Teledentistry and oral health in older adults - aspects for implementation of the "Patient centric solution for smart and sustainable healthcare (ACESO)" project.

P u r p o s e: Oral health and diseases are significant components of general health. However, oral health-care remains at the lowest of older patients' priorities. The inability to obtain dental care can result in progression of dental disease, leading to a diminished quality of life and overall health. Teledentistry (TD) provides an opportunity to improve the quality of oral health services. The aim of our narrative review was to analyze the usefulness of teledentistry as a part of telemedicine to improve oral health in the elderly. Materials/Methods: The PubMed database search was done for: teledentistry, oral health, oral- health related diseases, elderly, older adults. R e s u l t s: The applicability of TD has been demonstrated from children to older adults. Older adults have many obstacles in getting oral health care, including low income, lack health insurance, frailty, anxiety, depression, mobility problems or other handicaps. Available data suggests that the usefulness of TD in the provision of oral care in elderly people living in residential aged care facilities. Moreover, TD procedures were found to be as accurate as traditional face-to-face dental examinations, they was cost-effective and well accepted among patients and caregivers. C o n c l u s i o n s: TD might be a very useful tool for professional education, improving access and patient satisfaction of dental care. However, such TD modes would be difficult to widely implementation in community-dwelling older people who cannot access dental care. The ongoing "Patient centric solution for smart and sustainable healthcare (ACESO)" project will add to the intelligent oral health solutions.

Diode Laser Management of Cheek Cavernous Hemangioma in Dental Office.

Due to high energy content and specific characteristics of dental laser light, this kind of procedure optimizes the outcome on oral cavernous hemangioma removal, diminishing the risks, and complications. Management of a very rare internal cheek cavernous hemangioma presenting a high risk of injury in a patient with chronic acenocoumarol medication and high blood pressure, can be accomplished using diode 810nm laser, in the dental office with predictable results. Protocol complied diode laser, with specific fiber tip, specific power, and operation mode, for 1 minute/1 cm 2 irradiated area. Intervention sequences were repeated until complete disappearance. Laser procedure withdrew the lesion rapidly, completely. It has a lot of advantages that recommends it as a removal procedure before prosthetic treatment.

Survey on the Current Clinical and Technological Level of Implant Prosthesis Application and Its Complications among Romanian Prosthodontic Specialists.

Objectives: The present study aims to identify the current level of clinical and technological performance of dental prosthetic rehabilitation on implants and the possible existence of correlations between different designs and occurring complications in Romanian practice. Material and method: An online questionnaire with 36 questions, grouped into five sections, has been designed using the Google Forms application. In 2019, it was approved by the Romanian Dental and Maxillofacial Prosthetic Society, and the link to the questionnaire was distributed via email to 70 members. The answers with multiple choice option were summarized in an Excel document, coded and statistically processed in the specific software (SPSS v20.0; IBM Corp). Fisher's exact test, likelihood ratio and linearby- linear association were used, and pairs of two questions were tested considering a standard statistical significance p value=0.05. Results: The results show that screwed rehabilitations (80.5%) on platform switched (70.9%) bone level implant (76.4%) with multiunit (69.1%) abutments for fixed total prosthesis, and custom abutments (43.6%) for removable prosthesis are preferred in Romanian practice. Most common problems of fixed rehabilitation on implants are related to aesthetics (65.5%) and for overdenture to unscrewing (56.4%). Resin-polymerized material in the laboratory, acrylic teeth and milled metallic structure in both arches was the preferred design for fixed restauration in both arches. Multiple statistic significant correlations (p<0.05) were found between the design type and complications. Conclusions: Our findings outline current clinical and technological preferences in Romanian practice on prosthetic implant rehabilitations, illustrating a great need for further research and education consensus.

Five-year clinical trial using three attachment systems for implant overdentures.

OBJECTIVE: The objective is to compare, in a prospective randomized clinical trial, three types of attachment systems for mandibular implant overdenture, focusing on costs, maintenance requirements and complications from baseline to the end of 5-year follow-up period. MATERIALS AND METHODS: Sixty-nine fully mandibular and fully/partially maxillary edentulous patients received two screw-type Straumann implants, in the mandibular canine region. New overdentures with three types of attachment systems were inserted according to an early-loading protocol: Group B (balls, divided into Subgroup B.1 - retentive anchor with gold matrix and Subgroup B.2 - retentive anchor with titanium matrix) (n = 23), Group M (magnets) (n = 23) and Group L (locator) (n = 23). RESULTS: The highest maintenance event number (195) was observed in Group B vs. 31 in Group L and 15 in Group M. Significantly more complications were recorded in Subgroup B.1 than in Subgroup B.2, Group M and Group L (P < 0.05). Group M registered the highest prosthetic success (82.6%) in the 5 years, followed by Group L (78.2%). Subgroup B.1 had the lowest success rate (50%). The magnet group recorded statistically significant higher costs, comparing with the other two groups (P < 0.05). CONCLUSIONS: The three attachment systems functioned well after 5 years. The magnets had a low maintenance requirement and high success rate, despite the relatively increased initial costs. Retentive anchor with titanium matrix and locator may be a better choice from a financial point of view, taking into consideration the initial low cost of the components and also the reduced number of complications.

Palatal and mandibular tori in a Romanian removable denture-wearing population.

OBJECTIVE: To establish the prevalence of palatal tori (TP) and mandibular tori (TM) in a Romanian denture-wearing population in order to see how or if tori influenced the denture design or the treatment planning. BACKGROUND DATA: There are no available data regarding tori in an elderly Romanian population and its implication for treatment planning. It could be considered a local factor influencing the quality of prosthetic treatment. MATERIAL AND METHOD: Tori prevalence was investigated in 251 patients, with an average age of 62years. A statistical analysis was made, using odds ratio (OR) for the distribution related to gender and the Chi-squared test for the differences in prevalence related to age groups. Treatment planning difficulties because of presence of tori were recorded. RESULTS: Frequency of TP was significantly higher in both genders (OR=2.0661 and p=0.0446) and non-significant frequency for distribution between genders for TM (OR=0.9421 and p=0.8273). The differences in age groups showed both tori types have a variable prevalence related to age. The most frequent location for TP was found in the posterior one-third and two-thirds of the palate and for TM in the canine and first premolar area presenting with different sizes. CONCLUSIONS: Tori prevalence in our study group is high and is significantly related to age (p<0.05) having a peak at over 60 years. The preferential site of TP in the posterior palatal area and this location has an impact on decision making in treatment planning for the upper denture.