanje parodont patogena,
u ovoj studiji konkretno Porphyromonas gingivalis-a. Mjerena je grubost
površine na komercijalno čistom titanu (cp-Ti) i titan-aluminij-vanadij leguri (Ti-6Al-4V), koje su potom inokulirane s P. gingivalis. Viši stupanj
korozije na titanskoj površini može promicati bolje bakterijsko prianjanje
oralnih patogena (7).
Promatran je učinak fotodinamske terapije na kliničke upalne biomarkere te citokine koji se nalaze u sulkusnoj tekućini kod 22 pacijenata s umjerenim do uznapredovanim kroničnim parodontitisom. Podijeljeni su u dvije skupine pacijenata, ispitivanoj grupi je po zarvšetku struganja
i poliranja korjenova primijenjena dodatno pojedinačna doza fotodinamske terapije, dok je kontrola skupina imala samo struganje i poliranje korjenova. Kod pacijenata s kroničnim parodontitisom pojedinačna primjena
fotodinamske terapije (pomoću lasera valne duljine 638nm i toluidinskog modrila) nije pružila dodatne koristi u smislu kliničkih parametara ili
upalnih markera do 3 mjeseca nakon terapije (8).
Svrha ovog istraživanja bila je usporediti klinički ishod u liječenju dubokih jednozidnih intrakoštanih defekata (≥70% jednozidna komponenta i preostala dvozidna i trozidna komponenta u najapikalnijoj trećini) koristeći deproteinizirani goveđi koštani mineral (DBBM) u kombinaciji s
proteinom caklinskog matriksa (EMD) ili kolagenom membranom (CM).
Na 40 pacijenata uspoređivani su klinički parametri, dubina sondiranja i
klinička razina pričvrstka, na početku i nakon 12 mjeseci od zahvata. Obje
regenerativna terapije, EMD + DBBM i CM + DBBM, dale su usporedive kliničke rezultate kod dubokih jednozidnih intrakoštanih defekata nakon 12 mjeseci (9).
Nakon 5 godina napravljena je usporedba dviju terapija Miller klase II
recesija, kontrolna skupina koronarno pomaknuti režanj (CAF) s vezivnim
with previously unidentified pre-diabetes demonstrate a level of periodontal destruction between that observed for normoglycaemic individuals and
persons with diabetes. These data emphasize the association of oral findings to dysglycaemia, and suggest that periodontal disease and tooth loss
can be early complications of diabetes mellitus (2).
National Center for Statistics in Sweden provided information on
smoking rate of Swedish population to investigate the relationship between smoking rate and periodontal disease prevalence for the years 1970
– 2010. The age-standardized smoking rate in Sweden declined from 44%
in 1970 to 15% in 2010. In parallel with the smoking decline the calculated prevalence estimate of periodontal disease dropped from 26% to 12%.
The estimated prevalence of periodontal disease is closely related to real
changes in smoking rate. As smoking rates are declining, so will the prevalence of periodontal disease drop (3).
In a study comparing two regenerative surgical treatments for periimplantitis over 5 years 25 patients were observed. The first group was treated
with bone substitute material and resorbable membrane (13 patients with
23 implants), and the second group was treated only with bone substitute
material (12 patients with 22 implants). Five-year follow-up demonstrated
clinical and radiographic improvements in both groups. No implants were
lost due to progression of peri-implantitis. Both therapeutic procedures resulted in stable conditions and it can be concluded that the additional use
of the membrane does not improve outcome (4).
In order to investigate relationship between periodontitis and preeclampsia in never-smokers in a prospective study 283 pregnant women
were recruited at 21 to 24 weeks gestation, 67 pregnant women were with
periodontitis and 216 were without periodontitis. Of these 13 women
were diagnosed with preeclampsia. There was a significant relationship
between periodontitis and the occurrence of preeclampsia among neversmokers (5).
To determine the influence of non-surgical mechanical periodontal
treatment on inflammatory markers related to risk for cardiovascular disease a total of 64 patients with severe chronic periodontitis were divided
into two groups. Test group (n=32) received immediate periodontal treatment, while the control group (n=32) had a delayed periodontal treatment
meaning there was no treatment during the study period of 6 months. The
non-surgical periodontal treatment was effective in reducing the levels of
systemic inflammation markers and improved the lipid profile in subjects
with severe chronic periodontitis (6).
Titanium dental material can become corroded because of electrochemical interaction in the oral environment. The corrosion process may
result in surface modification and so it was hypothesized that a modified titanium surface may enhance the attachment of periodontal pathogens, primarily Porphyromonas gingivalis in this study. Surface roughness
was measured on commercially pure titanium (cp-Ti) and titanium-aluminum-vanadium alloy (Ti-6Al-4V) which were inoculated with P. gingivalis. A higher degree of corrosion on the titanium surface may promote
increased bacterial attachment by oral pathogens (7).
Effects of photodynamic therapy on clinical and gingival crevicular
fluid inflammatory biomarkers were observed in 22 patients with moderate-to-severe chronic periodontitis. They were divided into two groups
of patients, the test group was treated with conventional scaling and root
planning with single application of photodynamic therapy, while the control group was treated only with conventional scaling and root planning.
In patients with chronic periodontitis, a single application of PDT (using
a 638-nm laser and toluidine blue) did not provide any additional benefit
to SRP in terms of clinical parameters or inflammatory markers 3 months
following the intervention (8).
The purpose of this study was to compare clinical outcomes in the
treatment of deep non-contained intra-bony defects (≥70% 1-wall component and a residual 2- to 3-wall component in the most apical part) using
deproteinized bovine bone mineral (DBBM) combined with either enamel matrix protein derivative (EMD) or collagen membrane (CM). At baseline and after 12 months, clinical parameters including probing depth and
clinical attachment level were recorded on 40 patients. Regenerative therapy using either EMD + DBBM or CM + DBBM yielded comparable clinical outcomes in deep non-contained intrabony defects after 12 months (9).
Comparison and of clinical parameters at 5 years was performed on
Miller Class II gingival recession defects that were treated with either a
www.ascro.hr
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320
transplantatom (CTG) i ispitivana skupina koronarno pomaknuti režanj s
rekombinantnim humanim trombocitnim faktorom rasta s β-trikalcij fosfatom. Obje terapije pokazale su stabilne i klinički učinkovite rezultate nakon 5 godina, iako je CTG + CAF pokazao veće smanjenje recesije, veći
postotak pokrivanja korijenske površine i veći dobitak širine keratinizirane gingive (10).
Literatura
www.ascro.hr
1. Bokhari SA, Khan AA, Butt AK, Hanif M, Izhar M,
Tatakis DN, et al. Periodontitis in coronary heart
disease patients: strong association between bleeding on probing and systemic biomarkers. Journal of
clinical periodontology. 2014;41(11):1048-54.
2. Lamster IB, Cheng B, Burkett S, Lalla E. Periodontal findings in individuals with newly identified
pre-diabetes or diabetes mellitus. Journal of clinical
periodontology. 2014;41(11):1055-60.
3.
Bergstrom J. Smoking rate and periodontal disease prevalence: 40-year trends in Sweden
1970-2010. Journal of clinical periodontology.
2014;41(10):952-7.
4.Roos-Jansåker AM, Persson GR, Lindahl C, Renvert S. Surgical treatment of peri-implantitis using a
bone substitute with or without a resorbable membrane: a 5-year follow-up. Journal of clinical periodontology. 2014;41(11):1108-14.
connective tissue graft (CTG) (control) or recombinant human plateletderived growth factor-BB + β-tricalcium phosphate (test), both in combination with a coronally advanced flap (CAF). Treatment with either test
or control treatments for Miller Class II recession defects appear to lead to
stable, clinically effective results, although CTG + CAF resulted in greater
reductions in recession, greater percentage of root coverage, and increased
height of keratinized tissue (10).
5. Ha JE, Jun JK, Ko HJ, Paik DI, Bae KH. Association between periodontitis and preeclampsia in never-smokers: a prospective study. Journal of clinical
periodontology. 2014;41(9):869-74.
6. Caula AL, Lira-Junior R, Tinoco EM, Fischer RG.
The effect of periodontal therapy on cardiovascular
risk markers: a 6-month randomized clinical trial.
Journal of clinical periodontology. 2014;41(9):87582.
7. Barao VA, Yoon CJ, Mathew MT, Yuan JC, Wu
CD, Sukotjo C. Attachment of Porphyromonas
gingivalis to corroded commercially pure titanium
and titanium-aluminum-vanadium alloy. Journal of
periodontology. 2014;85(9):1275-82.
8. Pourabbas R, Kashefimehr A, Rahmanpour N, Babaloo Z, Kishen A, Tenenbaum HC, et al. Effects
of photodynamic therapy on clinical and gingival
crevicular fluid inflammatory biomarkers in chronic
periodontitis: a split-mouth randomized clinical trial. Journal of periodontology. 2014;85(9):1222-9.
9. Iorio-Siciliano V, Andreuccetti G, Blasi A, Matarasso M, Sculean A, Salvi GE. Clinical outcomes following regenerative therapy of non-contained intrabony defects using a deproteinized bovine bone
mineral combined with either enamel matrix derivative or collagen membrane. Journal of periodontology. 2014;85(10):1342-50.
10.McGuire MK, Scheyer ET, Snyder MB. Evaluation of recession defects treated with coronally advanced flaps and either recombinant human platelet-derived growth factor-BB plus beta-tricalcium
phosphate or connective tissue: comparison of
clinical parameters at 5 years. Journal of periodontology. 2014;85(10):1361-70.
Dr.sc. Domagoj Vražić

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