Kompozitni kočići: faktori uspeha u protetskoj rehabilitaciji

Protetska rehabilitacija endodontski lečenih zuba često uključuje upotrebu kanalnih kočića različitih vrsta, u pogledu materijala, oblika i dizajna. Savremeni zahtevi estetske stomatologije, kao i potreba za keramičkim nadoknadama, podstakli su razvoj kompozitnih kočića. Pored estetike, koja se postiže zahvaljujući boji kočića sličnoj prirodnom zubu, njihova glavna prednost leži u modulu elastičnosti sličnom dentinu (40 KPa). To omogućava fiziološki prenos okluzalnog opterećenja, čime se smanjuje rizik od vertikalne frakture korena zuba. Dodatne prednosti uključuju biokompatibilnost i manju potrebu za uklanjanjem zubnog tkiva tokom ugradnje, u poređenju s livenim nadogradnjama. Ove karakteristike čine kompozitne kočiće dugotrajnijim rešenjem. Od 1990. godine u kliničkoj praksi posebno se koriste kompozitni kočići ojačani staklenim vlaknima (FRC kočići), koji nude odličnu estetiku, odgovarajući modul elastičnosti i relativno nisku cenu. Ovi kočići se sastoje od staklenih vlakana, neorganskog punila i smolne matrice, s tim da preko 50% zapremine čine staklena vlakna orijentisana duž uzdužne ose kočića. Fiksiranje fiberglas kočića često je praćeno nedoumicama oko dubine preparacije, izbora cementa i pravilne pripreme kanala. Ovo predavanje će razjasniti ključne zablude, pružiti preporuke zasnovane na dokazima i dati smernice za optimalnu adheziju i dugotrajnu stabilnost kočića. Kompozitni kočići imaju i svoje nedostatke. Budući da se industrijski proizvode, prečnici kočića su standardizovani i ne moraju uvek odgovarati lumenu kanala korena. To može zahtevati dodatno širenje kanala korena ili korišćenje kočića manjeg prečnika. Klinička istraživanja pokazuju da stopa uspešnosti terapije endodonski lečenih zuba sa kompozitnim kočićem više zavisi od stepena prilagođenosti kompozitnog kočića anatomiji kanala korena, nego od vrste cementa koji se koristi za njihovo cementiranje. Cilj ovog predavanja je da analizira ključne faktore koji utiču na dugotrajnost endodontski lečenih zuba rehabilitovanih kompozitnim kočićima, kao i da predstavi najnovije trendove u razvoju ovih nadoknada

Komparativna procena kliničkih dijagnostičkih testova za ispitivanje statusa pulpnog tkiva i utvrđivanje referentnih vrednosti kod zdravih mladih osoba

Introduction/Objective Traditional diagnostic methods for assessing pulp vitality are commonly used but lack precision and reliability, whereas recent advancements offer non-invasive alternatives, focusing on pulp tissue blood flow and oxygen saturation. This study was designed to evaluate and compare the reliability of all available clinical diagnostic methods for assessing pulpal status and to establish reference values in healthy young individuals. Methods This cross-sectional observational study enrolled 25 voluntary participants (27.8 ± 5.2 years old), 150 upper front teeth. The participants were healthy individuals, non-smokers, teeth with a mature apex, no or minimal restorations, periodontally healthy, and radiographically visible pulp chambers. Various diagnostic tests were conducted, including electric, cold, and hot pulp testing, Laser Doppler flowmetry, and pulse oximetry (EPT, CPT, HPT, LDF, and PO); The reference values were established. Results Statistically significant differences were observed among all tooth groups (central incisors, lateral incisors, and canines) for EPT, LDF, and PO. In contrast, CPT and HPT showed no statistically significant differences between the tooth groups. The mean values across all patients were as follows: EPT – 17.7 ± 5.4, PO – 80.6 ± 1.8%, and LDF – 4.6 ± 1.6 perfusion units. Correlation analysis showed no significant relationships between all tests. Conclusion Modern diagnostic techniques show promise in offering more reliable results. Establishing reference values is essential for improving diagnostic accuracy. These values will not only enhance clinical decision-making but also serve as a foundation for future investigations.Uvod/Cilj Tradicionalne dijagnostičke metode za procenu senzibiliteta pulpe se uobičajeno koriste, ali im često nedostaje preciznost i pouzdanost, dok savremena dostignuća pružaju neinvazivne alternative, fokusirajući se na protok krvi i zasićenosti pulpe kiseonikom. Ova studija je osmišljena sa ciljem da proceni i uporedi pouzdanost svih dostupnih kliničkih metoda za procenu statusa pulpe, i da uspostavi referentne vrednosti kod zdravih mladih osoba. Metode Ova studija preseka obuhvatila je 25 dobrovoljaca (27,8 ± 5,2 godina,), 150 gornjih prednjih zuba. Učesnici su bili zdravi, nepušači, sa završenim rastom korena, bez ili sa minimalnim restaurativnim zahvatima, parodontološki zdravi i sa radiografski vidljivim pulpnim komorama. Izvršeni su različiti dijagnostički testovi: elektro-test, test na hladno i toplo, laserska dopler merač portoka krvi i pulsna oksimetrija (ET, TH, TT, LDMPK i PO). Utvrđene su referentne vrednosti. Rezultati Statistički značajne razlike su uočene između svih grupa zuba (centralni sekutić, lateralni sekutić i očnjak) za ET, LDMPK i PO. Nasuprot tome, TH i TT nisu pokazali statistički značajne razlike između grupa zuba. Prosečne vrednosti za sve ispitanike bile su: ET – 17,7 ± 5,4, PO – 80,6 ± 1,8%, i LDMPK – 4,6 ± 1,6 PU. Korelaciona analiza nije pokazala statistički značajne veze između testova. Zaključak Savremeni dijagnostički testovi pokazuju veliki potencijal u pružanju pouzdanijih rezultata. Uspostavljanje referentnih vrednosti je od suštinskog značaja za unapređenje dijagnostičke preciznosti. Ove vrednosti ne samo da će unaprediti kliničko donošenje odluka, već će poslužiti i kao osnova za buduća istraživanja

MISSLEADINGS AND MISSUSES OF THERAPEUTIC TOOLS IN THERAPY OF OSTEOPOROTIC PATIENTS

Objectives: This study aims to report some of possible missuses in the therapy of osteoporotic patients in the population of olds. Methods: In this study 119 partially edentulous and completely edentulous patients – 79 woman and 40 men from 67 to 83 years were observed, orally and systemically treated of osteoporosis. Results: The main intentions in oral therapy (within the scope of systemic therapy) of these osteoporotic patients regardsː selected and sporadic use of biphosphates (bisphosphonates), restricted use of calcitonin, priority of DEXA and parallel beam scanner prior to using of cone beam tomography, avoidance of unilaterally established occlusal scheme in prosthodontic dental construction and frequent recalls because of the pronounced need for relining and rebasing of removable dentures. Conclusion: Selected principles and advices should be applied in oral therapy of all of osteoporotic patients.Oral Presentation: OP 10

Micromorphology analysis after professional oral hygiene procedures on zirconia restorations: in vitro study

Objectives The aim of this in vitro study was to determine whether routine dental procedures, such as brushing and ultrasonic scaling, affect the surface microtopography of veneered and CAD/CAM milled zirconia (partially stabilized with yttrium) prosthetic restorations. Methods The samples (4 × 4 mm, thickness 2 mm; n = 36) were separated from zirconia blanks (3Y-TZP-LA). One group was veneered with ceramics (F) , and the other group of samples was CAD/CAM milled (C). Each group had two subgroups: polished (1) and glazed (2). The samples of both groups: zirconia veneered and zirconia milled were divided into 3 subgroups: 0-no treatment (control samples); a- exposed to ultrasonic scaling (with a ultrasonic scaler incorporated in a dental unit) for one minute; b- exposed to brushing with a professional dental polishing nylon brush and abrasive paste (Super Polish, Kerr) for one minute. The application of brushing or ultrasonic scaling of the samples lasted 1 min (in 10 rounds), imitating the procedure carried out over a period of 5 years. The parameters of surface micromorphology were calculated before and after simulating the given methods of the professional maintenance of oral hygiene. Scanning electron microscopy (SEM, Model JSM-6390, JEOL, Inc., Tokyo, Japan) was used to evaluate zirconia surface properties carried out at 150× magnification. Results The SEM analysis showed the greatest change in surface microtopography after the use of ultrasonic scaling on glazed zirconia samples, both veneered (88.31 μm) and CAD/CAM milled (45.38 μm) samples. Conclusions Routine methods of oral hygiene professional maintenance can damage the surfaces of glazed zirconia restorations.Poster Presentation: PP 5

Zbornik rezimea referata i radova XL Simpozijuma zdravstvenog vaspitanja u stomatologiji

Zbornik rezimea referata i radova XL Simpozijuma zdravstvenog vaspitanja u stomatologiji „Preventivne strategije kod specifičnih grupa pacijenata“, Kruševac, 21. juni 2024. godin

Bilateral Maxillary Duplication in Tessier No. 7 Cleft: An Uncommon Congenital Deformity with a Challenging Radiological Diagnosis

Tessier No. 7 cleft, known as lateral facial cleft, is a rare and understudied entity with an incidence of 1/80,000–1/300,000 live births. Besides perioral tissue abnormalities manifesting as macrostomia, Tessier 7 cleft also involves anomalies of the underlying bony structures. It can appear as part of a syndrome, such as Treacher-Collins syndrome or Goldenhar/Orbito-Auriculo-Vestibular Spectrum, or as an isolated form (unilateral or bilateral) with variable expressions. Bilateral maxillary duplication in Tessier 7 cleft is considered extremely rare, accounting for only two previously presented cases. Given that the cases presented in the literature mainly focus on clinical appearance and surgical treatment, without providing sufficient imaging, we aim to present key radiological features of Tessier 7 cleft in terms of evaluating the involved structures, which is essential for the therapeutic approach and final outcome. A 17-year-old male with incompetent lips and orthodontic abnormalities was referred to our Radiology Department for orthopantomography (OPG) and CT examinations. Hetero-anamnestic data revealed a history of surgical treatment of the commissural cleft conducted 2 months after the birth to enable feeding. Intraoral examination showed a maxillary cleft and supernumerary teeth. Since the given clinical presentation was inconclusive, radiological diagnostics took precedence in elucidating this complex entity

Faze u izradi livene fasetirane krunice (modelovanje, ulaganje, livenje, obrada) - diplomski rad

Livena fasetirana krunica predstavlja jedan od najkompleksnijih, ali i najefikasnijih pristupa u restauraciji zuba. Ovaj kompleksan proces obuhvata različite faze koje su međusobno povezane i jednako važne za postizanje konačnog cilja – izuzetne funkcionalnosti i estetike krunice. Jedna od ključnih prednosti livenih fasetiranih krunica je njihova izdržljivost. Metalna osnova pruža čvrstu strukturu koja može izdržati intenzivne sile koje se javljaju tokom žvakanja, čime se osigurava dugotrajnost i stabilnost restauracije. Pored toga, fasetni materijal, bilo da je keramički ili kompozitni, omogućava postizanje prirodnog izgleda zuba, što je od suštinskog značaja za pacijente koji žele da njihova dentalna restauracija bude estetski nenametljiva i harmonično uklopljena sa susednim zubima. Proces izrade livenih fasetiranih krunica zahtjeva visok nivo vještine i preciznosti. Ovo uključuje detaljno oblikovanje, pažljivo nanošenje fasetnog materijala i preciznu završnu obradu kako bi se postigla glatkoća i sjaj koji oponašaju prirodan zub. Uprkos složenosti i vremenskoj zahtjevnosti, rezultati koje pružaju livena fasetirana krunica su vrijedni truda. Pacijenti dobijaju restauraciju koja ne samo da vraća funkcionalnost zuba, već i značajno poboljšava njihov izgled. Ove krunice predstavljaju idealno rešenje za one koji traže pouzdanu, dugotrajnu i estetski superiornu opciju za restauraciju zuba. U svijetu moderne stomatologije, livena fasetirana krunica ostaje zlatni standard za restauraciju zuba u zoni visokog stresa, kombinirajući snagu metala i estetiku fasetnog materijala za najbolji mogući rezultat

Success of Endodontic Therapy of the Central Maxillary Incisor Internal Resorption – 3 Years Follow Up

Introduction: A 40-year-old female patient fell and applied to our Clinic for the treatment of fractured crowns of teeth 21 and 11. The presence of enamel and dentin defects revealed without exposing the pulp on teeth 21 and 11. Tooth 21 was sensitive to vertical percussion with the presence of luxation. Vitality tests revealed absence of pulp sensibility and analysis of the retroalveolar radiograph showed presence of limited illumination in the region of the middle third of the tooth root canal. Chemomechanical treatment of the root canal was performed with Protaper Next instruments using 2% sodium hypochlorite for irrigation. Two weeks of intracanal medication with calcium- hydroxide followed. The canal was obturated with calcium silicate cement (Bioroot, Septodont, France) with gutta-percha points. One and three years later, no presence of pathological changes in the area of the lesion and the surrounding bone was observed, and the clinical examination showed that the tooth was asymptomatic and without luxation. Discussion: As a result of trauma damage to the predentin and odontoblast layers, the activity of osteoclastic cells intiates the process of root dentin resorption. Endodontic therapy of internal resorptions is challenging due to removing necrotic and well- vascularized granulation tissue and obturation of irregularly shaped defects. Conclusion: Adequate obturation and successful canal therapy with internal resorption can be achieved by using calcium silicate cements. Due to their positive properties (bonding in a moist environment, good edge sealing, osteodentine and osteocement potential), calcium silicate cements are the materials of choice in the rehabilitation of tooth root canal resorptions.Poster Presentation: PP-41Dostupno na: [https://e-bass.org/28thcongress/wp-content/uploads/2024/07/28thBaSS-AbstractBOOK-7.24.pdf

Hronični rinosinuzitisi - diplomski rad

Hronični rinosinusitis je stanje karakterisano upalom paranazalnih sinusa i nosne šupljine koje traje najmanje 12 nedelja. Glavni simptomi uključuju bol i pritisak u licu, nazalnu opstrukciju, hiposmiju ili anosmiju, kao i nazalno curenje. Dijagnoza se postavlja na osnovu prisustva najmanje dva od četiri kardinalna simptoma, uz objektivne dokaze na fizičkom pregledu ili radiografiji. Lečenje hroničnog rinosinusitisa zahteva holistički pristup. Konzervativna terapija uključuje upotrebu intranazalnih kortikosteroida, nasalnih irigacija fiziološkim rastvorom i, u određenim slučajevima, oralnih kortikosteroida i antibiotika. Funkcionalna endoskopska hirurgija sinusa se primenjuje kod pacijenata sa refraktornim simptomima radi poboljšanja drenaže sinusa i olakšanja simptoma. Komplikacije hroničnog rinosinusitisa mogu biti ozbiljne, uključujući orbitalne, intrakranijalne i oftalmološke komplikacije, kao i infekcije kostiju i mekih tkiva. Pravovremena dijagnoza i adekvatno lečenje su ključni za upravljanje ovom bolešću i sprečavanje komplikacija