The Evaluation of the Cervical Marginal Sealing of Direct vs. Indirect Composite Resin Restorations in MOD Cavities

INTRODUCTION

The aim of this in vitro study was to compare the quality of marginal sealing at the cervical margins of indirect and direct composite resin restorations in mesio-occluso-distal (MOD) cavities.

MATERIAL AND METHOD

MOD preparations were performed on 30 extracted teeth. The mesial cervical margin of each tooth was relocated using a flow composite resin (Enamel Plus HRi Flow, Micerium, Avegno, GE, Italy), then the samples were divided into three groups. In group A, the cavities were directly restored using a nanohybrid composite resin (Miris 2 Coltène Whaledent, Altstaetten, Switzerland) and a universal adhesive (ScotchBond Universal, 3M ESPE, St. Paul, MN, USA) by the etch-and-rinse strategy, for group B, the restoration procedure was similar but the self-etch strategy was used, and the samples in group C were filled using the inlay technique. Each sample was stored for 48 h in a 2% methylene blue solution, then it was cut in a mesio-distal direction using a Struers Secotom 50 device (Cleveland, OH, USA). The marginal sealing and adhesive interface were assessed for each sample at the cervical margin by optical microscopy (OM) and scanning electron microscopy (SEM). One-way ANOVA and Bonferroni post-hoc tests were used with a significance level of 0.05.

RESULTS

Significant differences were recorded within groups A and C, between mesial and distal margins (p = 0.02 in group A and p = 0.043 in group C).

CONCLUSIONS

The marginal sealing is more effective in MOD inlay restoration compared to direct restorations. Relocation of the cervical margin with flow composite resin and the use of different adhesive strategies do not improve the marginal sealing.

Research on the Quality of Partially Removable Skeletal Prostheses Made Using Classical Versus Modern Sintering Techniques

Conventional partially removable skeletal dentures are one of the most common therapeutic solutions offered to edentulous patients worldwide. The present study aims to compare the skeleton of removable dentures realized via classical techniques to that realized via modern techniques, represented by the laser sintering technique, with the comparative aspects being realized through the evaluation of atomic force microscopy (AFM). A total of 20 metal frameworks made of Co-Cr were sectioned, representing the infrastructure of partially removable skeletal dentures, developed using the classical technique versus the laser sintering technique. The infrastructures of partially removable skeletal dentures were designed for both the maxilla and the mandible, with the design of each type of denture being identical, and were developed using both techniques. The roughness values are different depending on the technological method used; for the conventional casting technique, we have higher roughness for the component elements of the partially removable skeletal denture that have more stretch, e.g., the major connector, and for the 3D laser sintering technique, lower roughness is obtained for the component elements that have a lower stretch, e.g., the clasp arms, the minor connector, or the junction between the saddles and the major connector. The clinical implications of the presence of roughness at the level of the active arms or at the level of the connector saddle junction are represented by the risk of fracture, which confers real discomfort to the patient.

Trends in Access to Oral Health Care among Adults from the N-E Region of Romania

Aims and Objectives: To investigate the trends in access to dental services among adults from the N-E region of Romania and to evaluate the factors that influence access to dental care. Material and Methods: A self-administered questionnaire was used to evaluate the access and utilization of dental care among a sample of adults. We collected data on their demographic characteristics, their type of medical insurance, their monthly income, the type of dental office they visited, their reasons for choosing a certain type of dentist office, and their oral hygiene habits. It was found that their financial status determined by the occupation of the individual, as well as their monthly income, influenced their access to medical services. Data were analyzed using SPSS 20.0. Results: Of a total of 696 participants, 55.6% were female, 83.3% were from urban areas, 42.1% were retired, 62.3% of the subjects utilized dental emergency services, and 67.9% of the subjects self-funded their treatment. The reasons for women not attending dental offices included costs (24.3%) and dental fear (9.8%), while men's reasons were high costs (26.4%) and lack of time (5.9%). Significant differences were recorded between gender and reasons for visiting the dentist (p = 0.018), payment for dental services (p = 0.009), and preferred clinic (p = 0.010). In relation to occupation, there were significant differences for most of the variables evaluated (reasons to visit a dentist, payment for dental services, preferred dental clinic, self-rated oral health, etc.). Conclusions: Gender, occupation, and monthly income levels were found to influence access to dental medicine services of Romanians in the N-E region. Dental services were frequently accessed for emergency reasons. Dental services were found to be paid for by state insurance for those with low monthly incomes and self-funded for those with higher monthly incomes.

Influence of Implant Dimensions in the Resorbed and Bone Augmented Mandible: A Finite Element Study

Aims:

The scope of this study was to analyze the influence of clinically feasible implant diameter and length on the stress transmitted to the peri-implant bone in the case of a resorbed and bone augmented mandible through finite element analysis.

Settings and Design:

The study was carried out in silico.

Subjects and Methods:

Resorbed and bone-augmented 3D models were derived from in vivo cone-beam computed tomography scans of the same patient. Corresponding implant systems were modeled with the diameter ranging from 3.3 to 6 mm and length ranging from 5 to 13 mm, and masticatory loads were applied on the abutment surface.

Statistical Analysis Used:

None.

Results:

In the bone augmented ridge, maximum stress values in the peri-implant region drastically decreased only when using implants of a diameter of 5 mm and 6 mm. Implants up to 4 mm in diameter led to comparable stress values with the ones obtained in the resorbed ridge, when using the larger implants. The increase of length reduced stress in the resorbed mandible, whereas in the bone augmented model, it led to small variations only in implants up to 4 mm in diameter.

Conclusions:

It was concluded that bone augmentation provides the optimal framework for clinicians to use larger implants, which, in turn, reduces stress in the peri-implant region. Diameter and length play an equally important role in decreasing stress. Implant dimensions should be carefully considered with ridge geometry.

Epilepsy, a Neurological Emergency in Oro-maxi-facial Surgery - neuro - psychic Field

Dental practice does not start with the fear for accidents and complications, much less for emergency, but in order to prevent and effectively treat them, they must be known and diagnosed quickly, correctly and with great discernment. Fortunately, in dental practice, emergency is not met frequently, but if it occurs, however, doctor�s accurate and fast reaction can and save thepatient�s life. Emergency requires maximum efficiency and it imposes to give the most direct and shortest dental practice for solving. It is possible to trigger or aggravate generaldisorders caused by dental work, cases in which we have an obligation to recognize the accident or complication at the time of happening and to intervene urgently and effectively to save the patient�s life. Epilepsy is a neurological disease that alters the transmission of electrical signals within the brain. We conducted our study in the Oral and Maxillofacial Surgery Clinic on 187 patients studied between 2015 and 2018. Of these, 171 were emergencies. Regardingthe interventions suffered by the patient, it was observed that the most common neurological emergency installed in dentistry is the epileptic seizure. Serious and small epileptic seizures can occur from different causes and at various intervals, a professional anamnesis informing the doctor about the frequency and severity of seizures.

Quantification of N-Terminal Procollagen I Propeptide in Patients With Occlusal Trauma Induced by Prosthetic Factors

Occlusal trauma can be generated by a number of local factors, including incorrect dental prosthetic systems. Proper therapy can lead to improved tissue homeostasis, with an increase in bone neoformation, whose markers include the N-terminal procollagen I propeptide (PINP). The purpose of the study was to determine serum N-terminal procollagen I propeptide levels in patients with occlusal trauma caused by incorrect prosthetic systems, performed before and after the establishment of perio-prosthetic complex therapy. The study was performed on a group of 56 patients with periodontal disease and prosthetic systems generating nonphysiological, traumatic occlusal forces. These patients underwent the clinical examination, appropriate multidisciplinary therapy, and N-terminal procollagen I propeptide levels were evaluated in the serum at baseline, 6 months, and 12 months after the therapy completion. The results demonstrated significant improvements for periodontal parameters in both post-treatment assessments and an increase in N-terminal procollagen I propeptide, more significant at one year after treatment.

Oral Tumors Having the Origins in Multiple Tissues, Non-differentiated or Differentiated

The lesions in the oral cavity must be seen in the light of pathological and correlated system processeswith systemic illnesses because systemic illnesses cause oral manifestations and inversely - oral affections(Alvin Gardner). Many times, when symptoms and signs occur, the disease is in an advanced phase, the interest of the oral cavity being the expression of a generalized illness. Extremely varied tumors in shape and evolution come from multiple tissues undifferentiated or differentiated, often in a complication of different structures, which imparts to them a histological polymorphism. They can be found and traced in their evolution during a dental examination, more easily than those developed at the organs. An early detection of precancerous states and neoplasia can be made, and clinical and paraclinical data are corroborated in the dynamics of the evolutionary process, with the observation that, in the presence of benign histological aspects, evolution may be serious due to functional turbulence lymphangioma of the tongue with muscle fiber atrophy, epithelial ulceration and superadded inflammation with oral phlegmon), haemorrhages (oral mucosal hemangioma). We studied 120 patients with oral tumors originating in multiple non-differentiated tissues or differentiated, over a 5-year period, January 2012-December 2016. Malignant ganglion involvement includes a broad pathology requiring rigorous, clinical, paraclinical, histological and immunohistochemical examination to achieve effective therapeutic management. The degree of malignancy should be specified in all cases where this is possible with the help of available systems as it is of prognostic and predictive importance.

In vitro Evaluation of Enamel Surface Treated with Fluoride After Bleaching and Etching Erosive Processes

The anti-erosion effect of fluoride on the enamel surface was investigated by ATR-FTIR, SEM and EDX techniques. Four extracted teeth (two incisors and two premolars) were initially bleached with carabamide peroxide and etched with ortho-phosphoric acid then fluoride treatment was applied. Significant differences in enamel composition and morphology were observed providing the effect of fluoride application in remineralization of teeth. Infrared spectroscopy was employed to probe the changes in enamel structure. Scanning electron microscopy/energy dispersive X-ray spectroscopy analysis revealed higher content in F of teeth enamel. Morphology changes revealed a re-mineralization of enamel surface after the treatment with fluoride gel.

Implications of Digital Image Processing in the Paraclinical Assessment of the Partially Edentated Patient

The application of certain digital processing techniques offers the possibility of extra accuracy in the interpretation of paraclinical examinations of this type, with profound implications in the diagnosis as well as in the hierarchy of the treatment plan. The purpose of this study is to identify the type of imaging processing for the identification of pathological elements from orthopantomographies and articular tomographies. A number of 20 orthopantomographies and 15 temporo-mandibular joint tomography have undergone through various image enhancement techniques. Various methods of image enhancement (enhancement) have been used for those procedures whereby it becomes more useful in the following aspects: specific details are highlighted; noise is eliminated; the image becomes more visually attractive. The workings were done in Corel PhotoPaint 7.0, using the automatic procedures available.The choice of a particular type of image enhancement technique has been selected for each type of pathology found in orthopantomographies or articular tomography, providing the best accuracy for an optimal imaging interpretation that underpins a precision diagnosis.Of the most useful imaging processing in the optimization of the orthopantomographic image accuracy the point-to-point transformations are to be noted. The image processing proposed in this article focused primarily on improving the radiological image attributes to highlight specific anatomical structures, and secondly, the contour detection, where it was necessary for the diagnostic purposes as well.

Interrelations Between Anesthetic Substances, General Condition of the Patient and Implant Rehabilitation Procedure

The purpose of this study is to quantify the existing interrelationship between the anesthetic substances used in the implanto-prosthetic rehabilitation procedures with the general state of the patient, as well as the specific implant rehabilitation work.The analyzed lot brought together 110 patients, candidates for implanto-prosthetic rehabilitation, subjected to a general and local evaluation protocol for choosing general anesthesia in accordance with the general state and complexity of the implanto-prosthetic algorithm. Regarding connection between therapeutic approaches in oral implantation and types of anesthesia , we obtained correlative aspects between the use of inhalosedation and implantation algorithm in 80% clinical cases and augmentation with implantation was found in 20%.General anesthesia with Midazolam has been correlated with implantation and augmentation in 77% clinical cases and sinus lift and implantation was found in 23% clinical cases.General anesthesia with Midazolam was used in 64% clinical cases with implantation and sinus lift and 36% clinical cases with implantation.Careful monitoring of the patient and proper dental surgery where the intervention is performed are the key for a therapeutic success regarding sedation and anesthesia.

The Effect of ortho-Phosphoric Acid Etching Application on Enamel Surface ATR-FTIR and SEM studies

The acid etching procedure represents a procedure that increases the bond strength between the etched enamel and the composite resin. The aim of this study was to evaluate the effect of ortho-phosphoric acid 37% on the morphology and composition of the enamel surface. The surfaces of four extracted teeth (two incisors and two premolars) were etched with 37% ortho-phosphoric acid solution for 15 seconds. The teeth were examined by ATR-FTIR spectroscopy and SEM microscopy in order to determine the degree of the enamel demineralization. A major change on teeth composition and morphology has been found. The results are discussed and compared with those of the effects of different concentrations of bleaching agent (carbamide peroxide) on the enamel surface. Etching with 37% ortho-phosphoric acid caused structural and morphological changes to the dental enamel surfaces.

Malpraxis risk management in implantology

In present practice there is an increased demand from patients for prosthetic implant restoration solutions. At the same time one can notice a possible vulnerability regarding allegations of malpractice, as evidenced by the growing number of complaints of malpractice also maintained by negative reports, frequently incomplete or incorrectly documented from the press. This should require practitioners to have a professional attitude.

Incidence and prevalence of dental-periodontal conditions and edentation in Moldavia

The proper rehabilitation of the partially extended edentulous patient should lead to a state of balance between the components of the stomatognathic system and the therapeutic option selected for an as long as possible.

AIM

To outline the importance of a holistic biological perspective on the body-stomatognathic system relationships and the need for complex rehabilitation in view of obtaining a long lasting balance.

MATERIAL AND METHODS

3340 individuals from urban and rural areas of Iasi County were evaluated. The evaluation was based on the correlation of physical exam with data from a specially drafted questionnaire aimed at determining oral health behavior pattern, a sine-qua-non condition for a clear identification of oral conditions specific to the study area.

RESULTS

General health status was poor in 72.1% of the subjects from rural areas as compared to 27.9% in those from rural areas, with cardiovascular diseases ranking first but with higher rates in urban than in rural areas. In urban areas, odontal lesions were the most common and had a higher prevalence in 2012 than in the previous years, followed by the periodontal lesions with the same ascending trend in 2012.

CONCLUSIONS

Continuity with regard to the prophylaxis of general and oral conditions in the lasi County in both rural and urban areas is a must, health education being essential for improving population health.

Proprosthetic interventions in the posterior maxillary implant therapy

AIM

The purpose of this study is to evaluate the necessary number of pro-prosthetic interventions in view of the implanto-prosthetic rehabilitation of the defective prosthetic fields.

MATERIALS AND METHODS

We investigated a lot that included 230 patients aged between 18 and 82 who benefited from implant-prosthetic rehabilitation, the type of graft used, the types of membranes selected as well as the various remodeling and elevation techniques at the maxillary level dictated by the particularity of the clinical case.

RESULTS AND DISCUSSIONS

The edentulous posterior maxillary region presents in implantology a more difficult situation than any other region of the maxillary. The absence of teeth often triggers a progressive reduction of the alveolar process volume, a reduction that aims particularly at the bony vertical dimension, namely the region between the top of the alveolar ridge and the floor of the maxillary sinus, called the sub-sinus Misch vertical dimension. The presence of the maxillary sinus, combined with the reduction of height of available bone in the terminal maxillary region poses serious problems for implant insertion.

CONCLUSIONS

The success of the implant therapy depends on the absence of radio-transparent areas, while the per-implant bone resorption must be limited to the cervical region and should not involve the implant threads or its osteo-integrated area. The implant should also be fix, pain free, with no local infection.

[Surface aspect of fixed restaurations and parodontal influences]

Any new class of materials requires a new cutting technology which, unless complied with properly, may negatively impact on the advantages and performance of the material. The modifications appeared as a result of the technological processes in the structure or surface aspect of the materials not only affects the mechanical resistance of the restorations but also casts doubts on their biological qualities.

AIM

This study evaluates the impact of biomaterials involved in fixed restorations on the periodontal architecture, bearing extremely important connotations in the long run.

MATERIAL AND METHODS

The "in vitro" testing was conducted on culture cells for the cytotoxic effect of certain restorative materials--metallic alloys used in prosthetic restorations, composite materials, in collaboration with the Virology Laboratory of the Public Health Institute.The tested materials were metallic alloys, composite materials and acrylic resins used for the construction of standard sized plates (out of each material) in order to avoid the differences that might arise from the technological process. Artificial saliva processed to reach a pH = 7 was prepared in the Biophysics Laboratory of UMF Iasi. Material samples and the saliva inoculated with these were tested. -p.

RESULTS AND DISCUSSIONS

The cytotoxic effect of the tested materials on the celular cultures takes on extremely diverse forms, from discrete morphological modifications of the cells with regard to the size, shape, internal structure (for the noble and semi-noble alloys) up to the partial stripping-off of the celular film, the modification of density and coloration. In the case of the witness of non-inoculated culture, the testing results showed the presence of a continuous film, with cells having the same size, transparency and colouring, with an unaltered polyhedral contour, with visible nuclei, an image also kept in the case of the saliva witness.

CONCLUSIONS

The involvement of restaurative materials in triggering, maintaining and aggravating a periodontal pathology indicates the capital role played by the dentist in the identications of lesions during measures by avoiding or excluding etiological agents before an obvious lesions occurs in the process of active dispensarization.

[Reticulate polymers used in obtaining new dental materials]

This paper seeks the characterization of new polymers acrylic cross-linked structure, prepared in the presence of a template that creates the polymer synthesized the property of saving template form.

MATERIAL AND METHOD

For carrying out synthesis of polymers reticulate-based on dimethacrylate monomer was left to the mono-, di-and trietilenglicol dimethacrylate. Cross-linked polymerization reaction was initiated with benzoyl peroxide.

RESULTS

New structures are obtained witch respond to the need to diversify and improve the biomaterials used in dentistry. The materials are chemically thermally and mechanically inert. Reticulate polymers are non-biodegradable and therefore do not produce intoxication and not degrade biological fluids.

[Clinical evaluation of the possibilities of restoring the dental and periodontal esthetics using veneers vs. metal ceramic crowns]

Achiving the esthetic balance is one of the most important aims of the restorations used for the anterior area of the dental arches.

AIM

To evaluate the possibilities of veneers and metal ceramic crowns to restore dental and periodontal esthetics.

MATERIAL AND METHOD

We have evaluated 90 restorations, 40 veneers and 50 metal ceramic crowns, analysing the following parametres: gingival index, bleeding index, plaque index, also restorations margins index, presence/absence of secondary decays, marginal integrity index and the aspect of the restorations surfaces. The study also evaluates patient satisfaction using questionares.

RESULTS

Even the veneers seem to be more indicated to restore dental and periodontal esthetics, the esthetic outcome depends mainly on the way the clinician evaluates and manages the tissues and less on the technique used (all ceramic or metal ceramic).

[Viral patology and oral manifestation]

Although the medical and biological importance of ringworm infections was acknowledged a long time ago, the putting-up-to-date of some clinical notions is justified for at least three reasons: the improvement and accessibility of molecular biology techniques, the consideration of the major pathogenic role of these viruses in circumstances of immune depression, the possibility to control these infections by means of specific chemotherapy.

MATERIAL AND METHOD

A prospective study was carried out in the interval 1.01.2006 - 31.12. 2008, of all cases of ringworm infections with oral eclat, hospitalised in Infectious Diseases Hospital Iaşi. The diagnosis was established according to the clinical manifestations, the hematological modifications and, if the case, serological examination.

RESULTS

The study included 291 cases. The infection with EVB (infectious mononucleosis) was diagnosed within the age interval 8 months-60 years (median-10 years). The oral manifestations were mainly located at the level of the palatine and velopalatine vault. Chickenpox was diagnosed within the age interval 7 days-52 years (median-8 years). The chickenpox enantem was observed in 90.42% of the cases, being represented by varix wounds, or "hemorrhagic spots", mostly located at the level of the fibrous mucose membrane of the palatine vault--40.2%.

CONCLUSIONS

The knowledge of the oral manifestations in ringworm infections with highly contagious potential and a high risk of severe complications represents a fundamental method in early diagnosis as well as an important step in establishing the prophylaxy measures meant to prevent these pathogens from being transmitted to the dentist office.

[Posttherapeutic feed-back evaluation in oral rehabilitation]

The goal of this study was to assess the subjective post-therapeutic feedback for a group of patients in order to evaluate the possibility of including the psycho-behavioral parameters into the analysis structure of an expert system.

MATERIAL AND METHOD

135 patients diagnosed with class I and II Kennedy edentation, aged between 40 and 89 years old, where clinically examined. All patients filled in structured questionnaires focused on psycho-behavioral parameters.

RESULTS

Prosthetic treatment in oral rehabilitation improves subjective perception of facial aesthetic (66.86% total and moderate accord), psychological status (71.14% total and moderate accord) and of the social relations (77.47% total, moderate and low accord) but it is not subjective associated with the improving of general health (55.49% disagreement).

CONCLUSIONS

We can establish statistical support correlation between psycho-behavioral parameters and therapeutic solutions applied in oral rehabilitation, correlation that can be later quantified and used in the development of an expert system.

[Practical aspects of sepsis from oral bacterial infections]

Infections of the oral cavity are an important morbidity problem due to their frequency, their pluribacterial ethiology as well as their potential severe evolution, especially with the immunodepressive. The odontogenic infections are considered to be the cause of 40% of the deep throat infections. The infections of the submentonier space occur through direct extension from the mandibular incisors, those of the sublingual space start from the anterior mandibular teeth and those of the retrofaringian space start from the mandibular molar teeth.

MATERIAL AND METHOD

The present study included 24 pacients diagnosed with oral sepsis in Iaşi Infectious Diseases Clinic. We analysed the ethiology and the clinical response to the administered antibiotherapy.

RESULTS

In several immunodepressed patients (with diabetus melitus, neutropenia, liver disfunction, carcinomas, tuberculosis) was noted sistemic evolution of odontogenic infection and they mainly came from the Surgery Clinics, where surgery was performed for the drainage of collections. Etiology was confirmed in 8 cases reflecting normal oropharyngeal flora. These infections were treated with antibiotics in synergistic combinations (betalactamines, quinolones, Cloramfenicol) with good results in 19 cases.

CONCLUSION

Infections of the oral cavity are an important morbidity problem due to their frequency, their pluribacterial origin as well as their potential severe evolution, especially in immunodepressed patients.

[Study on noninvasive paraclinical evaluation methods according to particular aspects in patients diagnosed with partial dentition]

The aim of this study quantifies the contribution of the non invasive and minimally invasive methods of paraclinic evaluation corroborated with the clinical aspects, a particularly important element being represented by the inter-relation between the general condition--oral pathology.

MATERIAL AND METHOD

The study group was represented by patients with ages between 18 and 35 years, diagnosed with partial edentation, with various problems of the general condition. To the same extent, with concern to the study group a special emphasis was placed on the paraclinical results and the therapeutic trajectories directed by the use of the diagnodent, without ignoring the role the digital radiography has in the diagnostic stage as well as the therapeutic one.

RESULTS

The results obtained subsequent to the thermographic evaluation showed the initially hidden character of the general symptomatology, the patient being unaware of the presence of any pathology at the level of the apparatus and systems, factor which could have interfered negatively with the pathology specific to the field of dental medicine. Creating a hierarchy, the link offered by the thermogram between the systems and the dental segment is already known. The pathology under investigation, both at an oral level and at a general one pleads for the correlative aspects of the binomial dental unit--affected organ, the modifications of the thermographic trajectories for the somatic area analyzed after the specific therapy being eloquent.

[Clinical aspects of therapeutic options in oral rehabilitation of partially edentulous patients]

This study aims at identifying practical ways of approaching social cases, and creating a hierarchy of the final functions of restauration.

MATERIAL AND METHOD

In 2008 the Clinical Base for Learning from the School of Dental Medicine, Iaşi, recorded for the Partially Stretched Edentation Clinic and Therapy course a prevalence of biterminal partial edentation (Class I Kennedy)-66.39 per cent from the total number of patients, followed by uniterminal edentation (Class II Kennedy), having 40.24 per cent of the clinical cases, whereas INTERCALATE edentation (Class III Kennedy), frontal edentation (Class IV Kennedy), and subtotal edentation have about 20.12.1 per cent each.

RESULTS

The clinical form of edentation contributes to the election of a proper therapeutic solution as well as the odonto-parodontal and muco-osseous status of each clinical case, the patient's general condition or the socio economic and technical factors leading to a modern, classical or social prothesing. An important aspect to take into account is the large percentage of social cases diagnosed with partially edentation, pleading for provisional protheses with an established role in therapy, which sometimes may become social prothesing--an outstanding clinical reality. Social cases should be solved with a view to restoring functionality such as lower level redimensioning and cranio-mandibulary repositioning, whereas aesthetic requirements fall into therapies based on metallo-ceramic and hybrid prothesing or implanto-prothetic therapy.

[Role of computerised programs for the evaluation, diagnosis and treatment of partially edendulous patients]

In order to elaborate a correct plan of diagnosis and find the correct therapeutic solution of election in partial edentulous it would be necessary to use a Support System for Clinical Decisions (SSCD). This may bring many benefits both to the private medical assistance,and to institutions with wider therapeutic, educational and scientific objectives.

MATERIALS AND METHODS

Using as starting point the ProDent platform of application existing at the Faculty of Dental Medicine from The University of Medicine and Pharmacy Gr.T. Popa Iaşi we have developed an expert system for clinical case evaluation and for providing a reliable therapeutic solution. In this respect we have used the ProDent application database--a complete and complex database which records information about patients.

RESULTS

At the same time the application generates a table recording a clinico-biological data hierarchy, highlighting the categories which may require intervention during the specific preparation stage. The use of bayes inference also indicates the most reliable therapeutic solution, the initial plan of treatment, the reliability score and the oral rehabilitation predictions. By adding the patient initial score and the oral rehabilitation predictions provided by the application, we obtain the patient initial therapeutic score.

CONCLUSIONS

The simulation programs and the electronic format of the observation paper are efficient tools that provide an integrative holistic approach of patients with different forms of oral pathology, under the incidence of local, loco-regional and general complications.

[The role of the polimers in increased acrylic biomaterials qualities used in prosthetic restaurations]

This study is aimed at the improvement of the biomaterials used in the field of entirely removable prosthesis quality. One important aspect taken into consideration is the adhering of the Candida albicans fibres, a bacterium frequently met at the oral cavity level of old patients, to different variations of acrylate, in search of ways of counter-attacking this tendency of a very resistant microbian structure.

MATERIAL AND METHODS

A number of 19 test-tubes were made under the shape of thin, rectangular plates, 40 mm long and 20 mm wide and a depth varying from 1.8 to 2.5.

RESULTS

After analysing the test-tubes for traction forces, was observed: The beraking of the base material was followed by the taking over of the force by the metallic net: the small (elastic) distortions of the acrylate were not simultaneous with the distortions of the reinforcement materials. Polyethylene fibres are made by twisted threads and it presents a lower elasticity module compared tot hat of the acrylic resin, especially duet o the ondulation of the fibres.

CONCLUSIONS

Among the advantages of the use acrylic bases renforcement with polyetilene fibres we notice its lower interface effect in comparison with the net acrylical reinforcement.

[The biomechanical behaviour of the flexible acrylic partial prosthetics]

The simulation methods constitute a modern method absolutely necessary at the forerunner stage of the practical unwinding of the research stages, outlining the precise directions for the practical application, the final results influencing the dental practice.

AIM

Our study proposes itself to analyze through the method of the finite element the status of the tension and the deformations registered at the level of the partially extended indentured prosthetic field and at the level of the partially flexible acrylic prosthetics.

MATERIAL AND METHOD

The first step was constituted by the realization of CT followed by their scanning and the usage of the material constants. Following the tomographic computer exam at the patients submitted to the study, it was observed a resorption and an important atrophy at the level of the jaw indented crest, after a period of four months, with the flexible prosthetics type Valplast, this aspect having profound clinical and viability implications to the selected therapy solution.

RESULTS

For the 3D reconstruction of the different types of partial extended indentation the Amira universal program was used for the 3D reconstructions for any type of Tomographic Computer. Following the 3D reconstructions of the information obtained on the tomographic computer on the images it can be observed an important resorption of the jaw bone in the area of the edentulous space with an acrylic flexible prosthetics. The intrusion of the silicon material Rubber type, as a viable solution for the reduction of the absorption rate and atrophy of the partially indented prosthetics field, has results proportional to the type of the force applied and the applying of this.

CONCLUSIONS

The simulation of the real clinical situations following the contribution of the tomographic computer constitutes a highly important stage in the evaluation of the degree of resorption and atrophy at the level of the indented crests, process whose parameters are influenced by the factorial accumulation with a profound impact in the clinical result.

[Aspects of the biological behaviour of the rubber RS 330T-RTV silicon material]

The resorption and atrophy of the prosthodontic prosthetic field via the mobile restorations made of flexible acrylate, constitutes a controversial problem in the specialty literature, determining the interest of the clinicians with regard to the counterattacking or improving this process inherent to the indentation evolution. The study aims at analyzing the biological behavior of the silicon type RUBBER RS 330T-RTV, a material often used in the creation of the maxilo-facial prosthetics. The method proposed by us has the object of lining the prosthetics made of flexible acrylic type Valplast with this type of silicon. The practical aspects have been forwarded by the biocompatibility studies, applied to the silicon test-tubes, made in the dental technique laboratory, or to the hypodermic implants at the rodent laboratory animals. At the macroscopic examination it can be observed that the silicon fragment maintains it's almost parallelepiped form. The microscopic exam reveals structural mending phenomena, initially mainly the lymphohistocyte cells, and then mainly the fibrous cells. Biocompatibility aspects certifiable at the RUBBER RS 330T-RTV silicon material are fully according to the biocompatibility notions afferent to the silicon materials. Key words:

Oral rehabilitation between reality and paradigm

The oral rehabilitation represents the integrative concept which re-establishes every segment of the dental-jaw system that is affected by edentation in different clinical forms, without eluding the induced complications and the influence of general status within the chosen therapy algorithm. Despite the significant development of knowledge and techniques, it is still controversial to which degree the therapy solutions of oral rehabilitation approach the therapy's ideal, and also the way in which particular aspects of the prosthetic treatment, the general status and socioeconomic criterion influence the clinical result. The implant-prosthetic therapy represents the state of art in modern treatment of edentulous patients, starting from the simplest cases and ending up with complex situations. However the problem of choosing the best treatment option remains, the patient being confused between several possibilities and numerous limits. In the best of cases, the patient understands, accepts and can afford the adequate treatment option. In other cases, choosing the therapeutically solution can be made only under the impulse of external factors. In critical situations, the patient's fear, disbelief, the restrained economic possibilities exclude the ideal solution and compromise the long-term success of the treatment. Several complex cases that were treated accordingly to the ideal option, using complex integrated algorithms, support the idea that future economic development and improved education should surpass present obstacles, the reality becoming a paradigm.

[Perio Type--the premises of a successful therapy]

The Perio Type implants represent a current alternative for treatment for the implant-prosthetic rehabilitation, the design and the typological variety leading to a pertinent selection dictated by the particularity of the clinical case. The processed element method is eloquent for the biomechanical behavior of these types individualized implants on the clinical archetypes, crystals that have forwarded the clinical applications. The most often used implants from this category have been those from the x-class, characterized by a high degree of perio-integration.