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Objectives: We assessed the long-term cost-effectiveness of glass hybrid (GH) versus composite (CO) for restoring permanent molars using a health economic modelling approach. Methods: A multi-national (Croatia, Serbia, Italy, Turkey) split-mouth randomized trial comparing GH and CO in occlusal-proximal two-surfaced cavities in permanent molars (n=180/360 patients/molars) provided data on restoration failure and allocation probabilities (i.e. failure requiring re-restoration, repair or endodontic therapy). Using Markov modelling, we followed molars over the lifetime of an initially 12-years-old individual. Our health outcome was the time a tooth was retained. A mixed-payers' perspective within German healthcare was used to determine costs (in Euro 2018) using fee item catalogues. Monte-Carlo-microsimulations, univariate and probabilistic sensitivity analyses were conducted. Incremental cost-effectiveness ratios (ICER)s and costeffectiveness-acceptability were quantified. Results: In the base-case scenario, CO was more effective (tooth retention for a mean (SD) 54.4 (1.7) years) but also more costly (694 (54) Euro) than GH (53.9 (1.7) years; 614 (56 Euro). The ICER was 158 Euro/year, i.e. payers needed to be willing to invest 158 Euro per additional year of tooth retention when using CO. In a sensitivity analysis, this finding was confirmed or GH found more effective and less costly. Conclusion: CO was more costly and limitedly more effective than GH, and while there is uncertainty around our findings, GH is likely a cost-effectiveness option for restoring permanent molars. Clinical significance: When considering the long-term (life-time) cost-effectiveness, GH showed cost savings but CO was limitedly more effective. Overall, cost-effectiveness differences seems limited or in favour of GH., University of Zagreb, This original study was supported by a grant from the University of Zagreb (2015 and 2017).

To investigate the micro push-out bond strength of individually formed (everStick Post) and prefabricated (GC Fiber Post) fiber-reinforced composite (FRC) posts cemented with three different types of self-adhesive composite cements.Forty-two single-rooted human teeth were decoronated, endodontically treated, and had post spaces prepared for everStick Post (n = 21) or GC Fiber Post (n = 21). The teeth were randomly divided into three subgroups (n = 7), and posts were cemented either with G-CEM LinkAce (GC), SpeedCEM (Ivoclar Vivadent) or RelyX U200 (3M Oral Care). Specimens were then perpendicularly sectioned and divided at the cementoenamel junction into two root levels: coronal or apical. A micro push-out test was performed using an 0.8-mm-wide stainless steel plunger. Bond strength was calculated in MPa by dividing the fracture load (N) by the bonded surface area (mm2). Log-transformed data was statistically analyzed using factorial ANOVA and Tukey's post-hoc test (α0.05). Fracture modes were determined employing a stereomicroscope, and differences were evaluated using a likelihood ratio test and Pearson's chi-squared test. Specimens were also observed using SEM.Bond strengths were significantly affected by both post type and root level (p0.05), but not by self-adhesive cement (p0.05). Fracture types showed a significantly higher prevalence of adhesive fractures at the apical level, with all fractures starting at the cement-dentin interface.Individually formed FRC posts demonstrated greater bond strength than their prefabricated FRC counterparts. The apical level of the luted posts yielded lower bond strengths than the coronal level. Failures were predominantly adhesive at the cement-dentin interface.

In this study the mechanical behavior and water sorption (Ws) of experimental glass-ionomer-cements (GICs) with hydroxyapatite (HA) or calcium fluorapatite (CFA) prototype formulations were examined. Specimens from two experimental and one commercially available GIC were prepared in three protocols ; (1) according to the manufacturer’s instructions, (2) with coating and (3) with heat application. The specimens were stored in distilled water or artificial saliva at 37°C for 7- and 30-days. Flexural strength (FS), Vickers hardness (VHN) and Ws of GICs were evaluated. Experimental GICs showed higher FS values than commercial GIC (p0.05). The GICs with HA or CFA formulations might represent a promising approach due to their FS, VHN and Ws characteristics.

Objectives The aim of this study was to evaluate the effect of photon induced photoacoustic streaming (PIPS) technique in combination with EDTA on bond strength of gutta-percha/AH Plus and Resilon/RealSeal SE root canal fillings to root dentine. Materials and Methods Forty freshly extracted human maxillary anterior teeth with intact straight roots, were instrumented endodontically with rotating ProTaper instruments and randomly divided into two experimental groups. In group 1 (n = 20), root canals were rinsed for 1 minute with 2 ml of 17% EDTA. In group 2 (n = 20), Er:YAG laser, with a 14 mm long 400 μ diameter tapered PIPS tip, was used for 1 minute with 2 ml of 17% EDTA. The laser parameters used were: 20 mJ per pulse, 15 Hz, 50 microsecond. In each experimental group, half of the root canals (n = 10) were obturated with gutta-percha/AH Plus and other half (n = 10) with Resilon/RealSeal SE. A micropush-out test was performed on sectiond specimens of the filled roots using a universal testing machine and resistance to failure plus failure modes were determined. Results Both gutta-percha/AH Plus groups had higher bond strength to root dentin than the Resilon/RealSeal SE groups (P 0.05). Conclusion Within the limitations of this study, it was found that the application of the PIPS technique did not have an affect on the push-out bond strength of Resilon/RealSeal SE root canal filling to dentin nor on the gutta-percha/AH Plus. A significant difference in bond strength was noted between the two root canal filling materials. Lasers Surg. Med. © 2016 Wiley Periodicals, Inc.

Uvod: Svrha istraživanja bila je ispitati citotoksičnost dvaju različitih bioaktivnih materijala za punjenje korijenskih kanala temeljenih na mineral-trioksidnom agregatu MTA Fillapex (Angelus, Solucoes Odontologicas, Londrina, PR, Brazil) i biokeramici, Endosequence BC Sealer (Brasseler, Savannah, Georgia, SAD) u kulturi mišjih fibroblasta L929. Materijali i postupci: Mišji fibroblasti L929, dobiveni iz potkožnog veziva miševa linije C3Hf, uzgojeni su u plastičnim posudama za staničnu kulturu površine 75 cm2 u inkubatoru na temperaturi od 37 ºC, uz 5-posto CO2 i 90 posto vlažnosti. Svježe zamiješani materijali – (0,1 g) Endosequence BC Sealer i MTA Fillapex – naneseni su na sterilne teflonske diskove promjera šest milimetara. Diskovi s materijalom i prazni teflonski diskovi koji su služili kao kontrola, stavljeni su u bunariće pločica za staničnu kulturu. Nakon inkubacije od jedan sat, šest, 20 i 24 sata, uklonjeni su teflonski diskovi i određen je broj živih stanica tripanskim modrilom u Neubaerovoj komorici. Rezultati: Promatranjem razlike između ispitivanih materijala i kontrolne skupine u pojedinim inkubacijskim razdobljima, dokazano je da punilo MTA u svim inkubacijskim razdobljima pokazuje statistički značajan pad broja živih stanica (p ≤ 0,05), a kod punila BC pojavljuje se statistički značajna razlika od šestog do dvadeset i četvrtog sata inkubacije (p ≤ 0,05). Punilo MTA u odnosu na punilo BC pokazalo je statistički značajan pad broja živih stanica samo nakon prvog i dvadesetog sata inkubacije (p ≤ 0,05), a u ostalim inkubacijskim razdobljima ta razlika nije bila statistički značajna (p ≥ 0,05). Zaključak: Punila MTA i Endosequence BC bila su citotoksična u kulturi mišjih fibroblasta., Objective: The aim of this study was to investigate the cytotoxicity of two different bioactive root canal sealers: one based on mineral trioxide aggregate, MTA Fillapex (Angelus, Solucoes Odontologicas, Londrina, PR, Brazil), and the other based on bioceramics, Endosequence BC Sealer (Brasseler, Savannah, Georgia, USA), in culture of mouse L929 fibroblasts. Materials and methods: Mouse fibroblasts (L929), obtained from subcutaneous connective tissue of mouse line C3Hf, were cultivated in plastic culture flasks in an incubator at 37ºC, with 5% CO2 and 90% humidity. Freshly mixed Endosequence BC Sealer and MTA Fillapex (0.1 g each) were placed on sterile teflon discs, 6 mm in diameter. Teflon discs with the materials as well as empty discs serving as control were placed in wells of 12-well plate. After incubation times of 1, 6, 20 and 24 hours, the teflon discs were removed from the wells and the number of viable cells was determined using trypan blue in Neubauer chamber. Results: In comparison to the control group, MTA Fillapex had significantly less viable cells for all incubation periods (p≤0.05), while Endosequence BC sealer had significantly less viable cells after 6, 20, and 24 hours of incubation (p≤0.05). MTA Fillapex exhibited ignificantly less viable cells in comparison to Endosequence BC sealer after the first hour and after 20 hours of incubation (p≤0.05), while for the other incubation periods there were no significant differences (p≥0.05). Conclusion: MTA Fillapex and Endosequence BC sealer were both cytotoxic in cultures of mouse L929 fibroblasts.

SUMMARY – The aim of this in vitro study was to evaluate cytotoxicity and genotoxicity of six different dental nanocomposite materials, three conventional ones and three flowable composite resin materials, in human lymphocytes. The following materials were tested: Tetric EvoCeram, Tetric EvoFlow, Filtek Ultimate, Filtek Ultimate Flow, G-aenial and G-aenial Flo. Cytotoxicity was evaluated for two mass concentrations (0.007 g/mL and 0.013 g/mL) of each material, non-cured and cured, after 4 hours and 24 hours. Genotoxicity was evaluated using micronucleus assay under the same conditions as applied during the investigation of cytotoxicity. Uncured forms of Tetric EvoCeram, Tetric EvoFlow and Filtek Ultimate Flow in higher mass concentration caused genotoxic effect. Uncured G-aenial Flo in higher mass concentration induced apoptosis and necrosis. Uncured Tetric EvoFlow and uncured Filtek Ultimate Flow in higher mass concentration induced early apoptosis after both test periods. None of the conventional composite resin materials tested showed cytotoxicity except for uncured G-aenial, which induced apoptosis in higher mass concentration in both test periods. In conclusion, under the conditions of this in vitro study, cured conventional composites did not show cytotoxic or genotoxic effect, which is important for clinical application of these materials, whereas uncured forms exhibited certain level of cytotoxicity and genotoxicity, mainly because of monomers in their composition.

The primary objective of this in vitro study was to evaluate the efficiency of removal of cariogenic bacteria and carious dentin by ablation using two lasers: fluorescence-feedback controlled (FFC) Er:YAG laser and different pulses of Er:YAG laser based on variable square pulse technology (VSPt). The secondary objective was to measure the temperature during laser ablation of carious tissue. Seventy-two extracted human molars were used in this study. Sixty teeth with carious dentin were randomly divided into four experimental groups according to the treatment for caries removal: group 1: 400 ms (FFC group) ; group 2: super short pulse (SSP group, 50 ms pulse) ; group 3: medium short pulse (MSP group, 100 ms pulse) ; group 4: short pulse (SP group, 300 ms pulse) and one positive control group with no treatment. Twelve teeth without carious lesion were used as a negative control group. After caries removal, swabs were taken with cotton pellets and real-time PCR analysis was performed. During caries ablation, a thermal infrared camera was used to measure the temperature changes. In all experimental groups, specimens were free of bacterial contamination after the treatment. In the SSP, MSP and SP groups, temperatures measured during caries ablation were significantly higher compared to temperatures in the FFC group (Po0.001). In this in vitro study, laser treatment for removal of carious dentin and cariogenic bacteria was an efficient treatment modality without causing excessive temperatures that might adversely affect pulp vitality.

STATEMENT OF PROBLEM: Data on the retention of individually formed fiber-reinforced composite posts (everStick) cemented with self-adhesive cement are lacking. PURPOSE: The purpose of this in vitro study was to investigate the pull-out strength of 2 different fiber-reinforced composite posts (prefabricated and individually formed) cemented into extracted teeth with self-adhesive resin cement. MATERIAL AND METHODS: Thirty extracted single-rooted human teeth were decoronated, endodontically treated, and prepared with post spaces of equal length. Prepared specimens were divided into 2 groups (n=15 each) based on the type of post: commercially prefabricated fiber posts (GC) and individually formed resin posts (using GC reinforcing fibers). Self-adhesive resin cement (G-CEM LinkAce ; GC) was used to cement all posts. Each post was held with moderate pressure, and root surfaces were light polymerized for 20 seconds (650 mW/cm2). After cementation, the specimens were stored in saline solution for 30 days. Treated teeth were kept in water for 24 hours before pull-out testing parallel to the longitudinal axis of the posts. Data were analyzed using the Student t test (α=.05) and the coefficient of variance as the ratio of the standard deviation to the mean. RESULTS: The mean pull-out retention strength was 185.7 ±61.2 N for the prefabricated fiber posts and 98.9 ±56.5 N for the individually formed fiber posts (P=.026). CONCLUSIONS: The prefabricated fiber posts exhibited significantly higher retention forces than the individually formed posts.

Objective The aim of this study was to evaluate the bond strength of three calcium silicate- based root-end filling materials. Materials and methods The root canals of 30 single-rooted teeth were endodontically treated ; their root ends were resected and root-end cavities were prepared using ultrasonic tip.Theteethwererandomlydividedintothreegroupsa ccordingtothematerial:(1)Micro- Megamineraltrioxideaggregate (MM- MTA), (2) Biodentine, and (3) TotalFill root repair material (RRM). Push-out test was performed using universal testing machine, and failure mode was analyzed by stereomicroscope. The data were statistically analyzed using KruskalWallis and Man-Whitney post hoc tests. All p values

The aim of this study was to evaluate the effect of photon induced photoacoustic streaming (PIPS) technique in combination with EDTA on bond strength of gutta-percha/AH Plus and Resilon/RealSeal SE root canal fillings to root dentine.Forty freshly extracted human maxillary anterior teeth with intact straight roots, were instrumented endodontically with rotating ProTaper instruments and randomly divided into two experimental groups. In group 1 (n = 20), root canals were rinsed for 1 minute with 2 ml of 17% EDTA. In group 2 (n = 20), Er:YAG laser, with a 14 mm long 400 μ diameter tapered PIPS tip, was used for 1 minute with 2 ml of 17% EDTA. The laser parameters used were: 20 mJ per pulse, 15 Hz, 50 microsecond. In each experimental group, half of the root canals (n = 10) were obturated with gutta-percha/AH Plus and other half (n = 10) with Resilon/RealSeal SE. A micropush-out test was performed on sectiond specimens of the filled roots using a universal testing machine and resistance to failure plus failure modes were determined.Both gutta-percha/AH Plus groups had higher bond strength to root dentin than the Resilon/RealSeal SE groups (P 0.05). The smear layer removal protocol, with EDTA only or combining PIPS technique with EDTA, had no influence on bond strength of either gutta-percha/AH Plus, or Resilon/RealSeal SE (P 0.05).Within the limitations of this study, it was found that the application of the PIPS technique did not have an affect on the push-out bond strength of Resilon/RealSeal SE root canal filling to dentin nor on the gutta-percha/AH Plus. A significant difference in bond strength was noted between the two root canal filling materials. Lasers Surg. Med. 48:951-954, 2016. © 2016 Wiley Periodicals, Inc.

The primary objective of this study was to compare the dentin ablation volume and ablation rate of quantum square pulse (QSP), using two different pulse energy settings plus a new digitally controlled dental laser handpiece (X-Runner), with those of variable square pulse (VSP), using three different pulse durations. The secondary objective was to examine, by scanning electron microscopy (SEM), the surface effects of ablation with the different Er:YAG laser modes on the dentin surfaces.The available literature has limited data on the efficiency of different operating modes, pulse durations, and the new digitally controlled handpiece of the Er:YAG laser on human dentin.Freshly extracted human molars (n = 72) were divided into two experimental groups (n = 36 each): (1) QSP group, and (2) VSP group. Each group was randomly divided into three subgroups (n = 12 each). In the QSP group, preparations in dentin were performed using 250 and 500 mJ of pulse energy with the conventional handpiece, and with the X-Runner handpiece set at 250 mJ pulse energy. In the VSP group, cavity preparations were performed using three pulse variables: super short pulse (SSP), micro short pulse (MSP), and short pulse (SP). Cavity preparations were made in dentin at time intervals of 1, 2, and 5 sec. A laser triangulation profilometer was used to determine cavity volumes. Surface analysis of the ablated dentin specimens was performed by SEM.For time intervals of 1 and 2 sec, ablated volume and ablation rate for QSP-500 mJ were significantly higher than for all other groups (p 0.0001). For the 5-sec time interval, X-Runner and QSP-500 mJ were the most efficient in dentin ablation (p 0.0001). Dentin surfaces were free of smear layer in all groups.The most efficient modes of dentin ablation in the study were the QSP-500 mJ and X-Runner groups. Dentin surfaces were free of smear layer in all groups.

Svrha: Željelo se in vitro istražiti učinak ispiranja aktiviranog različitim erbijskim laserima na čvrstoću vezivanja individualnog kolčića ojačanog vlaknima na dentin korijenskog kanala. Materijali i metode: Dvadeset i sedam jednokorijenskih zuba endodontski su tretirani i poslije preparacije za postavljanje intrakanalnog kolčića podijeljeni u tri skupine (n = 9 po skupini), ovisno o vrsti predtretmana korijenskog dentina: 1. skupina – konvencionalno ispiranje fiziološkom otopinom (kontrolna skupina); 2. skupina – ispiranje fiziološkom otopinom i aktivacija PIPS nastavkom lasera Er:YAG; 3. skupina – ispiranje i aktivacija RFT2 nastavkom lasera Er,Cr:YSGG. Dva uzorka iz svake skupine upotrijebljena su za SEM analizu. U preostale je (n = 7 po skupini) cementiran individualni kolčić ojačan vlaknima everStick POST – korišten je samoadhezivni cement G-CEM LinkAce. Nakon cementiranja uzorci su prerezani okomito na uzdužnu os na nove jedan milimetar debele uzorke koji su podvrgnuti push-out testiranju (0,5 mm/min.). Rezultati su zabilježeni u MPa-u, a logaritmirani i statistički analizirani su ANOVA testom na razini značajnosti od 5 posto. Rezultati: U kontrolnoj skupini zaostatni sloj bio je još prisutan, u skupni Er:YAG bio je uklonjen, a u skupini Er,Cr:YSGG bio je djelomično uklonjen. U skupini Er,Cr:YSGG postignute su najviše vrijednosti čvrstoće vezivanja, slijedila je kontrolna skupina i tek tada skupina Er:YAG. Ipak, među vrijednostima čvrstoće vezivanja spomenutih skupina nije pronađena statistički značajna razlika (p = 0,564). Zaključak: Ispiranje aktivirano nastavcima erbijskih lasera PIPS i RFT2 nije utjecalo na čvrstoću vezivanja individualnih kolčića ojačanih vlaknima na dentin korijenskog kanala., Objective: The aim of this in vitro study was to investigate the effect of laser activated irrigation (LAI) using two erbium lasers on bond strength of individually formed fiber-reinforced composite (FRC) posts to root canal dentin. Materials and methods: Twenty-seven single-rooted human teeth were endodontically treated and after post space preparation divided into three groups (n=9 per group), according to the pre-treatment of post space preparation: 1) Conventional syringe irrigation (CSI) and saline; 2) Er.YAG photon-induced photoacoustic streaming (PIPS) technique and saline; 3) Er,Cr:YSGG activated irrigation with RFT2 tip. Two specimens from each group were used for SEM analysis. The remaining specimens (n=7 per group) received individually formed FRC post, everStick POST, luted with self-adhesive cement, G-CEM LinkAce. After cementation, the roots were perpendicularly sectioned into 1 mm thin sections and a push-out test was carried out (0.5 mm/min). The data were calculated as megapascals and were log transformed and statistically analysed using one-way ANOVA at the level of significance set at 5%. Results: In the control group, the smear layer was still present. In the Er:YAG group, the smear layer was removed. In the Er,Cr:YSGG group, the smear layer was partially removed. The Er,Cr:YSGG group achieved the highest bond strength values, followed by the control group and then the Er:YAG group, but no statistically significant difference was found in bond strength values in the tested group of post space pretreatment (p=0.564). Conclusions: LAI using two erbium lasers, with PIPS or RFT2 tip, did not affect the bond strength of individually formed FRC posts to root canal dentin.

The aim of the study was to evaluate the ablation rate of caries in dentin with fluorescence-feedback controlled Er:YAG, Variable Square Pulse technology (VSPt) based Er:YAG working in different pulse durations, and steel bur.Sixty human molar teeth with caries in dentin, extracted for periodontal reasons, were selected for this study. All selected teeth were randomly divided into five groups, each containing twelve specimens: (1) group FFC, fluorescence feedback-controlled Er:YAG laser; (2) group SSP (super short pulse: 50 μs); (3) group MSP (medium short pulse; 100 μs); (4) group SP (short pulse; 300 μs); and (5) group SB, steel bur in a slow-speed hand piece. A profilometer was used to determine the volume of the ablated caries in dentin. The clinical and real ablation rates of caries in dentin were calculated. Two specimens from each experimental group were selected randomly and subjected to SEM examination.The volumes of the ablated caries in dentin in the SSP and SB groups were statistically significantly different in comparison with other experimental groups (p0.05). The clinical and real ablation rate of caries in dentin was the highest for the SSP group (0.15±0.05 and 0.17±0.05 mm(3)/sec, respectively) and statistically significantly different in comparison with the MSP and SB groups (p0.05). The SB and FFC groups revealed a dentin surface with a smear layer and closed dentinal tubules on SEM micrographs. In the SSP, MSP, and SP groups, an irregular surface without a smear layer was found.Taking into consideration the experimental conditions of the present study, SSP was the most efficient in ablation of caries in dentin, providing a smear layer-free surface with open dentinal tubules.

Baraba A, Želježic D, Kopjar N, Mladinic M, Anic I, Miletic I. Evaluation of cytotoxic and genotoxic effects of two resin-based root-canal sealers and their components on human leucocytes in vitro. International Endodontic Journal, 44, 652–661, 2011. Abstract Aim To evaluate the in vitro genotoxicity and cytotoxicity of two resin-based root canal sealers and to determine the type of cell death they induce. Methodology The sealers tested were Epiphany and RealSeal. Each component of the material (Epiphany Primer, Epiphany Thinning Resin, Epiphany Sealant, RealSeal Primer, RealSeal Thinning Resin and RealSeal Root Canal Sealant), components in permutual combinations and all components mixed together were tested on human peripheral blood leucocytes using ethidium bromide/acridine orange viability staining and comet assay. Simultaneously, untreated negative control cultures were analysed in the same manner. DNA damage was evaluated following 4 h of treatment and after 24 h in the absence of the components of the materials. Results After 4 h of treatment, except thinning resin, each individual component and the different combinations of components induced a significant increase in DNA migration ability (P

The purpose was to measure and analyse the vertical force and torque developed in the wider and narrower root canals during hand ProTaper instrumentation. Twenty human incisors were divided in two groups. Upper incisors were experimental model for the wide, while the lower incisors for the narrow root canals. Measurements of the force and torque were done by a device constructed for this purpose. Differences between the groups were statistically analysed by Mann–Whitney U-test with the significance level set to P

Epiphany/Resilon™ und GuttaFlow® sind neu entwickelte Methoden zur Obturation des Wurzelkanalsystems. Epiphany/Resilon™ ist ein thermoplastisches, synthetisches Wurzelfullungsmaterial auf Polymerbasis, mit dem eine Haftung am Dentin der Wurzelkanalwand ermoglicht werden soll. GuttaFlow® ist ein Kaltfullsystem fur Wurzelkanale, welches Sealer und Guttapercha in einem Produkt vereint. Es wurde untersucht, ob mit Epiphany/Resilon™ oder GuttaFlow® eine dichtere Wurzelkanalfullung erzielt werden kann als mit der lateralen Kondensation von Guttapercha. Fur diese Studie wurden 45 extrahierte menschliche Zahne verwendet, welche zuerst alle chemomechanisch aufbereitet wurden und anschliesend in drei Gruppen aufgeteilt und mit folgenden Materialien gefullt: Guttapercha/AH Plus, Epiphany/Resilon™ und GuttaFlow®. Beim Farbstoffpenetrationstest wurden alle Zahne bei 400 U/min 3 Min. lang mit 1 ml 2 % Methylenblau zentrifugiert und 3 Tage in Salpetersaure 65 % gelegt, um sie aufzulosen. Danach wurde die Menge des in Losung gegangenen Farbstoffs im Photometer bestimmt. Wurzelkanalfullungen mit Epiphany/Resilon™ zeigten weniger Farbstoffpenetration als Wurzelkanalfullungen mit lateraler Kondensation von Guttapercha und GuttaFlow®. Epiphany/Resilon™ ist hervorragend als Wurzelkanalfullmaterial geeignet.

Obiettivi La gestione della carie dentaria rappresenta da sempre una delle procedure odontoiatriche più comuni in età pediatrica. Da un lato, fattori quali le abitudini alimentari e la (spesso) scarsa propensione all’igiene orale da parte dei piccoli pazienti contribuiscono di più, in questa fascia di età, all’accumulo di placca e alla formazione di lesioni cariose. Dall’altro, la presenza di altri fattori di rischio quali la presenza di una dentizione mista o di dispositivi ortodontici fissi e mobili rendono le manovre di igiene più difficoltose e aumentano la tendenza alle demineralizzazioni. Materiali e Metodi Un’analisi della letteratura è stata eseguita per interpretare gli approcci più comuni ai pazienti pediatrici. Gli obiettivi dell’Organizza- zione Mondiale della Sanità (OMS) sono ormai da anni indirizzati a una drastica riduzione della patologia cariosa nel bambino, e questo richiede una sinergia fra tutte le figure professionali che si occupano della salute del paziente, mettendo in pratica misure preventive ancora più che trattando lesioni ormai instauratesi. Molti passi avanti sono stati fatti negli anni anche dai governi nazionali e in Italia esistono da tempo delle chiare linee guida nazionali per aiutare i professionisti in un corretto approccio ai pazienti di età pediatrica. Risultati L’analisi delle linee guida suggerisce misure profilattiche e preventive che sono di facile applicazione e sono indicate per tutti i soggetti in età pediatrica. L’identificazione dei fattori di rischio porta a terapie appropriate e alla corretta scelta dei materiali da impiegare. Conclusioni L’identificazione dei soggetti a rischio rappresenta uno dei passi fondamentali nel paziente pediatrico, poiché può pesantemente influenzare la scelta del materiale, dei periodi di richiamo o anche del momento ideale per intraprendere un trattamento. Un errore può costare la perdita degli elementi dentari, decidui e permanenti, con conseguenti danni futuri al sorriso del paziente.

The aim of this study was to compare in vitro cytotoxicity and determine the type of cell death induced by Hermetic, Diaket, GuttaFlow, Epiphany, SuperEBA and IRM using human laryngeal carcinoma HEp2 cells as the model system. The cytotoxicity was determined by counting the total number of cells by electronic counter, while the number of viable cells was estimated under a light microscope. The number of apoptotic or necrotic cells was estimated under a fluorescent microscope according to their characteristic morphology and staining with specific fluorescent dyes. The results show that GuttaFlow was biocompatible, hardly reducing the number of living human laryngeal carcinoma HEp2 cells thorough all research periods(except after one month period). Different from that, Diaket, Epiphany, IRM, Hermetic, and Super EBA exhibited strong toxicity. Diaket and IRM mostly induced apoptosis while for Epiphany, Hermetic and Super EBA, necrosis was the predominant or only type of cell death.

The purpose of this study was to evaluate vibrations induced by an erbium:yttrium-aluminum-garnet (Er:YAG) laser in the non-contact mode and compare the vibrations with different pulse durations and energy parameters. The experiment was conducted on an extracted tooth built up in silicone impression material. The vibrations were measured by piezoelectric accelerometer for a super-short pulse (SSP), a very short pulse (VSP), and a short pulse (SP) at a frequency of 5 Hz for 1 s. For VSP and SP, the energy parameters tested were 200 mJ, 300 mJ, and 400 mJ. Measurements were performed 15 times for each individual irradiation energy level. The highest values of vibrations were measured for SP (0.160 +/- 0.04 m/s(2)), and the lowest were measured for VSP mode at the energy parameter 200 mJ (0.05 +/- 0.02 m/s(2)). There was a statistically significant (P0.01) difference between the various laser pulse modes (SSP, VSP, SP) at different energy parameters. At energy levels of 300 mJ and 400 mJ, the least amount of vibration during cavity preparations with the non-contact Er:YAG laser was produced by SSP mode.

Lasers are becoming widely used in medicine and dentistry due to their beneficial effects such as: coagulation properties (less postoperative bleeding), less pain and edema. Lasers also allow good and rapid healing, a very low level of discomfort both during and after intervention and a rapid disappearance of symptoms.Laser technology has certain advantages such as accuracy of the incision, absence of vibration and manual pressure during use ; this is also true for Er: YAG laser application. Due to laser positive coagulation effects during surgical procedure, better sight of the work field is obtained.Lasers have played an integral part in the evolution of oral and maxillofacial surgery (OMS) ; and rapidly became the standard of care for many procedures performed by oral surgeons.The reason for this transition is simple: many procedures can be executed more efficiently and with less morbidity using lasers when compared with scalpel, electrocautery or high frequency devices.Laser surgery has emerged as an established method in advanced medicine. Laser- induced remote tissue treatment provides a number of advantages: controllable coagulation and cutting of surgical tissues with wavelength tissue-specific cutting efficiency.

Background and Objectives Variable square pulse (VSP) Er:YAG laser should be quicker than older Er:YAG lasers. The objectives were: (1) comparison of VSP laser and mechanical handpiece efficacy for apicectomy and (2) determination of optimal pulse width/energy/frequency combination. Study Design/Materials and Methods Sixty extracted, single-rooted mature human teeth with round apical parts were instrumented, root filled, cleaned, and divided into four groups. Apical 2 mm of each root were apicectomized with mechanical handpiece and Er:YAG laser with three different settings (LaserA = 200 mJ/300 microseconds/ 8 Hz; LaserB = 200 mJ/100 microseconds/8 Hz; LaserC = 380 mJ/100 microseconds/20 Hz). Timing results were statistically compared. Results LaserC was the most efficient setting. Differences between groups were significant except between LaserC–Mechanical and LaserA–LaserC (P

AIM To examine the use of an Nd:YAG laser in removing gutta-percha fillings from root canals when used in conjunction with eucalyptol, dimethylformamide (DMF) or no solvent. METHODOLOGY Root-canal fillings (sealer and gutta-percha) were removed with laser irradiation of 20 Hz/1.5 W from 30 roots randomly divided in three groups. In group 1, the solvent was eucalyptol; in group 2, the solvent was DMF; and in group 3, no solvent was used. Laser irradiation was performed until the temperature measured on the root surface increased by 4 degrees C over room temperature. The treatment was deemed complete when the apical foramen was reached with the optical fibre and a reamer. The samples were split longitudinally, and the area of remaining gutta-percha on the root-canal walls was determined with the aid of a computer program. The total number of laser pulses to achieve length and the highest temperature recorded was determined for each tooth. The results were statistically analysed using Student's t-test (P < 0.05) for independent samples. RESULTS The average temperature increase in group 1 was 9.17 +/- 0.56 degrees C; in group 2, 9.56 +/- 0.28 degrees C; and in group 3, 8.29 +/- 0.41 degrees C. The shortest time to achieve length was in group 3 (6.4 +/- 0.49 min), then in group 1 (6.7 +/- 0.85 min) and group 2 (7.05 +/- 0.79 min). The area of remaining gutta-percha was the largest in group 2 (6.13 +/- 5.76%), whilst the smallest was for group 3 (4.69 +/- 4.03%), but the difference was not statistically significant. The number of pulses was not statistically significant between the groups. CONCLUSIONS Use of an Nd:YAG laser alone is capable of softening gutta-percha. The addition of solvents did not improve the retreatment, either in terms of the time required for the procedure or in terms of the area of remaining gutta-percha on root-canal walls.

U dosadašnjoj stručnoj literaturi na temelju poznatoga sakupljenog arheološkog materijala i podataka iz antičkih izvora, protopovijesno naselje, poznato pod nazivom Segesta/Segestika, smještano je na položaju Pogorelac na desnoj obali rijeke Kupe, tik prije njezina ušća u rijeku Savu. Ipak, zaštitna arheološka istraživanja u užem gradskom centru Siska, provođena u posljednjih desetak godina, otkrila su na nekoliko pozicija pretpovijesne slojeve ispod slojeva rimske Siscije, što je ukazalo kako je potrebna revizija starije teze. Jedan od tih položaja je i Povijesni arhiv, istraživan 2003. – 2004. godine. Analizom stratigrafskih odnosa i pokretnog materijala zaključeno je kako je ovaj segment predrimskog naselja, u razdoblju 3./2. - 1. st. pr. Kr., naseljavala zajednica koja je pripadala širem panonskom kulturnom krugu i bila samo djelomično latenizirana.

U radu se obrađuje keramika tankih stijenki s lokaliteta sv. Kvirin, nađena pri zaštitnom arheološkom istraživanju 2003., u bloku A i B, stratigrafskoj jedinici SJ 11, odnosno sloju koji je nastao nakon uništenja prve faze izgradnje rimske Siscije. Analizirana je te statistički obrađena do sada objavljena i obrađena keramika tankih stijenki nađena na području antičke Siscije. S lokaliteta sv. Kvirin analizirano je ukupno 100 ulomaka. Analizirana keramika tankih stijenki koji se razlikuju prema tehnici izrade, fakturi, po obliku te načinu ukrašavanja keramike. Izdvojeno je 11 različitih faktura kojima su dodijeljene oznake Sisc.kts.1–11. Prema načinu ukrašavanja podijeljena je na glatku, ukrašenu urezivanjem, utiskivanjem i apliciranim ukrasom. Usporedbom s ostalim materijalom nađenim u ovom sloju, kao i prema stratigrafiji, može se zaključiti kako je materijal vezan uz kasnotiberijevsko- klaudijevsko razdoblje., This paper discusses the thin-walled pottery from the site Sv. Kvirin (Saint Quirinus) , found during the 2003 rescue excavation in sectors A and B, stratigraphic unit SU 11, i.e. the layer formed after the destruction of the first phase of construction of the Roman Siscia. The published thinwalled pottery from the area of ancient Siscia has been examined and statistically analyzed. 100 fragments have been examined from the site Sv. Kvirin. The analyzed thinwalled pottery varies according to the clay body texture, production technique, shape and decoration method. 11 different structural compounds have been singled out and labeled Sisc.kts.1–11. According to the decoration techniques, the pottery was divided into smooth-surface ware, ware with incised decoration, indentation and appliqués. Compared to the rest of the material from this layer, as well as the stratigraphy, it can be concluded that the material dates to the late Tiberian-Claudian period.

Aim The aim of this study was to examine the apical sealing ability of five root canal sealers using a fluid transport model. Methodology A comparison of root canal scalers AH26, AH Plus, Diaket, Apexit, and Ketac-Endo were tested on 60 single-rooted teeth. The coronal part of each tooth was removed at the amelo-cemento junction, and also 3 mm of the root tip. Root canals were instrumented using the 'step-back' technique with Gates Glidden drills and irrigated with 2.5% NaOCl. The specimens were divided into five groups of 10 samples each and filled with test materials and gutta-percha points by the cold lateral condensation technique. Ten teeth were used as a control group, out of which five served as negative and five as positive controls. The leakage was measured by the movement of an air bubble in a capillary glass tube connected to the experimental root section. Results The differences in leakage amongst Ketac-Endo (0.318 microL: SD 0.084), AH26 (0.319 microL; SD 0.075), AH Plus (0.330L; SD 0.085) Apexit (0.360 microL; SD 0.127) and Diaket (0.387 microL; SD 0.140) were not statistically significant (P > 0.05). Conclusions Under the conditions of this study, all five sealers produced a satisfactory seal.

The aim of the study was to evaluate the microtensile bond strength of a composite resin to dentin modified with three different pulse durations of the Er:YAG laser based on variable square pulse technology and with one self-etch adhesive.The entire occlusal enamel was removed to obtain flat dentin surface for 48 human molar teeth. The teeth were randomly divided into four experimental groups (n=12 per group), according to the pretreatment of dentin: (1) control group; (2) super short pulse (SSP) (50 μsec); (3) medium short pulse (MSP) (100 μsec); and (4) short pulse (SP) (300 μsec) with Er:YAG laser. The energy of the laser used was 80 mJ with average power of 0.8 W. The microtensile bond strength was tested with a universal testing machine. Two specimens from each experimental group were subjected to scanning electron microscopic (SEM) examination, to observe the irradiated surface.Dentin surface treated with SSP showed significantly lower microtensile bond strength values (24±9.8 MPa) in comparison with the control group and SP group (35.3±12.8 and 32.9±10.7 MPa, respectively), (p0.05). The MSP and SP groups did not show any statistically significant difference in microtensile bond strength in comparsion with the control group (p0.05).The use of SP and MSP of the Er:YAG laser with one step self-etch adhesive does not impair or improve the microtensile bond strength in dentin, whereas SSP may not be suitable for dentin surface treatment prior to bonding procedures.

Purpose: High-energy lasers have been proposed as an alternative to the conventional surgical drill in oral and maxillofacial surgery. The aims of this study were to compare thermal changes of the bone surface, procedure time, and volume of the removed bone after drilling with an erbium (Er):yttriumaluminum-garnet (YAG) laser versus a low-speed surgical drill. The bone sections were observed under light microscopy and examined histologically. Material and Methods: Thirty bone blocks were prepared from porcine ribs. On each block 2 holes (tunnel preparations) were performed using a low-speed, 1.0-mm-wide, surgical pilot drill and an Er:YAG laser (pulse energy, 1,000 mJ; pulse duration, 300 s; frequency, 20 Hz). The temperature induced by the preparation techniques was measured using an infrared camera. The removed bone volume was calculated by a modified mathematical algorithm. The time required for the preparation was measured with a digital stopwatch and a time-measurement instrument integrated within the computer program. The cortical and spongiose surfaces of the specimens were examined microscopically and histologically under a light microscope with a high-resolution camera. Results: The Er:YAG laser removed significantly more bone tissue than the drill (P .01) in a significantly shorter time (P .01). The temperature was statistically lower during the laser preparation (P .01). Cavities prepared with the laser were regular with clear sharp edges and knifelike cuts. In the drill group, the preparations exhibited irregular edges full of bone fragments and fiberlike debris. Histologic examination of the laser sides showed a 30-m-thick altered sublayer. The tissue in the drill group was covered with a smear layer without any alterations. Conclusions: The Er:YAG laser produced preparations with regular and sharp edges, without bone fragments and debris, in a shorter time, and with less generated heat. Thermal alterations in the treated surface were minimal. © 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:2515-2521, 2012

The purpose was to measure and analyse the vertical force and torque developed in the wider and narrower root canals during hand ProTaper instrumentation. Twenty human incisors were divided in two groups. Upper incisors were experimental model for the wide, while the lower incisors for the narrow root canals. Measurements of the force and torque were done by a device constructed for this purpose. Differences between the groups were statistically analysed by Mann-Whitney U-test with the significance level set to P0.05. Vertical force in the upper incisors ranged 0.25-2.58 N, while in the lower incisors 0.38-6.94 N. Measured torque in the upper incisors ranged 0.53-12.03 Nmm, while in the lower incisor ranged 0.94-10.0 Nmm. Vertical force and torque were higher in the root canals of smaller diameter. The increase in the contact surface results in increase of the vertical force and torque as well in both narrower and wider root canals.

Grad Sisak, kao značajno industrijsko središte Hrvatske 20. stoljeća, jedan je od gradova s bogatom industrijskom baštinom. Od Pivovare iz 1855. godine, preko postrojenja starog Shella u krugu „INA Rafinerije”; Tvornice žeste Petra Teslića – današnja „Segestica”; Gradske munjare – prve električne centrale iz 1907. godine, kao i niza drugih građevina, dio su gradskog identiteta. U ovom se radu prezentiraju tri vrlo vrijedna primjera industrijske baštine: tvornički kompleks Segestice, Munjara te Stari most. Izdvojen je dakle primjer tvorničkog kompleksa, pojedinačne građevine i mostogradnje. Upravo se kroz njih prezentira početak rada na revitalizaciji i prenamjeni industrijske baštine grada Siska.

Cilj: Mjeriti i usporediti vrijednosti vertikalne sile i okretnog momenta ručnih čeličnih instrumenata kod Endo-Eze i step back tehnike tijekom instrumentacije na punoj radnoj dužini. Metode: Istraživanje je provedeno na 40 izvađenih ljudskih mandibularnih sjekutića s jednim ravnim kanalom, podijeljenih u dvije skupine po 20 u svakoj. Kanali su obrađeni ručnim Endo-Eze instrumentima, te K-proširivačima, K i H-strugačima. Vertikalna sila i okretni moment mjereni su posebno konstruiranim uređajem. Vrijednosti su izražene kao medijan i raspon. Statistička obrada podataka napravljena je pomoću Mann-Whitneyjeva U-testa uz P < 0,05. Rezultati: U step back tehnici sila i moment najveći su kod K-strugača veličine 25 (sila 3,58 N; moment 1,31 Nmm), a najmanji kod H-strugača veličine 15 (sila 0,14 N; moment 0,02 Nmm). H-strugač veličine15 je pokazao statistički značajno manji medijan vertikalne sile u odnosu na proširivače veličine 15 (P = 0,006) i 20 (P < 0,001), te u odnosu na K-strugače veličine 15 (P = 0,002) i 20 (P = 0,001). Kod Endo-Eze najveća sila i moment su kod instrumenta veličine 25 (sila 4,24 N; moment 1,31 Nmm). Najmanja vrijednost je kod instrumenta veličine 15 (sila 1,7 N; moment 0,44 Nmm). Instrument Endo-Eze veličine 25 imao je statistički značajno veći moment od instrumenata 15 (P < 0,001) i 20 (P = 0,014), i statistički značajno veću silu od instrumenta 15 (P < 0,001). Zaključak: Medijan mjerenih sila veći je kod proširivača, a najmanji kod H -strugača. Kod Endo-Eze instrumenata medijani vrijednosti sile i momenta povećavaju se s povećanjem promjera instrumenta. Na vrijednosti opterećenja utječe instrumentacijski slijed, konstrukcija instrumenta i različiti pokreti instrumentacije., Objective: Measure and compare the values of vertical force and torque produced by steel hand instruments during Endo-Eze and step back instrumentation techniques on the full working length. Methods: The study was conducted on 40 extracted human mandibular incisors with one single straight canal, divided into two groups of 20 each. The root canals were instrumented with hand Endo-Eze instruments, and K reamer, K and H files. Vertical forces and torque were measured by specially designed device. Values are expressed as median and range. Statistical analysis was made using the Mann-Whitney U-test, P

Kavezni uzgoj ribe u Republici Hrvatskoj jedna je od važnijih gospodarskih djelatnosti. Postavljanjem kaveza za uzgoj neizbježno se mijenja kakvoća morskog okoliša. Radi što manjeg narušavanja biostabilnosti donesene su mjere zaštite okoliša. Cilj je ovoga rada prikazati postupak koji prethodi postavljanju kaveza na planiranoj uzgojnoj lokaciji, te mjere zaštite okoliša, kao i programa praćenja stanja okoliša pri izgradnji uzgajališta bijele ribe., In the Republic of Croatia, fish cage farming is one of the most important economic activities. Fish cage farms inevitably influence the quality of marine environment. Environment protection measures are established in order to minimize negative effects on the stability of ecosystem. The aim of this paper is to give an overview on the procedure of fish cage farm allocation, environment protection measures, as also as program of monitoring before, during and after fish farming allocation.

Aim To assess Croatian dentists’ restorative treatment decisions on approximal caries lesions, including treatment threshold and restorative methods and materials. Methods Croatian translation of the questionnaire assessing restorative treatment decisions on approximal caries, previously validated and used in Norway and Sweden, was distributed to a random sample (n = 800) of Croatian dentists. A total of 307 (38%) dentists answered the questionnaire. The assessed variables were treatment threshold for hypothetical approximal caries lesion and the most favored types of restorative techniques and materials. Results A third of the respondents (39%, 95% confidence interval [CI], 34-44%) would intervene for an approximal caries lesion at the dentin-enamel junction, but a larger proportion (42%; 95% CI, 36-48%) would treat a caries lesion confined to the enamel. For restoration of approximal caries, the majority (66%; 95% CI, 61-71%) would use composite resin. Conclusion Croatian dentists tend to restore approximal caries lesions when the lesions are confined to the enamel and their development can still be arrested.

Objective: The aim of this study was to examine the temperature changes in the pulp chamber during cavity preparation with Er:YAG laser ( =2940 nm) with a very short pulse (VSP). Materials and methods: Nine groups of 10 intact molars were used. One root of each sample was amputated and thermocouple of thermometer (Fluke 52, Fotronic, USA) was inserted in the chamber. Class V cavity preparation in enamel was prepared, and then the preparation was proceed in dentine. Enamel was lased with 400 mJ, 360 mJ and 320 mJ in contact mode using the very short pulse with duration of 100  s. Diameter of fiber tip was 950  m. Frequencies of 15 Hz, 12 Hz and 10 Hz were used, and total time of irradiation was 10 s. Dentine was irradiated with 340 mJ, 280 mJ and 200 mJ and 10 Hz, 8 Hz and 5 Hz during 7 s. Cooling was done with water spray (73 psi / 50 mL/min). The differences were tested by MANOVA and Bonforroni post hoc test. Results: The highest rise in temperature in the pulp was achieved after enamel irradiation by 400 mJ/15 Hz (1.99  0.28 C), and the lowest for the enamel after irradiation by 320 mJ/10 Hz (0.70  0.18 C). In dentine the highest temperature increase was achieved with 340 mJ/10 Hz (1.37  0.42 C), and the lowest with 200 mJ/5 Hz (0.43  0.18 C). Two-way interaction for enamel and dentine showed that influence of energy on temperature increase is stronger than the influence of frequency. Conclusion: Cavity preparation with Er:YAG laser using a VSP mode in vitro did not caused significant increase of temperature in the pulp chamber of human molars.

To evaluate the effect of leakage on differences in genotoxicity of root canal sealers ex vivo according to their main components using two different cytogenetic assays.Six materials of different composition (GuttaFlow, Epiphany, Diaket, IRM, SuperEBA and Hermetic) were tested on human peripheral blood lymphocytes using the comet assay and chromosomal aberration analysis. Prepared materials were eluted in physiological solution for 1 h, 1 day, 5 and 30 days. Thereafter cultures were treated with 8 microg, 4 microg and 2 microg of each sealer. Frequencies of chromatide and chromosome breaks and accentric fragments were determined. Comet assay was used to evaluate primary DNA damage by measuring tail length and tail intensity. Chi-square, Fisher's PLSD (Protected Least Significant Difference) and Kruskall-Wallis non parametric tests were used for statistical analysis.After 1-h elution only the highest dose of Diaket, Hermetic and SuperEBA significantly (P = 0.035, P = 0.048, P = 0.037 respectively) affected the measured cytogenetic parameters. The migration ability of DNA was more strongly affected than induction of chromosomal aberrations. After elutions longer than 24 h none of the tested sealers exhibited a genotoxic effect.Under the conditions used in the study all sealers had acceptable biocompatibility in terms of genotoxicity.

Objectives: The objectives of this study were: (1) to compare the capability of enamel ablation for the Variable Square Pulse technology (VSPt) based Er:YAG laser working in maximum speed (MAX) mode, (1000 mJ/300 µ ; ; sec/20Hz), and the high-speed handpiece, (2) to compare the capability of dentin ablation for the VSPt based Er:YAG laser working in MAX mode and the low-speed handpiece, and (3) to analyze in vitro effects of Er:YAG ablation of enamel and dentine surfaces using SEM. Background Data: A VSPt based Er:YAG laser operating in MAX mode should be appropriate for achieving the maximum ablating speed in hard dental tissues. Materials and Methods: The experiment was conducted on extracted human molar teeth that were cleaned and sterilized. Cavity preparations were made in hard dental tissues with the VSPt Er:YAG laser in MAX mode, high-speed handpiece in enamel and low-speed handpiece in dentin, at different time intervals. A laser triangulation profilometer was used to determine cavity volumes. The cavity surfaces of five specimens were examined by SEM. Results: The Er:YAG laser removed a 3.3 times larger volume of enamel in comparison to the high-speed handpiece, for the same period of time. In dentin, the Er:YAG laser removed 8-18 times more volume when compared to the steel bur, for the same period of time. The Er:YAG ablation rate in dentin was faster than in enamel. SEM of laser prepared cavities showed a well-defined surface, free of the smear layer. Conclusions: The VSP-technology based Er:YAG laser, working in MAX mode, is a more efficient alternative to mechanical drills for enamel and dentine ablation.

Background The aim of this study was to perform a clinical assessment of the association between oral lichenoid reactions (OLR) and amalgam restorations and to determine the salivary concentrations of interleukin-6 (IL-6) and IL-8 before and after replacement of the amalgam restorations. Methods The study included 20 patients with OLR and 20 healthy volunteers, who were examined between 2001 and 2005 at the Oral Medicine Unit of the Medical Faculty University of Rijeka. All patients were skin patch tested by an experienced physician. Saliva samples were collected, prepared and analysed for IL-6 and IL-8 concentrations using enzyme-linked immunosorbent assay. Results Sixteen out of 20 patch-tested patients showed a sensitization to inorganic mercury or amalgam. Total replacement of all amalgam fillings was carried out on 20 patients with fillings based on composite resin, gold, porcelain or a combination of these. Sixteen out of 20 patients showed complete healing of OLR; three patients had marked improvement, whereas one patient showed no improvement. Levels of IL-6 detected before replacement were significantly higher than IL-6 levels following the replacement ( P = 0.003). The IL-8 levels measured before replacement procedure were significantly higher than the IL8 levels after replacement of the fillings ( P < 0.001). Conclusions On the basis of clinical observations, restorative therapy resulted in tissue healing. Following the replacement of amalgam fillings with fillings based on other restorative materials, levels of both IL-6 and IL-8 shifted towards normal, as measured in healthy subjects.

Aim.The aim of this study was to determine tumor necrosis factor-alpha (TNF-α) levels in periapical exudates and to evaluate their relationship with radiological findings.Methodology.Periapical exudates were collected from root canals of 60 single-rooted teeth using absorbent paper points. TNF-αlevels were determined by enzyme-linked immunosorbent assays. The samples were divided into three groups according to the periapical radiolucent area.Results.Nonparametric Kruskal-Wallis test revealed significant differences between TNF-αconcentrations in control group (40,57±28, 15 pg/mL) and group with larger radiolucent areas (2365,79±582, 95 pg/mL), as well as between control and canals with small radiolucent areas (507,66±278, 97) (P<.05).Conclusions.The levels of TNF-αincrease significantly in teeth with periapical pathosis, from smaller to bigger lesions. This research and its results have shown that objective analysis of the TNF-αlevels enables establishment of a relationship between different concentrations of TNF-αand different radiological changes.