About 50% of tooth loss is caused by either endodontic infection, periodontal disease or the combination of the two in the form on endo-perio lesions (EPL). Combined EPL develop due to the intimate anatomic and functional relation between endodontic and periodontal tissues. Both the pulp and periodontium share the same embryologic and anatomic origin. The various pathways connecting the two, added up to the extremely alike microorganisms in both illnesses’ etiology, create a complex condition in which interdisciplinary approach is required. Despite numerous decades of literature describing these lesions, they remain a continuous challenge for practitioners in both diagnosing and managing. The purpose of this article is to present a comprehensive review of various aspects of the combined EPL and to emphasize the importance of making a correct diagnosis and adopting the appropriate treatment method in the management of these challenging situations.
In the etiology of periodontal disease, dental caries act as a favoring factor. The purpose of our study was to evaluate the role of untreated or incorrectly treated carious lesions in the occurrence of pathological changes in the periodontal support. Material and methods: In order to evaluate the impact of the dental caries in the appearance of destructive lesions at the periodontal level, we examined 378 X-rays. The radiographies were selected based on the presence of approximal dental cavities, untreated or incorrectly treated and we appreciated the association of these factors with the presence and the level of bone resorption of the interdental septum. Results: On the 378 radiographies we examined, it was discovered the presence of 398 approximal carious lesions, of which 146 were associated with bone resorption. The examined radiographies permitted us to evaluate 1512 fillings inserted in second class cavities, of which 1103 were correctly done, and 309 were incorrect and associated with bone resorption phenomena. Incorrectly done restorations were associated with bone resorption phenomena due to the lack of contact with the adjacent tooth for 213 of these, and because of an inaccurate adaptation at the level of the gingival threshold for 96. Conclusions: The dentist has to pay a special attention to the approximal coronary restorations because these can favor the retention of bacterial plaque and, in most cases, can lead to bone loos in the alveolar ridge area.
Bacterial plaque has the primary etiologic role in triggering the pathological changes of periodontal disease. A major goal of periodontal therapy is supraand subgingival bacterial flora reduction through scaling and root planning, through local and general antimicrobial treatment. The aim of our study was to evaluate the effectiveness of the mechanical treatment of scaling and root planning in reducing or suppressing bacterial species from the periodontal pockets. In order to conduct this study we collected and analyzed subgingival plaque samples taken from the 50 periodontal pockets with a depth of about 5mm, from 50 subjects with diagnosis of generalized chronic periodontitis, before and after scaling and root planning. The usage of API 20A test allows a quick and easy identification of anaerobic bacteria based on biochemical properties. Additional complementary tests were used, such as examining the culture and the morpho-tinctorial features to confirm and complete the identification. The microbial flora that we were able to isolate from the periodontal pockets before scaling and root planning was very rich. After scaling and root planning the subjects showed clinical improvement in the periodontal status, and the microbiological analysis of the periodontal pockets mostly showed a quantitative and qualitative reduction of bacterial species. A local or general antimicrobial treatment is recommended to assure improved effectiveness because mechanical treatment alone cannot completely suppress bacterial flora.
Introduction: Pediatric Dentistry offers a completely different approach compared to that of adults especially in terms of patient cooperation, problems with growth and development and problems related to dental restoration in the context of a developing dentition.
Aim of the study: The purpose of this study was to assess the prevalence of primary and secondary dental dystrophies among preschool and school-age children.
Material and Methods: The group of 113 subjects with ages between 3 and 11 years was selected from two primary and preschool education establishments from Târgu-Mures. Simultaneously with the clinical examination of dental surfaces, 150 questionnaires were distributed to the parents of the subjects. The dystrophies determined clinically were arranged in a certain category of number, form, volume and structure and were correlated with the answers to the questionnaires.
Results: According to the data most cases of dental dystrophies are represented by dental fluorosis followed by severe early childhood caries S-ECC, and in equal percentages are present dyschromia, imperfect amelogenesis, MIH hypomineralization, dental fusion, macrodontia and hyperdontia.
Conclusions: There are significant correlations between the primary dental dystrophies and factors that intervened during pregnancy and in the post-natal period, both critical periods for dental formation and development.
Background: Despite the scarcity of studies regarding periodontal disease in young patients (teenagers and young adults), it seems that this disorder is also affecting the young population. Risk factors for periodontal disease include older age, chronic tobacco use, male gender, habits regarding oral hygiene, educational status, ethnicity, and financial status.
Aim: This study aimed to evaluate the periodontal health among adolescents in two high schools in Târgu Mureș that had dental practices.
Material and Methods: An online questionnaire consisting of 16 questions was distributed among high schoolers of Târgu Mureș. Data about personal characteristics, oral hygiene habits, family history of periodontal disease, risk factors for periodontal disease, and symptoms of periodontal disease observed by the respondents were collected and analyzed.
Results: Out of the 501 teenagers who responded to the online questionnaire, 114 (22.8%) were 18 years old and were mostly females (88.2%). Regarding oral hygiene habits, 75.8% prefer a manual toothbrush over an electric toothbrush, 66.7% brush their teeth twice a day, and 54.1% practice a horizontal method of toothbrushing. Mouthwash was the most used oral hygiene aid (58.3%). Family history of periodontal disease was observed in 21.9% of respondents. As favoring factors, nicotine addiction (23.8%), bruxism (24.4%), interposition of various objects between teeth (48.3%), past or present orthodontic treatments (38.7%) were recorded. Symptoms of gingivitis and periodontitis, such as gingival bleeding (81.4%), redness of gingiva (39.3%), increased gingival volume (44.5%), gingival retraction (22.8%), and halitosis (81%), were present in the responding teenagers.
Conclusions: In this study, periodontal disease was affecting mostly adolescent females who are practicing inappropriate methods of toothbrushing with inadequate frequency.
Developmental disabilities exist in children and adolescents, enabling them to live an independent and self-governing life, requiring special health related services. We are intended to inform dental professionals in planning and implementing a dental treatment for people with developmental disabilities. Cerebral palsy is defined as being a group of motor abnormalities and functional impairments that affect muscle coordination, and characterized by uncontrolled body movements, intellectual disabilities, balance-related abnormalities or seizure disorders. These patients can be successfully treated in normal dental practices, but because they have problems with movements, care must be tailored accordingly. Down syndrome, a very common genetic disorder, is usually associated with different physical and medical problems, intellectual disabilities, and a developmental delay. These patients can be treated with success in dental offices, this way making a difference in the medical care for people with special needs. Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication and by restricted and repetitive behavior. Self-injurious behavior, obsessive routines and unpredictable body movements can influence dental care. Because of the coexisting conditions (epilepsy or intellectual disability), one can find this people among the most challenging to treat. There is a need of greater awareness, focus and education in the field of the unique and complex oral health care that people with disabilities need. Making a difference their oral health positively influences an already challenged existence. According to the ethical principles, patients with developmental disabilities should be treated equitably depending on their necessities.