CONSIDERAŢII MEDICO-LEGALE PRIVIND ANESTEZIA LOCO-REGIONALĂ ÎN MEDICINA DENTARĂ

The problem of the interventions performed under loco-regional anesthesia – practiced in a dental office, must be seen in the context of increasing plurifactorial dental care in Romania, in private or public practice. Because of the many advantages it presents, loco-regional anesthesia is considered as a method household during dental care routine. Currently, anesthesia allows adaptation methods and techniques individualized for each patient, so as to benefit from a perfect anesthesia and with minimal risk. Modern medicine attaches great importance to prevention of incidents, accidents and complications in surgical techniques, anesthesia loco-regional not an exception. Anesthesiology is one of the medical specialties related to medical malpractice can sometimes have complications leading to death of the patient; errors are inadmissible in this area

DIVERSIFIED ORAL PATHOLOGY ASSOCIATED TO CHRONIC ALCOHOLISM

Nowadays the alcoholism represents reprezintă the most extensive drug addiction in all populational groups and is recognised by medical, social, economical and legal experts as a real “toxic pandemic”. The researchers consider that ethanol is the molecule with the most dedicated pages in the medical literature. The term “alcoholism” defines both the excessive and prolonged consume of alcohol (alcohol use disorder) and alcohol addiction. The alcoholism incidence increases worldwide in the industrialised countries as alcoholism is the third biggest cause of death after cardiovascular diseases and various categories of cancer. The dental medicine specialists have the possibility to experience the psichological aspects of dental pathology and an interdisciplinary collaboration with psychiatrist will facilitate the dental treatment of these patient

IMPLEMENTATION OF METHODS OF LOCO-REGIONAL ANESTHESIA IN DENTAL SURGERY

Even the minor surgery, anesthesia, by interrupting the normal course of life, bringing the patient into a state of dependence on the attending physician, the medical staff, the drugs, the preoccupation with the type of anesthesia, the duration and the course of the intervention, its success or complications, logically inspires a sense of fear. So, it is normal for the patient to be concerned about the method, technique and quality of anesthesia and surgery, the possibility of deficiency in the installation or the duration of anesthesia that could cause pain during the intervention or immediately afterwards. The problem of dento-alveolar surgery interventions in a dental practice ward presents multiple aspects and needs, in the context of increasing dental care both in private or state practice. Loco-regional anesthesia is the method by which chemical, physical or electric current are used to temporarily insensify the anatomical region on which it is intervening, while keeping the consciousness intact; in this kind of anesthesia only painful sensitivity is abolished, the thermal, tactile, and pressure sensitivities being retained, referred to by the American authors as “loco-regional analgesia”. In recent years new intraosseous anesthesia techniques have been developed and introduced on the market: the Stabident system; X-type; Quicksleeper; Intraflow; Hypo. With regard to injection methods of anesthetics, computerized electronic systems for the administration of anesthetics have appeared on the market. Intraoral application sites influence the time of installation and the duration of anesthesia after application of the local anesthetic

DENTAL HEALTHCARES SYSTEM DURING THE COVID-19 PANDEMIC AND IMPACT OF DIGITAL TECHNOLOGIES

The present study aims to analyze the impact of these modern methods of treatment on the current activity of dentists and their influence on the addressability of patients in dental offices during the pandemic. In the COVID-19 pandemic context, the addressability to the dental offices decreased. These digital technologies represent the future of dentistry and are essential, especially during this period. In this sense, a survey was done by distributing a questionnaire to 114 dentists with private practices in Iasi. Our questionnaire included specific items to objectively analyze the practitioners’ knowledge, their attitude towards the current use of digital technologies, and the impact of these methods on their activity. The answers clearly show that dentists are interested in implementing digital systems, allowing prosthetic work to be performed in a shorter time and with maximum accuracy, reducing materials consumption and the risk of contamination for patients and the dental team. Minimizing treatment time is favorable and excludes complications leading to optimal treatment results by simplifying the entire procedure.These systems allow the obtaining of optimal functional and aesthetic prosthetic constructions

MAXILLARY DISTOMOLARS AT PATIENTS WITHOUT ASSOCIATED SYNDROMES: A CASE REPORT

The distomolars are supernumerary teeth that forms behind of maxillary and mandibular third molars. The etiology of this numerary anomaly has multiple theories but none of them is fully accepted. Most of the time, supernumerary teeth are associated with genetics syndromes like labio-palatal cleft, cleidocranial dysostosis, Gardner syndrome, but at healthy patients the prevalence is very low. This study presents three cases diagnosticated at Hospital “Sf. Spiridon” Iasi, Oral and MaxilloFacial department, with maxillary distomolars at patients without any associated syndromes. The anomaly did not had local complications, it was diagnosticated following paraclinic exams like panoramic radiographs and cone-beam computer tomography

BENEFICII ALE UTILIZÃRII LASERILOR ÎN PROCEDURILE CHIRURGICALE PROPROTETICE

The complex oral rehabilitation aims the functions’ recovery of the stomatognathic system as well as the improvement of the clinical and biological indices of the prosthetic field. The pro-prosthetic stage includes the oral surgical procedures as follows: coronal elongation by gingivectomy and gingivoplasty, frenectomy, vestibuloplasty, sinus lifting, alveolar augmentation. Literature data sustain the laser-assissted pro-prosthetic surgical procedures due to a few benefits over conventional procedures. The most used lasers in the pro prosthetic stage are diode lasers (805nm-1064nm), Er:YAG laser (2780nm), and Er,Cr:YSGG laser (2940nm). The interaction with oral tissues is selective and accurate, reducing trauma, bleeding and postoperative complications. The excellent hemosthasis, the control over tissues ablation and the limited or absent postoperative pain are the major benefits of the laser-assisted surgical procedures performed in the pro-prosthetic stage

THE IMPLICATIONS OF THE MAIN FAVOURABLE FACTORS IN THE APPEARANCE OF VARIOUS FORMS OF CANCER AT THE LEVEL OF ORAL CAVITY MUCOSA

Our study aims to establish correlative elements between the role of the main contributing factors in triggering various forms of oral mucosal cancer and to quantify their contribution according to a number of characteristic parameters.Materials and Methods: The statistical study was conducted over a period of 5 years at the Oro-Maxilofacial Surgery Clinic of St. Spiridon Iasi on internalized patients diagnosed with oral mucosal cancer.Results and Discussions : A well-defined category of contributing factors correlates to a high percentage of oral or oropharyngeal cancer. In this hierarchy of favoritisers of the mucosa of the oral cavity, an important place is occupied by the consumption of tobacco and alcohol, which makes it difficult to separate the degree of contribution of one or the other of the two components.Conclusions: The dentist must have a more intense activity in raising awareness of oral cavity cancer patients, increasing the educational level of population and sensitizing patients to the harmful and oncogenic action of alcohol and smoking

ASSESING THE BLEEDING RISK IN PATIENTS USING DIRECT ORAL ANTICOAGULANTS SUBMITTED TO DENTAL SURGERY PROCEDURES: A SYSTEMATIC REVIEW

Aim of the study: The management of patients undergoing chronic oral anticoagulation raises concerns regarding the postoperative bleeding risk. In the last few years, new oral anticoagulants were released on the market, but the operative protocols for dental surgery interventions are still not well established. The purpose of this review is to summarize the articles` evidence that evaluate the risk of bleeding with the use of Direct Oral Anticoagulants (DOACs). Material and methods: A systematic literature search was conducted from January 2014 to June 2018, in PubMed, Science Direct, Web of Science and Scopus databases. Results: Six articles met the inclusion criteria, all being observational studies. Conclusions showed that dental surgery could be performed without cessation of the DOACs, with a low incidence of bleeding complications, by applying local haemostatic measures (suturing, haemostatic agents, compression with sterile gauzes soaked in 5% tranexamic acid or the use of mouthwash with 5% tranexamic acid)

The Effectiveness of Laser Applications and Photodynamic Therapy on Relevant Periodontal Pathogens (<i>Aggregatibacter actinomycetemcomitans</i>) Associated with Immunomodulating Anti-rheumatic Drugs

Considering the current context of the increasing resistance of bacterial species to antibiotics and other antimicrobial agents, a major objective is to develop other antimicrobial approaches, which would be able to inactivate pathogens with considerable effectiveness. Two such methods are photodynamic disinfection therapy and laser irradiation. In view of the immunocompromised status of some patients under immunosuppressive therapy and potential drug interactions that can be established between systemic antimicrobial agents, the research of local, minimally invasive methods of inactivating periodontal pathogens in the context of these systemic therapies with modifying drugs of the immune response is justified. This in vitro study evaluated the antimicrobial action of a diode laser, wavelength 940 nm, and photodisinfection therapy at 670 nm (photosensitizer, 3,7 dimethyl phenothiazine chloride) on a type strain of Aggregatibacter actinomycetemcomitans, a known periodontal pathogen, in the presence and absence of active substances used in autoimmune disease therapy (Etanercept, Infliximab, Metothrexate). The association of a conventional antirheumatic drug with anti-TNF-α therapy determined a significantly greater inhibition of the strain of A. actinomycetemcomitans compared to monotherapy, in vitro. Photodisinfection caused a significant reduction in bacterial burden after a 30 s exposure in vitro, regardless of the pharmaceutical associations of biological and conventional disease-modifying antirheumatic drugs (DMARDs). Irradiation with a diode laser for 30 s at a power of 5 W caused a greater reduction compared to irradiation with 1 W. The application of laser and photodisinfection induced a significant reduction in Aggregatibacter actinomycetemcomitans in vitro and could be considered important adjunctive measures for the eradication of this oral pathogen in the context of immunomodulating therapy

THE PLURIFACTORIAL APPROACH TO DENTO-SOMATO-FACIAL DISHARMONY AT THE CONFLUENCE OF NEW BIOMATERIALS, TECHNIQUES AND TECHNOLOGIES

The impact of aesthetic disharmonies on the balance of the stomatognathic system is an eloquent plea for the implementation of well-conducted prophylactic methods, with the elimination of etiopathogenic factors correlate with iatrogenicity, the type of biomaterial used, the technological approach, without avoiding the archetypes characterized by the specifics of the general binominal state-oral pathology . Considering the complexity and variety of the pathology generated by the dento – somato -facial disharmony, the study aimed to individualize an aesthetic evaluation algorithm, quantifying the installed complications and the present restorative treatments in triggering the area of signs and symptoms of this clinical entity with profound implications on the oral balance. After analyzing the parameters related to the units odontal and the relationships that are established between them at the level of the dental arches, between these lips and the main lines of the face, we will proceed to the analysis of the gingival festoon. The cases in which restoration of the dento-periodontal aesthetic balance can be achieved exclusively through a single treatment method are relatively few in numb