The aim of the study was to assess the influence of fixed orthodontic appliance on Streptococcus (S.) mutans and S. sobrinus counts in orthodontic patients with regard to their previous caries experience (Decayed, Missing and Filled Teeth (DMFT) index) during the first 12 weeks of orthodontic treatment. Twenty-two patients that satisfied inclusion criteria (healthy systemic and periodontal condition, avoidance of antibiotic therapy and antiseptic mouthwashes in the past three months) were included. All clinical measurements took place prior to and 12 weeks after fixed orthodontic appliance placement, in the following order: 1) stimulated saliva flow (SS); 2) Simplified Oral Hygiene Index (OHI-S); and 3) DMFT. The method of polymerase chain reaction (PCR) was used to detect the presence of S. mutans and S. sobrinus at T1 and T2. T-test showed significant increase in DMFT index and SS between T1 and T2. Results also indicated significant improvement in OHI-S index. By use of the PCR method, S. mutans was detected in two patients at T1. At T2, two more patients had S. mutans, but the increase was not statistically significant. Using the same method, S. sobrinus was detected only in two patients at T2. In conclusion, fixed orthodontic appliances did not induce statistically significant changes in caries microflora even in the presence of enhanced oral hygiene habits.

Previous studies reported that embryonic stem cells (ESCs) can be induced to differentiate into cells showing a mature osteoblastic phenotype by culturing them under osteo-inductive conditions. It is probable that osteogenic differentiation requires that ESCs undergo differentiation through an intermediary step involving a mesenchymal lineage precursor. Based on our previous studies indicating that adult mesenchymal progenitor cells express α-smooth muscle actin (αSMA), we have generated ESCs from transgenic mice in which an αSMA promoter directs the expression of red fluorescent protein (RFP) to mesenchymal progenitor cells. To track the transition of ESC-derived MSCs into mature osteoblasts, we have utilized a bone-specific fragment of rat type I collagen promoter driving green fluorescent protein (Col2.3GFP). Following osteogenic induction in ESCs, we have observed expression of alkaline phosphatase (ALP) and subsequent mineralization as detected by von Kossa staining. After 1 week of osteogenic induction, ESCs begin to express αSMARFP. This expression was localized to the peripheral area encircling a typical ESC colony. Nevertheless, these αSMARFP positive cells did not show activation of the Col2.3GFP promoter, even after 7 weeks of osteogenic differentiation in vitro. In contrast, Col2.3GFP expression was detected in vivo, in mineralized areas following teratoma formation. Our results indicate that detection of ALP activity and mineralization of ESCs cultured under osteogenic conditions is not sufficient to demonstrate osteogenic maturation. Our study indicates the utility of the promoter-visual transgene approach to assess the commitment and differentiation of ESCs into the osteoblast lineage.

Iatrogene perforacije krune zuba jedne su od nepoželjnih komplikacija koje se mogu pojaviti za vrijeme izrade trepanacijskog otvora kao i tijekom eksploracije endodontskog prostora visekorijenskih zuba. Svrha ovoga rada je prikazati postupak nekirurskog zbrinjavanja i zatvaranja dviju perofacija krune zuba koristenjem pripravka MTA. U prvom slucaju, pacijent dolazi zbog blagog oticanja i bolova u podrucju zuba 37. Klinicki, zub je neosjetljiv na test perkusije i palpacije, s vidljivom perforacijom u distalnom dijelu krune zuba. Radioloski je vidljiva blaga radiolucentna lezija u istoj regiji. U drugom slucaju, pacijentica dolazi zbog pojave bukalnog oticanja, fistule, boli na palpaciju i gubitka epitelnog pricvrstka te parodontnog džepa u podrucju zuba 46. Radioloski je vidljiv endodontski neadekvatno opskrbljen zub kao i velika radiolucencija u podrucju furkacije. U oba slucaja, kao terapiju izbora, koristili smo nekirursko zatvaranje perforacije MTA (Angelus, Londrina, Brazil). Korijenski kanali su endodontski sanirani, a krune zuba opskrbljene su ispunima u kombinaciji staklenoionomernog cementa i kompozita. Nakon sest mjeseci, u slucaju 2, radioloski je vidljivo cijeljenje, sa smanjenjem radiolucencije u regiji furkacije. Klinicki zub pokazuje zadovoljavajucu funkciju kao i izostanak simptoma. Izostanak periapikalne radiolucencije, boli i oticanja zajedno s funkcionalnom stabilnosti ukazuje na uspjesnost zatvaranja i sanacije perforacije u oba slucaja. MTA se time pokazuje kao uspjesan materijal za zatvaranje takvog tipa iatrogenih perforacija krune, poboljsavajuci time prognozu zubi koje bi u suprotnome bili ugroženi.

OBJECTIVETo determine the difference in the levels of Streptococcus mutans and S sobrinus in stimulated saliva in orthodontic patients with different bracket types (stainless steel and esthetic brackets) using polymerase chain reaction and cultivation method.MATERIALS AND METHODSThirty-two patients, aged 13 to 30 years, were selected following these criteria: 1) orthodontic treatment indication, 2) systemic health, and 3) no tobacco and antibiotic consummation for three months prior to the commencement of the study. Patients were divided into two groups according to the bracket type; 16 patients formed the conventional bracket group (stainless steel brackets), and 16 patients formed the esthetic bracket group (plastic brackets). The levels of S mutans and S sobrinus in stimulated whole saliva samples were collected prior to fixed orthodontic appliance placement (T1) and 12 weeks after placement (T2), as were the Decayed, Missing, and Filled Surface Index (DMFS) and Oral Hygiene Index-Simplified (OHI-S). Mann-Whitney, Wilcoxon, and chi-square tests were used for statistical analysis.RESULTSStatistical analysis (chi-square test) showed no difference in S mutans and S sobrinus counts among patients with different brackets at either T1 or T2. There was no difference in total bacteria counts after fixed orthodontic appliance placement.CONCLUSIONThe number of colony-forming units of S mutans and S sobrinus in stimulated saliva samples does not seem to be significantly different between patients with stainless steel brackets and patients with plastic brackets.

Adult mesenchymal progenitor cells have enormous potential for use in regenerative medicine. However, the true identity of the progenitors in vivo and their progeny has not been precisely defined. We hypothesize that cells expressing a smooth muscle α-actin promoter (αSMA)-directed Cre transgene represent mesenchymal progenitors of adult bone tissue. By combining complementary colors in combination with transgenes activating at mature stages of the lineage, we characterized the phenotype and confirmed the ability of isolated αSMA(+) cells to progress from a progenitor to fully mature state. In vivo lineage tracing experiments using a new bone formation model confirmed the osteogenic phenotype of αSMA(+) cells. In vitro analysis of the in vivo-labeled SMA9(+) cells supported their differentiation potential into mesenchymal lineages. Using a fracture-healing model, αSMA9(+) cells served as a pool of fibrocartilage and skeletal progenitors. Confirmation of the transition of αSMA9(+) progenitor cells to mature osteoblasts during fracture healing was assessed by activation of bone-specific Col2.3emd transgene. Our findings provide a novel in vivo identification of defined population of mesenchymal progenitor cells with active role in bone remodeling and regeneration.

OBJECTIVETo determine the effect of different bracket designs (conventional brackets and self-ligating brackets) on periodontal clinical parameters and periodontal pathogens in subgingival plaque.MATERIAL AND METHODSThe following inclusion criteria were used: requirement of orthodontic treatment plan starting with alignment and leveling, good general health, healthy periodontium, no antibiotic therapy in the previous 6 months before the beginning of the study, and no smoking. The study sample totaled 38 patients (13 male, 25 female; mean age, 14.6 ± 2.0 years). Patients were divided into two groups with random distribution of brackets. Recording of clinical parameters was done before the placement of the orthodontic appliance (T0) and at 6 weeks (T1), 12 weeks (T2), and 18 weeks (T3) after full bonding of orthodontic appliances. Periodontal pathogens of subgingival microflora were detected at T3 using a commercially available polymerase chain reaction test (micro-Dent test) that contains probes for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola.RESULTSThere was a statistically significant higher prevalence of A actinomycetemcomitans in patients with conventional brackets than in patients with self-ligating brackets, but there was no statistically significant difference for other putative periodontal pathogens. The two different types of brackets did not show statistically significant differences in periodontal clinical parameters.CONCLUSIONBracket design does not seem to have a strong influence on periodontal clinical parameters and periodontal pathogens in subgingival plaque. The correlation between some periodontal pathogens and clinical periodontal parameters was weak.

U prikazanom slucaju radi se o trinaestogodisnjoj pacijentici kod koje nedostaje gornji desni centralni inciziv kao posljedica traume i avulzije istog( slika1). Zbog ranog gubitka centralnog inciziva doslo je do pomaka sredine gornjeg zubnog niza spram sredine lica u desno za 2, 5 mm( slika2). Iz anamneze je vidljivo da je pacijentica od 10-te godine nosila gornju plocu sa umjetnim zubom 11.Ortodontskim pregledom utvrđena je klasa II po Anglu na L3, D3, L6 i D6. Oralna higijena je bila zadovoljavajuca i pacijentica je bila spremna na suradnju te smo se u dogovoru sa roditeljima odlucili na kombiniranu ortodontsko- konzervativnu terapiju. Gornji fiksni aparat je postavljen na nacin da je na zub 12 zalijepljena bravica 11, na 13 bravica 12 i na 14 bravica 13 kako bi u konacnici tip i torque odgovarali zubima koje nadomjestaju. Ovome je prethodilo pomicanje gornjeg desnog ocnjaka prema mezijalno. Prvi cilj je bio dobiti podudaranje sredine gornjeg zubnog luka i sredine lica na nacin da smo cijeli gornji lijevi kvadrant povukli u lijevo. Time je dobiven prostor za preoblikovanje kruna zuba( slike 3, 4, 5). Bravice su potom skinute i zubi preoblikovani i to 13 u 23 te 12 u 11( slike 6, 7, 8). Za taj zahvat smo odlucili koristiti nanohibridni kompozitni materijal Tetric EvoCeram (Ivoclar Vivadent) i adhezivnu tehniku rada jer se upotrebom kompozitnih materijala mogu postici visoko estetski i funkcionalno zadovoljavajuci rezultati uz minimalno ostecenje tvrdog zubnog tkiva. Nakon usklađivanja okluzije napravljeno je zavrsno finiranje i poliranje kompozitnih nadogradnji. Ortodontske bravice su nanovo postavljene na vec opisan nacin. Ocekujemo da ce u dogledno vrijeme doci do zatvaranja dijasteme između 11 i 21 pomakom desnog kvadranta u lijevo i da ce se uspostaviti klasa I po Anglu.

To comply with the requirements of satisfying patients is already for a long time a key task for all dental healthcare providers. On the other hand endodontic therapy itself is often understood as an unpleasant experience. The aim of this study was to evaluate the level of patient satisfaction with endodontic treatment. Sample consisted of 214 endodontic patients treated in five general dental practices in Zagreb and Department of Endodontics and Restorative Dentistry at School of Dental Medicine, University of Zagreb, during two months. Survey was conducted through specially designed questionnaire with five groups of questions which encompassed general data, the experience with former endodontic treatment, the attitude toward following endodontics, and the source of payment. Fifth group of questions, related to the experience with just finished treatment, was answered on the end of treatment. Level of satisfaction was expressed in grades from 1 to 5 (1- not satisfied, 5- very satisfied). Data were analyzed with Student-t test and Spearman's rho correlation. Half of male examinees (50.0%) were satisfied, while 51.2% of females were very satisfied with just performed endodontic treatment. The level of satisfaction positively correlated with lover pain experience and the greater level of satisfaction with prior endodontic therapy, positive patient attitude toward success of actual treatment and willingness to recommend that treatment to others (Spearman's rho, p<0.05). Negative correlation was associated with the negative experience with prior treatment, the loss of the priory treated tooth, and the fear and the level of stress before the actual treatment (Spearman's rho, p<0.05). Considering that half of male endodontic patients were satisfied and half of female patients were very satisfied, we can conclude that endodontic part of dental service is acceptable for patients.

Recent studies reported the successful differentiation of mouse or human ES cells into osteoblasts. To achieve osteogenic differentiation, some procedures utilize generation of embryoid bodies, while others use a direct differentiation protocol. It has been reported that ES cells can be induced to express a mature osteoblastic phenotype by culture in the presence of various osteo-inductive molecules (Vit D3, dexamethasone, ascorbic acid, s-glycerol phosphate and/or BMP2). It is conceivable that osteogenic differentiation requires that ES cells undergo differentiation through an intermediary step involving a mesenchymal lineage precursor. These cells are known as ESC-derived, mesenchymal stem cells (ES-MSCs) and they can be identified by functional and morphological criteria. To identify ES-MSC we have generated ES cells from previously developed transgenic mice in which an α-SMA promoter directs the expression of red fluorescent protein (RFP) to adult mesenchymal progenitor cells. To track the transition of ES-MSC into mature osteoblast lineage cells we have utilized a Col2.3 promoter driving green fluorescent protein (GFP). Osteogenic differentiation in the ES cells derived from dual transgenic mice was evaluated. Following osteogenic induction we have observed expression of alkaline phosphatase and subsequent mineralization as detected by von Kossa staining. However, gene expression analysis of the time course during the differentiation period showed an absence of markers of the mature osteoblast lineage (osteocalcin, bone sialoprotein). After one week of osteogenic induction, ES cells begin to express αSMA-RFP. This expression was localized to the peripheral area encircling a typical ES cell colony. Nevertheless, these α-SMA-RFP positive cells did not show activation of the Col2.3-GFP promoter even after 4 weeks of osteogenic differentiation. Our results indicate that expression of alkaline phosphatase and mineralization occuring during induction of ES cells are not sufficient critera to detect osteogenic maturation using ES cells. The procedures utilizing protocols for differentiation without the step of embryoid bodies formation require further studies. In addition, we are currently examining the activation of Col2.3GFP using an in vivo assay of teratoma formation. This would provide us with assurance that we can identify two steps during osteogenic differentiation of murine ES cells.