The Predictability of Difficultness of Lower Third Molar Odontectomy

The aim of this study was to establish an accurate algorithm for third molar odontectomy in order to help the surgeon to predict the duration and the difficultness of this surgical procedure. As material and methods, we used an algorithm that contains medical and radiographic data regarding lower wisdom tooth which was systematized in a preoperative questionnaire. In this study were included 27 patients with asymptomatic lower third molars during the period of 2015-2017. The prediction of the questionnaire was correlated with the difficulty and duration of the odontectomy. Results of our study showed that this algorithm can successfully predict the degree of difficulty of the lower wisdom tooth odontectomy and can guide the surgeon in the therapeutic decision. Moreover, this method is simple, easy and fast.

Determining the Biological Sealing Quality of the Implant-abutment Interface Using Streptococcus mutans in Both, Conical and Internal Hex Connections A comparative study

Implants have been around for many years already, having a lot of advantages and high success rates, by some authors even higher than 90%. Nevertheless, throughout the years, problems and failures have occurred in practice which led to bone loss around the implants and even, in some cases, to losing the implant itself. The phenomenon behind this pathological process -peri-implantitis - is believed to be the microleakage which occurs at the implant-abutment interface.This happens due to the existence of a gap present between the implant and the prosthetic abutment. Moreover, the microleakage is amplified because of the, so called, pumo effect. The pump effect occurs when the crown-abutment complex is subjected to occlusal, vertical and oblique, forces. During these micro-movements of the abutment, the microleakage intensifies and the bacteria can easily enter inside the implant, where is impossible to reach and remove through oral hygiene, thus, creating the perfect conditions for peri-implantitis. There are two major types of implant-abutment connections widely used nowadays -internal hex and conical -which are believed to influence the phenomenon and, so, the outcome. In the present study, both types of connections are tested, using Streptococcus Mutans, a common bacteria found in the oral cavity.

Detecting the Implant in vitro Microleakage Using Spectrophotometry and Neutral Red Dye

Implants are one of the most innovative and less invasive prosthetic procedures available. Almost all types of edentations can, nowadays, be treated with an implant-retained prosthetic piece, either fixed or removable. But regardless of the development in the industry over the last decades and the high success rate - estimated at over 95% - there are still some problems concerning single or multi-unit restorations[1-3]. One of the main concerns about implant therapy today is the microleakage phenomenon. The microleakage appears between the implant and the abutment and, due to masticatory forces, it creates a pump effect which can carry the oral bacteria inside the implant, where it�s almost impossible to reach, thus, creating a local inflammation, called peri-implantitis[4-6] . Many authors have tried to identify and quantify the phenomenon by diverse means, but a consensus hasn�t been reached on how or when exactly it appears. In the present study, Neutral Red dye was used to determine the sealing of the implant-abutment interface in dynamic conditions, with the help of the spectrophotometry.

CBCT fine preoperative evaluation of inflammatory radicular cysts and postoperative local integration appreciation of alloplastic grafts materials

The purpose of this paper is to point out the value of CBCT exam in pre and postoperative diagnosis assessment of inflammatory radicular cysts together with full appreciation of local integration of alloplastic graft materials used to repair the osseous defects. There were statistically retrospective evaluated the pre and postoperative results of CBCT and x-ray examinations of 34 patients with inflammatory radicular cysts clinically, biologically and histopathologically assessed at Oral and Maxilo-Facial Surgery Clinic from Timisoara. In all cases we proceeded to surgical radicular cysts removement, extraction of the associated non-vital tooth together with alloplastic graft materials repairement of the osseous defects. The CBCT preoperative scans clearly showed the extent, the morphological characteristics and the topoanatomic reports, in all 34 cases of inflammatory radicular cysts together with regional endodontic status. The CBCT postoperative scans revealed the very local integration of alloplastic graft materials used to repair the osseous defects and, in some cases, the dental rehabilitation by metallic implants. CBCT scan is the imaging method of choice in pre and postoperative diagnosis assessment of inflammatory radicular cysts together with alloplastic graft materials repairement of the osseous defects and dental rehabilitation by metallic implants, due to high specific abilities in bone tissue 3D evaluation.

How accurate replicates the Thermafil System the morphology of the apical endodontic space? An ex vivo study

AIM

To evaluate the morphology of the root canal in its apical third and the capacity of the Thermafil System to reproduce the entire morphology of the cleaned and shaped root canal.

MATERIALS AND METHODS

Thirty-two roots of periodontally compromised teeth were prepared using the ProTaper System to an apical size 30 and filled with the Thermafil obturation technique and sealer. The roots were surgically amputated and prepared for metallographic evaluation by incremental reductions of 0.5 mm each, starting with the apical foramen. Photomicrographs of each section were taken at a magnification of 500x and 100x. The images were analyzed and processed. The position of the apical foramen with respect to the anatomical apex was identified and marked. Additional morphological details as lateral canals and recesses were also recorded. The cross-sectioned area of the canal and gutta-percha, the total perimeter, the shaped perimeter and the filled perimeter were recorded for each sample and the results were expressed as percentages. Multiple images of successive sections were used to create a 3D reconstruction of the apical anatomy of the tooth. The ANOVA test was performed to assess mean differences between evaluations of perimeters/areas at different levels.

RESULTS

The anatomical apical foramen was found at the tip of the root in 50% of the evaluated samples. In the remaining samples, the foramen was located between 0.5 and 2.5 mm from the centre of the apex. Lateral canals, which opened in accessory foramens, were recorded in 25% of the evaluated samples. Statistical significant differences (p<0.05) were found between different levels of preparation and obturation.

CONCLUSIONS

The complex morphology of the apical third of the root canal is satisfactory microstructurally replicated by the Thermafil System. Moreover, polarized light microscopy and the 3D reconstruction offered a discriminative vision of morphological details as lateral canals, recesses, the gutta-percha and debris.