Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD.

OBJECTIVE: The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD), using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group. MATERIAL AND METHODS: The study included 80 participants aging between 18 and 65 years. The experimental group (EG) was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG), comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index). Quantity and pH value of saliva were determined in the laboratory. RESULTS: In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (p<0.001). Patients in the EG had a higher value of DMFT index when compared with the CG, although the difference was not statistically significant (p=0.199). Mean number of decayed teeth, as well as missing teeth, in the EG was statistically significantly higher than in the CG (p<0.001). Mean number of filled teeth in the EG was statistically significantly lower than in the CG (p<0.001). CONCLUSION: It was found that patients undergoing inhalation therapy face increasing risk of dental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice.

[The effect of gastric juice on the development of erosive changes in hard dental tissue].

INTRODUCTION: Gastroesophageal reflux disease (GERD) is an esophageal disorder where the refluxed gastric contents enters first into the esophagus followed by the pharynx, oral cavity, larynx, airway and middle ear, causing a range of disorders and symptoms. Hydrochloric acid from the gastric contents is responsible for the demineralization of dental hard tissues and release of matrix metalloproteinase from the dentin. OBJECTIVE: The aim of this study was to verify the SEM (scanning electron microscopy) analysis of the surface enamel, the enamel-dentin border and dentine after the exposure of intact teeth to filtrate of gastric contents obtained during routine endoscopy. METHODS: Material used in the research was 10 extracted human impacted third molars. The coronal part of the tooth was divided into two parts, and then the two halves of teeth were exposed to the filtrate of gastric juice obtained during routine gastroscopy, which had been frozen until the moment of the experiment initiation. All samples of teeth were immersed in the filtrate of the content at a temperature of 20 degrees C for 60 minutes. The prepared samples were observed by the SEM in the area of the enamel, the enamel-dentin border and in the area of dentin at different magnification. RESULTS: The SEM analysis showed that both enamel and dentin had a significant demineralization of these tissues. Enamel surface resembled a demineralization similar to that of acid conditioning before the application of composite restorations. The degree of mineralization was more intense towards the enamel - dentin border, and at this area the enamel prisms were not fully recognizable. The dentin had a complete loss of peritubular dentin, the entry points of the dentin tubules were expanded and intertubular dentin demineralization was also registered. CONCLUSION: SEM analysis showed a significant degree of destruction of enamel and dentin. Significant changes in the surface structure of enamel and dentin were also registered. The filtrate of the gastric juice degrades enamel pellicle and the dentin organic component.

Canal wall thickness after preparation with NiTi rotary files.

UNLABELLED: Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed, and safety of the preparation procedure. AIM: The aim of this research was to investigate measurement of maximal and minimal residual dentine thickness (RDT) and canal diameter after the canal preparation with different NiTi rotary files. METHODS: The research has been conducted on extracted human teeth in vitro conditions. The teeth have been divided in seven groups (20 teeth per group) depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper, and hand GT. The canals have been shaped in a crown-down manner and irrigated with 5.25% sodium hypochlorite. The roots of the teeth have been cut 1 and 3 mm from the apex. Apical preparation quality has been assessed under the polarized light microscope. RESULTS: The maximal residual dentine thickness at distance 1 mm from apex, ranged from 1.16 to 1.45 mm, and at distance 3 mm from apex, from 1.44 to 1.84 mm. The minimal dentine thickness at distance 1 mm from apex ranged from 0.52 to 0.73 mm, and at distance 3 mm from apex, from 0.66 to 0.83 mm. The canal diameters after preparation at distance 1 mm from apex ranged from 0.42 to 0.49 mm, and at distance 3 mm from apex, from 0.53 to 0.63 mm. CONCLUSIONS: There was no significant difference neither in maximal and minimal RDT, nor in canal diameters shaped with different NiTi instruments tested. All tested NiTi files have accomplished good quality preparation of apical root canal parts.

[Scanning electron microscopy investigation of canal cleaning after canal preparation with nickel titanium files].

INTRODUCTION: Root canal preparation is the most important phase of endodontic procedure and it consists of adequate canal space cleaning and shaping. In recent years, rotary instruments and techniques have gained importance because of the great efficacy, speed and safety of the preparation procedure. OBJECTIVE: The aim of this research was to investigate the influence of different NiTi files on the canal wall cleaning quality, residual dentine debris and smear layer. METHODS: The research was conducted on extracted human teeth in vitro conditions. Teeth were divided in 7 main groups depending on the kind of instruments used for root canal preparation: ProTaper, GT, ProFile, K-3, FlexMaster, hand ProTaper and hand GT. Root canal preparation was accomplished by crown-down technique. Prepared samples were assessed on scanning electron microscopy JEOL, JSM-6460 LV. The evaluation of dentine debris was done with 500x magnification, and the evaluation of smear layer with 1,000 times magnification. Quantitive assessment of dentine debris and smear layer was done according to the criteria of Hulsmann. RESULTS: The least amount of debris and smear layer has been found in canals shaped with ProFile instruments, and the largest amount in canals shaped with FlexMaster instruments. Canal cleaning efficacy of hand GTand ProTaperfiles has been similar to cleaning efficacy of rotary NiTi files. Statistic analysis has shown a significant difference in amount of dentine debris and smear layer on the canal walls between sample groups. shaped with different instruments. CONCLUSION: Completely clean canals have not been found in any tested group of instruments. The largest amount of debris and smear layer has been found in the apical third of all canals. The design and the type of endodontic instruments influence the efficacy of the canal cleaning.

[Reflux disease as an etiological factor of dental erosion].

INTRODUCTION: Gastroesophageal reflux is a frequent disease which has a significant influence on the development of dental erosions. OBJECTIVE: The aim of this research was to determine the frequency of dental erosions among the patients with gastroesophageal reflux, as well as to verify the most common symptoms of gastroesophageal disease. METHODS: The research comprised of two groups, each consisting of 30 patients aged 18-80 years. The experimental group comprised of patients diagnosed with gastroesophageal reflux disease (GERD), while the control group was composed of patients who were not diagnosed with GERD. Based on the illness history data, all patients of the experimental group were registered to have gastroesophageal and extraesophageal symptoms. Dental erosions were diagnosed during a stomatological inspection by using index system according to Eccles and Jenkins. Data processing was accomplished by the Statgraphics Centurion software package. RESULTS: Dental erosions were found in 76.7% of experimental group patients, and in 53.3% of control group patients. Forty-nine percent of teeth of the experimental group patients and 31.1% of the control group patients showed erosive changes. On average, the number of teeth with erosions in the experimental group was 15.7 per person and in the control group 10 per person. The teeth of the front region of the upper jaw, as well as the lower first molars had the highest average value of dental erosion index. In the experimental group 12.8% of teeth and 24% of teeth in the control group were diagnosed to have dental erosion index value 1. Furthermore, 23.4% of teeth in the experimental group and 7.1% of teeth in the control group were registered to have dental erosion index value 2. Finally, the dental erosion index value 3 was found in 13.0% of teeth in the experimental group only. The highest average value of regional erosion index in the experimental group was found in the region 13-23 equalling 1.0. The same value in the control group equalled 0.6. In the experimental group the average value of dental erosion index for the upper jaw was 0.9, while this value for the lower jaw equalled 0.8. The analysis of the illness history data obtained showed that there was a statistically significant difference between the two observed groups in terms of burning pain (noncardiac in origin) around the heart area, bad breath and dentine hypersensitivity as the dominant symptom of dental erosion (p < 0.05). CONCLUSION: Dental erosions could be considered to be the extraesophageal manifestation ofgastroesophageal reflux.

[Root canal preparation techniques using nickel-titanium rotary instruments].

INTRODUCTION: The main purpose of endodontic treatment is to clean the root canal system, eliminate the infected and toxic contents, and shape it in order to get a tridimensional obturation. The aim of this paper is to inform dental practitioners about crown-down technques for root canal preparation using nickel-titanium rotary instruments. ROOT CANAL PREPARATION: Today most endodontists believe that root canal preparation is more efficious, cleaning and shaping are better, if pre-enlargement of coronal two thirds is performed first, and shaping of the apical part later. Machine driven rotary instruments provide much quicker and better root canal preparation. CONCLUSION: Contemporary endodontic rotary files vary in regard to their taper, cutting blades, guiding tip and material they are made of. The usage of rotary nickel-titanium files adds a new quality to root canal preparation.

[Oral health in pregnancy]. / Oralno zdravlje u trudnoci.

INTRODUCTION: Good oral health care during pregnancy is essential but often overlooked factor of dental growth as well as of other structures of oral cavity. Pregnancy is the time when conscious approach to preventive oral care should increase. PREVENTIVE MEASURES DURING PREGNANCY: Preventive measures during pregnancy mean usage of fluorides, special dietary measures and increased oral hygiene habits. Preventive measures in pregnant women have one goal: providing conditions for development of fetal teeth as well as preventing tooth decay in pregnant women. The optimal period for introducing preventive measures is the first trimester of pregnancy. ALTERATIONS OF ORAL HEALTH DURING PREGNANCY: Because of hormonal alterations there is an increased incidence of dental diseases: gingivitis and low salivary pH (inflammation and bleeding gums). IMPACT OF NUTRITION DURING PREGNANCY ON ORAL HEALTH: Eating habits of pregnant women may lead to frequent snacking on candy or other decay-promoting foods, thereby increasing the risk of caries. However, very poor oral health, possible dental complications and their consequences to the health as well as emotional status represent very strong reasons for activation of dental health care in this period.