Periodontal health in patients with orthodontic retainers

Different orthodontic appliances can cause periodontal inflammation. Fixed retainers, most commonly used orthodontic appliance to stabilize dental elements after orthodontic treatment can influence on the periodontal health, too. The main aim of this study was to make assessment periodontal tissue health status on lower incisors of patients with fixed mandibular retainers using objective periodontal indexes. Total numbers of 60 subjects, 30 male and 30 female patients with fixed mandibular retainers were included in this study. Before placing the retainer, an oral hygiene session and adequate periodontal treatment (if there was need) were performed on all patients. All the subjects were investigated after 3, 6 and 12 months. Plaque index by Silness & Loe; Gingival index (GI) by Loe & Silness, probing depth, clinical loss of attachment and the presence of gingival recession were assessed on the six inferior frontal teeth. Results showed that the mean score for the Plaque Index (PI), after three months was 1.04, after six months was 1.28 and after 12 months was 1.55. The mean Gingival Index (GI) after 12 months was 1.74 and after three months was 1.12. Periodontal sockets and presence of gingival recession were found in just one patient (1.66 % form all subjects) in all three examined periods. In our study was found a statistically significant difference for the Plaque Indexes (P> 0.05) in both groups, with higher scores among subjects having retainers for 12 months. These results are similar to those for the gingival index. From the results obtained in this study, it can be concluded that for a period from 3, 6 to 12 months, even there are effects of the orthodontic retainers on the periodontal health, they are minimal

Effect of mechanical and chemical preparation of Artificial and Acrylate prosthetic base

Introduction: Preparation of the basal area in acrylate artificial teeth is a very important factor in the quality of a dental prosthesis. It refers to the link between artificial teeth and acrylic denture base made of heat polymerized acrylic. The most common reason for failure of mobile prosthetic works is falling artificial teeth acrylate prosthetic base. The failure is due to the manner of connection between the base and artificial teeth. As the main factor which affects the level of retention is mechanical preparation of the basal area in acrylate teeth. Materials and Methods: For realization of the setted aim 10 acrylic models were analysed. The research was designed to show the justification for the mechanical and chemical preparation of the basal area in acrylate artificial teeth, then using a light microscope to measure the size of the crack between acrylic artificial teeth and acrylic denture base. The research described two different techniques, the first one with chemical preparation and the second one with mechanical and chemical preparation, which justify the best technique of preparation. Results: The results showed that there is no distance to the interspace occurs in models from the first and the second group. For the models of second group interspace between artificial teeth and acrylic base have bgger contact area, so there is better connection. Conclusion: Combination of mechanical and chemical preparation of artificial teeth significantly affect the degree of physical connection and also provides greater contact surface with acrylate prosthetic base. Keywords: arteficial teeth connection, heat polymerization, mechanical preparation, chemical preparation

Position of the mental foramen in correlation with the lower premolars: a panoramic radiographic study

Background: Evaluation of the position of foramen mentale has great significance and it is very important aids in endodontic, oral-surgical, periodontal interventions, as well as diagnostic procedures. Thus, in view of this, the present study was conducted among the population in North Macedonia, to determine the most common location of the mental foramen and to estimate difference in position of foramen mentale in correlation with the second lower premolar teeth. The mental foramen is an opening located on the external surface of the mandible in the region of the mandibular premolars. Radiographically the foramen mentale can be as an oval or round radiolucent zone in the inferior part of corpus mandible on lateral sides, on the left and right side. Panoramic radiographs are the most commonly used extra-oral radiographic aids in dentistry since they provide a rapid and wide picture of mandible and the maxilla in the same time. This technique allows the adequate localization of foramen mentale. The main aim of study is to evaluate the position of the mental foramen and its relationship with mandibular premolars among the population in Republic of North Macedonia Material and method: A total number of 250 panoramic radiographs were evaluated for the positioning of the mental foramen. When assessing the position of the mental foramen, its position is determined in relation with the mandibular premolars and the mandibular median line. All radiographic images in which can not be localized and confirmed the presence of the mental aperture was also excluded from the examination. The examination was performed on a negatoscope if it is classical panoramic x-ray or adequate software used for digital panoramic x-rays. If necessary, magnification was used for magnification of the images. The relationship of foramen mentale with the lower premolars was given according to the following classification: (1) if the position of foramen mentale is distally from the line that passes between the second premolar and the first molar in the lower jaw-first class; (2) if the position of foramen mentale is between the vertical central axis of the second premolar and the passing line between the second premolar and the first molar in the lower jaw- second class; (3) if the position of the foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw- third class; (4) if the position of foramen mentale is between the line that passes between the first and second premolars in the lower jaw and the vertical central axis of the first premolar-fourth class and if the position of foramen mentale is mesially from the vertical center axis of the first premolar- fifth class. Results: On the basis of the data from our research, it is noted that in near 60%, foramen mentale is positioned between the roots of the first and second lower premolars. The most common position for foramen mentale is the third class (which means that foramen mentale is between the vertical axis of the second premolar and the line passing between the first and second premolars in the lower jaw). Conclusion: In conclusion, the present results showed variations in position of foramen mentale. So it must be noted that local differences in foramen mentale position may occur in a population. This variability should alert the oral surgeons while performing oral surgical and periodontal interventions. If the studies related to variations in the position of foramen mentale are carried out in larger numbers, this data will be reliable for dental medicine clinicians, and with this type of information the possibility of complications will be minimized. Keywords: foramen mentale, mental foramen, Ortopantomogram, panoramic x-ra

Oral hygiene practices and tooth cleaning techniques

Theoretical part (45 min) The importance of oral hygiene Basic and additional ways for maintaining adeqauate oral hygiene types and selection of toothbrushes Oral hygiene techniques Meaning and maintenance of interdental hygiene • Practical part (1.5 hours) Presentation of the most common techniques for brushing teeth Presentation of techniques for removing dental plaque from the interdental spaces Motivations to maintain an adequate level of oral hygiene Use of metil-blue for coloring the surfaces of the teth that have dental plaque and using the techniques for its cleanin

Devitilizing agents in endodontics

Different types of pulpal inflammation mostly are presented as a sequel of dental caries. Most of the general dental practitioners find management of the inflamed pulp challenging in their routine dental practice. First step in the mortal endodontic methods of treatment is positioning of devitalizing medicament. The devitalizing agents can compose of formaldehyde, cresol, paraformaldehydeor some arsenic compounds. These agents can be harmful to the patients mostly because of their highly toxic, allergic, carcinogenic and mutagenic/genotoxic properties. Toxic devitalizing agents such as arsenic trioxide and paraformaldehyde were commonly used in the past to devitalize inflamed pulps when effective anesthesia could not be obtained . Among these two substances an important role played paraformaldehyde pastes. Paraformaldehyde agents can play role as disinfectants and can devitalize inflamed pulps when local anesthesia is ineffective. Despite the clinical benefits, paraformaldehyde can penetrate through dentine and is gradually released as formaldehyde. Formaldehyde released through dentine has a destructive effect on periodontal and bone tissues

Optimal aesthetic results for implant-prosthetic restorations in the aesthetic area: anatomical and surgical considerations

Aesthetic effect of prosthetic suprastructures is the most important aspect of oral rehabilitation. To ensure satisfactory aesthetic when performing implant treatment, different anatomical and surgical considerations should be taken into account. Aim: Taking into account the growing importance of aesthetics in modern society, the main goal of this research was set - to make an analysis of the relevant anatomical and surgical factors that affect the aesthetics of implant superstructures. Material and method: Adequate literature research was performed to fulfill the main goal. Sources of information used in this study were obtained from the most used of all scientific databases- Pub Med. All of the used literature data was previously published in peer- reviewed publications and journals. Results: Numerous anatomical factors have been identified as influencing on the satisfactory aesthetics of definitive work such as: gingival aspects and positioning, periodontal biotype, position of the lower lips and interocclusal space. The second group of factors is connected to the surgical interventions such as: regeneration ability of soft tissues and alveolar bone, placing the implants in the proper position and flaph aproach. Prosthetic rehabilitation depends also from the morphology and correlation of superstructures, the correlation of prosthetic devices with the surrounding soft tissues and proper planning of prosthetic devices. Adequate handling of soft and bone tissues during implant therapyis of great importance. At the end of the surgical procedure, all the bony parts of the alveoli that protrude should be removed or covered with mucous membrane, which should then be sutured. Also traumatized and thermally unprotected bone should be removed. Conclusion: In conclusion we can note that the establishment of proper aesthetics of superstructures depends on the knowledge of anatomical and surgical aspects

TMD disorders among dental students

Temporomandibular Disorders (TMD) are a complex and poorly understood set of conditions characterized by pain in the temporomandibular joint and surrounding tissues and limitation in jaw movements. Objective: The aims of this study were to assess the incidence of temporomandibular joint (TMJ) pain and dysfunction among the dental students It consisted of a cross-sectional study at Goce Delcev University. Material and Methods. The study population comprised 54 dental students, from the last three years of studying. The main criterion in selection of the surveyed population was the consent of the students to participate in the research. The clinical examination involved TMJ mobility, TMJ pain, TMJ sounds, morphological and functional dental occlusion. Results: According to the criteria of TMD, the prevalence of TMD among the study participants was 9.8 %, with no statistically significant difference betweenthe two genders. Most of the subjects complains on TMJ sounds (10, 6%) and clinically registered TMJ pain (7.4%). According to the self-reported complaining 7.2% of the subjects responded positively. Only 9 ,4% from the subjects with some orthodontic anomalies showed TMD signs or symptoms Conclusion: The prevalence of TMD among dental students is high (near to ten percent), and it is simmular for girls and boys. Dental occlusion was not rejected as a possible concurrent factor in relation to TMJ pain and/or dysfunction among university students. Keywords dental students, prevalence, temporomandibular disorders, TMD, TMD pai

Dental Prosthetic Status and Prosthetic Needs of Institutionalized Elderly Population in Long-Term Residence in Skopje, Republic of N. Macedonia

Aim: Taking into consideration the poor oral health among the institutionalized elderly people the aim of this study was established: to determine the prosthetic status of the institutionalized elderly in the department "Mother Teresa", nursing home for long-term care in Skopje, Republic of Macedonia. Materials and Methods: Total number of 73 patients older than 65 years were examined. Research was conducted in the period from April to July 2018. Throughout the dental history we were noting whether the examined subjects wear prosthetic devices and whether they have problems with them. Also, the examinees were asked what are their dominant dental treatment needs. A thorough examination determined the presence and need of prosthetic appliances. Oral hygiene assessment of the prosthetic devices was done. Results: The study revealed that less than half of the participants wear prosthetic devices (exactly 42.7%). A large percentage from the participants who have prosthetic devices (64.5%) were complaining of difficulties associated with wearing dentures. Most of the examined elderly participants (53.23%) need various prosthetic treatments Total anodontia was registered in 47.95% of the surveyed elderly. Conclusion: The need for dental interventions is high, because the use of prostheses is quite low. Numerous problems associated with the use of prosthetic devices were noted. High prevalence of bimaxillary total anodontia and absence of prosthetic devices despite their unavoidable need is characteristic of institutionalized elderly. Also, unsatisfactory hygiene of prosthetic devices was noticed in our study. Keywords: Dental Prosthetic Status; Prosthetic Need; Geriatric Dentistry; Edentulous; Gerodontolog

Periodontology and dental implantology- “two-way street”

The relationship between periodontology and dental implantology is too close. Starting from the fact that the knowledge of periodontology is essential in the process of implant treatment, the main goal of this research was set- to present how periodontology is so important and necessary for successful dental implant therapy. Materials and method: Adequate literature research was performed to fulfill the main goal. All of the used literature data was from peer-reviewed publications and journals. Most of the articles have been published in English in the period from 2001 to 2021. Results: After the successful osseointegration of dental implants, the health of the peri-implant tissues and long-term success of dental implants are dependent from the ability of the soft-tissue interface of the suprastructure to protect against repeated attacks from the bacteria. It is important for clinicians to understand that there are both similarities and differences between the soft-tissue attachment of natural teeth and dental implants. Adequate zone of attached keratinized peri-implant gingiva, is essential for maintenance of periimplant health, prevention of gingival recession, establishment of stable levels of the connective tissue and alveolar bone attachments, and finely is most important for the aesthetic. Conclussion:One of the most important factor for the longevity of dental implants is adequate periodontal health. Therefore, every clinician who works with dental implants, need to know that primarily activity before placement of dental implant is to eliminate any disease in the periodontium

Side effects associated with chlorhexidine mouthwashes use

Introduction Chlorhexidine, a broad-spectrum antimicrobial cationic bisbiguanide, is used as topical antiseptic for the treatment of inflammatory dental conditions, especially gingivitis. It is approved by the American Dental Association as an antibacterial and anti-inflammatory agent and is one of the most effective antimicrobial agents for reducing the amount of dental plaque and periopathogenic microorganisms over a long period of time. Also, chlorhexidine use shows positive effects after periodontal surgery, participating in healing. However, its efficacy in cases where periodontal disease is present has not yet been established (Lim and Kam, 2008). Chlorhexidine-containing products are present on the market in the Republic of North Macedonia mostly in the form of mouthwashes or as a gels for intraoral use. All mouthwashes present on the market in our country contain 0.12% chlorhexidine and 11.6% alcohol with a pH of 5.5. Numerous side effects caused by chlorhexidine use have been reported in the literature. The most common side effects include: tooth color modification, reversible desquamation of the oral epithelium, alteration of the sense of taste and increased deposits, especially in the subgingival region (Balagopal and Arjunkumar, 2013; Flotra et al., 1971). Based on the aforementioned facts regarding the possibility of side effects when using chlorhexidine, the main goal of this research was to assess the most common complications when using chlorhexidine mouthwashes in everyday dental clinical practice in Republic of North Macedonia. Materials and methods An online survey among dentists was conducted to assess the prevalence of various complications that occur with chlorhexidine use. A total number of 41 dentists, employed in public and private dental health organizations or offices, participated in this study. The survey consisted of three questions: (1) whether dentists recommend the use of chlorhexidine as an adjunct to the basic activity for oral hygiene maintain among their patients; (2) what are the most common complications encountered in patients using chlorhexidine-containing mouthwashes, and (3) whether these complications are related to the duration of use of chlorhexidine-containing mouthwashes. Adequate instructions necessary to fulfill the questionnaire were given to all participants of this study. The questions were simple and respondents were given freedom to write answers that are in correlation to their knowledge and attitude. The collected data was statistic analyzed using SPSS (Statistical Package for Social Sciences) version 17.0. Descriptive statistics was drawn with respective percentages to have a comparative overview. Results and discussion Based on the obtained results, it can be noticed that most of the dentists participating in the study, or more precisely 87.8% recommend mouthwashes to their patients. The most common reason for recommendation of such type of mouthwashes are mouth odor-fetor ex ore (70.7%) and gingival or periodontal diseases (80.5%). Other reasons, in a significantly lower percentage, include the inability to maintain adequate oral hygiene, usage of 378 Clinical biochemistry/Toxicology/Food and nutrition Maced. pharm. bull., 68 (Suppl 1) 377 - 378 (2022) orthodontic appliances and fixed prosthodontic appliances. According to Fiorillo (2019), chlorhexidine, used as a mouthwash, is mostly used in order to reduce oral bacterial flora. Furthermore, this product can be used for prevention and treatment of related plaque diseases and some forms of gingivitis or periodontitis. The most common side effect the surveyed dentists noticed in patients or the patients had complaints about was: (1) inappropriate taste or taste disturbance (85.4% of dentists noticed it as the most common side effect), (2) xerostomia (78.1%) and (3) tooth discoloration (58.6%). In a smaller percentage, the most common side effects caused by chlorhexidine are: changes in the oral mucosa, occurrence of burning mouth syndrome, allergic reactions, etc. According to Brookes et al. (2020), chlorhexidine as a mouthwash or topical oral gel is not without adverse effects, some of the most common being dry mouth (xerostomia), altered taste sensations (hypogeusia), specifically salt and bitter, and a discolored or coated tongue. The data presented in this study largely coincide with the results obtained in our study. Based on the answers received from dentists, it can be noticed that most dentists or 80.5% of the surveyed clinicians believe that the side effects caused by chlorhexidine are positively correlated with the duration of use of chlorhexidine mouthwashes. Surveyed dentists believe that this finding implies that people using such mouthwashes for a long time are more likely to develop one or more side effects. The existence of a link between the duration of treatment with chlorhexidine-containing mouthwashes and the occurrence of side effects has been also confirmed by other published studies (Haraji and Rakhshan, 2015; Slot et al., 2010). Conclusion According to the results obtained in our study, although the application of chlorhexidine mouthwashes has a number of positive effects, it can also be related with numerous side effects, depending on duration of usage