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The introduction of nickel-titanium rotary instruments revolutionized shaping procedures as they were able to produce a well-tapered preparation while reducing operator fatigue. The major drawback of rotary instruments was the high risk of fracture due to bending and torsional stress. Thus, the creation of a glide path has been advocated and recommended by most rotary instrument manufacturers. The aim of the present review is to summarize existing knowledge on glide path preparation and identify areas where further research is needed. The primary goal is to provide a comprehensive overview of the techniques and instruments used in glide path preparation, highlighting their advantages and limitations. The secondary goal is to explore the effect of glide path creation on the overall success of endodontic treatment, particularly in terms of reducing procedural errors and improving treatment outcomes. An online search on PubMed, ScienceDirect, UCLA, and Scopus databases was conducted, and 116 articles were identified. Eligible articles were divided into nine categories based on what they researched and compared. The categories included centering ability and/or root canal transportation, cyclic fatigue resistance, glide path and shaping time, tortional stress resistance, apical extrusion of debris and/or bacteria, defects in dentine walls, file separation, postoperative pain assessment, and scouting ability and performance. Establishing a glide path reduces root canal transportation, especially with rotary methods. Reciprocating and heat-treated files offer higher fatigue resistance and shorter preparation time. Instruments with shorter pitch lengths have greater torsional strength. Preparation and coronal preflaring reduce apical debris and bacteria. Glide paths do not affect dentine microcracks, file separation, or defects but reduce immediate postoperative pain and improve cutting ability. Randomized trials are needed to assess their impact on treatment outcomes.

Periodontal disease and diabetes often co-occur; both are characterized by chronic inflammation. This study aimed to investigate the anti-inflammatory effects of carvacrol and magnolol when incorporated into a periodontal hydrogel and topically applied to Wistar rats with diabetes-associated periodontal disease. Forty male albino Wistar rats were divided into four groups: PD (induced diabetes and periodontitis), PDC (induced diabetes and periodontitis treated with carvacrol), PDM (induced diabetes and periodontitis treated with magnolol), and PDCM (induced diabetes and periodontitis treated with both carvacrol and magnolol). Post treatment, gingival tissue samples were collected to measure levels of the pro-inflammatory cytokines IL-6 and TNF-α. The PDCM group exhibited significantly lower levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) compared to the PD group. The combined application of a periodontal hydrogel containing carvacrol and magnolol may significantly reduce gingival inflammation in rats with diabetes-associated periodontal disease., Competing Interests: The authors declare no conflicts of interest.

Objectives: The article's aim is to test if rotary or reciprocating glide path influences the overall performance of WaveOne Gold in S-shaped canals., Methods: Sixty endo training blocks with an S-shape curvature were divided into three groups based on the glide path method used: no glide path; glide path preparation with ProGlider; glide path preparation with WaveOne Gold Glider. All blocks were then shaped with WaveOne Gold Primary. The time for shaping, the incidence in reaching working length and the number of pecking motions were recorded. ANOVA with Turkey's test was used, and the p -value was set to 0.05., Results: WaveOne Gold Primary reached working length faster in the control group when comparing total working times. No significant differences in the ability of the WaveOne Gold Primary to reach working length in all groups ( p > 0.05). The mean number of pecking motions was higher in the control group compared to other groups., Conclusions: No significant differences in the time needed to achieve a glide path between Proglider and WaveOne Gold Glider. WaveOne Gold Primary can shape a double curved canal faster if a glide path is present but takes less time to reach length if it is the only file used. No difference in the ability to reach working length.

It is well recognized that oxidative stress contributes to chronic stress-induced cytotoxicity, which is a major factor in the progression of many diseases, including periodontitis and diabetes. Formulas based on natural extracts with antioxidant properties are alternative treatment perspectives in the management of such diseases. The aim of our study was to assess how carvacrol and magnolol influence periodontitis associated with diabetes in Wistar rats. Ninety Wistar rats were distributed in nine groups: I-control group; II-diabetes group (D); III-periodontitis group (P); IV-periodontitis and diabetes group (PD); V-periodontitis and diabetes with vehicle alone (PDV); VI-periodontitis and diabetes treated with carvacrol (PDC); VII-periodontitis and diabetes treated with magnolol (PDM); VIII-periodontitis and diabetes treated with carvacrol and magnolol (PDCM); IX-healthy group with vehicle alone (CV). Blood malondialdehyde (MDA) levels and catalase activity levels (CAT) were measured as indicators of oxidative stress and antioxidant capacity, respectively. Where diabetes and periodontitis were induced, MDA was augmented and CAT was depleted significantly. Whether given alone (PDM) or in combination with carvacrol (PDCM), magnolol significantly decreased MDA. Between the PDM group and the PDCM group, there were no notable differences. In Wistar rats with periodontitis related to diabetes, topical use of hydrogels containing magnolol, either alone or in combination with carvacrol, may reduce oxidative stress.

Pediatric dental emergencies can occur as a result of untreated dental caries, or can be caused by trauma or periodontal issues. The lockdown imposed during the COVID-19 pandemic reduced the number of centers authorized to deliver dental services in Romania, with only a small number of dentists delivering dental emergency treatments. The aim of this study was to investigate the demographic characteristics of children and adolescent patients who were treated in the dental emergency department of Oradea, Romania and to compare the patients who were treated in the dental emergency department in the pre-lockdown (2019), lockdown (2020) and post-lockdown year (2021). All patients who were treated in the dental emergency department were included in the study except for adults and medical files that did not contain all relevant information. Several variables were investigated (age, gender, living environment, location of affected teeth, type of emergency). In 2019, 257 children and adolescents were treated, in 2020, 198, and in 2021, 136. Most patients were aged 7-12 years in all investigated years (2019-47.9%; 2020-50.5%; 2021-43.4%), and the most affected teeth were located in the lower posterior arch (2019-53.3%; 2020-53%; 2021-48.5%). The most frequent emergencies were pulpitis (2019-40.5%; 2020-43.9%) and acute apical periodontitis (2021-42.6%). It was observed that in 2019, patients aged between 0 and 6 years were more frequently associated with trauma ( p < 0.001), and in 2019 and 2020, patients aged between 7 and 12 years were more frequently associated with periodontal emergencies ( p < 0.001). In 2020, patients from rural areas were more frequently associated with pulpitis ( p = 0.025), and in 2021, patients from rural areas were more frequently associated with pulpitis or acute apical periodontitis, and patients from urban areas were associated more frequently with periodontal emergencies ( p = 0.042). Pediatric patients with ages between 7 and 12 years old, who lived in an urban environment were most affected. Teeth located in the lower and upper posterior dental arches were most affected, and pulpitis or acute apical periodontitis were the most common pathologies.

The COVID-19 pandemic affected the daily lives of the global population, not only in terms of social interaction but also in terms of access to medical and dental care. Non-urgent dental treatments could not be continued during the lockdown and only a small number of dental centres addressed patients with dental emergencies. The aim of this study was to evaluate the socio-demographic characteristics (age, gender, and living environment) of the individuals that accessed the dental emergency centre in Oradea (North-West Romania) and the main causes for accessing the dental emergency service among the population of Oradea (North-West Romania), during the COVID-19 lockdown, between March and May 2020 and, furthermore, to compare the results obtained in the lockdown timeframe (March-May 2020), with the results obtained in the corresponding timeframe in the pre-lockdown year (March-May 2019) and post-lockdown year (March-May 2021). The retrospective study was carried out by analysing the medical records of the patients who were treated in the dental emergency service of the Oradea County Emergency Clinical Hospital in the following periods: March-May 2019, March-May 2020, and March-May 2021. Most patients were treated in 2020, during the lockdown ( n = 784), predominantly in April ( n = 308). Most patients treated in April 2020 were male patients (43.7%, n = 205) and were aged between 30 and 39 years (19.4%, n = 74). The most frequent types of dental emergencies were acute apical periodontitis and acute pulpitis in all the months and years investigated. During the lockdown months of 2020, acute pulpitis was the most frequent type of emergency in March (42.2%, n = 100) and May (45.6%, n = 109), while in April, acute apical periodontitis was the most frequent type of emergency (43.5%, n = 166). The COVID-19 lockdown led to an increase in the number of patients that required emergency treatments and impacted all groups of people investigated.

Mini-implants have undeniable advantages in Orthodontics. However, the use of mini-implants shows some limitations and disadvantages related to patient age, the quality of the bone tissue, the characteristics of the oral mucosa, implant site, the state of health of the organism and the quality of oral hygiene. The aim of this paper was to analyze the rejection rate of mini-implants in teenage patients, depending on their insertion site, and examine their stability up to three months after insertion. This retrospective study was conducted on dental charts belonging to patients aged between 12 and 17 years, from Oradea, Romania. The mini-implants were placed for various therapeutic reasons and were inserted in the following sites: buccal maxillary area, the infrazygomatic region, palatal area, buccal mandibular area and lingual area; they had a diameter of 1.6 mm (inter-radicular spaces) and of 2 mm (nonbearing tooth areas), and a length of 6-8 mm (mandible) or 8-10 mm (maxilla). The rejection rate was checked in the first month, second month, third month and after the third month from insertion. A total of 432 patients were included in the study, and they had a total of 573 mini-implants. Most implants were placed in the buccal region of the maxilla (27.7%), and most patients had one mini-implant placed (65.7%). The highest rejection rate was obtained in the first month (15.2%). The rejection rate between genders was similar. The mini-implants from the buccal mandibular region had a significantly higher rate of rejection in the first month (M1) in comparison to the mini-implants from the palatal region (24.4% vs. 8.3%). The mini-implants from the lingual region of the mandible had a significantly higher rate of rejection in the second month (M2) in comparison to the mini-implants from the infrazygomatic or the palatal region (10.5% vs. 0%/0%). Mini-implants are very useful for carrying out various orthodontic treatments, but their stability should be enhanced.

During the COVID-19 pandemic, the protective face mask has proven to be essential. The protective face masks cover the lower part of the face, including teeth and, for orthodontic patients, the orthodontic appliances. The aim of this study was to assess the impact that the restrictive measures that were imposed during the COVID-19 pandemic and, especially, wearing a protective face mask had on a sample of Romanian children, and to compare the results previously obtained on a sample of Romanian teenagers with the results obtained after investigating children under the age of 12 years. The cross-sectional survey was conducted in two orthodontic offices from the city of Oradea, Romania. The study sample included children with ages between 8 and 11.9 years that were undergoing an orthodontic treatment with removable or fixed orthodontic appliances. After obtaining the results, comparisons were made with the answers provided by a group of adolescents previously investigated. The questionnaires consisted of 9 items that investigated children' attitudes toward protective face mask wearing and other aspects related to the COVID-19 pandemic. Two hundred fifty-six children were included in the study (53.1% female patients, 46.9% male patients). Most of the children were not worried that face masks would hide their orthodontic appliances (Item 1-Never, 40.2%; Rarely, 28.9%) and did not consider that the necessity of face mask wearing negatively impacted their desire to undergo an orthodontic treatment, despite the fact that it covered the appliances (Item 2-Never, 37.1%; Rarely, 31.6%). However, 44.5% of children were not happy because they had to wear a face mask during the orthodontic treatment, considering the fact that it covered the orthodontic appliance (Item 6), and most patients (49.2%) did not want the face mask to continue to be mandatory (Item 7). Although children were not happy that they had to wear a face mask that covered the orthodontic appliances, protective face masks were generally well tolerated by Romanian children.

(1) Background: In patients hospitalized with COVID-19 pneumonia, especially moderate and severe forms, a cytokine storm may occur, characterized by the worsening of symptoms and the alteration of biological parameters on days 8-12 of the disease. The therapeutic options for cytokine storms are still controversial, requiring further clarification; (2) Methods: Our study included 344 patients with moderate and severe pneumonia admitted to the internal medicine department who developed a cytokine storm (diagnosed by clinical and biochemical criteria). In group A, 149 patients were treated with Remdesivir and Tocilizumab (together with other drugs, including corticosteroids, antibiotics and anticoagulants), and in group B, 195 patients received Remdesivir and Anakinra. Patients were monitored clinically and by laboratory tests, with the main biochemical parameters being CRP (C-reactive protein), LDH (lactic dehydrogenase) and ferritin; (3) Results: Patients were followed up from a clinical point of view and also by the measurement of CRP, LDH and ferritin at the beginning of therapy, on days three to four and on the tenth day. In both groups, we registered a clinical improvement and a decrease in the parameters of the cytokine storm. In group A, with the IL-6 antagonist Tocilizumab, the beneficial effect occurred faster; in group B, with the IL-1 antagonist Anakinra, the beneficial effect was slower. (4) Conclusions: The use of the immunomodulators, Tocilizumab and Anakinra, in the cytokine storm showed favorable effects, both clinical and biochemical.

Dental age assessment is useful in various medical fields. The Demirjian method for dental age estimation is one of the most widely used in the field of pediatric dentistry. The aim of this study was to verify the accuracy of the Demirjian method in determining age in a sample of girls and boys from Oradea, Romania. This retrospective and radiographic study was based on the evaluation of 1006 panoramic radiographs, belonging to 1006 patients (431 boys and 575 girls) with ages between 3 and 13.9 years from the city of Oradea, Romania. They were collected from three private dental practices from Oradea and were analyzed between 1 September 2021, and 10 November 2021. The patients were distributed into 11 age groups, each group spanning over one year (e.g., 3−3.9, 4−4.9). For the assessment of dental age, the Demirjian method was used, which is based on the evaluation of the developmental stages of the lower left permanent teeth. The mean chronological age of the patients was 9.496 ± 2.218 years, and the mean dental age was 10.934 ± 2.585 years. The overestimation of dental age was obtained in all age groups for the entire sample. As such, dental age was higher than chronological age, with values varying from 0.34 years in the 3−3.9 years age group to 1.7 years in the 10−10.9 years age group. In girls, dental age was higher than chronological age, with values varying from 0.46 years in the 3−3.9 years age group to 1.73 years in the 11−11.9 years age group, while in boys, the values varied from 0.15 years in the first age group to 2.02 years in the 10−10.9 years age group. The comparison of the differences between chronological age and dental age according to the gender of the patients revealed that the distribution of the differences was nonparametric in both groups according to the Shapiro−Wilk test (p < 0.05). The differences between the groups were not significant according to the Mann−Whitney U test. However, larger differences were identified for boys (1.46 years) than girls (1.417 years), with an overestimation of the dental age. The Demirjian method overestimated the age of the children included in the investigated sample, with different values for the different age groups investigated, and requires adaptations.

Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34.94% male and 63.86% female) were included in the research. Sociodemographic data were collected, together with new institutional and personal rules regarding preventive behaviors. Fear of COVID-19 Scale was used to measure the fear of infection. Data was analyzed using SPSS (v.25, SPSS Inc., Chicago, IL, USA). During the first seven months of confinement, 3.9% of dentists were confirmed with COVID-19 and one fourth treated confirmed positive patients. A quarter of the doctors declared that they had periods when they lived away from home being afraid of transmitting the disease to their family members, and significant data were found in doctors being parents. The closure of dental offices had a negative impact on the financial situation of dentists, especially on those working in rural area offices. Many doctors encountered difficulties in purchasing protective suits and medical supplies, and more than half of the respondents (65.1%, N = 54) focused on the quality of protective suits when purchasing them. More than half of the dentists were trained how to use them. The score for fear of COVID 19 was similar to dentists from other countries. Respondents with chronic diseases were more prone to show higher level of anxiety when following the news and stories related to COVID-19 on TV, media, or social networks. One third of dentists mentioned that they had treated exclusively specific urgent dental problems since the onset of the pandemic and more than 13.3% declared that they refused to provide medical assistance to some specific pathologies because of the fear of infection. The results reflect new challenges and rules adopted by dentists in order to diminish the risk of infection and the impact of pandemic considering their psychological, familial, and financial context. Policymakers and professional associations around may benefit from these findings while formulating guidelines to support dentists during COVID-19 or any future pandemics.