In quest of optimal drug-supported and targeted bone regeneration in the cranio facial area: a review of techniques and methods.

Craniofacial bone structures are frequently and extensively affected by trauma, tumors, bone infections and diseases, age-related degeneration and atrophy, as well as congenital malformations and developmental anomalies. Consequently, severe encumbrances are imposed on both patients and healthcare systems due to the complex and lengthy treatment duration. The search for alternative methods to bone transplantation, grafting and the use of homologous or heterologous bone thus responds to one of the most significant problems in human medicine. This review focuses on the current consensus of bone-tissue engineering in the craniofacial area with emphasis on drug-induced stem cell differentiation and induced bone regeneration.

Lip Forces and Chewing Efficiency in Children with Peripheral Facial Paralysis.

Peripheral facial paralysis is accompanied by facial motor disorders and also, by oral dysfunctions. The aim of this study was to evaluate the lip forces and chewing efficiency in a group of children with peripheral facial paralysis. The degree of peripheral facial paralysis in the study group (n 11) was assessed using the House-Brackmann scale. The control group consisted of 21 children without facial nerve impairment. To assess lip forces, acrylic vestibular plates of three sizes were used: large (LVP), medium (MVP) and small (SVP). The lip force was recorded with a force transducer coupled with the data acquisition system. Masticatory efficiency was evaluated by the ability to mix two differently colored chewing gums. The images were processed with Adobe Photoshop CS3 (Delaware Corporation, San Jose, California, United States) and the number of pixels was quantified with the Image J software (DHHS/NIH/NIMH/RSB, Maryland, United States). For statistical analysis, the following statistical analysis were used: Pearson or Spearman correlation coefficient, multiple linear regression analysis, multiple logistic regression analysis, and optimal cutoff values for muscular dysfunction. There were statistically significant differences between lip forces in the following three groups: p=0.01 (LVP), p=0.01 (MVP), and p=0.008 (SVP). The cutoff values of lip forces in the study group were as follows: 7.08 N (LVP), 4.89 N (MVP), and 4.24 N (SVP). There were no statistically significant differences between the masticatory efficiency in the two groups (p=0.25). Lip forces were dependent on the degree of peripheral facial paralysis and age, but not on gender. In peripheral facial paralysis in children, a significant decrease of lip forces, but not masticatory efficiency, occurs.

Comparative study of the prognosis of an extracorporeal reduction and a closed treatment in mandibular condyle head and/or neck fractures.

PURPOSE: The objective of this study was a comparison of the prognosis between an extracorporeal reduction technique and closed treatment of a mandibular condyle fracture. The relationship between condylar resorption and several clinical variables was also studied. PATIENTS AND METHODS: Seventy-one patients who had a mandibular condyle fracture took part in this study. Thirty-five patients (female: 7, male: 28, age: 30.46 ± 14.27 years) were treated by extracorporeal reduction, and 36 patients (male: 24, female: 12, age: 24.28 ± 9.99 years) were treated using a closed treatment. The presence of complications such as condylar resorption, malocclusion, nerve disorder, and disc displacement was evaluated with panoramic radiographs and clinical examinations 12 months after treatment. The relationships between the complications and other clinical variables were evaluated statistically. RESULTS: The anatomic site and fracture type were closely related to condyle resorption in the bivariate analysis. Condylar head fractures showed significantly higher condyle resorption than condylar neck fractures (P = .023). A complex or compound fracture showed significantly higher condyle resorption compared with a simple fracture (P = .006). Patients who had a complex/compound fracture were 34.366 times more likely to have condyle resorption compared with those who had a simple fracture (P = .002). The patient's age and treatment method were also significant predictors for condyle resorption. CONCLUSION: Fracture type was the strongest predictor of condylar resorption. Because treatment method and patient age were also related to the prognosis, the optimal treatment for mandibular condylar head and/or neck fractures should be individualized according to the patient's condition.

Histopathological and clinical expression of periodontal disease related to the systemic inflammatory response.

Periodontal disease with its systemic implications is highly prevalent among the population, and this correlation could have an impact on the quality lives of many humans. The purpose of this study was to assess the clinical and histopathological changes of the periodontium correlated with the systemic inflammatory response in periodontal disease. An experimental study was performed on male Wistar rats which were subjected to a procedure of periodontitis induction through placing silk thread ligatures around the lower incisors, under general anesthesia. Clinically, the changes of the periodontal tissue induced by the periodontitis progression were daily assessed. Two blood samples were obtained from each animal, at baseline and on completion of the experiment. The plasma level of the cytokine IL-6 and haematological parameters such as leukocytes, neutrophils, lymphocytes, monocytes, and platelets were determined. After seven days the animals were sacrificed, and samples were prepared for histological evaluation. Clinical manifestations such as changes in the color, contour and consistency of the gingival tissue and the bleeding on probing were registered. Histopathological analysis showed an intense inflammatory cell infiltration, the presence of osteoclasts and an obvious bone resorption activity. A significant increase in IL-6 values during the progression of periodontitis in rats (p<0.001) was also observed. The results of this research demonstrated that the clinical and histological changes in the rat's periodontium are correlated with a notable systemic inflammatory response. Therefore, periodontitis control can be inserted as part of the programs of systemic disorders prevention, in clinical practice.

Assessment of the relationship between periodontal disease and cardiovascular disorders: a questionnaire-based study.

BACKGROUND AND AIMS: Periodontitis is an inflammatory disease, characterized by the loss of connective tissue and alveolar bone. There is an increasing evidence that periodontitis is associated with a number of chronic diseases. The aim of this study was to analyze the correlation between periodontitis and certain systemic diseases by identifying their risk factors in a population from North-West Romania. METHODS: A questionnaire-based study was conducted on participants ≥45 years of age in 4 dentistry or family medicine practices from the Cluj and Bihor counties, Romania, over a time frame spanning two months. The interviewer-administered questionnaire included 42 items assessing risk factors for periodontal and cardiovascular disease, current diagnostic and medical treatment of the participants, their diet and oral hygiene habits. RESULTS: Of 108 participants included in the study, 63 (58.3%) declared a previous diagnosis of periodontitis. A significant difference was observed between the participants with declared diagnosis of periodontitis (PD+) and participants without declared diagnosis of periodontitis (PD-) for fresh fruit consumption (p=0.01) and increased sport activity (p=0.009). A significant difference between groups was observed in the case of smoking duration (p=0.047), participants with >10 years of smoking were more likely to declare a diagnosis of periodontitis. Also, PD+ participants were more likely to have a family history of periodontal disease (p<0.001). Multivariate analyses suggested periodontitis as a predictive variable for atherosclerotic coronary artery disease with an OR of 4.85 (95% confidence interval 1.01-23.29, p=0.049). CONCLUSION: Our study found a statistically significant association between periodontal disease and a known family history of periodontal disorders and smoking duration. Daily intake of fresh fruit and increased sport activities were found to be protective factors against periodontal disease, while periodontitis was found as a risk factor for atherosclerotic cardiovascular disease.

[Pain and quality of life. Evaluation of oral health]. / Durerea si calitatea vietii. Evaluari în sanatatea orala.

UNLABELLED: Life quality has a major importance in the actual social context. The evaluation af the pain sensation as a stress major factor is difficult regarding the variety of the methods, their relevance and their compliance. MATERIAL AND METHOD: We've made an evaluation concerning the trigeminal essential neuralgia pain using different tipe of parameters. RESULTS: The results obtained proved a scientific and clinical value of the method that we've initiated and applied in these research.

[Use of laser-therapy for treatment of oral and maxillofacial hemangioma]. / Utilizarea laserterapiei pentru tratamentul hemangioamelor orale si maxilofaciale.

UNLABELLED: Laser-therapy opened new perspectives for the treatment of vascular lesions of the maxillofacial regions. MATERIAL AND METHOD: The study evaluated the results of diode laser percutaneous coagulation of oral and maxillofacial hemangioma. A group of 12 patients with sonographically certified hemangioma was treated using percutaneous coagulation with a diode laser. RESULTS: The results showed good and rapid healing, without any complications. All patients presented size reduction of the lesions, a favorable esthetic appearance and no morbidity. There were no complications over a follow-up period of 3 years. The study recommends diode laser-therapy as a valuable treatment option for hemangioma in correctly selected indications.

[New morpho-functional rehabilitation methods in cleft lip and palate]. / Noi metode de reabilitare morfo-functionala în despicaturile labio-maxilo-palatine.

UNLABELLED: The interdisciplinary, complex therapeutic protocol of the cleft lip and palate patients, applied in the Clinic of Cranio-Maxillo-Facial Surgery of "I. Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, involves the morphologic reconstruction as well as the functional rehabilitation. Functional rehabilitation is the aspect, which gives the esthetics, social and familial integration of the patient, offering good quality of life. METHOD: In the current study, a new method and concept of improving the phonetic function in the primary and secondary surgical steps, with the effect on muscle and bone, is presented. The new surgical techniques used comprise of the surgery of the levator veli palatini using the method designed by Sader, and bone distraction, during the same surgical procedure. The assessment of the phonetic results was performed using the NARSOM test. RESULTS: Following up the results of the techniques mentioned above, we consider that they improve extremely well the morphological status, while giving a functional and physiological support to the patient. CONCLUSION: Thus, they offer optimal conditions for the future progress of functional rehabilitation using specific speech therapy methods.