Scripta Scientifica Medicinae Dentalis

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Authors: Deyan Neychev, Ivan Chenchev, Dimitar Atanasov

AIM: To assess the incidence of mandibular second molar impaction and the treatment methods for this condition. MATERIALS AND METHODS: A retrospective review of the cases of patients diagnosed with impaction of mandibular molars at the Department of Oral Surgery of the Faculty of Dental Medicine - Plovdiv during the past 11 years was performed. RESULTS: 962 patients with impaction of mandibular molars were operated on in the analyzed period. This diagnosis is relatively rare in second mandibular molars and represents 0.94% of all cases. Most often, diagnosis is based on clinical evidence of missing molars and on panoramic radiographs. In the cases described by us, only surgical treatment was used. CONCLUSION: The treatment of this condition is a challenge which requires an individual approach to each case and an аssessment to determine what treatment approach is to be used - surgical or orthodontic.

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Authors: Elitsa Sabeva, Stefan Peev, Mariya Miteva, Milena Georgieva

The aim of this literature data review was to investigate the influence of the bone density, bone volume, cortical bone thickness and the anatomical area on the primary stability of dental implants. Understanding the effect of the bone quality could help us predict the primary stability and prevent to some extent the poor implant stability by choosing implants of different design, diameter, length or surface modification. Considering the reviewed articles, we have concluded that inserting implants in dense bone of higher quality with thick cortical portion, as well as implant placement in lower jaw could lead to higher primary stability of those implants. To enhance the primary stability in bone of poor quality we suggest the use of implants with such characteristics of the design or dimensions, which are proven to influence the primary stability of the implant in a positive way.

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Authors: Maya Doychinova, Vesselin Kussovski, Slavcho Dimitrov

AIM: The aim of this study is to evaluate and compare the in vitro antimicrobial effect of 2 photosensitizers: FotoSan®medium and ZnPcMe on a biofilm isolate of clinical strain of Streptococci species. MATERIALS AND METHODS: Twelve patients were instructed to stop using any kind of oral hygiene care for 24 hours. Plaque was collected with sterile dental floss, placed in vial containing 3ml of BFS. Tenfold dilution of the suspension was made. Samples of 0.1ml were plated on Mitis Salivarius agar. Bacteria were Gram-stained as well and underwent morphological identification. A bacterial suspension at a density of 106 cells/ml was used. An incubation mixture of 1 ml bacterial suspension (106 CFU/ml) and the corresponding photosensitizer were prepared, achieving a different final concentration of PS. LED light source with a wavelength of 643 nm was used for irradiation. Samples and controls for each tested PS after 24h incubation at 37ºC were reported. RESULTS: The control samples in dark showed a minor antimicrobial effect. Samples of bacterial suspension + PS + light irradiation expressed statistically relevant antibacterial effect on Streptococci species with small differences in the different concentrations and irradiation time used. CONCLUSION: The clinical strain of Streptococci species was susceptible to photodynamic inactivation by the used photosensitizers: FotoSan®medium and ZnPcMe. Full photoinactivation was not observed. Dark toxicity was to be neglected. ZnPcMe should undergo further trials and given the positive photodynamic effect in vitro, be licensed for clinical use. FotoSan®medium should undergo further in vivo and in vitro experiments in order to establish an alternative protocol for caries prevention.

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Authors: Polina Asenova Velcheva, Metodi Zahariev Abadzhiev, Plamen Mihailov Nenkov

INTRODUCTION: The shape of deciduous and permanent teeth can differ morphologically from that which is considered normal, partially or entirely. The variations in tooth shape can be hereditary or caused by a disease or trauma. Gemination, for example, means that two separate morphological units were created by division of the tooth germ. This is an extremely rare condition with a prevalence of 0.2 - 0.5%. AIM: A patient with symptomatic apical periodontitis of a previous endodontically treated tooth 21 was complaining of swelling and pain in the frontal area of maxilla. The basic features and specific appearance of geminated teeth were present - an enlarged mesio-distal diameter of the tooth crown, a groove on the incisal edge, a shallow or deeper groove on the vestibular and oral surface, which divides the tooth into two, usually unequal parts. MATERIALS AND METHODS: Isolation of the tooth was made by OpraDam (Ivoclar Vivadent). For the mechanical debridement of this complex root canal system, we used H-files and rotary files Pro Taper Next till X3 file. Cleaning was done by passive ultrasonic activation and photon-induced photoacoustic streaming by Er-YAG laser of 5.25% NaOCl, 16% EDTA and 2% XX. After double application of Ca(OH)2 as an intracanal medicament for at least 1 week, the sinus track and symptoms were gone. The obturation technique was warm vertical condensation with System B and Obtura(SybronEndo). CONCLUSION: Dentes geminati are extremely rare and difficult to treat endodontically but after proper cleaning, shaping and obturation of this complex root canal system with 2 main root canals with huge isthmus between them and lateral canals we can expect healing.

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Authors: Silviya Dimitrova, Nadia Bibova

The main part of dentists’ work is associated with the operative treatment of dental caries, aiming at the stabilization of the process and restoration of the natural anatomy and function of the teeth with artificial materials. With the emergence of restorative dental medicine came the questions related to the survival rate of the restorations, the reasons for their replacement and the possibilities for control and management of the factors, leading to activation and progression of the carious process. The aim of the literature overview is to study the most common reasons, leading to a decrease of the survival rate of different restorations within the conditions of the mouth cavity. It analyzes factors with direct and indirect importance for the development of secondary caries and the longevity of obturations, such as polymerization shrinkage, accumulation of dental biofilm, micropermeability, marginal adaptation, microgap, etc.

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Authors: Antoniya Pomakova, Nataliya Gateva, Nina Milcheva

INTRODUCTION: The role of simple carbohydrates as a major etiological factor for the carious process is well known. Studies have shown that frequent use of conventional sugar containing medications increases the risk for oral health. Today, a significant proportion of the population chooses alternative medicine and particularly homeopathy for treatment and prophylaxis, considering it effective and safe. However, its influence on oral conditions and its involvement as a risk factor for oral health still remains an under-discussed topic. MATERIALS AND METHODS: The study included 18 volunteer students in dental medicine. An in vitro saliva test with colored strips was used for four consecutive weeks and after intake of three commonly used homeopathic medications. The following entries were registered: baseline value, 15th, 30th and 60th minute following the intake of the respective homeopathic doses. During the first week, the study was carried out without intake of any homeopathic medicine. The data was subjected to statistical analysis. RESULTS: There was a fall in saliva pH following intake of homeopathic medications in all studied patients. The рH reduction was most significant at the 15th minute, and the average drop for the three homeopathic medications was - 0.68, 0.94, 1.07, respectively. On the 30th and 60th minute, the mean pH drop remained the highest for the third drug. CONCLUSION: There was a decrease in saliva pH in all individuals after administration of each medication. In a significant part of the cases the drop was below the critical value of 5.5. The values remained lower than the baseline even an hour following the intake.