Komparativna ispitivanja kruničnog zaptivanja metodom poprečnih preseka korena zuba

Objective: An in vitro comparison of coronal microleakage of three root canal sealers was performed using the dye leakage method. Methodology: Ninety-eight single-rooted human teeth were instrumented and randomly allocated to two groups. In the first group, root canals were treated with EDTA to remove the smear layer. The roots in both groups were obturated using laterally condensed gutta-percha and Sealapex, AH-26 or Ketac-Endo as the sealer. The teeth were suspended in 1% methylene blue dye for 6 days. The teeth were then rinsed, sectioned perpendicular to the long axis and evaluated for coronal dye penetration. Results: In general, Ketac-Endo root canal sealer showed greater dye penetration than Sealapex and AH-26. A statistically significant difference in the coronal penetration of the dye was found in the group with intact smear layer. Conclusion: Highly significant differences between AH-26 and Ketac-Endo (p lt 0.001) and Sealapex and Ketac Endo (p lt 0.001) were found.Cilj: Cilj ovog rada je bio da se ispita kvalitet kruničnog zaptivanja kod zuba opturisanih lateralnom kompakcijom primenom metode poprečnih preseka korena zuba. Materijal i metod: U istraživanjima je korišćeno 98 ekstrahovanih jednokorenih zuba, koji su endodontski obrađeni i podeljeni u dve eksperimentalne grupe. Svi kanali su obrađeni STEP-BACK tehnikom preparacije kanala korena uz primenu 2.5% rastvora NaOCl. Uzorci prve grupe su nakon instrumentacije tretirani rastvorom EDTA radi uklanjanja razmaznog sloja. Svi kanali iz obe grupe su opturisani tehnikom lateralne kompakcije primenom pasti SEALAPEX, AH-26 I KETAC-ENDO. Zubi su nakon opturacije potapani u 1% rastvor metilen-plavila tokom 6 dana i potom serijski presecani poprečno na različitoj udaljenosti od gleđno - cementne granice radi evaluacije kruničnog mikropropuštanja. Svaki poprečni presek je posmatran pod mikroskopom na uveličanju 50x. Rezultati: Dobijeni rezultati su generalno pokazali da je u uzoraka opturisanih pastom KETAC-ENDO uočen veći prodor boje nego kod SEALAPEX-a i AH-26. Statistički značajne razlike uočene su u grupi gde razmazni sloj nije uklonjen. Razlika je bila visoko značajna i između uzoraka zuba opturisanih pastom KETAC-ENDO i AH-26 (p lt .001) i između KETAC-ENDO i SEALAPEXa (p lt .001). Zaključak: Rezultati ove studije ukazuju da je bolje krunično zaptivanje ostvareno posle primene pasti AH-26 i SEALAPEX nego posle primene KETAC-ENDO cementa

Clinical effects of fixed functional Herbst appliance in the treatment of class II/1 malocclusion

Introduction. Sagittal mandible deficiency is the most common cause of skeletal Class II malocclusion. Treatment objective is to stimulate sagittal mandible growth. Fixed functional Herbst appliance use is beneficial for shortening the time required for treatment and does not depend on patient compliance. Case outline. A 13-year-old girl was referred to the Clinic of Orthodontics, School of Dentistry in Belgrade following previous unsuccessful treatment of her skeletal Class II malocclusion using an activator. The patient's poor cooperation had led to failure of the treatment. Patient was subjected to the Herbst treatment for 6 months followed by fixed appliance for another 8 months. Lateral cephalograms before and after the treatment was performed. The remodelation of condylar and fossal articulation was assessed by superimposition of pre- and post-treatment temporomandibular joint tomograms. The promotion of oral hygiene and fluoride use was performed because orthodontic treatment carries a high caries risk and risk for periodontal disease. Skeletal and dental changes were observed after treatment (correction [Max+Mand]: molar relation 7 mm, overjet 8 mm, skeletal relation 5 mm, molars 2 mm, incisors 3 mm). Combination of Herbst and fixed appliances was effective in the treatment of dental and skeletal irregularities for a short period of time. Conclusion . In the retention period, 14 months after treatment, occlusal stability exists. Follow-up care in oral prevention is based on regular recalls at the dental office and supervision at home by the parents

Ispitivanje efikasnosti dijagnostikovanja minimalnih karijesnih lezija

The aim of this study was to assess the accuracy of visual-tactile inspection (VTI) and laser fluorescence (LF) in detection of initial carious lesions on occlusal surfaces. Total of 120 premolars and molars, without any macroscopic cavitation on occlusal surface, planed to be extracted for orthodontic, prosthetic or surgical reasons, were included in this study. The agreement between histological diagnosis and diagnostic and treatment decisions of evaluated methods was assessed. The obtained results showed that specificities and sensitivities were for VTI=83 and 36%, and LF-77 and 96%. The percentage of correct treatment decisions were: VTI=54% and LF-80%. Diagnosing caries was significantly dependent on the fissure morphology and LF showed statistically better results than VTI. It can be concluded that laser fluorescence was significantly efficient and more accurate in diagnosing initial carious lesions on occlusal surfaces.Cilj ovog rada bio je da se ispita efikasnost vizuelno-taktilnog ispitivanja (VTI) i laser fluorescencije (LF) u otkrivanju početnih karijesa okluzalnih površina zuba. U ispitivanje je uključeno 120 premolara i molara dece različitog pola, bez jasno vidljivih kaviteta na okluzalnoj površini planiranih za ekstrakciju iz ortodontskih, protetskih ili hirurških razloga. Efikasnost dijagnostičkih metoda (vizuelno-taktilne i laser fluorescencije) i ispravnost terapijskih odluka korelirana je sa rezultatima histološke analize. Dobijeni rezultati su pokazali da je mogućnost otkrivanja početnih karijesnih lezija (osetljivost) bila značajno veća kod LF (96%) nego kod VTI (36%), dok je specifičnost bila veća kod VTI (83%) nego kod LF (77%). Ispravnost terapijskih odluka potvrđena je u 54% slučajeva kod VTI, odnosno u 80% slučajeva kod LF. Pravilna dijagnoza značajno je bila zavisna od morfološkog oblika fisura, a LF je pokazala statistički bolje rezultate od VTI. Dobijeni rezultati su pokazali daje metoda LF znatno efikasnija i preciznija u dijagnostikovanju početnih karijesnih lezija okluzalnih površina zuba

Klinička ispitivanja efikasnosti minimalnih restauracija okluzalnih površina zuba

Minimal dental restoration of occlusal surfaces using sealing for prevention, preserve sound tooth structure. The aim of this study was to clinicaly assess the performance of three different techniques in minimal dental restoration. A total of 90 teeth (premolars or molars) with minimal carious lesions were equally divided into three groups and included in this study. In group I and II teeth were restored either with the composite resin and the resin modified glass ionomer cement. Composite sealant (separately applied) was used in both groups. In group III teeth received resin modified glass ionomer cement. These materials were used at the same time as a restorative and a sealant. Modified Cvar and Ryge criteria were used for clinical evaluation after 1, 2, 3, 6 and 12 months. Complete retention at the end of the evaluation period for I, II and III group was 97%, 93% and 93% respectively. No secondary caries was recorded after the evaluation period. From the obtained results it can be concluded that minimal dental restorations presents an efficient and successful technique in the treatment of small occlusal carious lesions.Minimalne dentalne restauracije okluzalnih površina, koristeći zalivanje radi prevencije, čuvaju zdravu zubnu strukturu. Cilj ove studije bio je da se klinički ocene tri različite tehnike minimalnih dentalnih restauracija. Ukupno 90 zuba (premolara i molara) sa minimalnim karijesnim lezijama je podeljeno u tri grupe. U Grupama I i II zubi su restaurirani sa kompozitom ili smolom modifikovanim glas jonomer cementom. Kompozitni zalivač (aplikovan zasebno) je korišćen u obe grupe. U Grupi III zubi su restaurirani smolom modifikovanim glas jonomer cementom kao ispunom i materijalom za zalivanje fisura u isto vreme. Modifikovani Cvar i Ryge kriterijumi upotrebljeni su u kliničkom ocenjivanju posle 1,2,3,6 i 12 meseci. Kompletna retencija na kraju evaluacionog perioda za grupu I (97%), za grupu II (93%) i grupu III (93%). Sekundarni karijes nije zabeležen ni u jednom slučaju. Na osnovu dobijenih rezultata može se zaključiti da minimalne dentalne restauracije predstavljaju efikasnu i uspešnu tehniku u terapiji malih karijesnih lezija na okluzalnoj površini

Hipomineralizacija na prvim stalnim molarima i incizivima

The aim of this study was to point out the prevalence of hypomineralised molars and incisors and emphasize importance of this condition in pediatric dentistry. This condition is defined as hypomineralisation of one or more first permanent molars frequently affecting incisors and referred to as molar incisor hypomineralisation (MIH). Etiology of MIH has not been fully clarified and numerous etiological factors have been cited. Hypomineralised molars are more prone to caries, cause severe restorative problems and are frequently extracted due to serious damage and caries complications. Incisors can present demarcated enamel opacities, while enamel breakdown is uncommon. Considering the fact that permanent first molars with severe defects demand complex treatment, they represent a serious problem for the patient as well as for the dentist.Cilj rada je bio da se ukaže na pojavu hipomineralizacije na prvim stalnim molarima i incizivima i istakne značaj ovog problema u dečjoj stomatologiji. Hipomineralizacija prvih stalnih molara i inciziva definisana je kao smanjena mineralizacija jednog ili više prvih stalnih molara koja je često udružena s promenama na sekutićima. Etiologija ove pojave nije potpuno razjašnjena, a navode se razni faktori koji mogu izazvati ovaj poremećaj. S obzirom na to da su zahvaćeni prvi stalni molari i incizivi, smatra se da se promene dešavaju usled specifičnih uticaja na gleđ zahvaćenih zuba u fazi njihovog formiranja. O rasprostranjenosti ove pojave postoji malo raspoloživih podataka, koji uglavnom potiču iz zemalja severne Evrope, a u rasponu je od 3,6% do 25,0%. Promene su rangirane od beložutih ili žutobraon ograničenih zamućenosti, do težih oblika u vidu prekida kontinuiteta gleđi. Mogu biti zahvaćena, dva, tri ili sva četiri prva stalna molara. Ovi zubi mogu biti osetljivi na struju vazduha, promenu temperature (toplo- hladno), ali i na mehaničke nadražaje, kao što je pranje zuba. Hipomineralizovani molari, zavisno od stepena promena, više su skloni brzom i progresivnom razvoju karijesnih lezija, teški su za sanaciju i često, usled komplikacija, prerano izvađeni. Oštećenja na incizivima nisu tako obimna i retko se, osim promene boje, nalazi dezintegrisana gleđ. Budući da ovako promenjeni molari često zahtevaju obimno i složeno lečenje, predstavljaju ozbiljan problem, kako za bolesnika, tako i za stomatologa. Neophodno je uraditi opsežna ispitivanja koja će precizno utvrditi rasprostranjenost i moguće etiološke faktore (posebno za našu populaciju), te predložiti plan preventivnih i terapijskih mera kojima bi se kontrolisala ova pojava

Stanje oralnog zdravlja dece sa posebnim potrebama

Background/Aim. Due to their primary medical condition, children with special needs often display lower levels of oral hygiene, larger prevalence of caries and other oral diseases. The aim of this study was to estimate the prevalence of dental caries, oral cleanliness and presence of malocclusion in children with disabilities, as well as to evaluate eruption time of the permanent molars. Methods. Case-control study was carried out on a group of 107 children with disabilities at the Faculty of Dental Medicine, University of Belgrade, Serbia. The control group comprised of 104 healthy school children. Results. Children with disabilities had statistically higher mean [decayed missing and filled teeth - dmft for primary DMF for permanent dentition (dmft DMFT)] values in both dentitions than children from the control group (p lt 0.05). Oral cleanliness level was much lower in children with disabilities. A significantly higher percentage of Class II malocclusions and a higher tendency to have a delayed time of eruption of permanent molars were observed in the test group in permanent dentition. Conclusion. Considering poor oral health status and higher tendency for development of malloclusions and delayed eruption, it is necessary to develop preventive dental programmes for children with special needs, as well as improve public awareness about these issues.Uvod/Cilj. Deca sa posebnim potrebama često zbog svoje primarne bolesti, imaju niži nivo oralne higijene i veću prevalencu karijesa i drugih oralnih oboljenja. Cilj rada bio je da se proceni prevalenca karijesa, nivoa oralne higijene i prisustvo malokluzija kod dece sa posebnim potrebama, kao i vreme erupcije stalnih molara. Metode. Ispitivanjem oralnog zdravlja obuhvaćeno je 107 dece sa posebnim potrebama na Klinici za dečju i preventivnu stomatologiju Stomatološkog fakulteta u Beogradu. Kontrolnu grupu je činilo 104 zdrave školske dece. Rezultati. Deca sa posebnim potrebama imala su statistički značajno viši nivo indeksa karijesnih, ekstrahovanih i plombiranih zuba (KEP) u obe denticije, u odnosu na kontrolnu grupu (p lt 0.05). Nivo oralne higijene bio je lošiji kod dece sa posebnim potrebama. Takođe, primećeno je statistički značajno povećanje malokluzija klase II, kao i kasnije vreme erupcije stalnih molara kod dece sa posebnim potrebama u odnosu na kontrolnu grupu. Zaključak. Zbog lošijeg stanja oralnog zdravlja i povećane verovatnoće razvoja malokluzija i odloženog nicanja zuba, neophodno je formirati preventivne stomatološke programe za decu sa posebnim potrebama, kao i poboljšati informisanost javnosti o ovom problemu

Mineral trioksid-agregat kao materijal izbora u endodonciji

Mineral trioxide aggregate (MTA) is a material with broad indications in endodontics. Currently, this material is used for pulp capping, pulpotomy, as apical barrier in teeth with necrotic pulp and open apex, and in the treatment of various root canal perforations. By comparing the biological response of pulp tissue capped with calcium hydroxide and MTA, the superiority of MTA has been indicated. The bridge of hard tissue formed under MTA prevented the irritation of pulp. Histological studies of pulpotomy in dog teeth have shown after 120 days a hard tissue without necrosis formed under MTA. MTA is also the material of choice for retrograde root canal obturation and lateral perforation. Meta analysis of published papers on MTA in recent years indicated the great clinical success of this material which ensured a good canal seal and superior biocompatibility. It is the only material for retrograde root canal obturation that encourages tissue regeneration. Studies have also shown that MTA has inductive and conductive properties for hard tissue as well as the ability to release ions in a liquid medium. The main disadvantage of MTA is related to its color, the presence of iron and mangan ions, the difficulties in maintaining the characteristics of material during time, absence of solvent for this material and the difficulty for its removal after crosslinking.Mineral trioksid-agregat (MTA) je materijal koji ima široke indikacije u endodonciji. Danas se koristi kod prekrivanja vitalne pulpe i pulpotomije, kao apeksna barijera kod zuba s nekrotičnom pulpom i otvorenim apeksom korena, odnosno u lečenju različitih perforacija kanala korena. Poređenja biološkog odgovora tkiva pulpe prekrivene kalcijum-hidroksidom i MTA ukazuju na superiornost MTA, jer se formira most tvrdog tkiva koji sprečava iritaciju pulpe. Histološke studije pulpotomija na zubima pasa pokazaLe su da se ispod MTA stvara tvrdo koštano tkivo bez nekroze posle 120 dana. MTA je takođe materijal izbora za retrogradno punjenje kanala korena, odnosno za terapiju lateralnih perforacija. Metaanaliza publikovanih radova o MTA poslednjih godina ukazuje na veliki klinički uspeh ovog materijala, koji obezbeđuje dobro zaptivanje, pokazuje superiornu biokompatibilnost i jedini je materijal za retrogradno punjenje kanala korena zuba koji pospešuje regeneraciju tkiva. Istraživanja takođe pokazuju da MTA ima induktivna i konduktivna svojstva za formiranje tvrdog tkiva, kao i osobinu otpuštanja različitih jona kada se nalazi u tečnoj sredini. Glavni nedostatak MTA je u vezi sa bojom zbog prisustva gvožđa i mangana, sa teškoćama održavanja osobina materijala tokom vremena, sa izostankom rastvarača za ovaj materijal i sa teškoćama njegovog uklanjanja posle umrežavanja

Density of the ZnTiO3 nanopowder as a loose powder and as a compact obtained by different methods

Nanopowder density, as well as compact density, is due to powder particle size, different in their values, compared to micron powders. Also, the technique used for density determination induces large mutual value discrepancies. Scanning electron micrographs of as received powder are presented as an illustration of the shape and size of powder particles and agglomerates. The density of the loose powder pretreated differently was determined using mercury porosimetry and He pycnometry. The methods used for determining the apparent density of the compacts were pycnometry with water as the wetting liquid, mercury porosimetry and also a new approach using a combination of mercury pycnometry along with nitrogen adsorption. Bulk densities of compacts were determined by dimension measurement and mercury pycnometry. Conclusions about nanopowder usage as a charge for dry compaction as well as the most appropriate way for the determination of compact and powder densities are shown

Influence of promoter polymorphisms of the TNF-α (-308G/A) and IL-6 (-174G/C) genes on therapeutic response to etanercept in rheumatoid arthritis

Uvod: Genetički faktori su značajni za predviđanje ishoda lečenja bolesnika sa reumatoidnim artritisom (RA). Cilj studije bio je da se ispita uticaj-308G/A TNF-α (rs 1800629) i -174G/C IL-6 (rs1800795) promotorskih polimorfizama na terapijski odgovor na etanercept. Metode: U studiju su bila uključena 73 pacijenta sa aktivnim RA. Terapijski odgovor je procenjivan posle 6 i 12 meseci terapije po kriterijumima Evropske lige protiv reumatizma. Genotipizacija pacijenata za polimorfizme -308G/A TNF-α i -174G/C IL-6 urađena je PCR-RFLP metodom i procenjivan je uticaj genotipova na odgovor na etanercept. Rezultati: Nije bilo razlike u procentu respondera (pacijenti kod kojih se DAS28 popravio gt 1,2) između pacijenata sa TNF-α -308GG, GA i AA genotipom ni posle 6 ni posle 12 meseci tretmana. Posle 12 meseci lečenja procenat respondera je bio značajno veći kod pacijenata sa IL-6 -174GG u odnosu na pacijente sa GC ili CC genotipom (p= 0,006, x2 test). Poređenje pacijenata prema kombinovanim IL-6/TNF-α genotipovima pokazalo je da je IL-6 -174GG / TNF-α -308GG genotip učestaliji kod respondera u odnosu na druge kombinovane genotipove (p= 0.022, x2 test). Tačnije, svi pacijenti sa kombinovanim IL-6 -174GG / TNF-α -308GG genotipom bili su responderi posle 12 meseci terapije etanerceptom. Zaključak: Studija pokazuje da bolesnici sa genotipovima koji se povezuju sa manjom produkcijom TNF-α i IL-6 najbolje odgovaraju na terapiju etanerceptom.Background: The study was undertaken to assess the influence of functional -308G /A TNF-α (rs 1800629) and -174G/C IL-6 (rs1800795) promoter polymorphisms on the therapeutic response to etanercept, a TNF-α blocker, in patients with rheumatoid arthritis (RA). Methods: Seventy-three patients suffering from active RA were studied, at baseline and 6 and 12 months after therapy. The therapeutic response was estimated according to the European League Against Rheumatism response criteria. Patients were genotyped for -308G /A TNF-α and -174G/C IL-6 polymorphisms by the PCR-RFLP method, and the influence of genotype on etanercept response was assessed. Results: No difference in the percentage of responders (patients who had DAS28 improvement gt 1.2) between patients with the TNF-α -308GG and GA and AA genotype was detected after 6 and 12 months of treatment. After 12 months of treatment the percentage of responders was significantly increased in patients with the IL-6 -174GG genotype compared with those with the GC or CC genotype (p=0.006 by Chi-square test). Evaluation of the patients according to their combined IL-6/TNF-α genotypes showed that patients with the IL-6 -174GG / TNF-α -308GG genotype were more frequent among the responders compared to those with other combined genotypes (p=0.022 by Chisquare test). More precisely, all patients with the combined IL-6 -174GG / TNF-α -308GG genotype were responders after 12 months of etanercept treatment. Conclusions: The study suggests that patients who are genetically low TNF-α and IL-6 producers are the best responders to etanercept therapy

Influence of Promoter Polymorphisms of the Tnf-α (-308g/A) and IL-6 (-174g/C) Genes on Therapeutic Response to Etanercept in Rheumatoid Arthritis

Background: The study was undertaken to assess the influence of functional -308G/A TNF-alpha (rs 1800629) and -174G/C IL-6 (rs1800795) promoter polymorphisms on the therapeutic response to etanercept, a TNF-alpha. blocker, in patients with rheumatoid arthritis (RA). Methods: Seventy-three patients suffering from active RA were studied, at baseline and 6 and 12 months after therapy. The therapeutic response was estimated according to the European League Against Rheumatism response criteria. Patients were genotyped for -308G/A TNF-alpha and -174G/C IL-6 polymorphisms by the PCR-RFLP method, and the influence of genotype on etanercept response was assessed. Results: No difference in the percentage of responders (patients who had DAS28 improvement > 1.2) between patients with the TNF-alpha -308GG and GA and AA genotype was detected after 6 and 12 months of treatment. After 12 months of treatment the percentage of responders was significantly increased in patients with the IL-6 -174GG genotype compared with those with the GC or CC genotype (p=0.006 by Chi-square test). Evaluation of the patients according to their combined IL-6/INF-alpha genotypes showed that patients with the IL-6 -174GG / TNF-alpha -308GG genotype were more frequent among the responders compared to those with other combined genotypes (p=0.022 by Chi-square test). More precisely, all patients with the combined IL-6 -174GG / TNF-alpha -308GG genotype were responders after 12 months of etanercept treatment. Conclusions: The study suggests that patients who are genetically low TNF-alpha and IL-6 producers are the best responders to etanercept therapy