Dental Caries in the First Permanent Molar during the Mixed Dentition Stage.

Background: The early eruption of the first permanent molar (FPM) favors its exposure to the risk factors for dental caries specific to the mixed dentition stage of dental development. The aim of this study was to assess the prevalence and distribution pattern of FPM dental caries and of the consequences of this pathology - caries with pulp involvement in the FPM and missing FPM (FPM extraction) in a sample of Romanian children during the mixed dentition stage. Objective: To evaluate the effect of asanas in Yoga on the IOP of practicing individuals. Materials and methods: Eighty-seven children aged between five and 13 years, who attended a private dental clinic, were enrolled in the present study. The investigations were carried out as part of the comprehensive dental examinations. Written informed consent was obtained from one of the subjects' parents prior to his/her child's participation in this research. The collected data were statistically analyzed with STATA/MP13 software using the Chi square test. The level of significance was set at p<0.05. Results:The prevalence of FPM dental caries was 60.9%. There were statistically significant differences (p = 0.004) in the number of FPMs affected by dental caries per subject in relation to age. No statistically significant differences regarding the number of FPMs affected by dental caries per subject in relation to gender were found. With respect to the distribution pattern of FPM dental caries by location at tooth level, the mesial surface had the highest prevalence (in 36.8% of all investigated subjects), followed by the occlusal surface (33.3%). The prevalence of caries with pulp involvement in the FPM was 19.5% and children in the 10-11-year age group were the most affected (55.5%). There were statistically significant differences regarding the distribution pattern of caries with pulp involvement in the FPM by age (p = 0.0001). The prevalence of FPM extraction was 6.9% and, according to dental history and examination, loss of FPM was due to caries. Among children with missing FPM, five were older than the age recommended for achieving spontaneous space closure, which indicated the need for immediate intervention. Conclusions:Considering the results of the present study, it can be stated that FPM dental caries represents a highly prevalent pathology during the mixed dentition stage. The findings are relevant and useful for the current clinical dental practice, emphasizing the importance of caries detection and diagnosis in developing a comprehensive dental treatment plan tailored to the specific needs of pediatric patients.

A clinical and statistical study on enamel hypomineralization of the first permanent molar in the period of mixed dentition.

BACKGROUND: The first permanent molar (FPM) is the first tooth in the permanent dentition that emerges in the oral cavity, at around the age of six and behind the deciduous teeth, thus converting the primary dentition into a mixed dentition. Its early formation represents a risk factor for the onset of hard dental tissues disorders, the most common being the molar incisor hypomineralization (MIH). AIM: The aim of the study was to assess the hypomineralization type of developmental defects of enamel at FPM level during the mixed dentition stage, in a group of Romanian children. PATIENTS, MATERIALS AND METHODS: The research was conducted on 87 patients, 44 females and 43 males, divided into the following age groups: 5-6 years, 6-7 years, 7-8 years, 8-9 years, 9-10 years, 10-11 years, 11-12 years and older than 12 years. All children were examined in the dental office by a pediatric dentist. RESULTS: Of the subjects, 40.2% presented hypomineralization lesions on the FPM. Among the affected children, 62.9% were girls and 37.1% were boys. Mild forms were the most prevalent, being found in 71.4% of the affected subjects. Moderate forms were present in 22.9% and severe forms in 5.7% of the affected children. MIH prevalence significantly decreased with increasing age. Only two children belonging to the group 8-9 years and 10-11 years, respectively, showed severe MIH lesions. Statistically significant differences were determined in what regards the distribution of MIH children according to the severity of the lesions in relation to age (p=0.007). CONCLUSIONS: Children 6- to 7-year-old have been the most affected by FPM hypomineralization, which indicates the need for early management of the disease, through a thorough diagnosis, and preventive and interceptive therapeutic approaches.

Salvage Surgery for Small-Cell Lung Cancer-A Literature Review.

(1) Background: Salvation surgery for small-cell lung cancer (SCLC) is exceptionally performed, and only a few cases are published. (2) Methods: There are 6 publications that present 17 cases of salvation surgery for SCLC-the salvation surgery was performed in the context of modern clearly established protocols for SCLC and after including SCLC in the TNM (tumor, node, metastasis) staging in 2010. (3) Results: After a median follow-up of 29 months, the estimated overall survival (OS) was 86 months. The median estimated 2-year survival was 92%, and the median estimated 5-year survival was 66%. (4) Conclusion: Salvage surgery for SCLC is a relatively new and extremely uncommon concept and represents an alternative to second-line chemotherapy. It is valuable because it may offer a reasonable treatment for selected patients, good local control, and a favorable survival outcome.

Vitamin E and Selenium Given as Dietary Supplements Accumulate in Tissues and Semen and Improve Reproductive Parameters in Older Red Cornish.

The reproductive performance of broiler breeder chickens noticeably decreases toward the end of their commercial lives. Herein, we determined the effects of vitamin E and selenium dietary supplementation on semen traits, egg fertility (defined as fertilization and hatching rates) of adult (49-week-old) and older (63-week-old) Red Cornish breeders. We found that both vitamin E and selenium were concentrated in the liver and adipose tissue of adult and older Red Cornish breeders, and were transferred to the semen and egg yolk, respectively, in proportion to the level of supplementation. Vitamin E supplementation, in particular, improved ejaculate volume, total sperm count, sperm motility, and viability in both adult and older roosters, whereas selenium improved sperm motility and viability in the adult roosters. Egg fertility increased following supplementation with either vitamin E or selenium. The hatching rate also improved by both supplements in proportion to the level of supplementation. No significant synergistic effects of vitamin E and selenium were found. The levels of egg fertility and sperm trait improvements diminished with the age of the birds and depended on vitamin E and/or selenium doses. Thus, as dietary vitamin E and selenium supplements improved semen quality and egg fertility in these older Red Cornish broiler breeders, such birds could be maintained in flocks to prolong their reproductive output.

Morphometric study for the localization of the mental foramen in relation to the vertical reference plane.

BACKGROUND: The mental foramen (MnF) is the anatomic landmark where the mental neurovascular bundle exits the mandible. Precisely determining the position of the MnF is necessary before all dentoalveolar therapeutic procedures performed in the mandibular premolar area. MATERIALS AND METHODS: For the study, we performed two ex vivo direct morphometric determinations on dry human dentate and edentate mandibles, and two in vivo imaging morphometric determinations through cone-beam computed tomography (CBCT) and orthopantomography (OPG) in dentate human patients. The following landmarks were used to locate the MnF: the distance between the MnF and the superior border of the mandible (MnF-SB), the distance between the MnF and the inferior border of the mandible (MnF-IB), and the position of the MnF in relation to the root apices of the posterior teeth. The results obtained from these data were processed statistically using the analysis of variance (ANOVA). RESULTS: By direct morphometry on dentate mandibles, the MnF was situated closer to the IB and by direct morphometry on completely edentulous mandibles, the MnF was located closer to the SB. In both direct morphometry studies, the MnF transverse diameter was larger than the vertical one, with the MnF having an oval shape. ANOVA for both direct morphometry studies showed that the distances MnF-IB and MnF-SB significantly vary statistically with interactions and depending on age (p<0.00001). The vertical diameter of the MnF significantly varies statistically depending on age, interactions and between studies, and its transverse diameter varies statistically significantly with interactions and depending on age (p<0.00001). According to OPG and CBCT imaging studies, the MnF was located closer to the IB, and the transverse diameter of the MnF was larger than the vertical diameter; such results are similar to the direct morphometry study performed on dry dentate human mandibles. Regarding the position of the MnF in relation to the root apices, it was most frequently located inferior to the root apices in 79.45% of cases, in 19.23% of cases it was located at the root apices level and in 1.31% of cases it was located superior (coronal) to the root apices. ANOVA for both imaging morphometry studies showed that the MnF-IB distance varies statistically significantly with the interactions, the study, the sex of the patients and their age, the MnF-SB distance varies statistically significantly with the interactions, the study and the patients' age (p<0.05), and the MnF diameters vary statistically significantly with interactions and patient age (p<0.05). CONCLUSIONS: The results of this study can help dental practitioners in improving dentoalveolar surgery procedures in the posterior mandible.

Degenerative bony changes in the temporal component of the temporomandibular joint - review of the literature.

Temporomandibular joint (TMJ) changes are quite frequent in adults, but not all changes are degenerative. A high prevalence of bone alterations in the TMJs was reported by different research groups. Disturbed remodeling of bony articulating structures occurs because of overloading masticatory forces or because the mechanical loading in the area out-weighs the adaptive capacity of the TMJ structures. Although most of the degenerative TMJ alterations are identified at the level of the condylar process, a complete evaluation of the degenerative modifications encountered in the temporal TMJ region should not be forgotten as they are important for a comprehensive assessment and further management of the clinical situation. Several research groups have described osseous remodeling in the temporal component of the TMJ. Evidence is scarce for degenerative modifications at the level of the articular eminence and thickening of the roof of the glenoid fossa has been associated with osteoarthritis.

Morphometric study for determining the anteroposterior position of the mental foramen in dentate human subjects.

BACKGROUND: The mental foramen (MnF) is the place where the mental nerve and mental artery exit the body of the mandible, being an important landmark for dentoalveolar surgery. MATERIALS AND METHODS: For the assessment of MnF topography, we performed a direct morphometric study and two morphometric imaging studies through cone-beam computed tomography (CBCT) scans and orthopantomography (OPG). The following locations of the MnF were investigated: anterior to the first premolar, at the first premolar level, between the two premolars, at the second premolar level, between the second premolar and the 6-year molar, and at the level of the mesial root of the 6-year molar. The data obtained were statistically analyzed by chi-squared test. RESULTS: Through direct morphometry on dentate dry human mandibles, no statistically significant differences were found for the number of MnF located between the two premolars, at the level of the second premolar and between the second premolar and the 6-year molar, depending on age and analyzed side. The number of MnF located between the second premolar and the first molar varies statistically significantly in relation to the subject's gender but does not vary statistically significantly depending on age and side. By means of imaging morphometry through OPG, we found that the number of MnF located at the first premolar level, between the two premolars, at the second premolar level and between the second premolar and the 6-year molar varies statistically significantly in relation to the age of the patients. Using imaging morphometry trough CBCT scans, we found that the number of MnF located between the two premolars, at the second premolar level and between the second premolar and the 6-year molar varies statistically significantly according to the age of the patients. Comparing the results obtained from the three studies, we found that only according to age the number of MnF located between premolars and at the level of the second premolar varies statistically significantly. CONCLUSIONS: Wide and accurate knowledge of both the MnF topography and the key anatomical landmarks used in locating it proves to be essential and clinically relevant in dentoalveolar and endodontic surgery, and for improving anesthesia techniques.

Bifid mandibular canal - a case report.

One of the most common anatomical variations of the mandibular canal is the bifid mandibular canal (BMC), more frequently unilateral and rarely bilateral, often located at the level of the posterior mandible; according to literature, this anatomical variation presents several morphological types. The presence of the BMC must be considered prior to anesthesia and surgery performed on the ramus of the mandible (osteotomies) and on the posterior mandible (dentoalveolar surgery procedures). This study presents a clinical case of unilateral BMC on the left side, the buccolingual type, lingual variant, a rare anatomical variation illustrated radiographically in a 27-year-old male adult.

Factors influencing the articular eminence of the temporomandibular joint (Review).

The temporomandibular joint (TMJ), the most complex and evolved joint in humans, presents two articular surfaces: the condyle of the mandible and the articular eminence (AE) of the temporal bone. AE is the anterior root of the zygomatic process of the temporal bone and has an anterior and a posterior slope, the latter being also known as the articular surface. AE is utterly important in the biomechanics of the TMJ, as the mandibular condyle slides along the posterior slope of the AE while the mandible moves. The aim of this review was to assess significant factors influencing the inclination of the AE, especially modifications caused by aging, biological sex or edentulism. Studies have reported variations in the angles of the slopes of the AE between medieval and recent human dry skulls, as well as between subjects of different racial origin. Recent articles have emphasized the significant role that tooth loss has on the flattening of the AE. Although some papers have described biological sex or age as factors which could be associated with differences in AE angulations, edentulism seems to be a significant factor impacting on the inclination of the AE.

Cone beam computed tomography as a method of quantitative and qualitative analysis of alveolar crest in the frontal mandibular area.

UNLABELLED: New radiographic maxillofacial techniques, cone beam computerized tomography (CBCT) are a necessity in the assessment of jaw bone offer to effectively evaluate the treatment. AIM: To quantitatively and qualitatively evaluate anterior mandibular area on CBCT comparing to orthopantomography (OPG). MATERIAL AND METHODS: Fifty-one dental patients, aged between 20 and 77 years, were quantitatively analyzed and 81 dental patients, aged between 20 and 79 years, were qualitatively analyzed. ANOVA and Mann-Whitney tests were used for statistical analyses. RESULTS: Strong statistical significant differences were recorded between CBCT and OPG assessments for all groups of teeth (p<0.001), when evaluation was performed on distances to mandibular base. When assessing the distance to the incisive canal, the differences were recorded only for the left canine zone. Mean densities of central incisor, lateral incisor and canine regions, were 1,400-1,425 HU, 1,212-1,224 HU, and 1,150-1,175 HU, respectively. There was a marginal statistical evidence that bone density was lower in canine zone comparing to central incisor area (p=0.08). CONCLUSIONS: Measurements on CBCT are more accurate when compared with OPG. Bone density of central incisor region is higher. Therefore, CBCT permits the clinician to have all necessary information when planning dental implants.

Direct and imaging morphometry for the localization of the mandibular foramen (MF) in dentate and edentulous human subjects.

BACKGROUND: The mandibular foramen (MF) is the anatomic landmark where the interior alveolar nerve enters the mandibular ramus, and the area of choice where anesthesia of this nerve is performed. The position of the MF can vary, and accurately establishing its location and topographic variations is of great importance for the successful anesthesia of the inferior alveolar nerve. MATERIALS AND METHODS: We carried out two morphometric ex vivo studies concerning the topography of the MF, on dry human mandibles coming from dentate and completely edentulous human subjects of known age and gender and an in vivo morphometric study, through cone-beam computed tomography (CBCT) scans, concerning the topography of the MF in human subjects having Kennedy Class I mandibular edentulism. The morphological characteristics we investigated were: the distance between the MF and the anterior margin of the mandibular ramus (MF-AM distance), the distance between the MF and the posterior margin of the mandibular ramus (MF-PM distance), the distance between the MF and the inferior margin of the mandibular ramus (MF-IM distance), the distance between the MF and the temporal crest of the mandibular ramus (MF-TC distance), the distance between the MF and the superior margin of the mandibular ramus (MF-SM distance), and the vertical and transverse diameters of the MF. The results were statistically processed in Stata/MP13 software package using Student's t-test and two-way analysis of variance (ANOVA). RESULTS: Through direct morphometry on dentate dry human mandibles, the MF-AM and the MF-SM distances showed statistically significant differences for age, gender and for interactions, while the MF-PM and MF-IM distances showed statistically significant differences for age and for interactions. In the case of the MF-TC distance, the only significant difference observed was for the gender. No statistical significance was found for side, age, gender, and interactions in the cases of MF vertical and transverse diameters. Through direct morphometry on completely edentulous dry human mandibles, the MF-PM and MF-SM distances showed statistically significant differences for age, gender and for interactions, while the MF-AM, MF-IM, and MF-TC distances, as well as the MF vertical and transverse diameters showed statistically significant differences for age and for model (interactions). The results showed that MF is 2 mm closer to the anterior margin of the mandibular ramus after having lost teeth. Through imaging morphometry, the MF-PM distance and the vertical diameter of MF showed statistically significant differences for age, gender and for interactions, while the MF-AM, MF-IM, MF-SM and MF-TC distances, as well as the transverse diameter of MF showed statistically significant differences for age and for interactions. Comparing the results obtained by the three studies, we found no statistically significant differences in relation to the gender of the subjects. The MF-IM and MF-TC distances and the transverse diameter of MF showed statistically significant differences for age, study and for interactions, while the MF-AM, MF-PM and MF-SM distances, as well as MF vertical diameter showed statistically significant differences only for age and for interactions. Morphological symmetry was demonstrated through our three studies, no statistically significant differences being determined in relation to side. CONCLUSIONS: The results of this research should increase the level of awareness among dentists with respect to MF topography changes with loss of teeth and help dental practitioners in refining the inferior alveolar nerve block techniques.

Alveolar bone dehiscences and fenestrations: an anatomical study and review.

AIM: To determine the prevalence and distribution of fenestrations and dehiscences of the jaw bones among the Caucasian population, to find if any correlations can be established between their occurrence and certain teeth characteristics and to discuss the clinical implications the defects of alveolar process could have. MATERIAL AND METHODS: 138 skulls of specimens ranging from 21 to 54 years of age, having either complete dentition or reduced number of missing teeth were studied. Teeth found to have one of the two defects were examined for signs of faceting (attrition) that was considered an indicative for excessive occlusal forces and were submitted (except for the case of the third molars) to an analysis concerning their bucco-lingual inclination in the jaw. RESULTS: High-prevalence rates for both osseous entities were found. Fenestrations were present in 69.565% of the skulls and dehiscences were present in 53.623% of the skulls. More fenestrations were found in the maxilla: 74.679% and more dehiscences were found in the mandible: 71.613%. No correlations could be established between the presence of dehiscences and fenestrations and the development of high-occlusal forces, whereas all teeth affected either by dehiscences or by fenestrations were found to have modifications of the normal bucco-lingual inclination angle's values (p<0.05). DISCUSSION: The interest regarding the correlation between the alveolar processes morphology and the teeth dates back to 1963. The published studies are somewhat consistent with regard to prevalence and distribution of dehiscences and fenestrations, while opinions concerning their etiology are heterogenous. According to our study and the data provided by the specialized literature references, dehiscences and fenestrations are common findings related to the presence of the teeth. CONCLUSIONS: The potential of developing fenestrations and dehiscences must be carefully evaluated through oral surgery procedures. With regard to implant placement, this study aims to help the clinician design and manage treatment, in order to clinically correct the conditions and identify the principles of bone augmentation, so that endo-osseous implants can be properly placed.

A rare tumor in a rare location: giant cell tumor of the sacrum and ilium - case report and current perspectives.

Giant cell tumor (GCT) is considered a locally aggressive, intermediate grade benign bone neoplasm. In rare cases, GCT undergoes malignant degeneration or may cause distant metastasis, mainly in the pulmonary area. Most bone GCTs are situated in the epiphysis or metaphysis of long bones, while GCTs of the pelvis are quite rare. There is no standard treatment protocol for the GCT of pelvic bones. This paper presents the therapeutic management of a rare case of a stage III GCT, situated on the iliac tuberosity, sacral wing and partially the left iliac wing. The chosen treatment consisted in intralesional curettage, high-speed burring, phenolization and hydrogen peroxide lavage. At the six-week follow-up, the patient reported minimal disability. No complications and no local infections were revealed. Healing was confirmed by the two-year postoperative follow-up. This case report demonstrates that intralesional curettage complemented with adjuvant therapies is a viable alternative to wide resection surgery for the treatment of aggressive GCT.

The maxillary sinus floor in the oral implantology.

UNLABELLED: The aim of this study was to establish the mean distances between the maxillary sinus floor and the roots of the lateral maxillary teeth in dentate subjects, respectively the mean height of the available bone for oral implant placement in the corresponding area, in edentulous ones. MATERIAL AND METHODS: We determined the maxillary sinus floor position in relation to morphoclinical alveolodental benchmarks on 50 dry skulls, dentate 30 and edentulous 20, and correlations were performed by use of 40 CT-scans of the targeted area. In addition, 20 human adult cadavers were bilaterally dissected in order to bring topographical evidence at that level. RESULTS: The data we obtained lead us to define three dentosinusal relations: tangent (close) relation 60.8%; distanced relation 25.6%; penetrating relation: 13.6%; three subantral classes in edentulous patients, emphasizing the direct relation of the age of the edentulism and the degree of bone resorption. We discuss the results we obtained from the viewpoint of their application in the field of oral implantology. CONCLUSIONS: The maxillary sinus floor represents the danger zone for the oral implantology.

Morphological assessment of the mandibular canal trajectory in edentate subjects.

BACKGROUND: The mandibular canal and its content represent the vital structure, which can complicate dentoalveolar surgical procedures in the posterior region of the mandible. The purpose of the present study was to determine the path the mandibular canal takes in relation to the horizontal and the vertical anatomical reference planes in edentate subjects, in order to minimize the risk of affecting its neurovascular content during various oral surgery procedures. MATERIALS AND METHODS: Morphometric evaluations were performed on 12 dried fully edentulous human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 20 patients with either partial or complete edentulism. Both methods were utilized, in three target areas (corresponding to the second premolar, to the first molar and to the second molar regions), in order to measure the distance between the mandibular canal and the following reference points: (i) the lateral (buccal) surface of the mandible (MC-BS distance); (ii) the medial (lingual) surface of the mandible (MC-LS distance); (iii) the alveolar surface of the mandible (MC-AS distance). The results were statistically processed in Stata MP/13 software package using analysis of variance (ANOVA) test. RESULTS: The mandibular canal crossed the trabecular bone from the posterior towards the anterior, and from the lingual towards the buccal, reaching the premolar region, distal to the mental foramen, where it was located in the centre of the trabecular bone, main topographic pattern encountered in 27 (84.37%) of the cases. In five (15.63%) of the cases, in the premolar region, the mandibular canal was located near the buccal cortical plate. The mandibular canal descended from the second molar region towards the premolar region, main topographic pattern found in 28 (87.5%) of the cases. In four (12.5%) cases, the mandibular canal had a descending trajectory in the molar regions and it took a slightly ascending course in the premolar region. CONCLUSIONS: According to the results, the second molar region represents the highest risk area in the accidental injury to the content of the mandibular canal, during various oral surgery procedures.

Morphological assessment of the mandibular canal trajectory in dentate subjects.

BACKGROUND: The mandibular canal is the most important vital structure within the mandibular body. The aim of the present study was to determine the course of mandibular canal in relation to external surfaces of the mandible (buccal, lingual) and to root apices of the lateral teeth, in order to minimize the risk of its content being injured during either conservative or radical treatment of the mandibular lateral teeth. MATERIALS AND METHODS: Morphometric evaluations were performed on 11 dried dentate human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 18 dentate patients. By means of both methods, the following parameters were assessed: (i) the distance between the mandibular canal and the buccal (lateral) surface of the mandible (MC-BS distance); (ii) the distance between the mandibular canal and the lingual (medial) surface of the mandible (MC-LS distance); (iii) the distance between the mandibular canal and the root apices of the second premolar, the first and second molars (MC-T distance). The results were statistically processed in Stata MP÷13 software package using analysis of variance (ANOVA). RESULTS: With respect to buccal-lingual location, the mandibular canal passed horizontally through the mandibular trabecular bone, from posterior to anterior, and from lingual to lateral (buccal), and so at premolar level it approached the lateral (buccal) cortical bone plate, main topographic pattern found in 26 (89.65%) of the cases. The mandibular canal had a descending trajectory from the second molar to the first molar, after which it ascended slightly towards the second premolar, main topographic pattern found in 24 (82.75%) of the cases. CONCLUSIONS: According to the results, the second mandibular molar is the most common tooth involved in the accidental damaging of the content of the mandibular canal, during various therapeutic procedures. Overlooking the location of the mandibular canal can lead to complications in endodontic therapy and in dentoalveolar surgical procedures in the posterior region of the mandible.

Histopathological changes of renal tissue following sodium fluoride administration in two consecutive generations of mice. Correlation with the urinary elimination of fluoride.

The present study was designed to investigate the toxic effects (evaluated as histopathological changes) of sodium fluoride on the kidney in two consecutive generations of NMRI mice. An attempt to correlate the toxicity with the urinary elimination of fluoride has been made, as urinary fluoride excretion has been widely used as an indicator of fluoride intake and exposure. Six mixed (males and females) animal groups have been constituted by dividing the populations of mice derived from pregnant females (named "mothers" 0.5 mg sodium fluoride) treated with 0.5 mg sodium fluoride by daily gavage and pregnant females (named "mothers" 0.25 mg sodium fluoride) treated with 0.25 mg sodium fluoride by daily gavage; three types of sodium fluoride treatments were administrated: homeopathic, allopathic-homeopathic and allopathic. When the animals reached the adulthood, by randomization, they were selected in pairs for giving birth to the second generation of mice. No treatments were administrated to the second generation of mice; thus, the urinary elimination of fluoride in the second generation is attributed to exposure at sodium fluoride before birth. The administration of sodium fluoride to the first generation (F1) is realized until the mice reached the adulthood. For the first generation, the urine was collected at three times, every three weeks: at the age of four weeks, seven weeks and 11 weeks; single sampling urine, at the age of four weeks, has been conducted for the second generation. The urine samples have been analyzed using the ion selective electrode method for fluoride. For the histopathological examination, the animals were killed by cervical dislocation; the kidneys were collected in a 10% formalin solution. The preparation of samples for optical microscopy was realized with Hematoxylin-Eosin staining. The results indicate that the elimination of fluoride was similar (at the second evaluation, at 7-week-old of the first generation) for the both generations of mice. Histopathological observation of the kidney has revealed granular dystrophy of the renal tubules, necrosis of the endothelial cells and of the mesangial cells of renal glomerulus. The study indicates that different sodium fluoride treatments produce some pathological aspects of the kidneys and influence the urinary elimination of fluoride in two consecutive generations of mice. For the higher doses, the pathological changes of the kidney are more important, and the urinary elimination of fluoride is higher, especially for the allopathic doses.

Combined mucosal and alveolar fenestration: a clinical report and literature review.

BACKGROUND: This study reports the case of a 14-year-old girl in good state of health who presented with the apical third of the buccal root of the first upper right premolar that penetrated the alveolar buccal plate and overlying mucosa, being exposed to the oral environment. The treatment rationale is presented and compared with other therapeutic options described in the literature. METHODS: Endodontic treatment and root end resection in association with a guided tissue regeneration protocol were recommended to preserve the tooth. RESULTS: The evolution was favorable after surgery while the alveolar and mucosal defects were corrected through tissue regeneration and remodeling. A two-year follow-up period with every six months radiographic evaluation was considered. CONCLUSIONS: The therapeutic approach gave satisfactory results. The literature describes conservative treatment modalities in cases with mucosal fenestrations affecting permanent teeth.

A rare morphological variant of the first maxillary premolar: a case report.

Anatomical variations of the dental root morphology may lead to endodontic treatment failure. Knowledge of root morphology and possible anatomical variations may ensure proper endodontic treatment and long-term success. The present study describes the case of a three-rooted maxillary right first premolar with two buccal roots and one palatal root, each of them having one canal, diagnosed with symptomatic irreversible pulpitis. The treatment was applied according to traditional procedures, and the post-therapeutic evolution was favorable without any further complications.

Anatomical and clinical considerations regarding the greater palatine foramen.

OBJECTIVE: In this study, we mapped the topography of the greater palatine foramen (GPF), within the South-Eastern European population, according to clinically identifiable anatomical landmarks. MATERIALS AND METHODS: We used 100 dry adult human skulls, of which 75 were bilaterally dentate, whereas 25 were partially edentulous. RESULTS: The shape of the GPF was oval in 84% of the cases. The foramen was located internally from the third molar in 73% of the skulls. The greater palatine canal showed an antero-infero-medial direction in 82% of the cases. The average values of the distances between the GPF and the oral surfaces of the maxillary third molar, the medio-palatine suture, the posterior margin of the hard palate, the pterygoid hamulus and the pterygo-maxillary suture were 11.0 (SD 1.5), 14.5 (SD 0.8), 4.4 (SD 1.1), 12.0 (SD 1.8) and 10.5 mm (SD 1.3), respectively. CONCLUSIONS: A thorough knowledge of GPF's various positions may assist the clinicians in providing improved surgical techniques in the area.