Identifying the Etiological Factors Involved in the Occurrence of Non-Carious Lesions.

The study group comprised a total of 21 subjects (10 women and 11 men) from the urban area aged 20 to 72 who presented themselves to treatment at the Dental Office during July-December 2018. The purpose of the study was to identify the etiological factors responsible for the occurrence of non-carious lesions in the patients involved in the study. The study group of 21 patients (10 women and 11 men) from the urban area, aged 20 to 72 years, were clinically examined and dental impressions were obtained in order to ascertain the study patterns. Subjects diagnosed with non-carious lesions filled a questionnaire based on which the risk factors that led to these changes were identified. The study models were used to assess the degree of cervical tooth damage, according to SMITH-KNIGHT index. The main etiological factors found to be responsible for the occurrence of non-carious lesions in the studied group were the excessive consumption of acidic and carbonated beverages (71.42%), the presence of gastro-esophageal reflux disease (14.28%), incorrect technique of brushing (28.57%), vicious habits-nail biting (14.28%), daily consumption of sunflower seeds (9.52%), use of toothpicks as auxiliary hygiene (19.04%) and night teeth grinding (4,76%).

Clinical Study on Abfraction Lesions in Occlusal Dysfunction.

The abfraction theory states that under the action of the occlusal forces non-axially transmitted, the flexion of the tooth occurs in the cervical area, which initially leads to the appearance of cracks in the enamel and dentin, followed by the destruction of the dental structure. These lesions allow bacterial plaque retention, lead to dental hypersensitivity and can affect the vitality of the dental pulp. Thus, the study included 102 participants, of both sexes, 54% representing the male gender (55 subjects) and 46% the female gender (47 subjects), aged between 20 and 80, from the urban area 76% (77 subjects) and rural 24% (25 subjects), who came to the Dental Medicine office, between August 2018 and August 2019, representing 57.3%, of the total number of patients treated during the aforementioned period. They have been described the acid and abrasive processes involved in the generation of these lesions,and special attention was paid to the role of mechanical stress occurring at the occlusal level, due to the transmission of forces outside the dental axis.

Left Pleuropericardial Cyst.

INTRODUCTION: Cysts of the mediastinum, which are benign masses, are usually detected by chance, and constitute a small but important diagnose group, representing 7 to 18% of all primary mediastinal tumors. Pleuropericardial cysts, located most frequently in the left anterior and inferior mediastinum, are identified in the fourth or fifth decade of life affecting females more than males with a sex ratio of 8:4. MATERIAL AND METHOD: We present the case of a 52 year old woman diagnosed with pericardial cyst located in the left cardiophrenic angle. CPP was rather big and was initially diagnosed as encysted pleurisy. Ultrasound guided exploratory thoracentesis was performed evacuating 300 ml "water spring" like fluid very scarce in cells. We further investigated our patient for differential diagnosis but the patient refused surgery and she is now managed conservatively with a close follow-up. CONCLUSIONS: A pericardial cyst should always be suspected when a cystic lesion is detected in the mediastinum. Pleuropericardial cysts are usually suspected after an abnormal chest X-ray is obtained. If the patient is asymptomatic and the information provided by CT indicates a benign tumoral process suggestive for a pleuropericardial cyst, conservative management with careful follow-up is justified.

Rare Case of Pulmonary Tuberculosis with Hematogenous Spread to Larynx and Skin.

INTRODUCTION: Tuberculosis is an infectious disease with various clinical and radiological symptoms which are determined primarily by the immune system of the host towards the infection with Mycobacterium tuberculosis. The infection with M. tuberculosis can be limited to an organ or it can spread through hematogenous or lymphatic route to other organs (especially cases of younger or older people). Tuberculosis always needs bacteriological or histopathological confirmation. Matherial and method: We present the case of a 62 year old woman investigated and treated in our Hospital in 2009-2010 for Pulmonary tuberculosis complicated with Laryngeal Tuberculosis and Skin Tuberculosis (confirmed by histopathological exams). We intend to focus our case report on the cutaneous form of tuberculosis because of its rareness and clinical interest. CONCLUSIONS: Cutaneous tuberculosis is a very rare form of extrapulmonary tuberculosis and can be highly variable in its clinical appearance, significance and prognosis. Lesions of the skin are a real challenge for dermatologists. The treatment of cutaneous tuberculosis in most cases is the same as for pulmonary tuberculosis leading to regression and healing of the skin lesions.

Lung Involvement in Multiple Myeloma - Case Study.

INTRODUCTION: Mutiple mieloma (MM) cells are rarely found in extramedullary sites. The sites of extramedullary dissemination reported in the literature are spleen, liver, lymph nodes, kidneys, thyroid gland, adrenal gland, ovary, tests, lung, pleura, pericardium, intestinal tract and skin. We report a case in which the myeloma was diagnosed after we discovered the presence of monoclonal plasma cells in the bronchoalveolar lavage fluid (BAL). Matherial and method: a case in which diagnosis was established from bronchoalveolar lavage (BAL) fluid demonstrating the presence of monoclonal plasma cells in Craiova Pneumology Departament. RESULTS: Analysis of BAL fluid for the presence of plasma cells and for cytoplasmic immunoglobulin DNA provides a noninvasive means of establishing the diagnosis. CONCLUSIONS: Pulmonary parenchyma is an uncommon site of extramedullary involvement in multiple myeloma. Interstitial lung disease as pulmonary manifestation of multiple myeloma is even rarer; only isolated cases with histological proofs have been reported in the literature.

Correlations between craniofacial morphology and dento-maxillary anomalies in a population of children in the South west region of romania.

Purpose. Craniofacial morphology is usualy described by the head (cephalic index) and face form (prosopic index). The aim of this study was to establish the existence of correlations between the cranial and facial types and the dento-maxillary anomalies. Material and Methods. Data were collected from two groups of patients (a control group of 42 patients without dental anomalies and a test group of 76 patients with dento-maxillary anomalies) of both sexes and age range 11-16 years. Results. Both in the control and test groups, 50% of patients were classified in mesocephalic type and mesoprosopic type. Conclusions. Groups studied by us showed correlations between anomalies in the transverse plane and dolichocephalic type and correlations between anomalies in the sagittal plane and leptoprosopic type.

Theoretical study on the mechanics of the conjunct gnatoprothetic devices in the context of occlusive function rehabilitation.

The partially intercalated edentation offers the practitioner the possibility of the functional rehabilitation of the dental arcades through conjunct gnato-prosthetic devices. The functions of the dento-maxilar device, disturbed by the presence of edentation, require a treatment approach so that, without pre-planning or estimating, the result can lead most of the times to failure in terms of functionality. Clinical evaluation associated with pre- and proprosthetic treatment can also impose, in some situations the evaluation of the dental units involved in prosthetic rehabilitation. The association and implementation of the prosthetic construction in the occlusive-articular ensemble, as well as the counterbalancing of the mastication forces per dental unit and whole interarch system, linked to the distribution of the forces at the level of the pillar teeth and prosthetic construction, represent the goal of this theoretical study.

Histological changes of gingival epithelium in diabetic patients with periodontal disease.

UNLABELLED: The pathogenesis of the periodontal disease is complex, because it derives from the initiation and maintenance of the chronic inflammatory process by the plenty microbial flora and its numerous bacterial products. The purpose of our study was to make evidence of the histopathological changes occurring in the gingival epithelium in patients with both diabetes mellitus and periodontal disease. MATERIALS AND METHODS: Our study was carried out on gingival tissue from 68 diabetic patients with specific symptoms of periodontitis. The preparations were processed by Hematoxylin-Eosin staining technique and trichromic staining after the Goldner-Szekely method. RESULTS: Although non-specific, since they have been generally found in chronic gingival inflammation, the noticed changes were significant and some of them had specific aspects for the diabetic patients: gingival epithelium changes like acanthosis type; the presence of inflammatory cells such as polymorphonuclear leukocytes and/or lymphocytes among the cells of the stratified squamous epithelium; surface ulceration areas covered by hematic and fibrino-leukocytary detritus; the epitheliocytes keratinization in the superficial layers. CONCLUSIONS: The diabetic patients with periodontitis frequently associate hypertrophy changes of the gingival epithelium with the epithelial permeability alteration and the presence of the intraepithelial inflammatory cells, subsequently leading to degenerative lesions and epithelial ulceration.

Clinical and therapeutic aspects in dento-alveolar disharmony (DAD) with crowding.

UNLABELLED: Dento-alveolar disharmony (DAD) with crowding represents a predispose factor for periodontal pathology installing, especially when septic inflammation is associated. In this context, the identification of integrity or presence of the periodontal structure modifications becomes essential, any discovered element of periodontal pathology transforming into an important factor for a correct and beneficial orthodontic or periodontal-orthodontic therapy setup. The purpose of our study was to reveal the relations between the DAD existence and periodontal modifications within a lot of 528 subjects of 7 to 19 years old wearing different DAD who asked for an orthodontic control, and also the effects of orthodontic therapy upon periodontal structures for the situations in which this therapy was instituted. 74,87% was the percentage for patients with DAD and crowding who accepted the initiation of an orthodontic treatment and 12,75% of them had a friable C type periodontium (with great possibility to evolve towards a periodontal pathology), 25,62% had chronic gingivitis, and in 15,43% there have been noticed gingival recessions more than 2 mm. The orthodontic treatment was finalized for 44,96% of the patients, in 13,43% we noticed the persistence of C type periodontium, in 8,95% of gingival recessions more than 2 mm, in 25,37% chronic gingivitis and in 22,38% hypertrophic gingivitis. CONCLUSION: it is important to initiate an exhaustive control of the patient with DAD before, during and after the orthodontic treatment, especially if the patient is susceptible to develop a periodontal pathology, and also to maintain a good oral hygiene along the treatment.

The immunoexpression of EGFR and Her2/neu in oral squamous carcinoma.

In this study, we have analyzed the EGFR and Her2/neu expression in oral squamous carcinoma and adjacent dysplastic areas. The lesions were diagnosed especially in the sixth decade of life, in male patients, localized on the lips, especially as well and poorly differentiated carcinomas (34%). The EGFR immunostain has been intense in over 50% of the tumors cells in well-differentiated carcinomas, expression diminished in the moderately and poorly differentiated carcinomas. Her2/neu marker recorded a score of 3+ in moderately and poorly differentiated carcinomas, the reaction turning out positive in 25% of the cases.

P53, p16 and Ki67 immunoexpression in oral squamous carcinomas.

In this study, we have analyzed clinically, histopathologically and immunohistochemically a total of 34 cases of oral squamous carcinoma in 11 of the cases being identified adjacent epithelial dysplastic lesions. Carcinomas were diagnosed in patients aged 40-60 years, males, with chronic exposure to tobacco and/or alcohol, being located especially on the lips. Well-differentiated carcinomas have been predominant (52.9%) in stage I/II tumoral (88.3%). Immunoexpression analysis of p53, p16 and Ki67 did not reveal statistically significant differences between the expression of markers and clinical or histopathological parameters, except Ki67 whose increased expression was associated to the decrease of the degree of tumoral differentiation and with high degree dysplasia. The positivity index and the intensity of reaction were increased at the level of dysplasic epithelium for p16 and at the level of tumoral invasion front for the p53 and Ki67. The study highlights the value of the immunostain for p16 in identifying dysplasic lesions and predictive importance of p53 and Ki67 markers in identifying the aggressive forms of oral carcinomas.

Study on the histopathological modifications of the dental pulp in occlusal trauma.

The diagnosis of occlusion-generated disorders of the dento-maxillary apparatus represents a sensitive stage within the establishment of the therapeutic means for the functional rehabilitation of dental arches. The laborious effort carried out in order to specify the diagnosis resides in the fact that any trauma arising at the level of any component of the stomatognate system may lead to an occlusal dysfunction. The uncured carious processes, besides the pulp and periapical complications, may lead to an occlusal dysfunction through horizontal migrations of teeth resulting in the derangement of the occlusal curvatures as well as through vertical migrations of the teeth opposing a tooth diagnosed with occlusal caries or which largely reduced the coronary height. The dental iatrogenia, besides the eructation anomalies and neuromuscular dysfunction within the oromaxillofacial area also determines the appearance of occlusal dysfunction. The radiological examination through correlation with the clinical manifestations may provide significant data related to the magnitude of the prejudice caused to dento-paradontal units experiencing occlusal trauma. The histopathological study through correlation with the clinical manifestations provides significant data on the tolerance of dento-paradontal units within the occlusal dysfunction. Also, subsequent to the analysis of the possible actions of aggression generated by the occlusal trauma correlations could be determined between the type of the histological lesion of the pulp-dentine complex and the etiopathogenic factors, as well as correlations depending on the damage degree through occlusal trauma of the dental parts involved.

Occlusal screening as basis for the integration of conjunct gnato-prosthetic devices.

The functional disorders of the masticator apparatus impose the accomplishment of a phased assessment protocol which should permit the marking out and prefigure the future treatment plan, at the same time. The association of clinical data with therapeutic options and last but not least with the patient's "expectations" represent a particularly important stage within the final occlusal and aesthetic integration. In order to analyse the data collected through examination various assessment systems are available nowadays which permit the correlation of symptoms identified with adequate diagnoses. The planning of the therapy on the basis of clinical registrations associated with the challenges of the bio-aesthetics shall impose a new conduct within the orofacial rehabilitation of patients.