Abstract Introduction: Prostate cancer is one of the most common health threats for men in the developed world. With the advent of prostate cancer screening using serum prostate-specific antigen (PSA) tests, prostate cancer mortality has declined at the expense of substantial disease overtreatment. Modern prostate cancer therapy is performed according to certain guidelines. Antiandrogens are compounds that inhibit the action of androgens in prostate cancer cells by blocking receptors and preventing the binding of hormones to them. Aim: The aim of this research is to analyze the use of registered forms of LHRH agonists used in the treatment of locally advanced and metastatic prostate cancer in the last five years to examine trends in prescribing this group of drugs in Serbia whose patients gravitate towards the Urology Clinic at the UCC Kragujevac. Material and method: Using the ATC/DDD methodology, the use of LHRH agonists at the Urology Clinic of the UCC Kragujevac. A retrospective study of the use of this group of drugs according to the ATC classification was performed on the basis of data obtained from the hospital pharmacy for the period from year 2016 to year 2021, and the results are expressed by the number of DDD per 1000 inhabitants per day (1000/inhabitants/day). In the observed period, 1361 patients with a diagnosis of C61 (malignant prostate tumor) were treated at the Clinic of Urology. Results: In the observed period, a preparation containing triptorelin in a dose sufficient for one month of therapy was most often used. The total consumption of gonadorelin was lower compared to the rest of Serbia and EU countries, which was expected due to the protocol and the number of patients who gravitated towards the UCC Kragujevac. Conclusion: Despite certain limitations, this evaluation represents the first attempt to summarize the available evidence on the prescribing of LHRH agonists in Serbia. It was found that the consumption in UCCKG is lower compared to the consumption of these drugs in Serbia, Croatia and Italy at the same time intervals, for the same observed diagnosis.
Abstract Background: Appendiceal mucoceles represent neoplastic and non-neoplastic, dilatated, mucus filled appendix vermiformix. Appendectomy is obligatory due to a possible malignancy. It is crucially important to avoid rupturing of the mucocele because it can result in pseudomyxoma peritonei, with high morbidity and mortality. Case Report: We presented a 52-year-old man with pain and palpable mass in the lower right quadrant of the abdomen. The mucocele was removed without a rupture, and the patient was discharged from the surgical department one day after the surgery without a complication. Discussion: The resection must be done very carefully, because the rupture of a mucocele can cause pseudomyxoma peritonei, a very dangerous and often lethal condition. Due to the concern of rupture, we performed the classical resection through laparotomy. Conclusion: It is very important, especially for young, inexperienced surgeons to be aware of this rare diagnosis and perform a surgical intervention according to the guidelines of good clinical practice.
Abstract Functional dyspepsia (FD) is a syndrome mostly diagnosed by subjective patients’ symptoms after excluding organic, systemic and metabolic diseases. Aim: The goal of this study is to evaluate gastric emptying in patients with functional dyspepsia, by measuring the antral area (cm2) after the intake of a test meal using ultrasonography as an objective and widely applicable method. Material and Methods: This study included 30 patients (mean age of 46.53 ±9.73 years) with symptoms of FD according to the ROMA IV criteria and 30 healthy individuals (mean age of 42.87 ±4.42 years). A 5 MHz ultrasound probe was used to measure the stomach antral area at 6 different time points: in the fasting state, following the meal intake at 5, 30, 60, 90 and 120 min postprandially. Results: The antral area was statistically significantly larger after a 30-minute postprandial period in patients with FD comparing to healthy controls (p<0.05). There was a statistically significant difference in the rate of gastric emptying at 120 minutes in patients with functional dyspepsia, compared to healthy subjects (p <0.01). Patients with postprandial distress syndrome had the average value of gastric emptying 48.25 compared to 56.09 in patients with epigastric pain syndrome (p <0.05). The slowest emptying was observed in patients with nausea and postprandial fullness (p <0.05). Conclusion: Functional dyspepsia is associated with delayed gastric emptying. Using ultrasonography to measure the antral area helps us to assess gastric emptying and therefore to assess patients with functional dyspepsia. The antral area was significantly larger in patients with functional dyspepsia compared to healthy subjects after the test meal, suggesting slower gastric emptying in the dyspeptic patients. Since the diagnosis of functional dyspepsia is based mostly on diverse patients’ symptoms, using ultrasonography to measure the antral area helps us to objectively assess this problem.
Abstract Cancer patients infected with SARS-CoV-2 during their active anticancer treatment represent a highly vulnerable population. We aimed this investigation to show clinical features and outcomes of the patients who had mild to moderate COVID-19 symptoms or were asymptomatic at the admission to the COVID Center. The retrospective study included 25 cancer patients confirmed with SARS-CoV-2 within seven days of their last anticancer treatment. Clinical data were collected from medical records and processed by methods of descriptive and inferential statistics. Patients' mean age was 68.1±10.4 years. More than 2/3 of the patients were with ECOG PS 0 and 1, and about 4/5 of patients were in III or IV cancer stage. The most frequently applied types of therapy were radiotherapy and combined radio/chemotherapy. Eleven (44.0%) patients had bilateral while 4 (16%) had unilateral pneumonia. The most frequent symptoms were fever (72%), fatigue (72%), dyspnea (32%), and cough (32%). 1/5 of the patients needed oxygen support. Mean neutrophil (2.6±1.2), lymphocyte (0.9±0.6) and platelets (200.1±88.1) number significantly increased from admission to discharge (p=0.004, p=0.005, p<0.001). Median CRP significantly decreased from 40.4 (6.2-96.2) at admission to 11.35 (3.75-27.65) at discharge (p=0.008). Twenty-four patients were cured, and one patient died. Naso-pharyngeal SARS-CoV-2 clearance time was 19.4±6.9 days; the minimum was seven, and the maximum was 39 days. Cancer patients infected with SARS-CoV-2 during active anticancer treatment can successfully overcome COVID-19 without developing further respiratory or other complications during hospitalization. An increase in lymphocyte and neutrophil counts, with a decrease in CRP, may be markers of a favorable prognosis.
Abstract Despite advances in treatment, breast cancer remains one of the leading causes of death, and obviously new approaches to the treatment are needed. Due to minimal side effects, unlike more aggressive forms of therapy such as chemotherapy and radiotherapy, the application of irreversible electroporation-electrochemotherapy represents a new modality in the treatment of cancer. Electrochemotherapy uses an electric field (375 V cm -1) to allow increased absorption of chemotherapeutic drugs selectively in tumor cells. Accordingly, the total dose of these agents can be significantly reduced and numerous side effects can be avoided in this way. The Real Time Cell Analysis-RTCA-xCELLigence system was used to monitor the cytotoxic effects of the treatment. The results confirmed the justification of the use of paclitaxel in chemotherapy and showed cytotoxic effects of paclitaxel which were time and dose-dependent in both cell lines. When paclitaxel was administered in combination with an electric field, in both cell lines, the results showed a greater cytotoxic effect compared to the same treatment without electrochemotherapy. MCF-7 cells are more sensitive to electrochemotherapy treatment with paclitaxel compared to MDA-MB-231. Electrochemotherapy using paclitaxel in MCF-7 cells had a 6.4-fold higher cytotoxicity compared to the treatment only with paclitaxel. The results obtained support the current knowledge of the benefits of electrochemotherapy. It has been shown that electrochemotherapy can significantly increase the effects of paclitaxel in the tested cell lines. In this way, a very high concentration of chemotherapeutics in the targeted tissue was achieved, which represents localized chemotherapy.
Abstract The aim of this study is the assessment of sexual behavior and habits of medical and non-medical students in Belgrade. The research is designed as cross-sectional study conducted in the period from November until January 2016/2017. An anonymous and standardized questionnaire from the “National Health Survey” research protocol was used and variables of interest were added. A total of 1268 randomly selected students participated, from higher education institutions in Belgrade (College for Health Studies “Milutin Milankovic, Medical College of applied sciences in Zemun, Belgrade, Business Academy and Faculty of Security Studies in Belgrade). Results: Respondents from both groups almost had sexual relations with the opposite sex, although 2.2% of students of medical profession and 1.7% of nonmedical profession had sexual relations with the same sex. Condoms are most often contraceptive measures used in both groups, (>40%). The most common reason for not using condom in both groups were partner's trust or reducing pleasure during intercourse (p<0.005 and p<0.851 respectively). Students of non-medical professions comparing to students of medical professions, on the second year of study (7.3% vs 5.5%), and on the third year of study (14.1% vs 2.4%) stated that the reason for not using a condom is the high cost. Conclusions: According to the obtained results, students of medical professions were prone to risky sexual behaviour, despite greater knowledge about reproductive health and risky sexual behaviors. There is a significant need for an evaluation of educational programs about sexual and reproductive health of students from all orientations.
Abstract Since that use of bioactive mineral components of dental composites have been accompanied with various toxicities, including neurotoxicity, the aim of the study was to examine the effect of chronic application of hydroxyapatite, tricalcium phosphate and amorphous calcium phosphate in nanoparticles (nHA, nTCP, nACP) to parameters of sensitivity to thermal pain stimuli. Although the systemic toxicity of those compounds is frequently attributed to an oxidative damage, we also decided to examine the potential effects of Filipendula ulmaria extract on nociception alterations induced by the nano-sized mineral components of dental composites. Forty-two Wistar albino rats were divided into control and six experimental (equal) groups that orally received either nHA, nTCP, nACP alone, or simultaneously with FU extract for 30 days. Nociceptive alterations were quantified in the hot plate and tail flick test. The chronic administration of nHA and nACP resulted in significant increase in reactivity to thermal stimulus, with no significant change observed in nTCP group when compared to the control in the hot plate test, while simultaneous application of FU extract prevented any significant alteration of time to respond. The reaction time in the tail flick test for all three groups that received only nano calcium phosphates was reduced, with no changes in the groups treated with FU extract. The results of this study confirmed that calcium phosphates of mineral components of dental composites produced hyperalgesic effects, and this side effect were significantly attenuated by antioxidant supplementation.
Abstract Neonatal pneumopericardium, a collection of air in the pericardial sac, is less common form of air leak syndrome, but unfortunately with high mortality rate. We report a rare case of male fullterm newborn who soon after birth presented with respiratory distress. Chest radiograph showed spontaneous bilateral pneumothorax after which a chest drain was placed between anterior and midaxillary line in the 5th right intercostal space. The infant soon presented with tachypnea, dyspnea, muffled heart sounds, acidosis indicating cardiorespiratory worsening. On chest radiograph ‘’Halo” sign appeared indicating pneumopericardium. We believe that spontaneous reposition of a chest drain damaged the pericardial sac which combined with ventilation mechanism (‘’Macklin effect”) most likely led to pneumopericardium. After partial chest drain extraction the infant showed signs of improvement, but had to be closely monitored due to risk of tension pneumopericardium. Careful thoracal drain placement and fixation is crucial to prevent iatrogenic pneumopericardium, which can lead to deadly tension pneumopericardium.
Abstract This review aimed to revisit the old and introduce some of the new various cardioprotective effects of physical exercise, focusing on ischemia-reperfusion injury. A wealth of data shows that regular physical exercise is necessary to prevent cardiovascular diseases. In the last few years, a number of new training regimes, usually modified variations of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) protocols, have been rising in popularity among people of all ages. Since exercising is not limited to only healthy people, our study emphasized the benefits of HIIT and MICT in preventing or mitigating cardiac ischemia-reperfusion injury. Different kinds of research are being performed, studying the various positive and side effects of these training regimes, all in hopes of finding the most optimal ones. So far, all of them have shown that exercising to any extent, even for a short period of time, is beneficial in one way or another, and outweighs the possible risks it might have. We also revisited some of the known molecular mechanisms responsible for many of the effects of physical exercise and introduced some new findings related to them. Lastly, we summarized and compared the benefits of different HIIT and MICT protocols to narrow down the search for the most efficient training method.
Abstract The aim of the present study was to examine the antitumor and toxicity effects of ruthenium(II) complexes, [Ru(Cltpy)(en)Cl][Cl] (Ru-1) and [Ru(Cl-tpy)(dach)Cl][Cl] (Ru-2) on heterotopic murine colon carcinoma model. For tumor induction, 1×106 CT26 cells suspended in 100 μl of DMEM were injected subcutaneously into flank of male BALB/c mice. Treatment groups were as follows: Ru-1, Ru-2, oxaliplatin and control (saline). The intraperitoneal administration of the tested complexes began on 6th day after CT26 cells inoculation. Each complex was administered at dose of 5 mg/kg, twice weekly, four doses in total. To assess toxicity, serum values of urea, creatinine, AST and ALT were determined and histopathological analysis of organs and tumor were performed. In order to assess the effects of Ru(II) complexes on markers of oxidative stress and antioxidant defense system, we determined the TBARS, GSH, SOD and CAT in the homogenate of tumor, heart, liver, lungs and kidney tissues. The findings indicate that Ru-1 and Ru-2 exerts equal or better antitumor activity in comparison with oxaliplatin, but with pronounced toxic effects such as reduced survival rate, cardiotoxicity, nephrotoxicity and hepatotoxicity. The increased index of lipid peroxidation in the tissues of the kidneys and heart, but decreased in tumor tissue, after Ru(II) complexes administration, indicates the importance of the induction of oxidative stress as a possible mechanism of nephrotoxicity and cardiotoxicity, but not the mechanism by which they realize antitumor activity. Additional studies are needed to elucidate the mechanism of antitumor activity and toxicity of the Ru(II) complexes.
The aim of this study was to investigate in vitro antioxidant and antimicrobial potential of methanol and chloroform extracts of Sanguisorba minor L. subsp. muricata Briq. herba (S. minor). Total phenolic and flavonoid content of the investigated extracts were characterized. Antioxidant activity was estimated by five different in vitro assays. Antioxidant potency composite index was calculated also. Antimicrobial activity was tested against nine bacterial and one fungus strains by the micro-well dilution assay. The methanol extract of S. minor contains more phenols and shows the stronger antioxidant and antibacterial activity in comparison to the chloroform extract. However, the chloroform extract was superior to the methanol extract in content of flavonoids. Gram-positive bacteria were more sensitive than Gram-negative, to both extracts, Staphylococcus aureus being the most sensitive. Sanguisorba minor extracts were not considerably active against Candida albicans. The previous research data about Sanguisorba minor are scarce, so this data represent the first report on antimicrobial activity of S. minor. These results indicate that extracts of S. minor subsp. muricata have evidence-based potential for more comprehensive studies.
Angiotensin 2 impairs vascular function by activation of reactive oxygen species (ROS) production and development of endothelial dysfunction. Metformin, the first-line therapeutic agent for type 2 diabetes mellitus, has vascular protective properties, beyond its glucose lowering effects. The aim of the present study was to investigate the interaction between metformin and angiotensin 2 in human internal mammary arteries harvested from patients with coronary heart disease undergoing revascularization procedure, by evaluation of vascular function, reactive oxygen species (ROS) production and the gene expression of nitric oxide (NO) synthases (endothelial – eNOS, neuronal – nNOS and inducible – iNOS). To this aim, vascular samples were incubated with angiotensin 2 (Ang2, 12 h) with/without metformin (Metf, 10 μM) and used for ROS measurement (FOX assay), vascular reactivity in organ bath (contractility to phenylephrine, relaxation to acetylcholine, contractility to NG-nitro-L-arginine methyl ester/L-NAME) and RTPCT studies. Acute incubation of the vascular rings with Ang2 impaired vascular reactivity (increase contractility, decrease relaxation), increased ROS production, supressed eNOS/nNOS and increased iNOS mRNA expression. Ex vivo incubation with metformin at a clinically relevant concentration reversed all these effects. These data suggest that Metformin might be useful in alleviating endothelial dysfunction by improving the endothelial-dependent relaxation and mitigating oxidative stress in clinical setting associated with cardiovascular disease regardless the presence of impaired glucose metabolism.
Abstract Background. Symptoms of depression are often present in patients with chronic obstructive pulmonary disease (COPD) and treatment of depression may substantially improve the quality of life of such patients. The aim of our study was to investigate factors that influence the efficacy of antidepressant therapy in terms of the quality of life in patients with COPD and a depressive disorder. Materials and Methods. The study was designed as a prospective cross-sectional study and conducted between October 2016 and December 2019 in the Primary Health Center, Kragujevac, Serbia. The study sample included 87 patients. Associations between putative risk factors and change in the quality-of-life score were tested by a multivariate linear regression model and interpreted by the regression coefficients. Results. Our study showed a clear positive effect of therapy with SSRIs on the severity of depression symptoms and the quality of life of patients with co-occurrence of COPD and depression. However, multiple linear regression shows that the effect of SSRIs was more prominent in patients with a higher degree of COPD severity since patients with lower FEV1 values had a more extensive increase in the Q-LES-Q-SF score (B=-0,034; p=0,020). Conclusion. Treatment of depression that accompanies COPD is an important segment of managing such patients, which significantly improves HRQoL. Patients with more severe COPD would especially benefit from such treatment since their response to SSRIs is more pronounced.
Preeclampsia (PE) is a major complication of pregnancy with both mother and fetal adverse outcomes. Pregnancy is a state of increased oxidative stress that has been reported to be exacerbated when complicated with preeclampsia. However, conflicting data are available in literature regarding the systemic oxidative stress in PE pregnancies. The present pilot study was purported to assess systemic oxidative stress in preeclamptic vs healthy pregnancies. To this aim plasma derived compounds of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) were determined in mild and severe preeclamptic pregnancies using the Diacron equipment. Both healthy and preeclamptic pregnancies showed high levels of systemic oxidative stress. Paradoxically, significantly higher values of d-ROMs were found in healthy pregnancies as compared to the PE ones. At variance, in preeclamptic pregnancies, a major increase in the plasma antioxidant capacity occurred. In this pilot study, we report an increase in the systemic antioxidant capacity in preeclamptic pregnancies.
Abstract In the area of non-platinum complexes, various complexes containing gold, copper, ruthenium, and palladium have shown a strong cytotoxic effect on different cancer cell lines. The aim of our study was to examine the cytotoxicity of the Pd(II) complexes (C1-C5) and the corresponding ligands (L1-L5) on the DU-145 prostate cancer cell line. Also, due to its clinical application, the cytotoxicity of cisplatin has been examined. Our findings showed that C1- C5 complexes and cisplatin show dose-dependent and strong cytotoxic effects against the DU-145 cell line in vitro. Furthermore, the results demonstrated that early apoptosis was induced by all five Pd(II) complexes. Also, the results showed that complexes C1, C3, and C5 induced G0/G1 phase arrest on DU- 145 cells. Pd(II) complex C2 induced S phase arrest, while C4 complex induced G2/M phase arrest on cancer cells. Additionally, all tested complexes significantly reduced the amount of antiapoptotic protein Bcl-2. Also, there was a significant increase in the concentration of proapoptotic Bax protein in DU-145 cells treated C1-C5 complexes. The results of our research demonstrated that Pd(II) complexes induced apoptosis via the mitochondrial pathway. Thus, it is crucial to further investigate the cytotoxicity of these Pd(II) complexes in vivo. Complex C2 might be a good candidate for a new generation of anticancer drugs.
Abstract Тhis study aimed at exploring vitamin D levels in treated depressive patients in comparison to healthy individuals. The cross-sectional study included 20 ambulatory and inpatients with depressive episodes taking antidepressants and 30 healthy individuals. The serum concentration of 25(OH)D from collected blood samples was determined using biochemical analyzers. Serum 25(OH)D levels (ng/mL) in patients were significantly lower (the mean 13.1, standard deviation 7.3, median 11.4, minimal 3.8, maximal 35.9) then in control subjects (19.4, 9.1, 15.8, 7.6, 43.6) (p=0.004). Additional targeted research is needed because some lifestyle and dietary habits which are known to influence vitamin D status may confound observed effects.
Abstract Multiple susceptibility genes can be involved in the development of Hashimoto’s thyroiditis. Some of these genes are implicated in other autoimmune diseases, while others are specific to thyroid autoimmune response. 153 patients with thyroid pathology were enrolled in the study (152 women and 1 man, the average age was 46,02±14,3). They were divided into 3 groups: 16 patients with postoperative hypothyroidism; 65 patients with hypothyroidism resulting from autoimmune thyroiditis, and 72 patients with both AIT and elevated serum an anti-thyroglobulin and anti-thyroid peroxidase antibodies. We used a pathway-specific real-time Polymerase chain reaction array to identify and verify cytokines and receptor pathway-associated gene expression in peripheral white blood cells in randomly selected 12 individuals from each group. In the patients with postoperative hypothyroidism and those with hypothyroidism resulting from autoimmune thyroiditis, the expression of Chemokine (C-X3-C motif) receptor 1, Chemokine (C-X-C motif) receptor 4, Interleukin 6, and Interleukin 6 receptor significantly decreased, while the expression of IL6ST and IL10RA increased. In contrast, mRNA levels of Chemokine (C-X3-C motif) receptor 1, Chemokine (C-X-C motif) receptor 4, Interleukin 6, and Interleukin 6 receptor increased in the autoimmune thyroiditis patients with elevated serum anti-thyroglobulin and anti-thyroid peroxidase antibodies, while the expression of Interleukin 6 signal transducer and Interleukin 10 receptor, alpha decreased in this group of patients. The patients with hypothyroidism resulting from autoimmune thyroiditis and patients with elevated serum anti-thyroglobulin and anti-thyroid peroxidase antibodies had significantly lowered expression of Interleukin 10, while the expression of Interleukin 1, beta and Interleukin 1 receptor, type I was elevated. autoimmune thyroiditis and hypothyroidism affect the mRNA-level expression of cytokines and cytokine receptor genes in a gene-specific manner, and these changes to gene expression can be among the triggers of autoimmune inflammation progression in the thyroid gland. Transcriptional activity of cytokines, inducer, and receptor genes in the peripheral white blood cells can be used as an important minimally invasive prognostic marker of the autoimmune thyroid disease severity.
Abstract The number of hospitalized COVID patients varies in accordance with the waves of the pandemic. The aim of the study was to examine the characteristics of hospitalized COVID-19 patients and predictors of in-hospital died with special reference to the importance of comorbidity. A retrospective cohort study that included all COVID patients hospitalized at the Clinical Center Kragujevac in 2020. The data contained in the Hospitalization Report are described, and the predictors of hospital mortality are defined by binary logistic regression. 1336 COVID patients were hospitalized. The average age of the hospitalized patients was 58.1 ± 16.5 years, 2/3 of them were males. The largest number of hospitalized patients live in Kragujevac - 62.8%. During hospitalization, 19.4% (n = 206) of patients died, who were on average 13 years older (t = 14.13, df = 504.3, p <0.01), and stayed in the hospital 2 days shorter (Z = -5.36, p <0.01) when compared to discharged patients. 86.5% (n = 1155) of hospitalized patients had comorbidities, most often hypertension and other heart diseases, diabetes mellitus and renal failure. Statistically significant predictors of the lethal outcome of hospitalization were patients’ age (OR = 0.94 95% CI = 0.93-0.95), residence (OR = 0.84, 95% CI = 0.75-0.95), length of hospitalization (OR = 1.06, 95% CI = 1.04-1.09) and the presence of comorbidity as the strongest predictor (OR = 5.31, 95% CI = 2.37-11.89). COVID Patients with comorbidities require special attention because comorbidities affect the outcome of hospitalization.
Abstract Aim: The main aim is to show that the life of a patient depends on the decisions the doctor makes as well as the proper assessment of the case. The decision to avoid a surgical procedure and continuewith the conservative treatment following the vital parameters, was beneficial for the patient who was later discharged recovered. Case report:The case is about a patient who was in labor for the fifth time with the delivery complicated by severe postpartum hemorrhage in the secondary health care institution. Despite all conservative measures taken, the hemorrhage hasn’t stopped, therefore, the subtotal hysterectomy was performed, after which the patient was directed to the Clinical Centre Kragujevac. Regarding the fact that the postpartum hemorrhage hasn’t stopped and abdominal hematoma as well as intracranial hemorrhagewere diagnosed, the main dilemma was if the surgical procedure should be redone or if the conservative treatment should be continued. By applying the conservative treatment andcontinued consultations of the multidisciplinary team, the patient was discharged from the Clinical Centre Kragujevac. Conclusion: The main issue with severe cases like this one, is to define and direct the treatment towards the lower risk rate – repeated surgery could be fatal with the current state of the patient. The estimation was correct, at the end, the patient was released after thelengthy treatment, recovered.
Abstract The term bone quality is not clearly defined and depends on many factors, such as bone density, bone vascularity, bone metabolism and other factors that may affect implant outcome. The assessment of bone volume and bone density is most common in planning the treatment of dental implants. Bone quality is an important predictor of primary implant stability, which influences the future implant osseointegration. Numerous classifications have been described for the evaluation of bone density. The most commonly used has been the one proposed by Lekholmu and Zarb. For the objective evaluation of bone density, conventional computed tomography (CT) or Cone Beam Computed tomography (CBCT), have been proposed. Both methods are reliable for the measurement of bone density, but preference is given to CBCT, due to the lower radiation doses, greater comfort for the patient and the lower prices. Pre-operatively defined bone density is a good indicator of the future success of implant therapy. In addition to the bone density, vascularity of the jawbone is an important factor of the quality of the bone for the osseointegration of dental implants. Laser Doppler is a simple method that can determine the vascularity of bone during implant insertion. The development of modern diagnostic methods for assessing the quantity and quality of the jawbone has enabled easier implant planning and has provided a secure outcome.
