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In order to determine the effects of frontal sinus morphology on the morpho-functionality of the dento-maxillary apparatus and the therapeutic management of pathologies in the orthodontic or maxillofacial surgery area, paraclinical evaluation is extremely important. During time, radiography – a relatively old method, allowed complex explorations of the extreme cephalic area, providing details of cephalometric and facial indexes and information regarding the pneumatization and neuro- and viscera-cranium at the same time. Aim: This manuscript focuses on the correlation of elements related to craniofacial anomalies, in which frontal sinus malformations hold a particularly important place, with various dental anomalies which are particularly important aspects in optimizing the diagnostic and therapeutic protocol in both, orthodontic and orthognathic surgical approaches. Materials and methods: We set out to examine the frontal sinus, including a number of 112 patients, aged 4 to 78 years old, with malocclusions, the research being performed in the Radiology Clinic of Emergency Clinical Hospital “Sf. Spiridon” Iasi, during 2018-2020. We used in our research the landmarks represented by the frontal median septum and the upper orbital margin, on the basis of which we calculated the dimensions of the frontal sinus. The cases were as follows: 66 women (58,9%) and 46 men (41,1%), and age distribution was as follows: •4 – 9 years (20 cases – 17,9%); •10 – 19 years (22 cases – 19,6%); •20 – 45 years (31 cases – 27,7%); •46 – 60 years (19 cases – 17,0%); •over 60 years (20 cases – 17,9%). Results and discussions: The data obtained in our study are superimposable on those found in the literature, noting a frequency of absence of bilateral frontal sinus in 9,8% of cases, the elements of specificity belonging to the percentage of 6,1% for women and 15,2% for men, all cases being between 5-15 years. There are not significant differences between the planimetric measurements at patients with sinusitis compared with the others; instead, we found statistically significant differences between the planimetric measurements concerning the right sinus as well as the left sinus at the 3 classes of malocclusion – the patients in the I-st class have the smallest sinuses, the patients in the II-nd class have intermediary mesurements, while the patients in the III-rd class have the biggest measurements of the sinuses. Conclusions: In dental practice, cascading effects are extremely important, starting from frontal sinus malformations, which lead to different types of dento-dental anomalies, the implications being found in specific orthodontic therapy and orthognathic surgery.

The therapeutic solutions chosen were ceramics on a zirconium support or ceramics on a metal infrastructure made by laser technique, which is a therapeutic alternative beneficial for the relationship with the affected tissues, a situation that is found in patients with cardiovascular or other types of general diseases. In addition to the technological line chosen, the biomaterials chosen are also extremely important, with Co-Cr alloys remaining a biocompatible option that satisfies the optimal parameters of the final prosthetic construction. From the study group we selected a representative clinical case for cardiovascular pathology in conjunction with partial edentulousness.The aim of this study is to identify how modern fixed prosthodontic technologies optimize the integration of fixed prostheses in the context of the current oral manifestations which occur as a consequence of different types of systemic damage.The study group consisted of 200 patients diagnosed with different forms of partial edentulousness and at the same time presenting different general status disorders. Non-invasiveness in conjunction with precise modern technologies with a different degree of biocompatibility creates the prerequisites for a good integration of oral rehabilitation against the background of different types of complications in the territory of oral manifestations in patients with different types of systemic diseases.

Radiographic methods provide useful information about bone tissue changes, and radiographs have the advantage that they can be stored and reevaluated at any time. However, radiographic evaluations are subject to several sources of error. The purpose of this study was to analyze the maxillary bones by computer tomographic analysis, assessing the value of their density as a predictive element in the success of oral rehabilitation by classical or modern methods. In this study, we selected 35 patients for dental CT scans made with a Somatom Emotion device, Siemens in order to apply dental implants and removable prostheses. 20 women and 15 men aged between 60-80 years participated in the study . For comparison, 6 dental CT scans from the group of patients under the age of 65 were analyzed. The measurements were made on approximately symmetrical right-left areas. A line parallel to the long axis of the horizontal branch of the mandible, tangential to the lower edge, was drawn. The correlative aspects established between the patient’s sex, bone density and the dimensions of the edentulous ridges underline a prevalence, in percentage of 55%, of medium ridges in the frontal area, associated with the female sex and a D3 bone density, while medium ridges both frontally and laterally associated with D3 density and association with the male sex. The value of the CT examination in evaluating the quality of edentulous ridges and some foreign bodies and sinus inflammatory processes with the evaluation of the proximity of important anatomical structures as landmarks in implantology is evident.

The existential problems encountered by elderly patients are influenced by a series of parameters (physical, medical, psychological, or social) that make it difficult for them to carry out normal activities and can amplify the pathology of this fragile population category. Dental caries is quite common in the elderly patient, although we are tempted to believe that elderly teeth are less susceptible to caries due to involutional structural changes. As a chronic, slowly evolving infectious process with certain peculiarities, dental caries progresses in densified and hypermineralised tissues, both at coronal level but prevalent at root level. Clinically in the early stage the initial lesion appears on the proximal, buccal, or oral surface at the enamel/cement junction as one or more small, creamy, brownish, round, elliptical or fissural dots or spots (pigmentations) which merge, tend to expand, become circular, surround the root and encompass all surfaces closely forming serpiginous caries. Tending to progress circumferentially on the surface and not in depth, it causes weakening of the crown-root junction, with significant dental destruction, with splinter-like detachment of tissue, with increased risk of fracture. Dental medicine must consider the elderly as a complex being, an entity with a specific bio-psycho-social structure, with an individualised pathology of the dental system arising from physiological involution.

Aesthetic considerations have gradually influenced over time in various forms dental management so that they have reached the point where suboptimal aesthetic aspects are no longer accepted in the therapeutic outcome. The aim of the study is to analyze the opportunity of rehabilitation of metalo-ceramics and limits the possibilities to quantify the rehabilitated disturbances of balance the parameters of the facial aesthetic dental somatosensory setting in the treatment necessary in the studied group. A sample of 75 patients, 45 women and 30 men have been evaluated, ages between 24 and 69, who came at the clinical basis for Education of the Faculty of Dentistry Iasi, respectively in private practice. The contour of the dental units is the first morphological detail that is noticed by the human eye, before any other information related to the color, structure or shape itself is recorded. The possible aesthetic imbalances registered at the level of a tooth from the region of the anterior mandibular arch and especially the maxilla become immediately observable and generate very strong visual tensions. Restoring the aesthetic balance by individual prosthesis is a complex and difficult therapeutic method due to the large number of factors that condition the therapeutic success (exposure to lighting and direct vision, type of smile, proximity to natural dental structures).

Temporomandibular joint (TMJ) involvement with bone resorption of the mandible is a rare complication in systemic sclerosis (SSc), leading to restrictive mandibular movements, malocclusion, difficult swallowing and mastication, and subsequently altered nutrition. We report a case of SSc-related TMJ pathology in a 23-year woman, emphasizing the relevance of advanced imaging. Extensive bone resorption of mandibular condyle reveled on dental panoramic image explains the malocclusion and impaired interincisal opening, while CBCT demonstrates reshaping of the mandibular condyle with cortical lysis, osteophytes, decreased height and flattening. Furthermore, electromyography confirms masticatory muscles involvement.

Professional activity of a dental practitioner is widely recognized not only for the excessive biomechanical stress of the spine and the peripheral joints, but also for the high percentage of axial and peripheral musculoskeletal disorders. The aim of this study was to identify the risk factors and their consequences on the cervical spine in a cohort of dental practitioners who are currently involved in endodontic therapy. We included 30 dentists who worked daily in private offices in Iasi and in the Iasi county area. They were classified as belong to group A or B based on specific ergonomic criteria. We performed a complex analysis of all the participants in the current study based on a standard questionnaire aiming to identify if specific ergonomic measures may positively influence the musculoskeletal morbidity in dental practitioners. the endodontic field of the professional activity also generates different pathological conditions at this level. As a consequence, chronic pain, paresthesias, decreased muscle strength developed on a background of X-ray modifications including the malalignment of the cervical spine and degenerative disco-vertebral processes are commonly reported among dental practitioners, especially in those performing their daily activities in a non-ergonomic environment.

The term “diabetes mellitus” includes a varied number of chronic diseases characterized by hyperglycemia and relative or absolute insulin deficiency. Hyperglycemia is the most obvious biochemical marker in the complex of metabolic changes that affect carbohydrate, lipid, protid and electrolyte metabolism and can alter many organs and functions of the whole organism.The diagnosis of diabetes is based on clinical signs and laboratory explorations. The clinical picture is typical in about half of the cases and the main signs are polyuria, polydpsia, weight loss. In addition to these, others may be present in the clinical picture: asthenia, fatigue, decreased physical and intellectual strength, polyphagia. Sometimes, the diagnosis of diabetes can be revealed by the presence of signs of infectious complications, of the symptoms and signs of acute metabolic complications of diabetes or of the symptoms and signs of chronic degenerative complications. The terms of insulin-dependent and non-insulin-dependent have been eliminated, in favor of type 1 diabetes and type 2 diabetes. Type 1 is caused by autoimmune destruction of pancreatic beta cells, resulting in absolute insulin deficiency. Type 1 includes idiopathic and immune-mediated forms of β-pancreatic cell dysfunction that result in total insulin deficiency. Diabetes LADA (latent autoimmune diabetes in adults) is a recently recognized category of diabetes mellitus, which falls within the complex of type 1 diabetes. The study group consisted of 96 patients, 38 women (39.58%). and 58 men (60.42%) with oral manifestations in patients with diabetes and obesity.

Rheumatoid arthritis (RA) is one of the main chronic inflammatory rheumatic disorders characterized by chronic destructive peripheral arthritis as well as a wide range of systemic features, resulting in irreversible damage, significant disability, functional impairment and altered quality of life. Clinical temporomandibular joint (TMJ) involvement is commonly reported in up to 80% of RA patients. Although conventional radiological examination remains an important tool for diagnosis and assessment of TMJ disease, newer modern techniques including TMJ ultrasound, CT and cone beam CT (CBCT) are largely available and able to depict earlier changes in the TMJ. This report presents the clinical case of an established RA, emphasizing the potential diagnostic algorithm and therapeutic options for TMJ arthritis

The main aims of this paper were (i) to identify the pathology that occurs in the dentist’s hand in relation to different professional risk factors, particularly the trapezio-metacarpal osteoarthritis – a painful and highly disabling entity related to subluxation or dislocation complications, and (ii) to highlight the role of kinetotherapy for the prevention as well as therapy of the dentist’s hand. We enrolled twenty experienced dentists selected according to several inclusion criteria: a daily program of minimum 6 working hours, more than 15 years of professional experience, performing all techniques and procedures commonly encountered in a dental office. Dentists included in our research were classified in two main groups: group A performing an individual kinetotherapy program and group B without the kinetic program. Individualized kinetic programs aiming to reduce pain, restore joint mobility, tone different muscle groups and improve coordination are successful in refining work-related hand pathology in dentists.

Temporomandibular joint (TMJ) may be involved in different JIA subtypes, with a prevalence ranging between 40 to 70%, leading to various degrees of disability, mainly related to pain, inflammation, reduced mandibular mobility, damage of the condyle and secondary masticatory muscle impairment. The aim of the present work was to describe TMJ involvement in different subtypes of JIA, based on a complex epidemiological, clinical and imaging approach. We performed a prospective observational study on 22 consecutive JIA attending an academic rheumatology department. Imagistic assessments comprised: (i) an X-ray of vertebral (lumbar and cervical spine) as well as peripheral joints in order to support the diagnosis and to evaluate the stage of the disease; (ii) a TMJ ultrasonography; (iii) a TMJ CT scan; and (iv) a CBCT. The following parameters were evaluated in our patients: demographics and general characteristics (sex, age, duration of disease, JIA onset); TMJ-related data e.g. spontaneous or provoked unilateral or bilateral TMJ pain measured on a visual analog scale (VAS), accompanied by morning stiffness or stiffness after rest; clicking and crepitation were noted in the context mandible mobilization; muscle contracture (masseter, temporal, internal pterygoid); parafunctions; TMJ imaging; dental, gingival and occlusal status. TMJ involvement is classically described among JIA patients, presenting with various clinical signs and symptoms and different degrees of inflammation and condylar damage.

Dentistry is acknowledged as an outstandingly practical domain of medicine, with an excessive and extensive role of the hand acting in a professional dental environment, with specific working postures, repetitive movements and using different dental instruments. The main objective of our study was to evaluate occupational-hand pathology in dentists and potential trigger factors and to highlight the role of physical therapy in preventing and management of different musculoskeletal issues in dentistry settings. We performed a prospective 12-months study on 30 dentists (20 women), aged between 30 and 60 years, working in private practice aiming to assess professional hand involvement. Enrolled dentists were classified in two equal groups, according to their participation in a kinetic program: group A, dentists performing an individual kinetic program on a daily basis, and group B, dentists without being involved in a physical therapy program. All subjects were followed-up for 12 months. A specific questionnaire derived from the Cornell Musculoskeletal Discomfort Questionnaire was applied in all cases, evaluating different musculoskeletal items such as pain, paresthesias, muscle spasm and amyotrophy, but also joint mobility (wrist, metacarpophalangeal joints).Work-related hand pathology is widely confirmed among dentists, specifically connected to different professional factors such as working postures and movements, number of working hours, cumulative time and experience, as well as type of devices and tools handled. Moreover, dentistry performed according to ergonomic settings is essential in order to reduce the burden of musculoskeletal features and to improve related disability and working performance. Work-related hand pathology accounts for significant morbidity and physical discomfort among dental professionals. With a multifaceted pathobiology ranging from inflammatory to degenerative damage of both soft tissue, nerve and joints (wrist and fingers), musculoskeletal issues are typically linked to professional triggers during routine practice in dentistry.

The burden of work-related musculoskeletal pathology among dental professionals is widely recognized, particularly associated with specific risk factors in routine practice. Aim of the study: The main objective of our study was to evaluate musculoskeletal issues in students in dentistry based on their participation in different levels of professional activities, and to identify potential risk factors. Material and methods: We performed a cross-sectional study in 100 consecutive students attending the School of Dentistry, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, classified in two main groups: 50 students in their first and second year of study, not engaged in specific dental work (group A) and 50 students in their third to sixth year, already performing professional activities in patient (group B). A predefined questionnaire survey was applied in all students, including general data, risk factors for musculoskeletal problems, and information on pain (vertebral, hand) and muscle spasm as main musculoskeletal complains potentially related to their professional doings. Conclusions: Ergonomic postures adopted by the student / dentist in routine practice as well as ergonomic dental instruments are usually associated with less vertebral (lumbar spine) and hand pathology. Ergonomic principles must be applied in routine dental practice and the student educated about prevention of musculoskeletal pathology.

The Smith-Lemli-Opitz syndrome (SLOS) is a plurimalformative syndrome transmitted by autosomal recessive inheritance. SLOS is caused by the deficiency in the enzyme 7-dehydrocholesterol-delta-reductase (DHCR7) resulting in cholesterol metabolism disorders, more precisely the incapacity to transform dehydrocholesterol into cholesterol. The syndrome is marked by characteristic facial dysmorphism, multiple malformations and intellectual disability. We are reporting the case of a 15 year old patient diagnosed postnatally with bilateral hands and feet polydactyly, and clinodactyly in the 5th toe of the right foot which was surgically treated when the patient was 6 months old. The association with suggestive modifications of the oral cavity (dental impactions, palatoschisis, enlarged alveolar ridges and uvula bifida) that required complex orthodontic therapy and the genetic consult establish the diagnosis of Smith-Lemli-Opitz syndrome.

The aim of present work is a double one. On the first hand we tried to collect together the newest data concerning the enteroneurons’ morphology, their association in the parietal plexuses and their synaptic interconnections. All classes of enteroneurons were discussed in detail, but, despite their diversity, we have concluded that, essentially, they can be classified as motor, sensitive and interneurons, are disposed in layers and have the same functionality as the cerebral cortex neurons. According to their neurochemistry, we have imagined reflex circuits subserving motor and secretory functions, illustrated with original diagrams. Enteroglia and interstitial cells of Cajal are also assessed in interrelation with neurilema and myolema of gut muscles fibers. The second goal of our study was focussed on serotoninergic enteroneurons, their contribution to both motor and secretory gut functions and also on synuclein production in the enteroneurons, named by us extraparietointestinal. Their contribution to trigger the initial stages of Parkinson disease is proposed.

Considered as the most complex joint of the human body, the temporomandibular joint is at the same time one of the main components of the stomatognathic system, contributing to its basic functions: mastication, swallowing, phonation. The study conducted includes a group of 38 patients, selected from on-call care between 2019-2021, aged 45-75), requiring restoration of functions affected by various forms of edentulousness), dental wear, and to treat complaints influencing the functionality of the temporomandibular joint. The determination of a complete clinical diagnosis was based on the information obtained from the history and thorough clinical examination The TMJ examination was performed according to the known clinical protocol, supplemented by the analysis of the TMJ profile CT scan, performed in the closed and open mouth position. compensatory possibilities of the tissues.The results of the tomographic analysis associated with the evaluation of clinical symptoms can be considered relevant and concordant for the functional importance of the TMJ, in addition to quantifying the sagittal condylar and glenoid dimensions and specifying the frequency of condylar position changes in a symptomatic or asymptomatic clinical context.

Temporomandibular joint (TMJ) is widely involved in rheumatic disorders, especially in inflammatory but also in degenerative conditions. The burden of TMJ osteoarthritis is related to both soft and hard tissue damage meaning cartilage, subchondral bone and, to a lesser extent, synovial membrane involvement resulting in a wide range of clinical signs and symptoms and significant disability. The diagnosis of degenerative TMJ disease is challenging comprising a comprehensive algorithm based on both clinical as well as imaging techniques from simple radiology to newer ones such as cone beam computer tomography.

Due to a permanent and excessive overload of axial (cervical and lumbar spine segments) as well as peripheral joints (especially hand and shoulder), dentists usually present with significant burden of professional-related musculoskeletal issues. The aim of our study was to describe work-related cervical spine complains and to perform an electromyographic (EMG) analysis of cervical muscles during specific working activities in dentists. Cross-sectional 24-weeks study including 30 dentists and primary care physicians. Each participant in both groups was asked to complete a specific questionnaire derived from Cornell Musculoskeletal Discomfort Questionnaire that included: general data, clinical parameters (signs and symptoms of cervical spine involvement), data on occupational activity (working position prevailing during work, use of magnifying devices such as glass, microscope) and extra-professional. As a second step after completion of the above mentioned questionnaire, all subjects performed an EMG test. The muscles involved in the static and dynamic of the cervical spine e.g. splenius capitis and trapezium were examined with the help of a surface electrodiometer. Specific work overload in dentistry, prolonged vicious position of the head and cervical segment, asymmetric contraction of the posterior musculature of the spine, adverse static positions, permanent focused vision in a limited space, vibrating tools essentially contribute to musculoskeletal issues, particularly in the cervical spine.

Musculoskeletal pathology in dentistry settings has multifaceted triggers, including prolonged, either standing or sitting static postures, repetitive movements, vicious positions with excessive bending and rotation with subsequent overloading and overstress of the head, spine, scapula-humeral joint, hand, but also weight bearing joints such as hips and knees. The main objective of our study was to investigate the prevalence of musculoskeletal complains, especially cervical spine involvement, among dentists. We performed a cross-sectional study on 40 gender, age, and years of practice-matched subjects stratified in two groups according to their background profession – dentists in group I, general practitioners (GP) in group II, aiming to identify work-related musculoskeletal issues. A specific questionnaire derived from the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was applied in all cases, evaluating the sitting discomfort and working performance; we focused on two main items that reflect the level of comfort or discomfort (item 1) and cervical pain on a visual analogue scale of 0-10 cm (item 2). Working in specific dental environment must complain with ergonomic recommendations, particularly focused on working posture aiming to limit as a feasible extent the overload on lumbar spine and excessive negative influence on cervical segment. Sitting on an ergonomic chair or alternating sitting with standing posture during working day should be promoted in routine dentistry practice. Work-related musculoskeletal complains, with special emphasis on cervical spine pathology, is commonly reported among dentists; both static and dynamic overstress of the vertebral structure are responsible for abnormal biomechanics and subsequent pathology in routine dental professional practice.

Aim. The goals of this research were to determine the risk factors and predictors of peri-implantitis in patients with implant-supported posterior fixed prosthetic restorations. Materials and method. The logistic regression was performed within a cohort of 48 patients (mean age 63.04 ± 10.723 years) with posterior edentulism treated by implant-supported metal-ceramic fixed prosthetic restorations. Socio-demographic data (gender, age group) and anamnestic data were collected on: smoking status; periodontal grade; compliance to the supportive periodontal/peri-implant therapy; OHI index. Clinical and radiological parameters were measured in 166 implants to establish the status of the peri-implant tissues in relation to analysed parameters. Results. 45.8% of patients and 19,9% of implants were diagnosed with peri-implantitis. Conclusions. In univariate models, patients with in age group 40-60 yrs., males, smokers, periodontitis grade III (vs. I) and grade IV (vs. II), OHI 2-3, have an increased risk of peri-implantitis. In multivariate analysis, significant predictors of peri-implantitis were male gender, OHI 2-3, maxillary location, grafted implant sites.