Background and Objectives: Odontogenic infections (OIs) can lead to severe complications if not promptly diagnosed and treated. The Quick Sequential Organ Failure Assessment (qSOFA), derived Neutrophil-to-Lymphocyte Ratio (dNLR); Modified Early Warning Score (MEWS); and Predisposition, Infection, Response, and Organ Dysfunction (PIRO) scores are clinical tools used to predict the severity and outcomes in various infections. This study aims to evaluate the efficacy of these scores in predicting the severity of OIs in adult patients. Methods: A retrospective cohort study was conducted on 120 patients hospitalized for OIs, divided into two groups based on infection severity, using the Symptom Severity (SS) scale. The qSOFA, dNLR, MEWS, and PIRO scores were calculated upon admission. Statistical analyses were performed to assess the predictive value of these scores for severe OIs. Results: Patients with severe OIs (Group B) had significantly higher qSOFA, dNLR, MEWS, and PIRO scores compared to those with lower severity (Group A). The median qSOFA score was 2.00 in Group B versus 0.85 in Group A. No significant difference was observed between young patients and adults in terms of severity. ROC curve analysis showed that the PIRO score had the highest predictive value for severe OI (AUC = 0.912), followed by MEWS (AUC = 0.878), qSOFA (AUC = 0.845), and dNLR (AUC = 0.812). Multivariate logistic regression indicated that the PIRO score was an independent predictor of severe OI (OR = 8.45, 95% CI: 4.12–12.78). Conclusions: The qSOFA, dNLR, MEWS, and PIRO scores are valuable tools for predicting the severity of OIs. Among them, the PIRO score demonstrated the highest predictive accuracy and may be incorporated into clinical practice for early identification of high-risk patients.

The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial, and antioxidant properties. This systematic review synthesizes evidence from clinical trials to evaluate the efficacy of natural products in reducing inflammation and bacterial presence in orthodontic and orthognathic treatment settings. The database search was conducted across PubMed, Scopus, and Embase up to January 2024. The review focused on randomized controlled trials only. The selected studies centered on the anti-inflammatory, antibacterial, and antioxidant effects of natural products, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for data extraction. Nine studies, totaling 358 participants, were included. Significant findings demonstrated a reduction in gingival inflammation by over 40% with the use of Aloe vera compared to chlorhexidine. Another study noted a decrease in bleeding on probing by 13.6 points in the treatment group over placebo. Additionally, honey showed a rapid modulation of plaque pH and significantly reduced bacterial counts of Streptococcus mutans. Furthermore, the use of resveratrol emulgel was linked to substantial improvements in gingival health, with a reduction in the gingival index and probing pocket depth. The results indicate that natural products can significantly enhance orthodontic treatment outcomes by reducing inflammation and bacterial levels. These products offer effective alternatives to traditional treatments and show potential for integration into routine orthodontic care protocols. Further research is encouraged to standardize application methods and dosages to maximize clinical benefits and patient satisfaction.

Craniofacial asymmetry can have significant psychosocial implications, affecting the quality of life in adolescents and young adults. This study aimed to assess the impact of age and complexity of craniofacial asymmetry on quality of life and psychosocial outcomes in patients undergoing orthodontic and orthognathic correction. A cross-sectional study was conducted on 149 patients aged 13–26 years with moderate or severe craniofacial asymmetry that had a gnathion deviation higher than 2 mm, according to the American Association of Orthodontists. Participants were divided into three groups: teenagers (n = 53), adults (n = 46), and a control group (n = 50) with relative craniofacial asymmetry. Quality of life and psychosocial impacts were evaluated using validated questionnaires that measure health-related quality of life (SF-36), body image satisfaction and self-acceptance (BIQLI), anxiety and depression levels (HADS), and perceived stress (PSS-10). These tools provided an encompassing appraisal of the psychological and social implications associated with craniofacial asymmetry before and six months after orthodontic and orthognathic correction. Before the intervention, adults had higher mental health scores compared to teenagers (p = 0.037). At the 6-month follow-up, no significant differences in mental health scores were observed between the two groups (p = 0.121). BIQLI results showed significant differences in satisfaction with appearance and self-acceptance between teenagers and adults, both before intervention (p = 0.045 and p = 0.051, respectively) and at six months (p = 0.062 and p = 0.031, respectively). HADS results showed significant differences in anxiety levels before intervention (p = 0.039) but not at six months (p = 0.133). PSS-10 results showed no significant differences in perceived stress between the groups. In conclusion, this study demonstrates that craniofacial asymmetry significantly impacts the quality of life and psychosocial well-being of adolescents and young adults. Specifically, teenagers, as compared to young adults, reported lower satisfaction with their appearance and lower self-acceptance before intervention, underscoring the profound psychosocial challenges that adolescents with craniofacial asymmetry may experience. These age-related differences underscore the importance of tailored interventions to address unique psychosocial needs at different developmental stages.

With an increasing understanding of the differences between men and women's psychological experiences, this study aimed to probe the sex-based differences in anxiety, depressive symptoms, and coping strategies among orthognathic patients. The study hypothesis was that female patients would show higher levels of anxiety and depressive symptoms than males, and that coping mechanisms would differ between male and female sexes. A cross-sectional design was adopted, examining orthognathic patients from the Department of Oral and Maxillo-Facial Surgery at the Emergency Clinical Municipal Hospital in Timisoara, Romania, from 2020 to 2023. Eligible participants (18+ years with no prior orthognathic treatment) completed a comprehensive online questionnaire 6 weeks before scheduled surgery. This was composed of validated self-report instruments comprising the SF-36, GAD-7, and the PHQ-9, and the COPE-60, along with additional sociodemographic data. Of the 127 orthognathic patients analyzed (68 men and 59 women, aged 18 to 65 years, mean age 32), men rated their physical health status slightly better on the SF-36 scale. However, the most notable difference was in mental health, with females scoring higher on both the PHQ-9 (indicative of depression) and the GAD-7 (indicative of anxiety) scales. Specifically, female participants exhibited average PHQ-9 scores 1.8 points higher and GAD-7 scores 1.5 points higher than their male counterparts. Coping mechanisms also varied: 42% of male patients primarily employed "Disengagement" strategies, while 58% of females predominantly used "Engagement" and "Emotion Focused" strategies. Emotion-focused coping was associated with a 1.6-fold increased risk of depressive symptoms. Sex differences play a crucial role in the psychological experiences of orthognathic patients, evident in anxiety and depression levels, perceived health status, and coping strategies. This underlines the importance of sex-tailored psychological support in the preoperative phase for orthognathic surgery patients.

Whitening or bleaching is a procedure that improves the colour of the teeth and has an important role in the aesthetic look of the patient. It is known that standard materials used for whitening (hydrogen peroxide and carbamide peroxide) can have harmful effects on the tooth structure so in the recent years, emphasis has been put on using natural ingredients. Studies are being carried to see the efficacy of these natural products. The authors have reviewed the information available from a number of 12 studies that had the objective to demonstrate the efficacy of the natural ingredients on teeth whitening. The studies have been separated in 3 groups: group A baking soda, group B charcoal and group C citric acid. Each of them consists of 4 studies. In all cases, the colour of the teeth has been improved. Some studies showed that the natural ingredients don’t have a higher abrasivity than the toothpastes and are safe for use. Baking soda has an antibacterial role, has a low abrasivity and is compatible with the sodium fluoride found in toothpastes. Charcoal has a good whitening potential, but it is recommended to be used carefully because it cand induce enamel lesions. The citric acid has an antibacterial and anti-inflammatory role and the best concentration for teeth whitening is the 5% one. None of the studies showed great damage of the enamel and dentin structure. All the natural ingredients had similar esthetic results with the synthetic products but none of them had a greater effect regarding tooth substance loss. It has been demonstrated that natural ingredients have a good capacity of teeth whitening and some of them can reduce the plaque accumulation and increase the gum health. Whether they are used in a pure form or as ingredients in different gels or toothpaste, their good aesthetic results and reduced side effects recommend them in the bleaching procedure. Further studies should be carried to find the best formula for a natural whitening product.

In vitro studies have shown that rapid penetration of bacteria in the entire root canal system may occur after endodontic treatment without a coronal seal. A proper restorative technique is necessary to ensure a coronal seal and protection of the residual dental structure. The aim of this in vitro study was to evaluate the coronal sealing ability of the most relevant clinical materials by means of dye penetration (neutral red dye, Sigma‐Aldrich, Germany), through a light spectrometric device, and to establish which one of the tested dental materials possesses the best sealing ability. Forty‐two extracted teeth were prepared and used for this experiment; they were sealed with 5 different cements. The flow composite had the best absorbance value with 0.00675 ± 0.00096 (mean ± standard deviation) for monoradicular samples and 0.025 ± 0.00129 for pluriradicular samples. Under the constraints of the present study, both flowable and packable composite materials can be recommended as orifice sealing materials to prevent microleakage in an endodontically treated tooth. To assess the clinical superiority of any material, further in vivo studies are required.

Composite resin materials for posterior restorations are becoming more and more popular. According to the market, Ormocer materials are more expensive than composite resin this paper is comparing the resistance to fracture between nanohybrid composites and Ormocers under vertical forces to evaluate their cost efficiency in the dental cabinets. 20 teeth were prepared and filled with Ormocer and 20 with nanohybrid composite respectively. All the samples were sent for measuring under vertical pressure with the use of a universal testing machine. The average value of fracture for Ormocer was slightly higher (1541 N) than the average value of fracture of the nanohybrid composite (1431 N). Considering the similarity in the average values of the two materials we should look into the other properties (biocompatibility, shrinkage, aesthetics, etc) to take a final decision. Both materials can be used with the same rate of success taking in account always the protocol provided by the manufacturer.

The aim of the study was to determine the marginal and internal adaptation after curing of different composite resin restorations, using a nondestructive X-ray micro-computed tomography (micro-CT). Forty previously extracted human molars, kept in 10% formalin to preserve the bonding capabilities of the tooth structures, were divided into four groups based on the composite system used and different light-curing times. Class II (vertical slot) cavities were prepared on one proximal side and restored with dental composite using a Tofflemire matrix, with a bulk-fill composite resin (Venus Bulk Fill, Heraeus Kulzer) and a universal posterior composite (G-ænial Posterior, GC). A curing lamp (Kerr Demi Ultra) was used with different curing times. Micro-CT scanning was performed by using Nikon XTH 225ST to reveal any defects in adaptation or gaps at the tooth restoration interface. The 3D images of the adaptation around the restorations were reconstructed using VG Studio Max 2.2 and myVGL 2.2.6 64-bit software. All samples from the G-ænial group showed marginal and internal gaps, with G-ænial Posterior having higher polymerization shrinkage and marginal gap values. In the Venus Bulk Fill group, there were fewer restorations with internal and external gap formation. Micro-CT is a three-dimensional imaging technique that can nondestructively detect adaptation around the resin composite restorations at every level of the sample.

The main properties of dental adhesives should be good marginal adaptation, high retention strength and the possibility of not negatively influencing clinical sustainability Dental adhesives are continuously improving to increase their retention to dental structures by increasing penetration in these structures, as it was shownin the in-vitro tests requiring imaging and qualitative analysis to allow the evaluation of experimental samples as well as the development of new materials. The main objective of this study is the qualitative and quantitative analysis of the layer of modified dental adhesives with ferrous nanoparticles encapsulated in a SiO2 membrane located between the surface of the dental preparation and the surface of the photopolymerizable composite filling. For qualitative and quantitative analysis of the samples, technologies such as SEM, optical microscopy and EDX were used.

Implants have been around for many years already, having a lot of advantages and high success rates, by some authors even higher than 90%. Nevertheless, throughout the years, problems and failures have occurred in practice which led to bone loss around the implants and even, in some cases, to losing the implant itself. The phenomenon behind this pathological process -peri-implantitis - is believed to be the microleakage which occurs at the implant-abutment interface.This happens due to the existence of a gap present between the implant and the prosthetic abutment. Moreover, the microleakage is amplified because of the, so called, pumo effect. The pump effect occurs when the crown-abutment complex is subjected to occlusal, vertical and oblique, forces. During these micro-movements of the abutment, the microleakage intensifies and the bacteria can easily enter inside the implant, where is impossible to reach and remove through oral hygiene, thus, creating the perfect conditions for peri-implantitis. There are two major types of implant-abutment connections widely used nowadays -internal hex and conical -which are believed to influence the phenomenon and, so, the outcome. In the present study, both types of connections are tested, using Streptococcus Mutans, a common bacteria found in the oral cavity.

The aim of the study was to evaluate and to compare the interface and marginal leakage of dental composite resins using confocal laser scanning biological microscopy (CM). Ten class II cavities were prepared on the proximal surfaces of 10 extracted teeth, previously kept in 10% formalin to preserve the bonding properties of the tooth structures. Cavities were restored with dental composite resin using the 'open sandwich' technique and then assessed using CM Open marginal adaptations at the interfaces inside the composite resins were identified. The results obtained with CM helped to eliminate and reduce the background information collected from a distance from the focal plane and allowed for the acquisition of serial optical sections from thick tooth specimens. In vitro assessments were thus made using CM on the teeth structure, regarding the occurrence of potential micro-leakages at the restoration interface.

Implants and biomaterials used in hard and soft oral tissue augmentation are very complex, but predictable to use nowadays, as the technological advances haven't skipped this field of medicine. Cases that were impossible to treat with implant retained fixed prosthesis some years ago, have become the daily practice of oral surgeons and dentists around the world. The new user-friendly products, together with simplified protocols, increased the practitioners' predictability and success rate, thus the biomaterial industry took a huge leap forward. As the biomaterial industry keeps developing continuously, making better and safer products, the surgical and prosthetic protocols evolve and change as well. On this matter, the implant placement has become safer, using digital surgical guides. Guided implant placement doesn't just allow the practitioner place the implant in the patient's bone, but, moreover, it helps him place it in the correct, 3D, prosthetic position. And, thus, guiding the future bone augmentation and regeneration as well, accordingly. So, the implant placement has shifted from bone-orientated to prosthetic-orientated, offering at the same time a better primary stability for the implants, due to the prior planning. The present clinical study aims to analyze the outcome of the digital guided protocol. Unlike the free-handed surgery, the digital guided surgery allows dentists and oral surgeons to place implants according to the future prosthetic position of the crowns, even in conditions of alveolar ridges with bone resorption. Moreover, it makes possible the "one day implant" concept, the dental technician being able to create the provisional crown/s in advance, knowing precisely the future position of the implant placement. So, at the time of the surgery, the provisional crown is also put in place, guiding the soft and hard tissue healing and also giving the patient a greater satisfaction.

Implants are one of the most innovative and less invasive prosthetic procedures available. Almost all types of edentations can, nowadays, be treated with an implant-retained prosthetic piece, either fixed or removable. But regardless of the development in the industry over the last decades and the high success rate - estimated at over 95% - there are still some problems concerning single or multi-unit restorations[1-3]. One of the main concerns about implant therapy today is the microleakage phenomenon. The microleakage appears between the implant and the abutment and, due to masticatory forces, it creates a pump effect which can carry the oral bacteria inside the implant, where it's almost impossible to reach, thus, creating a local inflammation, called peri-implantitis[4-6]. Many authors have tried to identify and quantify the phenomenon by diverse means, but a consensus hasn't been reached on how or when exactly it appears. In the present study, Neutral Red dye was used to determine the sealing of the implant-abutment interface in dynamic conditions, with the help of the spectrophotometry.