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Introduction/Objective. Low-level laser therapy has been suggested as an alternative pain relief therapy in temporomandibular disorder patients. The aim of this study was to examine the effects of low-level laser therapy on reducing pain intensity in temporomandibular disorder patients, compared to nonsteroidal anti-inflammatory drugs. Methods. A total of 63 patients diagnosed with Research Diagnostic Criteria for Temporomandibular Disorders were divided into two groups. In the first group of 35 patients, low-level laser therapy was applied three times a week, 15 treatment sessions during five weeks (wavelength: 780 nm; power density: 70 mW/ cm2; radiant energy: 4.2 J; energy density: 4.2 J/cm2; total treatment dose: 16.8 J/cm2). The second group included 28 participants subjected to nonsteroidal anti-inflammatory drugs therapy (ibuprofen) during two weeks (first three days 3 ? 400 mg, remaining time 2 ? 400 mg per day). Pain was evaluated using 100 mm visual analog scale, at the baseline, during therapy, two weeks and three months after treatments. Results. Statistically significant reduction of pain intensity was achieved in both low-level laser therapy and in nonsteroidal anti-inflammatory drugs therapy groups and remained steady in the follow-up period of three months (p < 0.01). Differences in visual analog scale scores between the observed groups were not statistically significant in each of the evaluation periods, (p = 0.375, p = 0.665, p = 0.52, respectively). Conclusion. The low-level laser therapy protocol applied in this research was efficient in reducing pain in patients with temporomandibular disorders.

Due to the development of digital technologies, the modern concept of prosthetic-guided implantology is based on non-invasive surgical and restorative techniques. Computer-aided planning, computer-guided workup and computerguided surgery have largely ensured the predictability of the therapeutic outcome. This is supported by research data related to the frequency of implant therapy, according to which in the first half of 2020 there was an increase of 9.7%. However, anatomical limitations remain a challenge for the implant team. The most common problem related to implant therapy in edentulous patients is limited edentulous space in one or more spatial planes. Improving the design of surgical guides facilitates implantation in spatially limited and complex cases. By introducing interactive computed tomography into the field of implantology, a three-dimensional approach to every aspect of planning and implantation has become possible.

Introduction/Objective. Nasolacrimal duct obstruction with consequent epiphora and the development of dacryocystitis (DC) represents a common pathological entity in the clinical practice of ophthalmologists and maxillofacial surgeons. The etiology of DC is multifactorial and still has not been clarified in detail. It is considered that ascending infections from the nasal cavity and paranasal sinuses, injuries and surgical interventions in the middle third of the face, dacryoliths, tumors of the lacrimal sac and surrounding structures may be some of the etiological factors of nasolacrimal duct obstruction. The aim of this study is to present clinical characteristics and surgical treatment of DC. Methods. A retrospective study was carried out. It covered a period of 10 years during which 49 patients with clinically verified DC were treated after surgical examination and complete diagnostics. Out of the total number, 37 patients underwent surgery. Results. The occurrence of predisposing factors was present in 80% of the patients ? rhinitis and the inflammation of paranasal sinuses in 27 patients (72%), injuries and surgical interventions in the middle third of the face in nine patients (24%), whereas lacrimal sac and nasolacrimal duct tumors were noted in three patients (8%). Surgical failure, which was manifested in terms of recurrent DC and epiphora, was noted in six cases (16%). Conclusion. Regarding the possible complications of inadequately administered antibiotic therapy and a broad spectrum of pathological entities which comprise the differential diagnosis, dacryocystorhinostomy with an adequate histopathological analysis and appropriate antibiotic therapy in the acute stage represents a right way for the treatment of DC.

Properly implemented treatment plan implies adaptation to each individual case. The anatomical and morphological limitations of edentulous and partially edentulous jaws present a challenge for the clinician in the context of establishing an adequate implant position, retention and stabilization of dental restoration. On the other hand, highly aesthetic patient requirements play a significant role in achieving overall satisfaction with implant-prosthodontics treatment. From the perspective of the complexity of implant therapy, the first clinical phase of planning requires detailed sublimation of the criteria that define the treatment plan, among which the most important are: degree of regressive bone remodelling, type of prosthodontic restoration, loading time, type of retention, as well as aesthetic criteria. The ideal position of the implant is an important prerequisite for successful tissue integration. The aim of this paper was to present the complexity of the therapeutic plan based on the collected literature through the analysis of factors related to prosthodontic aspect.

In this research work, we synthesised poly(methyl methacrylate) (PMMA) enriched with 2 wt.% zinc oxide nanoparticles (ZnO) through conventional heat polymerisation and characterised its microstructure. It was found that the distribution of ZnO nanoparticles was homogeneous through the volume of the PMMA. The mechanical testing of the PMMA-ZnO composite primarily included the determination of the compressive properties on real dentures, while density measurements were performed using a pycnometer. The testing of functional properties involved the identification of the colour of the new PMMA-ZnO composite, where pure PMMA acted as a control. In the second step, the PMMA-ZnO cytotoxicity assays were measured in vitro, which were shown to be similar to the control PMMA. Based on this, it could be concluded that the newly formed PMMA-ZnO composite did not induce direct or indirect cytotoxic effects in L929 cell cultures, therefore, according to ISO/DIN 10993-5:2009, this composite was categorised as non-cytotoxic.

Introduction/Objective. The pain that originates from musculoskeletal structures of the mastication system is one of the symptoms belonging to the category of temporomandibular disorders or temporomandibular dysfunction (TMD). The objective of the research was to evaluate the effect of therapy with stabilizing occlusal splint in the control of painful symptoms of TMD in comparison with the effect of drug therapy. Methods. Using standard Research Diagnostic Criteria for Temporomandibular Disorders diagnostic protocol proposed by Dworkin and LeResche, a group of 44 patients with painful TMD was included. The patients were divided into three treatment groups by random selection. The first group was treated with stabilization occlusal splint for a period of one month. In the two control groups, therapy with non-steroidal anti-inflammatory drug ibuprofen (Brufen, Mylan, Canonsburg, PA, USA) or a combination therapy of ibuprofen and diazepam, a medication from the benzodiazepine family (Diazepam, Hemofarm, Vrsac, Serbia) was carried out over a period of three weeks. In order to assess the effects of the therapy with stabilizing occlusal splint and the drug therapy, before and after the therapy, pain intensity measurements were performed with visual analogue scale and digital pressure algometer. Results. A significant reduction in the intensity of painful symptoms was achieved in all three therapeutic groups. No significant differences in the effectiveness of pain reduction between the proposed therapeutic modalities were noted. Conclusion. The obtained results confirm that the therapy with stabilization occlusal splint is a valid procedure in the reduction of pain in patients with TMD.

Cancers of the oral tongue (OT) and floor of the mouth (FOM) are frequently grouped together as carcinomas of the tongue and floor of the mouth (OTFOM). The incidence rate of these cancers varies worldwide from 0.1/100,000 persons a year for females in Algeria, Chile and Korea to 7.4/100,000 persons a year for men in New Delhi, India. The aim of this study was to analyze the trends in age-standardized incidence rates of oral tongue cancer in the Belgrade population during the period of past 12 years. The data were obtained from the Serbian Cancer Registry (The Registry). Age-standardized incidence rates were calculated using the direct standardization method to the world standard population and presented as an incidence rate per 100,000 persons a year. Joinpoint regression analysis was used to analyze the trends and annual percentage change (APC). The results of the joinpoint regression analysis showed an increasing trend of OT cancers for both genders, with an APC of 4.1% among men and 1.7 % among women. The incidence rate for FOM cancers increased, with an APC of 4.8% among men and 6.8% among women. Our results showed a continuously increasing incidence rate of oral tongue and floor of the mouth carcinoma in the capital of the Republic of Serbia.

Background/Aim. Many studies investigated association between stress, anxiety or personality traits and sleep bruxism (SB), but results are still contradictory. We aimed to investigate whether there is a relation between clinically diagnosed sleep bruxism and salivary cortisol levels as one of the major stress biomarkers and to examine psychological factors and personality traits specific to sleep bruxism. Methods. A total of 23 sleep bruxism patients and 42 healthy non-sleep bruxism adults participated in this study. Diagnose of sleep-bruxism was assessed by selfreport and clinical examination and also confirmed by bedpartner. Morning saliva was collected from all participants for analyses of the cortisol level. Sleep bruxism patients underwent a psychodiagnostic personality interpretation using the Minnesota Multiphasic Personality Inventory ? MMPI-202 test. Results. Statistically significant difference between levels of morning salivary cortisol in the group of SB patients and the control group was recorded (t = 2.943, p < 0.01). Analysis of the personality profiles indicated that the sleep bruxism patients avoid contact with unpleasant feelings, especially depression, suppress the aggression and censor the expression of anger and rage. Conclusion. This study showed that patients with sleep bruxism have higher levels of salivary cortisol. Personality traits such as depression, hypomania and suppressed aggression were found to be common characteristics in patients with sleep bruxism. Present findings might support the hypothesis that sleep bruxism and psychological states such as stress may be related, but the cross-sectional nature of this study does not allow us to draw conclusions about the causal relationship between stress, personality traits and sleep bruxism.

Wear resistance is one of the most important physical properties of the artificial teeth used in acrylic dentures. The goal of this research was to synthesize a new composite material made of matrix Poly-(methyl methacrylate)-PMMA with different percentages (2 % and 3 % of volume fractions) of zinc-oxide nanoparticles (ZnO NPs) as reinforcing elements, to improve its mechanical properties. The dynamic mechanical behaviour of this composite was studied through the DMA method in comparison to the pure PMMA supported by the characterization of their microstructures. Then the wear resistance was analysed on the samples, which were prepared in the form of teeth. In this context their vertical height loss was measured after 100,000 chewing cycles on a chewing simulator, before and after the artificial thermal ageing. Investigations showed that the PMMA/ZnO NP composites dampened the vibrations better than the pure PMMA, which could be assigned to the homogenous distribution of ZnO NPs in the PMMA matrix. It was found that the mean vertical height loss for the pure PMMA teeth was significantly higher (more than 4 times) compared to composite teeth made with ZnO NPs. Introducing the thermal artificial ageing led to the finding that there was no effect on the height loss by the composite material with 3 % of volume fractions of ZnO NPs. Based on this it was concluded that PMMA/ZnO NPs composites showed improved in-vitro wear resistance compared to acrylic-resin denture teeth, so this new composite material should be preferred when occlusal stability is considered to be of high priority.

SummaryThe term necrotizing fasciitis (NF) was first used by Wilson in 1952, who described this rare, however, progressive infection that primarily affects the fascia and subcutaneous tissues. Necrotizing fasciitis may affect any part of the body; however, it usually appears on the extremities. The most common microorganisms isolated in NF areStaphylococcus aureus, groupA Streptococci, andEscherichia Coli.We are presenting the case of a sixty-seven-year old woman, who was admitted for the perforation of painful edema of the left cheek. Clinical examination of the anterior two-thirds of the left cheek revealed a defect of the full thickness of the skin, 3×4 cm in size. During the patient’s hospitalization she was treated by parenterally administered broad-spectrum antibiotics, necrotomy, fasciotomy of the cheek and the extraction of the remaining roots in the 3rdand 4thquadrant.Necrotic fasciitis is a rare, rapidly progressive infection of soft tissues, which, if untimely diagnosed and treated, may be life-threatening. The prognosis of treatment depends on the early recognition of the disease. It is treated with aggressive surgical debridement followed by antibiotic therapy.

Nasal defects can occur as a result of head and neck trauma, or due to partial or complete ablation or resection of the tumor in the nasal area and surroundings. Smaller defects can be reconstructed surgically while large defects are mainly reconstructed combined surgically and prosthetically. The aim of this paper was to present prosthetic reconstruction of the nasal defect by colored vinyl polysiloxane prosthesis retained with craniofacial basal disc implants. An adequate aesthetics and stability of the prosthesis was achieved during mandible and mimic muscles movements., Defekti nosa mogu nastati kao posledica traume glave i vrata ili usled delimične ili potpune ablacije, odnosno resekcije tumora predela nosa i okoline. Manji defekti nosa se rekonstruišu hirurški, dok se veliki defekti uglavnom rekonstruišu kombinovano, kako hirurški tako i protetski. Cilj ovoga rada bio je da se prikaže protetska rekonstrukcija defekta nosa protezom izrađenom od vinil-polisiloksana u boji sa retencijom preko kraniofacijalnih bazalnih disk-implantata. Ovakvom protetskom nadoknadom postignute su zadovoljavajuća estetika i stabilnost proteze pri pokretima mandibule i mimičnih mišića.

Hypodontia of upper lateral incisors is significant aesthetic problem in young people. Ideal solution to this problem would be an implant placement, but there is a problem of unfinished growth and development. It is therefore necessary to have a temporary solution in order to maintain normal stomatognathic system functions and solve aesthetic problems until the final restoration is placed. The aim of this study was to show the possibility of treating hypodontia of permanent upper lateral incisors by creating adhesive bridge in one visit. A 15-year-old patient was referred to the Department for Prosthodontics, School of Dental Medicine in Belgrade with hypodontia of permanent upper lateral incisors. The patient had braces until 14 years of age after which she was rehabilitated with partial denture that was neither aesthetically nor functionally acceptable solution for her and significantly affected her emotional security. The adhesive bridge was made using GC composite fibers and a set of GC composite materials for the purpose of temporary replacement of missing teeth. This treatment provided good functional and aesthetic results. The space for the placement of two endosseous implants is preserved and a period of adaptation positively influenced the patient’s social development in sensitive adolescent age.

Summary Ameloblastoma, a semi-benign odontogenic tumor, is divided into four subtypes based on the clinical presentation, radiological manifestations and histological characteristics. Radiologically, it manifests itself in the form of uni- or multicystic intrabony expansive lesions, with destruction of the medullary zone of the existing bone, resorption and possible perforation of the buccal and lingual cortex. The patient, a 62-year-old woman, came to the Clinic for Maxillofacial Surgery in Niš with an anamnestically present painless tumefaction in the anterior segment of the mandible present for the past three years. In the course of an intraoral examination in the region of symphysis and parasymphysis of the lower jaw on the left side, an oval-shaped tumor was spotted, 5x3 cm in size; palpation showed that it was hard, painless and motionless. Multislice computed tomography (MSCT) of the oro - and hypopharynx and neck showed an extensive tumor formation of the soft tissue density in the anterior segments of the lower jaw, with the signs of destruction of bone tissue of the buccal and lingual cortex of the lower jaw. The frequency of recurrence depends on the histological type of ameloblastoma and the degree of radicalism of the performed surgical intervention. Ameloblastoma in most cases is definitely diagnosed in the advanced stage of the disease due to the absence of symptoms and very slow tumor progression.

Implant stability is a principal precondition for the success of implant therapy. Extraoral implants (EO) are mainly used for anchoring of maxillofacial epithesis. However, assessment of implant stability is mostly based on principles derived from oral implants. The aim of this study was to investigate clinical stability of EO craniofacial disk implants (single, double, and triple) by resonance frequency analysis at different stages of the bone's healing. Twenty patients with orbital (11), nasal (5), and auricular (4) defects with 50 EO implants placed for epithesis anchorage were included. Implant stability was measured 3 times; after implant placement, at 3 months and at least after 6 months. A significant increase in implant stability values was noted between all of the measurements, except for triple-disk implants between third and sixth months, and screw implants between 0 and third months. Disk implants showed lower implant stability quotient (ISQ) values compared with screw implants. Triple-disk implants showed better stability compared with single and double-disk implants. Based on resonance frequency analysis values, disk implants could be safely loaded when their ISQ values are 38 (single disks), 47 (double disks), and 48 (triple disks). According to resonance frequency analysis, disk implant stability increased over time, which showed good osseointegration and increasing mineralization. Although EO screw implants showed higher ISQ values than disk implants, disk-type implants can be safely loaded even if lower values of stability are measured.

Summary Aesthetic outcome of implant therapy involves the appropriate architecture of peri-implant soft tissue and interdental papilla. The dynamic compression technique of soft tissue is mentioned in contemporary literature as one of the methods for achieving optimal emergence profile. The aim of this case report was to present soft tissue prosthetic modeling with temporary crowns on implants for obtaining an emergence profile of final restoration. A 25-year-old female patient with missing left maxillary central incisor was referred to the Department of Oral Surgery School of Dental Medicine University in Belgrade for dental implant placement. After detailed planning, implant placement of Straumann Bone level implant NC Ø 3, 3×12 mm (Straumann® Bone Level NC), in the position of 21 was performed. Upon completion of osseointegration period, screw retained laboratory temporary crown was fabricated. During the next 3 months emergence profile was scalloped by creating additional pressure on the soft tissue with periodic adding the composite resin material to a temporary crown. The created emergence profile was transferred to the master cast by using customized impression coping, making possible fabrication of the final implant restoration according to the design made with provisional restoration. Soft tissue conditioning using temporary dental restorations on implants presents a non-invasive method with predictable aesthetic result.

SUMMARY Orbital defects after tumor resection (exenteration of orbital content) have been traditionally reconstructed with adhesive-retained craniofacial prostheses, also known as epistheses. The breakthrough in rehabilitation of facial defects with implant-retained prostheses has come with development of modern silicones (vynilpolysiloxane) and bone anchorage called osseointegration. Craniofacial implant technology offers improved reconstructive options to patients. This paper describes therapeutical procedure on a patient who received craniofacial implant-retained orbital prosthesis after orbital exenteration. The patient reported excellent prosthesis handling and stability

In this research, the structure changes along the depth gradient layers of titanium substrate, after etching with NaOH and subsequent thermal treatment at various temperatures between 300 and 800 degrees C, were investigated by XRD, FTIR and AES. Particularly, the changes of Ti substrate after etching with NaOH, subsequent ionic exchange of Na+ with Ca2+ ions and thermal treatment at 700 degrees C were analysed. Due to this approach, it was possible to get insight into the chemical changes and changes of Ti oxidation states and consequent phase analysis, along the depth of the titanium oxide coatings. In addition, Secondary Electron Imaging (SEI) showed very interesting nanotopology of all samples. Particularly interesting topology, consisting of very thin nano-designed walls between mutually interconnected pores, was observed for the sample in which Na+ were replaced with Ca2+ ions. This structure might be suitable for deposition of hydroxyapatite by biomimetic or plasma methods and as an appropriate scaffold for cell adhesion and proliferation. (C) 2014 Elsevier Ltd. All rights reserved.

Background/Aim. Dimensional stability and accuracy of an impression after chemical disinfection by immersion in disinfectants are crucial for the accuracy of final prosthetic restorations. The aim of this study was to assess the deformation of addition and condensation silicone impressions after disinfection in antimicrobial solutions. Methods. A total of 120 impressions were made on the model of the upper arch representing three full metal-ceramic crown preparations. Four impression materials were used: two condensation silicones (Oranwash L - Zhermack and Xantopren L Blue - Heraeus Kulzer) and two addition silicones (Elite H-D + regular body - Zhermack and Flexitime correct flow - Heraeus Kulzer). After removal from the model the impressions were immediately immersed in appropriate disinfectant (glutaraldehyde, benzalkonium chloride - Sterigum and 5.25% NaOCl) for a period of 10 min. The control group consisted of samples that were not treated with disinfectant solution. Consecutive measurements of identical impressions were realized with a Canon G9 (12 megapixels, 2 fps, 6x/24x), and automated with a computer Asus Lamborghini VX-2R Intel C2D 2.4 GHz, by using Remote Capture software package, so that time-depending series of images of the same impression were obtained. Results. The dimensional changes of all the samples were significant both as a function of time and the applied disinfectant. The results show significant differences of the obtained dimensional changes between the group of condensation silicones and the group of addition silicones for the same time, and the same applied disinfectant (p = 0.026, F = 3.95). Conclusion. The greatest dimensional changes of addition and condensation silicone impressions appear in the first hour after their separation from the model., Uvod/Cilj. Dimenzionalna stabilnost i preciznost otiska posle hemijske dezinfekcije potapanjem u dezinficijens predstavljaju osnovu za preciznost definitivnih zubnih nadoknada. Cilj ovog istraživanja bio je da se proceni dimenzionalna stabilnost otisaka izrađenih od adicionih i kondenzacionih silikona posle dezinfekcije u antimikrobnim rastvorima. Metode. Napravljen je uzorak od 120 otisaka, dobijenih otiskivanjem modela gornje vilice sa ispreparisanim zubima za metalokeramičke krune. Od otisnih materijala korišćena su dva kondenzaciona silikona (Oranwash L - Zhermack i Xantopren L Blue - Heraeus Kulzer) i dva adiciona silikona (Elite H-D + regular body - Zhermack i Flexitime correct flow - Heraeus Kulzer). Odmah po odvajanju od modela, otisci su potopljeni u odgovarajući dezinficijens (glutaraldehid, benzalkonijum-hlorid - Sterigum i 5,25% NaOCl) u trajanju od 10 min. Kontrolnu grupu činili su uzorci koji nisu tretirani dezinficijensom. Uzastopna merenja istovetnih otisaka vršena su pomoću fotoaparata Canon G9 (12 megapiksela, 2 fps, 6x/24x), a automatizovana sa računara Asus VX 2R Lamborghini- Intel C2D 2,4 GHz, korišćenjem opcija softverskog paketa Remote Capture tako da su dobijene vremenske serije fotografija istog otiska. Rezultati. Utvrđene su izražene dimenzionalne promene svih uzoraka kako u funkciji vremena tako i u funkciji primenjenog dezinficijensa. Rezultati pokazuju postojanje značajnih razlika dimenzionalnih promena između grupe kondenzacionih silikona i grupe adicionih silikona za isto vreme i isti primenjeni dezinficijens (p = 0,026, F = 3,95). Zaključak. Najveće dimenzionalne promene otisaka uzetih adicionim i kondenzacionim silikonima beleže se u prvom satu po odvajanju sa modela.

The aim of this paper was to analyse the characteristic properties of different commercially available NiTi archwires (diameter 0.014 ''). Characteristic properties were determined by using DSC analysis for identification of phase temperatures and a tensile test for obtaining the mechanical properties, while semi-quantitative EDS analysis was used for their chemical composition. Analysis of phase temperatures showed that nickel- titanium orthodontic archwires, in the austenitic phase, were exhibiting superelastic effect in the oral environment (T=37 degrees C). The uniaxial stress-strain curves showed different values for the beginning and the end of loading due to the stress and transformation range. The investigation of the chemical composition showed an equiatomic NiTi alloy. The aim of the first phase of biocompatibility assessment of Ni-Ti archwires was to investigate the potential cytotoxicity on a model of rat thymocytes, where a direct contact exists between the archwire and the cells. The test was chosen because of the high sensitivity of thymocytes to proapoptotic stimuli and because the test includes the culture of non-adherent, non-proliferating cells, such as thymocytes, which is much more convenient for the evaluation of a material's cytotoxicity in direct contact, compared to the adherent cells such as fibroblasts. The experiment was designed to cultivate the Ni-Ti archwire samples with rat thymocytes, using different surface-over-volume ratios of the archwires in complete medium. The cytotoxic effect was evaluated by measuring the apoptosis. The aim of the second phase of the study was to investigate further the cytotoxic effects of Ni-Ti archwires in the short-term (24h) and long-term (48h) cultures of rat's thymocytes, which are highly sensitive to pro-apoptotic stimuli, where a direct contact exists between archwires and the cells.

Introduction. Facial defects may arise as a result of head and neck trauma or facial tumor ablation. Minor defects can be reconstructed surgically while large defects usually need combined surgical and prosthetic reconstruction. The aim of this study was to present the prosthetic reconstruction of the lateral facial defect using facial colored acrylic prosthesis. Case Report. A male patient with a maxillary defect on the left side and a large lateral facial defect on the same side received an obturator prosthesis as well as a facial colored acrylic prosthesis (facial-orbit) retained by the glasses frame. Satisfied aesthetics was accomplished. However, the stability of the prostheses during mandibular movements could not be achieved which resulted in saliva leakage over the lips. Conclusion. Better functional and aesthetic outcome could be achieved by combined surgical and prosthetic treatment of such large facial defect.

Craniomandibular dysfunction (CMD) is a set of structural and functional disorders of different etiology that affects temporomandibular joint (TMJ) and orofacial muscles. The most common etiologic factors are psychogenic, occlusal, trauma and congenital anomalies of craniofacial structures. About 75% of the examined population have mild symptoms of CMD while 3-4% have more severe symptoms which require medical attention. The main symptoms why people seek for medical attention are: facial pain which increases with chewing and irradiates in surrounding areas and pain in TMJ which irradiates in the ear canal, temporal area or neck. Painful restriction of mandible during mouth opening and eccentric movements is frequent as well as mandible deviation or deflection. Sound effects in TMJ such as popping or clicking during mouth opening are common. Initial and least invasive therapeutic procedure is reversible occlusal therapy using splints. There are two main types of occlusal splints: stabilization and relaxation. First type of splints works on condyle stabilization in orthopedically stable position; it is superoanterior condylar position in articular fossa with position of intercondylar discs between condyle and articular fossa when working cusps of the antagonists are in maximal contact with the splint. Another type of splint causes disocclussion of posterior teeth and eliminates negative effects of occlusal interference in the intercuspal position or during eccentric mandibular movements. During therapy, occlusal splint temporarily changes occlusal relationships as well as relations within TMJ, causing reduction of CMD symptoms. The best therapeutic effect for reduction of CMD symptoms is achieved by combination of physical therapy and medication.

Aim: To report the case of a patient who underwent facial reconstruction with nasal epithesis anchored on basal (disk) implants after ablation of midface squamous cell carcinoma. Methods: Ablative surgery of the midface region and insertion of 3 basal implants into the glabellar area of the frontal bone, the upper part of the right side of the alveolar crest, and the lateral side of the maxillary bone, which forms the left lateral wall of the nose, respectively, was performed. Implants were placed at the time of the primary surgical attempt. Results: After an unloaded osseointegration phase of 3 months, all implants appeared well integrated according to radiologic criteria and clinical stability At the end of the osseointegration process, the final epithesis was delivered. Epithesis was anchored to the bars that were fabricated to provide retention and better stability, whereas the implant on the left side was used individually only to improve stability. At the control examinations after 1, 3, 6, 12, and 18 months, respectively, there were no signs of recurrence of the tumor or any complications related to the implants. Conclusions: Disk implants that were applied to our patient present all excellent alternative, particularly in cases with minimal available bone. resulting in reduced complications in elderly oncologic patients.

The all-ceramic endocrowns are one piece restoration used in the therapy of endodontically treated teeth, usually, with a decreased vertical dimension of the tooth crown. The aim of this paper is to describe two techniques of the making of endocrowns using case studies and to present the advantages and disadvantages of both techniques by way of their comparison. Chair-side production with the Cerec CAD-CAM system and pressing of the ceramic with the Empres II system was used for the production of the endocrowns. Cerec CAD-CAM and Empres II systems yielded equally good results in the production of the endocrowns, in terms of their functionality, retention, aesthetic and duration. The basic difference between them is the length of the endocrown production procedure as the Cerec CAD-CAM system makes it possible to apply the treatment during a single visit using a wide range of materials…., Bezmetalne endokrune su jednokomadne nadoknade koje se koriste u terapiji endodontski lečenih zuba u uslovima smanjene vertikalne dimenzije krunice zuba. Cilj ovog rada je bio da se na slučajevima iz kliničke prakse predstave dve tehnike izrade endokruna i da se poređenjem karakteristika tih sistema ukaže na njihove prednosti i nedostatke. Kod jednog pacijenta, za izradu endokruna korišćena je jednoseansna izrada Cerec CAD-CAM sistemom, a kod drugog presovanje keramike Empres II sistemom. Obe tehnike, i Cerec CAD - CAM i Empress II sistem, pokazale su podjednako dobre rezultate, u smislu funkcionalnosti, retencije, estetike i dugotrajnosti endokruna. Osnovna razlika je u trajanju procedure izrade endokruna jer Cerec CAD - CAM sistem omogućava tretman u samo jednoj poseti pacijenta i koristi širu paletu gradivnih materijala.

CAD/CAM technology (Computer Aided Design / Computer Aided Manufacturing) in the matter of fact helps in design and development of two-dimensional or three-dimensional models and their realization on numerical controlled machines. The key to direct or indirect CAD/CAM dental restorations is the measurement of dental preparation in the mouth or on the plaster die. The aim of this paper is to describe the possibilities and the way of function of different computer aided inspection (CAI) systems as a first part of CAD/CAM systems. Different researchers have presented several approaches of methods for three dimensional (3D) measurement. Today, for chairside dental treatment, only the optical method of measurement has lead to satisfactory results in practice. Laboratory CAD/CAM systems use mechanical and optical technologies for 3D measurement. Optical impression grows as a leader of CAI segment of almost every new CAD/CAM system. The most important properties of 3D scanners are: accuracy, volume and speed of measurement and ergonomy of instrument., CAD/CAM (kompjuterom vođeno dizajniranje / kompjuterom kontrolisana izrada) tehnologija u suštini omogućuje kreiranje dvo dimenzionalnih ili trodime nzionalnih modela i njihovu materijalizaciju putem numerički vođenih maši na.Najvažniji segment izrade zubnih nadoknada pomoću sistema koji koriste CAD/CAM tehnologiju, predstavlja premeravanje preparacije zuba u ustima pacijenta ili na radnom modelu. Cilj rada je da prikaže mogućnosti i način funkcionisanja različitih sistema kompjuterom vođene inspekcije (otiskivanja), kao prvog segmenta svakog CAD/CAM sistema. Brojni istraživači su prezentovali različite pristupe metodi 3D skeniranja preparacije zuba. Kod jednoseansnih (ordinacijskih) metoda izrade zubnih nadoknada jedino su optičke metode skeniranja pružile zadovoljavajuće rezultate, dok laboratorijski sistemi i dalje koriste i mehaničke i optičke metode 3D skeniranja. Najvažnije osobine zbog kojih su optičke metode izrasle u lidera 3D skeniranja su: visoka preciznost, široko polje i brzina skeniranja, kao i ergonomija samog instrumenta.

Introduction: Porcelain to metal fused alloys with Au content are most frequently used in dentistry. Their characteristic is high biocompatibility and well fusion to ceramics. Aim of the study: The aim of this study was to present the procedure of production and technology of developing the new dental alloy with high gold content (Au). Materials and Methods: The dental alloy was melted and cast in a vacuum-induction melting furnace. Casting was followed by subsequent thermo-mechanical treatments (the procedures of profile and polish milling, and thermal treatment) and the cutting strips into regular shapes. Testing of the new Au dental alloy included an examination of alloy’s final condition. The measurement of hardness was carried out according to standard 6507-1:1998, and static tensile testing was performed for determination of the mechanical properties. Microscopic analysis of the dental alloy and the finished metal-ceramic bridge included an observation of the polished surface, and by performing qualitative and quantitative micro-chemical analyses. Results: The mechanical properties and hardness of new dental gold alloy was: Rp0.=630 [N/mm2], Rm =710 [N/mm2], A= 9%, 170 HV and CTE (25-600°C) about 14,55×10-6K-1. Macro-inspection of the finished metalceramic bridge showed that there was no porosity. However, during scanning electron microscopic examination, one of the tested sample shows porosity in one alloy region and in the ceramic layer. Detailed examination of the ceramic layer’s surface showed that there were two types of air or gas bubbles - larger with distinct bubbles (type I) and smaller with clearly porous microstructure (type II). Conclusions: According to the results of this study, it can be concluded that this new dental alloy from Zlatarna Celje satisfied all the required standards regarding mechanical properties and hardness. The application of new dental alloy with high gold content depends on the adequate technology when firing ceramics. It is necessary to obtain accurate oxidation temperature and cooling rates of metal-ceramic restorations because, otherwise, different defects may appear., Uvod: Visoko plemenite legure za metal-keramiku (PFM legure - porcelain fused to metal alloy) su najviše korišćene legure u stomatologiji a odlikuje ih visoka biološka prihvatljivost i dobro vezivanje sa keramikom. Cilj: Cilj ovog rada bio je da prikaže postupak dobijanja i tehnologiju razvoja i izrade nove dentalne legure sa visokim sadržajem zlata (Au). Materijal i metod: Pretapanje komponenti dentalne legure izvedeno je u vakuumskoj peći. Tome je sledila naknadna termo-mehanička obrada odlivka (postupcima profilnog i polirnog valjanja, toplotna obrada) kao i sečenje dobijene trake u propisani oblik. Testiranje nove Au dentalne legure uključivalo je testiranje izlaznog stanja legure. Merenje tvrdoće sprovedeno je po standardu 6507-1:1998, dok je za određivanje mehaničkih karakteristika upotrebljeno statično istezanje. Mikroskopska analiza dentalnih legura i završenog metal-keramičkog mosta uključivala je posmatranje polirane površine i izvođenje kvalitativne i kvantitativne mikro-hemijske analize. Rezultati: Mehaničke karakteristike i tvrdoća nove dentalne legure sa visokim sadržajem zlata iznosi Rp0.=630 [N/mm2], Rm =710 [N/mm2], A= 9%, 170 HV, a CTE (25-600°C) iznosi oko 14,55×10-6K-1. Makroskopski na površini metala i potom sinterovane keramike nije uočena poroznost dok je mikroskopskim pregledom ustanovljeno da je na pojedinim mestima jednog uzorka vidna poroznost metalne konstrukcije mosta kao i keramičke površine u vidu većih mehurića (tip I) i manjih sa izrazito poroznom mikrostrukturom (tip II). Zaključak: Na osnovu dobijenih rezultata može se zaključiti, da nova dentalna legura Zlatarne Celje odgovara propisanim standardima u pogledu mehaničkih karakteristika i tvrdoće. Neophodno je primeniti pravilnu temperaturu oksidacije i režim hlađenja fiksne zubne nadoknade, jer u suprotnom može doći do nastanka različitih defekata.

Occlusal analysis using computerized technology has become a part of modern information technology. The aim of this study was to show the possibilities of T-Scan II computerized occlusal analyzer in prosthetic and restorative postinsertion occlusal problems. The T-Scan II computerized occlusal analysis (Tekscan, Boston, USA) is an integral part of clinical functional analyses in prosthetic and restorative insertions. The T-Scan II computerized system can quickly determine prematurities, high points, regions of excessive force and nonuniform force concentration. It can also calculate disocclusion time accurately. Occlusal foil indicators can determine only the position, number and relative force of occlusal contacts., Analiza okluzije primenom okluzalnih indikatora ili kompjutera predstavlja sastavni deo savremene kliničke funkcijske analize. Cilj ovog rada bio je da se prikaže mogućnost kompjuterskog T-Scan sistema u analizi okluzije. Nova generacija T-Scan sistema (T-Scan II, Tekscan, USA) za kompjutersku analizu okluzije pre i posle okluzalne terapije restaurativnim ispunima ili zubnim nadoknadama omogućuje veoma precizno registrovanje broja kontakata, površinu, vreme njihovog trajanja, odnosno ukupno okluzalno opterećenje i raspored sila u odnosu na aproksimativno područje sumiranja rezultanti okluzalnih sila u završnom interkuspalnom položaju (Ikp) mandibule. Kompjuterska analiza pruža podatke o uravnoteženosti ili neuravnoteženosti okluzije odnosno registruje i intenzitet okluzalnih kontakata kao I distribuciju okluzalnih sila što predstavlja važan podatak za pravilan tok i ishod okluzalne terapije.

Timely und quality restauration of endodontically treated teeth is one of the major conditions for success of endodontic therapy. The aim of this study was to determine the efficiency of individual post cemented in endodontically treated teeth using radiographie parameters. 142 endodontically treated teeth restored with individual posts and permanent prosthetic restaurations were included in the clinical and radiographie research. The results of radiographie analysis reveled correctly made and cemented posts in 64% of the cases, inadequately placed posts in 14,4% and inadequate obturation between the tip of the post and radiographie apex, in 19,9% of the case. As a conclusion, correct course of endodontic treatment, clinicians knowing of anatomomorphological characteristics of root canals, correct gutta-percha removal and clinicians adaptibility to a specific case, are essential for the correct restauration of endodonticaly treated teeth with individual posts., Pravovremena i kvalitetna restauracija endodontski lečenih zuba, jedan je od osnovnih uslova za uspešan ishod lečenja obolelog zuba. Cilj rada je bio da se na osnovu rendgengrafskih parametara u endodontski lečenim zubima i restauriranim stalnim zubnim nadoknadama, analizira efiksnost individualno izrađenih i cementiranih kočića. Klinička i rendgengrafska ispitivanja obuhvatila su 142 zuba pacijenata kod kojih je nakon endodontskog lečenja urađena i cementirana individualna nadogradnja, a potom urađena stalna zubna nadoknada. Dobijeni rezultati rendgengrafske analize ukazali su na korektno urađen i cementiran kočić u 64% slučajeva, neadekvatno postavljen kočić u 14,9% slučajeva, a neadekvatna kanalna obturacija od vrha kanala do apeksa konstatovana je u 19,9% slučajeva. Na osnovu dobijenih rezultata, može se zaključiti daje za korektnu restauraciju endodontski lečenih zuba individualnim kočićima, neophodan pravilan plan tretmana, poznavanje anatomomorfoloških karakteristika kanala korena zuba, pravilno uklanjanje gutaperke iz kanala korena zuba, kao i mogućnost prilagođavanja terapeuta odgovarajućem kliničkom slučaju.

Introduction Patients with craniomandibular disorders suffer from hypertonic, fatigued and painful masticatory muscles. This condition can lead to limitation of mandibular jaw movements. All of these symptoms and signs are included in myofascial pain dysfunction syndrome. Transcutaneous electrical nerve stimulation (TENS) has been used for treatment of these patients. Objective The aim of this study was to assess the effect of TENS therapy on chronic pain reduction in patients with the muscular dysfunction symptom. Methods In order to evaluate the effect of TENS therapy before and after the treatment, Craniomandibular Index (Helkimo) was used. Pain intensity was measured by VAS. Patients had TENS treatment over two-week period. BURST TENS modality was used. Current intensity was individually adjusted. Results Two patients did not respond to TENS therapy. Complete pain reduction was recorded in 8 patients, while pain reduction was not significantly different after TENS therapy in 10 patients. Conclusion TENS therapy was confirmed as therapeutic procedure in orofacial muscle relaxation and pain reduction., Uvod Hiperaktivnost mastikatorne muskulature, pojačan tonus mišića, zamor i bol, uz smanjenje opsega funkcijskih kretnji donje vilice, jesu znaci i simptomi miofascijalnog bolnog disfunkcijskog sindroma. Različiti terapijski modaliteti koriste se u lečenju, među kojima je i terapija transkutanom električnom nervnom stimulacijom (TENS). Cilj rada Cilj rada bila je klinička potvrda efekta terapije TENS na intenzitet hroničnog bola kod osoba sa simptomima disfunkcije mišića. Metode rada Radi procene terapije TENS korišćen je Helkimov kraniomandibularni indeks. Za kvantifikaciju intenziteta bola pre i posle lečenja primenjena je vizuelno-analogna skala (VAS). Pacijenti su podvrgnuti terapiji tri puta nedeljno u trajanju od 40 minuta tokom dve nedelje. Primenjen je modalitet burst (kratki impulsi dužine 10 ms i frekvencije 2-3 Hz) uz individualno podešavanje intenziteta strujnog impulsa. Rezultati Nisu primećeni negativni sporedni efekti terapije TENS. Potpuno smanjenje intenziteta bola zabeleženo je kod osam ispitanika. Kod 10 ispitanika smanjenje bola nije bilo značajno. Dva pacijenta nisu reagovala na primenjenu terapiju. Zaključak Terapija TENS se preporučuje osobama s manjim stepenom kraniomandibularnih disfunkcija bez obzira na intenzitet bola.

Introduction. Mandible reconstruction is still very challenging for surgeons. Mandible defects could be the consequence of ablative surgery for malignancies, huge jaw cysts, infection and trauma. Segmental resection of the mandible may compromise orofacial function and often lead to patients psychological disorders. Despite very frequent use of microvascular flaps, autogenous bone grafts are still very reliable technique for mandible reconstruction. Comprehensive therapy means not only mandible reconstruction, but prosthodontic rehabilitation supported by dental implants, which can significantly improve patients quality of life. The aim of this paper was to evaluate possible techniques of mandible reconstruction and to present a patient who had been submitted to mandible resection and reconstruction with autogenous iliac bone graft and prosthodontic rehabilitation with fixed denture anchoraged by disc-shaped implants in early loading protocol. Case report. Mandible reconstruction was performed simultaneously with resection. Autogenous iliac bone graft was taken, reshaped and placed in two parts, to the required optimal contour of the mandible. After graft consolidation, decision was made for prosthodontics rehabilitation with fixed dentures supported by implants. In addition to the standard preoperative procedures, planning was done based on a biomodel gained by rapid prototyping after CT scan. It offered a real 3D planning to obtain a proper shape, dimension and the position of implants. Conclusion. If bone dimensions of a reconstructed mandible are insufficient, like in the presented case, the use of basal osseointegrated implants may be a method of choice. Avoiding bone augmentation procedures, as well as early loading protocol for this type of implants, shorten the total rehabilitation time, which is very convenient for patients. Fixed denture supported by dental implants is the best solution for comprehensive rehabilitation after mandible resection., Uvod. Rekonstrukcija mandibule još uvek predstavlja izazov za hirurga. Defekti mandibule mogu biti posledica radikalnog hirurškog tretmana malignih tumora, velikih vili- čnih cista, infekcija i povreda. Nedostatak dela vilične kosti kompromituje sve orofacijalne funkcije, a česti su i psihološki poremećaji. Pored sve učestalije primene mikrovaskularnih režnjeva, slobodni koštani graftovi su još uvek veoma pouzdan metod rekonstrukcije mandibule. Sveobuhvatna terapija pored rekonstrukcije mandibule podrazumeva i implantološko-protetičku rehabilitaciju, kojom se znatno poboljšava kvalitet života bolesnika. Cilj ovog rada bio je da se kroz pregled literature ocene metode rekonstrukcije mandibule i da se prikaže bolesnica kod koje je nakon segmentalne resekcije mandibule izvršena rehabilitacija fiksnom zubnom nadokanadom nošenom implantatima oblika diska. Prikaz bolesnika. U istom aktu sa resekcijom izvršena je i rekonstrukcija slobodnim koštanim ilijačnim graftom, koji je preoblikovan i postavljen iz dva dela, kako bi se uspostavio optimalan kontinuitet i forma mandibule. Po konsolidaciji grafta, postavljena je indikacija za izradu fiksne zubne nadoknade nošene implantatima. Pored standardnih preoperativnih procedura, izvršeno je realno trodimenzionalno planiranje na biomodelu dobijenim softverskom analizom CT podataka. Na taj način određen je oblik, veličina i najpovoljniji položaj implantata. Zaključak. Ukoliko su koštane dimenzije rekonstruisane mandibule nedovoljne, kao kod prikazane bolesnice, primena bazalnih oseointegrišućih implantata oblika diska može biti metoda izbora. Njihovom upotrebom izbegava se dodatna nadoknada kosti što uz rano opterećenje predstavlja pogodnost za bolesnike, jer se znatno skraćuje vreme rehabilitacije. Izrada fiksne zubne nadoknade nošene implantatima je najbolji način definitivne rehabilitacije bolesnika sa rekonstruisanom mandibulom.

Background/Aim. Color matching in prosthodontic therapy is a very important task because it influences the esthetic value of dental restorations. Visual shade matching represents the most frequently applied method in clinical practice. Instrumental measurements provide objective and quantified data in color assessment of natural teeth and restorations. In instrumental shade analysis, the goal is to achieve the smallest ΔE value possible, indicating the most accurate shade match. The aim of this study was to evaluate the reliability of commercially available ceramic shade guides. Methods. VITA Easyshade spectrophotometer (VITA, Germany) was used for instrumental color determination. Utilizing this device, color samples of ten VITA Classical and ten VITA 3D - Master shade guides were analyzed. Each color sample from all shade guides was measured three times and the basic parameters of color quality were examined: ΔL, ΔC, ΔH, ΔE, ΔElc. Based on these parameters spectrophotometer marks the shade matching as good, fair or adjust. Results. After performing 1,248 measurements of ceramic color samples, frequency of evaluations adjust, fair and good were statistically significantly different between VITA Classical and VITA 3D Master shade guides (p = 0.002). There were 27.1% cases scored as adjust, 66.3% as fair and 6.7% as good. In VITA 3D - Master shade guides 30.9% cases were evaluated as adjust, 66.4% as fair and 2.7% cases as good. Conclusion. Color samples from different shade guides, produced by the same manufacturer, show variability in basic color parameters, which once again proves the lack of precision and nonuniformity of the conventional method., Uvod/Cilj. Određivanje boje zuba u protetskoj terapiji predstavlja veoma važan zadatak jer utiče na prirodan izgled i estetsku vrednost zubnih nadoknada. Vizuelni metod određivanja boje zuba najčešće se koristi u kliničkoj praksi. Instrumentalna merenja pružaju objektivne i kvantifikovane podatke u proceni boje prirodnih zuba i restauracija. U instrumentalnoj analizi boje cilj je da se postigne najmanja moguća vrednost ΔE, što predstavlja najtačniji izbor nijanse. Cilj ovog istraživanja bio je da se utvrdi pouzdanost najčešće korišćenih ključeva za određivanje boje zuba. Metode. Za instrumentalni izbor boje korišćen je VITA Easyshade spektrofotometar (VITA, Germany). Uz pomoć ovog uređaja, analizirani su uzorci boja 10 VITA Classical i 10 VITA 3D - Master ključeva boja. Svaki uzorak boje analiziran je tri puta i ispitivani su osnovni parametri kvaliteta boje: ΔL, ΔC, ΔH, ΔE, ΔElc. Stepen poklapanje boje nadoknade sa ciljnom nijansom spektrofotometar izražava kroz tri ocene kvaliteta: good, fair i adjust. Rezultati. Nakon izvršenih 1 248 merenja keramičkih uzoraka boje, frekvencije ocena adjust, fair i good statistički su se značajno razlikovale između VITA Classical i VITA 3D - Master ključeva boja (p = 0.002). U VITA Classical ključu boja bilo je 27,1% ocene adjust, 66,3% fair i 6,7% ocene good. U VITA 3D - Master ključu boja bilo je 30,9% ocene adjust, 66,4% fair i 2,7% ocene good. Zaključak. Uzorci boje iz različitih ključeva boja proizvedenih od istog proizvođača, pokazuju varijabilnost u osnovnim parametrima boje, što ukazuje na nepreciznost i neuniformnost konvencionalne metode.

Background/Aim. Immediate loading is considered to be the most innovative technique in contemporary implant dentistry. Recent clinical and experimental findings have demonstrated that only implants with high primary stability can be subjected to immediate loading protocol with predictable results. It is generally accepted that the most important prerequsite for successful osseointegration is achievement and maintenance of implant stability. The aim of this in vivo study was to investigate the possibility for successful application of immediate loading protocol in implant systems with different surface properties. Methods. In the experimental study 2 mongrel dogs were edentulated bilaterally in the mandibular and maxillary premolar areas. After 3 months implants were placed in a pattern 4 different commercially available implants per quadrant (n = 32): Mk III TiUnite (Nobel Biocare, Sweden), ITI TPS (Straumann, Switzerland), 3IOsseotite (Implant Innovation, USA) and XiVE Cell-Plus (Friadent, Germany). Implants were subjected to immediate loading with 4 unit gold cast bridges, 2 days post implantation. The assessment of implant stability and immediate loading possibilities were done by performing Resonance frequency analysis (RFA). Results. After a 6- month loading period all bridges were in function and all implants occurred well osseointegrated. When summarizing the Implant Stability Quotient (ISQ) values, it was noted that resonance frequency was significantly higher for mandibular implants. The results of this experimental setting showed that all evaluated surfaces achieved good implant stability. Increase of ISQ values was found for all implants in the mandible and partially decrease of ISQ values for maxillary implants after 6 months of functional loading with 4 unit bridges. Conclusions. Investigated endooseal implants did not show different degree of osseointegration, because there was not statistically significant difference among observed parameters (ISQh i ISQp) between implant systems., Uvod/Cilj. Imedijatno opterećenje implantata smatra se jednim od najznačajnijih dostignuća savremene dentalne implantologije. Rezultati novijih kliničkih i eksperimentalnih studija pokazali su da samo implantati visoke primarne stabilnosti mogu biti izloženi protokolu imedijatnog opterećenja zubnom nadoknadom sa predvidivim ishodom. Cilj studije bio je da se ispita mogućnost uspešne primene protokola imedijatnog opterećenja implantata različitog mikrodizajna fiksnim zubnim nadoknadama. Metode. U eksperimentalno istraživanje uključena su dva psa, obezubljena obostrano u premolarnoj regiji gornje i donje vilice. Nakon tri meseca od ekstrakcije zuba, ugrađena su, po predviđenoj šemi, četiri različita implantata po kvadrantu (n = 32): Mk III TiUnite (Nobel Biocare, Sweden), ITI TPS (Straumann, Switzerland), 3I-Osseotite (Implant Innovation, USA) i XiVE Cell-Plus (Friadent, Germany). Implantati su imedijatno opterećeni fiksnim zubnim nadoknadama, četvoročlanim mostovima od plemenite legure zlato-platina, dva dana posle implantacije. Stabilnost implantata i mogućnost imedijatnog opterećenja ocenjivana je na osnovu analize rezonantnih frekvencija (RFA). Rezultati. Šest meseci nakon implantacije i imedijatnog opterećenja fiksnom zubnom nadoknadom, svi mostovi bili su u funkciji i svi implantati uspešno integrisani, ne pokazujući znake mobilnosti. Sumiranjem dobijenih vrednosti koeficijenta stabilnosti implantata (ISQ) ustanovljeno je da su rezonantne frekvencije bile značajno veće kod implantata u donjoj vilici. Rezultati eksperimentalnog istraživanja pokazali su da su sve analizirane površine ostvarile dobru implantatnu stabilnost. Utvrđen je porast ISQ vrednosti kod svih implantata u mandibuli i delimičan pad ISQ vrednosti za implantate u maksili, nakon šest meseci funkcionalnog opterećenja fiksnim zubnim nadoknadama. Zaključak. Ispitivani endoosealni implantati nisu pokazali različit stepen oseointegracije jer se rezultati merenih parametara hirurških (ISQh) i protetkih (ISQp), nisu statistički značajno razlikovali između implantatnih sistema.

Background/Aim. One of the results of many years of Cerec® 3D CAD/CAM system technological development is implementation of one intraoral and two extraoral optical scanning methods which, depending on the current indications, are applied in making fixed restorations. The aim of this study was to determine the degree of precision of optical scanning methods by the use of the Cerec®3D CAD/CAM system in the process of making ceramic inlays. Methods. The study was conducted in three experimental groups of inlays prepared using the procedure of three methods of scanning Cerec ®3D system. Ceramic inlays made by conventional methodology were the control group. The accuracy of optical scanning methods of the Cerec®3D system computer aided designcomputer aided manufacturing (CAD/CAM) was indirectly examined by measuring a marginal gap size between inlays and demarcation preparation by scanning electron microscope (SEM). Results. The results of the study showed a difference in the accuracy of the existing methods of scanning dental CAD/CAM systems. The highest level of accuracy was achieved by the extraoral optical superficial scanning technique. The value of marginal gap size inlays made with the technique of extraoral optical superficial scanning was 32.97 ± 13.17 μ. Techniques of intraoral optical superficial and extraoral point laser scanning showed a lower level of accuracy (40.29 ± 21.46 μ for inlays of intraoral optical superficial scanning and 99.67 ± 37.25 μ for inlays of extraoral point laser scanning). Conclusion. Optical scanning methods in dental CAM/CAM technologies are precise methods of digitizing the spatial models; application of extraoral optical scanning methods provides the hightest precision., Uvod/Cilj. Jedan od rezultata dugogodišnjeg tehnološkog usavršavanja Cerec®3D sistema jeste implementacija jednog intraoralnog i dva ekstraoralna metoda optičkog skeniranja koji se, u zavisnosti od postojeće indikacije, primenjuju u izradi fiksnih nadoknada. Cilj rada bio je da se utvrdi stepen preciznosti optičkih metoda skeniranja Cerec®3D sistema u postupku izrade keramičkih inleja. Metode. Ispitivanje je sprovedeno u okviru tri eksperimentalne grupe inleja u čijoj izradi su primenjena tri postupka skeniranja Cerec®3D sistema. Keramički inleji izrađeni konvencionalnom metodologijom predstavljali su kontrolnu grupu. Preciznost optičkih metoda skeniranja Cerec®3D sistema ispitivana je indirektno, merenjem veličine rubnog zaptivanja između inleja i demarkacije preparacije pomoću skenirajućeg elektronskog mikroskopa (SEM). Rezultati. Istraživanjem je ustanovljeno da postoji razlika u preciznosti postojećih metoda skeniranja stomatoloških Computer aided design-computer aided manufacturing (CAD/CAM) tehnologija. Najviši stepen preciznosti pokazala je tehnika optičkog ekstraoralnog površinskog skeniranja. Vrednost rubnog zaptivanja inleja izrađenih primenom ove tehnike iznosila je 32,97 ± 13,17 μ. Tehnike intraoralnog optičkog površinskog i ekstraoralnog tačkastog skeniranja pokazuju niži nivo preciznosti (40,29 ± 21,46 μ za inleje intraoralnog optičkog površinskog i 99,67 ± 37,25 μ za inleje ekstraoralnog tačkastog skeniranja). Zaključak. Optičke metode skeniranja u stomatološkim CAD/CAM tehnologijama predstavljaju precizne metode prostorne digitalizacije modela; pri tom, najveću preciznost pruža primena ekstraoralnih optičkih metoda skeniranja.

Introduction. Modern technologies offer a range of benefits and significantly improve specific therapeutic procedures in dentistry. However, despite gaining experience and training there are still some mistakes in their implementation. The aim of this study was to describe the most common errors during intraoral scanning, 'optical impression' procedure, during CAD-CAM technology for production of dental restorations. Material and Methods. Cerec® 3D CAD-CAM system for one visit tooth reconstruction by inlays, onlays, endocrowns, half and complete crowns and veneers from the ceramic material was used in the study. Results. Analysis included 1564 reconstruction during 5 years. The most common causes of errors performing optical impression were the result of: improper preparation of teeth, the instability of the scanner in the mouth of the patient, incorrect position and angle of the scanner to the object scanning, contrast spray applied in uneven layer, the presence of fluid in the region scan, the presence of artifacts in the region gingival sulcus. Conclusion. Optical impression is faster procedure than conventional impression, but technologically sensitive. The most frequent errors are: improper handling of the scanner, inadequate tooth preparation, irregular powder application on the tooth and irregular use in the gingival sulcus., Uvod. Savremene tehnologije u stomatologiji imaju niz prednosti i značajno unapređuju pojedine terapijske postupke. Međutim, i pored sticanja i usavršavanja određenih iskustava, javljaju se greške u njihovoj primeni. Cilj rada je bio da se prikažu najčešće greške prilikom postupka optičkog intraoralnog skeniranja (tzv. otiskivanja) kod CAD-CAM tehnologije izrade zubnih nadoknada. Materijal i metode rada. U radu je korišćen Cerec ® 3D CAD-CAM sistem za jednoseansnu rekonstrukciji zuba izradom inleja, onleja, endokruna, delimičnih i celih kruna, venira, najčešće izrađenih od keramičkih materijala. Rezultati. Analiza je obuhvatila 1.564 restauracije tokom petogodišnjeg rada. Najčešći uzroci grešaka kod optičkog otiskivanja bili su posledica nepravilne preparacije zuba, nestabilnosti skenera u ustima pacijenta, nepravilna pozicija i ugao skenera u odnosu na objekat snimanja, kontrastni sprej nanesen u neravnomernom sloju, zastupljenost tečnosti u regionu skeniranja i artefakta u regionu gingivalnog sulkusa. Zaključak. Optičko intraoralno skeniranje je jednostavniji i brži princip otiskivanja od konvencionalnog postupka, ali je tehnološki osetljiviji. Najčešće greške prilikom optičkog otiskivanja su: nepravilno rukovanje skenerom, neadekvatna priprema zuba, nepravilno nanošenje praha za matiranje površina i nepravilna priprema regiona gingivalnog sulkusa.

Cu-Al-Ni shape memory alloys (SMAs) have been investigated as materials for medical devices, but their biomedical application is still limited. The aim of this work was to compare the microstructure, corrosion and cytotoxicity in vitro of a Cu-Al-Ni SMA. Rapidly solidified (RS) thin ribbons, manufactured via melt spinning, were used for the tests. The control alloy was a permanent mould casting of the same composition, but without shape memory effect. The results show that RS ribbons are significantly more resistant to corrosion compared with the control alloy, as judged by the lesser release of Cu and Ni into the conditioning medium. These results correlate with the finding that RS ribbons were not cytotoxic to L929 mouse fibroblasts and rat thymocytes. In addition, the RS ribbon conditioning medium inhibited cellular proliferation and IL-2 production by activated rat splenocytes to a much lesser extent. The inhibitory effects were almost completely abolished by conditioning the RS ribbons in culture medium for 4 weeks. Microstructural analysis showed that RS ribbons are martensitic, with boron particles as a minor phase. In contrast, the control Cu-Al-Ni alloy had a complex multiphase microstructure. Examination of the alloy surfaces after conditioning by energy dispersive X-ray and Auger electron spectroscopy showed the formation of Cu and Al oxide layers and confirmed that the metals in RS ribbons are less susceptible to oxidation and corrosion compared with the control alloy. In conclusion, these results suggest that rapid solidification significantly improves the corrosion stability and biocompatibility in vitro of Cu-Al-Ni SMA ribbons.

Introduction Root coverage supported with complete regeneration of lost periodontal tissues represents the ultimate goal of gingival recession treatment. Objective This study was designed to evaluate clinical effectiveness of platelet rich plasma gel (PRP) with connective tissue graft (CTG) in the treatment of gingival recession. METHOD 15 gingival recessions Miller class I or II were treated with CTG and PRP (group PRP). Connective tissue graft was harvested from the premolar region using trap door technique. After elevation of the flap, the regional bone and root surface were smeared with activated PRP gel. CTG was also irrigated with PRP gel before placement over the exposed root surface and local bone. Fixed CTG was covered with a coronally advanced flap. The same number of gingival recessions were treated with CTG in combination with the coronally advanced flap with no PRP gel (group TVT). Clinical recordings included recession depth (RD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) before and 1 year after mucogingival surgical treatment. Results Mean value of RD was significantly decreased from 4.93?0.86 mm to 0.60?0.37 (p0.05). No statistically significant differences were observed between treatment groups in CAL and PD. Conclusion Clinical results validate both procedures as effective and highly predictable surgical techniques in solving gingival recession problem. Histological evaluation may confirm advantage of PRP use related to regeneration of periodontal tissues. .

The etiology of craniomandibular disorders (CMD) is multi-factorial and the treatment should be selected with recognition of the different factors. The aim of the study was to investigate the influence of occlusion splint therapy (Michigan splint), physical exercises and transcutaneous nerve stimulation (TENS) on CMD symptomatology. At the Clinic of Maxillofacial Surgery in Belgrade, in the period from May, 2001-December, 2003, 168 patients were examined by the CMD working group. This group, comprised of different specialties (maxillofacial surgeon, prosthodontist, orthodontist, neurologist, psychiatrist and physiatrician), enabled multidisciplinary treatment of CMD patients according to the guidelines given by American Academy for Craniomandibular Dysfunctions. In all, a total of 30 patients with prevalent muscular tensions among other CMD symptoms were included in this study. The examination form according to Fricton and Shiffman for Craniomandibular Index (CMI) was used in order to evaluate the function of Craniomandibular system before and after therapy. A statistically significant difference (t = 8.735; P lt 0.001) between the average values for CMI of patients before (0.2297 +/- 0.0827) and after therapy (0.1002 +/- 0.0479) was observed. Performed treatment resulted in complete response (pain relief and absence of CMD symptoms and signs) in over than 80% of patients and could be considered as a method of choice in reversible occlusal therapy.