 |
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski
ISSN: 1312-773X (Online)
Issue: Volume 15, Book 2, 2009
Subject Collection: Dental and Oral Medicine
Page: 3 - 112
Date of close:
CONTENTS:
Research of periodontal status and treatment needs by CPITN in patients on haemodialysis and renal transplanted patients
Dencheva M.
*Department of Image and Oral diagnostics,
Faculty of Dental Medicine, Medical University - Sofia, Bulgaria
Summary: The aim of the present study is to estimate the periodontal conditions and treatment needs by CPITN of 150 patients- 45 (30%) on haemodialysis, 45 (30%) renal transplanted patients and 60 (40%) healthy controls, age between 18 and 84.
The oral health of this population gives rise to a big interest within the past ten years. The interest about oral status is caused not just from age changes, but also from characteristic changes through main illness, dialysis and immunosuppressive drug therapy. Early prevention and diagnostics of oral diseases can improve the health status and graft survival of patients in ESRD.
Key words: CPITN, renal transplantation, haemodialysis, parodontal health, ESRD
/Page 3-5/ Published online - June 10, 2009,
Secretory immunoglobulin A (SIgA) and dental caries of children with different diseases and conditions influencing oral medium
Maya Rashkova*, M. Baleva**, M. Peneva*, N. Toneva*, G. Jegova*
*Department of Paediatric Dentistry, Faculty of Dental Medicine,
** Department of allergology, Laboratory of clinical immunology,
Medical University - Sofia, Bulgaria
Summary: SIgA is the main type immunoglobulin in the mixed saliva and is considered as the main secretion factor of the adaptive immunity in the mouth. The purpose of the study is an evaluation of the SIgA quantities and the connection of those antibodies with dental caries of children with different diseases and conditions influencing the oral medium. The study was performed with 116 children with diabetes, asthma, orthodontic problems (removable braces) and healthy controls. The following methods were used: (1) ELISA with “Salivary secretory IgA KIT of SalimetricsLLC USA; was used for quantitative determination of IgA-S in the saliva; (2) Evaluation of the liquid oral medium (test “Saliva check-GC”) and dental status (DMF-T) of the children studied.
The results obtained came to show that 2/3 of the healthy children and the children with diabetes have low values of c(<100 ìg/ml). In the group of healthy children there are no high values of SIgA; Middle values of SIgA (100 -300 ìg/ml) are most frequently met in children with asthmatic disease; Oone half of the children with orthodontic apparatuses have high values of SIgA (>300 ìg/ml); There is no dependence between secretory immunity and dental caries in children.
Key words: secretory IgA-antibodies, oral homeostasis, dental biofilm, diabetes, asthma, orthodontic treatment, dental caries, DMF
/Page 6-9/ < back > Published online - June 12, 2009,
RATIONAL ANTIBIOTIC THERAPY IN THE COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS
Tihomir Georgiev1, Kamen Nogalchev2, Kaloyan Georgiev3
1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, 2 Department of Prosthetic Dental Medicine, 3 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Medical University-Varna, Bulgaria
Summary: The article treats the problem of the application and choice of antibiotics when carrying our antimicrobial therapy in inflammatory diseases of the periodontium. Based on data obtained from the bacteriological test of the content of periodontal pockets, in 75% of the patients with generalized periodontitis with a different degree of severity, there are discovered aerobic – anaerobic – fungal associations with primarily obligate and facultative anaerobes. In view of the results from the determination of sensitivity of various bacterial strains to antibiotics of various classes, the most prospective preparation for the suppression of the growth of the whole specter of pathogenic flora, located in the periodontal pockets in patients with periodontitis, is Clindamycin MIP. The data about the high clinical and bacteriological efficiency of Clindamycin, obtained from the clinical and microbiological tests, give us grounds to recommend it in the complex treatment of severe forms of generalized periodontitis.
Key words: antibiotic therapy, periodontitis, periodntium, clindamycin.
/Page 10-13/ < back > Published online - June 22, 2009,
Method of treatment of periimplantitis
Tihomir Georgiev
Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The article deals with the problem of treatment of periimplantitis which is one of the most severe complications in the implant practice of a dental doctor. The author suggests a new method of treatment of periimplantitis which is substantiated by his clinical research and observations. The clinical comparative study demonstrates the reliability of this method as compared to the conventional methods.
Key words: periimplantitis, dental lasers, general osteotropic treatment.
/Page 14-15/ < back > Published online - June 22, 2009,
Sinus lifting and varieties of subantral implantation in the use of screw intrabone implants
Tihomir Georgiev
Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: There has been a long-lasting dispute over the question whether the screw or cylindrical implants are better to use. Subantral augmentation is one of the places which gives superiority to screw implants due to the opportunity to ensure their primary stabilization, hence to subject them to a single moment stress and to reduce surgical interventions. The author tests screw implants in three different clinical conditions of the maxillary sinus. The results of the clinical observations confirm the potentials of screw implants in intricate clinical varieties of “sinus procedans”.
Key words: sinus lifting, subantral augmentation, screw intrabone implants.
/Page 16-17/ < back > Published online - June 22, 2009,
Comparative characteristic of the mechanical strength of complete dentures performed by standard technique and IVOCAP technology
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The record of complete denture performing is almost the same as hasn’t undergone any changes since the introduction of acrylics by Kulzer in 1935. The air, included into the dentures, decreases their mechanical strength. This problem is solved by inventing the IVOCAP technology by IVOCLAR VIVADENT.
Key words: IVOCAP technology, MDI.
/Page 18-20/ < back > Published online - June 23, 2009,
Implant restorations maintenance
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: A gum inflammation around the implant that is harmless at first sight and may even run without clinical symptoms, can lead to crestal resorption. This calls for a regular professional maintenance, ensuring the successful functional life of the implants. But the conventional ultrasonic tips are aggressive and they can harm implant’s surface at cervical area.
This guide to more plague retention.
Key words: periimplantitis.
/Page 21-22/ < back > Published online - June 23, 2009,
Alternative sinus lift techniques
Literature review
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary:The sinus lift techniques had a lot of modifications through the years. In 1960 Boyene - published sinuslift with lateral access. In the beginning it was used for achieving an optimal intercrestal distance needed for denture making. But in the 1980 Boyen and James started to place implants in the newly created bone. The wish of patients and dentists for minimalivasive methods lead to the development of new innovation techniques.
/Page 23-27/ < back > Published online - June 23, 2009,
Effect of laser irradiation with different wavelength on the proliferation activity of human pulp fibroblast cells, depending on irradiation parameters and hard tissue thickness
Sl. Dimitrov, Violeta Dogandzhiyska, N. Ishkitiev*
Department of Operative dentistry and Endodontics, Faculty of Dental Medicin-Sofia, *Department of Biochemistry, Faculty of Medicine, Medical University, Sofia, Bulgaria
Summary: Several studies demonstrate, that low level laser therapy /LLLT/ improve the prognosis on direct and indirect pulp capping /6, 9, 10, 11, 12, 13, 14/. Biostimulatory effect of laser irradiation represents a set of structural, biochemical and functional changes in living microorganisms /6/. The positive effect is due to unspecific stimulatory action of laser beam - increase of colagen production, enzyme activity, micro- and lymph-circulation, fibroblast proliferation, decrease of local hypoxia, antiinflammatory effect and pain reduction /3, 4, 6, 8/.
Especially strong stimulatory effect is determined by irradiation with monochromatic red and infrared light with 630-905 nm wavelength. The low level laser irradiation from red and near infrared light spectrum correspond exactly to relevant characteristic energy and absorbtion level in the respiratory chain. It acts directly on stimulating components of the so-called antenna pigments of the respiratory chain and manifest as an immediate effect cell vitalization by ATP mitochondrial production increase /3/.
Biostimulatory effect of laser irradiation is determined by the magnitude of the absorbed light energy. Energy depth of penetration depends on many factors – wave length, optical and temperature characteristics, power, energy values, exposure time, wave shape, and optical characteristics of tissue- absorbtion and scattering coefficient /1, 2, 7, 16/. Each tissue because of their structural and biochemical diversity will have individual translucence for laser irradiation with different wavelength /2/.Greater oversight is typical of beam from red spectral area, and minimal such- of beam from blue spectral area /6/. As much translucenter tissue is, as minimal absorbtion and weaker biological effect of laser irradiation is. The cement is most transparent dental hard tissue, the second is dentin. Oversight of light energy through dentin is 0,2-0,8 %, and through enamel is 0,5-1,5 % /6/.
Key words: laser irradiation, pulp fibroblast cells, proliferation, biostimulatory effect.
/Page 28-31/ < back > Published online - June 25, 2009,
In vitro investigation of influence of temperature rising on periodontal tissue during endodontic treatment
Sl. Dimitrov, Tzvetelina Gueorgieva, V. Dogandzhiyska, I. Angelov*
Department of Operative dentistry and Endodontics, Faculty of Dental Medicin - Sofia, *Institute of Organic Chemistry, Bulgarian Academy of Sciences, Sofia, Bulgaria
Summary: Various manipulations during endodontic treatment and restoration of endodontic treated teeth can be associated with increase of the temperature in dental structure and periodontal tissue. These manipulations include: mechanical root canal preparation, obturation with warm condensation techniques, root – canal preparation for radicular post. The critical level of temperature, that doesn’t cause irreversible consequences is 43°C. The aim of this study is to investigate the temperature changes on external root surface during endodontic treatment depending of dentin thickness. Thirty six single - rooted, human teeth extracted for prosthetic or periodontal reasons were selected for this study. Teeth were divided into four groups-nine teeth in each one. The temperature changes during mechanical root canal preparation, vertical warm condensation, continious wave of condensation and root canal preparation for radicular post are explored and the results are presented.
Key words: temperature changes, external root surface, mechanical root canal preparation, warm condensation techniques for obturation, root canal preparation for radicular post.
/Page 32-35/ < back > Published online - June 25, 2009
Secretory immunoglobulin A (SIgA) and periodontal status in children with diseases and conditions influencing the oral environment
Maya Rashkova*, M. Baleva**, Toneva N.*, Jegova G.*
*Department of Paediatric Dentistry, Faculty of Dental Medicine,
** Department of allergology, Laboratory of clinical immunology,
Medical University - Sofia, Bulgaria
Summary: The secretory IgA-antibodies play an important role in the oral homeostasis. They are an indicator of the adaptive immunity in the mouth and influence the oral pathology by interaction on the oral microorganisms. It is the purpose of the present study to evaluate SIgA and the connection of those antibodies with the periodontal status of children with different diseases and conditions influencing their oral medium. The study was done with 116 children with diabetes, asthma, orthodontic treatment and healty controls. The following methods were used: (1) ELISA with "Salivary secretory IgA kit" of Salimetrics LLC-USA was used to determine quantitatively the SIgA in the saliva; (2) evaluation of the oral risk medium and periodontal status (PSR, PBI, OHI) of the children studied. The results show that plaque-induced gingivitis is observed in 50% of the children with diabetes and 30% of the children with orthodontic treatment. The gingivitis of healthy children and children with asthma is considerably lower (10%). The gingival diseases observed vary. The indexes used, (Papilla Bleeding Index(PBI) and Periodontal Screening and Recording Index (PSR), confirm the extent of inflammation of children studied and also confirm the clinical diagnosis made. SIgA of children with gingivitis does not differ statistically from the SIgA of children without gingivitis. This is a confirmation of the opinion of the weak influence of the secretory immunity on the periodontal health.
Key words: secretory IgA-antibodies, oral homeostasis, diabetes, asthma, orthodontic treatment, periodontal status, gingival diseases, Papilla Bleeding Index(PBI), Periodontal Screening and Recording Index (PSR)
/Page 36-40/ < back > Published online - June 30, 2009,
Clinical case of a child with Rhabdomyosarcoma (RMS), embryonic type, with oral complications post radiation therapy and chemotherapy
Maya Rashkova, Alexieva V., Jegova G.
Department of Paediatric Dentistry, Faculty of Dental Medicine,
Medical University - Sofia, Bulgaria
Summary: Case of a 7 years old female, with significant medical history of embrional type of RMS, diagnosed 2,5 years ago in left parapharingeal area. After surgical removal of the tumor, the area is radiated with 50Gy for 6 weeks and also has 3 courses of chemotherapy. By now the child is clinically healthy of RMS, but she has developed serious side effects of radiation therapy: erosive caries to all primary teeth, hyposalivation and total lost of function of the left parotid gland, delayed development of the teeth, facial asymmetry, caused by the arrested growth of left side mandibule.
Acute and chronic complications of radiation therapy act to the dynamic changes of the oral environment in a phase of active growth, dental eruptions and incomplete mineralization. The potential risk of osteoradionecrosis and radiation caries, resulted in the sequel of xerostomia and a cariogenic shift in micro flora, requires a prophylactic and heeling program to modulate the oral environment and to prevent or at lease, minimize the side effects and should be integral part of the treatment. Frequent dental follow – up should be scheduled throughout the treatment period to reinforce the importance of continued oral hygiene and to deal with the complications for a lifelong period of time.
Key words: Rhabdomyosarcoma (RMS) embryonic, alveolar RMS, and pleomorphic RMS, chemotherapy, radiation therapy, risk- oral environment, radiation caries, osteoradionecroses, salivary flow.
/Page 41-44/ < back > Published online - June 30, 2009,
The use of temporary mini-implants for fixed temporary restoration support at implant treatment of totally edentulous maxilla
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The matter of providing temporary restorations is of great importance at totally edentulous patients, wishful for fixed restorations over implants. Tempotary full denture, relined with soft resin, is the easiest solution, but there is a risk of failure of some of the implants. The possible solution in such cases is the use of temporary implants as a support for fixed structure.
Key words: temporary implants.
/Page 45-47/ < back > Published online - July 2, 2009,
Fixed prosthetic restoration, supported by natural teeth and SIP titanium implant. (A 14-years survey)
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The success of the implantologic treatment depends on many factors of surgical, prosthetic and prophylactic nature. The kind of the implantologic system is of particular importance so far as it fits to the specific clinical case (the kind of the prosthetic restoration, the bone type). The combined support, both on natural teeth and implants, is criticized by a number of authors. The most impartial assessment of the functional suitability of the implantologic treatment however, is the time proof.
Key words: implants, SIP.
/Page 48-49/ < back > Published online - July 2, 2009,
The use of IMTEC’s MDI mini-implants in the treatment of totally edentulous mandible
Metodi Abadzhiev, Miglena Balcheva
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: It is a hard task to produce full mandibular dentures for highly atrophic alveolar ridges. The lack of alveolar bone and attached gingiva enormously reduces the functional suitability of the dentures. The implantologic treatment is an often ignored opportunity, because of the necessity of additional surgical intervention for ridge augmentation and the advanced age of the patients. Thus implants with diameter 1.8 – 2.2 mm with spherical attachments for removable over-implant denture retention are possible alternative for the patients.
Key words: MDI, attached gingiva, over-implant denture.
/Page 50-51/ < back > Published online - July 2, 2009,
Comparative research of the subgingival impression quality by fixed prosthesis using one and double cord retraction technique
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The accurate impression of every detail of the prosthetic area is of extreme importance for the successful prosthetic restorations. One of the problems appearing in the process of fixed prosthetic restoration is the accurate impression of the marginal details. Contemporary dentistry uses hydrophilic impression materials (polyeter, A-silikone) allowing operation in damp environment. However, appropriate gingival retraction of sulcus gingivalis is of utmost importance, as even the most modern nano impression materials are unable to guarantee an accurate marginal detail. A high-quality impression that provides the necessary marginal detail is not only required for good fit, but also for optimal esthetic results.
Key words: Polyeter impression material, A-silikon, retraction cords.
/Page 52-54/ < back > Published online - July 2, 2009,
Effectiveness of additional therapy with NSAID (Aulin) on distribution of shallow and deep periodontal pockets in patients with chronic periodontitis (Pilot study)
Christina Popova, Antoaneta Mlachkova
Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, Bulgaria
Summary: Introduction: Currently accepted understanding about the role of the host inflammatory response in the progression of destructive periodontal diseases is the basis of therapeutic approaches with NSAIDs. Reduced levels of IL-1 and PGE2 in crevicular fluid and gingival tissues are measured in patients with adjunctive host modulation therapy in comparison with conventional mechanical therapy alone in numerous studies. The healing in patients with this additional therapy demonstrates successful elimination of gingival inflammation with pocket depth reduction and attachment level improvement.
Aim: To investigate the effectiveness of additional host modulation therapy with NSAID (Aulin) in patients with chronic periodontitis. Material and methods: The study involves 14 adult patients suffering moderate to advanced periodontitis, instructed for strict daily plaque control (including personal hygiene involving interdental brushes and dental floss) and antimicrobial mouth rinsing with 0.2% chlorhexidine (Corsodyl) and is treated with scaling and root planning. On the 5th day of the treatment the patients are put on adjunctive systemic administration of NSAID (Aulin) for 14 days, twice daily x100 mg. The efficiency of the therapy is measured at its 6th week with the same clinical parameters – PD, CAL, HI, and PBI. Results: The results of the treatment depict significant shift in the distribution of shallow and deep periodontal pockets. The shallow pockets (1-3mm) in the initial status of the patients are 23.8% from all measured pockets and at the end of the applied treatment this number rises up to 75.7%. The initial level of the deep periodontal pockets (>5mm) is 9.8% and decreases to 0.5% after treatment. The quantity of pockets with moderate depth (3-5mm) decreases from 66.5% to 38.7% at the end of the evaluated treatment. Conclusion: Within the limits of this pilot study we may conclude that the additional host modulation therapy with Aulin may enhance the outcomes of nonsurgical therapy in patients with chronic periodontitis.
Key words: chronic periodontitis, proinflammatory cytokines, nonsurgical therapy, NSAIDs, pocket depth.
/Page 55-57/ < back > Published online - July 2, 2009,
Ridge pråservàtion techniquå
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The extraction of deep fractured and compromised endodontically or parodontically teeth is a routine procedure for any dental practice. The extraction technique is of considerable importance for the bone loss in the course of the extraction as well as the post extraction period of healing. The post extraction bone loss is estimated to 40%-60% for the first six months (Cristensen GJ)
Bone presence is important for the further prosthetic recovery, especially when further implant treatment is under consideration.
/Page 58-60/ < back > Published online - July 6, 2009,
Implants’ second stage surgery techniques
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The sufficiency of attached gingival (AG) around teeth and fixed restorations is a sign for absence of local traumatic factors from dental or soft-tissue origin. Nevertheless the supporters are natural teeth or implants, the attached gingiva around the restoration is a guarantee for long-term, aesthetic and functional prosthetic restorations. This refers particularly to the attached gingival around the implants –periimplantitis develops quickly due to its absence. Different techniques can be used for implants’ second stage surgery time – uncovering with puncher, with ceramic bur, with electrosurgery , with partial thickness flap, with partial thickness flap and inserted connective tissue graft, with partial thickness flap and free epithelial-connective tissue graft.
Key words: attached gingival, periimplantitis, connective-tissue graft.
/Page 61-63/ < back > Published online - July 6, 2009,
Implant supported over dentures (Part I )
Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The treatment of completely toothless patients using oral implants does not always allow the insertion of adequate number implants to ensure an fixed construction, the reasons ranging from anatomical, or health restrictions to financial limitations. Unfortunately, implant supported overdentures have not gained due popularity in Bulgaria. On one hand there is the psychological barrier of having to take out the construction from the mouth, which appears to be a hard-to-overcome idea for patients. On the other, the deeply rooted opinion that mobile constructions are low quality ones and imply low financial status, reason many patients to choose the long and at times unpredictable bone augmentation techniques like sinus lift, guided bone regeneration (GBR), block grafts, distraction osteogenesis, etc. Another drawback in the development of implant prosthetics is the lack of adequate clinical and laboratory experience for the manufacturing of telescopic prostheses, individually locked clasp prostheses, and other multicomponent removable prosthetic constructions.
/Page 64-66/ < back > Published online - July 6, 2009,
Clinical application of the contemporary nano-materials (part 1 – laboratory composites)
Tsanka Dikova, Metodi Abadzhiev, Miglena Balcheva
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: Nano-technology and nano-materials have become an extremely active field of research in the last decade, because of their potential application in different areas like medicine, information technologies, energy storage etc. The unique properties of nano-sized particles, which are subject of quantum mechanics, determine the great interest.
The main purpose of using nano-technologies in dental materials is achieving higher mechanical properties, higher abrasion resistance and less shrinkage of dental composites, improved optical and aesthetic properties of composites and ceramics. Till now the nano-technologies are used in production of wide range of dental materials: light polymerization composites and their bonding systems, imprint materials, ceramics, coatings for dental implants and bioceramics. The aim of this paper is to make an overview of nano-materials, designed for and used in the practice of dental medicine.
Key words: laboratory composites, Adoro, Vectris, post-monoblock overlay.
/Page 67-70/ < back > Published online - July 6, 2009,
Advantages of Captek laboratory technology
Metodi Abadzhiev, Miglena Balcheva, Simeon Simeonov
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: After the introduction of vacuum firing of dental porcelain (1940) and especially after the realization of the connection metal – porcelain (S. Brecker, 1956), the metal-ceramic restorations gradually turned into a standard for aesthetic restorations. The dentists’ aspiration for satisfying the increasingly raising aesthetic and functional demands of the patients led to the development of new laboratory technologies. Captek is unique in its nature technology for producing of metal-ceramic restorations. Ceramic is laid over a gold-platinum-palladium frame, that is not cast.
Key words: Captek, gingival health.
/Page 71-72/ < back > Published online - July 6, 2009,
A case of Alopecia areata, associated with a focus of dental origin
Miglena Balcheva, Metodi Abadzhiev
Prosthodontic Department, Faculty of Dental Medicine, Medical University-Varna, Bulgaria
Summary: The focus is a clinically latent local inflammation with a few symptoms that can cause disturbance in the general reactivity of the body. Most of the focuses in children are of tonsillar origin, but in the adults the dental fields of disturbance prevail. They result in a variety of diseases and disorders – renal, joint, heart, dermal, etc. And the proper treatment requires a team collaboration of different well-grounded dental and medical specialists, respectively.
/Page 73-74/ < back > Published online - July 8, 2009,
SIXTH GENERATION ADAPTIVE APEX LOCATOR
Slavcho Dimitrov*, Dimitur Roshkev**
*Department of Conservative Dentistry, Faculty of Dental Medicine, Medical Academy, Sofia; ** OPTIKA LASER /OPTICS LASER/, Sofia, Bulgaria
Summary: A comparative analysis is made which is grounded on literary data concerning the advantages and disadvantages of apex locators of various generations that have been created following two different principles /19, 28/. The PURPOSE of this study is to create a method and a device that combine the established advantages of fourth and fifth generation instruments.
While measuring the working length of the root canals of 30 extracted human teeth /dry and filled with animal blood and sodium hypochlorite/, experimental research work was carried out which has served as a basis for creating both a method and an adaptive apex locator that combine the advantages of the two previous generations of appliances.
The prolonged direct and juxtaposing studies have made it possible to create a steady algorithm for adapting the method for measuring the working length of the root canal depending on the canal’s moisture characteristics. The method has been implemented in the apex locator of the so called sixth generation – the adaptive type.
Measurement with the adaptive apex locator has made it possible to eliminate the necessity of drying or moistening of the canal, as well as to achieve high degree of measurement precision in the presence of blood, of additionally imported liquid /sodium hypochlorite/, or while manipulating dry canals.
Clinical observations are yet to come that will help assess the device’s ability to determine the working length of root canals under various clinical conditions and situations.
Key words: adaptive apex locator, working length.
/Page 75-78/ < back > Published online - Aug 4, 2009,
In vitro study of bactericidal effect of antimicrobial agents used in modern endodontics
V. Kalchinov*, Slavcho Dimitrov*, M. Belcheva**
* Department of Conservative Dentistry, ** Department of Image and Oral Diagnostic; Faculty of Dental Medicine, Medical University - Sofia, Bulgaria
Summary: The purpose of this study is to carry out comparative in vitro study of bactericidal effect of antimicrobial drugs used in modern endodontics against some basic microbial agents of periodontitis. Using the agar diffusion method (experiment with sterilized disks and wells) antimicrobial effect of five antimicrobial agents used in endodontics is evaluated: Rockle, Cresophene, I2/KI, Cupral, Ca(OH)2- high dispersion. For the study three types of nutritious media are used: BHI- agar, MH- agar, Columbi blood agar. Tested microorganisms are: E. faecalis, S. aureus, bacterium of Prevotella spp. We found out through the standard agar diffusion method with disks that I2/KI has biggest bactericidal effect except for two cases when Cresophene is present. Using the method with wells we studied the antimicrobial effect only for Cupral and Ñà(ÎÍ)2- high dispersion. These agents have almost the same antimicrobial activity except for two cases when Cupral has bigger antimicrobial activity.
Key words: endodontics microbiology, agar diffusion method.
/Page 79-83/ < back > Published online - Sept 11, 2009,
SUBGINGIVAL IRRIGATIONS WITH POVIDONE-IODINE AS ADJUNCTIVE TREATMENT OF CHRONIC PERIODONTITIS
Kamen Kotsilkov, Denislav Emilov, Christina Popova
Department of Periodontology, Faculty of Dental Medicine, Medical University of Sofia, Bulgaria
Summary: BACKGROUND: Successful prevention and treatment of periodontitis is contingent upon effective control of the periodontopathic microbiota. Periodontal pathogens reside in deep subgingival sites but also colonize supragingival plaque, tongue dorsum and other oral sites. Antimicrobial agents administered systemically or locally can help suppress periodontal pathogens in periodontal sites and in the entire mouth.
MATERIALS AND METODS: Thirty patients with generalized severe chronic periodontitis with 567 periodontal pockets e”5mm were included in the presented study. The mechanical periodontal treatment was performed with ultrasonic device P5 Newtron in four visits. Subgingival irrigation of the periodontal pockets in the right two quadrants (split-mouth study) were performed with 10% povidone-iodine solutions. Full mouth periodontal status evaluation was recorded again on the last visit.
RESULTS: The results from this study show significant improvement of the clinical parameters of periodontitis in all treated patients and in almost all periodontal sites. In the regions treated with subgingival irrigation with 10% povidone-iodine solution superior reduction of the probing depth, more attachment gain and better reduction of the gingival inflammation were recorded in comparison with regions treated with SRP only.
CONCLUSION: This study demonstrates positive effect of the subgingival irrigations with 10% povidone-iodine in cases of severe chronic periodontitis. This results are rationale for future studies on the effectiveness of the iodophore solutions in the treatment of the disease and on the clinical significance of the investigated treatment.
Key words: chronic periodontitis, adjunctive antimicrobial therapy, povidone-iodine.
/Page 84-88/ < back > Published online - Oct. 8, 2009,
MICROBIOLOGICAL DIAGNOSIS OF THE SEVERE CHRONIC PERIODONTITIS
L. Boyanova, L. Setchanova, G. Gergova, T. Kostyanev, D. Yordanov, Christina Popova*, Kamen Kotsilkov*, I. Mitov
Department of Medical Microbiology, *Department of Periodontology, Faculty of Dental Medicine,
Medical University of Sofia, Bulgaria
Abstract: In total, 14 adult patients with severe chronic periodontitis were evaluated for the presence of associated anaerobic and aerobic bacteria. Subgingival plaque specimens from three pocket depths per patient were obtained. Microaerophilic and facultative anaerobic bacteria, probably involved in the periodontitis, were isolated in six (42.9%) patients. These were Gram negative species involving Aggregatibacter (Haemophilus) aphrophilus (14.3%), Haemophilus parainfluenzae (7.1%), Kingella denitrificans (7.1%) and Moraxella osloensis (7.1%) as well as Gram-positive species, including Arcanobacterium (Actinomyces) pyogenes (7.1%) and Rhodococcus equi (7.1%). Anaerobic microbiology was completed for 12 patients. Of them, suspected periodontopathogens were isolated in seven (58.3%) patients and comprised Prevotella intermedia (in 41.7% of the patients) and Porphyromonas gingivalis (25%) as well as Porphyromonas endodontalis (8.3%). Tannerella forsythia was detected by PCR in half of the 12 cases. In conclusion, the presence of periodontopathogens as well as other bacterial species of possible importance should be considered in the patients with severe chronic periodontitis.
Key words: periodontitis, microbiological diagnosis, periodontal pathogens, subgingival plaque, Susceptibility testing .
/Page 89-94/ < back > Published online - Oct. 8, 2009,
EFFECTIVENESS OF THE TARGET ANTIBIOTIC ADMINISTRATION IN THE TREATMENT OF THE SEVERE CHRONIC PERIODONTITIS PART I – MICROBIOLOGICAL EVALUATION
Kamen Kotsilkov*, Christina Popova*, L. Boyanova**, L. Setchanova**, G. Gergova**, T. Kostyanev**, D. Yordanov**, I. Mitov, V. Dosseva*
* Department of Periodontology, Faculty of Dental Medicine, ** Department of Microbiology, Faculty of Medicine, Medical University of Sofia, Bulgaria
Abstract: INTRODUCTION: The microbial etiology of inflammatory periodontal diseases provides the rationale for the use of antimicrobial medication in periodontal therapy. Scaling and root planning (SRP) is generally the first treatment employed for periodontitis. Antibiotics may be prescribed for periodontal patients who do not respond to conventional mechanical therapy, for patients with acute periodontal infections associated with systemic manifestations, for prophylaxis in medically compromised patients, and as an adjunct to surgical and non-surgical periodontal therapy.
AIM: The objects of the study are:
1. To determine the value of the microbiological diagnosis with culturing method in the treatment planning of the periodontal diseases.
2. To evaluate the importance of the susceptibility testing for the target antimicrobial treatment of periodontitis.
3. To evaluate the effectiveness of the adjunctive target antimicrobial administration in periodontitis cases.
MATERIALS AND METHODS: A total of 17 patients with aggressive or severe chronic periodontitis were included in this study. All patients must have at least 15 teeth and 4 periodontal sites with PD>4mm in different quadrants of the dentition. Microbiological samples were taken from the periodontal pockets using paper points. The samples were taken from tree categories periodontal sites with PD 3-5mm, 5-7mm and >7mm. All samples were analyzed with culture method. Selected colonies from the patients from the test groups were tested for antimicrobial susceptibility.
A standardized oral hygiene motivation program was applied to all patients. The Full Mouth Treatment approach was selected for therapy of the patients. Amoxicillin 500mg and Metronidazole 250mg tid for 10 days were administrated on the control group. The patients from the test group received antimicrobial treatment according to the results from the susceptibility analysis. Clinical, radiograph and microbiological evaluations are done again after 3 months.
RESULTS: The results from the microbiological analysis are presented in schemes.
CONCLUSION: The indiscriminate use of antimicrobials could be influencing the appearance of resistant strains associated with periodontal diseases in the population. That’s why the use of antibiotics must be based on susceptibility testing, instead of a unique protocol of adjunctive antimicrobial regimen.
Key words: periodontal disease, microbiological analysis, antimicrobial therapy, antimicrobial susceptibility .
/Page 95-101/ < back > Published online - Oct. 8, 2009,
Vital pulpotomy in primary teeth with mineral trioxide aggregate (MTA)
Kabaktchieva R., Gateva N.
Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia, Bulgaria
SUMMARY: Mortal pulpotomy is the most commonly used technique in Bulgaria for treatment of pulp chronic infections in primary teeth. Data from the special literature reveal another method for pulp treatment in primary teeth – vital pulpotomy associated with good adaptive healing response. During the past several years, special attention has been paid to Mineral Trioxide Aggregate -MTA as probable alternative of formocresol. According to the current trends in dental medicine about cessation of arsenic usage and limitation on formalin – containing medicaments usage, there will be a revision of commonly used method of mortal amputation, including application of arsenic, tricresolformalin, resorcine or resorcine –formalin solutions.
The aims of this study are to aprobate and popularize the technique of vital pulpotomy in primary teeth with MTA.
The study was carried out with children (the children’s age was 4 – 8 years) with primary molars approximately equally affected by a carious process which had reached the dental pulp and had to be treated. The total number of studied primary teeth was 33.
The methodology is “one visit” and was performed following equal clinical protocol for all teeth. The pulp stump was covered with an MTA paste- Angelus (Solucoes Odontologicas, Londrina, Brazil), prepared by mixing MTA powder with sterile saline using 3:1 powder/saline ratio. Restoration of the teeth was performed with GIC. All treated teeth were follow-up clinically and radiographically during 6 months, at 6 and 12 month after vital pulpotomy.
Results: The success rate of all pulpotomized teeth with MTA was 100 % after 6 months and shows statistically insignificant decrease to 90, 9% after 12 months (p>0, 05). The number of teeth with unsuccessful treatment is 3 or 9, 1 %.
Conclusion: Vital amputation with MTA is a reliable biological method for pulp treatment of primary teeth and could be recommended for the clinical practice.
(Page 102-108) < back > Published online - Nov. 3, 2009,
USE OF VALERIAN DRUG PREPARATIONS IN DENTAL PRACTICE
Donka Kirova, Hristina Lalabonova.
Department of Oral surgery, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
SUMMARY: A Valerian is a popular drug among the population. It can be use against anxiety, fear and intension. Our purpose was tu study to what a degree it is included in the practice of the doctors of dental medicine against the stress from the dental treatment. A direct anonymous group inquiry among 296 doctors of dental medicine in the whole country was carried out. From the received information we established that 77,7% from the investigated doctors have positive attitude toward applyng valerian and its derivates in affecting the stress from the dental treatment. The most of dem report on decrease of anxiety by the pacients, others - on hypotensive effect and some of them-on lack of effect.
Key words: valeriana, anxiety, dental practice
(Page 109-112) < back > Published online - Feb. 18, 2010,
Last edition: February 18, 2010