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Smiljka Cicmil

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Ana Cicmil, Smiljka Cicmil, Olivera Govedarica, Jelena Lečić, Tanja Ivanović, Marija Lučić, Ilija Joknić, Jelena Krunić

This study was aimed to investigate awareness of periodontitis among undergraduate students at a faculty of medicine in Bosnia and Herzegovina. This cross-sectional study was conducted among undergraduate students of the Faculty of Medicine Foca enrolled in three study programs (Medicine, Nursing, and Special Education and Rehabilitation). Knowledge and awareness of periodontitis were collected using a structured questionnaire. Approximately 58% of students had heard the term periodontitis. Higher percentage of Medicine and Nursing students identified Gum Recession, Bleeding Gums, Tooth Loss and Loose Tooth as common symptoms of periodontitis compared to Special Education and Rehabilitation students. Knowledge of risk factors for periodontitis differed between the groups, with Nursing students showing greater awareness but also incorrect recognizing of several risk factors. About one third of students answered that Diabetes Mellitus is related to periodontitis (32.4%). Significantly lower percentage of Nursing students assessed their knowledge of periodontitis as poor compared to Medicine and Special Education and Rehabilitation students. The findings revealed a lack of adequate knowledge of periodontitis across all the observed study programs. Strengthening periodontal education within undergraduate curricula is essential, particularly considering the established links between periodontal and systemic diseases.

Ana Cicmil, Smiljka Cicmil, Jelena Lečić, Olivera Govedarica, Tanja Ivanović, Marija Lučić, Ilija Joknić, Jelena Krunić

Objective. The aim of this study was to assess oral hygiene habits, as well as awareness and knowledge among undergraduate students at a Faculty of Medicine in Bosnia and Herzegovina. Methods. This cross-sectional study was conducted at the Faculty of Medicine in Foča and included 333 students across three study programs: Medicine (M), Nursing (N), and Special Education and Rehabilitation (SER). The questionnaire was used to obtain demographic information, as well as data on oral hygiene habits and knowledge of oral health. Results. The largest proportion of students (56.2%) brush their teeth twice daily. A higher percentage of N and SER students brush their teeth longer than M students (p=0.004). Students most often replace their toothbrushes every 3 months or sooner (76.3%); 58.9% regularly visit a dentist; and 61% report no oral health problems. Only 14.4% of students believe that dental plaque dysbiosis is the cause of caries, while more than half of the students (53.5%) do not know the impact of dental plaque. Additionally, more than one-third of students (35.7%) are unaware of preventive measures for oral disease. A greater number of M and N students than SER students reported that oral health is related to cardiovascular disease (p=0.002), and more M students reported that it is related to cancer compared to SER students (p=0.032). Conclusion. The results of this study indicate limited knowledge of oral health among students across all three study programs, underscoring the need to improve oral health education for health sciences students.

Verica Pavlić, K. Mizutani, Risako Mikami, Tijana Adamović, Smiljka Cicmil, Saša Dabić, Mirjana Gojkov Vukelić, Akira Aoki

Gingival melanin or metal tattoo pigmentation is occasionally observed and produces aesthetic problems to the patients while smiling. Among dental lasers, the Er:YAG laser used water spray minimizes the thermal changes of the irradiated soft tissue and safe and effective tool for depigmentation procedure. Microscope-assisted Er:YAG laser surgery can precisely detect and remove melanin pigmentation and metal debris embedded in the connective tissue. When using a laser device in a microsurgery, it is necessary to pay attention to safety. It is essential to wear protective goggles to protect from reflections and scattered light during treatment.

Bojana Davidovic, S. Jankovic, R. Mladenović, O. Dolić, Smiljka Cicmil, Jelena Lečić

The most significant contribution to the development of dentistry was made by Pierre Fauchard (1678-1761), whom we rightly consider the "father of modern dentistry". He wrote down his observations, thoughts, and innovations and in 1728 published "Le Chirurgien Dentiste ou Traite des Dentes". It is the first scientific textbook in this field and is considered to be the basis of a new age in dentistry. For the next hundred years, it was a basic textbook in dentistry. He managed to separate dental medicine from surgery, which has since been called odontology and set it on its own feet as an independent profession. As a result of Fauchard’s efforts, dental practice has changed for the better.

Verica Pavlić, Tijana Adamović, Smiljka Cicmil, Danijela Staletovic, Saša Dabić, Z. Brkic, Zdenka Stojanović

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Smiljka Cicmil, Ognjenka Janjić-Pavlović, Mihael Stanojević, Ana Cicmil, Olivera Govedarica, Z. Stojanović, Jelena Lečić

<p><strong>Introduction.</strong> Denture-induced fibrous hyperplasia (DFH) is a reactive lesion that occurs as a result of chronic trauma caused by the denture on the oral mucosa.</p> <p><strong>Case report.</strong> A female patient, 56 years old, reported to the Specialist Center for Dentistry at the Faculty of Medicine in Foča for the fabrication of complete dentures. She wore previous complete dentures for about 25 years and complained about their age and discoloration. Clinically, both dentures were poorly retained and stabilized by short wings, with pronounced signs of wear. Denture hygiene was poor. Multiple folds of hyperplasic connective tissue were observed in oral cavity upper vestibule mucosa. The lesion folds were pink and firm, corresponding to denture edges. Based on the anamnesis and clinical examination, a temporary diagnosis of denture-induced hyperplasia was made. The patient was informed about clinical condition assessment as well as possible therapeutic procedures and gave written consent to accept the offered therapeutic procedures. She was advised not to wear dentures for four weeks and to maintain proper oral hygiene. After that, the hyperplasia was surgically removed under local anesthesia. A tissue sample was sent for pathohistological analysis. A new pair of total dentures was made. Removed tissue pathohistological examination confirmed the diagnosis: &ldquo;Epulis fissuratum&rdquo;.</p> <p><strong>Conclusion.</strong> Education and regular check-ups are essential for the prevention of DFH. Patients should be given detailed oral and written instructions on oral and denture hygiene maintenance, with special reference to possible changes in oral tissues and the importance of regular follow-ups.</p>

Smiljka Cicmil, Ana Cicmil, Verica Pavlić, Jelena Krunić, Dragana Sladoje Puhalo, D. Bokonjić, M. Čolić

Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.

Nour Ammar, Nourhan M. Aly, M. Foláyan, Y. Khader, S. Mohebbi, Sameh Attia, H. Howaldt, Sebastian Boettger, J. Virtanen et al.

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.

Brankica Davidović, Ljiljana Bjelović, Igor Radovic, Bojana Davidovic, S. Jankovic, Smiljka Cicmil

Introduction. Successful endodontic treatment depends upon the clinician's knowledge and ability to recognize and diagnose the presence of anatomical and morphological variations of the root and canal system. The aim of this study was to establish the number of roots and root canal configurations of the maxillary second premolar in the population of Bosnia and Herzegovina. Methods. The study sample was comprised of 150 maxillary second premolar teeth extracted for orthodontic or prosthetic reasons. Endodontic drills were used for trepanation of cavum dentis, and the number and patency of each root canal were determined by Kexpander # 15. Then, the samples were decalcified, made transparent and colored, to enable 3D viewing of the canal system. Decalcified teeth were observed from two projections (clinical and approximal) and analyzed in detail with a magnifying glass under 3 × and 5 × magnification in order to determine the number of roots, number of canals, root canal configuration using Vertucci's classification and number of anastomoses between canals. Statistical significance was obtained using Chi-square test. Results. The results obtained by decalcification of the teeth showed that, by radiographic analysis from the clinical projection, all the teeth had a single root. While, by the analysis from the approximal projection, 94.0% had one, 6.0% two roots. From the approximal projection, 70.7% with a single root canal and 29.3% with two root canals are visualized. The most common type of root canal configuration in the maxillary second premolars was Type I in both clinical (87.9%) and approximal projection (40.7%). Conclusion. These results emphasize the importance of knowing the variations in root canal morphology, because excluding the possibility of morphological variations can lead to failure of endodontic therapy

Nour Ammar, Nourhan M. Aly, M. Foláyan, S. Mohebbi, Sameh Attia, H. Howaldt, Sebastian Boettger, Yousef S. Khader, D. Maharani et al.

COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants’ background variables. Multilevel linear models were used to assess the association between dental academics’ knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1 and 85.4%, P <  0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B) = 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B = 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B = 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B = 0.0007). Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.

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