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International Journal of Medical Dentistry

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1 THE BEGINNINGS OF ROMANIAN DENTAL MEDICAL EDUCATION. TWO FOUNDERS: GHEORGHE BILASCU AND D. D. NICULESCU, George LUCA, Nicolae MARCU
In Western European, starting with 1870, the stomatologist was an independent worker, refusing the allembracing patronage of surgery, while the dentistry profession used to acquire prestige and autonomy in the medical world. As the object of some modern, legal regulations, being also taught in universities as an independent discipline, dentistry was no longer viewed as a Cinderella of the medical science. Against the background of such a definite professional emancipation, the necessity to establish institutions forming doctors specialized in Dentistry became an impending one. The formal separation from the older sister Medicine and the creation of dental schools and departments was the more difficult, the more deeply rooted were the conservative mentalities and old traditions. Yet, the master minds of dentistry succeeded in imposing their ideas, supported by sound and convincing arguments, for the creation of the first schools of dental medicine in Romania. Consequently, as early as 1872, in the Austrian-Hungarian Empire, an imperial decree recognized the importance of dental practice and of its belonging to a separate branch of medicine, its exercising being permitted only to doctors in medicine. In such a politico-legislative context, the first faculty of stomatology was created at Cluj, in 1919, under the guidance of Gheorghe Bilacu. In the same period, in Bucureti, another daring character, great supporter of the stomatological school, dr. D. D. Niculescu, was taking great efforts to convince the decision-makers on the necessity of creating a faculty of stomatology, yet with no positive outcome. Several years were still to pass until the foundation of the first academic institution of dentistry in Romania (1936). The friendship uniting these two dreamers in the beginning of the XXth century is a perfect exemplification of the intense communication and cooperation within intelectual elites for the development of a medical stomatology school in the two Romanian provinces. Keywords: stomatological school, Gh Bilascu, D D Niculescu
2 CHIVA - ECOGRAPHIC ASPECTS AND SURGICAL RESULTS, I. EVA1, R. C. TIUTIUCA2, C. STANCIU3
Varices (milk leg) represent pathological dilatations of the superficial veins at the level of the inferior members. Up to now, the strictly anatomical aspect of varix formations inspired only traditional, strictly ablative treatments, generally applied without aiming at improving the haemodynamic condition of veins. Haemodynamic surgery attempts at modifying the reflux pattern, while preserving the most efficient channels of venous drainage. Implementation of such a treatment requires an exact understanding of the physiological principles and of the reflux patterns on which haemodynamic surgery relies. Ecographic evaluation of the venous system in patients with varicose dilatations permits drawing of a detailed map of the venous system, and also of its haemodynamic pattern [1]. Consequently, CHIVA appears as a viable therapy, applicable in outpatient services, as well. Post-surgery results are excellent and patients comfort is appreciated as highly satisfactory. The method is reliable, having produced no incidents, accidents or complications. Keywords: CHIVA, vascular ecography, haemodynamic surgery, varicose disease
3 DEFINING THE PERSONAL, LONG-TERM OBJECTIVES OF MEDICAL STUDENTS, VALENCIES AND SELF-CONCORDANCE OBJECTIVES, Maria ROMAN1, Iuliana Laura FERARIU2, Ticu CONSTANTIN3 , Carmen STADOLEANU4, Vasile BURLUI4
The study analyzes the relations between the manner of defining long-term objectives and the extent of their realization (academic success/failure) in the medical students of the Apolonia University of Ia?i. The investigation was developed on a group of 181 medical students of the first (Ist and IInd) years of study. For defining the long-term individual objectives, 1,267 concepts, such as: professional objectives, personal development objectives and leisure objectives, have been analyzed. The valence of the objectives was expressed as confrontation/offensive, avoidance/ defensive and neutral-type objectives. In the first stage of the evaluation, the variables considered in the analysis of objectives incidence were: age, gender of subjects and mean values of school scores. The results obtained agreed with the proposed hypotheses, according to which, comparatively with older students, the younger ones are oriented towards professional objectives of confrontation type. In a similar manner, comparatively with the less appreciated students, those with good professional results prefer professional objectives of confrontation type. Keywords: extended model of self-concordance scope objective, professional- personal development, leisure-type objectives, confrontation/offensive, avoidance/ defensive and neutral-type valencies
4 DIAGNOSTICATION OF PARAPROSTHETIC STOMATITES AND OF STOMATITES WITH CANDIDOSIC ETIOLOGY, Daniela Ivona TOMI?A1, Mihaela P?pu?a VASILIU2, Carmen STADOLEANU3, Cezarina DRAGOMIRESCU4, Iulia Andreea TUDOREAN5
Mobile gnatoprosthetic devices solve the problems caused by the morpho-functional recovery of the stomatognate system, even if their application affects the tissues contacting them. In the case in which the injuries produced to the mucous membrane of the prosthetic field exceed the physiological tolerance, various pathological modifications may occur, generically defined as paraprosthetic stomatopathies. Paraprosthetic stomatopathies and their occurrence are varied and their complexity is insufficiently known. The problem of etiopathogeneicity is still to be elucidated, as to the series of unknown quantities caused by the interference of the numerous systemic and local factors, whose individual influence is difficult to state. Several studies have indicated that the lesions of prosthetic stomatites are associated with the detected presence of Candida species, while other factors, such as local traumatisms, scarce hygiene of the prostheses, systemic maladies and immune deficiencies may be also involved [1,2]. Keywords: Candida spp., stomatitis paraprosthetic
5 INCIDENCE, AETIOLOGY AND PATTERN OF MANDIBLE FRACTURES IN SONEPAT, HARYANA (INDIA), Sunita MALIK1 and Gurdarshan SINGH2
Background: Maxillo-facial fractures can lead to substantial long-term functional, aesthetic and psychological complications, being considered among the most common facial accidents. As, in recent years, a significant increase of such cases has been recorded, the present study aims at describing the incidence, etiology and pattern of mandibular fractures recorded in Sonepat. Materials and method: A prospective study of maxillofacial injuriy cases was carried out at the newly created B.P.S Government Medical College for Women, Khanpur Kalan, Sonepat, from September 2011 to February 2013. Data on patients, including gender, age, mechanism of accident, fracture site and pattern were collected and analysed. Results: A total number of 474 patients with 86 mandibular fractures was registered, males outnumbering female patients by a ratio of 2.9:1. Age of patients ranged between 9 months and 72 years, maximum incidence occurring in the 18-34 year group of age. Most injuries were caused by road traffic accidents (48.83%), followed by assaults (26.74%) and sporting activities (13.95%). The most prominent site of mandibular fracture was parasymphysis (27.90%), followed by angle (24.41%) and body (18.60%) regions. 30.23% of the patients with mandible fractures were having multiple fracture sites. Also, 10% of the patients with mandible fracture had associated mid-facial fractures. Closed reduction was done in 13.6% of patients, open reduction and internal fixation was performed in 46.4% of cases, while 18.1% of them were treated conservatively. The mean duration of hospitalization was 10.12 6.24 days. Conclusions: The present study highlights the importance of dental surgery in the management of maxillofacial injuries and the need to reinforce legislation for reducing their number among both children and adults. Keywords: mandibular fracture, traffic accidents, assaults.
6 MANDIBULAR HYPO-HYPERDONTIA: A RARE CASE REPORT AND ITS MANAGEMENT, S.V.S.G. NIRMALA1, Sreekanth K. MALLINENI2, Sivakumar NUVVULA3
Dental anomalies of tooth number influencing the development of permanent dentition are quite common, and more numeorus than in the case of primary dentition, however, combined occurrence of hypodontia and hyperdontia is a rare phenomenon, especially in the same dental arch. The purpose of the present report is to describe a case of concomitant hypo-hyperdontia (CHH) in an 8 year-old male with missing mandibular central incisor and an erupted mandibular mesiodens, and its minimally invasive management. This is a unique case of CHH in the mandible in the dental literature, the two anomalies being manifested in the anterior region of the mandible. Furthermore, this is the only case report describing the evidence of taurodontism in association with mandibular CHH. Keywords: hypodontia, hyperdontia, mandible, taurodontism
7 ORO-DENTAL PATHOLOGY CHRONIC RESPIRATORY DISEASES CORRELATIONS, D. MUNTEANU1, D. VASINCU2, P. MANEA3, C. GAVRILESCU4
One of the most common chronic respiratory diseases, incapacitating the development and quality of life of patients and directly correlated with oro-dental cavity is represented by asthma, a chronic inflammatory disease affecting the airways, in which mast cells, eosinophils and T lymphocytes play an important role. A better understanding of the diagnosis and treatment of asthma became possible by accepting that the existence of chronic inflammation, with its variations, is reflected in the clinical condition of the patient, with implications on the dental status. Scope of the study: Determination of the prevalence and severity of oro-dental pathology in patients with chronic respiratory diseases, namely of individualized regimens, according to associated comorbidities that would contribute to improving the quality of life. Materials and method: A study was conducted on a group of 167 patients hospitalized in Vth Internal Medicine and Geriatrics - Gerontology Clinic, CF Hospital of Ia?i, along one year (2011-2012) and also on 53 patients consulted in a dental ambulatory unit. Results and discussion: The investigations conducted in the Vth Medical and Geriatrics Gerontology Clinic, respectively in the Ambulatory of University Dental Polyclinic, showed an increased prevalence of gingivitis, chronic marginal superficial periodontitis, coated tongue, possibly caused by insufficient ventilation in the nose and mouth breathing predominance. Angular cheilitis and stomatitis have been also had in view, as diseases of the oral cavity, in patients with asthma and chronically obstructive pulmonary diseases (COPD). Such cases were more frequent in male than in female patients, a possible explanation being the higher prevalence of smoking and increased exposure to professional allergens for males, as well as a higher incidence of viral and / or bacterial superinfections. Conclusions: Over 41.1% of the patients with chronic respiratory diseases and COPD AB present angular cheilitis (11.6% cases), stomatitis (22.3% cases) and candidosis (11.2% cases). In the experimental group, the level of oral hygiene is more satisfactory in women than in men, the same ratio being registered for smoker and nonsmoker patients. Also, caries occur more frequently in men than in women, the causes being, once again, health education, oral hygiene status and smoking.
8 PECULIARITIES OF INNOVATION IN MEDICAL CONTEXT, Iuliana Laura FERARIU1 , Carmen STADOLEANU2 , Vasile BURLUI2
Researches devoted to innovation are mainly aimed to finding the ways for stimulating the innovative potential of each individual. Numerous analyses have been dedicated to the factors that may influence the innovation process, among which special mention should be given to learning and working in a team as an effect of globalization, and also of the impact of informatics, known as imposing a rapid rhythm in all domains of activiy. The important observation made was that the process of innovation developed in various domains included the medical one involves four fundamental sequences, such as Generating Ideas, Risk Taking, Developing&Maintaining Relationships and Implementation. In addition, it can be mentioned that these connections are active not only within the sequences of the innovation act, but only in the manner in which people obtain the innovative results. The present paper discusses the results obtained on a sample group formed of medical students regarding their innovative profile and establishes the main directions of research in order to stimulate their innovative potential. Keywords: innovation process, innovative potential, innovative profile, instruments for stimulating innovative potential
9 PHOTODYNAMIC THERAPY, A NON-INVASIVE METHOD IN TUMOUR TREATMENT, Emil PETRESCU1, Cristina CRTOAJE1, Alexandra BURLUI2
Photodynamic therapy (PDT) promises to be a much better method in cancer treatment, compared to chemical procedures, due to its non-invasive character. Based on the combined effects of light and photoactive compounds i.e. photosensitizers - it can be used for both detection and treatment of benign or malign tumors. The main advantage of this method is the use of optical techniques instead of the radiation classical methods, which can seriously harm the healthy tissue around the affected area. The present paper presents the most common techniques and photosensitizers used in PDT. Keywords: photodynamic therapy, cancer, optical techniques, steady-state technique, time-resolved technique and frequency domain technique.
10 SUCCESS RATE OF DIFFERENT MICRO IMPLANT SYSTEMS, Adit ARORA1, Shanker Dayal GUPTA2, Amit PRAKASH3, Purushotam KUMAR4
Introduction: The present study was conducted to compare the stability of 3 different microimplant systems with different costs, over a period of 6 months. Methods: In 16 adult patients (7 males, 9 females; mean age, 19.81 years), a total number of 32 micro-implants (1.3-1.4 mm in diameter and 8 mm long) were placed between the roots of maxillary 2nd premolar and the first molar. A new system was used to classify microimplant failure on the upper left and right quadrant during a specified period of 6 months. Results: The overall success rate was 78.1%, a value suggesting that microimplants of S.K. surgicals are as stable as those of Denticon and Absoanchor (Dentos), and can be applied as cost-effective substitutes. Conclusions: When inserted between the roots of maxillary second premolar and first molar by a self-drilling, incision-free method, cost-effective microimplants appeared as stable as their more expensive counterparts. Female patients recorded a higher success rate than males, and the maxillary left quadrant had more success than the right quadrant. Orthodontic microimplant failure can be classified as: Grade I Inflammation associated with the microimplant, Grade II Mobility associated with the microimplant, Grade III Change in microimplant angulation, Grade IV - Complete luxation of the microimplant. Microimplant fracture during its removal can be considered as a Grade V microimplant failure. Keywords: microimplant, failure, stability
11 MANAGEMENT OF A COMPLICATED CROWN FRACTURE OF THE PERMANENT CENTRAL INCISOR BY FRAGMENT REATTACHMENT. A CASE REPORT , Nilesh S. KADAM, Ida De Noronha DE ATAIDE, Marina FERNANDES and Rajan LAMBOR
Coronal fractures of the anterior teeth are a common form of dental trauma, affecting mainly children and adolescents. Average incidence of injuries to anterior teeth reported in literature ranges from 4 to 46%, with 11 to 30% in primary dentition and 6 to 29% in permanent dentition. Traumatic dental injuries are associated with biological, socio-economic conditions, psychological and behavioral factors. Complicated crown fracture involves enamel, dentin and pulp. Various treatment modalities are available, depending upon the clinical, physiological and radiographic status of the teeth. The current case report describes the procedure of reattachment of tooth fragment of permanent maxillary central incisor in a 29 year-old patient with extensive fracture, involving subsequent pulp trauma.
12 EFFECT OF VISUAL IMPAIRMENT EDUCATION ON THE IMPROVEMENT OF ORAL HYGIENE AND REDUCTION OF PERIODONTITIS PREVALENCE , Z. KADKHODA, A. REZAEI, A. AMIRI
The present investigation is motivated by the fact that the incidence of visual impairment is increasing all over the world. Blind people may encounter specific problems in plaque control, leading to a higher risk of periodontal disorders. Objectives: To evidence the effect of alternative senses, other than sight, for controlling plaque formation and reducing periodontal indices in blind people. Methods: 51subjects (with ages between 15-45 years), both totally blind or with reduced sight were included in the study. They were instructed to brush their teeth by the M. Stilman method. The two important periodontal indices, Plaque Index (PLI), and Papillary Bleeding Index (PBI) were calculated both before and after the training session. Results: Blind individuals successfully learned the method of brushing by using their tactile sense, which significantly improved their oral hygiene in terms of PLI and PBI. Conclusions: Blind people are prone to properly control their oral hygiene, thus preventing possible periodontal problems and recording normal PLI and PBI values.
13 ONLINE EVALUATION OF PERIODONTAL DISEASE PREVALENCE IN PATIENTS WITH PULMONARY PATHOLOGY , Ionu? LUCHIAN, Alexandra WATTAD, Ioana MR?U, Monica TATARCIUC, Silvia MR?U
Periodontal affections can play a determinant role in the evolution of different systemic diseases. Periodontal pathogenic bacteria stimulate the release of pro-inflammatory cytokines or acute phase proteins. Materials and method. The current research involved developing of a questionnaire addressed to a number of 42 dentists from 12 different countries, who were asked to fill it in using an online platform. The questionnaire included five significant questions. Results and discussion. The main observation made was that the ratio of patients with pulmonary pathology, more frequently occurring as irreversible forms of periodontal disease (chronic and aggressive periodontitis), was higher, while fewer patients were diagnosed with different forms of gingivitis. Conclusions. Improving, enriching, optimizing and individualizing the means of oral hygiene all representing sound arguments in favor of reducing the inflammation of periodontal tissues appear as simple, cheap and efficient methods capable of decreasing the risk of pulmonary affections.
14 TREATMENT OF CHRONIC MARGINAL PERIODONTITIS WITH A ND-YAG LASER, COMPARATIVELY WITH THE CLASSICAL SURGICAL TREATMENT, Viorel IBRIC CIORANU, Vasile NICOLAE, Sorin GHISE, Sorin IBRIC CIORANU
he scope of the investigation was a comparative study between the classical surgical techniques applied in the treatment of chronic periodontitis and the adjuvant laser therapy. Materials and method. The study was performed on a batch of 20 patients diagnosed with progressive chronic periodontitis, subjected to the classical surgical treatment namely flap intervention in an operative field - versus a group of 18 patients with the same diagnosis, in whose case the surgical intervention was combined with ND-YAG laser phototherapy. Results and discussion. Chronic periodontites appear as morbid entities with plurifactorial, both local and general, usually complex causes. As all patients under analysis suffered from an advanced stage of the disease, flap intervention was practised. However, utilization of laser as an additional technique of periodontal surgery gave better results. In advanced stages of the disease, the only viable alternative remains the surgical removal of the granulation and osteitic tissue from the periodontal pockets, elimination of the abnormal gingival proliferations, in parallels with a harmonious reinsertion of the gingival festoon. Conclusions. Clinical investigations demonstrated that, in spite of the similar results registered in certain cases, a more rapid healing was noticed through laser utilization, as due to the vasodilatation produced at the level of microvascularization and to stimulation of neovascularization, and reduction of oedema in the affected zone.
15 CLINICAL STUDY ON AESTHETIC REHABILITATION THROUGH INTEGRALLY CERAMIC RESTAURATIONS AND ZIRCONIUM STRUCTURES , Vasile NICOLAE, Dana DUMITRA, Viorel IBRIC CIORANU
Scope of the study: evaluation of aesthetic rehabilitation of the dental-maxillary apparatus functions by selecting a correct treatment variant and suitable materials of prosthetic restauration, granting the expected results, at a convenient quality/price ratio. Materials and method. The study was performed on 25 male and female patients with ages ranging between 20 and 55 years. The subjects to whom aesthetic prosthetic (integrally ceramic or with ceramics on zirconium) restaurations were done suffered from odontal lesions, aesthetic defects caused by odontal repairs involving older obturations or by incorrectly fixed metallo-ceramic prosthetic restaurations. Results and discussion. To correct the physiognomy and dental aesthetics, repairs and even implanto-prosthetic reconstructions were necessary. In cases with a fine, transparent gingival biotype, the integrally ceramic prosthetic restaurations were preferred, the prosthetic limit being placed juxtagingivally, or with a minimum subgingival hollowing. In the patients with a generous biotype and certain dental devitalization, or when a bridge of at least two elements was available, ceramic restauration on zirconium was applied. Conclusions: Aesthetic restauration through either integrally ceramic or with ceramics on zirconium prosthetic repairs is superior to other techniques of aesthetic repair.
16 DENTISTRY AND DENTAL HIGH EDUCATION: ETHICAL ASPECTS, Aureliana CARAIANE, Francisc-Florin BARTOK, Cristina NICOLAE
The objective of dental education is to offer to the society well-trained dentists, capable of assuring public dental health. To achieve this, dental educators should have the ability to transmit to students a complex range of knowledge and dental manoeuvers specific to the field of dentistry. As much as this is possible, all these skills should be perfectly mastered until graduation, even if not sufficiently for the expected dental care standards. Dental practice requires from the part of the graduates to fully offer to their patients the highest standard of care they can benefit from. The dentist should treat his patients individually, fairly and impartially, according to medical ethics. Transforming aspiring students into dental professionals is the main ethical purpose to be attained. The present paper addresses ethical issues from the perspective of their everyday application in dental profession and dental education. In this context, dental ethics will be defined in relation to two different concepts: religion and law. Ethical issues will be presented as both life aspirations and obligations. The attemp at defining dental ethics, the concept of profession, and that of professionist will be employed. Distinction will be also made between dental profession and dental medicine as a profitable business. Some ethical issues to be taught in the medical ethics class of dental schools will be highlighted.
17 IN VITRO STRUCTURAL ASPECTS OF BLEACHING WITH CARBAMIDE PEROXIDE ON DENTAL ENAMEL , Aureliana CARAIANE, Cristina NICOLAE, Agripina ZAHARIA, N. IONESCU
The study evaluated the in vitro effects of 30% carbamide peroxide on human enamel by microhardness tests. Materials and method. 20 enamel slices were obtained from recently extracted premolars. To determine the microhardness index, the dental crowns were sectioned longitudinally into two mesial and distal halves. Sections were embedded in a self-polymerising epoxy resin, leaving open the enamel surface subjected to analysis. Enamel samples were randomly divided into two equal groups (n = 10), as follows: control group 1 - sections without whitening procedures, experimental group 2 - sections bleached with 30% carbamide peroxide for 15 min per day, along 14 days. After removing the bleaching gel, the specimens were stored in 250 ml artificial saliva at 37C, an operation repeated twice a day. Enamel microhardness evaluation was performed using Vickers microhardness test, applied in the beginning and end of treatment. Results. In the control group (1), the registered enamel hardness values ranged between 312 and 328 Mpa, with a mean value of 320.20 (p = 0.3>0.05); in the experimental group (2), the enamel hardness values ranged between 254 and 301 Mpa, with a mean value of 278.40 (p = 0.09>0.05). Intergroup comparison of microhardness values showed a statistically significant difference (p = 0.001 < 0.05). Conclusions. The results obtained demonstrated a significant decrease of enamel microhardness, induced by the action of the carbamide peroxide whitening product tested in the study.
18 ACCURACY OF COMPUTER-ASSISTED CEPHALOMETRIC MEASUREMENTS: A COMPARATIVE STUDY , Mihnea IACOB, Sorana RO?U, Irina ZETU
The aim of the present study was to comparatively evaluate the accuracy of the results obtained by manual and computer-assisted tracing of a group of cephalometric radiographs. Methods. A group of 60 initial cephalometric radiographs from 60 orthodontic patients, obtained on the same radiological device, was selected. The cephalometric radiographs were traced and measured using the classical (manual) method and the Orthalis cephalometric software, by the same examiner, using the parameters of Steiner and Tweed analysis. Results. With a few exceptions, the computer-assisted tracing technique gave results with an accuracy similar to that of the manual, clinically acceptable technique. Conclusions. The cephalometric tracing sofware represents a useful tool in both orthodontic diagnosis and treatment processes.
19 A standard protocol for six implants in the upper jaw , Thomas HAHN
The concept of telescopes on implants is a good opportunity for teethless patients. Instead of the prostheses with base reinforcement, the telescopic prothesis has numerous benefits. Due to the prolongued suspension of the denture it assures, bones resorption will be avoided. Also, a simple take in and take off of the telescopic prosthesis, its easy cleaning and the almost absent inflammation it assures recommends it even for older patients.
20 HEART RATE VARIABILITY IN PATIENTS WITH LIVER CIRRHOSIS A MARKER FOR AUTONOMIC DISFUNCTION , Robert D. NEGRU, Doina-Clementina COJOCARU, Anca TRIFAN, Corina DIMA-COZMA
The study aimed at evaluating the potential correlations between heart rate variability (HRV) parameters and liver cirrhosis severity and etiology, and at estimating the type of autonomic disfunction induced, over a 24 hour Holter monitoring. Methods. Included in the study were 48 patients with liver cirrhosis and 30 control subjects, submitted to a 24-hour ECG recording, whose time and frequency domain HRV parameters were analyzed. Results. The imbalance between the two autonomic components was reflected in significantly lower values recorded for the time-domain parameters (mean RR, SDNN, SDNN index and SDANN index), LF (P = 0.02) and LF/HF ratio (P < 0.001) in cirrhosis versus controls, except for HF, r-MSSD and pNN50, which suggests a markedly decreased sympathetic activity, with the vagal component less impaired. Alcoholic etiology recorded the most important impairment of HRV parameters. Conclusions. The 24-hour ECG monitoring of HRV parameters could help in establishing the noninvasive prognostic markers in patients with liver cirrhosis.
21 THE MICROBIOME THE SECRET WEAPON OF MODERN MEDICINE , Gheorghe MUSTA??, Mariana MUSTA??
We do not live alone in nature. Living in an ocean of microorganisms we establish various relations with them; some are parasitic, but most of them are harmless and create symbiotic mutualism. The microorganisms that fix on our body or inside it form the so-called microbiome.The number of microbial cells which establish relationships with our body is 10 times higher than the number of cells built by our own organism. The global genome of the microbiome is about 100 times larger than ones own genome. These two genomes are associated and form the so-called hologenome, which is especially important for the existence and evolution of the human species. The microorganisms of the microbiome establish their life environment both on and inside our organism forming somatic ecosystems. In either smaller or larger ecosystems, the microorganisms are interested in the health of the host. As a result of the relationships of symbiotic mutualism, the microbiome took over some functions of the organisms, fulfilling them totally or partially. In such situations, the organism becomes dependent on the microbiome, sometimes to such an extent that it cannot survive in its absence.Along the evolution process, symbiotic mutualism relationships were established between organisms and the microbiome. According to the theory of hologenomic evolution, elaborated by Richard Jefferson [1], human evolution itself was influenced by the microbiome. The microbiome protects us against the aggression of pathogenous agents and can be used as a weapon against them.
22 MANAGEMENT OF AN EFFICIENT COMMUNICATION IN THE MEDICAL OFFICE.STRUCTURAL ELEMENTS , Mihai LUCHIAN, Mihaela VASILIU, Carmen STROICI, Adina BRG?OANU, Carmen STADOLEANU
Communication represents a specific element of the activities developed in private medical offices, which assures a permanent functional link within the medical team, and the intentional relation with each patient in part. Communication is a dynamic process involving a continuous transmission, respectively reception, of a message, usually between two distinct entities, for establishing a correct diagnosis and an optimum therapeutical scheme. Medical communication is based on the ethical-moral principles specific to the field, once accepted the idea that a direct connection exists between the quality of communication and the expected performance. A balanced relationing will assure attainment of the final scope of any medical office, namely production, distribution and management of health services. The communication process, imagined as a constantly flowing fluid, is qualitatively influenced by both transmitter and receiver of the message. In time, such a relational graph tends to become a real psychological contract, a concomitantly verbal and especially subtle communication.
23 DOCTOR LUDMILA GALIN, A MODEL OF COMPETENT, HUMANE PHYSICIAN, Elena MARINESCU, Pompiliu COM?A
For more than four decades, the medical life of Galai city benefited from the multitudinous contributions to public health brought by the reputed pneumologist Ludmila Galin. Born in Bassarabia, where she attended her gymnasium years of study, in the autumn of 1940, she is obliged to take refuge in Galati, together with her family, when this territory had been annexed to the Soviet Union by the infame Ribbentrop-Molotov Dictate.
24 ATTITUDE AND PRACTICE ON HANDLING OF EXTRACTED TEETH FOR EDUCATIONAL USE AMONG THE STUDENTS OF A DENTAL COLLEGE IN SOUTHERN INDIA , H. V. AMITH, Audrey Madonna DCRUZ
To assess the attitude and practice on handling of extracted teeth among the students of a dental college in Southern India. Materials and method. A self-designed questionnaire was distributed among the 162 third and fourth year BDS students of a dental college in Southern India. Independent t test was used to compare the mean attitude and practice scores across genders and years of study. Results. More than half of the respondents felt that extracted teeth could cause infection if used without adequate precautions. About 93.2% of the students stated that extracted teeth need to be sterilized before use, while about 90.7% considered that mouth masks were necessary while disinfecting/sterilizing extracted teeth, as about 80.2% of them used the extracted teeth for preclinical exercises in the Department of Conservative Dentistry and Endodontics. Most of the participants collected the extracted teeth from private practitioners. Hydrogen peroxide was the most commonly preferred storage medium of extracted teeth. Only 48.7% of the students answered correctly that extracted teeth should be disposed off in yellow garbage bins after use. Conclusion. Although the dental students had a good attitude and practice on handling of extracted teeth for educational use, they did not indicate the most appropaite method of extracted teeth disposal after usage.
25 INFLUENCE OF SILICAGEL CONTAINING GOLD AND SILVER NANOPARTICLES ON THE BIOCHEMICAL INDICES OF EXPERIMENTALLY-INDUCED INFLAMMATION OF ORAL MUCOSA , A. V. BORYSENKO, O. V. LYNOVYTSKA, O. B. TKACH
Experimental study on rat oral mucosa inflammation and on the influence of drugs containing gold and silver nanoparticles upon the biochemical markers of inflammation and disbiosis. Materials and method. The study was conducted on 42 white rats, in which inflammation of the oral mucosa was experimentally induced by application of lipopolysaccharide (LPS). Preliminary applications, on the oral mucosa, of the gel containing gold and silver nanoparticles were made 2 days before experimental inflammation. The activity of the biochemical inflammation indices was determined in a gingiva and cheek mucosa homogenate. Results. Application of lipopolysaccharide LPS on rat oral mucosa increased the elastase activity and MDA content, which indicates inflammation. Application of gels containing Lyzomucoid with nanoparticles of gold and silver reduces the biochemical inflammation markers, but only in the oral mucosa. Under the action of LPS, catalase activity significantly increased in both gingiva and oral mucosa. The gel containing Lyzomucoid preparations and gold and silver nanoparticles significantly increases the activity of catalase and the antioxidant-prooxidant index (IPA) in both tissues, while decreasing oral mucosa disbiosis.
26 UTILIZATION OF CHLORHEXIDINE IN PROPHILACTIC TECHNIQUES OF PROFESSIONAL HYGIENIZATION , Marin CRISTIAN, Rodica LUCA
The present clinical study evaluates the results obtained by the application of the classical methods of professional hygienization through ultrasonic scaling, brushing, air flow, comparatively with the additional contribution brought about by chlorhexidine (CHX). The study was developed on a group of 328 subjects, equally divided into a reference, respectively an experimental group. Each group was subdivided into a batch of subjects affected with gingivitis, respectively a batch with persons suffering from periodontopathies. Each patient belonging to the reference group was subjected to professional hygienization, namely scaling with ultrasounds, professional brushing, fluorization, while the subjects forming the experimental group benefited from an additional application of chlorhexidine in the form of an 1% concentrated gel inside the subgingival ditches and interdental spaces.
27 ETIOPATHOGENIC INTERRELATIONS BETWEEN PERIODONTAL DISEASE AND RHEUMATOID ARTHRITIS , M?d?lin BOATC?, Ioana RUDNIC, Irina URS?RESCU, Alexandra MR?U, Teodor ?TEF?NACHE, Silvia MR?U
Purpose: To determine a possible relationship between periodontal disease and rheumatoid arthritis. Method: The prevalence of periodontal disease and rheumatoid arthritis was evaluated on 108 patients, divided into 3 groups: one with 40 patients affected with periodontal disease, a second one with 32 patients without periodontal disease, and a third one, including 36 patients with rheumatoid disease. Results: Clinical and radiographic evaluation revealed that the patients with periodontal disease showed a higher percentage of rheumatic disease than those without periodontal disease (5.16% vs 2.34%). Conclusions: People with moderate to severe periodontal disease have a higher risk of being affected with rheumatoid arthritis and vice versa.
28 MALOCCLUSIONS ASSESMENT IN A GROUP OF ROMANIAN SCHOOL CHILDREN WITH DIFFERENT SOCIO-ECONOMIC STATUS , Anne Marie RAUTEN, M?d?lina OLTEANU, Camelia MAGLAVICEANU, Mihai Raul POPESCU, Elina TEODORESCU, Petra SURLIN
To estimate the prevalence of malocclusions in school children of South-West Romania, related to sex, age and area of residence for obtaining an initial estimation, considering the total lack of information in the literature of the field upon this subject, either in Romania or in other South-Eastern European countries. Method: The epidemiological study was conducted on a sample group consisting of 923 children aged 7 to 15 years, 467 females and 456 males, coming from different socio-economic backgrounds. Results: Malocclusions were present in over half of the subjects from the examined community - 57.9%. Class I malocclusion was the most frequent (64%), whereas Class III appeared as the least frequently encountered subdivision (2%). The highest percentage of malocclusion - 59.4% - was recorded in areas with low socio-economic environment. Conclusions: Considering the high prevalence and involvement of life quality through functional and social limitations, the presence of malocclusions should be viewed as an important issue in oral health.
29 MANAGEMENT OF PROSTHETIC RESTORATIONS WITH THE CEREC SYSTEM , Mariana CONSTANTINIUC, Alina ZAHARIA, Alexandru-Victor BURDE, Daniela POPA, Sorana BACIU
The outcome of prosthetic restorations manufacturing in the field of dentistry and the remarkable functional results recorded depend equally on the accuracy of the clinical preparation and on the technology used. Currently, CAD-CAM systems represent the most advanced technology in restorative dentistry, which many practitioners consider to be the future of dentistry. This paper presents the operating procedure, the equipment and protocol used in the chair side and laboratory version of the CEREC system, summarizing the benefits it provides to both dental team and patients.
30 ADVANTAGES AND DIFFICULTIES IN THE PRACTICAL APPLICATION OF THE CONCEPT OF CONTINUING DEXTERITY EDUCATION, Vasile BURLUI, C?t?lina GRBEA, Carmen STADOLEANU, Maria ROMAN, Roxana D?SC?LESCU
Dexterity refers to the capacity of a person to use his hands and arms in order to perform the manual labour. Dexterity is an important component of any society and it affects economies and lifestyles. In our case, dentists have to be able to manipulate the tools required for the specific manual labour. The concept of continuing dexterity education is able to develop a detailed analysis of the students morpho-functional deficiencies, a continuing evaluation of the practical level, and all these elements contribute to the students development, not only as a practitioner, but also as an individual in the society. However, there are also some difficulties concerning the costs of the equipment, the technical limitations and some obsolete views of a part of the teaching staff who is not up to date with the modern educational standards.
31 EXTRACTION OF ENDONDONTICALLY-FAILED ANTERIOR TEETH BY IMMEDIATE REPLACEMENT AND LOADING OF AN IMPLANT-SUPPORTED CROWN. A CASE REPORT , Lalit KUMAR, Ritu BATRA, Hemant BATRA
Several restorative alternatives for replacing a missing anterior tooth are now in use. The single implant-supported crown is one of the best restorative options, under certain biological and biomechanical conditions such as sufficient bone quantity, condition and morphology of the periodontium, integrity of the natural and restored teeth. The long-term success of an implant depends upon the health and stability of the peri-implant hard and soft tissue.
32 MANAGEMENT OF DENTAL RADIOGRAPHIC WASTE: A REVIEW , Jyothirmai KONERU, Neha MAHAJAN, Mallika MAHALAKSHMI
In most cases, radiographies are used by dentists for the diagnosis and/or treatment of patients, so that they may be considered as a third eye for the dentist. Unfortunately, the radiographic procedures generate certain substances with potential challenge to the environment. Although individual dentists generate only small amounts of environmentally hazardous wastes, the accumulated waste produced by their profession may have a significant environmental impact, which in turn may pose risks to human health. This paper addresses the environmental impact of dental radiographic waste and describes measures that can be taken by dentists and their team to reduce the production of potentially harmful wastes.
33 STATISTICAL STUDY OF MALOCCLUSION IN A POPULATION OF CENTRAL ROMANIA REGION , Manuela CHIBELEAN (CIRE?-M?RGINEAN), Anamaria JURC?, Liliana-Gabriela HALI?CHI, Mariana P?CURAR
To evaluate the prevalence of malocclusions and the necessity of orthodontic treatment in a population of Central Romania Region. Method: A retrospective study, analyzing the files and dental cast of 417 patients aged between 12 and 29 years, was performed between 2010 and 2013, on patients from both urban and rural areas. Inclusion criteria: clinically healthy patient, no orthodontic treatment in antecedents. A number of 349 male and female patients were consulted for establishing the presence of malocclusions and their distribution according to sex and origin. Results: Out of the 295 patients with malocclusion, 25.08% evidenced class I Angle; 65.76% - class II; 9.15% - class III. A higher frequency of class I and II malocclusions was recorded in females, comparatively with males: class I - 66.22% females; class II - 68.04%. Class III malocclusion were more frequently observed in males: 55.56%. 78.31% of the cases from urban areas presented one of the three dental classes. Calculations (p=0.00040) evidenced a statistically significant relation between the presence of dental malocclusions and the area the patients came from. All three types of malocclusions had a higher frequency in the females coming from urban areas. Conclusions: A higher frequency of malocclusions (except class III), even if statistically insignificant, is recorded in females. No statistically significant differences were noticed between the origin region and the type of malocclusion, and/or between the type of malocclusion in females or males and their place of origin.The only statistically significant correlation is the one between the presence of malocclusion and the place of origin.
34 CEPHALOMETRIC FEATURES OF CLASS II MALOCCLUSION , Georgeta ZEGAN, Cristina Gena DASC?LU, Loredana GOLOVCENCU, Daniela ANISTOROAEI
The study aimed at identifying the quantitative and relational features of the bone, dental and soft tissue structures, for class II malocclusion, with its divisions on sexes and intervals of age, by means of 53 digital cephalometric measurements. 84 conventional lateral cephalometric radiographies were divided into two groups, according to ANB angle (60=class II and 24=class I), while the divisions of class II were clinically diagnosed according to the overjet (24=division 1 and 36=division 2). Application of Kolmogorov-Smirnov, t-Student and Levene tests of program SPSS, version 16.0, evidenced statistically significant differences between the two skeletal classes (28 characteristics), between the divisions of class II (10 characteristics), between sexes (6 measurements) and between the age intervals (28 measurements). The multitude of cephalometric characteristics of this malocclusion requires a special orthodontic therapy.
35 LIFE QUALITY AND THE SOCIO-ECONOMIC AND BEHAVIOURAL FACTORS IN TEENAGERS OF IASI , Adriana BALAN, Veronica PINTILICIUC ?ERBAN, Ana PETCU, Carina BALCO?
To evaluate the influence of clinical status and socio-economic condition, of family environment and subjective perceptions of the parents and children on their general and oral health condition. Materials and method:The study was developed on 120 adolescents, 72 girls (60%) and 48 boys (40%). Oral status was evaluated clinically, while parents and teenagers perception on their life quality was determined by means of a questionnaire. Results: 107 subjects (89.16%) showed carious lesions; the mean value of the DMFT index was of 3.78 (SD:0.48), and of the dmft index - of 0.92 (SD:1.13). The value of SiC index was 4.23. Teenagers have a better perception on their own oral health condition than their parents. A statistically significant association may be established between life quality and the DMFT value, the dental caries treatment need, gingival bleeding and the orthodontic treatments, the association being stronger for gingival bleeding and the orthodontic treatment need for all domains. Conclusions: Oral health, and especially the way in which this compound of the general health condition is perceived, has a considerable impact upon the life quality of teenagers.
36 QUALITY OF LIFE IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN PERIODONTITIS PATHOLOGY CONTEXT , Dorina Cerasella SINCAR, Sorina SOLOMON, Ioana RUDNIC, Teodor ?TEF?NACHE, Antonis GLYNIS, Silvia MR?U
The scope of the study was to evaluate the odontoperiodontal modifications observed in patients with chronic kidney disease, installed as a result of several chronic systemic pathologies, subjected to either dialysis or transplants. Materials and method. The group of patients suffering from chronic kidney disease included 42 persons (30 men and 12 women, with an average age of 42.6 9.2 years), while the control group was formed of 88 patients (36 men and 52 women, with an average age of 41.3 8.4 years). The investigation was developed in the Specialized Policlinics of the Sf. Apostol Andrei Emergency Hospital of Gala?i. Results and discussion. A statistically significant association was observed between the number of teeth covered by dental plaque or calculus and the number of elements with bleeding on probing (r=0.543, P
37 EFFECT OF CHLORINE DIOXIDE ON ENTEROCOCCUS FAECALIS IN EXPONENTIAL, STATIONARY AND STARVATION PHASES OF EXTRACTED HUMAN TEETH - AN IN VITRO STUDY , Shirur Krishnaraj SOMAYAJI, Shobha KL, Mohandas RAO KG
Enterococcus Faecalis (E. faecalis) is usually isolated from failed root canal-treated teeth. It can bind to dentin and co-aggregate with other organisms. The organism is resistant to intracanal medicaments and irrigants. It has the ability to produce biofilms and survive within the root canal and it may develop resistance in different phases of the bacterial growth cycle. Objective: To study the effect of chlorine dioxide on different phases of E. faecalis growth cycle for 1 and 3 min durations. Methodology: E. faecalis ATCC strain (29212) was grown in different culture phases on dentinal blocks of extracted human teeth. After treatment with chlorine dioxide, the left out colonies were counted from dentinal shavings. Scanning electron microscopic observations of the remaining biofilm in different phases were made and compared among them. Results: In all 3 phases, in the end of the 1 and 3 min time, significantly fewer (p