Analysis of Fixed Prosthetic Appliances in Patients living in the Metković Region, Croatia

Epidemiološke studije o stanju postojećih fiksnoprotetskih radova ili o potrebi za novim, a sa svrhom da se planiraju potrebni protetski timovi te poboljšaju materijali i postupci, prijeko su potrebni u suvremenoj protetici. Svrha rada bila je utvrditi koji je estetski materijal upotrijebljen za izradbu fiksnoprotetskih radova u pacijenata metkovićevske regije te utvrditi čestoću krunica i mostova ovisno o dobi, spolu, stručnoj spremi, zaposljenju, društveno-ekonomskom statusu i čestoći posjeta stomatologu. Pregledano je 212 pacijenata nositelja fiksnoprotetskih radova. Pregledi su izvedeni u Domu zdravlja Metković tijekom 2001. godine. Deskriptivna statistika i χ 2 testovi upotrijebljeni su prigodom statističke obradbe podataka. Izvedeni su sljedeći zaključci: Stariji pacijenti imali su znatno više mostova nego krunica (p0,05), niti između pacijenata različita stupnja naobrazbe (p>0,05). Umirovljeni pacijenti imali su znatno više mostova nego krunica u usporedbi sa zaposlenima ili nezaposlenima (p0,05). Pacijenti niske stručne spreme imali su više fiksnoprotetskih nadomjestaka starijih od 10 godina u usporedbi s pacijentima srednje ili visoke stručne spreme (p<0,01). Zabilježena je razmjerno česta upotreba keramike (64%) u usporedbi s polimernim materijalima (36%). Nije bilo razlike između spolova ovisno o materijalu za fasetiranje fiksnoprotetskoga rada (p>0,05). Pacijenti stariji od 60 godina i pacijenti niže stručne spreme imali su više polimernih fasetiranih radova od mlađih pacijenata (<39 godina) koji su imali uglavnom sve radove fasetirane keramičkim materijalima (p<0,01).Epidemiological studies on the condition of existing or the need for new fixed prosthodontic appliances, with the purpose of planning required prosthetic teams, improved materials and methods, are essential in modern prosthodontics. The aim of this study was to evaluate the aesthetic material used in patients with fixed prosthodontic appliances in the Metkovi} region and determine the frequency of crowns and bridges in relation to age, gender, level of education, employment, socio-economic status and frequency of regular visits to the dentist. examination The study included 212 patients, wearing fixed prosthodontic appliances, who were examined in the dental office (clinic) at the Metkovi} Medical Centre during 2001. Descriptive statistics and (2 tests were used during data analysis. The following conclusions were made: 1. The older group of patients had significantly more bridges than crowns (p0.05), or between patients of different levels of education (p>0.05). Retired patients had significantly more bridges than crowns compared to employed or unemployed patients (p0.,05). Less educated patients had more fixed prosthodontic appliances older than 10 years than better educated patients (p0.05). Patients older than 60 and less educated patients had more acrylic appliances than younger patients (<39 years) who had mainly only ceramic appliances (p<0.01)

[Assessment of the load exerted on particular teeth in patients with pathologic abrasion]

Unatoč mnogobrojnih istraživanja velikog broja autora, pojava patološke abrazije u nekim aspektima nije dovoljno razjašnjena. Trošenje tvrdih zubnih tkiva koje prelazi granicu fiziološkog dovodi do oštećenja zuba kao organa, njegovog poitpomog aparata odnosno cijelog stomatognatog sustava. Nesumnjivo je da će takovo patološko oštećenje zuba imati odraza na postignute vrijednosti žvačnih sila, a da će abradirani zub biti funkcionalno opterećen različito u odnosu na zub iz kontrolne skupine ispitanika. Stoga su provedena gnatodinamometrijska ispitivanja na odgovarajućem uzorku ispitanika s kliničkom slikom patološke abrazije i kontrolnoj skupini ispitanika bez abrazije. Analizom rezultata ustanovljeno je da je pojedini zub frontalnog segmenta abradiranog zubala opterećen s 10,97% manjom silom od frontalnog zuba neabradiiranog zubala, abradirani zub desnog segmenta 1 0 ,8 8% većom silom i abradirani zub lijevog segmenta 13,96% većom silom.Despite numerous studies of the subject, some aspects of pathologic abrasion appear to require more clarification. Wearing away of the hard dental tissues exceeding physiological limits damages the teeth as an organ, and its supporting structures as well, i. e. he entire stomatognathic system. Such a pathologic lesion to the teeth would unavoidably reflect upon the masticatory force values attained, while the functional load exerted on an abraded tooth would differ from that acting upon the control group teeth. Therefore, he gnathodynamometric studies were undertaken in a representative sample of subjects with clinical picture of pathologic obrasion and a control group of abrasion-free subjects. According to the results, the masticatory force acting upon individual abraded teeth of the frontal, right and left segments was by 10.97% lower, 10.88% higher and 13.96% higher compared to the load exerted on the respective non-abraded teeth, respectively

The Release of Metal Ions in the Gingival Fluid of Prosthodontic Patients

Korozija nadomjestka i njegovo trošenje u funkciji zatvaraju krug koji uzrokuje oštećenje nadomjestka i štetne reakcije na okolnome tkivu ili čak na udaljenim organima. Svrha ovoga istraživanja bila je identificirati ione Au, Pt, Ag i Pd u sulkusnoj tekućini (ST) u fiksnoprotetskih pacijenata i odrediti masu iona u dobivenom uzorku. U istraživanju je sudjelovalo 20 ispitanika, od toga 15 je imalo fiksne nadomjestke i isti stupanj higijene, a 5 nije imalo nikakav protetski rad te su poslužili kao kontrolna skupina. Nadomjesci su bili izrađenih od slitina Au − Pt, Au − Pt, Ag − Pd i Ni − Cr te pričvršćeni u ustima: - od 1-14 dana, i 3-8 godina. Uzorci su dobiveni ulaganjem adsorbcijskoga papirića (AP) u gingivni sulkus (GS) zuba nosača u vremenu od deset minuta. AP s uzorkom ST analizirani su s pomoću spektrometra masa s induciranom združenom plazmom (ICP-MS). Rezultati su statistički obrađeni programskim paketom SPSS, a upotrijebljena je deskriptivna statistika i korelacija uzoraka. U cijelome uzorku statistički se znatno povezane koncentracije Ag, Au i Pt, a koncentracija Pd ponaša se prema vlastitu uzorku. Raščlambom rezultata u kontrolnoj skupini nije utvrđena statistički znatna povezanost za iste međuodnose. U podskupini Ag-Pd slitine utvrđena je statistički znatna povezanost između koncentracija Ag, Au i Pd, a najizrazitija je veza između koncentracija Au i Pd. Postoji statistički znatna razlika u koncentraciji Pt između podskupina s novim radovima s najvišom vrijednosti u skupini slitina Au (P=0,023) u usporedbi s kontrolnom skupinom.Utvrđena je statistički znatna promjena vrijednosti Ag (P=0,011) i Pt (P=0,039) s padom vrijednosti obiju tih kovina u ispitanika sa starim protetskim radovima.Corrosion of prosthetic restorations and simultaneous wear during usage leads to damage of the restoration and harmful reactions on the surrounding tissues or even on distant organs. The aim of this study was to identify the ions Au, Pt, Ag and Pd in the gingival fluid of patients with fixed prosthetic appliances and to determine the mass of ions in the obtained sample . The study included 20 subjects: of which 15 had fixed prosthetic appliances and the same level of hygiene, and 5 without have any prosthetic appliances, who served as a control group. The prosthetic appliances were made from alloy compounds: Au - Pt, Au - Pt, Ag - Pd, Ni - Cr, fixed in the mouths: from 1-14 days, and 3-8 years. Samples were obtained by placing adsorbent paper (AP) in the gingival sulcus (GS) of the abutment tooth for a period of ten minutes. AP with samples gingival fluid (ST) were analysed by means of a mass spectrometer with fused plasma (ICP-MS). The results were statistically analysed by the programme packet SPSS, with descriptive statistics and correlation of samples. In the whole sample statistically significant correlation was found for the concentrations of Ag, Au and Pt, while the concentration of Pd was characteristic for each sample. Analysis of the results in the control group did not reveal statistically significant correlation for the same inter-relations. In the sub-group Ag-Pd alloys statistically significant correlation was established between the concentrations of Ag, Au and Pd, and the most marked correlation found was between the concentrations of Au and Pd. Statistically significant differences were determined in the concentrations of Pt between the subgroups with new appliances, with the highest value in the group of Au alloy (P=0.023) in comparison with the control group. Statistically significant changes were determined in the values of Ag (P=0.011) and Pt (P=0.039), with a fall in the values of both metals in subjects with older prosthetic appliances

[Gnathodynamometric studies in the conditions of pathologic abrasion]

Unatoč do sada izvršenim brojnim istraživanjima pojava patološke abrazije u svim svojim aspektima nije dovoljno razjašnjena. Osobito injeni uzroci vezani na dinamiku žvačnog sustava, veće \u27ili manje žvaćne sile kao i pojava individualno veće ili manje abrazijske otpornosti tvrdih zubnih tkiva mogu biti glavni činitelji u nastanku ove pojave. Kako smo željeli dati odgovor barem na neka od spomenutih pitanja, cilj ovog rada bio je usmjeren na to da se pronađe uzročna veza između veličine žvačnih sila i pojave patološke abrazije. U tu svrhu izvršeno je gnatodinamometnijsko ispitivanje na odgovarajućem uzorku ispitanika s kliničkom slikom patološke abrazije. Kontrolnu skupinu činile su osobe muškog spola u dobi od 18— 22 godine starosti s intaktnim, potpunim zubnim nizovima. Rezultati ispitivanja bilježeni su u posebno kreirane anketne listove, statistički obrađeni i sveobuhvatno znanstveno analizirani. Na temelju dobivenih rezultata utvrđeno je da su prosječne vrijednosti žvačnih sila u ispitanika s patološkom abrazijom evidentno manje u odnosu na žvačne isile ispitanika iz kontrolne skupine, dok su žvačne sile ispitanika s bmksizmom i parafunkcijskim stiskanjem zubi veće od prosječnih vrijednosti žvačnih sila za ukupni uzorak ispitanika s patološkom abrazijom.Despite numerous studies of the subject conducted so far, the occurrence of pathologic abrasion has not yet been fuMy clarified in all its aspects. The causes associated with the masticatory system dynamics, i. e. greater or lasser masticatory forces as well as individually higher or lower resistance of hard dental tissues to abrasion, may be the major factors for the onset of this lesion. As our attempt was to provide answers to at least some of the mentioned qgustions, this study was directed towards finding the causal relationship between the magnitude of masticatory forces and the occurrence of pathologic abrasion. The gmathodynamometric testing was therefore carried out in a representative sample of subjects presenting with clinical picture of pathologic abrasion. The control group consisted of male subjects aged 18— 22 years, with intact, complete sets of teeth. The results, recorded in special po II questionnaires, were statistically processed and comprehensivevly scientifically analyzed. On the basis of the results obtained, the mean masticatory force values in the subjects with pathologic abrasion were found to be apparently lower than those observed in the control group subjects, whereas in patients with bmx\u27ism and parafu notional occlusion the masticatory forces were higher than the mean walues of these forces in the total sample of subjects with pathologic abrasion

Investigation of Contact Allergies to Component and Auxiliary Prosthetic Materials

Kontaktna alergija je odgođena reakcija preosjetljivosti u kojoj se lokalizirana lezija kože ili sluznice javlja zbog opetovanoga doticaja s alergenom. Od fiksnog ili mobilnoga protetskog rada u usnoj šupljini nastaju korozijski procesi na površini nadomjestka te otpuštanja iona koji, kao hapteni, mogu pokrenuti alergijsku reakciju. Svrha ovoga istraživanja bila je epikutanim alergološkim testom ispitati pojavnost alergije na gradivne i pomoćne protetske materijale u pacijenta s lihen ruber planusom, stomatitisom i stomatopirozom. U istraživanju su sudjelovala 32 pacijenta s fiksnim i/ili mobilnim nadomjestkom i 7 pacijenata s jednom od navedenih dijagnoza bez nadomjestaka. Ispitivanje je provedeno standardnom tehnikom (patch testom) na 13 alergena. Rezultati istraživanja pokazuju veću vjerojatnost na pozitivan patch test u osoba s navedenim bolestima i s nadomjestkom u usporedbi s ispitanicima bez nadomjestaka (P = 0,62). Pričvršćenjem fiksnog ili postavljanjem mobilnoga nadomjestka raste vjerojatnost da će se simptomi pogoršati (P = 0,019), a pogotovo ako se radi o nadomjescima od Co-Cr-Mo slitine. Povećanjem broja članova fiksnih nadomjestaka, ili pak postojanjem mobilnih nadomjestaka u objema čeljustima, raste i vjerojatnost pozitivnoga rezultata patch testa na kobaltni klorid (P = 0,05). Lichen ruber planus povećava vjerojatnost na pozitivan patch test u najvećem broju slučajeva (P = 0,05). Najviše pozitivnih rezultata bilo je na alergene nikla, kobalta i kroma (svaki 17,95%), a negativan nalaz dobiven je kod dibutilftalata i HH smjese. Stomatopiroza povećava vjerojatnost da ispitanik ima pozitivan rezultat testiranja na krom (P = 0,019). U žena je pojava pozitivnoga patch testa veća na sve alergene (P = 0,05) osim na epoksidne smole, kod kojih je manja nego u muških ispitanika (P = 0,036). Zbog sve češće kontaktne alergije u populaciji potrebno je provesti potanka ispitivanja protetskih materijala prije nego što ih se uvede u kliničku praksu, a u pacijenata s atopijskom anamnezom alergološka testiranja i imunološke testove prije protetske sanacije.Contact allergy is a delayed reaction to sensitivity in which a localised lesion of the skin or mucous membrane occurs as a result of contact with an allergen. The fitting of a fixed, or placement of a mobile, prosthetic appliance in the oral cavity causes corrosive processes to occur on the surface of the restoration and the release of ions which, as haptens, can induce allergic reaction. The aim of this investigation was to examine the occurrence of allergies to component and auxiliary prosthetic materials by patch test in patients with lichen ruber planus, stomatitis and stomatopyrosis. Thirtytwo patients with fixed and/or mobile restorations and seven patients with one of the above diagnoses without a restoration, participated in the investigation. Testing was carried out by standard technique (patch test) with 13 allergens. The results of the investigation indicate the greater probability of a positive patch test in subjects with the aforementioned diseases and with a restoration, in relation to subjects without a restoration (P = 0.62). The probability of symptoms worsening increased with the insertion/ fitting of a fixed or placement of a mobile restoration (P = 0.019). This was particularly so in the case of restorations made of Co-Cr-Mo alloy. With the increase in the number of units of fixed restorations, or the presence of mobile restorations in both jaws, the probability of a positive patch test to cobalt chloride also increased (P = 0.05). Lichen ruber planus increased the probability of a positive patch test in the majority of cases (P = 0.05). The greatest number of positive results were for the allergens nickel, cobalt and chrome (each 17.95%) and a negative finding was obtained for dibutylphthalate and HH mix. Stomatopyrosis increased the probability that the subject would have a positive result for chrome (P = 0.019). The occurrence of a positive patch test was greater in women for all allergens (P = 0.05), apart from epoxy resin, where it was less than in the male subjects (P=0.036). Because of the greater incidence of contact allergies in the population a more detailed investigation of prosthetic materials is needed prior to their introduction into clinical practice. In the case of patients with atopic history allergological testing and immunological tests should be performed prior to prosthetic treatment

Intercondylar Distances of the Human Temporomandibular Joints

In a sample which included subjects of the Croatian population we made measurements of intercondylar distances between the temporomandibular joints in radiographs. A total of 101 subjects of both sexes ranging in age from 20 to 80 years, mostly residents in Zagreb, were evaluated. We measured the intercondylar distances from the condyle centers in the postero-anterior cranial radiographs which had previously been examined and traced on acetate paper. The measuring points were digitized prior to measurements. A special system of coordinates was devised for each radiograph. The results of our measurements were assessed by ANOVA analysis. The intercondylar distance between the two temporomandibular joints was within the range of 110 and 145 mm, with the mean of 126 mm. In men the intercondylar distance was within the range of 116 and 145 mm, with the mean of 130.2 mm. In women the distance ranged from 110 to 138 mm, with the mean of 123.5 mm. There was a significant difference between the two sexes. From a review of the literature, it is apparent that the results of our measurements do not support the results of similar studies assessed by a number of researchers in other countries. The intercondylar distance in the Croatian sample was 5.25% larger than the maximal values of the same parameters in other populations suggesting larger craniofacial skeletons. The development of this radiographic assessment method should improve evaluation of subjects seeking treatment