Search

A group of phenotypically similar bacteria, collectively known as mutant streptococci, are considered as the main bacterial components responsible for the onset and development of cavities. The aim of our study is to identify the salivary bacteria (Lactobacillus spp., Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius and Streptococcus mitis) and analyze their interdependence with the dental status. The study included 71 children (26 female and 45 male) at the age of 12 years. According to their dental health status, they were divided into: control group - 31 examinees without caries, missing teeth (extractions) and dental fillings (DMF = 0); and experimental group - 40 examinees with caries, missing teeth (extractions) and dental fillings. In all examinees clinical and microbiological examinations were carried out. The lactobacilli in the saliva were determined with a diagnostic test CRT-bacteria (Vivadent, Schaan, Lihtenstein). Undivided sputum samples with sterile swabs were planted on Mitis Salivarius Agar (Fluka, a substrate with sucrose, glucose, trypan blue and crystal violet) which is recommended for the isolation of mixed cultures of streptococci, in particular: Streptococcus mitis, Streptococcus mutans, Streptococcus salivarius, Enterococcus faecalis, etc. Between the detected bacteria in the saliva - Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Streptococcus mitis and the existence of dental caries there is a significant correlation (p < 0.001). Between the presences of Lactobacillus spp. in the saliva and the existence of dental caries there is a significant correlation (p < 0.01). The salivary bacterial parameters can be used as serious screening factors and can seriously participate as an instrument in the assessment of the dental caries risk. Key words: Dental caries, Salivary bacterial, Lactobacillus, Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Streptococcus mitis.

Orthodontic treatment, especially during the period of active growth, can significantly affect the development of the jaws and teeth. Treatment with extraction of molars is more complicated because the space that needs to be closed is larger than the premolar spaces and the time of treatment will be longer. However, in cases where we have a lack of space, teeth protrusion or dental asymmetry, and the extraction of permanent teeth is indicated, the damaged molars should be the first option for extraction when premolars are in better condition. The third molars in different ways are affected by orthodontic therapy. One of them is orthodontic treatment by applying the extraction of the third molars, this situation being widely explored. Extraction of third molar for orthodontic reasons is justified when it prevents the eruption of the second molar or otherwise affects the other teeth. The indications of extraction and selection of teeth to be removed depend on the specific aspects of malocclusion. Premolars are teeth that are usually extracted from orthodontic reasons, but this is not the rule and depends on individual treatment needs. The decision to correct the malocclusion with teeth extraction should be based on the ratio of the size of the dental arch with the size of the teeth, facial appearance and other factors arising from the diagnosis itself. Indications for extraction of the third molars during orthodontic treatment are: mandibular incisor crowding, if they in some way constitute a obstruction of orthodontic treatment as well as preparation for orthognathic surgery. The success of an orthodontic treatment involving the extraction of molars is directly related to the patient complaints and psychological profile, the absence of diseases and skeletal discrepancies, the professional experience as well as the fact whether the patient underwent previous orthodontic treatment with extraction. Patients with partially or completely non-erupted teeth are significantly more likely to have certain consequences: before, during or after the orthodontic treatment. Therefore, orthodontists need to raise patient awareness of these consequences in the context of orthodontic treatment. Keywords: indications, molars, orthodontists, treatment…

Saliva, acquired pellicle, dental structures and their relation to soft tissues in the oral cavity and tongue are in direct contact with the development of dental erosions. During the erosive attack of the saliva, its protective mechanisms such as dilution of erosive agents, neutralization and buffering of acids and slows down the decomposition of the enamel through the common ionic effect of calcium and phosphates. Saliva offers protective effects that act continuously, and at the same time, and dynamic effects that act during the challenge. Salivary flow and neutralization of acids are important dynamic effects of saliva that prevent demineralization. If these two effects are compared, the acid buffer is the most important because it is associated with improved remineralization. Fluoride in the saliva (from toothpaste and tooth materials and from foods and beverages) can cause remineralization and prevent demineralization. In a healthy environment, the pH of the inactive saliva is maintained at the limits of 6.7 to 7.4. The bicarbonate system buffer (HCO3) is the largest buffer present in the saliva. Just like in the peripheral blood, the combination of sodium bicarbonate, carbonic acid and gaseous carbon dioxide is an effective way of releasing the protons (hydrogen ions) from the system. When considering the dynamics of the buffer system. Saliva contains a large number of inorganic ions including calcium, phosphates, fluoride, magnesium, sodium, potassium and chloride.

GOAL: Streptococcus mutans and streptococcus sobrinus are considered to be the main etiological agents for the appearance of dental caries in humans. It has been established that in children of pre-school age in whose saliva s. mutans and s. sobrinus have a significantly higher incidence of dental caries than those with the presence of only s. mutans. METHODS AND MATERIALS: In the examination we included 74 examinees at the age from 4-6 years (primary dentition), from which 31 were with a dmft=0 (control group) and 43 examinees were with dental caries (studied group). Isolation of s. mutans and s. sobrinus samples of saliva we did with genomic charge switch Forensic DNa Purification kit (Invitrogen). (Invitrogen corporation 1600 Faraday). RESULTS: In the experimental group of 43 (58, 10%) children, s. mutans was isolated in 36 (48, 60%) of the saliva and 7 (9, 50%) was not isolated s. mutans. In the control group of a total of 31 (41, 90%) children, in 18 (24, 30%) of children from the saliva, s. mutans is isolated, and 13 (17, 60%) of children from the saliva is not isolated s. mutans. In the distribution of data related to the detection of streptococcus mutans in saliva in children with primary dentition, there is a significant difference between the two groups for Pearson chi square = 6. 01 and p

Introduction: A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches. It is considered one of the most common dental problems together with dental caries, gingival disease and dental fluorosis. Classification according to Angle is based on irregularities of teeth and jaws in anteroposterior or sagittal direction. There are three classes of malocclusion: Class I (neutroocclusion), Class II (distoocclusion) and Class III (mesioocclusion).The purpose of this study was to analyze and to assess the status of occlusion, the molar and the canine relationship of the permanent dentition. Aim: To assess the occurance of dental malocclusion in dental medicine students. Material and methods: The study included 22 students (11 female and 11 male) aged 22 to 31 of Dental Medicine from Goce Delchev University. An intraoral examination was performed. The students who were examined were informed that they would be included in our research. Results: From the total number of students 63.6% have Angle's Class I maloclussion, 22.7% have the presence of Angle's Class II molar relationship (Class II Division 1 or Class II Division 2) and 13.6 % have the presence of Angle's Class I molar relationship and Angle's Class II canine relationship (unilateral or bilateral). Frequency of crowding was observed in 77.3%, diastema was present in 4.5%, and posterior crossbite was 9.1%. Anterior crossbite was not detected. Conclusion: The most common malocclusion among students is Angle's Class I with normal canine and molar relationship. This study gives us valuable information on identifying occlusal problems, their incidence and the need for orthodontic treatment.

The patients think that visiting the dentist is stressful and terrifying. The reasons why they are avoiding the check-ups are often the reasons why the oral conditions are getting worse. Because of that the patients needs the regular check-ups in the dental office. The regular dental check-ups lead to maintaining the oral cavity in healthy state. Materials and methods: Total number of 50 patients, male and female, aged between 25-50 years, consulting for regular dental control check-up were evaluated. All of the subjects were with some of the most common reasons for regular dental check-ups and we divide them in some groups because of their similarity. Results: High prevalence of toothache in more than 90 % of the subjects was recorded among the patients. The results showed that there is a high significant correlation between the subjective situation (what the patient feels) and objective evaluation (what the dentist detects in patients` oral cavity). The most common reasons for regular dental checks ups are: toothache, bleeding gum, professional cleaning of teeth, something that the patient thinks is happening in the mouth but there isn’t any problem, orthodontic control etc. Conclusion: We can conclude that the most common reasons for dental check-ups are usually the first sights of some dental problems.

Diabetes mellitus is a systematic disease and has a major negative impact on different organs and systems, including oral cavity and teeth. Diabetes mellitus is a common and a serious public health problem. There are 3 types of diabetes: type 1 also known as juvenile or insulin dependent diabetes, type 2 or non-insulin-dependent diabetes mellitus and type 3 or gestational diabetes. Dentists often are faced with diabetic patients who are demanding orthodontic treatment. The main aim of this study was to evaluate the oral manifestation in orthodontic patients. Oral and dental manifestation of diabetes mellitus are: mouth dryness (xerostomia), burning mouth syndrome, dental caries, periodontitis and gingivitis, ketone breath in poorly controlled patients, teeth disposition and misalignment, brittle teeth, recurrent oral infections (e.g. oral candida, mouth ulcerations), altered taste sensation and also there is delayed healing of mucous membranes. Treatment considerations in patients with diabetes mellitus are: consideration before deciding orthodontic treatment, during the process of orthodontic intervention and diabetic emergencies during orthodontic treatment. Diabetic patients often seek for orthodontic treatment and dentists should be aware about the importance of this condition to prevent all possible complications. It is necessary for dentists to have a basic and solid knowledge about diabetes diagnosis, management, dental consequences, and the considerations to be taken during orthodontic treatment. Diabetes is not a contraindication to orthodontic treatment.

Maintaining good oral hygiene, reducing the presence of dental plaque in the mouth is an important part of the everyday lives of patients. The importance is even greater in patients undergoing orthodontic treatment. The aim of this study was to assess the oral hygiene behavior among the patients during orthodontic treatment with fixed appliances. One hundred and two orthodontic patients (65 female) and (37 male) treated with fixed appliances were studied. Patients were requested to fill out a structured questionnaire about oral hygiene behavior after placement of fixed orthodontic appliances. Results showed that 65.68 % from the patients brush their teeth twice a day. Most of them, 68.63% use orthodontic tooth brush and 78.43% use fluorid toothpaste. 33.33% from the patients use interdental brushes and 81.37% of them are using mouthwash solutions. Percentage of regular and occasional uses of dental floss were 7.84% and 21.57%. Oral hygiene instructions are necessary throughout the entire orthodontic treatment and they need to be strengthened. Patients undergoing fixed orthodontic treatment are required to be educated and motivated to maintain their oral hygiene on a high level. Keywords: Dental floss,Interdental brushes,Mouthwash solutions, Oral health, Orthodontic treatment

Background: The best make up on our face is smiling. All ceramics crown or bridges is the solutions for a beautiful smile that we all wish. All ceramics represent the highest achievements of modern dentistry. Aesthetic dentistry would be unthinkable without all ceramics. The purpose of this study was to show our management of smile design with all ceramics bridge. Case report: A 37 years old male patient visit our dental office searching for solution for his unsatisfactory smile appearance. Thought clinical examination, missing tooth, tooth discoloration after root canal treatment, low smile line and caries were found. All the solutions were offered to the patient, and a bridge was chosen all ceramics dental bridge as the best solution. A preparation on the three frontal teeth was made. Impressions were taken and sent to the laboratory where dental bridge with three anchor crown and one lateral pontic were made. After try-in the bridge were cemented by light curing cement. After follow-up there were no signs of changes in the bridge. Conclusion: А patient was satisfied with the restoration done. All-ceramic systems achieving the esthetic results and cover all indications in fixed prosthodontics while. Key words: Aesthetic, ceramics, dental bridge, fixed prosthodontics.

The toothbrush has a major role in maintaining proper oral hygiene. Its use has reduced the appearance of dental caries, but the risk of injuries to the hard and soft tissues in the mouth is increased. Gum injury is one of the most common caused by a toothbrush with bristles that are too hard, or using improper brushing techniques. Cuts on gums can be quite painful, and may take up to two weeks or more to heal. During a conversation with the patient, he explained that he began using a new toothbrush and after several days of use, felt pain in his mouth and spotted gum injuries. Gum injury is observed on the upper and lower jaws on the right side. The changes are localized to the palate in the area of the upper first molar and lingually at the lower second premolar. The patient is advised to use a gingival gel, to rinse the mouth with an antiseptic solution, avoid salty and spicy foods, cigarettes and alcohol. Traumatic injuries can be from superficial to penetrating injuries. Some of these can cause serious complications. The choice of appropriate treatment will depend on the type of injury. It is necessary to use a suitable toothbrush with soft fibers and to use the correct brushing technique with dosed force. It is necessary to train patients for the correct technique and method of brushing and also to help for the correct selection of tootbrushes. Keywords Dental examination, Injury, Oral hygiene, Patient, Toothbrush

Tooth discoloration can be the cause of great embarrassment and can make people feel self conscious about smiling. It is important to remember that no one’s teeth are naturally perfectly white and it’s normal for our teeth to become duller as we age.Nevertheless, important lifestyle factors also play a large part in tooth discolouration and it is important to recognise these. Aim: Тo perform a systematic literature review on materials used in everyday dental practice wich cause tooth discoloration. Materials and Methods: We made an evaluation on the literature, analyzed many studies and we pointed the most common causes. Results:Amalgam fillings often gives tooth discoloration. This is most noticeable in very old fillings, as pigment slowly leaches out of the amalgam filling material and its associated corroded surfaces.. Tetracycline is a broad spectrum antibiotic, and its derivative minocycline is common in the treatment of acne.The drug is able to chelate calcium ions and is incorporated into teeth, cartilage and bone. Later, the tetracycline oxidizes and the staining becomes more brown and no longer fluoresces under UV light. Other drugs derived from tetracycline such as glycylcycline share this side effect. Conclusion: We can conclude that the many of the patients have tooth discolorations after dental interventions caused by dental materials especially from amalgam, dental trauma and antibiotic.

Pregnancy as one of the most important periods in a woman's life causes major changes in maternal anatomy, physiology, and metabolism. Certain changes in the oral cavity occur and it does not present a reason to avoid the necessary dental treatments. Increased blood flow through the body, increased acidity in the mouth, as well as changes in hormonal status, particularly the increase in estrogen and progesterone during pregnancy can result in certain changes in the oral cavity. These changes include pregnancy gingivitis, periodontitis, tooth erosion, mobility of the teeth, pregnancy tumors, xerostomia and dental caries. Research shows that the most common change in the mouth is gingivitis with prevalence from 65% to 70%. Gingivitis is actually an inflammation of the gums characterized by gingival bleeding and occurs as a result of the presence of dental plaque. If it remains untreated, it may lead to a more severe form of periodontal disease. Periodontitis occurs when the inflammation expands into other tissues of the periodontium, resulting in their destruction, and over time leads to loss of teeth. During pregnancy, the oral cavity is more often exposed to gastric acid as a result of frequent morning vomiting, resulting in erosion of the teeth. Pregnancy tumors in the oral cavity that do not differ from the pyogenic tumor occur most often after the first trimester as a result of increased progesterone in combination with bacteria and local irritant factors. They usually withdraw after the birth of the baby. Mobility of teeth during pregnancy is associated with the extent of periodontal disease as well as the change in the mineral composition of the lamina dura. Changes in the composition of saliva and xerostomia are pregnancy-specific conditions that require increased oral hygiene and fluoride use, which will reduce the risk of dental caries. Treatment of these changes sometimes requires radiographic imaging that is not contraindicated in pregnancy, as exposure to low levels of radioactivity is presentand and all safety measures are taken.In pregnancy, local anesthetics with epinephrine are used. When the use of antibiotics is indicated, all penicillins, erythromycin, and cephalosporins are considered safe during pregnancy. The use of tetracyclines, vancomycin and streptomycin is contraindicated. Acetaminophen is the safest analgesic during pregnancy.Because there is a potential for liver toxicity, patients should be advised of the maximum daily dose and how to take the medicine. Adequate education is needed of pregnant patients for oral hygiene, possible changes in the mouth and regular dental visits.Dental examinations before and during pregnancy are important for the dentist to find and treat dental problems in the mouth. He may recommend treatment during pregnancy or after giving birth to the baby. Keywords: pregnancy, gingivitis, erosions, oral hygiene, education.

Oral health is essential for general health and quality of life. Healthy oral cavity prevents not only the GI disorder, but contribute to well-being of the human body. According to WHO it is a state of being free from mount and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking and psychosocial wellbeing. Good oral hygiene is important for everyone, but it is especially important for people with gastrointestinal disease. Gastrointestinal diseases are those that affect any section of the gastrointestinal tract, from the mouth to the anus. The commonest gastrointestinal tract disorders include: oesophageal reflux, abdominal hernia, irritable bowel syndrome, constipation, gall stones etc. Some of gastrointestinal (GI) diseases have oral manifestation like gum bleeding, gum proliferation, teeth abrasion, ulcerations, pain, etc. They need special oral care and hygiene to prevent of getting worse (teeth and gum disease). The combination of oral hygiene and the therapy of the GI disorder is very important to prevent worsening of the main GI disorder and the oral status. The dentist should give advice for maintenance better oral hygiene with special soft bristle toothbrush with appropriate size, to avoid tooth decay, gingivitis and periodontal disease. Proper oral hygiene include cleaning oral cavity and teeth correctly and regularly: brushing thoroughly twice a day with fluoride paste and flossing at least once daily, eating a balanced diet and limiting snacks between meals, using dental products that contain fluoride, including toothpaste, using antiseptic mouthwash twice a day, quitting cigarette smoking etc. Visit the dentist regularly for professional cleaning and check-ups is the most important habit to reduce the risk of getting worse the oral status. The teeth must be cleaned professionally in dental office by dentist at least twice per year. Dental visits should take place every 3 months to monitor the condition of oral cavity and the stage of oral manifestation of gastrointestinal disease. We recommended maintenance oral health with proper oral hygiene and combine with therapy of gastrointestinal disease to avoid worsening the systematic disorder. Keywords: oral hygiene, oral health, gastrointestinal disease, patient.

Introduction: Traumatic dental injury, caries and oral cancer are among the major public health care problems worldwide. They can cause irreversible dental loss of primary or permanent teeth. The reason for dental injury is accident due playing, car crash, fight etc. Avulsion, intrusion, infraction, subluxation, contusion, complicated and uncomplicated crown fracture, crown root fracture with or without pulp explosion are the most common traumatic injuries in primary teeth. The purpose of this study was to determine the most common traumatic injury. Materials and Methods: An electronic search was conducted using the following parameters: Terms: “teeth”, “trauma”, “dental injury”, and “primary teeth”. We found few articles and studies with this key words and arrange them and show results. Results: In 75% of the reviews we found that the most common dental injury is infraction and avulsion and the most common dental region is the front (central and lateral incisors, very rare canine). Conclusion: We concluded that primary teeth are more affected with traumatic dental injury than permanent teeth. Key words: primary teeth, dental injury, trauma

Background: Special needs children are handicapped children who are suffering from various systematic disorders such as physical, developmental, mental, sensory, behavioral, cognitive, emotional impairment. The main aim of this study was to determinate the oral health status of children with special needs in municipality of Shtip, as a high risk group for dental diseases. Material and Methods: Thirty children with special needs were included in the study. Determination of condition of the dentition and plaque index were done. The presence of dental plaque and condition of the teeth were determinate with Silness and Löe plaque index and Decayed, Missing, Filled (DMF) index. Results: Average value of Silness and Löe plaque index was 2.11, which shows very bad oral hygiene among subjects. The mean value of DMFT index among subjects was 12.3. Sixty-four percent had plaque index more than two, which means that they maintain unsatisfactory oral hygiene. The mean value of decayed teeth was 4.25, which means that children have a high prevalence of caries and should take appropriate measures for removing dental caries and adequate permanent fillings of those teeth. Conclusion: Oral health of children with special needs is bad and urgent attention is needed for planning a comprehensive dental care program for them. Keywords: children with special needs, handicapped children, DMFT, Silness and Löe plaque index

Background: Dental caries known in humans as tooth decay is one of the most common chronic diseases that can be seen in the pacient’s mouth. It can occur in the crown or the root of the tooth. Of particular importance after his detection is the correct treatment. It consists of a complete removal of dental caries and proper restoration of the tooth. There are two types of dental restoration. Direct tooth restoration involves placing a filling immediately and this procedure can be done in a single visit. Indirect tooth restoration requires more than one office visit, as it must be fabricated in a dental lab. Material and Methods: Thirty-eight students were included in this study. Intraoral examinations were made in each of them to determinate the number, the localization of the present direct restorations as well as the material from which they were made. The intraoral examination of the students was made by a dentist in a dental office. Results: As a result, we received a total of 238 restored teeth. In 2.63%, the highest number of restorations that was observed is 17, while in 7.89% of the students it was determined that they had no restorations. The frontal area is represented by 6.3%, while in the lateral region 93.7%. Most of the restorations are with composite filling precisely 92.44%, while amalgam fillings are represented by 7.56%. Conclusion: Dental caries is quite common in the population, but it is well controlled. Today there are a number of techniques and materials that allow the dentist to preserve the tooth and prevent his extraction. Key words: caries, teeth, restoration, materials…

Bruxism is a disorder of the stomatognatic system followed by parafunctional movements which includes clenching or grinding of the teeth. This is a very widespread problem that follows man from his genesis up to today's modern age. There are many definitions of bruxism. According to the American Academy of Orofacial Pain, bruxism is defined as “diurnal or nocturnal parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth.” Daily bruxism today is described as a special condition - bruxomania and is characterized only by clenching teeth. In patients with sleep bruxism, a clenching and grinding of the teeth is registered and it usually occurs in the early stage of sleep. Although this condition is with multifactorial etiology, many authors agree that stress and emotional factors are the primary cause of bruxism. In such situations, patients in order to relive tension unconsciously cause harmful parafunctional movements. Comparing to functional movements, parafunctional activities in bruxism develop much larger forces. The forces that occur can be vertical and horizontal. Therefore, bruxism can occur in two forms. The first is horizontal shape (grinding) when we have extreme horizontal movements. These movements cause attrition on the incisal edges and teeth cusps. This reduces patients’ vertical dimension. The other form is - vertical (clenching) where are described minimal movements, which affect the lingual surface of the upper and labial surface of the lower front teeth, but do not influence on patients’ vertical dimension. Objective signs and symptoms of bruxism are: abrasion, attrition; influence of the periodontal ligament and mobility of the teeth; hypertrophy of the masticatory muscles; changes in the temporomandibular joint; headaches and pain in the masticatory muscles. At the same time, genetic predisposition to bruxism has been confirmed, as well as the influence of some provocative factors - drugs, alcohol, cigarettes, malnutrition and central nervous system disorders. Bruxism can occur in all age groups, from young children to prosthetic carriers. However, the biggest incidence is registered in the adolescent period. The therapy of bruxism is complex, like any treatment of phenomena and conditions that do not have a clear etiology. Treatment should include reduction of psychological stress, treating the symptoms of mandibular dysfunction, adjusting the occlusion by using occlusal splints, and, if necessary, including pharmacotherapy. Occlusal therapy can reduce the negative consequences of parafunctional activities, but not to stop them. This kind of therapy is used when parafunctional activities cause problems in the stomatognatic system such as muscular and temporomandibular joint disorders, pain, excessive abrasion and attrition of the hard tooth substance as well as increased mobility of the teeth. The following forms of splint are used in therapy: interdental protectors, repositioning and stabilizing splints. Keywords: bruxism, parafunctional activities, teeth grinding, therapy.

The three-dimensional hermetic root canal obturation presents one of the most important conditions for successful prognosis in endodontic therapy. The objective of this study was evaluated the quality of three different gutta-percha techniques for root canal obturation. Sixty single root human teeth was used in this study. According to technique of gutta-percha application teeth were divided in three groups: I group – 20 endodontic treated teeth obturated with AH plus sealer and Gutta Flow technique; II group – 20 endodontic treated teeth obturated with AH plus sealer and single cone gutta-percha technique III group – 20 endodontic treated teeth obturated with AH plus sealer and Thermafil gutta-percha technique. the crowns were cut with turbine and diamond burs. teeth roots were divided on three cross-cut segments: orifice, middle and apical third. quantitative and qualitative analysis and evaluation of canal obturation was performed on Light microscope OLYMPUS® SZ61 by two irrespective researchers.