Table of Contents
Prof. Dr. Radu Septimiu Câmpian
Colegiul Medicilor Stomatologi Cluj
Dentistry is the most dynamic medical field because it has undergone the most numerous and significant changes in the last 25 years. One of the ten important challenges that dentistry has been and is subject to is the package of normative acts developed as a result of the current pandemic. Adaptation to the new conditions is necessary. Dentists need to reconsider their goals and priorities in the areas of finance, organization and continuing medical education. Each of the three directions of change has elements imposed explicitly and elements implicitly imposed by recent normative acts. The ability of each dentist to respond promptly, pertinently and effectively to these challenges can be a distinguishing criterion in the context of existing competition in the public dental services market. The relationship between the partners of the medical act is also subject to change. Patient empathy must be gained and manifested through new means. The concepts of oral health, prevention and prophylactic activities need to be reconsidered. Health policies in the field of dentistry need to be reconsidered and in this regard, the opinion and firmness of expressing the opinion of dentists is necessary. On the other hand, universities where dentists are trained must ensure that dental students have access to patients in specialized clinical internships. Patients have new reluctance and dissatisfaction with the availability and accessibility of medical services. The feeling that only with a positive SARS-CoV-2 test you can reach a specialized medical service is more and more often highlighted, but also the prognosis offered to the patients treated by COVID-19 in the medical services in Romania is worrying
Keywords: Dentistry, pandemic, COVID-19
„Full mouth reconstruction” – Current materials and techniques
Prof. Dr. Norina Consuela Forna, Şef lucr. Dr. Doriana Agop-Forna
UMF „Grigore T. Popa”, Iaşi
The current challenges addressed to local and loco regional dysfunctions and complications generated by extensive, subtotal and total edentations, as well as the multitude of possibilities and techniques to approach these situations require a complete and complex rehabilitation either through a “one stage surgery” approach, bone and mucous support using addition materials and oral implants, but also the approach of periodontal support – “full mouth reconstruction”, completed by a temporary “immediate loading”. This case management strategy that can be identified with such needs, has of course multiple advantages, with addressability for a limited number of patients, but also a part of disadvantages, which within certain limits must be accepted, assumed and foreseen, constituting in most situations, a restriction of their application, only in particular case situations.
Keywords: full mouth reconstruction, one stage surgery
Occlusal Clearance Problems related to Implant-Supported Superstructures
in the Load-Bearing Area
Dr. Radu Baston (1), Dr. Ioana Neagu (1), Dr. Mihaela Gaşpar (2)
(1)Peltecu Medical SRL, Bucureşti; (2)Confident, Bucureşti
Purpose: the aim of this lecture is to statistically assess the number and subdivisions for load-bearing area implant cases featuring various degrees of occlusal clearance problems, analyze their extent and present appropriate treatment solutions.
Materials: 223 implant cases.
Method: between January 2013 and August 2020 we inserted in all load-bearing areas a total of 281 fixtures which have been loaded with 223 non-removable superstructures. 116 (52%) were single crowns and 107 (48%) multiple crown units and bridges. Not a single case was treated with a removable implant-borne superstructure. For every implant case we took standardized snapshots (1) before beginning the treatment, (2) during relevant prosthetic procedures and (3) at treatment completion. The snapshots have been stored in individual PPT files and analyzed for occlusal clearance.
Results: the retrospective analysis identified 168 cases featuring clear-cut occlusal clearance problems, thus representing an absolute majority of 75%.
Discussion: occlusal clearance problems cases range from minor to close to the edge. Their identification and treatment is unfortunately not given the appropriate emphasis in many textbooks. Unapproached they lead to treatment failure. Beside a chair-side examination focused on the height of the occlusal clearance, pretreatment plasters or virtual 3D-casts and standardized snapshots are unbearable for proper diagnosis, thus lea-ding to rewarding treatment results.
Conclusion: every implant case in the load-bearing area has a very high potential of featuring occlusal clearance problems.
Keywords: load-bearing area, sufficient/ limited/ insufficient bone height associated with sufficient occlusal clearance, sufficient/ limited/ insufficient bone height associated with insufficient occlusal clearance, sufficient/ limited/ insufficient bone height associated with increased occlusal clearance, sufficient/ limited/ insufficient bone height associated with lost vertical dimension, e.g. uncertain occlusal clearance.
Implant-supported predictable prosthetic rehabilitation techniques
Dr. Bogdan Liviu Mirodot, Practică privată, Bucureşti
Oral rehabilitation using implant supported prosthetic restorations became routine no matter it is about single tooth anterior or posterior reconstruction, terminal and biterminal edentations or complete edentations.
Last decade brought new technologies that allow us to create predictable rehabilitations with functional and esthetic results.
This paper is a review of prosthetic rehabilitation possibilities for different edentulous classes but also an update to the necessary investigations, neo-alveoli preparation, implant insertion recommendations and possibilities for custom-made abutments and implant crowns.
Keywords: oral rehabilitation
Prosthetic constructive criteria common to additive and subtractive techniques
Conf. Dr. Mihaela-Păpușa Vasiliu, Prof. Dr. George Costin, Şef lucr. Dr. Andor Toni Cigu, Şef lucr. Dr. Daniela Ivona Tomiţa, Asist. Drd. Codrin Paul Fuioagă Universitatea Apollonia, Iaşi
Dentistry, in modern society, has known over the years several stages of development, and today we are witnessing the special development of digital systems that replace manual activities, eliminate the use of materials and instruments from the dental laboratory. This stage, also called digitization, gives the possibility to obtain much more accurate and precise works, made in a much shorter time with a reduced consumption of materials and better comfort for the patient. Additive technologies have another advantage, in terms of prosthetic dentistry, that they have the ability to print prostheses from different materials: polymers, composites, metals and alloys with a dense structure and predetermined surface roughness. The most common additive technologies applied in prosthetic dentistry are stereolithography (SLA), ink jet based system (3DP), selective laser sintering (SLS) and molten deposit modeling (FDM), mainly with wax, metal alloys, resin materials and ceramics. Due to the rapid prototyping, the 3D technique helps a lot during the planning and realization of a certain construction in the prosthetic treatment.
Keywords: prosthetics, additive technologies, 3D, laser sintering
Classic landmarks taken over in modern technologies
Prof. Dr. George Costin, Şef lucr. Dr. Toni Andor Cigu, Conf. Dr. Mihaela-Păpușa Vasiliu, Prof. Dr. Carmen Stadoleanu, Asist. Drd. Grigorii Deleu Universitatea Apollonia, Iași
Partially skeletal removable prostheses are usually made of metal alloys, either with cast hooks or with special devices, fixed on the teeth adjacent to the edentulous gaps, being a cheap and predictable treatment option for the rehabilitation of partially edentulous patients. An alternative to the conventional method of producing dental replacements and constructions are CAD / CAM technologies, which have developed in recent years, both in subtractive and additive production. The unacceptable aesthetic display of metal joints, the increased weight of the prosthesis, the potential for metallic taste and allergic reactions to metals have led to the introduction of a number of thermoplastic materials in clinical practice, such as nylon and acetal resins. One material used successfully in making permanent removable prostheses is polymer, a thermoplastic composite known as PolyEther Ether Cetone or PEEK – a new modified material containing 20% ceramic fillers for CAD/CAM dentistry, high performance, with high biocompatibility, good mechanical properties, high temperature resistance and chemical stability.
Keywords: CAD / CAM, thermoplastic materials, PEEK
The advantages of the digitized clinical-technological algorithm in dental practice
Prof. Dr. Carmen Stadoleanu, Asist. Drd. Oana Cucoveică, Asist. Drd. Alexandru Daniel Armenia, Prof. Dr. Liliana Sachelarie, Conf. Dr. Gabriela Mihalache Universitatea Apollonia, Iași
Contemporary dentistry, like other medical specialties, is under the constraint of technological progress and modern therapeutic trends. Among these modern trends, digitalization is inserted with a number of advantages contributing to increasing the sustainability of the medical system. The trend towards progress towards digitalization has been supplied by the need to minimize aberrations caused by human factor variability, calibration of therapeutic algorithms, efficiency of working time, therapeutic programming and simulation, facilitation of interdisciplinary collaborations, etc.
Keywords: digitized medicine, evidence-based medicine, minimally invasive medicine.
Considerations regarding the influence of atherosclerosis and the accompanying biochemical changes on the occurrence of different types of edentulousness
Şef lucr. Dr. Daniela Ivona Tomiţa, Şef lucr. Dr. Cezarina Dragomirescu, Dr. Simona Jitariu, Conf. Dr. Mihaela Păpușa Vasiliu, Asist. Drd. Grigorii Deleu, Şef lucr. Dr. Diana Gheban Universitatea Apollonia, Iași
Periodontal disease is a major cause of edentulous condition. In the situation of generalized periodontal lesions, which affect the entire arch, the causes are primarily diseases that affect the whole body – atherosclerosis being an example. Studies also indicate a close link between periodontal disease and atherosclerosis. It should also be mentioned that the same common favoring factors (genetic factors and risk factors) are involved in the etiology of chronic marginal periodontitis, partial or total edentulousness and atherosclerosis. The clinical study on atherosclerosis and different types of edentulousness was conducted on a group of 45 patients (23 women, 22 men) aged 44-76 years who benefit from dental treatments in the Dental Prosthetics Clinic of the Apollonia University of Iaşi. The clinical examination was subsequently followed by paraclinical-biochemical examinations. In case of patients with extensive partial edentations, most of them have high cholesterol and blood sugar is normal (52%), while 36% of them have high blood sugar and cholesterol. High blood sugar and normal cholesterol are found in 12% of these. In the case of patients with total edentation most of them have normal blood sugar and high cholesterol – 50%; 25% have high blood sugar, normal cholesterol and 25% have high blood sugar and high cholesterol.
Keywords: atherosclerosis, extensive partial edentations, total edentation
Mouthwash with Manuka Honey with antibacterial effect, obtained by the complexation technique in paste
Prof. Dr. Xenia Patraș(1), CS Dr. Răzvan Rotaru(2), CS Dr. Maria Fortuna(2), CS I Dr. Valeria Harabagiu(2); (1)Universitatea Apollonia, Iași; (2)Institutul de Chimie Macromoleculară „Petru Poni”, Iași
In the last years, there are more and more research that study with the use of natural medication in dental practice. Various technologies can highlight the active principles contained in plants and in-depth studies can explain some mechanisms of action of natural products that have been used throughout time in therapy. Nanotechnology is also applied in the apitherapeutic field by obtaining products that can amplify and improve the effect of natural products. The use of cyclodextrins as supports for efficient use and increase the bioavailability of bee products in gum disease is a possibility by increasing the known antibacterial effect of bee honey. We chose for the study Manuka Honey in order to achieve a new medicinal form, a mouthwash type, for obtaining a better therapeutic effect on inflammatory gingival pathology. Using supramolecular chemistry, we used cyclodextrins as a substrate for complexing Manuka honey. They can solubilize hydrophobic drugs in pharmaceutical and crosslinking applications to form polymers used for drug administration. Given these data as well as the results obtained by the research we performed, we recommend the use of Manuka honey inclusion complexes with beta cyclodextrin in the 80/20 ratio as an excipient instead of glycerin.
Keywords: Manuka Honey, antibacterial, complexation technique
Infections of the oral mucosa. Prevalence study
Şef lucr. Dr. Ioanina Părlătescu, Prof. Dr. Radu Petru Şerban Ţovaru, Dr.Radu Cazacu, Asist. Dr. Carmen Nicolae UMF „Carol Davila”, Bucureşti
Introduction. Oral mucosal infections are caused by bacteria, viruses or fungi. The clinical features are variable depending on patient-related factors such as general condition (associated systemic conditions), individual predisposition but also oral hygiene, smoking, dento-periodontal foci.
Material and method. A retrospective study was performed with the data contained in the register of new cases from the Clinical Department of Oral Pathology Discipline. The period between 1997 and 2017 was analyzed. All patients who were diagnosed with an infection of oral mucosa were selected.
Results and discussions. Oral mucosal infections were diagnosed in 1368 patients, which represents 12.51% of total cases (10930). Oral candidiasis is the most common infectious disease of the oral mucosa and accounted for 68% (n = 940) followed by viral infections in 24.7% (n = 338) and bacterial infections in 2.33%. Other rare infections such as syphilis and tuberculosis have been found in 40 cases.
Conclusions. Oral mucosal infections are clinical features encountered in dental practice. Their recognition, the establishment of the diagnostic algorithm, and the principles of treatment sometimes raise problems, especially due to their mimicking clinical aspect.
Keywords: oral mucosa infections, prevalence
Familial oral lichen planus. Presentation of two clinical cases.
Asist. Dr. Carmen Larisa Nicolae, Prof. Dr. Radu Petru Șerban Țovaru, Asist. Dr. Mihaela Țovaru, Șef lucr. Dr. Ioanina Părlătescu UMF „Carol Davila”, București
Lichen planus is a cutaneous and mucosal condition of unknown cause produced by a complex, autoimmune mechanism. It is also one of the main diseases of the oral mucosa encountered by dentists in their current practice. Although the genetic factor involved in the etiology of lichen planus is not yet fully clarified, there are numerous literature reports of some cases of familial oral lichen planus (OLP). This raises the possibility of genetic transmission of OLP.
The aim of this paper is to present the clinical and evolutive characteristics of two cases of familial OLP.
Material and method. In the period 2015-2019, 4 patients belonging to two families with clinically suggestive OLP lesions presented to the Discipline of Oral Pathology of UMF Carol Davila Bucharest for consultation and diagnosis. Histopathological examination confirmed this diagnosis. In the paper we described the characteristics of the onset and the clinical and evolutive features of these patients. Conclusions. The analysis of family cases of oral lichen planus shows certain special characteristics, such as: lower average age of patients, early onset, sometimes atypical clinical manifestations and certain features of severity characterized by frequent episodes of recurrence over time. Observations from these cases suggest that patients with familial OLP should be closely monitored over long periods of time.
Keywords: familial lichen planus, genetic transmission
The influence of oral breathing on craniofacial growth
Conf. Dr. Alexandrina Muntean, Şef lucr. Dr. Meda Romana Simu UMF „Iuliu Haţieganu”, Cluj-Napoca
The aim of this study was to assess, using cephalometric analysis, the consequences of oral breathing on the cranio-facial skeletal pattern, for patients in mixed dentition.
Methods. The sample comprised 80 patients (40 patients with nasal breathing and 40 patients with oral breathing) subjected to lateral cephalometric examination prior to orthodontic treatment. Cephalometric tracings were performed using a computerized software. Selected items (age, gender, SNA, SNB, ANB, FMA, IMPA, Z-angle and mandibular growth pattern) were descriptively analysed and the results were considered significant for p<0.05.
Results. We notice significant statistical differences (p <0.05) for the horizontal position of the mandible (SNB and ANB), the facial profile (Z-angle) and the axial inclination of the mandibular incisors (IMPA). No significant differences were detected regarding the SNA and FMA angles. Oral breathing patients have more retruded mandible in sagittal sense (associated with occlusal class 2 Angle) and tendency to develop a long-face pattern. Oral breathing superimposed on the growth curve of the child cause morphological alterations of the dento-facial complex.
Conclusions. Oral breathing in children need a prompt attention and a multidisciplinary approach to have early and appropriate diagnosis and therapy.
Keywords: oral breathing, cephalometric analysis
New possibilities in the cryogenic treatment of pretumoral pathologies of oral cavity organs in children
Prof. Dr. Gheorghe Țîbîrnă, Conf. Dr. Aurelia Spinei, Conf. Dr. Silvia Răilean, Conf. Dr. Andrei Țîbîrnă, Dr. Ursu Dănis USMF „Nicolae Testemiţanu”, Chişinău
The purpose of the research: To investigate the role of cryodestruction in the treatment of pretumoral pathology of the organs of the oral cavity in children.
Materials and methods. The medical records (over 15 years, 2004-2019) of patients aged 0-18 were examined. The questionnaires elaborated by the scientists executors of the project “Modern personalized surgery in the diagnosis and complex treatment of tumors in children” were also used. During these years, 53 children with pretumoral processes of the organs of the oral cavity were detected: Leukoplakia – 35 children; Papillomatosis – 10 children; Lichen ruber plan – 3 children; Drug induced stomatitis – 5 children.
Out of 53 patients, 35 were boys and 18 were girls.
Distribution by age: 0-1 years – 7 patients; 1-4 years – 12; 5-9 years – 22; 10-14 years – 3; 15-18 years – 9.
In 17 cases out of 53, cryodestruction of pretumoral pathologies of the oral cavity was applied.
Results: In all 17 cases, total healing was achieved. This method was used for the treatment of pathologies, located in hard to reach areas: soft palatine, palatal pillars, retro-molar region and buccal floor.
Conclusions: The proposed method is effective, simple to apply, practically without complications and with the possibility to be applied in patients under ambulatory conditions.
Keywords: cryodestruction, pretumoral pathologies, oral cavity, children
Personalized Surgical-orthodontic Treatment in children with Treacher Collins Syndrom
Conf. Dr. Silvia Răilean, Dr. Galia Ciobanu *USMF „Nicolae Testemiţanu”, Chişinău **Universitatea Medicală „Sapienza”, Roma
Introduction: Treacher Collins Syndrom (TCS), is autosomal disease characterized by morpho-functional abnormalities of the head and neck area. It is estimated as 1 case in 50.000.
Aim: Personalized orthodontic-surgical approach in craniofacial anomalies especially in TCS.
Method: 6 children with TCS (3 girls and 3 boys) were evaluated. Orthodontic treatment was initiated at all patients around the age of 7 year old. At early age surgery was performed in 3 patients versus another 3 patients where surgery that was performed in adolescence. Planning of the surgery was done using the Dolphin Imaging and Management Software.
Result: School-age children data before surgery: SNB angle was 70 degree and CO-GO-Me- 132 degree, after the surgery: SNB-78, Co-Go-Me-127. Adolescence children before surgery represented: SNB-65 and Co-Go-Me-140, after surgery: SNB-70, CO-GO-Me140.
Conclusion: After surgical treatment at early age, angle SNB, Co-Go-Me were reestablished to the normal values, comparing to those in adolescence that tended to the normal one.
Keywords: TCS, orthognatic surgery
Laser therapy as a biomodulation aid to periodontaly optimizing orthodontic tooth movement
Asist. Dr. Maria Alexandra Mârţu, Şef lucr. Dr. Ionuţ Luchian, Prof. Dr. Vasilica Toma, Conf. Dr. Carmen Savin, Conf. Dr. Ana Sîrghe, Asist. Dr. Ioana Sioustis, Conf. Dr. Sorina Solomon UMF „Grigore T. Popa”, Iaşi
Orthodontic treatment addressability has increased exponentially in recent years due to a higher concern for esthetic results not only among young patients but especially among adults. Complex oral rehabilitation imposes the collaboration of several specialists to meet the ever more selective needs of patients in order to deliver a truly comprehensive treatment plan.
A long-term orthodontic treatment is not only taxing for patients, resulting in diminishing compliance of patients throughout the duration, but could also cause a multitude of side effects, such as alveolar bone and root resorption, gingival recession and a higher caries risk.
In this context accelerating orthodontic tooth movement can significantly reduce treatment duration and thus the risks of side effects. The rate of orthodontic tooth movement is chiefly determined by the remodeling of tissues surrounding the roots.
Laser dentistry is a fast evolving field with many applications in surgery, implant dentistry, periodontology, endodontics, and orthodontics.
The purpose of this study is to analyze the possibility of accelerating orthodontic tooth movement through the use of low level laser treatment and to highlight the advantages, disadvantages and limitations of this technique in light of recent clinical and molecular findings.
Keywords: orthodontic treatment, accelerating tooth movement, Laser, photobiomodulation, bone remodeling
3d simulation for diagnosis and treatment of ectopic canine and alternative treatment solutions
Şef lucr. Dr. Liliana-Gabriela Halițchi, Asist. Drd. Raluca Georgescu, Dr. Ciobanu Stelian Universitatea Apollonia, Iaşi
Permanent canines play a fundamental role in facial appearance, dental aesthetics, development of the dento-alveolar arch and functional occlusion. Clinical guidance seeks to draw the attention of all dental health care providers to the need to identify potential cases of maxillary canine site abnormalities in a developing dentition in children aged 9 to 13 years.
For the radiological study, 32 orthopantomographies with site anomalies of the upper canine were selected, for which the angulation is greater than 30° and the distance from the incisal tip of the upper canine to the occlusion plane is greater than 20 mm.
The models were scanned in 3D with a CBCT Carestream CS 8100 resulting in DICOM files (digital imaging and communication in medicine) standard for virtual image storage in dentistry. The resulting files were converted to STL (stereolithography) files with the INVESALIUS program obtaining files that can be processed with CAD programs and / or imported on CAD systems. 12 reference points were applied and 3D measurements were made:
– molar width of maxillary arch
– length of maxillary arch
– available space on maxillary arch
– space required for frontal alignment
Keywords: canine, 3D simulation, setup
Is the concentration of fluoride in natural mineral waters important?
Asist. Dr. Eugeniu Mihalaș, Asist. Dr. Laura-Maria Vasîlca-Gavrilă, Conf. Dr. Ana Sîrghe, Conf. Dr. Carmen Savin UMF „Grigore T. Popa”, Iaşi
Fluoride ions (F) participate actively in the dental enamel remineralization process and inhibit the cariogenic bacteria activity from the oral biofilm. With over 2000 springs and 60% of the mineral water reserves in Europe, Romania is one of the countries with the richest underground water resources, the consumption and production of natural mineral water is continuously increasing. At European level, the concentration of F in bottled mineral waters varies, sometimes even reaching 14 mg/L in Portugal, 5 mg/L in Bulgaria and 8.5 mg/L in France. According to the national legislation, only mineral waters with a F concentration higher than 1.5 mg/L will have the warning on the label, labeling of the lower F concentrations being optional. A preliminary study that we carried out, revealed that only on 15% of the labels of the mineral waters evaluated, was specified the F concentration. In Romania, there are no current studies evaluating the F concentration in natural mineral waters (literature data from 1996 revealed concentrations between 0.93-0.01 mg/L). Thus, it is necessary to carry out laboratory studies to detect concentrations of F above the recommended limits, to verify the accuracy of the values on the label and afterwards, establish preventive measures regarding the safety of consumption and the risk of developing dental fluorosis.
Keywords: fluoride, mineral waters, children
Children use of smartphones for oral health-related activities
Asist. Dr. Mariana Cărămidă, Şef lucr. Dr. Ruxandra Sfeatcu, Prof. Dr. Mihaela Adina Dumitrache UMF „Carol Davila”, Bucureşti
Aim: The assessment of the level of both interest on and use of oral health related activities on smartphones among children and adolescents.
Material and method: The cross-sectional study took place between January and June 2020, on a sample of 100 children with a mean age 16.08 ± 2.58 years, using a self-administered questionnaire with 16 items, distributed on-line.
Results: Participants spend 265.98±179.42 minutes/day on their smartphones, 39% never used it for oral health-related activities, while 35% use it daily and spend 14.4±13.71 minutes per day. Among the reasons for what children and adolescents use their smartphone specifically for oral health-related aspects, the most frequently mentioned were for searching on-line information about dental and gingival home care (30%), supervising the teeth-brushing (29%) or getting familiar with dental treatments (21%). However, only 29% of subjects know specific oral health applications for smartphones.
Conclusion: Children and adolescents spend a lot of time daily on the smartphones and they are interested in using it also for oral health-related activities. Although the proportion of daily users and the time spent for this aim are low, oral health promotion via application or on-line could be an appealing method for this age group.
Keywords: oral health, smartphone, children
Multidisciplinary casuistry during “social distancing”
Asist. Dr. Andreea Toma (1), Dr. Alina Vrînceanu (1), Dr. Vadim Vrînceanu (2); (1) Spitalul Clinic Colţea, Bucureşti, (2)Clinica Stomatologică „Doma-Dentus”, Ploieşti
The need for collaboration was felt even more strongly in these times of social distancing. All doctors agree that they have consulted patients with more complex and serious diseases and syndromes than before. Many times the need for medical association was felt in the management of cases. It was often difficult.
Knowledge of polymorphic, serious, rare medical and surgical situations illustrated by iconography we believe will be useful for young residents-doctors.
Keywords: ENT, oral pathology, cancer, hematology
CBCT recording assessment strategy for maxillary sinus
Dr. Milan Uzelac, Private practice, Belgrade
Due to capability of reproducing fine bone/teeth anatomical structures and low radiation dose Cone Beam CT (CBCT) is golden standard for tridimensional radiological assessment in dentistry.
Although generally in CBCT radiographs we are missing capability to differentiate soft tissue characteristics in closed anatomical compartment as maxillary sinus is we can assess changes of mucosal lining and gain many invaluable data for clinical decision making.
We do assess maxillary sinus CBCT radiographs as point of primary interest (oroantral communications, foreign body presence, preparation for sinus floor elevation) and point of secondary interest as our obligation to overall assess radiographs.
As a border region between dentistry and ENT maxillary sinus frequently need mutual assessment.
As no other radiographical modality CBCT is capable to provide data in determination of dental pathology involvement of maxillary sinus changes.
During presentation we will address general assessment strategy, strategy in preparation for sinus lift procedures, need for mutual association of dental specialties and ENT.
Keywords: CBCT, maxillary sinus, sinus lift, assessment strategy
Influence of the use of CBCT in an endodontic office on the process of the decision making towards treatment/non treatment
Dr. Roberto Cristian Cristescu, Private Practice Endo En Zo, Amsterdam
Decision making is one of the most challenging parts during performing dentistry care for patients. The phrasing of a decision taken to choose one treatment option is often complicated, and it may be done quite often based on personal perspectives and one’s own experience than actually on a clear and objective analysis of treatment benefits, risks, cost, prognosis, and alternatives of treatment.
Endodontic decision making towards an intervention of the lack of it is based on both clinical and radiographic information. During the last decade more and more CBCT scans have been used in Endodontics Diagnosis process. The aim of this presentation is to highlight the advantages and disadvantages such a 3D imaging technique can bring into the equation of decision process in Endodontics. After a careful 3D volume analysis practitioners, and not only just from the endodontic field, will be more inclined to change their perspective of the clinical case and thus also the decision of intervention. The presentation will bring up clinical examples but also results of different research done in this area of dentistry.
Keywords: CBCT, Endodontics, decision-making
Controversies in the use of nanoparticles
Prof. Dr. Vasile Burlui, Asist. (1) Dr. Alexandra Burlui (2), Şef lucr. Dr. Laura Romila(1), Şef lucr. Dr. Oana Darabă(1); Universitatea Apollonia, Iaşi (1), UMF „Grigore T. Popa”, Iaşi (2)
The impetuous development of materials science has attracted from the beginning the interest of dentistry on the use of nanoparticles, due to the prosthetic specificity of organ supplementation or substitution on which this field of medicine is generally based. Dentistry has substantially benefited from the introduction of nanomaterials used in multiple specialties and medical techniques regarding the restoration of coronary morphology or the treatment of degenerative or infectious diseases in the field of tissue regeneration as well as in other fields. Either nanoparticles are administered for medical purposes, or they are used in food industry for color, taste, or agriculture, they can manifest a toxicity that depends on the constituent substance, on their size and shape, coating substance and, obviously, on the reactivity and concentration of the component substances. Progress in the field of nanoparticles should be rationally assimilated, based on authorized verification that do not compromise a positive idea, while simultaneously assures protection of the human organism.
Keywords: nanoparticles, nano products, nanotechnology, toxicity
Current trends in endodontic practice, from diagnosis to treatment
Conf. Dr. Constanţa Mocanu, Dr. Alexandru-Mihai Mocanu Apollonia University of Iasi
In dental practice, Endodontics as a discipline offers to the patients the opportunity to maintain their natural teeth for life. In recent years, root canal therapy has made significant progress in diagnosis and the type of procedure and armamentarium used, starting with the use of magnifiers and other equipment such as apex-locators, radiography/imaging techniques and systems, rotary instrumentation with NiTi. New procedures, techniques and materials are used for canal irrigation as well as for root canal obturation. As clinical implications, these new materials, techniques and instruments help dentists in providing a more predictable and reliable endodontic treatment.
Keywords: endodontics, new procedures, techniques and materials in root canal treatment
Factors that may influence amelo-dentinal adhesion
Prof. Dr. Dana Cristina Bodnar, UMF „Carol Davila” București
Enamel-dentin adhesion is influenced by the structural characteristics of hard dental tissues. The dental changes have an undeniable influence on the longevity of a restoration.
The loss of hard dental substance due to caries or trauma can cause a process of dentin sclerosis, which will affect the adhesion of restorative material.
Restoring an injury with loss of hard dental substance like edging, such as abfraction, will have greater longevity than an erosive injury and this directly related to tooth morphology and the changes appeared due to the causes of the lesions.
The longevity of a restoration depends on the strength of adhesive interface. This is closely related to the type of lesion, coronary positioning at dentin wound, the patient’s age, the type of adhesive used and how to achieve adhesion.
All of the above determine the requirement for a very careful analysis of existing clinical situation and the properties of different types of adhesive systems or existing commercial products within each class of dental adhesives.
Keywords: adhesion, adhesive interface, restoration longevity
The effect of calcium silicate-based materials on tertiary dentinogenesis
Prof. Dr. Andreea Cristiana Didilescu, UMF „Carol Davila”, Bucureşti
Tooth viability and functionality depend on maintaining dental pulp vitality. Dental pulp protection is ensured by dentin, a mineralized tissue with continuous formation. The odontoblasts, cells responsible for dentinogenesis, are hosted by dental pulp at its periphery. If noxious stimuli lead to pulp exposure, repair through dentin bridge formation, via tertiary dentinogenesis, can be achieved by use of biomaterials for pulp capping. The process of tertiary dentinogenesis involves differentiation of dental pulp stem cells into odontoblast-like cells and is modulated by bioactive molecules.
This lecture aims to update the knowledge in the field of conservative dental pulp therapy, as related to the effect of different calcium silicate-based materials currently used for pulp capping, on tertiary dentinogenesis, using research-based information from histological and immunohistochemical assessments.
Acknowledgement: This work was supported by a grant of Ministery of Research and Innovation, CNCS – UEFISCDI, project number PN-III-P4-ID-PCE-2016-0506, within PNCDI III.
Keywords: calcium silicate cements, pulp capping, tertiary dentin
If It’s Blue, It Must Be Working!
Dr. Shira Zary, 3M & Tel Aviv University, Department of Oral Rehabilitation
Light curing is one of the most common dental procedures, and greatly affects the quality and survivability of treatment. In fact, over 50% of our daily procedures depend on light curing, ranging from composite restorations to indirect cementation, but are we confident in the quality of polymerization? In this lecture, we will dive into the science behind light curing, discuss different curing techniques, different measuring instruments, and provide tips for improving clinical outcome.
Keywords: Elipar, light-cure, polymerization, light beam, blue light, composite light cure, composite restorations, curing techniques
Optical illusion. Aesthetic procedures of manipulating colour contrast and dental contour
Asist. Dr. Vitalie Gribenco, Dan Zagnat, Conf. Dr. Vasile Zagnat, Conf. Dr. Boris Golovin, USMF „Nicolae Testemițanu”, Chişinău
In complex clinical situations, accompanied by dental migration, excessive tooth wear, and gingival recessions, the aesthetic therapeutic goals are difficult to achieve. Knowing and rationally employing certain procedures of recontouring and manipulating the colour contrast of the frontal teeth is a key element of illusory change in the visual perception of the dento-gingival composition.
In this context, the guide-schema proposed by the group of authors complements the algorithm of designing and performing frontal tooth restorations, along with other methods of simulating dento-facial aesthetics.
The harmonization of the dento-gingival components of the human smile following the consecutive application of these procedures was demonstrated by the results found in the questionnaires filled by the patients participating in the study.
Keywords: optical illusion, dento-gingival composition, simulation procedures
Algorithms, standards or protocols in dentistry?
Prof. Dr. Valeriu Burlacu, Conf. Dr. Angela Cartaleanu, Dr. Victor Burlacu, USMF „Nicolae Testemițanu”, Chişinău
Purpose of the research: Analysis of the regulation of the “physician-patient” relationship in dentistry.
Materials and methods. In Encyclopaedia Britannica (LITERA Publishing House, Bucharest, 2010, volume I, p. 117; vol. XII, p. 294 and vol. XIV, p. 323) the notions “Algorithm”, ” Protocol” and “Standard of living” (namely of living and not of other vital human components) are explained in a well-argued form. Each notion reveals the philosophy of the logic of these postulates, while indicating the boundaries of their concrete use. The notion for “Standard of Living” states that “various quantitative indicators may be used for assessment, including life expectancy, access to … medical care”.
Discussions. Would it be legally correct to consider the “Algorithm”, “Protocol” and “Standard” as identical??? No! The “standard” represents a kit and its attributes, the “Protocol” – a set of rules that must be obeyed in certain situations, and the “Algorithm” includes actions. The correct actions and the rules that must be followed may favour the successes of the standard, the protocol, but there can be no sign of equality between them !!! Under no circumstances!!!
Conclusion. “Algorithms”, “Protocols” and “Standards” are not a panacea for the quality of dental care. They cannot become a universal norm, capable of raising the quality of treatment, which in reality is an absolutely erroneous opinion.
Keywords: algorithm, protocol, standard
Paedodontics practice today
Prof. Dr. Rodica Luca, UMF „Carol Davila”, Bucureşti
Dental caries, regarded nowadays as a preventable and curable disease, remains the most common oral disease in both dentitions.
The preventive strategy endorsed by the „Alliance for a Cavity-Free Future” emphasizes the need for early caries detection, during the non-cavitary stage, in order to ensure conditions for reversibility through non/micro/minimally invasive interventions.
Today’s clinical paedodontics endorse, on one hand, the non-operative concept in incipient lesions and, on the other hand, the biological approach of cavities. Both concepts are described with direct regard to the deciduous dentition.
Keywords: paedodontics, caries, treatment, primary teeth.”
Modern methods of imaging evaluation during the orthodontic treatment in Pediatric dentistry
Prof.dr. Mariana Păcurar, Drd. Ana Petra Lazăr UMFST „G. E. Palade”, Târgu Mureş
Introduction. The correlation between the dento-maxilar anomalies and the biological growth pattern constituted subjects of research in orthodontics field.
The aim. The existence of large number of children with dento-maxilar anomalies, in whom the orthodontic treatment must be applied after a radiological evaluation, determined us to do a study of the Rx methods.
Materials and methods. The study was realized at the Department of Orthodontics and The Imaging Center of Târgu Mureș on a number of 37 children patients, aged between7-12, with different types of anomalies. To determine the bone modifications, the patients were investigated by OPT (Demirjian method) and Telerx (CVM method) for analyzing
– The stage of root maturation
– The skeletal growth pattern
Results. Analyzing the parameters of the bone we found that are differences between the dental and chronological age .The orthodontic treatment doesn’t influence negatively the growth processes.
Conclusions. The start in orthodontic treatment must be done after detecting the values of the bone parameters and the relation between eruption and dental age.
Keywords: OPT, orthodontic treatment, children, CVM method
From dental general anaesthesia in early childhood to the Dental Home concept: a step worth taking
Şef lucr. Dr. Arina Vinereanu(1), Şef lucr. Dr. Aneta Munteanu(2); (1)Practică privată, Bucureşti (2)UMF „Carol Davila”, Bucureşti
Even in the 21-st century, dental caries remains the most prevalent chronic disease in children. Availability of general anesthesia (GA) for dental treatment is often perceived as a stress-free solution to these problems and encourages parents to underestimate the long-term impact of failure to build healthy feeding and oral hygiene habits since the earliest stages of life.
Another category for which GA is sometimes the only way to solve dental problems is that of patients with complex general diseases and special healthcare needs. The impact of the main disease on child and family’s life usually causes oral health to fall on a secondary place of concern, so dental care is often sought when symptoms occur, and the needed treatment is already complex enough to require good cooperation – or GA.
This presentation aims to point out that GA is not the key to stress-free dentistry, but merely a high-tech, costly means to solve complex clinical situations that could not be avoided. Repeated GA can – and must – be avoided on the long run both for healthy children and for patients with special healthcare needs. In this respect, the “Dental Home” concept is brought to attention.
Acknowledgements: This work is partly supported by the Erasmus + Project 2019-1-RO01-KA202-063820 – Oral Special Care Academic Resources (O.S.C.A.R.)
Keywords: dental caries, general anesthesia, Dental Home, prevention
Impact of the tumor necrosis factor alfa on affection with dental caries in children with severe central nervous system disorders
Conf. Dr. Aurelia Spinei, USMF „Nicolae Testemițanu”, Chișinău
Objectives. To study the impact of TNF-α level on dental caries (DC) affection in children with severe diseases of the central nervous system (CNS).
Material and methods. Indices of prevalence of dental caries (IP) and carious experience were assessed in 636 children with severe CNS disease (L1), compared with 636 conventionally healthy children (L0). The level of TNF-α in oral fluid (OF) and blood serum was assessed by the solid support enzyme-linked immunosorbent assay using the reagents of “OOO Vector-Best” (Russia) and in accordance with the manufacturer’s recommendations.
Results. In children with severe CNS disease, there were increased values of IP indices (79.40 ± 0.84%, p <0.001) and carious experience DMFT (4.03 ± 0.088, p <0.001), compared to conventional children healthy. In subjects from L1 the level of TNF-α in OF is 5.53 times higher, and in blood serum – 10.19 times higher compared to children in L0.
Conclusions. Excessive production of TNF-α, both locally and systemically, has influenced the increased risk for dental caries and caries morbidity in children with severe CNS disease, a fact that must be taken into account when planning complex and customized preventive measures.
Keywords: dental caries, TNF-α, oral fluid, central nervous system
Examination of enzymatic concentration of MMP20 and KLK4 in serum and saliva of children ages 0-5 years
Dr. Jumanna Hassan, Dr. Uri Zilberman Pediatric Dental clinic, Barzilai Medical University Center, Ashkelon, Israel
Objectives: to analyze the concentration of two proteases, MMP20 and KLK4 in the serum and saliva of children 0-5 years old, in order to correlate between the proteases concentration and MIH appearance.
Design: 1 ml of serum was collected from 500 children hospitalized for common childhood diseases. Saliva was collected from a different sample of 100 children. The concentration of KLK4 and MMP20 was determined using the ELISA method using testing kits.
Results: The concentration of KLK4 in the serum was between 0.26- 53.76ng\ml (mean 8.69ng\ml) and in the saliva between 0.1- 27.9ng/ml (mean 1.01ng/ml). The concentration of MMP20 in the serum was between 0.30- 198.62ng\ml (mean 31.62ng\ml) and in the saliva between 0.32-29.81ng/ml (mean 3.72ng/ml). In the serum and saliva, girls showed statistically higher concentration of MMP20 in comparison with boys. In the saliva only, girls showed higher concentrations of KLK4 with statistical significance. The concentration of MMP20 in the young group <24 months was reduced.
Conclusions: The reduced concentration of MMP20 in boys age <24 months may explain the clinical finding that only two thirds of the crown is affected by MIH. The finding that the concentration of MMP20 in girls is higher compared to boys may explain the lower prevalence of MIH in girls, in the same regional community.
Keywords: amelogenesis, MMP20, KLK4, amelogenin, enamelin
Secretory immunoglobulin a level in oral fluid in children affected by dental caries
Asist. Dr. Svetlana Plămădeală, Prof. Dr. Olga Tagadiuc, Conf. Dr. Aurelia Spinei USMF „Nicolae Testemițanu”, Chișinău
Objectives. Studying the secretory immunoglobulin A (sIgA ) level in oral fluid (OF) in children affected by dental caries.
Material and methods. In the case-control study 127 children aged between 3 and 14 years were clinically examined. The research group (L1) included 98 children with DC, and the control group (L0) consisted of 29 children free of caries. Were estimated carious experience indices (dft, dfs, DMFT, DMFS). Caries risk was assessed with the use of Software-Cariogram. The level of sIgA in OF was determined by the method of immunoenzymatic analysis with using the reagents of the company “OOO Vectior-Best” (Russia).
Results. In children with high and extremely high caries risk in OF, the decrease of sIgA level was detected (157.11 ± 33.43 mg / dl, p <0.001), compared to children free of caries (199.68 ± 6.81 mg / dl ) and was identified an average inverse correlation between the sIgА level in OF and the DMFT index (ρ =-0.606, p <0.001).
Conclusions. Decrease of the level sIgA in OF in children with high and extreme caries risk indicates a relative deficiency of sIgA at the time of evaluation, but also a possible deficiency of local immunity of the oral cavity, a fact necessary to consider when planning individualized cariopreventive measures.
Keywords: immunoglobulins, sIgA, oral fluid, caries risk, dental caries
Particularities of chemical composition of tooth enamel in premature birth children
Asist. Dr. Olga Bălteanu, Asist. Dr. Elena Hristea, Conf. Dr. Iurie Spinei, Dr. Laura Ursu, Conf. Dr. Aurelia Spinei – Republica Moldova
USMF „Nicolae Testemițanu”, Chișinău
Objectives. To study the particularities of the chemical composition of tooth enamel in premature birth children.
Material and methods. 216 children aged between 12 and 18 were clinically examined in this case-control study. The study group (L1) included 108 premature birth children weighing less than 2,500 grams at birth. The control (L0) included 108 children born with normal weight. For research of chemical composition of tooth enamel, 24 teeth extracted for orthodontic aim were studied by using Fourier transform infrared spectroscopy method (FTIR) using the M-80 („Karl Zeiss”, Jena). The study was conducted in accordance with ethical requirements.
Results. In children prematurely born, the weight of the organic component of tooth enamel in relation to the mineral were increased, the hydroxyapatite content and the percentage mass of P, Ca, Cl, Mg and Na, the percentage mass of C and N were increased.
Conclusions. The particularities of the chemical composition of tooth enamel established in premature birth children denote the increased risk of dental caries and indicate the need to implement effective measures to prevent dental diseases.
Keywords: tooth enamel, prematurity, Fourier spectroscopy
Disorder of oral fluid cytokine balance in children with diabetes mellitus
Asist. Dr. Ecaterina Bocancea, Conf. Dr. Iurie Spinei, Conf. Dr. Aurelia Spinei
USMF „Nicolae Testemițanu”, Chișinău
Objectives. To evaluate the cytokine profile in oral fluid (FO) and highlight their impact on oral health in children with diabetes mellitus (DM).
Material and methods. 117 children with DM (L1) aged between 5 and 18 years were clinically examined. 117 conventionally healthy children were included in the control group (L0). The state of oral health and the cytokine profile in FO were assessed. The level of pro- and anti-inflammatory cytokines was determined by the method of immunoenzymatic analysis on solid support using the reagents of the company “OOO Vector-Best” (Russia).
Results. Dental caries was registered at 73.50%, catarrhal gingivitis was detected at 57.26%, and hypertrophic gingivitis – at 26.91% of children with DM. In subjects from L1, the disturbance of the cytokine profile in FO was established, characterized by the statistically significant increase in the level of proinflammatory cytokines (TNF-α, IL-1β and IL-6) and the relative insufficiency of the anti-inflammatory cytokines IL-4 and IL-10.
Conclusions. The disorder of oral fluid cytokine balance in FO influenced the state of oral health in children with DM, a fact that must be taken into account when selecting rational methods of dental treatment and planning preventive measures.
Keywords: diabetes mellitus, oral health, cytokines, oral fluid.
SDF in pediatric dentistry
Asist. Dr. Laura-Maria Vasîlca-Gavrilă, Asist. Dr. Eugeniu Mihalaș, Asist. Dr. Maria Alexandra Mârțu, Prof. Dr. Adriana Bălan, Conf. Dr. Carmen Savin
UMF „Grigore T. Popa”, Iaşi
In today’s dentistry, there is an increasing emphasis on minimally invasive restorations. One of these approaches is based on the use of Silver Diamine Fluoride (SDF) as a minimally invasive treatment option. The aim of this review was to centralize the data available in the literature concerning the indication, technique and outcome of the SDF use. Material and Method. A review of the literature on the use of SDF in pediatric dentistry has been carried out. Results. The application of SDF in children leads to the stopping in evolution of the 79% of active lesions in temporary dentation. More than 50% of the parents of the children treated with SDF said they were satisfied with the results, despite the possibility of esthetic problems. Most children accept the procedure as relatively painless. Conclusions. Using SDF in modern pediatric dentistry represents an alternative, safe and effective technique in the management of caries in children.
Keywords: SDF, child, dental caries
Assessment of oral health status in a pediatric population with intellectual disabilities
Asist. Dr. Cătălina Farcașiu, Conf. Dr. Mihaela Tănase, Șef lucr. Dr. Titus-Alexandru Farcașiu, Şef lucr. Dr. Aneta Munteanu, Asist. Dr. Ioana-Andreea Stanciu
U.M.F. „Carol Davila”, București
Aim. To assess the oral health status in a sample of schoolchildren with intellectual disabilities from Ploiești, Romania.
Material and method. Retrospective cross-sectional study on a sample of 71 schoolchildren (47 boys, 24 girls) aged between 5-16 years (mean age=10,49 ± 2,72 years) from School for Children with Intellectual Disabilities from Ploiești, Prahova county. Data were collected through interviews and clinical examinations according to WHO criteria. Prevalence index (Ip), caries experience indexes (DMF-T/S, dmf-t/s) and traumatic injuries were evaluated according to gender, age and intellectual disability (MID=mild, MoID=moderate, SID=severe). Data were analyzed using Microsoft Excel and descriptive statistics (SPSS 20.0, p<0.05).
Results. a) Ip=81,70%; b) Ip-dp=69,02%, Ip-dt=61,53% c) For entire sample: DMF-T=2,01, DMF-S=4,20, dmf-t=2,39, dmf-s=7,65, the differences being non-statistically significant according to gender and intellectual disability; d) Boys: dmf-t=2,55, dmf-s=8,30, DMF-T=1,83, DMF-S=4,23, girls: dmf-t=2,08, dmf-s=6,38, DMF-T=2,38, DMF-S=4,13; e) SiC 30% dt=7,10; SiC 30% dp=4,48; f) Ip dental trauma=9,85%, 1,28 traumatized teeth/injured child, gender ratio boys/girls=2,5/1; g) none of the schoolchildren presented restorative or preventive dental treatments.
Conclusions. Regardless of the degree of intellectual deficit, the prevalence of caries in the studied group was high associated with the absence of any dental treatment. Specific comunitary prevention programs are needed, associated with an improved access to dental treatment.
Keywords: intellectual disabilities, oral health status
Treatment needs on immature first permanent molar
Asist. Dr. Ioana-Andreea Stanciu(1), Dr. Elisavet Salahat(2), Asist. Dr. Cătălina Farcașiu(1), Asist. Dr. Paula-Raluca Vacaru(1), Şef lucr. Dr. Aneta Munteanu(1)
(1)UMF „Carol Davila”, Bucureşti
Aim: assessment of dental status and treatment needs for immature first permanent molar (FPM).
Material and method: descriptive retrospective observational clinical study on dental files of 200 children (91 boys) aged between 6-9 years from the Pedodontics Clinic Bucharest. Data about age, sex, FPM dental status at the first visit were selected. Caries prevalence index for FPM (IpFPM) and caries experience indices DMF-T/SFPM indices were calculated. The distribution and severity of carious lesions were assessed, as well as the treatment methods applied. Statistical analysis was performed with SPSS 18.0, using t-test (p<0.05).
Results: a)IpFPM=67.5% (Ipboys=62.63%, Ipgirls=71.55%; p>0.05); DMF-TFPM=1.66±0.80;DMF-SFPM=2.39±1.22; b) FPM status at the first visit (778 FPM examined):57.20%-caries-free, 35.73%-uncomplicated caries,4.24%-complicated caries,1.03%-second caries of a filling, 1.80%-correct fillings. Status of FPM with uncomplicated caries – cavitary lesions: 17.94%-superficial; 28.05%-medium; 32.02%-deep; non-cavitary lesions: 21.95%. Status of FPM with complicated caries: 30.39%-pulpitis, 60.61%-necrosis; c) Treatment – uncomplicated caries: 62.5%-modified or classical technique, 37.5%-minimally-invasive technique; complicated caries: 76%-endodontic treatment, 24%-extraction.
Conclusions: The increased prevalence of caries on immature FPM, as well as the presence of complicated caries in the age group 6-9 years impose the need for regular dental check-ups so as to detect carious processes at an early stage with the possibility of minimally invasive treatments.
Keywords: first permanent molar, decay, treatment
Dental status of second permanent molar in children and adolescents
Şef lucr. Dr. Aneta Munteanu(1) Dr. Ana Maria Iuciuc(2), Prof. Dr. Rodica Luca(1), Asist. Dr. Cătălina Farcașiu(1), Asist. Dr. Ioana-Andreea Stanciu(1)
(1)UMF „Carol Davila”, Bucureşti
In the literature there are few studies on the dental status of permanent second molars, although they are important in mastication.
Aim. Analysis of caries experience of second permanent molar (SPM) in children and adolescents.
Material and method. Cross-sectional clinical study on a group of 141 patients (53 boys, 88 girls) aged between 11 and 17 years (mean age=14.38±2.07 years), treated in the Pedodontics Clinic, Carol Davila University Bucharest. A comparative analysis of SPM caries experience by age and sex, as well as by topography was performed.
Results. a) 63.12% of patients had at least one SPM with caries (60.37% of boys, 64.77% of girls; NS); b) the prevalence of caries on SPM increased from 40% at the age of 11 to 82.60% at the age of 17; c) carious experience indices at SPM: DMF-T=1.50±1.45; DMF-S=1.93 ± 2.29; d) 36.71% of the 523 erupted SPM had untreated caries; e) 53.22% of the 295 carious SPM had untreated cavitated caries on the occlusal surface.
Conclusions. Caries occurrence on SPM shortly after its eruption requires caries prevention measures to prevent early loss of this important tooth in mastication.
Keywords: permanent second molar, dental status, children, adolescents
Considerations about pulp treatment in immature permanent teeth
Asist. Dr. Daciana Zmărăndache, Conf. Dr. Mihaela Tănase, Prof. Dr. Andreea Cristiana Didilescu, Asist. Dr. Paula Raluca Vacaru, Asist. Dr. Ion-Victor Feraru
UMF „Carol Davila”, Bucureşti
Pulp pathology of immature permanent teeth (IPR) is not very common, but it has serious implications in the process of maturogenesis and apexogenesis.
Aim. Evaluation of the frequency of pulpal diseases in IPR and of treatment methods used.
Material and method. Retrospective study performed on a group of 650 patients (both genders), aged 6-15 years old (mean age= 11.5 ± 1.9 years old) from a specialized clinic, between 2015-2019. Data on dental status, dental diagnosis of IPR, treatment methods and materials used were analyzed. Statistical processing was performed with the PSPP 1.4.0 program.
Result. 12% of IPR showed pulpal pathology; the most affected IPR is the 1st molar (65%); the most frequent dental pathology is simple deep caries (75%); conservative treatment, represented by pulp capping, is the most used (45%).
Conclusion. A favorable prognosis in the case of an IPR with pulpal pathology is determined by the correlation of the early diagnosis with an optimal treatment.
Keywords: permanently immature tooth, pulpal pathology.
Predictors of periodontal disease in children and adolescents
Dr. Mădălina-Ștefania Stancu(1), Conf. Dr. Mihaela Tănase(1), Dr. Simona-Elena Feraru(2), Prof. Dr. Anca Maria Răducanu(1), Asist. Dr. Ion-Victor Feraru(1)
(1)UMF „Carol Davila”, București
Introduction. The prevalence of gingivitis in children and adolescents has values between 59-97%, according to the literature. This condition is a therapeutic challenge for paedodonts.
Material and method. The one-year retrospective cross-sectional study was performed on a sample of 530 patients treated at the Paedodontics Clinic of “Carol Davila” UMP, Bucharest. The study aimed to assess the frequency of diseases of the marginal periodontium and identify possible factors associated with their occurrence, the results being considered significant for p≤0.05.
Results. Periodontal disease was represented by gingivitis and was found in 64.5% (n=341) of patients. The severity of gingivitis was influenced by the degree of hygiene, age and patients’ carioactivity (p<0.05).
Conclusions. The increased prevalence of gingival inflammation and its increasing severity with age recommends the early establishment of prophylactic measures for predictive factors identified and adapted to the level of understanding of patients.
Keywords: gingivitis, oral hygiene, bacterial plaque
Clinical and histologic periodontal manifestations in some sistemic factors in young pacients
Prof. Dr. Anca Silvia Dumitriu, Acad. Prof. Dr. Horia Traian Dumitriu
UMF „Carol Davila”, Bucureşti
Periodontal disease are proved to have a spread to all population groups, regardless of age, sex or geographic region, with a plurifactorial etiology.
The personal clinic experience and a relevant literature proof, these young patients develop prepuberal but also young forms of periodontal diseases, localization and generalization, aggressive, rapid progressive, pregnancy, diabetesor some medication influenced forms of periodontitis.
In case of young patients it is found or the increase is incidence of periodontal inflammation in many people with phenomena of gingival overgrow.
The purpose of this study is to show the clinical aspect, but also the hormonal influence, as a favoring factor in the appearance and evolution of gingival enlargement, historical changes that take place in the affected structures.
The premise of care is started after finding that there are frequent increases in gingival volume increases, accompanied by functional disorders: mastication, phonation, physiognomy.
Material and method: it is used to assess the degree of hygiene and inflammation of the gums. Objective clinical indices: plaque index and bleeding index. Objective clinical indicators and periodontal status. For a detailed historical modifiable record, the optical examination of the microscope is performed.
The conclusions emphasize the significant role of oral hygiene, favoring the hyperplasic formator of hormonal disorders and other forms of periodontal status, in adolescents and young people, treatment early, complex and correct institutions.
Keywords: periodontal diseases, systemic factors, young patients
The importance of a multidisciplinary approach of the periodontopathic patient with systemic diseases
Conf. Dr. Mihaela Moisei
Universitatea „Dunărea de Jos”, Galaţi
Purpose: the need to establish a complex treatment within a multidisciplinary team for a patient with correlative systemic pathology and deep chronic marginal periodontitis associated with gingival hypergrowth.
Materials and method: the case of a 45-year-old patient diagnosed with a deep form of periodontal disease on the background of affected general status, insulin-dependent diabetes and hypertension was analyzed. Clinically, there was marked gingival inflammation, significant gingival hypergrowth associated with interdental papillae, gingival bleeding, purulent secretions from the sulcus, calculus and plaque deposits, periodontal pockets of around 6 -10 mm, mispositions and dental mobility grade III at the maxillary incisors. Radiologically, the deep generalized bone lysis was highlighted with the presence of periapical lesions.
Results: periodontal therapy was instituted after the interdisciplinary consultation and the initiation of general antibiotic therapy. Purulent secretions disappeared 6 days post antibiotic therapy, and gingival inflammation 14 days after the removal of unrecoverable teeth and professional cleaning. Hyperplasic papillae were corrected by laser therapy with the advantage of minimal bleeding and rapid healing. The front edentulous areas were prosthetically attached.
Conclusions: systemic diseases condition the evolution and treatment of periodontal diseases
Keywords: deep periodontitis, gingival hypergrowth, systemic disorders, multidisciplinary approach
The evaluation of current possibilities of instrumentation in periodontology
Conf. Dr. Sorina Mihaela Solomon
UMF „Gr. T. Popa”, Iaşi
Periodontal disease – an infectious disease with an increasing prevalence worldwide, has important inflammatory characteristics and a strong impact on general health, social and economic functionality and quality of life. The way periodontal pathogens are organized as a biofilm gives them a strong resistance to pharmacological and chemical treatments. Only therapies that have successfully disorganized subgingival biofilms have been successful.
Scaling and root planning (SRP) is the gold standard of periodontal therapy traditionally performed with Gracey curettes. Recently, mechanical instruments such as sonic or ultrasonic (US) devices gained ground. A popular system in many western countries but still absent in Romania is the system with reciprocal movements (Profin®) and Periotor inserts, developed by Axelsson in 1992.
Previous instrumentation principles supported the need to completely remove infected periodontal tissue, including cement infiltrated with endotoxins from bacterial cell membranes. Recent studies have suggested that the largest amount of endotoxins is found in the subgingival plaque, and only small amounts penetrate the cement surface. Therefore, the removal of infiltrated cement becomes unjustified and not recommended. The evaluation of the root surfaces debridement using reciprocating systems revealed only a slight loss of root substance.
Our research is justified by the lack of general agreement on the existence of an optimal instrumentation technique.
Keywords: SRP, Gracey curettes, US devices, Periotor
Osteoporosis, risk factor for periodontal disease
Şef lucr. Dr. Cristina Gabriela Pușcașu
Universitatea Ovidius, Constanţa
The connection between age and decrease of bone density with fracture risk was suggested first by Astley Cooper (1824); the term “osteoporosis” and its recognition as pathology was suggested by French pathologist, Jean Lobstein (1835). Periodontal disease leads to bone loss in jaws and osteoporosis favors bone loss at the whole skeleton. The difference is that osteoporosis is a systemic degenerative bone loss, periodontal disease leads to local inflammatory bone loss, which, untreated, favors the tooth loss. It was suggested that both pathologies can represent risk factor one for the other, requiring both treatments. Suggested mechanisms that link those two pathologies include: disturbance of bone remodeling homeostasis, hormonal imbalance and inflammation. It was shown that both osteoporosis and periodontitis affect half of the aged population over 65 years old. The number of patients suffering those pathologies is expected to increase with age, so knowledge of their connection could prevent both diseases.
Keywords: osteoporosis, periodontal disease, risk factor
From the clinical examination to the treatment plan in periodontal disease, current trends
Şef lucr. Dr. Marina-Cristina Giurgiu, Prof. Dr. Anca Silvia Dumitriu
UMF „Carol Davila”, Bucureşti
In the last years, there are important steps in the field of periodontology and the current technologies of guided tissue regeneration allowed saving teeth which were considered hopeless. The correct diagnostic and the recognition of individual factors that influence the clinic manifestation represent the starting point in the treatment of any disease. The development of microbiological tests, both classical and PCR, allowed the establishment of the microbial etiology of marginal periodontal damage,
which, along with other local and systemic factors, determine different patterns of tissue damage. The classification of marginal periodontitis has
also changed, in 2017 the European Federation of Periodontology, based on clinical and paraclinical studies in the literature, published a new classification that takes into account the severity, extent, but also the degree of complexity and risk for the disease. Based on the new classification, in 2020 EFP developed a practice guide in Periodontology, which help the clinicians, highlighting the phasing of periodontal treatment.
Key-words: periodontal disease, classification of periodontal disease, treatment plan
Clinical and fundamental elements of the periodontal – chronic liver diseases association
Prof. Dr. Petra Şurlin, Şef lucr. Dr. Dora Popescu, Asist. Dr. Dorin Gheorghe
Numerous bidirectional pathophysiologic connections have been proven between periodontal disease and various systemic conditions, allowing the development of the “periodontal medicine” concept. The normal functionality of the liver can be impaired by a vast array of diseases including viral infections (generating hepatic inflammation – hepatitis), accumulation of fat (steatosis) or life-threatening conditions such hepatic cirrhosis and hepato-cellular carcinoma. The entire metabolism can suffer specific alterations, as a result of a generalized dishomeostasis, caused by common pathophysiologic mechanisms shared by these conditions with different clinic and paraclinic features. The liver’s implication in the regulation of the immune system is well-known and the chronic hepatic inflammation is driven by the same mediators as those involved in periodontal pathology, as tumor-necrosis-factor-alpha or interleukin-1beta. Thus, periodontal disease can be considered a negative impact factor on the evolution of chronic liver disease. Therefore, a multidisciplinary approach of such patients is needed, providing them optimal therapeutic strategies that will lead to an improvement of their oral health and general well-being.
Keywords: periodontal disease, liver disease, associations
Update Regarding Oral and Periodontal Care For the Oncology Patient During Chemotherapy
Asist. Dr. Diana-Cristala Kappenberg-Nițescu, Şef lucr. Dr. Liliana Păsărin, Şef lucr. Dr. Ionuț Luchian, Şef lucr. Dr. Irina-Georgeta Șufaru, Asist. Dr. Ioana Andreea Sioustis, Asist. Dr. Bogdan Constantin Vasiliu, Conf. Dr. Sorina-Mihaela Solomon
UMF „Gr. T. Popa”, Iaşi
Periodontal disease and oral infections may be exacerbated during chemotherapy and represent an important risk due to the neutropenia that many of the patients develop during treatment. The main objectives of oral care during immunosuppression periods are maintaining the oral health status, evaluating and treating any side effects that may occur during chemotherapy and patient education regarding the importance of maintaining good oral hygiene in minimalizing the risk of oral complications and discomfort during the chemotherapy treatment. The aim of this study is to revise the means of treatment and prevention of the adverse effects of chemotherapy in oncology patients.
Keywords: chemotherapy, oral side effects, mucositis, dysgeusia, xerostomia, treatment, prevention
Particular aspects in the examination of changes in the level of marginal periodontum
Conf. Dr. Stana Păunică, Şef lucr. Dr. Marina Giurgiu, Asist. Dr. Ștefana Popa, Acad. Prof. Dr. Horia Traian Dumitriu, Prof. Dr. Anca Silvia Dumitriu
UMF „Carol Davila”, Bucureşti
The premise of the paper consists in the fact that many patients cannot benefit from complex investigations targeting the marginal periodontium since the beginning of the treatment.
The purpose of this paper was to describe the particularities of clinical manifestation in leukemic gingivitis and to examine the periodontium using the thermographic method.
Material and method – The present study included mainly patients hospitalized in specialized clinics with the following diagnoses: acute myelomonocytic leukemia (AML-M4) and acute lymphoblastic leukemia (ALL). Thermography is a method of measuring and recording thermal radiation emitted by different parts of the body, on the skin and mucous membranes under normal or pathological conditions.
Conclusions – Thermography utilized along with clinical examination, laboratory tests, mucosal biopsy and MRI examination the presence of blast cell infiltration from the marginal periodontium.
Keywords: marginal periodontium, thermography
Aggressive periodontitis – Case report –
Asist. Dr. Ștefana Popa, Conf. Dr. Stana Păunica, Șef lucr. Dr. Marina Giurgiu, Prof. Dr. Anca Silvia Dumitriu
UMF „Carol Davila”, Bucureşti
Aim: Periodontal disease is becoming more common among children and young adults and draw our attention because it usually takes on an advanced form if there are diagnosed late.
Materials and methods: case description of a young female adult, age 33, who presents to our clinic for specialized treatment, presenting symptoms specific to an aggressive form of periodontal disease, in an advance stage of periodontal damage.
Results: Following the anamnesis, clinical and paraclinical investigations of the patient we established the diagnosis of periodontitis, aggressive form. Thus, we immediately instituted a complex and multidisciplinary treatment, which is still under monitoring and progress
Conclusions: Despite their young age, there are situations that require a more radical attitude towards periodontal treatment and close collaboration with other specialties in dentistry. That is why it is very important to diagnose periodontal disease as early as possible so that the patient can benefit from a more conservative treatment.
Keywords: aggressive periodontitis, symptoms, treatment.
The relationship between orthodontic treatment and periodontal condition
Asist. Dr. Brînduşa Florina Mocanu, Asist. Dr. Fidan Bahtiar Ismail, Prof. Dr. Anca Silvia Dumitriu
UMF „Carol Davila”, Bucureşti
The aim: of this paper is to present the two ways relationship between orthodontic treatment and periodontal health.
Materials and methods: we examined 20 adolescents with initial healthy periodontium and 10 adults with chronic periodontitis that have received orthodontic treatment. We have performed clinical and radiological examination during the fixed orthodontic appliance.
Results: Orthodontic treatments may contribute to periodontal health, because they align teeth and balance occlusion, which improves hygiene, as it facilitates access to teeth and reduces occlusal trauma.6 However fixed orthodontic appliances may increase supragingival and subgingival biofilm accumulation and deteriorate periodontal health. Because of that, the disease should be controlled by means of adequate hygiene.
Conclusions: Moderate and severe PD often leads to posterior occlusion reduction, teeth malpositioning and occlusal trauma, causing malocclusions with progressive attachment loss. In these conditions, orthodontic treatment is a basic component of the patient’s aesthetics and function. Orthodontic treatment is highly recommended to be done after subsiding of inflammation in periodontal conditions.
On the other hand the introduction of a fixed orthodontics appliances into the mouse increases the number of the retention areas and thus the progression of a gingival reaction may result in increased periodontal involvement and damage.
Keywords: orthodontic treatment, periodontal health, biofilm, inflammation
Methods of periodontal risk assessment
Asist. Dr. Ismail Fidan Bahtiar, Asist. Dr. Brîndușa Florina Mocanu
UMF „Carol Davila”, Bucureşti
Background: During the last 50 years, numerous epidemiological studies conducted on incidence and prevalence of periodontal disease as well as more recent research on pathogenic mechanisms of chronic periodontitis emphasized the major role played by genetic, medical, behavioural, psychological and socio-economical characteristics of each patient in determining the risk of disease, the severity of the disease, the specific host response to treatment and the risk of further periodontal breakdown. Consequently, the determination of risk factors and indicators might help in preventing disease onset and in maintaining a good oral health.
Material and method: The paper aims to review the methods of periodontal disease progression risk assessment, validated by clinical trials and applicable in current clinical practice. At the same time, the currently recognized risk factors are described and the way in which their presence influences the diagnosis and the therapeutic approach is discussed.
Conclusions: Assessing the risk profile of every patient contributes to the early detection and diagnosis of periodontitis, especially in highly susceptible population and allows the clinician to individualise the active periodontal therapy and the maintenance care.
Keywords: risk assessment, periodontitis, progression, risk factors
Conjoined cytokine pathway networks in periodontal disease and rheumatoid arthritis
Asist. Dr. Maria Alexandra Mârtu, Şef lucr. Dr. Ionut Luchian, Asist. Dr. Bogdan Constantin Vasiliu, Şef lucr. Dr. Irina Georgeta Şufaru, Şef lucr. Dr. Liliana Păsărin, Prof. Dr. Liliana Foia, Conf. Dr. Sorina Solomon
UMF „Gr. T. Popa”, Iaşi
Although periodontal disease (PD) and rheumatoid arthritis (RA) have different etiologies, both diseases bear many common features – they are multifactorial diseases characterized by localized chronic inflammatory reactions that are governed by a similar set of cytokines (TNFα, IL-6 and IL-17) leading to high concentrations of inflammatory circulating markers such as C-reactive protein. In addition, T helper 17 proinflammatory cell proliferation is the hallmark of both diseases; moreover, they have common environmental and genetic risk factors.
The discovery and characterization of an enzyme expressed uniquely by P. gingivalis, peptidylarginine deiminase (PPAD), underpins the hypothesis that PPAD-mediated protein citrullination in inflamed periodontal sites may initiate a series of events that culminate in the production of anti-cytrudinate protein (ACPA) and, finally, in the clinical manifestation of RA.
The purpose of this study is to analyze the bidirectional relationship between PD and RA considering the complex cytokine pathways altered in both diseases.
Significant evidence suggests that genetic factors lead the host’s responses to chronic diseases with complex pathogenesis. In the future, more effective therapeutic approaches will include multiple synergistic host response modulation therapies combined with treatments that target microbial etiology. Further studies are needed to better understand these mechanisms and help maintain general health, oral health parameters requiring close monitoring in RA patients. Interventions to improve oral pathology may have direct and indirect systemic benefits.
Keywords: periodontitis, rheumatoid arthritis, cytokines, inflammation, bacteria
Local factors involved in wound healing strain in the oral cavity
Asist. Dr. George Alexandru Maftei, Şef lucr. Dr. Ana Maria Filioreanu, Şef lucr. Dr. Carmen Stelea, Şef lucr. Dr. Oana Ciurcanu, Şef lucr. Dr. Cristian Budacu, Conf. Dr. Cristina Popa, Prof. Dr. Liliana Foia
UMF „Gr. T. Popa”, Iaşi
Wound healing, as a normal biological process in the human body, is achieved through four precise and clearly programmed phases: hemostasis, inflammation, proliferation and remodeling. For a wound to heal successfully, all four phases must occur in the appropriate sequence and time frame. Many factors can interfere with one or more phases of this process, causing inadequate or affected wound healing. A better understanding of the influence of these factors on healing can lead to a therapeutic attitude that improves wound healing. In spite of numerous advancements in dentistry and contemporary oral surgery, the basis of most dental treatments continues to be dentoalveolar surgery.
The appropriate medical act not only comprises a precise diagnosis, efficient aesthesia, and proficient surgical technique, but the clinician must also have a complete grasp of the succession of physiologic biological phenomena that culminate in a healed post-extraction site without unwanted sequelae.
In this two part series we will explore the factors which can cause wound healing problems in the oral cavity in order to obtain a most satisfying clinical outcome.
Keywords: alveolar socket, postextraction, bone healing, soft tissue, healing deficit
Drug Therapy of Epileptic Syndromes and Periodontal Manifestations
Şef lucr. Dr. Liliana Păsărin, Prof. Dr. Silvia Mârţu, Şef lucr. Dr. Ionuţ Luchian, Şef lucr. Dr. Irina Georgeta Șufaru, Asist. Dr. Maria-Alexandra Mârţu, Asist. Dr. Silvia Teslaru, Asist. Dr. Diana Cristala Kappenberg-Niţescu, Asist. Dr. Ioana Andreea Sioustis, Asist. Dr. Ioana Rudnic, Asist. Dr. Alexandra Cornelia Teodorescu, Asist. Dr. Bogdan Constantin Vasiliu, Conf. Dr. Sorina Solomon
UMF „Gr. T. Popa”, Iaşi
Introduction: The anti-convulsivant drug therapy represents a risk factor for the periodontal impairments in patients with epileptic syndromes.
Aim of the study: We proposed an evaluation of the periodontal changes in epileptic patients, correlated to the systemic alterations induced by the disease and to the drug intake.
Materials and methods: We examined the periodontal status on a number of 58 patients with epilepsy; the data regarding the seizure type, drug therapy and periodontal changes were registered and statistically analyzed.
Results: A high percentage of patients followed mono-therapy; from these patients, 69.04% presented periodontal changes. Phenytoine determined the most frequent and severe forms of gingival overgrowth.
Discussions: We observed a high percentage of periodontal lesions, determined by a complex mixture of risk factors (local risk factors, associated to the anti-epileptic systemic medication). The periodontal impairment was directly proportional to the disease and drug history (as period of time).
Conclusions: The anti-epileptic drug regime determines significant changes in the periodontal tissues. The anti-epileptic drugs are an important systemic risk factor but, still, the bacterial plaque quantity and quality remains the main determinant factor for the various forms of periodontal disease.
Keywords: epilepsy, anti-epileptic therapy, gingival overgrowth, risk factors
Radiologic evaluation of alveolar bone loss markers in patients with periodontitis and osteoporosis
Şef lucr. Dr. Irina-Georgeta Şufaru, Şef lucr. Dr. Liliana Păsărin, Asist. Dr. Diana-Cristala Kappenberg- Niţescu, Asist. Dr. Ioana Andreea Sioustis, Asist. Dr. Silvia Teslaru, Asist. Drd. Georgeta-Maria Laza, Prof. Dr. Silvia Mârţu, Conf. Dr. Sorina-Mihaela Solomon
UMF „Gr. T. Popa”, Iaşi
The aim of the study was to evaluate the radiological parameters on digital orthopantomographs (OPG) in chronic periodontitis and osteoporosis patients, and to establish a correlation between them, bone mineral density and periodontal clinical parameters. The study was performed on a group of 41 subjects with chronic periodontitis, systemically healthy or diagnosed with osteoporosis. The following parameters were recorded: depth and bleeding on probing, periodontal attachment loss and gingival index. The analysis of radiographic parameters included the thickness of the mandibular cortex in the mental region (GCM), the panoramic mandibular index (IMP), the degree of resorption of the alveolar ridge (M / M ratio) and the morphological classification of the lower mandibular cortex (C classes). There was a link between the average loss of periodontal attachment and the plaque index, calculus index and gingival index. Low values of the T score were correlated with low values of cortical thickness (p <0.05). When the morphology class is C2 or C3 (moderate and severe erosions), the age is increased and the GCM decreases to a statistically significant level. OPG could be an effective and less expensive method of screening for osteoporosis, with a significant role for the dentist in this procedure.
Keywords: alveolar bone, bone loss, periodontitis, osteoporosis
Possibilities and Limits of Orthopantomography in the Radiological Diagnosis of Advanced Periodontitis
Asist. Dr. Silvia Teslaru, Asist. Dr. Alexandra Cornelia Teodorescu, Şef lucr. Dr. Liliana Păsărin, Şef lucr. Dr. Irina Șufaru, Asist. Dr. Ioana Andreea Sioustis, Asist. Dr. Ioana Rudnic, Şef lucr. Dr. Ionuț Luchian, Asist. Dr. Maria Alexandra Mârțu, Asist. Dr. Bogdan Constantin Vasiliu, Asist. Dr. Odette Elena Luca
UMF „Gr. T. Popa”, Iaşi
Imaging exploration is necessary in the correct diagnosis of advanced periodontitis and in the orientation towards the optimal treatment possibilities of the case, especially in the situation of large bone support losses.
Orthopantomography provides data on the size of the bone loss, the type of lysis (vertical / horizontal), the angle of the bone defect in the vertical lysis, the relationship of the marginal bone loss with the interradicular area or with the periapical bone lysis (in endo-periodontal lesions).
It is possible to appreciate globally the bone trabeculation, the aspect of the interdental bone septum, the relation of the large bone defects, to the teeth in terminal stage with important anatomical formations in the vicinity.
Limitations of orthopantomography: reduces three-dimensional structures (maxillary bones) to two dimensions. This disadvantage is today supplemented by the possibility of three-dimensional visualization by CBCT, valuable for assessing bone density (in Hounsfield units), the spatial architecture of vertical defects and interradicular bone loss in the case of molars.
Keywords: imaging exploration, advanced periodontitis
Pro-inflammatory cytokine’s assessment in gingival fluid samples of patients with chronic periodontitis and chronic hepatitis C
Asist. Dr. Dorin Gheorghe, Prof. Dr. Petra Şurlin, Şef lucr. Dora Popescu, Prof. Dr. Ion Rogoveanu
The level of pro-inflammatory cytokines can be a useful tool for the assessment of periodontal disease’s activity and evolution. These inflammation markers can also be influenced by other coexisting systemic conditions, such as chronic hepatitis C. The study’s objective is to analyze the impact that chronic hepatitis C could have on the local inflammatory status of patients with chronic periodontal disease, who also suffer from hepatitis C infection, by assessing the gingival fluid levels of interleukin-1 alpha (IL-1α) and interleukin-1 beta (IL-1β). After periodontal examination and the assessment of certain clinical periodontal parameters, gingival crevicular fluid samples were collected from all participating patients and used for immunological analysis of the targeted cytokines. The gingival fluid levels of cytokines were significantly higher for periodontitis patients with chronic hepatitis C than for the systemically healthy periodontitis patients (1.8-folds higher for IL-1α and 2.1-folds higher for IL-1β). Periodontitis patients with chronic hepatitis C exhibited elevated cytokine profiles, suggesting the additional impact that chronic hepatic inflammation may manifest on the local inflammatory status of periodontal disease and its consequent evolution.
Keywords: cytokine, gingival fluid, periodontal disease, chronic hepatitis C
Salivary pH modification – importance in management of periodontal disease ethiopathogeny
Asist. Dr. Ioana Rudnic, Dr. Cerasela Dorina Șincar, Şef lucr. Dr. Liliana Păsărin, Dr. Lucian Ștefan Burlea, Asist. Dr. Diana Cristala Kappenberg-Nițescu, Dr. Laura Elisabeta Checheriță, Dr. Mihaela Cărăușu, Conf. Dr. Sorina Mihaela Solomon
UMF „Gr. T. Popa”, Iaşi
Introduction. The clinical value of saliva continues to grow undoubtedly today because it serves as an easy source of information to be procured, the collection being made through a non-invasive technique. Reflecting the state of health in the body, salivary samples can be analyzed for: tissue fluid levels, emotional state, hormonal status, immune status, neurological status and nutritional / metabolic influences.
Aim of the study. The main purpose of the study was to develop a direct link between saliva testing and test results that become very useful diagnostic tools, communicating in a timely and accurate manner the oral status of the patient.
Materials and methods. 24 people were included in the study. The group included people aged between 18 and 50 years. Group A consisted of 8 patients with clinically healthy gums, Group B of 8 patients with chronic gingivitis and group C with 8 people who had chronic periodontitis. The “Saliva-check Buffer” kit produced by GC America was used to examine the saliva that is used to educate patients, assist in planning preventive treatment, and properly select dental materials to make the patient aware of their dental status and initiate changes. in his oral hygiene.
Results. The mean pH for the clinically healthy gum population was 7.17 ± 0.022, the mean pH of the group with generalized chronic gingivitis was 7.1 ± 0.21, and the mean pH of those with periodontitis generalized chronic was 6.32 ± 0.35.
Conclusions. With the help of laboratory tests it is possible to quantify the oral pH of patients that has an important clinical resonance in the development of therapeutic conduct. The multifunctional role of salivary components continues to be a very concentrated field of dental research.
Keywords: salivary pH, periodontal disease
Salivary cortisol levels at patients with depression and periodontal disease: A review
Asist. Dr. Bogdan-Constantin Vasiliu, Asist. Dr. Alexandra Cornelia Teodorescu, Asist. Dr. Diana-Cristala Kappenberg Nițescu, Asist. Dr. Maria Alexandra Mârțu, Asist. Dr. Ioana-Andreea Sioustis, Asist. Dr. Ioana Rudnic, Şef lucr. Dr. Ionuț Luchian, Şef lucr. Dr. Liliana Păsărin, Asist. Dr. Silvia Mârțu, Conf. Dr. Sorina Mihaela Solomon
UMF „Gr. T. Popa”, Iaşi
Introduction and aim. Periodontal disease is an inflammatory disease that affects the soft and hard structures that support the teeth.
The relationship between periodontitis and salivary cortisol levels has been a great interest in recent years.
The aim of this study was to conduct a systematic review of the literature supported by a certain level of evidence, in attempt to determine if salivary cortisol levels are different at patients with depression and periodontal disease and patients with depression and no periodontal disease.
Materials and method. Search strategy Two search steps were established in the present review.
In a first step we conducted a search of the Medline-PubMed database to retrieve articles that had studied the possible relationship between PD and depression, focusing particularly salivary cortisol levels.
In a second step we conducted a search in the Medline-PubMed, Cochrane, Embase and Scopus databases, using the following terms: periodontal disease AND depression AND salivary cortisol levels.
The search covered articles from the last 6 years (2014-2020), and was limited to articles published in English.
Conclusions. Observational studies results suggest that subjects with aggressive periodontitis have higher salivary cortisol levels than healthy ones or patients with chronic periodontitis.
Keywords: periodontal disease, salivary cortisol level
Patient Communication in Changing Times
Prof. Albert Waning
Society changed quickly; 24 hour news cycle, information at our fingertips through our mobile and instant likes (or not) on social media. The current COVID crisis accelerated this and adds special worries about visiting a dental office. Patients have become customers and we have to adapt, how do we approach them now and discuss treatment options? Social sciences can help us; how and how quickly do we judge people, which ones do we like and not? Practical example; if you speak to patients before or during the treament, do you do that with or without mask? In the treatment room or outside? We will disucss many of these aspects and put them in perspective to help dental patients accept responsible treatment plans.
Keywords: COVID, dental care, patient communication, 3M
2018 EFP/AAP Periodontal Workshop Classification: A Case-Based Review
Dr. Irina Florentina Drăgan
At the end of this presentation, participants will be able to identify clinical cases that are relevant to each of the 4 categories for the new EFP/AAP classification. The diagnosis will be completed by the executed treatment plan.
Keywords: classification, case-based, clinical applications
Surgical endodontics, possibilities and limits
Dr. Sergiu Gabriel Nicola
Practică privată, Bucureşti
In this lecture i will cover different aspects of surgical endodontics, including extraction and replantation, transplantation, incision techniques, suturing techinques.
Keywords: endodontics, surgical, extraction, replantation, transplantation
Violins are of 3 types: factory, workshop and master – Complete dentures , the old story that scares the world?
Dr. Octavian Jecherean
Medlife Genesys, Arad
Precisely you ask the question: there’s something new to say usable about the total prosthesis? Because we could say that it has a monotonous stereotype of phases and has the largest bibliography.
I will come today with some new things in the technique of making removable prostheses.
Today, in the implant era, it is worthwhile restoring total edentation with total prostheses?
If we ask questions, let’s put one: Why do we meet with so many “dreadfully” prostheses made?
Keywords: complete dentures, succesful treatment, completely edentulous patients, occlusal scheme