Breast cancer in women under 40 years of age.

PURPOSE: It is widely believed that breast cancer in young women is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinicopathological and biological characteristics in young patients with breast cancer. METHODS: The study enrolled 1029 consecutive female breast cancer patients who were admitted to the Clinical Centre Nis between July 2002 and December 2008. RESULTS: 91 (8.8%) patients were under and 938 (91.2%) were over 40 years. The mean age was 35.9 years for those under 40 years and 58.3 for those older than 40 years. In both patient groups, left breast was most commonly involved; the most common primary tumor site was the upper lateral quadrant; the most common histological type was ductal carcinoma; histological and nuclear grade 2 was most common. In the younger group of patients, the proportion of patients with T3 and T4 disease was higher (13.0 vs. 9.3% and 16.5 vs. 12.0%), the number of patients with histological and nuclear grade 3 disease was higher (27.5 vs. 24.7% and 37.4 vs. 33.2%), the proportion of patients with 4-9 and >10 positive lymph nodes was higher (22.6 vs. 18.3% and 7.1 vs. 4.0%), and the percentage of family history of breast cancer was higher (5.5 vs. 3.1%), without statistically significant differences between the two age groups. Patients in the younger age group exhibited higher estrogen (ER)/progesterone (PR) receptor negativity (32.6 vs. 24.4%) (p<0.05). CONCLUSION: Although uncommon, breast cancer in young women is worth special attention. The underlying causes of the disease must be investigated in large population- based studies in the future.

Polychlorinated biphenyls cause developmental enamel defects in children.

The aim of this study was to evaluate the effects of long-term exposure to polychlorinated biphenyls (PCBs) on developing dental enamel. 202 8- to 14-year-old children who were pre- and post-natally exposed to PCBs in the contaminated region of Bela Krajina, Slovenia, were studied. 202 controls from Brsljin were matched for age and sex. Risk assessment was based on the concentrations of toxic PCB congeners in the diet. Levels of PCBs in dentine were used to validate exposure. PCB levels were analysed by high-resolution gas chromatography. The prevalence of developmental defects of enamel was assessed using the FDI Index. Developmental defects of enamel in permanent teeth were found in 71.3% of exposed children, compared to 49.5% in the control group. The enamel was abnormal in 21.9% of the permanent index teeth of exposed children and in 12.7% of the control children. The difference was statistically significant (chi(2) = 84.18; p = 0.0019), mostly on account of demarcated opacities and hypoplasia. The extent of the defects was also greater in the exposed group (chi(2) = 61.3; p = 0.0001). No significant correlations were found between PCB exposure and developmental defects in deciduous teeth. In conclusion, our results showed that long-term exposure to PCBs may cause developmental defects of enamel.

Reasons for the caries decline in Slovenia.

In 1987, 1993 and 1998, nationwide surveys on the prevalence of dental caries were carried out in Slovenia. Sampling and examinations were performed according to WHO standards. The age groups 6, 12, 15, 18, 35-44 and 65 years or older were studied. In each age group, 200 persons or more were examined on each occasion. The results showed that the proportion of caries-free children and adolescents increased considerably over the 12-year period between the first and the last survey (from 6% to 40% for 12-year-olds). In the same period, the mean DMFT values decreased as follows: from 5.1 to 1.8 for 12-year-olds, from 10.2 to 4.3 for 15-year-olds, from 12.9 to 7.0 for 18-years-olds, from 20.5 to 14.7 for 35-44-year-olds, and from 27.0 to 22.5 for subjects aged 65 years or more. The notable improvement of dental health can be explained by the preventive programmes in operation in various periods. The most recent decline was most likely due to supervised brushing (with concentrated fluoride gel) taking place some 16-18 times a year in primary schools attended by children aged 7-15 years, improved oral hygiene, and a comprehensive programme of applying fissure sealants, particularly on first molars.

Retention of a fluoride-containing sealant on primary and permanent teeth 3 years after placement.

OBJECTIVE: The aim of this study, conducted in 132 randomly selected children, was to evaluate the retention of a fluoride-containing sealant on primary and permanent teeth. METHOD AND MATERIALS: In autumn 1995, a total of 195 primary molars in 36 children aged 4.5 years on average and 391 permanent premolars and molars in 96 children aged 10.5 years on average were sealed with Helioseal-F. The manufacturer's instructions were followed closely. The teeth were cleaned with a slurry of pumice and a rotating brush, isolated with cotton rolls, dried with air, etched for 60 seconds with an etching gel (37% phosphoric acid), rinsed with an air-water combination spray, and dried. Sealant was applied with a cannula and polymerized for 60 seconds. A saliva ejector was used throughout the procedure. Sealant retention was checked 3 years after placement. RESULTS: In the primary molars, full retention was found in 95.04%, partial retention in 3.12%, and loss of the sealant in 1.84% of the treated teeth. In the permanent molars, the corresponding rates were 95.81%, 2.83%, and 1.36%, respectively. CONCLUSION: Very good sealant retention was found 3 years after placement. The observed difference in retention between primary and permanent molars was not statistically significant.

Oral hygiene and root caries occurrence in Slovenian adults.

This study investigated root caries related findings made in connection with basic clinical dental routines. A total of 410 adults, mean age 42.8 years, seeking dental care in two Slovenian communities, rural Ravne and urban Ljubljana, during a three-month period, were clinically examined for root caries. Primary root caries was defined as a softened yellowish-brown lesion gently penetrable by an explorer and situated principally on a root surface. Past root caries was defined as fillings at a similar location. A subject's oral hygiene was judged clinically as good, fair or poor, based on presence of dental plaque and subgingival calculus. Subjects' background variables included age, gender, and number of teeth. Subjects had on average 23.1 teeth, from which 0.8 teeth had primary root caries and 0.4 had fillings on root surfaces. Primary root caries occurred in 42 per cent of subjects, in 38 per cent of men and 45 per cent of women (P = 0.21), but fillings on root surfaces in only 19 per cent of the subjects, 11 per cent of men and 25 per cent of women (P = 0.001). The strongest factors explaining the presence of root caries, with control for other factors, were poor oral hygiene (odds ratio 3.1), smaller number of teeth (odds ratio 2.3 to 2.7), and older age (odds ratio 2.1). In conclusion, in everyday clinical dental practice, more emphasis should be placed on patients' proper oral hygiene and their encouragement and motivation to achieve it.

The prevalence of dental caries in Europe 1990-1995. ORCA Saturday afternoon symposium 1995.

Caries prevalence data from recent studies in all European countries showed a general trend towards a further decline for children and adolescents. However, in several countries with already low caries prevalence in primary teeth, there was no further decrease. Regarding the permanent dentition, further reductions were observed in the 12-year age group, these being even more evident at the ages of 15-19 years. In some Central and Eastern European countries, caries prevalence in children and adolescents was still high. Few data were available on young adults, but the benefits of prevention are becoming manifest. The available data on the use of toothbrushes, fluorides and other pertinent items provided few clues as to the causes of the decline in caries prevalence.

The prevalence of dental caries in Slovenia in 1987 and 1993.

Two national oral pathfinder surveys were conducted in the Republic of Slovenia in 1987 (1623 subjects) and 1993 (1567 subjects). The assessment forms used in the surveys were those of the World Health Organization. Persons aged 6, 12, 15, 18, 35-44 and 65 years or older were examined in all nine geographical areas of Slovenia. The results showed that caries prevalence declined in all the age groups except the oldest one. Mean DMFT changed from 5.2 to 3.9 (dmft) at age 6 years, from 5.1 to 2.6 at 12 years, from 10.2 to 5.6 at 15 years, from 12.9 to 8.8 at 18 years, from 20.5 to 19.0 at 35-44 years, and from 27.0 to 28.0 in persons aged 65 years or older. The differences were statistically significant (P < 0.05) for all the age groups except the last two. The proportion with caries-free primary teeth increased from 13 per cent to 30 per cent for 6-year-old children and for permanent teeth, from 6 per cent to 31 per cent for 12-year-old children. The substantial decline in caries is attributed to the widespread use of fluoridated dentifrices, the distribution of fluoride tablets to children and expectant mothers, topical application of an amine fluoride gel in schoolchildren, and an extensive fissure-sealing programme.

Trends in dental caries in 12-year-old children in Ljubljana, Slovenia.

In Slovenia accurate data on caries trends have not been available. Therefore, in this epidemiological study the caries status of 12-year-old children was compared over time for the years 1970, 1985 and 1991. Each survey comprised examinations of around 150 children of similar socio-economic background, attending the same three schools in Ljubljana. Dental examinations in each survey were carried out by the same examiner. The mean number of decayed, missing and filled teeth (DMFT) decreased from 8.15 in 1970 to 2.96 in 1991 (64%) and the mean number of decayed, missing and filled surfaces (DMFS) decreased from 17.25 in 1970 to 5.11 in 1991 (70%). The mean number of carious surfaces per tooth dropped from 2.12 in 1970 to 1.72 in 1991. The greatest decline occurred on the approximal surfaces (92%), whereas the involvement of occlusal, lingual and buccal surfaces decreased by about 50-60%. The difference between mean DMFT in 1970 and 1985 was statistically significant. Similar differences were found for DMFS (p < 0.05). In the future, a further reduction in caries level may be expected following the introduction of fissure sealing for the preschool and schoolchild population.

Oral health in Slovenia, Yugoslavia.

An oral health epidemiological survey using WHO assessment forms was conducted in the Republic of Slovenia (Yugoslavia) in 1987. The study population consisted of 1623 persons aged 6, 12, 15, 18, 35-44 and over 65 yr. The survey included 10 towns in 9 geographical areas of Slovenia. The results showed the prevalence of dental caries in the Slovenian population to be very high (93.6% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMFT) scores were as follows: 5.1 at age 12 yr, 10.2 at 15 yr, 12.9 at 18 yr, 20.5 at 35-44 yr, and 27.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while shallow pockets prevailed in persons aged over 65 yr.

[New cavity designs]. / Sodobna zasnova preparacije kavitet.

Introduction of new dental materials and new technics cause the changes in cavity preparation and cavity designs especially after introduction of composite resins as a filling material. The majority of changes concern extension for prevention and cavity retention. Occlusal restoration using fissure sealant instead of extension for prevention is discussed as well as a conservative occlusal preparation with no extension for prevention. In addition, other changes in cavity preparation are mentioned in class I to V.

[Oral health in SR Slovenia]. / Oralno zdravje prebivalstva SR Slovenije.

Results of oral health epidemiological survey (using WHO assessment forms) which was conducted in SR Slovenia in the year 1987 are presented. The study population consisted of 1623 persons aged 6, 12, 15, 18, 35-44 and over 65 years. The survey included 10 towns. The results showed the prevalence of dental caries in the SR Slovenia population to be very high (93.6% in 12-yr olds). The mean decayed, missing and filled teeth (DMFT) scores was 5.1 at age 12-yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr.

[Clinical aspects of root surface caries]. / Klinicni vidiki kariesa korenine.

The present epidemiologic data indicate that root caries increases with age. Since the number of people in old age categories of population is increasing, root caries may be expected to become more and more common. This prediction is supported also by the anticipated increase in tooth longevity due to the declining caries prevalence in children and adolescents. Thus root caries is likely to become one of the problems in dentistry. Our present knowledge of root caries is insufficient and more research is needed into every aspect of the disease.

[The frequency of root caries in Slovenia]. / Pogostnost kariesa korenine v SR Sloveniji.

In the pilot study carried out in 1989 in Slovenia 410 persons of both sexes aged above 30 were examined. It was found out, that primary root caries was present in 41.9%, secondary root caries in 5.6% and root fillings in 18.8% of examined persons. More root caries was found in persons consuming more carbohydrates and having bad mouth hygiene.

[Root surface caries]. / Karijes zubnog korijena.

Review of the current knowledge related to the etiology, clinical picture, treatment, and prevention of root surface caries (RSC) is presented. The prevalence of RSC rates vary from 20 to 40 percentage depending on the age of the population studied and the definition of RSC applied. Prevention of RSC requires oral hygiene instructions and dietary advices as well as drinking of optimally fluoridated water combined with the appropriate use of topical fluoride agents. Glass ionomer cements are considered the best and the most successfully used filling material for root surface cavities. Epidemiologic data indicate that RSC increases with age and becomes a major health problem in dentistry. Since our present knowledge about root caries is insufficient, more research is needed in every aspect of the disease.

Caries prevalence in 12-year-old children in Ljubljana in 1970 and 1985.

In Yugoslavia accurate data on the caries trend have not been available so far. In the present study, we have compared the caries status of 12-yr-old children in the years 1970 and 1985. Dental examinations in both surveys were carried out by the same examiner. Each survey included about 150 children of similar socioeconomic background, attending the same three schools in Ljubljana. The average number of DMFT per child decreased from 8.15 in 1970 to 5.03 in 1985 (38.3%), and the average number of DMFS decreased from 17.25 in 1970 to 7.80 in 1985 (54.8%). The number of carious surfaces per tooth dropped from 2.12 in 1970 to 1.55 in 1985. The greatest decline occurred on the approximal surfaces (78.3%), whereas the involvement of occlusal, lingual, and buccal surfaces decreased by about 40%.

Oral health in SFR Yugoslavia in 1986.

A pilot oral health epidemiological survey using WHO assessment forms was conducted in Yugoslavia in the year 1986. The study population consisted of 2600 persons aged 6, 12, 15, 18, 35-44, and over 65 yr. The survey included 22 towns (11 developed and 11 underdeveloped) in the six Republics and two Provinces of Yugoslavia. The results showed the prevalence of dental caries in the Yugoslav population to be very high (98.7% in 12-yr-olds). The mean decayed, missing, and filled teeth (DMF) scores were as follows: 6.1 at age 12 yr, 9.6 at age 15, 10.9 at age 18, 18.0 at age 35-44, and 28.0 in persons aged over 65 yr. Assessment of the periodontal status showed calculus to be the predominant disorder in the age groups 18 and 35-44 yr, while loss of sextants prevailed in persons aged over 65 yr.