Dento-facial aesthetics in the eyes of adolescent patients during the Covid-19 pandemic.

Introduction: Dental malocclusions are considered a major issue in adolescence, and are often the main reason for which patients go to the dentist. Adolescents′ option to start an orthodontic treatment is questioned in the light of the restrictions imposed in the context of the Covid-19 pandemic. Aim of the study: The aim of this study was to assess adolescents’ perceptions of facial aesthetics and the impact of the Covid-19 pandemic on the decision to start an orthodontic treatment during this time, when a number of restrictions, such as face mask wearing, were imposed. Material and methods: A 15 items questionnaire was applied in the city of Oradea, Romania and distributed to orthodontic adolescent patients, with a previously diagnosed malocclusion, with ages between 12 and 17.9 years. The questionnaires were correctly filled in by 76 participants. Results: Patients tend to be affected by the aspect of their teeth (50%), and most patients considered that the aspect of their teeth forces them to socialize less (44.8%), and to avoid smiling (44.8%). 39.4% of the respondents considered that wearing a face mask is useful because it covers all dental malocclusions, and 31.6% of the respondents were not bothered that they had to wear a face mask. Conclusions: Patients declared that they were affected by the aspect of their teeth, and have a generally positive attitude regarding face masks.

Endodontic anatomy of lower premolars in a subpopulation from the Mureş county.

Background/Aim: Thorough knowledge of the endodontic anatomy and comprehensive understanding of root canal morphological variations are mandatory to ensure the successful outcome of the endodontic treatment. The purpose of this study was to compare the number of root canals of first and second lower premolars in a selected population to the root canal pattern reported by endodontic literature and to analyze the gender distribution. Material and methods: A total of 376 preoperative periapical radiographs were obtained from patients living in the Mureş County of Romania. The X-rays were analyzed by 3 endodontists into determining whether the mandibular premolars had one, two or three root canals. The difference between male and female gender distribution was also examined. Endodontic treatment was then performed using the operating microscope to confirm the root canal configuration of the radiographic analysis. The results were compared to common knowledge of the endodontic literature. Results: In this study, by using the radiographic method combined with direct observation aided by the operating microscope, 31.3% of first premolars and 14.6% of second premolars were found to have two root canals. A higher percentage of two root canals were found in females for both first (60.97%) and second premolars (76.9%). Conclusion: In the Mureş County region, mandibular premolars with two root canals have a significantly higher rate than the literature reports. Female patients have a higher prevalence than male patients. This should concern clinicians from this area to be aware of these facts as it can unquestionably influence the tooth’s long-term prognosis.

Nanostructured surface dental implants, a modern solution for the treatment of patients with chronic systemic diseases.

Introduction. In modern dentistry the oral rehabilitation of patients with the help of dental implants has a very high success rate. However, the problem is the situation of patients with serious chronic diseases in which the insertion of dental implants is problematic or dental procedures can complicate or aggravate the patients’ disease. Case report. We presented the case of a patient with associated chronic diseases who benefited from the insertion of implants with a nanostructured surface. The nanotube surface of the dental implant has been loaded with anti-inflammatory drugs to promote healing and stimulate the process of osteogenesis. Conclusions. Within the limitations of this study, we consider the therapy with avant-garde nanostructured dental implants to represent a viable treatment option for patients with a medical history with complicated chronic diseases.

Prevalence of nonsyndromic hypodontia in a south-east Transylvanian region.

Introduction. Clinicians claim that the prevalence of hypodontia has skyrocketed in recent years. However, there is no clear evidence whether it is really a change in dentition in Homo Sapiens or a purely hypothetical observation, due to the advanced modern technology used in the diagnosis of dento-maxillary anomalies. The aim of this study was to establish the prevalence and distribution of nonsyndromic hypodontia in young patients from the South-East Transylvanian region of Romania. Material and methods. A number of 325 dental charts were selected. The patients who needed orthodontic treatment were treated in the Pedodontics Department and Orthodontic Department of UMFST “George Emil Palade“ Targu Mures and two private dental offices during 2017-2019. The age of the patients was between 12 and 25 at the moment when the clinical and paraclinical examination were performed. Results. From a total number of 275 cases investigated, 78 patients were diagnosed with hypodontia in permanent dentition, not taking into consideration the third molars. Hypodontia’s prevalence is 6.47% for patients which seek orthodontic treatment, without taking into consideration the third molars. This value is found in the range of 2.8%-11.3% reported in studies in the literature. The present study showed that hypodontia affects a greater proportion of females (6.83%) than males (5.74%), without statistically significant differences. Conclusions. The prevalence of non-syndromic hypodontia in permanent dentition, compared to the total number of patients who requested orthodontic treatment, is 6.47%, being higher than the data reported in the literature of our country, but falls within the range reported in the international literature in general.

Changes in head posture after rapid palatal expansion in mouth-breathing children.

Introduction. It is well known that previously has been demonstrated a correlation between respiratory function and the harmonious craniofacial development and head posture respectively. Aim of the study. The purpose of this study was to investigate the correlation between rapid maxillary expansion (RME) and the change in natural head position (NHP) resulting from the consequent change in airway resistance and to elucidate how RME influences NHP in terms of cephalometric angles in children with nasal obstruction. Material and methods. The study included 12 girls and 8 boys who had a history of mouth breathing, as confirmed by the parents and ORL specialist and due to this fact, they underwent RME as part of orthodontic treatment. Dental casts, clinical photographs and lateral skull radiographs exposed in natural head position were obtained at the first visit (T1) and 8-10 months (T2) later for all subjects. In order to evaluate the patient’s lateral skull radiographs, I used AudaxCeph software, within which I created a new type of analysis. Student T test and Pearson correlation test were used to statistically analyze the results. Results. Our findings demonstrate that no significant changes in any of the variables are observed in patients treated with rapid maxillary expansion, however a positive correlation was observed in the variables measured before and after the treatment, respectively between the anomaly and the measured values. Positivity can also be detected when examining the correlation between the patient’s gender and the measured values. Conclusions. Based on the obtained results, we cannot state that there is a correlation between rapid maxillary expansion and cervical posture.

Efficiency of different instruments used for composite filling polishing.

Introduction: Improper finishing and polishing of fillings leads to surface roughness of the restoration which leads to excessive plaque accumulation, gingival irritation, increased surface staining and poor aesthetics of restored teeth. Therefore, it is essential to use polishing instruments and pastes as a final step of simple caries treatment in order to achieve optimal long-time results. The aim of this study is to evaluate the efficiency of 4 different finishing and polishing instruments used for surface smoothening of aesthetic restorative materials in vitro. Materials and methods: 40 composite (Reality X) samples were prepared in vitro. Their surface irregularities were measured along 3 diagonals before and after polishing. Sof-Lex discs (3M Espe), rubber cones (Kenda), Arkansas stone (Fino) and polishing paste and a professional toothbrush (Kerr) were used for polishing. Each sample was polished under 5N pressure for 30 seconds at 3000 rpm. The surface roughness was than measured using a profilometer. Statistic analysis was performed using ANOVA and unpaired T-tests, the significance level was set at a value of p<0.05. Results: Based on the mean values, the smallest roughness was found in the control group- 0.11, while the highest in the rubber polishers and Arkansas stone group- 0.47 and 0.48. The values for the Sof-Lex disc group and the polishing paste-toothbrush group were 0.40 and 0.39. Statistical analysis showed no significant differences between the four groups. Conclusion: It is mandatory to use polishing tools in order to obtain a smooth surface of the restoration and avoid the unwanted long-term complications. Polishing using brush and abrasive paste produced the smoothest surface of the composite.

Contribution to the study of improving the aesthetics of the smile by repairing and reshaping the incisors with composite materials.

Introduction. Dental aesthetics, although it seems something relative and difficult to evaluate, it is governed by a series of laws and rules that connect the dental disciplines, creating a unitary whole. It is structured by rules, perfected by artistic sense and by the inclination towards beauty of all specialists in dento-facial cosmetics. The aim of the study is to highlight an overview of aesthetic factors to consider when restoring anterior teeth with direct composite materials. Material and methods. A total of 25 patients were included in the study where the anterior teeth were restored using Gradia Direct Anterior (from GC) and Filtek Z550 (from3M-ESPE) composite kits, in perfect isolation using rubber damn, with a separate appointment after 24 hours for the polishing step, for which Rainbow Kit Technic and polishing Platina Hi-Gloss (from Prevest) paste were used. While the replacement of the tooth defect, we ensured that the composite increment, which we used should not be more than 2mm in thickness, and light cured for 20 seconds as the producer recommends. In none of all tooth shape modification (elongation in incisal zone) we did not modify the occlusion, by eliminating all premature contacts. All patients included in the study have signed the informed consent and agreed to participate in this research. Results. From a total of 25 patients, we repaired 20 central incisors with the mesial (18 cases) or distal (2 cases) angles fractured, in different accidents, 5 cases with diastema by small shape of the crown or malposition of one of the central incisors. Conclusions. Restoring the incisal angle or the incisal edge and refining a natural and improved smile of the patient is e very frequent dental intervention, especially nowadays when aesthetics plays an important role in the social society.

Fear and dental anxiety in children: a study of the contributing factors.

Introduction: Dental fear and anxiety are an important issue affecting children’s oral health and clinical management, and also an insufficiently studied subject in dentistry. Aim of the study: The aim of this study was to better understand the child patient - dentist versus dentist - child patient relationship and study the dental fear and anxiety of children in order to improve the dental office practice. Material and methods: In this study a personalized questionnaire was created and applied on a number of 333 children, in 4 schools from Mures county, Romania, on girls and boys between the ages of 8 and 13. The questionnaires used emoticons alongside words in order to better determine the state of anxiety created by the dental appointment and everything that it entails. All data and results obtained were analyzed using Excel and Graph Pad Prism 5.0 software. Results: Out of 333 patients, 133 subjects (40%) were 8-10-year-old, 143 subjects (42.9%) 11 - 13 years and 57 subjects (17.1%) were over 14 years. 175 girls (52.6%) and 158 boys (47.4%) demonstrated their courage and desire in participating in our study. It was determined that fear of dental appointments was caused in children over 14 years of age. The state of relaxation is generally enjoyed by urban children (45%) and those aged 11-13 years (37.1%); the percentage of boys in this category is an interesting aspect (40.5%). Conclusion: Dental anxiety is multifactorial and is far more complex than can be explained by a single contributing factor. The direct involvement of the child from the perspective of maintaining dental health, leads to the elimination of the state of fear and anxiety. Regular visits to the dental office, on the initiative of the child patient itself can reduce the anguish.