Introduction: X-ray radio imaging is commonly used because most diseases in the oral area can only be diagnosed by using this method. Proper identification of elements on a radiological image may also be difficult due to errors that may occur before, during or after the X-ray. These errors are called artifacts.
Aim of the study: The aim of our study is to distinguish the artifacts that can occur on two-dimensional and three-dimensional dental X-rays (intraoral or extraoral) from the actual pathology of the investigated area, by performing control X-rays.
Material and Methods: In our study we viewed, assessed and compared a number of 80 retroalveolar X-rays, 45 orthopantomographs (OPG) and 35 Cone Beam Computer Tomography (CBCT). In case of artifacts or errors, X-rays were repeated within 5 days or a CBCT was performed. In the case of OPGs, another option was to perform retroalveolar X-rays to establish the final diagnosis.
Results: From a total of 80 retroalveolar X-rays, in 13 cases (16.25%) we found artifacts. Of these, in only 4 cases (5%) diagnosis and treatment plan were changed following a clinical examination or a CBCT. In the case of OPGs, out of a total of 45 OPGs, 17 (37.7%) presented artifacts, but only in a percentage of 17.7% (8 cases) they affected the diagnosis. Of the 35 CBCTs, in 10 of them (28.57%) prosthetic works with a metal component or implants were present, with specific artifacts found, but their presence did not influence the diagnosis.
Conclusion: It is necessary for doctors to know the anatomy of the oral region, the most fervent appearance of the components and the different types of artifacts that may occur. Control X-ray is a very commonly used possibility, but there are cases where radiation exposure needs to be minimized.
Children`s dental anxiety is responsible for increasing dental health problems, as patients avoid seeking treatment. The aim of our study was to evaluate the level of dental anxiety and its correlation with dental health status in a group of children aged between 6-9 years.
Material and Methods. Our study included 56 children: first, they completed a questionnaire and then the decay-missing-filled teeth index was measured (DMFT).
Results. From a total of 59 children, 29 children had dental anxiety (51.78%) and the prevalence of caries was 69%. The mean and SD for the DMFT index was 1.76+/- 1.54 (2.04 +/- 1.98 for boys and 1.69 +/- 1.72 for girls, with p= 0.0391, p<0.05).
In conclusion, the level of dental anxiety can be reduced by frequent visits to the dental office. A favorable personal experience might help children increasing their confidence for dental treatment. There was a significant negative association between the value of filled teeth and the level of child's anxiety.
Introduction: Mitral insufficiency is a common valvular disease affecting 10% of the general population. The main treatment of the severe mitral regurgitation is surgical. We have analyzed the impact of cardiac surgery on the left ventricular performance and morphology, in patients treated for severe mitral insufficiency accordingly to the type of intervention, ischemic time and type of cardioplegia.
Methods: Ninety patients diagnosed with isolated severe mitral insufficiency that benefited from mitral valvular replacement or mitral valvuloplasty were retrospectively enrolled. The left ventricle, the left atrium, the right ventricle diameters and the left ventricle ejection fraction were measured by two-dimensional (2D) echocardiography before and after surgery. The influence of the myocardial ischemia time and the type of cardioplegia administered on the ventricular systolic function were also analyzed.
Results: Regardless the surgical technique chosen, after surgery we noticed a decreased size of the left ventricle (preoperative mean 54.91mm ±8.18 vs postoperative mean 51.94mm±8.15, p=0.035), right ventricle (preoperative mean 33.49mm±5,87 vs postoperative mean 32.41mm±6.03, p=0.0001), as well as the ejection fraction (preoperative mean 51.29%±8.51 vs postoperative mean 46.57%±8.71, p=0.0001).
Conclusions: Immediately after surgery, a decrease in the size of cardiac cavities as well as a decrease of the left ventricle ejection fraction is noticed.
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.
Objective: The aim of our study is to compare the ability of two nickel-titanium systems that use different rotation motions to create preparations that could promote a complete filling of the apical third of root canals.
Methods: We used 36 freshly extracted teeth, randomly divided in two groups, as follows: in Group A we used ProTaper Next, a system characterized by a continuous rotary motion and in Group B the teeth were instrumented with Wave-One, in which the files have a reciprocating motion. All teeth were root filled based on the same protocol, using gutta-percha and AH Plus. The teeth were further prepared for microleakage evaluation based on dye penetration technique, as follows: immersion in 2% methylene blue, longitudinally sectioned and examination of the apical thirds with an operating microscope. The distance of dye penetration along dentin walls was measured using the ImageJ program.
Results: The comparison between rotational and reciprocating systems showed that reciprocating files significantly promoted a reduced apical microleakage, as demonstrated by unpaired t test, Welch corrected (p=0.0346).
Conclusion: The use of Wave-One Reciprocating system was considered more effective in the shaping of root canals, as they demonstrating better conditions for the hermetic, tridimensional sealing of apical third of the roots canals.
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.
Background: In young patients, the most common cause of mitral valve regurgitation is prolapse or flail of the valve, which is morphologically reflected by myxomatous degeneration. In rare cases, such this presented in this paper, this lesion might be incidentally identified, in young people.
Case presentation: A 43-year-old male, with familial history of hypertension, presented in our Department of Cardiology for a routine check-up. Despite of lack of symptoms, an intense murmur was detected at mitral auscultation area. The echocardiography revealed a severe mitral regurgitation caused by flail of posterior mitral valve. The patient was transferred to the Cardiac Surgery Department for surgical intervention consisting in mitral valve repair. The histopathological examination revealed severe myxomatous degeneration of the spongiosa and fibrosa layers. The recovery after surgery was very good with no postoperative complications. The patient was discharged seven days after surgery, with no significant mitral regurgitation at the three-month follow-up.
Conclusions: In young, asymptomatic patients, the proper time for mitral valve repair should be decided by an interdisciplinary team. For a better understanding of myxomatous degeneration particularities, histopathological assessment should be done in any replaced valve. Certification of such lesions, under microscope, might be an indicator for familial cardiovascular screening, in first degree relatives.
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.
Aortic valve replacement is a safe therapy that can reverse cardiac remodeling and increase cardiac contractility, improve symptoms and quality of life. We presented a case of a 35-year-old male patient admitted to the Emergency Institute for Cardiovascular Disease and Transplantation of Târgu Mureș, Romania, due to severe aortic stenosis with severely depressed ejection fraction, left atrial myxome and a history of deep vein thrombosis and pulmonary thromboembolism. He underwent excision of the aortic valve and replacement with a mechanical prosthesis, excision of left atrial myxoma and tricuspid annuloplasty. The postoperative evolution was favourable with a significant recovery of the left ventricular systolic function and regression of cardiac symptomatology. This case was particular due to the rapid progression of the aortic pathology with the reduction of cardiac (systolic) function in a relatively short time as well as the occurrence of the thromboembolic event unrelated to the left atrial myxoma and rather associated with the background of cardiac failure with low cardiac output.
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.