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Introduction. Prognosis of root canal treatment is highly dependent on the quality of endodontic space obturation. The main task of successful root canal treatment is to achieve adequate reparation processes in the apical periodontium. The aim of this study was to evaluate the quality of root canal obturation using the method of gas (argon) penetration through three different endodontic materials. Material and Methods. Thirty recently extracted human single-rooted teeth after root canal instrumentation were divided into three identical groups and obturated with three different endodontic materials: group I - GuttaFlow (RSA, Germany), group II - AH Plus (DeTray, Germany), group III - Acroseal (Septodont, France). The quality of root canal obturation was evaluated using the method of gas permeability. Results. The best results were obtained with GuttaFlow. The average penetration rate of argon was 186.7 seconds. Slightly higher gas porosity had AH Plus, 179.9 seconds, while the highest gas permeability was observed after the application of Acroseal, 178.5 seconds. However, there was no statistically significant difference in gas penetration among these endodontic materials (p>0.05). Conclusion. All three endodontic materials showed gas permeability in a given time interval. The best quality of obturation was achieved with GuttaFlow, while the lowest quality was obtained with Acroseal., Uvod. Prognoza lečenja kanala korena zuba umnogome zavisi od kvaliteta opturacije endodontskog prostora. Uspešno izvedeno endodontsko lečenje omogućava i stimuliše odgovarajuće reparacijske procese u apikalnom periodoncijumu, što je osnovni zadatak svakog lečenja kanala korena zuba. Cilj ovog rada je bio da se metodom merenja prodora gasa (argon) kroz tri različita endodontska materijala utvrdi i uporedi dobijeni kvalitet opturacije kanala korena zuba. Materijal i metode rada. Trideset sveže ekstrahovanih jednokanalnih humanih zuba je nakon endodontske instrumentacije svrstano u tri identične grupe, nakon čega su opturisani primenom tri različita endodontska materijala: I grupa - GuttaFlow (Roeko, Nemačka), II grupa - AH Plus (DeTray, Nemačka), III grupa - Acroseal (Septodont, Francuska). Kvalitet dobijene opturacije kanala korena zuba ispitivan je metodom merenja gasne propustljivosti. Rezultati. Najbolje rezultate pokazao je endodontski materijal GuttaFlow, sa prosečnom brzinom prodora gasa argona od 186,7 sekundi. Nešto veću gasnu poroznost imala je pasta AH Plus, 179,9 sekundi, dok je najveća gasna propustljivost uočena nakon primene paste Acroseal - 178,5 sekundi. Međutim, između samih endodontskih materijala nije utvrđena statistički značajna razlika u brzini propuštanja gasa (p>0,05). Zaključak. Dobijeni rezultati su pokazali da je kod sva tri endodontska materijala došlo do propuštanja gasa argona u određenom vremenskom intervalu. Najbolji kvalitet opturacije ostvaren je primenom GuttaFlow, dok je najslabiji rezultat dobijen nakon primene paste Acroseal.

Introduction. Health care, as one of the most important and sensitive fields of human endeavor, has a significant social impact; therefore changes in this area have wide implications on society in general. The latest economic crisis resulted in slow growth of gross domestic product (GDP), high unemployment rates, low living standards, and increased poverty across the globe. This includes decreased capacity of health system, and reduced quality and supply of health services. The aim of the study was to explore possible impact of the current world economic crisis on the public health sector workforce in Serbia. Materials and Methods. The study was conducted as retrospective analyses of the Public Health Institute (PHI) human resource data, the Republic Statistical Office publications and database, the Republic Development Bureau report, as well as the analysis of healthcare expenditures obtained from the Chamber of Health Institutions reports. The comparative analytical method was used for the assessment of socio-economic and human resource indicators over the period of five years, 2006 to 2010. Results. Results showed that the world economic crisis discontinued steady economic growth in Serbia. Between 2006 and 2008, the real GDP growth rate has been fluctuating between 3.6% and 5.4 %, while in 2009 it had negative growth rate of -3.1 % and slight increase in 2010 of 1.0%. In 2006, the GDP per capita was US$ 3,943, and by 2008 it almost doubled reaching US$ 6,498, while in 2009 it fell down to US$ 5,499, and continued decrease in 2010 to US$ 5,006. In 2007, the overall inflation rate was 6.5%, and after fluctuaion between 11.7% in 2008 and 8.4% in 2009 it droped again to 6.5% in 2010. According to the PHI, from 2006 to 2008 there was steady increase of full-time employees in the public health care sector; from 108,975 in 2006 to 114,317 in 2008. In 2009, the number of full-time employees slightly declined to 114,175 and 114,432 in 2010. There was constant increase in, Uvod. Zdravstvena zaštita, kao jedna od najvažnijih i osetljivijih oblasti ljudskog delovanja, ima značajnu društvenu funkciju, pa promene u ovoj oblasti imaju široke implikacije na društvo u celini. Najnovija ekonomska kriza dovela je do sporog rasta bruto domaćeg proizvoda (BDP), visoke stope nezaposlenosti, nižeg životnog standarda i povećanja broja siromašnih širom sveta. Ovo uključuje i smanjenje kapaciteta zdravstvenog sistema, odnosno smanjenje obima i kvaliteta pruženih zdravstvenih usluga. Cilj rada bio je da se procene mogući uticaji svetske ekonomske krize na radnu snagu u javnom sektoru zdravstvenog sistema Republike Srbije. Materijal i metode rada. Retrospektivno su analizirani podaci o ljudskim resursima Instituta za javno zdravlje Srbije (IZJZS), baze podataka i publikacije Republičkog zavoda za statistiku, Republičkog fonda za razvoj, izveštaji Republičkog zavoda za tržište rada i podaci o zdravstvenim rashodima dobijeni iz izveštaja Komore zdravstvenih ustanova. Komparativna analitička metoda je korišćena za procenu socioekonomskih indikatora i kretanja ljudskih resursa tokom petogodišnjeg perioda (2006-2010. godine). Rezultati. Studija je pokazala da je svetska ekonomska kriza prekinula konstantan privredni rast u Srbiji. Između 2006. i 2008. godine realna stopa rasta BDP je fluktuirala između 3,6% i 5,4%, dok je u 2009. imala negativnu stopu rasta od -3,1% i blagi porast od 1% u 2010. U 2006. godini BDP po stanovniku bio je 3.943 američka dolara, a 2008. skoro dvostruko veći, dostigavši 6.498 dolara, dok je u 2009. pao na 5.499 dolara i nastavio da se smanjuje do 5.006 dolara u 2010. U 2007. godini ukupna inflacija bila je 6,5%, a posle fluktuiranja između 11,7% u 2008. i 8,4% u 2009, da bi se u 2010. ponovo smanjila na 6,5%. Prema podacima IZJZS, od 2006. do 2008. godine zabeleženo je stalno povećanje broja zaposlenih u javnom sektoru zdravstva sa 108.975 na 114.317. U 2009. broj stalno zaposlenih neznatno se smanjio na 114.175, odnosno na 114.43

Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (€ 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (€ 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anoma, Uvod. U okviru istraživanja troškova u sistemu zdravstvene zaštite poslednjih deset godina u svetu je sve veće interesovanje za izračunavanje troškova lečenja bolesnika. Ova vrednost je breme kojim određena bolest ili grupa oboljenja opterećuje društvo. Do 2000. godine, kada je Organizacija za ekonomski razvoj država (OECD) formirala Sistem zdravstvenih računa (SZR), nije postojalo okvirno metodološko uputstvo za izračunavanje cene lečenja bolesnika. Cilj ovog rada bio je da se utvrde troškovi zdravstvene zaštite u Srbiji prema Međunarodnoj klasifikaciji bolesti (MKB) od 2004. do 2009. godine. Materijal i metode rada. Urađena je retrospektivna i komparativna analiza zdravstvenih statističkih podataka iz baze Instituta za javno zdravlje Srbije i finansijskih podataka Republičkog zavoda za zdravstveno osiguranje za period 2004-2009. godine. Finansijski i podaci o uslugama bolničkog, ambulantnog i kućnog lečenja, pomoćnim uslugama zdravstvene zaštite, potrošnji lekova i potrošnih dobara u zdravstvu analizirani su primenom metodologije SZR. Rezultati. Tokom posmatranog perioda najveći trošak za zdravstvenu zaštitu ostvaren je 2009. godine, a iznosio je 144.150.456.906,00 dinara (1.503.321.134 evra; 2.160.253.219 američkih dolara), dok je najmanji ostvaren 2004. godine, a bio je 49.546.211.470,00 dinara (628.086.723 evra; 855.203.134 američkih dolara). Te godine najveći deo troškova bio je izdvojen za lečenje od kardiovaskularnih bolesti (18,98%) i tumora (11,12%), a najmanji deo za lečenje osoba s urođenim anomalijama (0,64%). U 2009. godini najveći deo sredstava utrošen je za lečenje od kardiovaskularnih oboljenja (18,87%), infektivnih i parazitskih bolesti (11,20%), oboljenja digestivnog sistema (9,26%), bolesti nervnog sistema (9,20%) i tumora (8,88%), dok je najmanje novčanih sredstava izdvojeno za lečenje osoba s urođenim poremećajima (0,33%). Zaključak. Komparativna analiza je pokazala da su se troškovi zdravstvene zaštite stanovnika Srbije od 2004. do 2009. godin

Introduction. Collecting data about the structure and function of private health care sector in Serbia and its inclusion in joint health care system is one of the most important issues for making decisions in health care and getting more accurate picture about the possibilities of health care system in Serbia. The aim of this analysis was to compare health institutions, personnel, visits, number of hospital days and morbidity by ICD-10 classification of diseases in public and private health sector in South Backa, Nisava, Toplica and Belgrade district in 2009. Material and Methods. A retrospective comparative analysis was performed using data about private providers of health services obtained from the Institute of Public Health Novi Sad, the Institute of Public Health Nis and the City Institute of Public Health Belgrade. Data about personnel and morbidity in public health sector in Serbia for 2009 was obtained from the Center for Information Technology of the Institute for Public Health of Serbia. Data about public health facilities in South Backa, Nisava, Toplica and Belgrade district in 2009 was obtained from Serbian Chamber of medical institutions. Results. The results showed that health care was provided in Belgrade district in 2009 by total of 1,051 employees in private sector and 31,404 in public sector. We found that public sector had a far wider range of health facilities than private sector, which was mainly due to the number of clinics. In South Backa district private sector had 323 practices, the district of Belgrade 655 and Nisava and Toplica district 173. Seventeen times more visits to households (4,650,423 vs. 267,356) and 111 times greater number of hospital days was provided in public health sector as compared to private health sector (781,083 vs. 7,023) in South Backa district. Conclusion. The conclusion of this analysis was that public health sector has remained the foundation of health care system in Serbia. Private health sector is expanding, but, Uvod. Prikupljanje podataka o strukturi i radu privatnog zdravstvenog sektora u Srbiji i njegovo uključivanje u planove funkcionisanja zdravstvene zaštite jedno je od važnih pitanja za donošenje odluka u zdravstvu, kako bi se dobila što preciznija slika o mogućnostima državnog i privatnog zdravstvenog sistema u Srbiji. Cilj ove komparativne analize bio je poređenje zdravstvenih ustanova, kadra, poseta lekaru, broja bolesničkih dana i morbiditeta prema Desetoj reviziji Međunarodne klasifikacije bolesti (MKB-10) u državnom i privatnom sektoru, u Južnobačkom, Nišavskom, Topličkom i Beogradskom okrugu u 2009. godini. Materijal i metode rada. Urađena je retrospektivna analitička komparativna studija na osnovu podataka o privatnim pružaocima zdravstvenih usluga dobijenim od Instituta za javno zdravlje u Novom Sadu, Instituta za javno zdravlje u Nišu i Gradskog zavoda za javno zdravlje u Beogradu. Podaci o kadru i morbiditetu u državnom sektoru zdravstvenog sistema Srbije za 2009. godinu preuzeti su od Centra za informatiku Instituta za javno zdravlje Srbije. Mreža državnih zdravstvenih ustanova u Južnobačkom, Nišavskom, Topličkom i Beogradskom okrugu u 2009. godini preuzeta je od Komore zdravstvenih ustanova Srbije. Rezultati. Analiza je pokazala da je zdravstvenu zaštitu u privatnom sektoru u 2009. godini u Beogradskom okrugu pružao ukupno 1.051 zaposlen medicinski radnik, dok su zdravstvenu zaštitu u državnom sektoru pružala 31.404 zaposlena lica. Utvrđeno je da državni zdravstveni sektor ima daleko širi spektar zdravstvenih ustanova od privatnog, koji se uglavnom temelji na velikom broju ordinacija. U Južnobačkom okrugu privatni sektor ima 323 ordinacije, u Beogradskom 655, a u Nišavskom i Topličkom 173. U državnom zdravstvenom sektoru u Južnobačkom okrugu ostvaruje se 17 puta veći broj poseta lekaru u odnosu na privatni (4.650.423 prema 267.356) i 111 puta veći broj bolesničkih dana (781.083 prema 7.023). Zaključak. Državni zdravstveni sektor je i dalje temelj zdravst

Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA)' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was low as the consequ, Uvod/Cilj. Glavni cilj zdravstvene politike svake zemlje jeste postizanje finansijske održivosti samog zdravstvenog sistema, kao i obezbeđenje veće dostupnosti zdravstvenim uslugama celom stanovništvu. U ostvarivanju ovog cilja zemlje Evropske unije ustanovile su i u svoje zdravstvene sisteme implementirale Nacionalne zdravstvene račune (NZR). Kao alatka za menadžment u zdravstvu na osnovu dokaza, NZR pruža podatke o finansijskim tokovima u zdravstvu na nacionalnom nivou i omogućuje međunarodno poređenje. Cilj ovog rada bio je da se pomoću NZR ispitaju finansijski tokovi u zdravstvenom sistemu Republike Srbije, utvrdi obrazac zdravstvene potrošnje i odrede zdravstveni indikatori koji će omogućiti poređenje zdravstvenog sistema Srbije sa sistemima drugih zemalja. Metode. Izvršena je retrospektivna analiza zdravstvenih i finansijskih statističkih podataka iz završnih izveštaja relevantnih državnih institucija u periodu od 2003. do 2006. godine. Mnogostruki izvori podataka o zdravstvenoj potrošnji analizirani su po metodologiji NZR i uputstvu Organisation for Economic, Cooperation and Development (OECD) 'System of Health Accounts (SHA)' Version 1.0. Rezultati. Ukupna izdvajanja za zdravstvo činila su 8,6% bruto domaćeg proizvoda (BDP) u 2003. godini, 8,3% BDP u 2004, 8,7% BDP u 2005. i 9% BDP u 2006. godini. Republički zavod za zdravstveno osiguranje (RZZO) bio je predominantni finansijer u javnom sektoru finansijera u zdravstvu sa 93% učešća u 2006. godini. Najveći deo finansijskih sredstava usmeravan je u bolnice i za usluge lečenja. Izdvajanje po glavi stanovnika u 2006. godini u Srbiji bilo je 356 dolara. Od ukupnih sopstvenih sredstava, stanovništvo Srbije finansiralo je državne ustanove sa 21,28%, što iznosi 7,3% od ukupnih rashoda za zdravstvo, a privatne sa 78,72%, što iznosi 27% od ukupnih rashoda za zdravstvo. Srbija je 2006. godine imala slična izdvajanja BDP sa prosekom Evropske unije, a od zemalja u regionu manje je izdvajala od Bosne i Hercegovine. Međuti

Introduction. Primary health care in the Republic of Serbia is predominantly funded by the Republic Health Insurance Fund (RHIF). From the total income of health centers and institutes at the primary level, with no pharmacy and pharmacies (Kosovo excluded), 84% in 2008 was paid by RHIF. Frequency of participation ranged from 63-95% and it was stable in all observed years. The aim of this study was to determine the expenditures for primary health care for each insured person in statistically defined districts in the Republic of Serbia, with an emphasis on prevention participation. Material and Methods. Retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia (IPHS) and financial data from the RHIF for the period 2006-2008 was done. Results. Observed by the districts in 2008, in Vojvodina, the lowest expenditure for primary health care had North Backa District (5,207 RSD) and greatest was in West Backa District (6,632 RSD) per capita. In the central Serbia territorial difference was much greater, ranging from 3,574 RSD in the District Morava to 6,701 RSD per capita in the District Toplica and Nisava. Expenditures for direct health care of RHIF per capita in the reporting period continuously have grown. Conclusion. The results showed that the largest cost for primary care for the insured person in the districts of Serbia was registered in the Nisava and Toplica (6,701 RSD) and lowest in the district of Morava (3,574 RSD) per capita., Uvod. Primarna zdravstvena zaštita u Republici Srbiji se dominantno finansira od Republičkog zavoda za zdravstveno osiguranje (RZZO). U ukupnim prihodima domova zdravlja i zavoda na primarnom nivou, bez apoteka i apotekarskih ustanova (isključujući Kosovo i Metohiju), RZZO je u 2008. godini učestvovao s prosečno 84%. Interval učešća je bio 63-95% i gotovo je istovetan u svim posmatranim godinama. Cilj rada je bio da se utvrde rashodi za primarnu zdravstvenu zaštitu po svakom osiguranom licu u statistički definisanim okruzima u Republici Srbiji, s osvrtom na preventivu. Materijal i metode rada. Izvršena je retrospektivna i komparativna analiza zdravstvenih statističkih podataka iz baze Instituta za javno zdravlje Srbije 'Dr Milan Jovanović Batut' i finansijskih podataka iz RZZO u periodu 2006-2008. godine. Rezultati. Posmatrano po okruzima u 2008. godini, u Vojvodini je najniže rashode za primarnu zdravstvenu zaštitu po stanovniku imao Severnobački okrug (5.207 dinara), a najviše Zapadnobački (6.632 dinara). U centralnoj Srbiji teritorijalne disperzije su znatno veće: od 3.574 dinara po stanovniku u Moravičkom okrugu do 6.701 dinar po stanovniku u Nišavskom i Topličkom okrugu. Rashodi za neposrednu zdravstvenu zaštitu RZZO po stanovniku su se u posmatranom periodu kontinuirano povećavali. Zaključak. Rezultati istraživanja su pokazali da je za primarnu zdravstvenu zaštitu po osiguranom licu u Republici Srbiji najviše potrošeno u Nišavskom i Topličkom okrugu, a najmanje u Moravičkom.

Introduction. The dental health sector reform in Serbia has commenced in order to implement health policy changes. Assessment of legally regulated citizens rights to preventive dental examination, revision of those rights and their promotion are one of the dental health reform priorities. Objective. The objective of this study was to assess the utilization of preventive dental examination (PDE) in Serbia in 2006 among different subject groups and different districts and to analyze financial resources spent for those measures. Also, study aims were to compare the utilization of rights to preventive dental examination in Republic of Serbia in period between 2003-2006. Methods. The retrospective analytical study of Public Health Institute and Republican Statistical Office data were conducted. The comparative analytical method was used for assessment of preventive dental examinations within the given time frame from 2003 to 2006. Results. Results achieved in realization of PDE show a broad spectre of district discrepancies. The variation factor depending on preventive examination or population group it is related to varies from 26.73% to 90.88%. Conclusion. Realization of preventive dental examinations in the Republic of Serbia was significantly lower than projected in the period 2003-2006., Uvod. Reforma stomatološkog zdravstvenog sektora u Srbiji počela je kako bi se usvojile i primenile promene u zdravstvenoj politici. Korišćenje zakonski regulisanih prava građana na preventivne stomatološke preglede (PSP), njihova revizija i promocija prava građana prioriteti su ove reforme. Cilj rada. Cilj istraživanja je bio da se u različitim okruzima u Srbiji proceni stepen realizacije PSP planiranih u 2006. godini kod različitih populacionih grupa i analizira dinamika ostvarivanja prava na preglede u periodu 2003-2006. godine. Metode rada. Ova retrospektivno-analitička studija urađena je na osnovu podataka Instituta za javno zdravlje Srbije 'Dr Milan Jovanović Batut' i Republičkog zavoda za statistiku. Za procenu realizacije PSP u posmatranom periodu korišćena je komparativna analitička metoda. Rezultati. Stepen realizacije PSP se razlikuje po regionima Srbije. Razlike zavise od vrste PSP i uzrasta ispitanika, a u rasponu su od 26,73% do 90,88%. Zaključak. Realizacija PSP u primarnoj zdravstvenoj zaštiti u Republici Srbiji tokom perioda 2003-2006. godine je daleko ispod predviđenog i planiranog obima.

Introduction. The first maxillary molar is a tooth with three roots, and mesiobuccal one is with the most complex canal morphology. Factors influencing variations of its morphology are numerous, and may significantly complicate endodontic treatment. Objective. The objective was to investigate the number, configuration and curvature orientation of the mesiobuccal root canals in the maxillary first molars. Methods. The study was conducted on 200 mesiobuccal (MB) roots of extracted first molars in human subjects using radiography. In each canal Flexofile was introduced until reaching the apical foramen and the root was then radiographed in series from two projections. Number of root canals (MB1, MB2 and MB3), configuration according to Vertucci classification, and the orientation of the curvature were established. Relevant statistical parameters and the significance of differences were computed (p lt 0.05). Results. Of total 200 mesiobuccal roots 86.5% were with two, 9% with three, and 4.5% with a single canal. Most frequent configurations were type IV (36%) and II (34.5%). From the clinical projection all MB1 canals were oriented distally, from the proximal 78% palatally and 22% buccally. The orientation of all MB2 canals was distal from the clinical projection, from the proximal projection 76% were oriented palatally, and 24% buccally. The MB3 canal was always oriented distally from the clinical projection, and buccally from the proximal aspect. Conclusion. The mesiobuccal roots of the first maxillary molars showed multiple canals in 96%, with dominant Vertucci type II and IV of configuration. All canals were curved., Uvod. Prvi maksilarni molar je zub koji najčešće ima tri korena, a meziobukalni je s najsloženijom kanalnom morfologijom. Faktora koji utiču na varijabilnost njegove morfologije ima mnogo i značajno otežavaju endodontsko lečenje ovih zuba. Cilj rada. Cilj rada je bio da se na ekstrahovanim prvim maksilarnim molarima ispitaju broj, konfiguracija i smer povijenosti meziobukalnih kanala. Metode rada. Istraživanja su urađena na 200 meziobukalnih (MB) korenova ekstrahovanih humanih prvih maksilarnih molara metodom radiografisanja. U svaki pojedinačni kanal postavljen je instrument tipa Flexofile do pojave na anatomskom otvoru i zatim radiografisan serijom snimaka iz dve projekcije. Zabeleženi su broj kanala (MB1, MB2 i MB3), konfiguracija prema Vertučijevoj (Vertucci) klasifikaciji i smer povijenosti. Utvrđeni su relevantni statistički parametri i razlike na nivou značajnosti p lt 0,05. Rezultati. Od ukupno 200 MB korenova, sa dva kanala bilo je njih 86,5% , sa tri 9%, a s jednim kanalom 4,5%. Najčešći tipovi kanalne konfiguracije bili su IV (36%) i II (34,5%). Smer povijenosti svih MB1 kanala iz kliničke projekcije bio je distalan, a iz aproksimalne 78% palatinalan i 22% bukalan. Svi MB2 kanali iz kliničke projekcije bili su distalno povijeni, a iz aproksimalne 76% palatinalno i 24% bukalno. MB3 kanal je bio povijen uvek distalno u kliničkoj, a najčešće bukalno u aproksimalnoj projekciji snimanja. Zaključak. Meziobukalni korenovi prvih maksilarnih molara su u 96% slučajeva imali višestruki broj kanala i konfiguracijski su pripadali tipu IV i II Vertučijeve klasifikacije. Svi kanali su bili povijeni.

Introduction. An ideal endodontic sealer should adhere firmly both to dentin and to gutta-percha. Objective. The aim of this study was to evaluate the adhesion of the root canal filling to dentin and gutta-percha using scanning electronic microscopy (SEM). Methods. The sealing ability of endodontic sealers to dentinal walls of the root canal was assessed in recently extracted human single canal premolars. Twenty teeth were prepared using the crown-down technique and irrigated with 3% NaOCl. A total of 20 samples were divided into two groups. The root canals were obturated using Ketac-Endo Aplicap and GutaFlow. The sealing ability and adhesion properties at the sealer-dentin interface were studied using SEM and the results were rated from 1 to 3; extremely good adhesion (rated 1), good adhesion (rated 2) and a relatively good adhesion (rated 3). Results. The results showed extremely good adhesion on Ketac-Endo and GuttaFlow dentin interface. GuttaFlow has strong adhesion (rated 1) to gutta-percha in comparison with Ketac-Endo to gutta-percha interface (rated 2). Conclusion. New GuttaFlow filling material has a strong sealing ability and excellent adhesion to dentinal walls and gutta-percha cones. Ketac-Endo showed excellent bond to dentin with a slightly weaker adhesion capacity to the gutta-percha cones in comparison to GuttaFlow., Uvod. Osnovne osobine materijala za trajno punjenje kanala korena zuba podrazumevaju idealno zaptivanje, kako tvrdog zubnog tkiva, tako i gutaperka- poena. Cilj rada. Cilj rada je bio da se ispita adhezivnost materijala za trajno punjenje kanala korena za dentin i gutaperka-kočiće korišćenjem skening-elektronske mikroskopije (SEM). Metode rada. Sposobnost zaptivanja dentinske površine obrađenog zida endodontskim silerima ispitana je na sveže izvađenim jednokorenim premolarima. Dvadeset zuba je preparisano krunično- apeksnom tehnikom uz ispiranje troprocentnim rastvorom natrijum-hipohlorita (NaOCl). Uzorci su svrstani u dve grupe: prva je opturisana sa materijalom Ketac-Endo, a druga sa GuttaFlow. Sposobnost zaptivanja i adezivnost na granici dodira silera i dentina, odnosno silera i gutaperke, analizirana je primenom SEM. Adhezivnost je označena kao: ekstremno dobra (ocena 1), dobra (ocena 2) i relativno dobra (ocena 3). Rezultati. Dobijeni rezultati su pokazali izuzetno dobru adhezivnost materijala Ketac-Endo i GuttaFlow za dentinsku površinu ispreparisanih zidova kanala korena zuba. GuttaFlow je pokazao veoma dobru vezu za gutaperka-kočić (ocena 1) u odnosu na Ketac-Endo (ocena 2). Zaključak. Novi materijal GuttaFlow ima izuzetno dobru adhezivnost, kako za dentin kanala korena, tako i za gutaperka-poene. Ketac-Endo ostvaruje veoma dobru sposobnost zaptivanja za dentin i dobru adhezivnost, ali nešto slabiju za gutaperku u odnosu na GuttaFlow.

Endodontic treatment of the teeth with severe root canal curvatures has become one of the greatest problems in clinical practice. Recently, new instruments and techniques have been introduced in the endodontic procedure. The aim of this study was, on the basis of clinical practice, to show the possibilities of the endodontic treatment in the teeth with severely curved root canals, after dependable decision about endodontic instruments and techniques. This article presents a complete endodontic procedure in two teeth with different curvature shape of the root canal in patients that were treated at the Department of Restorative Dentistry and Endodontics, School of Dentistry, Belgrade. Coronal to apical 'crown down' technique was used for the root canal preparation with hand NiTi ProTaper instruments with progressive multicone design. The main reasons for choosing manual technique were complexity, shape of presented curvatures and better tactile sensation control of canal instruments in order to avoid possible mistakes and complications. Clinical X-rays of the teeth with permanent obturation clearly showed that extremes of the root canal morphology could be successfully solved by the right choice of all factors during endodontic procedure., Endodontsko lečenje zuba s jako zakrivljenim korenovima je značajan problem u praksi. Primena novih instrumenata i tehnika u lečenju ovakvih zuba poslednjih godina je postala sve izvesnija.Cilj ovog rada je bio da se na primerima iz kliničke prakse ukaže na mogućnost endodontskog lečenjazuba s veoma izraženim krivinama kanala korena nakon pravilnog izbora endodontskih instrumenata, odnosno tehnike instrumentacije. U ovom radu je prikazan celokupni endodontski postupak lečenja dva zuba pacijenata Klinike za bolesti zuba Stomatološkog fakulteta u Beogradu sa različitim oblicima krivine centralnog korenskog kanala. Prime-njena je krunično-apeksna 'crown-down' tehnika preparacije uz korišćenje ručnih nikl-titanijumskih instrumenata tipa ProTaper s progresivnom multikoničnošću. Osnovni razlozi za odabir ručne tehnike preparacije bili su složenost morfologije, oblik prikazanih krivina i bolja taktilno-senzorna kontrola kanalnih instrumenata; cilj je bio da se izbegnu moguće greške i komplikacije. Prikazani radiografski snimci zuba sa jasno opturiranim kanalnim sistemom pokazuju da su i ekstremi morfološkog izgleda kanala rešivi pravilnim odabirom svih činilaca endodontske procedure. .

Introduction: Global markets and competition, fast changes, the explosion of information technology, integration processes in international relations are some of the initial factors for changes in health care organizations and their management. Management represents an evolving new generic function of all organizations of social significance across the world. Managers in the health sector have exceptionally complex roles that require new skills and methods. The objective of this study is to analyze in grater detail, explain and describe the role and necessary skills of a health care manager in the strategic transformation of health care management. The modern health care manager can get the best results by strengthening human resources and meeting employees' personal needs in accordance with the global and specific goals of the health care institution. The manager is at the same time a mentor and a facilitator, putting to best use the forementioned transformation strategies whilst expending the resources carefully, strengthening the collective efforts, involving employees in the decision-making process and motivating teamwork and collective problem-solving., Uvod: Globalna tržišta i kompeticija, brze promene, eksplozija informatičke tehnologije, integracioni procesi u međudržavnim odnosima samo su neki od faktora koji su inicirali nužnost promena i u zdravstvenim organizacijama i njihovom menadžmentu. Menadžment postaje nova generička funkcija svih organizacija od društvenog značaja širom sveta, koji ima izuzetno tešku ulogu da usaglasi kompleksne probleme kojima obiluje specifična delatnost zdravstvenih službi.U svetlu tih promena menja se i uloga kao i osobine i veštine menadžera u zdravstvu. Cilj ovog rada je da se jasnije opiše i sagleda uloga, potrebne veštine i metodi kojima se služe menadžeri u zdravstvu u strateškoj transformaciji zdravstvenog menadžmenta. Moderan zdravstveni menadžer postiže najbolje rezultate kroz ojačavanje ljudskih resursa i zadovoljenje individualnih potreba zaposlenih, a u skladu sa opštim i specifičnim ciljevima zdravstvene organizacije. Menadžer je u isto vreme i mentor i facilitator jer koristi maksimalno navedene strategije promena, a resurse oprezno uz učvršćivanje kolektivnih napora, uključivanje zaposlenih u odlučivanje, podsticanje timskog rada i grupnog rešavanja problema.

Introduction. Due to the inability to sterilize infected root canals during cleaning and shaping, contemporary endodontic materials are expected to possess certain antibacterial effect. Aim. The aim of this study was to evaluate antibacterial effect of four contemporary endodontic materials: Acroseal, AH-Plus, Gutta Flow and Mineral Trioxide Aggregate (MTA) in vitro. Materials and Methods. Antibacterial effect of tested materials was evaluated against bacterial species Enterococcus faecalis ATCC 29212 using the agar diffusion test. Results. Based on the obtained results, it can be concluded that freshly mixed Acroseal and AH-Plus exhibited significant antibacterial effect while Gutta Flow and MTA did not present any antimicrobial potential in this study. Conclusion. Endodontic sealers tested in this study, freshly mixed Acroseal and AH-Plus, possess certain antibacterial effect whereas in solid state this effect is not present., Uvod. Usled nemogućnosti potpunog obeskličavanja inficiranih kanala korena zuba tokom njihove mehaničko-medikamentozne obrade, od savremenih endodontskih materijala se očekuje da poseduju i odgovarajući antibakterijski efekat. Cilj. Cilj ovog rada je bio da se u in vitro uslovima ispita antibakterijski efekat četiri savremena endodontska materijala: Acroseal, AH-Plus, Gutta Flow i Mineral Trioxide Agregate (MTA). Materijal i metod. Antibakterijski potencijal testiranih materijala proveravan je na bakterijskom soju Enterococcus faecalisu ATCC 29212, primenom agar difuznog testa. Rezultati. Na osnovu dobijenih rezultata može se uočiti da su u sveže zamešenom stanju Acroseal i AH Plus ostvarili značajan antibakterijski efekat, dok Gutta Flow i MTA u ovom istraživanju nisu pokazali nikakvo antibakterijsko dejstvo. Kada su ispitivani materijali testirani u čvrstom stanju, nijedan od njih nije ispoljio antibakterijski efekat. Zaključak. Testirani materijali za opturaciju kanala korena zuba, Acroseal i AH-Plus, u sveže zamešenom stanju imaju izvestan antibakterijski efekat, dok u čvrstom stanju ovaj efekat nije izražen.

This experimental study was carried out on 35 Albino Wister rats Artificially created bone defects were grafted with bioactive ceramic materials or control material. Histological analysis was preformed 8 weeks and 6 months after the implantation. The results revealed that bone regeneration occurred in defects treated with bioactive ceramic materials while in the defects treated with the control material signs of tissue rejection were present. As stated before, it could be concluded that bioactive ceramics can be recommended as bone substitutes in orthopedic surgery and dentistry., Eksperimentalna studija sprovedena je na 35 Albino Wistar pacova kod kojih su, veštački napravljeni defekti u butnoj kosti, popunjavani bioaktivnim keramičkim materijalima i kontrolnim materijalom. Histološka procena zarastanja defekta vršena je 8 nedelja i 6 meseci nakon implantacije. Rezultati histološke analize ukazali su da je u defektima koji su tretirani biokeramičkim materijalima ostvarena koštana regeneracija, dok je u grupi koja je tretirana roze voskom, kao kontrolnim materijalom, bila prisutna reakcija odbacivanja. Na osnovu dobijenih rezultata može se zaključiti da se ispitivani biokeramički materijali mogu koristiti za popunjavanje koštanih defekta u ortopedskoj hirurgiji i stomatologiji.

The objective of this paper was to show the historical perspective of the „long centric" occlusal concept and its importance in the modern dentistry, especially from the gnathological aspect. The „long centric" concept represents therapeutic modality used in modern dentistry and occlusal adjustment in all patients showing differences in strong and weak closure of the lower jaw starting from the position of physiological rest/long centric" concept is applied only for anterior teeth and occlusal movements from rather than toward the center. Whenever the „long centric" parameters are not adequate, occlusal disturbance, resulting from the „wedge" effect during the initial closure of the lower jaw, is present. Different degrees of abrasion or hypermobility of the teeth are often the result of the above-mentioned occlusal disturbances and can potentially trigger bruxism and malfunction. Modus procedendi should be the regular approach of every dentist to any occlusion, because only the built-in „long centric" efficiently contributes to the occlusal stability of the anterior portion of the dentition. All occlusions should be routinely tested regarding their need for „long centric", especially when the extensive therapeutic interventions (conservative, prosthetics) of the occlusal complex are required., Cilj rada je bio da prikaže istorijsku perspektivu okluzalnog koncepta„long centric"(LC) i njegov značaj u savremenoj stomatologiji, posebno sa gnatološkog aspekta. Koncept LC predstavlja terapijski modalitet koji se koristi u savremenoj stomatologiji i okluzalnom podešavanju kod pacijenata kod kojih se čvrsto i blago zatvaranje donje vilice iz položaja fiziološkog mira razlikuje. LC se odnosi samo na anteriorne zube i na okluzalnu slobodu od centra, a ne u centru. Ako potreba za ovim konceptom nije adekvatno zadovoljena, javlja se okluzalna smetnja zbog tzv. efekta klina u inicijalnom zatvaranju donje vilice. Različiti obrasci abrazije ili nekog stepena hipermobilnosti zuba su često rezultat takve smetnje i mogu imati potencijal „okidača" za bruksizam i parafunkciju. Prikazan modus procedenti određivanja potrebe za LC treba da bude rutinski prilaz svakog lekara bilo kojoj okluziji, jer ugrađen LC efikasno doprinosi okluzalnoj stabilnosti prednjeg segmenta denticije. Sve okluzije bi trebalo rutinski testirati u pogledu potrebe za LC, naročito kada postoji potreba za ekstenzivnim terapijskim intervencijama (konzervativna, protetska) na okluzalnom kompleksu.