Stomatologija / issued by public institution "Odontologijos studija" ... [et al.]

Assessment of need for orthodontic treatment is complex and the opinion about it might differ between the orthodontist and children. Personal perception of the need for orthodontic treatment may be influenced by a variety of social, economical and cultural factors. The aim of this study was to investigate whether there is an association between normative and self-perceived orthodontic treatment need, and to evaluate the influence of age, gender and socioeconomic background on satisfaction of dental appearance and demand for orthodontic treatment. The study included 2024 schoolchildren: 1193 (657 girls and 536 boys) 10-11 year-old and 831 (450 girls, 381 boys) 14-15 year-old. The objective need for orthodontic treatment was found to be 42.6 percent while self-perceived need 35.3 percent among Lithuanian schoolchildren. Girls thought that they needed treatment more frequently than boys independent of age and living area.
The objectives of this study were to evaluate and compare the changes of the dental caries prevalence and severity of 7 to 8 year old schoolchildren in six Lithuanian regions over the past 26 years (1983-2009) and to propose recommendations based on the results of the study. The study is based on the analysis of data, containing 576 cases of children examined in 1983 and comparison with data containing 531 cases added in 2009. The studies were conducted in the same six regions of Lithuania among the children from 7 to 8 years of age. For the study of children the WHO oral assessment methodology was used (WHO Basic methods 1997). Severity of dental caries was described by df-t and DMF-T index. The average of individual df-t and DMF-T indices was calculated for all subjects and sorted by gender. Oral hygiene status was evaluated by applying the simplified Green-Vermilion index-OHI-S (1964) The prevalence of primary dental caries among the children 7 to 8 years of age was 92.4% in 1983 and 88.7% (p=0.43) in 2009. The prevalence of permanent dental caries decreased from 49.6% in 1983 to 29.7% (p<0.001) in 2009. Mean df-t score decreased from 4.9±3.4 in 1983 to 4.1±2.7 in 2009 and DMF-T index decreased from 1.1±1.7 in 1983 to 0.5±1.0 in 2009 (p<0.001). The OHI-S index was not significantly different during 1983-2009. In the period of last 26 years a tendency towards the decrease in the prevalence and severity of dental caries was observed. That could be related to the frequent using of the toothpastes with fluoride, as well as implementation of the caries prevention program with sealants among the children of that age. The poor oral hygiene and comparatively high caries prevalence in schoolchildren show that it is still necessary to improve preventive measures in Lithuania.
Upper arch crowding in age groups 15-21 and 35-44 
In the recent past there has been an increase in the number of adults seeking orthodontic treatment therefore special attention to periodontal status of these patients needs more careful evaluation. Periodontal considerations in adult orthodontic treatment are increasingly important as patients become older. The aim of the study was to assess the interrelationship between the severity of malposition of frontal teeth with periodontal health considering to age in Latvian population. The data were analyzed from a detailed crossectional study in Latvian population. Selected samples consisted of two age groups: 15-21 (n=323) and 35-44 (n=286) years old. For the assessment of periodontal health CPI scores was analyzed for upper frontal sextant. For assessment of malocclusion 2 components of ICON index were used: upper arch crowding and incisor overbite. The differences in the distribution of ICON index and CPI index between age groups were tested using Pearson chi(2)test. Statistical significance of the differences in the mean values was tested using t-test. Possible interaction between above mentioned indexes was tested by means of analysis of variance. Upper arch crowding and incisor overbite severity increase with age was statistical significant. There was statistically significant interrelation between upper arch crowding degree and incisor overbite and CPI scores severity in the age 15-21 and was not in the age 35-44. However comparing higher degree of the crowding and overbite severity to percent of subjects with bleeding, calculus and periodontal pockets greater percents of measurements were in older group. 1. Severity of upper arch crowding and overbite statistically significant increased with age with remarkable increasing of periodontal problems. 2. Interrelation between severity of upper arch crowding, incisor overbite and CPI scores was statistically significant in age group 15-21.
To evaluate the association between AXIN2, CDH1 and IRF6 with oral clefts in a cohort from Latvia. 283 unrelated individuals, 93 born with isolated oral clefts and 190 individuals born without any structural abnormalities were evaluated. Cleft type and dental anomalies outside the cleft area were determined by clinical examination. Four SNPs were selected for this study: rs2240308 and rs11867417 in AXIN2; rs9929218 in CDH1; and rs642961 in IRF6. Genotypes were determined by polymerase chain reaction using the Taqman assay method from a genomic DNA sample extracted from whole blood. Allele and genotype frequencies were compared between individuals born with or without oral clefts using the PLINK program. Tooth agenesis was the most frequent dental anomaly found among individuals born with oral clefts (N=10; frequency 10.8%). The allele A in the IRF6 marker rs642961 was associated with all combined types of oral clefts (OR=1.74; CI 95% 1.07-2.82) and with cases with cleft lip with or without cleft palate (OR=1.88, CI 95% 1.15-3.01; p=0.007). The IRF6 AP-2a binding site promoter polymorphism is associated with isolated oral clefts in Latvia.
Mean values of condylar and mandibular measurements between right and left side (in mm) 
Correlation coefficients between condylar and mandibular measurements 
Unlabelled: The condyle has a special multidirectional capacity for the growth and adaptive remodeling of temporomandibular joint (TMJ). Being part of TMJ structure, it plays an important role in the stability of long-term treatment results for orthodontic and orthognatic patients with Class II division 1 subdivision malocclusions. Several computed tomography (CT) investigation modes have been used to evaluate the craniofacial morphology and particularly, for TMJ. Dimensional images, acquired using new generation multislice CT (MSCT) and cone beam CT scanning data, are becoming increasingly popular in the clinical work and research. The aim of the study was to develop a new CT investigation protocol for the quantification of morphological structures and skeletal landmarks of condyle, procesus condylaris and mandible. For this purpose we created two dimensional (2D) and three dimensional (3D) reconstruction images from primary axial MSCT scans using IAC review and Transparent bone programms and acquired accordant measurements of condylar and mandibular structures. This technic allowed to get truly volumetric reflexion of the joint components in its real anatomical size and avoided the bony superimpositions. Our material included 12 patients with skeletal Class II division 1 subdivision malocclusion who had indications for combined orthodontic and orthognatic treatment. CT examination was performed before the start of treatment. For statistical analysis paired Student t-tests were applied to test the diferences of mean values and correlation coefficients were calculated to assess possible interrelations between measurements. The preliminary results showed weak corrrelation between condylar and mandibular measurements. More significant correlation was observed between procesus condylaris and mandible. It was a significant difference between right and left side in the height of procesus condylaris in patients without clinicaly relevant facial asymetry which could be considered in the individual planning of orthognatic treatment. Conclusion: The developed combined 2D and 3D MSCT investigation protocol for condylar and mandibular measurements provides precise and demonstrative quantitative images of condylar and mandibular structures and its dimensional relationships., which could be qualified as informative criteria for the individual treatment planning for patients with Class II division 1 subdivision malocclusion.
Schematic image of stress distribution on implant in Model 1, with load applied at an angle of 90° at 6mm from the center of the implant 
Schematic image of stress distribution on abutment screw in Model 1, with load applied at an angle of 90° at 6mm from the center of the implant 
Schematic image of stress distribution on abutment screw in Model 2, with load applied at an angle of 90° at 6mm from the center of the implant 
Schematic image of stress distribution on abutment screw in Model 2, with load applied at an angle of 90° at 6mm from the center of the implant 
This study evaluated the stress distribution by loads, under a internal connection implant system with two sort of abutment screws and prosthetic crown models at ten observation points. The analysis were made in two models with internal butt joint, and with gold and titanium screw, respectively. The load was 382N with 90 masculine to the occlusal surface and 15 masculine to the implant axis at 4 and 6 mm from the implant center. In both models, a large amount of stress was located around the implant neck and little stress was concentrated along the abutment screw. The simulations made suggest that the internal connection protects the abutment screw from the accumulated stresses; however, it exposes the implant walls to these stresses.
AIM OF THE STUDY. The aims of the study was to evaluate needs for prosthetic treatment among middle-aged and elderly population in Vilnius, to find out rates of edentulism among Vilnius inhabitants and to ask them about their approach to personal oral hygiene. MATERIALS AND METHODS. This cross-sectional study was approved by Lithuanian Bioethics Committee and carried out by one investigator. Our study was performed in period from 2008 to 2012. We have examined and interviewed 634 patients in the principle of free choice (randomized selection). Quantity of remaining teeth and previous prosthetic treatment was assessed. RESULTS. According to questionnaire previuos prosthetic treatment was attached for 204 (43.8%) male and 262 (56.8%) female patients, total 466 (73.5%) of all subjets involved into our research, 168 (26.5%) never had a prosthetic treatment. During examination we found, that 219 (34.5%) of all examined persons were treated with removable prosthesis, 180 (28.4%) treated with fixed prosthesis and for 67 (10.6%) both: fixed and removable kinds of prosthesis were attached. Toothless jaws were found in 26.5% (n=168) of population. We found 179 (28.2%) edentulous maxillas and 168 (26.5%) mandibles. CONCLUSIONS. The intensity of tooth loss in the middle-aged and eldery population of Vilnius city significantly increases with age. Lower rates of edentulism and an ageing population mean that older people will feature more prominently in dental services. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age.
The objective of the present study was to assess the public accessibility of orthodontic care in Lithuania. In 2008, a request for the information about various aspects of public orthodontic care during 2000-2007 in Lithuania was submitted to the State Patients' Fund at the Ministry of Health. The data on the demographic distribution of orthodontists in Lithuania were received from the Lithuanian Dental Chamber. The authors of the paper also analyzed the national legislation regulating the State Patients' Fund expenditure on orthodontic care and treatment. In 2007, there were 73 orthodontists-practitioners in Lithuania, most of them highly concentrated in major cities and towns: most of them were practicing in Vilnius (22) and Kaunas (20), while there were only 5 orthodontists in Klaipeda, 4 in Siauliai, 3 in each of Panevezys and Marijampole. The public orthodontic treatment is rendered only to patients suffering from most severe pathologies. With the constantly increasing expenditure of the State Patients' Fund, the national public orthodontic care system definitely undergoes significant development: the number of patients who received the treatment with removable and with fixed orthodontic appliances was gradually increasing during 2002-2007, with however, a very small number of new facilities for ambulatory treatment facilities of orthodontists (consultations included). The number of patients who received treatment with removable orthodontic appliances was specifically higher in Siauliai and Telsiai, Panevezys and Utena districts, with fixed orthodontic appliances - in Vilnius and Alytus, Kaunas and Marijampole, Panevezys and Utena regions. The analysis of the availability of public orthodontic treatment showed a marked increase in the number highly-specialized ambulatory facilities in Vilnius and Alytus district in 2002-2007. Specialists providing orthodontic treatment in the country are highly concentrated, while in general public orthodontic treatment undergoes development at the moment. The accessibility of orthodontic treatment in Lithuania, especially in the regions distant from Vilnius and Kaunas, remains inadequate.
The accessory parotid gland is salivary tissue separated from the main parotid gland and lying on masseter muscle. It has secondary duct emptying into the Stensen's duct. The accessory parotid gland exists in 21-61% of individuals. However, the appearance of an accessory parotid tumor is rare, with a reported frequency of 1-7.7% of all parotid gland tumors. Carcinoma ex pleomorphic adenoma arises from a pre-existing benign mixed tumor. Most of these tumors will have malignant epithelial component, but not malignant stromal component. Reports of Fine Needle Aspiration Cytological (FNAC) diagnosis of malignant mixed tumor are uncommon and have been limited to cases arising in the parotid. We report a case of carcinoma ex pleomorphic adenoma of the accessory lobe of the parotid, and address the cytopathology features and pitfalls of this condition. A 73 aged female presented with a right nontender midcheek mass. The lesion had been present 18 months, with a recent increase in size. FNA was performed and the smears demonstrated features indicative of pleomorphic adenoma admixed with findings indicative of a poorly differentiated carcinoma. FNAC can accurately diagnose carcinoma ex pleomorphic adenoma when strongly fixed requirements are implemented.
To compare, in vitro, the accuracy between dental stone casts obtained from the first and the second pour using metallic (Smart) and plastic (Triple Tray) dual-arch trays. The impressions were taken using Flexitime® vinyl polysiloxane from a typodont model with a mandibular right first molar prepared for a full crown. Ten impressions were made with each tray and poured using type IV die stone. After 1 hour, the casts were removed from the impressions and, 1-hour later, second pours were completed. The mesio-distal and the buccal-lingual widths at the gingival margin of the prepared tooth on the cast were measured in a perfil projector. The results were submitted to Student's t-test (α=0.05) using SPSS version 10.0. There was a statistically significant difference between the first and second pours using the plastic tray in the mesio-distal width. It could be suggested that a repeated pour is more accurate using a metallic tray.
Item-total, inter-item correlations 
Background: The Early Childhood Oral Health Impact Scale (ECOHIS) is a parent--assessed oral health related quality of life measure developed to assess the impact of oral health problems on preschool children. Aim: The aim of this study was to develop a Lithuanian version of the ECOHIS and evaluate its validity and reliability among preschool children in Lithuania. Design: A lithuanian version of ECOHIS (L-ECOHIS) was developed through a forward-backword translation. A cross-sectional study was performed to assess discriminant and convergent validity and internal consistency. Data was collected from 130 parents of 0-5 year-old children visiting the dental department. A subsample of parents filled the questionnaire again to assess the test-retest reliability. Results: Cronbach's alpha for the instrument was 0.869. Item-total correlation coefficients ranged from 0.389 to 0.797. Scores of the child and family sections were significantly correlated (P<0.001). The scale scores indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health and problem-based dental attendance. The intra-class correlation coefficient was 0.98. Conclusion: The L-ECOHIS is a valid and reliable measure to assess OHRQoL of 0-5 year-old children with Lithuanian speaking parents.
Mitotic activity of osteogenous cells in the control culture and culture with cAMP in concentration 10 -6 M 
The aim of this study was to evaluate the effect of cyclic 3', 5' adenosin-monophosphate (cAMP) on DNA synthesis of embryonic alveolar bone in tissue culture. Bone fragments were cultured in the medium composed of 80% medium 199, 15% horse serum, 4 mg/ml glucose, 100 microg/ml penicillin using the grid method. The explants were cultured up to 12 days. In the second series, the effect of cAMP in a concentration of 10(-6)M on bone during 12 days was studied. DNA synthesis was determined by calculating mitotic labelling indices for (3)H-thymidine incorporation into cells within cultured explants at 3 to 12 days. The medium was supplemented with 1 microCurie/ml (3)H-thymidine for 4 hours and processed for autoradiography. The mitotic labelling index was determined in the histological sections. All values wer presented as mean+/-standard deviation. Statistical significance was defined by p-values of 0.05 or less. Morphological and statistical analysis showed that there were differences in mitotic incidence (MI) and silver grain densities over osteoblasts in control cultures and with cAMP. The mean value of MI was 4,627+/-1,001 in control and 7,706+/-1,188 in the cultures where cAMP was added (p<0.05). Thus cAMP inhibited bone resorption and stimulated new bone formation in tissue culture. This study provides a novel concept that may help to identify new therapeutic targets.
Evaluate, in vitro, the microtensile bond strength (µTBS) of RelyX ARC conventional resin cement and RelyX Unicem and Maxcem self-adhesive resin cements to dentin, and the influence of polyacrylic acid pretreatment on the µTBS. Flat dentin surfaces were obtained in 15 third molars which were randomly divided into 5 groups: Group 1 - RelyX ARC (control); Group 2 - RelyX Unicem; Group 3 - Maxcem Elite; Group 4 - 22.5% polyacrylic acid and RelyX Unicem; Group 5 - 22.5% polyacrylic acid and Maxcem Elite. A block of composite resin was built over the resin cements. The samples were sectioned to obtain beams, and 20 specimens for each group were submitted to µTBS on a universal testing machine. Failure modes were analyzed by scanning electron microscopy. According to ANOVA and Tukey test, the highest µTBS mean (MPa) was obtained with RelyX ARC (21.38), which did not differ statistically from Maxcem Elite with polyacrylic acid pretreatment (19.22) and RelyX Unicem with polyacrylic acid pretreatment (17.75) (p>0.05). The latter two groups did not differ statistically from RelyX Unicem (16.98) (p>0.05). The lowest mean was obtained for Maxcem Elite (6.43), which differed statistically from the other groups (p<0.05). All failures were adhesive for Maxcem Elite without polyacrylic acid pretreatment, and mixed failures were predominant in the other groups. RelyX ARC achieved higher µTBS to dentin in comparison to the self-adhesive resin cements. Polyacrylic acid pretreatment was effective in improving the µTBS of Maxcem Elite, but did not influence the µTBS for RelyX Unicem.
The study aim was to compare the results of an Er,Cr:YSGG laser therapy used in adjunct to scaling and root planing (SRP), and of SRP alone, in a small group of patients with early to moderate periodontitis. Ten adult patients with periodontitis were treated according to split-mouth design, using Protocol A (SRP alone) or, Protocol B (Er;Cr:YSGG laser therapy combined with SRP). At baseline, and 3 months after the treatment the following periodontal parameters were evaluated: bleeding on probing (BOP), probing depth (PD), plaque index (PI). no statistically significant difference in plaque levels was noted before and after the treatment between the treated quadrants, however a tendency of a more pronounced decrease in plaque levels was noted in the group of laser-SRP treated teeth. After three months, 60-68% decrease of BOP-positive teeth compared to baseline status was noted in all treated quadrants, without significant difference between the treatment modes. The decrease of mean PD values was measured after three months compared to baseline: on the lingual surfaces in 'SRP" group the mean PD improvement value was 0,94+/-12, and in the laser-SRP group it was 1,96+/-11, (p<0,001); on the vestibular surfaces the mean improvement values were 0,99+/-0,14 and 2,03+/-0,11, respectively (p<0,001). Non-surgical periodontal therapy using both an Er;Cr:YSGG laser + SRP and SRP alone, lead to significant improvements in all the investigated clinical parameters. The combined treatment using laser as an adjunct to root scaling and planing seemed to be advantageous when compared to SRP alone, due to more efficient attachment level restoration.
OBJECTIVES. Complete Freund's Adjuvant (CFA)-induced arthritis in rats has been used widely as a model of rodent arthropathy and polyarthritis followed by osteoporosis, decreased bone formation and increased bone formation. Osteoporosis is characterized by rapid reduce of bone mass affecting more than 100 million people worldwide. Periodontitis a chronic inflammatory, of multifactorian origin disease has been associated with general osteoporosis. Protective bone-specific anabolic and antiresorptive effects of HMG-CoA reductase inhibitors have also been evaluated in normal and osteoporotic bone. AIM. The aim of the study was to investigate mandible and femur bone density in Freund's adjuvant induced arthritis rats under the influence of simvastatin. METHODS. Three groups (A, B, C) of 7 Wistar male rats each aged 3 months, (292±48.38 g) were used. A control. Group B and C subjected experimental arthritis via complete Freund's adjuvant injected in right paw. Group C was treated with simvastatin 0.5 mg/kg/daily po 14 days. Femur, mandible were isolated and sizes parameters, biochemical serum findings and BMD were estimated. RESULTS. CFA established by paw diameter, adrenals and spleen weight increase and thymus weight decrease, while biochemical serum findings were also affected. Reduced femur, mandible weight and general bone mass parameters BMD evaluated via DEXA occurred and restored under simvastatin treatment. CONCLUSIONS. CFA induced mandible and femur injuries are repaired by ssimvatatin treatment that could be therapeutically useful.
Quality of dental restorations in Lithuanian adolescent boys and girls
Quality of dental restorations in Lithuanian adolescents in urban and rural areas
Quality of dental restorations in Lithuanian adolescents in different geographical regions
The aims were to estimate the quality of dental restorations in Lithuanian adolescents and to relate differences in quality of restorations to gender, urbanization and residency. A total amount of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The California Dental Association Quality Evaluation System was used for the assessment of the quality of dental restorations. 60.35 % of all restorations were not acceptable and had to be changed. 47.58 % of them must be replaced because of not acceptable anatomic form. Only in 8.9 % of participants all their fillings were considered as satisfactory, while in 24.8 % of adolescents all their fillings had to be changed. Regarding the reasons for the need to replace restorations substantial differences among different geographical regions were found, whereas in relation to gender and urbanization the differences were less pronounced.
Measurements of socio-economic status
Socio-economic factors and their indicators (Confirmatory Factor Analysis*)
To explore disparities in needs for dental treatment which arise from individual and area-based socio-economic determinants. A cross-sectional study conducted in 22 randomly selected Lithuanian areas. In each of the pre-selected areas, one secondary school was randomly chosen. A total of 885 15-16-year-olds participated. Outcome measures. Dental treatment need was evaluated following the WHO guidelines and aQuantitative Summative Dental Treatment Needs Index (QSDTNI) was used to calculate the total burden of needs. The information about socio-economical determinants was obtained from a structured questionnaire and national statistics database. Individual socio-economic status (SES) measures were: parents' occupation, family structure, family income and affordability to have holiday used as a proxy measure for income. The area-based SES estimates were: unemployment, average household income, educational attainment, natural increase/decrease of population in an area and net migration rate. Data was analyzed by bivariate and multivariate analyses. None of significant bivariate associations between individual socio-economic variables and the QSDTNI were detected. Among area-based variables natural increase/decrease of population in an area and net migration rate were significantly related to the QSDTNI. Two individual and two area-based factors were extracted and introduced into Linear Multiple Regression Analysis (LMR). The LMR model was significant, but only one factor, i.e. area demographics, significantly contributed to this model. There are no clear social disparities in dental treatment needs in Lithuanian adolescents.
The aims were to overview the previous use of psychological theories for oral health education in adolescents and to discuss current approaches which could enhance the effectiveness of behaviour modification in this age group. The MEDLINE via OVID database was searched for relevant papers published during the last four decades. Only a few studies using psychological models and theories in oral health education for adolescents could be found and these studies were carried out a few decades ago. It was shown that socially disadvantaged adolescents, i.e. those who have the greatest need for improvements in oral health, might benefit most from the theory-based behavioural interventions. However, evidence from these trials can not be directly used to base oral health education in contemporary adolescents. An important consideration is that psychological models and theories developed for adults may not apply as well to adolescents, who are at different stages of behavioural development and with different cognitive abilities. Understanding the adolescent profile in oral health education appears to be crucial for success. The theory-based approaches to health behaviour modification, already successfully applied in other fields of medicine, might be a good alternative to conventional oral health promotion in adolescents.
The operationalization of the independent variables
Sample distribution according to the latest dental experience and mean DAS scores
Sample distribution according to the latest dental experience in different gender and urbanization groups
The study aimed to estimate the relationship between dental anxiety and past dental treatment experience in Lithuanian adolescents and to examine a possible influence of gender and area deprivation on dental anxiety. A total of 885 adolescents in 22 randomly pre-selected areas were clinically examined and completed a questionnaire regarding dental anxiety. Dental anxiety was estimated using the Corah's Dental Anxiety Scale (DAS). Past invasive dental treatment experience was defined as the number of extracted and filled teeth. The total mean (SD) score of the DAS was 10.07 (3.20). High levels of dental anxiety were reported in 11.3% of Lithuanian adolescents. The mean (SD) DAS score among adolescents who had no treatment experience was 9.51 (3.02), whereas adolescents who had treatment experience, had significantly higher mean (SD) DAS score, i.e. 10.25 (SD 3.23). The past dental treatment experience and dental anxiety were related in Lithuanian adolescents. Adolescents with no past invasive dental treatment experience were less anxious than those who had such experience. Girls reported higher dental anxiety than boys, while area deprivation had no effect on dental anxiety.
Dental treatment needs in Lithuanian adolescent boys and girls.
Dental treatment needs in Lithuanian adolescents in urban and rural areas.
The aims were to estimate dental treatment needs of 15-16-year-olds in Lithuania and to relate a number of background factors such as gender, urbanization and residency to possible differences in dental treatment needs. A total of 885 adolescents in 22 randomly pre-selected areas were clinically examined. The following criteria of dental treatment needs were used: tooth with primary caries, secondary caries, tooth which needs a non-operative treatment, tooth with trauma, which needs a restorative treatment, and tooth which needs either an endodontic treatment, a crown or an extraction. Only 7.7 % of all participants had all their teeth sound. The treatment due to primary caries was the most required dental treatment modality among Lithuanian adolescents. Significantly fewer teeth required treatment due to other aforementioned reasons. Significant differences in most dental treatment needs between boys and girls were found, whereas in relation to urbanization and area of residency the differences were less pronounced.
Research data regarding attitudes of general dental practitioners towards endodontic therapy is rare. The present review summarizes existing literature and analyzes human factors that could potentially influence the outcome of endodontic treatment in general dental practice. Root canal treatment usually fails when treatment falls short of acceptable standards. The results of questionnaire surveys from several countries indicate that differences between daily general practice and academic teaching exist. The results of studies indicated that majority of general practitioners disregard the most basic principles of endodontic treatment. The most striking finding is the generally negative attitude amongst general dental practitioners towards performing endodontic treatment and adoption of new technologies in a daily endodontic practice. The results confirm that root canal treatment is technically demanding and in general practice is carried out under less than optimal conditions. This review shows the importance of continuous dental education for practitioners in order to update their knowledge.
Aim: The aim of the study was to assess the prevalence of apical periodontitis and quality of root canal fillings in an adult Riga subpopulation. Materials and methods: Panoramic radiographs of Latvian adults 35-44 year old attending a private dental clinic for the first time during the period of 2004-2008 were included in the study. Totally, 312 out of 1248 panoramic radiographs were randomly selected and examined for periapical conditions and endodontic treatment quality. The technical quality of root fillings was evaluated in terms of length in relation to the root apex and lateral adaptation to the canal wall. The periapical status was assessed using the PAI index. The data were analyzed using SPSS 14 computer software program. Statistical significance was assessed by the chi-squared (Pearson's) test. Results: Out of the 312 individuals examined 224 (72%) had one or more teeth with apical periodontitis (PAI 3-5) and 272 individuals (87%) had one or more endodontically treated teeth. Amongst 7065 teeth evaluated 1255 (18%) were endodontically treated. Only 285 teeth (23%) of the root canal treated teeth were with complete root canal fillings. There was a statistically significant relationship between quality of root canal fillings and apical periodontitis (p<0.0001). In teeth with complete fillings only 15% were with apical periodontitis, but apical periodontitis were detected in 342 teeth (35%) with incomplete root fillings. Conclusion: The results from this study indicates a high prevalence of apical periodontitis and low quality of root fillings in a selected adult Riga population.
Unlabelled: A pilot study was conducted with the aim to test and develop a questionnaire which covers dental patients attendance, satisfaction with dental care, oral health self-evaluation, attitudes and knowledge about oral health, before applying it to a broad population. A total of 53 adult subjects (mean age 40.1) visiting Kaunas University of Medicine dental clinics, filled in the questionnaire presented by the researchers. Statement choices to define dental care satisfaction were selected from previously used instruments for similar studies in other countries. Results: Major difficulties in answering questions were related to using the Likert scale response alternatives. All statements concerning dental care satisfaction with the mean Likert score value below 2.0 were decided to be indicative for the importance of characteristics. According to factor analysis and distribution of the mean scores of dental care satisfaction characteristics it was decided to include no more than 8 questions in each dimension to the final version of questionnaire. In case of equal loadings of several statements in the factor analysis, the statement with lower mean score was used. Conclusions: The use of professional terminology in questionnaire survey should be tested before applying to a broad population. The final instrument for measuring dental care satisfaction should be formed on the basis of statistical evaluation of relative importance and comparative load of different questions/statements to be included in the questionnaire.
BACKGROUND. The need for appraisal of oral health-related quality of life has been increasingly recognized over the last decades. The aim of this study was to develope a Latvian and a Russian version and test the validity of the Oral Health Impact Profile (OHIP-49) for use among adults in Latvia. METHODS. The original English version of the OHIP-49 was translated using the forward-backward technique, pilot-tested, and then applied to 60 adults aged 18 years and above. The questionnaire was filled out during face-to-face interviews conducted by one specialist. The internal consistency of the questionnaire was evaluated using Cronbach's alpha (α) coefficient and inter-item and item-total correlations. Discriminant and convergent validities were assessed. RESULTS. Cronbach's α was estimated to be 0.96. Inter-item correlations coefficients ranged from 0.19 to 0.91, with averige value 0.35, while item-total correlations coefficients from 0.14 to 0.86. CONCLUSIONS. The OHIP-49 is a reliable and valid questionnaire for the assessment of OHRQoL among adults in Latvia.
To compare in vitro the cleanliness of root canal walls following automated or manual instrumentation. Thirty extracted human maxillary central incisors, maxillary and mandibular canines and premolars with single root canals were used in this study. The teeth were divided into two groups. In group 1 (20 teeth) automated canal preparation was performed using Anatomic Endodontic Technology (AET). In group 2 (10 teeth) manual instrumentation was performed with K-Flexofiles. Irrigation was performed using alternately 3.00% NaOCl and 18% EDTA, followed by rinsing with saline. The roots were split longitudinally into halves and the canals examined using a scanning electron microscope. The presence of debris and smear layer was recorded at coronal, middle and apical thirds of root canals using a four-step scoring scale. Mean scores for debris and smear layer were calculated and statistically analysed for significance (P<0.05) between and within groups, using the Mann-Whitney-Wilcoxon and Friedman nonparametric tests. At coronal and middle thirds the root canals prepared with manual instrumentation had significantly less surface debris on the canal walls compared with canals prepared with AET (p<0.05). At apical third root canals prepared with manual instrumentation had significantly more debris compared with AET group. The amount of smear layer was greater in the apical than in the coronal and middle thirds of the root and significantly less amount was in the AET group (P<0.05). Complete cleanliness was not achieved by any of the techniques and instruments investigated. It may be inferred that the choice between AET and hand instrumentation should be based on factors other than the amount of root canal debridement, which does not vary high significantly according to the instruments used.
OBJECTIVE. To investigate cleft disordered tissue in children with cleft palate and cleft lip with or without alveolar clefting for detection of local tissue growth factors and growth factor receptors and compare findings. Design. Morphological analysis of human tissue. Patients. Three groups were studied: 14 patients with cleft palate at the age from eight months to 18 years and two months, 12 patients with cleft lip with or without alveolar clefting in the age from four months to 15 years and four months and 11 control patients. RESULTS. In general, cleft palate disordered tissue showed more prominent expression of BMP2/4 (z=3.574; p=0.0004) and TGFβ (z=2.127; p=0.033), while expression of TGFBR3 significantly higher was only in connective tissue (z=3.822; p=0.0001). Cleft lip affected tissue showed significantly pronounced expression of FGFR1 in general as well as separately in epithelium. CONCLUSIONS. The marked and statistically significant expression of BMP 2/4 in cleft palate disordered soft tissue probably is delayed, but still proliferation and differentiation as well as tissue, especially, bone remodeling contributing signal. Cleft palate affected tissue show more prominent expression of TGFβ, still the weak regional expression of TGFβ type III receptors prove the disordered tissue growth and changed TGFβ signalling pathway in postnatal pathogenesis. In general, expression of TGFβ, BMP 2/4 and FGFR1 is significantly different, giving evidence to the involvement of these mentioned factors in the cleft severity morphopathogenesis.
The aim of the present study was to investigate pulp survival following crown fracture with and without pulp exposure as well as with and without associated subluxation and in relation to stage of root development and type of enamel-dentine fracture. This study consisted of 83 patients with 116 crown fractured incisors without pulp exposure and 35 patients with 44 complicated crown fractures. The effect of variables on the maintenance of tooth vitality were explored using the Linear Regression analysis , which assumes the effects of different factors on the pulp vitality such as (age, stage of the root development, contaminant subluxation, fracture depth, emergency treatment). The general distribution was 59 (71%) boys and 24 (29%) girls with uncomplicated crown fractures aged 7-17 years, mean 10.7 years ±2.83SD and 24 (68.5%) boys and 11 (31%) girls with complicated crown fracture. From 78 uncomplicated crown fractures without subluxation PN (pulp necrosis) was evaluated in 4 (4.88%) cases but from 20 uncomplicated crown fractures with subluxation PN was 14 (56.52%) cases. Univariate analysis showed that stage of root development p<0.05, subluxation p<0.001, fracture depth p<0.001 were significantly related to the pulp survival. The primary factors related to pulp healing events after crown fracture appears to be compromised pulp circulation due to concomitant subluxation as well as the stage of root development and fracture depth. For incisors with complicated crown fractures there were two more factors related to pulpal healing-time interval from injury until initial treatment and appropriate emergency treatment.
Unlabelled: Experimental data have demonstrated that impaired antioxidant capacity is associated with increased levels of reactive oxygen species (ROS) production. ROS can cause inactivation of critical enzymes and induce denaturation that renders proteins nonfunctional. Total blood is continuously exposed to oxidative stress. The aim of the current study was to investigate the reduction of nitroblue tetrazolium (NBT) by the total blood in persons with periodontitis and aged subjects. Materials and methods: The reduction of NBT in the total blood was measured according to a previously described procedure (Demehin et al., 2001), with modifications. Eight mL of venous blood were taken by venipuncture in the morning before meals and in portions of 2 mL placed into 4 plastic test tubes. Blood clotting was controlled with heparin (20 units/mL). Then the test tubes with blood were placed in the thermostat at the temperature of 37 degrees C and kept for 5 min. Next, NBT, the final concentration of which ranged to 1 x 10(-4), was added to the blood in the test tubes, which were kept for 20 min at the temperature of 37 degrees C. On completion of incubation, the tubes were centrifuged for 5 min at 2000 x g to sediment any cells. The supernatant was decanted into fresh test tubes, and the absorbance of NBT in the samples was measured spectrophotometrically at wave length of 570 nm at 25 degrees C. Results: Total blood antioxidant capacity in the patients with periodontitis and aged subjects was significantly lower (p<0.01 and p<0.05, respectively) than in the control subjects. In conclusion, the present study raise the necessity to search for causative agents of enhanced oxidative stress in patients with periodontitis and aged subjects and thus find the methods to diminish them.
Condition of dental prostheses in the middle-aged and elderly population of Kaunas city 
Distribution of the frequency of toothbrushing in the middle-aged and elderly population of Kaunas city 
The frequency of visits to the odontologist in the middle-aged and elderly population of Kaunas city 
Reasons for not visiting the odontologist in the middle-aged and elderly population of Kaunas city 
Self-evaluation of the oral condition in the middle-aged and elderly male and female population of Kaunas city 
The aim of the study was to evaluate the prevalence and the intensity of tooth decay among the middle-aged and elderly population of Kaunas, city, and to assess the need for prostheses as well as the possibilities for oral care. During 2006-2008, we studied 1,141 inhabitants of Kaunas city; the subjects' age was 45-72 years. Oral evaluation technique proposed by the WHO was used in the investigation. We evaluated the prevalence of tooth decay, and its intensity was evaluated using the DMF-T index. We also evaluated dental prostheses, the need for prosthetics, and asked the subjects how they took care of their oral health. The prevalence of tooth decay among middle-aged and elderly population of Kaunas city was 99.9%. The DMF-T index was 21.01+/-0.3 in the age group of 45-54 years, 23.52+/-0.4 - in the age group of 55-64 years, and 25.63+/-0.3 - in the elderly subjects. Full removable dentures were found in 14.0% of the elderly subjects, while 1.0% of the middle-aged subjects and 1.2% of the elderly subjects required full dentures. 57.7% of the subjects aged 45-54 years, 53.1% of the subjects aged 55-64 years, and 43.4% of the elderly subjects brushed their teeth twice daily. The intensity of tooth decay in middle-aged and elderly population of Kaunas city significantly increased with age (21.01-25.63). A relationship was found between oral hygiene status and the DMF-T index. In the middle-aged and elderly population of Kaunas city, the intensity of tooth decay was significantly lower (DMF-T 23.04%) among those who brushed their teeth twice daily than among those who brushed their teeth once daily or less frequently (DMF-T 24.01%). Reduction of the prevalence of tooth decay among middle-aged and elderly population of Kaunas city necessitates alterations in people's attitudes towards dental care, implementation of suitable hygiene habits, and creation and implementation of the dental disease prevention program for adults and the elderly, based on the strategy proposed by the World Health Organization.
Concomitant hypo-hyperdontia is a rare mixed numeric anomalous condition. The presence of this condition in the same area of dental arch and specifically in the mandibular anterior region is reported very infrequently. This case report presents a case of 20 years old male with congenitally missing permanent mandibular central incisors in conjunction with a mandibular midline supernumerary tooth. Only 3 cases have been documented in English literature till date. The article focuses on the review of mandibular mesiodens and the clarity regarding the usage of the terminology "mesiodens".
Patient's age is an important factor in orthodontic treatment. There are many studies about bone aging from the aspects of osteoporosis and other bone diseases. Both, aging and osteoporosis are associated problems and have a great importance in relation to their incidence. But not only osteoporosis or other bone related diseases are issue for many studies, because the knowledge of bone pathophysiology and diagnostics with signaling molecules makes it possible to predict treatment outcome and specific cell targeted pharmacology. In recent years immunohistological studies had become very popular in all fields of medicine including orthodontics, too. The question we tried to answer in this literature mini-review was--what kind of immunohistological studies were done from the aspect of bone aging in relation to patient`s age and orthodontic treatment? Search on Cochrane Library, PubMed, Science Direct, and DynaMed data bases by keywords: Alveolar bone aging, RANK, RANKL, OPG, MMP-1, MMP-8, IL-1, IL-6, TNF-α, TNF-β, and BM, resulted with 147 full-text articles; from them 90 met the criteria, 30 were reviews, and only in 22 articles from 60 bone aging from the aspect of signaling molecules were discussed. Interestingly, only 2 articles (Cei 2006 and Zhang 2003) were related to alveolar bone, and none studied it from the orthodontic point of view. Patient`s age plays an important role in orthodontic treatment, because of the bone response to mechanical loading. It is in accordance to clinical studies, or alike, that tooth movement in younger patient occurs much faster than in adults, but the question which factors are responsible for the process still remains.
The aim of this review is to analyze different factors which can affect natural face aging by delaying or expediting the process. Various studies shows that different factors such as ultraviolet light, gravity, habits, teeth loss may affect face appearance during aging. The articles from 1959 to 2011 related to topic were identified. 47 articles were selected for data collection.
Experimental apparatus 
Leakage differences in experimental groups 
Microbial leakage between experimental groups
The aim of this study was to determine and compare the microbial leakage of roots filled with EndoREZ sealer/EndoREZ Points and AH Plus sealer/ conventional gutta-percha points. 60 single-rooted teeth were prepared using step-back technique. The smear layer was removed with 18% EDTA. Teeth were divided into two experimental groups (n=25 each group) and two controls (n=5 each group). In AH Plus group root canals were obturated with AH Plus sealer/gutta-percha and in EndoREZ group with EndoREZ sealer/EndoREZ Points. Five teeth were served as negative controls and five as positive controls. All teeth were inserted into Eppendorf plastic tubes and suspended in glass bottles containing sterile Schaedler broth. The coronal chambers were filled with the mix of human saliva and broth (ratio 3:1). The medium was changed every 7 days. Microbial growth in the broth was evaluated every day up to the end of experiment. Leakage in the root canals of the teeth from experimental groups occurred between 4 and 75 days. The mean leakage in AH Plus group was 18.86 days, while in EndoREZ group it was 28.28. No statistically significant difference in microbial leakage between two tested filling materials was found. Both types of root fillings - EndoREZ sealer/EndoREZ Points and AH Plus sealer/gutta-percha points - showed microbial leakage.
OBJECTIVE. Upper airway changes caused by orthognathic surgery operations have been a topic of a concern in the orthodontic literature because of a possible development of obstructive sleep apnea. Diverse response of the airway patency could be expected if the dimensions of the airway differ among various malocclusions already before orthognathic treatment. However the associations between facial morphology and the upper airway dimensions have not been clarified. The purpose of this systematic review was to elucidate whether the upper airway dimensions differ among various sagittal craniofacial patterns. MATERIAL AND METHODS. MEDLINE and the Cochrane Library were searched up to November 2012. Reference lists of relevant articles were checked for further possible studies. Strict inclusion and exclusion criteria were applied when considering the studies to be included. Screening of eligible studies and data extraction were conducted independently by two reviewers. RESULTS. 758 studies were identified and 11 of these were recognized as suitable for further analysis. 75% of studies did not find differences in the nasopharyngeal dimensions among craniofacial patterns. The findings for the oropharyngeal dimensions were controversial as 5 of 11 investigations found these to be smaller in Class II subjects, and 6 of 11 concluded that oropharynx size is larger in Class III pattern. The vertical growth type of the subjects was not considered in five investigations, and 45% of the included studies used lateral cephalometry as only tool for airway assessment. CONCLUSIONS. Currently there is insufficient evidence that the upper airway dimensions differ in various sagittal skeletal patterns.
OBJECTIVES. To estimate the soft tissue determined individual features of the upper airway sagittal size which may predispose the patient to snoring and OSA and to find whether there is any relationship between the patient's body-mass index (BMI) and the severity of OSA. MATERIAL AND METHODS. 58 consecutive patients with a mean age of 33.4 years were surgically treated for snoring and OSA. Before the operation they were subject to the following: physical examination, a sleep study to determine the severity of sleep disturbed breathing (SDB); the body mass index (BMI) was calculated, lateral cephalometry (LC) was recorded. RESULTS. Snoring was found in 25 patients, OSA I (mild) - 15, OSA II (moderate) - 9, OSA III (severe) - in 9 patients. Among patients with obesity, the most widespread types of sleep disorders were OSA II and OSA III. (p=0.029). There were differences in the mean values of the BMI between the group of snorers and the group with OSA II (p=0.007), between snorers and OSA III (p=0.006). Differences in upper airway cephalometric mean values between groups were found, the thickness of the uvula (SPT) between snorers and OSA III (p=0.001), between the OSA I and OSA III groups (p=0.032), and between the OSA II and OSA III groups (p=0.075). CONCLUSION. Our study found narrowing in the anterior-posterior dimension of the airway at all levels, correlating with the severity of OSA as well as the BMI. The narrowest place was found in the oropharynx with an extension to the hypopharynx.
The objective: The objective of this work is to prove that oral cavity fluids diffuse into alginate mass of impressions. In addition, the information is presented on the subject that disinfectants used for alginate impressions disinfection not only diffuse into alginate mass but penetrate deeper than oral cavity fluids. Materials and methods of the study: Three examination groups were formed for the research, the results of which evidenced how deeply oral cavity fluids and disinfectants 'Alpha Guard GF' and 'Orbis' could possibly diffuse into alginate impression material 'Kromopan 100'. In the first examination group ten impressions from the upper jaw dental arch and mucosa were taken, firstly colouring oral cavity fluids with a special colouring tablet MIRA-2-TON (Hager Werken). Cuts were randomly selected from impressions and scanned aiming to establish the depth of the coloured oral cavity fluid penetration. In the second and the third examination groups taken alginate impressions were accordingly soaked in 'Alpha Guard GF' and 'Orbis' with pigment and later randomly selected cuts were scanned in the same manner as in the first research group. RESULTS. The research results establish that coloured dental cavity fluids maximum diffuse into alginate impression is up to 540 microm with the presence of 95% of discolouring while disinfectants 'Alpha Guard GF' and 'Orbis' accordingly diffuse into alginate mass up to 710 microm and 870 microm with the presence of 95% of discolouring. CONCLUSIONS. The results obtained show that disinfectants using them according to the recommendations of a manufacturer, diffuse into alginate mass deeper than oral cavity fluids at the time of impressions taking.
Van der Woude syndrome is a rare disorder of craniofacial development, characterized by the triad (congenital lip fistula, cleft lip and/or cleft palate). Discomfort caused by spontaneous or induced drainage of saliva/mucus when pressure is applied or during a meal as well as poor aesthetics match is one of the main complaints of patients with congenital lip fistula. This paper aims to describe an alternative technique for excision of the congenital fistula of lower lip in patient with Van der Woude syndrome, using gutta percha points and methylene blue for better identify the the fullest extent of the fistula. This approach aims to facilitate a dissection of fistula tissues providing better preservation of the tissues around the fistula, faster healing and better aesthetics lip of the patient.
Piezo ultra- sonic tip 
Dental root Nr. 22 must be ex- Fig. 5. Post-extraction socket tracted due to poor conservative treat- ment prognosis 
The aims were to overview healing of extraction socket, recommendations for atraumatic tooth extraction, possibilities of post extraction socket bone and soft tissues preservation, augmentation. A search was done in Pubmed on key words in English from 1962 to December 2011. Additionally, last decades different scientific publications, books from reference list were assessed for appropriate review if relevant. There was made intraalveolar and extraalveolar postextractional socket healing overview. There was established the importance and effectiveness of atraumatic tooth extraction and subsequent postextractional socket augmentation in limited hard and soft tissue defects. There are many different methods, techniques, periods, materials in regard to the review. It is difficult to compare the data and to give the priority to one.
Distribution of series the number of cases is out of parenthesis whereas the median delta IAJ is in parenthesis
Failed implants
Full arch prosthesis 
The final oral rehabilitation 
In the last decade, several investigators have reported that standard length implants (SLIs) have achieved excellent results but no report regarding SLIs (i.e. SLI, length=13 mm) inserted into alveolar bone sites previously augmented with frozen bone (FB) is available. The aim of this study was to evaluate the clinical outcome of SLIs inserted into alveolar bone sites previously augmented with FB. The survival and success rate of standard dental implants was evaluated after surgical placement into alveolar bone sites previously augmented with FB. The distance between Implant Abutment Junction and crestal bone level (i.e. delta IAJ) was measured to evaluate the peri-implant bone loss over time. Kaplan-Meier algorithm and Cox regression were used. The implant survival rate was 97.6% and no differences were detected among the studied variables by using implant loss. On the contrary, the Cox regression showed that implant surface (i.e. sandblasted and acid-etched-SLA- and CaPO(4)ceramic-blasted implants, p=0.0037), graft site (i.e. maxilla, p=0.0438) and prosthetic restoration (i.e. removable dentures, p=0.0003) correlated with a statistically significant reduced crestal bone loss (i.e. success rate). SLIs had a high survival and success rate similar to those reported in previous studies of two-stage procedures in non-grafted bone. FB is a reliable material for alveolar reconstruction and implant insertion.
Ameloblastoma is the common form of aggressive benign tumor of the jaws, but it is rare in childhood. The treatment of ameloblastoma is controversial. Surgical treatment of ameloblastoma in children follows the principles of the clinical and pathological aspects of the tumor and poses a special problem due to the incomplete growth of the jaws. With a unicystic ameloblastoma, the procedure of choice is a conservative approach. This paper describes the conservative treatment of a plexiform unicystic ameloblastoma in a child involving curettage of the tumor and the extraction of two teeth under local anesthesia, with a good prognosis of the case.
Multi fi ber conact illumination 
Overall clinical outcome by 10 years
Kaplan-Meier method for lesions divided in two groups – MFC group and Super fi cial illumination group 
Objective: This article presents long-term follow-up after use of topical photodynamic therapy (PDT) for basal cell carcinoma. PDT is treatment option for different tumors, involving use of specific agent which is activated by visible light and results in tissue destruction. Materials and methods: Overall 20 patients with 29 tumors were treated at the Latvian Oncology Center. Two illumination techniques were used: superficial for smaller lesions and multifiber contact for nodular tumors. Clinical outcome was evaluated at 1, 7, 44 months and 10 years after procedure. Results: By 10 year follow up, there were 2 tumor recurrences and in one case there was tumor residual tissue after first PDT treatment. Overall after ten years follow-up complete response was 80% of cases. Conclusion: Data in this study supports hypothesis that PDT could be used for the treatment of non-invasive (superficial and nodular) basal cell carcinoma. Results in this study correspond with similar long-term follow-up studies.
To review the results of studies reporting data on changes in aspects of children's oral-health-related quality of life (OHRQoL) following dental treatment under general anaesthesia (GA). To describe instruments measuring children's OHRQoL used in the studies. A literature review was carried out to identify relevant studies reporting data on changes in aspects of children's OHRQoL following dental treatment under GA. The data was extracted from the selected papers. The review included 11 journal articles, which presented the results of clinical trials. The studies were based on different questionnaires measuring children's OHRQoL and parental satisfaction. Oral rehabilitation under GA results in the immediate improvement of children's oral health and physical, emotional and social quality of life. It also has a positive impact on the family. However, a more accurate comparison of results is not possible due to differences in instruments used. And no single decision exists on the choice of the instrument measuring children's OHRQoL following dental treatment under GA. It may be concluded that further studies on measuring long term OHRQoL changes and studies surveying children are needed.
Characteristics of least reproducible measurements obtained from digitized acetate tracings and digital photographs of headfilms 
The emerging market of digital cephalographs and computerized cephalometry is overwhelming the need to examine the advantages and drawbacks of manual cephalometry, meanwhile, small offices continue to benefit from the economic efficacy and ease of use of analogue cephalograms. The use of modern cephalometric software requires import of digital cephalograms or digital capture of analogue data: scanning and digital photography. The validity of digital photographs of analogue headfilms rather than original headfilms in clinical practice has not been well established. Digital photography could be a fast and inexpensive method of digital capture of analogue cephalograms for use in digital cephalometry. The objective of this study was to determine the validity and reproducibility of measurements obtained from digital photographs of analogue headfilms in lateral cephalometry. Analogue cephalometric radiographs were performed on 15 human dry skulls. Each of them was traced on acetate paper and photographed three times independently. Acetate tracings and digital photographs were digitized and analyzed in cephalometric software. Linear regression model, paired t-test intergroup analysis and coefficient of repeatability were used to assess validity and reproducibility for 63 angular, linear and derivative measurements. 54 out of 63 measurements were determined to have clinically acceptable reproducibility in the acetate tracing group as well as 46 out of 63 in the digital photography group. The worst reproducibility was determined for measurements dependent on landmarks of incisors and poorly defined outlines, majority of them being angular measurements. Validity was acceptable for all measurements, and although statistically significant differences between methods existed for as many as 15 parameters, they appeared to be clinically insignificant being smaller than 1 unit of measurement. Validity was acceptable for 59 of 63 measurements obtained from digital photographs, substantiating the use of digital photography for headfilm capture and computer-aided cephalometric analysis.
Clinical appearance of three separate nerves, coming from three different foramina at the right side of the mandible 
Preoperative three-dimension computed tomography showing three mental foramina at the right side of the mandible 
Postoperative panoramic radiography showing only two mental foramina 
We have reported a case of triple mental foramina at the right side of the premolar region, which was discovered during reposition and ostheosynthesis of a mandible fracture. A review of the literature, was performed which disclosed no previous clinical cases reported but an incidence of 1.2% of triple foramina after investigating dry skulls or radiographics. The discussion stresses the importance of adequate preoperative radiological examination in the clinical situation especially when closed surgery is planned.
The purpose of this article was to review and update current data of the use of implants for orthodontic anchorage. A meta-analysis of selected literature was carried out and a total of 415 articles were identified in this process. Having reviewed the articles or their abstracts/summaries the data were evaluated and the articles were categorized according to the journal and the year of publication, the type of the article and the type of the implant. The interest in the possibilities of the implant usage for orthodontic anchorage is noticeably increasing and today it has reached the peak. In order to facilitate the understanding of the wide range of implants, we suggested the classification of the implants for orthodontic anchorage according to the shape and size, the implant bone contact and the application of the implant. We systemized the information about types of implants and their advantages in respect of traditional orthodontic treatment.
Outcomes of mandibular fractures were stated as frequent reason of temporomandibular joint dysfunctions. The objective of this study was to evaluate dynamical changes of occlusion and articulation during treatment of mandibular angle fractures. 12 subjects with mandibular angle fractures underwent analysis of occlusion and articulation in all stages of healing. Findings of investigations were presented in Posselt's and intercondylar axis diagrams, occlusiograms and relative force vs. time graphs. Comparison of results in first day, 1, 3 and 6 months after trauma showed that despite typical process of fragments healing and good fixation but with insufficiently balanced occlusion and posttraumatic discoordination of muscle activity first signs of TMJ articular discs dysfunction were found. Our results confirm the concept that early rehabilitation of mandibular function and occlusion are essential to prevent developing functional disorders of TMJ.
PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p<0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment.
425 patients with mandibular angle fractures were treated at the Hospital of Kaunas University of Medicine (HKUM) Clinic of Maxillo-Facial Surgery. Treatment included the application of closed fracture fragments fixation methods (wire splint fixation, and Kirschner wire osteosynthesis), and methods of open fixation--osteosynthesis using the supra-periosteal miniplate, and osteosynthesis using supra-osseous Zes Pol plate (the latter method was modified by the authors). Relative computerized densitometry showed that closed fixation methods result in a faster healing of fractures. The findings of the pain threshold testing showed that open fixation methods more severely damage the function of the lower alveolar nerve. Using closed fixation methods, osteomyelitis occurred in 5.3% of cases, while using open fixation methods--in 15.3% of cases. Thus, the authors of the article maintain that when mandibular angle fractures, in the presence of suitable conditions, closed fracture fragments fixation methods should be given a priority.
Unlabelled: AIM OF STUDY was complex detection of appearance and distribution of growth factors, facial bone growth stimulating genes, ground substance proteins and apoptosis in bone of ankylotic TMJ in primary and repeatedly operated children. Materials and methods: Ankylotic tissue was obtained during the arthroplastic surgery from two 6 years old children (boy and girl) with osseous type of disease. The girl underwent the repeated surgery in TMJ due to the same diagnosis in age of 12 years. Ankylotic tissue was proceeded for detection of BMP2/4, TGFβ, Msx2, osteopontin, osteocalcin immunohistochemically, and apoptosis. RESULTS demonstrated massive bone formation intermixed by neochondrogenesis the lack of BMP 2/4, but abundant number of TGFβ-containing cells in bone of all tested cases. Despite rich osteopontin positive structures in bone obtained from both - primary and repeated surgery, osteocalcin demonstrated variable appearance in 6 years aged children, but was abundant in joint 5 years later during disease recurrence. Expression of Msx2 varied widely before, but with tendency to decrease stabilized until few positive cells in bone of 12 years old girl. Apoptosis practically was not detected in primarily operated TMJ, but massively affected the supportive tissue in girl with recurrent ankylosis. Conclusions: The lack of BMP2/4 expression in ankylotic bone proves the disorders in cellular differentiation with simultaneous compensatory intensification of cellular proliferation and/or growth by rich expression of TGFβ leading to the remodelling of TMJ. Mainly rich distribution of osteocalcin and osteopontin indicate the intensive mineralization processes of ankylotic bone. Persistent Msx2 expression is characteristic for the supportive tissue of recurrent ankylosis of TMJ and indicates the persistent stimulation of bone growth compensatory limitated by massive increase of programmed cell death.
Top-cited authors
Alina Puriene
  • Vilnius University
Vytaute Peciuliene
  • Vilnius University
Vygandas Rutkunas
  • Vilnius University
Vilija Janulyte
  • Vilnius University
Ruta Bendinskaitė
  • Vilnius University