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

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

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&rsquo;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&mdash;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

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

The Assessment Of Root Canal Sealers Ph In The Treatment Of Periapical Inflammation Processes – An In Vitro Study

Introduction: The endodontic treatment represents the best conservative option for irreversible endodontically affected teeth maintenance on the dental arch. Besides the rigorous mechanic-chemical treatment, in aseptic conditions, the regenerative or, on the contrary, inhibitive qualities of the root canal sealer on the periradicular tissue play an important role in the long-term success of the treatment. The aim of the study The object of this study consisted in analysing the pH values of frequently used root canal sealers in the endodontic treatment, to make a series of correlations with their therapeutically indications. Materials and Methods We tested the following root canal sealers: AH-26 (De Trey), ZOE, Pulpispad (Spad, Dijon), Sealapex (Kerr), Endomethasone (Septodont), Endospad (Spad, Dijon). The materials were prepared according to the producer indications. The pH recordings were made on different time points: immediately after the preparation, after 24 hours, after a week and after two weeks. Results Our data analysis revealed a variation of the pH values of the 6 root canal sealers and differences in their pH values on different time recordings. The highest values were presented by Sealapex; in the alkaline values order, this was followed by Endomethasone and Endospad. The lowest pH values, to acid zones, were recorded from AH-26, ZOE and Pulpispad. Conclusions The presence in the root canal of an alkaline pH sealer ensures an additional opportunity for the infection control and tissue regeneration of the periradicular tissue. Due to this property, the root canal sealers that have calcium hydroxide in their composition are used more and more frequently

CLINICAL, HISTOLOGICAL AND RADIOLOGICAL ASPECTS REGARDING THE INFLUENCE OF SOME EXTERNAL FACTORS ON THE PULP-DENTIN COMPLEX

The present study aimed at assesssing – by clinical, histological and radiological investigations – the influence of some external factors on the pulp-dentin complex, and at providing a causal interpretation of the structural changes observed. Materials and methods. Clinical and radiological exams were performed on 65 old patients with ages between 60-75, and also on 40 young patients with ages between 20-35, presenting different dental-periodontal pathologies. The pulp-dentin complex was submitted to a morphopathological examination, to highlight the structural changes observed at microscopic level. Fragments of dental pulp were imersed in a 4% formaldehyde solution with phosphate buffer 0.1 M., pH 7.2, for 12 -14 hours, at a temperature of 4ºC, and 3-5 µm thick slices were prepared. The slices were coloured with hematoxylin-eosine (HE), by the trichromic technique – Masson. Photographies were taken with a Zeiss microscope, with Kodak 200 ASA. Results. Significant differences were observed, between the two groups of patients, as to the external factors that produce structural changes on pulp-dentin organ. In the group of young patients dental caries and coronal fillings prevailed, while the group of old patients was mostly associated with atrition and chronic marginal periodontitis. Out of the 40 young patients, 30 presented chronic dental caries (75%), while, among the 65 old patients, only 24 presented dental caries (36.9%). The percentages of coronary fillings between the two study groups were close, which could be considered as one of the causes producing changes in the pulp-dentin organ, following aggresive preparation of cavities, the action of materials used for the protection of pulp-dentin complex or of the materials used for coronry fillings. Conclusions. Dental pulp has a remarkable ability to counteract the action of harmful factors, producing a mineral barrier and stimulating the reparatory processes. Changes in the endodontic space can be produced in both experimental groups, but more intensely and more frequently in the old patients. The endodontic space is modified, both physiologically and pathologically, including deposition of secondary or tertiary dentin (reactionary or reparative dentin), as well as pulp reactions, such as: inflammation, fibrosis, calcium degeneration or vacuolisis. At cell level, microsocopic images showed a decrease of the odontoblasts number and sizes, as well as a reduced fibroblasts/fibrocytes ratios. These changes are associated with progressive vascular and nervous changes, that can be considered both theis cause and effect. These pathological transformations are related with a more difficult preparation of the endodontic space and can be considered as having a major role in the failure of endodontic therapy

COMPARATIVE STUDY ON VITALITY PRESERVATION OF YOUNG PERMANENT TEETH USING BIOACTIVE MATERIALS

Introduction Traumatic injuries and decays are the biggest challenges to the integrity of a young permanent tooth .The aim of this study was to compare the biostimulating and repairing action of mineral trioxide aggregate (MTA) and of the mineral aggregate with ceramic nanoparticles (BioAgreggate) with calcium hydroxide action, in terms of clinical-radiological parameters, after vital pulp therapy in young permanent teeth affected by dental caries or traumatic injury. Material and methods The study was conducted on a sample of 36 teeth from 31 patients of both sexes, aged between 7 and 15 years (mean 9.3 ± 1.9 years), divided into three groups, and took place for a period of up to 4 years. Results The results concerning the effectiveness of the three materials used were evaluated in terms of clinical and radiological manifestations. These were significantly correlated (Ȥ2 = 35.3, r = 0.705, p = 0.003, 95% CI), the study demonstrating an important differences between the three groups of teeth. Final evaluation showed a significant association (Ȥ2 = 18.69, r = 0.725, p = 0.001, 95% CI) between the material used and the final results. Conclusions Following clinical aseptic procedures, after removing bacterial contamination, applying a bio-stimulative dressing and an hermetic crown sealing, there are high chances (about 95%) that the pulp of a young permanent tooth, even seeming irreversibly inflamed, to return to the original status and continue to exercise its functions with longterm preservation of vitality

ELECTROCHEMICAL AND MECHANICAL EVALUATION OF SOME DENTAL MATERIALS EMPLOYED FOR IMMOBILIZATION DEVICES

Measurement of corrosion potential is a relatively simple concept, an unanimously accepted notion in industry for the monitorization of steel corrosion, in building industry and in other structures. Equally, in the last decades, this parameter has been intensively utilized for characterizing dental alloys in either natural oral environment or in simulated solutions. The corrosion potential may be measured directly versus a reference electrode, characterized by a highly stable semi-cell potential. In this respect, a reference electrode (or a separated sensor of the material to be monitorized) is introduced in the corrosive medium together with the metal or alloy under study, and the potential is measured directly with a millivoltmeter with very high input impedance. Additional details on the processes occurring in the system may be acquired if analyzing the curves of cyclic polarization, for whose obtaining the potential of the electrode formed with the investigated alloy is increased, at constant rate, in positive direction, up to a pre-established value, followed by its scavenging in reverse direction (towards negative values) until reaching the initial value or some other value. During scavenging of the potential, the electric power passing through the solution between the working electrode and an auxilliary (platinum-made) electrode is measured

POSSIBILITIES TO ASSESS THE BONE PERIAPICAL REMINERALISATION USING RADIODENSITOMETRIC MEASUREMENTS

Aim of the study This study aimed to explore the possibility that digitized conventional periapical radiographs to be used for an accurate assessment and measurement of the results of the endodontic treatment for patients with chronic apical periodontitis (CAP). Material and methods The study included 20 patients (12 males, 8 females) with ages between 18-38 years, presenting severe CAP with non-surgical endodontic treatment recommendation. For each patient, conventional intraalveolar periapical radiographs were taken initially (before and after treatment completion) and at interval of 24 months. The endodontic therapy used intracanalar medications (calcium hydroxide paste for 14 days) and endodontic sealer (Endoflas, Sanlor) with high antibacterial and remineralisation properties. The group of digitized radiographs was submitted to the radiodensitometric measurement. Results The results regarding the success rate of CAP healing were as follows: 1 case had no periapical healing (5%), 11 cases presented (55%) partial bone periapical healing and 8 cases (40%) presented complete periapical healing with total absence of periapical radiotransparence. The degree of bone remineralisation for the cases with partial bone healing varied between 52% and 80%, with a mean value of 66%. Conclusions The radiodensitometric measurements of periapical and CAP area provides a tool of quantitative assessment of the healing of CAP after completion of endodontic treatment