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Oral rehabilitation is a crucial aspect of dental medicine, focusing on restoring and enhancing the function, aesthetics, and overall quality of life for patients with missing or compromised teeth. The use of technology in restorative dentistry has significantly advanced the field, offering various options for dental prostheses, including implant-supported caps, micro-supported dentures, fixed partial dentures, and removable dentures. Increasing the performance of restorations was the major objective of these digital techniques. Computer-aided design and manufacturing (CAD/CAM) technology is utilized for the production of dentures, record bases, radiographic guides, conversion dentures, and verification jigs. This technology has revolutionized the fabrication process, offering precision and efficiency in creating dental prostheses.

Aim of the study. The emergence of digital technologies, eases the work of the dental technician and reduces the actual working time in reproduction the dental morphology, but at the same time, the use of a large number of devices can increase the degree of error of the final restoration in the absence of appropriate adjustments. For this reason, this study made a comparison between the classic wax-up method and the digital one to see the degree of accuracy now. Materials and methods. Starting from a model with intact morphology in the area of maxillary premolars and molars, the removal of the upper 1st molar and the grinding of the neighboring teeth were carried out. The restoration of the morphology was carried out by analog but also digital wax-up. Analysis was performed in 26 landmarks and relevant statistical differences were checked using Kruskal-Wallis and Wilcoxon Mann-Whitney tests. Results. The largest variations were recorded in the case of analog wax-up, statistical significance p

Aim of the study In the field of digital dentistry, Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) systems have changed the fabrication of prosthetic restorations by fulfilling both the aesthetic requirements and mechanical performance. This study aims to highlight, by conducting a chromatic evaluation of zirconium oxide when altering the sintering parameters Materials and methods Four groups of zirconium oxide each group formed by 5 copings were made through milling and Exocad digital design software. The design was completed and the files were processed with the Zeno 4030 M1 milling machine (I-MES Wieland). Following milling, the copings were sintered in HTS MIHM-VOGT furnace at a maximum sintering temperature of 1650°C and heating rates of 30°C/min or a rapid rate of 90°C/min. Controlled cooling prevented rapid temperature decrease, thereby minimizing internal stress. Modifications of time and temperature parameters were applied to groups 2, 3, and 4. Chromatic analysis of the specimens was registered with the Vita Easy Shade spectrophotometer. Results It was found that adjustments in sintering temperature and timing are significantly affecting the chromatic outcomes of the non-metallic zirconium structures. Temperature adjustments facilitate the coalescence of zirconium oxide particles and the formation of a robust structure, with changes in it affecting the optical behaviour of the structure. Deviations from the optimum temperature and sintering timing parameters negatively affect the shade. Conclusions In conclusion, milled and sintered zirconium oxide structures can achieve aesthetic excellence, provided by the sintering protocol when the temperatures and sintering furnaces are accurately calibrated.

The concept “Molar Incisor Hypomineralization” (MIH) was introduced in 2001 to specify enamel hypomineralization impacting one or more permanent first molars, commonly accompanied by the involvement of one or more permanent incisors. The severity of carious lesions can be influenced and exacerbated by alterations in the structure of enamel and dentin. Consequently, MIH syndrome (Molar Incisor Hypomineralization syndrome) may pose a significant health concern for pediatric, adolescent, and young adult patients, as well as their tutors or caregivers, and for both pediatric and general dental practitioners. MIH syndrome is gaining considerable attention amongst worldwide clinicians and pediatric dentists as a result of its extensive clinical impact on oral health and quality of life and its various consequences (immediate, medium and long term) on the dental arch development, occlusion and psychological impact on the pediatric patient.

The decisive role of chronic occlusal trauma in causing tissue stress is widely recognized. It could be the condition that facilitates bacterial infection of the periodontium and the transformation of saprophytic flora into opportunistic pathogens. Abnormal stressors such as malocclusion, parafunctions, and lingual dysfunction are present in the vast majority of cases of chronic gingival and periodontal inflammation. Treatment involving occlusal balancing by selective occlusal adjustment generates enormous changes in dental and periodontal areas regarding microcirculation, leading to improved tissue tropism and, consequently, bacterial dynamics. This study aimed to determine the benefits of treating periodontitis patients with combined occlusal adjustment and oral hygiene procedures compared to oral hygiene procedures used alone. The results show that one month after treatment, the bacterial flora of patients in group 2, treated by occlusal adjustment and dental hygiene procedures, showed a significantly higher cocci content than Group 1, treated only by oral hygiene. This difference reached an extremely high significance level (p

This study aimed to evaluate the degree of periodontal involvement in subjects with and without bruxism, with generalized chronic periodontitis of varying severity grades, and to assess the effects of occlusal correction therapy in association with non-surgical periodontal therapy on periodontal status. The following periodontal parameters were analyzed: probing depth (PD), clinical attachment level (CAL), Papilar bleeding index (PBI) and Plaque Index (PI), and X-rays, at the initial (pre-therapeutic) moment and at 3 months after therapy completion. The present study demonstrated that bruxism generates significant clinical changes in a periodontopathic environment. High values of periodontal attachment loss, recessions, missing teeth, tooth mobility, and furcation lesions translate into major losses of periodontal tissue in patients with periodontal disease and bruxism. Periodontal therapy, combined with occlusal correction and bruxism therapy, resulted in statistically significant improvements in periodontal parameters. Thus, occlusal trauma therapy in patients with bruxism becomes an absolute necessity in periodontal therapy.

The purpose of this article is to illustrate the clinical and technological steps of making a fixed prosthesis, using the substative method and a combination of materials – zirconia and ceramics – which are a sure guarantee for an optimal functional restoration. Digital technologies are used more and more frequently in dental practice due to their multiple advantages: reduced working time, the use of a wide range of materials, with good mechanical resistance and longevity, high precision of prostheses, increased comfort for the patient. These digital methods can be used to create a wide range of laboratory prosthetic elements, from temporary devices to metal, ceramic, or zirconia frameworks, crowns and bridges, and partial and complete dentures. Current concepts in fixed prosthetics are increasingly oriented towards all-ceramic processes becaus metal-ceramic prostheses no longer suffice to meet the demands of patients seeking aesthetic excellence and extreme perfection.

The orofacial region are often affected by a diverse spectrum of bacterial, viral, fungal, chlamydial, rickettsial, protozoal, and helminthic infections. Diagnosis of oral candidiasis is often made with a thorough history and the clinical examination findings. Some laboratory investigations can also be used as adjuncts to confirm the clinical presentation. Candida pathogens in a smear taken directly from the lesion are commonly identified using Gram staining or periodic acid Schiff staining, or by culturing the pathogen in Sabaraud’s dextrose agar. Regardless of the prevalence, incidence, and the advancement of treatment strategies, orofacial infections, either local or the manifestations of a generalized infection, may cause significant discomfort and suffering. Oral clinicians need to be equipped with up-to- date knowledge of the clinical pictures of new infections, approaches in accurate identification of orally limited infections vs oral manifestations of underlying systemic diseases. Treatment of oral candidiasis is primarily based on the identification of underlying predisposing factors and correcting them.

It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. Selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Patient education on oral hygiene is an important component of their overall treatment. Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. In conclusion, biofilm disruption mechanical methods integrated is indispensable for comprehensive oral healthcare.

Background and aim. This study aims to explore the most widely used methods for managing patients who are completely edentulous to determine the intermaxillary relations, also known as the centric relation and vertical dimension of occlusion. Material and methods. The information sources have been identified through searches of medical databases. A 20-year search frame, from 2001 to 2021 was performed. The terms “occlusal vertical dimension”, “totally edentulous”, “complete denture”, and “centric relation” were searched. The selected articles were acquired in full text, and two different authors resolved differences through conversation before evaluating them for inclusion. Results. Following the application of the search strategy, 514 articles were identified. 172 papers were screened after duplicate records were removed. Selecting the studies to be considered for inclusion in the first stage required considering their titles, abstracts, and studies’ significance to the study purpose. After obtaining the complete texts of the remaining twenty-seven papers, their relevance was evaluated. Conclusion. The relationship between the maxillary and mandibular arches is still established by the centric relation in occlusal examination and prosthetic treatment. Many methods with low variability and high intra-technical repeatability are available for recording centric relation. There is no one standard technique for recording the vertical dimension of occlusion; instead, the clinician must choose the most comfortable approach.

Chronic periodontitis is a disease caused by several factors; therefore, it can be called a multifactorial disease. Such risk factors include smoking, diabetes, genetics, depression, and stress. Depression is one of the chronic conditions with the highest prevalence worldwide. There is evidence to support the association between psychological disorders and the physiological and behavioral precursors of caries and periodontal disease, suggesting that such a connection may exist. Antidepressant and anxiolytic medication have been associated with decreased salivary flow and poor oral hygiene. The present study aimed to examine the local inflammatory status of patients with periodontal disease and no other systemic conditions and patients with periodontal disease and depression. Between February 2024 and March 2024, we conducted this study on 40 patients aged 20 and 48, evaluating the Quigley Hein Plaque Index, the GI Index of Löe and Silness, and the PBI Index. Analyzing the obtained results, we observed that the values of the periodontal parameters, such as the hygiene index, the gingival inflammation index, and the papillary bleeding index, were significantly higher in the group of patients with periodontal disease and depression compared to the group of patients with only periodontal disease.

Patients with osteoporosis exhibit a nearly twofold higher diagnosis rate of periodontitis compared to the general population, indicating osteoporosis is a potentially significant risk factor for periodontitis development. This study explored changes in periodontal and radiological parameters after systemic alendronate use in osteoporotic patients with periodontal disease. Sixty-four post-menopausal adults diagnosed with osteoporosis and periodontal disease were divided into two groups: Group A, without bisphosphonate therapy, and Group B, receiving alendronate (70mg/week) for 12 months. Both groups underwent non-surgical periodontal treatment. Parameters including plaque index (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic infrabony defect depth (IBD) were evaluated at baseline and after 12 months. Oral administration of alendronate at 70 mg/week for 12 months was found to be safe and effective in enhancing the outcomes of non-surgical periodontal therapy both clinically and radiologically. This suggests alendronate could be a valuable adjunctive treatment for managing periodontal disease in osteoporotic patients.

Pregnancy is a unique physiological state characterized by hormonal fluctuations and immunological adaptations that can impact various aspects of maternal health, including oral health. The influence of pregnancy on periodontal status has been the subject of extensive research, with studies highlighting the association between gestation and changes in the oral cavity. Elevated levels of estrogen and progesterone during pregnancy have been implicated in the exacerbation of gingival inflammation and periodontal disease progression. Immunological changes, including alterations in immune cell function and cytokine production, further contribute to the heightened inflammatory response observed in the periodontium of pregnant individuals. While the precise mechanisms underlying the relationship between pregnancy and periodontal status continue to be elucidated, preventive measures such as oral hygiene education, regular dental check-ups, and timely periodontal treatment are crucial for promoting optimal oral health outcomes for both mother and child during gestation. Understanding the influence of pregnancy on periodontal status is essential for providing comprehensive prenatal care and ensuring the well-being of pregnant individuals and their offspring.

Clinical research documents causal relationships between periodontitis and depression. Furthermore, it has been revealed that clinical depression can also negatively affect periodontal treatment outcomes. The present study aimed to analyze subgingival microbial profiles in patients with periodontal disease and those with depression by qualitative and quantitative determination of 4 periodontal pathogens. Material and method. The study was carried out on a number of 40 patients between the ages of 20 and 48 within the Periodontology Clinic of the Faculty of Dental Medicine, within the “Grigore T. Popa” University of Medicine and Pharmacy Iași or in an office with private practice within the radius of the city of Iași. Analyzing the obtained results, it can be seen that the average age is significantly lower for the group of patients with periodontal disease compared to the average age of patients with periodontal disease and depression (p=0.02). Regardless of which method, the individualized determination of periodontal pathogens helps guide targeted systemic antibiotic therapy (individualization of the treatment plan). It limits self-medication or the possibility of developing bacterial resistance.

Aim of study. The objective of this study was to evaluate the distribution of implants with peri-implantitis and healthy/peri-mucositis implant sites in relation to the periodontal status of the patients treated with implant-supported fixed prosthetic restorations. Materials and method. The study was performed on 206 implants inserted in a group of 54 patients treated by implant-supported fixed prosthetic restorations. The periodontal and peri-implant status were assessed by clinical and radiological examens. The assessed components of the periodontal status were as follows: periodontal parameters (CAL, PD, MBL), periodontal history, %BOP, %PD ≥ 5mm, stage and progression of periodontal disease, patients’ compliance to supportive periodontal therapy (STP). The distribution of implants without peri-implantitis vs. implants with peri-implantitis was assessed by statistical analyses performed in SPSS 29.0. Results. In patients with periodontal history, it was recorded higher percentage of implants with peri-implantitis (63,2%) vs. implants without peri-implantitis (19%). The distribution of implants in patients with >25% BOP sites was significantly higher for implants with peri-implantitis (52,6%) vs. implants without peri-implantitis (1,2%). The distribution of implants in patients with > 5% PPD ≥ 5mm was significantly higher for implants with peri-implantitis (68,4%) vs. implants without peri-implantitis (23,8%). The distribution of implants in patients with BL/age 1-1,50 was significantly higher for implants with peri-implantitis (57,9%) vs. implants without peri-implantitis (7,1%). The distribution of implants in relation to periodontitis stage/progression IV/C was significantly higher for implants with peri-implantitis (57,9%) vs. implants without peri-implantitis (7,1%). The distribution of implants in relation to periodontitis progression stage C was significantly higher for implants with peri-implantitis (57,9%) vs. implants without peri-implantitis (7,1%). The distribution of implants in relation to non-compliant patients to STP was significantly higher for implants with peri-implantitis (36,8%) vs. implants without peri-implantitis (7,1%). Conclusions. Components of periodontal status (periodontal history, %BOP sites, %PPD ≥ 5mm, BL/age, periodontitis susceptibility, STP compliance patients) influence significantly distribution of implants with peri-implantitis when compared to healthy/peri-mucositis implants.

Aim of study. The objective of this study was to evaluate the periodontal and peri-implant health status of patients treated with implant-supported fixed prosthetic restorations. Materials and method. The study was performed 54 partially edentulous patients (mean age 63.48 ± 11.062 yrs) rehabilitated by fixed implant-prosthetic therapy. The mean follow-up was 8,51 yrs. (range: 5-15 yrs.). The periodontal and peri-implant health status (208 implants) were evaluated by collecting data from charts and clinical and radiological examens at recall. Data regarding periodontal status and periodontitis susceptibility were compared between patients with health peri-implant status and those diagnosed with at least one implant with peri-implantitis. Results. All clinical and radiological periodontal parameters were significantly lower in patients without peri-implantitis when compared to patients diagnosed with at least one implant with peri-implantitis. The percent of patients with periodontal history diagnosed with at least one implant with peri-implantitis (90.9%) was significantly higher when compared to patients without periodontal history (68.75%). The periodontitis susceptibility of implant-prosthetic rehabilitated patients was significantly higher among patients diagnosed with at least one implant with peri-implantitis (72.5% of these patients were classified in stages III and IV, 45.5% with grade C) when compared to patients without peri-implantitis (50.1% in stages III and IV, 6.3% with grade C). Among patients with health peri-implant status, 87.5% were compliant to supportive periodontal therapy (STP); only 27.3% of patients diagnosed with at least one implant with peri-implantitis were STP compliant. Conclusions. The peri-implantitis was diagnosed in 18.4% of the implants in our cohort. The periodontal status of the implant-prosthetic rehabilitated patients diagnosed with peri-implantitis was significantly impaired when compared to patients without peri-implantitis. Also, prevalence of peri-implantitis was significantly higher in patients with periodontal history. The compliance of the implant-prosthetic rehabilitated patients to supportive periodontal therapy can ensure the long-term success of the fixed implant-prosthetic therapy.

Aim of the study is an ex-vivo time analysis comparing conventional and digital impression methods for prosthodontic restorations. Insights gleaned from ex-vivo experiments hold promise for enhancing existing practices. This primary experimental investigation will prioritize the consideration of both clinician and patient requirements when determining treatment modalities. Materials and Method: The study involved five stages: preparing an artificial arch, measuring time for gingival retraction with cords and paste, assessing time for conventional and digital impressions, and data analysis. A Frasaco maxillary model with 16 teeth was utilized, 14 prepared using cylindrical-conical burs. Gingival retraction cords and paste were applied, and impression times were recorded for both conventional and digital methods. Results and Discussions: Time analyses showed varying durations for gingival retraction techniques, with the paste method significantly faster than retraction cords. Digital impressions exhibited shorter scanning times compared to conventional methods, especially for fewer number of teeth. However, conventional two-step impressions took longer but provided better cervical area fidelity. This study highlighted the efficiency of digital scanning, offering shorter impression times and reduced patient discomfort. Research also emphasized the differences between retraction methods, with varied effects on periodontal tissues and impression quality. Comparison studies indicated benefits and challenges associated with different impression techniques. Conclusion: The findings underscored the need for practitioners to choose impression methods based on time efficiency and patient needs. Optical scanning proved quickest for fewer teeth, while retraction cord and paste methods require careful consideration. While the study didn’t explore gingival tissue effects, it highlighted crucial considerations for impression materials and chemical solutions. These insights offer practitioners guidance in selecting optimal techniques for effective and efficient dental procedures.

The aim of this study was to evaluate by means of coherence optical tomography (OCT) two synthetic bone augmentation materials based on hydroxyapatite and to quantify the degree of filling of the experimental cavities created one month and two months after their creation. We made 4 groups of 5 Whistar rats on which we created experimental cavities in calvaria and in the upper maxillary. Samples were obtained after one months for two study group and after two months for the other two. After obtaining the images from the optical coherence tomography examination, they were analysed with the ImageJ software. The results provided important information related to the healing pattern of the experimental cavities, the degree of their filling with newly formed bone tissue, but also about the presence of residual particles of synthetic bone graft materials.The increased refractive index of a synthetic bone augmentation material is an important advantage in assessing by OCT the presence of material particles in a bone cavity. The maxillary bone anatomy due to its convexities made more difficult the evaluation of the samples from this area compared to the flat surfaces offered by the calvaria samples. Optical coherence tomography remains a promising method for the evaluation of new-forming bone tissue when synthetic bone graft materials are used, both for research evaluation in order to compare different materials, but also for the potential to be used in clinical activity as well.

The aim of this study was to evaluate the possible correlations between the results of metabolic biochemical tests, the value of body mass index and periodontal / peri-implant clinical parameters in patients in the study group. All patients in the study group (n = 71), attending at least 1 year after implant prosthesis, were investigated and the following anthropometric, clinical and paraclinical parameters were analyzed: height, weight, body mass index, abdominal circumference, blood pressure, blood glucose, periodontal probing depth, bacterial plaque index, total bleeding index on probing, lipid profiling (total cholesterol, triglycerides (TGL), high-density lipoprotein (HDL), LDL). The data obtained after the epidemiological-statistical analysis indicated the existence of the correlations between metabolic biochemical markers and BMI (body mass index), also between abdominal circumference and age as well between bacterial plaque indicators and the presence of the disease in peri-implant tissues. In the case of correlations between metabolic biochemical markers and peri-implant disease as well as dyslipidemia and periodontal disease, no significant association was observed.

The present study aims to analyze the impact of these modern methods of treatment on the current activity of dentists and their influence on the addressability of patients in dental offices during the pandemic. In the COVID-19 pandemic context, the addressability to the dental offices decreased. These digital technologies represent the future of dentistry and are essential, especially during this period. In this sense, a survey was done by distributing a questionnaire to 114 dentists with private practices in Iasi. Our questionnaire included specific items to objectively analyze the practitioners’ knowledge, their attitude towards the current use of digital technologies, and the impact of these methods on their activity. The answers clearly show that dentists are interested in implementing digital systems, allowing prosthetic work to be performed in a shorter time and with maximum accuracy, reducing materials consumption and the risk of contamination for patients and the dental team. Minimizing treatment time is favorable and excludes complications leading to optimal treatment results by simplifying the entire procedure.These systems allow the obtaining of optimal functional and aesthetic prosthetic constructions.

The clinical guidelines for the treatment of patients with periodontitis stages I–III published from the European Federation of after the patient has been informed about his/her condition, the first step in the treatment process is directed toward motivation, targeting behavioral changes to achieve adequate self-performed oral hygiene practices and controlling local and systemic modifiable risk factors. Frequent re-evaluation of oral hygiene reinforcement outcomes is suggested, aiming to reinforce a patient’s motivation and keep the patient up to date with any changes that might occur in the periodontal status, enabling the patient to actively participate in the progress of the treatment plan. Periodontology in 2020, suggest treatment being provided to patients with periodontitis by a pre-established stepwise approach. The second step is focused on professional interventions to reduce and possibly eliminate subgingival biofilms and calculus. Promotes periodontal wound healing via reduction of tissue inflammation and shifts in the host responses.

With the increasing popularity of dental implants among patients as a treatment alternative for edentulousness of various causes, the occurrence of implant complications is continuously rising. The need to know the latest techniques for managing these complications is vital for clinicians. There is currently no data in the literature on possible biological or mechanical complications of this approach. The aim of this review was to identify, in the specialised literature databases, established pathogenic microorganisms associated with peri-implant disease and to observe their grafting onto the implant surface after the application of implantoplasty techniques. The search was performed in databases such as PubMed, Google Academic, Web of Science and Cochrane Library and was conducted for the last thirty years (1993 – 2023). Different combinations of keywords, treatment alternatives of peri-implant pathology, as well as pathogenic microorganisms, involved in the occurrence of the disease were used for the search. We identified elements of etiopathogenicity (dental plaque and smoking), molecular biology mechanisms involved in peri-implant pathology, and we detailed possible particular developments of invasive peri-implant therapies. Conclusions implantoplasty is a modern treatment alternative for peri-implant pathology. Using sensitive and specific methods (e.g., sequencing), numerous bacterial species associated with dental implants have been identified. In conclusion, implantoplasty requires careful prospective evaluation from microbiological point of view.

The purpose of this study was to evaluate the characteristics of three types of composite resins used for periodontal immobilization systems’ realization, the G-aenial Flo X (GC Corporator—Tokyo, Japan), the GrandioSO (VOCO—Cuxhawen, Germany), and the Clearfil Majesty ES flow (Kuraray Noritake Dental Inc.—Okayama, Japan). The structural analyses were realized by scanning electron microscopy, using a QUANTA 200 3D scanning electronic microscope (FEI, Netherlands), and the determination of the elemental composition of the materials was realized via X-ray spectroscopy with energy dispersion (EDX). The results showed that the GrandioSO composite demonstrated the most resistant nonporous structure, due to the presence of a homogeneous matrix characterized by low proportions of silicon and carbon. Further research is required in order to analyze the mechanical parameters of these resins and their behavior in different biological environments, in vitro and in vivo.

Dental caries remain a major oral health problem affecting children of small ages although it is a perfectly preventable disease. According to the American Association of Pediatric Dentistry, early childhood decay remains a major public health problem (AAPD, 2018). [1] The definition of severe early childhood caries (S-ECC) is any sign of smooth-surface caries in a child younger than three years of age, and from ages three through five, one or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth or a decayed, missing, or filled score of greater than or equal to four (age 3), greater than or equal to five (age 4), or greater than or equal to six (age 5).” The risk factors involved in the development of caries such as an imbalanced diet and high daily sugar intake are also involved in generating other diseases, such as diabetes or cardiovascular disease (WHO Report, 2003).[2] Reducing these risk factors could result in an overall improved quality of life which should be a priority for the medical health professionals. Reducing these risk factors should be a priority not for the dentist but also for all the medical health professionals as it can result in an overall improvement of the quality of life.

This narrative review summarizes the current evidence about the role that the fabrication and presence of dental prostheses and tooth-related factors have on the initiation and progression of gingivitis and periodontitis. Tooth anatomic factors, such as root abnormalities and fractures, and tooth relationships in the dental arch and with the opposing dentition can enhance plaque retention. Tooth-supported and/or tooth-retained restorations and their design, fabrication, delivery, and materials have often been associated with plaque retention and loss of attachment. Hypersensitivity reactions can occur to dental materials. Placement of restoration margins within the junctional epithelium and supracrestal connective tissue attachment can be associated with gingival inflammation and, potentially, recession. Restoration margins located within the gingival sulcus do not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance. The presence of fixed prostheses finish lines within the gingival sulcus or the wearing of partial, removable dental prostheses does not cause gingivitis if patients are compliant with self-performed plaque control and periodic maintenance.

Introduction. As the area of nano-based platforms for antimicrobial treatment aimed at pathogenic oral biofilms continues to expand, this review serves to bring together researchers from several disciplines to foster more collaboration and discovery among dental practitioners.

The aim of the study was to assess the mother’s knowledge, attitudes, and practices regarding oral health in relation to the oral health of 6-year-old children from Iasi, Romania. The results of our study showed that the level of knowledge and attitudes of mothers regarding oral health is moderate and the level of education influences the level of knowledge and attitudes regarding oral health among mothers, mothers with higher educational levels had a high level of knowledge compared to mothers with high school education.

The technologies for full dentures realization are almost the same for more than fifty years despite their being associated with many risks of error. In recent years, digital technologies have been increasingly used in dental practice, due to the many advantages it offers. The CAD / CAM technologies, are moving constantly in new directions, to provide exciting, innovative products and systems, with the highest quality standards. Thanks to CAD/CAM technologies, perfect clinical restorations can be achieved, with no secondary reactions and excellent esthetic appearance, through a digital cooperation between dentists and dental laboratories. CAD/CAM technology allows the realization of a well-fitting, aesthetic, and durable prosthetic appliances. Conventional technologies also have a number of advantages and disadvantages that must be known, and computerized methods have not only advantages but also disadvantages. We cannot notice that there is an ideal technology, but that we can choose, knowingly, the most appropriate method for each clinical case. The present paper aims to comparatively analyze a series of clinical parameters of conventional complete and CAD-CAM complete dentures.

Periodontal diseases are arguably among the most ancient and common infectious diseases affecting humans, leading to permanent destruction of the supporting structures of the dentition and ultimately tooth loss. It has been established that dental biofilm (‘‘plaque’’), consisting of many microbial species and their products, is an etiological agent of periodontal disease. It is widely accepted that immunological and inflammatory responses to dental plaque via hostparasite interaction are manifested by clinical signs 40 Dentino et al. and symptoms of periodontal diseases.

The materials frequently used for partial and full dentures are represented by acrylic resins, offering to those prosthetic constructions sufficient strength and a proper aesthetic appearance. The question that arises related to the practical aspects is whether conventional technologies remain the method of choice for getting full dentures and whether digital technologies can be implemented to obtain these prosthetic constructions. In recent years, CAD / CAM technologies for complete dentures realization became better known and more available, working flow and materials becoming more efficient, allowing to gain prosthetic constructions that satisfy the highest functional requirements. These procedures offer significant benefits to the dentist, dental technician and also to the patients. The present study analyzes the opinion of dental technicians regarding these modern methods of getting mobile prostheses and notice the percent of use of the digital technologies into the dental laboratories.

The aim of this study was the evaluation of the osseointegration degree of two synthetic bone augmentation materials, a commercial product and an experimental one, using the optical coherence tomography. We made two study groups composed of 8 laboratory Whistar rats on which we created experimental cavities with a diameter of 3 mm at the level of the parietal bone and mandible. Samples were obtained from both calvaria and the mandible of the animals after two months for first study group and after four months for the other. Optical coherence tomography (OCT) was used for a non-destructive evaluation of the surface and subsurface of bone tissue. The results of our study showed in general a good integration of the inserted materials; in some cases the healing of the augmented cavities with the experimental material was faster, while the commercial material offered a more reproducible healing pattern.

Aim of the study: The Covid-19 pandemic strongly affected education. This study aimed to determine the prevalence of test anxiety, gender differences and variables that moderate it among students of Dentistry Department, Oradea University, Romania. Material and methods: Spielberger’s Test anxiety inventory (TAI) adapted for Romanian population (IAT-III) was self-administered by undergraduate students, collecting demographical data next to the 20 standard items. Statistical significance level was set at p

The aim of this study was the microscopy evaluation of the outer prosthetic surfaces in the case of four restorative dental materials: two metal alloys, one noble and one non-noble, and two dental ceramics, one based on lithium disilicate, the other based on zirconia. The samples were made as anatomical crowns in dental laboratory using the specific protocol for each analysed material. The general appearance of the occlusal and buccal surfaces is shown at several magnifications and the results are discussed in relation to the data from the literature and their clinical importance. Among the metallic materials, the noble alloys offered more homogeneous images with smaller cavities, while the final layer of glaze offer a glossier surface for the ceramics materials, in which other small particles may be incorporated, depending on the analysed ceramics . The use of an optical microscope for the final evaluation of the prosthetic structure may bring important details leading to an improvement of the obtained prosthetic structures.

Objectives. The aim of this case report is to present a single patient case superimposed on the literature knowledge in regard to mophometric mandibular variations observed on dental panoramic radiography and used to identify patients with low bone mass density (BMD). Case presentation. A 62 years old female patient reported to the Blident Help Dental Clinic, for specific visits and treatments, 3 years apart. Based on the digital panoramic radiography and DXA measurement, an osteoporosis evaluation with radiomorphometric indices was performed. Values for maximum condylar height, maximum coronoid height, projective height of the mandibular ramus, minimum ramus breadth and antegonial angle are higher on both sides. the values decreased for gonial angle, gonial index, mandible cortical width (MCW), superior and inferior mental height and panoramic mandibular indices on both sides. Bigonial distance also dicreased and the mandibular cortical index (MCI) changed from C2 category in 2017 to C3 category in 2020. Discussions. This postmenopausal patient had a decline in MCW values which were lower than 3 mm (threshold to differentiate normal) on panoramic radiographs of women with low BMD. Antegonial Index had a decreased value and could be used as a prediction index for osteoporosis. MCI index changed from C2 to C3 in correlation with the changes of bone mass density in lumbar spine. Conclusions. MCI, MCW, antegonial index and bone density played an important role in determining significance of effects of lower BMD at postmenopausal on the mandibular ramus region.

Because it is well known that T cells are a heterogeneous population, and a balance between functionally of different T cell subsets is crucial in immune regulation, a series of studies have attempted to associate an impaired balance between each T cell subset and periodontal disease progression. This review aims is to give a perspective on the importance of Th1/Th2 and Th17/Treg balance in the pathogenesis of periodontal disease, considering that the activity of this disease is determined by a complex interaction between the immune system and periodontal pathogens. Because Treg cells modulate both innate and adaptive immunity, it may be helpful to use therapeutic strategies which apply the immunosuppressive abilities of Treg cells in periodontal disease. The re-examination of existing periodontal literature and further studies in the light of these new discoveries may help explain how the inflammatory response results in damage to the periodontium while generally failing to control the pathogens. This knowledge would be essential in order to develop interventional strategies to protect and minimize the destructive aspects of the periodontal host response.

Objectives. The objective of this study is to assess the state of oral health, from the perspective of the number of teeth present, according to the body mass index as a representative element of health. Materials and methods. This study consists of 180 patients from a private dental practice. All 180 patient records were reviewed for an assessment of the number of teeth present and the body mass index at menopausal age. The cohort of patients was divided into two groups, a group of women aged 40 to 54.9 years and the second group, which included women aged 55 and over. The 2 groups were divided based on premenopausal (group I) and postmenopausal (group II) age. Results. The average number of present teeth (based on radiographs) for the entire population of 180 patients is 22.02 teeth. In group I, for the 109 women in the premenopausal group, the average number of teeth is 23.94. The total number of teeth for the 71 women in the postmenopausal group is 19.07. The average BMI for the entire group of patients is 27.24 kg/m2, with a lower value in group I, 26.25 kg/m2, compared to group II, 28.78 kg/m2. Discussions. The average number of teeth in the premenopausal group is higher than in the postmenopausal group. The average body mass index places the whole series of patients in the overweight category. Conclusions. This study shows that the relationship between BMI and the number of lost teeth is positive and proportional, BMI increases with increasing number of teeth lost at premenopausal age.

Aim of the study This study investigated the knowledge amongst dentists and senior dental students from Romania, regarding the clinical forms of tooth wear, its etiology and various treatment options for non-carious cervical lesions. Material and methods A questionnaire was sent electronically to Romanian dentists and dental students using social media. The survey had 16 questions regarding the prevalence of non-carious cervical lesions in the participants dental practice, the awareness of their clinical signs, etiological mechanisms and treatment options. Results Romanian dentists and dental students felt competent in diagnosing and treating tooth wear and non-carious cervical lesions, although the awareness of their etiology was moderate. For the restoration of non-carious cervical lesions, the material preferred by Romanian dentists and dental students was flowable composite. Conclusions Our study showed the need for further clinical and laboratory studies of the etiological mechanisms of tooth wear and non-carious cervical lesions for a better understanding amongst dental practitioners.

SARS-CoV-2 was first discovered in December 2019 as the etiologic agent of a serious respiratory illness later called COVID-19 or coronavirus disease 2019. The first COVID-19 case was reported in Wuhan, China and since then, has reached a pandemic level, spreading all over the world and multiplying faster than any other respiratory disease known until now in modern times, with more than 85 million confirmed cases and almost 2 million deaths, according to the latest information from the World Health Organization (WHO). Periodontal disease is one of the most common diseases of the oral cavity that has systemic implications in the overall health homeostasis. It is an inflammatory disease that involves a series of dysbiotic events caused by periodontopathogenic microflora that causes destruction of the periodontal tissues locally, and an exacerbated proinflammatory status systemically. Diabetes mellitus, metabolic syndrome and obesity, hypertension, cardiovascular disease, chronic kidney disease, chronic obstructive pulmonary disease and autoimmune diseases have been identified as risk factors for both periodontitis and severe Covid-19 infections. These diseases have similar inflammatory pathways that are involved in the progression of these conditions, thus, it is fair to assume a pathological common link.

Lasers are used in oral surgery and periodontology liberally nowadays, however, solid therapeutic protocols are still lacking in some medical areas. An epulis is defined clinically as hyperplasia of the gingival tissues, usually situated in the proximity of the interdental papilla, however it may also occur in the edentulous ridges. Regarding the origin of this particular lesion the periodontun and the periosteum are considered principal components. In this case report we present an orthodontic patient with a recurrent fibrous epulis that was treated by ablation with a diode laser (940nm). This particular method was chosen due to the reduced treatment time and diminished intrasurgical bleeding. Furthermore, an improved gingival healing compared with classical scalpel blade surgical treatment was observed. We demonstrated that diode lasers are particularly useful tools in orthodontic patients that are predisposed to gingival hyperplasia and this treatment method has supplementary advantages compared to the classical scalpel regarding the presence and intensity of pain and postoperative discomfort

RAGE has historically been studied in periodontitis associated with diabetes. Activation of RAGE generates pro-inflammatory signals through its interaction with glycated molecules present in the serum and tissues of diabetic patients. This process is described as the AGE / RAGE axis. A body of evidence tends to show the involvement of this same receptor in the pathophysiology of periodontitis alone (not associated with diabetes). At the tissue level, RAGE is overexpressed in sites affected by periodontitis concomitantly with its AGER1 antagonist, limiting its inflammatory action. Finally, the serum concentration of the cleaved soluble forms of RAGE is reduced in periodontal patients and is negatively correlated with the clinical parameters of periodontitis. The pathophysiology of periodontitis seems to have an impact on the concentration of this antioxidant biomarker. The variation in the serum concentration of RAGE is associated with many systemic pathologies.

Antibiotics represent an important adjunctive method in the complex and effective periodontal therapy. Moreover, beside the curative effects of antibiotics, antibiotic prophylaxis needs to be taken into account when particular cases of infectious risk patients need to be correctly approached. An important criterion in the antibiotic prohylaxis selection includes the physiopathological state of the patient: his general state of health, his immune status, his medical-surgical history, his comorbidities and his current medications. All this in order not to carry out contraindicated associations and to avoid the potentiation of undesirable effects. Compliance with these selection criteria maximizes therapeutic efficacy while limiting individual risks (hypersensitivity, adverse effects) but also collective risks with respect to the emergence of bacterial resistance. In summary, antibiotic therapy must be justified with the best efficacy, the best possible tolerance and at a reasonable cost. In addition, the methods of compliance and the duration of the treatment can direct towards preferred molecules.

The silent nature of osteoporosis makes it difficult to diagnose. Therefore, all healthcare professionals should participate in the identification of patients suffering from this disease. Dental x-rays can be considered a minimally invasive and convenient method in identifying osteoporosis. The repercussions of osteopenia / osteoporosis on the periodontium appear to be proven. Periodontal parameters (clinical loss of attachment, probing depth, gingival index, and bleeding on probing) show signs of greater tissue degradation. The relationship between periodontal disease and osteoporosis appears to be linked by the risk factors they share and by the mechanism of bone loss. The inflammatory nature of these two pathologies has been demonstrated, which could highlight a pathogenic link between them. The literature does not currently suggest any specific conduct or protocol in assessing the risk of low bone density and in the management of these patients. But osteopenic / osteeporotic patients require special attention and medical dental care.

This article was aimed at addressing the key relationship between prosthodontics and periodontics. The impacts of healthy periodontium on longevity of prostheses were addressed. The interdisciplinary approach has been a trend for a comprehensive dental treatment. Within modern dentistry, periodontics and prosthodontics share an intimate and inseparable relationship in multiple aspects, including treatment plan, procedures execution, outcome achievement and maintenance. By controlling inflammation and preparing sites for proper prosthetic prostheses, periodontists no doubt can provide a solid foundation for successful prosthetic outcomes. On the other hand, prosthodontists could construct proper restorative margin, shapes and contacts that benefit the harmony of periodontium and prosthesis.

Radicular resorption and reduction of reparative capacity are related to the severity of the periodontal disease. In the teeth with compromised periodontal support, which involves the alteration of the ligament, as it occurs in periodontal disease, stress during mastication becomes excessive. The purpose of the study was to investigate the influence of occlusal forces on the radicular resorption of teeth with periodontal disease and the quantification of radicular resorption on teeth with and without occlusal contact. Material and Method: For this study, 66 teeth (22 premolars and 44 molars) with periodontal disease were used. Each tooth was then cut into two halves in the mid-distal sense, dehydrated in alcohol and then cleaned in toluene and embedded in paraffin. An average of 200 sections (1200 lm per tooth) were analyzed with an Olympus Bx40 microscope. The image was then analyzed with a software program (MICROIMAGE 3.0., Hamburg, Germany). Results. In the microscopy analysis, radicular resorption was found in all the studied teeth. Periodontally affected teeth showed significantly higher values for both the surface (p = 0.024) and the resorption volume (p = 0.003) compared to teeth without periodontal disease. The percentage of resorbed surface and volume was significantly higher in teeth that showed an antagonist compared to teeth without any antagonist. Conclusions. The results of this study suggest that traumatic forces exerted on teeth with loss of attachment generate a degree of radicular resorption and an accelaration of periodontal disease.

Traumatizing forces may act on an individual tooth or on groups of teeth in premature contact relationship; they may occur in conjunction with parafunctions such as clenching and bruxism, or in conjunction with loss or migration of premolar and molar teeth with an accompanying, gradually developing spread of the anterior teeth of the maxilla etc. The local, regional and systemic effects of bruxism include tooth wear, excessive stress on periodontal ligaments and alveolar bone, temporomandibular joint effects and even effects on the nervous central system.