The pandemic of COVID-19 has brought many changes in health care systems at all levels of health care. The increase in the number of cases of COVID-19 has led to overuse and misuse of antibiotics.The aim of this study was to compare the consumption of antibiotics for systemic use in outpatients in the Republic of Srpska (RS), before and during the first year of the COVID-19 pandemic, as well as the association between antibiotic consumption and the rate of incidence and mortality of COVID-19. The total consumption of the antibiotics for systemic use (J01) in outpatients in the Republic of Srpska during 2019 was 19.40 DDD/TID, with an increase to 30.80 DDD/TID in 2020.Significantly higher use of penicillin (10.58 ± 11.01 DDD/TID in 2019 vs. 17.10 ± 13.63 DDD/TID in 2020), cephalosporins (2.68 ± 1.90 DDD/TID in 2019 vs. 5.93 ± 2.77 DDD/TID in 2020) and macrolides (2.14 ± 2.22 DDD/TID in 2019 vs. 3.40 ± 3.44 DDD/TID in 2020) was observed during the pandemic period. It is necessary to improve the prescribing practice of antibiotics at the primary health care level, public awareness about rational use of antibiotics, as well as the current antibiotic stewardship programs and control their implementation.

Introduction. Visual-motor integration (VMI) is defined as the degree to which visual perception (VP) and finger-hand movements are well coordinated. The VMI consists of two components: VP and motor coordination (MC). The main goal of our research was to determine whether there are differences in age and gender categories in VMI, VP and MC scores, as well as whether there is a correlation between VMI and school success of younger school-aged children. Methods. Out of 103 student respondents, 52 were female (50.5%), aged 6 to 11 years (8.05 ± 1.44 years), divided into two groups according to age: 6-8 years (first, second and third grade) and 9-11 years (fourth to fifth grade). Data on the level of VMI were obtained by applying the following tests: Beery-Buktenica Developmental Test of VMI, VP test and MC test. Results. In the older age group of subjects, a significant difference was observed in the mean values of the score on the VMI (12.67 ± 1.92), VP (23.69 ± 3.21) and MC (24.34 ± 3.23) tests comparing to the younger group of subjects (9.98 ± 2.12; 20.80 ± 3.2; 19.65 ± 3.82) (p < 0.001), while the difference in the mean values of scores in relation to gender was not observed. A significant, positive and strong correlation was observed between the scores on the VMI, VP and MC test with the success of second to fifth grade students (p < 0.050). Conclusion. Given such a strong correlation between VMI and the success of younger students, we conclude that it is important that VMI disabilities are identified in time, so that these students can be referred for further assessment and receive the necessary support.

Introduction. Success in endodontic treatment depends upon the clinician's knowledge and ability to recognize and diagnose the presence of anatomical and morphological variations of the root and canal system. Mandibular canines are usually recognized as having one root and one root canal. In spite of the low incidence of mandibular canines with one root and two canals, their appearance should not be neglected due to the fact that the presence of a second canal in these teeth leads to difficulties in endodontic treatment. The aim of this case report is to describe mandibular canine with two root canals. Case presentation. 45-year-old patient presented for medical care due to the pain in a lower right canine. Clinical and radiographic examination revealed composite filling and caries with periapical radiolucent area and sensitivity to percussion in the mandibular right canine. By careful evaluation of the diagnostic radiology, it was observed that the mandibular canine had two canals. The patient was diagnosed with acute apical periodontitis and root canal therapy was given following the standard protocols. Conclusion. Although the prevalence of two canals in mandibular canine is low, the clinician should always be mindful of variations in the number of canals for appropriate therapeutic management.

Introduction. The success of endodontic treatment depends on the adequate biomechanical preparation and obturation of the entire root canal system. The untreated or poorly debrided/obturated root canals are among the most frequent causes of endodontic treatment failure. The endodontic treatment of maxillary molar has the highest failure rates due to the complexity of their root canal anatomy. The aim of the study is to present the endodontic treatment of maxillary second molar with two roots and two canals. Case report. The clinical case report presents the endodontic treatment of maxillary second molar with two roots and two canals in a patient, aged 32 years. After the analysis of preoperative diagnostic radiograph, opening the pulp chamber and access cavity preparation, two canal orifices were localized. After the biomechanical preparation, root canals were obturated with the Gutta-percha points and sealer during the same visit. Conclusion. Although maxillary second molar most commonly varies in terms of the number of root canals in the buccal roots, less common variations in anatomical and morphological traits, such as the presence of two roots and two canals, should be considered during endodontic treatment.

REZIME Uvod: Kompleksna građa kanalnog sistema ogranicava efekat mehanicke instrumentacije tokom endodontske terapije, pa je uporedo sa instrumentacijom, neophodna i primenaodgovarajucih irigacionih rastvora, kako bi se uklonio razmazni sloj i ispoljio dezinfekcioni efekat. Poznato je da tokom irigacije kanalni irigansi direktno dolaze u kontakt sa povrsinskim slojem dentina a zatim i dentinskim tubulima, kako bi izvrsili ciscenje. Pored efekta na razmazni sloj, kanalni irigansi mogu da uticu i na izmene u mineralnom sastavu dentina kanala korena. Cilj ovog istraživanja je bio da se uporedi efikasnost uklanjanja razmaznog sloja i promene u mineralnom sastavu korenskog dentina nakon ispiranja NaOCl i finalnog ispiranja MTAD, QMix i 17% EDTA. Materijal i metode: U istraživanje su ukljuceni jednokoreni zubi koji su pre instrumentacije i ispiranja NaOCl, metodom slucajnog uzorka podeljeni u cetiri grupe (n=10), da bi nakon toga u svakoj grupi bio primenjen razlicit irigans za finalno ispiranje: MTAD, QMix, EDTA i sterilna destilovana voda (kontrolna grupa). Povrsina dentina kanala korena analizirana je skening elektronskom mikroskopijom (SEM) u cilju određivanja prisustva razmaznog sloja. Energetsko disperzivna spektroskopija (EDS) koriscena je za određivanje mineralnog sastava dentina u svim grupama (MTAD, QMix, 17% EDTA i kontrolnoj grupi), kao i kod neobrađivanih uzoraka (neinstrumentirana grupa; n=10). Rezultati: Između razlicitihhelatnih sredstava nije bilo znacajnih razlika u uklanjanju razmaznog sloja u koronarnoj i srednjoj trecini (p>0,05). U apikalnoj trecini QMix-om je uklonjeno znacajno vise razmaznog sloja nego sa EDTA (p 0,05). Finalna irigacija MTAD-om uzrokovala je znacajno povecanje C i S u poređenju sa grupom u kojoj je primenjeni irigans bio EDTA (p<0,05). Nije bilo znacajne razlike u pogledu mineralnog sastava između grupa u kojima su primenjeni MTAD i QMix, osim za vrednosti sumpora (S) u apikalnoj trecini (p<0,05), iako su vrednosti mineralnih elemenata bile promenjene u MTAD grupi. Zakljucak: Efikasnost primene QMix irigansa za uklanjanje razmaznog sloja, slicna je efikasnosti MTAD irigansa, a efikasnija od 17% EDTA u apikalnoj trecini. Iako je irigacija MTAD-om bila pracena znatnim promenama mineralnog sastava korenskog dentina, razlike su bile znacajne samo za vrednost C i S u poređenju sa primenom 17% EDTA.

To compare the smear layer removal ability and mineral content of root canal dentine after initial irrigation with NaOCl and final irrigation with MTAD, QMix, and 17% EDTA. Forty extracted human maxillary incisors before root canal preparation and irrigation with NaOCl were randomly divided into four groups (n = 10) according to the type of final irrigants used: MTAD, QMix, 17% EDTA, and control (sterile distilled water). Scanning electron microscopy (SEM) was used to assess the presence of smear layer. SEM energy‐dispersive X‐ray spectroscopy was used to quantify dentin mineral composition in MTAD, QMix, 17% EDTA group, and in no‐treatment samples (no‐treatment group; n = 10). Among the various chelating agents, there were no significant differences in the smear layer removal in the middle and coronal thirds (p > .05). In the apical third, QMix removed significantly more smear layer than 17% EDTA (p < .05), but similarly to MTAD (p > .05). Final irrigation with MTAD resulted in a significant increase in the carbon (C) value compared to EDTA (p < .001). There was no significant difference in the mineral composition between the MTAD and the QMix group, although the values of the mineral elements were significantly altered in the MTAD group. QMix had smear layer removal capability similar to MTAD but better than EDTA in the apical third. MTAD yielded the most pronounced effect on mineral component of root dentin; however, differences were significant only for C level compared to 17% EDTA.

Abstract The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.

Abstract The aim of this study is to examine the technical quality of root canal fillings in an adult population in the Republic of Srpska, Bosnia and Herzegovina, who were treated in public dental institutions and private dental clinics. Radiographs of faculty patients, aged 25-60 years old, who came for the first time were examined for the technical quality of root canal fillings. Patients with endodonticallytreated teeth were invited for an interview to reveal the providers of the endodontic treatment. The percentages of teeth with adequate length (p<0.01) and taper (p<0.01) in institutions of public health cases were significantly greater than those in private clinic cases. In addition, the frequency of teeth with adequate root canal fillings in patients treated in public dental institutions was significantly greater than those treated in private dental clinics (p<0.01). A significantly higher percentage of adequate canal fillings is present in teeth where endodontic treatment was performed in public dental institutions compared to private dental clinics. This result indicates the need to improve the quality of endodontic treatment through more intensive training for dentists in private practice.

Abstract Introduction Self- assessment of oral health is simple, non-invasive and cost-effective method of collecting data that takes into account psychosocial aspects of oral health. The aim of this study was to investigate the effect of clinical factors on the self-perception of oral health in middle-aged patients in Republika Srpska (Bosnia and Herzegovina). Material and Methods The study included 126 subjects of both genders (34.1% male and 65.9% female) aged 24-54 years. Data were collected through questionnaires and clinical examination. Anonymous questionnaire contained questions related to socio-demographic characteristics of respondents. Clinical examination included teeth condition and the presence of prosthetic restorations. Self-perception of oral health was determined by one question. Results Bivariate analysis indicated significant effect of carious (p<0.001), missing (p<0.001) and filled teeth (p=0.022) but not the prosthetic status on self-perception of oral health. Correlation between the number of carious and missing teeth with self-perception of oral health was significant in regression analysis. Conclusion The number of carious and missing teeth had significant impact on self-assessment of oral health in studied population. Knowledge of effects of oral clinical variables on self-perception of oral health is very important to obtain clearer insight into the association between objectively and subjectively assessed oral health.

Uvod. Osnovni cilj endodontske terapije je adekvatna obrada i opturacija cjelokupnog kanalnog sistema. Nekompletna instrumentacija i ciscenje kanala, neadekvatna opturacija i zaboravljeni kanali najcesci su razlozi neuspjeha endodontske terapije. Stoga je poznavanje morfologije korijenskog sistema zuba od velikog znacaja i može da smanji neuspjeh endodontske terapije uzokovane nekompletnom kanalnom preparacijom i opturacijom. Cilj rada je da se prikaže endodontska terapija maksilarnog drugog molara sa dva palatinalna korijena i pet korijenskih kanala. Prikaz bolesnika. U radu je prikazan maksilarni drugi molar sa cetiri korijena kod pacijenta starosti 27 godina. Poslije klinickog ispitivanja i analize radiograma, uoceno je postojanje dva palatinalna korijena. Sprovedena je endodontska terapija u dvije posjete. Poslije zavrsene intrakanalne medikacije u trajanju od 15 dana, kanali su opturisani gutaperka poenima i silerom. Zakljucak. Prikaz istice važnost dobrog poznavanja kanalne morfologije i ukazuje da anatomske abnormalnosti treba uvijek uzeti u obzir kada se sprovodi endodontsko lijecenje.

Introduction. Dental caries is still an important social health problem in many countries. The aim of this study was to determine the incidence and impact of oral discomfort, particularly caused by dental caries on the quality of life of middle-aged people as well as the association between oral problems caused by caries and the current status of teeth. Material and Methods. The study included 72 patients, age 25-45 years. Serbian version of the questionnaire Oral Impacts on Daily Performance (OIDP) was used to determine the overall impact of oral health as well as the specific effect of caries (SP-OIDP) on the quality of life. To determine the status of teeth the DMFT index was used. Results. The incidence of oral health impact on daily activities was 68.1%. Carious teeth affected food intake (40.0%) and brushing teeth (31.0%) but had no effect on showing teeth and maintaining normal emotional state. Caries was the cause of oral discomfort in more than half of the respondents. Of all clinical variables only DMFT>22 was associated with the SP-OIDP score after inclusion of socio-demographic factors in the analysis (rs=0.273). Conclusion. The results of this study indicate that the incidence of the effect of oral conditions on the quality of life is high with most respondents showing difficulties while eating. Using specific questionnaire it was noted that dental caries had a significant effect on oral functions of respondents. Also, there was a significant correlation between dental status and the quality of life of middle-aged people.

Introduction. The aim of this study was to determine the prevalence of caries and gingivitis among adolescents who attend school in the municipality of Foca, Republika Srpska. Material and Methods. The total number of 352 school children - 135 students of the ninth grade of primary school (aged 15 years) and 217 students of the third and fourth grade of high school (aged 17-18 years) - were included in this cross-section study. The incidence of dental caries using DMFT index and its components was calculated as recommended by the World Health Organization. Periodontal tissue condition was determined using gingival index (GI) by Loe and Silness. Results. The mean DMFT in students age 15 was 6.6, and in students age 17-18 was 9.5. The dominant components of DMFT index in both studied groups were filled and carious teeth. In regards to gender, female students age 15 had significantly greater number of extracted teeth than male students (p<0.05). In older age group, females had significantly more filled teeth than males (p<0.05). Mild gingivitis was present in both studied groups. Conclusion. Our results showed that caries prevalence in the tested groups was high and mild gingivitis was present in most patients.

Introduction. The main goal of obturation is prevention of reinfection of the root canal system and consequently appearance of periapical lesion. Epidemiological studies have confirmed high prevalence of periapical lesions in endodontically treated teeth with inadequate root canal fillings. The aim of this study was to assess the quality of root canal fillings in teeth treated at students’ practical sessions. Iatrogenic errors during endodontic interventions were also assessed. Methods. Two hundred dental records of the patients treated by students in the study program Dentistry at the School of Medicine in Foca during the academic year 2010/2011 were randomly chosen. The length and homogeneity of the fillings or the presence of iatrogenic errors were recorded. A root canal filling was considered adequate if it had correct length and homogeneity in the absence of iatrogenic errors. Two students’ curricula V1 and V2 were evaluated for the treatment outcome. Results. Out of 128 endodontically treated teeth, adequate length of the canal filling to the physiological apex was observed in 57% of teeth, homogeneity in 78.9%, while both of these criteria were satisfied in 66 teeth (51.6%). Better quality of root canal fillings was achieved by students of the study curricula V2 and the difference between these two programs was significant (p<0.05). Better quality of root canal fillings in both study programs was recorded for incisors and canines as compared to premolars. Conclusion. The quality of endodontic treatment performed by students was considered adequate in 51.6% of cases. The type of curriculum for endodontic course had a significant impact on the quality of endodontic treatment performed by students.