Orthodontic tooth movement (OTM) is based on intermitted or continuous forces applied to teeth, changing the mechanical loading of the system and arousing a cellular response that leads to bone adaptation. The traditional orthodontic movement causes a remodeling of the alveolar bone and changes in the periodontal structures that lead to tooth movement. The use of a piezoelectric instrument in orthodontic surgery has already shown great advantages. The purpose of this study is to rank the behavior of inflammatory mediators in accelerating orthodontic tooth movement. Ten patients with malocclusion underwent orthodontic surgical treatment, which included a first stage of surgically guided orthodontic movement (monocortical tooth dislocation and ligament distraction, MTDLD) to accelerate orthodontic movements. In all cases, corticotomy was performed by Piezosurgery. Bone and dental biopsy was executed to evaluate changes in the cytokines IL-1beta, TNF-alpha and IL-2 in different time intervals (1, 2, 7, 14 and 28 days). The molecular mediators are IL-1 beta, TNF-alpha and IL-2. Immediately after the surgical procedure there was a mild expression of the three molecular markers, while the assertion of IL-1 beta and TNF-alpha reached the maximum value after 24 h and 48 h, indicating a strong activation of the treated tissues. The Piezosurgery® surgical technique induces an evident stress in short times, within 24–48 h from the treatment, but it decreases significantly during the follow-up.

With the development of X-ray computed tomography (CT) in the 1960s and its first use for clinical studies in 1972 by Sir Godfrey Hounsfield, radiological tomography attained widespread use and today is one of the essential imaging techniques in medical radiology. It is a technically mature and clinically widely accepted method and complements classical X-ray panoramic radiography in many areas. The technology is frequently used in craniofacial radiology, because of its characteristic low radiation dose, high spatial resolution and lower cost compared with CT. The aim of this work was to describe the principles of cone beam computed tomography, to make a brief description of the existing devices, to present briefly the use of 3D diagnosis in craniofacial medicine.

Traditional orthodontic tooth movement is based on the concept that application of a protracted force causes alveolar bone remodelling and adaptive changes in periodontal and dental tissues. Thus, if orthodontic tooth movement is described as a biological bone reaction to orthodontic forces mediated by the periodontal ligament (PDL), this event involves a series of sophisticated signal transduction processes that allows the PDL compression with specific histologic and biomolecular modifications. However, the preservation of the integrity of the PDL is generally difficult to achieve when it is associated with a long duration of orthodontic treatment. A total of 20 Caucasian patients with different dental-skeletal were treated using the Monocortical Tooth Dislocation and Ligament Distraction (MTDLD) technique with Piezosurgery associated with morphologic and histological evaluation of the PDL. The histological results obtained, confirm a good clinical outcome with an improvement of the speed on orthodontic treatment without any signs of tissue injury of PDL fiber without areas of hyalinization. The data suggests that MTDLD with Piezosurgery seems to be a valid alternative to the traditional orthodontic movement in adult patients preserving the anatomy and the integrity of PDL.

Secondary cleft lip nasal deformities corrective procedures are still a major concern for the maxillofacial surgeons.

Dear Editor-in-ChiefThe extrapolation of stress concept in the field of medicine is of great interest nowadays. In correlation with stress, anxiety often lies at the basis of the decisions to avoid an orthodontic treatment, delay the beginning of it or the scheduled visit to a consultation. The perception of the severity of a malocclusion varies according to the degree of physiognomic damage and according to the personal variables. Social anxiety, fear of being rejected by peers, conflicts with adults - parents, teachers - may occur both before and after applying the orthodontic appliance. The presence of a physical anomaly, especially when it affects patients' facial appearance, has psychological and social consequences, being in most cases a major source of stress for patients and their family.The ability of adjusting, also called coping, plays an essential role in controlling stress. The patient tries to cope with stress symptoms by developing a wide range of coping mechanisms. Coping stands for any mechanism of prevention and adjustment to stress, for any transaction between body and environment in order to reduce stress intensity. The coping mechanisms are, thus, acting to prevent, to alter or annihilate the presumed negative effects of a future event, or to adapt in order to reduce distress if it has already been induced (1). The concept of coping was first introduced in psychology by Lazarus in 1966 and he promoted it through a prodigious research activity (2)·In order to avoid the destructive effects of stress, the individual resorts to several defense mechanisms. These mechanisms are designed to protect the individual against anxiety and harmful emotional consequences caused by stress (3). The individual's ability to control and adjust to stress consists of: defense mechanisms, physical activities and sport, psychotherapy, stress adjusted biological responses (1). Children are brought to an orthodontist by their parents, accepting the treatment just to please or not to upset them. In an adolescent case, the request for orthodontic assistance should be regarded as an adaptive coping mechanism of the patient with the stress generated by their malocclusion. In most cases the decision to seek orthodontic treatment is influenced by a combination of socio-economic, ethnic and cultural factors, including the perception of the facial aesthetics and the smile (4, 5).The purpose of our study was to analyze the correlations between the following variables: perceived stress, state-anxiety, trait-anxiety and coping mechanisms. The study group consisted of 82 patients with an average age of 12yrs+3 months (age 7-18 years old), that requested orthodontic treatment at the Department of Dentistry, University of Oradea, Romania, during the year of 2013. There were 34 males (41.46%) and 48 females (58.54%) in the study group subjects. All patients were asked, by means of the provided answers, to clarify their position regarding the statements contained in the evaluation instruments that were used: the Perceived Stress Questionnaire (PSQ) (6) , the State-Trait Anxiety Inventory (for children - STAIC - up to 14 years, and for adults - STAI), (7) , and the COPE questionnaire (8). The COPE questionnaire describes 14 coping scales, such as: active coping, planning, suppression of competing activities, restraint coping, seeking instrumental social support, seeking emotional social support, positive reinterpretation, acceptance, denial, venting of emotions, turning to religion, mental disengagement, behavioral disengagement and alcoholdrug use. Research data were statistically processed using the Statistical Package for Social Sciences - PC, Windows Version 15.0 (SPSS Inc., Chicago, Illinois, USA).In the first stage of the research we determined the statistical values of the variables that measure patients' level of distress and anxiety. The next step was to conduct an analysis of correlation between variables that measure the level of stress, state-anxiety and trait-anxiety for the sample of patients included in the study (Table 1). …

AIM:The aim of this study was to evaluate and compare the cleaning ability and instrumentation time of manual method and use of endodontic handpiece for preparation of primary molar teeth.METHODS:Forty primary teeth canals were used in this experimental study. Access cavities were prepared and India ink was injected into the canals. The samples were divided into three groups according to the preparation technique. In the first group the root canals were manually instrumented by k_files. Endodontic handpiece (TEP-ER10, NSK, Japan) were used for canal preparation in the second group and the samples in the third group (control) were not instrumented. After preparing the canal, the teeth were cleared with methyl salicylate and the removal of India ink was measured in the cervical, middle and apical thirds. The instrumentation time was transcribed by chronometer. Statistical analysis was performed using Mann-Whitney and t-test.RESULTS:There was no significant difference in cleaning capacity between the two techniques, but results of the first and second group differ from those of the control group. In fact, time taken for preparation was significantly shorter with endodontic handpiece system.CONCLUSION:Seen the shorter working time of endodontic handpiece and the similar cleaning ability of the two techniques, the application of the endodontic handpiece is recommended for preparation of deciduous root canals during pulpectomy.

Canine transmigration is a very rare dental anomaly in which an unerupted mandibular canine migrates, crossing the mandibular midline. This unusual condition is most often diagnosed by chance during a routine X-ray examination. The most common clinical signs announcing the presence of this anomaly are over-retention of the deciduous canine and the absence of permanent canine from the dental arch after its physiological period of eruption. In this paper, we present a clinical case, 10-year-old boy, who was diagnosed with mandibular right canine transmigration at three years after the start of orthodontic treatment, during which we were expecting the eruption of mandibular canines. The orthopantomograph revealed the mandibular right canine to be in a horizontal position under the apices of the incisors - type 2 transmigration pattern classified by Mupparapu (2002). Based on cone-beam computer tomography examination, we recommended a surgical exposure of the canine and orthodontic alignment. Due to the risk of root resorption of the mandibular right lateral incisor during orthodontic movement phase of canine transmigrated to the dental arch, we decided to align the mandibular right canine in a transposition, between the two mandibular right incisors. Then we resorted to adapting the mandibular right lateral incisor coronary morphology to simulate a canine and also to reshaping the canine coronary morphology to resemble a lateral incisor. This therapeutic approach allowed us to restore morphologically and functionally the mandibular dento-alveolar arch, preserving the entire dental system.

Quercetin (3,3',4',5,7-pentahydroxyflavone) is the major bioflavonoid in the human diet and belongs to an extensive class of polyphenolic flavonoid compounds almost ubiquitous in plants and plant food sources. The estimated average daily dietary intake of quercetin by an individual in the United States is 25 mg. In recent years, research about quercetin has evolved from animal studies to in vitro and in vivo studies and to human clinical studies and trials in order to establish its real properties and effects. In oral medicine, quercetin has been extensively studied, as a real increase in major diseases like cancers, periodontal disease, oral lesions, tooth decay and infections have been reported worldwide by health providers.It has been thus established that quercetin exhibits beneficial effects on oral health with its broad pharmacological properties, as preventive and therapeutic agent in dental caries with anti-inflammatory effect against oral pathogens, as well as an antioxidant and anti-cancer agent .The aim of the review is to present evidence-based aspect of treatment with quercetin in order to validate its tremendous role in dentistry and maxillofacial surgery.

Background: The aim of present study was to clinically assess and compare a sonic toothbrush versus a rotating oscillating power toothbrush on plaque removal and gingival health in reducing plaque and bleeding on probing. Methods: Patients were selected according to specific inclusion and exclusion criteria and they were enrolled in test group or control group using Random Allocation Software. Visual score plaque index (PI) was recorded by the same blind operator using a plaque revelator and bleeding on probing (BoP) index was recorded using a periodontal probe at baseline, 15th day and 30th day. Results: The group of patients who used sonic toothbrush showed a greater reduction of PI and BoP comparing with patients who used rotating-oscillating power toothbrush. Conclusions: Although this pilot study has several limitations, it seems to indicate that sonic toothbrushes are capable of removing plaque and reducing bleeding on probing better than electric toothbrushes.

Simultaneous impactions of first, second, and third permanent molars on both mandibular sides together with the all maxillary second and third molars is a clinical situation never reported before in the literature and it might be a difficult challenge for maxillofacial surgeons and dentists. Early diagnosis and treatment of eruption disturbances contributes to optimal outcomes. This article reports the treatment of an adult with severe impaction of all mandibular first, second, and third molars together with all maxillary second and third molars, which limits the masticatory function and dental arch integrity. The impacted molars were surgically removed as the patients declined orthodontic treatment. The combined surgical-orthodontic approach represents a challenging treatment and the optimal one as it eliminates the need for prosthetic rehabilitation and implant replacement of the impacted molars, when accepted.

The occurrence of postoperative complications after various orthognatic surgery procedures is rare but all of them might be life-threatening complications. We report a case of a 22-year old female patient who underwent a bimaxillary orthognathic surgery procedure and developed bilateral pneumothorax and pneumomediastinum.

The present case report describes the case of a 15-year-old female who was referred with a radiolucent lesion between her mandibular right molars. The original radiographic image suggested the presence of an odontogenic cyst. The surgical enucleation and the following osteotomy of the residual cavity was performed by using the piezoelectric technology. The histological analysis confirmed that the lesion was an odontogenic keratocyst with no evidence of epithelial invasion in the connective tissue wall. The patient refused any further surgical treatment. In consideration of the pathological result - no presence of invasive epithelial cells in the connective tissue wall of the cyst- the patient was suggested a "follow-up and wait-and-see policy", with more extensive surgical treatment to be given only in case of a recurrence. The patient was followed up clinically and radiographically at 6 months intervals for 5 years.

Introduction The pathogenesis of the dento-maxillary apparatus includes dento-maxillary anomalies as a significant anomaly. These are considered deviations to the normal evolution of the dentomaxillary apparatus, being conditioned by various general and particular factors presenting a multifarious etiopathogenetic mechanism (Schapira 1973). Dento-maxillary anomalies could generate periodontal diseases as well as the mastication, phonation and physiognomic functions (Mtaya et al 2009). Due to the widespread amongst the population and to the fact that could pose a significant social integration obstacle, the dento-maxillary anomalies have become public health issue which require the determination of the mass expansion level (the prevalence) (Kenealy et al 1989; Dorobat et al 2011). It has been determined a tendancy of increasing prevalence of dento-maxillary anomalies (Dorobat et al 2011) . The studies conducted in Europe regarding dento-maxillary anomalies present frequencies ranging from 37 to 47% such as: following Tiominen et al 47% in Finland; following Korkhaus it is 43% in Germany; following Burgersdijk et al. it is 45% in Denmark; following Espeland it is 37% in Norway (Emrich et al 1965; Trifan 2014). In China a study found 93% of children with malocclusions (Lew et al 1993). In USA for the age group of 8 to 11 years old the prevalence of dento-maxillary anomalies is 20-55% depending on the type of anomaly (Proffit 2012). In Russia it was found a prevalence of dento-maxillary anomalies of 24% in case of temporary dentition, 49% in case of mixed dentition and 35% for permanent dentition. For Republic of Moldova it was established a prevalence of 25.2% of dento-maxillary anomalies for 16 to 17 years old adolescents (Trifan 2014). In our country the studies conducted on different children from different areas present an increasing tendency in dento-maxillary prevalence such as: following Schapira it is 52%; following Cocârlă and collaborators it is 50-60%; following Firu it is 75%; following Câmpeanu M. it is 46.7%; following Boboc it is 40%; following Scântei, Dorobăţ and collaborators it is 73.676.9% (Boboc 1971, Dorobat et al 2011; Trifan 2014). Abstract. Objectives: The current article aims to measure the prevalence of dento-maxillary anomalies within a population of children (with ages varying from 6 to 14 years old) from mining area of Rosia Montana as well as to assess the possible correlation between demographic factors (age, gender, ethnicity) and the presence of anomalies. Material and method: The study was conducted on a group of 291 children from the area with ages ranging from 7 to 14 years old (representing 33.92% of the total number of possible subjects from Rosia Montana mining area), during the phase of mixed dentition and the early stages of permanent dentition. The children were selected from schools from the mining area, both from rural and urban environments. They were examined into the medical facilities available in the area. All the personal data were collected based on the written approval of parents and will stay strictly confidential by the Romanian law and medical deontological practices. Results: About 92% of the subjects presented dento-maxillary anomalies. The results were similar if considering the gender distribution, whilst considering the age distribution of subjects the presence of anomalies varied from 84% to 100%; for ethnicity distribution of anomalies, the majority or Romanian subjects presented 94% anomalies, while Romany subjects presented 83% anomalies. Considering the 3 types of Angle malocclusions the highest percentage was for Angle Class I, respectively 61%, followed by Angle Class II/1 Angle (18%) and Angle Class II/2 (15%), while the smallest value was for Angle Class III (7%). The two categories of Angle Class II represented 33%, which was approximately half of the value for Angle Class I. Conclusion: The prevalence of dento-maxillary anomalies within the studied batch presented an average value of 92% which was significant higher than the values available within the specialized literature from Romania (values ranging from approx. 45% to 75%). This could be subject to separate in-deep studies to understand the causal.

Dental crowding is frequently associated with transverse jaw discrepancies, resulting in a less-than-ideal position of the teeth in the basal bone. The classic aproach for correcting bimaxillary crowding are extractions or arch expansion. Rapid maxilla-mandibular expansion was used to treat transverse discrepancies in growing patients, but with aging, the upper and lower jaw bones become increasingly resistant to expansion. The surgically assisted rapid maxillary expansion (SARME) and the mandibular midsymphyseal distraction osteogenesis procedure overcome this age limitation and are of great importance for the treatment of transverse discrepancies in adults. The aim of this paper is to report a case with a severe transverse deficiency treated with SARME, mandibular midsymphyseal distraction together with orthodontic treatment in an adult patient. The case highlights the esthetic advantages of increasing the transversal dimension of both jaws in patients with severe crowding associated with constricted dental arches and recommends the maxillo-mandibular transverse distraction osteogenesis as an and effective form of surgical treatment for patients with malocclusions or dentofacial deformities featuring severe transverse discrepancies, combined with a carefully monitored orthodontic treatment.

Introduction: Over the years, several different implant systems have been introduced, and the indications for implant rehabilitation have gradually been extended 2. Although an high success rates have consistently been reported for many implant systems, complications leading to loss of osseointegration still occurs 3. Thus, oral hygiene and maintenance are imperative, because implants, as well as teeth, are susceptible to accumulation of bacterial plaque and calculus formation. The aim of the present study was to evaluate and compare the in vivo cleaning efficacy of the three systems (air powder, curette, laser) comparing at the same time the alterations of the titanium abutment surface in terms of roughness. Methods: Forthy-two patients (25 males and 17 females) were included in the study. The 42 healing abutments were treated by the same clinician (UC). Results and conclusions: The rate of debris removal by the air powder was higher than that for the laser and than that for the curettes. The SEM analysis showed that the air powder system did not induce significant differences of the abutment if compared to the curettes as well as to the laser.

IntroductionEagle syndrome (ES) is an uncommon complication of styloid process elongation with stylohyoideal complex symptomatic calcification. It is an uncommon condition (4% of the population) that is symptomatic in only 4% of the cases. Eagle syndrome is usually an acquired condition that can be related to tonsillectomy or to a neck trauma. A type of ES is the styloid-carotid syndrome, a consequence of the irritation of pericarotid sympathetic fibers and compression on the carotid artery. Clinical manifestations are found most frequently after head turning and neck compression. Although conservative treatment (analgesics, anticonvulsants, antidepressants, local infiltration with steroids, or anesthetic agents) have been used, surgical treatment is often the only effective treatment in symptomatic cases. Materials and MethodsWe present the case of a 55-year-old patient, successfully treated under endotracheal anesthesia. The cranial portion of the calcified styloid process was shortened through an external approach, using a piezoelectric cutting device (Piezosurgery Medical II; Mectron Medical Technology, Carasco, Italy) with MT1-10 insert, pump level 4, vibration level 7. ResultsNo major postoperative complications such as nerve damage, hematoma, or wound dehiscence occurred. After 6 months, the patient was completely recovered. Two years after the surgery, the patient did not refer any symptoms related to ES. ConclusionsThe transcervical surgical approach in patients with ES seems to be safe and effective, despite the remarkable risk for transient marginal mandibular nerve palsy. This risk can be decreased by the use of the piezoelectric device for its distinctive characteristics—such as precision, selective cut action, and bloodless cut.

Bulimia nervosa is an eating disorder characterized by consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed (purging), typically by vomiting, taking a laxative, diuretic, or stimulant, and/or excessive exercise, because of an extensive concern for body weight. The frequent contact between teeth and gastric acid, in particular, may cause: severe dental erosion, perimolysis, or the erosion of tooth enamel and swollen salivary glands. Constant vomiting can lead to gastroesophageal reflux. The aim of this article is to report two cases of patients with severe dental demineralization associated with bulimia nervosa during orthodontic treatment. Diagnosis and prevention aspects are highlighted and discussed.

The aim of study was to determine and compare serum concentrations of interleukin 1 beta (IL-1β), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in patients with oral ameloblastoma and healthy controls. Sixteen patients with ameloblastoma and 16 healthy controls were enrolled in this study. Cytokine concentrations were measured by chemiluminescent enzyme linked immunoassay. Serum concentrations of IL-1β were below level of detection in all but four participants. No significant differences between the groups were observed in serum concentrations of IL-6. Serum TNF-α was significantly higher in control subjects than in ameloblastoma patients. Patients diagnosed with ameloblastoma have relatively normal levels of inflammatory cytokines in their blood and thus cannot be used as indicators of disease severity or for monitoring the treatment outcomes.

It has been reported that the immune system undergoes changes due to various factors, inflammation, surgery, medication, age and gender. The aim of this study was to investigate therapy-dependent changes of salivary IgA among healthy subjects undergoing active orthodontic treatment. The levels of IgA were determined at the beginning, and after 1,4, 8,16 weeks and 32 weaks of active orthodontic treatment. A total of 100 healthy individuals (aged 15-42 years) were enrolled in the study. Two milliliters of saliva were collected from all participants, and salivary IgA levels were measured by the ELISA technique. Mean salivary IgA levels were significantly higher in subjects after 1 week as compared to subjects at the beginning of orthodontic treatment (P < 0.01).. The mean levels of salivary IgA were significantly higher after 4 and 8 weeks of therapy than those observed in the control group (P < 0.00001 and P < 0.05, respectively) and reached the highest level at 16 weeks and then remained stable during treatment. Gender had no effect on the salivary levels of IgA as any significant differences were observed between men and women. The results highlight the importance of the salivary defense mechanism, translated through the increase in the levels of IgA, once orthodontic treatment is started.