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Chronic apical periodontitis (CAP) is considered to be a dynamic defence response against micro-organisms invasion into periradicular tissues, resulting in a destruction of surrounding periapical bone . Among other important regulatory functions, vitamin D demonstrated to have a role in modulating the inflammatory process of periradicular tissues, in calcium and bone homeostasis and apoptosis. This retrospective study aimed to assess the relationship between vitamin D (VitD) levels and the incidence of large periapical rarefactions in dental patients that further undergo complex prosthetic rehabilitation. In this regard, a number of 28 patients, 54,8% men (n=16) and 45,2% women (n=12) with a complete medical and dental history, in the age range of 18–50 years were taken under observation. They were examined radiographically and clinically to diagnose the presence of CAP, presence and quality of root canal fillings, quality of restoration and periapical status. Another group of 28 patients in the same age range and gender-matched individuals without any history of systemic disease or presence of CAP lesions were included in the study as the control group. Serum VitD levels were analyzed for all patients. The prevalence of teeth with large chronic periapical lesions was 85,7% in the analyzed group The results showed significantly different values of Vitamin D levels in individuals with CAP compared with control patients (P =0,003). The presence or absence of root canal fillings in affected teeth didn’t correlate with the lesion dimension or severity of the evolution.

Social anxiety is one of the most common psychological disorders along with depression and generalized anxiety. Avoiding eye contact, persistent fear of being judged and negatively evaluated by others, and social isolation are just some of the specific features of this type of anxiety.As part of the complex oral rehabilitation treatment, we also faced such a case which involved a lot of attention and time, but to which was also added the joint and muscle pathology, superposing with the social the dental treatments anxiety , the patient needing a special complex treatment approach.

The current study intends to highlight the relationship and, at times, the influence between anxiety disorders and dental dysfunctional syndromes of stomatognathic system(SDSS) in young students from our institution : Basis Of The Dental Care Clinic ,,Mihail Kogalniceanu,, Iasi. These are involved in various stressful intellectual activities and have identified a complex health problem that needed to be solved in light of the constant stress that the present time offers, laying the foundations for a focused and direct approach that will increase the certainty of growth. the quality of life. Be the way, the types of young social cases will be able to be solved, and will gather an extent of the accessible tools and skills. We also rely on the acquisition of skills through the experience conferred in this study to offer optimal solutions in these clinical situations.

Oral rehabilitation is a main branch of dentistry focused on diagnosing the patient’s problem and creating a treatment plan to restore aesthetics, recondition morphologically all components, and recover the functionality of the oral cavity. Biological compatibility of the materials used has a major importance, due to the direct contact with essential tissues, such as the soft and hard tissue of the periodontium and the potential influence on the outcome of the treatment. The present material aims to assess the inflammatory response after subcutaneous implantation of three materials frequently used in endodontics (Mineral Trioxide Aggregate—MTA, DiaRoot BioAggregate, and Sealapex). The evaluation of the reparative tissue reaction after 7, 30, and 60 days, respectively, subsequent to in vivo implantation, was carried out through electron microscopy imaging. Moreover, evaluation of the dynamics of the osteogenesis process was an indicator for the maintenance of internal homeostasis in the context of complex intraoral rehabilitation treatments that include fixed prosthodontics correlated with the particular periodontal-aesthetic aspects and completed by cranio-mandibular repositioning. Our study showed increased absolute values of alkaline phosphatase in all material-implanted cases (more pronounced in MTA and Bio Aggregate), highlighting that this enzyme could be an effective indicator of bone formation, which takes place after the material implantation, with the most significant elevated values at 30 days postoperatively.

Aim of the study In current clinical practice, the approach to appropriate orthodontic therapy should be considered by the specialist, with the evaluation of a complete clinical and radiological examination, for dental and facial diagnosis. Materials and methods. For our study, we conducted an electronic research about diagnostic elements and technological aspects for clear aligners in some databases – Web of Science, Google Scholar, PubMed, looking for significant papers and literature review. Results The aesthetic demand of patients has led research to the development of clear aligners. According to production methods, they can be grouped into two categories – aligners made from thermoplastic materials via manual set up and CAD-CAM technologies to design and produce aligners. Conclusions. The aligners represent a true orthodontic evolution, due to their aesthetics; the contribution of CAD-CAM technology allows a diagnosis and development of treatment plan easier for the practitioner and more educational for the patient.

Aim of the study The CAD/CAM technology changes all aspects in dentistry and the restorative process becomes much easier and more efficient for dentists, patients and laboratories, in order to get aesthetic and qualitative prosthetic rehabilitation. Use of the CAD-CAM technologies to manufacture prosthetic frameworks on dental implants is noticeably increasing. Material and methods Our paper presents some technological aspects in the complex digital workflow for a metallic framework fixed on four implants, on mandible of a complete edentulous patient. Results The CAD software was used to create a digital model of the soft tissue, patient’s occlusal relationship, opposed teeth, and implant scan body. Exocad software system helped us to make a virtual framework for fixed prosthodontics rehabilitation, and by milling we obtained the metallic Cr-Co framework. Conclusions Digital technology applied in full-arch implant rehabilitation has gained a lot in dental practice, but there is important to establish a complete digital workflow for implants, framework fabrication and aesthetic elements for optimum prosthetic appliances.

Aim of the study The successful endodontic therapy is due to the knowledge of the root and canal morphological variability of premolars. The aim of this study is to present this variability of number of roots/canals for the first and second premolars, both upper and lower, and to compare the results with data from literature. Material and methods Our study was done on a group of 52 teeth (28 upper premolars and 24 lower premolars) selected respecting some criteria, and were extracted for orthodontic purposes. Results Regarding the root morphology, the study showed that, for the first maxillary premolars, were registered 12 premolars with 2 roots (75%), 3 had a single root, and a single first maxillary premolar, 3 roots. The second maxillary premolars showed less variability: thus, the premolars with 2 roots were 9 in number, while only 3 second premolars were found with a single root. The root and canal morphology of the upper premolars in our studied group revealed a morphological pattern already mentioned in the literature. Conclusions The root morphology, especially the endodontic configuration of the root structure can be a decisive aspect in treating and maintaining a tooth on the dental arch, and use it for a prosthetic restoration.

The main purpose of oral rehabilitation is to restore the aesthetic appearance, to the dental level in accordance with the surrounding tissues and correlated with the facial appearance. In the last period of time, there were developed and introduced several computer software programs for Digital Smile Design (DSD), both in research activity and in clinical practice. Material and methods A 36-year-old female patient with aesthetic and functional disturbances, were evaluated in order to a complex rehabilitation treatment plan. Because there was complete mouth rehabilitation necessary, we decided to use the Digital Smile Design, after the initial clinical examination – all facial aspects, dental and gingival contours elements. Results After the Digital Smile Design simulation, the team dentist-dental technician decided to prepare a mock-up for a better and realistic image of the future prosthetic rehabilitation. Conclusions: The use of Digital Smile Design offers the possibility of restoring aesthetic aspects, correlated with the understanding of the dynamic movement and the connections between the teeth, gums, lips and smile, in order to increase the level of satisfaction of the patient with the complex prosthetic treatment.

Aim of the study. For a young patient it is important to re-establish the integrity and the functions of dental arches, quickly and efficient, in optimum conditions, with many advantages. Material and methods The study balanced the possibilities to fabricate a minimally invasive bridge for a young patient in order to appreciate the characteristics of a Maryland bridge in treating a reduced edentulous status. Results The study revealed that a minimally invasive bridge placed in the posterior area of a lower arch, fabricated on a metallic framework and an aesthetic part made by resin composite material represent a favourable option as a temporary reconstruction. Conclusions The precision of such minimally invasive bridges and the variability of the materials and technologies that can be used, determine the young patients to accept them as a treatment for reduced edentulous status.

Aim of the study The aim of this study was to evaluate the incidence of dental issues for children with Down syndrome, for a group which included 19 children diagnosed with Down syndrome, aged between 4 and 17 years old. Material and methods The protocol was the oral health assessment by dental exam, radiological examination and questionnaires completed by parents – the questionnaires completed by parents revealed that dental hygiene was very good for 10.52% of children with Down syndrome, good for 31.57% and 57.89% were poor for these patients. Malocclusion and dento-facial anomalies were recorded in most of the children with Down syndrome. Results The results of our study shown that oral hygiene is generally weak – for more than half of patients being detected cavities in clinical exams. Conclusions Regular oral health assessment should be carried out in all children with Down syndrome, in order to early detect the dental issues that can appear to these patients.

Aim of the study was to evaluate the presence, duration and intensity of chronic pain for orthodontic patients using the TMJ Scale questionnaire and to compare the data obtained. Material and methods The study included a total of 55 patients, ages 17 to 36 years, who were assessed for the presence, intensity and progression of chronic pain, chronicity and psychological factors, with a specific interpretation and statistical analysis performed using the SPSS 18.0 software. Results The presence of pain was reported at initial stage, at 1-3 months and 10-12 months – the intensity increased from 45.5% to 52.7% after 10-12 months monitoring, but with no statistically significant differences (p = 0.622). Conclusions The study highlighted and supported the need to assess the presence and intensity of chronic pain in patients with orthodontic treatment, and to establish a specific treatment to improve symptomatology.

Aim of the study The concept of quality of life in oral health involves psychological and social aspects for elderly patients – in this respect, there were created tools to quantify these elements, the representative is the complex questionnaires OHIP-14Sp. Material and methods The OHIP-14 questionnaire was applied to our study-group of 214 elderly patients, (121 women and 93 men), aged 57 to 74 years, from urban and rural areas. Recorded data were statistically processed using SPSS-18.0 software and interpreted, by correlating the psychological and social aspects and its impact on quality of life. Results The results obtained from the domains of the questionnaire revealed a moderate impaired quality of life, without statistically significant differences between Psychological and Social Disabilities (p=0,415/p=0,536). Conclusions This model demonstrates the importance of psychological factors and social aspects of quality of life in elderly patients, and the need for psycho-social approach in a broader spectrum within specialized medical treatments.

Cerebral palsy (CP) represents for children an important problem of health. At complete neurological picture may be associated other problems, less studied comparative to other aspects of CP. The aim of this study was to evaluate the prevalence and determinant factors of malocclusions in children with CP. The study group included 129 children (43 girls and 86 boys) aged 2-18 years, diagnosed with various forms of cerebral palsy according to the proposal of Surveillance of Cerebral Palsy in Europe Group and Gross Motor Function Classification System (GMFCS) after Palisano. The protocol of our study included general and neurological examination, psychological evaluation and dental exam. The data regarding oral hygiene were collected using a questionnaire administered to the parents. Dental examination recorded the 20 anterior/posterior cross bite and anterior open bite. Among the followed children with cerebral palsy, more than a half (77.52%) had poor hygiene of the oral cavity. Malocclusion was observed at 55.04% children with cerebral palsy. 69,01% of these patients were diagnosed with CP level III-V CMFCS and 30,99% were diagnosed with CP level I-II CMFCS. Orthodontic treatment was limited only at children with malocclusions and CP level I-III CMFCS. Poor oral hygiene was a predominant finding in our children with CP and the prevalence of malocclusions in these patients was found to be high. The severity of neuromuscular spasticity can favour the development of malocclusions and can be considered a determinant factor for these oral problems. Patient of paediatric age with cerebral palsy and malocclusion need orthodontic treatment, but the possibility of offering this treatment is limited.

Interrupted continuity of the dental arches by the first permanent molars loss in adolescents and young people is followed, more frequently and more rapidly than in adults, by morphological changes due to migration of teeth in the sagittal, transversal and vertical plans. These changes of position are likely to trigger an occlusal dysfunction, with a number of negative consequences for the entire dental/maxillary system. The aim of this study was to determine and reveal the changes of dental arches and occlusal relations after first permanent molar loss, in a population (224) of teenagers and young adults, with ages between 12 and 22 years old. The complete dental examination was conducted by two examiners, and data were recorded for each study participant, in terms of horizontal and vertical migrations. The most frequently changes of dimensions in dental arches were observed after the loss of first permanent mandibular molars, with uneven occlusal plane, asymmetry of sagittal and transverse curves and the appearance of premature contacts with a pathogenic action more pronounced in young adults

Aim of the study The purpose of this paper was to present a case of a teenager patient with traumatic injuries of anterior upper arch, in order to reveal the importance of applying a complex rehabilitation, prosthetic and orthodontic treatment. Material and methods A 12-year-old girl was referred as a patient to our dental office, in order to treat the edentulous anterior space after a traumatic injuries (bicycle accident), with premature loss of anterior permanent teeth (14, 13, 12, 11, 21, 22). Results The removable orthodontic appliance consist of a palatal acrylic plate, with a special three-dimensional screw placed by a custom section in order to move only lateral side arch segments, and to maintain the anterior zone, where there were placed artificial acrylic teeth, which can be easily adjusted in mixed dentition. Conclusions Complex prosthetic and orthodontic rehabilitation of teenagers with edentulous space after traumatic injuries with loss of permanent teeth, involves a multidisciplinary team, in order to apply the optimal treatment to restore all affected functions.

Introduction. The aesthetic dental coronary restorations are made-up by composite resins, compomers or non-metallic prostheses. Natural teeth are fluorescent, and so, the biomaterials used today are fluorescent, too. The determination of fluorescence for coronary restorations is useful in dental medicine and forensic medicine. Material and method. On a black cast of a maxillary arch there have been applied coronary restorations and fixed prostheses from some biomaterials frequently used today: Compafill A 1, Compafill C 3 (Wilde Dental, Germany), CeramX, Dyract extra, Quixfill (Dentsply DeTrey, Germany), Coltene (Whaledent, Germany), Degufill (Degussa, Germany), Concise (3M, USA), Superpont (Spofa Dental, Czech R.), Vita Akzent “sun kiss” ceramic material (Vita ZF., Germany). The fluorescence of these restorations was revealed in photos by the time of UV-A irradiations, than, the photos were comparatively examined from the point of view of intensity and fluorescence chromatics. Using the photometer appliance (fluorescent-photometer) assisted by a computer, realized by Professor Dr. Michael Bohnert, it was measured and graphic registered, the light-length and the intensity of light emitted on UV-A irradiation, thus, the fluorescence of each restoration from the black cast. Results. For each restoration made from such biomaterials, it was observed a particular fluorescence, characteristic. This characteristic was attested also by computerized determination of fluorescence reflected in specific curves. Discussions. In dental medicine, especially in dental prosthetics, it is necessary that restorations and fixed dental prostheses to have the same fluorescence as natural teeth. In forensic medicine, the specific fluorescence can offer an extra element to identify the unidentified bodies. Conclusions. The coronary dental restorations and fixed prostheses present a different fluorescence, corresponding to the biomaterial used. When there are used non-fluorescent biomaterials, they appear with a clear different chromatic aspect from natural teeth, in UV-radiation light, natural light and artificial light.

Aim of the study: Screening for the prevalence and severity of TMDs in individuals. Materials and methods . This cross-sectional study included a cohort of 109 consecutive volunteer patients (28 male and 81 female), with average age 38.31 ± 12.625 years, who attended a private praxis in Iasi at least once within ten months (February 2023 – October 2023). Before the clinical evaluation, the patients were invited to fill out the TMD-Pain Screener completed by Fonseca Anamnestic Index, consisting of 10 closed-ended questions. Results Proportion of 43.1% had mild craniomandibular dysfunction, moderate and severe dysfunctions were less common, occurring in 12.8% and 2.8% of patients. Our study observed a higher prevalence of TMD among female patients. Conclusions It can be concluded that the prevalence of TMD is a significant concern (58,7 %) that should be deemed a matter of significant importance in dental medicine and addressed accordingly.

Aim of the study Treatment possibilities for complete edentulous cases by placing implants result in superior functional results, for better aesthetics, as well as stability, strength and support of prostheses and improved masticatory efficiency. Materials and methods The objective of this study is to highlight the importance of fabricating appropriate implant-based fixed prostheses through the appropriate selection and design of all their components in the treatment plan for our patient, with total edentulousness. A 56-year-old patient presented himself at the dental office, with complete edentulous status, in both arches, and the treatment was the “Fast and Fixed” option of “All on 6” in the maxilla jaw and “All on 4” in the mandible, with framework from zirconia and PEEK, respectively. Results The rehabilitation of complete edentulous status with fixed implant supported prostheses is one of the challenging treatments, because of the aesthetic and functional factors that should be considered. Conclusions There is a superior prognosis of oral rehabilitation with implants compared to traditional methods, and statistical data shown a high success rate of around 95% for 10 years. Fixed restorative systems on dental implants are considered the ideal solution for replacing missing teeth in the case of total edentulous arches.

Aim of the study An important innovation in the field of prosthodontics is represented by the emergence of computer aided design and computer aided manufacturing (CAD/CAM) technology, which allows to obtain remarkable results in terms of anatomical and functional rehabilitation. Material and methods This study consisted in evaluating the software available on the market, used in prosthetics respecting the technologies and concepts of digital dentistry – among them, an important role is played by the Digital Smile Design method. Articles in the scientific literature (PubMed, Google Scholar) on the use of this software were analysed, and it was observed that allows excellent communication with patients, on one hand, and on the other hand, provides the doctor with the optimal tool for a correct therapeutic option, through algorithms. Results Digital technologies allow accurate treatment planning and facilitate the obtaining of aesthetic, functional and predictable prosthetic structures, Digital Smile Design benefiting from the application of a digital workflow for oral rehabilitation that can be evaluated and analysed by the patient, doctor and technician. Conclusions The information present in the scientific papers shows a positive evolution of digital technologies.