Prof. dr hab. Stefan Krus (Redaktor Honorowy – Honorary Editor)

Transkrypt

Zespół redakcyjny (Editorial Staff)
Prof. dr hab. Stefan Kruś (Redaktor Honorowy – Honorary Editor)
Prof. dr. hab. Piotr Fiedor (Redaktor Naczelny – Editor-in-Chief)
Mgr Mirosława Müldner-Kurpeta (Z-ca Red. Nacz. – Associate Editor)
Mgr Magdalena Zielonka (Z-ca Red. Nacz., korekta – Associate Editor, Proof-Reading)
Mgr Ewa Barciszewska (Asystent Red. Nacz. – Assistant Editor)
Współpraca ze środowiskiem (Public Relations)
Mgr Mariusz Foryś
Rada Programowa i Naukowa – Scientific Council
Profesor Janusz Piekarczyk – Rector of Medical University of Warsaw
Profesor Leszek Pa˛czek – Deputy Rector for Educational Affairs
Profesor Wiesław Gliński – Deputy Rector for Science and International Relations
Profesor Józef Sawicki – Deputy Rector for Human Resources
Profesor Grzegorz Opolski – Deputy Rector for Clinical Affairs, Development and Regional Cooperation
Profesor Marek Krawczyk – Dean of the First Medical Faculty
Profesor Hubert Wanyura – Deputy Dean for the Division of Dentistry
Profesor Jerzy Stelmachów – Dean of the Second Medical Faculty
Profesor Jerzy A. Polański – Deputy Dean for the English Division
Profesor Jan Pachecka – Dean of the Faculty of Pharmacy
Profesor Piotr Małkowski – Dean of the Faculty of Health Sciences
Profesor Wojciech Noszczyk – Dean of the Faculty of Postgraduate Studies
Wydawca:
Senacka Komisja ds. Informacji Naukowej i Wydawnictw Akademii Medycznej w Warszawie
Adres internetowy: www.amwaw.edu.pl
Adres Redakcji, Działu Promocji i Reklamy:
Sekretariat: mgr Ewa Ke˛pska, ul. Żwirki i Wigury 61, 02-091 Warszawa, tel. 5720-109
e-mail: [email protected] i [email protected]
Dokumentacja fotograficzna:
Dział Fotomedyczny AM
Prawa autorskie zastrzeżone
Skład tekstu, druk i oprawa
Medical Science International Sp. z o.o., ul. Ustrzycka 11, 02-141 Warszawa, tel./fax 868 12 65
Zakład Wydawniczo-Poligraficzny, 02-830 Warszawa, ul. Gawota 13 A
Med. Dydak. Wychow., Vol. XXXVI supl. 2/2004
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Instytut Stomatologii AM w Warszawie
Suplement „MEDYCYNA. DYDAKTYKA. WYCHOWANIE.”
Pod redakcja˛: dr n. med. Elżbiety Dybiżbańskiej i dr n. med. Ewy Iwanickiej - Grzegorek
30-lecie polsko - szedzkiej współpracy zakładów
Instytutu Stomatologii Akademii Medycznej
w Warszawie
Spis treści:
M. Wierzbicka
Współpraca Zakładu Stomatologii Zachowawczej AM w Warszawie z Uniwersytetem
w Lund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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E. Pierzynowska
Mie˛dzynarodowa współpraca naukowa Zakładu Stomatologii Zachowawczej w ostatnim
25-leciu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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E. Pierzynowska
Udział Zakładu Stomatologii Zachowawczej w pracach nad poprawa˛ stanu zdrowia jamy
ustnej populacji polskiej w latach 1993 - 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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E. Mierzwińska – Nastalska
Współpraca naukowa pomie˛dzy Katedra˛ Protetyki Stomatologicznej Akademii Medycznej
w Warszawie a Wydziałem Stomatologii Uniwersytetu w Lund z siedziba˛ w Malmö . . . . . . . . 11
A.Remiszewski
Współpraca naukowa i naukowo-dydaktyczna Zakładu Stomatologii Dziecie˛cej IS AM
w Warszawie z ośrodkami naukowymi w Szwecji . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
K. Thun – Szretter, A. Dowżenko
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM i Oddziału
Stomatologicznego I Wydziału Lekarskiego AM w Warszawie w latach 1970 – 2004. . . . . . . . 14
Sesja plakatowa: „Poste˛py w diagnostyce, zapobieganiu i leczeniu zaburzeń zespołu
twarzowo-czaszkowego”. Streszczenia
(Poster session: „Developments in the diagnosis, prevention and treatment of disorders
of the craniofacial complex”. Abstracts) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Indeks streszczeń (Index of abstracts) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Indeks autorów (Index of authors) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
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ZAKŁAD STOMATOLOGII ZACHOWAWCZEJ
Współpraca Zakładu Stomatologii Zachowawczej
AM w Warszawie z Uniwersytetem w Lund
Prof. dr hab. Maria Wierzbicka*
W maju 2004 roku celebrowaliśmy 30-lecie współpracy naszej
uczelni z Wydziałem Stomatologii Uniwersytetu w Lund, maja˛cym
swoja˛ siedzibe˛ w Malmö. Nasz partner – Wydział Stomatologii –
przed niespełna 10 laty stana˛ł wobec trudnej do przyje˛cia, choć
ne˛ca˛cej z finansowego punktu widzenia, propozycji wejścia w
skład nowo tworzonego Uniwersytetu w Malmö. Zasobna finansowo prowincja Scane upatrywała w utworzeniu własnego uniwersytetu szanse˛ dalszego znacza˛cego rozwoju. Dla starszej cze˛ści kadry
Wydziału Stomatologii odejście z Uniwersytetu w Lund, piele˛gnuja˛cego tradycje akademickie i ciesza˛cego sie˛ uznana˛ pozycja˛ w
świecie nauki, było przykra˛ koniecznościa˛. Dziś, wobec imponuja˛cej rozbudowy zarówno bazy dydaktycznej jak i naukowej znacznie już łatwiej identyfikować sie˛ z nowa˛ uczelnia˛.
Obchody „okra˛głej” rocznicy naszej współpracy miały należyta˛ oprawe˛. W zorganizowanej z tej okazji konferencji naukowej uczestniczył Ambasador Szwecji oraz Władze Uniwersytetu
w Malmö. W imieniu Jego Magnificencji gości witał i przyjmował Prorektor Pan prof.dr hab. Leszek Pa˛czek w towarzystwie
Pana prof. M. Krawczyka, Dziekana I Wydziału Lekarskiego
oraz władz i pracowników Instytutu Stomatologii, jak również
gości z całej Polski.
Trzy dekady to w życiu uczelni okres krótki, jak mgnienie oka.
W skali jednostki – każdego z uczestników programu współpracy –
to niemal epoka lub całe życie zawodowe. Rozpoczynaliśmy
współprace˛ w okresie pełnej kontroli politycznej nad działalnościa˛
uczelni, nasi partnerzy poznali uroki limitowanego doste˛pu do
żywności i używek, a także utrudnienia stanu wojennego, euforie˛
zwycie˛stwa solidarności oraz rozczarowania pocza˛tków okresu
transformacji. Kontynuacja współpracy, mimo tak odmiennych
uwarunkowań egzystencjalnych dowodzi niezbicie, że przynosiła
ona istotne korzyści obu stronom. Nam, pracownikom Zakładu
Stomatologii Zachowawczej, w określonym momencie historii
przyniosła bezcenna˛ wre˛cz szanse˛ doste˛pu do informacji naukowej
i kontaktów z mie˛dzynarodowym środowiskiem naukowym stomatologów. Kolejne, wspólnie realizowane projekty badawcze doskonaliły nas zawodowo i przygotowały do rozwia˛zywania problemów
zdrowotnych populacji regionu i kraju. Pierwszy udanie zrealizowany projekt i szereg naste˛powych publikacji krajowych i mie˛dzynarodowych poszerzało kra˛g osób zainteresowanych współpraca˛ z nami. Określone warunki w jakich pracowaliśmy wykluczały
możliwość realizacji wie˛cej niż jednego projektu w danym okresie
czasu. Okresowe zmiany bezpośrednich partnerów przydawały jednak atrakcyjności naszej współpracy. Wymiernym efektem naszej
współpracy z kolegami ze Szwecji jest ponad 40 prac publikowanych w je˛zyku polskim, kilka w szwedzkim i kilkanaście w angielskim ba˛dź niemieckim oraz kilkadziesia˛t streszczeń publikowanych w materiałach zjazdowych i czasopismach o zasie˛gu krajowym i mie˛dzynarodowym.
W uznaniu zasług dla naszej uczelni i kraju dwóch profesorów
Uniwersytetu w Lund otrzymało tytuł doktora honoris causa Akademii Medycznej w Warszawie, a mianowicie Bengt Owall i Douglas Bratthall.
Podtrzymaniu i rozwojowi naszej współpracy z kolegami z
Malmö służyły też organizowane w odste˛pach 5-letnich konferencje, w czasie których prezentowaliśmy przemiennie społeczności
jednej i drugiej uczelni wspólne dokonania ostatniego okresu.
Ostatnie pie˛ciolecie (1999-2004) naszej współpracy z kolegami z
Uniwersytetu w Malmö cechowało wzmożone zainteresowanie
wymiana˛ studentów i rozwojem kontaktów mie˛dzy młodymi nauczycielami akademickimi.
Dwie grupy studentów szwedzkich (4 i 9 osób) pod opieka˛
nauczyciela uczestniczyły w zaje˛ciach klinicznych w Warszawie i
wróciły do swego kraju pełne entuzjazmu dla idei wymiany studenckiej. Pie˛cioosobowa grupa naszych studentów pozostawiła w
Malmö niezwykle dobre wrażenie. Zachwycili poziomem intelektualnym, kultura˛ bycia, otwartościa˛ i chłonnościa˛ umysłów, poczuciem humoru, entuzjazmem. Zrobili tak wielkie wrażenie swoja˛
postawa˛ i cechami osobowymi, że chwalono ich przy każdej okazji.
Warto jednak wspomnieć, że grupa ta rekrutowała sie˛ spośród
studentów o najwyższej średniej z egzaminów. Dwóch z tych studentów uzyskało etat w naszej uczelni lub zostało przyje˛tych na
studia doktoranckie, a 3 dalsze osoby oczekuja˛ przyje˛cia na studia
doktoranckie. Miałam okazje˛ uczestniczyć w rozmowie kwalifikacyjnej tych osób i byłam, podobnie jak nasi Koledzy z Malmö,
zachwycona ich przygotowaniem do rozmowy i poziomem wypowiedzi.
Zgodnie z deklaracja˛ władz obu uczelni, prezentowana˛ w rozmowach kończa˛cych pobyt delegacji Uniwersytetu Malmö w Warszawie, wymiana studentów be˛dzie kontynuowana i obejmie pocza˛tkowo grupy około 8 osobowe (w wymiarze 1-2 tygodni). Równocześnie czynione be˛da˛ przygotowania do uruchomienia wymiany dwustronnej w ramach programu Erasmus.
Konferencje˛ zorganizowana˛ z okazji 30-lecia współpracy AM
w Warszawie z Uniwersytetem w Lund kończyła angloje˛zyczna
sesja plakatowa. Streszczenie prac prezentowanych w tej sesji
przedstawiono na dalszych stronach niniejszego suplementu.
*Prof.dr hab. Maria Wierzbicka, b. Kierownik Zakładu Stomatologii Zachowawczej, koordynator współpracy ze strony
polskiej, jest Doktorem Honoris Causa Uniwersytetu w Malmö.
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Zakład Stomatologii Zachowawczej
Mie˛dzynarodowa współpraca naukowa Zakładu
Stomatologii Zachowawczej w ostatnim 25-leciu
Lek. stom. Elżbieta Pierzynowska
Zakład Stomatologii Zachowawczej IS AM w Warszawie
Tegoroczne spotkanie polsko-szwedzkie stało sie˛ dobra˛
okazja˛ do przedstawienia różnych obszarów działalności Zakładu Stomatologii Zachowawczej i szerszego nieco potraktowania współpracy naukowej, która obejmowała różne
kraje i kierunki działań. W 1974 roku staraniem prof. E.
Spiechowicza, inicjatora i koordynatora, podpisane zostało
porozumienie o współpracy naukowej pomie˛dzy warszawska˛ Akademia˛ Medyczna˛, a Uniwersytetem w Lund (University of Lund, Malmö, Sweden). W latach 80. współpraca
pomie˛dzy uczelniami rozszerzyła sie˛ i prowadziły ja˛ niemal
wszystkie jednostki Instytutu Stomatologii. Zakład Stomatologii Zachowawczej nawia˛zał kontakty naukowe z Zakładem Kariologii i Zakładem Periodontologii, doste˛puja˛c
przywileju uczestnictwa w projektach badawczych wspólnie
ze znakomitymi naukowcami, takimi jak D. Bratthall, D.
Ericson i P. Carlsson (Department of Cariology) oraz G.
Bratthall i R. Attstrom (Department of Periodontology). Tematyka zagadnień be˛da˛cych przedmiotem ówczesnych badań dotyczyła wpływu programów profilaktycznych na próchnice˛ ze˛bów oraz liczbe˛ S. mutans (P. Carlsson, D. Bratthall, 1983-1986), klinicznych i radiologicznych kryteriów
kwalifikowania ubytku próchnicowego do opracowania metoda˛ tunelowa˛ (P. Carlsson, D. Ericson, D. Bratthall,19921996), wpływu uszczelniaczy glasjonomerowych na próchnice˛ i bakterie próchnicogenne (A. Hoszek, K. Wretlind, D.
Ericson, 1996-1998) oraz klinicznych i mikrobiologicznych
efektów skalingu i różnych programów kontroli płytki u
pacjentów z zapaleniem przyze˛bia (G. Bratthall, R. Attstrom, 1986-1988).
Prace prowadzone wspólnie ze znakomitymi naukowcami szwedzkimi otworzyły przed nami nowe perspektywy.
Pozwoliły na poszerzenie warsztatu naukowego poprzez
wprowadzenie nowych koncepcji i zastosowanie metod
diagnostycznych niedoste˛pnych w kraju, głównie z przyczyn
ekonomicznych.
Osia˛gnie˛cia naukowe tego okresu cechowały sie˛ śmiałym
nowatorstwem, a poczynione obserwacje należały do pierwszych w kraju. Prowadzono badania zarówno nad uwarunkowaniami próchnicy, jak i chorób przyze˛bia. Oceniano skuteczność programów zapobiegania próchnicy, opartych na
kontroli czynników ryzyka choroby. Wdrożono metody służa˛ce określeniu indywidualnego zagrożenia próchnica˛ u
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dzieci i osób w wieku dojrzałym. Opracowano narze˛dzia
pozwalaja˛ce na prognozowanie ataku próchnicy ze˛bów u
dzieci (na podstawie oznaczenia liczby drobnoustrojów z
grupy S. mutans w ślinie stymulowanej i równoczesnej ilościowej oceny indywidualnych skłonności do odkładania
złogów naze˛bnych). Z użyciem porównywalnych metod
mie˛dzynarodowych opisane zostały uwarunkowania stanu
jamy ustnej oraz szybkość poste˛pu próchnicy i zapaleń przyze˛bia w określonych grupach populacji polskiej. Przedstawiono metody ba˛dź programy profilaktyczne pozwalaja˛ce
na poprawe˛ stanu zdrowia populacji o określonych uwarunkowaniach etiologicznych próchnicy i chorób przyze˛bia
(indywidualizacja programów zapobiegania próchnicy i
chorób przyze˛bia), zgodnie z którymi intensywność działań
jest zróżnicowana zależnie od czynników ryzyka choroby.
Określono wykładniki wysokiego ryzyka próchnicy u dzieci
oraz poste˛p i przyrost próchnicy w uze˛bieniu stałym.
Prowadzono badania nad poste˛pem choroby przyze˛bia w
kraju. Wprowadzono nowe metody diagnozowania stanu
przyze˛bia na podstawie pomiaru ubytku przyczepu ła˛cznotkankowego, określono utrate˛ przyczepu ła˛cznotkankowego
w wybranych grupach dorosłych oraz potrzeby lecznicze
chorób przyze˛bia. Po raz pierwszy w kraju wprowadzone
zostały nowe metody leczenia chorób przyze˛bia zmierzaja˛ce
do regeneracji tkanek. Ponadto w sposób bardzo znacza˛cy
przyczyniliśmy sie˛ do określenia zwia˛zku pomie˛dzy infekcja˛ kieszonek dzia˛słowych drobnoustrojami z gatunku A.
actinomycetemcomitans i P. gingivalis, a zapaleniami przyze˛bia.
Na uwage˛ zasługuje również fakt, że w zakresie badań
nad glasjonomerowymi uszczelniaczami bruzd byliśmy pionierami, a poczynione obserwacje należa˛ do pierwszych w
kraju. Prowadziliśmy badania nad efektami materiałów
wzbogaconych fluorem o przedłużonym uwalnianiu jonów
fluorkowych. Badaliśmy proces hamowania próchnicy przy
wykorzystywaniu środków przeciwbakteryjnych długo zalegaja˛cych w jamie ustnej (chlorheksydyna), z wykorzystaniem nośnika umożliwiaja˛cego powolne ich uwalnianie.
Poziom działalności prowadzonej przez nasz zakład wyraża mie˛dzy innymi fakt, że prace nasze zostały dopuszczone do przedstawiania na zjazdach o najwyższej randze światowej w dziedzinie stomatologii (International Association
for Dental Research). Współpraca naukowa zaowocowała
wynikami badań, które znalazły uznanie w skali mie˛dzynarodowej: Wierzbicka M., Carlsson P., Strużycka I., Iwanicka-Frankowska E., Bratthall D.: Oral health and factors
related to oral health in Polish schoolchildren. Community
Dent. Oral Epidemiol., 1987, 15, 216-217. Carlsson P., Strużycka I., Wierzbicka M., Iwanicka-Frankowska E., Bratthall
D.: Effect of a preventive programme on dental caries and
mutans streptococci in Polish schoolchildren. Community
Dent. Oral Epidemiology., 1988, 16, 253-257. Wierzbicka
M., Frankowska E., Bratthall G., Słotwińska S., Kwiatkowska A.: Periodontal treatment needs of employees in a
Polish technical factory. Community Dent. Oral Epidemiol.,
1990, 18, 161.
Z końcem lat 80. Zakład Stomatologii Zachowawczej
nawia˛zał współprace˛ naukowa˛ z prof. P. Axelssonem (Preventive Oral Health Centre, Karlstad, Sweden). Problematyka wspólnych badań dotyczyła profilaktyki próchnicy ze˛bów i zapaleń dzia˛seł u dzieci w wieku szkolnym (Effects of
needs related preventive programme on dental caries and
gingivitis in Polish school children, 1988-1990). Współpraca zaowocowała konkretnymi wynikami badań, które po raz
kolejny znalazły uznanie w skali mie˛dzynarodowej: Strużycka I., Wierzbicka M., Axelsson P., Wojcieszek D., Zelenay
M.: Interproximal dental caries and gingivitis. J. Dent. Res.,
1996, 75(5), 19.
Bliska współpraca ze strona˛ szwedzka˛ ujawniła sie˛ nie
tylko poprzez liczne publikacje i prezentacje˛ prac na sesjach
naukowych. Zarówno w Polsce jak i w Szwecji zorganizowane zostały wspólne seminaria obejmuja˛ce tematyke˛ planowania zdrowia jamy ustnej (Oral health planning, postgraduate course, 1986 WHO small seminar group and visit
to District Main clinics), pracy z asystentka˛ na 4 re˛ce (Fourhanded dentistry, postgraduate course, 1986 Hoor), chemomechanicznego opracowywania ubytku próchnicowego
(Chemo-mechanical caries cavity preparation Warsaw,
2000), stomatologii prewencyjnej i epidemiologii (Preventive dentistry and epidemiology, Karlstad 1998).
Kolejni partnerzy naukowi, z którymi Zakład Stomatologii Zachowawczej nawia˛zał współprace˛ na pocza˛tku lat 90.
to prof. J. Banoczy (Semmelweis Medical University, Department of Conservative Dentistry, Budapest, Hungary)
oraz prof. G. Fosse (Department of Anatomy and Cell Biology, University of Bergen, Norway). Tematyka wspólnych
prac badawczych obejmowała zagadnienia zapobiegania
próchnicy cementu korzeniowego i oceny mikrotwardości
cementu korzeniowego in vivo oraz problem wpływu urbanizacji na ekspozycje˛ współczesnego człowieka na ołów. Badania prowadzono na usunie˛tych ze˛bach mlecznych uznanych za najlepszy materiał do oceny przewlekłej ekspozycji
organizmu na niektóre szkodliwe czynniki środowiska ży-
cia. Określono wyste˛powanie i niektóre uwarunkowania
etiologiczne próchnicy cementu. Po raz pierwszy w skali
światowej określono wpływ miejscowego stosowania różnych kompozycji zwia˛zków fluoru na mikrotwardość cementu korzeniowego in vivo. Wykazano, że stosowanie fluoroamin w poła˛czeniu z fluorkiem cynawym o obniżonym pH
powoduje redukcje˛ próchnicy cementu u osób zagrożonych
ta˛ choroba˛. Do najważniejszych osia˛gnie˛ć naukowych tego
okresu zaliczyć można wykazanie różnic w stopniu mineralizacji obnażonego cementu ze˛bów żuchwy i szcze˛ki oraz
określenie średniej wartości VHN tej tkanki in situ, wykazanie możliwej przydatności oznaczeń mikrotwardości tkanki
ze˛ba in vivo do planowania poste˛powania profilaktycznego i
rejestracji jego efektów u osób z ryzykiem próchnicy cementu. Osia˛gnie˛cia naukowe zakładu po raz kolejny cieszyły sie˛
dużym uznaniem: Nemes J., Banoczy J., Wierzbicka M.,
Rost M.: Effect of AmF/SnF2 toothpaste and mouthrinsing
on dental plaque accumulation and gingivitis in a mediumtermed study. Caries Res., 1991, 25, 229. Nems J., Banoczy
J., Wierzbicka M., Rost M.: Clinical study on the effect of
amine fluoride/ stannous fluoride on exposed root surfaces.
J. Clin. Dent., 1992, 2, 51-53. Fosse G., Wesenberg R.,
Tvinnereim H., Eiac R., Kristoffersen O., Nag O., Wierzbicka M., Banoczy J., De Oliverio A., Srisopak C., Zamudio
A.: Lead in deciduous teeth from larger cities of some countries. Int. J. Environmental Studies, 1995, 47, 203-210.
Symbolem nieustannych da˛żeń i che˛ci identyfikowania
sie˛ ze światem jest współpraca z Genewa˛ i Kopenhaga˛ (P.E.
Petersen), bez której trudno byłoby mówić o da˛żeniach do
globalnych tendencji w zakresie prac nad poprawa˛ stanu
zdrowia. W 1990 r. w Rikgransen wspólnie z dr. J. Mollerem
z Biura Regionalnego WHO w Kopenhadze przeprowadzono seminaria z planowania zdrowia publicznego i organizacji opieki zdrowotnej dla około 70 lekarzy z różnych kontynentów. Współpraca z WHO rozwija sie˛ nieustannie, czego
przykładem sa˛ wspólne prace (Wierzbicka M., Petersen P. E.,
Szatko F., Dybiżbańska E., Kalo I.: Changing oral health
status and oral health behaviour of schoolchildren in Poland, 2002, 19, 243-250), czy obecność w Global Data Bank
w Genewie aktualnych danych epidemiologicznych dla kraju.
Znacza˛cym wyznacznikiem aktywności Zakładu Stomatologii Zachowawczej na arenie mie˛dzynarodowej była i jest
współpraca z ADEE (Association for Dental Education in
Europe), zapocza˛tkowana w 1982 r. przyje˛ciem w skład
Europejskiej Federacji Szkół Stomatologicznych Oddziału
Stomatologii, którego reprezentantem do 2003 roku była
prof. M. Wierzbicka. Celem ADEE jest inspirowanie poste˛pu w nauczaniu stomatologii, ułatwianie kontaktów pomie˛dzy nauczycielami uczelni europejskich, przegla˛d i ocena
metod oraz celów nauczania stomatologii w Europie, rozwa-
5
żanie i ocena procedury szkolenia nauczycieli stomatologii
w Unii Europejskiej.
Oddział Stomatologii warszawskiej Akademii Medycznej
aktywnie uczestniczył i nadal uczestniczy w pracach federacji. Prace te obejmuja˛ zagadnienia dotycza˛ce czynników
warunkuja˛cych zwie˛kszenie skuteczności nauczania profilaktyki próchnicy i chorób przyze˛bia (Delhi, 1984), dotycza˛
sylwetki stomatologa – specjalisty (Gatwick, 1986), obejmuja˛ wizytacje Oddziałów Stomatologii Unii Europejskiej. Polegaja˛ też na opracowywaniu materiałów dotycza˛cych koncepcji i zakresu nauczania stomatologów w Europie, czy na
uczestnictwie w roboczych grupach dyskusyjnych. Ustalone
zostały priorytety i wzorce w dziedzinie nauczania i wytyczone konkretne kierunki (Shanley B.D.: Dental Education
in Europe; Wierzbicka M.: Chapter 7: Human Diseases.
Dental Press Kft., Budapest, Hungary, 2001.; FerilloP., Jonas I., Gundersen S., Jones M., Whitehouse N., Wierzbicka
M., Wochna-Sobańska M., Mario C., Yen E., Boari A.,
Frithiof L.: Human resource management. Eur. J. Dent.
Educ., 2002, 6, 107-114.)
Na podkreślenie zasługuje również współpraca z Council
of European Chief Dental Officers w dziedzinie promowania
zdrowia publicznego w Europie i prac nad usprawnieniem
opieki stomatologicznej w krajach europejskich (Widstrom
E., Eaton K.: Oral Healthcare systems in the Extended European Union, Oral Health Prev. Dent., 2004, 2, 155-194,
Dybiżbańska E.: Poland).
Współpraca naukowa Zakładu Stomatologii Zachowawczej ze znacza˛cymi partnerami w Europie rozwija sie˛ nieustannie, czego przykładem jest program Visiting Scholar
Stipend. W 2001 r., podczas spotkania naukowego Continental European Division of IADR w Rzymie po raz pierwszy przyznane zostały stypendia umożliwiaja˛ce młodym
badaczom prace˛ w ośrodkach naukowych pod okiem doświadczonych naukowców i przyswojenie nowych technik
doświadczalnych. Po przedstawieniu projektów prac badawczych możliwości tej dosta˛pili również młodzi naukowcy z
Zakładu Stomatologii Zachowawczej: E. Dybiżbańska (Influence of Interleukin-1 on Human Gingival Fibroblasts,
University of Liverpool, UK, prof. G. Embery), A. Mielczarek (Application of QLF and FMR in Early Caries Diagnosis, Karolinska Institute, Dental Faculty, Sweden, Prof. B.
Angmar-Mänsson), J. Iracki (Bonding Effectiveness of New
Self-etching Adhesives to Bur-cut Enamel and Dentin, Catholic University of Leuven, Belgium, Prof. B. van Meerbeek), M. Kacprzak (Subsurface structure of enamel treated
with whitening products for home use, Johan Gutenberg
University, Mainz, Germany, Prof. H. Duschner).
Obecnie prowadzimy współprace˛ z Procter&Gamble, dotycza˛ca˛ technik wybielania ze˛bów. Pracownicy naszego zakładu znajduja˛ sie˛ w grupie ekspertów europejskich ds. wy-
6
bielania. Kolejny raz mamy możliwość godnej reprezentacji
polskiej nauki w świecie: Barlow A., Gerlach R.W., Date
R.F., Brennan K., Strużycka I., Kwiatkowska A., Wierzbicka M.: Clinical response of two brush-applied peroxide
whitening systems. J. Clin. Dent., 2003, 14, 59-63.
Zakład Stomatologii Zachowawczej aktywnie uczestniczył w mie˛dzynarodowym życiu naukowym również poprzez organizacje˛ spotkań naukowych. W 1997 roku byliśmy współorganizatorami Konferencji Głównych Stomatologów Krajów Europejskich w Warszawie. Konferencja poświe˛cona była perspektywom rozwoju opieki stomatologicznej w krajach podlegaja˛cych transformacji i stanowiła istotny krok na drodze do poprawy zdrowia jamy ustnej w społeczeństwie polskim oraz społecznościach innych krajów.
W sierpniu 2000 roku w Warszawie odbył sie˛ 4th Joint
Meeting of IADR CED/NOF, na którym zaprezentowano
wiele własnych prac naukowych. Zaangażowanie to ujawniło sie˛ również poprzez działania nakierowane na promowanie rozwoju naukowych badań w regionie i publikacje˛ wyników. Tematyczne grupy dyskusyjne dla młodych naukowców z Europy centralnej i wschodniej zawierały specyficzne
pola badań naukowych: kariologie˛, materiały dentystyczne,
zdrowie publiczne, periodontologie˛, medycyne˛ jamy ustnej
(z doświadczonymi naukowcami), czy workshop na temat
pisania i publikowania prac naukowych moderowany przez
Editor-in-chief European Journal of Oral Sciences Anders
Linde.
Ponadto w maju tego roku byliśmy współorganizatorami
International Conference 30th Anniversary of Co-Operation
Between the Medical University of Warsaw and the University in Lund and Malmö.
Nieodła˛cznym ogniwem aktywnej działalności naukowej
o zasie˛gu światowym jest praca w zarza˛dach mie˛dzynarodowych organizacji naukowych. Pierwszym stomatologiem z
Europy środkowowschodniej i pierwsza˛ kobieta˛, która została Prezydentem Continental European Division of IADR
była prof. Maria Wierzbicka. W latach 2001-2005 uczestniczy ona także w pracach Komisji Rozwoju Regionalnego
(Regional Development Committee) przy Zarza˛dzie Głównym IADR (rozdział funduszy na przedsie˛wzie˛cia służa˛ce
rozwojowi nauki w różnych krajach naszego globu). Obecnie w zarza˛dzie oddziału europejskiego tej organizacji, jak
również w Zarza˛dzie Europejskiej Akademii Stomatologii
Zapobiegawczej aktywnie działa dr hab. I. Strużycka.
Przejawem cia˛gle niezaspokojonych che˛ci rozszerzania
mie˛dzynarodowej współpracy naukowej jest inicjatywa naszych studentów, którzy w 2002 roku w towarzystwie młodego nauczyciela, przy poparciu władz uczelni, zorganizowali wymiane˛ ze szkoła˛ w Dublinie i Malmö. Wizyty te,
bardzo pożyteczne dla obu stron, umożliwiły studentom
kontakt z różnymi metodami nauczania stomatologii oraz
Prof. dr hab. dr h. c. Maria Wierzbicka po odebraniu godności Doktora Honoris Causa Uniwersytetu w Malmö, w
gronie najbliższych współpracowników i wnuków. Od lewej: dr Ewa Iwanicka - Grzegorek, dr Agnieszka Mielczarek,
lek. stom. Anna Kwiatkowska, dr hab. Izabela Strużycka, lek. stom. Michał Ganowicz, Patrycja Wierzbicka.
wymiane˛ doświadczeń dotycza˛cych klinicznych problemów
przez nich napotykanych. Studenci wrócili z obu wyjazdów
entuzjastycznie nastawieni do nowych koncepcji aktywnego
przyswajania wiedzy, jak np. „problem based learning”, które zacze˛li wprowadzać w naszym zakładzie. Zainicjowanie
wymiany studentów jest znakiem cia˛głych da˛żeń do rozwoju
kontaktów osobistych i profesjonalnych pomie˛dzy naste˛pnym pokoleniem stomatologów.
Osia˛gnie˛cia naukowe Zakładu Stomatologii Zachowawczej zawsze cieszyły sie˛ i nadal sie˛ ciesza˛ dużym uznaniem
w skali mie˛dzynarodowej. Wyrazem uznania dla osia˛gnie˛ć
w dziedzinie nauki i edukacji jest przyznanie prof. Marii
Wierzbickiej tytułu Doktora Honoris Causa Uniwersytetu w
Malmö. Pani Profesor jest pierwszym polskim stomatologiem i pierwsza˛ kobieta˛ tej profesji, która otrzymała wspomniany tytuł z uczelni zagranicznej. Dowodem wysokiej
oceny naszego zakładu jest również cia˛gle rozwijaja˛ca sie˛
współpraca z czołowymi ośrodkami europejskimi, owocuja˛ca konkretnymi wynikami badań, które – be˛da˛c przedmiotem publikacji i wysta˛pień na spotkaniach naukowych –
znajduja˛ uznanie zarówno w skali mie˛dzynarodowej jak i
krajowej.
7
Udział Zakładu Stomatologii Zachowawczej
w pracach nad poprawa˛ stanu zdrowia jamy ustnej
populacji polskiej w latach 1993-2004
Lek. stom. Elżbieta Pierzynowska
Promocja zdrowia jamy ustnej, edukacja prozdrowotna
oraz szeroko poje˛ta profilaktyka należa˛ do zadań priorytetowych, wynikaja˛cych z formalnego zapisu celu 18 Narodowego Programu Zdrowia. Pocza˛wszy od roku 1990 w kraju
zaszło wiele istotnych zmian; transformacja systemu politycznego państwa przyniosła różne możliwości poprawy zdrowia jamy ustnej, a promocja zdrowia nabrała nowego wymiaru i zacze˛ła sie˛ dynamicznie rozwijać. Niezaprzeczalnie
najlepszym sposobem edukacji prozdrowotnej społeczeństwa, szeroko propagowanym przez Światowa˛ Organizacje˛
Zdrowia jako najbardziej efektywnym, jest wykorzystanie
potencjału i możliwości szkoły poprzez prowadzenie edukacji stomatologicznej z udziałem nauczycieli.
Znacza˛ce dowody wysokiej skuteczności dobrze przeprowadzonych akcji szkolnych znane sa˛ szeroko na świecie.
Szkoła, poprzez kreowanie sprzyjaja˛cego środowiska, postrzegana jest przez rodziców i społeczność lokalna˛ jako idealne miejsce na przekazywanie wiedzy, stwarzaja˛ce doskonałe warunki dla przyswajania odpowiednich zachowań
zdrowotnych. Dzieci odgrywaja˛ istotna role˛ w promocji
zdrowia jamy ustnej. Programy szkolne powoduja˛ przejmowanie przez dzieci kontroli nad swoim zdrowiem, przez co
staja˛ sie˛ one za nie odpowiedzialne. W Polsce tego typu
systematyczna˛ edukacje˛ stomatologiczna˛ podje˛to z inicjatywy Polskiego Towarzystwa Stomatologicznego oraz przemysłu (Blend-a-med), przy poparciu Światowej Organizacji
Zdrowia w roku szkolnym 1993/1994 – na podstawie decyzji Ministra Edukacji Narodowej z lipca 1993 r. Akcja promocyjna, która˛ zapocza˛tkowano pod nazwa˛ „Śnieżnobiały
Uśmiech”, ukierunkowana głównie na dzieci, obejmowała
również rodzine˛, środowisko szkoły i cała˛ społeczność lokalna˛. Program wdrożono w wie˛kszości szkół podstawowych w kraju, po uprzednim przeprowadzeniu kaskadowego
szkolenia organizatorów i realizatorów edukacji prozdrowotnej. Do programu klas pierwszych wprowadzone zostało
nauczanie zagadnień dotycza˛cych budowy, funkcji i sposobów piele˛gnacji ze˛bów oraz dzia˛seł. Zadaniem programu
było i jest systematyczne pogłe˛bianie wiadomości z zakresu
zdrowia i higieny jamy ustnej oraz – za pośrednictwem
rodziców i opiekunów – wyrobienie u dzieci odruchu pra-
8
widłowego szczotkowania ze˛bów i wykształcenie nawyków
dbania o zdrowie jamy ustnej. Za sprawa˛ sukcesu, jaki odniósł oraz udowodnionej wysokiej skuteczności profilaktycznej Stomatologiczny Program Edukacyjny dla klas pierwszych szkoły podstawowej uje˛ty został w Narodowym Programie Zdrowia jako zadanie, które winno być realizowane
we wszystkich szkołach. Ostatnia z modyfikacji programu o
nazwie „Szkoła Zdrowego Uśmiechu” ma również akceptacje˛ MEN i jest zalecana do wykorzystania przez nauczycieli.
Niezwykle istotnym aspektem w da˛żeniach do poprawy
zdrowia społeczeństwa polskiego jest identyfikowanie sie˛ z
osia˛gnie˛ciami w skali globalnej, czego wyrazem było spotkanie reprezentantów Biura Regionalnego WHO (prof. P. E.
Petersena i prof. I. Mollera) z krajowym nadzorem stomatologicznym (Warsztaty WHO/EURO pt.: Organizacja opieki zdrowotnej w Polsce, 28-29. 08.1997). Warsztaty te obejmowały problematyke˛ właściwie ukierunkowanej promocji
zdrowia, racjonalizacji profilaktyki stomatologicznej i jakości opieki, jak również zagadnienia systemu monitorowania.
Efektem prac stomatologicznych zespołów specjalistycznych i ustaleń poczynionych w czasie spotkania był program
resortowy i propozycja programu wielosektorowego postuluja˛ce podniesienie świadomości profilaktycznej organizatorów opieki zdrowotnej i personelu stomatologicznego,
wdrożenie modelu zapobiegania próchnicy, różnicuja˛cego
zabiegi i metody zależnie od czynników ryzyka choroby,
obniżenie nakładów finansowych na leczenie próchnicy i
zapaleń przyze˛bia oraz na leczenie endodontyczne i protetyczne.
Znacza˛cym krokiem w kierunku poprawy stanu zdrowia
jamy ustnej społeczeństwa polskiego jest opanowanie próchnicy u osób o wysokim narażeniu na czynniki ryzyka
choroby, co wymaga intensywnych, profesjonalnych działań
profilaktycznych, prowadza˛cych do zmiany zachowań zdrowotnych. Współczesne strategie zdrowia jamy ustnej zakładaja˛ różnicowanie programów zapobiegania próchnicy w
grupach populacji o różnym narażeniu na czynniki ryzyka
tej choroby. Indywidualizacja programów zapobiegania
skutkuje efektywniejszym wykorzystywaniem potencjału
profilaktyki. Wychodza˛c naprzeciw tym oczekiwaniom
opracowano dla potrzeb populacji polskiej „Publiczny program zapobiegania próchnicy dla dzieci i młodzieży z grupy
wysokiego ryzyka choroby”. Program zakłada obniżenie
wyste˛powania próchnicy wśród dzieci o wysokim stopniu
narażenia na czynniki ryzyka choroby poprzez indywidualnie ukierunkowane oddziaływania prozdrowotne oraz intensyfikacje˛ profesjonalnego zapobiegania (rozszerzenie zakresu zabiegów profilaktycznych i dostosowanie ich cze˛stości
do potrzeb dziecka), podniesienie świadomości zdrowotnej
młodzieży oraz rodziców dzieci o najniższym poziomie tej
świadomości.
Działaniami służa˛cymi poprawie stanu zdrowia społeczeństwa polskiego, bez których trudno byłoby myśleć o
nada˛żaniu za globalnymi tendencjami w tym zakresie, jest
współpraca z Głównymi Stomatologami Krajów Europejskich (Council of European Chief Dental Officers). Stowarzyszenie to skupia osoby zajmuja˛ce sie˛ zawodowo usprawnianiem opieki stomatologicznej w krajach europejskich i
promowaniem zdrowia publicznego.
W październiku 1997 roku odbyło sie˛ w Warszawie spotkanie poświe˛cone perspektywom rozwoju systemu opieki
stomatologicznej w krajach podlegaja˛cych transformacji.
Udział w konferencji głównych organizatorów opieki
stomatologicznej w Europie stworzył możliwości wymiany
doświadczeń oraz wspólnego poszukiwania nowych, doskonalszych rozwia˛zań. Przyje˛ta Strategia Zdrowia stanowiła
istotny krok na drodze do poprawy zdrowia jamy ustnej
społeczeństwa polskiego oraz społeczności innych krajów.
Ocena efektów funkcjonowania opieki zdrowotnej nie
byłaby możliwa bez równoczesnego prowadzenia badań systemów zdrowia oraz gruntownej analizy wprowadzanych w
tym zakresie zmian. Badania te sa˛ uznanym źródłem infor-
macji i nieodła˛cznym elementem pracy nad poprawa˛ stanu
zdrowia populacji. W kraju system cia˛głego monitorowania
stanu zdrowia jamy ustnej, umożliwiaja˛cy gromadzenie porównywalnych danych, wprowadzony został w 1997 roku
przy wsparciu Ministerstwa Zdrowia i współpracy wielu
ośrodków naukowych. Prowadzone w ramach monitoringu
systematyczne badania epidemiologiczne i socjomedyczne
obejmuja˛ różne grupy populacji, skupiaja˛c sie˛ na grupach
wiekowych przyje˛tych przez WHO jako indeksowe. Korzyści wynikaja˛ce z wprowadzenia i kontynuacji systemu monitoringu sa˛ ogromne. Przede wszystkim uzyskane dane umożliwiaja˛ ocene˛ zaawansowania realizacji celu 18 Narodowego Programu Zdrowia oraz ocene˛ skuteczności realizowanych lub nowo wprowadzanych programów profilaktycznych. Bez systemu monitorowania stanu zdrowia wybranie
właściwej dla kraju i regionu strategii zdrowia nie byłoby
możliwe. Ponadto niezwykle istotnym aspektem, bez którego trudno byłoby identyfikować sie˛ z Unia˛ Europejska˛, jest
możliwość porównania polskiego systemu z jakościa˛ systemów opieki zdrowotnej funkcjonuja˛cych w jej krajach.
Proces przekształceń opieki zdrowotnej tocza˛cy sie˛ w
krajach Europy środkowej i wschodniej, jest procesem trudnym i powolnym, i pomimo wielu dotychczasowych osia˛gnie˛ć zharmonizowanie polskiego systemu z systemami funkcjonuja˛cymi w krajach Unii Europejskiej jest jeszcze bardzo odległe. Trudności organizacyjne i ekonomiczne, z którymi borykaja˛ sie˛ organizatorzy i realizatorzy opieki stomatologicznej, znacznie ograniczaja˛ możliwości działań na
rzecz usprawnienia polityki zdrowotnej i stworzenia systemu doste˛pnego dla każdego. Tylko racjonalizacja profilaktyki i systemu opieki zdrowotnej przybliży nas do osia˛gnie˛cia
poziomu porównywalnego z krajami Unii Europejskiej.
9
IADR/CED/NOF Meeting, Warszawa 2000. Prof. Maria
Wierzbicka i prof. Aleksander Wolszczan - astronom (w
centrum), Prezydent IADR prof Mariorie Jeffcoat z małżonkiem, prof. Lars Petersson ze Szwecji, prof. A. Wojtowicz, dr J. Iracki.
Madryt‘97 - IADR/CED. Prof. M. Wierzbicka, prof. Sanz
(Prezydent CED/IADR), prof. Glanz (Prezydent IADR) z
żona˛.
Komitet organizacyjny - recepcja zjazdu IADR/CED/NOF
w Warszawie w 2000 r.
Mardyt‘97 - IADR/CED. Prof. Clarkson (Dyrektor IADR
USA, od stycznia 1998 - Irlandia) z żona˛ i prof. M. Wierzbicka.
Prof. Douglas Bratthall (drugi z lewej) po przyje˛ciu godności Doktora Honoris Causa AM w Warszawie w gronie
szwedzkich współpracowników.
Wizytacja Oddziału Stomatologii Uniwersytetu w Konya
w Turcji z ramienia ADEE, w ramach programu UE
DentEd. Grupie wizytatorów przewodniczy prof. M. Wierzbicka. W środku prof. Fuzun Ozer - prodziekan.
10
KATEDRA PROTETYKI STOMATOLOGICZNEJ
Współpraca naukowa pomie˛dzy Katedra˛ Protetyki
Stomatologicznej Akademii Medycznej
w Warszawie a Wydziałem Stomatologii
Uniwersytetu w Lund z siedziba˛ w Malmö
Prof. dr hab. Elżbieta Mierzwińska–Nastalska
Kierownik Katedry Protetyki Stomatologicznej IS AM w Warszawie
Nieformalna współpraca pomie˛dzy Katedrami Protetyki
Stomatologicznej w Warszawie i Malmö rozpocze˛ła sie˛ po
powrocie prof. E. Spiechowicza z pobytu naukowo-szkoleniowego w Szwecji (lata 1968/69). W roku 1970 prof. S.
Östlund, pełnia˛cy obowia˛zki Kierownika Zakładu Protetyki
w Malmö złożył wizyte˛ w Warszawie. W roku 1971 prof. G.
Nyquist, dziekan Wydziału Stomatologii i faktyczny kierownik Zakładu Protetyki w Malmö przebywał przez tydzień
w Warszawie (wykłady i konsultacje kliniczne). Dwa lata
później profesorowie G. Nyquist i B. Öwall złożyli wizyte˛ w
Warszawie, gdzie – z inicjatywy prof. E. Spiechowicza –
rozpocze˛to rozmowy na temat formalnej, dwustronnej
współpracy naukowej pomie˛dzy Instytutem Stomatologii
Akademii Medycznej w Warszawie i Wydziałem Stomatologii Uniwersytetu w Lund. Również w omawianym okresie
prof. E. Spiechowicz kilkakrotnie przebywał w Malmö,
omawiaja˛c warunki wspólnych działań. W wyniku tych rozmów w roku 1974 została w Warszawie podpisana formalna
umowa o współpracy naukowej i edukacyjnej pomie˛dzy
Akademia˛ Medyczna˛ w Warszawie i Wydziałami Medycyny i Stomatologii Uniwersytetu w Lund.
Szczególne zasługi w organizacji współpracy ze strony
szwedzkiej położyli profesorowie G. Nyquist i B. Öwall;
ostatni z wymienionych przez pierwsze 20 lat był jej koordynatorem. Ze strony polskiej przez 25 lat koordynatorem był
prof. E. Spiechowicz. W uznaniu zasług, jako organizatora i
koordynatora omawianej współpracy, Wydział Stomatologii
Uniwersytetu w Lund odznaczył prof. E. Spiechowicza w
roku 1977 Honorowym Medalem Uniwersytetu w Lund.
Z inicjatywy kierownika Katedry Protetyki Stomatologicznej AM w Warszawie prof. B. Öwall, ówczesny dziekan i
koordynator ze strony szwedzkiej, w roku 1984, jako pierwszy w historii polskiej stomatologii otrzymał tytuł Doktora
Honoris Causa Akademii Medycznej w Warszawie.
W omawianym okresie Katedra Protetyki Stomatologicz-
nej AM w Warszawie współpracowała z Zakładem Protetyki
Stomatologicznej, Diagnostyki Jamy Ustnej, Chirurgii
Stomatologicznej i okresowo z Zakładem Patologii Jamy
Ustnej. Realizowano naste˛puja˛ce tematy:
– Uczulenie na nikiel u użytkowników stałych protez
stomatologicznych.
– Leczenie protezami szkieletowymi.
– Napie˛cie powierzchniowe śliny i mieszaniny śliny z
drobnoustrojami.
– Wydolność żucia.
Wyniki wspólnych badań zaowocowały 13 publikacjami
w naste˛puja˛cych pismach krajowych i zagranicznych: Protetyka Stomatologiczna, Contact Dermatitis, Dysphagia, European Journal of Prosthodontic and Restorative Dentistry,
International Journal of Prosthodontics, Quintessence, Swedish Dentistry Journal. Były one również prezentowane na
mie˛dzynarodowych kongresach i konferencjach: Mie˛dzynarodowe Sympozjum na temat materiałów stomatologicznych, Frankfurt (1981); Mie˛dzynarodowa Konferencja Protetyki Stomatologicznej (1986) Reinhardsbrunn – Niemcy,
VI i VII Kongres Polskiego Towarzystwa Stomatologicznego, Łódź 1986 i 1991; Konferencja Europejskiego Towarzystwa Protetyki Stomatologicznej 1990, Amsterdam, Holandia; Mie˛dzynarodowy Kongres Litewskiego Towarzystwa
Stomatologicznego, Kowno 2000.
Wspólne osia˛gnie˛cia były również przedstawiane w formie wykładów na uniwersytetach: Meinz (1987, 1988) i
Frankfurt nad Menem (1988) – Niemcy, Stony Brook w
Nowym Jorku (1988, 1991) – Stany Zjednoczone A.P., Quebeck (1988) – Kanada, Aarhus i Kopenhaga (1994) – Dania
oraz na kilku konferencjach Polskiego Towarzystwa Stomatologicznego.
Wyniki prowadzonych badań były także kilkakrotnie prezentowane w Malmö, Warszawie i raz w Sztokholmie w
ramach wymiennych wizyt współpracuja˛cych zespołów.
11
ZAKŁAD STOMATOLOGII DZIECIE˛CEJ
Współpraca naukowa i naukowo-dydaktyczna
Zakładu Stomatologii Dziecie˛cej IS AM w Warszawie
z ośrodkami naukowymi w Szwecji
Dr n. med. Aleksander Remiszewski
Zakład Stomatologii Dziecie˛cej IS AM w Warszawie
Współpraca Zakładu Stomatologii Dziecie˛cej Instytutu
Stomatologii Akademii Medycznej w Warszawie z ośrodkami naukowymi w Szwecji rozpocze˛ła sie˛ w roku 1977.
Wieloletnia wymiana doświadczeń naukowo-dydaktycznych miała bardzo duży wpływ na rozwój stomatologii dziecie˛cej w ośrodku warszawskim i w Polsce. Kolejno prowadzone tematy prac naukowych umożliwiały zastosowanie
nowoczesnych preparatów i technik klinicznych. Osia˛gnie˛te
wyniki badań były podstawa˛ do zmian w programie dydaktycznym szkolenia przed i podyplomowego oraz w pracy
stomatologów. Współpraca ze strona˛ szwedzka˛ składała sie˛
z 3 etapów i jest kontynuowana.
I etap współpracy naukowej 1977-1980
Strona szwedzka:
Faculty of odontology, Karolinska Institute, Stockholm
Kierownik: G. Frostell
Strona polska:
Zakład Stomatologii Dziecie˛cej AM w Warszawie
Kierownik: K. Grodzka
Zakład Radiologii Stomatologicznej AM, Warszawa
Kierownik: K. Mlosek
Temat pracy: „Zastosowanie lakieru fluorowego Duraphat w uze˛bieniu mlecznym dzieci z przedszkoli warszawskich”
Wykonawcy: K. Grodzka, L. Augustyniak, J. Budny, K.
Czarnocka, J. Janicha, K. Mlosek, B. Moszczeńska – Cieślikowska, M. Szpringer, M. Wacińska, L. Petersson, G. Frostell
II etap współpracy naukowej 1984-87
Strona szwedzka:
Department of Pedodontics, Uniwersity of Lund, Malmö
Kierownik: L. Granath
Strona polska:
Kierownik: M. Szpringer – Nodzak
12
Zakład Radiologii Stomatologicznej IS AM w Warszawie
Kierownik: K. Mlosek
Temat pracy: „Zastosowanie amputacji cze˛ściowej w ze˛bach trzonowych mlecznych z użyciem techniki oszcze˛dzaja˛cej (gentle technique)”
Wykonawcy: U. Schröder, M. Szpringer – Nodzak, J.
Janicha, M. Wacińska – Drabińska, J. Budny, K. Mlosek
III etap współpracy naukowej 1987-1990
Strona szwedzka:
Departament of Pedodontics, University of Lund, Malmö
Kierownik: L. Granath
Strona polska:
Kierownik: M. Szpringer – Nodzak
Klinika Hematologii AM w Warszawie
Kierownik: R. Rokicka – Milewska
Temat pracy: „Osoczowe skazy krwotoczne u dzieci”
Wykonawcy: M. Szpringer – Nodzak, R. Rokicka – Milewska, U. Schröder, M. Wacińska – Drabińska, A. Grzybowska, A. Gordon, J. Perendyk, A. Klukowska, H. Gazda, M.
Wielopolska, A. Adamowicz – Salach.
IV etap współpracy naukowo-dydaktycznej 2003-2004
W dniach 27 września –1 października 2004r w Zakładzie
Stomatologii Dziecie˛cej IS AM w Warszawie odbyło sie˛
szkolenie pracowników naukowo-dydaktycznych, reprezentuja˛cych zakłady stomatologii dziecie˛cej z dziesie˛ciu ośrodków akademickich w Polsce. Szkolenie dotyczyło problemów stomatologii dziecie˛cej, takich jak: endodoncja, profilaktyka, nowoczesne techniki w stomatologii dziecie˛cej.
Wykładowcami byli prof. Ulla Schröder – Clinic for Paediatric Dentistry, Malmö i Claes-Göran Grossner, Postgraduate
Dental Education Center-Örebro. Organizatorem programu
jest International Association of Paediatric Dentistry IAPD.
Nazwa programu – „Dentist for all children”. Ośrodek warszawski jest koordynatorem i organizatorem ogólnopolskim,
Zakład Stomatologii Dziecie˛cej
reprezentowanym przez dr. n. med. Aleksandra Remiszewskiego z zespołem pracowników Zakładu Stomatologii
Dziecie˛cej IS AM w Warszawie. Program realizowany jest
od roku 2003 i ma na celu poprzez nowoczesna˛ edukacje˛
nauczycieli akademickich szkola˛cych lekarzy dentystów
podnieść poziom lecznictwa stomatologicznego u dzieci.
Szkolenie, oprócz wykładów i cze˛ści dydaktycznej, ma
aktywna˛ forme˛ wymiany doświadczeń obu stron – polskiej i
szwedzkiej. Program be˛dzie kontynuowany w latach naste˛pnych.
Opublikowane wspólne prace:
1. Grodzka K., Augustyniak L., Budny J., Czarnocka K.,
Janicha J., Mlosek K., Moszczeńska B., Szpringer M., Wacińska M., Petersson L., Frostell G.,: Caries increment in
primary teeth after application of Duraphat fluoride varnish. Community Dent. Oral Epidemiol. 1982; 10: 55-59
2. Schröder U., Szpringer – Nodzak M., Janicha J., Wacińska M., Budny J., Mlosek K.,: A one-year follow-up of
partial pulpotomy and calcium hydroxide capping in primary molars. Endod. Dent. Traumatol 1987; 3: 304-6
3. Szpringer – Nodzak M., Janicha J., Wacińska M., Budny J., Mlosek K, Schröder U.: Dwuletnia obserwacja ze˛bów
trzonowych mlecznych leczonych metoda˛ cze˛ściowej amputacji miazgi. Czas. Stomat. 1989, XLII, 3
4. Szpringer – Nodzak M., Tawczyńska A, Moszczeńska
– Cieślikowska B., Remiszewski A., Rokicka – Milewska
R., Klukowska A., Gazda H., Wielopolska M., Adamowicz
– Salach A., Schröder U.: Ocena stanu narza˛du żucia u
dzieci z osoczowymi skazami krwotocznymi. Czas. Stomat.,
1992, XLV,3
5. Szpringer – Nodzak M., Wacińska – Drabińska M.,
Tawczyńska A., Gordon A., Rokicka – Milewska R., Klukowska A, Schröder U.: Stan zdrowotny narza˛du żucia u dzieci
chorych na hemofilie˛ A, B i chorobe˛ Willebranda. Stomatologia Współczesna; 1994; 3
6. Szpringer – Nodzak M., Wacińska – Drabińska M.,
Remiszewski A, Tawczyńska A., Gordon A., Rokicka –
Milewska R., Klukowska A., Gazda H, Wielopolska M,
Adamowicz – Salach A., Schröder U.: Stan zdrowotny narza˛du żucia u dzieci z osoczowymi skazami krwotocznymi.
Przegla˛d Stomatologii Wieku Rozwojowego nr 5 1994
Wygłoszone referaty
1. Maria Szpringer – Nodzak, Jadwiga Janicha, Maria
Wacińska – Drabińska, Jerzy Budny, Krzysztof Mlosek, Ulla Schröder: Zastosowanie wodorotlenku wapnia w cze˛ściowej amputacji miazgi w ze˛bach mlecznych.
2. Maria Szpringer – Nodzak, Anna Tawczyńska, Barbara
Moszczeńska – Cieślikowska, Aleksander Remiszewski,
Roma Rokicka – Milewska, Anna Klukowska, Hanna Gazda, Małgorzata Wielopolska, Ulla Schröder: Ocena stanu
zdrowotnego narza˛du żucia u dzieci z osoczowymi skazami
krwotocznymi. Ogólnopolskie Sympozjum Naukowo-Szkoleniowe. 13-16 IX 1990 r. Kazimierz Dolny.
13
ZAKŁAD RADIOLOGII STOMATOLOGICZNEJ
I SZCZE˛KOWO-TWARZOWEJ
Zakład Radiologii Stomatologicznej
i Szcze˛kowo-Twarzowej IS Oddziału
Stomatologicznego I Wydziału Lekarskiego
AM w Warszawie w latach 1970-2004
Dr n med. Krystyna Thun-Szretter, dr hab. med. Anatol Dowżenko
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM w Warszawie
Radiologia stomatologiczna i szcze˛kowo-twarzowa jest
specjalnościa˛ zajmuja˛ca˛ sie˛ diagnostyka˛ w stomatologii. Powstanie i rozwój Zakładu Radiologii Stomatologicznej i
Szcze˛kowo-Twarzowej jest ściśle zwia˛zany z Instytutem
Stomatologii AM w Warszawie.
W 1970 roku Minister Zdrowia i Opieki Społecznej utworzył na Wydziale Lekarskim Akademii Medycznej w Warszawie Instytut Stomatologii. W ramach organizowanego
Instytutu Stomatologii AM w Warszawie stworzono Samodzielna˛ Pracownie˛ Radiologii i Fizykoterapii Stomatologicznej – samodzielna˛ jednostke˛ – baze˛ dla nauczania i badań w
zakresie radiologii stomatologicznej. W 1990 roku Samodzielna Pracownia Radiologii i Fizykoterapii Stomatologicznej IS AM w Warszawie została przekształcona w Zakład
Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM
w Warszawie, a główna˛ siedziba˛ zakładu stał sie˛ pawilon XI,
tak zwana podkowa na terenie Szpitala Klinicznego im. Dziecia˛tka Jezus Centrum Leczenia Obrażeń w Warszawie.
W latach 1970-1975 kierownikiem Samodzielnej Pracowni Radiologii i Fizykoterapii Stomatologicznej IS był dr
med. Jan Kozłowski. Dr med. Jan Kozłowski zorganizował
stomatologiczna˛ pracownie˛ rentgenowska˛ w budynku IS
AM przy ul. Miodowej 18 oraz w budynku Akademii Medycznej przy ul. Filtrowej 30, które stanowiły zaplecze diagnostyczne dla Zakładów i Klinik IS AM aż do przeniesienia
niektórych zakładów do pawilonu XI Szpitala Klinicznego
przy ul. Nowogrodzkiej 59.
W 1975 roku na stanowisko kierownika Samodzielnej
Pracowni Radiologii i Fizykoterapii Stomatologicznej IS
AM został powołany dr n. med. Krzysztof Mlosek. W 1980
roku doktor Krzysztof Mlosek na podstawie dorobku naukowego i rozprawy habilitacyjnej pt.: „Skuteczność diagnostyczna pantomografii i symptomatologii radiologicznej nowotworów twarzoczaszki” uzyskał stopień doktora habilitowa14
nego, a w marcu 1991 roku otrzymał nominacje˛ na profesora
nadzwyczajnego. Profesor Krzysztof Mlosek pełnił funkcje˛
kierownika Zakładu Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej do śmierci w 1995 roku. W latach 1995 2002 funkcje˛ p.o. kierownika sprawowała dr n. med. Hanna
Markiewicz. Od 2002 roku kierownikiem Zakładu Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM jest dr
hab. med. Anatol Dowżenko.
W latach 1970-1995 w Zakładzie Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM w Warszawie pracowali: dr n. med. Jerzy Budny, lek. dent. Renata Dobrowolny, lek. dent. Maria Klimek, dr med. Jan Kozłowski, mgr
Danuta Leitner, lek. med. Ewa Mańkowska, dr n. med. Hanna Markiewicz, lek. dent. Jolanta Radowicka, dr n. med.
Krystyna Thun - Szretter, lek. dent. Barbara Winnicka Szmielew, lek. med., lek. dent. Elżbieta Żochowska.
W latach 1995-2002 skład zespołu uległ zmianie i w 2002
roku były zatrudnione: dr n.med. Hanna Markiewicz – kierownik, lek. med. Ewa Mańkowska – asystent, lek. med.
Joanna Szymańska – asystent i dr n. med. Krystyna ThunSzretter – adiunkt.
W roku akademickim 2004-2005 pod kierownictwem dr.
hab. med. Anatola Dowżenko pracuje zespół w składzie: lek.
stom. Paweł Hojnacki – asystent, lek. stom. Stanisław Jalowski – stypendium doktoranckie, lek. med. Ewa Mańkowska
- Śliwa – asystent (urlop wychowawczy), lek. dent. Magdalena Piotrowska – asystent, dr n. med. Krystyna Thun Szretter – adiunkt.
Od pierwszych lat istnienia celem działalności Zakładu
Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS
AM, pocza˛tkowo jako Samodzielna Pracownia Radiologii i
Fizykoterapii Stomatologicznej IS AM jest organizowanie i
realizowanie nauczania radiologii stomatologicznej w ramach kształcenia przeddyplomowego w Oddziale Stoma-
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej
tologicznym I Wydziału Lekarskiego AM w Warszawie.
Zakład realizuje także kształcenie podyplomowe w formie
doskonala˛cych kursów organizowanych dwukrotnie w cia˛gu
roku oraz w formie indywidualnych staży w ramach specjalizacji w różnych dyscyplinach stomatologii. Od dwóch lat
zakład prowadzi również nauczanie radiologii stomatologicznej na licencjackich studiach w zakresie elektroradiologii.
Pocza˛tki nauczania radiologii stomatologicznej na studiach stomatologicznych w Oddziale Stomatologicznym
Wydziału Lekarskiego AM w Warszawie to 1957 rok. Z
inicjatywy profesora Janusza Krzywickiego, ówczesnego
kierownika Kliniki Stomatologii Zachowawczej, wprowadzono ćwiczenia z radiologii stomatologicznej w ramach
pensum dydaktycznego ze stomatologii zachowawczej. Wykorzystano do tych celów aparat rentgenowski do wykonywania rentgenowskich zdje˛ć ze˛bowych, znajduja˛cy sie˛ na
wyposażeniu kliniki w budynku IS AM przy ul. Miodowej
18, a zaje˛cia dydaktyczne prowadzili pracownicy naukowodydaktyczni kliniki: dr Jerzy Budny i doc. Zofia Raczew.
Program nauczania radiologii stomatologicznej i szcze˛kowo-twarzowej opracowany i realizowany w Zakładzie
Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS
AM był rekomendowany przez MZiOS jako wzór dla wszystkich uczelni medycznych w kraju. Podstawowe treści programu nauczania, sa˛ zawarte w podre˛cznikach opracowanych przez kierowników i pracowników zakładu. Korzystało
i korzysta z nich wiele pokoleń studentów i lekarzy. Profesor
Krzystof Mlosek jest współautorem i autorem kilku podre˛czników: „Radiologia. Podre˛cznik dla studentów medycyny”
pod redakcja˛ prof. dr hab. L. Zgliczyńskiego (1980 r.); „Zarys rentgenodiagnostyki stomatologicznej” (1980 r.); „Leksykon Radiologii” pod redakcja˛ prof. dr hab. J. Mastelerskiego (1992 r.); „Radiologia Stomatologiczna i Szcze˛kowoTwarzowa” (1994 r.). Dr n. med. Hanna Markiewicz jest
autorem monotematycznych rozdziałów w podre˛cznikach:
„Stomatologia Wieku Rozwojowego” pod redakcja˛ prof. dr
hab. M. Szpringer-Nodzak (1999 r.) oraz „Chirurgia szcze˛kowo-twarzowa” pod redakcja˛ prof. dr hab. L. Krysta (1999
r.), a dr n. med. Krystyna Thun - Szretter rozdziału w podre˛czniku „Diagnostyka obrazowa. Podstawy teoretyczne i metodyka badań” pod redakcja˛ prof. dr hab. B. Pruszyńskiego
(2000 r.).
Profesor Krzysztof Mlosek i dr n.med. Krystyna Thun Szretter maja˛ wkład w prace redakcyjne na łamach czasopism naukowych, be˛da˛cych oficjalnymi organami krajowych towarzystw naukowych, w których publikowane sa˛
prace z zakresu radiologii stomatologicznej, a czasopisma sa˛
zalecane jako źródłowe prace naukowe. Profesor Krzysztof
Mlosek jako wieloletni członek zarza˛du IADMF Radiology
uczestniczył również w redagowaniu News Letter, wydawanego przez IADMFR.
XXVII Sympozjum Sekcji Ortodoncji PTS w 2003 roku:
dr Krystyna Thun-Szretter i dr hab. Anatol Dowżenko
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM ma znacza˛cy udział w działalności organizacyjnej krajowych i mie˛dzynarodowych towarzystw naukowych, z którymi od wielu lat utrzymuje kontakty zawodowe.
Profesor Krzysztof Mlosek inspiruje utworzenie Sekcji Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej w ramach PLTR, a naste˛pnie PTS w 1985 roku. Siedziba˛ Sekcji
Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej jest
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM w Warszawie.
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej IS AM w Warszawie uczestniczył w pracach komitetów naukowych i komitetów organizacyjnych konferencji i
sympozjów organizowanych przez Sekcje˛ Radiologii
Stomatologicznej i Szcze˛kowo-Twarzowej PLTR i PTS:
Płock – 1976 r., Lublin – 1985 r., Warszawa – 1986 r.,
Wałbrzych – 1987 r., Piła – 1989r., Opole – 1991 r., Warszawa – 1993 r., Warszawa – 1994 r., Jelenia Góra – 1996 r.,
Warszawa – 1997 r. W konferencjach uczestniczyli przedstawiciele z kraju i ze świata zainteresowani diagnostyka˛
obrazowa˛ w stomatologii.
W 2002 roku Zakład Radiologii Stomatologicznej i
Szcze˛kowo-Twarzowej IS AM oraz Sekcja zorganizował
VIII Europejski Kongres DMFR Radiology, w którym uczestniczyło około 200 osób z Europy i innych krajów świata.
W 1983 roku doc. dr hab. Krzysztof Mlosek uczestniczył
po raz pierwszy w Światowym Kongresie Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej w Utrechcie (Holandia). Kongres w Utrechcie był pia˛tym kongresem zorganizowanym przez Mie˛dzynarodowe Towarzystwo Radiolgii
Stomatologicznej i Szcze˛kowo-Twarzowej (International
Association DentoMaxilloFacial Radiology – IADMFR).
Na naste˛pnych światowych kongresach IADMFR: Londyn –
1985 r., San Antonio – 1988 r., Budapeszt – 1991 r., Seul –
1994 r., Louisville – 1997 r., Osaka – 1999 r., Glasgow –
2001 r., Florianopolis – 2003 r. Zakład Radiologii Stoma-
15
Zakład Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej
tologicznej i Szcze˛kowo-Twarzowej IS AM prezentował zazwyczaj kilka prac.
Zakład brał również aktywny udział w programach naukowych Europejskich Kongresów Radiologii Stomatologicznej i Szcze˛kowo-Twarzowej w: Genewa – 1987 r., Kuopio
– 1989 r., Amsterdam – 1990 r., Turyn – 1993 r., Kolonia –
1995 r., Oslo – 1998 r., Ateny – 2000 r., Kraków – 2002 r.,
Malmö - 2004 r.
Członkiem IADMF Radiology był profesor Krzysztof
Mlosek. Członkami IADMFR sa˛ dr n. med. Hanna Markiewicz i dr n. med. Krystyna Thun-Szretter. W latach 1985 1994 prof. Krzysztof Mlosek był wybrany do władz
IADMFR i przez trzy kolejne kadencje był członkiem zarza˛du IADMFR. Dr n. med. Hanna Markiewicz uczestniczy w
pracach zarza˛du IADMFR od 1999 roku. Dr n. med. Krystyna Thun-Szretter jest od czerwca 2004 roku członkiem zarza˛du Europejskiej Akademii Radiologii Stomatologicznej i
Szcze˛kowo-Twarzowej (EADMFR).
W latach 1970-2004 Zakład Radiologii Stomatologicznej IS AM uczestniczył w badawczych programach krajowych i mie˛dzynarodowych. Mie˛dzynarodowe projekty
badawcze były zrealizowane dzie˛ki wymiennym pobytom
i stażom z Uniwersytetem w Lund, King’s College School of
Medicine and Dentistry w Londynie oraz School of Medicine and Dentistry w Rochester i Boston University Medical
Centre.
Działalność naukowo-badawcza jest realizowana na podstawie badań diagnostycznych wykonywanych u pacjentów
leczonych i konsultowanych w Instytucie Stomatologii AM
w Warszawie. Wdrożono do praktyki badania za pomoca˛:
zdje˛ć pantomograficznych, wewna˛trzustnych oraz systemów cyfrowych, co pozwala na zmniejszenie dawki promieniowania jonizuja˛cego w trakcie badania. W ostatnich latach
w Zakładzie Radiologii Stomatologicznej i Szcze˛kowoTwarzowej IS AM bada sie˛ około 16 tysie˛cy osób rocznie.
Wyniki badań naukowych sa˛ publikowane i prezentowane
na kongresach, zjazdach, konferencjach i sympozjach w kraju i za granica˛.
W 2004 roku Zakład Radiologii Stomatologicznej i
Szcze˛kowo-Twarzowej IS AM w Warszawie przygotowuje
sie˛ do zmian w programie nauczania na studiach stomatologicznych zwia˛zanych z przysta˛pieniem Polski do Unii Europejskiej i zmian systemowych w ochronie zdrowia.
21 maja 2004 r. odbyła sie˛ w Warszawie mie˛dzynarodowa konferencja
z okazji 30-lecia współpracy mie˛dzy Akademia˛ Medyczna˛ w Warszawie a Uniwersytetem w Lund i Malmö.
Na dalszych stronach niniejszego opracowania publikujemy streszczenia wszystkich prac naukowych przedstawionych podczas specjalnie
zorganizowanej z tej okazji sesji plakatowej pt.:
„Poste˛py w diagnostyce, zapobieganiu i leczeniu zaburzeń zespołu
twarzowo-czaszkowego.”
16
POSTER SESSION
Developments in the diagnosis, prevention and
treatment of disorders of the craniofacial complex
(Poste˛py w diagnostyce, zapobieganiu i leczeniu zaburzeń
zespołu czaszkowo-twarzowego)
CARIOLOGY
1. The level of cariogenic bacteria versus oral hygiene in children with and without palatal cleft treated by removable
appliances.
Antoszewska J., Matthews – Brzozowska T.
Wroclaw Medical Univ, Univ of Medical Sciences, Poznań, Poland
Background. Orthodontic appliances can worsen – usually temporarily – patients dental and gingival status since
thereby dental plaque accumulation is enhanced. Aim. The
purpose of this study was to evaluate oral hygiene and cariogenic bacterial levels of patients treated by means of removable orthodontic appliances. Material and methods. The
research was carried out in two groups – 100 people: patients
with (A) and without (B) palatal cleft. To evaluate oral
hygiene PLI was calculated – the index with possible values
within the range 0-3, according to Löe and Silness. Detection
of Lactobacillus (LB) and Streptococcus mutans (SM) –
bacteria at increased levels (≥ 105) in relation to caries – was
performed using the CRT-bacteria salivary test.
Results. Oral hygiene was insufficient – PLI values higher than 1,5 appeared in both groups, although dental plaque
retention was relatively stronger in clefted patients (PLI
value was 3 in 6 % of the A group). Statistic analyses, such
as chi-square tests (Pearson, NW and Yates) revealed correlation between high levels of bacteria responsible for caries
initiation and development and active orthodontic treatment
of none-clefted patients; the same was true in clefted patients, but only regarding LB. SM level was below 105 in
70% of the A group, despite the strong dental plaque accumulation.
Conclusion. This research also allows to conclude that in
clefted patients oral microbiological status is different compared to none-clefted. In spite of relatively low SM levels in
clefted children there is no doubt that careful monitoring of
oral hygiene during orthodontic treatment by removable appliances must not be neglected.
2. Streptococcus and Lactobacillus counts in carious lesions before and after cavity preparation using the chemo-mechanical Carisolv method.
Marczuk – Kolada G.
Department of Pedodontics, Medical University of Białystok
The chemo-mechanical treatment of caries is a method of
minimal dental intervention. It involves cavity preparation
using hand instruments and a carious dentine softening
agent.
Aim of the study. Determination of the counts of streptococci and lactobacilli cultured from dentine samples collected from carious lesions before and after chemo-mechanical
cavity preparation.
Material and methods. The study was carried out on 20
primary caries lesions in deciduous molars of children aged
6-10 years. The examinations were conducted by one dentist
in a separate surgery and using sterile equipment. Access to
each cavity was gained with a small spherical diamond in
a high speed hand piece. Samples for analysis were collected
twice with a sterile number 16 bur. The first dentine sample
(sample A) was obtained from the dentine-enamel junction
just after cavity opening. Then, carious cavities were prepared using hand instruments and Carisolve gel until hard
dentine was reached. The cavities were rinsed with saline
and dried. Following complete cavity preparation the second
dentine sample (sample B) was collected from the cavity
bottom. Immediately after collection, the samples were placed in 1 ml thioglycolinic broth with resuarine (Bio Merieux)
and transported to the microbiological laboratory. The samples
were shaken 2 x 15s in a Vortex apparatus, decimally diluted in
the broth and the 0.1 ml dilutions were plated onto three media:
supplemented with blood (Columbia agar + 5% sheep blood) –
Bio Merieux, Rogosa agar (Oxoid) and Mitis salivarius agar
17
Poster session
(Difco). The plates were incubated anaerobically at 37oC for
7 days and then the obtained colonies were counted. The results
were expressed as log10(CFU + 1) per sample; the parametric
t-Student test was used for statistical analysis.
Results. The analysis of the total count of bacteria isolated from samples A and B revealed a decrease after cavity
preparation (1.1E+03, 0.4E+01, respectively). Following
chemo-mechanical cavity preparation, lactobacilli were isolated from four samples, with a mean bacterial growth incre-
ase of 3.63E+02 in sample A and 0.3E+01 in sample B.
Streptococci were cultured from 3 samples, with a mean
increase of 1.8E+02 for sample A and 0.2E+01 for sample B.
Statistical analysis showed that all the differences were statistically significant at p<0.00001.
Conclusions. The results of the study allow the assumption that chemo-mechanical cavity preparation using Carisolv gel significantly reduces the number of streptococci and
lactobacilli in carious lesions.
3. Streptococcus Sobrinus, Streptococcus Mutans and dental caries in Polish schoolchildren.
Strużycka I 1, Hryniewicz W.2, Wierzbicka M.1, Skoczyńska A2., Walory J.2
1
Department of Conservative Dentistry, The Medical University, Warsaw, Poland
2
National Institute of Public Health, Warsaw, Poland
Introduction. The presence and the number of Streptococcus mutans in the oral cavity constitute a good laboratory
indication of the cariogenic process, although its nature is
much more complex. The most common cariogenic bacteria
associated with human dental caries are Streptococcus mutans and Streptococcus sobrinus. There are no studies that
show the prevalence of Streptococcus sobrinus in the Polish
population.
Aim. The aim of the study was to determine the prevalence of Streptococcus mutans and Streptococcus sobrinus in
Polish schoolchildren and their relation to dental caries.
Material and methods. Twelve– year– old children
(n=495) were randomly selected from 13 primary schools in
areas chosen to represent different socio-economical conditions. Dental caries was diagnosed according to WHO criteria. The mutans streptococci were obtained from stimulated
saliva samples. Salivary Streptococcus mutans counts were
determined by the Dentocult SM Strip Mutans Test (Orion
Diagnostica, Finland). PCR reactions with two sets of oligonucleotide primers specific for the glucosylotransferase genes, were run to confirm the presence of S. mutans and S.
sobrinus in material growing on the Dentocult SM, acc.Oho
et al. (Oral Microbiol. Immunol., 2000, 15, 258-62).
Results. Out of 495 samples tested, mutans streptococci
were found in 457 (92,1%) cases. Streptococcus mutans was
detected in 321 (64,7%), whereas Streptococcus sobrinus in
12 (2,4%) samples. Both species were detected in 124 (25%)
subjects. Clinical examination showed a high caries prevalence in the examined population.(DMFT=5.03.82, DMFS=
7.556.67).
Conclusions. Higher levels of caries indicators were observed in children in whom both bacteria species were detected, in
comparison to children with only Streptococcus mutans. Moreover, high and very high levels of Streptococcus mutans
were found in the stimulated saliva of children having also
Streptococcus mutans and/or Streptococcus sobrinus.
4. An analysis of consumption of cariogenic and non-cariogenic products sold in shops in primary, grammar and
secondary schools.
Łukasiewicz D., Bachanek T.
Department of Conservative Dentistry, Skubiszewski Medical University of Lublin, Poland,
e-mail: [email protected]
Introduction. Establishing healthy eating habits in childhood and adolescence is essential to young peoples future
dental and general health. In Poland, however, an increased
consumption of sweets, potato crisps and soft drinks has
been observed over the past decades.
Objective. The objective was to determine the range of
food products available at shops in primary schools, grammar-schools and a secondary school and to analyse the percentages of sales of these products in the light of their cariogenic or non-cariogenic properties so as to reflect the food
preferences in children and adolescents.
18
Materials and Methods. The range of food products in
shops of two primary schools (992 pupils), two grammarschools (949 pupils) and one secondary school (936 pupils)
in the city of Lublin (Poland) was recorded. The shopkeepers
were asked to estimate percentages of food product sales
according to the following groups: beverages, snacks, sweets
and chewing gum. The distribution of particular groups and
the products within the groups is presented in pie charts.
Results. The most frequently sold products in school
shops are: potato crisps, in primary schools (60% in the
group of snacks), potato crisps and buns, in grammar-scho-
Poster session
ols (each of them 45% in the group of snacks) and buns, in
the secondary school (75% in the group of snacks). In terms
of sales, the consumption of sweets in comparison with other
groups of products tends to decline with age (30% in primary
schools, 20% in grammar-schools and 10% in the secondary
school).
Conclusions. Children and adolescents require more education regarding proper eating and drinking habits to prevent
dental and oral diseases. More attention should be paid to the
assortment of food products in school shops so as to promote
less cariogenic food choices and proper dietary patterns
among children and adolescents.
5. Using the Clinical Examination of Children and Mothers to Assess The Risk of Dental Caries in Children up to Three
Years of Age.
Stanczak – Sionek D., Szpringer – Nodzak M., Remiszewski A.
Pediatric Dentistry Department, Medical University of Warsaw
Objectives. This presentation shows part of a project
aiming at an elaboration of a caries risk test for early childhood caries using questionnaires, clinical and bacteriological
examinations.
The aim. of the presented part was to assess the usefulness
of clinical examination of children and their mothers in determining the risk of caries in a group of 1-year-old children.
Materials and Methods. The research material included
122 1-year-old children of both sexes (58 girls and 64 boys)
and their mothers, who regularly visited a medical center in
one of the districts of Warsaw for prophylactic vaccination.
Preliminary clinical examination of the children and their
mothers was performed using a dental mirror and probe.
Clinical examination of the children consisted of the determination of the total dmf-s value (number of surfaces decayed, missing and filled) and the number of surfaces with
incipient caries.
Clinical examination of the mothers consisted of the determination of the total DMF-s value (analogically to the childrens
examination) and D-s value (number of surfaces with caries).
The childrens state of dentition was controlled every 6
months, up to the age of 3.
Correlations between the outcomes of the preliminary
clinical examinations of the children and their mothers and
the state of dentition of the children up to their 3rd year were
investigated.
Results and Conclusions. A highly significant correlation (p<0.001) was found between the dmf-s values of the
1-year-old children and their caries increment in the consecutive 2 years of observation.
The number of surfaces with incipient caries at the preliminary examination of the children was also significantly
(p=0.001) correlated with the caries increment but the values
of the correlation coefficient index were lower than for the
correlation between dmf-s values and caries increment.
Dmf-s values of the 1-year-old children can successfully
be used to test the risk of developing caries.
Counting tooth surfaces with incipient caries separately
seemed to not be reasonable in very young children.
There was a correlation (p<0.05) between D-s values of
the mothers at baseline examination and children’s caries
increment after 6 and 12 months. From the outcomes of
mother’s clinical examinations only the number of non-treated caries lesions, as a factor connected with bacterial transmission, can be used as an additional predictor of caries risk
in very young children.
6. Sealing primary molar teeth in 3-year old children as a method of caries prevention.
Remiszewski A., Wal A., Sobiech P.
Pediatric Dentistry Dep., Medical University of Warsaw, Poland.
The aim of this study was the assessment of the preventive seal method in primary molar teeth for the youngest
children. 78 three-year-old children from Warsaw kindergartens were examined. 71 children were qualified for fissure
sealing, but the procedure was performed in 28 cases. We
sealed the fissures in 108 teeth using Helioseal F material
(Vivadent). Check-up examination was performed after 1, 3,
6 and 12 months. We controlled the retention of material in
the fissures. We registered the partial and total loss of sealants in mesial and distal points of fissures of scaled teeth.
After one month the teeth were controlled and 79% of chil-
dren had sealant remaining, where as after 3 months their
number reduced to 65%, after 6 months to 53% and after 12
months to 47%. In this examination a relationship between
OHI-index and sealant prevalence was observed, and a relationship between sealant prevalence and high DMF index
was confirmed. There was a relatively high susceptibility to
caries in children who had a high value of DMF, which is
mostly caused by weak mineralization of hard tissues. Probably due to this fact there is better conditioning with etchant
when compared to children with low DMF index values.
19
Poster session
7. Safety of oral fluoride prophylaxis in the light of experimental research
Da˛browska E., Balunowska M., Stokowska W., Letko R.
Department of Conservative Dentistry of Medical University Białystok, Poland
Due to its efficacy in caries prevention and easy application, sodium fluoride (NaF) is still used in dentistry in the
form of fluoridated drinking water, fluoride tablets, fluoridated salt or milk. Orally administered sodium fluoride affects
the environment of the mouth and the whole organism of the
offspring in the subsequent metabolic stages. The organ that
immediately reacts to external compounds is the liver, the
site of most detoxification processes. Resultant pathomorphologic changes appear in response to the orally administered preparation. The aim of the experiment was to determine
the effect of fluoride on the changes in the oral cavity and
liver of the offspring, in relation to dose and time of administration at the following age intervals:
1. 4-day-old offspring – the effect of fluoride from conception, throughout the fetal period, mainly via the placenta,
2. 14-day-old offspring – receiving fluoride with mothers
milk only,
3. 30-day-old offspring – receiving fluoride with mothers
milk and in fluoridated drinking water
4. 60– and 90-day-old offspring – drinking fluoridated
water by themselves from 30 day of life,
5. 120-day-old offspring – i.e. 30 days after fluoride withdrawal.
To accomplish the aims of the study, 90 rats obtained
from 30 mothers were used. At the initial stage, 30 female
Wistar rats, 180-200 g body weight, were divided into 3
groups: one control and two experimental (I, II). The experimental females received fluoride in aqueous solutions of
sodium fluoride (NaF) at a concentration of 10.6 mg
NaF/dmł (group I) and 32.0 mg NaF/dmł (group II) before
conception, in pregnancy and during lactation. After delacta-
tion young rats received NaF in the above concentrations up
to the age of 90 days. Between 90 and 120 day of life all
animals were given tap water to drink. The experiment was
terminated on the 120 day of the animals life.
The following parameters were assayed in the biological
material collected from the dissected animals on days 4, 14,
30, 60, 90 and 120 of rats life: – dental fluoride content –
time of incisor enamel demineralization – saliva pH – fluoride in the alimentary contents of young offspring – fluoride
concentration in blood – fluoride content in the liver.
In order to evaluate the effect of fluoride on metabolic
processes, histoenzymatic reaction was determined for the
activity of enzymes: lactate dehydrogenase (LDH) and acid
phoshatase (APh), and glycogen content in hepatic cells(
PAS reaction).
The following conclusions have been drawn:
1. Long-term application of sodium fluoride in low concentrations in combination with calcium prevents tooth
demineralization.
2. Mothers milk intake protects dental hard tissues in
offspring against toxic action of fluoride.
3. Increased dental fluoride content does not condition the
increase in enamel acid-resistance.
4. The rat placenta is not a sufficient barrier to fluoride
ions and their effect on the offspring organs.
5. Fluoride absorbed from mothers milk should be taken
into consideration when a safe prophylactic dose of sodium
fluoride is determined.
6. Morphological changes observed in the rat liver are
mostly adaptive and subside following withdrawal of excessive fluoride doses.
8. The influence of early caries lesion acid-etching on the remineralization process – in vitro study.
Piesiak – Pańczyszyn D., Kaczmarek U., Woźniak J.
Department of Conservative and Pediatric Dentistry, Medical University of Wroclaw, Poland
Purpose. The evaluation of the influence of 37% phosphoric acid – etching of artificial early caries lesions on the
remineralization process using toothpaste with fluoride, phosphates and hydroxyapatite.
Material and methods. The material of the study consisted of 24 samples with artificial early caries on the smooth
surfaces of extracted human teeth. The teeth were immersed
in the demineralizing solution at 4.4 pH to produce lesions of
about 0.150 ± 0.03 mm depth. The material was divided into
four groups A, B, C and D, each group consisted of 6 samples. Groups A and B were treated with fluoride toothpaste for
3 minutes twice a day, groups C and D – with toothpaste
20
containing hydroxyapatite and phosphates for 3 minutes twice a day. Additionally, in groups B and D brushing was preceeded by 30 second etching with 37% phosphoric acid. Evaluation
of histological changes in specimens has been done after 4 and 10
weeks of the experiment with a polarized light microscope
(Olympus BX 50) connected with a computer image analysis
system – Multiscan program (08.98 version)
Results. The following results were obtained: in group A
– the change of caries lesion depth between the fourth and
tenth week of the study was around 8%, i.e. it decreased on
average 0.0116 mm ± 0.002, in group B – 13% (0.0166 mm
± 0.007), in group C – 13% (0.0188 mm ± 0.006) and in
Poster session
group d – 22% (0.0326mm ± 0.008). In group D the depth of
early caries lesion decreased nearly of 1/4 in 6 weeks, which
in comparison with the remaining groups is a satisfied result.
Conclusion. The data obtained may suggest that better
therapeutic results were achieved in the group in which
brushing of early caries lesion with toothpaste containing
phosphates and hydroxyapatite was preceeded by the etching
with 37% phosphoric acid.
9. Efficacy of „Duraphat” fluoride varnish in caries prophylaxis in children with deciduous teeth – an 18-month study
Sobiech I.1, Szpringer – Nodzak M.1, Pelc M.2, Remiszewski A.1
Paediatric Dentistry, Department of Dentistry, Warsaw Medical Uniwersity Division Supervisor: dr n. med. Aleksander
Remiszewski
2
Propaedeutic and Prophylactic Department of Dentistry, Warsaw Medical University
Division Supervisor: dr hab. n. med. Leopold Wagner
1
The aim of this study was to show the evaluation of a
preventive effect of „Duraphat” fluoride varnish on dentition
in children aged between 3 and 4.
The research focused on a population of 240 children from
Warsaw nurseries – 180 children accounted for an examined
(index) population and 60 children accounted for a control
population. A check-up and sanitation of dentition were performed. The population was divided into 3 groups: A, B, C –
depending on dmf-index. In case of children from the examined
population, „Duraphat” varnish was used in every group but
with different frequency: every 2 months for model I, every 3
months for model II, and every 6 months for model III. In the
control population – the examination of childrens dentition
was carried out every 6 months and the teeth were mechanically cleaned of deposits as in the control group .
Initial results of the examinations, after the 18-month
period, showed a lower increase of average number of dmft
and dmfs-index in the examined group regardless of Duraphat‘s mode of application, than in the control group. Moreover, it was observed that if „Duraphat” varnish was used
more frequently during the year the increase of caries was
lower in the examined population.
10. The evaluation of efficacy of two varnishes Cervitec and Fluor Protector in prophylaxis of pit and fissures surfaces
of first molar teeth.
Rodakowska E., Klimiuk A., Waszkiel D.
Department of Pedodontics Dentistry Medical University in Bialystok
Department of Restorative Dentistry Medical University in Bialystok
The purpose of this study was to evaluate the efficacy of
two varnishes: Cervitec and Fluor Protector in prophylaxis
of pit and fissure caries in first molars in 6 year old children.
Methods. The treatment was carried out in 60 teeth of 30
children six years old. All the children had tooth brushing
under a dentist’s control with Elmex gel once a week. Then
the teeth were carefully brushed with cleansing paste and
were monitored by Diagnodent laser fluorescence system
and then appropriate preventive therapy was selected according to KAVO indication for:
– 0-15– reversible lesions in enamel; two varnishes were
applied Cervitec on one tooth, and Fluor Protector on
another every two weeks 4 times during the six month
study,
– 15-30– irreversible lesions in enamel; indication for
preventive therapy or minimally invasive therapy.
The study lasted 6 months. The occlusal surfaces of first
molars with a Diagnodent value of up to 15 were qualified.
Every two weeks Fluor Protector and Cervitec was applied 4
times during the examination. Clinical evaluation was carried out at 3 and 6 months.
Results. In most cases both varnishes Fluor Protector and
Cervitec protected occlusal surfaces of first molars against caries. The 6 month examination showed that in only two teeth
varnished with Fluor Protector and two varnished with Cervitec
Diagnodent value exceeded 15 and oscillated between 15 and
30 and that teeth were qualified for fissure sealant.
Conclusion Varnish application to occlusal surfaces in
first molars may become an important element in caries
prophylaxis.
11. Diagnostic accuracy of chosen methods of early caries lesion diagnosis on molar occlusal surfaces.
Woźniak J., Kaczmarek U., Łoś P., Piesiak D., Czajczyńska A.
Department of Conservative and Pediatric Dentistry, Medical University of Wroclaw, Poland
According to the current knowledge early carious lesions
should be treated in non-invasive ways which promote their
21
Poster session
remineralisation. There is no ideal diagnostic method, i.e.
method characterized by 100% sensitivity, 100% specificity,
100% intra-examiner reproducibility and 100% inter-examiner reproducibility up till now, so new methods are searched
for and developed.
Purpose. Evaluation of sensitivity and specificity of visual examination, conventional x-ray, digital x-ray, diagnostic
laser and impedance spectroscopy verified by histological
examination.
Material and Methods. The study was conducted on
occlusal surfaces of 48 non filled third molars extracted for
orthodontic or periodontal reasons,. The teeth were examined by visual examination (without magnification), conventional x-ray, digital x-ray (Digora System), diagnostic laser
(Diagnodent) and ac impedance spectroscopy in a two-electrode system in the range of frequency from 100 to 400 KHz
using an Autolab 30 Analyser linked to a PC. The data
obtained were analysed using the software Zplot and Zview.
Agreement between two independent examiners (inter-exa-
miners) – e˛ value was counted for every method used and it
ranged from 0.72 to 1 depending on the applied method.
After all measurements were completed 40 m thick tooth
sections were examined using a light microscope (Olimpus
BX 50). Demineralisation depth in enamel and dentin was
evaluated.
The data were subjected to statistical analysis using suitable tests.
Results. Sensitivity (x) and specificity (y) of examined
methods referring to early caries lesions were as follows, for:
visual examination x=50.0%, y=88.2%; laser device
x=87.5%, y=93.5%; conventional x-ray x=0%, y=100%; digital x-ray x=12.5%, y=100%; and for most important parameter of impedance spectroscopy x=100%, y=100%.
Conclusions. Basing on the results obtained it can be
concluded that the parameter ϕ (phase angle) of the impedance spectroscopy method has the best diagnostic accuracy
referring to early caries lesions on occusal surfaces of molars.
ORAL EPIDEMIOLOGY AND BEHAVIOURAL SCIENCES
12. Caries risk factors in 3 year old children living in the Podlasie region.
Bagińska J., Stokowska W.
Department of Conservative Dentistry and Periodontal Diseases Medical Academy in Białystok
The aim of this study was to find which factors had the
strongest influence on caries severity in toddlers living in the
north-eastern part of Poland.
255 children, both sexes, aged from 36 to 48 months were
examined to determine their dental status. They were divided
into three groups depending on dmft: with dmft = 0, dmft =
1-3 and dmft ≥ 4. Parent or care-giver were asked to fill in
two questionnaires about child’s diet and dental habits at
present and during the first two years of life. Data were
analyzed statistically with chi-square test.
There were statistically significant relationships between
caries intensity in the examined population and age to which
children were fed by bottle as well as between caries intensity and age at which parents started to clean the child’s
mouth. At the age of three years the most important caries
risk factor was found to be frequency of eating cariogenic
food.
The conclusion is that dental status in toddlers living in
the Podlasie region depends first of all on diet and hygiene
habits during the first two years of life.
13. Caries intensity in deciduous teeth and condition of the sixth teeth in 7-year-old children from Białystok.
Szafrańska – Perkowska B., Waszkiel D.
The aim of the study was to evaluate the condition of the
deciduous teeth and the first permanent molars in 7-year-old
children. A correlation was also determined between caries
intensity in the deciduous molars and in the sixth teeth.
The study material consisted of 249 children (117 girls
and 132 boys), aged 7 years, from randomly chosen primary
schools in Białystok. In all the children, dental examination
of the oral cavity was performed, in artificial light, using a
mirror and probe. Carious defects, fillings, sealants and teeth
extracted due to caries were evaluated. The teeth which
22
reached the time of physiological exchange were excluded
from evaluation. The data were recorded on specially prepared examination charts. Statistical analysis was based on
u-test for two frequencies and Chi independence test, with
the level of significance for p<0.05.
The analysis revealed a high incidence (95.98%) and
intensity (puw=7.5) of caries in the deciduous teeth. The
intensity of caries affecting the sixth teeth, expressed by the
mean PUW value, was 0.68 in girls and 0.44 in boys. A
statistically significant correlation (p<0.0001) was found be-
Poster session
tween the intensity of the carious process in the deciduous
molars and in the sixth teeth.
The following conclusions can be drawn:
1. A high incidence of caries in the deciduous and permanent teeth indicate the necessity of more intense preventive
and therapeutic actions in kindergarten children,
2. The carious process in the deciduous molars is a threat
to the first permanent molar,
3. Intensification of carious disease affecting the deciduous teeth obliges to provide wide-ranging preventive care of
the sixth teeth.
14. Oral health in the year 2003 of 18 year old adolescents from the Pomorskie district.
Emerich – Poplatek K., Adamowicz – Klepalska B.
Department of Paediatric Dentistry, Medical University of Gdansk, Poland
The dental examination carried out in the Pomorskie district in the year 2003 allowed for real evaluation of the oral
health status and the availability of dental healthcare to adolescents under the economic changes and new healthcare
insurance system, existing since 1999. The study consisted
of 180 people ( 90 boys, 90 girls) at the age of 18, split
equally ( 60 people) from city, town and village. The dental
examination was carried out according to WHO guidelines,
recording DMFT, DMFT for the first permanent molars and
CPITN indexes.
The results showed that the DMFT index was the lowest
among the population from the city (DMFT=5,65) and was
the biggest in the town population (DMFT=7,73). Among
the 18-year-olds the main component of DMFT was F, although in the village population, decayed and filled teeth were
almost at the same level (3,07 and 3,22 respectively). The
mean value of DMFT for the first permanent molars was
high (2,94) among the examined population. The periodontal
status was as follows: 35% with a healthy periodontium in
the city compared to 27% with a healthy periodntium in the
whole district. Dental calculus was observed in 38% of adolescents from the Pomorskie district, compared to 26,7% in
the city and 45% in the town.
The oral health status of the 18 year-olds indicates the need
to intensify prophylaxis and the implementation of educational
programs, which should allow for a decrease of oral disease.
15. Comparison of Caries Intensivity in 18-Year-Old Adolescents from the Gdansk Region in Year 1995 and 2003.
Emerich – Poplatek K., Adamowicz – Klepalska B.
Department of Paediatric Dentistry, Medical University of Gdansk, Poland
The aim of the study was to asses and compare the
prevalence of dental caries and treatment needs of 18-yearolds young people from different environment areas of the
Gdansk region in Northern Poland. The need for information
on oral health status has increased, because of the health care
system transformation in Poland.
The study was carried out in 1995 and 2003 by the same
calibrated dental examiner (K.E-P) after a pre-survey training. The samples in the first study in 1995 were selected
using a three-stage random sampling procedure. The second
study in 2003 was carried out in the same living areas and at
the same schools. Data were collected according to the
WHO oral health assessment form. The sample consisted of
184 individuals in 1995 and 180 in 2003 from rural, small
town and big city areas.
The overall percentage of caries free adolescents was very
low and did not change significantly (3,26% in 1995 and
6,11% in 2003). The results showed a decrease in mean
DMFT score from 7,74 to 6,67 between 1995 and 2003.
Living area differences in caries prevalence were clearly
observed. The lowest mean DMFT score was observed in the
big city, 6,74 in 1995 and 5,65 in 2003 and the highest in the
small town, 8,27 in 1995 and 7,73 in 2003. In both years the
FT-component was low in samples from rural areas. The
DT-component was significantly higher in rural areas and
the FT-component in the big city.
Favorable change were observed in caries prevalence of
18-year-olds, but during the 8 year period the change of
mean DMFT scores should have been more significant. There is no hope for Polish children from the Gdansk region to
attain the Global Goals for Oral Health proposed by the
WHO for the year 2010.
16. Dental care of children in Poland. The system-reforming proposals.
Szatko F.1, Wierzbicka M.2, Jerominko A.1
1
Hygiene and Health Promotion Unit – Department of Hygiene and Epidemiology, Medical University of Lodz
2
Department of Conservative Dentistry, Medical University of Warsaw
23
Poster session
Objectives. To bring closer an answer to the question:
Which organizational activities should be introduced into the
Polish standard of dental care to decrease dental caries in
children?
Design. The results of the socio-epidemiologic studies
conducted within the Nation-wide Monitoring of Oral Health Status and its Conditioning indicate that oral health
status in a group of pre-school children stays at a poor level
(DMF=5,4), and in a group of 12-year olds DMF=3,9. The
sociological part of the monitoring reveals that: in comparison with 1995 the dental preventive programmes were reduced in about 60-90%, at the national and regional level there
is no person (institution) responsible for initiating, leading,
controlling and gathering funds for organized dental programmes; during the financial crisis of the public health care
sector the importance of stomatology has been systematically reduced.
Subjects. In a questionnaire interview the 16 purposely
selected consultants-experts (one from each voivodeship)
expressed their opinions on several proposals concerning the
improvement of the present dental care system.
Results and discussion. 12 consultants-experts fully, and
3 of them partially identify with the suggestion of separation
from the total sum of health insurance the sum that should be
assigned exclusively for the public dental care sector. That
should enable, even within the very modest funds (20
PLN/person/year), to schedule any preventive programme.
The consultants have similarly supported the need for additional dental care insurance, as well as the guarantee for
every child of the so-called "preventive set of dental care
services" (yearly oral examination together with the resultant information for parents, theoretical and practical tuition
of proper tooth cleaning with brush and dental floss, individual or group supplementation with fluoride components,
dental sealants).
Almost all consultants (14) identify with the proposal of
an obligatory educational programme in forms I-III of elementary schools and all 16 with the periodical educational
mass-media programmes.
13 consultants fully, and 3 of them partially support the
proposal of fluoridation of table salt, bakery goods and
mineral drinking waters. All the experts agree that dentistry
should not be governed exclusively by the free market economy. Especially considered has been the necessity of creating
on the national level the function (institution) of the National
Dental Care Supervisor, as well as on the voivodeship level
– of a person (an institution) responsible for initiating, conducting and surveying dental preventive programmes. All
the above proposals closely correlate with the concept of
public dentistry – typical for advanced countries.
17. The state of oral health and the dental treatment needs in a studied population with mucoviscidosis in the Podlasie
province.
Błahuszewska K., Da˛browska E., Minarowska A., Letko R., Stokowska W.
Department of Conservative Stomatology and Department of Paediatrics Medical University Białystok Poland
Mucoviscidosis (cystose fibrosis, ang. cystic fibrosis –
CF) is one of the most often occurring genetic diseases in the
world. It occurs in the white population and is caused by the
mutation of an individual gene, is inherited in an autosomal
recessive manner, is incurable, leads to shortening of the
patient‘s life. The aim of the study was to investigate the
state of the dentition in patients with muscoviscidosis from
the Podlasie region.
Material and method the investigation was carried out
on 23 people aged 2,5 to 24 years chosen from mucoviscidosis treated patients at Poradnia Mukowiscydozy Publicznego
Dziecie˛cego Szpitala Klinicznego in Białystok.
Patients were divided into three groups depending on
dentition (primary, mixed, permanent). The first group consisted of 4 persons, second – 9 persons, third group -10
persons. A routine dental examination was conducted using
a probe and mirror in artificial light. Methodology met the
requirements of World Health Organization guidelines.
Evaluated were:
– the state of the dentition – the frequency of caries (the
24
percentage with caries) as well as intensity of caries
(average puw / PUW)
– the effectiveness of treatment services – with the help
of the caries treatment index
– condition of the occlusion – the occurrence of occlusion defects as well as orthodontic treatment
– the oral hygiene – based on plaque index (after previous staining with Red Cote tablets)
– the presence of enamel opacities and hypoplasia
The information was recorded in a specially – designed
chart. The results of the state of dentition were shown tables.
The questionnaire, prepared specially for this study was used
to investigate behavior. The questionnaire questions concerned oral hygiene, tooth-decay prophylaxis, nutritional habits, frequency of visits to a dentist, the general state of
health, type of medicines used. Inquiry was addressed to
parents who individually filled the questionnaire outlining
the chosen answers.
Conclusions. With regard to severity of disease, the impossibility of cessation of administration of medicines, usage
Poster session
by patients of a highly energetic carbohydrate-rich diet, there
is a serious risk oral disease. Therefore patients should be
covered by specialist, complex dental care.
18. Dental caries in schoolchildren in Poland.
Wierzbicka M., Szatko F., Dybiżbańska E., Ganowicz M., Zawadziński M., Pierzynowska E.
A programme of systematic monitoring of oral health was
introduced in Poland in 1997. Since then, a survey has been
performed each year to cover selected age groups of the
population.
Material and methods. In 2003, a random sample of 7–
and 12-year-olds were examined. In each district, children
attending at least 8 schools were surveyed by 2 trained and
calibrated dentists. Dental caries was diagnosed acc. WHO
criteria with the help of a WHO probe. Before the clinical
examination, children completed a questionnaire concerning
their participation in fluoride mouth rinsing or tooth brushing programmes at school, or in other forms of caries prevention performed at home or under the supervision of dental or other personnel. Oral health attitudes and behaviour
were also registered. The questionnaire was completed in the
classroom in the presence of a teacher who, if necessary,
helped children with interpretation of the questions. Results:
The examined sample included 2766 7-year-olds (1424 boys, 1342 girls) living in large towns (1480) and small towns
and villages (1286), and 3338 12-year-olds (1688 boys, 1650
girls; 1720 inhabitants of large towns, 1618 inhabitants of
small towns and villages). 9.1% of examined 7-year-olds and
12.9% of 12-year-olds were caries free. Mean DMFT was
0.82 and 3.9 in the examined age groups, respectively. 72%
of the examined 12-year-olds had at least one tooth extracted
due to caries. Only 16.6% of 7-year-olds and 20.2% of
12-year-olds had participated in a preventive programme at
the school several times during the past year and as many as
64.8% of 12-year-olds brushed their teeth at least twice a
day. An analysis of the results of earlier epidemiological
studies showed a decrease in caries over the last 15 years.
However, in the last year, the mean DMFT value increased
in both age groups by around 0.1.
Conclusions. An accessible programme of exposure of
school children to an optimal level of fluoride should be
implemented in all districts in Poland. A policy of making
fluoride toothpaste accessible to all children should be developed and school-based oral health education should be extended. Parents and groups should also be covered by oral
health education programmes developed locally.
19. Periodontal Health of 7 Year Old and 12 Year Old Children from Poland in 2003.
Drabarczyk – Nasińska M., Strużycka I., Słotwińska S. M., Dybiżbańska E., Zawadziński M., Pierzynowska E., Wierzbicka M.
Department of Conservative Dentistry, Medical University of Warsaw, Poland
For public health purposes there is value in determining
the preventive and treatment needs in a population. The CPI
has been recommended as a practical screening process for
evaluating periodontal treatment needs.
The aim of this study was to compare the periodontal
conditions in 7 and 12 year old children from Poland in 2003,
and to assess the needs of periodontal care in these groups.
The study was conducted by trained examiners using CPI
and WHO diagnostic criteria. The study population comprised of 2401 children aged 7 years, and 3338 children aged 12
years including urban and rural populations.
The results show that 61.8 per cent of children aged 12
years had a healthy periodontium (CPI=0), almost 30.5 per
cent had bleeding, and over 7 per cent of children had calculus. Healthy periodontal tissues were found more often in
children from urban areas (66.3%) than from rural areas
(57.1%). 64.6 per cent of girls and 59.1 per cent of boys had
a CPI value of 0.
Among 7 year old children 72.2 per cent had healthy
periodontal tissues, 24.6 per cent had gingivitis which manifest with plaque and bleeding, only 3.2 per cent had calculus.
74.6 per cent of children from urban areas and 69.5 per cent
from rural areas had a healthy periodontium. A similar proportion of girls and boys had a healthy periodontium – 72%.
Conclusions: The data suggest a need for oral hygiene
instruction and motivation in 38.2% of 12 year old children
and 27.8% of 7 year old children. Some children in both
groups needed scaling: 7% children aged 12 years and 3.2%
children aged 7 years. The presented results show an improvement in childrens periodontal health compared to previous
years and may be useful in the further planning of oral health
education and preventive care for children.
25
Poster session
20. Proposal of a holistic concept of the stomatognathic system.
Panek H.
Department of Prosthodontics, Wrocław Medical University, Wrocław, Poland
Background. The earliest concepts of the stomatognathic
system derived from studies performed by Hanau, Trappozzano and Levin, were concentrated on relationship between
occlusion and temporo-mandibular joints. The later concepts, described by Held, Wigdorowicz-Makowerowa et al.,
Majewski, Fuhr and Solberg as well as by Troest, stressed
the importance of additional elements, such as the periodontium, neuro-muscular system and CNS. In the concept proposed by Panek the environment is included.
Presentation of own concept. In the proposed concept
the stomatognathic system is presented as a pyramid with
four apices imaging CNS and three „joints” (TMJ, periodontium joint, occlusal joint), and the edges imaging the neuromuscular system. The pyramid simply reveals that harmony
in the stomatognathic system is dependent on interaction of
particular elements of the system. The pyramid is placed
inside a sphere imaging a human body, signifying the dependence of the stomatognathic system on the general state
of health. Moreover, the sphere representing the human body
is placed inside a greater sphere imaging environment. The
environment may disturb the stomatognathic system directly
or indirectly or it may even effect the human genom by
influencing the growth process and structure of the stomatognathic system in the period of organogenesis.
In such a holistic presentation the stomatognathic system
may be considered as a morphological-functional unit involved
in dynamic transformation continued during the whole period
of life. In such circumstances a „norm” of stomatognathic
system in young persons with uncompleted growth may be
different from that in older subjects, where it may be additionally influenced by various processes connected with ageing and
„wearing” of the particular elements of the system.
21. Parents anxiety about dental treatment of their up-to-three-year-old children.
Wilk – Sieczak B., Gmyrek – Marciniak A.
Department of Conservative and Pediatric Dentistry, Medical University, Wrocław
The difficulty of treating up-to-three-year-old children is
not only associated with the child’s psychological development or the lack of methods for shaping behaviour of such
young patients, but also with anxieties of parents, who unconsciously reveal their fears.
Objective. This study was aimed at finding the relationship between the child’s behaviour during the dental visit and
his/her closest person’s anxieties.
Material and methods. The material consisted of the
statements expressed by 70 mothers and 70 carers. Before a
visit the participants were asked to fill in the questionnaire
assessing the level of dental anxiety (DAS), and the author’s
own questionnaire comprising of four questions regarding
anxiety about the child before, during and after the dental
visit. Apart from this, behaviour of 70 children during their
first appointment in the dental surgery was analysed. The
results obtained were analysed with Spearman and chi-square tests.
Results. As a rule, the level of the mothers’ (M) and
carers’ (C) declared anxiety about their children in the dental
setting reached an average (M-47.1%, C– 51.4%) or low
(M-42.9%, C-40%) value, whereas the level of dental anxiety, as measured with the DAS scale, was usually high (M47%, C-24.3%) or average (M-35.6%, C-55.7%). Most of
the children had not been prepared for their dental examination (co-operative behaviour was observed in 37.2% of
them, and pre-cooperative in 47.1%). A statistically significant relationship was found between the mothers’ behaviour
of hysterical type and their anxiety before the visit (p=0.02),
during the examination (p=0.02) and, most significantly,
before their children had undergone a dental procedure
(p=0.001).
Conclusion. The parents’ and carers’ anxiety were unconsciously passed on the children during their dental visits
and influenced the children’s behaviour in the dental environment.
22. The Influence of a Family’s Attitudes on Children’s Behaviour During the Adaptation Visit
Wilk – Sieczak B., Gmyrek – Marciniak A.
Department of Conservative and Pediatric Dentistry, Medical University, Wrocław
Children’s behaviour during their first dental appointment
depends on many different factors like the family’s emotional acts and their attitudes towards dental care, the small
26
child’s unpleasant general medical experiences as well as the
lack of the child’s appropriate preparation for such a visit. A
small child’s age, his/her psychological development, and
Poster session
competence of a dentist co-operating with a little patient are
also of great importance.
Objective. The assessment of the influence exerted on
children’s behaviour during their first dental visit by their
families’ attitudes.
Material and method. The subjects were 70 children (35
girls and 35 boys) aged from 8 to 35 months. They were seen
by the same doctor using an adaptation method (the Individualised Gradual Adaptation Method) in the surgery especially developed for this purpose. The visits were aimed at
introducing the children to dental treatment. They were videoed and the child’s behaviour was evaluated according to the
criteria worked out by the author. The children’s co-operative, pre-cooperative behaviour as well as the impediments to
co-operation were analysed. Moreover, the level of dental
anxiety of the mother, and of the person accompanying the
child most often (carer) was measured with the DAS scale,
whereas the level of the child’s confidence in the dentist was
determined with the DBS scale.
Results. The obtained results underwent statistical analysis with the chi-square and Spearman’s test. Most of the
participants came from families with secondary school education (28.6% of the mothers, 30% of the fathers) and higher
education (67.1% of the mothers, 58.6% of the fathers). The
level of the mothers’ anxiety tended to be high (47%) and
average (35.6%), and the guardians’, as a rule, appeared to
be mostly average (55.8%) and high (24.3%). Preparation
for the first visit was not carried out in the case of 21.4% of
the subjects. In the majority of mothers and guardians the
confidence in the dentist was high– 61.4% and 58.6%), respectively or average– 27.2% and 35.8% respectively. Cooperative behaviour making it possible to perform a non-invasive procedure in the course of the first appointment was
observed in 15.7% children, pre-cooperative behaviour in
47.1% of the children, and behaviour which impeded cooperation was revealed in 37.1% of them.
Conclusion. The majority of the mothers and carers revealed dental anxiety at an average and high level, which could
have affected their children’s behaviour during their visits.
The children whose mothers declared little confidence in
dentists acted in an uncooperative way during the visit significantly more often.
PULP BIOLOGY AND ENDODONTICS
23. Root canal obturation method with thermoplastic Thermafil points – in vitro and in vivo study.
Sobczak M.1, Raczyńska M.2, Grzybowska A.1, Jodkowska E.2, Remiszewski A.1
1
2
The aim of this study was to evaluate root canal fillings
with Thermafil points in vitro and in vivo.
In vivo study. 30 single-rooted teeth in 20 children of
both sexes were treated. Canals were prepared according to
the crown-down technique with ProFile instruments and
then obturated with thermoplastic Thermafil points, with
Ah-plus sealer. After the treatment, all teeth were X-rayed
for root canal filling evaluation. The quality of root canal
fillings was evaluated on a 3 degree scale: A– acceptable
obturation, B – overfilling, C– underfilling. Follow up examination after 12 months was conducted.
In vitro study. 10 human single-rooted teeth were prepared according to the crown-down technique with ProFile
instruments, and then obturated with thermoplasticized
Thermafil points using Ah-plus as the sealer. After the treatment all teeth were X-rayed. The depth of penetration of the
dye was evaluated for each root. All teeth were dissected and
observed through SEM Hitachi 3000 for evaluation of the
interface between the obturation and root canal walls.
Results: In vivo obturation was found to be acceptable in
16 teeth(53%), overfilling was observed in 16 teeth(36%),and underfilling in 3 teeth(10%). After 12 months
in clinical and radiological review a positive result of the
treatment was found in 100% of the cases.
In the in vitro study the mean depth of penetration of the
dye was 0,34 mm. SEM observations shows that Ah-plus
sealer has a granular structure. There was correct adaptation
of gutta-percha to the canal walls and the sealer.
24.The temperature changes on the outer surface of roots during filling with a hybrid technique.
Lipski M., Górski M., Woźniak K., Łagocka R., Buczkowska – Radlińska J.
Department of Conservative Dentistry, Pomeranian Medical University, Szczecin, Poland
The purpose of this in vitro study was to measure the
temperature rise on the outer surface of roots during filling
with a hybrid technique. Twelve extracted premolars with
single canals were prepared to an apical size 40 and filled
with a hybrid technique using Engine Plugger (VDW, Germany) size 50 at 10 000 g for 4 s. Temperature changes were
27
Poster session
measured using an infrared camera ThermaCam SC500
(Flir, Sweden). The temperature of certain regions of the
mesial surface was analyzed and the highest temperature
values were recorded. The mean increase of temperature
during the hybrid technique with Engine Plugger was
23.1oC. In conclusion, the hybrid technique generated a relatively high temperature rise that may cause periodontal tissue damage.
This research was supported by the State Committee for
Scientific Research (Grant no. 4PO5E13119).
25. The use of glass fibre pins in the treatment of root fractures of teeth.
Marczuk – Kolada G., Pawińska M., Tokajuk G.
Departament of Pedodontics, Medical University of Białystok
Department of Conservative Dentistry, Medical University of Białystok
Tooth fractures in the middle or coronal third of the root
require stamp splinting by means of endodontic pins. At
present, new pins that can be used for this purpose are
available.
The Fibre-Fill pins consist of glass fibres embedded in an
organic matrix and a gutta percha cone placed in the apical
part of the core. They are cemented using Root Canal Sealant, which unites with dental tissues, thus allowing closure
of the root canal without the use of additional materials or
canal filling methods.
The aim of the study is to present the results of treatment
in three cases of dental root fractures using Fibre-Fill glass
fibre pins.
Case 1. A patient M.S., aged 15, sustained craniofacial
trauma which resulted in a number of lesions in anterior
teeth. The root of tooth 22 was fractured in the coronal third.
The tooth was immobilized with a composite and pulp extirpation was performed under anaesthesia. The canal was filled temporarily with Biopulp and Pulpomoxin. A week later,
root stamps were sutured using a Fibre-Fill pin. Clinical and
radiographic examinations performed 3, 6 and 9 months later
indicated a successful course of therapy.
Case 2. A patient T.L, 13, sustained craniofacial trauma
with concurrent root fracture of tooth 11 in the middle part.
The tooth was immobilized with a Tigerstedt splint, pulp
extirpation was peformed under anaesthesia and the canal
was temporarily filled with Biopulp and Pulpomoxin. A
week later, root stamps were sutured with a Fibre-Fill pin. A
two-month observation suggested a favourable prognosis.
Case 3. A patient W.K., 31, presented at the surgery
because of tooth 22 restoration mobility. Before treatment,
radiographic findings revealed chronic granulomatous inflammation of the periapical tissues and perforation at the
coronal third of the lateral wall of the root, accompanied by
rarefaction of the osseous structure. During root canal preparation tooth 22 sustained root fracture from the perforation
site to the paragingival line (edge). After termination of
antiseptic root canal treatment root stamps were immobilized using a Fibre-Fill pin and Root Canal Sealant cement.
The crown was restored with Herculite using a celluloid
matrix. Because of uncertain prognosis, a surgical procedure
to close the perforation and for tissue regeneration was not
performed. One-year observation showed normal preservation of crown reconstruction and lack of clinical changes
within the neighbouring tissues. As the osteolytic defect is
still present in the alveolar bone in the vicinity of root wall
perforation, surgery is being planned.
26. 30-year observations of silver amalgam left beyond the root apex.
Sikorska – Bochińska J., Łagocka R., Jamroszczyk K., Buczkowska – Radlińska J.
Inserting non-resorbing material beyond the root apex
always arouses some uncertainty. In the described case, there was a double problem, because beyond the root apex there
was a fragment of silver amalgam. Presence of amalgam in
the tissues is an effect of penetration of amalgam file dust
when backfilling the root canal during 22 root apex resection. The resection was done in 1972. A few years later on
28
the alveolar mucosa an amalgam tattoo appeared in the same
area. Since that time the patient has been systematically
controlled until now. The size and location of both amalgam
file particles and the tattoo have not changed. No inflammatory reactions have been detected around the foreign body,
either. The patient has not reported any general complaints
that might have been caused by the amalgam.
Poster session
27. Assessment of physiological levels of pulpal blood flow in permanent incisors in children.
Pypeć L. J., Bruzda – Zwiech A., Proc P.
Department of Paediatric Dentistry Medical University of Lodz, Poland
A new method of non-invasive measurement of blood
flow i.e. the volume of blood passing through the vessels per
unit of time, has been described as a more sensitive technique for evaluating tooth vitality compared with conventional
methods. Electrical and thermal pulp tests can be negative in
teeth after traumatic injures even if circulation is restored.
There is still a need to evaluate the physiological levels of
blood flow in dental pulp.
The study aimed at evaluation of pulpal blood flow in
intact permanent incisors in children and at finding out if
there are any differences in pulpal blood flow due to patients
age and group of teeth.
Material and methods: Laser Doppler Flowmetry (Periflux 5010, Perimed) was used for pulp flow measurement of
1066 intact permanent incisors in 146 children (80 girls and
66 boys) aged from 7 to 12 years. To protect against the
influence of background on flow value the laser Doppler
probe was isolated with silicon discs. During examination
the probe was located on the palatal surface in the cervical
region of the teeth.
Results: Mean values of pulpal blood flow of upper incisors were: 9.89 PU in children aged from 7 to 8 years, 10.44
PU in 9-10 years-old and 12.657 PU at age 11-12 years.
Mean blood flow in lower incisors was 15.026 PU, 15.078
PU and 16.833 PU for children aged 7-8, 9-10 and 11-12
years-old respectively. Differences between mean values of
pulpal blood flow in children aged 7-8 vs. 11-12 years-old
and 9-10 vs. 11-12 years-old were statistically significant at
p < 0.001 in maxillary and madibular teeth. There were no
statistically significant differences in pulpal flow values in
lower incisors between girls and boys in any age group. In
upper incisors the mean flow values differed statistically for
girls and boys at age 9-10 (p=0.0026).
Conclusion: LDF seems to be an objective and reliable
method of assessment of pulp vitality, but even minimal
accidental movement of the LDF probe affects measurement. Mandibular teeth tended to demonstrate significantly
higher blood flow levels than maxillary teeth.
The range of pulpal flow level changes with the children’s
age.
28. Electrosensitivity of dental pulp in young central upper permanent incisors with fully-formed root apices.
Łuczaj – Cepowicz E.
Aim of the study. The aim of the present study was to
determine electrosensitivity of dental pulp in healthy central
upper permanent incisors with fully-formed root apices.
Material and methods. A hundred central upper permanent incisors were examined in 50 children (24 girls and 26
boys) aged 11-14 years. The teeth were healthy (free of
carious and non-carious lesions or restorative material), showing no changes in periodontal tissues.
The test was performed using a monopolar apparatus
Neosono (Satelec). Prior to testing, the teeth were professionally cleaned, dried and isolated from saliva. During pulp-testing procedures one electrode, moistened with Superpolish
paste to improve conductivity, was used to touch the tooth
surface. The other electrode in the form of a clip was placed
on the persons lip. The measurements were displayed on the
apparatus screen in a 1-99 scale.
Three sites on the tooth surface were examined: the trepanation point, gingival third of the labial surface and the
incisal edge, in random order. At each electrode placement
position, the examination was performed twice, with two-
minute intervals between the measurements.
Results. The mean threshold of pulp sensitivity in the
central incisors was 43.69 and did not differ between the
teeth on the right (43.62) and left side (43.76).
No significant differences were found in the minimum
and maximum values or medians between the teeth on the
right and left side and between girls and boys.
Higher electrosensitivity was observed in dental pulp at
the incisal edge (30.61) compared to the trepanation point
(43.63) and gingival third of the labial surface (44.55). Similar correlations were noted for central incisors on the right
and left side.
Conclusions:
1. There is no difference in electrosensitivity of dental
pulp in central permanent incisors between the right and left
side.
2. The outcome of the test is not sex-dependent.
3. The incisal edge is the optimum electrode placement
position.
29
Poster session
29. Intradental, inflammatory foci predispose to endocarditis
Wisniewska – Spychała B., Grajek S,1 Maksymiuk T.2
Dept of Dental Surgery, Institute of Stomatology, K. Marcinkowski University School of Medical Sciences, Poznań, Poland
1
Institute of Cardiology, Laboratory of Cardiomorphology, K. Marcinkowski niversity School of Medical Sciences, Poznań,
Poland
2
Dept of Public Health, Chair of Social Medicine, K. Marcinkowski University School of Medical Sciences, Poznań, Poland
The contribution of dentigenous, inflammatory foci in the
development of endocarditis is still not fully resolved. The
newly published findings point to the involvement of periodontopathic changes in this respect.
This study aims at explaining the alleged relationship
between the existence of inflammatory foci within teeth and
the development of endocarditis in adult patients. 60 patients, aged 19-69 (average 49), with acquired heart disease,
with history of bacterial endocarditis, and the occurrence of
at least two dentigenous, inflammatory foci were examined,
having been qualified for the heart valve placement procedure. Full medical examination was the basis for the qualification in the study. Medical histories of the group spanned
several weeks to 30 years. The tissues subject to microbiological examination included heart valves with inflammatory abnormalities, as well as blood. Swabs of periodontal
pockets, root canals, and of their periapical areas, as well as
of heart valves were also taken. A consistency of the culture
results from dental foci, blood and heart valves was observed
in 14 persons. An association between the intradental foci
bacteria and the consistency of the cultures (intradental foci,
blood and heart valves) was significant (p<0.017).
The development of endocarditis appears to be, as the
results show, influenced by the presence of dental, inflammatory foci.
PERIODONTAL RESEARCH AND ORAL MEDICINE&PATHOLOGY
30. Multidisciplinary orthodontic-periodontal treatment in secondary occlusion trauma due to periodontal disease.
Dembowska E.1, Górniak D.2
1
The Department of Periodontology, Medical University in Szczecin
2
The Department of Orthodontics, Medical University in Szczecin
The aim of the investigation. Evaluation of the influence
of orthodontic movement upon the quality of periodontium
in people with advanced periodontitis.
Materials and methods. During periodontitis there is a
loss of supporting tissues. The loss of supporting periodontal
tissues worsens the efficiency of the stomatognatic system.
Migration and drifting, tipping, rotation, extrusion and protrusion lead to changes in overbite and overjet. It is often the
result of decreasing vertical dimension of occlusion or loss
of supporting zones. In such inappropriate occlusal conditions the state of the periodontium worsens and the periodontitis process speeds up. Apart from aesthetic defects the
prognosis worsens, too. Occlusal trauma is a co-factor for
periodontal disease progress. In this investigation the influence of orthodontic movement on the periodontal status was
evaluated. It was based on experiences with people with
advanced periodontitis. 36 people, aged 18-60 (average age
42,7 with diagnosed periodontal disease: 9 people with aggressive periodontitis and 27 with chronic advanced periodontitis) were examined. The treatment results were monitored for 6 years.After initial therapy (oral hygiene instruction
and plaque control, subgingival scaling, root planing and
subgingival curettage) only the patients with very good oral
hygiene (PlI = 0,8) were classified for further orthodontic
30
treatment. For orthodontic movement fixed appliances were
used. After placing the teeth optimally the occlusion splint
was permanently adjusted. The monitoring stage consisted
of defining the value of plaque index PlI gingival index GI,
the periodontal pocket depth (mm) and the size of gingival
recession (mm). The occlusion conditions were checked and
photographic and radiological records were made.
Before a patient was treated they had the panthomogram
x-rays done. Radiograms on the Digora plate were made
additionally. They pictured the state of the alveolar process
in the area of incisors in the maxilla. The estimation of the
radiograms was done in Digora 2.1 programme. After finishing the treatment control visits were reapeted every 3
months and every 12 months the clinical parameters were
recorded and the phosphoric plates were irradiated. Maintenance therapy included plaque control, scaling and subgingival debridement.
The results of the investigation let us to claim that the
treatment of advanced periodontitis associated with orthodontic movement:
1. improves smile and aesthetics
2. improves function
3. enables permanent tooth splinting in more advantegous
conditions of occlusion
Poster session
4. lets the natural teeth be retained
5. orthodontic movement in periodontal disease does not
worsen its condition as long as very good oral hygiene is
maintained.
31. Necessity of periodontal care in patients with cardiovascular diseases
Bochniak M., Sadlak – Nowicka J., Łaska M.
Department of Periodontology, Medical University of Gdansk, Poland
Introduction Nowadays periodontitis – etiologically linked with bacterial flora, mainly anaerobic – is very often
pointed out as one of the risk factors for coronary heart
disease (CHD) and myocardial infarction (MI). Studies of
possible microbiologic, immunologic and biochemic relationships between periodontitis and CHD / MI are carried
out.
The aim of this study was to evaluate the frequency and
severity of periodontitis among patients with CHD and after
MI, hospitalized in 1st Clinic of Cardiology, Medical University in Gdansk, Poland and simultaneously to evaluate
periodontal prophylaxis and treatment needs in this patient
group.
Material and methods. 104 patients, aged 43-80 (average 60 years) were examined – 57 persons after MI (group I)
and 47 persons with CHD without acute events (group II).
Anamnesis, clinical examination using WHO recommended
parameters (API, SBI, PD, CAL, CPITN) and panoramic
X-ray were performed.
Results and conclusions. Periodontitis was diagnosed in
82,4% patients of group I and 72,2% of group II. Severity of
destructive lesions suggests long duration of disease, early
treatment negligence and possible negative influence of periodontal infection foci on general health status. It was concluded, that an obligatory education and treatment program
for this population should be created and implemented.
32. Evaluation of the efficacy of Corsodyl gel and Corsodyl fluid in the treatment of chronic periodontitis
Pietruska M.1, Peniczko A.2, Waszkiel D.3
Zakład Stomatologii Zachowawczej AM w Białymstoku1, NZOZ Specjalistyczna Lecznica Stomatologiczna AMB2, Zakład
Stomatologii Dziecie˛cej AMB3
Purpose: Evaluation of chlorhexidine gluconate (Corsodyl gel and Corsodyl fluid) in the treatment of periodontitis.
Method: Forty subjects, aged 30-65, with chronic periodontitis and with the presence of ≥ 4 mm deep periodontal
pockets were selected for the study. The patients were divided according to the mode of treatment into 4 groups, ten in
each group. In group I, patients rinsed the oral cavity with
Corsodyl fluid twice a day for 3 weeks. In group II, Corsodyl
gel was applied to the periodontal pockets three times (at
one-week intervals). In group III, in addition to Corsodyl gel
surgical dressing ResoPack was used to keep the drug in the
periodontal pockets longer. Group IV (control) consisted of
patients who were not treated pharmacologically.
In all the groups, teeth were cleaned professionally before
treatment. In the first three groups preliminary examination
was performed directly before pharmacological therapy, in
the control group before the scaling procedure. The check-up
was carried out one and three months after the preliminary
examination. The following clinical parameters were evaluated: plaque index (PI), sulcus bleeding index (SBI), gingival index (GI), as well as measures of periodontal pocket
depth and connective tissue attachment level.
Results: In all the groups, the check-up examination revealed improvement in clinical parameters. The greatest differences were observed in group III, where surgical dressing
ResoPack was applied in addition to Corsodyl gel.
Conclusion: Combined treatment of chronic periodontitis
with the use of Corsodyl gel and surgical dressing ResoPack
seems to have the most beneficial effect on the clinical state
of the periodontium.
33. Certain risk factors for drug-induced gingival overgrowth in renal transplant patients medicated with immunosuppressive drugs.
Lewińska – Chełstowska M., Banach J.
Chair of Restorative Dentistry and Periodontology, Department of Periodontology, Pomeranian Medical Academy in Szczecin.
Aim: In this review, we study the occurrence and expression of changes in the periodontium (gingival overgrowth) in
renal transplant patients treated with cyclosporin A and tac-
rolimus. We also identify certain risk factors which may be
related to such changes.
Material and methods: A sample group of 54 patients
31
Poster session
was divided into two subgroups of 27 by the type of immunosuppressive drug taken. The risk factors, such as Plaque
Index (PlI), Retention Index (RI), and Gingival Overgrowth
Index (GOI) were evaluated thrice, i.e. after 3 to 4 days, 3
months and 6 months from the renal transplantation. Moreover, total doses of both medications delivered over 3– and
6-month periods were determined. The prevalence of HLA I
and II antigens was evaluated in all patients, as well as, in
both subgroups, for persons suffering from gingival overgrowth and patients not affected by the above changes.
Results: Gingival hyperplasia occurred more frequently
in cyclosporin A (70.4%) than in the tacrolimus-treated group (18.5%). Its incidence was higher in persons over 40. The
initial changes appeared after 3 months and were gradually
developing. The most severe gingival overgrowth was observed in the anterior region (between the canine teeth). A close
relationship was found to exist between the overgrowth severity and increased PlI and RI values. No relationship was
identified between the hyperplasia and total dose of each
drug. It was established that the expression of HLA-B8 and
B18 antigens was more frequent in persons not affected by
overgrowth and included in the CsA-treated sample subgroup. In persons medicated with tacrolimus and suffering from
gingival changes the incidence of HLA-A9 is higher. After
examining the whole group of patients, it was found that the
HLA-A3,3; and DR2,4 phenotypes were more common in
persons with gingival hyperplasia.
34. Multidisciplinary treatment of aggressive periodontitis-case report.
Czerniuk M, Ne˛dzi – Góra M, Górska R.
Department of Periodontology and Oral Medicine, Medical University of Warsaw, Poland
Aggressive periodontitis (AP) is characterized with quick
clinical attachment loss and rapid destruction of alveolar
bone. Patients suffering from AP often require multidisciplinary treatment and attention of a dentist, periodontologist,
oral surgeon and orthodontist.
Aim of the work is to present the case of a 17-year old
female patient with generalized AP treated by these specialists.
Material and methods: The patient was directed to a
periodontologist by an orthodontist. In anamnesis she did not
report any systemic diseases, nor did she take any medicines.
At the baseline and after initial periodontal treatment clinical
state of periodontal tissues was recorded using standard parameters (CAL-clinical attachment loss, PD-pocket depth,
BI-bleeding index, PI-plaque index). X-ray analysis was
provided, Concentrations of MMP-8, MMp-9 and TIMP-1
were recorded in serum and saliva. Initial periodontal treatment included supra– and subgingival scaling, root planing,
oral hygiene instruction and patient motivation. Several teeth were to be treated endodontically in order to prevent
endo-perio complications. As additional treatment doxycyc-
line was used in a dose of 20 mg twice daily during 3
months. After initial treatment all periodontal parameters
improved.
During the surgical treatment phase the patient underwent
flap operations (according to Cieszynski-Neuman-Widman
technique) in all sextants, together with Bio-Oss application
(0,5g, 0,25-1 granules). After each surgical procedure antibiotics were prescribed [clindamicine (Dalacin C) 300 mg 3
times daily for 7 days]. Sutures were removed after two
weeks. The maintenance treatment phase was introduced
with control visits once a month. Six months after completing the surgical treatment phase clinical and radiological
examinations were renewed and the patient was redirected to
the orthodontist.
Results: Initial and surgical treatment phases resulted in
the reduction of all clinical parameters recorded and cleared
the way for the orthodontic treatment, focusing on restoration of proper occlusal conditions.
Authors strongly recommend a multidisciplinary approach in the treatment of patients with AP.
35. Analysis of prevalence of parafunctions in an adolescent population.
Mankiewicz M., Panek H.
Department of Prosthodontics, Medical University of Wrocław, Poland.
Background. Parafunctions may be defined as stereotypic involuntary motor activities of the stomatognathic system that are not involved in normal functions of the system,
eg. mastication, swallowing or speech. There are various
classifications of parafunctions. According to Fuchs classification they may be divided depending on involved tissues as:
32
D-D (Dens-Dens, eg. tooth grinding and clenching, bruxism), D-C (Dens-Corpus alienum, eg. nail biting, pen biting, chewing gum), D-M (Dens-Mucosa, eg. biting the mucosa of lip or cheek), M (Mucosa, eg. tongue pushing, jaw
bracing). The most destructive parafunction is bruxism. Bruxism was classified as nocturnal (sleep) or diurnal. More
Poster session
recently, bruxism has been classified into primary (idiopathic) and secondary (jatrogenic) forms. Both forms may occur during sleep or wakefulness, however, secondary bruxism is associated with medical conditions (eg. neurologic,
psychiatric, sleep disorders, use of medication) that may
exaggerate primary bruxism or may even cause bruxism.
Intensity of bruxism may be measured by an index proposed
by Panek. The data in the literature have indicated that
awareness of subjects about performing some parafunctions
is rather low.
The aim of the study was to determine the prevalence and
self-awareness of particular forms of parafunctions in a young healthy population.
Material of the study was 303 schoolboys attending the
Secondary Car School in Wrocław. Mean age of subjects
was 18,4 years.
Methods. All schoolboys underwent a routine dental examination and functional analyses of the stomathognatic system. Special attention was given to signs of biting the lip,
cheek and nails. Also signs of abrasion of anterior and posterior teeth, as well as increased tension or pain in the masticatory muscles were recorded. During history taking all subjects were asked about their self-awareness of various forms
of parafunctions.
Results. The frequency of particular forms of parafunctions according to Fuchs classification was presented in tables. Moreover the prevalence of parafunctions was established in relation to data obtained from self-reports of the
schoolboys.
Conclusion. In the studied population various forms of
parafunctions were found. The parafunctions were present as
an isolated form or as double or triple or even fourfold
coincidences in a single person. The majority of studied
subjects was not aware of clenching and bruxing the teeth.
There is a need to introduce an educational program to
schools in order to present the destructive consequences of
some parafunctions and the possibility of prophylaxis or
treatment of parafunctions.
36. Clinical and Mycological Evaluation of Mucous Membrane of the Oral Cavity in Postmenopausal Women.
Hüpsch – Marzec H., Kubicka – Musiał M., Wierucka B.
Department of Conservative Dentistry and Periodontal Diseases, Silesian Medical Academy.
The mucous membrane is a constantly regenerating tissue. The epithelium makes a sort of barrier against germs.
The aim of this paper was to compare the frequency of
occurrence of clinical changes in the mucous membrane of
the oral cavity in healthy female patients in the postmenopausal period, in relation to female patients with diagnosed
osteoporosis and identification of the presence of yeast-likefungi. Examinations were carried out in women aged 51-69.
The examined group consisted of female patients in whom
osteoporosis resulted in pathological fracture of the distal
epiphysis of the radial bone. The control group consisted of
healthy volunteer woman, who agreed to take part in the
examination. Evaluation of density of bone tissue was made
within calcaneum (IMU). Clinical examination was performed at a dental surgery, in artificial lighting, with the help of
essential diagnostic instruments. Cultures obtained on the
basis of direct swabs served to determine the presence of
yeast-like-fungi. The presence of Candida albicans colonies
was demonstrated in 23,64% of female patients. Presence of
Candida glabrata strain was recorded in 10,9% of women
and Candida tropicalis in 3,6% of examined women. Strongly expressed symptoms such as a burning sensation or pain
occurred in only 3 of the mentioned female patients. Despite
a clinically unchanged mucous membrane, typical symptoms for stomatodynia were recorded (1patient). Also in
individual cases features of a geographic tongue, plicated
tongue and swelling of the tongue were observed. In some
patients prosthetic stomatopathies were recorded complicated with yeast-like-fungal infection.
Conclusion. Atrophic changes within the mucous membrane of the oral cavity accompanying the postmenopausal
period and the presence of prosthetic restorations are conducive to yeast-like-fungal infections.
37. Quantitative and Qualitative Microscopic Evaluation of the Epithelium of the Oral Mucous Membrane in Postmenopausal Women.
Hüpsch – Marzec H., Ksia˛żek – Ba˛k H., Kubicka – Musiał M., Wierucka – Młynarczyk B., Mykietów – Smalec B.
Department of Conservative Dentistry and Periodontal Diseases, Silesian Medical Academy
The postmenopausal period is accompanied by a number
of symptoms from the side of the reproductory organs and
systemic symptoms. The aim of the paper was to compare
frequency of occurrence of changes in female patients in the
postmenopausal period, generally healthy, in relation to female patients with diagnosed osteoporosis. The examinations were carried out in women aged 51 to 69. The examined group consisted of female patients in whom osteoporosis
33
Poster session
resulted in pathological fractures of the distal epiphysis of
the radial bone. The control group consisted of healthy volunteer women, who agreed to take part in the examination.
Evaluation of density of bone tissue was made within calcaneum (IMU). For the quantitative evaluation of epithelium
the criteria of International Academy of Cytology were used
based on coloured reaction of cytoplasm of the cells. Index
of maturity (MI) karyopycnosis (KI) and acid absorbtion
(EI) were taken into consideration. For the qualitative evaluation Papanicolaou classification was applied, which took
into account variability of morphological features of cells or
their elements. Among changes observed within the epithelium in the analyzed groups were noticed: lobar desquamation, presence of erythrocytes and bacterial colonies, foci of
necrosis, features of a chronic inflammatory reaction and
diffuse inflammatory reaction. In both groups shift of MI to
the right and high indices of KI and EI were observed. The
results manifest the intensive wear of the examined cells and
simultaneously slowed down regenerative processes. Both
the process of maturation and desquamation of the cells are
the subject of disorder.
38. Partial Trisomy of 14q– Case Report.
Strzałkowska A.1, Matthews – Brzozowska T., Skulimowska G., Śle˛zak R.4, Śmigiel R.5
1
NZOZ Ortodoncja Kościuszki 108A/33 str. Wroclaw
Department of Maxillo-Facial Orthopaedics and Orthodontics , Wroclaw Medical University,
Department of Conservative Dentistry and Periodontology, Medical University Poznan
3
The Department of Neonatology and Intensive Therapy of Wroclaw Province Hospital
4,5
The Department of Genetics, Wroclaw Medical University
Introduction: The advancement of contemporary prenatal and postnatal diagnostics allows clinicians to rapidly
identify a variety of congenital disorders.
Objectives: The objective of the paper was to present the
postnatal assessment (genetic and clinical examination),
identification and early treatment of a newborn patient with
partial 14q trisomy.
Materials and methods: Genetic examination: metaphase were prepared from peripheral blood lymphocytes of the
patient, following standard protocols. Fluorescence in situ
hybridisation (FISH) was performed using Multiprobe System Kit (Cytocell), which consists of recombinant labelled
human chromosome-specific painting probes for 24 colour
FISH and additional directly labelled whole chromosome
painting probes for chromosome 14. The cytogenetic study
of both parents is in the process of analysis. Clinical examination included physical examination, radiography (chest,
skeletal system), ultrasonography (brain, abdomen, and heart), biochemical and microbiological analysis (blood, urine,
faeces, bronchial mucus). The differentiation included comparison of phenotype between Pierre-Robin Sequence and
Edwards Syndrome. Treatment: mechanical ventilation
(IMV, n-CPAP, O2 supplementation), antibiotics, catecholamines, parenteral feeding. Results: Genetic investigation
revealed an unbalanced karyotype with partial trisomy of the
long arm of chromosome 14. Combining the results of classical cytogenetics and FISH, the karyotype of patient was
determined as 47, XX, +del (14)(q21). The GTG – and
34
CBG-banded chromosome analysis showed an unbalanced
karyotype with additional chromosomal material. The extra
structure was smaller than D-group and bigger than G-group
chromosomes. The diagnosis was also established on the
basis of phenotype, which included: low birth weight (2500
g), cranio-facial dysmorphy (micrognathia; retrognathia;
glossoptosis; secondary cleft palate; low set ears; posteriorly
rotated ears; microphtalmia; strabismus; downward-slanting
palpebral fissures; hypertelorism; broad nose; flat nasal bridge; chubby cheeks; short, prominent philtrum; open mouth
appearance), brachycephaly, poor swallowing, short and wide neck, loose skin in neck, flat occiput, wide spaced nipples, abnormalities of the skeletal system (schisis of the Th6
vertebral body, talipes equinovarus), heart defect (PFO),
CNS – enlarged fourth ventricle, unsettled muscular tension.
The patient was discharged in 50th day of life. Interdisciplinary treatment was established (paediatrics, neurology, surgery, orthodontics, orthopaedics, cardiology, physical rehabilitation).
Conclusions: Partial trisomy of the long arm of chromosome 14 is a very rare chromosomal aberration. The most
frequent cause of this abnormality is the presence of a balanced interchromosomal translocation in one of the parents. In
such cases the risk of the birth of a baby with a chromosomal
aberration is high and directly depends on the kind of translocation. Rapid and accurate postnatal diagnosis lets the
clinicians establish adequate interdisciplinary treatment.
Poster session
39. The prevalence of halitosis in a population interested in maintaining oral health.
Iwanicka – Grzegorek E1., Ke˛pa J1., Michalik J2., Wierzbicka M1., Pierzynowska E1.
1) Department of Conservative Dentistry, Medical University of Warsaw
2) Department of Medical Informatics, Medical University of Warsaw
The aim of the study was to determine the prevalence of
halitosis and the mean concentration of volatile sulphur
compounds in a population concerned with maintaining oral
health.
The material comprised of 387 patients presenting at the
department of Conservative Dentistry for elective dental treatment. Patients underwent a dental examination and dental
health (DMFT) as well as periodontal health (CPI) was determined, and organoleptic examination was then performed
using a 6-point scale acc. Rosenberg. Using a portable halimeter for measuring the concentration of volatile sulphur
compounds, the mean levels of these were determined in
exhaled air.
Halitosis was diagnosed in 49.1% of the population examined. The mean result of the organoleptic examination was
2.39, and the mean level of volatile sulphur compounds
164.78ppb. In the population studied halitosis occured more
often in males – 55.6% than in females – 45.7%. The mean
values of organoleptic scores and halimeter results were also
higher in males than in females (2.67/ 208.29 ppb in males,
2.25/ 144.26 ppb in females). The highest proportion of
patients with halitosis was found in age groups 25-34 years
old and 45-54 years old.
ORAL AND MAXILLOFACIAL SURGERY
40. Atypical placement of retained teeth
Stopa Z., Krasny K., Abed K.
1st Department of Maxillofacial Surgery, Medical University of Warsaw
The epidemiological data shows that almost 17% of patients aged under 20 has at least one retained tooth. This
pathology mostly concerns the mandible and may cause
fistula, paresthesis, malocclusion, cysts and chronic pain.
The aim of this study was to present the treatment procedure
of 5 patients with atypical placement of retained teeth admitted to the 1st Department of Maxillofacial Surgery , Medical
University of Warsaw .
Surgical treatment was performed in all patients. Surgical
treatment was based on removing the retained tooth with
surrounding pathological changes (cysts, fistulas).
The results of our observation as well as literature data
show that the most succsesful method used in the treatment
of patients with the atypical placement of retained teeth is
their surgical removal.
41. Chronic sinusitis. The role of cytokines in maxillary bone resorption.
Wieczorek P., Wojtowicz A., Ostrowski K., Medical University of Warsaw
Sporniak – Tutak K., Pomeranian Medical Academy, Szczecin
The aim of the syudy:
1. immunohistochemical evaluation of the system of enzymes and their inhibitors i.e. metalloproteinases (MMPs 1,
2, 3), TIMP– tissue inhibitors of metalloproteinases, TGF B,
BMP6 expressed in human sinus mucosa in embryonic stages, physiology and chronic sinusitis in adults
2. Anterior and posterior maxillary bone radiometric analysis on panoramic CT (pantomograms)
Methodology:
1. Harvesting of tissue compartments containing maxillary bone with oral mucosa during surgical treatment
2. Histological and immunohistological ( MMPs, TIMP,
BMP 6, TGF B) staining on paraffin sections
3. Radiometric analysis of the maxillary bone height in
anterior and posterior area in physiology and chronic sinusitis
Conclusions:
1 . A strong reaction of MMPs and weak reaction of TIMP
in embryonic sinus mucosa is one of the factors involved in
the pneumatisation process of the sinuses
2. A strong reaction of MMPs characterizes the sinus
mucosa in chronic allergy
3. Higher maxillary bone resorption was found in the
posterior area in comparison with the area of the anterior
teeth
35
Poster session
42. Tooth extraction/replantation after endodontic treatment failure, not qualified for surgery ( case reports)
Lewandowski P.
Department of Conservative Dentistry & Periodontology, University of Medical Sciences, Poznań, Poland
The author describes his own clinical observations of
three teeth (two premolars, one molar) treated using extraction/replantation method. In these cases endodontic treatment failures were as follows:
1. perforation at 1/2 – 1/3 of the root length, tooth restored
with a core
2. periapical lesions, endodontic retreatment impossible
(obliteration)
3. inflammation at bifurcation around a gutta-percha cone
and debridement of sealant
In each case, tooth extraction was followed by preparation of root injury and filling it with silver amalgam (Amal-
cap plus, Vivadent).Additionally, root apices were subjected
to resection and retrograde filling with silver amalgam. The
teeth were replanted, immobilized, and finally reconstructed.
In the paper, the clinical course of therapy of each case
and respective radiological documentation were presented.
Conclusions:
Extraction/replantation of teeth represents an alternative
procedure to surgery in situ in cases particularly difficult
technically. It represents the last chance for preserving the
tooth in highly risky surgery e.g. anatomical structure damage.
43. The incidence of additional and supernumerary teeth in patients of the Department of Oral Surgery, Medical
University of Warsaw – epidemiological study.
Wychowański P. , Wojtowicz A. , Nosek M., Ciechowicz K., Jasiński P.
The aim of this study was to determine the incidence of
additional and supernumerary teeth in a Polish population.
Epidemiological studies were conducted.
The examined group consisted of 62 218 patients treated
at the department of Oral Surgery, Medical University of
Warsaw. The typical clinical examination, verified in chosen
cases by radiological studies, was made.
137 people with additional or supernumerary teeth were
found and 172 additional or supernumerary teeth were de-
scribed, which is 0,22% of total examined group. About 70%
of these teeth were found in the anterior part of the maxilla.
Nearly 95% of them were impacted.
Based on the results the authors of this study recommend
especially accurate examination, including radiological verification, of all young patients from 5 to 25 years old with
interrupted development of the anterior segment of the maxilla.
44. Significance of Psychotherapy in Treating Patients after Extensive Surgical Operations within the Facial Part of the
Skull.
Fra˛czak B., Fra˛czak P.
Department of Dental Prosthetics, Pomeranian Medical University in Szczecin
Manager: Dr Bogumiła Fra˛czak, PhD in Medicine
Surgical operations within the area of the facial part of the
skull are the most crippling operations concerning post-operation appearance of a patient, and the after-effects in form
of deficiencies appear to bring vast reconstruction problems.
The Authors of the article would like to emphasize the prob-
lem of poor quality of life of the patients involved and the
need to provide them with treatment including psychological
elements, i.e. appropriate pre-operation therapeutic procedures and after-operation therapeutic procedures to be continued upon surgical-prosthetic treatment being completed.
45. The role of cytokines in periapical inflammation and dental cyst development
Jankowska – Antczak E., Kozarzewska M., Wojtowicz A.
Department of Oral Surgery, Medical University of Warsaw
Introduction: Periapical lesions, granulomas and radicular cysts are an important clinical problem because of their
frequency. In the majority of cases apical periodontitis is
induced by an infective agent, originating from a root canal
36
with necrotic pulp as well as by the presence of Malasseza
cells in the periapical tissues. Despite of a lot of information
about the etiology of periapical lesions there is not a clear
pathogenesis of this disease especially its molecular mecha-
Poster session
nisms. Current research indicates that host-derived cytokines
and proteolytic enzymes play an important role in the inflammatory process. Investigated cytokines are able to initiate the inflammatory process: metalloproteinases (MMPs),
tumor necrosis factor α (TNFα) or processes responsible for
limitation of tissue destruction: tissue inhibitor of metalloproteinases (TIMP), transforming growth factor β (TGFβ)
and bone morphogenic protein –6 (BMP-6).
Objectives. The aim of this study was to evaluate the
expression of pro-inflammatory agents: MMP-1,-2,-3 and
TNFα and anti-inflammatory agents:TIMP-1, TGF and
BMP-6 in periapical granulomas and radicular cyst tissue.
Material and methods. Isolated tissue of periapical granulomas and radicular cysts, taken after extraction and formalin fixed were investigated. Paraffin slides 7 m thick were
stained immunohistochemically as recommended by the
producer of the antibody (Chemicon). All immunohistochemical staining was done at the same time and in the same
working conditions to limit the error of methods. Our results
were subjected to statistic alanalysis, with t– Student and
χ2 test.
Results and conclusions. Expression of MMPs, TIMP,
TNFα, TGFβ and BMP-6 in the investigated tissue proves
that the studied factors play an important role in formation of
lesions. There is a complex dependency between defence
and destructive mechanisms around periapical lesions. The
disturbance of the tissue equilibrium of activity of the investigated agents can determine progress of diseases, including
multiple cystic lesions.
46. Juvenile Pilocytic Astrocytoma – a case report.
Wanyura H., Uliasz M., Smolarz A.
Head: Professor Hubert Wanyura MD, DDS, PhD
Astrocytomas consist of tumor cells resembling astrocytes. Currently the most comprehensive and accepted classification system for brain tumors is that of the WHO from
1993. WHO classification enables grading which depends
on four main features (nuclear atypia, mitoses, microvascular proliferation and necrosis). In order of increasing anaplasia, types of astrocytomas usually include piocytic astrocytoma (grade I), diffuse astrocytoma (grade II), anaplastic astrocytoma (grade III) and glioblastoma (grade IV).
Pilocytic astrocytoma is the most common glioma of
childhood with most presenting in the first 2 decades of live.
It typically occurs in the cerebellum, optic nerve, optic
chiasm. Optic nerve glioma is a synonym for pilocytic astrocytoma of the optic nerve. Optic nerve glioma accounts for
66% of the all primary optic nerve tumors, and 4% of all
orbital lesions.
Whenever possible surgical resection alone is indicated.
Afterwards patients have a very good prognosis – 80% reach
20 year survival.
In this paper we would like to describe the clinical features and management of a 21 year old patient suffering from
pilocytic astrocytoma of the optic nerve.
47. Dry mouth problems in patients after renal transplantation
Jankowska – Antczak E., Pochwalski M., Wojtowicz A.
Department of Oral Surgery Medical University of Warsaw
Background: Xerostomia (dry mouth) is a clinical symptom, related to advanced age and presence of systemic
disorders and their treatment. There are above 400 different
drugs, which can cause or intensify xerostomia. Immunosuppressive drugs can lead to degeneration of salivary glands.
Progressive fibromatosis of blood vessels discriminates vascularization of glands and causes increasing disfuntion.
Objectives. The aim of this study was to evaluate incidence of xerostomia in patients on chronic immunosuppressive therapy following allogenic renal transplantation in
comparison with generally healthy patients.
Material and methods. The examination consisted of:
questionnaire, clinical examination as well as measurement
of quantity and pH of stimulated saliva. There were 40
patients in examined and control groups. Results. 75% patients from the examined group and 55% patients from the
control group reported oral and non-oral symptoms of xerostomia. The most common symptom of xerostomia was: dry
lips and skin, dry mouth and xeratoconjunctivitis sicca. We
found an increase in frequency of xerostomia symptoms
with age and with therapy of systemic diseases.
Conclusion: Chronic immunosuppressive therapy causes
an increase in the number of patients with symptoms of
xerostomia.
37
Poster session
48. Odontogenic tumors – radiological diagnostics.
Samolczyk – Wanyura D., Piekarczyk J., Szałwiński M., Piekarczyk P., Głe˛bowski P.
2nd Department of Maxillo-Facial Surgery Medical University of Warsaw
Department of Anatomy Medical University of Warsaw
The aim of this study was presentation of radiological
diagnostics and surgical treatment of odontogenic tumors.
Material was based on 73 cases operated at II department of
maxillo-facial surgery. Radiological diagnosis was performed on standard cranial radiograms, pantomograms and CT.
Description of size and localization of the tumors was based
on radiological examination which was necessary for access
and range of operation planning without risk of injury of
anatomical structures in the vicinity of tumors. Depending
on size and localization, sites after tumors were reconstructed with autogenic bone grafts or filled with soft tissues.
Tumors were totally removed which was evaluated during
operation by the surgeon and confirmed with histopathological examination. Our study confirmed CT as accurate for
bone tumors although panoramic and cross-sectional examinations seem to be sufficient in some cases embracing the
body of the mandible and alveolar process of the maxilla. All
these methods should give us information about the size and
expansion of tumor, decreasing risk of incomplete removal
or post operational complications. In some cases radiological
symptoms are characteristic.
49. Usefulness of the USG examination in the diagnosis of diseases occurring with enlarged lymph nodes.
Samolczyk – Wanyura D., Piekarczyk J., Jagielak M., Piekarczyk P., Szałwiński M., Thun – Szretter K.
2nd Department of Maxillo-Facial Surgery Medical University of Warsaw
Department of Maxillo-Facial Radiology Medical University of Warsaw
Department of Anatomy Medical University of Warsaw
The aim of this paper is to measure the usefulness and
application of the ultrasound examination in diagnosis of
diseases occurring with lymph node overgrowth in the area
of the face and neck.
The paper bases on ultrasound examinations performed in
2000-2002 by Department of Maxillo-Facial Radiology,
Medical University of Warsaw. The research was done on
medical histories of 20 patients (9 female, 11 male) treated in
2000-2002 in 2nd Department of Maxillo-Facial Surgery
Medical University of Warsaw.
This paper compares the patients ultrasound examination
with their clinical diagnosis. On this basis the authors have
proved that ultrasonography is a valuable method in diagnosing diseases occurring with lymph node overgrowth in the
area of the face and neck. It is also very helpful in planning
the treatment or/and excision of the lymph node for histopathological examination. Ultrasonography provides crucial
information about the lymph node shape, its size and placement of the surrounding tissues. It can also indicate the
character of the node’s transformation. The ultrasound examination is the first choice examination in diagnosing lymph
node pathology in the area of the head and neck.
PROSTHODONTICS AND ORTHODONTICS RESEARCH
50. Survey of the state of the masticatory organ and the effect of prosthetic rehabilitation on chewing ability of elderly
patients with osteoporosis.
Mierzwińska – Nastalska E., Rusiniak – Kubik K., Spiechowicz E., Weimert I., Feder T.
Department of Prosthodontics, Medical University of Warsaw, Poland
Elderly patients with osteoporosis exibit many physiological deficiences and dysfunctions of the masticatory system
that many influence their quality of life.
The purpose of the study was an assessment of the masticatory organ in elderly (partially or totally) edentulous patients.
Surveyed patients consisted of 2 groups. Group (0) – with
osteoporosis, low bone mineral density values (BMD) and
pronounced resorption of the residual ridges compared to
group (P) of age matched patients with moderate ridge re38
sorption and bone mineral density (BMD) within age-norm.
Clinical, radiological examinations and questionnaires were
completed and the state, function and dysfunctions of the
masticatory system were examined before and after prosthetic treatment.
The survey revealed that improper occlusion, dysfunctions of TMJ and lack of dentures or inadequate dental
reconstructions severely affected the masticatory ability and
caused eating problems in both groups of patients.
Prosthetic rehabilitation gave considerably improved de-
Poster session
nture retention and stabilization. The use of elastic denture
liners for base tissue preservation and balanced occlusion
contributed well to functional effectiveness and masticatory
ability of patients. Functional improvement of masticatory
effectiveness was especially evident in the group of patients
with osteoporosis.
51. A comparison between Sonic-sys System and inlays in class II restorations.
Feder T., Mierzwińska-Nastalska E., Adamczyk-Sosińska E., Gładkowski J., Siedlecki M.
In everyday practice we often face the problem of class II
restorations. Large cavities create serious problems with obtaining correct contact points, marginal fit (expecially in the
gingival area) and good resin polymerisation. In these cases
use of Sonic-Sys system and inlays seems to be the best
solution. The aim of this paper is to present the Sonic-Sys
system, as well as comparison of Empress II and Sonic-Sys
inlays in class II restorations. In clinical tests the colour,
marginal fit, contouring and articulating points were evaluated. The surfaces of preparations were examined in SEM
and differences between those made by means of Sonic-Sys
and standard diamond burs were shown. The results present
advantages and disadvantages of both methods. The best
choice is to consider the appropriate method after clinical
examination and treatment planning in each individual case.
52. The use of dental implants in the treatment of congenitally missing lateral incisors.
Pospiech J.1 Ziołecka B.2
1
Clinic of Oral Surgery, Poznań University of Medical Sciences
2
Clinic of Pediatric Dentistry, Poznań University of Medical Sciences
Hypodontia of lateral incisors in the maxilla is one of the
most frequent abnormalities of permanent teeth (about 20%
affected teeth ). Congenitally missing teeth in the permanent
dentition need thorough treatment planning and serious consideration on the use of different therapies in order to save
tooth substance and to optimise the outcome in a lifelong
perspective. In the frontal region orthodontic treatment is
usually considered prior to prosthodontic therapy.
There are several methods of treatment starting from replacement of lateral incisors by canines and followed by
slight rebuilding of the shape with composites. Composite
retained onlay bridges are also used to replace missing laterals. Ceramic bridges are not recommended because they
require shaping teeth to fix the bridge.
Currently in a case of lack of teeth a multidisciplinary team
approach is recommended. It involves specialists in pediatric dentistry, oral surgery, and prosthodontics. In some cases dental implants
may be used. They are accepted by most patients and give the best
results both in function and aesthetics. Before the insertion of implants augmentation procedures as well as orthodontic treatment are
sometimes needed.
The treatment of two patients with hypodontia of the
lateral incisors is presented in this paper
For implantation AlphaBio(Israel), and 3i(USA) systems
were used. After the three month time of healing ceramic
crowns were prepared and fixed on the implants. A very
good aesthetic and function result was achieved as expected
by the patient and the doctors.
53. Tobacco smoking and long-term implant survival.
Wiśniewska-Spychała B.
Dept of Oral Surgery, Institute of Stomatology, K. Marcinkowski University School of Medical Sciences, Poznań, Poland
Tobacco smoking is stated to constitute one of the riskfactors for periodontitis, as chain tobacco addicts are predisposed to, among other disorders, periodontitis.
The study assesses the long-term status of implants placed
in smokers with concomitant periodontal disease. The studied group comprised 20 subjects (average age 52 years),
smoking in excess of 15 cigarettes a day, for at least 10
years. The results were compared with a control group of 20
non-smoking persons.
Overall, ninety six implantations were performed; 52 in
the studied group, and 44 in the control group. Chief radiological and clinical indices were assessed, both at the time of
the implant placement, and during check-up visits.
Within a 1.5 – 5 year period after implantation the extent
of ridge resorption, a typical reaction to implant placement,
and clinical parameters were found to be comparable in both
groups. Two implants were lost, one in each group.
The results indicate that tobacco smoking does not appear to be a risk-factor for the long-term success of dental
implants.
39
Poster session
54. Prevalence of dynamic models of occlusion in natural dentition
Panek H.
Department of Prosthodontics, Wrocław Medical University, Wrocław, Poland.
Statement of problem. Selection of the most appropriate
occlusal scheme for prosthetic rehabilitation is still a controversial issue in dentistry. This almost 100-year old dilemma
in prosthodontics may be solved by studying the dynamic
occlusal schemes in natural dentition.
The purpose of this study was to determine the prevalence
of particular dynamic models of occlusion in natural dentition and their relationship to gender and age.
Material consisted of 834 subjects with complete natural
dentition. The age of examined subjects ranged from 20 to
63 years.
Method. In all subjects the dynamic models of occlusion
were recognized on the basis of clinical examination of the
masticatory system.
Results. The following dynamic models of occlusion were found: bilateral and unilateral cuspid-protected occlusion,
group-function occlusion, balanced occlusion and „others”.
Prevalence of particular models of occlusion was almost the
same in males and females, however, some of the models
were dependent on age. It was found that the frequency of
bilateral and unilateral cuspid-protected occlusion decreased
with age, while the frequency of group-function occlusion
increased. The frequencies of balanced occlusion and „other” types of occlusion were very low and remained nearly
unchanged in relation to age.
Conclusion. The decrease in frequency of unilateral and
bilateral cuspid-protected occlusion may suggest their transformation into group-function occlusion, i.e. due to tooth
attrition. This phenomenon may, however, indicate that group-function occlusion provides a better stimulation of periodontal tissues than other models, and thus contributes to
maintenance of dental arch continuity up to a late age. Group
function occlusion seems to be the most suitable pattern for
prosthetic rehabilitation of patients with missing teeth. However, further studies are needed to determine the relationship
of the occlusal models to periodontitis and TMDs.
55. The impact of pathological respiration and malocclusion on ventilatory disorders
Dyras M., Chomyszyn – Gajewska M., Łyszczarz J.1, Łyszczarz R2
Chair of Orthodontia CMUJ Krakow, Poland
1
Chair of Conservative Dentistry CMUJ Krakow, Poland
2
Chair of Oral Surgery CMUJ Krakow, Poland
Research data and clinical observations indicate that incorrect mouth breathing may lead not only to functional and
morphological malfunction of the masticatory organ but to
respiratory system disturbances as well. This kind of breathing is mainly caused by hypotonia of the masticatory muscles, overgrowth of the adenoid glands, allergic diseases and
obstruction in the upper respiratory tract. The aim of this
study was to evaluate the relationship between mouth breathing and occurrence of malocclusion and ventilatory disorders in early adolescence. The examination was carried out
among 131 boys and girls (aged 10-12): 85 pupils from
swimmer classes of the School of Sport Championships and
46 pupils from a standard school. The oral status was evaluated by clinical examination conducted with the use of artificial lighting and a basic diagnostic set: dental probe and
dental mirror. The frequency of malocclusion, oral hygiene
(API – Approximal Plaque Index) and severity of decay
(DMF Index– Decayed Missing Filled) were evaluated. Respiratory system efficiency was assessed by parameters obtained from spirometry and flow-volume loop using a com-
40
puterised spirometer „Lungtest„-Poland.
Proper respiration (through the nose) was found in 77
examined pupils (group I) and incorrect respiration (through
the mouth or mixed) in 54 pupils (group II). The mean value
of API was 24.35 and DMF was 3.06 in group I, whereas in
group II: API-30.48 and DMF-2.89. Normal occlusion was
observed more frequently in group I (51%) than in group II
(35%). Distocclusion was the disturbance found most often
in both groups of examined pupils.
The values of parameters describing respiratory muscle
strength and airflow in the central bronchi were significanty
higher (using Kolmorogow-Smirnow’s test) in pupils with
normal occlusion than in pupils with malocclusion
(FVC:3.010.l/2.590.48l; PEF:5.011.22/4.341.09 l/s; MEF75:
4.521.05 l/s respectively).
Pupils with a pathological type of breathing will undergo
an educational and rehabilitation programme including proper diet indications and exercises of the respiratory and
masticatory muscles. Orthodontic appliances will be also be
used where necessary.
Poster session
56. Temporomandibular disorders in patients after hemimandibulectomy – treatment considerations
Rolski D., Kostrzewa J., Mierzwińska – Nastalska E., Rusiniak K., Nawrocka J.
Rehabilitation of the masticatory system in patients after
operations in the craniofacial region and mandible, poses
several therapeutic problems due to impairment of function
and structural deficiences.
The survey concerned a group of 50 patients after operations for malignant tumors and after radiotherapy in the
mandible and neck region. Segmental-, partial or hemimandibulectomy was performed and the surrounding tissues
and masticatory muscles were affected. Patients exhibited
various morphologic and functional deficiencies. Immediate
reconstructive surgery was completed in some cases to treat
mandibular discontinuity defects but in the majority of patients the reconstruction was delayed or not succesful. All
patients suffered due to dysfunction symptoms and temporomandibular disorders (TMD) before treatment.
A multidisciplinary approach to the patients’ problems
included supportive physiotherapy, myotherapy and prosthetic treatment. Treatment performed with the use of therapeutic and corrective splints, special devices and fixed and removable prostheses with leading planes or guiding surfaces
helped to obtain sufficient functional efficiency of the masticatory system.
57. Dependence of TMJ dysfunctions on spatial configuration of third molars
Panek H., Mankiewicz M.
Department of Prosthodontics, Wrocław Medical University, Wrocław, Poland.
Background. Review of the literature has indicated that
the problem of third molars has been analyzed mainly in
relationship to pathology caused by erupted or impacted
third molars, especially lower ones. The following disorders
were described in the presence of third molars: pericoronitis,
foliculitis, caries of third or second molars, ameloblastoma.
Some authors even advocated the early prophylactic extraction of third molars to prevent possible prospective crowding
of the anterior teeth due to the molars. Only single cases
have been described of patients with chronic pain in the
posterior region of the dental arch that simulated TMJ syndrome.
The aim of the present study was to establish the prevalence of temporo-mandibular dysfunctions and their dependence on the spatial relationship of erupted third molars.
Material of the study was a seldom selected population
of 303 male adolescents– students of a Secondary Car School in Wrocław. Mean age of the subjects was 18,4 years.
Methods. All subjects underwent a routine dental examination and functional clinical analysis of the stomatognathic
system.
Results. The routine examination revealed that third molars were present in 114 subjects (37,6%). The functional
analysis of the stomatognathic system revealed that TMJ
dysfunctions were found in 170 (56,1%) subjects. The dependence of TMJ dysfunctions on various spatial positions
of the third molars was presented in 17 tables.
Conclusions: Results of the study indicated that the prevalence of TMJ dysfunctions was different in various spatial
relationships of erupted third molars. However, TMJ dysfunctions were most frequent in the presence of lower third
molars, especially those occluding with upper ones.
58. Symptomatology evaluation of temporomandibular disorders.
Uliasz M., Stopa Z, Domagała J., Wojtkowska M.
The prevalence of temporomandibular disorders differs
from study to study and is estimated to be 12-90% of the
general population. Development of civilization and associated psychosocial stress is often suggested to be the main
casual factor of temporomandibular dysfunction.
The aim of this study was to determine the type and the
severity of patients’ complaints according to the clinicaletiological groups of temporomandibular joint disorders.
The analyzed material comprised of 150 patients with
arthropathy treated at The Centre of TMJ Arthroscopy at the
1-st Department of Maxillofacial Surgery of Warsaw Medical University between years 2002 and 2003. According to
clinical examination 130 females and 20 males aged between 12 and 80, were divided into five clinical-etiological
groups. In 26 patients ( 17%) a diagnosis of Myofacial pain
syndrome (MPS) was made; 9 patients (6%) were diagnosed
with myofacial pain dysfunction syndrome (MPDS); 79
(53%) comprised patients with internal derangement (ID);
28 patients (19%) and 8 patients(5%) were diagnosed with
osteoarthrosis (OA) and external disorders respectively.
41
Poster session
Effects of occlusal and non-occlusal parafunctions and psychosocial stress on TMJ arthropathy were analyzed. The most
common complaints evaluated were: pain, joint clicking and
popping, mastication difficulties and hearing problems.
One of the innovative methods of treatment of TMJ disorders is arthroscopy. Main complaints followed by clinical
and radiological evaluation are important in qualifyng patients for arthroscopy.
59. Influence of functional disorders of the temporo-mandibular joints on maximum biting forces.
Gidzińska-Głódkowska M., Kochańska B., Lamentowicz A.
Department of Conservative Dentistry, Medical University of Gdańsk
The aim of this study was to measure and analyze the
maximum biting forces (MaxSN) in people with functional
disorders of the temporo-mandibular joints.
Material and methods: The study involved 20 people
(12 females and 8 males) aged between 34 and 67 (x=49±9),
with functional disorders of the temporo-mandibular joints,
based on clinical examination. A control group constituted
20 people (10 females and 10 males) aged between 44 and
58 (x=51±4) with a healthy stomatognathic system. The
measurements were taken with the help of a gnatodynamometer equipped with a tensometric detector. The MaxSN
values in the right and left molar, right and left premolar and
incisor teeth were measured in all patients. The values of
measured forces were described in Newtons [N].
Results: The values of MaxSN were significantly lower in
every group of teeth in subjects with functional disorders of
the temporo-mandibular joints compared to the control group. Average values of MaxSN in subjects with functional
disorders of the temporo-mandibular joints were as follows:
189±38 N and 183±31 N (for right and left molar teeth),
128±24 N and 146±19 N (for right and left premolar teeth),
109±21 N (for incisor teeth). In control group the MaxSN
values were as follows: 236±43 N and 233±45 N (for right
and left molar teeth), 200±30 N and 197±29 N (for right and
left premolar teeth), 160±19 N (for incisor teeth). The MaxSN
values in males with disorders of the temporo-mandibular
joints were higher than in females but the differences were
not statistically significant. However in the control group the
differences in male and female MaxSN values were statistically significant.
The MaxSN values in males with temporo-mandibular
joint disorders were lower than in males with a healthy
stomatognathic system. The MaxSN values in females with
temporo-mandibular joint disorders were lower than in females with a healthy stomatognathic system (differences
statistically significant). No characteristic differences were
noticed in MaxSN values for groups of right and left teeth in
subjects with temporo-mandibular joint functional disorders
and the control group. The distribution of measured forces in
the dental arch of patients with temporo-mandibular joint
disorders was similar to the control group, i.e. the highest
average values were found in molar teeth, lower in premolar
teeth and lowest in incisor teeth (differences statistically
significant).
Conclusion: Temporo-mandibular joint disorders have a
remarkable influence on MaxSN value, which is significantly
lower than in the control group. In the group of people with
temporo-mandibular joint disorders the MaxSN values in males were higher than in females, although the differences
were not statistically significant.
MINERALIZED TISSUES
60. Structure of Meckel’s cartilage in the early fetal period (9-12 weeks)
Wyganowska M.1 , Przystańska A.2, Woźniak W.2
1
Department of Conservative Dentistry and Periodontology, University of Medical Sciences, Poznan, Poland
2
Department of Anatomy, University of Medical Sciences, Poznan, Poland
The important role of Meckel’s cartilage in the development of the mandible, auditory ossicles, palate, and muscles
of mastication was a stimulus for this study. Investigations
were made in 7 human fetuses aged between 9 and 12 weeks.
All fetuses were decalcified and embedded "in toto" in paraplast and serially sectioned in three planes. Histological sections were stained according to various methods.In all fetuses Meckel’s cartilage extends from the symphysis through
the length of the mandible and is continuous with the malle-
42
us. However its posterior end gradually separates from the
malleus. Between them is a narrow, partly ligamentous
structure. The cartilage is also connected with the disc of the
temporomandibular joint. Most evident changes in the structure of Meckel’s cartilage are found at the level of the mandibular body, particularly in its anterior part. These changes
are related to ossification of the mandible and establishment
of the final attachment of muscles. The anterior part of the
cartilage is invaded by the developing bone and its cellular
Poster session
structure is also changing. Some cells aquire characteristics
of chondrocytes.It has to be pointed out that during the 10th
week the lateral pterygoid muscle, mylohyoid muscle, ge-
nioglossus muscle and geniohyoid muscle establish final
attachment to the mandible.
61. The root anatomy of permanent maxillary first molars obtained from skulls dated from XII – XIV century.
Łagocka R.1, Sikorska – Bochińska J.1, Lipski M.1, Buczkowska – Radlińska J.1, Chlubek D.2
1
2
Department of Biochemistry and Chemistry, Pomeranian Medical University, Szczecin, Poland
In the last two decades of the twentieth century new
technology and new methods of endodontic treatment have
been developed. This has caused the growth of interest in
tooth root and canal anatomy. Due to the complexity of the
roots and canal system in molars and premolars these teeth
especially are investigated. It appears that aberrations such
as C-shaped canals, additional canals or fused roots have
been found not only in the teeth of modern man.
The aim of the study was to examine the root anatomy of
permanent maxillary first molars from skulls found at three
archaeological burial sites in western Poland. One hundred
and seventy nine human permanent maxillary first molars
were collected (83 female, 96 male). The teeth were obtained
from skulls found at three archeological sites in Poland:
Sypniewo, Milicz and Wrocław. The skeletons dated from
XII–XIV century. The following features were evaluated:
number and shapes of the roots, number of apical foramen
per root and their position, length of the roots. This study has
shown that the basic dimensions of permanent maxillary first
molar roots have not changed during the last 700-900 years
in people of Caucasian origin residing in the territory of
present-day western Poland. Despite the complicated root
and canal anatomy of molars that has been described recently, the prevalence of four or more apical foramen in archeological maxillary first molars and the presence of a high
percentage of fused roots suggest that the morphology and
anatomy of these teeth was as complicated in the XII –XIV
centuries as in present-day teeth.
62. Argyria Affecting the Bone Structures in the Vicinity of Amalgam Fillings in the Skulls of German Soldiers from
the World War II Period.
Fra˛czak B., Ey – Chmielewska H., Sobolewska E.
Department of Dental Prosthetics, Pomeranian Medical University in Szczecin.
Head: Dr Bogumiła Fra˛czak, PhD in Medicine
Department of Anatomy, Pomeranian Medical University in Szczecin
Head: Prof. Florian Czerwiński, PhD in Medicine
The examinations were carried out on twenty jaws containing teeth, the jaws of mature German soldiers. The material
was obtained from the Department of Anatomy at the Pomeranian Medical Academy in Szczecin. In the course of examinations it was observed that in the vicinity of teeth with
amalgam fillings there were extensive areas of discoloration
in the bone structures adjacent to the filled teeth. Due to
special preservation restraints on the material received there
was no possibility to use biopsy method. The only technique
to be applied was visualization using a special digital apparatus; the examination effects have been presented in the
photos included in the article.
63. Acute Phase Protein in Serum of Patients with Osteoporosis.
Mierzwińska – Nastalska E., Rusiniak – Kubik K., Weimert I., Kucharski Z., Feder T., Skopińska – Różewska E.
Department of Laboratory Diagnostics and Immunology, NIT&LD, Warsaw, Poland
Osteoporosis is a risk factor for marked changes of bone
metabolism in the skeleton and alveolar process and for
residual ridge reduction in the jaw. Immunological aspects
of osteoporosis, bone metabolism and bone resorption are
still under investigation. Many cytokines play very important roles in immune homeostasis and remodelling of bone.
Objectives: The investigation of cytokine levels and their
receptors in blood serum of patients with osteoporosis is
employed in the clinical part of experimental investigations.
The purpose of the study was to evaluate the concentration
of acute phase protein: Alpha 1 – antitrypsin in blood serum.
Methods: The study covered a group of geriatric edentulous persons (63-83 years old) wearing complete dentures.
Interviews, clinical and radiological examination and densi-
43
Poster session
tometric surveys were carried out in these patients. The
concentration of Alpha1-antitrypsin in serum of patients
with osteoporosis was investigated with the use of radial
immunodiffusion with NOR-Partigen plates (Behring).
Results: Radiographic evaluation showed osteoporotic
changes in the mandibular interior cortex and resorption of
the mandibulae of all geriatric patients surveyed. A highly
increased level of Alpha1 – antitrypsin was detected in the
blood serum of the surveyed group.
Conclusions: Analysis of the correlation between marked
bone resorption and osteoporotic changes in the mandible
and the concentration of Alpha 1-antitrypsin in the blood
serum showed a positive dependence.
DENTAL MATERIALS
64. MagicFil – compomer restorative material for restoration of deciduous teeth.
Sobczak M.1, Grzybowska A.1, Raczyńska M.2, Jodkowska E.2, Remiszewski A.1
1
2
Zaklad Stomatologii Zachowawczej IS AM w Warszawie
The aim of the study was to evaluate clinical quality and
clinical properties of MagicFil material.
MagicFil is a dual cure compomer restorative material for
the restoration of deciduous teeth. There are four MagicFil
shades : sunny yellow, wild berry, ocean blue and universal.
The material is packed in syringes as a base and catalyst,
mixed in the Smartmix-Tip, and can be directly applied by
the intraoral tip. According to instructions etching should be
performed and adhesive (Solist) should be applied, before
placing the material.
Methods: In a group of 30 patients, of both sexes, aged
from 3 to 10 years old, 50 restorations were placed in deciduous molars. There were restorations of class I and II cavities.
Restorations were evaluated directly after treatment. This
clinical evaluation included examination of all margins to
ensure that no overhangs existed and the surface was finished adequately to the preparation margins.
We evaluated clinical properties of MagicFil material.
We also evaluated restoration colour preferences of young patients.
Results: In a group of 30 children 54% selected the ocean
blue colour of the material. The possibility of colour choice
allows young patients to participate in treatment procedures.
MagicFil compomer restoration requires, that proper techniques should be followed to achieve a very good clinical
result. Because of release of fluoride and zinc ions, MagicFil
can cause a cariostatic effect.
65. An assessment of the handling properties of the Polish composite Arkon
Bachanek T., Chałas R., Łukasiewicz D., Tarczydło B.
Department of Conservative Dentistry, Skubiszewski Medical University of Lublin, Poland, e-mail: [email protected]
The aim of this study was to assess the handling properties and to initially evaluate a new restorative composite
material Arkon manufactured in the Laboratory of Dental
Pharmacology Arkona in Lublin. This is an universal, microhybride, light-cure dental material used with MasterBond in
anterior and posterior dental restorations.
96 restorations were evaluated directly after placement
considering such properties as inserting into the cavity, marginal adaptation, surface shaping, color match, finishing and
polishing. Clinical assessment of the restorations was made
according to the Modified US Public Health Service criteria
(Rygea scale).
In the preliminary evaluation, all characteristics of the
investigated material received satisfactory ratings. The obtained results of initial evaluation also show that the examined material can be accepted by dentists because of easy
application and good esthetic effects.
66. Pre-clinical evaluation of silated hydroxyethylcellulose – test for genotoxicity.
Wierucka – Młynarczyk B.1, Mielżyńska D.2, Kubicka – Musiał M.1, Hüpsch – Marzec H.1, Ilewicz L.1
1
Teaching Department of Conservative Dentistry and Endodontics, Silesian Medical University, Katowice, Poland
2
Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
Silated hydroxyethylcellulose is one of the materials
44
which can be used as a carrier for drugs or grafts. The
Poster session
polymer creates a network of hydroxyethylcellulose chains
connected by silane coupling agents. Such a structure, enabling the penetration of newly formed bone into the polymer,
can help to treat bone defects. We predict the possibility of
using the polymer as a carrier for such materials as hydroxyapatite, tricalcium phosphate or calcium hydroxide in periodontology, surgery or endodontics.
The aim of our study was an evaluation of genotoxicity
caused by silated hydroxyethylcellulose using a short-term Salmonella test. This reverse mutation assay was conducted to
determine whether gene mutation, changes in chromosome
structure, or other DNA or gene changes could be observed.
Two strains of Salmonella typhimurium TA98 and TA100
were used. Aqueous extract of silated hydroxyethylcellulose
was evaluated in three doses: 125,250 and 500 µl per plate,
twice. The value of the mutagenic activity index and percentage
of bacterial survival was calculated. Statistical analysis was
performed using Bernstein’s test (p<0.05).
The mutagenic activity index for both strains was lower
then 1 (range from –0.03 to +0.27). The percentage of bacterial survival was bigger then 50 (range from 86.1 to 100).
The dose-response dependencies for silated hydroxyethylcellulose were not statistically significant.
Conclusion. Evaluation of silated hydroxyethylcellulose
properties with short-term in vitro tests showed no mutagenicity or toxicity for the bacterial strains used.
67. An assessment of the effectiveness of the Viva Style Paint On bleaching system
Małkiewicz K., Jodkowska E.
Department of Conservative Dentistry Medical University of Warsaw
Objective: The aim of the study was to evaluate the
efficacy of the paint-on whitening gel (Ivoclar Vivadent).
Methods: A total of 15 subjects (aged 19-27) were investigated. Patients were treated for 14 days by applying bleaching gel with a paintbrush directly on the labial surfaces of
teeth twice a day for 30 minutes. Tooth shade was evaluated
before starting bleaching, after 7 days and after 14 days of
treatment using the Shade Analyzer System ( IvoclarVivadent ). Analysis of digital images of the maxillary central
incisors was performed to assess changes in tooth color.
Whitening efficacy was determined by evaluating color
changes from baseline in tooth yellowness (delta b*) and
tooth brightness (delta L*).
Results: Data analysis showed a reduction of yellowness
after 14 days of bleaching giving a delta b* value of -0,496
for subjects using the paint-on gel. Analysis of measurements revealed an increase in brightness after treatment.
Delta L* after 14 days was 0,637. Conclusions: The study
showed that the product caused a reduction of yellowness of
bleached teeth and an increase of their brightness but the
study requires further investigation.
68. Effectiveness of three new generation diode units (LEDs) compared to a conventional halogen lamp – initial study
Ponto M., Fitak E., Wagner L.
Department of Basic Dental Sciences and Prevention Medical Academy of Warsaw
The photo initiators of the polymerization of dental composites are sensitive to light of wavelength between 460 and
480 nm. The general problem with traditional halogen units
is degradation of the lamp, filter and reflector with time. In
contrast, diode units (LEDs) offer a very long lasting and
relatively stable output of blue light. Many of the LEDs emit
light of the ideal 468 nm wavelength absorbed by the photo
initiator (camphoroquinone). Recently, a new generation of
LEDs, having much more radiometric power above 1000
mW/cm2 has been produced.
The aim of this initial study was an evaluation of the
effectiveness of three LEDs: Enalux (Mice-rium), Elipar
Freelight 2 (3M-ESPE) and Smart Light (Dentsply) compared to the conventional halogen lamp Elipar Threelight (3MESPE) by examining an indicator of complete polymerization of the dental materials – resistance to crushing. During
the evaluation, light curing composites with different opaci-
ty and transparency: Enamel HFO shade OW and IR6 (Micerium) and SureFil shade A and C (Dentsply) were used. 3
samples of each of these materials were inserted into a Helio-Test instrument (H:11 mm, W: 3,7 mm and L: 4,6 mm)
and irradiated by each of the units compared – during the
first test for 20 sec and during the second one for 40 sec. All
the samples were subjected to crushing in an Instron 4411
machine according to the ISO norm nr.4049 (the speed of
shifting the probe: 0,75+/-0,25 mm/min, press: 50 +/– 16
N/min). The press was continued until complete breakdown
of all samples.
On the basis of our initial examination we conclude that
all the evaluated units allow to obtain the proper grade of
polymerization of the composites according to the ISO norm
nr.4049
We will continue our study by examining other indicators
of complete polymerization of dental composites.
45
Poster session
69. Numerical calculations of thermal stresses in the tooth structure caused by polymerisation curing-unit -Three-dimensional model.
Preiskorn – Rynkiewicz M, Trykowski J
Central Military Medical Clinic „CePeLek”
Objective. The aim of the investigation was to calculate
thermal stresses inside dental tissues during warming by the
polymerisation lamp.
Material and methods. The numerical analysis was performed using a three-dimensional FEM model of the central
incisor tooth, without any structural changes, used earlier in
in vitro experiments. Basic dimensions of the investigated
tooth were determined from X-ray images. This enabled
three-dimensional fashioning of the tooth geometry. A professional COSMOS/M (SLAC, LA, USA) software package
was employed. The three-dimensional model of the tooth
was built wherein specific layers were differentiated, such
as: the enamel, the dentine, the pulp and the cement. Thermophysical properties of dental tissues were taken from
literature and were isotropic and unchangeable in the temperature function. In this case the effects of exposition of the
labial crown surface to radiation of an enlarged power halogen curing-unit Elipar HighLight (ESPE, Germany), was
investigated. Standard settings 10s, 20s and 40s of this unit
were used. The possibility of the comparison of numeric
results with values of the temperature measured on the real
tooth enabled the verification of calculations.
Results. The numeric model allows the calculation of
nascent stresses during warming of tooth tissues. Maximum
values obtained for stresses thermal of 10s, 20s, and 40s-periods were 5,2 MPa, 5,7 MPa, 5,9 MPa respectively. The
greatest thermal stress values were obtained at the border of
the affected field. The maximum thermal stress increase was
observed in the first 10 seconds. The maximal initial thermal
stress in the steady beginning state was 0,6 MPa.
Conclusions. It seems necessary to take into account
thermal stresses in the complete stress analysis of the tooth
structure. Thermal stress values caused by the polymerisation lamp can be significant for maintenance of dental restorations.
70. The thermal influence of dental curing units with alternative light sources on tooth tissues – in vitro investigations.
Preiskorn – Rynkiewicz M, Trykowski J.
Central Military Medical Clinic „CePeLek”
Objective: The aim of the in vitro study was to investigate thermal results (the temperature rise of the tooth) caused
by the light of chosen diode lamps and a plasma lamp.
Material and methods: A typical upper central incisor
extracted for periodontal indications was used in the study.
The tooth was without caries or dental fillings. The heat
transfer through the pulp was modeled by placing a copper
wire 1 mm in diameter inside the root of the tooth. The tooth
was mounted in a circular socket of an isostatic test chamber.
The running water bath temperature was stabilized at
36.6± 0.1C. The stand was designed to reproduce thermal
conditions of the environment of the oral cavity. Thermocouples K were placed at certain points inside the tooth and
on its surface. The measured signals are handled by a portable PC (laptop) equipped with a NI DAQ Card 4350.
Diode lamps – LUXoMAX (Akeda Dental, Denmark),
Elipar FreeLight (3M ESPE, Germany) and the plasma light
lamp Flipo (Lokki, France) were chosen for the study. Light
guides were positioned centrally, perpendicularly and 1mm
46
from the labial surface of the crown. The experiment was
repeated 20-times for every setting of the chosen curingunits. The normal disposition test, Shapiro-Wilk criterion
was used and middle values and standard deviations were
calculated.
Results: At the tooth-pulp junction, temperature increases did not exceed 1,7C for Elipar FreeLight. The diode
curing-unit LUXoMAX caused middle values of maximum
temperature rises not higher than 1.2C. The plasma lamp
Flipo caused temperature rises inside the tooth not higher
than 1,4C.
Conclusions: Values of thermal rises at the dentin-pulp
junction indicate that diode and plasma curing units are safe
for dental pulp. They can be an alternative for dental halogen
lamps with enlarged power. This investigation will be continued to check temperature rises caused by photo-curing
units in a tooth with a cavity (the polymerisation of bonding
material).
INDEX OF ABSTRACTS
1
The level of cariogenic bacteria versus oral hygiene in children with and
without palatal cleft treated by removable appliances.
Antoszewska J., Matthews-Brzozowska T.
2
Streptococcus and Lactobacillus counts in carious lesions before and after
cavity preparation using the chemo-mechanical Carisolv method.
Marczuk-Kolada G.
3
Streptococcus Sobrinus, Streptococcus Mutans and dental caries in Polish
schoolchildren
Strużycka I., Hryniewicz W.,
Wierzbicka M., Skoczyńska A., Walory J.
4
An analysis of consumption of cariogenic and non-cariogenic products sold
in shops in primary, grammar and secondary schools
Łukasiewicz D., Bachanek T.
5
Using a Clinical Examination of Children and Mothers to Assess the Risk
of Dental Caries in Children up to Three Years of Age.
Stanczak-Sionek D., Szpringer-Nodzak
M., Remiszewski A.
6
Sealing primary molar teeth in 3-year old children as a method of caries
prevention.
Remiszewski A., Wal A., Sobiech P.
7
Safety of oral fluoride prophylaxis in the light of experimental research
Da˛browska E., Balunowska M.,
Stokowska W., Letko R.
8
The influence of early caries lesion acid-etching on the remineralization
process – in vitro study
Piesiak-Pańczyszyn D., Kaczmarek U.,
Woźniak J.
9
Efficacy of „Duraphat” fluoride varnish in caries prophylaxis in children with
deciduous teeth – an 18-month study
Sobiech I., Szpringer– Nodzak M.,
Pelc M., Remiszewski A.
10
The evaluation of efficacy of two varnishes Cervitec and Fluor Protector
in prophylaxis of pit and fissures surfaces of first molar teeth
Rodakowska E., Klimiuk A., Waszkiel D.
11
Diagnostic accuracy of chosen methods of early caries lesion diagnosis
on molar occlusal surfaces
Wozniak J., Kaczmarek U., Łoś P., Piesiak
D., Czajczyńska A.
12
Caries risk factors in 3 year old children living in the Podlasie region.
Bagińska J., Stokowska W.
13
Caries intensity in deciduous teeth and condition of the sixth teeth
in 7-year-old children from Białystok
Szafrańska-Perkowska B., Waszkiel D.
14
Oral health in the year 2003 of 18 year old adolescents from the Pomorskie
district.
Emerich-Poplatek K.,
Adamowicz-Klepalska B.
15
Comparison of Caries Intensity in 18-Year-Old Adolescents from the Gdansk
Region in Year 1995 and 2003.
Emerich-Poplatek K.,
Adamowicz-Klepalska B.
16
Dental care of children in Poland. The system-reforming proposals.
Szatko F., Wierzbicka M., Jerominko A.
17
The state of oral health and the dental treatment needs in a studied population
with mucoviscidosis in the Podlasie province.
Błahuszewska K., Da˛browska E.,
Minarowska A., Letko R., Stokowska W.
18
Dental caries in schoolchildren in Poland
Wierzbicka M., Szatko F., Dybiżbańska
E., Ganowicz M., Zawadziński M.,
Pierzynowska E.
19
Periodontal Health of 7 Year Old and 12 Year Old Children from Poland
in 2003.
Drabarczyk-Nasińska M., Strużycka I.,
Słotwińska S. M., Dybiżbańska E.,
Zawadziński M., Pierzynowska E.,
Wierzbicka M.
20
Proposal of a holistic concept of the stomatognathic system
Panek H.
21
Parents anxiety about dental treatment of their up-to-three-year-old children
Wilk-Sieczak B., Gmyrek-Marciniak A.
22
The Influence of a Family’s Attitudes on Children’s Behaviour During the
Adaptation Visit
Wilk-Sieczak B., Gmyrek-Marciniak A.
23
Root canal obturation method with thermoplastic Thermafil points – in vitro
and in vivo study.
Sobczak M., Raczyńska M., Grzybowska A.,
Jodkowska E., Remiszewski A.
24
The temperature changes on the outer surface of roots during filling with a
hybrid technique
Lipski M., Górski M., Woźniak K.,
Łagocka R., Buczkowska-Radlińska J.
47
Index of abstracts
25
The use of glass fibre pins in the treatment of root fractures of teeth.
Marczuk-Kolada G., Pawińska M.,
Tokajuk G.
26
30-year observations of silver amalgam left beyond the root apex
Sikorska-Bochińska J., Łagocka R.,
Jamroszczyk K., Buczkowska-Radlińska J.
27
Assessment of physiological levels of pulpal blood flow in permanent incisors
Pypeć L. J., Bruzda-Zwiech A., Proc P.
in children.
28
Electrosensitivity of dental pulp in root ended young central upper permanent
incisors with fully – formed root apices.
Łuczaj-Cepowicz E.
29
Intradental, inflammatory foci predispose to endocarditis
Wisniewska-Spychala B., Grajek S.,
Maksymiuk T.
30
Multidisciplinary orthodontic-periodontal treatment in secondary occlusion
trauma due to periodontal disease.
Dembowska E., Górniak D.
31
Necessity of periodontal care in patients with cardiovascular diseases
Bochniak M., Sadlak-Nowicka J., Łaska M.
32
Evaluation of the efficacy of Corsodyl gel and Corsodyl fluid in the treatment
of chronic periodontitis
Pietruska M., Peniczko A., Waszkiel D.
33
Certain risk factors for drug-induced gingival overgrowth in renal transplant
patients medicated with immunosuppressive drugs
Lewińska-Chełstowska M., Banach J.
34
Multidisciplinary treatment of aggressive periodontitis-case report
Czerniuk M, Ne˛dzi-Góra M, Górska R.
35
Analysis of prevalence of parafunctions in an adolescent population
Mankiewicz M., Panek H.
36
Clinical and Mycological Estimation of Mucous Membrane of Oral Cavity at
Postmenopausal Women
Hüpsch– Marzec H., Kubicka-Musiał M.,
Wierucka B.
37
Quantitative and Qualitative Microscopic Evaluation of the Epithelium of the
Oral Mucous Membrane in Postmenopausal Women
Hüpsch-Marzec H., Ksia˛żek-Ba˛k H.,
Kubicka-Musiał M., WieruckaMłynarczyk B., Mykietów-Smalec B.
38
Partial Trisomy of 14q– Case Report.
Strzałkowska A., Matthews-Brzozowska
T., Skulimowska G., Śle˛zak R., Śmigiel R.
39
The prevalence of halitosis in a population interested in oral health.
Iwanicka-Grzegorek E., Ke˛pa J., Michalik
J., Wierzbicka M., Pierzynowska E.
40
Atypical placement of retained teeth
Stopa Z., Krasny K., Abed K.
41
Chronic sinusitis.The role of cytokines in maxillary bone resorption.
Wieczorek P., Wojtowicz A., Ostrowski K.
42
Tooth extraction/replantation after endodontic treatment failure, not qualified
for surgery ( case reports)
Lewandowski P.
43
The incidence of additional and supernumerary teeth in patients of the
Department of Oral Surgery Medical University of Warsaw– epidemiological
study.
Wychowański P., Wojtowicz A.,
Nosek M., Ciechowicz K., Jasiński P
44
Significance of Psychotherapy in Treating Patients after Extensive Surgical
Operations within the Facial Part of the Skull.
Fra˛czak B., Fra˛czak P.
45
The role of cytokines in periapical inflammation and dental cyst development
Jankowska-Antczak E., Kozarzewska M.,
Wojtowicz A.
46
Juvenile Pilocytic Astrocytoma – a case report.
Wanyura H., Uliasz M., Smolarz A.
47
Dry mouth problems in patients after renal transplantation
Jankowska-Antczak E., Pochwalski M.,
Wojtowicz A.
48
Odontogenic tumors – radiological diagnostics.
Samolczyk-Wanyura D., Piekarczyk J.,
Szałwiński M., Piekarczyk P.,
Głe˛bowski P.
49
Usefulness of the USG examination in the diagnosis of diseases occurring
with enlarged lymph nodes
Samolczyk-Wanyura D., Piekarczyk J.,
Jagielak M., Piekarczyk P., Szałwiński M.,
Thun-Szretter K.
48
Index of abstracts
50
Survey of the state of the masticatory organ and the effect of prosthetic
rehabilitation on chewing ability of elderly patients with osteoporosis
Mierzwińska-Nastalska E., RusiniakKubik K., Spiechowicz E., Weimert I.,
Feder T.
51
A comparison between Sonic-sys System and inlays in class II restorations.
Feder T., Mierzwińska-Nastalska E.,
Adamczyk-Sosińska E., Gładkowski J.,
Siedlecki M.
52
The use of dental implants in the treatment of congenitally missing lateral
incisors.
Pospiech J. Ziołecka B.
53
Tobacco smoking and long-term implant survival
Wiśniewska-Spychała B.
54
Prevalence of dynamic models of occlusion in natural dentition.
Panek H.
55
The impact of pathological respiration and malocclusion on ventilatory
disorders
Dyras M., Chomyszyn-Gajewska M.,
Łyszczarz J., Łyszczarz R.
56
Temporomandibular disorders in patients after hemimandibulectomy –
treatment considerations
Rolski D., Kostrzewa J., MierzwińskaNastalska E., Rusiniak K., Nawrocka J.
57
Dependence of TMJ dysfunctions on spatial configuration of third molars
Panek H., Mankiewicz M.
58
Symptomatology evaluation of temporomandibular disorders
Uliasz M., Stopa Z, Domagała J.,
Wojtkowska M.
59
Influence of functional disorders of the temporo-mandibular joints on
maximum biting forces.
Gidzińska-Głódkowska M., Kochańska B.,
Lamentowicz A.
60
Structure of Meckel’s cartilage in the early fetal period (9-12 weeks)
Wyganowska M., Przystańska A.,
Woźniak W.
61
The root anatomy of permanent maxillary first molars obtained from skulls
dated from XII – XIV century.
Łagocka R., Sikorska-Bochińska J., Lipski
M., Buczkowska-Radlińska J., Chlubek D.
62
Argyria Affecting the Bone Structure in the Vicinity of Amalgam Fillings in
the Skulls of German Soldiers from the World War II Period.
Fra˛czak B., Ey-Chmielewska H.,
Sobolewska E.
63
Acute Phase Protein in Serum of Patients with Osteoporosis.
Mierzwińska-Nastalska E., RusiniakKubik K., Weimert I., Kucharski Z.,
Feder T., Skopińska-Różewska E.
64
MagicFil – compomer restorative material for restoration of deciduous teeth.
Sobczak M., Grzybowska A., Raczyńska
M., Jodkowska E., Remiszewski A.
65
An assessment of the handling properties of the Polish composite Arkon
Bachanek T., Chałas R., Łukasiewicz D.,
Tarczydło B.
66
Wierucka–Młynarczyk B., Mielżyńska D.,
Pre-clinical evaluation of silated hydroxyethylcellulose – test for genotoxicity. Kubicka–Musiał M., Hüpsch-Marzec H.,
Ilewicz L.
67
An assessment of the effectiveness of the Viva Style Paint On bleaching
system
Małkiewicz K., Jodkowska E.
68
Effectiveness of three new generation diode units (LEDs) compared to a
conventional halogen lamp – initial study
Ponto M., Fitak E., Wagner L.
69
Numerical calculations of thermal stresses in the tooth structure caused by
polymerisation curing-unit -Three-dimensional model
Preiskorn-Rynkiewicz M, Trykowski J.
70
The thermal influence of dental curing units with alternative light sources on
tooth tissues – in vitro investigations
Preiskorn-Rynkiewicz M, Trykowski J.
49
INDEX OF AUTHORS
Abed K. - 40
Adamczyk – Sosińska E. - 51
Adamowicz – Klepalska B. - 14, 15
Antoszewska J. – 1
Bachanek T. – 4, 65
Bagińska J. – 12
Balunowska M. – 7
Banach J. – 33
Błahuszewska K. – 17
Bochniak M. – 31
Bruzda – Zwiech A. – 27
Buczkowska – Radlińska J. – 24, 26, 61
Chałas R. – 65
Chlubek D. – 61
Chomyszyn – Gajewska M. – 55
Ciechowicz K. – 43
Czajczyńska A. – 11
Czerniuk M. – 34
Da˛browska E. – 7, 17
Dembowska E. – 30
Domagała J. – 58
Drabarczyk – Nasińska M. – 19
Dybiżbańska E. – 18, 19
Dyras M. – 55
Emerich – Poplatek K. – 14, 15
Ey – Chmielewska H. – 62
Feder T. – 50, 51, 63
Fitak E. – 68
Fra˛czak B. – 44, 62
Fra˛czak P. - 44
Ganowicz M. – 18
Gidzińska – Głódkowska M. – 59
Gładkowski J. – 51
Głe˛bowski P. – 48
Gmyrek – Marciniak A. – 21, 22
Górniak D. – 30
Górska R. – 34
Górski M. – 24
Grajek S. – 29
Grzybowska A. 23, 64
Hryniewicz W. – 3
Hüpsch – Marzec M. – 36, 37, 67
Ilewicz L. – 66
Iwanicka – Grzegorek E. – 39
Jagielak M. – 49
Jankowska – Antczak E. – 45, 47
Jamroszczyk K. – 26
Jasiński P. – 43
Jerominko A. – 16
Jodkowska E. – 23, 64, 67
Kaczmarek U. – 8, 11
Ke˛pa J. – 39
Klimiuk A. – 10
Kochańska B. – 59
50
Kostrzewa J. – 56
Kozarzewska M. – 45
Krasny K. – 40
Ksia˛żek – Ba˛k H. - 37
Kubicka – Musiał M. – 36, 37, 66
Kucharski Z. – 63
Lamentowicz A. – 59
Letko R. – 7, 17
Lewandowski P. – 42
Lewińska – Chełstowska M. – 33
Lipski M. – 24, 61
Łagocka R. – 24, 26, 61
Łaska M. – 31
Łoś P. – 11
Łuczaj – Cepowicz E. – 28
Łukasiewicz D. – 4, 65
Łyszczarz J. – 55
Łyszczarz R. – 55
Maksymiuk T. – 29
Małkiewicz K. – 67
Mankiewicz M. – 35, 57
Marczuk – Kolada G. – 2, 25
Matthews – Brzozowska T. – 1, 38
Michalik J. – 39
Mielżyńska D. – 66
Mierzwińska – Nastalska E. – 50, 51, 56, 63
Minarowska A. – 17
Mykietów – Smalec B. – 37
Nawrocka J. – 56
Ne˛dzi – Góra M. – 34
Nosek M. – 43
Ostrowski K. – 41
Panek H. – 20, 35, 54, 57
Pawińska M. – 25
Pelc M. – 9
Peniczko A. – 32
Piekarczyk J. – 48, 49
Piekarczyk P. – 48, 49
Pierzynowska E. – 18, 19, 39
Piesiak D. – 11
Piesiak – Pańczyszyn D. – 8
Pietruska M. – 32
Pochwalski M. – 47
Ponto M. – 68
Pospiech J. – 52
Preiskorn – Rynkiewicz M. – 69, 70
Proc P. – 27
Przystańska A. – 60
Pypeć I., J. – 27
Raczyńska M. – 23, 64
Remiszewski A. – 5, 6, 9, 23, 64
Rodakowska E. – 10
Rolski D. – 56
Rusiniak K. – 56
Rusiniak – Kubik K. – 50, 63
Sadlak – Nowicka J. – 31
Samolczyk Wanyura D. – 48, 49
Siedlecki M. - 51
Sikorska – Bochińska J. – 26, 61
Skoczyńska A. – 3
Skopińska – Różewska E. – 63
Skulimowska G. – 38
Słotwińska S., M. – 19
Smolarz A. – 46
Sobczak M. – 23, 64
Sobiech I. – 9
Sobiech P. – 6
Sobolewska E. – 62
Spiechowicz E. – 50
Sporniak – Tutak K. - 41
Stanczak – Sionek D. – 5
Stokowska W. – 7, 12, 17
Stopa Z. – 40, 58
Strużycka I. – 3, 19
Strzałkowska A. – 38
Szafrańska – Perkowska B. – 13
Szałwiński M. – 48, 49
Szatko F. – 16, 18
Szpringer – Nodzak M. – 5, 9
Śle˛zak R. – 38
Śmigiel R. – 38
Tarczydło B. – 65
Thun – Szretter K. – 49
Tokajuk G. – 25
Trykowski J. – 69, 70
Uliasz M. – 46, 58
Wagner L. – 68
Wal A. – 6
Walory J. – 3
Wanyura H. – 46
Waszkiel D. – 10, 13, 32
Weimert I. – 50, 63
Wieczorek P. – 41
Wierucka B. – 36
Wierucka – Młynarczyk B. – 37, 66
Wierzbicka M. – 3, 16, 18, 19, 39
Wilk – Sieczak B. – 21, 22
Wiśniewska – Spychała B. – 29, 53
Wojtkowska M. – 58
Wojtowicz A. – 41, 43, 45, 47
Wozniak J. – 8, 11
Woźniak K. – 24
Woźniak W. – 60
Wychowański P. – 43
Wyganowska M. – 60
Zawadziński M. – 18, 19
Ziołecka B. - 52

Prof. dr hab. Stefan Krus (Redaktor Honorowy – Honorary Editor)

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