The formation of white spot lesions, or enamel demineralization, around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, which marks the result of a successfully completed case. This article is a contemporary review of the risk factors and preventive methods of these orthodontics scars. Preventive programmes must be emphasized to all orthodontic patients. The responsibility of an orthodontist is to minimize the risk of the patient having decalcification as a consequence of orthodontic treatment by educating and motivating the patients for excellent oral hygiene practice. Prophylaxis with topical fluoride application should be implemented: high-fluoride toothpastes, fluoride mouthwashes, gels and varnishes during and after the orthodontic treatment, especially for patients at high risk of caries.

Background/Aim: Increased levels of matrix metalloproteinase-8 (MMP-8) have been associated with risk of developing chronic periapical lesion (CPL). Gene polymorphisms are contributing factors in the pathogenesis of the inflammation. The aim of this study was to analyze polymorphism in the gene MMP-8 and its association and influence on clinical manifestation of CPL. Methods: A total of 240 unrelated Macedonian subjects were included in the present study. Polymorphism -799 C/T in the gene MMP-8 detected with restriction enzyme BgIII was studied in 120 patients with CPL and 120 controls without any signs of chronic or acute inflammatory process in the jaw. The amplification of the region of selected gene was made with polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP). Results: Our results showed that there were differences in the allele and genotype frequencies of the MMP8 -799 C/T polymorphisms between patients with CPL and controls (p < 0.05). Also this study suggests that MMP-8 polymorphism -799 C/T was a risk for expression of CPL (OR=8.27<3.44

BACKGROUND:Fear of the dentist and dental treatment is a common problem. It can cause treatment difficulties for the practitioner, as well as severe consequences for the patient. As is known, the level of stress can be evaluated thought electrodermal activity, cortisol measure in saliva, or indirectly by psychometric tests.AIM:The present study examined the psychological influence of dental interventions on the child as well as coping patterns used for stress diminution.METHODS:We examined two matched groups of patients: a) children with orthodontic problems (anomalies in shape, position and function of dentomaxillofacial structures) (N = 31, mean age 10.3 ± 2.02) years; and b) children with ordinary dental problems (N = 31, mean age 10.3 ± 2.4 years). As psychometric instruments, we used: 45 items Sarason’s scale for anxiety, 20 items simple Stress - test adapted for children, as well as A - cope test for evaluation coping patterns.RESULTS:Obtained scores confirmed the presence of moderate anxiety in both groups as well as moderate stress level. For Sarason’s test obtained scores for the group with dental problems are 20.63 ± 8.37 (from max 45); and for Stress test 7.63 ± 3.45 (from max 20); for the orthodontic group obtained scores are 18.66 ± 6.85 for Sarason’s test, while for the Stress test were 7.76 ± 3.78. One way ANOVA confirmed a significant difference in values of obtained scores related to the age and gender. Calculated Student t - test shows non-significant differences in obtained test results for both groups of examinees. Coping mechanisms evaluated by A - cope test shows that in both groups the most important patterns used for stress relief are: developing self-reliance and optimism; avoiding problems and engaging in demanding activity.CONCLUSION:This study confirmed that moderate stress level and anxiety are present in both groups of patients (orthodontic and dental). Obtained scores are depending on gender and age. As more used coping patterns in both groups are developing self-reliance and optimism; avoiding problems and engaging in demanding activity. Some strategies for managing this problem are discussed.

Class II major histocompatibility complex (MHC) antigen-presenting cells are associated with the early phase of the immune response. We have studied the distribution of class II-expressing cells in developing, healthy and carious human teeth to clarify, when human pulp acquires an immunologic defense potential and how this reacts to dental caries. Antigen-expressing cells were identified immunohistochemically with the following monoclonal antibodies: HLA-DR - for dendritic cells and CD68 - for macrophages. In the pulp of unerupted developing teeth, HLA-DR-positive cells were distributed mainly in and around the odontoblast layer. A few CD68 positive cells were located more coronary around the blood vessels. In erupted teeth, HLA-DR-positive cells were located, for the most part, just beneath the odontoblast layer. CD68 positive cells were also located coronary, mainly around the blood vessels. Superficial caries lesions caused an aggregation of HLA-DR-positive cells and macrophages in the dental pulp corresponding to the lesion. These findings showed that: (1) human teeth are already equipped with an immunological defense potential prior to eruption; (2) in the initial stage of caries infection, an immuno-response mediated by class-II-expressing cells is initiated in human dental pulp (Fig. 8, Ref. 33).

BACKGROUND:Circular caries occurs in the earliest age of the children (1 - 1.5 year), immediately after the eruption of the deciduous teeth. During this period, children are too young to be able to properly implement oral hygiene. Consequently, it is at a negligible level, with plenty of soft plaque on the deciduous tooth surfaces.OBJECTIVE:The main objective of this clinical trial was to determine the correlation between oral hygiene shown with Oral Hygiene index, and the initial stages of circular caries (initial lesion and superficial form), before and after topical fluoride treatment.MATERIAL AND METHODS:For determination of the OHI - index we used the method of Green - Vermillion. It was determined two times in 117 patients, during the first visit and immediately before physiological replacement of deciduous teeth. Patients were two to three years old and diagnosed with initial stages of circular caries. Amino fluoride solution was applied once a week, during six months.RESULTS:We obtained statistically significant improvement of OHI - index at the end of the test, among treated subjects from both major groups.CONCLUSION:It can be concluded that the level of oral hygiene is correlated with the progression of changes in enamel. Topical fluoride treatment has a positive impact on reducing ECC.

Even from the distant past the aesthetic perception in an individual was diminished by the presence of gap between the central incisors. This condition is found under the term "dents du bonheur" or "lucky teeth" and is encountered even among world famous figures including Brigitte Bardot, Eliah Wood, Madonna, Zac Efron, Amy Winehouse and Elton John. The teeth gaps are still considered main reasons for dissatisfaction of the dental patients and reasons for the requirement of aesthetic treatment. The purpose of this study is to exhibit the influence of the etiological factors in the occurrence of diastema mediana classified according to the dominance of their occurrence expressed in percentage values. Materials of this investigation were 100 patients with diastema mediana from the following factors: inheritance, disproportion in the dental arches, inborn or acquired missing teeth, harmful oral habits, high insertion of the labial frenulum as well as mesiodens. After the diagnosis and evaluation of the etiological factor for diastema mediana was performed, a decision regarding the course of treatment was made in direction of the removal of the etiological factor at an early age and orthodontic treatment. The end of the orthodontic treatment in a group of the patients was the beginning of prosthodontic reconstruction. From our clinical investigation we came to the realization that in 49 patients (49%) the hereditary influence was a dominant factor, next followed disproportions and discrepancies in the dental arch in 14 (14%), inborn or acquired missing teeth in 11 patients (11%), harmful oral habits in 10 (10%), high frenulum insertion in 4 (4%), and pathological objects between central incisors, mesiodens, iatrogenic factors and periodontal disease, in 3 of the clinical cases (3%) each. We concluded that the occurrence of diastema mediana is multi-causal. The dominant place is occupied by the hereditary factors. With regard to the mutual relationship between the multitudes of factors in the occurrence of diastema mediana, the diagnosis should be made conciliary and the clinical treatment should be interdisciplinary including a prosthodontist, orthodontist and oral surgeon.

RezimeUvod Ortodontski tretman ima brojne prednosti, uključujući i poboljšanje dentalne i facijalne estetike kod pacijenata. Cilj Cilj rada bio je da se evaluiraju in vitro efekti kazein fosfopeptidamorfnog kalcijum fosfata (CPP-ACP)

Ortodonske bravice i drugi ortodontski elementi, otežavaju oralni higijenu olakšavaju akumulaciju dentalnog plaka što povećava rizik od karijesa u toku ortodontskog tretmana. Cilj: ovog istraživanja bio je da se utvrdi koncentracija Ca i Mg u veštačkoj pljuvački posle preventivnog tretmana. Metode: Laboratorijsko ispitivanje (in vitro) obavljeno je na 90 zdravih zuba ekstrahovanih iz ortodontskih razloga. Formirane su tri grupe od po trideset zuba. Zubi iz svake grupe su podeljeni na polovine u buko-lingvalnom pravcu. Na taj način formirani su i ispitivani i kontrolni uzorak, oba od jednog istog zuba. Bravice su zalepljene pomoću GC Fuji OrthoTM LC (GC Amerika Čikago, III),glasjonomer cementom modifikovanim smolom, a zubi su zatim čuvani u veštačkoj pljuvački. Jednom dnevno zubi su premazivani topikalnim gelom-CG Tooth Mousse u trajanju od 5 minuta, a zatim vraćeni u veštačku pljuvačku. Preventivni tretman je sproveden u određenim intervalima od 1, 3 i 6 meseci. Posle svakog perioda ispitivanja, veštačka pljuvačka u kojoj su uzorci čuvani je bila korišćena za određivanje koncentracije Ca i Mg pomoću plamene atomske apsorpcione spektrofotometrije. Rezultati: Rezultati ovog (in vitro) istraživanja pokazali su da su koncentracije Ca i Mg u veštačkoj pljuvački značajno povećane čak i nakon prvog meseca od primene ovog sredstva, koje oslobađa Ca i druge minerale (uključujući cement bez fluora koji se koristi za lepljenje bravica) sa maksimalnom vrednošću nakon tri meseca primene. Ove vrednosti su bile značajno niže nakon šest meseci, verovatno kao rezultat njegove apsorpcije u gleđi. Rezultati za Mg su isti kao i za Ca, a vrednost se povećava, kao i njena stabilnost u pljuvački nakon prvog meseca. Zaključci: Rezultati ove in vitro studije jasno ukazuju da preventivni materijali koji se koriste u fiksnom ortodontskom tretmanu inhibiraju demineralizaciju gleđi oko bravica i ortodontskih prstenova. Preporuka za njihovu upotrebu kao dodatnih preventivnih metoda / sredstava je očigledna pored primarne oralne higijene.