Çocuklarda kapanış ilişkileri ve oklüzyon

The complementary part of oral health in children is the inspection of the eruption and maturation of deciduous, mixed and permanent dentition by a pediatric dentist. With this inspection the child will result with a functionally and esthetically stable and excaptable occlusion. Many changes occure in the dental occlusion from the time of birth to adulthood. These changes are minor in the permanent dentition while major in the mixed dentiton. The pediatric dentist should always be aware of these dental changes, be able to diagnose any abnormal development (malocclusion) in the child patient. This kind of a concept will stop the unnecessary treatment applied to the physiological changes. The aim of this review is to discuss the changes in the occlusal relations and occlusion from deciduous to permanent dentition in children. ÖZET Çocuk hastalarn ağız ve diş sağlığının korunmasındaki tamamlayıcı unsur dişlerin süt, karışık ve sürekli dişlenme dönemlerindeki sürme ve gelişimlerinin takibinin bir pedodontist tarafından yaplmasıdır. Yaplan bu takip sonucunda fonksiyonel ve estetik olarak kabul edilebilir, stabil bir oklüzyon sağlanmış olur. Doğumdan erişkinliğe kadar geçen süre boyunca dental oklüzyonda pek çok değişimler meydana gelir. Bu değişimler karışık dişlenme döneminde daha belirgin iken; sürekli dişlenme döneminde daha küçük değişimler şeklinde gözlenebilir. Hekimin, çocuk hastada meydana gelen dental değişimlerin farkında olması ve meydana gelebilecek herhangi bir anormal gelişime tanı koyabilmesi gereklidir. Böyle bir yaklaşım, çocuk hastada meydana gelen “normal” fizyolojik durumların gereksiz yere tedavi edilmesini de engellemiş olacaktır. Bu derlemenin amacı; çocuklarda dişsiz dönemden sürekli dişlenme dönemine kadar kapanış ilişkileri ve oklüzyonunda meydana gelen fizyolojik değişimleri incelemektir. Anahtar Kelimeler: Çocuklarda oklüzyon, maloklüzyon, kapanş ilişkis

Micro-Tensile Bond Strength of Fissure Sealants Treated with Different Antibacterial Agents

Svrha - Ovim istraživanjem in vitro željela se na pojednostavljenom modelu caklinske fisure procijeniti mikrozatezna snaga smole za pečaćenje tretirana antibakterijskim samojetkajućim adhezivnim sustavom, antibakterijskim predtretmanom prije nanošenja samojetkajućeg adhezivnog sustava i samojetkajućim sustavom. Materijali i metode: Tek izvađeni kravlji mandibularni sjekutići nasumce su podijeljeni u četiri skupine: A. 35-postotna fosforna kiselina + Clinpro sealant®; B. 35-postotna fosforna kiselina + Clearfil protect bond + Clinpro sealant®; C. 35-postotna fosforna kiselina + Consepsis Scrub® + Clearfil SE bond® + Clinpro sealant®; D. 35-postotna fosforna kiselina + Clearfil SE bond® + Clinpro sealant®. Dva komadića cakline učvršćena su voskom na sterilna stakalca s razmakom od 0,6 ± 0,1 milimetar. Zatim su okomito razrezani štapići (≈1mm x 1mm) podvrgnuti testu čvrstoće u univerzalnom stroju s konstantnom poprečnom brzinom glave (1mm/ min). Nakon toga je popucalim površinama određena vrsta frakture. Za statističku analizu korištena je jednosmjerna analiza varijance te Tukeyev i hi-kvadrat test. Rezultati: Mikrozatezna snaga veze u skupini C (34,63 ± 15,59 MPa) bila je mnogo veća nego u skupini A (19,86 ± 7,08 MPa) (p: 0,0001), B (24,49 ± 9,38 MPa) (p: 0,002) i D (19,84 ± 9,92 MPa) (p: 0,0001). Frakturne pukotine uglavnom su se nalazile u adhezivnom sloju, a među skupinama nije bilo statistički značajne razlike u obliku fraktura (p: 0,343). Zaključak: Mikrozatezna snaga veze samojetkajućeg adhezivnog sustava bila je na površinama tretiranima klorheksidinskim kavitetnim ezinficijensom značajno veća nego ona kod primijenjenog antibakterijskog samojetkajućeg sustava zasebno, samojetkajućeg adhezivnog sustava ili konvencionalnog jetkajućeg sustava kiselinom.Objective of this in vitro study was to evaluate the micro-tensile enamel bond strength of fissure sealants treated by an antibacterial self-etching agent, antibacterial pretreatment prior to application of a self-etching adhesive system and self-etching adhesive system alone using the simplified enamel fissure model. Materials and Methods: Fresh extracted bovine mandibular incisors were randomly divided into four groups: A. 35% phosphoric acid + Clinpro sealant®; B. 35% phosphoric acid + Clearfil protect bond + Clinpro sealant®; C. 35% phosphoric acid + Consepsis Scrub® + Clearfil SE bond® + Clinpro sealant®; D. 35% phosphoric acid + Clearfil SE bond® + Clinpro sealant®. Two pieces (4 x 6 mm) of enamel were secured with wax on a sterile glass slide to a mean distance of 0.6 ± 0.1 mm. Vertically sectioned bars (≈1mmx 1mm) were submitted to tensile tests at constant crosshead speed (1mm/min) using a universal testing machine. Fractured surfaces were inspected to determine the mode of fracture. Regarding statistical analysis, One-way variance, Tukey and Chi-square tests were applied. Results: The micro-tensile bond strengths of group C (34.63±15.59 MPa) was significantly higher than group A (19.86±7.08 MPa) (p:0.0001), group B (24.49±9.38 MPa) (p:0.002) and group D (19.84±9.92 MPa) (p:0.0001). Failures were predominantly adhesive in nature; where there were no statistically significant differences in fracture patterns between groups. (p:0,343). Conclusion: The micro-tensile bond strength of a self-etching adhesive system previously treated with chlorhexidine cavity disinfectant was significantly higher than an antibacterial self-etching adhesive system alone, a self-etching adhesive system and a conventional acid etching system

Micro-Tensile Dentin Bond Strength of Two All-in-One Adhesives and an Etch-and-Rinse Adhesive

Svrha: Istraživanjem se željela ocijeniti mikrozatezna čvrstoća dentinske veze dvaju jednokomponentnih adhezivnih sustava te jednoga koji se jetka i ispire. Ispitanici i postupak: Zubi su bili nasumce podijeljeni u tri skupine kako bi se ispitali u postupku sa sljedećim adhezivnim sustavima: Adhese One®, Futurabond M® i Adper Singlebond® (kontrola). Zbog toga su korijeni i apikalni dio dna pulpne komore bili uklonjeni mikrotomom. Nakon toga su nadogradnje rezane okomito u pravokutne (≈1mm x 1mm) štapiće, te su oni testirani - uz konstantnu brzinu glave (1mm/min) - na univerzalnom stroju za ispitivanje čvrstoće. Na taj je način bio ispitan svaki adhezivni sustav. Dobilo se petnaest uzoraka i testiran je bio svaki materijal povezan s dentinom. Frakturirane površine pregledane su kako bi se odredila vrsta oštećenja. Rezultati: Čvrstoća veze Adhese One (5,83±3,13 MPa) bila je znatno niža nego Futurabonda M (15,76±4,2 MPa) (p:0,0001) i Adper Singlebonda (21,14±5,04 MPa) (p:0,0001). Također je čvrstoća veze Futurabonda M bila statistički mnogo niža nego Adper Singlebonda (p:0,003). Zaključak: Ispitani jednokomponentni adhezivni sustavi pokazali su manju zateznu čvrstoću dentinske veze nego onaj s jetkanjem i ispiranjem.Aim: The purpose of the present study is to evaluate the micro-tensile bond strength to dentin of two all-in-one adhesives and an etch-and-rinse adhesive. Material and Methods: The teeth were randomly divided into three groups for treatment with one of the following adhesives: Adhese One®, Futurabond M® and Adper Singlebond® (control). Roots and the apical floor of pulp chambers were removed with a microtome. The build-ups were vertically sectioned into rectangular (≈1mmx 1mm) compound bars with microtome. The bars were submitted to tensile tests at constant crosshead speed (1mm/min) using a universal testing machine and tested for each adhesive. Fifteen specimens were manufactured and tested for each material for permanent dentin. Fractured surfaces were inspected to determine the mode of fracture. Results: The bond strengths of Adhese One (5,83±3,13 MPa) was significantly lower than Futurabond M (15,76±4,2 MPa) (p:0,0001) and Adper Singlebond (21,14±5,04 MPa) (p:0,0001) while dentin bond strenght of Futurabond M was significantly lower than that of Adper Singlebond (p:0,003). Conclusions: The tested all-in-one adhesives showed lower dentin bond strengths than an etch-and-rinse adhesive

A Quantitative Analysis of a Probiotic Storage Media for Avulsed Teeth

Svrha istraživanja bila je u uvjetima in vitro ispitati potencijal različitih medija za pohranu izbijenog zuba kao što je, primjerice, probiotski jogurt (Bifidibacterium animalis DN 173010) u usporedbi s Hankovom slanom otopinom (HBSS), fiziološkom otopinom i mlijekom te ocijeniti njihov potencijal u održavanju vitalnosti stanica parodontnog ligamenta (PDL). Materijali i metode: Trideset i šest jednokorijenskih ekstrahiranih zuba sa zatvorenim korijenima podijeljeno je u šest eksperimentalnih grupa (N = 6). Izvađeni su atraumatski i isprani fiziološkom otopinom kako bi se uklonila zaostala krv. Nakon ekstrakcije sa svakog zuba uklonjena su tri milimetra koronalnog dijela stanica parodontnog ligamenta kako bi se uklonile potencijalno oštećene stanice. Pozitivna i negativna kontrola obavljene su odmah te ponovno nakon osmosatnog sušenja. Nakon ekstrakcije uzorci u pozitivnoj kontroli odmah su tretirani dispazom i kolagenazom. Uzorci u negativnoj kontroli osušeni su i ostavljeni osam sati te su nakon toga tretirani dispazom i kolagenazom, bez prethodnog tretiranja određenom otopinom. Broj vitalnih PDL stanica prebrojen je svjetlosnim mikroskopom s pomoću hemocitometra (20 x povećanje). Rezultati su analizirani nanoparametrijskom ANOVA-om te Kruskal-Wallisovim i Dunnovim testom višestruke usporedbe. Rezultati: U pozitivnoj kontroli zabilježeni su znatno bolji rezultati negoli u ostalim skupinama. Uočena je statistički značajna razlika između pozitivne kontrole i ostalih testiranih grupa (p = 0,000). Zubi pohranjeni u otopini imali su u pozitivnoj kontroli najviše vitalnih PDL stanica, a zatim slijede stanice pohranjene u jogurtu, HDSS-u, fiziološkoj otopini i mlijeku. Zaključak: Bifidibacterium animalis DN 173010 dobra je alternativa za privremeno pohranjivanje izbijenih zuba zbog mnoštva vitalnih PDL stanica. Probiotici su se pokazali kao medij pogodan za transport izbijenih zuba, ali je potrebno daljnje istraživanje kako bi se odredili komercijalno dostupni proizvodi za pohranu takvih zuba.Aim: The aim of the present in vitro study was to investigate the potential of a storage medium, probiotic yogurt (Bifidibacterium animalis DN 173010) in comparison with Hank’s balanced salt solution (HBSS), saline and milk in maintaining viable periodontal ligament (PDL) cells on simulated avulsed teeth. Materials and methods: Thirty-six freshly extracted single-rooted human teeth with closed apices were divided into six experimental groups (N=6). The teeth were extracted as atraumatically as possible and washed in sterile saline solution to eliminate residual blood. Following extractions, the coronal 3 mm of PDL tissues were scraped with a #15 scalpel to remove cells that may have been damaged. The positive and negative controls corresponded to 0 minutes and an 8-hour dry time, respectively. After extraction, the positive control teeth were immediately treated with dispase and collagenase. The negative control teeth were bench-dried for 8 h, with no follow-up storage solution time, and then placed in the dispase and collagenase. The number of viable protective least significant difference PDL cells were counted under a light microscope with a hemocytometer at 20x magnification and analyzed. Statistical analysis of the data was accomplished using Nonparametric ANOVA complemented by Kruskal-Wallis Test and Dunn’s Multiple Comparisons Test. Results: Positive control was found to be significantly better than the others, there were statistically significant differences between positive control and other test groups (p=0.000). The teeth stored in positive control demonstrated the highest number of viable PDL cells followed in order by probiotic yogurt, HBSS, saline and milk. Conclusion: Bifidibacterium animalis DN 173010 seems to be an alternative for the temporary storage of avulsed teeth, due to high number of viable PDL cells. Probiotics may be suitable transport media for avulsed teeth, but further research is warranted using the commercially available products

Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort

Svrha rada: Željelo se odrediti utječe li topikalna uporaba otopine lokalnog anestetika na neugodnu senzaciju pri ubodu igle u nepce. Metode: Provedeno je nasumično, dvostruko slijepo istraživanje uz sudjelovanje placebo-skupine. Odabrano je 25 zdravih dobrovoljaca koji su bili podvrgnuti dvostrukom ubodu igle tijekom jednog posjeta stomatologu. Mjesto uboda nalazilo se centimetar od marginalne gingive prvih maksilarnih premolara sa svake strane usta. Korištene su 13-milimetarske igle koje su bile pričvršćene na štrcaljke napunjene 2-postotnim lidokainom s 0,125mg/ml epinefrina ili fiziološkom otopinom. Prije svakog uboda stomatolog je istisnuo kap otopine na vrh igle te je 20 sekundi prislonio na nepce i vrh igle i kap. Neugodna senzacija ocijenjena je na 100 milimetarskoj vizualnoj ljestvici na kojoj su krajnje vrijednosti označene s bez boli i nepodnošljiva bol. Rezultati: Pri ubodu nije bilo statistički značajne razlike između dviju otopina na razini neugode (prosječna vrijednost = 26 80 ± 19,36 mm za lidokain i 26 20 ± 18,39 mm za fiziološku otopinu), iako su ispitanici naveli da je drugi ubod bio bolniji od prvoga (prosječna vrijednost = 31,00 ± 19,84 mm za lidokain i 22,00 ± 16,65 mm za fiziološku otopinu). Zaključak: Topikalna primjena otopine lokalnog anestetika nije utjecala na razinu boli nakon uboda iglom u nepce.Aim: To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate. Methods: A placebo-controlled, randomised, doubleblind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit. The penetration sites were 1 cm from the gingival margin of the first maxillary premolars on each side of the mouth. 30 gauge-13 mm needles which were attached to syringes that contained either 2% lidocaine with 0.125mg/ml epinephrine or physiological saline were used. For each penetration an operator encouraged a drop of solution to appear at the end of the needle and placed this drop with the bevel of the needle flat on the palate for 20 seconds. The discomfort was noted on a 100 mm visual analogue scale with end points marked “No pain” and “Unbearable pain”. Results: There was no significant difference in penetration discomfort between solutions, (mean VAS = 26.80±19.36mm for lidocaine and 26.20±18.39mm for saline) however the 2nd penetration was significantly more uncomfortable than the first (mean VAS = 31.00±19.84 mm and 22.00±16.65 mm respectively). Conclusion: Pre-injection diffusion of local anaesthetic solution did not influence the discomfort of needle penetration in the palate

Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort

Aim: To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate. Methods: A placebo-controlled, randomised, doubleblind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit. The penetration sites were 1 cm from the gingival margin of the first maxillary premolars on each side of the mouth. 30 gauge-13 mm needles which were attached to syringes that contained either 2% lidocaine with 0.125mg/ml epinephrine or physiological saline were used. For each penetration an operator encouraged a drop of solution to appear at the end of the needle and placed this drop with the bevel of the needle flat on the palate for 20 seconds. The discomfort was noted on a 100 mm visual analogue scale with end points marked “No pain” and “Unbearable pain”. Results: There was no significant difference in penetration discomfort between solutions, (mean VAS = 26.80±19.36mm for lidocaine and 26.20±18.39mm for saline) however the 2nd penetration was significantly more uncomfortable than the first (mean VAS = 31.00±19.84 mm and 22.00±16.65 mm respectively). Conclusion: Pre-injection diffusion of local anaesthetic solution did not influence the discomfort of needle penetration in the palate

Effect of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of newly developed restorative materials

ObjectivesTo evaluate the effects of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of five restorative material