Biomaterials and Regenerative Biomedicine

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Authors: Sanda Mihaela Popescu, Mihaela Jana Ţuculină, Horia Octavian Manolea, Veronica Mercuţ, Monica Scrieciu
Abstract: AIM: To evaluate the clinical performance of adhesive restorations of resin-modified glass-ionomer cements (RMGIC) compared with of resin composite (RC), and RMGIC liner base laminated with a resin composite in non carious cervical lesions (NCCL).METHODS: The randomized clinical trial included 45 patients (25-65 year-old), with at least two similar sized NCCL on premolars. After sample size calculation, 220 restorations were placed, according to one of the following groups: (G1) Resin-modified glass-ionomer cement (Vitremer); (G2) a resin composite and an adhesive layer (Versaflo); (G3) RMGIC liner base laminated with a resin composite (Vitremer and Versaflo). The restorations were clinically followed every 6 months for up to 24 months using the USPHS modified criteria for clinical evaluation. Survival estimates for restoration longevity were evaluated using the Kaplan-Meier method. Log-rank test (P< 0.05) was used to compare the differences in the success rate according to the type of the restorative material.RESULTS: At the end of 24 months, 172 restorations were evaluated in 37 patients, with a recall rate of 82.22%. The type of restorative material used did not influence the longevity of the restorations. The survival rates for the follow-up were similar regarding the number of restored surfaces and the tooth (upper or lower premolar). Estimated survival rates of the restorations were 100%, 100%, 98,25% and 90,69% at 6, 12, 18 and 24 months of clinical evaluations, respectively. A statistically significant difference was observed between RMGIC and RC or RMGIC laminated with RC for color match, but no other significant difference was observed among the three types of restorations.CONCLUSIONS: The survival rates were similar for the three types of restorations in NCCL. Different types of materials demonstrated acceptable clinical performance in non-carious cervical lesions.
Authors: Mihaela Jana Ţuculină, Lelia Gheorghiţă, Oana Andreea Diaconu, Marilena Bătăiosu, Ionela Teodora Dascălu, Sanda Mihaela Popescu, Horia Octavian Manolea, Monica Scrieciu
Abstract: AIM: This study draws a comparison, through the transparentization method, focusing on the quality of the canal obturation made with thermoplasticized gutta-percha, between two different systems: GuttaMaster VDW (München, Germany), based on obturators made of a plastic core, covered in alpha gutta-percha, and a system of vertical warm condensation.MATERIALS AND METHODS: The study focused on twenty teeth extracted for various reasons which underwent the endodontic treatment realized through a hybrid technique, using the rotary files system of NiTi MTWO (VDW, München, Germany), and the manual files k-file type (Kendo, VDW, München, Germany). The teeth were distributed into two groups of ten. The teeth in the first group underwent obturation using the CWC technique of vertical warm obturation, and the teeth in the second group underwent root obturation using the GuttaMaster system (VDW, München, Germany). The teeth were decalcified in nitric acid. Using the method of transparentization with methyl salicylate, there were emphasized aspects regarding the abilities of each method to seal three-dimensionally the endodontic space.RESULTS: The teeth which underwent vertical obturation presented many more holes in the obturation material, holes situated mainly in the medial and coronary third. However, these teeth presented the highest degree of insertion in the lateral canals, as compared to the other obturation technique employed. The homogeneity of the root obturation had not had any statistical significant differences between the two techniques. However, the technique of injecting thermoplasticized gutta-percha was superior to the other one regarding the tightness on the edge and the degree of penetration in the lateral canals.CONCLUSIONS: The knowledge of both the qualities and the limits of the obturation material chosen, as well as the correctness of performing the two techniques, determines a definite improvement of the quality of the canal treatment, which ends with a three-dimensional canal obturation.
Authors: Mugur George Popescu, Diana Marian, Ramona Amina Popovici, Teodora Ștefănescu
Abstract: The correct endodontic treatment involves the exact determination of the working length. This is accomplished by combining several techniques: the tactile technique, X-ray with the needle or the endodontic probe in the root canal and comparing with the average tooth length.The determination of average tooth length depends on the geographic area. The current table used in practice contains the values gathered on a population group that is different than ours; the table has been made on Caucasian subjects.In conclusion, our study aims to determine the proper average values of our geographic zone, the table obtained by completing the equation of the endodontic therapy that will admit the proximity of the Romanian reality.
Authors: Radu Rîcă, Ana Maria Rîcă, Horia Octavian Manolea, Mirela Opri, Mihai Dodocioiu
Abstract: A fixed restoration has many important properties. Not only it has to resist in the harsh oral environment but it also has to resist bite forces and to remain intact for an extended period of time and porcelain has all these qualities and it also gives excellent esthetic results. The aim of the study was to evaluate the influence of each layer of porcelain fused to the metal coping on the final aspect of a metal ceramic restoration using the Ivoclar dSign system. Therefore we have chosen three methods to apply the porcelain by varying the thickness of the dentin and enamel layers fused on the metal substructure. The layer thickness of the opaque porcelain, the body porcelain (dentin), and the incisal porcelain greatly influence the final aspect of the metal ceramic restoration and this variation must be taken into consideration in order for the dental technician to obtain the desired shade
Authors: Cristian Ratiu, Simona Cavalu, Grigore Lazarescu, Anca Porumb
Abstract: The ability to achieve predictable results in oral implantology depends on indepth knowledge of all factors affecting bone healing, as well as on implant characteristics and the mechanical forces involved in immediate loading. The success of the immediate loading protocol relies on three main factors: (1) primary stability, which limits micromotion of the implant, (2) secondary biologic stability, resulting in osteogenesis in the peri-implant area, and (3) the control of bone resorption caused by deleterious loading forces that lead to implant instability during healing. Activated platelets play a crucial role in peri-implant healing and the use of Plasma Rich in Growth Factors (PRGF) in association with immediate implant placement could be a viable therapeutic option for the reabilitation of postextraction sockets. In our case-study, the implants and the abutments were welded with a titanium bar in order to provide predictable fixation and immobility of implants in early stages of bone healing. The implants have been properly integrated at both the bone and gingiva levels allowing the patient to resume both esthetic and masticatory functions from the very day the implants are inserted.
Authors: Cristian Ratiu, Simona Cavalu
Abstract: Different graft materials and techniques are suggested based on the number of bony walls that remain after the tooth is removed. If the implant can’t be inserted within the bone contours, bone augmentation must be performed, and the graft must be stabilized with a membrane or a thin bone block graft. In the present study, two cases are presented both with small bone defects on the buccal plate. Bone augmentation with autogenous bone graft was performed in one case, respectively titanium implants with zirconia necks were used in the second case. It was demonstrated that titanium implants with zirconia necks are a good choice in some cases where small parts of the buccal plate are missing.
Authors: Ionel Cristian Ştirbu, Sanda Mihaela Popescu, Mihaela Jana Ţuculină, Veronica Mercuţ, Horia Octavian Manolea, Daniel Iorgulescu
Abstract: The article presents the experience of a new therapeutic method, addressing postoperative implant pathology.Methods: Hyaluronic acid has been used in the management of various mucoperiosteal pathologies (directing secondary healing of oral wounds, restoration / increasing the volume of connective tissue – periosteal preoperativ or the papillary volume).Hyaluronic acid used had different concentration. The presentation forms both viscous and fluid particle size and type/acid’s grade of complexation) provided various therapeutic effects with specific indication of administration respected by the authors. Different products available at this time in Romania were used analyzing the results in time.Results: This therapeutic approach provided a good management in secondary granulation and wound healing of oral tissues in difficult cases (GBR, implant therapy) in which the persistence of dehiscence wound can cause a failure of surgical treatment (loss of membrane, alloplastic material or implant).Conclusion: This results places this innovative therapeutic method with others successful therapeutic solutions in usual dental practice, providing a quick and efficient settlement of some difficult clinical cases.
Authors: Anca Porumb, Cristian Ratiu, Simona Cavalu, Alexandrina Muntean
Abstract: The materials used in the treatment of an adult patient with severe cleft palate need to be choose very carefull, according with the biological aspects. First of all, is mandatory to choose a proper material for endodontic treatment and use a correct technique. Second, the cement used in order to fix a RPD (rapid palatinal disjunctor) has to be glass-ionomer cement, because the oral and nasal cavity are still communicating. On the other hand, the dental ceramic material used in the prosthetic treatment has to be a special one, pink-colored in those regions where cleavage is present. For this reason, the cases with cleavage need a complex treatment, usually during a few years and several steps. They need a good collaboration between doctors of different specialities: maxillo-facial surgery, orthodontics, prosthetics and plastic surgery. The aim of the present study is to underline the assessment of ceramic dental materials during the laborious treatment in the case of an adult with cleft palate, in order to obtain the best results.
Authors: Adriana Maria Monea, K. Ivacson A. Csinszka, Bukhari Csilla, Gabriela Bereșescu
Abstract: Posterior composite restorations are difficult to contour and polish due to their occlusal anatomy and opposing occlusion. Our study describes a technique for duplicating occlusal surface anatomy, using different dental materials that are able to copy anatomic details. The aim of the study was to evaluate the efficiency of occlusal matrix technique, by comparing technical ease of different dental materials. The study was conducted on extracted teeth which had intact occlusal surfaces or initial carious lesions at this level. An impression of the occlusal surface was made prior to cavity preparation, with four different dental materials: a flow composite, a dual-cure resin cement, a temporary acrylic resin (powder and liquid) and a temporary crown and bridge two-component material in a Unidose®. When the last layer of composite has been placed, the occlusal matrix was forced into the uncured composite to replicate the original occlusal surface, instead of performing manual curing and shaping as in the standard approach. Time needed for complete finishing the case, the hardness of each occlusal matrix and the final morphology obtained were evaluated. The main benefits of the occlusal matrix technique are the technical ease of use due to its simplicity and its high accuracy in reconstructing occlusal morphology. Although the shortest time needed for occlusal matrix preparation was for the dual-cure resin cement, the best oclusssal matrix was obtained with the temporary acrylic resin (powder and liquid).

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