The aim of the present study was to evaluate the adjunctive effect of hyaluronic acid (HA) gel in the treatment of residual periodontal pockets over a 12-month period. Periodontal patients presenting at least one residual periodontal pocket 5–9 mm of depth in the anterior area were recruited from six university-based centers. Each patient was randomly assigned to subgingival instrumentation (SI) with the local adjunctive use of HA for test treatment or adjunctive use of local placebo for control treatment at baseline and after 3 months. Clinical parameters ( )probing depth (PD), bleeding on probing (BoP), plaque index (PI), recession (REC), clinical attachment level (CAL)) and microbiological samples for the investigation of the total bacterial count (TBC) and presence of specific bacterial species (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum) were taken at baseline and every 3 months, until study termination. PD was determined as the primary outcome variable. From a total of 144 enrolled, 126 participants (53 males, 73 females) completed the entire protocol. Both treatments resulted in statistically significant clinical and microbiological improvements compared to baseline. Although the local application of HA showed a tendency for better results, there was a lack of statistically significant differences between the groups.

Purpose: Dental education institutions worldwide experienced disruptive changes amid the COVID-19 pandemic, with a rapid switch to the online learning format. Thus, this study aimed to assess the impact of the COVID-19 pandemic on dental education and evaluates the perceptions and attitudes of students towards the introduction of online learning in the School of Dental Medicine in Zagreb, Croatia. Methods: A survey was conducted on a population of undergraduate students. It was comprised of perceptions and attitudes of students on the impact of the COVID-19 pandemic on their psychoemotional status, changes introduced in the educational system, and online learning in particular. Results: Of the 352 students that completed the survey, 66.2% of students reported being psychoemotionally affected by the lockdown. The most significant impact of the switch from in-person to online learning was observed in terms of missing contact with lecturers (60.3%) and peers (90.3%) and loss of practical courses, regarding which 65% of students agreed that they could not be compensated. While only 36.1% reported that online teaching fully met their expectations, the majority of the students (61.9%) agreed that online lectures were as valuable as in-person lectures and that the theoretical courses could be carried out online in the future as well (69.9%). Conclusions: Students reported relative satisfaction with changes in the learning format and a positive attitude towards online learning; however, several challenges and obstacles were identified.

The aim of this research was to investigate the association of chronic and aggressive periodontitis with the severity of coronary artery disease which was angiographically verified. Subjects were selected among the hospitalized patients at the University Hospital Centre Zagreb who had coronary angiography done because of the chest pain. Thorough clinical examination included periodontal indices and clinical and socio-demographic characteristics of participants. Subjects were divided in two test groups, acute coronary syndrome (ACS) and stable coronary artery disease (CAD), and the control group with no significant CAD. Data were analyzed using Kruskal-Wallis and Pearson’s Chi-Square test. From 106 subjects, 66 (62.3%) were hospitalized for ACS, 22 (20.7%) had stable CAD and only 18 (17.0%) had no significant CAD. Only 26 (24.5%) out of 106 patients were never smokers (p<0.05). Chronic periodontitis was the most common finding with 68.2% in ACS group and 54.5% in stable CAD group, while healthy patients without periodontitis (72.6%) were dominant in the control group (p<0.001). Stable CAD group had the highest mean probing depth (PD) 3.92±1.16, gingival recession (GR) 1.34±0.78, clinical attachment level (CAL) 4.60±1.41 and bleeding on probing (BOP) 45.98±26.19 values, whereas ACS group had mean PD value of 3.77±0.91, GR 1.11±0.66, CAL 4.32±1.08 and BOP 41.30±22.09, and no significant CAD group had mean PD value of 3.27±0.97, GR 0.69±0.37, CAL 3.62±1.04 and BOP 26.39±13.92 (p<0.05). Periodontitis was shown to be associated with angiographically verified coronary artery disease. Physical inactivity, poor oral hygiene and periodontal inflammation were observed in patients with ACS and stable CAD.

To evaluate the perceptions of altered incisor gingival position among dental specialists, dentists, dental students, and laypeople. Four digital smile photographs with altered gingival margin position of the right maxillary incisor (0, 1, 2, and 3 mm) were presented to a sample of 232 respondents (71.1% female; 28.9% male): 42 dental specialists, 63 dentists, 33 dental students (1^st to 3^rd year), 38 dental students (4^th to 6^th year) and 56 laypeople. The questionnaire consisted of four randomly displayed photographs, administered via Google Form, and respondents were asked to rate the images on a scale from 1 to 5, from the least attractive to the most attractive. A statistical analysis was performed using the TIBCO Statistica program (v. 13.3. 0, TIBCO Software Inc., Palo Alto, CA, USA; 2017). According to the Shapiro- Wilk's test, the data were not distributed normally. The Kruskal-Wallis test with post hoc multiple comparisons with the Bonferroni adjustment were used to compare group esthetic scores and to determine the threshold levels of deviation at which each group was discriminated between esthetic and non-esthetic situations. Median values of esthetic scores decreased in all groups as the gingival asymmetries increased. Dental professionals were significantly more critical of esthetics than laypeople in all levels of asymmetry. The greatest difference was found for 2 mm of gingival asymmetry (p=0.002). From the results of our study, we can conclude that the perception of gingival asymmetries in the esthetic zone of smile differs among dental specialists, doctors, students, and laypeople. Dental specialists, doctors, and clinical students were more critical of these asymmetries, while preclinical students and laypeople noticed only 2 mm or more of gingival asymmetry of central incisors.

Antiresorptive drugs (AR) have been used for many years in the treatment of various bone conditions such as osteoporosis, osteopenia, Paget's disease, bone metastases, multiple myeloma and the associated malignant hypercalcemia. As a side effect of AR therapy, medication-related osteonecrosis of the jaw, which affects the mandible more commonly than the maxilla, (MRONJ) has become an increased risk regarding patients’ health and quality of life. The incidence of osteonecrosis has increased significantly in the last few years. One of the main methods of the disease prevention is the education of patients and doctors of dental medicine (DDMs). This is evidenced by the national program of information and prevention of antiresorptive therapy side effects, which was also the impetus for this study. This study aims to test the knowledge of DDMSs on AR, especially on bisphosphonate (BF) therapy, MRONJ as well as on the risk factors of the disease itself. 458 DDMs from the Republic of Croatia participated in the survey and responded by an anonymous questionnaire to questions about the knowledge of AR/BF and the risk of MRONJ. The results showed that 36.68% of DDMs do not know that MRONJ is the main complication of AR/BF therapy. The results are significantly different in terms of academic degree, specialization, workplace, and work experience. 60.26% of respondents do not know the main indications for AR/BF use, 53.26% do not know the factors affecting the onset of the disease, and 42.58% do not know which therapy is not recommended for patients on AR/BF therapy. 93.89% of respondents expressed the desire to educate on this issue. This current study was carried out to further investigate the pilot study findings which was conducted in the year 2015, but it had a significantly lower number of participants. This research suggests that further education of DDMS on this topic is necessary to prevent or to start early treatment of MRONJ.

Background/Objectives: Dental implants are a preferred solution for missing teeth, but peri-implantitis remains a major challenge in implant dentistry. This narrative review provides an overview of the therapeutic interventions for peri-implantitis based on the current literature and illustrates a new clinical approach using novel magnesium membrane through three case presentations. Methods: A comprehensive literature search on peri-implantitis management was conducted, with emphasis on current clinical practice guidelines. In addition, three clinical cases were presented to demonstrate the use of a fully resorbable magnesium membrane in combination with a bovine xenograft with hyaluronate. Results: The narrative review identified and summarized a wide range of non-surgical and surgical therapeutic strategies for treatment of peri-implantitis. Additionally, three case reports with novel magnesium membrane highlighted distinct clinical scenarios: (1) bone defect reconstruction without implant removal, (2) reconstruction following implant removal, and (3) a minimally invasive shield technique performed without removal of the implant or crown. All cases demonstrated favorable clinical outcomes following the novel biomaterial approach. Conclusions: The combination of a resorbable magnesium membrane with bovine xenograft with hyaluronate represents a promising therapeutic strategy for treatment of peri-implantitis. This approach may improve clinical outcomes and potentially set new standards in implant dentistry. Further studies with larger cohorts and control groups are required to confirm these preliminary findings.