Research on the Quality of Partially Removable Skeletal Prostheses Made Using Classical Versus Modern Sintering Techniques.

Conventional partially removable skeletal dentures are one of the most common therapeutic solutions offered to edentulous patients worldwide. The present study aims to compare the skeleton of removable dentures realized via classical techniques to that realized via modern techniques, represented by the laser sintering technique, with the comparative aspects being realized through the evaluation of atomic force microscopy (AFM). A total of 20 metal frameworks made of Co-Cr were sectioned, representing the infrastructure of partially removable skeletal dentures, developed using the classical technique versus the laser sintering technique. The infrastructures of partially removable skeletal dentures were designed for both the maxilla and the mandible, with the design of each type of denture being identical, and were developed using both techniques. The roughness values are different depending on the technological method used; for the conventional casting technique, we have higher roughness for the component elements of the partially removable skeletal denture that have more stretch, e.g., the major connector, and for the 3D laser sintering technique, lower roughness is obtained for the component elements that have a lower stretch, e.g., the clasp arms, the minor connector, or the junction between the saddles and the major connector. The clinical implications of the presence of roughness at the level of the active arms or at the level of the connector saddle junction are represented by the risk of fracture, which confers real discomfort to the patient.

The Influence of Beverages on Resin Composites: An In Vitro Study.

Dental composites, through their structural diversity, represent the biomaterials frequently used in dental reconstructive therapy. The aim of our study was to observe the influence of different beverage environment conditions on seven types of obturation dental materials with different compositions. Our research focused on the surface modification analysis of the materials after the immersion in the different beverages; in this regard, we used the EDAX technique correlated with the energy-dispersive X-ray fluorescence (XRF). The pH of the drinks and that of the simulated saliva solution were determined by the titrimetric method, a sodium hydroxide solution 0.1 mol/dm3 was prepared and used for the titration. An amount of 5 mL of each analyzed solution was added to 15 mL of distilled water to obtain a dilution, to which 3 drops of phenolphthalein (as a color indicator-Phenolphthalein, 3,3-Bis(4-hydroxyphenyl)-1(3H)-isobenzofuranone, C20H14O4 Mw: 318.32, purchased from Merck) were added for each analysis. For each solution, the experiment was repeated three times in order to obtain accurate results. The results of our study materialized into a real plea for modifying the patients' behavior in terms of diet and preferences for acidic drinks, so that their quality-of-life valence can be improved by keeping the composite materials in a long-term unalterable state on the one hand; on the other hand, systemic damage can be prevented as well.

A Retrospective Clinical Trial Regarding Oral Rehabilitation Diagnosis Strategies Based on Stomatognathic System Pathology.

INTRODUCTION: Orofacial pain is a common occurrence in daily dental practice; it is frequently attributed to temporomandibular dysfunction, one of its major causes, followed by pathology of the salivary glands, without avoiding interference at the level of the pain pathways caused by complications of periodontal pathology. The main objective of this study is to identify an important cause of pain in the oral-maxillofacial territory by quantifying the changes at the salivary glandular level using stereological methods. The secondary objective of the present research is to identify the implications of periodontal changes as a consequence of salivary quantitative and qualitative changes, quantified using periodontal indices, on the balance of the temporomandibular joint, dysfunction of it being an important cause of facial pain and having a profound impact on the complex oral rehabilitation algorithm of each clinical case, a condition evaluated with the analysis of the results of the Souleroy questionnaire. MATERIAL AND METHODS: In a retrospective study, we evaluated the clinical results obtained after applying complex rehabilitation treatment to 35 subjects, 20 women and 15 men with salivary and TMJ dysfunctions, selected between 2020 and 2021 from the Clinic of Maxillofacial Surgery, Iasi. RESULTS AND DISCUSSION: The most common symptoms of temporomandibular disorders (TMDs) that were identified through the Souleroy questionnaire were pain and different types of damage to the masticatory muscles. The most significant changes in elders are reported in the case of serous cells, which reduced their percentage volume from 46.7% to 37.4%. CONCLUSION: As regards stereological analysis in conjunction with histological images, there were significant changes in diameters, perimeters, and longitudinal axes in the adult patients as opposed to the elderly patients, which were also influenced by the type of pathology at this level. The scores recorded on the diagnostic Souleroy scale indicated a large number of patients with low efficiency and maximum stress levels: 20.0% in level 1, 25.7% in level 2, and 25.7% in level 3.

Research Regarding Dental Mobility Phenomena in the Clinical Recognition Diagnosis of Temporomandibular Disorders.

The main objective of this study is to quantify the implications of the complications of periodontal pathology and dental mobility on the pathology of dysfunctional algo syndrome, a clinical entity with profound implications for the patient's quality of life. METHODOLOGY: Clinical and laboratory evaluation was conducted in the 2018-2022 period, on a group of 110 women and 130 men, aged between 20-69, selected from our practice venue, Policlinica Stomatologica nr. 1 Iasi, Clinical Base of Dentistry Education "Mihail Kogalniceanu" Iasi, "Grigore T. Popa" University of Medicine and Pharmacy Iasi and "Apollonia" University Iasi. Overall, 125 subjects were diagnosed with periodontal disease with complications and TMJ disorders and followed periodontal therapy in the context of oral complex rehabilitation treatments (study group); the results of their clinical evaluation were compared with the results of the evaluation of the control group, made from the other 115 patients). RESULTS: Dental mobility and gingival recession were identified as more frequent in the study sample compared with the control sample, the differences being statistically significant in both cases. In total, 26.7% of patients had different types of TMJ disorders and 22.9% of patients had occlusal changes; the percentages are slightly increased in the study sample compared with the control one, but the recorded differences are not statistically significant. CONCLUSIONS: Dental mobility, most of the time, is a negative consequence of periodontal disease, leading to the alteration of the mandibular-cranial relations, materializing in an important proportion as an etiopathogenic factor of the dysfunctional syndrome of the stomatognathic system.

10-Months Study Regarding the COVID-19 Spreading in Romanian Counties.

The paper analyzes the evolution of COVID-19 cases in Romanian counties over a period of 10 months, to highlight possible similarities that may contribute to a better understanding of the spreading pattern. The study uses the numbers of active cases for each county in Romania, as well as Bucharest and the whole country, reported daily by the Romanian Ministry of Health (https://datelazi.ro) between April 2nd, 2020 and January 25th, 2021. We compared the disease's evolution in Suceava county (the first outbreak of spread) with other counties in Romania in order to highlight the gaps between them. We calculated the cross-correlations between counties, interpreted as time series. The recorded lags varied between 1-15 days, the most counties having a lag of 6-7 days compared with Suceava. Therefore, on long term there are no important discrepancies between the regions in Romania regarding the evolution of the disease, which shows that the intervention efforts of the medical staff were uniform in efficiency. The existence of a lag of only one day between Suceava and the whole country shows that on long term, even in this county the situation is not very discrepant, belonging to the general evolution.

Volumetric Cone Beam Computed Tomography for the Assessment of Oral Manifestations in Systemic Sclerosis: Data from an EUSTAR Cohort.

Background: Oral health issues are commonly reported in systemic sclerosis (SSc), comprising a broad spectrum of manifestations, e.g., reduced mouth opening, periodontal disease, increased periodontal ligament (PDL) space width, and mandibular resorption. We aimed to assess oral radiographic abnormalities, particularly PDL space widening and erosions, and to identify potential relations with disease measures. Methods: cross-sectional study in 43 SSc and matching controls receiving systematic oral assessments (full mouth dental/periodontal) and imaging (radiographs and cone beam computed tomography (CBCT)). Associations between disease variables and radiologic findings were investigated by univariate and multivariate analysis (SPSS-v.20, p < 0.05). Results: CBCT demonstrated generalized PDL space widening in up to half SSc, with at least one tooth involved, essentially in the posterior region (p < 0.05). Significant correlations between number of teeth with PDL space widening and disease severity, skin score, disease subset, topoisomerase I specificity, age, and disease duration were reported (p < 0.05). Additionally, mandibular erosions were described in one out of four patients, commonly condylar erosions. Conclusions: Tridimensional CBCT approach confirmed widening of PDL and mandibular erosions as common dental findings in scleroderma. Furthermore, widened PDL spaces correlated with several disease characteristics including severity, skin extent, and antibody profile.

Incidence and prevalence of dental-periodontal conditions and edentation in Moldavia.

UNLABELLED: The proper rehabilitation of the partially extended edentulous patient should lead to a state of balance between the components of the stomatognathic system and the therapeutic option selected for an as long as possible. AIM: To outline the importance of a holistic biological perspective on the body-stomatognathic system relationships and the need for complex rehabilitation in view of obtaining a long lasting balance. MATERIAL AND METHODS: 3340 individuals from urban and rural areas of Iasi County were evaluated. The evaluation was based on the correlation of physical exam with data from a specially drafted questionnaire aimed at determining oral health behavior pattern, a sine-qua-non condition for a clear identification of oral conditions specific to the study area. RESULTS: General health status was poor in 72.1% of the subjects from rural areas as compared to 27.9% in those from rural areas, with cardiovascular diseases ranking first but with higher rates in urban than in rural areas. In urban areas, odontal lesions were the most common and had a higher prevalence in 2012 than in the previous years, followed by the periodontal lesions with the same ascending trend in 2012. CONCLUSIONS: Continuity with regard to the prophylaxis of general and oral conditions in the lasi County in both rural and urban areas is a must, health education being essential for improving population health.

[Epidemiological aspects of frontal edentation of child and adolescent]. / Aspecte epidemiologice ale edentatiei frontale la copil si adolescent.

UNLABELLED: Increasingly frequency of frontal edentation of children and adolescents, mainly because of dental caries and its complications and other diseases requires closer analysis and a reconsideration of therapeutic attitudes that must be carefully adapted and refined. AIM: To study the establishment of prevalence and incidence of child and adolescent frontal edentation, identifying its etiology and prospects of restoration of morpho-functional parameters affected, anchored in temporary or permanent solutions, according to age and morpho-functional development of the patient. MATERIAL AND METHODS: We studied a group composed of 450 patients, aged between 8 and 19 years of age, diagnosed with frontal edentation of different etiologies. RESULTS: The two most common causes which are involved in producing edentation are odontal injuries and chronic periodontal disease. CONCLUSION: Etiology of frontal edentation has an esential part in the anatomoclinical shape of edentation, without evading the impact on bio-psycho-social dimension of this clinical entity. The size of the edentation, the emotional impact for the child, and the medical aspects are very important in the decision of the right treatment for longtime.

[Posttherapeutic feed-back evaluation in oral rehabilitation]. / Evaluarea feedback-ului postterapeutic în reabilitarea orala in acord cu diferitele metode de amprentare.

UNLABELLED: The goal of this study was to assess the subjective post-therapeutic feedback for a group of patients in order to evaluate the possibility of including the psycho-behavioral parameters into the analysis structure of an expert system. MATERIAL AND METHOD: 135 patients diagnosed with class I and II Kennedy edentation, aged between 40 and 89 years old, where clinically examined. All patients filled in structured questionnaires focused on psycho-behavioral parameters. RESULTS: Prosthetic treatment in oral rehabilitation improves subjective perception of facial aesthetic (66.86% total and moderate accord), psychological status (71.14% total and moderate accord) and of the social relations (77.47% total, moderate and low accord) but it is not subjective associated with the improving of general health (55.49% disagreement). CONCLUSIONS: We can establish statistical support correlation between psycho-behavioral parameters and therapeutic solutions applied in oral rehabilitation, correlation that can be later quantified and used in the development of an expert system.

Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals.

Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.

[The role of the polimers in increased acrylic biomaterials qualities used in prosthetic restaurations]. / Rolul polimerilor in optimizarea biomaterialelor acrilice utilizate in restaurarile protetice.

UNLABELLED: This study is aimed at the improvement of the biomaterials used in the field of entirely removable prosthesis quality. One important aspect taken into consideration is the adhering of the Candida albicans fibres, a bacterium frequently met at the oral cavity level of old patients, to different variations of acrylate, in search of ways of counter-attacking this tendency of a very resistant microbian structure. MATERIAL AND METHODS: A number of 19 test-tubes were made under the shape of thin, rectangular plates, 40 mm long and 20 mm wide and a depth varying from 1.8 to 2.5. RESULTS: After analysing the test-tubes for traction forces, was observed: The beraking of the base material was followed by the taking over of the force by the metallic net: the small (elastic) distortions of the acrylate were not simultaneous with the distortions of the reinforcement materials. Polyethylene fibres are made by twisted threads and it presents a lower elasticity module compared tot hat of the acrylic resin, especially duet o the ondulation of the fibres. CONCLUSIONS: Among the advantages of the use acrylic bases renforcement with polyetilene fibres we notice its lower interface effect in comparison with the net acrylical reinforcement.

[Role of computerised programs for the evaluation, diagnosis and treatment of partially edendulous patients]. / Aportul programelor computerizate in evaluare, diagnostic si tratament la pacientul edentat partial.

UNLABELLED: In order to elaborate a correct plan of diagnosis and find the correct therapeutic solution of election in partial edentulous it would be necessary to use a Support System for Clinical Decisions (SSCD). This may bring many benefits both to the private medical assistance,and to institutions with wider therapeutic, educational and scientific objectives. MATERIALS AND METHODS: Using as starting point the ProDent platform of application existing at the Faculty of Dental Medicine from The University of Medicine and Pharmacy Gr.T. Popa Iasi we have developed an expert system for clinical case evaluation and for providing a reliable therapeutic solution. In this respect we have used the ProDent application database--a complete and complex database which records information about patients. RESULTS: At the same time the application generates a table recording a clinico-biological data hierarchy, highlighting the categories which may require intervention during the specific preparation stage. The use of bayes inference also indicates the most reliable therapeutic solution, the initial plan of treatment, the reliability score and the oral rehabilitation predictions. By adding the patient initial score and the oral rehabilitation predictions provided by the application, we obtain the patient initial therapeutic score. CONCLUSIONS: The simulation programs and the electronic format of the observation paper are efficient tools that provide an integrative holistic approach of patients with different forms of oral pathology, under the incidence of local, loco-regional and general complications.

[The principal components analysis--method to classify the statistical variables with applications in medicine]. / Analiza componentelor principale--metoda de ierarhizare a variabilelor statistice cu aplicatii in medicina.

Based on the eigenvalues and the eigenvectors analysis, the principal component analysis has the purpose to identify the subspace of the main components from a set of parameters, which are enough to characterize the whole set of parameters. Interpreting the data for analysis as a cloud of points, we find through geometrical transformations the directions where the cloud's dispersion is maximal--the lines that pass through the cloud's center of weight and have a maximal density of points around them (by defining an appropriate criteria function and its minimization. This method can be successfully used in order to simplify the statistical analysis on questionnaires--because it helps us to select from a set of items only the most relevant ones, which cover the variations of the whole set of data. For instance, in the presented sample we started from a questionnaire with 28 items and, applying the principal component analysis we identified 7 principal components--or main items--fact that simplifies significantly the further data statistical analysis.

[Biomechanical behaviour of oro-maxillofacial prostheses]. / Comportamentul biomecanic al protezelor oro-maxilo-faciale.

The tumor pathology resulted in substance losses and the traumas at facial level are only several aspects that mark patients in a mutilating way, modifying significantly and sometimes irreversibly their behaviour, turning them from active, social people into isolated ones. A prosthesis and so much the more an obturator shall not be worn unless they remake the lost functions and are accepted by the sick person from the psychic viewpoint. The final goal of treatment follows the improvement of the sick person's quality of life and represents a psychological support both for them and for their families. The losses of intra-oral substance are solved in the clinical register by means of augmentation biomaterials of the Bio Oss type. As for the losses of extra-oral substance, they are solved following the mathematical modeling by applying simple pressure at the prosthesis level or by fixing the prosthesis with four magnets that were attached beforehand to the bone. The substance losses represent a complex pathology, the contribution of the filling materials, the prosthetic means correlated to the particularity of the clinical case are essential for a successful clinical finality. We may not speak of a successful prosthetic implant if we do not pay special attention to the mucous-bony deficit by specific prosthetic techniques.

[Clinical aspects of therapeutic options in oral rehabilitation of partially edentulous patients]. / Aspecte clinice ale terapiei edentatiei partial intinse la cazurile sociale.

UNLABELLED: This study aims at identifying practical ways of approaching social cases, and creating a hierarchy of the final functions of restauration. MATERIAL AND METHOD: In 2008 the Clinical Base for Learning from the School of Dental Medicine, Iasi, recorded for the Partially Stretched Edentation Clinic and Therapy course a prevalence of biterminal partial edentation (Class I Kennedy)-66.39 per cent from the total number of patients, followed by uniterminal edentation (Class II Kennedy), having 40.24 per cent of the clinical cases, whereas INTERCALATE edentation (Class III Kennedy), frontal edentation (Class IV Kennedy), and subtotal edentation have about 20.12.1 per cent each. RESULTS: The clinical form of edentation contributes to the election of a proper therapeutic solution as well as the odonto-parodontal and muco-osseous status of each clinical case, the patient's general condition or the socio economic and technical factors leading to a modern, classical or social prothesing. An important aspect to take into account is the large percentage of social cases diagnosed with partially edentation, pleading for provisional protheses with an established role in therapy, which sometimes may become social prothesing--an outstanding clinical reality. Social cases should be solved with a view to restoring functionality such as lower level redimensioning and cranio-mandibulary repositioning, whereas aesthetic requirements fall into therapies based on metallo-ceramic and hybrid prothesing or implanto-prothetic therapy.

[Study on noninvasive paraclinical evaluation methods according to particular aspects in patients diagnosed with partial dentition]. / Studiu privind metodele de evaluare paraclinica noninvaziva in acord cu particularitatea cazului clinic diagnosticat cu edentatie partial intinsa.

UNLABELLED: The aim of this study quantifies the contribution of the non invasive and minimally invasive methods of paraclinic evaluation corroborated with the clinical aspects, a particularly important element being represented by the inter-relation between the general condition--oral pathology. MATERIAL AND METHOD: The study group was represented by patients with ages between 18 and 35 years, diagnosed with partial edentation, with various problems of the general condition. To the same extent, with concern to the study group a special emphasis was placed on the paraclinical results and the therapeutic trajectories directed by the use of the diagnodent, without ignoring the role the digital radiography has in the diagnostic stage as well as the therapeutic one. RESULTS: The results obtained subsequent to the thermographic evaluation showed the initially hidden character of the general symptomatology, the patient being unaware of the presence of any pathology at the level of the apparatus and systems, factor which could have interfered negatively with the pathology specific to the field of dental medicine. Creating a hierarchy, the link offered by the thermogram between the systems and the dental segment is already known. The pathology under investigation, both at an oral level and at a general one pleads for the correlative aspects of the binomial dental unit--affected organ, the modifications of the thermographic trajectories for the somatic area analyzed after the specific therapy being eloquent.