Irreversible Pulpitis Of Primary Teeth

Острото възпаление на пулпата започва от забавянето на кръвния ток в областта на дразненето с наличие на аглутинация на червените кръвни клетки- еритроцитите в средата на кръвоносните съдове и струпване от полиморфоядрени левкоцити. Под действието на хемотаксични фактори левкоцитите се преместват в зоната на възпалението. При дезинтегрирането левкоцитите избират протеолитичните ензими в големи количества, в резултат на което области на гноен ексудат се появяват в пулпата. Други биоактивни, агресивни вещества на възпалението въздействат и в резултат на което нараства и пропускливостта на съдовете. Това е механизма на излизане на клетките от кръвната циркулация и плазмата и от кръвното русло в пулпната тъкан. Увеличава се осмоларитета, развива се хипоксия и ацидоза в пулпата на зъба. Описаният процес предопределя развитието на възпалението, дразненето на нервните окончания и причинява спонтанна болка.Acute inflammation of the pulp starts with the slowing of blood flow in the area of irritation with the presence of agglutination of red blood cells - erythrocytes in the middle of the blood vessels and accumulation of polymorphonuclear leukocytes. Under the action of chemotaxic factors, the leukocytes move to the inflammation site. In disintegration, leukocytes select proteolytic enzymes in large quantities, resulting in areas of purulent exudate occurring in the pulp. Other bioactive aggressive substances in the inflammation act and as a result, the permeability of the vessels also increases. This is the mechanism via which the cells leave the blood circulation and the plasma and move from the bloodstream into the pulp tissue. The process described predetermines the development of inflammation, irritation of nerve endings and causes spontaneous pain

Risk assessment for the development of caries from 3 to 6 years

Увод: Корекцията в поведението помага за самоконтрол на оралната среда и недопускане на развитие на кариозни лезии.Цел: Оценка на риска на някои от рисковите фактори (слюнка и орална хигиена).Материал и методи: Предмет на изследване - рискът от кариес на временните зъби. Обект на изследване са деца на възраст от 3 до 6 г. Проучването се реализира във Факултет по дентална медицина, МУ-Варна. За да се оцени рискът от въглехидратното хранене, се възлага на родителите на 30 от децата да водят „Хранителен дневник` за период от 7-10 дни. Децата се преглеждат с анамнеза и подробно регистриране на клиничен статус. Оценката се получава и с помощта на теста „GC Saliva - Check Mutans`, като се спазва точно методиката на теста.Децата от експерименталната група (30) боледуват от кариес и имат поставени обтурации до етапа на изследване. Приемайки това, си поставихме задачата в това изследване да анализираме степента на някои присъстващи рискови фактори при децата от 3 до 6 години и да ги сравним с контролната група деца (30), които не боледуват от кариес.Резултати: Изследванията показват, че разликата между двете групи за честотата на въглехидратните приеми е съществена. Обратимите активни кариесни лезии означават, че оралната околна на временните зъби среда е силно кариесогенна. Оралната хигиена е висок рисков фактор за развитието на началния дентален кариес при голям брой от изследваните деца. Анализът на данните за оценката на кариесогенната микрофлора от микробиологичните изследвания показаха, че почти 100% от децата на експерименталната група (боледуващи и лекувани от кариес) са с високо микробно число на Streptococcus Mutans и висок риск от развитие на кариес между 3 и 6-годишна възраст.Изводи: 1. Оценката на риска е лесна и достъпна за клинично изпълнение задача. 2. Изграждането на подробни данни за всеки клиничен случай на дете от оценката на риска, диагностиката, диференциалната диагностика и окончателната поставена диагноза ни осигурява точния план за лечение за всеки един пациент.Introduction: Correction in the behavior allows self-control the oral environment and prevention of the development of carious lesions.Objective: To assess the risk of certain risk factors (saliva and oral hygiene).Materials and Мethods: Subject of research - the risk of caries of temporary teeth. Subject of the study are: Children aged 3-6 years. The research was carried out at the Faculty of Dental Medicine - Varna. In order to assess the risk of carbohydrate diet the parents of 30 children were assigned to keep a food log for a period of 7-10 days. Parents recorded in the log everything they had given as a food to their child, everything they had consumed and the time at which each food was taken for 10 days (excluding weekends). Children are examined with a history and detailed registration of clinical status. The assessment was obtained with the help of test „GC Saliva - Check Mutans`, following carefully the methodology of the test. Children are medically clinically healthy, without specifics in their health. Children from the experimental group (30) suffer from tooth decay and have fillings set until the stage of study. Assuming this, we set ourselves the task in this study to analyze the extent of any risk factors present in children aged 3 to 6 years and compare them with the test group of children who do not suffer from caries (30).Results: Studies show that the difference between the two groups for the frequency of carbohydrate intake is essential. The results show that oral hygiene is a high risk factor for the development of initial dental caries in a large number of the children studied. Data analysis for the assessment of the cariogenic microflora from the microbiological studies have shown that almost 100% of the children of the experimental group (suffering and with treated caries) have a high micro bial count of Streptococcus Mutans and high risk of developing caries between 3 and 6 years of age.Conclusions: 1. An evaluation of risk is a task easy and affordable for clinical performance. Building up similar details for each clinical case per child from the risk assessment, diagnosis, differential diagnosis and the final diagnosis provided us the exact treatment plan for each patient. 2. Taking the so obtained results of the risk assessment for each child patient one prepares individual programs for prevention and non-invasive treatment of children aged 3 to 6 years

In vitro studies with X-ray diffraction

Увод: Различните зъби и зъбни повърхности са с променлив риск от развитие на кариес. Напълно развитият емайл се състои от карбонат хидроксилапатит (КХА) (92-93% тегловно за временните зъби) и по-малко от 1-2% тегловно от органични вещества. Емайлът няма клетки и следователно не може да бъде биологично възстановен. Целта на изследването е анализ на покритието, отложено върху емайла на временните зъби. Материал и Методи: Обектът представлява временни зъби, върху емайла на които е нанесено покритие от минерализиращ лак Clinpro™ White Varnish with TCP (Tri-Calcium phosphate) (3M). Изследването се направи във „Високотехнологична лаборатория за специализирани рентгенови методи и томография` на апарат за рентгеноструктурен анализ, система Empyrean, производство на PANalytical. Резултати и Обсъждане: При измерванията от приповърхностният тънък филм, експериментът показва отместване на пиковете към по-големи ъгли, отговарящи на наличен флуорапатит. Анализът на покритието показа - Флуорапатит (Fluorapatit, Apatit-(CaF)) с обща формула Ca5[F|(PO4)3]. Изводи: Наблюдава се формиране на покритие в следствие на дифузия на йони от лака към повърхността на емайла на зъба. Покритието е изградено предимно от флуорапатит. В дълбочина на емайла постепенно преобладаваща фаза става хидроксилапатита. Направеният анализ на сърцевината на зъба показва, че е изграден от хидроксилапатит и калцит.Introduction: Different teeth and tooth surfaces with a variable risk of developing caries. Fully developed enamel consists of hydroxylapatite carbonate (KHA) (92-93% by weight of the temporary teeth) and less than 1-2% by weight of organic substances. Enamel no cells and therefore can not be biologically restored. Objective: The purpose of the study is an analysis of the coating deposited on the enamel of deciduous teeth.Methods: The hotel is on temporary teeth enamel which is coated with lacquer mineralization Clinpro™ White Varnish with TCP (Tri-Calcium phosphate) (3M). The study is done in‚ High-tech laboratory for specialized X-ray and tomography methods „of an apparatus for X-ray system PANalytical Empyrean. Results: Measurements of the near-surface thin film experiment shows shift peak at larger angles corresponding to available fluorapatite. Analysis of the coating: Fluorapatite (Fluor Apatite, Apatite- (CaF)) of the formula Ca5 [F | (PO4) 3].Conclusions: There is formation of the coating due to the diffusion of ions of the lacquer to the surface of the enamel of the tooth. Cover is constructed mainly of fluorapatite. In the depth of enamel gradually becomes predominant phase hydroxyapatite. Analysis of the core shows that the tooth is composed of hydroxyapatite and calcium

Risk factors associated with the development of dental caries in Bulgarian children

The purpose of this study was to examine the risk factors associated with the development of dental caries in children in Bulgaria. The research has been carried out at the Faculty of Dental Medicine, in the period 2015-2016, with the permission of the University Scientific Research Committee and informed consent signed by each parent. The subject of observation was parents of children from Varna region in Bulgaria. The results were statistically processed with SPSS v.20.0, using variation and comparison (chi-square) analyzes. For significance level we assume p<0.05. The volume of observation encompasses 100 persons. Units of observation are patients aged three to six years with the need for prevention and treatment of dental caries of the primary dentition. The registration was done in a specially developed questionnaire, including 22 questions, each with the possibility of more than one answer. In processing the obtained data, Student's criterion was used to compare the mean values of two independent samples. In a comparative analysis of the results, we found that 71.01% of children aged three to six years visit a dentist, and patients use fluoride only in the form of toothpaste containing fluoride. When studying the knowledge and behavior of parents in the direction of risk factors for the development of dental caries and oral prophylaxis, need for a new approach of pediatric dentists has been found, focused on programming preventive and non-invasive treatment of children according to their individual needs

Primary restorative fillings used in clinical practice

Introduction: The purpose of the American Academy of Pediatric Dental Medicine (AAPD) is to provide guidance for pediatric dental practitioners to make decisions about what materials and techniques are appropriate for child fillings.Materials and Methods: A total of 602 patients, children with primary, mixed and permanent teeth, who have received treatment with restorative fillings, were monitored. The minimum age of children was 3 and the maximum age of participants was 18 years of age. Patients were divided into 16 age groups. Patients underwent a pre-made risk assessment using a clinical instrument. Children included in the study had a proven high risk of developing caries dmft (T) > 1. This was a retrospective study based on participants’ medical records and examined the incidence, proportion and correlation of reversible and irreversible pulp inflammation diagnosed as d3, d4 cavitated caries lesions. The data was processed with a modern package of mathematical and statistical analysis SPSS v 20.0Results: The inverse ratio, a strong dependence indicates that as age increases, fillings made of resin modified glass ionomer cements decrease (r = - 0.661; p < 0.001). The inverse ratio, proportional and moderate dependence proves that as the age increases, the number, frequency, and use of compomer fillings in children over 12 years of age decreases (r = - 0.368; p < 0.001). With proportional dependence, we found that with the increasing age, the number of placed silants in childhood increased (r = 0.646, p < 0.001).Conclusion: In all tests we have shown a statistically significant difference. The inverse correlation, proves that with the increasing age of children the use of glass ionomer cements and the use of compomers fillings decreases.

Assessment of the oral health status of twins - clinical cases

Увод: В съвременната медицина като един от най-точните методи за установяване на вариабилността в характеристиките на близнаците е използването на генетичните изследвания и изучаването на взаимодействието на генетичните фактори върху денталното развитие на близнаците.Цел. Да се оцени и сравни орално хигиенния статус в изследваните и лекувани четири двойки близнаци на 8 до 10 години.Материал и методи: Изследването наблюдава орално хигиенния статус на 4 двойки близнаци от 8 до 10 години (една двойка от мъжки пол и 3 двойки от женски пол). За определяне нивото на оралната хигиена беше използван орално-хигиенен индекс на Greene-Vermilion (OHI-S). Беше отчетено наличието на плака след оцветяване върху съответните повърхности на репрезентативните зъби. Индексът на Silness and Loe определи дебелината и количеството на плаковия биофилм в гингивалната трета зона на коронките на изследваните зъби. Проучването се реализира във Факултет Дентална Медицина - Варна, през 2017 - 2018 учебна година. Получено е предварително информирано съгласие от всеки родител. Подборът на деца е случаен. Изпълнител е докторът, специалист по детска дентална медицина. Резултатите са обработени с помощта на статистическата програма SPSS v. 20.0, като са използвани вариационен, дисперсивен и сравнителен анализи.Резултати: Резултатите от анализа на оралнo-хигиенния статус показват, че изследваните от нас двойки близнаци имат задоволителна орална хигиенна според двата индекса. От гледна точка на възрастовия показател отчетохме, че близнаците на възраст под 10 години (8 и 9 години) имат по лоша орална хигиена, отколкото тези на 10 години (р<0,05). Според OHI Green-Vermillion индексът е равен съответно 1.53 0.34 за близнаците над 10 години и 1.93 0.27 за тези под 10 години. Индексът - PLI Silness-Löe е равен на 1.81 0.53 за децата под 10 години и 1.34 0.21 за тези над 10 години.Изводи: Установи се наличието на съществена разлика в орално-хигиеннните индекси между близнаците на 8 и 9 години, което показва, че има разлика по отношение на създадените хигиенни навици, тъй като те имат еднакъв генетичен фон.Introduction:  In modern medicine, one of the most accurate methods for detecting variability in the characteristics of twins is the use of genetic research and the study of the interaction of genetic factors on the dental development of the twins.Aim: To evaluate and compare the oral hygiene status in the studied and treated four twin pairs on 8 to 10 years.Materials and Methods: The study monitored the oral hygiene status of 4 twin pairs from 8 to 10 years of age (one male and 3 female pairs). To determine the level of oral hygiene, a Greene-Vermillion Oral Hygiene Index (OHI-S) was used. The presence of plaque after staining on the corresponding surfaces of the representative teeth was recorded. The Silness and Loe index determined the thickness and amount of plaque biofilm in the gingival third zone of the crowns of the examined teeth. The study was conducted at the Faculty of Dental Medicine - Varna, during the 2017/2018 academic year. Informed consent was obtained from each parent. The selection of children was random. The study was conducted by doctors, specialist in pediatric dentistry. The results were processed using the statistical program SPSS v. 20.0, using variation, dispersion and comparative analyzes.Results: The results of the oral-hygienic status analysis showed that the twins studied had satisfactory oral hygiene according to the two indices. In terms of age, we noticed that twins under the age of 10 (8 and 9 years) had poorer oral hygiene than those at 10 years of age (p<0.05). According to OHI Green-Vermillion, the index was equal to 1.53 ± 0.34 for twins over 10 years, and 1.93 ± 0.27 for those under 10 years of age. The PLI Silness-Löe index was 1.81 ± 0.53 for children under 10, and 1.34 ± 0.21 for those over 10 years.Conclusion: There was a significant difference in oral hygiene indices between 8 and 9 years of age, indicating that there was a difference in hygiene habits as they had the same genetic background

Non-invasive treatment of caries of temporary teeth with mineralization varnish

Емайлът е най-външната твърда тъкан на короната на зъба и е най-силно минерализирана тъкан в човешкото тяло. Зъбите и особено емайла, претърпяват малко морфологични промените след пробива и приключването на минерализацията. Минерализацията на емайла на временните зъби започва вътреутробно и завършва около 3-3.5 годишна възраст. Повърхностният слой /16-45μm/ е апризматичен при повече от 60% от временните зъби и силно реактивен и се вляе от рН на слюнката и флуорни апликации. Зъбният кариес, едно от най-разпространените хронични заболявания в световен мащаб (90% от младежите). Като многофакторно заболяване включващо бактериите от оралния биофилм, въглехидратното хранене и оралната хигиена. Зъбният кариес е предотвратимо, развитие на начални кариозни лезии. Промените са в подхода за лечение - като поведенческо заболяване. Неоперативно превантивно лечение е нов подход, определен от новите средства. Търсене на нови решения за профилактика и лечение, на базата на морфологичните промени в зъбните тъкани, възможност за диагностициране и доказване на ефекта на флуоридите в детската възраст.The enamel is the outermost solid tissue of the crown of the tooth and is the hardest mineralized tissue in the human body. Tooth enamel, especially, suffer little morphological change after drilling and completion of mineralization. Mineralization of the enamel of deciduous teeth begins in embryonic development and ends around 3-3.5 years.The surface layer /16-45μm/ layer without prisms is more than 60% of the temporary teeth and highly reactive and depends on the the pH of the saliva and fluorine applications. Dental caries, one of the most common chronic diseases worldwide (90% of young people). Caries is a disease of many factors, involving bacteria from the oral biofilm, carbohydrate diet and oral hygiene.Dental caries is preventable, development of initial carious lesions. Changes in the approach to treatment - as a behavioral disease. Non-surgical preventive treatment is a new approach defined by new means. Search for new solutions for the prophylaxis or treatment, on the basis of morphological changes in dental tissues, capable of diagnosing and establish the effect of fluoride in childhood

The knowledge of dentists for preventive influence of the caries process

The line of knowledge runs from the general social, legal, financial and managerial framework. It is necessary to present the object of professional activity, the peculiarities of professional work and the methods for its optimization. Subjects of the survey were 100 dentists who perform treatment of deciduous teeth from the city of Varna, Bulgaria. The individual addressed anonymous survey was fulfilled during educational, clinical and organization meetings at the Faculty of Dental Medicine-Varna and on the territory of the city of Varna. The interviewed dentists encounter difficulties with the diagnosis of the initial dental caries in primary dentition. The dentists included in the survey rely mainly on their theoretical and practical experience and routine clinical methods for non-invasive treatment of the initial dental caries. Work experience and the specialty do not have a significant impact on the awareness of dentists about the new criteria related to the diagnosis and prevention of dental caries in the primary dentition. The age, work experience and specialty of dentists are factors for their awareness of the new approaches to treatment of children, as doctors up to 30 years of age, with a recognized specialty and work experience up to five years are more informed

Dental caries management by risk assessment among children

Dental caries is the highest-frequency oral disease. The purpose of this study is to assess the risk of developing dental caries for groups of children aged three to six in the city of Varna, Bulgaria, taking into account clinical risk factors. The population of this study included 300 children aged 3 to 6 years. Hence, as many 30 children for the experimental and 30 children for the control groups were included in the study with saliva tests. After that, standardized means of decayed, filled surfaces (DFS) index was estimated. The teeth of the children in the experimental group were covered for three months with Clinpro™ White Varnish. The Research Ethics Committee at the MU-Varna University approved the study. We applied the Greene and Vermillion oral hygiene index. Biostatistics was conducted with a specialized package for statistical analyzes was used StatSoft, STATISTICA manual (Software system for data analysis STATISTICA 10.0, 2010. The results in our study show the strong influence of carbohydrate nutrition and poor oral hygiene on the development and progression of the caries process. The results of the study of the frequency of caries lesions on surfaces show a value of 6.35±0.65. Caries lesions on 1 and 2 surfaces predominate (23.75%). Almost 100% of the children in the control group had Streptococcus mutans and a high risk of caries. From the risk assessment results obtained for each child patient, individual prevention programs are prepared for children

Relative share, frequency and correlation of restorations in both dental dentitions in childhood

This research aimed to analyze of the relative share, frequency and correlation of restorations in both dental dentitions in childhood. The decayed, missing, and filled permanent teeth (DMFT) index is one of the most commonly used indices in epidemiologic surveys of dental caries. It quantifies dental health status based on the number of carious, missing and filled teeth. A total of 602 schoolchildren in Varna, aged 3-18 years were selected for this study. The children have a determined high caries risk DMFT index &gt;1. The patients are divided into 16 groups according to age limit. The research takes place in the Faculty of Dental Medicine, Medical University of Varna, in the time period 2016-2018. This study is retrospective, based on medical data of the participants. Pearson's correlation and simple linear regression were used to estimate the correlation between restorations, DMF (T+t) and age. The average value of determining the level of caries of the examined groups of children is DMF (T+t) =5.46±3.95 (range 0-20). With the correlation analysis we proved a direct dependence of the ratio. The number of preventive fillings with photopolymers and composites increased with increasing age of the studied children (r=0.725; p&lt;0.001). Their high distribution among the studied patients was established by determining the average frequency of carious lesions. The correlation analysis determined that with increasing age of the patients the number and frequency of composite restorations and sealants in the control groups increased