Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review.

Effective subgingival biofilm removal is crucial for achieving positive and stable outcomes in periodontal therapy, forming an indispensable part of any periodontal treatment approach. The development of air-polishing tools has emerged as a promising alternative to hand and ultrasonic scalers for dental biofilm removal. The objective of this systematic review was to assess existing literature regarding the subgingival use of various types of air-polishing powders, as an effective method of subgingival biofilm control. For this, 55 articles on this subjected were sourced from searched databases and subjected to an evaluation process of their contained information, which was subsequently structured and compiled into this manuscript. The existing literature acknowledges that good subgingival biofilm control is essential for the success of periodontal therapy, including through subgingival air-polishing, as an adjunctive procedure. This approach has the potential to enhance patient comfort during and after subgingival mechanical plaque removal, thereby mitigating damage to periodontal structures. Consequently, it may lead to improved healing capabilities within the periodontal tissues and the formation of a more stable reparative gingival junctional epithelium.

Applications of Optical Coherence Tomography in the Diagnosis of Enamel Defects.

Developmental defects of enamel (DDEs) are deviations from the normal appearance in terms of the quantity and quality of tooth enamel. They may be genetic or acquired. The most important DDEs are hypomineralization and hypoplasia. The aim of this study was to produce "in vivo" DDE in Wistar rats by administering amoxicillin to pregnant females and to highlight these lesions after sacrifice of the pups by macroscopic and microscopic examination and optical coherence tomography (OCT). Amoxicillin (100 mg/kg) was administered to two pregnant Wistar female rats for the production of DDEs. When the pups were 2 months old, they were sacrificed, and their jaws were harvested together with their teeth. The jaws were examined macroscopically, microscopically, and by OCT. Following the macroscopic and microscopic examination, it was established that four pups had a total of 42 DDE lesions. At the OCT examination, the hypomineralization was characterized by an intense, inhomogeneous OCT signal, and the hypoplasia was characterized by the absence of the signal. Administration of amoxicillin to pregnant females of Wistar rats resulted in DDEs in their offspring. The OCT examination confirmed the presence of these lesions in the teeth of rat pups.

A rare case of transmigrated mandibular canine and combined orthodontic-surgical management.

Canines are paramount teeth for esthetics and function. Transmigration of the lower permanent canine is a rare process of alteration of the eruption path toward the opposite part of the mandible. The position of the migrating tooth varies at different ages, so early detection of the tendency to cross the midline is crucial; canines that have already passed through the center of the mandible can be impossible to realign. Transmigration can start any time before the normal age of eruption. Comparing two radiographic images taken at different ages offers important diagnosis information. Camilleri & Scerri (2003) described a progressive alteration of the tooth position in four steps, from the normal appearance to a low position inside the corpus of the mandible. Following this classification, this article's aim was to present a case of an impacted lower canine that was diagnosed between the second and third stage of transmigration, around the age of 10, and to detail the combined orthodontic-surgical treatment strategy for "recapturing" and the orthodontic mechanics used to align it. After the examination of cone-beam computed tomography, we have decided to use a lingual arch as a space maintainer and anchorage tool and to surgically expose the tooth. The canine's initial position and the direction of the force of traction used allowed a proper alignment of the tooth inside the dental arch. The periodontal tissues management was important for good healing, stability, and aesthetics. The early detection allowed a proper interdisciplinary orthodontic-surgical management, and a successful outcome.

Oral Health, Nutritional-Related Patterns and Body Mass Index in Children.

Regarding the influence of obesity on general health of children, scientific literature showed the importance of early management of children's overweight. In terms of oral health, overweight and obese children were shown to have accelerated dental development and increased prevalence of caries. OBJECTIVES: The aim of the present study is to evaluate the influence of Body Mass Index (BMI) and dietary behaviors on the oral status, eruptions and hygiene in children. MATERIAL AND METHODS: Ninety-two children aged 6-12 years were investigated about the oral hygiene habits, nutritional related behaviors, presence of systemic diseases. Values of BMI and oral status were noted. Statistical analysis was performed. RESULTS: Significant moderate correlations between the values of BMI with tooth eruption and weak but significantly with dental lesions were determined. CONCLUSIONS: The dietary behaviors and BMI could influence the oral status, eruptions and oral hygiene in children.

Periodontal clinico-morphological changes in patients wearing old nickel-chromium and copper alloys bridges.

Elderly population frequently presents more than one prosthetic restoration realized from different types of dental alloys which, in time, suffer various alterations in the oral environment. Metallic ions are released in saliva due to its electrolytic qualities, interacting with the contact tissues. Studies regarding cytotoxicity of dental alloys are providing contradictory results. Besides biocompatibility, the microbial factor is also greatly influencing the long-term success of the prosthetic rehabilitation. This study's aim was to assess the response of the gingival tissue to nickel-chromium (Ni-Cr) and copper (Cu)-based dental casting alloys from fixed dentures present in many patients from Romania. Gingival samples were taken from 124 patients wearing fixed dental restorations made from these two types of alloys from injured areas surrounding the abutment teeth; histological specimens were prepared, fixed in 10% neutral buffered formalin, paraffin-embedded and stained with Hematoxylin-Eosin (HE). Histological analysis showed the existence of a chronic inflammatory infiltrate in the gingival chorion, necrosis areas, and vascular congestion. Various morphological alterations appeared, depending on the intensity of the inflammation and the immune response. The surface epithelium suffered a hyperplasic reaction, either limited to acanthosis or involving the whole epithelium, the release of the Cu(2+) and Ni(2+) ions from the dental alloys used in bridges and crowns being responsible for inducing gingival hyperplasia and a chronic inflammation in the areas situated around the abutment teeth. The immunohistochemical study allowed us to observe an increased number of positive cluster of differentiation 3 (CD3) T-lymphocytes in periodontium, proving that the cellular immune response is rapid and intense.

Suspicions of titanium allergic reaction influencing the prosthetic solution in a rare case of implant "flowering".

The aim of this paper is to eliminate suspicions of a titanium (Ti) allergy in a rare case of "flowered" implant in a 43-year-old female patient with metal allergies and no history of bruxism, using a histological and immunohistochemical (IHC) analysis to determine the phenotype of cells that participated in the immune response; also, to assess the prognosis of a future implant treatment and to highlight the psychological impact of osseointegrated implant failure caused by fracture, and the influence that the necessity to use extensive surgical procedures for reimplantation can have on the treatment solution chosen by the patient. The results of our IHC analysis did not indicate a clear response for a potential Ti allergy; still, due to psychological reasons, the patient rejected the replantation and considered the use of other restorative option, a three-unit bridge, as being the most appropriate for her. Considering her opinion and attitude, the fixed prosthetic denture assured the therapeutic success.

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.

A rare case of mandibulary parapremolars in siblings: case report and literature review.

Supernumerary teeth in permanent dentition are influenced by hereditary and environmental, having clinical variations such as location, number and morphology. Parapremolars can be found as a single supernumerary tooth or as multiple, usually in the lower jaw, sometimes in association with other types of supernumerary teeth. Familial inheritance often involves more than one generation. This paper presents a case of two brothers, one with only one parapremolar and a good oral status and hygiene, the other with poor hygiene, multiple parapremolars and one mesiodens, causing various complications. The aim of this paper is to show the presence of parapremolars in brothers with no other medical relevant history, located in the same site, and to point the influence of genetic factors in the etiology of supernumerary teeth. Along with a review of the literature, this article shows the importance of an early diagnosis and follow-up using successive panoramic radiographs of such cases, in order to limit or prevent the inflammatory, carious, periodontal and occlusal complications that can seriously affect both the jaws and the normal dentition.

Maxillary distomolars: case reports, differential diagnosis and literature review.

Supernumerary teeth can be found anywhere in the oral cavity, during deciduous or permanent dentition, in males and females. They are rare, owned to various genetic or environmental factors and usually impacted. This article first reports three cases of young adult patients coming to the office for other reasons than their maxillary distomolars and without any pathology caused by them. The decision of keeping or removing these teeth was made based on other associated factors. The fourth case is one of a 40-year-old partially edentulous male patient, also with a good general health and no other associated condition, having a unilateral maxillary fourth molar; it was small, only partially erupted, with a normal morphology with crown and root and an impacted perpendicular position on the distal face of the third molar. It was extracted because of the periodontal and carious complications that it caused to the third molar facing it. The last reported case is a 64-year-old partially edentulous female patient with a maxillary tooth very similar to a distomolar because of its form and position; it was extracted because it interfered with the new removable partial denture treatment plan. The differential diagnosis between a distomolar and an anatomical variant of a third molar was difficult to make even using panoramic X-ray, also because of a very small inferior third molar. In young patients, distomolars are rather accidentally discovered during radiographic examination; later in life, they can cause both pathological issues and difficulties in diagnosis and prosthetic treatment.

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.

Morphological and clinical characteristics of the torus palatinus and torus mandibularis in a sample of young and adults' Romanian people.

The oral exostoses are protuberance located on the alveolar surfaces of the jawbones with nodular, flat or pedunculated shape. The purpose of this study was to highlight the variability of the morphological and clinical characteristics of torus palatinus (TP) and torus mandibularis (TM) in a sample of young and adults' Romanian people. The study was conducted on 74 participants examined in Dental Prosthetics Clinic of the Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Romania, during October-December 2014. The morphological characteristics of the tori were non-metrical evaluated by the standard procedures of the clinical examination. Descriptive statistics only including means, averages and percentage incidence have been used to describe the results. Of the 74 study participants, 31 (41.89%) were males and 43 (55.40%) were females. Six had only TP, seven had only TM and three participants had both TP and TM. The most of the palatal tori had spindle shaped, located in all area of the hard palate The round mandibular tori with big size were located in the area of both premolars, and those with elongate shape were located in the canine-premolars area. The palatal tori were more frequently in women and the frequency of mandibular tori was equally in men and women. Most of the palatal tori had spindle shape and most of the mandibular tori were solitary bilateral.

Immunohistochemical study of the epithelial and stromal components of Warthin's tumor.

Warthin's tumor is a benign monomorphic adenoma with unclear origin with the highest incidence in the sixth and seventh decades. The analysis of tumor markers involved in the pathogenesis of Warthin's tumor can improve the patients' prognosis. This study included 29 cases of Warthin's tumor, which were histopathologically and immunohistochemically examined for different compartments of tumors. For immunohistochemical study, we used as specific markers for epithelial compartment CD117, CEA and AMA, respectively S100 and D2-40 for the stromal compartment. The evaluation of immunoreactions was performed by semiquantitative analysis. The analysis of the CEA, CD117 and AAM immunoexpression allowed observing various patterns of immunostaining for tumor double-layered epithelia, which has the tendency of being similar to that in the normal ductal epithelia. S100 protein positivity similar to Langerhans cells suggests that delayed hypersensitivity can be involved in tumor development. The presence of D2-40 expression in majority of tumor subcapsular vessels, similar to lymph nodes structure, confirms the hypothesis that Warthin's tumor has its origin in regional lymph nodes.

Effects of therapy with two combinations of antibiotics on the imbalance of MMP-2÷TIMP-2 in chronic periodontitis.

UNLABELLED: Periodontitis represents a chronic bacterial infection that induces immuno-inflammatory conditions affecting gingiva and tooth-supporting tissues. The role of some biological mediators in periodontal disease was widely investigated, especially that of MMP-8 and MMP-9. Recently, MMP-2 was also considered to be an appropriate therapeutic target for prevention of periodontal disease progression. However, effects of the combination of metronidazole with amoxicillin or spiramycin on the release and activation of MMP-2 and the balance MMP-2÷TIMP-2 were rarely studied. This study was designed to assess the influence of two combinations of antibiotics used for treatment of periodontitis on the balance MMP-2÷TIMP-2. Gingival samples obtained from patients with no pharmacological treated chronic periodontitis and those receiving either the association between amoxicillin-metronidazole and spyramicin-metronidazole were processed for paraffin embedding and then used to perform immunohistochemical reactions in order to detect MMP-2 and TIMP-2. All subjects were evaluated clinically and radiographic at the first visit and after treatment completed, the Loe & Silnees gingival index at six sites per tooth for the whole mouth being recorded. Statistical analysis was performed using non-parametrical techniques. Gingiva samples from untreated chronic periodontitis patients revealed a diffuse positive reaction for MMP-2 in the epithelium and also in fibroblasts and macrophages from the lamina propria. For gingiva samples from patients treated with antibiotics, MMP-2 positive reaction was restricted to deep epithelial layers and few cells of the connective tissue. No significant difference was observed for TIMP-2 expression. The clinical indexes were in accordance with immunohistochemical results. After treatment, gingival index values were significantly lower then before (p<0.001) in both groups treated with antibiotics. CONCLUSIONS: The two combinations of antibiotics tested in our study seem to have a dual ability to reduce inflammation as well as to inhibit MMP-2 activity.

Changing the root morphology in a case of periodontal impairment at a maxillary molar used as a sustaining tooth.

Research evolution regarding dental research determines the increase of patient's desire to preserve their dentition for a long time. The loss of a molar tooth as the last teeth present on the dental arch, raises issues regarding how the prosthesis should be placed, still patients are usually reluctant to use as last resort the prosthetic solution. This article describes the technique of root amputation to save a maxillary molar used as bridge abutments.

Restoration of molar morphology with a split cast post and core.

The teeth with extensive coronal destructions due to carious process can be saved by using split cast post and core. This technique has been used for a long time and with positive results recognized by many authors. The clinical case presented here describes indirectly the reconstitution technique with split cast post and core with latch of a maxillary molar with divergent roots and extensive coronal destruction both in area and depth.

Immunohistochemical expression of CK7, CK5/6, CK19, and p63 in Warthin tumor.

Our study included a number of 24 cases with Warthin tumor, diagnosed between 2007-2011, which were analyzed in terms of clinical, histopathological and immunohistochemistry point of view, using CK7, CK5/6, CK19, and p63 antibodies. Warthin tumor is most often a tumor with a slow evolution, painless, usually affecting males (M/F 3.2/1) in the seventh decade of life. Histopathologically, it is distinguished the predominance of the typical forms of the tumor, with a balanced ratio epithelium/stroma. The immunostaining for CK7 showed positivity in all the investigated cases both in the columnar luminal cells and basal cells. The immunostaining for CK5/6 was positive in all the investigated cases in bilayer epithelial basal cells, both in the structure of the cysts and the papillae. In the case of the immunostaining for p63 we noticed limited nuclear positivity in the basal cells, while the columnar cells' nucleus were negative. The immunohistochemical study of the bilayer epithelial component of Warthin tumor showed different immunstaining of the two types of epithelia, the oncocytary columnar and the basal on, similar to those found in the salivary gland ducts.

The failures of root canal preparation with hand ProTaper.

UNLABELLED: The failures of root canal preparation are due to some anatomical deviation (canal in "C" or "S") and some technique errors. The technique errors are usually present in canal root cleansing and shaping stage and are the result of endodontic treatment objectives deviation. OBJECTIVES: Our study was made on technique errors while preparing the canal roots with hand ProTaper. METHODOLOGY: Our study was made "in vitro" on 84 extracted teeth (molars, premolars, incisors and canines). The canal root of these teeth were cleansed and shaped with hand ProTaper by crown-down technique and canal irrigation with NaOCl(2,5%). The dental preparation control was made by X-ray. RESULTS: During canal root preparation some failures were observed like: canal root overinstrumentation, zipping and stripping phenomenon, discarded and/or fractured instruments. CONCLUSIONS: Hand ProTaper represents a revolutionary progress of endodontic treatment, but a deviation from accepted rules of canal root instrumentation can lead to failures of endodontic treatment.

Whitening non vital teeth - a case report.

Commonly used in cosmetic dentistry teeth whitening can be used combined with other restorative techniques during dental treatment. Non-vital teeth whitening is necessary whenever we need an improvement of their aspect, as it's a known fact that these teeth can have a grey or pink-grey coloration when they are not correctly endodontical treated.

Considerations on dental bridges' stability and balance for mandibulary teeth with coronary-root amputation.

Dental occlusion represent the function of dentomaxillary system at which realization participate all the components of that system holding the equilibrium between them. Setting up the treatment with dental bridges in partial edentuluous is rule by some principles that have aims like restore the morphology and functions change by edentuluous condition and also prevention disorders of remaining teeth and other structures and functions of dentomaxillary system. During the prosthetic treatment with fixed bridgeworks in clinical cases presents in this study , we used also terapeutical techniques specifically other dental domains like endodontology and oral surgery. For avoid the appearance of occlusal dysfunction is necessary a good knowledge and respecting the biomorphocinematic behaviour of dentomaxillary system structure under action of occlusal force during mastication and also biomechanical rules that influence the functional equilibrium of teeth and dental bridges.

Warthin tumor--morphological study of the stromal compartment.

Warthin tumor is the second most common benign tumors of the parotid gland, after pleomorphic adenoma. Our study was performed on 21 cases with Warthin tumor diagnosed between 2005-2010, which were analyzed clinically, histologically and immunohistochemically, using anti-CD20 and anti-CD45RO antibodies. The analysis of age distribution within the investigated cases indicated that Warthin tumor incidence is increasing in the seventh decade of life, most patients being male (M/F 5/2). Histopathological, the analysis report of stroma÷parenchyma in 14 cases revealed a balanced distribution of the two components, in four cases, the epithelial component was predominant and in three cases, the stromal component was predominant. Immunohistochemical study for the two specific lymphocyte proliferation markers indicated positivity for both epithelial component and stroma. Cell layout of CD45RO and CD20cy at the level of lymphoid stroma had a similar pattern with normal or reactive lymph nodes.