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The importance of preserving dental tissues together with the evolution of dental techniques and materials has led to advances in the field of endodontics and new principles in tooth restoration. Endodontically treated teeth are more prone to fracture and endodontically treated abutment teeth have a lower survival rate compared to vital abutment teeth. The aim of this study was to establish the evolution of teeth with endodontic treatment in a group of patients from Craiova, the frequency of various forms of failure of endodontic treatment and to identify the factors that contributed to the failure or success of endodontic treatment. Materials and Methods: This study was carried out based on the clinical and radiological examination and the consultation of the treatment sheets of some patients who came for treatment in the Dental Prosthetics Clinic of the Faculty of Dental Medicine of the University of Medicine and Pharmacy Craiova. The general technical quality of the endodontic treatment was evaluated based on the guidelines published by the European Society of Endodontology, following the radiological appearance of the root canal obturation as well as the presence of periapical lesions. The periapical index (PAI) proposed by Orstavik et al. was used to assess the periapical condition of teeth with root canal fillings. Results: The most common indications for endodontic treatment were irreversible pulpitis (64.05%) and endodontic treatment for prosthetic purposes (23.72%). Periapical lesions were observed in 33.4% of all endodontically treated teeth. Periapical lesions were observed in 35.2% of endodontically treated abutment teeth compared to 7.1% of vital abutment teeth. Conclusions: The most common indications for endodontic treatment were irreversible pulpitis and endodontic treatment for prosthetic purposes. Endodontic treatments for prosthetic purpose were very frequent although there are clear recommendations against it. Periapical complications were recorded in a higher proportion in case of abutment teeth.

Aim of the study: to evaluate the degree of statistical association between the oral parameter represented by the total number of permanent lost teeth (NLT) on both arches, and a certain type of cardiovascular disease. Materials and methods: 84 hospitalized participants in the Cardiology Department from DrobetaTurnu-Severin County Emergency Clinical Hospital were evaluated in the Emergency Dentistry Department of the same hospital. The demographic and clinical data were collected and statistically analyzed using Chi-square and Kendall’s tau-b, followed by two binomial regression models. Results: A strong, positive association between the NLT and the presence of heart valve diseases, respectively cardiomyopathy was highlighted by Chi-square tests (χ2(2) = 8.774, p = 0.023, respectively χ2(2) = 19.137, p < 0.0005) Also, NLT between 9 and 14 may be considered a statistically significant predictor of developing cardiomyopathy (unadjusted OR = 6.548, 95%CI = 1.764 – 24.304, p < 0.0005), and NLT between 15-27 for developing heart valve diseases (unadjusted OR = 7.886, 95% CI = 1.698 – 36.616, p = 0.008). Conclusions: For the group of participants included in the study, NLT had a statistically significant predictive value especially for heart valve diseases and cardiomyopathy.

The use of custom CAD/CAM abutments in implant restorations has become a reality, but there are questions about the existence of micro-gaps at the implant-abutment junction larger than those of the original standard stock abutments. The purpose of this study was to compare dimensions of the micro-gaps between four types of implant abutments (original dental implant stock abutments, compatible dental implant stock abutments, and two types of customized CAD/CAM dental implant abutments) all with the same connection of Bredent Sky system mounted on a standard implant. Material and Method: Micro-gap measurements were made on four groups of Titanium abutments: 1) original dental implant stock abutments – industrial machined, 2) compatible dental implant stock abutments – industrial machined and 3) and 4) compatible customized CAD/CAM dental implant abutments – non-industrial milled with two different parameters in hyperDENT CAM software and Paragon Tools. The Nikon SMZ745T stereomicroscope was used to measure the micro-gaps of each dental implant abutment and results were statistically analyzed. Results: The micro-gaps measured on implant-abutments junction did not show significant differences between original abutment, and the three types of compatible abutments. Conclusions: No significant differences of the micro-gap at the implant-abutment junction were observed between the original implant abutments and compatible abutments, and customized abutments. Micro-gap dimensions were within the clinically accepted limit and the use of custom CAD/CAM dental implant abutments is reliable.

Aim of the study The purpose of this study was to evaluate the microhardness evolution of several finished and polished dental composites modified by bleaching materials, when applied to restoration surfaces. Material and methods Three microhybrid composites and one nano-filled composite that are used in dental restorations were selected. Using these composites, a series of samples were finished and polished over which the “Office Bleach” dental bleaching protocol with 40% hydrogen peroxide gel or the “Home Bleach” dental bleaching protocol with 16% carbamide peroxide gel was applied. Results For all composite types, the differences between the microhardness values corresponding to the control and bleaching groups were statistically significant (p < 0.05). Following the bleaching protocol with 40% hydrogen peroxide gel it was found that the microhardness of the samples decreased considerably compared to the control samples, and the lowest value was recorded for the GC G-aenial Anterior sample (after “Office Bleach”). Following the 16% carbamide peroxide bleaching protocol (“Home Bleach”) it was noted that the microhardness of the samples was not as affected as for the samples bleached with 40% hydrogen peroxide. Conclusions For both the “Home Bleach” and the “Office Bleach” dental bleaching protocols, the differences between the variation in microhardness of the 4 types of composites (before and after bleaching) were statistically significant (p < 0.05), with the “Office Bleach” protocol proving to be the most aggressive for all types of composites.

Psoriasis is an increasingly common chronic immune-mediated skin disease recognized for its systemic effects that extend beyond the skin and include various cardiovascular diseases, neurological diseases, type 2 diabetes, and metabolic syndrome. This study aimed to explore the complex relationship between psoriasis and metabolic syndrome by analyzing clinical, biochemical, and immunological parameters in patients with psoriasis alone and in patients combining psoriasis and metabolic syndrome. A total of 150 patients were enrolled, 76 with psoriasis only (PSO) and 74 with psoriasis and metabolic syndrome (PSO–MS). Data collected included anthropometric measurements, blood tests, and inflammatory markers. Statistical analysis was performed using the independent t-test, Mann–Whitney U test, Kruskal–Wallis test, and chi-square test to compare the two groups. Patients in the PSO–MS group had a significantly higher body weight, abdominal circumference, BMI, and inflammatory markers compared to patients with PSO. In addition, increased levels of IL-17A, cholesterol, triglycerides, and glucose were observed in the PSO–MS group. This study highlights the increased metabolic risk and exacerbated systemic inflammation associated with the coexistence of psoriasis and metabolic syndrome. These findings demonstrate the need for a comprehensive therapeutic approach and early intervention to manage metabolic complications in patients with psoriasis and metabolic syndrome.

Introduction: Dental occlusion refers to the static and dynamic relationships that are established between the teeth of the two arches and is an important factor in the homeostasis of the dento-maxillary system. The objective of the present study was to compare two digital occlusal analysis systems: the T-Scan III system and the Medit I600 intraoral scanner. Materials and Methods: The study was carried out on 20 students from the Faculty of Dental Medicine Craiova, whose dental occlusion was assessed with the T-Scan III system and with the Medit I600 intraoral scanner. Dental occlusion was assessed in the maximum intercuspation position, the edge-to-edge protrusion position, and the edge-to-edge position in right and left laterotrusion. The images of the 2D occlusal contact areas obtained by both methods were converted to .jpeg format and then transferred to Adobe Photoshop CS6 2021 (Adobe Systems, San Jose, CA, USA) for comparison. The recorded data were statistically processed. Results: Analyzing the data provided by the two digital occlusal analysis systems, it was found that the T-Scan III system provided data related to the amplitude of the occlusal forces, the surface on which they were distributed (the contact surface), the dynamics of the occlusal contacts, and the proportion in which they were distributed at the level of the two hemiarches, and the Medit I600 intraoral scanner performed an evaluation of the occlusal interface of the two arches, highlighting the extent of the contact areas with the degree of overlapping of the occlusal components. Although both methods of occlusal analysis recorded the highest values for the maximum intercuspation position, the results could not be compared. Conclusions: The two digital systems provide different data in occlusal analysis. As the T-Scan III system is considered the gold standard for occlusal analysis, more studies are needed to understand the data provided by the Medit I600 intraoral scanner and their significance.

Background: Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing. Methods: A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction. Results: CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant (p ˂ 0.0005). Conclusions: The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.

The aim of this study was to assess the level of odontal lesions to permanent and temporary teeth in a group of school-aged children and to identify the determining factors of odontal lesions in relation to children’s diet. Material and method. The study group included 200 children, 78 girls (representing 39% of the entire study group) and 122 boys (representing 61%), aged between 7 and 16 years old, with a mean age of 12.3 ± 3 years. The majority of participants were from urban areas (190 children, representing 95%), while the remaining 10 children (5%) were from rural areas. The data were statistically processed, and the results were considered significant, and important results for this study were centralized. Results. A total of 614 teeth with lesions were identified, 560 being permanent teeth and 54 being temporary teeth. For permanent teeth: 171 (30.54%) in the first quadrant (majority 1.6 and 1.7), 120 (21.43%) in the second quadrant (majority 2.6 and 2.7), 125 (22.32%) in the fourth quadrant (majority 4.7 and 4.6) and 144 (25.71%) in the third quadrant (majority 3.6 and 3.7). For temporary teeth: 14 (25.93%) in the first quadrant (5.5 and 5.4), 10 (18.52%) in the second quadrant (6.5 and 6.4), 16 (29.63%) in the fourth quadrant (8.5 and 8.4), 14 (25.93%) in the third quadrant (mostly 7.5). Conclusions. Dental caries was present for most children included in the study group. Statistically significant associations were found with the consumption of acidic drinks, pre-meal sweets, juices, and energy drinks. The number of teeth with class I caries increases with age.

Colorectal cancer is one of the most widespread types of cancer that still causes many deaths worldwide. The development of new diagnostic and prognostic markers, as well as new therapeutic methods, is necessary. The calcitonin gene-related peptide (CGRP) neuropeptide alongside its receptor calcitonin receptor-like receptor (CRLR) could represent future biomarkers and a potential therapeutic target. Increased levels of CGRP have been demonstrated in thyroid, prostate, lung, and breast cancers and may also have a role in colorectal cancer. At the tumor level, it acts through different mechanisms, such as the angiogenesis, migration, and proliferation of tumor cells. The aim of this study was to measure the level of CGRP in colorectal cancer patients’ serum by enzyme-linked immunosorbent assay (ELISA) and determine the level of CGRP and CRLR at the tumor level after histopathological (HP) and immunohistochemical (IHC) analysis, and then to correlate them with the TNM stage and with different tumoral characteristics. A total of 54 patients with newly diagnosed colorectal adenocarcinoma were evaluated. We showed that serum levels of CGRP, as well as CGRP and CRLR tumor level expression, correlate with the TNM stage, with local tumor extension, the presence of lymph node metastasis, and distant metastasis, and also with the tumor differentiation degree. CGRP is present in colorectal cancer from the incipient TNM stage, with levels increasing with the stage, and can be used as a diagnostic and prognostic marker and may also represent a potentially new therapeutic target.

Malocclusions have a continuously increasing prevalence from one generation to another as a result of climate change, soil, atmosphere, and water pollution. All of these aspects have unfavorable consequences for the nutritional scheme. Thus, nutrition, together with other etiopathogenic factors, contributes to complex alterations in the somatic development of the entire organism and, implicitly, of the cephalic extremity. The study group included 4147 children from randomly selected schools from Vâlcea County, Romania. The aim of this study is to determine the prevalence of malocclusions in schoolchildren in Vâlcea County, Romania, according to the three main classes of malocclusions (according to Angle’s classification), age groups (from 6 to 10 years old and from 11 to 14 years old), gender (male and female), and place of origin (rural and urban). For Angle class I malocclusions, we recorded the highest prevalence (48.78% of the total number of schoolchildren with malocclusions), followed by Angle class II malocclusions (45.85% of the total number of schoolchildren with malocclusions), and for Angle class III malocclusions we found the lowest prevalence (5.37% of the total number of schoolchildren with malocclusions). According to gender, we found the highest prevalence in the female gender (29.90% of the total number of female subjects), while in the male gender, we recorded a prevalence of 27.70% of the total number of male subjects. Regarding the place of origin, there is a higher prevalence of malocclusions in urban areas (29.16%). The study subgroup included 140 children randomly selected from the total number of subjects in the study group. They were included in a more advanced study. The aim is to find potential associations between the presence of malocclusions and various oral variables. Categorical variables were expressed as numerical values and percentages, and their association was evaluated with either the Chi-square test of association or homogeneity, or the Fisher Exact test. The acquired data were incorporated into a binomial logistic regression model to assess the likelihood of developing malocclusions in relation to the following variables: defective phonation, bruxism, frequency of teeth brushing, onychophagia, oral respiration, infantile deglutition, placing objects between the maxillaries, thumb sucking, and salivary aspects. It is also aimed at comparing the results obtained with similar ones from the specialized literature.

Over the years, several theories regarding the etiology of bruxism have been proposed. Even though these theories are difficult to confirm or infirm, due to the controversial particularities of this disease, most of them suggest a multifactorial etiology. Many authors have emphasized the importance of separating sleep bruxism from awake bruxism, as they might have different etiologies, ending with the New Consensus which provided two different definitions for those two forms of bruxism. In 2020, experts proposed the creation of a standardized system for bruxism evaluation – STAB (Standardized Tool for the Assessment of Bruxism). According to this system, future research over bruxism will be oriented in two directions: axis A that will include studies regarding evaluation methods, and axis B that will concern studies related to etiology, risk factors and predisposing factors.

Aim of the study Medication related osteonecrosis of the jaw (MRONJ) is a severe drug adverse effect, often being diagnosed in an advanced stage. The aim of this epidemiological study was to determine the frequency of MRONJ in cancer patients from Oltenia region, during 2012-2017. Material and methods Data retrieved from the clinical charts and used in this study were age, gender, residency, neoplasm type, location, and stage of MRONJ. Microsoft Excel and SPSS for Windows were used for analysis. Results The study included 57 patients, 31 females and 26 males, mean age 63.8±9.8. MRONJ was found in older patients, females mostly under 65 years old, males mostly over 65 years old (p = 0.023). Age distribution was correlated with the neoplasm type, while median ages between the breast neoplasm (58.5 years old) and prostate neoplasm (70 years old) groups were significantly different (p = 0.002). All patients with MRONJ have been previously treated with intravenous zoledronic acid for bone metastasis. Mandibular MRONJ was 2.35 times more frequent than maxillary MRONJ (p = 0.002) and stage II of MRONJ was commonly encountered. Conclusions MRONJ has been found mostly in patients with breast or prostate adenoma cancers with bone metastases who have been treated with intravenous. zoledronic acid and was present especially in the lower jaw, in advanced stages.

Colorectal cancer (CRC) remains one of the most important global health problems, being in the top 3 neoplasms in terms of the number of cases worldwide. Although CRC develops predominantly from the adenoma–adenocarcinoma sequence through APC gene mutations, in recent years, studies have demonstrated the role of chronic inflammation in this neoplasia pathogenesis. Cytokines are important components of chronic inflammation, being some of the host regulators in response to inflammation. The pro-inflammatory cytokines IL-1β, IL-6, and TNF-α are involved in tumor cell proliferation, angiogenesis, and metastasis and seem to strengthen each other’s mode of action, these being stimulated by the same mediators. In our study, we collected data on 68 patients with CRC and 20 healthy patients from the Gastroenterology Department of Craiova County Emergency Clinical Hospital, who were assessed between January 2022 and February 2023. The main purpose of this study was to investigate the correlation between increased plasma levels of the cytokines and the extent of the tumor, lymph nodes, and metastasis—(TNM stage), as well as the patients’ prognoses. We also compared the plasma levels of cytokines and acute inflammatory markers, namely, the erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and fibrinogen, along with the tumor markers, carcinoembryonic antigen (CEA) and carbohydrate antigen 19.9 (CA 19.9), in CRC patients. We showed that all the pro-inflammatory cytokines studied had higher levels in patients with CRC in comparison with the control group. We also showed that the acute inflammatory markers of erythrocyte sedimentation rate, C-reactive protein, and fibrinogen, and the tumor markers of CEA and CA 19.9 can be useful in diagnosis and prognosis in patients with CRC. Considering the association between pro-inflammatory cytokines and CRC, the development of new targeted therapies against IL-1β, IL-6, and TNF-α can improve patient care and the CRC survival rate.

Composite materials used in dental restorations are considered resistant, long-lasting and aesthetic. As the wear of restorations is an important element in long-term use, the aim of this study was to evaluate the surface condition of nanohybrid and microfilled composite resins, after being subjected to the erosive action of dental bleaching protocols. This paper reflects a comparative study between one nanofilled composite and three microfilled composites used in restorations. For each composite, three sets of samples (under the form of composite discs) were created: a control group, an “office bleach” group with discs bleached with 40% hydrogen peroxide gel, and a “home bleach” group with discs bleached with 16% carbamide peroxide gel. Wear was numerically determined as the trace and the coefficients of friction obtained using a tribometer, the ball-on-disk test method, and two balls: alumina and sapphire. For all composite groups, there were statistically significant differences between the wear corresponding to the control and bleaching groups, for both testing balls. Regarding the composite type, the largest traces were recorded for GC Gradia direct anterior, for all groups, using the alumina ball. In contrast, for the sapphire ball, 3M ESPE Filtek Z550 was characterized by the largest traces. With respect to the friction coefficients, the “office bleach” group recorded the largest values, no matter the composite or the ball type used. The 3M ESPE Valux Plus composite recorded the largest friction coefficients for the alumina ball, and 3M ESPE Filtek Z550 for the sapphire ball. Overall, the “office bleach” group was characterized by higher composite wear, compared to the “home bleach” protocol or control group. Nanofilled composite resins showed superior wear resistance to microfilled resins after undergoing a bleaching protocol.

Impairment of the immune response in MRONJ (medication-related osteonecrosis of the jaws) is one of the still unclear etiopathogenic mechanisms of this condition encountered in cancer patients treated with bisphosphonates, with negative effects on the patient’s quality of life. The aim of the present study was to correlate the immune response with etiopathogenic factors via immunohistochemical evaluation of the maxillary tissues in zoledronic acid osteonecrosis. The retrospective study included a group of 51 patients with various types of cancers, diagnosed with stage 2 or 3 MRONJ at zoledronic acid and treated surgically. Immunohistochemical expressions of αSMA, CD3, CD4, CD8, CD20, CD79α, CD68, CD204, and tryptase were evaluated. Immunohistochemical markers expressions were statistically analyzed according to the duration of the treatment, the trigger factor, the location of the MRONJ, and the healing status. Analysis of the immune response included T lymphocytes, B lymphocytes, plasma cells, macrophages, and mast cells. The duration of treatment significantly influenced the immunohistochemical expression of most markers (p < 0.05). For an increasing trend in treatment duration, a decreasing trend in marker score was observed, suggesting an inverse correlation. The expression of the markers was different depending on the trigger factor, on MRONJ localization (maxilla/mandible), and the healing status, being more intense in patients cured per primam compared to those who had relapses. The patient’s immune response was negatively influenced by the duration of the treatment, the trigger factor, the location of the lesion in the mandible, and the recurrence of MRONJ.

In this article the author presents some aspects of the hydrogen market, this fuel is essential to support the European Union's commitment to achieving climate neutrality by 2050. In 2020, the crisis caused by the Covid-19 pandemic has given a boost by speeding up the global long-term challenge of climate change, with more and more countries committing to achieving 'zero net' emissions. The energy system in the single internal market is responsible for 75% of greenhouse gas emissions. According to the Green Deal Pact. In the context of the crisis caused by the Pandemic Corona, the European Commission issued the Hydrogen Strategy in which it provided for an investment plan in green energy with the aim of economic recovery in Europe. In this sense, green hydrogen can be the fuel that contributes to reducing energy costs at European level.Decarbonisation leads to a significant increase in the role of electricity, which can cover the demand of over 50% of final energy by 2050, compared to about 20% today.Hydrogen contributes to the security of energy supply by reducing dependence on the import of fossil energy and natural gas. Thus, the diversification of energy supply takes place by facilitating the implementation of renewable energy sources. This is assessed by the estimation of imported fossil fuels that will be replaced by hydrogen based on domestic renewable sources.Green hydrogen can be obtained from clean energy where investments in renewable energy, whose prices are falling, and innovation are a viable solution for the green economy. Hydrogen does not emit greenhouse gases and does not pollute the air when used.In Romania, the potential for renewable energy production is estimated to be almost ten times higher in 2030 than at present, which creates a significant opportunity to use some of this potential in the production of hydrogen that can replace fossil fuels.

The success of endodontic treatment is dependent on the removal of bacteria. A modern strategy to reduce bacterial load is laser irradiation. During this procedure, there is a local increase in temperature with possible side effects. The aim of this study was to determine the thermal behavior of a maxillary first molar when performing the conventional irradiation technique using a diode laser. For this study, a 3D virtual model of a maxillary first molar was created. The preparation of the access cavity, the rotary instrumentation of the palatal root canal and the laser irradiation protocol were simulated. The model was exported in a finite element analysis program where the temperature and heat flux were studied. Temperature and heat flux maps were obtained, and the temperature increase on the internal wall of the root canal was analyzed. The maximum temperature value exceeded 400 °C and was maintained for less than 0.5 s. The obtained temperature maps support the bactericidal effect of diode laser and the limitation of damage to surrounding tissues. On internal root walls, the temperature reached several hundred degrees Celsius, but for very short durations. Conventional laser irradiation is an adjuvant method of decontamination of the endodontic system.

The purpose of this study is to identify and quantify preclinical changes with the help of optical coherence tomography angiography (OCTA) within the retinal microcirculation of young type 1 diabetes (T1D) patients without clinical signs of diabetic retinopathy (DR) and to compare these results with those obtained from healthy age-matched subjects. OCTA is currently used for monitoring diabetic retinopathy; however, there is no current consensus on which OCTA parameter alterations predict the first clinical signs of diabetic retinopathy. The main challenge that young patients with T1D face during the course of the disease is that they can rapidly progress to the development of DR, especially during adolescence. Moreover, they also present an increased risk of rapid progression toward advanced stages of DR and vision loss compared to type 2 diabetes patients, indicating the importance of early diagnosis and intervention. The limitations of the currently used screening procedures that led to the conceptualization of our study are the difficulties in performing fluorescein angiography tests for diagnosing the clinical signs of DR on young patients, namely the invasive procedure of dye injection, the risk of allergic reactions and the long duration of the examination. Moreover, given the long life expectancy of young T1D patients, it is essential to identify the preclinical changes in retinal microvasculature before reaching the first clinical signs quantifiable by FFA. The clinical study enrolled 119 subjects aged between 4 and 30 years old with a mean age of 13 years old, comprising 61 T1D patients with a mean duration of the disease of 4 years and 8 months and 58 healthy age-matched subjects for the control group. OCTA scans were performed using the RevoNX 130 OCTA device (Optopol) to evaluate the following retinal parameters: foveal avascular zone (FAZ) area, perimeter and circularity, overall foveal thickness, and superficial and deep vessel densities. Statistically significant differences between the two groups were identified for the following parameters: the FAZ area in the T1D group (0.42 ± 0.17) was larger than the control group (0.26 ± 0.080), the FAZ circularity (0.41 ± 0.11) was decreased compared to the control group (0.61 ± 0.08) and the FAZ perimeter was larger (3.63 ± 0.97) compared to the control group (2.30 ± 0.50). The overall foveal thickness was decreased in the T1D group (222.98 ± 17.33) compared to the control group (230.64 ± 20.82). The total vessel density of the superficial capillary plexus (SCP) on an investigated area of 6 X 6 mm centered around the fovea was decreased in the T1D group (37.4164 ± 2.14) compared to the control group (38.0241 ± 2.44). Our data suggest that specific imaging biomarkers such as FAZ perimeter, area and circularity, decreased overall foveal thickness and decreased vessel density in the SCP precede the clinical diagnosis of DR in young T1D patients and represent useful parameters in quantifying capillary nonperfusion in T1D patients without clinical signs of DR.

Aim of the study The aim of our study was to determine and compare the prevalence and severity of acquired developmental defects of enamel (DDE) in a group of children coming from a rural area in Dolj County, Romania, aged between 3 and 19 years. Material and methods A total of 213 children were examined using the modified DDE Index, for screening studies. Their assessment included the clinical examination, performed by completing an excel document. Results The prevalence of DDE was 11.27%. Of the 5452 primary and permanent teeth examined, 49 (0.90%) had some form of DDE. Diffuse opacity was the most common type of DDE observed in primary teeth, while in permanent dentition, the number of the 2 forms of opacity was very similar. We did not find any hypoplasia. Conclusions DDE is currently increasing, having major implications for children’s lives, which makes it a significant public health problem.

Aim of the study This study investigated the knowledge amongst dentists and senior dental students from Romania, regarding the clinical forms of tooth wear, its etiology and various treatment options for non-carious cervical lesions. Material and methods A questionnaire was sent electronically to Romanian dentists and dental students using social media. The survey had 16 questions regarding the prevalence of non-carious cervical lesions in the participants dental practice, the awareness of their clinical signs, etiological mechanisms and treatment options. Results Romanian dentists and dental students felt competent in diagnosing and treating tooth wear and non-carious cervical lesions, although the awareness of their etiology was moderate. For the restoration of non-carious cervical lesions, the material preferred by Romanian dentists and dental students was flowable composite. Conclusions Our study showed the need for further clinical and laboratory studies of the etiological mechanisms of tooth wear and non-carious cervical lesions for a better understanding amongst dental practitioners.

We present the case of a 31-year-old patient, without cardiovascular risk factors, without significant pathological or family history of cardiovascular disease, who was diagnosed with severe coronary artery disease, left main bifurcation localization, which required surgical coronary revascularization. The angiographic and intraoperative aspect excluded the most common causes of non-atherosclerotic causes of coronary lesions. Vasculitis was another possible etiology but was also excluded based on the normal clinical examination, negative inflammation markers, lack of diffuse vascular impairment, TPHA and negative VDRL. Prolonged mental stress can lead to accelerated progression of atherosclerosis by inducing endothelial dysfunction, our patient describing a “burnout syndrome” in the last few months. The particularity of the presented case is the severe coronary artery disease in a young patient without discovering the main etiology of the advanced atherosclerotic process.

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

In this article, the author presents some aspects of the Romanian energy system which undergoes crucial transformations in the conditions of sustainable development. The promotion of energy from renewable resources is one of the challenges currently facing the Romanian economy. Due to the efficient political support so far, the electricity generated by renewable energy already represents a relevant share of 24%. As a result, forced market integration and higher renewable energy supply are considered crucial in the next stages of the transformation process. In the long term, the opportunity of installing new coal and natural gas capacities will be given by the evolution of the prices of the ETS certificates, the necessity of establishing a strategic reserve for the SEN safety, the increase of the demand for electricity, the performance of the installed capacities, of the prices of technologies. Romania is among the 14 EU member states that maintain the option of using nuclear energy and investments in two nuclear power plants. But the energy produced by nuclear power plants can be replaced by electricity obtained from renewable sources with much lower costs under sustainable development conditions.

Background: Developmental defects of enamel (DDE) are frequently encountered in primary and permanent teeth, yet their etiology is not completely known. Enamel hypoplasia is considered a predisposing factor for early caries. The objective of this study was the evaluation of several risk factors potentially causing DDE and the possible association between DDE and dental caries. Methods: This study was performed on a group of 213 rural children from Romania. It combined a thorough dental examination for all children, and a questionnaire filled in by their mothers, regarding the evolution of their pregnancy and the child’s health status in the first years of life. Results: There was no statistically significant association between DDE presence and data regarding the evolution of pregnancy, mothers’ health status or children’s conditions during early childhood. There was a significant association between the use of amoxicillin, ibuprofen, and cephalosporin during the period of formation of permanent teeth, and one environmental factor (water source), and the presence of DDE (Chi Square, p < 0.05). Also, DDEs were associated with the presence of caries (Fisher, p = 0.001). Conclusions: Children who consumed water from private wells and children who received medication during early childhood developed more enamel defects, presenting a higher risk of caries development.

Pre- and pro- prosthodontic root canal treatment (RCT) must be performed under specific indications. The purpose of this treatment is to ensure the aggregation of dental prostheses and prevent certain subsequent dental pulp complications. However, pre- and pro- prosthodontic RCT had been previously done only in order to provide comfort for both patient and doctor, a fact that generated periapical complications in some cases. The aim of the study was to investigate the prevalence of periapical lesions associated with endodontic treatment of abutment teeth, in a group of adult Romanian patients. Material and methods: The study consisted of 472 patients, clinically examined and whose ortopantomographies were assessed for the quality of the abutment teeth’s endodontic treatment and periapical status. Results: Of the 1544 investigated abutment teeth, 68.13% were root-filled. Chronic periapical lesions were observed in 49.80% of the abutment teeth with RCT, compared to 34.15% in the abutment teeth without endodontic treatment. Conclusions: Apical periodontitis recorded a high prevalence in root-filled abutment teeth of adult patients, taking part in the study.

This article addresses aspects of competition in the European gas market and more precisely analyzes the abuse of Gazprom's dominant position by preventing the free flow of gas among the Member States of the European Union and by its unfair prices. In line with the European principle of freedom of movement for goods, services, persons and capital, the European Commission adopted three directives, approved in 1998, 2003 and 2009, by introducing competition on a market which had been closed down until then. From a macroeconomic perspective, there has been significant theoretical and empirical evidence suggesting that the liberalization of the European gas market has positive effects on the energy industry in terms of lower prices and security of supply. But the competition law in the European energy sector is not always properly applied and consumers are discouraged in terms of implementing the legislative and regulatory framework. In accordance with art. 102 of the Treaty on the Functioning of the European Union (TFEU), EU countries importing natural gas must benefit from transparent, fair pricing contracts. However, in some cases, abusive practices have been used for gas importers in central and Eastern Europe.

Background and objectives: Occlusal overloads produce a series of manifestations in teeth, especially attrition and non-carious cervical lesions (NCCL). Optical Coherence Tomography (OCT) can highlight and evaluate tooth lesions. The aim of this study was to examine the changes of dental hard tissues in the cervical area because of occlusal overload by macroscopic examination and using in vitro Swept Source OCT examination. Materials and Methods: The study was performed on 21 extracted teeth with occlusal trauma. After macroscopic and OCT examination, the 2D OCT images were transformed into 3D images using ImageJ software. Statistical analysis of macroscopic and OCT images was performed with Statistical Package for Social Sciences. Results: On 21 teeth, 88 cervical lesions (cracks) were identified. Upper premolars with an occlusal Smith and Knight tooth wear score of 2 had the most NCCL. Statistical analysis revealed significant differences in the median widths of cervical lesions between teeth with score 1 and score 3. Additionally, we obtained statistically significant differences in median widths between the buccal and oral surfaces. Conclusions: These cracks can be considered precursors of NCCL. NCCL can be located on dental surfaces in the cervical area other than the buccal one. A 3D reconstruction of OCT images emphasized that cracks are located especially at enamel level, evolving towards the enamel–dentin junction, with multiple ramifications.

The Hepatitis C Virus (HCV) infection often associates medical and mental health conditions which lead to increased levels of distress. Our study aimed at assessing the level of perceived stress on a sample of 90 HCV infected patients treated with Direct-Acting Antiviral (DAA) agents for 12 weeks, and its possible correlations with clinical and evolutionary elements. The evaluation was conducted in three phases: before administration of the DAAs (BSL), at the End of the Treatment (EOT), and 24 weeks after the BSL (Sustained Viral Response—SVR). The perceived stress was measured using the Perceived Stress Scale (PSS). The efficiency of the DAA treatment reduced the levels of stress (98.99% moderate and high stress at BSL to 70.00% at SVR). It was observed, for the entire study period (BSL to SVR), that the decrease in the perceived stress severity was significantly associated with demographic items such as gender (p < 0.01), urban environment (p < 0.001), the age of the subjects (p < 0.05), and clinical data such as F4 degree of fibrosis (p = 0.001) and overweight or obesity class II (p < 0.01). The perceived stress is directly associated with the severity of the HCV infection, and it could be significantly lowered by an efficient therapeutic approach, as DAAs are nowadays.

Developmental defects of enamel (DDEs) are deviations from the normal appearance in terms of the quantity and quality of tooth enamel. They may be genetic or acquired. The most important DDEs are hypomineralization and hypoplasia. The aim of this study was to produce “in vivo” DDE in Wistar rats by administering amoxicillin to pregnant females and to highlight these lesions after sacrifice of the pups by macroscopic and microscopic examination and optical coherence tomography (OCT). Amoxicillin (100 mg/kg) was administered to two pregnant Wistar female rats for the production of DDEs. When the pups were 2 months old, they were sacrificed, and their jaws were harvested together with their teeth. The jaws were examined macroscopically, microscopically, and by OCT. Following the macroscopic and microscopic examination, it was established that four pups had a total of 42 DDE lesions. At the OCT examination, the hypomineralization was characterized by an intense, inhomogeneous OCT signal, and the hypoplasia was characterized by the absence of the signal. Administration of amoxicillin to pregnant females of Wistar rats resulted in DDEs in their offspring. The OCT examination confirmed the presence of these lesions in the teeth of rat pups.

Until few years ago, radiological methods were widely used for the examination and investigation of the digestive tract. Today, wireless capsule endoscopy represents an innovative, noninvasive, effective solution that does not imply a risk of irradiation. Due to the impressive number of images captured on the entire “trip” covered by the video capsule, diagnostic accuracy is greatly improved, also allowing the visualization of certain areas of the digestive tract that were previously inaccessible. Captured images can be analyzed by a specialist who can identify lesions or possible active bleeding within the digestive tract. This paper presents the implementation of a recovery system for endoscopic images based on Content-Based Image Retrieval (CBIR) technique.

One of the most frequent diseases all over the world is represented by dental caries, hence it is of utmost importance to detect them as early as possible, in order to prevent massive tooth decay. Next to clinical examination, radiographic images are essential in identifying caries, especially for lesions located on the contact surface between the posterior teeth. Incipient caries are difficult to identify, sometimes even for specialists, so segmentation and detection through various image processing techniques may be useful. This paper presents an analysis of edge and texture parameters in X-rays containing caries, based on Sobel and Canny operators, Gabor filters and local binary pattern (LBP) operator. Our study set consisted in 80 X-rays from Bitewing Radiography Caries Detection Challenge 2015. Final results align with literature results and confirm the fact that caries segmentation in X-rays is a difficult task, with an average of less than 35% edge pixels correctly identified and poor results for texture segmentation; they also motivate us to refine our work in search of new algorithms and methods for caries segmentation and detection.

The experimental investigation of a prototypical set-up simulating a loss of flow accident in a helium-cooled breeding blanket first wall mock-up under typical heat load conditions is presented. The experimental campaign reproduces the expected DEMO thermal-hydraulics conditions during normal and off-normal situations and aims at providing some insight into the fast transients associated with the loss of flow in the blanket first wall. The experimental set-up and the definition of the experimental matrix are discussed, including pre-test analysis performed in support of these activities. The major experimental results are discussed, and a procedure of using the acquired data for validating and calibrating the RELAP-3D model of the mock-up is introduced. All these activities contributed to the creation of a relevant theoretical and practical experience that can be used in further studies concerning incidental transients in real-plant scenarios in the framework of DEMO plant fusion safety activities.

The validation of numerical tools employed in the analysis of incidental transients in a fusion reactor is a topic of main concern. KIT is taking part in this task providing both experimental data and by performing numerical analysis in support of the main codes used for the safety analyses of the Helium Cooled Pebble Bed (HCPB) blanket concept. In recent years, an experimental campaign has been performed in the KIT-HELOKA facility to investigate the behavior of a First Wall Mock-Up (FWMU) under Loss Of Flow Accident (LOFA) conditions. The aim of the experimental campaign was twofold: to check the expected DEMO thermal-hydraulics conditions during normal and off-normal conditions and to provide robust data for code validation. The present work is part of these validation efforts, and it deals with the analysis of the LOFA experimental campaign with the system code MELCOR 1.8.6 for fusion. A best-estimate methodology has been used in support of this analysis to ease the distinction between user’s assumptions and code limitations. The numerical analyses are here described together with their goals, achievements, and lesson learnt.

The development and the validation of old and new software in relevant DEMO reactor conditions have been exploited in the latest years within the EUROfusion Consortium. The aim was to use—if possible—the software already validated for fission reactors and to fill the gaps with new ad-hoc software. As contribution to this effort, the Karlsruhe Institute of Technology (KIT) developed and tested a novel software to apply the Best-Estimate Model Calibration and Prediction through Experimental Data Assimilation methodology to the system codes RELAP5-3D, MELCOR 1.8.6, and MELCOR 2.2. This software is called Best-estimate for SYstem Codes (BeSYC), and it is developed as a MATLAB App. The application is in charge of applying the mathematical framework of the methodology, writing and executing the code runs required by the methodology, and printing the obtained results. The main goal of BeSYC is to wrap up the methodology in a software suitable to be used by any user through a simple graphical user interface. Albeit developed in the fusion research context, BeSYC can be applied to any reactor/scenario type supported by the specific system code. The goals of BeSYC, the mathematical framework, the main characteristics, and the performed verification and validation activities are described in this paper.

The 2019 novel coronavirus, known as severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19), is causing a global pandemic. The virus primarily affects the upper and lower respiratory tracts and raises the risk of a variety of non-pulmonary consequences, the most severe and possibly fatal of which are cardiovascular problems. Data show that almost one-third of the patients with a moderate or severe form of COVID-19 had preexisting cardiovascular comorbidities such as diabetes mellitus, obesity, hypertension, heart failure, or coronary artery disease. SARS-CoV2 causes hyper inflammation, hypoxia, apoptosis, and a renin–angiotensin system imbalance in a variety of cell types, primarily endothelial cells. Profound endothelial dysfunction associated with COVID-19 can be the cause of impaired organ perfusion that may generate acute myocardial injury, renal failure, and a procoagulant state resulting in thromboembolic events. We discuss the most recent results on the involvement of endothelial dysfunction in the pathogenesis of COVID-19 in patients with cardiometabolic diseases in this review. We also provide insights on treatments that may reduce the severity of this viral infection.

Data mining techniques allow information analyzing and their results use as decisional supports. The companies may successfully use data mining techniques without expend too much for hardware and software because data mining may also be applied to a large range of data structures, such as relational databases, transactional databases, object-oriented databases, data warehouses.

The objective of this paper is to analyze the development of natural gas infrastructure in the EU and discuss its prospects. The first part is shown the relationship between the regulatory framework of the European Union and development investments to increase competition in the gas sector. High consumption of natural gas in the Member States of the European Union has led to a dramatic increase in imports, and this trend is likely to continue in the future. In addition, resource security after prolonged disruptions of gas supply initiates a series of projects that should enhance security of supply by promoting market integration and allow natural gas flows reversed. In this context the European regulations to encourage investment coming into interstate natural gas transmission pipelines, an industry characterized by a special regulatory framework. The European Commission adopted in 2015 a list of 195 key energy infrastructure projects that will help achieve the objectives on energy and climate in Europe and form key elements of the EU Energy Union. The projects - known as project of common interest (PCIs) - will allow connection Energy Union through gradual integration of energy markets in Europe and the diversification of energy sources and transport routes. In Europe it is found that the gas market is generally well integrated physically in the west, but in Southeast Europe, there is severe congestion. Following the failure of infrastructure projects in the region, Nabucco and South Stream project is investigating BRUA for infrastructure integration in this region of Europe. In the second part of the article analyzes the integration of Romanian gas transmission system in the European market during the next decade. Economic theories of investment in gas infrastructure does not provide clear indications of the conditions in which levels of investment can be effectively achieved, but demonstrated the added value of using a new institutional economic prospects. The author tries to make an assessment of the impact of national gas infrastructure development on the Romanian economy.

In this paper the author analyzes the dependence between energy and industrial competitiveness before and after the 2008 economic crisis in the European Union. The Europe 2020 strategy aims energy major industrial competitiveness and increasing energy efficiency. But the economic crisis of 2008 led to reduced energy consumption and prices have increased considerably, so prices in the European Union in the energy industry are estimated to be twice higher than in the United States and Russia and 20% higher than those in China. According to the 2020 European Strategy for Sustainable Growth proposed increasing share of renewables to 20% increasing 20% energy efficiency and 20% reduction of greenhouse gas emissions greenhouse (or even 30 %, in favorable conditions) compared to 1990. The economic analysis in this paper are based on statistical quantitative method. Indicators used in this analysis are available on major platforms Eurostat data.

Wireless capsule endoscopy, the gold standard in the screening and diagnosis of small bowel diseases, is one of the most recent investigations for gastrointestinal pathology. This examination has the advantages of being non-invasive, painless, with a large clinical yield, especially for small bowel diseases, but also some disadvantages. The long time necessary for reading and interpreting all frames acquired is one of these disadvantages. This inconvenient could be improved through different methods by using software applications. In this study we have used a software application for texture analysis based on local binary pattern (LBP) operator. This operator detects and removes non-informative frames in a first step, then identifies potential lesions. Our study group consisted of 33 patients from the Gastroenterology and Hepatology Centre Craiova and from the 1st Internal Medicine and Gastroenterology Clinic from the Emergency County Hospital of Craiova. The patients included in the study have corresponded to our inclusion criteria established. The exclusion criteria were represented by the contraindications of the capsule endoscopy. In the first phase of the study, we have removed the non-informative frames from the original videos obtained, and we have acquired an average reduction of 6.96% from the total number of images. In the second phase, using the same LBP operator, we have correctly identified 93.16% of telangiectasia lesions. Our study demonstrated that software applications based on LBP operator can lead to a shorter analysis time, by reducing the overall frames number, and can also provide support in diagnosis.