Choice of root canal irrigants by Serbian dental practitioners.

BACKGROUND/AIM: Root canal treatment is considered to be the one of the most important procedures in endodontic treatment. To irrigate the root canal it is most common to use sodium hypochlorite (NaOCl), chlorhexodine, ethylenediaminetetraacetic acid (EDTA), local anesthetic solution, while the most used in Serbia is hydrogen peroxide (H2O2). The aim of this survey was to reveal the preferred root canal irrigants used by general dental practitioners in Serbia and to determine the influence of the continuing education program, delivered over the 3-year observation period, on work habits of dental practitioners. This was the first comprehensive survey of this nature carried out in Serbia. METHODS: The survey was conducted in two instances, a 4-month observation period each, from November 1, 2009 to March 1, 2010 and from November 1, 2012 to March 1, 2013. Internet Web Page Survey was posted on the official web site of the Serbian Association of Private Dentists. In the first survey, 569 completed questionnaires were subjected to analysis. In the next attempt (3 years later), the survey was launched again and 615 completed questionnaires were analyzed using the same criteria. The statistical analysis was carried out with simple descriptive statistics applying the x2 test, at a significance level of p < 0.05. RESULTS: The first survey included 569 dental practitioners, while 3 years later the number of them was 615. Analyzing the questionnaires revealed the number of 10 to 30 interventins on the root canal montly. The most commonly used irrigant solution was H2O2 in 2009, while in 2012 it was yet H2O2, but also NaOCl, chlorhexodine, and a little less EDTA. CONCLUSION: This study shows significant changes in the irrigation protocol applied in Serbian dental community. After 3 years of observation, NaOCl became widely accepted as the irrigant of choice, whereas H2O2 lost its popularity.

[Scanning electron microscopy analysis of marginal adaptation of composite resines to enamel after using of standard and gradual photopolimerization].

INTRODUCTION: Bonding between composite and hard dental tissue is most commonly assessed by measuring bonding strength or absence of marginal gap along the restoration interface. Marginal index (MI) is a significant indicator of the efficiency of the bond between material and dental tissue because it also shows the values of width and length of marginal gap. OBJECTIVE: The aim of this investigation was to estimate quantitative and qualitative features of the bond between composite resin and enamel and to determine the values of MI in enamel after application of two techniques of photopolymerization with two composite systems. METHODS: Forty Class V cavities on extracted teeth were prepared and restored for scanning electron microscope (SEM) analysis of composite bonding to enamel. Adhesion to enamel was achieved by Adper Single Bond 2 - ASB (3M ESPE), or by Adper Easy One--AEO (3M ESPE). Photopolymerization of Filtek Ultimate--FU (3M ESPE) was performed using constant halogen light (HIP) or soft start program (SOF). RESULTS: Quantitative and qualitative analysis, showed better mikromorphological bonding with SOF photopolymerization and ASB/FU composite system. Differences in MI between different photopolymerization techniques (HIP: 0.6707; SOF: 0.2395) were statistically significant (p < 0.001), as well as differences between the composite systems (ASB/FU: 0.0470; AEO/ FU: 0.8651) (p < 0.001) by two-way ANOVA test. CONCLUSION: Better marginal adaptation of composite to enamel was obtained with SOF photopolymerization in both composite systems.

Telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement.

INTRODUCTION: In the management of edentulous spaces, there is a permanent need of a dentist-prosthetician in charge to consult other specialists. Modern telemedicine, based on powerful computer and telecomunication systems, offers an adequate answer to these challenges, being able to transfer and obtain clinical data and consultation information over large distances. Using smartphone or a computer, the teleconsultant acces the system, downloads and review the data and photographs and gave suggestions. The system then enables direct, real time contact with the consultant, chat, or directs them to contact each other by phone. CASE REPORT: We presented telemedicine consulting in the patient preparation and planning of prosthetic tooth replacement in 3 cases with different teleconsultation requirements: the first case for prosthetic rehabilitation of his upper teeth, the second one for prosthetic management of his partial edentulousness and "a growth on his gums" in the vestibular region of the frontal teeth and the third one for prosthetic management of total edentulousness of her upper jaw. We used the system of telemedicine in dentistry, established at the Faculty of Medicine in Kosovska Mitrovica. The operation was based on the computer application system XPA3 Online, computer networking and mobile smartphone network. All consultations were succefull with no need for further procedures in regional center. CONCLUSION: The use of a mobile smartphone has brought about the mobility and availability of teleconsultant specialists in an extent never seen before. Prostheticians are thus able to offer better service to their patients and improve the quality of management of partially or totally edentulous patients, especially in rural areas.

Novelty seeking and medication adherence in patients with schizophrenia.

The study explored the association between temperament and character and medication adherence in 76 patients with schizophrenia. Patients were assessed with the Temperament and Character Inventory, the Beck Depression Inventory, and the Positive and Negative Syndrome Scale. First-degree relatives were used as informants on adherence. The patients differed in their adherence based on the effect of gender, as males were found to be less adherent than females. Adherence differed based on novelty seeking. The temperament of the patient should be considered during the assessment of adherence.

Relations of internalized stigma with temperament and character in patients with schizophrenia.

OBJECTIVE: The aim of the study was to assess the associations between self-stigma and temperament and character dimensions. METHODS: One hundred twenty outpatients with diagnosis of schizophrenia, established with Mini International Neuropsychiatric Interview were consecutively included in the study. Self-stigma was assessed with Internalized Stigma of Mental Illness (ISMI), personality dimensions with Temperament and Character Inventory, and psychopathology with Positive and Negative Symptom Scale. RESULTS: The results showed that higher level of harm avoidance, lower self-directedness, and persistence correlated with ISMI and all its subscales. Self-transcendence correlated with ISMI subscales alienation, discrimination, and stigma resistance. Regression analyses controlling for psychopathology, age, length of illness, and number of hospitalizations revealed that higher level of harm avoidance and low self-directedness predicted internalized stigma. CONCLUSION: The finding suggests that the experience of self-stigma is related to personality dimensions. Interpretations of these findings include the possibility that, irrespective of patients' psychopathology or functional characteristics, experience of self-stigma and its consequences might depend on personality dimensions. Further studies are needed.

[Efficiency of final irrigation of root canal in removal of smear layer].

INTRODUCTION: A smear layer forms on the root canal walls as the consequence of root instrumentation. The smear layer formed in such a way considerably influences the quality of root obturation and endodontic treatment outcome. OBJECTIVE: The aim of this study was to ultrastructurally analyse the surface of intracanal dentine after removal of the smear layer by the solution of doxycycline, citric acid and detergent Tween-80 (MTAD). METHODS: The study involved 60 single-rooted, extracted, human teeth divided into four groups. All samples were instrumented by a step-back technique and manual K-files, and rinsed during instrumentation by 2% CHX and H2O2. The first group of samples was exclusively rinsed by CHX and H2O2; in the second group, besides using CHX and H2O2, MTAD solution was used for the final irrigation. The samples which were rinsed by distilled water (+ control) and the samples rinsed by 5.25% NaOCI and 17% Na EDTA (-control) served as control groups. All samples were observed under the scanning electronic microscope JEOL-JSM-5300. The coronary, middle and apex thirds of the radix region were analysed. RESULTS: The obtained results of the SEM analysis showed that the application of 2% chlorhexidine and hydrogen peroxide did not give clear dentine walls, and the smear layer could not be removed completely. The application of the same combination (CHX and H2O2), added by the final MTAD irrigation solution, led to the efficient removal of the smear layer, while the morphological structure of dentine surface remained unchanged. Statistical analysis showed that canal walls in the experimental group with MTAD as the final irrigation were significantly clearer compared to the control group (p < 0.001). CONCLUSION: Based on the obtained results, it can be concluded that MTAD is an efficient solution for the final irrigation of the canal system.