Alen Braut

Recurrent aphthous stomatitis (RAS) is the most common inflammatory ulcerative disease of the oral mucosa characterised by painfull, round, or ovoid ulcers with circumscribed margins, erythematous haloes, and yellow-grayish...

Background and purpose: The purposes of this study were to analyse the prevalence of oral mucosal lesions with an emphasis on oral regions and possible predictors for their occurrence among removable prosthesis wearers.Materials and methods: The study included 125 removable prosthesis wearers (96 women and 29 men) who were divided into two groups: complete (n=86) and partial (n=39) denture prosthesis wearers. Predictors and oral mucosal lesions were assessed using a questionnaire and clinical oral examination. Multiple logistic regression was used to assess the association of oral lesions with predictors.Results: Oral mucosal lesions presented in 74.40% of examinees and their occurrence was linked to the male gender (p=0.045, OR 3.72; 95% CI:1.03-13.39) and xerostomia (p=0.005, OR 4.472; 95% CI:1.56-12.79). The majority of the lesions were present on the tongue (50.40%) and palate (43.20%), with the least occurring on the oral cavity floor (2.40%). The occurrence of palatal lesions was linked to age (p=0.008, OR 1.097; 95% CI:1.03-1.18), prosthesis age (p=0.002, OR 1.817; 95% CI:1.72-1.93), prosthesis wearing at night (p<0.001, OR 13.01; 95% CI:1.82-18.98), smoking (p=0.033, OR 4.532; 95% CI:1.13-18.11) and xerostomia (p=0.003, OR 5.874; 95% CI:1.81-18.98). The occurrence of tongue lesions was linked to age (p=0.042, OR 1.135; 95% CI:1.02-1.25).Conclusions: Increased care and frequent follow-ups need to be implemented among denture prosthesis wearers that are male, elderly, smokers, who wear prosthesis at night and patients with older prosthesis in order to diagnose and cure oral mucosal lesions in time.

Objective: To report a conservative treatment of a rare developmental anomaly.Case report: A 73‐year‐old patient with previously initiated therapy and acute apical abscess of a maxillary right central incisor fused with the supernumerary tooth sought treatment. The conservative approach included nonsurgical root canal treatment and composite restoration.Conclusion: This case illustrates the importance of an individual approach when treating anomalous teeth. Priorities in pain and infection management to properly and functionally restore teeth should be unaffected by age.

This study investigated the relationship between chronic head, face and neck pain, and the level of depression in Croatian war veterans with post-traumatic stress disorder (PTSD). The presence of self-reported pain, pain on digital palpation, and pain severity in masticatory and neck muscles, temporomandibular joints and sinuses, as well as the level of depression were assessed in a group of war veterans with PTSD (n=52). Control groups consisted of war veterans without PTSD (n=50) and healthy men that were not engaged in war actions and were free from PTSD (n=50). The number of self-reported pain and number of painful sites were correlated with the level of depression. More self-reported pain and painful sites were recorded in the group of war veterans with PTSD as compared with either war veterans without PTSD or healthy men. Furthermore, PTSD patients mostly suffered from severe depression. There was a statistically significant positive correlation between all investigated pain parameters and level of depression. As the most important finding, the present study demonstrated chronic head, face and neck pain to be related to depression in PTSD patients.

To analyze the influence of the needle type, insertion depth, and irrigant flow rate on irrigant flow pattern, flow velocity, and apical pressure by ex-vivo based endodontic irrigation computational fluid dynamics (CFD) analysis. Human upper canine root canal was prepared using rotary files. Contrast fluid was introduced in the root canal and scanned by computed tomography (CT) providing a three-dimensional object that was exported to the computer-assisted design (CAD) software. Two probe points were established in the apical portion of the root canal model for flow velocity and pressure measurement. Three different CAD models of 27G irrigation needles (closed-end side-vented, notched open-end, and bevel open-end) were created and placed at 25, 50, 75, and 95% of the working length (WL). Flow rates of 0.05, 0.1, 0.2, 0.3, and 0.4 mL/s were simulated. A total of 60 irrigation simulations were performed by CFD fluid flow solver. Closed-end side-vented needle required insertion depth closer to WL, regarding efficient irrigant replacement, compared to open-end irrigation needle types, which besides increased velocity produced increased irrigant apical pressure. For all irrigation needle types and needle insertion depths, the increase of flow rate was followed by an increased irrigant apical pressure. The human root canal shape obtained by CT is applicable in the CFD analysis of endodontic irrigation. All the analyzed values -irrigant flow pattern, velocity, and pressure - were influenced by irrigation needle type, as well as needle insertion depth and irrigant flow rate.

The purpose was to measure and analyse the vertical force and torque developed in the wider and narrower root canals during hand ProTaper instrumentation. Twenty human incisors were divided in two groups. Upper incisors were experimental model for the wide, while the lower incisors for the narrow root canals. Measurements of the force and torque were done by a device constructed for this purpose. Differences between the groups were statistically analysed by Mann–Whitney U‐test with the significance level set to P < 0.05. Vertical force in the upper incisors ranged 0.25–2.58 N, while in the lower incisors 0.38–6.94 N. Measured torque in the upper incisors ranged 0.53–12.03 Nmm, while in the lower incisor ranged 0.94–10.0 Nmm. Vertical force and torque were higher in the root canals of smaller diameter. The increase in the contact surface results in increase of the vertical force and torque as well in both narrower and wider root canals.

The purpose of the study was to histologically analyse transition from pulpitis to periapical periodontitis on dog's teeth. Pulps of mandibular premolars (37 roots) were exposed using a low‐speed handpiece. Teeth were left open to the oral environment for 20, 35, 50 and 65 days. After the experimental period animals were sacrificed. Undemineralised teeth with surrounding bone, embedded in methylmetacrylate, were prepared for standard histological analysis. All teeth with pulpitis (five roots), regardless of the experimental period, had acute serose periapical periodontitis. All teeth (15 roots) with partial pulp necrosis had subacute periapical periodontitis. Teeth with complete pulp necrosis (19 roots) had chronic periapical periodontitis and in one case suppurative apical periodontitis. The condition of the pulp correlates with the histopathological findings of periapical tissue in the open types of pulp infection. Acute periapical periodontitis begins during pulpitis and can occur before 20 days of pulp exposure in the dog.

The effects of irradiation on different cell compartments in the submandibular gland were analyzed in adult C57BL/6 mice exposed to X-ray irradiation and followed up for 10 days. Apoptosis was quantified using the terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end labeling method (TUNEL). Cell proliferation was detected using immunohistochemistry for proliferating cell nuclear antigen (PCNA). Radiation-induced apoptosis occurred rapidly, reaching a maximum 3 days post-irradiation. The percentage of apoptotic cells increased with the irradiation dose. At day 1 post-irradiation, cell proliferation was significantly reduced in comparison to sham-irradiated controls. After post-irradiation arrest of the cell cycle, proliferation increased in all gland compartments, reaching a maximum at day 6 post-irradiation. The proliferation response corresponded to the dose of irradiation. We suggest that the reason for gland dysfunction could be the coexistence of high apoptotic and proliferative activity in the irradiated gland.

The power for appreciating complex cellular interactions during embryonic development using green fluorescent protein (GFP) as a visual histological marker has not been applied to adult tissues due to loss of GFP signal during paraffin embedding and a high autofluorescent background, particularly in section of bone and bone marrow. Here we demonstrate that the GFP signal is well preserved in frozen sections of adult decalcified bone. Using a tape-transfer system that preserves histological relationships, GFP expression can be related to standard histological stains used in bone biology research. The choice of a dual-filter cube and a strong GFP signal makes it possible to readily distinguish at least four different GFP colors that are distinctly different from the autofluorescent background. An additional advantage of the frozen sections is better preservation of immunological epitopes that allow colocalization of an immunostained section with an endogenous GFP and a strong lacZ signal emanating from a β-gal marker gene. We present an approach for recording multiple images from the same histological section that allows colocalization of a GFP signal with subsequent stains and procedures that destroy GFP. Examples that illustrate the flexibility for dual imaging of various fluorescent signals are described in this study. The same imaging approach can serve as a vehicle for archiving, retrieving, and sharing histological images among research groups.

Previous work suggested that cleft lip with or without cleft palate (CL/P) is genetically distinct from isolated cleft secondary palate (CP). Mutations in the Bmp target gene Msx1 in families with both forms of orofacial clefting has implicated Bmp signaling in both pathways. To dissect the function of Bmp signaling in orofacial clefting, we conditionally inactivated the type 1 Bmp receptor Bmpr1a in the facial primordia, using the Nestin cre transgenic line. Nestin cre; Bmpr1a mutants had completely penetrant, bilateral CL/P with arrested tooth formation. The cleft secondary palate of Nestin cre; Bmpr1a mutant embryos was associated with diminished cell proliferation in maxillary process mesenchyme and defective anterior posterior patterning. By contrast, we observed elevated apoptosis in the fusing region of the Nestin cre; Bmpr1a mutant medial nasal process. Moreover, conditional inactivation of the Bmp4 gene using the Nestin cre transgenic line resulted in isolated cleft lip. Our data uncover a Bmp4-Bmpr1a genetic pathway that functions in lip fusion, and reveal that Bmp signaling has distinct roles in lip and palate fusion.