15 research outputs found
INJECTION-MOLDING APPROACH IN THE RESTORATION OF LATERAL TEETH INTERDENTAL ANATOMY
Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Directiva stomatologiei operative contemporane este realizarea restaurărilor estetice într-un mod simplificat, dar cu prezervarea aspectelor structurale și funcționale. Tehnica injection-molding permite refacerea elementelor de anatomie interdentară, respectând conceptul biomimetic. Scopul lucrării. Relevarea avatajelor restabilirii anatomiei interdentare la dinții laterali în baza abordului injection-molding. Material și Metode. Au fost supuși examenului clinic și paraclinic pacienți care au prezentat cavități carioase aproximale localizate la nivelul dinților laterali. Restabilirea morfo-funcțională a fost realizată prin tehnica injection-molding, cu utilizarea sistemului de matrici și pene interdentare Bioclear. Rezultate. Tratamentul restaurator prin aplicarea tehnicii injection-molding și sistemului Bioclear a permis restabilirea eficientă a suprafeței de contact, atunci când distanța dintre marginea cervicală a cavității carioase și dintele adiacent a fost mai mare de 0.7 mm. Folosirea matricilor anatomice și compozitului preîncălzit a determinat o bună adaptare marginală a materialului, cu refacerea ambrazurilor ocluzale, cervicale, vestibulare și orale. Concluzii. Redesign-ul de preparare a cavităților carioase aproximale la dinții laterali, sistemul translucent de matrici, combinația compozitului flowabil cu cel de tip pastă favorizează restabilirea anatomică a morfologiei proximale, cu evitarea marginilor debordante.Background. The directive of contemporary operative dentistry is to carry out aesthetic restorations in a simplified way, but with the preservation of structural and functional aspects. The injection-molding technique allows the rehabilitation of interdental anatomy elements, respecting the biomimetic concept. Objective of the study. Revealing the benefits of restoring lateral teeth interdental anatomy based on the injection-molding approach. Material and Methods. Patients with proximal carious cavities located in the lateral teeth were subjected to clinical and paraclinical examination. The morpho-functional restoration was performed by the injection-molding technique, using the matrices and wedges of Bioclear system. Results. Restorative treatment by injection-molding technique and Bioclear system allowed the effective restoration of the contact area, when the distance between the cervical edge of the carious cavity and the adjacent tooth was more than 0.7 mm. The use of anatomical matrices and preheated composite determined a good marginal adaptation of the material, with the rehabilitation of occlusal, cervical, vestibular, and oral embrasures. Conclusion. The redesigned preparation of proximal carious cavities in lateral teeth, the translucent matrix system, the combination of flowable composite with paste composite favor the anatomical restoration of the proximal morphology, avoiding the overhanging margins
Joining functionality and esthethics in the treatment of reduced unidental edentation by means of adhesive bridges
Therapeutic Stomatology,
Department FCEMPh, Orthopedic Stomatology Department,
State Medical and Pharmaceutical University „Nicolae Testemitanu”, Chisinau,
Republic of Moldova.Introduction: Partial unidental edentations of dental arcades in the front side, including the
absence of the premolars lead to disorder from aesthetic perspective and of the occlusal function. In
line with the biological principle, the modern concept of stomatological treatment provides for
mini-invasive interventions on the dental tissues. On the background of this concept, fixed
prosthetic restoration supported on implantation blunts continue to be elected therapeutic solutions
of treating unidental edentations. In clinical situations with relative or absolute contraindications to
implantation therapy, the adhesive bridges, achieved by direct restoration technique, ensure a longlasting in-between solution in the dentist treatment schemes. Using the wax-up technique under this
treatment is efficient because of visualizing the form and design of the future construction, but also
as a reference for the individual rehabilitation of the overjet and overbite, occlusal parameters that
characterize the anterior guidance.
Materials and methods: There were examined and assessed 5 patients with partial unidental
edentations in the front side of the dental arcades, including the lack of premolars. Along with the
clinical examination, there were performed orthopantomographies; if needed-dental-periodontal xrays; as well as instrumental functional diagnosis. Based on the diagnosis models, there were
assessed the parameters of the potential prosthetic space. The data of the aesthetic evaluation were
input in a special fiche developed by us.
Results: Data of the clinical-instrumental examination provided us information about the
condition of the teeth, condition of the mucous membrane, form and profile of deprived teeth
ridges. Assessment of parameters of potential prosthetic area in the selected clinical cases proved
insufficient space to plan an implant-prosthetic treatment. Wax-up has been performed on diagnosis
models mounted in the adjustable articulator, taking into account the condition of the overjet and
overbite, which feature the anterior guidance. The data from the aesthetic evaluation fiche provided
useful information in the treatment consisting of direct restoration with adhesive dental bridges.
ConcIusions:The results of the aesthetic evaluation, as well as the data of the examination of
unidental edentation patients governed the choice of a treatment with adhesive bridges,
accomplished by means of direct method
Abordarea tehnicii injection-molding în restabilirea anatomiei interdentare a dinților laterali
Background. The directive of contemporary operative dentistry
is to carry out aesthetic restorations in a simplified
way, but with the preservation of structural and functional
aspects. The injection-molding technique allows the rehabilitation
of interdental anatomy elements, respecting the biomimetic
concept. Objective of the study. Revealing the benefits
of restoring lateral teeth interdental anatomy based
on the injection-molding approach. Material and Methods.
Patients with proximal carious cavities located in the lateral
teeth were subjected to clinical and paraclinical examination.
The morpho-functional restoration was performed by
the injection-molding technique, using the matrices and wedges
of Bioclear system. Results. Restorative treatment by
injection-molding technique and Bioclear system allowed
the effective restoration of the contact area, when the distance
between the cervical edge of the carious cavity and
the adjacent tooth was more than 0.7 mm. The use of anatomical
matrices and preheated composite determined a good
marginal adaptation of the material, with the rehabilitation
of occlusal, cervical, vestibular, and oral embrasures. Conclusion.
The redesigned preparation of proximal carious
cavities in lateral teeth, the translucent matrix system, the
combination of flowable composite with paste composite
favor the anatomical restoration of the proximal morphology,
avoiding the overhanging margins.Introducere. Directiva stomatologiei operative contemporane
este realizarea restaurărilor estetice într-un mod
simplificat, dar cu prezervarea aspectelor structurale și
funcționale. Tehnica injection-molding permite refacerea
elementelor de anatomie interdentară, respectând conceptul
biomimetic. Scopul lucrării. Relevarea avatajelor restabilirii
anatomiei interdentare la dinții laterali în baza abordului
injection-molding. Material și Metode. Au fost supuși
examenului clinic și paraclinic pacienți care au prezentat
cavități carioase aproximale localizate la nivelul dinților
laterali. Restabilirea morfo-funcțională a fost realizată prin
tehnica injection-molding, cu utilizarea sistemului de matrici
și pene interdentare Bioclear. Rezultate. Tratamentul
restaurator prin aplicarea tehnicii injection-molding și sistemului
Bioclear a permis restabilirea eficientă a suprafeței
de contact, atunci când distanța dintre marginea cervicală a
cavității carioase și dintele adiacent a fost mai mare de 0.7
mm. Folosirea matricilor anatomice și compozitului preîncălzit
a determinat o bună adaptare marginală a materialului,
cu refacerea ambrazurilor ocluzale, cervicale, vestibulare
și orale. Concluzii. Redesign-ul de preparare a cavităților
carioase aproximale la dinții laterali, sistemul translucent
de matrici, combinația compozitului flowabil cu cel de tip
pastă favorizează restabilirea anatomică a morfologiei proximale,
cu evitarea marginilor debordante
Theoretical considerations in the selection of dowel core devices under the prosthetic treatment by means of substitution method
Coordonator ştiinţific Gribenco Vitalie – asist.univ.
Catedra Stomatologie Ortopedică „I.Postolachi”The substitution method of treating coronary odontal lesions that are widespread in terms of surface and depth is based on the substitution of the natural tooth crown with a fixed prosthetic restauration mounted on a dowel core device. The assessment of the odontal and parodontal status, clinical conditioning in line with the requirements, physical properties of the substances the dowel core devices are made of, esthetical exigencies,the absence or presence of muscular parafunctions underlie the selection of the appropriate dowel core devices and techniques, which, in the end, would ensure the efficiency of the treatment method and a favorable forecast.
Metoda substituirii de tratament a leziunilor odontale coronare(LOC) întinse în suprafaţă şi profunzime are la bază înlocuirea coroanei naturale a dintelui cu o restaurare protetică fixă agregrată pe un dispozitiv corono-radicular(DCR). Evaluarea statusul odontal şi parodontal, condiţionarea clinică conform cerinţelor, proprietăţile fizice ale materialelor din care sunt confecţionate DCR, exigenţele estetice, lipsa sau prezenţa parafuncţiilor musculare stau la baza selectării DCR –urilor şi tehnicilor respective, care în final vor asigura eficienţa metodei de tratament şi un prognostic favorabil
Abordarea clinico-morfologică a leziunilor albe ale mucoasei orale
Background. The white lesions of the oral mucosa have a wide range of clinical manifestations with
different etiology and varied prognosis, from benign conditions to dysplastic or carcinomatous lesions.
Their study is a primary direction in the management of white lesions. Objective of the
study. Presentation of known aspects, but also the continuous development of terms and systems with
a clinical value of white lesions, as well as information on how these terms should be used in an
international consensus. Material and Methods. 14 patients, 8 women and 6 men, aged 20-65, were
questioned and examined. During the inspection and palpation of oral cavity mucosa, the presence of
white lesions was outlined. To establish a differential diagnosis, histopathological examination of the
bioptates was performed. Results: Of the total number of patients included in the study, 4 patients
(28.6%) were diagnosed with oral leukoplakia (2 patients - verrucous form, 1 - flat form, 1 - erosive
form), 5 (35.7%) – oral lichen planus, 3 (21.4%) - oral candidiasis, 2 (14.3%) - chemical lesion of the
oral mucosa. The histopathological examination was performed for 7 patients, 4 patients have presented
oral leukoplakia and 3 - oral lichen planus. Conclusion. The characteristic aspects of white lesions are
based on a various pathogenetic mechanism and are conditioned by keratinization disorders
(leukoplakia, oral lichen planus), the development of surface fungal colonies (oral candidiasis), the
presence of epithelial necrosis (chemical lesions).
Introducere. Leziunile albe ale mucoasei cavității orale prezintă un spectru larg de manifestări clinice
cu diferită etiologie și variat pronostic, de la formațiuni benigne până la leziuni displazice sau
carcinomatoase. Studierea acestora reprezintă o direcție primordială în managementul leziunilor
albe. Scopul lucrării. Prezentarea aspectelor cunoscute, dar și continua dezvoltare a termenilor și a
sistemelor cu o valoare clinică a leziunilor albe, precum și informarea asupra modului în care acești
termeni ar trebui utilizați în cadrul unui consens internațional. Material și Metode. Au fost supuși
chestionării și examinării 14 pacienți, 8 femei și 6 bărbați, cu vârsta cuprinsă între 20-65 de ani. La
inspecția și palparea mucoasei cavității orale a fost conturată prezența leziunilor albe. Pentru stabilirea
unui diagnostic diferențial a fost realizat examenul histopatologic al țesuturilor bioptate. Rezultate. Din
totalul pacienților incluși în studiu, 4 pacienți (28,6 %) au fost diagnosticați cu leucoplazia mucoasei
cavității orale (2 pacienți – forma verucoasă, 1 – forma plată, 1 – forma erozivă), 5 (35,7 %) – lichen
plan bucal, 3 (21,4 %) – candidoza bucală, 2 (14,3 %) – leziune chimică a mucoasei cavității orale.
Examenului histopatologic au fost supuși 7 pacienți, dintre care 4 au prezentat leucoplazia mucoasei
cavității orale și 3 – lichen plan bucal. Concluzii. Aspectele caracteristice leziunilor albe au la bază un
mecanism patogenetic divers și sunt condiționate de tulburările de keratinizare (leucoplazia, lichenul
plan bucal), dezvoltarea coloniilor fungice de suprafață (candidoza bucală), prezența necrozei epiteliale
(leziunile chimice)
Caracteristicile morfopatologice ale leucoplaziei mucoasei cavității orale
Catedra de odontologie, parodontologie și patologie orală,
USMF „Nicolae Testemiţanu”Background. Morphopathological examination is an important step in diagnosis establishment of oral
leukoplakia. Morphopathological changes, correlated with clinical manifestations, direct the
management of oral leukoplakia. Objective of the study. Establishment of morphopathological changes
characteristic for oral leukoplakia. Material and Methods. We questioned and examined 6 patients, 4
women and 2 men, who had oral leukoplakia. A partial excisional biopsy of the affected mucosa was
applied, with the transfer and histopathological analysis of the bioptate in the morphopathology
department. Results. 6 cases were marked by the presence of the phenomenon of hyperkeratosis,
represented by the increased thickness of the keratinized layer. In 2 of the cases, parakeratosis was
highlighted, characterized by incomplete keratinization of epithelial cells, with the disappearance of the
granular layer and the persistence of pycnoctic nucleus cells in the stratum corneum, and 1 case revealed
glycogenic acanthosis. The lack of cellular atypism, irregular stratification of the epithelium, increased
mitotic activity determined the presence of non-dysplastic morphopathological changes. Conclusion. In
the absence of cellular atypism, the morphopathological picture characterized by hyperkeratosis,
parakeratosis and glycogenic acanthosis determines a low potential for malignant transformation of
leukoplastic changes.Introducere Examenul morfopatologic reprezintă o etapă importantă în stabilirea diagnosticului de
leucoplazie a cavității orale. Modificările morfopatologice, corelate cu manifestările clinice, dirijează
managementul afecțiunilor leucoplazice. Scopul lucrării. Stabilirea schimbărilor morfopatologice,
caracteristice leucoplaziei mucoasei cavității orale. Material și Metode. Au fost supuși chestionării și
examinării 6 pacienți, 4 femei și 2 bărbați, ce prezentau leucoplazia mucoasei cavității orale. A fost
aplicată biopsia excizională parțială a mucoasei afectate, cu transferarea și analiza histopatologică a
bioptatului, în secția de morfopatologie. Rezultate. Cele 6 cazuri au fost marcate de prezența
fenomenului de hiperkeratoză, reprezentată de creșterea grosimii stratului cheratinizat. În 2 dintre cazuri
s-a evidențiat parakeratoza, caracterizată prin cheratinizarea incompletă a celulelor epiteliale, cu
dispariția stratului granular și persistența celulelor cu nucleu picnoctic în stratul cornos, iar în 1 caz a
relevat acantoza glicogenică. Lipsa atipismului celular, a stratificării neregulate a epiteliului și a creșterii
activității mitotice a determinat prezența unor modificări morfopatologice non-displazice. Concluzii. În
lipsa atipismului celular, a tabloului morfopatologic caracterizat prin hiperkeratoză, parakeratoză și
acantoză glicogenică se determină un potențial scăzut de transformare malignă a afecțiunilor leucoplazice
Clinical-morphological approach of white lesions of the oral mucosa
Odontology, Periodontology and Oral Pathology chair, Faculty of Stomatology, 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. The white lesions of the oral mucosa have a wide range of
clinical manifestations with different etiology and varied
prognosis, from benign conditions to dysplastic or
carcinomatous lesions. Besides the fact that some specific
classical characteristics are known that allow the
differentiation of lesions, there are a number of other
similar manifestations that complicate the determination of
the disease, so the diagnosis establishment represent a
primary direction in their management. PURPOSE. Presentation of known aspects, but also the continuous
development of terms and systems with a clinical value of
white lesions, as well as information on how these terms
should be used in an international consensus. RESULTS. Of the total number of patients included in the study, 4
patients (28.6%) were diagnosed with oral leukoplakia (2
patients - verrucous form, 1 - flat form, 1 - erosive form), 5
(35.7%) – oral lichen planus, 3 (21.4%) - oral candidiasis,
2 (14.3%) - chemical lesion of the oral mucosa.
During the histopathological examination signs of
hyperkeratosis, parakeratosis, acanthosis underlined oral
leukoplakia in 4 cases and signs of hyperkeratosis,
orthokeratosis, the presence of Civatte bodies cells -
oral lichen planus in 3 cases. CONCLUSIONS. The characteristic aspects of white lesions of the oral
mucosa are based on a various pathogenetic mechanism and
are conditioned by keratinization disorders (leukoplakia,
oral lichen planus), the development of surface fungal
colonies (oral candidiasis), the presence of epithelial
necrosis (chemical lesions)
The concept of oral pre-cancer
Rezumat
Scopul lucrării date a fost de a efectua o
analiză cu privire la pre-cancerul oral şi diagnosticul lui precoce. În baza studiului efectuat s-a ajuns la concluzia că leziunile precanceroase constituie una din problemele actuale
ale medicinii contemporane teoretico-practice. Diagnosticul întârziat al acestor leziuni
duce la creşterea numărului de cazuri de
transformare a lor în cancer.
În prezent, a obţinut recunoştinţă conceptul de „pre-cancer”, care pune în evidenţă
schimbările precanceroase ce stau la baza stărilor precanceroase. În aspectul prezentărilor
contemporane a cancerogenezei pre-cancerul
este o stare dinamică de transformare în cancer. În astfel de împrejurări, veriga principală
în profilaxia cancerului o constituie diagnosticul precoce al acestor leziuni, care presupune un examen clinic minuţios şi competent.Summary
The purpose of this article was to carry
out an analysis regarding the oral pre–cancer
and its early diagnosis. Based on the study it
was underlined that the precancerous lesions
are one of the actual problems of theoretical
and practical contemporary medicine. Delayed diagnosis of these lesions increases the
number of cases of malignant transformation.
Currently, the concept of “pre–cancer” has
developed. It points out precancerous changes
that are the background of precancerous conditions. In the aspect of contemporary presentations of carcinogenesis, pre–cancer — it
is a dynamic condition of malignant transformation. The main step in cancer prophylaxis
is the early diagnosis of these lesions, which
involves a careful and responsable clinical examination
Diagnosis and management of recurrent caries
Odontology, Periodontology and Oral Pathology chair, Faculty of StomatologyIntroduction. Dental caries is a biofilm-mediated, diet modulated, multifactorial, noncommunicable,
dynamic disease resulting in net mineral loss of dental hard
tissues and it is determined by biological, behavioral, psychosocial and
environmental factors. But despite the fact that today there are a lot of modern
materials to restore the hard tissue affected by caries, a problem remains the
appearance of reccurent or secondary caries that has developed adjacent to
margins of restorations. So, a vital part is the early detection of recurrent caries
that may allow provision of less invasive treatment options like resealing or
repairing instead of complete removal and replacement of restorations.
Purpose. To assess how to control, detect and treat secondary caries.
Material and methods. It was performed the examination of 16 patients, 8 men and 8 women, between
the ages of 18-55. Clinical and paraclinical examination have established the
diagnosis of recurrent caries for 32 teeth. The treatment was done by cleaning
the caries and repairing or replacement of existing restorations.
Results. From 32 teeth taken into the study, 22 were maxilla teeth (68,75 %) and 10 were
mandibular teeth (31,25 %); 25 were posterior teeth (78,13 %) and 7 - anterior
teeth (21,87%). From 45 surfaces affected by recurrent caries, occlusal surfaces
were involved in 10 cases (22, 3 %), mesial surfaces in 14 cases (31,2 %), distal
surfaces in 16 cases (35,5 %), vestibular surfaces in 4 cases (8,8 %) and oral
surfaces in 1 case (2,2 %). According to the treatment methods of recurrent
caries, 19 teeth (56,37 %) were treated by using repairing method and 13 teeth
(40,63%) by using replacement method.
Conclusions. 1.The etiology of recurrent caries is similar to primary
dental caries, but accelerated accumulation of biofilm
mass is caused my microleakage, poor marginal fit of
restoration and overhangs. Proximal surfaces of the
teeth are the most affected.
2.The diagnosis of caries is established during visual
inspection, tactile sensation with explorer usage and
radiographic interpretation. Detected secondary caries
can be managed by repair of the defective part of the
restoration or its complete replacement. Its depends on
the patient and teeth criteria.
3.The prophylaxis of recurrent caries is directed to
patient dental care and doctor’s work
Etiology, pathogenesis, diagnosis and treatment options of abfraction lesions
Odontology, Periodontology and Oral Pathology chair, Faculty of StomatologyIntroduction. Abfraction lesions are noncarious cervical lesions that affect structural
integrity, retention of dental plaque, tooth sensitivity, pulpal vitality and
esthetics. The pathogenesis of NCCLs is considered to be multifactorial,
with occlusal loading, biocorrosion in combination with cervical stress
stemming from hyperfunctional or parafunctional occlusal forces, acting
synergistically rather than in isolation. The way in which abfraction lesions
are restored and managed depends on the etiology and risk factors.
Purpose. To establish the therapeutical treatment
strategy of abfraction lesions.
Material and methods. 9 patients, 6 men and 3 women, between the ages of 26-63, were
questioned and examined. The diagnosis of abfractions lesions was
established according to careful history taking and proper clinical
examination.
Results. From 9 patients examined , 3 (33,3 %) patients presented generalized
abfraction lesions with the association with chronic marginal generalized
periodontitis and 6 (67,7%) patients with localized abfraction lesions, from
them 2 patients (33,3%) with unidental edentations and 4 patients (67,7%)
with occlusal interferences.
6 patients with localized lesions presented the involvement of 13 teeth.
From these teeth 10 (76,9 %) were premolars (4 upper and 6 lower), 3 (23,1
%) incisors (2 central lower and 1 lateral lower). As restorative treatment,
4 patients received microfilled composite resin materials, 4 – nanohybrid
composite resin materials, 1 - glass ionomer ciment.
Conclusions. 1.Abfractions lesions have a multifactorial etiology, the most
important being occlusal stress, erosive tooth wear or an association
of these factors.
2.A careful history taking and proper clinical examination are
mandatory to reach at a correct diagnosis and a differential diagnosis.
3.Therapeutical treatment of abfraction lesions involves problem
identification, diagnosis, etiological factor removal or treatment and, if
necessary, restoration. Materials with a low elastic modulus that will
accommodate tooth flexure - such as microfilled, nanohybrid or
nanofilled composite resin, glass ionomer or resin modified glass
ionomer - are a good choice for restoring abfraction lesions