Патолошка состојба на плунковните жлезди - Сијалолитијаза

Резиме:Сијалолитијазата или калкулус на плунковните одводни канали се најчестата патолошка состојба на плунковните жлезди. Сијалолитијазата претставува повеќе од 50% од сите главни заболувања на плунковните жлезди кои се јавуваат кај постарата популација, но често се јавува и кај младите лица. Калкулусите се депозити на калциумови соли кои вршат опструкција на одводните канали на малите и големи плунковни жлезди, а не ретко ги зафаќаат и паренхиматозните делови на плунковните жлезди. Сијалолитот е изграден од органски супстанции какогликопротеини, мукополисахариди и клеточен дебрис, како и неоргански супстанции калциум карбонат и калциум фосфат. Најчесто имаат овална форма и при испитување со PCR методата се пронајдени остатоци од бактериска DNA. Заболувањето најчесто се јавува кај возрасни во средна годишна возраст, но можна е појавата и кај деца и помлади. Два до три пати е почеста појавата кај мажи од колку кај жени. Најчесто се јавува во една плункова жлезда, но кај околу 3% од случите се јавува истовремено во повеќе жлезди. Во поголемите жлезди калкулусите се почесто локализирани во главниот изводен канал отколку интрагландуларно. Симптомите на опструкција на плунковните жлезди од калкулуси почетно одат со благи колики, додека подоцна се јавува едем на зафатените плунковни жлезди.Симптомите се јавуваат кога покрај постоење на калкулусите во одводни канали ќе се јави нарушување во истекување на плунката, односно ќе дојде до враќање на плунка кон ацинусите –Backflou. Лекување на сијалолитијаза е примарно хируршки. Отстранувањето на калкулусите е индицирано во периодот кога нема знак за акутна инфекција во изводен канал или во самата жлезда. Ако е калкулусот е мал од 1 до 2мм а се наоѓа во близина или на самиот орифициум на изводниот канал, неговото отстранување може да биде со масажа на жлездата. Во други случаи доколку калкулусот се отстранува по хируршки пат. Сијалолитијазата како често заболување на постарата популација но и на помладата популација, заслужува посебно внимание бидејќи често оваа болест може да биде превенирана преку правилно одржување на оралната хигиена, санирање на оралните фактори кои доведуваат до нарушување на Ph вредноста на усната празнина, третман на придружните коморбидитенти состојби. Клучни зборови: Плунковна жлезда, калкулус, калциум фосфат, калциум карбонат, Warton –ов канал

Pathological condition of the salivary glands - Sialolithiasis

Sialolithiasis or salivary duct calculus is the most common pathological condition of the salivary glands. Sialolithiasis represents more than 50% of all major diseases of the salivary glands that occur in the elderly population, but it often occurs in young people as well. Calculi are deposits of calcium salts that obstruct the drainage channels of the small and large salivary glands, and not infrequently affect the parenchymal parts of the salivary glands. Sialolite is made up of organic substances such as glycoproteins, mucopolysaccharides and cellular debris, as well as inorganic substances calcium carbonate and calcium phosphate.Most of the time, they have an oval shape and during examination with the PCR method, the remains of bacterial DNA were found. The disease usually occurs in middle-aged adults, but it can also occur in children and younger people. It occurs two to three times more often in men than in women. It most often occurs in one salivary gland, but in about 3% of cases it occurs simultaneously in several glands. In larger glands, calculi are more often localized in the main duct than intraglandular. The symptoms of obstruction of the salivary glands from calculi initially go with mild colic, while later edema of the affected salivary glands occurs. The symptoms appear when, in addition to the existence of calculi in drainage channels, there is a disturbance in the flow of saliva, that is, there will be a return of saliva to the acini -Backflou.Treatment of sialolithiasis is primarily surgical. The removal of calculi is indicated in the period when there is no sign of acute infection in the duct or in the gland itself. If the calculus is small from 1 to 2 mm and is located near or at the orifice of the outlet channel, its removal can be done by massaging the gland.In other cases, if the calculus is removed surgically. Sialolithiasis, as a frequent disease of the elderly population but also of the younger population,deserves special attention because this disease can often be prevented through proper maintenance of oral hygiene, remediation of oral factors that lead to disturbance of the Ph value of the oral cavity, treatment of associated comorbidities conditions. Keywords:salivary gland, calculi, calcium phosphate, calcium carbonate, Wharton’s duct

Дигитални отпечатоци-современ тренд на денешницата

Земањето на отпечаток претставува најбитна процедура во секојдневната стоматолошка пракса. Целта на земањето на точен и прецизен отпечаток е да се прикаже димензиски стабилен негатив кој ја претставува моменталната ситуација од усната празнина. За изработка на адекватни протетски изработки најбитно е што е можно поточно репродуцирање на интраоралната состојба, и особено значајно е дека при присутна грешка може да се добие неквалитетна конечна изработка. Современите дентални отпечаточни материјали се прецизни, хидрофилни и димензионално стабилни и можат автоматски да се замешуваат. Компаративно со развојот на конвенционалните отпечаточни материјали доаѓа до појава на интраорални скенери за дигитално отпечатување на различните структури во усната празнина. Интраоралните скенери се дигитални апарати кој во стоматолошката ординациија се користат за дигитално земање на отпечатоци и прикажување на реалната состојба од усната празнина на пациентот и на пазарот и во секојдневната стоматолошка пракса се појавуваат во осумдесетите години на минатиот век. Механизмот на нивната работа се темели на емитирање на структурирана светлосна мрежа или ласерски зрак кој доаѓа во контакт со површината која се скенира. За време на контактот со површината зраците се деформираат и се враќаат во камерата која го праќа примениот сигнал во софтверот. Софтверот ги комбинира сите примени слики од снимените разни агли, земајќи ги во предвид движењата на скенерот како и оддалеченоста на објектите кои се скенираат, и на тој начин се реконструира скенираниот објект. Денес на пазарот постојат разни интраорални скенери базирани на разни оптички компоненти и извори на светлина. Се разликуваат скенери базирани на активно произведување на бранова должина (True Definition Scanner, 3M), паралелна конфокална микроскопија (3Shape) и на оптичка триангулација (Sirona CEREC Omnicam). Покрај наведените постојат скенери кои користат и вештачка интелегенција како по секое скенирање имаат повеќе информации и податоци во врска со природните заби. Најзначајните предности при употребата на дигиталните отпечатоци се однесуваат на тоа дека со нивната примена се скратува времетраењето на самите интервенции, има помала непријатност кај пациентите, станува збор за едноставна процедура, постои можност за електронски трансфер на самите податоци и се добива значително попрецизна и поточна презентација на состојбите од усната празнина на самите пациенти. Клучни зборови: дигитално отпечатување, интраорални скенери, отпечаток, отпечаточни материјал

Oral hygiene practices and tooth cleaning techniques

Theoretical part (45 min) The importance of oral hygiene Basic and additional ways for maintaining adeqauate oral hygiene types and selection of toothbrushes Oral hygiene techniques Meaning and maintenance of interdental hygiene • Practical part (1.5 hours) Presentation of the most common techniques for brushing teeth Presentation of techniques for removing dental plaque from the interdental spaces Motivations to maintain an adequate level of oral hygiene Use of metil-blue for coloring the surfaces of the teth that have dental plaque and using the techniques for its cleanin

Influence of xerostomia on diet and nutrition among institutionalized elderly

Adequate meals are very important for enhancing quality of life among institutionalized elderly. The function of saliva mainly is to maintain the integrity of the hard and soft tissues of the oral cavity, and also has influence on the speech, swallowing and tasting process. Also, saliva plays an important role as a solvent of taste substances, but the prevalence of dysgeusia and hypogeusia are increasing in patients with xersotomia. Reduced salivary secretion leads to dryness of oral mucosa and accelerates the damage on the taste receptor cells. Based on the above mentioned facts, the main aim of this study was determined - to assess whether the present xerostomia has an impact on food choice in institutionalized elderly. Total number of 70 subjects older than 65 years institutionalized in one long-term care institution was evaluated. Adequate printed questionnaire for the subjective representation and expression of xerostomia was. Each of the groups in which there was a subjectively assessed xerostomia that was tested for satisfaction with their diet and nutrition intake. Data obtained from the questionnaire was appropriately statistically processed. For statistical analysis we have used special software for statistical analysis of data- Statistica 7.1. 62.8% from subjects had subjective feeling of xerostomia. After processing the data obtained from the questionnaire may be noticed that most of the examined population or 41.4% had mild (xerostomia 1), while 25.7% of subjects based on the answers to the questionnaire had severe xerostomia (xerostomia 3). Also, it must be noted that 64.7% from subjects with severe xerostomia indicated an unsatisfactory diet, versus 37.9% of subjects with mild xerostomia. Based on the research, we can conclude that xerostomia is often present in institutionalized elderly and it has a great impact on nutrition. Stronger xerostomia negatively affects the diet of these elderly people

CLASSIFICATION OF TEMPOROMANDIBULAR DISORDERS

Temporomandibular joint (TMJ), also known as jaw joint or mandibular joint, is a bilateral synovial articulation between the temporal bone above and the mandible below. The TMJ is certainly one of the most complex joints in the body. The movements in both joints are synchronized and allow movement of the lower jaw. The term temporomandibular joint dysfunction is used for structural and functional disorders related to the temporomandibular joints, masticatory muscles, and surrounding structures. It is characteristic that all the signs and symptoms worsen with the movement of the lower jaw, which occurs: limited mobility of the lower jaw, increased sensitivity to palpation and pain in the masticatory muscles, increased sensitivity and pain in the joint, locking and squeaking when moving the lower jaw, pain during movement, improper movement of the lower jaw, headache, neck pain, possible hearing and balance problems. Temporomandibular disorders (TMDs) can be classified into the following categories: Masticatory muscle disorders (muscle pain, muscle spasm, myositis and tendonitis); Derangements of the condyle-disc disorders (disk displacement with reduction, disc displacement without reduction, disc perforation, structural changes in the articular surfaces of the temporomandibular joint and temporomandibular joint dislocation); Inflammatory and degenerative disorders (arthritis and osteoarthritis); Limited mobility of TMJ – hypomobility (forward disc displacement, ankylosis and trismus) and Congenital and developmental anomalies. In order to successfully manage the temporomandibular disorders, we must consider that here are numerous types of problems and variety of etiologies that cause them. Separating these disorders into common groups of symptoms and classifying them is a process called diagnosis. This is very important because for each diagnosis there is an appropriate treatment. There is no treatment that is universal and appropriate for all temporomandibular disorders. In many situations, the success of therapy depends less on how the treatment is performed than on whether the therapy is appropriate and correct for the disorder. Therefore, making a correct diagnosis is extremely important for proper treatment. Keywords: classification, temporomandibular disorders, temporomandibular joint dysfunction

Prevalence of peri-implant diseases

Background: Peri-implantitis is inflammatory condition caused by a bacterial origin and characterized by inflammation in the peri-implant soft tissues and a progressive loss of supporting bone. Mucositis is inflammation of the peri-implant mucosa without any bone loss. This main aim of this study was to determine the prevalence of peri-implant diseases, mucositis and peri-implantitis in two different types of implant systems. Material and method: Total number of 44 implants placed in 30 patients was examined. Clinical examination of all placed implants was done. Clinical pocket depth and bleeding upon probing, plaque index, implant mobility, presence of suppuration and radiographic bone loss, were analyzed for every implant. We have compared two types of implants- conventional (20 implants) and platform switching (24 implants) after one year of loading. Results: 70.45 % from all implants presented as healthy, 20.45 % from all implants presented peri-implant mucositis and 9.1 % of all implants showed signs for peri-implantitis. Platform switching implants showed lower incidence of mucositis and peri-implantitis, but there was not significant difference (p = 0.575) Conclusion: Within the limitations of the current study, we have noted lower prevalence of peri-implantitis with platform switching Implant

Fatigue failure mode of porcelain veneers with different preparation designs

Introduction: Due to high aesthetic qualities, proven biocompatibility and prognosis for long term durability, porcelain veneers have become a routine restorative procedure for treatment of frontal teeth. The aim of this in vitro study was to examine the influence of the preparation designs on the fatigue failure of porcelain veneers. Materials and method: In this in vitro study porcelain veneers with three different types of preparation design – feather, bevel and incisal overlap – palatal chamfer were analyzed. The veneers were made on maxillary central incisor by refractory die technique. The samples from all three groups were loaded to failure in a testing machine TRITECH WF 10056. The force was applied at angle of 45° to the long axis of the tooth, with constant speed of 0,5 mm/min. The mode of failure was determined as debonding or fracture. The data were statistically analyzed using statistical program Statistica 7.1; SPSS17.0. Results: In feather preparation as a consequence of mechanical strength, fracture is registered in 20.0% of samples and debonding at 80.0%. In bevel preparation fracture is register in 93.3% and debonding in 6.7%. In incisal overlap – palatal chamfer due to mechanical strength is registered fracture in 96.7% and debonding in 3.3%. The percentage difference between the registered mode of failure – fracture against debonding between the groups according to Difference test was statistically significant between group I against group II, and I against III group, for p<0.05 (p=0.0438). Conclusion: The most common fatigue failure in porcelain veneers with feather preparation is debonding, while in other preparation designs fracture dominates. Key words: fatigue failure, fracture resistance, porcelain veneers, preparation designs

Analysis of Golden percentage on Maxillary Anterior Teeth for Estethic Smile Design

Introduction The teeth in front are an important segment in the aesthetics of an individual, but the maxillary central incisors are the dominant element, they need to have appropriate proportions in terms of height and width in order to have the best possible aesthetic results. Aim The aim of this study is through digital photographs and computer analysis, to determine the Golden percentage according to Snow where the individual width of the front tooth is calculated as a percentage of the total width of the front six teeth, and for canines is 10%, for lateral incisions it is 15%, and for central incisions it is 25% of the total distance measured in the frontal segment, in patients with natural teeth. Material and Methods Frontal photographs were taken of patients with a posed smile, using a digital camera (NIKON) under standardized conditions, 1 meter away from the patient's, and the lens was aimed at the patient's lips. A digital computer program was used to process the photos and take the measurements. A total number of patiens is 15 respondents, aged between 18 to 30, of which 6 are men and 9 are women. An equal number of patients are included in the Angle classification. Results After the conducted analyzes and the summarized results regarding the gender classification, we obtained the following percentage representation in the male population is 12.49%, 14.83% and 21.95%, while in the female population it is 12.93%, 15.16% and 21.9%. Regarding the Angle classification in patients with Class I, we obtained the following percentage of 12.12%, 15.18%, 22.57%, in Class II 14%, 15.14% and 21.39%, while in Class III it is 13.74%, 14.72% and 21.45% . Conclusion According to the obtained results, the percentage of lateral incisions is the only one that is close to the golden percentage, while all other obtained results do not match. Key words: analysis, esthetic smile, golden percentage, maxillary anterior teeth

Dental caries and salivary bacteria in school children at age of 12 with present and absent dental caries

A group of phenotypically similar bacteria, collectively known as mutant streptococci, are considered as the main bacterial components responsible for the onset and development of cavities. The aim of our study is to identify the salivary bacteria (Lactobacillus spp., Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius and Streptococcus mitis) and analyze their interdependence with the dental status. The study included 71 children (26 female and 45 male) at the age of 12 years. According to their dental health status, they were divided into: control group - 31 examinees without caries, missing teeth (extractions) and dental fillings (DMF = 0); and experimental group - 40 examinees with caries, missing teeth (extractions) and dental fillings. In all examinees clinical and microbiological examinations were carried out. The lactobacilli in the saliva were determined with a diagnostic test CRT-bacteria (Vivadent, Schaan, Lihtenstein). Undivided sputum samples with sterile swabs were planted on Mitis Salivarius Agar (Fluka, a substrate with sucrose, glucose, trypan blue and crystal violet) which is recommended for the isolation of mixed cultures of streptococci, in particular: Streptococcus mitis, Streptococcus mutans, Streptococcus salivarius, Enterococcus faecalis, etc. Between the detected bacteria in the saliva - Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Streptococcus mitis and the existence of dental caries there is a significant correlation (p < 0.001). Between the presences of Lactobacillus spp. in the saliva and the existence of dental caries there is a significant correlation (p < 0.01). The salivary bacterial parameters can be used as serious screening factors and can seriously participate as an instrument in the assessment of the dental caries risk. Key words: Dental caries, Salivary bacterial, Lactobacillus, Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Streptococcus mitis