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Knowledge about the proximity of important anatomical structures is crucial for all surgical interventions, including those in the lower jaw region. One of these important structures is the mental foramen, which transmits the mental nerve, whose branches provide sensory innervation to the chin, lower lip, and gingiva. The mental foramen variations can influence the effectiveness of the mental nerve anesthesia and can also be related to complications during surgical procedures such as implant placement, apicoectomy, vestibuloplasty, etc. We present a very rare case of agenesis of left mental foramen coexisting with two right mental foramina incidentally found in a patient examined by cone-beam computed tomography.

Apical cysts are typically caused by dental pulp disease and are difficult to treat. In the majority of cases, surgical intervention is required. The rate of success after apical osteotomy varies between 60% and 91%. The introduction of platelet concentrates in treating chronic apical periodontitis is a promising direction for achieving quick and secure results. This article examines the healing of a sizable apical cyst after conservative surgical intervention and the application of platelet concentrate. We present the case of a patient with a large apical cyst (0.799 cm3) of teeth 24 and 25 which was treated in this study. The precise endodontic treatment was performed with regenerative components such as gaseous ozone and EDTA irrigation. Apical osteotomy was performed, followed by inserting advanced platelet-rich fibrin plus (A-PRF+) into the surgical wound. Nine months after treatment, the bones of teeth 24 and 25 were fully healed without any changes to the sinus and nine months after surgically removing the radicular cyst, rapid and complete tissue repair was demonstrated.

Purpose: Indirect restorations can be performed using different impression techniques (conventional, laboratory, or intraoral scanners). Their accuracy determined their longevity. This study compares the marginal and internal adaptation of milled CAD/CAM composite inlays fabricated by conventional, hybrid, and digital methods. Material and methods: Thirty human premolars were prepared for MOD composite inlays(CI). They were divided into three equal groups depending on the process of fabrication: Group 1 (conventional group)— impression and laboratory-fabricated CI, Group 2 (hybrid group)— impression, laboratory scanner and milled CAD/CAM CI, and Group 3(digital group)— digital impression (intraoral scanner) and milled CAD/CAM CI. The marginal gap (MG), absolute marginal discrepancy (AMD), and internal gap (IG) were measured at 120 different points per CI using X‐ray microtomography. The data were analyzed using Kolmogorov–Smirnov and Mann–Whitney U tests. Results: The conventional and digital composite inlays present significantly smaller marginal and internal gaps than the CAD/CAM group manufactured by hybrid methods. Conclusions: Within the limitations of this in vitro study, we concluded that the CAD-CAM composite inlays fabricated by digital method exhibited statistically better marginal and internal adaptation results than composite CAD-CAM inlays by hybrid methods. The composite CAD-CAM inlays made by digital methods are an alternative to those made by a conventional methodology.

Introduction: The action of ozone is associated with the prevention of dental plaque formation, and the reduction of bacterial development supports the prevention of dental caries. This paper aims to establish the effect of gaseous ozone on developing new caries lesions two years after its application for caries-active patients. Material and Methods: Patients aged 30 to 50 were selected with no common diseases. They all have five or more caries on the teeth, without missing teeth. Patients were divided into two groups of 10 participants. One group had ozonation of all teeth, and another is a control group without ozonation. Results: After two years, the number of caries lesions in the group without prophylactic ozonation is more significant. The results showed that the patients in the ozonation group had significantly fewer primary caries than those in the control group( p≤0.0001). Conclusions: Repeated ozonation of all teeth according to the applied methodology (10 times, distributed twice a week by 24 seconds exposure to ozone in a gaseous state) has a caries-protective effect against new caries lesions.

AbstractThe development of regenerative endodontic therapy offers new opportunities for faster tooth recovery in chronic apical periodontitis. This study aimed to use three different surgical protocols to compare the results (filling the apical lesion with bone tissue over 6 months) of treatment in patients with chronic apical periodontitis. This study included 23 patients and 30 teeth with chronic apical periodontitis. The patients were divided into three groups: (1) Endodontic treatment and apical osteotomy without filling; (2) Endodontic treatment and apical osteotomy with the placement of blood concentrate according to the advanced platelet-rich fibrin A-PRF + protocol; (3) Endodontic treatment and apical osteotomy with the placement of blood concentrate according to the ‘sticky bone’ and A-PRF + protocols with allograft. The results were reported after 6 months using cone-beam computed tomography. The results showed a statistically significant difference (Mann–Whitney U test) in the filling of the bone defect in the healing process between the first group (average rank 31.490) and the second group (average rank 96.015), as well as between the first group (average rank 31.490) and the third group (average rank 91.765). No significant difference was found in the filling of the bone defects between the second and third groups. We show that placement of A-PRF + blood concentrate alone or combined with alloplastic graft after classical apical osteotomy of teeth with chronic apical periodontitis leads to a size reduction of the bone defect with 95.25% for group 2 and 90.80% for group 3 after 6 months.

Aim of the study: This study aims to evaluate the possible relationship between the occurrence of bruxism and perceived stress during the Covid-19 pandemic period. Material and methods: Two questionnaires were administered to one hundred forty-five (145) respondents randomly selected from different age groups and gender. Each patient was screened with and Perceived Stress Scale–10 (PSS-10) containing ten questions. The questionnaire assessed patients about stress related to everyday problems, personal events, and coping methods. The answers were scored using an ordinal five-point scale. In this study, a six-item self-administered questionnaire was used to evaluate self-reported awake and sleep bruxism. Results: In the present study, bruxism was not statistically significantly correlated with self-reported perceived stress based on PSS-10 (rank correlation coefficient was rho (145) = 0.080, p < 0.341). There was no statistically significant difference within the study group between genders in the frequency of low, moderate, and high PSS-10 results (U = 2329.5, p = 0.339). The analysis also showed no statistically significant difference between males and females regarding bruxism score (U = 2381.5, p = 0.434). Conclusions: Results do not confirm the findings of a positive association between bruxism and perceived stress. Within the limitations of this study, the data suggest that the relationship between perceived stress and the expression of bruxism is more complex. Given the results of the current research, this issue requires further investigation.

Aim of the study: The study aims to assess the possible relationship between bruxism and TMJ sounds. Material and methods: The relationship between temporomandibular joint (TMJ) sounds and bruxism was evaluated in a sample composed of 62 females and 39 males varied in age from 21 to 56 years with a mean age of 40.0±1.07. The participants were informed about the purpose of this study, and they gave their consent. The main methods we used in registering TMJ sound were palpation and auscultation. A self-administered Bruxism Assessment Questionnaire assessed bruxism. Results: The prevalence of bruxism in study group was 60.39% (n = 61) – sleep bruxism (SB) and awake bruxism (AB) were 38.2% and 23.4%, respectively. A total of 53.47% (n = 54) of the sample exhibited some type of clicking joint sound. Chi-square test for independence (with Yates Continuity Correction) indicated significant association between bruxism and TMJ sounds, χ2 (1, n = 101) = 4.183, p = .046, phi = .28. Conclusions: Biomechanical factors seem to play a significant role in TMJ disk displacement development. Based on the research, it should be concluded that bruxism may be associated with joint pathologies, such as disc displacement and joint noises.

Aim of the study: The aim is to evaluate and compare marginal microleakage of class II resin composite restorations using a flowable composite and resin-modified glass-ionomer cement as intermediate layers, and to assess whether a difference in the thickness, consistency, and position of these layers would influence microleakage. Material and Methods: Forty-two extracted intacted molars were divided into six groups. Class II cavities in medial and distal parts were prepared. Cavities in Group А were lined with a flowable composite resin; Group В had no lining; in Group С1, the axial wall was covered with a 1.5 mm resin-modified glass-ionomer cement (RMGIC) layer; in Group С2, axial and gingival walls were covered with a 2.5 mm RMGIC layer; in Group С3, the axial wall was covered with a 1 mm RMGIC layer; and in Group С4, axial and gingival walls were covered with a 1 mm RMGIC layer. Results: No significant microleakage differences existed between groups A and B and the experimental group C3. In group C3, a low-viscosity RMGIC was applied only on the axial dentin wall of the cavity. Such difference, however, exists in comparison of group C1 or C2 with each of the groups A or B (p < 0.0001). The difference between groups C4 and A (p < 0.0001) was also significant. Conclusion: The least microleakage along the gingival walls of the model cavities with RMGIC occurs when a 1-mm layer of resin-modified glass-ionomer with fluid consistency covers only the axial wall of the proximal cavity.

Background: Successful endodontic treatment requires effective biomechanical preparation of the root canals and three-dimensional obturation of the root canal system. This can be achieved only by knowing and identifying the variations in the root canal system of the endodontically treated teeth. The Aim: The aim of this article is to present cases of endodontic treatment of maxillary first premolar with three root canals – different types. Material and Methods: Five clinical cases of successful endodontic treatment of patients with maxillary first premolar and three root canals are described. Result and Discussion: It is noted that good endodontic practice requires good knowledge of dental anatomy and possible variations, accurate X-ray images, as well as use of magnifying equipment. Conclusion: Knowledge of dental anatomy is fundamental for good endodontic practice.

Background: Because of their main characteristics: transparency, opalescence and color density, the tooth structures are extremely difficult to restore by means of completely inconspicuous restorations of the natural tooth tissue characteristics. The aim is to show successful aesthetic restoration of III Class dental lesions in upper incisors by means of high quality composites. Materials and method: A female patient visited the clinic being not satisfied with the esthetics of her front teeth. The intraoral examination showed previous restorations and carious lesions in 12, 11, 21, 22. After defining the tooth color a silicone key was made. The treatment was performed under anesthesia, the existing restorations were removed and the carious lesions in teeth 11, 12, 21, 22 were treated with restorations using Vanini edge preparation. The teeth were restored by means of stratification technique. After etching and rinsing, bonding was applied for 20 sec. and then polymerized. After fixing the silicone key enamel shade was applied and then dentine shades UD2, UD3, UD4 of 0.5mm thickness each. The polymerization was done layer by layer. Applied were 10 to 15 layers in total. The composite material was preheated in oven up to 55. Teeth 21 and 22 are restored with Enamel Plus HRi (Micerium). Results and Discussion: Excellent aesthetics is achieved with composite material. They have enamel and dentine shades and allow high quality aesthetics. The polishing is excellent in Enamel Plus HRi (Micerium) which is typical for this type of composite. The result of the carious lesion treatment in this patient is real improvement of the dental appearance of her anterior incisors. Conclusion: Materials show excellent aesthetic results due to their characteristics and the stratification technique used.

Introduction: Maxillary central incisors usually have one root with one root canal. The cases with two root canals are extremely rare. Purpose: The aim was to present an unusual case of a maxillary first incisor with two root canals and the methods of treatment. Material and methods: The 48-year old patient had a painful swelling above the first maxillary incisor. The diagnosis was Periodontitis chronica granulomatosa diffusa exacerbata. After exploration of the pulp chamber, the inspection with an operating microscope was found two root canals. The lesion was covered to periapical and the part of marginal periodontium. The decision was taken of combined endodontic and surgery treatment. Results and discussion: After 7-year follow-up, there was a healing of the lesions and no recurrence. Conclusions: The combined endodontic and surgery treatment was successful choice for preservation of the tooth.

Introduction: There are cases in the endodontic treatment which are a real challenge. There are teeth with taurodontism and radix entomolaris. Patients usually lose their teeth because these anatomical features are less familiar. Purpose: The aim of this study is to investigate several cases with taurodontism and radix entomolaris. Material and methods: Two cases with taurodontism and one with radix entomolaris that are described in the following article. Careful exploration of the grooves between all orifices with magnification, use of ultrasonic irrigation; and a modified filling technique are of particular use. Results: Results are observed after several years. In performing a root canal treatment on such teeth, one should appreciate the complexity of the root canal system, canal obliteration and configuration, and the potential for additional root canal systems. Conclusions: Knowledge of the phenomenon of taurodontism and radix entomolaris will improve the medical practice of the general dental practitioner.

Introduction: The patients with C-shaped configuration of the root canal system are definitely a problem in the everyday dental practice. The C-shaped configuration of the root canal can be seen in the mandibular and maxillary molars. The treatment of these teeth is very difficult. Purpose: To trace the treatment of clinical cases with C-shaped configuration of the root canal system. Material and methods: There are some different cases that are described with a C-shaped configuration of the root canal system with one, two, three and four separate root canals. Careful exploration of the floor of the pulp chamber, inspection with magnification, use of ultrasonic irrigation and a modified filling technique are of particular use. Results and Discussion: Clinical cases of a C-shaped pulp chamber and root canal system shows that this root canal aberration occurs in a wide variety and variability with a single root canal up to two, three and four separate root canals. The diameter of the root canal themselves also varies from very wide to such with a small diameter. Conclusions: Knowledge of the different anatomical variations will improve the endododntic practice of the general dental practitioners.

Background: The ability to self-assess is a critical skill that all health professionals must be able to do, in order to achieve competence. This is essential for the doctors of dental medicine. During their education and practice they apply different clinical and para-clinical procedures. The aim is to evaluate the students' self-assessment skills during the education of clinic and pre-clinic of prosthetic dentistry. Material and methods: After the completion of certain work - preparation for full veneer crown, a questionnaire was provided to each student in preclinical course (n=30) and clinical course (n=30) for self-evaluation. The questionnaire involved: axial reduction, occlusal reduction, facial and lingual reduction, smoothing and finishing. The answers were based on the standard for the university grading scale. Than, the same questionnaire was fulfilled by the assistant professor without seeing students' self-evaluation. Results and Discussion: Results have been reported in percentages. 100% respond rate has been achieved. The students from the preclinical course tend to overestimate their performance (50%). The students from the clinical course tend to submit overall lower grades than the faculty evaluation (25%). Conclusions: The students from clinics have better self-assessment skills. The discrepancy was most pronounced in the junior students. The different evaluations (self-assessment and assistant professor's) help students to improve their understanding of certain principles and improve the teaching effectiveness of education of prosthetic dentistry.