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12

DENTAL TRIBUNE

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Ekstrakcije zuba u
ortodontske svrhe
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DENTAL TRIBUNE

35 , . $ =6/8$ -$

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Kad razmiljamo o ekstrakcijskom lijeenju moramo


dati prednost facijalnoj estetici pred dentalnom estetikom

13

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spec. ortodont
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u mjeovitoj denticiji

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Kod pacijenata s otvorenim zagrizom


lake je donijeti odluku
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