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  • Author: Alexandra Stoica x
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Original Research. The Influence of Desquamative Gingivitis on Periodontal Health

Abstract

Background: Desquamative gingivitis (DG) is a non-plaque-induced, blistering and painful condition occurring most frequently on the labial aspect of the attached gingiva of anterior teeth. The incidence of DG is highest around 50 years of age, and usually indicates the presence of oral or systemic diseases. The purpose of our study was to determine the impact of DG on periodontal health by recording the plaque index, gingival index and gingival bleeding index in a group of patients with DG, compared to healthy controls. Materials and methods: Recordings of specific indices were performed in a group of 26 patients with DG and compared with 24 healthy individuals. These were followed by radiographic examinations in order to assess the loss of marginal alveolar bone. Results: The results showed that patients with DG had a statistically significant increase in periodontal indices, with more gingival inflammation and plaque retention compared to the control group (p <0.05). The highest scores for gingival inflammation were recorded in patients with DG, but on radiographic evaluation the difference was related only to gender, men being more affected by alveolar bone loss in both groups (p <0.05). Conclusions: The incidence and severity of gingival inflammation proved to be higher in patients with DG, which calls for better preventive and maintenance treatment protocols in this group of patients. Early diagnosis and initial-phase periodontal treatment are very important in preventing further tissue breakdown.

Open access
An Insight into Histopathologic Examination as a Gold Standard for the Diagnosis of Chronic Apical Periodontitis

Abstract

Objective: The purpose of our study was to determine the level of correlation between histopathologic results after surgery for chronic apical periodontitis and the radiographic and clinical diagnosis. The status of gold standard technique of histologic examination was evaluated in the diagnosis of apical radiolucency in necrotic teeth.

Methods: Out of 154 patients with incorrect root fillings and apical radiolucency included in an endodontic retreatment protocol, 87 patients (108 teeth) were scheduled for apical surgery at 3-6 months control recall. Clinical and radiographic exams were completed prior to surgery and compared to the histological results of apical biopsies. The collected data were statistically analyzed with the SPSS version 20.0 and the Chi-square test was used to determine the associations between clinical and histologic diagnosis. A value of p <0.05 was considered statistically significant.

Results: There was a statistically significant difference between the number of cases diagnosed as granulomas or cysts during clinical and radiological evaluation compared to histologic evaluation of tissue samples, with 40.9% to 75.9% and 54.2% to 16.8% respectively (p<0.05).

Conclusions: The final diagnosis was obtained only after histologic examination of apical tissue samples, which means that the observations made based on radiologic investigations must be confirmed by biopsy.

Open access
A Rare Cause of Chronic Hepatitis: Celiac Disease

Abstract

Introduction. Celiac disease is a chronic bowel disease with a prevalence of 1% in the general population. This condition, immune-mediated, may exhibit multiple extra-intestinal changes, including the liver.

Case presentation. We present the case of a 43-year-old patient presenting in our clinic for fatigue, associated with cytolytic and cholestatic hepatic syndrome with an onset of 10 years. During this time, the patient performed multiple investigations with the exclusion of viral, autoimmune etiology, primitive biliary cirrhosis and Wilson's disease. An abdominal ultrasound recorded an elongated, with an infundibular septum gallbladder. Abdominal computer tomography did not detect any changes. The final diagnosis is chronic alithiasic cholecystitis receiving hepatoprotective treatment with symptom relief and improved hepatic disorders. Over the past 2 years, the patient was diagnosed with osteoporosis (T score = -2.7 followed by treatment with Calcium and Vitamin D and improvement in T score to -2.1), and an iron deficiency anemia corrected with oral iron treatment. Upon resuming the anamnesis, we notice the presence of an intermittent bloating associated with diarrhea. Positive anti-transglutaminase antibodies required upper endoscopy with biopsy witch confirmed celiac disease.

Conclusion. Despite the rather low prevalence of celiac disease in the etiology of hepatocytolysis, it is important to investigate its presence in the context of hepatic changes with uncertain etiology. This case motivates us to be rigorous in looking for secondary causes of hepatic impairment even in patients with apparently benign changes.

Open access
Beyond the Arteries in Peripheral Artery Disease

Abstract

Objectives. This study aimed to examine peripheral artery disease severity impact on psychological profile of arteriopathy patients.

Material and methods. The prospective study included consecutive PAD patients admitted to the 2nd Department of Internal Medicine and the Department of Cardiology of the Emergency Clinical Hospital “Sf. Spiridon” Iasi, between January and September, 2017.

Rezults. The group included 139 PAD patients, 80.6% male and 19.4% female, with an average age of 63.23±9.44 years. PAD stages have a very strong association with level of quality of life (p<0.0001). All Leriche-Fontaine classification categories were significantly associated with the depressive symptoms (p<0.0001). The stress level was moderate in stages IIA, IIB and III and extremely severe in the terminal stage. The prevalence of anxiety was lowest in incipient PADstages with the highest value in stage III.

Conclusions. The fragment of the PhD study presented the psychological profile in the PAD staging and advocates a personalized, wide-ranging approach to the arteriopathy patient including pain and depressive-anxiety management, with amajor impact on the quality of life at terminal stages.

Open access