Publications by authors named "Danuta Nowakowska"

16 Publications

  • Page 1 of 1

Biological Response Induced in Primary Human Gingival Fibroblasts upon Exposure to Various Types of Injectable Astringent Retraction Agents.

Materials (Basel) 2021 Apr 20;14(8). Epub 2021 Apr 20.

Department of Molecular and Cellular Biology, Wroclaw Medical University, 50-556 Wroclaw, Poland.

Traditional chemo-mechanical retraction/displacement materials can impact the gingival margin tissues. This study was undertaken to analyze biological responses induced in human gingival fibroblasts (HGFs) upon application of injectable astringent-based agents used in the cordless retraction technique. HGFs were exposed to hemostatic agents (five gels, three pastes, and one foam) based on aluminium chloride, aluminium sulphate and ferric sulphate. Changes in cell viability and proliferation were evaluated using an MTT assay and a BrdU assay. The cytoskeleton structure organization (zyxin and F-actin) was visualized by confocal laser scanning microscopy. Oxidative stress was determined using the Griess Reagent System. The RNA expression levels of antioxidant enzymes were quantified by real-time RT-PCR. The statistical significance was evaluated using Student's t-test and one-way ANOVA with post-hoc Tukey HSD test. The evaluated agents did not downregulate fibroblast viability or proliferation. No significant cytoskeleton reorganization was observed. Only one agent (Expasyl) induced oxidative stress, demonstrated by the increased level of nitrites. Incubation with the studied agents significantly increased the RNA expression of some antioxidant enzymes (SOD1, SOD3, GPX1). However, no significant influence on the expression of SOD2 and HMOX1 was detected. The injectable forms of chemical retraction agents revealed biocompatibility with HGFs, suggesting their potential clinical usefulness in gingival margin retraction.
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http://dx.doi.org/10.3390/ma14082081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074361PMC
April 2021

Release and Recharge of Fluoride Ions from Acrylic Resin Modified with Bioactive Glass.

Polymers (Basel) 2021 Mar 27;13(7). Epub 2021 Mar 27.

Department of Prosthodontics, Wroclaw Medical University, 50-425 Wroclaw, Poland.

Background: Oral hygiene is essential for maintaining residual dentition of partial denture wearers. The dental material should positively affect the oral environment. Fluoride-releasing dental materials help to inhibit microbial colonization and formation of plaque as well as to initiate the remineralization process in the early cavity area.

Aim: To evaluate fluoride ion release and recharge capacity, sorption, and solubility of polymethyl methacrylate (PMMA) dental resin modified with bioactive glass addition.

Materials And Methods: Two bioactive glass materials (5 wt% Kavitan, 10 wt% Kavitan, and 10 wt% Fritex) and pure 10 wt% NaF were added to dental acrylic resin. After polymerization of the modified resins, the release levels of fluoride anions were measured based on color complex formation by using a spectrophotometer after 7, 14, 28, and 35 days of storage in distilled water at 37 °C. Subsequently, specimens were brushed with a fluoride-containing tooth paste on each side for 30 s, and the fluoride recharge and release potential was investigated after 1, 7, and 14 days. Sorption and solubility after 7 days of storage in distilled water was also investigated.

Results: The acrylic resins with addition of 10% bioactive glass materials released fluoride ions for over 4 weeks (from 0.14 to 2.27 µg/cm). The amount of fluoride ions released from the PMMA resin with addition of 10 wt% Fritex glass was higher than that from the resin with addition of 10 wt% Kavitan. The acrylic resin containing 10 wt% NaF released a high amount of ions over a period of 1 week (1.58 µg/cm), but the amount of released ions decreased rapidly after 14 days of storage. For specimens containing 5 wt% Kavitan glass, the ion-releasing capacity also lasted only for 14 days. Fluoride ion rechargeable properties were observed for the PMMA resin modified with addition of 10 wt% Fritex glass. The ion release levels after recharge ranged from 0.32 to 0.48 µg/cm. Sorption values ranged from 10.23 μm/mm for unmodified PMMA resin to 12.11 μm/mm for specimens modified with 10 wt% Kavitan glass. No significant differences were found regarding solubility levels after 7 days.

Conclusions: The addition of 10 wt% Fritex and 10 wt% Kavitan bioactive glass materials to heat-cured acrylic resin may improve its material properties, with bioactive fluoride ion release ability lasting for over 4 weeks. The resin modified with 10 wt% Fritex glass could absorb fluoride ions from the toothpaste solution and then effectively release them. Addition of fluoride releasing fillers have a small effect on sorption and solubility increase of the modified PMMA resin.

Clinical Significance: The addition of bioactive glass may be promising in the development of the novel bioactive heat-cured denture base resin.
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http://dx.doi.org/10.3390/polym13071054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037481PMC
March 2021

Update on acrylic resins used in dentistry.

Mini Rev Med Chem 2021 Feb 26. Epub 2021 Feb 26.

Department of Prosthodontics, Wroclaw Medical University, Wrocław. Poland.

Acrylic resins are the most commonly used materials in prosthetics and orthodontics until now. They have a well-documented history of use as biomaterials in the manufacture of different types of dental appliances. The objective of this study was to describe the properties of acrylic resins and the processing methods used for these materials in dentistry. The review depicts the most important achievements in this area, indicating that the resin technology evolved in different directions. The mechanical and biological properties of acrylic resins were improved by the addition of mineral or natural fibers, and/or fillers including nanofillers, as well as by poly(methyl methacrylate) surface modification. The presence of residual monomer was reduced as a result of postpolymerization activity. New types of acrylic resins were developed for processing Computer-Aided Design/Computer-Aided Manufacturing systems and three-dimensional printing.
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http://dx.doi.org/10.2174/1389557521666210226151214DOI Listing
February 2021

Influence of silanized silica and silanized feldspar addition on the mechanical behavior of polymethyl methacrylate resin denture teeth.

J Prosthet Dent 2020 Apr 28;123(4):647.e1-647.e7. Epub 2020 Feb 28.

Professor, Department of Prosthodontics, Wroclaw Medical University, Wrocław, Poland.

Statement Of Problem: Artificial denture teeth made of polymethyl methacrylate (PMMA) resin have good adhesion to the denture base but are relatively soft and have limited wear resistance during function.

Purpose: The purpose of this in vitro study was to evaluate the influence of the addition of 2 inorganic nanofillers on the flexural strength, maximal displacement, elastic modulus, Isolde impact resistance, and Brinell hardness of acrylic resin denture teeth.

Material And Methods: Heat polymerizing polymethyl methacrylate resin was mixed with silanized silica or silanized feldspar in concentrations of 5 wt%, 10 wt%, and 15 wt%. The first test was conducted after 24 hours of storage in laboratory conditions, and the second assessment was conducted after 3 months of storage in distilled water at 37 °C. The Brinell hardness was evaluated, and the elastic modulus and maximal displacement at fracture were calculated. The flexural strength and Isolde impact resistance were measured with a 3-point flexural test. Acrylic resin specimens without filler addition were used as a control group. Statistical analysis included 2-way ANOVA for independent variables (α=.05) and the Student t test for time-dependent changes (α=.05). These were performed with Statistica 12 software.

Results: The acrylic resin specimens modified with the addition of silanized feldspar had significantly higher Brinell hardness, elastic modulus, maximal displacement, and flexural strength and also had no adverse effect on Isolde impact resistance compared with the conventional acrylic resin. Silica filler increased the Brinell hardness and elastic modulus of acrylic resins but significantly reduced the flexural strength and Isolde impact resistance.
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http://dx.doi.org/10.1016/j.prosdent.2019.12.007DOI Listing
April 2020

effects of vasoconstrictive retraction agents on primary human gingival fibroblasts.

Exp Ther Med 2020 Mar 20;19(3):2037-2044. Epub 2020 Jan 20.

Department of Molecular and Cellular Biology, Wroclaw Medical University, Wroclaw 50-556, Poland.

The biological activity of chemical retraction/displacement agents in surrounding periodontal tissues is of unquestionable importance, but the activity of these agents has not been completely elucidated. In the present study, we aimed to evaluate the effects of vasoconstrictive retraction agents on primary human gingival fibroblasts (HGFs). A total of six commercial adrenergic solutions (0.05 and 0.01% HCl-epinephrine, two based on 0.05% HCl-tetrahydrozoline, 0.05% HCl-oxymetazoline, and 10% HCl-phenylephrine) and three experimental gel formulations (EG-1, EG-2, and EG-3) were used to treat primary HGFs. The biological effect of the retraction treatment on the expression of collagen types I and III was detected by performing immunocytochemical analysis. The generation of reactive oxygen species triggered by the retraction agents were evaluated by using the dichlorofluorescein (DCF) fluorescent probe. The effect of retraction agents on the expression of fibronectin was visualized by confocal laser scanning microscopy. According to the results, experimental retraction gels did not limit the expression of collagen types I and III. EG-3 even induced the synthesis of both types of collagen. The DCF assay indicated oxidative stress similar to the control cells for most of the selected retraction agents. Experimental gels did not cause degradation of the cellular shape and morphology of the primary HGFs. The proposed experimental retraction gels in the present study demonstrated higher biocompatibility with primary HGFs, suggesting their use as clinical vasoconstrictive agents for the application of gingival retraction with minimal damage to periodontal tissues.
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http://dx.doi.org/10.3892/etm.2020.8462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027151PMC
March 2020

Design and characteristics of new experimental chlorhexidine dental gels with anti-staining properties.

Adv Clin Exp Med 2019 07;28(7):885-890

Department of Dental Prosthetics, Wroclaw Medical University, Poland.

Background: Chlorhexidine-based products are often used in medicine and dentistry as dental hygiene and therapeutic products, especially by patients with various oral tissue diseases. However, these products have disadvantages, such as low stability, as well as discoloration of the teeth and dental reconstruction materials.

Objectives: The aim of this study was to create and evaluate experimental chlorhexidine (CHX) gels with anti-staining properties and to compare them with 3 commercially available products.

Material And Methods: For this study, 4 new formulations containing 1% CHX and different anti-staining agents were developed. The properties of these gels were compared with 3 commercial CHX-based dental products. The pH, viscosity, disintegration in water, and anti-staining properties were evaluated.

Results: The pH level of the 4 new CHX gels ranged from 5.92 to 6.33. The viscosity of the experimental gels was higher (85.7÷217.7 Pa∙s) than the commercial ones (11.6÷72.7 Pa∙s). Among the experimental formulations with 1% CHX, the formulation with 5% polyvinylpyrrolidone (PVP) and 0.2% citric acid and the formulation with 1% citric acid were the most stable in terms of pH and viscosity. The disintegration times of the experimental gels were longer (50-70 min) as compared with the commercial products (approx. 20 min). These 2 CHX gels caused less color change of glass ionomer cements in black tea solution.

Conclusions: To conclude, 2 new experimental dental gels based on 1% CHX, one with 1% citric acid and the second with 5% PVP and 0.2% citric acid, had the most favorable physicochemical properties. Further research is needed to evaluate their therapeutic potential in the treatment of diseases of the oral cavity.
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http://dx.doi.org/10.17219/acem/94152DOI Listing
July 2019

Effect of water quantity and quality on the properties of alginate impression materials.

Dent Med Probl 2018 Jan-Mar;55(1):43-48

Department of Dental Prosthetics, Wroclaw Medical University, Poland.

Background: Alginates are impression materials commonly used in prosthodontics and orthodontics. However, all these materials have some disadvantages, such as limited elasticity, tearing resistance and low dimensional stability.

Objectives: The aim of this research was to investigate the effect of various water quantities and qualities on changes in the properties of alginates.

Material And Methods: Two alginates, Neocolloid and Tulip, were mixed with different volumes of water, water with calcium ions, or sparkling water with CO2. The dimensions, setting times, and hardness of the specimens were measured and Young's modulus was calculated. The significance of the difference between the mean values of different groups and the control group was assessed by Student's t-test or the Mann-Whitney U test.

Results: The dimensional stability changes of both alginate impression materials were statistically dependent on the quantity of water used for mixing. Sample storage over 24 h of samples prepared with +15% water led to 5.00% shrinkage for Neocolloid and 4.41% for Tulip. The setting times of Neocolloid and Tulip were significantly prolonged when the alginates were prepared with +15% water; the addition of calcium ions shortened the setting times of both alginates. Specimens mixed with the water containing Ca2+ ions were characterized by greater hardness and Young's modulus values when compared to the alginate mixed with distilled water.

Conclusions: For mixing alginates, it is necessary to use the manufacturers' recommended mixing ratios between powder and water. To obtain the right setting time, hardness and elasticity, the application of distilled or demineralized water is advised.
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http://dx.doi.org/10.17219/dmp/82179DOI Listing
August 2019

The Setting Time of Polyether Impression Materials after Contact with Conventional and Experimental Gingival Margin Displacement Agents.

J Prosthodont 2018 Feb 22;27(2):182-188. Epub 2016 Jun 22.

Department of Prosthodontics, Wroclaw Medical University, Wroclaw, Poland.

Purpose: The compatibility of chemical gingival margin displacement agents with polyether impression materials has not been determined. The aim of this study was to evaluate the setting time of polyether impression elastomers after contact with conventional and experimental gingival displacement agents.

Materials And Methods: The study compared the setting time of two polyether impression materials: medium body (Impregum Penta Soft) and light body (Impregum Garant L DuoSoft) after contact with 10 gingival displacement agents, including 5 conventional astringents (10%, 20%, and 25% aluminum chloride, 25% aluminum sulfate, and 15.5% ferric sulfate) and 5 experimental adrenergics (0.1% and 0.01% HCl-epinephrine, 0.05% HCl-tetrahydrozoline, 0.05% HCl-oxymetazoline, and 10% HCl-phenylephrine). As many as 120 specimens (60 light body and 60 medium body) were mixed with 20 μl of each of 10 gingival displacement agents, and the time to achieve maximum viscosity was measured with a viscometer. The setting times of these specimens were compared with the control group of 12 specimens, which were polymerized without contact with the displacement agents. The experiments were performed in two environments: 23°C and 37°C (± 0.1°C). Individual and average polymerization time compatibility indices (PTCI) were calculated. Data were analyzed by 2-way ANOVA (α = 0.05).

Results: The evaluated chemical displacement agents from both groups changed the setting time of light- and medium-body PE. The negative individual PTCI values achieved astringent (20% aluminum chloride) with two PE in both temperature environments. The average PTCI values of the experimental displacement agents at laboratory and intraoral temperatures were significantly higher than the conventional agents.

Conclusions: The present findings suggest that experimental retraction agents can be recommended clinically as gingival margin displacement agents with minimal effects on the setting time of medium- and light-body polyether impression materials; however, direct contact of chemical displacement agents and polyether impression materials can be avoided.
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http://dx.doi.org/10.1111/jopr.12471DOI Listing
February 2018

Chemical Retraction Agents - in vivo and in vitro Studies into their Physico-Chemical Properties, Biocompatibility with Gingival Margin Tissues and Compatibility with Elastomer Impression Materials.

Mini Rev Med Chem 2017 ;17(5):435-444

Department of Dental Materials, Wroclaw Medical University, Poland.

Gingival margin retraction/displacement (GMR/D) is a commonly accepted procedure in restorative dentistry. Of the various retraction methods, the chemo-mechanical approach with retraction media and chemical retraction agents (ChRAs) is mostly used. Different local and/or systemic side effects were observed after "chemical attacks" from these retraction agents. Moreover, no consensus exists as to the compatibility of chemical agents with different impression materials. This paper reports the findings of in vivo and in vitro studies and we discuss the physico-chemical properties of chemical retraction agents, their undesirable clinical side effects, biological activity and compatibility with selected groups of elastomer impression materials.
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http://dx.doi.org/10.2174/1389557516666160418122701DOI Listing
September 2017

Combination of therapy with 5-fluorouracil and cisplatin with electroporation in human ovarian carcinoma model in vitro.

Biomed Pharmacother 2014 Jun 12;68(5):573-80. Epub 2014 Jun 12.

Department of Medical Biochemistry, Wroclaw Medical University, 10, street Chalubinskiego, 50-368 Wroclaw, Poland. Electronic address:

High electric field, applied to plasma membrane, affects organization of the lipid molecules, generating transient hydrophilic electropores. The application of the cell membrane electroporation in combination with cytotoxic drugs could increase the drug transport into cells. This approach is known as electrochemotherapy (ECT). Our work shows new data concerning the influence of electrochemical reaction with cisplatin or with 5-fluorouracil (5-FU) on cancer ovarian cells resistant to standard therapy with cisplatin, in comparison to ECT effect on human primary fibroblasts. We investigated the effect of electroporation and electrochemotherapy with 5-FU and cisplatin on human ovarian clear-cell carcinoma cell line (OvBH-1) and epithelial ovarian carcinoma cell line (SKOV-3) - both resistant to cisplatin typically used in ovarian cancers. As control cells, human gingival fibroblasts (HGF's) from primary culture were used. Electropermeabilization efficiency was determined by FACS analysis with iodide propidium. Efficiency of electrochemotherapy was evaluated with viability assay. The cytotoxic effect was dependent on the electroporation parameters and on drug concentration. Electroporation alone only insignificantly decreased cells proliferation in OvBH-1 line; SKOV-3 line was more sensitive to the electrical field. Electrochemotherapy with cisplatin and 5-FU showed promising effects on both ovarian cell lines with recovery of normal cells revealed after 72 hours.
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http://dx.doi.org/10.1016/j.biopha.2014.05.005DOI Listing
June 2014

Comparison of selected kinematic facebows applied to mandibular tracing.

Biomed Res Int 2014 7;2014:818694. Epub 2014 May 7.

Department of Prosthetic Dentistry, Faculty of Dentistry, Wroclaw Medical University, 50425 Wroclaw, Poland.

The study focused on the comparison between mechanical and computerized registration methods used by the two selected kinematic facebows. The material consisted of 35 women aged 18 to 35, studied using the Gerber Dynamic Facebow and the computerized ARCUSdigma II axiograph. To compare the devices the condylar path inclination (CPI) was recorded according to the Camper's line, enabling the acquisition of easily comparable values based on which the devices were objectively and subjectively analyzed. Statistics was performed for the obtained data. The study showed that the values for the CPI registrated by the ARCUSdigma II are significantly higher than those obtained by using the Gerber Dynamic Facebow. The significant difference in the records of the CPI is most likely a result of the differences in the registration techniques assumptions. ARCUSdigma II provides the user with more diagnostic options than Gerber Dynamic Facebow. Mechanical facebow handling has a higher risk of hand-measuring errors in tracing procedure. Due to high discrepancy of achieved results from different systems the authors recommend to use articulator compatible with facebow whose measurement has been done.
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http://dx.doi.org/10.1155/2014/818694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033495PMC
November 2015

The influence of retraction agents on cytoskeleton reorganization and oxidative stress in primary human gingival fibroblasts (HGFs).

Arch Oral Biol 2014 Mar 8;59(3):341-8. Epub 2014 Jan 8.

Department of Medical Biochemistry, Wroclaw Medical University, Poland. Electronic address:

Objective: Contemporary gingival retraction chemicals are not without disagreeable side-effects; there appears to be no best gingival retraction agent. The aim of this research was to select the most biocompatible retraction agents based on examination of the parameters of oxidative stress in fibroblasts derived from human primary cell culture.

Design: In this in vitro study we evaluated parameters of oxidative stress after treatment with retraction agents. Visine, Afrin, Neosynephrin, Strazolin and Adrenaline were the commercial products studied as gingival retraction agents. Additionally we examined three experimental agents. We determined lipid peroxidation and protein damage and monitored changes in cellular cytoskeleton proteins. Proliferative and survival efficiency were also evaluated.

Results: Oxidative changes included by evaluated retraction agents were at the lowest level in the case of the experimental gels. Also cytoskeleton observations suggest that the experimental agents did not degrade the cellular structure of human gingival fibroblasts (HGFs).

Conclusions: The current study was performed because of a need to project new nontoxic and save retraction agents for peridontological therapeutic usage. We suggest that the new investigational gels are most biocompatible with periodontal tissues and can be applied as new vasoconstrictor chemical retraction agents.
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http://dx.doi.org/10.1016/j.archoralbio.2013.12.011DOI Listing
March 2014

Polymerization time compatibility index of polyvinyl siloxane impression materials with conventional and experimental gingival margin displacement agents.

J Prosthet Dent 2014 Aug 23;112(2):168-75. Epub 2014 Jan 23.

Professor, Department of Prosthodontics, Wroclaw Medical University, Poland.

Statement Of Problem: No consensus exists as to the compatibility of chemical agents used with gingival displacement methods with different impression materials.

Purpose: The purpose of this study was to investigate the effect of conventional and experimental gingival displacement agents on the polymerization time of polyvinyl siloxane impression elastomers.

Material And Methods: The study comprised 10 gingival displacement agents, including 5 conventional astringents (10%, 20%, and 25% aluminum chloride, 25% aluminum sulfate, and 15.5% ferric sulfate) and 5 experimental adrenergics (0.1% and 0.01% HCl-epinephrine, 0.05% HCl-tetrahydrozoline, 0.05% HCl-oxymetazoline, and 10% HCl-phenylephrine). The polymerization time of 240 specimens (weight 3.3 g) of 4 polyvinyl siloxane (PVS) impression elastomers, type 3 (Colorise Thermochromic, Hydrorise, Express, and Take 1 Advanced), after mixing with 20 μL of each displacement agent, was measured with a viscometer. The 24 specimens from the control group were polymerized without contact with the displacement agents. The studies were performed at 23°C and 37°C (± 0.1°C).

Results: A polymerization time compatibility index (PTCI) was devised, where the polymerization time of PVS mixed with the displacement agents was expressed as the percentage of the standard polymerization time of the impression material. The PTCI values at 23°C were higher than those at 37°C for both groups of displacement agents. At 37°C, the experimental displacement agents achieved higher PTCI values than the conventional agents.

Conclusions: All of the evaluated displacement agents at laboratory and intraoral temperatures induced changes in the polymerization time of PVS. Therefore, chemical displacement agents should not come into direct contact with PVS impression materials.
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http://dx.doi.org/10.1016/j.prosdent.2013.09.024DOI Listing
August 2014

Dynamic occlusions in natural permanent dentition.

Quintessence Int 2008 Apr;39(4):337-42

Department of Prosthodontics, Wroclaw Medical University, Wroclaw, Poland.

Objectives: The problem of occlusion pattern for prosthetic or orthodontic rehabilitation continues to be discussed in the literature. This controversial dilemma may be solved by studying the prevalence of dynamic occlusions in natural permanent dentition. The aim of this study was to assess which schemas of dynamic occlusion are typical of natural dentition in young and older subjects and to determine if any dynamic occlusions are dependent on gender or age.

Method And Materials: A total of 834 subjects with natural dentition and no prosthetic replacements were included in the study. The age of the subjects ranged from 20 to 63 years. Dynamic occlusions in all subjects were identified during clinical examination of lateral and protrusive tooth-guided excursions of the mandible.

Results: The following dynamic occlusions were found: bilateral and unilateral canine-protected occlusion, group function occlusion, balanced occlusion, and "other occlusions." Occurrences of particular forms of dynamic occlusion were almost the same in men and women; however, some of the occlusions were dependent on age. The frequencies of bilateral and unilateral canine-protected occlusions decreased with age, while the frequency of group function occlusion increased. The frequencies of balanced occlusion and "other occlusions" were very low and remained nearly unchanged in relation to age.

Conclusion: Bilateral canine-protected and group function occlusions were the most typical occlusions for younger patients, while group function occlusion was more common for older patients. The canine-protected occlusion seems to be the most suitable pattern for orthodontic and prosthetic rehabilitation planned in younger patients, while the group function occlusion may be a good pattern for prosthetic rehabilitation in older patients. Further studies are needed to determine the relationship of the occlusal schemas to periodontitis, bruxism, or temporomandibular disorders.
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April 2008

[Arterial hypertension in children and adolescents living in Kluczbork City].

Wiad Lek 2005 ;58 Suppl 1:29-34

Z Przychodni Lekarskiej SPZOZ w Kluczborku oraz z.

Hypertension in children and adolescents is usually recognized incidentally. The aim of the study was evaluation of prevalence of elevated blood pressure (BP) in pupils of the primary and secondary schools in Kluczbork city. The studied population was a representative sample of children and adolescents aged 7-19 years (1293 girls and 1530 boys). BP measurements were taken thrice and classification of hypertension were done following the guidelines of the III Report of the Task Force on Blood Pressure Control in Children. In the whole population weight, height and BMI were examined and family history of hypertension was also taken into account. Hypertension was found in 64 cases (2%), borderline hypertension in 181 pupils (6%), particularly in older boys. The occurrence of elevated BP was significantly higher in obese children (BMI > 25) and in children of hypertensive parents.
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October 2005