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<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>

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.

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.

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

Objective COVID-19 pandemic led to major life changes. We assessed the psychological impact of COVID-19 on dental academics globally and on changes in their behaviors. Methods We invited dental academics to complete a cross-sectional, online survey from March to May 2020. The survey was based on the Theory of Planned Behavior (TPB). The survey collected data on participants’ stress levels (using the Impact of Event Scale), attitude (fears, and worries because of COVID-19 extracted by Principal Component Analysis (PCA), perceived control (resulting from training on public health emergencies), norms (country-level COVID-19 fatality rate), and personal and professional backgrounds. We used multilevel regression models to assess the association between the study outcome variables (frequent handwashing and avoidance of crowded places) and explanatory variables (stress, attitude, perceived control and norms). Results 1862 academics from 28 countries participated in the survey (response rate = 11.3%). Of those, 53.4% were female, 32.9% were <46 years old and 9.9% had severe stress. PCA extracted three main factors: fear of infection, worries because of professional responsibilities, and worries because of restricted mobility. These factors had significant dose-dependent association with stress and were significantly associated with more frequent handwashing by dental academics (B = 0.56, 0.33, and 0.34) and avoiding crowded places (B = 0.55, 0.30, and 0.28). Low country fatality rates were significantly associated with more handwashing (B = -2.82) and avoiding crowded places (B = -6.61). Training on public health emergencies was not significantly associated with behavior change (B = -0.01 and -0.11). Conclusions COVID-19 had a considerable psychological impact on dental academics. There was a direct, dose-dependent association between change in behaviors and worries but no association between these changes and training on public health emergencies. More change in behaviors was associated with lower country COVID-19 fatality rates. Fears and stresses were associated with greater adoption of preventive measures against the pandemic.

Introduction. Decreased salivary flow is frequently associated with numerous diseases such as diabetes mellitus and may lead to numerous oral diseases. The aim of this study was to compare salivary flow rate and oral health status in type 2 diabetics and healthy controls. Material and methods. The study involved 90 patients, divided into the three groups: 30 with well controlled (HbA1c<9%), 30 will poorly controlled (HbA1c?9%) diabetes and 30 healthy subjects. The following clinical parameters were determined: decayed, missing and filled teeth (DMFT); plaque index (PI), sulcus bleeding index (SBI), probing pocket depth (PPD) and clinical attachment level (CAL). Culture of Candida spp. specimens were obtained from tongue dorsum and inoculated into Sabouraud Dextrose Agar. Saliva was collected using ?a spit technique?. Results. Highest mean of unstimulated salivary flow was in healthy subjects; however significant difference between groups was not observed. Stimulated salivary flow results indicate significant reduction in diabetics as well as significant relation between metabolic control and salivary flow. Unstimulated and stimulated salivary flows were negatively and significantly correlated with periodontal parameters and DMFT. Conclusion. The present findings indicate that decreased salivary flow rate could have a significant impact on oral health status in type 2 diabetics.

Many of medicaments used historically in root canal treatment have been shown to be cytotoxic. Paraformaldehid agents (such as Toxavit and Depulpin) are used to devitalize inflamed pulp when local anesthesia is ineffective. The misuse of pulp devitalizing agents may cause damage to gingiva and alveolar bone. This case report demonstrates complications arising after application of paraformaldehyde containing paste, necrosis of the gingiva and alveolar cortical bone, which resulted in great loss of supporting bone. Surgical intervention was required wherein necrotic bone was removed and bone defect was filled with xenograft of bovine origin. After three months endodontic treatment was performed. After the treatment, the patient?s complaints were resolved. The use of paraformaldehyde-based agents during endodontic therapy requires special caution.