Knowledge and Attitudes towards Medical Emergencies among Dentists in Iași, Romania.

The aim of this study was to evaluate the level of knowledge of resident dentists and new graduates regarding the etiology, clinical diagnosis, and treatment of the main medical emergency conditions. The study included a sample of 152 new graduates and residents in the first, second, and third year of training in Prosthodontics and General Dentistry from the Faculty of Dental Medicine in Iasi, Romania. Their level of knowledge and the attitudes were assessed using a questionnaire with 24 questions, divided into four sections. The differences among groups were identified using the chi-square test (p < 0.05). A high level of knowledge was found among the three groups of subjects for the questions regarding the recognition of clinical signs in hypoglycemic crisis (88-100%), in anaphylactic shock (83.3-94.5%), and the treatment of angina pectoris (76.2-84.2%). In contrast, a low level of knowledge was found for the questions regarding pulse evaluation in the case of an emergency (26.3-35.7%), the parameters of normal breathing (28.9-43%), and the treatment of hypoglycemic crisis (27.8-44.8%). The study indicated that the dentists had a moderate understanding of dental office medical emergencies and preferred practical training over theoretical courses.

Long-Term Clinical Outcomes of 3D-Printed Subperiosteal Titanium Implants: A 6-Year Follow-Up.

As an alternative to regenerative therapies, numerous authors have recently proposed bringing back subperiosteal implants. The aim of the study was to present our clinical experience with a subperiosteal jaw implant that needs minimal bone preparation and enables the rapid implantation of prosthetic teeth in edentulous, atrophic alveolar bone. The research included 36 complete or partial edentulous patients (61 subperiostal implants) over a period of 6 years. To create the patient-specific subperiostal implants design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used and fabricated with a Mysint 100 (Sisma S.p.A., Piovene Rocchette, Italy) by titanium alloy powder. The results showed that only 9 of the 36 cases were successful at 6-year follow-up, while 27 cases had complications, including exposure of the metal frame (early or delayed), mobility of the device prior to the first 4-6 months, and late mobility due to recurrent infections and progressive structure exposure; 1 case failed for reasons unrelated to the device. This study indicated that the prudent application of fully customized subperiosteal jaw implants is a dependable alternative for the dental rehabilitation of atrophic edentulous cases that necessitate bone grafts for traditional fixed dental implant solutions.

Creating and Validating a Questionnaire for Assessing Dentists' Self-Perception on Oral Healthcare Management-A Pilot Study.

BACKGROUND AND OBJECTIVES: Questionnaires designed to test knowledge and self-perception can be valuable tools for diagnosing a dentist's understanding of the management and administration of a practice. The objective of this study was to create and authenticate a questionnaire for assessing dentists' self-perception on oral healthcare management developed from discussions with experts in this field. MATERIAL AND METHODS: In order to create and verify a questionnaire survey, a cross-sectional, descriptive, and analytical study was carried out. Participants' personal information and 31 statements across four categories made up the final questionnaire form. The answers to the questionnaire were in the form of a Likert scale. After refining the initial version, a total of 36 interviews were conducted at dental offices to verify the validity. For the Exploratory Factor Analysis (EFA), we used the Kaiser-Meyer-Olkin (KMO) index, the Bartlett sphericity test, and also Cronbach alpha coefficient for the validity of the questionnaire. RESULTS: The accuracy of the instrument was measured by intrarater and interrater reliability. For the EFA, all the communalities exceeded the threshold of 0.05. With a Cronbach's alpha coefficient of 0.898, the questionnaire has sufficient internal consistency. CONCLUSIONS: The questionnaire demonstrates robust reliability and validity, thereby affirming its suitability for its intended purpose.

The Use of 3D Technology in the Management of Residual Asymmetry following Orthognathic Surgery: A Case Report.

The purpose of this case report was to present the aesthetic result of the reconstruction of facial residual asymmetry after orthognathic surgery using a patient-specific three-dimensional (3D) mold and a custom-made polymethyl methacrylate implant. Through computer-aided design (CAD), the healthy contralateral side of the mandible was superimposed onto the side with the defect. Exocad Gallway (exocad GmbH, Darmstadt, Germany) was used to design the patient-specific implants (PSIs) of the right mandibular angle. Next, the implant mold was created using the Meshmixer software (Version 3.5, Autodesk Inc., San Rafael, CA, USA) and fabricated using additive manufacturing. During the surgical procedure, the patient-specific implant (PSI) was cast inside the resin mold using Simplex P bone cement (Stryker, Mahwah, NJ, USA). The implant was fixed using three screws. Combining both indirect (involving the dental laboratory) and direct (with surgical intervention) approaches, this innovative hybrid method, which incorporates both computer-aided design and additive manufacturing (AM), not only enhanced facial aesthetics, functional rehabilitation, and patient quality of life but also mitigated the potential risks linked to conventional grafting methods.

A Contemporary Review of Clinical Factors Involved in Speech-Perspectives from a Prosthodontist Point of View.

Background and Objectives: Learning to speak properly requires a fully formed brain, good eyesight, and a functioning auditory system. Defective phonation is the outcome of a failure in the development of any of the systems or components involved in speech production. Dentures with strong phonetic skills can be fabricated with the help of a dentist who has a firm grasp of speech production and phonetic characteristics. Every dentist strives to perfect their craft by perfecting the balance between the technical, cosmetic, and acoustic aspects of dentistry, or "phonetics". The ideal prosthesis for a patient is one that not only sounds good but also functions well mechanically and aesthetically. Words are spoken by using articulators that alter their size and form. Conclusions: Therefore, a prosthesis should be made in such a way that it does not interfere with the ability to communicate. As a result, a prosthodontist has to have a solid grasp of how speech is made and the numerous parts that go into it.

Advanced Techniques for Bone Restoration and Immediate Loading after Implant Failure: A Case Report.

The objective of this study was to report a clinical case of dental implant failure with significant bone loss that was treated using reconstructive surgical techniques. We present a 58-year-old man with a history of implant surgery and implant failure on the mandible. Data collected using cone beam computed tomography (CBCT) and intraoral scans were exported into Exoplan (exocad GmbH, Darmstadt, Germany), from which a standard tessellation file was obtained. To create a customized mandible mesh design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used. Based on guided bone regeneration, the method involved bone reconstruction and the application of a custom titanium mesh. The bone mix was obtained by combining a xenograft (Cerabone, Bottis biomaterials Gmbh, Zossen, Germany), an allograft (Max Graft, granules Bottis biomaterials Gmbh, Zossen, Germany), and an autograft. The titanium meshes were fixed to the bone using self-drilling screws and covered with a resorbable membrane. Immediately after surgery, an impression was recorded, and the next day, the patient received a milled polymethyl methacrylate interim denture. Based on our case study, the presented custom-made implant can be considered a temporary solution, during which guided bone regeneration is expected to take place.

Experimental Study on Mechanical Properties of Different Resins Used in Oral Environments.

Background and Objectives: Acrylic resins remain the materials of choice for removable prosthesis due to their indisputable qualities. The continuous evolution in the field of dental materials offers practitioners today a multitude of therapeutic options. With the development of digital technologies, including both subtractive and additive methods, workflow has been considerably reduced and the precision of prosthetic devices has increased. The superiority of prostheses made by digital methods compared to conventional prostheses is much debated in the literature. Our study's objective was to compare the mechanical and surface properties of three types of resins used in conventional, subtractive, and additive technologies and to determine the optimal material and the most appropriate technology to obtain removable dentures with the highest mechanical longevity over time. Materials and Methods: For the mechanical tests, 90 samples were fabricated using the conventional method (heat curing), CAD/CAM milling, and 3D printing technology. The samples were analyzed for hardness, roughness, and tensile tests, and the data were statistically compared using Stata 16.1 software (StataCorp, College Station, TX, USA). A finite element method was used to show the behavior of the experimental samples in terms of the crack shape and its direction of propagation. For this assessment the materials had to be designed inside simulation software that has similar mechanical properties to those used for obtaining specimens for tensile tests. Results: The results of this study suggested that CAD/CAM milled samples showed superior surface characteristics and mechanical properties, comparable with conventional heat-cured resin samples. The propagation direction predicted by the finite element analysis (FEA) software was similar to that observed in a real-life specimen subjected to a tensile test. Conclusions: Removable dentures made from heat-cured resins remain a clinically acceptable option due to their surface quality, mechanical properties, and affordability. Three-dimensional printing technology can be successfully used as a provisional or emergency therapeutic solution. CAD/CAM milled resins exhibit the best mechanical properties with great surface finishes compared to the other two processing methods.

Managing Predicted Post-Orthognathic Surgical Defects Using Combined Digital Software: A Case Report.

For facial abnormalities, recent developments in virtual surgical planning (VSP) and the virtual design of surgical splints are accessible. Software companies have worked closely with surgical teams for accurate outcomes, but they are only as reliable as the data provided to them. The current case's aim was to show a fully digitized workflow using a combination of three digital software to correct predicted post-upward sliding genioplasty defects. To reach our goal, we presented a 28-year-old man with long-face syndrome for orthodontic treatment. Before orthognathic surgery, a clinical and paraclinical examination was performed. For a virtual surgical plan, we used the dedicated surgical planning software NemoFab (Nemotec, Madrid, Spain) and Autodesk MeshMixer (Autodesk Inc., San Rafael, CA, USA). To create the design of the digital guides, DentalCAD 3.0 Galway (exocad GmbH, Darmstadt, Germany) and Autodesk MeshMixer (Autodesk Inc., San Rafael, CA, USA) were used. The patient had undergone bilateral sagittal split osteotomy in addition to Le Fort 1 osteotomy and genioplasty, followed by mandible base recontouring ostectomy. Stable fixation was used for each osteotomy. Based on our case, the current orthognathic surgery planning software was not able to perform all the necessary operations autonomously; therefore, future updates are eagerly awaited.

Evaluation of Knowledge and Practice of Resident Dentists in Iasi, Romania in the Management of Traumatic Dental Injuries: A Cross-Sectional Study.

Dentists play an essential role in the treatment of dental and periodontal traumatic injuries by providing early and correct treatment. The purpose of the present study was to assess the level of knowledge of dental residents regarding dental trauma. The cross-sectional study was conducted at the Faculty of Dental Medicine within the "Grigore T. Popa" University of Medicine and Pharmacy in Iasi, Romania on a sample of 366 residents in General Dentistry, Pediatric Dentistry and Periodontology. To assess their knowledge, a questionnaire was created containing 18 questions about the clinical signs and therapy of dental trauma, with a focus on tooth avulsion. A very low level of knowledge (<25%) was found only for the type of splinting required to maintain an avulsed tooth on the arch. The highest number of correct answers was provided by the residents in Periodontology. Physiological serum as storage medium was recognized by a percentage of 75.9-80% of the subjects, and 60-77% of them recognized pulp necrosis as complication of dental avulsion. The study underlines the need to introduce in the curriculum of all categories of residents additional information, not only in the already existent theoretical form, but also as possible scenarios of various clinical situations.

Does the Loss of Teeth Have an Impact on Geriatric Patients' Cognitive Status?

Significant changes in the microstructure of the brain cause dementia and other mental declines associated with aging and disease. Although research has established a connection between oral health and dementia, the underlying pathologic mechanisms are still unknown. AIM: Our aim was to evaluate dentures' impact on the cognitive state of geriatric patients. MATERIAL AND METHODS: A total of 108 individuals seeking treatment at the Faculty of Dental Medicine in Iasi, Romania, participated in the study, which ran from May 2022 to October 2022. Cognitive dysfunction was assessed using the Mini-Mental State Examination. The acquired data were analyzed with IBM SPSS 26.0, and the p-value was set at 0.05. RESULTS: The average value of the MMSE score was 21.81 ± 3.872. Differences between groups of wearer/non-wearer subjects were statistically significant for most of the questions in the questionnaire. Linear regression analysis showed that individuals with a high MMSE score have prosthodontic treatment. A decrease in the MMSE score is associated with a decrease in masticatory efficiency (B = 1.513, p = 0.268). CONCLUSIONS: This study provides further evidence that tooth loss is associated with worse cognitive performance. It is thus conceivable that the necessary effects can be achieved by increasing the efforts dedicated to preventing tooth loss in the adult population.

The Involvement of Photobiology in Contemporary Dentistry-A Narrative Review.

Light is an emerging treatment approach that is being used to treat many diseases and conditions such as pain, inflammation, and wound healing. The light used in dental therapy generally lies in visible and invisible spectral regions. Despite many positive results in the treatment of different conditions, this therapy still faces some skepticism, which has prevented its widespread adoption in clinics. The main reason for this skepticism is the lack of comprehensive information about the molecular, cellular, and tissular mechanisms of action, which underpin the positive effects of phototherapy. However, there is currently promising evidence in support of the use of light therapy across a spectrum of oral hard and soft tissues, as well as in a variety of important dental subspecialties, such as endodontics, periodontics, orthodontics, and maxillofacial surgery. The merging of diagnostic and therapeutic light procedures is also seen as a promising area for future expansion. In the next decade, several light technologies are foreseen as becoming integral parts of modern dentistry practice.

Various Surgical Interventions in Treating Odontogenic Keratocyst: A Radiological Case Report.

The odontogenic keratocyst (OKC) is among the most aggressive odontogenic cysts because of its high recurrent rate. This study's objective was to describe a 7-year radiological and clinical follow-up of an OKC with two recurrences and a combination of surgical treatments. The cyst contents were drained at the biopsy to allow decompression, and then marsupialization (Partsch I) was carried out with good results. In the following two years, the endodontic and radiological evaluation of the neighboring teeth indicated endodontic avoidance. The remaining OKC enucleation (Partsch II) with chemical curettage and suture was performed two years after the first presentation, and the multifocal recurrences developed were also treated by enucleation and chemical curettage. At the last radiological follow-up, no recurrence was evident. Based on our experience, we concluded that patients diagnosed with a OKC should be radiologically evaluated at least once a year for at least 7 years, the endodontic diagnosis and treatment of neighboring teeth should be performed as early as possible, and the combination of surgical treatment and the long follow-up period is challenging.

Customized 3D-Printed Titanium Mesh Developed for an Aesthetic Zone to Regenerate a Complex Bone Defect Resulting after a Deficient Odontectomy: A Case Report.

Background and Objectives: Alveolar ridge augmentation in the complex bone defect is a popular topic in implantology. Guided bone regeneration (GBR) is one of the most commonly applied methods to reconstruct alveolar bone. The application of a membrane is the fundamental principle of GBR. There are many membrane types used in oral surgery, but the advantage of the titanium mesh is the rigidity which provides space maintenance and prevents contour collapse. The smooth surface also reduces bacterial contamination. Using computer-aided design (CAD) and computer-aided manufacturing (CAM) in dentistry allows us to obtain the perfect architecture form of the mesh, which covers and protects the bone reconstruction. Case presentation: We present a surgical case of a 27-year-old female patient with severe aesthetic bone atrophy after a deficient odontectomy. Based on the GBR clinical applications, the technique consists of bone reconstruction and a customized titanium mesh application. Using mesh titanium in this case presentation was a reliable alternative to perform a lateral alveolar bone augmentation and reconstruct ridge deformities before reaching an ideal implant placement. Conclusions: According to our case report, the customized titanium mesh could be a valuable option for guided bone regeneration in aesthetic maxillary defects.

A Comparative Analysis of Dental Measurements in Physical and Digital Orthodontic Case Study Models.

Background and Objectives: Study models are essential tools used in the dental teaching process. The aim of the present study was to compare the values obtained by manual and digital orthodontic measurements on physical and digital case study models. Materials and Methods: The physical experimental models were obtained by traditional pouring (improved stone-type IV gypsum products) and by additive manufacturing (resins). The digital experimental models were created by scanning the physical ones, using a white light-emitting diode (LED) source and an L-shaped dental scanner­Swing DOF (DOF, Seoul, Korea). The physical study models were first measured using a digital caliper, and then, they were scanned and evaluated using the DentalCad 3.0 Galway software (exocad GmbH, Darmstadt, Germany). The Pont, Linder−Harth, and Bolton indices, which are used in orthodontics for training students, were derived using the available data. Results: When comparing the linear measurement mean ranks taken on physical study models to those of digital models, no statistically significant differences (p > 0.05) were found. A similar result was also shown when the dentoalveolar growth indicators were analyzed. Conclusions: It can be concluded that dental study models made by direct light processing (DLP) and pouring type IV class gypsum are both acceptable for orthodontic teaching purposes.

Knowledge, Practice, and Awareness of Oral Cancer and HPV Infection among Dental Students and Residents: A Cross-Sectional Study.

Background and Objectives: Dentists play a very important part in the early identification of oral cancer lesions. This aspect of dental practice depends on the knowledge acquired during the faculty years. The aim of this study was to assess dental students' and residents' levels of awareness in terms of oral cancer. Materials and Methods: The cross-sectional study was conducted at the Faculty of Dental Medicine within the "Grigore T. Popa" University of Medicine and Pharmacy in Iasi, on a sample of 197 students in the fourth and the fifth years and first year residents in general dentistry. To assess their knowledge, a questionnaire was created containing 22 questions about the risk factors for oral cancer, with a focus on HPV infection. Results: Most participants correctly identified smoking, alcohol, and the HPV infection as risk factors and leukoplakia and erythroplasia as potentially malignant lesions. At the opposite site, aspects considered as unsatisfactory focused on the palpation of lymphatic nodules, a procedure largely carried out by 41.6% of the fourth year students, the counseling only of the patients at risk performed by 59.7% of residents, the lack of knowledge about the prevention of oral cancer through anti-HPV immunization found in 39.7% of the fifth year students. Other incorrect answers focused on other types of suspicious lesions, such as actinic cheilitis, as well as certain areas in the oral cavity subject to the frequent onset of oral cancer, such as buccal mucosa. Conclusions: Although the fifth year students and residents have better knowledge than the fourth year students, the gaps in terms of knowledge and practice encountered in all three categories of participants require a reevaluation of the academic curriculum and the focus on the building of the skills necessary for the correct screening of oral cancer.

An Interdisciplinary Study Regarding the Characteristics of Dental Resins Used for Temporary Bridges.

Background and Objectives: The surface condition of the materials that are used for temporary prostheses influences their microbial colonization, with a direct impact on the oral tissues. This study aims at a comparative analysis of three types of resins for temporary bridges using conventional and digital technologies. The attention was focused on the analysis of the surface characteristics and mechanical strength of these materials. Materials and Methods: The surface condition was assessed for three distinct materials both before and after polishing- heat-curing resin Superpont C + B (SpofaDental, Jicin, Czech Republic) used unconventional technology, Zotion dental milling polymethyl methacrylate (PMMA) block (Zotion, Chongqing, China) for provisional crowns/bridges used in digital subtractive technologies and Freeprint Temp (Detax GmbH & Co. KG, Ettlingen, Germany) resin for temporary crowns and bridges that are used in 3D printing technologies. The two-way ANOVA analysis indicated that polishing leads to a statistically significant increase in roughness coefficients for all the three resins that were tested (p < 0.001). While the highest roughness coefficients were displayed in the 3D cured sample, the largest decrease was reported by the milled sample Results: The results revealed that surface roughness was significantly influenced by both the type of resin that was used (p < 0.001) and the treatment that was induced by finishing and polishing (p < 0.001). Similar p-values were obtained for each of the three resins. Conclusions: The results demonstrated a significant optimization of the surfaces after finishing and polishing and statistically significant differences between the surface parameters and the mechanical properties of the samples. The low values of the roughness and the acceptable values of the mechanical resistance for the conventional samples indicate these materials for the long-term temporary bridge's realization, allowing the correct restoration of the functions and the rehabilitation at the oral level.

Quality of Life of Complete Denture Wearers-A Comparative Study between Conventional Dentures and Acrylic Dentures with Vitamin B12 Incorporated.

Background and objectives: This paper is a sequel to the studies that focused on the optimization of the structure of classical acrylates with vitamin B12 as a template and their impact on patients' general and local health. In this context, we aim to investigate the relationships between attitudes and behavior regarding oral health, oral health status, and quality of life related to oral health in the case of patients with conventional dentures and those with dentures improved with vitamin B12. Material and Methods: The sample size was estimated from previous studies, and 252 participants were enrolled and divided into two groups, one of which received as a treatment complete dentures with B12, and the other group was represented by complete edentulous patients treated with conventional complete dentures. The impact of oral health in general on patient satisfaction and quality of life was assessed using Oral Health Impact Profile OHIP-14 questionnaires. The descriptive statistical analysis was performed using SPSS 20.0. A value of p < 0.05 was considered statistically significant. Results: Differences registered between the two groups were statistically significant in all evaluated dimensions. The largest differences were recorded for physical, psychological, and social disability as well as for the level of disability, all in favor of denture B12 wearers. Conclusions: The materials used in the treatment of complete edentation can be a future research direction that can not only improve their mechanical strength but can contribute to maintaining the superior health of the oral mucosa and can also be a way of transporting substances necessary for the normal development of the metabolism of the whole body, such as vitamin B12 in our case.

[Influence of finishing techniques on the surface roughness of metallic components of prosthetic restorations]. / Influenta tehnicilor de finisare asupra rugozitatii suprafetelor componentelor metalice ale restaurarilor protetice.

UNLABELLED: The paper proposes to examine the influence of mechanical and electrolytic finishing techniques on metal surface roughness. MATERIAL AND METHOD: Six non-noble dental alloys and three versions of finishing have been taken into consideration: mechanical polishing with rubber polisher, mechanical polishing with cotton polisher and abrasive paste and electrolytic polishing. Examinations on roughness have made reference to Rz, Ra and Rq. RESULTS: The experimental results obtained have shown that mechanical polishing with rubber polisher is recommended for Co-Cr-Mo alloys, while mechanical polishing with cotton polisher and abrasive paste or electrolytic polishing are suited for Ni-Cr alloys. CONCLUSION: Analysis of values obtained led to formulation of recommendations concerning the best polishing method for each non-noble alloy considered.