Vertical Fractures of the Tooth Crown With Amalgam Filling

Amalgam se kao restorativni materijal rabi već više od 150 godina. Mehaničko opterećenje može rezultirati dimenzijskim promjenama dovodeći do nastanka rubnih pukotina i fraktura tvdoga zubnog tkiva. Svrha rada bila je utvrditi čestoću i lokaciju takvih fraktura kod zuba s amalgamskim ispunom. Ispitano je 30 ispitanika (21 muškog i 9 ženskog spola) u dobi od 16. do 42. godine. Kliničkim pregledom u 23 od 30 ispitanika (159 zubi) ustanovljene su frakture. Rezultati su pokazali da: 1. 48% fraktura postoji kod primarnih amalgamskih restauracija, 2. frakture su lokalizirane bukalno (31%) i disto-aproksimalno (26%), 3. gotovo polovica ispuna I. i II. razreda ima frakture, 4. najčešće su kod gornjih molara (75%), osobito kod prvoga molara (80%), 5. u 61% ispitanika frakture su locirane disto-aproksimalano, 6. nema statistički znatne razlike između muškoga i ženskoga spola po čestoći fraktura, 7. čestoća fraktura raste s godinama starosti. Frakture su uvjetovane svojstvima amalgama, utjecaju opterećenja na amalgamsku restauraciju i drugim čimbenicima. Ovo ispitivanje navodi nas na zaključak da svaki drugi pacijent s amalgamskim ispunom ima frakturu te je potrebna točna dijagnoza i zamjena ispuna kako bi se spriječila daljnja napuknuća tvrdoga zubnog tkiva.Amalgam has been used as a restorative material for 150 years. Mechanical loading can lead to dimensional changes resulting in marginal gaps and cracking of the hard dental tissue. The aim of this investigation was to locate and find out how often cracks happen with amalgam restorations. On order to determine this 30 examines were examined (21 male and 9 female), aged from 16 to 42 years. Clinical examination resulted in 23 out of 30 examined patients (159 teeth) had cracks. Cracks were drawn on formerly prepared schemes. Results showed that: 1. 48% of cracks were in primary amalgam restorations; 2. cracks were localized buccally (31%) and distally-proximally (26%); 3. nearly half of all Black Class I and II restorations had cracks; 4. cracks were found in upper molars (75%) and especially in first ones (80%); 5. 61% of examines with cracks were distally-proximally; 6. There were no statistically significant differences between male and female examines; 7. Frequency of cracking raises with age. Cracking is bound with properties of amalgam, influence of loading on amalgam restorations and other factors. This investigation lead us to conclude that every second patient with an amalgam restoration had a crack and better diagnosis and repairing is needed to prevent further cracking

Accessory Root Canals in the Apex Third of Lower Permanent Incisors and Canines

U ovom radu istraživana je devijacija apeksnoga otvora od anatomskoga vrška korijena, zastupljenost i broj akcesornih kanalića te udaljenost glavnoga foramena od anatomskog vrška na četrdesetšest ekstrahiranih donjih trajnih prednjih zuba. Sa stereomikroskopskom i s pomičnom mjerkom na presjecima je korijena određivana čestoća devijacije glavnoga foramena, udaljenost glavnoga foramena od anatomskog apeksa te pojavnost akcesornih kanalića u apeksnoj trećini korijena. Akcesorni kanalići su zastupljeni u 43,5% uzoraka, a devijacija glavnoga foramena u 50% uzoraka. Prosječna udaljenost glavnoga foramena od vrha korijena je 0,35 mm.There is no successful endodontic therapy without an intimate knowledge of the root canal morphology. The objective of this study was to develop a technique utilizing computer image processing, which would allow three-dimensional imaging of root canals. The study included the preparation of samples, construction of a cutting-measuring device, sample resection, optical registration of cross sections and graphic computer-assisted sample reconstruction. The described method allowed a three-dimensional graphic reconstruction of the experimental model. The rebuilt model could be transversally and longitudinally resected. The method may prove useful for external and internal study root morphology. With some midifications, it could be also used in other fields of dentistry

Remaining Filling on the Root Canal Walls after Retreatment with Three Gutta-percha Solvents

Svrha istraživanja bila je utvrditi količinu zaostale gutaperke i cementa na stijenkama korijenskoga kanala nakon uporabe triju različitih otapala gutaperke: eukaliptusova ulja, halotana i narančina ulja. Sedamdeset jednokorijenskih zuba je instrumentirano «step back» tehnikom te ispunjeno gutaperkom i Diaket cementom tehnikom hladne lateralne kondenzacije. Nakon 180 dana pohrane u fiziološkoj otopini uzorci su podijeljeni u tri skupine. Revizija je napravljena ručnim instrumentima s dodatkom otapala. Postupak je završen kada nije bilo tragova gutaperke i cementa na instrumentu ili na papirnatome štapiću. Zubi su raskoljeni te snimljeni kamerom montiranom na steromikroskop. Površina zaostale gutaperke i cementa izračunane su računalnim programom «ISSA». Najviše je punila zaostalo na stijenkama korijenskoga kanala nakon revizije s narančinim uljem (3,85 ±3,15 mm2), zatim s halotanom (3,72 ±2,52 mm2), a najbolji su rezultati postignuti s eukaliptusovim uljem (2,82 ±1,31 mm2), ali bez statistički znatne razlike.The aim of the investigation was to evaluate the amount of remaining gutta-percha and cement on dentine walls of the root canal after retreatment with three different gutta-percha solvents: eucalyptus oil, halothane and orange oil. Seventy one-rooted teeth were instrumented by “step-back” technique and filled with gutta-percha and Diaket cement using a cold lateral condensation technique. After 180 days storing in saline solution the samples were divided into three groups. Retreatment was done by hand instruments with the addition of solvent. The procedure was considered finished when there were not obvious traces of guttapercha and cement on the instrument or paper point. The teeth were split and photographed by camera mounted on a stereomicroscope. The area of remaining gutta-percha and cement was calculated by computer program “ISSA”. The greatest amount of remaining root canal filling was found after retreatment with orange oil (3.85 ±3.15 mm2), followed by halothane (3.72 ±2.52 mm2), and the best result was achieved with eucalyptus oil (2.82 ±1.31 mm2), but without statistical significance

Selection of Appropriate Artificial Frontal Teeth Size Using Dimensions of Hard Palate

Eighty dentate students participated as a study group and another 74 as a control group. The aim was to determine a possibility to reconstruct maxillary frontal teeth dimensions by use of certain hard palate dimensions. The height (IH) and the incisal (IW), contact point (CtW) and cervical width (CW) of maxillary central incisors (MCI), hamular width (HW) and the distance between the incisive papilla and the palatine foveas (IP-FP) were measured on the maxillary casts. CtW of maxillary lateral incisors and canines were measured too. In the study group the ratios were computed: HW/IW (5.71), HW/CtW (5.69), HW/CW (5.51) and IP-FP/IH (4.76). These ratios were multiplied by incisor’s dimensions (obtained from the control group) to calculate the hard palate dimensions. No significant differences were obtained between the calculated and the measured (study group) hard palate dimensions. Furthermore, there was no significant difference between the HW and the Sum of contact-point widths of all maxillary frontal teeth (p>0.05) in the both groups. The results revealed: 1. MCI width and height might be calculated by dividing dimensions of a patient’s hard palate and appropriate ratio; 2. hamular width dimension can be used as a selection guide for the sum of contact-point widths of six maxillary frontal teeth

A Comparison of Oral Status of the Fourth-Year Students of Various Colleges at the University of Zagreb

Svrha: Svrha istraživanja bila je usporediti oralni status studenata četvrte godine Stomatološkog fakulteta te studenata četvrte godine ostalih fakulteta Sveučilišta u Zagrebu. Ispitanici i postupci: Istraživanjem je bilo obuhvaćeno 78 studenata stomatologije i 78 njihovih kolega s ostalih fakulteta Sveučilišta u Zagrebu. Pregledi su obavljeni prema metodologiji i kriterijima SZO-a (WHO-a) stomatološkim zrcalom, a parodontološkom sondom Community periodontal index (CPI). Rezultati: Prosječna vrijednost KEP-indeksa svih ispitanika bila 7,97 (s.d.= 4,48), a bila je veća kod muškaraca negoli kod žena (p=0,043). Studenti stomatologije imali su prosječan KEP 6,96 (s.d.=4,82), a oni s ostalih fakulteta 8,97 (s.d.=3,88), sa statistički značajnom razlikom (p=0,005). Prosječan CPI statistički se značajno razlikovao (p=0.001) i kod studenata stomatologije je iznosio 1,91 (s.d.=2,40), a kod ostalih 2,99 (s.d.=2,23). Većina studenata ostalih fakulteta ( 66 %) treba, osim preventivnog tretmana, i konzervativno liječenje za razliku od studenata stomatologije od kojih 83 posto ne treba nikakvo liječenje ili treba samo preventivno. Zaključak: Premda je pojavnost karijesa, parodontnih bolesti i potreba za stomatološkim liječenjem niža kod studenata stomatologije, razmjerno visoka vrijednost KEP-a u objema skupinama ispitanika upućuje na nužnost boljeg preventivnog djelovanja u društvu. Zbog svijesti o oralnom zdravlju i preventivnim mjerama studenti stomatologije mogu biti pozitivan primjer kolegama s ostalih fakulteta.Objectives: To compare oral status of the fourth-year students of the School of Dental Medicine, and other fourth year students from the University of Zagreb. Materials and methods: Research included 78 dental students and 78 students of other colleges of the University of Zagreb. A standard dental check-up was performed following the WHO‑prescribed methodology and criteria, and by using a dental mirror and community periodontal index (CPI) probe. Results: Mean DMFT of all examined subjects was 7.97 (s.d. = 4.48), with a higher value for males than females (p =0.043). The dental students had a mean DMFT of 6.96 (s.d. =4.82) and the non-dental students group DMFT of 8.97 (s.d. =3.88). This difference was statistically significant (p =0.005). Average CPI indices difference of the examined groups (dental students – 1.91, s.d. =2.40; non-dental students – 2.99, s.d. =2.23) was also statistically significant (p=0.001). The majority of non-dental students (66%) needed, in addition to preventive measures, a conservative dental treatment, in contrast to the dental-students group, where 83% required only preventive or no dental treatment at all. Conclusions: Although the incidence of dental caries, periodontal diseases and treatment need is lower in dental students, the relatively high value of DMFT indices in both groups indicates the need for better preventive measures. Due to an inherent increased awareness of oral health and preventive measures, the dental students could set a good example to their fellowstudents of other colleges

Compomer as Restorative Material for Carious and Noncarious Lesions

Raznolike promjene na zubnim strukturama u području zubnih vratova (preosjetljivost dentina, karijesne i nekarijesne lezije) jedan su od ozbiljnijih problema dentalne patologije. Klinasti defekti i kaviteti petoga razreda zahtijevaju estetesku rekonstrukciju izgubljenoga tkiva materijalima s određenim fizičkokemijskim svojstvima. Naime, uporabu postojećih kompozitnih materijala koji imaju hidrofobna svojstva kompromitira blizina gingivnog sulkusa svojom sekrecijom, česta nazočnost cementa na gingivnome rubu preparacije, te nedostatna debljina cakline za adekvatnu retenciju. Klasični stakleno-ionomerni cementi (SIC) nemaju prihvatljivu estetiku. Kompomeri, smolama modificirani SIC, ujedinjuju kemizam kompozitnih smola i klasičnih SIC čime je dobiven materijal pogodan za estetsku i djelotvornu terapiju klinastih defekata te za ispune petoga razreda.Cervical abrasive lesions and class 5 composite restorations need specific restorative material, which is retentive, moist resistant and has high aesthetics. The class 5 composite restoration is not immune to microleakage. Studies have shown that microleakage occurs more frequently and to a greater extent at the cervical margins of these restorations because of gingival sulcus secretion, low enamel thickness and often the presence o f dental cement at the cervical margins o f the preparation. Glass ionomer cements (GIC) are unacceptable because of insufficient aesthetics. Polyacid modified glass ionomer cements incorporate composite resins and GIC chemistry and enable chemical bonds to enamel and dentine, moist resistance, caries prophylaxis and high aesthetics

Periapical Status of Endodontically Treated Teeth in Relation to the Quality of the Coronal Restoration

Svrha ovoga rada bila je procijeniti povezanost kakvoće restaurativnoga poslijeendodontskoga nadomjestka zuba i kakvoće ispuna korijenskoga kanala s periapeksnim statusom liječenoga zuba temeljem radiografske raščlambe. Pregledavani su ortopani slučajno izabranih pacijenata Zavoda za bolesti zubi te Zavoda za parodontologiju Stomatološkog fakulteta u Zagrebu. Dva su ispitivača neovisno jedan od drugoga procijenili 696 endodontski liječenih zubi s 265 ortopana. Prema unaprijed dogovorenim radiografskim kriterijima tehnička kakvoća punjenja kanala (PK) procijenjena je kao dobra ili kao loša, a isto tako i kakvoća poslijeendodontskoga nadomjestka (PEN). Apeksna trećina korijena s okolnim strukturama radiografski je proučena te je periapeksni status kategoriziran kao nepostojanje periradikularne upale (NPU) ili kao postojanje periradikularne upale (PPU). Pojavnost NPU-a u ispitanim endodontski liječenim zubima bila je 45%. Dobro punjenje kanala rezultiralo je sa statistički znatno više NPU slučajeva (89%), za razliku od dobre kakvoće PEN-a (68%). Loš PK imalo je nešto višu pojavnost PPU-a (81%) u usporedbi s lošim PEN-om (79%). Kombinacija dobar PK/dobar PEN pokazala je najviše NPU slučajeva (94%), a skupina loš PK/ loš PEN najmanje (14%). Razlike između pojedinih skupina s obzirom na kakvoću ispuna kanala i kakvoću nadomjestka zuba statistički su znatne (p< 0,05).The purpose of this study was to evaluate the relationship of the quality of the postendodontic restoration and root canal obturation on the radiographic periapical status of endodontically treated teeth. Panoramic adiographs of randomly selected patients from the Department of Endodontics and Restorative Dentistry and the Department of Periodontology, School of Dental Medicine in Zagreb, were examined. Six hundred and ninety-six endodontically treated teeth from 265 panoramic radiographs were evaluated independently by two examiners. According to a predetermined radiographic set of criteria, the technical quality of the root filling of each tooth was scored as either good or poor, and the quality of the postendodontic restoration similarly good or poor. The apical one-third of the root and surrounding structures were then evaluated radiographically and the periapical status categorized as absence (API) or presence (PPI) of periradicular inflammation. The rate of API for all endodontically treated teeth was 45%. Good endodontic filling (GE) resulted in significantly more API cases than good postendodontic restoration (GR), 89% versus 68%. Poor endodontic filling (PE) resulted in slightly more PPI cases than poor postendodontically restoration (PR), 81% versus 79%. The combination of GE and GR had the highest API rate of 94%, significantly higher than PE and PR, with API rate of 14%. Differences among groups regarding the technical quality of the root filling, and the quality of the postendodontic restoration were statistically significant (p< 0.05)

Measurement of the Root Canal Length by Endometers ES-02 and ES-03

Svrha rada bila je usporediti točnost mjerenja duljine korijenskih kanala apeks-lokatorima ES-02 i ES-03 u suhim kanalima te u kanalima ispunjenima natrij-hipokloritom i etilendiaminotetraoctenom kiselinom. Za pokus je rabljen 31 ekstrahirani humani jednokorijenski zub. Duljine korijenskih kanala određene su vizualno proširivačem #15, što je služilo kao kontrolne vrijednosti. Nakon toga zubi su uronjeni u posudu sa svježe zamiješanim alginatom u koji je postavljena i elektroda te su obavljena mjerenja s oba uređaja. Na svakom uzorku, za svaki uređaj, mjerile su se po dvije vrijednosti u suhom kanalu te u kanalu ispunjenom natrij-hipokloritom i kelatorom etilendiaminotetraoctenom kiselinom - EDTA. Prva vrijednost je radna duljina određena prema oznaki -1,0 na ljestvici, odnosno na ekranu, kao mjesto apikalnog sužetka. Druga vrijednost je mjerena prema oznaki 0,0 koja označava vanjski otvor korijenskog kanala. Dobiveni rezultati statistički su obrađeni testom MANOVA. Kao post-hoc test koristio se Student-t test. Uređajem ES-02 postignuto je 65%, a ES-03 uređajem 61% mjerenja jednakoj kontroli pri točki -1,0 u suhim kanalima, premda razlika između uređaja nije statistički znatna. Tekućine u kanalu statistički negativno utječu na točnost jerenja, ali ta je značajnost oko 10 puta veća kod točke mjerenja -1,0 u odnosu prema točki 0,0.The aim of this study was to compare the accuracy of measurements of endometers ES-02 and ES-03 in dry canals and canals filled with sodium-hypochlorite and ethylenediaminetetraacetic acid (EDTA). For the experiment 31 one-rooted human extracted teeth were used. Working length of the root canal was determined visually using a #15 reamer as a control measurement. After that the teeth were mbedded in vial with freshly mixed alginate and the measurements were made with both devices. Two measurements were made in dry canal and canal filled with sodiumhypochlorite and EDTA for each device. The first value was the working length determined according to the sign -1,0 on the scale and display, respectively, which corresponds to the apical constriction. The second value was measured according to the sign 0,0 which corresponds to the external foramen. Results were analyzed statistically by MANOVA test, and as post-hoc test Student-t test was used. The measurements same as control were in 65% for ES-02 device, and 61%, for ES-03 device at point -1,0 in dry canal, although the difference was not statistically significant. Fluids in root canal statistically significant negatively influence on accuracy of measurements but that significance was 10 times greater at point of measurement -1,0 than at 0,0

Microleakage Evaluation of Resin Composite Fillings - A Pilot Study

Svrha rada bila je ispitati propusnost između restorativnog materijala i stijenke zuba kod primjene dvaju različitih adhezijskih sustava. Ispitivanje je provedeno na 12 intaktnih trećih kutnjaka ekstrahiranih iz ortodontskih razloga. Zubi su prepiljeni na caklinsko-cementnom spojištu te su dobiveni krunski segmenti. Na okluzalnim površinama izrađeni su kaviteti I. razreda. Uzorci su podijeljeni u dvije skupine – po šest u svakoj. Za izradbu ispuna uporabljen je restorativni kompozitni materijal “Tetric Ceram” (Vivadent, Schaan, Liechtenstein) i dva različita samojetkajuća adhezijska sustava - u jednoj skupini dvofazni adhezijski sustav AdheSE (Vivadent, Schaan, Liechtenstein), a u drugoj jednofazni adhezijski sustav Xeno III (DeTrey, Konstanz, SR Njemačka). Za mjerenje mikropropusnosti koristila su se dva postupka – konstrukcija za prijenos tekućine i tehnika prodora boje. U rezultatima dobivenima konstrukcijom za prijenos tekućine nije ustanovljena statistički znatna razlika između dviju skupina uzoraka (p=0,7488). Mjerenje rubnog propuštanja tehnikom prodora boje pokazalo je statistički znatno veće propuštanje (p=0,002) u skupini u kojoj je uporabljen adhezijski sustav Xeno III.The purpose of this study was to evaluate microleakage of two different adhesive systems between resin composite restorations and cavity walls. The experiment was conducted on 12 intact human third molars, extracted for orthodontic reasons, sectioned at the cemento-enamel junction to provide crown segments. The cavities were prepared in the occlusal surfaces. The samples were divided into two groups, six samples in each. Restorations were made with the resin composite “Tetric Ceram” (Vivadent, Schaan, Liechtenstein) and two different self-etch adhesive systems: in one group two-step self-etch AdheSE (Vivadent, Schaan, Liechtenstein), and in the other single-step self-etch Xeno III (DeTrey, Konstanz, Germany). Microleakage was measured by two different methods, fl uid transport model and dye penetration. The results using fl uid transport model showed no statistically signifi cant difference between two groups of samples (p=0,7488). Marginal leakage measured using dye penetration technique method showed statistically signifi cant higher degree of marginal leakage (p=0,002) in the group where Xeno III was used

Remaining Filling on the Root Canal Walls after Retreatment with Three Gutta-percha Solvents

Svrha istraživanja bila je utvrditi količinu zaostale gutaperke i cementa na stijenkama korijenskoga kanala nakon uporabe triju različitih otapala gutaperke: eukaliptusova ulja, halotana i narančina ulja. Sedamdeset jednokorijenskih zuba je instrumentirano «step back» tehnikom te ispunjeno gutaperkom i Diaket cementom tehnikom hladne lateralne kondenzacije. Nakon 180 dana pohrane u fiziološkoj otopini uzorci su podijeljeni u tri skupine. Revizija je napravljena ručnim instrumentima s dodatkom otapala. Postupak je završen kada nije bilo tragova gutaperke i cementa na instrumentu ili na papirnatome štapiću. Zubi su raskoljeni te snimljeni kamerom montiranom na steromikroskop. Površina zaostale gutaperke i cementa izračunane su računalnim programom «ISSA». Najviše je punila zaostalo na stijenkama korijenskoga kanala nakon revizije s narančinim uljem (3,85 ±3,15 mm2), zatim s halotanom (3,72 ±2,52 mm2), a najbolji su rezultati postignuti s eukaliptusovim uljem (2,82 ±1,31 mm2), ali bez statistički znatne razlike.The aim of the investigation was to evaluate the amount of remaining gutta-percha and cement on dentine walls of the root canal after retreatment with three different gutta-percha solvents: eucalyptus oil, halothane and orange oil. Seventy one-rooted teeth were instrumented by “step-back” technique and filled with gutta-percha and Diaket cement using a cold lateral condensation technique. After 180 days storing in saline solution the samples were divided into three groups. Retreatment was done by hand instruments with the addition of solvent. The procedure was considered finished when there were not obvious traces of guttapercha and cement on the instrument or paper point. The teeth were split and photographed by camera mounted on a stereomicroscope. The area of remaining gutta-percha and cement was calculated by computer program “ISSA”. The greatest amount of remaining root canal filling was found after retreatment with orange oil (3.85 ±3.15 mm2), followed by halothane (3.72 ±2.52 mm2), and the best result was achieved with eucalyptus oil (2.82 ±1.31 mm2), but without statistical significance