Ivica Stancic

Retention of telescopic denture in elderly patients with maximum partially edentulous arch.

UNLABELLED The telescopic denture is one possible solution for prosthetic rehabilitation for a partially dentate arch with few remaining teeth, which is the reason why it is usually considered in elderly patients. The system of double crowns consists of the male component of attachment or patrix, which is cemented to the abutment tooth, and the female component of attachment or matrix, which is the removable part of the restoration. Retention force represents resistance to those forces which tend to separate the partial denture and supporting tissue in the occlusal direction. Its optimal value is 5-9 N per each patrix and it should strictly be between these limits as a stronger or weaker force will endanger the functionality of the denture or damage the supporting tissue of the abutment teeth. OBJECTIVE The goal of this study was to establish the exact value of the individual and total retention force of the completed telescopic system. METHOD The Bredent dynamometer was used for measuring these values. The study involved measuring the individual force of separation of 50 patrix-matrix components, and total force of 20 partial dentures of various designs retained by double crowns made in the Dental Laboratory of the Clinic for Prosthetic Dentistry, Faculty of Stomatology, Belgrade University. The research was carried out in the period from January 2006 to October 2006. RESULTS AND CONCLUSION The results showed different values of separation force - from very low values to those exceeding optimal limits. A reduction in the force of separation is necessary in the case of excessive tightness. If there was looseness between patrix and matrix, the cylindrical components of double crowns need to be lined by a suitable composite material.

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) scale in the elderly population of Bosnia and Herzegovina

OBJECTIVES To adapt the Oral Impacts on Daily Performance (OIDP) index for elderly people in Bosnia and Herzegovina and test its validity, reliability and responsiveness to change. BACKGROUND Clinical measures alone may not be adequate for assessing the oral health of individuals. Subjective oral health indicators tested within a particular cultural context may not be relevant across cultures. MATERIALS AND METHODS The study population comprised 231 free-living adults aged 65 years or older. The OIDP was cross-culturally adapted from English into the Serbian language and its psychometric properties were tested. Data were collected using a clinical examination and a questionnaire containing the OIDP. RESULTS In terms of reliability, Cronbachs alpha coefficient was 0.82 and the intraclass correlation coefficient 0.88. The very high correlation of OIDP with self-rated oral health (r = 0.78) verified criterion validity, while construct validity was demonstrated through its significant and graded associations with other subjective health measures. OIDP change scores on a treated subsample showed moderate effect size (0.59) and were associated with perceptions of oral health change, providing evidence for its responsiveness to change. CONCLUSION The Bosnian version of the OIDP showed satisfactory validity, reliability and responsiveness to change confirming its appropriateness for use among older populations in Bosnia and Herzegovina.

Analysis of the compressive strain below the removable and fixed prosthesis in the posterior mandible using a digital image correlation method

It was the purpose of this study to determine and analyse strains in the bone of posterior mandible below the removable and fixed partial dentures using Digital Image Correlation Method. Dried mandible with shortened dental arch (Kennedy Class 1) was used in the experiment. The mandible model was prepared for accepting two types of restorations for bilaterally missing molars conventional therapy, and removable and fixed partial dentures were manufactured following standard prosthetic protocol. The models with prosthetic restorations placed in situ were subjected to loading of 50–300 N, and photographed using two digital cameras as part of the digital image correlation method equipment. Afterwards, the obtained data for strains within restored mandible during loading ciclus were analysed in the software Aramis and graphically presented. Percentage size of the mandible strains within the line section are from 0.14 to 0.19% for the removable partial denture experimental model and 0–0.14% for the fixed partial denture experimental model. The study has demonstrated that Digital Image Correlation method can be used to measure strain on the mandible surface and replacements during loading and that from biomechanical perspective both therapeutic modalities can be equally useful for the restoration of the mandible with bilaterally distal edentulous spaces.

Adaptability of different canal sealers to the root canal dentin - scanning electron microscopy analysis

Introduction. The aim of this in vitro study was to test and analyze the sealing ability of three endodontic materials used for permanent obturation, in between the dentin walls and the gutta-percha points, using a scanning electron microscope. Material and Methods. Forty-five recently extracted single-root teeth, treated by a step-back technique, were divided into three groups (15 teeth in each); the canals were filled with three different permanent obturation materials: N2 zinc oxide root canal cement, Gutta Flow (Coltene), and Endomethasone N (Septodont). Their sealing ability and adhesive properties were analyzed using field emission gun scanning electron microscope, at the time when they were applied between the dentin walls of the canal and the gutta-percha. Results. The results of the scanning electron microscope analysis have shown that all the three sealers have good adhesion properties when used over the root canal walls in the apical third. Good adaptation of the filling used for the root canal walls in the middle and the cervical third was found only in teeth obturated using Gutta Flow, while samples obturated by N2 zinc oxide root canal cement and Endomethasone showed the weakest adhesion, and greatest number of cracks between the sealer and the canal wall. Conclusion. When using a single-cone obturation technique, compared to other obturation materials, Gutta Flow shows considerably better adaptation to the root canal wall and the guttapercha points in the apical, middle, and the cervical third of the root.

Magnetic Resonance Imaging in Complete Denture Treated Edentulous Patients with Obstructive Sleep Apnea Syndrome-A Preliminary Study

Background: Complex clinical presentation of obstructive sleep apnea syndrome (OSAS) is increasingly present in modern dentistry. In this research, we have been assumed that the reconstruction of optimal vertical dimension of occlusion (VDO) with complete dentures could reduce symptoms of mild to moderate sleep apnea in edentulous patients who have not worn dentures or have used inadequate ones. The aim of this study was to determine how the prosthetic treatment of edentulous patients with OSAS can extend the upper airways, reduce the accompanying day and night symptoms of sleep apnea and reduce the value of apnea-hypopnea index (AHI/h). Methods: The study comprised 9 edentulous patients with OSAS (AHI/h 5.70 to 26.30). The complete dentures with optimal VDO reconstruction were made for all patients. For the purposes of this study, the following were used: Epworth sleepiness scale (ESS) polysomnographic registration (PSG) of AHI/h, the diagnosis of the diameter of the upper respiratory tract by magnetic resonance imaging (MRI) before and 3 months after the prosthetic rehabilitation. Results: Prosthetic treatment of edentulous patients reduces day and night time symptoms of OSAS. Sagittal and axial tomograms of the pharynx in edentulous patients with OSAS before and 3 months after the treatment indicate significant differences in the diameter of the upper airways, which are correlated with reduced AHI/h (49.93%). Conclusion: The complete dentures prosthetic rehabilitation of edentulous patients, with optimal VDO reconstruction, increases the diameter of the upper respiratory tract which is reflected in a significant reduction of OSAS symptoms and AHI/h.

Oral health of institutionalized elderly in Belgrade

Uvod. Povećanje broja starih institucionalizovanih osoba u svetu iziskuje dobru opštu zdravstvenu i stomatološku zaštitu ove grupe ljudi. Cilj rada bio je ispitati nivo oralne higijene, zatim dentalni, parodontalni i protetski status institucionalizovanih osoba starosti preko 65 godina, u tri staračka doma u Beogradu. Materijal i metod. Anketirana je i pregledana 301 osoba. Anketa je obuhvatala sociodemografske podatke, navike u održavanju oralne higijene, subjektivnu procenu opšteg zdravstvenog stanja i stomatoprotetskog statusa. Kliničkim pregledom utvrđen je status zuba i parodontalnih tkiva korištenjem DFMT i CPITN indeksa. Evidentirano je i zdravlje mekih tkiva usta. Postojeće proteze ocenjene su u pogledu retencije, stabilizacije, abradiranosti, higijene i neophodnosti reparature. Rezultati. Od ukupnog broja pregledanih, 16,6% nije održavalo oralnu higijenu. Pomoć u održavanju oralne higijene dobijalo je 2,3% ispitanika, iako je 36,5% bilo zavisno od tuđe nege. Prosečan DMFT iznosio je 26,36. CPITN indeks prosečno je iznosio 2,23. Protetski nije bilo zbrinuto 45,1% pregledanih osoba koje su imale potrebu za protezom. Reparaturu je zahtevalo 55,2% proteza, a higijena proteze bila je loša u 50,0% slučajeva. Od ukupnog broja pregledanih osoba, 11,9% bilo je bezubo i nije imalo totalne proteze. Zaključak. Može se zaključiti da stare institucionalizovane osobe ne dobijaju pomoć u održavanju oralne higijene, iako su u velikom broju zavisne od tuđe nege. Takođe, prisutan je veliki broj nedostajućih zuba i potreba za kompletnom parodontološkom i protetskom terapijom većine osoba. Neophodno je poboljšati stomatološku zdravstvenu zaštitu pacijenata u staračkim domovima. Klјučne reči: oralno zdravlje, stare osobe, institucionalizovani Abstract