[CARIES GENESIS IN THE ERA OF "OMICS"].

The search for an understanding of the genesis of tooth decay spans millennia. Streptococcus mutans have been proposed as the main etiological agents of dental cariessince the species discovery in 1924. However "Omics" era has provided a unique opportunity to unravel contemporary paradigms in the etiology of dental caries. Novel approaches using OMICS techniques has uncovered an extraordinarily diverse ecosystem of carious lesions where S. mutans accounts only a tiny fraction of the bacterial community. This supports the concept that caries has polymicrobial nature that do not follow classical Koch's postulates of infectious diseases and that the microbial causative agents are better described as pathobionts. Understanding the etiology of dental caries is not a mere academic exercise; it provides the basis for preventive, diagnostic, and treatment strategies and gives the dentist a theoretical framework to become a better professional.

THE PECULIARITIES OF TREATMENT OF UNCOMPLICATED AND COMPLICATED DENTAL INJURIES CAUSED BY TRAUMA.

Trauma related injuries of permanent teeth occur frequently and are the most pressing issue the dentists are facing today. In different age groups the same type of trauma affects the teeth with different frequencies. For instance, accident related dental trauma in children and adults affected permanent teeth in 30% and deciduous teeth in 20%, respectively. It should also be noted that front teeth are more susceptible to traumatic injuries compared to the incisors. Upper front teeth were injured in 72% of cases, while lower central, upper lateral incisors, canines and premolars only in 6-8%. The severity of dental injury depends on the type and extent of the trauma. Dental injury can be result of either direct or indirect trauma. A strong, «fast as lightning¼ impact most often affects the dental crown. A weak and dull impact (thump) extends toward the root apical direction resulting in avulsion of the tooth and root fracture. Dental injury caused by trauma has been always considered as an emergency condition. It requires prompt complex treatment methods from maintaining pulp vitality to tooth extraction option. Treatment plan always depends on the type and severity of the injury and on current clinical condition of tooth. In all cases, the combined treatment includes: care of visible wound, fixation of teeth, performance of surgical manipulations, determining of the need of endodontic treatment, restorations and orthodontic consultation. The recorded clinical cases include descriptions of dental injuries of various types, as well as performed diagnostic and treatment procedures. In both cases root was fractured by impact. In Clinical Case 1 the tooth 2.1 vertical partial displacement of the tooth (extrusion) with root fracture in the apical third was observed; Clinical Case 2 - 1.1 dental root fracture in its middle third and vertical extrusion. Treatment strategy is dictated by pulp condition (Assessment of pulp vitality and status). In both cases, the complex treatment protocol included repositioning of the teeth back into the alveolar socket and their fixation. In tooth 2.1 treatment endodontic therapy was necessary treatment of choice, while in another case (tooth 1.1) endodontic intervention was not indicated. X-ray visiographic diagnostics and clinical examinations of the teeth (after 1 and 3 years monitoring) revealed positive outcomes. Patients are under monitoring of clinical condition.

Articaine - the best choice of local anesthetic in contemporary dentistry.

Local anesthesia forms the foundation of pain control techniques in clinical dentistry. Within the rich local anesthetic drugs available in dentistry for the prevention and management of pain 4% articaine solutions achieve highest level of anesthetic potency and lowest systemic toxicity in all clinical situations, prior to its superlative physicochemical characteristics and the pharmacological profile. These are - low lipid solubility, high plasma protein binding rate, fast metabolization, fast elimination half time; low blood level. Articaine inactivates in both ways: in the liver and the blood serum. It has good spreading through tissues. Thus, articaine seems to be the local anesthetic of first choice in tissues with suppurative inflammation, for adults, children (over 4), elderly, pregnant women, breastfeeding women, patients suffering from hepatic disorders and renal function impairment. In Articaine solutions (1: 200,000) epinephrine is in low concentration, thus in patients at high risk adverse responses are maximally decreased. In these patients articaine should be used with careful consideration of risk/benefit ratio. Articaine solutions must not be used in persons who are allergic or hypersensitive to sulphite, due to content of Sodium metabisulfite as vasoconstrictor's antioxidant in it. Incidence of serious adverse effects related to dental anesthesia with articaine is very low. Toxic reactions are usually due to an inadvertent intravascular injection or use of excessive dose. To avoid overdoses maximum recommendation dose (MRD) must not be exceeded and aspiration test always performed prior all LA injections. In these article we introduce new graphs providing a quick and effect way to determine maximum LA dose. If the overdose reactions develop, adherence to the basic step of emergency management with end to a successful outcome in virtually all cases.

Simultaneous determination of cyclodol and diprazin by thin layer chromatography and high performance liquid chromatography.

Ciklodol (trihexyphenidil)--the central and peripheral m-cholinoblocker is currently used with other antipsychotic drugs such as phenotiazines and tricycle antidepressants. For the purpose of simultaneous determination of ciklodol and diprazine, were selected two methods of analysis: Thin Layer Chromatography (TLC) and High Performance Liquid Chromatography (HPLC). During development of TLC method was studied the 10 visualizing system and 24 mobile systems. For individual or simultaneous determination of ciklodol and diprazine were recommended the following solvents' systems: 1. Toluene-acetone-ethanole-25%NH(4)OH (45:45: 7.5:2.5), 2. Hexane-ethyl acetate (15:5), 3. Chloroform-heptene-25%NH(4)OH (16:3:3), 4. Ethylacetate-hexane (10:10), 5. Acetonitrile-metanol (10:10) and 6.Heptene-chloroform-ethanol-25% NH(4)OH (5:10:3:1). As visualizing systems were chosen: Iodine vapors, blacklight (UV254) and reagent of FNP. Reagent of FNP gives colored spot just with diprazine and it is also could be used for separation of both objects in simultaneous analysis. Developed HPLC method of simultaneous determination of ciklodol and diprazine: like mobile phase is recommended: Acetonitril- 0.05M KH(2)PO4 (55:45) (v/v) +H(3)PO(4) (pH3.5), column EC250 x 4.6mm, with solid phase Nucleosil, flow rate 1ml/min, sample volume 40 microl. In given conditions, the retention time of ciklodol is 6.005min and diprazine 7.227min. Developed method of simultaneous determination and separation of ciklodol and diprazine in respective mixtures could be successfully applied as in the pharmaceutical, as well in the chemical-toxicological laboratories.

[Polymer films of antiviral preparation Rodopes for dental practice].

There was created new medical form of antiviral reparation Rodopes that surpassed previous forms - Rodopes adhesive ointment and Rodopes ointment - and also traditional preparations Zovirax and Interferon with its increased therapeutic effectiveness. Rodopes polymer films are much more comfortable way of clinical usage and can be successfully and widely used in stomatological practice.

Fibroscan and FibroTest/FibroMax to assess liver fibrosis/cirrhosis in patients with chronic HBV and HCV infection in Georgia.

Although, liver biopsy is the gold standard in assessment of the degree of liver damage, the method has some limitations. For this reason, assessment of liver damage using non-invasive methods is currently an important topic in hepatology. The aim of the study was to evaluate liver fibrosis/cirrhosis using Transient Elastography and FibroTest/FibroMax in patients with chronic HCV and HBV infection in Georgia and to compare Fibroscan and FibroTest/FibroMax results. 252 patients were included in the study, among them 185 with chronic HCV infection and 67 with chronic HBV infection. These patients were investigated at the Georgian-French Joint Hepatology Clinic "Hepa", from December 2007 to November 2008. In patients with chronic HCV or HBV infection Fibroscan and Fibrotest/FibroMax results were correlated in 127 (68.6%) and 45 (67.2%) cases, respectively. Discordance in one degree of fibrosis stage was found in 36 (19.5%) patients with chronic HCV infection and in 14 (20.9%) patients with chronic HBV infection. Discordance in more then one degree of fibrosis stage was found in 22 (11.9%) and 8 (11.9%) cases. In patients with Fibroscan and Fibrotest/FibroMax concordant results liver biopsy might be avoided. Fibroscan and Fibrotest/Max appear to be very valuable methods for detecting early stages of fibrosis among patients with chronic HCV and HBV infection, allowing to avoid the progression of liver damage, as well as end-stage liver disease. These methods are easy to perform and therefore allows regular follow-up of the course of LF.