Relationship between Behavior and Periodontal Health Self-Perception in Diabetic and Non-Diabetic Patients from Transylvania, Romania-A Self-Report Study, including The Desire to Use a Mobile App for Oral Care Improvements.

The study aimed to assess self-reported symptoms of periodontal disease (gingival bleeding, tooth mobility and halitosis) among diabetic and non-diabetic patients from Transylvania, Romania. Using statistical analysis methods, correlation between the aforementioned symptoms and diet, oral hygiene habits, stress, physical activity, and BMI (body mass index) were researched. Another secondary objective was to assess the impact of self-reported oral health, aesthetics, and halitosis on their life. Patients' willingness to use a mobile app for generating awareness of oro-dental complications, improving their knowledge of oro-dental health, and reminding them to visit the dentist based on an awareness-raising function, was also assessed. Methods: The study was based on an original self-administered questionnaire, applied to 182 subjects, in an unselected, randomized manner. A total of 110 questionnaires were applied in two dental offices and 72 questionnaires were applied in a public clinic for diabetic patients from Cluj-Napoca, Romania. Results: Warning signs and symptoms relevant to periodontal disease were identified by respondents, having statistically significant associations with the declared oral health-care habits, including interdental aids, vicious habits (nail biting, bruxism), etc. Some of these periodontal signs could be correlated with a certain lifestyle, such as the perceived stress, smoking status, practicing maintenance sports, and alcohol consumption. A total of 66% of the non-diabetics and 68% of the diabetics of the surveyed subjects consider a software application for generating awareness of oro-dental complications useful, and are willing to pay around EUR 6 for it. Conclusions: Having a medical condition such as diabetes makes patients pay more attention to dental health compared with non-diabetic patients. Patients expressed their desire to use a software application to help them to be aware of their condition and for improving their self-report capabilities, including their oral-health-related status.

Oral health, the patients' perspective during the COVID 19 pandemic.

Background and aims: On March 16, 2020, the state of emergency was established with drastic measures of isolation and quarantine. Among the measures taken in the context of the state of emergency was the closure of dental offices throughout the country. The aim of our questionnaire-based cross-sectional study was to identify the psycho-affective implications of the Romanian citizens induced by the COVID-19 pandemic period as well as their opinion related to the self-perceived oral health status during this period. Methods: An original questionnaire was designed consisting of 41 questions, which were distributed to the general population via the Internet. The first part of the questionnaire investigated the respondents' opinion regarding the impact of this COVID-19 pandemic period of isolation on their oral health and the attention paid by the subjects to oral hygiene during restrictions. The second part refers to their addressability to the dental services during this pandemic and the third part interrogates different characteristics, namely the presence of comorbidities, possible anxiety, and stress. Results: A total of 769 participants answered the questionnaire online. Conclusion: According to their responses most of the respondents were not afraid of the possibility of contracting Sars-Cov-2 during dental treatments, but were in certain periods deprived of accessing dental services due to lockdown restrictions. They are aware of their oral health problems and pay more attention to oral hygiene so that they do not get worse during restrictions.

3D Ultrasound Reconstructions of the Carotid Artery and Thyroid Gland Using Artificial-Intelligence-Based Automatic Segmentation-Qualitative and Quantitative Evaluation of the Segmentation Results via Comparison with CT Angiography.

The aim of this study was to evaluate the feasibility of a noninvasive and low-operator-dependent imaging method for carotid-artery-stenosis diagnosis. A previously developed prototype for 3D ultrasound scans based on a standard ultrasound machine and a pose reading sensor was used for this study. Working in a 3D space and processing data using automatic segmentation lowers operator dependency. Additionally, ultrasound imaging is a noninvasive diagnosis method. Artificial intelligence (AI)-based automatic segmentation of the acquired data was performed for the reconstruction and visualization of the scanned area: the carotid artery wall, the carotid artery circulated lumen, soft plaque, and calcified plaque. A qualitative evaluation was conducted via comparing the US reconstruction results with the CT angiographies of healthy and carotid-artery-disease patients. The overall scores for the automated segmentation using the MultiResUNet model for all segmented classes in our study were 0.80 for the IoU and 0.94 for the Dice. The present study demonstrated the potential of the MultiResUNet-based model for 2D-ultrasound-image automated segmentation for atherosclerosis diagnosis purposes. Using 3D ultrasound reconstructions may help operators achieve better spatial orientation and evaluation of segmentation results.

Effects of Acidic Environments on Dental Structures after Bracket Debonding.

Brackets are metallic dental devices that are very often associated with acidic soft drinks such as cola and energy drinks. Acid erosion may affect the bonding between brackets and the enamel surface. The purpose of this study was to investigate the characteristics of brackets' adhesion, in the presence of two different commercially available drinks. Sixty human teeth were divided into six groups and bonded with either resin-modified glass ionomer (RMGIC) or resin composite (CR). A shared bond test (SBS) was evaluated by comparing two control groups with four other categories, in which teeth were immersed in either Coca-ColaTM or Red BullTM energy drink. The debonding between the bracket and enamel was evaluated by SEM. The morphological aspect correlated with SBS results showed the best results for the samples exposed to artificial saliva. The best adhesion resistance to the acid erosion environment was observed in the group of teeth immersed in Red BullTM and with brackets bonded with RMGIC. The debonded structures were also exposed to Coca-ColaTM and Red BullTM to assess, by atomic force microscopy investigation (AFM), the erosive effect on the enamel surface after debonding and after polishing restoration. The results showed a significant increase in surface roughness due to acid erosion. Polishing restoration of the enamel surface significantly reduced the surface roughness that resulted after debonding, and inhibited acid erosion. The roughness values obtained from polished samples after exposure to Coca-ColaTM and Red BullTM were significantly lower in that case than for the debonded structures. Statistical results evaluating roughness showed that Red BullTM has a more erosive effect than Coca-Cola™. This result is supported by the large contact surface that resulted after debonding. In conclusion, the prolonged exposure of the brackets to acidic drinks affected the bonding strength due to erosion propagation into both the enamel-adhesive interface and the bonding layer. The best resistance to acid erosion was obtained by RMGIC.

Mechanical Properties of Orthodontic Cements and Their Behavior in Acidic Environments.

The present research is focused on three different classes of orthodontic cements: resin composites (e.g., BracePaste); resin-modified glass ionomer RMGIC (e.g., Fuji Ortho) and resin cement (e.g., Transbond). Their mechanical properties such as compressive strength, diametral tensile strength and flexural strength were correlated with the samples' microstructures, liquid absorption, and solubility in liquid. The results show that the best compressive (100 MPa) and flexural strength (75 Mpa) was obtained by BracePaste and the best diametral tensile strength was obtained by Transbond (230 MPa). The lowestvalues were obtained by Fuji Ortho RMGIC. The elastic modulus is relatively high around 14 GPa for BracePaste, and Fuji Ortho and Transbond have only 7 GPa. The samples were also subjected to artificial saliva and tested in different acidic environments such as Coca-Cola and Red Bull. Their absorption and solubility were investigated at different times ranging from 1 day to 21 days. Fuji Ortho presents the highest liquid absorption followed by Transbond, the artificial saliva has the best absorption and Red Bull has the lowest absorption. The best resistance to the liquids was obtained by BracePaste in all environments. Coca-Cola presents values four times greater than the ones observed for artificial saliva. Solubility tests show that BracePaste is more soluble in artificial saliva, and Fuji Ortho and Transbond are more soluble in Red Bull and Coca-Cola. Scanning electron microscopy (SEM) images evidenced a compact structure for BracePaste in all environments sustaining the lower liquid absorption values. Fuji Ortho and Transbond present a fissure network allowing the liquid to carry out in-depth penetration of materials. SEM observations are in good agreement with the atomic force microscopy (AFM) results. The surface roughness decreases with the acidity increasing for BracePaste meanwhile it increases with the acidity for Fuji Ortho and Transbond. In conclusion: BracePaste is recommended for long-term orthodontic treatment for patients who regularly consume acidic beverages, Fuji Ortho is recommended for short-term orthodontic treatment for patients who regularly consume acidic beverages and Transbond is recommended for orthodontic treatment over an average time period for patients who do not regularly consume acidic beverages.

Automatic Segmentation of Periodontal Tissue Ultrasound Images with Artificial Intelligence: A Novel Method for Improving Dataset Quality.

This research aimed to evaluate Mask R-CNN and U-Net convolutional neural network models for pixel-level classification in order to perform the automatic segmentation of bi-dimensional images of US dental arches, identifying anatomical elements required for periodontal diagnosis. A secondary aim was to evaluate the efficiency of a correction method of the ground truth masks segmented by an operator, for improving the quality of the datasets used for training the neural network models, by 3D ultrasound reconstructions of the examined periodontal tissue. METHODS: Ultrasound periodontal investigations were performed for 52 teeth of 11 patients using a 3D ultrasound scanner prototype. The original ultrasound images were segmented by a low experienced operator using region growing-based segmentation algorithms. Three-dimensional ultrasound reconstructions were used for the quality check and correction of the segmentation. Mask R-CNN and U-NET were trained and used for prediction of periodontal tissue's elements identification. RESULTS: The average Intersection over Union ranged between 10% for the periodontal pocket and 75.6% for gingiva. Even though the original dataset contained 3417 images from 11 patients, and the corrected dataset only 2135 images from 5 patients, the prediction's accuracy is significantly better for the models trained with the corrected dataset. CONCLUSIONS: The proposed quality check and correction method by evaluating in the 3D space the operator's ground truth segmentation had a positive impact on the quality of the datasets demonstrated through higher IoU after retraining the models using the corrected dataset.

Human Enamel Fluorination Enhancement by Photodynamic Laser Treatment.

Poor oral hygiene leads to serious damages of theteeth's surface enamel such as micro-abrasions and acid erosion. These alterations combined with bacterial plaque result in cavity appearance. Prophylactic measures include various techniques for enamel surface restoration. Fluorination is one of the most important treatments for this purpose. Therefore, in the present research, we investigated the classical fluorination treatment compared with laser photodynamic fluorination performed on human enamel samples with poor surface quality. Three sample groups were investigated: veneer (F), inlay (I), and crowns (C). The general morphologic aspect was investigated by scanning electron microscopy (SEM), and the specific details such as the fine microstructure and nanostructure were investigated by atomic force microscopy (AFM) of the surface roughness. The samples were also investigated by Fourier transformed infrared attenuated total reflectance (FTIR-ATR) to evidence the fluorination effect on the enamel surface. Results showed that all initial samples had an altered state with micro-abrasions and erosion with mineral loss, which increase the surface roughness. The F group was the most damaged, having a higher roughness, and the I group was less damaged. Classic fluorination treatment partially restored the enamel by local re-mineralization, but did not obtain the parameters of healthy enamel. However, a significant decrease of the roughness was observed (statistical relevance p = 0.001 with the Breusch-Pagan Test). This fact was supported by the presence of newly formed fluorides in the FTIR-ATR spectra. The photodynamic laser fluorination restores the enamel in an enhanced manner by a strong re-mineralization, which implies a significant roughness value decrease comparable to healthy enamel. The Breusch-Pagan Test confirmed the relevance with p = 0.001. This is due to an extended re-mineralization abundant in fluoride crystals as observed by AFM and FTIR. Statistical p-values regarding laser application were in the range of 0.02-0.06, supporting its relevance in the fluorination effect. The final conclusion is that the photodynamic effect is able to favor the newly formed fluoride deposition onto the affected sites of the enamel surface.

Accuracy Report on a Handheld 3D Ultrasound Scanner Prototype Based on a Standard Ultrasound Machine and a Spatial Pose Reading Sensor.

The aim of this study was to develop and evaluate a 3D ultrasound scanning method. The main requirements were the freehand architecture of the scanner and high accuracy of the reconstructions. A quantitative evaluation of a freehand 3D ultrasound scanner prototype was performed, comparing the ultrasonographic reconstructions with the CAD (computer-aided design) model of the scanned object, to determine the accuracy of the result. For six consecutive scans, the 3D ultrasonographic reconstructions were scaled and aligned with the model. The mean distance between the 3D objects ranged between 0.019 and 0.05 mm and the standard deviation between 0.287 mm and 0.565 mm. Despite some inherent limitations of our study, the quantitative evaluation of the 3D ultrasonographic reconstructions showed comparable results to other studies performed on smaller areas of the scanned objects, demonstrating the future potential of the developed prototype.

Photodynamic Therapy with Natural Photosensitizers in the Management of Periodontal Disease Induced in Rats.

This study aims to investigate the effect of new natural photosensitizers (PS) (based on oregano essential oil, curcuma extract, and arnica oil) through in vitro cytotoxicity and biological tests in rat-induced periodontal disease, treated with photodynamic therapy (aPDT). The cytotoxicity of PS was performed on human dental pulp mesenchymal stem cells (dMSCs) and human keratinocyte (HaCaT) cell lines. Periodontal disease was induced by ligation of the first mandibular molar of 25 rats, which were divided into 5 groups: control group, periodontitis group, Curcuma and aPDT-treated group, oregano and aPDT-treated group, and aPDT group. The animals were euthanized after 4 weeks of study. Computed tomography imaging has been used to evaluate alveolar bone loss. Hematological and histological evaluation showed a greater magnitude of the inflammatory response and severe destruction of the periodontal ligaments in the untreated group.. For the group with the induced periodontitis and treated with natural photosensitizers, the aPDT improved the results; this therapy could be an important adjuvant treatment. The obtained results of these preliminary studies encourage us to continue the research of periodontitis treated with natural photosensitizers activated by photodynamic therapy.

Photodynamic Therapy (PDT) in Prosthodontics: Disinfection of Human Teeth Exposed to Streptococcus mutans and the Effect on the Adhesion of Full Ceramic Veneers, Crowns, and Inlays: An In Vitro Study.

The use of PDT in prosthodontics as a disinfection protocol can eradicate bacteria from tooth surfaces by causing the death of the microorganisms to which the photosensitizer binds, absorbing the energy of laser light during irradiation. The aim of the study was to investigate the capacity of PDT to increase the bond strength of full ceramic restorations. In this study, 45 extracted human teeth were prepared for veneers, crowns, and inlays and contaminated with Streptococcus mutans. Tooth surfaces decontamination was performed using a diode laser and methylene blue as a photosensitizer. The disinfection effect and the impact on tensile bond strength were evaluated by scanning electron microscopy (SEM) and pull-out tests of the cemented ceramic prosthesis. Results show that the number of bacteria was reduced from colonized prepared tooth surfaces, and the bond strength was increased when PDT was used. In conclusion, the present study indicates that using PDT as a protocol before the final adhesive cementation of ceramic restorations could be a promising approach, with outstanding advantages over conventional methods.

Three-dimensional periodontal investigations using a prototype handheld ultrasound scanner with spatial positioning reading sensor.

AIM: To demonstrate the feasibility of the 3D ultrasound periodontal tissue reconstruction of the lateral area of a porcine mandible using standard 2D ultrasound equipment and spatial positioning reading sensors. MATERIAL AND METHOD: Periodontal 3D reconstructions were performed using a free-hand prototype based on a 2D US scanner and a spatial positioning reading sensor. For automated data processing, deep learning algorithms were implemented and trained using semi-automatically seg-mented images by highly specialized imaging professionals. RESULTS: US probe movement analysis showed that non-parallel 2D frames were acquired during the scanning procedure. Comparing 3 different 3D periodontal reconstructions of the same porcine mandible, the accuracy ranged between 0.179 mm and 0.235 mm. CONCLUSION: The present study demonstrated the diagnostic potential of 3D reconstruction using a free-hand 2D US scanner with spatial positioning readings. The use of auto-mated data processing with deep learning algorithms makes the process practical in the clinical environment for assessment of periodontal soft tissues.

Assessment and Characterization of Some New Photosensitizers for Antimicrobial Photodynamic Therapy (aPDT).

The novelty of this study consists on the formulation and evaluation of five complex experimental natural photosensitizers (PS): gel with oregano essential oil (O), gel with methylene blue (AM), gel with a mixture of essential oils (Thieves-H), gel with arnica oil and curcuma extract (CU) and gel with frankincense essential oil (T), used as photosensitizing agents (PS) in antimicrobial photodynamic therapy (aPDT) in the control of microbial biofilm in oral cavity. The experimental PS were characterized by gas chromatography-mass spectrometry (GC-MS), Fourier-transform infrared spectroscopy (FTIR), UV-Vis spectroscopy, cytotoxicity assay, antimicrobial effect and scanning electron microscopy (SEM). The IR spectra of the experimental PS with essential oils exhibit absorption bands due to the presence of water and glycerol in high quantities. The studied compounds had a reduced cytotoxic effect on cell cultures. The lowest cytotoxic effect was observed in experimental PS with oregano essential oil and methylene blue PS. Essential oils with proven antibacterial capabilities used in experimental PS confer antibacterial activity to the gels in which they are incorporated, an activity that may be more efficient use of a PDT therapy. Single bacteria were detected mainly by SEM after 12 h, while aggregate bacteria and micro colonies dominated the samples at 48 h.

Periodontal evaluation using a non-invasive imaging method (ultrasonography).

The periodontal disease and gingival bleeding are highly prevalent in the adult population worldwide. The World Health Organization (WHO) data shows that 90-100% of the 34-year-old adults present gingival inflammation. Therefore, an investigation method is required to allow the assessment of the periodontal disease as well as the monitoring of the evolution of the gingival inflammation after periodontal treatments. Non-invasive and operator-independent methods for periodontal examination are necessary for diagnosing and monitoring the periodontal disease. The periodontal ultrasonography is a reliable technique for visualizing the anatomical elements which are necessary to diagnose the periodontal status. Using this imaging technique the dentino-enamel junction, the cortical bone, the radicular surface from the crown to the alveolar bone, the gingival tissue can be seen without interfering with those elements during the examination. Also, calculus visualization is possible before and after scaling in order to evaluate the quality of the treatment. Using 2D ultrasonography is not feasible in dental practice as it requires extensive experience and is also time consuming. The reproducibility of the 2D slices is very difficult in order to have the possibility to compare different investigations efficiently. 3D reconstructions of the periodontal tissue can be a very good alternative to eliminate the operator dependence. Ultrasonography allows the practitioner to visualize the anatomic elements involved in making a periodontal diagnosis. It also allows tracking of subsequent changes. This method is not commonly used for periodontal examination and further studies are required. Previous studies show that ultrasonography can be a reliable non-invasive method to diagnose and monitor the periodontal disease.

Chair-side saliva parameters assessment and caries experience evaluation.

INTRODUCTION: Carioreceptivity-based, individualized prevention protocols allow a minimally invasive approach in many patients, in all age groups. The long-term success of such protocols depends not only on the actual caries experience of the patients, but also on the possible responses based on natural defense mechanisms. Therefore the salivary flow, the buffer capacity of stimulated and non-stimulated saliva and mostly the Streptococcus Mutans and Lactobacilli number are highly important in deciding whether a long-term remineralization therapy can be successfully applied for early stage caries lesions. Similar tests may record the the acidogenicity of dental biofilms. These risk factors can be entered into a computer-based risk assessment program (such as Cariogram). METHODOLOGY: An extensive literature search was performed on Medline/PubMed using as key-words: Streptococcus Mutans, Lactobacilli, saliva volume, pH and buffer capacity. The methodology of selecting the reviewed literature and the inclusion criteria were based on articles published in the last ten years. RESULTS: Besides topically applied remineralization products, either in-office or at-home, changes in the diet can diminish the number of cario-active bacteria, especially Lactobacilli. Latest researches show that dentifrices, especially toothpastes containing xylitol and/or probiotics can have a significant cario-protective effect. CONCLUSIONS: Dental caries assessment is very important for specific age groups, because most risk factors have specific consequences in different age groups. Pre-teen and teenage patients need more individualized caries management strategies in order to avoid the onset of new caries lesions. Root caries risk may be decreased by an intensive and continuous preventive care.

Computer-assisted identification of the gingival sulcus and periodontal epithelial junction on high-frequency ultrasound images.

UNLABELLED: The primary aim of this study was to demonstrate that periodontal ultrasonography is a reliable method with which to identify and evaluate the attachment level of the gingival junctional epithelium. A secondary aim was to devise an automated computer-assisted method that allows the examiner to more easily identify the gingival sulcus contour on ultrasound images. MATERIAL AND METHODS: This in vitro study was carried out on 36 sites on the lingual surface of eight pig mandibles. For each site, periodontal ultrasonography was performed by the same examiner, using DermaScan C Cortex Technology (Denmark) with a 20-MHz transducer. Subsequently, the mandibles were sectioned with a microtome and examined by direct microscopy. To facilitate identification of the gingival sulcus on ultrasound images, a computational method was adopted. RESULTS: Computer processing of the ultrasound images slightly modified the contour of the gingival sulcus. The absolute mean differences in the linear measurements of the Dermascan-automated computer-generated values and the corresponding values of microscopy, which is the gold standard, varied between 0.06 and 1.75 mm. Statistical analysis showed that with respect to the gingival sulcus height, the correlation between the computer-processed ultrasound images and the direct microscopy images was stronger than the correlation between the non-processed ultrasound images and those from direct microscopy. CONCLUSIONS: Ultrasonographic examination of the periodontal tissues allows the examiner to localize the gingival epithelial attachment level and provides substantial data regarding the soft gingival tissues.

Identification of the anatomical elements used in periodontal diagnosis on 40 MHz periodontal ultrasonography.

Gingival inflammation is highly prevalent among adult populations in all regions of the world. High rates of chronic periodontitis have been reported worldwide. The methods for assessing the gingival inflammation and periodontal disease would need more precision and less user-dependence. The aim of this study consists in identifying the information for diagnosis and staging of periodontal disease using 40 MHz periodontal ultrasonography. Our in vivo study has been made on 49 teeth of 10 patients with marginal periodontal disease. Standard clinical and radiological periodontal examinations were performed. Afterwards the results were compared with the information obtained from images recorded with Ultrasonix SonoTouch used at 40 MHz. On the ultrasound images, were performed very accurate measurements between the cortical bone and the cement-enamel junction or the root wall compared with the measurements made on intraoral digital radiographs. Those measurements could be used to diagnose the bone resorption. In order to monitor the gingival inflammation could be recorded the width of the attached gingival mucosa and the height of the gingival margin on ultrasound images. 40 MHz periodontal ultrasonography is a reliable imagistic method for identifying the necessary anatomical elements in order to make an accurate periodontal diagnosis for the examined area.

The utility of 40 MHz periodontal ultrasonography in the assessment of gingival inflammation evolution following professional teeth cleaning.

UNLABELLED: The AIM of this study was to evaluate the usefulness of 40 MHz periodontal ultrasonography in the assessment of gingival inflammation, following professional teeth cleaning. MATERIAL AND METHODS: The study was performed on 18 teeth without restorations having subgingival calculus (upper and lower premolars and frontal teeth). After the clinical exam the Gingival Index and the Sulcus Bleeding Index were calculated. Then a 40MHz transducer (ULTRASONIX SonoTouch device) was used to obtain longitudinal sections in the frontal plane. Three measurements were performed: alveolar crest - cementum-enamel junction distance (ACJ), gingival height (GH), and gingival width (GW). Professional cleaning was performed by ultrasound scaling (SatelecP5 booster, France) and airflow (NSK, Japan). Two and seven days after the first evaluation, ultrasonographic and clinical examinations were repeated. RESULTS: Two days after the treatment the median value of the ACJ, was 2.70 (2.38; 2.95) mm, whereas 7 days after treatment it was 2.55 (2.45; 3.01) mm. The intraclass correlation coefficient for ACJ measurement was 98.8 (p<0.001).The values obtained measuring GH [3.84(3.44; 4.27) mm vs. 3.52 (3.00; 3.76) mm] and GW [(1.81 (1.65; 1.95) mm vs.1.62 (1.40; 1.95) mm) had statistically significant differences between the 2nd and 7th day. CONCLUSIONS: Periodontal ultrasonography is a highly precise and reproducible imagistic method, with which bone resorption, gingival inflammation as well as the presence or absence of subgingival calculus can be assessed.

Mathematical methods for assessing the prognostic of fixed partial dentures resulting from evaluating a group of dental patients in Romania.

Based on some mathematical and statistical approaches, our study leads to some conclusions concerning the procedures related to the orodental prosthetics. Occlusal equilibration in orodental prosthetics is a major issue because besides motivating patients for a regular daily oral hygiene, it could significantly increase the longevity of FPR. More dental hygiene information should be given after prosthetic treatment and patients should be motivated to attend recalls on a regular basis for professional teeth-cleaning. Interdental cleaning aids should be explained and the patients have to be motivated to use them at least once a day and the using technique should be individualized. Regarding the application of the deformable models theory, implemented in the context of an expert type software environment, it is known that the fact that modelling by advanced methods and techniques based on the deformable surfaces theory increases the efficiency of the dentofacial prosthetics procedures is a domain of great interest in the actual medical research.

Saliva characteristics, diet and carioreceptivity in dental students.

BACKGROUND AND AIMS: The use of sugar by dental plaque microorganisms leads to acid formation from the bacteria metabolism, which determines a decrease of pH onto teeth surfaces. The value of the critical pH is 5.2-5.5. We aimed to evaluate the capacity of patients to change their diet towards caries prevention after acknowledging the values of saliva parameters (pH, buffer capacity). MATERIAL AND METHODS: A group of 52 subjects were clinically examined according to the International Caries Assessment and Detection System protocol. They were required to complete a diet questionnaire and salivary tests were made for the oral mucosa hydration level, pH, buffer capacity, salivary flow rate at rest and upon stimulation. 4 pre-calibrated 6th year students and 2 dentists performed the tests and the ICDAS examination. One week after the tests, the subjects were asked to complete the diet questionnaire again. The studied group consisted of students aged between 23-26 years, randomly selected among 6(th) year students of the Faculty of Dentistry from Cluj-Napoca. RESULTS AND DISCUSSION: The mean DMF-S index was 18.39. Most of the patients (65%) had a DMF-S index between 9 and 21. Just 2.5% had an index of 3, which was the lowest value recorded. 5% of the patients had a DMFS of 35, which was the maximal value recorded. The distribution of DMF-S was normal. 50% of the patients had no active caries. Even though most subjects (19.23%) had a pH within the normal interval, most of them were at the bottom value of the interval (6.8). Most subjects had a pH of 6.4, which is moderately acid. The mean pH was 6.7, therefore, a moderately acid one. The Pearson correlation coefficient between DMFS and pH was 0.255. A mild negative correlation (-0.275) was found between the cariogenic food and buffer capacity. A week later we noticed a statistically significant decrease of cariogenic foods and drinks in students with acid pH and with low buffer capacity. CONCLUSIONS: A regular intake of cakes, bonbons and chocolate was reported by subjects who had a high DMF-S value and a low saliva buffer capacity. Only after the patients were aware of their caries risk, did they change their diet towards a non-cariogenic one, even though they had had the theoretical knowledge regarding caries prevention for at least 3 years. We conclude that the use of the chair-side salivary test should be highly recommended for cario-receptive patients.

The evaluation of 20 MHz ultrasonography, computed tomography scans as compared to direct microscopy for periodontal system assessment.

AIM: To identify by ultrasonography (DermaScan C, Cortex Technology1) the reference points necessary to monitor the horizontal bone resorbtion and to assess the accuracy of the measurements by comparing with Cone Beam Computed Tomography images, having direct microscopic section measurements as a gold standard. MATERIAL AND METHODS: We performed the examinations on the lingual side of the alveolar bone of 4 pig mandibles. We tried to identify the enamel-cementum junction, the root, the periodontal space at the appearance of the tooth from the alveolar bone, the edge of cortical bone at its coronary limit (in order to assess the horizontal bone resorption). We measured the distance between the enamel-cementum junction and the coronal edge of cortical bone. RESULTS: There was a strong positive correlation between the alveolar bone level measured with the 3 techniques. Correlation parametric R2 tests were statistically significant for DermaScan measurements compared to microscopy ones (p<0.0001). Linear regression showed statistically significant correlations for alveolar bone level measurements made by CBCT compared to microscopy (p<0.05). CONCLUSIONS: The cementum-enamel junction may be identified on ultrasonic images with high accuracy according to the tooth anatomical convexities, therefore this method can be used for monitoring the periodontium.