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ISSN 1011 - 4181
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EPIEXOMENA
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PAKTIKA EMATA
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Hellenic Dental Association
Hellenic
Stomatological
Review
CONTENTS
PROPRIETOR:
EDITOR -IN- CHIEF:
J. G. Tzoutzas
EDITORIAL BOARD:
G. Douvitsas
F. Zervou - Valvi
H. Karkazis
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Hellenic Stomatological Review is the
official publication of the Hellenic Dental
Association, published trimonthly.
Annual subscription
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PUBLISHER:
Panos Alexiou
President of the Hellenic Dental Association
HEADQUARTERS
38 Themistokleous Str., Athens, 106 78
Phone#: (3210) 38.13.380
Fax#: (3210) 38.34.385
VOLUME 49, ISSUE 2

APRIL - JUNE 2005
ISSN 1011 - 4181
RESEARCH PAPERS
Special characteristics of dental phobic patients treated under

general anesthesia
E. Boghossian, T. Zouridaki and M. Fragakis ............................129-135
CASE REPORT
Intraoral manifestations of resistant acute myelomonocytic

leukaemia. Therapeutic approach
M. Papadopoulou, J. Stergiopoulos,
D. Tzitiridis and N. Papanikolaou..............................................137-140
LITERATURE REVIEWS
Per os and intravenus sedation in oral surgery

E. Stavrou, N. Papachristou, L. Prezas and I. Stavrou...............141-146
The role of the dentist in the prevention of infective endocarditis
T. Almaghout, V. Karagkiozaki, I. Litsas and A. Zorbas .............147-154
Bleeding disorders and oral surgery
L. Hadjipetrou, D. Mangoudi and K. Antoniades ......................155-168
Guided bone regeneration adjacent to implants placed into
immediate extraction sockets
M. Manda, E. Dima, I. Karoussis and I. Fourmousis ..................169-178
Xerostomia and complete dentures
S. Yannikakis, A. Dimitriou and A. Zissis...................................179-187
Timing of performing Guided Bone Regeneration in Implant
Dentistry
E. Sinanioti and V. Piperias ......................................................189-198
Intrauterine preventive dentistry
A. Polychronopoulou, K. Divaris and K. Kavvadia ....................199-209
Behavioral sciences in Dentistry
H. Koletsi-Kounari, J. Avgeris ...................................................211-218
stomatologika exof.
3-10-08 13:09
604
Hellenic
Stomatological
Review
PROPRIETOR:
EDITOR -IN- CHIEF:
J. G. Tzoutzas
EDITORIAL BOARD:
G. Douvitsas
F. Zervou - Valvi
H. Karkazis
E. Katsavrias
G. Mountouris
L. Papagiannoulis
D. Tziafas
V. Topitsoglou - Themeli
COPY EDITOR:
Evelin Babai
PRODUCTION - PROMOTION:
TypeProduct
V. & E. Babai Ltd
32 Epikourou Str., Athens Hellas
Phone#: (3210) 32.14.904
Fax#: (3210) 32.14.991
ADVERTISEMENTS - PUBLIC
RELATIONS:
M. Morfoniou - S. Gogas
Phone#: (3210) 33.02.343
Fax: (3210) 38.34.385
Hellenic Stomatological Review is the
official publication of the Hellenic Dental
Association, published trimonthly.
Annual subscription
40 $ USD
PUBLISHER:
Panos Alexiou
President of the Hellenic Dental Association
HEADQUARTERS
38 Themistokleous Str., Athens, 106 78
Phone#: (3210) 38.13.380
Fax#: (3210) 38.34.385
VOLUME 49, ISSUE 2

APRIL - JUNE 2005
ISSN 1011 - 4181
PRACTICAL NOTES
Usefulness of microbiological testing in Clinical Periodontology

D. Sakellari, C. Xatzigeorgiou and A. Konstantinidis .................219-227
The use of mini-comparator in the construction of an oculofacial
prosthesis
P. Kafas, S. Dalambiras, M. Vourvachis and M. Bamber ...........229-233
stomatologika exof.
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SUMMARY
Special characteristics of dental phobic patients

treated under general anesthesia
E. Boghossian, T. Zouridaki, M. Fragakis
hellenic stomatological review 49: 129-135, 2005
Dental fear and anxiety is a world-wide problem and a

barrier to oral health care services. Fears acquired in
childhood through direct experiences or indirect through
parents, siblings or friends may persist into adulthood.
Phobia is a persisting and irrational fear for an object,
situation or activity, which results in avoidance behavior.
Dental phobia is a special phobia as well as Blood-InjuryInjection phobia. Corah's Dental Anxiety Scale is used
since 1969 in order to assess dental fear and anxiety. The
scale yields a score from 4 to 20. Score greater than 17
indicates dental phobia.
The purpose of this study is to record the special
characteristics and evaluate the experience that derives
from applying general anesthesia for treatment of dental
phobic patients.
The present study is a retrospective longitudinal evaluation
of 5.158 patients examined during the period 1991-2.000
in the Dental Clinic of University Hospital of Heraklion and
it showed that 946 (18,34%) presented anxiety for dental
procedures, 243 (4,71%) scored more than 17 points in
the Dental Anxiety Scale. 62 of them were treated with the
use of general anesthesia.
After completing the medical and dental history, all
patients completed the Corah Dental Anxiety Scale (DAS).
They all underwent basic preoperative control, including
clinical dental and x-ray examination.
Out of 62 patients 23 (37,1%) were male and 39 (62,9%)
female. The patients' age ranged from 6 to 63 years. Of the
62 patients 46 (82,25%) were 11-40 years old. All patients
scored at the Dental Anxiety Scale more than 17 points. 37
of them referred to previous traumatic dental experience, 8
suffered from Blood-Injury-Injection phobia, 8 presented
phobia for medical procedures and establishments
caused of severe chronic therapies. 9 patients presented
134
coexisting psychiatric conditions. The dental treatment

included 187 extractions, 40 surgical extractions, 29
extractions of impacted third molars, 31 fillings, 9
endodontic therapies, 8 apicectomies, 6 scaling
procedures and so on. All patients underwent treatment
without any problems or complications. The total time of
hospitalization was 130 days with an average of 2,1 days
per patient.
Dental fear and anxiety are common reasons why patients
fail to seek dental care. All dental patients have some fear
and anxiety. About 5% of dental patients suffer from severe
dental phobia. The majority of patients in this study were
female. This is in accordance with WHO and findings from
other studies indicating that fear and anxiety are more
prevalent among females. A great percentage of the
study's patients aged between 11-40 years. International
Classification of Diseases indicate that specific phobias
usually arise in childhood or early adult life and can persist
for decades if they remain untreated. That is in accordance
with related studies indicating that dental anxiety is less
prevalent among older adults. Corah's DAS is the most
widely used measure of dental anxiety. It has satisfactory
reliability, validity and it is easy to use. The most prevalent
cause of patients' fear was reported to be previous dental
traumatic experience especially in childhood. In addition
social, economical and educational factors and individual
personality traits seem to be associated with dental
phobia. Prevention of fear development through the use of
effective behavioral child management techniques
combined with preventive dentistry is possible to improve
the level of oral hygiene and the fear of dental treatment as
well. Blood-Injury-Injection phobia often co-exists with
dental phobia. The number of extractions illustrates the
patients' oral health status. It has been proved from several
studies that dental anxiety is positively correlated with
dental problems and it is likely to be a significant predictor
of dental caries experience. General anesthesia is a safe
and effective treatment tool for providing comprehensive
dental and oral surgical treatment for the dental phobic
patients. It is possible that phobic patients would seek oral
health care more regularly if general anesthesia was more
prevalent.
Conclusively dental phobia results in severe dental
problems for many patients. Using general anesthesia it is
possible not only to cope with this problem and improve
their oral health status but also to change their apprehension about dentistry.
Key words: Fear, dental anxiety, dental phodia, dental treatment,
general anesthesia
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A E I. T O E.O.O. 1990: 148.
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T O E.O.O. 1991: 88-89.
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25: 72-7.
22. Little JW, Falace DA: Dental management of medically
compromised patient, Mosby ed, St. Liouis 1988: 403-420.
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older adults, J Dent Res 1991; 70: 198-203.
24. Epstein S: Treatment of the geriatric dentally phobic patient,
Dent Clin North Am 1988; 32: 715-21.
25. Waal-Manning HJ, de Hamel FA: Smoking habit and
psychometric scores: A community study, N Z Med J 1978;
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smoking, Br J Soc Clin Psychol 1978; 17: 269-73.
27. Moore R, Brodsgaard I, Birn H: Manifestations, acquisition
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35(7): 583-90.
29. De Jongh A, Bongaarts G, Vermeule I, Visser K, De Vos P,
Makkes P: Blood-injury-injection phobia and dental phobia,
Behav Res Ther 1998; 36: 971-82.
30. Kruger E, Thomson W.M, Poulton R, Davies S, Brown RH, Silva
PA: Dental caries and changes in dental anxiety in late
adolescence, Community Dent Oral Epidimiol 1998; 26: 355-9.
31. Standards and Guidelines for General Anesthesia for
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M.
. X 6,
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T: 2810-392473, 2810-392475
49: 129-135, 2005
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Intraoral Manifestations of Resistant

Acute Myelomonocytic Leukaemia.
Therapeutic Approach
M. Papadopoulou, J. Stergiopoulos,
D. Tzitiridis, N. Papanikolaou
This is a case report of resistant acute myelomonocytic

leukaemia in a 57 years old female patient. Clinical examination revealed refractory extramedullary infiltrations in the
gingivae and necrotic ulcerative lesions in the oral
mucosa. The patient had not received any antileukaemic
medication for the previous 5 months because of the
resistance of the disease. She had followed-up in Haematology Out-Patients while she was treated conservatively
(blood and platelet transfusions, management of
infections). The oral manifestations occurred as a result
not only of leukaemic cell infiltrates in the gingivae (white
blood cells 55,000 /mm with 95% myelomonoblasts) but
also from haemorrhagic diathesis and local infections by
fungi. The patient was subjected to combined therapy
comprising: chemotherapy with hydroxyurea per os (2gr
daily) for the systemic disease and local treatment by
gentle cleaning, mouthrinses with saline, chlorhexidine
digluconate 0.12% and locally-delivered antifungal and
analgesic drugs (nystatin oral suspension, xylocain gel).
Additionally itraconazole was administered systemically.
Finally platelets were given for the haemorrhagic diathesis.
One week later the patient showed marked local
improvement (chewing, deglutition and speech without
discomfort) while laboratory tests showed severe pancytopenia for which support with transfusions were given.
Hydroxyurea was stopped and systematic close dental
screening and care supplemented with circumstantial
management of her haematologic disorders were
implemented. The oral lesions disappeared while the
systemic disease persisted. Oral and perioral manifestations of acute leukaemia are reported to have a prevalence of 18% to 80%, whereas in about 4% of the cases
these are the first sign of the disease leading to the
139
3-10-08 13:11
140
diagnosis of leukaemia. They are more common in acute

monocytic or myelomonocytic leukaemias, and they
complicate the treatment of the disease. They can be
classified as: 1) Primary manifestations with generalised or
localised gingival overgrowth, odontalgia and tooth
mobility due to leukaemic infiltrates in soft tissues and
alveolar bone of the oral cavity.2) Secondary manifestations as a result of anaemia, leukopenia and thrombocytopenia resulting in paleness and aching necrotic lesions
due to superinfections and microhaemorrhages. 3)
Tertiary manifestations resulting from chemo - or radiotherapy toxicity and Graft versus Host Disease (GVHD). In
this reported case the patient exhibited primary as well as
secondary lesions which demanded the bi-disciplinary
Heamatologist-Dentist approach. Furthermore this emphasises the importance of dental care and stringent oral
hygiene measures in immuno-compromised patients
which substantially reduce the severity of intraoral lesions,
enhancing the quality of life for these patients.
Key words: acute myelomonocytic leukaemia (AMML), oral manifrstations, therapy
BIBIOPAIA
1. Miller BK: Clinical Manifestations of Acute Myeloid
Leukemia In Hoffman R. Hematology Basic Principal and
Practice, p: 997-1000. Churchill Livingstone Second Edition
NY, USA 1995.
2. Sklavounou-Andricopoulou A, Piperi E, Paikos S: Oral and

maxillofacial manifestations of malignant haemopoietic and
lymphoreticular disorders Part IIA Haema 2002; 5(4): 305319.
3. Sklavounou-Andricopoulou A, Piperi E, Paikos S: Oral and
maxillofacial manifestations of malignant haemopoietic and
lyphoreticular disorders Part IIB Haema 2003; 6 (1): 48-53.
4. X E, N- O, M M, N , K :
: . E
X 1998; 13 (3): 125-129.
5. BA, N , M I,
, X, K : A o
: . 2002;
59 (3): 120-124.
6. T E, NA: H . 1997; 11
(1): 30-36.
7. N- O, I, K K,
: : . 1997; 11 (4): 148-152.
8. Hou GL , Huang JS , Tsai CC: Analysis of oral manifestations
of leukemia: A retrospecive study. Oral Dis 1997; 3: 31-38.
9. Barrett AP: Oral changes as initial diagnostic indicators in
acute leukemia. J Oral Med 1986; 41(4): 234-238.
:
M.
K 16, K 60100
T: 23510-39475
E-mail: pepper 2@ otenet.gr.
140
49: 137-140, 2005
141-146 SEL. - STAVROY
3-10-08 13:11
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3-10-08 13:11
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3-10-08 13:11
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SUMMARY
Per os and intravenus sedation in oral surgery

E. Stavrou, N. Papachristou, L. Prezas, I. Stavrou
Fear, pain, the inability of the patient (mainly children or

mentally retarded people) to co-operate with his doctor,
and special groups of patients (people with systemic
diseases) are common reasons for postponing oral
surgery. In order to deal with this situation conscious
sedation (CS) was developed. CS is a method of keeping
the patient relaxed, while the latter remains conscious. CS
is achieved by means of oral or -mainly- IV administration
of drugs. Even though per os sedation is the most simple
and desirable technique, it has some serious defects,
resulting to the prevalence of the IV sedation. Most
commonly benzodiazepines like diazepam and midazolam are used, with midazolam appearing to be more
safe and effective. Propofol is also a potent IV agent with
major pharmacokinetic benefits. CS is used for over
twenty years for dental purposes in many counties (not in
Greece). The safety and effectiveness of CS increases its
use and reduces the need for general anesthesia.
Therefore, it constitutes the ideal method for most dental
patients.
Key words: Conscious sedation, oral surgery, diazepam, midazolam, propofol
49: 141-146, 2005
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1. K , -K: E
, 1 . E 1993:
75-80.
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8. Sanders LD, Piggott SE, Isaac PA, Okell RW, Roberts B,
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66: 445-453.
9. E . E EO 2000: 171-7.
10. Huron C, Servais C Danion JM: Lorazepam and diazepam
impair true, but not false, recognition in healthy volunteers.
Psychopharmacology 2001; 155: 204-209.
11. OBoyle CA, Harris D, Barry H: Sedation in outpatient oral
surgery. Comparison of temazepam by mouth and diazepam
i.v. Br J Anaesth 1986; 58: 378-384.
12. Gatti JE: Oral sedation allows for comfort and amnesia during
office surgery. Ann Plast Surg 2000; 44: 502-7.
13. Jones RD, Chan K, Roulson CJ, Brown AG, Smith ID, Mya GH:
Pharmacokinetics of flumazenil and midazolam. Br J
Anaesth 1993; 70: 286-92.
14. Bell GD: Premedication, preparation and surveillance.
Endosc 2002; 34: 2-12.
15. Foley J: The way forward for dental sedation and primary
care? Br Dent J 2002; 193: 161-164.
16. Bell GD: Review article:premedication and intravenous
sedation for upper gastrointestinal endoscopy. Alimen
Pharmacol Ther 1990; 4: 103-122.
17. Barker I, Butchart DG, Gibson J, Lawson JI , Mackenzie N. I.v:
sedation for conservative dentistry. A comparison of
midazolam and diazepam. Br J Anaesth 1986; 58: 371-377.
18. Sanders LD, Davies-Evans J, Rosen M, Robinson JO.:
Comparison of diazepam with midazolam as i.v. sedation for
outpatient gastroscopy. Br J Anaesth 1989; 63 726-731.
19. Nuotto EJ, Korttila KT, Lichtor JL, Ostman PL, Rupani G:
Sedation and recovery of psychomotor function after
intravenous administration of various doses of midazolam
and diazepam. Anaesth Analg 1992; 74, 265-271.
20. Pachulski RT, Adkins DC, Mirza H: Conscious sedation with
intermittent midazolam and fentanyl in electrophysiology
procedures. J Interv Cardiol 2001; 14: 143-6.
21. Townsend: Sabiston textbook of surgery,16th edition,
Saunders 2001: 283-291.
22. Singleton MA, Rosen GL, Fissher DM: Pharmacokinetics of
fentanyl in the eldely. Br J Anjaesth 1988; 60: 619-622.
23. Scott JC, Ponganis KV, Stanski DR: EEG quantitation of
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145
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B A
26. Valtonen M, Salonen M, Forssell H, Scheinin M, Viinamaki:

Propofol infusion for sedation in outpatient oral surgery.
Anaesthesia 1989; 44: 730-4.
27. Skipsey IG, Colvin JR, Mackenzie N, Kenny NC: Sedaton with
propofol during surgery under local blockade. Anaesthesia
1993; 48: 210-3.
28. Vuyk J, Oostwouder CJ, Vletter AA, Burm AGL, Bovill JG.:
Gender differences in the pharmacokinetics of propofol in
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29. Kirkpatrick T, Cockshott ID, Douglas EJ , Nimmo WS:
Pharmacokinetics of propofol (diprivan) in elderly patients.
Br J Anaesth 1998; 60: 146-50.
30. Tramer MR, Moore RA, McQuay HJ: Propofol and
bradycardia: causation, frequency and severity. Br J Anaesth
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Propofol depresses the hypoxic ventilatory response during
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1993; 79: 1177-1182.

32. Wiklund R, Rosenbaum S: Anesthesiology- First of Two Parts.
N Eng J Med 1997; 337: 1132-114.
33. Nuttall NM, Bradnock G, White D, Morris J, Nunn J: Dental
attendance in 1998 and implications for the future. Br Dent J
2001; 190: 177-182.
34. Leitch JA, Anderson K, Gambhir S, Millar K, Robb ND,
McHugh S et al. A partially blinded randomized controlled
trial of patient-maintained propofol sedation and operator
controlled midazolam sedation in third molar extractions,
Anaesthesia 2004; 59: 853-860.
35. Lahoud GY, Averley PA, Hanlon MR. Sevoflurane inhalation
conscious sedation for children having dental treatment.
Anaesthesia 2001; 56: 476-480.
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randomized controlled trial of paediatric conscious sedation
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:
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SUMMARY
The role of the dentist in the prevention
of infective endocarditis
T.P Almaghout, V. Karagkiozaki, I. Litsas, A. Zorbas
Infective endocarditis (IE) is a disease characterized by

the microbial infection of the inner surface of the heart. It
is caused mainly by streptococci, staphylococci, gramnegative bacteria, fungi, and rarely by rickettsiae and
clamydiae. The entrance of these microorganisms in the
blood circulation is necessary for the development of
infective endocarditis, and it occurs usually via the oral
cavity (teeth extractions, periodontal diseases etc.), the
skin, the respiratory system and the system.
The possibility of inducing endocarditis after dental therapy should worry the dentist. Thorough and accurate
medical record of the patient along with the knowledge of
the diseases that predispose to the development of IE,
allow the prevention of IE mainly by providing the proper
antibiotic prophylaxis for every patient and by maintaining
good oral health.
This paper presents the reasons for IE, its symptoms, the
diseases that predispose the development of IE and
finally the dental procedures that can cause IE, as well as
the proper antibiotic regimens and treatment for the
patients in risk of developing IE.
Key words: Infective endocarditis, Bacteremia, Antibiotic prophylaxis
BIBIOPAIA
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B A
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diagnosis. In: Kaye D. ed. Infective Endocarditis, 2nd ed.
New York. 1992 Raven Press, p.99.
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edition, 2001.
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SUMMARY
Bleeding disorders and oral surgery

L. Hadjipetrou, D. Mangoudi, K. Antoniades
Hemorrhage is an inevitable consequence to surgical

incisions and dissections. Hemostasis, the arrest of
bleeding from an injured blood vessel, requires the
combined activity of vascular, platelet, and plasma factors.
Hemostatic abnormalities can lead to prolonged or
excessive bleeding. Hemostasis in a surgical procedure
should be considered in three stages: presurgical,
surgical and postsurgical. The presurgical stage
highlights the importance of any medical intervention
dealing with the correction of defective hemostasis before
surgery. A thorough medical and dental history and
comprehensive clinical and laboratory examinations are
the basis of preventative care and should be an essential
component of the oral and maxillofacial care of all patients
with a bleeding disorder. In addition to that, the presurgical stage involves the use of local anesthetic with vasoconstrictor or hypotensive anesthesia. The management
of hemostasis involves the use of any local measures
essential to contribute to the control of any bleeding
during surgery. In most instances it is vital that dental
extractions or other surgical procedures should only be
done under the care of a hospital dental or oral and
166
maxillofacial surgery department. Postoperatively, the

surgeon should be able to control any bleeding and
ensure that hemostasis is permanently achieved.
Key words: hemorrhage, hemostasis, bleeding disorders, oral
surgery
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SUMMARY
Guided bone regeneration adjacent to implants

placed into immediate extraction sockets
M. G. Manda, El. G. Dima, I. K. Karoussis, I. Fourmousis
NEA EOMENA THN OTIKH ANAAH

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YMEPAMATA
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Extensive research has demonstrated through clinical and

histological studies that guided bone regeneration is a
regenerative procedure used for ridge augmentation prior
to or in conjuction with dental implants placement.
Guided bone regeneration, using membrane barriers, has
enabled implant placement in sites compromised by
insufficient bone volume, including immediate extraction
sites.
This review evaluates the combination of guided bone
regeneration and immediate implant placement by
presenting the available experimental and human studies,
which have shown great rates of success both for onestage and two-stage endosseous dental implant systems.
Different kinds of membranes, absorbable and nonabsorbable, have been used for this purpose, both
resulting in similar success rates.
The possibility of incorporation of bone grafts and bone
substitutes with or without the use of membranes along
with the immediate implant installation, is also discussed.
Key words: guided bone regeneration, submerged, transmucosal, immediate
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SUMMARY
Xerostomia and complete dentures

S. Yannikakis, A. Dimitriou, A. Zissis
Saliva serves many physiologic needs and is critical in

maintaining oral health and promoting normal function of
the stomatognathic system. Oral mucosa, covered by a
considerably thin saliva layer, exerts a deficient resistance
against exogenous influences such as toxins, acids,
bacterial metabolic products, and allergic and mechanical
irritants. Moreover, saliva is a lubricant for the oral mucosa
and the tongue and it is necessary for the microbiologic
balance of the oral cavity. Factors involved in the quantity
and quality of saliva can cause not only a significant
discomfort, but may also have a negative effect on the oral
tissues, called xerostomia or dry mouth.
Many systematic diseases (e.g. Sjogrens syndrome), dehydration conditions (e.g. diabetic acidosis), depression,
aging etc. can cause xerostomia. Furthermore, a dramatic
decrease in the saliva secretion is performed when the
salivary glands are exposed to high doses of radiation, as
it may occur in the radiotherapy treatment of head and
neck cancer.
Xerostomia is appeared to be one of the most common
side effects of drugs intake, particularly caused by those
with an atropinic action. Atropine, bella donna, chlorpromazine, anti-hypertensives, anti-spasmodies, skeletal
muscle relaxants, cardiac antiarrhythmics, anti-neoplastic
agents, anxiolytics, tranquilizers, sedatives, general
anesthetics are some of the drugs that can induce in a
light, moderate or severe xerostomia.
Saliva is particularly important for the removable denture
wearers by protecting the underlying oral mucosa from
mechanical irritation and infections, and promoting the
retention of complete dentures.
The aim of this review paper was to present the salivary
glands malfunction problem and associate it with the
complete dentures. A number of treatment methods, such
as a specific diet, use of special toothpaste and mouth
rinse wash, sialogogue drugs or artificial saliva, are
described and discussed. Emphasis has been given on
the construction characteristics applied on a complete
denture for the xerostomic patient. Maxillary complete
dentures made of a metal base instead of an acrylic one,
seems to be more comfortable to the patient. Mandibular
complete dentures, relined by a permanent soft liner seem
to improve the denture-altered mucosa contact. On the
other hand, construction of an artificial saliva reservoir in a
denture, despite the laboratory difficulties, might be an
effective way of minimizing the problem.
Early diagnosis of xerostomia and its cause is of primary
importance. The treatment plan must be based on the real
needs of each one patient.
Key words: xerostomia, dry mouth, burning mouth, complete
dentures, saliva, artificial saliva, salivary glands
186
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:

N 6, 106 80 A
T: 210-7715814, 210-3600005
Fax: 210-7715814
E-mail: yannista@otenet.gr
49: 179-187, 2005
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I. TAYTOXPONH EAPMOH
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SUMMARY
Timing of performing Guided Bone

Regeneration in Implant Dentistry
E. 19: T 4 .
E. Sinanioti, V. Piperias
E. 20: Y 4 ( ).
49: 189-198, 2005
Ideal architectural structure of the alveolar crest facilitate

ideal prosthetic placement of dental implants from the
aesthetic and functional point of view. The reconstruction
of deficient alveolar ridges through Guided Bone
Regeneration (GBR) is capable of promoting new bone
formation in horizontal or vertical dimensions or both.
GBR has been successfully used in Implant Dentistry with
high predictability(1, 2, 3, 4, 5, 6, 7). GBR procedures are reported
as being performed prior (staged approach) to or during
(simultaneous approach) dental implant placement. The
regenerative activity can take place at the time of
extraction (immediate implant placement), 4 to 8 weeks
after extraction (early implant placement), after gingival
healing, or after 3 to 6 months or later, when the bony
197
3-10-08 13:14
198
B A
extraction vault has healed. In cases of early implant

placement the sockets are partially healed, implant bed
preparation is less difficult and if present infections have
cleared so the long term success of therapy is
improving(1). The primary stability of the dental implants is
of paramount importance for successful results of GBR in
cases of simultaneous approach.
The timing of GBR may be the dictating factor influencing
the end point when extensive bone damage is observed in
the presence of a tooth that will be extracted. Performing
GBR in large osseous defects is a demanding surgery
which requires clinical experience and technical capabilities.
Key words: Dental implants, guided bone regeneration (GBR),
timing, clinical experience
EIIKH HMEIH
O
K A .
K T
. E
. I. N E. K
A . A. .
BIBIOPAIA
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K 12, N. 154 51
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198
49: 189-198, 2005
199-209 SEL.-POLYXRONOPOULOU
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(p<0,05)(41)
: I=42,1%
T : I=17,6% (p<0,05)(41)
A ( 2 )
RR=26,2 (p<0,05)(39)
3-10-08 13:17

RR=3,5-7,07
(p<0,05)(30-36)

ms>106 CFU
23: I=65%
(p<0,05)(28)
1.
2. (,
)
S. mutans
S. sobrinus
M mutans
(ms):

ms<3x105 CFU
23:
I=35%
M
(21-24), :
TEPHONA
A ms
NOHMA
TOMATO
MHTEPA
1B: E .
N .
202
49: 199-209, 2005
O: 86 ( 3-4 )
OE: 110 ( 3-4 )
O: 33 ( 2 )
OE: 32 ( 2 )
O: 180 ( 1-3.5 )
OE: 180
- ( 1-3,5
)
O: 199 ( 5-6 )
OE: 75 ( 5-6 )
O: 43 ( 2 )
OE: 38 ( 2 )
Gunay .,
1998(47)
Brambilla
., 1998(48)
Gomez
., 2001(51)
49: 199-209, 2005
Gomez
., 2001(52)
Zanata .,
2003(29)
203
O (2 ): 14,7%
OE (2 ): 33,3%
O (5 ): 86.7%

OE (5 ): 50%
(p<0.05)
O (1-3.5 ): 97%

OE (1-3.5 ): 77%

O (4 ): 91,5%

OE (4 ): 57,7%

(p<0,001)
O: 100% ms<103CFU
OE: 81,5% ms<103CFU
(p<0,001)
O: A ms:
22,5
OE: A ms:
18,2
(p<0,005)
T
(dft)
ms
AOTEEMATA TO AII
O: , OE: , ms: mutans
i. E, OY
ii. A IRM
.P
iii. T NaF
/Iodine*
iv. ,
2-3
2
i. E, OY
ii. A,
iii. 1mgF per os (6 . )
iv. NaF 0.05% (6 . )
v. 0,12% (6 .
)
vi.
3 2
i. E, OY ( triclosan
2 )
ii. A,
iii. A (Listerfluor)
iv. E
v.
i. E, OY
ii. A
iii. T
iv.
v.
3
3-4
4 5-6
EPIEXOMENO POHTIKOY
POPAMMATO
ENAPH & IAPKEIA

APEMBAH
3-10-08 13:17
*(1g KI + 1,2g NaF + 53ml Glyc. + H2O/100ml : pH=4,5)
EIMA MEETH
EPEYNHTE
2: A .
203
3-10-08 13:17
204
B A
1mg F ,
(49), , (1, 50).
T
Gomez .(51, 52) Zanata .(29)
NaF-Iodine (1g KI + 1,2g NaF + 53ml Glyc. +
H2O/100ml: pH=4,5), . K ,
, 5 .
M , ,(34, 35, 52) 3. A

. Mitchell-Lewis
.(53) , , ,
. Lopez .(34)
Jeffcoat .(35) 0,12% 250mg, . T

, 5,5 .
POTEINOMENH APEMBAH TH MHTEPA
M ,
.
4A, ,
. ,
, NaF 0,05%
16 (48). E ,

0,12%(34, 48). E, , , (35).
O

(54). K

204
,
. A (55). E , (11, 54, 56).
, (13).
, , , , (12). E,
(13).
H , ( 4B).
A Lydon-Rochelle
.(57), (58% ) 26
. K ,

,
,
(58). E, ,
, /(54). ,
(1, 3, 57). ,
, , .
YMEPAMATA
A :
1) O ,
.
2) O .
3) H
mutans , .
49: 181-189, 2005
28
E 2-3
O:200
OE: 200
O: 366
OE: 723
Lopez .,
2002(34)
Jeffcoat
., 2003(35)
49: 181-189, 2005
O..Y
A
P
0,12%
O..Y
A,
P

A
O A :4,9%
O B: 0,8%
O : 3,3%
OE: 6,3%
O: 2,5%
OE: 8,6%
RR=5,49 (p<0,05)
O: 13,5%
OE: 18,9%
AOTEEMATA TO AII
( /
)
O: , OE: , RR:
Y- :
i. A,
ii. P
iii. X 250mg (3
1 )
Y- B:
i. A,
ii. P
iii. X placebo (3 )
Y- A:
i. A
ii.
iii. X placebo (3 )
i.
ii.
iii.
iv.
i.
ii.
iii.
iv.
v.
EPIEXOMENO POHTIKOY
POPAMMATO
3-10-08 13:17
21 - 25
XPONO & IAPKEIA

APEMBAH
O:74
OE: 90
EIMA MEETH
Mitchell-Lewis
., 2001(53)
EPEYNHTE
3: A M .
205
205
206
, K, K, E.
* , **
A ().
: ,
, ( 1:100.000).
A .
A .
A .
A

.
AOKATATAH
3-10-08 13:17
OY
A
* NaF 0,05%
** 0,12%
OY
A
**P
** 0,12%
* NaF 0,05%
**X (M)
OY
A
>28 .
POHH
2
16<. <28
1
<16 .
TPIMHNO KYHH
4A: .
.
206
49: 181-189, 2005
49: 199-209, 2005
E

:
E
-

:
CMV, , ,
.
, ,
N2O.
O, , .
E (, , Rh, / ).
K, , , (, )
(, , ).
, & .Y .
.Y. .
>28 .
3-10-08 13:17
A:
E
:
, , . .
2
16<. <28
1
<16 .
TPIMHNO KYHH
4B: .
.
207
207
3-10-08 13:17
208
B A
4) O mutans .
5) H ,
mutans ,
.
6) H , .
7) H

.
SUMMARY
Intrauterine preventive dentistry

A. Polychronopoulou, K. Divaris, K. Kavvadia
The aim of this study was a) to review in utero risk factors for
offspring oral disease, as well as dental intervention
programs applied to expectant mothers, and b) to develop a
comprehensive intrauterine oral disease prevention
program by pregnancy semester.
Health problems during pregnancy, medication use,
malnutrition, deleterious habits, and presence of caries and
periodontitis constitute the main maternal risk factors for
child oral disease. Intervention studies in pregnant women
to control their cariogenic flora, show delayed colonization
with mutans streptococci and significant decrease in caries
occurrence both in primary and permanent dentition.
Furthermore, treatment of maternal periodontal disease
reduces the risk for premature or low birth weight child, by
5.5 times. Noteworthingly, premature and low weight birth,
increases the risk for enamel hypoplastic defects development.
In a comprehensive program of intrauterine preventive
dentistry, the pregnant mother must be informed regarding
the etiology and pathogenesis of oral diseases and the
possible consequences to the offspring. Furthermore, a
preventive program must be followed to control dental
plaque, both qualitatively and quantitatively, as well as
periodontal disease. Controlling dental plaque should be
facilitated by meticulous oral hygiene, during all three
pregnancy semesters. Periodontal therapy should not be
postponed; curettage can be performed, if indicated,
during the 2nd semester and may be supplemented with
antimicrobial agent administration. Elective dental treatment
should be performed between the 16th and 28th week of
gestation, whereas consulting with the physician in charge
must precede emergency treatment.
In conclusion, intrauterine preventive dentistry is feasible and
has proved to be effective in maintaining child oral health
Key words: prevention, pregnancy, oral diseases, offspring
208
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I, A, O
A 1987: 75-79.
:
A.
A 21, 116 35 A
e-mail: argypoly@dent.uoa.gr
49: 199-209, 2005
209
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3-10-08 13:17
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(major competence), .
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49: 211-218, 2005
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4. A

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215
3-10-08 13:17
216
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(5 26)

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49: 211-218, 2005
3-10-08 13:17
217
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DENTED37.
SUMMARY
Behavioral sciefnces in dentistry

H. Koletsi - Kounari, J. Avgeris
The aim of this article is to determine the factors that make

Behavioral Sciences an indispensable component of
dental undergraduate curricula and to present the trends
in teaching Behavioral Sciences in Dental Schools
worldwide.
In modern societies the main goal of dentistry is oral health
promotion of the populations according to the holistic
definition of health. This view of oral health recognizes that
a range of social and behavioral factors affect oral
conditions, hence dental care cannot be isolated from the
psychological makeup and social background of the
person receiving it and the person providing it. However,
this approach requires additional professional skills from
dentists, which go beyond the traditional biological and
mechanistic framework of the profession. It requires
developing a foundation of sociological and psychological
skills.
The practice of dentistry rests on the basic tenets of
appropriate communicative and ethical relationships
between dentist and patients. Not only is there the
relationship between dentist and patient, but also the
interface between dentist and community. Psychology and
sociology can aid the dental professionals to develop their
work both in the dental practice and, if they choose, in the
wider community. Behavioral sciences study the ways in
which people behave and the reasons for this behavior and
while they primarily describe the combination of the
subjects of psychology and sociology, other areas such as
ethics, communication, economics, and epidemiology are
also included. Behavioral sciences in dentistry may be
defined as the study to understand or explain the behavior
of people in relation to oral health. The appropriate setting
for behavioral dentistry, in theory and application, is in
clinical practice or within community oral health care
delivery systems. The concern is with intrapersonal,
interpersonal and social processes that occur while oral
health care is being discussed or delivered.
The inclusion of behavioral sciences in the graduate
dental curricula can help dental practitioners to deliver
optimal health care, since behavioral dentistry adapts and
integrates theory, empirical findings and practical skills
49: 211-218, 2005
from the social and behavioral sciences. Behavioral

sciences should be taught throughout the dental course
with careful integration so that that the subject matter
assumes its proper relevance to the care of the patients.
Instruction should provide students with an awareness of
the social and psychological aspects of patient care, in
order to appreciate the patient as an individual whose
response to dental care is determined by personality,
experience, and social and cultural influences. The core
behavioral dentistry curriculum aims to develop in dental
students an understanding of basic conceptualizations
that describe the causes of patient, dentist, and
community behavior and enhance students competence
in responding to the challenges involved in delivery of oral
health care.
Professional organizations, councils and associations
have had a pivotal role in developing guidelines for
teaching behavioral sciences in Dental Schools as well in
advising and making recommendations on this matter.
These documents promote the inclusion of behavioral
sciences in dental curricula and nowadays a considerable
number of Dental Schools have added the study of
behavioral sciences as a comprehensive part of their
curricula in the USA, Canada and Europe. Many variations
remain in the teaching that makes comparison between
schools difficult and it is recommended that more specific
guidance to be given to teachers of behavioral sciences in
dentistry. However, many Dental Schools have not
developed teaching of behavioral sciences in their
curricula and there is an urgent need to raise awareness of
the serious deficiency in this most important area of dental
education.
Key words: Behavioral Sciences, Dental Education, Oral Health
Promotion
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policy. Med J Aust 2000; 172(8): 379-382.
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2002; 6: 167-178.
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training in dental schools. J Dent Educ 1983; 4: 466-471.
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undergraduate curriculum. London: 1997, General Dental
Council, London.
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Ed 1992; 56: 209-213.
40. Humphris MG, Ling M: The development of a behavioural
science course into the dental curriculum at Liverpool Dental
School. Br Dent J 1995; 179: 293-299.
41. Graber DR, O Neil HE, Bellack J, Musham C, Javed T:
Academic Deans perceptions of current and ideal
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42. Grembowski D: The role of health services in the renaissance
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43. Lange MB, Dunning GD, Lewis AM: A Baseline Study of
Behavioral Science Instruction in Dental Schools. J Dent Ed
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SUMMARY
Usefulness of microbiological testing

in Clinical Periodontology
D. Sakellari, C. Xatzigeorgiou, A. Konstantinidis
Although the microbial aetiology and the specific

subgingival flora of various forms of periodontal diseases
are well documented in the literature, microbial testing is not
yet officially incorporated in clinical practice and diagnosis
is still based on clinical recordings and radiological
findings. Microbiological testing does not affect the initial
treatment phase of various forms of periodontitis which
always includes oral hygiene instructions, supragingival and
subgingival scaling and root planing. Data in the literature
suggest that, certain categories of patients such as
aggressive periodontitis benefit from microbial testing,
especially after the initial healing phase, when the outcomes
of therapy are not satisfactory. Microbial testing can
determine residual pathogens and serve to guide further
therapy.The application of cultural techniques allows for
antibiograms,the recommended approach for correct
assesment of proper administration of antimicrobials.
Cultural techniques are considered the "gold standard" for
investigation of the complex subgingival flora, but can be
applied in well-organized, specialized laboratories and
require technical expertise. During the last years,molecular
biology techniques are widely used in periodontal research
mainly due to their ability to overcome technical problems of
anaerobic cultures and their specificity. These techniques
as well as immunofluorescence do not require viable
bacterial cells and are proven to be more rapid and sensitive
than culture.In clinical practice, the molecular biology
approach is more convenient although it does not allow the
determination of antibiotic susceptibility. Polymerase chain
reaction (PCR), whole genomic, synthetic oligonucleotide
and 16srRNA probes are examples of molecular techniques
applied in clinical periodontology. The Department of
Preventive Dentistry, Periodontology and Implant Biology,
Dental School, Aristotle University of Thessaloniki routinely
uses the checkerboard DNA-DNA hybridization technique
which allows the simultaneous processing of up to 30
clinical samples for up to 45 bacterial species or up to 90
samples for 4 species. This technique is used to monitor
226
periodontal patients and determine antibiotic regimens for

aggressive periodontitis patients or recurrency of disease in
chronic periodontitis patients. Systemic administration of
antibiotics is considered after the initial healing phase, in an
effort to limit overusage of antimicrobials which can lead to
development of resistant strains.
Key words: Microbiological testing, periodontitis, antimicrobials.
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40. De Soete S, Mongardini C, Peuwels M, Haffajee A, Socransky
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DNA-DNA hybridization. J Periodontol 2001; 72(3): 374-382.
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42. Wall M, Sissons CH, Anderson SA, Lee M: Checkerboard
DNA-DNA hybridisation technology focused on the analysis
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:
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SUMMARY
The use of mini-comparator in the construction

of an oculofacial prosthesis
P. Kafas, S. Dalambiras, M. Vourvachis, M.A. Bamber
Maxillofacial prosthetic rehabilitation after extensive tumor

resection constitutes a serious medical problem, especially when the post-surgical defect is wide.
The positive psychological effect created by a successful
prosthesis is essential for such a patient to confront - apart
from a biological problem - a radical treatment that results
in a large defect.
Radical treatment is usually required for Neurifibromatosis
type- 1 or von Recklinghausen disease. This is particularly
difficult when the affected facial area is extensive. The
surgical treatment of such a disease usually causes a
broad post-surgical defect that requires rehabilitation.
Prosthetic rehabilitation methods of facial defects, and
particularly of the peri-orbital region, set up a various range
of techniques used for the retention of such prosthesis.
Usually, such techniques are the mechanical retention, the
retention using the anatomical undercuts, the medical
adhesion and the modern use of osseointegrated implants.
This case report presents a post-surgical oculofacial defect
of the middle right facial third with orbital exenteration and
critical reduction of bone in the zygomatico-orbital complex.
The use of extra-oral osseointegrated implants for the
rehabilitation of this area was excluded due to inadequate
bone availability, after assessing this area using 3D-CT scan

and fusing deposition modeling (FDM). The estimation of
the soft tissues was performed using the surface Laser
assisted simulation and computer tomography (CT).
The options of mechanical and anatomical retentions were
excluded. Alternatively, retention of the prosthesis was
achieved using medical adhesion. This case report
presents the rehabilitation technique of medical adhesion
significantly improved for the construction of such a
prosthesis using the mini- comparatr for assessment of
the orbital characteristics.
This device assessed the orbital area dimensions giving
the ability to the clinicians to achieve high standards of
aesthetics.
Key words: Oculofacial prosthesis, von Recklinghausen disease, 3D-CT scan, mini comparatr, fused deposition modeling
(FDM), surface laser simulation.
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E-mail: panos@kafas.gr
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stomatologika exof.

ENTYO KEITO AP. A. 520/92

EITHMONIKO ENTYO ME ENIKH ANANPIH

ISSN 1011 - 4181

ISSN 1011 - 4181

TOMO 49, TEYXO 2

TOMO 49, TEYXO 2

Hellenic Dental Association

VOLUME 49, ISSUE 2

Special characteristics of dental phobic patients treated under

Intraoral manifestations of resistant acute myelomonocytic

Per os and intravenus sedation in oral surgery

Hellenic Dental Association

VOLUME 49, ISSUE 2

Usefulness of microbiological testing in Clinical Periodontology

Scanning Electron Microscopy

ANAEPHMENE OHIE IA TOY YPAEI

129-135 SEL - FRAGAKIS*

129-135 SEL - FRAGAKIS*

49: 129-135, 2005

129-135 SEL - FRAGAKIS*

129-135 SEL - FRAGAKIS*

129-135 SEL - FRAGAKIS*

129-135 SEL - FRAGAKIS*

Special characteristics of dental phobic patients

Dental fear and anxiety is a world-wide problem and a

coexisting psychiatric conditions. The dental treatment

129-135 SEL - FRAGAKIS*

Odontoiatriche. Preventione e cura, Torino. Edizioni minerva

report measurements of dental anxiety and fear in children: a

49: 129-135, 2005

137-140 SEL. PAPADOPOULOU*

137-140 SEL. PAPADOPOULOU*

49: 137-140, 2005

137-140 SEL. PAPADOPOULOU*

Intraoral Manifestations of Resistant

This is a case report of resistant acute myelomonocytic

137-140 SEL. PAPADOPOULOU*

diagnosis of leukaemia. They are more common in acute

2. Sklavounou-Andricopoulou A, Piperi E, Paikos S: Oral and

49: 137-140, 2005

141-146 SEL. - STAVROY

141-146 SEL. - STAVROY

BENZOIAZEINE: IAZEAMH KAI MIAZOAMH

141-146 SEL. - STAVROY

141-146 SEL. - STAVROY

141-146 SEL. - STAVROY

, , N2O O2(35). H N2O ,

Per os and intravenus sedation in oral surgery

Fear, pain, the inability of the patient (mainly children or

141-146 SEL. - STAVROY

26. Valtonen M, Salonen M, Forssell H, Scheinin M, Viinamaki:

1993; 79: 1177-1182.

49: 141-146, 2005

in vitro. T , 109 1010

OONTIATPIKE PAEI OY EN AAITOYN XHMEIOPOYAH ENANTION TH ENOKAPITIA

49: 147-154, 2005

, 12,9%. A, , 8,3%, . T AHA . ,

E:2,0gr per os, : 50mg/kg

E: 600 mg, : 20 mg/kg

E:2,0gr per os, : 50mg/kg

E: 500 mg, : 15 mg/kg

* T Dajani 1997 (20).