Faculty Bibliography

The aim of the study was to present the distribution of traumatic dental injuries in the permanent anterior teeth in 447 consecutively selected patients in the age interval of 6 to 25 years treated at the Department of Paediatric Dentistry at the University Dental Clinic in Rijeka, Croatia, in the period from 2001 to 2006. Data on age, gender, number of injured teeth and type of injury were taken from the dental records. Of all 447 consecutively selected patients with traumatic dental injury 56.2% were boys and 43.8% were girls with a male/female ratio 1.28:1 (P < 0.01). The highest frequency of tooth injuries occurred among 10- to 13-years-old children. Among 30.6% of the cases, two or more teeth were injured (38.6% in boys and 21.4% in girls). Traumatic injuries affecting teeth in the upper jaw were more frequent (P < 0.001). The most commonly affected teeth were the maxillary central incisors (42.4% of right central incisors and 38% of left central incisors). The most frequent injury was enamel and dentin fracture without pulpal involvement (38.7%). In conclusion, more attention should be paid to preventive measures.

The aim of this study was to investigate retention of composite fissure sealant polymerized with standard and soft-start technique after a three year clinical trial. One hundred teeth were divided into two groups (A&B) of teeth and sealed with composite material (Visioseal, 3M Espe) using split mouth design. Sealants were polymerized using standard (Group A) and soft-start (Group B) techniques with commercial polymerization unit (Elipar Highlight, 3M Espe). Retention rate in Group A was 72%. In 14 teeth sealant was partially or completely missing. Group B showed retention rate of 80%. Sealant was partially or completely missing in 10 teeth. Six new caries lesions in Group A (3) and B (3) were detected. Mann-Whitney test did not reveal significant differences between the polymerization techniques. After three years complete retention of sealants, regardless of the group, was 76% (76 teeth) with six new caries lesions. Soft-start polymerization showed a comparable retention rate as the standard polymerization technique.

The aim of the study was to evaluate dental fear in children with and without dental injuries in a randomly selected children in Croatia (59 girls and 88 boys). Children were divided into three groups depending on dental trauma experience. They were also divided into two age groups: 5-8 and 9-12 years. Only dental trauma to the permanent teeth was included in the study. The CFSS-DS, CDAS and CMFQ were used for evaluation of dental anxiety and the ISP Hollingshead Index of Social Position was calculated for evaluation of social status. The mean values of CDAS, CFSS-DS and CMFQ tests revealed that the anxiety level decreases with increasing experience of dental injury. The analysis of variance performed for CDAS showed a significant difference between children with and without dental trauma (p = 0,010). Regarding the groups, the analysis of variance for CMFQ (p = 0,021) and CFSS-DS (p = 0,001) showed a significant difference, as well as regarding age (CMFQ; p = 0,001 and CFSS-DS; p = 0,016). Cronbach's alpha coefficients revealed the highest reliability for CFSS-DS (alpha = 0,910). Pearson's correlation coefficients revealed significant correlations between the anxiety scores, age and ISP values for children without dental trauma, and between the anxiety scores and age for children with repeated dental trauma. The results of the ISP Hollingshead Index exhibited the highest frequency in children with dental injuries who belonged to the families with poor social background (ISP = 44-60). No significant difference was obtained between children with and without dental injuries depending on either gender or the ISP value.

The investigation was performed on 113 adolescents in the age between 15 and 18 years (63 boys, 50 girls). Corah Dental Anxiety Scale (CDAS) and Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) were used for evaluation of dental fear and Child Medical Fear Questionnaire (CMFQ) for evaluation of the fear of medical treatment. Achenbach Youth Self Report questionnaire (YSR) was used for evaluation of emotional and behavioral problems. The tests were filled in by children. The aim of the study was to evaluate the level of dental anxiety in adolescents and to assess a cause--consequence relationship between dental anxiety and emotional and behavioral problems in adolescents. The results of CDAS, CFSS-DS and CMFQ tests showed that dental anxiety scores and the total internalizing problems were higher in girls. Girls displayed more physical problems (p < 0.001) and were more prone to anxiety/depression disorders (p < 0.05). Both boys and girls were more aggressive, more prone to delinquent behaviour and had more externalizing problems in comparison with the average values obtained for the Croatian population. Significant correlation coefficients for boys were calculated for age and anxiety/depression, and delinquent behaviour and aggression (p < 0.05). Significant correlations were observed between physical problems and dental anxiety measured by the CFSS-DS test (p < 0.01), and between physical problems and the total internalizing problems (p < 0.05). In girls, the CMFQ scores showed significant correlations between dental anxiety and physical problems (p < 0.05), and anxiety/ depression (p < 0.01) and the total internalizing and externalizing problems (p < 0.05). Significant correlations were calculated for age and the total internalizing and externalizing problems for boys (p < 0.05). According to the results of both CDAS and CMFQ tests, anxiety in girls showed significant correlations with delinquent behaviour (p < 0.01). CDAS scores for girls showed significant correlations with aggression (p < 0.05) and the total externalizing problems (p < 0.01).

The aim of the study was to evaluate oral health conditions and dental caries status in disabled and healthy children. Two groups of randomly selected children 3-17 years old were examined. The first group comprised 80 children with disabilities (cerebral palsy, mental retardation, Down syndrome, autism and hearing-speaking disorders) and the second (control) group included 80 healthy children. Examined children were selected from several institutions which take care of disabled persons, kindergardens and four elementary schools. Clinical examination was performed by using a mirror and a probe and revealed the presence of dental caries, missing (extracted) and filled teeth. All clinically detected cavitations were registered as dental caries. The degree of oral hygiene was evaluated according to the OHI-S index values, which was determined by marking the plaque with 1% eozine solution. The values of OHI-S index ranged from 3.8-4.53 in disabled children and 2.73-2.84 in healthy children. In disabled children, the average dft values were 3.42 in deciduous teeth and 5.24 in mixed dentition. In healthy children, the average dft values were 1.43 in deciduous teeth and 5.1 in mixed dentition. The average DMFT index in disabled children was 1.41 for mixed and 6.39 for permanent dentitions. In healthy children, the average DMFT values were 1.23 in mixed and 4.76 in permanent dentitions. In general, the results revealed significantly poor level of oral hygiene and quite high level of caries prevalence in both disabled and healthy children, accentuating the need to reorganize preventive care measurements and improve dental care, particularly in disabled children in Croatia.

This cross-sectional study aimed at explaining the nature of needle phobia and its relationship in dental phobic children with evidence on age-related differences. The patient sample included randomly selected patients and an group of referred anxious children. The children were divided into three age groups and arranged into three anxiety groups. Needle phobia was demonstrated to be age-related, but should be considered as a separate phenomenon, being not specific for dental anxiety.

AIM: The aim of this study was to ascertain age and gender related differences that contribute to dental anxiety and to find relations with early onset of child dental anxiety in a population of 4-11 years old Dutch children. MATERIALS AND METHODS: The study was conducted among 2,865 patients (48.2% girls) aged between 4 and 11 years old. The sample included a normative (n = 2,153) and an anxious group of children (n = 712), who were referred to the Special Dental Care Clinic in Amsterdam because of manifested dental phobia. Children were divided into three age groups (4-6, 7-9 and 10-11 years). Dental anxiety was assessed using the Children Fear Survey Schedule-Dental Subscale. Three levels of dental anxiety were used: low (CFSS-DS = 15-25), moderate (CFSS-DS = 26-36) and high (CFSS-DS above 37). Only children with CFSS-DS scores above 37 were considered dentally phobic. STATISTICS: Statistical analysis was performed in Statistics for Windows 10. RESULTS: In the total group a significantly higher level of dental anxiety was found among girls (p = 0.004; t = -3.262). There was a considerably lower number of dentally phobic boys (7.1%) and girls (9.2%) in the older group compared with the younger (51.8%, 52.8% respectively). One way Anova results revealed a statistically significant age related difference between the oldest and the youngest as well as the middle-aged groups (p < 0.001, p = 0.001). In general dental anxiety was explained better in the younger than in the older group. The regression analysis accounted for a higher percentage of the explained variance. CONCLUSIONS: The study confirmed the highest level of dental anxiety was present at 4 years of age and an overall decrease in dental anxiety occurred as children became older. In different age groups, dental anxiety seems to be related to different aspects of dentistry, indicating the causes shift from simple initial stimuli to more complex events.

PURPOSE: This cross-sectional study aimed to explain the nature of needle phobia and its relationship in dental phobic children with evidence on age-related differences. METHODS: The study used 2,865 patients (52% boys, 48% girls), 4 to 11 years old (mean=7.18 years). The patient sample included randomly selected patients (N=2,153) and an anxious group of children (N=712). Children were divided into 3 age groups (4-6, 7-9, and 10-11 years). The Children Fear Survey Schedule--Dental Subscale (CFSS-DS) was used to assess age-related needle phobia (CFSS-DS question 3) and dental anxiety. Children were arranged into 3 anxiety groups (cutoffs=scores of 25 and 37). Children who scored >37 were considered needle-phobic. Statistical analysis was performed using Statistics for Windows 10. RESULTS: Needle phobia progressively decreases with increasing age (19% of 4- to 6-year-old vs 11% of 10- to 11-year-old needle phobics; P< or =05). Stepwise regression analysis revealed needle phobia does not primarily seem to be related to dental anxiety. Other aspects, like having had someone examine the mouth and the dentist drilling, contribute the most to dental anxiety in both low- and high-anxiety children. Fear of doctors is more specific for high-anxiety children (P < or =05). A significant age-related difference regarding needle phobia is found between children ages 4 to 6 and 7 to 9 and between children ages 4 to 6 and 10 to 11 (P < or =001). CONCLUSIONS: Needle phobia is age related, but should be considered a separate phenomenon. It is not specific for dental anxiety and is related to other painful treatment.

AIM: To achieve satisfactory aesthetic appearance of ceramic veneers food debris retention and plaque formation, resulting in possible irritation of surrounding tissues, should be avoided. It is, therefore, necessary to decrease the roughness of ceramic surfaces as much as possible. The aim of this study was to evaluate surface roughness of ceramic veneers after polishin15038787 g with four different techniques. METHODS: Twenty veneers were fabricated using Cerec 2 CAD/CAM method (Sirona AG, Bensheim, Germany) from Cerec VITA MARK II ceramic blocks (Vita Zahnfabrik, Bad Sackingen, Germany) and cemented onto prepared extracted teeth. Veneers were divided into 4 groups of 5 specimens and polished with 4 different techniques: 1. Sof-lex discs grit 150, 360, 600, 1200 (3M, St. Paul, MN, USA); 2. Hawe brushes (Hawe Neos Dental, Bioggio, Switzerland); 3. Hawe brushes and diamond paste Diabrill (Oralia Dental GmbH, Kostanz, Germany); 4. Politip-P rubber cups (Vivadent, Schaan, Liechtenstein). Surface profile was measured using Perthometer Perthen S8P 4.5 (Feinpruf Perthen GmbH, Goettingen, Germany) profilometer. STATISTICS: Data were analysed using ANOVA with Tukey HSD test. RESULTS: Sof-lex discs revealed significant statistical differences for Rz, Ra, Rk, Rpk values (p=0.0002) (Rz=2.92 mm; Ra=0.462 mm; Rk=1.098 mm; Rpk=0.472 mm). Values for Rvk were statistically significant only for rubber cups with diamond paste (p=0,002) (Rvk 4=3.04 mm). Rvk values for all other techniques were not statistically significant (Rvk 1=1.148 mm; Rvk 2=1.936 mm; Rvk 3=2.18 mm). CONCLUSION: The best surface smoothness was achieved with Sof-lex discs polishing system. All other methods are clinically acceptable. Selection of polishing technique should be made according to geometric construction of the polishing instrument and possibility of reaching various restoration areas with the polishing instrument.

Hypohidrotic ectodermal dysplasia (HED) is characterized by clinical manifestations of severe hypodontia or anodontia, hypotrichosis, hypohidrosis, and specific facial appearance. Affected males show complete expression of clinical features of this condition. Their mothers, who are gene carriers, express only some signs, which are usually very mild. Currently available clinical methods are not sufficient for routine identification of the HED heterozygous gene carriers. The purpose of this study was to identify and describe the facial characteristics of HED patients and their mothers and to evaluate the usefulness of craniofacial pattern profile analysis (CFPP) in the diagnosis of this syndrome and the detection of gene carriers. In this study six affected males and their mothers were evaluated. Z-scores for each variable were calculated and compared with age- and sex-matched controls. Anthropometric analysis showed a specific dysmorphic pattern in CST patients that includes decreased skull base width (t-t: -1.67 Z); decreased forehead width (ft-ft: -1.8 Z), decreased midface depth (sn-t: -2.02 Z), markedly decreased total facial height (n-gn: -3.4 Z), and markedly decreased maxillary arc (t-sn-t: -2.5 Z). Gene carriers showed a similar tendency in their pattern profiles. They showed the same tendency towards lower Z-values for forehead width, facial height, and mouth width. The values for these measurements were between those of the affected and healthy controls. The most pronounced findings were increased head width (eu-eu: +2.83 Z), increased lower face width (go-go: +2.06 Z), and reduction of total facial height (n-gn: -0.95 Z). They also displayed increased nose width (al-al: +2.41 Z) and increased biocular distance (ex-ex: +2.01 Z). When used in conjunction with other methods the anthropometrics pattern profile analysis can considerably enhance detection of gene carriers for HED and increase objective assessment of the craniofacial region in HED patients.