Bruxism Unconscious Oral Habit in Everyday Life.

BACKGROUND: Bruxism is defined as an unconscious oral habit of rhythmical, unfunctional clenching, grinding and making chewy sounds with the teeth while making movements that are not part of the masticatory function and that lead to occlusal trauma. AIM: The purpose of this article is to show the habit bruxism, in everyday life, reviewing literature data. METHODS: Data was researched by using information on the internet on Researchgate, Pubmed, ScienceDirect, by analysing written articles and books and student books. From 200 articles that were analysed, 45 articles and two textbooks were involved in writing of this review article. RESULTS: Results derived from the analyzed literature, classify the main consequences of bruxism, from fatigue, pain, wasting of the incisal edges and occlusal surfaces of the teeth to loss of teeth, dental implants, headaches, periodontal lesions and TMD (dysfunctions of the masticatory muscles and temporomandibular joint (TMJ)) in severe cases. All these problems negatively affect the quality of everyday life of the patient. CONCLUSION: Bruxism as a parafunctional habit is present in everyday life needing a multidisciplinary approach for prevention of the teeth, bone and prosthetic restorations. The prevalence of bruxism is growing related to stress, drugs, changes in lifestyle, bad nutrition and sleep problems. The therapist should follow signs and symptoms to ensure the best treatment plan of the patient.

The Effect of the Use of Different Types of Cement and Zirconium Post Systems on Endondontically Treated Teeth.

BACKGROUND: Prefabricated zirconium upgrading systems were examined to satisfy aesthetic needs in endodontically treated teeth. Endodontically treated teeth, together with non-metallic posts and superstructure, are substructures that enable the production of prosthetic structures that will allow aesthetics, resulting from normal light transmission. To investigate and analyse the retention of zirconium post systems cemented with RelyX Unicem 2 Automix (RLX) cement with Pull-out test. AIM: To examine the retention of zirconium post systems, cemented with Multi-Link Automix (MLA) cement and RelyX Unicem 2 Automix (RLX) cement with Pull-out test. MATERIAL AND METHODS: In this study were used, 120 post systems of the company ZIRIX NORDIN - Switzerland, with different diameters d1 = 1.2, were used: d2 = 1.35, d3 = 1.5, and two types of resin cements: Multilink Automix-Ivoclar (MLA), and RelyX Unicem 2 Automix (RLX) - 3 M ESPE. RESULTS: The analysis of the extraction force in newtons (N) zirconium post systems of Multilink Automix cement according to subgroups of three diameters is consequently 481.3 ± 1.9 vs 462.9 ± 4.5 vs 454.2 ± 2.2. The analysis of the extraction strength in the newtons (N) zirconium post systems of RelyX Unicem 2 Automix cement in the entire sample is 577.9 ± 6.1 N. CONCLUSION: The largest diameter of the posts significantly increases the resistance of fractures compared to the smaller two diameters used in the experimental study.

Contemporary Dental Ceramic Materials, A Review: Chemical Composition, Physical and Mechanical Properties, Indications for Use.

BACKGROUND: The high esthetic expectations from the prosthodontic restorations have directed the qualitative development of the materials towards the all-ceramic materials that are capable of replacing porcelain-fused-to-metal systems. AIM: This article reviews the literature covering the contemporary all-ceramic materials and systems with a focus on the chemical composition and materials' properties; also it provides clinical recommendations for their use. RESULTS: The glass-matrix ceramics and polycrystalline ceramics are presented, as well as recently introduced machinable materials, all-zirconia and resin-matrix ceramics. The specific properties of zirconia, such as transformation toughening, stabilisation of the crystallographic structure, low-temperature degradation and factors affecting the zirconia's ageing, are emphasised. CONCLUSION: The favourable properties of the resin-matrix ceramics, such as modulus of elasticity similar to dentin, shock-absorbing characteristics and high resilience and fracture resistance, are also covered in this article.

Retention of Approximal Guiding Plane Surfaces in Removable Partial Skeletal Prosthesis.

BACKGROUND: The morphology of the retention tooth often does not correspond with the required design; hence there is often an indication for enamel recontouring or other restorative procedures. AIM: The study aimed to determine the impact of changing the path of insertion of the prosthesis by reshaping the anatomical and morphological structures of the natural teeth predetermined for the retention of the prosthesis. MATERIAL AND METHODS: The group of 40 patients with Class II, Subclass 1 according to Kennedy was formed, and 120 approximal surfaces of retention teeth were obtained. Two different types of prostheses were made on the models: one group in the zero point position of the model, and another group in the zero position of the model, with changing of the direction of input at an angle of 2°. RESULTS: The difference between the established and theoretical normal distribution of frequencies was tested with the Kolmogorov-Smirnov and Lilliefors tests (r < 0.10; r < 0.01). The first group showed a retention force of 0.08 N. In the second group the retention force was 0.94 N. CONCLUSION: It could be concluded that the change in the path of insertion of the dental prosthesis with conservative restorations as composite inlays, as well as the accurate extension of the prosthesis onto guiding plane surfaces, will undoubtedly increase the retention force of the prosthesis.

Acid Etching as Surface Treatment Method for Luting of Glass-Ceramic Restorations, part 1: Acids, Application Protocol and Etching Effectiveness.

AIM: The purpose of this review is to represent acids that can be used as surface etchant before adhesive luting of ceramic restorations, placement of orthodontic brackets or repair of chipped porcelain restorations. Chemical reactions, application protocol, and etching effect are presented as well. STUDY SELECTION: Available scientific articles published in PubMed and Scopus literature databases, scientific reports and manufacturers' instructions and product information from internet websites, written in English, using following search terms: "acid etching, ceramic surface treatment, hydrofluoric acid, acidulated phosphate fluoride, ammonium hydrogen bifluoride", have been reviewed. RESULTS: There are several acids with fluoride ion in their composition that can be used as ceramic surface etchants. The etching effect depends on the acid type and its concentration, etching time, as well as ceramic type. The most effective etching pattern is achieved when using hydrofluoric acid; the numerous micropores and channels of different sizes, honeycomb-like appearance, extruded crystals or scattered irregular ceramic particles, depending on the ceramic type, have been detected on the etched surfaces. CONCLUSION: Acid etching of the bonding surface of glass - ceramic restorations is considered as the most effective treatment method that provides a reliable bond with composite cement. Selective removing of the glassy matrix of silicate ceramics results in a micromorphological three-dimensional porous surface that allows micromechanical interlocking of the luting composite.

Overdentures on Implants for Better Quality of Life Among the Fully Edentulous Patients - Case Reports.

Global aging population has brought several challenges for their medical systems and total edentulism is one of them. The fabrication of removable acrylic dentures seems to be a simple and cheap treatment solution, but a majority of patients is not satisfied with their functional instability, causing limited diets, mouth soreness, speech and psycho-social problems etc. The results in many studies indicate an impact of oral conditions associated with the full denture wearing on oral-health related quality of life, especially in lower jaw. The reason for improper denture retention could be alveolar ridge bone resorption and numerous studies about this problem are plausible. Bone resorption in lower jaw may turn the alveolar ridge into a flabby soft tissue which is unable to sustain proper denture retention. The implant-retained prosthesis is an alternative treatment option in these situations. Implants will provide retention, stability, function and aesthetics and they are not so expensive solution. The aim of this article is to show solving of retention problems of a lower denture in two different clinical cases using implants and without any special technology.

Influence of the Ethnic Affiliation, Level of Education and Place of Living on Oral Health at Geriatric Population with Total and Partial Dentures in Republic of Macedonia.

INTRODUCTION: Health is the main component of the quality of life, while oral health is component of the general health. The socio-demographic characteristics are one of the important factors for perception of the oral health and the quality of life. The main purpose of this study was to perform an evaluation of the quality of life of geriatric patients (older than 65) with built-in oral prosthetic dentures depending on the ethnic affiliation, level of education and place of living, as socio-demographic characteristics. MATERIALS AND METHODS: The survey was a prospective transversal (cross-sectional) study conducted among 165 institutionally sheltered patients at the Gerontology Institute (inspected group - IG) and 170 patients from the dental specialist clinics (control group CG) at the age of 65 and older. The statistical program SPSS for Windows ver. 13.0 was used for statistical processing. RESULTS AND DISCUSSION: Patients with upper and lower total dentures dominated (43.6% vs. 26.5%). The highest GOHAI score had the other ethnicities of IC (32.08) and Roma of IG (31.00), while the lowest was in the Albanians of CG (25.91). The highest value of 30.15 had the IG of patients living in urban areas. CONCLUSION: The quality of life and oral health of the geriatric patients are at unsatisfactory level, with significant influence of the place of living and insignificant influence of the ethnic affiliation and level of education.

Comparative Analysis of the Mechanical Properties between the Fiber-Reinforced Composite and Zirconium Posts.

OBJECTIVES: To make a comparative analysis of the mechanical properties between FRC and zirconium posts Methods: The patients with FRC and zirconium posts were divided in two groups with three subgroups, each of them composed of 10 samples. Subgroup I with 1.2 mm; Subgroup II with 1.35 mm and Subgroup III with 1.5 mm post diameter. The fracture force, bending and tensile strength of each group were measured with Shimadzu Universal Testing Machine. RESULTS: The fracture force for the first group measured in the first, second and third subgroup was 34.80900N; 67.15390N; 46.53100N and for the second group, first, second and third subgroup was 34.80900N; 46.53100N; 67.15390N correspondingly. The bending strength for the first group measured in the first, second and third subgroup was 401.4420N; 444.6425N; 333.6828N and for the second group, first, second and third subgroup was 307.9352N; 289.1030N; 304.1649N correspondingly. The tensile strength for the first group measured in the first, second and third subgroup was 5.442267N; 4.350545N; 2.943465N and for the second group, first, second and third subgroup was 4.224141N; 3.751466N; 3.168756N correspondingly. CONCLUSIONS: The longest diameter of the posts significantly increases the resistance to fracture in relation to the two smaller diameters. The larger diameter, the higher values of the bending strength, as well as the lowest values of the tensile strength of the material contribute to improved mechanical properties of the fiber and zirconium posts.

White spot lesions: prevention and management during the orthodontic treatment.

The formation of white spot lesions, or enamel demineralization, around fixed orthodontic attachments is a common complication during and following fixed orthodontic treatment, which marks the result of a successfully completed case. This article is a contemporary review of the risk factors and preventive methods of these orthodontics scars. Preventive programmes must be emphasized to all orthodontic patients. The responsibility of an orthodontist is to minimize the risk of the patient having decalcification as a consequence of orthodontic treatment by educating and motivating the patients for excellent oral hygiene practice. Prophylaxis with topical fluoride application should be implemented: high-fluoride toothpastes, fluoride mouthwashes, gels and varnishes during and after the orthodontic treatment, especially for patients at high risk of caries.

The influence of etiological factors in the occurence of diastema mediana.

Even from the distant past the aesthetic perception in an individual was diminished by the presence of gap between the central incisors. This condition is found under the term "dents du bonheur" or "lucky teeth" and is encountered even among world famous figures including Brigitte Bardot, Eliah Wood, Madonna, Zac Efron, Amy Winehouse and Elton John. The teeth gaps are still considered main reasons for dissatisfaction of the dental patients and reasons for the requirement of aesthetic treatment. The purpose of this study is to exhibit the influence of the etiological factors in the occurrence of diastema mediana classified according to the dominance of their occurrence expressed in percentage values. Materials of this investigation were 100 patients with diastema mediana from the following factors: inheritance, disproportion in the dental arches, inborn or acquired missing teeth, harmful oral habits, high insertion of the labial frenulum as well as mesiodens. After the diagnosis and evaluation of the etiological factor for diastema mediana was performed, a decision regarding the course of treatment was made in direction of the removal of the etiological factor at an early age and orthodontic treatment. The end of the orthodontic treatment in a group of the patients was the beginning of prosthodontic reconstruction. From our clinical investigation we came to the realization that in 49 patients (49%) the hereditary influence was a dominant factor, next followed disproportions and discrepancies in the dental arch in 14 (14%), inborn or acquired missing teeth in 11 patients (11%), harmful oral habits in 10 (10%), high frenulum insertion in 4 (4%), and pathological objects between central incisors, mesiodens, iatrogenic factors and periodontal disease, in 3 of the clinical cases (3%) each. We concluded that the occurrence of diastema mediana is multi-causal. The dominant place is occupied by the hereditary factors. With regard to the mutual relationship between the multitudes of factors in the occurrence of diastema mediana, the diagnosis should be made conciliary and the clinical treatment should be interdisciplinary including a prosthodontist, orthodontist and oral surgeon.

An assessment of career satisfaction among Macedonian dentists.

AIM: The aim of this study was to assess the level of overall career satisfaction in relation to various personal and work-related factors among the dentists in the Republic of Macedonia. MATERIALS AND METHODS: The sample comprised 118 registered dentists, working in different conditions (34 public practice dentists, 32 completely private, 42 private dentists who work with a health insurance fund and 10 concessioners). All of them filled in a questionnaire which contained 16 items, divided into five groups. The different clusters of questions were related to various working conditions and personal factors. The first four groups of questions were answered with a--point Likert format with a score range from 1 (very dissatisfied) to 4 (very satisfied). In the fifth group, dentists chose one of four offered answers. The statistical analyses were made by one-way ANOVA and chi-square tests. RESULTS: Significant differences related to working conditions were found between public practitioners (moderately dissatisfied) and private practitioners (very satisfied) (F=41.41 (df=3); p<0.01). A high prevalence of dentists (89.83%) had felt stressed on their work place and 61.8% of public dental health practitioners had felt stressed at work "very often". The main sources of job-related stress for public dental practitioners were their supervisors (50%) and patients (26. 47%), while private practitioners were mostly stressed by inspectors (76.19%) and patients (21.87%) (χ2=44.5 (df=9); p<0.01). CONCLUSION: The findings in our study showed overall low levels of career satisfaction among the dentists (public and private) in the Republic of Macedonia. The finding that high percentages of dentists feel stress at their work place very often requires further exploration.

Bruxism and TMD disorders of everyday dental clinical practice.

Bruxism, as an etiological factor for the development of TMD, includes different disorders of the TMJ and the masticatory muscles, exhibiting pain and disruption of the stomatognathic functions. Our goal was to study patients with bruxism and TMD from everyday dental clinical practice, in terms of diagnosis, identification of etiological factors, classification and treatment of these disorders. We treated 120 patients, divided into 2 groups of 60 patients. The first group had disorders of the TMJ, and the second of the masticatory muscles. The groups were divided into subgroups of 20 patients with dislocation of the articular disk with or without reduction and inflammation of TMJ. The second group was organized from patients with myofascial pain, myositis and muscular trismus. Our conservative treatment consisted of patient education, NSAID, myorelaxants, fabrication of prosthetics, repositioning and stabilization splints. The progress of the patients was followed immediately after the delivery of the prosthetics and the splint, after 1, 6 and 12 months. The results showed that in patients with disorders of the TMJ there were visible signs of recovery after 6 months in 68.3% patients, and in 85% after 12 months. In the second group we achieved faster results with the elimination of symptoms. Patients with afflictions of the muscles in 88.3% of cases noticed relief of symptoms even after 6 months and in 98.3% after 12 months. As therapists we concluded that timely treated complications of bruxism and TMD prevent the destruction of the TMJ, masticatory muscles and the entire stomatognatic system.

Technology and the use of acrylics for provisional dentine protection.

Acrylics are compounds polymerized from monomers of acrylic, metacrylic acid or acrylonitrates. The purpose of this paper is to present the technology and use of acrylics for provisional dentine protection in the practice of dental prosthodontics. For this reason, we followed 120 clinical cases from the everyday clinical practice, divided into 4 groups of 30 patients who needed prosthetic reconstruction. The first group included cases in which we applied celluloid crowns for dentine protection, for the second group we used acrylic teeth from a set of teeth for complete dentures; in the third and fourth groups the fabrication was done with the system of an impression matrix and the acrylic resin block technique respectively. In all the examined patients, the gingival index by Silness and Loe and the vitality of the dental pulp were verified clinically, after preparation and 8 days from the placement of the provisional crown. The value for dental sensitivity measured after preparation was 2.59, and 8 days after the placement of the provisional crown it bwas 3.1. From these results we can conclude that after the 8th day from the placement of the provisional crown, there was an adaptation period, characterized by a decrease in the painful sensations. The value of the Silness and Loe gingival index measured after the preparation was 1.34, and 8 days from the placement of the provisional crown was 0.94. The results inclined us to the fact that the provisional acrylic crowns facilitated the reparation of the periodontal tissue.