[Prophylaxis and treatment of periimpalntitis].

Ultrasonic Vector System (Dürr Dental, Germany) is the best means for complex treatment of peri-implantitis. The therapeutic effect of the system proved anti-inflammatory and regenerative impact of calcium hydroxyapatite on the soft tissue around the implant. The effectiveness of the result provided full, persistent and safe removal of bacteria, dental plaque, infected granulation tissue; the possibility of regular monitoring, prevention of re-infection of pathological pockets, without damaging the hard and soft tissues around the implant, the implant itself and artificial fragile crown, securing superb cleaning and polishing of the implant surface, which is an important condition for the further reduction and inactivation of pathogenic bacteria population. Healing peri-implantitis pockets at the expense of using conventional oral hygiene is not possible. Tools of carbon fiber in combination with a suspension Vector Fluid Polish and the Vector machine successfully accomplish the function of disinfection and polishing. The aim of the research was to present the results of peri-implantitis treatment with a new ultrasonic device Ultrasonic Vector System. Surgical treatment (21% of patients) was atraumatic. The risk of infection was decreased and necessary conditions were created for a significant acceleration of the tissue healing process. Relying on the successful results we recommend Vector- therapy before surgical procedures. Complex treatment was repeated depending on the clinical manifestations of inflammation around the implant. To prevent peri-implantitis, and get timely diagnosis of unwanted changes, and to maintain implants and the soft tissues around them in a healthy condition, the patients were strongly recommended to visit the dentist 3-4 times a year. They were offered professional oral hygiene and accessible parts of the implants with the help of a Vector machine. Relying on the results of the research we conducted during the treatment of peri-implantitis, we have seen the "magic" efficiency and the need to apply the «Vector¼ system into the complex treatment of this disease.

[Pain management in dentistry].

The aim of the study was to determine the most effective dose of Ibuprofen - one of the non-steroidal anti-inflammatory drugs frequently used in dental practice for pain management. According to our observations, Ibuprofen markedly softens and quickly reduces procedural pain in 55 (91.67%) patients and post-procedural pain in 44 (73.33%) patients, reduces the post-procedural need for or the amount of the drug, removes the fear of anesthesia and endodontic treatment; with irreversible pulpits significantly increases the efficiency of the inferior alveolar nerve block by local anesthetics. Our clinical observation of taking ibuprofen pre-procedurally demonstrates its effectiveness not only as a means for the relief of pain episodes, but also as an excellent anti-inflammatory treatment for chronic toothache Based on our research, the appointment of non-steroidal anti-inflammatory drugs before dental interventions, in this case - Ibuprofen turned out to be the key to the success of effective pain management. We suggest that administration of analgesics in order to relieve and effectively pre-empt pain before, during or after treatment should start before surgery and furthermore, this treatment should be extended into the postoperative period. Premedication with ibuprofen significantly increased the success rates of inferior alveolar nerve block anesthesia in teeth with irreversible pulpitis.

[Influence of antioxidant therapy on teeth firm tissues after endobleaching].

By endobleaching in the issue of peroxide penetration, extensively decreases adhesion of teeth tissues in dentinal canaliculus that in turn, demands to delay for some days the procedure of restoration by a filling. And it is inconvenient enough for patients. Proceeding from carried out researches, it is possible to consider the best way out an antioxidants usage after bleaching. Under their influence, the peroxide sedimentary layer against the firm tooth tissue is neutralized much more quickly. Antioxidants influence improves the microcirculation process passing in teeth, and also a respiratory chain that causes increase in adhesiveness, therefore appears a powerful transitive hybrid layer. The last, creates close contact between a filling and a tooth, and also excludes occurrence of microspacing and, accordingly, secondary caries. It is received micro strength of these teeth firm tissues, teeth edges do not require in additional tool finishing and their color from the aesthetic point of view is satisfactory. The aforesaid enables us to consider the antioxidant usage in endobleaching practice of devital teeth as a perspective direction.

[Flexible root posts].

The article discusses the current state of restoration techniques of root canal treatment. Nowadays, technical progress allows manufacturers to develop flexible fiberglass posts, aspiring not only to an excellent aesthetics and mechanical properties (first of all, in comparison with metal and cast posts), but also to maintenance of their radio density and a wide range of forms. Growth of fiberglass posts popularity testifies to their clinical efficiency that also is confirmed by results of long-term researches. Introduction of fiberglass posts in a dental practice has rendered huge influence on restoration techniques of root canal treatment. Convincing factors of fiberglass posts superiority provide restoration the appearance similar with the natural dentition; possess close to dentine elasticity; creation of monolithic structure with hard tooth tissues and composite cement, posts, in case of need, can be easily adjusted on length, adhesive linkage of posts gives them additional stability. Modern researches have confirmed that only elastic, namely carbon fiber and the fiberglass posts made of modern technologies possess similar physical properties, as tooth structure. They can create reliable biomimetic design; solve a complex of aesthetic and functional restoration problems.

[Periodontitis treatment by "vector" system].

Periodontal therapy by means of Vector device directly effects an environment of the tooth. It allows removing sub gingival dental plaque destroying pathogenic microorganisms and their toxins, washing out periodontal pockets carefully and polishing teeth roots. During treatment the hard tissues are not injured and the gum is not injured as well. Efficiency of a new ultrasonic technique in the complex treatment of periodontal diseases was declared. Periodontal therapy with the ultrasonic device leads to clinical improvements. It was found that Vector treatment was effective in the treatment of patients suffering from periodontitis.

["Golden proportion" and its application to calculate dentition].

Within an evolutionary process, the nature has created the standard of aesthetics - a "gold proportion" on the basis of which, the parts of human body, to be more exact, teeth and denture correspond to each other and to own parts by the size, which is the ideal precondition for ideal appearance. The charming smile serves as the proof, that teeth in denture are located by a principle of "gold proportion". A "gold proportion" is the corner stone of beauty and it can be applied with success in stomatology. Proportion is the certain ratio between parts, and proportional means a proper correlation of parts among themselves. It is reputed, that knowledge about "gold proportion" Pythagor has got from products of the Egyptian and Babylon scientists. And this is true, proportions of cult constructions, bas-relieves, pyramids in Giza, home appliances and ornaments from Tutanhamon tomb testify, that under their creation the Egyptian masters were guided by a principle of "gold proportion". The facade of ancient Greek temple Parthenon is built by a principle of "gold proportion". During archeological digs of this temple the compasses which sculptors and architects of an ancient world used has been found. The "gold proportion" is mentioned in the work which has reached us "Beginning" the author is the scientist of antique epoch Euclid. In 1509, in Venice the book of Luka Pacholi the "Divine proportion" has been published, its illustration is attributed to Leonardo de Vinci. This work has been recognized as a "Hymn of a gold proportion". In 1885 the German researcher professor Zeising published his work - "Aesthetic researches". When Zeising has received numerical values of piece length, he saw that they coincided with figures of some numerical sequence, which was offered by the great Italian mathematician of Middle Ages Fibonacci (or Leonardo Pisano). In his composition the "Abacus Book" Leonardo Fibonacci showed aforesaid sequence of numbers, by means of which he has explained the formula of duplication of rabbits. The specified sequence scientists have seen in many phenomena of the Universe. In sequence of Fibonacci, in some division of its term on previous, it is received irrational number 1,61803398875.., known as Fibonacci. It is used in the reduced, approximated kind as F = 1,618 or phi = 0,618. Fibonacci also gave a proportional number (...3:2, 5:3, 8:5, 13:8...), where numerator represents the sum of two previous numbers in Fibonacci sequence. And in proportional number, similar to numerical sequence, the result of any ratio will be approximately the same - this an irrational number which asymptotically comes to 1,61803398875.... Two numbers of Fibonacci sequence F = 1,618 or phi = 0,618 or phi = 1:F... represent constants of the same sequence. It is actual in stomatology to use proportional way. For example, in orthopedic stomatology taking into consideration of ratio 5:3, promotes improvement of basic fabrics tension, prolongation of teeth functioning and denture, and also planning of correct redistribution of chewing function. In 60th -70th years the American stomatologists carried out many researches to define what kind of part "gold proportion" takes in this area of medicine. Orthodontist Robert Rikets has established that separate teeth correlate with each other by a principle of "gold proportion". In his works Roberts Rickets has specified, that mentioned data is necessary to be considered in aesthetic stomatology during teeth reconstruction. An eminent stomatologist from California, the surgeon, doctor Shtefan Markvart has found out that the height of lateral incisors corresponds to width of lateral incisors by a principle of "gold proportion". This fact has helped the decision of many aesthetic problems. Knowing the width, it is easy to calculate the height and vice versa. When the width is optimum, it cannot be broken with the purpose of closing of an interval. The principle of "gold proportion" in connection with a denture consists in the following: the central incisors are hardly longer than lateral incisors and are almost equal to the length of canines: and lateral incisors are slightly shorter and thinner than the central incisors. The width and the length of each tooth is measured by compasses and calculated for each patient individually. According to a "gold proportion" fore-teeth as a part of person appearance are in the certain ratio to each other. The basic key for the description and construction of four incisors and two canines considers the size (which is accepted as unit) of the width of a small piece of teeth arch or a lateral incisor. On the basis of a lateral incisor width, by the formula of "gold proportion", it is formed the width of the central incisors and canines, and also the length of a fore-part of a dental arch, and vise versa if the length of a fore-part of a dental arch is known, to achieve an ideal aesthetic condition by a principle of "gold proportion", it is defined the width of all fore-teeth. Teeth measurement is taken to define an initial condition, denture calculation, verification of the received results during teeth construction and estimation of the complete denture reconstruction.

[Benefits of antioxidant agents' use for dental filling consequent to the endo-bleaching].

Efficacy of antioxidant agents' use after dental endo bleaching was studied in clinical trial. The study enrolled 169 patients, ranging age 16 to 60 years in age. The patients were randomized into 2 groups: control (63) and trial (106). In patients of the control group tooth cavity was left open after endo bleaching, and was filled only after 7 days. In patients of the trial group antioxidant agent was administered into the dental tissues consequently to the endo bleaching, and the cavity was filled immediately. Assessment of the immediate and distant effects revealed unwanted results of postponed dental filling (control group) in terms of tooth color stability and forming micro cracks. Results of antioxidant use and immediate dental filling after endo bleaching have proven our earlier experimental studies on benefits of antioxidant use to be right. Based on the results of our clinical study we can recommend use of antioxidant after endo bleaching to achieve successful dental fillings in clinical practice.

[Correlation of bleached teeth's tissue micro-durability and time of placing the dental filling].

Bleaching of discolored teeth has become one of the pressing issues of modern aesthetic dentistry in Georgia. Correct selection of endo-bleaching substances is crucial in resolving this issue, as it is well known that endo-bleaching agents penetrate into the dental tissues, causing "microcracks". Aim of our study became selection of right materials for dental bleaching, as well as finding additional methods of prevention these materials from penetrating into the dental tissue. Serving this aim, we have studied several types of endo-bleaching substances, as well as micro-durability of dental tissue, based on the numerous methods of its determination. Subsequently we observed the effect of endo-bleaching materials "endoopalescence" and "endoperox" on dental tissue. Data analysis has shown that there were significantly less "microcracks" found after use of "endoopalescence", than "endoperox". The most beneficial results were obtained during concomitant use of endo-bleaching material "endoopalescence" and antioxidant, since the latter improves micro-durability of dental tissue. Based on all of the above we recommend use of "endoopalescence" as an endo-bleaching substance, in complex with antioxidants.

[Study of influence of endoopalescence on the solid tissue by means of raster microscope].

During the process of endowhitening as a result of penetration of peroxide into dentine tubules the adhesion of tooth tissues sharply decreases, it requires the delay of restoration by filling for several days. Surely it is not comfortable for the patient. The best way out is the application of antioxidants after whitening. Under their influence the sedimentary layer on the hard tissues of the teeth neutralizes much quicker. The urgency of this issue is preconditioned by the fact that under the influence of antioxidant the restored adhesiveness enables the immediate restoration of tooth. Our previous experiment is the good proof of that. In the experiment we studied the level of micro leakage and origination of microfissures by effecting with antioxidant, precisely with 10% sodium ascorbate on the hard tissues of tooth after using the whitening agent. As a result of this experiment we have not obtained any microfissure in the teeth covered with antioxidant unlike those teeth where we had not used the antioxidant. According to the reference data it is known that after acide angraving there occurs the removing of adhesive layer from the enamel and dentin of tooth. As a result of this the prisms of enamel and the dentine tubules are widened and this creates condition for the further penetration of the primer of the adhesive system. This process is followed by the origination of transitional i.e. hybrid layer. The latter one is the best link for the adhesive tar and tooth tissues. Modern investigations in the esthetic stomatology prove that the whitening agents produce the peroxide molecules during the process of whitening. These molecules cause the widening of the tooth enamel prisms. We also studied the results of post endo-whitening influence of peroxidation processes on the enamel and dentine of tooth by means of the raster microscope. Studies by electron microscope showed that the antioxidant - 10% sodium ascorbate was characterized by high penetration and was equally distributed in the dentine. It totally covered the dentine, actively interacted with the peroxide accumulated in the tubules and caused their neutralization. In the II experimental group, most parts of the dentine tubules were tightly obturated, it originated the strong hybrid circle and the fissure was not observed in any of it's areas. It may be concluded that the adhesiveness disturbed as a result of peroxidation processes improved by their neutralization by means of antioxidant that accelerated the terms of filling postponed after the application of whitener enabled the immediate filling of the tooth. Development of strong hybrid layer on the electron-diffraction pattern of teeth of this group without the microfissure is the precondition for successful therapy.

[Influence of whitening endoopalescence systems on the restoration of devitalized teeth].

At the end 80s of the XX century bleaching of teeth became one of the most important issues in the stomatological industry. Currently there are two methods of bleaching: external and internal (endo bleaching) methods. It is proved that the adhesive ability of the tooth tissues reduces as a result of peroxide penetration into enamel and dentine. Based on this, the aim of our study was to use the antioxidants for excluding the peroxides from tooth tissues and for rehabilitation of reduced adhesion. For this purpose we used central and side 36 healthy incisors, where after processing of tooth tissue with antioxidants and without them we studied the formation of micro rift between the operation material and dentine, and intensity of micro flowing by means of stereo microscope. We used 30% endo-opalescence as a bleacher and used 10% sodium acrobat as antioxidant. As a result of experiment we found out that the teeth where we used antioxidant were not penetrated with metaline blue; unlikely, the teeth where we did not use the same method we got the approximate result in the group of teeth, where for peroxide exclusion we performed the crown reconstruction not immediately, but after 7 days. During the whole experiment the teeth were kept in thermostat at 37 degrees C in saliva to create the natural conditions for them. In overall we can conclude that the deteriorated adhesive ability with peroxide influence can be improved by application of antioxidants.