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Svrha: U ovom se istraživanju ispitivao antibakterijski učinak dvaju materijala za retrogradno brtvljenje korijenskog kanala testom bakterijske difuzije agara. Materijali i postupci: Ploče krvnog agara inokulirane su zasebno bakterijama Streptococcus mutans, Streptotoccus mitis, Lactobacillus acidophilus, Staphylococcus aureus i Enterococcus faecalis te polimikrobnom suspenzijom od svih testiranih bakterija. Na inokulirane ploče bili su raspoređeni uzorci materijala i nakon 48 sati inkubacije očitane su zone inhibicije (ZI) u milimetrima promjera. Rezultati: Najsnažniji antibakterijski učinak MTA je pokazao kod bakterije Streptococcus mutans (ZI =7,6 mm, s.d. 1,0), zatim prema Streptotoccus mitis i Lactobacillus acidophilus (ZI=7,3 mm, s.d. 0,5). ZI za Enterococcus faecalis iznosio je 5,6 milmetara, s.d. 0,7, a za polimikrobnu suspenziju 5,3 milimetra, s.d. 1,0. Jedina bakterija na koju MTA nije imao antibakterijski učinak jest Staphylococcus aureus. Amalgam nije pokazao antibakterijski učinak na ni jednu ispitivanu bakteriju. Zaključak: MTA je pokazao antibakterijski učinak prema četiri od pet ispitivanih bakterija i polimikrobnih suspenzija, a amalgam nije inhibirao rast ni jedne testirane bakterije., The purpose of this study was to evaluate the antibacterial effect of root-end filling materials, MTA and amalgam, by agar diffusion test. Materials and methods: Blood agar plates were inoculated with bacteria Streptococcus mutans, Streptococcus mitis, Lactobacillus acidophilus, Staphylococcus aureus and Enterococcus faecalis each, and a polymicrobial suspension consisting of all the tested bacteria. Material samples were divided among the inoculated plates, and after 48 hours of incubation, the diameters of the inhibition zone (IZ) were recorded. Results: The strongest antibacterial effect of MTA was against Streptococcus mutans (IZ = 7.6 mm, sd 1.0), followed by Streptococcus mitis and Lactobacillus acidophilus (IZ = 7.3 mm, sd 0.5). The inhibition zone (IZ) for Enterococcus faecalis was 5.6 mm (sd 0.7), and for the polymicrobial suspension 5.3 mm (sd 1.0). Staphylococcus aureus was the only bacteria MTA did not show any antibacterial effect against. Amalgam showed no antibacterial effect against any of the bacteria tested. Conclusion: MTA showed antibacterial effect against 4 of 5 tested bacteria and the polymicrobial suspension, while amalgam did not inhibit the growth of any of the bacteria tested.

Svrha rada bila je istražiti i ustanoviti primarne razloge za ekstrakciju zuba u trajnoj denticiji. Materijali i postupci: Istraživanje smo organizirali od siječnja do ožujka 2007. na Stomatološkom fakultetu u Zagrebu, u Zavodu za endodonciju i restaurativnu stomatologiju i Zavodu za oralnu kirurgiju. Kao metodu odabrali smo upitnik koji je, osim osobnih podataka pacijenta, sadržavao i osnovne razloge za ekstrakciju. Prikupljene podatke statistički smo obradili parametrijskom i neparametrijskom analizom varijance, ovisno o distribucijama dobivenih podataka. Rezultati: Ukupno je bilo anketirano 113 ispitanika u dobi od 10 do 85 godina - 61 (54%) žena i 52 (46%) muškarca. S obzirom na to koliko su često odlazili stomatologu, više je bilo neredovitih pacijenata (54,9%). U svim dobnim skupinama najčešći razlog za ekstrakciju bio je karijes (53,4%), a kod većine pacijenata (75,7%) prije toga nije bila provedena nikakva endodontska terapija. Najčešće ekstrahirani zubi bili su prvi trajni molari zbog karijesa (25,3%), a donji frontalni bili su uglavnom izvađeni zbog parodontopatija i to u dobnim skupinama iznad 45 godina (8,7%), a kod mlađih bili su ekstrahirani prvi premolari uglavnom iz ortodontskih razloga. Zaključak: Zbog opsežnih karioznih destrukcija molara nije bilo moguće obaviti adekvatnu endodontsku i/ili konzervativnu terapiju, pa je ekstrakcija bila jedina terapijska mogućnost. Zbog toga se mora više truda uložiti u preventivne programe kako bi se sačuvalo oralno zdravlje., The purpose of this study was to identify and investigate the essential reasons for the extractions of the teeth of the permanent dentition. Materials and methods: The research was done at the Department of Endodontics and Restorative Dentistry and the Department of Oral Surgery School of Dental Medicine in Zagreb, Croatia, during the period from January through March 2007. The method was based upon a questionnaire which, other than the basic personal data on the patient, also included the essential reasons for each particular extraction. The data collected was then statistically processed by parametric and non-parametric analyses of variance, depending on the respective distributions of the results. Results: A total of 113 subjects, within the age bracket 10 - 85, was interviewed. Of that number, 61 (54%) were female and 52 (46%) male patients. With regard to the declared frequency of visits to the dentist, slightly prevailing (54.9%) were those with an irregular history of visits. The principal reason for a tooth extraction was caries (53.4%). Furthermore, 75.7% of the patients did not have any previous endodontic treatment prior to extraction. With regard to the position of the teeth, the most frequently extracted were the first permanent molars, on the account of caries (25.3%). The lower front teeth were extracted mostly because of periodontitis, and in the 45+ age-group (8.7%), whereas in the younger-age groups it was the first premolars, extracted exclusively for orthodontic reasons. Conclusion: Due to extensive carious destructions of the molars it was not possible to provide an adequate endodontic treatment and/or conservative therapy, so extraction was the sole option for those unrestorable teeth. It is therefore recommendable that prevention programs be pursued to achieve and maintain oral health.

Svrha istraživanja bila je procijeniti opće-zdravstveni status opulacije stomatoloških pacijenata, nakon obrade podataka iz ispunjenih Upitnika o zdravlju FDI-a koje je preporučila Hrvatska stomatološka komora. Podaci iz 2045 upitnika koje su ispunili pacijenti Zavoda za endodonciju i restaurativnu stomatologiju tijekom godine 2005. uneseni su u kompjutorsku bazu podataka te statistički obrađeni. Obrada podataka pokazala je da 30,1% stomatoloških pacijenata boluje od neke bolesti, a najčešće su kardiovaskularne (14,7%). Česte su i alergije bolesti (13,1%). U upitnicima je registrirano i 1,5% pacijenata s virusnim hepatitisom te 0,6% s TBC-om. Razmjerno malo pacijenata upisalo je HIV-seropozitivnost (0,2%) i izloženost virusu HIV-a (0,5%). Transfuziju je primilo 12% pacijenata. Stomatološki pacijent iznad 75 godina u prosjeku uzima 2,16 lijekova. Vrlo česte sistemske bolesti kod stomatoloških pacijenata te povećana potrošnja lijekova kod pacijenata starije dobi, upućuje na to da je potrebna dodatna izobrazba stomatologa kako bi se s takvim bolesnicima moglo odgovarajuće postupati., The purpose of the study was to evaluate the general health condition i.e. overall health-status of the dental patients population by processing the data obtained from the FDI health-questionnaires which was recommended by the Croatian Dental Chamber. The data which was collected from a total of 2045 individual medical history questionnaires - personally filled in by the patients who attended this Department of Endodontics and Restorative Dentistry during the year of 2005 - was loaded into a computer data-base and statistically analyzed. The analysis showed presence of some kind of a disease in 30.1% of patients; topping the list by incidence were cardiovascular diseases (14.7%). Also, highly represented were various allergic diseases (13.1%). A 1.5% had developed a viral hepatitis, whereas 0.6% of the patients had even had TBC. A comparatively small percentage of patients (0.2%) had admitted to HIV seropositivity resp. exposure to the HIV virus (0.5%). A total of 12% of the group had received a blood-transfusion at some point. Typically, a dental patient above 75 years of age was taking in average 2.16 different types of medicinal drugs. High incidence of systemic diseases in dental patients and an increased consumption of medicinal drugs in the elderly dental patients indicates the need for an enhanced education of the dentist in order to enable his/her proper attitude toward such patients.

Fuzija zubi rijetka je razvojna anomalija i ubraja se u anomalije veličine zuba. Stapanje se može dogoditi samo na razini cakline ili na razini cakline i dentina. Rezultat toga je nastanak jednoga zuba s klinički povećanom krunom. Etiologija fuzije nije do kraja razjašnjena. Prema dostupnoj literaturi vrijednost incidencije fuzije kreće se u rasponu 0,2 - 2,5% i uobičajenija je u mliječnoj denticiji. U prikazu slučaja stopljeni incizivi su nakon endodontskoga liječenja rekonstruirani kompozitnim materijalom., Dental fusion is a rare developmental anomaly which is included in the anomalies of tooth size. Fusion can occur at the level of enamel or enamel and dentin which results in the formation of a single tooth with enlarged clinical crown. Etiology of fusion is not fully clarified. According to the available literature, the incidence of fusion ranges from 0.2 to 2.5% and is more common in decidious dentition. In the case report presented, fused incisors were treated endodontically and reconstructed by composite materials.

Ispitivalo se je djelovanje kolagena na zubnu pulpu i njegova moguća uporaba u dentalnoj patologiji. Pokusi su izvedeni na psima mješancima. Oni su bili anestezirani, a zubi izolirani gumenom plahticom. S bukalne su strane na dva gornja i donja sjekutića svih životinja izrađeni klasični kaviteti petoga razreda i trepanirana je pulpna komorica. U jednoj je skupini zuba na pulpnu ranu stavljena bioresorbirajuća kolagena membrana, u drugoj sterilni teflonski disk, a u trećoj su kaviteti zatvoreni samo Ketac-Silver cementom. Kaviteti su u prvim dvjema skupinama trajno zatvoreni Ketac-Silver cementom. Nakon šest tjedana zubi su izvađeni i priređeni za histološku obradbu. Histološka slika pripravka tretiranih samim Ketac Silver cementom pokazala je potpunu nekrozu tkiva, a građa pulpe histološki se nije dala razaznati. Od osam pripravaka tretiranih teflonskim diskovima dva su pokazala potpunu nekrozu, a na šest se vidio djelomičan gubitak morfološke građe. Na pripravcima tretiranim kolagenim bioresorbirajućim membranama pulpno je tkivo u većoj mjeri sačuvalo vitalitet i morfologiju. Opažena je pojačana prokrvljenost i porast broja krvožilnih elemenata. Ni na jednom se pripravku nije opazilo stvaranje dentinskoga reparatornog mosta., The study evaluates the effect of collagen bioresorbable membrane as a pulp capping material. Experiments were carried out on mongrel dogs. The dogs were anesthetized and teeth were isolated by rubber dum. In all animals, along the buccal side, class V cavities were prepared on two maxillary and mandibular incisors. The pulp chambers were exposed and bioresorbable collagen membrane Bio Gide was placed on the pulp wound in the first group of the teeth. In the second group the pulp wound was covered with a sterile Teflon disk and in the third group the cavities were closed by Ketac-Silver cementum only. The cavities in the first two groups of teeth were permanently closed by Ketac-Silver cementum. After six weeks the specimen teeth were extracted and prepared for histological examination. The histological findings of the specimens treated only with Ketac-Silver cementum showed complete necrosis of the pulp tissue. Two samples treated with Teflon disks showed complete necrosis of the pulp, while on six samples partial loss of morphologic structure could be seen. On the specimens treated with collagen bioresorbable membranes the pulp tissue preserved its vitality to a much greater extent. Particularly noticeable was a better blood supply in the pulp, with an increased number of blood vessels. The creation of a reparatory bridge was not noticed in any of the tested samples.

Za pokus su rabljeni sojevi Staphylococcus aureus i Enterococcus faecalis. Bakterijski inokulum od 0,5 Mc Farlanda razrijeđen je fiziološkom otopinom u omjerima 1:10, 1:10 2, 1:10 3, 1:10 4, 1:10 5 i 1:10 6. Otapalo količine 0,2 ml pomiješano je s istom količinom bakterijske suspenzije. Za svaku bakterijsku vrstu učinjeno je 60 uzoraka tj. po 10 uzoraka za pojedino razrjeđenje. Uzorci su hermetički zatvoreni i ostavljeni 10 i 30 minuta. Količina od 0,1 ml pojedinog uzorka nasađena je na krvnu ploču i pohranjena u termostat 24 h na temperaturi od 37˚C. Postupak je ponovljen dva puta. Halotan je pokazao najveću antibakterijsku aktivnost. Uništio je sve koncentracije sojeva Staphylococcus aureus i Enterococcus faecalis. Eukaliptol je djelovao na sojeve Staphylococcus aureus, a narančino ulje nije pokazalo antibakterijski učinak na ispitivane sojeve., Staphylococcus aureus and Enterococcus faecalis species were used for the experiment. 0,5 McFarland bacterial inoculum was diluted using saline in proportions 1:10, 1:10 2, 1:10 3, 1:10 4, 1:10 5 and 1:10 6. 0.2 millilitre of solving agent was mixed with an equal quantity of bacterial suspension. Sixty specimens, 10 for each proportion, were prepared. Specimens were hermetically closed and left for 10 and 30 minutes. 0.1 millilitre of each specimen was planted to the blood agar and put in the thermostat at 37°C for 24 hours. The procedure was repeated twice. Halothane exhibited greatest antibacterial activity, destroying all concentrations of Staphylococcus aureus and Enterococcus faecalis. Eucalyptol showed activity towards Staphylococcus aureus, while orange oil did not show any antibacterial effect on the examined bacteria.

Lateralni kanalići na zubu mogu stomatologu stvarati probleme pri dijagnosticiranju pulpitičnih boli nakon endodoncije, a znanje o njima znatno olakšati rad. Ovo ispitivanje provedeno je da bi se proširile spoznaje o morfologiji zuba i time poboljšao rad stomatologa. Lateralni kanalići proučavani su na slučajnom uzorku od 110 trajnih, jednoko- rijenih, prednjih gornjih i donjih zuba. U ispitivanju upotrebljene su metode prebrojavanja, promatranja pod povećalom i bojenja. Utvrđeno je postojanje lateralnih kanalića koji se otvaraju na srednjoj trećini korijena kod 5 zuba (4,5%). Statističkom raščlambom utvrđeno je da ispitivanu pojavu možemo očekivati u populaciji s 95% vjerojatno- sti u intervalu od 0,7% do 8,3%. Ispitivanu pojavu potrebno je potanje ispitati ne samo na prednjim zubima već i na svim skupinama zuba., Although accessory canals can cause problems in diagnosing post endodontic pulpal pain adequate knowledge about it can make the work easier. This investigation was carried out in order to improve knowledge about teeth morphology and to improve the work of dentists. Accessory canals were investigated on a accident sample of 110 permanent, singlerooted, frontal upper and lower teeth. Methods used in this investigation were: counting, magnifying, observing and colouring. It was established that accessory canals appear on the middle third of the root surface on upper and lower frontal, permanent, singlerooted teeth in 4.5% cases (5 teeth). Statistically, it was established that we could expect the frequency of accessory canals on the middle third of the root surface in the population ranging from 0.7% to 8.3%, with 95% probability. The problem investigated should be thoroughly studied in the future, not only on frontal teeth but all groups of teeth.

Treći su kutnjaci zubi koji kongenitalno najčešće nedostaju. Istraživanja o razvoju trećih kutnjaka upućuju nas da utvrđujemo radiografske osobitosti korisne u predviđanju nicanja tih zuba. Istražili smo klinički i radiografski nalaz donjih trećih kutnjaka i pronašli pet različitih tipova impakcije donjih trećih kutnjaka., Third molars are the most often congenitally missing teeth. Studies on the development o f third molars have lead to the identification o f radiographic characteristics that are useful in predicting the eruption. We have investigated the clinical and radiographic status of lower third molars. In the course of our studies five different types o f impaction pattern of the mandibular third molars have been revealed.

Dan je pregled današnjih spoznaja o mehaničkom i kemijskom trošenju zuba i dentalnih ispuna te o povezanosti atricijsko-abrazijsko-erozijskih djelovanja u svjetlu tribologijske znanosti i naših kliničkih iskustava. Navedeni su unutarnji i vanjski uzroci nastalih defekata, njihov odnos prema kliničkoj slici s posebnim osvrtom na kliničke manifestacije subkliničkih erozija cakline i dentina. Navedeni su neki od indeksa za kliničku klasifikaciju potrošenoga zuba i nove tehnologije koje se rabe u znanstvenom istraživanju te problematike., A review is given o f the present state o f art on mechanical and chemical wearing away o f teeth and dental fillings, and on the relationship between the effects o f attrition, abrasion and erosion in the light of tribology and our own clinical experience. Endogenous and exogenous causes o f defects, as well as their relation with the clinical picture are presented, with particular reference to clinical manifestation of subclinical enamel and dentin erosions. Some indices for clinical classification of tooth wear and new relevant research technologies are described.

U ovom radu naveli smo moguće putove ulaska sastojaka oslobođenih iz amalgamskih ispuna u čovjekov organizam i njihov mogući patološki utjecaj. Opisani su mehanizmi djelovanja i navedena su istraživanja o utjecaju amalgamskog ispuna na sluznicu usne šupljine, parodont, pulpu, bubrege, živčani sustav, krvožilni sustav, imunološki i probavni sustav. Analizirana je moguća reakcija preosjetljivosti na amalgamski ispun, a navedeni su i nalazi o mogućem teratogenom učinku amalgamskog ispuna i mogućem štetnom utjecaju dentalnog amalgama (osobito otpadnoga dentalnog amalgama) na okoliš. Prema postojećim podatcima moglo bi se zaključiti da utjecaj amalgamskog ispuna na organizam još nije dostatno razjašnjen jer različita istraživanja daju suprotne nalaze. Ipak, budući da se živa iz odbačenoga dentalnoga amalgama može metilirati u okolišu (u ribljim škrgama i djelovanjem nekih mikroorganizama) u visokotoksičnu organsku živu, amalgam čini veliku opasnost za okoliš. Zato pozornost treba obratiti na prikupljanje, skladištenje i recikliranje otpadnoga materijala., This review describes possible ways of penetration of components released from the amalgam filling into the individual’s organism and their possible pathologic effect. Some activity mechanisms are described and research cited on the influence of amalgam filling on oral mucous,periodontal, pulp, kidneys, neural, cardiovascular, immunologic and digestive systems. Possible hipersensibility reaction to amalgam filling is analyzed. Furthermore, the results o f possible teratologic effect o f amalgam filling, as well as the effect o f dental amalgam (especially waste dental amalgam) on the environment, is discussed. According to existing data it can be concluded the that the influence of amalgam filling on the organism o f the individual has not yet been sufficiently explained, because the results o f investigations are contradictory. However, in the environment (within fish and bay activity o f some microorganisms) mercury from waste dental amalgam can be transformed into highly toxic organic mercury, which can be a great danger to the environment. Consequently, great attention should be paid to the collection, storage and recycling of waste dental amalgam.

This paper describes cases of severe tooth wear, caused by a strong abrasive component in bread (stone particles), and loss o f enamel and dentine o f the “pressure-chipping ” type, as a consequence o f grinding a mineralized substance (shrimps legs), which is a little known type of tooth wear in primitive Inuits of Alaska, Canada and Greenland., U radu su opisane opsežne abrazivne promjene cakline i dentina zuba uzrokovane neuobičajenim prehrambenim navikama netipičnim za današnjicu. Slične promjene tvrdih zubnih struktura nađene su u eskima sa Aljaske, Kanade i Grenlanda.

Iako dentalni amalgam osim pozitivnih ima i negativna svojstva, ipak je najčešće rabljeni materijal za ispune stražnjih zuba. Jedno od negativnih svojstava jest i učinak na električna zbivanja u usnoj šupljini. U radu je, in vivo, ispitivan električni potencijal različitih vrsta amalgama neposredno nakon unošenja u kavitet, te sedam dana prije i poslije poliranja. Osim toga, ispitivan je učinak prisutnosti protetskih kovina na električni potencijal u usnoj šupljini. Razlika električnog potencijala između poliranih i nepoliranih ispuna statistički je vjerodostojna kod svih ispitivanih dentalnih amalgama (p, In this study, electrical potential of four different commercial dental amalgams in in vivo conditions was studied. Additionally, the effects of polishing of the amalgam filling and presence of prosthetic metal on electrical potential were also assessed. Electrical potential was measured at the gingiva and fresh amalgam filling. After seven days, the potential was measured again at the same fillings before and after polishing of the amalgam surface. The difference in electrical potential between the polished and non-polished amalgam fillings was statistically significant in all the dental amalgams tested (p

Prema postavljenoj zadaći, metodom slučajnog odabira pregledani su zubi 413 radnika u tekstilnoj tvornici s ciljem da se otkrije pojava profesionalnih uzura vezanih za tehnologiju rada. Od pregledanih, 40,6% (168) povremeno je ili stalno prekidalo konac zubima, a ne škarama kako je predviđeno tehnološkim procesom. Uzure su otkrivene samo u radnika koji su konac pre kidali zubima (P < 0,01). Nađene su kod 10,9% svih ispitanika (413), to jest kod 26,8% (45) ispitanika koji su konac prekidali zubima. Uzure su nastale pretežito na gornjim sjekutićima, a po izgledu su klinaste, ovalne ili kombinirane. Po stupnju istrošenosti zuba, prema TW1, zahvatile su samo caklinu, osim jednog slučaja gdje su doprle do dentina. Na nastanak uzura djelovala je dugotrajnost mehaničkog oštećenja zuba (Q - 0,45), vrsta konca (Q - 0,55), i neobavještenost radnika o mogućem štetnom djelovanju loših radnih navika na zub., A cohort of 413 textile industry workers were randomly chose to assess the presence of professional abrasion notches (dental fissures) as a result of manufacture technology. It was found that 168 (4.06%) examined workers temporarily or permanently bite the thread instead of cutting it by the scissors during the working process, as regulated by the technological process. Dental fissures were only detected in the workers reporting to bite the thread (P

Dentalni amalgam je bio materijal izbora za ispune na stražnjim zubima tijekom proteklih 150 godina. U radu je prikazan p o vijesni razvoj amalgama, njegov obvezni sastav, te podjela dentalnih amalgama prema količinskom udjelu bakra i prema obliku čestica. Navedena su svojstva amalgama s posebnim osvrtom na njegovu toksičnost. Poznato je da se posljednjih godina pojačao napad na amalgam i u znanstvenoj i u popularnoj literaturi, a u svezi s njegovim navodnim patološkim djelovanjem na organizam. Stoga su navedene preporuke Američkog dentalnog udruženja (AD A) o uporabi dentalnog amalgama. Prema svim dosadašnjim istraživanjima ne postoje znanstveno utemeljeni dokazi o štetnosti amalgamskih ispuna., Dental amalgam has been the material o f choice for the posterior tooth fillings for the past 150 years. Presented in this paper are the historic development o f amalgam, its obligatory composition, as well as the division o f different types o f amalgam according to the quantitative content o f copper and the shape o f the particles. Also, the properties o f amalgam with special regard to its toxicity are listed. It is well known that, over the past few years, attacks on dental amalgam have intensified, both in scientific and popular literature, concerning its possible pathologic impact on human body. Enumerated in the paper are recommendations by the A m erican Dental Association (ADA) on the use o f dental amalgam. In view o f the scientific research available, there is no scientifically founded evidence o f the amalgam fillings being noxious.

Provedeno je kliničko ispitivanje 265 kompozitnih ispuna na prednjim zubima trećega, četvrtoga i petoga razreda u bolesnika starijih od 20 godina. Ispitivani su boja, rubna promjena boje, rubna prilagodba, morfološki oblik punjenja i pojava sekundarnoga karijesa. Pritom su rabljeni parametri USPHS postupka. Nađeno je kako su materijali za ispune bili otporniji na trošenje nego na promjenu boje ispuna i rubnu obojenost. Kod loše oralne higijene bilo je više neuspjeha nego kod primjerene čistoće zubi. U 7% ispuna došlo je do promjene boje, rubnoga obojenja, lošega rubnog zatvaranja i pojave sekundarnoga karijesa već kod ispuna starih godinu dana, što je zabrinjavajuće visok postotak neuspjeha., In total, 265 resin fillings on the anterior teeth o f the third, fourth and fifth classes in patients aged > 20 years were clinically examined. Changes in the color and marginal color, marginal adjustment and filling morphology, and the occurrence o f secondary caries were assessed using the USPHS method parameters. The filling materials were found to be more resistant to wear by use than to changes in the filling color and marginal color. Low success was more frequently recorded with poor than with good oral hygiene. In 7% o f the fillings, changes in the color and marginal color, poor marginal occlusion and secondary caries occurred within not more than a year, which is a critically high percentage o f failure.