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Materials and techniques used for direct pulp capping are closely related to the pulp vitality prognosis and long-term success of therapy. In the recent years, the performance and potential of these materials has improved significantly, alongside their capacity to induce formation of a new dentin barrier after pulp exposure. As there is not one single way of performing direct pulp capping, this study aims to report current trends applied to this procedure, and generally accepted characteristics of the most widespread materials – adhesive systems, calcium hydroxide, MTA, and other bioactive endodontic cements.

This article from the Romanian Journal of Oral Rehabilitation explores the connection between temporomandibular joint (TMJ) dysfunction, obesity, and stress disorders in patients. The study found that TMJ dysfunction can occur even without dental issues, due to unfavorable biomechanics in prosthetic treatments. The article emphasizes the importance of a comprehensive treatment approach that considers the relationship between obesity, stress, and TMJ dysfunction. The study involved 22 patients and focused on clinical and paraclinical evaluations to develop a treatment protocol. The text also discusses the diagnosis and treatment plan for an impacted tooth in the mandible, attributing the cause to genetics. The recommended treatment involves maintaining good oral hygiene and does not require specific interventions. The article concludes by highlighting the potential connection between obesity and dental health, stressing the need for early interventions and further research. [Extracted from the article]

This article discusses the relationship between dysfunctional syndrome of the stomatognathic system and schizophrenia, emphasizing the need for an interdisciplinary approach in treating complex oral rehabilitation cases in patients with schizophrenia. It provides a detailed clinical case of a patient with schizophrenia and their specific oral rehabilitation needs. The article also discusses therapeutic solutions and objectives for the rehabilitation process. Additionally, the document is a clinical examination report that assesses the oral health status of a schizophrenic patient, including their medical history, physical condition, dental examination findings, and periodontal risk factors. The report aims to develop a treatment plan that addresses both the patient's dental needs and psychological well-being. [Extracted from the article]

The article titled "TEMPORO-MANDIBULAR MANIFESTATION AN IMPORTANT ISSUE IN REHABILITATION TREATMENT PLAN AT PATIENTS WITH OBESITY PATHOLOGY AND STRESS DISORDERS.- clinical and paraclinical examination part 1-" explores the connection between temporomandibular joint (TMJ) disorders, obesity, and stress disorders in oral rehabilitation treatment plans. It emphasizes the need to prevent obesity and metabolic diseases in this population and highlights the impact of co-occurring conditions like type 2 diabetes on periodontal health management. The study also discusses the use of clinical and paraclinical examinations, such as stress questionnaires and blood tests, to assess and treat patients with TMJ disorders. The article provides insights into the challenges and considerations involved in dental care for obese individuals. Additionally, the given text is a clinical examination report that evaluates the oral and maxillofacial health of a patient, focusing on muscle groups, TMJ function, intra-oral examination, occlusion parameters, and mandibulocranial relations. While the report does not provide specific information about the patient's condition or symptoms, it emphasizes the importance of a comprehensive evaluation for complete rehabilitation and mentions the potential correlation between obesity, stress, and oral health. [Extracted from the article]

This article from the Romanian Journal of Oral Rehabilitation examines the use of interdisciplinary approaches in treating young patients with social anxiety who require complex intraoral rehabilitation. The authors stress the significance of a well-developed protocol to instill confidence and ensure effective and efficient therapeutic treatment. The study focuses on twenty cases of social anxiety and explores the relationship between psychiatric and dental anxiety. The article also presents a diagnosis and treatment plan for a specific patient, discussing the management and treatment of patients with dental and social anxiety in the context of oral cavity treatments. It emphasizes the importance of behavioral therapy and personalized treatment plans to address the mild to moderate effects of anxiety. The study also highlights the importance of multidisciplinary approaches and specialized protocols for patients with special needs. The text references various studies and scales used to measure anxiety levels and examines the connection between anxiety and oral health. [Extracted from the article]

This article from the Romanian Journal of Oral Rehabilitation examines the relationship between hearing loss and mental health issues, as well as the treatment options for patients with hearing loss. The study focuses on the therapeutic implications of diagnosing and treating comorbid conditions such as hearing loss, mental disorders, and temporomandibular joint (TMJ) disorders. The research sample consisted of 28 patients with hearing loss who sought treatment for TMJ disorders. The article outlines the stages of the treatment plan and suggests that further testing is needed to determine the long-term effects of the treatment. It also discusses the potential role of orthognathic therapy in improving ear function and dental malocclusion. Temporomandibular disorders (TMDs) are a common condition associated with orofacial pain and can be linked to comorbid conditions such as headaches, tinnitus, and hearing loss. Physiotherapy treatments have been shown to be effective in treating TMDs and improving symptoms. Complex oral rehabilitation can lead to recovery and homeostasis in patients with TMDs. [Extracted from the article]

This article explores the topic of aesthetic rehabilitation through implant-supported fixed prostheses for patients with complete tooth loss. It emphasizes the benefits of using implant-based prostheses compared to traditional methods, with a success rate of around 95% over a 10-year period. The article also discusses the use of digital technology in the treatment process. It provides details on the digital positioning and fabrication process for both maxillary and mandibular dental prostheses, highlighting the materials used and the steps involved. The article underscores the importance of collaboration between the medical team and dental technician in achieving successful outcomes for edentulous patients. [Extracted from the article]

The article titled "Interdisciplinarity Approaches in Context of Complex Intraoral Rehabilitation Treatment at Young Patients with Social Anxiety - Clinical Examination - Part 1" discusses the impact of social anxiety on oral rehabilitation treatment. It emphasizes the importance of an interdisciplinary approach to address the complex needs of patients with social anxiety. The article provides a detailed description of a clinical examination conducted on a patient, including various aspects such as extraoral examination, examination of muscle groups, inspection of the temporomandibular joint (TMJ), and examination of the oral orifice. The examination also includes assessments of occlusion and mandibulocranial relations, with the use of radiography for further analysis and diagnosis. The text does not provide information on the context or purpose of the examination. [Extracted from the article]

This article from the Romanian Journal of Oral Rehabilitation examines the connection between vitamin D levels and the presence of large chronic periapical lesions in patients undergoing complex oral rehabilitation treatment. The study involved 28 patients with dental issues and 28 control patients without systemic disease. Analysis of serum vitamin D levels revealed significant differences between individuals with chronic apical periodontitis and the control group. The study suggests that vitamin D may have a role in regulating inflammation in periradicular tissues. Further research is needed to determine the best method of vitamin D supplementation. [Extracted from the article]

Introduction: The implementation of CBCT in endodontics has been supported by the European Endodontic Society. Our aim was to assess the impact of using CBCT examination carried out according to the European Commission Guidelines versus retrodentoalveolar radiography in terms of diagnostic and treatment plan. CBCT will require a new index, still being researched, PESS (Periapical and Endodontic Status Scale ). Material and Method: Our study includes 57 patients with teeth that have not been endodontically treated, diagnosed with pulp necrosis and 30 patients with periapical lesions, with or without symptoms. The examiners - two endodontics specialists (12) and one general and dentomaxillofacial radiologist (3) - carried out a preliminary diagnosis, after a clinical evaluation, taking into account the patients' history, clinical signs, diagnosis tests, retrodentoalveolar radiographs for each of the teeth presenting one of the above mentioned pathologies. Both the retrodentoalveolar radiography and the CBCT were carried out in the same private clinic. Results: The population included in the study consisted of 87 patients: 44 women - 51.2% and 43 men - 48.8%. The average age of the men was 33.69 ± 11.774 and of the women 33.23 ± 11.287, without any statistically significant differences in terms of age or gender (p = 0.857) Among the 57 patients with pulp necrosis, periapical radiotransparency was diagnosed in 80 roots by using retrodentoalveolar radiographs, compared to 92 diagnosed using CBCT. Among the 30 patients with periapical lesions, 35 affected roots were found by using retrodentoalveolar radiographs versus 54 diagnosed by using CBCT. Using the CBCT-PAI index in order to evaluate the periapical lesions, the maximum value for the maxillary was S3 49.5% and for the mandible - S4 65.1%. Discussion: The CBCT examination revealed significantly more periapical lesions than retrodentoalveolar radiographs did. One must take into account the fact that the CBCT examination had a great influence on the choice of diagnosis and treatment plan. Conclusions: The diagnosis and treatment plan were changed for the teeth in which periapical lesions were found as a result of the CBCT examination. [ABSTRACT FROM AUTHOR]

As the market offer for bioadhesive materials is constantly increasing, while the dental surfaces on which they are applied show specific features, different from those commonly resulting from the preparation of carious processes, knowledge on their behavioral characteristics is absolutely necessary for their utilization under optimum conditions, through methods assuming prolongued clinical performances, assured by dimensional and colouristic stability and by a reduced cure contraction, for diminishing as much as possible the space of marginal percolation and fracture of the free enamel-free margins, as well as for delamination of immobilization from the afferent dental structure. Selection of the type of material for periodonthic teeth immobilization and of the technique to be applied is decided on the basis of a systematic, clinical and radiological analysis meant at establishing: the number of affected teeth, the type of occlusion and the possible parafunctions, oral hygiene, the aesthetic requirements of the patient, his/her age and motivation for a periodical monitorization. Numerous modern materials employed in the immobilization of periodonthic teeth are closely related not only to their physical properties and long-term stability, but also to the oral environment in which they are functioning. Modern adhesive materials are well-suited for dental recovery of the remaining healthy structures, due to their capacity of chemically and micromechanically adhering onto them. [ABSTRACT FROM AUTHOR]

Measurement of corrosion potential is a relatively simple concept, an unanimously accepted notion in industry for the monitorization of steel corrosion, in building industry and in other structures. Equally, in the last decades, this parameter has been intensively utilized for characterizing dental alloys in either natural oral environment or in simulated solutions. The corrosion potential may be measured directly versus a reference electrode, characterized by a highly stable semi-cell potential. In this respect, a reference electrode (or a separated sensor of the material to be monitorized) is introduced in the corrosive medium together with the metal or alloy under study, and the potential is measured directly with a millivoltmeter with very high input impedance. Additional details on the processes occurring in the system may be acquired if analyzing the curves of cyclic polarization, for whose obtaining the potential of the electrode formed with the investigated alloy is increased, at constant rate, in positive direction, up to a pre-established value, followed by its scavenging in reverse direction (towards negative values) until reaching the initial value or some other value. During scavenging of the potential, the electric power passing through the solution between the working electrode and an auxilliary (platinum-made) electrode is measured. [ABSTRACT FROM AUTHOR]

Several clinical cases outline the difficulties of root canal treatment, due to the morphological changes of the endodontic space in elderly patients. The changes in the shape of pulp chamber and root canal make the treatment more difficult. It is also shown that the pulp chamber diminishes, due to reparative dentin. Calcification of the pulp space makes more difficult the access to the cavity. The obliterated canals lead to a challenging negotiation of the root canals. To avoid errors in the appreciation of the general health condition of the patient, the specialists should have an accurate preoperative radiograph or cone beam computing tomography (CBCT), use magnification (dental operative microscope), safe-ended burs, consider carefully any morphological changes, and apply the most proper techniques. [ABSTRACT FROM AUTHOR]

The present study aimed at assesssing - by clinical, histological and radiological investigations - the influence of some external factors on the pulp-dentin complex, and at providing a causal interpretation of the structural changes observed. Materials and methods. Clinical and radiological exams were performed on 65 old patients with ages between 60-75, and also on 40 young patients with ages between 20-35, presenting different dental-periodontal pathologies. The pulp-dentin complex was submitted to a morphopathological examination, to highlight the structural changes observed at microscopic level. Fragments of dental pulp were imersed in a 4% formaldehyde solution with phosphate buffer 0.1 M., pH 7.2, for 12-14 hours, at a temperature of 4°C, and 3-5 µm thick slices were prepared. The slices were coloured with hematoxylin-eosine (HE), by the trichromic technique - Masson. Photographies were taken with a Zeiss microscope, with Kodak 200 ASA. Results. Significant differences were observed, between the two groups of patients, as to the external factors that produce structural changes on pulp-dentin organ. In the group of young patients dental caries and coronal fillings prevailed, while the group of old patients was mostly associated with atrition and chronic marginal periodontitis. Out of the 40 young patients, 30 presented chronic dental caries (75%), while, among the 65 old patients, only 24 presented dental caries (36.9%). The percentages of coronary fillings between the two study groups were close, which could be considered as one of the causes producing changes in the pulp-dentin organ, following aggresive preparation of cavities, the action of materials used for the protection of pulp-dentin complex or of the materials used for coronry fillings. Conclusions. Dental pulp has a remarkable ability to counteract the action of harmful factors, producing a mineral barrier and stimulating the reparatory processes. Changes in the endodontic space can be produced in both experimental groups, but more intensely and more frequently in the old patients. The endodontic space is modified, both physiologically and pathologically, including deposition of secondary or tertiary dentin (reactionary or reparative dentin), as well as pulp reactions, such as: inflammation, fibrosis, calcium degeneration or vacuolisis. At cell level, microsocopic images showed a decrease of the odontoblasts number and sizes, as well as a reduced fibroblasts/fibrocytes ratios. These changes are associated with progressive vascular and nervous changes, that can be considered both theis cause and effect. These pathological transformations are related with a more difficult preparation of the endodontic space and can be considered as having a major role in the failure of endodontic therapy. [ABSTRACT FROM AUTHOR]

Objective: Periapical granulomas, chronic periapical osteitis produced particularly by the bacterial continuous agression from the endodontic space, can develop accordingly, or they can transform in epithelial or cystic granulomas, their diagnosis being more difficult to determine at these stages. This study aimed to emphasize a few aspects that can conduce to an easier diagnosis establishment. Materials and method: 78 patients with periapical chronic periodontitis have been evaluated in order to assess their evolution to epithelial or cystic granulomas. These cases were monitorised during the endodontic treatment and, were necessary, endodontic surgery was performed and samples for the histopathologic exam were drawn, in order to make an accurate diagnose. Results: From the 78 cases of teeth with chronic periapical periodontitis, 18 required surgical approach: 4 curettages, 5 apicectomies, 9 extractions, from which 7 were labeled as cystic granulomas, after the microscope examination. Conclusions: Untill the comming out of an accurate diagnosis method for these lesions, the practitioner must consider all possible data from the anamnesis to the clinic and radiographic exam, the only relyable method to establish a correct diagnosis being the histopathologic exam. [ABSTRACT FROM AUTHOR]

Dental mobility from different causes as: trauma, periolesions, tumors is a terrible symptom for patients, no matter about age. For dental mobility third degree, the treatment is usually radical as extraction; in some cases we can make a conservative treatment as a preventive method followed by success if the pacient respects the therapy dynamic. [ABSTRACT FROM AUTHOR]

The purpose of the study is to assess the apical sealing ability of the endodontic space using two types of canal filling techniques: vertical compaction of warm gutta-percha and AhPlus sealer compared with Resilon and Real- Seal SE. Two sets of extracted human teeth were prepared with rotary instruments, each 20 teeth being obturated by the two techniques: the classical and the adhesive root canal filling. The apical leakage of the root canal filling made with Resilon and RealSeal SE was higher than the one with gutta-percha and AhPlus. The difference was statistically significant. [ABSTRACT FROM AUTHOR]

Unlabelled: Root perforation is an unwanted incident which may occur at any stage of endodontic treatment and can adversely affect tooth prognosis., Aim: To compare the recovery rate after treatment of root perforations in the interradicular area of the molars, using two different materials: MTA and ceramic nanoparticles mineral cement DiaRoot BioAggregate, by a clinical-radiological and statistical analysis over a period of up to 24 months., Material and Methods: The study was conducted on 28 molars from patients of both sexes, mean age 33.29 +/- 6.2DS, with iatrogenic perforation of pulp chamber floor. The teeth were divided into 2 groups according to the applied material: group 1--gray MTA (ProRoot MTA, Dentsply, Tulsa Dental), and group 2--BioAggregate (Diadent Group International, Vancouver). Patients included in the study were monitored and assessed by radiological examinations at 6, 12 and 18 months., Results: Pulp chamber floor perforations are significantly associated with tooth location (chi2 = 35.60, r = 0.67, p = 0.00359, 95% CI). Both when the perforation was repaired with MTA and BioAggregate, the clinical improvement was significant (chi2 = 17.608, r = 0.58, p = 0.0035, 95% CI)., Conclusions: Based on the results of this study, both MTA and BioAggregate are excellent materials for root perforation repair.

Unlabelled: Our study aimed to assess the possibilities of healing in periapical lesions following endodontic therapy, using a standardised technique., Material and Methods: Study group included 34 patients with 15-45 age. 40 teeth with periapical granuloma and periapical difuse osteitis were endodontically treated. All teeth presented radicular obturations with adequate length and density consisting of gutaperca points and antiseptic sealer (Endoflas, Sanlor). Optimum coronal sealing was provided through prosthetic restorations or composite resins associated with glassionomer cements. All treated teeth were radiographically monitorised on a 24 months time interval. Periapical Index (PAI) were used for assessment of periapical healing processes. Recorded data were used for statistical analysis in SPSS 16 trial., Results: The assessment of periapical status after 24 months showed a complete periapical healing for 42.5% teeth (PAI 1-2), partial periapical healing for 52.5% teeth and 5% endodontic failures. Median values for PAI indices decreased from an initial 4.75 value to 4.30 after 3 months, 3.33 after 12 months and 2.60 after 24 months. Wilcoxon tests confirm significant statistical differences between PAI indices at different time intervals., Conclusions: Adequate radicular obturation associated with optimum coronal sealing provide a favourable environment for periapical healing processes, providing success in endodontic therapy of chronic apical periodontitis. Time interval represents a major factor that influences periapical remineralisation degree.