Prosthodontics Status and Treatment Needs among the Elderly in the Republic of Macedonia

BACKGROUND: Oral health care management among the elderly differs from the rest of the population, due to some specific physiological changes and general health status related to age. We know very little about the oral health in elderly in the Republic of Macedonia, because there are only a few articles published about dental health status and edentulism of this population.AIM: The study aimed to evaluate the prosthodontic status of older adults over 65 years in the Republic of Macedonia, about their socio-economic status and individual factors.MATERIAL AND METHODS: A cross-sectional study was conducted in 8 regions, in rural and urban areas of Macedonia and a representative sample of 432 people (age > 65 years) was examined. Statistical analyses of the data were made by chi-square tests and the corresponding C-coefficient.RESULTS: Only 6% of all participants had not any prosthetic appliance, 9.5% had more than one bridge, 28.7% of examinees had partial dentures, both bridge(s) and partial denture(s) had 10.7% participants, and 45.1% of examinees were toothless. There was a significant difference between patients who visited the dentist more than once a year and those who did not (c2 = 14.2; df = 4, p < 0.01). From all of the participants, 40.3% used public dental care organisations.CONCLUSIONS: We found a high prevalence of edentulousness among older adults over 65 years in Macedonia. The study confirmed the necessity for establishing healthcare educational programs for the dental treatment of elderly in Macedonia

Спектрофотометриска проценка на разликите во бојата кај максиларните централни инцизиви кај пациенти од различен пол

Цел Да ги одредиме разликите во бојата на забите помеѓу мажите и жените со спектрофотометриско мерење на бојата на централните максиларни инцизиви, како и влијанието на полот врз дистрибуцијата на бојата според три различни клучеви за избор на боја. Материјал и метод Бојата ја измеривме кај 250 пациенти на возраст од 18-69 години од кои 135 жени, a 115 мажи со спектрофотометар со оптичка геометрија 45/0° ShаdePilotТМ (Degu Dent, Germany). Поради критериумите за селекција од целокупниот број анализиравме 235 снимки. За да ја одредиме дистрибуцијата на бојата на забите ја избиравме најблиската нијанса измерена во средната третина на коронката според три различни клучеви Vita Classical, Ivoclar Chromascop, Vita 3D Master. Параметрите на бојата беа анализирани според CIE Lab системот. Статистичката обработка на податоците ја направивме со тестовите Pearson Chi-square и ANOVA/MANOVA Factorial Anova (F). Резултати Дистрибуцијата на нијансите помеѓу мажите и жените статистички значително се разликуваше кај трите клучеви. За Vita Classical p<0,01 (p=0,005), кај Ivoclar Chromascop p<0,001 (p=0,000) и Vita 3D Master p<0,001(p=0,000). Постои значајна разлика во светлоста на бојата L *(F=18,2 и p<0,001(p=0,000)). Жените имаат повисоки вредности за L* и тоа за 1,4 Delta L единици. Параметарот b* значајно се разликува помеѓу половите (F=37,79 p<0,001 (p=0,000)), мажите имаат значително повисоки вредности и тоа за 1,8 Delta b*единици. Заклучок Полот е значаен фактор кој треба да се земе во предвид при изборот на бојата на забите. Мажите имаат пожолти и потемни заби од жените според L*ab системот. Клучни зборови: нијанси на забите, клучеви за избор на боја, инструментално мерење на бојата

Implant-prosthetic therapy failure in smoker and nonsmoker patients

Introduction: Implant-prosthetic therapy has predictable success, and the complications are associated with a lot of factors. Smoking cigarettes is reason for different oral diseases, bone loss, loss of soft tissue and teeth, appearance of periimplantitis and implant loss. The corellation of smoking and implant-prosthetic therapy failure was examined in the clinical study. Materials and method: Fifty patients with FDP on 61 implants in frontal and molar region were investigated. They were divided in two groups: smokers and nonsmokers. Thirty four patients were smokers, and sixteen didn’t smoke cigarettes in the last two years. Criteria data for the success of the therapy were mobility of the implant, pain, peri-implant bone loss higher than 1.5 mm, absence of technical complications and function and aesthetics appeal. Control checkups were made after six months, one and two years. Patients had questionnaires, clinical examination and X-ray. Results: There is a statistically significant difference between smokers and nonsmokers in the failure rates of dental implants. During first year 0,5 mm of bone was lost around eleven implants, and 0,05 mm next years.Total seven implants failed, five in smoker group at the beginning of the first year, and 2 in nonsmoker group during second year. Conclusion: Results showed that smoking habit can increase the risk of early implants loss two times more often in smokers. For some complications like periimplantitis, local factors have greater influence. Smoking does not increase the risk of late implant loss, but the implants at patients with smoking habit, in correlation with several different local risk factors, is contraindicated. Early complications are results of smoking, while quality and quantity of surrounding bone are responsible for late complications.The results from the investigation, also give informations for proper treatment planning, and patient education for quiting their harmfull habit. Keywords Implants, therapy failure, smoking, periimplantitis

Fracture Localisation of Porcelain Veneers with Different Preparation Designs

BACKGROUND: Porcelain veneers are permanent restorations that combine good aesthetic with functionality by minimal destructive techniques. AIM: This study aimed to investigate the influence of the preparation designs on the fracture localisation. MATERIAL AND METHODS: Three preparation designs of porcelain veneers fabricated by a method of laying on a fireproof abutment on maxillary central incisor were examined in this in vitro study-feather preparation, bevel preparation and incisal overlap – palatal chamfer. The samples from all three groups were loaded into a universal test machine-TRITECH WF 10056 until damage occurred on the porcelain veneer. Fracture localisation was classified as an incisal, gingival or combination. Data were analysed with statistical programs: STATISTICA 7.1; SPSS 17.0. RESULTS: In feather preparation, as a consequence of the mechanical force, the most common is the incisal localisation (66.7%), followed by the combined (33.3%), while the gingival fracture localisation is not registered. In bevel preparation, the most common fracture localisation is combined (53.6%), followed by incisal (35.7%) and subsequent gingival localisation (10.7%). In incisal overlap (palatal chamfer), combined and gingival localisation of the fracture is equally recorded in 14.3% of the samples, while the incisal is the most common localisation and is registered in 72.4%. CONCLUSION: During the study, a statistically significant dependence was found between the localisation of the occurred changes (incisal, gingival and combination) and the three different types of preparation

Contemporary Dental Ceramic Materials, A Review: Chemical Composition, Physical and Mechanical Properties, Indications for Use

BACKGROUND: The high esthetic expectations from the prosthodontic restorations have directed the qualitative development of the materials towards the all-ceramic materials that are capable of replacing porcelain-fused-to-metal systems. AIM: This article reviews the literature covering the contemporary all-ceramic materials and systems with a focus on the chemical composition and materials’ properties; also it provides clinical recommendations for their use. RESULTS: The glass-matrix ceramics and polycrystalline ceramics are presented, as well as recently introduced machinable materials, all-zirconia and resin-matrix ceramics. The specific properties of zirconia, such as transformation toughening, stabilisation of the crystallographic structure, low-temperature degradation and factors affecting the zirconia’s ageing, are emphasised. CONCLUSION: The favourable properties of the resin-matrix ceramics, such as modulus of elasticity similar to dentin, shock-absorbing characteristics and high resilience and fracture resistance, are also covered in this article

Acid Etching as Surface Treatment Method for Luting of Glass-Ceramic Restorations, part 1: Acids, Application Protocol and Etching Effectiveness

AIM: The purpose of this review is to represent acids that can be used as surface etchant before adhesive luting of ceramic restorations, placement of orthodontic brackets or repair of chipped porcelain restorations. Chemical reactions, application protocol, and etching effect are presented as well.STUDY SELECTION: Available scientific articles published in PubMed and Scopus literature databases, scientific reports and manufacturers' instructions and product information from internet websites, written in English, using following search terms: “acid etching, ceramic surface treatment, hydrofluoric acid, acidulated phosphate fluoride, ammonium hydrogen bifluorideâ€, have been reviewed.RESULTS: There are several acids with fluoride ion in their composition that can be used as ceramic surface etchants. The etching effect depends on the acid type and its concentration, etching time, as well as ceramic type. The most effective etching pattern is achieved when using hydrofluoric acid; the numerous micropores and channels of different sizes, honeycomb-like appearance, extruded crystals or scattered irregular ceramic particles, depending on the ceramic type, have been detected on the etched surfaces.CONCLUSION: Acid etching of the bonding surface of glass - ceramic restorations is considered as the most effective treatment method that provides a reliable bond with composite cement. Selective removing of the glassy matrix of silicate ceramics results in a micromorphological three-dimensional porous surface that allows micromechanical interlocking of the luting composite

Вклучување на студентите во процесот на учење: работни групи и студиски тимови

Вовед: Студентите најдобро учат кога се активно вклучени во процесот на учење. Сознанијата укажуваат дека, без разлика за кој наставен предметот се работи,соработката на студентите во мали групи има тенденција да научат повеќе од она што се учи и го задржуваат истото повеќе отколку кога истата содржина е претставена во други наставни форми. Постојат три општи типови на работа во групи: неформални групи за учење, формални групи за учење и студиски тимови. Цел: Цел на трудот е да се покаже ефектот од имплементацијата на процесот на учење кај неколку различни групи и тимови на студенти. Материјал, метод и резултати: Во истражувањето беа вклучени 190 студентите од прва, втора и трета година на студиските програми по Стоматологија (130 студенти), како и студентите од Стручните студии за забен техничар – протетичар (60 студенти) на Факултетот за медицински науки во Штип. Беа применети три вида на учење: неформалното учење во групи - ad hoc времени групи на студентите во рамките на една сесија; формалното учење во групи - тимови формирани со цел да се заврши одредена задача (вообичаено, студентите работат заедно додека проектната задача е завршена и оценета) и студиските тимови - долгорочни групи, обично постоечките во текот на еден семестар. Резултатите укажуваат дека колку е поголема класата и предметот е посложен, толку се поголеми вредностите на студиските тимови. Кај овие тимови и групи најдобри резултати беа постигнати преку поддршка со компјутерска обработка на колаборативно учење (CSCL) кое се нарекува Е-учење 2.0. Заклучок: Концептот на соработка na групи за учење при наставните методи се наменети за поттикнување на студентите да работат заедно. Потребно е да се прави разлика помеѓу колаборативно учење од моделот на традиционалниот "директен пренос", во која се смета дека професорот треба да биде дистрибутер на знаења и вештини. Клучни зборови: вклучување, учење, подучување, настава Introduction: Students learn best when they are actively involved in the learning process. Researchers report that, regardless of the subject matter, students working in small groups tend to learn more of what is taught and retain it longer than when the same content is presented in other instructional formats. Тhere are three general types of group work: informal learning groups, formal learning groups, and study teams. Aim: The aim of this study was to show the implementation effect of teaching process in different students groups and study group. Material, methods and results: Тhe investigation included 190 students of the first, second and third study year of the Study program of General Stomatology (130 students), as well as dental technicians students – prosthetic (130 students) of the Faculty of Medical sciences – Stip. There were used three type of learning: Informal learning groups - ad hoc temporary groups of students within a single class session; Formal learning groups - teams established to complete a specific task (usually, students work together until the task is finished and graded); Study teams are long-term groups (usually existing over the course of a semester). The results shows that as the larger was the class and the more complex the subject matter, the more valuable study teams can be. The best results were achieved with support of Computer-Supported Collaborative Learning which is named E-learning 2.0. Conclusion: Concept of cooperation of learning groups in the teaching methods are designed to encourage the students to work together. It is necessary to distinguish between collaborative learning model of the traditional "direct transmission", which considers that the professor should be a distributor of knowledge and skills. Keywords: inclusion, learning, teaching, education

Non-surgical endodontic treatment of periapical lesions 3 years retrospectiv study

Objective: The aim of this three years retrospective study were to present our experience with Nd: Yag laser in the therapy of chronically periapical lesions. Study design: On 56 teeth with X-ray we determined periapical radiolucency and most of them had acute symptoms characteristic for the exacerbation stadium. The teeth were opened, the contents of the canals were removed and we achieved drainage in the first session. In the second step we prepared endodontic treatment, crown-down technique for root canal instrumentation and NaOCl irrigation after each file change. The root canals were dried with paper points. The optic fiber, from the pulsed Nd YAG laser was set in each canal and laser radiation with circular slow motions from the apex to the crown was applied 3 times, each period of 5 seconds. After the treatment the root canals were obturated temporally or permanent with AH plus and gutta-percha. We made control radiograms in different periods of time after the therapy. Results: Out of the 56 tested cases, in 3 patients, after the first laser treatment, subjective symptoms were found and the patients were submitted for surgical treatment. Seventeen root canals after the sterilization with Nd: Yag laser were obturated temporally with Ca(OH)2 paste. In two cases after first laser therapy the canal system was filled with secretion and a dry working field has been achieved after 2 or 3 minutes, and then we apply a canal filling medicament. Conclusions: Nd YAG laser is efficient in the therapy of the chronically infected root canals and the periapical lesions. Тhe endodontic treatment is shorter and laser therapy calms the subjective symptoms and the clinical manifestations

The significance of training and education in accurate evaluation of natural tooth color

Color is undoubtedly one of the parameters with the highest weight when it comes to assessing the quality of restoration by the patient, especially in the anterior zone of the oral cavity. By precisely matching the restoration color with the remaining teeth, the possibility of inconvenience such as a correction or re-making of the same restoration is minimized. Since determining tooth color in everyday practice is done visually by using specially made color selection shade guides, unawareness of the correct method and the conditions under which it should be administered may increase the failure of the therapy. The aim of our research was to determine whether education and training in determining tooth color influence the choice of precise and correct shade. The study included a total of (N = 90)dental medicine students who were first tested with the Ishihara color vision test and Farnsworth-Munsell 100 HueColor Vision test to exclude the possibility of an error due to the presence of a color vision anomaly of the eye. We have formed two groups with an equal number of respondents, work and control group. Both groups were tested twice with a special color coding program ToothGuideTrainer WEB-final exam, which uses VITA Linearguide 3D-MASTER® shade guide. During the testing, the working group went through education, in the form of lectures, exercises and training tests for determining the color. The control group did not attend the training. The results from both tests were electronically counted. Mean value and standard deviation were determined. Differences between the work and control group were analyzed with t-test. The workgroup showed statistically significant higher points after education and training than the control group. The points earned before training did not differ significantly between the two groups. The education and training for shade matching in dentistry significantly affect the success of selecting the perfect color for future restoration. It is necessary to include more intensive training in determining color within the program of dental medicine studies. The conditions in which the tooth color matching is performed should be strictly controlled

Oral hygiene in patients with fixed prosthodontic restorations

The aim of this study was to estimate the oral hygiene and gingival condition in patients with fixed prosthodontic restorations for a period of 3 months along with the oral hygiene instructions. The study included 60 patients with fixed prosthetic appliances. Medical examinations of dental condition were carried out using basic diagnostic tools like dental mirror and periodontal probe. As well, we examine how factors, such as: age, gender, type of fixed dental prosthesis (single crown or fixed partial denture) and material (metal or porcelain fused to metal) are statistically associated with oral hygiene and gingival condition. Plaque and Gingiva index was taken according to the method of Silness and Löe. The examination was accomplished on the first dental visit, after 14 days and three months appropriately with the oral hygiene instructions. Statistical analysis was performed by using paired sample t-test from Statistical software SPSS for Windows version 23. A p-value <0.05 was considered as statistically significant. Our results confirmed that the Plaque and Gingiva index had higher values in the first visit than that found in the other periods. Patients with crowns had better oral hygiene levels compared to fixed dental prosthesis wearers. No statistical differences were found for type of material. Also, younger patients showed better hygiene levels than the older ones. Our research showed that adequate education and instructions for oral hygiene maintenance lead to improved oral hygiene both in patients with single crown or fixed dental prosthesis