Analiza okluzije u pacijenata sa fiksnim zubnim nadoknadama na implantatima primenom kompjutera

The development of aesthetic and restorative dentistry and implantology leads to an increasing use of implants in the treatment of care for the loss of one or more teeth. The question is whether the existing guidelines, originally formulated for the occlusion of natural dentition and conventional prosthetic treatment can be applied to the implant prosthodontics. Due to initial differences in the vertical mobility of teeth and dental implants, present in the same dental arch, although the model of occlusion is ideal, undesirable premature occlusal contacts on the fixed dental restorations on implants may be present. Occlusal forces, in the dental arch partially reconstructed with fixed dental restorations on implants, must be planned so that the initial contacts in a position of maximum intercuspidation are on the natural teeth or fixed dental restorations on natural teeth. With the concept of delayed initial occlusal contacts on implants, you get balanced distribution of occlusal forces, physiological load of implants, preserve the integrity of peri-implant bone tissue, with favorable effects on prognosis and longlasting prosthetic treatment in implants. The main objective of the doctoral dissertation was to examine the intensity and time of establishing occlusal contacts of natural teeth and fixed dental restorations on implants with antagonists at different head postures, in a position of maximum intercuspidation. The research was conducted as a prospective clinical study in which research subjects were followed in period of one year. For the achievement of set goals and tasks, in this study two groups were included: control group included 17 patients of both sexes, with a full dental arches in the upper and lower jaw, and the experimental group that consisted of 14 patients with full dental arches in the upper and lower jaw, who in the past year had prosthetic treatment with fixed dental restorations on implants. In both groups of patients clinical functional analysis of occlusion and the conventional procedure of testing the occlusal equilibration was first performed. Then the condition of the occlusal complex of nature teeth and fixed dental restorations on implants was tested with the latest computerized T-Scan III method. Research results indicate that because of the initial difference in the vertical mobility of teeth and implants present in the same dental arch, premature occlusal contacts may be present on fixed dental restorations on implants. Quantitative occlusal analysis showed statistically significantly higher number of premature occlusal contacts in the experimental group of patients at all three positions of the head, of which approximately one early contact was localized on implant crowns. Relative occlusal forces were statistically significantly stronger on posterior compared to anterior teeth. The relative occlusal forces values on the front teeth in all three positions of the head, were higher in the experimental group subjects, while bilateral uniform distribution of occlusal forces around mediosagittal plane was registered in both groups. Longer time of establishing occlusal contacts was recorded in the experimental group subjects, but without statistical significance...Razvoj estetske restaurativne stomatologije i implantologije, dovodi do sve veće primene implantata u terapiji zbrinjavanja gubitka jednog ili više zuba. Pitanje je da li se postojeće smernice, originalno formulisane za okluziju u prirodnoj denticiji i konvencionalnoj protetskoj terapiji, mogu primeniti i u implantat protetici. Zbog inicijalne razlike u vertikalnoj pokretljivosti zuba i implantata prisutnih u istom zubnom luku i pored idealnog modela okluzije, mogu biti prisutni neželjeni prevremeni kontakti na fiksnim zubnim nadoknadama na implantatima. Okluzalne sile se, u zubnom luku delimično rekonstruisanom fiksnim zubnim nadoknadama na implantatima, moraju ostvarivati tako da se inicijalni kontakti u maksimalnoj Ikp nalaze na prirodnim zubima ili fiksnim zubnim nadoknadama na prirodnim zubima. Konceptom odlaganja inicijalnog okluzalnog kontakta na implantatima, postiže se uravnotežena distribucija okluzalnih sila, fiziološko opterećenje implantata, očuvanje integriteta peri-implantatnog koštanog tkiva, sa povoljnim uticajem na prognozu i dugotrajnost protetske terapije na implantatima. Osnovni cilj doktorske disertacije bio je ispitati intenzitet i vreme uspostavljanja okluzalnih kontakata prirodnih zuba i fiksnih zubnih nadoknada na implantatima sa antagonistima pri različitim položajima glave, u toku maksimalne interkuspacije mandibule. Istraživanje je sprovedeno kao prospektivna klinička studija u kojoj su subjekti istraživanja praćeni u vremenskom periodu od godinu dana. Za ostvarivanje postavljenih ciljeva i zadataka, u istraživanje su bile uključene dve grupe pacijenata: Kontrolnu grupu činilo je 17 pacijenata, oba pola, sa punim zubnim nizom u gornjoj i donjoj vilici, dok je eksperimentalnu grupu činilo je 14 pacijenata sa punim zubnim nizom u gornjoj i donjoj vilici koji su u poslednjih godinu dana protetski zbrinuti fiksnim zubnim nadoknadama na implantatima. Ispitanicima obe grupe je prvo izvršena klinička funkcijska analiza okluzije i konvencionalni postupak provere okluzalnog uravnoteženja. Zatim je stanje okluzalnog kompleksa prirodnih zuba i fiksnih zubnih nadoknada na implantatima ispitivano najsavremenijom kompjuterskom T-Scan III metodom. Rezultati istraživanja ukazuju na to da zbog inicijalne razlike u vertikalnoj pokretljivosti zuba i implantata prisutnih u istom zubnom luku i pored idealnog modela okluzije, mogu biti prisutni neželjeni prevremeni kontakti na fiksnim zubnim nadoknadama na implantatima. Kvantitativnom analizom okluzije evidentiran je statistički značajno veći broj prevremenih okluzalnih kontakata u eksperimentalnoj grupi ispitanika pri sva tri položaja glave, od čega je prosečno jedan prevremeni kontakt bio lokalizovan na krunama na implantatima. Relativne sile u sva tri položaja glave, bile su statistički značajno jače na bočnim u odnosu na prednje zube. Vrednosti relativnih sila na prednjim zubima u sva ti položaja glave, bile su veće u eksperimentalnoj grupi ispitanika, dok je bilateralna ravnomerna distribucija okluzalnih sila oko mediosagitalne ravni registrovana u obe grupe ispitanika. Više vrednosti vremena uspostavljanja okluzalih kontakata zabeležene su u eksperimentalnoj grupi ispitanika, ali bez statističke značajnosti..

Pouzdanost primene konvencionalnih ključeva za određivanje boje zuba

Background/Aim. Color matching in prosthodontic therapy is a very important task because it influences the esthetic value of dental restorations. Visual shade matching represents the most frequently applied method in clinical practice. Instrumental measurements provide objective and quantified data in color assessment of natural teeth and restorations. In instrumental shade analysis, the goal is to achieve the smallest ΔE value possible, indicating the most accurate shade match. The aim of this study was to evaluate the reliability of commercially available ceramic shade guides. Methods. VITA Easyshade spectrophotometer (VITA, Germany) was used for instrumental color determination. Utilizing this device, color samples of ten VITA Classical and ten VITA 3D - Master shade guides were analyzed. Each color sample from all shade guides was measured three times and the basic parameters of color quality were examined: ΔL, ΔC, ΔH, ΔE, ΔElc. Based on these parameters spectrophotometer marks the shade matching as good, fair or adjust. Results. After performing 1,248 measurements of ceramic color samples, frequency of evaluations adjust, fair and good were statistically significantly different between VITA Classical and VITA 3D Master shade guides (p = 0.002). There were 27.1% cases scored as adjust, 66.3% as fair and 6.7% as good. In VITA 3D - Master shade guides 30.9% cases were evaluated as adjust, 66.4% as fair and 2.7% cases as good. Conclusion. Color samples from different shade guides, produced by the same manufacturer, show variability in basic color parameters, which once again proves the lack of precision and nonuniformity of the conventional method.Uvod/Cilj. Određivanje boje zuba u protetskoj terapiji predstavlja veoma važan zadatak jer utiče na prirodan izgled i estetsku vrednost zubnih nadoknada. Vizuelni metod određivanja boje zuba najčešće se koristi u kliničkoj praksi. Instrumentalna merenja pružaju objektivne i kvantifikovane podatke u proceni boje prirodnih zuba i restauracija. U instrumentalnoj analizi boje cilj je da se postigne najmanja moguća vrednost ΔE, što predstavlja najtačniji izbor nijanse. Cilj ovog istraživanja bio je da se utvrdi pouzdanost najčešće korišćenih ključeva za određivanje boje zuba. Metode. Za instrumentalni izbor boje korišćen je VITA Easyshade spektrofotometar (VITA, Germany). Uz pomoć ovog uređaja, analizirani su uzorci boja 10 VITA Classical i 10 VITA 3D - Master ključeva boja. Svaki uzorak boje analiziran je tri puta i ispitivani su osnovni parametri kvaliteta boje: ΔL, ΔC, ΔH, ΔE, ΔElc. Stepen poklapanje boje nadoknade sa ciljnom nijansom spektrofotometar izražava kroz tri ocene kvaliteta: good, fair i adjust. Rezultati. Nakon izvršenih 1 248 merenja keramičkih uzoraka boje, frekvencije ocena adjust, fair i good statistički su se značajno razlikovale između VITA Classical i VITA 3D - Master ključeva boja (p = 0.002). U VITA Classical ključu boja bilo je 27,1% ocene adjust, 66,3% fair i 6,7% ocene good. U VITA 3D - Master ključu boja bilo je 30,9% ocene adjust, 66,4% fair i 2,7% ocene good. Zaključak. Uzorci boje iz različitih ključeva boja proizvedenih od istog proizvođača, pokazuju varijabilnost u osnovnim parametrima boje, što ukazuje na nepreciznost i neuniformnost konvencionalne metode

Expression of antioxidant enzymes and transcription factor Nrf2 in patients with benign, premalignant and malignant endometrial transformation .

Tokom čitavog životnog ciklusa aerobni organizmi su izloženi brojnim endogenim i egzogenim faktorima koji indukuju povećanje produkcije ROS-a. Prisutni u fiziološkim koncentracijama, reaktivni molekuli ROS-a imaju značajnu ulogu u važnim ćelijskim procesima kao što su regulacija signalnih kaskada i genske ekspresije. U visokim koncentracijama ROS mogu oksidovati ćelijske proteine, lipide i DNK i time dovesti do promena strukture i funkcije, oštećenja, pa i smrti ćelije. Kada koncentracija slobodnih radikala premaši fiziološki nivo, smatra se da se ćelija nalazi u stanju oksidativnog stresa. Kako bi sprečili nastanak i umanjili posledice ove vrste stresa, živi organizmi su razvili moćan antioksidativni sistem zaštite (AOS). Ovaj sistem uključuje seriju mehanizama kojima se nivo slobodnih radikala održava u uskom opsegu između fiziološke i toksične koncentracije. Najvažnije enzimske komponente AOS su: superoksid dismutaze (SOD), katalaza (CAT), glutation peroksidaza (GPx) i glutation reduktaza (GR). Ovi enzimi uklanjaju višak ROS-a i učestvuju u održavanju nivoa redukovanog glutationa, čime obezbeđuju očuvanje osnovnih životnih funkcija i sprečavaju nastanak oštećenja i bolesti ćelije. Zbog tako važne uloge AOS, regulacija funkcionalne ekspresije njegovih komponenti je naročito značajna za fiziološke i patološke procese u aerobnim organizmima. Jedan od najvažnijih regulatornih molekula u tom sistemu je Nrf2 (NF-E2 related factor 2). Nrf2 je transkripcioni faktor koji indukuje ekspresiju mnogih citoprotektivnih proteina uključujući i antioksidativne enzime, zbog čega ima značajnu ulogu u regulaciji oksidativnog stresa. Savremena istraživanja na različitim model-sistemima ukazuju na povezanost oksidativnog stresa i kancerogeneze. Razvoj kancera je višestepeni proces koji se razvija kroz tri faze: inicijaciju, promociju i progresiju, a oksidativni stres je povezan sa svakim od ova tri stadijuma transformacije ćelije. Osim toga i sam antioksidativni profil je u ćelijama kancera izmenjen u odnosu na zdrave, normalne ćelije, pa ovi molekuli mogu biti i značajni biomarkeri u dijagnostici, proceni rizika i stepena kancerogeneze...During the life cycle aerobic organisms are exposed to a number of endogenous and exogenous sources of ROS. Present in low to moderate concentrations these reactive molecules play an important role in many physiological processes such as regulation of signaling cascades and gene expression. In high concentrations, ROS can oxidize cellular proteins, lipids and DNA, causing changes in structure and function, damage and even cell death. When the concentration of free radicals exceeds the physiological level, a cell is said to be in a state of oxidative stress. To prevent the onset and reduce the consequences of oxidative stress, living organisms have developed powerful antioxidant system (AOS). This system includes a set of mechanisms to maintain the level of free radicals in the narrow range between physiological and toxic concentrations. The most important enzyme components in AOS are: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione reductase (GR). These enzymes are involved in the removal of ROS and participate in maintaining level of reduced glutathione, thus ensuring the preservation of physiological functions and inhibit the development of cell damage and disease. Because of such an important role of AOS, the regulation of the functional expression of its components is of particular importance for physiological and pathological processes in aerobic organisms. One of the most important regulatory molecules in this system is Nrf2 (NF-E2 related factor 2). Nrf2 is a transcription factor that induces expression of many cytoprotective proteins including antioxidant enzymes, and therefore play an important role in the regulation of oxidative stress. Previous studies have clearly demonstrated a link between oxidative stress and carcinogenesis. Cancer is a multistage process that develops over three stages: initiation, promotion and progression and oxidative stress is associated with each of them. Moreover, antioxidant profile is altered in cancer cells compared with healthy, normal tissue, so these molecules may be important biomarkers in the assessment of risk and the degree of carcinogenesi

Computerized occlusal analysis in patients with fixed dental restorations on implants

Razvoj estetske restaurativne stomatologije i implantologije, dovodi do sve veće primene implantata u terapiji zbrinjavanja gubitka jednog ili više zuba. Pitanje je da li se postojeće smernice, originalno formulisane za okluziju u prirodnoj denticiji i konvencionalnoj protetskoj terapiji, mogu primeniti i u implantat protetici. Zbog inicijalne razlike u vertikalnoj pokretljivosti zuba i implantata prisutnih u istom zubnom luku i pored idealnog modela okluzije, mogu biti prisutni neželjeni prevremeni kontakti na fiksnim zubnim nadoknadama na implantatima. Okluzalne sile se, u zubnom luku delimično rekonstruisanom fiksnim zubnim nadoknadama na implantatima, moraju ostvarivati tako da se inicijalni kontakti u maksimalnoj Ikp nalaze na prirodnim zubima ili fiksnim zubnim nadoknadama na prirodnim zubima. Konceptom odlaganja inicijalnog okluzalnog kontakta na implantatima, postiže se uravnotežena distribucija okluzalnih sila, fiziološko opterećenje implantata, očuvanje integriteta peri-implantatnog koštanog tkiva, sa povoljnim uticajem na prognozu i dugotrajnost protetske terapije na implantatima. Osnovni cilj doktorske disertacije bio je ispitati intenzitet i vreme uspostavljanja okluzalnih kontakata prirodnih zuba i fiksnih zubnih nadoknada na implantatima sa antagonistima pri različitim položajima glave, u toku maksimalne interkuspacije mandibule. Istraživanje je sprovedeno kao prospektivna klinička studija u kojoj su subjekti istraživanja praćeni u vremenskom periodu od godinu dana. Za ostvarivanje postavljenih ciljeva i zadataka, u istraživanje su bile uključene dve grupe pacijenata: Kontrolnu grupu činilo je 17 pacijenata, oba pola, sa punim zubnim nizom u gornjoj i donjoj vilici, dok je eksperimentalnu grupu činilo je 14 pacijenata sa punim zubnim nizom u gornjoj i donjoj vilici koji su u poslednjih godinu dana protetski zbrinuti fiksnim zubnim nadoknadama na implantatima. Ispitanicima obe grupe je prvo izvršena klinička funkcijska analiza okluzije i konvencionalni postupak provere okluzalnog uravnoteženja. Zatim je stanje okluzalnog kompleksa prirodnih zuba i fiksnih zubnih nadoknada na implantatima ispitivano najsavremenijom kompjuterskom T-Scan III metodom. Rezultati istraživanja ukazuju na to da zbog inicijalne razlike u vertikalnoj pokretljivosti zuba i implantata prisutnih u istom zubnom luku i pored idealnog modela okluzije, mogu biti prisutni neželjeni prevremeni kontakti na fiksnim zubnim nadoknadama na implantatima. Kvantitativnom analizom okluzije evidentiran je statistički značajno veći broj prevremenih okluzalnih kontakata u eksperimentalnoj grupi ispitanika pri sva tri položaja glave, od čega je prosečno jedan prevremeni kontakt bio lokalizovan na krunama na implantatima. Relativne sile u sva tri položaja glave, bile su statistički značajno jače na bočnim u odnosu na prednje zube. Vrednosti relativnih sila na prednjim zubima u sva ti položaja glave, bile su veće u eksperimentalnoj grupi ispitanika, dok je bilateralna ravnomerna distribucija okluzalnih sila oko mediosagitalne ravni registrovana u obe grupe ispitanika. Više vrednosti vremena uspostavljanja okluzalih kontakata zabeležene su u eksperimentalnoj grupi ispitanika, ali bez statističke značajnosti...The development of aesthetic and restorative dentistry and implantology leads to an increasing use of implants in the treatment of care for the loss of one or more teeth. The question is whether the existing guidelines, originally formulated for the occlusion of natural dentition and conventional prosthetic treatment can be applied to the implant prosthodontics. Due to initial differences in the vertical mobility of teeth and dental implants, present in the same dental arch, although the model of occlusion is ideal, undesirable premature occlusal contacts on the fixed dental restorations on implants may be present. Occlusal forces, in the dental arch partially reconstructed with fixed dental restorations on implants, must be planned so that the initial contacts in a position of maximum intercuspidation are on the natural teeth or fixed dental restorations on natural teeth. With the concept of delayed initial occlusal contacts on implants, you get balanced distribution of occlusal forces, physiological load of implants, preserve the integrity of peri-implant bone tissue, with favorable effects on prognosis and longlasting prosthetic treatment in implants. The main objective of the doctoral dissertation was to examine the intensity and time of establishing occlusal contacts of natural teeth and fixed dental restorations on implants with antagonists at different head postures, in a position of maximum intercuspidation. The research was conducted as a prospective clinical study in which research subjects were followed in period of one year. For the achievement of set goals and tasks, in this study two groups were included: control group included 17 patients of both sexes, with a full dental arches in the upper and lower jaw, and the experimental group that consisted of 14 patients with full dental arches in the upper and lower jaw, who in the past year had prosthetic treatment with fixed dental restorations on implants. In both groups of patients clinical functional analysis of occlusion and the conventional procedure of testing the occlusal equilibration was first performed. Then the condition of the occlusal complex of nature teeth and fixed dental restorations on implants was tested with the latest computerized T-Scan III method. Research results indicate that because of the initial difference in the vertical mobility of teeth and implants present in the same dental arch, premature occlusal contacts may be present on fixed dental restorations on implants. Quantitative occlusal analysis showed statistically significantly higher number of premature occlusal contacts in the experimental group of patients at all three positions of the head, of which approximately one early contact was localized on implant crowns. Relative occlusal forces were statistically significantly stronger on posterior compared to anterior teeth. The relative occlusal forces values on the front teeth in all three positions of the head, were higher in the experimental group subjects, while bilateral uniform distribution of occlusal forces around mediosagittal plane was registered in both groups. Longer time of establishing occlusal contacts was recorded in the experimental group subjects, but without statistical significance..

Expression of antioxidant enzymes and transcription factor Nrf2 in patients with benign, premalignant and malignant endometrial transformation .

Tokom čitavog životnog ciklusa aerobni organizmi su izloženi brojnim endogenim i egzogenim faktorima koji indukuju povećanje produkcije ROS-a. Prisutni u fiziološkim koncentracijama, reaktivni molekuli ROS-a imaju značajnu ulogu u važnim ćelijskim procesima kao što su regulacija signalnih kaskada i genske ekspresije. U visokim koncentracijama ROS mogu oksidovati ćelijske proteine, lipide i DNK i time dovesti do promena strukture i funkcije, oštećenja, pa i smrti ćelije. Kada koncentracija slobodnih radikala premaši fiziološki nivo, smatra se da se ćelija nalazi u stanju oksidativnog stresa. Kako bi sprečili nastanak i umanjili posledice ove vrste stresa, živi organizmi su razvili moćan antioksidativni sistem zaštite (AOS). Ovaj sistem uključuje seriju mehanizama kojima se nivo slobodnih radikala održava u uskom opsegu između fiziološke i toksične koncentracije. Najvažnije enzimske komponente AOS su: superoksid dismutaze (SOD), katalaza (CAT), glutation peroksidaza (GPx) i glutation reduktaza (GR). Ovi enzimi uklanjaju višak ROS-a i učestvuju u održavanju nivoa redukovanog glutationa, čime obezbeđuju očuvanje osnovnih životnih funkcija i sprečavaju nastanak oštećenja i bolesti ćelije. Zbog tako važne uloge AOS, regulacija funkcionalne ekspresije njegovih komponenti je naročito značajna za fiziološke i patološke procese u aerobnim organizmima. Jedan od najvažnijih regulatornih molekula u tom sistemu je Nrf2 (NF-E2 related factor 2). Nrf2 je transkripcioni faktor koji indukuje ekspresiju mnogih citoprotektivnih proteina uključujući i antioksidativne enzime, zbog čega ima značajnu ulogu u regulaciji oksidativnog stresa. Savremena istraživanja na različitim model-sistemima ukazuju na povezanost oksidativnog stresa i kancerogeneze. Razvoj kancera je višestepeni proces koji se razvija kroz tri faze: inicijaciju, promociju i progresiju, a oksidativni stres je povezan sa svakim od ova tri stadijuma transformacije ćelije. Osim toga i sam antioksidativni profil je u ćelijama kancera izmenjen u odnosu na zdrave, normalne ćelije, pa ovi molekuli mogu biti i značajni biomarkeri u dijagnostici, proceni rizika i stepena kancerogeneze...During the life cycle aerobic organisms are exposed to a number of endogenous and exogenous sources of ROS. Present in low to moderate concentrations these reactive molecules play an important role in many physiological processes such as regulation of signaling cascades and gene expression. In high concentrations, ROS can oxidize cellular proteins, lipids and DNA, causing changes in structure and function, damage and even cell death. When the concentration of free radicals exceeds the physiological level, a cell is said to be in a state of oxidative stress. To prevent the onset and reduce the consequences of oxidative stress, living organisms have developed powerful antioxidant system (AOS). This system includes a set of mechanisms to maintain the level of free radicals in the narrow range between physiological and toxic concentrations. The most important enzyme components in AOS are: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione reductase (GR). These enzymes are involved in the removal of ROS and participate in maintaining level of reduced glutathione, thus ensuring the preservation of physiological functions and inhibit the development of cell damage and disease. Because of such an important role of AOS, the regulation of the functional expression of its components is of particular importance for physiological and pathological processes in aerobic organisms. One of the most important regulatory molecules in this system is Nrf2 (NF-E2 related factor 2). Nrf2 is a transcription factor that induces expression of many cytoprotective proteins including antioxidant enzymes, and therefore play an important role in the regulation of oxidative stress. Previous studies have clearly demonstrated a link between oxidative stress and carcinogenesis. Cancer is a multistage process that develops over three stages: initiation, promotion and progression and oxidative stress is associated with each of them. Moreover, antioxidant profile is altered in cancer cells compared with healthy, normal tissue, so these molecules may be important biomarkers in the assessment of risk and the degree of carcinogenesi

Vlaknima ojačan kompozitni most kao zamena za neiznikli gornji stalni lateralni sekutić - prikaz bolesnika

Hypodontia of upper lateral incisors is significant aesthetic problem in young people. Ideal solution to this problem would be an implant placement, but there is a problem of unfinished growth and development. It is therefore necessary to have a temporary solution in order to maintain normal stomatognathic system functions and solve aesthetic problems until the final restoration is placed. The aim of this study was to show the possibility of treating hypodontia of permanent upper lateral incisors by creating adhesive bridge in one visit. A 15-year-old patient was referred to the Department for Prosthodontics, School of Dental Medicine in Belgrade with hypodontia of permanent upper lateral incisors. The patient had braces until 14 years of age after which she was rehabilitated with partial denture that was neither aesthetically nor functionally acceptable solution for her and significantly affected her emotional security. The adhesive bridge was made using GC composite fibers and a set of GC composite materials for the purpose of temporary replacement of missing teeth. This treatment provided good functional and aesthetic results. The space for the placement of two endosseous implants is preserved and a period of adaptation positively influenced the patient's social development in sensitive adolescent age.Hipodoncija gornjih lateralnih sekutića predstavlja značajan estetski problem mladih osoba. Idealno rešenje ovog problema bi predstavljala ugradnja implantata i izrada krunice, ali je prisutan problem nezavršenog rasta i razvoja. Zbog toga je neophodno izraditi privremeno rešenje, kako bi se normalno odvijale funkcije stomatognatnog sistema i rešili estetski problemi, sve do izrade trajne nadoknade. Cilj ovog rada bio je da se prikaže mogućnost zbrinjavanja hipodoncije stalnih gornjih lateralnih sekutića izradom adhezivnog mosta u jednoj poseti. Pacijentkinja starosti 15 godina javila se na Kliniku za stomatološku protetiku Stomatološkog fakulteta u Beogradu sa hipodoncijom stalnih gornjih lateralnih sekutića. U anamnezi je navela da je nosila fiksni ortodontski aparat do svoje 14. godine, a potom bila rehabilitovana parcijalnom pločastom protezom, kojom nije bila zadovoljna ni estetski ni funkcionalno, što je značajno uticalo na njenu emocionalnu nesigurnost. Izrađen je adhezivni most primenom GC kompozitnih vlakana i setom GC kompozitnih materijala sa ciljem privremene nadoknade neizniklih zuba. Primenjenom terapijom je postignut zadovoljavajući funkcionalni i estetski rezultat do momenta realizacije trajnog protetskog rešenja. Sačuvan je prostor za ugradnju dva endosealna implantata, a period adaptacije je pozitvno uticao na socijalni razvoj osobe u osetljivom pubertetskom dobu.

Procena stresa kod bolesnika sa klinički dijagnostikovanim bruksizmom

Background/Aim. Many studies investigated association between stress, anxiety or personality traits and sleep bruxism (SB), but results are still contradictory. We aimed to investigate whether there is a relation between clinically diagnosed sleep bruxism and salivary cortisol levels as one of the major stress biomarkers and to examine psychological factors and personality traits specific to sleep bruxism. Methods. A total of 23 sleep bruxism patients and 42 healthy non-sleep bruxism adults participated in this study. Diagnose of sleep-bruxism was assessed by self-report and clinical examination and also confirmed by bed-partner. Morning saliva was collected from all participants for analyses of the cortisol level. Sleep bruxism patients underwent a psychodiagnostic personality interpretation using the Minnesota Multiphasic Personality Inventory - MMPI-202 test. Results. Statistically significant difference between levels of morning salivary cortisol in the group of SB patients and the control group was recorded (t = 2.943, p lt 0.01). Analysis of the personality profiles indicated that the sleep bruxism patients avoid contact with unpleasant feelings, especially depression, suppress the aggression and censor the expression of anger and rage. Conclusion. This study showed that patients with sleep bruxism have higher levels of salivary cortisol. Personality traits such as depression, hypomania and suppressed aggression were found to be common characteristics in patients with sleep bruxism. Present findings might support the hypothesis that sleep bruxism and psychological states such as stress may be related, but the cross-sectional nature of this study does not allow us to draw conclusions about the causal relationship between stress, personality traits and sleep bruxism.Uvod/Cilj. Mnoge studije ispitivale su povezanost između stresa, anksioznosti, crta ličnosti i bruksizma, ali su rezultati i dalje kontradiktorni. Cilj ove studije bio je da se ispita da li postoji povezanost između klinički dijagnostikovanog bruksizma koji se javlja tokom spavanja i koncentracije kortizola u salivi koja se smatra jednim od glavnih biomarkera stresa, kao i da se ispitaju psihološki faktori i crte ličnosti osoba sa bruksizmom. Metode. Studija je obuhvatila 23 bolesnika sa bruksizmom i 42 zdrava ispitanika bez znakova bruksizma. Dijagnoza bruksizma uspostavljena je na osnovu spostvene izjave i kliničkog pregleda kao i potvrde partnera. Uzorci jutarnje pljuvačke prikupljani su radi analize kortizola. Bolesnici sa bruksizmom podvrgnuti su psihodijagnostičkom ispitivanju pomoću Minesota multifaznog testa ličnosti - MMPI-202. Rezultati. U grupi bolesnika sa bruksizmom registrovana je značajno veća koncentracija kortizola u pljuvačci u poređenju sa pacijentima bez znakova bruksizma (t = 2.943, p lt 0.01). Psihodijagnostička interpretacija profila ličnosti pokazala je da ispitanike sa bruksizmom karakteriše izbegavanje kontakta sa neprijatnim osećanjima, posebno depresijom i potiskivanje agresivnosti, odnosno izražena autocenzura na otvoreno ispoljavanje ljutnje i besa. Zaključak. Kod bolesnika sa bruksizmom registrovane su povećane koncentracije kortizola u salivi. Psihodijagnostička analiza ukazuje da su depresija, hipomanija i supresija agresije izražene kod bolesnika sa bruksizmom. Nalazi bi mogli da podrže hipotezu povezanosti bruksizma u toku spavanja i stresa, ali priroda ove studije ne dozvoljava izvođenje zaključaka o uzročnoj povezanosti stresa, crta ličnosti i bruksizma u toku spavanja

Analysis of accuracy and precision of optical 3D digitisation devices in dental computer-aided-design and computer-aided-manufacturing systems

The implementation of intraoral and extraoral computer-aided-design and computer-aided-manufacturing (CAD/CAM) systems in prosthetic dentistry has simplified the procedure, shortened the period of design and manufacture and improved accuracy and aesthetic properties of dental restorations. Three-dimensional (3D) digitisation has become an adequate replacement for conventional dental impressions. The market offers a variety of diverse optical intraoral and extraoral CAD/CAM systems equipped with digitisation devices that are based on different working principles. The main goal of this research is to determine whether precision and accuracy differ among optical digitisation devices. The research includes five high-end devices: Cerec AC, Cerec InEos, Trios, KaVo Everest and Sinergia Scan. The evaluation methodology of the experiment is based on CAD inspection. The results, obtained from accuracy and precision measurements with tolerance levels of 0.01, 0.25 and 0.05 mm, indicate that there is a difference in accuracy and precision between optical digitisation devices based on different working principles

Oblikovanje mekih tkiva privremenim zubnim nadoknadama na implantatima - prikaz slučaja

Aesthetic outcome of implant therapy involves the appropriate architecture of peri-implant soft tissue and interdental papilla. The dynamic compression technique of soft tissue is mentioned in contemporary literature as one of the methods for achieving optimal emergence profile. The aim of this case report was to present soft tissue prosthetic modeling with temporary crowns on implants for obtaining an emergence profile of final restoration. A 25-year-old female patient with missing left maxillary central incisor was referred to the Department of Oral Surgery School of Dental Medicine University in Belgrade for dental implant placement. After detailed planning, implant placement of Straumann Bone level implant NC O 3, 3×12 mm (StraumannR Bone Level NC), in the position of 21 was performed. Upon completion of osseointegration period, screw retained laboratory temporary crown was fabricated. During the next 3 months emergence profile was scalloped by creating additional pressure on the soft tissue with periodic adding the composite resin material to a temporary crown. The created emergence profile was transferred to the master cast by using customized impression coping, making possible fabrication of the final implant restoration according to the design made with provisional restoration. Soft tissue conditioning using temporary dental restorations on implants presents a non-invasive method with predictable aesthetic result.Estetski uspeh implantološke terapije podrazumeva odgovarajuću arhitekturu periimplantatnih mekih tkiva i interdentalne papile. Tehnika dinamičke kompresije mekih tkiva pominje se u savremenoj literaturi kao jedna od metoda za postizanje optimalnog izlaznog profila. Cilj ovog rada je bio da se predstavi mogućnost protetičkog modelovanja mekih tkiva zubnom nadoknadom na implantatu za dobijanje izlaznog profila definitivne nadoknade. Žena stara 25 godina sa nedostatkom centralnog sekutića u gornjoj vilici s leve strane upućena je na Kliniku za oralnu hirurgiju Stomatološkog fakulteta Univerziteta u Beogradu radi ugradnje implantata. Posle detaljnog planiranja, u predelu zuba 21 ugrađen je Straumann Bone level implant NC O 3,3×12,0 mm (Straumann® Bone Level NC). Po završenom periodu oseointegracije izrađena je laboratorijska privremena krunica retinirana zavrtnjem. Tokom sledeća tri meseca izlazni profil je oblikovan periodičnim stvaranjem dodatnog pritiska na meka tkiva dodavanjem kompozitnog materijala na privremenu krunicu. Izlazni mekotkivni profil je pomoću individualizovanog transfera pozicije implantata prenet na radni model, što je omogućilo izradu konačne keramičke hibridne krunice prema dizajnu koji je kreiran privremenom nadoknadom. Priprema mekih tkiva privremenim zubnim nadoknadama na implantatima je neinvazivna klinička metoda s predvidljivim estetskim rezultatom i zadovoljavajućom visinom i širinom interdentalne papile

Analgesic efficacy of 0.75% ropivacaine for lower third molar surgery

Introduction: Since there is no data concerning local analgesic efficacy of ropivacaine for lower third molar surgery, the aim of this doubleblind study was to compare local anaesthetic parameters and postoperative analgesic requirements after the use of ropivacaine and bupivacaine for the inferior alveolar nerve block. Materials and Method: 20 healthy patients were equally randomized into the ropivacaine (0.75%, 2 ml) or bupivacaine (0.5%, 2 ml) groups. The onset and duration of anaesthesia (the lower lip numbness and pinprick test) and intensity of anaesthesia (visual analogue and verbal rating scales) were determined. The postoperative pain reports and analgesic requirements were also recorded. Results: There were no significant differences concerning parameters of the achieved anaesthesia. 2 patients in the bupivacaine group felt postoperative pain without the need for pain medication. Conclusion: Ropivacaine is suitable for achieving local anaesthesia in lower third molar surgery, especially when prolonged analgesia is desired