The anterior and middle superior alveolar nerve block may be recommended if maxillary permanent premolars have to be extracted.
Introduction. A lack of appropriate adhesiveness is one of the biggest problems in the restorative dentistry today and the main cause of the microleakage between restorations and hard dental tissue. The aim of this study was to assess the adhesiveness of two different glass ionomer cement restorations class V on the hard dental tissue using the SEM analysis and dye penetration test. Material and methods. The study included 80 extracted teeth for orthodontic reasons (premolars and molars) in both genders and different age. On the vestibular and oral side of the teeth, adhesive preparations class V were done (size 3Ч2Ч2 mm). On the vestibular preparation, GC Fuji II was applicated and GC Fuji II LC-improved on the oral side. The quality of the adhesiveness between restorations and hard dental tissue was evaluated using the SEM analysis and dye penetration test (0.5% basic fuxsin). Linear penetration of the dye was observed using 10 times magnification. Results. The results showed that microleakage was presented with both materials but a ratio was less with Fuji II LC compared with Fuji II. Also, the microleakage was less on the occlusal parts of the restorations than on the gingival, with both materials. Microleakage was noticed in 93.44% teeth with Fuji II GJC restorations with index of microleakage of 148 on all edges. Fuji II LC GJC restorations showed microleakage in 68.4% teeth with index of microleakage 75 on all edges. The SEM analysis showed that both glass ionomer materials had better adhesiveness to the enamel than to the dentin. The average gap length between Fuji II LC and dentin was 9 μm and Fuji II 17 μm, respectively. Conclusion. Better adhesiveness to the hard dental tissue was achieved with materials of the newer generations, resin modificated glas ionomer cements
Supernumerary teeth may have all characteristics of normal teeth (dens supernumeratus) or, more frequently, appear as rudimentary remains of the tooth bud (dens accessories). Such teeth may cause various complications and the most frequent are orthodontic anomalies and follicular cysts. Among all supernumerary teeth, the most frequent is mesiodens. It may be of different shape, but most often is conical. Untimely diagnosed and treated mesiodens may, in older age, result in complications and compromise prosthodontic rehabilitation. The aim of this study was to present a case where untimely treatment (diagnostics and extraction) of a mesiodens resulted in the formation of a follicular cyst and a partial resorption of the root of an adjacent tooth (central incisor), which had to be extracted. The patient sought a prosthodontic treatment. However, a hazelnut-size tumor was found in the upper anterior region. Clinical and X-ray examination implied the presence of a follicular cyst around a supernumerary tooth, which was situated between upper central incisors. Cystical sac was removed in a usual manner along with the extraction of the impacted mesiodens. Unfortunately, the upper central left incisor had to be extracted as well due to a progressed root resorption
Introduction.Epulis is a change in gingival tissue that occurs under the influence of chronic irritation. Histologically, there are several different types of epulis. Fibrous epulis is benign tumor of gingiva that most often occurs in interdental papilla area as a result of local irritation (inadequate restorative fillings, carious teeth, subgingival deposits or the combination of them). The aim of this paper is to present a clinical case of fibrous epulis. Case report.A 25-year-old girl reported to the Specialist Center for Dentistry in Foca. Clinical examination revealed a gingival tissue enlargement in the area of the upper jaw central incisors with speech and chewing function disturbances. Intraoral examination revealed a change above the level of gingiva, reddish-pink in color with smooth surface texture and soft consistency. The size of the change was 1 x 1.5 cm. It was connected to the interdental gingiva between teeth 12 and 21 by a narrower base. Clinically, a significant amount of soft and hard dental deposits surrounded the remaining teeth. Remaining gingiva was swollen, red, bleeding on provocation. The anamnesis did not confirm the presence of other acute and chronic diseases. The patient was not pregnant. She was informed about clinical condition assessment, as well as possible therapeutic procedures. Our patient was treated with non-surgical periodontal therapy and surgical excision of the enlargement. After histopathological examination of the removed tissue, the diagnosis was made: "Fibrous epulis cum ulceration". Conclusion.Clinical examination is insufficient for definite diagnosis. Therefore, a histopathological examination of the tissue is mandatory for fibrous epulis definite diagnosis. Treatment of choice is surgical excision of the enlargement and removal of predisposing factors to avoid recurrence.
Introduction. The emergence of deciduous teeth in the mouth of a child usually brings a joy to every parent. However, after ”short-time euphoria” deciduous teeth, in most cases, become the cause of pain, swelling, infection and further complications. The aim of this study was to assess the status of deciduous teeth in school children. Material and Methods. The study included children age 6-10 years from four cities in Republika Srpska. All respondents were divided in two groups: Group I included those who voluntarily came to be examined at the dental clinic and the Group II-those who were randomly chosen in schools. The examination was performed using dental mirror and probe. Caries verification was carried out by Klein-Palmer system, dmft (d - decay; m - missing; f - filling), and its related indices: Person caries index (pci) and Average caries index (aci). In addition, a survey was conducted. Results. A total number of 228 respondents were examined. Total pci was 96.1%. On average, each child had aci= 4.17 while 10.52% of the children had fillings in primary teeth. None of the children had sealed fissures on deciduous teeth. Physical examination revealed that 12.2% of the children had submucous abscess in oral cavity. The survey revealed that 3% of children did not have a tooth brush. Conclusion. The prevalence of caries in primary teeth is high, despite the fact that the Health Insurance Fund in Republika Srpska covers full cost for complete restoration of teeth in children up to 15 years old. Responsibility for the low percentage of healthy and filled teeth is relying mostly on parents as well as the entire community that should provide development and availability of public health dental care in all areas
Many of medicaments used historically in root canal treatment have been shown to be cytotoxic. Paraformaldehid agents (such as Toxavit and Depulpin) are used to devitalize inflamed pulp when local anesthesia is ineffective. The misuse of pulp devitalizing agents may cause damage to gingiva and alveolar bone. This case report demonstrates complications arising after application of paraformaldehyde containing paste, necrosis of the gingiva and alveolar cortical bone, which resulted in great loss of supporting bone. Surgical intervention was required wherein necrotic bone was removed and bone defect was filled with xenograft of bovine origin. After three months endodontic treatment was performed. After the treatment, the patient?s complaints were resolved. The use of paraformaldehyde-based agents during endodontic therapy requires special caution.
Introduction The anterior and middle superior alveolar (AMSA) nerve block is an alternative technique of local anesthesia in the maxilla, unpredictably efficient for pulpal anesthesia. The aim of this study was to determine the anesthetic efficacy of the AMSA injection for pulpal anesthesia, using computer-controlled injection system or conventional syringe, and two local anesthetic solutions with or without adrenaline. Methods The authors administered two AMSA injections during two separate appointments, utilizing the computer-controlled system and conventional syringe to 40 subjects, divided into two groups of 20 subjects each depending on the local anesthetic used. A pulp tester was used to test the achieved anesthesia of the central and lateral incisors, canine, first and second premolars, and the first molar in 10-minute cycles over a period of 60 minutes. Duration of anesthesia for all the mentioned teeth was also determined for both the anesthetic solutions and ways of application. Results The AMSA injection with both types of equipment was successful, showing slow onset, satisfying intensity, and declining duration of pulpal anesthesia at the last two measurements. Local anesthetic with vasoconstrictor exhibited a significantly longer pulpal anesthesia. Conclusion The AMSA nerve block could be recommended for achieving pulpal anesthesia of maxillary teeth from the region of the first incisor to the second premolar.
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