Monica Scrieciu

Hypertensive Patients and Their Management in Dentistry

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.

Dental Anxiety and its Association with Behavioral Factors in Children.

Background: Dental anxiety is a condition that causes a decrease in population addressability to the dentist with adverse consequences for long-term oral health. Assessment of behavioral factors that correlate with dental anxiety is important for accurate evaluation of dental fear. Its diagnosis in childhood is important for establishing therapeutic management strategies to reduce anxiety and promote oral health. Objective: To determine the prevalence of dental anxiety in a group of Romanian schoolchildren, and assess its correlation with behavioral factors. Methods: This cross-sectional survey included a number of 650 schoolchildren attending public schools, randomly chosen. Data were collected from September 2013 to October 2013. 485 children aged 6–12 years responded the questionnaires and were included in the study (248 female, 237 male). Each subject was asked to independently complete a questionnaire including Dental Anxiety Scale (DAS) and other questions about children behavior towards dental health education and practice. Children having a score of 13 and above were included in the anxious group while those scoring under 13 were placed in the non anxious group. The data collected was processed and analyzed using the SPSS statistical software. Results: The overall prevalence of dental anxiety was 22.68% amongst subjects included in the study. No significant differences in dental anxiety scores between boys and girls were found in this study. Dental anxiety scores decreased with increasing age. Dental anxiety correlated positively with chewing gum use and sweet consumption frequency and negatively with age and dental health education. Conclusions: Prevalence of dental anxiety in the 6–12 year old children of this study was 22.68%. Factors like chewing gum use, sweet consumption frequency, age and dental health education were correlated with dental anxiety.

Zirconia Biocompatibility in Animal Studies - A Systematic Review

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.

OCT investigation of dental lesions

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.

OCT aspects of dental hard tissue changes induced by excessive occlusal forces

The study purpose is to highlight dental hard tissues changes of a tooth with dental wear as a consequence of excessive occlusal forces, using OCT. Methods: a central incisor extracted for periodontal reason was cleaned and it was embedded in a black acrylic resin block. The block was sectioned along the longitudinal axis of the tooth and prepared for OCT analysis. Results: The OCT signal showed differences between the labial and palatal dental hard tissue structures, even in areas without excessive occlusal solicitations. Conclusion: The OCT signal highlights changes of dental hard tissues structures according to excessive occlusal solicitations areas.

The Clinical Approach in A Case of An Endodontic Therapeutic Failure At Upper First Molar Level (Clinical Case)

The persistence of functional teeth on the arch for a long enough period of time represents an accomplished goal due to the existence and constant improvement of the conservative means of treatment. The misapprehension regarding the complexity of endodontic space is one of the various failures of the endodontic treatment. The aim of this article is to emphasize the clinical approach of a retreatment case of endodontic therapeutic failure at upper first molar level. First, it would be preferable to try an orthograde endodontic retreatment because this is the most conservative way of treatment. Keywors: upper fist molar, endodontic space, orthograde endodontic retreatment

Randomized Clinical Trial of Adhesive Restorations in Non Carious Cervical Lesions

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.

Comparative Study Regarding Two Obturation Methods with Thermoplasticized Gutta-Percha for the Root Canals

AIM: This study draws a comparison, through the transparentization method, focusing on the quality of the canal obturation made with thermoplasticized gutta-percha, between two different systems: GuttaMaster VDW (München, Germany), based on obturators made of a plastic core, covered in alpha gutta-percha, and a system of vertical warm condensation.MATERIALS AND METHODS: The study focused on twenty teeth extracted for various reasons which underwent the endodontic treatment realized through a hybrid technique, using the rotary files system of NiTi MTWO (VDW, München, Germany), and the manual files k-file type (Kendo, VDW, München, Germany). The teeth were distributed into two groups of ten. The teeth in the first group underwent obturation using the CWC technique of vertical warm obturation, and the teeth in the second group underwent root obturation using the GuttaMaster system (VDW, München, Germany). The teeth were decalcified in nitric acid. Using the method of transparentization with methyl salicylate, there were emphasized aspects regarding the abilities of each method to seal three-dimensionally the endodontic space.RESULTS: The teeth which underwent vertical obturation presented many more holes in the obturation material, holes situated mainly in the medial and coronary third. However, these teeth presented the highest degree of insertion in the lateral canals, as compared to the other obturation technique employed. The homogeneity of the root obturation had not had any statistical significant differences between the two techniques. However, the technique of injecting thermoplasticized gutta-percha was superior to the other one regarding the tightness on the edge and the degree of penetration in the lateral canals.CONCLUSIONS: The knowledge of both the qualities and the limits of the obturation material chosen, as well as the correctness of performing the two techniques, determines a definite improvement of the quality of the canal treatment, which ends with a three-dimensional canal obturation.

Face Basosquamous Carcinoma, a Case Report.

Face basosquamous or metatypical carcinoma is a rare and controversial form of skin cancer. It is characterized by increased incidence of recurrence and distant metastases. We present the case of a patient of 71 years with an ulcerative lesion of 3/4 cm in the nasal pyramid. The injury occurred due to trauma to the nasal pyramid, produced 13 years ago. After investigation, which included ORL examination, imaging and oncology exam, surgery was decided to completely ablate tumor formation. The resulted defect of 4/5 cm was covered by mobilizing a forehead flap based on right supratrohleare artery pedicle. Histopathological examination revealed the diagnosis of basosquamous or metatypical carcinoma. The patient was referred to the oncology service for treatment.