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  • Author: Cecilia Petrovan x
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Assessment of Periodontal Status of Surgically Exposed and Orthodontically Aligned Impacted Maxillary Canines

Abstract

Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment. Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth. Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of teeth. Conclusions: The assessed periodontal indices may signal the appearance of a periodontal disease around the teeth that were surgically and orthodontically treated

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Erratum
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Original Research. Candida in Oral and Maxillofacial Pathology: Clinical Findings and Risk Factors

Abstract

Background: Candida, and especially Candida albicans, colonizes the oral mucosa and becomes invasive when the immune system weakens. Therefore, frequently, oral and maxillofacial pathology can be associated with Candida. Objective: The qualitative and quantitative assessment of Candida colonization of the oral cavity in patients with oro-maxillo-facial conditions; to establish an association between the different contributing factors and colonization. Material and methods: Samples were collected from 70 patients hospitalized in the Clinic of Oral and Maxillo-Facial Surgery, by rinsing the mouth with sterile saline; historical data were also collected. The samples were analyzed at the Microbiology Laboratory of the University of Medicine and Pharmacy of Tîrgu Mureș, using Sabouraud agar medium. For each isolate, the antifungigram for Fluconazole and Voriconazole was performed following the CLSI standards. Results: From the 70 samples 45.7% were positive for 11 different yeast species. Regarding predisposing factors, most importantly, smoking was significantly associated with Candida colonization (OR = 2.34; 95% CI = 1.42-3.84; p <0.05). Other factors, such as radiotherapy, oral hygiene or antibiotics, are related, but not statistically significant in our study. Candida albicans was the predominant species (38.8%). The testing of Candida albicans and non-albicans to Fluconazole showed an increased resistance (52.4%) in both cases, while the resistance to Voriconazole was 50% and 12.5%, respectively. Conclusions: Colonization of the oral cavity with Candida is present in about half of the patients with OMF conditions, and this is probably not only due to classical predisposing factors, but also due to chronic oral pathology and to several risk factors like smoking or radiotherapy.

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Oral Epithelioid Hemangioendothelioma — Unusual Location of a Rare Entity

Abstract

Introduction: Epithelioid hemangioendothelioma is a rare, locally aggressive vascular tumor, originating from soft tissue, bone, skin, and organs such as the liver or lung, exceptionally located in the oral cavity. Most of the cases of oral epithelioid hemangioendothelioma are asymptomatic, and diagnosis is hampered by the fact that the histological features are somewhat between hemangioma and angiosarcoma, with epithelioid cells, intracytoplasmic vacuoles, low mitotic activity, and (rarely) necrosis. Immunohistochemical analysis is required to rule out carcinoma or other epithelioid vascular neoplasms.

Case presentation: We present a rare case of a 59-year-old Caucasian male patient with oral epithelioid hemangioendothelioma for which clinical and cytological diagnosis was difficult, in spite of the patient’s history. The lesion was nonspecific, mimicking ulcerative stomatitis, but histological and immunohistochemical evaluation finally managed to establish the right diagnosis. Subsequently, the patient underwent surgical excision of the lesion followed by oncological treatment — chemotherapy.

Conclusions: Although at first examination seemed that another lesion has developed, rigorous histology and immunohistochemistry tests proved the presence of epithelioid hemangioendothelioma, a very rare entity located in the oral cavity, which required a proper surgical and oncological approach.

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Experimental Evaluation of Dental Implant Biomechanics Given Certain Stages of the Fixing Substrate Deterioration by Video Image Correlation Method

Abstract

Background: Dental implants are useful tools and represent a widely spread technique for oral rehabilitation. Their long standingness is highly influenced by the mechanical and geometrical properties of the surrounding osseous tissue in which they are placed. In some unsuccessful cases though, the dental implant is exposed to masticatory forces and other functional acts, and osseous tissue may resorb near its vicinity, leading to the dental implants loss. We investigated the strain distribution inside the fixating substrate, given certain stages of its deterioration near the dental implants.

Material and methods: For our investigations we used cilindro-conical screw-type dental which were submitted to vertical forces between 0-1000 N. The dental implants were fixed inside a plastic material used in photo-elastic measurements.

To evaluate the strain distribution inside the fixing substrate, we used a non-contact, experimental investigation tool, the Video Image Correlation (VIC-3D) optical system. This system allows the implementation in the dental implants optimisation from stress-strain state point of view.

Results: The strain field distribution inside the fixating substrate was measured at three different levels of the dental implant, when it was loaded alone and in the case when there were loaded two dental implants simultaneously.

Conclusions: The most stresses are concentrated in the neck-area of the dental implant. If there are loaded two or more dental implants simultaneously, the distance between them influences strain distribution. The measurements were conducted in vitro and do not represent the in vivo conditions, but serve further important facts regarding biomechanical properties of dental implants.

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Bisphosphonate-Related Osteonecrosis of the Jaws: a real Challenge for Dentists

Abstract

Background: Osteonecrosis of the jaw is a serious complication associated with oral and intravenous bisphosphonate therapy. Its pathogenesis is not well understood and its management is difficult. The aim of ourstudy was to evaluate the awareness of dentists in Târgu Mureş on the possibilities of treating patients who are treated with bisphosphonate in dental offices.

Material and method: We carried out a questionnaire-based study among dentists in Târgu Mureş reaching important issues such as: if the patient is asked if medical history follows / followed treatment with bisphosphonates, if they made surgical treatment in these patients, if they know under what conditions can they perform this treatment, if they deem it is necessary to contact the prescriber before surgical treatment.

Results: Seventy questionnaires were returned. During the medical history most clinicians (60%) asked the patients whether they follow/followed treatment with bisphosphonates and most of them (42.85%) did not perform treatments in these patients. While 85.71% of respondents declared that they do contact the prescriber before performing surgical treatment, 48,57% were not aware under what conditions they could undergone the treatment.

Conclusions: The dentists did not seem to be well informed about this pathological entity, known only since 2003. In the absence of appropriate protocols they could not provide a high quality treatment and in these circumstances they might do more harm than good.

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Knowledge and Attitude of Dentists Regarding Patients Undergoing Bisphosphonate Treatment: a Comparative Questionnaire

Abstract

Background: Osteonecrosis of the jaw is an uncommon but serious complication related to oral and intravenous bisphosphonate (BP) therapy. Its pathogenesis is not well understood, and there are no universal protocols accepted to treat it.

The aim of our study was to use the same questionnaire as four years ago to evaluate the awareness of dentists in Tîrgu Mureș regarding the dental treatments that can be applied in patients on BP therapy, and to assess how their knowledge on the subject has evolved over these years.

Material and method: We used the same questionnaire-based study as four years ago among dentists in Tîrgu Mureș, raising important issues such as: is the patient asked about current or previous treatments with BPs, do they perform surgical treatment in these patients, do they know under what conditions they can perform this treatment, or do they deem it necessary to contact the prescriber before surgical treatment.

Results: One-hundred twenty questionnaires were returned. The majority of respondents (n = 113, 94.2%) included the question regarding the use of BPs in their medical records. Of all respondents, 48 (40%) perform dental or surgical treatments on patients undergoing BP therapy, 68 (56.7%) do not perform dental or surgical treatments on these patients, and four of the respondents (3.3%) did not know the answer. One hundred (83.3%) respondents always contact the prescriber prior to surgery in these patients, regardless of how BPs are administered.

Conclusions: According to the findings of the present study, many of the respondent doctors have heard about BPs and their complications, but they are not aware of the fundamental concepts of bisphosphonate-related osteonecrosis of the jaw prevention and treatment protocols. In the absence of appropriate protocols, the quality of life of these patients is compromised.

Open access