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Third molars are frequently absent or impacted; their unpredictable prevalence and morphology, with frequent anatomical variations, is a challenge for the practitioner. The number of roots of the upper third molars vary from one to five, but five roots upper third molars' cases are extremely rare. The case reported here is of a normotrophic male patient, with no significant general medical history, having extracted an impacted maxillary upper molar, with an unusual position and dimensions and five completely separated formed roots, orientated in diverse directions. It highlights the importance of using the correct surgical technique, without excessive pressure, for avoiding the fracture of the maxillary tuberosity, the displacement of the molar into the pterygopalatine fossa or the opening of the maxillary sinus, especially in the absence of good quality imagistic information like cone-beam computed tomography. The case presented in this paper is very rare and highlights the significance of anatomical knowledge, which is mandatory for managing these cases, to avoid trauma, accidents, and complications and to maintain an optimal time of extraction, since such variations occur, and the conventional radiographs do not offer enough data to clarify the diagnosis.

In the jaws, the healing process of bone defects occurs differently compared with other anatomical sites where healing is done by the formation of scar tissue. This is due to physiological bone remodeling and continuous bone resorption and apposition. In the case of large cysts, there is an increased risk of postoperative infection due to the retraction of the blood clot on the bony walls. The use of plasma rich in growth factors (PRGF), with or without autologous bone addition, for filling the cystic cavities is beneficial not only for its antimicrobial effect, but also due to simultaneously release of growth factors from platelet alpha granules and adhesive proteins. The aim of our work was to emphasize the spontaneous bone healing of the maxilla and mandible after the enucleation of large and medium-sized cysts in asymptomatic patients of different age. The outcome of three patients who underwent surgery for removal of radicular cysts is presented. Imagistic [cone-beam computed tomography (CBCT)] and histological examination was performed aiming to evaluate the quality of new bone at the site of the bone defect, after different time intervals. By using PRGF approach, the healing of mandibular bone occurred 18 months after cystectomy in a smoker patient, 54-year-old, while the healing of maxillary bone using autologous bone mixed with PRGF occurred after six months in a 63-year-old patient. In a young patient (14 years old), the regeneration period was six months, using PRGF and a fibrin cloth for filling the defect.

The current very high success rate of dental implants osseointegration has led to patients having increasingly high expectations in regards to aesthetic outcomes; therefore, effective management of soft tissues and healing of attached gingiva and papillae are essential in the effort to obtain satisfying aesthetic results for the patient. Obtaining papillae to address aesthetic requirements cannot be accomplished without bone reconstruction; an adequate volume of bone is essential in providing necessary long-term dimensional stability. The aim of this work was to highlight the advantages of autogenous bone grafting combined with plasma rich in growth factors (PRGF) in order to improve healing and reduce dehiscence risks. Two clinical cases were presented, both with important (horizontal and vertical) bone loss: in the first case, bone augmentation was performed at the same time as tooth extraction with no surgery needed for reconstruction of dental papillae, keratinized and attached mucosa; in the second case, vertical augmentation was performed by placing the bone graft in contact with an uninfected tooth. In both cases, aesthetic outcomes were as desired at the completion of treatment and also satisfactory at seven years follow-up.

Anomalies of permanent dentition, by the frequency of the cases, also correspond to some unanimously recognized problems of public health. The objective of this study is to determine the prevalence of non-syndromic hypodontia and oligodontia and to identify the types of associated dental anomalies in the permanent dentition of children and adolescents in the NW of Romania. The study was conducted between 2008 and 2015 on a group of 566 children aged between 12-18 years old. Dental agenesis was diagnosed using clinical and radiological criteria. The numbers and types of teeth missing were noted. Third molars were excluded. Hypodontia had a prevalence of 2% in girls and 3.76% in boys (p=0.007), and oligodontia of 0.33% in girls and 0.38% in boys (p=0.367). Unique abnormalities were registered at 1% in girls and 1.5% in boys (p=0.026), those with two associations at 0.67% in girls and 1.5% in boys (p=0.015), and those with triple association at 0.67% in girls and 1.13% in boys (p=0.037). Hypodontia∕oligodontia has been identified in association with other dental abnormalities, such as inclusion, microdontia, and enamel hypomineralization. The most frequent was the association of hypodontia with enamel hypomineralization.

The article presents aspects of crown and root morphology of the superior wisdom teeth, aiming to several parameters: size, shape crown and occlusal surface, number, topography and orientation of the roots in order to determine which the most common morphological types are. For this purpose, the upper wisdom teeth were collected. According to studies, the dominant form of the dental crown is parallelepipedic, the rectangular or parallelogram shape of the occlusal surface has large mesial and distal-oriented sides. The positive occlusal forms are generally poorly demarcated; cusps are less tall and rarely individualized. In half of the cases, the root is unique, voluminous, straight or with a curved distal tip.