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The main purpose of the study was to highlight the incidence of various changes in the oral mucosa associated with wearing removable acrylic dentures. Materials and method. The study was performed on a total of 45 subjects who presented at the Prosthodontics Clinic and the Oral Rehabilitation Clinic of Craiova Faculty of Dental Medicine during January 2018-May 2020. Results. Of the 45 subjects that were wearing at least one acrylic denture 31,11% presented oral mucosa changes or lesions. The most common mucosal lesion was type 1 according to Newton's classification.

Reducing the thickness of hard dental tissues through the preparation of teeth for fixed prosthodontics represents an aggression for the dentin-pulp complex and may cause changes in dental pulp tissues, by means of acute or chronic inflammation, or by asymptomatic, atrophic modifications.The aim of the study was to histological and immunohistochemical evaluate samples of dental pulp selected from previously prepared teeth, which had been functioning as abutment teeth for some years.The starting point of the study was a statistical study conducted on a batch of 276 patients, of which 64 needed to change the fixed prosthetic restorations. Some of the existing abutment teeth were extracted, others presented previously performed root canal treatments and others required endodontic treatment.Of the 21 samples taken, 12 showed atrophic pulp modifications, represented by low cellularity, collagen fibrosis, vascular congestion, and pulpal calcifications.Certain irreversible atrophic changes can be observed in abutment teeth's pulps, a fact that justifies the need of performing pre-prosthetic endodontic treatment.

Zirconia is a metal used in dental implantology. Its biocompatibility was studied in vitro and in vivo, results of the studies being analyzed in reviews and meta analyses. The aim of this systematic review was to evaluate biocompatibility of zirconia in animal studies in vivo expressed as results of histomorphometric tests. Databases were searched from 1980 until February 2016, with different combination of the following MeSH terms: zirconium, biocompatibility, dental implants, in vivo, animal studies. Letters to the editors, case reports, commentaries, review articles and articles published in other languages then English were excluded. The search of PubMed, ScienceDirect and Google Scholar databases yielded 690 titles. After abstract screening and duplicate discarding 50 articles were identified and finally, 40 were included in the review. Most of the studies compared zirconia with titanium, a well established material for dental implants. In majority of the studies zirconia showed a similar osseointegration with titanium. Surface implant treatments, like sandblasted and etched zirconia (ZrO2-SLA), alumina toughed zirconia (ATZ), and powder injection molding (PIM) were used to improve osseointegration of zirconia with good results. In the light of histomorphometric test, zirconia, no matter physical and structural forms tested, is a biocompatible material.

Periapical granuloma is one of the most frequent periodontal pathology and belongs to the group named as apical periodontitis.Out of 78 of diagnosed granulomas, we selected samples that we analyzed histologically and immunohistochemically.The histopathological aspect has been dominated by the presence of mononuclear cells of the lymphocyte and plasma cells type, showing the chronic aspect of the apical lesion. Also, we noticed that in the apical granuloma macrophages occur most often. This density of macrophages explains cellular and tissular disruption that occur in apical region of the tooth under the influence of bacterial flora that reached this area, as they have the role to phagocyte pathogens and cell and tissue residues that result from bacterial aggression. The reaction of the plasma cells, determined by their number, has been always associated with the age of the granulomas, and it is more intense in old, neglected granulomas, compared to recent granulomas.The number and type of immunity cells varies in the apical granuloma accordingly to the age of granuloma.

AIM: To evaluate the clinical performance of adhesive restorations of resin-modified glass-ionomer cements (RMGIC) compared with of resin composite (RC), and RMGIC liner base laminated with a resin composite in non carious cervical lesions (NCCL).METHODS: The randomized clinical trial included 45 patients (25-65 year-old), with at least two similar sized NCCL on premolars. After sample size calculation, 220 restorations were placed, according to one of the following groups: (G1) Resin-modified glass-ionomer cement (Vitremer); (G2) a resin composite and an adhesive layer (Versaflo); (G3) RMGIC liner base laminated with a resin composite (Vitremer and Versaflo). The restorations were clinically followed every 6 months for up to 24 months using the USPHS modified criteria for clinical evaluation. Survival estimates for restoration longevity were evaluated using the Kaplan-Meier method. Log-rank test (P< 0.05) was used to compare the differences in the success rate according to the type of the restorative material.RESULTS: At the end of 24 months, 172 restorations were evaluated in 37 patients, with a recall rate of 82.22%. The type of restorative material used did not influence the longevity of the restorations. The survival rates for the follow-up were similar regarding the number of restored surfaces and the tooth (upper or lower premolar). Estimated survival rates of the restorations were 100%, 100%, 98,25% and 90,69% at 6, 12, 18 and 24 months of clinical evaluations, respectively. A statistically significant difference was observed between RMGIC and RC or RMGIC laminated with RC for color match, but no other significant difference was observed among the three types of restorations.CONCLUSIONS: The survival rates were similar for the three types of restorations in NCCL. Different types of materials demonstrated acceptable clinical performance in non-carious cervical lesions.

The article presents the experience of a new therapeutic method, addressing postoperative implant pathology.Methods: Hyaluronic acid has been used in the management of various mucoperiosteal pathologies (directing secondary healing of oral wounds, restoration / increasing the volume of connective tissue – periosteal preoperativ or the papillary volume).Hyaluronic acid used had different concentration. The presentation forms both viscous and fluid particle size and type/acid’s grade of complexation) provided various therapeutic effects with specific indication of administration respected by the authors. Different products available at this time in Romania were used analyzing the results in time.Results: This therapeutic approach provided a good management in secondary granulation and wound healing of oral tissues in difficult cases (GBR, implant therapy) in which the persistence of dehiscence wound can cause a failure of surgical treatment (loss of membrane, alloplastic material or implant).Conclusion: This results places this innovative therapeutic method with others successful therapeutic solutions in usual dental practice, providing a quick and efficient settlement of some difficult clinical cases.

Tongue squamous carcinoma can be found in many forms, having a lot of risk factors, and whose morphological characteristics can be used as a prognostic. The purpose of this study was to histologically characterize a number of 54 patients diagnosed between 2012-2014, with tongue squamous carcinoma. Surgical resection specimens of tongue tumors were processed by paraffin inclusion technique. The diagnose samples were reevaluated according to the World Health Organization (WHO) criteria for head and neck tumors diagnosis, by screening the Hematoxylin-Eosin staining sections. The most common histopathological variety of tongue carcinoma observed in our cases was the non-keratinized form, the basaloid and sarcomatoid types of carcinoma being ranked on the last places. The study outlined the prevalence of non-keratinized forms of tongue squamous carcinoma and all types of tumoral invasion patterns have been observed in different percentages.

The aim of the present study was to evaluate the oral status in a group of institutionalized individuals from Craiova, a city in South-Western Romania. Also, another objective of the study was to highlight the clinical, histological and immunohistochemical (IHC) aspects of periodontal disorders in the elderly. The study was performed on 48 institutionalized individuals examined in the Clinic of Dental Prosthetics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Romania, in 2013. The data were collected using medical records and intraoral clinical examination. The data were processed by descriptive statistical analysis. The gingival mucosa samples were harvested from subjects with teeth mobility. The gingival fragments collected were processed through the histological technique of paraffin inclusion. The serial sections were commonly stained with Hematoxylin-Eosin and processed by the IHC technique with anti-CD3, anti-CD45RO and anti-CD20 antibodies. Of the 48 study participants, 20 were males, 28 were females, aged over 56 years old. 66.6% of them had poor oral hygiene, with a mean simplified oral hygiene index (OHI-S) of 1.57, 16 had the generalized periodontitis, three experienced some form of gingival overgrowth at the remaining teeth caused by incorrect fixed prosthesis, and 25 participants presented a form of periodontitis with gingival retraction. Gingival mucosa samples were histologically diagnosed with papillomatosis with discrete parakeratosis and rich chronic inflammatory infiltrate. The IHC reactions for the studied antibodies were different for T- and B-cells, which had different disposition in lamina propria.

There are several important non carious lesions affecting the tooth structure, lesions which may be classified into four clinical forms of dental wear: abfraction, erosion, attrition and abrasion, and different types of root resorption. Search for new, non-invasive and fast methods able to detect and describe such injuries is of utmost importance. Optical coherence tomography (OCT) proved itself as an appropriate investigation method for several medical fields including ophthalmology, dermatology, cardiology etc. Our study reveals OCT preliminary investigations as a promising tool for detecting and evaluating of the mentioned lesions.

Dental wear represents an irreversible loss of dental hard tissue under the action of physical, chemical and mechanical factors, excluding dental caries and acute trauma. Four clinical forms of dental wear are described: erosion, attrition, abfraction, and abrasion. Most experts agree that in each clinical form multiple etiological factors are involved, one being predominant. Optical coherence tomography (OCT) is a non-invasive optical method characterized by a micronic resolution. The applications of this type of investigation are multiple in the medical field in recent years, and OCT is gaining a growing importance in dentistry. The study pointed out through OCT imaging for the erosive tooth wear lesion the existence of chemical aggression, with strong demineralization of enamel and dentin. For attrition lesion, OCT images showed the contribution of excessive force and friction movements specific to bruxism. In abfraction, OCT image revealed the importance of the mechanic factor in producing this form of tooth wear and abrasion damage studied may be considered physiological, according to patient age. OCT examination may reveal existing lesions in hard dental tissues for each clinical form and could bring evidence on the mechanisms involved.

Pathological external root resorption is a process by which the hard tooth substance is lost because of action of different local irritative or systemic factors. Six forms of external root resorption are described: surface external root resorption, inflammatory external root resorption, replacement external root resorption, invasive external cervical root resorption, ankylosis and transient apical breakdown. The objective of the study was to establish the prevalence of the pathological root resorption in a retrospective radiological study, to highlight radiological aspects of external root resorption and to describe optical coherence tomography (OCT) aspects in pathological root resorption. External root resorption prevalence in our study was 17%. Radiological exam was very useful to detect the form of root resorption but also to establish possible etiological factors. The study presents the radiological aspects of some forms of pathological external root resorption highlighted on radiography accompanied by radiolucency of the adjacent bone to resorption lesion (as in inflammatory external root resorption and in invasive cervical root resorption) or as changes of the root form, in which the missing part of the root is replaced by the bone tissue, without radiolucency (as in replacement root resorption). The comparison of the OCT aspects of the physiological root resorption in primary teeth with the OCT aspects of pathological root resorption in permanent teeth showed an obvious difference between the images of the OCT signal of the two types of resorption. The OCT signal from the cement is stronger in pathological root resorption, and the OCT signal from the dentin in teeth with inflammatory external root resorption showed a demineralized dentin with multiple heterogeneities, anfractuosities corresponding to resorption craters, with craze lines in subjacent layers of dentin.

Hypertension is a common disease encountered in dental setting. Its wide spreading, terrible consequences, and life-long treatment require an attentive approach by dentists. Hypertension management in dental office includes disease recognition and correct measurement, knowledge of its treatment and oral adverse effects, and risk assessment for dental treatment. Dentist role in screening undiagnosed and undertreated hypertension is very important since this may lead to improved monitoring and treatment.

The overgrowth, depending on its extension, has multiple effects on the stomatognathic apparatus: functional disorders (impaired speech), difficulty in chewing and aesthetic problems but can cause significant psychological problems. We proposed this study, motivated by the relative increased frequency of the gum outgrowth, its multifactorial etiopathogeny, but especially from the point of view of the specialist practitioner, by the problems that this pathology raises not only for the functionality of the stomatognathic apparatus but also for the facial esthetics, and especially for future therapeutic attitudes needed to solve the existing pathology at this level. We conducted a clinical study and a histological one. For the clinical study, we selected 74 patients who experienced different degrees of gingival outgrowing associated with fillings, dental caries, fixed prostheses, mobile prostheses, orthodontic apparatus. Thirty gingival fragments from patients with gingival outgrowing were processed by paraffin-embedding histological technique and stained with Hematoxylin-Eosin. The morphological results obtained provide the necessary support for understanding the possibility of developing a therapeutic strategy to prevent or minimize the gum outgrowth by administering antibiotic and anti-inflammatory medications associated with medications, which shall cause the apoptosis of the fibroblasts.

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

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

The histological changes of the oral mucosa in contact with a metal alloy dentures is one of the current issues widely debated in the literature.To highlight the expression of vascular endothelial growth factor (VEGF) in human paraprosthetic gingival mucosa exposed to nickel and copper compounds using the immunohistochemical technique. The selected participants were wearers of fixed dentures made of nickel-based alloys and copper-based alloys. The gingival mucosa fragments were prelevated through excision after removing fixed denture and extraction one of its affected teeth. The gingival mucosa fragments were processed through the histological technique of paraffin inclusion. The paraffin-embedded tissue sections were usually stained with Hematoxylin-Eosin and processed by immunohistochemical technique with VEGF antibody. The gingival mucosa fragments from nickel-based alloys dentures wearers were diagnosed with papilloma and, also, gingival mucosa samples prelevated from copper-based alloys dentures wearers were diagnosed with condyloma acuminata. Immunohistochemical reaction for VEGF was different in the gingival mucosa fragments with papilloma compared with condyloma acuminata samples. In papillomatosis gingival mucosa fragments, VEGF was implicated in principal in vasodilatation and inflammation process, and secondary in angiogenesis. In gingival mucosa fragments with condyloma acuminata, the principal role of VEGF was in angiogenesis and secondary in inflammation.

The oral mucosa is a component of the oral ecosystem, which can be aggressed by corrosion products released from the dental alloys used in prosthetic dentistry therapy. The purpose of this study was to compare the in vivo effect of nickel and copper compounds on the oral mucosa cells, including their ability to induce cell death, by analyzing the cytochrome c (cyt. c) immunohistochemical expression. Gingival mucosa fragments obtained from the subjects with dentures manufactured by nickel or copper casting alloys were processed through the histological technique of paraffin inclusion. The sections obtained were stained by usually histological methods in order to highlight the histopathological lesions and also analyzed using the immunohistochemical technique in order to study the cyt. c expression. The papillomatosis lesions were observed in the gingival mucosa fragments obtained from the subjects with nickel-based alloy dentures and the condyloma acuminata lesions were observed in those obtained from the subjects with copper-based alloy dentures. The cyt. c immunohistochemical expression was different in the epithelial layer of two types of mucosal fragments but it was the same in their lamina propria connective tissue. We can conclude that the two types of metal alloys have different effects on the adjacent gingival mucosa.

The article discuss the case of an edentulous patient presented to the dental clinic for pain and burning sensation of oral mucosa and diagnosed subsequently with oxyphilic adenoma. A 58-year-old patient, with maxillary edentulism, treated with complete denture, presented to the Clinic of Prosthetic Dentistry of the Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Romania, for pain of oral mucosa and bad stability of denture. The diagnosis of erythematous denture stomatitis as consequence of salivary flow reduction was establish after patient's clinical examination, and by unstimulated sialometry. Clinical exam suggested hyposalivation could be a consequence of a tumor situated at the level of the left parotid gland. The echography confirmed the diagnosis of left parotid gland tumor. The tumor was surgical removed and histopathological exam confirmed oxyphilic adenoma. Education of patient for wearing new denture while maintaining a strict oral hygiene and dealing with low salivary flow was the treatment for denture stomatitis. General dentist has an important role in finding and diagnosing patients with systemic diseases, especially salivary tumors.

Commonly is accepted that a non-vital tooth has a higher risk of root fracture but there is a relatively little knowledge about the specific biomechanical behavior of non-vital frontal teeth with chronic apical periodontitis. The aim of our study was to evaluate the deformation and tensile generated in these teeth while vertically loading them because it is crucial to assess the moment when the absorbed occlusal forces exceed the elasticity of root dentine. Using the method of finite-element analysis, we highlighted the distribution patterns of the compressive and tension tensile, as well as their concentration areas. The vertical forces of 100 N generate deformations of no clinical risk in teeth with chronic apical periodontitis. The tensile developed in these teeth are higher than those in the vital teeth are but do not exceed the value of the elastic modulus of the radicular dentin. By increasing the force to 300 N occur elastic deformations, which cannot be neglected anymore. Even so, the 300 N forces do not generate deformations of the alveolar bone. The highest tensile at loading with 300 N was generated in vertical direction but in the cervical area of the tooth also developed tensile in lingual and mesiodistal direction that must be taken into consideration because they are near the risk limit of the elasticity modulus. The crack lines or fractures can appear both in case of excessive or even usual but accumulative occlusal forces that gradually alter the mechanical resistance of the tooth.

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

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

The variations of anatomical and morphological characteristics of the teeth are very important for any practitioner. These differences in root morphology are influencing the success of the endodontic therapy and the long-term prognosis of the tooth, especially when it is an abutment for a prosthetic restoration. Before beginning an endodontic treatment, the clinician must take into account the morphological variations of the root anatomy. This article describes the therapeutic approach in a case of mandibular second molar with four canals abnormally located instead of three. This anatomical variation is a major risk for both endodontic and prosthetic treatment failure. The lack of knowledge of root and pulp anatomy permits the errors in diagnosing and treatment planning. Unfilled canals, left like this by omission, can compromise both the endodontic and prosthetic treatment. For the success of the any dental treatment is critical to know the normal configuration of the pulp and to be aware of the possible variations.

The edentulous ridge's mucosa presents various histological aspects and different histoenzymatic equipment. These aspects are determined by constitutional factors (genetic, nutritional), as well as by age and by the associated pathology. The purpose of this paper is to evidentiate, through histochemical techniques, the aerobe (NADH2-cytochrome-c reductase) and anaerobe (lactatdehydrogenase) oxidoreducing enzymatic activities, as well as the hydrolytic enzyme's activity (ATP-ases, pH 9.4), corroborated with the histological aspects of the edentulous ridge's mucosa. The enzymatic activity and the morphological alterations present various aspects, depending on the metabolic type (aerobe oxidative, anaerobe oxidative, hydrolytic), according to the mucosal area (epithelium, chorion), to the different cell types, or even within the same cellular type (especially at the level of the connective lamina propria cells). They also vary from one edentulous patient to another, depending on the existence of a previous prosthetic treatment and on the type of this treatment. The local clinical examination, sustained by a histoenzymatic investigation, reveals the importance of the structural alterations and they can offer guidance for the proper prosthetic treatment and for the achievement of functional prosthetic restorations that provide the oral mucosa its necessary trophicity for as long as possible.

The oral mucosa of the edentulous ridges presents many morphological macroscopic and microscopic variations, from one area of the edentulous ridge to another, as well as from one patient to another. Because the mobile prosthetic treatment realizes a direct contact between the dental prosthesis and the mucosa of the denture supporting structures and of the peripheral structures, the prosthetic success depends on establishing a correct and long lasting relation between them. The present article's purpose is to present the pro-prosthetic and prosthetic treatment possibilities for partial or complete edentulous patients who have variations of the mucosa of the residual ridges, as well as to present the histopathological importance of these variations. The mucosal characteristics essentially influence the attitude in the different treatment phases of a mobile dental prosthesis, the prosthetic success depending on the establishment of a correct and long lasting relation between the dental prosthesis and the oral mucosa.

The multiple and various changes that the human gingival mucosa undergoes when coming into contact with a denture, require a histopathological study correlated with that of clinical manifestations. The highlighting of the histological lesions of the prosthetic field's mucosa is extremely important in the study concerning the tolerance of the oral cavity tissues towards the materials of dentures, because it has been observed that different materials can cause the same type of clinical changes. The clinical research has been carried out having as a basis a group of patients, carriers of fixed dentures made of different materials, the study method consisting in their clinical evaluation. The investigation of microscopic preparations, obtained through drawing mucosa from those patients under study, has been made by using both usual colorations for an overall examination of the tissue architecture, as well as special colorations for pointing out certain structures. The results of the investigation have made clear the fact that the clinical changes of the prosthetic field's mucosa can be adaptable to the denture or can react pathologically to the various possibilities of denture aggression. The histopathological picture of the paraprosthetic mucosa lesions is polymorphous due to the morphofunctional complexity as well as to the reacting capacity of the oral mucosa when interfering with a fixed denture.

Evaluate the antigen profile of cellular population from basal cell adenomas.Histopathological and immunohistochemical evaluation of four-salivary gland basal cell adenomas; the pathological samples were provided by the Oral Maxilla Facial Surgery Department of the Clinical County Hospital from Craiova.All basal cell adenoma exhibit differentiation toward 3 cell phenotypes: ductal luminal, basal and myoepithelial.The antigen profile of these tumors closely regard with other variants of salivary gland adenomas, such as pleomorphic adenoma and myoepithelioma. So, we can conclude that these tumors had a common origin, most probably from intercalated ducts and the proportion of those 3 cellular types, their cytoarchitectural arrangements and the quantity of extracellular matrix production can do the differentiation between them.