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Periodontal health is essential before and after a prosthetic restoration. Thus, the most accurate reproduction of the size and shape of dental crowns with that of natural teeth is the key to maintain a normal relationship between the joint and the occlusal relief and to maintain the integrity and health of periodontal tissues. Maintaining the periodontal health of the teeth with prosthetic restorations, with the placement of the margins in contact with the marginal gingival tissue, is a challenge, because the odonto-periodontal unit is constantly affected by microbial flora and the bacterial plaque accumulation can be stimulated by the presence of dental restorations. The objective of the present study was to analize the effects of fixed dental prostheses on periodontal inflammatory status and hygiene. After ethical approval, patients were clinically examined, their data was recorded and statistically processed. The results showed the existence of significant differences or correlations between the plaque, calculus or gingival indices and the characteristics of dental prosthesis in some situations. In conclusion, the presence of prosthetic restorations could influence the oral hygiene and be associated wih periodontal changes.

Oral hygiene is a dental procedure with the role of removing bacterial plaque and action to prevent oral diseases, including periodontal disease. Oral prophylaxis includes both daily dental hygiene (daily brushing, flossing and mouthwash) and the visits to the dentist for professional hygiene and prophylaxis. The correct brushing of the teeth is important not only for maintaining oral health but also for the health of the whole body, because there are correlations between diseases of the oral cavity and problems of the digestive tract or even heart disease.

During odontogenesis, the interactions between the epithelium and the adjacent mesenchyme involve the participation of a complex system consisting of signaling molecules, corresponding receptors and transcriptional control systems. In this context, the tooth eruption is accompanied by numerous periodontal changes including bone remodeling and regressive changes in the periodontal ligament causing an increase in local cytokine production (MMP, TIMP). Understanding the ongoing process occurring in periodontal tissues during tooth development can prevent adverse consequences associated with eruption disturbances.

The health of periodontal tissues is the key to the long-term success of prosthetic restorations. A negative impact on it can have subgingival margins, an inaccurate marginal fit, materials that favor the accumulation of plaque and can suffer the corrosion process. All these characteristics can stimulate the appearance of a biological response, that can be translated by increased proinflammatory markers (interleukins, matrix metalloproteinases) in gingival crevicular fluid. The acquisition of the aspects that describe the relationship between the two elements mentioned above, could ensure a favorable prognosis of fixed prosthetic therapy.

Aim:The aim of this study was analyze peri-implantary marginal bone loss one year after the prosthetic load in association with body mass index (BMI) and other general favoring factors: metabolic disorder and high blood pressure (HTA). Material and Methods:One hundred and twenty-four patients attended the examination, 69 females and 59 males (mean age 54, range: 27-82 ). Patients were examined for demographic information, medical health history, diabetes, smoking, patient-reported height and weight, also the clinical (oral examination, periodontometry) and radiological evaluation. To determine the degree of peri-implantary marginal bone loss, it was used radiological measures. The measures were made one year after the prosthetic load with complying with the same sites and range of report for all the analyzed patients.The data were analyzed to observe the association between peri-implantary marginal bone loss one year after the prosthetic load in association with BMI and other general favoring factors: metabolic disorder and high blood pressure(HTA). Results: A reduced statistically association (r=0.111) was noticed in the correlation analysis between variables: peri-implantary bone loss and the body mass index(BMI>24.9) value. After analyzing the correlation between peri-implantary bone loss and the presence of general illnesses (metabolic disease, high blood pressure) it was noticed the existence of a reduced, but statistically significant, association (r=0.224). Conclusion:The correlation between peri-implantary bone loss and coexistence of general factors (general health issues, high BMI) is low in patients from the analyzed studygroupduring the period taken into consideration for evaluation and treatment.

The term molar-incisor hypomineralization describes an uncommon pathological entity characterized by the hypomineralization of permanent first molars and commonly affecting permanent incisors. In this paper, we describe a case of a 12 years old male patient attended with severe dental sensibility, masticatory and phonetic difficulties. Clinical examination revealed extended atypical restorations on permanent first molars, associated with opacities at the border of the restorations, enamel breakdown and opaque stains affecting permanent incisors. MIH diagnosis for this case is justified not only by the visual aspect of the lesions, but also by dental affection pattern.

The number of patients undergoing hormone replacement therapy (HRT) to counterbalance hormonal changes is increasing. Patients follow HRT not only to avoid climatic symptoms but also to protect themselves from cardiovascular disease and osteoporosis. HRT is an option for women who need drug therapy to reduce the risk of osteoporosis, including women at high risk of fracture for the next 5-10 years. Oestrogen supplementation can modulate the periodontal destruction rate through mechanisms involving inhibition of matrix metalloproteinases (MMP-8 and MMP-13) and cytokines involved in bone resorption

The metabolic syndrome is a complex pathology, multisystemic, with numerous consequences that include: high blood sugar, hypertension, visceral obesity, dyslipidemia with high levels of triglycerides (TG) and low levels of HDL. Recent studies have published in the specialty literature, data that suggest the existence of a possible association between obesity and periimplantitis. The purpose of this report cases is to explore the possible relation between the metabolic syndrome and the development of periimplantitis. To reach the proposed objective we have evaluated the characteristics of periimplant tissues in patients that have a metabolic syndrome associated.

Implantology aims at the lasting restoration of masticatory function and also of aesthetics, phonetics and patient comfort. But, at the same time, among the purposes of treatment with dental implants is the stabilization of the peri-implant bone, whose resorption is thus stopped at the time of implant insertion, as well as the peri-implant soft tissues, which are supported by the peri-implant bone and after their collapse, in the event of bone atrophy, it appears an unsightly appearance of the teeth and the contour of the gingival mucosa.

Local risk factors could influence directly the periodontium, the most often involved local risk factors being dental calculus, malocclusions, improper or aged and degraded dental or prosthetic treatments, orthodontic appliances, affecting also the masticatory, esthetical and phonetical function consequently decreasing the quality of life. A good domestic plaque control performed by the patient and its removal professionally may be insufficient for the resolution of periodontal inflammation, as the local/systemic risk factors may still favour plaque accumulation or cause a misbalance of the host immune response. Therefore, plaque removal should be always accompanied by a sustained effort of the dental practitioners’ team to correct, or to, at least, control the predisposing local and systemic risk factors.

Achievement of holistic oral health is dependent upon first carrying out a thorough examination, so as to establish a comprehensive diagnosis of patient etiologies, needs, and required therapies. Restorative therapy often includes splinting of mobile teeth, coverage of sensitive roots, and correction of occlusal abnormalities to improve periodontal prognoses. The components of a thorough clinical examination include periodontal probing depths, assessment of clinical attachment levels, hard – and soft – tissue examination, models, and face – bow records. However, it is important to realize that a complete examination begins with an open discussion with the individual patient, as a step in determining the patient’s needs and desires. In this way, treatment plans may be formulated that are in the best interest of the patient and represent a greater value for the patient. Conclussion. Simple and complex patients may be successfully treated in this periodontaly challenging context, with success being defined as long – term stability and maximization of patient comfort, function, and aesthetics.

The periodontal apparatus is very well connected with the rest of the human body, by means of vascular, lymphatic and nervous structures. These connections make the periodontal structures easily accessible to different distant pathologic mechanisms, such as inflammatory reactions, that can influence the onset and evolution of periodontal diseases. In certain situations, these influences have a mutual nature, transforming the relationship of the periodontal pathology with the systemic conditions into a bi-directional one. Understanding the mechanisms that drive and promote these pathogenic connections is important for offering periodontal patients a comprehensive treatment and for including periodontal screening for certain systemic diseases’ patients.

Obesity is a chronic , complex, multifactorial disease, which develops as a result of the interaction between genotype and life style. Up to now has not been fully elucidated the mechanism by which it occurs and is developing obesity, but it has been noted that it involves both social factors, as well as those cultural, behavioural, physiological, metabolic, and genetic. The aim of this review is to evaluate how different sistemic diseases, beside type 2 diabetes,smoking , obesity may be risk factors in the onset of perimplantitis. The association between periodontal disease and obesity has been shown in several studies to different age groups. Excessive adipose tissue produces a reduced inflammation which is a cause of oral amendments. In obesity was noticed this inflammation which can be a point of contact between this and periodontal disease or periimplantitis disease.

Aim of the study The main goal of our study was to highlight the changes of preclinical and clinical periodontal status indices in a group of children and teen-agers with insulin-dependent diabetes (IDDM). Material and methods For objectifying our purpose 60 children, aged 7 to 18 years divided into three groups of 20 subjects each were examined: control group - children without diabetes, with good general condition, but with varying degrees of periodontal involvement, IDDM batch with good metabolic control (HbA1c ˂7,5%) and IDDM group with poorly metabolic control (HbA1c ˃7,5%). On all these subjects the following parameters were assessed: plaque index - Quigley-Hein (QHI), gingival index (GI), clinical attachment loss (CAL). The gingival crevicular fluid (GCF) volume from mesial sites of the incisors and first permanent molars was also evaluated. Results Our results show no significant differences in plaque index values between control and diabetic groups. Statistically significant differences were recorded when considering gingival index, higher values being recorded in children with IDDM and especially those with poorly controlled metabolic control, compared to control group. Clinical attachment loss registered augmented levels in children with IDDM compared to the control group, and in terms of measuring the GCF volume, values have been found significantly elevated in diabetics compared to control group, the largest being recorded in poorly metabolic controlled diabetic children and teen-agers. Conclusions Among the values of the evaluated indices, the highest increases were observed with parameters associated to significant inflammation, GI and GCF volume respectively. Our results are consistent with scientific literature in the field that claims inflammation as a major mechanism involved in the pathogenesis of both disorders: periodontal disease and diabetes.

Diabetes, a pathology that is extremly widespread, involves an alteration homeostasis in the glucose metabolism. Periodontitis is a infectious disease resulting in irreversible destruction of the tooth attachment apparatus. At present, periodontitis is one of the major reasons for adult tooth loss. The periodontal clinical examination determined the following diagnosis categories: chronic gingivitis and chronic periodontitis , all of them being modulated by the systemic disease. Aim of the study is to highlight possible correlations between periodontal status and diabetic clinical parameters characterizing patients diagnosed with type 1 diabetes(T1D). Material and methods This study was conducted on 62 patients. We analysed the general information of the patients and an oral examination for establishing the parodontal diagnosis. The probing depth has been established, number of teeth with pockets Larbert than 6mm and the plaque index Silness and Loe. Results Significant differences were found between the IP values on children and adults but there were no significant differences between IP on GTA and GCA or between IP on GTC and GCC. We did not find a statistically significant correlation between HbA1c and severity of periodontal diagnosis GTC. But found a direct correlation between HbA1c and statistically significant in periodontal diagnosis GTA. Conclusions The results obtained in this study show a possible relationship between metabolic changes caused by periodontal T1D and, especially in the group of adult patients.

Noncarious cervical lesions (NCCLs) are defined by the loss of hard dental tissues localized at the cervical area of the teeth, having different etiology as compared to carious lesions. They occupy an important place in dental pathology and can be a real challenge for the specialist in terms of diagnosis and treatment plan. The management of all the etiological factors involved in their occurrence, as well as the selection of the ideal restorative materials and techniques still remain controversial topics. NCCLs have a significant negative impact on dental and periodontal health while certain histo-morphological features make both the diagnosis and treatment phases difficult. The NCCLs clinical approach involves the identification and elimination of all ethiological and risk factors involved in their occurrence and the actual restoration of lost dental tissues. Both the characteristics of the lesion and the proximity of the periodontal tissues should be considered when choosing the working protocols and materials in order to maintain the periodontal health. The behaviour and specific features of composite materials derive from their composition and structure. Their major disadvantage is the polymerization shrinkage, which negatively influences the clinical performance of restorations, especially in the case of NCCLs. The aim of this article is to highlight certain important aspects regarding the properties and performance of flowable composites in restoring NCCLs.

Background and aims. Periodontal disease and NAFLD present similar risk factors, thus the possible influence of NAFLD on the clinical evolution of periodontal disease is being pursued. Material and Methods. For this study were selected 87 patients who presented themselves at the Clinic of Periodontology of the Faculty of Dental Medicine in Craiova and at the dental office S.C. MED-COM S.R.L, for periodontal reasons, and Gastroenterology Clinic within the County Clinical Emergency Hospital Craiova, between April 2018 and March 2019.The patients were diagnosed with periodontitis using periodontal measurements, having periodontal pocket depth (PD)≥ 4 mm, and with NAFLD using laboratory tests and abdominal ultrasound. Results. The participants with NAFLD had slightly more sites with PD≥ 4 mm than patients with only periodontitis, also in the cases where the laboratory test were inconclusive with normal levels of ASL, and mild elevated levels of ALT, GGT, total cholesterol and sugar levels.

Sampling of saliva is simple and effective. It is a simple method in that it does not require expertise for collection and is less expensive. Periodontal disease is a chronic microbial and inflammatory process characterized by the presence of pathogenic bacteria. Saliva, by its importance in biofilm formation and in host defense, secretes biomarkers that can play a significant role in the establishment and progression of periodontal disease. Determining salivary biomarkers helps in the early diagnosis of diseases and increases the success rate of the treatment.

Aim of the study: to compare the metabolic status using chemical blood test markers for periodontal disease-diagnosed patients suffering or not from systemic conditions (diabetes mellitus and chronic viral hepatitis). Material and Methods. 195 patients diagnosed with various stages of chronic periodontal disease (PD) were divided into four groups: PD + diabetes mellitus (n=60), PD + hepatitis B (n=16), PD + hepatitis C (n=10) and PD only (n=109). The patients’ blood samples were analyzed for: biochemical parameters (blood sugar – glucose, total cholesterol, hepatic enzymes – transaminase ALT and AST, triglycerides) and cellular parameters (full blood count, erythrocyte sedimentation rate, prothrombin time and international normalized ratio). Data collection and statistical analysis t-test were performed for comparison, p < 0.05 for statistical significance. Results. Our retrospective study shows elevated levels of hepatic enzymes (both AST and ALT) for the periodontal patients diagnosed with chronic HCV/HBV infection than for systemic-healthy periodontal patients. The total cholesterol mean values expressed no statistically significant difference between the four group of patients. Triglycerides mean levels were lower than the physiological reference value for periodontal patients with no co-morbidities but expressed higher average values for systemic-diseased ones. Glucose levels were the highest for the periodontal patients with diabetes. Conclusion. Metabolic parameters in periodontal patients suffer alterations caused by diabetes and HBV/HCV infection.

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.