Odontogena bol

Pain has the function of a warning to tissue damage and activation of defensive mechanisms, with the aim of prevention of further damage. The stimulus which damages or threatens to damage a tissue activates the nociceptors which in turn carry the information by a system of neurons to cortex, where it is processed and recognized as pain. Most somatosensory information from the area of orofacial system is transported via n. trigeminus. In order to remove pain, it is necessary to recognize and properly diagnose the caus of pain. This is not always easy, due to numerous variations within the clinical findings, and the latent possibility that pain has referred from odontogenis structure onto the nonodontogenis ones, and vice versa. Knowing the pathways and mechanisms of pain, possible causes and different characters of orofacial pain, as well as a thorough anamnesis, clinical examination and testing will eventually lead to a proper diagnosis. An odontogenic source of pain is well defined and has an apparent cause, and therefore the provocation tests lead to the symptoms contained in the anamnesis. Any deviation from standard clinical status should be taken with caution. Once odontogenic cause of pain has been excluded, other potential causes of orofacial pain should be taken into consideration, in order to establish a valid diagnosis.Bol ima funkciju upozoravanja na oštećenje tkiva te funkciju aktivacije obrambenih refleksa radi prevencije daljnjeg oštećenja. Podražaj koji oštećuje tkivo ili prijeti oštećenjem tkiva aktivira nociceptore koji prenose informaciju sustavom neurona do kore velikog mozga, gdje se obrađuje i interpretira kao bol. Većinu somatosenzornih informacija iz područja orofacijalnog sustava prenosi n. trigeminus. Da bismo uklonili bol, potrebno je prepoznati i dijagnosticirati uzrok boli. To nije uvijek jednostavno zbog mnogih varijacija kliničke slike te mogućnosti boli da se referira iz odontogenih struktura u neodontogene i obratno. Poznavanje puta i mehanizma boli te mogućih uzroka i karaktera orofacijalne boli, odnosno detaljna anamneza, klinički pregled i testiranja, dovest će do prave dijagnoze. Odontogeni izvor boli obično ima tipičan karakter, evidentan uzrok, te se provokacijskim testovima dobivaju simptomi navedeni u anamnezi. Svakom odstupanju od klasične slike treba pristupiti s oprezom. Isključivanjem odontogenog uzroka boli treba ispitati ostale potencijalne uzroke orofacijalne boli kako bi se postavila pouzdana dijagnoza

Biocompatibility of Dental Adhesives

The accomplishment of developing a truly adhesive bond between a restorative material and the natural tooth structures is the goal of adhesive dentistry. Dentine adhesive systems come into close contact with dental and oral tissue, especially the pulp and gingival cells. Due to this close and long-term contact, adhesives should exhibit a high degree of biocompatibility. Biocompatibility is one of the most important properties of dental materials, and adhesives are no exception. It has been long demonstrated that different components of adhesives can be released. Numerous in vitro investigations have shown that released monomers and other components can cause damage to cultured cells. In addition, many in vivo studies have shown that uncured components which reach the pulpal space cause inflammatory response and tissue disorganization. Only a combination of various in vitro and in vivo tests can provide an overview of the interaction of biomaterials with the host. Therefore, it is necessary on a regular basis to carry out and re-verify the biological compatibility of the increasing number of new dental materials. Adhesives should be biofunctional, protective, and preventive, with health-promoting effects that contribute to a better prognosis for restorative treatments and its biocompatibility

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

Attitude towards Oral Health at Various Colleges of the University of Zagreb: A Pilot Study

Svrha rada: Željeli smo procijeniti razlike u stajalištima o oralnom zdravlju, pa smo zato promatrali tri različite grupe studenata Sveučilišta u Zagrebu: studente Stomatološkog fakulteta, studente društvenih znanosti i studente tehničkih znanosti. Ispitanici i postupci: U istraživanju je sudjelovalo 58 ispitanika u dobi od 20 do 28 godina i svi su bili studenti Sveučilišta u Zagrebu. Odgovorili su na tri pitanja: koliko često peru zube, koliko često idu stomatologu i koliko ima je važno oralno zdravlje. Nakon toga je svima uzet status te iz njega izračunat KEP-indeks, a dobili su i indikator plaka Mira-2-Ton® (Hager Werken, Dursburg, Njemačka) koji su otopili u ustima. Nakon toga izračunat im je indeks plaka. Za statističku analizu korišten je test ANOVA. Rezultati: Studenti stomatologije imali su manje plaka od kolega s društvenih i tehničkih fakulteta, a razlika je bila statistički značajna (p = 0,0018; f = 7,14). Iako su studenti stomatologije imali i nešto niže vrijednosti KEP-indeksa, razlika nije bila statistički značajna. Da zube peru dva puta na dan, odgovorilo je 83 posto ispitanika, a jedino su studenti Stomatološkog fakulteta (njih 21 %) zaokružili odgovor više od tri puta dnevno. Iz odgovara na postavljena pitanja zaključeno je da je percepcija oralnoga zdravlja na visokoj razini, no percepcija oralnih bolesti znatno je lošija. Jasno je da na odgovore ispitanika uvelike djeluje čimbenik tzv. društvene prihvatljivosti odgovora. Zaključak: Na primjeru studenata stomatologije vidi se da se educiranjem o pravilnoj njezi i o važnosti oralne higijene mogu poboljšati navike.Purpose: The aim of this study was to compare the oral status of three various groups of students: students of the School of Dental Medicine, students of technical sciences and students of humanities. Material and methods: Research included 58 students of the University of Zagreb. They answered 3 questions: how often they brush their teeth, how often they visit their dentist and how important dental health is to them. After a standard dental check-up we calculated the DMFT index. They were given an indicator for plaque Mira-2-Ton® (Hager Werken, Duisburg, Germany) and we calculated the plaque index. For statistical analysis the ANOVA test was used. Results: Students of the School of Dental Medicine had a lower plaque index than other students and this was statistically significant (p=0.0018; f=7.14). They also had a lower DMFT index, but it was not statistically significant (p=0.1004; f=2.4). 83% of students said that they brushed their teeth 2-3 times a day. Only 17% of all students brush their teeth more than 3 times a day and they are all students of the School of Dental Medicine (21% of them). Perception of oral health is on a high level, but perception of oral disease is not. The social approval of the answer was also an important factor. Conclusion: Students of the School of Dental Medicine are an illustrative example of improving our habits due to education

The Effect of Liquid Absorption on Gas Barrier Properties of Triplex Film Coated with Silicon Oxide

Polymeric triplex film with SiOx deposit (polyethylene terephthalate/polyethylene terephthalate+ SiOx/polyethylene) was analysed for its gas permeance characteristics. For this purpose the permeance of triplex film to oxygen, nitrogen and carbon dioxide was analysed before and after the immersion into the test solutions (ethanol, acetic acid and distilled water). Gas permeance measurements were performed in temperature range from 20 to 60 °C. The permeability of the treated triplex film (181–241 cm3m–2 d–1 bar–1) showed negligible changes in comparison with the untreated ones (164–257 cm3 m–2 d–1 bar–1). Due to the existence of inflection point at 40 oC, the Arrhenius equation was applied in narrow temperature ranges (20–35 oC and 40–60 oC). The obtained activation energies for the permeance of gases were correlated with different physical characteristics of permeates

Procjena in vitro toksičnosti stakleno-ionomernih cemenata primjenom mikronukleus testa, alkalnog komet testa i komet testa modificiranog hOGG1 enzimom

The purpose of this study was to evaluate the genotoxic potential of components leached from two conventional self-curing glass-ionomer cements (Fuji IX and Ketac Molar), and light-curing, resin modified glass-ionomer cements (Vitrebond, Fuji II LC). Evaluation was performed on human lymphocytes using alkaline and hOGG1 modified comet, and micronucleus assays. Each material, polymerised and unpolymerised, was eluted in extracellular saline (1 cm2 mL-1) for 1 h, 1 day, and 5 days. Cultures were treated with eluates using final dilutions of 10-2, 10-3, and 10-4. Alkaline comet assay did not detect changes in DNA migration of treated cells regardless of the ionomer tested, polymerisation state, and elution duration. Glass ionomers failed to significantly influence micronucleus frequency. No oxidative DNA damage in treated lymphocytes was observed using hOGG1 modified comet assay. Obtained results indicate high biocompatibility of all tested materials used in the study under experimental conditions.Svrha istraživanja bila je procijeniti genotoksični potencijal komponenata koje izlučuju dva konvencionalna samopolimerizirajuća stakleno-ionomerna cementa (Fuji IX i Ketac Molar) te svjetlosno polimerizirajući i smolom modificirani stakleno-ionomerni cementi (Vitrebond, Fuji II LC). Istraživanje je provedeno na ljudskim limfocitima primjenom alkalnog komet testa, komet testa modificiranog hOGG1 enzimom te mikronukleus testa. Svaki materijal, polimerizirani i nepolimerizirani, eluiran je u fiziološkoj otopini (1 cm2 mL-1) tijekom jednog sata, jednog dana i tijekom 5 dana. Kulture limfocita tretirane su eluatima u razrjeđenjima 10-2, 10-3 i 10-4. Alkalnim komet testom nisu zabilježene promjene u migraciji DNA iz tretiranih stanica bez obzira na ispitani ionomer, vrstu polimerizacije i trajanje elucije. Izloženost staklenim ionomerima nije značajno utjecala na učestalost mikronukleusa. Primjenom hOGG1 modificiranog komet testa nije zamijećeno oksidativno oštećenje DNA u tretiranim limfocitima. Dobiveni rezultati upućuju na visoki stupanj biokompatibilnosti svih testiranih materijala koji su se koristili u eksperimentalnim uvjetima

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

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