Prevalence of Malocclusions among Schoolchildren from Southwestern Romania.

Malocclusions have a continuously increasing prevalence from one generation to another as a result of climate change, soil, atmosphere, and water pollution. All of these aspects have unfavorable consequences for the nutritional scheme. Thus, nutrition, together with other etiopathogenic factors, contributes to complex alterations in the somatic development of the entire organism and, implicitly, of the cephalic extremity. The study group included 4147 children from randomly selected schools from Vâlcea County, Romania. The aim of this study is to determine the prevalence of malocclusions in schoolchildren in Vâlcea County, Romania, according to the three main classes of malocclusions (according to Angle's classification), age groups (from 6 to 10 years old and from 11 to 14 years old), gender (male and female), and place of origin (rural and urban). For Angle class I malocclusions, we recorded the highest prevalence (48.78% of the total number of schoolchildren with malocclusions), followed by Angle class II malocclusions (45.85% of the total number of schoolchildren with malocclusions), and for Angle class III malocclusions we found the lowest prevalence (5.37% of the total number of schoolchildren with malocclusions). According to gender, we found the highest prevalence in the female gender (29.90% of the total number of female subjects), while in the male gender, we recorded a prevalence of 27.70% of the total number of male subjects. Regarding the place of origin, there is a higher prevalence of malocclusions in urban areas (29.16%). The study subgroup included 140 children randomly selected from the total number of subjects in the study group. They were included in a more advanced study. The aim is to find potential associations between the presence of malocclusions and various oral variables. Categorical variables were expressed as numerical values and percentages, and their association was evaluated with either the Chi-square test of association or homogeneity, or the Fisher Exact test. The acquired data were incorporated into a binomial logistic regression model to assess the likelihood of developing malocclusions in relation to the following variables: defective phonation, bruxism, frequency of teeth brushing, onychophagia, oral respiration, infantile deglutition, placing objects between the maxillaries, thumb sucking, and salivary aspects. It is also aimed at comparing the results obtained with similar ones from the specialized literature.

Clinical Efficacy Analysis of the Personalization of Prosthetic Abutments in Implant Supported Restorations in Comparison to Available Standard Titanium Abutments.

Personalized medicine has become an important direction to offer better solutions for health problems. In implantology, this trend was materialized through customizing dental abutments to each clinical situation. The demands for better esthetics and function of implant-supported restorations have imposed a more personalized variety of prosthetic abutments. This retrospective study compared clinical efficiency of personalized implant abutments with standard implant abutments in multiple implant restorations. Clinical data of patients who were admitted in a private clinic between 2011 and 2022 and received dental implant treatments were collected. All complications and undesired events from the patients' medical record charts were statistically analyzed. The implants were loaded using either standard or customized abutments. For complete arch rehabilitations with the SKY Fast & Fixed protocol, standard titanium prosthetic abutments were used. Our results suggest that the abutments choice for patients has moved throughout the years more towards the use of customized abutments. The number of customized abutments (414) was higher compared with the number of standard abutments (293). In our database, the most used abutments for the anterior area implants were made of titanium and zirconia, whereas for the posterior area, the preferred abutments were mostly titanium. The standard abutments were used almost entirely for immediate loading and implantation in both anterior and posterior areas (Fast & Fixed protocol). Complications were encountered mainly in restorations with standard abutments (9.22%) compared to customized abutments (2.7%), with titanium abutments being the most reliable, having only 1.79% complications.

Osseointegration evaluation of an experimental bone graft material based on hydroxyapatite, reinforced with titanium-based particles.

Bone graft materials are more and more frequently used in dentistry for improving the periodontal support and for creating a bone support favorable for the insertion of dental implants. The experimental study carried out on laboratory animals aimed to evaluate the biocompatibility and the manner of integration of an experimental bone augmentation material, based on hydroxyapatite (HAp), reinforced with titanium-based particles by comparison with a commercial synthetic graft material already existing on the profile market, also based on HAp. We noticed a common pattern of evolution, although there were differences related to the speed of new bone tissue formation and implicitly the morphological elements captured at the two moments of time. In the presence of both synthetic materials, ossification also begins from the center of the cavity at distance from the margins of the bone defect, with a common pattern with an appearance with the presence of osteon-like structures. The experimental material generally determined a more intense initial inflammatory reaction, followed by the generation of a repair bone tissue with a denser appearance but with a less uniform structure and a greater number of residual particles.

Comparative Study of Dental Custom CAD-CAM Implant Abutments and Dental Implant Stock Abutments.

The implementation of CAD-CAM systems in dentistry has significantly influenced the evolution of dental implantology and implant-supported prosthetics within the past three decades. Implant-supported prostheses are comfortable and aesthetic. The prosthetic abutment has also faced a rapid design evolution, from the individualization of standard stock abutments offered by various manufacturers to a modern customization process using CAD-CAM technology. This paper presents a comparative study between 20 dental custom CAD-CAM implant abutments and 20 dental implant stock abutments, based on a set of measurements performed on the digital casts obtained from 24 cases of prosthetic rehabilitation on implants. The statistical analysis (Mann-Whitney U test) revealed significant differences between these two types of abutments: the incisal margin line diameter dimensions for custom abutments were significantly improved compared to standard abutments at the cervical level (U = 343.00, z = 3.868, p < 0.0005) and the incisal/occlusal level (U = 352.00, z = 4.112, p < 0.0005), while the inclination angle of the custom abutments relative to the 0-axis was significantly smaller than that of standard abutments (U = 115.50, z = -2.286, p = 0.022). The use of custom abutments leads to an increase in the final size of the abutment, an improvement in the retention of the prosthetic work, and reduces the angulation of the abutment in relation to the implant axis, thus decreasing the risk of unscrewing or fracturing the dental screw.

Aspects of Dental Occlusion Assessed with the T-Scan System among a Group of Romanian Dental Students in a Cross-Sectional Study.

This study evaluated the occlusal relationships in students with bruxism, using the T-Scan III system, and their correlation with the activity of the masticatory muscles assessed through surface electromyography (sEMG). The study group was divided into two subgroups (based on self-reporting): 20 participants with possible bruxism and 20 participants without possible bruxism; all participants underwent the following evaluations: sEMG recordings using the dia-BRUXO device for masticatory muscles assessment, as well as static and dynamic occlusion using the T-SCAN III system. The analysis of the maximum intercuspidal (MI) position revealed a positive moderate association between the values of the occlusal forces in MI distributed along the two hemiarches, and the number of grinding events during daytime, which was statistically significant (p < 0.05). The analysis of protrusion movements reflected statistically significant differences between the non-working interferences and sEMG parameters specific to bruxism (p < 0.05). The analysis of laterotrusion movements indicated that participants with anterolateral guidance presented higher values of awake bruxism indexes and higher values of clenching events during nighttime. For all three mandibular movements, their duration was higher for the study group compared to the control group. Therefore, this study confirmed the utility of sEMG recordings in the bruxism diagnosis process, as well as the association between dental occlusion and bruxism.

Clinical, histopathological and immunohistochemical changes of the superficial marginal periodontium caused by orthodontic treatment with fixed metallic orthodontic appliances.

Malocclusions negatively influence dental function, physical well-being, and quality of life. According to data provided by the World Health Organization (WHO), malocclusions represent the third most widespread oral health problem, after dental caries and periodontal diseases. In recent years, more and more people call for orthodontic treatment with fixed braces that aim at establishing a dental, aesthetic, and functional balance, compatible with a normal life. Our study assessed the histopathological and immunohistochemical changes that occurred in superficial marginal periodontal components, in a number of 23 patients diagnosed with malocclusions, as a result of orthodontic treatment with fixed metal braces. The purpose of the study was to evaluate the remodeling of the tissues in the superficial periodontium during orthodontic migration, microscopic aspects that are essential to evaluate the effectiveness of the orthodontic treatment.

Boron-containing compounds in Dentistry: a narrative review.

Research on the use of boron (B) in the field of oral health has gained momentum in recent years, with various studies on the possibilities of using various B-containing compounds (BCCs). A multitude of applications have been discovered, from cariostatic activity to anti-inflammatory and antifungal activity, paving the way for other new research directions. B is a microelement that is commonly found in the human diet, and present throughout the body, with the highest concentration in the structure of bones, teeth, and gastrointestinal mucus gel layer. Multiple studies have demonstrated that B plays some important roles, especially in bone development and recently has been proposed to have an essential role in the healthy symbiosis. In addition, B has also attracted the interest of researchers, as various studies used BCCs in conventional or modern biomaterials. In this review, we have brought together the information we have found about B updates in the dental field and analyzing its future perspectives and potential for further studies.

Ecological Momentary Assessment of Masseter Muscle Activity in Patients with Bruxism.

According to the International Bruxism Consensus, bruxism refers to the activity of the masticatory muscles reflecting contraction disorders, regardless of whether it is during sleep (SB) or an awake (AB) state. The objective of the present study was to evaluate the activity of the masseter muscle by surface electromyographic (sEMG) recordings. This study was performed on 20 participants with self-reported "possible bruxism" (study group) and 20 participants with no self-reported bruxism (control group); all participants underwent an evaluation of the masseter muscle activity using the dia-BRUXO device, which provides numerical parameters regarding sEMG (the total duration and the type of bruxism specific events, the effort made by the masticatory muscles during the recording period, and the personal bruxism index of each participant). Participants from the study group presented more clenching events during AB, three times more frequent than the control group (p = 0.002, Mann−Whitney U test); for SB, the frequency of clenching and grinding events was comparable within the study group, being more frequent than for the control group; the mean value of the effort index was higher for AB (1.177%) than SB (0.470%) and the same for the duration index, with a mean value of 2.788% for AB and 1.054% for SB. All participants from the control group presented reduced values for all acquired parameters. Overall, the personal bruxism index in AB was approximately four times higher for the study group (2.251%) compared to the control group (0.585%) (p < 0.005, Mann−Whitney U test). Similar values were obtained for SB. All participants with "possible bruxism" from the study group presented a higher activity of the masseter muscle, which is specific for bruxism, thus being defined as "definite bruxism".

Preclinical and histological study of boron-containing compounds hydrogels on experimental model of periodontal disease.

Periodontitis is a disease that affects a wide group of people, and there has been an increased interest in the research of finding useful materials that help reduce inflammation and the further loss of tissue. In this study, we have tested a boron-containing compound (BCC) Calcium Fructoborate (CaFB) and Boric Acid (BA) hydrogels on the gingival level on Wistar rats. First, we have induced the periodontal disease at the lower incisors, we have applied the hydrogels and after a week, we have euthanized the rats. Next, the oral soft tissue reaction was clinically and then histologically investigated. Our study has shown good clinical response of the oral tissue, and we have noticed lower levels of inflammation on the experimental groups treated with the BCCs hydrogels. Despite the generally good response of the biological structures to the presence of BA and CaFB on periodontal level, more scientifically proved information is needed to obtain the desired biological responses in all clinical situations.

A software approach for identifying the effect of dental caries on dentin-enamel junction.

Dental decay is the most prevalent oral disease worldwide since more than 2.4 billion people suffer from caries of permanent teeth. Therefore, any details about its progression into the hard-dental tissues could contribute to unravelling the mechanisms underlying this process. We have analyzed dental tissue sections with and without caries in order to detect structure differences corelating them with clinical aspects observable from the tooth surface. Our working hypothesis was based on finding a link between the process of tertiary dentin laying (as a response to coronal caries) and the subsequent obliteration of dentin tubules. We have selected N=10 extracted teeth with/without coronal caries, resin-embedded and sectioned them. A specific software was used to digitally quantify the density of unobliterated dentin tubules reaching the dentin-enamel junction (DEJ), considering as positive threshold criteria the presence of the odontoblast process inside the analyzed tubule. This study showed the differences between the healthy and carious-affected hard-dental coronal tissues. More odontoblast processes reached the DEJ in unaffected teeth. Using specific software, we have quantified their density decrease near a lesion. We have studied the dynamics of the carious study and measured the consequent structural modifications of the dentin. In conclusion, there is a significant difference between the number of dentin tubules containing odontoblast processes that reach the DEJ in healthy∕altered tissues. The tooth reacts not only by production of tertiary dentin to protect the pulp chamber, but also by obliteration of dentin tubules, thus reducing the number of odontoblast processes reaching the DEJ. This pilot study could serve as the starting point in developing a dedicated software that could deliver a personalized pattern for decay progression by analyzing one single tooth and extrapolate the result to all the patient's remaining ones.

The Frequency of Dental Materials Use for Fixed Prostheses in a General Dental Practice.

This retrospective study aimed to evaluate the frequency of dental materials use for fixed prosthesis depending on the location of the teeth, the restorative prosthetic type, the age and sex of the patients from a dental practice in Essen, Germany. The analysis of the collected data showed that zirconia is currently the most common material for making dental fixed prostheses, a larger number of prosthetic elements for women and a significant increase for these restorations at ages over 40 years. Most of the prosthetic elements were made in the mandibular molar area, with an increased frequency of zirconia bridges in the mandible, while for the upper jaw the number of crowns was higher. Zirconia was more frequent used in female patients and in the age group 60-69.

Frequency of Bone Augmentation Materials Use in a General Dental Practice.

This retrospective study aimed to evaluate the frequency of bone augmentation materials used for implant or periodontal surgical treatment depending on the age and sex of the patients from a dental practice in Essen, Germany, but also the implants dimensions and respectively the stage and progression grade of the periodontitis. The analysis of the data showed that bone augmentation materials are used much more frequently in the implant surgical cases (43,33%) compared to periodontal surgical cases (13,33%). While the correlations with sex and age were less obvious, the use of bone augmentation materials in the implant surgical cases was correlated with the use of shorter implants, while their use in the periodontal surgical cases was correlated with the stage 3 periodontitis.

Calcium fructoborate coating of titanium-hydroxyapatite implants by chemisorption deposition improves implant osseointegration in the femur of New Zealand White rabbit experimental model.

BACKGROUND: The identification of biocomposites that improve cell adhesion and reduce bone integration time is a great challenge for implantology and bone reconstruction. AIM: Our aim was to evaluate a new method of chemisorption deposition (CD) for improving the biointegration of hydroxyapatite-coated titanium (HApTi) implants. CD method was used to prepare a calcium fructoborate (CaFb) coating on a HApTi (HApTiCaFb) implant followed by evaluation of histological features related to bone healing at the interface of a bioceramic material in an animal model. METHODS: The coating composition was investigated by high-performance thin-layer chromatography/mass spectrometry. The surface morphology of the coating was studied by scanning electron microscopy (SEM), before and after the in vitro study. We implanted two types of bioceramic cylinders, HApTi and HApTiCaFb, in the femur of 10 New Zealand White (NZW) rabbits. RESULTS: The release of CaFb from HApTiCaFb occurred rapidly within the first three days after phosphate-buffered saline immersion; there was then a linear release for up to 14 days. SEM analysis showed similar morphology and particle size diameter for both implants. Around the porous HApTiCaFb implant, fibrosis and inflammation were not highlighted. CONCLUSIONS: Easily applied using CD method, CaFb coatings promote HApTi implant osseointegration in the femur of NZW rabbits.

Immunohistochemical study of experimentally drug-induced gingival overgrowth.

The increasing frequency of using in the medical practice drugs that have the potential to induce gingival overgrowth (GO) and the existence of many unknown aspects in GO etiopathogenesis have prompted us to carry out this immunohistochemical experimental animal study. We conducted a cell proliferation study by Ki67 immunostaining and a cytokeratin (CK) study using anti-pan-CK AE1∕AE3 and anti-MNF116 antibodies, investigating the differences induced by different classes of drugs that are more frequently involved in the induction of GO. The results of our study indicate that CK AE1∕AE3 plays an important role not only in normal cellular proliferation, but also in hypertrophic tissues, and can be considered a marker of the proliferative process occurring in GO. Immunostaining for the anti-MNF116 antibody was weaker and inconsistent in intensity compared to anti-CK AE1∕AE3 antibody, its staining pattern appearing as diffuse or zonal.

A microscopic insight of the morphological changes induced by dental zirconia prosthetic structures.

As zirconia is today probably the dental material with the largest increase in the frequency of use in dental prosthetics, the reason for this study was based on a series of clinical observations made following its use in clinical prosthetics. Thus, we were interested in two aspects: the histological evaluation of the response of the oral soft tissues to the presence of the prosthetic structures in zirconia, and the microscopic evaluation of the abrasion lesions that appeared in the hard dental tissues of the zirconia prostheses antagonists. For the first part, samples from three zirconia-based dental prosthetics commercial products were implanted submucosal in the oral cavity of male Wistar rats. After six weeks, the oral soft tissue reaction was clinically and then histologically investigated. For the second part, we made two study groups to investigate the influence of the zirconia-glazed surface vs. polished surface to the wear pattern of the antagonist enamel, using a tribological equipment and a dedicated software. Our study showed a good clinical response of the oral soft tissues surrounding the inserted zirconia samples, with subclinical, only histological revealed, signs of inflammation, of a foreign body reaction, while polished zirconia samples determined abrasion surfaces, with a different pattern and significantly smaller dimensions, compared to zirconia glazed samples, at the level of the hard dental tissues of the antagonist teeth. Despite the generally good response of the biological structures to the presence of zirconia prosthetic structures in the oral environment, more scientifically proved information is needed to obtain the desired biological responses in all clinical situations.

The evaluation of the morphological evolution of the tissue integration of dental implants through conventional histology and immunohistochemistry techniques.

Soft peri-implant tissues are important to ensure the integration of a dental implant, and information on their morphophysiology may explain some clinical failures. Through this study, we aim to contribute to a better understanding of the behavior of peri-implant soft tissue, the morphological support being the one that can explain the different clinical situations. Thus, we sought to reconcile clinical, histopathological and immunohistochemical (IHC) aspects of soft peri-implant tissue, in patients who did not show clinical mobility or radiological signs of bone resorption four months after insertion of implants, some of them showing no clinical signs of inflammation. Immunohistochemically, we highlighted the cellular populations participating in the inflammatory process present in the peri-implant mucosa, in the two groups of patients. The IHC identification of these types of cells and the degree to which each of them was represented by the use of monoclonal antibodies can provide additional insight into the local response of peri-implant soft tissue in healing and osseointegration. This helps the clinician to improve the clinical success of dental implant treatment because the soft tissue surrounding the dental implant separates the implant from the oral cavity and makes a biological seal that prevents the development of the peri-implant pathology. Thus, the soft tissue surrounding the dental implants ensures the conditions of osseointegration and hence the long-term survival of an implant.

Histopathological aspects of some rare forms of facial basal cell carcinoma.

AIM: The main objective of the study was to highlight the histopathological aspects of some rare forms of facial basal cell carcinomas. PATIENTS, MATERIALS AND METHODS: The 65 selected patients were diagnosed with head basal cell carcinoma (BCC), during 2011-2013, and they underwent surgery. The excised tumor tissue fragments were processed for paraffin embedding and stained with Hematoxylin-Eosin (HE), Masson's trichrome with Aniline Blue, and Alcian Blue-Periodic Acid Schiff (AB-PAS). RESULTS: The youngest patient was 23 years old, while the oldest was 91 years. The facial BCC there was slightly higher prevalence in males of 34 out of 65 cases. Histopathologically, great varieties of morphological types have been identified in the 65 cases investigated. According to our data, by far the most common are nodular BCCs type, which represented 44.6% from the investigated cases, followed at some distance by morpheiform and superficial subtypes with 13.8% and 10.7%, respectively. The most rare cases of facial BCCs were: cystic, adenoid, fibroepithelial and basal with adnexal differentiation with in one single case each. Relatively rare were the following varieties: pigmented (four cases), combinations of several forms (four cases), metatypical (three cases), keratotic (three cases), and micronodular (two cases). CONCLUSIONS: Within the limits of this study, the data reported here shown that such a lesional pleomorphism very often requires to make a careful differential diagnosis with a number of other tumor or non-tumor entities.

Histological and immunohistochemical study on the dental pulp of patients with diabetes mellitus.

Diabetes mellitus is a disease that brings numerous alterations in the human body, mainly on the blood vessels and nervous system, its complications being difficult to treat most of the time. Oral complications are largely known and studied. Changes that occur in the dental pulp are of importance for the dentists, considering regular procedures outcome. In early stages of the disease, new blood vessels appear especially under the odontoblasts layer as a reaction to stimuli. In later stages, the defense systems of the dental pulp are outnumbered, nervous branches will be destroyed and disorganized. When periodontal disease occurs as well the mortification of the dental pulp will be faster.

An evaluation of a collagen-based material osseointegration.

The aim of this study is to evaluate the osseointegration of a collagen-based material Alveoprotect, suitable for socket preservations, while preserving the vestibular bone lamella. This material is intended to be used in the field of implantology for smaller bone defects. Thus, 3-mm diameter experimental cavities were carried out on the calvaria and maxilla of 18 laboratory Wistar rats. The cavities were augmented with the collagen fleece Alveoprotect or left unaugmented as a control group and half of the laboratory animals were sacrificed after two months, and the other half after four months in order to evaluate in vivo the way in which the inserted material is osseointegrated. The obtained samples were submitted to a histological and immunohistochemical study. The bone defects healing followed the same pattern in all the three groups, but the bone wound healing evolution in the cases augmented with material Alveoprotect offered spectacular results especially in the cavities prepared in the calvaria. On the histological samples, we generally noticed the experimental defects filling with connective tissue with various bone ingrowths from the surrounding bone tissue. The collagen-based material Alveoprotect appeared as a biocompatible augmentation material that can be used successfully for the maintenance of bone volume in the case of small bone defects.

The prevalence of crown injuries to frontal teeth at schoolchildren aged 6 to 14 and their effects on the periodontal tissue.

The research aims at emphasizing the interrelation between the social impact and the self-esteem of schoolchildren with dental crown fractures in the frontal group. Dental traumatic injuries are frequently met to schoolchildren, therefore, the prevention and interception of traumatic pathology within parents, teachers and children is more than necessary. Our statistical study intends to determine the prevalence of dental trauma to southwestern Romanian schoolchildren aged 6 to 14. The survey included a number of 1684 schoolchildren attending public schools, randomly chosen. Data were collected from October 2012 to December 2013. Clinical examination was conducted to assess the dental traumatic injuries. Age and gender distribution, etiological factors, risk factors and the cause of injuries were the parameters taken into consideration. The data collected was processed and analyzed using the SPSS (Statistical Package for the Social Sciences) statistical software. The overall prevalence of dental trauma was 4.63% amongst the subjects examined. The maxillary central incisor was the most commonly affected tooth (85.19% in boys and 97.87% in girls). We observed a significant statistical difference in the number of children with one, two or three fractured teeth from the urban and rural areas. The percentage of schoolchildren with crown fractures that we examined was of 3.09% in the urban area and 1.54% in the rural area. The traumatic injuries of the maxillary upper teeth were most prevalent. Since the dental trauma of incisors has a strong impact on the quality of life of children and their families, health preventive policies are needed in order to avoid psychological implications on the lifelong existence of children affected.