Diagnostic significance of the “lead line”

Autor navodi različita mišljenja o dijagnostičkom značenju olovnog ruba i tumačenja mehanizma njegova nastajanja na gingivi. Zatim se osvrće na upalne promjene na gingivi u odnosu na olovni rub. Da odgovori na postavljena pitanja (da li olovni rub ima dijagnostičko značenje; koji faktori odlučuju pri nastajanju olovnog ruba i da li higijena usne šupljine ima pritom udjela). Autor je obradio podatke o stanju usne šupljine kod 50 radnika u tvornici akumulatora i kod 50 radnika u rudniku i topionici olova. Kontrolnu grupu sačinjavalo je 50 radnika metalne struke. Autor je na osnovu tih istraživanja došao do ovih zaključaka; 1. Olovni rub nije bitan simptom intoksikacije olovom; 2. Pri nastajanju olovnog ruba pored olova i sumporovodika sudjeluje vjerojatno i permeabilnost gingivalnog epitela; 3. Čini se da ekspozicija olovu po goduje razvitku zubnog kamenca; 4. Higijenu usne šupljine ima samo sporednu ulogu u stvaranju olovnog rubaIntroducing his paper the author reviews various opinions regarding the diagnostic significance of the »lead line«. In order to clear some controversial points with regard to the formation and diagnostic value of the »lead line«, the author has examined 50 workers of a storage battery plant, and 50 workers in a lead mine and smelting plant. The control group consisted of 50 metal workers which have not been exposed to lead. His results may be summarized as follows: (I) the »lead line« is not an essential symptom of lead poisoning; (2) there are other factors besides lead and hydrogen sulphyde which contribute to the formation of the »lead line«, they are probably related to the physiological state of the epithelial tissue of the gingiva; (3) the oral hygiene plays a secondary role in the formation of the »Iead line«

Die Entwicklung der sektion für stomatologie der kroatischen Arztevereinigung

U kratkom pregledu društvene aktivnosti zubnih liječnika, stomatologa u posljednjih 70 godina u Zagrebu, autor ističe neka važnija zbivanja (osnivanje Zadruge hrvatskih stomatologa 1903. godine, organiziranje i rad Sekcija zubnih liječnika između 2 velika svjetska rata i 3 kongresa u tom razdoblju). Nakon Oslobođenja zemlje počinje se ponovno stručnim radom, međutim, veći se zamah opaža tek od 1952. godine, kad je održan prvi poslijeratni stomatološki kongres. Usporedo s visokoškolskom edukacijom novih kadrova, intenzivira se rad Stomatološke sekcije Zbora Liječnika Hrvatske. Taj se rad odražava u mjesečnim i interepubličkim sastancima, predavanjima izvan Zagreba, sudjelovanju članova Sekcije na nacionalnim i internacionalnim kongresima. Brineći se za postdiplomsko uzdizanje svojih članova, Sekcija organizira zubozdravstvene dane u okviru izložbe » M e- dicina i tehnika« i postdiplomske tečajeve, a ona je i suizdavač časopisa Acta Stomatologica Croatica. Stomatološka Sekcija se pridružuje proslavi 20 godišnjeg jubileja visokoškolske stomatološke nastave u SRH i nada se da će i nadalje uspijevati u svojoj brizi za ugled i prosperitet stomatologije kod nas.In the short survey of the social activities of dental practitioners, stomatologists, during the last 70 years, in Zagreb, the author mentions some significant events (the foundation of the Society of Croatian Dentists in 1903, the organization and activity of the dental profession between the two wars, and the three congresses in that period). After 1945, the professional activity is renewed, but a greater swing is noted from 1952, after the first afterwar congress of dental practitioners. With the high school education of the new generations, the activity of the Stomatologic Section of the Medical Association of Croatia is also intensified. There are monthly conferences, interrepublic meetings, lectures outside of Zagreb, participation of members at the national and international congresses, etc. In its efforts for the post-graduate education of its members the Section organizes refresher courses and conferences during the exposition Medicine and Medical Aids which takes place every two years. It participates in the publication of the Acta Stomatologica Croatica. The Stomatologic Section joins in the celebration of the 20th Anniversary of the high school dental education in our Republic, in the hope for a further prosperity and renown of the profession in our country.In einer kurzen Übersicht der gesellschaftlichen Tätigkeit der Zahnärzte in den letzten 70 Jahren in Zagreb hebt der Verfasser die bedeutendsten Ereignisse hervor. Das sind: die Gründung der Vereinigung der kroatischen Stomatologen im Jahre 1903, die Organisation und Tätigkeit der Sektion der Zahnärzte zwischen den zwei Weltkriegen und die Abhaltung von drei Kongresen in dieser Zeitspanne. Nach der Befreiung des Landes beginnt neuerdings die Fachtätigkeit, doch grösseren Schwung bekommt diese Tätigkeit erst 1952 mit der Abhaltung des ersten stomatologischen Nachkriegskonresses. Hand in Hand mit der Hochschulerziehung von neuen Generationen verstärkt sich die Tätigkeit der Stomatologischen Sektion der Kroatischen Ärztevereinigung. Diese Aktivität kommt zum Ausdruck in monatlichen und interrepublikanischen Zusammenkünften, Vortägen ausserhalb der Stadt Zagreb und in der Anteilnahme der mitglieder an nationalen und internationalen Kongressen. Auf die Fortbildung ihrer Mitglieder bedacht hat die Sektion im Rahmen der Ausstellung »Medizin und Technik« Zahnärztliche Tage organisiert, ferner spezielle Fortbildungskurse, die Sektion ist auch Mitherausgeber der Fachzeitschrift Acta Stomatologica Croatica. Die Sektion für Stomatologie nimmt Anteil an der Feier des 20 jährigen Bestehens des stomatologischen Hochschulunterrichts in der Sozialistischen Republik Kroatiens und hofft auch weiterhin mit Erfolg für das Ansehen und Gedeihen unserer Stomatologie zu wirken

Oral manifestations in occupational mercury poisoning

Industrijsko zubarstvo kao ogranak industrijske medicine sprečava, dijagnosticira i liječi sve one promjene, koje mogu nastali u području usne šupljine u vezi s radnim uvjetima čovjeka. Da bi stomatolog mogao uspješno surađivati s liječnikom za profesionalna oboljenja potrebno je da dobro poznaje toksične osobine pojedinih materijala, s kojima ljudi dolaze u dodir prilikom rada. kao i sve promjene, koje mogu naslati u području usne šupljine zbog profesionalnih otrovanja. Za sprečavanje profesionalnih oboljenja ima ustanovljenje ranih simptoma otrovanja osobitu važnost. Autor iznosi rezultate svojih opažanja oralnih simptoma kod otrovanja živom u nekim našim industrijama i preporučuje da se tim simptomima ubrati naročita pažnja u Loku periodičkih kontrolnih pregleda.The author discusses his observations of the oral symptoms found in workers in the mercury mine and the smelting plant of ldria. Owing to the high temperature (22-23° C), the small velocity of air movement and rather high concentrations of mercury (2.00 mg/m3 to 5.90 mg/m3) in the fits of native mercury is won. The number of incidents of subacute intoxications with mercury vapours was high (Table 1). In the smelting plant where mercury hazards exist for some workers only (cleaning of condensations pipes and of the chimney, filling of steel bottles) less oral symptoms of subacute poisoning was found (Table 2). In a felt hat factory at Škofja Loka, where mercury compounds are still in use, the author found signs of chronic intoxication, of the mucous membrane of the pharynx and the gum. These findings went together with symptoms of chronic disturbances in the central nervous system (Table 3). The oral hygiene of the examined persons was found to be poor and nowhere satisfying (Table 1. 2, 3). As good oral hygiene and healthy condition of teeth play an important part in prevention of oral manifestations and edentulous persons did not show any signs of gingivitis, great responsibility rests on the dental profession and the importance of industrial dentistry is pointed out. Because of the facts (1) that the oral cavity presents the main entrance for many toxic agents, (2) that it shows initial symptoms of some intoxications and (3) that it is easily accessible, the purpose of a fruitful collaboration between the dentist and the industrial physician is the periodic examination of the oral cavity of workers exposed to occupational oral hazard

Periapicals Trepanation

Uvodno autori navode razloge zbog kojih se i danas, usprkos poboljšanoj kvaliteti silikatnog cementa, relativno često susreće u zubnim ambulantama gangrenski raspad zubne pulpe. Budući da proces odumiranja zubne pulpe pri silikatnom punjenju ima kroničan tijek, pacijenti traže pomoć stomatologa tek kad je nastao periapeksni proces. Na 81 slučaju klinički i rendgenski ustanovljenih kroničnih periapeksnih difuznih procesa, u pretežno mladih pacijenata autori su primijenili periapeksnu trepanaciju. Nakon klasičnog širenja i čišćenja korijenskog kanala, on se ispuni mješavinom paste N2 Medical i Terracortrila. U injekcijskoj anesteziji se izvrši trepanacija tvrdih i mekih dijelova. U jednom slučaju perzistirala je fistula i nakon tri mjeseca, u dvama je bila potrebna ekskohleacija, a preostali slučajevi su bili uspješni.In the introduction, the authors discuss the reasons why in spite of an improved quality of silicate, relatively often a gangraene of the pulp is found. Because of the fact, the necrosis of the pulp in connection with silicate fillings is of a chronical type the patients seek the dentist when an inflammatory process of the periapex has developed. In 81 cases, clinically and X-rays diagnosed, as chronical inflammatory diffuse processes in young persons, the periapical trephining has been done. After the classical cleaning and enlarging of the root canals a paste containing N2 Medical and Terracortrill was deposited. In local anaesthesia the buccal cortical plate using a trephin was perforated. In one case fistulation persisted for 3 month, in two Cases excochleation was necessary and the remaining cases had been successful.Einleitend werden Gründe angegeben weshalb noch heute, obwohl die Qualität des Silicates verbessert wurde, relativ oft in zahnärztlichen Ambulanzen eine Gangraen der Pulpa diagnostiziert wird. Da das Absterben des Pulpagewebes unter Silicatfüllungen einen chronischen Verlauf hat, wird die fachmännische Hilfe von den Patienten erst als es zu periapikalen Komplikationen kommt, verlangt.Bei 81 klinisch und röntgenologisch festgestellten Fällen von chronischen, periapicalen diffusen Prozessen in vorwiegend jungen Patienten, wurde eine periapicale Trepanation angewendet. Nachdem die klassische Reiningung und Erweiterung des Wurzelkanals durchgeführt war, wurde der Kanal mit einer Paste die ein Gemisch von N2 medical und Terracortril enthielt, ausgefüllt. Nachdem wurde in localer Anaesthesie eine Trepanation des weichen und harten Teile ausgeführt. In einem Fall persistierte eine Fistel noch drei Monate, in zwei Patienten war eine Excochleation notwendig und in den übrigen Fällen waren die Resultate zufriedenstellend

Primjena adsorptivnih sredstava u Iječenju nekrotične inficirane zubne pulpe

Nalaz kvantuma eksudacije pokazao je da slaba eksudacija daje doduše u većini slučajeva jednak rendgenski nalaz iza punjenja korijenskog kanala adsorbensom, ali daje i manji rendgenski nalaz pogotovo u 1/4 slučajeva. Kod intenzivne eksudacije nisu se pokazale promjene u koštanoj supstanciji koje bi ukazivale na smanjenje koštane destrukcije iza punjenja kanala. Ti rezultati mogu se interpretirati odgovorom organizma na noksu koja se sastoji od dekompozicije koštane supstancije

Antibiotic therapy in endodontics

Indikaciju za primjenu antibiotika u endodonciji treba promatrati s triju aspekata: a) liječenje postojećih infekcija, kad se antibiotici primjenjuju u tretiranju ostitičkih ilezija, ovisno o težini kliničke slike i općem zdravstvenom stanju pacijenta, b) zaštita osjetljivih tkiva i osoba prilikom endodontskog rada, kad se terapijski postupak i antibiotska zaštita određuje individualno, prema težini osnovne bolesti, c) zaštita osoba predisponiranih za bakterijski endokarditis; endodontski se zahvat provodi tek kad je pacijent u potpunosti pod antibiotskom zaštitom. Terapijski se postupak u tom slučaju prilagođava situaciji. U radu su prikazani uspoređeni mikrobiološki nalazi bakterijskog endokarditisa u Klinici za zarazne boIesti » Dr Fran Mihaljević« u Zagrebu i u University of Michigan Hospitalu , u približno istom razdoblju (od 1962. do 1975. godine). Ustanovljena je promjena ekologije infekcije u tehnički naprednijoj sredini. U izboru antibiotika u endodonciji, prednost imaju penicilinski antibiotici, alternativno cefalosporini eritromicin. Za zaštitu osoba predisponiranih za bakterijski endokarditis, upotrebljavaju se samo antibiotici baktericidnog djelovanja. Najbolji su penicilini cefalosporini, koji se administriraju peroralno dva sata prije zahvata, a parenteralno pola sata prije endodontskog zahvata, u dovoljno visokim dozama. U nekim će slučajevima biti potrebna kombinacija antibiotskih lijekova, uz konsultaciju s liječnikom koji prati stanje bolesnika nakon preboljene osnovne bolesti. Najboljom se smatra kombinacija penicilinskih antibiotika i aminoglukozida, uz nužan oprez radi ototoksičkog i nefrotiksičkog djelovanja aminoglikozida. Lokalna primjena antibiotika, u kombinaciji s hidrokortizonskim preparatima, kontraindicirana je u osoba predisponiranih za bakterijski endokarditis.Microbiological findings of bacterial endocarditis from the University Hospital for Infectious Diseases Dr. Fran MihaIjević in Zagreb are presented and compared to the findings collected at the University of Michigan Hospital during the approximately same period (1962 — 1975). A change in infection ecology has been observed in technically more advanced environment. In the choice of antibiotics in endodontics the priority is given to penicillin antbiotics and alternatively to cephalosporins and erythromycin. For the protection of persons predisposed to bacterial endocarditis only bactericidal antibiotics are used. The best ones are penicillins and cephalosporins, which are administered perorally two hours before the endodontic treatment or parenterally half an hour before the treatment in sufficiently high doses. In some cases a combination of antibiotics is necessary as well as the consultation with the physician following up the patients condition after curing the basic disease. The combination of penicillin antibiotics and aminoglucosides applied with due caution, which is necessary because of ototoxic and nephrotoxic aminoglucoside action, is considered to be the best one. The local application of antibiotics combined with hidrocortisones is contraindicated in persons predisposed to bacterial endocarditis

Die Korrektur gewisser ungenügender endodontischer Eingriffe

Autori u uvodu daju suvremenu definiciju uspješnog endodontskog zahvata. Naglašavaju da je osnovni i glavni cilj endodontske terapije potpuna evakuacija pulpnog tkiva, opskrba apikalnog foramena i totalna opturacija korijenskog kanala. Ukazuju zatim na česte greške u radu, koje nastaju najčešće uslijed nekompletne instrumentacije korijenskog kanala, što rezultira neadekvatnim ispunom kanala. U svom prikazu autori se ograničavaju na problematiku nedovoljne opturacije korijenskog kanala, jer je praktičar u dilemi, kako da takav zub tretira. Autori opisuju svoj način rada — odstranjivanje nedovoljnog ispuna, temeljitu instrumentaciju korijenskog kanala i dobru opskrbu kanala. Iz većeg broja uspješno tretiranih zubi autori prikazuju nekoliko slučajeva, koristeći se pritom rendgenogramom prije, za vrijeme zahvata i poslije njega. Navode da je njihova metoda rada bila uspješna i preporučaju je praktičarima.A contemporary definition of a successful endodontic intervention is given by the authors in the introduction. They emphasize that the fundamental and chief aim of endodontic therapy is complete removal of the pulp tissue, supply of the apical foramen and total obturation of the root canal. The authors mention frequent errors at work which occur most often because of incomplete instrumentation of the root canal, resulting in an inadequately filled root canal. In their review the authors limit themselves to the problems of inadequate filling of the root canal because the practician is in a dilemma as to how to treat such a tooth. The authors describe their method of work that is the removal of the inadequate filling, thorough instrumentation of the root canal and good supply of the canal. From a large number of successfully treated teeth the authors have selected a few cases, making use of a roentgenogram taken before, during and after the treatment had been completed. They stated that their method of work was successful and recommend it to the practicians.Eingangs heben die Autoren hervor, dass das Hauptziel einer endodontischer Behandlung die vollständige Entfernung des Pulpagewebes, die Versorgung der apikalen Öffnung und die vollkommene Verschliessung des Wurzelkanals ist. Fehler entstehen häufig infolge der ungenügenden Vorbereitung des Wurzelkanals, was eine unvollständige Füllung zur Folge hat. Die Autoren beschreiben ihr System der Entfernung von unvollständigen Füllungen, gründlicher Aufschliessung und guter Versorgung des Wurzelkanals, weil sie von grosser praktischer Bedeutung ist. An einigen Fällen, ausgewählt aus einer grossen Anzahl von erfolgreich behandelten, und an Hand von Röntgenogrammen vor, während und nach der Behandlung, beweisen die Autoren dass ihr System erfolgreich ist