Many of medicaments used historically in root canal treatment have been shown to be cytotoxic. Paraformaldehid agents (such as Toxavit and Depulpin) are used to devitalize inflamed pulp when local anesthesia is ineffective. The misuse of pulp devitalizing agents may cause damage to gingiva and alveolar bone. This case report demonstrates complications arising after application of paraformaldehyde containing paste, necrosis of the gingiva and alveolar cortical bone, which resulted in great loss of supporting bone. Surgical intervention was required wherein necrotic bone was removed and bone defect was filled with xenograft of bovine origin. After three months endodontic treatment was performed. After the treatment, the patient?s complaints were resolved. The use of paraformaldehyde-based agents during endodontic therapy requires special caution.

Introduction. Decreased salivary flow is frequently associated with numerous diseases such as diabetes mellitus and may lead to numerous oral diseases. The aim of this study was to compare salivary flow rate and oral health status in type 2 diabetics and healthy controls. Material and methods. The study involved 90 patients, divided into the three groups: 30 with well controlled (HbA1c<9%), 30 will poorly controlled (HbA1c?9%) diabetes and 30 healthy subjects. The following clinical parameters were determined: decayed, missing and filled teeth (DMFT); plaque index (PI), sulcus bleeding index (SBI), probing pocket depth (PPD) and clinical attachment level (CAL). Culture of Candida spp. specimens were obtained from tongue dorsum and inoculated into Sabouraud Dextrose Agar. Saliva was collected using ?a spit technique?. Results. Highest mean of unstimulated salivary flow was in healthy subjects; however significant difference between groups was not observed. Stimulated salivary flow results indicate significant reduction in diabetics as well as significant relation between metabolic control and salivary flow. Unstimulated and stimulated salivary flows were negatively and significantly correlated with periodontal parameters and DMFT. Conclusion. The present findings indicate that decreased salivary flow rate could have a significant impact on oral health status in type 2 diabetics.

Assessment of historical buildings presents specific engineering task, considering the ways they were built and the materials, which were used. Many of them belong to cultural heritage and merit special care and protection. This concerns also the historical buildings in Bosnia and Herzegovina. The country is situated in seismic active region of South-East Europe and the majority of the historical buildings were made of stone-masonry. In the case of stronger earthquake motion such buildings could suffer heavy damages. The damages are sometimes cumulated through many years and many causes. Substantial damages were caused by recent war disaster, as well. The aim is to preserve and reveal their aesthetic and historical values and to use original materials and original way of construction, if possible. In most cases seismic assessment procedures result in the requirements for the strengthening or retrofit of the old masonry building structures. Design and construction procedures of repair and strengthening of two medieval stone masonry buildings are presented. Equilibrium between aesthetical and structural demands is discussed.

Introduction. Acute rhinosinusitis (ARS) encompasses a heterogeneous group of inflammatory disorders affecting nasal mucosa and paranasal sinuses. Rhinosinusitis is the most common condition in the United States. It is estimated that over 30 million people annually visit the doctor due to this condition, while every sixth adult suffers from ARS. Among all ARS complications, over 91% are orbital complications (OC) with an average prevalence of 6% and a higher incidence in children compared to adults. Case report. Twelve-year-old boy, accompanied by his mother, was urgently referred to the Department of Otorhinolaryngology at the University Hospital in Foca due to a sudden red and painful left periorbital edema, pain in the left eye and a fever reaching 38.5ºC. After laboratory and CT scan diagnostics, an ophthalmologic examination and inpatient clinical findings after 36 hours of parenteral triple antibiotic therapy, the patient was referred to a tertiary-type institution for further treatment. The same procedure was performed conservatively during the hospitalization within 6 days. Conclusion. The initial treatment of orbital complications in children is conservative. Treatment should be started empirically, using triple antibiotic therapy. The choice of antibiotics and treatment protocols among pediatric population have not been agreed yet. If 36-48 hours after the beginning of the conservative treatment, there is lack of the clinical response, surgical treatment is absolutely indicated, regardless of the stage of orbital complication.

Introduction/Objective. Tonsillitis is a very common condition found in the pediatric population but also in adult patients. One of the consequences of such conditions is poor voice quality. Hoarseness, poor voice impostation, interruption, and hypernazalization are just some of the differences in patient voice quality. The objective of this paper was to examine the effects of tonsillectomy on the voice quality. Methods. The sample included 37 patients, 17 female and 20 male, ranging in age 3?39 years. The method involved recording patients one month before and one month after tonsillectomy with a digital sound recorder, with recordings analyzed in the Praat program. The variables monitored in the basic voice were as follows: voice pitch, standard deviation of voice, degree of voice interruption, jitter, shimmer, and signal-to-noise ratio. In the statistical analysis, in addition to standard descriptive analyzes, t-test and ACNOVA were also used. Results. The results showed that there are effects of tonsillectomy on standard deviation of baseline voice (p = 0.002), shimmer (p = 0.002), baseline voice interruption rate (p = 0.023), signal to noise ratio (p = 0.003). There were no differences in the effects of tonsillectomy with respect to the sex of the subjects. Conclusion. Based on the conducted research, there were some methodological conclusions that could be considered as a recommendation for future research: increase the number of persons in the sample, introduce a variable of chronological age, type of surgical intervention, and gradation of size of the tonsil and adenoid tissue.

Introduction. Matrix metalloproteinase-9 (MMP-9) plays one of the key roles in the migration of inflammatory cells and the destructive behavior of acquired middle ear cholesteatoma. The aim of the study was to determine the expression levels of MMP-9 in chronic otitis media, with and without acquired cholesteatoma, as well as to determine the correlation between them and the pathomorphological changes in the tympanic membrane (TM). Methods. Immunohistochemical study included 178 patients of both sexes, aged 5-75 years, who underwent microsurgical treatment of chronic otitis media (COM) at the Ear, Nose and Throat Department of the University Clinical Center of the Republic of Srpska in Banja Luka from 2015 to 2018. Patients were divided into two groups on the basis of the presence or absence of acquired cholesteatoma: 97 (CCOM) and 81 (COMWC). The samples of the perimatrix of acquired cholesteatoma (n=97) and inflamed middle ear mucosa (n=81) were taken intraoperatively. The presence of retraction and certain types and subtypes of TM perforations were examined by intraoperative exploration. MMP-9 expression levels were determined by immunohistochemical analysis. Results. In the presence of cholesteatoma and highly positive expression of MMP-9, the marginal type of TM perforation was more likely to occur (p<0.01) while in negative expression of MMP-9 in the COMWC group, the central type was more likely to occur (p<0.01). There was a higher probability of the presence of attic subtype of TM perforation in patients with cholesteatoma and moderate positive expression of MMP-9 (p<0.01). There was not a statistically significant contribution of any of the factors in the prediction of the influence on the occurrence of TM retraction. Conclusion. The presence of acquired middle ear cholesteatoma and highly positive expression of MMP-9 are statistically significant predictors of the presence of marginal type and attic subtype of TM perforation. Expression levels of MMP-9 may have potential clinical significance in the development of irreversible pathomorphological changes on TM in middle ear cholesteatoma.

Uvod. Matriks metaloproteinaza 9 (MMP-9) ima jednu od kljucnih uloga umigraciji inflamatornih celija i destruktivnom ponasanju stecenog holesteatomasrednjeg uha. Cilj studije je bio da se utvrde nivoi ekspresije MMP-9 kod hronicnog otitis media, sa i bez stecenog holesteatoma i njihovakorelacija sa patomorfoloskim promjenama na membrani timpani (MT).Metode. Imunohistohemijska studija je ukljucila 178 ispitanika oba pola,od 5 do 75 godina, koji su podvrgnuti mikrohirurskom lijecenju hronicnogotitis media (HOM) u Klinici za bolesti uha, grla i nosa, Univerzitetskog klinickogcentra RS, Banja Luka od 2015. do 2018. godine. Ispitanici su podijeljeniu dvije grupe na osnovu prisustva ili odsustva stecenog holesteatoma:97 (HHOM) i 81 (HOM). Uzorci perimatriksa stecenog holesteatoma(n=97) i inflamirane sluznice srednjeg uha (n=81) su uzeti intraoperativno.Intraoperativnom eksploracijom je ispitivano prisustvo retrakcije i pojedinihtipova i podtipova perforacije MT. Nivoi ekspresije MMP-9 su određeniimunohistohemijskom analizom.Rezultati. U prisustvu holesteatoma i visoko pozitivne ekspresije MMP-9,veca je vjerovatnoca pojave ivicnog tipa perforacije MT (p<0,01), dok je kodnegativne ekspresije MMP-9 u HOM grupi, veca vjerovatnoca centralnogtipa perforacije MT (p<0,01). Veca je vjerovatnoca prisustva atik podtipaperforacije MT kod ispitanika s holesteatomom i umjereno pozitivne ekspresijeMMP-9 (p<0,01). Nije dokazan statisticki znacajan doprinos nijednogod faktora u predikciji uticaja na pojavu retrakcije MT.Zakljucak. Prisustvo stecenog holesteatoma srednjeg uha i visoko pozitivnaekspresija MMP-9 cine statisticki znacajne prediktore ivicnog tipa i atikpodtipa perforacije MT. Nivoi ekspresije MMP-9 mogu da imaju potencijalniklinicki znacaj u nastanku ireverzibilnih patomorfoloskih promjena na MTkod holesteatoma srednjeg uha.

Introduction/Objective. Malocclusions are one of the most frequent disorders in dentistry, and pose a risk for the onset of caries and periodontal diseases. Fixed orthodontic treatment solves the problem of malocclusions; however, it requires simultaneous cooperation of the patients, parents, and dentists involved. The objective of this study is to examine the effects of fixed orthodontic therapy on the Streptococcus mutans and Lactobacillus spp. bacteria in saliva, the pH value, and buffering capacity of saliva. Methods. The research was carried out at the Faculty of Medicine in Foca, Department of Dentistry. The study included 100 respondents, aged 13 to 17 years. The respondents were divided into two groups: the study group (respondents wearing fixed braces) and the control group (respondents not subjected to fixed braces therapy). Saliva samples were taken from the respondents four, 12, and 18 weeks after the start of the orthodontic therapy. The study used the bacteria caries risk test (CRT) and CRT buffer (Ivoclar Vivadent). Results. The study showed an increased number of bacteria in saliva of the respondents during all three follow-up periods (χ2 test, p = 0.001). The largest numbers of the Streptococcus mutans and Lactobacillus spp. bacteria were found in week 12 of the therapy. Saliva pH value and buffering capacity of saliva increased statistically significantly in week 12 of the therapy (χ2 test, p = 0.001). Conclusion. Oral conditions in patients changed during the fixed orthodontic therapy: the number of bacteria increased, the pH value and buffering capacity of saliva changed. It was necessary to use preventive measures in order to avoid complications during the fixed orthodontic appliances therapy.