Profile of the oral healthcare team in countries with emerging economies.

Health is a critical dimension of human well-being and flourishing, and oral health is an integral component of health: one is not healthy without oral health. Significant barriers exist to ensuring the world's people receive basic healthcare, including oral healthcare. Amongst these are poverty, ignorance, inadequate financial resources and lack of adequate numbers of educated and trained (oral) healthcare workers. Emerging economies are encouraged to develop a national strategic plan for oral health. International organizations have developed goals for oral health that can be referenced and adapted by emerging economies as they seek to formulate specific objectives for their countries. Demographic data that assess the nature and extent of oral diseases in a country are essential to sound planning and the development of an oral healthcare system that is relevant, effective and economically viable. Prevention should be emphasized and priority consideration be given to oral healthcare for children. The types and numbers of members of the oral healthcare team (workforce) will vary from country to country depending on the system developed. Potential members of the workforce include: generalist dentists, specialist dentists, dental therapists, dental hygienists, denturists, expanded function dental assistants (dental nurses) and community oral health workers/aides. Competences for dentists, and other members of the team, should be developed to ensure quality care and developed economies should cooperate with emerging economies. The development, by more advanced economies, of digital, virtual curricula, which could be used by emerging economies for educating and training members of the oral healthcare team, should be an important initiative. The International Federation of Dental Educators and Associations (IFDEA) should lead in such an effort.

Analysis of mandibular variability in humans of different geographic areas.

The mandible is the single mobile bone of the skull. It develops from the sixth week of the intrauterine life. The aim of our study is to confirm the variability of different mandibular landmarks in humans of different geographic areas. A number of 100 young persons from different geographic areas (Europe, Middle Orient, Asia and Africa) were selected. We used the classical measurement with the metric band and Baudeloque compass and analysed 50 cephalograms in frontal and lateral views. The focus of our measurements were the opening of the mandibular angle (gonion), ramal length and width, condylar diameters and the gonion-menton distance. In the European specimens, the opening of the mandibular angle is smaller than in the Asians. Africans had a lower value of the mandibular angle than Asians. Significant differences appeared in the gonion-menton distance measurements, as well. In conclusion, there is a positive correlation between the mandibular angle and the menton-gonion distance, respectively.

[Some aspects concerning the electrochemical corrosion of the Gaudent-S dental alloy]. / Unele aspecte privind coroziunea electrochimica a aliajului dentar Gaudent-S.

The potentiodynamic polarization methods have been employed to evaluate the corrosion resistance of the Gaudent-S dental alloy in a slightly acid artificial saliva (Fusayama's saliva; pH = 6.18), a slightly alkaline artificial saliva (Rondelli's saliva; pH = 7.75) and in an acid saline solution (NaCl/lactic acid; pH = 2.64). The results were compared with those obtained for copper and aluminium--the principal components of the studied alloy. In Fusayama's artificial saliva both the copper and Gaudent alloy exhibit close indentic cyclic voltammograms, typical for pitting corrosion; the pitting potentials being 1550 mV (SCE) for Gaudent-S and 1350 mV (SCE) for copper, while the repassivation potential is 700 mV (SCE), the same for the two analysed metals. In the Rondelli's artificial saliva and in acidic saline solution the passivation domain is considerable reduced; the corrosion potential and the repassivation potential coincides. In the saline acid solution the current densities are two times higher than those obtained in the other two solutions. In the aluminium case it can be noticed that the passivation domain is very reduced, no cathodic peak is observed and much more current densities are registered in the positive potential domain.

[The role of anthropologic study in the stomatognatic morphologic changes through time]. / Importanta studiului antropologic în modificarile morfologice ale sistemului stomatognat de-a lungul timpului.

OBJECTIVES: The possibility of a prognosis regarding the morphologic aspect of the passive component of stomatognathic apparatus was assessed through some researches on the viscero-cranium aspect. METHOD: The study used 20 skulls or skull fragments, 8 were from the first century A.D., 4 from the Middle Ages and the rest of 8 were from the XX-th century. All The skulls were found on the Romanian territory. A series of measurements were made on the maxilla, mandible and on the face as a whole; the results were compared with the literature data. RESULTS: The skulls discovered in the Neolithic necropolis existing on the Romanian territory are of mediterranoic type, with an antero-posterior prolonged skull and with narrow dental arches, presenting a prognathism according to the shape of the skull. After the Neolithic, the shape of the skull changes to a more rounded one and the dental arches become upsiloid. In the Middle Age, the dental arches tend to evolve from the upsiloid type to the paraboloid type. In our century, the paraboloid form of the dental arches is maintained (semiellipitic shape of the maxilla and the parabolic shape of the mandible). CONCLUSIONS: During the ages, the evolution of masticator apparatus was influenced mainly by the genetic factor regarding the shape and the pathology, but also, in some degree, by the dietary habits. Multiple changes have been made possible a gene crossing between individuals. Due to the genetic mixture between the local element and the migratory population, the evolution of the stomatognathic apparatus to paraboloid dental arches is explained, although upsiloid dental arches can be found.

[An unusual case of multiple endocrine neoplasia]. / Un caz atipic de neoplazie endocrina multipla.

The patient A.M., woman, presented Multiple Endocrine Neoplasia, associating hyperparathyroidism, an adrenal tumor and pancreatic tumor; one can observe that the disease had features of Multiple Endocrine Neoplasia type-1 (pancreatic tumor), as well as Multiple Endocrine Neoplasia type-2 (MEN-2, pheochromocytoma), while the hyperparathyroidism is common for both two types of the syndrome. The development of the disease is extended over approximate forty years of life and finally led to death. The first symptoms appeared during pregnancy, at age 26, when the severe hyperparathyroidism determined bone mass acute loose, with decrease in height by affecting columnary vertebrae, severe bone pain due to bone resorption and soon after symptoms of renal stone disease. The patient suffered two surgical interventions for renal lithiasis. The biliary symptoms required also the surgical removal of the gall bladder, putting the diagnosis of active metabolic stone disease. At age 56, was established the diagnosis of carcinoma of the adrenal cortex, which was solved with surgical therapy. At age 66, digestive symptoms suggested the presence of a carcinoid tumor. Abdominal ultrasonography revealed a well-lined pancreatic tumor of 2-3 centimeters in diameter, probably adenoma. The malignant evolution of this tumor was rapid, leading to death in less than two years. The constant refuse of other investigations, by the patient, made us incapable to determine the type of secretion of the pancreatic tumor; we rather suspected a VIPoma, because of the watery diarrhea and severe weight loss. The most difficult to treat was anyway the hyperparathyroidism and its complications.

[Periodontal regeneration with enamel derivate proteins (Emdogain)--clinical evaluation]. / Régénération parodontale a dérivés de la matrice proteique de l'email (Emdogain)--évaluation clinique.

UNLABELLED: The study was undertaken in order to evaluate the effect of Emdogain as an adjuvant in periodontal surgery in promoting bone level gain, compared to bone levels after surgery. METHOD: The study was realised on 6 patients. who had pair test sites and control sites. Two interproximal sites were selected in each patient at a distance from each other, in the same maxilla, with infra-osseous defects with depth > or = 4 mm and width > or = 2 mm. The patients were followed on a long term period, initially and after 8 and 16 months. RESULTS: The average values of the clinical attachment level were evaluated both in the test sites and in the control group at 8 months and 16 months, The radiographic osseous level continued to recede at the group treated with Emdogain, and in the control group it remained at its initial level. The radiographic gain was ascertained after 16 months. CONCLUSION: This study proves that the topic use of Emdogain as an adjuvant, during periodontal defects surgery, on radicular surfaces, determines a gain in the clinical attachment and an osseous gain observed on X-rays.

Esthetic principles in prosthetic dentistry.

Dento-facial esthetics represents today the fourth clinical dimension in our activity. Together with morphological, functional and biomechanical factors, aesthetics contribute to a successful clinical result in prosthodontics. Dento-facial esthetics takes over the visual perception principles adapting them to dental requirements. Continuously assimilating esthetics information, being a good observer and training visual perception is important for the final complete result in prosthetic dentistry.

[The technic for the reoptimization of laryngeal cannulae by recoating them with a silicone material]. / La technologie de reoptimisation des canules laryngiennes par recouvrement d'un materiau siliconique.

In the laryngeal surgical pathology area, the application of a cannula with temporary or long term indications is necessary for ensuring the respiratory function troubled by various causes (inflammatory, tumor or traumatic) that obstruction the respiratory tract. The most frequently used standard cannula is rigid and does not show proper adaptation for every clinical situation, thus leading to local troubles. In this paper, the realization technique of a rigid/flexible and individual cannula applied after the tracheotomy is presented. In order to carry out the cannula, a rigid material is utilized (acrylic resin) for maintaining the shape and dimensions of the laryngeal stoma. It is also utilized an elastically material (acrylic resin with a retard plug--Simpa) that ensures the optimal adaptation, tight close and tissue protection around the stoma. In co-operation with the ORL Clinic--Recuperation Hospital, these cannulae were applied to fifteen patients pursuing their evolution in time.

[A comparative study of the bacterial dental plaque formation on fixed dentures with different surface characteristics]. / Studiu comparative asupra formarii placii dentare bacteriene pe aparatele gnato-protetice conjuncte cu diverse caracteristici de suprafata.

The accumulation of dental plaque on fixed prostheses made of various biomaterials is influenced by the roughness of the surface. For the investigation of this aspects it was necessary of a method rapid, facile and cheaper in comparison with bacterial culturing and identification which is laborious and expansive. In this study we followed the accumulation of dental plaque on biomaterials like chrome-cobalt and gaudent polished and unpolished, at different periods of time (3 and 14 days). We observed that after 3 days the aspect is predominant coccoid and after 14 days is predominant bacillary. On unpolished crowns the width of dental plaque is greater and on gaudent crowns the plaque is structural organised around of filamentous organisms.

[Gram-negative anaerobic bacilli identified in the subgingival microflora associated with fixed dentures]. / Bacili gram negativi anaerobi identificati în microflora subgingivala asociata aparatelor gnato-protetice conjuncte.

The prosthodontics devices have a major role in healthy state or disease of periodontal structures. They may initiate or amplify tissues destruction when technical features or the used material are not the most appropriate. The aim of this study was to establish the influence of different materials on the evolution of chronic periodontal diseases by comparison to lesions associated with natural teeth. Lot of study was represented by 21 partial edentulous patients with periodontitis in both natural teeth and fixed prosthodontics. Periodontal pockets were sampled and then Gram stained smear and cultivation onto selective media (Schadler + 5% sheep blood + nalidixic acid + vancomycin) were done. The isolated bacteria were identified by standard methods. We observed quantitative and qualitative differences between studied patients according to the material used for making the fixed prosthodontics.

Peri-implant tissue and the longevity of restoration.

The clinical success was analysed several times, based upon the good results obtained and unfortunately not on a basis of correct scientific researches, as the cellular and ultrastructural investigations. In the randomized study a more numerous failures are seen in the first, respectively second year, after the application of the implant. The failures were predominantly observed in case of mandible implants. The quality of the bone is an essential factor for the success of the implant without correlation with the age of the patient. The most objective choice of the patients as well as a correct conceived and executed therapeutical plan, the follow-up cooperation with the patient, in what concerns the strict oral hygiene, would had to an increasing number of successfully solved cases. The success of the implant may be ensured when besides the content of the patient, the long-term stability of the soft and bone peri-implant tissues is achieved. By this is also obtained by morphological stability, which may be evaluated following clinical X-ray parameters. This stability is under dependence of the biological status. Conclusively this means an established biomechanical balance and stable relationships between the immune defense system of the least and the pathogenic potential of the microorganisms.

Peri-implantitis.

Peri-implant lesions are directly linked to the relationship between the implant and the soft tissue. These lesions are rare in the case of pure Ti smooth implants, but appear frequently around the rough-surfaced implants. A marginal inflammation may result in a rapid peri-implant bone loss, since the peri-implant connective tissue constitutes in a less effective barrier than the same tissue surrounding the tooth. The morphopathological examination of the peri-implant tissues revealed after their removal that the gum's mucous membrane is not inflamed, but degenerative lesions were observed both on the epithelium and chorion. The papillary lamina propria contains few cells, but it is rich in collagen fibers; vasodilatation and edema were also present. Multiple areas of lysis of the intercellular junctions were also observed at the intermediary level of the gum peri-implant epithelium (the epithelial cells undergo a process of involution at the intermediary level of the epithelium). Important changes can be seen both at the level of intercellular junction systems and at the junction between the basal extremity of the epithelial cells and the basal membrane.

[Failure in implantology]. / Esecul în implantologie.

Establishing of success-failure criteria, implies assessment of benefits brought by these implants, and the time-span one can enjoy these benefits. Bone quality represents a crucial factor for success, irrespective of age.

[Technological difficulties in realizing the Sandhaus prosthesis]. / Dificultati tehnologice în realizarea protezei Sandhaus.

Due to multialveolar infra and superstructure Holoprosthesis will resume the integrity of edentulous arcs, and the simplicity of intervention, all cases of reduced and extended edentulism will be solved. TCS implant, and Sandhaus implant by means of Holoprosthesis which is attached to these systems, will allow diminishing of harmful forces so that prosthesis movement and the occurrence of shearing forces are prevented.