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Changes in tooth form, texture and shade inevitably accompany the aging of the people. The desire of improving smile appearance leads to an increase in the request of esthetic dental procedures. Bleaching is now the most common and non-invasive esthetic dental treatment. Even if it is considered a cosmetic dental treatment, the dentist always should establish a diagnosis and treatment plan before initiate the procedure. This study aims to evaluate the Romanian dentists approach to vital and non-vital bleaching procedures and to assess if there are correlations between their options and the time of clinical practice or the postgraduate training. The cross-sectional study was undertaken using a closed questionnaire addressed to dentists by online method. The twenty questions focused on the following topics: time of clinical practice, self-perception on safety of the treatment, self-confidence in providing bleaching, postgraduate training, the main technique for vital and non-vital tooth bleaching therapies, first choice material, the use of light activation, the need for desensitizing agents and the attitude towards restorations.

This study is a review of the literature to obtain a topical retrospective on the clinical implications of endodontic treatment in the prevention and cure of periapical lesions. To carry out this study, a number of 50 books and specialty articles were studied (see bibliography). Non-surgical and surgical endodontic treatments have a high success rate in treating and preventing apical periodontitis when performed in accordance with standard and accepted clinical principles. However, periapical endodontic lesions remain in some cases an additional treatment to be considered when apical periodontitis persists. (1) Periapical lesions of endodontic origin are common pathological diseases that affect the periradicular tissues. Microbial infection of the pulpal tissues is primarily responsible for the onset and progression of apical periodontitis. (2) Evaluation of the healing of periapical lesions should be done periodically, which requires long-term follow-up. Even large periapical lesions and retreatment cases in which the lesion is of endodontic origin have been successfully managed non-surgically with orthograde endodontic therapy. (2)

The desideratum of any dentist / endodontist should be to preserve the pulpal vitality, according to the principle witch says that the best canal filling is the dental pulp itself. In daily practice we must be guided by the postulate of Hippocrates: “Primum non nocere.” Several maintain that the pulp cannot sustain any insult, while others are convinced that because it is very resistant any attempt to preserve it is justified [1]. It was once thought that only pinpoint exposures could be pulp capped, however more recent research would suggest that the size of exposure has no bearing on clinical outcome [2,3,4]. The issue of age is also difficult, as there is no clear cut-off when a direct pulp cap should no longer be considered. The ageing process is gradual and with increased age the pulp tissue becomes more fibrous with a reduction in pulp volume as a result of physiological secondary dentine formation and reactionary dentine due to external stimuli such as trauma, caries and tooth wear. The blood supply to the dental pulp is critical to its health and regenerative capacity, and as this decreases with age so does its capacity to respond to a direct pulp cap [5]. Finally the location of the exposure is important as there should be no pulp tissue coronal to the exposure. Exposure in a cervical cavity would lead to reactionary dentine formation which would restrict the blood supply to the tissue more coronal to it, leading to necrosis and failure. These teeth should therefore be root treated [6]. As Barchall states:” More than 15 years ago, the treatment demarcation for a pulpotomy and/or pulp-capping procedure versus performing a pulpectomy was fairly straightforward. A pulpotomy or pulp-capping procedure was a temporary treatment of the pulp until a full rooth canal treatment could be scheduled. Advancements in technology and materials in the field of endodontics have led to a paradigm shift in vital pulp therapy over the past years. With the arrival of modern method of endodontic treatment, rotary endodontic instruments, apex locator, endodontic micromotors, vertical warm condensing systems, pulpectomies became the treatment of choice over pulp-capping and pulpotomies on a vital pulp. This was because the clinician was now able to effectively and efficiently perform root canal treatment with rotary endodontic files as compared to using all hand-file instrumentation as previously. Specifically, these advancements are the clinician’s ability to histologically assess a carious-involved pulp and the advent of bioceramic materials. Up to a few years ago, the prevailing thought was that if a carious lesion encroached the pulp and the pretreatment pulpal diagnosis was a normal pulp or reversible pulpitis, the entire pulp tissue was considered inflamed and would require a pulpectomy “[7]. Ricucci et al found that clinical pulpal diagnosis of a normal pulp or reversible pulpitis had a 96.6% histological match to the normal pulp tissue in a tooth [7, 8] This study also showed that, in this type of case scenario, pulpal inflammation was localized to the area of the caries alone and the rest of the pulp tissue was observed to be normal. Consequently, the therapy of vital pulp is the treatment of choice if the pulp is exposed during the removal of caries, followed by the placement of a permanent restoration.

The aim of the study is to show the importance of performing a correct endodontic treatment followed by periodic radiological monitoring of teeth with extensive apical lesions. Material and method: On radiological examination it was observed the existence of an extensive apical lesion at the level of the tooth 46. Results: The chemo-mechanical treatment was performed, the root canals were filled, the rest oration was made with a crown and periodic radiographs were performed at 6,12 and 24 months. Conclusions: Our study confirms that large periapical inflammatory lesions can be cured by non-surgical endodontic therapy.

Aim of the study: the purpose of this study is to compare the two rotary systems in terms of efficiency and quality of curved root canals instrumentation. Material and methods: to perform this study, 20 molars with fully formed apexes and root canals with curves between 25 and 35 degrees were used.Subsequently, all teeth were divided into two groups, each group having a number of 10 root canals: Group A - Mtwo system (VDW) was used, Group B - ProTaper Next system was used (Dentsply Maillefer). Results All teeth were x-rayed initially and after the canal fillings were completed. During the study, the following were noted: working length, apical diameter, working time, the degree of widening of the canals given by each rotary system, the ability of each system to respect the initial anatomy of the canals, the quality of the canal fillings, possible accidents during instrumentation. Conclusions The ability of Ni-Ti rotary instruments to remove dentin and pulpal debris is closely related to the design features of the instruments, in particular the cross-sectional appearance and the cutting blades

This study is a literature review in order to irrigants in endodontics. A successful endodontic treatment relies on eradicating the germs found in the canal system and preventing reinfection. Alongside the irrigants commonly used in endodontics, in order for the treatment to be successful there have been introduced different irrigation systems that bring benefits such as: decreased time to act and the way of penetration at the isthmi level and lateral canals and of irrigation substances, where instrumentation is not sufficient.

Dentoalveolar ankylosis represents the fusion of cement to the alveolar bone with obliteration of the periodontal space. The aim of the study is to describe the macroscopic and microscopic appearance of dentoalveolar ankylosis in order to establish the nature of the connection between the dental roots and the alveolar bone. Material and methods: The study was performed on 7 extracted teeth, one monoradicular (canine) and six pluriradicular teeth in which at the time of extraction the presence of an alveolar bone fragment attached to the root was observed. For macroscopic identification of tooth ankylosis lesions, we used photographs made with Canon DSLR 600EOS. Evaluation of dentoalveolar ankylosis lesions was performed by microscopic analysis using the Nikon SMZ745T stereomicroscope recommended for both industrial and biomedical applications. Results and discussions: Microscopic analysis revealed features of the root surface affected by ankylosis, features of the bone tissue attached to the root surface and the nature of the connection between the two components of ankylosis. Conclusions: The microscopic study established that there are areas where ankylosis is complete with the disappearance of periodontal space and areas where ankylosis is incomplete.

Aim of the study This study aims to define the prevalence of partial edentation in a group of patients, based on the Kennedy classification and the size of dental breaches, establishing also correlations with social-economical and local factors. Material and methods Our study group consisted of 337 patients with rural residence, with ages comprised between 17 and 79 years old. Results Partial edentation was identified for 325 patients, at early ages too, and its prevalence increased progressively up to 50-60 years old, when the number of patients with full dental arches becomes almost insignificant. Kennedy Class III has the highest prevalence for both maxillaries; and the size of edentation breaches increases proportionally with age. Most patients presented also caries (92.62%). Conclusions Our study emphasized a high prevalence of partial edentation, for both maxillaries, the most frequent edentation form being Kennedy Class III identified for both young and adult patients

Aim of the study This study investigated the magnitude and distribution of stress in a maxillary first premolar subjected to normal and heavy occlusal loads, that were directed vertically and horizontally, using Finite Element Analysis. Material and methods A virtual 3D model of a maxillary first premolar was created using the CT images of a 14 year-old patient and the physical and mechanical properties of the dental tissues used in other studies. We obtained 8 scenarios for the vertical loading and 8 scenarios for the horizontal loading. Results The magnitude and distribution of stress were the least favorable in the case of the heavy horizontal loading applied on the intact tooth. Conclusions Our study showed that the intact tooth was the most affected by stress regardless of the loading applied.

In this study we have monitored the assessment of the prognosis related to the root amputation therapy and the examination of factors which influenced the failures and had an effect upon the viability of this surgical technique. The statistical analysis carried out within this study comprised two groups of patients summarizing a total number of 146 patients; the study was carried out for a period of 8 years, between 2003 and 2011 respectively. The overall number of patients examined was divided in two groups, maxillary and mandibular. The results of the study evidenced that the failure rate due to periodontal diseases for the two groups of patients represented 30.8%. A higher percentage was recorded for Group 1 – Maxillary as compared to Group 2 – Mandibular. The results of the coronary radicular amputation could be impacted by different factors, known as risk factors which affect the evolution of the periodontal disease; a significant role for that purpose is played by those factors related to the inner resection, to the patient, to the respective tooth and its topography.