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Caloian CS, Ciurea A, Negucioiu M, Roman A, Micu IC, Picoș A, Soancă A. Systemic Impact of Subgingival Infection Control in Periodontitis Patients with Cardiovascular Disease: A Narrative Review. Antibiotics (Basel) 2024; 13:359. [PMID: 38667035 PMCID: PMC11047730 DOI: 10.3390/antibiotics13040359] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
INTRODUCTION Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial burden and local inflammation, while also potentially bringing systemic benefits for patients with both periodontitis and CVD. This review examines systemic effects of subgingival instrumentation with or without antimicrobial products in individuals with periodontitis and CVD, and explores intricate pathogenetic interactions between periodontitis and CVD. MATERIAL AND METHODS English-language databases (PubMed MEDLINE and Cochrane Library) were searched for studies assessing the effects of nonsurgical periodontal therapies in periodontitis patients with or without CVD. RESULTS While the ability of periodontal therapy to reduce mortality- and morbidity-related outcomes in CVD patients with periodontitis remains uncertain, some studies indicate a decrease in inflammatory markers and blood cell counts. Subgingival mechanical instrumentation delivered over multiple short sessions carries lower risks of adverse effects, particularly systemic inflammation, compared to the full-mouth delivery, making it a preferable option for CVD patients. CONCLUSIONS Subgingival mechanical instrumentation, ideally conducted in a quadrant-based therapeutic approach, to decontaminate periodontal pockets has the potential to reduce both local and systemic inflammation with minimal adverse effects in patients suffering from periodontitis and concurrent CVD.
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Affiliation(s)
- Carmen Silvia Caloian
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania;
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
| | - Andrei Picoș
- Department of Prevention in Dental Medicine, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400083 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania; (C.S.C.); (A.C.); (I.C.M.); (A.S.)
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Ciurea A, Stanomir A, Șurlin P, Micu IC, Pamfil C, Leucuța DC, Rednic S, Rasperini G, Soancă A, Țigu AB, Roman A, Picoș A, Delean AG. Insights into the Relationship between Periodontitis and Systemic Sclerosis Based on the New Periodontitis Classification (2018): A Cross-Sectional Study. Diagnostics (Basel) 2024; 14:540. [PMID: 38473012 DOI: 10.3390/diagnostics14050540] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
(1) Background: This study aimed to assess the periodontitis burden in systemic sclerosis patients and the possible association between them, and the degree to which some potential risk factors and two potential diagnostic biomarkers may account for this association. (2) Methods: This cross-sectional study included a test group (systemic sclerosis patients) and a control group (non-systemic sclerosis patients). Both groups benefited from medical, periodontal examination and saliva sampling to determine the salivary flow rate and two inflammatory biomarkers (calprotectin, psoriasin). A systemic sclerosis severity scale was established. (3) Results: In the studied groups, comparable periodontitis rates of 88.68% and 85.85%, respectively, were identified. There were no significant differences in the severity of periodontitis among different systemic sclerosis severity, or in the positivity for anti-centromere and anti-SCL70 antibodies. Musculoskeletal lesions were significantly more common in stage III/IV periodontitis (n = 33, 86.84%) than in those in stage I/II (n = 1, 100%, and n = 3, 37.5%, respectively) (p = 0.007). Comparable levels of the inflammatory mediators were displayed by the two groups. There were no significant differences in calprotectin and psoriasin levels between diffuse and limited forms of systemic sclerosis. (4) Conclusions: Within the limitations of the current study, no associations between systemic sclerosis and periodontitis, or between their risk factors, could be proven.
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Affiliation(s)
- Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
| | - Alina Stanomir
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cristina Pamfil
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
- Department of Rheumatology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Simona Rednic
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
- Department of Rheumatology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Foundation IRCCS Ca' Granda Policlinic, 20122 Milan, Italy
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
| | - Adrian Bogdan Țigu
- Research Centre for Advanced Medicine (MEDFUTURE), Iuliu Hatieganu University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Emergency County Clinical Hospital Cluj, 400006 Cluj-Napoca, Romania
| | - Andrei Picoș
- Department of Prevention in Dental Medicine, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Odontology and Endodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania
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Soancă A, Leucuța DC, Roman A, Ciurea A, Negucioiu M, Pascu LC, Picoș A, Delean AG, Micu IC, Popa Wagner A, Rusu D. The Treatment of Severe Periodontitis Using a Local Antiseptic Desiccant and Subgingival Mechanical Instrumentation: A Pilot Study. J Clin Med 2023; 12:4286. [PMID: 37445321 DOI: 10.3390/jcm12134286] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
This randomized, split-mouth, controlled clinical study assessed the additional clinical benefits of a local desiccant antimicrobial agent (HY) combined with subgingival mechanical instrumentation (SRP) vs. SRP alone in treating severe periodontitis. Patients with stages III and IV periodontitis received full-mouth periodontal examinations at baseline and after a three-month follow-up. Two randomly selected hemiarches in each periodontitis patient were treated with SRP plus HY and were included in the test group, while the other two hemiarches received only SRP and were included in the control group. In thirty patients, the analyses of the evolution of the periodontal parameters over time showed statistically significant mean differences for the probing depths and clinical attachment level values resulting from all the examined sites, as well as from the interproximal sites (p < 0.001) in both the test and control groups. The intergroup comparisons of the same four parameters showed no significant differences (p = 0.322, p = 0.36, p = 0.516, and p = 0.509, respectively). Based on these study results, no additional benefits were obtained after HY subgingival applications.
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Affiliation(s)
- Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuța
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur St., No. 6, 400349 Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Laurențiu Cătălin Pascu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Andrei Picoș
- Department of Prevention in Dental Medicine, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400347 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Cariology, Endodontics and Oral Pathology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Motilor St., No. 33, 400001 Cluj-Napoca, Romania
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babes St., No. 15, 400012 Cluj-Napoca, Romania
| | - Aurel Popa Wagner
- Vascular Neurology and Dementia Center, University of Medicine, Essen, Hufeland St., No. 55, 45122 Essen, Germany
- Experimental Research Center in Normal and Pathological Aging (ARES), University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Darian Rusu
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-Implant Diseases, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, Bulevardul Revolutiei din 1989, No. 9, 300230 Timisoara, Romania
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Stanomir A, Micu IC, Picoș A, Roman A, Soancă A, Onet D, Onea TN, Rednic S, Ciurea A, Pamfil C. Periodontitis Burden in Diffuse Versus Limited Systemic Sclerosis Subtypes: A Pilot Study. Curr Health Sci J 2023; 49:280-287. [PMID: 37779832 PMCID: PMC10541067 DOI: 10.12865/chsj.49.02.280] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/18/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION This study aimed to evaluate the periodontal status of a group of Romanian systemic sclerosis (SSc) patients and to investigate the relationships between periodontitis and SSc subtypes. MATERIALS AND METHODS This observational study included patients diagnosed with limited SSc (lcSSc) and diffuse SSc (dcSSc). Demographic data were collected from medical records. Each participant underwent a full-mouth periodontal examination including Bleeding on Probing (BoP) index, Oral Hygiene (OH) index, Probing Depth (PD), Gingival Recession (GR), and Clinical Attachment Loss (CAL). The periodontal status was defined according to presently recognised case definition system. RESULTS The study included 30 patients with lcSSc and 30 patients with dcSSc with a mean age of 52.45±11.75 years. The overall periodontitis frequence in our SSc group was 95%. The frequency of stage III/IV periodontitis was higher in the dcSSc group (90%) than in the lcSSc group (60%). Within the group of SSc patients, significant positive correlations were observed between age, BoP index, OH index, the number of missing teeth, mean PD, mean CAL on one side and periodontitis diagnosis on the other side (r=0.588, p=0.001; r=0.399, p=0.002; r=0.388, p=0.002; r=0.574, p=0.001; r=0.444, p=0.001; r=0.571, p=0.001). A significant positive correlation existed between the diagnostic of periodontitis and SSc subtypes (r=0.327, p <0.001). CONCLUSIONS Periodontitis was highly prevalent in both lcSSc and dcSSc groups. More stage III/IV periodontitis cases were detected dcSSc group of patients.
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Affiliation(s)
- Alina Stanomir
- Discipline of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Iulia Cristina Micu
- Discipline of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Andrei Picoș
- Discipline of Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Alexandra Roman
- Discipline of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
- County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Andrada Soancă
- Discipline of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
- County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Diana Onet
- Discipline of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Teodor Nicolae Onea
- Faculty of Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Simona Rednic
- County Emergency Clinical Hospital, Cluj-Napoca, Romania
- Department of Rheumatology, Faculty of Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
| | - Andreea Ciurea
- Discipline of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
- County Emergency Clinical Hospital, Cluj-Napoca, Romania
| | - Cristina Pamfil
- County Emergency Clinical Hospital, Cluj-Napoca, Romania
- Department of Rheumatology, Faculty of Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania
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Ciurea A, Rednic NV, Soancă A, Micu IC, Stanomir A, Oneț D, Șurlin P, Filipescu I, Roman A, Stratul ȘI, Pamfil C. Current Perspectives on Periodontitis in Systemic Sclerosis: Associative Relationships, Pathogenic Links, and Best Practices. Diagnostics (Basel) 2023; 13:diagnostics13050841. [PMID: 36899985 PMCID: PMC10000920 DOI: 10.3390/diagnostics13050841] [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: 01/16/2023] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Systemic sclerosis is a chronic, autoimmune, multisystemic disease characterized by aberrant extracellular matrix protein deposition and extreme progressive microvasculopathy. These processes lead to damage within the skin, lungs, or gastrointestinal tract, but also to facial changes with physiognomic and functional alterations, and dental and periodontal lesions. Orofacial manifestations are common in SSc but are frequently overshadowed by systemic complications. In clinical practice, oral manifestations of SSc are suboptimally addressed, while their management is not included in the general treatment recommendations. Periodontitis is associated with autoimmune-mediated systemic diseases, including systemic sclerosis. In periodontitis, the microbial subgingival biofilm induces host-mediated inflammation with subsequent tissue damage, periodontal attachment, and bone loss. When these diseases coexist, patients experience additive damage, increasing malnutrition, and morbidity. The present review discusses the links between SSc and periodontitis, and provides a clinical guide for preventive and therapeutical approaches in the management of these patients.
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Affiliation(s)
- Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania
| | - Nicolae Voicu Rednic
- Department of Gastroenterology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, “Prof. Dr. Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Croitorilor St., No. 19, 400394 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania
| | - Alina Stanomir
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania
| | - Diana Oneț
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania
| | - Petra Șurlin
- Department of Periodontology, University of Medicine and Pharmacy Craiova, Petru Rareș St., No. 2, 200349 Craiova, Romania
| | - Ileana Filipescu
- Department of Rheumatology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 2, 400000 Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeș St., No. 15, 400012 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-722-627-488
| | - Ștefan Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babeș University of Medicine and Pharmacy Timișoara, Revoluției from 1989 St., No. 9, 300041 Timișoara, Romania
| | - Cristina Pamfil
- Department of Rheumatology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 2, 400000 Cluj-Napoca, Romania
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Oneț D, Roman A, Soancă A, Ciurea A, Micu IC, Vesa ȘC, Popescu DM, Rîcă AM. The Cytotoxicity of Dental Restorative Materials on Gingival Stromal Mesenchymal Cells-an In Vitro Study. Curr Health Sci J 2022; 48:331-339. [PMID: 36815086 PMCID: PMC9940923 DOI: 10.12865/chsj.48.03.12] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/21/2022] [Indexed: 02/24/2023]
Abstract
BACKGROUND Due to their minimally invasive high-quality adhesive, aesthetic and mechanical qualities, composite resins are the most frequently used materials in modern restorative dentistry. However, polymerization shrinkage and cytotoxicity are still unresolved drawbacks associated with these biomaterials. PURPOSE The present study aimed to assess the cytotoxicity of some restorative resin-based materials on gingival mesenchymal stromal cells (gMSCs), assuming that no differences in their behavior will be highlighted. MATERIAL AND METHODS The cytotoxicity of the tested materials was evaluated by comparing the behavior of gMSCs cultured in normal conditions and in association with disc-shaped material samples indirectly through functionality tests (colony-forming unit-fibroblast assay, migratory potential) and directly through the MTT assay. The results were statistically analyzed with the ANOVA test and Tukey's Honest Significant Difference test. RESULTS According to the MTT assay, there are no statistically significant differences regarding the viability of gMSCs cultured in normal conditions or in the presence of resin-based material samples. On the other hand, the present study identified a significantly reduced number of colonies formed by the gMSCs cultured in association with BF and B discs, compared to that of gMSCs cultured in normal conditions. Also, the migratory potential was significantly lower for control gMSCs when compared to ZE-gMSCs and significantly higher for ZE-gMSCs when compared to BF-gMSCs or BFL-gMSCs. CONCLUSIONS The results of the present study highlight a possible risk of cytotoxicity when using resin based-materials in dental practice, but they cannot be directly extrapolated to in vivo situations.
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Affiliation(s)
- Diana Oneț
- Department of Periodontology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Iulia Cristina Micu
- Department of Periodontology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dora-Maria Popescu
- Department of Odontology, University of Medicine and Pharmacy of Craiova, Romania
| | - Ana-Maria Rîcă
- Department of Periodontology, University of Medicine and Pharmacy of Craiova, Romania
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Costea CA, Popescu DM, Roman A, Stratul ȘI, Șurlin P, Negucioiu M, Micu IC, Ciurea A, Lucaciu PO, Lazăr L, Mircioagă DE, Soancă A. The Impact of the COVID-19 Pandemic on Romanian Postgraduate Periodontal Residency Teaching: Past Experience, Present Imperatives and Future Considerations in a Multicentric Evaluation. IJERPH 2022; 19:ijerph19084488. [PMID: 35457356 PMCID: PMC9031164 DOI: 10.3390/ijerph19084488] [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: 01/24/2022] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 01/27/2023]
Abstract
The aims of this study were to identify the challenges in periodontology postgraduate residency programs during the COVID-19 pandemic by identifying the modifications of educational instruments, to evaluate the impact of hybrid education on periodontology postgraduate programs in terms of resident-centred outcomes, and to evaluate the education efficiency of an innovative teaching approach. Resident doctors from three Romanian dental faculties were included in study groups based on the intensity of clinical training. A web-based questionnaire was used to collect information on residents’ perception about teaching activity. Important educational changes were identified. Moreover, residents learned a periodontal procedure through online training and then performed it on preclinical models three times. The working times were recorded. Statistical analysis was performed. Resident doctors were unsatisfied with clinical practice during the pandemic year, but they positively valued the development of online courses. Learning efficiency improved by repeating the same procedure on preclinical models, as proved by the significant decrease of the working times. E-learning was appreciated as an important component of the new hybrid teaching approach. Reorganization and further emphasis on both preclinical and medical practice, targeted to aid residents perform more accurate and efficient procedures, are recommended.
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Affiliation(s)
- Cristina Andrada Costea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.R.); (I.C.M.); (A.C.); (A.S.)
| | - Dora Maria Popescu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy from Craiova, 2 Petru Rares St., 200349 Craiova, Romania; (D.M.P.); (P.Ș.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.R.); (I.C.M.); (A.C.); (A.S.)
| | - Ștefan-Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Anton Sculean Research Center for Periodontal and Peri-Implant Diseases, Victor Babeș University of Medicine and Pharmacy Timișoara, Bulevardul Revoluției din 1989, No. 9, 300230 Timișoara, Romania;
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy from Craiova, 2 Petru Rares St., 200349 Craiova, Romania; (D.M.P.); (P.Ș.)
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania;
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.R.); (I.C.M.); (A.C.); (A.S.)
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.R.); (I.C.M.); (A.C.); (A.S.)
| | - Patricia Ondine Lucaciu
- Department of Oral Health, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
- Correspondence: (P.O.L.); (L.L.)
| | - Luminița Lazăr
- Department of Periodontology, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Str. Gheorghe Marinescu Nr. 38, 540139 Târgu Mureș, Romania
- Correspondence: (P.O.L.); (L.L.)
| | - Doina Elena Mircioagă
- Department of Physical Education, University Sport Research Center for Evaluation of Fitness Level–CUSENF, Victor Babeș University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square, No. 2, 300041 Timișoara, Romania;
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.R.); (I.C.M.); (A.C.); (A.S.)
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Costea CA, Christodorescu R, Soancă A, Roman A, Micu IC, Stratul ȘI, Rusu D, Popescu DM, Popa-Wagner A, Bulboacă AE. Periodontitis in Ischemic Stroke Patients: Case Definition Challenges of the New Classification Scheme (2018). J Clin Med 2022; 11:jcm11030520. [PMID: 35159973 PMCID: PMC8836590 DOI: 10.3390/jcm11030520] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/16/2022] Open
Abstract
The identification of the associative relationships between ischemic stroke (IS) and risk factors such as advanced age and periodontitis is essential to design real screening protocols and to address them using primary and secondary preventive policies. This study primarily aimed to evaluate the diagnostic performance of the 2018 European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) case definition in detecting periodontitis against the 2012 Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) case definition in a group of IS patients. Secondarily, we report the periodontal status of IS patients and the associative relationship with respect to some risk factors. Patients with their first IS were assessed based on demographic data, medical, oral risk factors and periodontal parameters. The two case definitions were applied to identify the periodontitis burden. The agreement between the two case definition systems, as well as the misclassification ratio, were calculated. A total of 141 patients were included. According to the 2012 CDC/AAP and the 2018 EFP/AAP case definitions, a frequency of periodontitis of 98.5% and 97.8% based on two modalities of inclusion of cases in the severity groups, sensitivity values of 98.54% or 100%, and specificity values of 25% or 14.7% were calculated. Thus, the new case definition system has a higher capacity to detect periodontitis, especially the well-established forms.
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Affiliation(s)
- Cristina Andrada Costea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Ruxandra Christodorescu
- Institute of Cardiovascular Diseases Research Center, Victor Babeș University of Medicine and Pharmacy Timisoara, Bulevardul Revoluției, No. 12, 300024 Timisoara, Romania;
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania; (C.A.C.); (A.S.); (A.R.)
- Correspondence: (A.P.-W.); (I.C.M.)
| | - Ștefan Ioan Stratul
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timisoara, Bulevardul Revoluției din 1989, No. 9, 300230 Timisoara, Romania; (Ș.I.S.); (D.R.)
| | - Darian Rusu
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timisoara, Bulevardul Revoluției din 1989, No. 9, 300230 Timisoara, Romania; (Ș.I.S.); (D.R.)
| | - Dora Maria Popescu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Petru Rareș St., No. 2, 200349 Craiova, Romania;
| | - Aurel Popa-Wagner
- Chair of Vascular Neurology and Dementia Center, University of Medicine, Essen, Hufeland St., No. 55, 45122 Essen, Germany
- Experimental Research Center in Normal and Pathological Aging (ARES), University of Medicine and Pharmacy, 200349 Craiova, Romania
- Correspondence: (A.P.-W.); (I.C.M.)
| | - Adriana Elena Bulboacă
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy, Victor Babeș St., No. 2–4, 400012 Cluj-Napoca, Romania;
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Ciurea A, Delean AG, Didilescu A, Monea M, Roman A, Boariu M, Stratul ȘI, Mîrza CM, Micu IC, Șurlin P, Soancă A. In Vitro Study on the Adhesive Performance of Some Resin-Based Materials Used to Restore Class II Cavities. Materials (Basel) 2021; 14:ma14154299. [PMID: 34361493 PMCID: PMC8348953 DOI: 10.3390/ma14154299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022]
Abstract
The study aimed to evaluate the adhesive performances of two ormocer materials and two micro-hybrid composites placed to restore class II cavities. We tested the null hypothesis, which considered that the adhesive behaviors of tested materials did not differ. On each extracted tooth, two class II cavities were prepared having an enamel located cervical margin and a cementum located cervical margin, respectively, and were restored using two different restoration techniques. The teeth followed a tooth impregnating protocol and were sectioned and evaluated by optical microscopy to highlight the marginal microleakage around restorations. Cervical and occlusal microleakage as well as microleakage ratios were calculated. The microleakage test showed that all tested materials exhibited some degree of dentinal microleakage both on cervical and occlusal areas irrespective of the restoration technique. Some significant differences were recorded in adhesion performance of the materials. The cervical microleakage ratio was significantly increased for one of the micro-hybrid resin composites in comparison with one of the ormocer materials (p = 0.0159). Significantly differences were observed in occlusal microleakage ratios when the two micro-hybrid composites were compared (p = 0.047). The results failed to reject the null hypothesis. The present study could not demonstrate the superiority of ormocer-materials relative to conventional composites.
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Affiliation(s)
- Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, 15 Victor Babeş St., 400012 Cluj-Napoca, Romania; (A.C.); (I.C.M.); (A.S.)
| | - Ada Gabriela Delean
- Department of Odontology and Endodontics, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 33 Moților St., 400012 Cluj-Napoca, Romania;
| | - Andreea Didilescu
- Department of Embryology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania;
| | - Monica Monea
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu St., 540139 Târgu Mureș, Romania;
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, 15 Victor Babeş St., 400012 Cluj-Napoca, Romania; (A.C.); (I.C.M.); (A.S.)
- Correspondence: ; Tel.: +40-264-597256
| | - Marius Boariu
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy, 9 Bd. Revoluției 1989 St., 300070 Timisoara, Romania;
| | - Ștefan Ioan Stratul
- Department of Periodontology, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy, 9 Bd. Revoluției 1989 St., 300070 Timisoara, Romania;
| | - Camelia-Manuela Mîrza
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy, 2-4 V.Babeș St., 400012 Cluj-Napoca, Romania;
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, 15 Victor Babeş St., 400012 Cluj-Napoca, Romania; (A.C.); (I.C.M.); (A.S.)
| | - Petra Șurlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, 2 Petru Rares St., 200349 Craiova, Romania;
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, 15 Victor Babeş St., 400012 Cluj-Napoca, Romania; (A.C.); (I.C.M.); (A.S.)
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Stănescu I, Bulboacă AE, Micu IC, Bolboacă SD, Feștilă DG, Bulboacă AC, Bodizs G, Dogaru G, Boarescu PM, Popa-Wagner A, Roman A. Gender Differences in the Levels of Periodontal Destruction, Behavioral Risk Factors and Systemic Oxidative Stress in Ischemic Stroke Patients: A Cohort Pilot Study. J Clin Med 2020; 9:jcm9061744. [PMID: 32512870 PMCID: PMC7356570 DOI: 10.3390/jcm9061744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Due to the higher frequency of ischemic stroke in men compared to women, we aimed to determine if gender differences exist regarding periodontal status and several plasma biomarkers in patients with a recent large artery atherosclerosis ischemic stroke (IS). Material and methods: Patients with their first IS within less than six weeks who were able to undergo periodontal examinations were evaluated. Demographic data, periodontal status, oxidative stress parameters/plasma antioxidant capacity, and C-reactive protein in patients who suffered a recent large artery atherosclerosis ischemic stroke were reccorded. Results: 93 patients were included in the study. More men were smokers (12/57 vs. 3/36) and consumed alcohol (17/57 vs. 3/36), and more women had higher glycemic values (p = 0.023), total cholesterol (p < 0.001), LDL (low-density lipoprotein)-cholesterol (p = 0.010), and HDL (high-density lipoprotein)-cholesterol (p = 0.005) levels. Significantly more men than women had moderate plus severe periodontal disease (p = 0.018), significantly higher levels of nitric oxide (p = 0.034), and significantly lower levels of total antioxidant capacity (p = 0.028). Conclusions: In this pilot study, men seem to be more prone to oxidative stress and to develop more severe forms of periodontitis among patients with stroke, but the results need validation on a larger sample.
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Affiliation(s)
- Ioana Stănescu
- Department of Neurology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania; (I.S.); (A.C.B.)
| | - Adriana Elena Bulboacă
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
- Correspondence: (A.E.B.); (S.D.B.); (A.P.-W.); Tel.: +40-264-408-008 (A.E.B.); +40-374-834-506 (S.D.B.); +40-765-660-569 (A.P.-W.)
| | - Iulia Cristina Micu
- Department of Periodontology, Faculty of Dental Medicine, IuliuHaţieganu University of Medicine and Pharmacy, Victor Babeş Str., no. 15, 400012 Cluj-Napoca, Romania; (I.C.M.); (A.R.)
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, IuliuHațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania
- Correspondence: (A.E.B.); (S.D.B.); (A.P.-W.); Tel.: +40-264-408-008 (A.E.B.); +40-374-834-506 (S.D.B.); +40-765-660-569 (A.P.-W.)
| | - Dana Gabriela Feștilă
- Department of Orthodontics, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
| | - Angelo C. Bulboacă
- Department of Neurology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania; (I.S.); (A.C.B.)
| | - Gyorgy Bodizs
- Clinical Rehabilitation Hospital, Viilor Str., no. 46-50, 400347 Cluj-Napoca, Romania;
| | - Gabriela Dogaru
- Department of Physical Medicine and Rehabilitation, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
| | - Paul Mihai Boarescu
- Department of Pathophysiology, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Str., no. 6, 400349 Cluj-Napoca, Romania;
| | - Aurel Popa-Wagner
- Department of Patho-Biochemistry, University of Medicine and Pharmacy Craiova, Petru Rareș Str., No. 2-4, 200349 Craiova, Romania
- Vascular Neurology and Dementia, University of Medicine, Essen, HufelandStr., no. 55, 45122 Essen, Germany
- Correspondence: (A.E.B.); (S.D.B.); (A.P.-W.); Tel.: +40-264-408-008 (A.E.B.); +40-374-834-506 (S.D.B.); +40-765-660-569 (A.P.-W.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, IuliuHaţieganu University of Medicine and Pharmacy, Victor Babeş Str., no. 15, 400012 Cluj-Napoca, Romania; (I.C.M.); (A.R.)
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Micu IC, Roman A, Ticala F, Soanca A, Ciurea A, Objelean A, Iancu M, Muresan D, Caracostea GV. Relationship between preterm birth and post-partum periodontal maternal status: a hospital-based Romanian study. Arch Gynecol Obstet 2020; 301:1189-1198. [PMID: 32274638 DOI: 10.1007/s00404-020-05521-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/22/2019] [Accepted: 03/28/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE This cross-sectional case-control study of post-partum women aimed to estimate whether maternal periodontitis was a predictive contributor to preterm birth and to identify other risk factors associated with preterm birth in our target population. METHODS The case group included women who delivered preterm (74 cases) and the control group included women who had a normal term delivery (120 controls). Medical records, a 16-item questionnaire, and a full-mouth periodontal examination were used to collect information about socio-demographic characteristics, general health problems, birth-related information, behavioral factors and periodontal status. Logistic regression analysis was used to estimate the strength of the relationship between predictors and the categorical outcome variable, preterm birth. RESULTS The bivariate analysis revealed the significant associations between preterm birth and socio-demographic factors (educational level, p = 0.003), antepartum smoking habit (p = 0.001) and birth weight lower than 2500 g (p < 0.001). The multivariate analysis highlighted that the presence of post-partum maternal periodontitis and its severity remained independent risk factors of preterm birth in the presence of antepartum smoking habit and route of delivery [adjusted OR 2.26, 95% CI (1.06; 4.82), respectively, OR 3.46, 95% CI (1.08; 11.15)]. CONCLUSION Post-partum maternal periodontal disease and its severity might, in part, be considered as contributor to preterm deliveries before 37 weeks of gestation.
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Affiliation(s)
- I C Micu
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania
| | - A Roman
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - F Ticala
- Department of Obstetrics and Gynecology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 3-5 Clinicilor St, 400006, Cluj-Napoca, Romania
| | - A Soanca
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - A Ciurea
- Department of Periodontology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania
| | - A Objelean
- Department of Dental Materials, "Iuliu Haţieganu" University of Medicine and Pharmacy, 15 V. Babeş St., 400012, Cluj-Napoca, Romania
| | - M Iancu
- Department of Medical Informatics and Biostatistics, "Iuliu Haţieganu" University of Medicine and Pharmacy, 6 Louis Pasteur St., 400349, Cluj-Napoca, Romania.
| | - D Muresan
- Department of Obstetrics and Gynecology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 3-5 Clinicilor St, 400006, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
| | - G V Caracostea
- Department of Obstetrics and Gynecology, "Iuliu Haţieganu" University of Medicine and Pharmacy, 3-5 Clinicilor St, 400006, Cluj-Napoca, Romania.,Emegency County Clinical Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania
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