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Canines are paramount teeth for esthetics and function. Transmigration of the lower permanent canine is a rare process of alteration of the eruption path toward the opposite part of the mandible. The position of the migrating tooth varies at different ages, so early detection of the tendency to cross the midline is crucial; canines that have already passed through the center of the mandible can be impossible to realign. Transmigration can start any time before the normal age of eruption. Comparing two radiographic images taken at different ages offers important diagnosis information. CamilleriScerri (2003) described a progressive alteration of the tooth position in four steps, from the normal appearance to a low position inside the corpus of the mandible. Following this classification, this article's aim was to present a case of an impacted lower canine that was diagnosed between the second and third stage of transmigration, around the age of 10, and to detail the combined orthodontic-surgical treatment strategy for "recapturing" and the orthodontic mechanics used to align it. After the examination of cone-beam computed tomography, we have decided to use a lingual arch as a space maintainer and anchorage tool and to surgically expose the tooth. The canine's initial position and the direction of the force of traction used allowed a proper alignment of the tooth inside the dental arch. The periodontal tissues management was important for good healing, stability, and aesthetics. The early detection allowed a proper interdisciplinary orthodontic-surgical management, and a successful outcome.

For the present study, a total number of 109 pregnant patients in the second trimester of pregnancy were selected from the case studies of the Clinic of Obstetrics and Gynaecology of the Municipal Clinical Hospital Filantropia in Craiova. Among these, 56 patients had gingivitis, 26 had mild, moderate, or severe periodontitis, and 27 patients were used as a control segment. Each patient had her leukocytes values tested and they had their oral cavity examined. Leukocyte neutrophils are the primary cells of the body�s defence system as well as primary protective cells against periodontal disease. Based on the study, we can say that there is a significant difference between the average number of leukocytes found in the four groups, because the result of the ANOVA test was below the threshold p [0.001. By analyzing the involvement of the leucocytosis parameter in the occurrence or presence of pregnancy complications, we found it present in periodontal disease pregnant women who had complications, namely: premature birth, preeclampsia, or intrauterine growth restriction.

Dental injuries, especially those in the frontal area, through the complications they can cause, are an important topic due to the psychosocial impact they have on young patients. Saliva is an important biological resource, useful for conducting diagnostic tests; also, it can be harvested non-invasively, without the need for prior training or special equipment. The biochemical analysis of the concentration of salivary parameters may suggest the susceptibility and resistance to carious lesions. The aim of the present study is to evaluate a causal relationship between the values of salivary parameters, salivary calcium, phosphates and salivary pH, and the incidence of dental caries.

Teriparatide (TPT) (C181H291N55O51S2) represents a recombinant molecule acting as human osteoanabolic agent. Transitory hypercalcemia (TH) has been reported in osteoporotic patients treated with daily TPT. Our purpose is to analyze the biochemical features as well as clinical risk factors for fractures in patients with severe osteoporosis treated with TPT who developed TH during first 12 months. This is an observational real-life study. In patients with TH biochemical blood markers like osteocalcin, CrossLaps and P1NP assessed at one year have statistically significant higher values than in subjects associating serum calcium within normal limits under the drug.

This is a cross-sectional retrospective study of observational type. 157 menopausal subjects were included. A number of N1=89 were younger of 60 years old (also included) and a number of N2=68 were older than 60 years old. Median of age was of 55 years, respective 66 years.The biochemical parameters like total and ionic serum calcium, serum magnesium, and phosphorus between the two groups N1-N2 were similar (p]0.05).The median values of mentioned chemical elements were within normal limits.The bone turnover markers were not statistically significant different between N1 and N2. 25OHD was found deficient in both populations, irrespective of age. DXA- BMD and T-score N1-N2 difference was statistical significant for all the four central sites. Biochemical mineral parameters seem not to be influenced by the cut off of 60 years in menopausal women aged between 40 and 80 years. Yet, a large prevalence of hypovitaminosis D is identified regardless the age without secondary PTH raise. The statistical significant results are for BMD and T-score for all the four central sites.

The aim of the research was to realize a clinical study on menopausal patients, focused on 25-hydroxyvitamin D (25OHD) assays versus Dual-Energy X-Ray Absorptiometry (DXA) categories. This transversal, observational, real-life study was effectuated on Caucasian Romanian females. A total of 60 subjects were grouped according to lumbar T-score: normal T-score (N=28), osteopenia (N=22), and osteoporosis (N=10). The lowest average value of 25OHD is found in patients with osteoporosis, which is statistically significant lower than in patients with osteopenia. The average values of PTH were within normal levels for each group. 25OHD did not correlate with PTH or lumbar BMD. Overall the mean values of 25OHD are in deficient ranges regardless osteoporosis, osteopenia or normal DXA.

Elderly population frequently presents more than one prosthetic restoration realized from different types of dental alloys which, in time, suffer various alterations in the oral environment. Metallic ions are released in saliva due to its electrolytic qualities, interacting with the contact tissues. Studies regarding cytotoxicity of dental alloys are providing contradictory results. Besides biocompatibility, the microbial factor is also greatly influencing the long-term success of the prosthetic rehabilitation. This study's aim was to assess the response of the gingival tissue to nickel-chromium (Ni-Cr) and copper (Cu)-based dental casting alloys from fixed dentures present in many patients from Romania. Gingival samples were taken from 124 patients wearing fixed dental restorations made from these two types of alloys from injured areas surrounding the abutment teeth; histological specimens were prepared, fixed in 10% neutral buffered formalin, paraffin-embedded and stained with Hematoxylin-Eosin (HE). Histological analysis showed the existence of a chronic inflammatory infiltrate in the gingival chorion, necrosis areas, and vascular congestion. Various morphological alterations appeared, depending on the intensity of the inflammation and the immune response. The surface epithelium suffered a hyperplasic reaction, either limited to acanthosis or involving the whole epithelium, the release of the Cu(2+) and Ni(2+) ions from the dental alloys used in bridges and crowns being responsible for inducing gingival hyperplasia and a chronic inflammation in the areas situated around the abutment teeth. The immunohistochemical study allowed us to observe an increased number of positive cluster of differentiation 3 (CD3) T-lymphocytes in periodontium, proving that the cellular immune response is rapid and intense.

5-hydroxytryptamine (5-HT) dually influences skeleton status through positive, indirect central effect and negative, direct, gut-associated impact. Circulating form is usually tested via venous blood sample. A limited number of clinical studies are published on this specific topic. We introduce a cross-sectional study on menopausal women with normal (N=29) and low bone mineral density (N=32) based on lumbar Dual-Energy X-Ray Absorptiometry (DXA) to whom serum serotonin was assessed and found no correlation with bone loss. This aspect confirms conflicting published data regarding the relationship between circulating levels and fracture risk assessment.

Heart failure (HF) and renal dysfunction are frequent associated in the same patient. The purpose of our study was to assess the prevalence of renal dysfunction and the clinical status in admitted patients for decompensated HF. Material and Methods. 397 patients succesively hospitalized for decompensated HF, NYHA III or IV functional class, with left ventricular ejection fraction (LVEF) � 45% were included in the study. Renal dysfunction was defined by glomerular filtration rate (GFR) [ 60 mL/min/1.73 m 2. The mean GFR in patients with HF was 63.89 � 21.5 mL/min/1.73 m2 .The prevalence of renal dysfunction was 49.6%. Patients with GFR [ 60 mL/min/1.73m2, compared with those with preserved renal function were significantly more frequent older (75.37 � 6.84 vs. 71.33 � 8.08 years; p [0.001), females (53,8% vs. 43.5%; p = 0.04), had a significantly higher prevalence of diabetes mellitus (50.2% vs. 28.5%; p [0.001), atrial fibrillation (53.8% vs 46.2%, p = 0.04) and anemia (47.7% vs. 29.5% ; p [0.001). Also, patients with renal dysfunction had more severe HF than those without renal dysfunction (NYHA class IV: 65% vs 45%, p [0.001, clinical congestion: 78.2% vs 68%, p = 0.02, LVEF [35%: 47.21% vs � 35%, p [0.001). Renal dysfunction can be considered an additional marker of severe cardiac dysfunction along with NYHA IV class and low LVEF. The presence of both renal dysfunction and anemia could represent prognostic markers in HF patients with reduced LVEF.

The aim of this study is to highlight the morphology of the second maxillary molars root canals and to draw a comparison between the data obtained with and without magnifying means. The study covered a total of 31 extracted human second maxillary molars. After being examined by a thorough physical exam and an X-ray examination, teeth were trepanned in the place of election. Thereby the access cavity was performed using: a) for the stage of pulp chamber ceiling penetration, a globular diamond bur for the turbine, b) for the stage of broadening access cavity, a cylindrical bur inactive in the head for the opposite-angle piece and c ) a Batt bur for the flaring and finishing stage.Afterwards, the sighting of the main root canals was performed using the endodontic probe or Miller file. Examination and sighting of the additional canals was made under magnification using the dental microscope. The molars with three canals had the highest prevalence of endodontic morphology of two upper molars (90.32%). But there were special cases with two channels morphology (6.45%) and four channels morphology (3.22%). After examining the endodontic space under the microscope, there have been identified and secondary canals, approximately 32.25% of molars examined presenting one or more secondary canals. The anatomy of the most frequent upper second molar was three roots with three root canals; the most common variation in morphology is the presence of an mesiobuccal additional canal (MB2). However, we can encounter an unusual number of canals. The importance of magnification, of the dental microscope in our study cannot be ignored because using only the latter we could highlight the real endodontic morphology of the two upper molars extracted examined, finding additional canals in 32.25% of the molars undergoing examination.

The aim of this paper is to eliminate suspicions of a titanium (Ti) allergy in a rare case of "flowered" implant in a 43-year-old female patient with metal allergies and no history of bruxism, using a histological and immunohistochemical (IHC) analysis to determine the phenotype of cells that participated in the immune response; also, to assess the prognosis of a future implant treatment and to highlight the psychological impact of osseointegrated implant failure caused by fracture, and the influence that the necessity to use extensive surgical procedures for reimplantation can have on the treatment solution chosen by the patient. The results of our IHC analysis did not indicate a clear response for a potential Ti allergy; still, due to psychological reasons, the patient rejected the replantation and considered the use of other restorative option, a three-unit bridge, as being the most appropriate for her. Considering her opinion and attitude, the fixed prosthetic denture assured the therapeutic success.

Supernumerary teeth in permanent dentition are influenced by hereditary and environmental, having clinical variations such as location, number and morphology. Parapremolars can be found as a single supernumerary tooth or as multiple, usually in the lower jaw, sometimes in association with other types of supernumerary teeth. Familial inheritance often involves more than one generation. This paper presents a case of two brothers, one with only one parapremolar and a good oral status and hygiene, the other with poor hygiene, multiple parapremolars and one mesiodens, causing various complications. The aim of this paper is to show the presence of parapremolars in brothers with no other medical relevant history, located in the same site, and to point the influence of genetic factors in the etiology of supernumerary teeth. Along with a review of the literature, this article shows the importance of an early diagnosis and follow-up using successive panoramic radiographs of such cases, in order to limit or prevent the inflammatory, carious, periodontal and occlusal complications that can seriously affect both the jaws and the normal dentition.

Supernumerary teeth can be found anywhere in the oral cavity, during deciduous or permanent dentition, in males and females. They are rare, owned to various genetic or environmental factors and usually impacted. This article first reports three cases of young adult patients coming to the office for other reasons than their maxillary distomolars and without any pathology caused by them. The decision of keeping or removing these teeth was made based on other associated factors. The fourth case is one of a 40-year-old partially edentulous male patient, also with a good general health and no other associated condition, having a unilateral maxillary fourth molar; it was small, only partially erupted, with a normal morphology with crown and root and an impacted perpendicular position on the distal face of the third molar. It was extracted because of the periodontal and carious complications that it caused to the third molar facing it. The last reported case is a 64-year-old partially edentulous female patient with a maxillary tooth very similar to a distomolar because of its form and position; it was extracted because it interfered with the new removable partial denture treatment plan. The differential diagnosis between a distomolar and an anatomical variant of a third molar was difficult to make even using panoramic X-ray, also because of a very small inferior third molar. In young patients, distomolars are rather accidentally discovered during radiographic examination; later in life, they can cause both pathological issues and difficulties in diagnosis and prosthetic treatment.

Diabetes mellitus is a disease that brings numerous alterations in the human body, mainly on the blood vessels and nervous system, its complications being difficult to treat most of the time. Oral complications are largely known and studied. Changes that occur in the dental pulp are of importance for the dentists, considering regular procedures outcome. In early stages of the disease, new blood vessels appear especially under the odontoblasts layer as a reaction to stimuli. In later stages, the defense systems of the dental pulp are outnumbered, nervous branches will be destroyed and disorganized. When periodontal disease occurs as well the mortification of the dental pulp will be faster.

Introduction: The World Health Organization has a long tradition on the methodology and monitorization of oral health epidemiological investigations, even in the field of dental caries. According to the targets to be attained in 2020, at the age of 6 years, 80% of children should be cavity‐free and, at the age of 12, DMFT should be no more than 1.5. Based on WHO targets for 2020, an epidemio‐ logical study was performed on school children affected by dental caries, aged between 7‐12 years, from the rural areas of the Dolj County. Methodology: The study protocol included conventional and meticulous visual clinical examination of students, according to WHO methodology, in the Pedodontic Clinics of Craiova ‐ Faculty of Medical Dentistry. Also calculated was the DMFT index, by analy‐ sis of the DT, MT, FT components, as well as the dmft index, by analysis of the dt, mt, ft components. Results: The mean indices of carious experience in temporary den‐ tition decrease with age, due to the progressive disappear‐ ance of milk teeth. The DMFT index values are given, in particular, by components that indicate the number of teeth affected by caries and not of the blocked ones. Con‐ clusions: The results obtained emphasize the need for den‐ tal health education programs at national and community level, the kindergartens and schools having a great poten‐ tial to influence dental health care habits in children. Also emphasized was the need for regional prevention pro‐ grams, as part of an overall national program, which has to consider the socio‐economic and cultural factors.

The research aims at emphasizing the interrelation between the social impact and the self-esteem of schoolchildren with dental crown fractures in the frontal group. Dental traumatic injuries are frequently met to schoolchildren, therefore, the prevention and interception of traumatic pathology within parents, teachers and children is more than necessary. Our statistical study intends to determine the prevalence of dental trauma to southwestern Romanian schoolchildren aged 6 to 14. The survey included a number of 1684 schoolchildren attending public schools, randomly chosen. Data were collected from October 2012 to December 2013. Clinical examination was conducted to assess the dental traumatic injuries. Age and gender distribution, etiological factors, risk factors and the cause of injuries were the parameters taken into consideration. The data collected was processed and analyzed using the SPSS (Statistical Package for the Social Sciences) statistical software. The overall prevalence of dental trauma was 4.63% amongst the subjects examined. The maxillary central incisor was the most commonly affected tooth (85.19% in boys and 97.87% in girls). We observed a significant statistical difference in the number of children with one, two or three fractured teeth from the urban and rural areas. The percentage of schoolchildren with crown fractures that we examined was of 3.09% in the urban area and 1.54% in the rural area. The traumatic injuries of the maxillary upper teeth were most prevalent. Since the dental trauma of incisors has a strong impact on the quality of life of children and their families, health preventive policies are needed in order to avoid psychological implications on the lifelong existence of children affected.

The oral exostoses are protuberance located on the alveolar surfaces of the jawbones with nodular, flat or pedunculated shape. The purpose of this study was to highlight the variability of the morphological and clinical characteristics of torus palatinus (TP) and torus mandibularis (TM) in a sample of young and adults' Romanian people. The study was conducted on 74 participants examined in Dental Prosthetics Clinic of the Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Romania, during October-December 2014. The morphological characteristics of the tori were non-metrical evaluated by the standard procedures of the clinical examination. Descriptive statistics only including means, averages and percentage incidence have been used to describe the results. Of the 74 study participants, 31 (41.89%) were males and 43 (55.40%) were females. Six had only TP, seven had only TM and three participants had both TP and TM. The most of the palatal tori had spindle shaped, located in all area of the hard palate The round mandibular tori with big size were located in the area of both premolars, and those with elongate shape were located in the canine-premolars area. The palatal tori were more frequently in women and the frequency of mandibular tori was equally in men and women. Most of the palatal tori had spindle shape and most of the mandibular tori were solitary bilateral.

Warthin's tumor is a benign monomorphic adenoma with unclear origin with the highest incidence in the sixth and seventh decades. The analysis of tumor markers involved in the pathogenesis of Warthin's tumor can improve the patients' prognosis. This study included 29 cases of Warthin's tumor, which were histopathologically and immunohistochemically examined for different compartments of tumors. For immunohistochemical study, we used as specific markers for epithelial compartment CD117, CEA and AMA, respectively S100 and D2-40 for the stromal compartment. The evaluation of immunoreactions was performed by semiquantitative analysis. The analysis of the CEA, CD117 and AAM immunoexpression allowed observing various patterns of immunostaining for tumor double-layered epithelia, which has the tendency of being similar to that in the normal ductal epithelia. S100 protein positivity similar to Langerhans cells suggests that delayed hypersensitivity can be involved in tumor development. The presence of D2-40 expression in majority of tumor subcapsular vessels, similar to lymph nodes structure, confirms the hypothesis that Warthin's tumor has its origin in regional lymph nodes.

Research evolution regarding dental research determines the increase of patient's desire to preserve their dentition for a long time. The loss of a molar tooth as the last teeth present on the dental arch, raises issues regarding how the prosthesis should be placed, still patients are usually reluctant to use as last resort the prosthetic solution. This article describes the technique of root amputation to save a maxillary molar used as bridge abutments.

The teeth with extensive coronal destructions due to carious process can be saved by using split cast post and core. This technique has been used for a long time and with positive results recognized by many authors. The clinical case presented here describes indirectly the reconstitution technique with split cast post and core with latch of a maxillary molar with divergent roots and extensive coronal destruction both in area and depth.

Dental occlusion represent the function of dentomaxillary system at which realization participate all the components of that system holding the equilibrium between them. Setting up the treatment with dental bridges in partial edentuluous is rule by some principles that have aims like restore the morphology and functions change by edentuluous condition and also prevention disorders of remaining teeth and other structures and functions of dentomaxillary system. During the prosthetic treatment with fixed bridgeworks in clinical cases presents in this study , we used also terapeutical techniques specifically other dental domains like endodontology and oral surgery. For avoid the appearance of occlusal dysfunction is necessary a good knowledge and respecting the biomorphocinematic behaviour of dentomaxillary system structure under action of occlusal force during mastication and also biomechanical rules that influence the functional equilibrium of teeth and dental bridges.

Our study included a number of 24 cases with Warthin tumor, diagnosed between 2007-2011, which were analyzed in terms of clinical, histopathological and immunohistochemistry point of view, using CK7, CK5/6, CK19, and p63 antibodies. Warthin tumor is most often a tumor with a slow evolution, painless, usually affecting males (M/F 3.2/1) in the seventh decade of life. Histopathologically, it is distinguished the predominance of the typical forms of the tumor, with a balanced ratio epithelium/stroma. The immunostaining for CK7 showed positivity in all the investigated cases both in the columnar luminal cells and basal cells. The immunostaining for CK5/6 was positive in all the investigated cases in bilayer epithelial basal cells, both in the structure of the cysts and the papillae. In the case of the immunostaining for p63 we noticed limited nuclear positivity in the basal cells, while the columnar cells' nucleus were negative. The immunohistochemical study of the bilayer epithelial component of Warthin tumor showed different immunstaining of the two types of epithelia, the oncocytary columnar and the basal on, similar to those found in the salivary gland ducts.

Warthin tumor is the second most common benign tumors of the parotid gland, after pleomorphic adenoma. Our study was performed on 21 cases with Warthin tumor diagnosed between 2005-2010, which were analyzed clinically, histologically and immunohistochemically, using anti-CD20 and anti-CD45RO antibodies. The analysis of age distribution within the investigated cases indicated that Warthin tumor incidence is increasing in the seventh decade of life, most patients being male (M/F 5/2). Histopathological, the analysis report of stroma÷parenchyma in 14 cases revealed a balanced distribution of the two components, in four cases, the epithelial component was predominant and in three cases, the stromal component was predominant. Immunohistochemical study for the two specific lymphocyte proliferation markers indicated positivity for both epithelial component and stroma. Cell layout of CD45RO and CD20cy at the level of lymphoid stroma had a similar pattern with normal or reactive lymph nodes.