Abstract Objective  This study investigated biomechanical behavior of custom post core made of six different materials on the tooth with and without the ferrule under different occlusal load. Materials and Methods  Three-dimensional models of mandibular first premolar, with and without ferrule, reconstructed from micro-computed tomography image are restored with different custom post core and zirconia crowns. By using the finite element analysis, von Mises stress shown in MPa was measured under simulated axial and oblique load of 200 [N]. To compare the stress distribution, six different custom post core materials were chosen: zirconia, Ni-Cr alloy, gold alloy, glass fiber-polyether ether ketone, polyether ether ketone, and carbon fiber-polyether ether ketone. Results  Custom post cores with a higher modulus of elasticity showed higher measured stress in the posts, but less stress in dentin. Measured stress in custom post core under oblique loading was approximately three times higher compared with axial loading. Stress in custom post core and in dentin under both types of loads was slightly higher in teeth without ferrule effect. Conclusion  The use of custom cast post cores made of different alloys is recommended in restoration of endodontically treated teeth, with extensive loss of tooth structure especially in teeth without ferrule effect.

Aim To investigate the frequency of consumption of sweet and salty snacks among children aged 2-18 years in relation to their mothers' education level. Methods A descriptive epidemiological study was conducted in five dental practices at the School of Medicine of the University of Mostar from May to October 2022. The data were collected from medical records. Results: Out of a total of 477 children, 172 (36.1%) had mothers with a high school education, while 305 (63.9%) had mothers with a university degree. In the group of preschool children (aged 2-6 years), there were 42 mothers with high school education and 105 with university degree. In the group of school children (age 7-18 years) there were 130 mothers with high school education and 200 with university degree. The difference in the consumption of sweetened beverages among children of mothers with high school and university was not statistically significant. Similar results were found for the consumption of salty snacks, lollipops, caramels and candies. The frequency of the consumption of biscuits, chocolate and cakes (several times a day) was statistically significantly higher among the children of mothers with high school education (p=0.04), especially among school children. Eating habits of children, regardless of the level of education of their mothers, differed significantly only in the consumption of lollipops, caramels, and candies (p=0.03), which were consumed once a day by 79 (63.7%) schoolchildren and 45 (36.3%) of pre-schoolers. Conclusion A higher level of education among mothers does not necessarily equate to proper nutritional knowledge.

Objectives Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day’s busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well. Aims To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers. Methods The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits. Results ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%); dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children’s parents (CI=10.55%, RI=10.80%, TI=12.98%). Conclusion Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.

Background: Dental fear and anxiety (DFA) is ubiquitous among the adult population. The anxiety component of DFA is more strongly expressed in adults, and includes a physiological and psychological component, and is more often analyzed in research. Oral-surgical interventions represent a significant source of stress for the appearance of anxiety in subjects. The research aim was to analyze the presence of anxiety with the use of the revised Corah Dental Anxiety Scale (DASR) and the Spielberger State-Trait Anxiety Inventory (STAI) in adult patients during the treatment of extraction of impacted third permanent molars by oral surgery. Material and Methods: The study included adult patients of both sexes, who were previously scheduled for oral-surgical removal of third permanent molars. Anxiety levels were assessed preoperatively and postoperatively as follows: 1st measurement (day of examination)-DASR, and STAI (X1 and X2); 2nd measurement (immediately before the intervention)-STAI (X1 and X2); 3rd measurement (day after the intervention)-STAI (X1 and X2). Results: Preoperatively, the presence of high levels of general anxiety, situational anxiety, and dental anxiety was determined. The levels were decreased before the planned surgery and were significantly reduced in the postoperative period. The STAI scale could be used to assess the presence of situational anxiety in the dental office on an equal footing with other known measuring instruments (e.g. DASR). Conclusions: Adequate therapy should be considered to prevent preoperative anxiety, which would increase the satisfaction of patients and therapists while reducing complications related to this type of intervention.

Background/Aim: Surgical removal of impacted third molars is associated with possible complications that are primarily comprehended as expected. Increase in incidence and severity of complications is directly related to the depth of impaction, and to the age of the patient as well. The aim of this research was to investigate the possible influence of the treatment duration relating to age and gender of the patients, the occurrence of pain, and the existence of previous anxiety experience connected with surgical wisdom tooth removal. Material and Methods. The study included adults of both gender indicated for surgical removal of impacted third molars. The existence of previous wisdom tooth removal experience was determined during the first examination, and the subjects' anxiety and pain levels were determined pre-, and postoperatively. Results: There were no differences concerning the place of treatment (dental office/operating room) and the duration of surgery. Younger participants showed the lowest levels of preoperative anxiety and the highest levels of postoperative anxiety, and frequently reported postoperative pain. Female participants showed higher levels of preoperative and postoperative anxiety, and also frequently reported postoperative pain. Conclusions: Anxiety and pain scores were lower when there was a previous experience with removal of impacted wisdom teeth.

Background/Aim: The aim of the research was to examine the general attitude, knoweledge and practice of pediatricians about caries in children of preschool age. Material and Methods: The research was conducted from November 2019 to the end of January 2020. The research consisted of a survey of pediatricians. The questionnaire consisted of 4 modules and 37 questions, which related to the attitude, knowledge and practice of pediatricians on the prevention of early childhood caries. Results: The majority of pediatricians (84.9%) stated that they assess the nutrition of their patients, while 32.1% of them always do oral health assessment, and half of them in the second month of the child's life; and 39.6% assess oral health only if there is a problem. The majority of pediatricians (86.8%) recommended the first dental examination, most often in the first year of the child's life (79.5%), and then every 6 months (43.5%). The majority of respondents did not required information about the dental health of their patients' mothers, fluoride toothpastes and topical application of fluoride as well (62.3-75.5%). The majority of pediatricians (79.2%) have never provided or sometimes provided educational material on caries prevention and control to the parents of their patients. The most accurate answers and the highest percentage of correct answers that the pediatricians had were about attitudes (Z=8.98, 66.63%), while the fewest correct answers and the lowest percentage of correct answers regarding the practices on the prevention of early childhood caries (Z=11.91, 58.90%). Conclusions: The research showed that pediatricians have the good attitudes and knowledge, but do not implement prevention of early childhood caries in practice. The basic deficiency of attitude, knowledge and perception of the importance of prevention is a consequence of insufficient education of pediatricians.

Background/Aim: Deep carious lesions on primary teeth usually have been causing infectious dental pulp changes. If indicated, traditional endodontic root canal treatment for these kinds of pulpal infections in primary teeth usually should involve the performing of pulpectomy methods, but often with questionable prognosis. The lesion sterilization and tissue repair (LSTR) approach is one of the good endodontic therapeutic alternatives for affected primary teeth with a poor prognosis, which could otherwise be condemned to premature extraction. Aim was to evaluate the medium-term clinical success in everyday practice of the LSTR method applied in affected primary teeth with irreversible pulpal tissue infections by observation of reduction/absence of their clinical symptoms. Material and methods: The study sample included child patients who had one or more of their affected primary molars with irreversible pulpal tissue changes of poor prognosis treated with the LSTR method. For each patient whose primary molar tooth was endodontically treated with the LSTR method a clinical evaluation of treated tooth was performed at intervals of 1 and 12 months afterwards. Results: Study sample was consisted of 40 child patients aged 4 to 9 years, with 45 primary molars included in total. It was obvious that the symptoms related to affected sample teeth have already been decreased almost immediately after initial action of triple antibiotic paste. Final outcome after 12-months follow-up period was success of applied LSTR method in 43 (95.6%) affected sample teeth in a way that initial clinical symptoms completely decreased and disappeared. Conclusions: LSTR method has been shown as successful pulpotomy technique for noninstrumental endodontic approach in non-vital pulp treatment of primary molar teeth in a 12-months follow-up period.

Introduction: Composite materials may be exposed to chemicals in food and beverages in the oral cavity, which can lead to changes in surface roughness. The aim of this in vitro study was to evaluate the surface roughness of two restorative materials after exposure to coffee and green tea followed by a dental bleaching procedure. Methods: For nanofilled composite and microhybrid composite, 15 samples each were fabricated. Five specimens from each composite were stored in instant coffee and green tea for 4 h a day. After 30 days of immersion, specimens received dental at-home bleaching, using 16% carbamide peroxide (CP), for 7 h a day. The control group was stored in deionized water for 30 days. Surface roughness was determined by profilometry 24 h after polymerization, after 30 days of immersion, and after bleaching. The data were analyzed using a t-test for paired samples and mixed analysis of variance, at a 0.05 significance level. Results: Neither beverages nor CP treatment significantly altered the surface roughness of the composites. There was no difference between the tested composite materials regarding roughness. Conclusion: Surface roughness of the microhybrid and nanohybrid composites was not modified by coffee, green tea, and subsequent whitening treatment.

Introduction: Dental fear and anxiety (DFA) is a ubiquitous entity among dental patients in terms of their prevalence and incidence. It is among the major clinical problems in dentistry. In addition, the differences in DFA prevalence were present considering the age and gender of patients and over time, but with some opposite reports. The aim of this study is to examine the prevalence of DFA presence in children concerning their age, gender, and over time. Methods: The survey sample comprised 200 of 9–12-year-old children. The DFA presence was determined twice by the modified version of the CFSS-DS scale (CFSS-DS-mod scale) during a 6-months long period between the first and the subsequent dental appointment due to the need for restorative dental treatment. The scale was applied before the restorative treatment started on both occasions. Results: The prevalence of DFA was 17.5% in the study sample and decreased over time. It was slightly higher in girls. Conclusions: The DFA prevalence in 9–12-year-old children is decreasing over time. Latent manifestations of DFA presence should be considered for evaluation in the future.

Background: As the pandemic time went by in Bosnia and Herzegovina (B&H), various patterns toward COVID-19 itself and its impacts, implementation of prescribed preventive measures among the team members, and those of their patients, including immunization process, have been revealed. These patterns were of both empirical and evidence-based kind and consequently formed dental personnel behavior. The aim was to evaluate and compare the COVID-19 status of dentists in B&H, implementation of prescribed preventive measures, and usage of various kinds of PPE, at the beginning of the pandemics and now, 2.5 years later, including dentists’ current vaccination status, and their opinions and attitudes toward the national COVID-19 economic impact on dental practice. Methodology: Study research was in a form of a cross-sectional longitudinally designed online survey and was conducted in two parts. Results and conclusions: Dental professionals in B&H had a high frequency of COVID-19 symptoms in the second pandemic year. The vaccination status of dentists in B&H was in line with the global average values of vaccinated professionals. Dentists used patient management preventive measures and PPE recommended by WHO, but some preventive measures have been changed and prioritized recently. The economic impact of pandemics on dentistry was predominantly negative.

Objectives Oral health in children is additionally burdened with the presence of dental fear and anxiety (DFA). These clinical psychologic entities in their progressive stages inevitably lead to avoidance of dental appointments, which makes prevention and therapy of oral diseases more difficult. Upon the onset of DFA in general, as one of the emotional outcomes of stress in a dental office, most children patients could define the specific stressors that were most intense for them, which could predict the presence of DFA. Aim To examine the predictors of DFA presence in 9-12-year-old children, and investigate how they could explain the DFA occurrence in study participants. Material and Methods The sample consisted of 200 children aged from 9 to 12 years. The DFA presence was determined by the modified version of the CFSS-DS scale. The child's behavior in the dental office during the treatment was evaluated by the trained observer using Venham anxiety and behavior rating scales. Socioeconomic status, characteristics of dental office visits, and previous caries experience were also analyzed. Results The main DFA predictors were related to invasive dental treatments, where the behavior during dental treatment was the most accurate expression of the DFA appearance. Conclusions Invasive dental procedures are the main stressful factor for DFA occurrence. Predisposing factors could strengthen the DFA occurrence.

Background: The most commonly used diagnostic tests for evaluation of the dental fear and anxiety (DFA) presence in children were psychometric scales, where interpretation in determining and using of their cut-off scores sometimes was not completely exact. Also, several studies have been conducted where the results were conflicting in terms of who better assessed the DFA presence - the children, their parents, or dentists. Objective: To determine the normative values in the child and parental versions of the Modified version of the CFSS-DS scale (CFSS-DS-mod scale) and to compare the ways in which children, their parents, and the dentist assessed the DFA presence in the dental office. Methods: Survey sample consisted of 200 children aged from 9 to 12 years, whose DFA presence was determined by the CFSS-DS-mod scale. Child parents answered to their version of this scale, and the dentist observed the child behavior in the dental office during the treatment using Venham Anxiety and Behaviour Rating Scales. Results: Parental version of the CFSS-DS-mod scale found to be reliable (Cronbach alpha = 0.955) and valid (67.87% of variance explained) instrument for assessment of the DFA presence in children. Two cut-off scores were determined in a child (37 and 43), as well as in a parental version of CFSS-DS-mod scale (36 and 44), respectively. Dentists assessed the DFA presence in child patients most accurately. Conclusion: The normative values of psychometric instruments should be considered prior to their use. The borderline area of DFA presence should also be taken into account in the future studies. Children could underestimate DFA existence by themselves while interviewing.

Introduction: Having in mind the importance of providing continuous pediatric dental services during the COVID-19 pandemic and the fact that children have similar viral loads to adults, the potential to spread the virus to others, and with variable clinical presentation of COVID-19 infection, this study aimed to analyze the impact of COVID-19 outbreak on pediatric dentistry service provision, risks, and preventive measures before and during dental treatment. Method: Structured and closed epidemiological cross-sectional survey involved seven Southeastern European countries. The questionnaire was developed using the modified Delphi method, pretested, and tested in North Italy during April 2020. The sample consisted of licensed dental professionals reached via national dental chambers and social media using the best strategies according to the national setting. Results: A total of 3227 dentists participated in the survey, and we included 643 specialists in this study—among them, 164 were pediatric dentists. Most pediatric dentists worked in the public sector (61.0%) and provided emergency (64.6%) and routine dental treatment (18.3%) during the outbreak. One-third of pediatric dentists were COVID-19 tested, statistically significantly more than other specialties, and 3.0% tested COVID-19 positive. In addition, significantly more pediatric dentists (13.4%) reported the presence of at least one symptom related to COVID-19 compared to other specialists (6.1%). None of the pediatric dentists reported PPE shortage. However, 26.2% of all specialists stated that they lacked clear step by step professional guidance in a national language. Similarly, in both groups, around 10% of specialists attended education on coronavirus. Conclusions: Considering that most pediatric dentists provided dental treatment during lockdown in their countries in public health centers and that they will continue to work during pandemic, our results suggest that pediatric dentists might be at higher risk of COVID-19 infection. Further research should focus on finding better ways to promote and adapt preventive, protective measures and PPE in the pediatric dental setting to be behaviorally acceptable. Moreover, additional efforts should be invested in dental education regarding COVID-19 in the mother tongue.