Citotoksični i genotoksični učinak kompozitnih materijala na stanicama ljudskih limfocita in vitro

The aim of this in vitro study was to evaluate cytotoxicity and genotoxicity of six diff erent dental nanocomposite materials, three conventional ones and three fl owable composite resin materials, in human lymphocytes. Th e following materials were tested: Tetric EvoCeram, Tetric Evo-Flow, Filtek Ultimate, Filtek Ultimate Flow, G-aenial and G-aenial Flo. Cytotoxicity was evaluated for two mass concentrations (0.007 g/mL and 0.013 g/mL) of each material, non-cured and cured, after 4 hours and 24 hours. Genotoxicity was evaluated using micronucleus assay under the same conditions as applied during the investigation of cytotoxicity. Uncured forms of Tetric EvoCeram, Tetric EvoFlow and Filtek Ultimate Flow in higher mass concentration caused genotoxic eff ect. Uncured G-aenial Flo in higher mass concentration induced apoptosis and necrosis. Uncured Tetric EvoFlow and uncured Filtek Ultimate Flow in higher mass concentration induced early apoptosis after both test periods. None of the conventional composite resin materials tested showed cytotoxicity except for uncured G-aenial, which induced apoptosis in higher mass concentration in both test periods. In conclusion, under the conditions of this in vitro study, cured conventional composites did not show cytotoxic or genotoxic eff ect, which is important for clinical application of these materials, whereas uncured forms exhibited certain level of cytotoxicity and genotoxicity, mainly because of monomers in their composition.Svrha ovoga istraživanja bila je ispitati in vitro citotoksični i genotoksični učinak šest različitih nanokompozitnih materijala, tri tekuća i tri konvencionalna kompozitna materijala na stanicama ljudskih limfocita. Istraživanje je provedeno na materijalima: Tetric EvoCeram, Tetric EvoFlow, Filtek Ultimate, Filtek Ultimate Flow, G-aenial i G-aenial Flo. Ispitivan je citotoksični učinak dviju masenih koncentracija (0,007 g/mL i 0,013 g/mL) svakog ispitivanog polimeriziranog i nepolimeriziranog materijala nakon 4 sata i 24 sata. Genotoksični učinak je ispitivan primjenom mikronukleus testa u istim uvjetima kao što je učinjeno u ispitivanju citotoksičnog učinka. Nepolimerizirani oblici materijala: Tetric EvoCeram, Tetric EvoFlow i Filtek Ultimate Flow u većoj masenoj koncentraciji pokazali su genotoksični učinak. Nepolimerizirani G-aenial Flo je u većoj masenoj koncentraciji izazvao apoptozu i nekrozu. U oba ispitivana razdoblja nepolimerizirani Tetric EvoFlow i nepolimerizirani Filtek Ultimate Flow su u većoj materijala nije uzrokovao citotoksični učinak osim nepolimeriziranog G-aeniala koji je izazvao apoptozu u većoj masenoj koncentraciji u oba ispitivana razdoblja. Ovo istraživanje provedeno je u in vitro uvjetima. Polimerizirani oblici konvencionalnih kompozitnih materijala nisu pokazali citotoksični i genotoksični učinak koji bi bio važan za kliničku primjenu ovih materijala, dok su nepolimerizirani oblici ukazali na citotoksični i genotoksični učinak uglavnom kao rezultat djelovanja monomera koji se nalaze u sastavu kompozitnih materijala

Bone tissue reparation and regeneration using bioactive material in endodontic surgery – a case report

Posljednjih godina u kliničkoj primjeni dentalnih materijala dogodila se značajna evolucija. Bioaktivni materijali potiču cijeljenje pulpnog i periapikalnog tkiva te ostvaruju interaktivni učinak sa stanicama i tkivima. Iz toga proizlazi široko indikacijsko područje i raznolikost primjene kroz restaurativni i regenerativni rezultat terapije u različitim specijalističkim granama dentalne medicine. U ovom prikazu kliničkog slučaja provedena je apikotomija zuba 21 uz enukleaciju tvorbe, uzimanje uzorka za patohistološku analizu, izradu retrogradnog kaviteta i primjenu bioaktivnog materijala. Retrogradni kavitet je izrađen piezoelektričnim ultrazvučnim nastavkom i zatvoren Biodentinom (Septodont, Saint-Maur-des Fosses, Francuska). Mukoperiostalni režanj je reponiran i zašiven. Radiološki kontrolni pregled proveden je nakon šest mjeseci te nakon godinu dana u svrhu praćenja dinamike cijeljenja koštanog defekta. Cijeljenje lezije uočljivo je već nakon šest mjeseci. Zbog svoje biološke sigurnosti i induktivnoga biološkog učinka te širokoga indikacijskog područja primjene, bioaktivni dentalni materijali fiziološki nadomještaju oštećenu zubnu strukturu, induciraju regeneraciju periapikalnih upalnih lezija te revaskularizaciju i revitalizaciju tkiva.In recent years, a significant evolution has taken place in the clinical application of dental materials. Bioactive materials promote pulpal and periapical tissue healing and induce an interactive effect with cells and tissues. This results in a wide range of indications and a variety of applications through the restorative and regenerative results of therapy in various specialist branches of dental medicine. In this presentation of the clinical case, an apicotomy of tooth 21 was performed with enucleation of the formation, taking a sample for pathohistological analysis, making a retrograde cavity and applying bioactive material. The retrograde cavity was created with a piezoelectric ultrasound attachment and closed with Biodentin (Septodont, Saint-Maur-des Fosses, France). The mucoperiosteal flap was repositioned and sutured. A radiological control examination was carried out after six months and after one year in order to monitor the dynamics of bone defect healing. The healing of the lesion was already noticeable after six months. Due to their biological safety, inductive biological effect, and wide indication area of application, bioactive dental materials physiologically replace the damaged tooth structure, induce regeneration of periapical inflammatory lesions and tissue revascularization and revitalization

A measurement of irradiance of light-curing units in dental offices in three Croatian cities

Aim To determine irradiance of light-curing units (LCUs) in dental offices in three Croatian cities and to compare irradiance values with the age and model of LCUs. Methods Private and public dental offices in three most prominent cities in Croatia (Rijeka, Split and Zagreb) were included in this study. In total, 195 LCUs were tested, using radiometer Ivoclar Bluephase Meter 2 for irradiance (mW/cm2 ). The minimum acceptable value was set at 400 mW/cm2 . The age, model and difference between declared and measured irradiance of the LCUs were also determined. Of the total of 195 LCUs, 190 (98%) were LED (light-emitting diode) and 5 (2%) were QTH (quartz-tungsten – halogen). Results The mean age of tested LCUs was 4.43±3.4 years; the oldest was in Rijeka, 5.2±3.8 years. The overall mean irradiance for all three cities was 806.4 mW/cm2 (p=0.0004). Of all LCUs, 11.3% were considered clinically unacceptable with irradiance of less than 400 mW/cm2 . Of all tested LCUs 42% (p=0.0005) had a 30% lower value of irradiance than the manufacturer of the LCU declared. In 73% tested LCUs, there was a matching between measured and declared irradiance. The age and model of LCUs had the most significant impact on irradiance. Conclusion The most commonly used LCU included in dental offices was LED. Mean irradiance was good enough to secure adequate polymerization of resin-based materials. Irradiance decreases with usage time of LCU

Knowledge and Use of Caries Risk Assessment for Adult Patients Croatian Dentists

Svrha rada: Svrha istraživanja bila je evaluirati upotrebu procjene rizika za nastanak karijesa (PRK)kod hrvatskih općih stomatologa i procijeniti njihovo znanje i stajališta o PRK-u. Materijal i postupci: Poveznica za on-line upitnik poslana je na e-adrese 1500 stomatologa u Hrvatskoj. Dobiveni podatcianalizirani su s pomoću deskriptivne statistike, logističke regresije i Chi-kvradrat testa. Rezultati: Od257 ispitanika njih 47 % obavlja PRK rutinski, a samo se 4,5 % pritom koristi specifičnim formularima.Među ispitanicima znatno je varirala važnost različitih čimbenika pri pripremi plana terapije. Nadalje,77 % ispitanika temeljilo je individualnu prevenciju (IPK) karijesa na PRK-u. Veza između PRK i IPK tePRK i plana terapije bila je statistički značajna (p = 0,001). Praktičari koji primjenjuju PRK češće pla-niraju terapiju i provode IPK prema PRK-u. Na uporabu PRK-a nisu utjecali ni specijalizacija, ni iskustvo stomatologa. Zaključci: Velikom dijelu (53 %) hrvatskih općih stomatologa PRK nije dio rutinskeprakse i postoji značajna povezanost između njegove primjene i planiranja terapije te IPK. Potrebno je promicati uporabu PRK-a u svakodnevnoj dentalnoj praksi u Hrvatskoj.Objective: The aim of this study was to evaluate the usage of caries risk assessment (CRA) by Croatian general practitioners and evaluate their knowledge and attitudes towards CRA. Material and methods: A link to an online questionnaire was sent via e-mail to a sample of 1,500 general dentists in Croatia. The obtained data were analyzed using descriptive statistics, logistic regression analyses and chi-square tests. Results: Of 257 respondents, 47% performed CRA routinely, but only 4.5% of them used a specific CRA form. The significance of different actors in the development of a treat-ment plan varied considerably among respondents. Furthermore, in 77% of the respondents CRA was a basis for planning individual caries prevention (ICP). The association between CRA and ICP, and be-tween CRA and treatment planning was statistically significant (p=0.001). The practitioners doing CRA more often plan their treatment and ICP according to CRA. The use of CRA was not influenced by specialty and dentists’ experience. Conclusions: In a considerable percentage (53%) of Croatian general dentists, CRA is not part of their routine practice, and there is a strong association between the use of CRA and treatment plans and ICP. There is a need to promote the use of CRA in daily dental practice in Croatia

Mechanical Properties of High Viscosity Glass Ionomer and Glass Hybrid Restorative Materials

Svrha rada: Željela su se odrediti mehanička svojstva hibridnih i visokoviskoznih staklenoionomernih cemenata. Mjerila se tlačna čvrstoća i tvrdoća triju staklenoionomernoh cemenata (SIC-ova) – Ketac™ Universal Aplicap™, EQUIA Fil® i EQUIA FORTE Fil® te je obavljena SEM analiza uzoraka. Materijali i metode: Uzorci za mjerenje tlačne čvrstoće pripremljeni su s pomoću silikonskih kalupa dimenzija 6 mm u visinu i 4 mm u širinu te su pet dana bili pohranjeni u deioniziranoj vodi, a uzorci za mjerenje tvrdoće pripremljeni su s pomoću teflonskih kalupa dimenzija 2 mm u visinu i 5 mm u širinu i zatim pohranjeni 25 dana u vodi na temperaturi od 37 stupnjeva. Reprezentativni uzorak svakog materijala podvrgnut je SEM ikroskopiji. Za usporedbu dobivenih vrijednosti korišten je ANOVA-test, a za višestruku usporedbu Tukeyev test. Rezultati: Nema značajnije razlike između tlačne čvrstoće triju ispitivanih materijala (p < 0,05), a dobivene vrijednosti tvrdoće iznosile su: Ketac™ Universal Aplicap™ – 157 HV0,2, EQUIA Fil® – 47 HV0,2 i EQUIA FORTE Fil® – 39 HV0,2. Zaključak: Promatrajući dobivene rezultate tvrdoće uočavaju se značajno veće vrijednosti za materijal Ketac™ Universal Aplicap™. SEM analiza uzoraka nije otkrila značajnije razlike u strukturi ispitivanih materijala EQUIA FORTE Fil® , EQUIA Fil® i Ketac™ Univesal Aplicap™.Objectives: to determine the mechanical properties of hybrid and high-viscosity glass ionomer cements. Compressive strength and hardness of three glass ionomer cements (GIC) were measured: Ketac ™ Universal Aplicap ™, EQUIA Fil® and EQUIA FORTE Fil®, and the SEM sample analysis were performed. Material and Methods: The samples for measuring the compressive strength were prepared using silicone molds with standard dimensions of 6 mm x 4 mm and stored in deionized water for five days, while the samples for hardness measurement were prepared using Teflon molds with a cylindrical opening in the middle, dimensions 2 mm in height and 5 mm in width. For each material, one sample was made (n = 1) and stored in deionized water at 37ºC for 25 days. A representative sample of each material was analyzed using SEM. For the comparison of obtained values, the ANOVA test was used, while Tukey test was used for the multiple comparison. Results: There were no significant differences between the compressive strength of the three tested materials (p <0.05). The hardness values were: 157 HV0,2 for Ketac ™ Universal Aplicap ™ , 47 HV0,2 for EQUIA Fil® and 39 HV0,2 for EQUIA FORTE Fil®, respectively, and were significantly different, implying that Ketac ™ Universal Aplicap ™ has much higher hardness values than the other materials tested. SEM sample analysis revealed similar fracture modes of the tested materials. Conclusion: It was concluded that there were no statistically significant differences in compressive strength and fracture modes between the tested materials, while Ketac ™ Universal Aplicap ™ hardness results were significantly higher than the ones measured for EQUIA Fil® and EQUIA FORTE Fil®

Fluoride Release from Glass Ionomer with Nano Filled Coat and Varnish

Svrha rada: Ovo istraživanje in vitro uspoređuje otpuštanje fluora iz mikrolaminiranog staklenog ionomera temeljenog na stakleno-hibridnoj tehnologiji premazanog dvama različitim premazima. Materijali i postupci: Ukupno 18 uzoraka podijeljeno je u skupine po šest uzoraka: (1) stakleni ionomer Equia Forte Fil premazan Equia Forte Coatom (Equia + EC), (2) stakleni ionomer Equia Forte Fil premazan GC Fuji Varnishem (Equia + VC) i (3) nepremazani stakleni ionomer Equia Forte (EQUIA kont). Otpuštanje fluora mjereno je fluor-selektivnom elektrodom (ORION EA 940) nakon 24 sata, 4 dana, 30 dana i 64 dana. ANOVA, Tukeyjev test multiplih usporedbi i paired t-test korišteni su u testiranju razlika među skupinama. Rezultati: Statistički značajne bile su razlike među skupinama i četirima točkama u vremenu (ANOVA, p < 0,0001). Kumulativno otpuštanje iona fluora nakon 64 dana bilo je redom 66,01 mg/l, 123,54 mg/l i 203,22 mg/l za EQUIA + EC, EQUIA + VC i EQUIA kont. Sve su razlike bile statistički značajno različite, osim one između EQUIA + VC i EQUIA kont. nakon 24 sata. Zaključci: Količina otpuštenog fluora bila je značajno manja u uzorcima premazanima nanopunjenim premazom u usporedbi s onima premazanima varnishem i bez premaza.Objective: This in vitro study compares the fluoride release from microlaminated glass ionomer based on glass hybrid technology coated with two different surface coating agents. Materials and Methods: A total of 18 samples were divided into three groups of six samples each: (1) glass ionomer Equia Forte Fil coated with Equia Forte Coat (Equia+EC), (2) glass ionomer Equia Forte Fil coated with GC Fuji Varnish (Equia+VC) and (3) uncoated glass ionomer Equia Forte (EQUIA cont). Fluoride release was measured using an ion-selective electrode (ORION EA 940) after 24 hours, 4 days, 30 days and 64 days. Repeated measures ANOVA, multiple comparisons, Tukey’s test and paired t-test were used to test the differences between the groups. Results: The differences between the groups and four time points were statistically significant (ANOVA, p<0.0001). Cumulative fluoride ion release after 64 days was 66.01 mg/l, 123.54mg/l and 203.22 mg/l for EQUIA+EC, EQUIA+VC and EQUIA cont, respectively. All the differences were statistically significant except the difference between EQUIA+VC and EQUIA cont after 24 hours. Conclusions: The amount of released fluoride was significantly lower in the samples coated with nanofilled surface coating agent compared to the samples coated with varnish and uncoated samples

Procjena oštećenja endodontskih instrumenata vizualno i optičkim pomagalima

Objectives: To determine the accuracy of visual damage evaluation of rotating and reciprocal endodontic instruments with the naked eye and optical devices. Material and methods: Four examiners were involved, divided into two age groups: I. 20-30 years, n = 2, II. 40-50 years, n = 2. They visually assessed the existence of damage to rotating or reciprocal endodontic instruments by their naked eye and with two types of optical aids. A total of 239 instruments from different manufacturers were evaluated by each examiner. Before damage estimation, each examiner calibrated the eye on a new instrument. Sensitivity of the detection method was calculated as by the naked eye. When an instrument was detected as damaged by the naked eye, the damage assessment was stopped and the instrument was considered to be damaged by the other two methods, as well. Results: Damage was found in 178 instruments. Sensitivity of the naked eye was calculated to be 49.7%, for the loupe 66.2% and for the operating microscope 76.5%. The three methods of damage assessment had significant differences (p < 0.05) in sensitivity. Conclusion: It was concluded that there is a significant difference between age groups in estimating instrument damage. Also, it was noted that the damage assessment with the naked eye and optical aids were different. Finally, in terms of ease of damage recognition, significant differences between the types of engine-driven endodontic instruments were found. However, no type of instrument was more prone to damage than any other type of instrument.Cilj istraživanja: Odrediti preciznost vizualne procjene oštećenja rotirajućih i recipročnih endodontskih instrumenata vizualno i optičkim pomagalima. Materijal i postupci: Istraživanje su provela četiri ispitivača podijeljena u dvije dobne skupine: 1. skupina od 20 do 30 godina - n = 2 i 2. skupina od 40 do 50 godina - n = 2. Vizualno su procijenili postoje li oštećenja rotirajućih ili recipročnih endodontskih instrumenata samo okom i dvjema vrstama optičkih pomagala. Svaki ispitivač pregledao je ukupno 239 instrumenata različitih proizvođača. Svi su kalibrirali oko na novom instrumentu prije procjene oštećenja. Osjetljivost metode procjene obavljena je golim okom. Kada je instrument okom procijenjen kao oštećen, procjena je prekinuta te se instrument i dvjema drugim metodama procjene smatrao oštećenim. Rezultati: Pronađeno je oštećenje na 178 instrumenata. Osjetljivost procjene oštećenja okom iznosi 49,7 %, za povećala 66,2 %, a za operacijski mikroskop 76,5 %. Trima metodama procjene oštećenja dobivene su značajne razlike u osjetljivosti (p < 0,05). Zaključak: Zaključeno je da postoji značajna razlika između dobnih skupina u procjeni oštećenja instrumenta. Također je uočeno da se razlikuje procjena oštećenja samo okom i optičkim pomagalima. Konačno, kad je riječ o lakoći prepoznavanja oštećenja, pronađene su značajne razlike između različitih strojnih endodontskih instrumenata. No ni jedna vrsta instrumenta nije bila sklonija oštećenjima od drugih

Compressive Strength of New Glass Ionomer Cement Technology based Restorative Materials after Thermocycling and Cyclic Loading

Svrha rada: Željela se usporediti, nakon cikličkog opterećenja i termocikliranja, kompresijska (tlačna) čvrstoća dvaju materijala temeljenih na staklenim ionomerima sa svjetlosno polimerizirajućim nanopunjenim premazom ili bez njega. Materijali i metode: Kako bi se odredila kompresijska čvrstoća novih restaurativnih materijala tijekom duljeg razdoblja, analizirani su nakon simulacije mastikatornog opterećenja cikličkim opterećenjem i termalnih oscilacija u usnoj šupljini termocikliranjem. Četiri skupine uzoraka (n = 7) – (1) Equia Fil (GC, Tokio, Japan) bez premaza, (2) Equia Fil premazan Equia Coatom (GC, Tokio, Japan), (3) Equia Forte Fil (GC, Tokio, Japan) bez premaza i (4) Equia Forte Fil premazan Equia Forte coatom (GC, Tokio, Japan) – podvrgnuti su cikličkom opterećenju (240 000 ciklusa) u žvačnom simulatoru (MOD, Esetron Smart Robotechnologies, Ankara, Turska). Rezultati: Mjerenja kompresijske čvrstoće provedena su prema standardima ISO 9917-1:2007. na univerzalnom uređaju za mjerenja mehaničkih svojstava (Instron, Lloyd, UK). Analiza Scanning elektronskim mikroskopom (SEM) obavljena je nakon termocikliranja. Nije bilo statistički značajne razlike između materijala Equia Fil i Equia Forte Fil, neovisno o premazu (p < 0,05), ali je zabilježen trend povećanja kompresijske čvrstoće na premazanim uzorcima. Zaključak: Premaz povećava kompresijsku čvrstoću Equia Fila i Equia Forte Fila, ali ne značajno.Objective: The objective of the study was to compare compressive strengths of two glass ionomerbased materials, with and without a light-cured, nano-filled coating, after cyclic loading and thermocycling. Materials and methods: To determine compressive strength of new restorative materials over a longer period of time, materials were analysed under simulated conditions where cyclic loading replicated masticatory loading and thermocycling simulated thermal oscillations in the oral cavity. Four groups of samples (n=7)—(1) Equia Fil (GC, Tokyo, Japan) uncoated; (2) Equia Fil coated with Equia Coat (GC, Tokyo, Japan); (3) Equia Forte Fil (GC, Tokyo, Japan) uncoated; and (4) Equia Forte Fil coated with Equia Forte coat (GC, Tokyo, Japan)—were subjected to cyclic loading (240,000 cycles) using a chewing simulator (MOD, Esetron Smart Robotechnologies, Ankara, Turkey). Results: Compressive strength measurements were performed according to ISO 9917-1:2007, using the universal mechanical testing machine (Instron, Lloyd, UK). Scanning electron microscope (SEM) analysis was performed after thermocycling. There were no statistically significant differences between Equia Fil and Equia Forte Fil irrespective of the coating (p<0.05), but a trend of increasing compressive strength in the coated samples was observed. Conclusions: Coating increases the compressive strength of Equia Fil and Equia Forte Fil, but not significantly