The Evaluation of the Cervical Marginal Sealing of Direct vs. Indirect Composite Resin Restorations in MOD Cavities.

INTRODUCTION: The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities. MATERIAL AND METHOD: MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05. RESULTS: Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C). CONCLUSIONS: The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

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.

An Observational Study on Oral Health and Quality of Life for RPD Wearers in the N-E Region of Romania.

There is a lack of information regarding the oral health of the elderly population in Romania; only a few articles have been published about their edentulism, and there are no official data regarding the oral health, OHRQoL, and prosthodontic status of this population. The objective of this study was to assess the relationship between the essential functional qualities of removable partial dentures (RPD) and participants' oral-health-related wellbeing among an edentulous population from the N-E region in Romania using the OHIP-5-questionnaire. In total, 546 patients from Gr. T. Popa Iasi University were enrolled after following a set of sorting procedures. We used the Kruskal-Wallis test and the Mann-Whitney test to determine whether there were significant differences between the various groups of patients. For questions 1, 2, 3, and 5 of the OHIP, the null hypothesis was rejected, as there were statistically significant differences between the three groups. This study was limited to a specific group. However, it can provide an insight into RPD patients' happiness when treated in an academic environment.

Moldova Region Population Study of Social Cases Affected by Partial Edentation.

As the number of partially edentulous patients grows, so will the demand for removable partial dentures (RPDs) in clinical practice because it is a safe, conservative, and cost-effective alternative that provides good plaque control but necessitates periodic maintenance visits. The goal of this research was to look at the incidence of partial edentulism, RPD type, design, and components, as well as their frequency of use, among patients at the Dental Faculty's Department of Partial Dentures in Iasi.

Trends in Access to Oral Health Care among Adults from the N-E Region of Romania.

Aims and Objectives: To investigate the trends in access to dental services among adults from the N-E region of Romania and to evaluate the factors that influence access to dental care. Material and Methods: A self-administered questionnaire was used to evaluate the access and utilization of dental care among a sample of adults. We collected data on their demographic characteristics, their type of medical insurance, their monthly income, the type of dental office they visited, their reasons for choosing a certain type of dentist office, and their oral hygiene habits. It was found that their financial status determined by the occupation of the individual, as well as their monthly income, influenced their access to medical services. Data were analyzed using SPSS 20.0. Results: Of a total of 696 participants, 55.6% were female, 83.3% were from urban areas, 42.1% were retired, 62.3% of the subjects utilized dental emergency services, and 67.9% of the subjects self-funded their treatment. The reasons for women not attending dental offices included costs (24.3%) and dental fear (9.8%), while men's reasons were high costs (26.4%) and lack of time (5.9%). Significant differences were recorded between gender and reasons for visiting the dentist (p = 0.018), payment for dental services (p = 0.009), and preferred clinic (p = 0.010). In relation to occupation, there were significant differences for most of the variables evaluated (reasons to visit a dentist, payment for dental services, preferred dental clinic, self-rated oral health, etc.). Conclusions: Gender, occupation, and monthly income levels were found to influence access to dental medicine services of Romanians in the N-E region. Dental services were frequently accessed for emergency reasons. Dental services were found to be paid for by state insurance for those with low monthly incomes and self-funded for those with higher monthly incomes.

Influence of Implant Dimensions in the Resorbed and Bone Augmented Mandible: A Finite Element Study.

AIMS: The scope of this study was to analyze the influence of clinically feasible implant diameter and length on the stress transmitted to the peri-implant bone in the case of a resorbed and bone augmented mandible through finite element analysis. SETTINGS AND DESIGN: The study was carried out in silico. SUBJECTS AND METHODS: Resorbed and bone-augmented 3D models were derived from in vivo cone-beam computed tomography scans of the same patient. Corresponding implant systems were modeled with the diameter ranging from 3.3 to 6 mm and length ranging from 5 to 13 mm, and masticatory loads were applied on the abutment surface. STATISTICAL ANALYSIS USED: None. RESULTS: In the bone augmented ridge, maximum stress values in the peri-implant region drastically decreased only when using implants of a diameter of 5 mm and 6 mm. Implants up to 4 mm in diameter led to comparable stress values with the ones obtained in the resorbed ridge, when using the larger implants. The increase of length reduced stress in the resorbed mandible, whereas in the bone augmented model, it led to small variations only in implants up to 4 mm in diameter. CONCLUSIONS: It was concluded that bone augmentation provides the optimal framework for clinicians to use larger implants, which, in turn, reduces stress in the peri-implant region. Diameter and length play an equally important role in decreasing stress. Implant dimensions should be carefully considered with ridge geometry.

Importance of Dental Maxillofacial Aesthetics in Dental Therapy.

The recent development of aesthetic dentistry reflects a concentration of the dentists' concern for satisfying patients' requests for an aesthetic appearance of their teeth. Modern dentistry combines medical treatment with the art of aesthetic restorations. Over the years, the restoration of the facial harmony has changed its character, from random to necessary, and from optional to compulsory, as the aesthetic defects have become less and less accepted. Aim: Contributions to understanding the principles that must be respected in dental-facial aesthetics and their application in various accessible prosthetic techniques that lead to significant improvement of the aesthetic appearance of the final restoration. Material and methods: The study included 22 (aged 40 to 80 years) patients (mean age: 60 years), presenting to the Department of Clinical Dentistry for different types of prosthetic restorations. Results and discussions: Taking into consideration the aesthetic principles and criteria, the prosthetic restorations in two similar clinical situations were performed using a different methodology. Conclusions: To grant the actual interventions the necessary provisions of true clinical success, the dentist must have and develop the skills that allow him/her to be valued as both a scientist, and an artist.

Malpraxis risk management in implantology.

In present practice there is an increased demand from patients for prosthetic implant restoration solutions. At the same time one can notice a possible vulnerability regarding allegations of malpractice, as evidenced by the growing number of complaints of malpractice also maintained by negative reports, frequently incomplete or incorrectly documented from the press. This should require practitioners to have a professional attitude.

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.

[Surface aspect of fixed restaurations and parodontal influences]. / Starea de suprafata a restaurarilor fixe si influenta asupra parodontiului.

UNLABELLED: Any new class of materials requires a new cutting technology which, unless complied with properly, may negatively impact on the advantages and performance of the material. The modifications appeared as a result of the technological processes in the structure or surface aspect of the materials not only affects the mechanical resistance of the restorations but also casts doubts on their biological qualities. AIM: This study evaluates the impact of biomaterials involved in fixed restorations on the periodontal architecture, bearing extremely important connotations in the long run. MATERIAL AND METHODS: The "in vitro" testing was conducted on culture cells for the cytotoxic effect of certain restorative materials--metallic alloys used in prosthetic restorations, composite materials, in collaboration with the Virology Laboratory of the Public Health Institute.The tested materials were metallic alloys, composite materials and acrylic resins used for the construction of standard sized plates (out of each material) in order to avoid the differences that might arise from the technological process. Artificial saliva processed to reach a pH = 7 was prepared in the Biophysics Laboratory of UMF Iasi. Material samples and the saliva inoculated with these were tested. -p. RESULTS AND DISCUSSIONS: The cytotoxic effect of the tested materials on the celular cultures takes on extremely diverse forms, from discrete morphological modifications of the cells with regard to the size, shape, internal structure (for the noble and semi-noble alloys) up to the partial stripping-off of the celular film, the modification of density and coloration. In the case of the witness of non-inoculated culture, the testing results showed the presence of a continuous film, with cells having the same size, transparency and colouring, with an unaltered polyhedral contour, with visible nuclei, an image also kept in the case of the saliva witness. CONCLUSIONS: The involvement of restaurative materials in triggering, maintaining and aggravating a periodontal pathology indicates the capital role played by the dentist in the identications of lesions during measures by avoiding or excluding etiological agents before an obvious lesions occurs in the process of active dispensarization.

Proprosthetic interventions in the posterior maxillary implant therapy.

AIM: The purpose of this study is to evaluate the necessary number of pro-prosthetic interventions in view of the implanto-prosthetic rehabilitation of the defective prosthetic fields. MATERIALS AND METHODS: We investigated a lot that included 230 patients aged between 18 and 82 who benefited from implant-prosthetic rehabilitation, the type of graft used, the types of membranes selected as well as the various remodeling and elevation techniques at the maxillary level dictated by the particularity of the clinical case. RESULTS AND DISCUSSIONS: The edentulous posterior maxillary region presents in implantology a more difficult situation than any other region of the maxillary. The absence of teeth often triggers a progressive reduction of the alveolar process volume, a reduction that aims particularly at the bony vertical dimension, namely the region between the top of the alveolar ridge and the floor of the maxillary sinus, called the sub-sinus Misch vertical dimension. The presence of the maxillary sinus, combined with the reduction of height of available bone in the terminal maxillary region poses serious problems for implant insertion. CONCLUSIONS: The success of the implant therapy depends on the absence of radio-transparent areas, while the per-implant bone resorption must be limited to the cervical region and should not involve the implant threads or its osteo-integrated area. The implant should also be fix, pain free, with no local infection.

[Viral patology and oral manifestation]. / Aspecte de interferenta între patologia virala si manifestarile orale.

UNLABELLED: Although the medical and biological importance of ringworm infections was acknowledged a long time ago, the putting-up-to-date of some clinical notions is justified for at least three reasons: the improvement and accessibility of molecular biology techniques, the consideration of the major pathogenic role of these viruses in circumstances of immune depression, the possibility to control these infections by means of specific chemotherapy. MATERIAL AND METHOD: A prospective study was carried out in the interval 1.01.2006 - 31.12. 2008, of all cases of ringworm infections with oral eclat, hospitalised in Infectious Diseases Hospital Iasi. The diagnosis was established according to the clinical manifestations, the hematological modifications and, if the case, serological examination. RESULTS: The study included 291 cases. The infection with EVB (infectious mononucleosis) was diagnosed within the age interval 8 months-60 years (median-10 years). The oral manifestations were mainly located at the level of the palatine and velopalatine vault. Chickenpox was diagnosed within the age interval 7 days-52 years (median-8 years). The chickenpox enantem was observed in 90.42% of the cases, being represented by varix wounds, or "hemorrhagic spots", mostly located at the level of the fibrous mucose membrane of the palatine vault--40.2%. CONCLUSIONS: The knowledge of the oral manifestations in ringworm infections with highly contagious potential and a high risk of severe complications represents a fundamental method in early diagnosis as well as an important step in establishing the prophylaxy measures meant to prevent these pathogens from being transmitted to the dentist office.

[Practical aspects of sepsis from oral bacterial infections]. / Aspecte practice ale sepsisului cu poarta de intrare orala.

UNLABELLED: Infections of the oral cavity are an important morbidity problem due to their frequency, their pluribacterial ethiology as well as their potential severe evolution, especially with the immunodepressive. The odontogenic infections are considered to be the cause of 40% of the deep throat infections. The infections of the submentonier space occur through direct extension from the mandibular incisors, those of the sublingual space start from the anterior mandibular teeth and those of the retrofaringian space start from the mandibular molar teeth. MATERIAL AND METHOD: The present study included 24 pacients diagnosed with oral sepsis in Iasi Infectious Diseases Clinic. We analysed the ethiology and the clinical response to the administered antibiotherapy. RESULTS: In several immunodepressed patients (with diabetus melitus, neutropenia, liver disfunction, carcinomas, tuberculosis) was noted sistemic evolution of odontogenic infection and they mainly came from the Surgery Clinics, where surgery was performed for the drainage of collections. Etiology was confirmed in 8 cases reflecting normal oropharyngeal flora. These infections were treated with antibiotics in synergistic combinations (betalactamines, quinolones, Cloramfenicol) with good results in 19 cases. CONCLUSION: Infections of the oral cavity are an important morbidity problem due to their frequency, their pluribacterial origin as well as their potential severe evolution, especially in immunodepressed patients.

[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.

[Coping mechanisms of mentally disabled patients in need of dental treatment]. / Mecanisme de coping ale pacientilor cu disabilitati psihice implicate în nevoia de tratament stomatologic.

UNLABELLED: The concept of the study appeared as a necessity of a better understanding the patients with mental disabilities, exposed to the need of professional dental treatment. AIM: The study's purpose consists in the investigation of mechanisms by which the patients with mental disabilities react while exposed to the action of a stress agent, represented in the study by the necessity of following a dental treatment. MATERIALS: The lot consisted in 52 patients with mental disabilities from the University Hospital of Psychiatry "Socola"-Iasi, who needed prosthetic restaurative treatment which implies the use of syringe with needle, extraction and endodonthic tools, dental turbine. METHOD: The evaluation was made on the basis of: the coping COPE questionnaire. The procedure consists in registering 14 scales for the measurement of so many forms of coping which can have a preponderantly active state or a passive one. RESULTS: From the statistical point of view, the only significant differences were found depending on the sex of patients in the case of coping C14 study method (using alcohol or medicines). The highest score was obtained for coping C7 (positive reinterpretation). CONCLUSIONS: Due to the analysis of parameters' values of coping in the studied lot, we can conclude that the patients with mental disabilities, in the need of dental treatment, preponderantly react by active mechanisms of coping, focused on the issue, in disfavour of passive ones.

[Clinical evaluation of the possibilities of restoring the dental and periodontal esthetics using veneers vs. metal ceramic crowns]. / Evaluarea posibilitatilor de refacere a echilibrului estetic dento-parodontal prin mjloace protetice: fatete ceramice vs. coroane de învelis metalo-ceramice.

UNLABELLED: Achiving the esthetic balance is one of the most important aims of the restorations used for the anterior area of the dental arches. AIM: To evaluate the possibilities of veneers and metal ceramic crowns to restore dental and periodontal esthetics. MATERIAL AND METHOD: We have evaluated 90 restorations, 40 veneers and 50 metal ceramic crowns, analysing the following parametres: gingival index, bleeding index, plaque index, also restorations margins index, presence/absence of secondary decays, marginal integrity index and the aspect of the restorations surfaces. The study also evaluates patient satisfaction using questionares. RESULTS: Even the veneers seem to be more indicated to restore dental and periodontal esthetics, the esthetic outcome depends mainly on the way the clinician evaluates and manages the tissues and less on the technique used (all ceramic or metal ceramic).

[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.

[Reticulate polymers used in obtaining new dental materials]. / Polimeri reticulati acrilici utilizati pentru obtinerea de noi materiale dentare.

UNLABELLED: This paper seeks the characterization of new polymers acrylic cross-linked structure, prepared in the presence of a template that creates the polymer synthesized the property of saving template form. MATERIAL AND METHOD: For carrying out synthesis of polymers reticulate-based on dimethacrylate monomer was left to the mono-, di-and trietilenglicol dimethacrylate. Cross-linked polymerization reaction was initiated with benzoyl peroxide. RESULTS: New structures are obtained witch respond to the need to diversify and improve the biomaterials used in dentistry. The materials are chemically thermally and mechanically inert. Reticulate polymers are non-biodegradable and therefore do not produce intoxication and not degrade biological fluids.

[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.