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1. Nickel-titanium files in endodontics: Development, improvement and modifications of nickel-titanium alloy

Author: Živković Slavoljub, Jovanović-Medojević Milica, Nešković Jelena, and Popović-Bajić Marijana
Subjects: dental alloys, endodontics, mechanical phenomena, nickel, root canal preparation, surface properties, titanium, Medicine (General), R5-920
Abstract: nema
Published: 2023
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2. Oral microbiome, COVID-19 and probiotics

Author: Nikolić-Jakoba Nataša, Manojlović Dragica, and Jovanović-Medojević Milica
Subjects: gastrointestinal microbiome, microbiota, mouth, covid-19, probiotics, virus diseases, immunity, symbiosis, Medicine (General), R5-920
Abstract: nema
Published: 2023
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3. Endodontic glide path - importance and performance techniques

Author: Jovanović-Medojević Milica, Stošić Мiljan, Opačić-Galić Vanja, and Petrović Violeta
Subjects: glide path, hand k-files, rotary niti instruments, Medicine
Abstract: Glide path is a procedure that precedes mechanical instrumentation of the root canals. It is defined as a procedure used to expand or create a smooth tunnel from the coronal part of the root canal to its physiological terminus. It is performed using small-size hand files or specially designed mechanical NiTi instruments. An adequately created glide path extends the life of rotary NiTi instruments, enables better mechanical and chemical debridement and easier preservation of original morphology of endodontic space during further mechanical instrumentation. Frequent use of mechanical instrumentation in daily practice requires better understanding of the glide path, its significance, and instruments and techniques used for its creation.
Published: 2023
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4. Comparison of the efficiency of cleaning and disinfection protocols for hand endodontic instruments

Author: Jovanović-Medojević Milica, Opačić-Galić Vanja, Geler Katarina, and Pavlica Dušan
Subjects: decontamination, dental instruments, endodontics, infection control, root canal preparation, Medicine (General), R5-920
Abstract: Background/Aim. There is no standard protocol for cleaning and disinfection of used endodontic instruments before their sterilization and reuse. The aim of this study was to determine the efficiency of the different methods of removing biological debris from different types of used hand stainless steel endodontic instruments. Methods. A total of 120 hand stainless steel endodontic instruments: KerrTM reamers, KerrTM files, and HedströmTM files, each forty ISO 25, used for root canal treatment on extracted teeth, were analyzed. The used instruments were divided into four groups based on different decontamination protocols. The evaluation of the efficiency of the cleaning methods was based on the evaluation of the amount of stained organic residues on the instruments (Van Gieson staining). Samples were analyzed by stereomicroscopy (x40). Statistical analysis was performed using the Mann-Whitney U test for the KerrTM reamers and HedströmTM files, while the One-Way ANOVA/Bonferroni test was used for the KerrTM files, at a significance level of 5 % ( α = 0 .05). Results. Residual biological debris was observed on 93.3% of all the samples taken. The thermal disinfectant cleaning method showed the lowest contamination values for all types of instruments. The method of mechanical cleaning showed that the mean value of maximum biologic contamination (MBC) was 58.5% for the KerrTM reamers and 56.2% for KerrTM files, while for HedströmTM files, the highest MBC (50.2%) was shown by the ultrasonic method of cleaning. Conclusion. The use of a thermal disinfectant was the most efficient cleaning method for all three types of hand endodontic instruments.
Published: 2023
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5. Glide path preparation with hand K-files and rotary PathFiles in simulated curved root canals: An in vitro study

Author: Stošić Miljan, Geler Katarina, Petrović Violeta, and Jovanović-Medojević Milica
Subjects: glide path, curved canals, hand k-files, rotary niti pathfiles, Medicine
Abstract: Introduction: Preparation of glide path is an important precondition for the safe use of rotary NiTi instruments during endodontic treatment. Aim: The aim of this study was to examine the duration of glide path preparation as well as all the changes in canal morphology and canal diameter after the use of hand K-files and NiTi rotary PathFiles. Material and methods: This research was performed on a total of twenty Endo Training Blocks (Dentsply, Maillefer, Switzerland). The glide path was prepared using hand stainless steel K-files ISO #10-15-20 (Dentsply, Sirona, USA) (n = 10) and NiTi rotary PathFiles ISO #13, #16 and #19 (Dentsply, Sirona, Switzerland) (n = 10). The time required to establish the glide path was measured with an iPhone stopwatch (Apple Inc. Cupertino, California). The images of the apical segment of canals before and after glide path preparation were taken under the stereomicroscope (Boeco BSZ-405, Germany), and then images were analyzed and processed with Scopeimage 9.0 (Teleskop, Austria). Statistical analysis was performed with the Mann-Whitney test at the level of significance 5% (a = 0.05). Results: A statistically significant difference was observed in terms of the time required for glide path preparation. The mean total time for glide path preparation was significantly longer with K-files (382 ± 62 s) than with PathFile (200 ± 11 s) (p < 0.05). A statistically significant difference in terms of changing the morphology of the apical part of the canal (p > 0.05) was not observed. The difference in the diameter of the root canal was at the limit of statistical significance (p ≈ 0.05). Conclusion: Instrumentation with NiTi rotary PathFiles reduces the time required for glide path preparation. Preparing endodontic space for rotary instrumentation with hand K-Files and rotary PathFiles leads to similar changes in the morphology of the apical segment. A slightly larger diameter of the root canal was measured after preparation with the hand K-files.
Published: 2023
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6. A single-file endodontic treatment: A promising endodontic concept

Author: Živković Slavoljub, Popović-Bajić Marijana, Jovanović-Medojević Milica, and Nešković Jelena
Subjects: endodontics, nickel, root canal preparation, titanium, tooth, Medicine (General), R5-920
Abstract: nema
Published: 2022
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7. Effects of sodium hypochlorite on corrosion of the rotary nickel-titanium endodontic instruments - SEM analysis

Author: Jovanović-Medojević Milica, Nešković Jelena, Popović-Bajić Marijana, Stratimirović Đorđe, and Živković Slavoljub
Subjects: corrosion, ni-ti file, scanning electron microscopy (sem), Medicine
Abstract: Introduction/Objective. of this study is to use scanning electron microscopy (SEM) analysis to examine surfaces of new and same sets of Ni-Ti instruments after canal preparations, to check their suspectability to corrosion. Methods. In this study, we used five different endodontic Ni-Ti instruments: K3, Mtwo, ProTaper Universal, HyFlex and BioRaCe. Instruments were analyzed before and after preparation of canals of different curvature, using SEM (150–2000 ×). Results. Corrosion of the working part was observed in 5.5% of new Ni-Ti instruments of the K3 system (apical and middle segment), in 5.5% of Mtwo instruments (apical third), and in 11.1% of ProTaper Universal systems (apical and middle third). Corrosion was not observed on the new instruments of the HyFlex and BioRaCe kits. After instrumentation, disinfection, and sterilization, corrosion was observed in all sets of K3 and ProTaper Universal systems and in all HyFlex instruments of the first group. Corrosion was observed in the HyFlex system in the second group in 16.7% of instruments (apical and middle third) and in the third 83.3% in the apical and 66.7% in the middle segment. In the Mtwo set, corrosion was observed in 16.7% of instruments in the first (apical and middle third), in the second group in 33.3% of instruments in the apical part and 50% in the middle third, while in the third group, corrosion was observed in 16.7% of instruments in the middle third of instruments. Conclusion. Rotary Ni-Ti instruments K3 and ProTaper Universal are susceptible to corrosion in a very high percentage. Ni-Ti systems with post-heat treatment of the working part (HyFlex) are somewhat more resistant to corrosion, while in Ni-Ti systems with electropolished surface (BioRaCe), corrosion is not observed.
Published: 2022
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8. How to prevent fracture of NiTi files

Author: Živković Slavoljub, Popović-Bajić Marijana, Jovanović-Medojević Milica, and Nešković Jelena
Subjects: niti files, fractures, file design, motion dynamics, Dentistry, RK1-715
Abstract: More certain therapeutic and significantly facilitated solution of everyday endodontic problems are provided by the introduction of NiTi rotary files in endodontic practice and their proper application. However, their widespread use has caused more and more frequent fractures and has become a significant frustrating factor that diminishes their numerous benefits. Torsional stress and cyclic fatigue are the main reasons for the occurrence of a fracture, and the frequency of NiTi file fractures is exactly proportional to the degree of bending of the canal, knowledge of the features of the file, ie. the skill and expertise of the therapist. The most dominant factor for the occurrence of fractures is the dentist who, in addition to manual dexterity, must have a good knowledge of the anatomy of various canal systems and file design in order to make the best choice for each individual case. Properly formed access cavity and knowledge of the working part of NiTi files enable maximum realization of endodontic skills, increased efficiency of intervention and reduced possibility of error during canal instrumentation. The special treatment of NiTi alloy and new solutions related to the design of the working part have significantly increased file flexibility and resistance to cyclic fatigue. Specific design (reduced number of threads, change of conicity, interruption of blade continuity), reduced engagement of file, ie. change of dynamics of movement in the canal (full rotation, reciprocal, eccentric, transaxial), as well as reduced number of processing files, have also significantly influenced the reduction of fracture risks. The aim of this paper was to analyze the most common reasons for the fracture of NiTi files and emphasize measures and factors that can increase their safe use and reduce complications during canal instrumentation.
Published: 2021
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9. SEM analysis of Mtwo instruments after instrumentation of root canals with different curvatures

Author: Jovanović-Medojević Milica, Milanović Ivana, Zdravković Alena, and Stratimirović Đorđe
Subjects: mtwo, ni-ti instruments, deformation, curved canals, Dentistry, RK1-715
Abstract: Introduction Deformations and fractures of Ni-Ti instruments during chemomechanical instrumentation of root canals occur due to the action of cyclic and torsional forces. The aim of this research was to analyze the surfaces of the working parts of Mtwo instruments after preparation of root canals with different curvatures using SEM and determine possible changes and deformations after instrumentation. Materials and methods The study included 3 sets of Mtwo (VDW, Munich, Germany) instruments. Each set was used to instrument 10 canals in three experimental groups (straight, slightly curved, and highly curved canals). Instrumentation was carried out using crown-down technique with the following irrigation solutions, 2% NaOCl (CHLORAXID 2%, Cerkamed, Polska) and Distilled water (Iva, Serbia) in the amount of 5 cm³. The apical and middle third of the instruments were scanned in two directions using SEM at different magnifications (150-2000X). The SEM images were analyzed using qualitative analysis for the presence of different irregularities according to Eggert et al. Statistical analysis of obtained data was performed using Fisher test at a confidence level of 5% ( a = 0.05). Results Most defects (37.3%) were observed in instruments used in highly curved canals, followed by the instruments of the second group (35.6%), and the least defects were (27.1%) observed in the group with straight canals. Higher prevalence of defects was observed in the apical thirds of instruments (54.2%), especially in the experimental group of curved canals where the highest presence was observed (20.3%). The presence of production grooves was observed in all instruments, and the most common types of defects after instrumentation were the appearance of corrosion and changes in the cutting edges. In the group with extremely curved canals fractures were observed in two instruments (10/0.04 and 15/0.05). Conclusion Root canal curvature significantly affects the occurrence of deformations and fractures of Ni-Ti rotating instruments. The most common types of defects were grooves, corrosion and changes in the blade edges. Mtwo instruments showed deformations in terms of thread changes, microfractures and two complete fractures.
Published: 2021
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10. Evaluation of surface characteristics of new rotary nickel-titanium instruments: SEM-EDS analysis

Author: Jovanović-Medojević Milica, Zdravković Alena, Medojević Mina, and Stratimirović Đorđe
Subjects: ni-ti instruments, manufacturing defects, sem-eds, Dentistry, RK1-715
Abstract: Introduction Modern endodontic procedure implies the use of rotary Ni-Ti instruments during chemomechanical treatment of root canals. The aim of this study is to analyze the surfaces of new (unused) rotary endodontic instruments using the SEM-EDS method and determine how frequently manufacture defects or impurities appear on their working surfaces. Material and method Five new different sets of rotary endodontic Ni-Ti instruments were included in this study: K3, Mtwo, ProTaper Universal, HyFlex and BioRaCe. The working part of endodontic instrument was analyzed using SEMEDS method (magnifications ×150 to ×2000), which determined the morphological characteristics of the instrument surface and chemical composition of the found impurities. Statistical analysis was performed using the Fisher's test (p < 0.05). Results The results of SEM-EDS analysis showed that there is no new instrument without defects on its surface. The most common defects were observed in K3 (27.43%) and ProTaper Universal group (27.21%) and the least were in BioRaCe instruments (7.67%). The most common type of defect in tested instruments was fretting. In addition, the presence of debris and metal strips was found on all instruments, while corrosion of the working part was observed only in K3, ProTaper Universal and Mtwo systems in a small percentage. Conclusion Based on the results of this research, it can be concluded that manufacturing defects were noticed in all examined instruments. The most common defect is pitting. Impurities such as debris and metal strips have also been registered. No organic debris was observed on electropolished surface of BioRaCe instruments, but a small percentage of other types of defects were registered.
Published: 2021
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11. SEM analysis of working surface in new manual endodontic instruments

Author: Jovanović-Medojević Milica, Pelemiš Martina, Nešković Jelena, Popović-Bajić Marijana, Stratimirović Đorđe, and Živković Slavoljub
Subjects: stainless-steel hand endodontic instruments, defects sem, debris, Dentistry, RK1-715
Abstract: Introduction The aim of this study was to analyze working surfaces of new hand endodontic instruments and to check possible existence of dirt or defects on working surface that resulted from manufacturing process using SEM. Material and methods Three sets of new hand instruments: K-File (KF), (18 instruments) (Dentsply Maillefer, Switzerland) and Hedstorm Files (HF), (18 instruments) (SybronEndo Co, USA) were used. Instruments were analyzed by SEM method at 170× magnification while semi-quantitative EDS analysis was used to determine chemical composition of dirt particles. Fisher test (p < 0.05) was applied in statistical analysis. Results Results showed that none of the instruments was defect-free. The most common defects were metal strips and fretting noticed at the surface of all tested instruments. Debris was present on all KF (100% in apical and middle third) and HF (56% in apical and 56% in middle third) instruments. Pitting was noticed in KF (33% in apical and 39% in middle third) and HF (11% in apical and 6% in middle third) instruments. Corrosion of working surface, metal flash and disruption of cutting edge were marked only in KF group. Conclusion Manufacturing defects were noticed in all instruments and the most common type of irregularity were metal strips and fretting.
Published: 2020

12. Analysis of working surface in new manual and rotary endodontic instruments (scanning electron microscopy)

Author: Jovanović-Medojević Milica, Pelemiš Martina, Nešković Jelena, Popović-Bajić Marijana, Stratimirović Đorđe, and Živković Slavoljub
Subjects: stainless-steel manual instruments, ni-ti rotary instruments, defects, sem, debris, Medicine
Abstract: Introduction/Objective. The objective of this study is to use scanning electron microscopy (SEM) to analyze working surfaces of new manual and rotary endodontic instruments and to check possible existence of manufacture dirt particles or defects on the working surface. Methods. In this study, we used three sets of new manual instruments: K-File, KF (Dentsply Maillefer, Switzerland) and Hedstorm Files, HF (SybronEndo Co, USA) and three sets of mechanical Ni-Ti instruments – type K3 (SybronEndo Co, USA) and BioRaCe (FKG DENTAIRE Swiss Dental Products, Switzerland). The instruments were analyzed using SEM method at 170 × magnification while semi-quantitative energy dispersive x-ray analysis was used to determine chemical composition of dirt particles. Fisher test (p < 0.05) was applied in statistical analysis. Results. Results showed that none of the instruments were defect-free. The most common defect type was the presence of metal strips, which were noticed at the surface of all tested instruments. Debris was present on all manual and only one type of mechanical instruments, K3 (39% in the apical and 33% in the middle third). Fretting was noticed in all manual KF and all mechanical instruments of the K3 group. Pitting was common in all manual instruments, KF (33% in the apical and 39% in the middle third) and HF (11% in the apical and 6% in the middle third). Corrosion of the working surface, metal flash, and disruption of the cutting edge were marked only in the KF group. Conclusion. Manufacture defects were noticed in all instruments and the most common type of irregularity were metal strips. Electropolished surface of BioRaCe instruments showed no debris of organic origin.
Published: 2020
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13. The influence of the final irrigation protocol on the efficiency of root canal cleaning

Author: Nešković Jelena, Ninković Neda, Opačić-Galić Vanja, Jovanović-Medojević Milica, Popović-Bajić Marijana, Maksimović Miloš, and Živković Slavoljub
Subjects: final irrigation protocol, irrigants, smear layer removal, Medicine
Abstract: Introduction/Objective. Irrigation has an important role in root canal cleaning and its efficiency depends on the type of irrigants, the amount, the technique and the irrigation protocol. The aim of this work was to estimate the efficiency of cleaning of the canal walls by using scanning electron microscope analysis after the instrumentation by rotary NiTi instruments with the use of three different irrigation solutions and two final irrigation protocols. Methods. Sixty extracted human incisors were divided into two groups after the rotary instrumentation with the iRace instruments. In both groups, the same amount (1.5 ml) of three solutions (2% sodium hypochlorite solution, 2% chlorhexidine solution, and 10% citric acid solution) and total final irrigation time (90 seconds) was the same. The final irrigation in the first group was accomplished using the technique of continuous irrigation and in the second group it was done using the intermittent protocol. The roots were cut longitudinally and analyzed by thirds (coronal, middle, and apical) on a scanning electron microscope (JSM 6460LV, JEOL Ltd., Tokyo, Japan) with 1,000× magnification. Results. The most efficient cleaning of the root canal walls in both groups was seen after the use of citric acid with the intermittent protocol of the final irrigation (90.7% clean walls), while the least efficient was the final irrigation by chlorhexidine with continuous irrigation (80.3%). The most efficient cleaning of the canal walls in both groups was observed in the coronal third and the largest amount of the smear layer in the apical third. Conclusion. The most efficient cleaning of the canal was achieved by the use of citric acid and the intermittent protocol of the final irrigation. In all tested solutions, the intermittent protocol of irrigation was more efficient than continuous irrigation.
Published: 2020
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14. Efficiency of root canal cleaning using a single instrument with reciprocating motion systems and full rotation systems: SEM study

Author: Živković Slavoljub, Nešković Jelena, Jovanović-Medojević Milica, Popović-Bajić Marijana, and Ostojić Dejan
Subjects: smear layer, reciprocal movements, niti rotating instruments, sem, Dentistry, RK1-715
Abstract: Introduction Efficient cleaning and canal design present a basic precondition for successful endodontic treatment. The aim of this study was to evaluate, using SEM analysis, the efficacy of cleaning the apical third of the canal with one instrument in both reciprocating motion and full rotation systems. Materials and methods Thirty (30) single-rooted teeth (upper incisors), extracted due to periodontal problems, were used and selected in 2 groups. In the group 1, instrumentation was done with a single instrument UNICONE with reciprocal movements (MEDIN, Czech Republic), while in the group 2, a single instrument XPS endo SHAPER (XPS) (FKG, Dentaire, Swiss) with full rotation was used. 2% solution of NaOCl and 17% EDTA solution were used as irrigation agents in both groups. SEM analysis of the smear layer in the apical third was done at standard magnification of 1000x and presented on a scale of 1-5. Results showed mostly clean canal walls and no smear layer in the apical region in both tested groups. Canal walls were somewhat cleaner after using UNICONE with reciprocal movements (80%) compared to the canals instrumented with XPS ENDO SHAPER (76%), but this difference was not statistically significant. Conclusion Single-file NiTi systems did not remove smear layer completely, but provided efficient cleaning in the api-cal part of the canal. UNICONE file with reciprocal movements was somewhat more efficient in removing the smear layer compared to the full rotation XPS ENDO SHAPER file.
Published: 2018

15. Microbiological status of root canal after unsuccessful endodontic treatment

Author: Nešković Jelena, Jovanović-Medojević Milica, Grga Đurica, Popović Branka, and Živković Slavoljub
Subjects: pcr, e. faecalis, endodontic failure, Dentistry, RK1-715
Abstract: Introduction the main objective of endodontic treatment is to eliminate infection from root canal and prevent re-infection by three-dimensional hermetic obturation of the canal system. Endodontic failure can occur due to inability of complete control and elimination of infection from the root canal. The aim of this study is to investigate, by PCR technique, microbiological status of previously endodontically unsuccessfully treated teeth immediately after the removal of obturation material. Material and Methods the analysis included 30 teeth indicated for endodontic retreatment. After removing previous root canal filling material, the bacteriological sample was taken by sterile instrument (# 15) and paper points. Standard PCR technique was used to analyze the incidence of E.faecalis, P.micros, P.intermedia, P. endodontalis and a.actinomycetemcomitans. Results Positive bacteriological findings were registered in 80% of cases, while bacteria were not identified in 20% of all samples (all taken from the root canals without significant changes in periapical tissue). From 24 canals with identified bacteria, 17 had affected apical periodontium. The most dominant microbe in root canals with positive bacteriological finding was E.faecalis (83.3% of the canals) and P.intermedia (75%). In case of teeth with chronic periapical changes, the most common was E. faecalis (94%) and P.intermedia (82.3%). Conclusion the presence of periapical lesions significantly affects microbiological status of endodontically treated teeth. The presence of bacteria was confirmed in most teeth with periapical lesions, while the most frequently identified bacteria were E. faecalis, P.intermedia and P.micros.
Published: 2018

16. The efficacy of XP-endo shaper (XPS) in cleaning the apical third of the root canal

Author: Živković Slavoljub, Nešković Jelena, Jovanović-Medojević Milica, Popović-Bajić Marijana, and Živković-Sandić Marija
Subjects: XP endo SHAPER, XP endo FINISHER, smear layer, conventional irrigation, Dentistry, RK1-715
Abstract: Introduction The aim of this study was to evaluate the efficacy of new rotary NiTi instrument XP endo SHAPER (XPS) used with conventional irrigation protocol on the root canal cleaning in the apical area. Material and methods The research was conducted in vitro on 40 extracted single-rooted teeth divided into the four groups. Instrumentation in the first group was performed using iRa Ce NiTi rotary instruments, in the second group the same instruments were used plus XP endo FINISHER (XPF) for smear layer removal. In the third group, canal instrumentation was done using new instrument XPS, and in the fourth XPS instruments plus XPF was used. During the instrumentation 2% NaOCl solution was used for rinsing canals. The SEM analysis of the cleaning quality in the apical third of the canal was performed on longitudinal root cross-sections and standardized microphotography with a 2000x magnification. Results The thickest smear layer in the apical third was recorded in the first group (iRa Ce) NiTi instruments (2.12), and somewhat less in the group with the new XPS instrument (1.95). An identical and somewhat smaller amount of smear layer was registered in the second and fourth groups where XPF was used with the final irrigant (1.64) (p
Published: 2017

17. Endodontic treatment of lower molar in a patient with paraesthesia of inferior alveolar nerve: A case report

Author: Jovanović-Medojević Milica and Nešković Jelena
Subjects: paraesthesia, C-shaped canal, Guttaflow paste, Dentistry, RK1-715
Abstract: Root canal (endodontic) treatment is demanding and complex procedure. A variety of difficulties can occur in different phases of endodontic procedure. Complex anatomorphological tooth structure, curved canals, close proximity of lower molars and premolars to inferior alveolar nerve make endodontic treatment even more challenging. During endodontic treatment, an inferior alveolar nerve may become traumatized and symptoms may vary from mild neurosensory dysfunction to a complete loss of sensation in the innervation area of damaged nerve. The aim of this paper is to present a clinical case of endodontic treatment of lower second molar with C-shaped root canal in a patient with paraesthesia of inferior alveolar nerve due to endodontic origin.
Published: 2017

18. Music as an alternative therapy method in dentistry

Author: Jovanović-Medojević Milica, Nešković Jelena, and Medojević Aleksandar
Subjects: dental fear, music therapy, dental office, Dentistry, RK1-715
Abstract: Dental fear represents a significant social concern. Therefore, an individual approach to each patient and timely recognition and elimination of dental stress are necessary in order to provide adequate and successful treatment. The aim of this paper was to present possible application of music therapy in dentistry and its role in reducing dental fear. Music has shown great prospective as an alternative therapy method in various fields of medicine. Music therapy is painless and noninvasive anxiolytic method that reduces dental anxiety as it provides relaxation and distraction. Music in dental office creates positive atmosphere among patients and their company as well as dental staff.
Published: 2016

19. XP-endo Finisher: A new solution for smear layer removal

Author: Živković Slavoljub, Nešković Jelena, Jovanović-Medojević Milica, Popović-Bajić Marijana, and Živković-Sandić Marija
Subjects: XP-endo Finisher, smear layer, NiTi rotary instruments, SEM, Dentistry, RK1-715
Abstract: Introduction The aim of this study was to evaluate using SEM analysis the effectiveness of a new instrument XP-endo Finisher in cleaning root canal walls after instrumentation with BioRaCe NiTi rotary instruments. Material and Methods This in vitro study was conducted on 30 extracted single rooted teeth divided in two groups. Instrumentation of all canals was done using basic BioRaCe NiTi rotary instruments with copious irrigation of 2% NaOCl. In the first group, after complete instrumentation smear layer was removed using XP-endo Finisher, while the other group served as negative control. The roots were then after longitudinally cut and SEM analysis was performed. The presence of smear layer in the coronal, middle and apical third was assessed. The data were statistically analyzed using Mann-Whitney U-test (p
Published: 2015

20. Dental anxiety: Etiology and treatment options

Author: Jovanović-Medojević Milica, Nešković Jelena, and Medojević Aleksandar
Subjects: dental fear, dental anxiety, etiology, therapy, Dentistry, RK1-715
Abstract: Dental anxiety might be the cause of serious health problems. Avoiding dental visits can lead to complications with functional, esthetic and sociological consequences. In order to have a simple and efficient dental procedure, it is very important to diagnose dental anxiety and to react adequately. The aim of this paper is using available literature to present most frequent causes, consequences as well as treatment options for dental anxiety. Treating dental anxiety and choosing the right treatment is not always easy, however, it is important for dental practitioners to be able to assess patient's behavior, possible causes of such behavior and select adequate therapy methods. Individual approach is very important as well as timely recognition and gradation of dental anxiety in order to apply adequate and successful dental treatment.
Published: 2015

21. Application of screw-retained and cement-retained implant supported fixed restorations: A case report

Author: Medojević Aleksandar, Jovanović-Medojević Milica, and Nejković Đorđe
Subjects: screw-retained, cement-retained, implant supported fixed restorations, Dentistry, RK1-715
Abstract: Implantology has become an important therapeutic procedure that allows complete aesthetic and functional rehabilitation of the oro-facial system in edentulous patients. Implant supported prosthetic restorations can be fixed in two ways, by cement or screws. Both techniques have advantages and disadvantages and their selection depend on situation in patient’s mouth. The aim of this study was to describe complete process of prosthetic rehabilitation in an edentulous patient, from pre-implant preparation, through implant placement and fixation of final restoration on implants. In this case report, one ceramo-metal bridge was fixed by screws in the lower jaw while the other one was fixed using glass-ionomer cement in the upper jaw. After bone augmentation and time necessary for its osseointegration (6 to 8 months), 16 implants were placed in both jaws. Eight weeks after the implant placement, final prosthetic rehabilitation was achieved by cementation of one ceramo-metal bridge in the upper jaw using glass ionomer cement and fixation of the second bridge with screws in the lower jaw. To achieve successful implant supported prosthetic rehabilitation, the treatment protocol must be followed from the beginning to the end of the therapy.
Published: 2012
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22. Dental status of institutionalized persons with special needs who live in Special institution 'Srce u jabuci' in Pancevo

Author: Savić-Stanković Tatjana, Jovanović-Medojević Milica, and Živković Slavoljub
Subjects: persons with special needs, caries, extraction, restoration, Dentistry, RK1-715
Abstract: Introduction. Dental status of most people with special needs is not satisfactory. Many of them are edentulous or toothless, with acute extensive caries lesions present, high DMFT index and severe periodontal disease. The objective of this study was to examine the dental status of mentally impaired persons who live in the special institution “Srce u jabuci” in Pancevo. Material and Methods. Clinical examination was performed on 114 institutionalized patients (68 male and 46 female), age 22 to 71 years. Patients were divided in two groups; the first group consisted of 71 persons who had a moderate mental disorder (F71), while the second group included 43 respondents with severe mental retardation (F72). Oral examination revealed: the number of present teeth, caries lesions, the presence of restorations, the number of extracted teeth, the presence of residual roots, fractures and the presence and number of fixed restorations. Results. The mean DMFT of total examined teeth was 20.33±7.63. The greatest percentage found for extracted teeth (63.76%): in the first group 63.23%, and in the second 64.06%. The percentage of teeth that had caries lesions of all examined teeth was 33.48%, while the lowest percentage was for restored teeth (2.76%). In majority of examined people, initial caries, deep caries, or tooth with the exposed pulp (K1 - 51.74% K2 - 40.35%, K3 - 51.75%) were not found. A high percentage of examined people had more than 10 extracted teeth (52.63%). Most of them did not have any restoration in the mouth (81%) and only three persons had fixed denture. Conclusion. Dental status of institutionalized mentally impaired persons showed high prevalence of extracted teeth, significant presence of carious lesions and small percentage of restored teeth with inadequate oral hygiene.
Published: 2011
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23. Primary and secondary dentine thickness at the apical foramen of the mesial and distal root of the lower first permanent molar

Author: Jovanović-Medojević Milica
Subjects: lower first molar, root canal, dentine, dental anatomy, endodontic treatment, Dentistry, RK1-715
Abstract: Introduction Knowledge of the complexity of the root canal system in lower first molars and particularly the apical part of the root affects significantly the realization and success of the endodontic procedure. Aim The aim of this paper was to determine the thickness of the primary and secondary dentine around the main foramen of the mesial and distal root of the lower first permanent molar in teeth of various ages. Material and Method Fifty extracted lower first molars of both male and female patients extracted for various reasons were used in the study. All teeth were allocated to three age groups: under 25 years old (15 teeth), between 26 and 50 (20 teeth) and over 51 years old (15 teeth). After access cavity preparation, canal orifices were enlarged and root canals were explored using hand K-files #10. Using a diamond disc, the root tip was then cut off in the area of the apical foramen. Dentine thickness was determined using a complex configuration comprising of several devices which were interconnected by software. These included a polarised microscope (Leica DMLSP), a digital camera (Leica DC300) and a scanner. Results The results showed that the greatest mean thickness of the primary dentine was in the mesial root of the first lower molar in the first age group (0.177 mm), followed by the third (0.145 mm) whilst the least mean thickness was observed in the second age group (0.141 mm). In the distal root, the mean thickness of the primary dentine was in the second (0.175 mm), then the first (0.138 mm) and finally the third group (0.100 mm). The mean thickness of the secondary dentine in the mesial root was observed in the second group (1.25 mm), followed by the third (1.11 mm) whilst the least mean thickness was found in the first age group (0.95 mm). The mean thickness of the secondary dentine in the distal root was observed in the second group (1.26 mm), then the third (1.18 mm) whilst the least mean thickness was found in the first age group (0.99 mm). Conclusion The obtained results suggested that the mean thickness of the primary dentine in the mesial and distal roots was comparable. For both mesial and distal roots, the greatest mean thickness of the secondary dentine was observed in the second age group.
Published: 2009
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24. The distance of the main and auxiliary openings from the top of medial and distal root of the first lower permanent molar

Author: Jovanović-Medojević Milica and Živković Slavoljub
Subjects: lower first molar, main opening, auxiliary opening, Dentistry, RK1-715
Abstract: The main prerequisite for a successful treatment of pulp disease in apex periodontium is knowledge of morphological characteristics of root canal system, especially one third of his apex. The aim of this work was to define the exact distance of the main and auxiliary openings from the top of medial and distal roots of the first lower permanent molars. Methods: as a research material it was used a hundred extracted first lower molars of the patients of both gender, divided into three age groups. The analysis of the one third of apex was done with the help of binocular magnifying glass and digital roentgenography analysis half of the samples, which were filed with capillary contrast. Results: The results obtained showed that the longest average distance of the main opening from the top of medial root was 0.84mm, and the shortest was 0.61mm; while for the distal root the longest average distance was 0.89mm, and the shortest was 0.62mm. Maximum distance of the auxiliary openings from the top of medial root in the first group was 3.5mm, and the maximum distance of the auxiliary openings from the top of distal root was 2, 5 mm. The results obtained with digital rentgenography showed that the longest average distance of the main opening from the top of medial root was the one noticed in the second age group (0.91mm) then the one from the first group (0,83), and the shortest one in the third age group (0,71mm); as for the distal root: the longest average distance of the main opening from the top of the root was noticed in the third age group (0,95mm) then in the first (0,90mm) and than shortest in the second age group (0,89mm). Conclusion: The distance of the main and auxiliary openings from the top of medial and distal root of the first lower molar varies in the range from 0 to 3,5mm and it depends on the tooth age. .
Published: 2005
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25. Localisation of main and ancillary foramina within the mesial and distal roots of the first lower molars

Author: Jovanović-Medojević Milica and Živković Slavoljub
Subjects: first lower molar, main orifice, auxiliary orifice, location, Medicine
Abstract: Introduction. Understanding the morphology of the root canal system, and especially its apical third, represents the basic precondition for the successful treatment of diseased pulp and the apical endodontium. Aim. The aim of this study was to precisely locate the main and ancillary foramina in the mesial and distal first lower molars. Method. One hundred extracted first lower molars, originating from persons of both sexes and three different age groups, were used in the study. Results. The analysis of the sampled molars’ apical third was carried out using a binocular magnifier and a digital X-ray scanner (Trophy). The results showed that the main mesial and distal root foramina were located mostly on the distal surface. The ancillary mesial and distal root foramina were located at the lingual end, in most cases. Statistical analysis demonstrated the congruence of results achieved using the binocular magnifier and digital x-ray in 100% of cases if the main foramen is located on the very top of the mesial root (χ2 =17.23; p
Published: 2005
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26. Opto-magnetic imaging spectroscopy in analyzing rotary NiTi endodontic instruments

Author: Jovanović-Medojević, Milica, Dragičević, Aleksandra, Milanović, Ivana, Matija, Lidija, and Živković, Slavoljub
Published: 2023
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27. Comparison of the efficiency of cleaning and disinfection protocols for hand endodontic instruments

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Opačić-Galić, Vanja, Geler, Katarina, Pavlica, Dušan, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Opačić-Galić, Vanja, Geler, Katarina, and Pavlica, Dušan
Abstract: Background/Aim. There is no standard protocol for cleaning and disinfection of used endodontic instruments before their sterilization and reuse. The aim of this study was to determine the efficiency of the different methods of removing biological debris from different types of used hand stainless steel endodontic instruments. Methods. A total of 120 hand stainless steel endodontic instruments: KerrTM reamers, KerrTM files, and HedströmTM files, each forty ISO 25, used for root canal treatment on extracted teeth, were analyzed. The used instruments were divided into four groups based on different decontamination protocols. The evaluation of the efficiency of the cleaning methods was based on the evaluation of the amount of stained organic residues on the instruments (Van Gieson staining). Samples were analyzed by stereomicroscopy (x40). Statistical analysis was performed using the Mann-Whitney U test for the KerrTM reamers and HedströmTM files, while the One-Way ANOVA/Bonferroni test was used for the KerrTM files, at a significance level of 5% (a = 0.05). Results. Residual biological debris was observed on 93.3% of all the samples taken. The thermal disinfectant cleaning method showed the lowest contamination values for all types of instruments. The method of mechanical cleaning showed that the mean value of maximum biologic contamination (MBC) was 58.5% for the KerrTM reamers and 56.2% for KerrTM files, while for HedströmTM files, the highest MBC (50.2%) was shown by the ultrasonic method of cleaning. Conclusion. The use of a thermal disinfectant was the most efficient cleaning method for all three types of hand endodontic instruments., Uvod/Cilj. Ne postoji standard za čišćenje i dezinfekciju upotrebljenih endodontskih instrumenata pre njihove sterilizacije i ponovnog korišćenja. Cilj rada bio je da se ustanovi efikasnost različitih metoda uklanjanja ostataka biološkog materijala sa radnih površina upotrebljenih ručnih endodontskih instrumenata od nerđajućeg čelika. Metode. Analizirano je ukupno 120 ručnih endodontskih instrumenata od nerđajućeg čelika: po četrdeset KerrTM proširivača, KerrTM turpija i HedströmTM turpija ISO 25, upotrebljenih za obradu kanala korena na ekstrahovanim zubima. Na osnovu protokola koji je korišćen za dekontaminaciju instrumenata, upotrebljeni instrumenti su podeljeni u četiri grupe. Procena efikasnosti korišćenih metoda čišćenja zasnovana je na proceni količine prebojenih organskih ostataka na instrumentima (bojenje po Van Gieson-u). Uzorci su analizirani stereomikroskopijom (x40). Statistička analiza dobijenih rezultata izvršena je MannWhitney U testom za KerrTM proširivače i HedströmTM turpije dok je za KerrTM turpije korišćen One-Way ANOVA/Bonferoni test, na nivou pouzdanosti od 5% (a = 0,05). Rezultati. Prisustvo rezidualnih ostataka biološkog materijala uočeno je na 93,3% svih analiziranih instrumenata. Metoda čišćenja toplotnim dezinfikatorom pokazala je najniže vrednosti kontaminacije za sve tipove instrumenata. Metoda mehaničkog čišćenja pokazala je da je srednja vrednost parametra maksimum biološke kontaminacije (MBK) bila 58,5% za KerrTM proširivače i 56,2% za KerrTM turpije, dok je za HedströmTM turpije najviša vrednost MBK (50,2%) bila posle ultrazvučne metode čišćenja instrumenata. Zaključak. Primena toplotnog dezinfikatora je najefikasnija metoda čišćenja za sva tri tipa ručnih endodontskih instrumenata.
Published: 2023

28. Effects of sodium hypochlorite on corrosion of the rotary nickel-titanium endodontic instruments - SEM analysis

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, Popović-Bajić, Marijana, Stratimirović, Đorđe, Živković, Slavoljub, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, Popović-Bajić, Marijana, Stratimirović, Đorđe, and Živković, Slavoljub
Abstract: Introduction/Objective of this study is to use scanning electron microscopy (SEM) analysis to examine surfaces of new and same sets of Ni-Ti instruments after canal preparations, to check their suspectability to corrosion. Methods In this study, we used five different endodontic Ni-Ti instruments: K3, Mtwo, ProTaper Universal, HyFlex and BioRaCe. Instruments were analyzed before and after preparation of canals of different curvature, using SEM (150-2000 ×). Results Corrosion of the working part was observed in 5.5% of new Ni-Ti instruments of the K3 system (apical and middle segment), in 5.5% of Mtwo instruments (apical third), and in 11.1% of ProTaper Universal systems (apical and middle third). Corrosion was not observed on the new instruments of the HyFlex and BioRaCe kits. After instrumentation, disinfection, and sterilization, corrosion was observed in all sets of K3 and ProTaper Universal systems and in all HyFlex instruments of the first group. Corrosion was observed in the HyFlex system in the second group in 16.7% of instruments (apical and middle third) and in the third 83.3% in the apical and 66.7% in the middle segment. In the Mtwo set, corrosion was observed in 16.7% of instruments in the first (apical and middle third), in the second group in 33.3% of instruments in the apical part and 50% in the middle third, while in the third group, corrosion was observed in 16.7% of instruments in the middle third of instruments. Conclusion Rotary Ni-Ti instruments K3 and ProTaper Universal are susceptible to corrosion in a very high percentage. Ni-Ti systems with post-heat treatment of the working part (HyFlex) are somewhat more resistant to corrosion, while in Ni-Ti systems with electropolished surface (BioRaCe), corrosion is not observed., Uvod/Cilj Cilj istraživanja je bio da se primenom skenirajuće elektronske mikroskopije (SEM) analiziraju površine nekorišćenih i istih setova nikl-titanijmskih (Ni-Ti) rotirajućih instrumenata nakon preparacije kanala, odnosno da se proveri njihova podložnost za pojavu korozije. Metod U istraživanje je uključeno pet različitih setova mašinskih endodontskih Ni-Ti instrumenata: K3, Mtwo, ProTaper Universal, HyFlex i BioRaCe. Instrumenti su analizirani pre upotrebe i nakon preparacije kanala različite povijenosti, pomoću SEM-a (150-2000 ×). Svaki set instrumenata je korišćen za obradu 10 kanala u tri eksperimentalne grupe (pravi, blago i izrazito povijeni kanali). Rezultati Korozija radnog dela uočena je kod 5,5% novih Ni-Ti instrumenata sistema K3 (apikalni i srednji segment), kod 5,5% Mtwo instrumenta (apikalna trećina) i kod 11,1% sistema ProTaper Universal (apikalna i srednja trećina). Korozija nije uočena na novim instrumentima HyFlex i BioRaCe setova. Nakon instrumentacije, dezinfekcije i sterilizacije korozija je primećena kod svih setova sistema K3 i ProTaper Universal i kod svih HyFlex instrumenata prve grupe. Korozija je uočena kod HyFlex sistema u drugoj grupi kod 16,7% instrumenata (apikalna i srednja trećina), a u trećoj grupi kod 83,3% instrumenata u apikalnom i 66,7% u srednjem segmentu. Kod Mtwo seta korozija je uočena kod 16,7% instrumenata u prvoj grupi (apikalna i srednja trećina), u drugoj grupi kod 33,3% instrumenata u apikalnom delu i 50% u srednjoj trećini, dok je u trećoj grupi korozija primećena kod 16,7% instrumenata u srednjoj trećini instrumenata. Zaključak Rotirajući Ni-Ti instrumenti K3 i ProTaper Universal podložni su koroziji u veoma visokom procentu. Ni-Ti sistemi sa naknadnom termičkom obradom radnog dela (HyFlex) nešto su otporniji na koroziju, dok kod Ni-Ti sistema sa elektropoliranom površinom (BioRaCe) korizija nije uočena.
Published: 2022

29. Glide path preparation with hand K-files and rotary PathFiles in simulated curved root canals: An in vitro study

Author: Stošić, Miljan, Stošić, Miljan, Geler, Katarina, Petrović, Violeta, Jovanović-Medojević, Milica, Stošić, Miljan, Stošić, Miljan, Geler, Katarina, Petrović, Violeta, and Jovanović-Medojević, Milica
Abstract: Introduction: Preparation of glide path is an important precondition for the safe use of rotary NiTi instruments during endodontic treatment. Aim: The aim of this study was to examine the duration of glide path preparation as well as all the changes in canal morphology and canal diameter after the use of hand K-files and NiTi rotary PathFiles. Material and methods: This research was performed on a total of twenty Endo Training Blocks (Dentsply, Maillefer, Switzerland). The glide path was prepared using hand stainless steel K-files ISO #10-15-20 (Dentsply, Sirona, USA) (n = 10) and NiTi rotary PathFiles ISO #13, #16 and #19 (Dentsply, Sirona, Switzerland) (n = 10). The time required to establish the glide path was measured with an iPhone stopwatch (Apple Inc. Cupertino, California). The images of the apical segment of canals before and after glide path preparation were taken under the stereomicroscope (Boeco BSZ-405, Germany), and then images were analyzed and processed with Scopeimage 9.0 (Teleskop, Austria). Statistical analysis was performed with the Mann-Whitney test at the level of significance 5% (a = 0.05). Results: A statistically significant difference was observed in terms of the time required for glide path preparation. The mean total time for glide path preparation was significantly longer with K-files (382 ± 62 s) than with PathFile (200 ± 11 s) (p < 0.05). A statistically significant difference in terms of changing the morphology of the apical part of the canal (p > 0.05) was not observed. The difference in the diameter of the root canal was at the limit of statistical significance (p ≈ 0.05). Conclusion: Instrumentation with NiTi rotary PathFiles reduces the time required for glide path preparation. Preparing endodontic space for rotary instrumentation with hand K-Files and rotary PathFiles leads to similar changes in the morphology of the apical segment. A slightly larger diameter of the root canal was measured after preparation with the hand K-files., Uvod: Uspostavljanje instrumentacione putanje je važan preduslov za bezbednu primenu mašinskih NiTi instrumentata tokom oblikovanja kanalskih sistema. Cilj: Cilj ovog rada je bio da se uporedi vreme potrebno za formiranje instrumentacione putanje, kao i promene u morfologiji apikalnog segmenta i prečniku apikalnog otvora kanala posle primene ručnih K-turpija i mašinskih PathFile instrumenata. Materijal i metode: Istraživanje je realizovano na 20 "endo trening" modela (Dentsply Maillefer, Switzerland). Instrumentaciona putanja je uspostavljena primenom ručnih K-turpija od nerđajućeg čelika (#10-15-20) (Dentsply, Sirona, Switzerland) (n = 10), odnosno mašinskih PathFile NiTi instrumenata (Dentsply, Sirona, Switzerland) (n = 10). Vreme potrebno za uspostavljanje instrumentacione putanje mereno je iPhone stopwatch (Apple Inc. Cupertino, California). Slike apikalnog segmenta kanala, pre i posle formiranja instrumentacione putanje, snimane su stereomikroskopom (Boeco BSZ-405, Germany), a zatim obrađene i analizirane u softverskom programu Scopeimage 9.0. Dobijeni podaci statistički su obrađeni Man-Vitnijevim (Mann-Whitney) testom (a = 0,05). Rezultati: Uočena je statistički značajna razlika u pogledu vremena potrebnog za uspostavljanje instrumentacione putanje između ručnih K-turpija (6 min. 22 s) i mašinskih PathFile instrumenata (3 min. 20 s) (p < 0,05). U pogledu morfologije apikalnog segmenta nisu uočene značajne razlike (p > 0,05). Razlike u prečniku apikalnog otvora bile su na granici statističke značajnosti (p ≈ 0,05). Zaključak: Primena mašinskih PathFile instrumenata rezultirala je bržim formiranjem instrumentacione putanje u poređenju sa ručnim K-turpijama. Obe ispitivane grupe instrumenata dovele su do sličnih promena u morfologiji apikalnog segmenta kanala. Nešto veći prečnik apikalnog otvora kanala izmeren je posle primene ručnih K-turpija.
Published: 2023

30. Nickel-titanium files in endodontics: Development, improvement and modifications of nickel-titanium alloy

Author: Živković, Slavoljub, Živković, Slavoljub, Jovanović-Medojević, Milica, Nešković, Jelena, Popović-Bajić, Marijana, Živković, Slavoljub, Živković, Slavoljub, Jovanović-Medojević, Milica, Nešković, Jelena, and Popović-Bajić, Marijana
Published: 2023

31. Oral microbiome, COVID-19 and probiotics

Author: Nikolić-Jakoba, Nataša, Nikolić-Jakoba, Nataša, Manojlović, Dragica, Jovanović-Medojević, Milica, Nikolić-Jakoba, Nataša, Nikolić-Jakoba, Nataša, Manojlović, Dragica, and Jovanović-Medojević, Milica
Published: 2023

32. Evaluation of surface characteristics of new rotary nickel-titanium instruments - SEM-EDS analysis

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Zdravković, Alena, Medojević, Mina, Stratimirović, Đorđe, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Zdravković, Alena, Medojević, Mina, and Stratimirović, Đorđe
Abstract: Introduction. Modern endodontic procedure implies the use of rotary Ni-Ti instruments during chemomechanical treatment of root canals. The aim of this study is to analyze the surfaces of new (unused) rotary endodontic instruments using the SEM-EDS method and determine how frequently manufacture defects or impurities appear on their working surfaces. Material and method. Five new different sets of rotary endodontic Ni-Ti instruments were included in this study: K3, Mtwo, ProTaper Universal, HyFlex and BioRaCe. The working part of endodontic instrument was analyzed using SEMEDS method (magnifications ×150 to ×2000), which determined the morphological characteristics of the instrument surface and chemical composition of the found impurities. Statistical analysis was performed using the Fisher’s test (p < 0.05). Results. The results of SEM-EDS analysis showed that there is no new instrument without defects on its surface. The most common defects were observed in K3 (27.43%) and ProTaper Universal group (27.21%) and the least were in BioRaCe instruments (7.67%). The most common type of defect in tested instruments was fretting. In addition, the presence of debris and metal strips was found on all instruments, while corrosion of the working part was observed only in K3, ProTaper Universal and Mtwo systems in a small percentage. Conclusion. Based on the results of this research, it can be concluded that manufacturing defects were noticed in all examined instruments. The most common defect is pitting. Impurities such as debris and metal strips have also been registered. No organic debris was observed on electropolished surface of BioRaCe instruments, but a small percentage of other types of defects were registered., Uvod Moderna endodontska procedura podrazumeva upotrebu mašinskih rotirajućih Ni-Ti instrumenata tokom hemomehaničke obrade kanala korena. Cilj ovog rada je bio da se primenom SEM-EDS metode analiziraju površine novih (neupotrebljenih) rotirajućih endodontskih instrumenata i utvrdi učestalost pojave proizvodnih defekata ili nečistoća na njihovim radnim površinama. Materijal i metoda U istraživanje je uključeno pet različitih novih setova mašinskih endodontskih Ni-Ti instrumenata: K3, Mtwo, ProTaper Universal, HyFlex i BioRaCe. Radni deo svakog instrumenta je podvrgnut SEM-EDS analizi (uvećanja ×150 do ×2000), čime su utvrđene morfološke karakteristike površine instrumenata i hemijski sastav zatečenih nečistoća. Statistička analiza je urađena primenom Fišer testa (p < 0,05). Rezultati Rezultati SEM-EDS analize su pokazali da ne postoji nijedan novi instrument bez defekta na svojoj površini. Najučestaliji defekti su uočeni kod K3 (27,43%) i ProTaper Universal grupe (27,21%), a najmanje ih je bilo na BioRaCe instrumentima (7,67%). Najzastupljeniji tip defekata kod testiranih instrumenata je bilo prisustvo žljebova. Osim toga, utvrđeno je i prisustvo debrisa i metalnih opiljaka na svim instrumentima, dok je korozija radnog dela primećena samo kod K3, ProTaper Universal i Mtwo sistema u malom procentu. Zaključak Na osnovu rezultata ovog istraživanja može se zaključiti da su na svim ispitivanim instrumentima uočeni proizvodni defekti, od kojih su najzastupljeniji žljebovi. Takođe su registrovane i nečistoće kao što su debrisa i metalni opiljci. Na elektropoliranoj površini BioRaCe instrumenata nije uočeno prisustvo organskog debrisa, ali je registrovan Mali procenat ostalih tipova defekata.
Published: 2021

33. A single-file endodontic treatment: A promising endodontic concept

Author: Živković, Slavoljub, Živković, Slavoljub, Popović-Bajić, Marijana, Jovanović-Medojević, Milica, Nešković, Jelena, Živković, Slavoljub, Živković, Slavoljub, Popović-Bajić, Marijana, Jovanović-Medojević, Milica, and Nešković, Jelena
Published: 2022

34. Sem analysis of working surface in new manual endodontic instruments

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Pelemiš, Martina, Nešković, Jelena, Popović-Bajić, Marijana, Stratimirović, Đorđe, Živković, Slavoljub, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Pelemiš, Martina, Nešković, Jelena, Popović-Bajić, Marijana, Stratimirović, Đorđe, and Živković, Slavoljub
Abstract: Introduction. The aim of this study was to analyze working surfaces of new hand endodontic instruments and to check possible existence of dirt or defects on working surface that resulted from manufacturing process using SEM. Material and methods. Three sets of new hand instruments: K-File (KF), (18 instruments) (Dentsply Maillefer, Switzerland) and Hedstorm Files (HF), (18 instruments) (SybronEndo Co, USA) were used. Instruments were analyzed by SEM method at 170× magnification while semi-quantitative EDS analysis was used to determine chemical composition of dirt particles. Fisher test (p < 0.05) was applied in statistical analysis. Results. Results showed that none of the instruments was defect-free. The most common defects were metal strips and fretting noticed at the surface of all tested instruments. Debris was present on all KF (100% in apical and middle third) and HF (56% in apical and 56% in middle third) instruments. Pitting was noticed in KF (33% in apical and 39% in middle third) and HF (11% in apical and 6% in middle third) instruments. Corrosion of working surface, metal flash and disruption of cutting edge were marked only in KF group. Conclusion. Manufacturing defects were noticed in all instruments and the most common type of irregularity were metal strips and fretting., Uvod Cilj ovog rada je bio da se primenom skenirajuće elektronske mikroskopije analiziraju površine novih ručnih endodontskih instrumenata i proveri eventualno postojanje proizvodnih nečistoća ili defekata na radnom delu. Materijal i metod U istraživanju su korišćena po tri seta novih ručnih instrumenata: K-File (KF), (18 instrumenata) (Dentsply Maillefer, Switzerland) i Hedstorm Files (HF), (18 instrumenata) (SybronEndo Co, USA). Instrumenti su podvrgnuti SEM analizi sa uvećanjem 170×, a semikvantitativnom EDXS analizom utvrđivan je hemijski sastav nečistoće. Statistička analiza je urađena primenom Fišerovog testa (p < 0,05). Rezultati Rezultati su pokazali da ne postoji nijedan instrument bez defekta. Najučestaliji tip defekta je bilo prisustvo metalnih opiljaka i žlebova, koji su uočeni na površini svih ispitivanih instrumenata. Debri je uočen na svim KF (100% apikalno i u srednjoj trećini) i HF (56% apikalno i 56% u srednjoj trećini). Prisustvo udubljenja zabeleženo je kod KF (33% apikalno i 39% u srednjoj trećini) i HF (11% apikalno i 6% u srednjoj trećini). Korozija radne površine, pojava uglačane površine i prekid sečivne ivice su uočeni samo u grupi KF. Zaključak Na svim ispitivanim ručnim instrumentima su uočeni proizvodni defekti, a najučestaliji tip nepravilnosti je bilo prisustvo metalnih opiljaka i žlebova.
Published: 2020

35. Analysis of working surface in new manual and rotary endodontic instruments (scanning electron microscopy)

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Pelemiš, Martina, Nešković, Jelena, Popović-Bajić, Marijana, Stratimirović, Đorđe, Živković, Slavoljub, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Pelemiš, Martina, Nešković, Jelena, Popović-Bajić, Marijana, Stratimirović, Đorđe, and Živković, Slavoljub
Abstract: Introduction/Objective. The objective of this study is to use scanning electron microscopy (SEM) to analyze working surfaces of new manual and rotary endodontic instruments and to check possible existence of manufacture dirt particles or defects on the working surface. Methods. In this study, we used three sets of new manual instruments: K-File, KF (Dentsply Maillefer, Switzerland) and Hedstorm Files, HF (SybronEndo Co, USA) and three sets of mechanical Ni-Ti instruments – type K3 (SybronEndo Co, USA) and BioRaCe (FKG DENTAIRE Swiss Dental Products, Switzerland). The instruments were analyzed using SEM method at 170 × magnification while semi-quantitative energy dispersive x-ray analysis was used to determine chemical composition of dirt particles. Fisher test (p < 0.05) was applied in statistical analysis. Results. Results showed that none of the instruments were defect-free. The most common defect type was the presence of metal strips, which were noticed at the surface of all tested instruments. Debris was present on all manual and only one type of mechanical instruments, K3 (39% in the apical and 33% in the middle third). Fretting was noticed in all manual KF and all mechanical instruments of the K3 group. Pitting was common in all manual instruments, KF (33% in the apical and 39% in the middle third) and HF (11% in the apical and 6% in the middle third). Corrosion of the working surface, metal flash, and disruption of the cutting edge were marked only in the KF group. Conclusion. Manufacture defects were noticed in all instruments and the most common type of irregularity were metal strips. Electropolished surface of BioRaCe instruments showed no debris of organic origin., Uvod/Cilj Cilj ovog rada je bio da se primenom skenirajuće elektronske mikroskopije (SEM) analiziraju površine novih ručnih i mašinskih endodontskih instrumenata i proveri eventualno postojanje proizvodnih nečistoća ili defekata na radnom delu. Metode U istraživanju su korišćena po tri seta novih ručnih instrumenata: K-File, KF (Dentsply Maillefer, Švajcarska) i Hedstorm Files, HF (SybronEndo Co, SAD) i po tri seta mašinskih Ni-Ti instrumenata, tipa K3 (SybronEndo Co) i BioRaCe (FKG DENTAIRE Swiss Dental Products, Švajcarska). Instrumenti su podvrgnuti SEM analizi sa uvećanjem 170×, a semikvantitativnom, EDXS analizom utvrđivan je hemijski sastav nečistoće. Statistička analiza je urađena primenom Fišerovog testa (p < 0,05). Rezultati Rezultati su pokazali da ne postoji nijedan instrument bez defekta. Najučestaliji tip defekta je bilo prisustvo metalnih opiljaka, koji su uočeni na površini svih ispitivanih instrumenata. Debri je uočen na svim ručnim i samo na jednom tipu mašinskih instrumenata, K3 (39% na apikalnoj i 33% na srednjoj trećini). Žlebovi su uočeni na svim ručnim KF i svim mašinskim instrumentima grupe K3. Prisustvo udubljenja zabeleženo je kod ručnih instrumenata, KF (33% apikalna i 39% srednja trećina) i HF (11% apikalna i 6% srednja trećina). Korozija radne površine, pojava uglačane površine i prekid sečivne ivice su uočeni samo u grupi KF. Zaključak Na svim ispitivanim instrumentima su uočeni proizvodni defekti, a najučestaliji tip nepravilnosti su metalni opiljci. Na elektropoliranoj površini instrumenata BioRaCe nije uočeno prisustvo organskog debrija.
Published: 2020

36. Analiza deformacija i loma rotirajućih nikltitanijumskih instrumenata nakon preparacije kanalskih sistema

Author: Jovanović-Medojević, Milica, Živković, Slavoljub, Grga, Đurica, Matija, Lidija, Šarić, Kristina, and Ilić, Jugoslav
Subjects: Ni-Ti instruments, deformation, fracture, SEM-EDS, OMIS, NiTi instrumenti, deformacije, frakture, SEM-EDS, OMIS
Abstract: Savremena klinička endodoncija je težak i zahtevan mikrohiruški zahvat koji se sastoji se od niza postupaka, počev od formiranja kaviteta i pristupa kanalima pa sve do adekvatne trodimenzionalne opturacije očišćenog endodontskog prostora. Da bi bila uspešna, endodontska terapija mora zadovoljiti biološke i mehaničke ciljeve. Biološki aspekt se sprovodi adekvatnim debridmanom i dezinfekcijom unutrašnjeg endodontskog prostora, dok se mehanički ostvaruje preparacijom kanala u vidu konusa, uz maksimalno čuvanje originalne endodontske morfologije. Tokom poslednjih decenija, mašinska obrada kanala korena uz primenu nikltitanijumskih (NiTi) instrumenata, postala je standardna klinička procedura. Mašinski NiTi instrumenti, različitog dizajna i veličine, omogućili su lakšu i bržu instrumentaciju uklanjajući manju količinu dentina, uz značajno manju kanalnu transportaciju, bolju mogućnost centritanja duž kanala i bolju prilagođenost povijenosti kanala korena, posebno u apikalnoj zoni. Primena NiTi za izradu rotirajućih endodontskih instrumenata iskoristila je superelastična svojstva legure, njenu sposobnost povratka u prvobitni oblik (shape-memory effect), kao i visok stepen otpornosti na koroziju. Upotreba rotirajućih NiTi instrumenata u endodontskoj proceduri znatno olakšava i ubrzava njeno izvođenje, ali sa mogućnošću pojave proceduralnih greški (promena oblika kanala, formiranje stepenika i useka, transportacija, perforacija zida kanala, formiranje peščanog sata i fraktura instrumenta u kanalu). Fraktura NiTi instrumenta je najkompleksnija greška tokom mašinske instrumentacije. Za razliku od instrumenata od nerđajućeg čelika koji se vidno deformišu pre frakture, rotirajući NiTi instrumenti se vrlo često lome bez upozorenja i vidljivih znakova deformacije. Fraktura mašinskih NiTi instrumenata može nastati kao rezultat torzionog naprezanja, cikličnog zamora, ili kombinacijom ova dva faktora. Mogućnost frakture NiTi instrumenata svakako je povećana njihovom primenom u povijenim kanalskim sistemima ali i korišćenjem prekomerne sile tokom instrumentacije. Prisustvo iregularnosti površinske strukture i taloženje različitih naslaga na novim nekorišćenim instrumentima takođe može uticati na deformaciju i lom ovih instrumenata. Mogućnost deformacije ili čak loma instrumenata zavisi od brojnih različitih faktora: vrste materijala od kog su izrađeni instrumenti, anatomskih osobina kanala koji se obrađuju, dinamike i učestalosti primene instrumenata u kanalu, načina pripreme i sterilizacije, dizajna radnog dela instrumenta, kao i primene različitih hemijskih sredstava tokom instrumentacije. Svi ovi faktori su svakako i u bliskoj vezi sa manuelnom spretnošću i stručnošću terapeuta. Zalomljeni instrumenti su definitivno smetnja pri obradi, irigaciji i opturaciji kanala korena i mogu nepovoljno uticati na ishod endodontske terapije. Teškoće pri uklanjanu zalomljenih fragmenata mogu uzrokovati prekomerno uklanjanje dentina korena, što dodatno može oslabiti koren, ili čak dovesti do njegove perforacije. Posledice koje ova komplikacija uzrokuje, najčešći su razlog izbegavanja mašinske instrumentacije u endodontskoj proceduri. Imajući u vidu važnost predviđanja eventualnog loma NiTi rotirajućih turpija postavljen je osnovni CILJ istraživanja analize i provere površinskih i strukturnih promena, odnosno, nanostrukturnih karakteristika novih i NiTi rotirajućih instrumenata upotrebljenih u kanalskim sistemima različite povijenosti... Modern clinical endodontics is a difficult and demanding microsurgical procedure that consists of a series of procedures, ranging from cavity formation and access to the canals to adequate threedimensional obturation of the cleaned endodontic space. To be successful, endodontic therapy must meet biological and mechanical goals. The biological aspect is carried out by adequate debridement and disinfection of the internal endodontic space, while mechanically it is achieved by cone preparation, with maximum preservation of the original endodontic morphology. In past decades, rotary root canal treatment using nickel-titanium (Ni-Ti) instruments has become a standard clinical procedure. Rotary Ni-Ti instruments of different design and size, have made instrumentation easier and faster by removing less dentin, with significantly less canal transportation, better centering along the canal, and better adaptation to root canal curvature, especially in the apical zone. The use of Ni-Ti for the manufacture of rotary endodontic instruments utilizes the super-elastic properties of the alloy (shape-memory effect) as well as a high degree of corrosion resistance. The use of rotary Ni-Ti instruments in the endodontic procedure greatly facilitates and accelerates the performance, but with the possibility of procedural errors (change of canal shape, step and ledge formation, transportation, canal wall perforation, hourglass formation and instrument fracture in the canal). Ni-Ti instrument fracture is the most complex error during rotary instrumentation. Unlike stainless steel instruments that are visibly deformed before fracture, rotating Ni-Ti instruments often break without warning and visible signs of deformation. Fracture of rotary Ni-Ti instruments can result from torsional stress, cyclic fatigue, or a combination of these two factors. The possibility of fracture of Ni-Ti instruments is certainly increased by their application in curved canal systems but also by the use of excessive force during instrumentation. The presence of irregularities in the surface structure and the deposition of different deposits on new unused instruments can also influence the deformation and fracture of these instruments. The possibility of deformation or even fracture of instruments depends on a number of factors: the type of material from which the instruments are made, the anatomical properties of the canals being processed, the dynamics and frequency of application of the instruments in the canal, the method of preparation and sterilization, the design of the working part of the instrument, as well as the application of different chemical agents during instrumentation. All of these factors are certainly closely related to the therapist's manual dexterity and expertise. Broken instruments are a serious impediment to the treatment, irrigation, and obturation of the root canal and may adversely affect the outcome of endodontic therapy. Difficulties in removing broken fragments can cause excessive dentin removal of the root, which can further weaken the root, or even lead to its perforation. The consequences of this complication are the most common reason for avoiding rotary instrumentation in an endodontic procedure...
Published: 2021

37. How to prevent fracture of NiTi files

Author: Živković, Slavoljub, Živković, Slavoljub, Popović-Bajić, Marijana, Jovanović-Medojević, Milica, Nešković, Jelena, Živković, Slavoljub, Živković, Slavoljub, Popović-Bajić, Marijana, Jovanović-Medojević, Milica, and Nešković, Jelena
Abstract: More certain therapeutic and significantly facilitated solution of everyday endodontic problems are provided by the introduction of NiTi rotary files in endodontic practice and their proper application. However, their widespread use has caused more and more frequent fractures and has become a significant frustrating factor that diminishes their numerous benefits. Torsional stress and cyclic fatigue are the main reasons for the occurrence of a fracture, and the frequency of NiTi file fractures is exactly proportional to the degree of bending of the canal, knowledge of the features of the file, ie. the skill and expertise of the therapist. The most dominant factor for the occurrence of fractures is the dentist who, in addition to manual dexterity, must have a good knowledge of the anatomy of various canal systems and file design in order to make the best choice for each individual case. Properly formed access cavity and knowledge of the working part of NiTi files enable maximum realization of endodontic skills, increased efficiency of intervention and reduced possibility of error during canal instrumentation. The special treatment of NiTi alloy and new solutions related to the design of the working part have significantly increased file flexibility and resistance to cyclic fatigue. Specific design (reduced number of threads, change of conicity, interruption of blade continuity), reduced engagement of file, ie. change of dynamics of movement in the canal (full rotation, reciprocal, eccentric, transaxial), as well as reduced number of processing files, have also significantly influenced the reduction of fracture risks. The aim of this paper was to analyze the most common reasons for the fracture of NiTi files and emphasize measures and factors that can increase their safe use and reduce complications during canal instrumentation., Uvođenjem NiTi rotirajućih instrumenata u endodontsku praksu i njihovom pravilnom primenom obezbeđena su izvesnija terapijska rešenja i znatno je olakšano rešavanje svakodnevnih endodontskih problema. Međutim, njihova široka primena uzrokovala je sve učestalije frakture i postala značajan frustrirajući faktor koji umanjuje njihove brojne benefite. Torziono naprezanje i ciklični zamor su glavni razlozi za nastanak frakture, a učestalost loma NiTi turpija je upravo srazmerna stepenu povijenosti kanala, poznavanju karakteristika instrumenta, odnosno veštini i stručnosti terapeuta. Najdominantniji faktor za nastanak fraktura je stomatolog, koji osim manuelne spretnosti mora dobro poznavati anatomiju različitih kanalskih sistema i dizajn turpije kako bi napravio najbolji izbor za svaki pojedinačni slučaj. Pravilno formiran pristupni kavitet i poznavanje radnog dela NiTi instrumenata omogućavaju maksimalnu realizaciju endodontske veštine, povećanu efikasnost intervencije i smanjenu mogućnost greške tokom obrade kanala. Poseban tretman NiTi legure i nova rešenja vezana za dizajn radnog dela značajno su povećali fleksibilnost turpije i otpornost na ciklični zamor. Specifičan dizajn (smanjen broj navoja, promena koničnosti, prekid kontinuiteta sečiva) i smanjena angažovanost instrumenta, odnosno promena dinamike kretanja u kanalu (puna rotacija, recipročna, ekcentrična, transaksijalna) i smanjenje broja turpija za obradu, uticali su i na značajno smanjenje rizika od preloma. Cilj ovog rada je bio da ukaže na najčešće razloge za pojavu fraktura NiTi turpija i apostrofira mere i faktore koji mogu povećati sigurnost instrumentacije i smanjiti moguće komplikacije tokom obrade kanala.
Published: 2021

38. The influence of the final irrigation protocol on the efficiency of root canal cleaning

Author: Nešković, Jelena, Nešković, Jelena, Ninković, Neda, Opačić-Galić, Vanja, Jovanović-Medojević, Milica, Popović-Bajić, Marijana, Maksimović, Miloš, Živković, Slavoljub, Nešković, Jelena, Nešković, Jelena, Ninković, Neda, Opačić-Galić, Vanja, Jovanović-Medojević, Milica, Popović-Bajić, Marijana, Maksimović, Miloš, and Živković, Slavoljub
Abstract: Introduction/Objective Irrigation has an important role in root canal cleaning and its efficiency depends on the type of irrigants, the amount, the technique and the irrigation protocol. The aim of this work was to estimate the efficiency of cleaning of the canal walls by using scanning electron microscope analysis after the instrumentation by rotary NiTi instruments with the use of three different irrigation solutions and two final irrigation protocols. Methods Sixty extracted human incisors were divided into two groups after the rotary instrumentation with the iRace instruments. In both groups, the same amount (1.5 ml) of three solutions (2% sodium hypochlorite solution, 2% chlorhexidine solution, and 10% citric acid solution) and total final irrigation time (90 seconds) was the same. The final irrigation in the first group was accomplished using the technique of continuous irrigation and in the second group it was done using the intermittent protocol. The roots were cut longitudinally and analyzed by thirds (coronal, middle, and apical) on a scanning electron microscope (JSM 6460LV, JEOL Ltd., Tokyo, Japan) with 1,000× magnification. Results the most efficient cleaning of the root canal walls in both groups was seen after the use of citric acid with the intermittent protocol of the final irrigation (90.7% clean walls), while the least efficient was the final irrigation by chlorhexidine with continuous irrigation (80.3%). The most efficient cleaning of the canal walls in both groups was observed in the coronal third and the largest amount of the smear layer in the apical third. Conclusion the most efficient cleaning of the canal was achieved by the use of citric acid and the intermittent protocol of the final irrigation. In all tested solutions, the intermittent protocol of irrigation was more efficient than continuous irrigation., Uvod/Cilj Irigacija ima važnu ulogu u čišćenju kanala korena, a njena efikasnost zavisi od vrste irigansa, količine, odnosno tehnike i protokola irigacije. Cilj ovog rada bio je da se analizom SEM proceni efikasnost čišćenja zidova kanala posle instrumentacije rotirajućim NiTi instrumentima uz primenu tri različita rastvora za irigaciju i dva protokola finalne irigacije. Metode Šezdeset ekstrahovanih humanih sekutića je posle mašinske instrumentacije iRaCe instrumentima podeljeno u dve grupe. U obe grupe su korišćena po tri rastvora - 2% rastvor natrijum-hipohlorita, 2% rastvor hlorheksidina i 10% rastvor limunske kiseline, u istoj količini (1,5 ml) i ukupnom vremenu finalne irigacije (90 sekundi). Finalna irigacija u prvoj grupi je realizovana tehnikom kontinuirane, a u drugoj tehnikom intermitentne irigacije. Korenovi su presečeni uzdužno i analizirani po trećinama (krunična, srednja i apikalna) na skenirajućem elektronskom mikroskopu (JSM 6460LV JEOL, Tokio, Japan) na uveličanju od 1000×. Rezultati Najefikasnije čišćenje zidova kanala korena u obe grupe uočeno je posle primene limunske kiseline uz intermitentni protokol finalne irigacije (90,7% čistih zidova), dok je najmanje efikasna bila finalna irigacija hlorheksidinom uz kontinuiranu irigaciju (80,3%). Najefikasnije čišćenje zidova kanala i u prvoj i u drugoj grupi uočeno je u kruničnoj trećini, a najviše razmaznog sloja u apikalnoj trećini. Zaključak Najefikasnije čišćenje kanala ostvareno je primenom limunske kiseline i intermitentnog protokola finalne irigacije. Kod svih testiranih rastvora intermitentni protokol irigacije je bio nešto efikasniji od protokola kontinuirane irigacije.
Published: 2020

39. The efficiency of canal cleaning with reciprocating movements instruments: SEM study

Author: Živković, Slavoljub, Živković, Slavoljub, Nešković, Jelena, Popović-Bajić, Marijana, Jovanović-Medojević, Milica, Živković, Slavoljub, Živković, Slavoljub, Nešković, Jelena, Popović-Bajić, Marijana, and Jovanović-Medojević, Milica
Abstract: Introduction/Objective The application of nickel-titanium (NiTi) instruments in cleaning and shaping of the root canal system is a standard and a precondition for the success of endodontic treatment. The objective of this study was to use scanning electron microscopy (SEM) analysis in order to examine the efficiency of cleaning the apical third of the root canal system using two different NiTi systems with reciprocating movements. Methods The study included 20 single-rooted teeth (premolars) divided into two groups. In group 1, the canal preparation was realized with a single file UNICONE with reciprocating movements (MEDIN, Inc., Nové Město na Moravě, Czech Republic), and in group 2, with a RECIPROC BLUE instrument with reciprocating movements (VDW GmbH, Munich, Germany). The same quantities of 2% NaOCl solution and 17% EDTA solution were used as irrigation solutions. The samples prepared for SEM analysis of the smear layer in the apical third were evaluated on a scale of 1-5 and at a magnification of 1,000×. Results SEM analysis pointed to mostly clean canal walls in the apical segment in both tested groups. Slightly cleaner walls were observed after the application of the UNICONE file (78%) compared to the samples of the second group, where the instrumentation was realized by the RECIPROC BLUE file (76%), but without statistically significant differences. Conclusion Single-file reciprocating systems do not remove the smear layer completely, but provide efficient cleaning of the apical region of the canal., Uvod/Cilj Primena instrumenata od legure nikl-titanijum (NiTi) u čišćenju i oblikovanju kanala je standard i preduslov za uspeh endodontskog tretmana. Cilj ovog rada je bio da se analizom skenirajućim elektronskim mikroskopom (SEM) proveri efikasnost čišćenja apikalne trećine kanala primenom dva različita NiTi sistema sa recipročnim pokretima. Metode U istraživanje je uključeno 20 jednokorenih zuba (pretkutnjaka) podeljenih u dve grupe. Preparacija kanala u prvoj grupi je realizovana jednom turpijom sa recipročnim pokretima UNICONE (MEDIN, Nove Mjesto u Moravskoj, Češka), a u drugoj instrumentom sa recipročnim pokretima RECIPROC BLUE (VDW Gmbh, Minhen, Nemačka). Kao rastvori za irigaciju korišćene su iste količine 2% rastvora NaOCl i 17% rastvor EDTA. Uzorci pripremljeni za analizu SEM razmaznog sloja u apikalnoj trećini su evoluirani prema skali 1-5 i na uveličanju od 1000×. Rezultati Analiza SEM je ukazala na uglavnom čiste zidove kanala u apeksnom segmentu u obe testirane grupe. Nešto čistiji zidovi uočeni su posle primene turpije UNICON (78%) u odnosu na uzorke druge grupe, gde je instrumentacija realizovana turpijom RECIPROC BLUE (76%), ali bez statistički značajnih razlika. Zaključak Recipročni sistemi sa jednom turpijom ne uklanjaju potpuno razmazni sloj, ali obezbeđuju efikasno čišćenje apikalne regije kanala.
Published: 2020

40. Clinical and radiological analysis of the causes for endodontic treatment failure

Author: Nešković Jelena, Jovanović Medojević Milica, and Živković Slavoljub
Subjects: lcsh:RK1-715, stomatognathic diseases, coronal restoration, lcsh:Dentistry, endodontic failure, retreatment, obturation
Abstract: Introduction Development of inflammatory lesions or their persistence after primary treatment is considered endodontic failure. The reason for failure can be complex anatomy of the canal system and numerous iatrogenic factors. The objective of this study was to analyze, clinically and radiographically, the causes of primary endodontic treatment failure and assess possibilities for retreatment of teeth with failed endodontic treatment. Method The study included 79 teeth (36 multirooted and 43 singlerooted tooth) indicated for repeated endodontic treatment. Based on the radiographic assessment of the status of periapical structures, teeth were divided into two groups. The first group included teeth without periapical lesions, i.e. the healthy periodontal tissues (PAI score of 1 and 2) in which retreatment was required for prosthodontic reason due to the poor quality of obturation (28 teeth), and the second group included teeth with visible signs of periapical tissue damage (PAI scores 3, 4 and 5) (51 teeth). In both groups, quality of obturation, coronal sealing and the presence or absence of clinical symptoms was analyzed. Results The most common radiographic finding of definitive obturation was short filling (65.8% of cases); “forgotten” canals (25.3%); non-homogeneous obturation with correct length (5.1%) and fractured instrument (3.8%). There was significant difference between healthy periodontal ligament and adequate restoration (P < 0.001). In 95% of patients with symptoms, changes in the periapical tissue were observed. Also, there was significant difference in the presence of symptoms after primary treatments, between the teeth with healthy apical periodontal tissue and teeth with periapical lesions (P = 0.019). Conclusion The outcome of the root canal treatment is significantly affected by the quality (density) of obturation and the presence and quality of coronal restoration. In patients with symptoms there were changes in the periapical tissue.
Published: 2017

41. Endodontic treatment of lower molar in a patient with paraesthesia of inferior alveolar nerve: A case report

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, and Nešković, Jelena
Abstract: Root canal (endodontic) treatment is demanding and complex procedure. A variety of difficulties can occur in different phases of endodontic procedure. Complex anatomorphological tooth structure, curved canals, close proximity of lower molars and premolars to inferior alveolar nerve make endodontic treatment even more challenging. During endodontic treatment, an inferior alveolar nerve may become traumatized and symptoms may vary from mild neurosensory dysfunction to a complete loss of sensation in the innervation area of damaged nerve. The aim of this paper is to present a clinical case of endodontic treatment of lower second molar with C-shaped root canal in a patient with paraesthesia of inferior alveolar nerve due to endodontic origin., Endodontska terapija kanala korena zuba je težak i kompleksan zahvat, pa su zato česti i problemi u različitim fazama endodontskog postupka. Komplikovana anatomomorfološka struktura zuba, povijenost kanala, blizak odnos donjih molara i premolara i alveolarnog nerva dodatno komplikuje endodontsku proceduru. Tokom realizacije endodontske terapije može doći do traume donjeg alveolarnog nerva, a simptomi oštećenja alveolarnog nerva mogu da variraju od blage neurosenzorne disfunkcije do potpunog gubitka senzacija u predelu inervacionog područja oštećenog nerva. Cilj ovog rada je bio da se na jednom slučaju iz kliničke prakse predstavi endodontski postupak lečenja kanala korena donjeg drugog molara, karakterističnog c-oblika, kod pacijenta sa parestezijom donjeg alveolarnog nerva endodontskog porekla.
Published: 2017

42. Efficiency of XP endo Shaper (XPS) and irrigation protocol on the quality of cleaning the apical third of root canal: SEM study

Author: Živković, Slavoljub, Živković, Slavoljub, Jovanović-Medojević, Milica, Nešković, Jelena, Popović-Bajić, Marijana, Živković-Sandić, Marija, Živković, Slavoljub, Živković, Slavoljub, Jovanović-Medojević, Milica, Nešković, Jelena, Popović-Bajić, Marijana, and Živković-Sandić, Marija
Abstract: Background/Aim: The aim of this study was to evaluate the efficacy of new rotary NiTi instrument XP-endo SHAPER (XPS) used with two irrigation protocols on the root canal cleaning in the apical area. Material and Methods: The research was conducted on 30 single-rooted teeth extracted for orthodontic reasons which were divided into the two groups. Instrumentation of the canals was conducted with XPS instrument and 2% solution of NaOCl was used as irrigant. Instrumentation in the first group was performed using a conventional continuous irrigation, in the second group, protocol of final irrigation was performed intermittently in 3 cycles. The SEM analysis of the apical third of the canal was performed on longitudinal root cross-section standardized photomicrography with a magnification of 2000X. Results: Results showed that a thicker smear layer was observed in the first group and with continuous irrigation protocol (2,10) in relation to the intermittent irrigation protocol in 3 cycles (1,96), but without significant differences. The walls of the root canal in the apical third of the samples of the second group were slightly cleaner (73.3%) in comparison with the teeth of the first group (64, 7%), but also without significant differences. Conclusions: The use of XPS and 2% solution of NaOCl in the root canal enables efficient cleaning of the apical third of tooth. The final irrigation protocol in three cycles improves the efficiency of the smear layer removal in the apical segment of the canal.
Published: 2019

43. Music as an alternative therapy method in dentistry

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, Medojević, Aleksandar, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, and Medojević, Aleksandar
Abstract: Dental fear represents a significant social concern. Therefore, an individual approach to each patient and timely recognition and elimination of dental stress are necessary in order to provide adequate and successful treatment. The aim of this paper was to present possible application of music therapy in dentistry and its role in reducing dental fear. Music has shown great prospective as an alternative therapy method in various fields of medicine. Music therapy is painless and noninvasive anxiolytic method that reduces dental anxiety as it provides relaxation and distraction. Music in dental office creates positive atmosphere among patients and their company as well as dental staff., Strah od stomatološke intervencije je i danas značajan društveni problem, pa su za to neophodni individualni pristup svakom pacijentu i pravovremeno prepoznavanje i eliminacija dentalnog stresa, kako bi se realizovala odgovarajuća i uspešna terapija. Cilj ovog rada je bio da ukaže na mogućnosti primene muziko terapije u stomatologiji i predstavi njene efekte u eliminaciji dentalne anksioznosti. Muzika ima značajan pozitivan potencijal kao alternativna terapijska metoda u raznim poljima medicine. Muziko terapija je bezbolna i neinvazivna anksiolitička metoda koja smanjuje dentalnu uznemirenost svojim opuštajućim ili efektom skretanja pažnje. Muzika u stomatološkoj ordinaciji stvara pozitivnu atmosferu pacijentima, njihovoj pratnji, ali i stručnom osoblju.
Published: 2016

44. Mikrobiloški status kanala korena endodonski neuspešno lečenih zuba

Author: Nešković, Jelena, Jovanović-Medojević, Milica, Grga, Đurica, Popović, Branka, and Živković, Slavoljub
Subjects: stomatognathic diseases, endodontski neuspeh, PCR, stomatognathic system, E. faecalis, endodontic failure
Abstract: Introduction the main objective of endodontic treatment is to eliminate infection from root canal and prevent re-infection by three-dimensional hermetic obturation of the canal system. Endodontic failure can occur due to inability of complete control and elimination of infection from the root canal. The aim of this study is to investigate, by PCR technique, microbiological status of previously endodontically unsuccessfully treated teeth immediately after the removal of obturation material. Material and Methods the analysis included 30 teeth indicated for endodontic retreatment. After removing previous root canal filling material, the bacteriological sample was taken by sterile instrument (# 15) and paper points. Standard PCR technique was used to analyze the incidence of E.faecalis, P.micros, P.intermedia, P. endodontalis and a.actinomycetemcomitans. Results Positive bacteriological findings were registered in 80% of cases, while bacteria were not identified in 20% of all samples (all taken from the root canals without significant changes in periapical tissue). From 24 canals with identified bacteria, 17 had affected apical periodontium. The most dominant microbe in root canals with positive bacteriological finding was E.faecalis (83.3% of the canals) and P.intermedia (75%). In case of teeth with chronic periapical changes, the most common was E. faecalis (94%) and P.intermedia (82.3%). Conclusion the presence of periapical lesions significantly affects microbiological status of endodontically treated teeth. The presence of bacteria was confirmed in most teeth with periapical lesions, while the most frequently identified bacteria were E. faecalis, P.intermedia and P.micros., Uvod Osnovni zadatak endodontskog tretmana je da eliminiše infekciju iz kanala korena I spreči reinfekciju trodimenzionalnom hermetičkom opturacijom kanalskog sistema. Usled nemogućnosti potpune kontrole I eliminacije infekcije iz kanala korena može doći do pojave endodontskog neuspeha. Cilj ovog rada je bio da se neposredno posle uklanjanja materijala za opturaciju kod zuba sa neuspelim endodontskim lečenjem PCR tehnikom proveri mikrobiološki status endodontski lečenih zuba. Metode Mikrobiološka studija je obuhvatila 30 zuba (osam višekorenih I 22 jednokorena) indikovanih za ponovljeni endodontski tretman. Posle dezinfekcije radnog polja I dezopturacije koja je urađena isključivo mehaničkim putem, uzorak je uzet sterilnim kanalnim instrumentom tipa pulpekstirpatora (#15) ili Hoedstrem-turpije (#15) I uz pomoć papirnih poena kojima je sušen kanal. Ependorfice su čuvane na temperaturi od -20˚C do mikrobiološke analize. Putem klasičnog PCR analizirana je zastupljenost bakterija: Enterococcus faecalis, Peptostreptococcus micros, Prevotela intermedia, Porphyromonas endodontalis I Actinobacilus actinomicetemcomitans. Rezultati Pozitivan bakteriološki nalaz registrovan je u 80% slučajeva, dok bakterije nisu identifikovane u 20% uzoraka. Svi negativni uzorci su uzeti iz kanala korena zuba bez značajnih promena u apeksnom periodoncijumu, dok je 17 od 24 kanala sa identifikovanim bakterijama pripadalo zubima sa oštećenim apeksnim parodoncijumom. Najprisutniji mikroorganizam u kanalima sa pozitivnim bakteriološkim nalazom bio je E. faecalis, koji je identifikovan u 83,3% kanala, zatim P. inermedia sa 75% I P. micros sa zastupljenošću od 58,3%. Kod zuba sa hroničnim periapikalnim promenama najzastupljeniji je bio E. faecalis, koji je identifikovan u 94% kanala, zatim P. intermedia, koja je bila prisutna u 82,3% uzoraka. Mikroorganizmi E. faecalis I P. intermedia su registrovani kod svih pacijenata sa nekim od simptoma. Zaključak Prisustvo periapikalnih lezija značajno utiče na mikrobiološki status kanala korena endodontski lečenih zuba. Prisustvo bakterija u kanalima korena potvrđeno je u većini endodontski neuspešno lečenih zuba, a najčećše identifikovane bakterije bile su E. faecalis, zatim P. intermedia, P. micros I P. endodontalis.
Published: 2018

45. Efficiency of XP endo Shaper (XPS) and irrigation protocol on the quality of cleaning the apical third of root canal: SEM study

Author: Živković, Slavoljub, primary, Jovanović-Medojević, Milica, additional, Nešković, Jelena, additional, Popović-Bajić, Marijana, additional, and Živković-Sandić, Marija, additional
Published: 2019
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46. Dental anxiety: Etiology and treatment options

Author: Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, Medojević, Aleksandar, Jovanović-Medojević, Milica, Jovanović-Medojević, Milica, Nešković, Jelena, and Medojević, Aleksandar
Abstract: Dental anxiety might be the cause of serious health problems. Avoiding dental visits can lead to complications with functional, esthetic and sociological consequences. In order to have a simple and efficient dental procedure, it is very important to diagnose dental anxiety and to react adequately. The aim of this paper is using available literature to present most frequent causes, consequences as well as treatment options for dental anxiety. Treating dental anxiety and choosing the right treatment is not always easy, however, it is important for dental practitioners to be able to assess patient's behavior, possible causes of such behavior and select adequate therapy methods. Individual approach is very important as well as timely recognition and gradation of dental anxiety in order to apply adequate and successful dental treatment., Strah od stomatoloških zahvata može biti uzrok težih zdravstvenih problema. Izbegavanje poseta stomatologu neminovno dovodi do komplikacija u lečenju obolelih oralnih tkiva, uzrokujući funkcionalne, estetske i sociološke posledice. Za uspeh stomatološke intervencije i njeno lakše izvođenje veoma su važni pravilno dijagnostikovanje dentalne uznemirenosti i odgovarajuća reakcija stomatologa. Cilj rada je bio da se na osnovu dostupne literature predstave najčešći uzroci, posledice i terapijske mogućnosti u zbrinjavanju ovog vrlo raširenog problema. Tretman dentalnog straha i izbor prave metode nisu uvek laki, pa je zbog toga za stomatologe najznačajnije da razviju veštinu procene ponašanja pacijenta, razloge njihovih problema i traženja odgovarajućih metoda lečenja. Neophodni su individualni pristup svakom pacijentu i pravovremeno prepoznavanje i gradacija dentalnog stresa, kako bi se primenila odgovarajuća i uspešna stomatološka terapija.
Published: 2015

47. Efficiency of root canal cleaning using a single instrument with reciprocating motion systems and full rotation systems: SEM study

Author: Živković, Slavoljub, Živković, Slavoljub, Nešković, Jelena, Jovanović-Medojević, Milica, Popović-Bajić, Marijana, Ostojić, Dejan, Živković, Slavoljub, Živković, Slavoljub, Nešković, Jelena, Jovanović-Medojević, Milica, Popović-Bajić, Marijana, and Ostojić, Dejan
Abstract: Introduction Efficient cleaning and canal design present a basic precondition for successful endodontic treatment. The aim of this study was to evaluate, using SEM analysis, the efficacy of cleaning the apical third of the canal with one instrument in both reciprocating motion and full rotation systems. Materials and methods Thirty (30) single-rooted teeth (upper incisors), extracted due to periodontal problems, were used and selected in 2 groups. In the group 1, instrumentation was done with a single instrument UNICONE with reciprocal movements (MEDIN, Czech Republic), while in the group 2, a single instrument XPS endo SHAPER (XPS) (FKG, Dentaire, Swiss) with full rotation was used. 2% solution of NaOCl and 17% EDTA solution were used as irrigation agents in both groups. SEM analysis of the smear layer in the apical third was done at standard magnification of 1000x and presented on a scale of 1-5. Results showed mostly clean canal walls and no smear layer in the apical region in both tested groups. Canal walls were somewhat cleaner after using UNICONE with reciprocal movements (80%) compared to the canals instrumented with XPS ENDO SHAPER (76%), but this difference was not statistically significant. Conclusion Single-file NiTi systems did not remove smear layer completely, but provided efficient cleaning in the api-cal part of the canal. UNICONE file with reciprocal movements was somewhat more efficient in removing the smear layer compared to the full rotation XPS ENDO SHAPER file., Uvod Efikasno čišćenje I oblikovanje kanala je osnovni preduslov za uspeh endodontskog tretmana. Cilj ovog rada je bio da se SEM analizom proveri efikasnost čišćenja apikalne trećine kanala jednim instrumentom kod sistema sa recipročnim pokretima I sistema sa punom rotacijom. Materijal I metode Korišćeno je 30 jednokorenih zuba (gornji sekutići) ekstrahovanih zbog parodontalnih problema I podeljenih u dve grupe. U prvoj grupi preparacija kanala je realizovana instrumentom sa recipročnim pokretima - UNICONE (MEDIN, Czech Republic), a u drugoj instrumentom sa punom rotacijom - XP-endo Shaper (XPS) (FKG, DENTAIRE, Swiss). Kao sredstvo za irigaciju u obe grupe korišćen je 2% rastvor NaOCl I 17% rastvor EDTA. SEM analiza razmaznog sloja apikalne trećine je urađena na standardnom uvećanju od 1000× I procenjivana prema skali od 1 do 5. Rezultati Istraživanje je ukazalo na uglavnom čiste zidove kanala I bez razmaznog sloja u apikalnoj regiji u obe testirane grupe. Zidovi kanala su bili nešto čistiji posle primene instrumenta sa recipročnim pokretima - UNICONE (80%) u odnosu na kanale druge grupe gde je korišćen instrument sa punom rotacijom - XPS (76%), ali bez statistički značajnih razlika. Zaključak NiTi sistemi sa samo jednom turpijom ne uklanjaju potpuno razmazni sloj, ali obezbeđuju efikasno čišćenje apikalnog dela kanala. Turpija sa recipročnim pokretima UNICONE je bila nešto efikasnija u uklanjanju razmaznog sloja u odnosu na XPS turpiju sa punom rotacijom.
Published: 2018

48. Microbiological status of root canal after unsuccessful endodontic treatment

Author: Nešković, Jelena, Nešković, Jelena, Jovanović-Medojević, Milica, Grga, Đurica, Popović, Branka, Živković, Slavoljub, Nešković, Jelena, Nešković, Jelena, Jovanović-Medojević, Milica, Grga, Đurica, Popović, Branka, and Živković, Slavoljub
Abstract: Introduction the main objective of endodontic treatment is to eliminate infection from root canal and prevent re-infection by three-dimensional hermetic obturation of the canal system. Endodontic failure can occur due to inability of complete control and elimination of infection from the root canal. The aim of this study is to investigate, by PCR technique, microbiological status of previously endodontically unsuccessfully treated teeth immediately after the removal of obturation material. Material and Methods the analysis included 30 teeth indicated for endodontic retreatment. After removing previous root canal filling material, the bacteriological sample was taken by sterile instrument (# 15) and paper points. Standard PCR technique was used to analyze the incidence of E.faecalis, P.micros, P.intermedia, P. endodontalis and a.actinomycetemcomitans. Results Positive bacteriological findings were registered in 80% of cases, while bacteria were not identified in 20% of all samples (all taken from the root canals without significant changes in periapical tissue). From 24 canals with identified bacteria, 17 had affected apical periodontium. The most dominant microbe in root canals with positive bacteriological finding was E.faecalis (83.3% of the canals) and P.intermedia (75%). In case of teeth with chronic periapical changes, the most common was E. faecalis (94%) and P.intermedia (82.3%). Conclusion the presence of periapical lesions significantly affects microbiological status of endodontically treated teeth. The presence of bacteria was confirmed in most teeth with periapical lesions, while the most frequently identified bacteria were E. faecalis, P.intermedia and P.micros., Uvod Osnovni zadatak endodontskog tretmana je da eliminiše infekciju iz kanala korena I spreči reinfekciju trodimenzionalnom hermetičkom opturacijom kanalskog sistema. Usled nemogućnosti potpune kontrole I eliminacije infekcije iz kanala korena može doći do pojave endodontskog neuspeha. Cilj ovog rada je bio da se neposredno posle uklanjanja materijala za opturaciju kod zuba sa neuspelim endodontskim lečenjem PCR tehnikom proveri mikrobiološki status endodontski lečenih zuba. Metode Mikrobiološka studija je obuhvatila 30 zuba (osam višekorenih I 22 jednokorena) indikovanih za ponovljeni endodontski tretman. Posle dezinfekcije radnog polja I dezopturacije koja je urađena isključivo mehaničkim putem, uzorak je uzet sterilnim kanalnim instrumentom tipa pulpekstirpatora (#15) ili Hoedstrem-turpije (#15) I uz pomoć papirnih poena kojima je sušen kanal. Ependorfice su čuvane na temperaturi od -20˚C do mikrobiološke analize. Putem klasičnog PCR analizirana je zastupljenost bakterija: Enterococcus faecalis, Peptostreptococcus micros, Prevotela intermedia, Porphyromonas endodontalis I Actinobacilus actinomicetemcomitans. Rezultati Pozitivan bakteriološki nalaz registrovan je u 80% slučajeva, dok bakterije nisu identifikovane u 20% uzoraka. Svi negativni uzorci su uzeti iz kanala korena zuba bez značajnih promena u apeksnom periodoncijumu, dok je 17 od 24 kanala sa identifikovanim bakterijama pripadalo zubima sa oštećenim apeksnim parodoncijumom. Najprisutniji mikroorganizam u kanalima sa pozitivnim bakteriološkim nalazom bio je E. faecalis, koji je identifikovan u 83,3% kanala, zatim P. inermedia sa 75% I P. micros sa zastupljenošću od 58,3%. Kod zuba sa hroničnim periapikalnim promenama najzastupljeniji je bio E. faecalis, koji je identifikovan u 94% kanala, zatim P. intermedia, koja je bila prisutna u 82,3% uzoraka. Mikroorganizmi E. faecalis I P. intermedia su registrovani kod svih pacijenata sa nekim od simptoma. Zaključak Prisustvo periapikalnih lezija značajno utiče na
Published: 2018

49. Uzroci neuspeha endodontskog lečenja zuba

Author: Nešković, Jelena, Jovanović-Medojević, Milica, and Živković, Slavoljub
Subjects: stomatognathic diseases, endodontski neuspeh, coronal restoration, opturacija, endodontic failure, retreatment, restauracija, obturation
Abstract: Introduction Development of inflammatory lesions or their persistence after primary treatment is considered endodontic failure. The reason for failure can be complex anatomy of the canal system and numerous iatrogenic factors. The objective of this study was to analyze, clinically and radiographically, the causes of primary endodontic treatment failure and assess possibilities for retreatment of teeth with failed endodontic treatment. Method The study included 79 teeth (36 multirooted and 43 singlerooted tooth) indicated for repeated endodontic treatment. Based on the radiographic assessment of the status of periapical structures, teeth were divided into two groups. The first group included teeth without periapical lesions, i.e. the healthy periodontal tissues (PAI score of 1 and 2) in which retreatment was required for prosthodontic reason due to the poor quality of obturation (28 teeth), and the second group included teeth with visible signs of periapical tissue damage (PAI scores 3, 4 and 5) (51 teeth). In both groups, quality of obturation, coronal sealing and the presence or absence of clinical symptoms was analyzed. Results The most common radiographic finding of definitive obturation was short filling (65.8% of cases); “forgotten” canals (25.3%); non-homogeneous obturation with correct length (5.1%) and fractured instrument (3.8%). There was significant difference between healthy periodontal ligament and adequate restoration (P lt 0.001). In 95% of patients with symptoms, changes in the periapical tissue were observed. Also, there was significant difference in the presence of symptoms after primary treatments, between the teeth with healthy apical periodontal tissue and teeth with periapical lesions (P = 0.019). Conclusion The outcome of the root canal treatment is significantly affected by the quality (density) of obturation and the presence and quality of coronal restoration. In patients with symptoms there were changes in the periapical tissue., Uvod Neuspehom endodontskog lečenja smatra se pojava radiografskog nalaza inflamatorne lezije, odnosno njeno perzistiranje ili uvećanje posle preduzete primarne endodontske terapije. Razlog za neuspeh mogu biti kompleksna anatomija kanalnog sistema, ali i brojni jatrogeni faktori. Cilj ovog rada je bio da se kod zuba sa neuspelim endodontskim lečenjem klinički i radiografski analizira uzrok neuspeha primarnog endodontskog tretmana i procene mogućnosti za ponovni endodontski zahvat. Metod rada U ovo istraživanje je uključeno 79 zuba (36 višekorenih i 43 jednokorena zuba) indikovanih za ponovljeni endodontski tretman. Na osnovu radiografske ocene stanja periapikalnih struktura zubi su podeljeni u dve grupe: prvu grupu su činili zubi bez periapikalnih promena, tj. sa zdravim parodoncijumom (PAI skor 1 i 2) kod kojih je retretman bio neophodan iz protetskih razloga – zbog lošeg kvaliteta definitivne opturacije (28 zuba), a drugu zubi sa vidljivim znacima oštećenja apeksnog parodoncijuma (PAI skor 3, 4 i 5) (51 zub). U obe grupe analiziran je kvalitet opturacije, kvalitet kruničnog zaptivanja i prisustvo ili odsustvo kliničkih simptoma. Rezultati Najčešći radiografski nalazi kvaliteta definitivne opturacije kanala bili su: kratko punjenje (65,8% slučajeva), “zaboravljeni” kanali (25,3%), klinički nehomogeno punjenje uz korektnu dužinu definitivnog punjenja (5,1%) i frakturiran instrument (3,8%). Nađe- na je statistički visoko značajna razlika između adekvatne restauracije i zdravog parodoncijuma, odnosno pojave mikrocurenja zbog neadekvatne restauracije i periapikalnih promena (p lt 0,001). Kod 95% pacijenata sa simptomima uočene su promene u apeksnom parodoncijumu. Takođe, nađena je statistički značajna razlika u prisustvu simptoma nakon primarne endodontske terapije između zuba sa zdravim parodoncijumom i zuba sa periapikalnim lezijama (p = 0,019) Zaključak Na ishod endodontskog lečenja značajno utiču kvalitet (hermetičnost) opturacije kanala korena, odnosno prisusutvo i kvalitet koronarne restauracije. Kod pacijenata sa simptomima uglavnom su postojale i promene u apeksnom parodoncijumu nakon endodontskog lečenja.
Published: 2017

50. Muzika kao alternativna terapijska metoda u stomatologiji

Author: Jovanović-Medojević, Milica, Nešković, Jelena, and Medojević, Aleksandar
Subjects: stomatognathic diseases, stomatološka ordinacija, stomatognathic system, dental fear, music therapy, muziko terapija, dental office, dentalni strah, behavioral disciplines and activities, humanities
Abstract: Dental fear represents a significant social concern. Therefore, an individual approach to each patient and timely recognition and elimination of dental stress are necessary in order to provide adequate and successful treatment. The aim of this paper was to present possible application of music therapy in dentistry and its role in reducing dental fear. Music has shown great prospective as an alternative therapy method in various fields of medicine. Music therapy is painless and noninvasive anxiolytic method that reduces dental anxiety as it provides relaxation and distraction. Music in dental office creates positive atmosphere among patients and their company as well as dental staff., Strah od stomatološke intervencije je i danas značajan društveni problem, pa su za to neophodni individualni pristup svakom pacijentu i pravovremeno prepoznavanje i eliminacija dentalnog stresa, kako bi se realizovala odgovarajuća i uspešna terapija. Cilj ovog rada je bio da ukaže na mogućnosti primene muziko terapije u stomatologiji i predstavi njene efekte u eliminaciji dentalne anksioznosti. Muzika ima značajan pozitivan potencijal kao alternativna terapijska metoda u raznim poljima medicine. Muziko terapija je bezbolna i neinvazivna anksiolitička metoda koja smanjuje dentalnu uznemirenost svojim opuštajućim ili efektom skretanja pažnje. Muzika u stomatološkoj ordinaciji stvara pozitivnu atmosferu pacijentima, njihovoj pratnji, ali i stručnom osoblju.
Published: 2016

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