Oral Rehabilitation Therapies in A Patient with Facial Dysmorphia and Psychiatric Profile - Clinical Case Report

This article describes rehabilitation of one case, complex psychiatric treatment, facial asimetry, with mandibular and maxilla missing teeth and dental disharmony, with a fixed and also removable hybrid prosthesis. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is irregular deformities and unfavorable biomechanics encountered at the prosthetic field for complex rehabilitation.In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance</em

In Vivo Evaluation of Biocompatibility of Three Biomaterials Used in Endodontics for Prosthetic Purposes in Complex Rehabilitation Treatment

The ideal biomaterial used in endodontics in the process of sealing the radicular canals should possess a group of qualities for a predictable outcome: biocompatibility, initiation of ontogenesis and cementogenesis, ease of handling, sufficient manipulation time, and convenient price. For a perfect sealing, the root canal treatment can be followed by prosthetic restoration. This study of biocompatibility aims to determine the quantification of the local reaction following the implantation of three biomaterials in the rabbit subcutaneous connective tissue. The used biomaterials with particular reparative properties are: MTA (Mineral Trioxide Aggregate, Dentsply, Tulsa Dental, Johnson City, TN, USA), Sealapex (Kerr, Switzerland), and DiaRoot BioAggregate (Innovative BioCaramix Inc, Vancouver, BC, Canada). The first two biomaterials (MTA, Sealapex) are already being used in endodontic treatments, and the latter was newly introduced during the concrete development of the study. This is an experimental study focused on qualitative and quantitative analysis based on histopathological examination and underlined by the positive result of the study undertaken of the applicability of oral rehabilitation treatments, increasing patients’ quality of life by a significant proportion of 95%, and generating optimal functionality of the stomatognathic system with prosthetic devices as well as accomplishing the objectives of homeostasis

Periodontal Tissue Reaction Consecutive Implantation of Endodontic Materials and Subsequent Integration of Complex Oral Rehabilitation Treatments

Oral rehabilitation is a main branch of dentistry focused on diagnosing the patient’s problem and creating a treatment plan to restore aesthetics, recondition morphologically all components, and recover the functionality of the oral cavity. Biological compatibility of the materials used has a major importance, due to the direct contact with essential tissues, such as the soft and hard tissue of the periodontium and the potential influence on the outcome of the treatment. The present material aims to assess the inflammatory response after subcutaneous implantation of three materials frequently used in endodontics (Mineral Trioxide Aggregate—MTA, DiaRoot BioAggregate, and Sealapex). The evaluation of the reparative tissue reaction after 7, 30, and 60 days, respectively, subsequent to in vivo implantation, was carried out through electron microscopy imaging. Moreover, evaluation of the dynamics of the osteogenesis process was an indicator for the maintenance of internal homeostasis in the context of complex intraoral rehabilitation treatments that include fixed prosthodontics correlated with the particular periodontal-aesthetic aspects and completed by cranio-mandibular repositioning. Our study showed increased absolute values of alkaline phosphatase in all material-implanted cases (more pronounced in MTA and Bio Aggregate), highlighting that this enzyme could be an effective indicator of bone formation, which takes place after the material implantation, with the most significant elevated values at 30 days postoperatively

THE IMPACT OF THE HEALTH SYSTEM DETERMINANTS

Social determinants usually identified as factors that influence health and health equity, including equity, such as housing, employment and education - factors of "upstream". More and more evidence from a variety of areas indicate that health systems are themselves factors of social determinants. They are seen more frequently as determinants of "downstream" type - as means of access to health services for disadvantaged groups, and this shows how health systems have significant influence, affecting the socio-political and economic environmen

CLINICAL AND TECHNOLOGICAL REHABILITATION OF PARTIAL EDENTATION COMPLICATIONS

The aim of the study is the quantification of the main factors that influence the rehabilitation of the complications of partially edentation in view of choosing the best therapeutic solution from the field of both classic and modern prostheses, as well as the identification of the clinical and technological rehabilitation actions in agreement with the particularity of the clinical case. Material and Methods: The study lot included a number of 120 patients diagnosed with partially edentation who reported to the Clinical Basis for Education of the Faculty of Dental Medicine in the period 2015-2017, the lot comprising 70 women, 50 men, aged between 38 and 73. The assessment of the patients was made by clinical and paraclinical exams. Results: We notice a prevalence of the female sex, in a proportion of 58.3% of the lot, while the male sex represents 41%, this aspect being influenced more by esthetic reasons, being much stricter in case of the female sex. As far as the status of the local indices is concerned, of course in correlation with the other factors that decisively influence the therapeutic decision, we notice a proportional equality of 50% between the positive and negative clinical – biological indices, a very important aspect in the therapeutic decision to opt for a hybrid prosthesis that uses extra-coronary races as preservation, support and stabilization elements, which can only be used in case of a very good dental implantation. Conclusions: The identification, using clinical and paraclinical methods, of the entire set of complications triggered by edentation is in fact, an essential condition of targeted therapy, but also a starting point for the rigorous selection of the therapeutic algorithm, of the dental materials used and of the requirements related to the recreation of a high—fidelity morphology

Neuromuscular Disabilities in Patients Diagnosed with Algo-Dysfunctional Syndrome

Introduction: Stomatognathic system dysfunctional syndrome is triggered by cumulative intra- and over-systemic factors, morphological and functional asymmetries favouring the occurance of the syndrome. Aim of the study: The present study intended to evaluate the relationship between the general manifestations of Parkinson’s disease, hemifacial spasm, and the dysfunctional syndrome of stomatognathic system. Material and methods: The study comprised 2 groups of patients, 33 diagnosed with Parkinson’s disease, and 10 patients with hemispasm, that were evaluated not only by paraclinical parameters, but also by the clinical neurological and dental signs (some of them being totally and other partial, edentulous). Results: The edentulous degree and also the uncoordinated function of the stomatognathic muscles system were factors that significantly influenced the pain and articular noises. Clinical overview was clearly dominated by the muscular signs. Conclusions: Both groups of enrolled patients displayed different stages of stomatognathic system dysfunctional syndrome (SSDS). Considering the high incidence of Parkinson disease within the third age population, the accurate evaluation and therapy of the stomatognathic system disorders becomes mandatory for the dental practitioner. Moreover, the proper treatment plan should corroborate the dental therapy with treatment of the systemic disorder

STATISTICAL STUDIES REGARDING THERAPEUTIC APPROACHES FOR EDENTULOUS SOCIAL CLINICAL CASES IN STUDENTS`PRACTICAL STAGES

The variety of clinical cases met by the practitioner is a very important element in the choice of particularities for the development of partially removable prosthetic structures. Aim:The purpose of this study is materialized by the quantification of incidence and prevalence of edentation and its complications in social pacients, with an emphasis on establishing the relationship between the general state of the patient, the environmental factors and the clinical and biological indices. Material and method:A large group of patients was selected and studied in a group of 68 patients – 36 women and 32 men, coming from the urban area 54.55% and 45.45% from the rural area, who were examined and treated for a period of two years (2015-2017) at Clinical Base of the Faculty of Dental Medicine – UMF “Gr. T. Popa” Iasi. Results:The most common situation was that of the Kennedy 1 class – found in 33% of cases, followed by Kennedy’s second grade (17%) and grade III (14%). A comparable percentage of patients (10%) had a Kennedy 4th grade, and the lowest incidences were recorded for edentation classes V and VI (14% and 12% respectively).Conclusions :Each clinical case is having a possible ideal therapeutical solution based on a complex algorithm of conception, selection and materializatio

ASPECTS OF ORAL REHABILITATION USING REMOVABLE DENTURES: ESTHETICS AND FUNCTIONALITY

Aim of the study The study analyzed the impact of various types of prostheses in the field of removable dentures on the edentation rehabilitation degree. Material and methods The study lot consisted of a number of 75 patients (aged between 30 and 82), reuniting clinical entities in the field of dental prostheses. Results After and evolutive analysis of integrative aspects, we can notice a rising curve of defects shown by removable dentures and the age of the restoration, while we can assess negative effects that are limited to the type of modern dentures, where the biomechanical principle is well observed, the anti-tilting elements being well-placed. The dental occlusion, the landmark of any prosthetic restoration, was balanced in a percentage of 39.47% of the study lot, a percentage of 60.53% remaining in the field of occlusion with modified parameters, this percentage being also found in the deterioration of fixed or removable dentures. The dynamic occlusion was characterized by positive indices at a percentage of 40.72%, while 59.28% of the cases indicate discontinuous trajectories and unstable dento-dental contacts. Conclusions The loco-regional aspects and the dento-periodontal clinical and biological indices, as well as the mucous bony ones dictate the design of the final prosthetic construction and the choice of the maintenance, support and stabilization elements

COMPLICATIONS OF PREMATURITY AS RISK FACTORS FOR OUTCOME

The increased rate of prematurity has been accompanied by high rates of neonatal complications and neurodevelopment sequels. Objective: The study was design to evaluate whether identifying certain complications of prematurity may be useful in predicting neurodevelopment outcome. Observational longitudinal study, over six years, of a cohort of premature infants. The risk factors quantified were: gestational age, birth weight, birth asphyxia, necessity of mechanical ventilation , specific pathology (respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia) ,results of Amiel –Tison, neurologic exam at discharge, total numbers of evaluations, final results of evaluations, acording to Bayley Scales of Infant Development, 2nd Edition at two years corrected age. The data were analyzed using SPSS Statistics version 18.0. From January 1, 2005 to December 31, 2011 the incidence of prematurity in our maternity was 13.65%. 33.03% (n=2182) were prematures and from these, 1845 were enrolled in this study. Complications of prematurity, developped by included patients were : respiratory distress syndrome (70.51%), apneea of prematurity (40.76%), perinatal asphyxia (22.82%), intraventricular hemorrhage (17.01%), periventricular leukomalacia (5.42%). Birth weight less than 1500g, type of mechanical ventilation , intraventricular hemorrhage, results of Amiel-Tison evaluations and adherence of patients to program are predictive factors for results of final evaluation. Gestational age remains the leading factor in including premature infants in a specific group of risk (F=69.65, p<<0.01, 95%CI). We speculate that early identification of the degree of risk may facilitate early interventions with the potential to improve the neurological outcome of these patients

IMPRESSION IN EXTENDED PARTIALLY EDENTATION – IMPLICATIONS IN METHODS OF TRAINING FOR DENTAL TECHNICIANS

In practice, we want to be as effective in time and achievement, but impressions must be carried out with the utmost attention to detail and dedication to perfection, because it is a mirror of what we want to do. THE PURPOSE of this study is to identify the clinical peculiarities of the different types of impression used in the partially stretched edentation with profound impact in the technological algorithm and in the end of the therapeutic solution approached in the territory of partially removable prosthesesMATERIAL AND METHOD Different types of impressions have been analyzed and materialized in the clinical algorithm of a rehabilitative technique in the partial stretching, dictated by the specificity of the clinical case. Knowing the technological particularities according to the clinical stages is an important demand of this study.RESULTS AND DISCUSSIONS Regarding the use of techniques and materials in practice, several studies have been conducted to observe the choices of practitioners and the methods used in dental schools in the world. In the last decade, the development of fully digitized techniques in all areas of dental medicine began. CONCLUSIONS Functional impression is a particularly important clinical stage with profound impact on the final development of prosthesi