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The aim of this study was to evaluate the antibacterial activity and dentin bonding ability of a commercial self-etch adhesive Clearfil SE Protect (Kuraray Noritake Dental, Tokyo, Japan) in combination with sodium hypochlorite (NaOCl). Agar disc diffusion tests and measurement of minimum inhibitory/bactericidal concentrations (MIC/MBC) against Streptococcus mutans were performed to evaluate antibacterial effects. The mixture solution of 5.25% NaOCl and the primer of Clearfil SE Protect demonstrated less antibacterial activity than primer only. In microtensile bond strength tests using non-carious human molars, pretreatment with 5.25% NaOCl aqueous solution had no influence on the bond strength of Clearfil SE Protect. These results indicate that pretreatment with NaOCl does not influence the bonding ability of Clearfil SE Protect, while their combined use does not enhance cavity disinfecting effects.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a complication of the bisphosphonate (BP) treatment and its pathopysiology is still not fully understood. The existing preventive and treatment options require updates and more attention. Geranylgeraniol (GGOH) so far demonstrated an increased activity and viability of the cells previously treated with zoledronic acid (ZA). The aim of this study was to evaluate the in vivo effects of GGOH on the development of BRONJ.A total of 30 male Wistar rats were included in the study, divided into three groups: two experimental groups (EG1 and EG2) and a control group (CG). Rats from EG1 and EG2 were treated with 0,06 mg/kg ZA ip weekly in a duration of five weeks, while CG received saline ip. On the third week all animals underwent extraction of the lower right first molars. The rats from EG2 received a local solution of GGOH in concentration of 5 mM in the socket every day after the tooth extraction. The analyses included clinical evaluation on the wound healing and pathohistological evaluation for presence and level of osteonecrosis.EG2 showed significantly improved wound healing and tissue proliferation, when compared to EG1. EG2 significantly differed from EG1 and CG (p0,05) for the presence of microscopical osteonecrosis (80% vs 22,2% vs 0%). Regarding to the number of empty lacunes without osteocytes and the level of necrosis, all groups demonstrated significant differences.Geranylgeraniol in a form of local solution may be a promising option for prevention and treatment of BRONJ.

Background/Aim. Apical periodontitis is mainly caused by bacterial infection within the root canal and periapical bone destruction which are prominent features of this lesion. The aim of this study was to determine the quantity of interleukin-1β in the tissues of periapical lesions and to analyze its relationships with: lesion size, previous treatments and pathohistological finding of involved teeth. Methods. Periapical tissues were obtained from patients undergoing periapical surgery. Out of all 80 cases included in the study, 24 had no previous endodontic treatment (open lesions), 37 were with endodontic failure (closed lesion) and in 15 cases root canal retreatment was performed few months before the surgery. By excluding four samples, the total of 76 samples, consisted of periapical lesions and the apical part of the tooth root, was collected. Each periapical tissue sample was divided into two equal parts. The one half of each lesion was used for quantification of interleukin-1β in tissue homogenates by the enzyme-linked immunosorbent assay (ELISA) method. The other part of each lesion was used for histopathological evaluation. Results. For each of the tissue homogenates, the quantity of interleukin-1β was measured, and it ranged from 0.6 pg/mg up to 74 pg/mg. There was no significant difference between the symptomatology and amount of interleukin-1β. Statistical data analysis showed a moderate correlation between lesion size and interleukin-1β measured values. The highest levels of interleukin-1β corresponded with chronic lesions in the stages of acute exacerbation and granulomas in early developing stages. Persistant granulomas, scar tissues, non-inflamed cysts and teeth with recently finished endodontic treatments showed a significantly lower level of interleukin-1β. Conclusion. The study results suggest that the differences in quantity of interleukin-1β correlate to lesion progression and phases of development., Uvod/Cilj. Periapikalni periodontitis najčešće je prouzrokovan bakterijskom infekcijom unetom putem kanala zubnog korena i periapikalnom destrukcijom kosti koje predstavlja glavno obeležje ovih lezija. Cilj ovog istraživanja bio je da se odredi količina interleukina-1β u uzorcima periapikalnih lezija i da se analizira njihova povezanost sa: veličinom lezija, postojanjem prethodnih endodontskih tretmana i patohistološkim nalazima. Metode. Ispitivani su uzorci periapikalnih lezija sakupljeni tokom periapikalnih operativnih intervencija. Od svih 80 bolesnika uključenih u studiju, 24 su pripadali bolesnicima koji nisu podvrgnuti endodontskom tretmanu pre apikotomije (otvorene lezije), 37 su tretirani kao endodontski neuspeh (zatvorene lezije), a kod 15 bolesnika endodontski retreatman je sproveden nekoliko meseci pre oralno-hirurške intervencije; četiri uzorka su isključena iz studije. Svaki uzorak koji se sastojao od periapikalne lezije i vrha korena zuba podeljen je na dva jednaka dela. Prva polovina svakog uzorka korišćena je za kvantifikaciju interleukina-1β u tkivnom homogenatu metodom enzyme-linked immunosorbent assay (ELISA). Druga polovina uzorka korišćena je za histopatološku analizu. Rezultati. U svakom tkivnom homogenatu izmerena je količina interleukina-1β, čije vrednosti su se kretale od 0,6 do 74 pg/mg. Naši rezultati nisu potvrdili značajnu razliku između simptomatomatičnih i asimptomatičnih slučajeva; dokazano je prisustvo umerene korelacije između veličine lezija i vrednosti interleukina-1β. Najviše vrednosti interleukina-1β potvrđene su u fazama akutnog pogoršanja hroničnih lezija i kod granuloma u ranim razvojnim fazama. Kod starih granuloma, ožiljačnih tkiva, zuba sa nedavno završenim endodontskim retretmanom i neinflamiranih cista, vrednosti interleukina-1β bile su značajno niže. Zaključak. Rezultati istraživanja pokazuju da su razlike u količini interleukina-1β u korelaciji sa progresijom lezija i fazama njihovog razvoja.

Introduction: The present study aimed to assess the presence of main types of microorganisms involved in the aetiopathogenesis of chronic periodontitis with PCR technique and determinates the presence of composite IL-1 genotype and their associations with founded bacteria. Material and method: The examined group was consisted from 20 subjects with diagnosed chronic periodontitis and 20 healthy control without periodontitis. Clinical parameters like gingival index (GI), plaque index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD) and clinical attachment lost (CAL) were determinates. Subgingival dental plaque was collected using a sterilized paper point. We used Parodontose Plus test, reverse hybridization kit, for the detection of periodontal marker bacteria, as well as for the detection of composite Interleukin -1 Genotype Results: The most present bacterial species detected from subgingival dental plaque was Treponema denticola and Porfiromonas gingivalis which was present in 65% of examined patients. In relation to the presence of positive genotype in patients, there was no significant difference between the test and control group for p> 0.05 (p = 1.00). For χ2=8,17 (p=0,06, pPrevotella intermedia, and composite genotype. Between positive genotype and analyzed bacterial species A. actinomycetem comitans for p> 0.05 (p = 1.00), P. gingivalis for p> 0.05 (p = 0.16), T. Forsythia for p> 0.05 (p = 0.20), T. Denticola for p> 0.05 (p = 0.64) no association was found. Conclusion. This investigations confirmed the strong association of these five examined periopathogenes with periodontitis.

Osteoradionecrosis (ORN) of the jaws is a serious complication of radiotherapy of head and neck malignancies. Different assumptions about its occurring, risk factors and possible therapeutical modalities exist, but the clinical outcome of such patients is still not on the desired level. This article presents a clinical case of ORN of the mandible, occurring with exposed and infected bone, necrotic process that extended through all the mandible body, as well as cutaneous fistula. The first site of ORN was detected 2 years after radiotherapy for oral cancer, with the second one detected 3 and a half years after radiotherapy. In both, the reason for exposing the bone was local trauma due to tooth extraction. Due to the stage of the condition, a decision for surgical treatment accompanied with antibiotics was made. It is very important and critical for irradiated patients and patients with osteoradionecrosis to perform appropriate oral hygiene and frequent dental checks. Establishing protocols for prevention and treatment, but involving some new strategies regarding to this condition, are strongly recommended.

OBJECTIVE: To compare the therapeutic effects of the application of doxycycline-full dose (100 mg) and sub-dose (20 mg) in the treatment of periodontal disease.MATERIAL AND METHODS: A total of 60 patients with periodontal disease were examined. Patients are divided into two groups: A) treated with antimicrobial dose of 100 mg doxycycline once daily for 30 days, and B) treated with 2 x 20 mg/day. doxycycline, during 75 days. Among all patients a conservative treatment was carried out and ordinated the proper dose doxycycline in total dose during treatment from 3 gr. Index of dental plaque by Löe-Sillness, index of gingival inflammation and gingival bleeding by Cowell were followed.RESULTS: Values of dental plaque in relation first examination, 10th, 20th day, 1 month and 2.5 months, showed that after 2.5 months, average value (x = 0.83) of dental plaque in second group is slightly less than the value (x = 0.93) of dental plaque in the first group. The average value (x = 0.17) of gingival inflammation in second group is significantly less than the value (x = 0.50) of gingival inflammation in the first group. The average value (x = 0.97) of gingival bleeding in patients from the first group was significantly higher than value(x = 0.37) of gingival bleeding in the second group.CONCLUSION: Patients whose therapy was helped by a sub-dose doxycycline demonstrated positive therapeutic effects on gingival inflammation and bleeding.

Background: To investigate the salivary humoral mechanisms in patients with bullous lichen planus, in the phases of exacerbation and remission. Material and Method: Nineteen patients with bullous oral lichen planus were followed. Saliva was collected in the morning without stimulation in the amount from 5-10 cm2. The determination of immunoglobulins, C3 and C4 in the saliva was performed using the micro-ELISA technique. The circulating immune complexes in the serum and saliva were determined by the PEG method. The results were compared with a control group and within the group in the phases of exacerbation and remission. The results were statistically processed by Student's t - test . Results: Salivary IgA showed a significant decrease, whereas IgG and IgM significantly increased. The values of immunoglobulin A, G and M in the phase of remission were significantly increased compared with the control group. By comparing salivary immunoglobulins in the phases of exacerbation and remission, identical amounts of IgG in both stages of the disease were observed. However, considerably elevated values of IgA and slightly significant increase in the values of IgM were noted. CIC values in the control group and in patients ' group in the phases of exacerbation and remission were increased. Data suggest a highly significant depression of C3 component in the exacerbation phase, while in remission a slightly significant decrease was evident. Complement component C4 in the remission phase compared with a control group was declined. Conclusion: There is an evident involvement of certain saliva components in the pathogenesis of oral lichen planus, but the final predominance of humoral mechanisms in the pathogenesis of bullous lichen planus does not exist yet.

Recurrent aphthous stomatitis (RAS) is a quite frequent, painful, ulcerative disease that affects the lining of the oral cavity and has an unknown etiology. The aim of this article is to examine the impact of the medication proaftol on epithelization speed and severity of pain in patients with RAS. In this randomized, double-blind, placebo-controlled study respondents were divided into two groups where one group was treated with proaftol spray and the other with a placebo. Aphthae considered for treatment had a diameter of 5-6 mm. The participants were given instruction on the use of the spray, two sprayings on the place of the aphtae 3-4 times a day. We examined two parameters in the symptomatology of RAS-lesion size (mm) and pain intensity (noted on four subjective levels: 0-no pain, 1-discomfort, 2-moderate pain, 3-severe pain). These parameters were noted on the baseline, the third, the fifth and the eighth days of examination. Results: A significant faster reduction of the dimension of aphthous ulcers in patients treated with proaftol 3rd day p < 0.001, 5th day p < 0.0006, 8th day full epithelization in the control group. The magnitude of pain in the experimental compared with the control group on 3rd, 5th and 8th day was also significantly reduced: p < 0.0001, p < 0.007, p < 0.007 respectively. Conclusion: The use of proaftol positively influences the rate of epithelization and reduction of subjective feeling of pain in patients with RAS. The action of propolis should be the goal of studies with a larger number of subjects.

The primary goal of periodontal treatment is to stop periodontal disease progression and reduce future risks in disease recurrence. In order to overcome the limitations of the conventional treatment, controlled drug delivery systems for application in periodontal pockets have been developed. Their use offers several advantages: the therapeutic agent is targeted directly to the disease site and concentrations are 10-100 folds higher than the concentrations achieved by systemic administration, with low incidence of side effects. The PerioChip® is as local controlled-release biodegradable delivery system containing chlorhexidine digluconate. Several multicenter clinical trials have shown that the application of the PerioChip® in periodontal pockets as adjunct to the conventional periodontal treatment significantly improved the clinical parameters. In this article, the results from controlled clinical studies aimed to evaluate the clinical and microbiological efficacy of the PerioChip®, are discussed.

INTRODUCTION The basic work principle of all ultrasonic techniques is the piezoelectric effect of producing high frequency ultrasounds of small length, which are transmitted over the endodontic extensions or canal instruments into the root canal. When in contact with the tissue, ultrasonic vibrations are converted into mechanical oscillations. Ultrasonic waves and the obtained oscillations along with the synergic effect of irrigation bring about the elimination of smear layer from the root canal walls. OBJECTIVE The aim of the study was to ultrastucturally examine the effect of smear layer removal from the walls of canals by the application of the active ultrasonic method without irrigation, that is by the application of ultrasound and irrigation using distilled water and 2.5% NaOCl. METHOD The investigation comprised 35 single-canal, extracted human teeth. After removal of the root canal content, experimental samples were divided into three groups. According to the procedure required, the first group was treated by ultrasound without irrigation; the second one by ultrasound with irrigation using distilled water; and the third group was treated by ultrasound and irrigation using 2.5% NaOCl solution. The control samples were treated by machine rotating instruments (Pro-File) and were rinsed by distilled water. RESULTS The obtained results showed that the ultrasonic treatment of the root canal without irrigation did not remove the smear layer. The dentine canals are masked, and big dentine particles are scattered on the intertubular dentine. The ultrasonic treatment by using irrigation with distilled water provides cleaner dentine walls and open dentine tubules but with smaller particles on the intertubular dentine. The ultrasound treatment by using irrigation with 2.5% NaOCl solution provides a clean intertubular dentine surface without a smear layer and clearly open dentine tubules. CONCLUSION Instrumentation of the root canal by application of ultrasound by using NaOCl as irrigation provides a clean dentine surface of the root canal without a smear layer.

Aim: To examine the role of IgA, CIC and component C3 as indicators of humoral immune response in the etiopathogenesis of oral erosive lichen planus (OELP). Material and method: The study comprised 19 patients with OELP whose samples of blood, saliva and tissue were obtained after carefully taken medical history and clinical examination. Samples of oral mucosa were taken from the site of lesion, i.e. exclusively from buccal mucosa (1 cm in width and length), and from the deep epithelium as well as a segment from the lamina propria. Determination of immunoglobulins in serum and saliva, and determination of component C3, was done using the micro-elisa technique by Rook & Cameron, Engvall and Ulman. Determination of CIC in serum and mixed saliva was done with the PEG (polyethylene glycol) method. Determination of immunoglobulin A and component C3 in biopsy material was done with direct immunofluorescence. Results: Levels of immunoglobulin A in serum in OELP during exacerbation were decreased (1.04 ± 0.49 gr/l) and during remission increased (5.92 ± 0.62) in comparison with the control group (p < 0.001). Levels of CIC during exacerbation and remission were increased (p < 0.001), and component C3 levels were increased in both examined phases in the examined group compared with the control group (p < 0.05). Deposits of IgA were registered in one (5.88%) patient with OELP and component C3 was registered in 3 (17.64%) patients. Conclusion: Changes in IgA values, as well as CIC and component C3, may correlate with changes in oral mucosa emphasizing the role of humoral immune response in the pathogenesis of oral lichen planus.

Recurrent aphthous stomatitis (RAS) is a quite frequent, painful, ulcerative disease that affects the lining of the oral cavity and has an unknown etiology. The aim of this article is to examine the impact of the medication proaftol on epithelization speed and severity of pain in patients with RAS. In this randomized, double-blind, placebo-controlled study respondents were divided into two groups where one group was treated with proaftol spray and the other with a placebo. Aphthae considered for treatment had a diameter of 5-6 mm. The participants were given instruction on the use of the spray, two sprayings on the place of the aphtae 3-4 times a day. We examined two parameters in the symptomatology of RAS-lesion size (mm) and pain intensity (noted on four subjective levels: 0-no pain, 1-discomfort, 2-moderate pain, 3-severe pain). These parameters were noted on the baseline, the third, the fifth and the eighth days of examination.A significant faster reduction of the dimension of aphthous ulcers in patients treated with proaftol 3rd day p0.001, 5th day p0.0006, 8th day full epithelization in the control group. The magnitude of pain in the experimental compared with the control group on 3rd, 5th and 8th day was also significantly reduced: p0.0001, p0.007, p0.007 respectively.The use of proaftol positively influences the rate of epithelization and reduction of subjective feeling of pain in patients with RAS. The action of propolis should be the goal of studies with a larger number of subjects.

Most of the composites and sealants used in dentistry are based on bisphenol A diglycidylether methacrylate (Bis‐GMA) and triethylenglycol dimethacrylate (Teg‐DMA). Reports revealed that in situ polymerization is not complete and that free monomers can be detected by different analytical methods. We studied residual Bis‐GMA and Teg‐DMA after in vitro polymerization by high performance liquid chromatography (HPLC) after 24 hr, 7, and 14 days. For quantitative analysis, an RP column (250 × 4.6 mm; 5 µm) as stationary phase and isocratic elution with CH3CN:H2O (60:40) was used. A calibration curve was constructed using standard solutions of Bis‐GMA and Teg‐DMA in the concentration range from 1 × 10−3 to 5 × 10−5 mol/L. The limits of detection (LOD) and quantification (LOQ) for both analytes were determined (for Bis‐GMA: 0.0076 and 0.0229 mmol/L; and for Teg‐DMA: 0.0123 and 0.0373 mmol/L, respectively). The accuracy of the method was confirmed by standard additions. The HPLC analysis of residual comp...