The histological analysis of the consequences of root-canal traumatic perforation

Autori su željeli detaljnije obraditi problem traumatske perforacije, koja se kao komplikacija može pojaviti prilikom endodontskog liječenja. U vezi s tim, cilj im je bio ispitati kako djeluju medikamentozna sredstva kavit i diaket na perforirani zub i njegovu okolinu, za razliku od kontrolne skupine u kojoj su traumatske perforacije ostajale neopskrbljene. Na 64 zuba albino štakora izvršena je histološka pretraga i načinjena su 192 histološka preparata. Promatralo se što se zbiva u tkivu, koje se nalazi oko traumatske perforacije zuba: hiperemiju, hemoragiju, vrst i množinu stanica koje se pojavljuju u upalnom infiltratu, kao i pojavu i razvoj granulacijskog tkiva. Pratili smo mijenjanje patohistološke slike u životinja koje smo u različitim vremenskim razmacima žrtvovali (4, 20, 43. i 63. dana). Rezultati ispitivanja su pokazali, da su diaket i kavit dobra medikamentozna sredstva za zatvaranje traumatske perforacije, međutim, kavit je pokazao izvjesne prednosti u odnosu na diaket. Kavit je sredstvo koje se lakše adaptira perforacijskom području, ne prolijeva se po ulazima u kanale, kao što je to slučaj s diaketom. Bolje od diaketa podnosi sekreciju, koja je jače ili slabije izražena u području traumatske perforacije.A detailed description of the problem of traumatic perforation which may appear as a complication in endodontic treatment is given. The goal of the work was to determine the effect of medicaments, cavit and diaket, on the perforated tooth and its environment and to compare it to the control group in which traumatic perforation remain untreated. The histological analysis was performed on 64 albino rats and 192 histological preparations were made. All the changes occurring in the tissue surrounding the traumatic tooth perforation were observed: hyperemia, hemorrhage, the type end the quantity of the cells appearing in the inflammatory infiltrate and the development of granulation tissue. The changes in pathohistologiical findings obtained in animals sacrificed at different time intervals were followed up (after 4, 20, 43 and 63 days). The results of the investigation show that both cavit and diaket are suitable medicaments for the closure of the traumatic perforation and that cavit displays certain advantages in relation to diaket. It is more easily adapted to perforated area, it does not run into the canal entrances as diaket and lit supports better secretion which is more or less expressed in the area of traumatic perforation

Gram pozitivne fakultativne bakterije u pulpo-parodontnom kompleksu

Ispitivana je mikrobiološka flora korijenskog kanala zuba i dubokih parodontnih džepova kod 35 pacijenata u kojih je klinički dijagnosticirana pulpno-parodontna ili parodontno-pulpna afekcija. Za prikupljanje inokuluma (70 uzoraka) koristila se tehnika suhih papirnatih kolčića, a za mikrobiološko ispitivanje korištene su standardne mikrobiološke metode. U 37,14% slučajeva (13 od 35 ispitanika) iste gram pozitivne fakultativne bakterije su izolirane iz džepova i korijenskih kanala, 20 puta u čistoj i 5 puta u miješanoj kulturi. Enterococcus je izoliran četiri puta, Streptococcus pneumoniae tri puta, Saprofitni gram pozitivni štapići dva puta, te Streptococcus species (viridans), Streptococcus alpha hemolyticus, Streptococcus anhaemolyticus i Staphylococus coag. negativus po jedamput

Microbial flora of dental plaque in subjects wearing total acrylate dentures

Klinički je ispitano 115 osoba s totalnim akrilatnim protezama. Stupanj upale sluznice utvrđen je pomoću Newtonova indeksa, a plak pomoću modificiranog Tarbetova indeksa. Uzorci plaka uzeti su s unutarnje površine proteze. Uzorci sa sluznice ispod proteza zahvaćene upalom uzeti su u 20 ispitanika. Higijena je bila na niskoj razini i u 79% bolesnika nađen je indeks plaka >2. U 92% bolesnika ispod proteze je bila prisutna upala, ako je u 25% ispitanika stupanj upale iznosio > 2. U protetskom plaku prevladali su streptokoki (52.8% na unutarnjoj površini proteze i 69.6% na upaljenoj sluznici), dok je postotak candide bio 20.5% na unutarnjoj površini proteze te 16.6% na upaljenoj sluznici. Sve to ukazuje na važnost poduke bolesnika u provođenju pravilne higijene usne šupljine.As the cause of denture stomatitis is of a multifactorial nature, and denture cleanliness and denture plaque play one of the most important roles, the composition of denture plaque was studied in correlation with denture cleanliness and degree of mucosal inflammation under denture base. A group of 115 subjects, all of them wearing total acrylate prostheses, were clinically eyamined. the degree of mucosal inflammation was scored by Newton’s index, and plaque by modified Tarbet’s index. Plaque samples were taken from inner surfaces of dentures, while inflamed mucosa under the dentures was sampled in 20 subjects. The higiene was found to be poor and plaque index > 2 recorded in 79% of subjects. In 92% of the patients, inflammation was present under the denture base, while in 25% of the patients the degree of inflammation was > 1. In denture plaque, Streptococci were predominant (52.8% on the inner surface of the denture and 69.6% on inflamed micosa), whereas the percentage of Candida was 20.5% on the inner surface of the denture and 16.6% of inflamed micosa. It is therefore important to teach patients how to perform proper oral hygiene

Trichomonas tenax u usnoj šupljini

Fifty-one patients were investigated in order to determine the presence of Trichomonas tenax in various oral structures (saliva, dental plaque from physiologically clean and unclean tooth areas, carious dentin, root canal contents). Samples were cultivated in liquid Diamond’s axenic broth medium. The results were considered positive if living oral Trichomonas was found in smears. The prevalence of Trichomonas tenax in the study patients was 35.5%. Trichomonas tenax was most frequently found in dental plaque (23.2%) and in the root canal content (30.0%) (p > 0.05). The variables observed in this study (patient’s age and sex, oral hygiene, gingivitis, number of carious teeth, smoking and coffee intake) did not influence the presence of Trichomonas tenax. According to the results obtained, a mature dental plaque appears to be the oral structure favoring the growth and survival of oral Trichomonas in the physiologic conditions. It is possible that Trichomonas tenax spreads from dental plaque into the diseased endodontium.Prisutnost Trichomonas tenaxa na različitim strukturama usne šupljine (slina, dentobakterijski plak s fiziološki čistoga i nečistoga mjesta na zubu, karijesni dentin, sadržaj korijenskih kanala) istražena je u 51 ispitanika. Uzorci su kultivirani na Diamondovoj akseničnoj hranjivoj tekućoj podlozi. Nalaz živoga parazita u uzorku smatran je pozitivnim nalazom. Prevalencija Trichomonas tenaxa u ispitanika iznosila je 35,3%, a nađen je u zubnom plaku (23,2%) i u korijenskim kanalima (30,0%) (p > 0,05). U našem istraživanju ispitivane varijable (dob i spol ispitanika, stupanj oralne higijene, upala gingive, broj karijesnih zubi, pušenje i konzumiranje kave) nisu utjecale na pojavnost Trichomonas tenaxa. Prema rezultatima ovoga rada, zreli zubni plak omogućuje rast i razvoj oralnoga Trichomonasa u fiziološkim uvjetima u usnoj šupljini, a Trichomonas može prijeći iz zubnoga plaka u bolesni endodont

The Condition of Tooth Hard Tissue Among Workers in the Battery Manufactory

U radu je pregledano sto ispitanika. Pedeset ispitanika radi u tvornici akumulatora (akumulatorskim stanicama), u pogonima zatvorenog tehnološkog procesa formiranja akumulatorskih ploča, a 50 ih je sačinjavalo kontrolnu grupu. Cilj rada bio je utvrditi stanje tvrdih zubnih tkiva kod radnika u akumulatorskim stanicama. U tu svrhu ispitivana je prevalencija erozija, prevalencija karijesa, stupanj oralne higijene i stanje gingive. Kod ispitanika nisu nađene klinički vidljive erozivne promjene (rade u zatvorenom tehnološkom procesu formiranja akumulatorskih ploča), što je znak poboljšanja radnih uvjeta, kretanja koncentracije para sumporne kiseline u granicama dopuštenih vrijednosti (1-1,75 mg/m3), te provođenja osobne zaštite na radu (grupa I. - 92%, grupa II. - 68%). Porast karijesa značajan je kod ispitanika koji rade puno radno vrijeme (grupa II.) u odnosu na one koji rade pola radnog vremena (grupa L), kao i na one koji ne rade u tim radnim uvjetima (kontrolna grupa). To može biti znak da duža izloženost nepovoljnim uvjetima (atmosferi s kiselinskim parama) predstavlja mogući predisponirajući faktor većoj osjetljivosti zuba na karijesnu demineralizaciju, uzročenu vanjskim faktorima. Kod ispitanika koji su radili puno radno vrijeme, nađeno je više zubnog kamenca i više upalnih promjena na gingivi, što se može dovesti u vezu s lošijom oralnom higijenom u toj grupi. U vezi s time, potrebno je kod radnika koji rade u akumulatorskim stanicama (tvornicama akumulatora) provoditi preventivne mjere fluoridacije zubi, posvetiti posebnu pažnju zdravstvenom prosvjećivanju i češćoj kontroli.In this work 100 people were examined. Half o f them work in the battery stations (of battery manufactory), in the departments with closed technological process o f forming battery plates. Other half of the examined sample was a control group. The aim o f this work is to indicate the condition o f tooth hard tissue among workers in the battery manufactory. For this purpose, prevalence o f erosion and caries, stage of oral hygiene and the state of gingiva were examined. No clinically visible erosion changes were found at workers. This may be due to better working conditions (they work in close technological process o f forming battery plates), fluctuation o f the concentration o f sulphuric acid within tolerable (acceptable) values (1-1,75 mg/m3), as well as to carrying out selfprotection at work (1st group - 92%, 2nd group - 68%). The increase o f caries is significant among examinees working full time (2nd group) in comparison to those working only half time (1st group), as well as to those who were not working under the same conditions (control group). It could be the sign o f longer exposure to unfavourable conditions (acid vapourisedlsaturated atmosphere) and presents possible predisposing factor to the greater sensitivity of teeth to the caries demineralization, caused by the external factors. Among examinees, working full time, much more tartar is found and more inflamatory changes on the gingiva. That can be brought into relation with poorer oral hygiene in the group. Because o f that, it is necessary to carry out prevention measures with teeth fluoridation among those working in the battery stations (battery manufactories). Special stress should be given to health education and more frequent check up

Die Zusammenarbeit zwischen Patient und Zahnarzt in der therapeutischen Stomatologie

Autori pridaju važnost suradnji između pacijenta i terapeuta i smatraju, da ona predstavlja važan preduvjet za egzaktan rad u usnoj šupljim, posebno pri vršenju endodontskih zahvata. Stoga su autori na kllmičkom materijalu od 89 slučajeva obradili mjerenjem krvnog tlaka oscilacije sisto- ličkog i dijastoličkog tlaka pri vitalnoj ekstirpaciji pulpe i preparacije kaviteta sa anasteziijom (i bez nje. Oscilacije tlaka u ispitanika gdje je zahtjev vršen primjenom lokalne anestezije i ispitanika, gdje je zahvat vršen bez anestezije uz prethodnu psihološku pripremu, bile su približno iste. Neznatne osciladije u onom odnosu sistoličkog li dijastoličkog tlaka mogle bi se pripisati neurovegetativnoj komponenti. Prednost bi dakle, trebalo dati psihološkoj obradi pacijenta, a u onim slučajevima gdje postoje bolne senzacije indicirana je i lokalna anestezija.In everyday dental practice cooperation between the patient and the therapeutist is of extreme importance because it represents a component on which frequently depend the choice of the dental intervention and equally the success of this intervention. Better cooperation with the patient may be achieved by the appropriate approach, thus reducing fear and psychical tension which the patient experiences at the time of entering the dentist\u27s practice. The authors have taken the blood pressure of a control and an experimental group of test subjects starting from the assumption that oscillations of pressure might partly be an indicator of internal tension in the patient.Die Autoren sind der Meinung, dass die Zusammenarbeit zwischen Patient und Zahnarzt eine wichtige Voraussetzung für die erfolgreiche Ausführung, insbesondere der endodontischen Arbeiten, darstellt. Aus diesem Grunde haben d)ie Autoren an 89 Patienten die Oszillation des systolischen und die diastolischen Blutdrucks bei der vitalen Pulpaexirpation und bei der Präparation von Kavitäten, mit und ohne Anaesthesie, gemessen. Die Oscillation des Blutdrucks bei Probanden bei denen der Eingriff unter Lokalanaesthesie, verglichen mit Probanden wo er ohne Anaesthesie, aber nach psychologischer Vorbereitung, vorgenommen wurde, ergaben ungefähr die gleichen Resultate. Geringe Oscillationen im Vergleich des systolischen und diastolischen Blutdrucks, können der neurovegetativen Komponente zugeschrieben werden. Der Vorzug wäre demnach der psychologischen Vorbereitung der Patienten zu geben; in Fällen von schmerzhaften Sensationen ist die Lokalanaesthesie angezeigt

Hard Dental Tissue Erosions

Autori raspravljaju o etiološkim faktorima koji dovode do erozije zubnih tkiva. Daju klinički opis izgleda erodiranih površina, diferencijalnu dijagnozu i terapiju erozivnih promjena. Etiološke faktore dijele na egzogene i endogene. Najčešći egzogeni uzroci erozija zubnih površina su prehrambeni artikli i pića, neki lijekovi, te profesionalna ekspozicija kiselinama u industriji i laboratorijima, a endogeni kronična regurgitacija želučanog sadržaja. Ovisno o putu unosa kiselina lokalizirane su i erozivne promjene. Tako su egzogene smještene na labijalnim, a endogene na palatinalnim (rjeđe lingvalnim) plohama zahvaćenih zuba. U terapiji se predlažu: preventivne mjere, restauracija erodiranih površina kompozitnim materijalima ili protetski.Etiologic factors causing erosion o f hard dental tissue, clinical description, differential diagnosis and therapy are discussed. The most common exogenous factors are highly acid food and drink, some medicaments, professional exposure in industry and laboratory, etc. The most common endogenous factor is chronic regurgitation o f stomach contents. Exogenous erosions are localized on the labial surfaces, and endogenous erosions on palatinal or lingual surfaces of the teeth. Therapy of hard dental tissue erosion is based on preventive measures, composite restoration and prosthetic replacement

Hard Dental Tissue Erosions

Autori raspravljaju o etiološkim faktorima koji dovode do erozije zubnih tkiva. Daju klinički opis izgleda erodiranih površina, diferencijalnu dijagnozu i terapiju erozivnih promjena. Etiološke faktore dijele na egzogene i endogene. Najčešći egzogeni uzroci erozija zubnih površina su prehrambeni artikli i pića, neki lijekovi, te profesionalna ekspozicija kiselinama u industriji i laboratorijima, a endogeni kronična regurgitacija želučanog sadržaja. Ovisno o putu unosa kiselina lokalizirane su i erozivne promjene. Tako su egzogene smještene na labijalnim, a endogene na palatinalnim (rjeđe lingvalnim) plohama zahvaćenih zuba. U terapiji se predlažu: preventivne mjere, restauracija erodiranih površina kompozitnim materijalima ili protetski.Etiologic factors causing erosion o f hard dental tissue, clinical description, differential diagnosis and therapy are discussed. The most common exogenous factors are highly acid food and drink, some medicaments, professional exposure in industry and laboratory, etc. The most common endogenous factor is chronic regurgitation o f stomach contents. Exogenous erosions are localized on the labial surfaces, and endogenous erosions on palatinal or lingual surfaces of the teeth. Therapy of hard dental tissue erosion is based on preventive measures, composite restoration and prosthetic replacement

The Condition of Tooth Hard Tissue Among Workers in the Battery Manufactory

U radu je pregledano sto ispitanika. Pedeset ispitanika radi u tvornici akumulatora (akumulatorskim stanicama), u pogonima zatvorenog tehnološkog procesa formiranja akumulatorskih ploča, a 50 ih je sačinjavalo kontrolnu grupu. Cilj rada bio je utvrditi stanje tvrdih zubnih tkiva kod radnika u akumulatorskim stanicama. U tu svrhu ispitivana je prevalencija erozija, prevalencija karijesa, stupanj oralne higijene i stanje gingive. Kod ispitanika nisu nađene klinički vidljive erozivne promjene (rade u zatvorenom tehnološkom procesu formiranja akumulatorskih ploča), što je znak poboljšanja radnih uvjeta, kretanja koncentracije para sumporne kiseline u granicama dopuštenih vrijednosti (1-1,75 mg/m3), te provođenja osobne zaštite na radu (grupa I. - 92%, grupa II. - 68%). Porast karijesa značajan je kod ispitanika koji rade puno radno vrijeme (grupa II.) u odnosu na one koji rade pola radnog vremena (grupa L), kao i na one koji ne rade u tim radnim uvjetima (kontrolna grupa). To može biti znak da duža izloženost nepovoljnim uvjetima (atmosferi s kiselinskim parama) predstavlja mogući predisponirajući faktor većoj osjetljivosti zuba na karijesnu demineralizaciju, uzročenu vanjskim faktorima. Kod ispitanika koji su radili puno radno vrijeme, nađeno je više zubnog kamenca i više upalnih promjena na gingivi, što se može dovesti u vezu s lošijom oralnom higijenom u toj grupi. U vezi s time, potrebno je kod radnika koji rade u akumulatorskim stanicama (tvornicama akumulatora) provoditi preventivne mjere fluoridacije zubi, posvetiti posebnu pažnju zdravstvenom prosvjećivanju i češćoj kontroli.In this work 100 people were examined. Half o f them work in the battery stations (of battery manufactory), in the departments with closed technological process o f forming battery plates. Other half of the examined sample was a control group. The aim o f this work is to indicate the condition o f tooth hard tissue among workers in the battery manufactory. For this purpose, prevalence o f erosion and caries, stage of oral hygiene and the state of gingiva were examined. No clinically visible erosion changes were found at workers. This may be due to better working conditions (they work in close technological process o f forming battery plates), fluctuation o f the concentration o f sulphuric acid within tolerable (acceptable) values (1-1,75 mg/m3), as well as to carrying out selfprotection at work (1st group - 92%, 2nd group - 68%). The increase o f caries is significant among examinees working full time (2nd group) in comparison to those working only half time (1st group), as well as to those who were not working under the same conditions (control group). It could be the sign o f longer exposure to unfavourable conditions (acid vapourisedlsaturated atmosphere) and presents possible predisposing factor to the greater sensitivity of teeth to the caries demineralization, caused by the external factors. Among examinees, working full time, much more tartar is found and more inflamatory changes on the gingiva. That can be brought into relation with poorer oral hygiene in the group. Because o f that, it is necessary to carry out prevention measures with teeth fluoridation among those working in the battery stations (battery manufactories). Special stress should be given to health education and more frequent check up

Mechanical and Chemical Tooth Wear - a Review

Dan je pregled današnjih spoznaja o mehaničkom i kemijskom trošenju zuba i dentalnih ispuna te o povezanosti atricijsko-abrazijsko-erozijskih djelovanja u svjetlu tribologijske znanosti i naših kliničkih iskustava. Navedeni su unutarnji i vanjski uzroci nastalih defekata, njihov odnos prema kliničkoj slici s posebnim osvrtom na kliničke manifestacije subkliničkih erozija cakline i dentina. Navedeni su neki od indeksa za kliničku klasifikaciju potrošenoga zuba i nove tehnologije koje se rabe u znanstvenom istraživanju te problematike.A review is given o f the present state o f art on mechanical and chemical wearing away o f teeth and dental fillings, and on the relationship between the effects o f attrition, abrasion and erosion in the light of tribology and our own clinical experience. Endogenous and exogenous causes o f defects, as well as their relation with the clinical picture are presented, with particular reference to clinical manifestation of subclinical enamel and dentin erosions. Some indices for clinical classification of tooth wear and new relevant research technologies are described