26 research outputs found
Clinical evaluation of metal-ceramic fixed partial dentures.
Department of Dental
Propedeutics Pavel Godoroja,
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of MoldovaIntroduction. Edentulism - a pathological condition characterized by the absence of one or more
teeth in the dental arch - is a major health problem regardless of societies, regions, ethnicities
and social stratification. A fixed bridge (called also as fixed bridge prosthesis, bridge or fixed
partial denture) is attached to remaining teeth to replace a missing tooth, and teeth serving as
attachments for a fixed bridge are called abutments. The part of the fixed bridge, which veneers
the abutment tooth is called a retainer and the part which replaces a missing tooth is called a
pontic.
Aim of the study. The study aims to evaluate the treatment need of fixed bridges according to
the distribution of pontics in dentition, in different age groups and to investigate the primary and
late complications and survival of the conventional fixed metal ceramic prostheses, as well as
patients' satisfaction with the prosthetic treatment.
Materials and methods. An electronic MEDLINE search supplemented by manual searching
was conducted to identify prospective and retrospective cohort studies on FPDs with a mean
follow-up time of at least 5 years. The whole material consisted of the patients treated with fixed
metal ceramic prostheses at the Department of Dental Propaedeutics, Nicolae Testemitanu State
University of Medicine and Pharmacy, during the years 2014–2018. Patients had to have been
examined clinically at the follow-up visit. The study included 18 patients (6 men and 12
females) with partial edentulism. After clinical and paraclinical examination, patients were
devided into two groups: first group consisted of 8 patients with dental bridges fixed on vital
teeth. The second group consisted of 10 patients with dental bridges fixed on endodontically
treated teeth.
Results. Fixed bridges are most often prepared to replace upper first premolars and lower first
molars also in the future. The most usual primary complications related to fixed bridges occurred
during preprosthetic endodontic treatment of abutment teeth and during the preparation of the
root canals. Patients were satisfied with aesthetics and function of the fixed metal ceramic
prostheses. Late complications found in clinical examinations were few, and the survival rate for
the fixed metal ceramic bridge prostheses was calculated to be 84 % after 10 years, long fixed
bridges having a lower survival than the shorter ones. The treatment need for conventional fixed
bridges seems to be highest among patients over 50 years of age in the future. No patients
reported adverse reactions to the material.
Conclusions. The success of prosthetic rehabilitation with metal-ceramic fixed partial dentures
is the result of a medical reasoning based on theoretical and practical skills. Avoidance of
tempestuous preparation, deficitary marginal closing, partial filling of the root canal, crown
perforation with interradicular pivots, pushing the filling material by apex can prevent pulpits,
necrosis, gangrene and other severe complications appearance, occurred in the post-prosthetic
belated period
Tratamentul protetic în edentaţia unidentară
La moment sunt disponibile o varietate largă de posibilităţi pentru restabilirea integrităţii arcadelor dentare în cazul breşelor unidentare: proteza parţială mobilizabilă, proteza fixă şi construcţii implanto-protetice. Scopul: studierea surselor
bibliografice în vederea evaluării metodelor de tratament în edentaţiile unidentare. Material şi metode. Au fost examinate
manuale de specialitate, articole din surse medicale naţionale, cât şi internaţionale on-line aşa ca: Medline, PubMed, Catalogul electronic al USMF „Nicolae Testemiţanu“ Bibliotecii Ştiinţifi ce Medicale (OPAC), Biblioteca Electronică Didactică a USMF„Nicolae Testemiţanu“. Au fost selectate 40 surse bibliografice, fiiind cele mai informative pentru aplicarea în studiul dat. Rezultate. Tratamentul edentaţiei parţiale unidentare utilizează mijloace protetice pentru a reconstitui arcadele dentare în funcţie de topografi a edentaţiei, obiectivele şi criteriile de tratament. Mijloacele de tratament protetic sunt clasificate după diverse criterii: modalitatea de transmitere a presiunilor asupra oaselor maxilare; raportul cu grupul dentar restant; modalitatea de integrare a piesei protetice la sisitemul stomatognat. În dependenţă de suportul pe care sunt realizate, mijloacele de tratament protetic pot fi cu suport odonto-paradontal, muco-osos şi suport implantar.
Concluzii. Puntea dentară duce la deteriorarea dinţilor limitrofi breşei, iar proteza parţial mobilizabilă provoacă rezorbţia
procesului alveolar, ceea ce limitează mult utilizarea acestor metode de tratament în edentaţia unidentară. Reabilitarea implanto-protetică permite menţinerea integrităţii dinţilor vecini unei breşe, micşorează rezorbţia procesului alveolar, îmbunătăţind estetica dentară. Rezolvarea estetică şi funcţională a edentaţiilor unidentare prin intermediul protezării pe implanturi necesită o colaborare perfectă între medicul chirurg, medicul protetician şi tehnicianul dentar. Sarcina evaluării şi echilibrării forţelor ocluzale exercitate pe restaurarea finală îi revine proteticianului, care va evita dereglări ale ocluziei dentare printr-o refacere protetică corectă
Implant supported restoration in single-tooth replacement
Pavel Godoroja Department of Dental Propaedeutics, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: The implant-prosthetic restoration in single missing tooth is a viable treatment option for the functional rehabilitation of tooth loss. Several
published studies show that the deadline and the type of functional loading of the implant for single missing teeth is not decisive for the survival and
success rate of the implant. Although the conventional protocol is still the “gold standard”, the immediate loading of dental implants in the fresh postextraction socket of the aesthetic area has an excellent prognosis. Immediate functional loading is successfully adopted to minimize the treatment time
with immediate and impact benefit on the patient’s quality of life and satisfaction. The aesthetic result is not yet systematically included in the success
criteria of the therapy through implant, although a trend for this is more common in recent publications, particularly in publications evaluating the implant
prosthetic rehabilitation in the anterior maxilla and mandible. In order to obtain optimal aesthetic results, it is necessary to take into account the other
aesthetic parameters, together with the chosen material for the fabrication of the implant-supported single crown and the type of prosthetic abutment.
Conclusions: The systematic review of the contemporary specialty literature examines the types of implantations and implant-supported restorations for
single tooth replacement, the survival rates of the implant, the survival of the crown on the implant and the successful implant, incidence of biological,
technical and aesthetical complications of the implants and prosthetic restorations on implants, the quality of life related to the oral health to patients
with implant-prosthetic treatment
Opțiunile de tratament protetic în edentațiile unidentare
Background. Preservation of soft and hard tissues after tooth loss in order to restore function and
aesthetics through prosthetic treatment is one of the main goals of clinicians. The treatment of single
missing tooth can be achieved by several methods. Objective of the study. Elaboration and
argumentation of a management algorithm of patients with single tooth edetulism based on the
comparative estimation of the treatment results with implant supported prostheses or with conventional
fixed partial dentures. Material and Methods. The prospective controlled clinical trial included 180
consecutive patients aged 18-60 years with single missing tooth in the upper or lower jaw, restored with
fixed partial conventional dentures (90 patients) or with crowns on implant support (90 patients), which
signed the written consent to participate in the study. Results. In this study, the survival rate of fixed
partial dentures (FPD) was statistically significantly lower compared to the implant supported crown
(94.4% and 100.0%, p<0.05). Total complication rates (61.1% and 43.3%; p<0.05), technical(5.6% and
0%; p <0.05) and biological complications were statistically significantly higher in patients with single
missing tooth treated with FPD, and the rate of aesthetic complications (23.3% and 43.3%,p <0.01) -
statistically significantly higher in patients with single missing tooth treated with implant supported
prostheses. By the results of our study, we developed a management algorithm for patients with single
tooth edentulism. Conclusion. Given the large number of variables that affect treatment decisions, there
is no universally effective solution for treating single missing tooth. The selection of the treatment
method must be made on the basis of a risk profile specific to the situation of each patient.
Introducere. Conservarea țesuturilor moi și dure după pierderea dinților în scopul restaurării funcției și
esteticii prin intermediul tratamentului protetic este unul din obiectivele principale ale clinicienilor.
Tratamentul edentației unidentare poate fi realizat prin mai multe metode. Scopul lucrării. Elaborarea și
argumentarea unui algoritm de management al pacienţilor cu edentații unidentare în baza estimării
comparative a rezultatelor tratamentului cu proteze pe suport implantar sau cu proteze parțiale fixe
convenționale. Material și Metode. În studiul clinic prospectiv controlat au fost incluși consecutiv 180 de
pacienți cu vârsta cuprinsă între 18-60 de ani, cu edentații unidentare la maxilarul superior sau inferior,
restabilite cu proteze parțiale fixe convenționale (90 de pacienți) sau cu coroane pe suport implantar (90
de pacienți), care au semnat consimțământul scris pentru participare în studiu. Rezultate. În studiul dat,
rata de supraviețuire a protezelor parțiale fixe (PPF) a fost semnificativ statistic mai mică, comparativ cu
rata de supraviețuire a coroanei pe suport implantar (94,4% și 100,0%, p<0,05). Ratele de complicații total
(61,1% și 43,3%, p<0,05), tehnice (5,6% și 0%; p<0,05) și biologice erau semnificativ statistic mai mari
la pacienții cu edentații unidentare tratați cu PPF, iar rata de complicații estetice (23,3% și 43,3%; p<0,01)
– statistic semnificativ mai mare la pacienții cu edentații unidentare tratați cu proteze pe suport implantar.
În baza evaluării rezultatelor studiului nostru, am elaborat un algoritm de management al pacienţilor cu
edentații unidentare. Concluzii. Având în vedere numărul mare de variabile care afectează deciziile de
tratament, o soluție universal eficientă de tratament a edentației unidentare nu există. Selectarea metodei
de tratament trebuie efectuată în baza unui profil de risc specific pentru situația fiecărui pacient
The incidence of oral mucosa diseases to the patients with chronic viral hepatitis
Actualitatea
În activitatea zilnică profesională, medicul stomatolog este confruntat cu o largă
paletă de afecţiuni ale cavităţii orale inclusiv şi cele care pot reflecta îmbolnăviri
grave ale întregului organism. Printre acestea trebuie menţionate, în mod cert, cele
legate de manifestările orale asociate hetatitelor virale, care, în ultima perioadă de
timp, au devenit din ce în ce mai frecvente şi mai răspândite. Scopul este de a
efectua o totalizare şi de a crea o viziune ce ţine de incidenţa maladiilor mucoasei
bucale la pacienţii cu hepatite cronice virale pe plan mondial.
Materiale si metode
Au fost selectate şi studiate articole ştiinţifice internaţionale din mai multe ţări.
S-a efectuat o reprezentare grafica a analizei statistice conform datelor selectate
privind incidenţa afecţiunilor mucoasei bucale la pacienţii cu hepatite cronice virale.
Rezultate
In urma datelor selectate s-a constatat că afecţiunile mucoaselor bucale cel mai
des se manifestă ca rezultatul reacţiei imune a organizmului in bolile sistemice. În
Germania — 68,7% din pacienţii cu HCV (hepatita C) fiind diagnosticaţi cu lichen
plan bucal. În Iran s-a efectuat un studiu mai amănunţit privind asocierea lichenului
plan bucal cu HCV unde s-a constatat o prevalenţă nesemnificativă. În Japonia rezultatele arată o prevalenţă de 68% a pacienţilor cu
lichen plan bucal si HCV. In Rusia fiind efectuat un
studiu generalizat privind asocierea afecţiunilor mucoaselor
bucale cu hepatitele cronice virale in 87,5%
din cazuri.
Concluzii
Totuşi reieşind din faptul ultimilor date epidemiologice
privind creşterea cazurilor de hepatite
cronice virale şi lipsa unor studii in Republica Moldova
care dovedesc corelaţiile cu alte maladii aşa cum
sunt afecţiunile mucoasei cavităţii bucale aparute
pe fundalul imudeficienţei acestor pacienţi, această
problemă necesită să fie cercetată mai amănunţit pentru
monitorizarea acestui grup de pacienţi.Actuality
Every working day, the dentist meets a lot of oral
cavity diseases including those which can be reflected
as a result of systemic diseases. We should mention
an important point of association of oral mucosa diseases
with chronic viral hepatitis which frequency
were increased last period of time. The aim of study is
to create a vision about the incidence of oral mucosa diseases in correlation with chronic viral hepatitis in
the world.
Materials and methods
In this study were selected the dates from the scientific
articles from different countries. There were
created the graphical presentation of statistical analyses
of incidence of oral mucosa lesions to the patient
with chronic viral hepatitis.
Results
According to the selected information we can
mention that oral mucosa diseases appear as a result
of immunodeficiency of the organism with systemic
diseases. In Germany — 68,7% of the patients with
viral hepatitis C manifest oral lichen planus (OLP). In
Iran were made a deep study of association of OLP
with chronic viral hepatitis C, the result of prevalence
were not insignificant. The prevalence of 68% of the
patient with OLP in association with chronic viral
hepatitis C were identified in Japan. In Russia were
made a general study of prevalence of association of
oral mucosa diseases with chronic viral hepatitis being
87,5% of cases.
Conclusions
According to the last epidemiological dates which
show the increasing of the cases of chronic viral hepatitis
and absence of any studies in Republic of Moldova
which confirm the correlation with oral mucosa
diseases, this problem needs to be investigated deeply
in order to be able to monitoring this group of patients
Maloclussion patterns in physically, auditory and visually handicapped patients in Republic of Moldova
Department of Dental
propedeutics Pavel Godoroja,
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of MoldovaIntroduction. The main problems of orthodontics from Republic of Moldova is to determine
either the genetics or enviromental factors influence the development of malocclusions
Aim of the study. The purpose of the study is to determine the prevalence of maloclusion in
children with special needs and relation with neurological disorders in the process of social
behavoir of children.
Materials and methods. It was examined 2057 children with special needs (physically, visually,
auditory, others) aged between 7-15 from diferent orphaned school from Republic of Moldova.
Clinical examination of children included: disponsable dental mirror, chemical pencil, wooden
spatula, calipser, portable light. Control group were selected 1345 children from normal school
who did not have any neurological disorders and treatment of maloclusions.
Results. In sagital plan maloclusion was associated with 69 (9,75%) cases with auditory
handicapped, 74(14,8%) children with visually handicapped, but in 33(18,33%) - with physically
handicapped children. Mostly, malocclusion have been detected in physically handicapped
children in vertical and transversal plan. Malocclusion varied in boys between 58,8% and
63,89% and in girls between 36,11% and 41,21%. The most affected age is 12-15 in visually
handicapped children, 9-12 – auditory handicapped children and 7-9 age- in physically
handicapped children.
Conclusions. Auditory, visually and physically disorders can be considered as key predictors
and risk factors in appearance of malocclusion in children. Children with special needs may be
treated according to the age and the nature of maloclusions
Contemporary treatment of single missing tooth — systematic literature review
Rezumat.
Revizuirea sistematică a literaturii de specialitate
contemporană analizează tipurile,
rata de supravieţuire, rata de succes, incidenţa
complicaţiilor biologice și tehnice ale implanturilor,
restaurărilor protetice pe implanturi și
protezelor parţiale fixe, calitatea vieţii legată
de sănătatea orală la pacienţii cu tratament
implanto-protetic sau cu proteze parţiale fixe
în edentaţiile unidentare.
Deși protezele parţiale fixe sunt larg folosite
în ultimele 6 decenii, s-a demonstrat că acestea
prezintă o rată scăzută de supravieţuire: 90-
92% la 10 ani și 74-75% la 15 ani de încărcare
funcţională. Cele mai frecvente complicaţii
biologice în timp la pacienţii cu edentaţii unidentare
trataţi prin metoda tradiţională (punţi
protetice convenţionale) sunt: cariile dinţilor
stâlpi, pierderea vitalităţii dinţilor stâlpi, resorbţia
osului crestei alveolare, recesiuni gingivale,
iritaţia parodontală profundă și fractura
dinţilor stâlpi. Cele mai frecvente complicaţii
tehnice la acest grup de pacienţi sunt: pierderea
de retenţie, cu sau fără pierderea de reconstrucţie,
și fracturi ale materialului de faţetare,
cu sau fără pierderea de reconstrucţie.
Mai multe studii publicate arată că termenele
și tipul de instalare a implantului, restaurării
protetice pe implant și încărcării funcţionale
a implantului pentru edentaţia unidentară nu
este decisiv pentru supravieţuirea şi succesul
implantului. Deși protocolul convenţional reprezintă
încă ”standardul de aur”, restaurarea
şi încărcarea funcţională imediată a implanturilor
instalate în alveolele post-extracţionale
proaspete ale zonei estetice prezintă un
prognostic excelent și este adoptată cu succes
pentru minimizarea timpului de tratament cu beneficiu imediat și impact relevant asupra
calităţii vieţii și satisfacţiei pacientului. Rezultatul estetic nu este încă inclus sistematic în
criteriile de succes ale terapiei prin implant, cutoate că o tendinţă pentru acest lucru este mai frecventă în publicaţiile recente, în special în lucrările care evaluează reabilitările protetice pe suport de implant în sectoarele anterioare maxilare și mandibulare.Summary.
The systematic review of the contemporary
literature analyzes the types, survival
rate, success rate, the incidence of the biological
and technical complications of implants,
prosthetic restorations on implants
and fixed partial prostheses, the quality of
life related to oral health in implanto-prosthetic
or fixed partial prostheses in single
missing tooth.
Although fixed partial prostheses have
been widely used over the past 6 decades,
they have been shown to exhibit a low survival
rate: 90-92% at 10 years and 74-75% at
15 years of functional load. The most common
biologic complications over time in
patients with single missing tooth treated by
the traditional method (conventional prosthetic
bridges) are tooth decay, loss of vitality
tooth poles, alveolar crest bone resorption,
gingival recession, deep periodontal
irritation, and tooth fracture fracture. The
most common technical complications in
this group of patients are: loss of retention,
with or without loss of reconstruction, and
fracture of the veneer with or without loss of
reconstruction. Several published studies show that the
timing and type of implant installation, prosthetic
restoration on the implant and functional
loading of the implant for a one-day
editorial are not decisive for the survival and
success of the implant. Although the conventional
protocol is still the „gold standard“, the
immediate restoration and immediate loading
of implants installed in the fresh postextraction
areas of the aesthetic area have excellent
prognosis and are successfully adopted
to minimize treatment time with immediate
benefit and impact on quality life and patient
satisfaction. The aesthetic result is not yet systematically
included in the success criteria of mediciimplant
therapy, although a trend for this is
more common in recent publications, especially
in works evaluating prosthetic rehabilitation
on implant support in anterior maxillary
and mandibular sectors
MALOCLUSSION PATTERNS IN PHYSICALLY, AUDITORY AND VISUALLY HANDICAPPED PATIENTS IN REPUBLIC OF MOLDOVA
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, Department of Dental propedeutics Pavel GodorojaIntroduction. The main problems of orthodontics from Republic of Moldova is to determine either the genetics or enviromental factors influence the development of malocclusions
Aim of the study. The purpose of the study is to determine the prevalence of maloclusion in children with special needs and relation with neurological disorders in the process of social behavoir of children
Prosthetic treatment options in single tooth edentulism
Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Catedra de propedeutică stomatologică „Pavel Godoroja”, Catedra de chirurgie OMF şi implantologie orală „Arsenie Guţan”, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction. Preservation of soft and hard tissues after tooth loss in order to restore function and aesthetics through prosthetic treatment is one of the main goals of clinicians. The treatment of single missing tooth can be achieved by several methods. In order to make an optimal
decision, it is necessary to evaluate all treatment alternatives. Purpose. Elaboration and argumentation of a management
algorithm of patients with single tooth edetulism based on the
comparative estimation of the treatment results with implant
supported prostheses or with conventional fixed partial dentures. Material and methods. The prospective controlled clinical trial
included 180 consecutive patients aged 18-60 years with single
missing tooth in the upper or lower jaw, restored with fixed
partial conventional dentures (90 patients) or with crowns on
implant support (90 patients), which signed the written consent to
participate in the study. The main reasons for the lack of teeth
were complications of dental caries, periodontitis, dental trauma
and orthodontic causes. Results. In this study, the survival rate of fixed partial dentures (FPD) was statistically significantly lower compared to the implant supported crown (94.4% and 100.0%, p<0.05). Total complication rates
(61.1% and 43.3%; p<0.05), technical(5.6% and 0%; p <0.05) and biological complications were statistically significantly higher in patients with single missing tooth treated with FPD, and the rate of aesthetic
complications (23.3% and 43.3%,p <0.01) - statistically significantly higher in patients with single missing tooth treated with implant supported prostheses. By the results of our study, we developed a
management algorithm for patients with single tooth edentulism. Conclusions. Given the large number of variables that affect treatment decisions, there is no universally effective solution for treating single missing tooth. The selection of the treatment method
must be made on the basis of a risk profile specific to the situation of each patient
The Clinical Characteristics, Diagnosis and Treatment of Oral Candidosis
Catedra Stomatologie terapeutică USMF „Nicolae Testemiţanu”, Firma BosnalijekIn the last few years a growth of oral candidosis frequency was observed. 38 patients with oral candidosis were examined and treated. For diagnosis, laboratory investigations were estabilished ( direct microscopic examination and seeding with Sabouraud media). The systemic antifungus medicine – Funzol (Fluconazol) from Bosnalijek Company was used, which demonstrated to be a good drug in treatment of oral candidosis.
Pe parcursul ultimilor ani s-a observat o creştere a frecvenţei candidozelor orale. Au fost examinaţi complex şi trataţi 38 pacienţi cu candidoză orală.. Pentru stabilirea diagnosticului s-au efectuat cercetări de laborator ( examenul microscopic direct şi însămînţări pe mediul Sabouraud). S-a utilizat preparatul antifungic sistemic – Funzol, firma Bosnalijek (Fluconazol), care a demonstrat că este un preparat de elecţie în tratamentul candidozelor orale