Zastupljenost bakterije Aggregatibacter actinomycetemcomitans u dubokim karijesnim lezijama

Introduction Deep caries is a reversible process where caries lesion has affected bigger part of dentin and only thin layer of softened dentin that separates lesion from the pulp is remained. The objective of this study was to identify and determine serotypes of Aggregatibacter actinomycetemcomitans in teeth with deep caries lesions at the beginning of their treatment. Material and methods Clinical research included 29 patients of both genders, aged 16 to 40 and 45 permanent teeth with diagnosed deep caries lesions based on medical history, clinical and radiographic examination. After cavity preparation and removal of softened dentin, microbiological swab was taken from the bottom of the cavity. Swabs were disposed in special sterile micro tubes and stored at the temperature of -80oC until serotyping was done (determination of serotypes of A. actinomycetemcomitans bacterium). Results In one of the 3 samples two serotypes of A. actinomycetemcomitans (b and c) were identified which is relatively rare finding, while in the second and third sample serotypes (a) and serotype (b) was identified, respectively. Conclusion In the three samples the 3 serotypes were found (a, b and c) and one of the samples was carrying even two different serotypes, which is a rare phenomenon. For more serious epidemiological study of A. Actinomycetemcomitans serotypes at the population level incomparably larger starting material is necessary, at least few hundred of samples.Uvod Duboki karijes je reverzibilni proces kod kojeg je karijesna lezija zahvatila veći deo dentina i samo tanak sloj razmekšalog dentina razdvaja leziju od pulpe. Cilj ovog rada je bio da se na početku terapije utvrde i odrede serotipovi bakterije Aggregatibacter actynomycetemcomitans kod zuba sa dubokim karijesnim lezijama. Materijal i metod rada Kliničko ispitivanje je obuhvatalo 29 pacijenata, oba pola, uzrasta od 16 do 40 godina i 45 stalnih zuba kod kojih je na osnovu anamneze, kliničkog i radiografskog pregleda dijagnostikovan duboki karijes. Posle preparacije kaviteta i uklanjanja razmekšalog dentina, sa dna kaviteta je uziman bris, odlagan u posebne sterilne mikrotubice i čuvan na temperaturi od -80oC do postupka serotipizacije (utvrđivanja serotipova bakterije Aggregatibacter actynomycetemcomitans) primenom metode multipleks PCR. Rezultati Serotipizacija je registrovana u samo tri uzorka. U jednom od tri uzorka identifikovana su dva serotipa A. actynomycetemcomitans - b i c, što je relativno redak nalaz, dok su u drugom i trećem uzorku identifikovani serotipovi a, odnosno serotip b. Zaključak U tri uzorka nađena su tri serotipa - a, b i c, a jedan od uzoraka je nosio čak dva različita serotipa, što je redak fenomen. Za ozbiljniju epidemiološku studiju serotipova A. Actynomycetemcomitans na nivou populacije neophodan je neuporedivo veći uzorak i to reda veličine nekoliko stotina

Microbiological findings in deep caries lesions

Introduction Caries is one of the most significant and widespread oral diseases. It has been confirmed that dental plaque, i.e. microorganisms in it, are the most important factor in the development of dental caries. Caries profunda represents deep carious lesion from where bacterial toxins may affect pulp through dentinal tubules. The aim of this study is to assess the efficacy of indirect pulp capping based on microbiological findings of bacteria present in deep carious lesions before and after the treatment. Material and Methods The clinical study included 29 patients of both genders, aged 16 to 40 and 45 permanent teeth with deep caries lesions. The first microbiological sample was taken after cavity preparation and removal of soft dentin from the bottom of the cavity. The second sample was taken after the removal of temporary filling and calcium hydroxide paste 60 days after the indirect pulp capping treatment. The collected samples were stored in special sterile micro tubes (Eppendorf) and kept at the temperature of -80°C until microbiological analysis was performed. Samples were tested for the presence of the following microorganisms: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Enterococcus faecalis using the multiplex polymerase chain reaction (PCR) method. Results The results showed that prior to the treatment of deep carious lesions the most common species was E. faecalis (80% of samples), followed by A. actinomycetemcomitans (32% of samples), while the least common was P. gingivalis (16% of samples). After the treatment with products based on calcium hydroxide, E. faecalis was registered in 18% of samples, A. actinomycetemcomitans in 16% of samples and P. gingivalis was not registered in any sample. Conclusion The most common bacterial species in teeth with deep caries lesions was E. faecalis, whereas A. actinomycetemcomitans and P. gingivalis were found in lower number of samples

Indirect pulp capping using different calcium hydroxide products: A clinical study

Introduction. Indirect pulp capping is a therapeutic intervention in the treatment of deep carious lesion in order to stimulate odontoblasts to produce tertiary dentin using different biomaterials based mainly on calcium hydroxide. The aim of this study was to assess the effect of hard-setting (Dycal) and a suspension of calcium hydroxide (Calcipulp) in the treatment of deep carious lesion (caries profunda). Materials and Methods. Clinical study included 29 patients of both genders, age 16 to 40, and 45 teeth of different morphological groups with verified caries profunda using clinical and radiographic examination. After the cavity preparation, calcium hydroxide materials (Dycal or Calcipulp) were applied on the pulpal wall and cavities temporarily restored (phosphate cement) for the period of two months. After this period cavities were restored with composite materials and clinically observed during twelve months, with mandatory check-ups after three and six months. Results. Obtained results showed that indirect pulp capping using calcium hydroxide suspension (90.0%) was more successful than hard-setting material (84.0%), but with no statistically significant difference. Conclusion. Suspension and hard-setting calcium hydroxide were equally successful in the treatment of caries profunda

Lead concentration in hard dental tissues: SEM/EDS analysis

Introduction Currently, one of the most important ecological issues is exposure to lead in environment, since it is a metal with evident toxic effects on human organism. Hard dental tissues are suitable structures for assessing long-term effects of exposure to toxic metals. The aim of this paper was to determine the concentration of lead in hard dental tissues of a rat with experimentally induced DM using SEM/EDS analysis, after 14 and 30 days of exposing animals to lead. Material and methods The study was conducted in rats of Wistar strains divided into the three groups. The first group consisted of 8 rats (128 molars and premolars of the upper and lower jaws) with experimentally induced DM, taking lead in the course of 14 days at the concentration of 1500 ppm; the second group included 8 rats (128 molars and premolars of the upper and lower jaws) taking lead in the course of 30 days at the concentration of 1500 ppm, while the third control group consisted of 5 healthy rats (80 molars and premolars of the upper and lower jaws). Experimental animals received lead-acetate every day at the concentration of 1500 ppm via water ad libitum. In these animals, diabetes mellitus was induced by Alloxan. The teeth samples were analysed using scanning electron microscopy (SEM). EDS analysis determined the mass fraction of lead and other elements in hard dental tissues. Results No lead was detected in a single tooth layer in the teeth of rats that received lead in drinking water in the course of 14 days. The average values of the mass fraction of lead, calcium, and phosphorus in enamel of teeth of rats receiving lead in the course of 30 days amounted to: lead 0.36%, calcium 15.48%, and phosphorus 10.62%. Lead was registered only in enamel. Conclusion Lead was detected in enamel only in rats receiving lead in the course of 30 days while it was not detected in teeth after the course of 14 days

Analiza mikrobiološkog statusa dubokih karijesnih lezija

Introduction Caries is one of the most significant and widespread oral diseases. It has been confirmed that dental plaque, i.e. microorganisms in it, are the most important factor in the development of dental caries. Caries profunda represents deep carious lesion from where bacterial toxins may affect pulp through dentinal tubules. The aim of this study is to assess the efficacy of indirect pulp capping based on microbiological findings of bacteria present in deep carious lesions before and after the treatment. Material and Methods The clinical study included 29 patients of both genders, aged 16 to 40 and 45 permanent teeth with deep caries lesions. The first microbiological sample was taken after cavity preparation and removal of soft dentin from the bottom of the cavity. The second sample was taken after the removal of temporary filling and calcium hydroxide paste 60 days after the indirect pulp capping treatment. The collected samples were stored in special sterile micro tubes (Eppendorf) and kept at the temperature of -80°C until microbiological analysis was performed. Samples were tested for the presence of the following microorganisms: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Enterococcus faecalis using the multiplex polymerase chain reaction (PCR) method. Results The results showed that prior to the treatment of deep carious lesions the most common species was E. faecalis (80% of samples), followed by A. actinomycetemcomitans (32% of samples), while the least common was P. gingivalis (16% of samples). After the treatment with products based on calcium hydroxide, E. faecalis was registered in 18% of samples, A. actinomycetemcomitans in 16% of samples and P. gingivalis was not registered in any sample. Conclusion The most common bacterial species in teeth with deep caries lesions was E. faecalis, whereas A. actinomycetemcomitans and P. gingivalis were found in lower number of samples.Uvod Karijes je jedno od najznačajnijih i najrasprostranjenijih oboljenja usne duplje. Danas je sigurno da su dentalni plak, odnosno mikroorganizmi u njemu, najvažniji faktor nastanka karijesa. Caries profunda je duboka karijesna lezija koja predstavlja mesto odakle bakterijsko-toksični agensi preko dentinskih kanalića ugrožavaju pulpu. Cilj ovog rada je bio da se na osnovu mikrobiološke analize bakterija zastupljenih u karijesnoj leziji pre i posle terapije, odnosno na osnovu kliničkih istraživanja proveri efikasnost lečenja dubokih karijesnih lezija indirektnim prekrivanjem pulpe. Materijal i metode rada - Kliničko istraživanje je obuhvatilo 29 pacijenata oba pola, uzrasta od 16 do 40 godina, odnosno 45 stalnih zuba sa dubokim karijesnim lezijama. Posle preparacije kaviteta i uklanjanja razmekšalog dentina, sa dna kaviteta je uzet prvi bris. Drugi bris je uzet posle delovanja i uklanjanja privremenog ispuna i paste kalcijum-hidroksida nakon 60 dana. Uzeti brisevi su odloženi u posebne sterilne mikrotubice (ependorfe) i čuvani na temperaturi od -80°C do mikrobiološke analize. Uzorci materijala su ispitani na prisustvo sledećih mikroorganizama: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans i Enterococcus faecalis primenom metode multipleks tehnika reakcije lančanog umnožavanja DNK (engl. polymerase chain reaction - PCR). Rezultati - Rezultat je pokazao da je pre početka lečenja dubokih karijesnih lezija najčešća bakterijabila E.faecalis (80% uzoraka), potom A. actinomycetemcomitans (32% uzoraka), dok je najređa bila bakterija P. gingivalis (16% uzoraka). Nakon sprovedene terapije preparatima na bazi kalcijum-hidroksida, E.faecalis je zabeležen u 18% uzoraka, a A. actinomycetemcomitans u 16%, dok P. gingivalis nije registrovan ni u jednom uzorku. Zaključak - U zubima sa dubokim karijesnim lezijama najčešća bakterija bila je E. faecalis, potom A. actinomycetemcomitans, a u najmanjem broju uzoraka je ustanovljen P. Gingivalis

Oral health in children with hearing and speech impairment in Banjaluka

Introduction. Children with hearing impairment do not understand speech without specific instructions and cannot meet daily life requirements. Children with hearing and speech impairment have higher DMFT index and poorer oral hygiene than healthy children of the same age. The aim of this study was to determine oral health status and the prevalence of dental caries in children attending The Center for Education and Rehabilitation of Speech and Hearing in Banjaluka. Material and Methods. The study was conducted as a cross-sectional study and it included 66 children of both genders, age 3 to 18 years, with deciduous, mixed and permanent dentition. General information about the respondents, their socioeconomic status, dental hygiene habits and frequency of dental visits were obtained using a questionnaire. Dental examination was performed using a dental mirror, regular and proximal probe on the daylight, in accordance with World Health Organization guidelines. Oral examination included: number of present teeth, presence of caries, restorations, number of extracted teeth. These data was entered in each patient’s dental record. The DMFT index was used for the assessment of dental status. Results. Results showed that the mean DMFT value in the total sample was 7.79. There was no significant difference in the DMFT index between genders (p=0.19). The significant difference was not found between children who live with parents and those who live in foster families (p=0.15). It was observed that the respondents from rural areas had higher DMFT index (8.68) than respondents from urban areas (5.83). The DMFT index increased with age and school age (p<0.001). Examined patients were most affected with dental caries (6.62%) and least affected with extracted teeth (0.38%). It was revealed that 6% of respondents do not brush their teeth, and 25.8% of respondents had never visited dentist. Conclusion. Children with hearing and speech impairment from Banjaluka have low level of oral health. The DMFT index, as one of the most important parameters of oral health in these children was much higher compared to European countries and other countries in the region

Stanje zuba dece s posebnim potrebama u Banjaluci

Introduction. Dental status in people with special needs is generally non satisfactory. Children with special needs have difficulties in maintaining oral hygiene, they require special conditions for dental care and because of previous negative experience they often show emotional vulnerability. Development of oral and dental diseases in these subjects is the consequence of insufficient knowledge about the causes of these diseases, poor eating habits, low level of oral hygiene and inadequate number of visits to dentist. The aim of this study was to determine dental status and the prevalence of dental caries in children with special needs in the institution 'Zaštiti me' in Banjaluka. Material and Methods. The study included 82 children (53 boys and 29 girls) with mixed and permanent dentition age 5-15 years. They were divided into four groups according to their diagnosis. The first group included children with combined disorders of speech development and hearing, in the second group were children who had neurological disorders without mental retardation, third group included children with mild mental retardation and fourth group comprised children with moderate mental retardation. For each patient the number of teeth, the presence of caries and restorations, the number of extracted teeth, the presence of residual roots and the presence and number of fixed restorations were recorded. Results. Mean DMFT of all teeth was 9.77. Detailed analysis showed the greatest number of decayed teeth (83.83%), and filled teeth (9.52%) whereas the least number was for extracted teeth (6.65%). The highest percentage of children (79.27%) did not have any class I composite filling or one amalgam filling class I (82.92%). Only one child had a fixed restoration. Conclusion. The status of teeth in children with special needs in the institution 'Zaštiti me' in Banjaluka indicated high percentage of carious teeth, small percentage of restorations and extracted teeth, and inadequate oral hygiene.Uvod. Stanje zuba osoba s posebnim potrebama uglavnom nije zadovoljavajuće. Deca s posebnim potrebama imaju poteškoća u održavanju higijene usta i zuba, zahtevaju posebne uslove pri zbrinjavanju u stomatološkim ordinacijama i neretko, zbog prethodnih loših iskustava, pokazuju emotivnu preosetljivost. Značajnu ulogu u nastanku oboljenja usta i zuba kod ovih osoba imaju nedovoljna znanja o uzrocima ovih oboljenja, loše navike u ishrani, nizak nivo oralne higijene i nedovoljan broj poseta stomatologu. Cilj ovog rada bio je da se utvrde stanje zuba dece s posebnim potrebama koja borave u ustanovi 'Zaštiti me' u Banjaluci i prevalencija karijesa kod ovih osoba. Materijal i metode rada. Istraživanjem su obuhvaćena 82 deteta s mešovitom i stalnom denticijom (uzrasta 5-15 godina), od čega 53 dečaka i 29 devojčica. Ispitanici su svrstani u četiri grupe prema dijagnozi. Prvu grupu činila su deca s kombinovanim smetnjama razvoja govora i sluha, drugu deca s neurološkim poremećajima bez mentalne retardacije, treću deca s blagom mentalnom retardacijom, a četvrtu grupu deca s umerenom mentalnom retardacijom. Stomatološkim pregledom su utvrđeni: broj zuba, postojanje karijesa, postojanje ispuna, broj izvađenih zuba, postojanje zaostalih korenova i postojanje i broj fiksnih nadoknada. Ovi podaci upisani su u stomatološke kartone svakog pacijenta. Rezultati. Srednja vrednost indeksa KEP ukupno pregledanih zuba bila je 9,77. Detaljnim analizama je utvrđeno da je bilo najviše zuba zahvaćenih karijesom (83,83%), zatim plombiranih zuba (9,52%), a najmanje ekstrahovanih zuba (6,65%). Najveći procenat dece (79,27%) nije imao nijedan kompozitni ispun prve klase, odnosno jedan amalgamski ispun prve klase (82,92%). Samo je jedno dete imalo fiksnu nadoknadu. Zaključak. Stanje zuba dece s posebnim potrebama u Banjaluci ukazuje na visok procenat karijesnih zuba i mali procenat plombiranih i ekstrahovanih zuba, kao i na neodgovarajuću oralnu higijenu

Analysis of sliding mechanics force degradation during postextraction space closure

Introduction Due to its simplicity, sliding mechanism is very often used in clinical practice for post-extraction space closure, however, the efficiency of this method may be reduced due to friction and changes in the properties of the materials used in this method. The most commonly used methods of sliding mechanics are nickel titanium (NiTi) closed coil spring and elastic chain. The aim of this study was to analyze force degradation in the application of nickel titanium closed coil springs and elastic chains during post-extraction space closure within treatment with fixed orthodontic appliances. Material and Methods The total sample in this study consisted of 78 post-extraction spaces in patients who were indicated for extraction of first premolars and treatment with fixed orthodontic appliances. Nickel titanium closed coil springs and elastic chains were used to close the post-extraction spaces. Post-extraction spaces were monitored for 6 months with follow up examinations every 4 weeks. Measurements of initial force, at the beginning of mechanism activation and residual force in the observation period were performed during control examinations. Results Results of this research showed that with both methods of sliding mechanism there was a significant decrease in the observation period. When using NiTi closed coil springs, the value of average initial force at control examination was between 189.00-210.25 g, while residual was in the range of 117.56-133.50 g that NiTi closed coil springs kept an average 61.57% of initial force. The average initial force on the control examinations for elastic chains was between 184.5-205.38 g, while residual force was in range of 100.39-113.00 g, that elastic chains retained an average 53.41% of initial force. Conclusion There was a significant force degradation between inspections, when sliding mechanics were applied. The loss of force between activation phases of NiTi closed coil springs was smaller compared to the forces produced by elastic chains

Evaluation of adhesive remnant index after metal brackets removal using AutoCAD software

Introduction After the completion of treatment with fixed orthodontic appliances, it is necessary to remove the brackets and bands from teeth using an appropriate method. The aim of this study was to determine the most common way of bond failure between teeth and metal brackets, as well as to compare bond failure between the brackets and upper and lower premolars. Material and Method Metal brackets were bonded with Aspire composite material on 154 human premolars, extracted for orthodontic purposes. After debonding, the surface of remaining adhesive on the teeth and brackets was measured. Adhesive Remnant Index (ARI) was used to estimate bond failure between teeth and metal brackets. Results The average size of remaining adhesive surface after removing brackets from the upper premolars was 12.06 mm2 , while it was 9.32 mm2 on the lower premolars. The average size of the remaining adhesive surface area on the brackets removed from the upper premolars was 0.37 mm2 , while it was 2.08 mm2 on the brackets removed from lower premolars. A statistically significant difference was found between these values. The most common score of ARIteeth was 3 (85.71%) and the most frequent score of ARIbrackets was 0 (85.71%). Conclusion The most common way of bond failure between teeth and metal brackets was between the bracket base and adhesive surface. A statistically significant difference was found between the values of the size of residual adhesive surface on the upper and lower premolars as well as on the brackets debonded from them

Examination of the presence of periodontitis and gingivitis in rats with induced diabetes mellitus

Introduction Diabetes mellitus (DM) is a state of chronic hyperglycemia that is a predisposing factor to caries, gingivitis, inflammation of periodontium, oral candidiasis, xerostomia and many other diseases of the oral cavity. Inflammation of the supporting tissue of the tooth is a chronic disease that destroys the supporting structure of the tooth, i.e. periodontal ligament and alveolar bone. The aim of this study was to examine using histological analysis the presence of periodontitis and gingivitis in rats with experimentally induced DM that were sacrificed after 14 and 30 days. Material and methods The research was conducted on 42 Wistar rats. DM in experimental animals was induced by the use of Alloxan intraperitoneally. The first group (Exp_14) consisted of 16 rats in which DM was induced and sacrificed after 14 days, the second group (Exp_30) consisted of 16 rats in which DM was induced and they were sacrificed after 30 days, while the control consisted of 10 healthy rats. Results Periodontitis and gingivitis in the first group of rats (Exp_14) were determined in 54.5% of cases, while in the second group (Exp_30) in 88% of cases. In the control group no case of periodontitis and gingivitis was recorded. A highly statistically significant difference was found between the examined groups (Chi-square = 14.685; p < 0.001). Conclusion In the group of rats with experimentally induced DM that were sacrificed after 30 days, a significantly higher incidence of periodontitis and gingivitis was found compared to the group of rats that were sacrificed after 14 days