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.

The Influence of Fixed Dental Prostheses on the Expression of Inflammatory Markers and Periodontal Status-Narrative Review.

A dental prosthesis will only be successful if the restoration lasts for a long period and does not cause any illness. The presence of permanent prosthetic restorations has been linked to an increased risk of periodontal infections, according to a large body of research that has been gathered. When chronic inflammation is brought on by fixed prosthetic constructions, both cellular and noncellular immunity are activated as adaptive immune mechanisms. It has previously been stated that both clinically adequate and inadequate restorations might cause gingival inflammation. Areas surrounding the abutment teeth presented periodontal pockets, attachment loss, congestion, bleeding on probing, and gingival hyperplasia after fixed restorations were removed. The depth of pockets, bleeding on probing, and bone loss are all closely correlated with disease's severity and IL-1ß concentration in gingival crevicular fluid; IL-1ß shows higher values in disease sites than in healthy ones. hs-CRP and TNF-α blood levels showed a considerable reduction one day after fixed restorations were applied, in comparison with the pre-treatment values. Collaboration between prosthodontists and periodontists is essential for a good treatment outcome since it will increase the restoration's lifespan, enhance periodontal health, and improve the quality of life for dental patients.

Using the Finite Element Method to Determine the Odonto-Periodontal Stress for a Patient with Angle Class II Division 1 Malocclusion.

The finite element method (FEM) is a computational method that can solve all biomechanical problems, including the field of orthodontics. The purpose of this virtual experimental study is to determine the behavior of a real orthodontic system subjected to different systems of loads. To analyze the real orthodontic system, we studied the case of a 21-year-old female patient. We used the InVesalius program, which can transform a set of DICOM-type images taken from cone beam computed tomography (CBCT) into three-dimensional structures. These structures were edited, modified, completed, and analyzed from a geometric point of view with the help of the Geomagic software. The final result of these operations must be a three-dimensional model made up of perfectly closed surfaces so that they can be transformed into virtual solids. The model consisting of perfectly closed surfaces is loaded into computer-aided design (CAD) programs. Bracket and tube components, as well as orthodontic wires, can be added to these models, similar to the analyzed patient's tissues. When the model is complete and geometrically correct, it is exported to a program that uses FEM, such as Ansys Workbench. The simulation was performed for the forces of 0.5, 0.6, 0.7, 0.8, 0.9, and 1 N. The intention was to determine the behavior of the entire orthodontic system for these force values. After running the simulations, result maps were obtained that were composed of displacement, strain, and stress diagrams. It was also found that, in addition to the known rigidity, the orthodontic system has some elasticity due to the orthodontic wires, as well as the periodontal ligaments. Thus, a virtual analysis study can be carried out starting from a real patient with pre-treatment CBCT images and the virtual models of the bracket and tube elements and of the orthodontic wires.

Peripheral adenopathies in children - an attempt of clinical morphological profile.

AIM: The authors have proposed to assess peripheral adenopathies in a series of hospitalized children in order to identify and define clinical and morphological profiles of different types of lymph node (LN) diseases. MATERIALS AND METHODS: The studied group consisted of 58 patients less than 18 years of age. The investigation algorithm included: gender, age, site, involvement, side, extension and histopathological (HP) type of LN lesions. Tissue fragments were processed using classical histological techniques (formalin fixation and paraffin embedment) and stained with Hematoxylin-Eosin (HE). In some cases (tuberculous lesions and lymphomas), special stainings (Ziehl-Neelsen) and immunohistochemistry were used. Stratification scales of cases were defined according to each parameter in order to compare the data. All obtained data were assessed individually, compared to each other and with similar data from the literature with the help of a statistical apparatus [χ² (chi-squared) test and analysis of variance (ANOVA) test] in some cases. RESULTS: The young patients were slightly more frequently boys, of all ages but with a mean age of 10 and half years. The affected LNs belonged most often to neck region, either on the left or on the right side but sometimes bilateral or even on the midline; usually, more than one LN was involved in the area. In most of the cases, the lesions were localized in only one LN area. HP picture was dominated by the inflammatory processes, firstly the nonspecific ones, followed by tuberculosis. DISCUSSIONS: Our observations fitted, for each parameter, with the wide ranges found in the literature. Comparisons between parameters' variations revealed differences, sometimes significant that we tried to organize in clinical and morphological profiles. CONCLUSIONS: The assessment of our data allowed us to define some clinical and morphological profiles of different types of adenopathy that, by improvement on studies including larger series, could be of real use in daily pediatric practice.

Microscopic aspects of junction between dental hard tissues and composite material depending on composite insertion: layering versus bulk-fill.

Polymerization stresses in adhesive structure could determine an adhesive or cohesive failure and interfacial gaps forming. Some clinical procedures - as light curing composite resin layering in 2-3 mm increments (especially for dental fills) or using dental reconfiguring clear acetate crowns - are sat up to combat (in some way) the polymerization shrinkage. This study approaches the manner how clinical dental adhesive application could influence the hard dental tissues-composite materials interface. The sample studied consisted of 12 upper bicuspids, extracted for orthodontic reasons. In our study, we chose the adhesion technique in "two steps". We prepared enamel and dentine areas, and then filled them with light-polymerization composite. After that, the teeth were subject of microscopic investigations, at 100× and 200× magnification. As conclusion of our study, we sustain that light curing composite resin applying clinical technique (by layering or with acetate crown) might influence a good dental restoration clinical performance.

Quantitative assessment of morphological changes of dental pulp components of teeth affected by occlusal trauma.

AIM: In the general economy of the stomatognathic system functionality, the occlusal function has an important role, meaning both the dental-dental reports and the dynamic reports interarch-interarch. Because of the interrelationships and inter-dependency that govern the functioning of the biological systems, a pathological change affecting a component of the stomatognathic system produces impaired functioning of the others. The aim of the present study is to assess the morphological changes occurred in the dental pulp components of teeth affected by occlusal trauma. MATERIALS AND METHODS: Fragments of dental pulp coming from 45 patients with occlusal trauma were processed using classical histological techniques (formalin fixation and paraffin embedment) and stained with Hematoxylin-Eosin (HE), Masson's trichrome and anti-CD34 antibody immunostaining, in order to highlight the peripheral zone and central connective tissue of dental pulp morphological changes. A set of parameters namely thickness of peripheral zone components, calcifications, fibrosis and vascular density in the dental pulp were assessed individually and based on three topographical criteria namely the affected tooth, the position on the dental arches and the position according to sagittal plane. RESULTS: There was no correlation between morphological changes of dental pulp and the topography of teeth with occlusal trauma. The size of the peripheral area of the dental pulp and that of its components evolved in the same sense, whether it was growth or decrease. Decrease of the peripheral area was associated with the increase of collagen fibers density, calcium deposits and density of the capillary network. The direct correlation between the amount of collagen fibers and vascular density seems somewhat paradoxical but it can be explained by the reemergence of chronic inflammatory events located in the dental pulp. CONCLUSIONS: It seems that dental pulp morphological changes are not influenced by the teeth with occlusal trauma topography. With one exception (the components of peripheral zone), most of the correlations between the dental pulp morphological changes were only suggested but not validated statistically, which requires further studies on larger groups together with the introduction of inflammatory cell population studies.

Morphological changes of gums in occlusal trauma.

AIM: Occlusal trauma causes major modifications of the coverage periodontium, which in turn reflect on the dental unit. The aim of the present study is to evaluate some of the morphological modifications occurred in the marginal periodontium surrounding teeth affected by occlusal trauma. MATERIALS AND METHODS: Fragments of marginal periodontium coming from 51 patients with occlusal trauma were processed using classical histological techniques (formalin fixation and paraffin embedment) and stained with Hematoxylin-Eosin (HE), Masson's trichrome and anti-CD34 antibody immunostaining, in order to highlight the epithelial and connective tissue changes of gingival mucosa. A set of epithelial and connective tissue morphological parameters were assessed individually and based on three topographical criteria concerning the affected tooth. RESULTS: The epithelium and especially its superficial compartment presented changes depending on the tooth type and the dental arch. Epithelial thickness had the tendency to decrease as the fibrosis in both corium compartments and vascular density in the deep corium compartment were increasing. Leukoplakia present around the affected teeth but not always was related with the tooth type and was more obvious as the superficial compartment of the epithelium was thicker and as fibrosis was more reduced in the papillary compartment of the corium. Vascular density reduced when fibrosis process increased in the corium. CONCLUSIONS: Lesions determined by occlusal trauma and their topography can and are influencing locally the different structures of the surrounding periodontium.

Matrix metalloproteinase -7, -8, -9 and -13 in gingival tissue of patients with type 1 diabetes and periodontitis.

There is scientific data to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting the diabetic status. Our study aims to investigate the expression of MMP-7, -8, -9 and -13 in the gingiva of the young patients with aggressive periodontitis (AP) and type 1 diabetes mellitus (T1D). Gingival biopsies were harvested from five adult patients aged 19-29 years with T1D+AP with moderate (three cases) to severe (two cases) forms of AP and from four adult patients aged 18-28 years with moderate AP without T1D. The MMP-7 immunoreaction was positive in the five cases with T1D+AP with different staining patterns. The MMP-8 immunostaining was positive in all cases. The reaction was more intense in cases with T1D+AP, especially in those with severe periodontitis. The MMP-9 immunoreaction was present in all the structures of the gingival mucosa with different intensity, being frequently present surrounding the blood vessels of the chorion. In most of the patients, reaction to MMP-9 was intense, localized at the level of the cells in the superficial chorion and very rarely at the level of some dispersed cells in the connective vascular islands. MMP-13 was present in all cases, but it was more intense in the two cases with T1D+AP with probing depth (PD)>6 mm when it had similar patterns as MMP-9 staining and in one case with AP when the staining was observed strictly in the lamina propria associated with moderate chronic inflammatory infiltrate. The expression of MMP-7, -8, -9 and -13 in the gingiva of the young patients with aggressive periodontitis and T1D was positive in all studied cases supporting the hypothesis that both are inflammatory diseases with common pathogenic mechanisms involving inflammatory mediators and may be possible biomarkers of disease status.