Tlačna i posmična otpornost sveze kompozita i dentina

Transverse and. tensile resistance o f a dentin-bonded composite resin restoration was tested. The composite resins (Fluorocore, Coradent and Coracore) were retained routinely by a dentin adhesive (Syntac) on dentin samples. The specimens were mounted on a mechanical testing device, and each o f the 23 specimens was loaded perpendicularly to its long axis. The transverse force was applied at a crosshead speed o f 0.5 mm/min until failure occurred. The next 22 specimens were loaded in parallel with their long axis in the same conditions. All the three materials showed a satisfactory compressive shear bond strength, but transverse resistance was inadequate and restorative pins had to be used.Ispitivana je mehanička otpornost triju kompozitnih materijala i sveze dentinskoga adheziva Syntaca s dentinom. Kompozitne smole (Fluorocore, Coradent i Coracore) rabljene su za izradbu nadgradnje na korijenskom dentinu pretkutnjaka. Kompozitne nadogradnje (22) tlačene su okomito i paralelno (23) s uzdužnom osi zuba dok nije puknula nadgradnja, sveza ili dentin. Sva tri materijala pokazala su klinički dovoljnu tlačnu, ali ne i posmičnu otpornost. Za opsežnije kompozitne nadgradnje vitalnih zuba potrebno je uporabiti i parapulpalne kolčiće

Postendodontic Tooth Restoration - Part I: The Aim and the Plan of the Procedure

Endodontskim zahvatom uklanjamo pulpu, nekrotičan dentin i dio zdrava tvrdoga zubnog tkiva. Time smanjujemo otpornost preostala zubnoga tkiva na sile vlaka i tlaka koje nastaju pri okluzijskim dodirima zuba. Zato restaurativna opskrba endodontski liječena zuba mora zadovoljiti zahtjeve retencije restorativnoga nadomjestka, otpornosti nadomjestka i zubnoga tkiva na sile unutar žvačnoga sustava, dobra koronarnog i intraradikularnoga brtvljenja te estetske zahtjeve. Poslijeendodontska opskrba uključuje sljedeće postupke: nadoknadu izgubljena zubnoga tkiva aloplastičnim materijalima u izravnoj ili neizravnoj izvedbi (ispunom amalgamom, kompozitom, stakleno ionomernim cementom, ili izradbom inleja, onleja ili overleja); uporabom intrakanalnih i parapulpnih kolčića uz nadoknadu zubne krune aloplastičnim materijalom; izradbu batrljka zuba aloplastičnim materijalom s uporabom intrakanalnih i parapulpnih kolčića ili bez njih uz nadoknadu zubne krune protetskim nadomjestkom; laboratorijski izrađenom nadogradnjom uz nadoknadu zubne krune protetskim nadomjestkom. U nekim slučajevima bit će dovoljno samo zabrtviti pristupni kavitet nekim od aloplastičnih materijala, a u drugim bit će potrebno osigurati okomitu stabilizaciju preostaloj kruni u obliku intraradikularne nadogradnje i izraditi protetski nadomjestak. Izbor postupka ovisit će o stupnju razorenosti zubne krune, smještaju zuba u zubnome luku, okluzijskim dodirima zuba, morfologiji korijenskih kanala, funkcijskim i estetskim zahtjevima, materijalnim mogućnostima te o vremenu koje imamo na raspolaganju. Pravilno prepoznata indikacija uz poštivanje svih faza izabranog postupka poslijeendodontske opskrbe osigurat će opskrbljenom zubu punopravnu ulogu u stomatognatom sustavu.Endodontic procedure requires removal of the pulp tissue and necrotic dentine, as well as a significant amount of healthy hard dental tissue, which results in reducing the resistance of the tooth to the occlusal loading forces. Restoration of such a tooth needs to satisfy requirements for retention of the restorative material, its resistance, as well as the resistance of the remaining dental tissue to occlusal forces, good coronal and intraradicular obturation and also aesthetic requirements. Postendodontic treatment includes the following procedures: replacement of lost tissues using alloplastic materials directly or indirectly (amalgam, composite resin and glass-ionomer cement fillings or inlay, onlay or overlay restorations); the alloplastic material crown restorations using intracanal posts and parapulpal pins; the alloplastic material core buildup with or without intracanal posts and parapulpal pins covered with prosthetic crown; restoration of lost tooth structure using laboratory made post and core covered with prosthetic crown. Sealing of endodontic cavity using one of the alloplastic materials would be the treatment of choice in uncomplicated cases, whereas in severely damaged teeth ensuring remaining tooth structure by vertical stabilization and the prosthetic crown would be necessary. The choice of procedure depends on the severity of crown damage, the tooth position in the arch, occlusal contacts, morphology of root canal spaces, functional and aesthetic aspects, financial ability and available time for performing the procedure. The correct indication evaluation respecting all steps of the chosen procedure will provide long term survival of the postendodontically treated tooth in the stomatognathic system

Periodontal Health in Croatia

Godine 1992. provedeno je u Republici Hrvatskoj epidemiološko istraživanje o učestalosti parodontnih bolesti. Pregledano je 269 ispitanika u dobi između 15 i 70 godina iz različitih regija Hrvatske. Ispitanici su bili podijeljeni u tri dobne skupine. Prvu su sačinjavali ispitanici u dobi od 15 do 19 godina, drugu od 35 do 44 godine, a treću od 65 i više godina. Bila je ravnomjerna zastupljenost ispitanika iz srednjohrvatske, slavonske i primorsko-dalmatinske regije. Za procjenu stanja parodonta korišteni su standardi Svjetske zdravstvene organizacije (WHO) - Zajednički parodontni indeks potreba tretmana (CPITN). U dobnoj skupini od 15 do 19 godina nađen je zubni kamenac u 62% ispitanika. Plitki džepovi su pronađeni u 42% ispitanika u dobi od 35 do 45 godina, dok su duboki parodontni džepovi prisutni u 34% ispitanika od 65 i više godina. Podaci o parodontnom statusu i potrebi tretmana za sve dobne skupine pokazuju da preventivne mjere treba usmjeriti na poboljšanje higijene.A periodontal health epidemiological survey using WHO assesment forms was carried out in Republic of Croatia in 1992. The study population consisted o f 269 persons aged 15-19, 35-44 and over 65 years. The survey included three geografical areas of Croatia. Assesment o f the periodontal status showed calculus to be the predominant disorder in the age group 15-19 year, shallow pockets in the age group 35-44 year while deep pockets and 2,5 excluded sextants prevailed in persons aged over 65 years. The data o f the periodontal status and treatment needs for all the age groups suggested that preventive effects should focus on the improvement of hygiene

Three-Rooted Maxillary First Premolars: Five Clinical Cases

Prvi gornji trokorijeni pretkutnjaci ne pojavljuju se često, ali njihovu pojavnost moramo imati na umu pri endodontskom tretmanu gornjih pretkutnjaka. Ulazi u bukalne korijenske kanale obično nisu dobro vidljivi, pa unatoč dobrom poznavanju anatomije, kliničkom iskustvu i radiografskoj snimci jedan od bukalnih kanala ostaje neobrađen. Incidencija prvih gornjih pretkutnjaka s tri odvojena korijena, tri kanala i tri apeksna otvora je između 4-6%. U radu je prikazano 5 endodontskih liječenja prvih maksilarnih pretkutnjaka s 3 korijenska kanala. Prvi slučaj je liječenje zbog protetske indikacije gdje su odmah uočena i tretirana sva 3 kanala, što je radiografski dokumentirano. Preostala 4 slučaja su retretmani jer prijašnja liječenja nisu bila uspješna zbog neprepoznavanja i netretiranja trećega kanala. Učinjeni retretmani radiografski su kontrolirani.Three-rooted maxillary first premolars do not occur usually, but their possibility always has to be considered. The buccal orifices of the root canals are not clearly visible. In spite of a good knowledge of tooth anatomy, clinical experience, and X-rays, the third canal is often overlooked. The incidence of maxillary first premolars with three roots, three canals and three foramina is about 4-6%. In this article 5 clinical endodontic cases of first maxillary premolars with three canals are presented. The first case presents endodontic treatment of the first right maxillary premolar for a prosthetic reason. All three canals were recognized and treated as documented by radiographs. The remaining cases were retreatment of the first maxillary premolars where third canals had remained unrecognized during previous endodontic procedures, resulting in failure of treatment. Retreatments were performed and results documented by radiographs

Microleakage of Different Root Canal Obturation Techniques

Za ispitivanje propusnosti rabljena je konstrukcija za prijenos tekućine u kojoj se pomakom zračnoga mjehurića mjerila propusnost korijenskih kanala punjenih tehnikama hladne lateralne kondenzacije, Touch\u27n Heat-a i Thermafil tehnike. Kao punilo uz gutaperku se rabio AH Plus i RoekoSeal. Pošto su materijali pohranjeni u fiziološkoj otopini, propusnost se je mjerila nakon mjesec dana, 6 mjeseci i jedne godine. Za svako to ispitivano razdoblje najmanje propuštanje utvrđeno je kod tehnike hladne lateralne kondenzacije, a najveće kod Thermafil tehnike (p<0,05). Znatno veće propuštanje utvrđeno je kod svih ispitivanih uzoraka nakon 12 mjeseci za sve ispitivane tehnike (p<0,05). RoekoSeal i AH Plus podjednako su brtvili kod svake ispitivane tehnike punjenja.Leakage examination was performed using fluid transport system measuring movement of an air bubble. Tested techniques were cold lateral condensation technique, Touch`n Heat and Thermafil technique. Root canals were obturated with gutta-percha in combination with AH Plus and RoekoSeal sealers. After storing in saline solution, microleakage was measured in intervals of one month, six months and one year. The minimum microleakage values were obtained in all intervals in canals obturated using cold lateral condensation technique, while maximum values were obtained in Thermafil technique (p< 0.05). Significantly more leakage was found for all tested techniques in the interval of 12 months after obturation (p< 0.05). There was no difference between obturation quality between RoekoSeal and AH Plus, no matter what obturation technique was used

Periodontal Health in Croatia

Godine 1992. provedeno je u Republici Hrvatskoj epidemiološko istraživanje o učestalosti parodontnih bolesti. Pregledano je 269 ispitanika u dobi između 15 i 70 godina iz različitih regija Hrvatske. Ispitanici su bili podijeljeni u tri dobne skupine. Prvu su sačinjavali ispitanici u dobi od 15 do 19 godina, drugu od 35 do 44 godine, a treću od 65 i više godina. Bila je ravnomjerna zastupljenost ispitanika iz srednjohrvatske, slavonske i primorsko-dalmatinske regije. Za procjenu stanja parodonta korišteni su standardi Svjetske zdravstvene organizacije (WHO) - Zajednički parodontni indeks potreba tretmana (CPITN). U dobnoj skupini od 15 do 19 godina nađen je zubni kamenac u 62% ispitanika. Plitki džepovi su pronađeni u 42% ispitanika u dobi od 35 do 45 godina, dok su duboki parodontni džepovi prisutni u 34% ispitanika od 65 i više godina. Podaci o parodontnom statusu i potrebi tretmana za sve dobne skupine pokazuju da preventivne mjere treba usmjeriti na poboljšanje higijene.A periodontal health epidemiological survey using WHO assesment forms was carried out in Republic of Croatia in 1992. The study population consisted o f 269 persons aged 15-19, 35-44 and over 65 years. The survey included three geografical areas of Croatia. Assesment o f the periodontal status showed calculus to be the predominant disorder in the age group 15-19 year, shallow pockets in the age group 35-44 year while deep pockets and 2,5 excluded sextants prevailed in persons aged over 65 years. The data o f the periodontal status and treatment needs for all the age groups suggested that preventive effects should focus on the improvement of hygiene

Genotoxic Potential of Dentin Bonding Agents

Svrha rada bila je ispitati genotoksično djelovanje pet dentinskih adheziva: Adper Single Bonda, Adper Single Bonda 2, Prompt L-popa, Excitea i OptiBonda Solo Plus. Ispitivanje genotoksičnosti provedeno je na humanim limfocitima periferne krvi u uvjetima in vitro, ispitane koncentracije adheziva bile su 0,2, 0,5 i 5 μg/ml, a testirana vremena eluacije 1 sat, 24 sata i 5 dana. Genotoksičnost adheziva ispitivala se citogenetičkom metodom - analizom strukturnih aberacija kromosoma, dakle, određivanjem ukupnog broja kromosomskih lomova, kromatidnih lomova i acentričnih fragmenata. Rezultati pokazuju genotoksičnost OptiBonda Solo Plus već u koncentraciji 0,2 μg/ml i to nakon 24-satne eluacije, zatim OptiBonda Solo Plus u koncentraciji 0,5 μg/ml nakon jednosatne eluacije, OptiBonda Solo Plus, Adper Single Bonda 2 i Excitea u koncentraciji 0,5 μg/ml nakon jednodnevne eluacije. U koncentraciji 5 μg/ml nakon jednosatne eluacije genotoksičnost su pokazali OptiBond Solo Plus, Excite, Adper Single Bond 2 i Adper Single Bond, a nakon jednodnevne eluacije svi su ispitivani adhezivi pokazali genotoksičnost. Iz rezultata je jasno da enotoksičnost raste s porastom koncentracije adheziva, a smanjuje se s vremenom. Najveća genotoksičnost zabilježena je nakon 24-satne eluacije.The aim of this study was to examine the genotoxic activity of five dentin bonding agents: Adper Single Bond, Adper Single Bond 2, Prompt L-pop, Excite and Opti-Bond Solo Plus. This in vitro study was performed on human lymphocytes from peripheral blood, and the concentrations of dentin bonding agents tested were 0.2, 0.5 i 5 μg/ml, and elution times tested were 1 hour, 24 hours and 5 days. Genotoxicity testing was done using the Structural chromosomal aberration analysis cytogenic method , which determined the complete number of chromosome breaks, chromatide breaks and acentric fragments. The results showed genotoxicity of Opti-Bond Solo Plus in the 0.2 μg/ml concentration after a 24-hour elution period, then OptiBond Solo Plus in the 0.5 μg/ml concentration after a 1 hour elution period and OptiBond Solo Plus, Adper Single Bond 2 and Excite in the 0.5 μg/ml concentration after a 1 day elution period. In the 5 μg/ml concentration after 1 hour of elution, genotoxic potential was observed in cultures with OptiBond Solo Plus, Excite, Adper Single Bond 2 and Adper Single Bond, while all dentin bonding agents showed genotoxicity at that highest concentration but after 1 day of elution. From the results it is obvious that genotoxicity increases with the concentration of the dentin bonding agent, and decreases over time. The highest genotoxicity was observed after a 24-hour-elution period

Dental Caries Experience and Tobacco Use in 19-year-old Croatian Army Recruits

The aim of this study is to investigate caries prevalence and smoking habit in the population of 19-year-old Croatian male recruits. Dental examination of 505 male recruits was conducted in 2001 in the military centre in Koprivnica. Caries status was described by the FS-T (Filled and Sound Teeth) index and DMFT (Decayed, Missing and Filled Teeth) index. Mean DMFT scores were 7.32 and FST 23.56. There was a significant statistical difference in comparison of smoking habits depending on the reason to visit the dentist (p=0.001). The subjects who do not smoke tobacco have less decayed teeth (DT index with p<0.001), and more teeth with fillings and/or sound teeth (FT with p=0.005 and FST with p=0.004). There is no statistically significant difference for the DMFT (p=0.657) and MT (p=0.703). In conclusion, it showed that FS-T is a more appropriate index for describing variation in the population with higher caries experience. In the population of Croatian recruits, there were an astonishing 58.6% of smokers

Trichomonas tenax u usnoj šupljini

Fifty-one patients were investigated in order to determine the presence of Trichomonas tenax in various oral structures (saliva, dental plaque from physiologically clean and unclean tooth areas, carious dentin, root canal contents). Samples were cultivated in liquid Diamond’s axenic broth medium. The results were considered positive if living oral Trichomonas was found in smears. The prevalence of Trichomonas tenax in the study patients was 35.5%. Trichomonas tenax was most frequently found in dental plaque (23.2%) and in the root canal content (30.0%) (p > 0.05). The variables observed in this study (patient’s age and sex, oral hygiene, gingivitis, number of carious teeth, smoking and coffee intake) did not influence the presence of Trichomonas tenax. According to the results obtained, a mature dental plaque appears to be the oral structure favoring the growth and survival of oral Trichomonas in the physiologic conditions. It is possible that Trichomonas tenax spreads from dental plaque into the diseased endodontium.Prisutnost Trichomonas tenaxa na različitim strukturama usne šupljine (slina, dentobakterijski plak s fiziološki čistoga i nečistoga mjesta na zubu, karijesni dentin, sadržaj korijenskih kanala) istražena je u 51 ispitanika. Uzorci su kultivirani na Diamondovoj akseničnoj hranjivoj tekućoj podlozi. Nalaz živoga parazita u uzorku smatran je pozitivnim nalazom. Prevalencija Trichomonas tenaxa u ispitanika iznosila je 35,3%, a nađen je u zubnom plaku (23,2%) i u korijenskim kanalima (30,0%) (p > 0,05). U našem istraživanju ispitivane varijable (dob i spol ispitanika, stupanj oralne higijene, upala gingive, broj karijesnih zubi, pušenje i konzumiranje kave) nisu utjecale na pojavnost Trichomonas tenaxa. Prema rezultatima ovoga rada, zreli zubni plak omogućuje rast i razvoj oralnoga Trichomonasa u fiziološkim uvjetima u usnoj šupljini, a Trichomonas može prijeći iz zubnoga plaka u bolesni endodont

Microleakage of Postendodontic Systems

Svrha rada bila je upozoriti na nužnost poštivanja pravila pri izradbi poslijeendodontskih nadogradnji zuba. Poslijeendodontski sustav mora osigurati retenciju i rezistenciju nadogradnje, rezistenciju preostaloga zubnog tkiva, te dobro brtvljenje korijenskoga kanala. Mikropropusnost se ipak može javiti i u definitivno ispunjenom kanalu, i u kanalu poslijeendodontski restaurativno opskrbljena zuba. Treba imati na umu da nakon izradbe intraradikularnoga ležišta u kanalu ostaje skraćeno apeksno punjenje, 3-5 mm dugačko, koje ne može spriječiti prolaz mikroorganizama i njihovih toksina u periradikularno tkivo. Zato pri izradbi poslijeendodontske nadogradnje treba poπtivati pravila izabranoga postupka i aseptičke uvjete rada.The aim of this paper is to emphasize the importance of following the proper rules for performing a procedure, such as making a postendodontic post and core system. A postendodontic system should provide retention and resistance of the restoration, resistance of the remaining tooth structure and good sealing of the root canal. Microleakage can occur in the root canal filling as well as in the post and core system. After preparation of the intraradicular post space remains apical root canal filling which is 3-5 mm in length, and is a questionable barrier to prevent microorganisms and their toxins from penetrating into the periradicular tissue. Therefore, one should use the proper techniques in aseptic conditions during post and core treatments