Mirjana Janosevic

Aspects of Orthodontic-Prosthetic Rehabilitation of Dentofacial Anomalies

Skeletal class III malocclusion is one of the most difficult dentofacial anomalies, characterized by deviation in the development of the mandible and maxilla in the sagittal plane, where the mandible is dominant in relation to the maxilla. In patients with class III malocclusion, anomalies in the dentoalveolar level and esthetic discrepancies are also frequent. The etiology of class III malocclusion is multifactorial due to the interaction of hereditary and environmental factors. Rehabilitation and treatment of malocclusion is one of the major goals of modern dentistry. This article presents the orthodontic-prosthetic therapy and rehabilitation of a 45-year-old patient with an abnormal occlusal vertical dimension and a skeletal class III malocclusion. The patient came to the clinic complaining about degraded esthetics and disordered functions of the orofacial region (functions of eating, swallowing, speech) and also pain in the temporomandibular joint. After the diagnosis was made, the patient was first referred to orthodontic treatment with fixed orthodontic appliances (self-ligating brackets system Rot 0.22). Upon completion of the orthodontic treatment, the patient was sent for further prosthetic treatment. Fixed prosthetic restorations were made in the upper and lower jaw, thus achieving a satisfactory result in terms of esthetics and function of the stomatognathic system.

Nitric oxide as prediction factor of gingival inflammation in orthodontic patients

Background/Aim. Nowadays therapy with fixed orthodontic appliances is widely spread, having in mind positive effects it has in malocclusion treatments The side effect is increased gingivial inflammation in treated patients. The aims of this research are to estimate the inflammatory condition of gingiva in the first 6 months of orthodontic therapy on the basis of clinical parameters of sulcus bleeding index, plaque index, gingival crevicular fluid and salivary nitric oxide concentration, and to investigate role of nitric oxide as predicting factor of gingival inflammation in orthodontic patients. Methods. In this study, 30 patients of the Dental Clinic treated with fixed orthodontic appliances (11 males and 19 females), aged 1522 years, were examined. Clinical parameters were evaluated and gingival crevicular fluid and saliva were collected, before the beginning of orthodontics therapy, and then, three and six months after it. Results. The approximate values of clinical parameters, gingival crevicular fluid and salivary nitric oxide concentration progressively increased. Low statistical significance of correlations among gingival crevicular fluid and salivary nitric oxide concentration and the measured clinical parameters were found. There is a statistically significant correlation between gingival crevicular fluid and salivary nitric oxide concentration. Conclusion. According to the obtained results, we can conclude that gingival crevicular fluid and saliva are reliable mediums for monitoring of the gingival inflammatory condition. More studies are needed to investigate a potential role of nitric oxide as predicting factor of gingival inflammation in orthodontic patients.

Extraction and non-extraction therapy in class II/1 patients

Introduction: Class II malocclusion is characterized by distoclusion and is divided into two divisions depending on the inclination of the upper front teeth. The first division is characterized by protrusion of the upper front teeth. Treatment possibilities of class II/1 malocclusion depend on the skeletal form. Therapy of dentoalveolar types of class II/1 malocclusion is exclusively orthodontic. More emphasized skeletal forms of class II/1 malocclusion may require surgery apart from orthodontic therapy. Casse raport: In this paper, the extraction and nonextraction treatment of 13 years old patients - M.P.(boy) and I.T. (girl) was shown, respectively. The diagnosis was based on clinical and functional intraoral findings, analysis of dental casts, face photos, orthopatomogram and profile x-ray. Nonextraction therapy was suggested for a boy and extraction therapy for a girl, combined with the use of upper and lower fixed appliances. In the treatment, technique of straight arch, Dentaurum brackets, root prescriptions, slot 22 were used. In the male patient, there was a slight maxillary prognathism, mandibular retrognathism, anterior type of growth, protrusion of the upper incisors and retrusion of the lower ones. The body of maxilla was shorter by 4 mm with regard to the cranial base. In the female patient the extraction of the upper first premolars was performed because of maxillary prognathism, mandibular retrognathism, increased length of the body of maxilla, decreased length of the body of maxilla and severe protrusion of the upper frontal teeth. After the treatment, functional occlusion and improvement in facial aesthetics was achieved in both patients. Facial changes were more apparent in the patient who underwent the extraction treatment. After completion of treatment, it is necessary to maintain the obtained results.

Asymmetry in the root development of mandibular permanent molars

The aim of this research was to determine the existence of asymmetry in the root development of the first and second permanent molar at different ages. The research was carried out based on orthopantomographic X-ray images of 523 children ( 253 boys and 270 girls), 6-14 years of age, who were orthodontic patients at the Dental Clinic of Nis. Asymmetry in the root development of the first and second permanent molar was analyzed by means of Gleisers and Hunts method, Tijanics modification (1981). Asymmetric M1 root development is not present in any of the examinees. Asymmetric M2 root development is present in a total of 28 children (5,35 %), in 15 boys (5,93 %) and in 13 girls (4,81%). The difference in the stages of root formation is within the limits of one stage. Asymmetric root development is most often present in 5th and 6th stage, 46,67 % in boys and 38,4 % in girls. The next most prominent stages are 7th and 8th, 33,33 % in boys and 32,14 % in girls. Asymmetry in the root development of the lower, first permanent molar is not present in the examined samples, while asymmetry of the root development of the second lower permanent molar is present in the lower stages of development.