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Staicu AN, Țuculină MJ, Cumpătă CN, Rîcă AM, Beznă MC, Popa DL, Popescu AD, Diaconu OA. A Finite Element Method Study on a Simulation of the Thermal Behaviour of Four Methods for the Restoration of Class II Cavities. J Funct Biomater 2024; 15:86. [PMID: 38667543 PMCID: PMC11050888 DOI: 10.3390/jfb15040086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
The possibility of dental pulp damage during dental procedures is well known. According to studies, during finishing and polishing without cooling, temperatures of up to 140 °C or more can be generated. There are many studies that have analysed the influence of the finishing and polishing of fillings on the mechanical parameters, but the analysis of thermal parameters has led to uncertain results due to the difficulty of performing this in vivo. Background: We set out to conduct a study, using the finite element method, to determine the extent to which the type of class II cavity and the volume of the composite filling influence the duration of heat transfer to the pulp during finishing and polishing without cooling. Materials and Methods: A virtual model of an upper primary molar was used, with a caries process located on the distal aspect, in which four types of cavities were digitally prepared: direct access, horizontal slot, vertical slot and occlusal-proximal. All four cavity types were filled using a Filtek Supreme XT nanocomposite. Results: The study showed that the filling volume almost inversely proportionally influences the time at which the dental pulp reaches the critical temperature of irreversible damage. The lowest duration occurred in occlusal-distal restorations and the highest in direct access restorations. Conclusions: based on the results of the study, a working protocol can be issued so that finishing and polishing restorations without cooling are safe for pulpal health.
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Affiliation(s)
- Adela Nicoleta Staicu
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.N.S.); (A.M.R.); (A.D.P.); (O.A.D.)
| | - Mihaela Jana Țuculină
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.N.S.); (A.M.R.); (A.D.P.); (O.A.D.)
| | - Cristian Niky Cumpătă
- Department of maxillofacial surgery, Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 67A Gheorghe Petrascu Str., 031593 Bucharest, Romania
| | - Ana Maria Rîcă
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.N.S.); (A.M.R.); (A.D.P.); (O.A.D.)
| | - Maria Cristina Beznă
- Department of Pathophysiology, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Dragoș Laurențiu Popa
- Department of Automotive, Transportation and Industrial Engineering, Faculty of Mechanics, University of Craiova, 200478 Craiova, Romania;
| | - Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.N.S.); (A.M.R.); (A.D.P.); (O.A.D.)
| | - Oana Andreea Diaconu
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.N.S.); (A.M.R.); (A.D.P.); (O.A.D.)
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Țuculină MJ, Staicu AN, Munteanu MC, Cumpătă CN, Dimitriu B, Rîcă AM, Beznă MC, Popa DL, Popescu AD, Țîrcă T. Study on the Restoration of Class II Carious Cavities by Virtual Methods: Simulation of Mechanical Behavior. J Funct Biomater 2023; 14:354. [PMID: 37504849 PMCID: PMC10381501 DOI: 10.3390/jfb14070354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
The restoration of class II cavities is predominantly carried out with composite materials. Due to the high failure rate in restoring this type of cavity, composite materials with much-improved properties and new application techniques have been promoted. The study aimed to analyze the mechanical behavior of several topical composite materials (nanocomposites, nanohybrids and ormocer) using different application techniques. In a lower second molar, a class II occlusal cavity was prepared. As filling materials, we used the following combinations: Admira Fusion and Admira Fusion Flow, Grandio and Grandio Flow, Filtek Supreme XT and Filtek Supreme Flow. These were applied using a snow plow, injection molded and Bichacho techniques. Three-dimensional scanning of the molar with the prepared cavity was performed, and then scanning of each layer of added composite material was performed, obtaining three-dimensional models. The virtual molar models were analyzed with software specific to the finite element analysis method, where their physical-mechanical properties were entered and assigned to the components of the virtual molar. Simulations at high forces specific to bruxism were then carried out and analyzed, and compared. The values of displacements and strain, for all six analyzed situations, are relatively small (range from 5.25 × 10-6-3.21 × 10-5 for displacement, 6.22 × 10-3-4.34 × 10-3 for strain), which validates all three methods and the materials used. As far as the stress values are concerned, they are similar for all methods (250-300 MPa), except for the snow plow and injection-molded techniques using Grandio and Grandio Flow composites, where the maximum von Mises stress value was more than double (approximately 700 MPa). When using the combination of Grandio and Grandio Flow materials, the 1 mm thickness of the fluid composite layer was found to have a major influence on occlusal forces damping as opposed to 0.5 mm. Therefore, the Bichacho technique is indicated at the expense of the snow plow and injection-molded techniques. The composite materials used by us in this study are state-of-the-art, with clear indications for restoring cavities resulting from the treatment of carious lesions. However, their association and application technique in the case of Class II cavities is of clinical importance for resistance to masticatory forces.
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Affiliation(s)
- Mihaela Jana Țuculină
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Adela Nicoleta Staicu
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Cristina Munteanu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cristian Niky Cumpătă
- Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 67A Gheorghe Petrascu Str., 031593 Bucharest, Romania
| | - Bogdan Dimitriu
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
| | - Ana Maria Rîcă
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Cristina Beznă
- Department of Pathophysiology, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dragoș Laurențiu Popa
- Department of Automotive, Transportation and Industrial Engineering, Faculty of Mechanics, University of Craiova, 200478 Craiova, Romania
| | - Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Tiberiu Țîrcă
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Nicola AG, Carsote M, Gheorghe AM, Petrova E, Popescu AD, Staicu AN, Țuculină MJ, Petcu C, Dascălu IT, Tircă T. Approach of Heterogeneous Spectrum Involving 3beta-Hydroxysteroid Dehydrogenase 2 Deficiency. Diagnostics (Basel) 2022; 12:diagnostics12092168. [PMID: 36140569 PMCID: PMC9497988 DOI: 10.3390/diagnostics12092168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
We aim to review data on 3beta-hydroxysteroid dehydrogenase type II (3βHSD2) deficiency. We identified 30 studies within the last decade on PubMed: 1 longitudinal study (N = 14), 2 cross-sectional studies, 1 retrospective study (N = 16), and 26 case reports (total: 98 individuals). Regarding geographic area: Algeria (N = 14), Turkey (N = 31), China (2 case reports), Morocco (2 sisters), Anatolia (6 cases), and Italy (N = 1). Patients’ age varied from first days of life to puberty; the oldest was of 34 y. Majority forms displayed were salt-wasting (SW); some associated disorders of sexual development (DSD) were attendant also—mostly 46,XY males and mild virilisation in some 46,XX females. SW pushed forward an early diagnosis due to severity of SW crisis. The clinical spectrum goes to: premature puberty (80%); 9 with testicular adrenal rest tumours (TARTs); one female with ovarian adrenal rest tumours (OARTs), and some cases with adrenal hyperplasia; cardio-metabolic complications, including iatrogenic Cushing’ syndrome. More incidental (unusual) associations include: 1 subject with Barter syndrome, 1 Addison’s disease, 2 subjects of Klinefelter syndrome (47,XXY/46,XX, respective 47,XXY). Neonatal screening for 21OHD was the scenario of detection in some cases; 17OHP might be elevated due to peripheral production (pitfall for misdiagnosis of 21OHD). An ACTH stimulation test was used in 2 studies. Liquid chromatography tandem–mass spectrometry unequivocally sustains the diagnostic by expressing high baseline 17OH-pregnenolone to cortisol ratio as well as 11-oxyandrogen levels. HSD3B2 gene sequencing was provided in 26 articles; around 20 mutations were described as “novel pathogenic mutation” (frameshift, missense or nonsense); many subjects had a consanguineous background. The current COVID-19 pandemic showed that CAH-associated chronic adrenal insufficiency is at higher risk. Non-adherence to hormonal replacement contributed to TARTs growth, thus making them surgery candidates. To our knowledge, this is the largest study on published cases strictly concerning 3βHSD2 deficiency according to our methodology. Adequate case management underlines the recent shift from evidence-based medicine to individualized (patient-oriented) medicine, this approach being particularly applicable in this exceptional and challenging disorder.
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Affiliation(s)
- Andreea Gabriela Nicola
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mara Carsote
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 011863 Bucharest, Romania
- Department of Endocrinology, C.I. Parhon National Institute of Endocrinology, Aviatorilor Ave 34-38, Sector 1, 011863 Bucharest, Romania
- Correspondence: (M.C.); (A.-M.G.); Tel.: +40-744-851-934 (M.C.)
| | - Ana-Maria Gheorghe
- Department of Endocrinology, C.I. Parhon National Institute of Endocrinology, Aviatorilor Ave 34-38, Sector 1, 011863 Bucharest, Romania
- Correspondence: (M.C.); (A.-M.G.); Tel.: +40-744-851-934 (M.C.)
| | - Eugenia Petrova
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 011863 Bucharest, Romania
- Department of Endocrinology, C.I. Parhon National Institute of Endocrinology, Aviatorilor Ave 34-38, Sector 1, 011863 Bucharest, Romania
| | - Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Adela Nicoleta Staicu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Jana Țuculină
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cristian Petcu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ionela Teodora Dascălu
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Tiberiu Tircă
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Popescu AD, Popa DL, Nicola AG, Dascălu IT, Petcu C, Tircă T, Tuculina MJ, Mocanu H, Staicu AN, Gheorghiță LM. Post Placement and Restoration of Endodontically Treated Canines: A Finite Element Analysis Study. IJERPH 2022; 19:ijerph19158928. [PMID: 35897304 PMCID: PMC9332447 DOI: 10.3390/ijerph19158928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to show the improved outcomes of restoring endodontically treated teeth with fiberglass posts compared to restorations using metal posts. In our study, we used the Finite Element Method (FEM), which is based on the principle that a physical model that supports a given load distributes the stress throughout its volume. We sought to assess what stress results in a tooth when it is restored using a fiberglass post compared to restoration using a metal post. The finite element analysis showed that a system consisting of a tooth with a fiberglass post is more stable in terms of the maximum stress than a system consisting of a tooth with a metal post. The maximum displacements and deformations were obtained in the case of a canine restored with a fiberglass post, which showed that this system had a high elasticity, therefore, higher strength than a canine restored with a metal post, which had high rigidity.
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Affiliation(s)
- Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Dragoș Laurențiu Popa
- Department of Automotive, Transportation and Industrial Engineering, Faculty of Mechanics, University of Craiova, 200478 Craiova, Romania
- Correspondence: (D.L.P.); (M.J.T.)
| | - Andreea Gabriela Nicola
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.G.N.); (T.T.)
| | - Ionela Teodora Dascălu
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Cristian Petcu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Tiberiu Tircă
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.G.N.); (T.T.)
| | - Mihaela Jana Tuculina
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
- Correspondence: (D.L.P.); (M.J.T.)
| | - Horia Mocanu
- Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 031593 Bucharest, Romania;
| | - Adela Nicoleta Staicu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Lelia Mihaela Gheorghiță
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
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