The objective of this study was to analyse the pattern of medication prescribing among dental practitioners in the Republic of Croatia and to compare it with general medical practice patterns at the ...national level.
Data on drug prescriptions were obtained from the Croatian Health Insurance Fund. The number of dentist prescriptions, the cost of medicine denominated in the national currency (Croatian Kuna HRK), and the number of packages and days prescribed have been included in the analysis.
Results indicate that there was an increase in medication prescribing(+5.7%) by dentists, with antimicrobials comprising the majority, whereas national medical antimicrobial prescribing had slightly decreased. Antibiotics accounted for 80% of all dentists’ prescriptions, with penicillins being the most commonly prescribed. In particular, amoxicillin with clavulanic acid accounted for 56.4% of all antibiotics prescribed. Such broad-spectrum antibiotics were prescribed more frequently than those of narrow-spectrum. Antibiotics were followed by nonsteroidal anti-inflammatory drugs, with prescribing frequency for ibuprofen increasing by 75%.
Current trends show an increase in the overall prescription rate for all medications prescribed by dentists. The largest increase was observed for the broad-spectrum amoxicillin with clavulanic acid, and ibuprofen. As the apparent widespread use of broad-spectrum antibiotics by dentists in Croatia is in contrast to national and international recommendations for antibiotic stewardship, there is a need for further prospective investigation and possible provider education and guidelines.
Antibiotic prophylaxis (AP) of infective endocarditis (IE) in dental practice is a controversial topic. We evaluated the characteristics of the odontogenic IE and assessed the practice and sources of ...information pertaining to the topic utilized by the Croatian dentists. We conducted a retrospective review of consecutive medical charts of adult patients with IE, admitted to the University Hospital for Infectious Diseases in Zagreb, Croatia, between January 2007 and December 2017. In addition, a cross-sectional, self-reporting questionnaire survey was conducted with participation of 348 Croatian dentists. Of the 811 admissions for suspected IE (40.3% of all Croatian and 92.1% of all Zagreb hospitals), 386 patients were confirmed as definite IE: 68 with odontogenic IE and 318 with IE of other origin. Their first hospital admissions were analyzed. Definite odontogenic IE was defined as a positive echocardiographic result in conjunction with two separate positive blood cultures showing exclusive oral cavity pathogen or
Streptococcus viridans
associated with current or recent (< 1 month) dental, periodontal, or oral cavity infection. The annual number of new odontogenic IE patients appeared constant over time. In 91.2% of the cases, odontogenic IE was not preceded by a dental procedure; poor oral health was found in 51.5% of patients, and 47.1% had no cardiac condition that increases the IE risk. In-hospital mortality was 5.1% with conservative treatment and 4.5% with cardiac surgery and was much lower for odontogenic IE than in non-odontogenic IE (14.6% and 34.4%, respectively). An increasing number of admissions for non-odontogenic IE were observed in parallel with an increasing number of staphylococcal IE. Surveyed dentists (500 invited, 69.6% responded) were aware of the AP recommendations, but were largely reluctant to treat patients at risk. In people with poor oral health, AP should be considered regardless of cardiac risk factors. Improvement of oral health should be the cornerstone of odontogenic IE prevention.
The aim of this study was to determine the concentration of fluoride ions present in various solvent solutions and compare it to the label amount of fluoride concentration.
The gel containing amine ...fluoride and sodium fluoride was compared to gel containing sodium fluoride only. The solvents used in this study were distilled water, redistilled water, tap water, 0.9% sodium chloride solution and the artificial saliva. The amount of fluoride ion (F
) was determined by the use of fluoride ion-selective electrode. The ANOVA and the Post hoc Tukey's test were used. The significance level was α = 5%.
The differences between F
ion release in various solvents were statistically significant (p < 0.05). The F
ion concentrations measured in both gels' redistilled water solutions were higher than the label concentration. There was a significant difference in fluoride ion release in sodium fluoride only gel solutions. Fluoride ion release was significantly different in combined fluoride gel solutions.
Amine fluorides do not interact with other ions present in the solution, whereas F
ion release from sodium fluoride alters when other ions are dissolved in the same solution. Amine fluorides deliver F
ions for caries prevention more efficiently.
Objective: This study aimed to compare the force degradation of elastomeric chains submerged in commonly used mouthrinses. Methods: One hundred samples of elastomeric orthodontic chains from five ...different brands (Ormco, GC, RMO, Forestandent, and 3M Unitek) were initially activated on double length, and the force was measured with a universal mechanical testing machine. Then, elastomeric modules were thermocycled and immersed into four different mouthrinses: Octenident, Vitis Orthodontic, Perio Plus+, and Listerine through a total number of three cycles which simulated 30 days of intraoral exposure. Force decay was measured after each cycle. Results: All specimens showed statistically significant force degradation over the tested period (p < 0.001). After thermocycling and immersion in oral antiseptics, the lowest measured force was found in Forestadent EOC in Listerine with a median of 70 cN (70–75 cN) and Vitis orthodontic with a median of 70 cN (70–80 cN). On the contrary, the least prone to force reduction was the control group of Ormco 280 cN (275–285 cN) and RMO 280 cN (270–280 cN). Conclusions: Elastomeric chains’ force degradation could be exacerbated by the use of mouth rinses. These data could be beneficial in choosing the appropriate combination of elastomeric chain and mouthrinse for optimal results of orthodontic therapy.
To determine the effect of two adhesive systems and a glass ionomer coating resin on fluoride release and concurrent pH changes over a period of 168 days.
Four restorative materials were ...investigated: a giomer Beautiful II, an "alkasite" material Cention, a conventional composite Filtek Z250, and a glass ionomer cement Fuji IX Extra. Light-cured composite specimens were coated using G-aenial Bond and Clearfil Universal Bond Quick. Glass ionomer specimens were coated using GC Fuji Coat LC. Uncoated specimens were used as references. Quantitative fluoride release and pH changes were measured after1 h, 24 h, 2 days, 7 days, 28 days, 84 days, and 168 days.
The cumulative fluoride release after 168 days increased for uncoated specimens in the following order: Filtek Z250 < Beautifil II < Cention < Fuji IX Extra. A comparatively lower fluoride release was measured for the composites coated with Clearfil Universal Bond Quick, with cumulative values after 168 days increasing in the following order: Filtek Z250 < Beautifil II < Cention. The composites coated with G-aenial Bond showed lower fluoride release compared to the uncoated specimens, with cumulative values increasing in the following order: Filtek Z250 < Beautifil II < Cention. The composites coated with G-aenial Bond showed pH values in the acidic range (4.4-5.7) after 1 h and 24 h.
Fluoride release varied among the investigated restorative materials and depended on the use of dental adhesives and coatings. The pH of all materials, coating types and time points varied.
The 2019 coronavirus pandemic (COVID-19) has affected clinical practice and, consequently, drug prescribing in dental practice. We investigated how the pandemic affected the prescribing behavior of ...dentists in Croatia. Data on prescribing practices for this study were provided by the Croatian Health Insurance Institute. The analysis included the number of prescriptions, costs, and the number of packages prescribed. The World Health Organization's defined daily dose per 1000 inhabitants (DID) per day was used as an objective utilization comparison. During the first pandemic year, prescribing practice changed the most. Wide-spectrum antibiotics, analgesics, and antiseptics showed the highest trend in change. A statistically significant change in prescribing practices during the pandemic period was noted for amoxicillin with clavulanic acid, ibuprofen, and ketoprofen which showed an increase in trend, while cephalexin and diclofenac showed a statistically significant decrease. The highest increase in trend was recorded for azithromycin, at +39.3%. The COVID-19 pandemic has been associated with a marked increase in medication utilization, especially in the first year of the pandemic. The increase in wide-spectrum antibiotic classes needs to be addressed and regulated so that patients accept that antibiotics are not a substitute for dental treatment and dentists always start treatment with narrow-spectrum antibiotics regardless of specific times, as is the case with the pandemic.
To assess the impact of pH level on force decay and color stability of orthodontic elastomeric chains (EOC) after exposure to commonly used beverages.
A total of 120 chain cuts were prepared from 2 ...different manufacturers (GC Orthodontics Europe GmbH, Breckerfeld, Germany, and FORESTADENT® - Bernhard Foerster GmbH, Pforzheim, Germany). According to the distance between loops, two types of chains were selected from each manufacturer: short and medium ones. Chains were immersed into 10 commonly used beverages with different pH values. After 7 days, force degradation was evaluated with the universal machine for mechanical testing (Model 4411; Instron, Canton, USA) and color change using a VITA Easyshade® digital spectrophotometer. Kruskal-Wallis with post-hoc Dunn's test for intergroup comparison and Wilcoxon rank test for intragroup comparison.
Initial force varied among EOC brands, with GC short chains having the highest force and Forestadent medium chains the lowest. The most pronounced force decay occurred within 24 h, notably affecting Forestadent short chains the most, followed by Forestadent medium, GC short, and GC medium chains. Despite a higher force drop rate over seven days, short EOCs maintained higher forces than medium EOCs. GC EOCs consistently maintained higher forces after seven days compared to Forestadent EOCs. After the immersion of EOC in different solutions for 24 h, only Evian water, Soy milk, and Coconut water did not change color. After 7 days, the greatest color change was recorded in coffee.
There is no correlation between pH value and force decay of polyurethane chains. Short chains showed more constant force delivery and greater value of remaining force in comparison to medium ones. Color stability was mostly affected by coffee, followed by matcha tea, soy milk, and apple juice.
While smoking is recognized as one of the factors for the development and progression of periodontal diseases, a relation between the composition of the subgingival microbiota and smoking is yet to ...be elucidated. The aim of this study was to investigate the prevalence of subgingival bacteria in young smokers and non-smokers without clinical signs of periodontal disease. In this cross-sectional study, performed at the Department of Pharmacology, School of Dental Medicine, University of Zagreb, we enrolled 32 periodontally healthy smokers and 32 non-smokers, aged 25-35 years old. The number of oral bacteria and the prevalence of particular bacteria were assessed for each subject. Subgingival plaque samples were collected with sterile paper points from two first molars for microbiological analyses with MALDI-TOF mass spectrometry. In smokers, a significantly higher prevalence of
was observed compared to non-smokers, and a significantly lower prevalence of
was observed compared to non-smokers. Smoking affects the composition of subgingival microbiota, either via depletion of beneficial bacteria or the increase in pathogenic bacteria.
This article discusses the possible cariostatic mechanisms of the action of fluoride. In the past, fluoride inhibition of caries was ascribed to reduced solubility of enamel due to incorporation of ...fluoride (F–) into the enamel minerals. The present evidence from clinical and laboratory studies suggests that the caries-preventive mode of action of fluoride is mainly topical. There is convincing evidence that fluoride has a major effect on demineralisation and remineralisation of dental hard tissue. The source of this fluoride could either be fluorapatite (formed due to the incorporation of fluoride into enamel) or calcium fluoride (CaF2)-like precipitates, which are formed on the enamel and in the plaque after application of topical fluoride. Calcium fluoride deposits are protected from rapid dissolution by a phosphate –protein coating of salivary origin. At lower pH, the coating is lost and an increased dissolution rate of calcium fluoride occurs. The CaF2, therefore, act as an efficient source of free fluoride ions during the cariogenic challenge. The current evidence indicates that fluoride has a direct and indirect effect on bacterial cells, although the in vivo implications of this are still not clear. Conclusion. A better understanding of the mechanisms of the action of fluoride is very important for caries prevention and control. The effectiveness of fluoride as a cariostatic agent depends on the availability of free fluoride in plaque during cariogenic challenge, i.e. during acid production. Thus, a constant supply of low levels of fluoride in biofilm/saliva/dental interference is considered the most beneficial in preventing dental caries.
The aim of this study was to quantify vibrations and their influence on visual acuity. The study consisted of two parts, laboratory and clinical. Time-averaged holographic interferometry (TAHI) ...method was used in laboratory for measuring the amplitude of tooth vibrations induced by dental handpiece. The amplitudes of tooth vibrations were measured for the three diameters and three speeds. The larger diameter coupled with increasing speed resulted in greater vibration amplitudes, whereby a maximum amplitude of less than one micrometer was detected. For quantifying the natural visual acuity for the corresponding tooth vibrations, we have used the clinical condition approach with miniaturized Snellen optotype as an assessing tool. Central visual acuity did not display variance in visual acuity at rest or under load. Results indicate that the vibrations induced during cavity preparation are not sufficient to negatively affect visual acuity of dentists.
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