Showing papers in "Stomatoloski Glasnik Srbije in 2012"

Nanotechnology in dentistry: Current state and future perspectives

Abstract: Nanotechnology has been considered as multidisciplinary field of scientific research about different types of nanoparticles as well as the application of new nanomaterials and nanodevices in numerous areas of human interest. It offers advances in industry, engineering, information and communication technology, electronics, environmental science and energy savings, economics etc. New nanoproducts and nanotehnology could be applied in almost all fields of human activity. Potential benefit of nanomaterials and nanorobots applied in medicine and dentistry is of main concern when thinking about nanoadvances. However, nanotechnology has become a controversial issue between scientific and public opinions due to the insufficient knowledge of potential hazard to human health and environment. Some of the raised questions are what are the advantages and disadvantages of nanotechnological evolution, and what kind of future can be expected when changes gain wider scale? The aim of this study was to present the importance of nanotechnology in various areas, especially in medicine and dentistry, and to point out possible consequences of their use to human health and environment.

Biochemical markers in saliva of patients with diabetes mellitus

Abstract: Diabetes mellitus is metabolic syndrome characterized by disorder in metabolism of carbon hydrates, lipids and proteins. The diagnosis of diabetes is established by measuring the blood glucose level using standardized methods. Frequent monitoring of blood glucose level could be inconvenient for patients because of possible pain during blood sample taking. In the last few years biological materials with non invasive sampling, like saliva, have been analyzed. Research has confirmed that some organic and inorganic components of saliva are modified in diabetic patients (glucose, lipid and protein components, oxidative stress markers, electrolytes). Beside other markers, the analysis of glucose in saliva is an attempt to find a non-invasive and painless way for frequent monitoring of glucose concentration in diabetic patients. Collecting saliva is simple and economical, it neither requires expensive equipment nor specially trained staff. Saliva can be taken many times and in unlimited quantity. In regards to the data about the possibilities for using saliva as biological sample in monitoring diabetes mellitus, which could be alternative to blood serum or plasma, the conclusion is that saliva becomes more important in this context.

Oral health assessment among dental students

Abstract: Introduction. Oral health is an important part of general health. Knowledge, beliefs and attitudes that students acquire during dental school can influence their behavior towards not just their own health, but also towards health in their immediate environment. The aim of the study was to assess the level of oral health among dental students of the second and fifth year at the University of East Sarajevo. Material and Methods. Sixty-six students from the Dental Department of the Faculty of Medicine, the University of East Sarajevo were assessed. The study was conducted in 2012. The parameters used to assess oral health were: DMFT (decayed, missing, filled teeth) index and its components, index for the assessment of periodontal tissues (CPITN), and Green’s Vermillion oral hygiene debris index (DI). According to the methodology and criteria of the World Health Organization (WHO) all patients were examined using standard dental diagnostic tools under artificial light on dental chair. Results. Average number of decayed teeth of the second year students was 9.93 while it was 11.44 in the fifth year students. The mean dental caries index was 38.23% and person caries index was 100%. The average value of the debris index was 0.42. Healthy periodontium had 18.2% of students, while in 34.8% of students shallow periodontal pockets were observed. Conclusion. Oral hygiene and periodontal health was satisfactory in dental students. However, high average values of decayed teeth indicated that for better results caries preventive services should be activated earlier, even in school or preschool period.

Dental health estimation for children age twelve and fifteen

Abstract: Introduction. The problem of chronic diseases such as caries is very complex because it appears very early in life, often during childhood. The number of involved people is growing as well as the number of affected teeth and surfaces that eventually lead to teeth loss. The aim of this study was to determine the dental status of adolescents age 12 and 15 in three municipalities in Bosnia, Foca, Cajnice and Kalinovik. Material and methods. The study included 506 school children both genders of six schools in three municipalities (Foca, Cajnice and Kalinovik). Teeth examination and criteria for diagnosis and coding were estimated based of criteria of the European Academy of Paediatric Dentistry (EAPD). To estimate dental health DMFT index [number of carious teeth (D), missing (M) and filled teeth (F)] and related indices (Person Caries Index, Teeth Caries Index, Average Caries Index and DMFT structure) were used. Results. Dental health status and caries prevalence were presented through the values of the Average Caries Index. The value of Average Caries Index for examined children was 6.17. Of all examined children 96.05% of them had at least one carious tooth. The average value of Teeth Caries Index was 23.04%. Conclusion. Dental health of the children in the examined region was characterized by high values of untreated carious teeth as well as the other components of DMFT index. Therefore, preventive measures and primary dental care must be implemented better among school children.

The efficacy of the interventional health education program for oral health improvement in school children

Abstract: Introduction. Dental caries and gingivitis are common in school children although they can be prevented through the health education and application of preventive measures. The aim of this study was to determine the prevalence of caries, gingivitis and orthodontic irregularities in school children and to assess the efficacy of health education program in relation to the plaque and gingivitis control as well as caries treatment. Material and Methods. This study included 56 second grade students with early mixed dentition and 56 seventh grade students with permanent dentition, from elementary school “Borislav Petrov Braca” in Pancevo. DMFT/dmft index, Plaque index (PI) according to Sillness-Loe, and the prevalence of gingivitis and orthodontic anomalies were determined by clinical examination. The Interventional Program included oral hygiene education and the application of prophylactic measures. At one and six months follow-ups, PI, gingival health and changes in DMFT/dmft structure were reexamined. Results. Gingivitis was recorded in 78.56% of II and 50% of VII grade students. In the II grade students, mean DMFT was 1.36±1.41, and dmft 5.07±2.66. In the VII grade students mean DMFT was 4.36±3.34. The most common orthodontic anomalies were narrow maxilla, deep bite and distal bite. After six months of conducting the Program, reduction of gingivitis and number of carious teeth in DMFT/dmft structure as well as oral hygiene improvement were achieved in both age groups. Conclusion. Oral hygiene, dental status and the prevalence of orthodontic anomalies in school children indicate the necessity to intensify preventive measures. Health education programs contribute to improvement of oral health and increase motivation for self-care in children.

The assessment of periodontal health in children age 12 to 15

Abstract: Introduction. Periodontal diseases and primarily gingivitis occur relatively early in the childhood. It was found that 8.8% of children 3-6 years old had gingivitis and that number increased with age. Gingivitis is especially common during puberty and mixed dentition. The aim was to determine the prevalence and characteristics of gingival and periodontal diseases in children age twelve and fifteen in Republika Srpska. Material and Methods. The study included 506 students of both genders from six schools on the territory of the municipalities Foca, Cajnice and Kalinovik. For the evaluation of oral hygiene and periodontal status, indices suitable for research in pediatric population were used: Greene-Vermillion Debris Index (DI), Greene’s Calculus Index (CI), Oral Hygiene Index (OHI) and Community Periodontal Index of Treatment Needs (CPITN). The evaluation was carried out in accordance with the criteria for the diagnosis and non- communicable diseases, established in 1997 in Geneva. Results. The average DI value for all children was 0.86, the average CI 0.13, and OHI was 0.99. Healthy periodontium had 14.6% of respondents, while deep periodontal pockets of 4-5mm were found in 8.7% of fifteen-year-old children. Conclusion. A significant prevalence of gingivitis was found among examined children. It is necessary to highlight the importance of primary prevention measures, health education, proper training and regular oral hygiene, as well as regular check-ups in order to achieve better periodontal health in children.

Public health sector workforce in Serbia and world economic crisis

Abstract: Introduction. Health care, as one of the most important and sensitive fields of human endeavor, has a significant social impact; therefore changes in this area have wide implications on society in general. The latest economic crisis resulted in slow growth of gross domestic product (GDP), high unemployment rates, low living standards, and increased poverty across the globe. This includes decreased capacity of health system, and reduced quality and supply of health services. The aim of the study was to explore possible impact of the current world economic crisis on the public health sector workforce in Serbia. Materials and Methods. The study was conducted as retrospective analyses of the Public Health Institute (PHI) human resource data, the Republic Statistical Office publications and database, the Republic Development Bureau report, as well as the analysis of healthcare expenditures obtained from the Chamber of Health Institutions reports. The comparative analytical method was used for the assessment of socio-economic and human resource indicators over the period of five years, 2006 to 2010. Results. Results showed that the world economic crisis discontinued steady economic growth in Serbia. Between 2006 and 2008, the real GDP growth rate has been fluctuating between 3.6% and 5.4 %, while in 2009 it had negative growth rate of -3.1 % and slight increase in 2010 of 1.0%. In 2006, the GDP per capita was US$ 3,943, and by 2008 it almost doubled reaching US$ 6,498, while in 2009 it fell down to US$ 5,499, and continued decrease in 2010 to US$ 5,006. In 2007, the overall inflation rate was 6.5%, and after fluctuaion between 11.7% in 2008 and 8.4% in 2009 it droped again to 6.5% in 2010. According to the PHI, from 2006 to 2008 there was steady increase of full-time employees in the public health care sector; from 108,975 in 2006 to 114,317 in 2008. In 2009, the number of full-time employees slightly declined to 114,175 and 114,432 in 2010. There was constant increase in total number of employees in the public health care sector, from 125,081 in 2006 to 129,357 in 2008. In 2009, the total number of employees decreased to 128,694 and in 2010 to 122,695. At the same time, the total expenditure of human resources in the health sector as the percentage of total health expenditure declined from 37.7% in 2006 to 34.7% in 2010. The public health sector salaries after steady increase from 59.9% of total health expenditure in 2006 to 61.2% in 2007 and 2008, decreased to 56.2% in 2010. The unemployment rate for medical doctors almost doubled in 2010 as compared to 2006. Conclusion. Preliminary study results showed that the world economic crisis had negative impact not only on GDP growth rate, the inflation and unemployment rate, but on the public health sector workforce, their salaries and unemployment rate in Serbia.

Assessment of deciduous dentition in 6-10 year old school children

Abstract: Introduction. The emergence of deciduous teeth in the mouth of a child usually brings a joy to every parent. However, after ”short-time euphoria” deciduous teeth, in most cases, become the cause of pain, swelling, infection and further complications. The aim of this study was to assess the status of deciduous teeth in school children. Material and Methods. The study included children age 6-10 years from four cities in Republika Srpska. All respondents were divided in two groups: Group I included those who voluntarily came to be examined at the dental clinic and the Group II-those who were randomly chosen in schools. The examination was performed using dental mirror and probe. Caries verification was carried out by Klein-Palmer system, dmft (d - decay; m - missing; f - filling), and its related indices: Person caries index (pci) and Average caries index (aci). In addition, a survey was conducted. Results. A total number of 228 respondents were examined. Total pci was 96.1%. On average, each child had aci= 4.17 while 10.52% of the children had fillings in primary teeth. None of the children had sealed fissures on deciduous teeth. Physical examination revealed that 12.2% of the children had submucous abscess in oral cavity. The survey revealed that 3% of children did not have a tooth brush. Conclusion. The prevalence of caries in primary teeth is high, despite the fact that the Health Insurance Fund in Republika Srpska covers full cost for complete restoration of teeth in children up to 15 years old. Responsibility for the low percentage of healthy and filled teeth is relying mostly on parents as well as the entire community that should provide development and availability of public health dental care in all areas.

The effect of excessive coca-cola consumption on the development of dental erosions

Abstract: The last few years have brought many changes in daily habits and overall lifestyle of human population, which is accompanied by increased exposure to acidic substances and increased consumption of acidic food. Regardless of the numerous warnings given by the World Health Organization about the harmful effects of carbonated beverages on general health, popularity and frequency of Coca-Cola usage have been growing steadily. Numerous epidemiological studies have demonstrated its potential negative effects on tooth structure. Good health education in developed countries has improved the awareness of the importance of oral hygiene; on the other hand, greater consumption of soft drinks has increased the incidence of dental erosions. Effective prevention and monitoring of dental erosions mostly depend on the knowledge about the etiology and early recognition of signs and symptoms of these lesions in clinical practice.

Trainer system appliances in early treatment of malocclusions

Abstract: Orthodontics is dental specialty focused on preventing and treating morphological and functional irregularities of orofacial system in order to establish adequate function of mastication apparatus, good occlusion and pleasant facial appearance. It has been shown that early treatment of orthodontic anomalies during the period of children’s growth is very important. The purpose of early orthodontic treatment is to eliminate or modify deviant skeletal growth and to stimulate adequate dentoalveolar and skeletal development. As known, the treatment of malocclusions should begin in primary or early mixed dentition, since the status of primary dentition has profound effect on the development of permanent dentition. Functional orthodontic appliances are most commonly used in early orthodontic treatment. The aim of this study was to describe a new prefabricated polyurethane myo-functional appliance clinically proved to be very effective.

Physico-chemical properties of calcium phosphates

Abstract: Calcium phosphates have important role in biological and pathological mineralization. While only one of calcium phosphates, carbonate apatite, represents the main mineral component of teeth and bones, octacalcium phosphate, calcium hydrogenphosphate dihydrate and beta-tricalcium phosphate occur in pathological deposits. From the stand-point of chemists, processes of biological and pathological mineralization could be considered as deposition of inorganic phase within organic matrix, i.e. formation of inorganic-organic composites. Although this approach is very simplified at first glance, it allows clarification of important issues related to biomineralization (e.g. what is the role of individual components of organic matrix in the emerging solid tissue), and design and preparation of new materials for hard tissue regeneration (e.g. process of transformation after implantation). The importance of investigation about calcium phosphates will be presented through the overview of basic physico-chemical reactions related to the formation and transformation of biologically relevant calcium phosphates and their interaction with various organic additives in the laboratory.

Sensitivity of composite materials to ambient light and clinical working time

Abstract: Introduction. The aim of this study was to determine sensitivity of composite materials to ambient light by a modified standard ISO 4049:2000 and clinical working time. Materials and Methods. The following materials were tested: nano-hybrid Herculite XRV Ultra (Kerr), micro-hybrid Herculite XRV (Kerr), Zmack (Zhermack), SuperCor (SpofaDental) and Valux Plus (3M ESPE). Five samples in each group were exposed to ambient light of 8000 lx, which comprised dental unit light and natural light. After 60 sec of exposure, each sample was visually examined for signs of inhomogeneity meaning that material did not pass the test. Clinical working time was studied by applying a custom-built, standardized indenter into composite specimens of about 2 mm thickness during the same exposure to ambient light. Completion of polymerization was tested by dissolving samples in ethanol and measuring the difference in thickness before and after the test. Results were statistically analyzed using ANOVA at the significance level of 0.05. Results. Only Herculite XRV Ultra passed the test of sensitivity to ambient light, while other materials showed signs of inhomogeneity. Herculite XRV Ultra showed significantly longer working time than other composites, the average was 250 sec (p<0.05). The mean values of working time for other materials ranged between 117-131 sec and there was no significant difference between them (p>0.05). Conclusion. Due to the lower sensitivity to ambient light and significantly longer clinical working time compared to micro-hybrid composites, Herculite XRV Ultra can be recommended for clinical procedures that require prolonged working time with material in plastic condition. [Projekat Ministarstva nauke Republike Srbije, br. ON172007]

Prevalence of caries and gingivitis among school children in the municipality of Foča

Abstract: Introduction. The aim of this study was to determine the prevalence of caries and gingivitis among adolescents who attend school in the municipality of Foca, Republika Srpska. Material and Methods. The total number of 352 school children - 135 students of the ninth grade of primary school (aged 15 years) and 217 students of the third and fourth grade of high school (aged 17-18 years) - were included in this cross-section study. The incidence of dental caries using DMFT index and its components was calculated as recommended by the World Health Organization. Periodontal tissue condition was determined using gingival index (GI) by Loe and Silness. Results. The mean DMFT in students age 15 was 6.6, and in students age 17-18 was 9.5. The dominant components of DMFT index in both studied groups were filled and carious teeth. In regards to gender, female students age 15 had significantly greater number of extracted teeth than male students (p<0.05). In older age group, females had significantly more filled teeth than males (p<0.05). Mild gingivitis was present in both studied groups. Conclusion. Our results showed that caries prevalence in the tested groups was high and mild gingivitis was present in most patients.

Mucous patch on the tongue as isolated manifestation of the secondary stage of syphilis: Case report

Abstract: Introduction. Syphilis is sexually transmitted infection caused by the anaerobic spirochete Treponema pallidum. Oral lesions are present and described in all stages of the disease. These lesions as well as blood and saliva of infected persons are highly contagious in early syphilis. The aim of this case report was to point out to the possibility of the secondary syphilis in differential diagnosis of oral diseases. Case Report. A 38-year-old asymptomatic man showed up at the clinic with suspicious of syphilis infection. Clinical presentation of the disease was a mucous patch on the tongue, however no other mucous membrane or cutaneous lesions were detected. No lymph nodes were enlarged. The serologic tests on syphilis were positive. After conducting systemic antibiotic therapy with benzathine penicillin the tongue lesion disappeared. Conclusion. Depending on the clinical picture, the possibility of syphilis should not be overlooked in the differential diagnosis of oral lesions.

Application of screw-retained and cement-retained implant supported fixed restorations: A case report

Abstract: Implantology has become an important therapeutic procedure that allows complete aesthetic and functional rehabilitation of the oro-facial system in edentulous patients. Implant supported prosthetic restorations can be fixed in two ways, by cement or screws. Both techniques have advantages and disadvantages and their selection depend on situation in patient’s mouth. The aim of this study was to describe complete process of prosthetic rehabilitation in an edentulous patient, from pre-implant preparation, through implant placement and fixation of final restoration on implants. In this case report, one ceramo-metal bridge was fixed by screws in the lower jaw while the other one was fixed using glass-ionomer cement in the upper jaw. After bone augmentation and time necessary for its osseointegration (6 to 8 months), 16 implants were placed in both jaws. Eight weeks after the implant placement, final prosthetic rehabilitation was achieved by cementation of one ceramo-metal bridge in the upper jaw using glass ionomer cement and fixation of the second bridge with screws in the lower jaw. To achieve successful implant supported prosthetic rehabilitation, the treatment protocol must be followed from the beginning to the end of the therapy.

Prosthetic therapy of the lateral facial defect

Abstract: Introduction. Facial defects may arise as a result of head and neck trauma or facial tumor ablation. Minor defects can be reconstructed surgically while large defects usually need combined surgical and prosthetic reconstruction. The aim of this study was to present the prosthetic reconstruction of the lateral facial defect using facial colored acrylic prosthesis. Case Report. A male patient with a maxillary defect on the left side and a large lateral facial defect on the same side received an obturator prosthesis as well as a facial colored acrylic prosthesis (facial-orbit) retained by the glasses frame. Satisfied aesthetics was accomplished. However, the stability of the prostheses during mandibular movements could not be achieved which resulted in saliva leakage over the lips. Conclusion. Better functional and aesthetic outcome could be achieved by combined surgical and prosthetic treatment of such large facial defect.

How to restore endodontically treated posterior teeth: A conservative approach

Abstract: Reconstruction of endodontically treated teeth is common procedure in everyday clinical practice. It has great impact on prognosis of endodontically treated teeth, however, there is no consensus regarding the most predictable restorative procedure. Widely accepted procedure has included the use of post and core and crown. Nowadays, sound tooth structure preservation has become one of the most influencing factors in terms of survival rate of treated teeth. Therefore, direct restorations have become more advantageous as compared to crowns. This article is a review about conservative reconstruction of endodontically treated posterior teeth. The purpose was to give the guidelines for clinicians how to choose the most successful therapeutic procedure for each individual case.

Endodontic management of maxillary first molar with five canals: Report of a case aided with spiral computed tomography

Abstract: Introduction. Maxillary first molars have shown substantial dissimilarity regarding their number of roots, canals and morphology. Most commonly, it has three roots and four canals, two mesiobuccal, one distobuccal and one palatal canal. The incidence of second mesiobuccal canal has been reported between 18% and 96.1% while the incidence of two distobuccal canals was found in 1.64% to 9.50% of cases. Periapical (PA) radiography has been commonly used to determine root canal anatomy even though it is two-dimensional representation of a three-dimensional object. Advanced diagnostic methods as spiral computed tomography (SCT) provide three-dimensional images useful to determine complex canal morphology. Case Report. A 31-year-old male patient was referred for endodontic treatment of the maxillary right first molar. Endodontic access cavity revealed two canal openings in each of the mesiobuccal and distobuccal roots and one canal in the palatal root later confirmed using the SCT and conventional PA radiography. The canals were instrumented using crown down technique with ProTaper NiTi rotary files. Obturation was performed using single gutta-percha cone and AH Plus paste. The patient remained asymptomatic during the regular checkups. Conclusion. Knowledge, detection and management of complex canal anatomy is of the foremost importance in endodontics since missed canals are one of well recognised reasons for endodontic treatment failure.

Prosthetics rehabilitation of a male patient with a unique looped metal palate denture: A case report

Abstract: Complete denture can improve both function and aesthetics Even though mastication is highly improved, one of the most common problems for new full upper acrylic denture wearers is lack of feeling sensations such as hot and cold, loss of taste and fracture in the mid palatal region These patients require a denture that allows them to feel sensations as close to normal as possible The present case report discusses an alternative way of designing a metal palate for maxillary complete denture that along with fulfilling the above mentioned functions, has specially designed loops incorporated in such manner and directions to improve mechanical interlocking of acrylic within the metal loops and not to interfere with teeth arrangement

Restorative approach in prosthetic rehabilitation of unilaterally resorbed maxillary edentulous ridge and partly resorbed mandibular edentulous ridges: A case report

Abstract: Introduction. The aim of this study was to fabricate a complete upper acrylic denture and a partial lower acrylic denture and provide occlusal rehabilitation with added benefit of correcting the position of altered condyle in a dysfunctional stomatognathic system. Case Report. Procedures for fabrication of acrylic dentures are thoroughly described. Specific scheme of occlusion was applied in the treatment of this patent. Occlusal contacts were established as tripod minor contacts on the side where the part of upper edentulous ridge was intensively reduced (on the right side) with divergent tracing of the condyle due to dysfunction. Tripod contacts were established on occlusal surfaces of opposing teeth as well. Contacts on the left side were formed as circumferential surfaces. Specially distributed occlusal contacts favorably influenced reduction of occlusal stresses on supporting tissues in the mouth of the patient. Tooth contacts arranged in such particular order were established to redistribute loading as well as to prevent excessive propulsion and latero-protrusive movements of the lower jaw. Conclusion. Occlusal pattern of tripod and single-point contacts was used to compensate differences in condylar movements of this patient with stomatognathic dysfunction, intending to diminish loads on reduced surfaces.

Recurrent solid ameloblastoma of the maxillary sinus: A case report

Abstract: Introduction. Ameloblastomas are clinically the most important type of odontogenic tumors. Solid or multicystic form most commonly affects mandible, it is highly aggressive and shows high rates of recurrence. The aim was to report aggressive behavior of a rare maxillary solid ameloblastoma, emphasizing the clinical, tomographic and histological aspects. Case Report. A young and asymptomatic patient, presenting a solid ameloblastoma initially located in the maxillary sinus with rapid spreading to the adjacent tissues, had early recurrence despite radical surgical approach. Conclusion. Multicystic or solid ameloblastoma has lower incidence in maxilla and extremely aggressive behavior, justifying careful follow-up of the patients.

The status of teeth in relation to socio-demographic characteristics, oral hygiene habits and oral health behavior among adolescents in the eastern region of Republika Srpska

Abstract: Introduction. The aim of this study was to determine the prevalence of dental caries and analyze the status of teeth in relation to sociodemographic factors and habits and behavior related to oral health among adolescents in the eastern region of Republika Srpska. Material and Methods. The study included 212 adolescents (71 males and 141 females) age 16-18 years. Information about sociodemographic characteristics, oral hygiene habits and behaviors related to oral health were collected using a questionnaire. The prevalence of dental caries was determined by applying the DMFT index and its components (D - decayed, M - extracted, F - filled teeth). The status of teeth was analyzed in relation to socio-demographic variables, oral hygiene habits and behavior related to oral health. Results. The mean DMFT value of examined population was approximately 8.6. A significant difference in the status of teeth of adolescents was reported in relation to the place of residence and oral hygiene habits - brushing frequency and the use of dental floss. A significant difference in the caries prevalence was recorded depending on the elapsed time from last visit and reasons for visiting dentist. Conclusion. The results suggested that the place of residence, oral hygiene habits and behavior related to oral health influenced the status of teeth of adolescents in the eastern region of Republika Srpska.