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.

[Applicability of visual-analogue scale in patients with orofacial ain].

INTRODUCTION: Orofacial pain occurs in various disorders of the orofacial region. OBJECTIVE: The aim of this study was to examine applicability of the visual-analogue scale (VAS) in patients with orofacial pain (model of acute and chronic pain). METHODS: The study involved 60 patients, aged 18-70 years. The first group consisted of patients with dentin hypersensitivity, and the second group of patients with chronic rhinosinusitis. All patients were asked to fill-in a pain questionnaire and to rate pain intensity on the modified visual analogue scale (VAS; 0-10). Air indexing method was performed in the patients with dentin hypersensitivity in order to provoke pain, while the patients with chronic rhinosinusitis underwent CT imaging of paranasal sinuses. Wilcoxon's test and Pearson's correlation coefficient were used for statistical analysis. RESULTS: In patients with dentin hypersensitivity provocation increased subjective feeling of pain, but without statistical significance (t = 164.5; p > 0.05). In patients with chronic rhinosinusitis a significant statistical correlation (r = 0.53; p < 0.05) was found between subjective pain assessment of VAS and CT findings. CONCLUSION: Applying VAS in the evaluation of acute and chronic pain can indicate progression or regression of pathological state under clinical conditions. This study showed that VAS, as a method for follow-up of pathological state, is more applicable and efficient when applied in chronic pain evaluation.

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.

[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.

Microleakage of contemporary composite systems in dentin cavities.

This study evaluated microleakage in vitro of self-etch and multi-step, total-etch adhesive systems. Ninety extracted non-carious human molars were randomly assigned to nine groups (n=10) and restored with nine different composite systems: Gluma CPS/Charisma, Syntac Sprint/Tetric Ceram, 3M Single Bond/Silux, Admira Bond/Admira, Optibond Solo Plus/Herculite, Trendy Bond/Saremco, Excite/Tetric Ceram, Syntac Sprint/Compoglass and Promt-L-Pop/Silux. Cavities (2 mm diameter/2 mm deep) were prepared on the facial and lingual surfaces of each tooth previously abraded with a silicon-carbide abrasion discs to produce two level dentin surfaces with whole margins in dentin. Each group of composite systems was treated following the manufacturer's instructions. After they were finished and polished, the specimens were subjected to 100 thermal cycles in baths of 4 degrees +/- 2 degrees C and 58 degrees +/- 2 degrees C with 60 seconds of dwell time for each bath. After the thermocycling, the specimens were sealed with acid-resistant varnish, leaving a 1-mm window around the cervical margin interface, and immersed in 1% methylene blue buffered solution for 4 hours. Then the specimens were sectioned longitudinally in half and evaluated under stereomicroscopy at 30 times magnification, using inserted millimeter measurer. Each specimen was measured for dye penetration, thickness of composite filling and distance from the bottom ofcavity to the pulp chamber. The data were analyzed using Kruskal-Wallis Analysis of Variance (ANOVA) and Pearson t- test. Syntac Sprint/Tetric Ceram, 3M Single Bond/Silux, Admira Bond/Admira, Optibond Solo Plus/Herculite and Gluma CPS/Charisma showed the least microleakage at the occlusal part of the cavity. There was no significant difference of microleakage at gingival part of cavity for all tested composite systems and the best sealing ability showed 3M Single Bond/Silux. Self-etch and multi-step, total-etch adhesive systems showed more or less similar microleakage "in vitro" conditions and marginal sealing ability of all tested composite systems was significantly lower at gingival margins of cavities.

[Multi-factoriality of dentine hypersensitivity].

INTRODUCTION: Dentine hypersensitivity has been defined as a sharp, short pain arising from exposed dentin in response to stimuli typically thermal, evaporative tactile, osmoticor, chemical and which cannot be ascribed to any other form of dental defect or pathology. PREVALENCE: The most affected patients range in age from 20 to 40. The following teeth tend to be most sensitive: cuspids, premnolars and incisors, location-concentrated on the facial surface. MORPHOLOGICAL BASES OF DENTINE HYPERSENSITIVITY: Sensitive teeth have much greater numbers of open tubules per unit area and the average diameter of tubules is almost 2 times greater than tubules in nonsensitive teeth. MECHANISMS OF DENTINE HYPERSENSITIVITY: The most widely accepted theory of how the pain occurs is Brannstroms theory. ETIOLOGY: Dentine hypersensitivity represents a condition of presumable multifactorial pathology. Two processes are essential for its development: (1) dentin must be exposed through either genetic disturbance, enamel defect (lamellae, tufs and spindles), loss of enamel (erosion, abrasion, attrition, abfraction), gingival recession with rapid loss of cementum and (2) the dentin tubules must be open to both the oral cavity and the pulp. DIAGNOSIS: Diagnostic protocol for this condition consisted of Medical, Dental Dietary, Oral Hygiene History and Inra-oral examinations with air indexing method. Differential Dianosis: We must take into consideration a numnber of variables such as: dental caries, cracked tooth, restorative sensitivity, medication sensitivity, bleaching sensitivity and abscessed or non-vital tooth. CONCLUSION: Dentin hypersensitivity is a problem that bothers many patients. Many conditions share the symptoms of tooth sensitivity so differential diagnosis is essential for suitable treatment or preventive measures.

[Effects of fluoride in drinking water on health of deciduous teeth]. / Uticaj fluorida u pijacoj vodi na zdravlje mlecnih zuba.

INTRODUCTION: High incidence of decayed deciduous teeth, as well as lack of adequate therapy, makes tooth decay prevention very important. One of the simplest ways to reduce tooth decay is fluoridation of drinking water. The optimal concentration of fluoride in drinking water is 1 ppm/l, and many waters naturally contain this quantity. Waters in Vojvodina are mainly poor in fluoride, except in a few regions. It has long been postulated that fluoride has a prophyilactic effect during intrauterine life. Today a theory of greater local impact of fluoride has been accepted, as well as its role in de- and remineralization of solid tooth tissue. MATERIAL AND METHOD: This epidemiological study was performed in the area of Vojvodina, in places with various fluoride concentrations in drinking water (0.18-1.04 ppm/l). Dental examination was performed among 145 children, 6 years of age. For tooth decay detection DMF index was used. RESULTS AND DISCUSSION: In places with low and optimal fluoride concentration in drinking water the percentage of children with decayed teeth is different, but without statistical significance. The percentage of affected deciduous teeth is high in all places. In places with low fluoride concentration it is 24.2-32.3%, in places with optimal concentration is it 27-32%. The average value of DMF in all places is between 4.7-6.4. These results show that the optimal fluoride concentration in drinking water decreases the incidence of tooth decay, but this difference is not significant. CONCLUSION: Presence of fluoride in drinking water doesn't affect health of deciduous teeth. Decreased incidence of decayed deciduous teeth can be achieved only with combined usage of fluoride (local and systemic), as well as with an intensive health education program.