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Allma Pitru,1 Dorin Nicolae Gheorghe,2 Dora Maria Popescu,2 Flavia Mirela Nicolae,2 Mihail Virgil Boldeanu,3 Adina Turcu-Stiolica,4 Cristian Cosmin Arsenie,5 Petra Surlin,2 Sergiu Marian Cazacu,6 Ion Rogoveanu6 1Oral Pathology Department, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania; 2Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania; 3Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania; 4Department of Pharmacoeconomics and Statistical Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania; 5Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania; 6Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, 200349, RomaniaCorrespondence: Petra Surlin, Department of Periodontology, Research Center of Periodontal-Systemic Interactions, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania, Email surlinpetra@gmail.com Sergiu Marian Cazacu, Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, 200349, Romania, Email sergiucazacu@umfcv.comPurpose: Non-alcoholic fatty liver disease (NAFLD) represents a heterogeneous spectrum of liver diseases that encompass simple steatosis, non-alcoholic steatohepatitis (NASH), and advanced fibrosis or cirrhosis. Periodontitis is a chronic infectious disease with multiple causal factors that presents a complex interaction between the microbial biofilm and the host’s immune response. The aim of this study was to investigate the concentrations of Vascular Adhesion Protein-1 (VAP-1) and Thrombospondin-1 (TSP-1) in patients with coexisting periodontitis and NAFLD.Patients and Methods: This study included 48 patients, who were dental and periodontal assessed. Of these patients, 25 were diagnosed with NAFLD. After performing the periodontal clinical examination, gingival crevicular fluid (GCF) samples were collected. Enzyme-linked immunosorbent assay (ELISA) dedicated kits tests were used for the detection and quantitative determination of VAP-1 and TSP-1 in GCF samples. Statistical methods were applied for the comparison and correlation of data.Results: VAP-1 and TSP-1 levels showed significant differences between all test and control groups (p< 0.0001). Statistically significant correlations (p< 0.05) between VAP-1 and periodontal and liver parameters were found in patients with NAFLD and periodontitis.Conclusion: Periodontal inflammation is more marked in patients with periodontitis-NAFLD association. Vascular adhesion and angiogenesis could be affected in patients with periodontitis and NAFLD. These findings could suggest that addressing periodontal inflammation in individuals with the periodontitis-NAFLD association may have a broader impact on vascular adhesion and angiogenesis, highlighting the interplay between oral health and liver conditions for comprehensive patient care.Keywords: non-alcoholic fatty liver disease, periodontitis, VAP-1, TSP-1, gingival crevicular fluid, periodontal disease

Periodontal disease as a spectrum of diseases has a high prevalence all over the world, affecting all ages but even more so the elderly. Although the advancement of the medical field has made many breakthroughs in a multitude of diseases, still a specific and reliable treatment has not been discovered yet in this particular pathology. Periodontitis is an oral disease which affects the soft and hard tissues surrounding teeth and it causes the gradual attachment loss of dental structures, eventually leading to the complete expulsion of the dental unit. It is defined the formation of periodontal pockets accompanied, or not, by gingival recession. The etiological factor and the initiators of the disease are microorganisms and their by-products which cause dysbiosis and an exacerbated host inflammatory response. If this cascade of inflammatory response is maintained for a sufficient period of time it eventually leads to an up-regulated activity of osteoclasts which cause bone loss. Considering the worldwide health burden of this pathology and the many associations and interdependencies with a multitude of other systemic diseases epidemiological analysis have had a pivotal task in aiding the discovery and implication of risk factors for the disease. Furthermore, such studies further the field by assessing the treatment necessities of populations and can offer insight to health regulators.

Periodontal health is essential before and after a prosthetic restoration. Thus, the most accurate reproduction of the size and shape of dental crowns with that of natural teeth is the key to maintain a normal relationship between the joint and the occlusal relief and to maintain the integrity and health of periodontal tissues. Maintaining the periodontal health of the teeth with prosthetic restorations, with the placement of the margins in contact with the marginal gingival tissue, is a challenge, because the odonto-periodontal unit is constantly affected by microbial flora and the bacterial plaque accumulation can be stimulated by the presence of dental restorations. The objective of the present study was to analize the effects of fixed dental prostheses on periodontal inflammatory status and hygiene. After ethical approval, patients were clinically examined, their data was recorded and statistically processed. The results showed the existence of significant differences or correlations between the plaque, calculus or gingival indices and the characteristics of dental prosthesis in some situations. In conclusion, the presence of prosthetic restorations could influence the oral hygiene and be associated wih periodontal changes.

Abstract The precise location of gastric and colorectal tumors is of paramount importance for the oncological surgeon as it dictates the limits of resection and the extent of lymphadenectomy. However, this task proves sometimes to be very challenging, especially in the laparoscopic setting when the tumors are small, have a soft texture, and do not invade the serosa. In this view, our research team has developed a new instrument adapted to minimally-invasive surgery, and manipulated solely by the operating surgeon which has the potential to locate precisely tumors of the digestive tract. It consists of an inductive proximity sensor and an electronic block encapsulated into an autoclavable stainless-steel cage that works in tandem with an endoscopic hemostatic clip whose structure was modified to increase detectability. By scanning the serosal side of the colon or stomach, the instrument is capable to accurately pinpoint the location of the clip placed previously during diagnostic endoscopy on the normal bowel mucosa, adjacent to the tumor. In the current in-vivo experiments performed on large animals, the modified clips were transported without difficulties to the point of interest and attached to the mucosa of the bowel. Using a laparoscopic approach, the detection rate of this system reached 65% when the sensor scanned the bowel at a speed of 0.3 cm/s, and applying slight pressure on the serosa. This value increased to 95% when the sensor was guided directly on the point of clip attachment. The detection rate dropped sharply when the scanning speed exceeded 1 cm/s and when the sensor-clip distance exceeded the cut-off value of 3 mm. In conclusion, the proposed detection system demonstrated its potential to offer a swift and convenient solution for the digestive laparoscopic surgeons, however its detection range still needs to be improved to render it useful for the clinical setting.

During odontogenesis, the interactions between the epithelium and the adjacent mesenchyme involve the participation of a complex system consisting of signaling molecules, corresponding receptors and transcriptional control systems. In this context, the tooth eruption is accompanied by numerous periodontal changes including bone remodeling and regressive changes in the periodontal ligament causing an increase in local cytokine production (MMP, TIMP). Understanding the ongoing process occurring in periodontal tissues during tooth development can prevent adverse consequences associated with eruption disturbances.

The health of periodontal tissues is the key to the long-term success of prosthetic restorations. A negative impact on it can have subgingival margins, an inaccurate marginal fit, materials that favor the accumulation of plaque and can suffer the corrosion process. All these characteristics can stimulate the appearance of a biological response, that can be translated by increased proinflammatory markers (interleukins, matrix metalloproteinases) in gingival crevicular fluid. The acquisition of the aspects that describe the relationship between the two elements mentioned above, could ensure a favorable prognosis of fixed prosthetic therapy.

Aim:The aim of this study was analyze peri-implantary marginal bone loss one year after the prosthetic load in association with body mass index (BMI) and other general favoring factors: metabolic disorder and high blood pressure (HTA). Material and Methods:One hundred and twenty-four patients attended the examination, 69 females and 59 males (mean age 54, range: 27-82 ). Patients were examined for demographic information, medical health history, diabetes, smoking, patient-reported height and weight, also the clinical (oral examination, periodontometry) and radiological evaluation. To determine the degree of peri-implantary marginal bone loss, it was used radiological measures. The measures were made one year after the prosthetic load with complying with the same sites and range of report for all the analyzed patients.The data were analyzed to observe the association between peri-implantary marginal bone loss one year after the prosthetic load in association with BMI and other general favoring factors: metabolic disorder and high blood pressure(HTA). Results: A reduced statistically association (r=0.111) was noticed in the correlation analysis between variables: peri-implantary bone loss and the body mass index(BMI>24.9) value. After analyzing the correlation between peri-implantary bone loss and the presence of general illnesses (metabolic disease, high blood pressure) it was noticed the existence of a reduced, but statistically significant, association (r=0.224). Conclusion:The correlation between peri-implantary bone loss and coexistence of general factors (general health issues, high BMI) is low in patients from the analyzed studygroupduring the period taken into consideration for evaluation and treatment.

The term molar-incisor hypomineralization describes an uncommon pathological entity characterized by the hypomineralization of permanent first molars and commonly affecting permanent incisors. In this paper, we describe a case of a 12 years old male patient attended with severe dental sensibility, masticatory and phonetic difficulties. Clinical examination revealed extended atypical restorations on permanent first molars, associated with opacities at the border of the restorations, enamel breakdown and opaque stains affecting permanent incisors. MIH diagnosis for this case is justified not only by the visual aspect of the lesions, but also by dental affection pattern.

The number of patients undergoing hormone replacement therapy (HRT) to counterbalance hormonal changes is increasing. Patients follow HRT not only to avoid climatic symptoms but also to protect themselves from cardiovascular disease and osteoporosis. HRT is an option for women who need drug therapy to reduce the risk of osteoporosis, including women at high risk of fracture for the next 5-10 years. Oestrogen supplementation can modulate the periodontal destruction rate through mechanisms involving inhibition of matrix metalloproteinases (MMP-8 and MMP-13) and cytokines involved in bone resorption

The metabolic syndrome is a complex pathology, multisystemic, with numerous consequences that include: high blood sugar, hypertension, visceral obesity, dyslipidemia with high levels of triglycerides (TG) and low levels of HDL. Recent studies have published in the specialty literature, data that suggest the existence of a possible association between obesity and periimplantitis. The purpose of this report cases is to explore the possible relation between the metabolic syndrome and the development of periimplantitis. To reach the proposed objective we have evaluated the characteristics of periimplant tissues in patients that have a metabolic syndrome associated.

Implantology aims at the lasting restoration of masticatory function and also of aesthetics, phonetics and patient comfort. But, at the same time, among the purposes of treatment with dental implants is the stabilization of the peri-implant bone, whose resorption is thus stopped at the time of implant insertion, as well as the peri-implant soft tissues, which are supported by the peri-implant bone and after their collapse, in the event of bone atrophy, it appears an unsightly appearance of the teeth and the contour of the gingival mucosa.

Local risk factors could influence directly the periodontium, the most often involved local risk factors being dental calculus, malocclusions, improper or aged and degraded dental or prosthetic treatments, orthodontic appliances, affecting also the masticatory, esthetical and phonetical function consequently decreasing the quality of life. A good domestic plaque control performed by the patient and its removal professionally may be insufficient for the resolution of periodontal inflammation, as the local/systemic risk factors may still favour plaque accumulation or cause a misbalance of the host immune response. Therefore, plaque removal should be always accompanied by a sustained effort of the dental practitioners’ team to correct, or to, at least, control the predisposing local and systemic risk factors.

Achievement of holistic oral health is dependent upon first carrying out a thorough examination, so as to establish a comprehensive diagnosis of patient etiologies, needs, and required therapies. Restorative therapy often includes splinting of mobile teeth, coverage of sensitive roots, and correction of occlusal abnormalities to improve periodontal prognoses. The components of a thorough clinical examination include periodontal probing depths, assessment of clinical attachment levels, hard – and soft – tissue examination, models, and face – bow records. However, it is important to realize that a complete examination begins with an open discussion with the individual patient, as a step in determining the patient’s needs and desires. In this way, treatment plans may be formulated that are in the best interest of the patient and represent a greater value for the patient. Conclussion. Simple and complex patients may be successfully treated in this periodontaly challenging context, with success being defined as long – term stability and maximization of patient comfort, function, and aesthetics.

The periodontal apparatus is very well connected with the rest of the human body, by means of vascular, lymphatic and nervous structures. These connections make the periodontal structures easily accessible to different distant pathologic mechanisms, such as inflammatory reactions, that can influence the onset and evolution of periodontal diseases. In certain situations, these influences have a mutual nature, transforming the relationship of the periodontal pathology with the systemic conditions into a bi-directional one. Understanding the mechanisms that drive and promote these pathogenic connections is important for offering periodontal patients a comprehensive treatment and for including periodontal screening for certain systemic diseases’ patients.

Obesity is a chronic , complex, multifactorial disease, which develops as a result of the interaction between genotype and life style. Up to now has not been fully elucidated the mechanism by which it occurs and is developing obesity, but it has been noted that it involves both social factors, as well as those cultural, behavioural, physiological, metabolic, and genetic. The aim of this review is to evaluate how different sistemic diseases, beside type 2 diabetes,smoking , obesity may be risk factors in the onset of perimplantitis. The association between periodontal disease and obesity has been shown in several studies to different age groups. Excessive adipose tissue produces a reduced inflammation which is a cause of oral amendments. In obesity was noticed this inflammation which can be a point of contact between this and periodontal disease or periimplantitis disease.

The study is aimed at assessing the impact that periodontal disease and chronic hepatitis C could have on gingival crevicular fluid levels of the NLRP3 inflammasome, caspase-1 (CASP-1), and interleukin-18 (IL-18) and at evaluating whether the increased local inflammatory reaction with clinical periodontal consequences is correlated to their upregulation. Patients were divided into four groups, according to their periodontal status and previously diagnosed hepatitis C, as follows: (i) CHC group, chronic hepatitis C patients; (ii) P group, periodontal disease patients, systemically healthy; (iii) CHC + P group, patients suffering from both conditions; and (iv) H group, systemically and periodontally healthy controls. Gingival crevicular samples were collected for quantitative analysis of the NLRP3 inflammasome, CASP-1, and IL-18. CHC + P patients expressed the worse periodontal status and the highest NLRP3, CASP-1, and IL-18 levels, the difference being statistically significant (p

Objectives: The aim of the study was to present the results obtained in our experiment regarding the management of postoperative enterocutaneous fistulas (PECF). Materials and Methods: We conducted a retrospective study on 64 PECF registered after 2030 abdominal surgeries (1525 digestive tract surgeries and 505 extra-digestive ones) over a period of 7 years (1st of January 2014–31th of December 2020) in the 1st and 2nd Surgery Clinics, Clinical County Emergency Hospital of Craiova, Romania. The group included 41 men (64.06%) and 23 women (35.34%), aged between 21–94 years. Of the cases, 71.85% occurred in elderly patients over 65 years old. Spontaneous fistulas in Crohn’s disease, intestinal diverticulosis, or specific inflammatory bowel disease were excluded. Results: The overall incidence of 3.15% varied according to the surgery type: 6.22% after gastroduodenal surgery, 1.78% after enterectomies, 4.30% after colorectal surgery, 4.28% after bilio-digestive anastomoses, and 0.39% after extra-digestive surgery. We recorded a 70.31% fistula closure rate, 78.94% after exclusive conservative treatment and 57.61% after surgery; morbidity was 79.68%, mortality was 29.68%. Conclusion: PECF management requires a multidisciplinary approach and is carried out according to an algorithm underlying well-established objectives and priorities. Conservative treatment including resuscitation, sepsis control, output control, skin protection, and nutritional support is the first line treatment; surgery is reserved for complications or permanent repair of fistulas that do not close under conservative treatment. The therapeutic strategy is adapted to topography, morphological characteristics and fistula output, age, general condition, and response to therapy.

Background: Natural orifice transluminal endoscopic surgery (NOTES) emerged as a new alternative method in minimally invasive techniques. Although a very small number of studies have compared the physiologic response in NOTES to laparoscopy, the results remain controversial. Aim: This experimental animal study aims to evaluate the intraoperative cardiovascular and respiratory effects of pure transluminal natural orifice surgery and conventional laparoscopy. Materials and Methods: Twenty female pigs (Sus scrofa domesticus) equally divided into two study groups were assigned to either pure natural orifice transluminal endoscopic techniques (Group 1) or conventional laparoscopic surgery (Group 2) and monitored intraoperatively in terms of heart rate (HR), systolic blood pressure (SBP) and O2saturation (SpO2) for 1 h. Both groups underwent simple surgical procedures such as gastrojejunostomy, oophorectomy and adnexectomy. Results: All procedures were successfully completed. The findings indicated statistically significant differences between SBP (P = 0.0065) and SpO2(P = 0.027) in the two groups at the beginning of the interventions. HR showed significant differences during the last 20 min of the interventions (min 40 and 45; P < 0.001). For the whole procedure (from the beginning of the intervention to 60 min interval), HR, SBP and SpO2values showed no statistical difference. Conclusions: Although significant differences in terms of HR, mean blood pressure and SpO2were noted at specific intervals during surgery, no real variance of the cardiovascular parameters was observed when considering the entire procedure. Therefore, NOTES seems to be a safe approach with minimally intraoperative cardiovascular and respiratory implications.

Nowadays we have novel equipment for lung cancer diagnosis, however; due to lack of symptoms, lung cancer is still diagnosed at a late stage. Currently we have the following therapies for non-small cell lung cancer: a) non-specific cytotoxic agents, b) targeted therapies and c) immunotherapy. Each therapy has its own advantages and adverse effects. In the current case we will present a rare case of psoriacic arthritis that was presented after two cycles of nivolumab administration and we will also present a review of the literature. Keywords: Lung cancer, Adenocarcinoma, Convex endobronchial ultrasound, PD-L1, Targeted therapy

Dental extraction can trigger certain sequences of complex processes that involve both hard (alveolar bone) and soft tissue (periodontal ligament, gingiva) remodeling. Type 2 diabetes is a serious risk factor for many oral pathologies, both in terms of progression and severity, but also regarding subsequent rehabilitation possibilities. The aim of this study was to establish whether certain molecules: osteoprotegerin (OPG), kappa B nuclear factor receptor activator ligand (RANKL), hepatocyte growth factor (HGF), tumor necrosis factor-α (TNF-α), interleukin 18 (IL-18), matrix metalloproteinase 9 (MMP-9) and oxidative stress markers—total oxidant status (TOS), total antioxidant capacity (TAC)—evaluated in saliva are modified post-extraction in type 2 diabetes mellitus subjects and whether there is a correlation with HbA1c levels. The aforementioned markers plus HbA1c were investigated in a group of systemically healthy subjects (n = 45) and in a type 2 diabetes mellitus group (n = 41) before and three months after a tooth extraction. Diabetes patients’ recorded increased levels of OPG, RANKL, TNF-α, MMP-9, IL-18 and TOS compared to controls both pre- and post-extraction. In both study groups, the average OPG, HGF and TAC level recorded an upward trend three months post-extraction. TNF-α registered a statistically significant decrease only in the diabetes group after dental extraction, together with a decrement of mean HbA1c levels in the diabetes group. By plotting the ROC (receiver operating characteristic) curve, at baseline RANKL, TNF-α, IL-18, MMP-9, TOS and OPG were good predictors of HbA1c levels. Post-extraction, there was a significant correlation between HbA1c and oxidative status biomarkers, however the linear regression model indicated the influence of all studied salivary markers in HbA1c determinism, in a considerable proportion. In conclusion, our study demonstrated that several oxidative status markers and proinflammatory biomarkers are modified in the saliva of diabetic patients and they correlate to HbA1c levels, thus being potential indicators of the post-extraction healing status in the oral cavity.

Konstantinos Sapalidis,1 Christoforos Kosmidis,1 Nikos Michalopoulos,1 Stylianni Laskou,1 Efstathios Pavlidis,1 Stelios Mantalovas,1 Dimitrios Giannakidis,1 Aikaterini Amaniti,1 Charilaos Koulouris,1 Athanasios Katsaounis,1 Alexandru C Munteanu,1 Valeriou Surlin,1 Paul Zarogoulidis,2 Isaak Kesisoglou1 1Third Department of Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Pulmonary-Oncology Department, “Theageneio” Cancer Hospital, Thessaloniki, Greece Background: In recent years, mini-laparoscopic procedures are gaining the preference of most surgeons due to their potentially better surgical outcomes. The Mini Lap Percutaneous Surgical System with MiniGrip® Handle is currently the less invasive instrument and can be applied to a wide range of operations. The current paper presents its application on percutaneous laparoscopic cholecystectomy. Materials and methods: From January 2017 to June 2017, 32 patients underwent percutaneous laparoscopic cholecystectomy with the MiniLap® system. All operations were performed by the same surgical team. Results: No conversions and no overall complications were reported. Drainage were not necessary. Mean surgical time was 35 minutes, while patients were released in

(1) Background: The aim of this split-mouth design study was to analyze the clinical periodontal indexes and oxidative stress markers in gingival crevicular fluid modifications after three periodontal disease treatment possibilities (scaling and root planning—SRP; SRP and diode laser—L; SRP and photodynamic therapy—PDT). (2) Methods: The study was conducted on 52 patients: systemically healthy subjects with periodontal disease—non-RA (n = 26); and test group (n = 26) subjects with rheumatoid arthritis and periodontal disease—RA. Clinical periodontal measurements (probing depth—PD; Löe and Silness gingival index—GI; papillary bleeding index—PBI; and periodontal community index of treatment needs—CPITN) and oxidative stress markers (8-hydroxy-2’-deoxyguanosine (8-OHdG) and 4 hydroxynonenal (4-HNE)) were analyzed at baseline (T0), after three sessions of periodontal treatment (T1), and 6 months after treatment (T2). (3) Results: Periodontal therapy improved clinical periodontal measurements and oxidative stress markers in both analyzed groups, with supplementary benefits for laser- and PDT-treated periodontal pockets. (4) Conclusions: The analyzed oxidative stress markers decreased significantly following non-surgical periodontal therapy in both rheumatoid arthritis and systemically healthy patients. All the periodontal disease treatment possibilities analyzed in this study offered clinical and paraclinical improvements; however, the association of laser with SRP and photodisinfection with SRP yielded the best clinical and paraclinical outcomes when compared to SRP alone.

Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects’ immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients’ saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients’ inflammatory status.

Aim of the study The main goal of our study was to highlight the changes of preclinical and clinical periodontal status indices in a group of children and teen-agers with insulin-dependent diabetes (IDDM). Material and methods For objectifying our purpose 60 children, aged 7 to 18 years divided into three groups of 20 subjects each were examined: control group - children without diabetes, with good general condition, but with varying degrees of periodontal involvement, IDDM batch with good metabolic control (HbA1c ˂7,5%) and IDDM group with poorly metabolic control (HbA1c ˃7,5%). On all these subjects the following parameters were assessed: plaque index - Quigley-Hein (QHI), gingival index (GI), clinical attachment loss (CAL). The gingival crevicular fluid (GCF) volume from mesial sites of the incisors and first permanent molars was also evaluated. Results Our results show no significant differences in plaque index values between control and diabetic groups. Statistically significant differences were recorded when considering gingival index, higher values being recorded in children with IDDM and especially those with poorly controlled metabolic control, compared to control group. Clinical attachment loss registered augmented levels in children with IDDM compared to the control group, and in terms of measuring the GCF volume, values have been found significantly elevated in diabetics compared to control group, the largest being recorded in poorly metabolic controlled diabetic children and teen-agers. Conclusions Among the values of the evaluated indices, the highest increases were observed with parameters associated to significant inflammation, GI and GCF volume respectively. Our results are consistent with scientific literature in the field that claims inflammation as a major mechanism involved in the pathogenesis of both disorders: periodontal disease and diabetes.

Background. Wound healing is a tissue repair process after an injury, and two of its main components are inflammation and angiogenesis, in which course a cascade of mediators is involved. The aim of this research was to evaluate the involvement of Pentraxin 3 and Thrombospondin 1 in wound healing after periodontal surgery (gingivectomy) for gingival overgrowth during orthodontic treatment with or without magnification devices, by assessing their levels in GCF. Methods. From 19 patients with gingival overgrowth as a result of fixed orthodontic treatment, the overgrown gingiva was removed by gingivectomy, from one half of the mandibular arch without magnification and from the other under magnification. Pentraxin 3 and Thrombospondin 1 were determined from gingival crevicular fluid by ELISA tests. Results. Statistically significant differences (p

Diabetes, a pathology that is extremly widespread, involves an alteration homeostasis in the glucose metabolism. Periodontitis is a infectious disease resulting in irreversible destruction of the tooth attachment apparatus. At present, periodontitis is one of the major reasons for adult tooth loss. The periodontal clinical examination determined the following diagnosis categories: chronic gingivitis and chronic periodontitis , all of them being modulated by the systemic disease. Aim of the study is to highlight possible correlations between periodontal status and diabetic clinical parameters characterizing patients diagnosed with type 1 diabetes(T1D). Material and methods This study was conducted on 62 patients. We analysed the general information of the patients and an oral examination for establishing the parodontal diagnosis. The probing depth has been established, number of teeth with pockets Larbert than 6mm and the plaque index Silness and Loe. Results Significant differences were found between the IP values on children and adults but there were no significant differences between IP on GTA and GCA or between IP on GTC and GCC. We did not find a statistically significant correlation between HbA1c and severity of periodontal diagnosis GTC. But found a direct correlation between HbA1c and statistically significant in periodontal diagnosis GTA. Conclusions The results obtained in this study show a possible relationship between metabolic changes caused by periodontal T1D and, especially in the group of adult patients.

Deep accidental hypothermia is an unusual clinical entity in developed countries. We report a case of a 30 year old male Caucasian patient with accidental severe hypothermia who was transferred to the emergency department of our hospital after prolonged exposure in the urban city's night environment cold as a result of alcohol and drugs abuse. The patient was found unconscious in the first early hours from onlookers. The time that the patient remained unconscious is unknown. During the transfer to the hospital because of cardiac arrest cardiopulmonary resuscitation began. In the emergency department an extracorporeal life support system (ECLS) was implanted under cardiopulmonary resuscitation in order to achieve hemodynamic stabilization and rapid and safe rewarming. The patient's rewarming lasted 6 hours. The patient was extubated the next day. Keywords: Hypothermia, Resuscitation, ECMO, Cardiac arrest

In the recent years, statistically significant associations between rheumatoid arthritis (RA) and periodontal disease have been identified. Emerging as a chronic inflammatory joint disease, RA displays various features and pathogenetic events similar to chronic periodontitis (CP). The purpose of this study was to evaluate the utility of determining systemic and crevicular levels of metalloproteinase-9 (MMP-9) as potential biomarkers for association between RA and CP. A total of fifty-six patients were included in the study. The subjects were categorized into four groups as follows: healthy-control (n=21), active RA (n=16), CP (n=14), and RA-CP association (n=12). Assessment of serum and crevicular concentrations of total MMP-9 (active and pro-MMP-9) was based on ELISA technique. The results of this study showed statistically significant differences of serum MMP-9 between patients groups and control. Serum levels of MMP-9 were similar in RA and RA-CP associated patients. Gingival crevicular fluid (GCF) recorded increased MMP-9 levels in RA-CP association subjects as compared to CP. Considering that RA-CP association is characterized by a disregulation of the inflammatory response, MMP-9 may play a role in the pathogenesis of RA-CP association. MMP-9 is therefore a sensitive tool in the diagnosis and management of patients affected by this binomial association.

In the present study the aim was to measure the levels of Thrombospondin-1 (TSP1) and Lipocalin-2/matrix metalloproteinase 9 (MMP9/NGAL) complex in gingival crevicular fluid (GCF) at different time points of orthodontic treatment, to determine the relationship between these values and those of total-matrix metalloproteinase 9 (MMP9) and theirs implication in angiogenesis balance, in the situation of a good control of the bacterial plaque, emphasizing the role of TSP1 and MMP9/NGAL complex. GCF samples were collected from 16 young orthodontic patients requiring upper canine distalization (test tooth) with first premolar extraction. The contralateral canine (control tooth) was free from orthodontic force. For the orthodontic appliance, brackets Roth 0.018 inch with 0.012 inch NiTi archwire and a laceback were used. TSP1, MMP9/NGAL, and MMP9 increased from 1 hour before activation of orthodontic appliance to a maximum at 8 hours for MMP9 and 72 hours for MMP9/NGAL and TSP1. The results show a change in time of TSP1, MMP9/NGAL, and MMP9 levels in GCF of patients with this method of orthodontic treatment. The powerful correlation of MMP9/NGAL with TSP1 suggests their stronger involvement in angiogenesis processes in PDL during orthodontic periodontal remodeling, in the situation of a healthy periodontium and a good control of the bacterial plaque.