Chronic kidney disease (CKD) is a condition defined by the progressive loss of renal function and damaging, in the course of months or years. Its rising incidence on a global scale compels doctors of dental medicine to be aware of the oral manifestations and symptoms affecting the soft and hard dental tissues, which are related to the underlying condition or its treatment. The objective of this review is to look into the oral changes affecting some of the patients with terminal kidney failure receiving chronic dialysis treatment.

Dentists usually recommend at least two minutes of brushing two times per day as a minimum. The purpose of this study is to establish the frequency of teeth brushing for patients with terminal stage of chronic kidney disease and for healthy controls. Materials and methods: 140 patients from Northeastern Bulgaria took informed participation, volunteering, in this study. They are separated into two groups – 70 people were diagnosed with terminal stage of chronic kidney disease (CKD) and chroniohemodialysis at different stages of disease duration and 70 healthy controls. Anamnestic and socio-demographic data were collected, about gender, age and frequency of teeth brushing. The result was statistically processed using the IBM SPSS Statistics software, Version 20. Results: Data show that there is a statistically significant difference (χ2 = 79,031, p=0,000 ) between the patients of the groups studied. As we have expected, the patients from the control group brush their teeth more often (between 2 and 3 times per day). The Mann-Whitney test with Bonferroni correction shows that the CKD patients brush their teeth daily less than the people from the control group. Statistically significant difference (U = 1831,000, р = 0,004) is established between the two group participants. Conclusion: The frequency of teeth brushing as a main factor for maintaining good personal oral hygiene is higher for the healthy controls in comparison to the patients under the study, who belong to the group of people with CKD. We need more studies in order to understand better how could the frequency of teeth brushing influence the limitation of oral problems for people with kidney diseases on chroniodialysis.

The main criterion for personal oral hygiene is the frequency of daily effective tooth brushing.The aim of the study is to establish any differences in the frequency of tooth brushing in patients with dental prostheses and in healthy controls. Materials and methods:The study was based on the informed, voluntary participation of 140 dental patients from the North-East of Bulgaria, who were divided into 2 groups, each comprising 70 individuals: a Group of patients with removable and/or fixed dentures and a Control Group including healthy volunteers without any missing or restored teeth. The patients were further divided into two Age groups: 19 -32 year-olds (Young Age) and 33 -90 yearolds (Middle age, Adults and Elderly).Results: The mean age of the subjects included in the study was43.5 years. The Control Group consisted of 19-year-old adolescents, and the group of patients with prosthetic constructions involved individuals aged 22 -90 years (mean age 53.14 years, SD = 17.48).The participants in the Control Group tend to perform a more frequent tooth brushing as opposed to those in the Group of patients with dental prostheses (U = 628.500, p = 0.000). Under the age of 32 are 15.70% of the patients with prosthetic constructions who brush their teeth once a day. The highest percentage (60%) of participants who brush their teeth once a day is represented by middle-aged and adult individuals, followed by patients brushing their teeth twice a day who are also of the same age group (24.30%). Conclusion:The frequency of oral care is poor in patients with a prosthetically restored masticatory apparatus (up to once daily) compared to healthy volunteers.

Катедра по дентално материалознание и пропедевтика на протетична дентална медицина, Факултет по дентална медицина, Медицински университет -Варна 2 Катедра по орална хирургия, Факултет по дентална медицина, Медицински университет -Варна

During the rehabilitation of patients with the atrophic maxilla, the dental medicine doctor may faced before the challenge of achieving the exact placing of the intraosseous implants. We would like to present you the case of a 33-year woman with a prosthetic of implants after a Rehermanns plastic. The clinical and radiographic examinations show an absorbed maxilla with the horizontal and vertical bone deficit. The patient used a placeholder till the complete bone restoration after the surgical intervention. She did not want a final rehabilitation of the defect using a bridge-like structure due to the necessary intervention of the teeth neigboring the defect. The decision about the placing of intraosseous implants was made after the CBCT examination. The control examinations made after 6 months, 1 year, 3 years, and 5 years show satisfying results in regard to the function and aesthetics, and also the lack of subjective sensation for the patient.