Pain Relieve after Impacted Wisdom Teeth Extraction Dependent on the Drug Therapy

Purpose of this study was to compare the effects of combined therapy using nonsteroid anti-inflammatory analgetics and corticosteroids, and the effects of the mono-therapy with same drugs for post-operative pain after surgical removal of the impacted mandibular third molar. The study was completed at the Department of Oral Surgery and at the Department of Dental Medicine of the Public Institute Health Center Zenica in Zenica. The research included 60 patients divided into 3 groups using random selection, including both sexes. Age range was between 18 and 45 years. All participants came without any pain or other inflammatory symptoms at the time of oral surgical intervention. Two medicaments were prescribed after the impacted tooth removal: 15 mg of nonsteroid anti-inflammatory analgesic drug (Meloxicam, Bosnalijek, BiH) and 32 mg Methylprednisolone (corticosteroid, Bosnalijek, BiH). Both medicaments were applied per os, according to schedule determined by the research protocol. The level of post-surgical pain was evaluated by the 1–10 visual analog scale (VAS). One way ANOVA was made with Tuckey post-hoc tests. Statistically significant difference (p<0.05) was found between the group treated with mono therapy and the group treated with combined therapy. Application of mono therapy using only corticosteroids or only nonsteroid anti-inflammatory pain-killers was less effective compared to the combined therapy with both medicaments after surgical removal of the impacted mandibular third molar

The Choice of Tooth Form for Removable Dentures

U radu su opisane različite metode koje pomažu izboru umjetnih zuba za potpune proteze. Prva je poznata teorija još iz prošloga stoljeća, a temelji se na Hipokratovoj podjeli temperamenta na neurotične, sangvinične, bilijarne i astenične tipove, pri čemu svakom temperamentu odgovara određen oblik zuba. Tu je teoriju istisnula geometrijska teorija Leona Williamsa (početak prošloga stoljeća) koja povezuje oblik lica i oblik zuba. Prema Williamsu, konturna linija gornjih središnjih sjekutića umanjena je i obrnuta kontura lica. To je najpoznatija teorija koja se spominje u gotovo svim udžbenicima protetike u svijetu. Sljedeća teorija je tzv. Dentogena, tj. SPA teorija po Frushu i Fisheru. Prema toj teoriji postoje razlike između spolova (S=sex), pacijentove osobnosti (P=personality) i dobi (A=age), jer žene imaju manje lateralne gornje sjekutiće od muškaraca, snažniji pak karakteri imaju naglašeniji očnjak, a stariji ljudi imaju tamnije i abradiranije zube, što se mora uzeti u obzir prigodom izbora zuba. Postoje još i sljedeće teorije: teorija estetskoga trokuta, koja uz povezanost između oblika lica i zuba uključuje i oblik bezubog alveolarnoga grebena, teorija individualnih preferencija, teorija koja preporučuje upotrebu starih fotografija, ekstrahiranih pacijentovih zuba ili gipsanih odljevaka čeljusti i zuba prije ekstrakcije za izbor zuba, teorija koja sa starih fotografija izračunava dužinu i širinu umjetnih zuba, itd. Također je u radu opisana važnost postavljanja zuba te mogućnost preoblikovanja zuba konturiranjem umjetne gingive.Different methods for the choice of artificial teeth for complete dentures are described in this study. The first known theory, based upon Hippocrates division of human temperaments into neurotic, sanquinic, biliar and asthenic types dates from the last century and says that the teeth form should be chosen according to a person\u27s temperament. The temperament theory was replaced by Leon Williams geometric theory (at the beginning of this century) which correlates tooth form and face shape. According to Williams the shape of upper central incisor is in accordance with the shape of the face, i.e., central upper incisor is reduced and rotated facial form. The Williams theory is the most famous theory in the world, which is mentioned in almost all of the textbooks. The first theory after Williams on the choice of artificial teeth for removable dentures was the dentogenic theory of Frush and Fisher, i.e. SPA theory (sex, personality, age). The choice of artificial teeth relied on sex, personality and age, as women have smaller second upper incisors than men, stronger personalities have more pronounced canines and older populations have darker and more abrasive teeth than younger populations, which should be considered during the teeth choice. Other theories are as follows: the theory of aesthetic triangle which correlates tooth shape, face form and residual ridge form; the theory of individual preferences; the theory which recommends the use of old photographs, teeth which are extracted or plaster casts made before extraction, the theory which calculates the width and the length of the central upper incisors from old photographs, etc. However, the importance of the tooth setting and the possibility of reshaping the teeth during setting and contouring of artificial gingiva is also mentioned in the paper

Pain Relieve after Impacted Wisdom Teeth Extraction Dependent on the Drug Therapy

Purpose of this study was to compare the effects of combined therapy using nonsteroid anti-inflammatory analgetics and corticosteroids, and the effects of the mono-therapy with same drugs for post-operative pain after surgical removal of the impacted mandibular third molar. The study was completed at the Department of Oral Surgery and at the Department of Dental Medicine of the Public Institute Health Center Zenica in Zenica. The research included 60 patients divided into 3 groups using random selection, including both sexes. Age range was between 18 and 45 years. All participants came without any pain or other inflammatory symptoms at the time of oral surgical intervention. Two medicaments were prescribed after the impacted tooth removal: 15 mg of nonsteroid anti-inflammatory analgesic drug (Meloxicam, Bosnalijek, BiH) and 32 mg Methylprednisolone (corticosteroid, Bosnalijek, BiH). Both medicaments were applied per os, according to schedule determined by the research protocol. The level of post-surgical pain was evaluated by the 1–10 visual analog scale (VAS). One way ANOVA was made with Tuckey post-hoc tests. Statistically significant difference (p<0.05) was found between the group treated with mono therapy and the group treated with combined therapy. Application of mono therapy using only corticosteroids or only nonsteroid anti-inflammatory pain-killers was less effective compared to the combined therapy with both medicaments after surgical removal of the impacted mandibular third molar

Relations of Reference Planes for Orientation of the Prosthetic Plane

Tijekom izrade protetskih nadomjestaka često se nameće upotreba jedne ili više referentnih ravnina. U literaturi postoje različita mišljenja o međusobnim odnosima referentnih ravnina koje se rabe u protetskom zbrinjavanju pacijenata. Na uzorku od 60 kefalograma, ispitanika s normalnom okluzijom, analizirano je sedam varijabli ili kutova: kut koji zatvaraju (1) okluzijska i mandibularna linija, (2) Camperova i palatalna linija, (3) frankfurtska i Camperova linija, (4) frankfurtska i palatalna linija, (5) palatalna i okluzijska linija, (6) frankfurtska i okuzijska linija i (7) Camperova i okluzalna linija. Primijenjena je rendgenkefalometrijska tehnika i kutovi između linija su izmjereni. Dobiveni rezultati statistički su obrađeni primjenom osnovnih statističkih parametara i raščlambom korelacija. Rezultati pokazuju varijabilnost okuzijske ravnine u odnosu prema ostalim referentnim ravninama čak i u ispitanika s normalnom okuzijom. Najveću varijabilnost pokazao je kut između Camperove i okuzijske ravnine. Velika varijabilnost toga kuta upućuje na nepouzdanost određivanja protetske ravnine ili umjetne okluzijske ravnine s pomoću camperove ravnine.During construction of dentures there is frequently a need for one or more reference planes. Various opinions have been expressed in literature on the mutual relations of reference planes used in prosthetic care of patients. On a sample of 60 cephalograms of patients with almost normal occlusion, seven variables were analysed. by roentgencephalometric method. The results of this study revealed the mean values of angles measured and their variability as well as their mutual correlation. Basic statistical parameters revealed significant variability of the occlusal plane inclination in the group of examinees with almost normal occlusion. The highest level of variability was found for the Camper\u27s line - Occlusal line angle which indicates that the use of Camper\u27s line to determine the occlusal plane is unreliable

Prevention of trismus with different pharmacological therapies after surgical extraction of impacted mandibular third molar

Aim To assess prevention and reduction of trismus after surgically extracted impacted mandibular third molars with individual and combined therapy with corticosteroids and anti-inflammatory analgesics. Methods The research included 60 randomly selected patients (3 groups) attended to the Dental Oral Surgery of the Public Institution Healthcare Center Zenica during the period January-December 2008. Patients of both genders, 18-45 years of age, were presented without pain and other inflammatory symptoms at the time of surgery. According to a scheme established in the research protocol, two medications were administered orally: methylprednisolone (corticosteroid) 32 mg and meloxicam (non-steroidal anti-inflammatory analgesic, NSAID) 15 mg as a single drug, or a combination of both drugs. The level of trismus is assessed on the basis of differences of preoperative and postoperative values ​​of interincisal spaces when fully opening the mouth on the second and the seventh post-operative day. The differences between groups of patients were evaluated by means of Tukey’s HSD test. Results On the second and on the seventh post-operative day significantly better results were registered in the group that received only corticosteroids and in the group that received both, corticosteroids and NSAIDs compared to the group that received only NSAIDs. A tendency of trismus reduction was present in all patient groups for the second and seventh day after surgery. Conclusion Prevention and control of postoperative trismus after surgical extraction of impacted mandibular third molars with combined therapy is effective and superior comparing to individual therapy with meloxicam-or methylprednisolone alone

EGO DEFENCE MECHANISMS IN PATIENTS WITH EPILEPSY

Background: In order to protect itself from the pain or discomf ort that would result from the forbidden instinctual impulses, the ego developed defence mechanisms (DM). Mature DMs are associated with adaptive functioning. Immature and neurotic DMs are associated with maladaptive functioning. Our goal was to determine the intensity of the most frequently used immature, neurotic and mature ego DMs in patients with epilepsy. Subjects and methods: We examined 50 patients with epilepsy, using a Defense Style Questionnaire (DSQ-40). We measured the intensity of individual DMs. Mature DMs: sublimation, humour, suppression and anticipation; neurotic DMs: undoing, pseudo- altruism, idealization and reactive formation; and immature DMs: projections, passive aggression, acting out, isolation, devaluation, autistic fantasies, denial, displacement, dissociation, splitting, rationalization and somatization. The control group consiste d of 36 healthy subjects. Groups are equal in age and level of education. Results: Patients with epilepsy use neurotic (p=0.0290) and immature (p=0.0155) defensive styles significantly more. Individually, they most intensively use acting out, humour and sublimation, and statistically significantly more they use displ acement (p=0.0161), denial (p=0.05) and somatization (p=0.0019). Conclusion: Patients with epilepsy use the neurotic and immature styles of ego defence more intensively. As such, they are less adaptable to new situations. Our knowledge can be useful for planning future interventions for people living with epilepsy

The Effect of Scaling and Root Planing on the Clinical and Microbiological Parameters of Periodontal Diseases

Postojanje parodontnih patogena u subgingivnoj flori parodontitisa rizik je za napredovanje parodontne bolesti. Zato mikrobiološka dijagnostika ima opravdanu indikaciju u otkrivanju patogena, praćenju uspjeha terapije i ishoda bolesti. Svrha ovoga rada bila je prikazati učinak struganja i poliranja korijena (SRP) na kliničke i mikrobiološke čimbenike u 28 pacijenata s kroničnim i agresivnim parodontitisom. Klinička procjena i mikrobiološko testiranje provedeni su prije mehaničke terapije (SRP) i tri mjeseca nakon terapije. Klinički je utvrđeno postojanje ili nepostojanje bakterijskoga plaka i gingivnoga krvarenja, te je određena dubina sondiranja i gubitak pričvrstka prije struganja i poliranja korijena te tri mjeseca nankon toga.Uzorci subgingivnoga plaka uzeti iz parodontnih džepova analizirani su tehnikom lančane reakcije polimeraze (PCR) na nazočnost sedam bakterijskih patogena. Rezultati kliničkih pokazatelja i čestoća bakterijskih vrsta analizirani su prije i poslije terapije Wilcoxson- testom rangova. Srednja vrijednost dubine sondiranja izrazito se je smanjila, od 3,9 na 3 mm. Gubitak pričvrstka smanjio se je umjereno, i to od 4,1 na 3,8 mm. Srednja vrijednost plaka i gingivnoga krvarenja također su smanjeni nakon terapije. Čestoća subgingivnih patogena u ispitanika bila je sljedeća: samo jedna patogena vrsta nađena je u 28,6% ispitanika, dvije vrste u 46,4% i tri u 14,3% ispitanika. Najčešće zastupljeni ispitivani patogeni bili su: Bacteroides forsythus u 85,7%, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans (A.a.) i Fusobacterium nucleatum u 32,1% ispitanika. Nakon terapije čestoća patogena umjereno se je smanjila. Ukupni broj ispitivanih patogena smanjio se je u 12 ispitanika i taj nalaz bio je statistički znatan (p=0,001). U 16 ispitanika broj patogena ostao je isti, a nije se povećao ni u jednog ispitanika. Nalazi pokazuju da se struganjem i poliranjem korijena u liječenju parodontitisa djelotvorno postiže kliničko i mikrobioloπko poboljšanje smanjenjem čestoće patogena odgovornih za napredovanje bolesti.The occurence of periodontal pathogens in subgingival flora in periodontitis is a risk for periodontal disease progression. Therefore microbiologic diagnostic procedures are justifiably indicated in the detection of pathogens, monitoring of therapy success and outcome of the disease. The aim of this study was to show the effect of scaling and root planing on clinical and microbiological factors in 28 patients with chronic and aggressive periodontitis. Clinical assessment and microbiological testing were performed prior to, and three months after mechanical therapy. The presence or absence of bacterial plaque, gingival bleeding, pocket depth and attachment loss were assessed before and three months after scaling and root planing. Samples of subgingival plaque taken from periodontal pockets, were analysed by polymerase chain reaction technique for the presence of seven bacterial pathogens. Results of clinical parameters and bacterial prevalence were analysed before and after therapy by Wilcoxon Rank test. The mean pocket depth significantly decreased from 3.9 to 3.0 mm. Clinical attachment level decreased moderately from 4.1 to 3.8 mm. Mean plaque and gingival bleeding values also decreased after therapy. The prevalence of subgingival pathogens in relation to subjects was as follows: only one pathogenic species was found in 28.6%, two were found in 46.4% and three in 14.3% of subjects. The most prevalent pathogens were bacteroides forsythus in 85.7%, Porphyromonas gingivalis in 32.1%, Actinobacillus actinomycetemcomitans and Fusobacterium in 32.1% of subjects. After therapy the prevalence of pathogens decreased moderately. The total number of tested pathogens decreased in 12 subjects and this result was statistically significant. (p=0.001). In 16 subjects the number of pathogens was the same, and did not increase in any of the subjects. The results indicate that the effect of scaling and root planing in the treatment of periodontitis was effective in achieving clinical and microbiological improvement by decreasing the prevalence of pathogens responsible for disease progression

Correlation between the Size of Maxillary Frontal Teeth, the Width between Alae Nasi and the Width between Corners of the Lips

Svrha ovoga rada bila je ustanoviti poklapa li se širina prednjih gornjih sjekutića (ŠČETINC), širina između vrškova gornjih očnjaka (ŠTRITRI) ili širina sjekutića i očnjaka zajedno (distoaproksimalne plohe očnjaka) (UŠTRITRI) sa širinom nosnih krila (ŠN) ili sa širinom rime oris (ŠRO) na reprezentativnom uzorku te pronaći odnose i omjere između tih parametara koji bi mogli biti korisni u kliničkoj praksi. U tu svrhu provedena su mjerenja kod 2000 ispitanika u dobi od 18 do 24 godine s pomoću precizne pomične mjerke. Svi ispitanici imali su intaktne gornje prednje zube. Bilo je 920 ispitanika muškoga spola i 1080 ispitanika ženskoga spola. Prema dobivenim rezultatima zaključeno je: 1. Postoji statistički znatna razlika između muškoga i ženskoga spola za sve izmjerene varijable (ŠN, ŠRO, ŠČETINC, ŠTRITRI i UŠTRITRI, p0,05). 3. Širina nosa približno odgovara širini između vrškova očnjaka (1,08:1). Preostali omjeri iznose: ŠN/ŠČETINC = 1,206:1, ŠRO:UŠTRITRI = 1,228:1, UŠTRITRI:ŠN = 1,158:1 i zajedno s izmjerenim prosječnim vrijednostima ŠČETNC, ŠTRITRI, UŠTRITRI u ispitivanoj populaciji mogu pomoći prigodom izbora veličine gornjih prednjih zuba i njihova postavljanja u potpunoj protezi.The aim of this study was to determine correlation between the width of upper incisors (WUI) or the width between the tips of the upper canines (WTC), or the width between distoaproximal surfaces of upper canines (WDaC) with the width of the alae of the nose (WAN) or the width between the corners of the mouth (WCM) on a representative sample. The aim was also to calculate the ratio between the measured variables, which could be helpful in clinical practice. For this purpose two thousand individuals aged from 18 to 24 years, with intact frontal teeth were measured. There were 920 males and 1080 females. According to statistical analysis of the results it was concluded: 1. Statistically significant difference between males and females existed for all the measured variables (WAN, WCM, WUI, WTC and WDaC), i.e. males had bigger dimensions. 2.There was no significant difference between sexes for all the calculated ratios: WCM/WAN, WAN/WUI, WCM/WDaC, WAN/WTC, WDaC/WAN (p>0.05). 3. The width of the nose approximates to the width between the tips of the cusps of upper canines (1.08:1). The other calculated ratios are: WAN/WUI = 1.206:1; WCM:WDaC = 1.228:1, WDac:WAN = 1.158:1 and these ratios together with the measured mean values: WUI, WCT, WDaC in the examined population, both for men and women, could be helpful for the choice of the proper size of upper frontal artificial teeth and for their setting in the wax of the denture

The Effect of Scaling and Root Planing on the Clinical and Microbiological Parameters of Periodontal Diseases

Postojanje parodontnih patogena u subgingivnoj flori parodontitisa rizik je za napredovanje parodontne bolesti. Zato mikrobiološka dijagnostika ima opravdanu indikaciju u otkrivanju patogena, praćenju uspjeha terapije i ishoda bolesti. Svrha ovoga rada bila je prikazati učinak struganja i poliranja korijena (SRP) na kliničke i mikrobiološke čimbenike u 28 pacijenata s kroničnim i agresivnim parodontitisom. Klinička procjena i mikrobiološko testiranje provedeni su prije mehaničke terapije (SRP) i tri mjeseca nakon terapije. Klinički je utvrđeno postojanje ili nepostojanje bakterijskoga plaka i gingivnoga krvarenja, te je određena dubina sondiranja i gubitak pričvrstka prije struganja i poliranja korijena te tri mjeseca nankon toga.Uzorci subgingivnoga plaka uzeti iz parodontnih džepova analizirani su tehnikom lančane reakcije polimeraze (PCR) na nazočnost sedam bakterijskih patogena. Rezultati kliničkih pokazatelja i čestoća bakterijskih vrsta analizirani su prije i poslije terapije Wilcoxson- testom rangova. Srednja vrijednost dubine sondiranja izrazito se je smanjila, od 3,9 na 3 mm. Gubitak pričvrstka smanjio se je umjereno, i to od 4,1 na 3,8 mm. Srednja vrijednost plaka i gingivnoga krvarenja također su smanjeni nakon terapije. Čestoća subgingivnih patogena u ispitanika bila je sljedeća: samo jedna patogena vrsta nađena je u 28,6% ispitanika, dvije vrste u 46,4% i tri u 14,3% ispitanika. Najčešće zastupljeni ispitivani patogeni bili su: Bacteroides forsythus u 85,7%, Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans (A.a.) i Fusobacterium nucleatum u 32,1% ispitanika. Nakon terapije čestoća patogena umjereno se je smanjila. Ukupni broj ispitivanih patogena smanjio se je u 12 ispitanika i taj nalaz bio je statistički znatan (p=0,001). U 16 ispitanika broj patogena ostao je isti, a nije se povećao ni u jednog ispitanika. Nalazi pokazuju da se struganjem i poliranjem korijena u liječenju parodontitisa djelotvorno postiže kliničko i mikrobioloπko poboljšanje smanjenjem čestoće patogena odgovornih za napredovanje bolesti.The occurence of periodontal pathogens in subgingival flora in periodontitis is a risk for periodontal disease progression. Therefore microbiologic diagnostic procedures are justifiably indicated in the detection of pathogens, monitoring of therapy success and outcome of the disease. The aim of this study was to show the effect of scaling and root planing on clinical and microbiological factors in 28 patients with chronic and aggressive periodontitis. Clinical assessment and microbiological testing were performed prior to, and three months after mechanical therapy. The presence or absence of bacterial plaque, gingival bleeding, pocket depth and attachment loss were assessed before and three months after scaling and root planing. Samples of subgingival plaque taken from periodontal pockets, were analysed by polymerase chain reaction technique for the presence of seven bacterial pathogens. Results of clinical parameters and bacterial prevalence were analysed before and after therapy by Wilcoxon Rank test. The mean pocket depth significantly decreased from 3.9 to 3.0 mm. Clinical attachment level decreased moderately from 4.1 to 3.8 mm. Mean plaque and gingival bleeding values also decreased after therapy. The prevalence of subgingival pathogens in relation to subjects was as follows: only one pathogenic species was found in 28.6%, two were found in 46.4% and three in 14.3% of subjects. The most prevalent pathogens were bacteroides forsythus in 85.7%, Porphyromonas gingivalis in 32.1%, Actinobacillus actinomycetemcomitans and Fusobacterium in 32.1% of subjects. After therapy the prevalence of pathogens decreased moderately. The total number of tested pathogens decreased in 12 subjects and this result was statistically significant. (p=0.001). In 16 subjects the number of pathogens was the same, and did not increase in any of the subjects. The results indicate that the effect of scaling and root planing in the treatment of periodontitis was effective in achieving clinical and microbiological improvement by decreasing the prevalence of pathogens responsible for disease progression

EGO DEFENCE MECHANISMS IN PATIENTS WITH EPILEPSY

Background: In order to protect itself from the pain or discomf ort that would result from the forbidden instinctual impulses, the ego developed defence mechanisms (DM). Mature DMs are associated with adaptive functioning. Immature and neurotic DMs are associated with maladaptive functioning. Our goal was to determine the intensity of the most frequently used immature, neurotic and mature ego DMs in patients with epilepsy. Subjects and methods: We examined 50 patients with epilepsy, using a Defense Style Questionnaire (DSQ-40). We measured the intensity of individual DMs. Mature DMs: sublimation, humour, suppression and anticipation; neurotic DMs: undoing, pseudo- altruism, idealization and reactive formation; and immature DMs: projections, passive aggression, acting out, isolation, devaluation, autistic fantasies, denial, displacement, dissociation, splitting, rationalization and somatization. The control group consiste d of 36 healthy subjects. Groups are equal in age and level of education. Results: Patients with epilepsy use neurotic (p=0.0290) and immature (p=0.0155) defensive styles significantly more. Individually, they most intensively use acting out, humour and sublimation, and statistically significantly more they use displ acement (p=0.0161), denial (p=0.05) and somatization (p=0.0019). Conclusion: Patients with epilepsy use the neurotic and immature styles of ego defence more intensively. As such, they are less adaptable to new situations. Our knowledge can be useful for planning future interventions for people living with epilepsy