Stomatology

Introduction: The use of mobile phones has become a common phenomenon, with 6.9 billion subscriptions worldwide. The International Agency for Research on Cancer (IARC) has classified the electromagnetic fields emitted from mobile phone devices as group 2b, i.e. “maybe being carcinogenic to humans”. Objectives: The aim of present study was to investigate the potential effects of microwave radiation on the proliferation activity of parotid gland by measuring Ki-67 protein levels. Material and methods: Sixteen male adult New Zealand white rabbits were divided fifty-fifty into control and experimental groups. The experimental group was exposed to the radiation one hour daily, six days every week for 6 months. The rabbits were sacrificed according to ethical methods and parotid glands were removed after the exposure period has ended; so, sixteen biopsies stained with monoclonal antibody Ki-67 were obtained. The method of calculating the percentage of immunopositive cells from the total c...

Bruxism is referred to as grinding and clenching of the teeth. It is a disorder affecting an increasing number of patients. This disease causes severe ailments that negatively influencing the daily functioning and manifesting, among the others, as toothaches, masticatory muscle pain, headaches, and tooth hypersensitivity. The aim of the work is to analyse the contemporary treatment methods and methods of alleviating the effects of the disease. In addition, it evaluates the usefulness of these methods in daily dental practice. The article shows the contemporary view of treatment, including the multidisciplinary approach. The authors present treatment methods of bruxism, such as: splints, physiotherapy, psychotherapy, biofeedback, and pharmacological treatment. The variety of methods currently used and the lack of clear guidelines for treatment of bruxism should be emphasised. The article also draws attention to the need to modify the daily behaviour of the patient through relaxation exercises or biofeedback, in order to eliminate bruxism and not just alleviate its symptoms. A multidirectional approach and treatment of bruxism can produce satisfactory and lasting results.

The article is devoted to the research of the psychological peculiarities of professional identity and its connection with The Burnout syndrome of dentists. The specific of professional activity of dentists and its influence on personal identity are described. The features of the Burnout syndrome of the dentists with different professional identity are analyzed.

http://link.springer.com/article/10.1007/s10856-013-4898-1?wt_mc

Dental caries, also known as tooth decay or a cavity, remains a major public health problem in the most communities even though the prevalence of disease has decreased since the introduction of fluorides for dental care. Therefore, biomaterials to fill dental defects appear to be necessary to fulfill customers’ needs regarding the properties and the processing of the products. Bioceramics and glass–ceramics are widely used for these purposes, as dental inlays, onlays, veneers, crowns or bridges. Calcium orthophosphates belong to bioceramics but they have some specific advantages over other types of bioceramics due to a chemical similarity to the inorganic part of both human and mammalian bones and teeth. Therefore, calcium orthophosphates (both alone and as components of various formulations) are used in dentistry as both dental fillers and implantable scaffolds. This review provides brief information on calcium orthophosphates and describes in details current state-of-the-art on their applications in dentistry and dentistry-related fields. Among the recognized dental specialties, calcium orthophosphates are most frequently used in periodontics; however, the majority of the publications on calcium orthophosphates in dentistry are devoted to unspecified “dental” fields.

A cross - sectional descriptive study was carried out to determine the level of knowledge about biosecurity in stomatology in the technical and professional staff of the Julio A. Mella Clinic in Guantanamo province. The universe was constituted by the stomatological personnel who showed willingness to fill out the questionnaire. Knowledge about biosafety was analyzed: (knowledge of Biosafety standards, indications of surface disinfection and instruments, communicable diseases and general evaluation of Biosafety knowledge). An exhaustive bibliographical revision on the subject was carried out with universal and national literatures. The primary data were obtained from a survey sheet prepared by the authors. There were low numbers on a level of knowledge that was moderately sufficient, most of them showed insufficiency.

Nowadays, Laser stands for an avantgarde technolgy in dentistry. Its applications continues to expand since it was introduced to the dental profession, being available on a wide range of wavelengths. Lasers provide a simple and safe in-office treatment alternative and at the same time reducing the risks of infection, swelling, discomfort and scaring. The present article reviews the most common applications of lasers in oral pathology.

În prezent, laserul reprezintă o tehnologie de avangardă în domeniul medicinei dentare. Aplicațiile sale sunt într-o continuă expansiune începând cu momentul introducerii sale în acest domeniu, la ora actuală fiind disponibilă o varietate mare de lungimi de undă. Echipamentele laser asigură o alternativă de tratament simplă, sigură și care în același timp reduce riscurile de apariție a infecției, inflamației, disconfortului și cicatrizării. Articolul de față face o trecere în revistă a celor mai des utilizate aplicații ale laserului în patologia orală.

Ostatnie dwudziestolecie przyniosło kolejne niezwykłe wynalazki i zastosowania szkła. Jego specyficzne właściwości docenił przemysł budowlany, architektoniczny i samochodowy, ale również branża telekomunikacyjna, IT oraz medycyna. Oto, jak to się stało i jak z tego korzystamy.

The nasopalatine cyst (NPC) is a non-odontogenic cyst, it occurs mainly in adult patients in some cases can bring difficulties to the diagnostic due to its silent growing. We are going to present in this paper report case in a 10-year child emphasizing the histophatological characteristics and the findings in obtained images by Cone Beam Computed Tomography (CBCT). The  nasopalatine  cyst  (NPC)  represents  from  38  to  43.66%  of  the non-odontogenic cysts, followed by oral lympho epithelial cyst and  epidermoid  cyst.  This  cyst  wound  still  represents  about  1.87  to 10% of the jaw cysts. With major frequency in men, between the fourth and sixth decades [1-3].This non-odontogenic cyst is labeled as a development cyst, and its pathogenesis are not clear described yet, are believed to arise from the remnants of nasopalatine ducts in the incisive canal [4]. For  the  most  part  are  asymptomatic,  sometimes  NPCs  are  oligosymptomatic,  slow  growth  and  discovered  in  image  exams  done for other purposes. Symptomatic in about 48% of the patients [5],  in  signs  and  irritation  presence  [6].  The  patients  present  as  frequent main complain the “swelling” well defined associated to  pain  by  secondary  irritation  or  nasopalatine  nerve  pressure,  therefore  the  most  common  symptom  is  the  tumefaction  usually  placed  in  the  front  region  of  the  palate  medium  line.  It  can  be  present in the medium line of the vestibular region in the alveolar ridge  and  in  some  cases,  vestibular  and  palate  tumefaction  [4].  The bone expansion, abscess, slow healing after dental extraction, bulging  in  the  nasal  cavity  and  distortion  of  the  nasal  septum  are  other found signs [7,8].

Recently, archeologists have reported the earliest evidence of a dental procedure practiced on dental caries dating back to the Upper Paleolithic (over 14,000 years BC) - an occlusal carious cavity on a lower molar, partially cleaned with flint tools, practiced on a modern human specimen originating from a site in Northern Italy (Villabruna).
With this recent discovery in mind, a discovery which shows that dental interventions have a long history, let us follow the steps taken by dental practice since the dawn of human history until today.
Since then dental practice has taken huge strides in its development. Archeological finds suggest that Neolithic people had dental skills – for instance, the eleven human molars with drill holes made by a flint tool in a cemetery in Pakistan (7,500 to 9,000 BC) or evidence of dental treatments performed with a spring-operated drill on a site in the Indus Valley (7,000 BC).

This study aimed to systematically assess the outcomes of intentional replantation (IR) of teeth and to determine the survival rate, success rate, and prognostic factors related to the treatment. A search was conducted for all relevant English language articles published from January 2000 to October 2017. The search terms included "intentional replantation" and "teeth" according to the inclusion criteria. The Methodological Index for Non-randomized Studies (MINORS) was used to assess the methodological quality of included studies. Twelve studies were identified as relevant for the systematic review. In total, 896 patients with 905 teeth were examined for intentional teeth replantation. The success rate was greater than 90% in four studies (33.33%) and between 70% and 80% in five studies. At short-term follow-up (<6 months), the survival rate was approximately 90% in four studies. At longer-term follow-up (>36 months), the survival rates of teeth were slightly reduced in four studies, and tended to be stable after 48 months. In conclusion, the long-term success and survival rate of IR are likely dependent upon short extraoral time, reduced pocket depth, type of tooth, type of root-end filling material, and the prevention of atraumatic tooth root damage.

Objectives. The objective of this study was to explore the experience of patients who had stoma surgery to treat cancer in order to explicate why problems associated with stoma surgery are not decreasing despite technical improvements in stoma care.

Introduction: Information on the fluoride content in toothpastes commercialised in Indonesia is not yet available. Objectives: The objective of this study is to determine the fluoride content of toothpastes marketed in Indonesia and to determine if the fluoride content is in accordance with the information provided on the packaging and following the standards from evidence-based dentistry and Indonesian regulations. Material and methods: In vitro analysis of total fluoride (TF) in 10 brands of toothpaste for adults and eight for children, purchased from different stores. The toothpastes were analysed in triplicate using a fluoride ion-selective electrode. Statistical analyses were performed using a one-sample t-test or one-sample Wilcoxon signed-rank test to compare the difference between the fluoride concentration stated on the tube and the measured value. Results: The TF concentration in toothpastes for adults and children did not match the fluoride content provided on the packaging for most samples. Eleven toothpaste brands contained fluoride > 1000 ppm F, whereas the others contained fluoride < 1000 ppm F. Only one toothpaste contained fluoride that matched the standard from evidence-based dentistry and Indonesian regulations. Conclusions: Most toothpastes for adults marketed in Indonesia do not meet the required fluoride concentration for caries control. The results call for strengthened regulation and quality control of fluoride toothpaste in Indonesia to provide the maximum anti-caries effect.

Objective. The objective of this study was to explore the experience of patients who had stoma surgery to treat cancer in order to explicate why problems associated with stoma surgery are not decreasing despite technical improvements in stoma care.


Design. A longitudinal design was used in order to capture the process of preparing for surgery and dealing with its aftermath. Participants were interviewed using a semi-structured protocol on three occasions; 1-2 weeks before surgery (eight participants), 1-2 weeks after surgery (seven participants), and 3 months after surgery (four participants).


Method. Transcripts were analysed guided by the procedures of grounded theory. This involved developing categories from the data and linking them together to form a conceptual understanding of our participants' experience.


Results. Lowered personal control was the most important concept to emerge from the analysis. We identified perceived causes of lowered control, its mitigating factors, the strategies used to manage this experience and the consequences of these processes.


Conclusions. We make three recommendations based on the conclusion that improvements could be implemented in the psychological aspects of stoma care and, in particular, the enabling of patient perceived self-efficacy. First, improvements could be made in doctor-patient communication with doctors becoming more aware of their psychological impact on patients. Second, specialist stoma care nurses could be trained to recognize patients with dysfunctional self-efficacy beliefs and/or delayed adaptation. Finally, we identify a need for more prolonged practical emotional support for at least some stoma out-patients.

Introduction: Despite the advent of endoscopic sinus surgery, an external approach to the maxillary sinus may be ideal in certain situations. Objectives: This retrospective study reviews the relevance of, and the indications for, an external approach to the maxillary sinus via Caldwell-Luc operation or its modifications in a health resource-limited setting. Material and methods: Data from case notes and operating records of patients who had the Caldwell-Luc operation or its modifications between January 2004 and June 2018 at the Department of Maxillofacial Surgery of a University Teaching Hospital were retrospectively studied. Findings from descriptive statistics are represented in the form of tables and charts. Results: A total of 26 patients had the Caldwell-Luc operation within the period reviewed, and this consisted of 16 (61.5%) males and 10 (38.5%) females, giving a male to female ratio of 1.6 : 1. Patients' ages ranged from 10 to 45 years with a mean of 31.0 ± 8.8 years. The paediatric age group accounted for only 11.5% of cases. The main indication for performing the Caldwell-Luc operation was chronic maxillary sinusitis (n = 14; 53.8%), and occipitomental radiograph (n = 24; 92.3%) was the main imaging modality used for assessment. Compliance with follow-up review was poor. Conclusions: Despite the advent of functional endoscopic sinus surgery, an external approach to the maxillary sinus using the Caldwell-Luc operation is still relevant, especially in health resource-limited settings.

Introduction: There is an emerging need to improve oral health literacy (OHL) for good oral health outcomes worldwide. Many OHL tools have been developed, and the Indonesian version of Health Literacy in Dentistry (HeLD-ID) has the potential to be a valid and reliable oral health instrument for use in Indonesia. Objectives: We aimed to measure OHL using HeLD-ID and to analyze the socioeconomic determinants of OHL among adults in Jakarta. Material and methods: In total, 1000 adults representing five regions of Jakarta completed a 29-item OHL self-assessment using the HeLD-ID scale. The self-assessment also gathered socioeconomic and demographic data. The responses were graded on a 5-point Likert-type scale. A higher score indicated better OHL. Results: The overall mean HeLD-ID score was 2.73 ± 1.03. The score was significantly affected by age, region, marital status, the number of dependents, occupation, the level of education, income, and the type of health insurance. Only sex did not affect the scores. The overall Cronbach's α coefficient of the questionnaire was 0.958, and none of the CITC values were < 0.3. Conclusion: This study showed that HeLD-ID can successfully be applied to assess the OHL of adults in Jakarta. Additionally, it found that the overall OHL was lower than that of a previous study, with many sociodemographic factors significantly affecting OHL.

Introduction: Joint Vibration Analysis (JVA) is based on simple principles of motion and friction and is used to the diagnosis of temporomandibular disorders. The efficacy of diagnostic modalities of JVA, assessed by reliability, need to be proved. Aim: The aim of the study was to assess the intra-rater reliability of TMJ joint vibration. Material and methods: Thirty-two healthy subjects (14 men and 18 women ; mean age 28.4±7.4) were recruited. The BioJVA Joint Vibration Analysis , compatible with BioPAK Measurement System, was used for the recording as the electrovibratography. The vibrations were recorded in two sessions with 15 minutes of rest between measurements. IBM SPSS STATISTICS 21 program was used to prepare the statistical analysis. For the determination the intra-rater reliability of TMJ joint vibration, intraclass correlation coefficients (ICC) and 95% Confidence Interval (95% CI) were used. Results: Total integral variables, peak amplitude for both sides and median frequency for right side showed excellent reliability across two sessions (ICC: >0.75). The peak frequency, distance to CO for both sides, median frequency for the left side and the ratio of >300/<300 Hz for right side showed fair/good reliability (ICC: 0.4-0.75). The ratio of >300/<300 Hz for left side showed poor reliability (ICC:<0.4). Conclusions: The JVA measurements were qualitatively similar over both sessions. To evaluate the diagnostic value of JVA in patients with temporoman-dibular disorders, studies need to be continued.

PRIŠTINA 24, 25. i 26. OKTOMBAR !4sa VII Jugoslovenski simpozijum o zdravstvenoj zaštiti na nivou doma zdravlja Simpoziumi VII Jugosilav per mbrojtjen shendetesore ne nivel te shtepise se shendetit VII Jugoslovenski simpozij o zdravstvenom varstvu na razini doma zdravlja VII Југословенски симпозиум за здравствената заш тита на ниво на здравствени дом Zbornik Mi SEDMI JUGOSLOVENSKI SIMPOZIJUM O ZDRAVSTVENOJ ZAŠTITI NA NIVOU DOMA ZDRAVLJA PRIŠTINA, 24 -26. X 1979. ZBORNIK RADOVA m Ш FARMAKOS P R I Z R E N 1979.

Recent advances in removable prosthodontics include biofunctional prosthetic system (BPS), which closely replicates aesthetics, comfort, functional, and phonetic aspects of natural dentition. With this background in mind, we conducted a systematic review to critically evaluate application of BPS over conventional dentures in removable prosthodontics. A search for full text articles with keywords "biofunctional prosthetic system (BPS)", using PubMed search engine was carried out. Nine full text articles were eligible for final review and among them, three were of original research studies. All the original research articles were questionnaire-based studies. Six articles were reports of edentulous cases rehabilitated using BPS. The clinical findings and questionnaire responses of the studies revealed that the BPS performed better than the conventional dentures in most aspects of clinical evaluation. Moreover, the results showed that BPS systems outperformed conventional dentures in aesthetics, patient comfort, and function. Based on these findings, we concluded that the volume of literature available regarding the comparison of BPS to the conventional denture is insufficient to prove that it has a significant advantage over the conventional system. There is a definite need for larger number of clinical trials to establish the competitive superiority of BPS technique.

Introduction: the removable dental prostheses is a rehabilitation treatment that returns the functions to the stomatognathic system; for its successful action it is necessary responsibility and commitment between the professional and the patient on hygiene and mode of use.
Objective: to determine the hygienic condition of the removable acrylic prostheses in patients attended in the dental clinics at San Gregorio de Portoviejo University in the period March - August 2019.
Method: A cross-sectional descriptive study was conducted using a validated questionnaire and observation worksheet. Allparticipantsin the research provided handwritten signature informed consent form before answering the questionnaire and being examined. Descriptive statistics, frequency and percentage were applied.
Results: a total of 100 patients were evaluated, with higher prevalence in females (74%), and 50 years of age or more (54%). The results show that 53% of the patients use prostheses made for five or more years, and 94% have not attended subsequent checks. The mechanical method (86%) is the most used to sanitize the prostheses, and in 65% of the prostheses was observed accumulation of bacterial plaque and food debris. Most patients (78%) wear their prostheses throughout the day (24 hours) and about half have clinical signs of subprosthetic stomatitis (46%).
Conclusions: Most patients do not comply with the rules of hygiene and use of removable prostheses so a change is needed in their education and monitoring.

Introduction: The pleomorphic adenoma is a benign tumor of the salivary glands. Its extra parotid locations are rare. The aim of this study is to describe the particular management of the pleomorphic adenoma in its unusual location. Observation: This patient was a 35 - year - old patient referred from Zinder Hospital for the management of tumefaction in the mandibular region that had been undergoing surgery for 10 years. The clinical and paraclinical examinations led to the conclusion of a pleomorphic adenoma of the submandibular gland, by imaging and confirmed by the anatomo-pathological examination of the surgical specimen, which measured 15x12x8cm following submandibulectomy with complete tumor resection. The follow-up was simple and no recurrence or malignant transformation was reported after a mean follow-up of one year. Conclusion: The extra-parotid localization of the pleomorphic adenoma is dominated by the submandibular gland. This localization stands out in its clinical and therapeutic peculiarities.

Given the relatively recent history of geosynthetic clay liners (GCLs), questions remain over their longterm performance in landfills. Defects in the geomembrane (GM) overlying the clayey barrier are likely to develop, providing an advective pathway for contaminants to migrate into the liner and the underlying groundwater. The effects of this process on the integrity of the liner have been usually quantified through hydraulic leakage rates, which does not account for diffusion effects. More recently, efforts have been made to couple leakage with contaminant migration analyses that take into account defects in the geomembrane and evaluate chemical concentration in the groundwater, as well as leakage rates. However, these studies have always been conducted in 1D or 2D, despite the fact that 3D effects are clearly present.

Introduction: Assessment of dental health attitudes among older people in the region of West Pomerania, Poland, and a comparison with their dental status shown by the decayed, missing, and filled teeth (DMFT) index. Material and methods: The study involved 294 people aged 65-74 years living in West Pomerania, NW Poland. The study was conducted in the city of Szczecin and the towns of Łobez and Police in 2014-2015. Interviews with the participants provided information on their health attitudes. Clinical examinations evaluated their dentition to produce a DMFT index. Results: The largest group of respondents (106 people, 36%) visited the dentist once a year. Only 50.3% (n = 148) visited the dentist because of a follow-up. As many as 3.7% of patients used a toothbrush less than once a day or not at all, while 6.8% replaced their toothbrush less than once a year or not at all. Only 20.4% of the respondents cleaned their interdental spaces. The mean number of missing teeth, and the DMFT index were higher among older adults with the lowest level of health attitudes. Conclusions: The examined older adults in West Pomerania showed inadequate dental health attitudes. Only a fraction reported a habit of cleaning interdental spaces. In general, health attitudes had a significant impact on the dental health of the examined older adults. This paper shows the need for systematic, standardised, and reproducible epidemiological studies in older adults.

Introduction: Tobacco smoking is a very common addiction worldwide and an environmental factor predisposing to periodontal disease. The role of cytokines and chemokines in chronic periodontitis pathogenesis has been previously confirmed. Evaluating serum cytokines and chemokines is essential in determining inflammatory responses in periodontitis patients. Previous findings imply a close relationship between elevated cytokine interleukin-18 (IL-18) levels and chronic periodontitis pathogenesis in smokers; however, the usefulness of IL-18 as an inflammatory marker in gingivitis remains unclear. The aim of the study was to analyze IL-18 levels in smokers with chronic periodontitis. Objectives: The purpose of this study was to analyze the relevance of IL-18 levels to the severity of chronic periodontitis in smokers in terms of the radiographic features of mandibular posterior teeth. Material and methods: A cross-sectional study of 76 male subjects aged 19-34 years with chronic periodontitis in Depok, Indonesia was performed. Clinical data (OHIS, pockets, CAL), smoking status, and IL-18 samples were collected; samples were detected using ELISA. Results: IL-18 levels in smokers with moderate periodontitis were higher than in those with mild periodontitis. However, the results showed that the differences in IL-18 levels were not significant based on daily cigarette consumption, and no significant correlation was revealed regarding IL-18 concentrations in smokers based on smoking duration. The correlation test results demonstrated a significant relationship between periodontitis severity and the number of cigarettes consumed per day, but no significant correlation between periodontitis severity in smokers and smoking duration. Conclusions: IL-18 levels in saliva and gingival crevicular fluid can be used as a predictable biomarker for periodontal disease progression, but cannot be used to determine the patients' smoking habits. Further studies are required to confirm the relationship between IL-18 and chronic periodontitis in smokers.

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

As the inorganic constituents of skeletons, dentine and the enamel of teeth in all vertebrates, as well as antlers of male deer, calcium orthophosphates (CaPO4) appear to be the key materials to sustain all life on Earth. Therefore, biologically relevant CaPO4 possess all the necessary features of the biomaterials, such as biocompatibility, bioactivity, bioresorbability, osteoconductivity, osteoinductivity, and appear to be non-toxic, non-inflammatory and non-immunogenic. In this book, the author presents current state-of-the-art applications of CaPO4 as bioceramics, deposits (coatings, films and layers) and in dentistry. Topics discussed include chemical composition and preparation, forming and shaping, sintering and firing for CaPO4-based bioceramics, chemical composition and preparation, pre- and post-deposition treatments for CaPO4-based deposits, followed by the detailed description of their major properties, biomedical applications and in vivo behavior. The detailed description of current CaPO4 applications in dentistry both for dental caries prevention and as various types of dental treatments is given in the last section of this book.

The loss of tooth substancecolloquially often referred to as abrasionis one of natural wear and tear and is not primarily to be regarded as pathological. Although abrasion is tangible after a few months of biting or chewing on any given tooth, its scientific consideration in the normal study of human skeletal remains has been rather neglected. The etiology contributes to conceptual diversity: abrasion, attrition, erosion/corrosion, abfraction etc. In addition, the often subjective way results are ordered into one of the many classification schemes makes comparing findings more difficult. The basis for the results -individuals' denture compared to the overall dental findingsleads to a subdivision in the analysis.

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

Introduction: Young dentist after graduation often have to perform a wide range of dental treatments without any assistance. Objectives: The aim of the study was to assess dental education in different medical universities in Poland. Material and methods: A paper-pencil survey was carried out among fifth-year students of dentistry in 8 medical universities. The questionnaire assessed a self-perceived confidence in clinical skills and evaluated the level of preparation for independent work in general dental practice. Each respondent completed the given questionnaire independently in the allocated time. Results: Out of 500 participants, only 98 (19.6%) considered themself well-prepared for independent work after graduation. The students felt mostly unready for endodontic treatment with rotary instruments (79.4%) and warm gutta-percha (89.2%) as well as for preparing teeth for fixed dentures (77.2%). Most students felt well-prepared for direct filling restoration (83.6%) and tooth extraction (79.8%). About half of the students considered themself prepared for using a rubber dam (48.2%), making complete denture (58.6%), and teeth splinting (43.6%). Conclusions: Dental students feel well-prepared for those procedures, which they repeated multiple times during their education. That is why clinical preparation is significant in the conditions of medical simulation for all clinical procedures, which young dentists will perform in their future work.

End colostomy rates following colorectal resection vary across institutions in high‐income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left‐sided colorectal resection.

Introduction: temporomandibular dysfunction syndrome is an alteration that includes a set of signs and symptoms related to the structures of the stomatognathic system. Objective: to determine the effectiveness of the joint treatment of laser and drug support therapy, applied to patients with pain syndrome temporomandibular joint dysfunction. Method: a therapeutic intervention was carried out in 84 patients who attended the prosthesis consultation of the "Julio Antonio Mella" Stomatology Clinic in Guantánamo, in the period from September 2014 to the same month of 2015. Two therapeutic groups were formed: one received laser and drug support therapy and, the other, drug support therapy, each group with 42 patients who were evaluated at 5, 10 and 15 days. General and clinical variables were taken into account: age, degree of severity, pain behavior and evaluation criteria. Results: the combination therapy of laser and drug therapy proved to be more effective than drug therapy, as the symptoms disappear in a shorter period of time. Conclusions: it was validated that the combined treatment of laser and drug support therapy was more effective as the symptomatology progressively disappeared in a shorter period of time, in relation to those that were treated with conventional treatment and therefore its application is feasible.

VIII JugoslovenskI simpozljum o zdravstvenoj zaštiti na nivou Doma zdravlja VIII Jugosiovanski simpozij o zdravstvenom varstvu na ravni Zdravstvenoga doma VIII Југословенсни симпозијум за здравствена заштита на н иво на Здравствени дом SimpozlumI I Vlll-te jugosilav mbi mbrojtjen shendetšsore nš nivelin e shtšpise se shendetit zbornik radova Koiašin, 1-4, oktobra 1980. MEDICINSKI CENTAR, LJIG P UŠENJE KAO ETI OL O Š KI FAKTOR VEĆEG BROJA LEUKOPLAKIJA SLUZOKOŽE USNE DUPLJE

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.