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With the help of dental implants, an oral rehabilitation can be performed not only very complex, but also very complete of various types of edentulous spaces. After insertion of the dental implants, they can be subsequently prosthetically restored through a wide range of implant-supported prosthetic restorations. In this material, we tried to highlight some particular aspects from the point of view of the laboratory stages of dental technique, which intervene in the technological flow of making implant-supported prosthetic restorations from ceramic masses on Zirconia structure.

Post and core devices are elements that contribute to the complete restoration of the coronary abutment, over which the final prosthetic restoration will be created. Their role is to retain the coronary portion of the restoration and to protect the remaining coronary structures. The retention function is dictated by the major indication of the method, massive coronary destruction that does not provide conditions for coronary aggregation of the restoration. Thus, this material is approaching two unique methods of making post and core devices totally metallic and/or hybrid (metal + totally ceramic component), using both classical technology, modern technologies, but also combinations of them.

Dental biofilm-induced gingivitis is extremely common in children and adolescents and it affects the majority of children over 7 years old. It is characterised by inflammation, consisting in changes of colour, size, consistency and texture. Although most of the times gingivitis does not progress into periodontitis, it is important to diagnose and properly treat this disease, as gingivitis precedes periodontitis. The present paper aims to review the main findings of microbial etiology and epidemiology of dental biofilm-induced gingivitis mediated by local risk factors, as well as the role of oral hygiene in preventing bacterial colonization.

Dead tracts are dentin areas characterized by degenerated odontoblastic processes; may result from injury caused by caries, attrition, erosion, or cavity preparation. Odontoblasts can also form tertiary dentin, as a response to injury, in association with caries, trauma, or restorative procedures. Generally, this dentin is less organized than primary and secondary dentin and mostly localized to the site of injury. The reactive dentin formation that lays under caries, the pulp displays chronic inflammation and tertiary dentinogenesis takes place on the inner walls of the pulp space, in the region of the dentinal tubules associated with the base of the carious lesion. Higher-power photomicrograph of tertiary dentin shown in a primary dentin, first period of tertiary dentin formation, second period of tertiary dentin formation. We initiated a case study regarding depositition of tertiary dentin in the close proximity of the cervical perforation hole on mesial root of the second maxillary molar. The repair material used (Biodentine, Septodont) was found placed under the tertiary dentin layer, rather than at the perforation place, mentioning the fact that the group of residents was not experienced with the management of the endodontic microscope and did not use a proper field. We consider that we have identified dead tracts due to the fact that they were formed consequently carious lesions pathology, thereafter the tertiary dentin at the appearance of the coronal aspect was identified at the end of the dead tracts. The portion of the canal entrances were investigated both with analyzed filters (Crossed Polars) and with compensatory devices (retardation plates). The present study identified tertiary dentine deposits in the coronary portion of the adjacent root canal entered in the perforation. At a thorough analysis of the coronal portions of the mesial root canal with compensating devices and analyzers filters, it was noticed a soft dentin blanket in which the dentinary tubules do not exist or are of very rare deposition.

Restoring teeth with second class cavities is a challenge in dentistry. Both the carious process and the preparation of the cavity for the dental restoration reduces the tooth resistance to the masticatory forces. It has been shown that modern aesthetic materials using an adhesive system improve the stress resistance of the restored teeth. There is a series of studies that attempted to determine the type of optimal material that would provide increased resistance to occlusal demands. In the present study we tried to determine the fracture resistance of molars with second class cavities restored with different categories of aesthetic materials. Thus, forty intact molars were divided into five groups of 8 teeth, MOD cavities were prepared and the teeth were restored with three types of materials: nanofilled composite, mycrohibrid composite and ormocer. The teeth of the first group were left unprepared, and those belonging to the second group were subjected to the preparation of MOD cavities but were not filled. Samples were subjected to compression using an Universal Loading Machine (Lloyd Instruments) and the value of the force they failed was recorded. Intact teeth showed the highest resistance to compression and those with MOD cavities prepared but not filled showed the smallest. Of the groups that benefited from restoration with filling material, the teeth restored with ormocer had the highest resistance, followed by those restored with nanofilled composite, and finally by those restored with mycrohibrid composite.

The aim of our study was to compare the fracture resistance of teeth presenting non-carious cervical lesions restored with different types of esthetic composite materials. 20 extracted unspoiled maxillary first molars were mechanically cleaned and immersed in saline solution containing 0.1% thymol at 4�C for a period of 48 hours. Cervical cavities with a cervical-occlusal diameter of 2 mm and a mesial-distal diameter of 3mm were filled with ormocer, flow nano-composite, nano-composite and compomer. Fracture resistance was tested with a universal loading machine (Lloyd Instruments), with a maximum force of 5 kN and a crosshead speed of 1.0 mm/min; the authors used NEXYGEN Data Analysis Software and ANOVA method. For the group A (commercial grade ormocer), the smallest load that determined the sample failure was 650 N and the highest load was 1050 N, the mean value being 858 N � 150.89 N. For the group B (commercial grade flow nano-composite), the smallest load is 530 N, the highest load is 800 N, mean value being 654 N � 112.6 N. For the group C (commercial grade nano-composite), the smallest load is 680 N, the highest load is 1200 N, mean value being 926 N � 209.35 N. For the group D (commercial grade compomer), the smallest load is 1100 N, highest load is 1250N, mean value being 1180 N � 62.04 N. A p value of 0.000311 (p[0.05) shows that there are significant differences between the four groups. Conclusions. The best fracture resistance of teeth presenting non-carious cervical lesions, restored with different types of esthetic composite materials is assured by the compomer, followed by the nano-composite, which proved to be superior to ormocer. The flow nano-composite gives the lowest fracture resistance.

The restoration of a proximal wall depends on several factors, the conformation system playing one of the most important parts of the working protocol. The vertical, transversal and sagittal adaptation of the matrix band implies the use of one or two wedges and of a sectional matrix device (usually with a ring shape) with tines. The size, configuration and the material the tines are made of determine most of the quality of the adaption and stabilization of the matrix band. Even if these standardized tines have various designs and variable flexibility, a truly efficient tine should have a customized configuration which can be obtained after taking the impression of the initial proximal wall. The clinical situations that allow the customization of the standard tines imply proximal caries that have not interrupted the proximal wall or that have interrupted it less than one third of the transversal distance.

Several methods and materials are used in modern restorative dentistry for anterior dental lesions treatment. The desired aesthetic outcome can be obtained only with the correct treatment method correlated to case particularities. Sometimes, subjective and unrealistic approaches lead immediately or in time to undesirable dental restorations. The aim of the present paper is to evaluate the statistic distribution of aesthetic anterior dysfunctions detected on 425 patients from both genders that had restorative treatment during a period of 10 years. For each patient, there has been conducted an initial clinical examination and a photographic documentation was made. Also, each patient was asked to submit a questionnaire regarding his dental history. The results of the study represented the foundation for the discussions regarding the causes that led to aesthetic dysfunctions. The conclusions indicated that all errors that conducted to an initial failure of treatment are only connected with the medical decisions made by the dentist.

The aim of this study was to compare fracture resistance of teeth presenting medium-sized mesial-occlusal-distal (MOD) cavities using different base materials. Thirty-six extracted molars were immersed for 48 h in saline solution (0.1% thymol at 4 °C) and divided into six groups. In group A, the molars were untouched, and in group B, cavities were prepared, but not filled. In group C, we used zinc polycarboxylate cement, in group D—conventional glass ionomer cement, in group E—resin modified glass ionomer cement, and in group F—flow composite. Fracture resistance was tested using a universal loading machine (Lloyd Instruments) with a maximum force of 5 kN and a crosshead speed of 1.0 mm/min, we used NEXYGEN Data Analysis Software and ANOVA Method (p &lt, 0.05). The smallest load that determined the sample failure was 2780 N for Group A, 865 N for Group B, 1210 N for Group C, 1340 N for Group D, 1630 N for Group E and 1742 N for Group F. The highest loads were 3050 N (A), 1040 N (B), 1430 N (C), 1500 N (D), 1790 N (E), and 3320 N (F), the mean values being 2902 ± 114 N (A), 972 ± 65 N (B), 1339 ± 84 N (C), 1415 ± 67 N (D), 1712 ± 62 N (E), and 2334 ± 662 N (F). A p = 0.000195 shows a statistically significant difference between groups C, D, E and F. For medium sized mesial-occlusal-distal (MOD) cavities, the best base material regarding fracture resistance was flow composite, followed by glass ionomer modified with resin, conventional glass ionomer cement and zinc polycarboxylate cement. It can be concluded that light-cured base materials are a better option for the analyzed use case, one of the possible reasons being their compatibility with the final restoration material, also light-cured.

Implant-supported restorations are being used increasingly by dentists to treat maxillary or mandibular total edentulous patients in parallel with the old methods involving acrylic full dentures. Purpose. In this study, we attempted to perform an assessment of satisfaction degree in elderly total edentulous patients who were carriers of acrylic full dentures and were subsequently rehabilitated using cement retained implant-supported restorations. Material and method. The study was conducted using a 5-point questionnaire, applied to a study group of 39 patients aged between 67 and 77 years between April 2014 and June 2018. Results and discussions. The results provide information on how the edentulous condition is perceived, as well as the classical and modern treatment modalities. Conclusions. The treatment of the edentulous condition by fixed implant-supported prosthesis should be regarded as an alternative from the beginning of the treatment.

Congenital absence of the teeth, affecting both physiognomy and mastication, can have a great impact on patients' quality of life. It may appear unilateral or bilateral; frequently, it associates with certain general conditions. Familial hypodontia in clinically healthy patients is rare. Genetic transmission, as a determinant factor in missing teeth, can be autosomal dominant, recessive, or related to the sex chromosomes. In case of congenitally missing permanent teeth, the corresponding deciduous teeth can be still found on the arch at adult age. The aim of this article is to present rare cases of familial non-syndromic unilateral and bilateral hypodontia in Romanian adult siblings, highlighting also a cross gene transmission between aunt and niece and evaluating the treatment options in accordance with patient's age and oral status. It shows that early diagnosis of hypodontia is crucial for the patient's future oral health. The decision to keep the temporary teeth or to extract them is influenced by the presence and status of the deciduous teeth, patient's access to treatment and parent's agreement. Asymptomatic adult patients, in which hypodontia was diagnosed during a routine control, do not usually solicit therapeutic intervention until the deciduous teeth are also lost; still, in situations where complications arise through their loss, the treatment of hypodontia is complex, involving a close collaboration between a team of specialists. The article also includes a detailed review of literature referring to the prevalence of hypodontia among different populations.

Purpose. Starting from a very recent event on the market of disinfectants, where for many years very diluted disinfectant products were marketed in Romania, the antimicrobial activity being non-existent, we tried, on the basis of simple experiments, to study the antimicrobial efficiency of the active substances of some common products used on impression materials in implant-prosthetic rehabilitation, but also in classical dental prosthetics and in orthodontics and dentofacial orthopedics, products approved and used in the European Union. Material and method. 7 decontamination and/or disinfectant products were tested for qualitative screening for the sensitivity to different microbial strains as well as for quantitative testing of antimicrobial activity. Results and discussions. The study results for the two objectives are influenced by the active substances of the tested products. Conclusions. Decontamination of dental impressions must also become a certainty in implant-prosthetic rehabilitation, in classical dental prosthetics and in orthodontics and dentofacial orthopedics even if this work is disregarded and ignored by many practitioners.

Purpose. The adhesion ability of microorganisms present in the oral microbial plaque is a certainty for solid surfaces at this level (including coronal restorations, classical prosthetic restorations and implantsupported restorations fixed and mobile, orthodontic appliances). Therefore, in this study, we have attempted to demonstrate the ability of these microorganisms from the oral cavity to adhere on the surface of some common impression materials used in implant-prosthetic rehabilitation. Material and method. The study was conducted on the main impression materials used in implant supported prosthetic restorations as well as in dental medicine: irreversible hydrocolloids, zinc oxide eugenol pastes, polyethers, condensation and addition silicones. The study was conducted between June and July 2017. Results and discussions. With the help of microorganisms isolated from the 87 patients, an inoculation of standard samples of impression materials was performed. Verification of adherence was achieved at different time intervals, the results being significant. Conclusions. For the tested materials, it was noted that the degree of adhesion was either influenced by the products incorporated in the base substance or by the secondary products resulted from chemical setting of material.

Introduction. Any dental treatment has a traumatic character, even for clinically healthy patients, and especially for sensitive patients or the ones in special conditions (children, the elderly, pregnant women). Therefore, risk assessment in patients with dental disorders is very important in the usual practice in the dental office. The purpose of our paper is to present the results of a study conducted by us to assess the overall risk before, during or after a common dental treatment, which is rather difficult, considering the multitude of factors involved. The material was represented by a cohort of 200 patients, 111 women and 89 men, aged between 20 and 60 plus, clinically and anamnestically assessed. 157 of them were considered clinically healthy and 43 had a pathological personal history. Their behaviour in the dental office was observed during the study and the results showed a total of 18 (9%) minor accidents, different in manifestation and severity, during the common dental treatment, i.e. 10 (5%) in clinically healthy patients and 8 (4%) in those having medical history. The discussions highlight the most frequent medical emergencies encountered as well as their probable causes. In conclusion, the frequency of general medical emergencies in the dental office is not too high. However, they may occur at any time, and the correct and rapid medical response can and should allow for their professional management. Therefore, it is necessary that the dental practitioner should be properly trained in this regard and should know the patient medical history. The responsibility for the decisions made and their consequences lies with the doctor, who has the professional, moral, and legal obligation to prevent medical emergencies, to recognise and address them appropriately, to know what can be done and what should not be done in such cases.

The purpose of the paper was to highlight the qualitative changes in the tongue of stroke patients and to explain the possible etiopathogenic mechanisms, in correlation with local and general risk factors. The working method consisted in a multidisciplinary study, using a rigorous working programme, on 91 patients of both genders, aged between 50 and 90 plus, hospitalised in the National Institute of Neurology and Neurovascular Diseases – Bucharest, based on a standard medical observation record, employing classical exploration, through a specialised clinical exam, as well as modern investigation means, and, when possible, metabolic research, in connection with the pathology of cerebrovascular diseases. The results indicated a 25,27% frequency of glossitis in stroke patients, as well as a wide variety of clinical manifestations. We studied a series of factors that may be incriminated in glossitis etiopathogeny, related to the clinical characteristics of the disease, the occurrence of comorbidity and the localisation of cerebrovascular lesions. The data of the study are presented in graphs and exemplified through the presentation of some significant cases. The important conclusion of the paper is that the high frequency of glossitis in cerebrovascular disease sufferers, the etiopathogeny, can be justified not only by the existence of local-regional conditions and comorbidity but also by the fact that an important percentage of glossitis occurred in patients of any age and especially in elderly ones could be explained considering the most important disease of the century, atherosclerosis.

The authors report their experience using platelet-rich fibrin (PRF) therapy for the treatment of ten patients presenting bisphosphonate-related osteonecrosis of the jaw (BRONJ). The aim of our study was to evaluate the effect of this therapy on recurrent BRONJ and to describe the clinical and histopathological/immunohistochemical staining features of PRF treatment. As such, we describe the method we used and report the results observed in the areas treated as well as side effects. The reported results recommend the safety and efficacy of PRF in treatment of BRONJ.

Cherubism is a familial benign fibro-osseous disease of the jaws. On radiography, the lesions exhibit bilateral multinuclear radiolucent areas. Histopathology reveals multinucleated giant cells in the background of proliferating fibrous connective tissue. Mutations in the SH3BP2 gene are identified as the cause of cherubism. A 12-year-old girl with prominence of the lower face was investigated. Her chief complaint was her facial appearance with asymmetrical swelling of the cheeks. Clinical and radiographic examinations, and biopsy, biochemical analysis and genetic investigations were performed.