Possibilities of the Application of Fibre Reinforced Composites in Implantological Therapy

Vlaknima ojačani kompoziti (engl. fiber reinforced composites, FRC) posebna su skupina materijala sastavljena od kompozita u koji je uložena određena vrsta vlakana. Vlakna se razlikuju po kemijskome sastavu i po načinu izradbe. S obzirom na kemijski sastav, danas se u restaurativnoj i estetskoj stomatologiji najčešće rabe polietilenska i staklena vlakna (osim te dvije vrste mogu se naći ugljična i kevlar vlakna). Prema načinu izradbe vlakna mogu biti istosmjerna ili pletena. Pletena vlakna međusobno se razlikuju po veličini i načinu pletenja. Uporaba vlakana u svakodnevnom kliničkom radu posljednjih godina sve više dobiva na važnosti. Svoju uporabu našla su u gotovo svim dijelovima stomatološke struke: parodontologiji, restaurativnoj stomatologiji, traumatologiji, ortodonciji, itd. Vlakna mogu biti izrađena u dva osnovna oblika: preimpregnirana i neimpregnirana. Preimpregnirana vlakna u posebnom su načinu pakiranja i već obložena kompozitnom osnovom, a kod neimpregniranih vlakana potrebna je predpriprema prije ulaganja u kompozitni materijal. Uporaba vlaknima ojačanih kompozita otvorila je nove mogućnosti u rješavanju određenih problema koji mogu nastati tijekom implantološkoprotetske terapije. Cilj je predavanja prikazati mogućnosti upotrebe vlaknima ojačanih kompozita u različitim kliničkim slučajevima te uputiti na pogrješke tijekom kliničke izradbe.Fibre reinforced composites (FRC) are a specific group of materials consisting of composites in which determined types of fibre are inserted. The fibres differ according to their chemical composition and method of construction. With regard to the chemical composition, polyethylene and glass fibres are most frequently used today in restorative and aesthetic dentistry (apart from these two types, carbon and kevlar fibre can be found). According to the method of construction the fibres can be parallel or plaited. Plaited fibres differ mutually with regard to the size and method of plaiting. In the last few years application of fibres in daily clinical work has become increasingly important. Their application has been found in almost all areas of the dental profession: periodontology, restorative dental medicine, traumatology, orthodontics, etc. The fibres can be constructed in two basic forms: impregnated and unimpregnated. Impregnated fibres are packed in a special way and already coated with the composite base, while in the case of unimpregnated fibres prior preparation is necessary before insertion in the composite material. The application of fibre reinforced composites has opened up new possibilities in the treatment of specific problems which can occur during implantological-prosthetic therapy. The purpose of the lecture is to show the possibilities of the application of fibre reinforced composites in different clinical cases and to describe possible errors during clinical construction

Compound odontoma in a 9-year-old male patient – Case report

Odontomas are odontogenic benign tumours composed of hard dental tissue formed from the epithelial and mesenchymal base. Although odontomas are sometimes suspected in case of delayed eruption of a permanent heir or a persistent deciduous tooth in the dental arch, they are usually asymptomatic and are incidentally found during routine radiographic imaging. Odontomas are histopathologically divided into complex and compound odontomas. We here describe a 9-year-old male patient with compound odontoma, thereby wish to summarize this tumour: its diagnosis and treatment

Diagnosis of Occlusal Carious Lesions Using KaVo DIAGNOdent 2095

Svrha je ovoga rada pojasniti način uporabe i utvrditi prednosti KaVo DIAGNOdent 2095 uređaja u kliničkoj detekciji raznih demineralizaciskih promjena u caklini okluzalnih ploha zuba, koje se podrazumjevaju inicijalnom karijesnom lezijom. Znatna prednost KaVo DIAGNOdent laserskoga uređaja temelji se na mogućnosti registracije i vrjednovanja fluorescentnoga zračenja, na načelu emisije pulsirajuće zrake valne duljine 655 nm. Na taj je način omogućen pristup sićušnim područjima okluzalnih caklinskih ploha koje nisu dostupne primjenom drugih dijagnostičkih metoda. Specifičnost i polivalentnost u uporabi temelje se i na mogućnosti dijagnoze dentalnoga plaka, diskoloracija i zubnoga kamenaca. Jednostavnost u rukovanju te pouzdanost i objektivnost kliničkoga nalaza (> 90 %) upućuju na prednosti u usporedbi s kliničkim radiografskim metodama. Ima veliku važnost za postavljanje dijagnoze u planiranju neinvanzivnih postupaka liječenje. Zato se preporučuje češća uporaba uređaja u svakodnevnoj kliničkoj dijagnostici karijesa zbog manje invanzivnoga pristupa u restorativnoj stomatologiji koji omogućuje da se maksimalno očuva zdravo zubno tkivo.The aim of the study was to explain in detail the usage of KaVo DIAGNOdent 2095 and to determine its advantages in clinical detection of early demineralisation of oclusal enamel surfaces, pronounced as initial occlusal caries lesins. The great advantage in diagnosis offered by KaVo DIAGNOdent laser based on its ability to register and evaluate fluorescent emission of the pulsed beam of the 655 nm wavelength. It enables access to the most minute occlusal routes, otherwise unreachable by other means of diagnosing techniques. Specificity and multidimensional approach is based on the pssibility of diagnosin dental plaque, discoloration and calculus. Simplicity and the ability to produce a reliable and objective clinical diagnosis (> 90 %) are the advantages in comparison with classical radiographic methods and inspection using a probe. It is of great importance in planning noninvasive and preventive conservative treatments. It is recommended for use more frequently in everyday clinical diagnosis of caries lesions, because of it’s less invasive approach in restorative dentistry, which leads to preservation of healthy tooth tissue

Comparison of the effects of xylocain and cystocain in dentistry

Ovim radom željeli smo usporedbom pronaći svojstva lokalnih anestetika Xylocaina i Cystocaina aplikacijom tih anestetika u određenu regiju usne šupljine. Na osnovu tih ispitivanja preporučili bismo stomatologu praktičaru, po našem mišljenju pogodniji anestetik za primjenu u stomatologiji. Ispitivanja smo provodili u dobrovoljaca oba spola u dobi od 22 do 31 godine. Bilo je 72 ispitanika. U svakog smo ispitanika pomoću električnog pulpa-stimulatora ustanovili najnižu vrijednost podražljivosti vitaliteta zuba. Zatim smo ispitanicima izmjerili tlak i puls. Mjerenja tlaka i pulsa ponovljena su još dvaput u razmacima od po pet minuta. Zatim smo aplicirala anestetik u područje gornjeg lateratnog sjekutića. Minutu nakon aplikacije podražili smo svaki pojedini zub strujom prethodno utvrđenog najmanjeg intenziteta. Ispitivanje vitaliteta zuba nastavljeno je 3, 6, 10, 15 i 30 minuta nakon aplikacije anestetika. Tlak i puls smo registrirali 5, 10 i 15, minuta nakon aplikacije anestetika. Dobivene rezultate unosili smo u posebnu za to namjenjenu karticu. Nakon provedenih ispitivanja učinjena je obrada dobivenih podataka iz kartice. Po dobivenim rezultatima mogli smo zaključiti kako od ova dva lokalna anestetika, Xylocaina i Cystocaina, prednost možemo dati Cystocainu ds. zbog njegove mogućnosti vrlo dobre penetracije u kost. Usprkos višestruko niskog sadržaja kateholamina, on postiže bolji intenzitet i dužinu anestezije u ciljanom području od Xylocaina. Jedino mu je početno djelovanje nešto sporije, što je za njegovu primjenu u stomatologiji zanemarivo.This study was an attempt to compare the adventageous and disadvantageous characteristics of Xylocain and Cystocain, by the application of these two anesthetics into particular region of oral cavity. The results thus obtained would then serve as a basis for recommending the practicing stomatologists to use the anesthetic which has proven to be more suitable in dentistry. The study was carried out in 72 volunteers of both sexes, aged 22— 31 years. The lowest value of the tooth vitality irritability was established in each examinee by means of an electric pulp stimulator, which was followed by the blood pressure and pulse determinations. Then the anesthetic was applied in the upper small incisor region. A minute after the application, each tooth was irritated by electric current of the lowest previously determined (intensity. The tooth vitality testing was repeated at 3, 6, 10, 15 and 30 minutes after the application of anesthetics, whereas blood pressure and pulse rate recordings were taken at 5,10 and 15 minutes after the application of these agents. The results thus obtained were recorded in the special file cards designed for this purpose. On the completion of the study procedures, the file card data were processed. The results obtained by the file card data processing have led too conclusion that between the two local anesthetics studied (Xylocain and Cystocain), priority should be given to Cystocain ds. Owing to its capacity of penetration into the bone and despite a multiply low content of catecholamines, higher intensity and longer duration of anesthesia in a target region can be achieved by Cystocain ds compared to Xylocain. Only its initial action is quite slow, but this can be neglected when used in dentistry

Maxillary Sinus Floor Elevation

Distalna bezubost gornje čeljusti, povezana s jakom resorpcijom alveolarnog grebena ili jakom pneumatizacijom maksilarnog sinusa, često je limitirajući čimbenik implanto-protetske rehabilitacije. Insuficijentni koštani volumen moguće je nadomjestiti operativnim zahvatom tako da se podigne dno maksilarnog sinusa (elevacija dna maksilarnog sinusa ili osinus-lifting). Elevacija dna sinusa operativni je zahvat kojim se premješta sinusno dno prema kranijalnoj kosti, uz istodobnu augmentaciju koštanog defekta kako bi se stvorila dovoljna visina koštanog fundamenta potrebnog za ugradnju dentalnih implantata. Ta operativna tehnika uobičajena je u kliničkoj primjeni od godine 1986. i od tada se sve više modificira i usavršava. Svrha ovoga rada jest predstaviti različite tehnike podizanja dna maksilarnog sinusa sa svim prednostima i nedostacima, kako bi u kliničkoj praksi njihova primjena bila što uspješnija. Elevacija dna maksilarnog sinusa, uz augmentaciju aloplastičnim ili autolognim koštanim implantatima, pouzdana je tehnika kojom se jako proširuju indikacije za ugradnju dentalnih implantata u molarnu regiju alveolarnog nastavka, što nije bilo moguće zbog voluminoznog maksilarnog sinusa.Distal edentulousness of the maxilla, together with extensive resorption of the alveolar crest or high pneumatization of the maxillary sinus, is often a limiting factor for implant-prosthetic rehabilitation. It is possible to compensate insufficient bone volume by elevating the floor of the maxillary sinus using an operative procedure (sinus floor elevation or sinus lifting). Elevation of the sinus floor is an operative procedure based on moving the bottom of the sinus cranially while simultaneously augmenting the bone defect, with the purpose of creating sufficient height at the bone fundament needed for the placement of dental implants. This operative technique has been routine in clinical practice since 1986 and is constantly being improved and modified. The purpose of this review is to present the different techniques in sinus lifting with all their advantages and disadvantages in order to render their implementation in clinical practice as successful as possible. Elevating the maxillary sinus floor by augmentation with allograft or autologous bone implants is a reliable method which broadens the indications for the placement of dental implants in the molar region of alveolar bone A, where, due to extensive pneumatization of the maxillary sinus, it was not previously possible

Pain After Tooth Extraction Masking Primary Extranodal Non-Hodgkin’s Lymphoma of the Oral Cavity

Maligni su limfomi u usnoj šupljini rijetki i čine približno 3,5 posto svih malignih promjena u oralnoj regiji. Opisan je slučaj primarnog non-Hodgkinova limfoma na lijevoj strani mandibule. Nakon što je pacijentu izvađen donji lijevi umnjak, perzistirala je spontana i intermitentna bol na lijevoj strani donje čeljusti. Intraoralnim pregledom ustanovljeno je da sporo cijeli postekstrakcijska alveola. Panoramska radiološka snimka pokazala je radiolucenciju s nepravilnim rubovima u stražnjoj mandibularnoj regiji na lijevoj strani. Nakon desetodnevne terapije antibiotikom, bol se smanjila, ali postekstrakcijska je alveola još neadekvatno cijelila. Inicijalno je bila pogrešno postavljena dijagnoza kroničnog osteomijelitisa. Na temelju histološkog i imunohistokemijskog nalaza postavljena je konačna dijagnoza - difuzni velikostanični limfom B-imunofenotipa. Nakon kombinacije radioterapije i kemoterapije, kod pacijenta se postigla potpuna remisija te su se povukli svi klinički znakovi bolesti. Dijagnosticiranje ekstranodularnog limfoma čeljusti je izazov, jer gotovo uvijek postoji sumnja na malignu tvorbu, a često je prikriven oralnim i dentalnim patološkim stanjima. Stomatolog je vrlo važan u ranom otkrivanju malignih limfoma usne šupljine.Malignant lymphoma of the oral region are uncommon and account for approximately 3.5% of all oral malignancies. In this report, a case of primary non-Hodgkin lymphoma of the left mandible is presented. The spontaneous and intermittent pain of the left mandible had continued after third left molar extraction. Intraoral examination revealed healing retardation of the postextraction socket. A panoramic radiograph revealed a radiolucency in the posterior mandibular region with irregular margins. After the 10-day course of antibiotics the spontaneous pain diminished, but the inadequacy of the healing at the extraction site was still present. We initially misdiagnosed it as chronic osteomyelitis. Based on the histological and immunohistochemical examination, we made the diagnosis of diffused large cell lymphoma of the B-cell type. After the combination of chemotherapy and radiotherapy patient showed complete remission with the disappearance of all clinical evidence of disease. The diagnosis of extranodal lymphoma of the jaw may be chalenging, because frequently there is a low index of clinical suspicion and malignant tumor may mimic common oral and dental pathological conditions. Dentists can play the important rule in the early detection of the malignant lymphoma of the oral cavity

All that can be Hidden Behind the Clinical Appearance of Odontogenic Abscesses. Oversight or Error? - Presentation of Two Cases

Ovim se radom želi upozoriti na važnost iscrpnoga kliničkog pregleda, dijagnostičke obradbe i dobroga poznavanja patologije usne šupljine kako se ne bi dogodilo pogrješno liječenje i gubitak dragocijena vremena. Prvi pacijent R. J., tridesetπest godina, dolazi zbog perimandibularnog otoka i trizmusa desne strane lica u OB Karlovac, ORL odjel. Tu mu se dva puta učini ekstraoralna incizija pod sumnjom odontogenog apscesa. Dolaskom oralnoga kirurga u bolnicu i uvidom u stanje usne šupljine pacijent se dogovorno premješta u KKL»U KB “Dubrava”. Pregledom se intraoralno našao ispod jezika jasan ulkus desno te golem infiltrat gotovo cijele prednje dvije trećine jezika. Palpacijom se nađu fiksirane metastaze u regiji dva i tri veličine 50 milimetra. Nakon prikaza, na onkološkom konziliju indicira se samo iradijacija. Na kontroli, nakon πest mjeseci, vidljiva je djelomična regresija bolesti. Drugi pacijent I. J., tridesettri godine, dolazi u ambulantu oralne kirurgije pod sumnjom palatinalnog apscesa od gornjih lijevih molara. Gornja lijeva šestica se trepanira, a suspektni apsces dva puta incidira. U tijeku šest mjeseci uopće nije bilo regresije bolesti pa se pacijent upućuje u KKL»U KB “Dubrava”. Tamo mu se učini citopunkcija, biopsija, CT maksile te se utvrdi da se radi o mukoepidermoidnom karcinomu tvrdoga nepca. Nakon preoperativne pripreme pacijentu se učini parcijalna resekcija gornje čeljusti. Terapija pacijenta je u tijeku. Ta dva slučaja govore da se jasno moraju znati uzročnici različitih oteklina u području glave i vrata i da, ako se radi o odontogenoj upali, ona na odgovarajuću terapiju reagira za kratko vrijeme.The aim of this study was to show the importance of a detailed clinical examination, diagnostic analysis and good knowledge of the pathology of the oral cavity, in order to avoid erroneous treatment and loss of precious time. The first patient, R. J., a 36-year-old man, was admitted to the ENT Department of the General Hospital, Karlovac, because of a perimandibular swelling and trismuss of the right side of the face. Because an odontogenic abscess was suspected extraoral incision was performed on two occasions. After the arrival of an oral surgeon to the hospital and examination of the oral cavity the patient was transferred to the Clinical Department of Oral and Maxillofacial Surgery, University Hospital Dubrava. During an intraoral examination an ulcer was detected beneath the tongue on the right side and a massive infiltrate of almost the whole of the anterior two thirds of the tongue. Immovable metastasis was detected by palpation in regions two and three, 50 millimetres in size. After consultation at an oncological Meeting irradiation only was indicated. A check-up six months later showed partial regression of the disease. The second patient, K. J., a 33 year-old man, came to the Out-patient Department of Oral Surgery with suspected palatinal abscess of the upper left molar. The upper left six was trepanated and the suspect abscess incidirated twice. For a period of six months no regression occurred and consequently the patient was sent to the Clinical Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, where cytopuncture, biopsy, CT of the maxilla were performed which confirmed mucoepidermoid carcinoma of the hard palate. After preoperative preparation partial resection of the upper jaw was performed. Therapy is presently in course. These two cases indicate the need to know the causative agents of swellings in the area of the head and neck, and if odontogenic inflammation is the case it quickly responds to appropriate therapy