Telemedicine as a Means of Delivering Prenatal Care

Information technology (IT) has become a means of disseminating medical services.  Telemedicine provides an opportunity to contribute to the provision of obstetric care in the context of a pandemic without risk for patients and healthcare specialists. Concurrently, the healthcare sector faces challenges such as limited resources, and fear of spreading infection when having personal consultation.  The opinion of practising midwives and pregnant women was studied regarding their attitudes to the implementation of new technologies in the delivery of prenatal care. The results highlight the necessity to apply innovative means of monitoring and consulting pregnant women in the circumstances of a pandemic.Telemedicine is a means of maintaining high quality healthcare during pregnancy in the circumstances of a pandemic without breaking off the contact between doctors and patients and at the same time guaranteeing successful perinatal outcomes

Interaction and problematics of the bronze coinage minted for Apollonia Pontica at the edge of the 4th towards the 3rd century BC

The bronze issue of Apollonia Pontica depicting a seated Apollo on an omphalos has been indisputably connected for decades to the Seleucid presence in Thrace and, based on its iconography, dated to the middle of the 3rd century BC. Most of the remaining bronze issues have been placed in a vague chronological order before or after due to lack of solid evidence. Discrepancies of stylistic and stratigraphic chronology demanded a broad review of the many types often represented by only a few examples. An arrangement through die links and a review of the interactions in a denomination sys-tem may help fill the gaps in the chronology. Furthermore, all relevant characteristics of Classical and Hellenistic art shall be considered in this paper to reattribute the issues and bridge the gap between these periods. The discussion emphasizes the weight of each chronological feature that should be contemplated, since they are applied not only in numismatics but also in other small finds disciplines

Ethical Aspects of Vulnerable Group of Patients in Clinical Trials

The current publication aims to review and analyse the ethical aspects and regulations to protect the category of vulnerable patients, as defined in the European legislation. These patients need special protection and require more detailed approach throughout the clinical trials’ life cycle

The correlation between the rotation of upper first permanent molars and malocclusions in the individual dental arch and in the occlusion

IntroductionMalocclusions disturb the integrity of the dental arch and the interdental/occlusal relationship. All this leads to a change in the position of the upper molars in the sagittal, transversal and vertical plane. The rotation of the upper first molar leads to a shift of position of molar cups in a mesio-distal direction demonstrated by the great impact on the distribution of occlusal forces.AimThe rotation of upper first molars should not be underestimated in the biometrical analysis of diagnostic dental casts as this can lead to incomplete and improper treatment plan.Ðœaterials and MethodsOur study investigated 681 children aged 7-10 years who attended the Department of Orthodontics at the Faculty of Dental Medicine in Varna. All children were clinically evaluated and biometrical assessment of diagnostic dental casts was performed. Diagnostic records included also photo-analysis and measurements of diagnostic dental casts. The relationship between the rotation of upper first permanent molars and the transversal and sagittal dimension, and also the overjet were assessed. The degrees of rotation were classified using the Friel and Vigano methods.ResultsA regressional statistical analysis was conducted to determine the frequency of malocclusion and to establish the relationship between the rotation of upper first permanent molar and the length of the arch, the intercanine distance, and the overjet. The comparative analysis demonstrated inverse relationship not only between the rotational position of the molars and the length of the arch, but also between the canine distance and the rotation of the upper molars (p<0.01). It is reported that when an overjet up to 4 mm is present,  the mediopalatal rotation of the molars is negatively affected.ConclusionLosing the length of the arch leads to compression of the dental arch, medialization of permanent molars and crowding of the frontal teeth. The problem of mesiopalatal rotation of upper first permanent molars is manifested through increased overjet and increased overbite

The importance of upper first permanent molars position for the orthognatic occlusion

Development of the dental arches and occlusion in permanent dentition can be divided into several stages and has to be observed regularly. The first permanent molar eruption is related to the onset of significant changes in the developing occlusion. Although this tooth is seen as the `key to occlusion` its value as an anchorage is debatable.The aim of the article is to study the correct position of the upper first molars in the two planes of space - the sagittal and transverse planes.In this article the position of the first upper molar is examined with the aid of diagnostic records, such as study cast, orthopantomogram (OPG), and lateral cephalometrics. A literature review includes Bulgarian and foreigner authors.Angle, who in 1899 referred to the maxillary first permanent molars as the `key to occlusion`, was the first to mention their importance within the dentition. According to Angle, the line passing through the middle of the mesiobuccal cusp of the upper first molar coincides with the line passing through the buccal groove of the lower first molar. After Angle, other authors have discussed the position of upper molars from different point of view, such as their relation or position in the maxilla, anteroposterior axial inclination and rotation. As indicated by Lamons and Holmes molar rotations commonly exist in Class II malocclusions. The molars are usually rotated around an axis lingual to their central fossae. In an ideal occlusion the buccal surfaces of the upper first molars are usually parallel to each other.On the OPG Kurol and Bjerklin measured the axial mesial inclination of upper first molar. The tipping of the molars is measured by the angle formed between the tangent line to the mesial surfaces of the root and crown and the line through the lower margins of the left and right orbits.According to Sassouni, the mesial contour of upper first molar should to lie on the 4th arc - the temporal arc. If the molar is anterior to this arc, a treatment with distalization could be initiated. The temporal arcnasion distance measured on the radius is equal to the distance from point ANS to the upper first molar. The position of the upper first molar varies with the position of the upper central incisors. The basic hypothesis is that if the upper first molar has a fixed position in the face, any increase in the total upper dental arch length will be transferred to the incisor area. Any change in the anteroposterior position of the upper first molar could influence the position of the mandibular- leading to Class II malocclusion.Ricketts pointed out that the average distance from the pterygoid vertical (PTV) to the distal surface of upper first molar is the sum of the age of the patient + 3mm, in a growing patient. This diagnostic method can help the orthodontist to decide whether to extract teeth or to distalize the molars.Any loss of space in the arch is a justification for early orthodontic treatment. Mediopalatal rotation of the upper molar is an additional problem in the final phase as well. The rotation of upper first molars is measured by the angles formed by the intersection of lines going over the tips of the mesiopalatal and distobuccal cusps of each molar (Ricketts line) with a straight line marked over the palatine raphe.The problem of reduced arch length has an impact on the final treatment stage when the major orthodontic goal is establishing a tight teeth intercuspation. The molars influence the transfer of occlusal forces to the facial skeleton. The upper first molar tolerates more changes in the position than the lower one. The correct position of the upper molar ensures a stable occlusion with significantly low grade of relapse

Diagnostic approach to the incorrect position of lower second premolars

Abstract: The lower second premolar is regarded as the third most common impacted tooth after lower wisdom teeth and upper canines. The aim of the present study is to apply objective diagnostic methods to help determine the impaction likelihood of lower second premolars and their distal inclination. For the purpose of this study 137 panoramic radiographs (OPGs) have been examined of children aged 8 - 16 years. The methodology used in this study helped measure the inclination and angle between the lower second premolar and the crown and axis of the first permanent molar and the mandibular plane. Prevalence of the distal inclination of lower second premolars was observed. Indicators for the impacted lower second premolar proved to be the germ inclination of the lower fifth tooth in relation to the first molar of more than 30° and the intersection of the crown of the sixth tooth by the axis of premolar as well as the inclination towards the mandibular plane of less than 68°. Early extraction of deciduous molars, reserving or creating space when there is a lack of space, allow for favourable conditions for altering the eruption path of the premolar