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Achievements in the field of biomaterials have as a basis three scientific domains: chemistry, biology and physics, then the technical application or the putting up culminating with clinical achievements. Dental prostheses, regardless of their type, replaced the lack of teeth. Although, mainly, many people that lost their teeth could continue life with the help of prostheses in a way pretty decent, dental prostheses shows some disadvantages that make them even unbearable for some people. The study aims at analyzing the biological behavior of sandwich type structures that reunite the classic acrylate and a silicone layer, namely the Flexite type elastic acrylate. We used a silicone material, RUBBER 732 RTV, which is frequently used in mucous-bone support deficits, especially in oral maxillofacial surgery post interventions. The tensile strength was tested ona TEXTENSER traction test machine, in view of establishing the chemical analysis of the 2 materials used. Regarding the maximum tensile strength for sandwich-type test samples, the flexible acrylate - silicone RUBBER 732 RTV structure broke at 1125N, while for the classic acrylate - silicone material a fracture value of 950N was recorded. The structure of the two biomaterials within the sandwich type test samples decisively influences the force and tension at which the fracture occurs, as well as the fracture route, which is linear, without the displacement of fragments, both the flexible acrylate and the silicone being affected, respectively a linear route at the level of the acrylic structure, affecting the acrylate - silicone interface for the classic acrylate - silicone test samples.

The face is a complex anatomical structure and reconstructive surgery to repair soft facial tissue defects is difficult and requires careful attention. When choosing the reconstruction method, it should be taken into consideration the general condition of the patient with the associated comorbidities that may affect the local vascularization or favour the appearance of complications and necrosis of the flap. The retrospective study included 68 patients with different types of carcinomas located on the facial skin. For aesthetic reasons, the key areas of the face must be known and respected, avoiding unnecessary distortion due to the chosen reconstruction technique. Postoperative scars can be optimally camouflaged at the boundary between the different aesthetic units, where the observer’s eye expects a change of contour. The inconvenience of “moving” existing pre-carcinomatous lesions from the adjacent skin into the defect must be considered when designing a flap, but also the need to be as economical with the soft tissues as possible, in order to obtain a better aesthetic appearance.

The uncontrolled negative emotional stress, will increase the intensity of the pain experience due to the decrease of the pain threshold and to changes of the tolerance to medication. The most dental treatments are performed under various types of anaesthesia (loco-regional, potentialised, general). In some clinical situations and for specific dental procedures (especially oral surgery) the dentists use a combination of psychologic preparation, pharmaco-therapeutic sedation and loco-regional anaesthesia. The pre-anaesthesia and pre-medication have the role to control the psychic reaction to pain. For the most patients with a balanced psychic, calm and cooperative, the loco-regional anaesthesia techniques can be used successfully

Nowadays the allergic accidents to the local anesthetics are exceptional and rare. The additional agents can be a source of allergy. Also the individual factors can favourise the onset of the allergic reactions. The quest of a patient with history of allergic reactions will be included in the medical record. The diagnostic of allergy must be confirmed by using allergy tests, by the selection of a proper and non-allergenic anesthetic, and by ensuring the optimal operatory comfort both for the patient and the dental practitioner. Despite the low frequency of the allergic accidents in the oral surgery (0, 96 % minor allergic reactions, 0,032 % severe allergic reactions), they must be considered due to the potential risk for the patient’ vital prognostic. The allergy tests (Prick test, IDR, provoking tests) are requested to remove the contraindicated materials with high risk for the initiation of the allergic reactions.

Nowadays the alcoholism represents reprezintă the most extensive drug addiction in all populational groups and is recognised by medical, social, economical and legal experts as a real “toxic pandemic”. The researchers consider that ethanol is the molecule with the most dedicated pages in the medical literature. The term “alcoholism” defines both the excessive and prolonged consume of alcohol (alcohol use disorder) and alcohol addiction. The alcoholism incidence increases worldwide in the industrialised countries as alcoholism is the third biggest cause of death after cardiovascular diseases and various categories of cancer. The dental medicine specialists have the possibility to experience the psichological aspects of dental pathology and an interdisciplinary collaboration with psychiatrist will facilitate the dental treatment of these patients

The problem of the interventions performed under loco-regional anesthesia – practiced in a dental office, must be seen in the context of increasing plurifactorial dental care in Romania, in private or public practice. Because of the many advantages it presents, loco-regional anesthesia is considered as a method household during dental care routine. Currently, anesthesia allows adaptation methods and techniques individualized for each patient, so as to benefit from a perfect anesthesia and with minimal risk. Modern medicine attaches great importance to prevention of incidents, accidents and complications in surgical techniques, anesthesia loco-regional not an exception. Anesthesiology is one of the medical specialties related to medical malpractice can sometimes have complications leading to death of the patient; errors are inadmissible in this area.

Our study aims to establish correlative elements between the role of the main contributing factors in triggering various forms of oral mucosal cancer and to quantify their contribution according to a number of characteristic parameters.Materials and Methods: The statistical study was conducted over a period of 5 years at the Oro-Maxilofacial Surgery Clinic of St. Spiridon Iasi on internalized patients diagnosed with oral mucosal cancer.Results and Discussions : A well-defined category of contributing factors correlates to a high percentage of oral or oropharyngeal cancer. In this hierarchy of favoritisers of the mucosa of the oral cavity, an important place is occupied by the consumption of tobacco and alcohol, which makes it difficult to separate the degree of contribution of one or the other of the two components.Conclusions: The dentist must have a more intense activity in raising awareness of oral cavity cancer patients, increasing the educational level of population and sensitizing patients to the harmful and oncogenic action of alcohol and smoking.

Oro-facial soft parts may be the site of benign or malignant tumors, which, although presenting histological similarities, aspects and clinical development vary depending on the affected region. An upper lip lesion that does not heal in a few days could be a big health problem. Also, the presence of chronic inflammation, thickening, or whitish appearance in the lip are all alarm signals. Lip cancer is manifested by the presence of the upper or lower lip tumor, which may be solitary or multiple, ulcers that do not heal for more than three weeks, haemorrhages in the tumor. Sometimes it is considered as being a trenant/delayed herpes, the spinocellular carcinoma of the lip is the most common form of localized cancer in the head and neck level. The lip cancer occurs predominantly in men between 50 and 70 years of age but cases have been identified in young patients aged 20-30 years, too. The study includes 95 patients with lower lip cancer studied in 2016-2017. A good collaboration between ablative surgeon and restorer surgeon gives the patient the best opportunity for complete resection and restoration of the shape and function of the involved structures; the ablative surgeon can remove the tumor without compromising the excision due to a specific reconstruction plan. Reconstruction possibilities from the lower lip were adapted to each patient, depending on the size of the tumor and the properties of the facial tissues.

At this end of the millennium we witness an impressive increase in cancer frequency. According to WHO reports, cancer is the second cause of death, being overpriced by cardiovascular disease only. The oral cavity cancer is part of the ENT sphere malignant tumor group. It may appear at the level of any component structure: mobile tongue, mouth floor, retromolar trine (behind the last molar teeth in the lower arch), tough palate, internal cheek, lips, mouth vestibule or alveolar rebord. Salivary glands, although opening into the oral cavity, can not be included in this category, due to histological and enlargement features. Oral cancer is very easy to be noted because it causes a mouthstroke that does not heal over several weeks. This is the main symptom of the disease, but not the only one. Other signs are: whitish spots in the mouth, unexplained bleeding, difficulty in moving the jaw or chewing; hoarseness or considerable change in voice, loss of sensation or pain in the mouth, face or neck area, undue ear pain. The study includes 544 cases, and the statistical data collected over a 5-year period, 2013-2017, and: age, environment, sex, risk factors involved, location, tumor study and treatment are of interest. Combined therapy was reserved for patients with a low healing rate. The most common form of treatment was tumor removal within the limits of tumor safety, followed by another type of intervention: tumor extirpation and ganglion recording, whether or not associated with radiotherapy. An important role is also played by patients who come late, either due to a lack of health education or because of the fear of illness, or in most cases due to the oligosymptomatic character of the disease at the onset of onset.

In surgical practice, the problems raised by diabetics are extremely complex and require for solving the knowledge of both the physiopathological disorders characteristic of these disease and the changes caused on this pathological field by various dental aggressions. Sometimes, patients with complications of undiagnosed diabetes mellitus are present in the dentistry where all problems of dental and metabolic therapeutics must be solved by the dentist. The lack of knowledge of the general pathophysiology data of the diabetic mellitus disease and of the metabolitical rebalancing methods of these patients on dental aggressions as well as the lack of early knowledge of the events that precede the installation of real metabolic dramas can lead to disaster. The diabetic patient may present in time various dental conditions, some of which are directly or indirectly related to diabetic disease - lesions in the oral cavity are polymorphic and physiologically interpreted in a very different way. The oro-dental changes in diabetes mellitus have as substrate the degenerative arterial involvement in the context of early tissue aging. The hypoglycemia is a factor that makes doctors reluctant to maintain normal blood sugar levels in diabetic anesthetized patients. Hyperglycemia leads to glucosuria, then polyuria, which in turn causes dehydration of the patient through osmotic diuresis. Hyperglycemia decreases the patient�s ability to resist infections.During a period of 6 years, 2011-2016, we observed, treated and monitored a number of 75 patients with diabetes mellitus. Of these, 45 were men and 30 women and the age was between 18-65 years, with the highest incidence between 45-60 years.The importance of diabetic mellitus field in dental practice is not only determined by the high frequency of complications requiring surgery, but also that in these patients any aggression, even limited, can cause entry into a vicious circle where the local lesion aggravates the diabetic state and in turn it worsens the local development of the lesions. The appropriate premedication, protective antibiotic therapy, quality loco-regional anesthesia, rigorous applying of aseptic and antisepsic rules, soft, non-traumatic maneuvers, are mandatory measures addressed to the diabetic patient for performing risk-free surgery.

Labio-maxilo-palatine clefts are embryogenesis disorders of the stomatognathic system that occur due to the action of genetic or non-genetic factors in weeks 5-6 of intrauterine life. The clefts are part of the group of congenital malformations of the face. They appear from birth as a slit in the upper lip, hard palate and/or soft palate.Labio-maxilo-palatine cleafts are a current medical problem, especially regarding surgical recovery; they are congenital malformations of the face characterized by the absence of substance in the upper lip and/or in the palatine vault caused by the lack of fusion of labial and / or palatine buds during embryonic development.Simple labial cleft concerns only the lip, unlike the complete labial cleft which affects also the alveolar maxillary arch. In the case of this malformation, more serious than labial cleft, the cleft also affects the bone structures (the alveolar maxillary arche, the buccal palate) so that the oral cavity communicates with the nasal cavity and prevents sucking in infants. An early surgical recovery restores the integrity of anatomical structures, reestablishes disturbed functions, creates favorable conditions for speech education and social adaptation of the child according to age.The procedure is applied prior to the primary suture of the lip and of the anterior palate in order to minimize the dislocation of the segments of the maxillary arch. The correction of the malformation of the jaw arch in the case of bilateral clefts is much more difficult, but it has a greater importance due to the difficulty of reconstruction of the muscular plan and severe deformations, what will persist if the segments can not be aligned.In the bilateral clefts, the lateral segments are displaced medially, and the medial segment is protruding. The purpose of preoperative orthodontic treatment is to reposition the lateral segments so that the medial segment can be coaxed between them together as a vault key of the maxillary arch. In order to study the occurrence of labio-palatine cleft, we used eight groups of Wistar females rat, weighing between 200 and 250 grams. Each sample consists of 10 females rats. Most of the labial and palatine clefts are the result of multiple, genetic and non-genetic factors, each producing a minor developmental defect, called multifactorial heritage;It can be represented by a model in which responsibility for a disease is a variable caused by a combination of genetic and environmental factors. The therapeutic outcome depends on the complexity of the malformation, on the moment of surgery and on the selection of the most modern techniques and equipment suitable for the patient.

Disabilities are complex, dynamic, multidimensional and also contested; one or more key functions of the organism can be affected so to diminish an individual�s freedom of expression and of action. The transition from an individual, medical perspective to a structural, social perspective was described as a shift from a medical model to a social model where individuals are more likely considered disabled by the society then by their own bodies. Disabilities represent a part of the human condition due to its bidirectional connection with poverty: the existence of disabilities can increase the risk of poverty, and poverty can increase the risk of disability. The experience of disability that results from the interaction of the state of health, personal factors and environmental factors varies greatly. Stress, anxiety or different unpleasant moments can cause a temporary decrease in salivary flow but a constant decrease can indicate the existence of a serious health problem. Xerostomia represents the subjective sensation of dry mouth. It can be accompanied by hyposalivation, an objective phenomenon but this is not always the case. Even if the patient declares the existence of xerostomia, this does not necessarily imply the existence of hyposalivation. Xerostomia can be determined by modifications in the oral cavity, as the sensitivity level to moistening, adverse reactions to certain drugs (anti-depressants, inhibitors of the conversion enzyme). The handicap, now called disability represents a special condition of the individual, reason why he must benefit of the support of the society and of those around him. Dental treatment in patients with psychiatric disabilities must consider the general and local involutive modifications, the existent overlay polypathologies that can influence the dental treatment. The study was conducted practically and included the direct interaction as part of the medical team and the registration of 145 patients presented on request with various types of psychological disorders, sometimes covered by the mask of somatic disorders, indicating a masked depression, or a physical depression, where the emotional condition of yesterday and today differ very much. Pointing out the role of the dentist in approaching patients with physical and psychical disabilities, motivating and making them aware of the necessity of adopting a proper oral hygiene for preventing oral disorders. The dramatic impact on the psyche and the well-chosen words stressed by the clinician increase patient awareness and motivation in order to make him collaborate during the treatment.

The recent development of aesthetic dentistry reflects a concentration of the dentists’ concern for satisfying patients’ requests for an aesthetic appearance of their teeth. Modern dentistry combines medical treatment with the art of aesthetic restorations. Over the years, the restoration of the facial harmony has changed its character, from random to necessary, and from optional to compulsory, as the aesthetic defects have become less and less accepted. Aim: Contributions to understanding the principles that must be respected in dental-facial aesthetics and their application in various accessible prosthetic techniques that lead to significant improvement of the aesthetic appearance of the final restoration. Material and methods: The study included 22 (aged 40 to 80 years) patients (mean age: 60 years), presenting to the Department of Clinical Dentistry for different types of prosthetic restorations. Results and discussions: Taking into consideration the aesthetic principles and criteria, the prosthetic restorations in two similar clinical situations were performed using a different methodology. Conclusions: To grant the actual interventions the necessary provisions of true clinical success, the dentist must have and develop the skills that allow him/her to be valued as both a scientist, and an artist.

Post extractionaly wound healing involves a primary mechanism for the recovery of tissue integrity after damage; is a complex process regulated by many local factors and general, and knowledge and understanding of this process at the molecular level, biochemical and tissue allows dentists and oral and maxillo-facial surgeon adoption of a suitable transmission techniques for therapeutic success. Dry alveolitis caused by local adrenaline prolonged ischemia is the most dramatic – by the discomfort created for the patient, accident of local anesthesia with vasoconstrictor used in the therapy of dento-alveolar surgery.

Through it’s techniques, modern anesthesia has as main \"target\" shaping the patient\'s condition and his comfort by inhibiting the negative emotion which has a vital role in shaping the degree and intensity of pain by increasing the central and autonomic nervous system activity that weakens cognitive process, allowing a balanced reaction during surgery. As they have discovered new techniques and systems for management for dental pain , dental practitioners have been given the chance to have handy ways of anesthesia for teeth and soft parts, methods that were initially viewed with great restraint and suspicion. Using a topical anesthetic before the puncture anesthesia is or should be a routine measure in the practice of dentistry.

Anesthesia and the degree of control over the perception of pain depends on the personality of the individual, the socio-economic conditions, potential previous painful experiences and, last but not least, on fatigue and fear of the dentist. The perception of pain in patients is closely connected to their mental state. Pain is defined as a sensation of discomfort, with wide variations, both in quality and intensity, for different people in seemingly identical conditions; an unpleasant sensitive and emotional phenomena connected to the threat of a wound or caused in the tissues or described in the terms of this disease. The essential element of any type of anesthesia is analgesia, an effect which in some cases cannot be achived, due to the patient�s particularities or the physician�s lack of experience in anesthesia. Locoregional anesthesia (LRA) represents the blocking of the nociceptive sensitive and sympathetic autonomic afferents as well as that of motor efferents at the level of peripheral nerves� axons, by means of local anesthetic. To achieve the set purpose, we carried out a study on a representative human sample comprised of 10.123 patients treated in the Oral and Maxillofacial Surgery Clinic (Ambulatory) from the County Clinic Emergency Hospital St. Spiridon Iasi, between 01.01.2015-31.12.2016. The reason for the exclusion of certain categories of patients in the reseach was: the patients with a special conditions background require individual pre-anesthesia schemes, personalised for the nature of the pre-existing general condition, which must be further approved by the attending specialist physician : cardiologist, internist, diabetologist; children under 18 years old, with a high degree of anxiety; a high precentage of elderly patients, over 60 years old, possess a combination of general issues, thus requiring a special approach. The thoroughness lying at the core of the anesthetic practice, most especially the safegurading of a technical accuracy in the performance of anesthesia [12,], instead of improvisations, the lack of anatomical and stomatological training in general and the resulting inefficiency as such, is the underlying in-depth structuring element of this paper.