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Background/Aim. Helicobacter (H.) pylori is a widespread bacterium and its involvement in pathogenesis of gastric diseases is well-known. However, H. pylori role in etiology of other histologically similar conditions, especially recurrent aphthous stomatitis (RAS) is still controversial. Research regarding H. pylori and its association with RAS, as well as the treatment options were always conducted on patients with diagnosed gastric problems. The aim of this study was to determine whether H. pylori is present in the oral cavity of patients suffering from RAS but without any symptoms or medical history of gastric disease. Methods. A total of 15 patients with RAS participated in the study. None of the participants suffered from any gastrointestinal disorders. Two dental plaque samples from each participant were collected. The first was analyzed using rapid urease test and the second one was put in transport medium and sent for cultivation. The sensitivity of H. pylori to antibiotics was established using disk diffusion method of sensitivity testing for every patient individually and adequate therapy was prescribed. Results. Before the treatment the mean annual recurrence rate of RAS was 8.1 ± 2.1, with the average number of lesions being 3.9 ± 1.9. During the 12-month observation period after the eradication therapy, none of the patients reported recurrence of aphthous lesions. The treatment was successful in all cases. Conclusion. This study shows that RAS can be effectively treated by successful eradication of oral H. pylori, and that RAS could be possibly considered as an early warning sign of potential gastric infection by H. pilory.

Background: Premixedcalcium silicate-based sealers are ready-to-use, injectable materials with advantageous biological properties that create environment favorable for periapical tissues repair and health. The aim of our study was to examine the radiopacities of premixed calcium silicate-based sealers:TotalFill BCSealer, EndoSequence BC Sealer, Ceraseal, Bio-C Sealer and to compare them with epoxy-basedsealer, AH Plus. Material and methods: Three specimens (2 mm thick and 5 mm in diameter) of each sealer were radiographed using charge-coupled device-baseddigital sensor (Trophy Radiology, Cedex, France) along with an aluminum stepwedge reference.For radiopacity determination, a graph of the logarithm of aluminum thickness versus radiographic density was plotted and a calibration curve was generated. Radiopacities were assessed from the graph and presented as millimeters of aluminum per millimeter of material (mmAl).ANOVA with a post hoc Tukey test was used for statistical analysis and significance was set at 0.05. Results: Radiopacity values of EndoSequence BC Sealer and Bio-C Sealerwere significantly lower than radiopacities of Ceraseal and AH Plus. Differences in values between EndoSequence BC Sealer and Bio-C Sealer as well as between Ceraseal and AH Plus were nonsignificant. TotalFill BC Sealer was nonsignificantly different from all other sealers. Conclusion: Premixed calcium silicate-based endodontic sealers evaluated in our study had radiopacity values higher than 9 mmAl, in ascending order,from Bio-C Sealer, EndoSequence BC Sealer, TotalFill BC Sealer to Ceraseal.

Introduction. Prognosis of root canal treatment is highly dependent on the quality of endodontic space obturation. The main task of successful root canal treatment is to achieve adequate reparation processes in the apical periodontium. The aim of this study was to evaluate the quality of root canal obturation using the method of gas (argon) penetration through three different endodontic materials. Material and Methods. Thirty recently extracted human single-rooted teeth after root canal instrumentation were divided into three identical groups and obturated with three different endodontic materials: group I - GuttaFlow (RSA, Germany), group II - AH Plus (DeTray, Germany), group III - Acroseal (Septodont, France). The quality of root canal obturation was evaluated using the method of gas permeability. Results. The best results were obtained with GuttaFlow. The average penetration rate of argon was 186.7 seconds. Slightly higher gas porosity had AH Plus, 179.9 seconds, while the highest gas permeability was observed after the application of Acroseal, 178.5 seconds. However, there was no statistically significant difference in gas penetration among these endodontic materials (p>0.05). Conclusion. All three endodontic materials showed gas permeability in a given time interval. The best quality of obturation was achieved with GuttaFlow, while the lowest quality was obtained with Acroseal.

Dental materials are specific materials that were developed as a general materials for specific aplication in oral environment. To determinate the functional properties of this materials, we are obligated to use nonstandard approach and specific methods. In this study, two methodologies of material testing-artificial agging and quantification of visual informations for life circle assessment of hydroxyapatite (Hap) based materials, were used. Hap was chemically synthetized which produced the material with high purity and crystallinity. Artificially produced Hap is used in stomatology for repair of bone tissue, as a filling for periodontal defects, and as a preservative augmentation for alveolar ridges. In the mean time those materials are used for definitive root canal obturation in endodontic therapy procedure as an apical plug or as complete filling material. This research was focused on the analysis of the bonding properties of the Hap based materials to the root canal walls. The methodology of artificial agging was used together with the quantification of visual informations in purpose to quantify the Hap bonding properties and bonding quality. Experiments were done in-vitro, with the artificia saliva as the agressive agent. The experimental tooths were analyzed by the high resolution optical microscope for the morphological characterisation of the bonding layer. The model for the bond life circle assessment was developed. Hap based materials proved that has favorable properties for the dental use. The presented results proved that the combination of two methodologies (artificial agging and quantification of visual informations could be used as the tool for analyzing the material-dentine interaction.

Introduction. Health care, as one of the most important and sensitive fields of human endeavour, has a significant social impact; therefore changes in this area have wide implications on society in general. The latest economic crisis resulted in slow growth of gross domestic product (GDP), high unemployment rates, low living standards, and increased poverty across the globe. This includes decreased capacity of health system, and reduced quality and supply of health services. The aim of the study was to explore possible impact of the current world economic crisis on the public health sector workforce in Serbia. Materials and Methods. The study was conducted as retrospective analyses of the Public Health Institute (PHI) human resource data, the Republic Statistical Office publications and database, the Republic Development Bureau report, as well as the analysis of healthcare expenditures obtained from the Chamber of Health Institutions reports. The comparative analytical method was used for the assessment of socio-economic and human resource indicators over the period of five years, 2006 to 2010. Results. Results showed that the world economic crisis discontinued steady economic growth in Serbia. Between 2006 and 2008, the real GDP growth rate has been fluctuating between 3.6% and 5.4 %, while in 2009 it had negative growth rate of -3.1 % and slight increase in 2010 of 1.0%. In 2006, the GDP per capita was US$ 3,943, and by 2008 it almost doubled reaching US$ 6,498, while in 2009 it fell down to US$ 5,499, and continued decrease in 2010 to US$ 5,006. In 2007, the overall inflation rate was 6.5%, and after fluctuaion between 11.7% in 2008 and 8.4% in 2009 it droped again to 6.5% in 2010. According to the PHI, from 2006 to 2008 there was steady increase of full-time employees in the public health care sector; from 108,975 in 2006 to 114,317 in 2008. In 2009, the number of full-time employees slightly declined to 114,175 and 114,432 in 2010. There was constant increase in total number of employees in the public health care sector, from 125,081 in 2006 to 129,357 in 2008. In 2009, the total number of employees decreased to 128,694 and in 2010 to 122,695. At the same time, the total expenditure of human resources in the health sector as the percentage of total health expenditure declined from 37.7% in 2006 to 34.7% in 2010. The public health sector salaries after steady increase from 59.9% of total health expenditure in 2006 to 61.2% in 2007 and 2008, decreased to 56.2% in 2010. The unemployment rate for medical doctors almost doubled in 2010 as compared to 2006. Conclusion. Preliminary study results showed that the world economic crisis had negative impact not only on GDP growth rate, the inflation and unemployment rate, but on the public health sector workforce, their salaries and unemployment rate in Serbia.

Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (€ 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (€ 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anomalies (0.33%). Conclusion. Comparative analysis showed that the value of overall spending in healthcare increased three times in 2009 as compared to 2004.

Introduction. Collecting data about the structure and function of private health care sector in Serbia and its inclusion in joint health care system is one of the most important issues for making decisions in health care and getting more accurate picture about the possibilities of health care system in Serbia. The aim of this analysis was to compare health institutions, personnel, visits, number of hospital days and morbidity by ICD-10 classification of diseases in public and private health sector in South Backa, Nisava, Toplica and Belgrade district in 2009. Material and Methods. A retrospective comparative analysis was performed using data about private providers of health services obtained from the Institute of Public Health Novi Sad, the Institute of Public Health Nis and the City Institute of Public Health Belgrade. Data about personnel and morbidity in public health sector in Serbia for 2009 was obtained from the Center for Information Technology of the Institute for Public Health of Serbia. Data about public health facilities in South Backa, Nisava, Toplica and Belgrade district in 2009 was obtained from Serbian Chamber of medical institutions. Results. The results showed that health care was provided in Belgrade district in 2009 by total of 1,051 employees in private sector and 31,404 in public sector. We found that public sector had a far wider range of health facilities than private sector, which was mainly due to the number of clinics. In South Backa district private sector had 323 practices, the district of Belgrade 655 and Nisava and Toplica district 173. Seventeen times more visits to households (4,650,423 vs. 267,356) and 111 times greater number of hospital days was provided in public health sector as compared to private health sector (781,083 vs. 7,023) in South Backa district. Conclusion. The conclusion of this analysis was that public health sector has remained the foundation of health care system in Serbia. Private health sector is expanding, but its structure and scope of services is still undervalued as compared to public sector.

Introduction. Primary health care in the Republic of Serbia is predominantly funded by the Republic Health Insurance Fund (RHIF). From the total income of health centers and institutes at the primary level, with no pharmacy and pharmacies (Kosovo excluded), 84% in 2008 was paid by RHIF. Frequency of participation ranged from 63-95% and it was stable in all observed years. The aim of this study was to determine the expenditures for primary health care for each insured person in statistically defined districts in the Republic of Serbia, with an emphasis on prevention participation. Material and Methods. Retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia (IPHS) and financial data from the RHIF for the period 2006-2008 was done. Results. Observed by the districts in 2008, in Vojvodina, the lowest expenditure for primary health care had North Backa District (5,207 RSD) and greatest was in West Backa District (6,632 RSD) per capita. In the central Serbia territorial difference was much greater, ranging from 3,574 RSD in the District Morava to 6,701 RSD per capita in the District Toplica and Nisava. Expenditures for direct health care of RHIF per capita in the reporting period continuously have grown. Conclusion. The results showed that the largest cost for primary care for the insured person in the districts of Serbia was registered in the Nisava and Toplica (6,701 RSD) and lowest in the district of Morava (3,574 RSD) per capita.

Introduction. The dental health sector reform in Serbia has commenced in order to implement health policy changes. Assessment of legally regulated citizens rights to preventive dental examination, revision of those rights and their promotion are one of the dental health reform priorities. Objective. The objective of this study was to assess the utilization of preventive dental examination (PDE) in Serbia in 2006 among different subject groups and different districts and to analyze financial resources spent for those measures. Also, study aims were to compare the utilization of rights to preventive dental examination in Republic of Serbia in period between 2003-2006. Methods. The retrospective analytical study of Public Health Institute and Republican Statistical Office data were conducted. The comparative analytical method was used for assessment of preventive dental examinations within the given time frame from 2003 to 2006. Results. Results achieved in realization of PDE show a broad spectre of district discrepancies. The variation factor depending on preventive examination or population group it is related to varies from 26.73% to 90.88%. Conclusion. Realization of preventive dental examinations in the Republic of Serbia was significantly lower than projected in the period 2003-2006.

Introduction. An ideal endodontic sealer should adhere firmly both to dentin and to gutta-percha. Objective. The aim of this study was to evaluate the adhesion of the root canal filling to dentin and gutta-percha using scanning electronic microscopy (SEM). Methods. The sealing ability of endodontic sealers to dentinal walls of the root canal was assessed in recently extracted human single canal premolars. Twenty teeth were prepared using the crown-down technique and irrigated with 3% NaOCl. A total of 20 samples were divided into two groups. The root canals were obturated using Ketac-Endo Aplicap and GutaFlow. The sealing ability and adhesion properties at the sealer-dentin interface were studied using SEM and the results were rated from 1 to 3; extremely good adhesion (rated 1), good adhesion (rated 2) and a relatively good adhesion (rated 3). Results. The results showed extremely good adhesion on Ketac-Endo and GuttaFlow dentin interface. GuttaFlow has strong adhesion (rated 1) to gutta-percha in comparison with Ketac-Endo to gutta-percha interface (rated 2). Conclusion. New GuttaFlow filling material has a strong sealing ability and excellent adhesion to dentinal walls and gutta-percha cones. Ketac-Endo showed excellent bond to dentin with a slightly weaker adhesion capacity to the gutta-percha cones in comparison to GuttaFlow.

Introduction. The first maxillary molar is a tooth with three roots, and mesiobuccal one is with the most complex canal morphology. Factors influencing variations of its morphology are numerous, and may significantly complicate endodontic treatment. Objective. The objective was to investigate the number, configuration and curvature orientation of the mesiobuccal root canals in the maxillary first molars. Methods. The study was conducted on 200 mesiobuccal (MB) roots of extracted first molars in human subjects using radiography. In each canal Flexofile was introduced until reaching the apical foramen and the root was then radiographed in series from two projections. Number of root canals (MB1, MB2 and MB3), configuration according to Vertucci classification, and the orientation of the curvature were established. Relevant statistical parameters and the significance of differences were computed (p

Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA)' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was low as the consequence of relatively low level of GDP in Serbia. Conclusion. Establishing NHA provided a pattern of national healtcare spending and allowed a comparison of healthcare system in Serbia with the systems of other countries. Analysing a period 2003- 2006 revealed a similarity between Serbia and the countries of the European Unity in regard to the level of average financial resources allocation for healthcare expressed as a percentage of GDP, as well as in regard to financiers in the system of healthcare. A high purchasing power disparity, however, in healthcare services was observed between the population of Serbia and other European countries.

Endodontic treatment of the teeth with severe root canal curvatures has become one of the greatest problems in clinical practice. Recently, new instruments and techniques have been introduced in the endodontic procedure. The aim of this study was, on the basis of clinical practice, to show the possibilities of the endodontic treatment in the teeth with severely curved root canals, after dependable decision about endodontic instruments and techniques. This article presents a complete endodontic procedure in two teeth with different curvature shape of the root canal in patients that were treated at the Department of Restorative Dentistry and Endodontics, School of Dentistry, Belgrade. Coronal to apical 'crown down' technique was used for the root canal preparation with hand NiTi ProTaper instruments with progressive multicone design. The main reasons for choosing manual technique were complexity, shape of presented curvatures and better tactile sensation control of canal instruments in order to avoid possible mistakes and complications. Clinical X-rays of the teeth with permanent obturation clearly showed that extremes of the root canal morphology could be successfully solved by the right choice of all factors during endodontic procedure.

Introduction: The importance of studying management in one of the most sensitive and complex areas of human endeavor that is healthcare is of great significance for providing high quality and efficient easily-accessible healthcare in the future. Studying the challenges that need to be overcome towards achieving this goal is of great importance not only from the viewpoint of scientific management theory but primarily to help bring about strategically important decisions that are crucial for the continued evolution and reformation of the healthcare system, in which the employees have a new, much more complex role. The objective: was to more thoroughly study, describe and understand the role the employees have in the transformation of health care management. Material and method: During this research the material used was foreign and local literature, processed using the Analytical method as well as the Observation and Comparative methods. Conclusion: In the transformation of the health care management a very important role is played by the health care employees. Without the transformation of the current practice and significant changes in both the structure and work ethic of all the employees in health care services (nurses and people in management alike) there will be no improvement in the health care system overall.

Introduction: Global markets and competition, fast changes, the explosion of information technology, integration processes in international relations are some of the initial factors for changes in health care organizations and their management. Management represents an evolving new generic function of all organizations of social significance across the world. Managers in the health sector have exceptionally complex roles that require new skills and methods. The objective of this study is to analyze in grater detail, explain and describe the role and necessary skills of a health care manager in the strategic transformation of health care management. The modern health care manager can get the best results by strengthening human resources and meeting employees' personal needs in accordance with the global and specific goals of the health care institution. The manager is at the same time a mentor and a facilitator, putting to best use the forementioned transformation strategies whilst expending the resources carefully, strengthening the collective efforts, involving employees in the decision-making process and motivating teamwork and collective problem-solving.

Introduction: The sealing ability of endodontic sealers to dentinal surfaces of root canals is an important feature of these materials. Root canal sealers are necessary to seal the spaces between the dentinal walls and the obturating core material. Aim: The aim of this study was to examine the sealing ability of two endodontic sealers to dentin walls and guttapercha cones using scanning electron microscopic analysis-SEM. Materials and Methods: 24 recently extracted human single-rooted teeth were instrumented and allocated to two groups; root canals were filled with either GuttaFlow (Roeko,Germany), a new endo-sealer (group 1), or Acroseal (Septodont, France), a calcium hydroxide based sealer, (group 2). The sealing ability and adhesion properties of the sealer-dentin interface were studied using SEM. Results: The specimens filled with GuttaFlow showed smooth contact lines at the sealer-dentin interface, and this material also showed strong bonding and good adaptation to guttapercha cones. Acroseal showed good adhesion to dentin walls, and bonding surface was represented as a slightly curved contact line, with some gaps on material-dentin walls and guttapercha cones interface. Conclusion: New GuttaFlow material possesses strong sealing ability and excellent adhesion to dentin walls and guttapercha cones. Acroseal showed good bonding to dentin and slightly weaker adhesion to guttapercha cones, in comparison to GuttaFlow.

Introduction. Due to the inability to sterilize infected root canals during cleaning and shaping, contemporary endodontic materials are expected to possess certain antibacterial effect. Aim. The aim of this study was to evaluate antibacterial effect of four contemporary endodontic materials: Acroseal, AH-Plus, Gutta Flow and Mineral Trioxide Aggregate (MTA) in vitro. Materials and Methods. Antibacterial effect of tested materials was evaluated against bacterial species Enterococcus faecalis ATCC 29212 using the agar diffusion test. Results. Based on the obtained results, it can be concluded that freshly mixed Acroseal and AH-Plus exhibited significant antibacterial effect while Gutta Flow and MTA did not present any antimicrobial potential in this study. Conclusion. Endodontic sealers tested in this study, freshly mixed Acroseal and AH-Plus, possess certain antibacterial effect whereas in solid state this effect is not present. .

Introduction. Oval root canals are all groups of human teeth. In such canals it is a challenge to fulfill the necessary preconditions for a successful outcome of root canal therapy - complete cleaning, shaping and obturation. Aim. The aim of this study was to investigate the shape and diameter of root canals in the apical and middle third of human mandibular molars and premolars, to determine the prevalence and extent of long oval canals. Materials and methods. The study was carried out on 80 extracted human teeth, 40 molars and 40 premolars. The teeth were placed in a specially designed muffle mould and embedded in transparent acrylic resin. After the polymerization of the acrylic resin, the teeth were taken out of the mould and sectioned at levels 3 and 6 mm from the apex. The cross-sections were photographed under 30Х magnification using a digital camera. The long and short canal diameter were measured on the images and their ratio calculated. Results. In the apical third 22% of the premolars and 35% of the molars had oval root canal morphology. In the middle third 36% of premolars and 41 % of molars. Conclusion. Root canals of mandibular molars and premolars are often oval in their cross-section. They seem to be more frequently oval in their cross-section than previous studies have shown.

Aim.To evaluate the crown-down preparation technique, and the use of hydroxylapatite based material for the definitive root canal obturation. Methods. The investigation included 20 single-canal roots with chronic periapical inflammatory lesion. Biomechanical medicamentous canal preparation was done using the double flared technique with balanced force, and the obturation was performed with hydroxylapatite sealer (unicone technique). Clinical and radiographic check-up performed 12 months after the treatment, used the following parameters: pain, swelling, percussion and palpation sensitivity, and the presence of fistula. Results. The obtained results showed a successful treatment in 18 cases, while in the 2 cases the treatment failed. Conclusion. These findings suggested that the crown-down preparation technique efficiently cleaned and shaped the root canal, and that the hydroxylapatite-based material created the homogenous and hermetic root canal obturation, so this methodology could be recommended for the endodontic therapy.

The objective of this paper was to show the historical perspective of the „long centric" occlusal concept and its importance in the modern dentistry, especially from the gnathological aspect. The „long centric" concept represents therapeutic modality used in modern dentistry and occlusal adjustment in all patients showing differences in strong and weak closure of the lower jaw starting from the position of physiological rest/long centric" concept is applied only for anterior teeth and occlusal movements from rather than toward the center. Whenever the „long centric" parameters are not adequate, occlusal disturbance, resulting from the „wedge" effect during the initial closure of the lower jaw, is present. Different degrees of abrasion or hypermobility of the teeth are often the result of the above-mentioned occlusal disturbances and can potentially trigger bruxism and malfunction. Modus procedendi should be the regular approach of every dentist to any occlusion, because only the built-in „long centric" efficiently contributes to the occlusal stability of the anterior portion of the dentition. All occlusions should be routinely tested regarding their need for „long centric", especially when the extensive therapeutic interventions (conservative, prosthetics) of the occlusal complex are required.