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Cilj istraživanja: Ispitati učestalost patoloških lezija oralne sluznice, suspektnih potencijalno malignih oralnih lezija te lezija suspektnih na oralni karcinom u osoba koje su se odazvale pregledu u svrhu ranog otkrivanja oralnog karcinoma prilikom obilježavanja Svjetskog tjedna svjesnosti o karcinomu usne šupljine, glave i vrata u travnju 2022. i 2023. godine u ambulanti za oralnu medicinu KBC-a Split. Materijali i metode: U istraživanju je dobrovoljno sudjelovalo 440 ispitanika koji su se odazvali na preventivni pregled u svrhu ranog otkrivanja oralnog karcinoma u sklopu organiziranog Dana otvorenih vrata. Raspon dobi ispitanika je od 18 do 93 godine. Svim ispitanicima uzeta je detaljna anamneza. Prilikom neinvazivnog kliničkog pregleda usne šupljine zabilježeni su podatci o stanju oralne sluznice te o vrsti lezije koja je pronađena. Pacijenti kojima su pronađene patološke promjene u usnoj šupljini upućeni su na daljnju specijalističku obradu. Oni ispitanici kod kojih je pronađena lezija suspektna na karcinom upućeni su na maksilofacijalnu kirurgiju kako bi se napravila biopsija i patohistološka analiza lezije. Rezultati: U istraživanju je sudjelovalo 208 (47,3 %) muškaraca i 232 (52,7 %) žene. Srednja vrijednost dobi iznosila je 62,8 dok je medijan bio 66 godina. Pronađenih prekanceroza bilo je ukupno 32 (7,3%). Od toga su 23 (5,2 %) klinička nalaza imponirala erozivnim formama oralnoga lihen planusa. Sedam (1,6 %) patoloških promjena bilo je suspektno na karcinom. Na pitanje o svakodnevnoj konzumaciji alkohola 112 (25,5 %) ih je odgovorilo potvrdno, dok se 104 (23,6 %) izjasnilo kao pušači. Zaključci: Patološka promjena koja je suspektna na karcinom pronađena je u sedam ispitanika od pregledanih 440. U ovome istraživanju pronađeno je ukupno 117 patoloških promjena sluznice, od čega su 32 okarakterizirane kao potencijalno maligna lezija. Najčešće pronađena potencijalno maligna lezija bio je erozivni oblik oralnog lihen planusa. Ukupno su 104 ispitanika zahtijevala dodatni specijalistički pregled, što je za većinu bio pregled specijalista oralne medicine. Od sedmero ispitanika kod kojih je pronađena lezija suspektna na karcinom njih četvero negira konzumaciju alkohola i duhanskih proizvoda., Objectives: To examine the frequency of pathological lesions of the oral mucosa, suspected potentially malignant oral lesions and lesions suspicious for oral cancer in persons who responded to the examination for early detection of oral cancer during the promoting of the Oral, Head and Neck Cancer Awareness Week in April 2022 and 2023. in the clinic for oral medicine of the University Hospital of Split. Materials and methods: 440 subjects, who responded to a preventive examination for early detection of oral cancer as part of the organized Open Day, voluntarily participated in the research. The age range of the respondents is from 18 to 93 years. A detailed medical history was taken from all subjects. During the non-invasive clinical examination of the oral cavity, data on the condition of the oral mucosa and the type of lesion that was found were recorded. Patients who were found to have a pathological lesion of the oral cavity were referred for further specialist treatment. Subjects who were found to have a lesion suspicious of cancer were referred to the clinic for maxillofacial surgery in order to perform a biopsy and pathohistological analysis of the lesion. Results: 208 (47.3%) men and 232 (52.7%) women participated in the research. The mean age was 62.8, while the median was 66 years. A total of 32 (7.3%) precancerous lesions were found. Of these, 23 (5.2%) had clinical findings of erosive forms of oral lichen planus. Seven (1.6%) pathological changes were associated with oral cancer. When asked about daily alcohol consumption, 112 (25.5%) answered yes, while 104 (23.6%) declared themselves as smokers. Conclusion: A pathological change suspicious of cancer was found in seven subjects out of 440 examined. In this study, a total of 117 pathological changes of the mucous membrane were found, of which 32 were characterized as potentially malignant lesions. The most frequently found potentially malignant lesion was the erosive form of oral lichen planus. A total of 104 respondents required an additional specialist examination, which for the majority was an examination by an oral medicine specialist. Of the seven subjects in whom a lesion suspicious of cancer was found, four of them denied the consumption of alcohol and tobacco products.

Cilj istraživanja: Usporediti učinkovitost primjene plazme bogate faktorima rasta (PRGF) kao potencijalne metode liječenja erozivnog oralnog lichen planusa (EOLP) s topikalnom primjenom kortikosteroida koja predstavlja trenutni zlatni standard u liječenju ove bolesti. Materijali i metode: U studiju su bili uključeni pacijenti kojima je biopsijom potvrđena dijagnoza EOLP-a. Pacijenti koji su zadovoljili sve kriterije i odlučili sudjelovati, potpisali su suglasnost. Istraživanje smo proveli kao split- mouth kontroliranu studiju. U jednoj polovici usne šupljine primijenili smo PRGF, a u drugoj kortikosteroid kao zlatni stanard u terapiji. Randomizaciju smo proveli metodom slučajnog odabira. Radili smo četiri aplikacije svakih sedam dana kroz četiri tjedna zaredom te potom kontrolne preglede u četiri vremenske točke (7, 30, 60 i 90 dana nakon zadnje aplikacije). Prilikom svakog posjeta određivali smo veličinu lezija, radili kliničke fotografije prije svake primjene te zatražili pacijenta da ocijeni subjektivne simptome boli i pečenja za svaku stranu usne šupljine prema VAS-i. Također, pacijenti su ispunili OHIP-14 upitnik pri prvoj aplikaciji te prvoj i četvrtoj kontrolnoj posjeti. Rezultati: Ova split-mouth studija je provedena na 15 ispitanika. Uspoređivane su razine boli i pečenja za svaku grupu pojedinačno te između grupa. Dokazano je kako između grupa nema statistički značajne razlike dok je unutar grupa dokazana statistički značajna razlika između dolazaka. Veličina lezija se u obje grupe kontinuirano smanjivala te je također dokazano kako nema statistički značajne razlike između grupa. Dinamika OHIP-14 zbira kontinuriano se smanjivala između triju točaka mjerenja. Zaključci: Primjena PRGF- a kao i kortikosteroida dovela je do značajnog smanjenja boli, pečenja i veličine lezija kao i do poboljšanja kvalitete života. Dokazano je kako nema statistički značajne razlike između grupa te nisu zabilježene nikakve nuspojave nakon terapijske aplikacije PRGF-a. Potrebna su daljnja istraživanja kako bi se potvrdili dobiveni rezultati, ali PRGF se može razmatrati kao alternativna metoda u liječenju EOLP- a., Research objective: Comparing the efficacy of using growth factor rich plasma (PRGF) as a potential method for treating erosive oral lichen planus (EOLP) to the topical use of corticosteroids, which is the current gold standard when it comes to treating this disease. Materials and methods: This study included patients with biopsy- confirmed EOLP diagnosis. Patients that fit all of the criteria and decided to participate in the study signed the consent forms. The research was conducted as a split-mouth control study. One half of the oral cavity was treated using PRGF, and the other used corticosteroids which is the golden standard in therapy. Randomization was conducted by the random selection method. The therapy was applied four times, every seven days over the course of four weeks, with control examinations at four different points in time (7, 30, 60 and 90 days after the last application). During each of the visits, we determined the size of the lesions, made clinical photographs before each application, and asked the patients to grade their subjective pain symptoms and burning sensation using the VAS (visual analog scale) for each side of the oral cavity. Patients also filled out the OHIP-14 questionnaire before the first application and during the first and fourth control visit. Results: This split-mouth study has been conducted on 15 patients by comparing different levels of pain and the burning sensation for each group individually and among different groups. It has been proven that there are no statistically significant differences between the groups but there are statistically significant differences between different sessions inside the same group. In both groups, lesion size had been continuously decreasing and it was proven that there were no statistically significant differences between the groups. The dynamics of OHIP-14 sum had been continuously decreasing between the three measurement points. Conclusion: Using the PRGF method, as well as the use of corticosteroids brought a significant decrease of pain levels and the burning sensation, decrease in lesion size and an improved quality of life. It was proven that there are no statistically significant difference between the groups and there was no noted side effects after the therapeutic application of PRGF. Additional research is needed to confirm the results, but the PRGF can be considered as an alternative method in treating EOLP.

Cilj: Glavni cilj istraživanja je bio usporediti aktivnost SAA-e u bolesnika s OLP-om u odnosu na zdrave kontrolne ispitanike. Ostali ciljevi bili su odrediti najčešće lokalizacije OLP-a, razinu depresije, anksioznosti, stresa te kvalitetu života kod svih ispitanika. Dodatni ciljevi su bili odrediti duljinu trajanja bolesti i intenzitet simptoma (bol/pečenje) u oboljelih, te usporediti sve navedene parametre između ispitne i kontrolne skupine te unutar samih skupina. Materijali i metode: U istraživanju je sudjelovalo ukupno 50 ispitanika podijeljenih u dvije skupine. Ispitnu skupinu (N=30) su činili bolesnici s potvrđenom dijagnozom OLP-a. Kontrolna skupina se sastojala od 20 ispitanika. Bolesnicima s OLP-om je zabilježen oblik bolesti (neerozivni, erozivni), duljina trajanja bolesti (mjeseci), intenzitet simptoma (VAS ljestvica). Svim ispitanicima je izmjerena aktivnost SAA-e (kinetičkom kolorimetrijskom metodom), određen psihološki profil (DASS-21) i kvaliteta života (OHIP-CRO14). Rezultati: Nije uočena statistički značajna razlika aktivnosti SAA-e u bolesnika s OLP-om u odnosu na zdrave kontrolne ispitanike (P = 0,314). Najčešće lokalizacije OLP-a su bile sluznica obraza desno (SZO19) i sluznica obraza lijevo (SZO20). Pokazana je dobra pozitivna statistički značajna korelacija kvalitete života (ukupno) s intenzitetom simptoma (r = 0,584, P < 0,001) i depresijom (r = 0,651, P < 0,001), anksioznosti (r = 0,653, P < 0,001), stresom (r = 0,578, P < 0,001). Pokazana je statistički značajna razlika subsklale OHIPCRO14 fizička bol između bolesnika s erozivnim oblikom OLP-a u odnosu na neerozivni (2,7±2,3 naspram 0,8±1,3, P = 0,012). Zaključak: Bolesnici s OLP-om pokazuju znatno više vrijednosti depresije, anksioznosti, stresa u odnosu na kontrolne ispitanike. Naše istraživanje je pokazalo snažnu povezanost psihičkih poremećaja i kvalitete života u bolesnika s OLP-om. Možemo zaključiti da je interdisciplinarni psihoneuroimunološki pristup nužan u bolesnika s OLP-om neovisno jesu li psihički poremećaji dio etiološkog mehanizma bolesti ili su njegova posljedica., Objectives: The main objective of the study was to compare the activity of SAA in patients with OLP compared with control subjects. Other objectives were to determine the most common topography of OLP, the level of depression, anxiety, stress, and quality of life in all subjects. Specific objectives were to determine the disease duration and the intensity of symptoms (pain/burning) in patients with OLP and to compare all the above parameters between the test and control groups and within the groups themselves. Materials and Methods: A total of 50 subjects, divided into two groups, participated in the cross-sectional study. The test group (N=30) consisted of patients diagnosed with OLP. The control group consisted of 20 subjects. In the patients with OLP, the form of the disease (nonerosive, erosive), the disease duration (months), the intensity of the symptoms (VAS scale) were recorded. In all subjects, SAA activity (using the kinetic colorimetric method), psychological profile (DASS-21) and quality of life (OHIP-CRO14) were determined. Results: There was no statistically significant difference in SAA activity in patients with OLP compared to control subjects (P = 0.314). The most frequent topography of OLP were the mucosa of the right cheek (SZO19) and the mucosa of the left cheek (SZO20). There was a good positive statistically significant correlation of quality of life (total) with symptom intensity (r = 0.584, P < 0.001) and depression (r = 0.651, P < 0.001), anxiety (r = 0.653, P < 0.001), stress (r = 0.578, P < 0.001). There was a statistically significant difference in the OHIP-CRO14 physical pain subscale between patients with an erosive form of OLP compared to a non-erosive form (2.7±2.3 vs. 0.8±1.3, P = 0.012). Conclusion: Patients with OLP had significantly higher scores for depression, anxiety, and stress compared with control subjects. Our cross-sectional study showed a strong association between mental disorders and quality of life in patients with OLP. We can conclude that an interdisciplinary psychoneuroimmunological approach is necessary in patients with OLP, regardless of whether mental disorders are part of the etiological mechanism of the disease or its consequence.

Ciljevi: Glavni cilj ovog istraživanja bio je utvrditi učestalost bolesti štitnjače kod pacijenata sa oralnim lichen ruberom. Specifični ciljevi bili su utvrditi učestalost povišenih vrijednosti TSH, T3 i T4 te učestalost pozitivnog nalaza antiTPO i antiTg kod osoba s oralnim lichen ruberom. Materijali, metode i ustroj istraživanja: Uzete su anamneze pacijenata te su po potrebi su učinjene serološke pretrage (TSH, T3, T4, antiTPO i antiTG). Rezultati: Bolest štitnjače pronađena je kod više od polovice pacijenata s dijagnosticiranim OLR-om. Povišena serumska vrijednost TSH pronađena je kod 22,7% pacijenata. Parametar je bio povišen kod polovice slučajeva kad bolest štitnjače nije dijagnosticirana. Vrijednost T3 bila je povišena kod 18,2% pacijenata te manje od polovice (40%) onih bez dijagnosticirane bolesti štitnjače. Serumske razine T4 unutar referentnog intervala uz povišene vrijednosti TSH mogu upućivati na subklinički hipotireoidizam. Serumske vrijednosti protutijela antiTPO i antiTG bile su pozitivne kod 13,6% pacijenata. Iste su iste bile pozitivne kod 30% pacijenata koji nisu imali dijagnosticiranu bolest štitnjače. Zaključci: Bolest štitnjače pronađena je kod više od polovice pacijenata s dijagnosticiranim oralnim lichen ruberom. Povišena serumska vrijednost hormona TSH i T3 pronađena je kod dijela pacijenata s ORL-om i oko polovice istih bez prethodne dijagnoze bolesti štitnjače. Serumske razine T4 unutar referentnog intervala uz povišene vrijednosti TSH mogu upućivati na subklinički hipotireoidizam. Serumske vrijednosti protutijela antiTPO i antiTG bile su pozitivne kod manjeg broja pacijenata i oko trećine pacijenata koji nisu imali dijagnosticiranu bolest štitnjače., Objectives: The main aim of this study was to determine the frequency of thyroid gland disease in patients with oral lichen ruber. Specific aims were to determine the frequency of elevated levels TSH, T3, T4 and the frequency of positive antibody tests for TPOAb and TgAb in patients with oral lichen ruber. Materials, methods and organization of research: Patients' anamnesis were taken and serological tests were made if needed. Results: Thyroid disease was found in more than half of patients with diagnosed oral lichen ruber. Elevated TSH serum level was found in 22,7% of patients. Parameter was raised in half cases when ORL hasn't been diagnosed. T3 level was raised in 18,2% of patients and in less then half (40%) of them without diagnosed thyroid disease. Serum levels of T4 in reference interval with elevated TSH levels can refer to subclinical hypothyroidism. TPOAb and TgAb serum levels were positive in 13,6% patients. The same were positive in 30% patients without diagnosed thyroid disease. Conclusions: Thyroid disease was found in more than half of patients with diagnosed oral lichen ruber. Elevated serum levels of TSH and T3 were found in some of the patients and half of the same without previous thyroid disease diagnosis. Serum levels of T4 in reference interval with elevated TSH levels can refer to subclinical hypothyroidism. TPOAb and TgAb serum levels were positive in a smaller number of patients and about a third of patients that were not diagnosed with thyroid disease.

Literaturni podaci upućuju na to da neplodne pacijentice imaju lošiji parodontni status, što može biti uzrok komplikacijama začeća. Matriksna metaloproteinaza 8 (MMP-8) je enzim u slini koji je izravno povezan s parodontnom upalom. Cilj ove studije bio je validacija ordinacijskog testa koji detektira aktivni oblik MMP8 (aMMP8) iz ispirka usne šupljine u populaciji žena s neobjašnjivom neplodnošću u usporedbi s plodnim ženama odgovarajuće dobi s i bez parodontitisa. Pretpostavljali smo da će neplodne žene imati lošiji parodontni status i veći broj pozitivnih aMMP-8 testova u usporedbi s plodnim ženama. Istraživanje je uključilo 50 zdravih žena s urednim ovulacijskim ciklusima u dobi od 25-45 godina i strogo definiranom neobjašnjivom (idiopatskom) neplodnošću i 50 zdravih žena s urednim ovulacijskim ciklusima iste dobi koje su zatrudnjele i rodile prirodnim putem. Svim sudionicama napravljen je klinički parodontološki pregled i ordinacijski test na aMMP-8 iz ispirka usne šupljine. Polovici pacijentica u svakoj skupini dijagnosticiran je parodontitis, dok je druga polovica bila bez parodontitisa. Osjetljivost i specifičnost testa za otkrivanje parodontitisa iznosila je 84% i 72% u skupini neplodnih, 88% i 68% u skupini plodnih pacijentica te 86% i 70% u ukupnoj populaciji pacijentica. Neplodne pacijentice s parodontitisom imale su manje uznapredovali parodontitis od kontrolne skupine, iako ta razlika nije bila statistički značajna. Rezultati su pokazali da su neplodne bolesnice imale bolji parodontni status i manje uznapredovali parodontitis od plodnih žena iste dobi te da osjetljivost i specifičnost testa rastu sa stupnjem uznapredovalosti parodontitisa. Testom se može razmjerno dobro identificirati pacijentice s parodontitisom, ali je, s obzirom na naše rezultate, korist od tog testiranja u obradi i liječenju idiopatske neplodnosti upitna. Aim: Literature data suggest that infertile patients present worse periodontal status, which may be a factor that complicates conception. Matrix metalloproteinase 8 (MMP-8) is an enzyme in saliva that is directly related to periodontal inflammation. The aim of our study was to validate a chairside mouth rinse test for detection of active form of MMP8 (aMMP8) in a population of women with unexplained infertility compared to age-matched fertile women, with and without periodontitis. Our hypothesis was that infertile women will have worse periodontal health and more positive MMP8 tests, compared to fertile women. Materials and methods: The study included 50 healthy norm-ovulatory females ages 25-45 with strictly defined unexplained infertility, and 50 healthy norm-ovulatory women at the same age who have conceived and delivered naturally. All participants underwent clinical periodontal examination and a chairside aMMP-8 oral rinse test. One half of the participants in each group was diagnosed with periodontitis, while the other half was without periodontitis. Results: The sensitivity and specificity of the test for the detection of periodontitis in the group of infertile patients was 88% and 68%, in the group of fertile patients 84% and 72% and 86% and 70% in the total patient population. Infertile patients with periodontitis had less advanced periodontitis than the control group, although the difference was not statistically significant. Conclusion: Our results have shown that infertile patients had better periodontal status and less advanced periodontitis than fertile women of the same age. Sensitivity and specificity of the test increase with the degree of progression of periodontitis. Patients with periodontitis can be relatively well identified, but based on our results, the benefit of this test in the treatment of idiopathic infertility is questionable.

Oralna leukoplakija (OL) je potencijalno zloćudna lezija sluznice usne šupljine kod koje postoji povećan rizik za zloćudnu transformaciju u odnosu na zdravu sluznicu. Razumijevanje procesa karcinogeneze i razvoj molekularne biologije doveo je do otkrivanja novih molekularnih biomarkera poput Ki67 i CD44 koji bi mogli pomoći u ranom otkivanju tumora te njihovom liječenju. Cilj ovog retrospektivnog presječnog istraživanja je imunohistokemijski utvrditi izraženost CD44 i Ki67 u OL te usporediti dobivene podatke s izraženosti CD44 i Ki67 u oralnom planocelularnom karcinomu (OPK) i zdravoj oralnoj sluznici, kako bi se iz obrazaca njihovih pojavnosti pretpostavila uključenost u patološke događaje, a što bi moguće indiciralo potrebu za prospektivnim studijama koje uključuju i ishode. Analizirano je 30 uzoraka sluznice usne šupljine s dijagnozom OL, 30 uzoraka sluznice usne šupljine s dijagnozom OPK i 20 uzoraka sluznice usne šupljine bez patohistoloških promjena. Imunohistokemijska analiza za protutijela vodila se LSAB metodom kao vizualizacijskim sistemom na Dako TechMate TM Horizon (Dako, Copenhagen, Danska) automatiziranom stroju za imunohistokemijsko bojenje. Zabilježena je značajna razlika između ispitivanih skupina u odnosu na izraženost CD44 u epitelu kao i u odnosu na izraženost Ki67 u epitelu. Statistički značajna razlika zabilježena je između ispitivanih skupina u odnosu na imunohistokemijsku izraženost CD44 u upalnom infiltratu, dok je značajna razlika s obzirom na izraženost Ki67 u upalnom infiltratu zabilježena između skupine OPK i OL te OPK i zdrave sluznice, ali ne i između OL i zdrave sluznice. Pozitivna korelacija zabilježena je između upale detektirane na hematoksilin eozinskom preparatu (HE) i Ki67 u upalnom infiltratu u skupini OL. Značajne i pozitivne korelacije zabilježene su i s CD44 i u epitelu i u upalnom infiltratu iste skupine. Nije zabilježena značajna korelacija između upale HE i ispitivanih molekularnih biljega u skupini OPK. Značajna pozitivna korelacija zabilježena je između CD44 u upalnom infiltratu s CD44 i Ki67 u epitelu, ali samo u skupini OL, dok za OPK nije bilo značajne povezanosti. Povećana imunohistokemijska izraženost biljega CD44 i Ki67 u OL upućuje na potrebu provođenja novih opsežnijih studija koje bi omogućile kliničarima dodatne mogućnosti praćenja i predviđanja ponašanja pojedinih lezija. INTRODUCTION: Oral leukoplakia (OL) is a potentially malignant lesion of the oral mucosa in which there is an increased risk of malignant transformation compared to healthy mucosa. Today, many clinical, histopathological, and molecular factors are used as potential predictors of malignant transformation. Overall, conventional histopathological assessment remains the golden standard to determine malignancy in such cases. However, the assessment of dysplasia is subjective and for an accurate histopathological assessment experience is necessary. Understanding the process of carcinogenesis and the development of molecular biology has led to the discovery of new molecular biomarkers such as Ki67 and CD44 that could help in the early detection of tumors and their treatment. AIM OF THE RESEARCH: The aim of the research to immunohistochemically determine the presence of CD44 and Ki67 in OL and to compare the obtained data with the presence of CD44 and Ki67 in the oral squamous cell carcinoma (OSCC) and healthy oral mucosa. METHODS: 30 samples of oral mucosa diagnosed with OL, 30 samples of oral mucosa diagnosed with OSCC and 20 samples of oral mucosa without pathohistological changes analyzed. Sections of paraffin blocks and primary monoclonal antibodies to Ki67 (MO A-HU Ki67, clone MIB-1, 1: 150, DAKO) and to CD44 (MO A-HU CD44, clone DF 1485, 1:50, DAKO) used for immunohistochemical analysis. Immunohistochemical analysis for antibodies performed using the LSAB method as a visualization system on a Dako TechMateTM Horizon (Dako, Copenhagen, Denmark) automated machine for immunohistochemical staining. RESULTS: In the group diagnosed with OSCC, significantly more men compared to the OL groups and healthy oral mucosa were detected. The OSCC group was the oldest with a median age of 66.5 (IQR 52.2–72.0) years. A significant difference was noticed considering the presence of inflammation between the OL and OSCC group in regard to healthy mucosa, while no difference between the OL and OSCC group were observed. The inflammatory infiltrate described on hemalaun eosin (HE) in the stroma correlated with the presence of Ki67 in the inflammatory infiltrate in the stroma. Significant difference between the examined groups in relation to the presence of CD44 in the epithelium as well as in relation to the presence of Ki67 in the epithelium were observed. A statistically significant difference between the examined groups in relation to the CD44 in inflammatory infiltrate was observed, while a significant difference in terms of Ki67 in inflammatory infiltrate between OSCC and OL and OSCC and healthy mucosa, but not between OL and healthy mucosa were detected. A positive correlation between HE and Ki67 in the inflammatory infiltrate in the OL group were observed. Significant and positive correlations between HE inflammatory infiltrate and CD44 both in the epithelium and in the inflammatory infiltrate of the same group were observed. No significant correlation between HE inflammation and the examined molecular markers in the OSCC group was observed. A significant positive correlation between CD44 in inflammatory infiltrate with CD44 and Ki67 in the epithelium was observed, but only in the OL group, whereas no significant connection for OSCC was observed. CONCLUSION: An increased immunohistochemical presence of CD44 and Ki67 markers in OL suggests the need for new more extensive studies that would provide clinicians additional options for monitoring and predicting the behavior of individual lesions.

Cilj istraživanja: Cilj ove studije bio je odrediti točnost biopsije malih labijalnih žlijezda slinovnica u dijagnozi SS. Specifični ciljevi istraživanja bili su: utvrditi postoji li korelacija FS-a s anti-SSA (Ro), anti-SSB (La), anti-SSA+SSB protutijelima, Qs i Qss, odrediti i usporediti vrijednosti Qs i Qss u obje skupine ispitanika te usporediti korisnost Qs i Qss u obje skupine ispitanika. Materijali i metode: Istraživanje je provedeno na 37 ispitanika. Ispitanici su podijeljeni u dvije skupine. Ispitnu skupina se sastojala od 15 pacijenata s dijagnozom SS-a, dok je kontrolna skupina od 22 pacijenata uključivala one pacijente koji nisu zadovoljavali ACR/EULAR dijagnostičke kriterije. Rezultati: Izračunata osjetljivost, specifičnost i točnost biopsije MLŽS iznosili su 86,7 %, 100 % i 94,6 %. Nadalje, rezultati pokazuju statistički značajnu povezanost FS-a i ANA (P = 0,002). Također je Pearsonovom korelacijom pokazana slaba, negativna i statistički neznačajna korelacija Qs (r = -0,058, P = 0,731) i Qss (r = -0,022, P = 0,899) obzirom na FS. Dobiveni rezultati ukazuju na veću korisnost Qss u odnosu na Qs u dijagnostici SS-a. Zaključak: Iako biopsija MLŽS ima veliku dijagnostičku vrijednost u dijagnozi SS-a te pokazuje veliku točnost, ona nije uvijek točna. Za točnije rezultate potrebna je standardizacija histopatološke interpretacije., Objectives: This study aimed to determine the accuracy of minor salivary gland biopsy in diagnosing Sjögren syndrome. The specific purposes of the research were to determine whether FS correlates with anti-SSA (Ro), anti-SSB (La), anti-SSA+SSB, Qs and Qss, and to determine and compare the usefulness of Qs and Qss in both groups of respondents. Materials and methods: The research was conducted on 37 subjects. The respondents were divided into two groups. The test group consisted of 15 patients diagnosed with SS, while the control group of 22 patients included those patients who did not meet the ACR/EULAR diagnostic criteria. Results: The calculated sensitivity, specificity and accuracy of minor salivary gland biopsy were 86.7%, 100% and 94.6%. Furthermore, the results obtained by the Fisher exact test show a statistically significant association between FS and ANA (P = 0.002). Also, Pearson's correlation showed a weak, negative, statistically insignificant correlation between Qs (r = -0.058, P = 0.731 and Qss (r = -0.022, P = 0.899) to FS. Obtained results indicate greater usefulness of Qss compared to Qs in diagnosing SS. Conclusion: Although minor salivary gland biopsy has a significant diagnostic value in the diagnosis of SS and shows excellent accuracy, it is not always accurate. Standardization of histopathological interpretation is needed for more accurate results.

Transplantacija bubrega najučinkovitija je metoda nadomještanja bubrežne funkcije. Napredovanjem transplantacijske medicine i imunosupresivne terapije sve je bolja prognoza preživljenja bolesnika s presađenim bubregom. Posljedično se povećava i broj takvih pacijenata koji će tražiti stomatološku pomoć. Stomatolozi imaju aktivnu ulogu u pripremi pacijenata za transplantaciju, kao i u liječenju i praćenju pacijenata dugoročno nakon transplantacije. Zbog visoke imunosupresije nakon transplantacije, znatno je povećana podložnost infekcijama, reducirana obrana od njih i povećana opasnost od sistemskog širenja, stoga oralni fokusi za ove bolesnike mogu biti fatalni. Cilj je transplantaciji pristupiti sa zdravom oralnom šupljinom. Imajući na umu sve komplikacije kronične bubrežne bolesti i hemodijalize koje mogu utjecati na zahvate u oralnoj šupljini, stomatolog se konzultira s nadležnim specijalistom. Dogovaraju se mjere opreza vezane uz krvarenje, potencijalna primjena antibiotske profilakse te koje lijekove i u kojoj dozi primijeniti. Potrebno je dijagnosticirati i liječiti sve oralne bolesti, a naročito one koje bi mogle rezultirati infekcijom ili potrebom za oralno kirurškim zahvatom neposredno nakon transplantacije kada su pacijenti najugroženiji. Šest mjeseci nakon transplantacije pacijenti primaju najviše doze imunosupresivnih lijekova jer su pod višim rizikom od odbacivanja transplantata, također su češće su ostale komplikacije i skloni su infekcijama. Stoga je uloga stomatologa u ovom razdoblju palijativne i preventivne naravi, ne radi se ništa elektivno, a hitni zahvati obavljaju se u bolničkim uvjetima nakon konzultacije s nadležnim liječnikom. Kada se pacijentovo stanje stabilizira, stomatološki zahvati mogu se sigurno obavljati. U dogovoru s timom koji vodi pacijenta u posttransplantacijskom razdoblju definira se potreba za antibiotskom profilaksom, nadomjesnom kortikosteroidnom terapijom, hematološkim testovima i ostalim modifikacijama liječenja ovisnih o pacijentovu općem stanju. Pacijenti se uključuju u aktivni recall program i naručuju svakih tri do šest mjeseci kako bi se na vrijeme dijagnosticirale i liječile sve promjene. Na svakom pregledu pacijentu se ponavljaju upute u oralnu higijenu, pregledava kompletna oralna šupljina i traže znakovi infekcije ili maligniteta. Kidney transplantation is the most effective method of replacing kidney function. With the advancement of transplantation medicine and immunosuppressive therapy, the survival prognosis of kidney transplant patients is getting better. As a result, the number of such patients who will seek dental care is also increasing. Dentists play an active role in the preparation of patients for transplantation as well as in the treatment and monitoring of patients in the long term after transplantation. Due to high immunosuppression after transplantation, the susceptibility to infections is significantly increased, the defense against them is reduced and the risk of systemic spread is enlarged, therefore oral foci can be fatal for these patients. The main aim is to approach the transplantation with a healthy oral cavity. Bearing in mind all the complications of chronic kidney disease and hemodialysis that can affect procedures in the oral cavity, the dentist consults with a competent specialist. Precautions related to bleeding, the potential use of antibiotic prophylaxis and which drugs to use and in what dose are agreed upon. It is necessary to diagnose and treat all oral diseases, especially those which could result in infection or the need for oral surgery immediately after transplantation, when patients are most vulnerable. During the period of 6 months after transplantation, patients receive the highest doses of immunosuppressive drugs because they are at a higher risk of transplant rejection, other complications are also more common and they are prone to infections. Therefore, the dentist's role in this period is of a palliative and preventive nature, nothing elective is done and emergency procedures are performed in hospital conditions after consultation with the competent doctor. When the patient's condition is stabilized, dental procedures can be performed safely. In agreement with the team managing the patient in the post-transplant period, the need for antibiotic prophylaxis, additional corticosteroid therapy, hematological tests and other treatment modifications depending on the patient's general condition are defined. Patients are included in the active recall program with appointments every 3 to 6 months in order to diagnose and treat any changes in time. At each examination, the patient is given repeated oral hygiene instructions, the entire oral cavity is examined and signs of infection or malignancy are looked for.

Uvod i cilj rada: Oralni mukozitis (OM) upala je koju prate bolne ulceracije u usnoj šupljini narušavajući tako njezinu funkciju i onemogućujući osnovne radnje poput konzumiranja hrane, gutanja i govora. Javlja se u više od 95 % pacijenata zaraženih u području glave i vrata i jedna je od najteže podnošljivih nuspojava. Obično se javlja na kraju prvog tjedna radioterapije (RT) i traje nekoliko tjedana nakon prestanka terapije. Intenzitet OM-a ponekad može dovesti do prekida radioterapije. Cilj ovog istraživanja jest utvrditi pojavnost i karakteristike OM-a kod pacijenata s karcinomom glave i vrata liječenih zračenjem, kao i uključenost stomatologa/specijalista oralne medicine u liječenju takvih pacijenata. Ispitanici i postupci: Za potrebe ove studije kreiran je anketni upitnik s pitanjima koja se posredno ili neposredno odnose na problematiku OM-a. Upitnik je ispunilo 30 pacijenata s anamnezom karcinoma glave i vrata koji su bili zračeni s ili bez adjuvantne kemoterapije. Rezultati: Oralni mukozitis razvilo je 22 pacijenta. Najveći broj pacijenata razvilo je treći stupanj OM-a, odnosno, mogli su konzumirati samo tekuću hranu. Najviše pacijenata razvilo ga je unutar deset dana od početka radioterapije/kemoradioterapije. Kod najvećeg broja ispitanika OM je trajao dva tjedna nakon prekida kemoterapije/radioterapije. Deset pacijenata liječilo ga je prema uputama specijalista oralne medicine, osmero prema uputama specijalista nadležnog za osnovnu bolest, a četvero ga uopće nije liječilo. Najčešće korišten lijek je gel na bazi polivinil pirolidona (Gelclair). Zaključak: Iako je OM najčešća neželjena nuspojava zračenja i kemoterapije u pacijenata s karcinomom glave i vrata, stomatolozi i specijalisti oralne medicine kao najbolji poznavatelji prevencije i liječenja OM-a i dalje nisu dovoljno zastupljeni u uobičajenu sastavu onkološkog tima. Introduction and aim of the work: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area and is one of the most difficult to tolerate side effects. OM represents inflammation accompanied by painful ulcerations in the oral cavity, disrupting its function and preventing basic functions such as eating, swallowing, and speaking. It occurs at the end of the first week of RT and lasts for several weeks after stopping. The intensity of OM can sometimes lead to the interruption of RT. The aim of this thesis was to determine the occurrence and characteristics of OM in patients with head and neck cancer, as well as the involvement of dentists/oral medicine specialists in the treatment of such patients. Respondents and procedures: For the purposes of this thesis, a unique survey questionnaire was created with questions that are directly or indirectly related to the issue of OM. The questionnaire was completed by 30 patients with a history of head and neck cancer who were irradiated and/or receiving chemotherapy. Results: 22 patients developed OM. The largest number of patients developed the third degree of OM, that is, they could only consume liquid food. The largest number of patients developed OM up to ten days after the start of radiotherapy/chemoradiotherapy. In the largest number of subjects, OM lasted for two weeks after cessation of radiotherapy/chemotherapy. Ten patients were treated by OM according to the instructions of an oral medicine specialist, eight according to the instructions of a specialist responsible for the underlying disease, and four were not treated by OM at all. The most commonly used agent is a gel based on polyvinyl pyrrolidone (Gelclair). Conclusion: Although OM is the most common unwanted side effect of radiation and chemotherapy in head and neck cancer, dentists and oral medicine specialists, as the best experts in the prevention and treatment of OM, are still not sufficiently involved in the oncology team.

Pemfigus i pemfigoid su potencijalno smrtonosne autoimune bulozne bolesti koje mogu zahvatiti sluznice i kožu. Dijagnoza se postavlja na temelju laboratorijskih i histoloških pretraga, kliničkog pregleda te anamneze. Patohistološki je pemfigus obilježen akantolizom tj. pucanjem međustaničnih veza (dezmosoma) koje se nalaze u trnastom sloju epitela zbog stvaranja antitijela usmjerenih prema tim spojevima. Posljedica toga je nastanak intraepitelnog mjehura. Kod pemfigoida su protutijela usmjerena protiv hemidezmosoma, multiproteinskih kompleksa koji se nalaze duž bazalne membrane i spajaju epitel s vezivom, te je prisutan nalaz subepitelnog mjehura. Nakon pucanja mjehura nastaju erozije, lezije koje se mogu inficirati ukoliko nije ordinirana lokalna i/ili sustavna terapija koja smanjuje upalu i imunološku reakciju, ublažava simptome i potiče epitelizaciju sluznice. Zlatni standard za detekciju bolesti je direktna imunofluorescencija koja se provodi uzimanjem uzorka iz nepromijenjenog perilezijskog tkiva. Kako bi se potvrdila dijagnoza ovih autoimunih bolesti tkivo ne smije biti razoreno te mora sadržavati u sebi depozite imunoglobulina G i/ili C3 komponentu komplementa na odgovarajućoj lokalizaciji, ovisno o tome koji je ciljni antigen. Uz patohistološku analizu i direktnu imunofluorescenciju tkiva moguće je koristiti indirektnu imunofluorescenciju za praćenje tijeka bolesti te ELISA-u (engl. enzyme-linked immunosorbent assay), visoko osjetljivi i specifični imunoenzimski test. Pravodobna dijagnostika te odgovarajuća terapija uvelike utječe na prognozu i krajnji ishod bolesti. Primarno liječenje pemfigusa su sistemski kortikosteroidi u kombinaciji s adjuvantnim imunosupresivima ili rituksimab (anti-CD20 monoklonalno antitijelo) dok se u teškim slučajevima mogu primijeniti i intravenski imunoglobulini i plazmafereza. Liječenje pemfigoida obično uključuje topikalnu primjenu sredstva za ublažavanje bolova s protuupalnim djelovanjem, a za tu svrhu odlični su lokalni kortikosteroidi. Mogu se propisati i pomoćni imunosupresivni lijekovi. Novije metode liječenja i jasnije razumijevanje patogeneze bolesti poboljšali su prognozu pemfigusa/pemfigoida te smanjili mortalitet. Pemphigus and pemphigoid are potentially fatal autoimmune diseases with blisters that affect mucocutaneous surfaces and skin. The diagnosis is made on the basis of laboratory and histopathological tests, clinical examination and medical history. Histopathologically, pemphigus is characterized by acantholysis i.e. the breaking of intercellular connections (desmosomes) located in the spinous layer of the epithelium due to the formation of antibodies directed towards these connections. The consequence of these events is the formation of an intraepithelial blister. In pemphigoid the antibodies are directed against hemidesmosomes, multiprotein complexes that are located along the basement membrane and connect the epithelium with the connective tissue. There is a finding of a subepithelial blister. After the bursting of the blisters, erosions occur, lesions that can become infected if supportive antiseptic therapy with agents that stimulate epithelialization of the mucous membrane has not been conducted. The gold standard for the detection of the disease is direct immunofluorescence, which is performed by taking a sample from the unchanged perilesional tissue. In order to confirm the diagnosis of these autoimmune diseases, the tissue must not be necrotic and must contain deposits of immunoglobulin G and/or the C3 component of complement in the appropriate localization, depending on which antigen is affected. In addition to pathohistological analysis and direct immunofluorescence of the tissue, it is possible to use indirect immunofluorescence to monitor the course of the disease and ELISA, enzyme-linked immunosorbent assay, a highly sensitive and specific immunoenzymatic test. Timely diagnosis and appropriate therapy greatly influence the prognosis and the final outcome of the disease. The primary treatment of pemphigus are systemic corticosteroids in combination with adjuvant immunosuppressants or rituximab (anti-CD20 monoclonal antibody), while in severe cases intravenous immunoglobulins and plasmapheresis can also be used. Treatment of pemphigoid usually involves the topical application of a pain reliever with an anti-inflammatory effect, and topical corticosteroids are excellent for this purpose. Auxiliary immunosuppressive drugs may also be prescribed. Newer treatment methods and a clearer understanding of the pathogenesis of the disease have improved the prognosis of pemphigus/pemphigoid and reduced mortality.

Cilj istraživanja: Cilj ovog istraživanja bio je ispitati iskustva njegovateljica i medicinskih sestara koje su zaposlene u domovima za starije i nemoćne osobe o načinima provođenja oralne higijene u štićenika koji to nisu u mogućnosti učiniti sami, kao i procjeniti potrebu njegovatelja za dodatnim edukacijama. Metode: U razdoblju od ožujka do lipnja 2022. godine je provodeno istraživanje u kojem je sudjelovalo 50 ispitanica koje su zaposlene u domovima za starije i nemoćne osobe. Istraživanje je provedeno korištenjem izrađenog upitnika koji je bio podijeljen po domovima za starije i nemoćne u papirnatom formatu. Anketni upitnik se sastojao od dva dijela. Prvi dio upitnika se sastojao od pitanja s jednim točnim odgovorom koja su se odnosila na opće podatke kako što su spol, dob, zanimanje, godine radnog staža. U drugom dijelu upitnika ponuđene su izjavne tvrdnje kojima se procjenjuje educiranost njegovateljica i medicinskih sestara o oralnom zdravlju, te kako oralno zdravlje može imati utjecaj na opće zdravlje i obrnuto. U ovom dijelu upitnika je korištena Likertova skala s vrijednostim od 1 do 5. Provođenje istraživanja je odobrilo Etičko povjerenstvo Medicinskog fakulteta u Splitu. Rezultati: U ovom istraživanju su svi ispitanici bili ženskog spola. 30 njih su bile njegovateljice, dok su ostale bile medicinske sestre. 80% ispitanica je u sklopu svog obrazovanja ili zaposlenja prošla obuko o oralnoj zdravstvenoj njezi. Gotovo sve ispitanice pomažu u provođenju oralne higijene štićenicima koji to nisu u mogućnosti sami učiniti. Najčešće to čine jedan ili dva puta dnevno i 72% ih pri tome čisti jezik. 84% ispitanica koriste gaze koje su natopljenje antiseptikom i to rade u slučajevima kako štićenici nemaju zube ili ako ne mogu jako otvoriti usta. Međutim, ipak 2% njih to radi kada štićenici imaju neke ranice u ustima. Svi štićenici pružaju otpor prilikom provođenja oralne higijene, neki uvijek ,a neki ponekad. Isto tako, svi nose proteze koje tijekom noći skidanju i pohranjuju ih u posudi uronjene u vodu. Samo 58% ispitanica svaki dan čiste proteze štićenicima, dok 38% njih to rade povremeno. Većina štićenika odlazi na preglede kod stomatologa samo po potrebi (bol, klimavost, krvarenje), a 16% ih odlazi redovito, odnosno 2 puta godišnje. Gotovo sve ispitanice smatraju da ranice koje ne cijele u usnoj šupljini mogu potencijalno biti prekanceroze, kao i da je oralno zdravlje povezano s kvalitetom okusa, žvakanja i gutanja. Zadovoljavajuća je i razina znanja vezana za utjecaj oralnih bolesti na sistemnske poremećaje i obrnuto. Lošiji rezulatati ovog istraživanja se uočavaju kod pitanja i tvrdnji koje se odnose na komorbiditete starijih osoba i povezanost oralne njege s aspiracijskom pneumonijom, gdje polovica ispitanica smatra kako nema povezanosti. Nadalje, ipak se 82% ispitanica slaže kako je upala pluća vodeći uzrok smrti kod starijih osoba. Veliki postotak ispitanica smatra da su im potrebne dodatne edukacije o oralnom zdravlju. 74% ispitanica ne zna da se stečena pneumonija može prevenirati mehaničkim čišćenjem, korištenjem antiseptika i redovitom stomatološkom njegom. Zaključak: Temeljem ovog istraživanja vidljivo je da većina njegovateljica i medicinskih sestara ima zadovoljavajući nivo znanja vezan za pravilno provođenje oralne higijene kod starijih i nemoćnih osoba. Oralnu higijenu vjerojatno provode na ispravan način, ali ne i onoliko učestalo koliko bi trebalo. Smatraju da je oralno zdravlje važno i da ima utjecaj na opće zdravlje. Većina ispitanica pokazuje zainteresiranost za dodatno educiranje o metodama za očuvanje oralnog zdravlja., Objectives: The goal of this research was to examine the experiences of caregivers and nurses who are employed in homes for the elderly and infirm regarding ways of performing oral hygiene in residents who are unable to do it themselves, as well as to assess the caregivers' need for additional education. Materials and metods: In the period from March to June 2022, a survey was conducted in which 50 respondents who worked in homes for the elderly and infirm participated. The research was conducted using a questionnaire that was distributed to homes for the elderly and infirm in paper format. The questionnaire consisted of two parts. The first part of the questionnaire consisted of questions with one correct answer that related to general information such as gender, age, occupation, years of work experience. In the second part of the questionnaire, statements were offered that assess the education of caregivers and nurses about oral health, and how oral health can have an impact on general health and vice versa. In this part of the questionnaire, a Likert scale with a value of 1 to 5 was used. The conduct of the research was approved by the Ethics Committee of the University of Split School of Medicine. Results: In this research, all respondents were female. 30 of them were caregivers, while the rest were nurses. 80% of the respondents received oral health care training as part of their education or employment. Almost all of the respondents help in the implementation of oral hygiene for residents who are not able to do it themselves. Most often, they do it once or twice a day and 72% of them clean their tongue. 84% of the respondents use gauze soaked with an antiseptic and they do this in cases where residents have no teeth or if they cannot open their mouths wide. However, 2% of them still do it when residents have some sores in their mouths. All residents resist oral hygiene, some always and some sometimes. Likewise, everyone wears prostheses, which they remove during the night and store them in a container immersed in water. Only 58% of the respondents clean their residents' dentures every day, while 38% of them do it occasionally. Most of the residents go to the dentist only when necessary (pain, unsteadiness, bleeding), and 16% of them go regularly, that is, twice a year. Almost all respondents believe that non-healing sores in the oral cavity can potentially be precancerous, as well as that oral health is related to the quality of taste, chewing and swallowing. The level of knowledge related to the impact of oral diseases on systemic disorders and vice versa is also satisfactory. Worse results of this research can be seen with questions and statements related to comorbidities of the elderly and the connection between oral care and aspiration pneumonia, where half of the respondents believe that there is no connection. Furthermore, 82% of respondents agree that pneumonia is the leading cause of death in the elderly. A large percentage of respondents believe that they need additional education about oral health. 74% of respondents do not know that acquired pneumonia can be prevented by mechanical cleaning, using antiseptics and regular dental care. Conclusion: Based on this research, it is evident that the majority of caregivers and nurses have a satisfactory level of knowledge related to the proper implementation of oral hygiene in the elderly and infirm. Oral hygiene is probably performed correctly, but not as often as it should be. They believe that oral health is important and has an impact on general health. Most of the respondents showed an interest in additional education on methods for preserving oral health.

Cilj istraživanja: Cilj ovog istraživanja bio je procijeniti stavove i iskustva medicinskih sestara o mjerama provođenja oralne higijene u hospitaliziranih pacijenata. Materijali i metode: Intervjui su provedeni u svrhu istraživanja za izradu diplomskog rada. Vođeni su od strane E.K., ženske osobe i studentice 6. godine dentalne medicine te od asistentice na fakultetu i liječnice. Intervjui su provedeni preko internetske platforme Zoom, uključujući audio i video zapis. U istraživanju je sudjelovalo 7 ispitanika. Samo trajanje intervjua variralo je između 15 i 45 minuta. Rezultati: U provedenom istraživanju ispitanici su govorili o postojanju svijesti o važnosti oralne higijene. Naime, kod ispitanika uočena je percepcija važnosti oralne higijene. Govoreći o protokolima za provođenje oralne higijene kod hospitaliziranih bolesnika, uočeno je znanje o postojanju istih, ali i nedostatak znanja kod određenih ispitanika. Prijašnja edukacija, u vidu spominjanja važnosti provođenja OH tokom školovanja, nije na zavidnom nivou. Nedostatak materijala, vremena i osoblja predstavlja veliki problem i izazov većini ispitanika. Većina ispitanika zbrinjava mobilne proteze prilikom njege hospitaiziranog pacijenta. Zaključak: Na temelju prikupljenih informacije, ustanovljeno je da u svih ispitivanih medicinskih sestara postoje stavovi o važnosti oralne higijene u hospitaliziranih pacijenata. Također da postoji praksa provođenja oralne higijene različitim materijalima, metodama, opremom i frekvencijom u hospitaliziranih pacijenata. Uočeno je da postoje prepreke u implementaciji oralne higijene u skladu s dostupnim smjernicama, prvenstveno u vidu manjka vremena, osoblja i opreme. Također istraživani su i čimbenici koji bi mogli pomoći u provedbi odgovarajuće oralne higijene, primarno u vidu poboljšanje edukacije te novih smjernica i protokola kako bi se njega bolesnika dovela na veći nivo., The aim of the research: The aim of this research was to evaluate the attitudes and experiences of nurses regarding measures of oral hygiene in hospitalized patients. Materials and methods: The interviews were conducted for the purpose of research for the preparation of a diploma thesis. They were led by E.K., a female student in her 6th year of dental medicine, and by a faculty assistant and a doctor. The interviews were conducted via the internet platform Zoom, including audio and video recordings. 7 respondents participated in the research. The duration of the interview itself varied between 15 and 45 minutes. Results: In the conducted research, respondents spoke about the existence of awareness of the importance of oral hygiene. Namely, the respondents perceived the importance of oral hygiene. Speaking about the protocols for performing oral hygiene in hospitalized patients, knowledge of their existence, but also a lack of knowledge among certain respondents, was observed. Previous education, in the form of mention of the importance of implementing OH during schooling, is not at an enviable level. The lack of materials, time and personnel is a big problem and challenge for most respondents. Most respondents take care of mobile prostheses when caring for a hospitalized patient. Conclusion: Based on the collected information, it was established that all the examined nurses have opinions about the importance of oral hygiene in hospitalized patients. Also that there is a practice of conducting oral hygiene with different materials, methods, equipment and frequency in hospitalized patients. It was observed that there are obstacles in the implementation of oral hygiene in accordance with the available guidelines, primarily in the form of a lack of time, personnel and equipment. Factors that could help in the implementation of adequate oral hygiene were also investigated, primarily in terms of improving education and new guidelines and protocols in order to bring patient care to a higher level.

Cilj istraživanja: Cilj ovoga istraživanja je ispitati oralno-higijenske navike i kvalitetu života u odnosu na oralno zdravlje studenata prve i pete godine dentalne medicine. Materijali i metode: U istraživanju je sudjelovalo 57 studenata dentalne medicine, odnosno dvije skupine od kojih je jedna bila prva godina dentalne medicine, a druga peta godina dentalne medicine. Ispitanicima su zabilježeni dob, spol, navike pušenja, broj godišnjih odlazaka doktoru dentalne medicine te kotištenje sredstava za održavanje oralne higijene. Uz navedene parametre studenti su ispunili Oral Health Impact Profile upitnik (OHIP-14) te im je izmjeren KEP indeks. Rezultati: Anamnestičkim upitnikom utvrđeno je kako ispitanici nisu u velikom broju bili pušači te su odlazili na redovne kontrole kod doktora dentalne medicine. Studenti pete godine su imali veću akumulaciju plaka, što se pokazalo i kao statistički značajan podatak (P < 0,001). Oralno-higijenske navike u obje skupine studenata pokazale su se kao odlične, odnosno velika većina je navela kako pere zube više od dva puta dnevno. Od svih ponuđenih dodatnih sredstava za održavanje oralne higijene, svi studenti koriste barem jedan. Na prvoj godini to je zubni konac, dok studenti pete godine osim konca koristi i interdentalne četkice, što se pokazalo statistički značajno (P = 0,004). U većoj mjeri koriste i vodice za ispiranje usta (P = 0,038), a prijavili su i češće profesionalno uklanjanje naslaga od studenata na prvoj godini (P = 0,015). Studenti prve i pete godine razlikovali su se i prema KEP indeksu (P = 0,017), odnosno, studenti pete godine imali su veću vrijednost KEP indeksa. Studenti pete godine imali su više saniranih zubi (P < 0,001) te više ekstrahiranih zubi (P = 0,014), dok su studenti prve godine imali veći broj intaktnih zubi. Ispunjavanjem OHIP-14 upitnika nisu se pokazale statistički značajne razlike, odnosno, obje skupine imaju visoku kvalitetu života vezanu za oralno zdravlje. Zaključak: Rezultati ovog istraživanja pokazuju kako postoje razlike u oralno-higijenskim navikama studenata prve i pete godine dentalne medicine. Također, razlika postoji i u KEP indeksu koji se mjerio u sklopu ovog istraživanja, dok u kvaliteti života u odnosu na oralno zdravlje nismo pronašli razlike među ispitivanim skupinama., Objectives: The aim of this study was to examine oral-hygiene habits and quality of life in relation to the oral health of first and fifth year dental students. Materials and methods: The study involved 57 dental students, ie two groups, one of which was the first year of dental medicine and the other the fifth year of dental medicine. Respondents were recorded age, gender, smoking habits, number of annual visits to the dentist and means for maintaining oral hygiene. In addition to the above parameters, students completed the Oral Health Impact Profile Questionnaire (OHIP-14) and their KEP index was measured. Results: The anamnestic questionnaire determined that a large number of respondents were non smokers and went for regular check-ups with dentists. Fifth-year students had a higher accumulation of plaque, which proved to be a statistically significant data (P < 0,001). Oral hygiene habits in both groups of students proved to be excellent, ie the vast majority stated that they brush their teeth more than twice a day. Of all the additional oral hygiene products offered, all students use at least one. In the first year it is dental floss, while the fifth year students use interdental brushes in addition to floss, which proved to be statistically significant (P = 0,004) and to a greater extent they also use mouthwashes (P = 0,038) and are more frequent with professional removal of deposits from the first year of students (P = 0,015). First and fifth year students also differed according to the KEP index (P = 0,017), ie fifth year students had a higher value of the KEP index. Fifth-year students had more filled teeth (P < 0,001) and more extracted teeth (P = 0,014), while the first year had a higher number of sound teeth. Completion of the OHIP-14 questionnaire did not show statistically significant differences, ie both groups have a high quality of life related to oral health. Conclusion: The results of this research show that there are differences in the oral hygiene habits of first and fifth year dental students. There is also a difference in the KEP index measured in this study, while we did not find statistically significant differences in quality of life compared to oral health.

Ciljevi: Glavni cilj ovog istraživanja bio je ispitati postoji li razlika u pojavnosti patoloških promjena na sluznici usne šupljine u trudnica u odnosu na žene koje nisu trudne. Metode i materijali: Anamnestički su se od ispitanica (N = 48) uzimali podaci o tome puše li, imaju li kronične bolesti i subjektivne simptome u usnoj šupljini. Napravljen je klinički pregled, sijalometrija i izmjeren pH sline. Ispitnu skupinu su činile 24 trudnice, a kontrolnu skupinu 24 žene reproduktivne dobi koje nisu trudne. Rezultati: Rezultati su potvrdili statistički značajnu razliku u količini izlučene sline tijekom pet minuta (P = 0,000) i pH vrijednosti sline (P = 0,000) između trudnica i kontrola. Također je utvrđena statistički značajna razlika u ispitnoj skupini prije i tijekom trudnoće u učestalosti subjektivnih simptoma u usnoj šupljini (P = 0,012), suhoći usne šupljine (P = 0,028) i broju dijagnoza (P = 0,000). Zaključci: Trudnice imaju smanjenu salivaciju i niži pH u odnosu na žene reproduktivne dobi koje nisu trudne. Tijekom trudnoće je došlo do povećanja učestalosti simptoma u usnoj šupljini, porasta suhoće usne šupljine i povećane učestalosti pojave patoloških promjena na sluznice usne šupljine u odnosu na vrijeme prije trudnoće. Svakako bi trebalo provesti više istraživanja na ovu temu, obuhvatiti veći broj ispitanica i pratiti ispitnu skupinu prije, tijekom i nakon trudnoće., Objectives: The aims of this study were to invastigate whether there is a difference in the incidence of oral mucosal changes in pregnant women compared to non – pregnant women of reproductive age. Materials and Methods: Patient madical data (pregnant and non – pregnant subjects) was collected from the subjects (N = 48) on whether they smoke, whether they have chronic disease and subjective symptoms in the oral cavity. A clinical examination, sialometry and pH value of saliva were measured. The study group consisted of 24 pregnant women and the control group consisted of 24 non – pregnant women of reproductive age. Results: The results confirmed a statistically significant difference in saliva secreted during 5 minutes (P = 0,000) and pH values (P = 0,000) between pregnant and non – pregnant subjects. A statistically significant difference was also found in the study group before and during pregnancy in the frequency of symptoms in the oral cavity (P = 0,012), mouth dryness (P = 0,028 ) and number od diagnoses (P = 0,000). Conclusion: Pregnant subjects have lower salivary flow and lower pH value compared to non – pregnant women of reproductive age. During pregnancy, there was an increase in the frequency of symptoms in the oral cavity, an increse in the dryness of the oral cavity and an increase in the frequency of pathological changes in the oral mocosa compered to time before pregnancy. Certainly, more research should be conducted on this topic, a larger number of test subjects should be included and the study group should be monitored before, during and after pregnancy.

Mukozitis je bolna, ulcerozna upala koja nastaje uslijed citotoksičnog učinka kemoterapije i radioterapije na epitelne stanice sluznice te zahvaća sluznicu gastrointestinalnog sustava, kojem pripada i sluznica usta i ždrijela. Prezentira se najčešće kao eritem, atrofija ili ulceracija sluznice. Pojavljuje se u gotovo svih pacijenata koji primaju terapiju zračenjem u području glave i vrata, u 20 do 40 % pacijenata na kemoterapiji te 60 do 85 % bolesnika koji idu na transplantaciju hematopoetskih matičnih stanica. Mukozitis se razvija nekoliko dana nakon početka terapije, najčešće između prvog i drugog tjedna, prisutan je dok traje terapija te prestaje dva do četiri tjedna nakon završetka terapije. Podatci iz literature pokazuju da je 19 % pacijenata liječenih kemoterapijom i zračenjem u području glave i vrata hospitalizirano uslijed razvoja teškog oblika oralnog mukozitisa. Posljedično, odgađa se antineoplastična terapija dok ne nastupi poboljšanje stanja, smanjena je kvaliteta života, lošija prognoza osnovne bolesti i rastu troškovi liječenja pacijenta. Ključno je informirati pacijenta o ovoj mogućoj nuspojavi terapije karcinoma i o dostupnim načinima liječenja koji će olakšati simptome i omogućiti neprekinuto provođenje liječenja osnovne bolesti, za optimalan terapijski učinak. Mucositis is a painful, ulcerative inflammation that occurs due to the cytotoxic effect of chemotherapy and radiotherapy on the epithelial cells of the mucosa and affects the mucosa of the gastrointestinal system, which includes the mucous membranes of the mouth and throat. It is most commonly presented as erythema, atrophy, or ulceration of the mucosa. It occurs in almost all patients receiving radiation therapy of the head and neck, in 20-40% of patients on chemotherapy and 60-85% of patients undergoing hematopoietic stem cell transplantation. Mucositis develops a few days after the start of therapy, usually between the first and second week, lasts the entire duration of the therapy and stops two to four weeks after the end of therapy. Data from the literature show that 19% of patients treated with chemotherapy and radiation of the head and neck area were hospitalized due to the development of severe oral mucositis. Consequently, antineoplastic therapy delayed until the condition improves. The quality of life is reduced; poorer prognosis of the underlying disease is given, and the cost of treating the patient increased. It is crucial to inform the patient on this possible side effect of cancer therapy and on the available treatments that will alleviate the symptoms and allow continuous treatment of the underlying disease, for optimal therapeutic effect.

Osteonekroza čeljusti odnosi se na odumiranje koštanog dijela čeljusti, a uzrokovana je raznim stanjima. Možemo ju podijeliti na medikamentoznu osteonekrozu čeljusti, osteoradionekrozu, traumatsku, netraumatsku i spontanu osteonekrozu. Medikamentozna osteonekroza uzrokovana je antiresorptivnim ili antiangiogenim lijekovima. Nastanak ovakvog stanja posljedica je uzajamnog djelovanja lijekova, mikrobiološke kontaminacije i lokalne traume. Glavni je klinički pokazatelj kost koja je eksponirana dulje od osam tjedana, ali može doći i do otekline mekih tkiva, ograničene gnojne upale ili fistule. Terapija osteonekroze dijeli se na konzervativnu koja je usmjerena na podizanje kvalitete pacijentova života te na kiruršku kojom se odstranjuje dio nekrotične kosti. Osteoradionekroza teška je komplikacija zračenja koja se javlja kod pacijenata oboljelih od raka glave i vrata. Definira se kao područje eksponirane kosti koje ne cijeli dulje od tri mjeseca nakon zračenja, a nema znakova primarnog tumora, recidiva ili metastaza. Klinički uz eksponiranu kost mogu se javiti i ulceracije te nekroza kože ili mukoze. Čimbenici rizika za razvoj osteonekroze su: trauma (vađenje zuba), lokalizacija tumora, ukupna doza zračenja, površina ozračene kosti, oralna higijena i drugi. Konzervativno liječenje uključuje oralnu njegu samu ili u kombinaciji s ultrazvukom ili hiperbaričnom oksigenacijom. Kirurško zbrinjavanje uključuje resekciju nekrotične kosti i mekog tkiva s raznim vrstama rekonstrukcije. U manjem broju slučajeva osteonekroza se javlja i zbog drugih stanja, a uzroke možemo podjeliti na traumatske i netraumatske. U traumatske ubrajamo osteonekrozu nastalu uslijed termičkog, mehaničkog ili kemijskog oštećenja, dok u netraumatsku ubrajamo osteonekrozu nastalu uslijed infekcije (bakterijska, virusna, gljivična, infekcijski osteomijelitis), stečene i kongenitalne bolesti te djelovanja raznih supstanci. Uloga stomatologa u prevenciji razvoja osteonekroze izuzetno je bitna. Pravovremenom sanacijom pacijenata koji su upućeni na zračenje ili prije početka uzimanja antiresorptivne ili antiangiogene terapije moguće je spriječiti razvoj osteonekroze i time značajno poboljšati kvalitetu života ovakvim pacijentima Osteonecrosis of the jaw refers to the disruption of the bone tissue of the mandible and it is caused by various conditions. We can categorize it as medication- related osteonecrosis of the jaw, osteoradionecrosis, trauma- induced, nontraumatic and spontaneous osteonecrosis. Medication- related osteonecrosis is caused by antiresorptive or antiangiogenic medication. The simultaneous impact of said medication, microbiological contamination and local trauma can cause the onset of this condition. The main clinical indicator is an exposed bone, which is present for more than 8 weeks, but soft tissue swelling, limited purulent inflammation and fistulae may also occur. Osteonecrosis treatment can be conservative, which is directed at raising the quality of the patient's life or surgical, which refers to the removal of the part of necrotic bone. Osteoradionecrosis is a severe complication of radiation which occurs in patients suffering from head and neck cancer. It is defined as the area of exposed bone which does not heal for more than three months after the radiation treatment and has no signs of primary tumor, relapses or metastasis. Clinically, other than exposed bone, ulcerations and skin necrosis or mucosae may also occur. Developmental risk factors for osteonecrosis are: trauma (tooth extraction), tumor localization, total radiation dose, irradiated bone surface, oral hygiene and others. Conservative treatment includes oral care alone or combined with ultrasound or hyperbaric oxygenation. Surgical treatment includes resection of the necrotic bone and soft tissue with various types of reconstruction. In the minority of cases, osteonecrosis may be caused by other conditions and those cases can be trauma induced or nontraumatic. Trauma induced includes osteonecrosis resulting from thermal, mechanical or chemical damage, while nontraumatic cases include osteonecrosis caused by infections (bacterial, viral, fungal, infectious osteomyelitis), acquired and congenital diseases and the impact of various substances. The dentists' role in osteonecrosis prevention is extremely important. With timely remediation of patients referred for radiation or before exposure to antiresorptive/ antiangiogenic treatment, it's possible to prevent the development of osteonecrosis and thereby significantly improve the quality of life for such patients.

Oral submucous fibrosis (OSF) is a chronic progressive condition affecting the oral cavity, oropharynx and upper third of the oesophagus. It is a potentially malignant disorder. The authors collated and analysed the existing literature to establish the overall malignant transformation rate (MTR). A retrospective analysis of medical and dental scientific literature using online indexed databases was conducted for the period 1956 to 2021. The quality of the enrolled studies was assessed by the Newcastle-Ottawa Scale (NOS). A meta-analysis using a random effects model of a single proportion was performed along with statistical tests for heterogeneity. The overall proportion of malignancy across all studies was 0.06 (95% CI, 0.02–0.10), indicating an overall 6% risk of malignant transformation across all studies and cohorts. Sub-group analyses revealed strong differences in proportion of malignancy according to ethnicity/cohort ; Chinese = 0.02 (95% CI 0.01–0.02), Taiwanese = 0.06 (95% CI, 0.03– 0.10), Indian = 0.08 (95% CI, 0.03–0.14) and Pakistani = 0.27 (95% CI 0.25–0.29). Overall, the MTR was 6% ; however, wide heterogeneity of the included studies was noted. Geographic variations in MTR were noted but were not statistically significant. Further studies are required to analyse the difference between cohort groups.

Oral squamous cell carcinoma (OSCC) is frequently diagnosed in the advanced stages. The purpose of this paper is to determine the salivary values of SCCA1, SCCA2 and TROP2 in patients with T1N0M0 OSCC and to compare them with the values obtained from healthy individuals. Unstimulated (UWS) and stimulated (SWS) saliva was sampled from 29 patients with T1N0M0 OSCC and 29 sex- and age-matched healthy individuals. Statistical difference was observed in SCCA1 and SCCA2 levels both in UWS and SWS samples. TROP2 was not measurable in most of the salivary samples. Both SCCA1 and SCCA2 could represent potential biomarkers for the early-stage OSCC. Research on a larger sample and biomarker validation is needed to assess the clinical potential of SCCA1 and SCCA2 in the OSCC early diagnostics.

Zeolites and zeolitic imidazolate frameworks (ZIFs) are widely studied as drug carrying nanoplatforms to enhance the specificity and efficacy of traditional anticancer drugs. At present, there is no other systematic review that assesses the potency of zeolites/ZIFs as anticancer drug carriers. Due to the porous nature and inherent pH-sensitive properties of zeolites/ZIFs, the compounds can entrap and selectively release anticancer drugs into the acidic tumor microenvironment. Therefore, it is valuable to provide a comprehensive overview of available evidence on the topic to identify the benefits of the compound as well as potential gaps in knowledge. The purpose of this study was to evaluate the potential therapeutic applications of zeolites/ZIFs as drug delivery systems delivering doxorubicin (DOX), 5-fluorouracil (5-FU), curcumin, cisplatin, and miR-34a. Following PRISMA guidelines, an exhaustive search of PubMed, Scopus, Embase, and Web of Science was conducted. No language or time limitations were used up to 25th August 2021. Only full text articles were selected that pertained to the usage of zeolites/ZIFs in delivering anticancer drugs. Initially, 1279 studies were identified, of which 572 duplicate records were excluded. After screening for the title, abstract, and full texts, 53 articles remained and were included in the qualitative synthesis. An Inter-Rater Reliability (IRR) test, which included a percent user agreement and reliability percent, was conducted for the 53 articles. The included studies suggest that anticancer drug-incorporated zeolites/ZIFs can be used as alternative treatment options to enhance the efficacy of cancer treatment by mitigating the drawbacks of drugs under conventional treatment.

Ciljevi: Glavni cilj istraživanja bio je istražiti i analizirati korelaciju nalaza ambulantnog testa vitalnog bojanja toluidinskim modrilom i patohistološkog nalaza lezije oralne sluznice na Katedri za Oralnu medicinu i parodontologiju Medicinskog fakulteta te u ambulanti za oralnu medicinu Odjela za dentalnu medicinu Zavoda za maksilofacijalnu kirurgiju KBC-Split. Materijali i metode: U istraživanju je dobrovoljno sudjelovalo 30 ispitanika s patološkom promjenom na sluznici usne šupljine kojima je uzeta detaljna anamneza i napravljen klinički pregled od strane specijalista oralne medicine. Nakon kliničkog pregleda pristupilo se bojanju suspektne lezije sluznice usne šupljine toluidinskim modrilom i biopsiji lezije za patohistološku analizu. Podaci su uneseni u proračunske tablice te je napravljena deskriptivna statistika. Rezultati: Od ukupno 30 ispitanika, dijagnoza OLP-a je potvrđena u njih 10 ispitanika (33%), kao i dijagnoza leukoplakije. Aktinički cheilitis imalo je pet ispitanika (17%), dok je kod dva ispitanika (7%) potvrđen planocelularni karcinom. Pozitivan nalaz toluidinskog testa imalo je ukupno pet (17%) ispitanika. Svih pet patoloških lezija koje su imale pozitivan toluidinski test su bile odmah klinički suspektne na malignitet. U dva ispitanika (6,5%) patohistološkom analizom utvrđena je displazija epitela, dok je u također dva ispitanika (6,5%) utvrđen planocelularni karcinom. U jednog je ispitanika s OLP-om toluidinski test bio pozitivan, dok patohistološka analiza nije ukazala na postojanje displazije epitela. Zaključci: Temeljem dobivenih rezultata može se potvrditi pozitivna korelacija ambulantnog testa vitalnog bojanja toluidinom i patohistološkog nalaza bioptirane suspektne lezije. Toluidinski test koristimo u diferencijalnoj dijagnostici oralnih lezija i ulceracija različitih etiologija prema zloćudnim promjenama u ustima. Prednosti ovog testa su sposobnost definiranja područja koja mogu biti zloćudna ili abnormalna. Vitalno bojenje pomaže u procjeni opsega potencijalno zloćudne lezije za eksciziju, naročito kada se radi o difuznim, velikim lezijama ili multilokularnim lezijama. Nažalost, ovaj test nije 100% specifičan. Iako nijedan od dodatnih dijagnostičkih testova ne može u potpunosti zamijeniti biopsiju tkiva i patohistološku analizu, toluidinski test se ipak pokazao kao vrijedan dodatni dijagnostički alat u slučaju potencijalno premalignih i malignih lezija usne šupljine., Objectives: The main objective of the research was to establish and analyse the correlation between the findings of the ambulatory test of vital toluidine blue staining and the pathohistological findings of oral mucosal lesions at the Chair of Oral Medicine and Periodontology of the School of Medicine and at the outpatient clinic for oral medicine of the Division for Dental Medicine of the Department of Maxillo-facial Surgery of the University Hospital of Split. Materials and methods: The total of 30 patients with a pathological change in the oral mucosa participated in the research on a voluntary basis. Oral medicine specialists obtained a detailed medical history of the patients and performed a clinical examination. After the clinical examination, staining of a suspected lesion of the oral mucosa with toluidine blue and biopsy of the lesion for pathohistological analysis were performed. The data were entered into spreadsheets and descriptive statistics was conducted. Results: Out of the total number of 30 respondents, the diagnosis of OLP, as well as the diagnosis of leukoplakia, were confirmed in 10 respondents (33%). A total of five respondents (17%) had cheilitis actinica, while squamous cell carcinoma was confirmed in two respondents (7%). A total of five respondents (17%) tested positive for toluidine blue stain. All five pathological lesions that tested positive for toluidine blue stain were immediately clinically suspected of malignancy. Epithelial dysplasia was detected in two respondents (6.5%) by means of pathohistological analysis, while squamous cell carcinoma was detected in two respondents (6.5%). The toluidine blue stain test was positive in one respondent with OLP, while pathohistological analysis did not indicate the presence of epithelial dysplasia. Findings: Based on the obtained results, a positive correlation between the ambulatory test of vital toluidine blue staining and pathohistological finfing of the biopsied suspicious lesions can be confirmed. The toluidine blue stain test is used in the differential diagnosis of oral lesions and ulcerations of various etiologies according to malignant changes in the mouth. The advantages of this test are the ability to define areas that may be malignant or abnormal. Vital staining helps assess the extent of a potentially malignant lesion for excision, especially when it comes to diffuse, large lesions, or multilocular lesions. Unfortunately, this test is not 100% specific. Although none of the additional diagnostic tests can completely replace tissue biopsy and pathohistological analysis, the toluidine blue stain test has nevertheless proved to be a valuable additional diagnostic tool in the case of potentially premalignant and malignant oral lesions.

Cilj: Glavni cilj ovog istraživanja bio je ispitati stavove i znanja studenata četvrte, pete i šeste godine studija Dentalne medicine u Splitu o antikoagulantnim lijekovima. Specifični ciljevi ovog istraživanja bili su ispitati poznaju li studenti dentalne medicine interakcije antikoagulantnih lijekova, koliko su informirani o mogućim štetnim posljedicama nepoznavanja antikoagulantne terapije u dentalnoj medicini te utvrditi postoji li potreba za dodatnom edukacijom studenata dentalne medicine o antikoagulantnim lijekovima. Materijali i metode: Istraživanje je temeljeno na anonimnoj anketi koja je provedena među studentima četvrte, pete i šeste godine studija Dentalne medicine u Splitu. Istraživanje je temeljeno na online upitniku putem Google forms obrasca (Prilog), a provođenje istraživanja odobrilo je Etičko povjerenstvo Medicinskog fakulteta u Splitu. Ukupno je sudjelovalo 67 ispitanika, a upitnik se sastojao od tri dijela i 40 pitanja. U prvom dijelu upitnika ispitanici su popunjavali osobne podatke, u drugom dijelu izrazili stavove o liječenju u budućoj kliničkoj praksi, dok se u trećem ispitalo znanje o antikoagulantnim lijekovima. Podaci su obrađeni u programskom paketu STATISTICA 11. Rezultati: Studenti svih triju godina pokazali su ispodprosječno do prosječno znanje o antikoagulantnim lijekovima, uz iznimku nekoliko pitanja s odličnim rezultatima. Samo 20,9 % ispitanika je prepoznalo sve ponuđene antikoagulanse. Ispitanici su imali odlične rezultate na pitanjima o varfarinu i INR-u za pacijente na terapiji istim, no čak 46,3 % ispitanika bi tražilo pogrešan i nepotreban test kod pacijenata na NOAK-ima. Nadalje, samo 40,3 % ispitanika je znalo točan odgovor kada nastaviti terapiju u slučaju prekidanja terapije dabigatranom što također potvrđuje slabije znanje kada se radi o NOAK-ima. Znanja o interakciji lijekova s antikoagulansima se razlikuju ovisno o pitanju. Najviše studenata (67,2 %) je prepoznalo nistatin kao antimikotik izbora kod pacijenata na terapiji varfarinom, a tek nešto više od polovice ispitanika (55,2 %) paracetamol kao analgetik izbora uz antikoagulantnu terapiju. Samo 59,7 % studenata se složilo da je korištenje antibiotika jednokratno za profilaksu sigurno kod pacijenata na antikoagulantnoj terapiji, dok čak 43,3 % studenata misli da je kod pacijenata na dualnoj antitrombocitnoj terapijji potrebno ukinuti jedan od lijekova 24 sata prije ekstrakcije. Najbolje znanje ispitanici su pokazali u zadnjoj skupini pitanja gdje su spajali ponuđene terapije s procijenjenim rizikom krvarenja te je raspon točnih odgovora za tu skupinu pitanja bio od 38,8 % do 98,5 % (66,1±22,4 %) s medijanom vrijednošću 65,7 % . Zaključak: Temeljem rezultata ovog istraživanja pokazalo se kako većina studenata nema dovoljno znanja o antikoagulantnim lijekovima te da ne postoji značajna razlika u znanju ovisno o godini studija. Loše znanje o smjernicama, interakcijama te posljedicama prekidanja antikoagulantne terapije upućuje na potrebu za dodatnom edukacijom i ažuriranim smjernicama na ovu temu., Objectives: The main aim of this study was to assess knowledge and attitudes of fourth, fifth and sixth year dental students at the University of Split School of Medicine about anticoagulants. The specific aims of this study were to determine whether dental students know the interactions of anticoagulants, possible harmful consequences of interruption of anticoagulant therapy and to assess the need for additional education of dental students about anticoagulants. Materials and Methods: This study has been carried out using an anonymous questionnaire among students of fourth, fifth and sixth year of integrated dental study of the School of Medicine in Split. The study was based on an online questionnaire via Google forms and has been approved by the Ethics Committee of the Medical School in Split. A total of 67 students participated and the questionnaire consisted of three parts and 40 questions. In the first part, the respondents filled in personal data, in the second part they expressed their attitudes about treatment in future clinical practice, and in the third part, the knowledge about anticoagulant therapy was examined. The gathered data were processed in the software package STATISTICA 11.0. Results: Students of all three years showed below-average to average knowledge of anticoagulant therapy, with the exception of a few questions with excellent results. Only 20.9 % of participants recognized all the anticoagulants offered. Students had excellent results on questions about warfarin and INR for patients on the same therapy, but as many as 46.3 % of students would order a wrong and unnecessary test in patients on NOACs. Furthermore, only 40.3 % of participants knew when to continue therapy in case of discontinuation of dabigatran therapy, which also confirms poorer knowledge when it comes to NOACs. Knowledge of drug interaction with anticoagulants varies depending on the issue. 67.2 % of students recognized nystatin as the antifungal of choice in patients on warfarin therapy, and just over half of the students (55.2 %) recognized paracetamol as the analgetic of choice with anticoagulant therapy. Only 59.7 % of students agreed that the use of a single antibiotic dose for prophylaxis is safe in patients on anticoagulant therapy, while as many as 43.3 % of students think that patients on dual antiplatelet therapy should discontinue one of the drugs 24 hours before extraction. Participants showed the best knowledge in the last group of questions where they combined the offered therapies with the estimated risk of bleeding and the range of correct answers for this group of questions ranged from 38.8 % to 98.5 % (66.1 ± 22.4 %) with a median worth 65.7 % . Conclusion: Based on the results of this study, it was shown that most students do not have enough knowledge about anticoagulant therapy and that there is no significant difference in knowledge depending on the year of study. Poor knowledge of the guidelines, interactions, and the consequences of discontinuation of anticoagulant therapy, suggests the need for additional education and updated guidelines on this topic.

Međunarodno udruženje za proučavanje boli (eng. The International Association for the Study of Pain, IASP) opisalo je sindrom pekućih usta kao kronično stanje okarakterizirano osjećajem pečenja usne šupljine čiji uzrok nije moguće pronaći. Intenzivan osjećaj pečenja odnosno žarenja i boli usne šupljine najizraženiji je na prednjem dijelu jezika, no može zahvatiti bilo koji dio sluznice usne šupljine. Javlja se spontano, obično bilateralno odnosno simetrično, a prisutan je tokom cijelog dana. Pečenje i bol intenziviraju se tokom dana, slabije su izraženi neposredno nakon buđenja, u jutarnjim satima, a ublažavaju se i nakon obroka ili konzumacije pića. Kao popratni simptomi se kod pacijenata javlja i osjećaj suhoće usta kao i promjena osjeta okusa što dodatno narušava kvalitetu njihova života. Unatoč navedenim simptomima na sluznici nije moguće vidjeti nikakve promjene ili lezije, ona je klinički zdrava. Najčešće se javlja u žena i to u postmenopauzalnom razdoblju. Incidencija pojave sindroma pekućih usta raste s brojem godina, rijetko ga nalazimo u mlađih osoba. Mehanizam nastanka i dalje nije dovoljno istražen no znamo da se radi o neuropatskoj boli koja može biti potaknuta brojnim lokalnim, sistemskim i psihološkim predisponirajućim čimbenicima. Dijagnostika se temelji na detaljnom kliničkom pregledu i opće medicinskoj odnosno stomatološkoj anamnezi uz isključivanje drugih medicinskih stanja sličnih simptoma koji bi mogli biti potencijalna dijagnoza. Važno je istaknuti da je za dijagnozu potreban nalaz klinički zdrave sluznice, bez vidljivih lezija. Kao terapija sindroma pekućih usta na raspolaganju nam je farmakološka i nefarmakološka terapija. Izbor same terapije ovisit će o iskustvu kliničara i samom zdravstvenom stanju pacijenta jer ne postoji univerzalan lijek za koji možemo tvrditi da će sigurno pomoći u terapiji sindroma. Dakle terapija sindroma pekućih usta individualna je. Kod nekih pacijenata nažalost neće biti učinkovita, a kod nekih se simptomi sindroma mogu sami povući. Sindrom pekućih usta je specifična dijagnoza zbog još uvijek nedovoljno podataka o točnom mehanizmu nastanka, svim uzročnicima koji mogu inicirati njegov nastanak, ali i samom načinu liječenja. The International Association for the Study of Pain described burning mouth syndrome as a chronic condition characterized by a burning sensation of oral mucosa for which no cause can be found. Intensive burning sensation and pain are usually appear in the anterior part of the tongue, but other oral cavity sites may also be affected. The burning sensation starts spontaneously, is usually symmetrical and present every day for most of the time. The sensation reaches its maximum during the day and its minimum or iscompletely absent early in the morning or during mealtimes. The burning sensation and pain are often accompanied by the dryness of the mouth and reduced taste intensity. Despite all these symptoms, the oral mucosa remains normal. Most of the affected patients are postmenopausal women. The frequency of burning mouth syndrome increases with age and is an extremely rare condition in young patients. The etiology of burning mouth syndrome is still poorly understood. Still, we know that the syndrome has the characteristics of neuropathic pain that can be caused by numerous local, systemic and psychological factors. A detailed clinical examination, next to thorough anamnesis and the exclution of various diseases with the same symptomatology are necessary for a correct diagnosis of this syndrome. A diagnosis can be made only in cases where the oral mucosa is clinically normal. Burning mouth syndrome can be managed by pharmacological or by nonpharmacological methods. There is no standard treatment since it is empirical and primarily based on personal and expert opinion. Management is purely symptomatic, and therefore expectations of the treatment's result should not be unrealistic. Burning mouth syndrome is a complex condition with little knowledge of etiology, causative factors or satisfactory treatment.

Cilj: Glavni cilj ovog istraživanja bio je utvrditi stavove i iskustva doktora dentalne medicine u vezi s liječenjem pacijenata oboljelih od mentalnih bolesti i poremećaja. Također, bilo jepotrebno utvrditi kako se stavovi ispitanika razlikuju s obzirom na dob, spol i godine radnog staža te istražiti postoji li potreba za dodatnom edukacijom doktora dentalne medicine u pristupu pacijentima oboljelim od mentalnih bolesti i poremećaja. Materijali i metode: U razdoblju od početka ožujka do kraja lipnja 2021. godine provedenoje presječno istraživanje koje je uključivalo doktore dentalne medicine. Istraživanje je temeljeno na anketnom upitniku koji se sastoji od četiri dijela, od čega prvi dio sadržava pitanja u vezi s općim podacima kao što su dob, spol i godine radnog staža. Druga skupina pitanja je usmjerena na samporocjenu dosadašnjh iskustava ispitanika tijekom liječenja ove skupine pacijenata i stavova koje su o njima formirali, treća skupina pitanja odnosi se na nuspojave i interakcije psihofarmaka od značaja za stomatološko liječenje, posljednja skupina pitanja odnosi se na osobne doživljaje ispitanika tijekom susreta s mentalno bolesnim pacijentom kao i na njihove stavove u vezi s ulogom koju doktor dentalne medicine ima u liječenju istog. Provođenje istraživanja odobrilo je Etičko povjerenstvo Medicinskog fakulteta u Splitu. Rezultati: U istraživanju je sudjelovao ukupno 101 doktor dentalne medicine. Od toga su 78% ispitanika bile žene, a 22% muškarci. Oko polovine ispitanika prilikom uzimanja medicinske anamneze, postavlja pacijentima uvijek i pitanje o tome imaju li dijagnosticiranu neku od bolesti iz skupine mentalnih bolesti i poremećaja, a 65% njih prilikom postavljanja pitanja o lijekovima, uvijek provjere s pacijentom koristi li neki od psihotropnih lijekova. 41% ispitanika imalo je tijekom dosadašnjeg radnog staža neugodno iskustvo u liječenju pacijenta s mentalnom bolesti ili poremećajem, a 15% njih je odbilo raditi s pacijentom oboljelim od mentalne bolesti ili poremećaja. Preko 90% ispitanika smatra da je oralno zdravlje pacijenata oboljelih od teških mentalnih bolesti i poremećaja ugroženo više od oralnog zdravlja ostatka populacije, da je za prevenciju oralnog zdravlja pacijenata oboljelih od mentalnih bolesti i poremećaja od značaja rano upućivanje stomatologu te da je pacijentima oboljelim od teških mentalnih bolesti i poremećaja potrebna profesionalna pomoć u provođenju oralne higijene smatra 94% ispitanika. Varijable kao što su dob, spol i godine radnog staža nisu statistički značajno utjecale na odgovore na većinu postavljenih pitanja. Zaključak: Temeljem rezultata ovog istraživanja potvrđeno je da većina doktora dentalne medicine ne smatra da ima dovoljno znanja o liječenju pacijenta s mentalnim poremećajima., Objective: The main purpose of this study was to investigate experiences and attitudes towards treatment of mentally ill patients among dental practitioners, as well as to explore how their attitudes correlate with sex, age and years of service, and to determine if there is a need for additional education of dental practicioners regarding treatment of patients with mental illnes. Materials and Methods: A cross-sectional study including on dental practitioners was carried out in period of three months between March and July 2021, and was based on a questionnire that consisted of four sets of questions. The first set was related to general information such as sex, age and years of service. The second set was focused on self-assesment of experiences that respondents have had when treating mentally ill patients, as well as their attitudes, the third set focused on adverse effects and interactions of psychopharmaceuticals relevant to dental treatment, and the final set was related to respondents personal experiences with treating mentally ill patients and their perception of the role that dental practitioner has in their overall treatment. Results: A total of 101 dental practitioners completed the survey, of which 78% were female and 22% were male doctors. Around one half of respondents inquire about mental illnes and disorders while taking patients medical history, and 65% of them always check if patient is taking any of the psychotropic drugs. 41% of the respondents had an unpleasant experience while treating mentally ill patient, and 15% of them had refused to work with these patients. Over 90% of the respondents reported that oral health of mentally ill patient is at more risk than that of the general population, that early dental referral is significant in ensuring their oral health, and that professional help is needed in maintaining their oral hygiene. Variables such as sex, age and years of service had not shown statistical significance for most of the questions asked. Conclusion: This study shows that dental practitioners mostly do not consider themselves informed enough about treating mentally ill patients. Majority of dental practitioners agrees that an underlying mental illnes or its treatment affects the outcome of dental treatment. Most dental practitioners wish for additional education on the management of patients with mental illness.

Ciljevi: Ciljevi ovog istraživanja bili su ispitati karakteristike oralnog lichen planusa u pacijenata liječenih u ambulanti za oralnu medicinu KBC-a Split u vremenu od otvaranja ambulante te učestalost maligne alteracije s obzirom na klinički oblik OLP-a. Također, cilj je bio ispitati učestalost pojedinog kliničkog oblika OLP-a, učestalost navike pušenja među oboljelima te spolnu i dobnu strukturu ispitanika. Materijali i metode: U ovom ispitivanju je sudjelovao 51 ispitanik za kojeg su retrospektivno uzeti anamnestički podatci o spolu, dobi te navikama s naglaskom na svakodnevno pušenje cigareta. Također su uzeti podatci iz zapisa o kliničkom pregledu od kojih su važni bili klinički oblik i lokalizacija OLP-a na sluznici. Posebno su se skupljali podatci o pacijentima s patohistološki potvrđenom displazijom oralnog epitela te dijagnozom oralnog karcinoma. Podatci su uneseni u proračunske tablice te je napravljena deskriptivna statistika. Rezultati: U ambulanti za oralnu medicinu KBC-a Split, OLP se pronašao najviše kod žena (78,4 %) srednje i starije životne dobi (medijan 58 godina). Najčešća lokalizacija OLP-a bile su obrazna sluznica i gingiva. Najveći dio ispitanika bili su nepušači (92,2 %). Češće od neerozivnog javljao se erozivni oblik OLP-a (82,4 %). Deskvamativni gingivitis je pronađen kod žena (100 %) mlađe i srednje životne dobi (medijan 39 godina). Za većinu oboljelih (94,1 %) dostatna je bila lokalna terapija. Oralni karcinom je pronađen u 11,7 % oboljelih od OLP-a, od kojih su svi bili nepušači (100 %) te su svi imali erozivni oblik OLP-a (100 %). Zaključci: Temeljem dobivenih rezultata mogu se potvrditi dosadašnja saznanja da je OLP kronična mukokutana autoimuna bolest koja najčešće pogađa žene srednje i starije životne dobi. Lezije se najčešće javljaju bilateralno simetrično, i to na obraznoj sluznici. Pojavnost OLP-a nije ovisna o pušenju kao ni maligna alteracija. Najčešći oblik OLP-a je erozivni te on najčešće maligno alterira. Deskvamativni gingivitis je klinička forma češće vidljiva u žena mlađe i srednje životne dobi., Objectives: The aims of this study were investigating carachteristics of oral lichen planus at Oral Medicine Clinic of University Hospital of Split since opening and malignant alteration frequency considering clinical appearance, as well as investigating clinical forms of OLP according to sex and age of patients and the number of smokers among them. Materials and methods: This study included 51 patients. Patientsˈ medical data were examined retrospectively. Data of interest were sex, age, habit of cigarette smoking, clinical form and localisation of OLP. Patient data of patohistologicaly confirmed oral epithelial dysplasia or oral cancer were collected separately. All of the collected data were imported into spreadsheets and descriptive statistic analysis was made. Results: At Oral Medicine Clinict of University Hospital of Split, OLP was mosty found amongst middle aged and older (median age of 58 years old) women (78,4 %). Most common localisations were buccal mucosa and gingiva. Patients were mostly non-smokers (92,2 %). Erosive form of OLP was more common than non-erosive form (82,4 %). Desquamative gingivitis was found amongst younger and middle aged (median age of 39 years old) women (100 %). Local therapy was adequate for most patients (94,1 %). Oral carcinoma was found in 11,7 % patients with OLP, all of which were non-smokers (100 %) with erosive form of OLP (100 %). Conclusions: Based on provided results it can be confirmed that OLP is chronic mucocutaneus autoimmune condition that affects mostly middle aged and older women. Lesions occur mainly bilaterally and simmetrically, especially on buccal mucosa. Occurances of OLP or malignant alteration are not dependent on habit of smoking. Erosive form of OLP is most common and with the highest risk of malignant alteration. Desquamative gingivitis is a condition that affects mostly younger and middle aged women.

Ciljevi: Ciljevi ovog istraživanja bili su ispitati postoji li razlika u vrijednostima serumske koncentracije vitamina D između ispitanika oboljelih od OLP-a i ispitanika bez patoloških promjena na sluznici usne šupljine te ispitati postoje li razlike u pacijenata s različitim kliničkim formama OLP-a. Materijali i metode: Anamnestički su od svakog ispitanika (n = 68) uzeti podatci o dobi, spolu i navici svakodnevnog pušenja cigareta. Uzorci krvi izvađeni su svakom od ispitanika kako bi se odredile vrijednosti vitamina D u krvi. Ispitnu skupinu činila su 34 ispitanika s dijagnozom OLP-a (od čega 28 s erozivnim i 6 s ne erozivnim oblikom), a kontrolnu skupinu činila su 34 ispitanika bez patoloških promjena na oralnoj sluznici. Rezultati: Rezultati su potvrdili statistički značajnu razliku u razini serumskog vitamina D između zdravih ispitanika i onih s dijagnosticiranim erozivnim oblikom OLP (p=0,045). Nije nađena statistički značajna razlika između koncentracija vitamina D u serumu ispitanika s erozivnim u odnosu na ne erozivni oblik kao ni između zdravih ispitanika i onih s ne erozivnim oblikom OLP. Vrijednosti vitamina D u serumu su pokazali statistički značajnu razliku između razine vitamina D u OLP populaciji koja je razvila karcinom u odnosu na OLP populaciju bez karcinoma (p=0,013) te između OLP populacije koja je razvila karcinom i zdrave populacije (p=0,0004). Zaključci: Temeljem dobivenih rezultata može se zaključiti kako postoji značajna razlika u razini vitamina D između zdrave kontrolne skupine i one kod koje je dijagnosticiran OLP. Točan mehanizam povezanosti vitamina D i OLP-a i dalje ostaje nepoznanica. Potrebna su buduća istraživanja na većem uzorku kako bi se utvrdila njihova povezanost. Buduća istraživanja o koncentraciji vitamina D u serumu oboljelih od OLP-a također su potrebna kako bi se potvrdili rezultati ovog istraživanja., Objectives: The aim of this study was to examine whether there is a difference in the values of serum vitamin D concentration between subjects with OLP and subjects without pathological changes in the oral mucosa. Materials and Methods: Patient medical data (OLP and control group) included age, gender, and smoking status were taken from each respondent (n = 68). Blood samples were taken from each of the subjects to determine the levels of vitamin D in the blood. The study group consisted of 34 subjects diagnosed with OLP (of which 28 with erosive and 6 those with non-erosive form), and the control group consisted of 34 subjects without pathological changes in the oral mucosa. Results: The results confirmed a statistically significant difference in serum vitamin D levels between healthy subjects and those diagnosed with the erosive form of OLP (p = 0.045). No statistically significant difference was found between the serum concentrations of vitamin D in subjects with erosive versus non-erosive form as well as between healthy subjects and those with non-erosive form of OLP. Serum vitamin D values showed a statistically significant difference between the level of vitamin D in the OLP population that developed cancer compared to the OLP population without cancer (p = 0.013) and between the OLP population that developed cancer and healthy population (p = 0, 0004). Conclusions: Based on the obtained results, it can be concluded that there is a significant difference in the level of vitamin D between the healthy control group and the one diagnosed with OLP. The exact mechanism of binding of vitamin D and OLP remains unknown. Future research on a larger sample is needed to determine their association. Future studies on the serum vitamin D concentration of OLP patients are also needed to confirm the results of this study.

Osnovna znanja o kardiovaskularnim bolestima, simptomima i komplikacijama koje mogu nastati tijekom stomatološkog zahvata, kao i postupak rada tijekom zahvata kod pacijenata s kardiovaskularnom bolesti, nužna su svakom stomatologu. U slučaju da stomatološki pacijenti koji boluju od kardiovaskularnih bolesti nisu pravilno liječeni i nemaju adekvatnu kontrolu osnovne bolesti, postoji veća opasnost od pogoršanja osnovne bolesti tijekom stomatološkog zahvata. Cilj rada je sažeto prikazati posebnosti stomatološkog zbrinjavanja bolesnika s učestalim kardiovaskularnim poremećajima. Basic knowledge of cardiovascular diseases, symptoms and complications that can occur during a dental procedure, as well as the familiarity with the procedure when treating cardiovascular patients, are necessary for every dentist. If dental patients suffering from cardiovascular diseases are not properly treated and an adequate control of underlying disease has not been ensured, there is an increased risk of the aggravation of underlying disease during a dental procedure. The aim of this thesis is to briefly present the specific characteristics of dental care for patients with frequent cardiovascular disorders.

Simple Summary An established dataset of histopathology images obtained by biopsy and reviewed by two pathologists is used to create a two-stage oral squamous cell carcinoma diagnostic AI-based system. In the first stage, automated multiclass grading of OSCC is performed to improve the objectivity and reproducibility of histopathological examination. Furthermore, in the second stage, semantic segmentation of OSCC on epithelial and stromal tissue is performed in order to assist the clinician in discovering new informative features. Proposed AI-system based on deep convolutional neural networks and preprocessing methods achieved satisfactory results in terms of multiclass grading and segmenting. This research is the first step in analysing the tumor microenvironment, i.e., tumor-stroma ratio and segmentation of the microenvironment cells. Abstract Oral squamous cell carcinoma is most frequent histological neoplasm of head and neck cancers, and although it is localized in a region that is accessible to see and can be detected very early, this usually does not occur. The standard procedure for the diagnosis of oral cancer is based on histopathological examination, however, the main problem in this kind of procedure is tumor heterogeneity where a subjective component of the examination could directly impact patient-specific treatment intervention. For this reason, artificial intelligence (AI) algorithms are widely used as computational aid in the diagnosis for classification and segmentation of tumors, in order to reduce inter- and intra-observer variability. In this research, a two-stage AI-based system for automatic multiclass grading (the first stage) and segmentation of the epithelial and stromal tissue (the second stage) from oral histopathological images is proposed in order to assist the clinician in oral squamous cell carcinoma diagnosis. The integration of Xception and SWT resulted in the highest classification value of 0.963 (σ = 0.042) AUCmacro and 0.966 (σ = 0.027) AUCmicro while using DeepLabv3+ along with Xception_65 as backbone and data preprocessing, semantic segmentation prediction resulted in 0.878 (σ = 0.027) mIOU and 0.955 (σ = 0.014) F1 score. Obtained results reveal that the proposed AI-based system has great potential in the diagnosis of OSCC.

Ciljevi: Cilj ovog istraživanja bio je ispitati učestalost pojavljivanja i kliničke karakteristike potencijalno malignih oralnih lezija u ambulanti za oralnu medicinu KBC-a Split u vremenskom razdoblju od godine dana. Materijali i metode: U ovom ispitivanju je sudjelovalo 148 ispitanika za koje su retrospektivno izvučeni iz medicinske dokumentacije anamnestički podatci o spolu i dobi te navikama svakodnevnog pušenja i uživanja alkoholnih pića. Također su uzeti podatci iz zapisa o kliničkom pregledu, s naglaskom na potencijalno malignim lezijama oralne sluznice i njihovoj lokalizaciji. Posebno su se analizirali podatci o pacijentima s patohistološki potvrđenom displazijom oralnog epitela i dijagnozom oralnog karcinoma. Podatci su uneseni u proračunske tablice te je napravljena deskriptivna statistika. Rezultati: U ambulanti za oralnu medicinu KBC-a Split ukupno je na prvi pregled od lipnja 2020. do lipnja 2021. godine došlo 148 pacijenata, od kojih je u njih 23 (15,5 %) postavljena sumnja na potencijalno malignu leziju oralne sluznice. Od tih 23 pacijenata, osam (34,8 %) ih je bilo muškog spola, a 15 ženskog (65,2 %). Pušača je bilo sedam (30,4 %), a četvero njih (17,4 %) je navelo da svakodnevno konzumira alkohol. Srednja dob svih ispitanika s nalazom potencijalno maligne lezije na sluznici usne šupljine iznosila je 61,13, a medijan 59 godina. Najčešća dijagnosticirana potencijalno maligna lezija na sluznici usne šupljine bila je erozija ili ulceracija u sklopu erozivnog oblika oralnog lihen planusa, u čak 12 ispitanika (52,2 %). U četiri ispitanika (17,4 %) to je bila leukoplakija, dok se u po jednog ispitanika (4,3 %) postavila sumnja na eritroplakiju, leuko/eritroplakiju i aktinički heilitis. U četiri ispitanika (17,4 %) odmah je pri prvom pregledu postavljena sumnja na oralni karcinom. Patohistološka dijagnoza potvrdila je dijagnozu postavljenu na temelju kliničkog nalaza u svim slučajevima nalaza potencijalno maligne lezije na oralnoj sluznici (100 %). Zaključci: Potencijalno maligna lezija oralne sluznice pronađena je u 23 od 148 (15,5 %) pregledanih osoba, od čega je bilo osam (34,8 %) muškaraca, a 15 žena (65,2 %), s prosječnom dobi od 61 godine. Najčešća dijagnosticirana potencijalno maligna lezija na sluznici usne šupljine bio je erozivni lihen u 12 ispitanika (52,2 %), zatim leukoplakija u četiri ispitanika (17,4 %). U po jednog ispitanika (4,3 %) dijagnosticirane eritroplakija, leuko/eritroplakija i aktinički heilitis. U četiri ispitanika (17,4 %) potvrđen je oralni karcinom patohistološkim nalazom koji je potvrdio klinički postavljenu dijagnozu i u svim drugim slučajevima (100 %). Sedmero (30,4 %) ispitanika izjasnili su se kao pušači, a samo su četiri ispitanika (17,4 %) odgovorila da svakodnevno piju alkohol., Objectives: The aim of this study was to examine the frequency of occurrence and clinical characteristics of potentially malignant oral lesions in the oral clinic of KBC Split in a period of one year. Materials and methods: This study involved 148 subjects for whom anamnestic data on gender, age and habits of daily smoking and alcohol consumption were extracted from the medical records. Data from clinical examination records were also taken with emphasis on potentially malignant lesions of the oral mucosa and their localization. In particular, data on patients with pathohistologically confirmed oral epithelial dysplasia and a diagnosis of oral cancer were analyzed. The data were entered into spreadsheets and descriptive statistics were made. The results: From June 2020 to June 2021, a total of 148 patients came to the oral clinic of the Clinical Hospital Center Split for an oral examination. 23 (15.5%) patients were suspected of having a potentially malignant lesion of the oral mucosa. Of those 23 patients, 8 (34.8%) were male and 15 were female (65.2%). There were seven smokers (30.4%), and four of them (17.4%) stated that they consume alcohol on a daily basis. The mean age of all subjects with the finding of a potentially malignant lesion on the oral mucosa was 61.13, and the median was 59 years. The most commonly diagnosed potentially malignant lesion on the oral mucosa was erosion or ulceration as part of the erosive form of oral lichen planus, in as many as 12 subjects (52.2%). In four subjects (17.4%) it was leukoplakia, while in one subject (4.3%) erythroplakia, leuko / erythroplakia and actinic cheilitis were suspected. Four subjects (17.4%) were immediately suspected of having oral cancer at the first examination. Pathohistological diagnosis confirmed the diagnosis made on the basis of clinical findings in all of the cases of potentially malignant lesions on the oral mucosa (100%). Conclusion: Potentially malignant lesion of oral mucosa was found in 23 out of 148 (15.5 %) persons examined, of which 8 men (34.8 %) and 15 women (65.2%), with an average age of 61.The most commonly diagnosed potentially malignant lesion on the oral mucosa was erosive lichen in 12 subjects (52.2%), followed by leukoplakia in four subjects (17.4%). In one subject each (4.3 %) diagnosed with erythroplakia, leuko/erythroplakia and actinic cheilitis. In four subjects (17.4 %) oral cancer was confirmed by a pathohistological finding that confirmed the clinically diagnosed diagnosis in all other cases (100 %). Seven (30.4%) respondents declared themselves smokers, with only four respondents (17.4%) replied that they drink alcohol every day.

Cilj: Glavni cilj ovog istraživanja bio je utvrditi znanje i stavove studenata dentalne medicine Medicinskog fakulteta Sveučilišta u Splitu o radiologiji orofacijalnoga područja. Materijali i metode: U ovom radu provedeno je presječno istraživanje, metodom upitnika. Anketni upitnik je sadržavao 43 pitanja. U prvom dijelu su prikupljeni opći podaci o ispitaniku i stavovi ispitanika o radiologiji orofacijalnoga područja, a u drugom se ispitivalo znanje o radiologiji orofacijalnoga područja. U istraživanju su dobrovoljno sudjelovali studenti 3., 4., 5. i 6. godine dentalne medicine Medicinskog fakulteta u Splitu. Ukupno je sudjelovalo 112 studenata. Podaci su uneseni u program Microsoft Office Excel (Office 2010, Microsoft corporation, Redmond, WA, SAD) te nakon toga obrađeni u programskom paketu STATISTICA 11.0 (Statsoft Inc., v 11.0, Tulsa, OK, USA). Rezultati: Studenti dentalne medicine pokazali su nizak stupanj znanja o radiologiji orofacijalnoga područja. Porazni rezultati su dobiveni na tvrdnje iz područja općih načela radiologije. Suprotno očekivanju, studenti viših godina pokazali su lošije znanje. 20 (17,8%) studenata je imalo priliku više od 20 puta tijekom vježbi analizirati radiografsku snimku. 105 (93,8%) ispitanika je odgovorilo da bi se željeli dodatno educirati tijekom dodiplomskog studija o radiologiji orofacijalnoga područja, a čak 76 (67,9%) ispitanika smatra da će morati koristiti dodatne poslijediplomske tečajeve i edukacije o radiologiji orofacijalnoga područja. Zaključak: U ovom radu pokazali smo da studenti imaju nedostatno znanje o radiologiji orofacijalnoga područja te kako nema razlike između znanja i stavova studenata s obzirom na godinu studija koju pohađaju. Studenti su pokazali želju za boljom edukacijom u području radiologije orofacijalnoga područja., Objectives: The main goal of this research was to determine the knowledge and attitudes of dental students at the University of Split School of Medicine toward oral radiology. Materials and Methods: In this study, a cross-sectional survey using the questionnaire method was conducted. The questionnaire contained 43 questions. In the first part, general data on the respondent and the attitudes toward oral radiology were collected, and in the other part the knowledge of oral radiology was examined. Students of 3rd, 4th, 5th and 6th year of dental medicine at the Split School of Medicine volunteered in the research. A total of 112 students took part in the research. The data were entered in Microsoft Office Excel (Office 2010, Microsoft corporation, Redmond, WA, SAD) and then processed in STATISTICA 11.0 (Statsoft Inc., v 11.0, Tulsa, OK, USA). Results: Dental students showed a low level of knowledge of oral radiology. Defeating results were obtained on statements from the field of general principles of radiology. Contrary to expectations, senior students showed even poorer knowledge. 20 (17,8%) students had the opportunity to analyze the radiograph more than 20 times during the exercises. 105 (93,8%) respondents stated that the additional education during the undergraduate study of oral radiology would be needed, and as many as 76 (67,9%) respondents believe that they will require additional postgraduate courses and education of oral radiology. Conclusion: In this study we have shown that students have insufficient knowledge of oral radiology and that there is no difference between students' knowledge and attitudes depending on the year of study they attend. Students showed a desire for better education in the field of oral radiology.

Cilj istraživanja: Ispitati prevalenciju bolesti i stanja iz područja oralne medicine kod pacijenata liječenih na Odjelu za oralnu medicinu Stomatološke poliklinike u Splitu za period od 1. siječnja 2018. do 31. prosinca 2019. Materijali i metode: Provedeno je presječno, retrospektivno istraživanje. Prikupljeni podaci su pohranjeni u arhivi Odjela za oralnu medicinu, od 1. siječnja 2018. do 31. prosinca 2019. U istraživanje su uključeni svi pacijenti kojima je prebivalište na području Splitsko-dalmatinske županije, a koji su liječeni na odjelu u tom razdoblju. Pacijenti kojima je prebivalište izvan SDŽ-a isključeni su iz istraživanja. Ukupno je uključeno 774 ispitanika (225 muški i 549 ženski) koje smo podijelili s obzirom na spol, dob, stupanj obrazovanja i prebivalište. Rezultati: Najprevalentnija je kandidijaza (14,8%), a prate ju sicca sindromom (8,3%), kserostomija (7,8%), oralni lichen planus (6,7%), glossitits exfoliative areata migrans (5,4%), lingua villosa (4,2%), sindrom pekućih usta (4,1%), fibrom (3,8%), stomatitis nicotina (2,5%), ulcus (2,2%), rekurentni aftozni stomatitis (2,0%), erozije (2,0%), Sjögrenov sindrom (2,0%), frikcijska hiperkeratoza (1,9%), lingua fissurata (1,9%), leukoedem (1,7%), mukokela (1,5%), varices (1,4%), glossopyrosis (1,3%) i stomatitis simplex (1,2%) Zaključak: Rezultati ove studije pružaju određene informacije o prevalenciji bolesti i stanja u Splitsko-dalmatinskoj županiji. Rezultati pokazuju da je kandidijaza najprevalentnija bolest s 14,8% i da je puno prevalentnija među ženskom populacijom (19,48%) nego muškom (11,56%). To nam ukazuje na potrebu za boljom edukacijom pacijenata o oralnom zdravlju, pogotovo onih u starijim dobnim skupinama i među ženama., Aim: To examine the prevalence of diseases and conditions in the field of oral medicine in patients treated at the Department of Oral Medicine of the Dental Polyclinic in Split for the period from January 1, 2018 to December 31, 2019. Materials and methods: A cross-sectional, retrospective study was conducted. The collected data were stored in the archives of the Department of Oral Medicine, from 1 January 2018 to 31 December 2019. The study included all patients residing in the Split-Dalmatia County, who were treated at the department in that period. Patients residing outside the Split-Dalmatia County were excluded from the study. A total of 774 respondents (225 male and 549 female) were included, which we divided according to gender, age, level of education and residence. Results: The most prevalent is candidiasis (14.8%), followed by sicca syndrome (8.3%), xerostomia (7.8%), oral lichen planus (6.7%), glossitits exfoliative areata migrans (5.4%). , lingua villosa (4.2%), burning mouth syndrome (4.1%), fibroma (3.8%), nicotine stomatitis (2.5%), ulcer (2.2%), recurrent aphthous stomatitis (2.0%), erosions (2.0%), Sjögren's syndrome (2.0%), frictional hyperkeratosis (1.9%), lingua fissurata (1.9%), leukoedema (1.7%), mucocele (1.5%), varices (1.4%), glossopyrosis (1.3%) and stomatitis simplex (1.2%) Conclusion: The results of this study provide some information on the prevalence of diseases and conditions in the Split - Dalmatia County. The results show that candidiasis is the most prevalent disease (14.8%) and that there is a bigger prevalence among the female population (19.48%) than the male (11.56%). This indicates to us the need for better patient education about oral health, especially of those in older age groups and among women.

Cilj: Cilj ovog istraživanja bio je procijeniti znanje i stavove studenata dentalne medicine Medicinskog fakulteta Sveučilišta u Rijeci, Medicinskog fakulteta Sveučilišta u Splitu i Stomatološkog fakulteta Sveučilišta u Zagrebu o prekanceroznim lezijama oralne sluznice te utvrditi postoje li razlike u znanju i stavovima između studenata od četvrte do šeste godine studija Dentalne medicine svakog fakulteta te između studija Dentalne medicine različitih fakulteta. Materijali i metode: U ovom radu provedeno je presječno istraživanje, metodom internetskog upitnika. Anketni upitnik, sastavljen za potrebe ovog istraživanja, sadržavao je 30 pitanja. U prvom su dijelu prikupljeni opći podaci o ispitaniku (spol, dob, fakultet, godina studija), a u drugom ispitani znanje i stavovi o prekanceroznim lezijama oralne sluznice putem otvorenih pitanja te zatvorenih pitanja višestrukog izbora odgovora. U istraživanju su dobrovoljno sudjelovali studenti četvrte, pete i šeste godine integriranog studija Dentalne medicine Medicinskog fakulteta Sveučilišta u Splitu, Medicinskog fakulteta Sveučilišta u Rijeci te Stomatološkog fakulteta Sveučilišta u Zagrebu. Ukupno je sudjelovalo 128 studenata, od kojih 47 s Medicinskog fakulteta Sveučilišta u Splitu, 33 s Medicinskog fakulteta Sveučilišta u Rijeci i 48 sa Stomatološkog fakulteta Sveučilišta u Zagrebu. Podaci su uneseni u program Microsoft Office Excel 2007 te nakon toga obrađeni u programskom paketu STATISTICA 11.0 Rezultati: Studenti triju odabranih fakulteta pokazali su dobro znanje o prekanceroznim lezijama oralne sluznice uz iznimku nekoliko pitanja gdje je postotak točnih odgovora bio vrlo nizak kod ispitanika sva tri fakulteta. Svega 18 (47,4 %) studenata četvrte godine točno je istaknulo eritroplakiju kao prekanceroznu leziju oralne sluznice s najvećim potencijalom maligne alteracije, ali taj postotak raste na petoj (63,2 %) i šestoj (86,5 %) godini studija. Mali broj ispitanika, njih 9 (27,3 %) s Medicinskog fakulteta Sveučilišta u Rijeci, 7 (14,9 %) s Medicinskog fakulteta Sveučilišta u Splitu i 10 (20,8 %) sa Stomatološkog fakulteta Sveučilišta u Zagrebu točno su naveli sva obilježja leukoplakije (najčešće bolest starije životne dobi, neprozirna bijela promjena, u nastanku značajnu ulogu imaju dugotrajne i učestale lokalne iritacije), iako većina ispitanih studenata (60 %) prepoznaje leukoplakiju kao najčešću prekancerozu oralne sluznice i ispravno prepoznaje kliničke oblike najrizičnije za malignu alteraciju. Najveći dio ispitanika (njih 22, odn. 46,8 %) s Medicinskog fakulteta Sveučilišta u Splitu naveo je samo dno usne šupljine kao najrizičniji predio usne šupljine za malignu alteraciju prekancerozne lezije, dok svega 19 (40,4 %) studenata ispravno prepoznaje sve najrizičnije predjele. Studenti dentalne medicine nisu sasvim dobro upoznati s novijim znanstvenim spoznajama o rizičnim čimbenicima za malignu alteraciju prekanceroznih lezija oralne sluznice. Svega 10,9 % ispitanih studenata dentalne medicine navodi sve moguće čimbenike rizika. Veliki dio ispitanika (njih 99, odn. 77,3 %) ispravno prepoznaje kako je nakon dva tjedna perzistiranja suspektne lezije koja ne odgovara na terapiju pacijenta potrebno uputiti na daljnju dijagnostičku obradu. Svoje znanje o prekanceroznim lezijama oralne sluznice studenti dentalne medicine najčešće su ocijenili vrlo dobrim (55 ispitanika, odn. 43 % njih), a njih čak 99 (77,3 %) navodi Oralnu medicinu kao kolegij na kojem su imali priliku najviše čuti o ovoj temi. Najveći broj studenata triju odabranih fakulteta, njih čak 49 (38,3 %), izjašnjavaju se da su tijekom kliničkih vježbi imali mogućnost obaviti manje od pet kliničkih pregleda pacijenata s prekanceroznom lezijom, što je poražavajući podatak kada je poznata važnost kliničkog iskustva za detekciju prekanceroznih lezija i time prevenciju oralnog karcinoma. Najviše njih, čak 120 (93,8 %) ispitanika ocijenilo je informiranost pacijenata o čimbenicima rizika za razvoj raka usne šupljine kao lošu ili vrlo lošu. Zaključak: U ovom radu pokazali smo kako postoji razlika u znanju i stavovima studenata dentalne medicine triju odabranih fakulteta o prekanceroznim lezijama oralne sluznice, iako ona nije značajna, te kako se znanje o prekanceroznim lezijama mijenja s godinama studija, od četvrte do šeste godine. Uloga studenata, kao budućih doktora dentalne medicine ključna je u ranoj dijagnozi prekanceroznih lezija i prevenciji raka usne šupljine, stoga je iznimno važna edukacija i podizanje svijesti o ovoj tematici tijekom nastavnog procesa., Objective: The aim of this research was to assess knowledge and attitudes of dental students of the Faculty of Medicine of the University of Rijeka, School of Medicine in Split and the School of Dental Medicine of the University of Zagreb about precancerous lesions of oral mucosa and to determine whether there are differences in knowledge and attitudes between students from fourth to sixth year of dental study of each faculty as well as between dental studies of different faculties. Materials and methods: In this paper, a cross-sectional study has been carried out using a questionnaire method. The questionnaire was composed of 30 questions. In the first part, general information about the study participant were gathered and, in the second part, knowledge and attitudes about precancerous lesions of oral mucosa. Students of fourth, fifth and sixth year of integrated dental study of the School of Medicine in Split, Faculty of Medicine of the University of Rijeka and the School of Dental Medicine of the University of Zagreb voluntarily participated in this research. A total of 128 students participated, 47 from the School of Medicine in Split, 33 from the Faculty of Medicine of the University of Rijeka and 48 from the School of Dental Medicine of the University of Zagreb. The gathered data were entered in the Microsoft Office Excel 2007 software and after that processed in the software package STATISTICA 11.0. Results: Students from the three selected faculties showed good knowledge on precancerous lesions of oral mucosa with an exception of a few questions where the percentage of correct answers was very low in study participants on all three faculties. Only 18 (47,4%) fourth year students correctly emphasized erythroplakia as precancerous lesion of oral mucosa with highest malignant alteration potential, however, this percentage rises significantly on the fifth (63,2%) and sixth (86,5%) study year. A small number of study participants, 9 (27,3%) from the Faculty of Medicine of the University of Rijeka, 7 (14,9%) from the School of Medicine in Split and 10 (20,8%) from the School of Dental Medicine of the University of Zagreb accurately stated all the characteristics of leukoplakia (most often an old age disease, non-transparent white patches, prolonged and frequent local irritations play a significant role in emergence), even though the majority of students who participated in the study (60%) recognized leukoplakia as the most common precancerous lesion of oral mucosa and accurately recognized the most risky clinical forms for malignant alteration. The largest share of study participants (22, i.e., 46,8%) from the School of Medicine in Split listed only the bottom of the oral cavity as the most at risk part of oral cavity for malignant alteration of precancerous lesion, while only 19 (40,4%) students accurately recognized all the most at risk parts of cavity. Dental students are not quite familiar with the newest scientific knowledge on risk factors for malignant alteration of precancerous lesions of the oral mucosa. Only 10,9% of dental students who participated in the study lists all possible risk factors. A great share of study participants (99, i.e., 77,3%) correctly recognizes that it is necessary to direct the patient to further diagnostic processing after two weeks of persistence of suspected lesion that does not respond to treatment. Dental students most often rated their knowledge about precancerous lesions of oral mucosa as very good (55, i.e., 43%), and as many as 99 (77.3%) mentioned Oral medicine as the course where they had the opportunity to hear the most about this topic. The largest share of students from selected faculties, 49 (38,3%) professes that during clinical exercises they had the possibility to carry out less than five clinical examinations of patients with precancerous lesions which is a devastating information given the fact that the importance of clinical experience for detection of precancerous lesions, and with this also prevention of oral cancer, is well known. Most of them, as much as 120 (93,8%) of study participants rated the level at which the patient is informed about the risk factors for developing oral cavity cancer as bad or extremely bad. Conclusion: In this paper, we have shown that there is a difference in knowledge and attitudes of dental students of the three selected faculties about precancerous lesions of oral mucosa even though it is not that significant, as well as that the knowledge on precancerous lesions changes as the academic years progress from fourth to sixth year. Role of students as future dental practitioners is crucial in early diagnostics of precancerous lesions and prevention of oral cavity cancer, therefore, the education and awareness-raising on this topic during education is of key importance.

CILJ: Cilj istraživanja bio je ispitati stavove i navike osoba starije životne dobi, kliničkim pregledom utvrditi stanje gingive, status usne šupljine te funkciju žlijezda slinovnica. Za kraj smo htjeli ispitati koliko stavovi i navike osoba starije životne dobi utječu na oralno zdravlje. ISPITANICI I METODE: Istraživanje je provedeno na Stomatološkoj poliklinici Split, odjel Oralne medicine. U istraživanju su sudjelovala 73 ispitanika koja su starija od 65 godina. Za potrebe istraživanja napravljen je anonimni anketni upitnik koji je sadržavao 17 pitanja o navikama, stavovima te ponašanju ispitanika vezanim za oralnu higijenu, oralno te opće zdravlje. Klinički pregled je uključivao određivanje statusa usne šupljine pomoću KEP indeksa, zatim, klinički status gingive te određivanje količine izlučene sline. Istraživanje je trajalo od početka lipnja do polovice srpnja. REZULTATI: U istraživanju su sudjelovale najvećim djelom osobe ženskog spola (83.56%), a najviše ispitanika je imalo završenu srednju stručnu spremu (43,83%). Većina ispitanika (84,93%) boluje od neke sustavne bolesti, a hipertenzija je najzastupljenija (47,94%). Također, skoro svi ispitanici imaju neku oralnu bolest (94,52%), a najčešća među njima je Oralna kandidijaza (41,09%). Većinu zubi je izgubilo 41,10% ispitanika. 20,54% ispitanika je potpuno bezubo, a 79,45% djelomično bezubo. Svi potpuno bezubi ispitanici (N=15) nose potpunu protezu, osim jednog ispitanika. Djelomično bezubi ispitanici (N=58) najviše nose djelomičnu protezu (34,48%) ili ne nose ništa (41,37%). Kliničkim pregledom se utvrdilo da je malo manje od polovice ispitanika (41,37%) imalo upaljenu gingivu. Dobiveni KEP indeks je 22,64, a količina nestimulirane sline 1,15 ml/5 minuta. 46,58% ispitanika stanje zuba i desni opisuje kao osrednje. 71,23% ih smatra da zdravlje usta i zuba utječu na opće zdravlje, te isti broj ih smatra da izgled usta i zuba utječe na dojam koji ostavljamo na druge. 45,21% ispitanika zna koja je hrana loša za zube. Svoje zdravstveno stanje kao dobro procjenjuje 61.64% ispitanih. 73,61% ispitanika pere zube/protezu nekoliko puta dnevno, a 70% navodi da pere zube/protezu 1-2 minute. 46,48% njih kupuje četkicu za zube/protezu svaka 3 mjeseca, a najviše ih koristi srednju četkicu (49,30%). Neodređenim pokretima pere najviše ispitanika (38,57%). Samo dva ispitanika ne koristi pasu za zube, vodicu za usta koristi njih 17,14%, zubni konac koristi 20%, a interdentalnu četkicu 11,27% ispitanika. Skoro svi ispitanici (90-91%) ne puše i ne konzumiraju alkohol, a 87,67% ispitanika pije neke lijekove. Najviše ispitanika posljednji put kod doktora dentalne medicine je bilo u zadnjih 6 mjeseci (63,01%), a razlog istog najviše navode redovni pregled (56,34%). KEP indeks se smanjuje češćim pranjem zuba, ali rezultat nije statistički značajan (p=0,748). KEP indeks se smanjuje duljim pranjem zubi, ali rezultat također nije statistički značajan (p=0,728). Prosječna vrijednost KEP indeksa je veća kod pacijenata koji ne znaju ili nisu sigurna koja je hrana loša za zube (p=0,015). Vrijednost KEP indeksa je manja kod ispitanika koji ne boluju od sustavnih bolesti, ali rezultat nije statistički značajan (p=0,444). Ispitivanjem veze između količine nestimulirane i stimulirane sline sa KEP indeksom, dobiveni rezultat pokazuje da vrijednost KEP indeksa je manja što je veća količina nestimulirane i stimulirane sline i obratno (p=0,017, p=0,014). ZAKLJUČAK: Dobivenim rezultatima utvrđeno je da stavovi i navike osoba starije životne dobi i nisu tako loše kao što smo očekivali, ali status usne šupljine utvrđen KEP indeksom je dosta visok i govori nam da oralno zdravlje osoba starije životne dobi nije na zadovoljavajućoj razini., OBJECTIVE: The aim of the study was to examine the attitudes and habits of the elderly, to determine the condition of the gingiva, the status of the oral cavity and the function of the salivary glands by clinical examination. Finally, we wanted to examine how much the attitudes and habits of older people affect oral health. MATERIALS AND METHODS: The research was conducted at the Dental clinic Split, Department of Oral Medicine. The study involved 73 respondents over the age of 65 years. For the purposes of the research, a questionnaire was made which contained 17 questions about the habits, attitudes and behavior of the respondents related to oral hygiene, oral and general health. Clinical examination included determining the status of the oral cavity using the KEP index, then, the clinical status of the gingiva, and determining the amount of saliva secreted. The survey lasted from early June to mid-July. RESULTS: The majority of participants in the research were females (83.56%), and most of the respondents had completed secondary education (43.83%). The majority of respondents (84.93%) suffer from a systemic disease, and hypertension is the most common (47.94%). Also, almost all subjects have some kind of oral disease (94.52%), and the most common among them is Oral candidiasis (41.09%). 41.10% of the respondents lost most of their teeth. 20.54% of respondents are completely toothless and 79.45% are partially toothless. All completely edentulous subjects (N = 15) wear a complete denture, except one subject. Partially edentulous subjects (N = 58) mostly wear a partial denture (34.48%) or wear nothing (41.37%). Clinical examination revealed that slightly less than half of the subjects (41.37%) had inflamed gingiva. The obtained KEP index is 22.64 and the amount of unstimulated saliva is 1.15 ml / 5 minutes. 46.58% of respondents describe the condition of their teeth and gums as mediocre. 71.23% of them believe that the health of the mouth and teeth affect general health, and the same number of them believe that the appearance of the mouth and teeth affects the impression we leave on others. 45.21% of respondents know which foods are bad for their teeth. 61.64% of respondents assess their health condition as good. 73.61% of respondents brush their teeth / dentures several times a day, and 70% state that they brush their teeth / dentures for 1-2 minutes. 46.48% of them buy a toothbrush / denture every 3 months, and most of them use a medium toothbrush (49.30%). Most respondents wash with indefinite movements (38.57%). Only two subjects do not use toothpaste, 17.14% use mouthwash, 20% use dental floss, and 11.27% use interdental toothbrush. Almost all respondents (90-91%) do not smoke or consume alcohol, and 87.67% of respondents drink some medications. The last number of examinees was last seen by a dentist in the last 6 months (63.01%), and the reason for the same is mostly stated by a regular examination (56.34%). The KEP index decreases with more frequent brushing, but the result is not statistically significant (p = 0.748). The KEP index decreases with longer brushing, but the result is also not statistically significant (p = 0.728). The average value of the KEP index is higher in patients who do not know or are not sure which food is bad for their teeth (p = 0.015). The value of the KEP index is lower in subjects who do not suffer from systemic diseases, but the result is not statistically significant (p = 0.444). By examining the relationship between the amount of unstimulated and stimulated saliva with the KEP index, the obtained result shows that the value of the KEP index is smaller the higher the amount of unstimulated and stimulated saliva and vice versa (p = 0.017, p = 0.014). CONCLUSION: The obtained results show that the attitudes and habits of the elderly are not as bad as we expected, but the status of the oral cavity determined by the KEP index is quite high and tells us that the oral health of the elderly is not satisfactory.

Uvod: Dentinska preosjetljivost česta je pojava, koju prati jaka i oštra bol na fizički ili kemijski podražaj što znatno utječe na pacijentovu svakodnevnicu i tako mu narušava kvalitetu života. Cilj: Utvrditi povezanost dentinske preosjetljivosti i inicijalne parodontne terapije. Materijali i metode: 25 ispitanika u sustavu potporne terapije Kliničkog bolničkog centra Rijeka ispunjavalo je modificiranu verziju anketnog upitnika „Dentine hypersensitivity experience questionnaire“ (DHEQ) za procjenu kvalitete života. Upitnik je klasificiran po Likertovoj skali, a sastoji se od petnaest pitanja kojima se promatrao utjecaj dentinske preosjetljivosti na domenu ograničenja, suočavanja, socijalnog funkcioniranja, emocionalnog funkcioniranja te osobnog identiteta. Rezultati: Ne postoji statistički značajna razlika u promatranim domenama, premda su ispitanici potvrdili da najveće poteškoće imaju u domeni ograničenja i emocionalnog funkcioniranja. Utjecaj dobi, spola i oralne higijene na stupanj dentinske preosjetljivost u svim domenama nije pokazao značaj. Zaključak: Trajanje potporne terapije obrnuto je proporcionalno sa stupnjem poteškoća u svim domenama. Zbog prilagodbe ispitanika na dentinsku preosjetljivost tijekom dužeg vremena potporne terapije, najveće olakšanje su osjetili u domeni emocionalnog funkcioniranja. Specificirane paste za zube za dentinsku preosjetljivost također pridonose boljoj kvaliteti života unatoč postojanosti stanja. Introduction: Dentine hypersensitivity is a common finding, and it followed by severe and sharp pain on physical or chemical stimulation, which significantly affects the patients' daily life and, subsequently, impairs their quality of life. Objective: To determine the association between dentine hypersensitivity and initial periodontal therapy. Materials and methods: 25 subjects included in the supportive therapy at the Clinical Hospital Center Rijeka filled out a modified version of the questionnaire "Dentine hypersensitivity experience questionnaire" (DHEQ) to assess the quality of life. The questionnaire is classified according to the Likert scale and consists of fifteen questions that assess the impact of dentinal hypersensitivity on the domain of limitation, confrontation, social interactions, emotional interactions and personal identity. Results: There were no statistically significant differences in the observed domains, although the subjects confirmed that they have the greatest difficulties in the domain of limitations and emotional interactions. The influence of age, gender, and oral hygiene on the degree of dentine hypersensitivity in all domains showed no significance. Conclusion: The duration of supportive therapy is inversely proportional to the degree of difficulty in all domains. Due to the adjustment of the subjects to dentinal hypersensitivity over a long period of supportive therapy, they felt the greatest relief in the domain of emotional interactions. Special toothpastes targeting dentinal hypersensitivity also contribute to a better quality of life despite the persistence of the condition.

Uspjeh primjene psihofarmaka ovisi o osobinama lijeka, njegovom načinu djelovanja, toksičnosti, o ispravnoj indikaciji i toleranciji organizma. Postizanjem optimalne doze lijeka uspijeva se djelovati na simptome bolesti istovremeno omogućavajući nepohodnu komunikaciju s okolinom na što bolji način i kako bi se bolesniku što bolje pristupilo kroz druge vrste terapije. Ono što je cilj korištenjem psihofarmaka kod osoba s mentalnim poteškoćama je da mu se pomogne živjeti jer on sam to ne može. S time se i cijeli psihički nivo bolesnika podiže i omogućava bolja socijalna komunikacija. Kao i svaki lijek tako i psihofarmaci uzrokuju određene nuspojave, pogotovo prilikom dugoročnog uzimanja. To su često nuspojave povezane s usnom šupljinom gdje mogu pacijentima uzrokovati nelagodu i bol,a samim time i smanjiti njihovu kvalitetu života. Zato je važno pravovremeno reagirati na takve nuspojave, pomoći im pri održavanju pravilne higijene i omogućiti im redovite preglede u stomatološkoj ordinaciji., Psychopharmaceutical drugs are used in therapy in people with mental disabilities. The success of the use of psychopharmaceutical drugs depends on the properties of the drug, its mode of action, toxicity, the correct indication and tolerance of the organism. By achieving the optimal dose of the drug it is possible to act on the symptoms of the disease while enabling the necessary communication with the environment in the best possible way and in order to better approach the patient through other types of therapy. The goal of using psychopharmaceutical drugs in people with mental disabilities is to help them to live. With this drugs the entire mental level of the patient is raised and better social communication is enabled. Like any medicine, psychopharmaceuticals cause certain side effects, especially when taken for a long time. These are often side effects associated with the oral cavity where they can cause patients discomfort and pain, and reduce their quality of life. That is why it is important to react to such side effects in a timely manner, help them maintain proper hygiene and enable them to have regular check-ups in the dental office.

Parkinsonova bolest (PB) je progresivni neurodegenerativni poremećaj obilježen bradikinezijom, rigidnošću, tremorom i posturalnom nestabilnosti. U završnom radu istražene su oralne manifestacije i učinci Parkinsonove bolesti na funkciju struktura u usnoj šupljini. Isto tako istražene su smjernice dentalne terapije te preporuke oralne higijene za ovu skupinu bolesnika. Pretražena literatura je pokazala kako bolesnici s PB-om zbog više čimbenika kao što su: oštećenje motorike, apatija, depresija i demencija mogu imati veće poteškoće u oralnoj zdravstvenoj praksi. Lijekovi za neurodegenerativne bolesti mogu prouzročiti kserostomiju, što će dovesti do nastanka oralnih infekcija i zubnog karijesa. Također može doći i do drugih problema poput bruksizma, suhog grla, gingivitisa, edema jezika i lošeg okusa. Većina bolesnika s PB-om ima poteškoća u svakodnevnoj oralnoj higijeni obzirom da važne aktivnosti poput četkanja zuba, korištenja zubnog konca i čišćenja zubne proteze obavljaju daleko rjeđe od zdravih osoba iste dobi. Tijekom dentalno-medicinskog liječenja takvim bolesnicima potrebno je posvetiti maksimalnu pažnju kao bi se unaprijedilo njihovo oralno zdravlje a time i kvaliteta života. Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by manifestations such as bradykinesia, rigidity, tremor, and postural instability. This final thesis researched the relationship between oral health and Parkinson's disease, which has its manifestations and effects on the functional structure in the oral cavity. Guidelines for correct dental therapy and recommendations of oral hygiene for this group of patients were also investigated. Research has shown that patients with PD may have greater difficulty with practicing oral health due to several factors: movement impairment, apathy, depression, and dementia. Medications for neurodegenerative diseases can produce xerostomia, which can lead to infection and dental caries. It can also produce other problems such as bruxism, dry throat, gingivitis, tongue edema and abnormal taste. Most patients with PB have difficulty with their daily oral hygiene. Important activities such as brushing teeth, flossing and cleaning dentures are performed far less frequently than by healthy people of the same age. During dental treatments, such patients need to be given maximum attention in order to improve their oral health and thus their quality of life.

U završnom radu prikazan je značaj oralnog zdravlja te njegov utjecaj na fizičko i psihičko zdravlje ljudi.Osim toga je prikazana uloga zdrave prehrane u održavanju kvalitetnih i zdravih zubi. Pretražena literatura je pokazala kako karijes umanjuje kvalitetu života kod djece na način da mogu doživljavati nelagodu i omalovažavanje, a može se javiti i poremećaj spavanja, prehrane i tjelesne težine. Djeca stara tri godine koja imaju karijes teže oko 1 kg manje od djece bez karijesa, jer zubobolja i infekcije mijenjaju navike spavanja i prehrane, njihov unos i metaboličke procese. U zemljama u razvoju rastu kronične bolesti poput pretilosti, dijabetesa i karijesa, što implicira da će se u mnogim slučajevima pogoršati kvaliteta života povezana s oralnim zdravljem, a time i opća kvaliteta života. Budući da oralne i druge kronične bolesti imaju zajedničke odrednice, trebalo bi dati više važnosti samom pristupu tim čimbenicima rizika. Ključni koncept na kojem bi se trebale temeljiti buduće strategije oralnog zdravlja je usredotočenje na poboljšanje zdravstvenih stanja općenito cijele populacije a pogotovo za skupine s visokim rizikom, smanjujući tako socijalnu nejednakost. Stomatološko zdravlje je povezano s pravilnom prehranom a utjecaj pravilne prehrane važan je od rane dječje dobi kada se uspostavljaju osnove trajnih zubi.Temelj pravilne prehrane za rast i očuvanje zdravlja zubi su minerali poput kalcija, željeza, magnezija i floura, vitamini te bjelančevine. This final paper shows the importance of oral health and how much it affects people physically as well as psychologically. The role of a well balancednutrition in maintaining good and healthy teeth is also presented. Caries can reduce quality in the life of children: they experience discomfort, being made fun of, acute and chronic infections, and thus a higher risk of hospitalization with high costs of treatment, sleeping, eating and weight disorders. Because toothache and infections can alter sleeping and eating habits, as well as food intake and metabolic processes,childrenwho are three years old with caries will weigh about 1 kg less than children without it. In developing countries, diseases such as obesity, caries and diabetes are on the rise, implying that in many cases oral health-related and general quality of life will get worse. Since oral and other chronic diseases have common causes more importance should be given on how to access risk factors. Future oral health strategies should be based on important strategies, improvinggeneral health conditions for everyone, especially high-risk groups. Oral health is closely linked to proper nutrition. It is important to start from a young age because then the foundations for permanent teeth are formed. Minerals like calcium, magnesium, iron and flour, form the base of a proper nutrition for growth and maintenance of dental health, as well as vitamins, andanimal or vegetable proteins.

Preosjetljivost dentina je bolno kliničko stanje koje pogađa oko 30% odraslih osoba, a najčešće se javlja u dobi između trideset i četrdeset godina. To stanje se javlja zbog gubitka cakline, zubnog cementa ili povlačenja gingive u području zubnog vrata. Bol se manifestira pojavom kratkotrajne i oštre boli, najčešće potaknute termičkim podražajima, kiselom hranom i pićima. Da bi se javila preosjetljivost dentina, navedeni podražaji dovode do pokretanja dentinske tekućine, koja podražuje živčane završetke zbog čega se stvara i prenosi osjet boli. Dentinska preosjetljivost najčešće je posljedica međudjelovanja nekoliko uzročnih čimbenika kao što su erozija, atricija, abrazija i abfrakcija. Nepravilna tehnika četkanja zuba i konzumacija kiselih pića i hrane može dovesti do preosjetljivog dentina i trošenja cakline. Sredstva za suzbijanje dentinske preosjetljivosti dijele se na sredstva koja pacijent samostalno primjenjuje u kućnoj upotrebi u obliku desenzibilizirajuće paste i otopine za ispiranje usne šupljine, dostupne u drogerijama i ljekarnama te sredstva koja se koriste u ordinaciji dentalne medicine a koje primjenjuje stomatolog, kao što su lakovi koji potiču odlaganje minerala u dentinskim kanalićima i svjetlosno stvrdnjavajuće smole koje prekrivaju dentinske kanaliće. Dentine hypersensitivity is a painful clinical condition that affects about 30% of adults and most commonly occurs between the ages of thirty and forty. This condition occurs due to loss of enamel, dental cementum or reccesion of the gums in the cervical area. Pain is short and sharp, and most often triggered by thermal stimuli, acid foods and drinks. In order to cause dentin hypersensitivity, these stimuli lead to the activation of dentinal fluid that stimulates the nerve endings, which then creates and transmits a sensation of pain. Dentine hypersensitivity is most often caused by the interaction of several factors such as erosion, atricia, abrasion, and abfraction. Improper brushing technique and consumption of acid beverages and food can lead to hypersensitive dentin and enamel wear. Dentine hypersensitivity can be treated with agents that the patient self-administers at home in the form of a desensitizing paste and mouthwash solution, available in drugstores and pharmacies. Treatment can also be provided by a dentist in the dental practice with varnishes which stimulate the deposition of minerals in the dentinal tubules, and light-curing resins that cover the dentinal tubules.

Oralno zdravlje čini važan dio općeg zdravlja, a podrazumijeva zdravlje cjelokupne usne šupljine. Svi dijelovi našega tijela, pa tako i usna šupljina, izloženi su kolonizaciji širokog spektra mikroorganizama te domaćin i mikrobiološki svijet većinom žive u ravnoteži. Pravilnim provođenjem oralne higijene, odnosno korištenjem kemijskih i mehaničkih sredstava, onemogućava se nakupljanje plaka i njegova mineralizacija, koji bi doveli do mnogih bolesti usne šupljine. Četkanje zuba esencijalan je dio održavanja oralne higijene, a ova rutina obično uključuje korištenje četkice za zube i paste za zube. Ukoliko se osobe odluče za manualnu četkicu imaju veliku mogućnost izbora, a najčešće biraju prema osobnom dojmu ili prema preporuci stomatologa. Stomatolozi najčešće preporučuju korištenje četkice male glave, mekih najlonskih vlakana zaobljenih vrhova, različite dužine snopića i drškom koja je ugodna za korištenje. Pacijenti se mogu odlučiti i za korištenje električnih četkica koja je posebno učinkovita kod osoba slabo motiviranih za održavanje oralne higijene, kod pacijenata koji imaju slabu manualnu spretnost i kod parodontoloških pacijenata koji imaju lošu kontrolu plaka. Različitim tehnikama četkanja odstranjuje se plak s lingvalnih, bukalnih i okluzalnih zubnih ploha, ali to nije dovoljno učinkovito za odstranjenje zubnog plaka u interdentalnom prostoru. Za to su potrebna dodatna sredstva kao što su konac i traka za zube, interdentalna četkica, interdentalni stimulatori i sredstva za irigaciju. Sredstva koja se koriste za čišćenje interdentalnog prostora ovise o veličini međuzubnih područja, položaju zuba i postavi u zubnom luku, prisutnosti furkacija višekorijenskih zuba, prisutnosti fiksnih protetskih radova i ortodontskih aparata, te sposobnosti i motivaciji pacijenta. Oral health is an important part of general health, and implies the health of the entire oral cavity. All parts of our body, including the oral cavity, are exposed to the colonization of a wide range of microorganisms, and the host and microbiological world mostly live in balance. Proper oral hygiene, i.e. the use of chemical and mechanical means, prevents the accumulation of plaque and its mineralization, which would lead to numerous diseases of the oral cavity. Toothbrushing is an essential part of oral hygiene maintenance, and this routine usually involves the use of a toothbrush and toothpaste. If one should decide to use a manual brush, they have a wide choice, and usually choose according to their personal impression or according to the dentist's recommendation. Dentists most often recommend the use of a small head brush, soft nylon fibers with rounded tips, different bundle lengths and a handle that is comfortable to use. Patients may also choose to use electric brushes, which are especially effective in people who are poorly motivated to maintain oral hygiene, in patients who have poor manual dexterity, and in periodontal patients who have poor plaque control. Various brushing techniques remove plaque from lingual, buccal, and occlusal dental surfaces, but they are not effective in removing plaque from the interdental spaces. This requires additional means such as dental floss and tape, an interdental brush, interdental stimulators and irrigators. The agents used to clean the interdental spaces depend on the size of the interdental areas, the position of the teeth and their placement in the dental arch, the presence of multi-rooted tooth furcations, the presence of fixed prosthetic works and orthodontic appliances, and the patient's ability and motivation

Sindrom pečenja usta je kronična orofacijalna bol koja je karakterizirana osjećajem pečenja na klinički zdravoj oralnoj sluznici. Etiološki gledano, SPU se dijeli na primarni (nepoznati uzrok) i sekundarni (lokalni, sistemski, neurološki, psihološki etiološki čimbenici). Psihološki čimbenici kao što su anksioznost i depresija mogu imati vaţnu ulogu u simptomatologiji i etiologiji SPU-a. Cilj ovog rada bio je procijeniti psihološki status pacijenata sa SPU-a i procijeniti postoji li povezanost psiholoških čimbenika sa pojavom pečenja. U istraţivanju je sudjelovalo petna est pacijenta s dijagnozom SPU-a i 15 pacijenata u kontrolnoj skupini. Dijagnoza SPU-a postavljenja je kod pacijenata sa simptomima pečenja i normalnim nalazom oralne sluznice, dok kontrolnu skupinu čine pacijenti bez oralnih smetnji. Psihološki status pacijenata procijenjen je pomoću sljedećih upitnika: GAD-7,PHQ-9, i PCS. Na temelju provedenog istraţivanja dokazano je da za svaku pojedinačnu skalu ne postoji statistički značajna razlika izmeĎu SPU skupine i kontrolne skupine (p˃ 0,05), a pozitivna umjereno linearna koleracija potvrĎena je izmeĎu intenziteta pečenja i razine katastrofiziranja koja je vrlo često prisutna kod pacijenata koji pate od depresije i/ili ankzionosti. Na temelju toga moţemo zaključiti da ipak postoji uzročno posljedična povezanost SPU-a i psihološkog statusa. Burning mouth syndrome (BMS) is a chronic orofacial pain disorder characterized by burning sensation in the clinically healthy oral mucosa. Based on etiology, BMS can be divided into primary (unknown cause) and secondary (local, systemic,neurological, psychological factors). Psychological factors such as somatoform pain disorder, anxiety, and depression can play a important role in symptomatology and etiology. The aim of the study was to assess the psychological status of BMS patients as well as whether psychologic factors are related to pain reports. Fifthteen patients with BMS along with 15 healthy patients as controls were included in this study. Inclusion criteria for BMS patients were burning sensation in the mouth and normal oral mucosa while the control group was without any oral complaints. The patient's psychological status was assesed using the following queries: GAD-7, PHQ-9, PCS. Based on the conducted research, it was proved that for each scale there is no statistically significant difference between the SPU group and the control group (p˃ 0.05). Positive moderately linear correlation is a confirmation between the intensity of burning and the level of catastrophism that is very often present in patients that suffer from depression and/or anxiety. Based on this, we can conclude that there is nevertheless a consequential connection between SPU and psychological status

Dječje bolesti predstavljaju neiscrpnu temu i velik interes u svim područjima opće i dentalne medicine. Kongenitalne, razvojne i nasljedne bolesti prisutne su pri rođenju, ili se javljaju u ranoj dječjoj dobi. Infektivne bolesti mekih tkiva relativno su česte u dječjoj populaciji zbog stalne izloženosti djece mikroorganizmima. Prema uzročnicima, infektivne bolesti moguće je podijeliti na bakterijske, virusne i gljivične. Bakterijske infekcije mogu biti odontogenog i neodontogenog podrijetla. Najčešće bakterije prisutne kod djece su streptokoki i stafilokoki. Najčešći uzročnik gljivičnih infekcija je Candida albicans. Klinički se razlikuje nekoliko oblika kandidijaze, a kod djece najčešće nalazimo pseudomembranozni i eritematozni oblik, te angularni heilitis. Uzročnici virusnih infekcija mogu biti DNK ili RNK virusi. Virusne infekcije još se mogu podijeliti u primarne, ako zahvaćaju samo usnu šupljinu, i sekundarne, kada je zahvaćen cijeli organizam. (Infekcija Herpes simplex virusom tipa jedan može se javiti kao herpetični gingivostomatitis ili recidivirajući herpes. Coxsackie virus kod djece može izazvati herpanginu ili bolest usta, šaka i stopala. Djeca infekciju virusom humane imunodeficijencije najčešće steknu intrauterino od zaražene majke, a ostale izvore zaraze u pedijatrijskoj populaciji predstavljaju krvni proizvodi, transfuzija i majčino mlijeko.) U dječjoj dobi relativno su česti i benigni tumori, te različite vrste ozljeda oralne sluznice. Childhood diseases are an inexhaustible topic and great interest in all areas of both general and dental medicine. Congenital, developmental and hereditary diseases may be present at birth, or occur in early childhood age. Infectious diseases are relatively common in the children's population because of the constant exposure of children to microorganisms. According to agents, infectious diseases can be divided into bacterial, viral and fungal infections. Bacterial infections can be odontogenic and non-odontogenic. The most common bacteria present in children are streptococci and staphylococci. The most common cause of fungal infections is C.albicans. Clinically, there are different types of candidiasis, and in children, most common are pseudomembranous and erythematous forms and cheilitis angularis. Viral infections can be grouped according to the genetic material of a virus: DNA or RNA. Viral infections can also be divided into primary, if they only affect the oral cavity, and secondary, if the whole organism is affected. Herpes simplex type one infection may occur as herpetic gingivostomatitis or herpes simplex recidivans. Coxsackie virus in children can cause herpangina or hand, foot and mouth disease. Children with HIV infection are often infected during pregnancy from infected mothers. Other sources of infection in the pediatric population are blood products, transfusions and breastmilk. Benign tumors and various types of oral mucosal injuries are also relatively common in childhood

Dirofilariasis is an endemic infestation in tropical and subtropical countries caused by about 40 different species. It rarely occurs in the oral cavity and is mostly presented as mucosal and submucosal nodules. Differential diagnoses include lipoma, mucocele, and pleomorphic adenoma. We report a rare case of oral dirofilariasis mimicking mucocele in a 41-year-old male patient from Croatia without an epidemiological history of travelling outside the country. He came in because of non-painful lower lip swelling that had lasted for two months. The parasite was surgically removed from the lesion. This is the first reported case of oral dirofilariasis in Croatia. It is important to point out this rare diagnosis in order to make dentists aware of the possibility of the presence of such an infestation in common lesions of the oral mucosa.

Background: The objective of this study was to determine the most effective treatment option for burning mouth syndrome. Methods: Informative treatment alone, B vitamin injections, oral cavity probiotics, and low-level laser therapy were evaluated and compared. The study included new patients diagnosed with burning mouth syndrome, who were randomly allocated into one of four treatment groups. The primary outcome was improvement in patient’s quality of life as determined by a self-perceived Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire before and after therapy. The secondary outcome was determination of mucosal symptom intensity according to visual analog scale (VAS) grading from 0 to 10. Data were submitted to statistical analysis. Results: A total of 62 patients completed the study. Oral cavity probiotics and LLLT scores for OHIP-14 resulted in a statistically significant difference before and after therapy. Standardized effect sizes between OHIP scores before and after treatment were the greatest for patients who had received oral cavity probiotics. Conclusions: Oral cavity probiotics and LLLT were the most effective treatment for improvement in quality of life. Further investigation on a larger group of patients is required.

Cilj: Cilj ovog istraživanja bio je utvrditi osobitosti karcinoma jezika dijagnosticiranih u KBC-u Split u šestogodišnjem razdoblju između od 01.01.2012. do 31.12.2017. godine. Materijali i metode: U ovu studiju retrospektivnog tipa uključeni su svi bolesnici kojima je karcinom jezika dijagnosticiran na Kliničkom zavodu za patologiju, sudsku medicinu i citologiju u razdoblju KBC Split u razdoblju od 01.01. 2012. do 31.12. 2017. godine. Iz računalne baze prikupljeni su patohistološki nalazi iz kojih su izuzeti podaci o spolu i dobi bolesnika, veličini tumora, histološkom tipu i stupnju diferencijacije, a kod bolesnika koji su operiranu u KBC Split i podaci o veličini tumora i statusu limfnih čvorova. Rezultati: U šestogodišnjem razdoblju dijagnosticirano je 106 bolesnika sa karcinomom jezika. Kod većine bolesnika (n=68) uzeti su samo bioptički uzorci dok je kod 38 bolesnika nakon biopsije izvršen i operativni zahvat. Karcinomi jezika zastupljeniji su u muškaraca (83,9%) nego u žena (16,1%). Najzastupljeniji su u dobi od 50 do 70 godina (58,5%). Najčešći histološki tip karcinoma jezika je planocelularni karcinom uobičajenog podtipa (96%), slijede ga bazaloidni (4,7%), verukozni (n=0,95%%) i adenoid cistični ( 0,95%). Većina karcinoma jezika je srednje (55,1%) i dobro diferencirana (35,5%), dok su najmanje zastupljeni slabo diferencirani karcinomi (13,3%). U 2/3 operiranih bolesnika nađene su metastaze u cervikalnim limfnim čvorovima. Zaključak: Epidemiološki profil karcinoma jezika u našoj populaciji upućuje na značajno češću pojavnost ovog tumora kod muškaraca i u starijoj životnoj dobi. Predominanti histološki podtip je uobičajeno planocelularni karcinom, uglavnom dobro i srednje diferenciran, dok su drugi histološki tipovi i slabo diferencirani karcinomi rijetki. Većina karcinoma jezika koji su operirani imaju metastazama zahvaćene regionalne limfne čvorove., Objective: The aim of this study was to determine the characteristics of tongue cancer diagnosed at KBC Split during the six year period from January 1st 2012 to December 31st 2017. Materials and methods: All samples diagnosed with tongue cancer at the Department of pathology, medical jurisprudence and citology of Clinical hospital center Split from January 1st 2012 to December 31st 2017 were included in this study. All the pathohistological findings were taken from the data base after which the information on age and sex of the patients, tumor size, histological type and differentiation rate was used. In cases when patients were surgically treated at KBC Split, both the data on tumor size and lymph node status were taken. Results: In the period of 6 years 106 patients were diagnosed with tongue cancer. Most of the patients (n=68) had tissue biopsy while 38 patients underwent surgery after the biopsy was performed. Tongue cancer has a higher incidence in male patients (83,9%) compared to female patients (16,1%). They are most common between 50 and 70 years of age (58,5%). The most common histological type of the cancer is the planocellular, conventional type cancer (96%), followed by basaloid (4,7%), verrucous (0,95%) and adenoid cystic(0,95%). Most of the cancers are moderately (55,1%) and well differentiated (35,5%), while poorly differentiated carcinomas have the lowest incidence (13,3%). Two thirds of surgically treated patients had cervical lymph nodes metastasis. Conclusion: Epidemiologic profile of the cancer in our population indicates a much higher incidence in male and older patients. The dominant histological subtype is conventional type planocellular cancer, being moderately and well differentiated in most cases while other histological types and poorly differentiated cancers occur much more rarely. Most of the surgically treated patients had regional lymph node metastasis.

Multipla skleroza (MS) je bolest karakterizirana multicentričnom demijelinizacijom središnjeg živčanog sustava. Etiologija nije jasno utvrđena. Kod oboljelih su često prisutni simptomi u orofacijalnoj regiji. Cilj istraživanja bio je utvrditi prevalenciju oralnih simptoma u bolesnika s multiplom sklerozom i utvrditi povezanost oralnih simptoma s trajanjem bolesti. U istraživanju je sudjelovalo 33 bolesnika sa sekundarno progresivnom multiplom sklerozom prema McDonaldsovim dijagnostičkim kriterijima koji su obrađeni u Udruzi multiple skleroze PGŽ-a i 33 kontrolnih ispitanika koji su obrađeni u primarnoj ordinaciji dentalne medicine. Ispitanici su ispunili anketni upitnik o biografskim podacima, zdravstvenom stanju te oralnim simptomima. Bolesnici s MS-om imaju značajno više oralnih simptoma nego kontrolni ispitanici. Najčešće su se žalili na otežano gutanje (42,4%) i otežani govor (42,4%). Prosječan broj oralnih simptoma u bolesnika s MS-om bio je 2,52±1,94, dok je u kontrolnih ispitanika broj oralnih simptoma bio 0,36±0,54. Nije utvrđena statistički značajna korelacija između broja oralnih simptoma i trajanja MS-a (r=0,16; p>0,05). Bolesnici s MS-om koji boluju više od 20 godina imaju 6,5 puta veći rizik za nastanak otežanog gutanja. Dobiveni rezultati ukazuju povećanu pojavnost oralnih simptoma, odnosno narušenu funkciju usne šupljine u bolesnika s MS-om. Multiple sclerosis is a disease characterized by multicenter demyelination of the central nervous system. The etiology is not clearly established. Symptoms in the orofacial region are often present in patients with Multiple sclerosis. The aim of the study was to determine the prevalence of oral symptoms by patients with multiple sclerosis and to determine the association of oral symptoms with the duration of the disease. The study involved 33 patients with secondary progressive multiple sclerosis according to McDonald's diagnostic criteria, which were processed in the Association of Multiple Sclerosis of the Primorje - Gorski kotar County and 33 control subjects who were processed in the primary dental office. Respondents completed a questionnaire about biographical information, health status and oral symptoms. Patients with MS have significantly more oral symptoms than control subjects. They most often complained of difficulty swallowing (42.4%) and impaired speech (42.4%). The average number of oral symptoms in patients with MS was 2.52 ± 1.94, while in control subjects the number of oral symptoms was 0.36 ± 0.54. No statistically significant correlation was found between the number of oral symptoms and the duration of MS (r = 0.16; p> 0.05). Patients with MS who have been ill for more than 20 years have a 6.5 – fold increased risk of difficulty swallowing. The obtained results indicate an increased prevalence of oral symptoms, ie impaired oral function in patients with MS.

Okus pripada jednom o pet glavnih osjetila kod čovjeka. Nastaje kao posljedica interakcije različitih kemijskih tvari s okusnim stanicama. Čovjek može osjetiti pet glavnih okusa poput slatkog, kiselog, gorkog, slanog i umami. Svaki od ovih okusa ima specifičnu ulogu kod čovjeka, poput detekcije visokokalorijske hrane ili potencijalno toksičnih tvari. Prije nego što se okus može percipirati sve kemijske tvari moraju biti u tekućoj formi. Bitnu ulogu u percepciji okusa ima slina. Slina otapa različite tvari i omogućava njihov transport do okusnih stanica. U okusnim stanicama dolazi do pretvorbe kemijske energije u elektrokemijsku. Elektrokemijska energija koja nastaje u okusnim stanicama prenosi se putem kranijalnih živaca prema središnjem živčanom sustavu u određeni centar u kojemu nastaje osjet okusa. Poremećaji okusa mogu se podijeliti na ageuziju, hipogeuziju, hipergeuziju i disgeuziju. Široki spektar uzročnika može dovesti do poremećaja okusa. Uzročnici mogu biti sve od lokalnih, koji zahvaćaju samo usnu šupljinu, pa sve do generalnih kao što su sistemske bolesti. Pri dijagnostici poremećaja osjeta okusa nužno je da terapeut od pacijenta uzme detaljnu medicnsku, dentalnu i socijalnu anamnezu i napravi detaljan klinički pregled usne šupljine, glave i vrata. Klinički dijagnostički testovi za poremećaj okusa dijele se na jednostvne i specifične. Oni služe kako bi diferencirali poremećaje okusa koji nastaju od oralnih ili neoralnih uzročnika. Liječenje poremećaja okusa ovisi o etiologiji. Za neke poremećaje potrebna je ciljanja terapija, za neke ne treba terapija dok neki poremećaji okusa nestaju spontano. U slučaju da ne postoji specifično liječenje, pacijenta je potrebno naučiti kako da se nosi s bolešću te ga uputiti u specijalističku ustanovu koja se bavi ovakvom problematikom Taste, one of the five basic human senses, is a result of interaction between different chemical substances and gustatory cells. Humans can recognize few submodalities within taste: sweet, sour, bitter, salty and umami. Each of these tastes has a specific role, such as detection of high calorific food or potential toxic substances. All chemical substances have to be in liquid form before taste perception can happen. Saliva has an important role in taste perception: it acts as a dissolving medium for various substances and enables their transport to gustatory cells, where chemical energy is transformed into electrochemical energy. This electrochemical energy then travels via cranial nerves towards the central nervous system to the specific center, where sense of taste is created. Taste disorders include ageusia, hypogeusia, hypergeusia and dysgeusia, and can be caused by a wide range of miscellaneous factors. Taste disorders can vary from local (affecting only oral cavity) to general (systemic diseases). Proper diagnosis is the first step in the treatment of taste disorders. It is important that clinician is familiar with patient's medical, dental and social history and thoroughly examines oral cavity, head and neck. Taste disorders can be evaluated via clinical tests (simple or specific), used to differentiate taste disorders caused by oral factors from those caused by non-oral factors. Taste disorder treatment depends on the etiology; some disorders require targeted therapy, while some may go away on their own. In case there is no specific treatment, patient should be taught to cope with the disorder and referred to an institution specialized in treating taste disorders.

Leukoplakija je bijela mrlja ili plak koji se ni klinički ni histološki ne može okarakterizirati kao neka druga lezija i nije povezana ni s jednim fizikalnim ili kemijskim uzročnim faktorom, osim upotrebe duhana. Dosadašnji načini liječenja poput ekscizije skalpelom, lokalne ili sistemske primjene retinoida i nekih lasera u manjem ili većem broju slučajeva dovode do recidiva leukoplakije. Iz tog razloga postoji potreba za pronalaskom učinkovitijih metoda liječenja oralne leukoplakije. Stoga je svrha ovog istraživanja bila odrediti učinkovitosti visokoenergetskih ablativnih lasera u liječenju oralne leukoplakije. Nadalje, svrha je bila međusobno usporediti i procijeniti subjektivne i objektivne postoperativne parametre za dva različita ispitivana ablativna lasera, erbij, itrij, aluminij, garnet laser (Er:YAG) i erbij, kromij dopiran s itrijem, skandijem, galijem, garnetom laser (Er,Cr:YSGG). U istraživanju su sudjelovala 54 ispitanika, od čega 16 muškaraca i 38 žena. Nasumičnim odabirom ispitanici su bili razvrstani u jednu od dvije ispitivane skupine. U prvoj skupini pacijentima se leukoplakična lezija uklanjala visokoenergetskim ablativnim laserom Er:YAG, a pacijentima u drugoj skupini visokoenergetskim ablativnim Er,Cr:YSGG laserom. Pacijentima je prije početka liječenja utvrđena veličina leukoplakične lezije, izmjerena u milimetrima. Kriterij za procjenu učinkovitosti lasera bila je pojava recidiva leukoplakije u razdoblju praćenja od jedne godine i šest mjeseci. Rezultati su pokazali da postoji statistički značajna razlika u lokalizaciji pojave lezija između muškaraca i žena. Kod muškaraca lezija se najčešće nalazila na obrazu, dok se kod žena javljala u retromolarnom području i području mekog nepca. Kod muškaraca je bila utvrđena češća pojava recidiva nego kod žena. Lezije liječene Er:Cr:YSGG laserom nakon prve terapije pokazale su manje recidiva nego lezije liječene Er:YAG laserom, te su ispitanici imali nižu razinu postoperativne boli i veću kvalitetu života nakon liječenja Er:Cr:YSGG laserom. Iz navedenih rezultata može se zaključiti da je Er;Cr:YSGG laser učinkovitiji i prihvatljiviji za liječenje oralne leukoplakije nego Er:YAG laser. Aim: The aim of this study was to determine the most effective non-invasive surgical therapy in the treatment of oral leukoplakia by means of high energy ablative lasers. In addition, the aim was to compare the efficacy of ablative lasers and to evaluate subjective and objective postoperative parameters (healing, postoperative pain, quality of life, recurrence), all for the purpose of identifying the optimal laser and precision settings of lasers for clinical use in order to achieve a successful treatment of oral leucoplakias. Previous treatment methods such as scalpel excision, topical or systemic administration of retinoids and some lasers in a smaller or larger number of cases lead to recurrence of leukoplakia. For this reason, there is a need for finding more effective methods of treating oral leukoplakia. Therefore, the purpose of this study was to determine the efficacy of high energy ablative lasers in the treatment of oral leukoplakia. Furthermore, the purpose was to compare and evaluate subjective and objective postoperative parameters for two different ablative lasers such as erbium, yttrium, aluminum, garnet (Er: YAG) and erbium, chromium doped with yttrium, scandium, gallium, and garnet laser (Er: Cr: YSGG). Materials and methods: The study involved 54 subjects, of whom 16 men and 38 women. By random selection, the subjects were classified into one of the two study groups. In the first group of patients, the leukoplakic lesion was removed by high energy ablation laser Er: YAG and patients in the second group were treated by use of high energy ablative Er, Cr: YSGG laser. At the very beginning, the size of the leukoplakic lesion was measured in millimeters. The criterion for laser efficacy estimate was the recurrence of leukoplakic lesion during the one-year and six-month follow-up period. For the statistical analysis of the data, the Fisher's exact test was used for comparing discrete characteristics and the multivariate variance analysis (MANOVA) with three classification variables for comparing continuous characteristics. The Pearson correlation coefficient was used as the correlation measure. The analysis was made using the SAS statistical package on the Windows platform. Values of less than 0.05 were considered significant (p

Atipična orofacijalna bol predstavlja ozbiljno zdravstveno stanje koje negativno utječe na kvalitetu života. Nedostatak jasne kliničke slike na žalost često dovodi do neprepoznavanja stanja te se pacijent u pokušajima da mu se pomogne podvrguje nepotrebnim i štetnim zahvatima koji dodatno narušavaju stanje pacijenta, opterećuju zdravstveni sustav te predstavljaju izvor frustracije za liječnika. Doktor dentalne medicine je često prvi u nizu doktora kod kojih pacijent dođe te je na njemu velika odgovornost da se ne upušta olako u nepotrebne stomatološke tretmane te da uputi pacijenta na daljnje dijagnostičke pretrage. Dijagnoza se postavlja nakon iscrpne diferencijalne dijagnostike procesom eliminacije. Terapija primarno uključuje farmakološku terapiju tricikličkim antidepresivima uz kognitivno bihevioralnu terapiju kako bi se pacijenta pokušalo osloboditi boli te mu se omogućila bolja kvaliteta života. Atypical orofacial pain is a serious medical condition that has a very negative impact on the quality of life. A lack of a clear clinical image regretfully often means that the condition stays unrecognised. Usually, the patient undergoes a number of unnecesarry treatments which further aggravate the condition and further degrade the patients' quality of life, burdens the healthcare system and is very frustrating for the therapist. Dental practicioner is often the very first that the patient comes to for help and carries the responsability to be wary of unnecessary treatments and, when necessary, advise further analysis. An atypical orofacial pain diagnosis can only be made after extensive differential analysis through elimination. A common therapy s primarly pharmacological, using tricyclic antideppressants, paired with cognitive-bihevioural therapy sessions so the patient could be free of pain and to improve the quality of life.

Varicella zoster virus jedan je od osam herpes virusa koji je patogen samo za ljude. Nakon ulaska u organizam virus se razmnožava u limfatičkom sustavu i regionalnim limfnim čvorovima te diseminira prema koži i sluznicama uzrokujući generalizirani vezikularni osip i nastaje varičela (vodene kozice). Nakon primarne infekcije ili cjepljenja, VZV ostaje u latentnom stanju pohranjen u senzornim stanicama spinalnog ili moždanog ganglija. Čimbenici kao što su starenje, stres, imunokompromitirajuće stanje i imunosuprimirajući lijekovi mogu dovesti dovesti do reaktivacije virusa i nastanka herpes zostera. Herpes zoster infekcija obično je karakterizirana jednostranim, bolnim vezikularnim osipom koji je ograničen na određeni dermatom. VZV infekcije stvaraju lezije i na oralnoj sluznici. Oralne i perioralne manifestacije varičele su prilično česte i mogu prethoditi kožnim lezijama. Lezije se najviše pojavljuju na rubovima usana, nepcu i bukalnoj sluznici. Mogu biti prisutne i na gingivi, obrazu, sluznici usana, jeziku i orofarinksu. Svaka zasebna lezija započinje kao mala vezikula koja brzo rupturira pa nastaju ulceracije. Herpes zoster maksilarne grane trigeminalnog živca stvara vezikule na nepcu, uvuli i tonzilama, a u slučaju infekcije mandibularne grane vezikule se pojavljuju na prednjem dijelu jezika, dnu usne šupljine i bukalnoj sluznici. Oralni herpes zoster ima izgled raspršenih, malih, bolnih vezikula ili ulkusa smještenih unilateralno The varicella-zoster virus is one of the eight types of herpes viruses known to be pathogenic only for humans. After entering the body, the virus propagates in the lymphatic system and regional lymph nodes. It then disseminates towards the skin and mucous membranes causing a generalized vesicular rash and the onset of varicella (chickenpox). After the primary infection or vaccination, VZV will stay in the latent state in the sensory cells of the spinal or basal ganglia. Various factors, such as aging, stress, immunodeficiency and immunosuppressive medications, can enable the reactivation of the virus and the onset of herpes zoster. The herpes zoster infection is usually characterized by a one-sided, painful vesicular rash limited to a specific dermatome. VZV infections also create lesions of the oral mucosa. The oral and perioral manifestations of the varicella virus are rather common and can be a precursor to the skin lesions. The lesions most often appear on the lip edges and the palate and, successively, on the buccal mucosa. The gingiva, cheek, the mucous membrane of the lips, tongue, and oropharynx are areas where lesions can also appear. Each lesion is firstly a small vesicle, which ruptures in a short time, causing ulcerations. Herpes zoster of the maxillary branch of trigeminal nerve creates vesicles on the palate, uvula, and tonsils. If there is an infection of the mandibular branch, the vesicles will then appear on the front (oral) part of the tongue, the floor of the oral cavity and buccal mucosa. The oral herpes zoster has the appearance of small, scattered, painful vesicles, or ulcers, placed unilaterally.

Cilj: Cilj istraživanja bio je procijeniti navike i znanja roditelja o oralnom zdravlju djece te kliničkim pregledom utvrditi klinički status usne šupljine djece predškolske dobi. Materijali i metode: Istraživanje je provedeno u Dječjem vrtiću „Trogir”. U istraživanju je sudjelovalo 198 roditelja koji su ispunili anketni upitnik te 178 djece predškolske dobi koja su klinički pregledana. Klinički status utvrđen je KEP i SIC indeksom. Rezultati: Rezultati istraživanja pokazali su da je 93,43% djece predškolske dobi posjetilo doktora dentalne medicine te da je 43,94% djece posjeduje Zubnu putovnicu. Prije upisa u vrtić 73,23% djece je posjetilo doktora dentalne medicine. Utvrđeno je da je 50,51% roditelja djetetu počelo četkati zube u prvoj godini života. Strah od doktora dentalne medicine ima 19,19% djece. Približno polovica roditelja imaju saznanja da dijete ima karijes dok njih 58,08% tvrdi da njihovoj djeci nije saniran karijes ili da nemaju karijes. Dentalnu traumu je doživjelo 6,57% djece. Pastu s dodatkom fluora ne koristi 34,34% djece. Slatkišima djecu svakodnevno hrani 54,04% roditelja, a zaslađene napitke konzumira 23,74% djece. Dobiveni rezultati navika roditelja o dnevnoj potrebi četkanja zubi djeteta pokazali su da je najveći broj roditelja (73,23%) odgovorio da se odvija dvaput dnevno. Znanje i spoznaje o oralnom zdravlju 52,53% roditelja steklo je od doktora dentalne medicine. Da se karijes može spriječiti smatra 85,35% roditelja, a 43,43% roditelja ne zna da zubna pasta s dodatkom fluora ima utjecaj na prevenciju karijesa. Da dojenje ne može uzrokovati karijes smatra 64,65% roditelja. Većina roditelja, njih 73,23% smatra da je zube potrebno četkati tri minute, a 22,22% roditelja smatra da je dovoljno dvije minute. Dok 89,39% roditelja smatra da se karijes na mliječnim zubima treba popraviti, njih 66,16% karijes ne smatra zaraznom bolesti. Predškolska djeca grada Trogira imaju prosječni kp indeks u vrijednosti 3,72 te SIC indeks 8,08. Trogodišnjaci imaju prosječni kp indeks 3,25, a SIC 8,0. Četverogodišnjaci imaju prosječni kp indeks 1,89, a SIC 5,17. Petogodišnjaci imaju prosječni kp indeks 3,98 dok SIC iznosi 8,27. Prosječni kp indeks šestogodišnjaka iznosi 4,15. SIC je približne vrijednosti kao kod petogodišnjaka 8,59. Sedmogodišnjaci imaju prosječni kp indeks 2,27. SIC je nešto niži nego kod šestogodišnjaka i iznosi 6,0. Zaključak: Temeljem rezultata ovog istraživanja zaključeno je da navike i stavovi roditelja o oralnom zdravlju djece nisu zadovoljavajući, a kp indeks predškolske djece grada Trogira visok je i ne zadovoljava standarde EU., Objective: The aim of the study was to evaluate the parents' oral health habits and knowledge and to determine the clinical status of the oral cavity of preschool children by clinical examination. Materials and methods: The research was conducted in the Kindergarten "Trogir". The study involved 198 parents who completed a survey questionnaire and 178 preschool children who were clinically examined. Clinical status was determined by DMF and SIC index. Results: The results of the study showed that 93.43% of preschool children visited a dental doctor and that 43.94% of children had a dental passport. Before enrollment in kindergarten, 73.23% of children visited a dental doctor. It was found that 50.51% of parents started brushing their teeth in the first year of life. 19.19% of children have a fear of having a dental doctor. About half of the parents are aware that the child has caries, while 58.08% claim that the children did not have caries or had no caries. Dental trauma was experienced by 6.57% of children. 34.34% of children do not use fluoride paste. 54.04% of parents feed on sweets every day, and 23.74% of children consume sweetened beverages. The obtained results of the parents' habits on the daily need for brushing their teeth showed that the largest number of parents (73.23%) answered that it takes place twice a day. Oral health knowledge and insights 52.53% of parents acquired dental medicine. 85.35% of parents consider that caries can be prevented, and 43.43% of parents do not know that fluoride-containing toothpaste has an effect on the prevention of caries. 64.65% of parents consider that breastfeeding cannot cause caries. Most parents, 73.23% think that teeth need brushing for three minutes, and 22.22% of parents think that two minutes is enough. While 89.39% of parents think that caries on dairy teeth needs to be repaired, 66.16% of caries do not consider it contagious. Preschool children in Trogir have an average dmf index of 3.72 and a SIC index of 8.08. Three-year-olds have an average dmf index of 3.25 and a SIC of 8.0. Four-year-olds have an average dmf index of 1.89 and SIC 5.17. Five-year-olds have an average dmf index of 3.98 while the SIC is 8.27. The average dmf index of a six-year-old is 4.15. The SIC is approximate to that of a 5-year-old 8.59. Seven-year-olds have an average dmf index of 2.27. The SIC is slightly lower than that of six-year-olds and stands at 6.0. Conclusion: Based on the results of this study, it is concluded that the parents' habits and attitudes about the oral health of children are not satisfactory, and the dmf index of pre-school children in the city of Trogir is high and does not meet EU standards.