Summary

The aim of the study was to present the possibilities of physiotherapy in a patient with cerebellopontine tumour. A description is given of a case of a patient who underwent a number of operations and who was rehabilitated in the Clinic of Physiotherapy in Szczecin. After the physiotherapy a reduction in the asymmetry of the face was obtained, together with improvement in the strength and function of the mimetic muscles of the face, reduction in disturbances of equilibrium and improvement in the control of fluid leakage during eating. Physiotherapy constitutes an indispensable element of rehabilitation in patients with cerebellopontine tumour. Systematic working on the patient, based on a holistic approach and patient activation during the course of therapy, give measurably positive effects.

Summary

Background. The pregnant woman in her particular physiological state should be covered by interdisciplinary medical care both on the part of the gynaecologist and of the dentist. The changes that occur in the organism during pregnancy favour the development of pathologies in the oral cavity. Objectives. An evaluation of the health of the oral cavity in patients at the Institute and Medical Centre for Polish Mothers (ICZMP) during the perinatal period. Analysis of the health behaviours of pregnant women. Materials and methods. Questionnaire and clinical examinations were carried out on 70 patients from the ICZMP. Analysis was carried out on the values for the indicators for caries susceptibility and for the periodontal treatment needs. Results. Amongst the mothers to be, 35% restricted visits to the dentist due to pregnancy, and 30% did not visit the dental office. The majority (92%) of pregnant women choose a private dental office. The mean value for DMF among the examined population is 12.3 (Me 12). However, according to the indicator CPITN, 43% of women are in the treatment needs category, and 29% are in category II. In 78% respondents brushed their teeth twice daily and used mouthwashes (54%) and dental floss (42%) as additional hygienic methods. Almost 2/3 of those taking part in the study regard the state of their dentition as satisfactory, only one in four women is of the opinion that the state of her dentition can be evaluated as very good. Conclusions. During pregnancy it should be the standard to have dental examination with determination of a preventive plan or treatment. Public dental care should increase awareness in expectant women by educational programs directed at them. It is essential to work out the conditions for cooperation on the level dentist – gynecologist in cases where there is a pregnant woman under the care of both.

Summary

The pyogenic granuloma is a non-neoplastic lesion occurring singly on the skin and on the oral mucous membrane. During its development the volume of the gum becomes enlarged. This granuloma is also described as pyogenic or angiogenic, although, because of the histological picture, the lack of pus content and the rich amount of blood vessels, this deserves to be named lobular capillary haemangioma. The aetiology of granuloma is considered to be found in trauma – especially chronic, hormonal changes and also as a sequel to using certain medicines. The study describes a case of a 58-year-old female patient who was referred to the University Dental Clinic in Cracow by her dentist due to the absence of improvement in the treatment of changes that had been wrongly diagnosed as an intra-oral fistula in connection with chronic inflammation in the periapical tissues of tooth 34. The patient presented at The Central Outpatient Dental Clinic, where, after the taking of the medical history, clinical examination and radiology, pyogenic granuloma was diagnosed. The change was completely excised together with a margin of healthy tissue. Endodontic treatment was also carried out of adjoining teeth that did not show any signs of vitality. Histopathological examination confirmed the initial diagnosis. Regular control visits did not show any tendency of recurrence.

Streszczenie

W kolejnym przypadku z praktyki autora opisanym w fotoreportażu klinicznym spotykamy się z pacjentka, która zgłosiła się do kliniki na konsultację z powodu problemów estetycznych. Zaniepokoiła ją zarówno zmiana kształtu zębów, jak i ich koloru. Jednocześnie była zainteresowana jak najmniej agresywną metodą odbudowy. Jako rekomendowaną w takich przypadkach metodę zastosowano licówki porcelanowe.

Summary

In a further case from the author’s practice illustrated with a clinical photo report, we meet a female patient who presented at the clinic for a consultation regarding aesthetic problems. She was disturbed both by the change of shape of teeth as well as their colour. At the same time she was interested in a maximally least aggressive method of reconstruction. As is recommended in such cases, the method used was porcelain facings.

Streszczenie

W pracy opisano postępowanie z całkowicie zwichniętym zębem 21 oraz częściowo zwichniętymi zębami 11 i 22 u pacjenta M.L., lat 7. Ząb 21 z niezamkniętym wierzchołkiem był przetransportowany w mleku i został replantowany po około 20 minutach od urazu. Zęby 12, 11, 21, 22, 63 unieruchomiono szyną półsztywną na tydzień. Miazga zęba 21 obumarła po 2 miesiącach od replantacji, co zostało potwierdzone użyciem przepływomierza Periflux 5010. Zastosowano stymulację rozwoju wierzchołka korzenia z użyciem preparatów wodorotlenku wapnia, co doprowadziło po 9 miesiącach do wytworzenia się bariery z tkanki zmineralizowanej w wierzchołku korzenia. W obserwacji 3-letniej nie stwierdzono objawów patologicznych. Zaobserwowano natomiast obliterację kanału zęba 22. Pacjent obecnie jest leczony ortodontycznie.

Summary

The study describes procedure with complete avulsion of 21 and partial avulsion of 11 and 22 in patient M.L., aged 7 years. Tooth 21 with unclosed apex, was transported in milk and was replanted within about 20 minutes after injury. Teeth 12, 11, 21, 22, 63 were immobilised with a semi-rigid splint for a week. The pulp of tooth 21 was non-vital two months after replantatation, which was confirmed using the the laser Doppler flowmetry device PeriFlux 5010. Stimulation of apical development using calcium hydroxide preparations was used, which, after 9 months, lead to the formation of a barrier of mineralised tissue at the root apex. Three-year observation did not reveal any pathological changes. There was, however, observed to be obliteration of the root canal of tooth 22. The patient is at present undergoing orthodontic treatment.

Streszczenie

Całkowicie zatrzymane zęby przedtrzonowe są rzadkim zaburzeniem rozwojowym występującym tylko w uzębieniu stałym. W pracy przedstawiono wielospecjalistyczne leczenie pacjentki, u której w szczęce po stronie lewej stwierdzono obecność niewyrzniętego drugiego zęba przedtrzonowego ułożonego podniebiennie. Leczenie polegało na chirurgicznym odsłonięciu zęba połączonym z leczeniem ortodontycznym, mającym na celu sprowadzenie go do zgryzu.

Summary

Completely retained premolar teeth are a rare developmental defect that occurs only in the permanent dentition. The study describes multi-specialist treatment of a female patient, who, in the left side of the maxilla, had present an unerupted second premolar situated palatally. Treatment consisted of surgical exposure in connection with orthodontic treatment whose aim was to position it into the occlusion.

Streszczenie

W pracy przedstawiono opis przypadku rzadko występującego szkliwiaka zębopochodnego szczęki.

Summary

The article describes a rare case of odontogenic myxoma occurring in the maxilla.

Streszczenie

W pracy przedstawiono metodę trójwymiarowego opracowania systemu kanałowego z wykorzystaniem jednonarzędziowego systemu Self-Adjusting File (SAF) z jednoczesną irygacją. Proponowany sposób pracy z użyciem systemu SAF oparto na sześciomiesięcznym doświadczeniu jednego z operatorów oraz na danych z piśmiennictwa. W tym czasie opracowano ponad 100 kanałów korzeniowych o różnej trudności.

Summary

The study describes a three-dimentional method of preparing root canals using the one-instrument Self-Adjusting File (SAF) system with concurrent irrigation. The proposed method of working using the SAF system is based on six months experience of one of the workers and on data from the literature. During this period over 100 root canals of varying difficulty were instrumented.

Streszczenie
W pracy opisano możliwości stabilizacji koferdamu i alternatywnej metody izolacji pola zabiegowego z wykorzystaniem preparatu Expasyl w określonych zabiegach zachowawczych.

Summary
The study describes the possibilities of stabilising rubber dam and alternative methods of isolating the operative field using the preparation Expasyl in selected conservative procedures.

Summary

The study, which is a review of the literature, constitutes a mini-compendium of knowledge about temporary prostheses and their therapeutic-rehabilitational functions. Based on the literature, in an abridged way, the main functions of temporary restorations are presented in the therapeutic-rehabilitational process of the stomatognathic system with the aim of using them in multi-stage prosthetic treatment. The study is an attempt to make a generalised, systematised description of the actions of the dental prosthetist, who, carrying out therapeutic-rehabilitational functions, creates optimal conditions for the functioning of temporary prostheses.

Streszczenie

Zabiegi chirurgiczne mające na celu leczenie nowotworów okolicy szczękowo-twarzowej niosą ze sobą utratę dużej lub nawet bardzo dużej ilości tkanek własnych pacjenta, doprowadzając często do połączenia między jamą ustną a nosową. Pacjenci ci wymagają natychmiastowej specjalistycznej rehabilitacji protetycznej z wykorzystaniem obturatorów, aby zminimalizować negatywne skutki zabiegu chirurgicznego. Twardy materiał akrylowy obturatora stwarza niekorzystne warunki do gojenia się ran pooperacyjnych, dlatego wszystkie obturatory i protezy pooperacyjne powinny być podścielone materiałem elastycznym. Po pierwszej fazie leczenia należy wykonać docelowe uzupełnienia protetyczne. Pracownicy Zakładu Protetyki Stomatologicznej Uniwersytetu Medycznemu w Lublinie wykorzystują podścielenie miękkie jako wycisk czynnościowy. Dzięki takiemu postępowaniu można uzyskać idealnie odwzorowane podłoże protetyczne. Autorzy przedstawiają także własny przypadek kliniczny pacjenta leczonego opisaną metodą.

Summary

Surgical procedures with the aim of treating neoplasms in the maxillo-facial region, are associated with the loss of large or even very large quantities of patient tissue that frequently lead to a connection between the oral cavity and the nasal cavities. These patients require immediate specialist prosthetic rehabilitation with the use of obturators, in order to minimise the negative aspects of the surgical procedure. The hard acrylic material of the obturator creates unfavourable conditions for postoperative wound healing and all postoperative obturators and prostheses should, therefore, be lined with elastic material. After the initial phase of treatment, final prostheses should be made. At The Department of Dental Prosthetics, Lublin Medical University, they use a soft lining as a functional impression. Thanks to such a procedure it is possible to obtain an ideal reproduction of the base for the prosthesis. The authors also present their own clinical case of a patient treated by the method described.

Summary

Objectives. The aim of the study was to analyse the intensity of change in periodontal tissue of patients with various degrees of reduction in dental arches from the aspect of carrying out prosthetic treatment. Materials and methods. The material for the study consisted of 120 patients, males and females between the ages of 41-65 years, who presented at the Chair and Department of Prosthetics, Medical Academy, Wroclaw during the years 2007-2011. The patients were divided into three groups, A, B and C, with 40 individuals in each, depending on the level of reduction of the dental arches. All of the patients underwent medical history and clinical examination that included the state of the periodontal tissues, using the PPI, PBI indices and classification of periodontal recession according to Miller. Instrumental examination of the periodontal tissues use was made of the Periotest. The results were subjected to statistical analysis. Results. Evaluation of the periodontal tissues showed significant progression of inflammatory conditions with minimal in group B when compared to group A. With the group of patients with reduced dental arch there was a larger incidence of disappearance of gingival papilla with inflammatory states and loss of periodontal tissue; there was also found to be a larger number of teeth with periodontal recession and increased mobility when compared to group C with complete dental arches. Conclusions. Cases with extreme reduction of dental arch are most commonly characterised by the greatest loss of periodontal tissue. Because of this they form the group of patients with the greatest treatment needs.

Summary

Dental clinicians in everyday practice often face the problem of utilizing certain teeth in the reconstruction of the continuity of the dental arches. This concerns cases where the existing teeth are in a condition that questions the possibility of their retention in the oral cavity or the possibility of reconstruction by the use of conventional methods. The aim of the study was to describe prosthetic treatment aiming to retain teeth that were initially qualified for extraction. The study describes four cases of patients (2 females, 2 males) in whom there were teeth that were mobile, with significant alveolar resorption, elongated – significantly exceeding the occlusal plane, improperly treated endodontically, that were initially qualified for removal. In the cases mentioned prosthetic treatment was undertaken using cast root posts (root copings) that were subsequently used as denture abutments for skeleton dentures. After a few years of observation (from 2 to 9 years) there was found to be satisfactory function of the dentures used in all of the patients. Only in one case (after 9 years) was it necessary to remove one of the two retained roots fitted with root posts. From the prosthetic perspective the procedure used, not only creates greater comfort for the patient, but is indicated for physiological reasons. The retention of teeth, however, retards the resorption of the alveolar process and the behaviour of the periodontal receptors favours better neuromuscular coordination, which allows for the control and gradual increase of forces released during chewing, thus retaining the size of the alveolar process, improving the retention and stability of removable prostheses.

Summary

Background. Telescopic prostheses are a useful solution for patients with residual dentition. They ensure good loading of abutment teeth and stability of denture during eating. They eliminate the pulling, tearing and unsteady movements that occur during use of partial dentures with clasps. Objectives. The authors described a case of a patient using a telescopic prostheses in the mandible for twelve years. Result. The 82-year-old patient appeared for prosthetic treatment. He has been using a complete denture in the maxilla and a telescopic one in the mandible for 12 years. During treatment a new full denture was made in the maxilla and the telescopic denture was totally rebuilt. The finished dentures were returned for further use to the patient. Conclusions. The telescopic crowns system has many advantages that indicate the aptness of using these prostheses in the treatment of elderly peoples with limited mobility, poor vision and who are not candidatesfor intraosseous implants.

Summary

The study describes the results of examination of changes in incidence and intensity of dental caries in deciduous teeth in pre-school children from rural areas of Lviv region. It was found that the mean incidence of caries is 84.69 ± 2.21% with changes in intensity of 4.35 ± 0.17. In children above the second year of life caries of the anterior teeth dominated. In the ages of three to six years an increase of caries intensity was found in molars. This data confirms the necessity of introducing and applying dental prevention measures in pre-school children.

Streszczenie

Praca stanowi próbę zaprezentowania obszernego tematu, jakim są powikłania znieczulenia ogólnego, do których może dojść podczas leczenia w gabinecie stomatologicznym. Autorzy przedstawili trzy przypadki kliniczne, opiniowane w Zakładzie Medycyny Sądowej Uniwersytetu Medycznego w Łodzi pod kątem prawidłowości postępowania medycznego, ilustrujące różnorodność potencjalnych komplikacji, z którymi może się zetknąć w swojej praktyce zarówno lekarz dentysta, jak i lekarz anestezjolog. W rozdziale „Omówienie i dyskusja” starano się przybliżyć obraz postępowania karnego w sytuacji podejrzenia popełnienia błędu medycznego przez lekarzy oraz tego, w jaki sposób wielospecjalistyczne zespoły biegłych konstruują opinie sądowo-lekarskie, natomiast w rozdziale „Wnioski” podjęto próbę wskazania, jak można się starać zmniejszyć częstość występowania powikłań po zabiegach stomatologicznych wykonywanych w znieczuleniu ogólnym.

Summary

The study consists of an attempt to present a wide subject, as are the complications of general anaesthesia, that may occur during treatment in the dental office. The authors presented three clinical cases that were asked for a judgement from the Department of Forensic Medicine at the Medical University in Lodz from the point of view of the correctness of medical procedure. This illustrated the variety of potential complications that can be confronted in clinical practice both by the dentist as well as by the anaesthesiologist. In the chapter entitled “Overview and Discussion” an attempt was made to elucidate criminal proceedings in the situation where there is a suspicion that a medical mistake has been made by the doctor. There is also a discussion as to how multi-specialised teams construe medical legal opinions. In the chapter entitled “Conclusions” an attempt was made to indicate how there can be a reduction in the incidence of complications after dental procedures under general anaesthesia.

Streszczenie

W pracy opisano zalety tomografii stożkowej. Przedstawiono przypadki, w których badanie w postaci obrazowania 2D okazało się niewystarczające do postawienia prawidłowej diagnozy i podjęcia właściwego leczenia. Przypadki te pokazują, że badanie trójwymiarowe tomografii stożkowej o zmiennym polu obrazowania może być w niektórych przypadkach koniecznym składnikiem procedury diagnostycznej i prawidłowego planowania leczenia.

Summary

The study describes the advantages of cone beam computed tomography. Cases are presented in which examination in the form of 2D imaging turned out to be insufficient to make proper diagnosis and to undertake the proper treatment. These cases show that three dimensional cone beam computer tomography with a variable field of imaging may, in some cases, be a necessary constituent of diagnostic procedure and proper treatment planning.

Streszczenie

W pracy przedstawiono leczenie pacjenta w podeszłym wieku, wymagającego kompleksowego leczenia stomatologicznego, poczynając od fazy higienizacyjnej, a na zaawansowanym leczeniu protetycznym kończąc. Podkreślono znaczenie higienizacji dla powodzenia leczenia stomatologicznego oraz zadowolenie pacjenta z rehabilitacji protetycznej z zastosowaniem protezy szkieletowej klasycznej oraz protezy teleskopowej.

Summary

The study describes the treatment of an elderly patient, requiring complex dental treatment, starting with the hygiene stage and finishing with advanced prosthetics. Emphasis is made of the meaning of hygiene for successful dental treatment and for the satisfaction of the patient with prosthetic work using a classical skeleton denture and a telescopic denture.

Summary

The study describes the clinical experience of the authors regarding surgical removal of third mandibular molars and histopathological analysis of inflammatory lesions surrounding the teeth. During the years 2008-2011 in the examined group of 963 generally healthy individuals, there were 2062 out-patient surgical procedures for removal of teeth that were partially or totally retained. In addition, there were noticed clinically and radiologically, 747 cases of pathological changes which were examined by histopathology. Analysis revealed incidences of inflammation, cysts and a few cases of initial stage ameloblastoma of small dimensions, typical and not causing concern in the radiological picture.

Summary

Treatment of disturbances in lateral growth of the maxilla in adult patients makes ossification of the palatal and pterygoid-palatal sutures difficult. These sutures increase their resistance to expansion as maturity progresses. Modern orthodontics does not unequivocally determine the upper age limit to which it is still possible to effectively widen the palatal suture using orthodontics. Among orthodontists there is quite a widespread opinion that widening of the palatal suture after the sixteenth year of life without surgery may be ineffective and is burdened with the risk of complications. Opinions, however, are divided in the literature. The authors describe a case of a 30-year-old female patient with Class II malocclusion with associated narrowing of the maxilla and increased intensity of crowding in both dental arches. She was treated using the method of rapid maxillary expansion without additional surgery.