Introduction: Impaction may be defined as the failure of complete eruption into a normal functional position of one tooth within normal time due to lack of space in the dental arch, caused by obstruction byanother tooth or development in an abnormal position. The mandibular third molar is the most frequently impacted tooth. The incidence varies from 9.5% to 68% in different populations.Methods: The study was conducted in Department of Oral Surgery, Faculty of Dentistry, University in Sarajevo. Study represents retrospective analysis of panoramic radiographs (orthopantomograms) of patientsreferred to Department of Oral Surgery from January 2010 to February 2013 with indication for surgical removal of impacted third molars.Results: Of the 2000 radiographs, 761 presented with at least one impacted third molar (38%). A total of 1034 impacted mandibular third molars were present (51.7%). The most common age group was thirddecade (61.2%). Signifi cant statistical difference in incidence of third molar impaction was found between females and males (p<0.05), but there was no statistical difference in incidence in urban and suburbanpopulation (p=0.374). Vertical angulation was the most common pattern of impaction (65%). Frequency of third molars erupted into their normal position (class IA) was 42%. Impacted mandibular molars wereassociated with periodontal pockets in 134 (6.5%) cases and with dentigerous cysts in 5 cases (0.2%).Conclusion: The present study provides useful data regarding the clinical status of third molars in population of Bosnia and Herzegovina.
It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality) or the patient complained about pain or discomfort (parameters of pain and discomfort), we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied after the insufficient mandibular block, is obvious.
Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation.
In their practice every dentist is brought into a situation to treat patients with grossly impaired kidney function. Kidney diseases, whether acute or acquired, imply a number of body dysfunctions such as prolonged bleeding, high blood pressure, infection tendency etc. which, in turn, pose a threat involving serious complications in cases of dental interventions in these patients. The aim of this article is to provide a review of current dental practice in patients with kidney disease. This implies dental intervention and preparations of patients with chronic renal disease, nephritic syndrome, patients on dialysis, and patients with kidney transplants. Certainly, cooperation between the dentist and nephrologist is an imperative for the appropriate dental treatment of patients with grossly impaired renal function.
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