Evaluation of Periodontal Changes in Patients Before, During, and After a Fixed Orthodontic Therapy

Background:

Periodontal complications are one of the common side effects associated with orthodontic therapy.

Objective:

This study aimed to evaluate the periodontal changes in patients before, during, and after the therapy with a fixed orthodontic appliance.

Methods:

Out of 38 healthy adolescents with permanent dentition who were indicated for fixed orthodontic therapy were included in this study. Patients were selected from Class I, treated by non-extraction methods, by using conventional orthodontic braces. After their examination and treatment by an orthodontist, the patients were referred to the periodontist before the placement of a fixed orthodontic appliance. The patients underwent the application of a periodontal anamnestic-diagnostic protocol, and the clinical-radiological evaluation. After a fixed orthodontic appliance was placed, the respondents were referred to the periodontist for regular mandatory check-ups, initially, after three months, and later on-after 6 months, after 1 year and after 2 years until the end of orthodontic therapy.

Results:

An increase in the mean value of the Plaque Index and Sulcus Bleeding Index was found at each check-up after the placement of a fixed orthodontic appliance. There is a statistically significant difference in the presence of gingival hyperplasia found by monitoring the changes after three and six months, and after one and two years following the start of orthodontic therapy.

Conclusion:

The assessment of periodontal changes in patients before, during and after the completion of fixed orthodontic therapy revealed that there is a strong need for mutual and close cooperation between orthodontist and periodontist during orthodontic therapy.

Comparative Evaluation of the Effects of Diode Laser and Desensitizing Agents on the Treatment of Dentin Hypersensitivity: a Clinical Study

Background:

Dentine hypersensitivity (DH) is a frequent clinical problem that represents a long-term painful discomfort for the patients, and for the dentists, it represents a diagnostic and therapeutic challenge.

Objective:

The aim of the research is to verify the effect of the treatment with diode laser SiroLaser Blue (660nm) of DH alone or in combination with different impregnating agents.

Methods:

Fifty patients were included in this research, separated into five groups. All the patients have been asked to define the level of dentine hypersensitivity using VAS (0-10). The first group was treated with Fluor Protector, the second group after the application of Fluor Protector has undergone irradiation with SiroLaser Blue (660nm), the third group was treated with impregnating agent Vivasens, the fourth group, after the application of impregnating agent Vivasens, has had SiroLaser Blue (660nm) irradiation. The fifth group has just been treated with SiroLaser Blue (660nm). The efficiency of the treatment was checked using VAS for every group immediately after the conducted treatment, after 7 days and 1 month.

Results:

Our results showed that all of the desensitizing agents used in the research alone or in combination with a diode laser (660nm) have shown a reduction of DH. The difference has been proven statistically significant in mean values by groups and examinations. Vivasens and diode laser irradiation have provided the best results in the review of mean values after the first examination and one month after the treatment of DH (p<0,05). In our research, the application of diode laser alone has not proven superior to other treatment methods that have been used in the research.

Conclusion:

Vivasens plus diode laser irradiation has provided the best results even after one month since the treatment of DH.

The Effects of Smoking "The Hookah" on the Oral Health of Fourth, Fifth and Sixth-year Students of the Faculty of Dentistry in Sarajevo

Introduction:

Cigarette or hookah smoking, as well as alcohol consumption and abuse, are considered to be the most common etiological factors for the onset of oral cavity diseases, such as changes on the lips, tongue, stomatopyrosis, glossopyrosis, candidiasis.

Aim:

Research aims to determine the harmful effect of smoking the hookah as well as other harmful factors on the oral health of the student population of the Faculty of Dentistry in Sarajevo.

Methods:

The fourth, fifth, and sixth-year students of the Faculty of Dentistry in Sarajevo participated in this cross-sectional study. All of them are systemically healthy and consume some harmful habits: smoking cigarettes, alcohol consumption, and hookah. All students participated in the study voluntarily and they signed informed consent before the clinical examination. All the subjects gave an extensive medical history which recorded all the data on oral hygiene, harmful habits, manner and length of consumption; they were also given a clinical examination of the oral mucosa and the periodontium, as well as determining periodontal indices, and oral tests that are used for diagnostic purposes. The data is entered into work charts specially designed for these purposes.

Results:

The results are statistically processed in the SPSS Statistics 21.0 program and are discussed along with the results of other authors, published in relevant databases.

Conclusion:

The conclusion consists of important facts that originate from the results and the discussion.

Evaluation of Efficacy of Surgical Periodontal Therapy with the Use of Bone Graft in the Treatment of Periodontal Intrabony Defects

INTRODUCTION

One of the most important goals of periodontitis therapy is the elimination of deep periodontal pockets. In regenerative periodontal therapy, different types of bone grafts, membranes, growth factors, etc. are used to improve regeneration of lost periodontal tissue. The aim of this study was to evaluate the effect of surgical therapy supported by the use of bone replacement material in the treatment of deep intrabony pockets, compared to surgical treatment (flap surgery) without the use of bone replacement in advanced periodontitis.

METHODS AND MATERIALS

The study included 50 patients of both sexes with advanced periodontitis, divided into two groups. After initial periodontal therapy was performed, plaque index (PI), papillary bleeding index (PBI) were verified, and depth of periodontal pockets was measured in both groups. One group (group 1) of the patients underwent surgical therapy, open flap surgery, while the other group (group 2) underwent the same surgical treatment method (open flap surgery), during which bone defects were filled with bone replacement material.

RESULTS

The results showed that both group 1 and group 2 experienced improvements after periodontal surgical therapy. In group 1, there are no statistically significant changes in all three plaque index measurements (PI), while there has been a significant reduction in PI in group 2 following the surgery. For the PBI index, it was determined that there were statistically significant changes in values in group 1, both after surgical procedures and six months later, as well as in group 2. Statistical analysis of the results of the probing depth of pockets has shown that there are significant changes in the measurement of the depth of periodontal pocket one month after the surgery, as well as six months later, meaning that there has been a significant reduction in the depth of the periodontal pocket one month following the surgery as well as six months later, for both groups. However, we did not determine a statistically significant difference in the probing depth of pockets between these two groups.

CONCLUSION

Six months after a surgical therapy, clinical parameters showed a reduction of the probing depth of the periodontal pocket in both examined groups. The use of bone replacement did not yield significantly better results in reducing the depth of probing compared to the standard flap surgery. We believe that future research should focus on testing the effectiveness of new regenerative methods and materials (bone replacements with various properties, membranes, and surgical methods) that will result in better treatment results with predictable outcomes.

Importance of Early Detection of Potentially Malignant Lesions in the Prevention of Oral Cancer

Objective:

The aim of this study was to assess the importance of early diagnosis of potentially malignant lesions in the prevention of oral cancer.

Material and methods:

In order to achieve the set objectives, we selected our participant pool. Of the 340 patients who came to the initial examination at the Clinic for Oral Medicine and Periodontology, we selected 40 patients with potentially malignant oral lesions (PMOL) of both sexes and of different ages. After an extensive anamnesis and a clinical examination of all mucous membranes, we documented potentially malignant lesions, their localization, subjective and objective symptoms, duration of pathological lesion, and bad habits (smoking and alcohol). All lesions were colored with Toluidine blue, which indicates malignancy in 75% of cases. Patients who had a positive Toluidine blue staining test were sent to biopsy and pathohistological analysis.

Results:

The most common potentially malignant lesions are Lichen reticularis (25%), Lichen erosivus (20%), and Leukoplakia (15%). The most common localization of lesions is the buccal mucosa bilaterally (26%), buccal mucosa unilaterally (10%), and the lower lip (10%). The staining test with Toluidine blue was positive at 23% PMOLs. In patients with positive Toluidine staining findings, biopsy and pathohistological analysis were performed, which showed that 20% of all lesions are carcinoma (CIS, Baseocellular Carcinoma, Squamocellular Carcinoma), while 14% are mucosal epithelial dysplasia. Statistical analysis confirmed the significance of positive staining of Toluidine blue and Leukoplakia (Spearman’s coefficient = 0.427, p = 0.006, N = 40), and statistically significant positive association of Squamocellular Carcinoma and Toluidine blue staining (Spearman’s coefficient = 0.619, p = 0.000, N = 40).

Conclusion:

Most oral cancers are caused by potentially malignant lesions, which is why a very detailed clinical examination with the visualization of pathological lesions is very important. Toluidine blue test can be an auxiliary tool for clinical diagnosis but does not replace the pathohistological finding. Biopsy and pathohistological findings are the gold standard in the diagnosis of oral cancers, as confirmed in our research.

Application of Diode Laser in the Treatment of Dentine Hypersensitivity

INTRODUCTION

Dentine hypersensitivity is characterized by acute, sharp pain arising from the exposed dentine, most commonly in response to thermal, tactile, or chemical stimuli, and which cannot be linked to any other pathological changes in the tooth or the environment. Therapy uses various impregnating agents in the form of solutions or gels and, in more recent times, laser.

AIM

The aim of this research was to examine the effects of treatment of hypersensitive dental cervix with diode laser.

MATERIALS AND METHODS

The study included 18 patients with 82 sensitive teeth. The degree of dentine hypersensitivity was evaluated by visual analogue scale (VAS), and the treatment was carried out by application of low-power diode laser over the span of three visits, which depended on the initial sensitivity.

RESULTS

There is a significant difference in VAS values measured at the onset of treatment (baseline) and immediately after the first laser treatment (t=9.275; p=0.000), after 7 days, after the second laser treatment (14 days) (t=7.085, p=0.000), as well as after 14 days and the third laser treatment (t=5.517, p=0.000), which confirms the effectiveness of this therapeutic procedure. The results showed a reduction of hypersensitivity in response to tactile stimulus with a probe after the third treatment, even with teeth whose value on the VAS was very high at the beginning of treatment (baseline).

CONCLUSION

Within the scope of the conducted study, laser therapy has provided extremely safe and effective results in the treatment of cervical dentine hypersensitivity.

Laser treatment of oral mucosa tattoo

The most common oral solitary pigmented lesion is the dental amalgam tattoo. It occurs as a result of colouring of the tissue by alien pigment which was administered intra or subepidermaly either intentionally or accidentally. The most common material used for the colouring of the oral mucosa is amalgam from amalgam fillings and metal particles from prosthetic restorations which are absorbed accidentally. The oral mucosa tattoos are most often found in the area of the marginal gingiva or the buccal mucosa. The metal particles may accidentally reach the area of the oral mucosa during various dentistry interventions. The therapy most often involves surgical intervention with excisional biopsy while in the recent period the low power laser therapy has provided exceptional results. The aim of the paper was to present the successful removal of the oral mucosa tattoo in a single visit.

Scleroderma--from the aspect of dental medicine

Modern etiopathogenic and diagnostic procedures of oral diseases are founded on molecular biology, genetic engineering, autoimmunity, pathohistological, cytological and immunofluorescence methods. The autoimmune processes may include the humoral and cellular immune responses and all organ systems may be involved. The systematic and orofacial manifestations of the scleroderma with medical and pathohistological documentation indicates to interdisciplinary cooperation in the treatment of such patients. The multidisciplinary approach in patients with scleroderma requires and suggests the most efficient prophylaxis treatment from the aspect of dental medicine. The systematic and orofacial manifestations of the scleroderma with medical and pathohistological documentation indicates to interdisciplinary cooperation in the treatment of such patients. The multidisciplinary approach in patients with scleroderma requires and suggests the most efficient prophylaxis treatment from the aspect of dental medicine.