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REZUMATE

Al X-lea Congres Naional al UNAS


ACTUALITI N ETIOPATOGENIA PARODONTITELOR
AGRESIVE
IMPLICAIA HERPES-VIRUSURILOR

Ioana Rudnic*, Silvia Mru*, Maria Ursache**


*Disciplina de Parodontologie, Facultatea de Medicin Dentar, Universitatea de
Medicin i Farmacie Gr. T. Popa, Iai
**Disciplina de Semiologie Odontologic, Facultatea de Medicin Dentar,
Universitatea de Medicin i Farmacie Gr. T. Popa, Iai

Obiective. Herpesvirusurile sunt mai frecvent ntlnite n esuturile


gingivale i lichidul crevicular din leziunile parodontale i poate fi observat o
accelerare a colapsului parodontal n situsurile parodontale expuse la mai multe infecii
cu herpesvirusuri dect cele cu expunere limitat. Dintre acestea cel mai frecvent
incriminate sunt Citomegalovirus, Epstein-Barr i Herpes simplex de tip 1. n acest
context etiopatologic literatura de specialitate relev faptul c virusurile herpetice au
capacitatea s determine infecii latente care se acutizeaz periodic (asemntoare cu
recidiva din parodontite) i c reactivarea ulterioar a acestora diminueaz rezistena
esutului parodontal, ducnd la o cretere excesiv a bacteriilor patogene cu eliberarea
de citochine i ageni chemotactici de ctre celulele gazd. Se pare c influena
virusurilor asupra bolii parodontale implic i un rspuns inadecvat al limfocitelor T.
Concluzii. Virusurile herpetice pot crete virulena bacteriilor
parodontopatogene iar reactivarea lor periodic poate duce la un colaps parodontal.
Cuvinte cheie: Herpes-virusuri, Porphyromonas gingivalis, parodontite
agresive

AFECTAREA PARODONTAL A ZONEI FRONTALE N


CTEVA ANOMALII DENTO-MAXILARE
THE ALTERATION OF THE PERIODONTAL SUPPORT OF THE
ANTERIOR TEETH IN CERTAIN MALOCCLUSIONS

Asist. Dr. tefan Milicescu jr.*, Asist. Dr. Angelica Bencze**, Prof. Dr.
Elena Preoteasa***, ef lucr. Dr. Ioana Duduca-Milicescu****;
*Catedra de Protetic Dentar Fix i Ocluzologie, Facultatea de Medicin Dentar,
UMF Carol Davila, Bucureti
**Catedra de Reabilitare Oral, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti
***Catedra de Protetic Dentar Mobil, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti
****Catedra de Ortodonie i Ortopedie Dento-Facial, Facultatea de Medicin
Dentar, UMF Carol Davila, Bucureti

Scopul lucrrii. Tratamentul ortodontic la adult este o realitate abordat pe


plan mondial n ultimele decenii. Dincolo de indicaiile problematicii fizionomice din
punct de vedere social i frecvent profesional, cele dou mari complicaii care impun
acest tratament sunt complicaiile parodontale i cele legate de articulaia temporo-
mandibular. Lucrarea noastr i propune s investigheze asocierea dintre diferite

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Rezumate
forme clinice de anomalii dento-maxilare i complicaiile parodontale la nivelul zonei
frontale.
Material i metod. A fost studiat un lot de 21 de pacieni tineri i aduli (10
brbai i 11 femei), cu vrste cuprinse ntre 18 i 35 de ani, nainte de nceperea
tratamentului ortodontic. Pentru fiecare dintre ei s-a evaluat sntatea parodontal a
zonei frontale prin indicatori pentru starea de igien local (indicele de plac Silness i
Loe), pentru inflamaie (indicele de sngerare gingival), i prezena altor semne de
afectare (retracii gingivale, pungi, mobilitate dentar).
Rezultate. Autorii abordeaz patologia parodontal frontal att ca suferin
n sine, ct i pentru implicaiile ei socio-profesionale. n cadrul lotului studiat au fost
gsite corelaii ntre tipul i gravitatea anumitor anomalii dento-maxilare i unii
parametri ai sntii parodontale.
Concluzii. Lucrarea susine ideea beneficiului adus structurilor parodontale
de suport de ctre instituirea ct mai precoce a terapiei ortodontice bine conduse ntr-o
anomalie dento-maxilar.
Cuvinte cheie: complicaii parodontale, anomalie dento-maxilar, terapie
tardiv

Aim. The increasing number of adult patients receiving orthodontic


treatment is a reality of the last decades. Their motivations are, beyond esthetics and
social implications, the occurrence of two great complications of an untreated
malocclusion: the periodontal alteration and the temporomandibular disorders. Our
scientific paper evaluates the correlations between orthodontic anomalies and
periodontal conditions of the anterior teeth.
Material and methods. The study group consisted of a sample of 21 young
adults (10 males and 11 females), aged 18 to 35 years, and prior of the beginning of
orthodontic treatment. The subjects were examined for evaluation of periodontal
conditions using the Plaque Index Silness and Loe, the Gingival Bleeding Index, the
existence of pockets, gingival recessions, and teeth mobility.
Results. The authors analyze the periodontal disease both as a health
condition and as a situation with clinical implications for the patient. In this study
correlations were found between some orthodontic anomalies and certain indices of
periodontal conditions.
Conclusions. This study provides valuable indication on the usefulness of
making early and proper orthodontic treatment on the ground of preservation of
periodontal condition.
Keywords: periodontal complications, orthodontic anomaly, late
orthodontic treatment

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Al X-lea Congres Naional al UNAS

AFECIUNI DENTO-PARODONTALE LA PACIENI


DIAGNOSTICAI CU BOAL PARKINSON
DENTO-PERIODONTAL PATHOLOGY IN PATIENTS WITH
PARKINSON DISEASE

ef lucr. Dr. Dana Cristina Bodnar*, Prep. Dr. Mdlina Boaghe*, Conf.
Dr. Constantin Vrlan*, ef lucr. Dr. Virginia Vrlan*, Asist.. Dr. Traian
Bodnar**, Prof. Dr. Mariana Brndua Popa
*Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti
**Catedra de Protetic Dentar Mobil, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti

Studiul clinico-statistic cu privire la asocierea leziunilor dento-parodontale


cu una din bolile neurodegenerative cunoscut sub denumirea de boala Parkinson sau
paralizia agitant, prezentat n lucrare, ilustreaz relaia ntre un factor etiologic care
atinge subiecii de vrst mijlocie sau naintat i leziunile aprute la nivelul
structurilor aparatului dento-maxilar.
Examenul interdisciplinar, neurologic i stomatologic, ilustrarea paraclinic
i imagistic, n contextul clinic, sugereaz existena unui determinism probabil,
nespecific, ntre boala Parkinson i leziunile dento-maxilare.
Raritatea observaiilor din literatur privind aceste aspecte i expresivitatea
clinic imagistic a acestora, reprezint un element de cunoatere. n acelai timp, n
practica stomatologic diagnosticul acestor modificri presupune abordri terapeutice
deosebite.
Cuvinte cheie: boala Parkinson, examene paraclinice, leziuni dento-
parodontale, interdisciplinaritate, abordare terapeutic

This is a clinico-statistical study regarding dento-periodontal lesions in


Parkinson disease (paralysis agitans) a well known neurodegenerative disease, thus
intending to reveal the correlation between an etiologic factor that affects middle-aged
or elderly persons and different dento-maxillary lesions.
Interdisciplinary exam dental and neurological clinical and paraclinical
evaluations showed that a nonspecific determinism between Parkinson disease and
dento-periodontal lesions existed.
Few data existing in the specialty literature and the clinical aspects of this
affection will be an interesting issue for dental practitioners.
In conclusion, for the dental practitioner, all these influences require special
therapeutic approaches.
Keywords: Parkinson disease, paraclinic exams, dento-periodontal lesions,
interdisciplinary, therapeutic approach

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APRECIEREA FACTORULUI DE RISC N MANAGEMENTUL
BOLII PARODONTALE
ASSESSMENT OF THE RISK FACTOR IN THE MANAGEMENT
OF THE PERIODONTAL DISEASE

Prof. Dr. Doina Onisei


Facultatea de Medicin Dentar, UMF Victor Babe, Timioara

Ultimele cercetri n parodontologia modern confirm faptul c nu factorul


microbian joac cel mai important rol n patogeneza bolii parodontale, ci factorul
gazd. n acest sens au fost identificai cei mai importani factori de risc, care mresc
susceptibilitatea gazdei la apariia i progresia bolii parodontale. Aprecierea riscului
parodontal (ARP) constituie o component esenial a diagnosticului i planului de
tratament parodontal. n acelai timp, ARP servete la determinarea frecvenei i
secvenialitii terapiei de meninere.
Cuvinte cheie: boal parodontal, factori de risc

Latest research of contemporary periodontology confirms that the host


factor overcomes the microbial factor in the pathogenesis of the periodontal disease.
Accordingly, the most important risk factors which increase the host susceptibility
leading to the apparition and progression of the periodontal disease have been
identified. The assessment of the periodontal risk (APR) becomes a main component
of the periodontal diagnosis and treatment planning. Simultaneously, the APR becomes
an important tool in determining the frequency and the sequence of the supportive
periodontal therapy.
Keywords: periodontal disease, risk factors

ASOCIEREA COMBINAIEI AMOXICILIN I


METRONIDAZOL N TRATAMENTUL UNOR FORME CLINICE
DE PARODONTITE MARGINALE
ASSOCIATION OF AMOXICILLIN AND METRONIDAZOL IN
PERIODONTAL TREATMENT

Asist. Dr. Marina Giurgiu, Conf. Dr. Anca Dumitriu, Asist. Dr. Stana
Punic, Asist. Dr. Brndua Mocanu, Prof. Dr. Horia Traian Dumitriu
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Premiza. Boala parodontal se caracterizeaz printr-o serie de inflamatorii


cauzate de microorganismele din spaiul parodontal, care n final conduc la distrucia
parodoniului profund.
Obiective. Urmrirea modificrii unor parametrii clinici n urma utilizrii
combinaiei amoxicilin + metronidazol n tratamentul parodontal.
Material i metod. Am selectat un lot de pacieni cu diferite forme de
afectare parodontal crora n cursul tratamentului parodontal le-am indicat
amoxicilin + metronidazol pe cale general i am urmrit modificarea statusului
parodontal la patru sptmni de la terminarea tratamentului.

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Al X-lea Congres Naional al UNAS
Rezultate. La patru sptmni de la terminarea tratamentului se constat o
real ameliorare a statusului parodontal.
Concluzii. Rezultatele acestui stadiu pun n eviden efectele benefice ale
asocierii amoxicilin + metronidazol n tratamentul bolii parodontale.

Background. Periodontal disease is characterized by inflammatory reactions


caused by microorganism within periodontal space, which finally lead to periodontal
destruction.
Objective. Change of clinical parameters after Amoxicillin + Metronidazol
association in periodontal treatment.
Material and methods. We selected patients with different forms of
periodontal disease and in periodontal treatment we indicated Amoxicillin and
Metronidazol per oral with monitoring the periodontal status at four weeks after
treatment.
Results. Al four weeks after treatment we observed a real amelioration of
periodontal status.
Conclusion. The study establishes the benefic effects of Amoxicillin +
Metronidazol in periodontal treatment.

ASPECTE CLINICE PRIVIND ROLUL TRATAMENTULUI DE


ALINIERE DENTAR ASUPRA STRUCTURILOR
PARODONTALE
CLINICAL ASPECTS CONCERNING THE INFLUENCE OF
TOOTH ALIGNMENT TREATMENT ON THE PERIODONTAL
STRUCTURES

Asist. Dr. Cristina Gabriela Pucau*, ef lucr. Dr. Drago Totolici**,


Conf. Dr. Anca Silvia Dumitriu***, Horia Traian Dumitriu***
*Disciplina Parodontologie, Facultatea de Medicin Dentar i Farmacie,
Universitatea Ovidius, Constana
**Disciplina Ortodonie, Facultatea de Medicin Dentar i Farmacie, Universitatea
Ovidius, Constana
***Disciplina Parodontologie, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti

Incongruena dento-alveolar cu nghesuire poate avea consecine nefaste


asupra structurilor parodontale, de aceea tratamentul de aliniere dentar poate fi privit
ca fcnd parte din tratamentul profilactic i curativ al bolii parodontale.
Scopul acestei lucrri l constituie ilustrarea ctorva aspecte pozitive ale
tratamentului de aliniere dentar asupra:
-structurilor gingivale, prin reconturarea fiziologic i fizionomic odat cu
reducerea gradului de inflamaie gingival pre-existent, fr alt tratament local
antiinflamator,
-osului alveolar prin refacerea i remineralizarea septurilor osoase afectate
de un viciu de poziie care exista iniial.
Concluzia lucrrii pledeaz pentru existena unei bune colaborri ortodont-
parodontolog n vederea realizrii unui tratament complex pacienilor cu incongruen
dento-alveolar cu nghesuire i boal parodontal..

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Rezumate
Cuvinte cheie: nghesuire dentar, gingivit, parodontit
Dental crowding can lead to undesired consequences on the periodontal
structures, therefore tooth alignment therapy can be considered also as part of
preventive and curative periodontal treatment.

The aim of this presentation is to illustrate some of the beneficial effects of


tooth alignment therapy on:
-gingival structures which gain physiognomic and physiologic new aspect,
reduction of pre-existent degree of gingival inflammation without any local anti-
inflammatory treatment;
-alveolar bone septa affected by an initial existing malposition, by
restructuring and re-mineralization.
The conclusion of the presentation encourages a proper collaboration that
must exist between orthodontist and periodontologist for best treatment choice of
patients with dental crowding and periodontal disease.
Keywords: dental crowding, periodontitis, gingivitis.

ASPECTE CLINICO-EPIDEMIOLOGICE ALE INFECIEI


TUBERCULOASE N SFERA ORO-MAXILO-FACIAL

Conf. Dr. erban ovaru*, Prof. Dr. Alexandru Bucur*, Maria Necula**,
Ioanina Prltescu*
*Spitalul Universitar de Stomatologie Dan Theodorescu, Bucureti
**Institutul Naional de Pneumologie Marius Nasta, Bucureti

Dat fiind incidena mare a tuberculozei n Romnia (una dintre cele mai
ridicate din Europa), am realizat un studiu retrospectiv privind unele aspecte
epidemiologice ale acesteia n sfera OMF, asupra unui lot de 160 de pacieni, cu
tuberculoz localizat la acest nivel, internai n perioada 01.01.1985 31.12.2005 n
Spitalul Universitar de Stomatologie Dan Theodorescu Bucureti, acetia
reprezentnd procentaj de 0,24% din totalul internrilor (65287) din perioada
menionat.
Diagnosticul de certitudine a fost stabilit pe baza examenului histopatologic.
Din totalul de 160 de cazuri de tuberculoz extrapulmonar, 117 cazuri (73,1%)
prezentau tuberculoz cu localizare ganglionar (submandibular, submentonier i
latero-cervical), 15 cazuri (9,3%) la nivelul mucoasei orale, 21 de cazuri (13,1%)
la nivelul glandei parotide i 7 cazuri (4,5%) alte localizri (maseterin,
suprahioidian, genian).
Distribuia pacienilor n funcie de criteriile:
Sex: Brbai 56 (35%); Femei 104 (65%);
Vrst: 1-30 ani: 54 (33,75%); 31-60 ani: 58 (36,25%); Peste 61 ani: 48
(30%);
Mediul de provenien: Urban: 102 (63,7%); Rural: 58 (36,3%).
Din datele prelucrate a rezultat c 13 pacieni (8,12%), au avut n
antecedente tuberculoz pulmonar, iar 12 pacieni (7,5%) prezentau modificri
radiologice sugestive pentru afectare pulmonar concomitent n momentul
examinrii.
Pentru investigaii de specialitate suplimentare, n funcie de afeciunile
asociate, pacienii au ajuns n serviciul de chirurgie OMF, fiind trimii de medici de

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specialiti diferite, astfel: medicin de familie: 35 (21,88%), ORL: 25 (15,62%),
stomatologie: 18 (11,25%), chirurgie general: 17 (10,62%), boli interne: 13 (8,12%),
chirurgie OMF i pediatrie: cte 6 (3,75%), boli infecioase i endocrinologie: cte 3
(1,87%), pneumo-ftiziologie i hematologie: cte 2 (1,25%), oncologie, dermatologie,
psihiatrie i urologie: cte 1 (0,62%). Din proprie iniiativ s-au prezentat la camera de
gard 27 (16, 87%).
Concluzii:
- leziunile tuberculoase n sfera OMF sunt rar ntlnite;
- toate cazurile aflate n studiu au prezentat manifestri ale tuberculozei
secundare;
- localizarea cea mai frecvent a tuberculozei extrapulmonare este cea
ganglionar, cel mai afectat fiind grupul ganglionilor laterocervicali i submandibulari;
astfel, se recomand ca medicul stomatolog, observnd adenopatiile localizate la aceste
niveluri, s ia n considerare i etiologia tuberculoas, fiind necesare investigaii
suplimentare obligatorii: radiografie pulmonar, IDR la tuberculin, astfel nct s fie
descoperite localizri concomitente ale tuberculozei, pentru un diagnostic precoce.
Cuvinte cheie: tuberculoz, infecii specifice, OMF

ASPECTE CLINICO-TEHNICE ALE ARMRII BAZELOR


ACRILICE CU FIBRE DE STICL

Prof. Dr. Elena Preoteasa, Dr. Cristina Teodora Preoteasa


Catedra de Protetic Mobil, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti

Obiective: Selectarea aspectelor clinice cu risc crescut de fractur a


protezelor mobile i a necesitii creterii rezistenei mecanice a bazelor acrilice.
Prezentarea unei modaliti tehnice de armare a PMMA cu fibre de sticl, cu avantajele
clinico-tehnice i biocompatibile comparativ cu acrilate nearmate i alte modaliti de
armare (plas metalic).
Material i metod: S-au realizat observaii clinice asupra cazurilor cu
fractur a bazelor acrilice, cu analiza i evaluarea unor aspecte clinice cu risc crescut
de fractur (maxilar/mandibul, cu linie de fractur median/paramedian, tip scheletal
de clasa a II/1, II/2, III, vrsta pacienilor, dinii antagoniti etc.), care asociate cresc i
mai mult riscul la fractur. Ca soluii alternative s-a ales armarea cu fibre de sticl,
realiznd observaii asupra tehnicii folosite, avantajelor clinice i tehnice, privit
comparativ cu armarea cu plas metalic.
Rezultate i concluzii: Observaiile clinice au artat prezena riscului de
fractur la protezele acrilice, cu necesitatea n primul rnd a conceperii i realizrii
corecte a protezelor mobile, dar i a utilizrii unor inserturi. Noi recomandm fibrele
de sticl, o tehnic simpl, cu posibiliti largi de utilizare, care conduce la materiale
compozite cu caracteristici fizice superioare acrilatelor simple.

Aim. The selection of the clinical aspects with an increased risk of mobile
dentures fracture and the necessity of the increase in mechanical resistance of acrylic
dentures. The presentation of a technical procedure for the reinforcement of PMMA
with glass fibers. This procedure allows us to create a product, better than the usual
acrylic resins and those reinforced with a metallic mesh.

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Rezumate
Material and methods. We analyzed a group of patients who frequently
fractured their dentures. We registered the location of the fracture (maxilla/mandible,
medial/paramedial), the skeletal class of the patient (Class II/1, II/2 and III), their age,
the state of the other dental arch. We found out that the association between multiple
factors increases the risk of denture base fracture. In order to prevent it, we chosen the
reinforcement with glass fibers, and we made a few clinical and technical remarks.
Results and conclusions. Our clinical observations proved that there is a real
risk of base denture fracture. To avoid it, we must first of all conceive and realize a
correct mobile denture, and we can use sometimes insertions. The authors recommend
the glass fibers, which are easy to manipulate and create a composite structure superior
to the original acrylic resin.

ASPECTE INTERDISCIPLINARE ALE TRATAMENTULUI LA


BOLNAVII PARODONTOPAI
INTERDISCIPLINARY ASPECTS OF TREATMENT OF
PATIENTS WITH PERIODONTAL DISEASE

Asist. Dr. Magdalena Cureu, ef lucr. Dr. Manuela Popescu, Prof. Dr.
Horia Traian Dumitriu
Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti

Dinii cu suferin parodontal avansat i modific poziia, aprnd treme


i diasteme patologice. De aici, necesitatea instituirii unui tratament ortodontic n
paralel cu cel parodontal, att pentru a corecta poziia dinilor ct i cu rol de sistem de
imobilizare.
Material i metod. S-au folosit pentru acest studiu pacieni cu parodontit
marginal cronic profund i 1 pacient cu gingivit hiperplazic asociat cu
compresiune de maxilar. Acestora li s-a efectuat tratamentul antimicrobian i
chirurgical, n funcie de situaia clinic.
Rezultate. Msurtorile clinice i examenele radiologice au artat creterea
suportului osos i mbuntirea implantrii dinilor. Tratamentul ortodontic a dus la
restabilirea poziiei normale a dinilor.
Concluzii. Asocierea tratamentului ortodontic la cel parodontal este esenial
pentru obinerea unui status dento-parodontal ct mai apropiat de cel fiziologic.
Cuvinte cheie: tratament ortodontic, paciet parodontopat, interdisciplinar

Teeth with advanced periodontal disease can change their position, resulting
in pathological diastema and other spaces between teeth. Hence, it is better to practice
an orthodontic treatment in the same time with periodontal treatment, both for
correcting teeth position and for fixing the teeth.
Material and method. For this study patients with advanced periodontal
disease have been used and 1 patient with gingival hyperplasia associated with jaw
compression. All these patients have been performed antimicrobial and surgical
treatment, depending on their clinical form.
Results. Clinical measurements and x-ray exams have shown increase in
bone quantity and teeth implantation improvement. Orthodontic treatment has resulted
in reestablishing a normal teeth position.
Conclusions. Associating orthodontic treatment with periodontal one is
proper for obtaining a dental status as normal as possible.

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Keywords: orthodontic treatment, periodontal patient, interdisciplinary

ASPECTE PARODONTALE N PROTEZAREA PARIAL


AMOVIBIL

Ioana Roxana Constantinescu, Prof. Dr. Maria Ursache


Departamentul de Reabilitare Oral Complex, Facultatea de Medicin Dentar,
Universitatea de Medicin i Farmacie ,,Gr.T.Popa, Iai

Protezarea parial amovibil este metod terapeutic frecvent utilizat n


restaurarea morfo-funcional a edentaiilor parial ntinse, dar uneori prezena acestora
n cavitatea oral poate antrena apariia unor leziuni la nivelul esuturilor de vecintate,
inclusiv a celor parodontale. Scop. Stabilirea efectelor conectorilor principali asupra
parodoniului, la subiecii cu edentaii parial ntinse terminale mandibulare i
evaluarea modificrilor parodontale de la nivelul dinilor n contact direct cu
elementele protezelor. Material i metod. Pacienii selectai au fost distribuii n trei
loturi de studiu, n funcie de tipul protezrii i tipul conectorului principal. Pacienii
au fost investigai clinic i paraclinic, stabilindu-se modificrile parodontale imediat
dup protezare i la 1 an., prin cuantificarea modificrilor pe baz de indici: indicele de
plac, gingival, adncimea pungilor parodontale la sondare, mobilitatea dentar i
recesiunea gingival. Rezultate. Se remarc diferene semnificative, la 1 an de la
protezare cu privire la indicii de plac, indicele gingival, adncimea pungilor
parodontale, mobiltitatea dentar i recesiunea gingival, ntre dinii stlpi i dinii care
nu vin n contact cu elementele protezei. Concluzii. Alegerea corect a conectorilor
principali i a elementelor de meninere, sprijin i stabilizare, calitatea manoperelor
clinice i a execuiei tehnologice, meninerea unei stri de igien corespunztoare i
dispensarizarea pacienilor n timp, sunt factori care pot contribui la reducerea
modificrilor parodontale.
Cuvinte cheie: parodoniu, proteze parial amovibile, conectori principali
mandibulari

ASPECTE TERAPEUTICE MODERNE N LEZIUNILE


COMBINATE ENDO-PARODONTALE
MODERN THERAPEUTIC ASPECTS IN COMBINED
ENDODONTIC PERIODONTAL LESIONS

Dr. Darian Rusu


Facultatea de Medicin Dentar, UMF Victor Babe, Timioara

Terapia leziunilor combinate endo-parodontale este strns legat de


diagnosticarea acestora. Dificultile diagnostice frecvente sunt consecina siturii
acestor leziuni la grania dintre patologia pulpar i cea parodontal. Interrelaionarea
dintre cele doua esuturi, cile de comunicare dintre acestea, posibilitatea traversrii
patogenilor de la nivelul unui esut la cellalt reprezint cauzele principale ale apariiei
leziunilor endo-parodontale. Diagnosticarea nu vizeaz doar identificarea leziunii n
sine, ci i stabilirea caracterului primar, secundar sau concomitent al leziunii.

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Rezumate
Clasificarea leziunilor endo-parodontale servete unei diagnosticri corecte. Pentru
aceste cazuri, eroarea de diagnostic poate duce la pierderea dintelui.
Ultimele tendine n terapia leziunilor combinate urmresc instituirea unui
tratament specific clasei din care aceasta face parte. Cea mai utilizat clasificare este
cea propus de Simon, Glick i Frank n 1985. Terapia endodontic unic sau
combinarea dintre terapia endodontic i parodontal, succesiunea celor dou tipuri de
terapii sau momentul instituirii celei de-a doua, utilizarea sau nu a metodelor adjuvante
precum materialele de umplere osoas sau membranele, reprezint elementele
terapeutice moderne care vin s sporeasc rata de succes terapeutic, pentru situaii a
cror soluionare era pn nu demult extracia dentar.
Cuvinte cheie: leziuni combinate endo-parodontale

The treatment of combined endodontic-periodontal lesions is closely related


to their diagnosis. The frequent diagnostic difficulties are the consequences of the
situation of these lesions at the border between the pulpal and the periodontal
pathology. The interrelations between the two tissues, the communications between
them and the possibility of germs crossing in both directions are the main causes of the
combined lesions. The diagnosis aims not only the identification of the lesion as such,
but also establishing its primary, secondary or simultaneous character. The
classification of the endodontic-periodontal lesions helps to establish a proper
diagnosis. In such cases, the diagnostic error could easily lead to the loss of the tooth.
Latest tendencies in the therapy of the combined lesions aim to establish a
specific treatment for each individual class of lesion. The most used classification
today was proposed by Simon, Glick and Frank in 1985. Endodontic therapy alone or
the combination of endodontic and periodontal therapy, the sequence of such therapies
or the moment to perform the latter, using or not accessory methods as bone graft
materials and/or membranes these all represent modern therapies leading to
increased success rates for teeth destined in the past to extraction.
Keywords: combined endodontic-periodontal lesions

ASSOCIATIONS OF PERIODONTAL DISEASE WITH OTHER


DISEASES

Prof. Dr. Nils Skaug


Department of Oral Sciences, Faculty of Dentistry, University of Bergen

Current epidemiologic evidence suggests that periodontal disease is


moderately associated with cardiovascular disease. However, intervention studies are
required to establish whether periodontal treatment reduces the onset and/or
progression of atherosclerosis-induced diseases. Evidence is lacking that oral bacteria
are causal factors of cardiovascular disease.
Among certain populations, systematic reviews have concluded that mothers
with severe periodontitis have a higher incidence of pregnancy complications than
have mothers with little or no periodontitis. Preliminary evidence suggests that
periodontal treatment may reduce the incidence of adverse pregnancy outcomes.
Scientific evidence supports the view that the relationship between diabetes
and periodontal diseases is bidirectional. There is sufficient evidence to recommend
further studies to firmly establish that treating periodontal diseases can contribute to
glycemic management.

12
Al X-lea Congres Naional al UNAS
Oral colonization by respiratory pathogens appears to be a risk factor for
lung infection in high-risk subjects. Oral interventions that improve oral hygiene and
possibly reduce oral inflammation may prove to be simple, inexpensive and effective
means to lower risk of pneumonia in institutionalized populations.
In conclusion, causal associations between periodontal disease and other
diseases have not been established. Scientific evidence that treating periodontal disease
will prevent the occurrence of other diseases is lacking.
Keywords: periodontal disease, associations with general diseases

AUGMENTAREA GINGIEI ATAATE OBIECTIV PRINCIPAL


AL CHIRURGIEI MUCOGINGIVALE. TEHNICI I INDICAII
INCREASING THE ATTACHED GINGIVAL MAIN OBJECTIVE
OF MUCOGINGIVAL SURGERY: TECHNIQUES AND
INDICATIONS

ef lucr. Dr. Dr. tefan-Ioan Stratul


Facultatea de Medicin Dentar, UMF Victor Babe, Timioara

Obiectivul principal al chirurgiei mucogingivale este ameliorarea condiiei


parodontale prin augmentarea zonei de gingie ataat i acoperirea radicular.
Friedman (1957) definete chirurgia mucogingival ca fiind un tip de chirurgie plastic
ce se ocup cu relaiile dintre complexul mucogingival i gingia fix, osul alveolar,
frenuri i bride, ataamentele musculare i anul vestibular. Chirurgia mucogingival
se indic n ameliorarea zonelor cu gingie ataat foarte redus, cu inflamaii gingivale
rebele la terapia iniial sau n regiuni cu recesii gingivale avansate. Din contr, ea este
contraindicat n zone cu gingie sntoas, dei ngust sau chiar absent. Reflexia
terapeutic cea mai important se adreseaz gingiei ataate: este aceasta suficient de
lat? Rspunsul la aceast ntrebare decide tipul de procedur chirurgical n terapia
pungilor parodontale sau a defectelor osoase. Prezentarea exemplific alegerea
metodei terapeutice n funcie de cei 3 factori principali: zona de gingie ataat,
prezent/absent defectelor intarosoase, situarea pungilor parodontale
deasupra/dedesubtul limitei mucogingivale, i actualizeaz informaiile existente n
literatur.
Cuvinte cheie: gingie ataat, chirurgie mucogingival

The main objective of mucogingival surgery is directed to improve the


periodontal environment by increasing the attached gingiva and providing root
coverage. Friedman (1957) described mucogingival surgery as plastic surgery that
concerns relations between the mucogingival complex and attached gingiva, alveolar
mucosa, frena, muscle attachment and vestibule. Mucogingival surgery is indicated
where there is little attached gingiva and recurrent inflammation after initial therapy, or
in areas with advanced gingival recessions. It is contra-indicated where gingiva even
narrow is healthy or there is no attached gingiva at all. The important question when
considering mucogingival surgery is whether there is a sufficient band of attached
gingiva or not. The answer to this question decides the type surgical procedure for the
treatment of periodontal pockets or intrabony defects. The presentation describes the
choice of therapy depending on the main factors: the band of attached gingiva, the

13
Rezumate
presence/absence of intrabony defects and the position of the bottom of periodontal
pocket in relation with the mucogingival line.
Keywords: attached gingiva, mucogingival surgery

CONCEPEREA I REALIZAREA PROTEZRII MOBILE N


RAPORT CU ASPECTE PARODONTALE

Prof. Dr. Elena Preoteasa


Catedra de Protetic Mobil, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti

Protezarea mobil parial (acrilic sau scheletat), supraprotezarea sau


chiar protezarea total uni sau bimaxilar ce urmeaz dup pierderea dinilor prin
afectare parodontal, trebuie s ia n considerare aspecte ce rezult din inter-relaia
proteze, ocluzie, parodoniu i respectiv comportamentul structurilor muco-osoase de
sprijin.
De aceea n protezarea mobil trebuie luate n calcul o serie de aspecte
legate de alegerea alternativei de protezare mobil, a dinilor de suport, a elementelor
de sprijin, meninere i stabilizare, a raportului elementelor protetice cu parodoniul
marginal, relaiile ocluzale, aspectele legate de evoluia structurilor orale i protezri
ulterioare. Conceperea protezrii mobile trebuie s coreleze echilibrul protezelor,
presiunile dezvoltate, capacitatea de suport a structurilor orale, precum i considerente
estetice.

CORELAIA VALORILOR TNF-ALFA CU FORMELE CLINICE


DE PARODONTIT MARGINAL CRONIC FORMA
PROFUND I DISTROFIC
TUMOR NECROSIS FACTOR- ALPHA (TNF-) VALUES IN
CREVICULAR FLUID AND CLINICAL TYPES OF
PERIODONTAL DISEASE

Biol. Carmen Defta*, Dr. Irina Alexiu**, Dr. Daniela Petruca**, Asist.
Dr. Silviu Alecu*, Conf. Dr. Gabriela Bncescu*, Prof. Dr. Silvia
Dumitriu*
*Catedra de Microbiologie, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti
**Institutul de Virusologie Sf. Nicolau", Bucureti

TNF-alfa este o citokin care stimuleaz infiltrarea celulelor inflamatoare,


prin reglarea moleculelor de adeziune a leucocitelor pe celulele endoteliale servind
astfel ca agent chemotactic pentru monocite i activeaz mecanismul de fagocitoz.
Studiul nostru a urmrit evidenierea corelaiei dintre valorile TNF-alfa i
formele clinice de boal parodontal. S-au recoltat probe de lichid crevicular de la
pacienii cu aceste afeciuni si au fost analizate prin metoda ELISA. Rezultatele
obinute au evideniat valori mai mari n Parodontita marginal distrofic i mai mici n
Parodontita marginal cronic profund. Au fost nregistrate i dou excepii, n sensul
c 2 Parodontite marginale cronice distrofice au avut valori sczute.

14
Al X-lea Congres Naional al UNAS
Concluzia studiului nostru relev faptul, c exist o corelaie a valorii TNF-
alfa cu tipul de Parodontopatie marginal, astfel acest parametru fiind un indiciu
paraclinic important n susinerea diagnosticului clinic.
Cuvinte cheie: parodontit marginal cronic diagnostic, citokine, factorul
de necroz tisular (TNF-)

TNF-alpha is a cytokine that promote the inflammatory cell infiltration by


upregulating leukocyte adhesion molecule on endothelial cells, serve as a chemotactic
agent for monocytes and activate phagocyte killing mechanisms.
The goal of our study was to observe the correlations between the values of
TNF-alpha in crevicular fluid and the clinical forms of periodontal disease. The
samples from the periodontal pockets were analyzed using ELISA in order to establish
the level of TNF-alpha. Our results have shown a good correlation between high levels
of TNF-alpha and dystrophic periodontitis. In conclusion TNF-alpha could play a
significant role in the diagnostic of periodontal disease.
Keywords: periodontal disease diagnosis, cytokines, tumor necrosis factor
(TNF)

DOZAREA NIVELELOR ICAM-1, UN INSTRUMENT N


SUSINEREA DIAGNOSTICULUI DE LABORATOR AL
PARODONTOPATIILOR MARGINALE CRONICE
THE INTERCELLULAR ADHESION MOLECULE-1 (ICAM-1)
VALUES IN CREVICULAR FLUID COULD SUPPORT THE
LABORATORY DIAGNOSIS OF CHRONIC PERIODONTAL
DISEASE

Dr. Irina Alexiu*, Biol. Carmen Defta**, Asist. Dr. Silviu Alecu**, Asist.
Dr. Bogdan Dabu**, Prof. Dr. Silvia Dumitriu**
*Institutul de Virusologie Sf. Nicolau", Bucureti
**Catedra de Microbiologie, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti

Molecula de Adeziune Intercelular-1 (ICAM-1) este o glicoprotein de 95


kDa, existent pe suprafaa celulelor implicate n rspunsul imun, dar care poate exista
i n form solubil.
Creterea cantitii de ICAM-1 solubil determin blocarea parial a
adeziunii leucocitare, cu scderea eficienei rspunsului imun.
n acest studiu au fost probe din pungile parodontale de la 19 pacieni cu
diagnostic clinic de parodontit marginal cronic. Probele au fost analizate
microscopic din punct de vedere al aspectului cantitativ i al compoziiei florei
microbiene i n paralel s-a dozat ICAM-1 solubil din fiecare prob.
Valorile ICAM-1 au fost crescute n 7 din 19 cazuri, corelndu-se foarte
bine cu o flor microbian bogat i cu coninut mare de spirochete, ceea ce se traduce
clinic printr-un grad avansat de evoluie a bolii.
Cuvinte cheie: parodontopatii marginale cronice, diagnostic de laborator,
molecula de adeziune intercelular (ICAM-1), rspuns imun

15
Rezumate
Intercellular Adhesion Molecule-1 (ICAM-1) is a 95 kDa glycoprotein
which is expressed on the surface of the leucocytes, being involved in their adhesion;
the ICAM-1, also exist in a soluble form that can interfere with the adhesion of the
leucocytes, that are partially blocked and so the immune response is decreased.
The specimens sampled from the periodontal pockets of 19 patients with
chronic periodontitis, were evaluated with respect to the quantity and composition of
micro flora and in the same time the soluble ICAM-1 was measured using an
immunoenzymometric technique.
The sICAM-1 values were increased in 7 from 19 samples. The results
showed a very good correlation with microbiological findings in these certain
situations (great numbers of spirochetes that reflect a bad clinical status).
Keywords: chronic periodontitis, laboratory diagnosis in periodontology,
Intercellular Adhesion Molecule-1 (ICAM-1)

EFECTUL ANTIMICROBIAN AL OZONULUI N


TRATAMENTUL CARIILOR RADICULARE PRIMARE
ANTIMICROBIAL EFFECT OF OZONE GAS IN PRIMARY
ROOT CARIES TREATMENT.

Skaug N, Strand GV and Nielsen


Department of Oral Sciences, Faculty of Dentistry, University of Bergen

Ozone therapy of primary root caries significantly reduced the total


cultivable microflora in vivo (Baysan and Lynch 2004) and in vitro, and in vitro also
mutans streptococci (Baysan et al. 2000). Objectives: To assess in vitro the
antimicrobial effect of ozone gas treatment on the microflora of primary root caries
lesions. Methods: 12 freshly extracted teeth from eight gerodontic patients were
handled aseptically and used in the study. Half of each carious lesion, being two mm
deep or less, was removed using a sterile excavator and then transferred to a pre-
weighed sterile vial that was weighed again. Subsequently, the lesions were exposed to
ozone gas for 60 sec using an ozone-generating device (KaVo HealOzone) as
recommended by the manufacturer (KaVo-Dental, Germany). Thereafter, the
remaining part of the carious lesions were excavated and weighed as described above.
Prior to wortexing, 0.5 ml reduced transport fluid and some sterile glass beads were
added to each sample vial. Ten l fluid specimens in triplicate from four dilutions of
each vial were cultivated 1) aerobically and anaerobically on blood agar (total bacteria)
and on 2) MS agar (oral streptococci), 3) MSB agar (mutans streptococci), 4) Rogosa
agar (lactobacilli), and 5) CFAT (Actinomyces). Growth was recorded as colony
forming units (CFU)/mg. Results: Paired comparison of autologous specimens showed
that ozone gas treatment reduced CFU on all media by more than 90% in one carious
lesion, reduced CFU by more than 72% for some of the media in seven others, and
reduced CFU by less than 72% on all media in the remaining four lesions. Conclusion:
None of the 12 ozone gas treated carious lesions fulfilled the claim of the manufacturer
that the bacteria are reduced by 99.9% after KaVo HealOzone treatment for 20 sec.

Ozone therapy of primary root caries significantly reduced the total


cultivable microflora in vivo (Baysan and Lynch 2004) and in vitro, and in vitro also
mutans streptococci (Baysan et al. 2000). Objectives: To assess in vitro the
antimicrobial effect of ozone gas treatment on the microflora of primary root caries

16
Al X-lea Congres Naional al UNAS
lesions. Methods: 12 freshly extracted teeth from eight gerodontic patients were
handled aseptically and used in the study. Half of each carious lesion, being two mm
deep or less, was removed using a sterile excavator and then transferred to a pre-
weighed sterile vial that was weighed again. Subsequently, the lesions were exposed to
ozone gas for 60 sec using an ozone-generating device (KaVo HealOzone) as
recommended by the manufacturer (KaVo-Dental, Germany). Thereafter, the
remaining part of the carious lesions were excavated and weighed as described above.
Prior to wortexing, 0.5 ml reduced transport fluid and some sterile glass beads were
added to each sample vial. Ten l fluid specimens in triplicate from four dilutions of
each vial were cultivated 1) aerobically and anaerobically on blood agar (total bacteria)
and on 2) MS agar (oral streptococci), 3) MSB agar (mutans streptococci), 4) Rogosa
agar (lactobacilli), and 5) CFAT (Actinomyces). Growth was recorded as colony
forming units (CFU)/mg. Results: Paired comparison of autologous specimens showed
that ozone gas treatment reduced CFU on all media by more than 90% in one carious
lesion, reduced CFU by more than 72% for some of the media in seven others, and
reduced CFU by less than 72% on all media in the remaining four lesions. Conclusion:
None of the 12 ozone gas treated carious lesions fulfilled the claim of the manufacturer
that the bacteria are reduced by 99.9% after KaVo HealOzone treatment for 20 sec.

EFFICACY OF HIGH LEVEL MICROWAVE DISINFECTION OF


DENTAL GYPSUM CASTS

Skaug N, Berg E and Nielsen


University of Bergen, Norway

Our purpose was to test whether microwave oven irradiation can disinfect
gypsum casts in compliance with current disinfection requirements. Samples of
irreversible hydrocolloid impressions of a disinfected acrylic resin model or of the
upper and lower jaws of test persons were made. Before pouring, the former
impressions were contaminated with suspensions of recommended strains of
Staphylococcus aureus or Pseudomonas aeruginosa. All impressions were poured and
the resulting casts cut in two halves. One half of each cast was exposed to five minutes
of irradiation in a Samsung microwave oven at 2.450 MHz and 900W for five minutes.
The other halves were left untreated (controls). All casts were incubated aerobically
and then assessed for bacterial growth by counting colony-forming units per ml
(cfu/ml). The results showed that microwave-irradiated casts had cfu/ml counts with a
median log value of 0 while that of untreated casts was 6. The bactericidal effect was
maintained even at maximum capacity of the microwave oven (16 casts with a total
weight of about 550 g). Based on these results it can be concluded that disinfection in a
microwave oven at 2.450 MHz and 900W for five minutes satisfy current disinfection
requirements.
Keywords: microwave desinfection, gypsum casts

17
Rezumate
EFICIENA TRATAMENTULUI ANTIMICROBIAN PRIN
APLICAREA PASTELOR CU ANTIBIOTIC N BOALA
PARODONTAL
EFICIENTY OF ANTIMICROBIAN TREATMENT USING
TOPICAL ANTIBIOTICS IN PERIODONTAL DISEASES

Conf. Dr. Anca Dumitriu, ef .lucr Dr. Cinel Malia, Asist. Dr. Stana
Punic, Asist.Dr. Magdalena Cureu, Prep. Dr. Roxana Constantinescu
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Premiza este aceea c n majoritatea formelor clinice de boal parodontal


factorul determinant este cel microbian
Scopul lucrrii eficiena utilizrii diferitelor antibiotice cu aciune local n
inflamaii gingivale
Material i metod. Pacienii cu boal parodontal diverse forme clinice,
paste ce conin antibiotice cu aciune asupra germenilor gram+ i gram-, aerobi i
anaerobi.
- monitorizerea prin indici specifici de inflamaie a evoluiei terapeutice.
Concluzii. Tratamentul antimicrobian corect efectuat este absolut necesar i
de eficiena sa depinde evoluia i prognosticul bolii parodontale.

The aim is that in the most periodontal diseases the microbial factor is the
causal.
In the treatment of the periodontal diseases is a fact that topical antibiotics
are eficients in gingival inflammation
Material and method. the patients worth periodontal diseases, and clinical
index; using topical antibiotics active on gram+ and gram-, aerob and anaerob.
Conclusions. antimicrobial treatment is absolutely necessary and influences
the evolution and the prognosis of periodontal diseases.

ELEMENTE CLINICO-ETIOPATOGENICE ALE ANCHILOZEI


DENTARE
CLINICAL AND ETHIOPATOGENIC ASPECTS OF DENTAL
ANKYLOSIS

Prof. Dr. Ecaterina Ionescu*, ef lucr. Dr. Ioana Duduca-Milicescu*,


Asist. Dr. Angelica Bencze**, Prof. Dr. Viorica Milicescu*;
*Catedra de Ortodonie i Ortopedie Dento-Facial, Facultatea de Medicin
Dentar, UMF Carol Davila, Bucureti
**Catedra de Reabilitare Oral, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti

Scopul lucrrii. Anchiloza dentar este o afeciune n care concepiile


etiopatogenice foarte variate a reputai cercettori nu au reuit pn azi s ntruneasc
acceptul relativ unanim al specialitilor. Lucrarea de fa i propune trecerea n revist
a teoriilor etiopatogenice cu cea mai larg rspndire n prezent i sublinierea
aspectelor clinice caracteristice fiecrei forme de anchiloz.

18
Al X-lea Congres Naional al UNAS
Material i metod. Anchilozele dentare sunt prezentate ca fiind traumatice,
rezultate n urma unei injurii directe sau indirecte asupra dintelui, iatrogenice, i
atraumatice. Indiferent de teorie, implicarea structurilor parodontale este cert, ntr-o
succesiune ireversibil, pe care clinicianul frecvent nu o poate stopa.
Rezultate. Lucrarea prezint cazuri clinice reprezentative, cu discuia
metodelor terapeutice indicate fiecruia dintre ele.
Concluzii. Autorii demonstreaz c, de cele mai multe ori, stoparea unui
proces evolutiv de anchiloz dentar implic instituirea unei terapii forte, aproape la
fel de categorice ca i mecanismul etiopatogenic nc incomplet elucidat.
Cuvinte cheie: anchiloz, parodoniu, fiziopatologie parodontal, ortodonia
anchilozei.

Aim. The ethio-pathogenic hypotheses on dental ankylosis havent yet


succeeded to gather the consent of the scientific community. The authors review the
different ethio-pathogenetic hypotheses of tooth ankylosis and the clinical
characteristics of the different types of ankylosis.
Material and method. The authors classified the ankylosis in three big
groups: traumatic ankylosis due to direct and indirect injuries to the tooth, iatrogenic
ankylosis, and atraumatic ankylosis. Regardless the theory, the periodontium is always
involved and the clinician can only seldom stop its evolution.
Results: The scientific paper presents a few clinical cases, which are
representative, with different therapeutic approaches.
Conclusions: The authors demonstrate that the clinician can stop the process
of ankylosis only if he can establish an appropriate therapeutic procedure.
Keywords: ankylosis, periodontium, periodontal physiopathology, the
orthodontics of ankylosis

EVALUAREA STRII DE SNTATE DENTO-PARODONTAL


LA UN LOT DE SPORTIVI CU DIZABILITI PSIHICE
ORAL HEALTH ASSESSMENT IN A GROUP OF MENTALLY
DISABLED ATHLETES

ef lucr. Dr. Arina Vinereanu, Prof. Dr. Rodica Luca, Asist. Dr. Ioana
Stanciu, Asist. Dr. Aneta Ivan, Prep. Dr. Aurora Olaru, Drd. Iulia
Dumitracu, Asist. Dr. Ctlina Farcaiu
Catedra de Pedodonie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Scopul lucrrii a fost acela de a evalua statusul dento-parodontal al unui


grup de sportivi Special Olympics. Material i metod. Grupul de studiu a constat din
194 subieci (152 biei) cu vrste ntre 12 si 18 ani (15,43 1,51 ani) selectai pe
criteriul vrstei dintr-un grup mai larg, aleator constituit din sportivi participani la
dou competiii sportive pentru persoane cu dizabiliti intelectuale (septembrie 2005,
iunie 2006). Examinarea s-a fcut conform recomandrilor OMS (1987). S-a
consemnat prezena leziunilor carioase i a tratamentelor stomatologice prealabile,
starea parodoniului marginal, prezena tartrului i a plcii bacteriene. Datele au fost
prelucrate folosind un program de statistic. Rezultate. 89,2% din subieci prezentau
leziuni carioase. Indicele de restaurare (RI = [F/(F+D)]x100) a fost 13,83 26,23.
57,2% din subieci prezentau depozite de plac bacterian, 42,8% prezentau depozite

19
Rezumate
de tartru i 33,5% prezentau semne de inflamaie gingival evidente la simpla
inspecie. Concluzii. 1. Un procentaj mare din subieci prezentau carii, n majoritate
netratate. 2. Afectarea parodontal este deja prezent n ciuda vrstei relativ mici a
lotului. 3. Creterea adresabilitii la medicul dentist a persoanelor cu dizabiliti ar
putea contribui la mbuntirea strii de sntate oral a acestora.
Cuvinte cheie: status dento-parodontal, dizabiliti psihice

Aim. To evaluate the dental and periodontal status of a group of Special


Olympics athletes. Material and methods. The study group consisted of 194 subjects
(152 boys) aged 12 to 18 years (15.43 1.51 years) selected by age from a larger
group of athletes, randomly selected from the participants in two sports competitions
for mentally disabled persons (September 2005, June 2006). The subjects were
examined according to the WHO recommendations (1987). Presence of caries,
previous dental treatments, calculus, dental plaque and gingival condition were
recorded. Data was processed using a dedicated statistical package. Results. 89.2% of
the subjects had caries. The mean restoration index (RI = [F/(F+D)]x100) was 13.83
26.23. 57.2% of the subjects had plaque, 42.8% had calculus and 33.5% had visible
signs of gingivitis. Conclusions. 1. A high proportion of the subjects had caries, mostly
untreated. 2. Periodontal condition is already present, in spite of the relatively young
age of the study group. 3. Specialized dental clinics could increase addressability and
help improve the oral status of mentally impaired patients.
Keywords: dental and periodontal status, mentally disabled

FENOMENUL THIELEMANN. CAUZ I EFECT. CAZ CLINIC

ef lucr. Dr. Simona Andreea Sandu


Catedra de Protetic Mobil, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti

Fenomenul Thielemann este o consecin a traumei ocluzale, aprnd la


distan de dinii aflai n suprasolicitare. Fenomenul Thielemann este evideniat prin
vestibularizarea dinilor frontali superiori (n mod frecvent incisivii centrali sau
laterali) cu migrri verticale, rotaii i cu apariia diastemei.
n acest caz dinii aflai n traum ocluzal sunt ultimii molari de pe arcade
bilateral. Cauzele generatoare de traum ocluzal sunt obturaiile masive, intempestive
de la nivelul ultimilor molari. Aceti factori cauzali genereaz contacte premature i
interferene n micarea de propulsie cu repercusiuni la nivelul dinilor frontali.
Un dinte aflat n traum ocluzal are o vibraie anormal care se percepe
prin palparea cu degetul n momentul n care este n ocluzie.
n cazul fenomenului Thielemann, n primul rnd, se nltur cauza traumei
ocluzale de la nivelul molarilor prin ndeprtarea contactelor premature i a
interferenelor n cadrul echilibrrii ocluzale. n al doilea rnd, se intervine la nivelul
dinilor frontali, unde principalul obiectiv restaurator este obinerea dezideratului
estetic.

20
Al X-lea Congres Naional al UNAS
FLORA MICROBIAN SPECIFIC FACTOR DE RISC
PENTRU COMPLEXUL DENTO-PARODONTAL LA COPII I
ADOLESCENI

Anne-Marie Rauten*, Petra Surlin**


*Clinica de Ortodonie, Facultatea de Medicin Dentar, UMF Craiova
**Clinica de Parodontologie, Facultatea de Medicin Dentar, UMF Craiova

Cea mai mare parte a germenilor cu potenial parodontogen recunoscut se


regsete i n dentiia mixt. Pentru c alterrile calitative i cantitative ale florei
microbiene saprofite sunt susceptibile s induc gingivite i parodontite, iar aplicarea
aparatelor ortodontice este urmat de acumulri inerente de plac, ne-am propus sa
evideniem schimbrile survenite la nivelul acesteia dup iniierea unui tratament
ortodontic.
Cuvinte cheie: gingivit, parodontit flor saprofit

FOTO-TERAPIA N TRATAMENTUL BOLII PARODONTALE

Drd. Vieru Dana Rozalia, Prof. Dr. Horia Traian Dumitriu


Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

n tratamentul parodontitei marginale cronice profunde progresive, am


asociat terapia laser de joas frecven {LLLT} cu tratamentul chirurgical de chiuretaj
subgingival i adiie de biovitroceramic.
Dintr-un numr de 50 de pacieni, 37 au fost iradiai cu laser si 13 nu.
Am folosit un laser diod, BTL, cu l = 830, energia de pn la 2 J/cm2, n
modul pulsat Nogier. Laserul a fost folosit ntr-un complex de proceduri terapeutice:
odontale, antiinflamatorii locale, att n cabinet ct i acas, cu tratament protetic i de
reabilitare ocluzal.
Efectele imediate au fost: o evoluie fr sngerare i fr complicaii
postoperatorii cum pot aprea la pacienii care nu au beneficiat de laser (durere,
hematom, alterarea funciilor masticatorie i fizionomic n prima sptmn
postoperatorie).
esutul operat se reface mai rapid. Procentul de recidiv descrete i
depinde mai puin de potenialul biologic i imunitatea fiecrui individ.
Am observat scurtarea timpului de coagulare pn la 80%, a timpului de
cicatrizare pn la 30-45%, a timpului de vindecare pn la 50%. Incidena recidivelor
(suprainfecii purulente parodontale, inflamaii, durere) reprezint 0,1%.
Terapia cu laser de joas frecven produce, de asemenea, alte efecte
benefice: mineralizare mai compact a osului, fr durere, cu meninerea funciilor
aparatului dento-maxilar, i, nu n ultimul rnd, o via social nentrerupt.
Cuvinte cheie: parodontit marginal cronic profund progresiv, laser de
joasa putere (lllt), biovitroceramic

21
Rezumate
IMPLANTUL POSTEXTRACIONAL IMEDIAT SOLUIE DE
TRATAMENT N PARODONTOPATIA MARGINAL CRONIC
PROFUND
POSTEXTRACTION IMPLANT TREATMENT SOLUTION IN
CHRONIC DEEP PERIODONTITIS

ef lucr. Dr. Vasile Nicolae*, ef lucr. Dr. Mariana Sabu*, Asist Dr.
Andreea Smarandache**, Drd. Dana Elena Dumitra*
*Facultatea de Medicin Victor Papilian", Universitatea Lucian Blaga", Sibiu
**Facultatea de Medicin Dentar, UMF Carol Davila", Bucureti

Scopul lucrrii. n contextul n care parodontopatia marginal cronic


profund este din ce n ce mai frecvent n rndul populaiei i la grupe de vrst tot
mai tinere, am considerat absolut necesar soluionarea acestei afeciuni, printr-o
metod de tratament care s constituie o alternativ la metodele terapeutice clasice i
s ofere o serie de avantaje.
Material i metod. n vederea instituirii tratamentului de inserie a
implantului imediat postextracional n cazul parodontopatiei marginale cronice, am
efectuat urmtoarele:
1. Am cules date legate de starea general de sntate a pacientului.
2. Am efectuat un examen clinic endooral complet i complex pentru
stabilirea factorilor locali cauzatori ai parodontopatiei marginale cronice, gradul de
afectare al parodoniului superficial i al parodoniului de susinere.
3. A urmat apoi de examenul paraclinic (ortopantomografie,
computertomografie) prin care s-a reuit aprecierea tuturor parametrilor ofertei osoase
necesari unei terapii de inserie postextracional imediat.
Rezultate i discuii. n cazul nostru, am reuit inseria imediat
postextracional a unui numr de 7 implanturi la nivelul arcadei inferioare i tot attea
la nivelul arcadei superioare, n edine separate. A fost necesar i augmentarea cu
material de gref osoas protejat de membran rezsrbabil. Ca i o particularitate a
unui caz, a fost prezena lui 2.5 inclus, fapt soluionat prin odontectomia acestuia i
augmentarea alveolei. Rezultate obinute n acest caz au fost deosebite.
Concluzii. Prin instituirea tratamentului de inserie imediat
postextracional a implanturilor am reuit ncetinirea semnificativ a resorbiei
osoase, iar n final obinerea unor rezultate funcionale i estetice deosebite prin
lucrrile protetice inserate pe implanturi.
Cuvinte cheie: inserie imediat postextracional a implantelor,
parodontopatie marginal cronic

Paper purpose. In present, chronic deep periodontitis has a higher frequency


at young patients and we consider that the treatment must be an alternative to classic
methods and must offer several advantages.
Materials and method. In order to insert an implant soon after an extraction
in patients with chronic deep periodontitis, we made:
1. We collected information about health status of the patients.
2. We made a complex oral examination to find out the cause of
periodontitis and the degree of alteration of the superficial and sustaining
periodontium.

22
Al X-lea Congres Naional al UNAS
3. Radiologic examination (TC, panoramic radiography) to evaluate the
bone offer essential for implant therapy immediately after extraction.
Results and discussions. We made implant therapy immediately after
extraction at 7 cases at the inferior arcade and 7 at superior arcade, in separated
meeting therapy. It was also necessary the augmentation with bone graft protected by a
resorbable membrane. In particular, one case with 2.5 included, needed odontectomy
and augmentation of the alveoli. The results were very good.
Conclusions. Using implant therapy immediately after extraction we
observed that bone resorbtion slowed down and our results, (functional and esthetic),
after prosthetic treatment, were special.
Keywords: implant therapy immediately after extraction, chronic deep
periodontitis

IMPLICAREA CELULELOR DENDRITICE N IMUNOLOGIA


BOLII PARODONTALE
DENDRITIC CELLS INVOLVEMENT IN THE PERIODONTAL
DISEASE IMMUNOLOGY

Asist. Drd. Lia Maria Coman


Universitatea de Medicin i Farmacie, Trgu Mure

Celulele dendritice (Langerhans) sunt celule care capteaz, nglobeaz i


rein antigenele n starea lor imatur , le transform n peptide i le prezint celulelor T
n starea lor matur CD83+. n acest fel, celulele dendritice joac rolul unei puni de
legtur ntre rspunsurile imune nnscute i cele dobndite. Clulele T din esuturile
gingivale sunt n primul rnd celule de memorie, iar n dezvoltarea bolii parodontale
antigenele plcii bacteriene sunt iniial prezentate celulelor T din limfonodulii
regionali, dup care celule T sensibilizate revin n esuturile gingivale unde se
activeaz n continuare. Este demonstrat prezena unui numr mai ridicat de celule
Langerhans CD1+ n epiteliu n cursul gingivitelor marginale i a parodontitelor
adultului, dect n esuturile sntoase. Imunofluorescena dubl a artat asocierea ntre
P. gingivalis i celule Langerhans CD1+ imature n epiteliu.
Prezenta lucrare este o trecere n revist a literaturii privind rolul acestor
celule n imunologia parodontal. Se subliniaz aspecte privind implicarea
etiopatogenic a acestora, precum i perspectivele terapeutice pe care celulele
dendritice ar putea s le prezinte n boala parodontal

Dendritic (Langerhans) cells are antigen-presenting cells that capture


antigens in their immature state, process them into peptides, and present them to T-
cells in their mature CD83+ state. In this way, dendritic cells serve as a bridge between
innate and adaptative immune responses. T-cells in the gingival tissues are
primed/memory cells, and in the development of periodontal disease, plaque bacterial
antigens are most likely initially presented to T-cells in the regional lymph nodes, after
which sensitized T-cells home back to the gingival tissues where they are further
activated. Higher numbers of CD1+ Langerhans cells have been demonstrated in the
epithelium of marginal gingivitis and adult periodontitis than in healthy tissues.
Double immunofluorescence showed an association between P. gingivalis and
immature CD1a+ Langerhans cells in the epithelium.

23
Rezumate
This presentation is a review of the literature data concerning the role of
these cells in periodontal immunology. Their etiopathogenic involvement, as well as
the therapeutic perspectives of the dendritic cells pulsed with protective antigens of
periodontopathic bacteria as an appropriate form of treatment are pointed out.

IMPLICAII SISTEMICE ALE PATOLOGIEI DENTAIEI


TEMPORARE
THE SYSTEMIC IMPLICATIONS OF PRIMARY DENTITION
PATHOLOGY

Prof. Dr. Adam A. Maxim


Disciplina de Pedodonie, Facultatea de Medicin Dentar, UMF Gr. T. Popa, Iai

Pornind de la conceptul actual tridimensional al sntii orale fizic,


mental i social autorul i propune s argumenteze, pe baza datelor din literatura de
specialitate n coroborare cu experiena personal n domeniu, relevana integrativ
sistemic a dinilor temporari, ca normalitate i patologie, asupra homeostaziei
sistemului stomatognat pe termen scurt, mediu i lung.
Motivaia temei propuse o reprezint tendina actual de minimalizare a
relevanei dentaiei temporare, dei n perioada de vrst 3-5 ani i au originea
majoritatea problemelor adolescentului i adultului tnr privind:
- patologia odonto-parodontal
- durerea, frica, anxietatea i fobia dentar
- demodularea comportamental versus cabinetul stomatologic
- dizarmonii dento-alveolare i anomalii dento-maxilare
- implicaii psiho-estetice i psiho-sociale.
Complexitatea indubitabil oral, somatic, non-somatic i psiho-social a
factorului de risc reprezentat de patologia dentaiei temporare impune cu stringen
reconsiderarea atitudinii privind managementul stomatologic comportamental i
terapeutic al perioadei de vrst 3-5 ani, implicit promovarea i practicarea unei
prevenii i intercepii stomatologice pediatrice agresive (Ripa) la nivel comunitar i
individual.
Cuvinte cheie: patologia dentaiei temporare, prevenie, intercepie,
implicaii sistemice

The motivation of this theme is actual tendency of minimization of primary


dentition importance, although between 3-5 years old there is the origin of the most
adolescents and youths problems regarding:
- odonto-periodontal pathology
- pain, fear, anxiety and dental phobia
- behavioral demodulation versus dental office
- dento-alveolar anomalies and dento-maxilar anomalies
- psycho-esthetic and psychosocial implications.
The oral, somatic, non-somatic and psychosocial complexity of the risk
factor represented by the primary dentition pathology require reconsideration of the
attitude regarding behavioral and therapeutically dental management between 3-5
years old, implicitly promotion and practicing of aggressive pediatric dentistry
prevention and interception (Ripa) at the individual and community level.

24
Al X-lea Congres Naional al UNAS
Keywords: primary dentition pathology, prevention, interception, systemic
implication

IMPORTANA CONTROLULUI DIABETULUI ZAHARAT N


PATOLOGIA PARODONTAL A ADOLESCENTULUI
CONTROL IMPORTANCE OF INSULIN-DEPENDENT
DIABETES IN TEENAGER PERIODONTAL DISEASES

Asist. Dr. Vasilica Toma, Prof. Dr. Adam A. Maxim, Conf. Dr. Adriana
Blan, Conf. Dr. Marinela Psreanu, Prep Dr. Carmen Drgan, Prep. Dr.
Ana Petcu
Disciplina de Pedodonie, Facultatea de Medicin Dentar, UMF Gr. T. Popa, Iai

Cuvinte cheie: boal parodontal, adolescent, IDD, IL-1 beta

The discrepancy between periodontal destruction aggressing in teenagers


and the amount of plaque in some periodontal diseases made some researchers state
that bacteria, even if absolutely necessary for periodontal disease development, are
nevertheless insufficient to develop periodontitits, being thus implied the hosts
predisposal, his/her terrain (Page et alt., 1988).
Insulin-dependent diabetes (IDD) is one of the systemic diseases considered
a risk factor associated to the periodontal disease (Bimstein, 2001).
In this presentation we have analyzed the variation of some periodontal
disease clinical indicators and of an inflammation mediator (IL-1 beta) on a controlled
and low controlled IDD teenager lot in comparison to a control group.
The results of the research, in agreement with some other researches and in
disagreement with some others, reveals in most of the cases a correlation between the
quality of the metabolic control of diabetes and the state of the disease of the marginal
periodontium in these subjects; moreover, the results are more obvious in the case of
the preclinical exploration, respectively of IL-1beta evaluation, showing the fact that
the destructive processes at the tissue level, precede the clinical ones, the
determination of these markers having an important predictive role for the diagnostic
and treatment of these subjects.
Keywords: periodontal disease, teenager, IDD, IL-1beta

IMPORTANA DETERMINRILOR MICROELEMENTELOR N


DIAGNOSTICUL I TRATAMENTUL AFECIUNILOR
PARODONIULUI MARGINAL
THE IMPORTANCE OF MICROELEMENTS DETERMINATIONS
IN DIAGNOSIS AND TREATMENT OF PERIODONTAL
AFFLICTIONS

Asist. Dr. Magdalena Cureu, Asist. Dr. Bahtiar Memet, Prof. Dr. Horia
Traian Dumitriu
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

25
Rezumate
Scop. Microelementele au un rol important n formarea i dezvoltarea
esuturilor gingivale. Variaiile lor pot influena calitatea esuturilor parodontale i
rspunsul la agresiunile microbiene.
Material i metod. Studiile s-au efectuat pe un lot de 61 de pacieni, dintre
care 31 de sex feminin i 30 de sex masculin, cu vrste cuprinse ntre 15 i 73 de ani.
Un numr de 7 subieci au reprezentat lotul martor i 54 de subieci au avut diverse
forme clinice de gingivite i parodontite.
Rezultate. S-au observat variaii ale microelementelor n esuturile gingivale
n funcie de formele clinice.
Concluzii. Cunoaterea modificrilor tisulare ale elementelor minerale n
funcie de forma clinic ne poate duce spre un diagnostic precoce i ne poate orienta
tratamentul spre o formul ct mai precis i complet.

Purpose. Microelements have an important role in formation and


development of gingival tissues. Their variations can influence the quality of
periodontal tissues and their response in germ attack.
Material, methods. Studies have been performed on a 61 number of patients,
31 females and 30 males, ages between 15 and 73 years old. 7 of them represented
control group and 54 presented different forms of gingivitis and periodontitis.
Results. A lot of variations in microelements were observed depending on
their clinical forms.
Conclusions. The knowledge of tissue modifications of mineral elements
depending on their clinical forms can lead us to an earlier diagnosis and a complete
and precise treatment.

IMPORTANA IGIENEI ORALE LA PACIENII CU AFECIUNI


CARDIOVASCULARE I PULMONARE CRONICE
THE IMPORTANCE OF ORAL HYGIENE IN PATIENTS WITH
CARDIOVASCULAR AND CHRONIC PULMONARY DISEASES

ef lucr. Dr. Andreea Didilescu


Catedra de Anatomie i Embriologie, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti

Aproximativ ase bilioane de microbi rezid n cavitatea oral. n timp ce


majoritatea acestor microorganisme sunt comensale, o parte par s fie patogeni
oportuniti care pot cauza boli sistemice. Astfel, s-a raportat c bacteriile orale sunt
implicate n endocardita bacterian, pneumonia de aspiraie, osteomielita la copii,
natere nainte de termen asociat cu greutate sczut, precum i infarct cerebral.
De aceea considerm c o atenie special trebuie acordat igienei orale la
indivizii cu boli cardiovasculare i afeciuni respiratorii cronice, considerai a fi la risc
n a contracta endocardit i infecii respiratorii acute.
Cuvinte cheie: igien oral, afeciuni cardiovasculare, afeciuni pulmonare
cronice

Approximately six billion microbes reside in the oral cavity. While the
majority of these organisms are commensals, a subset of them is likely to be
opportunistic pathogens that can cause systemic disease. It has been reported that oral

26
Al X-lea Congres Naional al UNAS
bacteria are implicated in bacterial endocarditis, aspiration pneumonia, osteomyelitis
in children, preterm low birth weight, and cerebral infarction.
We therefore consider that special attention must be paid to oral hygiene
care in individuals with cardiovascular diseases and chronic lung diseases, who are
considered being at risk of acquiring endocarditis and acute respiratory infections.
Keywords: oral hygiene, cardiovascular diseases, chronic pulmonary
diseases

INDICELE HELKIMO N APRECIEREA SUFERINEI


ARTICULAIEI TEMPORO-MANDIBULARE LA PACIENII CU
ANOMALII DENTO-MAXILARE
THE USE OF HELMIKO INDEX AS CONCERNS OF
TEMPOROMANDIBULAR DISORDERS IN PATIENTS WITH
MALOCCLUSIONS

Asist. Dr. Angelica Bencze*, Prof. Dr. Viorica Milicescu**, Prof. Dr.
Ecaterina Ionescu**, ef lucr. Dr. Ioana Duduca-Milicescu**, ef lucr. Dr.
Ioana Suciu***
*Catedra de Reabilitare Oral, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti
**Catedra de Ortodonie i Ortopedie Dento-Facial, Facultatea de Medicin
Dentar, UMF Carol Davila, Bucureti
***Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti

Scopul lucrrii. Studiu clinic realizat pentru evaluarea relaiilor dintre


diferitele tipuri de anomalii dento-maxilare i prezena semnelor clinice de afectare a
articulaiei temporo-mandibulare, cuantificate prin intermediul indicelui Helkimo.
Acest indice este un criteriu de apreciere relativ matematic al numrului de simptome
i al gravitii lor.
Material i metod. Studiul a fost realizat pe un lot format din 31 de pacieni
(17 fete i 14 biei), cu vrste cuprinse ntre 7-23 ani, din cazuistica Clinicii de
Ortodonie i Ortopedie Dento-Facial. Pentru fiecare dintre ei, n cadrul examenului
clinic complet, pe lng amendarea clasic a suferinei articulare n cadrul anomaliilor
dento-maxilare, s-a fcut o apreciere prin introducerea indicelui Helkimo. Un numr
redus de cazuri a beneficiat de aprecieri pre- i postterapeutice.
Rezultate. Un singur caz a prezentat relaii de ocluzie neutrale, ceilali 30
avnd diferite tipuri de anomalii dento-maxilare: 19,35% (6 pacieni) prezentau
disfuncii articulare moderate (indici Helkimo 5-9); 45,16% (14 pacieni), disfuncii
articulare uoare (indici Helkimo 1-4). Valori mai mari ale indicelui Helkimo s-au
nregistrat la pacienii cu anomalii dento-maxilare mai severe i la vrste mai mari.
Concluzii. Autorii consider c indicele Helkimo este util pentru
uniformizarea statistic a datelor suferinei articulare i deci pentru reducerea gradului
de subiectivism clinic n aprecierea afectrii articulaiei temporo-mandibulare pre- i
postterapeutic. De asemenea, indicele poate fi un limbaj comun interdisciplinar.
Cuvinte cheie: afectarea articulaiei temporo-mandibulare, cuantificarea
suferinei articulare, valoare clinic

27
Rezumate
Aim. The present clinical study evaluates the associations between different
types of dental and maxillary anomalies and the symptoms and signs of
temporomandibular disorders, using the Helkimo index. The Helkimo index is an
almost mathematical criterion for the evaluation of the number and of the gravity of
these symptoms.
Material and methods. The sample comprised 31 subjects (17-F, 14-M) aged
7-23, selected from the patients of the Department of Orthodontics. Each patient was
examined to check for the presence or absence of signs and symptoms of
temporomandibular disorders and malocclusion through interview and clinical
examination. The symptoms were quantified through the Helkimo index. A few
subjects were evaluated before and after the orthodontic treatment.
Results. One subject presented neutral occlusion the other 30 patients had
different types of dental or maxillary anomalies. 19.35% (6 patients) had moderate
disorders (Helkimo index = 5-9), and 45.16% (14 patients) had light disorders
(Helkimo index = 1-4). The subects with more severe malocclusion and increased age
presented greater values of the indices.
Conclusions. The authors consider that the Helkimo index contributes to the
statistical registration of the symptoms and signs of the temporomandibular disorders
and to the decrease of the subjectivity in clinical evaluation of temporomandibular
disorders. The Helkimo index can also represent an interdisciplinary term.
Keywords: temporomandibular disorders, statistical registration, clinical
value

INTERACIUNI NTRE FUSOBACTERIUM NUCLEATUM I


CELULE ORALE DE ORIGINE UMAN

G. Dabija, V. Bakken, M. R. Cmpan, D. E. Costea, N. Skaug


University of Bergen, Norway

Introducere Inflamaia i distrucia esuturilor periodontale n boala


parodontal sunt cauzate de infecia bacterian dar i de un rspuns particular al
celulelor organismului gazd. Celulele mucoasei bucale pot fi colonizate de o larg
varietate de specii, incluznd cele implicate n boala parodontal, cum ar fi
Fusobacterium nucleatum..
Ipoteza de lucru. F. nucleatum are abilitatea de a ptrunde n celulele
esuturilor parodontale i poate influena metabolismul acestora, n sensul produciei
de cytokine sau declanarea apoptozei.
Obiectivul acestui studiu este investigarea interaciunii dintre F. nucleatum
i celulele umane din componena anului gingival.
Materiale si metode. Ptrunderea bacteriilor (F. nucleatum ATCC 10953) n
celule, mecanismul de penetrare a acestora, rspunsul celular la expunere i
supravieuirea bacteriilor intracelular sunt studiate in vitro folosind celule umane
primare izolate din mucoasa bucal normal, n culturi celulare clasice (monolayer)
precum i n modele tridimensionale de mucoas gingival .
Rezultate Diverse condiii au fost testate pentru a investiga supravieuirea
bacteriilor n mediul de cultur pentru celule, ct i transportul lor n celule. Testul
invaziei bacteriene a artat c F. nucleatum a ptruns n celule nc din prima or de
co-incubare i persist intracelular mai mult de 24 de ore. Imagini luate cu ajutorul

28
Al X-lea Congres Naional al UNAS
microscopului confocal i prelucrarea lor n trei dimensiuni confirm prezena
bacteriilor n interiorul celulelor.
Cuvinte cheie: Fusobacterium nucleatum, culturi celulare

KERATOZELE IDIOPATICE ALE MUCOASEI BUCALE


CORELAII CLINICOHISTOPATOLOGICE

Conf. Dr. erban ovaru*, Asist. Dr. Mihaela ovaru**, Prep. Dr.
Prltescu Ioanina Mihaela*
*Catedra de Patologie Oral, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti
**Catedra de Dermatologie, Facultatea de Medidin General, UMF Carol Davila
Bucureti

Keratozele mucoasei bucale sunt leziuni de etiologie divers caracterizate


prin depunerea anormal a keratinei pe mucoas. Ele pot fi fiziologice, genetice,
simptomatice n cadrul unor afeciuni reacionale (tutun, traumatisme, etc.) precum i
keratoze idiopatice.
Clinic, keratozele apar sub form de papule, reele, plci, leziuni verucoase,
keratoz punctat sau leziuni difuze.
Pot fi unice sau multiple, cu dispoziie specific sau nespecific. Se pot
ntlni oriunde n cavitatea bucal. De foarte multe ori cauza lor poate fi decelabil.
Keratozele idiopatice sunt acele tipuri de keratoze n care etiologia nu poate
fi gsit. Ele sunt clasificate de OMS n omogene i neomogene, acestea din urm fiind
submprite n eritroleucoplazie, leucoplazie nodular, leucoplazie verucoas (Upsalla
1994).
Din punct de vedere histologic se caracterizeaz prin hiper orto sau
parakeratoz, acantoz, jonciune epitelio-conjunctiv neregulat, grade diferite de
displazie intraepitelial pn la carcinom invaziv, precum i prezena unui infiltrat
subepitelial limfoplasmocitar cu grade diferite de intensitate.
O rat mai mare de malignizare se produce n special la leucoplaziile situate
n zonele de maxim risc ale cavitaii bucale la tipul neomogen i la leucoplaziile care
prezint displazie.
Considerm important examenul virusologic pentru Human Papiloma Virus
n cadrul protocolului de abordare al leucoplaziilor.
Prezentul referat exemplific prin imagini clinice i histopatologice corelaia
existent ntre sediu i mrime, gradul de displazie i comportamentul leucoplaziilor
idiopatice.
Cuvinte cheie: keratoze idiopatice, corelaii clinico-histo-patologice

LOCUL I VALOAREA UNOR TEHNICI ALE ACUPUNCTURII


N STOMATOLOGIE
ACUPUNCTURE PLACE & MEANING IN DENTISTRY
PROCEDURES

ef lucr. Dr. Cinel Malia, Conf. Dr. Anca Dumitriu, Prof. Dr. Horia-Traian
Dumitriu

29
Rezumate
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Obiectiv.Tehnicile acupuncturii se constituie ca metode adjuvante n tratarea


unor afeciuni parodontale. n realitate, se vorbete de medicini alternative dat fiind c
acestea insumeaz metode specifice i particularizate, unele desprinse din medicinile
tradiionale.
Material i metod. Experiena noastr de peste 25 de ani n domeniul
acupuncturii ne-a determinat s evalum care este locul i valoarea acestui fel de
medicin i s desprindem unele concluzii. Pentru aceasta am selecionat o serie de
cazuri potrivite spre a le aplica tehnici specifice de acupunctur, alturi de mijloacele
devenite clasice ale parodontologiei.
Rezultatele cercetrilor efectuate de noi ne determin s realizm c de fapt
medicina alternativ nu are capacitatea de a se substitui tehnicilor medicinii alopate,
reprezentnd de fapt un auxiliar binevenit n tehnicile parodontale.
Concluzii. Medicina alternativ alturi de procedurile medicinii vestice
mrete ansele de reuit n abordarea terapeutic a diverselor stri de mbolnvire
parodontal.
Cuvinte cheie: medicina alternativ, acupunctur, medicin alopat,
procedurile medicinii vestice

Background. Acupuncture can be considerate as an adjuvant treatment way


in periodontal procedures. This kind of medicine which accounts some classical &
traditional specific methods seems to a have a restrictive & clear limit.
Resources & methods. In such conditions, we decided to evaluate some
acupuncture treatment procedures in periodontics. Thus, with the help of more than 25
years of traditional medicine experience, combined with some suitable cases, we have
finally offered a concluding personal opinion. For this reasons, we choose some
concluded patients, suitable for acupuncture treatments methods.
Results. It seems that alternative medicine procedures in periodontics
represent a very good auxiliary system without the well-known allopathic periodontal
procedures.
Conclusions. In fact, alternative medicine procedures can enhance final
results together with western periodontal medicine.
Keywords: alternative medicine, acupuncture, allopathic periodontal
procedures, western periodontal medicine

MANIFESTRI CLINICE ALE COMPLICAIILOR ODONTO-


PARODONTALE N EDENTAIA PARIAL
CLINICAL MANIFESTATIONS OF DENTAL MIGRATIONS IN
PARTIAL EDENTULOUS

ef lucr. Dr. Monica Scrieciu, Conf. Dr. Veronica Mercu, ef lucr. Dr. R.
Popescu, Asist. Dr. Mihaela Vtu,
Asist. Dr. Dguci Constantin, Prep. Dr. Monica earpe
Disciplina de Protetic Dentar, Facultatea de Medicin Dentar, U.M.F. Craiova

30
Al X-lea Congres Naional al UNAS
Edentaia parial reprezint o afeciune complex, care altereaz toate
elementele componente ale sistemului stomatognat, fiind perturbate chiar relaiile
morfo-funcionale ntre acestea. Formele clinice ale edentaiei pariale sunt foarte
numeroase, de la edentaii unidentare pn la edentaii subtotale. Oricare dintre aceste
forme de edentaii pariale se nsoesc de complicaii mai mult sau mai puin decelabile
clinic. Cu ct forma de edentaie se caracterizeaz prin lipsa mai multor uniti dento-
parodontale, cu att complicaiile care apar sunt mai grave i mai evidente.
Complicaiile odontale ale edentaiei pariale pot avea aspecte clinice dintre
cele mai variate, de la cele mai simple pn la cele extrem de grave, care pun probleme
deosebite din punct de vedere al planului terapeutic. Complexitatea complicaiilor
odontale depinde de numrul, ntinderea, topografia i vechimea breelor edentate.
Obiectivul prezentei lucrri este de a evidenia varietatea aspectelor clinice
ale complicaiilor odontale ale diverselor forme de edentaii pariale, precum i de a
preciza consecinele acestora asupra echilibrului planului de ocluzie i asupra relaiilor
intermaxilare.
Materialul studiat a fost reprezentat de pacieni care s-au prezentat n
Clinica de Protetic Dentar n scopul reabilitrii morfo-funcionale a cavitaii orale.
Pacienii selecionai pentru acest studiu au prezentat diverse forme de edentaie
parial.
Metoda de studiu a constat n examinarea clinic a pacienilor luai n
studiu, precum i n evidenierea complicaiilor odontale ale edentaiilor pariale
ntlnite la acetia. De asemenea, au fost analizate efectele apariiei acestor complicaii
asupra funciei ocluzale, precum i principalele probleme terapeutice aprute.
Rezultatele studiului au pus n eviden o varietate de forme de complicaii
odontale n edentaia parial, unele mai des, altele mai rar ntlnite, care perturb
relaiile ocluzale, complexitatea acestora punnd probleme terapeutice, uneori
deosebite. Din aceste considerente, apreciem c este necesar cunoaterea i analiza
complicaiilor odontale ale edentaiei pariale, n scopul elaborrii unui plan terapeutic
adecvat fiecrei situaii clinice.
Cuvinte cheie: edentaie parial, complicaii odontale, migrri dentare,
relaii intermaxilare, probleme terapeutice

Partial edentulous represents a complex disease which disturbs all the


elements of the stomatognatic system, even the morpho-functional relationships among
them. The clinical forms of partial edentulous are very numerous, beginning with one
dental edentulous up to subtotal edentulous. Each of these forms is accompanied by
more or less visible clinical complications. The more the edentulous form is
characterized by the absence of more dental units, the more serious and evident are the
eventual complications.
The dental complications of partial edentulous can present the most various
clinical aspects starting from the simple ones up to the most serious, which are
uncertain especially from the point of view of therapeutic plan. The complexity of
dental complications depends on the number, length, location and age of the
edentulous spaces.
The goal of this paper is to highlight the variety of clinical aspects of the
complications regarding diverse forms of partial edentulous. The paper also tackles the
consequences of these complications upon occlusal stability and intermaxillary
relationships.
The material under study was represented by patients who came to the
Dental Prosthetics Clinic in order to have their oral cavity morpho-functionally

31
Rezumate
rehabilitated. The patients selected for this study presented different forms of partial
edentulous.
The method consisted in the examination and diagnosis of these patients and
also in the spotlighting of dental complications of the encountered partial edentulous.
The effects of the apparition of these complications upon the occlusal function as well
as the main therapeutic problems that may appear were studied.
The results of the study bring forth a variety of dental complications in
partial edentulous. Some appear more often, others more rarely, but all disturb the
occlusal relationships, their complexity sometimes causing special therapeutic
problems. As a consequence, we consider that it is necessary to know and analyze the
dental complications of partial edentulous in order to elaborate a therapeutic plan
suitable for any clinical situation.
Keywords: partial edentulous, dental complications, dental migrations,
intermaxillary relationships, therapeutic problems

MANIFESTRI PARODONTALE N ANOMALIILE DENTO-


MAXILARE LA COPII
PERIODONTAL SIGNS IN CHILDRENS DENTO-MAXILARY
ANOMALIES

ef lucr. Dr. Manuela Popescu, Asist. Dr. Oana Eftene, Dr. Oana
Apostolescu, Asist. Dr. Olivia Popoviciu
Catedra de Ortodonie i Ortopedie Dento-Facial, Facultatea de Medicin Dentar,
UMF Carol Davila, Bucureti

Exist o varietate de manifestri parodontale patologice la copii, asociate,


cel mai adesea, cu prezena anomaliilor dento-maxilare constituite.
Material i metod. Dintr-un grup mai larg de pacieni copii, cu vrste
cuprinse ntre 6 i 10 ani, care s-au prezentat pentru consult ortodontic de specialitate,
am selecionat 23 de cazuri la care am diagnosticat anomalii dento-alveolare i
scheletale cu manifestri patologice asociate. Evaluarea clinic ortodontic i
parodontal, i prin examene complementare, a permis o clasificare a patologiei
parodontale n lotul respectiv, n funcie de factorii etiologici posibil incriminai i de
forma de manifestare.
Rezultate. Cele mai frecvente sunt gingivitele i retraciile gingivale, cu sau
fr pierdere de substan osoas. Instituirea tratamentului ortodontic i, n funcie de
forma clinic, a terapiei parodontale, nu asigur n toate cazurile restabilirea unui
status parodontal normal, fie datorit incriminrii i a altor factori etiologici, fie
datorit unor leziuni cu caracter ireversibil.
Concluzii. Patologia parodontal diagnosticat la vrsta de cretere
reprezint una din indicaiile majore de supraveghere periodic ortodontic sau de
instituire a tratamentului ortodontic, asociat cu terapie parodontal specific acestei
categorii de vrst.
Cuvinte cheie: copil, patologie parodontal, anomalie dento-maxilar

There is a wide variety of pathological periodontal signs in children, most


frequently associated with the presence of dento-maxilary anomalies.
Material and method. Of a larger group of young patients, aged between 6-
10 years, who requested a specialist orthodontic consultation, we selected 23 cases

32
Al X-lea Congres Naional al UNAS
with diagnosed dento-alveolary and skeletal anomalies and associated pathological
signs. The clinical orthodontic and periodontology evaluation together with
complementary examinations permitted the classification of the periodontal pathology
in the analyzed sample based on the potential etiologic factors and the clinical signs.
Results. The most frequent encountered are gingivitis and gingival
recessions, with or without bone loss. Commencement of orthodontic and, where
necessary, periodontal treatment does not insure reestablishing of a normal periodontal
status in all cases, due either to the presence of other etiologic factors or to the initial
presence of irreversible lesions.
Conclusions. The periodontal pathology diagnosed early represents one of
the major indications for regular orthodontic observation or orthodontic treatment
initiation, associated with age specific periodontal therapy.
Keywords: child, periodontal pathology, dento-maxilary anomaly

MANIFESTRI POSTCHIMIOTERAPICE ORALE I GINGIVO-


PARODONTALE LA BOLNAVII LEUCEMICI
ORAL AND GINGIVALPARODONTAL MANIFESTATION AFTER
CHIMIOTHERAPY TREATMENT AT LEUKEMICAL PATIENTS

Asist. Dr. Stana Punic, Asist. Dr. Brndua Mocanu, Asist. Marina
Giurgiu, Prof. Dr. Horia Traian Dumitriu
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Premiza. La bolnavii leucemici apar manifestri orale i gingivo-


parodontale att primare, datorate bolii leucemice ct i secundare, datorate
tratamentului aplicat.
Scopul a fost descrierea particularitilor de manifestri orale i gingivo-
parodontale aprute n urma tratamenului antileucemic aplicat.
Material i metod. Au fost investigai clinic 25 de pacieni cu diferite forme
de leucemie aflai n faza de aplazie medular postchimioterapic.
Rezultate. La bolnavii leucemici apar manifestri orale i gingivo-
parodontale n urma tratamentului aplicat ce pot fi clasificate n:
- manifestri directe datorate tratamentului chimioterapic mucozite s-au
gingivo-stomatite toxice medicamentoase,
- manifestri indirecte secundare tratamentului chimioterapic datorate
pancitopeniei periferice.
Concuzii. Manifestrile orale i gingivo-parodontale secundare
tratamentului antileucemic reprezint o categorie distinct de leziuni orale, iar
intensitatea mucozitelor orale poate fi redus prin tratamentul antimicrobian,
antiinflamator local aplicat.

Premise. on leukemic patients appear oral and gingivo- periodontal


manifestations first due to leukemic disease and second due to treatment applied.
Purpose. To describe particularities of oral and gingivo-periodontal
manifestations appeared as a result of the antileukemic treatment used.
Method. It has been investigated a sample of 25 patients with different
forms leukemia, all of them being in the aplasia bone morrow phase.

33
Rezumate
Results. On leukemic patients appear oral and gingivo-periodontal
manifestations as a result of the treatment applied can be classified as follows:
- direct manifestations determined by chimiotherapy fenomen as mucositis
gingivo-stomatities;
- indirect manifestations determined by pancitopenie peripheric.
Conclusions. oral and gingivo-periodontal manifestations as secondary
result of antileukemic treatment represents a distinct category of oral lesion, the
intensity of oral mucosities can be reduced by antimicrobial, antiinflammatory local
treatment.

MEDICINA PARODONTAL, CONCEPTUL PROFUND


MEDICAL N STOMATOLOGIE
PERIODONTAL MEDICINE: INMOST MEDICAL CONCEPT IN
DENTISTRY

Prof. Dr. Silvia Mru


Disciplina de Parodontologie, Facultatea de Medicin Dentar, Universitatea de
Medicin i Farmacie Gr. T. Popa, Iai

Noiunea conform creia infecia oral sau parodontal poate influena


starea general nu este nou n stomatologie ns relativ recent este reintrodus
asocierea dinte infecia oral i afeciunea sistemic pe seama studiilor tiinifice
riguroase n contextul conceptual al evidence-based dentistry. Din aceast
perspectiv devine tot mai susinut ideea biunivoc conform creia boala parodontal
poate aciona ca factor de risc independent pentru condiii sistemice, iar afeciunile
sistemice influeneaz rspunsul parodontal fa de agenii etiopatogenici recunoscui
ai acesteia. Noiunea de medicin parodontal se concentreaz astfel pe validarea
acestor inter-relaii i plauzibilitii sale biologice la populaii umane i modele
experimentale. Scopul acestei conferine este de a fundamenta tratamentul actual prin
prisma relaiei biunivoce ntre boala parodontal i starea sistemic, respectiv a
morbiditii sau mortalitii bolii.
Cuvinte cheie: medicin parodontal, evaluarea riscului, boal parodontal,
condiii sistemice

The notion according to the oral or periodontal infection may influence the
general systemic health is not new in dentistry but only relatively recently based on the
rigorous evidence-based scientific researches the association between oral infection
and general condition has been re-established.
From this sight the inter-related idea that periodontal disease may act as an
independent risk factor for the systemic conditions and general diseases influence the
periodontal answer facing to the recognized pathogenic factors of periodontal disease
is increasingly get more sustain.
Therefore, the notion of periodontal medicine focuses on the validation of
these inter-relations and their biologic plausibility in human populations and
experimental models of study.
The aim of this conference is to ground or actualize the nowadays principles
of treatment regarding this inter-relation between periodontal disease and systemic
condition, and respectively of the disease morbidity or mortality.

34
Al X-lea Congres Naional al UNAS
Keywords: periodontal medicine, risk assessment, periodontal disease,
systemic conditions

METODE MODERNE DE EVALUARE A GRADULUI DE


INFLAMAIE I COLONIZARE MICROBIAN N BOALA
PARODONTAL
MODERN METHODS FOR PERIODONTAL INFLAMMATION
AND MICROBIAL LOAD ASSESSMENT IN PERIODONTAL
DISEASE

Asist. Dr. Cristina Gabriela Pucau*, Conf. Dr. Irina Totolici**, Conf. Dr.
Anca Silvia Dumitriu***, Prof. Dr. Horia Traian Dumitriu***
*Disciplina Parodontologie, Facultatea de Medicin Dentar i Farmacie,
Universitatea Ovidius, Constana
**Disciplina Pedodonie, Facultatea de Medicin Dentar i Farmacie,
Universitatea Ovidius, Constana
***Disciplina Parodontologie, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti

Exist la ora actual n parodontologie o serie de metode de investigare care


completeaz examenul clinic oferind astfel o imagine ct mai exact asupra statusului
parodontal.
Scopul acestei lucrri l constituie prezentarea importanei folosirii a dou
dintre aceste metode moderne care au avantajul c se pot efectua n cabinetul de
medicin dentar i anume testul biochimic TOPAS i testul microbian-enzimatic
BANA.
Rezultatele studiului statistic efectuat pe un lot de 61 de pacieni aduli tineri
i adolesceni cu diferite forme clinice de mbolnvire parodontal arat c exist o
bun corelaie ntre rezultatul testului BANA i stadiul actual de evoluie al proceselor
inflamator-destructive parodontale. Corelaii bune au fost gsite ntre gradul de
inflamaie gingival (evaluat cu ajutorul indicelui de sngerare papilar) i rezultatele
obinute la testul TOPAS pe acelai lot de pacieni.
Concluzia studiului ncurajeaz folosirea unor astfel de teste rapide att n
cadrul examinrii ct i pentru evaluarea rezultatelor obinute pe parcursul
tratamentului bolnavului parodontopat.
Cuvinte cheie: boal parodontal, test BANA, test TOPAS.

Many methods of periodontal assessment are available today which are


designed to offer an accurate image of the periodontal status.
The aim of this presentation is to illustrate the importance in using two of
these modern chair-side methods: the biochemical TOPAS test and the microbial-
enzymatic BANA test.
The results of the statistical evaluation performed on a group of 61 young
patients having certain forms of periodontal disease show positive correlation between
BANA test results and the severity of periodontal destruction. Also positive correlation
was set between the degree of gingival inflammation (assessed with papilla bleeding
index) and TOPAS test results in the same group of patients.

35
Rezumate
The conclusion of the presentation encourages the use of such tests
associated with clinical examination as well as for evaluation of the results of the
periodontal treatment.
Keywords: periodontal disease, BANA test, TOPAS test.

MICROSCOPIA DIRECT: UN INSTRUMENT UTIL IN


DIAGNOSTICUL BOLII PARODONTALE
DIRECT MICROSCOPY: A VALUABLE INSTRUMENT FOR
DIAGNOSIS AND PROGNOSIS OF PERIODONTAL DISEASE

Asist. Dr. Silviu Alecu*, Biol. Carmen Defta*, Conf. Dr. Anca
Dumitriu**, Asist. Dr. Marina Giurgiu**, Prof. Dr. Silvia Dumitriu*
*Catedra de Microbiologie, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti
**Catedra de Parodontologie,Facultatea de Medicin Dentar, UMF Carol
Davila", Bucureti

Obiectivul acestui studiu a fost urmrirea compoziiei florei microbiene din


pungile parodontale i corelarea rezultatelor cu diagnosticul clinic.
Introducere. Este cunoscut c boala parodontal debuteaz odat cu
creterea numrului de germeni Gram negativi anaerobi din flora subgingival n
acelai timp cu diminuarea florei Gram pozitive facultativ anaerobe. Cu alte cuvinte
modificarea compoziiei florei subgingivale de la Gram pozitiv la gram negativ are
semnificaie patologic, aspect ce poate fi observat folosind tehnicile de microscopie.
Material i metod. S-au recoltat probe din pungile parodontale de la 30 de
pacieni cu diagnostic de parodontit marginal cronic. Acestea au fost examinate
microscopic i n continuare evaluate din punct de vedere cultural prin nsmnare pe
medii de cultur, incubate n atmosfera anaerob.
Rezultate. n 955 din probe a dominat flora Gram negativ, aspect observat
cu uurin pe frotiuri colorate Gram. De asemenea prezena bacteriilor spiralate s-a
corelat cu pungile parodontale adnci i sngernde, reprezentnd un criteriu
microscopic de evaluare a gravitii bolii.
Concluzie. Excelenta corelare a datelor clinice cu elementele relevate de
examenul microscopic recomand metoda ca fiind un instrument ieftin n diagnosticul
de laborator al parodontopatiilor marginale.
Cuvinte cheie: flor subgingival, bacili anaerobi Gram negativi,
spirochete, microscopie direct, diagnostic parodontopatii

Objective: To appreciate the composition of micro flora from periodontal


pockets, using light microscopy and to compare it with clinical status.
Introduction: It is generally accepted that periodontal disease occurs when
anaerobic Gram-negative flora increase in number with the subsequent decrease of
facultative anaerobe Gram-positive bacteria. In other words, the switch from Gram-
positive to Gram-negative of sub-gingival flora has a pathologic significance and could
be observed using direct microscopy.
Materials and methods: 30 specimens sampled with sterile paper points
from periodontal pockets and 10 samples from clinical healthy persons were included
in this study.

36
Al X-lea Congres Naional al UNAS
Each sample was diluted in 0.5 ml saline solution and, with a calibrated
loop, there were taken 10 L aliquots in order to prepare a smear for microscopic
examination and for inoculation on solid media (Columbia with 5% sheep blood).
The smears were Gram stained and the culture plates were incubated in
anaerobic conditions (72h, 37C) and in air (24h, 37C).
Results: In 95% of samples from patients with periodontal disease, easily
notable, high number of Gram-negative bacteria at direct microscopy, associated with
abundant growth in anaerobic condition and poor growth in air.
In 9 from 10 healthy patients, the Gram-negative flora was almost absent
and Gram-positive bacteria were in high number, correlated with the absence of
bacterial growth in anaerobiosis and some growth in air.
The presence of Treponema spp. at direct microscopy was associated with
deep and bleeding periodontal pockets. After few days of proper therapy, the good
clinical status was well correlated with an increasing number of gram-positive bacteria.
Conclusion: The good correlation between the clinical status and
microscopic finding recommend it as an easy to use diagnostic method in dentistry.
Keywords: periodontal pockets bacteria, anaerobic bacilli, periodontal
disease, microscopy, spirochetes

MODIFICRI HISTOPATOLOGICE ALE PARODONIULUI


MARGINAL SUPERFICIAL LA MENOPAUZ
GINGIVAL MANIFESTATIONS OF THE MENOPAUSE

Asist. Dr. Alexandru Georgescu, Asist. Dr. Memet Bahtiar, Asist. Dr.
Mocanu Brndua, Prof. Dr. Horia Traian Dumitriu
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Premis. Hormonii sexuali pot afecta starea general de sntate a femeii


ncepnd nc de la pubertate, continund n timpul sarcinii i regsindu-se i dup
menopauz. Datorit variaiilor nivelurilor hormonale pot aprea anumite modificri
patologice de ordin local i general. Hormonii sexuali pot afecta sntatea parodontal
prin favorizarea inflamaiilor gingivale i prin scderea rezistenei parodontale la
aciunea plcii bacteriene.
Obiectiv. Precizarea corelaiilor dintre debutul sau perioada de stare a
menopauzei i modificrile parodoniului marginal superficial n funcie de existena
sau nu a tratamentului hormonal de substituie i a asocierii cu osteoporoza.
Material i metod. S-au realizat investigaii clinice i paraclinice la un
numr de paciente cu vrste cuprinse ntre 45 i 66 de ani, cu nregistrarea aspectului
parodoniului superficial (gingiei) macroscopic, microscopic i radiologic. Am folosit
coloraii de tip hematoxilina-eozina pentru evidenierea morfologiei epiteliale specifice
acestei perioade.
Rezultate. n urma analizei cupelor histologice, pacientele aflate la
menopauz i diagnosticate cu osteoporoz prezint clinic modificri atrofice i
involutive la nivelul parodoniului marginal superficial spre deosebire de cele fr
osteoporoz sau fa de cele care urmeaz tratament de substituie hormonal.
Concuzii. Hormonii sexuali intervin n meninerea echilibrului histologic al
parodoniului marginal superficial influennd starea de sntate parodontal i explic
corelaia dintre simptomatologia subiectiv specific menopauzei i aspectul

37
Rezumate
histopatologic de la nivelul epitelial. n timpul menopauzei, ca urmare a nregistrrii de
niveluri sczute de estrogeni i progesteron, apare o stare de disconfort oral prin
inducerea modificrilor parodoniului superficial i iniierea pierderilor de os alveolar
n cadrul osteoporozei.

Background. The sex hormones may affect the health state of the woman
starting from puberty, continuing during pregnancy, until after menopause. Due to
variation of hormonal levels, certain local and general pathological changes may occur.
The sex hormones may influence periodontal health producing, for example,
gingivitis and reduce the resistance to dental plaque.
Objective. Defining the correlations between periodontal changes and the
beginning of menopausal period, in the presence of HRT (hormone replacement
therapy) and osteoporosis or not.
Methods. A number of female patients, aging 45-66, were both clinically
and Para clinically investigated recording microscopic and macroscopic aspects of the
gingival. Hematoxilin-eozin colorations were used to develop epithelial morphology.
Results. Association between menopause and osteoporosis lead to involutive
aspects of the periodontium, in the absence of the HRT.
Conclusions. Fluctuating levels of sex hormones may have direct and
indirect effects on histological balance of the oral epithelium. During menopause, due
to reduced levels of estrogen and progesterone an oral discomfort may occur explained
by the altered architecture of the gingival epithelium.

MONITORIZAREA TRATAMENTULUI ENDODONTIC


CONSERVATOR N PARODONTITELE APICALE CRONICE
THE FOLLOW-UP OF THE CONSERVATIVE ENDODONTIC
TREATMENT IN CHRONIC APICAL PERIODONTITIS

Asist. Dr. Irina-Maria Gheorghiu*, Prep. Dr. Radia Iliescu**, Prep. Dr.
Alexandru Andrei Iliescu***, Prof. Dr. Andrei Iliescu****
*Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti
**Catedra de Perfecionare Stomatologic, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti
***Catedra de Implantolologie Oral, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti
****Catedra de Endodonie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Scopul acestui studiu a fost de a examina rspunsul, precum i evoluia


clinic ale tratamentului endodontic conservator n parodontitele apicale cronice.
Au fost tratai nouzeciicinci dini cu pulp necrotic i parodontit apical
cronic asimptomatic, confirmate radiologic.
Dup prepararea biomecanic a canalelor radiculare i irigaia cu soluie de
2,5% hipoclorit de sodiu, a fost aplicat ca medicaie temporar endodontic o past cu
hidroxid de calciu.
Aspectele clinice au fost meticulos nregistrate la fiecare edin de
tratament, pe tot parcursul acestuia. Datele nregistrate la fiecare vizit au fost:

38
Al X-lea Congres Naional al UNAS
simptomatologia subiectiv i obiectiv, aspectul restaurrii temporare sau definitive,
precum i informaii oferite de examenul radiologic.
Rezultatul global al tratamentului a fost analizat pe baza aspectelor clinice
determinate pe parcursul perioadei de monitorizare, precum i prin analizarea i
compararea imaginilor radiologice realizate n momentul finalizrii tratamentului i
ulterior.
Rezultatele indic faptul c hidroxidul de calciu reprezint un bun antiseptic
de uz endodontic datorit proprietilor antibacteriene i de asemenea reduce incidena
acutizrilor ntre edinele de tratament. Pe termen lung, hidroxidul de calciu este
foarte util ca medicaie endodontic temporar pentru o mare varietate de leziuni
periapicale legate de dini devitali, mai ales n situaiile unde este necesar inducerea
reosificrii osoase periapicale.
Cuvinte cheie: parodontite apicale cronice, tratament medicamentos
endodontic, hidroxid de calciu, rspuns clinic, reosificare periapical

The purpose of this study was to examine the clinical response and
evolution of the conservative endodontic treatment in chronic apical periodontitis.
Ninety five teeth with necrotic pulps and symptomless chronic apical
periodontitis, verified radiographically, were treated.
After the biomechanical preparation of the root canals, and 2,5% NaHOCl
irrigation solution, a calcium hydroxide root canal paste was applied as dressing.
The clinical aspects were meticulously recorded on each visit, during the
whole treatment period. Data recorded at every visit were: symptoms, clinical signs,
the aspect of the temporary or final restoration and the radiographic information.
Treatment outcome was judge on the basis of clinical findings recorded at
the follow-up visits and comparison of the radiographs obtained at postobturation and
the follow-up visits.
The results indicate that calcium hydroxide is a good intracanal medication
because of its bactericidal properties and it also reduces the incidence of
interappointment flare-ups. On long term, calcium hydroxide is very useful as a
temporary dressing to treat a variety of endodontic problems related to teeth with non-
vital pulps, especially in cases where the induction of calcification response is
necessary.
Keywords: chronic apical periodontitis, endodontic medication treatment,
calcium hydroxide, clinical response, periapical recovering

NECESITATEA TRATAMENTULUI ORTODONTIC LA ADULT


ABORDARE INTERDISCIPLINAR
INTERDISCIPLINARY APPROACH REGARDING THE NEED
OF ORTHODONTIC TREATMENT OF ADULTS

ef lucr. Dr. Manuela Popescu*, Asist. Dr. Magdalena Cureu**


*Catedra de Ortodonie i Ortopedie Dento-Facial, Facultatea de Medicin
Dentar, UMF Carol Davila, Bucureti
**Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti

Din ce n ce mai frecvent, tratamentul ortodontic, ca indicaie terapeutic de


specialitate, este acceptat i chiar solicitat de pacientul adult, fie din motive de ordin

39
Rezumate
estetic, fie de ordin funcional. Adultul care va deveni pacient de ortodonie prezint o
important disfuncie fizionomic, agravat de boala parodontal.
Material i metod. Am investigat cazurile a ase pacieni care s-au
prezentat pentru tratament ortodontic la recomandarea specialistului parodontolog.
Tratamentul ortodontic instituit a avut ca scop restabilirea ct mai funcional a
rapoartelor de ocluzie i a dinamicii ocluzale, cunoscute fiind migrrile dentare,
consecin a bolii parodontale, pentru a face posibil tratamentul parodontal complex.
Rezultate. Tratamentul ortodontic, ca terapie adjuvant terapiei parodontale,
a avut o durat medie de 8-10 luni, obinndu-se o mbuntire a statusului
parodontal, estetic i funcional, att prin restabilirea funciei ocluzale, ct i prin
refacerea implantrii dentare.
Concluzii. Abordarea terapeutic a bolii parodontale la adult presupune,
adesea, un tratament combinat ortodontic i parodontal, la care trebuie asociate, n
funcie de caz, i alte specialiti: protetic, implantologie. n migrrile dentare ce apar
ca o consecin a bolii parodontale, tratamentul ortodontic are o durat considerat
scurt sau medie pentru aceast terapie, i este mai uor acceptat de pacient.
Restabilirea axelor normale de implantare dentar asigur o mai mare eficien
tratamentului parodontal. Din aceste considerente, bolnavului parodontopat trebuie sa i
se acorde un consult interdisciplinar, pentru a se stabili daca ar putea s beneficieze de
tratament ortodontic adjuvant.
Cuvinte cheie: adult, boal parodontal, tratament ortodontic,
interdisciplinar

More and more frequently the orthodontic treatment, as specialty


therapeutic indication, is accepted, even requested, by the adult patient, for esthetic or
functional reasons. The prospective adult patient presents an important esthetic
disfunction, worsened by the periodontal disease.
Material and method. We investigated six cases of patients who requested
orthodontic treatment following periodontologists indications. Taking into account
dental displacements due to the periodontal disease, the orthodontic treatment aimed at
re-establishing functional occlusion, in both static and dynamic aspects, to allow
completion of the complex periodontal treatment.
Results: The orthodontic treatment, as complementary to the periodontal
therapy, lasted 8-10 months on the average and leaded to an improvement of the
periodontal, esthetic and functional status, through reestablishing the dental occlusion
and regaining dental implantation.
Conclusions: The therapeutic approach of the periodontal disease in adults
includes, frequently, a combined orthodontic and periodontal treatment, associating (on
a case basis) the input of other specialties: prosthetics, implantology. For dental
displacements due to periodontal disease the orthodontic treatment time is of short
duration (considering usual orthodontic treatment durations) and is easier accepted by
the patient. Re-establishing normal dental implantation axes insures a higher efficiency
of the periodontal treatment. For these reasons, the patient with periodontal disease
would require an interdisciplinary consultation, to determine whether he might benefit
from additional orthodontic treatment.
Keywords: adult, periodontal disease, orthodontic treatment,
interdisciplinary

40
Al X-lea Congres Naional al UNAS
OBSERVAII PRIVIND IATROGENIA PARODONTAL
CONSECUTIV RESTAURRILOR CORONARE OCLUZO-
PROXIMALE LA DINII LATERALI

Prep. Dr. Teodor Videanu, ef Lucr. Dr. Dana Cristina Bodnar, Conf. Dr.
Constantin Vrlan, ef Lucr. Dr. Virginia Vrlan, Asist. Dr. Andrei
Stamate, Prep. Dr. Mdlina Boaghe
Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti

n tratamentul restaurator al leziunilor coronare ocluzo-proximale un factor


esenial este reprezentat de protecia parodoniului marginal att prin refacerea corect
a punctului de contact interdentar, ct i prin respectarea conturului peretelui gingival
al preparaiei. Consecinele ignorrii acestor factori pot fi grave, n sensul apariiei unei
parodontopatii cronice marginale cu grad de profunzime variabil, funcie de timpul
meninerii restaurrii, ce poate duce chiar la pierderea dintelui n cauz.
Studiul nostru cuprinde dou pri: un prim segment ce se refer la aspectele
de patologie odonto-parodontal incriminate, iar a doua parte descrie posibilitile de
tratament, precum i urmrirea n timp a vindecrii parodontale. n cadrul grupului de
pacieni studiai s-a urmrit clinic i radiologic corectitudinea refacerilor coronare
ocluzo-proximale directe/indirecte la dinii laterali, precum i gradul afectrii
parodontale n cazul celor incorecte. Dup refacerea restaurrilor incorecte, s-a realizat
controlul clinic i radiologic al noilor restaurri, s-a realizat, dup caz, tratament
parodontal, iar ulterior s-a urmrit pe o perioad de 3, 6 apoi 12 luni refacerea
parodoniului marginal afectat.
Concluziile studiului ne indic importana corectitudinii oricrui tip de
restaurare ce implic i zona gingival, n sntatea parodontal, iatrogeniile din
aceast categorie, fiind din pcate mult prea des ntlnite.

OBSERVAII PRIVIND UTILIZAREA LASERULUI N


TRATAMENTUL HIPERSENSIBILITII DENTINARE
USING LASER RADIATIONS IN DENTINA HYPERSENSITIVITY
TREATMENT

Asist. Dr. Andrei Stamate, ef lucr. Dr. Virginia Vrlan, ef lucr. Dr. Dana
Cristina Bodnar, Conf. Dr. Constantin Marian Vrlan, Prof. Dr. Mariana
Brndua Popa
Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti

Prin evoluia tehnologic din industria materialelor i aparaturii de uz


stomatologic s-a lrgit n mod considerabil spectrul oportunitilor de abordare
terapeutic a vitalitii pulpare, chiar i n cazuri deosebite de evoluie a proceselor
patologice ce afecteaz structurile dentare.
Descoperirea laserului reprezint un eveniment important n istoria
inovaiilor tiinifice, primele sisteme laser operaionale fiind realizate nc din anii
`60. Anii urmtori au adus ptrunderea lui i n medicin, laserul ctignd teren rapid,

41
Rezumate
simplificnd i optimiznd multe manevre chirurgicale i de diagnostic. Stomatologia
este i ea o ramur n care laserul a ptruns i a evoluat; printre multiplele utilizri ale
laserului n stomatologie, se afl i tratamentul hipersensibilitii dentinare, afeciune
care beneficiaz n prezent de diferite metode de tratament (majoritatea bazate pe
sigilarea canaliculelor dentinare), tratamente care de multe ori se dovedesc a nu avea
randamentul dorit.
Prin aceast prezentare ne propunem s aducem n discuie valoarea,
eficiena i limitele tratamentului cu laser n astfel de situaii, precum i detalii tehnice
de calibrare i utilizare a dispozitivelor laser.
Concluziile studiului indic o apreciere judicioas a deciziei de tratament a
hipersensibilitii dentinare, cu luarea n considerare a limitelor de indicaie a acesteia,
n raport cu afeciunile locale i generale existente, i corelarea tehnicii de realizare
pentru fiecare caz n parte.
Cuvinte cheie: hipersensibilitate dentinar, laser

The technological evolution of the dental treatment armamentarium has


considerably enlarged the area of opportunities for the vital dental pulp therapeutic
approach, even in special situations of evolution of the pathological processes affecting
dental structures.
The discovery of laser represents an important moment in the history of
scientific innovations and the first operational laser systems have been used since
1960. Next years brought lasers into medical activities, with a fast development,
simplifying and improving several surgical and diagnosis techniques. Dental medicine
benefits also from the use and evolution of lasers; among the various possibilities there
is also the treatment of dentinal hypersensitivity. The affected teeth can be treated
using different techniques (most of them based on sealing of the exposed dentinal
tubules) and very often these treatments prove to be rather ineffective.
This presentation intends to discuss the value, the efficiency and the
limitations of laser treatment in such situations, together with some technical details
about calibration and working with laser devices.
The conclusions suggest the adequate assessment for the decision of dental
hypersensitivity treatment considering its limitations due to the existing local and
systemic diseases and also the need for a correlated therapeutic technique that should
be used in these clinical situations.
Keywords: dentinal hypersensitivity, laser

PARODONTIT HIPERPLAZIC LOCALIZAT ASPECTE


CLINICE, HISTOPATOLOGICE I TERAPEUTICE.
PREZENTARE DE CAZ
LOCALIZED HYPERPLASIC PERIODONTITIS CLINICAL,
HISTOPATHOLOGICAL AND THERAPEUTIC ASPECTS CASE
REPORT

Asist. Dr. Bahtiar Memet, Asist. Dr. Alexandru Georgescu, Asist. Dr.
Magdalena Cureu, Conf. Dr. Anca Silvia Dumitriu
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

42
Al X-lea Congres Naional al UNAS
Premiza. Parodontitele hiperplazice localizate reprezint forme destul de
rare de mbolnvire parodontal care necesit un diagnostic pozitiv i diferenial corect
urmat de un tratament complex i complet n vederea obinerii vindecrii clinice i
prevenirea recidivelor.
Obiective. Diagnosticarea corect pe baza examenului clinic i paraclinic
radiologic i histopatologic i rezolvarea acestui caz prin tratament complex
parodontal.
Material i metod. Lucrarea de fa prezint cazul unui tnr de 28 de ani
care s-a prezentat n clinica noastr cu o formaiune tumoral localizat pe faa
vestibular a lui 13, cu secreie purulent n anul gingival i mobilitate patologic de
gradul I. Examenul clinic i radiologic pune n eviden prezena de pungi parodontale
adevrate pe suprafeele proximale ale caninului, de aproximativ 9 mm i a unei pungi
adevrate pe suprafaa vestibular de 7 mm. Gingia palatinal i papilele interdentare
sunt de aspect normal.
Rezultate. n urma tratamentului cu antibiotice se obine o reducere
semnificativ a volumului hiperplaziei i dispariia secreiei purulente. Primul timp
chirurgical a ndeprtat gingia hiperplazic denudnd ns suprafaa radicular; al
doilea timp chirurgical a reuit acoperirea parial a defectului radicular.
Concluzii. Un diagnostic corect i un tratament complex parodontal adecvat
fiecrui caz n parte pot asigura succesul interveniei.

Background. Localized hyperplasic periodontitis is a rare type of disease


which needs accurate positive and differential diagnosis, followed by complex
periodontal treatment in order to obtain clinical healing and absence of recurrence.
Objectives. Correct diagnosing on basis of clinical, radiological and
histopathological examination and complex periodontal treatment.
Material and methods. The paper presents the case of a young male patient
of 28 years old who came to our clinic at his dentist advice presenting an overgrowth
on the facial aspect of the upper right canine, purulent secretion in the gingival crevice
and degree I mobility. Clinical and radiological examination revealed the presence of
approx. 9 mm true periodontal pockets on both proximal aspects of the tooth and a 7
mm true periodontal pocket on the facial aspect. Both palatal gingiva and the papillae
were normal.
Results. Following antibiotic treatment there is a significant reduction of
gingival enlargement and no secretion in the crevice. The first surgical step has
removed the hyperplasic gingiva leaving the root exposed; the second surgical step
achieved partial root covering.
Conclusions. Correct diagnosing and case adequate complex periodontal
treatment may ensure success.

PIEZOSURGERY CONCEPT NOVATOR N TRATAMENTUL


BOLII PARODONTALE
PIEZOSURGERY - NEW CONCEPT IN PERIODONTAL
DISEASE TREATMENT

ef lucr. Dr. Daniel Iorgulescu, Dr. Cristian Stirbu


Spitalul Clinic de Urgen Militar Central, Bucureti

43
Rezumate
Scop. Prezentarea experienei noastre n utilizarea unei metode moderne de
tratament n afeciunile cronice ale parodoniului marginal.
Material i metod. Autorii prezint o serie de cazuri clinice cu afeciuni
cronice ale parodoniului marginal tratate cu Piezosurgery. Sunt nfiate avantajele i
indicaiile acestei metode comparativ cu tehnica clasic.
Rezultate i concluzii. Se evideniaz rolul pozitiv al acestei metode
moderne n ncercarea de a gsi tehnici ct mai puin traumatizante n tratamentul bolii
parodontale.
Cuvinte cheie: piezosurgery, biologic, atraumatic, ultrasunete, boal
parodontal

Aim. The introduction of a new trend in the treatment for periodontal


disease.
Material and method. The authors present a series of clinical cases in which
Piezosurgery was used as an election therapy for the periodontal disease.
Results and conclusions. The importance of this new technique is stressed
upon in the attempt to find less traumatizing treatments for the periodontal disease.
Keywords: piezosurgery, biologic, atraumatic, ultrasounds, periodontal
disease

PLANIFICAREA TRATAMENTULUI CHIRURGICAL N


OCLUZIA DESCHIS GRAV
SURGICAL TREATMENT PLANNING IN SEVERE OPEN
OCCLUSION

Conf. Dr. Viorel Ibric Cioranu, Dr. tirbu Cristian, Stud. Sorin Ibric
Cioranu
Facultatea de Medicin Dentar, Universitatea Titu Maiorescu, Bucureti

Introducere. Ocluzia deschis grav n care tratamentul orotodontic nu d


rezultate beneficiaz de tratament chirurgical.
Material i metod. Planificarea i etapizarea acestui tratament nu este o
sarcin uoar. Pentru ca rezultatele s fie bune i durabile alturi de chirurg trebuie s
participe o ntreag echip format din ortodont, protetician, imagist, etc. care vor
individualiza tratamentul n funcie de o serie de criterii precum: localizarea i
ntinderea afeciunii, etiologie, asocierea cu alte anomalii dento-maxilare.
Este prezentat experiena noastr n ultimii 5 ani n tratamentul ocluziei
deschise grave. Soluiile chirurgicale au fost alese numai dup un examen clinic
minuios completat cu examen fotografic, determinarea punctelor antropometrice pe
teleradiografii, stabilirea traseelor de osteotomie cu ajutorul unui ocluzoanalizor.
Rezultate i concluzii: Obinerea unor corecii adecvate, stabile n timp nu se
poate realiza dect printr-o planificare riguroas a interveniei chirurgicale, lucrnd
ntr-o echip pluridisciplinar, etapele de tratament stabilindu-se judicios n urma unor
investigaii complete.
Acestea vor impune totodat i soluiile chirurgicale alese.
Cuvinte cheie: ocluzie deschis, tratament chirurgical

When the orthodontic treatment has no result in severe open occlusion, the
only solution is the surgical treatment.

44
Al X-lea Congres Naional al UNAS
Materials and methods. Planning the surgical treatment its not an easy task.
In order to achieve a long-lasting result the surgeon must be helped by orthodontics,
prosthetics specialists and an imagist. Depending of some criteria like the extension
and seat of the pathological form, the processes that caused it or the association with
other facial syndromes the members of the team will individualize the treatment.
We present our 5 year experience regarding the treatment of severe open
occlusion.
With the help of a thorough clinical exam, a precise X-ray analysis, a
determination of the anthropometrical points, a specification of the osteotomy lines
using an occlusion analyzer we could select the adequate surgical treatment.
Results: Only an exact planning of the surgical steps and working in a
complex team can assure a long lasting effective concerning the occlusion correction.
Keywords: open occlusion, surgical treatment

PREVENIREA I MANAGEMENTUL NON-INVAZIV AL CARIEI


RADICULARE
PREVENTION AND NON-INVASIVE MANAGEMENT OF ROOT
CAVITIES

Drd. Mihaela Pepel


Cabinet Aegidius, Bucureti

Numrul pacienilor vrstnici care se adreseaz practicianului generalist a


crescut ca rezultat al creterii speranei de via, iar retenia dinilor pe o perioad
crescut de timp va conduce la creterea numrului de suprafee radiculare cu risc de a
dezvolta carii radiculare. Pentru o populaie mbtrnit i numrul de dini restaurai
va crete, astfel nct dentitii vor fi pui n situaia de a preveni si cariile secundare
radiculare. Prevenirea primar se adreseaz grupelor de populaie cu risc crescut pentru
caria radicular, i se realizeaz cu ageni chemoterapeutici de tipul clorhexidinei i
fluorurilor. Prevenirea secundar, numit i managementul non-invaziv al cariei
radiculare ctig tot mai mult teren n faa atitudinii restauratoare. Studiile in vitro i
in vivo au demonstrat naltul potenial de oprire n evoluie al cariilor radiculare
primare necavitare utiliznd variate regimuri: fluorizri locale profesionale sau
autofluorizri, laser cu argon, aplicaii cu ozon asociat cu autoaplicri de soluii
remineralizante.
Cuvinte cheie: prevenire primar i secundar, carie radicular primar,
remineralizare, tratament non-invaziv

As a result of the increase of life expectancy the number of elderly patients


visiting the general practitioner office has increased, and increased teeth retention will
lead to an increased number of root surfaces at risk for root caries. For an elderly
population, the number of restored teeth will grow, and the dentists must be able to
prevent also secondary root caries. Primary prevention is targeted to population groups
at risk for root caries, and is accomplished mainly with chemo-therapeutic agents like
chlorhexidine and fluoride. Secondary prevention or non-invasive management of root
caries is the attitude of choice against restorative management. In vitro and in vivo
studies demonstrated that primary non-cavity root lesions have a high arresting
potential by applying various regimens: professional or self fluoridation, argon laser,
ozone therapy and remineralizing products.

45
Rezumate
Keywords: primary and secondary prevention, primary root carious lesions,
remineralization, non-invasive treatment

PROFILAXIA SUPORTULUI DENTO-PARODONTAL PRIN


ANALIZA STRESULUI INDUS DE PIVOTURILE RADICULARE
METALICE I NEMETALICE
THE PROPHILAXY OF DENTAL SUPPORTING TISSUES BY A
F.E.M. ANALYSIS OF THE STRESSES INDUCED BY METALLIC
AND NON-METALLIC POST AND CORE SYSTEMS

ef lucr. Dr. Anca Vialariu*, Conf. Ing. Dr. Radu Comneci**, Conf. Ing.
Dr. Ctlin Dumitra**, Prof. Dr. Monica Tatarciuc*
*Facultatea de Medicin Dentar, UMF. Gr. T. POPA, Iai
**Universitatea Tehnic Gh. Asachi, Iai

Scopul acestei analize prin metoda elementului finit (MEF) este de a


determina comparativ influena materialului din care este realizat pivotul radicular
asupra tensiunilor induse n suportul dento-parodontal.
Material i metod. Au fost utilizate programul Algor i dou modele
tridimensionale reprezentnd un incisiv central maxilar intact i unul reconstituit cu
diferite tipuri de pivoturi radiculare: din titan, din ceramic i din compozit armat cu
fibre de carbon i de sticl. Fora simulat a avut valoarea de 30daN i a fost aplicat
pe faa palatinal a coroanei. Au fost analizate i comparate intensitatea, localizarea i
concentrarea tensiunilor von Mises nregistrate pentru fiecare model n parte.
Rezultate. Distribuia i valorile tensiunilor von Mises n cazul dinilor reconstituii cu
pivoturi armate cu fibre de carbon i de sticl au fost cele mai apropiate de cele
nregistrate n cazul dintelui integru. Pivoturile metalice (titan) au determinat cea mai
mare concentrare a tensiunilor la interfaa pivot/perei radiculari, iar cele din ceramic
au avut un comportament asemntor celor metalice. Concluzii. Pivoturile din titan
produc cea mai mare concentraie a tensiunilor la nivelul interfeei pivot/rdcin,
acest comportament explicnd frecvena ridicat a fracturilor radiculare verticale
nregistrate in vivo. Pivoturile armate cu fibre determin cea mai mic concentrare a
tensiunilor n interiorul rdcinii, datorit faptului ca modulul lor de elasticitate este
foarte apropiat de cel al dentinei i au un comportament similar la compresiune. Aceste
concluzii recomand alegerea pivoturilor armate cu fibre pentru reconstituirea dinilor
tratai endodontic.
Cuvinte cheie: metoda elementului finit, pivot cu fibre de carbon, pivot cu
fibre de sticl, pivot din titan, pivot ceramic

The aim of this finite element analysis was to determine and compare the
influence of different post-and-core systems on stress transmission into the dental
supporting tissues.
Material and method. The study software (Algor) performed stress analysis
of dental structures by finite element analysis. There were created two 3D models
representing 1 intact maxillary incisor and 1 reconstructed maxillary incisor with
different kind of post (titan post, carbon fiber post, glass fiber post, ceramic post). The
simulated compressive load was 30daN and applied under a 45 angle on the palatal

46
Al X-lea Congres Naional al UNAS
surface of the crown. The software computed the stresses for each model, comparing
maximum intensity observed, localization and concentration into the root and the post.
Results. The von Misses stresses recorded in the root reconstructed with
carbon and glass fiber posts are closer to that recorded in a root without a post,
compared with the other posts studied. The metal post (titan) produces the greatest
stress concentration at the post-dentin interface and the ceramic post behavior was
similar with the metallic post.
Conclusion. The metal post produces the greatest stress concentration at the
post-dentin interface, this behavior explaining the high frequency of the vertical root
fractures recorded in vivo. The fiber reinforced posts showed the lowest peak stresses
inside the root and are more favorable for the durability of the tooth, because they have
similar Youngs modulus and, as a result, the similar behavior on the compressive load.
This means that fiber reinforced posts are the best choice for reconstruct an
endodontically treated tooth.
Keywords: finite element analysis, carbon fiber post, glass fiber post, titan
post, ceramic post

RSPUNSUL PARODONTAL N TRANSPOZIIA DENTAR


THE PERIODONTAL REACTION IN DENTAL
TRANSPOSITIONS

ef lucr. Dr. Ioana Duduca-Milicescu*, Prof. Dr. Ecaterina Ionescu*,


Asist. Dr. Angelica Bencze**, Asist. Dr. Ozana Alexandrescu***, Prof.
Dr. Viorica Milicescu*
*Catedra de Ortodonie i Ortopedie Dento-Facial, Facultatea de Medicin
Dentar, UMF Carol Davila, Bucureti
**Catedra de Reabilitare Oral, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti
***Catedra de Ortodonie i Ortopedie Dento-Facial, Universitatea Titu
Maiorescu", Bucureti

Scopul lucrrii. Anomalia intereseaz mai ales caninii superiori, legai de


patologia eruptiv fie de incisivul lateral, fie de premolarul unu, mergnd de la forme
clinice complete la cele incomplete. Lucrarea noastr investigheaz aspectele clinice
ale transpoziiei i starea parodoniului dinilor implicai.
Material i metod. A fost realizat un studiu clinic pe un lot de 28 de
pacieni, cu transpoziie de canin, tratai ortodontic. Fiecare pacient a fost investigat
clinic i paraclinic (radiografii retroalveolare, ortopantomograme, teleradiografii).
Rezultate. Studiul nostru demonstreaz c modificrile parodontale ale
dinilor implicai n fenomenul de transpoziie pot mbrca o plaj foarte larg, de la
acceptarea transferului de poziie fr modificri evidente clinic, pn la generarea
unor suferine ale tuturor structurilor parodontale. Afectarea parodontal poate fi
primar, iniial, dar poate aprea i n cursul evoluiei anomaliei netratate. De
asemenea, am observat degradarea strii de sntate parodontal n cursul terapiei
ortodontice cu diverse aparaturi, evoluie la fel de imprevizibil ca i meninerea unei
snti parodontale aproape surprinztoare n cadrul definitivrii transpoziiei
incomplete ca soluie terapeutic.

47
Rezumate
Concluzii. Indiferent de observaiile autorilor, respectarea timpilor clasici
terapeutici i cunoaterea dinamicii parodontale rmn o obligaie fundamental a
terapeutului ortodont.
Cuvinte cheie: transpoziie, comportament parodontal, fiziopatologie
parodontal, terapia de elecie a transpoziiei

Aim: The most common transposition involves the maxillary canine, which
is transposed with the lateral incisor or the first premolar. The dental transposition can
be complete or incomplete and it may be accompanied with the affectation of
periodontal condition of the transposed teeth.
Material and method: We analyzed a group of 28 patients with transposed
canines. For every patient we carried out a clinical examination and X-rays (peri-apical
radiographs, dental pantomograms).
Results: Our study demonstrates that the modifications of the periodontal
conditions may vary a lot: from a good periodontal health to a clinical brake-down of
all its structures. The periodontal condition of the transposed teeth may be altered from
the beginning or it may degrade in time if the dental anomaly is not treated. We also
found a few cases which degrade during the orthodontic therapy.
Conclusions: The authors support the idea that the orthodontist must always
respect the classical succession of the therapeutic procedures and witness the
complexity of the periodontal structures.
Keywords: transposition, periodontal behavior, periodontal
physiopathology, elective treatment of transposition

SPECII DE PREVOTELLA IZOLATE DIN ABCESE


PARODONTALE I ABCESE ALE LOJILOR FEEI I GTULUI
SPECIES OF PREVOTELLA ISOLATED FROM PERIODONTAL
ABSCESSES AND ABSCESSES OF FASCIA SPACES OF THE
FACE AND NECK

Conf. Dr. Gabriela Bncescu*, Conf. Dr. Adrian Bncescu*, Biol. Princ.
Carmen Defta*, Biol. Princ. Cristina Teodorescu**, ef lucr. Loredana
Popa*, Asist. Dr. Silviu Alecu*, Asist. Dr. Bogdan Dabu*, Prof. Dr. Silvia
Dumitriu*
*Catedra de Microbiologie, Facultatea de Medicin Dentar, UMF Carol Davila",
Bucureti
**C.M.D.T.A. Acad. tefan Milcu, Bucureti

Scopul studiului a fost acela de a izola tulpini de Prevotella din 37 probe de


puroi recoltate prin puncie-aspiraie de la pacieni diagnosticai cu abcese parodontale
sau cu abcese ale lojilor feei i gtului, i de a identifica aceste izolate la nivel de
specie. Din fiecare prob s-au efectuat: examenul microscopic direct (frotiuri Gram) al
produsului patologic i nsmnri pe medii selective i neselective, incubate n
condiii de aerobioz i anaerobioz. Toi bacilii Gram-negativi au fost identificai la
nivel de gen i specie cu ajutorul metodelor convenionale de diagnostic i al
sistemului Rapid ID 32 A (BioMrieux, France). Tulpinile de Prevotella au fost izolate
din 46% probe investigate i au aparinut, n ordinea descresctoare a frecvenei,
urmtoarelor specii: P. melaninogenica, P. oralis, P. denticola i P. loescheii. n

48
Al X-lea Congres Naional al UNAS
concluzie, rata izolrii prevotelelor a fost relativ crescut i au fost identificate specii
diferite, lipsind ns P. intermedia.
Cuvinte cheie: abces parodontal, abcese ale lojilor feei i gtului,
Prevotella

The aim of the present study was to isolate strains of Prevotella from 37
samples of pus collected by needle aspiration in patients with periodontal abscesses
and abscesses of fascia spaces of the face and neck, and to identify those isolates at
species level. Microscopy (Gram-stained direct smears) and cultures on selective and
nonselective media incubated aerobically and anaerobically were performed in each
pus sample. All strains of Gram-negative strictly anaerobic bacilli were identified to
genus and species level by conventional methods of diagnosis and the Rapid ID 32 A
system (BioMrieux, France). The Prevotella isolates were recovered in 46% of the
investigated specimens and belonged to the following species, listed in descending
order of frequency: P. melaninogenica, P. oralis, P. denticola and P. loescheii. In
conclusion, the rate of Prevotella isolation was high and different species were
identified, but P. intermedia was missing.
Keywords: periodontal absscess, abscesses of fascial spaces of the face and
neck, Prevotella

STUDIU CLINICO-STATISTIC PRIVIND ETIOPATOGENIA


LEZIUNILOR CERVICALE NON-CARIOASE

Conf. Dr. Constatin Vrlan, ef Lucr. Dr. Dana Bodnar, Prep. Dr. Teodor
Videanu, ef Lucr. Dr. Virginia Vrlan, Prep. Dr. Cristina Roman, ef
Lucr. Dr. Narcis Marcov
Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti

Leziunile necarioase entitate aparte n patologia odontal, prezint la


momentul actual o inciden crescut. Cele cu localizare la nivelul coletului dentar
reprezint segmentul majoritar din cadrul acestui tip de leziuni.
n realizarea studiului am ncercat aprecierea factorilor posibil
etiopatogenici din dou perspective distincte. Astfel, am studiat dou grupuri: un prim
asemenea grup reprezentat de pacieni ce prezentau un astfel de tip de leziuni, iar cel
de-al doilea grup reprezentat de medicii curani ai acestor pacieni.
S-au folosit chestionare tip de dou feluri, unele destinate completrii de
ctre pacienii n discuie, celelalte, profesionale, fiind adresate medicilor. Dup
sumarea rezultatelor s-a realizat att analiza separat ct i comparativ la nivelul celor
dou grupuri din cadrul studiului.
Deoarece, prin evoluia materialelor i tehnicilor de tratament, perioada de
meninere a unui dinte funcional pe arcad a crescut semnificativ, s-a prelungit, n
mod logic, i expunerea acestuia la factorii etiopatogenici ai leziunilor cervicale
necarioase. Se dovedete extrem de util i studierea patologiei odontale non-carioase,
att n vederea lrgirii posibilitilor de tratament, dar mai ales preveniei acestui tip de
mbolnvire.

49
Rezumate
STUDIU IN VITRO PRIVIND EFICACITATEA EXAMENULUI
RADIOLOGIC DIGITAL INDIRECT N DIAGNOSTICUL CARIEI
SIMPLE PE BAZA ANALIZEI CURBELOR ROC
AN IN VITRO STUDY REGARDING THE POWER OF DIGITAL
MANIPULATION OF THE RADIOLOGICAL IMAGE OVER THE
DIAGNOSTIC PERFORMANCE OF CARIES USING ROC
ANALYSIS

Prep Dr. Elena-Cristina Roman, ef lucr. Dr. Narcis Marcov, ef lucr. Dr.
Dana Bodnar
Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti

Metoda radiologic digital indirect cu scanare de radiografii obinute prin


tehnici clasice i prelucrarea ulterioar a acestora cu editori de imagine crete calitatea
diagnosticului de carie simpl att timp ct alegerea funciilor care mbuntesc
imaginea radiologic corespunde tipului de leziune carioas simpl i condiiilor de
efectuare a studiului.
Scopul acestui studiu in vitro a fost evaluarea posibilitilor de prelucrare
digital a imaginii radiologice n detectarea i evaluarea profunzimii cariilor simple
proximale pe baza performanei diagnostice analizate prin curbe ROC.
S-au realizat radiografii standardizate prin tehnica paralel pentru 100 de
fee aproximale aparinnd la 25 de dini anteriori i 25 de dini posteriori extrai care
au fost, ulterior, scanate. Imaginile rezultate, prelucrate digital cu un editor de imagine,
au fost utilizate n diagnosticarea proceselor carioase proximale. Validarea metodei s-a
realizat prin analiza fragmentelor de interes la microscopul electronic de baleiaj.
Observatorii implicai n acest tip de analiz statistic au prezentat experien de grade
diferite n domeniul radiologic.
Performana diagnostic medie A(z) pentru imaginea radiologic pentru
senzorul radiologic clasic este de 0,672, iar valoarea medie a acesteia pentru imaginile
rezultate n urma prelucrrii digitale este de 0,766 (p>0,05). Rezultatele acestui studiu
demonstreaz o legtur ntre profunzimea leziunii carioase i funcia digital utilizat
pentru a nregistra o performan diagnostic bun. Variaiile interobservator au fost
mari n cazul cariilor n smal, n timp ce cariile n dentin au determinat valori mai
mici.
Performana diagnostic a crescut pentru toi observatorii n cazul
imaginilor radiologice digitale prelucrate cu editori de imagine comparativ cu
radiografiile convenionale. Comenzile alese au variat n funcie de tipul de leziune
carioas analizat precum i de experiena clinic, radiologic i de utilizare a unui
program de manipulare digital a imaginii.
Cuvinte cheie: examen radiologic, carie simpl, curbe ROC
The purpose of this in vitro study was the evaluation of the possibilities of
digital manipulation of the radiological images in the detection and evaluation of the
depth of proximal caries using a Receiver Operating Characteristics analysis.
100 proximal sides belonging to 25 anterior extracted teeth and 25 posterior
extracted teeth were radiographed using the parallel technique. The radiographs were
scanned and the images were digitally processed and enhanced. The gold standard was

50
Al X-lea Congres Naional al UNAS
represented by the images of the fragments viewed at the scanning electronic
microscope. The observers had variable degrees of experience in radiology.
The mean value of the diagnosis performance A(z) was 0.672 for the images
on film and 0.766 for the processed and enhanced images (p>0.05).
Analyzing the results, we established a link between the type of caries and
the type of commands used to improve the quality of the radiological digital image.
The interobserver agreement was higher for the dentin caries than for the enamel
caries. The selected commands varied according to the clinical and radiological
experience and computer skills.
The study demonstrates the power of the digitally processed images over the
improvement of the diagnosis performance for all observers.
Keywords: radiologic examination, ROC curves

TENDINE DEMOGRAFICE ACTUALE LA NIVEL ZONAL


ROMNIA ALE PARODONIULUI MARGINAL LA COPIL I
ADOLESCENT
ACTUAL DEMOGRAPHIC TRENDS AT THE REGIONAL LEVEL
ROMANIA OF THE MARGINAL PERIODONTAL TISSUE IN
CHILD AND ADOLESCENT

Conf. Dr. Adriana Blan, Prof. Dr. Adam A. Maxim, Conf. Dr. Marinela
Psreanu, Prep. Dr. Ana Petcu, Asist. Dr. Vasilica Toma, Prep. Dr.
Carmen Drgan, Dana Cristiana Rotaru
Disciplina de Pedodonie, Facultatea de Medicin Dentar, UMF Gr. T. Popa, Iai

n scopul optimizrii i eficientizrii programului naional de prevenie


stomatologic primar i secundar, autorii i propun n lucrarea de fa abordarea
unor elemente de screening-diagnostic parodontal la nivelul populaiei pediatrice
actuale din Romnia.
Cuvinte cheie: prevenie parodontal, screening-diagnostic

For the optimization and efficiency of the national program of primary and
secondary dental prevention, the authors propose in this paper the approaching of some
elements of periodontal screening-diagnostic at the actual pediatric population level
from Romania.
Keywords: periodontal prevention, screening-diagnostic

TESTUL BANA UN INDICATOR MICROBIOLOGIC PENTRU


EVALUAREA PARODONTITELOR CRONICE NAINTE I DUP
TRATAMENT
BANA TEST A MICROBIOLOGIC INDICATOR FOR THE
EVALUATION OF CHRONIC PERIODONTITIS BEFORE AND
AFTER TREATMENT

Asist. Dr. Brndua Mocanu, Asist. Dr. Marina Giurgiu, Asist. Dr. Stana
Punic

51
Rezumate
Catedra de Parodontologie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Premiza. Porphyromonas gingivalis, Treponema denticola i Bacteroides


forsythus fac parte din speciile anaerobe frecvent asociate cu mbolnvirile parodontale
ale adultului. Concentraia patogenilor parodontali din biofilmul subgingival difer n
funcie de tipul de parodontit marginal cronic i de asemenea este diferit nainte i
dup tratament.
Obiectivul acestei lucrri este de a prezenta un test rapid (BANA), care
poate fi efectuat n cabinetul stomatologic i care n corelaie cu parametrii clinici este
util naintea tratamentului n vederea stabilirii unui diagnostic parodontal corect i
dup tratament pentru aprecierea eficienei tratamentului. Prin acest test se detecteaz
prezena unei enzime, arginin hidrolaza, produs de cele trei microorganisme anaerobe
menionate mai sus, enzim care hidrolizeaz peptidul sintetic benzoil- DL-arginin-
naftilamid (BANA).
Material i metod. Au fost examinai 20 de pacieni, 5 sntoi din punct de
vedere parodontal i 15 cu parodontit marginal cronic, la care s-au efectuat
msurtori parodontale i testul BANA att nainte ct i dup tratament.
Rezultate. 90% din testele BANA efectuate n grupul parodontitelor
marginale cronice profunde nainte de tratament au avut rezultat pozitiv. n cadrul
grupului parodontitelor distrofice doar 30% din testele BANA efectuate au avut
rezultat pozitiv n timp ce 65 % au fost slab pozitive i 5% negative. n cadrul grupului
de pacieni fr afectare parodontal toate testele au ieit negative. De asemenea dup
tratament majoritatea testelor s-au negativat 90%.
Concluzii. Testul BANA reflect nivelele subgingivale ale speciilor
Porphyromonas gingivalis, Treponema denticola i Bacteroides forsythus dar i
parametrii clinici de mbolnvire parodontal.

Premise. Treponema denticola, Porphyromonas gingivalis, Bacteroides


forsytus are among the anaerobic species frequently associated with adult forms of
periodontal disease. The periodontal pathogens level differs with every form of
marginal chronic periodontitis and also before and after treatment.
The aim of this paper is to present a easy and rapid test that can be done in
dental office and in correlation with clinical parameters is useful before treatment in
order to establish the accurate diagnosis of periodontal disease and after treatment for
the evaluation of therapy. This test detects the presence of an enzyme, arginin
hydrolase, excreted by those three species mentioned above, that hydrolyze the
synthetic peptide benzoyl-DL-arginine-naphtylamide (BANA).
Material and method. The study was performed on 20 patients, 5 were
periodontal healthy and 15 with chronic periodontitis, on whom we performed
periodontal measurements and BANA test before and after treatment.
Results. The study revealed that 90 % of the tests made in the group of
profound marginal chronic periodontitis had positive results before treatment. In the
group of dystrophic periodontitis only 30% of the tests were positives while 35% had
weak positive reaction and 5% had a negative reaction. In the group of healthy
periodontal patients all tests had negative reactions. The majority of tests were
negative after treatment - 90%.
Conclusions. BANA test reflects the subgingival levels of Porphyromonas
gingivalis, Treponema denticola i Bacteroides forsythus anh has also the ability to
reflect clinical parameters of periodontal disease.

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Al X-lea Congres Naional al UNAS

TRATAMENTUL CHIRURGICAL AL RETRACIILOR


GINGIVALE NTRE REALITATE CLINIC I BIOLOGIE
MOLECULAR
THE SURGICAL TREATMENT OF GINGIVAL RECESSIONS
BETWEEN CLINICAL REALITY AND MOLECULAR BIOLOGY

Conf. Dr. Alexandra Roman


Catedra de Odontologie-Parodontologie, Facultatea de Medicin Dentar,
UMF Iuliu Haieganu", Cluj-Napoca

Scop. Se dorete a se trece n revist locul diferitelor tipuri de grefe n


tratamentul retraciilor gingivale, precum i a factorilor de predictabilitate a evoluiei
interveniilor chirurgicale: tipul grefei realizate, nlimea osului proximal i a papilei
interdentare, mrimea recesiunii, tipul de dinte i poziia lui n arcad, vechimea
abraziilor cervicale asociate, factorii generali de sntate.
Material i metod. Sunt trecute n revist indicaiile i particularitile
intervenionale ale diferitelor metode de acoperire a retraciilor gingivale, n corelaie
cu aspecte etiologice i clinice ale acestora, pe baza unor cazuri clinice.
Rezultate. Relevarea comparativ a succesului i predictabilitii
acoperirilor radiculare ale diferitelor tipuri de grefe se realizeaz pe baza rezultatelor
literaturii de specialitate. Evenimentele moleculare i celulare asociate regenerrii
parodontale locale, fenomenele de bridging" i creeping attachement" vor fi i ele
menionate.
Concluzii. Tehnicile intervenionale de acoperire radicular sunt influenate
de o multitudine de factori, iar experiena i ndemnarea operatorului joac un rol
major n predictabilitatea acoperirilor.
Cuvinte cheie: retracie gingival, gref gingival, ataament rampant,
regenerare parodontal

Aim. To review the surgical procedures for covering gingival recessions and
the factors influencing the evolution of muco-gingival surgery techniques: the type of
chosen procedure, the height of the interproximal bone and interdental papilla, the
surface area of the denuded root, the tooth type and location in the arch, the presence
of long-standing cervical abrasions, general factors. Material and method. There are
described the indications and the characteristic features of the graft surgical
procedures, in correlation with etiological and clinical aspects of gingival recessions,
based on clinical cases. Results. The success and the predictability of various types of
root coverage methods are reviewed. Molecular and cellular events associated with
local periodontal regeneration, "bridging" and "creeping attachment" are also
mentioned. Conclusions. Root coverage procedures are technique sensitive, depending
on various factors. The skill and experience of the operator play a major role in
obtaining predictable root coverage.
Keywords: gingival recession-gingival graft- creeping attachment-
periodontal regeneration

53
Rezumate
TRATAMENTUL IMPLANTO-PROTETIC AL
PARODONTOPATIEI MARGINALE CRONICE PROFUNDE
(PMCP) DIN INSUFICIENA RENAL CRONIC (IRC)
IMPLANTO-PROSTHETIC TREATMENT OF CHRONIC
PERIODONTITIS IN PATIENTS WITH CHRONIC RENAL
FAILURE

ef lucr. Dr. Mariana Sabu*, ef lucr. Dr. Vasile Nicolae*, Asist. Dr.
Andreea Smarandache**, Drd. Dana Elena Dumitra*
*Facultatea de Medicin Victor Papilian", Universitatea Lucian Blaga", Sibiu
**Facultatea de Medicin Dentar, UMF Carol Davila", Bucureti

Scopul lucrrii. Scopul lucrrii a fost acela de a studia posibilitatea instituirii


unei terapii implanto-protetice, n contextul n care la nivelul cavitii bucale se
manifestau fenomene caracteristice parodontopatiei marginale cronice profunde pe
fondul unei boli sistemice reprezentate de IRC.
Material i metod. n vederea aprecierii posibilitii de instituire a terapiei
implanto-protetice la pacienii cu IRC am efectuat urmtoarele:
1. examen clinic general care ne-a oferit date necesare aprecierii strii de
sntate actual a pacienilor.
2. examen clinic local, endooral, care ne-a furnizat date legate de stadiul de
evoluie al parodontopatiei marginale cornice.
3. examen paraclinic (ortopantomografie, computertomografie), care ne-au
permis aprecierea ofertei i structurii osoase.
In studiul nostru am examinat un numr de 50, diagnosticai cu
parodontopatie marginal cronic pe fond de IRC, crora li s-a instituit un tratament
implanto-protetic.
Rezultate. Parodontopatia marginal cronic profund, este rezultatul unui
proces multifactorial, astfel rezultatele obinute au fost satisfctoare n 90% din cazuri
n contextul n care pacienii au respectat toate indicaiile legate de meninerea unei
bune igiene locale, afeciunea general aflndu-se sub controlul medicului specialist.
Concluzii. Aspectul intraoperator, coroborat cu starea general a pacienilor
ne-a determinat ca n unele cazuri s apelm la tehnici de augmentare osoas, urmat
de inseria ulterioar a implanturilor. Prin tratamentul instituit am obinut ncetinirea
semnificativ a procesului de resorbie osoas.
Cuvinte cheie: tratament implanto-protetic, parodontopatie marginal
cronic profund, insuficien renal cronic

Premise. The work purpose was the evaluation of the opportunity of the
implanto-prosthetic treatment in patients with chronic renal failure and chronic deep
periodontitis.
Material and method. In order to realize our purpose we followed these
steps:
1. Clinical general and biological examination, offered the necessary
information for a correct evaluation of the health status of the patients.
2. Oral examination gives us information about the stage of periodontitis.
3. Radiological examinations (TC, OPT) made possible the evaluation of the
bone offer.

54
Al X-lea Congres Naional al UNAS
We studied a group of 50 patients with chronic renal failure and chronic
deep periodontitis. We applied in this group of patients an implanto-prosthetic
treatment.
Results. The results of treatment were good in 90% of cases. All of the
patients must follow the indications concerning local hygiene and their systemic
diseases were under control.
Conclusions. The surgical aspect together with clinical status of the patients
made us to choose the bone augmentation techniques followed by implant insertion.
We obtained an important decline of the bone resorbtion process
Keywords: implanto-prosthetic treatment, chronic deep periodontitis,
chronic renal failure

UZURA DENTAR CA FACTOR FAVORIZANT AL


TRAUMATISMULUI OCLUZAL I AL BOLII PARODONTALE
LA ANIMALE I OM

Prof. Dr. tefan Lctuu


Disciplina de Cariologie, Facultatea de Medicin Dentar, UMF Gr. T. Popa, Iai

Conferina prezint aspecte ale arcadelor dentare cu grade avansate de


abrazie i boal parodontal. Imaginile au fost selectate n urma unor studii efectuate
pe resturi fosile de animale i om care au trit n diverse etape istorice. Studiul face o
comparaie ntre acestea i aspectele ntlnite la omul actual. Examinarea loturilor de
studiu a fost efectuat prin mijloace clinice i paraclinice. Concluziile au valoare
practic pentru medicii stomatologi n elaborarea strategiilor de tratament preventiv i
curativ.
Cuvinte cheie: uzur dentar, traumatism ocluzal, boal parodontal

VALENE ESTETICE N PROTEZAREA CONJUNCT


AESTHETIC VALENCES INTO THE FIXED PROSTHETIC
REHABILITATION

Prof. Dr. Monica Tatarciuc, ef lucr. Dr. Anca Vialariu, ef lucr. Dr.
Diana Diaconu
Facultatea de Medicin Dentar, UMF Gr. T. Popa, Iai

Obiective. ntr-un sistem stomatognat echilibrat, armonia dintre dinii


naturali i parodoniu atrage atenia ntruct este un ideal de perfeciune, pe care
restaurrile dentare fixe tind s-l ating. Acesta reprezint un scop spre care orice
medic i tehnician trebuie s accead, realiznd o adaptare ct mai exact la forma,
culoarea i aspectul dinilor restani, vecini i antagoniti, precum i prin asigurarea
premizelor principiului igienico-profilactic, obiective care pot influena succesul
terapiei gnatoprotetice prin aplicarea de proteze fixe plurale.
Metod. Competiia dintre biomateriale i tehnologii a lansat noi posibiliti
de rezolvare terapeutic, aducnd n atenia practicienilor noile tipuri de rini diacrilo-
compozite, polisticlele, agenii de cuplare i metodele de condiionare a suprafeelor
metalice (n scopul optimizrii legturii metalo-nemetalice i a aspectului estetic prin
ecranarea infrastructurii) i mai recent sistemele integral ceramice.

55
Rezumate
Rezultate. Tehnologiile moderne de placare sau de realizare de restaurri
integral ceramice sau compozite iau n considerare parametrii obiectivi ai reabilitrilor
estetice: saturaia, opalescena, transluciditatea, nuana, asociate cu sisteme obiective
de determinare a culorii, respectiv sistemele computerizate (Vintage Halo CCS, etc.).
Rezultatele constau n posibilitatea de a nlocui unitile dentare pierdute printr-un
substitut protetic care se integreaz perfect n echilibrul dento-somato-facial.
Concluzii. Practicienii trebuie s aib mereu n vedere faptul c structura
metalic din construciile protetice mixte formeaz o barier pentru transmisia
luminoas, n timp ce acest lucru dispare prin folosirea optim a sistemelor integral
ceramice sau integral compozite. Este unanim recunoscut c nu poate fi realizat o
protezare conjunct fr reabilitarea estetic, aceast dimensiune acoperind un spaiu
aproape la fel de amplu ca i domeniul protezrii fixe n sine, ea cuprinznd
reabilitarea contururilor faciale, redarea formei, a dimensiunii, a reliefului, a simetriei,
a culorii i a aspectului de naturalee, valene proprii dinilor naturali.
Cuvinte cheie: opalescen, nuan, saturaie, sisteme computerizate de
determinare a culorii, proteze fixe

Objectives. Into an equilibrate sthomatognatic system, the harmony between


the natural teeth and periodontium is important because it represents an ideal of
perfection, a goal that the fixed prosthetic appliances tend to accede. That represents a
target for every dentist and every dental technician, achieved by realizing an optimal
adaptation relating to the shape, color, aspect according to the remaining teeth, located
on the opposite or the same arch, and by respecting the conditions proper to the
hygienic and prophylactic principle, objectives which can influence the success of the
gnatho-prosthetic treatment based on fixed prosthetic appliances.
Method. The competition between biomaterials and technologies generated
new methods of therapy, by offering the possibility of using the new types of materials:
dyacrilo-composite resins, poliglasses, coupling agents, conditioning methods for the
metallic surfaces in order to enhance the metallic-non-metallic link and the aesthetic
aspect by covering the metallic framework or the full-ceramic systems.
Results. The modern technologies used to realize the aesthetic element for
bridges and crowns or to realize full ceramic or composite restorations take into
consideration objectives parameters proper to the aesthetic rehabilitations: hue, value,
chroma, and computerized systems for color determination (Vintage Hallo CCS, etc.).
The results are represented by the possibility of replacing teeth with a prosthetic
substitute perfectly integrated in the sthomatognatic equilibrium.
Conclusions. The practitioner shouldn't forget that the metallic framework
represents a stopper for the light transmission, disadvantage removed by the full
ceramic or composite systems. It is unanimous accepted that every restoration has to
rehabilitate the aesthetic appearance, these aspects being as important as the prosthetic
field, and is related to the rehabilitation of the facial contours, of the shape,
dimensions, relief, symmetry, color, natural aspect, parameters characteristic for the
natural teeth.
Keywords: hue, value, chroma, computerized system for color
determination

VALOAREA DIAGNOSTIC A EXAMENULUI RADIOLOGIC N


PARODONTITELE APICALE CRONICE

56
Al X-lea Congres Naional al UNAS
THE DIAGNOSTIC VALUE OF RADIOLOGICAL
EXAMINATION IN CHRONIC APICAL PERIODONTITIS

Asist. Dr. Irina-Maria Gheorghiu*, Prep. Dr. Alexandru Andrei Iliescu**,


Prep. Dr. Radia Iliescu***, Prof. Dr. Andrei Iliescu****
*Catedra de Odontoterapie Restauratoare, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti
**Catedra de Implantolologie Oral, Facultatea de Medicin Dentar, UMF Carol
Davila, Bucureti
*** Catedra de Perfecionare Stomatologic, Facultatea de Medicin Dentar, UMF
Carol Davila, Bucureti
****Catedra de Endodonie, Facultatea de Medicin Dentar, UMF Carol Davila,
Bucureti

Radiografiile reprezint un mare ajutor n endodonie, n mod deosebit n


cazul parodontitelor apicale cronice.
Scopul acestui studiu este de a aduce n discuie utilizarea, rolul, precum i
importana examenului radiologic n cadrul fiecrei etape a abordrii terapeutice.
Examinarea radiologic este esenial pentru stabilirea diagnosticului
pozitiv, al celui diferenial i a planului de tratament. De asemenea, este important pe
tot parcursul tratamentului, al perioadei de monitorizare i aprecierea abordrii clinice
a leziunilor complexe periapicale.
Informaia radiologic, dar i interpretarea sa corect ghideaz conduita
terapeutic, astfel mbuntind ansele de vindecare.
n acest studiu prezentm un numr de cazuri clinice cu leziuni periapicale
extinse, n care utilizarea examenului radiologic ne-a permis evaluarea corect a
extinderii leziunilor, precum i relaiile spaiale cu formaiunile anatomice.
Imaginile radiologice ofer de asemenea informaii despre tipul leziunii i
gradul de reparaie osoas att n timpul tratamentului conservator endodontic, ct i
dup ce acesta a fost finalizat.
Cuvinte cheie: parodontite apicale cronice, diagnostic radiologic, tratament
endodontic conservator, monitorizare

Radiographs are important aids in endodontics, especially in chronic apical


periodontitis.
The purpose of this study is to discuss the use, the role and the importance
of radiological exam in every step of the therapeutic approach.
Radiological examination is important in positive and differential diagnosis,
treatment planning, follow-up and overall clinical management of complex periapical
lesions.
The radiographic information and the correct interpretation guide the
treatment and enhancing the relationship between pathology and healing.
In this study we present a number of clinical cases with extensive periapical
lesions, in which the use of radiological exam allowed evaluation of the true extent of
the lesion and its spatial relationship to anatomical landmarks.
Radiographic images also provided specific information about the type of
lesion and the degree of bone repair during the treatment and after the conservative
endodontic treatment had been completed as well.

57
Rezumate
Keywords: chronic apical periodontitis, radiological diagnosis,
conservative endodontic treatment, follow-up

58