The therapeutic effects of occlusal equilibration in patients with craniomandibular disorders

In order to evaluate the role of occlusal factors in the etiology of CMD two groups of participants were selected for this investigation according to the value of the craniomandibular index ( CMI), Fricton and Schiffman 1975. The control group consisted of 17 participants, both male and female between 18 and 25 years of age with the preserved natural dentition, no indices of orthodontic treatment and with the value of the CMI = 0. The experimental group consisted of 15 participants, male and female, between 18 and 25 years of age with preserved natural dentition, no indices of orthodontic treatmen, but with evident signs and symptoms of CM disorders the CMI >0). The chosen participants of the control and experimental group were subject to detailed occlusal analysis which included the number of occlusal contacts in the ICP, RCP,the type of lateral guidance of the mandible and the presence of occlusal interferences during mandibular movements. Using selective grinding the occlusal interferences were eliminated in participants of the experimetal group. The CMI was calculated in this group after selective grinding. The results of the occlusal analysis in this study point to the signifficantly greater number of mediotrusive, retrusive and protrusive interferences in participants of the experimental group The values of CMI before ( CMI I) and after selective grinding (CMI II) in the experimental group confirm the assumption that occlusal interferences play a significant role in the etiology of CMD

Inlej retineri kao nosači tela mosta u bočnom segmentu - prikaz slučaja

Inlay retained adhesive restorations are an interesting alternative to conventional methods when a single tooth is missing. The aim of this paper was to present possibilities for the application of inlay retained adhesive prosthodontic restorations based on composite systems. The clinical procedure is minimally invasive and simple to conduct. The introduction of fiber-reinforced composites as well as the improvement of adhesive cementing techniques makes these restorations a long-term solution with good esthetic and functional results. This case report offers an insight into the clinical procedure during the preparation of inlay retained adhesive restorations.Inlej retinirane adhezivne nadoknade predstavljaju interesantnu alternativu konvencionalnim metodama, u slučaju nedostatka pojedinačnog zuba. Cilj ovog rada je bio da ukaže na mogućnosti primene inlay retiniranih adhezivnih protetskih nadoknada baziranih na kompozitnim sistemima. Klinička procedura je minimalno invazivna, i jednostavna za izvođenje. Uvođenje vlaknima-ojačanih kompozita, kao i poboljšanje adhezivnih tehnika cementiranja čine ove restauracije dugotrajnim rešenjem, sa dobrim estetskim i funkcionalnim rezultatima. Ovaj prikaz slučaja iz prakse daje uvid u kliničke postupke tokom izrade inlej retiniranih adhezivnih nadoknada

Kinematska analiza graničnih kretnji donje vilice u osoba sa kraniomandibularnim disfunkcijama

Disturbances in mandibular kinematics are supposed to be one of the main signs of craniomandibular disorders (CMD). In that regard, recordings of mandibular border movements may offer valuable data in assessing functional efficiency of the OF complex, as well as in diagnosing CM disorders. The electronic pantograph Arcus Digma (Kavo EWL GmBH, Leutkirch, Germany) was used in this study to record and evaluate the trajectories of the interincisal point in three planes during mandibular protrusion laterotrusion and mouth opening. Two groups of volunteers between 18 and 26 years of age were established for this investigation: one consisting of persons with signs (symptoms) of CMD and the other of persons without such signs and symptoms. The results of this study point out the significant differences in the length and shape of interincisal point tracings in the horisontal plane, as well as in angulation of laterotrusive tracings between the examined groups. The reduced mandibular opening was established in 17% of females and 13% of males in the group presenting the signs (symptoms) of CMD.Poremećena kinematika donje vilice jedan je od osnovnih znakova kraniomandibularnih disfunkcija (CMD). Registrovanje graničnih kretnji donje vilice može dati dragocene podatke za procenu funkcionalne efikasnosti orofacijalnog kompleksa kao i za dijagnostiku CMD-a. U ovoj studiji je korišćen elektronski pantograf Arkus Digma (Kavo EWL. GmBH, Leutkirch Germany) za registraciju i evaluaciju trajektorija interincizalne tačke u tri ravni pri protruziji, laterotruziji mandibule i pri otvaranju (zatvaranju) usta. U istraživanju su obradjene dve grupe dobrovoljaca izmedju 18 i 26 godina starosti. Jednu su činile osobe sa prisutnim znacima (simptomima) CMD-a, a drugu osobe bez takvih znakova (simptoma). Rezultati ove studije pokazuju signifikantne razlike u dužini i obliku trajektorija interincizalne tačke u horizontalnoj ravni kao i u angulaciji laterotruzijskih trajektorija izmedju ispitivanih grupa. Smanjen dijapazon maksimalnog otvaranja usta je utvrdjen kod 17% žena i 13% muškaraca u grupi sa prisutnim znacima (simptomima) CMD-a

Uloga okluzije u nastanku temporomandibularnih disfunkcija

Introduction. The influence of occlusal condition at the onset of temporomandibular disorders (TMD) has been strongly debated for many years and still is the source of controversy. Up to the eighties in the last century, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position and retruded contact position greater than two millimeters, retrusive and nonworking side interferences and loss of posterior teeth were considered to be the primary causes of TMD. Objective. The aim of this study was to estimate the role of occlusal factor in the etiology of craniomandibular dysfunction and therapeutic effects of irreversible occlusal therapy (occlusal equilibration) in patients with TMD. Methods. In the investigation we studied a group of 200 men and women. The average age of the selected patients was between18 and 25 years. The purpose of TMD signs and symptoms was confirmed in every patient using a special functional analysis and evaluating the craniomandibular index (CMI) according to Fricton and Schiffman. The value of craniomandibular index was determined in the group of 15 patients with signs and symptoms of temporomandibular dysfunction. In the study groups occlusal equilibration (selective grinding) was performed according to Okeson using the central position of the mandible as the referent position in the occlusal therapy. The value of CMI was determined before and 30 days after occlusal equilibration. Results. The results of this study confirmed the significant reduction in the signs and symptoms of TMD after occlusal equilibration. The statistical elaboration of the differences between the values of CMI I (before treatment) and CMI II (30 days after treatment) revealed highly significant differences. The CMI I values in the group ranged between 0.076 and 0.346 with the mean value of 0.188±0.082.The values of CMI II ranged between 0.038 and 0.19 with the mean value of 0.038±0.053. Conclusion. The study conformed the validity of irreversible occlusal therapy (selective grinding) in patients with TMD.Uvod. Uloga okluzivnih disharmonija u nastanku temporo-mandibularnih disfunkcija (TMD) i dalje je pitanje u stručnoj literaturi i kliničkoj praksi koje ostaje bez odgovora. Do osamdesetih godina dvadesetog veka okluzivni faktori, kao što su određene malokluzije, razlike između retrudovanog kontaktnog položaja i interkuspalnog položaja veće od 2 mm, okluzivne smetnje (posebno mediotruzijske i retruzijske) i gubitak bočnih zuba, smatrali su se glavnim etiološkim faktorima u nastanku TMD. Cilj rada. Cilj rada je bio da se utvrdi uloga okluzivnih faktora u razvoju TMD i oceni uspeh primene ireverzibilne okluzivne terapije (selektivno brušenje) kod osoba sa TMD. Metode rada. U svrhu istraživanja pregledano je 200 osoba oba pola uzrasta 18-25 godina. Znaci i simptomi TMD su vrednovani na osnovu posebne funkcionalne analize i izraženi kraniomandibularnim indeksom (CMI) po Friktonu (Fricton) i Šifmanu (Schiffman). Na osnovu ovoga indeksa formirana je studijska grupa koju je činilo 15 ispitanika sa znacima i simptomima TMD. Kod njih je urađeno selektivno uklanjanje okluzivnih smetnji brušenjem prema metodi Oksona (Okeson) korišćenjem centralnog položaja kao referentnog položaja tokom okluzivne terapije. Vrednovanje CMI je ponovljeno trideset dana nakon okluzivnog uravnoteženja. Rezultati. Rezultati istraživanja su pokazali značajno smanjenje znakova i simptoma TMD posle okluzivnog uravnoteženja. Statističkom analizom je utvrđeno da između vrednosti CMI pre lečenja (CMI I) i trideset dana kanije (CMI II) postoji statistički značajna razlika. Vrednost CMI I bila je između 0,076 i 0,0346, dok je srednja vrednost bila 0,188±0,082. Vrednost CMI II bila je između 0,038 i 0,19, a srednja vrednost 0,038±0,053. Zaključak. Ova studija je potvrdila značaj ireverzibilne okluzivne terapije (selektivno brušenje) kod osoba sa TMD

Rendgenkraniometrijska evaluacija kraniofacijalnih dimenzija kod osoba sa simptomima temporomandibularnih disfunkcija

Background/aim: The aim of this study was to evaluate the possible association between certain morphologic features of the craniofacial skeleton and the presence of symptoms of temporomandibular disorders in young subjects with natural dentitions. Methods. The investigation was carried out on 80 lateral cephalometric radiographs of two groups of male and female subjects between 18 and 25 years of age with natural dentitions. The analysed group consisted of 30 subjects with symptoms of temporomandibular disorders, and the control group of 50 subjects without such symptoms. According to the values of the ANB angle (position of the maxilla with the mandible- Steiner cephalometric analysis) all subjects were classified in the skeletal class 1. The roentgen craniometric analysis of cephalometric radiographs included the evaluation of 25 linear dimensions which values were compared between the examined groups and with the values of the same dimensions in the Bolton standards for 18 years of age. Results. The results of this study confirmed the presence of significant differences between the examined linear dimensions in the Bolton standards and the same dimensions measured in the subjects of the analyzed and the control group. The comparative analysis of these values between the groups confirmed the presence of significant differences in following linear dimensions at the level of p lt 0,00: S - Cs(Go), Mol - PP, Mol - MP and Ar - Go. Conclusion. Significant differences between the examined linear dimensions measured in the subjects included in this study and the same dimensions in the Bolton standards can be explained by specific morphologic features of the craniofacial skeleton in people of our population. Within the limitation of this study, the minor differences in the values of the examined linear variables between the subjects of the experimental and the control group can not be accepted as indicators of disturbed function of the orofacial system.Uvod/cilj: Ovo istraživanje je sprovedeno sa ciljem da se utvrdi eventualna veza između određenih morfoloških karakteristika kraniofacijalnog skeleta i prisutnih simptoma temporomandibularnih disfunkcija (TMD) kod mladih osoba sa prirodnom denticijom. Metode. Istraživanja su obavljena na 80 profilnih teleradiografskih snimaka načinjenih kod dve grupe ispitanika muškog i ženskog pola, starosti između 18 i 25 godina sa očuvanim prirodnim zubalom. Analiziranu grupu činilo je 30 ispitanika sa simptomima temporomandibularnih poremećaja, a kontrolnu 50 ispitanika bez takvih simptoma. Prema vrednostima ugla ANB (položaj maksile u odnosu na madibulu-Steinerova kefalometrijska analiza) svi ispitanici su klasifikovani u skeletnu klasu I. Rendgenkraniometrijska analiza obavljena na svakoj profilnoj teleradiografiji obuhvatila je vrednovanje 25 linearnih dimenzija čije su vrednosti upoređivane između ispitivanih grupa, kao i sa vrednostima istih dimenzija u Boltonovim standardima za uzrast od 18 godina. Rezultati. Rezultati ove studije ukazali su na značajne razlike između ispitivanih linearnih dimenzija prema Boltonovim standardima i istih vrednosti izmerenih u eksperimentalnoj i u kontrolnoj grupi. Uporedna analiza ovih vrednosti između ispitivanih grupa pokazala je da statistički značajne razlike postoje u sledećim dimenzijama na nivou verovatnoće od p lt 0,001: S-Cs(Go), Mol-PP, Mol- MP i Ar-Go. Zaključak. Značajne razlike između ispitivanih linearnih dimenzija izmerenih kod ispitanika uključenih u ovu studiju i istih dimenzija u Boltonovim standardima verovatno su vezane za specifičnosti kraniofacijalnog skeleta kod naše populacije. Imajući u vidu specifičnosti ove studije, neznatne razlike u vrednostima ispitivanih linearnih varijabli između ispitanika analizirane i kontrolne grupe ne mogu se smatrati indikatorima poremećene funkcije orofacijalnog sistema

Analiza sagitalne kondilne putanje kod ispitanika sa temporomandibularnim disfunkcijama

Bacground/Aim. Disturbances of mandibular border movements is considered to be one of the major signs of temporomandibular disorders (TMD). The purpose of this study was to evaluate the possible association between disturbances of mandibular border movements and the presence of symptoms of TMD in the young. Methods. This study included two groups of volunteers between 18 and 26 years of age. The study group included 30 examiners with signs (symptoms) of TMD, and the control group also included 30 persons without any signs (symptoms) of TMD. The presence of TMD was confirmed according to the craniomandibular index (Helkimo). The functional analysis of mandibular movements was performed in each subject using the computer pantograph. Results. The results of this study did not confirm any significant differences between the values of the condylar variables/sagittal condylar inclination, length of the sagital condylar guidance, in the control and in the study group. Conclusion. The study did not confirm significant differences in the length and inclination of the protrusive condylar guidance, as well as in the values of the sagital condylar inclination between the subjects with the signs and symptoms of TMD and the normal asymptomatic subjects.Uvod/Cilj. Poremećena pokretljivost donje vilice jedan je od osnovnih znakova temporomandibularnih disfunkcija (TMD). Cilj ovog istraživanja bio je da se utvrdi eventualna veza između poremećene pokretljivosti donje vilice i prisutnih simptoma TMD kod mladih. Metode. Ovo istraživanje obuhvatilo je dve grupe ispitanika starosti od 18 do 25 godina. Studijsku grupu činilo je 30 ispitanika sa znacima i simptomima TMD, dok je kontrolnu grupu činilo 30 ispitanika bez znakova i simptoma TMD. Prisustvo TMD potvrđeno je uz pomoć kraniomandibularnog indeksa (Helkimo). Funkcionalna analiza kretnji donje vilice urađena je uz pomoć kompjuterskog pantografa. Rezultati. Našim ispitivanjem nije ustanovljena značajna razlika u vrednosti nagiba i dužine sagitalne kondilne putanje, između ispitanika kontrolne i studijske grupe. Zaključak. U ovom istraživanju nisu utvrđene statistički značajne razlike u dužini i inklinaciji protruzione putanje kondila, kao i vrednosti sagitalne kondilne putanje između ispitanika kod kojih postoje znaci i simptomi TMD i ispitanika bez znakova i simptoma TMD

Povezanost okluzalnih disharmonija i simptoma temporomandibularnih disfunkcija

Introduction: The influence of occlusal condition on the onset of temporomandibular disorder (TMD) has been strongly debated for many years and is still the source of controversy. Until 1980s, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position (ICP) and retruded contact position (RCP) greater than two millimeters, occlusal abnormality, particularly mediotrusion and retrusion, and loss of posterior teeth were considered the primary causes of TMD. Objective: The objective of our study was to find correlation of occlusion disharmonies (difference between ICP and RCP) and present sings and symptoms of TMD. Method: The study involved 60 subjects between 18 and 26 years of age who were divided in two groups. The study group consisted of 30 subjects between 18 and 26 years of age with sings and symptoms of temporomandibular disorders (TMD). TMD was confirmed according to Helkimo index. An average value of Helkimo index in this group was 1. The control group included 30 subjects between 20 and 25 years of age without TMD sings and symptoms. An average value of Helkimo index in this group was 0. The function analysis of cinematic centers position in RCP and ICP was performed in each subject using the computer pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany). Results: The results of our study showed that the translation tracing of cinematic points from RCP to ICP was significantly different in TMD subjects and asymptomatic group (p>0.16). In addition, the study revealed that 53.4 % of subjects with sings and symptoms of temporomandibular disorders had marked translation in the lower temporomandibular joint (0.61-1.2 mm) what directed to intracapsular disorders. Conclusion: The results of our study suggested significant difference of RCP and ICP between subjects with sings and symptoms of the temporomandibular disorders and subjects without sings and symptoms.Uvod: Uloga okluzalnih disharmonija u etiologiji temporomandibularnih disfunkcija (TMD) još uvek je kontroverzno pitanje u stručnoj literaturi i kliničkoj praksi. Do osamdeseti h godina prošlog veka smatralo se da su etiološki faktori presudni za nastanak TMD: okluzalni faktori (poput određenih malokluzija), razlike između retrudovanog kontaktnog položaja (RKP) i interkuspalnog položaja (IKP) veće od 2 mm, postojanje okluzalnih smetnji (naročito mediotruzijskih i retruzijskih), kao i gubitak bočnih zuba. Cilj rada: Cilj rada bilo je utvrđivanje veze između okluzalnih disharmonija (razlika između RKP i IKP) i prisutnih znakova (simptoma) TMD. Metod rada: Istraživanjem je obuhvaćeno 60 ispitanika oba pola, starosti od 18 do 26 godina, podeljenih u dve grupe. Studijsku grupu činilo je 30 ispitanika očuvane prirodne okluzije, sa utvrđenim određenim znacima (simptomima) TMD (indeks disfunkcije po Helkimu bio je veći od 1). Kontrolnu grupu činilo je 30 ispitanika očuvane prirodne okluzije, bez registrovanih znakova (simptoma) TMD (indeks disfunkcije po Helkimu bio je jednak 0). Funkcionalna analiza pozicije kinematskih centara u RKP i IKP (EPA te st) vršena je pomoću kompjuterskog pantografa "arkus digma" (proizvođača KaVo EWL GmbH, Lojtkirh, Nemačka). Rezultati: Rezultati su pokazali da je translat orno pomeranje kinematskog cent ra rotacije na relaciji RKP-IKP (mereno na nivou zgloba) signifikantno veće kod ispitanika sa simptomima TMD (p>0,16). Izrazit translatorni pomak u donjem zglobnom prostoru (0,61−1,2 mm) imalo je 53,4% ispitanika iz ove grupe, što upućuje na prisustvo intrakapsularnih poremećaja. Zaključak: Ustanovljeno je postojanje signifikantnih razlika između RKP i IKP kod ispitanika sa znacima i simptomima temporomandibularnih disfunkcija i ispitanika bez ovih znakova

Ispitivanje kapaciteta konvencionalne i digitalne radiografije za utvrđivanje razlika kod materijala na radiogramu zavisno od prisutnog kontrastnog sredstva

Bacground/Aim. The radiopacity of an endodontic material can considerably vary as measured on film and a digital sensor. Digital radiography offers numerous advantages over convential film-based radiography in dental clinical practice regarding both diagnostic capabilities and postintervention procedures. The aim of this study was to investigate the capacity of conventional and charge-conpled device (CCD) based digital radiography to detect material on radiograph depending on the radio-pacifying agent present in the material. Methods. Experimental cements were formulated by mixing Portland cement with the following radiopacifying agents: zinc oxide (ZnO), zirconium oxide (ZrO2), titanium dioxide (TiO2), barium sulphate (BaSO4), iodoform (CHI3), bismuth oxide (Bi2O3) and ytterbium trifluoride (YbF3). In addition, 5 endodontic materials comprising Endomethasone®, Diaket®, N2®, Roth 801® and Acroseal® were investigated to serve as control. Per three specimens of each material were radiographed alongside an aluminum step wedge on film (Eastman Kodak Company®, Rochester, NY) and a CCD-based digital sensor (Trophy Radiologie®, Cedex, France). Radiopacity values were calculated by converting the radiographic densities of the specimens expressed as a mean optical densities or mean grey scale values into equivalent thickness of aluminum. Results. Twoway ANOVA detected no significant differences with respect to the imaging system (p > 0.05), but the differences were significant with respect to radiopacifier (p lt 0.001) and the interaction of the two factors (p lt 0.05). Paired ttest revealed significant differences between the methods used for pure Portland cement, all concentrations of BaSO4 and CHI3, 10% and 20% additions of ZrO2 and Bi2O3 and 10% and 30% addition of YbF3 (p lt 0.05). Conclusion. The materials which incorporate CHI3 or BaSO4 as radiopacifying agents are expected to be significantly more radiopaque on a digital sensor than on film. During clinical practice one should concern to the quality of contrast assessement obtained by digital according to conventional radiography.Uvod/Cilj. Radiokontrastnost jednog endodontskog materijala može znatno varirati u zavisnosti od toga da li je određivano na filmu ili digitalnim senzorom. Digitalna radiografija pruža mnogobrojne prednosti u odnosu na konvencionalnu radiografiju u svakodnevnoj stomatološkoj kliničkoj praksi, kako u pogledu dijagnostičkih mogućnosti, tako i u praćenju rezultata lečenja. Cilj ove studije bio je da se ispitaju mogućnost i konvencionalne i charge-conpled device (CCD) digitalne radiografije za vizualizaciju materijala na radiogramu u zavisnosti od kontrastnog sredstva prisutnog u materijalu. Metode. Eksperimentalni cementi su pripremljeni dodavanjem sledećih kontrastnih sredstava u Portland cement: cink-oksid (ZnO), cirkonijum-oksid (ZrO2), titanijum-dioksid (TiO2), barijum-sulfat (BaSO4), jodoform (CHI3), bizmut-oksid (Bi2O3) i iterbijum-trifluorid (YbF3). Takođe, ispitivano je pet kontrolnih endodontskih cementa: Endomethasone®, Diaket®, N2®, Roth 801® i Acroseal®. Po tri uzorka svakog materijala su radiografisana pored aluminijumskog stepeničastog etalona na filmu (Eastman Kodak Company, Rochester, NY) i CCD digitalnom senzoru (Trophy Radiologie, Cedex, France). Vrednosti rendgenkontrastnosti izračunavane su konverzijom radiografskih gustina uzoraka izraženih optičkim gustinama ili stepenom tona sivo-bele skale u odgovarajuću debljinu aluminijuma. Rezultati. Dvostrukom analizom varijanse nije ustanovljena statistički značajna razlika između primenjenih metoda radiografisanja (p > 0.05), ali su vrsta kontrastnog sredstva (p lt 0.001) i interakcija ova dva faktora (p lt 0.05) bili značajno različiti. Upareni t-test pokazao je statistički značajnu razliku između korišćenih metoda za čisti Portland cement, sve koncentracije BaSO4 i CHI3, 10% i 20% dodatka ZrO2 i Bi2O3 i 10% i 30% dodatka YbF3 (p lt 0.05). Zaključak. Očekuje se da materijali koji sadrže CHI3 ili BaSO4 kao kontrastna sredstva budu lakše uočljivi na digitalnom senzoru nego na konvencionalnom dentalnom filmu. U kliničkom radu mora se imati u vidu kvalitet procene kontrasta koju pokazuje digitalna slika u odnosu na sliku dobijenu konvencionalnom radiografijom

Efekti ortognatskog hirurškog lečenja na kretnje donje vilice osoba s mandibularnim prognatizmom

Introduction. Mandibular prognathism, one of the most severe dentofacial deformities, affects the person’s appearance, psychological health and the quality of life in the most sensitive age period. Objective. The aim of this study was to evaluate the effects of sagittal split ramus osteotomy on the range of mandibular border movements in the early postoperative period. Methods. The study was conducted on 20 patients, of mean age 20.8 years, with mandibular prognathism. All patients included in this study were operated on by bilateral sagittal spliting ramus osteotomy according to Obwegeser and Dal Pont followed by mandibular immobilization during eight weeks. In all patients mandibular border movements were recorded before and six months after surgery using the computerized pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany). Results. The analysis of the chosen kinematic parameters revealed that sagittal split ramus osteotomy followed by eight weeks of mandibular immobilization had severe effects on the mouth opening. Six months after surgery the range of maximal mouth opening decreased for approximately 13.9 mm in relation to the preoperative stage. On the contrary, the ranges of maximal protrusion and the border of laterotrusive excursions increased significantly after surgery. Conclusion. In patients with mandibular prognathism where enormous mandibular growth was the main causal factor of the deformity, the sagittal split ramus osteotomy yielded good results. The rigid fixation of bone fragments and reduced period of mandibular immobilization followed by appropriate physical therapy could considerably contribute to a more rapid recovery of mandibular kinematics in the postoperative period.Uvod. Mandibularni prognatizam je jedan od najtežih dentofacijalnih deformiteta koji se u punoj meri manifestuje u najosetljivijim godinama života, ugrožavajući izgled osobe, njeno psihičko zdravlje i kvalitet života. Cilj rada. Cilj rada je bio da se ispita efekat sagitalne klizajuće osteotomije ramusa mandibule na dijapazone graničnih kretnji donje vilice u ranom postoperacionom periodu. Metode rada. Istraživanje je obavljeno na dvadeset osoba s mandibularnim prognatizmom prosečnog uzrasta od 20,8 godina. Svi ispitanici su operisani bilateralnom sagitalnom klizajućom osteotomijom ramusa mandibule po Obvegezeru (Obwegeser) i Dal Pontu (Dal Pont), nakon čega je primenjena intermaksilarna imobilizacija mandibule u trajanju od osam nedelja. Granične kretnje donje vilice su zabeležene kod svih ispitanika pre i šest meseci nakon hirurške korekcije pomoću kompjuterskog pantografa Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany). Rezultati. Rezultati analize odabranih kinematskih parametara pokazuju da je hirurški zahvat udružen s intermaksilarnom imobilizacijom mandibule tokom osam nedelja imao izrazito loš uticaj na dijapazon maksimalnog otvaranja usta kod operisanih ispitanika. Šest meseci nakon operacije dijapazon maksimalnog otvaranja usta je bio u proseku za 13 mm manji u odnosu na stanje pre hirurškog lečenja. S druge strane, dijapazoni maksimalne protruzije i graničnih lateralnih pokreta su se nakon operacije znatno povećali. Zaključak. Sagitalna klizajuća osteotomija ramusa mandibule daje dobre rezultate kod osoba s mandibularnim prognatizmom kod kojih je enorman rast donje vilice glavni uzročnik deformiteta. Rigidna fiksacija koštanih fragmenata i skraćen period intermaksilarne imobilizacije uz primenu odgovarajuće fizikalne terapije znatno bi doprineli bržoj rehabilitaciji pokreta mandibule u postoperacionom periodu

Porcelain veneers - preparation design: A retrospective review

This paper discusses the preparation of tooth design for porcelain veneers. It follows the literature more than three decades back in the past. From the very beginning, porcelain veneers were placed to no/minimally prepared tooth substance, showing different problems in clinical use. Later, the technique of etching the porcelain and controlling the reduction of tooth structure, presented the great steps forward in porcelain veneers accepting. A special accent concerning the preparative design was placed on variations of incisal edge preparation - the problem, which is still present in current practice. Additionally, the paper emphasizes the extremely demanding protocols in making the porcelain veneers as well as their expanded clinical indications