Stereomicroscopic Aspects of Non-Carious Cervical Lesions.

Non-carious cervical lesions (NCCLs) represent a form of tooth wear, characterized by the irreversible loss of dental hard tissues at the enamel-cement junction, without the involvement of caries and dental trauma. The aim of this study was to highlight the morphological elements of NCCLs via their stereomicroscopic examination and to confirm the role of this examination in the diagnosis of early lesions. In addition, the association between the morphological aspects identified during the stereomicroscopic examination of NCCLs and their etiological factors was determined. For this study, extracted teeth with NCCLs were examined with a stereomicroscope. The morphological aspects of NCCLs were evaluated at magnifications up to 75×. In wedge-shaped NCCLs, the stereomicroscopic examination allowed the identification and measurement of scratches, furrows and cracks. In saucer-shaped NCCLs, the stereomicroscopic examination highlighted the smooth appearance of the walls. The presented study highlighted the role of stereomicroscopic examination in the assessment of NCCL morphology and in their early diagnosis. The study confirmed, in particular, the role of occlusal overloads and tooth brushing in determining the morphology of NCCLs.

Etiology Study of Acquired Developmental Defects of Enamel and Their Association with Dental Caries in Children between 3 and 19 Years Old from Dolj County, Romania.

Background: Developmental defects of enamel (DDE) are frequently encountered in primary and permanent teeth, yet their etiology is not completely known. Enamel hypoplasia is considered a predisposing factor for early caries. The objective of this study was the evaluation of several risk factors potentially causing DDE and the possible association between DDE and dental caries. Methods: This study was performed on a group of 213 rural children from Romania. It combined a thorough dental examination for all children, and a questionnaire filled in by their mothers, regarding the evolution of their pregnancy and the child's health status in the first years of life. Results: There was no statistically significant association between DDE presence and data regarding the evolution of pregnancy, mothers' health status or children's conditions during early childhood. There was a significant association between the use of amoxicillin, ibuprofen, and cephalosporin during the period of formation of permanent teeth, and one environmental factor (water source), and the presence of DDE (Chi Square, p < 0.05). Also, DDEs were associated with the presence of caries (Fisher, p = 0.001). Conclusions: Children who consumed water from private wells and children who received medication during early childhood developed more enamel defects, presenting a higher risk of caries development.

Translation and validation of the ageism scale for dental students in Romanian (ASDS-Rom).

AIMS: The aim of this paper was to validate the Romanian version of an ageism scale for dental students. MATERIALS AND METHODS: The initial 27-item ageism scale was translated into Romanian and administered to 210 dental students in Craiova. The data were analysed using principal components analysis (PCA) with an orthogonal, Varimax rotation. The answers were then compared across several demographic variables using a combination of independent samples t tests and one-way between-subjects analysis of variance (ANOVA). RESULTS: Adequate factorability was confirmed with a Kaiser-Meyer-Olkin (KMO) of 0.676 and a Bartlett's Test of Sphericity yielding P < 0.001. PCA revealed a 10-item scale distributed into three components that accounted for 58% of the overall variance. The first component contained 4 items related to the cost-benefit of providing care to older patients (α = 0.80). The second contained 3 items that revolved around the perceptions about older people and their value in the society (α = 0.59). The third contained 3 items related to gerodontology training (α = 0.46). Discriminant validity showed differences in the first component based on whether a student had an older family member. CONCLUSIONS: The 10-item, three components scale demonstrated acceptable validity and reliability.

Oral Mucosa Changes Associated with Wearing Removable Acrylic Dentures.

The main purpose of the study was to highlight the incidence of various changes in the oral mucosa associated with wearing removable acrylic dentures. Materials and method. The study was performed on a total of 45 subjects who presented at the Prosthodontics Clinic and the Oral Rehabilitation Clinic of Craiova Faculty of Dental Medicine during January 2018-May 2020. Results. Of the 45 subjects that were wearing at least one acrylic denture 31,11% presented oral mucosa changes or lesions. The most common mucosal lesion was type 1 according to Newton's classification.

Histological and immunohistochemical aspects of the atrophic dental pulp modifications of abutment teeth.

BACKGROUND: Reducing the thickness of hard dental tissues through the preparation of teeth for fixed prosthodontics represents an aggression for the dentin-pulp complex and may cause changes in dental pulp tissues, by means of acute or chronic inflammation, or by asymptomatic, atrophic modifications. AIM: The aim of the study was to histological and immunohistochemical evaluate samples of dental pulp selected from previously prepared teeth, which had been functioning as abutment teeth for some years. PATIENTS, MATERIALS AND METHODS: The starting point of the study was a statistical study conducted on a batch of 276 patients, of which 64 needed to change the fixed prosthetic restorations. Some of the existing abutment teeth were extracted, others presented previously performed root canal treatments and others required endodontic treatment. RESULTS: Of the 21 samples taken, 12 showed atrophic pulp modifications, represented by low cellularity, collagen fibrosis, vascular congestion, and pulpal calcifications. CONCLUSIONS: Certain irreversible atrophic changes can be observed in abutment teeth's pulps, a fact that justifies the need of performing pre-prosthetic endodontic treatment.

Histological and immunohistochemical study on the apical granuloma.

INTRODUCTION: Periapical granuloma is one of the most frequent periodontal pathology and belongs to the group named as apical periodontitis. MATERIALS AND METHODS: Out of 78 of diagnosed granulomas, we selected samples that we analyzed histologically and immunohistochemically. RESULTS: The histopathological aspect has been dominated by the presence of mononuclear cells of the lymphocyte and plasma cells type, showing the chronic aspect of the apical lesion. Also, we noticed that in the apical granuloma macrophages occur most often. This density of macrophages explains cellular and tissular disruption that occur in apical region of the tooth under the influence of bacterial flora that reached this area, as they have the role to phagocyte pathogens and cell and tissue residues that result from bacterial aggression. The reaction of the plasma cells, determined by their number, has been always associated with the age of the granulomas, and it is more intense in old, neglected granulomas, compared to recent granulomas. CONCLUSIONS: The number and type of immunity cells varies in the apical granuloma accordingly to the age of granuloma.

Morphological features of tongue squamous cell carcinoma diagnosed in Dolj County population between 2012-2014.

Tongue squamous carcinoma can be found in many forms, having a lot of risk factors, and whose morphological characteristics can be used as a prognostic. The purpose of this study was to histologically characterize a number of 54 patients diagnosed between 2012-2014, with tongue squamous carcinoma. Surgical resection specimens of tongue tumors were processed by paraffin inclusion technique. The diagnose samples were reevaluated according to the World Health Organization (WHO) criteria for head and neck tumors diagnosis, by screening the Hematoxylin-Eosin staining sections. The most common histopathological variety of tongue carcinoma observed in our cases was the non-keratinized form, the basaloid and sarcomatoid types of carcinoma being ranked on the last places. The study outlined the prevalence of non-keratinized forms of tongue squamous carcinoma and all types of tumoral invasion patterns have been observed in different percentages.

Root fractures: epidemiological, clinical and radiographic aspects.

Chronic root fractures are a relative frequent dental condition, occurring both in vital teeth and in teeth with root canal treatment, with a difficult and frustrating diagnosis. Two clinical forms are described: crown-root fractures with crown origin and vertical root fractures with root origin. The aim of the study was to determine the prevalence of the root fractured extracted teeth in two dental clinics with different profile [oral rehabilitation (OR) and endodontics (E)] and to present some particular aspects of the root fractures. A retrospective study over a period of five years was performed to determine the number of extracted teeth and the motives for extraction. For root fractured extracted teeth were noted: fracture type, tooth vitality, restoration type. Although the number of the patients with tooth extractions in the five years period was significantly higher in OR clinic than in E clinic, the number of tooth extractions was almost similar. Most of the teeth (70.6%) were extracted for caries complications. The prevalence of the root fractured extracted teeth was 17.93%. In OR clinic, women had more root fractured extracted teeth compared with E clinic, where the number of root fractured extracted teeth was higher in men. Most extracted teeth for root fracture were teeth with prosthetic restorations followed by teeth with root canal treatment and dental fillings. The most extracted teeth for root fracture were maxillary premolars, almost similar for both sexes, followed by mandibular molars. The teeth with least extractions for root fractures were mandibular incisors and mandibular canine.

Optical coherence tomography applications in tooth wear diagnosis.

Dental wear represents an irreversible loss of dental hard tissue under the action of physical, chemical and mechanical factors, excluding dental caries and acute trauma. Four clinical forms of dental wear are described: erosion, attrition, abfraction, and abrasion. Most experts agree that in each clinical form multiple etiological factors are involved, one being predominant. Optical coherence tomography (OCT) is a non-invasive optical method characterized by a micronic resolution. The applications of this type of investigation are multiple in the medical field in recent years, and OCT is gaining a growing importance in dentistry. The study pointed out through OCT imaging for the erosive tooth wear lesion the existence of chemical aggression, with strong demineralization of enamel and dentin. For attrition lesion, OCT images showed the contribution of excessive force and friction movements specific to bruxism. In abfraction, OCT image revealed the importance of the mechanic factor in producing this form of tooth wear and abrasion damage studied may be considered physiological, according to patient age. OCT examination may reveal existing lesions in hard dental tissues for each clinical form and could bring evidence on the mechanisms involved.

Radiological and optical coherence tomography aspects in external root resorption.

Pathological external root resorption is a process by which the hard tooth substance is lost because of action of different local irritative or systemic factors. Six forms of external root resorption are described: surface external root resorption, inflammatory external root resorption, replacement external root resorption, invasive external cervical root resorption, ankylosis and transient apical breakdown. The objective of the study was to establish the prevalence of the pathological root resorption in a retrospective radiological study, to highlight radiological aspects of external root resorption and to describe optical coherence tomography (OCT) aspects in pathological root resorption. External root resorption prevalence in our study was 17%. Radiological exam was very useful to detect the form of root resorption but also to establish possible etiological factors. The study presents the radiological aspects of some forms of pathological external root resorption highlighted on radiography accompanied by radiolucency of the adjacent bone to resorption lesion (as in inflammatory external root resorption and in invasive cervical root resorption) or as changes of the root form, in which the missing part of the root is replaced by the bone tissue, without radiolucency (as in replacement root resorption). The comparison of the OCT aspects of the physiological root resorption in primary teeth with the OCT aspects of pathological root resorption in permanent teeth showed an obvious difference between the images of the OCT signal of the two types of resorption. The OCT signal from the cement is stronger in pathological root resorption, and the OCT signal from the dentin in teeth with inflammatory external root resorption showed a demineralized dentin with multiple heterogeneities, anfractuosities corresponding to resorption craters, with craze lines in subjacent layers of dentin.

Interrelationship between oral status and histopathological aspects of periodontitis in patients from Craiova, Romania.

The aim of the present study was to evaluate the oral status in a group of institutionalized individuals from Craiova, a city in South-Western Romania. Also, another objective of the study was to highlight the clinical, histological and immunohistochemical (IHC) aspects of periodontal disorders in the elderly. The study was performed on 48 institutionalized individuals examined in the Clinic of Dental Prosthetics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Romania, in 2013. The data were collected using medical records and intraoral clinical examination. The data were processed by descriptive statistical analysis. The gingival mucosa samples were harvested from subjects with teeth mobility. The gingival fragments collected were processed through the histological technique of paraffin inclusion. The serial sections were commonly stained with Hematoxylin-Eosin and processed by the IHC technique with anti-CD3, anti-CD45RO and anti-CD20 antibodies. Of the 48 study participants, 20 were males, 28 were females, aged over 56 years old. 66.6% of them had poor oral hygiene, with a mean simplified oral hygiene index (OHI-S) of 1.57, 16 had the generalized periodontitis, three experienced some form of gingival overgrowth at the remaining teeth caused by incorrect fixed prosthesis, and 25 participants presented a form of periodontitis with gingival retraction. Gingival mucosa samples were histologically diagnosed with papillomatosis with discrete parakeratosis and rich chronic inflammatory infiltrate. The IHC reactions for the studied antibodies were different for T- and B-cells, which had different disposition in lamina propria.

Local cause of gingival overgrowth. Clinical and histological study.

The overgrowth, depending on its extension, has multiple effects on the stomatognathic apparatus: functional disorders (impaired speech), difficulty in chewing and aesthetic problems but can cause significant psychological problems. We proposed this study, motivated by the relative increased frequency of the gum outgrowth, its multifactorial etiopathogeny, but especially from the point of view of the specialist practitioner, by the problems that this pathology raises not only for the functionality of the stomatognathic apparatus but also for the facial esthetics, and especially for future therapeutic attitudes needed to solve the existing pathology at this level. We conducted a clinical study and a histological one. For the clinical study, we selected 74 patients who experienced different degrees of gingival outgrowing associated with fillings, dental caries, fixed prostheses, mobile prostheses, orthodontic apparatus. Thirty gingival fragments from patients with gingival outgrowing were processed by paraffin-embedding histological technique and stained with Hematoxylin-Eosin. The morphological results obtained provide the necessary support for understanding the possibility of developing a therapeutic strategy to prevent or minimize the gum outgrowth by administering antibiotic and anti-inflammatory medications associated with medications, which shall cause the apoptosis of the fibroblasts.

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.

Immunoexpression of vascular endothelial growth factor in gingival mucosa with papilloma and condyloma acuminata.

UNLABELLED: The histological changes of the oral mucosa in contact with a metal alloy dentures is one of the current issues widely debated in the literature. AIM: To highlight the expression of vascular endothelial growth factor (VEGF) in human paraprosthetic gingival mucosa exposed to nickel and copper compounds using the immunohistochemical technique. The selected participants were wearers of fixed dentures made of nickel-based alloys and copper-based alloys. The gingival mucosa fragments were prelevated through excision after removing fixed denture and extraction one of its affected teeth. The gingival mucosa fragments were processed through the histological technique of paraffin inclusion. The paraffin-embedded tissue sections were usually stained with Hematoxylin-Eosin and processed by immunohistochemical technique with VEGF antibody. The gingival mucosa fragments from nickel-based alloys dentures wearers were diagnosed with papilloma and, also, gingival mucosa samples prelevated from copper-based alloys dentures wearers were diagnosed with condyloma acuminata. Immunohistochemical reaction for VEGF was different in the gingival mucosa fragments with papilloma compared with condyloma acuminata samples. In papillomatosis gingival mucosa fragments, VEGF was implicated in principal in vasodilatation and inflammation process, and secondary in angiogenesis. In gingival mucosa fragments with condyloma acuminata, the principal role of VEGF was in angiogenesis and secondary in inflammation.

Immunohistochemical aspects of apoptosis in gingival mucosa with papilloma and condyloma acuminata.

The oral mucosa is a component of the oral ecosystem, which can be aggressed by corrosion products released from the dental alloys used in prosthetic dentistry therapy. The purpose of this study was to compare the in vivo effect of nickel and copper compounds on the oral mucosa cells, including their ability to induce cell death, by analyzing the cytochrome c (cyt. c) immunohistochemical expression. Gingival mucosa fragments obtained from the subjects with dentures manufactured by nickel or copper casting alloys were processed through the histological technique of paraffin inclusion. The sections obtained were stained by usually histological methods in order to highlight the histopathological lesions and also analyzed using the immunohistochemical technique in order to study the cyt. c expression. The papillomatosis lesions were observed in the gingival mucosa fragments obtained from the subjects with nickel-based alloy dentures and the condyloma acuminata lesions were observed in those obtained from the subjects with copper-based alloy dentures. The cyt. c immunohistochemical expression was different in the epithelial layer of two types of mucosal fragments but it was the same in their lamina propria connective tissue. We can conclude that the two types of metal alloys have different effects on the adjacent gingival mucosa.

A case with tumor of left parotid gland and denture stomatitis.

The article discuss the case of an edentulous patient presented to the dental clinic for pain and burning sensation of oral mucosa and diagnosed subsequently with oxyphilic adenoma. A 58-year-old patient, with maxillary edentulism, treated with complete denture, presented to the Clinic of Prosthetic Dentistry of the Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania, for pain of oral mucosa and bad stability of denture. The diagnosis of erythematous denture stomatitis as consequence of salivary flow reduction was establish after patient's clinical examination, and by unstimulated sialometry. Clinical exam suggested hyposalivation could be a consequence of a tumor situated at the level of the left parotid gland. The echography confirmed the diagnosis of left parotid gland tumor. The tumor was surgical removed and histopathological exam confirmed oxyphilic adenoma. Education of patient for wearing new denture while maintaining a strict oral hygiene and dealing with low salivary flow was the treatment for denture stomatitis. General dentist has an important role in finding and diagnosing patients with systemic diseases, especially salivary tumors.

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.

Dental Anxiety and its Association with Behavioral Factors in Children.

BACKGROUND: Dental anxiety is a condition that causes a decrease in population addressability to the dentist with adverse consequences for long-term oral health. Assessment of behavioral factors that correlate with dental anxiety is important for accurate evaluation of dental fear. Its diagnosis in childhood is important for establishing therapeutic management strategies to reduce anxiety and promote oral health. OBJECTIVE: To determine the prevalence of dental anxiety in a group of Romanian schoolchildren, and assess its correlation with behavioral factors. METHODS: This cross-sectional survey included a number of 650 schoolchildren attending public schools, randomly chosen. Data were collected from September 2013 to October 2013. 485 children aged 6-12 years responded the questionnaires and were included in the study (248 female, 237 male). Each subject was asked to independently complete a questionnaire including Dental Anxiety Scale (DAS) and other questions about children behavior towards dental health education and practice. Children having a score of 13 and above were included in the anxious group while those scoring under 13 were placed in the non anxious group. The data collected was processed and analyzed using the SPSS statistical software. RESULTS: The overall prevalence of dental anxiety was 22.68% amongst subjects included in the study. No significant differences in dental anxiety scores between boys and girls were found in this study. Dental anxiety scores decreased with increasing age. Dental anxiety correlated positively with chewing gum use and sweet consumption frequency and negatively with age and dental health education. CONCLUSIONS: Prevalence of dental anxiety in the 6-12 year old children of this study was 22.68%. Factors like chewing gum use, sweet consumption frequency, age and dental health education were correlated with dental anxiety.

Masticatory tensile developed in upper anterior teeth with chronic apical periodontitis. A finite-element analysis study.

Commonly is accepted that a non-vital tooth has a higher risk of root fracture but there is a relatively little knowledge about the specific biomechanical behavior of non-vital frontal teeth with chronic apical periodontitis. The aim of our study was to evaluate the deformation and tensile generated in these teeth while vertically loading them because it is crucial to assess the moment when the absorbed occlusal forces exceed the elasticity of root dentine. Using the method of finite-element analysis, we highlighted the distribution patterns of the compressive and tension tensile, as well as their concentration areas. The vertical forces of 100 N generate deformations of no clinical risk in teeth with chronic apical periodontitis. The tensile developed in these teeth are higher than those in the vital teeth are but do not exceed the value of the elastic modulus of the radicular dentin. By increasing the force to 300 N occur elastic deformations, which cannot be neglected anymore. Even so, the 300 N forces do not generate deformations of the alveolar bone. The highest tensile at loading with 300 N was generated in vertical direction but in the cervical area of the tooth also developed tensile in lingual and mesiodistal direction that must be taken into consideration because they are near the risk limit of the elasticity modulus. The crack lines or fractures can appear both in case of excessive or even usual but accumulative occlusal forces that gradually alter the mechanical resistance of the tooth.