The aim of the study was to estimate the effect of arthrocentesis in the treatment of osteoarthri... more The aim of the study was to estimate the effect of arthrocentesis in the treatment of osteoarthritis of the temporomandibular joint (TMJ), evaluate and compare cytological and biochemical findings in the synovial fluid (SF) as well in venous blood samples and to determine the effectiveness of arthrocentesis with regard to TMJ pain intensity and mandibular movement. Twenty three consecutive patients with a diagnosis of TMJ osteoarthritis (Wilkes´ stages III, IV) after noneffective conservative treatment were treated with arthrocentesis using push and pull technique (Alstergren et al. 1995). Preoperative radiographs and the scores pre- and posttreatment (after 6 months), maximal interincisal opening (MIO) and visual analogue scale (VAS) for pain estimation were performed. Blocking the auriculotemporal nerve with a 2 mL of 2% lidocaine solution, the needle was inserted into the upper joint compartment and connected with the three-way stopcock for infusion therapy (Discofix® Braun) and ...
This chapter describes the diagnostics of temporomandibular joint disorders (TMDs) with the main ... more This chapter describes the diagnostics of temporomandibular joint disorders (TMDs) with the main focus on the radiographic changes and the role of different bone markers as procollagen type I N-terminal propeptide (P1NP), C-telopeptide crosslaps of type I collagen (CTX-1) as well as vitamin D (25(OH)D) in the pathogenesis of TMDs. From our population-based study, 47% subjects had TMJ problems where pain is commonly accompanied by stiffness, sounds and functional limitations, resulting in a decreased quality of life, and thus exert a significant negative impact on activities of daily living (ADL). Assessment of individual pain level is important in the evaluation of TMD. Radiographic examination is commonly used for assessment of TMJ problems. Orthopantomograph (OPTG) is the most routine method for assessment of bone structural changes as erosions, flattening and osteophytes of the condyle and temporal part of TMJ. It is found that subjects with increased levels of P1NP, CTX-1 have less TMJ pain/discomfort. Increased levels of CTX-1 would probably cause an immediate increase of P1NP which is known as a sensitive marker of bone formation. TMJ radiographic changes seem to be related to the low level of 25(OH)D level. Hence, the aim of this chapter is to critically review the evidence of possible association between TMJ pain and bone radiographic changes with main focus on the role of different bone markers and vitamin D.
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2011
OBJECTIVE. The aim of this population based study was to compare radiographic changes in the temp... more OBJECTIVE. The aim of this population based study was to compare radiographic changes in the temporomandibular joint (TMJ) with the lumbar spine and femoral neck BMD. To find whether there is any relationship between TMJ radiographic changes, vitamin D (25(OH)D) and bone markers levels and the number of missing teeth. MATERIAL AND METHODS. The study included 95 randomly selected participants. Bilateral TMJ images were obtained using an orthopantomograph (OPTG) and were evaluated for presence of radiographic signs. BMD was measured by dual energy X-ray absorptiometry (DXA). BMD of the lumbar spine (LT score) and femur (FT score) was detected by DXA. The level of type I collagen telopeptide fragments (P1NP), of C-telopeptide crosslaps of type I collagen (CTX-1) and of 25(OH)D were also measured. RESULTS. Subjects with a lower LT score had significantly fewer occluding pairs of teeth (p=0.018) and were more frequent users of removable prostheses (p=0.008). Radiographic changes were neg...
International Journal of Oral and Maxillofacial Surgery, 2011
Introduction: Sickle-cell disease (SCD) is characterised by episodes of acute self-limiting pain ... more Introduction: Sickle-cell disease (SCD) is characterised by episodes of acute self-limiting pain due to vasoocclusion. Around two-thirds of SCD patients are HbSS homozygotes whilst most of the remainder have HbSC disease. The HbSC phenotype is typically milder and patients experience fewer pain episodes. Whilst oral and maxillofacial pain and altered facial sensation have been reported in SCD, no genotype-specific data has been published. Methods: 208 SCD patients were surveyed via post, telephone or face-to-face interview on oral and maxillofacial sequelae of sickle-cell crises. Patients that did not have HbSS or HbSC SCD were excluded from the study. Results: 179 patients met the inclusion criteria; 101 had HbSS disease and 78 HbSC. 66% of HbSS patients experienced sickle bone pain once a month or more, compared to 49% of HbSC patients (P < 0.05 Chi-Square). 40% of HbSS sufferers had experienced painful crises associated with the jaw and/or face, compared to 24% of HbSC patients (P < 0.05 Chi-Squared). 36% of HbSS patients had experienced altered facial sensation compared to 8% of HbSC patients (P < 0.05 Chi Square). Conclusion: These data further delineate the HbSS and HbSC phenotypes. Altered facial sensation, and sickle crises associated with oral and maxillofacial pain are more common in patients with HbSS-SCD than HbSC-SCD. The most common trigger for SCD patients to access medical services is due to painful crises; Medical and Dental professionals must be aware of the potential involvement of the face and jaw, especially in HbSS patients. Conflict of interest: None declared.
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2007
The aim of this study was to evaluate the effect of cyclic 3', 5' adenosin-monophosphate ... more The aim of this study was to evaluate the effect of cyclic 3', 5' adenosin-monophosphate (cAMP) on DNA synthesis of embryonic alveolar bone in tissue culture. Bone fragments were cultured in the medium composed of 80% medium 199, 15% horse serum, 4 mg/ml glucose, 100 microg/ml penicillin using the grid method. The explants were cultured up to 12 days. In the second series, the effect of cAMP in a concentration of 10(-6)M on bone during 12 days was studied. DNA synthesis was determined by calculating mitotic labelling indices for (3)H-thymidine incorporation into cells within cultured explants at 3 to 12 days. The medium was supplemented with 1 microCurie/ml (3)H-thymidine for 4 hours and processed for autoradiography. The mitotic labelling index was determined in the histological sections. All values wer presented as mean+/-standard deviation. Statistical significance was defined by p-values of 0.05 or less. Morphological and statistical analysis showed that there were diffe...
Dentist's personality values are known to be one of the most important qualities on which profess... more Dentist's personality values are known to be one of the most important qualities on which professionalism is based on. The aim of this study was to find out which attributes, according to Baltic dental students, are the most important for a "reliable dentist". Material and methods. 190 Lithuanian, Latvian and Estonian dental students were given an anonymous questionnaire. The questionnaire included a number of questions about dentist's personality, work and scientific activity attributes. The answers about the importance of dentist's personality attributes were presented on a 5-point Likert scale, allocated according to the level of importance with the given dentist's quality. Results. 113 respondents (60%) were Lithuanian dental students, 30 (16%) were Latvian and 45 (24%) were Estonian students. Lithuanian students' response rate was 90,4%, Latvian -83,3%, Estonian -58%. 88% Lithuanian, 93% Latvian and 97% Estonian respondents accentuated the importance of behaviour during painful and unpleasant procedures and pain management. Ability to control stressful situations was more essential for Estonian (p<0,001) and Latvian students (p=0,007) than for Lithuanian respondents. Self confidence was more appreciated by Estonians than by Lithuanian dental students (p=0.045). Dentist's gender was more valued by male respondents (p<0,05). Estonians and Latvians accentuated dentist's gender, empathy, neat clothing and punctuality more than Lithuanian students (p<0.05).
Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, foll... more Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of public accountability, maintaining European standards and the improvement of dental education. Many examples are known where recommendations from both external and internal evaluation are used for the improvement of dental education. Unfortunately, the implementation of the recommendations is inconsistent, rarely systematic and usually not transparent. This section agreed that it is essential to apply CQI in a structured, systematic and transparent way if we are to improve and maintain the quality of dental education. A model is proposed which includes three aspects: a) the process of CQI; b) the subjects to which CQI should be applied; and c) the management tools to govern CQI. It is stressed, that CQI is a process that can be applied in any dental school irrespective of curriculum or educational approach within the relevant context of the country or the region. The approach needs to recognize the complexity and the need to balance a quality improvement with accountability. A CQI system is also constrained in any organization by the attitudes and values of the staff. Inevitably there has to be a wide range in the application of CQI. Nevertheless, an agreed model on CQI might enhance convergence towards higher standards of dental education. The process of CQI can be supported by developments in information and communication technology (ICT): collection of data, identifying the steps in CQI, formats of reports, etc. The section was set, as one of its tasks, to advise on the development of a network based on a number of case studies on the application of CQI in dental education.
Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition char... more Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium resulting in numerous attached and unattached osteocartilagenous (calcified) loose bodies within the joint. The purpose of this article is to present a case of SC of the TMJ and to discuss current diagnostic approaches, treatment options and relevant follow-up data. We present a case of SC in the TMJ that was confirmed by histopathological analysis and treated via arthrotomy, and present the typical imaging findings, including Computed Tomography (CT) and orthopantomography (OPTG) findings.
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2016
The aim of this study was to compare the effect of intramuscular injection of botulinum toxin (BT... more The aim of this study was to compare the effect of intramuscular injection of botulinum toxin (BTX-A) as an adjunct to arthrocentesis with the effect of BTX-A injections alone in the treatment of temporomandibular joint disorders (TMDs) with masticatory muscles tension. The clinical study included 20 TMD patients divided into 2 groups. The influence of daily activities on pain in the temporomandibular joint (TMJ) area was evaluated in both groups using the rating scale by List and Helkimo. Range of maximal interincisial opening (MIO) and joint pain as measured by the visual analogue scale (VAS) were examined to determine the clinical efficiency of the procedures before and after treatment. Group A consisted of 12 patients; they were treated with arthrocentesis and BTX-A injections in the temporal and masseter muscles. Group B consisted of 8 patients; they had only BTX-A injections in the same muscles as mentioned. In group A, VAS decreased significantly (P = .005), and MIO improved significantly (P &amp;amp;amp;amp;amp;amp;lt; .005). Arthrocentesis with BTX-A seems to affect the clinical outcomes with regard to MIO and VAS compared with the results when BTX-A only was used. BTX-A in combination with arthrocentesis improved the TMJ area symptoms.
This paper evaluates the reliability and validity of eight published dental age estimation method... more This paper evaluates the reliability and validity of eight published dental age estimation methods for adults that may aid in victim identification. Age was calculated on 20 Caucasian teeth of known age according to the methods of Kvaal (for in situ and extracted teeth), Solheim (for in situ and sectioned teeth), Lamendin (for extracted teeth), Johanson (for sectioned teeth) and Bang (for extracted and sectioned teeth) by one independent observer. For each method, mean age error and standard error were assessed as the measures of accuracy and precision. In addition, method simplicity, requirements for tooth preparation and the equipment necessary were assessed and recommendations given for forensic use in various situations. Methods for sectioned teeth gave more reliable results when compared to methods for intact teeth.
Stomatologija Issued By Public Institution Odontologijos Studija Et Al, Feb 1, 2007
We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. ... more We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. She complaining of bilateral swelling of eyelids and the parotid glands of three weeks duration. Physical examination revealed a bilateral enlargement of both parotid glands, which were solid and painful. Sjögren s syndrome was suspected at that stage, and the serologic and specific analysis were done. All these tests didn t find any autoimmune or visceral features typical of Sjögren s syndrome and autoantibodies were negative. During follow-up time the right facial nerve palsy developed. Pulmonary radiography revealed bihilar lymphadenopathy and labial salivary gland biopsy revealed non-caseating granuloma. The patient was classified as having stage I sarcoidosis. This case demonstrates the importance of being aware of the leading clinical signs and symptoms in case of Heerfordt syndrome.
A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improv... more A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improving individual outcomes in hepatocellular carcinoma
We report the case of a 74-year-old woman who developed a follicular ameloblastoma of the right m... more We report the case of a 74-year-old woman who developed a follicular ameloblastoma of the right mandible and 22 months later developed a cribriform adenoid cystic carcinoma of the soft palate on the right maxilla. The ameloblastoma was treated by hemimandibulectomy, and the adenoid cystic carcinoma was managed by resection of the soft palate and the surrounding tissue and bone followed by a 6-week course of radiotherapy. Our review of the literature indicates that only one similar case has been previously reported where an odontogenic tumor and a salivary gland tumor involved two different anatomic locations in the same patient at nearly the same time.
The aim of this study was to analyse the long-term treatment results of mandibular ameloblastomas... more The aim of this study was to analyse the long-term treatment results of mandibular ameloblastomas over a 28-year period and determine the most appropriate method of management of these tumours. Sixteen patients with a diagnosis of mandibular ameloblastoma treated in our Department between January 1977 and December 2004 were selected for this retrospective study. Data included gender, age at surgery, symptoms, tumour type, size and site of lesion, radiological findings, primary surgical methods, complications, recurrences, and follow-up period. There were eight male and eight female patients. Their age ranged from 15 to 74 years (average 43.4 years). The dominant symptom was facial deformity (9 cases). From analysis of ortopantomographs or radiographs, four cases were unilocular and 12 cases were multilocular, and its size ranged from 2 to 11 cm. Observation time varied from 5 to 27 years after treatment. Histologically prevalence of follicular type was observed. The treatment select...
Objectives: To investigate the predictive value of inflammatory mediators and markers for the dev... more Objectives: To investigate the predictive value of inflammatory mediators and markers for the development of temporomandibular joint (TMJ) radiographic changes in patients with rheumatoid arthritis (RA). Methods: The TMJs of thirteen patients (eleven females and two males) with a median age of 46 years were investigated by computed tomography. The median (25th/75th percentile) interval between first and last investigation was 91 months. The radiographs were assessed for presence of erosions, sclerosis, flattening, osteophytes and subchondral pseudocysts. The serum (S) or plasma (P) concentrations of C-reactive protein (CRP), thrombocyte particle concentration (TPC), serotonin (5-HT), tumor necrosis factor (TNF) as well as the erythrocyte sedimentation rate (ESR) were measured. Results: P-TNF at the beginning of the observation period was positively correlated to change in flattening (rs=0.74 n=13 p=0.003). ESR and TPC at the beginning of the observation period were positively correl...
Objective: TMJ pain is often accompanied by stiffness, sounds, functional limitations which resul... more Objective: TMJ pain is often accompanied by stiffness, sounds, functional limitations which result in decreased quality of life, and thus exert a significant negative impact on activities of daily living.The aim of this investigation was to analyze the associations of TMJ pain/discomfort and bone characteristics on the ADL in a population based study. Method: The study included 95 randomly selected participants. The impact of temporomandibular joint pain/discomfort on the daily activities was assessed by using the daily living scale of List and Helkimo (1995). The levels of serum type I collagen telopeptide fragments, C-telopeptide crosslaps of type I collagen and vitamin D were analysed. The Mann-Whitney U-test, Spearman rank correlation coefficent (rs) were used. Activities of daily living were influenced by temporomandibular joint pain/discomfort to varying degrees. Result: The influence from quantitative changes in bone turnover appeared to play a significant role on activities ...
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2007
We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. ... more We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. She complaining of bilateral swelling of eyelids and the parotid glands of three weeks duration. Physical examination revealed a bilateral enlargement of both parotid glands, which were solid and painful. Sjögren s syndrome was suspected at that stage, and the serologic and specific analysis were done. All these tests didn t find any autoimmune or visceral features typical of Sjögren s syndrome and autoantibodies were negative. During follow-up time the right facial nerve palsy developed. Pulmonary radiography revealed bihilar lymphadenopathy and labial salivary gland biopsy revealed non-caseating granuloma. The patient was classified as having stage I sarcoidosis. This case demonstrates the importance of being aware of the leading clinical signs and symptoms in case of Heerfordt syndrome.
The aim of this study was to investigate the relation between the inflammatory mediators tumor ne... more The aim of this study was to investigate the relation between the inflammatory mediators tumor necrosis factor alpha (TNFalpha) and serotonin (5-HT), the inflammatory markers erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as rheumatoid factor (RF) and thrombocyte particle concentration (TPC) in blood versus temporomandibular joint (TMJ) radiographic changes in patients with clinical TMJ involvement by rheumatoid arthritis (RA). Twenty patients were included. Venous blood was collected for quantification of the mediators, markers, and TPC. The radiographic signs of erosion, flattening, sclerosis, subchondral pseudocyst, and osteophyte as well as radiographic grade were investigated with computed tomography. The median (IQR) plasma levels of TNFalpha and 5-HT were 0 (13) pg/ mL and 13 (22) nmol/L, respectively, while serum level of 5-HT was 1360 874) nmol/L ESR, CRP, and TPC were abnormally high in 53%, 250%, and 15% of the patients, respectively. The most ...
The aim of the study was to estimate the effect of arthrocentesis in the treatment of osteoarthri... more The aim of the study was to estimate the effect of arthrocentesis in the treatment of osteoarthritis of the temporomandibular joint (TMJ), evaluate and compare cytological and biochemical findings in the synovial fluid (SF) as well in venous blood samples and to determine the effectiveness of arthrocentesis with regard to TMJ pain intensity and mandibular movement. Twenty three consecutive patients with a diagnosis of TMJ osteoarthritis (Wilkes´ stages III, IV) after noneffective conservative treatment were treated with arthrocentesis using push and pull technique (Alstergren et al. 1995). Preoperative radiographs and the scores pre- and posttreatment (after 6 months), maximal interincisal opening (MIO) and visual analogue scale (VAS) for pain estimation were performed. Blocking the auriculotemporal nerve with a 2 mL of 2% lidocaine solution, the needle was inserted into the upper joint compartment and connected with the three-way stopcock for infusion therapy (Discofix® Braun) and ...
This chapter describes the diagnostics of temporomandibular joint disorders (TMDs) with the main ... more This chapter describes the diagnostics of temporomandibular joint disorders (TMDs) with the main focus on the radiographic changes and the role of different bone markers as procollagen type I N-terminal propeptide (P1NP), C-telopeptide crosslaps of type I collagen (CTX-1) as well as vitamin D (25(OH)D) in the pathogenesis of TMDs. From our population-based study, 47% subjects had TMJ problems where pain is commonly accompanied by stiffness, sounds and functional limitations, resulting in a decreased quality of life, and thus exert a significant negative impact on activities of daily living (ADL). Assessment of individual pain level is important in the evaluation of TMD. Radiographic examination is commonly used for assessment of TMJ problems. Orthopantomograph (OPTG) is the most routine method for assessment of bone structural changes as erosions, flattening and osteophytes of the condyle and temporal part of TMJ. It is found that subjects with increased levels of P1NP, CTX-1 have less TMJ pain/discomfort. Increased levels of CTX-1 would probably cause an immediate increase of P1NP which is known as a sensitive marker of bone formation. TMJ radiographic changes seem to be related to the low level of 25(OH)D level. Hence, the aim of this chapter is to critically review the evidence of possible association between TMJ pain and bone radiographic changes with main focus on the role of different bone markers and vitamin D.
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2011
OBJECTIVE. The aim of this population based study was to compare radiographic changes in the temp... more OBJECTIVE. The aim of this population based study was to compare radiographic changes in the temporomandibular joint (TMJ) with the lumbar spine and femoral neck BMD. To find whether there is any relationship between TMJ radiographic changes, vitamin D (25(OH)D) and bone markers levels and the number of missing teeth. MATERIAL AND METHODS. The study included 95 randomly selected participants. Bilateral TMJ images were obtained using an orthopantomograph (OPTG) and were evaluated for presence of radiographic signs. BMD was measured by dual energy X-ray absorptiometry (DXA). BMD of the lumbar spine (LT score) and femur (FT score) was detected by DXA. The level of type I collagen telopeptide fragments (P1NP), of C-telopeptide crosslaps of type I collagen (CTX-1) and of 25(OH)D were also measured. RESULTS. Subjects with a lower LT score had significantly fewer occluding pairs of teeth (p=0.018) and were more frequent users of removable prostheses (p=0.008). Radiographic changes were neg...
International Journal of Oral and Maxillofacial Surgery, 2011
Introduction: Sickle-cell disease (SCD) is characterised by episodes of acute self-limiting pain ... more Introduction: Sickle-cell disease (SCD) is characterised by episodes of acute self-limiting pain due to vasoocclusion. Around two-thirds of SCD patients are HbSS homozygotes whilst most of the remainder have HbSC disease. The HbSC phenotype is typically milder and patients experience fewer pain episodes. Whilst oral and maxillofacial pain and altered facial sensation have been reported in SCD, no genotype-specific data has been published. Methods: 208 SCD patients were surveyed via post, telephone or face-to-face interview on oral and maxillofacial sequelae of sickle-cell crises. Patients that did not have HbSS or HbSC SCD were excluded from the study. Results: 179 patients met the inclusion criteria; 101 had HbSS disease and 78 HbSC. 66% of HbSS patients experienced sickle bone pain once a month or more, compared to 49% of HbSC patients (P < 0.05 Chi-Square). 40% of HbSS sufferers had experienced painful crises associated with the jaw and/or face, compared to 24% of HbSC patients (P < 0.05 Chi-Squared). 36% of HbSS patients had experienced altered facial sensation compared to 8% of HbSC patients (P < 0.05 Chi Square). Conclusion: These data further delineate the HbSS and HbSC phenotypes. Altered facial sensation, and sickle crises associated with oral and maxillofacial pain are more common in patients with HbSS-SCD than HbSC-SCD. The most common trigger for SCD patients to access medical services is due to painful crises; Medical and Dental professionals must be aware of the potential involvement of the face and jaw, especially in HbSS patients. Conflict of interest: None declared.
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2007
The aim of this study was to evaluate the effect of cyclic 3', 5' adenosin-monophosphate ... more The aim of this study was to evaluate the effect of cyclic 3', 5' adenosin-monophosphate (cAMP) on DNA synthesis of embryonic alveolar bone in tissue culture. Bone fragments were cultured in the medium composed of 80% medium 199, 15% horse serum, 4 mg/ml glucose, 100 microg/ml penicillin using the grid method. The explants were cultured up to 12 days. In the second series, the effect of cAMP in a concentration of 10(-6)M on bone during 12 days was studied. DNA synthesis was determined by calculating mitotic labelling indices for (3)H-thymidine incorporation into cells within cultured explants at 3 to 12 days. The medium was supplemented with 1 microCurie/ml (3)H-thymidine for 4 hours and processed for autoradiography. The mitotic labelling index was determined in the histological sections. All values wer presented as mean+/-standard deviation. Statistical significance was defined by p-values of 0.05 or less. Morphological and statistical analysis showed that there were diffe...
Dentist's personality values are known to be one of the most important qualities on which profess... more Dentist's personality values are known to be one of the most important qualities on which professionalism is based on. The aim of this study was to find out which attributes, according to Baltic dental students, are the most important for a "reliable dentist". Material and methods. 190 Lithuanian, Latvian and Estonian dental students were given an anonymous questionnaire. The questionnaire included a number of questions about dentist's personality, work and scientific activity attributes. The answers about the importance of dentist's personality attributes were presented on a 5-point Likert scale, allocated according to the level of importance with the given dentist's quality. Results. 113 respondents (60%) were Lithuanian dental students, 30 (16%) were Latvian and 45 (24%) were Estonian students. Lithuanian students' response rate was 90,4%, Latvian -83,3%, Estonian -58%. 88% Lithuanian, 93% Latvian and 97% Estonian respondents accentuated the importance of behaviour during painful and unpleasant procedures and pain management. Ability to control stressful situations was more essential for Estonian (p<0,001) and Latvian students (p=0,007) than for Lithuanian respondents. Self confidence was more appreciated by Estonians than by Lithuanian dental students (p=0.045). Dentist's gender was more valued by male respondents (p<0,05). Estonians and Latvians accentuated dentist's gender, empathy, neat clothing and punctuality more than Lithuanian students (p<0.05).
Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, foll... more Continuous quality improvement (CQI) can be envisaged as a circular process of goal-setting, followed by external and internal evaluations resulting in improvements that can serve as goals for a next cycle. The need for CQI is apparent, because of public accountability, maintaining European standards and the improvement of dental education. Many examples are known where recommendations from both external and internal evaluation are used for the improvement of dental education. Unfortunately, the implementation of the recommendations is inconsistent, rarely systematic and usually not transparent. This section agreed that it is essential to apply CQI in a structured, systematic and transparent way if we are to improve and maintain the quality of dental education. A model is proposed which includes three aspects: a) the process of CQI; b) the subjects to which CQI should be applied; and c) the management tools to govern CQI. It is stressed, that CQI is a process that can be applied in any dental school irrespective of curriculum or educational approach within the relevant context of the country or the region. The approach needs to recognize the complexity and the need to balance a quality improvement with accountability. A CQI system is also constrained in any organization by the attitudes and values of the staff. Inevitably there has to be a wide range in the application of CQI. Nevertheless, an agreed model on CQI might enhance convergence towards higher standards of dental education. The process of CQI can be supported by developments in information and communication technology (ICT): collection of data, identifying the steps in CQI, formats of reports, etc. The section was set, as one of its tasks, to advise on the development of a network based on a number of case studies on the application of CQI in dental education.
Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition char... more Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium resulting in numerous attached and unattached osteocartilagenous (calcified) loose bodies within the joint. The purpose of this article is to present a case of SC of the TMJ and to discuss current diagnostic approaches, treatment options and relevant follow-up data. We present a case of SC in the TMJ that was confirmed by histopathological analysis and treated via arthrotomy, and present the typical imaging findings, including Computed Tomography (CT) and orthopantomography (OPTG) findings.
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2016
The aim of this study was to compare the effect of intramuscular injection of botulinum toxin (BT... more The aim of this study was to compare the effect of intramuscular injection of botulinum toxin (BTX-A) as an adjunct to arthrocentesis with the effect of BTX-A injections alone in the treatment of temporomandibular joint disorders (TMDs) with masticatory muscles tension. The clinical study included 20 TMD patients divided into 2 groups. The influence of daily activities on pain in the temporomandibular joint (TMJ) area was evaluated in both groups using the rating scale by List and Helkimo. Range of maximal interincisial opening (MIO) and joint pain as measured by the visual analogue scale (VAS) were examined to determine the clinical efficiency of the procedures before and after treatment. Group A consisted of 12 patients; they were treated with arthrocentesis and BTX-A injections in the temporal and masseter muscles. Group B consisted of 8 patients; they had only BTX-A injections in the same muscles as mentioned. In group A, VAS decreased significantly (P = .005), and MIO improved significantly (P &amp;amp;amp;amp;amp;amp;lt; .005). Arthrocentesis with BTX-A seems to affect the clinical outcomes with regard to MIO and VAS compared with the results when BTX-A only was used. BTX-A in combination with arthrocentesis improved the TMJ area symptoms.
This paper evaluates the reliability and validity of eight published dental age estimation method... more This paper evaluates the reliability and validity of eight published dental age estimation methods for adults that may aid in victim identification. Age was calculated on 20 Caucasian teeth of known age according to the methods of Kvaal (for in situ and extracted teeth), Solheim (for in situ and sectioned teeth), Lamendin (for extracted teeth), Johanson (for sectioned teeth) and Bang (for extracted and sectioned teeth) by one independent observer. For each method, mean age error and standard error were assessed as the measures of accuracy and precision. In addition, method simplicity, requirements for tooth preparation and the equipment necessary were assessed and recommendations given for forensic use in various situations. Methods for sectioned teeth gave more reliable results when compared to methods for intact teeth.
Stomatologija Issued By Public Institution Odontologijos Studija Et Al, Feb 1, 2007
We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. ... more We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. She complaining of bilateral swelling of eyelids and the parotid glands of three weeks duration. Physical examination revealed a bilateral enlargement of both parotid glands, which were solid and painful. Sjögren s syndrome was suspected at that stage, and the serologic and specific analysis were done. All these tests didn t find any autoimmune or visceral features typical of Sjögren s syndrome and autoantibodies were negative. During follow-up time the right facial nerve palsy developed. Pulmonary radiography revealed bihilar lymphadenopathy and labial salivary gland biopsy revealed non-caseating granuloma. The patient was classified as having stage I sarcoidosis. This case demonstrates the importance of being aware of the leading clinical signs and symptoms in case of Heerfordt syndrome.
A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improv... more A1 Predictive and prognostic biomarker panel for targeted application of radioembolisation improving individual outcomes in hepatocellular carcinoma
We report the case of a 74-year-old woman who developed a follicular ameloblastoma of the right m... more We report the case of a 74-year-old woman who developed a follicular ameloblastoma of the right mandible and 22 months later developed a cribriform adenoid cystic carcinoma of the soft palate on the right maxilla. The ameloblastoma was treated by hemimandibulectomy, and the adenoid cystic carcinoma was managed by resection of the soft palate and the surrounding tissue and bone followed by a 6-week course of radiotherapy. Our review of the literature indicates that only one similar case has been previously reported where an odontogenic tumor and a salivary gland tumor involved two different anatomic locations in the same patient at nearly the same time.
The aim of this study was to analyse the long-term treatment results of mandibular ameloblastomas... more The aim of this study was to analyse the long-term treatment results of mandibular ameloblastomas over a 28-year period and determine the most appropriate method of management of these tumours. Sixteen patients with a diagnosis of mandibular ameloblastoma treated in our Department between January 1977 and December 2004 were selected for this retrospective study. Data included gender, age at surgery, symptoms, tumour type, size and site of lesion, radiological findings, primary surgical methods, complications, recurrences, and follow-up period. There were eight male and eight female patients. Their age ranged from 15 to 74 years (average 43.4 years). The dominant symptom was facial deformity (9 cases). From analysis of ortopantomographs or radiographs, four cases were unilocular and 12 cases were multilocular, and its size ranged from 2 to 11 cm. Observation time varied from 5 to 27 years after treatment. Histologically prevalence of follicular type was observed. The treatment select...
Objectives: To investigate the predictive value of inflammatory mediators and markers for the dev... more Objectives: To investigate the predictive value of inflammatory mediators and markers for the development of temporomandibular joint (TMJ) radiographic changes in patients with rheumatoid arthritis (RA). Methods: The TMJs of thirteen patients (eleven females and two males) with a median age of 46 years were investigated by computed tomography. The median (25th/75th percentile) interval between first and last investigation was 91 months. The radiographs were assessed for presence of erosions, sclerosis, flattening, osteophytes and subchondral pseudocysts. The serum (S) or plasma (P) concentrations of C-reactive protein (CRP), thrombocyte particle concentration (TPC), serotonin (5-HT), tumor necrosis factor (TNF) as well as the erythrocyte sedimentation rate (ESR) were measured. Results: P-TNF at the beginning of the observation period was positively correlated to change in flattening (rs=0.74 n=13 p=0.003). ESR and TPC at the beginning of the observation period were positively correl...
Objective: TMJ pain is often accompanied by stiffness, sounds, functional limitations which resul... more Objective: TMJ pain is often accompanied by stiffness, sounds, functional limitations which result in decreased quality of life, and thus exert a significant negative impact on activities of daily living.The aim of this investigation was to analyze the associations of TMJ pain/discomfort and bone characteristics on the ADL in a population based study. Method: The study included 95 randomly selected participants. The impact of temporomandibular joint pain/discomfort on the daily activities was assessed by using the daily living scale of List and Helkimo (1995). The levels of serum type I collagen telopeptide fragments, C-telopeptide crosslaps of type I collagen and vitamin D were analysed. The Mann-Whitney U-test, Spearman rank correlation coefficent (rs) were used. Activities of daily living were influenced by temporomandibular joint pain/discomfort to varying degrees. Result: The influence from quantitative changes in bone turnover appeared to play a significant role on activities ...
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.], 2007
We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. ... more We report the case of a 22-year-old woman who is suspected of having primary Sjögren s syndrome. She complaining of bilateral swelling of eyelids and the parotid glands of three weeks duration. Physical examination revealed a bilateral enlargement of both parotid glands, which were solid and painful. Sjögren s syndrome was suspected at that stage, and the serologic and specific analysis were done. All these tests didn t find any autoimmune or visceral features typical of Sjögren s syndrome and autoantibodies were negative. During follow-up time the right facial nerve palsy developed. Pulmonary radiography revealed bihilar lymphadenopathy and labial salivary gland biopsy revealed non-caseating granuloma. The patient was classified as having stage I sarcoidosis. This case demonstrates the importance of being aware of the leading clinical signs and symptoms in case of Heerfordt syndrome.
The aim of this study was to investigate the relation between the inflammatory mediators tumor ne... more The aim of this study was to investigate the relation between the inflammatory mediators tumor necrosis factor alpha (TNFalpha) and serotonin (5-HT), the inflammatory markers erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as rheumatoid factor (RF) and thrombocyte particle concentration (TPC) in blood versus temporomandibular joint (TMJ) radiographic changes in patients with clinical TMJ involvement by rheumatoid arthritis (RA). Twenty patients were included. Venous blood was collected for quantification of the mediators, markers, and TPC. The radiographic signs of erosion, flattening, sclerosis, subchondral pseudocyst, and osteophyte as well as radiographic grade were investigated with computed tomography. The median (IQR) plasma levels of TNFalpha and 5-HT were 0 (13) pg/ mL and 13 (22) nmol/L, respectively, while serum level of 5-HT was 1360 874) nmol/L ESR, CRP, and TPC were abnormally high in 53%, 250%, and 15% of the patients, respectively. The most ...
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Papers by Edvitar Leibur