Zastupljenost bakterije Aggregatibacter actinomycetemcomitans u dubokim karijesnim lezijama

Introduction Deep caries is a reversible process where caries lesion has affected bigger part of dentin and only thin layer of softened dentin that separates lesion from the pulp is remained. The objective of this study was to identify and determine serotypes of Aggregatibacter actinomycetemcomitans in teeth with deep caries lesions at the beginning of their treatment. Material and methods Clinical research included 29 patients of both genders, aged 16 to 40 and 45 permanent teeth with diagnosed deep caries lesions based on medical history, clinical and radiographic examination. After cavity preparation and removal of softened dentin, microbiological swab was taken from the bottom of the cavity. Swabs were disposed in special sterile micro tubes and stored at the temperature of -80oC until serotyping was done (determination of serotypes of A. actinomycetemcomitans bacterium). Results In one of the 3 samples two serotypes of A. actinomycetemcomitans (b and c) were identified which is relatively rare finding, while in the second and third sample serotypes (a) and serotype (b) was identified, respectively. Conclusion In the three samples the 3 serotypes were found (a, b and c) and one of the samples was carrying even two different serotypes, which is a rare phenomenon. For more serious epidemiological study of A. Actinomycetemcomitans serotypes at the population level incomparably larger starting material is necessary, at least few hundred of samples.Uvod Duboki karijes je reverzibilni proces kod kojeg je karijesna lezija zahvatila veći deo dentina i samo tanak sloj razmekšalog dentina razdvaja leziju od pulpe. Cilj ovog rada je bio da se na početku terapije utvrde i odrede serotipovi bakterije Aggregatibacter actynomycetemcomitans kod zuba sa dubokim karijesnim lezijama. Materijal i metod rada Kliničko ispitivanje je obuhvatalo 29 pacijenata, oba pola, uzrasta od 16 do 40 godina i 45 stalnih zuba kod kojih je na osnovu anamneze, kliničkog i radiografskog pregleda dijagnostikovan duboki karijes. Posle preparacije kaviteta i uklanjanja razmekšalog dentina, sa dna kaviteta je uziman bris, odlagan u posebne sterilne mikrotubice i čuvan na temperaturi od -80oC do postupka serotipizacije (utvrđivanja serotipova bakterije Aggregatibacter actynomycetemcomitans) primenom metode multipleks PCR. Rezultati Serotipizacija je registrovana u samo tri uzorka. U jednom od tri uzorka identifikovana su dva serotipa A. actynomycetemcomitans - b i c, što je relativno redak nalaz, dok su u drugom i trećem uzorku identifikovani serotipovi a, odnosno serotip b. Zaključak U tri uzorka nađena su tri serotipa - a, b i c, a jedan od uzoraka je nosio čak dva različita serotipa, što je redak fenomen. Za ozbiljniju epidemiološku studiju serotipova A. Actynomycetemcomitans na nivou populacije neophodan je neuporedivo veći uzorak i to reda veličine nekoliko stotina

Indirect pulp capping using different calcium hydroxide products: A clinical study

Introduction. Indirect pulp capping is a therapeutic intervention in the treatment of deep carious lesion in order to stimulate odontoblasts to produce tertiary dentin using different biomaterials based mainly on calcium hydroxide. The aim of this study was to assess the effect of hard-setting (Dycal) and a suspension of calcium hydroxide (Calcipulp) in the treatment of deep carious lesion (caries profunda). Materials and Methods. Clinical study included 29 patients of both genders, age 16 to 40, and 45 teeth of different morphological groups with verified caries profunda using clinical and radiographic examination. After the cavity preparation, calcium hydroxide materials (Dycal or Calcipulp) were applied on the pulpal wall and cavities temporarily restored (phosphate cement) for the period of two months. After this period cavities were restored with composite materials and clinically observed during twelve months, with mandatory check-ups after three and six months. Results. Obtained results showed that indirect pulp capping using calcium hydroxide suspension (90.0%) was more successful than hard-setting material (84.0%), but with no statistically significant difference. Conclusion. Suspension and hard-setting calcium hydroxide were equally successful in the treatment of caries profunda

Primena fotogrametrije za prostorne analize u ortodontskoj dijagnostici

Introduction Lundstrom segmental analysis is often used analysis in orthodontic diagnosis. It includes measurements of available and needed space in the arch in order to determine whether there is a lack or excess of space for proper teeth alignment. Measurements are traditionally performed on plaster study models, but with recent developments of computer-based systems, there is an increase in use of digital models in measuring process. The aim of this study was to present a photogrammetry based measurement approach that requires no specialized and expensive hardware and compare results with ones obtained on 3D scanned models. Material and method On 50 plaster study models measurements of 24 teeth, widths of 12 segments and Lundstrom segmental analysis were performed. 3D scanned study models were analyzed in the photogrammetry software OrthoPhoto4D on the set of four photographs of the study model in custom made measurement apparatus. The software corrects for finite distance of the camera and corrects errors due to perspective distortion. Results Statistical analysis performed on obtained measurements provided Bland-Altman plots that strongly suggested high degree of correspondence between the two measurements methods. Discrepancies for maxilla for individual segments were under 0.25 mm with standard deviation of up to 0.16 mm, and less than 1 mm and deviation of up to 0.4 mm for complete arch. For mandible the differences were up to 0.27 mm for segments with 0.15 mm deviation and 0.6 mm for complete arch with up to 0.24 mm deviation. Correlation coefficient was over 0.985 in all cases. Conclusions Both analyzed methods can be equally used in clinical practice.Uvod Najčešća prostorna analiza koja se koristi u ortodontskoj dijagnostici je Lundstromova segmentna analiza. Na osnovu dobijenih rezultata merenja upoređuje se potreban i raspoloživ prostor u zubnom nizu i dobijaju informacije o višku ili manjku prostora za pravilan smeštaj zuba. Merenja se tradicionalno vrše na gipsanim studijskim modelima, ali je usled razvoja računarskih sistema sve prisutnija upotreba digitalnih reprezentacija modela u procesu merenja. Cilj ovog rada je bio da se predstavi fotogrametrijski pristup merenjima koji ne zahteva specijalizovan i skup hardver i dobijeni rezultati uporede sa merenjima na skeniranim 3D modelima. Metod Na 50 studijskih modela su merene meziodistalne širine 24 zuba, te širine 12 segmenata i izvršena je Lundstromova prostorna analiza. Merenja su vršena na 3D skeniranom modelu studijskim modelima i u fotogrametrijskom programu OrthoPhoto4D na osnovu četiri fotografije modela u namenski projektovanom držaču modela. Program uzima u obzir konačnu udaljenost kamere od modela i vrši korekcije grešaka nastalih usled perspektivne distorzije. Rezultati Provedena statistička analiza na prikupljenim merenjima i priloženi Bland-Altman grafici snažno sugerišu da postoji visok stepen saglasnosti između dva metoda merenja. Odstupanja za maksilu za pojedinačne segmente su iznosila do 0,25 mm sa standardnom devijacijom od 0,16 mm, za celu vilicu manje od 1 mm uz devijaciju od 0,4 mm, za mandibulu odstupanja za segmente iznose ispod 0,27 mm uz devijaciju od 0,15 mm, te za celu vilicu do 0,6 mm uz devijaciju od 0,24 mm. Koeficijenti korelacije su preko 0,985 u svim slučajevima. Zaključak Fotogrametrijski metod se može opravdano koristiti u kliničkoj praksi za dijagnostiku ortodontskih nepravilnosti

Microbiological findings in deep caries lesions

Introduction Caries is one of the most significant and widespread oral diseases. It has been confirmed that dental plaque, i.e. microorganisms in it, are the most important factor in the development of dental caries. Caries profunda represents deep carious lesion from where bacterial toxins may affect pulp through dentinal tubules. The aim of this study is to assess the efficacy of indirect pulp capping based on microbiological findings of bacteria present in deep carious lesions before and after the treatment. Material and Methods The clinical study included 29 patients of both genders, aged 16 to 40 and 45 permanent teeth with deep caries lesions. The first microbiological sample was taken after cavity preparation and removal of soft dentin from the bottom of the cavity. The second sample was taken after the removal of temporary filling and calcium hydroxide paste 60 days after the indirect pulp capping treatment. The collected samples were stored in special sterile micro tubes (Eppendorf) and kept at the temperature of -80°C until microbiological analysis was performed. Samples were tested for the presence of the following microorganisms: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Enterococcus faecalis using the multiplex polymerase chain reaction (PCR) method. Results The results showed that prior to the treatment of deep carious lesions the most common species was E. faecalis (80% of samples), followed by A. actinomycetemcomitans (32% of samples), while the least common was P. gingivalis (16% of samples). After the treatment with products based on calcium hydroxide, E. faecalis was registered in 18% of samples, A. actinomycetemcomitans in 16% of samples and P. gingivalis was not registered in any sample. Conclusion The most common bacterial species in teeth with deep caries lesions was E. faecalis, whereas A. actinomycetemcomitans and P. gingivalis were found in lower number of samples

Novi metod fotogrametrijskih merenja studijskih modela u ortodonciji

Introduction/Objective Rapid developments in information technologies lead to the wider use of digital representations of dental study models in orthodontics. Most popular way of digitizing the models is to use a 3D scanner and then perform measurements on 3D models, which requires additional and expensive hardware and software resources. In this paper we present an alternative approach based on the use of photogrammetry in the newly developed OrthoPhoto4D software that calculates and corrects perspective distortion errors. Methods We measured individual tooth width for 24 teeth, 12 two-teeth segments as well as inter-molar and inter-canine distances on 50 models. Measurements are performed in OrthoPhoto4D software that uses four photographs of each model for measurements, uses QR codes for automation, calculates the camera position and corrects perspective distortion-caused errors in measurements. Obtained measurements are compared to ones obtained from models generated by structured light 3D scanner. Results Statistical analysis strongly indicates that there is no significant difference between the two methods. The recorded differences also have no clinical impact as they have mean values of 0.2 mm for individual tooth widths, approximately 0.2 mm for two teeth segments, and under 0.3 mm for both inter-canine and inter-molar distances. All recorded differences fall within the expected measurement error. Conclusion We concluded that the described photogrammetry measurements performed in OrthoPhoto4D can be used in diagnosis and therapy planning.Uvod/Cilj Brzi razvoj informacionih tehnologija doveo je do široke upotrebe digitalnih studijskih modela u ortodonciji. Najpopularniji način digitalizacije modela je korišćenje 3D skenera, a zatim i merenja na 3D modelima, što zahteva dodatne i skupe hardverske i softverske resurse. U ovom radu predstavljamo alternativni pristup zasnovan na korišćenju fotogrametrije u novorazvijenom softveru OrthoPhoto4D, koji izračunava i ispravlja greške nastale kao posledica perspektivne distorzije. Metod Na 50 studijskih modela merena je meziodistalna širina za 24 zuba, širina 12 segmenata dvostrukih zuba, kao i interkanina i intermolarna širina. Merenja su vršena u programu OrthoPhoto4D, koji koristi četiri fotografije svakog merenog modela, QR kodove za automatizaciju, računa udaljenost kamere i koriguje greške merenja izazvane perspektivom. Merenja su poređena sa rezultatima dobijenim na modelima generisanim 3D skenerom. Rezultati Analiza rezultata snažno ukazuje na to da ne postoji statistički značajna razlika između dva metoda. Zabeležene razlike takođe nemaju klinički značaj, jer su srednje vrednosti do 0,2 mm za pojedinačne širine zuba, do približno 0,2 mm za segmente od dva zuba i ispod 0,3 mm za interkaninu i intermolarnu širinu. Sve zabeležene razlike su unutar očekivane greške merenja. Zaključak Opisani metod fotogrametrijskih merenja u programu OrthoPhoto4D se može koristiti u dijagnozi i planiranju ortodontske terapije

Lead concentration in hard dental tissues: SEM/EDS analysis

Introduction Currently, one of the most important ecological issues is exposure to lead in environment, since it is a metal with evident toxic effects on human organism. Hard dental tissues are suitable structures for assessing long-term effects of exposure to toxic metals. The aim of this paper was to determine the concentration of lead in hard dental tissues of a rat with experimentally induced DM using SEM/EDS analysis, after 14 and 30 days of exposing animals to lead. Material and methods The study was conducted in rats of Wistar strains divided into the three groups. The first group consisted of 8 rats (128 molars and premolars of the upper and lower jaws) with experimentally induced DM, taking lead in the course of 14 days at the concentration of 1500 ppm; the second group included 8 rats (128 molars and premolars of the upper and lower jaws) taking lead in the course of 30 days at the concentration of 1500 ppm, while the third control group consisted of 5 healthy rats (80 molars and premolars of the upper and lower jaws). Experimental animals received lead-acetate every day at the concentration of 1500 ppm via water ad libitum. In these animals, diabetes mellitus was induced by Alloxan. The teeth samples were analysed using scanning electron microscopy (SEM). EDS analysis determined the mass fraction of lead and other elements in hard dental tissues. Results No lead was detected in a single tooth layer in the teeth of rats that received lead in drinking water in the course of 14 days. The average values of the mass fraction of lead, calcium, and phosphorus in enamel of teeth of rats receiving lead in the course of 30 days amounted to: lead 0.36%, calcium 15.48%, and phosphorus 10.62%. Lead was registered only in enamel. Conclusion Lead was detected in enamel only in rats receiving lead in the course of 30 days while it was not detected in teeth after the course of 14 days

Orthodontic treatment need in 11-13 years old shoolchildren in Republika Srpska

Introduction Need for orthodontic treatment is determined by the severity of specific malocclusion. Orthodontic indices are used to objectively present treatment needs. The most commonly used is the Index of Orthodontic Treatment Need (IOTN). The aim of this study was to determine the need for orthodontic therapy in 11 to 13 years old schoolchildren in Republika Srpska. Material and Methods 1377 patients, 11 to 13 years old, were included in this study. The examinations were performed in elementary schools, using daylight, flat mirror and two-dimensional orthodontic caliper. Patients were ranked into 5 grades according to the Dental Health Component (DHC) and graded on a scale 1 to 10 for the Aesthetic Component (AC) of the IOTN index. Results According to the Dental Health Component (DHC), 79.23% of patients needed orthodontic treatment. Little and borderline orthodontic need was present in 27.74% and 24.83% children, respectively, while severe need was present in 19.98% and 6.68% respectively. 20.77% of subjects did not need orthodontic treatment. In regards to the Aesthetic Component (AC) (face appearance related to orthodontic need) little or no treatment was needed in 91.42% of subjects while 6.42% were borderline and 2.16% of subjects had severe relation between orthodontic need and facial appearance. Conclusion Due to the wide presence of orthodontic irregularities in schoolchildren 11-13 years old in Republika Srpska, it is important to introduce orthodontic indices in clinical practice in order to determine orthodontic treatment needs

Analiza mikrobiološkog statusa dubokih karijesnih lezija

Introduction Caries is one of the most significant and widespread oral diseases. It has been confirmed that dental plaque, i.e. microorganisms in it, are the most important factor in the development of dental caries. Caries profunda represents deep carious lesion from where bacterial toxins may affect pulp through dentinal tubules. The aim of this study is to assess the efficacy of indirect pulp capping based on microbiological findings of bacteria present in deep carious lesions before and after the treatment. Material and Methods The clinical study included 29 patients of both genders, aged 16 to 40 and 45 permanent teeth with deep caries lesions. The first microbiological sample was taken after cavity preparation and removal of soft dentin from the bottom of the cavity. The second sample was taken after the removal of temporary filling and calcium hydroxide paste 60 days after the indirect pulp capping treatment. The collected samples were stored in special sterile micro tubes (Eppendorf) and kept at the temperature of -80°C until microbiological analysis was performed. Samples were tested for the presence of the following microorganisms: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Enterococcus faecalis using the multiplex polymerase chain reaction (PCR) method. Results The results showed that prior to the treatment of deep carious lesions the most common species was E. faecalis (80% of samples), followed by A. actinomycetemcomitans (32% of samples), while the least common was P. gingivalis (16% of samples). After the treatment with products based on calcium hydroxide, E. faecalis was registered in 18% of samples, A. actinomycetemcomitans in 16% of samples and P. gingivalis was not registered in any sample. Conclusion The most common bacterial species in teeth with deep caries lesions was E. faecalis, whereas A. actinomycetemcomitans and P. gingivalis were found in lower number of samples.Uvod Karijes je jedno od najznačajnijih i najrasprostranjenijih oboljenja usne duplje. Danas je sigurno da su dentalni plak, odnosno mikroorganizmi u njemu, najvažniji faktor nastanka karijesa. Caries profunda je duboka karijesna lezija koja predstavlja mesto odakle bakterijsko-toksični agensi preko dentinskih kanalića ugrožavaju pulpu. Cilj ovog rada je bio da se na osnovu mikrobiološke analize bakterija zastupljenih u karijesnoj leziji pre i posle terapije, odnosno na osnovu kliničkih istraživanja proveri efikasnost lečenja dubokih karijesnih lezija indirektnim prekrivanjem pulpe. Materijal i metode rada - Kliničko istraživanje je obuhvatilo 29 pacijenata oba pola, uzrasta od 16 do 40 godina, odnosno 45 stalnih zuba sa dubokim karijesnim lezijama. Posle preparacije kaviteta i uklanjanja razmekšalog dentina, sa dna kaviteta je uzet prvi bris. Drugi bris je uzet posle delovanja i uklanjanja privremenog ispuna i paste kalcijum-hidroksida nakon 60 dana. Uzeti brisevi su odloženi u posebne sterilne mikrotubice (ependorfe) i čuvani na temperaturi od -80°C do mikrobiološke analize. Uzorci materijala su ispitani na prisustvo sledećih mikroorganizama: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans i Enterococcus faecalis primenom metode multipleks tehnika reakcije lančanog umnožavanja DNK (engl. polymerase chain reaction - PCR). Rezultati - Rezultat je pokazao da je pre početka lečenja dubokih karijesnih lezija najčešća bakterijabila E.faecalis (80% uzoraka), potom A. actinomycetemcomitans (32% uzoraka), dok je najređa bila bakterija P. gingivalis (16% uzoraka). Nakon sprovedene terapije preparatima na bazi kalcijum-hidroksida, E.faecalis je zabeležen u 18% uzoraka, a A. actinomycetemcomitans u 16%, dok P. gingivalis nije registrovan ni u jednom uzorku. Zaključak - U zubima sa dubokim karijesnim lezijama najčešća bakterija bila je E. faecalis, potom A. actinomycetemcomitans, a u najmanjem broju uzoraka je ustanovljen P. Gingivalis

Linear measurements of facial morphology using automatic approach

Introduction Clinical extraoral examination prior to orthodontic treatment includes face analysis (front and profile). Development of computer technology has increased efficacy and simplified this process through automating several steps of the analysis. The aim of this paper was to examine the possibility of automatic determining of linear measurements based on the facial image of a patient. Material and Methods Based on the set of 20 patients in NHP (Natural Head Position) position, three sets of measurements were conducted. Trained orthodontist performed positioning of predefined points on the image of the patient two times with one week apart, after which the points were automatically determined using customized computer software. Based on the position of the points, measurements for bizygomatic distance, upper and lower facial height and full facial height were computed. Three sets of measurements were compared and statistically analyzed. Results showed that computer software produced measurements comparable to measurements obtained by a trained orthodontist. Statistical analysis included calculating mean values and standard deviations, as well as paired two-tailed T-test. Differences between measurements ranged from 0.03% to 0.6% suggesting that automatic method can be successfully used. Conclusions The results of this research suggest that it is possible to ease, accelerate and automate work of the orthodontist on the image analysis using suitable software without significant differences in measured values

Analysis of sliding mechanics force degradation during postextraction space closure

Introduction Due to its simplicity, sliding mechanism is very often used in clinical practice for post-extraction space closure, however, the efficiency of this method may be reduced due to friction and changes in the properties of the materials used in this method. The most commonly used methods of sliding mechanics are nickel titanium (NiTi) closed coil spring and elastic chain. The aim of this study was to analyze force degradation in the application of nickel titanium closed coil springs and elastic chains during post-extraction space closure within treatment with fixed orthodontic appliances. Material and Methods The total sample in this study consisted of 78 post-extraction spaces in patients who were indicated for extraction of first premolars and treatment with fixed orthodontic appliances. Nickel titanium closed coil springs and elastic chains were used to close the post-extraction spaces. Post-extraction spaces were monitored for 6 months with follow up examinations every 4 weeks. Measurements of initial force, at the beginning of mechanism activation and residual force in the observation period were performed during control examinations. Results Results of this research showed that with both methods of sliding mechanism there was a significant decrease in the observation period. When using NiTi closed coil springs, the value of average initial force at control examination was between 189.00-210.25 g, while residual was in the range of 117.56-133.50 g that NiTi closed coil springs kept an average 61.57% of initial force. The average initial force on the control examinations for elastic chains was between 184.5-205.38 g, while residual force was in range of 100.39-113.00 g, that elastic chains retained an average 53.41% of initial force. Conclusion There was a significant force degradation between inspections, when sliding mechanics were applied. The loss of force between activation phases of NiTi closed coil springs was smaller compared to the forces produced by elastic chains