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In the control of occlusal caries, the major challenges are related not only to the detection of non-cavitary lesions, but also to the establishment of the treatment strategies to be subsequently applied. Considering the objective of each treatment, that of helping the patient, it is essential to control the progression of carious lesions by means of nonsurgical, preventive/therapeutical methods, whenever necessary. The new strategies applied in caries management are based on the evaluation and predictibility of possible risks, a major aspect in the daily taking of therapeutical decisions. The management plan should include: (I) patient’s level of risk, (II) patient’s activity level and (III) severity of the lesion. Various strategies for a most efficient management of patient’s problems, as well as of the carious lesions, have been elaborated by specialized medical organisms, such as: strategies established within ICDAS, CAMBRA, strategies of the caries management system (SMC) and protocols indicated by the system of caries classification according to ADA (American Dental Association). The mission of any new model of caries management is first of all to preserve the dental tissues, and to restore them when only recommended – an idea to guide the decisions of practitioners, starting with the moment of anamnesis, clinical examination and estabishment of diagnosis, until the end of the treatment

Due to the multifactorial etiology of the carious process and also to the dynamic character of the disease, its clinicaltherapeutical management becomes increasingly complex. The strategies applied in the management of occlusal caries have had several stages, starting with the pre-restorative period, when only few empirical and simple restorative methods were available. The following so-called ”restorative” stage was dominated by the belief of specialists and researchers that the only efficient treatment of carious lesions, whichever their evolution stage, is reconstruction of the odontal functional morphology through obturations. In the last decades of the last century, the preventive principles, supported by a better understanding of the mechanisms of action of fluoride, gained more and more space, ”the preventive stage” being now in progress. The major challenge in the management of the carious process is the control of its advance especially through preventive/therapeutical non-operative measures. The scope of any pattern of caries management is first to maintain the dental tissues, and to restore them only when recommended: such a desiderate should be considered in all decisions taken during anamnesis, clinical examination, establishment of diagnostis, until the end of the treatment.

The aim of the study was to evaluate the surface condition, after finishing and polishing with 3 different systems, of a flowable composite material, starting from the microstructure experimentally analyzed by atomic force microscopy. Materials and method. The material tested in the present study was Filtek Ultimate Flowable Restorative (3M ESPE) composite. 20 cylindrical samples, 5 mm in diameter and 2 mm thick, were prepared by using metallic molds. The samples were randomly divided into 4 groups: a group containing 5 control samples, not subjected to finishing and 3 groups formed, each, of 5 samples for each of the three finishing and polishing systems, respectively system 1: the two-step Sof-Lex (3M ESPE), system 2: multistep Super Snap (Shofu, Inc. Kyoto, Japan) and system 3: multi-step OptiDisc (KerrHawe SA, Switzerland). The surfaces of the samples were analyzed by atomic force microscopy. For quantitative evaluations, the rugosity parameter (Ra), and the mean deviation of the determined profile were calculated. Results. All 3 polishing systems determined an increase of the Ra parameter, comparatively with the control samples; the highest mean Ra value, of 1.19 µm, was recorded for system 3, followed by system 2 (mean Ra value = 1.12 µm), while the lowest mean value, of 1.10 µm, was registered for system 1. Conclusions. All three systems under investigation induced increased rugosity on the surfaces of the samples prepared from the Filtek Ultimate Flowable Restorative (3M ESPE) composite resin. The most abrasive system appears to be OptiDisc (KerrHawe SA, Switzerland), followed by the Super Snap (Shofu, Inc. Kyoto, Japan) system, the one recording the lowest abrasion being SofLex (3M ESPE).

The aim of this study was to evaluate the variation of salivary micro-crystallization saliva index (IMK) in patients with gastroesophageal reflux desease, after utilisation of a remineralization product. Materials and method. Twelve patients suffering from gastroesophageal reflux were included in the study. Unstimulated saliva was collected in the same day and at the same hour for each patient. A total amount of 0.5 ml of unstimulated saliva was placed on a glass plate, dried for 30 min in a thermostate at +37oC, then analyzed on a Nikon Eclipse E 600 device. The images were saved and stored in a computer. The IMK index was determined using formula: IMK= none of the eye network points projected on crystals/ none of the eye network points projected on the entire saliva drop. All patients were subjected to dental hard tissues remineralization using Recaldent MI Paste (GC Corporation) for 3 weeks, after which the IMK index was determined for each patient. Results. The appearance of crystals formed by saliva precipitation on the plates corresponds to one of these aspects: dendrite-shaped crystals, camomile flower, multiple points, micronetwork, cube or egg-shaped forms. The mean values of the IMK index varied from 0.4 before tratment to 0.9 after remineralization with Recaldent MI Paste. Conclusions. Recaldent MI Paste increased the remineralization capacity of saliva when applied to patients with gastroesophageal reflux disease.

The aim of the study was to compare the surface morphology of enamel and the variation of the mineral ions concentration after the manifestation of the erosive effect determined by various commercial beverages for athletes. 14 premolars extracted from orthodontic reasons have been cut in two halves. On each section, an enamel surface of 3x3 mm was preserved for investigations. The samples have been divided into 4 groups. In the control group, the 7 sections were kept in artificial saliva while, in the other 3 groups, the sections were introduced in 3 beverages for athletes: Gatorade Citron (Pepsi Cola Co.), 5-hour Energy (Living Essentials), Powerade Cherry (Coca Cola Co.). The samples were analyzed on an electronic microscope with Vega II LSH scanning device, coupled with EDX Quantax QX2 detector. SEM analysis evidenced erosion zones at the level of enamel, which appears pinched in the samples subjected to the action of acid beverages. A decreasing tendency of the average values of calcium ion concentrations was observed in the batches in which the enamel samples had been subjected to the action of beverages for athletes. The highest relative variations of calcium and phosphorous ions (10%, respectively 8%) were recorded for Gatorade, followed, in decreasing order, by Powerade, for which variations of 9%, respectively 6%, were noticed, and by the 5-hour Energy beverage, in which the relative losses were of 5%, respectively 3%. All beverages for athletes tested in the present study showed erosion potential upon the dental enamel. Gatorade appeared as the most aggressive beverage for athletes followed by Powerade and 5-hour Energy.

The objective of the present investigation was to compare the precision of canal working length (Ll) measurements by electronic and radiological methods. Materials and method. The study was developed on a group of 122 anterior teeth of 118 patients, with ages between 23 and 58 years. The teeth were divided into 3 groups. The first one included 45 teeth, for which the working length was calculated with an electronic device (Apex Locator model iPex, NSK, Japan). In the second group of teeth (39 in all), the working length was calculated by the radiographic method of Ingle and, in the third one (38) – by the method of Bregman. When the technique of canal modeling was applied to all groups of teeth, a primary gutta percha cone (master) was positioned on the canal at the exact working length calculated for each tooth in part, after which an intra-oral radiography was made and the distance between the apical end of the master cone and the apical constriction was measured. Results. In group I, 91.1% of the Ll measurements were exact, and 8.9% of them were shorter, yet remaining within the limit of 2 mm versus the apical constriction. In group II, 71.7% of Ll were correctly measured, in 5.1% of the cases the calculated length was higher and in 23.2% of them the obtained values led to sub-obturation. Out of the inexact measurements, 44.4% evidenced the tip of the master cone within the limit of 2 mm versus the apical stricture. In group III, 60.5% of the measurements gave exact results, 13.1% of them – higher and 26.4%, respectively – lower. 53.8% of the cases of over- or sub-instrumentations occurred within the limit of 2 mm versus the apical constriction. Conclusions. The method for the calculation of working length with an electronic device of apical localization appeared as the most correct one, being followed by the radiographic technique of Ingle and by the method of Bregman. Application of the electronic method showed no case of apical over-instrumentation, while the sub-instrumentation cases were within the limit of the apical 2 mm, considered as accepted limits. The highest number of both over-instrumentation and sub-instrumentations was registered with the Bregman method.

The purpose of the study was to establish and compare the effects of ortophosphoric and hydrochloric acids on the enamel affected by incipient carious lesions with different evolution. Materials and method. 20 teeth with acute and chronic non-cavitary carious lesions were considered for the study. The teeth were sectioned in two halves through the middle of the non-cavitary lesions. The halves of 5 white spot-type lesions and of 5 brown spot-type ones were analyzed as to their surface roughness, on an atomic force microscope (AFM). 5 halves with white spot-type lesions and 5 halves with brown spot-type ones were subjected to acid etching with 37% ortophosphoric acid (Scotchbond etchant gel, 3M ESPE), and an equal number of samples was subjected to the action of 15% hydrochloric acid (ICON-etch, DMG Dental Products Ltd) for 2 min, then washed with water and analyzed by AFM. Results. The initial surface roughness of the enamel was higher in the white spot–type carious lesions, comparatively with the brown spot-type ones. For both types of carious non-cavitary lesions, acid etching with phosphoric and hydrochloric acid significantly increased the surface roughness of the enamel, comparatively with the status of the enamel surface prior to etching. The hydrochloric acid led to a surface roughness significantly higher than in the case of ortophosphoric acid, in both acute and chronic non-cavitary carious lesions. The roughness values obtained through etching with ortophosphoric and hydrochloric acid were higher in the white spot-type carious lesions, comparatively with the brown spot-type ones. Conclusions. Both the 37% ortophosphoric acid and the 15% hydrochloric acid determined a significantly higher surface roughness of the enamel affected by acute and chronic non-cavitary carious lesions. The surface condition of the brown spot-type carious lesions was less significantly modified, comparatively with that of the white spot-type lesions, by the action of either ortophosphoric or hydrochloric acid.

Oscillation energy has been proposed in a new method to condense resin composites. The principle of this technique assumes that vibration lowers the viscosity of the resin, allowing the material to flow and easily adapt to the cavity walls, in a similar way as a flowable composite. The aim of the study was to assess the efficiency and quality of composite compaction, using one of these new devices. MATERIALS AND METHOD: The study included 20 class I cavities prepared in extracted human molars. The teeth were randomly divided into two groups of 10 cavities. Both groups were filled with composite material Filtek Z250 and the adhesive system Single Bond Plus Adhesive Adper TM Adhesive (3M ESPE). In the control group, condensation of the composite was done with standard instruments. In the experimental group, condensation was done using a vibration instrument: Compothixo (Kerr). The prepared sections were observed on a scanning electron microscope (SEM), VEGA II model LSH (TESCAN). RESULTS: When using Compothixo, the average working time was 8.53 min / restoration while, when using standard instruments, the average working time was 10.32 min, which seems to indicate that the vibration technique was more effective than traditional condensation. Microscopic images have shown that neither vibrating condensation nor manual condensation precluded the formation of a hiatus in some areas of the interface between the restoration and the cavity walls, especially in areas of small irregularities. CONCLUSIONS: Condensation of composite resins can be faster when using vibrating instruments. Adaptation of the material to the cavity walls is comparable to that obtained by traditional techniques.