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Anatomical knowledge of the facial vasculature is crucial for successful plastic, reconstructive, and minimally invasive procedures of the face. The facial artery is palpated as it crosses the inferior mandibular rim immediately anterior to the insertion of the masseter muscle. This point is also helpful in locating the course of the mandibular branch of the facial nerve. After crossing the mandibular rim, the facial artery and vein then follow an anterosuperior course in the direction of the oral commissure. Near the angle of the mouth, the inferior labial artery and then the superior labial artery branch off medially The facial vein, also referred to as the anterior facial vein, is a paired vessel and the main vein of the face. The facial veins stem from the angular veins on each side of the root of the nose. Some sources claim that the angular vein, which arises from the confluence of the supratrochlear and supraorbital veins, is only an initial segment of the facial vein.

Bone seen as tissue is an extremely dynamic biological system, comprising a series of tightly regulated and synergistic anabolic and catabolic processes that lead to a metabolic homeostasis corresponding to skeletal structures. Osteoporosis is defined as an evolutive disease of the skeletal system characterized by loss of bone mass and alterations in the microarchitecture of bone tissue, resulting in increased bone fragility and the risk of fractures. Osteoporosis has gained a huge resonance in recent years both personally and economically. In this review we are going to present some of the best known bone markers of resorption and bone formation, determined from blood and / or urine samples. Research for new biomarkers, which can predict abnormal bone mass loss at various stages of the disease, is ongoing. The impact of osteoporosis on the susceptibility of the host to periodontal damage is still being understood. It is clear that the efforts should be directed towards the prevention of periodontal disease in patients at risk for osteoporosis. Patients with osteoporosis should benefit from frequent periodontal treatments, especially if periodontal disease is already present. Starting from the studies collected from the literature, it is very interesting to define the relationship of periodontal disease and osteoporosis following a series of markers of bone resorption in patients diagnosed with periodontal disease. A better understanding of the relationship between the two diseases, osteoporosis and periodontal disease, would help in the preventive and therapeutic measures as soon as it is possible.

The purpose of this study is to analyze the opportunity of metal or non- metallic reinforcement of mobilizable prostheses in accordance with the main factors can lead to fracture of partial or totally removable prostheses. Equally, establishing the correlations between the evaluated anatomical features and the intervention of general and loco-regional factors is part of the objectives of the statistical study, crowned with the mirror of the necessary treatment, a clear premise of the motivation of research to improve the quality of total prosthesis. For this purpose, we evaluated a study group consisting of a number of 84 patients diagnosed with total uni and bimaxillary edentation, subtotal and partially extended edentation that were presented in the Clinical Education Base of the Faculty of Dentistry Iasi, respectively in practice private offices, in the period 2018-2020. Regarding the need to reinforce the total prostheses , we remarked a need for 39%, 15% for nemetallic reinforcement and 24% for metallic reinforcement. The clinical statements encountered in the jaw antagonist of the total edentulous one have been edentulous partially stretched, respectively edentulous subtotal that involve forces higher in time carrying out the functions of mastication ( in the case of prosthetic joint ) elements which call for optimizing the possibilities of reinforcing the total prosthesis.

The oral cavity represents an area access zone from the external environment to the internal areas of the body and saliva is at the interface between microbial ecosystems and oral immune cells. Any imbalance of saliva physiology has an impact on oral and systemic health. Elevated inflammatory cytokines in saliva, for example, activates dysbiosis (disease) of periodontal tissues, feeding forward tissue inflammation, leading to oral tissue loss. Host–microbiome interactions complex modulate pathological transitions including gingivitis, periodontal diseases, and oral cancer. However, mechanisms involving these interactions are poorly understood at the molecular level.

From a clinical perspective doctors rely on auspicious wound healing on a daily basis. Without a thorough understanding of this process success in treatment cannot be obtained. Thus it is of utmost importance that clinicians know and understand both the local, but more importantly, the systemic factors, which most of the time are not so apparent, which can affect and delay wound healing. The oral cavity hosts a plethora of tissues that serve various functions, and in this complex environment cells, bacteria, viruses, and fungi live in a subtly balanced ecosystem. It is this complexity of factors, both systemic and local, that offer the healing particularities and challenges of the oral cavity.

The reconstruction of segmental mandibular and maxillary defects remains a challenge for the reconstructive surgeon, from both a functional and an esthetic point of view. This paper reviews the history of oral cavity, especially of the maxillary and mandibular defects reconstruction over the past 60 years and evolution of surgical and prothetic reconstruction, examines the different techniques currently in use for mandibular and maxillary reconstruction as related to a range of etiologies, including the different bone donor sites, the alternative to free flaps, as welll the contribution of computer-assisted surgey. Osseouss free flaps allows relable and satisfying outcomes. Locoregional flap, distraction osteogenesis, induced membrane techniques are other potential options in less favorable cases. The introduction of microvascular surgery, the description and undestanding of the different soft tissue and composite tissues available for reconstruction along with technologic development in osseointegration and virtual surgical planning have transformed the lives of patients treated surgically for oral tumors.

Regardless the etiology, location, extent or topography, edentation is a pathological entity that, through evolution and complications, causes serious imbalances in the stomatognathic system. The restoration of specific homeostasis involves the satisfaction of the laws of geometric and biomechanical balance by restoring the initial mechanical parameters and the basic constants of the stomatognathic system represented by the posture relation, the centric relation, the occlusion relation and the small mandibular dyna. The design and implementation of the rehabilitation of fixed prosthetics must take into account the real needensuring a long-lasting congruence between the prosthetic part and the tissues of the stomatognathic system, but also ensuring an optimal resistance to environmental stresses. Although the concepts underlying the principles listed are different, each of them incorporates elements of significance for the biomechanical balancing of the dento-prosthetic assembly. One of the main prophylactic problems is the discerning use of dento-periodontal or, as the case may be, muco-osseous support, in order to disperse as much as possible the pressure and traction forces on the different elements of the prosthetic field.The observance of the curative principle presupposes the obtaining of a morpho-functional restoration capable of ensuring the resumption of the altered functions, in optimal conditions. The individualized occlusal modeling and in correct relation with the antagonistic teeth will contribute to the most physiological transmission of the masticatory forces to the maxillary bone bases.

Patients with mental disorders have a series of general and oral health problems correlated to specific psychiatric drugs, along with the difficulty of behavior and concentration, preventing them from respecting the real need for oral care. Many people affected by these disorders cannot perform oral hygiene satisfactorily. This is exacerbated by the prolonged use of mouth-drying medicines, as well as by the excessive use of tobacco products and alcohol, which contribute to poor oral health. The aim of this study is to evaluate evaluate the oral health of mentally ill patients who had medical assistance at the Dentistry Clinic of St. Spiridon Hospital in Iasi. Matherial and methods:A cross-sectional descriptive study was conducted between October 2016 and May 2017 on a number of 30 psychiatric patients under treatment at the Faculty of General Medicine and Dentistry.A well-structured questionnaire was applied to collect information on the socio-demographic characteristics of the respondents,clinical evaluation of oral health status was performend using EGOHID assesement correlated with the general health status and specific psychiatric medication. Results: Regarding the psychiatric disorders that the 30 patients presented, their distribution was: 33.3% with schizophrenia, 26.7% depression, 30% bipolar disorder, 16.7% paranoid disorder and 16.7% with mixed dissorder. For the associated general pathology, diabetes was associated in a proportion of 27%, liver diseases 20%, thyroid diseases 16.7%, kidney diseases 10% and cardiovascular diseases 24%. As for medication, the highest frequency was recorded for the drugs Haldol (73.3%), Carbamazepine (46%), Clonazepam (43.3%), Diazepam (30%) and Amitril (16%), producing different modiffications in terms of saliva flow, buffer capacity and pH, resulting modifications in the oral health status. Conclusions: Patients with mental illness had significantly altered values ​​for salivary pH, salivary flow and buffer capacity of saliva in the sense of a marked decrease of values in patients with depression and bipolar disorder, compared to patients diagnosed with schizophrenia. There were no significant differences between salivary pH, salivary flow, or buffer capacity in monotherapy and multitherapy patients.

Hydrogen peroxide (PH) is the main active substance used in current bleaching treatments. the mechanism of the bleaching reaction is based on the ability of PH to penetrate the enamel surface followed by its degradation into free radicals that will oxidize dentin-fixed chromogens releasing several types of intermediates: free radicals and hydroperoxyl anions. The dissociation of the peroxide and the type of intermediate product varies depending on the temperature, the concentration of the peroxide, the pH of the bleaching solution and the presence of co-catalysts. The study was performed in vitro on a number of 22 patients. Patients were given PH-40% with 1.1% fluorine and 3% potassium nitrate in two successive applications in a single session. Statistical data processing was performed with the SPSS 14 program for Windows, with the t-students paired test establishing a statistical significance threshold of p≤0.05. Within the limits of this study, it can be concluded that the effect of in vitro use of 40% hydrogen peroxide was immediate and statistically significant on average with a difference of five shades on the analog visual scale.

Topical hyaluronic acid (HA) has recently been recognized as an adjuvant treatment for chronic inflammatory disease in addition to its use to improve healing after dental procedures. To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the soft periodontal tissue, gingiva, and periodontal ligament as well as to the hard tissue such as alveolar bone and cementum. The aim of our work was to systematically review the published literature about potential effects of HA as an adjuvant treatment for chronic inflammatory disease, in addition to its use to improve healing after common dental procedures.

Both periodontal disease and chronic kidney disease (CKD) are inflammatory disorders that considerably affect the patients’ overall health and life quality. Periodontal disease occurs somehow more often in CKD people, but it remains indeterminate whether periodontal disease is an independent risk factor in this population or what the true nature of their relationship is. Objectives. Our study focused on investigating the relationship between CKD and periodontitis, and the influence of the latter’s presence and severity on the former, through evaluation of the periodontal status in predialysis and dialysis CKD and healthy subjects with periodontitis. Materials and method. The patients included in our study were divided in two groups, study (n=59) with end-stage CKD and periodontitis, and control (n=20), with periodontitis but without renal impairment. All the subjects underwent dental and periodontal evaluation, using parameters common in clinical examination (Periodontal Disease Index –PDI, dental mobility, bleeding on probing – BOP, inflammatory hyperplasia, gingival recession, probing depth – PD and clinical attachment loss – CAL). Both groups also answered questions about their meal plan and oral hygiene habits and their access to dental care. Results. There were visible differences between the groups when considering social and economic status and access to dental and periodontal services, which is relevant for the distribution of periodontal disease severity between groups (56% from the study group had severe periodontitis, with only 10% in the control group). The study group also had more missing teeth, deeper periodontal pockets and more signs of inflammation. It is still unclear if this is due only to low social and economic status or is it a consequence of CKD and hemodialysis. Conclusions. There is a link between the two entities, but it is still unclear if this is due just to the pathophysiology of periodontitis and CKD, or are the external and local factors involved. Further investigation is needed to clarify this issue and to be able to produce viable prevention and treatment programs for people with end-stage CKD.