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Anterior cross bite is an occlusal etiological factor for the occurrence of gingival recession and resorption of the alveolar bone. Aim: To examine the condition of the alveolar bone in relation to incisor inclination in subjects with anterior cross bite. Materials and methods: Sixty one eligible subjects, with a mean age of 25.66±10.51 years, presented with anterior cross bite of a single teeth or a group of teeth. The distribution of patients by sex is women-42.6% and men-57.4%. The inclination of the upper and lower incisors was evaluated and analysed with Steiner C method. The bone resorption in the two jaws (distance from the enamel-cement junction of the incisors up to the beginning of the alveolar bone) was measured up to 0.01 mm. Results: Protrusions constituted a higher percentage than retrusion in both jaws. The mean value of bone resorption in the maxilla of subjects with retrusion was 4.01mm, whereas in subjects with protrusion, it was 3.42mm (p = 0.062). The mean value of bone resorption in the mandible of subjects with retrusion was 4.56mm, whereas in subjects with protrusion, it was 4.36mm. The bone resorption mean of the patients with retrusion in the mandible was 0.55mm higher than the mean of the patients with retrusion in the maxilla with high statistical significance (p = 0.008). Conclusion: Higher levels of bone resorption were observed in the mandible as compared to the maxilla. A significant linear relationship was found between the inclination of the incisors and the degree of bone resorption.

The use of infrared (IR) light in dentistry has developed rapidly over the past few decades. Devices do not require an external energy source but can be activated by body heat. IR can be used to improve diagnosis or treatment. Currently, the use of infrared thermography (ITR) in modern medicine is experiencing continuous growth due to the technological advantages of the method in the prevention and monitoring of some diseases, the selection and evaluation of treatments, as well as its high diagnostic sensitivity and specificity reported by specialized studies. Technological advances in the new generations of infrared detectors have led to an increase in the level of precision offered by thermal imaging as an alternative method of medical diagnosis or treatment. The improved thermal sensitivity has contributed to the expansion of the use of IR in all medical fields, including dentistry, in specialities such as endodontics, odontology, periodontics, prosthetics, oral and maxillofacial surgery, TMJ pathology, implantology, allergology, oral pathology, photostimulation. Thermograms can be stored, processed and sent digitally, which makes them compatible with other modern technologies. Colour coded thermograms are easier to interpret. Infrared thermography has numerous advantages, such as speed of realization, comfort for the patient, absence of contraindications and side effects, qualitative evaluation of the examined affection.

Purpose: To assess the degree of bone destruction for teeth in anterior crossbite by means of 3D cone beam computed tomography and lateral cephalometry. Material/methods: 20 patients with anterior crossbite underwent 3D cone beam computed tomography and lateral cephalometry of the anterior segments of the maxilla and mandible. The destruction of the bone in the anterior segments of the maxilla and mandible was measured (vestibularly and lingually)– the distance from the cemento-enamel junction to the top of the alveolar bone. The parameters of bone resorption for teeth 21 and 31 on cephalogramsand 3D computed tomography images were compared. For both incisors, the mean value registered by means of cephalometry was slightly higher than that registered with 3D. Results: The total mean value of bone destruction for anterior teeth was significantly higher vestibularly compared to lingually, both for the maxilla (p = 0.030) and mandible (p = 0.030). Significantly higher mean values ​​of bone destruction were found in the mandible compared to the maxilla. For both incisors (21 and 31), the mean value of resorption recorded by cephalometry was slightly higher than that recorded by 3D cone beam computed tomography, but without statistical significance. Conclusion: We found significantly higher values ​​of vestibular bone destruction compared to lingual bone destruction. Bone destruction in the mandible reached a significantly higher level than that in the maxilla. No statistically significant difference was found between the mean values ​​of bone destruction measured by means of cephalometry and 3D cone beam computed tomography.

Non-nutritive sucking and oral uptake of glucose 25% are often non-pharmacological methods used to manage procedural pain in newborns. Aim: To compare the effect of using non-nutritive suction (NNS) and Sol.Glucosae 25% for reducing/eliminating neonatal pain due to heel prick. Material and methods: Term infants were studied: group (A), NNS, n = 40, and group (B) oral uptake of Sol.Glucosae 25%, n = 40. The severity of procedural pain was assessed using the Neonatal Facial Coding System (NFCS) scale: 30 seconds before the procedure, at the 30th second and at the 5th minute after the procedure. Physiological pain markers were monitored at these intervals: respiratory, heart rate, transcutaneous saturation (tSpO2), arterial blood pressure. Results and Discussion: Newborns in a group (B) had a lower evaluation at the 5th minute compared to those treated with non-nutritive suckling(A). There are significant differences in heart rate, breathing frequency and before the procedure. The intake of Sol. Glucose 25% compared to NNS causes a higher heart rate and a decrease in at the 30th second after the painful procedure. In contrast to the heart rate, for respiratory rate and tSpO2 at 5th min. we reported lower than the norms in both groups A and B. Conclusion: Unlike NNS, glucose intake eliminates pain within 5 minutes after a heel prick. Excluding arterial blood pressure, all other physiological pain markers undergo changes before the procedure but not after it.

Aim: The study was governed by two main goals: 1) To assess the skeletal maturation of young patients who were undergoing orthodontic treatment with rapid maxillary expansion; 2) To compare their chronological age with their skeletal maturation stage. Material and methods: Lateral cephalometric radiographs of 74 patients were randomly selected and analyzed. The sample included 51 girls and 23 boys in late mixed and permanent dentition, with an average age of 13.2 (± 2.24) in the range from 9 to 17 years. The assessment of skeletal maturation followed the cervical vertebral maturation (CVM) methods of Baccetti et al. and Lamparski. Results: The results showed 53% consistency and 47% discrepancy between the chronological and skeletal age of the patients. In the age group 9-13.5 years, the discrepancies reached 73.5%. The difference in percentages was statistically significant, p

The problem with choosing a suitable pre-medication protocols before local anesthesia in dentistry in allergic patients is always discussed, as in the dental practice different schemes are already proven (3,5). The propose of this communication is to share the experience on those pre-medication schemes in allergic patients during and outside pollen season.

Introduction: A number of studies have indicated that only certain types of, such as proclined teeth, deep bite and anterior crossbite, can be considered risk factors for gingival recession. Aim: The aim of our study was to examine the association between anterior crossbite and gingival recession. Materials and methods: We monitored 80 patients aged 18 - 52 with anterior crossbite in one or more teeth. 960 teeth were examined, of which 501 exhibited gingival recession. To determine the site of the crossbite intraoral examination was utilized. We visually ascertained the presence of gingival recession and measured it with a periodontal probe CP15(UNC15). Odds ratio and chi-square test were used to examine the association between anterior crossbite and gingival recession. Results were considered statistically significant at alpha ≤ 0.05. Results: Our results show no statistically significant relationship between the presence of gingival recession and anterior crossbite in the upper jaw (p>0.05), and a statistically significant association in the lower jaw (p< 0.05). The Odd Ratio (OR) values in all lower frontal teeth were higher than 1 and statistically significant (p< 0.05). Conclusion: The risk of gingival recession development is higher in teeth with anterior crossbite in the lower jaw. In the maxilla, there is no statistically significant relationship between crossbite and gingival recession occurrence.

Aim: The aim of this study was to compare the skeletal and chronological age of adolescent Bulgarian female and male patients with а transverse maxillary deficit in order to establish the level of consistencies and discrepancies within and between the two sexes. Material and methods: The data included lateral cephalometric radiographs of 74 patients, among whom 51 girls and 23 boys. The patients’ ages ranged between 9 and 17 years, with an average age of 13.2 years (±2.24). The assessment of skeletal maturation followed the cervical vertebral maturation (CVM) methods of Baccetti et al. and Lamparski. Comparison of skeletal and chronological age was performed for patients before age spurt and after age spurt within the female and male groups. The two sexes were compared in view of consistencies and discrepancies between chronological and skeletal age. Results: The results showed a statistically lower percentage of consistencies and a higher percentage of discrepancies in patients before age spurt for both sexes. Vice versa, in patients after age spurt consistencies, constituted a statistically higher percentage for both sexes. As a whole, the female patients had a slightly higher percentage of consistency (54%) between chronological and skeletal age than the male patients (48%), but the difference of 6% was not statistically significant p = 0.73. The discrepancies towards a higher skeletal age constituted 83% of the total number of discrepancies among the female patients and 75% of the discrepancies among the male patients. The difference of 8% was not significant, p = 0.56. The mean chronological age of the female and male patients in each CVS stage was very similar. Conclusion: In patients with incomplete skeletal growth, skeletal age corresponds to a higher level of maturation than predicted by the patients’ chronological age in both female and male patients. The two sexes show similar trends of accelerated skeletal maturation without statistically significant differences. Our results differ from previous findings of the existence of sexual dimorphism in skeletal age maturation.

The incorporation of nanoparticles into glass powder of glass ionomers led to wider particle size distribution, which resulted in higher mechanical values. Consequently they can occupy the empty spaces between the Glass ionomer particles and act as reinforcing material in the composition of the glass ionomer cements. The nanofiller components of nano ionomers also enhance some physical properties of the hardened restorative. Its bonding mechanism should be attributed to micro-mechanical interlocking provided by the surface roughness, most likely combined with chemical interaction through its acrylic/itaconic acid copolymers. The paper reviews their secondary caries prevention – fluoride release properties, mechanical and physical propreties, biocompatibility aspects, and antimicrobial activity.

Extensive studies have been undertaken to improve dental composites with advances in filler compositions and resin chemistry. The unique nature of the filler particles of nanocomposites provides mechanical strength and wear resistance similar to hybrid composites, and superior polish and gloss retention similar to micro fill composites. The polymerization shrinkage in composites depends on the chemistry of the organic matrix. The flexural strength depends on the filler content and the filler chemistry. The nanometric particles and nanoclusters in the nanocomposites improve mechanical properties such as compressive strength, flexural strengths, and wear resistance of several nanocomposites were as good as those of universal hybrid composites. They provide high esthetics, hence they can provide optimal optical characteristics since the size of the nanometric particle is below the wavelength of light. This is relevant because the size is not measurable by the refractive index that can result in formulations having a broad spectrum of shade and opacity. Nanocomposite denture teeth comprises of polymethylmethacrylate, and uniformly dispersed nano - sized filler particles. Their advantages are: - highly polishable, stain and impact resistant material; - lively surface structure; - superior surface hardness and wear resistance.

Objective: Calprotectin is a calcium binding heterocomplex protein which appear to have regulatory functions in the inflammatory process. Epithelial cells which expressing calprotectin are more resistant to bacterial invasion . In acute phase inflammatory reactions calprotectin is detectable in elevated levels. The aim of the present study is to detect the calprotectin level in saliva in patients with periodontal disease (chronic and aggressive periodontitis and gingivitis) and to follow calprotectin level during azithromycin treatment. Methods and materials: In nine healthy patients without systemic disease and malignancy whole unstimulated saliva was investigated. Salivary calprotectin levels were measured by enzyme-linked-immunosorbent using a commercial kit (ELISA Hycult Biotech). Azithromycin treatment was taken as 500 mg (2 x 250 mg tabls.) once daily at 10.00 am for 4 consecutive days. Results: At baseline Day levels of calprotectin ranged between 1.45 and 2.97; median 2.19. On Day 5 (first day after azithromycin treatment) the salivary calprotectin levels decreased in 6 of the patients. The measured values at Day 10 were more similar to those at Day 5, than those at Day zero. This was confirmed by the values of the average median of calprotectin. Conclusion: We present the first study with the application of antibiotic and measurement the calprotectin levels before, during and after azithromycin intake with no side effects reported. Measuring calprotectin levels could benefit the monitoring of antibiotic treatment efficacy in patients with gingivitis and periodontitis.

A The oral signs and symptoms may be reflect a undetected serious systemic diseases. Depending on the oral manifestation the dentists and physicians make attention and focusing on specific diagnoses. In some cases oral involvement may be frequently herald the onset of the disease which requires the dentists to better knowledge of changes in the oral cavity. In the oral cavity local symptoms and findings of leukemia include paleness of the oral mucosa with gingival bleeding that develops into painless gingival hyperplasia, petechiae, hemorrhages, and ulcerative necrotic lesionsBecause of their clinical importance, all such lesions deserve the full attention of the dental doctors. The aim is to evaluate in detail the oral complications of leukemia at initial presentation and present a clinical case of 54 old female with oral manifestation as initial signs of the disease.

A multitude of acrylic monomers is used in dentistry, and when dental personnel, patients or students of dental medicine become sensitized, it is of great importance to identify the dental ;acrylic preparations to which the sensitized individual can be exposed. Numerous studies confirm high incidence of sensitization to (meth) acrylates in dentatal professionals, as well as in patients undergoing dental treatment and exposed to resin-based materials. Quite a few studies are available aiming to evaluate the incidence of sensitization in students of dental medicineThe purpose of the study is to evaluate the incidence of contact sensitization to some (meth) acrylates in students of dental medicine at the time of their education, in dental professionals (dentists, nurses and attendants) and in patients, the manifestation of co-reactivity.A total of 139 participants were included in the study, divided into four groups: occupationally exposed to (meth)acrylates and acrylic monomers dental professionals, 3-4 year-of-education students of dental medicine, 6th year–of-education students of dental medicine and patients with suspected or established sensitization to acrylates, without occupational exposure. All of them were patch-tested with methyl methacrylate (MMA), triethyleneglycol dimethacrylate (TREGDMA), ethyleneglycol dimethacrylate (EGDMA), 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy) phenyl]propane (bis-GMA), 2-hydroxyethyl methacrylate (2-HEMA), and tetrahidrofurfuril metacrylate. The overall sensitization rates to methacrylates in the studied population are comparative high – from 25.9% for MMA to 31.7% for TREGDMA. Significantly higher incidence of sensitization in the group of 3-4 course students compared to the one in the group of dental professionals for MMA and TREGDMA was observed. Highest was the incidence of sensitization to ethyleneglycol dimethacrylate, BIS-GMA, 2-HEMA and tetrahydrofurfuryl methacrylate in the group of patients, with statistical significance comparing them to the group of dental professionals. More intensive risk management training programs in exposure to methacrylates and use of proper personal protection among students is recommended.

Hepatitis B virus is the most important infectious hazard in dental profession. Vectors of HBV infection are not only blood, but also saliva, nasopharyngeal secretions, crevicular fluid.The aim of the study was to evaluate serum and salivary HBV DNA levels in subjects with chronic infection and dynamics of HBV levels during the first 3 months of peginterferon α-2a therapy to be determined. Nineteen parallel samples were tested for HBV DNA by real-time PCR assay. All nineteen sera were positive for HBV DNA with levels ranging from 494 to 6 300 000 000 cp/ml. HBV DNA was detected in all saliva samples even in patients with very low viremia. HBV DNA levels in serum and saliva were quite similar in cases with serum HBV DNA < 10 000 cp/ml. Patients with viremia higher than 10 000 cp/ml had significantly lower HBV DNA levels in saliva.The presence of HBV DNA in saliva might not be only due to transudation or exudation of fluid containing virus from the general circulation into various body fluids. These facts clearly demonstrate the role of saliva in routes of HBV transmission. Our results confirm the possibility of dentist’s particiation in infection transmission and suggests that salivary analysis holds promise as a non-invasive approach to identify biomarkers for diseases.

The reactivity to food proteins is specific, but in certain patients cross reactions are observed between food proteins of plant or animal origin and non-food ones. The most common clinical manifestation of this cross reactivity is oral allergy syndrome (OAS). It develops mainly in patients with pollen allergy after fresh fruit and vegetables consumption. The symptoms are oro-pharyngeal pruritus, papules and vesicles which resemble mouth ulcers on the labial mucosa and labial, palatal and lingual swelling. There may also be a sensation of pharyngeal swelling. The symptoms appear very quickly and may be followed by urticaria or contiguous facial erythema. The progress of this syndrome is due to homology of structural proteins in foods of plant origin and in pollens.

Theaim of this study was to determine the tongue-coating status (using modern index system), the degree of gingival hyperplasia, to register the observed oral lesions in 30 patients with replaced renal function (hemodialysis and renal transplanted).

Infective endocarditis is a rare condition with significant morbidity and mortality. It may arise following bacteraemia in a patient with a predisposing cardiac lesion. In an attempt to prevent this disease, over the past 50 years, at-risk patients have been given antibiotic prophylaxis before dental procedures.

In most of the patients with chronic hepatitis B and C, the disease progression to liver cirrhosis and a liver transplantation is necessary. Untreated oral diseases (including dental problems) can lead to infections and sepsis and may cause many complications in transplanted patients and a prerequisite dental evaluation is usually recommended for potential organ transplant candidates.Our aim was to determine the dental status in patients with chronic liver disease, knowing that liver transplant will be a life choices.

The aim is to present some of the most prescribed premedication schemes prior to an upcoming dental analgesia in non-allergic patients. These schemes we would like to be proved as “standard protocols” in dental practice.

Inflammatory bowel diseases (IBD) refer to two chronic diseases which involve the large and small intestines: ulcerative colitis and Crohn's disease.The aim of the review is to focus on main oral signs which are related to a specific treatment. Most of the articles on IBD patients consider just the typical oral disease manifestations, without taking into account oral manifestations as results from the administrated treatment.

Topical corticosteroids have been commonly used over the last 50 years to treat various inflammatory mucosal conditions. The wide spectrum of potencies and bases allows these medications to be used effectively and safely under the care of an experienced dental practitioner.

An idiopathic form of erythema exudativum multiforme, characterized by atypical localization and lack of skin manifestation at the moment of the clinical exam, was found. It was diagnosed rather late, after two biopsies of the skin and one of the oral lesion. The authors would like to accentuate the problems of treatment of idiopаthic forms their search for new solutions

The aim of this study was to present the clinical-laboratory picture of patients with oral carcinomas compared to healthy subjects. The alterations of oral and dental status, the level of salivary proteins and the abuse of main oral carcinogens (alcohol and nicotine) were studied