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Introduction. Root resorption may occur as a consequence of avulsion injury and may lead to the progressive loss of tooth structure. The aim was to report the outcome of root resorption treated with mineral trioxide aggregate in a replanted immature permanent incisor after 10 years of follow-up. Case outline. This case presents external root resorption that was detected 18 months after the avulsion injury in a nine-year-old child. Apical portion of the canal was filled with mineral trioxide aggregate and the rest of the canal was filled with a canal sealer and gutta-percha. Control examinations were performed six months after the completion of the endodontic treatment and afterwards yearly. The tooth was asymptomatic clinically and radiographs did not show progression of root resorption up to four years of follow-up. Infraposition of the injured tooth was detected five years after the replantation, but without significant radiographic changes, until the eight-year follow-up, when root resorption was detected again. However, the tooth was still hard and symptomless at the 10-year follow-up. Conclusion. Mineral trioxide aggregate may have an important role in the preservation of replanted immature teeth for a prolonged period.

Introduction/Objective. The purpose of this study was to compare clinical efficacy of casein phosphopeptide – amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) with 0.05% NaF, and to assess their influence on the quality of life among individuals with Sjogren’s syndrome. Methods. Thirty patients were randomized into three groups treated with different remineralizing agents: CPP-ACP, CPP-ACFP, and 0.05% NaF. Oral health was evaluated at the beginning of the study, after 28 days (short-term effects), and after six months. The diagnosis of dental caries was performed using the decayed, missing, and filled teeth (DMFT) / decayed and filled surfaces (DFS) criteria. Enamel demineralization was visually examined using the white spot lesion index (Gorelick). The gingival health was evaluated with the gingival index (Loe–Silness). Assessment of oral hygiene was done using the simplified oral hygiene index (Greene–Vermilion). The Xerostomia Inventory was used to quantify dry-mouth symptoms. The oral health-related quality of life was analyzed using the short form of the Oral Health Impact Profile (OHIP-14). Results. During the evaluation period, caries increment was not significant. Considerable regression of white spot lesions was noted in all three experimental groups (p < 0.001). No significant improvement in gingival health and oral hygiene was observed. Physical pain was decreased in all three experimental groups, and subjective feeling of dry mouth was reduced in CPP-ACP and CPP-ACFP groups. Conclusion. CPP-ACP and CPP-ACFP may reduce the caries activity and relieve the dry-mouth symptoms in patients with Sjogren’s syndrome.

Introduction/Objective. The purpose of this study was to assess effectiveness of endodontic root canal procedures in traumatized permanent teeth with necrotic pulps and chronic periapical lesions after definitive obturation with mineral trioxide aggregate (MTA) products. Adobe Photoshop CS (San Jose, CA, USA) image-analysis software was used for healing assessment. Methods. Twenty-seven traumatized single-rooted permanent teeth diagnosed with necrotic pulps and chronic periapical lesions were treated with non-surgical procedure using a tri-antibiotic paste and calcium hydroxide as intra-canal medication. Definitive obturation was performed with ProRoot MTA (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) or MTA+ Cerkamed (Cerkamed, Stalowa Wola, Poland). Control follow-ups were done three, six, 12, and 24 months following the completion of treatment. Results. The positive clinical outcome was recorded in 24 (88.9%) cases, while radiographic success was present in 26 (96.3%) cases. A statistically significant decrease in the sizes of periapical lesions was consistently observed at follow-up periods (p < 0.001). There was no statistically significant difference between the two tested MTA materials (p > 0.05). Conclusion. The MTA products were effective for the root canal obturation and appeared to contribute to the significant reduction or complete regression of periapical lesions in teeth treated. The presented procedure may be proposed for everyday clinical practice. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 172026]

Background/Aim. The main task of endodontic treatment is to eliminate pathologically altered tissue, to disinfect root canal space and to obtain its three-dimensional hermetic obturation. The main purpose of this study was to evaluate antimicrobial activity of new endodontic nano-structured highly active calcium silicates based materials albo-mineral plyoxide carbonate aggregate (ALBO-MPCA) and calcium silicates (CS) in comparison to mineral trioxide aggregate (MTA+) and UltraCal XS (CH). Methods. The antimicrobial activity of materials was tested against Staphylococcus aureus (ATCC 25923) and Enterococcus faecalis (ATCC 14506) strains, and following clinical isolates: Rothia dentocariosa, Enterococcus faecalis, Staphylococcus aureus, Streptococcus anginosus and Streptococcus vestibularis using a double layer agar diffusion test. The pH measurements were performed using the pH meter. Total amount of released ions was determined by inductively coupled plasma optical emission spectrometry (ICP-OES). Results. All tested materials showed the best antibacterial potential after 1 h of incubation. After 3h and 24h of the incubation period, the antibacterial potential of all tested materials were similar. The Agar diffusion test showed that ALBO-MPCA, CS and MTA+ had similar inhibition zones (p > 0.05), except in the activity against Staphylococcus aureus where ALBO-MPCA showed better antimicrobial properties than MTA+ in 3h and 24h of the incubation period (p < 0.05). Following 24h of the incubation, the inhibition zones were the strongest with CH against Staphylococcus aureus (16.67 ± 2.34 mm) followed by ALBO-MPCA (14.67 ± 1.21 mm) and the weakest with CS against Enterococcus faecalis (6.50 ± 1.76 mm). CH showed the highest pH, followed by ALBO-MPCA, CS and MTA+. Conclusion. The expressed antibacterial effects indicate that materials based on nano-structured highly active calcium silicates represent effective therapeutic agents for root canal obturation in one-visit apexification treatment, therefore they are recommend for further examination and clinical trials as they are proposed for MTA substitution. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 172026 Grant no. TR31079]

We report of a 39 years old male patient who was admitted to hospital for a surgical treatment of endocarditis of the prosthetic aortic valve. Just after surgery, he had developed a severe inflammatory response with acute kidney and liver injury. Because of that, beside the usual therapy, on the second postoperative day, continuous renal replacement therapy (CRRT) started in CVVHDF mode with hemadsorption using Cytosorb. The Cytosorb therapy is based on an extracorporeal blood purification that reduces excessive levels of inflammatory mediators. After 5 days of CRRT and Cytosorb therapy patient was stable, extubated, with normal kidney and liver function. On the next day, patient was unstable again with significant leukocytosis. Performed reoperation was done due to cardiac tamponade and after that CRRT and Cytosorb therapy were re-established. A few hours later patient was hemodynamically stable. Summary: The Cytosorb treatment can be very useful in postoperative treatment of acute kidney injury and sepsis in patients after the surgical treatment of bacterial endocarditis.

Stem cells have shown great potential for in vitro tissue engineering, regenerative medicine, cell therapy and pharmaceutical applications. All these applications, especially in clinical trials, will require guided production of high-quality cells. Traditional culture techniques and applications have been performed for the majority of primary and established cell lines and standardized for various analyses. Still, these culture conditions are unable to mimic dynamic and specialized three-dimensional microenvironment of the stem cells' niche from in vivo conditions. In an attempt to provide biomimetic microenvironments for stem cells in vitro growth, three-dimensional culture techniques have been developed. In our study advantages of newly developed porous scaffolds as the most promising in vitro imitation of niche that provides physical support, enables cell growth, regeneration and neovascularization, while they are replaced in time with newly created tissue was explained. Furthermore, dynamic cultivation techniques have been described, as new way of cell culturing that will be the main subject of our future research. In that manner, by developing an optimal dynamic culturing method, high-quality new cells and tissues would be possible to obtain, for any future clinical application.

Introduction. Implantation of the new-generation left ventricular assist device (LVAD) is an efficient therapeutic option as a bridge to transplantation in adults, as well as in children and adolescents with small body surface. The aim of this work was to present a case of a successful surgical treatment of terminal heart failure in a male adolescent who had an LVAD implanted as a bridge to heart transplantation. Case outline. The patient, a 17-year-old male, was admitted with the end-stage heart failure due to the dilated cardiomyopathy and implanted LVAD. Fourteen months after LVAD implantation, a successful “second stage” surgical procedure was performed – orthotopic heart transplantation preceded by the LVAD explantation. Conclusion. Long-term mechanical circulatory support is an effective and safe method in treatment of the end-stage heart failure as a bridge to transplantation in the adolescent period.

The provision of universal postal service involves high costs for operator, especially in rural areas. The aim of this paper is to propose and test tool for managing the cost of providing universal postal service and maintaining the postal network in order to facilitate understanding of the problem in the sector. The proposed approach use standard prices and standard quantities (the redefined number of postal units, the number of employees, etc.) as well as average costs for calculation of the costs of the universal postal service and postal network. The methodology provides the efficiency analysis, benchmarking and identification of causes of poor performance of management and resource allocation. It can be used for postal operators that do not have modern accounting systems.

Background/Aim. Apical periodontitis is mainly caused by bacterial infection within the root canal and periapical bone destruction which are prominent features of this lesion. The aim of this study was to determine the quantity of interleukin-1β in the tissues of periapical lesions and to analyze its relationships with: lesion size, previous treatments and pathohistological finding of involved teeth. Methods. Periapical tissues were obtained from patients undergoing periapical surgery. Out of all 80 cases included in the study, 24 had no previous endodontic treatment (open lesions), 37 were with endodontic failure (closed lesion) and in 15 cases root canal retreatment was performed few months before the surgery. By excluding four samples, the total of 76 samples, consisted of periapical lesions and the apical part of the tooth root, was collected. Each periapical tissue sample was divided into two equal parts. The one half of each lesion was used for quantification of interleukin-1β in tissue homogenates by the enzyme-linked immunosorbent assay (ELISA) method. The other part of each lesion was used for histopathological evaluation. Results. For each of the tissue homogenates, the quantity of interleukin-1β was measured, and it ranged from 0.6 pg/mg up to 74 pg/mg. There was no significant difference between the symptomatology and amount of interleukin-1β. Statistical data analysis showed a moderate correlation between lesion size and interleukin-1β measured values. The highest levels of interleukin-1β corresponded with chronic lesions in the stages of acute exacerbation and granulomas in early developing stages. Persistant granulomas, scar tissues, non-inflamed cysts and teeth with recently finished endodontic treatments showed a significantly lower level of interleukin-1β. Conclusion. The study results suggest that the differences in quantity of interleukin-1β correlate to lesion progression and phases of development.

Heart transplantation is a method of choice for the surgical treatment of a terminal stage of cardiac insufficiency. The lack of donors that all health systems in the world are experiencing has led to the intensive development of devices for permanent mechanical support of circulation. Implantable devices, such as the LVAD circulation pump, are widely accepted as a therapeutic option for improving the quality of life and survival of patients with terminal heart failure. Indications for incorporation include bridge to transplant (BTT), bridge to candidacy (BTC) and destination therapy (DT). The article presents a case of successful surgical treatment of terminal heart failure. The patient was implanted with a circular support device for left heart chamber for the maintenance of vital parameters and bridging the period to heart transplantation.

Background/Aim. The longevity of a dental restoration may be predicted to some degree by its adhesive ability, and this, in turn, can be measured by bond strength testing between restorative materials and tooth structure. The aim of this study was to test an innovative joggle lap shearing jig that integrates the tooth and the entire biomechanical unit into testing, to compare the shear bond strengths of Class I occlusal composite restorations in deep cavity preparations lined with Dycal, Dycal LC, conventional glass ionomer or resin-modified glass ionomer. The mode of failure (adhesive, cohesive, mixed) after debonding was determined by stereomicroscopy. Methods. A total of 150 standardized occlusal cavities were prepared and divided into five groups. The group I cavities (n = 30) were coated with adhesive (ExciTE®F) and filled directly with composite (TetricEvoCeram). The group II and III cavities were lined with Dycal (n = 30) or Dycal LC (n = 30) before placing composite. The groups IV and V specimens were based with Fuji IX (n = 30) or Fuji II LC (n = 30). Shear bond strengths were determined with a universal testing machine and fractured bonding sites were analyzed under stereomicroscope. The mean bond strengths were analyzed using one-way ANOVA test (p < 0.05) and the means between the groups were analyzed with Student’s t-test. Results. The shear bond strength (MPa) of composite restorations in cavities without base (23.91 ± 4.54) was higher than cavities lined with Fuji II LC (17.45 ± 2.74), Fuji IX (8.76 ± 2.57), Dycal LC (13.07 ± 1.84) or Dycal (6.12 ± 1.28). The results using the jogged lap shearing jig were consistent with the literature. Conclusion. The shear bond strength of occlusal composite restorations in deep cavities without liners was greater than cavities lined with Fuji II LC > Fuji IX > Dycal LC > Dycal.

Introduction. Biodegradable porous scaffolds are found to be very promising bone substitutes, acting as a temporary physical support to guide new tissue regeneration, until the entire scaffold is totally degraded and replaced by the new tissue. Objective. The aim of this study was to investigate cytotoxicity of a synthesized calcium hydroxyapatite based scaffold, named ALBO-OS, with high porosity and optimal topology. Methods. The ALBO-OS scaffold was synthesized by the method of polymer foam template. The analysis of pore geometry and scaffold walls’ topography was made by scanning electron microscope (SEM). The biological investigations assumed the examinations of ALBO-OS cytotoxicity to mouse L929 fibroblasts, using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromidefor (MTT) and lactate dehydrogenase (LDH) tests and inverse phase microscopy. Results. The SEM analysis showed high porosity with fair pore distribution and interesting morphology from the biological standpoint. The biological investigations showed that the material is not cytotoxic to L929 cells. Comparison of ALBO-OS with Bio-Oss, as the global gold standard as a bone substitute, showed similar results in MTT test, while LDH test showed significantly higher rate of cell multiplication with ALBO-OS. Conclusion. The scaffold design from the aspect of pore size, distribution, and topology seems to be very convenient for cell adhesion and occupation, which makes it a promising material as a bone substitute. The results of biological assays proved that ALBO-OS is not cytotoxic for L929 fibroblasts. In comparison with Bio-Oss, similar or even better results were obtained. [Projekat Ministarstva nauke Republike Srbije, br. 172026]

Introduction. Models of excellence are considered a practical tool in the field of management that should help a variety of organizations, including dental, to carry out the measurement of the quality of provided services, and so define their position in relation to excellence. The quality of healthcare implies the degree within which the system of healthcare and health services increases the likelihood of positive treatment outcome. Objective. The aim of the present study was to define a model of excellence in the field of dental healthcare (DHC) in the Republic of Serbia and suggest the model of DHC whose services will have the characteristics of outstanding service in the dental practice. Methods. In this study a specially designed questionnaire was used for the assessment of the maturity level of applied management regarding quality in healthcare organizations of the Republic of Serbia. The questionnaire consists of 13 units and a total of 240 questions. Results. The results of the study were discussed involving four areas: (1) defining the main criteria and sub-criteria, (2) the elements of excellence of DHC in the Republic of Serbia, (3) the quality of DHC in the Republic of Serbia, and (4) defining the framework of the model of excellence for the DHC in the Republic of Serbia. The main criteria which defined the framework and implementation model of excellence in the field of DHC in Serbia were: leadership, management, human resources, policy and strategy, other resources, processes, patients’ satisfaction, employee’s satisfaction, impact on society and business results. The model had two main parts: the possibilities for the first five criteria and options for the other four criteria. Conclusion. Excellence in DHC business as well as the excellence of provided dental services are increasingly becoming the norm and good practice, and progressively less the exception.

Introduction. A non-carious lesion (NCL) is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. Objective. The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH), as well as their possible risk factors in children, in the population of the city of Novi Sad. Methods. A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE) index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. Results. The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (χ2=3.86, df=1, p=0.04). The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65%) and canine permanent teeth (51%). BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36%) did not respond to air stimulus, while most patients with permanent teeth (74.29%) did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. Conclusion. Research has shown that despite the lack of subjective symptoms, these lesions have distinct clinical characteristics. The fact that they occur even in deciduous dentition justifies the need for further investigations.

Introduction. It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. Objective. The aim of the study was to determine the oral health status of children with asthma and to evaluate the oral health parameters according to the medications and severity of the disease. Methods. The study group consisted of 158 children with asthma and 100 healthy control subjects aged 2-18 years. The diagnosis of dental caries was performed using the Decayed, Missing, and Filled Teeth (DMFT/dmft) criteria. The oral hygiene, periodontal status and gingival health were assessed with the Simplified Oral Hygiene Index (Greene-Vermillion), Community Periodontal Index of Treatment Needs and Gingival Index (Löe-Silness), respectively. Results. Thirty (19%) patients with asthma and 43 (43%) healthy children were caries-free (p

The first record of scientific medicine in Serbia has been found in the early of 12th century. For centuries lifestyle, nutrition, natural environment, armies passing through, cultural heritage, and prejudice have affected healthcare in Serbia. Until 1820, Serbia has not had any educated doctor. Fourteen district physicians from 1839 and Dr. Karlo Beloni, to the last one, Dr. Selimir Đorđević - have spent part of their professional careers in Jagodina. All of them have had influence on raising health culture of Jagodina and its population and helped to overcome easily and quickly all existing diseases and epidemics. The Jagodina Hospital has been working without interruption for 147 years and represents one of the oldest healthcare institutions in Serbia.

Bioactive glasses are often used nanomaterials in tissue engineering of bone and soft tissue. Many newly synthesized materials for applications in medicine and dentistry are based on these bioactive substances. Bioactive glass is usually used as a scaffold or as an implant coating on implants and it allows fast formation of apatite layer with positive effect on osteoblasts proliferation. These biomaterials play an important role in dentistry and endodontics. This study is mostly part of the monograph titled 'Nanomedicine, the Greatest Challenge of the 21st Century', that for two years has received attention from professional and scientific community in various fields. Information presented in this paper highlight structural characteristics of bioactive glasses that have a significant role in bone tissue engineering.

Introduction/Aim. Avulsions are severe dental injuries with high impact on patients’ quality of life due to prolonged treatment and possible severe complications. The aim of the study was to analyze the epidemiological factors related to the occurrence, treatment and outcome of avulsions in Serbian children. Methods. This research included 2,194 patients aged 1-18 years with traumatic dental injuries. The history, demographic, clinical and radiographic data of the patients were observed from dental medical records. Results. A total of 266 avulsions were observed in 207 patients. The frequency of avulsions was 12% in primary dentition and 5% in permanent dentition. A statistically significant relationship between place, cause of avulsion and outcome was observed. Replantation of permanent teeth was performed in 46.7% with a mean time 6.9 h. Almost a half of permanently avulsed teeth (48.7%) were not retrieved from the accident site and 11.3% of replanted teeth were transported in adequate media. The observed incidence of complications was 31.9%. Conclusions. Replantation was not performed in more than a half of all eligible teeth due to either loss or inadequate/delayed transport, which emphasizes the need for preventive strategies and health education in population. [Projekat Ministarstva nauke Republike Srbije, br. 172026]

Background/Aim. Autogenous bone grafting has been the gold standard in clinical cases when bone grafts are required for bone defects in dentistry. The study was undertaken to evaluate multilevel designed carbonated hydroxyapatite (CHA) obtained by hydrothermal method, as a bone substitute in healing bone defects with or without corticosteroid treatment in rats as assessed by histopathologic methods. Methods. Bone defects were created in the alveolar bone by teeth extraction in 12 rats. The animals were initially divided into two groups. The experimental group was pretreated with corticosteroids: methylprednisolone and dexamethasone, intramuscularly, while the control group was without therapy. Posterior teeth extraction had been performed after the corticosteroid therapy. The extraction defects were fulfilled with hydroxyapatite with bimodal particle sizes in the range of 50-250 μm and the sample from postextocactional defect of the alveolar bone was analyzed pathohystologically. Results. The histopatological investigations confirmed the biologic properties of the applied material. The evident growth of new bone in the alveolar ridge was clearly noticed in both groups of rats. Carbonated HA obtained by hydrothermal method promoted bone formation in the preformed defects, confirming its efficacy for usage in bone defects. Complete resorption of the material’s particles took place after 25 weeks. Conclusion. Hydroxyapatite completely meets the clinical requirements for a bone substitute material. Due to its microstructure, complete resorption took place during the observation period of the study. Corticosteroid treatment did not significantly affect new bone formation in the region of postextractional defects. [Projekat Ministarstva nauke Republike Srbije, br. 172026]

In vitro chlorophyll a degradation by horseradish peroxidase in the presence of the resorcinol was investigated in this work, and the influence of pH and temperature was particularly studied. Chlorophyll a degradation was followed by UV-VIS and HPLC. Chlorophyll a was degraded when hydrogen peroxide was added into reaction mixture containing chlorophyll fraction, horseradish peroxidase, resorcinol and phosphate buffer. HPLC analysis has identified the main degradation product of chlorophyll a as 132 -hydroxychlorophyll a. The degradation was traced at different temperatures and pH values. The increasing temperatures led to increase of chlorophyll a degradation, with a maximum at 37 °C. The degradation also increased with increasing pH values, reaching maximum at pH 6.

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Introduction. Comprehensive epidemiological data regarding factors associated with traumatic dental injuries are scarce. Objective. The aim of the present study was to assess the frequency and analyze the factors associated with traumatic dental injuries in Serbian children. Methods. Research included children and adolescents with traumatic dental injury aged 0-19 year during the period from 2003 to 2010, in four University Dental Centres in Serbia: Belgrade, Nis, Novi Sad and Kragujevac. Patient history, demographic, clinical and radiographic data were obtained from dental trauma forms. Results. Total of 2,194 patients (748 girls, 1,446 boys) (χ2=222.1; p

Introduction. Dental injuries in immature permanent teeth often result in endodontic complications. Apexification technique using calcium hydroxide is associated with certain flaws, such as long treatment time, the possibility of tooth fracture and incomplete calcification. The use of an apical plug employing mineral trioxide aggregate (MTA) is an alternative treatment option. Case report. We reported the successful treatment of 4 maxillary incisors (in a 7-year-old boy and a 10-year-old girl) with open apices and periapical lesions. Apical portions of the canals were filled with MTA plugs in both cases. Coronal parts of the root canals were filled with gutta-percha and sealer. Clinical findings were clear 6 months after the definite obturation with no pathological changes on the radiographs in both cases. Conclusion. The use of MTA for apical plugging appears to be a valid treatment option in traumatized immature teeth with endodontic complications.

Horseradish peroxidase (HRP), a highly-investigated member of the peroxidase family has been known, among many other biological activities, to catalyze the oxidation of flavonoids and phenolic substrates overall, including quercetin. On the other hand, quercetin is very well known for its antioxidant activities, which in the case of UV external radiation is exibited partly in a preventive manner since it is an excellent UV-absorber. Therefore the aim of this investigation is to study quercetin oxidation by HRP in phosphate buffer under the conditions of UV-stress, i.e. continuous, prolonged UV-B irradiation. The results show that while UV-B irradiation affects the activity of HRP, and the overal rate of quercetin oxidation by HRP, it probably has very little effect on it for longer UV-B-irradiation periods (>30 min). [Acknowledgements. This work was supported by the Ministry of Education and Science of the Republic of Serbia under Project No.TR-34012 and OI-172044]

Introduction. Mineral trioxide aggregate (MTA) is one of the most commonly used materials in endodontics. Given its shortcomings, there is an intensive search for new materials. Calcium-silicate phase (CS phase) is a new material synthesized by the method based on a combination of sol-gel process and self-propagation synthesis which can significantly improve setting time through accelerated hydration. The aim of this study was to explain the mechanisms of hardening of CS phase in aqueous medium as similar mechanism is expected in contact with body fluids. Materials and Methods. CS phases Ca3SiO5 (C3S) and 2β-CaSiO4 (β-C2S) were synthesized from CaCl2•5H2O (Merck, Germany). To investigate the process of hydration, CS were mixed with water and kept at 37 °C for 28 days in closed polyethylene containers. Analysis of the composition of samples before and after immersion in water for 1, 3, 7 and 28 days was performed using X - ray diffractometry and IR. Results. XRD patterns for hydrated samples during 1, 3, 7 and 28 days showed that the amount of hydrated tobermorite phases relative to the amount of CS phase changes with the time of hydration. After 1 day, in addition to the hydrated phases, a significant amount of untransformed β-C2S and C3S were found while after 28 days hydrated CS phase was completely transformed to tobermorite with a small amount of portlandite. Conclusion. Using combined method of sol-gel and self-propagating waves at high temperature very active nanostructured silicate phases were obtained. Hydration process of CS phases was analyzed using XRD and FTIR, the mechanism of hydration was proposed and it was pointed to the difficulties in determining the exact reaction as well as the problem of determining the exact structure of tobermorite. [Projekat Ministarstva nauke Republike Srbije, br. 172026]

Background/Aim. Retention of fissure sealants and good adaptation to enamel are essential for their success. Fluoride releasing resin-based materials are widely accepted for pit and fissure sealing, but newly designed glass ionomers can serve as a good alternative. The aim of this study was to evaluate microleakage and sealing ability in vitro, and to clinically assess two fluoride releasing fissure sealants. Methods. The sample for experimental study consisted of 20 freshly extracted intact human third molars, divided in two experimental groups according to the sealing material: fluoride releasing resin-based (Heliosel F) and glass ionomer (Fuji Triage) material. Digital images and scanning electron microscope were used to assess microleakage and adaptation ability. Sample for clinical study consisted of 60 children, aged 6-8 years, with high caries risk, divided in two groups according to the sealant material. Fissure sealant was applied to all erupted, caries-free first permanent molars. Sealants were evaluated after 3, 6 and 12 months using modified Ryge criteria for retention, marginal adaptation, colour match, surface smoothness and caries. Results. Microleakage was detected in more than half of the specimen, without significant differences between the two groups (p > 0.05). Both materials exhibited acceptable sealing ability. Complete retention at the end of the observation period was 81.8% for resin-based, and 21.1% for glass-ionomer fissure sealant (p < 0.001). The presence of caries in sealed molars has been detected in one patient in both groups. During the 12-month observation period, Helioseal F demonstrated better retention, marginal adaptation and surface smoothness (p < 0.001). There were no differences between the two materials regarding caries and color match (p > 0.05). Conclusion. Both tested materials demonstrate satisfactory clinical and caries prophylactic characteristics that justify their use in contemporary preventive dentistry.

Introduction. Anaesthesia affects kidney function by reducing the renal blood flow and glomerular filtration rate. As chronic renal failure (CRF) significantly influences drug metabolism and elimination, we studied the effects of rocuronium bromide (RB) in patients with CRF. Objective. The aim of the study was to examine whether, when using RB in patients with CFR, there are differences regarding the onset time of neuromuscular block (NMB) development, duration time, speed of recovery and cumulative effects of RB. Methods. Prospective study included 60 patients who underwent urologic surgery procedures. The patients were divided into 3 groups: the first group (G1) - 20 patients with CRF and residual dieresis, the second group (G2) - 20 patients with CRF and without dieresis, and third group (G3) - 20 patients with normal renal function (control group). During surgery RB was administrated for muscle paralysis in all patients. Train-of-four (TOF) Guard acceleromyography was used for NMB monitoring. Results. Onset time in three groups was 132.3 s; 139.5 s and 113.2 s (r0.05). The number of RB repeated doses was 3-8, 3-7 and 4-8 (r>0.05). The duration time until spontaneous recovery was 31.8, 31.6 and 29.8 minutes (r>0.01). The recovery index was 16.8, 16.7 and 10.6 minutes (r

Mineral trioxide aggregate (MTA) is a material with broad indications in endodontics. Currently, this material is used for pulp capping, pulpotomy, as apical barrier in teeth with necrotic pulp and open apex, and in the treatment of various root canal perforations. By comparing the biological response of pulp tissue capped with calcium hydroxide and MTA, the superiority of MTA has been indicated. The bridge of hard tissue formed under MTA prevented the irritation of pulp. Histological studies of pulpotomy in dog teeth have shown after 120 days a hard tissue without necrosis formed under MTA. MTA is also the material of choice for retrograde root canal obturation and lateral perforation. Meta analysis of published papers on MTA in recent years indicated the great clinical success of this material which ensured a good canal seal and superior biocompatibility. It is the only material for retrograde root canal obturation that encourages tissue regeneration. Studies have also shown that MTA has inductive and conductive properties for hard tissue as well as the ability to release ions in a liquid medium. The main disadvantage of MTA is related to its color, the presence of iron and mangan ions, the difficulties in maintaining the characteristics of material during time, absence of solvent for this material and the difficulty for its removal after crosslinking.

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Business excellence models have a long history of development of sixty years. Today, the business excellence model can be essentially classified as world’s most famous models/awards for excellence (Japanese, American and European), the most popular national models of excellence (the Australian, British, German, French), as well as models of excellence companies (Siemens, Philips, Toyota). In the world today there are about 120 models of excellence. The best way to improve quality of health organizations that have systems of quality management is by application of the concept of total quality (TQM). This approach ensures the improvement of overall performance of health organizations, primarily the internal organization including management, resources, processes and human resources, health services and performance of business results. The market requires high quality products and services to improve the quality of life, or TQM excellence models in all areas of social subjects operations. It is a process that never ends, and knowing the nature of man who was never satisfied with achieved, that is main driving force for social development. We are witnesses today that some countries are introducing awards to organizations which succeeded in implementation of TQM and models of excellence for quality achievement. The development of a model of business excellence (BE) for dental health care is the main subject of the current study. The aim of this study is to present and analyze the existing criteria for product excellence and based on that, to define criteria for models of excellence for dental health care in Serbia.

Etiology of abnormalities in tooth structure has been subject of numerous studies but still has not been fully understood. Heredity is an established etiological factor for many types of structural anomalies of the teeth. Factors that cause changes in enamel structure may be genetic, immunologic and teratogenic or systemic diseases. Genetic changes may include individual genes, micro deletions or chromosomal defects. Systemic diseases can be associated with anomalies of tooth structure and diversity of clinical picture requires a multidisciplinary approach to the therapy. Amelogenesis imperfecta (AI) represents a large group of structural abnormalities of the teeth. AI can exist independently or as a part of large number of syndromes and systemic diseases. Knowledge of clinical presentation, etiology, pathogenesis of structural anomalies of the teeth and their association with certain systemic diseases is of great importance to everyday dental practice in terms of prevention, prognosis and therapy. Also, it is necessary to expand basic knowledge of pediatricians in regards to the clinical picture of anomalies in tooth structure and their possible association with a wide range of systemic diseases and syndromes, in order to provide comprehensive clinical treatment. Therefore, the aim of this study was to present etiopathogenesis and classification and to describe the most important abnormalities of enamel structure and their association with systemic diseases and syndromes.

Introduction. The aim of the study was to assess the formation of biomimetic calcium hydroxyapatite (HAP) on the surface of different substrates. Material and Methods. Silica coated stainless steel tapes and thin polymer films (alginate, cellulose, poly lactide-co-glycolide - PLGA) deposited on hydroxyapatite scaffold were used as substrate. Supersaturated simulated body fluid (SBF) and SBF combined with Fetal Calf Serum (FCS) or Eagle’s Minimum Essential Medium (EMEM) were used as bioactive liquid medium where biomimetic nucleation of HAP occurred. Infrared spectroscopy with Fourier transformation was used to analyze the formed phases, while scanning electron microscopy indicated the morphology of nucleated phase. Results. The results of measuring the mass with volume adjustments done by the BET method showed that the thickness of the film of nucleated calcium hydroxyapatite depended on the time that samples spent soaked in SBF-in as well as the type of selected biomimetic medium. Conclusion. Biomimetic calcium hydroxyapatite is possible to produce by self nucleation on different substrates in the presence of simulating body fluid.

The standards ISO 9000 series, brought in 1987, were the driving force for the development and application of quality management (QM) in various areas, including health care. Currently, there are over one million certificates for quality management (QMC), and they were main initiators of quality improvement. In addition to the model for quality management of products/services, other models are also in use. The aim of this study was to present methods and techniques for quality improvement of health services, with special emphasis on dental health care services (DHS), and possibility for enhancement.

Introduction. Endovascular aneurysm repair (EVAR) has been introduced into clinical practice at the beginning of the 90's of the last century. Because of economic, political and social problems during the last 25 years, the introduction of this procedure in Serbia was not possible. Objective. The aim of this study was to present preliminary experiences and results of the Clinic for Vascular Surgery of the Serbian Clinical Centre in Belgrade in endovascular treatment of thoracic and abdominal aortic aneurysms. Methods. The procedure was performed in 33 patients (3 female and 30 male), aged from 42 to 83 years. Ten patients had a descending thoracic aorta aneurysm (three atherosclerotic, four traumatic - three chronic and one acute as a part of polytrauma, one dissected, two penetrated atherosclerotic ulcers), while 23 patients had the abdominal aortic aneurysm, one ruptured and two isolated iliac artery aneurysms. The indications for EVAR were isthmic aneurismal localisation, aged over 80 years and associated comorbidity (cardiac, pulmonary and cerebrovasular diseases, previous thoracotomy or multiple laparotomies associated with abdominal infection, idiopatic thrombocitopaenia). All of these patients had three or more risk factors. The diagnosis was established using duplex ultrasonography, angiography and MSCT. In the case of thoracic aneurysm, a Medtronic-Valiant® endovascular stent graft was implanted, while for the abdominal aortic aneurysm Medtronic-Talent® endovascular stent grafts with delivery systems were used. In three patients, following EVAR a surgical repair of the femoral artery aneurysm was performed, and in another three patients femoro-femoral cross over bypass followed implantation of aortouniiliac stent graft. Results. During procedure and follow-up period (mean 1.6 years), there were: one death, one conversion, one endoleak type 1, six patients with endoleak type 2 that disappeared during the follow-up period, one early graft thrombosis. No other complications, including aneurysm expansion, collapse, deformity and migration of the endovascular stent grafts, were registered. Conclusion. According to all medical and economic aspects, we recommend EVAR to treat acute traumatic thoracic aortic aneurysm, as well as in elderly and high-risk patients with abdominal or thoracic aneurysms, when open surgery is related to a significantly higher mortality and morbidity.

INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74). RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25%) patients died, while two (16.6%) had paraplegia. Nine patients (75%) were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years). CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases) or external heparin-bonded shunts (five of our cases). Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

INTRODUCTION Treatment of carotid stenosis could be surgical: eversion endarterectomy, conventional endarterectomy and patch-plasty, resection with graft interposition and bypass procedure or, in the past few years, carotid artery angioplasty (PTA) with stent implantation. OBJECTIVE The aim of this study is to present early results of carotid artery angioplasty and stenting, as well as to identify indications for this procedure. METHOD Twenty-three patients with stenosis of internal carotid artery were included in the prospective study which was performed in the period from July 2006 to July 2007. For PTA and stenting of the carotid artery we used Balloon dilatation catheter Ultra-softTM SV and Carotid WallstentTM MonorailTM. During the procedure, brain protection by embolic protection system Filter Wire EZ was essentially performed. Descriptive statistical methods were performed to present and describe the patient characteristics, risk factors and results. RESULTS 23 patients were examined. In four (17.39%) cases there was asymptomatic, while in 19 (82.61%) there was symptomatic homodynamic significant stenosis of the internal carotid artery. Four of these 19 patients (17.39%) had late restenosis following carotid endarterectomy, four (17.39%) important respiratory failure, and 11 (47.83%) important heart disease. Patients were followed up for the first 30 postopertive days. In that period, there were no mortality and no needs for surgical conversions. In one case (4.35%), residual stenosis of 30% remained. Two patients (8.70%) had TIA and one (4.35%) had CVI. CONCLUSION Main indications for PTA and stenting of carotid arteries are: surgically inaccessible lesions (at or above C2; or subclavial); radiation-induced carotid stenosis; prior ispilateral radical neck dissection; prior carotid endarterectomy (restenosis), severe cardiac and pulmonary conditions. Limitations and contraindications to carotid angioplasty and stentning include: significant peripheral occlusive diseases; unfavorable aortic arch anatomy; severe tortuosity of the common and internal carotid artery; severely calcified stenosis, lesions containing fresh thrombus; stenosis longer than 2 cm; critical (>99%) stenosis; associated carotid artery aneurysm; contrast-related issues and severe aortic valve stenosis.

Contemporary tendencies in dentistry are based on the concept of maximal protection of healthy tooth tissues. Caries removal has been done traditionally with mechanical rotary instruments that are fast and precise. However, conventional cavity preparation has potential adverse effects to the pulp due to heat, pressure and vibrations. Moreover, drilling often causes pain and requires local anaesthesia, and these procedures are frequently perceived as unpleasant. Etiology, development and prevention of dental caries are better understood today and new restorative materials that bond micromechanically and/or chemically to dental tissues have been introduced. Thus, development of a new, less destructive caries removal technique is allowed. In the last decades, many alternative methods have been introduced in an attempt to replace rotary instruments. These are claimed to be efficient and selective for diseased tissues and to offer comfortable treatment to the patients. New methods include air abrasion, air polishing, ultrasonic, polymer burs, enzymes, systems for chemo-mechanical caries removal, and lasers. The aim of this paper was to discuss various caries removal techniques and possibilities of their use in clinical practice. Based on the literature review it can be concluded that none of the new caries removal methods can completely replace conventional rotary instruments.

INTRODUCTION A recombinant form of activated factor VII (rFVIIa) is a haemostatic drug that is approved for use in haemophiliacs with antibodies to factor VIII or factor IX. Most recent studies and clinical experience have shown that rFVIIa (NovoSeven ®, Novo Nordisk A/S, Denmark) gives extreme haemostatic effect in patients with severe "non-haemophilic" bleeding produced after trauma and major surgery. OBJECTIVE We present our preliminary experience of the use of rFVIIa in vascular surgery when conventional haemostatic measures are inadequate. METHOD There were 32 patients divided into five groups: Group I - 14 patients with ruptured abdominal aortic aneurysms; Group II - 10 patients with thoracoabdominal aortic aneurysms; Group III - 5 patients with retroperitoneal tumors involving great abdominal vessels; Group IV - 2 patients with portal hypertension and Group V - one patient with iatrogenic injury of brachial artery and vein during fibrinolytic treatment, because of myocardial infarction. RESULTS Clinical improvement was detected following treatment in 29 patients. Bleeding was successfully controlled as evidenced by improved haemodynamic parameters and decreased inotropic and transfusion requirements. CONCLUSION In vascular patients more liberal use of rFVIIa is limited, because no randomized controlled trial has proved its efficacy and safety in such patients; while also keeping in mind that the price of a 4.8 mg of rFVIIa is $4,080. We recommend the use of rFVIIa in vascular surgery only during and after operative treatment of thoracoabdominal aortic aneurysms, ruptured abdominal aortic aneurysms, retroperitoneal tumors involving the aorta and/or inferior vena cava, as well as portal hypertension, when non-surgical massive uncontrolled bleeding are present.

Background/Aim. There are very few data about the effects of endogenous growth factors in vital pulp therapy, and still they are often controversial. The aim of the study was to evaluate the effects of platelet rich plasma (PRP) in conjugation with hydroxyapatite (HAP), as pulp capping materials, to root and periodontium formation. Methods. Eight young monkeys (Cercopithecus Aethiops) with permanent dentition and incomplete root formation were involved in this study. After pulpotomy, the pulp lesion was capped with calcium hydroxide (control), hydroxyapatite (experimental group I) or hydroxyapatite in conjugation with PRP (experimental group II). Six months later, the animals were sacrificed, the tissue was removed en block, and prepared for the histological analysis in a routine way. Results. The results of the histological analysis revealed that healing process was characterised by dentin bridge formation, maintained morphological and functional integrity of dental pulp and complete formation of dental root and surrounding periodontium. The inflammatory reaction was scored as mild to moderate, in almost all the samples in all groups, suggesting the biocompatibility of the used materials. Conclusion. Materials used in this study are convenient as capping agents, contributing maintaining the integrity of the pulp tissue and facilitating root and periodontium formation. According to histological data it could be suggested that hydroxyapatite in conjugation with endogenous growth factors, represents superior alternative to other materials used in this study.

Restoring carious teeth is one of the major dental treatment needs of young children. Conventional glassionomer materials are frequently used as filling materials in contemporary pediatric dentistry. The objective of this study was to evaluate the restorative and prophylactic efficacy of the newly marketed glass ionomer, Fuji Triage (GC, Tokyo, Japan), through morphological analysis of the interface zone between the material and the enamel and the dentin of primary molars and to determine the extent of the ion exchange at the interface zone. The sample consisted of 5 extracted intact first primary molars in which glassionomer had been used as filling material after standard class I cavity preparation. The material was placed according to the manufacturer's instructions and teeth were placed into dionised water prior to experiment. Six sections of each tooth had been examined using scanning electron microscopic and electron dispersive spectroscopic techniques (SEM/EDS). The parameters for evaluation included: morphological characteristics of the interface zone and the extent of the ion exchange between the material and the tooth structures Results were statistically analyzed using descriptive statistical methods. SEM/EDS analysis revealed the presence of the chemical bonding between the glass ionomer and the enamel and dentin, 5 and 15 μm in width, respectively. Ion exchange has not been detected in the enamel at the EDS sensitivity level. Strontium and fluor penetration has been detected in dentin. The ion exchange and chemical bonding formation justify the usage of the conventional glass ionomer materials for restorative procedures in primary molars.

To date, three types of dental stem cells have been isolated: Dental Pulp Stem Cells (DPSC), Stem Cells From Human Exfoliated Deciduous Teeth (SHED) and Immature Dental Pulp Stem Cells (IDPC). These dental stem cells are considered as mesenchymal stem cells. They reside within the perivascular niche of dental pulp. They are highly proliferative, clonogenic, multipotent and are similar to mesenchymal Bone Marrow Stem Cells (BMSC). Also, they have high plasticity and can be easy isolated. The expressions of the alkaline phosphatase gene, dentin matrix protein 1 and dentinsialophosphoprotein are verified in these cells. Analyses of gene expression patterns indicated several genes which encode extracellular matrix components, cell adhesion molecules, growth factors and transcription regulators, cell signaling, cell communication or cell metabolism. In both conditions, in vivo and in vitro, these cells have the ability to differentiate into odontoblasts, chondrocytes, osteoblasts, adipocytes, neurons, melanocytes, smooth and skeletal muscles and endothelial cells. In vivo, after implantation, they have shown potential to differentiate into dentin but also into tissues like bone, adipose or neural tissue. In general, DPSCs are considered to have antiinflammatory and immunomodulatory abilities. After being grafted into allogenic tissues these cells are ableto induce immunological tolerance. Immunosuppressive effect is shown through the ability to inhibit proliferation of T lymphocytes. Dental pulp stem cells open new perspectives in therapeutic use not only in dentin regeneration, periodontal tissues and skeletoarticular, tissues of craniofacial region but also in treatment of neurotrauma, autoimmune diseases, myocardial infarction, muscular dystrophy and connective tissue damages.

Chylopericardium refers to existing communication between the pericardial sac and the thoracic duct carrying the chyle. The objective of our report was to highlight the specificity of diagnosis and treatment of this rare but tedious condition through the analysis of two case reports. Male patient, aged 63 years, with chylopericardium was diagnosed perioperatively (implantation of artificial aortic - St. Jude No 21 and mitral valve - St. Jude No 29). Etiology of pericardial effusion was established by Sudan III staining of punctate specimen obtained by subxiphoid pericardial puncture. Probable cause of chylopericardium was the lesion of ductus thoracicus during cross-clamping of the superior caval vein with a Cooley clamp. Initial treatment included diet rich in medium-chain triglycerides which resulted in resolution of the effusion. During five-year follow-up, there were no recurrences of pericardial effusion. The second patient was female, 21 years old, with chylopericardium after partial pericardiectomy performed because of the chronic severely symptomatic pericardial effusion, resistant to other forms of treatment. Pericardiocentesis provided 650 ml of yellowish fluid with a high concentration of cholesterol (3.2 mmol/l), triglycerides (16.6 mmol/l), and proteins (64.7 g/l), which verified chylopericardium, most probably as a consequence of the lesion of ductus thoracicus during partial pericardiectomy. Diet rich in medium-chain triglycerides failed to decrease the effusion, after two weeks of treatment (daily secretion 250-350 ml). Lymphography revealed lesion of ductus thoracicus, most probably at Th9/Th10 level, with no direct visualization of extravasal accumulation of contrast media. Surgical ligation of ductus thoracicus was performed through the right thoracotomy. However, postoperative secretion increased to 1000 ml/day. Patient underwent redo surgery comprising the ligation of lymphatic vessels, guided by extravasation of intraoperatively iwected methylene-blue indicator. During one-year follow-up, there were no recurrences of pericardial effusion. In conclusion, intraoperative lymphography significantly contributed to successful surgical treatment of patients with chylopericardium.

Introduction: As one of the most important dental diseases, caries cannot be treated with classic therapeutic measures, but very often, there is a need for preventive and prophylactic measures. Aim: The aim of this study was to assess clinical efficiency of composite materials and glass-ionomer cements as pit and fissure sealants in caries prevention. Materials and Methods: The study comprised 50 patients (141 teeth), both sexes, 6-7 years old with at least two erupted first permanent molars. The main diagnostic criterion was smooth enamel surface with no probe faltering on the tooth. Materials tested in this study were two composite materials (Heiloseal-Opak and Helioseal-Transparent) and two glass-ionomers (Fisurit and Fuji VII). For clinical assessment of these materials, modified Cvar-Ryge criteria were used. Results: The obtained results showed no statistically significant differences among materials in respect to retention, marginal adaptation, discoloration and secondary caries. The difference was significant in respect to surface roughness between Fuji VII and Fisurit and Fuji VII and Helioseal-Opak (p

One of the most efficient prophylactic measures in caries prevention is sealing pits and fissures. After improvements of physical and mechanical properties, glass-ionomers are frequently used as sealing materials. The aim of this study was to evaluate the prophylactic efficiency of Fuji VII, a glass-ionomer fissure sealant, through adaptation ability and fluoride reeasing potential assessment using scanning electron microscopic and energy dispersive spectroscopic techniques. The sample consisted of 20 extracted intact human teeth, 10 premolars and 10 molars. Six sections of each tooth were analyzed using SEM. EDS analysis was conducted one week and three months after material placement. The parameters used for the evaluation included: adaptation ability, penetration depth, material structure, integrity of the interfacial zone and ion exchange extent. The sealant penetration depth was observed at 30 X magnification, and the interfacial zone between the material and the enamel at 500-10000 X. EDS was used for quantitative analysis of the material structure, interfacial zone and the enamel surface. The results were statistically analyzed the using chisquare test and descriptive statistical methods. SEM analysis revealed the zone of interaction between the enamel surface and the glass-ionomer with predominant cohesive failures within the sealant material, and satisfactory adaptation ability of the sealing material. The mean value of the penetration was 83% of the total fissure depth, without a statistically significant difference between the tested teeth groups. A lower penetration ability was observed in deep pits and fissures with a larger diameter of unfilled space (p

Objective: An in vitro comparison of coronal microleakage of three root canal sealers was performed using the dye leakage method. Methodology: Ninety-eight single-rooted human teeth were instrumented and randomly allocated to two groups. In the first group, root canals were treated with EDTA to remove the smear layer. The roots in both groups were obturated using laterally condensed gutta-percha and Sealapex, AH-26 or Ketac-Endo as the sealer. The teeth were suspended in 1% methylene blue dye for 6 days. The teeth were then rinsed, sectioned perpendicular to the long axis and evaluated for coronal dye penetration. Results: In general, Ketac-Endo root canal sealer showed greater dye penetration than Sealapex and AH-26. A statistically significant difference in the coronal penetration of the dye was found in the group with intact smear layer. Conclusion: Highly significant differences between AH-26 and Ketac-Endo (p < 0.001) and Sealapex and Ketac Endo (p < 0.001) were found.

Introduction: In contemporary preventive dentistry there are numerous experimental in vitro and clinical studies on the growing number of materials for sealing pits and fissures. Aim: the aim of this study was to evaluate the impact of occlusal tooth morphology on penetrating abilities of two types of fissure sealants and measure the unfilled space at the bottom of occlusal groove using scanning electron microscopy (SEM). Materials and methods: The sample consisted of 10 freshly extraced intact premolars and 10 molars randomly divided into 4 groups. In group I (5 premolars), and group II (5 molars) glass ionomer Fuji VII was used as fissure sealant, while in groups III (5 premolars) and IV (5 molars) resin-based sealant (Helioseal-F) was used. Six sections of each tooth were prepared for SEM. Sealant penetration was observed at 30x magnification and the unfilled space at the bottom of the groove at 500x. Sealant penetration in relation to the absolute depth of occlusal grooves was recorded and the unfilled space beneath the sealant was expressed through its greatest diameter. Results were statistically analyzed using χ2 test. Results: There was no statistically significant difference in penetration ability and the unfilled space between tested materials or teeth groups. The average depth of penetration for glass ionomer was 83% and for resin-based sealant 81% of fissure depth. Mean diameters of the unfilled space beneath the sealants were 95 μm (glass ionomer) and 93 μm (resin-based sealant). Shallower penetration of both sealing materials was observed in deep pits and fissures with greater diameter of unfilled space (p

The aim of this study was to discuss therapy possibilities in the management of molar incisor hypomineralization. Molar incisor hypomineralization (MIH) is defined as hypomineralization of one or more first permanent molars frequently affecting incisors. Etiology of MIH is not fully clarified and numerous etiological factors have been cited. Hypomineralized molars are more prone to caries, cause severe restorative problems and are frequently extracted due to serious damage and caries complications. Incisors can present demarcated enamel opacities, while enamel breakdown is uncommon. Clinically, affected molars can be sensitive to thermal and chemical irritations even when there is no enamel breakdown. Molars can be sensitive to mechanical irritations making even regular tooth brushing painful. Specific problems related to the treatment of these teeth are sensitivity and occlusion in molars and aesthetics in incisors. Considering the fact that permanent first molars with severe defects and incisors demand complex and multidisciplinary treatment they present serious problem for the patient as well as for the dentist.

Saliva is a secretion of the salivary and mucous glands and is of major importance in the maintainance of oral health. Over the last few decades, saliva has been evaluated as a diagnostic fluid in medicine for determining systemic disease markers as well as for monitoring numerous drugs, narcotics, and hormones. The biochemical analysis of saliva is particularly important in dentistry. The estimation of the risk of appearance and diagnosis of disease, monitoring of disease progression, evaluation of therapy efficacy for caries, periodontitis, premalignant and malignant oral lesions, as well as infectious diseases of the oral cavity, can be assessed by analyzing different constituent: of saliva, individuals at risk of caries can be identified using test: that determine saliva flow rate, saliva buffer capacity, and colonization of the oral cavity by cariogenic bacteria. Today, these rapid and simple diagnostic tests are used routinely in caries risk determination. The study and use of saliva-based diagnostics have increased over the last few decades. Clinical testing of saliva shows much promise. However, there is a need for much additional research in this area, before the true clinical value of saliva as a diagnostic fluid in dentistry can be determined.

Minimal dental restoration of occlusal surfaces using sealing for prevention, preserve sound tooth structure. The aim of this study was to clinicaly assess the performance of three different techniques in minimal dental restoration. A total of 90 teeth (premolars or molars) with minimal carious lesions were equally divided into three groups and included in this study. In group I and II teeth were restored either with the composite resin and the resin modified glass ionomer cement. Composite sealant (separately applied) was used in both groups. In group III teeth received resin modified glass ionomer cement. These materials were used at the same time as a restorative and a sealant. Modified Cvar and Ryge criteria were used for clinical evaluation after 1, 2, 3, 6 and 12 months. Complete retention at the end of the evaluation period for I, II and III group was 97%, 93% and 93% respectively. No secondary caries was recorded after the evaluation period. From the obtained results it can be concluded that minimal dental restorations presents an efficient and successful technique in the treatment of small occlusal carious lesions.