ALTERNATIVE TECHNIQUE FOR THE COSMETICISATION OF THE UPPER FRONTAL TOOTH GROUP (PILOT STUDY)

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. În stomatologia estetică este actuală cosmetizarea problemelor estetice la nivel de grup frontal superior, fiind propuse numeroase scheme și metode, însă cu eficacitate, pronostic variabil și neaplicabile pentru fiecare situație clinică. Scopul lucrării. Elaborarea unei tehnici alternative de cosmetizare a compoziției dento-gingivale frontale superioare la pacienții cu acuze estetice. Material și Metode. Tehnica a fost dezvoltată pe modele dentare, recreându-se similitudinea aspectului și concordanța cromatică a dinților omologi (cheia de culori, harta cromatică). La 16 pacienți cu acuze estetice, s-a aplicat tehnica prin metoda directă (compozite), cu evaluarea autopercepției esteticii orofaciale (chestionarul OES) pre- (T1) și post-tratament (T2). Rezultate. Impactul utilizării tehnicii propuse în reabilitarea estetică a fost evaluată pozitiv de către pacienți, fiind atestate următoarele ameliorări statistic semnificative (p<0.01) ale mediei itemilor chestionarului OES (T2 vs. T1): aspectul feței în plan frontal (+15.7 %), alinierea dinților (+10.9%), conturul dinților (+21.2%), culoarea (26.7%), impresia generală (+23.6%), scor total (+30.4%). Concluzii. Tehnica propusă a demonstrat viabilitatea în cosmetizarea acuzelor estetice a grupului frontal superior de dinți, având un potențial de extindere și adaptare pentru situații clinice complexe.Background. A current topic in aesthetic dentistry is the cosmeticisation of aesthetic issues of the upper frontal teeth. Numerous solutions and methods have been proposed in this regard, exhibiting varying efficacy and prognosis while being inapplicable for every single clinical situation. Objective of the study. To develop an alternative technique for the cosmeticisation of the upper frontal dento-gingival composition in patients with aesthetic complaints. Material and Methods. The technique was developed on dental models, recreating the similarity in appearance and chromatic concordance of homologous teeth (shade guide, shade map). It was applied by direct technique (composites) in 16 patients with aesthetic complaints, assessing their self-perception of orofacial aesthetics (OES questionnaire) pre- (T1) and post-treatment (T2). Results. The impact of using the proposed technique in aesthetic rehabilitation was positively evaluated by the patients, with the following statistically significant improvements (p<0.01) in the the mean of the OES questionnaire items (T2 vs. T1): facial appearance from the frontal view (+15.7%), tooth alignment (+10.9%), tooth contour (+21.2%), tooth color (+26.7%), overall impression (+23.6%), total score (+30.4%). Conclusion. The proposed technique has demonstrated viability in cosmeticising aesthetic complaints of the upper frontal group of teeth, with potential for expansion and adaptation for complex clinical situations

A digital workflow in aesthetic crown lengthening procedures

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Erupția pasivă alterată apare din cauza suprapunerii gingiei peste smalțul dintelui. Aceste dizarmonii pot fi corectate printr-o operație de alungire coronară. Tehnologiile digitale care permit gingivectomia ghidată, cu sau fără îndepărtarea osului subiacent, pot ajuta clinicianul să obțină rezultatele predictibile. Scopul lucrării. Demonstrarea, prin intermediul unui caz clinic, a unui posibil flux de lucru digital în procedurile estetice de alungire a coroanelor clinice. Material și metode. Examenul pacientului a depistat coroane clinic scurte. A fost planificată o procedură de alungire coronară cu rezecție osoasă. Tomografia computerizată cu fascicul conic (CBCT), scanarea intraorală și imprimarea 3D au fost utilizate pentru a proiecta și imprima un ghid chirurgical, care a servit drept referință atât pentru gingivectomie, cât și pentru osteoectomie în timpul procedurii de alungire coronară ghidată. Rezultate. După 6 luni, pacientul a apreciat rezultatul estetic obținut drept satisfăcător, cu absența excesului gingival vizibil, o înălțime adecvată a coroanei și fără recurență a dizarmoniei. Concluzii. Fluxul de lucru digital propus poate fi implementat cu succes în cazul procedurilor estetice parodontale. Rezultatele previzibile, cu relații armonioase între formele și dimensiunile dentare și gingivale pot fi obținute cu ajutorul tehnologiilor digitale moderne.Background. Altered passive eruption occurs due to excessive gum overlapping the enamel. These cases can be handled with a crown lengthening surgery. Modern digital technologies enabling guided gingivectomy with or without removing the underlying supporting bone can help the clinician in achieving predictable and desired results. Objective of the study. To demonstrate a possible digital workflow in aesthetic crown lengthening procedures through a clinical case. Material and methods. The patient examination revealed the presence of short clinical crowns. A crown lengthening procedure with bone resection was planned. Cone-beam computed tomography (CBCT), intraoral scanning, and 3D printing were used to design and print a single surgical guide that provided a reference for both gingivectomy and osteoectomy during the guided aesthetic crown lengthening procedure. Results. After 6 months, the patient assessed the aesthetic result as satisfactory, presenting with an absence of visible gingival excess, and adequate crown height, with no recurrence of disease. Conclusion. The proposed digital workflow can be successfully implemented in case of periodontal aesthetic procedures. Predictable results, harmonious relationship between dental and gingival shapes and dimensions can be achieved using modern digital technologies

Diagnosis of Symptomatic Intracranial Atherosclerotic Disease

Intracranial atherosclerotic stroke differs from extracranial atherosclerotic stroke in many aspects, including risk factors and stroke patterns. It occurs in association with in situ thrombotic occlusion, artery-to-artery embolism, branch occlusion, and hemodynamic insufficiency. Intracranial atherosclerotic stenosis (ICAS) could have only been diagnosed by transcranial Doppler (TCD) and transcranial color-coded sonography (TCCS), which are burdened by a risk of bias, or catheter angiography (DSA), which, on the contrary, is very precise, but rarely it is done in clinical practice due to its invasiveness. Computed tomography angiography (CT-A) and magnetic resonance imaging angiography (MR-A) have increased the identification of ICAS in a wider stroke population

Cerebral Vein and Dural Sinus Thrombosis

Cerebral venous thrombosis (CVT) is an uncommon disorder in the general population. At least 1 risk factor can be identified in 85% of patients with CVT. Because of the high frequency of thrombophilia among patients with CVT, screening for hypercoagulable conditions should be performed. Two pathophysiological mechanisms contribute to their highly variable clinical presentation. Four major syndromes have been described: isolated intracranial hypertension, focal neurological abnormalities, seizures, and encephalopathy. Cavernous sinus thrombosis represents the single CVT which produces a characteristic clinical syndrome. Head Computed Tomography is the most frequently performed imaging study, but Magnetic Resonance Imaging of the head combined with Magnetic Resonance venography are the most sensitive studies. Acute phase therapy for CVT focuses on anticoagulation, management of seizures, increased intracranial pressure, and prevention of cerebral herniation. The majority of patients have a complete or partial recovery, however they have an increased incidence of venous thromboembolism. Clinical and imaging follow-ups 3–6 months after diagnosis are recommended to assess for recanalization

Perception of consumers and producers on milk traceability supply chain

Food traceability (FT) in is an important tool for reducing the occurrence of foodborne diseases in the current context of a continuously growing volume and movement of food. The aim of the research was to determine the perception of consumers and producers regarding FT, the impact on purchase / sale and loyalty to traceable food products (FTP). Thus, a survey was conducted on the milk supply chain in Neamț County, Romania with two questionnaires: for consumers and for producers. The TwoStep Cluster analysis allowed the establishment of 2 clusters for consumers and 2 for producers. Cluster 1 consumers (40.6%) priority: rural area, between 30 and 60 years old; secondary education, women are informed about FT. They consider that FTs are 10% more expensive than non-traceable products and traceability is a formality. Cluster 2 consumers (34.8%) priority: urban environment, with secondary education, men, well informed about FT and are willing to buy for food safety even if the price would increase by 20%. Cluster 1 producers (61.1%) priority: rural area, secondary education, information on FT at medium level and appreciate that traceability is expensive and the information provided can reduce the competitive advantage and increase taxation. Cluster 2 producers (38.9%) priority: rural area, with secondary education, women who have above average information about FT consider that FT allows the legal assurance of their own activity and can determine the increase of sales

The global assessment of the state of food security and progress towards achieving the hunger and food insecurity targets

This scientific approach presents an updated global assessment of food insecurity and nutrition for up to the year 2021 and a scientific approach on progress towards meeting SDG Targets 1 and 2 ending hunger and ensuring access to safe, nutritious and sufficient food for all people all year round and eradicating all forms of malnutrition. Despite hopes that the world would emerge more quickly from the crisis and food security would begin to recover from the pandemic in 2021, the pandemic held its grip and even tightened it in some parts of the world. The rebound of gross domestic product (GDP) growth observed in most countries in 2021 did not translate into gains in food security in the same year. Enormous challenges are still faced by those who continue to be the most affected: those with less wealth, lower and more unstable incomes and poorer access to critical basic services. Another crisis is unfolding as this scientific approach is being written with potentially sobering implications for global food security and nutrition: the war in Ukraine. Although the statistics presented in this scientific approach represent the state of food security and nutrition up until 2021, the direct and indirect effects of the conflict in 2022 will have multiple implications for global agricultural markets through the channels of trade, production and prices. Ultimately, this casts a shadow over the state of food security and nutrition for many countries, in particular those that are already facing hunger and food crisis situations, and poses an additional challenge for achieving the SDG 2 targets of ending hunger and ensuring access to adequate food for all (SDG Target 1) and of eliminating all forms of malnutrition (SDG Target 2)

Vascular Aphasias

Aphasia represents an acquired central disorder of language that impairs a person’s ability to understand and/or produce spoken and written language, caused by lesions situated usually in the dominant (left) cerebral hemisphere, in right-handed persons. Aphasia has a prevalence of 25–30% in acute ischemic stroke (vascular aphasia). It is considered as an important stroke severity marker, being associated with a higher risk of mortality, poor functional prognosis, and augmented risk of vascular dementia. The assessment of aphasias in clinical practice is based on classical analysis of oral production and comprehension. The language disturbances are frequently combined into aphasic syndromes which are components of different vascular syndromes that may evolve/involve rapidly at the acute stage of ischemic stroke. The main determinant of the type of vascular aphasia is the infarct location (especially left middle cerebral artery territory). Recent studies at the hyperacute stage of ischemic stroke have observed features of aphasia, have reanalyzed its neuroanatomy using new imaging techniques, and have shown that aphasias have a parallel course to that of cortico-subcortical hypoperfusion. Thus, the reversal of hypoperfusion, following recanalization (spontaneous or secondary to thrombolysis or thrombectomy), is associated with resolution of aphasia. Speech therapy is needed as soon as permitted by clinical condition

Study on cost analysis in farms in the N-E and S-E development regions of Romania

An important problem of Romanian agriculture is the fragmentation of land which correlates significantly with the diversification of household production. The evolution of agricultural production systems worldwide is influenced by the globalization of international trade in the current stage of socio-economic development, which amplifies structural interdependence for economies in different regions. The aim of the paper is to analyses costs on farms in the North-East and South-East regions of Romania. Field research was conducted in the agricultural year 2020-2021 on a representative sample, by size categories, of 60 farms in the NE and SE development regions, 30 in each region and 5 in each county. The 5 farms were selected by economic size (below 100 thousand SO; 100 thousand SO - 250 thousand SO; 250 thousand SO - 500 thousand SO; 500 thousand SO - 750 thousand SO; above 750 thousand SO). The economic size of the farms was pre-determined in the survey in order to accurately determine the costs in agriculture. The results suggest significant variability in costs by structure, farm size and area of activity. The sum of the influence of these factors can also be associated with a diversified management system

Work satisfaction in the food industry - a premise for economic performance

The greatest challenge for Romania’s food industry is to achieve technical and economic parity with the rest of Europe. Therefore, businesses require productive employees, and labor productivity depends on employee satisfaction. This study’s primary objective was to investigate employee satisfaction in the bakery industry in order to enhance economic performance. This topic is rarely researched, but it is necessary to enhance the economic performance and work processes of this industry. A combination of quantitative and qualitative research methods were used, including an online questionnaire survey of 254 employees and a focus group meeting with 17 managers from 60 companies in the Northeast and Southeast regions of Romania. Total pay (5.3 points on a 1–7-point scale), amount of work (4.9 points), and number of working hours (4.8 points) were the top motivators. The average weighted value for job satisfaction on a scale of 100 points was 27.4 points. The relationship between labor costs and employee satisfaction was strong. Low levels of satisfaction are costlier for employers than high levels of satisfaction. The originality of this study lies in its determination of how strongly employees perceive each aspect of job satisfaction and its correlation to the economic performance of companies