Stoma Nr-2 2011 Rezumate Congres

REVISTA ROMN DE STOMATOLOGIE VOLUMUL LVII, NR.
2, AN 2011
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REZUMATELE CONGRESULUI
MODIFICRILE MORFO-FUNCIONALE LA NIVELUL ADM N FUNCIE DE MOMENTUL EXTRACIEI MOLARULUI DE ASE ANI ef Lucr. Dr. Anca Fril, ef Lucr. Dr. Cornel Boitor, Conf. Dr. Mariana Sabu, Conf. Dr. Liana Stanciu Facultatea de Medicin Victor Papilian, Universitatea Lucian Blaga, Sibiu Facultatea de Medicin Dentar, Universitatea Titu Maiorescu, Bucureti Introducere: Molarul de 6 ani este cel mai afectat prin carie dentar dintre dinii permaneni, ind denumit de Kunzel (1988) copilul problem al stomatologiei infantile. Urmrile extraciei precoce a molarului de 6 ani sunt legate de momentul pierderii dintelui, dar n toate perioadele de vrst apar complicaii i dezavantaje. Extracia timpurie a molarului de 6 ani atrage instalarea unor modicri morfologice i funcionale cu perturbarea funciei de masticaie i autocurire i apariia dizarmoniilor dento-maxilare. Material i metod: Am efectuat un studiu clinico-statistic i radiologic pe un lot de 198 de pacieni aduli, cu vrste cuprinse ntre 21 i 40 de ani, care prezentau extracia timpurie n copilrie a molarului de ase ani, din diverse cauze. Au fost consemnate n e individuale data examinrii, date personale, statusul odontal, aspecte radiograce. Ulterior, datele au fost centralizate i prelucrate cu ajutorul programului Excel. Rezultate i discuii: Vrsta la care a fost efectuat extracia molarului de ase ani, la lotul de pacieni luai n studiu, este la 8-9 ani la 57% dintre acetia, urmat de vrsta de 9-10 ani la 32% i de vrsta de 10-12 ani la 11%. Am constatat o inciden crescut a edentaiei a doi molari de ase ani (53%), comparativ cu prezena edentaiei unui singur molar de ase ani (21,21% ). Majoritatea pacienilor cu edentaie de molar de ase ani rmn neprotezai pn la vrsta adult (88%), cu migrarea dinilor limitani breei edentate, cu afectarea funciilor aparatului dento-maxilar i instalarea disfunciei ocluzale. Urmrile extraciei molarului de 6 ani sunt n raport cu momentul n care a avut loc pierderea dinilor. Boala carioas are impact asupra creterii i dezvoltrii copilului, dar i asupra calitii vieii copilului i a adultului de mai trziu. Concluzii 1. Pierderea precoce a molarului de ase ani perturb funciile aparatului dento-maxilar, n special a funciei masticatorii, cu afectarea ocluziei n plan sagital nsoit de unele modicri i n plan vertical datorat migrrilor dinilor limitani breei edentate. 2. Molarul de ase ani reprezint un factor primordial n dezvoltarea aparatului dentomaxilar i de aceea este imperios necesar aplicarea msurilor de prolaxie i tratament precoce a cariei simple. Morpho-functional changes in the dento-maxillary system according to the time of six years molar extraction The 6-year molar is the most affected by dental caries of permanent teeth, being named by Kunzel (1988) as child problem of the infant dental medicine. The consequences of early 6 years molar extraction are related to tooth loss time but in all time periods disadvantages and complications arise. Early extraction of 6-year molar draws morphological and functional changes with the disturbance of chewing function and self-cleaning and the occurrence of jaw and dental disharmonies. Material and method: We performed a statistical clinical and radiological study on a sample of 198 adult patients aged between 21 and 40 who had early childhood molar extraction six years, from various causes. Individual records were recorded in individual les like the examination date, dental status, radiographic aspects. Later data have been accumulated and processed using Excel. Results and discussion: The six years molar extraction were carried out at 8-9 years to 57% of group of patients followed by 9-10 years age at 32% and 10-12 years at 11% of patients. We found an increased incidence of edentulous of two sixyear molars (53%) compared with the presence of one edentulous six years molar (21.21%). Most of the molar edentulous patients are not provided with prosthetic restorations six years until adulthood (88%), with the migration of limiting tooth of the edentulous space, impaired function of dento-max-
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REVISTA ROMN DE STOMATOLOGIE VOLUMUL LVII, NR. 2, AN 2011
illary system and installation of occlusal dysfunction. The consequences of 6 years molar extraction are depending with the time of tooth loss occurring time. Carious disease has an impact on child growth and development but also the quality of life of children and adults later. Conclusions 1. Early loss of six years molar disrupts dentomaxillary function especially masticatory function, impaired occlusion in sagital plane accompanied by some changes in vertical migration due to limiting the damage edentulous teeth. 2. Molar of six years is a primary factor in the development of dento-maxillary and therefore it is absolutely necessary to apply preventive measures and early treatment of simple caries. ELEMENTE PREVENTIVE N REABILITAREA PROTETIC PRIN IMPLANT Dr. M. Rescu, Dr. A.M. Bechir, Dr. A. Stvilaru, Dr. B. Calenic Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti Pacientul reabilitat oral prin implant endoosos este un pacient parodontopat. Tratamentul preventiv individualizat asigur succesul n timp. Schemele clasice de prolaxie au fost mbuntite cu terapii neconvenionale (terapia cranio-sacral, posturologia), astfel nct rezultatele s e ct mai apropiate de starea pacientului anterioar edentaiei. Cunoaterea i dezvoltarea acestor tehnici vine n ajutorul medicului pentru prevenirea eecului. Cuvinte cheie: tratament preventiv, reabilitare prin implant, terapie cranio-sacral, posturologie Preventive elements for implant proshetic rehabilitation The oral implant rehabilitated pacient is always a pacient with periodontal disease. The individual preventive treatment can offer success in time. Clasic prophylactic types of therapy are now increased with new non conventional therapies (cranio-sacral therapy, posturology); All these types of therapy are used to obtain a very functional rehabilitation similar to a pacient without missing teeth. It is important for dentists to know the advantages and disadvantage of all this kind of methods to prevent the treatment failure. Key words: preventive treatment, implant rehabilitation, cranio-sacral therapy, posturology.
ESTIMAREA RISCULUI LA CARIE CU AJUTORUL CARIOGRAMEI Prof. Dr. Cornelia Bcleanu, Asist. Univ. Ddr. Anamaria Florescu, Asist. Univ. Ddr. Andreea Tudose, Conf. Dr. Gabriela Despa, Asist. Univ. Dr. Bogdan Blaj Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti Scopul acestui studiu este de a descrie programul cariogram i utilizarea sa n practica dentar. Material i metod: Evaluarea riscului la carie al pacienilor reprezint o etap important n managementul de rutin a cariilor dentare. Programul Software Cariogram a fost dezvoltat de coala dentar suedez cu scopul de a sistematiza evaluarea factorilor de risc de producere a cariei dentare i de a aplica scheme specice terapeutice de prevenie bazate pe ncadrarea pacienilor n grupe de risc. Dup introducerea datelor pacientului, programul evalueaz i rezum rezultatele ca o diagram de structur circular, care ilustreaz grac ansa de a evita cariile n viitor (ca un sector verde). Acest mod de a ilustra interaciunea dintre factorii care contribuie la dezvoltarea cariilor sistematizeaz evaluarea i analizarea componentelor individuale de risc la carie. De asemenea, servete ca un instrument didactic util pentru clinician atunci cnd trebuie s ncadreze pacienii n grupe de risc. Acest studiu demonstreaz aplicarea Software Cariogram n gestionarea managementului a 3 pacieni cu leziuni carioase. Rezultate i discuii: Cariogram este un instrument didactic util pentru stomatologi i igieniti n evaluarea riscului la carie al pacienilor i aplicarea sa pare s aib rol de prevenie promitor. Programul Cariogram completeaz tendina actual spre gestionarea computerizat a datelor clinice. Concluzii: Prin creterea duratei de via a crescut i necesitatea meninerii sntii dentare o perioad mai mare de timp, de aceea dentitii trebuie s monitorizeze i s gestioneze ecient leziunile carioase pe toat durata vieii. Cazurile prezentate subliniaz rolul programului Software Cariogram n stabilirea factorilor etiologici ai cariei i a schemelor terapeutice adecvate. Estimating Cavity Risk with the Cariogram The aim of this study is to describe the Cariogram program and its use in dental practice. Material and method: Evaluating patients cavity risk is an important stage in routine manage-
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ment of dental caries. The Cariogram software was developed by a Swedish dental school in order to systematize the evaluation of risk factors in producing dental caries and to apply specic therapeutic schemes for prevention based on enframing patients withing risk groups. Following the introduction of the patients data, the software evaluates and summarizes the results in the form of pie circle-diagram, which graphically illustrates the chances to avoid caries in the future (as a green sector). This way of illustrating the interaction between the factors which contribute to developing caries systematizes the evaluation and analysis of the cavity risk individual components. It also serves as a useful didactic tool for the clinicians when they have to enframe patients within risk groups. This study demonstrates the use of Software Cariogram in handling the management of 2 patients with carious lesions. Results and discussions: Cariogram is a useful didactic tool for dentists and hygenists in evaluating the patients cavity risk and using it seems to play a promising prevention role. The Cariogram software completes the present trend in the computerised management of clinical data. Conclusions: During lifetime, the necessity of maintaining dental health for a longer period has been increased and that is why dentists have to efciently control and manage the carious lesions along the whole life span. The presented cases underline the role of the Cariogram shows if the patient over all is at high, intermediate or at low risk for caries. It also shows for every individual examined, which etiological factors are considered responsible for the caries risk. The results also indicate where targeted actions to improve the situation will have the best effect. MODIFICAREA UMECTABILITII SUPRAFEELOR ACRILICE PRIN TRATAMENT CU PLASM LA PRESIUNE ATMOSFERIC Dr. Alexandru-Titus Farcaiu1, Dr. E.C. Stancu2, Dr. M.D. Ioni2, Dr. O.C. Andrei1, Dr. G. Dinescu2 1 Facultatea de Medicin Dentar, Universitatea de Medicin i Farmacie Carol Davila, Bucureti 2 Institutul Naional de Fizica Laserilor, Plasmei i Radiaiilor Introducere: Plasma este un gaz ionizat ce conine electroni liberi, ioni i radicali liberi, cu un potenial foarte mare de activitate chimic. S-a
constatat c plasma crete umectabilitatea materialelor polimerice prin modicri chimice ale suprafeei. Material i metod: Au fost confecionate eantioane din 3 tipuri de rin acrilic pentru baza protezelor. Eantioanele au fost tratate cu plasm la presiune atmosferic n argon, la o putere de radiofrecven de 14 W, pentru diferite intervale de timp. Aprecierea modicrii umectabilitii suprafeelor s-a fcut prin msurarea unghiurilor de contact pentru ecare eantion, ind folosit un sistem CAM101 (KSV Instruments Ltd., Finlanda). Rezultate: Unghiul de contact pentru Superacryl (SpofaDental, Republica Ceh) a sczut de la 79 de grade la 21 de grade dup 5 minute de tratament. Valoarea unghiului de contact pentru Meliodent HC (Heraeus Kulzer, Germania) a variat de la 58 de grade pentru eantioanele netratate, pn la 34 grade dup 5 minute de tratament cu plasm. n cazul acrilatului Acry Pol Plus (Ruthinium Group, Italia), variaia a fost de la 58 la 33 grade pentru unghiul de contact. Discuii: Efectul plasmei asupra materialelor polimerice este studiat de aproximativ 15 ani, timp n care s-a claricat mecanismul prin care crete umectabilitatea, respectiv prin creterea raiei atomice O/C consecutiv ncorporrii gruprilor ce conin oxigen. Este cunoscut i faptul c efectul plasmei se pierde n timp, invers proporional cu timpul de tratament; de asemenea, eciena in vivo rmne s e determinat. Concluzii: Tratamentul cu plasm are efecte pozitive certe n ceea ce privete umectabilitatea rinilor acrilice, reprezentnd o alternativ noninvaziv la tratamentul de suprafa mecanic prin sablare. Elementele de urmrit sunt nivelul refacerii hidrofobiei dup aplicarea plasmei i posibilitatea depunerii unui strat microscopic hidrol pe suprafeele mucozale ale protezelor acrilice. Acrylic surface wettability modication after atmospheric pressure plasma treatment Introduction: Plasma is a ionized gas containing moving electrons, ions and free radicals with a high potential for chemical activity. It is well stated that plasma can increase the wettability of polimeric material. Material and method: Samples from 3 types of denture base materials were fabricated. The samples were treated with atmospheric pressure plasma in argon, operated at 14W of radiofrequency power, for different periods of time. The evaluation of surface wettability was done by contact angle measurements using a CAM101 (KSV Intruments Ltd., Finland) system.
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Results: The contact angle for Superacryl (Spofa Dental, Czech Republic) decreased from 79 to 21 degrees after a 5 minute treatment. The contact angle value for Meliodent HC (Heraeus Kulzer, Germany) modied from 58 to 34 degrees, similar to Acry Pol Plus (Ruthinium Group, Italy) whos contact angle varied from 58 to 33 degrees. Discussion: The effect of plasma on polimeric material is studied for about 15 years during these years being established the mechanism which improves the wettability, respectively trough increasing the O/C atomic ratio following the incorporation of oxygen-containing groups. It is known that plasma effect diminishes in time, inversely proportional with the treatment duration; although, the in vivo efciency remains to be measured. Conclusions: The plasma treatment has clear positive effects regarding the wettability of denture base materials, representing a non-invasive alternative to sandblasting. Issues to follow are the restoration of hydrofobia and the possibility of deposing a microscopic hydrophilic layer on the mucosal surfaces of dentures. REABILITARE COMPLEX POSTTRAUMATIC A UNUI DINTE PERMANENT IMATUR CAZ CLINIC Ctlina Farcaiu1, Rodica Luca1, Valentina Badea1, Alexandru-Titus Farcaiu2, Oana-Cella Andrei2 1 Facultatea de Medicin Dentar, Universitatea de Medicin i Farmacie Carol Davila, Bucureti Introducere: Fracturile coronare ale dinilor anteriori la copii i adolesceni sunt o form comun de traumatism. Principalele cauze sunt cderile i accidentele de joac, iar inocluzia sagital de 3-6 mm este un factor favorizant important. Raport de caz: O pacient n vrst de 8 ani s-a prezentat n cadrul Disciplinei de Pedodonie a Facultii de Medicin Dentar, UMF Carol Davila, Bucureti, cu gangrena pulpar posttraumatic la nivelul lui 1.1 datorat unei fracturi coronare penetrante, veche de 7 luni. Cauza traumatismului a fost un accident de joac. Pacienta se ncadra n Clasa I Angle cu compresie de maxilar i o inocluzie sagital de 4 mm, pentru care urma s primeasc tratament ortodontic. Examenul radiologic a evideniat la nivelul lui 1.1 o rdcin incomplet format cu un apex larg deschis. Obiectivul principal a fost realizarea apexicrii. Acest lucru a fost realizat prin aplicri succesive de hidroxid de calciu pe canal, timp de 2 ani. n tot acest timp, pacienta a
fost monitorizat clinic i radiologic. Dintele a fost refcut cu o reconstituire turnat i o coroan metalo-compozit semizionomic n vederea unei mai bune adeziuni a bracketului. Tratamentul ortodontic s-a realizat cu aparate xe i a fost nalizat n 18 luni. Acum pacienta este n perioada de contenie, iar coroana a fost nlocuit pentru mbuntirea esteticii. Concluzii: Tratamentul pacienilor cu traumatisme dentare este deseori dicil, mai ales atunci cnt a trecut o perioad mare de timp de la petrecerea accidentului. Prinii trebuie s e avizai c anumite anomalii ortodontice constituie factori favorizani. n cazul nostru, traumatismul dentar a ntrziat tratamentul i a sczut calitatea vieii pacientei. Posttraumatic complex rehabilitation in an young permanent tooth a case report. Introduction: Anterior crown fractures in children and adolescents are a common form of injuries. Most of them are caused by falls and playing accidents and one of the predisposing factors is an overjet between 3-6 mm. Case report: An eight year old female patient referred to the Paediatric Dentistry Department of Dental Medicine Faculty from U.M.F. Carol Davila Bucharest, with 1.1 pulp necrosis and periapical radiotranslucency due to a coronal fracture with pulp exposure. The fracture was caused by a playing accident that happened 7 months ago. The patient is a Class I (Angle) with narrow upper jaw and an overjet of 4 mm for which was about to receive orthodontic treatment. Periapical radiographs revealed not fully formed apex. Our main concern was to complete the apexication so we applied calcium hydroxide paste on root canal for 2 years, until the apex was formed and the endodontic treatment was completed. During this time, the patient was clinically and radiologicaly monitorized . The tooth was restored with a cast post and a partially aesthetic metallo-composite crown, for a better adhesion of the brackets. The orthodontist indicated therapy with xed appliances and whole treatment was nished in 18 months. Now the patient is in retention period and the crown was replaced to improve esthetics. Conclusion: Dental treatment for patients with dental trauma is often difcult, especially when long time passed between the accident and the visit at the dentist. Parents should be aware of the fact that some orthodontic disorders are predisposing. In this case, dental trauma delayed the beginning of orthodontic treatment and decreased patients quality of life.
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EVALUAREA PRECIZIEI DE DETERMINARE A LUNGIMII DE LUCRU N TRATAMENTUL ENDODONTIC: STUDIU IN VITRO Lector Drd. Anna Maria Pangic, Lector Dr. Dana Stanciu, Drd. Diana Rdulescu, Prof. Dr. Valeriu Cherlea, Drd. tefan Manea Universitatea Titu Maiorescu, Bucureti Introducere: Determinarea lungimii corecte de lucru este principalul factor care duce la realizarea cu succes a unui tratament endodontic. Studiile recente au artat c rezultatele histologice dup tratamentul endodontic sunt superioare atunci cnd instrumentarea i obturarea canalului sunt limitate la constricia apical. Scop: Scopul studiului este de a stabili prin msurtori succesive corectitudinea determinrii lungimii de lucru prin metoda radiologic cu ac pe canal i metoda electronic i stabilirea prin calcul statistic a marjei de eroare. Material i metod: Determinrile s-au efectuat pe un numr de 25 de dini mono i pluriradiculari extrai din cauza afeciunilor parodontale. nainte de msurarea electronic a lungimii canalului radicular s-a introdus pe ecare canal un ac Kexole nr. 15 pn cnd vrful acestuia a devenit vizibil prin foramen. Acul a fost retras pn cnd acesta a devenit tangent la foramenul apical. S-a msurat aceast lungime ce a fost nregistrat ca lungime de referin (lungimea de control) i care corespunde lungimii reale. Pentru ecare canal n parte s-a msurat lungimea de lucru cu ajutorul a dou apex locatoare (WDV Gold i Morrita Root ZX). S-au realizat, de asemenea, msurtori ale lungimii canalului pe radiograile efectuate cu ac pe canal. Datele obinute au fost centralizate pentru a se observa diferenele aprute prin cele 2 metode selectate: radiologic i electronic. Rezultate: Precizia determinrii lungimii de lucru oferit de apex locatoare s-a dovedit superioar celei date de metoda radiologic cu ac pe canal. Avantajele apex locatoarelor constau i n faptul c sunt uor i rapid de utilizat, reduc nevoia de expunere radiologic, pot msura spaiul pulpar pn la constricie. Evaluation of the accuracy of determining the working length in endodontic treatment: a study in vitro Abstract: Determining correct working length is the main factor leading to the success of endodontic treatment. Recent studies have shown that
the histological results after endodontic treatment and handling are superior when the canal is limited to the apical constriction. Purpose: The purpose of this study is to establish the accuracy of determining the length of successive measurements by X-ray work with endodontics instruments and method of electronic channel and setting the statistical calculation of the margin of error. Methods: Measurements were made on a number of 25 mono and pluriradicular teeth extracted because of periodontal disease. Before electronic measurement of root canal length was placed on each channel, a K-Action exole no. 15 until its tip became visible through the foramen. The needle was withdrawn until it became tangent to the apical foramen. To measure this length has been recorded as the reference length (lengthcontrol) and corresponding real length. For each channel length was measured using the work of two apex locators (Root ZX Morra Gold WDV). They also made measurements of the channel length radiographs made with the needle channel. Data were centralized to see the differences encountered by the two selected methods: radiological and electronics. Results: The accuracy of determining the working length given by the apex locators was superior X-ray data channel needle. Advantages of apex locators is the fact that they are easy and quick to use, reduce the need for radiation exposure, can measure up to the constriction area pulp. MANAGEMENTUL PERFORMANEI N TRATAMENTUL CANALELOR INFECTATE Lector Drd. Anna Maria Pangic, Asist. Univ. Dr. Dana Stanciu, Prof. Dr. Valeriu Cherlea, Prof. Dr. Cornelia Bcleanu, Asist. Univ. Drd. tefan Manea, Lector Drd. Anca Popescu Universitatea Titu Maiorescu, Bucureti Rezumat: Stabilirea unui plan managerial n tratamentul canalelor infectate presupune cunoaterea stadiului iniial prin diagnostic corect, etape de parcurs cu termene de realizare prin stpnirea anatomiei canalelor radiculare, cunoaterea aciunii substanelor medicamentoase, ct i realizarea unor criterii de evaluare periodice i nale asupra performanei tratamentului. Scop: Acest studiu stabilete un protocol operator n tratamentul canalelor infectate i o endodontic prin care s putem evalua performana tratamentului.
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Metod i materiale: Am realizat un chestionar pentru pacient i pentru medic i am urmrit evoluia clinic a pacienilor i eciena tratamentului prin teste microbiologice. Am luat n studiu 26 de pacieni i am ntocmit un studiu statistic care la unii pacieni a fost realizat pe o perioad de doi ani i jumtate. Rezultate: Protocolul operator este foarte important. Utilizarea tehnicilor i tratamentului medicamentos trebuie s e eciente n doza minim activ. Rigoarea i respectarea completrii ei endodontice chiar dac uneori din punct de vedere clinic rezultatele nu sunt imediat pozitive, n nal urmrirea corect a etapelor duce la un rezultat pozitiv Management of performance in the treatment of infected rooth Abstract: Setting up a management plan for the treatment of infected canals initial stage involves knowing the correct diagnosis, stages with completion dates to go through mastery of root canal anatomy, knowledge of action, drug substances and achieve benchmarks on the performance of regular and nal treatment. The purpose of this study was to establish a protocol processor in the treatment of infected canals and endodontic form in which we can evaluate the performance of treatment. Method and materials: We have developed a questionnaire to the patient and the doctor and I followed the clinical course of patients and treatment effectiveness through microbiological tests. We studied 26 patients and we made a statistical study in some patients was conducted on aperiod of two years and a half. Results: Protocol controller is very important. Using techniques and medical treatment to be effective in the lowest active. Endodontic lling sheet riguarea and respect even if sometimes immediately clinically positive results are nally correct follow the steps leading to a positive result. DIFERITE TIPURI DE SUPRAPROTEZE CU SISTEME MAGNETICE DE RETENIE Asist. Univ. Dr. Ana Maria Tancu, Prof. Dr. Elena Preoteasa, Asist. Univ. Dr. Marina Melescanu Imre Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti Scop: Compararea a dou alternative de tratament, respectiv metoda direct i cea indirect n protezarea total.
Material i metod: Ilustrarea prin cazuri clinice de supraprotezri maxilare i mandibulare a metodelor directe i indirecte de retenie folosind magnei. n ambele cazuri, sistemul magnetic este compus dintr-un keeper (realizat n laborator, n cazul metodei indirecte, sau prefabricat, n cazul metodei directe), keeper cimentat pe dinte i de pastila magnetic plasat n baza protezei. S-au folosit magneii MAGFIT RK (tip S) cu 500 gf valoare de retenionare, i MAGFIT DX cu 600 gf retenie, ambele produse de rma AICHI STEEL, Japonia. Dup prepararea endodontic a canalului i pregtirea bontului coronar s-au cimentat sistemele magnetice cu cimentul dual Nexus NX 3, au fost aplicate supraprotezele efectuate respectnd tehnologia clasic a protezei totale. Rezultate: Folosirea sistemelor magnetice este simpl n ambele protocoale protetice, att metoda direct ct i cea indirect. Satisfacia pacienilor este foarte bun att la protezele totale, ct i la cele pariale. Metoda direct reduce timpul de tratament, prin etapele de laborator, dar i cea indirect prezint avantajul unui timp de lucru redus n cabinetul dentar. Concluzii: Sistemele magnetice de retenie, folosite att direct ct i indirect, pentru supraproteze totale sau pariale, ofer avantajele unui protocol protetic simplu pentru practician i benecii maxime ntru satisfacia pacientului. Cuvinte cheie: supraprotez, sisteme magnetice, metod direct, metod indirect Various types of supported teeth overdentures with magnetic systems Objective: To make a comparison between overdentures on magnetic systems using the direct and indirect method. Materials and method: The illustration by clinical cases of mandibular and maxillary overdentures realised on using two billateral magnetic systems, direct or indirect method. The magnetic system is composed in both cases of one keeper (produced in the laboratory, in the indirect method or provided by company, in the direct method), cemented on the tooth, and the magnetic pill, retained in the overdentureses base. We have used MAGFIT RK magnetic system (tipe S, at), with 500 gf retention value and MAGFIT DX, with 600 gf retention, both produced by Aichi Steel, Japan. After the preparation of the remaining teeth (endodontic treatment, the preparation of the coronar parts), by cementation with Nexus NX 3 dual bond resin in all cases,
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we applied the magnetic systems, after we obtained the partial or complete denture, following all the rules of the dentures, clinical and technical steps, both on the remaining teeth and magnetic systems. Results: The use of the magnetic system is very simple in all cases, even in the indirect method. The patients are very satised with the functional qualities of the complete and partial overdentures. The use of the direct method, without the dental laboratory, reduces the treatment time and makes it easier but the indirect methos is very simple to use too. Conclusions: The magnetic systems in the direct and indirect method used under overdentures (complete or partial) offer advantages for the practitioner (very simple, easy to use) and maximum benets for the patient. Key words: overdenture, magnetic system, direct method, indirect method CARACTERISTICI ALE INTEGRRII TISULARE IN VIVO A IMPLANTURILOR DENTARE DIN TITAN STUDIU HISTOLOGIC Asist. Univ. Dr. Andreea-Mariana Bneanu, Prof. Dr. Emilian Hutu, Asist. Univ. Dr. Cristina Hineal, Dr. Diana Rdulescu, Conf. Dr. Ana-Maria Bechir Universitatea Titu Maiorescu, Bucureti Pentru succesul tratamentului prin implanturi dentare, un prim pas important l constituie osteointegrarea implantului dentar. Scopul lucrrii este de a aprecia, in vivo, procesul de osteointegrare a implanturilor din titan sub form de aliaj. Material i metod: Pentru evaluarea procesului de osteintegrare s-a realizat un studiu al aspectelor morfologice i histologice osoase perimplantare pe loturi de iepuri. Histointegrarea a fost urmrit n dinamic la un interval de 30 de zile i 60 de zile. Rezultatele au artat faptul c procesul de osteointegrare a cunoscut un ritm uor diferit de evoluie la loturile studiate. Fenomenele osteoinductive la nivelul implanturilor din titan s-au desfurat la un interval de 30 de zile, ntr-un ritm mai rapid la 65% dintre cazuri, dar dup 60 de zile la toate cazurile. La nivelul locului de inserie al implanturilor exista structur osoas care a nlocuit complet esutul bros. Concluziile studiului conrm proprietile osteoinductive ale aliajelor de titan i evideniaz faptul c dei n un ele cazuri, n aceleai condiii clinice, exist la 30 de zile diferene privind
integrarea osoas, dup 60 de zile, la toate cazurile, se structureaz un esut osos cu aceleai caliti. Cuvinte cheie: implant, titan, osteointegrare. Characteristics of in vivo histointegration of titanium dental implants Treatment success with dental implants is an important rst step dental implant osseointegration. The purpose of this paper is to assess, in vivo, the process of osseointegration of titanium implants in the form of alloy. Material and methods: For the evaluation process osseointegration we made a study of morphological and histological aspects of bone around the implant on batch of rabbits. The histological integration was followed in a dynamic period of 30 days and 60 days. The results showed that the process of osseointegration has risen slightly different trend in the groups studied. Osteoinductive phenomena were conducted at an interval of 30 days in a faster rate to 65% of cases, but after 60 days in all cases, at the implant insertion site was formed bone which completely replaced the brous tissue. The ndings demonstrates the osteoinductive proprieties of titanium alloys and points out that although in some cases, in the same clinical conditions, there are differences after 30 days bone integration, after 60 days, a structured bone with the same qualities is present in all cases. Key words: implant, titanium, osseointegration STUDIU REFERITOR LA UTILIZAREA DEZINFECTANTELOR N MEDICINA DENTAR Conf. Dr. Anamaria Bechir1, Prof. Dr. Doina Lucia Ghergic1, Student Edwin Sever Bechir3, ef Lucr. Drd. Oana Smtrea1, Asist. Univ. Dr. Andreea Bneanu1, Dr. Diana Rdulescu3 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Student, Facultatea de Medicin Dentar, Universitatea Ovidius, Constana 3 Medic dentist i Tehnician dentar, Bucureti n scopul prevenirii infeciei ncruciate, procedurile eciente de control ale infeciei ar trebui s e efectuate de ctre toi medicii dentiti n cabinetul stomatologic, respectiv de ctre toi tehnicienii n laboratoarele de tehnic dentar. Obiectivul acestui studiu a fost de investigare comparativ a modului de folosire a dezinfectanilor
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n practic de rutin, n cabinetele stomatologice i n laboratoarele de tehnic dentar. Studiul, bazat pe completarea chestionarelor special conceput de ctre cadrele didactice din Facultatea de Medicin Dentar a Universitii Titu Maiorescu, Bucureti, a fost realizat cu implicarea a 136 stomatologi i tehnicieni dentari din reeaua privat. Studiul a relevat faptul c rareori laboratoarele de tehnic dentar primesc informaii de la medicii dentiti referitoare la efectuarea/neefectuarea dezinfectrii amprentei, respectiv informaii specice despre tipul de soluie dezinfectant utilizat, metoda de dezinfectare folosit (inersie/pulverizare), intervalul de timp ct a durat dezinfectarea. Rspunsurile indic nevoia de educaie suplimentar cu privire la practicile de control a infeciei ncruciate ntre cabinetul stomatologic i laboratorul de tehnic dentar, precum i necesitatea unei mai bune comunicri dintre medicii stomatologi i tehnicienii dentari. Cuvinte cheie: medicin dentar, dezinfectante Study concerning the use of disinfectants in dentistry To prevent cross infection, efcient infection control procedures should be performed by all dentists in the dental ofce, and by all technicians in dental laboratories. The objective of this study was the comparative investigation of the use of disinfectants in routine practice, in dental ofces and in dental laboratories. The study, based on the completing the questionnaires especially conceived by the teachers of the Dental Medicine Faculty of the University Titu Maiorescu, Bucharest, was conducted with the involvement of 136 dental technicians and dentists from private practice network. The study revealed that dental laboratories rarely receive information from dentists about the disinfection modality of the impressions, specic information about the type of used disinfectant, the used disinfection method (immersion / spray) and the time interval for disinfection. The responses indicate the need for additional education concerning cross infection control practices between dental ofce and dental laboratory, as well as the need for better communication between the dentists and dental technicians. Keywords: dental medicine, disinfectants
KERATINOCITELE STEM I MUCOASA ORAL ARTIFICIAL Dr. Bogdan Calenic, Dr. Mihaela Rescu Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti Obiectiv: Obiectivul specic al studiului de fa este acela de a izola i caracteriza folosind o tehnic de separaie magnetic, o populaie de keratinocyte stem orale. Metod: Keratinocitele orale obinute din mucoasa oral keratinizat au fost separate magnetic folosind doi markeri: integrina 64 i markerul de proliferare CD71. Expresia unui panel de markeri stem: CD44H, Nestin, Nanog, Oct3/4, CD117 a fost vericat prin imunouorescen. Rezultate: Fraciunea celular 64 pos CD71 neg s-a colorat pozitiv pentru Oct , CD44H i citokeratin 19, n timp ce markerii Nanog, Nestin i CD117 au fost negativi. Concluzii: Fraciunea 64 pos CD71neg a fost intens pozitiv pentru markeri stem importani i ar putea un bun candidat pentru formarea unei viitoare mucoase orale articiale. Cuvinte cheie: keratinocite orale, celule stem, separaie magnetic, mucoas oral. Oral keratinocyte stem cells and future articial mucosa Objective: The specic aim of the present study is to characterize an oral keratinocyte stem-cell population separated using a magnetic technique. Methods: Oral human keratinocytes obtained from keratinized oral mucosa were magnetically separated using a proliferation-related marker, CD 71 and 64 integrin. The expression of different stem cell markers: CD44H, Nestin, Nanog, Oct3/4, CD117 was checked by immunouorescence. Results: Our 64 pos CD71neg stem cell fraction was positive for Oct , CD44H and cytokeratin 19 while Nanog, Nestin and CD117 expression was absent. Conclusions: The human gingival 64 pos CD 71neg fraction was strongly positive for a panel of stem cell markers and could form oral epithelial equivalent. Key words: oral keratinocyte, stem cell, magnetic separation, oral mucosa INCIDENA CARIEI DENTARE SIMPLE LA NIVELUL MOLARILOR DE ASE ANI N MEDIUL URBAN ef Lucr. Dr. Cornel Gh. Boitor, ef Lucr. Dr. Anca Fril,
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Conf. Dr. Mariana Sabu Disciplina Cariologie, Facultatea de Medicin V. Papilian, Sibiu Importana meninerii integritii coronare a acestor dini este considerat astzi primordial pentru dezvoltarea armonioas a ntregului aparat dento-maxilar. Studiul a fost efectuat pe un lot de 102 pacieni, cu vrste cuprinse ntre 8 i 12 ani, care s-au prezentat n ambulatoriul clinic de specialitate al Spitalului Clinic Judeean Sibiu, n perioada 20092011. Studiul relev incidena crescut i tratamentul decitar al cariei dentare simple la nivelul molarilor de ase ani erupi pe arcade relativ recent, n urm cu 4-6 ani. n urma studiului am constatat urmtoarele: 15% dintre cei examinai prezentau toi molarii de 6 ani cariai, 40% prezentau trei molari cariai, 27% prezentau doi molari cariai i doar 18% un singur molar cariat. Prin tratamentele efectuate am urmrit restabilirea morfologic i funcional a dinilor afectai, dar i determinarea unei motivaii privind prevenirea apariiei unor noi leziuni carioase. The simple dental caries occurenceto six age molar in urban area The coronary integrity maintenance is considered as primordial in whole dento-maxilar system. The study was conducted on a sample of 102 patients aged between 8 and 12 years who came in a specialized clinical outpatient Sibiu County Hospital in 2009-2011. Study reveals high incidence of dental caries and poor treatment of the single sixyear molars erupted recently on the arches 4-6 years ago. The study done, we found that: 15% of the examined patients had all decayed molars 6 years, 40% had three decayed molars, 27% had two molars decayed and only 18% one decayed molar. Throw the treatments, we followed the morphological and functional restoration of affected teeth, and also the motivation and determination to prevent the emergence of new carious lesions. POSIBILITI TERAPEUTICE N CAZUL ANODONIEI BILATERALE DE INCISIV LATERAL SUPERIOR Asist. Univ. Dr. Dumitru Victor Burtea1, Dr. Marius Mari2, ef Lucr. Dr. Raluca Monica Comneanu1 1 Universitatea Titu Maiorescu, Bucureti 2 UMF Carol Davila, Bucureti
Rezumat: Dintre toate formele clinice ale minusului n formula dentar, cel mai frecvent se ntlnete anodonia redus care intereseaz de preferin ultimii dini din serie, excepie de la regul fcnd grupul incisiv inferior, unde primul interesat este incisivul central. Complexitatea tulburrilor generate n special de anodoniile ntinse impune rezolvarea terapeutic de urgen n condiii ct mai biologice i ziologice, adecvate vrstei pacientului. Depistarea precoce este indispensabil pentru interceptarea complicaiilor i tulburrilor, iar decizia terapeutic este inuenat de: momentul depistrii anomaliei, contextul general bucodentar, starea dinilor temporari, localizarea anomaliei, potenialul biologic al pacientului, vrsta acestuia. Variantele terapeutice sunt reprezentate e de pstrarea dintelui temporar, e de extracia dintelui temporar urmat de dou variante posibile de tratament: reducerea spaiilor prin dirijarea ortodontic a dinilor permaneni sau meninerea spaiilor i rezolvarea ulterioar a acestora prin mijloace protetice sau chirurgicale. Cuvinte cheie: anodonie, anomalie dentar, dirijare ortodontic, interceptarea complicaiilor. ANALIZA CAUZELOR EXTRACIEI DENTARE PE UN LOT DE PACIENI DIN BUCURETI Prep. Univ. Dr. Ruxandra Mrgrit, ef Lucr. Dr. Oana-Cella Andrei, Asist. Univ. Dr. Irina-Maria Gheorghiu Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti Introducere: Scopul acestui studiu este de a investiga cauzele ce au determinat extracia dentar i corelaia acestora cu vrsta i genul pacienilor n cadrul unui eantion de pacieni prezent n practica privat din Bucureti. Material i metod: n studiu au fost inclui 844 de pacieni, 327 de brbai i 517 femei, cu vrste cuprinse ntre 18 i 84 de ani. Au fost nregistrate date despre vrst, genul pacienilor, numrul dinilor extrai precum i motivele ce au dus la extracie, acestea realizndu-se pe o perioad de 5 ani (2006-2011). Rezultate i discuii: Pe perioada studiului au fost extrai 1570 de dini permaneni din diferite motive. Rezultatele au artat c principalele cauze ale extraciei au fost reprezentate de cariile dentare, eecul tratamentului endodontic i boala parodontal. Cariile au fost principala cauz a extraciei n cazul pacienilor n vrst de pn la 44 de ani, n timp ce boala parodontal a fost principala cauz a
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extraciei dentare n cazul pacienilor peste 45 de ani. Eecul tratamentului endodontic este, de asemenea, o cauz important ce a determinat extracia dentar, iar n comparaie cu alte studii, n cazul prezent procentul gsit este semnicativ mai mare. Celelalte cauze ale extraciei dentare, precum fracturi radiculare, accidente de erupie, cauze protetice, ortodontice, au nregistrat un procent relativ redus, i totui acestea trebuiesc luate n consideraie. Concluzii: Cele trei cauze principale care au determinat extracia dentar au fost reprezentate de caria dentar i complicaiile acesteia, boala parodontal i eecul tratamentului endodontic. n concluzie, orice efort de limitare a acestor cauze este n folosul pacienilor, prevenind astfel pierderea unitilor dentare ce poate avea consecine nedorite funcionale i psihologice. Cuvinte cheie: extracie dentar, carii, eec tratament endodontic, boal parodontal. Analysis of causes of dental extractions on a lot of patients in Bucharest Introduction: The purpose of this study is to investigate the causes of tooth extraction and their correlation with patient age and gender in a sample of patients present in a private practice in Bucharest. Materials and methods: The study included 844 patients, 327 men and 517 women, aged between 18 and 84 years. Data were recorded about age, gender, number of teeth extracted and the reasons that led to the extraction, the study being realized over a period of ve years (2006-2011). Results and discussion: During the study period 1570 permanent teeth were extracted from different reasons. The results showed that the main causes of extraction were represented by dental caries, endodontic treatment failure and periodontal disease. Dental caries was the main cause of tooth extraction for patients younger than 44 years, while periodontal disease was the main cause of tooth extraction in patients over 45 years. Endodontic treatment failure is also an important cause that led to tooth extraction, and in comparison with other studies, the percentage found in the present case is signicantly higher. The other causes of tooth extraction like root fractures, accidents of eruption, prosthetic reasons, orthodontic reasons, recorded a relatively small percentage, yet these must be taken into account. Conclusions: The three main causes that led to tooth extraction were dental caries and their complications, periodontal disease and endodontic
treatment failure. In conclusion, any effort to limit these cases is for the benet of patients, thereby preventing loss of dental units that may have undesirable functional and psychological consequences. Key words: tooth extraction, caries, endodontic treatment failure, periodontal disease. TRATAMENTUL EDENTAIEI PRECOCE DE MOLAR 1 INFERIOR ef Lucr. Dr. Oana-Cella Andrei, Ddr. Magdalena-Natalia Dina Disciplina de Protezare Parial Mobilizabil, UMF Carol Davila, Bucureti Introducere: Edentaia de molar unu inferior se ntlnete frecvent la vrste tinere. Protezarea corect a acestei edentaii reprezint o provocare din punct de vedere protetic, cu att mai mult cu ct se petrece de cele mai multe ori ntr-un stadiu tardiv. nclinarea molarului doi ctre spaiul edentat, accentuat de prezena molarului de minte n erupie, determin ngustarea spaiului mezio-distal, iar calitatea i cantitatea osului sunt diminuate. Factorii care inueneaz alegerea soluiei de protezare sunt variai; se ine cont de limea breei, de starea osului, de situaia dinilor limitani, de raportul cu antagonitii, de vrsta i starea de sntate general a pacientului, de gradul de igien i de posibilitile nanciare. Studiu de caz: Acest articol aduce n discuie un caz de edentaie precoce de molar unu inferior neprotezat o perioad de timp de 5 ani, n care soluia de tratament aleas a fost plasarea unui implant. Tratamentul s-a derulat n dou etape: o prim faz chirurgical, n care a fost inserat implantul, dup care la un interval de 5 luni a urmat realizarea unei coroane metalo-ceramice. Spaiul disponibil pentru protezare a fost obinut prin corectarea angulaiei feei meziale a molarului doi cu ajutorul unei obturaii de clasa a doua. Concluzii: Soluia de tratament prezentat a reprezentat cea mai conservativ variant posibil n cazul clinic prezentat, avnd n vedere c dinii limitani ai breei i-au pstrat vitalitatea. Cuvinte cheie: edentaie, molar unu inferior, implant dentar, tratament protetic. Treatment of early edentulous of the 1st lower molar Introduction: The loss of the mandibular rst molar is frequently met at a young age. The correct prosthetic rehabilitation in these cases can be a challenge, especially since it unfolds mostly in a
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late stage. The inclination of the second molar towards the edentulous space, enhanced by the presence of erupting third molar, causes the narrowing of the mesio-distal space and reduces the bone quality and quantity. There are various factors that inuence the choice of the prosthetic solution; we must take into account the width of the edentulous space, the condition of the bone, the situation of the limiting teeth, the occlusal relations, the age and the general health of the patient, the degree of his oral hygiene and also his nancial possibilities. Case report: This paper discusses a case of a premature loss of mandibular rst molar remained untreated for a period of 5 years, for which the elected treatment solution is the placement of a single implant. The treatment was developed in two stages: the rst surgery stage when the implant was inserted, and the second prosthetic stage, after a period of ve months, when the metal-ceramic crown was made. The necessary available space for the crown was obtained by correcting the second molars angulation with a class 2 lling. Conclusions: This treatment solution was the most conservative possible option for this case, considering that the limiting teeth of the edentulous space have retained their vitality. Key words: edentulous space, mandibular rst molar, dental implant, prosthetic solution METODE ACTUALE UTILIZABILE N DETERMINAREA CULORII DENTARE N VEDEREA REALIZRII UNOR RESTAURRI CU MATERIALE COMPOZITE ef Lucr. Dr. Mona Iona, Conf. Dr. Mariana Sabu, Asist. Univ. Dr. Diana Mrza, Drd. Alina Cristian Universitatea Lucian Blaga, Sibiu Introducere: Alegerea culorii pentru efectuarea de restaurri cu materiale compozite este important n estetica dentar. Apariia unor materiale compozite noi, cu o coloristic asemntoare cheii 3D Master (3D Direct, Vident, USA), readuce n prim plan alegerea culorii prin metode vizuale i instrumentale. Material i metod: Este prezentat modul de determinare a culorii cu cheia VITA Linearguide 3D Master i sistemul VITA Easyshade Compact, un sistem de determinare instrumental a culorii. Determinarea culorii dentare prin metoda vizual s-a efectuat dup o testare a existenei unor deciene de percepie a culorilor printr-un test Ishihara.
Rezultate: Rezultatele determinrilor coloristice au fost asemntoare, oricare dintre cele dou metode permind alegerea corect i rapid a culorii dentare. Discuii: Cheile de culori cele mai folosite la determinarea coloristicii structurilor dentare sunt realizate din materiale ceramice. Recomandarea actual privitoare la materialele compozite este de a folosi n practica clinic chei de culori realizate din materialele utilizate, ba chiar mai mult realizate din aceeai arja de materiale. Astfel, diferena coloristic ntre etalon i materialul compozit folosit va minim. Concluzii: Metodele moderne de determinare a culorii dentare permit o selectare reproductibil prin mai multe variante a culorii dentare, dar reproducerea culorii selectate cu ajutorul materialelor compozite poate problematic. Cuvinte cheie: culoare dentar, materiale compozite, VITA Linearguide 3D Master, VITA Easyshade Compact Current methods used to determine dental color for the realization of material composite restoration work Introduction: Selecting the color for performing restaurations with composite material is important in dental aesthetics. The occurrence of new composite material with colors similar to the 3D Master key (3D Direct, Vident, USA) reinforces the importance of color selection through visual and instrumental methods. Material and method: Shows the method by which the color is determined with the VITA Linearguide 3D Master key and the VITA Easyshade Compact system, an instrumental system used to determine color. The color was determined through visual method after testing the existence of color vision deciencies through an Ishihara test. Results: The color determination results were similar to each other; both methods allow a correct and fast tooth color selection. Discussions: The most frequently used color keys for determining tooth color structure are made of ceramic material. The current recommendation regarding composite materials is to use color keys made of materials used and realized from the same material load. Thus the color difference between the standard and the composite material will be very small. Conclusions: Modern methods to determine tooth color allow a selection reproducible through several variants of tooth color but the color repro-
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duction selected by means of composite material can be a problem. Key words: dental color, composite material, VITA Linearguide 3D Master, VITA Easyshade Compact EVOLUIA I PATOLOGIA SPECIFIC SISTEMULUI ORO-FACIAL LA PERSOANELE DE VRSTA A TREIA Dr. Alina Gabriela Filipescu, Prof. Dr. Doina Lucia Ghergic, Dr. Raluca Monica Comneanu, Dr. Horia Mihail Barbu Universitatea Titu Maiorescu, Bucureti Evoluia tratamentelor protetice n ultima jumtate a secolului arat o mbuntire a statusului dentar n rndul populaiei, deoarece costul devine uor mai sczut, iar stomatologia preventiv ocup un loc din ce n ce mai important. Tratamentele prolactice ale cariilor i parodontopatiilor au ca rezultat meninerea ct mai ndelungat a dinilor pe arcada dentar, acetia putnd inclui n restaurri protetice xe de mare anvergur, pentru a evita protezrile mobile. Ponderea protezrilor xe n raport cu cele mobilizabile depinde de factorii socio- i bioeconomici i de msurile de prolaxie instituite, acestea ind diferite de la o ar la alta i de la o regiune la alta, n funcie de mediul urban sau rural i de eciena sistemului de asigurri de sntate. Motivaia populaiei sau sancionarea ei n unele cazuri determin atitudinea pentru tratamentul stomatologic care trebuie s e sprijinit din punct de vedere organizatoric i nanciar. Pentru evaluarea necesitii de tratament a pacienilor este necesar o cercetare managerial a tuturor tratamentelor protetice care trebuie s in seama de impactul socio-economic la populaia de vrsta a treia i implicit de doleanele acestora. Realizarea tuturor tratamentelor protetice la pacienii de vrsta a treia include n mod special studierea factorilor economici care pot inuena elaborarea unui plan de tratament corect cu o eventual educaie sanitar specic acestui domeniu, avnd n vedere evoluia tratamentelor care pot tolerate perfect de organism sau, dimpotriv, pot provoca disconfort. Cuvinte cheie: tratament protetic, pacieni de vrsta a treia, management, factori bioeconomici, factori socioeconomici.
The evolution and pathology of the oro-facial system specic to elderly people Evolution of prosthetic treatment in the last half century show an improvement in dental status in the population, because the cost is slightly lower and preventive dentistry plays an increasingly more important. Preventive treatment of caries and periodontal disease result in maintaining longer the teeth on dental arches so that they can be included in largescale xed prosthetic restorations to avoid mobile prosthesis. Share of xed prosthesis in relation to the movable depends on socio-and bio and prevention measures in place, they are different from one country to another and from one region to another, depending on urban or rural environment and system efciency health insurance. Motivation population or punish them in some cases determined attitude to dental treatment to be supported in terms of both organizational and nancial. To evaluate the need for treatment of patients is necessary to research prosthetic management of all treatments must take account of socio-economic impact of older population and therefore in their wishes. Making all prosthetic treatment of elderly patients in particular includes the study of economic factors that may inuence the development of a treatment plan to correct any specic health education in this area, having regard to the development of treatments that can be perfectly tolerated by the body, or conversely may cause discomfort. Key words: prosthetic treatment, elderly patients, management, bio-economic factors, socioeconomic factors. CONSTATRI STATISTICE OBINUTE N CERCETAREA PROTEZELOR PARIALE ELASTICE Dr. Rzvan Lea1, Prof. Dr. Emilian Hutu2, Th. Gabriela Lea3 1 Facultatea de Medicin Dentar Dunrea de Jos, Galai 2 Facultatea de Medicin Dentar Titu Maiorescu, Bucureti 3 Laborator privat, Galai Proteza exibil ca i metod de tratament prezint avantaje care au fost luate n considerare frecvent cu privire la tehnologia protezrii totale i pariale. Noi considerm acestea mari avantaje n tratamentul cu protez exibil parial i obinerea
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succesului protetic pe termen lung. Acest studiu ilustreaz comparaia ntre proteza acrilic i cea exibil statistic. Au fost examinai i comparai 64 de pacieni cu edentaii pariale. Introducere: Materialele termoplastice din care sunt executate lucrrile mobile elastice sunt produse din compui care sunt aprobai n uzul medical. Proteza dentar este o pies mecanic ce se insereaz ntr-un organism viu, ce ar trebui s se integreze total n ansamblul aparatului dento-maxilar, integrarea ind condiionat de stabilizarea estetic i dinamic a protezei. Scopul lucrrii: Scopul acestei lucrri este de a evalua comparativ reactivitatea protezei elastice i a celei acrilice pe un lot de pacieni cu edentaii pariale, aai n tratament protetic i alei aleator. Pentru realizarea scopului propus a fost selectat un lot de pacieni cu edentaii pariale protezai elastic i urmrii n decursul a trei ani de tratament, ind separat de alt lot de pacieni, cu alte intervenii protetice la edentaia parial. Material i metod: Numrul de pacieni inclui n studiul despre inuena protezei elastice asupra esuturilor de sprijin, respectiv os-mucoas-dinte-parodoniu, a fost triat dintr-un numr mult mai mare de pacieni protezai. n studiu am aplicat metode moderne de investigaii ind prezentate argumente care demonstreaz comparativ efectul materialului elastic folosit pentru diferite perioade de timp. Proteza acrilic clasic. Prima grup a fost realizat din 58 de pacieni edentai parial 31 de brbai i 27 de femei la care s-au realizat proteze clasice-acrilice. Proteza elastic. Cea de-a doua grup, la care au participat 64 de pacieni 41 de barbai i 23 de femei, a fost constituit din persoane la care s-au aplicat proteze elastice, cu sprijin mixt, fcndu-se comparaia ntre rezultatele statistice obinute. Rezultate i discuii: Atuul principal n protezarea elastic este rezolvarea acelor cazuri de edentaie unde ar necesar executarea de proteze scheletate, deci cu suport metalic. Aceste proteze termoplastice pot reparate, rebazate sau se pot aduga dini, ceea ce n cazul unei proteze scheletate este mult mai greu sau poate duce la compromiterea protezei. Pe scurt, avantajele acestor proteze termoplastice ar tocmai proprietile, confortul, caracteristicile, gradele de elasticitate i, nu n ultimul rnd, adaptarea pe cmpul protetic, aceasta desprinzndu-se din statisticile analizate. Concluzii: n urma cercetrii pe lot de pacieni bine denit i n urma analizrii rezultatelor obinute se desprind urmtoarele aspecte:
protezarea elastic superioar celei acrilice, n anumite cazuri i la anumite tipuri i grupuri de pacieni. se observ clar c viteza de vindecare crete la purttorii de proteze elastice. reactivitatea este mrit la pacienii protezai clasic acrilic. afeciunile mucoasei sunt mai dese la protezaii clasic modicrile structurale sunt mai rapide n timp la proteza elastic. Cuvinte cheie: statistici, reactivitate, protez elastic, afectare parodontal Statistical research ndings, obtained in the research of elastic partial dentures Flexible dentures, as a treatment method, offer advantages which have been frequently considered regarding total and partial prosthesis technology. We consider this to be a great advantage in exible partial denture treatment and a long-term prosthetic success. This study illustrates the comparison between an acrylic denture and statisticaly exible one. There were examined and compared 64 patients with partial edentulous. Introduction: Thermoplastic materials, constituting the elastic mobile works, are products that are approved for medical use. Dental prosthesis is a mechanical part that is inserted into a living organism which should be integrated throughout all dento-maxillary unit, integration being subject to the aesthetic and dynamic stabilization of the prosthesis. The siss purpose: The purpose of this thesis is to assess, by comparising, the reactivity of the elastic denture and the acrylic one, on a lot of partial edentulous patients, which are under prosthetic treatment and are chosen randomly. To achieve this purpose, it has been selected a group of edentulous patients with partial elastic prosthesis, and followed within three years of treatment, being separated from another group of patients, with other edentulous interventions on their partial dentures. Materials and methods: Number of patients included in the study about the inuence of elastic prosthesis on support tissues, respectively bonemucosa-paradontium, was sifted from a much larger number of patients with prosthesis. In this study we have applied modern methods of investigation being presented arguments to demonstrate, by comparising, the effect of elastic material used for different periods of time.
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Classic acrylic denture: The rst group was made of 58 patients, partially edentulous 31 males and 27 females on which classic acrylic prosthesis were made. Elastic denture: The second group, involving 64 patients 41 males and 23 females was made up of people which had elastic prosthesis applied, with mixed support, making the statistical comparison between the statistical obtained results. Results and discussions: The main advantage is the elastic prosthesis is solving those cases of edentulous where would be necessary to implement the skeletal prostheses, so with metal support. These thermoplastic prosthesis can be repaired, rebased or add teeth, which, in the case of skeletal prostheses, it is more difcult, or may compromise the prosthesis. Briey, these benets of this thermoplastic prosthesis, would be exactly their properties, the comfort, the features, degree of elasticity, and last but not least, the adaptation on the prosthetic eld, this proceeding from analyzed statistics. Conclusions: Following research on a well-dened group of patients and further analysis results, the following aspects appear: elastic prosthesis is superior to acrylic, in certain cases and certain types and groups of patients. it is clearly noticeable, that the speed of healing increases at the elastic prostheses users. reactivity is increased on patients with classic acrylic prosthesis. mucosal disorders are more frequent on classic prosthesis users. structural changes are faster, in time, on the elastic prosthesis. Key words: statistics, reactivity, elastic prothesis, periodontal disease ASPECTE PRACTICE PRIVIND NREGISTRRILE PIEZOGRAFICE N PROTEZAREA TOTAL MANDIBULAR Conf. Dr. L. Muntianu1, Prof. Dr. E. Hutu2, Conf. Dr. M. Burlibasa3, Dr. I. Creneac4, Asist. Univ. Dr. O. Andrei5 1,2 Catedra de Protezare Mobil, UMF Carol Davila, Bucureti 3 Catedra de Implantologie, UMF Carol Davila, Bucureti 4 Medic rezident anul II, Protetic Dentar, UMF Carol Davila, Bucureti, 5 Catedra de Protezare Mobil, UMF Carol Davila, Bucureti
Scop: mbuntirea stabilitii unei proteze mandibulare utliznd nregistrarea piezograc n situaia unui cmp protetic atroat sever Material i metod: A fost selectat un pacient edentat total bimaxilar, avnd un grad mare de dicultate n protezare datorit afectrii grave a condiiilor de echilibru prin atroa sever. Prin nregistrri piezograce se mbuntete stabilitatea protezelor noi ale pacientului, recomformndu-se relieful versatului vestibular i lingual al protezei mandibulare. Se poate folosi Aheseal verde sau orice material n stare plastic. Modelarea piezograc utilizeaz fonaia i deglutiia, la care am adugat i modelri funcionale. Rezultate i discuii: n urma nregistrrilor piezograce, utiliznd cear bucoplastic tip Adheseal verde, s-a obinut o mbuntire a stabilitii protezei mandibulare raportat de pacient chiar n timpul nregistrrilor. Metoda poate folosit ncepnd n faza de ablon, n cadrul nregistrrii zonei neutrale sau aplicat n faza de machet (cu baz din acrilat), pentru a modela versantul vestibular i lingual al viitoarei proteze, sau se poate folosi i la proteza la gata. mbuntirea stabilitii utilizeaz tonicitatea musculaturii de la periferia cmpului protetic. Concluzii: 1. Piezograa este o metod care poate aplicat n protezarea total convenional n cazul atroilor severe att mandibulare, ct i maxilare. 2. Este indicat, de asemenea, a utilizat n supraprotezrile totale pe implanturi 3. Este o metod uor de realizat i mpreun cu nregistrarea zonei neutrale n cazurile de atroe sever mandibular contribuie semnicativ la mbuntirea echilibrului protezei totale Practical aspects in total mandibular prostheses Aim: Enhancing mandibular denture stability by piezographic record, in a severe mandibular atrophy Material and method: a complete edentulous patient was selected, presenting a high degree of diculty treatment conditions due to severe mandibular atrophy.By piezographyc record of denture polished surface stability was improved, obtaining a recontured cameo surface.It was used green Adheseal or any material in plastic fase. The piezographic record uses phonetic modeling and funtional muscular modeling was aded. Results and discutions: piezographic record of cameo denture surface, produced an improvement
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of mandibular denture stability, reported by the patient durring the record. Piezographic record can be used with the occlusal rim base, or at the trial denture and also with the processed denture as well. Stability enhancement makes use of muscular tonicity. Conclusions: 1. Piezgrphy is a methos that can be used bimaxillary edentoulism, presenting severe atrophy 2. It is highly recomended in complete overdenture on implants 3. It is easy to realise and together with neutral zone record in severe atrophy, improves signicantly the equilibrum of complete denture Key words: piezograc record, severe atrophy, neutral zone, complete denture IMPORTANA RESTABILIRII CONTACTELOR DENTO-DENTARE FUNCIONALE PENTRU CALITATEA VIEII PREZENTARE DE CAZ Conf. Dr. Mariana Sabu, Dr. Mona Iona, Dr. Albertina Stnil Universitatea Lucian Blaga, Sibiu Introducere: Acest articol subliniaz importana restabilirii contactelor dento-dentare funcionale n cazul protezrii arcadelor dentare ale unui pacient, prin structuri protetice complexe mobile i mobilizabile. Integrarea pieselor protetice n sistemul stomatognat are rol primordial n exercitarea corect a funciilor aparatului dento-maxilar i deci n creterea calitii vieii pacienilor edentai total sau parial. Material i metod: Lucrarea de fa a fost elaborat cu scopul de a sublinia ideile de baz privind importana contactelor dento-dentare stabile asupra funcionalitii aparatului dento-maxilar. Pentru a sublinia aceste idei vom prezenta cazul clinic al unei paciente care a fost reabilitat oral prin realizarea unor piese protetice mobile i mobilizabile. Rezultate i discuii: Protezarea mobil i mobilizabil, restabilete contacte dento-dentare funcionale multiple. Prin acest tip de protezare, toate funciile aparatului dento-maxilar sunt restabilite integrnd astfel piesele protetice n sistemul stomatognat. Concluzii: 1. Dezechilibrele ocluzale determinate de protezri incorecte sau incomplete produc traumatisme articulare, cu dezechilibre la nivelul
aparatului dento-maxilar i al funciilor acestuia. 2. Prin acest tip de protezare (mobil i mobilizabil), toate funciile aparatului dento-maxilar sunt restabilite integrnd astfel piesele protetice n sistemul stomatognat. 3. Restabilirea contactelor dento-dentare funcionale prin protezare mbuntete calitatea vieii pacienilor. The signicance of dental-dental functional contacts and restore the quality of life Clinical case This article emphasizes the importance of functional dental restoration through dental contacts where a patients dental arch is restablished by complex prosthetic phones and movable structures. Stomatognathic system integration of prosthetic parts primordial serves the proper exercise of dento-maxillary functions and therefore quality of life in total or partially edentulous patients. Method and material: This work was developed in order to emphasize the basic ideas of the importance of steady contacts dento-dental-maxillary dento functionality. To emphasize these ideas we present the case of a patient who was rehabilitated by making oral prosthetic mobile and movable parts. Results and discussions: Prosthesis restores furniture and mobilize multi-functional dental contacts. With this type of prosthetic device all the functions are restored maxillary dental prosthetic parts thus integrating the stomatognathic system. Conclusions: 1. Occlusal imbalances caused by incorrect or incomplete prosthesis produce joint injuries, imbalances in the dento-maxillary functions. 2. With this type of prosthesis (furniture and mobilization) all functions are restored maxillary dento-prosthetic parts thus integrating the stomatognathic system. 3. Restoration of the functional tooth contacts dental prosthetics improves quality of life for patients. METODE IMAGISTICE COMBINATE PENTRU EVALUAREA FACIAL, A PROFILULUI, N REABILITAREA ORAL A EDENTATULUI TOTAL Asist. Univ. Dr. Marina Melecanu-Imre, Prof. Dr. Elena Preoteasa,
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Asist. Univ. Dr. Ana-Maria Tncu, Prof. Dr. Emilian Hutu Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti Scop: De-a lungul ultimelor decenii, etapele clinico-tehnice ale elaborrii protezei totale nu s-au schimbat foarte mult. Ceea ce s-a schimbat evident n terapia edentatului total sunt, pe de o parte, ateptrile pacientului, apariia unor noi alternative de tratament i, pe de alt parte, posibilitile tehnice de investigare, n special cele imagistice, de analiz i planicare ale planului de tratament. Pacientul poate benecia astfel de un rezultat predictibil i satisfctor att funcional, ct i estetic, att n protezarea convenional, ct i n supraprotezarea pe implanturi. Material i metod: Folosirea teleradiograei de prol n protetic pentru studiul prolului pacientului i montarea dinilor, pe lng regulile protezrii totale, n funcie de reperele osoase analizate i de cefalometrie cu evidenierea claselor scheletale. Tehnica digital de suprapunere a teleradiograei peste fotograe, cu conturarea prilor moi, pentru o vizualizare perfect a zonei de echilibru a montrii dinilor raportat la repere osoase i elemente ale conturului facial, cu implicaii majore n realizarea aa numitei estetici funcionale. Aceste tehnici pot folosite att ca elemente de diagnostic, ct i ca evaluare n tratament sau ca ghid chirurgical n terapia pe implanturi. Prezentarea unui program imagistic digital de evaluare estetic a edentatului total pornind de la fotograe, n vederea prognosticului terapiei prin protez total. Rezultate. Folosirea tehnicii teleradiograei de prol, a suprapunerii acesteia peste fotograa digital, obiectivizeaz montarea dinilor la proteza total convenional sau pe implanturi, raportat la reperele osoase i prile moi. Permite o form individualizat de montare comparabil cu cea a dentatului. Evidenierea unor structuri anatomice ce pot prognostica evoluia ulterioar a edentaiei. Concluzii. Restaurarea protetic morfo-funcional este dicil de multe ori din cauza interpretrii diferite a montrii dinilor sesizat de pacient fa de medic i tehnician, n multe situaii din cauza strii de senectute. Aceste evaluri imagistice permit obiectivizarea tratamentului, gsirea zonei de echilibru optime a montrii dinilor, posibilitatea transmiterii pacientului unui rezultat predictibil i satisfctor att estetic, ct i funcional.
AUGMENTAREA VERTICAL I ORIZONTAL A CRESTEI REZIDUALE Dr. Alexandru Burcea1, Dr. Horia Mihail Barbu2, Dr. Ane Marie Stancu2, Dr. Raluca Monica Comneanu2, Prof. Dr. Doina Lucia Ghergic2 1 Helpdent Clinic 2 Universitatea Titu Maiorescu, Bucureti Introducere: Oferta tridimensional redus a crestelor edentate poate ameliorat prin utilizarea tehnicilor de regenerare osoas ghidat, ce permit mbuntirea clasei osoase n vederea inserrii implanturilor dentare. Material i metod: n studiul nostru am realizat o augmentare a unei creste osoase decitare cu material de tip alogref, cu denumirea comercial Regenaform, asociat cu utilizarea PRF-ului (PlateletRich Fibrin) i a unei membrane neresorbabile de tip Cytoplast. PRF-ul este un concentrat de trombocite bogat n brin, utilizat pe scar larg pentru a accelera vindecarea esuturilor moi i dure. Alogrefa descris anterior a fost inserat la un pacient n vrst de 30 de ani, clinic sntos, cu un important defect osos rezultat n urma practicrii unei chistectomii la arcada maxilar. Rezultate: Tehnica descris aduce benecii inestimabile att pentru medicii dentiti, ct i pentru pacieni, ind exprimate prin creterea calitii actului medical, scurtarea timpului de refacere osoas, creterea calitii osului de neoformaie i pregtirea rapid i ecient a patului osos necesar implanturilor orale, scurtnd astfel practic timpul pe care pacientul era obligat s-l atepte din momentul diagnosticrii i pn n momentul cnd devine posesorul de drept al unui implant dentar (12-18 luni). Concluzii: Augmentarea vertical i orizontal a crestei edentate folosind materiale de adiie de tip alogref asociat cu utilizarea PRF-ului (PlateletRich Fibrin) i a unei membrane de tip Cytoplast duc la o vindecare rapid nainte de inserarea implanturilor dentare. Din punct de vedere histologic, perioada de vindecare ar putea redus la 4 luni, dar studiile pe scar larg sunt nc necesare pentru a valida aceste prime rezultate pozitive. n majoritatea cazurilor, eecul implantului se datoreaz caracteristicilor precare ale biomaterialelor de origine animal sau sintetic utilizate. Cuvinte cheie: alogref, regenerare osoas ghidat, Regenaform, Cytoplast, PRF.
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Vertical and horizontal ridge augmentation Introduction: Low tridimensional offer of edentulous ridge can be improved by using guided bone regeneration techniques, which can help us to improve bone class in order to incorporate dental implants. Material and method: In our study, we performed an augmentation of a decient bone crest with allograft material composed by Regenaform associated with PRFs (Platelets-Fibrin Rich) and an Cytoplast membrane. PRFs is a concentrated platelet-rich brin widely used to accelerate healing of soft and hard tissues. Allograft described above was inserted in a 30 years old patient, clinically healthy, with a major bone defect resulting from the practice of cystectomies the maxillary arch. Results: The described technique give invaluable benets for both dentists and patients as being expressed by increasing the quality of medical care, shortening bone recovery time, increased bone neoformation quality and rapid and efcient preparation of needed bed bone for oral implants, shortening the time in which the patient was obliged to wait from diagnosis to the time when it becomes legal owner of an dental implant (12-18 months). Conclusions: Vertical and horizontal augmentation of the edentulous ridge using allograft materials associated with the use of PRFs (Platelets-Fibrin Rich) and Cytoplast membranes give rapid healing before insertion of dental implants. From histologically examinations, the healing period could be reduced to four months, but extensive studies are still needed to validate these initial positive results. In most cases, implant failure is produced by poor characteristics of the animal or synthetic used biomaterials. Key words: allograft, guided bone regeneration, Regenaform, Cytoplast, PRF. VALOAREA MANAGERIAL A TRATAMENTULUI COMPLEX N CAZUL UNUI PACIENT CE PREZINT MAI MULTE TIPURI DE AFECTARE A PARODONIULUI MARGINAL PREZENTARE DE CAZ ef Lucr. Drd. Silviu Stnescu1, Prof. Dr. Horia Traian Dumitriu2, Membru Corespondent al Academiei de tiine Medicale, ef Lucr. Drd. Anca Iuliana Popescu1 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti
Scopul lucrrii: Managementul afeciunilor cavitii bucale este azi una dintre cele mai importante etape ale tratamentului stomatologic. n aceast lucrare v prezentm un caz clinic complex de gingivit hiperplazic asociat cu parodontita marginal cronic a adultului la care aplicarea acestui program de management a fost cheia succesului. Material i metod: Am planicat tratamentul, am avut de realizat tratamente parodontale, endodontice, protetice susinute de examene radiologice, histologice, dar i de consiliere psihologic a pacientului. Succesul unui astfel de tratament depinde i de meninerea rezultatelor prin dispensarizarea n timp a pacientului. Rezultate i discuii: n urma tratamentului s-au obinut: refacerea morfologic a arcadelor dentare, starea de sntate parodontal i refacerea semnicativ morfologic a parodoniului marginal, refacerea funciei masticatorii i refacerea estetic. Concluzii: ntr-un caz complex i dicil de tratat de afectare dento-parodontal, cu o important hiperplazie gingival, cu modicri estetice i funcionale am instituit un tratament modern, conform cerinelor actuale, prin igienizarea cavitii bucale, ndeprtarea lucrrilor protetice vechi, tratament medicamentos local i pe cale general i am obinut rezultate semnicative la un pacient echilibrat ocluzal i cu funciile masticatorii i estetice refcute n totalitate. Cuvinte cheie: gingivita hiperplazic, parodontita marginal cronic a adultului, tratament parodontal, protetic, ocluzie, management. Value management of complex treatment for a patient who has several types of the periodontal disease Case report Aim: The management of oral cavity affections represents one of the most important stage of the dental treatment. In this paper, we present you a complex clinical case, of a hyperplastic gingivitis in association with an adult chronic marginal periodontitis where the application of this management program was the key to success. Methods and materials: We have planned treatament, we have to achieve parodontal, endodontics, protetics treatments sustained by radiologic and hystologic examinations, but also sustained by psychological counseling of the patient. The success of such treatment depends on maintaing the results through time by calling back the patient every six month for check-out.
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Results: After the treatment there were obtained: morphological restoration of dental archways, periodontal health and morphological signicant restoration of the marginal supporting tissue of the tooth, restoration of the mastication function and the aesthetic restoration. Conclusions: In a complex and difcult case to treat of dento-parodontal affectation with an important gingival hyperplasia, with aesthetic and functional changes, we have instituted a modern treatment through cleaning the mouth, removal of the old prosthetic works, local and general medical treatment and we have obtained signicant results for a patient with balanced occlusion and with mastication and aesthetic functions that were fully restored. Key words: hyperplastic gingivitis, adult chronic marginal periodontitis, protetics, treatments, management. RESTAURRI ZIRCONIU-CERAMICE PE DINI I IMPLANTURI LA PACIENTUL CU AFECTARE PARODONTAL. CAZ CLINIC Conf. Dr. Simona Andreea Sandu Disciplina Protezare Parial Mobilizabil, U.M.F. ,,Carol Davila, Bucureti Parodontopatiile marginale au devenit o provocare pentru medici din punct de vedere al tratamentului i al reabilitrii protetice att cu lucrri pe dinii naturali, ct i cu lucrri pe implanturi. Reabilitarea estetic necesit adesea o abordare interdisciplinar pentru obinerea rezultatelor dorite. Cazul clinic prezentat este relevant prin restaurrile zirconiu ceramice realizate dup tratamentul parodontal la pacientul edentat parial. Particularitile cazului clinic sunt sintetizate n trei aspecte: 1. restaurarea coronar realizat dup intervenia chirurgical cu adiie, pentru eliminarea pungilor parodontale osoase; 2. restaurri coronare dup realizarea gingivectomiilor, pentru reducerea pungilor false, n scop estetic; 3. coroana individual pe implant. Pe parcursul a doi ani s-au vericat parametrii parodontali i estetici care au fost favorabili. Coroanele pe structur de zirconiu mbuntesc estetica, sunt funcionale i determin un rspuns bun biologic att pe dini, ct i pe implanturi. Cuvinte cheie: parodontopatie marginal, coroane zirconiu ceramice, implant
Zirconia ceramic restorations on teeth and implants in periodontally compromised patient. Clinical case Periodontitis renders a great challenge to clinicians with regard to treat ment and prosthodontic rehabilitation on teeth and implants. The aesthetic rehabilitation require a multidisciplinary approach to obtain ideal results. The clinical case is important because of zirconiu ceramic restorations made after periodontally treatment in partially edentulous patient. The peculiarity of this case are: 1. crown restoration made after grafting surgical procedures for remove periodontal socket; 2. crown restoration made after gingivectomy for false socket in aesthetic purpose; 3. single crown on implant. During two years of function, periodontal and aesthetic parameters have been checking, and were favorable. The zirconiu crowns improved aesthetic, function and established a good biological response on teeth and implants. Key words: periodontitis, zirconia ceramic crowns, implants RESTAURAREA MORFO-FUNCIONAL COMPLEX PRIN SUDAREA INTRAORAL A ELEMENTELOR DIN TITAN ef Lucr. Dr. Lzrescu Grigore, Asist. Univ. Drd. Andreea Mariana Bneanu, Drd. Diana Rdulescu Universitatea Titu Maiorescu, Bucureti Sudura intraoral a elementelor din titan constituie o metod complex, de actualitate, n cadrul tratamentului stomatologic. Aplicarea acestei metode permite creterea calitii interveniei stomatologice i totodat scderea numrului de edine necesare nalizrii tratamentului. Scopul lucrrii este de a prezenta caracteristicile i avantajele acestei metode de sudur intraoral a elementelor din titan. Material i metod: Pentru atingerea scopului propus sunt prezentate cazuri clinice n care s-a realizat o refacere morfo-funcional prin protezarea pe implanturi dentare din titan. Particularitile cazurilor constau n faptul c implanturile de titan inserate au fost solidarizate prin intermediul unor bare de titan care au fost sudate intraoral. Rezultate i discuii: Sudura intraoral a barei de titan la nivelul ecrui implant inserat faciliteaz obinerea unei construcii stabile, rezistente, care s
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susin ecient lucrrile protetice i s asigure o repartiie optim a forelor ocluzale asupra cmpului protetic. Concluzii: Realizarea acestei metode de sudur intraoral a elementelor din titan crete rata de succes a protezrii pe implanturi, scurteaz semnicativ durata tratamentului stomatologic i crete astfel calitatea actului medical. Cuvinte cheie: sudura intaoral, implanturi dentare, titan, protezare pe implanturi Complex morpho-functional restoration by welding of the elements titanium intraoral Summary: Intraoral welding of titanium components is a complex method within the dental treatment. Applying this method will increase the quality of dental surgery and also will required fewer sessions to complete treatment. The purpose of this paper is to present the features and advantages of this method of welding titanium intraoral items. Material and method to achieve the intended purposef, there are presented clinical cases of morpho-functional recovery achieved by a prosthesis made of titanium dental implants. Peculiarities of the cases consist in the fact that titanium implants inserted were secured through the titanium bar which was welded intraoral. Results and discussion: Intraoral welding of titanium rod at each implant delivers a stable construction, a durable prosthetic work which effectively support and ensure optimal distribution of occlusal forces on the prosthetic eld. Conclusions: The implementation of this method of welding titanium intraoral elements increase the success rate of prosthesis on implant, shortens the duration of dental treatment and increase the quality of medical care. Key words: intraoral welding, dental implants, titanium bar CIMENTAT SAU NURUBAT? Dr. Radu Baston1, Dr. Mihaela Gaspar2, Dr. Cristina Ilea-Peltecu1 1 Peltecu Medical SRL, Bucureti 2 Universitatea Titu Maiorescu, Bucureti Scopul lucrrii este de a prezenta metodele de xare intraoral ale reabilitrilor pe implanturi, de a compara avantajele i dezavantajele acestor metode i de a prezenta un ghid practic pentru alegerea celei mai potrivite metode de xare.
Materialul folosit sunt cazuri personale din perioada 1993-2011. Metoda: Conferina prezint cazuri tipice de edentaii tratate cu suprastructuri pe implanturi. Aproape ecare caz ilustreaz o alt situaie care a cerut o alt metod de xare a suprastructurii. Concluzii: Fiecare protocol de xare i are indicaiie, avantajele i dezavantajele sale: cimentarea provizorie sau semidenitiv face posibil n majoritatea cazurilor ndeprtarea ulterioar a suprastructurilor cimentarea denitiv neadeziv sau adeziv anuleaz aceast opiune. Trebuie folosit numai dup ce reabilitarea a funcionat intraoral corespunztor o perioad lung de timp. nurubarea permite oricnd ndeprtarea sigur a suprastructurilor i este metoda de elecie pentru zonele laterale ce suport presiuni masticatorii. Cemented versus Screw-retained Purpose. The aims of this lecture are: to present available options for linking implant-supported superstructures to the corresponding xtures. to compare the advantages and disadvantages of cemented versus screw-retained superstructures. to provide a clear-cut clinical guide for selecting the appropriate superstructure retention method. The materials used in this lecture are our implant-supported rehabilitation cases covering the period 1993-2011. Method: The presentation features typical implant-supported rehabilitation cases. Almost every case features a different situation which imposed a specic superstructure linking, e.g. inserting protocole. Conclusions: each superstructure insertion protocole has its indications, but its ups and downs as well: both temporary and semidenitive cementing protocoles enable in most of the cases later superstructure removal. both non-adhesive and adhesive denitive cementing methodes cancel this future removal option and should be used only after the superstucture has prooved its faultlessy intraoral function for a sufcient time. the screw-retained method stands for safe superstructure removal at any time. According to our opinion this is the method of choice for the lateral load-bearig area.
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VALOAREA DIAGNOSTIC A INVESTIGAIEI RADIOLOGICE N PATOLOGIA PERIAPICAL Asist. Univ. Dr. Irina-Maria Gheorghiu, Dr. Ruxandra Mrgrit, ef Lucr. Dr. Oana-Cella Andrei Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti Introducere: Radiograile reprezint un mare ajutor n endodonie, n mod deosebit n cazul parodontitelor apicale cronice. Material i metod de lucru: Scopul acestui studiu este de a aduce n discuie utilizarea, rolul, precum i importana examenului radiologic n cadrul ecrei etape a abordrii terapeutice a parodontitelor apicale cronice. n acest studiu prezentm un numr de cazuri clinice de parodontite apicale cronice extinse n care investigarea radiologic s-a realizat astfel: iniial, pentru a permite determinarea real a ntinderii leziunilor, precum i relaiile spaiale cu reperele anatomice. A doua investigare radiologic: n cursul tratamentului endodontic, i cea de-a treia investigare: pe parcursul perioadei de monitorizare. Rezultate i discuii: Examenul radiologic iniial: ofer relaii asupra formei, dimensiunii i structurii leziunii periapicale, precum i date legate de morfologia radicular (numrul rdcinilor, forma lor, angulaiile acestora etc.), tratamente endodontice anterioare i calitatea lor, ci false, implantarea dintelui. Examenul radiologic n timpul tratamentului: este util pentru a verica direcia de naintare cu acele pe canale, odontometrie i pentru aprecierea corectitudinii obturaiei de canal. Examenul radiologic pe parcursul perioadei de monitorizare: este esenial pentru aprecierea rezultatelor, prin evaluarea comparativ a aspectului leziunii periapicale. Concluzii: Informaia radiologic, dar i interpretarea sa corect ghideaz conduita terapeutic, mbuntind astfel ansele de vindecare. 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 nalizat.
Cuvinte cheie: parodontite apicale cronice, diagnostic radiologic, tratament endodontic conservator, monitorizare The diagnostic value of radiological investigation in periapical pathology Introduction: Radiographs are important aids in endodontics, especially in chronic apical periodontitis. Material and method: 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. In this study we present a number of clinical cases with extensive periapical lesions, in which the use of radiological exam was performed in three stages: initial radiographic examination, which allowed evaluation of the true extent of the lesion and its spatial relationship to anatomical landmarks. The second radiographic examination: during endodontic treatment and the third one: in the follow-up period. Results and discutions: Initial radiographic examination offers dates about the shape, dimension and structure of periapical lesions and also informations about the radicular morphology and previous endodontic treatments. The radiological investigation during endodontic treatment is mandatory to appreciate the working length and the correct endodontic nal seal. The nal radiological evaluations, on the follow-up period, are essential to estimate the resuls, by comparing the images of periapical area. Conclusions: Radiographic images provided specic information about the type of lesion ad the degreee of bone repair during the treatment and after the conservative endodontic treatment had been completed. The radiographic information and the correct interpretation guide the treatment and enhancing the relationship between pathology and healing. Key words: chronic apical periodontitis, radiological diagnosis, conservative endodontic treatment, follow-up
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REDUCEREA ETAPELOR DE TRATAMENT LA PACIENTUL EDENTAT TOTAL Conf. Dr. Elena Gabriela Despa1, Dr. Gabriela Moise2, Ddr. Cristina Mihai3, Prof. Dr. Cornelia Bcleanu1, ef Lucr. Dr. Laurenia Lelia Mihai1, Asist. Univ. Dr. Graziella Emilia Cndescu1 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Cabinet privat 3 Facultatea de Medicin Dentar, UMF Carol Davila, Bucureti Introducere: Pacienii edentai total prezint cele mai diversicate tablouri morfo-clinice, ceea ce constituie pentru muli medici dentiti factori deosebit de favorabili din punct de vedere al formrii i al dezvoltrii experienei profesionale. Rezolvarea cazurilor foarte complexe vor materializa capacitatea profesional pe care o posed la etapa respectiv. Metoda de reducere a etapelor de tratament a ncercat s mbunteasc ecacitatea tratamentului la aceti pacieni. Material i metod: Metoda de reducere a etapelor clinice de tratament a constat n eliminarea fazei de amprentare preliminare, adaptare a lingurii individuale, nu au fost necesare abloane de ocluzie. edinele de tratament au fost reduse la trei: n prima edin s-a amprentat funcional cu vechile proteze cmpurile protetice edentate total, au fost determinate i nregistrate relaiile intermaxilare, n a doua edin s-a efectuat proba machetelor, iar a treia edin a constat n aplicarea protezelor. Concluzii: 1. metoda se poate aplica la pacienii edentai total bimaxilar protezai ale cror proteze nu asigur meninere i stabilitate pe cmp; 2. protezele sunt cu o vechime de 3-5 ani, fr reparaii, iar relaiile ocluzale sunt pstrate; 3. aceast metod reduce timpul de lucru att pentru medicul dentist, ct i pentru pacieni, avnd n vedere vrsta acestora.
Reducing treatment stages of a total edentulous patient Introduction: Totally edentulous patients present the most varied morpho-clinical aspects. To many dentists these constitute extremely favourable factors from the professional experience formation and development point of view. Solving very complex cases shall show the professional ability that the dentist has achieved until that phase. The method of reducing the treatment phases has tried to improve the treatment efciency in these patients. Material and method: The method of reducing the clinical phases treatment consisted of eliminating the preliminary phase of taking impressions, adjusting the individual spoon and occlusal patterns which were not needed. The treatment sessions were reduced to three: during the rst appointment, from the totally edentulous elds were taken functional impressions with the old prosthesis and also were determined and recorded the intermaxillary relationships, during the second appointment the molds were tested and during the third appointment the prostheses were tted in. Conclusion: The method can be used in totally bimaxillary edentulous patients having prosthesis that do not insure maintenance and stability on the prosthetic eld. 3-5 year-old prosthesis can be maintained without repairs and occlusal relationships. This method reduces the working time both for the dentist and the patients, having in view their age. EVALUAREA SUPORTULUI MUCO-OSOS N VEDEREA REALIZRII SUPRASTRUCTURILOR DIN ZIRCONIU (STUDIU STATISTIC) ef Lucr. Dr. Lelia Laurenia Mihai1, Asist. Univ. Dr. Graziella Emilia Cndescu1, Drd. Dr. Mihai Cristina Nicoleta2, Conf. Dr. Elena Gabriela Despa1 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti
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Facultatea de Medicin Dentar, Universitatea Carol Davila, Bucureti Datorit caracteristicilor zico-chimice, zirconiul se situeaz ntre aluminiu i oelurile inoxidabile. Caracteristicele care l recomand s e indicat pentru realizarea implantelor sunt: structura polimorf rezultat prin adugarea hafniului i a itriului n procente de 0,5-15%, aceast structur i confer duritate i rezisten la deformarea plasto-elastic; de asemenea, prezint rezisten la fracturare cnd forele acioneaz perpendicular pe lungimea implantului; rezistena mecanic este determinat de structura microglobular care i confer i o duritate foarte mare; conductibilitatea la variaiile termice i electrice este foarte redus. Aceste caracteristici sunt foarte necesare, dar i corespunztoare pentru a suporta forele ocluzale transmise de protezele supraimplantare. Material i metod: Studiul pacienilor l-am efectuat pe o perioad de 4 ani (2006-2010) i a inclus iniial un numr de 292 de pacieni. Lotul a fost stabilit aleatoriu. Din lot au fost exclui un numr de 136 de pacieni datorit patologiei sistemice. Astfel, lotul studiat a cuprins un numr de 156 de pacieni, la care am stabilit statusul dentoparodontal. Fiecare pacient a fost evaluat din punct de vedere al: motivului prezentrii, antecedente patologice personale, statusului dento-parodontal, edentaiilor existente, numrul i poziia dinilor restani, existena sau nu a tratamentelor odontale (corecte/incorecte), suportului osos (evaluat clinic i imagistic). Preoperator am apreciat din punct de vedere cantitativ i calitativ oferta osoas pentru a ti ce tip de implant (lungime, diametru) este necesar. Totodat trebuie cunoscute i elementele anatomice din vecintatea zonei de inserare a implantului, elemente ce pot determina anumite procedee chirurgicale de mbuntire a suportului osos (augmentare osoas, lift sinus). Examinarea ofertei osoase a fost realizat din punct de vedere clinic i imagistic. Rezultate i dicuii: n ceea ce privete topograa i tipul de edentaie pentru care pacienii s-au prezentat la tratament implanto-protetic, pot arma: ntre 21-30 de ani, pacienii au prezentat mai frecvent edentaii laterale 11 pacieni, comparativ cu cele terminale 10 pacieni sau frontale 3 pacieni, mai frecvent la maxilar 16 pacieni dect la mandibul-8 pacieni; ntre 31-40 de ani, 25 de pacieni au prezentat edentaii la maxilar i 22 la mandibul, dintre care 13 pacieni prezentau edentaii mixte, 12 edentaii terminale i 22 laterale; ntre 41-50 de
ani, frecvena mare a edentaiilor au fost la maxilar 34 comparativ cu mandibula 39, din care 26 edentaii mixte, 6 edentaii frontale, 8 edentaii laterale i 33 edentaii terminale; ntre 51-69 de ani, au fost 7 cazuri la maxilar i 5 cazuri la mandibul, din care: 2 cazuri de edentaie terminal, 2 cazuri de edentaie lateral, 2 de edentaie frontal i 6 cazuri prezentau edentaii mixte. Igiena bucal decitar, reprezentnd o contraindicaie temporar a implantrii, are impact moderat doar la grupa de vrst de peste 51 de ani i poate corelat cu factorii culturali i socio-economici. Ca urmare a studiului lotului selectat, n ceea ce privete oferta osoas necesar implantrii, am constatat: atroa crestei edentate era mai frecvent n edentaii terminale, necesitnd augumentri osoase (datorit vechimii edentaiei); oferta osoas era decitar la pacienii cu vrsta cuprins ntre 51-69 de ani; din punct de vedere imagistic, n 21,83% dintre cazuri oferta osoas era redus la maxilar, iar la mandibul n 17,9% dintre cazuri. Evaluation of muco-osseous support for the achievement of the zirconium superstructures (statistical study) Zirconium due to physico-chemical characteristics it is rank between aluminum and stainless steel. Its characteristics it recommended to be suitable for achieving the implants.These features are polymorphic structure resulting by adding a percentage of 0.5 to 15% of Itriu and Hafniu; this structure gives it strength and resistance to plasto-elastic deformation; also it has a resistance to fracture when the forces are acting perpendicular to the length of the implant; the mechanical strength is determined by the structure micro-globular giving a very high hardness; conductivity of thermal and electrical of variation is very low. These features, characteristics are very necessary and appropriate to support occlusal forces transmitted by over-implants dentures. Materials and methods: We performed and conducted this patients study over a period of four years (2006-2010) and originally study, at the beginning, included a total of 292 patients. The group was determined randomly. From this group were excluded a number of 136 patients due to systemic pathology. Hereby this study group comprised 156 patients, whom we determined the dento-periodontal status. Each patient was evaluated in terms of: presenting complaint, history of personal pathology, dental
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and periodontal status, existing toothless, number and position of remaining teeth, dental treatment whether or not (correct/incorrect), bone support (assessed clinically and imaging). Preoperatively we assess and found in terms of quantity and quality of supplied bone to know what type of implant (length, diameter) is required. Also must be known the anatomical elements of anatomical proximity of the implant insertion area, that may cause certain surgical procedures to improve support bone (bone augmentation, sinus lift). Examination of the bone tender was made in terms of clinical and imaging. Results and discussions: Regarding to topography and type of edentulous for wich patients were submitted to implanto-prosthetic treatment, we can assert that: between 21-30 years, patients had more frequent a posterior edentulous side 11 patients, compared with those with terminal edentulous area 10 patients or front edentulous area 3 patients, more frequently in the upper jaw (maxilary) 16 patients, than mandibular 8 patients, between 31 40 years, 25 patients had the edentulous area in the maxilla and 22 to the mandible, in which 13 patients had mixed edentulous areas, 12 terminal edentulous areas and 22 posterior edentulous side; between 41-50 years, high frequency of edentulous areas were to upper jaw 34 compared to the mandible-39, of which 26 mixed edentulous areas, 6 front edentulous areas, side and 33 terminal edentulous sides; between 51-69 years were 7 cases in the maxilla and 5 cases in the mandible, of which 2 terminally edentulous cases, 2 cases of posterior edentulous side, 2 front edentulous areas and 6 cases had mixed edentulous areas. Poor oral hygiene, representing a temporary contraindication to implantoprosthetic treatment, has only moderate impact in the age group over 51 years and may be correlated with cultural and socio-economic factors. As a result of the selected study group, regarding bone supply necessary for implant prosthetic treatment we found that: the atrophy of edentulous ridge was more common in terminal edentulous areas, requiring bone augmentation (due to the age of edentulous side); bone offer was decient in patients with ages between 51-69 years old, in terms of imaging, in 21.83% of cases the bone offer was reduced to the upper jaw and at the mandible in 17.9% of cases. EFICACITATEA STRUCTURILOR DIN ZIRCONIU ef Lucr. Dr. Lelia Laurenia Mihai1, Asist. Univ. Dr. Graziella Emilia Cndescu1, Drd. Dr. Mihai Cristina Nicoleta2, Conf. Dr. Elena Gabriela Despa1
Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Facultatea de Medicin Dentar, Universitatea Carol Davila, Bucureti
1
Pentru a demonstra eciena suprastructurilor din zirconiu, am realizat un studiu in vitro cu o durat de 2 ani (2007-2009); testarea rezistenei la fracturare a coroanelor din ceramic a fost structurat n 5 pri. Experimentul a fost realizat n colaborare cu Institutul Politehnic din Bucureti. Material i metod: Testarea rezistenei la fracturare a coroanelor din ceramic clasic a utilizat 40 de dreptunghiuri din ceramic cu dimensiuni standard de: lungime=15,3 mm, lime=3,2 mm i grosime=1,7 mm. Studiul a fost efectuat in vitro. Testarea rezistenei la fracturare a coroanelor din alumin In Ceram a utilizat 18 dini ce erau pregtii pentru acoperire cu o coroan fabricat din alumin In Ceram. 9 bonturi au fost preparate cu prag n unghi de 90, iar 9 cu prag chamfers la 120. Pe bonturi au fost cimentate coroanele cu ciment fosfat de zinc, iar suprafaa de seciune a rdcinii a fost acoperit cu un lac antialunecare, simulnd un ligament parodontal. n nal, dinii au fost stabilizai n blocuri acrilice folosind modele de gips. Compararea rezistenei la fracturare a coroanei din alumin i zirconiu a fost realizat pe un numr de 60 de coroane fabricate astfel: 30 identice din alumin i 30 identice din zirconiu, iar pentru placare s-a folosit ceramica compatibil. Fiecare lot de 30 de coroane a fost mprit la rndul su n cte 3 grupe de 10 coroane. Testarea rezistenei la fracturare a coroanelor obinute prin tehnica CAD CAM a utilizat un numr de 18 pacieni, nou brbai i nou femei. Lucrrile protetice nlocuiau cel mult doi dini lips, n total ind 26 de dini lips. Testarea rezistenei la fracturare a coroanelor din ceramic aplicate pe dini versus cele aplicate pe implanturi dentare a utlizat dou bonturi de implant din titan, unul pentru premolar superior i altul pentru molar superior. Scannd cele dou bonturi i folosind tehnica CAD CAM, am realizat 24 de coroane din alumin i 24 din zirconiu. Apoi cele dou grupuri de cte 24 de coroane au fost mprite n cte dou loturi de 12; astfel, 12 pentru a susinute de implanturi i 12 pe dini. Rezultate i discuii: n prima parte a studiului, rezistena la fracturare a artat c, expunerea la saliv a unei coroane din ceramic nainte de glazurare scade rezistena acesteia.
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n partea a doua a studiului, coroanele au fost gsite funcionale ntre 6 i 12 luni, dar la 24 de luni o coroan s-a fracturat. n a treia parte a studiului au aprut dou tipuri de fracturi: total, n smal i dentin; parial, numai n smal. toate structurile protetice utilizate la cei 18 pacieni nu au avut nici o modicare la 12 luni de la cimentare. La 2 ani de la cimentare, au aprut casri minore, 89% dintre pacieni ind mulumii de structurile protetice. n acest studiu, structurile protetice aplicate pe implant au rezistat la 60% ncrcrii fa de cele aplicate pe dini. Rezultatul a fost semnicativ la nivelul p=0,003. Toate fracturile au fost fracturi totale care au aprut n zona corpului de punte, la unirea cu elementul de agregare. Concluzii: Zirconiul este de 3 ori mai rezistent i mai dur dect alumina. Rezistena la fracturare a aluminei este de aproximativ 400 MPa, iar duritatea la fracturare de 3 MPa. Astfel, valorile care corespund zirconiului sunt de 1200 MPa i respectiv 9 MPa, care sunt net superioare aluminei. Rezultatele studiului sunt pe o perioad de 2 ani. Putem spune c rata de succes este de 100%. Expunerea pe termen scurt la saliv, nainte de ultima ardere, poate avea un efect negativ asupra rezistenei ceramicii dentare. Toate coroanele ar trebui cimentate pe preparaii cu prag, pentru a rezista la ncrcarea extins ori de cte ori acest lucru este posibil. Effective structure of zirconia To demonstrate the effectiveness of the prosthetic over-structure from zirconium, we conducted an in vitro study that lasted about 2 years (20072009), testing the fracture resistance of ceramic crowns was divided into ve parts. The experiment was conducted in collaboration with the Polytechnic Institute of Bucharest. Material and methods: Testing for resistance to fracture of classic ceramic crowns using 40 rectangles classic ceramic standard size: length = 15.3 mm, width = 3.2 mm and thickness = 1.7 mm The study was conducted in vitro. Testing fracture resistance of alumina In Ceram crowns used 18 teeth that were prepared for coating with a crown made of alumina In Ceram as prosthetic over structure. 9 abutments were prepared with the threshold angle of 90 and 9 with the chamfers threshold at 120. The crowns were cemented over
abutments with zinc phosphate cement and the section surface of the root was covered with a slip lake, simulating a periodontal ligament. Finally the teeth were stabilized with acrylic blocks using plaster models. Comparison of fracture resistance of alumina and zirconia crown was made on a total of 60 crowns made as follows: 30 identical from alumina and 30 identical from zirconia and compatible ceramic was used for plating. Each group of 30 crowns in turn was divided into three groups of 10 crowns (each). Testing for resistance to fracture of crowns obtained by CAD CAM technique used a number of 18 patients, nine men and nine women. Prosthetic restoration replacing more than two teeth missing, a total of 26 teeth were missing. Testing for resistance to fracture of ceramic crowns as prosthetic over-structure applied on teeth versus those applied to implants used two titanium implant abutments, one for upper bicuspid and one for the upper molar. Scanning th e two abutments and using CAD CAM technology, we achieved 24 alumina crowns and 24 of zirconia crowns. Then the two groups of 24 crowns were divided into two groups of 12; so 12 to be supported by implants and 12 by teeth. Results and discussion: the rst part of the study, resistance to fracture showed that exposure to saliva of a ceramic crowns before varnishing, glazing ceramic crowns its resistance decreases. In the second part of the study, the crowns were found functional between 6 and 12 months; but to 24 months a crown was fractured. In the third part of the study were two types of fractures: a total fracture, in enamel and dentin; partially fracture, only in enamel. all prosthetic structures that were used of the 18 patients had no change at 12 months after cementation. At 2 years after cementing, disposal appeared were minor, 89% of patients being satised with prosthetic structures. In this study, the prosthetic structures applied on implants have withstood at 60% loading compared with those applied to the teeth. The result was signicant at level p = 0.003. All fractures were total fractures that occurred in the deck area of the body, at the union with the element of aggregation. Conclusions: Zirconium is 3 times stronger and tougher than alumina. Fracture resistance of alumina is about 400 MPa and fracture toughness of 3 MPa. Thus, zirconium corresponding values are
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1200 MPa and 9 MPa respectively, which are superior to alumina. The results are for a period of two years, we can say that the success rate is 100%. Short-term exposure to saliva, before the last ring, may have a negative effect on the strength of dental ceramics. All crowns should be cemented on the processing facilitie with threshold to withstand extended load whenever possible. CAZURI CLINICE ALE ERUPIEI NTRZIATE DE CAUZE LOCALE LA DINII PERMANENI ef Lucr. Dr. Ane-Marie Stancu1, Dr. Rzvan Stancu1, Asist. Univ. Dr. Dona Rdulescu Iordan2, ef Lucr. Dr. Dnu Chiru1 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Medic primar Rezumat: n aceast lucrare autorii vor s ilustreze prin cteva cazuri clinice, cteva dintre cauzele locale ale erupiei ntrziate ale dinilor permaneni, cum ar : prezena obstacolelor pe traseul eruptiv, persistent dinilor temporari peste limita normal de exfoliere, organizarea unui capac osteobros supraiacent dintelui succesional, consecutive pierderii dintelui temporar corespunztor cu mai mult de 2-3 ani naintea momentului normal de exfoliere, poziii anormale ale germenilor dinilor permaneni. Aceste situaii se identifc n urma examenului clinic la care se observ e absena dintelui permanent, e persisten pe arcad peste limita normal a dintelui temporar. Examenul radiologic vine s conrme i s stabileasc cauza ntrzierii acestor dini permaneni. n concluzie, autorii subliniaz obligativitatea controalelor clinice i radiologice periodice pentru depistarea acestor cazuri i rezolvarea lor astfel nct acestea s nu conduc n nal la tulburri mai grave de dezvoltare dento-maxilar, cu repercursiuni severe asupra ocluziei dentare. Cuvinte cheie: erupie ntrziat a dinilor permaneni, cauze locale, examen clinic i radiologic periodic Clinical cases of delayed eruption of permanent teeth causes local In this paper the authors want to illustrate by some clinical cases, some of local causes of delayed eruption of permanent teeth, such as: obstacles in the route of eruption, persistence of temporary teeth above normal exfoliation, organizing a osteobros cover overlying the succesional tooth consecutive of temporary tooth loss in a row corresponding to
more than 2-3 years before the normal time of exfoliation, abnormal position of permanent tooth germ. These statements are identied by clinical examination which note the absence of permanent tooth or persistent temporary tooth on the arch above normal exfoliation. Radiologic examination conrm and establish the fault of delay of these permanent teeth. In conclusion, the authors emphasize the obligation of regular clinical and radiological controls to detect these cases and treat them so ultimately does not result more severe disorders in dentomaxilary develop with repercussions on occlusion. Key words: delayed eruption of permanent teeth, local causes, regular clinical and radiological examination. REZULTATE N TERAPIA STOMATITEI AFTOASE CU LASER-TERAPIE SOFT Conf. Dr. Anamaria Bechir1, Prof. Dr. Doina Lucia Ghergic1, Student Edwin Sever Bechir2, ef Lucr. Drd. Dr. Raluca Monica Comneanu1, Dr. Cristina Balan3 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Facultatea de Medicin Dentar, Universitatea Ovidius, Constana 3 Medic dentist i Tehnician dentar, Bucureti Terapia laser-soft se bazeaz pe utilizarea terapiei laser de nivel sczut (LLLT) n procesul de biostimulare celular. Laser-terapia soft utilizeaz o doz foarte mic de lumin coerent a laserului, care poate avea aciune de sterilizare, efect antialgic, efect antiinamator etc. Obiectivul acestui studiu clinic a fost cel de evaluare a efectului iradierii cu laser de nivele sczute, n terapia de vindecare a leziunilor provocate de stomatita aftoas. Material i metod: 44 de pacieni cu stomatit aftoas au fost mprii n dou grupe: primul grup de 22 de pacieni cu stomatit aftoas a fost tratat prin iradiere cu laser-soft, iar al doilea grup de 22 de pacienti a fost reprezentat de grupul martor, de control. Frecvena tratamentului a fost de o iradiere pe zi, timp de 3 zile consecutive. Prezena i gradul eritemului, al durerii i al tumefaciei au fost evaluate nainte i dup ecare sesiune de terapie lasersoft. Rezultate: Ameliorarea durerii, gradul eritemului i al tumefaciei n primul grup al pacienilor avnd stomatit aftoas tratat prin terapie lasersoft au fost semnicativ mbuntite ntr-o perioad
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mai scurt de timp, comparativ cu grupul martor al pacienilor. Concluzie: Laser-terapia soft poate un tratament adecvat pentru stomatita aftoas, care ar trebui s e considerat ca ind o metod terapeutic alternativ. Cuvinte cheie: Stomatit aftoas, LLLT, vindecare Results in the therapy of aphthous stomatitis with L.L.L.T. Softlaser therapy is based on the working principles of Low Level Laser Therapy (LLLT) in cellular biostimulation process. LLLT uses a very low dose of coherent laser light, which can have a sterilization action, antialgic effect, antiinammatory effect, etc. The objective of this clinical study was to evaluate the effect of irradiation with low-level laser in the healing therapy of the lesions caused by aphthous stomatitis. Material and method: 44 patients with aphthous stomatitis were divided in two groups: the rst group of 22 patients with aphthous ulcers was treated with LLLT, and the second group of 22 patients was represented by the witness control group. The frequency of treatment was one application per day, for 3 consecutive days. The presence and the degree of redness, of pain and of swelling were assessed before and after every session with low laser therapy. Results: The pain relief, the redness and the swelling in the rst group of patients with aphthous ulcers, treated with LLLT, were signicantly improved in a shorter period of time comparing to witness control group of patients. Conclusion: LLLT can be an appropriate treatment for aphthous ulcers and should be considered as an alternative treatment method. Keywords: aphthous stomatitis, LLLT, healing STUDIU PRIVIND EVALUAREA LA UN AN A LEZIUNILOR CERVICALE Prof. Dr. Cornelia Bcleanu, Asist. Univ. Ddr. Anamaria Florescu, Asist. Univ. Ddr. Andreea Tudose, Conf. Dr. Gabriela Despa, Asist. Univ. Dr. Bogdan Blaj Facultatea de Medicin i Medicin Dentar, UTM, Bucureti Scopul acestui studiu este de a demonstra eciena unor tehnici terapeutice utilizate pentru tratamentul defectelor dentare cervicale, e c sunt
leziuni carioase sau cu alt etiologie (leziuni necarioase tip, eroziune, abrazie dentar etc.). Material i metod: Studiul s-a realizat pe un lot de 44 de pacieni, dintre care 28 de femei i 16 brbai, cu vrste cuprinse ntre 18 i 70 de ani. Lotul s-a mprit n 3 grupe la care s-a realizat prepararea de caviti de cls a-V-a clasice, preparaii n vederea restaurrii cu materiale adezive i restaurri fr preparaii speciale. Restaurrile au fost fcute cu CIS (58 de restaurri), preparaia cavitii a constat n periaj profesional, cu compozit (32 de restaurri), iar preparaia cavitii a constat n periaj profesional i schiarea unor anuri de retenie n zonele mrginite de cement i cu amalgam (16 restaurri), cu preparaie clasic, cu respectarea timpilor operatori ai lui Black. Evaluarea s-a realizat prin monitorizare i control la 6 luni i 1 an prin metoda clinica Ryge-USPHS. Rezultate i discuii: La 6 luni scorul Ryge arta valori Alfa pentru calitatea suprafeei compozitului, adaptarea marginal, discoloraie la CIS i uzur la compozit i amalgam, iar la evaluarea dup un an valori Charlie la adaptare marginal a compozitului i amalgamului, discoloraie la compozit. Concluzii: Pentru reuita clinic a restaurrilor n zona cervical trebuie s se coreleze tipul de preparaie cu materialul folosit. A study on evaluation of one year old cervical lesions The aim of this study is to prove the efciency of some therapeutical techniques used in treatment of cervical dental defects, be they carious lesions or of a different etiology (erosion, abrasion, abfraction). Material and method: The study was performed on 44 patients, of which 28 women and 16 men, aged between 18 and 70 years old. Three groups were formed and the followiong procedures were done: preparation of classic Vth class cavities, preparations in view of restorations with adhesive materials and restorations without special preparations. Restorations were made with CIS (58 restorations), while preparation of the cavity consisted in professional brushing; with composite (32 restorations), while preparation of the cavity consisted in professional brushing and cutting out retention grooves in cement; and with silver alloy (16 restorations), with a classical preparation while respecting Blacks operational timers. Evaluation was done through surveying and controlling after 6 and 12 months through the clinical Ryge-USPHS method.
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Results and discusions: After 6 months, the Ryge score showed Alfa values for the quality of the composite surface, marginal adaptation and dioscoloration in the case of CIS and wear for the composite and silver alloy, while, after 12 months, Charlie values for marginal adaptation of the composite and silver alloy discoloration of the composite. Conclusions: For the restorations to be clinically successful in the cervical area, there has to be a correlation between the type of preparation and that of material employed. STUDIU ASUPRA FACTORILOR POSIBIL IMPLICAI N TRANSFORMAREA MALIGN A LEUCOPLAZIEI ORALE Asist. Univ. Dr. Ioanina Parlatescu1, Lector Dr. Lelia Mihai2, Dr. Carmen Gheorghe1, Prof. Dr. erban Tovaru1, Dr. Vanya Sivkova Nedelcu3 1 Facultatea de Medicin Dentar, Universitatea de Medicin i Farmacie Carol Davila, Bucureti 2 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 3 D.D.S., Velingrad, Bulgaria Introducere: Leucoplazia oral (LO) este o leziune premalign denit ca o leziune predominant alb a mucoasei bucale care nu poate ncadrat n orice alt leziune cunoscut. (T. Axll-1994, Uppsala). n cadrul LO se poate ntlni o gam larg de caractere histologice care variaz de la simpla hiperplazie, fr displazie, pn la carcinom invaziv. Material i metod: Pentru acest studiu retrospectiv au fost selectate 172 de foi de observaie cu diagnosticul clinic de LO consultai n cadrul serviciului de Patologie Oral, UMF Carol Davila, n perioada 2000-2010. S-au notat datele despre vrst, sex, obiceiurile legate de fumat i alcool, forma clinic a leziunilor, localizarea, ntinderea. Au fost prelevate 47 de biopsii urmate de examen histopatologic. Rezultate i discuii: n lotul selectat, 133 de pacieni (77,32%) erau fumtori, 26 nefumtori i 13 foti fumtori. Vrsta medie la fumtori 51.31 ani a fost mai redus dect la nefumtori 61.19 ani. Legat de localizarea leziunilor, la fumtori cel mai mult a fost afectat mucoasa jugal, urmat de procesul alveolar, localizarea multicentric i planeul oral. La nefumtori mucoasa jugal,
procesul alveolar i limba. Rezultatele histopatologice au evideniat la fumtori, carcinom oral n 2,25% dintre cazuri i displazie 4,51% dintre cazuri i la nefumtori carcinom 15,38% dintre cazuri i displazie n 3,84% dintre cazuri. Concluzii: Prezena fumatului inueneaz localizarea leziunilor leucoplazice orale. O inciden semnicativ mai mare de displazie i carcinom au fost gsite n grupul de nefumtori, precum au raportat studiile anterioare ceea ce ar putea sugera implicarea unor factori genetici n transfomarea malign a leucoplaziei orale. Study of possible factors involved in malignant transformation of oral leukoplakia Introduction: Oral leukoplakia (OL) is a premalignant lesion dened as a predominantly white lesion of the oral mucosa that can not be classied in any other known lesion (T. Axll 1994, Uppsala). A wide scale of histological characteristics can be seen within OL, ranging from simple hyperplasia without dysplasia, to invasive carcinoma. Material and method: For this retrospective study, we selected 172 charts with a clinical diagnosis of OL, from the Oral Medicine- Oral Pathology Department, Carol Davila University of Medicine during the period 2000-2010. Data concerning age, gender, smoking and alcohol habits, clinical form of injuries, location and extent were noted down. 47 biopsies were taken followed by histopathological examination. Results and discussions: In the selected group 133 patients (77.32%) were smokers, 26 non-smokers and 13 former smokers. The average age of smokers was 51.31 years lower than non-smokers 61.19 years. Regarding the location of the lesions, in smokers the most frequently affected was the buccal mucosa, followed by the alveolar ridge localization, multicentric locations and oor of the mouth. In non-smokers buccal mucosa, alveolar process and tongue. Histopathological results showed in smokers, oral carcinoma in 2.25% of cases and dysplasia in 4.51% of cases and in nonsmokers: carcinoma in 15.38% of cases and dysplasia in 3.84% of cases. Conclusions: The presence smoking inuences location of OL. As previous studies reported, a signicantly higher incidence of dysplasia and carcinoma were found in the smoking group compared to nonsmokers, which could suggest involvement of genetic factors in malignant transformation of OL.
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ASPECTE COMPARATIVE N REALIZAREA SPRIJINULUI DENTO-PARODONTAL AL PROTEZELOR SCHELETATE CROETE VERSUS SISTEME SPECIALE ef Lucr. Dr. Oana-Cella Andrei, Asist. Univ. Dr. Alexandru Titus Farcaiu, Prof. Dr. Emilian Hutu Catedra de Protetic Mobil, Disciplina de Protezare Parial Mobilizabil, UMF Carol Davila, Bucureti Obiective: Protezele pariale sunt supuse multor fore, cum ar cele de masticaie (verticale i laterale), de desprindere (alimente lipicioase) precum i aciunii limbii, buzelor i obrajilor. nelegerea fundamental a proiectrii protezelor pariale presupune o nelegere solid a unor simple principii mecanice. Material i metod: Pentru a putea realiza un proiect de protez funcional i corect medicul trebuie s neleag noiuni de baz din zic despre distribuia sarcinilor (pentru a realiza un bun sprijin pe dini i esuturi) i prghii. Muli medici las din acest motiv proiectarea protezei pe seama laboratorului sau realizeaz un proiect oarecare care nu va rspunde nevoilor ziologice ale pacientului. Rezultatul este c, n loc s se obin un aparat care s completeze esuturile orale i mecanismul masticator, i se livreaz pacientului o protez care accelereaz degradarea i distrugerea esuturilor orale. Rezultate: Exist diferene notabile n transmiterea presiunilor la suportul dento-parodontal ntre o PPS cu croete i o alta cu sisteme speciale. Concluzii: n acest articol este descris transmiterea presiunilor ctre suportul dento-parodontal, comparnd o protez parial scheletat cu croete cu una cu sisteme speciale. Cuvinte cheie: protez parial scheletat, sprijin dento-parodontal, distribuia sarcinilor Comparative aspects of dento-periodontal support in the implementation of skeletal prostheses Objectives: Partial dentures are subject to many forces, such as chewing (vertical and lateral), lifting (sticky foods) and actions of the tongue, lips and cheeks. For a good and functional design of the denture, the dentist must understand essential physics involved in the distribution of loads (for a good tooth and tissue support) and levers. Material and methods: Fundamental to understanding partial denture design is a solid grasp of simple mechanical principles. For that reason, a lot
of dentists leave the design to their laboratory or make a design that will not take into consideration the physiological needs of the patient. The result is, rather than providing an appliance which compliments the oral tissues and masticatory mechanism, the patient is given a prosthesis which accelerates the degradation and destruction of the oral tissues. Results: There are important differences between tooth support in a RPD with clasps and one with attachments. Conclusions: This article describes the load distribution to the tooth supported saddles, comparing the clasp designed RPD with the attachment designed one. Key words: removable partial denture, tooth support, load distribution STUDIU PRIVIND INCIDENA PROCESELOR CARIOASE SIMPLE I COMPLICATE LA UN LOT DE COPII Dr. Elena David, ef Lucr. Dr. Ane Marie Stancu, Asist. Univ. Dr. Andreea Iordan Dumitru, Asist. Univ. Dr. Raluca Monica Comneanu Universitatea Titu Maiorescu, Bucureti Introducere: Caria dentar simpl i complicat din dentiia temporar i mixt reprezint afeciuni ntlnite n mod frecvent la pacientul copil. Material i metod: Studiul nostru a fost realizat pe un lot de 54 de copii, cu vrste cuprinse ntre 4 i 13 ani, care s-au adresat cabinetelor de pedodonie din cadrul Facultii de Medicin i Medicin Dentar a Universitii Titu Maiorescu din Bucureti, n periada 11 octombrie 2010 1 aprilie 2011. Rezultate: La grupa de vrst 4-8 ani am ntlnit 13 pacieni de sex feminin i 9 de sex masculin, iar la grupa de vrst 9-13 ani numrul majoritar al pacienilor a fost reprezentat tot de fete (21 de fete fa de 11 biei). n dentiia temporar am depistat un numr de 11 procese carioase simple i 86 de procese carioase complicate. n ceea ce privete dentiia denitiv, raportul s-a schimbat, n sensul diagnosticrii a 30 de procese carioase simple i 12 complicate. Concluzii: La lotul studiat am constatat c procesele carioase simple sunt mai frecvent ntlnite n dentiia denitiv, iar procesele carioase complicate au o inciden mai mare n dentiia mixt. Procesele carioase simple sunt mai greu de surprins n dentiia temporar din cauza grosimii reduse a straturilor de dentin i smal, care sunt mai rapid afectate. Caria
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dentar are astfel o propagare mai rapid ctre pulpa dentar cu afectarea ei consecutiv. Cuvinte cheie: carie simpl, carie complicat, dentiie temporar, dentiie mixt. Study about the incidence of simple and complicated decay in a group of children Introduction: Simple and complicated decay in temporary and mixed dentition are disorders frequently encountered in child patient. Materials and methods: Our study was conducted on a group of 54 children aged between 4 and 13 who were sent to the pedodontic ofces of Faculty of Medicine and Dentistry, Titu Maiorescu University of Bucharest between October 11, 2010 April 1, 2011. Results: At 4-8 years age group we have met 13 female patients and 9 male patients and the 9-13 years age group the number of patients was mostly accounted for all the girls (21 girls against 11 boys). In the temporary dentition we detected a total of 11 simple decays and 86 complicated decays. Regarding permanent dentition, the ratio has changed: 30 simple decays and 12 complicated decays. Conclusions: In our study we found that simple decay are more common in permanent dentition and complicated decay have a higher incidence in mixed dentition. Simple decays are more difcult to diagnose in temporary dentition because of the thinness of layers of dentin and enamel, which are rapidly affected. Dental decay is spreading quicker in dental pulp with its consequent damage. Key words: simple decay, complicated decay, temporary dentition, mixed dentition. PLANIFICAREA REABILITRII ORALE NTR-UN CAZ COMPLEX UTILIZND SOFT-UL SIMPLANT ef Lucr. Dr. Horia Mihail Barbu, Asist. Univ. Dr. Raluca Monica Comneanu, Dr. Drd. Alexandru Burcea, Prep. Univ. Dr. Cristina Hineal, Asist. Univ. Dr. Oana Smtrea, Prof. Dr. Doina Lucia Ghergic Universitatea Titu Maiorescu, Bucureti Introducere: Spre deosebire de mandibul, ncrcarea imediat la nivel maxilar este posibil ntr-un numr redus de cazuri din cauza densitii mai reduse a osului de la acest nivel, care de multe ori necesit o perioad mai mare de timp pentru integrarea implanturilor. Tendina actual este de a realiza pe ct posibil ncrcarea imediat, astfel nct vindecarea s e accelerat ca urmare a
stimurii depunerii osului de neoformaie sub presiunea forelor masticatorii. Material i metod: SimPlant este cel mai performant soft la ora actual pe plan mondial dedicat planicrii detaliate a tratamentelor implanto-protetice. Programul permite analiza rezultatelor obinute n urma tomograei dentare tridimensionale, simularea inserrii implanturilor, dar i etapizarea terapiei protetice. Cazul tratat de noi este al unui pacient n vrst de 55 ani, cu osteoporoz de inactivitate, care a beneciat de realizarea unei ncrcri imediate provizorii la nivel maxilar, pe care pacientul o va purta timp de 8 luni. Rezultate i discuii: Densitatea osului de neoformaie obinut prin grefare ne-a permis planicarea inserrii unui numr de 10 implanturi la arcada maxilar, dintre care 4 n regiunea anterioar i 6 n regiunea sinusului maxilar (n poziiile 17-16-1513-12 i 22-23-25-26-27). Implanturile alese aveau un diametru de 3,75 mm; opt dintre acestea aveau lungimea de 13 mm i dou de 16 mm lungime (23 i 26). Osteoporoza de inactivitate a modicat planul de tratament n sensul inserrii unui numr mai mare de implanturi dentare i n sensul prelungirii duratei estimate pentru vindecare. Concluzii: Utilizarea programului SimPlant n planicarea tratamentului implanto-protetic permite scurtarea duratei de tratament, reducerea numrului de edine, restabilirea rapid a funciilor ADM i nu n ultimul rnd ofer pacientului posibilitatea reintegrrii rapide n societate Cuvinte cheie: sinus lifting, implant dentar, ncrcare imediat, SimPlant. Planning oral rehabilitation in a complex case using SimPlant software Introduction: Unlike the mandible, immediate loading of the jaw is possible in a reduced number of cases due to the lower bone density at this level, which often requires a longer period of time for implants integration. The current trend is to make possible the immediate loading, so that healing is accelerated as a result of stimulation of depositing new formed bone under masticatory forces pressure. Materials and methods: SimPlan is the most powerful software in the world today, dedicated to detailed prosthetic implants treatment planning. The program allows for the analysis of results obtained from three-dimensional dental tomography, implant insertion simulation, but also for creation of prosthetic treatment stages. Our case is a 55 years old patient, with osteoporosis of inactivity,
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who beneted from temporary immediate loading of the jaw, a provisional bridge that the patient will carry for 8 months. Results and discussion: The density of new formed bone obtained through grafting allowed us to plan for the insertion of 10 implants in the maxillary arch, 4 of which in the anterior maxillary and 6 in the sinus region (positions 17-16-15-13-12 and 22-23-25-26-27).We choose 3.75 mm diameter implants, eight of which were 13 mm long and two 16 mm long (23 and 26). Inactivity osteoporosis changed the treatment plan through insertion of a greater number of dental implants and by prolonging the estimated healing duration. Conclusions: Using SimPlant software in implanto-prosthetic treatment planning allows for shorter treatment duration, fewer treatment sessions, a quick restoration of dento-maxillary functions, and not least providing the patient a chance for rapid reintegration into society. Key words: sinus lifting, dental implant, immediate loading, SimPlant. FRECVENA TRATAMENTELOR PREPROTETICE N EDENTAIA TOTAL Asist. Univ. Dr. Graziella Emilia Cndescu1, Conf. Dr. Elena Gabriela Despa1, Dr. Gabriela Moise2, Dr. Drd. Cristina Mihai3, ef Lucr. Dr. Laurenia Lelia Mihai1 1 Facultatea de Medicin i Medicin Dentar, Universitatea Titu Maiorescu, Bucureti 2 Medic dentist cabinet privat 3 Facultatea de Medicin Dentar, Universitatea Carol Davila, Bucureti Introducere: Pentru creterea calitii protezrii (sprijin, meninere, stabilitate, funcionalitate), dar i a calitii esuturilor de suport i a celor din periferie, se impun de multe ori i n protezarea total intervenii chirurgicale cu caracter pre i proprotetic. n edentaia total e indispensabil cunoaterea relaiilor anatomice ce vor stabilite de viitoarea protez total, precum i a condiiilor de sprijin i echilibru (meninere i stabilitate) i de funcionalitate (zionomie, masticaie, fonaie) oferite pentru viitoarele proteze totale. Din analiza acestor condiii ce se impun n protezare, ori de cte ori apare posibilitatea de mbuntire a calitii protezrii prin meninerea strii de sntate a esuturilor de suport i din periferie, prin creterea echilibrului i a calitilor funcionale ale protezelor, se impune luarea n primul rnd a acelor msuri
chirurgicale cu caracter pre- i proprotetic i ulterior instituirea tratamentului protetic. Material i metod: Crearea celor mai bune condiii pentru realizarea i funcionarea protezelor totale este legat n mare parte de pregtirea protezrii, printr-un tratament corect pre i proprotetic ce se impune n multe dintre situaiile clinice. O evaluare clinic corect a esuturilor de suport, a celor periprotetice i a relaiilor intermaxilare(RIM) trebuie realizat nainte de orice tratament prin proteze totale pentru adoptarea celor mai potrivite atitudini terapeutice. Pregtirea n vederea protezrii totale trebuie s e complex ncepnd cu o pregtire a pacientului privind protezarea i continund cu intervenii asupra esuturilor de suport, periprotetice i a RIM. Modalitatea de rezolvare este de cele mai multe ori e pe cale chirurgical, e pe cale protetic. Cele mai frecvente intervenii chirurgicale pe dini, n cazul edentaiei totale sau n iminena de a deveni edentat total, sunt cele de extracie a unor dini irecuperabili, a celor inclui (mai ales a celor care au dat accidente de erupie sau care sunt superciali, ntr-o poziie de erupie posibil sub presiunea protezei. Intervenii chirurgicale pe os: Aa cum tim, cnd extracia dinilor nu a fost realizat cu destul profesionalism, post extracional pot rmne zone proeminente sensibile la presiune, ce impun o corectare proprotetic, pentru a mbunti sprijinul viitoarei proteze. Intervenii chirurgicale pe mucoas: n urma pierderii dinilor, la nivelul mucoasei pot aprea o serie de modicri legate e de cauza edentaiei, e datorit unei relaii greite a protezelor ca baze, dar mai ales ca relaii ocluzale. Modicrile pot prezente e la nivelul mucoasei xe, e la nivelul mucoasei pasiv-mobile sau mobile. Ca urmare a defeciunilor prezente la protezele vechi, la nivelul mucoasei xe s-a constat o cretere a rezilienei mucoasei maxilare i o tendin la hiperplazie prezent i la nivelul fundului de sac vestibular. Rezultate i discuii: Interveniile pre i proprotetice n edentaia total se realizeaz mai ales pe cale chirurgical sau protetic. Interveniile pot de la simple la complicate, n funcie de situaia clinic, dotare, experien, respectiv de la corectarea unor exostoze i extracia unor dini irecuperabili la implanturi i adncirea fundurilor de sac prin mutarea inseriilor musculare i de la pstrarea unor dini sub proteza cu obturaii, la aplicarea de capse, telescoape, magnei, sisteme de bare. Indiferent de amploarea interveniei pre sau proprotetice nimic nu scutete practicianul de
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respectarea tuturor normelor ce se impun ntr-o protezare total corect. Frequency preprosthetic treatments in total edentulous Introduction: To increase the quality of complete denture (support, maintenance, stability, functionality) but also the quality of support tissues and those from the periphery, often in making complete denture, are required surgical intervention which has a pre and pro prosthetic character. In a total edentalous case treatment, there are essential knowledge about anatomical relationship that will be established by future complete denture; and also will be determined the conditions of support and balance (retention and stability) and terms of function (physiognomy, mastication, phonation) offered for future complete denture. The analysis of these conditions, that will be imposed in the complete denture prosthetic, wherever the opportunity arises to improve the prosthetic quality by maintaining the health of support tissues and of those from the periphery, by increasing balance and functional qualities of complete denture, st, should be taken, that surgical measure with a pre and pro-prosthetic treatment and prosthetic treatment subsequent establishment. Material and method: Creating the best conditions for establishment and functioning of complete denture is related largely to the prosthetic preparation through a proper, fair treatment pre and proprosthetic that it is necessary in many clinical situations. A proper clinical evaluation of tissue support, tissue from the periphery and occlusion relations of mandible and upper ach (RIM) must be made before any treatment by complete denture, to adopt the most appropriate therapeutic attitude. Prepare for prosthetic must be complex from a patients readiness for wearing complete denture and continues to action, surgical interventions on support tis-
sues, and on those from the periphery and RIM. The solution is often either surgically or by prosthetics. The most common surgery on teeth in case of total edentulous or imminent to become totally toothless are the extraction of teeth sunk, those included (mostly those who have given the rash or eruption accidents, or those that are supercial, in a position possible eruption under the pressure of denture. Surgery on bone: As we know when tooth extraction was not done with enough professionalism, socket may remain prominent areas susceptible to pressure, requiring prosthetic correction to help improve the support for future denture. Surgery on the mucosa: Following the loss of teeth, the mucous membrane may occur a number of changes in either case of edentaluos or due to a misuse of denture relations as bases, but especially as occlusion relations. Amendments may be either on xed, passive-mobile and mobile mucous membrane. As a result of present faults in the old dentures, xed mucous membrane was found an increase of the resilience to the maxillary mucous membrane and a tendency to hyperplasia present in the back of the vestibular passive-mobile mucous membrane (peripheral vestibular roll). Results and discussions: Interventions in pre and pro prosthetic total edentaluos is achieved mainly surgically or prosthetics. Interventions can range from simple to complex depending on the clinical situation, equipment, experience, and from the correction of exostza and extraction of depending stranded teeth - to implants and the maintenance of some teeth under complete denture with llings, the application of staples, telescopes, magnets, bar systems. Regardless of the intervention scale pre or pro prosthetic nothing exempt the practitioner from compliance with all rules that require a prosthetic proper complete denture.

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