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The aim of study was to assess CARS criteria and two optical methods used in the detection of carious lesions adjacent to posterior composite resins restorations (DiagnoDent Pen, VistaCam ix). Material and Methods. Study group included 10 patients aged between 22-28 years with 15 composite resins restorations (Class I) located in molars, with suspicion of caries adjacent to restorations, were evaluated at 3-5 years post-treatment. A clinical evaluation of the aesthetic coronal restorations was performed clinically, establishing the CARS index values. Subsequently, a paraclinical evaluation was carried out using the DiagnoDent Pen (KaVo) and VistacamIX (Dürr Dental), following the protocol indicated for each device used. Initially, images of each evaluated tooth were captured using VistaCam with the intraoral camera tip, followed by an assessment of the fillings using the Proof tip of the same device. Afterward, the DiagnoDent Pen was used to evaluate each coronal restoration included in the study. Distribution of CARS scores, DiagnoDent Pen values and VistaCam IX values was calculated and exposed in Microsoft Excel graphs. Results. Most frequent CARS scores were 3.3. (46,62%), followed by 3.2 (40,06%), 3.4. (6,66%), 3.5 (6,66%). Most frequent DiagnoDent pen values were >25 (40%), followed by 20-25 (33,30%), 13-19 (20%), and

Sjögren’s syndrome is an autoimmune disease that is associated with inflammatory changes, reduced salivary flow, and altered saliva composition. The effects of medications and injuries to the salivary ducts can contribute to the increased salivary viscosity with serious consequences for the teeth and soft tissues. The remineralization capacity of saliva is based on its ability to provide the necessary minerals, maintain a favorable pH balance, and support the natural mechanisms implied in the repair processes of the tooth structure. The aim of this study is to evaluate the impact of salivary pathology in Sjögren’s Syndrome, and the correlations on certain cariogenic risk parameters. Materials and method: The study was conducted on 30 patients: Study group (15 patients) with primary Sjögren’s Syndrome; Control group (15 patients) – without associated general pathology. The evaluation focused on the analysis of DMFT and the following salivary parameters: resting salivary flow (RSF), stimulated salivary flow (SSF), buffering capacity (BC), saliva viscosity (SV), and the index of salivary microcrystallization (IMK). The evaluated results demonstrate that the effects of Sjögren’s syndrome on the selected indicators (DMFT, RFR, RFS, CT, SV, IMK) are significantly different compared to the control group, indicating the Sjögren syndrome’s impact on the dental and salivary status of affected patients. Conclusions: There is a correlation between dental caries, saliva, and Sjögren’s syndrome. Reduced saliva production in Sjögren’s syndrome can lead to xerostomia-associated phenomena, disturb the balance between demineralization and remineralization processes, and may contribute to an increased risk of caries.

The aim of the present study was to assess by using a questionnaire, the knowledge and understanding level of dental postoperative sensitivity through dental practitioners. A number of 431 dental practitioners coming from rural or urban practices, in private or public environment, with a bachelor’s degree or with postgraduate studies received this specifically developed questionnaire. The questionnaire consisted of a series of socio-demographic questions, followed by 14 questions related to postoperative sensitivity. The questionnaire contained 7 single-choice and 7 multiple-choice questions. For the statistical analysis of the obtained results Pearson Chi-square and Independent sample t-test were used. For all 14 questions, the correct answers were indicated by the majority of respondents, regardless of the training level or the environment of origin. Both postgraduate and bachelor’s degree dental practitioners had a similar level of knowledge regarding the etiology, symptomatology and therapeutic management of postoperative dental sensitivity. The knowledge level about dental postoperative sensitivity does not differ between dental practitioners in the public and private sectors.

Tobacco smoke contains a variety of harmful chemicals such as tar, benzopyrene, formaldehyde and hydrogen cyanide. These substances can affect both the quality and quantity of saliva, thus disrupting remineralization processes. Smoking can have a significant impact on the inorganic component of saliva and, consequently, can affect its viscosity and degree of mineralization.The aim of this study was to evaluate the impact of smoking and the correlations of some cariogenic risk parameters such as DMFT Index, resting and stimulated salivary flow rate, salivary pH and buffer capacity and micro-crystallization index in smokers using classic and electronic cigarettes. Material and method:The study was performed on 50 patients from the Clinical Base of the Faculty of Dental Medicine, “Grigore T. Popa” University of Iași, Romania with a medium number of carious lesions and a medium carious risk. The patients aged between 19 and 35 years, were divided into five groups (n=10): I – non-smokers, II – light smokers (1-10 classic cigarettes/day), III – moderate smokers (10-20 classic cigarettes/day), IV – high consumption (over 20 classic cigarettes/day) and V – electronic cigarette smokers. Results showed that the DMFT index values were very low in non-smokers while the highest values were reached by the electronic cigarettes users. Regarding the resting and stimulated salivary flow rate, the values decreased significantly in classic cigarettes medium and high consumers and in electronic cigarettes users when compared to non-smokers. When analyzing the pH and buffer capacity values it can be observed that smoking more than 10 cigarettes per day or the use electronic cigarettes can significantly reduce the values. The micro-crystallization index is also reduced in electronic cigarettes smokers or in medium or high classic cigarettes consumers. Conclusions: Consumption of more than 10 classic cigarettes per day or electronic cigarette affects the resting and stimulated salivary flow rate, the salivary pH value, the buffer capacity and the micro-crystallization index. E-cigarette users or smokers of more than 20 cigarettes per day are associated with an increased number of decayed, missing or filled teeth.

Aim of the study Since a century ago, xylitol, a white, crystalline carbohydrate, has been known as a naturally occurring five-carbon sugar polyol. Its impact on dental caries has been extensively researched during the previous forty years. It can be derived from plant materials rich in xylan, like the wood of birch and beech trees, and is naturally present in fruits, vegetables, and berries. The amount of MS in dental plaque and saliva is reduced because xylitol interferes with the energy-producing processes of Mutans Streptococci (MS), causing their death. It also reduces the adhesion of these microorganisms to the surface of teeth and, as a result, decreases their acid-producing potential. Conclusions Despite all the information available on xylitol, further study is still required to fully understand its mechanisms of action, the clinical implications of xylitol resistance, and how it affects Streptococcus Mutans and the plaque-saliva complex. Properly planned randomised controlled clinical trials must be conducted in conjunction with research to show that xylitol prevention is feasible in a variety of groups with various dietary and dental hygiene practices. It is also necessary to thoroughly confirm the best delivery methods for xylitol and the degree to which it can be “diluted” with other polyols without losing its ability to prevent dental caries. It is necessary to calibrate the minimal daily dose and frequency required for xylitol’s effects on MS, dental plaque, and caries.

There are two main methods used for dentin hypersensitivity (DH) treatment: dentinal tubule occlusion and blockage of nerve activity. Dentifrices are the most common vehicles for active ingredients used for DH treatment. The aim of this study was to evaluate the efficacy of three toothpastes on dentinal tubule occlusion, mineral acquisition, and dentin hardness. Forty human dentin disks were submerged in 40% citric acid for 30 s and then exposed to tooth brushing for 2 min twice a day for 14 days using three toothpastes: Dontodent Sensitive (group 1), Dr. Wolff’s Biorepair (group 2), and Sensodyne Repair and Protect (group 3). In the control group (group 4), the samples were brushed with water. All of the samples were evaluated using scanning electron microscopy (SEM), energy-dispersive X-ray (EDX), and Vickers dentin hardness determination. On SEM images, the degree of dentinal tubule occlusion was assessed using a five-grade scale. The mean score values in groups 1–4 were 3.60 ± 0.69, 2.20 ± 0.91, 2.30 ± 1.16, and 5.00 ± 0.00, significantly higher in study groups when compared to the control group (Kruskal Wallis test p < 0.05). EDX evaluation showed significantly higher calcium and phosphorus concentrations in groups 1 and 3 when compared to control group d. The mean values of Vickers dentin hardness numbers in groups 1–4 were 243.03 ± 10.014, 327.38 ± 56.65, 260.29 ± 37.69, and 225.83 ± 29.93, respectively. No statistically significant results were obtained when comparing the hardness mean values in groups (Kruskal-Wallis statistical test, p = 0.372 > 0.05). All three toothpastes tested demonstrated significant occlusion of dentinal tubules. Dontodent Sensitive and Sensodyne Repair and Protect toothpastes enhanced the calcium and phosphorus content of the dentin surface. None of the toothpastes increased dentin hardness as a result of mineral acquisition.

Oral tuberculosis lesions are the only manifestations of this disease that represents a real challenge for the clinician in terms of diagnosis. This clinical case presents a 58-year-old patient who came in for painful sensation when chewing and gingival bleeding around 1.4 tooth. Past medical history it reveals that she has pulmonary tuberculosis treated 6 months ago. At the time of the oral examination, the patient had no active pleuro-pulmonary lesions of pulmonary tuberculosis (TBP). By collaborating clinical examination and paraclinical data, we established the main diagnosis as beeing: endo-periodontal syndrome 1.4. We prescribed an associated treatment. We managed the periodontal support in a session (identification and quantification of periodontal pathogens in the red complex and also of the pathogen Mycobacterium tuberculosis by the qPCR Test method.) Ultrasonic supra- and subgingival scaling associated with 3% hydrogen peroxide irrigation and a session photodynamic therapy – diode were performed. Endodontic treatment was in two stages: mechano-chemical debridement in combination with irrigation with NaOCl 3% (ChloraxiD 3%), EDTA gel MD-CHELCREAM 19% and sonic activation of the irrigant, medicinal paste, then we performed the final root filling. Photodynamic therapy – diode afterwords. Coronary filling performed one week after the root filling. The probability that this endo-periodontal syndrome is a form of tuberculosis is very small. At the time of examination the patient did not have regional lymphadenopathy and no positive BK in the sputum or in the periodontal pouch present at tooth 1.4.

The aim of the study was to evaluate if there are significantly differences in immediate marginal adaptation of a self-adhesive flowable composite resin used in association with a universal bonding agent and to compare the sealing ability to a conventional flowable composite resin. Class V cavities were prepared on the buccal and lingual surfaces of eighteen molars and bicusps. The cavities were restore using a self-adhesive flowable composite resin (Vertise™ Flow, Kerr Dental), a conventional flowable composite resin (Neo Spectra™ ST Flow, Dentsply Sirona), and a universal adhesive system (Prime and Bond Active, Dentsply Sirona) applied in etch and rinse or self etch strategy. The teeeth were submersed in distilled water for 24 hours, then in 2% methilen blue solution for 24 hours. Buccal-lingual sections were obtained by cutting the teeth and were evaluated using an optic microscope. The microleakage at gingival and occlusal margins was assessed by dye penetration according to a 4 grade scale. There was no significantly different microleakage when using Vertise™ Flow in association with the universal bonding agent or without it. The use of Vertise™ Flow self-adhesive composite resin determined similar enamel and dentin microleakage, irrespective the use of a bonding system or the strategy of bonding application. Conventional flowable resin Neo Spectra™ ST used in association with the bonding agent lead to a significantly higher microleakage when comparing to self-adhesive composite resin Vertise™ Flow used in the same conditions.The association of a bonding agent applied in etch and rinse or self etch strategy and the conventional flowable resin Neo Spectra™ ST significantly decreases enamel and dentin microleakage.

Silver diamine fluoride (SDF) is now considered as an efficient, non-invasive material that can be used in prevention and arresting of dental caries. Potassium iodide (KI) is used to reduce the dental staining produced by SDF. The aim of this study was to assess the effect of SDF+KI application on demineralized dentin immediately after application and 3 days after a simulated caries attack. Materials and methods. Demineralized dentin specimens were treated by applying SDF-KI. Half of the specimens were stored in lactate buffer solution for 3 days. The specimens were subsequently analyzed by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Results. SEM evaluation of SDF+KI treated specimens showed a thin continuous layer of material covering the dentin surface. The EDS analysis showed decreasing percentages of silver and iodine, concurrent with the increase of calcium and phosphate concentrations from the external surface towards the inner dentin. The specimens subjected to the acidic challenge after SDF+KI application showed the same pattern of element distribution. Conclusions. The application of SDF-KI on demineralized dentin resulted in the formation of an external layer containing high percentages of silver and iodine. The silver-rich layer was resistant to acidic challenge and effective in protecting the subjacent dentin from further demineralization.

The aim of the study was to evaluate the antibacterial activity and surface hardness of a light-activated microhybrid composite resin modified with green silver nanoparticles (AgNPs). AgNPs were synthesized using an Equisetum sylvaticum extract and characterized through different methods such as UV-Vis, EDX, and FTIR. The obtained AgNPs were mixed with a microhybrid composite resin (Herculite XRV, Kerr Corp., Orange, CA, USA) in different concentrations: 0% (group A-control); 0.5% (group B); 1% (group C); and 1.5% (group D). A total of 120 composite resin disk-shaped samples were obtained and divided into 4 groups (n = 30) according to AgNP concentration. Each group was then divided into 2 subgroups: subgroup 1—samples were not soaked in 0.01 M NaOH solution; and subgroup 2—samples were soaked in 0.01 M NaOH solution. The antibacterial activity against Streptococcus mutans was determined using a direct contact test. A digital electronic hardness tester was used to determine the composite resin’s Vickers surface hardness (VH). Statistical analysis was performed using the Mann–Whitney U and Kruskal–Wallis nonparametric tests with a confidence level of 95%. Groups C and D showed higher antibacterial activity against S. mutans when compared to the control group (p < 0.05). No significant differences were recorded between VH values (p > 0.05). The use of AgNPs synthesized from Equisetum sylvaticum as a composite resin filler in 1% wt. and 1.5% wt. reduced the activity of Streptococcus mutans. Soaking of the experimental composite resin decreased the antibacterial efficacy. The loading of a microhybrid composite resin with AgNPs in concentrations of 0.5% wt., 1% wt., and 1.5% wt. did not influence the surface hardness.

The aim of the study was to evaluate the influence of some characteristic of the light curing unit (polymeriyation mode and the distance between light curing tip to the surface of composite resin) on the efficiency of SDR® Plus bulk fill flowable base composite. U (universal), A2, and A3 shades was used in the study. Fiftyfive samples from each shade were prepared by injection the flowable resin in cylindrical plastic molds with the intern diameter of 5 mm. Three types of plastic molds according to their hight were used: 6 mm, 8 mm, and 10 mm. The tip of the light curing unit was placed on top of the mold and composite resin was light cure for 20 seconds for U shade and 40 seconds for A2 and A3 shades. Top and bottom surface Vickers hardness was determined using a digital microhardness. The hardness ratio of each specimen was also calculated Polymerization efficiency of SRD® Plus bulk-fill flowable base composite resin was not affected by the distance from the light sourse to the surface of the material and the light curing mode. Staggared polymerization mode of the light curing unit determines slightly low values of surface hardness when comparing to inclined and normal polymerization modes. Darker shades of bulf fill flowable base composite resin seems to present decreased surface hardness when comparing to ligther shades irrespective the distance from the light curing unit to the material surface and the mode of polymerization.

The aim of the present study was to evaluate, based on a DHEQ questionnaire, the quality of life of a group of 25 students, 12 men and 13 women, from the Faculty of Dentistry, U.M.F. “Grigore T.Popa” Iasi (Romania) suffering from dentinal hypersensitivity. Materials and method. Patients were divided into 4 groups according to age: 20-25; 26-30; 31-35 and 36-40 years. The questionnaire included 15 questions, each with scores from 1 to 7 according to Likert scale. The data were analysed using Excel. Results. High scores values ​​ (5-7) on each question in the questionnaire (> 50% of the respondents) were obtained in 10 of the 15 questions, 84% of the people giving high scores to question no. 3; 80% to question 12; and 76% to questions 4,5,6,7,8. The lowest percentage (40%) of people who gave scores between 5-7 were for questions 9, 10, 13.15. Conclusions. As dental hypersensitivity is increasingly common in young people, we believe that the questionnaire method can be a means of quickly and completely assessing this condition. This method can help the dentist together with the clinical and paraclinical examination in making a correct diagnosis and developing an appropriate treatment plan. At the same time, with this quick method, the patient can become aware that the symptoms cannot be neglected and he must address to the dentist for diagnosis and treatment.

Aim of the study: The aim of this study was to validate and implement the Romanian version of DHEQ-15. Material and methods: A total of 132 questionnaires DHEQ-15 were distributed among senior dental students (6th year of study). The DHEQ-15 consists of 15 items with coded responses on 7-point Likert scales. The form was translated into Romanian using the forward-backward process. The standard descriptive methods were applied to determine the characteristics of the sample. Results: The response rate of the self-administered questionnaire was 87.87%. A total of 74 students (63.8%) declared that had experienced DH in the last month and 58% of them disagreed that this condition had a negative impact on their lives. The average total score recorded was 46.16 ± 19.680. Conclusions: This is the first study that validates the Romanian version of DHEQ-15. The findings of this research indicate that senior dental students do not consider that DH has a negative impact on their quality of life.

Background: The aim of the study was to assess the protective effect of applying potassium iodide (KI) over silver diamine fluoride (SDF) on demineralized root dentin in the case of a sustained acidogenic attack. Methods: Forty caries-free third molars were used in the study. A diamond disc was used to separate the roots and the tooth crowns from the roots. Each root fragment was randomly distributed in one of the four study groups: C—samples were not demineralized; DD—demineralized samples; RS1—demineralized samples covered with SDF+KI (RS-Riva Star product, SDI limited, Bayswater, Australia); RS2—demineralized samples covered with SDF+KI and submersed to another acidic challenge for 3 days. SEM and EDX were used for the morphological and elemental analysis. Vickers hardness assessment was performed using a tribometer CETR UMT-2 (Bruker Corporation, Berlin, Germany). One-way ANOVA and post hoc Bonferroni tests were used for the statistical analysis with a significance level of p < 0.05. Results: Morphological and elemental changes were observed on the surface of the study samples. Significant differences were observed between the recorded hardness values of groups C and DD (p = 0.005), C and RS2 (p = 0.002), DD and RS1 (p = 0.011); RS1 and RS2 (p = 0.004). Conclusions: The application of SDF and KI (Riva Star product) on root dentin caries resulted in the formation of a heterogeneous outer layer that sealed the dentin and increased the microhardness of the treated surface. In the conditions of the present study, this layer did not provide enough protection for root dentin exposed to continuous attacks.

The traditional view, that consider the carious disease as an infectious disease where the therapeutic strategy requires the removal of bacteria and affected tissues, is no longer valid today. Alternative therapies involving the control of causative factors (carbohydrate restrictions, biofilm removal) or to rebalance de- and remineralization processes (fluoride and other remineralization strategies or sealing placement) have become the cornerstone of “the tooth decay management”. These new therapies allow “the inactivation / control of the caries process, preservation of dental hard tissues, avoidance of repetitive restorative cycle, and maintenance of the tooth throughout the patient’s life “. Today we have techniques for the selective removal of decayed the carious tissues that maintain a minimal area of soft or firm dentin near to the pulp and create a sealing area on the periphery in which healthy dentin and enamel on the walls and borders of the cavity provide an effective substrate for bio-adhesive restorations.

The aim of the study was to evaluate the composite resin-tooth interface when using a universal adhesive applied in different etching strategies. Materials and method: 20 class V cavities were prepared in extracted teeth and restored with a composite resin using a universal adhesive system. Half of the restorations were applied using etch-and-rinse technique and the other half were applied with self-etch technique. The samples had been subjected to a dye penetration microleakage test and then the teeth were axially sectioned. The microleakage scores and the morphology of the adhesive joint were evaluated using an optical microscope and a scanning electron microscope. Results: The microleakage scores did not show a significant difference between the self-etch group and the total etch-group. For both groups, no significant gaps were noticed, however few cracks were visible within the adhesive layer. The SEM images showed the preservation of a tide contact between the composite resin and the dental tissues in most specimens of the both groups. An adhesive joint involving a layer of adhesive resin was formed between composite resin and both enamel and dentin regardless of the chosen technique (self-etch or total etch strategy). Conclusions: The immediate sealing qualities and the morphology of the interface did not significantly change when total etch strategy had been used when comparing to self-etch strategy.

The aim of this case report was to assess the effectiveness of antimicrobial photodynamic therapy when associated with non-surgical endodontic treatment of large periapical cyst. Case report: A 52-years-old female patient complained of sharp pain in the upper maxillary anterior area of the mouth. The clinical exam showed for tooth 1.2. moderate dental dyschromia, slightly positive axial percussion and loss of hard bone substance of about 0,5 cm2. As well as negative response to thermal tests. The non-surgical endodontic treatment was associated to photodynamic therapy performed by diode laser 808nm following the irrigation with. Theroot canals were filled with Ca(OH)2 paste for 14 days. The paste was changed after 14 days, and the root canal photodynamic therapy was repeated. In the third session it was performed the definitive root canal filling and coronal-radicular reconstruction. Results: check-ups performed at 6 months, 12 months, 2 years and 5 years, demonstrated progressive healing of treated large periapical cyst, with total absence of signs or symptoms. Conclusion: the addition of photodynamic therapy to conventional endodontic treatment can increase the reduction of microbial load in the endodontic space and the long-term success rate in non-surgical treatment of large periapical cysts

Background and Objectives: The aim of this in vitro study was to evaluate the combined effect of a 2% chlorhexidine aqueous solution and a universal adhesive system applied in self-etch and etch-and-rinse strategies on the composite resin–dentin interface. Materials and Methods: Class V cavities were prepared on the facial and lingual surfaces of forty caries-free molars extracted for orthodontic reasons. The samples were randomly divided into two groups corresponding to the used etching protocol: I—etch-and-rinse; II—self-etch. In each tooth, one cavity was assigned for the control subgroups -IA (n = 20) and IIA (n = 20)—adhesive only, and the opposite cavity was pretreated with a 2% chlorhexidine solution—Gluco CHeX Cerkamed—subgroups IB (n = 20) and IIB (n = 20). Both sets of groups were restored using a universal adhesive system (Single Bond Universal Adhesive, 3M-ESPE) and a bulk-fill composite resin (Filtek One Bulk Fill Restorative, 3M-ESPE). The roots and the pulp tissue were then removed, and a needle connected to a perfusor with 100 mL saline solution was used for pulp pressure simulation with a hydrostatic pressure of 20 cm H2O. Cariogenic attack was simulated using a demineralizing solution for 3 days at a constant temperature of 25 °C. The teeth were then sectioned in a facial-lingual direction and the microleakages at the occlusal and cervical margins were registered and scored using an optical Carl-Zeiss AXIO Imager A1m microscope (Carl-Zeiss). The composite resin–dentin interface was analyzed using a SEM Vega Tescan LMH II. Statistical analysis was performed using the Kruskal–Wallis test with a significance level of p < 0.05. Results: Microleakage evaluation showed no significant differences among the study groups (p > 0.05). In subgroup IA, significant differences were recorded between occlusal and cervical margins (p < 0.05). Conclusions: Application of chlorhexidine on tooth substrate before using a universal bonding system in total etch or self-etch mode has no influence on the adhesive interface in the condition of cariogenic attack. The thickness of the adhesive resin layer seems to be less uniform when using chlorhexidine, but the morphological differences at the adhesive interface have no influence on the sealing capacity of the universal bonding system, regardless of the etching strategy.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of gastric acid associated with the effect of toothbrushing on the surface roughness of different types of composite resin used for direct restorations. Materials and Methods: The materials used in this study were two microhybrid (Filtek Z250, Herculite XRV) and two nanohybrid (Filtek Z550, Herculite XRV Ultra) composite resins. Two hundred and forty cylindrical samples with a height of 2 mm and a diameter of 6 mm were divided into four groups (groups A, B, C and D) corresponding to each tested material (n = 60). Each group was divided in two subgroups: subgroup I—the samples were submersed in hydrochloric acid and immediately submitted to toothbrushing; subgroup II—the samples were submitted only to toothbrushing. The simulation of the acid attack was performed by immersing the samples in a 0.01 M hydrochloric acid solution for 90 min. This procedure was followed immediately by toothbrushing simulation with 10,000 cycles. The acid attack and toothbrushing simulation were performed for two times. The surface roughness evaluation was performed with a Proscan 2100 profilometer. Repeated Measures ANOVA and Bonferroni post-hoc tests were used to perform the statistical analysis. Results: Simulation of one year of toothbrushing associated or not to hydrochloric acid exposure increases the surface roughness of microhybrid and nanohybrid composite resins. Six months of toothbrushing associated to six months of hydrochloric acid exposure increase the surface roughness of nanohybrid composite resins. Conclusions: Microhybrid composite resins surface becomes rougher after toothbrush and acid submersion when comparing to nanohybrid composite resins.

Background and Objectives: Alveolar ridge augmentation in the complex bone defect is a popular topic in implantology. Guided bone regeneration (GBR) is one of the most commonly applied methods to reconstruct alveolar bone. The application of a membrane is the fundamental principle of GBR. There are many membrane types used in oral surgery, but the advantage of the titanium mesh is the rigidity which provides space maintenance and prevents contour collapse. The smooth surface also reduces bacterial contamination. Using computer-aided design (CAD) and computer-aided manufacturing (CAM) in dentistry allows us to obtain the perfect architecture form of the mesh, which covers and protects the bone reconstruction. Case presentation: We present a surgical case of a 27-year-old female patient with severe aesthetic bone atrophy after a deficient odontectomy. Based on the GBR clinical applications, the technique consists of bone reconstruction and a customized titanium mesh application. Using mesh titanium in this case presentation was a reliable alternative to perform a lateral alveolar bone augmentation and reconstruct ridge deformities before reaching an ideal implant placement. Conclusions: According to our case report, the customized titanium mesh could be a valuable option for guided bone regeneration in aesthetic maxillary defects.

Background and Objectives: The aim of this in vitro study was to evaluate the effect of simulated gastric acid associated with toothbrushing on the surface condition of three resin-modified glass-ionomer cements (RMGIC). Materials and Methods: One hundred and sixty samples of each material were obtained and included in three study groups according to the tested material: Group I (Ionolux, VOCO GmbH, Cuxhaven, Germany); Group II (Vitremer, 3 M-ESPE, St. Paul, MN, USA); and Group III (Fuji II LC, GC Corporation, Tokyo, Japan). The samples were submersed in hydrochloric acid 0.01 M (pH 3.8) for 3 h and exposed to a toothbrushing procedure at a frequency of 10,000 cycles with medium and hard bristles immediately or 30 min after the acid attack. Profilometric measurements were performed by using a non-contact profilometer (Dektak XT, Bruker, Billerica, MA, USA) in order to assess the surface roughness. ANOVA and Bonferroni post hoc tests were used for the statistical analysis at a significance level of p < 0.05. Results: Exposure of RMGICs to the erosive effect of hydrochloric acid in association with toothbrushing 30 min after the chemical attack increased the surface roughness of all three RMGICs. Exposure of the three tested materials exclusively to the action of hydrochloric acid did not affect the surface roughness. Conclusions: One year of hydrochloric acid challenge associated with one year of toothbrushing with medium-hardness bristles performed 30 min after the acid attack increase the surface roughness of two of the three types of RMGIC tested (Ionolux and Fuji II LC).

The aim of this study was to assess, by using VAS indices and SCHIFF scale, the effectiveness of a desensitising product with role in the blocking of the dentinal tubules, at 24 hours and 1 week after its application. Material and methods. The clinical study was performed on 37 teeth (7 incisive; 9 canines; 17 premolars and 4 molars), divided in two groups: Group 1 (n = 18) –teeth treated with desensitiser agent Voco Profluorid® Varnish; Group 2 (n=19) –placebo (distilled water). Results. VAS indices at baseline were 5.14 (at stimulation with air spray). 24 hours after desensitising session the mean value of VAS indices decreased, in group 1, from 6.07 to 1.00. 1 week after desensitising session the mean value of VAS indices was 1.03. VAS indices for placebo group remained 3.05. Schiff indices at baseline had 1.78 mean values for the teeth taken in study. Schiff indices for group 1 decreased from 2.38 to 0.357 after 24 hours, and increased to 0.864 after 1 week. Placebo group had the same Schiff value (0.86) during the study period. Conclusions. Voco Profluorid® Varnish was effective in the treatment of the dental cervical hypersensitivity with one single session, and the desensitising effect was maintained after 1 week. The use of this product in multiple treatment sessions could determine the complete closure of the dentinal tubules.

The aim of study was to assess, based on FDI criteria, a group of esthetic posterior direct restorations and to establish the proper refurbishment or repair methods. Materials and method 59 composite resins posterior restorations, from 15 patients, were assessed based on FDI criteria. Data were statistically analyzed using Microsoft Excel 2007. Results The study found a high percent of the assessed direct restorations with good and excellent esthetic, functional and biological FDI criteria. For the restorations with satisfactory FDI criteria it was indicated minimal invasive repair technique, and for the restorations with poor FDI criteria it was indicated replacement. Conclusions The clinical assessment criteria help dentists to decide the use of minimal invasive repair interventions, thus prolonging the functional, anatomical, esthetic durability of aesthetic posterior direct restorations

The aim of the present study was to assess by atomic force microscopy (AFM) the surface roughness of a traditional glass ionomer cement- GIC (Fuji IX GP, GC Corporation, Tokyo, Japan) and a resin modified glass ionomer cement- RMGIC (Vitremer, 3M ESPE, St. Paul, MN, USA) after different immersion regimes on some acidic drinks. Sixteen cylindrical samples having the height of 5 mm and the thickness of 2 mm were obtained from each material and they were divided into two groups: Group I (Fuji IX samples) and Group II (Vitremer samples). Specimens of each group were then randomly divided into 4 subgroups: subgroup A (control)—15 samples were kept in artificial saliva and in the other three subgroups, each having 15 samples the samples were immersed in Coca-Cola (subgroup B), Cappy lemonade and mint (subgroup C) and Fuzetea (subgroup D) for 7 days (subgroups A1–D1), 14 days (subgroups A2–D2), and 21 days (subgroups A3–D3). AFM qualitative and quantitative surface evaluation (mean value of surface roughness parameter, Sa) of each sample was performed. The highest surface roughness was determined when both materials were submerged 14 days in acidic drinks. Traditional GIC was more affected by acidic environment when comparing to RMGIC.

Aim of the study: The management of patients undergoing chronic oral anticoagulation raises concerns regarding the postoperative bleeding risk. In the last few years, new oral anticoagulants were released on the market, but the operative protocols for dental surgery interventions are still not well established. The purpose of this review is to summarize the articles` evidence that evaluate the risk of bleeding with the use of Direct Oral Anticoagulants (DOACs). Material and methods: A systematic literature search was conducted from January 2014 to June 2018, in PubMed, Science Direct, Web of Science and Scopus databases. Results: Six articles met the inclusion criteria, all being observational studies. Conclusions showed that dental surgery could be performed without cessation of the DOACs, with a low incidence of bleeding complications, by applying local haemostatic measures (suturing, haemostatic agents, compression with sterile gauzes soaked in 5% tranexamic acid or the use of mouthwash with 5% tranexamic acid).

The aim of this study was to evaluate the Vickers hardness (HV), indentation and Young`s modulus to 4 materials of coronal restoration. Materials and methods Six samples of 5mm in diameter and 6 inches were made of the following materials: Filtek Z250 (3M ESPE Co.), Zmack Comp (Zermack SpA, Italy), Kalore (GC Corporation, Japan); Dyract eXtra (Dentsply De Trey Gmbh, Germany). After polymerization of the samples for 40 seconds using the LEDidition lamp (Ivoclaire Vivadent clinical, Austria), these were finished, polished and kept in distilled water at room temperature for 48 hours. The hardness was measured at the UMT-2 Tribometer (CETR), and the values obtained in GPA were converted to Vickers hardness (kgf/mm2). For each sample, six indentations were made and the mean of the values obtained was calculated. On the same device, the Young`s modulus was also measured for all samples. Results Statistical data showed that the mean HV and modulus of elasticity values were the folowing: Filtek Z 250> Zmack Comp> Dyract eXtra> Kalore. In the case of the depth of the indentation, the values were inversely proportional to the Vickers hardness of the materials: Kalore> Dyract eXtra> Zmack Comp> Filtek Z 250. Conclusion Vickers hardness and Young's modulus were higher to the microhybrid composite compared to nano-hybrid composite and compomer.

This in vitro study aimed to assess the erosive effect of hydrochloric acid in association with toothbrushing procedure on the surface condition of three bulk-fill composite resins used for direct restoration. A total of 480 samples (160 from each composite resin): X-tra Fil (VOCO, Germany)—group A, Filtek Bulk-fill Posterior (3M-ESPE, St. Paul, MN, USA)—group B, G-aenial Posterior (GC Japan)—group C were prepared, submitted to chemical attack for 60 min with hydrochloric acid 30% and, subsequently, submitted to the abrasive effect of toothbrushing using 10,000 cycles with medium and hard bristles, at three different times (immediately and after 30 min after acid attack or without any chemical attack). The surface roughness of the samples was measured using a noncontact profilometer (Dektak XT, Bruker, Billerica, MA, USA). The values were analyzed using ANOVA and post hoc Bonferroni tests, with a p < 0.05. Chemical attack for 60 min associated with one year of toothbrushing with toothbrushes having medium or hard bristles increase the surface roughness of tested bulk-fill composite resins. No differences were recorded between toothbrushing with medium or firm bristles immediately or 30 min after acidic challenge for each of the three bulk-fill composite resins. Exposure to hydrochloric acid determines no effect on surface roughness of bulk-fill composite resins.

The aim of this in vitro study was to evaluate the effect of hydrochloric acid associated with the abrasive effect of toothbrushing on the surface condition of three flowable composite resins used for direct restoration. Seventy samples of each composite resin: Grandio Flow (VOCO, Germany)—group A, Filtek Ultimate Flow (3M-ESPE, MN, USA)—group B, G-aenial Flo X (GC Europe)—group C were prepared, submersed in hydrochloric acid 30% for 60 min and then submitted to simulated toothbrushing procedure using 5000 cycles with toothbrushes with medium and hard bristles, immediately after the chemical attack, after 30 min or without any chemical attack. The sample’s surface roughness was analyzed using a noncontact profilometer (Dektak XT, Bruker, USA). ANOVA and post hoc Bonferroni tests, with a p < 0.05, were used to analyze the values. Hydrochloric acid action for 60 min and six months of toothbrushing using toothbrushes having medium hardness or firm bristles affects the surface roughness of tested flowable composite resins. Toothbrushing with firm bristles immediately after acidic challenge determines increased surface roughness for two of the three flowable composite resins (Grandio Flow and Filtek Ultimate Flow). Toothbrushing with medium or firm bristles thirty minutes after the acidic aggression determine no effect on surface condition of flowable composite resins.

The use of correct criteria for assessing direct restorations is of major importance in dental practice in the context of incorrect use or the use of invalid criteria may lead to erroneous repair / replacement decisions or over-treatment. The purpose of the study was to determine the aesthetic performance of composite resin restorations in relation to a number of clinical and biological variables (patient sex, age of restoration, type of cavity). Material and method: The study group consisted of 80 patients aged 16-44 years (male 35, 45-females). The evaluation of the restorations was performed in relation to the sex of the patients (male, female), the age of the restorations (1-2 years, 3-4 years) and the type of cavity (class III, class IV, class V). The evaluation was done through the aesthetic FDI criteria. Results: Our study did not aim to correlate surface changes and color changes with cariogenic risk or oral hygiene of patients, but this is a subject that can be addressed in later research. In our study, the comparison of clinical performance at different time intervals (1-2 years vs. 4-6 years) was relevant for observing the age of age in changes in aesthetic criteria under the condition that incorrect techniques of restoration, finishing and polishing or frequent consumption beverages with potential for degradation and coloring of the surface of composite resins can lead to failure in the first 12 months. Conclusions: The percentage of restorations in aesthetic composite resins (SE

The surface characteristics of the dental restoration influence the esthetic quality, the tactile sensation, the resistance to corrosion-abrasion phenomena and the adhesion of the bacterial biofilm. Recently a new system has been introduced for finishing and polishing composite restorations. Profine (Dentatus) system consists of a contraangle handpiece using reciprocating movement and special diamond and carbide tips. The purpose of of this study was to investigate the surface roughness of several composite resins when using the Profine System with Lamineer tips. Four commercially light-cured composite resins were tested. 10 discs were prepared for each material. Profine handpiece was used for finishing procedures. For each material 5 discs were finished using the diamond tips and the other 5 using the tungsten carbide tips. The surface roughness was evaluated using a profilometer (Surftest SJ-210, Mitutoyo). Significant differences of the surface roughness have been found between the tested materials, for both types of Lamineer tips. The surface roughness of composites seems to be dependent on both material and type of Lamineer tip used for polishing. Although the Profine-Lamineer system has shown promising results, further studies on the influence of time, pressure, and speed of the movement are needed in order to assess the best protocols for polishing restorations when using this system

Xylitol is a natural polyol, used as saccharine replacer and noncariogenic edulcorant, promoting the remineralisation both by the increasing of saliva rate and inhibition of bacteria growth. Despite these anticariogenic properties, the proofs related to clinical effectiveness of xylitol are controversial. The aim of study The aim of this study is to assess the effect of xyilitol from oral hygiene products (toothpastes, mouthwashes, chewing gums) on the saliva parameters (saliva microcrystallisation index (IMK), saliva resting flow rate (RFR), saliva stimulated flow rate (SFR), saliva buffering capacity (BC)) and the carioactivity of bacteria biofilm (ATP) for patients with medium cariogenic risk. Material and metods: The study group included 12 patients with medium cariogenic risk, submitted to the use of oral hygiene products xylitol-based for three weeks (toothpastes, mouthwashes, chewing gums). The following parameters were assessed before and after the use of xylitol-based products: saliva microcrystallisation index (IMK), saliva resting flow rate (RFR), saliva stimulated flow rate (SFR), saliva buffering capacity (BC), bacterial biofilm activity (ATP). Results and discution: The results show the significant improving of salivary parameters (IMK, RFR, SFR, BC) and the decrease of ATP levels after the use of xylitol-based oral hygiene products for three weeks Conclusions: The use of xylitol-based products in oral hygiene is effective both in the improvement of salivary parameters and the decrease of bacterial biofilm activity for patients with high cariogenic risk

The study aimed to compare the remineralization capacity of toothpastes containing arginine by surface morphology evaluation and calcium and phosphate ions concentration assessment in enamel and dentine. Colgate Total, Colgate Sensitive ProRelief and Colgate Maximum Cavity Protection were selected for this study. Enamel and dentine samples were subjected to demineralization for 1 hour, three times a day, 14 days (group I, control). In groups II-IV the same demineralization cycles were applied, but the first and the last demineralization cycle was followed by the application of three toothpaste slurries for 3 minutes. In the conditions of this study, all the tested toothpastes provided remineralization of enamel and dentine after acid challenge. The toothpastes containing arginine leaded to higher remineralization when compared to the products that contains only fluoride.

The aim of this study was to analyze the various salivary organic compounds in 158 patients who were divided into three groups: 32 in the control group (without general diseases), 108 with general diseases (asthma, diabetes) and 18 with head and neck radiotherapy. The values of the salivary organic compounds were compared with those in the blood, in all groups studied. Materials and methods: The study consisted of the collection of saliva in test tubes which were maintained at a temperature of – 20 ° C. The samples were centrifuged at 10,000 rotations per minute. Laboratory analyzes were performed at an automatic analyzer, observing the protocols specific to each parameter studied. The results obtained from each component salivary considered in the study were statistically analyzed by performing comparisons between groups of patients examined and between the values of these components in the blood vs. saliva. Were obtained lower salivary amylase levels in the group of patients that followed the head and neck radiotherapy (M amylase = 44633.3) compared to the group of patients with general diseases (M amylase = 105,440.0) and control group (M amylase = 114,456.3). In our study we observed a high concentration of urea in the study group (30,9mmol/L) and the radiotherapy, compared to control group (27,31mmol / L). In diabetic patients examined in our study we found high levels of salivary glucose (M glucose = 5.35) than the control group (M glucose = 1.34). Conclusions: The results confirm previous observations showing that, through different general diseases are mainly affected parotid salivary glands, salivary source of key organic compounds (amylase, total protein, glucose). The variations of these chemical compounds in saliva have repercussions on the protective effect of saliva against cariogenic microbial agents and cause finally increase caries risk.

The incidence of the occlusal dental caries is still high, despite the numerous available preventive and therapeutic methods and materials. Further researches are requested to find the most effective preventive method. The aim of study was to assess during a year, by using Replica Test method, the retention degree and microbiology of the bacterial biofilm adjacent to the sealants performed by three types of materials: glass ionomer cement (group I), fluoride-releasing composite sealant (group II), and composite sealant without fluoride (group III). Results. For the group I, sealed with glass ionomer cement Replica Test results show low variations associated with high protective effect, due to the fluoride release. To the end of the research period, a slight increase of the bacterial biofilm activity was recorded. For the group II, sealed with a fluoride-releasing sealant, Replica Test results show, for the first 6 months, low variations associated with the high protective effect, due to the fluoride release. After 6 months, a slight increase of the bacterial biofilm activity the recorded, due to the decrease of the released fluoride ions level. For the group III, sealed with sealant without fluoride, Replica Test results show a progressive increase of the bacterial biofilm activity during the 12 months study period, more significant than to the other study groups. Conclusions. The results of our study show that all three sealing materials offer a low retentive surface associated with a reduction of the cariogenic bacterial biofilm adjacent to the sealings. The most significant reduction of the bacterial load was associated to the glass ionomer cement GC Fuji Triage, followed by flowable composite Fisurit FX and composite Fluid SDI Wave.

The orthodontic fixed appliances determine increased retention of bacteria associated with increased cariogenic activity and enamel demineralization. The aim of study is to quantify, by ATP luminiscence method the effectiveness of a remineralizing calcium-phosphate-fluoride-based product used to decrease cariogenic activity to patients submitted to orthodontic fixed appliances therapy. Results. Initially, ATP mean values increased from 3818.3 to 7439.2 after 3 weeks of orthodontic therapy; following the non operative treatment with MI Paste Plus, ATP mean value decreased to 3883.0. Conclusions. The use of fixed appliances in orthodontic treatment influences the retention rate and increases the cariogenic activity of the adjacent bacterial biofilm. The remineralizing calcium-phosphate-fluoride-based products can decrease the cariogenic activity of the bacterial biofilm associated to orthodontic braces. ATP bioluminescence technique can be used for the rapid quantification of bacterial levels and for monitoring the oral hygiene and effectiveness of preventive-therapeutic measures during orthodontic therapy.

Dental erosion is a dental non-cariogenic lesion produced by internal (gastro oesophageal reflux, regurgitations, gastro-intestinal diseases, symptoms associated to bulimia) or external factors (foods, beverages, erosive drugs). The treatment of non-cariogenic lesions is complex. It will include the removal of causal factors and preventive-therapeutical measures aiming to increase the resistance of dental tissues by remineralization. The coronal reconstruction varies from direct composite resins restorations to indirect restorations (veneers, inlays, crowns) in severe cases. The aim of this study is to present and discuss a clinical case of dental erosion produced by GERD (gastro oesophageal reflux disease) associated with frequent consume of acid foods (citrics). Conclusions. The treatment of dental lesions produced by erosions, using non-prep ceramic micro-veneers, represent an affordable, esthetical, biological and functional therapeutic solution, with optimal results both for patient and dental team.

The aim of the study was to investigate the chemical corrosion in artificial saliva of some commercial composite resins. Material and method. 20 samples of a nanocomposite resin (Filtek Supreme XT, 3M ESPE) and 20 samples of a microhybrid composite resin (Filek Z250, 3M ESPE) were immersed for 30 days in Fusayama artificial saliva. After that, they were examined by scanning electron microscopy and energydispersive X-ray spectroscopy. Results. It resulted that the corrosion is mainly due to the pitting, micrometric holes being observed for both materials. Also, preferred directions of corrosion resulted, as consequence of micro-scratches formation during the samples preparation. The oxygen content generally increased due to the oxides formation, while carbon, silicon and zirconium normalized atomic percents decreased. Conclusions. The corrosion of the composite resins in artificial saliva is mainly represented by pitting, and micrometric holes. The chemical corrosion affected both polymeric matrix and filler particles.

Root dental caries represent an issue focusing many dental researchers. However due to morphologic and structural particularities of cement and root dentine as well as the nearby of dental pulp, root dental caries is a challenge regarding therapeutical success. The aim of this study was to assess the clinical performance of two restorative materials: glassionomer cement CGI with high density and a resin-modified glassionomer cement (RMGC), using ART technique in complex cervical root cavities. The assessment of restorations quality parameters was performed after 1 and 6 months using ART assessment criteria. After 6 months, success rate was 100 % for GC Fuji II LC and 96,6 % for Fuji VIII. After 6 months, success rate of ART technique for all 20 patients was 98,3 %. A higher success rate of our study, comparing with literature data, is due to the improvement of ART technique combined with the use of superior dental materials. (GC Fuji VIII, GC Fuji II LC), as well as the use of photopolimerisable resin-modified glassionomer cement GC Fuji II LC. More the use of conditioner, previously to the insertion of restoration material, improves significantly the adhesion and prevent microleakage. The superior esthetics and surface parameters are due to the use of varnish. Our study proved that ART method for aged patients, in cervical root dental caries treatment, was more efficient, both for simple cavities (1 surface) and complex cavities, after a 6 months periode. The results were promising for both researched glassionomer cements.

Introduction: Dental decay is one of the most common disorders of the oral-dental system, affecting 80-98% of the population. Identifying the factors that cause premature caries process has a significant impact in the success of specialized treatment. The purpose of the study is to assess caries risk to a group of children diagnosed with seasonal allergic rhinitis, in the context of salivary levels of MS. Material si method: 32 children aged between 7 and 12 years from rural areas take out with seasonal allergic rhinitis and under specific treatment, received dental checkup and determining the salivary level of MS using saliva kit Check Mutans. The working method included visual and tactile examination, recording individual data sheet and a questionnaire in which they were registered the dates for dental control presentation, oral hygiene habits and eating habits. Results and discussions: Saliva test made for assessing the level the MS was positive for all subjects, after its being placed in high caries risk category . It was found that subjects treated with Aerius shows a number of caries lesions smaller than those treated with histidine, but in addition, they have been identified with dental erosion. Conclusions: we can sustain that salivary level of SM is closely related to the occurrence of caries and caries risk increassement. Further studies are needed to demonstrate that treatment with Aerius and Histidine for children with seasonal allergic rhinitis affects the number of MS and increase caries risk by the appearance of new cavities lesions.

This in vitro study evaluated the effects of dentifrices containing nano-hydroxyapatite (n-HAp) on dentinal tubule occlusion and on mineral deposition. Dentin specimens of ten human teeth were submersed for 30 s in 40% citric acid and then randomly divided into four groups (three study groups and one control group). In the study groups, the dentin samples were exposed to three different n-HAp toothpastes: Karex (Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany), Biorepair Plus Sensitive (Coswell SpA, Bologna, Italy), and Dr. Wolff’s Biorepair (Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany); in the control group no toothpaste was applied. All of the samples were evaluated using scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) analysis. In the control group all of the samples showed a frank and wide opening of the dentinal tubules, whereas in the study groups different degrees of tubule closure by mineral depositions were observed. Toothpastes containing n-HAp determined a significant occlusion of dentinal tubules and a significant increase of mineral deposition on the dentin surface. All three tested toothpastes showed similar results regarding the degree of dentinal tubule closure. Varying degrees of differences in calcium, phosphate, carbon, and oxygen ion concentrations among the three tested toothpastes were obtained.

The study aimed to investigate the effects of endodontic space decontamination using a laser combined with ozonated water in the therapy of complicated pulp gangrene. The subject of this in vivo study was a 12-year-old patient diagnosed with extensive periapical periodontitis on the mandibular right first molar. Biological samples were initially collected to identify the active pathogen—Enterococcus faecalis, then the nonsurgical endodontic treatment was performed in a single visit, according to the active disinfection guidelines of the identified pathogen. Two-month postoperative, clinical and radiological examination revealed a complete healing of the periapical lesion. The correct diagnosis of this endodontic–periodontal pathology, and the unconventional treatment of the complex system of infected root canals, allowed a favorable treatment result without any surgical intervention. This unconventional approach, which combines a laser technique with ozonated water, allows for predictable results in periapical lesion treatment.

This paper aims to evaluate ,,in vitro’’ the tightness of root fillings in monoradicular teeth using distinct techniques: monocone classic technique, cold lateral condensation technique and warm vertical condensation ultrasound associated technique, underlining some issues of particular interest regarding clinical outcomes over time for endodontic treatment. The study group consists of 45 permanent, monoradicular maxillary and mandibular teeth. The study results showed a higher degree of dye infiltration in the teeth root, filled with monocone classic technique compared to cold lateral condensation and hot vertical condensation ultrasound associated methods; slightly higher dye infiltration in teeth filled by cold lateral condensation technique compared to the teeth group with hot vertical condensation ultrasound associated technique; the control group showed overall richest dye penetration in root canals and dentinal tubules. Warm root canal filling with fluid gutta-percha makes a more qualitative 3D sealing, especially in the medium and coronal thirds compared to other techniques used.

The aim of study: The aim of this study is to assess the capacity of chemo-mechanical system KariKlinz to remove carious cervical and root dental tissues and effect on cariogenic bacteria comparing with clasical mechanical method. Materials and method: The cervical and root carious lesions (n =28) (active, vital teeth) were randomly distributed to one of the next carious dentine removal methods: (Study group I) chemomechanical method Kariklinz Vladmiva (n = 14), (Study group II) classical mechanical method using conventional speed and spherical bur (n = 14). The assessment was performed using laserfluorescence method DIAGNOdent® (Kavo, Biberach, Germania) before and after preparation and microbial test (Replica Test) used for detection of Mutans Streptococcus localised on the surface of prepared cavities. Results: Both methods have similar results regarding the ability to reduce carious flora level after carious dentine removal; the percentages of residual bacteria are 2,78% for chemo-mechanical method and 2,85% for classical mechanical method. The reading of DIAGNOdent were significantly lower after cavities preparation (9,07 for chemo-mechanical method and 8,85 for classical mechanical method). Conclusions: Both excavation methods investigated in this study demonstrated similar efficiency in carious dentine removal, accordingly to results of DIAGNOdent® method and microbial test (Replica Test).

The aim of this study was to compare in vivo and in vitro accuracy (sensitivity and specificity) of visual inspection and laserfluorescence method in the detection of incipient occlusal carious lesions. Material and methods. 106 occlusal areas (mesial, distal, central) selected in a study group of 53 molars and bicusps forthcoming for extraction, were examined using visual inspection and laserfluorescence method using DIAGNodent device (KaVo, Biberach, Germany). After extraction, teeth were submitted to new clinical and paraclinical examen (visual inspection, laserfluorescence method). The teeth were cut in longitudinal axis and the slices were examined by optical microscopy. The results of histological examen were considered gold standard and were used to calculate the sensitivity and specificity of the tested detection methods. The statistical analysis used test Mc Nemar both for in vivo and in vitro results. Results. For carious lesions limited to external half of enamel, the in vivo sensitivity was 56% for visual inspection and 91% for laserfluorescence method. For carious lesions extended to inner half of enamel, the in vivo sensitivity was 57% for visual inspection and 90% for laserfluorescence method. For carious lesions limited to external half of enamel, the in vivo specificity was 66% for visual inspection and 86% for laserfluorescence method. For carious lesions extended to inner half of enamel, the in vivo specificity was 76% for visual inspection and 88% for laserfluorescence method. In vitro sensitivity and specificity values were lower than in vivo values, but it was not found significant statistical differences. Conclusions. The laserfluorescence examen, in vivo and in vitro, had higher sensitivity for incipient occlusal carious lesions limited to external half of enamel and higher specificity for incipient occlusal carious lesions extended in the inner half of enamel.

The aim of this study was to identify the anatomo-clinical features of tissues relations in the cervical area and to establish the presence and retention of bacterial biofilm related to the types of cementoenamel junction (CEJ). Material and methods: The study included 16 extracted teeth (4 incisors, 2 canines, 4 bicusps, 6 molars). The teeth, having unaffected cervical area, were cut in 4 sections preserving the bucal, lingual, mesial and distal cervical areas. The dental sections were assessed regarding the aspect and the morphology of the cementoenamel junction using SEM. Also the retention degree of bacterial biofilm was examined. Results: The highest percent (62%) CEJ are represented by the type of edge-to-edge. The bicusps present a percent of 76% of edge-to-edge CEJ, with a 14% percent of CEJ junctions associated with enamel covered by cement. Conclusions The type of cementoenamel junction varies accordingly to dental type and topography. The retention of bacterial biofilm was highest in cementoenamel junctions with exposed dentine.

The aim of study was to compare the level of fluorescence emission of two types of composite resins customary used in dental practice. Material and method. Two composite resins were used in this study: Herculite XRV (Kerr Company) and Z250 (3M ESPE). The enamel was restored with shades A3 for both composite resins, while dentine was restored with A3 for Herculite and universal dentine shade for Z250. From each material were performed 6 samples having 50 mm in lenght, 5 mm in width and 1mm in height. The samples were obtained by materials photopolymerisation between two glass plates with a LED lamp (LED B, Guilin Woodpwcker Medical Instrument Co., Ltd, China) for 40 seconds. The fluorescence emission of the composite resins was assesed by spectrometry (using spectrometer device LS 55, Perkin Elmer Inc, USA). The samples were excited using an UV fascicle with wavelength spectrum between 330-630 nm. The spectrum of emission was recorded using software FL Win Lab. Results. Considering this spectrum, the fluorescence emission for Herculite XRV dentine had the peak around 452 nm. For Herculite XRV enamel, considering the same spectrum of wavelenght, the fluorescence emission had the peak around 443,5 nm. The fluorescence emission of Z 250 dentine recorded the peak for wavelenght spectrum of UV fascicle between 330 şi 630 nm. Conclusions. For both tested materials, the fluorescence emission of dentine shades was higher comparing with enamel shades. The highest values of fluorescence emission were recorded for highest values of wavelengths, for both composite resins included in study

Aim of the study The aim of study was to determine the relation between laserfluorescence values scale and depth of early occlusal dental caries. Material and methods The in vivo study was performed on a study group of 65 patients and 78 molars with early occlusal dental caries. The selected occlusal surfaces were examined using ICDAS system (clinical exam) and laserfluorescence method (Diagnodent, KAVO) by a single examiner with an experience of two years in the use of ICDAS system and Diagnodent. The depth of demineralisation was recorded with periodontal probe after minimal invasive intervention with bur 330. The categories of early occlusal carious lesions were classified accordingly to Downer indices. Results Enamel occlusal early caries are found in high percentages for ICDAS codes 02 (69%) and Diagnodent values scale 20-24 (76%). Occlusal early caries extended in dentine are found in high percentages for ICDAS codes 03 (80%), 04 (100%) and Diagnodent values scales 25-29 (80%), 35-99 (100%). Conclusions Significant statistical differences were found between different laserfluorescence values range (20-24, 25-29, 30-34, 35-99) related to correlation with demineralization depth.

Aim of the study The aim of this study was to analyze the adhesive joint with enamel for a single-component system which can be used in either self- or selective-etching procedures. Material and methods The study group included 10 extracted third molars. Class V cavities were prepared in both lingual and labial surface and restored using a composite resin (Filtek Z550, 3MESPE) and the adhesive Single Bond Universal (3M ESPE). For the facial cavities, the adhesive was applied using a total-etch procedure. In the lingual cavities no etching gel was applied. The prepared teeth were split in an axial linguo-facial direction. The sections were observed by scanning electron microscopy using a VEGA II LSH (TESCAN) microscope. Results The images have showed that an adhesive joint was formed between composite and enamel regardless of the chosen technique (with or without etching). The adhesive layer interposed between the enamel and the composite resin was thicker in most samples were the specimens were subjected to acid etching. Conclusions Phosphoric acid pre-treatment could be beneficial for bonding to enamel when using mild self-etching adhesive systems.

This case report describes the achievement of endodontic space decontamination with ozonated water (conc. 20 mg mL-1, 1 min) used as canal irrigant to a central incisor from the maxilary, second quadrant, diagnosed with progressive diffuse chronic apical periodontitis. Conservative treatment of the root canal was performed in a single session. Postoperative clinical and radiological examination after 3 months revealed complete healing of periapical lesions of endodontic origin. Proper diagnosis of periapical lesions and unconventional treatment of the complex system of infected root canal allowed complete healing of the lesion without interfering through surgical endodontic therapy. This case report demonstrates the successful healing of persistent periapical lesions using an alternative (non-conventional) method with ozonated water.

The aim of the study was to evaluate the effect of three different one-step and two-steps polishing systems on the surface roughness of two composite resins, one with nanoparticles and one microhybrid: Filtek Supreme XT (3M ESPE) and Filtek Z 250 (3M ESPE). 35 samples (30 mm X 8 mm X 2 mm) were made from each material. 5 samples of each material were polished using the finishing long flame bur for composite resins (NTI, Kahla GmbH, Germany) without water cooling, 5 samples using the one-step abrasive rubber P20032 (NTI, Kahla GmbH, Germany) without water cooling, 5 samples using the two-steps finishing system which uses the abrasive rubbers P1932 and P19032 (NTI, Kahla GmbH, Germany). The other samples were finished with the same systems, but under water cooling. 5 non-finished and non-polished samples of each material were considered control samples. The samples surfaces were analyzed using the atomic force microscopy. The use of two-steps polishing systems led to a significantly smoother surfaces of both types of composite resins when comparing with the one-step polishing systems (Anova and Bonferroni statistical test, p