Category Archives: Dental materials

The Use of Pre-Fabricated Composite Veneers to Enhance Esthetics

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Stela Panteqi1 / Adem Alushi2 / Orges Simeon1

1 Faculty of Dental Sciences, Aldent University Tirana, Albania
2 Faculty of Dental Medicine University of Medicine, Tirana, Albania


Background: This article is focused on the use of polymerized, prefabricated nano-hybrid-composite veneers to close diastema and to regain a vitality appearance of non vital discolored teeth. Case Reports: A 24-year old patient presented herself with a major complaint about the discoloration of her maxillary central incisors. The prefabricated composite veneers were recommended as the perfect solution in this case. Tooth shape and size was evaluated with the contour guide. Two pre-fabricated composite veneers size “M” were trimmed and cemented with the same hybrid composite resin that they were made from. A 28 year-old patient presented herself with a major complaint about her diastema. Her maxillary frontal teeth were intact. It was decided to use two veneers; size “L” and shade A2/B2 and Enamel Universal were chosen. Identical steps were followed as in clinical case 2. Conclusion: This new technique of treatment resulted to be an affordable way to regain esthetics. It is a one session treatment and requires no lab sessions, which makes it very comfortable for both dentist and patients. As with all new techniques, there is still a lot to be done, to confirm its effectiveness as a long term solution in esthetic dentistry.

Keywords: Veneers; Composite; Direct technique; Esthetics


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Citation Information:Balkan Journal of Dental Medicine, ISSN (Online) 2335-0245, DOI: Citation

In Vitro Biocompatibility of Nanostructured Endodontic Materials Using SCAP Cells

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Bojana Ćetenović1 / Božana Čolović1 / Saša Vasilijić2 / Snežana Pašalić1 / Vukoman Jokanović1 / Dejan Marković3

1 Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
2 Military Medical Academy, Faculty of Medicine, University of Defense, Belgrade, Serbia
3 School of Dentistry, University of Belgrade, Belgrade, Serbia


Background/Aim: Lately, fully innovative sol-gel method with high-temperature self-propagating reaction was used for the synthesis of new nanostructured endodontic materials, in combination with different radiopacifiers: bismuth (ALBO-MPCA1) and barium (ALBO-MPCA2). The aim of this study was to investigate the biocompatibility of nanostructured endodontic materials based on highly active calcium silicates and mixed with different radiopacifiers in comparison to MTA+ using human stem cells from the apical papilla- SCAP cells. Material and Methods: Morphology of the samples was studied by SEM. The tested materials were mixed with distilled water in a ratio 2:1 (m/m). Fifteen minutes fter the preparation, samples were used in the experiment. The biocompatibility of fresh materials, after 3h and 7 days, was tested using 3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide- MTT test. Results: Samples mostly consisted of spherical and rode-like. The relative viability of cells increased following the exposure time. Conclusion: The biocompatibility of synthesized materials is comparable to the control material MTA+, and therefore these materials can be recommended for for further clinical stuadies.

Keywords: Biocompatibility; Calcium Silicates; MTT; MTA; Biomaterials


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Citation Information:Balkan Journal of Dental Medicine, ISSN (Online) 2335-0245, DOI: Citation


Practical Aspects of Finite Element Method Applications in Dentistry

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 / Dimitrije Mihajlović

Faculty of Mechanical Engineering, University of Belgrade, Belgrade, Serbia


The use of numerical methods, such as finite element method (FEM), has been widely adopted in solving structural problems with complex geometry under external loads when analytical solutions are unachievable. Basic idea behind FEM is to divide the complex body geometry into smaller and simpler domains, called finite elements, and then to formulate solution for each element instead of seeking a solution for the entire domain. After finding the solutions for all elements they can be combined to obtain a solution for the whole domain. This numerical method is mostly used in engineering, but it is also useful for studying the biomechanical properties of materials used in medicine and the influence of mechanical forces on the biological systems. Since its introduction in dentistry four decades ago, FEM became powerful tool for the predictions of stress and strain distribution on teeth, dentures, implants and surrounding bone. FEM can indicate aspects of biomaterials and human tissues that can hardly be measured in vivo and can predict the stress distribution in the contact areas which are not accessible, such as areas between the implant and cortical bone, denture and gingiva, or around the apex of the implant in trabecular bone. Aim of this paper is to present – using results of several successful FEM studies – the usefulness of this method in solving dentistry problems, as well as discussing practical aspects of FEM applications in dentistry. Some of the method limitations, such as impossibility of complete replication of clinical conditions and need for simplified assumptions regarding loads and materials modeling, are also presented. However, the emphasis is on FE modelling of teeth, bone, dentures and implants and their modifications according to the requirements. All presented studies have been carried out in commercial software for FE analysis ANSYS Workbench.

Keywords: Finite Element Method; Biomechanical Systems; Computer Simulations; Stress Analysis


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Citation Information: Balkan Journal of Dental Medicine, ISSN (Online) 2335-0245, DOI: Export Citation

Treatment of Biphosphonate-Related Osteonecrosis of the Jaw (BRONJ) Combining Surgical Resection and PRGF-Endoret® and Rehabilitation with Dental Implants: Case Report

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1Eduardo Anitua Foundation, Vitoria, Spain


Background: The first cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) were reported in 2003. Since then number of possible treatments have been proposed.

Case report: We report a case of a 50-year-old patient with bisphosphonate-related osteonecrosis of the jaw (BRONJ). The treatment included resection of necrotic bone and the application of plasma rich in growth factors (PRGF®-Endoret®). We closed the ulcer in the soft tissue and the treated bone was regenerated one year later. Finally the regenerated area was rehabilitated with dental implants.

Conclusion: Resection followed by PRGF® -Endoret® was successful in promoting closure of the wound and the recovery of nerve function.

Keywords: Bisphosponates-Related Osteonecrosis (BRONJ); Medicament-Related Osteonecorosis (MRONJ); Nerve Injury; Platelet Rich Plasma; PRGF


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Citation Information: Balkan Journal of Dental Medicine. Volume 21, Issue 1, Pages 55–59, ISSN (Online) 2335-0245, DOI:, March 2017


In Vitro Microleakage of class V Composite Restorations prepared by Er,Cr:YSGG Laser and Carbide BUR

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Athanasios Synarellis1 / Pantelis Kouros1 / Elisabeth Koulaouzidou1 / Dimitrios Strakas1 / 1

1School of Dentistry, Department of Operative Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece


Background: The aim of this in vitro study was to compare the degree of microleakage on enamel and dentin margins of class V cavities prepared with either a high-speed drill or an Er,Cr:YSGG laser (2780 nm) and to associate their use with a beveling method for the margin.

Method and Materials: Sixty bovine incisors were randomly distributed into three groups. Group 1 (G1) cavities were laser prepared and bur beveled, group 2 (G2) cavities were bur prepared and beveled, while cavities of group 3 (G3) were laser prepared and beveled. Cavities were restored with selective enamel etching, using the same bonding agent and nano-hybrid resin composite for all groups. After thermocycling, microleakage was assessed using a methylene blue dye penetration method.

Results: Statistical analysis (Mann-Whitney, Kruskal-Wallis and post-hoc Dunn’s multiple comparison tests) demonstrated significantly higher microleakage for dentin compared to enamel margins in G1. Enamel margin microleakage was found to be significantly higher at G3 compared to G1 (p=0.032) and G2 (p=0.001), while no significant differences were found between G1 and G2 (p=0.850). Regarding dentin margins, G2 group performed significantly better than G1 and G3 (p<<0.001), while there was no significant difference among G1 and G3 scores (p=1.000).

Conclusions: The conventional cavity preparation method seems to perform better in terms of microleakage than the Er,Cr;YSGG laser. Laser-prepared cavities could perform better in terms of microleakage if an additional step of enamel bur-beveling is performed prior to restoration.

Keywords: Bovine Teeth; Enamel Etching; Er,Cr:YSGG Laser; Microleakage


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  42. Ekworapoj P, Sidhu SK, McCabe JF. Effect of different power parameters of Er,Cr:YSGG laser on human dentine. Lasers Med Sci, 2007; 22:175-182.[Web of Science] [Crossref]
  43. Phanombualert J, Chimtim P, Heebthamai T, Weera-Archakul W. Microleakage of Self-Etch Adhesive System in Class V Cavities Prepared by Using Er:YAG Laser with Different Pulse Modes. Photomed Laser Surg, 2015; 33:467-472.[Crossref] [Web of Science]
  44. Delme KI, Deman PJ, De Moor RJ. Microleakage of class V resin composite restorations after conventional and Er:YAG laser preparation. J Oral Rehabil, 2005; 32:676-685.[Crossref]
  45. Delmé KI, Deman PJ, De Bruyne MA, Nammour S, De Moor RJ. Microleakage of glass ionomer formulations after erbium:yttrium-aluminium-garnet laser preparation. Lasers Med Sci, 2010; 25:171-180.[Web of Science] [Crossref]
Citation Information: Balkan Journal of Dental Medicine. Volume 21, Issue 1, Pages 24–31, ISSN (Online) 2335-0245, DOI:, March 2017


Extrusion of Root Canal Sealer in Periapical Tissues – Report of Two Cases with Different Treatment Management and Literature Review

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1 / Nikolaos Economides2 / Vasilis Evangelidis3

1Undergraduate student, Aristotle University, Dental School, Thessaloniki, Greece
2Associate Professor, Aristotle University, Dental School, Thessaloniki, Greece
3Graduate student, Dental School, Thessaloniki, Greece


Background: Extrusion of root canal sealers may cause damage to the surrounding anatomic structures. Clinical symptoms like pain, swelling and paresthesia or anesthesia may be present. The purpose of this presentation is to describe two cases of root canal sealer penetration into periapical tissues. A different treatment management was followed in each case.

Case reports: A 55 year-old man underwent root canal retreatment of the right mandibular first molar tooth due to a periapical lesion. Postoperative periapical radiographs revealed the presence of root canal sealer (AH26) beyond the apex in the distal root in proximity to the mandibular canal. The patient reported pain for the next 7 days. Radiographic examination after 1 year showed complete healing of the periapical area and a small absorption of the root canal sealer. A 42 year-old woman was referred complained of swelling and pain in the area of the right maxillary first incisor. Radiographic examination showed extrusion of root canal sealer in the periapical area associated with a periapical lesion. Surgical intervention was decided upon, which included removal of the sealer, apicoectomy of the tooth and retrograde filling with MTA. After 1 year, complete healing of the area was observed.

Conclusion: In conclusion, cases of root canal sealer extrusion, surgical treatment should be decided on only in association with clinical symptoms or with radiographic evidence of increasing periapical lesion.

Keywords: Extrusion; Root Canal Sealer; Symptoms; Treatment Management


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Citation Information: Balkan Journal of Dental Medicine. Volume 21, Issue 1, Pages 12–18, ISSN (Online) 2335-0245, DOI:, March 2017


Investigation of Antioxidant Capacity of Several Luting Cements Processes by HPMC Method

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1 / Kosovka Obradović-Đuričić2 / Vesna Medic2 / Srđan Poštić2 / Stanislava Z Gorjanović3 / Ferenc Pastor4 / Katarina Radović2

1School of Dental Medicine, Endodont. Dpt., Belgrade University, Rankeova 4, Belgrade,Serbia
2School of Dental Medicine, Prosthodont. Dpt., Belgrade University,Serbia
3Institute of General and Physical Chemistry,Serbia
4Faculty of Chemistry, University of Belgrade, Belgrade,Serbia


Background: Free radicals (FR) occur in oral cavity where lot of food was transferred to through entire life under specific saliva conditions. Many enzymes, microorganism, alcohol beverages, nicotine and other harmful or indifferent substances when in contact to oral tissues might provoke oxidation process under specific condition creating FRʼs. The similar role might have various dental materials.

Aim: Of the study was to record the level of antioxidant (AO) activity of several permanent (P) luting cements alone or combined with quercetin AO substance.

Materials/Methods: P cements were Zn-phosphate, Zn-polycarboxilate, GIC and composite resin cement. They were prepared as original prescription and their variant by 1%weight addition of quercetin. AO activity of cements was measured by HPMC test evaluated by Student t test.

Results: There were statistically significant differences among Zn-phosphate, Zn-polycarboxilate and resin dental cements (p ˃ 0,05). GIC displayed significantly higher AO values (p < 0,01) versus other three cements. There were no difference in AO capacity between sample of original P cements and their corresponding quercetin variants (p ˃ 0,05).

Conclusions: Conventional GIC displayed the most powerful AO activity among P luting cements. Addition of 1% antioxidant quercetin did not improve AO capacity of investigated cements.

Keywords: Antioxidant; Antioxidant capacity; Free radicals; Luting cement; Glass ionomer cement; Eugenol; Quercetin; Flavone


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Citation Information: Balkan Journal of Dental Medicine. Volume 20, Issue 3, Pages 155–159, ISSN (Online) 2335-0245, DOI:, November 2016