Influence of Hyaluronic Acid in Periodontal Tissue Regeneration

Hyaluronic acid is a high molecular weight polysaccharide - glycosaminoglycan, which plays a vital role in the functioning of extracellular matrices, including those of mineralized and non-mineralized periodontal tissues. Hyaluronic acid is also important because of its numerous actions in the mechanisms associated with inflammation and the wound healing process. Hyaluronic acid has been identified in all periodontal tissues in varying quantities, being more prominent in the non-mineralized tissues, such as gingiva and periodontal ligament, compared to mineralized tissues, such as the cement and alveolar bone. Preliminary evidence suggests that hyaluronic acid is a very promising candidate as a mediator of periodontal tissue regeneration and periodontal disease treatment, by promoting a rapid remission of symptoms, not only to the marginal gingiva, but also to the deeper seated periodontal tissues. However, further researches for the therapeutic effects of hyaluronic acid in periodontal disease are essential for realization of true benefits of hyaluronic administration in periodontal tissue regeneration. Keywords: Hyaluronic Acid; Gingival Inflammation; Periodontal Disease; Periodontal Reparatio

Surgical procedures for soft tissue ridge augmentation - interposition grafting procedure

Background: Numerous surgical grafting procedures designed to reconstruct a partially toothless ridge or ridge defects have been described in the literature over the years. The procedures can be grouped according to the means used to increase the ridge such as soft and hard tissue augmentation procedures. To illustrate the different approaches to utilizing soft tissue augmentation, the following procedures will be discussed: Pedicle graft, Roll graft and Free graft procedures (Pouch graft, Interposition graft and Onlay graft procedure). Description of the procedure: In interpositional graft procedures, there is no need to remove the epithelium from the surface of the donor tissue. If augmentation is required in both buccolingual and apico-coronary direction, part of the graft must be placed above the surface of the tissue around the recipient site. Some of the grafted connective tissue surfaces will be exposed in the oral cavity. "Envelope" or partial thickness flap with relaxing incisions, is prepared on the vestibular surface of the defective area. An appropriate donor site is selected at the palate or in the area of the maxillary tubercle, and a free epithelial-connective tissue graft is harvested. If enlargement of the ridge height is not required, the epithelial surface of the graft is placed with the surrounding epithelium. The graft is sutured all over the tissue at the recipient site. The temporary bridge is positioned to serve as a reference when estimating the amount of tissue needed to fill the defect. Outcomes: The newly formed granulation tissue during healing will make a border between the graft and the adjacent tissue, smooth and properly epithelialized. Edema, which occurs postoperatively, will help contour the ridge. Conclusions: Class III ridge defects are a major challenge for the dentists, as the ridge needs to be enlarged in both vertical and horizontal dimensions. The combined procedures can be used successfully in such situation

Oral erythema multiforme –case reports, diagnostic and treatment dilemma

Erythema multiforme is acute mucocutaneous condition that is considered to be immune-mediated hypersensitivity reaction to medicine or an infection.There are described three forms of erythema multiforme: “minor form”, “major form” and oral erythema multiforme.It presents a diagnostic dilemma due to varied possible manifestations.Diagnosis is often made based on history and clinical examination.In this article we report 5 cases of different forms of erythema multiforme following drug administration.Keywords:erythema multiforme,drug induced

Impact of Covid-19 pandemic оn orthodontic treatment

Purpose: The purpose of the study is to determine the relationship between the COVID-19 pandemic and the attitudes, behaviors and beliefs related to orthodontic treatment. Methodological approach: The research represents a retrospective cross sectional study conducted on a sample of 192 orthodontic patients from public and private facilities. Results: A strong majority of respondents stated that the pandemic had an impact on their orthodontic treatment, lifestyle and financial situation. Only 19.8% of respondents would cancel scheduled orthodontic check-ups due to fear of infection with COVID-19, yet more than half of patients reported having anxiety related to COVID-19. More than half of the patients said they followed the orthodontist's instructions during the pandemic. Conclusion: The results generate useful information to help meenage the expectations and needs of patients and orthodontic practices during a pandemic, contributing to the continuous improvement of community dental health services. COVID-19-related anxiety is a factor in the success of orthodontic treatment as well as adequate communication between orthodontist and patient. Keywords: orthodontics, Covid-19, pandemi

Is there any difference in arch dimension measurements at digital vs. plaster models?

Digital models are a reliable alternative to conventional plaster models that are accurate, efficient, easy to use, and allow visualization of the planned treatment results. The Aim: To make a comparison of arch dimensions measurements(width, length, and height) made on digital and plaster models. Material-Methods: Orthodontic plaster models of 60 patients with dental crowding, aged 13-18 years were observed. Linear measurements of arch dimensions were performed first manually with a digital caliper and then digitally with 3Shape’s OrthoAnalyzer TM software program on the scanned plaster models with 3Shape D800 TM scanner. Dental arch width, length and height by Harper were performed. Arch width was measured as intercanine, inter-premolar (IPM4, IPM5) and intermolar (IM6) distance. Arch length was measured as measured as the distance between the distal surface of the first permanent molar and the point of contact between the central incisors. Arch height was measured as the distance between the distal surfaces of the first permanent molars and the septal margin of the central incisors, following the linea mediana. Results: There is no statistically significant difference in the width of the dental arches between plaster and digital models. There is a statistically significant difference, in the length and height of both dental arches in favor of smaller length dimensions in digital models, and in addition to larger height dimensions in digital models. Conclusions: Measurements on digital models are suited for reliable diagnostic measurements, which compare well to those obtained from plaster casts, the current gold standard. Keywords: conventional plaster models, digital models, gnathometric analysis

Facial convexity in macedonian subjects

Objective: The assessment of the patient’s soft tissue profile is a critical step in orthodontic diagnosis and treatment planning. Achieving a pleasing esthetic profile is an important goal of orthodontic therapy, and can influence the treatment plan and mechanotherapy. The aim of the present study was to evaluate the convexity angles in Macedonian participants with different sagittal irregularities. The examination was performed on 90 profile cephalograms on Macedonian subjects with permanent dentition, aged 16-21 years, divided in Class I, II/1 and III malocclusions, with symmetrical gender distribution and no previous orthodontic treatment. Examined parameters were angle of facial convexity (N’– Sn’-Pg’) and angle of total facial convexity (N’-Pr’-Pg’). Results: The analysis of the size of the angle of facial convexity and angle of total facial convexity showed that the highest average value was in the subjects of class III, followed by class I and the lowest average values were in the subjects with II/1. For p <0.05, the analysis of variance indicated a significant difference between the three groups of malocclusion, in both sexes. There is a significant linear positive weak correlation between age and the parameter N’– Sn’-Pg ‘(with increasing age the value of this parameter also increased ). Conclusion: Our study has shown that the biological range of facial soft tissue values needs to be determined according to age, sex, and orthodontic anomalies for each ethnic group. Keywords: esthetic profile, orthodontic therapy, cephalogram

Oral signs of adverse drug reactions

BACKGROUND: Adverse reactions to drugs are common and may have a variety of clinical presentations in the oral cavity. They are harmful and unintended responses to a medical product. As newer therapeutic agents are approved, it is likely that more adverse drug events will be encountered. The extent of adverse drug reactions is unknown; however, because a lot of them are asymptomatic, many are believed to go unnoticed. Their pathogenesis, especially of the mucosal reactions, is largely unknown and appears to involve complex interactions between the drug, other medications, the patient’s underlying disease, genetics and lifestyle factors. AIM: to describe the most common adverse drug reactions that dentists may encounter in daily clinical practice. MATERIALS AND METHODS: research was done exploring specialized databases PubMed, MEDLINE, EBSCO, Science Direct, and Scopus for the period 2010-2023, by use of MeSH terms: adverse drug reaction, drug-induced reactions, oral manifestation. RESULTS. The most common oral manifestations were categorized into groups as follows: saliva and salivary gland involvement, soft tissue alterations, hard tissue damage, and non-specific oral conditions. CONCLUSIONS: Knowledge of adverse drug-induced oral effects helps dental professionals to better diagnose oral disease, administer drugs, and improve patient compliance during drug therapy which may foster a more rational use of drugs. Keywords: oral cavity, adverse drug reactions, oral signs

Несакани реакции на лекови - орални манифестации

Несаканите реакции на лекови се честа појава која може да се манифестира во усната празнина. Од страна на СЗО несаканата реакција на лекот е дефинирана како „одговор на лек кој е штетен и неочекуван, и кој се јавува при доза која нормално се користи кај човекот за профилакса, дијагноза, терапија на болест или за модификација на физиолошката функција“ Цел: да се опишат најчестите несаканите реакции на лекот со кои може да се сретнат стоматолозите во секојдневната клиничка пракса. Методи: беше направено истражување на специјализираните бази на податоци PubMed, PubMed Central, MEDLINE, EBSCO, Science Direct, Scopus за периодот 2010-2022 год. со користење на MeSH термини: несакана реакција на лекови, реакции индуцирани од лекови, уста, орална манифестација. Резултати: заболувањата и најчестите состојбите беа категоризирани во групи и тоа: зафатеност на плунковните жлезди, мукозни промени, промени на тврдите ткива и не специфични состојби. Заклучок: Консумација на антибиотици, нестероидни антиинфламаторни лекови (НСАИЛ) и имуносупресори се најчести лекови кои предизвикуваат несакани реакции во усната празнина. Зголемување на животниот век, и се поголемиот број на постара популација која има потреба од различни групи лекови, ја наметнува улогата на стоматолозите детално да бидат запознаени со несакани ефекти на лековите, нивната клиничка манифестација и начинот на нивното правовремено менаџирање

Assessment of changes in the enamel topography after debonding adhesive remnants

Introduction: At orthodontic treatment completion, knowledge about the effects of adhesive remnant removal on enamel topography is paramount. Aim: To determine the changes in enamel topography when applying different methods for debonding adhesive remnants. Material and methods: A sample of 40 extracted premolars were divided into 2 groups of 20 premolars each depending on the instrument used to remove the adhesive remnants: an ultrasonic instrument (Soniflex) and a tungsten-carbide bur and a low-speed handpiece ( 3,000mpr) water cooled. Metal brackets (Dentaurum, Germany) were bonded with the adhesive system of (Ormco Enlight Light Cure Adhesive; Ormco, USA), according to the manufacturer's instructions, and stored in saline at room temperature for 48 hours, before debonding with adhesive removal plier from everyday clinical practice. The assessment of the changes in the enamel topography was based on the surface roughness index (SRI-Surface Roughness Index) according to the Vidor, using a 3D performance stereomicroscope. Results: When comparing TKB and ultrasound, we observed that there is a non-significantly lower score of damage to the enamel surface when using a tungsten carbide bur compared to ultrasound. Conclusion: A more efficient and safe method for removing adhesive remnants is when using a low-speed tungsten carbide bur, with which we have minimal damage to the enamel, insignificant subtraction from the thickness of the enamel surface, compared to ultrasound, which showed unsatisfactory results. Keywords: adhesive remnants, debonding, enamel damage, tungsten carbide bur, ultrasoun

Интердисциплинарен пристап и план на терапија кај пациенти со олигодонција

Oligodontia is a rare developmental dental anomaly in humans characterized by the absence of six or more teeth. In European populations the estimated prevalence of both syndromic and non- syndromic oligodontia is 0.14%. Clinical  features of oligodontia include six or more missing teeth, lack of development of maxillary and mandibular alveolar bone height and reduced lower facial height. Variation in tooth morphology, anomalies of the enamel, reduced size and aberrant form, delayed eruption have also been observed. Oligodontia is also associated with reduced salivary secretion rates.  These bring a functional  and esthetic  limitations and impact on emotional well-being. The aim of this study was to present a case of a 12-year-old girl with oligodontia and therapeutic procedures for orthodontic-prosthetic rehabilitation and normal orofacial function. A multidisciplinary approach that includes orthodontic and prosthetic therapy is often necessary for dental management in young patients with oligodontia. Oral rehabilitation and maintenance care in individuals with many missing permanent teeth is a long-standing commitment that requires involvement of different specialists. Methods used are age-dependent, and early diagnosis is crucial. Orthodontic treatment,  autotransplantation,  dental implants, avoiding tooth preparations, and partial prosthetic dentures are treatment choices.Олигодонцијата е ретка дентална аномалија кај хуманата популација, која се карактеризира со недостаток на шест или повеќе заби. Во Европа, преваленцијата на синдромската и несиндромската олигодонција е 0,14%. Клиничките манифестации вклучуваат недостаток на шест или повеќе заби, недоволен развој на максиларниот и мандибуларниот алвеоларен гребен и редуцирана долна третина од лицето. Варијациите во денталната морфологија, редуцираната големина и аберантна форма, аномалиите во емајлот, како и  доцната ерупција, додатно ја влошуваат клиничката слика. Олигодонцијата е асоцирана и со редуцирана саливарна секреција. Сето ова генерира функционални и естетски проблеми, со импакт на емоционалното здравје. Целта на студијата е да се прикаже случај на 12-годишно девојче со олигодонција, и преземените тераписки процедури за ортодонтско-протетска рехабилитација и воспоставување на нормална орофацијална функција. Може да се заклучи дека оралната рехабилитација кај индивидуите со олигодонција  е долготраен процес во кој се вклучени различни специјалисти. Третманот зависи од возраста, а раната дијагноза е круцијална. Превенцијата на кариес, ортодонтскиот третман, автотрансплантацијата, денталните импланти, избегнувањето на препарации на забите и парцијалните протетски надоместоци се препорачани методи