The clinical significance of intrapulpal anesthesia for painless dental procedure

Introduction:The elimination of odontalgia and all other forms of oral pain that occurs on dental tissues during dental interventions is still one of the main goals in the dental profession. Aim: The aim of this paper wasto perform an analysis of the literature data on the use of supplementary intrapulpal anesthesia in clinical dental practice. Material and methods: Literature data on the use of intrapulpal anesthesia, the characteristics of this technique of supplementary anesthesia as well as the results of its application were collected. Various databases were used for this purpose, digital data from Google Scholar, Medline, Science-Direct, as well as traditional libraries with manuscripts in printed form were most often taken. Conclusion: The use of supplementary intrapulpal anesthesia in dental/endodontic practice represents a practical and successful type of local anesthesia, when standard mandibular anesthesia for the lower alveolar nerve does not provide a deep enough periinterventional analgesia for dental procedures.

Properties and applications of dental polyamides

Introduction: By examining numerous thermoplastic and flexible materials that would aesthetically and functionally surpass acrylates used for the production of dental prostheses, polyamides were discovered as materials with great potential application in prosthodontics. The aim of this study was to describe polyamide materials used for the production of partial dentures. Material and methods: The main methodological approach of this study was a systematic search of the literature in two electronic databases: Google Scholar and PubMed using predefined keyword combinations. Results: The advantage of polyamide dentures is the comfort and ease of accommodation of the patient, with preserved optimal mechanical and physical properties. The dentures are flexible but rigid enough to be resistant to shock and fractures. Due to their low specific weight, polyamide dentures are light, extremely thin and do not interrupt patient speech. Excellent aesthetics are provided by a high choice of working colors and high translucency of the material, which ensures that the soft tissue that's covered by the denture base or clasp is seen through the prosthesis and gives it a more natural appearance in the patient's mouth. Conslusion: Polyamides, unlike acrylates, do not contain residual monomers, so they have an greater degree of biocompatibility. They can be used for the production of both complete and partial dentures, in combination with a Cr-Co skeleton, or crowns and bridges.

Lichen planus: Oral manifestations, differential diagnosis and treatment

Introduction: Some of the typical skin diseases, such as Pemphigus vulgaris, Pemphigoid mucosae oris, Erythema exudativum multiforme, Sclerodremia, Dermatitis herpetiformis-Duhring and Lichen planus, can cause swelling and irritation in mucous membranes of the oral cavity. Aim: The aim of the study was to precise diagnosis and treatment of oral Lichen planus manifestations. Methods: Analyzing the literature data and the experience of clinicians, the most common oral lichen planus manifestations were investigated. Results: This disease most commonly occurs in middle-aged patients (30-60 years) and is more common in women than in men. Oral Lichen planus is rarely seen in children. The disease presents in 0.5% to 2% of the population. Clinical history established the relation between oral Lichen planus and oral carcinoma, and therefore this disease should be considered a precancerous lesion. Conclusion: Dermatoses in the mouth are localized most often in the oral mucosa, both at the height of the occlusal line and in the mucous membrane of the retromolar area, but they can also occur in the mucous membranes of the tongue, the floor of the mouth and lips.

Assessment of smile esthetics and various types of face profiles

Background: Imperfect smile and face profile is one of the main reasons why patients turn to orthodontists. Aim was to investigate if there is a difference in perception of smile and profile esthetics between the examined groups. Subjects and method: In conducted research, smiles of 21 persons (8 male and 13 female), 18 to 30 years old were evaluated by 15 orthodontists, 15 students of dentistry and 15 laypeople. They were to rate esthetics of every smile from 1 to 9 and choose just one main reason that impairs aesthetics. Orthodontists and laypeople should also evaluate male and female normal, bimaxillary prognathic and bimaxillary retrognathic profiles from 1 to 3. The most beautiful profile should be marked with number 3. Results: Although there was no statistically significant difference in the evaluation of smile esthetics among groups, laypeople gave the lowest evaluation. Apart from irregular position of certain teeth, all investigated groups emphasized different factors that impair smile esthetics. Orthodontists and laypeople marked bimaxillary prognathic male and female profile as less beautiful than the others. Conclusion: Because of the differences in perception of the smile aesthetics between orthodontists and laypeople, it is necessary to create a new diagnostic plan of treatment protocols that includes studies investigating laypeople perception of smile and facial esthetics.

Dens evaginatus and dens invaginatus: A report of two cases

Introduction: Developmental disturbances of teeth at the stage of morpho-differentiation have been related to abnormalities associated with changes in the tooth shape and size. Dens evaginatus and dens invaginatus are the developmental variations of the human dentition. Dens evaginatus, a rare anomaly characterized by the presence of a tubercle on the occlusal surface of teeth is seen to occur due to abnormal proliferation and folding of the inner enamel epithelium and part of the dental papilla into the stellate reticulum of the enamel organ; whereas, dens invaginatus is seen to occur due to infolding of the enamel and dentine into the pulp cavity and sometimes extending to the root apex. Case report: We report cases with bilateral dens evaginatus in mandibular second premolars and dens invaginatus in maxillary lateral incisor. Conclusion: Such developmental anomalies of teeth deserve clinical importance, as high chances of early pulpal pathosis.

Caries risk profile of preschool children in the City of Niš

Introduction: Primary caries prevention from the earliest childhood has multiple significance. Its efficacy is largely conditioned by the knowledge of the caries risk profile of the subpopulation at risk, as an important prerequisite for developing effective strategies and measures for disease prevention and control. Aim: To assess the caries risk profile of preschool children in the City of Niš using a reduced computer Cariogram ® model. Material and methods: To realize the set objectives, a cross-sectional study was conducted, which included preschool children, aged 36-48 months, with permanent residence in the City of Niš since birth. The collection of data was done by interviewing mothers, and by the clinical examination of subjects. The caries risk profile of the subjects was performed using a reduced Cariogram ® model. Results: The study included 276 subjects of preschool age, mean age 41.28 ± 4.40 months. The highest percentage of subjects has a moderate caries risk, with an average of 50% chance of avoiding a new carious lesion in the future. In the assessed caries risk profile of children, the most vulnerable sectors are "susceptibility" (18%) and "bacteria" (14%), related to the use of fluoride by children of this age and their oral hygiene. The highest percentage of subjects belongs to the moderate caries risk group. Conclusion: According to the conducted study, insufficient exposure of teeth to fluoride and inadequate oral hygiene may be considered significant caries risk factors in preschool children, which should be considered when choosing measures and strategies for disease prevention and control. Also, it is necessary to reconsider the time of diagnostic examinations to reduce the prevalence of caries and its negative consequences at this age to a minimum.

Periodontal health and detection of periodontal bacteria in patients with acute coronary syndrome

Introduction: Recent studies have found that patients with periodontitis have greater risk of incurring fatal cardiovascular disease than patients without periodontitis. Emerging research has identified inflammation caused by periodontitis as significantly increasing the risk for ACS. Aim: The aim of this study was to investigate a periodontal status in the patients with ACS, and to assess the association of different periodontal parameters with ACS. Material and methods: In the first group, patients both with ACS and periodontitis were enrolled as cases. Patients were examined 3 days after ischemia. The second group consisted of patients who had only periodontitis. The control group consisted of healthy individuals. Periodontal parameters were measured and matched on the basis of demographic characteristics and assessed between the groups. The severity of periodontitis in both cases was analyzed. Results: Analysis of the periodontal parameters showed that median scores were higher in patients in the first and the second group compared to the third control group but significantly higher in group with ACS. Levels of inflammatory markers were highest in the first group, compared to the second group and the control group. Periodontal pathogens were more strongly present in patients with ACS than in the group with periodontitis, indicating that it was a serious illness in these patients. Conclusion: This study supports an association between periodontitis and ACS. Severe periodontitis is present in this patients indicating that periodontitis can further act on the development of ACS.

Examining dentists' attitudes about ethical principles in everyday practice

Introduction: Patient care, knowledge of medical law and compliance with the law contribute to more efficient dealing with the ethical dilemmas often faced by today's dentists. Moreover, when it comes to determining 'the best' dental treatment, patients also play a certain role. The aim of the research was to examine the attitudes of Serbian dentists related to ethical dilemmas in everyday practice, so as to determine the factors that affect solving the dilemmas. Materials and methods: The paper was carried out as a cross-sectional study. The research included 88 respondents, 42 final year dentistry students at the Faculty of Medicine in Niš and the Faculty of Dentistry in Belgrade and 46 dentists from both private and state practice. The first part of the questionnaire included socio-demographic information on the respondents, and the second part consisted of 7 closed-ended questions about particular ethical dilemmas. Statistical analysis was done using Excel from Microsoft Office and SPSS, version 18.0. Results: There were no significant differences regarding the students and dentists' answers about individual ethical aspects, except for the domain of question 2b, whether the oral surgeon should have extracted both teeth on the patient's request, although the patient had a heart disease. A statistically significant difference was found (ch 2 =18,834, p<0,0001) regarding the dentists' answers in comparison with the students' answers. Conclusion: The knowledge about ethical principles of the majority of the respondents was satisfying. A smaller proportion of the respondents were not sufficiently aware of the importance of applying ethical principles in dental practice. Consequently, it is necessary to promote education programs about medical ethics for dentists and dentistry students.

Bioaerosol in dental prosthodontics

Introdution: During many dental interventions, performed using handpiece instruments and pusters, an aerosol is created,which is converted into a bioaerosol (BIOA) by mixing with the particles of various organic components from the patient's oral cavity.When the high-speed mashine is started, the air becomes instantly contaminated and practically covers the entire room. Pollution is registered all the times, as well as after prosthetic treatment. BIOA created during prosthetic workcontains various bacteria, fungi and viruses from the patient's oral cavity. These microorganisms pose a real hazard to health workers and are a potential risk for infection. The most common pathogens include influenza viruses, herpes viruses, as well as pathogenic streptococci and staphylococci. Infectious diseases, biosynosis, acute toxic reactions, allergies, atopic diseases, conjunctivitis, contact dermatitis, infections of the respiratory system, and even some types of cancer, are possible manifestations of side effects of BIOA. Conclusion:BIOA poses a potential danger to contamination of air, work surfaces and objects in dental offices. Direct and indirect exposure of dental staff and patients to BIOA is especially pronounced in the conditions of COVID 19. Although it is impossible to completely eliminate the risk of adverse effects of BIOA, it is important to pay attention to all prevention measures that can reduce the likelihood of contamination.

Occupational hazard for Dental staff exposed to the SARS-CoV-2 virus during Dental procedures

Introduction: The dental profession is a high-risk profession, considering the aspect of a possible 100% infection from patients who are carriers of bacterial, viral and fungal diseases during dental interventions. Aim: To perform the analysis of all data that explain the possibility of a SARS-CoV-2 virus infection in dental practice. Material and Methods: The literature data on the presence of SARS-CoV-2 virus, and its characteristics and behavior in the external environment and in living tissues was analyzed. Databases from the Medline, Cochrane Library, Science-Direct, EMBASE, and Google scholar libraries were used, as well as other sources of literature information about this virus. Results: SARS-CoV-2 is an RNA virus, which has a submicron size and the ability to survive in various environments. The retention of SARS-CoV-2 virus in air / aerosol lasts an average of 3 hours, while the half-life of this virus is 5 to 6 hours on stainless steel and 6 to 8 hours on plastic. Infected patients with SARS-CoV-2 virus develop COVID-19 disease, which manifests itself through presymptomatic, symptomatic and post-symptomatic periods of the disease. Conclusion: The SARS-CoV-2 virus can be found in aerosols generated by dental equipment, which uses compressed air for its work. Protection of dentists and staff from infection with the virus is possible by wearing an N95 respiratory mask with protection levels 2 and 3, which has a filtration efficiency, i.e. retention of submicron particles with an efficiency of ≥ 98%. Waterproof goggles with a protective visor or a special industrially designed facial visor in the form of a full face mask, which has its own motor for the supply of filtered air to the mask, and which prevents the contamination of the mucous membranes of the eyes, nose and mouth from liquid or solid aerosol in the air, need to be used. Other disposable protective equipment also must be waterproof. Korona virus izaziva prehladu kod ljudi, koja ima uobičajne simptome prehlade gornjih respiratornih puteva; zahvata nosnu šupljinu,a ponekad se širi i na ždrelo, larinks i sinuse 5,6,7 . Sa druge strane, SARS-CoV-2 virus, koji je izazivač masovne/globalne virusne infekcije, ima sličnosti sa druga dva korona virusa -beta korona virusom (SARS-CoV-1) i virusom srednjeistočnog respiratonog sindroma (MERS-CoV).