Predrag 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.

Perioral and sublingual hematoma: Oral anticoagulation therapy complication: Case study

Introduction. Anticoagulation therapy includes drugs which prevent intravascular formation and spreading of a thrombus. Heparin and dicoumarin preparation are in use. Heparin preparations are commonly used when a rapid anticoagulant effect is required, they are administered intravenously, act immediately performing the inhibition of thromboplastin activation, prothrombin to thrombin conversion, and the effect of thrombin to fibrinogen. Oral anticoagulation therapy (OAT) includes drugs - antagonists of vitamin K, which is responsible for the synthesis of prothrombin complex factors - II, VII, IX and X. They are derived from coumarin and indandione. One of the most frequently used drugs from the OAT group is warfarin. It is a competitive inhibitor of vitamin K required for the carboxylation of the residues of PK factor glutamic acid. The results of this inhibition lead to the unsuccessful formation of gama carboxyglutamic acid and the production of functionally inert coagulation proteins. The aim of this study was to show a rare but dangerous complication of an inadequate application of oral anticoagulation therapy. Case study. Patient S.S., male, aged 79, was admitted to the Oral Surgery Department, Clinic of Dentistry of the Faculty of Medicine in Nis on October 5, 2012 due to a severe general condition with massive hematoma in the facial area. Anamnestic data showed that during the previous couple of days, the patient was voluntarily taking a whole tablet of Farin instead of the prescribed dose. The patient started receiving intravenous low-molecular-weight heparin therapy (Fraxarin 0.3/12h) along with the antibiotic therapy. In the following period, the patient reported daily at the Oral Surgery Department for regular check-ups. The hematoma was absorbed and the swelling was completely gone within the next 7 to 10 days.

Asymmetry in development (mineralisation) of permanent mandibular canine roots

Introduction. The development of the teeth is closely associated with the proper and unobstructed physical and psychological development of the child. Aim. To determine the existence of asymmetry in the development of the roots of the lower permanent canine teeth in different age groups of children of both sexes. Material and methods. The study was conducted on 523 ortopantomograms (253 boys and 270 girls) of orthodontic patients aged 6 to 14 years of the Dental Clinic in Nis. We analyzed the development of asymmetry in the lower permanent canine root, using the method of Gleiser and Hunt, or the modification by Tijanic (1981). Results. It was found that asymmetry in the development of the root in both sexes of the lower canine teeth was present in 20 patients (3.82%), 10 boys (3.95%) and 10 girls (3.70%). The difference is in the range of one stage. Asymmetric development of the roots of the lower incisors in girls and boys usually present in the 7th and 8th stages (60% in girls and in 50% in boys). In 90% of girls in developing asymmetry the root of the lower canine is present in a single stage, and in 10% of girls it presents within three stages. Asymmetric development of the root of the lower canine is the most common in the 7th and 8th stages of development (55%). Conclusion. Asymmetric root development of permanent lower canines was found in 3.82% of patients. More than half of respondents (55%) had asymmetrical canine root development stage in half and three quarters of the total root length. The results of this study indicate that the canine is the tooth with very little variations in its development.