Sanamed

2016; 11(1): 21–27

Authors: Lyapina Maya, Dencheva Maria, Krasteva Assya, Tzekova Mariana, Deliverska Mariela, Kisselova Angelina

Introduction: Occupational allergic contact sensitization is common in dental personnel. Some of the most common occupational allergens in dental practice are some formaldehyde-releasers, formaldehyde and glutaraldehyde. Aim: The aim of the present study was to evaluate the rate of contact sensitization to formaldehyde, quaternium-15, imidazolidinyl urea, diazolidinyl urea, and to glutaraldehyde in students of dental medicine and dental patients. Material and methods: A total of 50 participants were included in the study: 40 students of dental medicine exposed to formaldehyde-releasers, formaldehyde and glutaraldehyde during the course of their education; 10 dental patients without occupational exposure to the latter substances served as a control group. All of them were patch-tested with the studied allergens. Results: The sensitization rate to formaldehyde was significantly higher in the group of dental patients if compared to the one of dental students (χ2=5.37; p=0.021). Positive skin patch test reactions to quaternium-15 and to imidazolidinyl urea were observed only in the group of dental students. A significantly higher rate of sensitization to diazolidinyl urea, if compared to the one to imidazolidinyl urea (χ2=5.4; p=0.02) and to quaternium-15 (χ2=6.76; p=0.009), as well as to glutaraldehyde, if compared to the one to quaternium-15 (χ2=3.96; p=0.04) for the whole studied population was established. For the whole studied population, significantly increased rate of concomitant sensitization to formaldehyde and glutaraldehyde (χ2=6.18 p=0.013), as well as to diazolidinyl urea and to glutaraldehyde was established (χ2=9.12 p=0.003). Conclusions: We consider the importance of exposure to diazolidinyl urea, quaternium-15, imidazolidinyl urea and glutaraldehyde during the course of practical education in dentistry for the onset of sensitization. The exposure to formaldehyde is ubiquitous and is difficult to distinguish the roles of environmental and occupational exposures. The promotion of proper personal protection as well as adequate information on occupational chemical hazards should start as early as during the first years of education in dentistry. Key words: contact sensitization, students of dental medicine, formaldehyde, formaldehyde-releasing preservatives, glutaraldehyde

2016; 11(1): 35–38

Authors: Borislavova Marinova-Takorova Mirela, Anastasova Radostina, Panov Vladimir

Background: Bleaching has gradually became a popular procedure for people searching for aesthetic improvement. The aim of this in vitro study was to investigate the effect of bleaching with 45% carbamide peroxide on the level of mineralization of enamel, using laser fluorescence. Materials and methods: Sixty extracted human teeth were treated with 45% carbamid peroxide (Opalescence, Ultradent), 4 consecutive days for one hour each day. The effect of the bleaching agent on the level of mineralization of enamel was measured with DIAGNO dent pen. The statistical method we use was descriptive analysis. Results: The average values, measured before the applications of the carbamid peroxide were 6.33. On the first day they were 5.41, on the second 5.38, on the third 5.11 and 5.35 on the forth. Conclusion: There was observed a slight remineralization effect due to the incorporated Ca2+ and F- ions in the bleaching agent that we have used. Key words: bleaching, DIAGNO den pent, carbamide peroxide

2016; 11(1): 47–52

Authors: Georgieva Daniela, Poposka Anastasika, Bozinovski Zoran, Samardziski Milan, Dzoleva-Tolevska Roza, Nanceva Jasminka

Introduction: Hallux valgus represents a complex progressive deformity of the front part of the foot, with the most distinguished malformation as lateral deviation of the toe. Radiography is extremely important in the decision of the surgical procedure for the best correction of this deformity. Aim:The aim of this work is to show the significance of radiographic examinations in operated patients with Hallux Valgus deformityaccording to Mitchell and Keller techniques. Material and methods: The study included 70 patients having hallux valgus deformity of the foot, and they were divided to two groups. The patients were grouped according their sex, age, the degree of deformity (moderate or severe degree of deformity) and according to radiographic findings. The first group (Group 1) was composed of 35 patients who were treated by osteotomy of the 1st metatarsal bone according to Mitchell, while the second group (Group 2) was also composed of 35 patients who were treated by resectional arthroplasty according to Keller. Radiographic examinations (Method of Hardy and Clapham, Piggott classification, presence and absence of the secondary arthritic and reactive changes of the first metatarsophalangeal joint) were analyzed comparatively during the evaluation. The analyses of the radiographic results were performed pre-operatively and post-operatively for the two groups. Results: According to their sex, the patients were 5 men and 65 women. The average age of the patients in group 1 was 42 years, while for group 2 it was 56 years. There is no significant difference (p>0.05) in the patients of the two groups concerning the pre-operative mean dimension values of the I metatarsophalangeal angle and 1st intermetatarsal angle. However, the radiographic analysis of the same angles in both groups, one year post-operatively, showed a high statistically significant difference (p<0.001). The patients operated by Mitchell’s technique, according to Piggott classification, have deviation significantly more often on the 1st metatarsophalangeal joint of 51.43% as a result of their hallux valgus deformity. Significantly more often, there is a subluxation of 77.14% on the 1st metatarsophalangeal joint in the patients treated by Keller’s technique. The radiographic analysis of the 1st metatarsophalangeal joint (presence and absence of the secondary arthritic and reactive changes) in both groups, pre-operatively (p<0.01) and one year post-operatively (p<0.001), showed a high statistically significant difference. Conclusion: Radiographic analyses were of enormous benefit as in the choice of the decision on the type of the operative procedure and also for the evaluation of the postoperative results. Key words: radiographic analysis, Mitchell, Keller, hallux valgus

2016; 11(1): 57–6

Authors: Bozinovski Zoran, Jakimova Marija, Georgieva Daniela, Dzoleva-Tolevska Roza, Nanceva Jasmina

The patient TK, 7 years old, had sustained a supracondylar fracture of the left elbow after fall on the left hand with elbow extended. She was admitted in local hospital where the clinical examination and X ray were made and they confirmed the diagnosis of supracondylar fracture of the left elbow (Gartland Type III). She was treated with closed reduction (without anaesthesia) and cast immobilization for four weeks. With poor to no function of the left hand she was send to physical therapy for duration of 10 days, but she did not gain her function of the left hand, almost all active movements of the left hand were impossible and the muscles of the left under arm were hypothonic. Due to loss of left hand function,EMG was made and the EMG result showed acute lesion of the nerves of the left forearm caused by possible nerve compression (n.ulnaris, n.medianus, n. radialis). After four months she was admitted in our Clinic were we perform operation of the left elbow with removing callus formation in which we find entrapped median and ulnar nerves. We also did an osteotomy of the humerus for correction of the angular deformity and fixation with K wire. The patient was put in cast immobilisation after surgery for four weeks. After the removal of the cast and K wire she was sent to intensive rehabilitation. One year after surgery she regain almost all of hand and elbow function with satisfying range of motion. She is now able to fullfil every day function without any help or support.