Ozone Treatment of Initial Lesions

Karijes je bolest tvrdoga zubnog tkiva za koji je da bi nastao potrebno nekoliko čimebnika od kojih su najvažniji domaćin (zub), uzročnik (mikroorganizmi), utjecaj okoline i vrijeme. Razvojem tehnologije uvedene su nove suvremene metode dijagnostike karijesnih lezija. Među njima važno mjesto zauzima laserska fluorescencija. Usporedno s razvojem dijagnostike klasično “Blackovo načelo” preparacije kaviteta u terapiji karijesnih lezija ispunom zamijenila je ponajprije koncepcija “minimalno invazivne atraumatske stomatologije”, a nedavno je u svrhu terapije karijesa uporabljen i ozon. Baktericidni i dezinfekcijski učinak ozona omogućio je novu koncepciju “bezbolne terapije” karijesnih lezija.Caries is a disease of hard dental tissue caused by the following factors: host (the tooth), cause (microorganisms), environmental influence and time. With improved technology new, contemporary, methods of diagnosing caries lesions have been introduced, one of the most important being laser fluorescence. Parallel with the development of new diagnostic methods, the classical “Black’s principle” of cavity preparation, was replaced, first with “minimally invasive non-traumatic dentistry”, and more recently with “ozone therapy”. Bactericide and disinfective properties of ozone enabled a new concept of “painless therapy” in treatment of caries lesions

Esthetic Reconstruction of Teeth in Patient with Dentinogenesis Imperfecta – A Case Report

Dentinogenesis imperfecta (DI) is the result of a dominant genetic defect and affects both the deciduous and permanent dentitions. It is characterized by opalescent teeth composed of irregularly formed and undemineralized dentin which obliterates pulp chamber and root canal. DI can appear as a separate disorder or with osteogenesis imperfecta (OI). The teeth with DI show a grayish-blue to brown hue with dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration, which all may lead to rapid and extensive attrition which require adequate crown reconstruction. The aim of this study was to show a reconstruction of frontal teeth in upper jaw with direct composite veneers in young adult patient with DI

Endodontic Treatment of Dens Invaginatus – Case Report

Invaginirani je zub razvojna anomalija koja se očituje uvlačenjem cakline i dentina u unutrašnost krune i korijena. Aberacija se može očitovati u široku spektru morfoloških varijacija od foramen coecum do manjeg ili većeg uvlačenja u korijen, a ponekad sve do vrška korijena. Liječenje ovisi o tipu anomalije i njezine komunikacije s pulpom i periapeksnim tkivom. Svrha rada bila je prikazati mogućnosti endodontskoga liječenja navedene anomalije.Dens invaginatus is a developmental anomaly, manifested by the insertion of the enamel and dentin inside crown and root. Aberration is manifested by the broad spectrum of morphological variations from foramen coecum to the smaller or larger root insertion, sometimes to the very apex. The treatment depends on the type of anomaly and whether there is a communication with the pulp and the periapical tissue. The purpose of this study was to show endodontic treatment possibilities for this anomaly

Digital Holographic Interferometry - A New Method for Measuring Polymerization Shrinkage of Composite Materials

Polimerizacija kompozitnih materijala smatra se iznimno važnim čimbenikom dugotrajnosti kompozitnog ispuna. Kakvoća polimerizacije utječe na fizičko-mehanička svojstva, stabilnost boje, volumetrijske promjene restoracije te na biokompatibilnost samoga materijala. Neizbježna posljedica stvrdnjavanja kompozitnih materijala jest polimerizacijsko skupljanje. Iznos polimerizacijskoga skupljanja do sada se je mjerio s viπe različitih postupaka. Digitalna holografska interferometrija, opisana u ovome radu, jedini je postupak koji omogućuje da se izravno prati polimerizacijsko skupljanje u svakoj sekundi osvjetljavanja kompozitnog materijala. Vrijednosti polimerizacijskoga skupljanja dobivene ovim postupkom u okviru su veličina polimerizacijskoga skupljanja izmjerenih drugim postupcima.Polymerization of composite filling is considered to be an important factor in achieving longevity of the restorative treatment. Quality of the polymerization influences physico-mechanical characteristics, color stability, volumetric changes of restoration and biocompatibility of the material itself. Polymerization shrinkage is an unavoidable consequence of setting of the composite material. So far, it has been measured by several different methods. Digital holographic interferometry, a method described in this study, is the only procedure that enables direct monitoring of the polymerization shrinkage for every second of polymerization of the composite material. Values of the polymerization shrinkage obtained by this method correspond with the values obtained by other methods

Aesthetic Reconstruction of Hypodoncy Using Kevlar Fibres

Estetski nedostatak nastao zbog hipodoncije gornjih lijevih pretkutnjaka u pacijenta u dobi od dvadeset pet godina utvrđen je kliničkim i radiološkim pregledom. Tijekom vremena prostor se je smanjio zbog pomicanja trajnoga gornjeg očnjaka u distalnome smjeru na mjesto drugoga gornjeg pretkutnjaka, a nastali međuprostor je odgovarao širini gornjega očnjaka. Minimalnim traumatskim terapijskim postupkom očnjak je nadomješten uporabom kevlar vlakana, adhezijskim postupkom i kompozitnim materijalom.Aesthetic inadequacy due to hypodoncy of the upper left first premolar of a 20 yearold patient was detected by clinical and radiological examination. After a certain period of time space reduction had occurred because of shifting of a permanent upper canine tooth in the distal direction to the place of the second upper premolar, and the gap created corresponded to the width of the upper canine tooth. By a minimal traumatic therapy procedure we substituted the canine tooth by using fibres, adhesive procedure and composite materials

The Effect of Chewing Gum in the Prevention of Caries

Zubni karijes je zbog svoje rasprostranjenosti u svijetu velik javnozdravstveni problem. Zbog toga ne iznenađuje činjenica da postoji velik broj materijala i postupaka kojima je svrha prevencija nastanka zubnoga karijesa. Jedan je od tih postupaka uporaba guma za žvakanje koje simuliranjem lučenja sline sprječavaju stvaranje dentobakterijskoga plaka na površinu zuba i uklanjaju već akumulirani plak. Ispitivanje je obuhvatilo 16 studenata (12 studentice i 4 studenta) 3., 4. i 5. godine Stomatološkog fakulteta Sveučilišta u Zagrebu. Mjerena je količina lučenja nestimulirane sline za svakoga studenta, stimulirane sline sa štapićima voska preuzetim iz Caries risk test seta (Shaan, Vivadent) te dvije vrste guma za žvakanje Orbit (Wrigley) Winterfresh i Wild Strawberry. Ispitanici su vosak i gume za žvakanje prvo žvakali jednu minutu i svu skupljenu slinu bi progutali, a zatim su žvakali još tri minute i svu su slinu skupljali u graduiranu menzuru. Dobiveni rezultati su istraženi kao srednja vrijednost i standardna devijacija, a njihova razlika putem student t-testa. Također je izračunan i KEP indeks (DMF/t) za svakog ispitanika. Dobiveni rezultati pokazuju znatan porast lučenja stimulirane sline prigodom žvakanja guma za žvakanje u usporedbi sa žvakanjem voska. Također postoji razlika u lučenju sline u odnosu prema okusu gume za žvakanje. Kod gume za žvakanje s okusom Wild Strawberry volumen sline bio je veći. Rezultati ovog istraživanja potvrđuju opravdanost uporabe guma za žvakanje, pogotovo ako uzmemo u obzir da su većina današnjih guma za žvakaknje zaslađene umjetnim sladilima kao što je ksilitol koji ima i protukarijesno djelovanje.Dental caries, because of its spread worldwide, represents a public health problem. It is therefore, not surprising to find a great number of materials and procedures whose goal is the prevention of its formation. One such procedure is use of chewing gums which stimulate the secretion of saliva, thus preventing the formation of dental bacterial plaque on the surface of the teeth as well as a removal of existing plaque. The study included 16 students (12 female and 4 male) of the 3rd, 4th and 5th year of the Dental School of the Zagreb Universitiy. The goal was to measure the quantity of secretion of unstimulated saliva as opposed to that of stimulated saliva for each student, using the wax sticks borrowed from the Caries risk test set (Schaan, Vivadent) and two kinds of Orbit chewing gum (Wrigley: Winterfresh and Wild Strawberry). The examinees first chewed the wax and the chewing gum for one minute and then swallowed all the secreted saliva. Afterwards they chewed for another three minutes, this time collecting the secreted saliva into a calibrated measuring cup. The achived results are expressed as the medium value and standard deviation, the difference between them being noted with Student t-test. KEP index (DMF/t) for each examinee was also calculated. The achived results showed a significant difference in the saliva secretion during the use of chewing gum and the use of wax. There was also a difference in the secretion of saliva regarding the flavour of the chewing gum. The volume of saliva was more when Wild Strawberry was used. The results of the study justify the use of chewing gums, especially if we take into consideration that many of them contain an artificial sweetner, such as xylithol, with a strong anticaries effect

Vertical Fractures of the Tooth Crown With Amalgam Filling

Amalgam se kao restorativni materijal rabi već više od 150 godina. Mehaničko opterećenje može rezultirati dimenzijskim promjenama dovodeći do nastanka rubnih pukotina i fraktura tvdoga zubnog tkiva. Svrha rada bila je utvrditi čestoću i lokaciju takvih fraktura kod zuba s amalgamskim ispunom. Ispitano je 30 ispitanika (21 muškog i 9 ženskog spola) u dobi od 16. do 42. godine. Kliničkim pregledom u 23 od 30 ispitanika (159 zubi) ustanovljene su frakture. Rezultati su pokazali da: 1. 48% fraktura postoji kod primarnih amalgamskih restauracija, 2. frakture su lokalizirane bukalno (31%) i disto-aproksimalno (26%), 3. gotovo polovica ispuna I. i II. razreda ima frakture, 4. najčešće su kod gornjih molara (75%), osobito kod prvoga molara (80%), 5. u 61% ispitanika frakture su locirane disto-aproksimalano, 6. nema statistički znatne razlike između muškoga i ženskoga spola po čestoći fraktura, 7. čestoća fraktura raste s godinama starosti. Frakture su uvjetovane svojstvima amalgama, utjecaju opterećenja na amalgamsku restauraciju i drugim čimbenicima. Ovo ispitivanje navodi nas na zaključak da svaki drugi pacijent s amalgamskim ispunom ima frakturu te je potrebna točna dijagnoza i zamjena ispuna kako bi se spriječila daljnja napuknuća tvrdoga zubnog tkiva.Amalgam has been used as a restorative material for 150 years. Mechanical loading can lead to dimensional changes resulting in marginal gaps and cracking of the hard dental tissue. The aim of this investigation was to locate and find out how often cracks happen with amalgam restorations. On order to determine this 30 examines were examined (21 male and 9 female), aged from 16 to 42 years. Clinical examination resulted in 23 out of 30 examined patients (159 teeth) had cracks. Cracks were drawn on formerly prepared schemes. Results showed that: 1. 48% of cracks were in primary amalgam restorations; 2. cracks were localized buccally (31%) and distally-proximally (26%); 3. nearly half of all Black Class I and II restorations had cracks; 4. cracks were found in upper molars (75%) and especially in first ones (80%); 5. 61% of examines with cracks were distally-proximally; 6. There were no statistically significant differences between male and female examines; 7. Frequency of cracking raises with age. Cracking is bound with properties of amalgam, influence of loading on amalgam restorations and other factors. This investigation lead us to conclude that every second patient with an amalgam restoration had a crack and better diagnosis and repairing is needed to prevent further cracking

Esthetic Reconstruction of the Incisal Edge of Upper Central Incisors

Oštećeni incizijski bridovi središnjih gornjih sjekutića smatraju se značajnim i razmerno složenim problemom u restorativnoj stomatologiji zbog minimalnoga stupnja oštećenja, složenih estetskih zahtijeva te zbog osiguravanja dugotrajnosti provedene rekonstrukcije. Za opskrbu incizijskih defekata postoji niz tehnika. Među njima je najmanje invanzivna izravna tehnika kompozitnim smolama. Svrha rad bila je prikazati jednu od mogućnosti rekonstrukcije traumom oštećenog incizijskoga brida. Pacijent K.R., u dobi od 22 godine, imao je nakon udarca tvrdim predmetom frakture cakline i dijela dentina na incizijskome bridu. Prijašnji restorativni zahvat nije bio odgovarajući pa se proveo nov postupak uporabom Artemis (Vivadent, Schaan, Liechtenstein) mikrohibridnoga kompozitnoga materijala s paletom estetskih nijansi za stimuliranje cakline, dentina i posebnih efekata. Opakne nijanse boja stimulirale su izgubljeni dentin, prozirne caklinske boje caklinu, a mamelonske i jasne transparentne boje posebne efekte. Rekonstrukcija je provedena u slojevitoj tehnici uz uporabu instrumenata za plasticiranje i odgovarajućih kistova uz polimerizaciju svakoga sloja posebno.Damaged incisal edges of the upper central incisors are considered to be an important as well as a relatively complex problem in restorative dentistry because the degree of damage is minimal yet esthetical demand provision of long-lasting reconstruction complex. There are several techniques for provision of incisal defects, the least invasive being direct technique with composite resins. The purpose of this study was to present one of the possibilities for reconstruction of trauma damaged incisal edge. A 22 year old patient after being strike by a hard object, sustained fractures od enamel and part of the dentin on the incisal edge. Previously performed restorative treatment was not satisfactory, so a new procedure was undertaken, using Artemis (Vivadent, Schaan, Liechtenstein) microhybrid composite material with a wide spectrum of shades for enamel and dentin simulation as well as special effects. Opaque shades of colours simulated lost dentin, transparent enamel shades enamel, and mammelon and clear transparent shades special effects. Reconstruction was performed in layer technique with the use of instruments for plasticizing including responding brushes and polymerization of each layer separately

Influence of Prepared Cavity Surface on Microleakage - Pilot Study

Caklina i dentin po svojoj su kemijskoj građi dva različita supstrata pa ih je potrebno pažljivo i različito prirediti za postavljanje kompozitnoga materijala. Svrha rada bila je pokazati kako različit predtretman cakline i dentina (“total-etch” tehnika i samojetkajući adhezivi) utječe na kakvoću sveze s kompozitnim materijalom. Dobiveni su rezultati pokazali da je optimalno vrijeme jetkanja 37%- tnom ortofosfornom kiselinom 20 sekundi za caklinu i 10 sekundi za dentin.Enamel and dentin are, by their very chemical structure, two different substrates which necessitate different preparation before placing of composite resin. The aim of this study was to show how various enamel and dental pretreatment methods (“total etch” technique and self etching adhesives) affect the quality of bonding with composite resin. The results obtained showed optimal etching time, using 37% orthophospohoric acid, of 20 seconds for enamel and 10 seconds for dentin

Dens Invaginatus - Treatment method

Dens invaginatus je razvojna anomalija koja se očituje uvlačenjem cakline i dentina u unutrašnjost krune i korijena. Aberacija se može očitovati u širokome spektru morfoloških varijacija of foramen coecum do manjeg ili većeg uvlačenja u korijen, a ponekad sve do vrška korijena. Suvremenu podjelu anomalije ponudio je Oehlers godine 1957. Prema njoj postoje tri tipa abnormalnosti. Najčešće se otkriva radiografskim pregledom. Ako postoji komunikacija invaginacije s pulpom ili periradikularnim tkivom, vrlo će brzo nakon nicanja zuba nastati promjene u vitalnosti pulpe, njezine afekcije, nekroze i periapikalne patološke promjene koje zahtijevaju hitnu intervenciju. Liječenje ovisi o tipu anomalije i njezine komunikacije s pulpom i periapikalnim tkivom. Svrha rada bila je prikazati mogućnosti endodontskoga liječenja navedene anomalije. Dvadesetogodišnji pacijent javio se je u Zavod za dentalnu patologiju Stomatološkoga fakulteta u Zagrebu zbog bolova u području gornjega desnog središnjeg sjekutića. Kliničkim pregledom ustanovljena je palatinalna protuberancija i Y oblik palatinalne plohe zuba, te tri foramena. Radiološkom pretragom vidljiva je invaginacija klase III po Oehlersu s komunikacijom s periapeksom te s opsežnim periapeksnim procesom. Provelo se je endodontsko liječenje, a istodobno su proširena oba invaginacijska otvora i središnji prostor između njih. Distalni kanal imao je oblik C, a mezijalni je bio ovalan. Instrumentacija je provedena kombinirano: profile i step-back tehnikom. Radna dužina korijenskoga kanala provjeravana je elektroničkim uređajem Endometer ES-03. Kanali su ispunjeni termoplastičnim postupkom i napravljena je kontrolna snimka nakon što je ispunjen endodontski prostor. Kruna je estetski rekonstruirana kompozitnom smolom. Kontrola je provedena nakon jedan, tri i šest mjeseci, te je opažena redukcija patološkog procesa bez kliničkih simptoma.Dens invaginatus is a developmental anomaly, manifested by insertion of enamel and dentin inside the crown and root. This aberration is revealed by the broad spectrum of morphological variations, from the foramen coecum to the smaller larger insertion in the root, sometimes extending to the very apex. Current anomaly classification, presented by Oehlers in 1957, divides the anomaly into three categories. It is usually detected by roentgen examination. If there is a communication between the invagination and the pulp or a periradicular tissue, soon after tooth eruption change occurs in the pulp vitality in the form of affectation, necrosis and periapical pathological transformation wich necessitates urgent dental intervention. The treatment depends on the type of anomaly and its communication with the pulp and the periapical tissue. The purpose of the study was to present endodontic treatment possibility for the stated anomaly. A 20 yearold patient contacted the Department of Restorative Dentistry at the University of Zagreb school of Dental Medicine complaining of pain in the area of the upper right central incisor. Clinical examination determined palatal protuberation and Y shape form of the palatal tooth surface including three foramens. Radiological examination showed class II invgination according to Oehlers with periapical communication and extensive periapical process. Endodontic treatment was performed simultaneously with enlargement of both invagination foramens as well as the central area inbetween. Distal root canal was C-shaped while the mesial was oval. Method of instrumentation was combined Profile and “step-back” techniqe. Working lenght of the root canal was verified using electronic device Endometer ES-03. Root canals were filled using thermoplastic techniqe and the control X-rays was made after the endodontic treatment. Finally, the crown was esthetically reconstucted with composite resin. Follow through after one, three and six months revealed a reduction of the pathological process as well as disppearance of clinical symtoms