Scripta Scientifica Medicinae Dentalis

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Authors: Stefan Peev, Elitsa Sabeva, Angela Gusiyska, Tihomir Georgiev, Tsvetan Tonchev

INTRODUCTION: The aim of this study was to assess the reduced length implants as an alternative of conventional length implants in combination with bone augmentation. The following criteria were observed: survival rate, marginal bone loss, bleeding on probing. MATERIAL AND METHODS: This study included 186 Straumann Standard Plus implants with dimensions: length of 6 mm and diameter of 4.8 mm. The implants were loaded with non-removable crowns or bridges at least 10 weeks after the implant placement. Depending on the type of the prosthetic option the distribution of the implants was as follows: 83 implants were co-abutments to one more implant with conventional length (8-14 mm); 67 implants were co-abutments to more than one implant with conventional length, 33 implants were loaded with single crowns. RESULTS: The mean period of observation was 5.59 years. The mean marginal bone resorption was 0,224mm. In 12.4% from the cases was registered BOP (bleeding on probing). A correlation was found between the BOP and mean marginal bone resorption. No correlation was found between the values of marginal bone resorption and the type of the prosthetics. The survival rate of the implants in the observation period was 99.5%. CONCLUSION: Тreatment by short implants is a reliable alternative to implants with conventional length with combination of bone grafting procedures. It is less invasive, cost effective and consumes less treatment time.

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Authors: Stefan Peev, Borislav Ivanov, Elitsa Sabeva, Tihomir Georgiev

Introduction: The aim of this investigation was to evaluate the 5-year outcomes regarding presence of intraoperative and postoperative complications and the survival rate of implants placed simultaneously with lower alveolar nerve lateralization or transposition. Material and Methods: implants placement was performed on 34 patients with advanced atrophy of the posterior mandible simultaneously with lower alveolar nerve lateralization or transposition. Transposition was done only in two cases; in the rest of the cases lateralization of lower alveolar nerve was performed. Results: The survival rate at the end of the fifth year after implant placement was 100%. The mean height of residual bone at the region of implant placement was 2.76 mm. The mean marginal bone resorption for at the fifth year was 0.309 mm. In 20.6% of cases a positive BOP (bleeding on probing) was registered. 14.7% of the patients were free of symptoms of NSD (neuro-sensory dysfunction). In the rest of the patients the mean duration of NSD was 2.06 weeks. In 76.4% of patients the symptoms of NSD of nervus alveolaris inf. resolved after the second week. The maximum period of reported NSD was 6 weeks. No permanent NSD occurred. Conclusion: Properly performed lateralization or transposition of the lower alveolar nerve is associated with minimal risk of permanent neuro-sensory dysfunction and providing an opportunity for placement of intraosseal implants in the posterior mandible with high survival rate.

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Authors: Vassil Svechtarov, Savina Nencheva-Svechtarova, Tsvetan Tonchev, Krassimira Prodanova

Introduction: The aim of this study is to evaluate the distribution of the most common etiological factors responsible for the development of chronic temporomandibular disorders, and to test the pain – relief effectiveness of combined gallium-aluminum-arsenide laser (GaAlAs; 785 nm) and superluminiscent diods (SLD; 633 nm) phototherapy (MedX 1100 device) for most common tension and compression pain-related diagnostic subgroups of chronic temporomandibular disorders. Material and methods: This study includes 62 patients - 7 men and 55 women, aged between 21-74 years with clinical signs and symptoms of chronic temporomandibular joint and myofascial pain. Using DC/TMD instruments the most common causative factors were identified, and part of the TMDs assessed were classified to tension and compression related diagnostic subgroups. Trigger point oriented combination of laser (MedX 1100 console with three GaAlAs laser diodes, 785 nm, 3x33 mW, 100 s, 8 J/cm 2 per spot) and SLD red light sessions (633 nm, 200 mW, 300 s, 8 J/cm 2 per spot) was applied for temporomandibular joints and affected muscles. Results and conclusion: Using descriptive analysis and paired samples Student’s t-test, the most statistically manifested pain reduction is found for Arthralgia attributed to Tension-related TMDs (Subluxations, Dislocations, Sprain and strain of joints, ligaments and TMJ – related structures, Flexion-extension injuries; р=0,000001), followed by Myalgia for the same disorders (р=0,000014), followed by Arthralgia attributed to Compression-related TMDs (bruxism, psychosomatic parafunctions, occlusal microtrauma, dentofacial anomalies and malocclusions, р=0,000037), and Myalgia attributed to the same TMDs (р=0,000808). This study shows that combined phototherapy provides statistically significant reduction of pain symptoms for the most common temporomandibular disorders, and that Arthralgia and Myalgia attributed to tension-related disorders are better influenced by combined phototherapy than compression-related ones.

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Authors: Iveta Katreva, Metodi Abadjiev, Simeon Simeonov, Ognjan Tivchev, Maya Doychinova, Tsvetan Tonchev

Purpose: The purpose of this study is to observe, compare and evaluate the effect of two α-adrenomimetic decongestants which are clinically approved nasal and eye drops – 0.05% xylometazoline hydrochloride and 0.05% tetrahydrozoline hydrochloride, when applied as chemical agents for chemo-mechanical retraction of free gingiva prior to impression making in fixed prosthodontics. Materials and methods: The study includes 90 prepared abutment teeth indicated for fixed prosthodontic treatment. α-adrenomimetic decongestants in the composition of 2 approved for clinical usage nasal and eye drops commercial products were applied as chemical agents for gingival retraction – Xylometazoline (0.05% xylometazoline hydrochloride) and Visine (0.05% tetrahydrozoline hydrochloride). Ultrapak retraction cord of four different sizes impregnated with the investigated chemical agents was used. Two steps twolayered impressions with polyvinyl and polydimethylsiloxane were taken from the prosthetic fields. Impression sections were fabricated and studied under microscope. Results: The low viscosity polyvinyl and polydimethyl siloxane layers tend to penetrate deeper in the gingival groove after chemo-mechanical retraction with Xylometazoline compared to the second group impressions fabricated after Visine retraction. Conclusion: The conducted testing demonstrated that effective retraction of the free marginal gingiva is possible to obtain with α-adernomimetic decongestants. 0.05% xylometazoline hydrochloride (Xylometazoline) provides better results in comparison to the eye decongestant drops 0.05% tеtrahydrozoline hydrochloride (Visine).

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Authors: Elitsa Deliverska, Assya Krasteva

Epidermolysis bullosa (EB) represents a rare chronic autoimmune subepidermal vesiculobullous disorder that affects the skin and mucosa and is characterized by blistering and mechanical fragility of the skin. The most recent classification recognizes four major EB groups: intraepidermal EB (Simplex), junctional EB, dermolytic EB (Dystrophic), and mixed EB (Kindler syndrome). Kindler syndrome is a rare genodermatosis with clinical features of trauma-induced blistering, poikiloderma, skin atrophy, mucosal inflammation and varying degrees of photosensitivity. Although Kindler syndrome is classified as a subtype of epidermolysis bullosa, it has distinct clinicopathological and molecular abnormalities. The clinical features of the syndrome have been annotated by different authors but definite criteria to confirm the diagnosis have not yet been generally accepted.

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Authors: Assya Zaharieva Krasteva

INTRODUCTION: Sturge-Weber syndrome is a rather uncommon congenital condition that occurs sporadically, characterized by the combination of ipsilateral angiomatous lesions of the face, oral soft tissues, and jaws with venous angioma of the leptomeninges over the cerebral cortex. However, the main clinical features of this syndrome are facial vascular cutaneous naevus, usually unilateral, which often follows the outline distribution of the trigeminal nerve. MATERIAL AND METHODS: We report two cases of 7-year-old and 11-year-old girls with diagnosis Sturge-Weber syndrome, emphasizing the oral and extraoral manifestation related to the syndrome. The patients were presented with a cutaneous vascular nevus on the face during early childhood as well as epileptic crisis episodes, with no ophthalmic alterations. CONCLUSION: Sturge-Weber syndrome commonly affects the oral cavity therefore, it is important for the dentists’ knowledge in order to provide an adequate dental management without complications.

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Authors: Tsvetelina Borisova-Papancheva, Vladimir Panov, Stefan Peev, Georgi Papanchev

The aim of this study is to describe different root-end filling materials according to the literature and to compare their antibacterial activity, sealing ability, biocompatibility and microleakage. The purpose of a root-end filling is to establish a seal between the root canal space and the periapical tissues. A number of materials have been suggested for use as root-end fillings, including gutta-percha, amalgam, Cavit, intermediate restorative material (IRM), super EBA, glass ionomers, composite resins, carboxylate cements, zync phosphate cements, zinc oxide-eugenol cements and mineral trioxide aggregate (MTA).

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Authors: Georgi Papanchev, Tihomir Georgiev, Stefan Peev, Hristina Arnautska, Nedyalka Zgurova, Tsvetelina Borisova-Papancheva, Elitza Dzhongova

Maxillary sinus floor augmentation has been used for occlusal rehabilitation with prosthetic appliances installed over dental implants in the posterior maxilla despite the fact that this region often presents loss of alveolar bone and increased maxillary sinus pneumatization, particularly when all of the molars are absent. The shortage and quality of the remaining bone often implies a challenge when rehabilitating with dental implants. Different kinds of grafts have been used in an endeavour to solve these problems. The aim of this study is to find out if there is a significant difference in the bone formation between the 6th- and the 9th - month periods after sinus lift grafting with a calcium- phosphate paste (Maxresorb inj. (Botiss Dental, Berlin, Germany)). For this purpose а bilateral sinus lift has been made by own methodology. Results showed no significant difference in the percentage of newly formed bone in the sixth and the ninth month, which warrants the dental implants to be placed on the sixth month post-sinus lifting.