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Publikacije (28)

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S. Tomić, Lado Davidović, Djordje Božović, Mihael Stanojević, Smiljka Cicmil, Zoran Tatić, M. Bubalo, L. Todorović

Introduction. The anterior and middle superior alveolar (AMSA) nerve block is an alternative technique of local anesthesia in the maxilla, unpredictably efficient for pulpal anesthesia. The aim of this study was to determine the anesthetic efficacy of the AMSA injection for pulpal anesthesia, using computer-controlled injection system or conventional syringe, and two local anesthetic solutions with or without adrenaline. Methods. The authors administered two AMSA injections during two separate appointments, utilizing the computer-controlled system and conventional syringe to 40 subjects, divided into two groups of 20 subjects each depending on the local anesthetic used. A pulp tester was used to test the achieved anesthesia of the central and lateral incisors, canine, first and second premolars, and the first molar in 10-minute cycles over a period of 60 minutes. Duration of anesthesia for all the mentioned teeth was also determined for both the anesthetic solutions and ways of application. Results. The AMSA injection with both types of equipment was successful, showing slow onset, satisfying intensity, and declining duration of pulpal anesthesia at the last two measurements. Local anesthetic with vasoconstrictor exhibited a significantly longer pulpal anesthesia. Conclusion. The AMSA nerve block could be recommended for achieving pulpal anesthesia of maxillary teeth from the region of the first incisor to the second premolar.

Smiljka Cicmil, Irena Mladenović, Jelena Krunić, D. Ivanović, N. Stojanović

Summary Diabetes mellitus is one of the most common chronic diseases which continue to increase in number and significance. It presents the third most prevalent condition among medically compromised patients referring for dental treatment. Diabetes mellitus has been defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Hyperglycemia leads to widespread multisystem damage which has an effect on oral tissue. The present article summarizes current knowledge regarding the association between diabetes mellitus and oral and dental health.

OBJECTIVES Interprofessional teamwork is best attained through education that promotes mutual trust and effective communication. The primary aim of the study was to evaluate the impact of interprofessional learning on knowledge about diabetes. METHODS The cross-sectional study included students of medicine, dentistry and nursing at the Faculty of Medicine Foča, Bosnia and Herzegovina. The students were randomly allocated into one of two groups. Group 1 attended an interprofessional course on diabetes while group 2 was divided into three subgroups and each of the subgroups attended an uniprofessional diabetes course. The measuring instrument used in the course in order to assess the participants' knowledge about diabetic care was a test containing multiple-choice questions about diabetes. The Interprofessional Questionnaire was used to explore the attitudes, views, values and beliefs of students regarding interprofessional education (IPE). RESULTS No statistically significant difference in total score on the test was found between the groups at baseline, but at follow-up the difference was highly statistically significant (F=10.87; p=0.002). The students from Group 1 had better results (21.82 points), compared to Group 2 (18.77 points). The statistically significant difference was observed in mean values (t=-3.997; p=0.001), between Groups 1 and 2; the students from Group 1 obtained 20.42 points, which is considered to indicate a respectively positive self-assessment of communication and teamwork skills. However, Group 2 indicated a negative self-assessment of communication and teamwork skills. CONCLUSION The findings suggest that IPE activities may provide health profession students with valuable collaborative learning opportunities.

Ognjenka Janjić-Pavlović, I. Stančić, Smiljka Cicmil, Z. Stojanović, Jelena Lečić, Sašo Elenčevski

Summary Introduction Local therapy of denture stomatitis (DS) associated with Candida species fungi infection usually involves the application of nystatin and miconazole. Due to the fact that these drugs may be less efficient against biofilm and possible resistance development, a new approach in the treatment includes the use of antiseptic agents. The aim of the study was to compare clinical and microbiological therapeutic outcomes of antiseptic solution Listerine® and Daktanol® antifungal oral gel in the treatment of DS associated with Candida species fungi. Material and Methods The study included 30 patients affected by DS, divided into the two treatment groups, control group (n=15) treated by Daktanol® gel and experimental group (n=15) treated by the antiseptic solution Listerine®. Successful treatment was evaluated based on palatal mucosa inflammation reduction classified according to the Newton classification and the difference in the number of fungal colony- forming units (CFU) isolated by smears before and after the treatment that lasted 14 days. Results Reduction in inflammation intensity and fungal CFU number on palatal mucosa (p<0,01) as well as on denture base (p<0,01) were observed in both groups of subjects after the treatment. Conclusion Antiseptic solution Listerine® and Daktanol® antifungal gel both reduced palatal mucosal inflammation and CFU number of fungi in mouth without significant differences among them. CFU number of fungi isolated from denture base was significantly lower after the treatment with Listerine® (p<0.05).

Ana Cicmil, Olivera Govedarica, Jelena Lečić, S. Mališ, Smiljka Cicmil, S. Čakić

Summary Background: Good glycoregulation at patients with diabetes mellitus is essential for prevention of many complications, including those in oral cavity. Results of numerous studies indicate that xerostomia and neurosensory oral disorders are present in type 2 diabetics. A review of the literature shows contradictory results about prevalence of oral mucosal lesions in diabetics. The aim of this study was to evaluate the presence of xerostomia, neurosensory disorders and mucosal lesions in oral cavity of type 2 diabetics. Material and Methods: This study involved 90 adults, 60 with type 2 diabetes and 30 healthy subjects, aged 45-65 years. With regard to value of HbA1c level diabetics were divided into two groups: 30 subjects with satisfactory glycoregulation (HbA1c<9%) and 30 subjects with poor glycoregulation (HbA1c≥9%). All patients recruited into the study completed a questionnaire that included their demographic, medical and oral health data. Clinical examination of the oral mucosa was performed by a single examiner. Results: In relation to the presence of xerostomia and dysgeusia between satisfactory controlled diabetics and healthy subjects a significant difference was observed (p<0.05). Compared with healthy subjects, poor controlled diabetics had significantly higher presence of xerostomia (p<0.001) and neurosensory disoders (p<0.05). A higher prevalence of oral mucosal lesions was found in poor controlled diabetics, but significant difference between groups was not observed (p>0.05). A significant positive correlation was revealed between smoking and glossodynia as well as smoking and glossopyrosis (p>0.05). Conclusion: Glycemic control level seems to influence the susceptibility of type 2 diabetics to xerostomia and neurosensory disorders. Less clear is whether diabetes are corellated to oral mucosal lesions.

Jelena Lečić, S. Čakić, Ognjenka Janjic Pavlovic, Ana Cicmil, Olivera Vukotić, V. Petrović, Smiljka Cicmil

Abstract Objective: The aim of this study was to evaluate clinical efficacy of different chlorhexidine gluconate (CHX) preparations applied subgingivally as an adjunct to scaling and root planing (SRP). Material and methods: A total of 120 periodontal pockets was included in this randomized, controlled, split mouth designed study. According to protocols used in treatment, periodontal pockets were assigned to experimental and control groups as follows: CHX solution as an addition to SRP versus control SRP group; CHX gel as an addition to SRP versus control SRP; CHX chip as an addition to SRP versus control SRP group. Following clinical parameters were recorded at baseline, one and three months after the baseline: plaque index (PI), probing pocket depth (PPD), bleeding index (BI) and clinical attachment level (CAL). Results: The most significant improvements were found concerning PI in CHX solution with SRP and CHX gel with SRP groups over controls at one month recall, as well as concerning BI and PPD in CHX chip with SRP group over SRP alone at three-month recall. Conclusion: Results of this study favour combination therapy using CHX chip as an adjunct to SRP due to greater improvements in BI and PPD compared to those obtained by SRP alone in the treatment of chronic periodontitis.

N. Stojanović, Jelena Krunić, Smiljka Cicmil, Olivera Vukotić

INTRODUCTION As a systemic disease, diabetes mellitus may lead to several complications affecting both the quality and the length of life. While periodontal disease is one of the major oral health problems in patients with diabetes, reports of an increased risk of dental caries among diabetics are controversial. OBJECTIVE The aim of this study was to investigate oral health status in patients with diabetes mellitus type 2 in relation to metabolic control of the disease. METHODS The study included 47 randomly sampled diabetics patients, divided into two groups; those with poorly controlled diabetes (glycosylated haemoglobin--HbA1c > or =9%) and those with better controlled diabetes (HbA1c < 9%). All patients completed a questionnaire about their medical and oral health. Decayed, missing, and filled teeth (DMFT) and plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL) were recorded. RESULTS The patients with poorly controlled diabetes had a significantly higher number of tooth caries compared to those with better controlled diabetes (6.5 +/- 4.3 vs. 4.3 +/- 2.9; p < 0.05). Of periodontal parameters, only PPD was significantly higher in the patients with poorly controlled diabetes than in those with better controlled diabetes (5.8 +/- 0.9 vs. 5.2 +/- 0.8; p < 0.05). DMFT index, PI, PPD and CAL exhibited positive correlation only with patients' age. CONCLUSION The study indicates that there is a relationship between poor control of diabetes and caries, and periodontal disease.

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