Search Results (191)

Medical education is the paradigm of 21st century education and the current changes involve the adoption of integrative and comprehensive patient-centered teaching and learning approaches. Thus, curricular developers from George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu Mures (G.E. Palade UMPhST of Targu Mures) have recently designed and implemented an innovative medical curriculum, as well as two valuable assessment tools for both theoretical knowledge and practical skills. Thus, during the first three preclinical years, the students will benefit from an organ- and system-centered block teaching approach, while the clinical years will focus on enabling students to achieve the most important practical skills in clinical practice, based on a patient bedside teaching system. In terms of theoretical knowledge assessment, the UNiX center at G.E. Palade UMPhST of Targu Mures, a recently designed center endowed with the latest next-generation technology, enables individualized, secured multiple-choice question-based assessments of the student’s learning outcomes. Moreover, an intelligent assessment tool for practical skills was also recently implemented in our branch in Hamburg, the Objective Structured Clinical Examination (O.S.C.E). This system uses direct observations for testing the student’s practical skills regarding anamnesis, clinical exams, procedures/maneuvers, the interpretation of laboratory tests and paraclinical investigations, differential diagnosis, management plans, communication, and medical counselling. The integrative, comprehensive, patient-centered curriculum and the intelligent assessment system, implemented in G.E Palade UMPhST of Targu Mures, help define innovation in education and enable the students to benefit from a high-quality medical education. Full article

Background/Objectives: Miscarriage is a common pregnancy complication that significantly impacts individuals’ health due to its physical and psychological effects. This study aimed to investigate the association between periodontal health and hematological parameters in women who experienced miscarriage before the 20th week of gestation, and to assess the potential predictive value of these parameters for miscarriage risk by comparing them with those of women with an uncomplicated pregnancy course. Methods: This study was a prospective case–control and cross-sectional study. It included a total of 82 participants, comprising 41 women with miscarriage and 41 healthy pregnant controls. The periodontal examinations included measurements of the Gingival Index (GI), Plaque Index (PI), Probing Depth (PD), Clinical Attachment Loss (CAL), and Simplified Calculus Index (SCI). Additionally, complete blood counts (CBCs) were obtained from all participants. Appropriate statistical analyses, including non-parametric, correlation, logistic regression, and ROC analyses, were conducted, with the significance level set at p < 0.05. Results: The primary outcome measure was CAL as an indicator of periodontal disease severity and its association with miscarriage risk. Additional outcomes included Plateletcrit (PCT), the Platelet Count (PLT), and the Neutrophil-to-Lymphocyte Ratio (NLR) to evaluate systemic inflammatory responses and their correlations with periodontal parameters. CAL was significantly elevated in the miscarriage group (p < 0.001) and emerged as the strongest predictor of miscarriage risk (OR = 0.0537, p < 0.001, AUC = 0.8691). PCT was significantly higher in the miscarriage group (p = 0.017) and positively correlated with the GI (p = 0.041), suggesting a link between systemic inflammation and periodontal health. Conclusions: Considering this study’s limitations, CAL was the strongest predictor of miscarriage, while PLT and PCT had some discriminative power. Collaboration between obstetricians and dentists can facilitate early diagnosis and intervention by promoting routine oral health check-ups before and during pregnancy. Additionally, integrating oral health assessments into prenatal care and developing public health policies could enhance access to dental services during both preconception and pregnancy periods. Full article

Background/Objectives: Alzheimer’s disease (AD), a neurodegenerative condition, produces dementia and cognitive debility. Lately, preclinical models of AD have shown neuroregenerative potential of mesenchymal stem cells of dental origin (DMSC). This scoping review aims to map and synthesize the evidence on the therapeutic applications of DMSCs in AD management. Methods: This review followed the Arksey and O’Malley framework for scoping reviews and PRISMA-ScR guidelines. Scopus, Medline (Pubmed), Web of Science, and Embase databases were searched for published literature until February 2025. Data was mapped according to the type of DMSC and their therapeutic properties useful in AD management, like neuro differentiation, neuroprotection through increased neuron number and vitality, anti-neuroinflammation, mitochondrial repair, and improved cognition. Results: A total of 22 articles were included. A research gap existed, as most studies were preclinical (in vitro and animal models) with no clinical trials in humans. Furthermore, they mostly evaluated neuroregenerative properties of dental pulp stem cells (DPSC) and stem cells from human-exfoliated deciduous teeth (SHED), while Periodontal ligament stem cells (PDLSC) were least studied. All the DMSCs were neuroprotective and increased neuron number and vitality. Neurodifferentiation was reported in DPSCs and PDLSCs, while DPSCs and SHEDs showed anti-neuroinflammation, mitochondrial repair, and improved cognition in AD animal models. Conclusions: Although the DPSCs and SHEDs showed promising outcomes in preclinical models of AD, a gap exists as results have not been translated into human clinical trials. Future advances may identify plausible ways of applying the DMSCs to regain the lost neurons and re-establish a healthy brain microenvironment. Full article

Objectives: This study investigated the use of artificial intelligence (AI) in the design of lingual bracket indirect bonding trays and its association with bracket transfer accuracy using three-dimensional (3D) printing. Methods: Digital impressions of patient’s dental arches were captured using an intraoral scanner, and orthodontic setups were virtually constructed. Brackets were virtually positioned in their ideal locations using the digital setups guided by virtual archwire templates. Indirect bonding trays were automatically generated using the AI-powered Auto Creation function of the Medit Splints application, which analyzes anatomical features to streamline design. Bracket transfer accuracy was evaluated in vivo by comparing planned and actual bracket positions across grouped and individual tray configurations. Linear and angular deviations were measured using conventional 3D inspection software. Results: Most bracket transfer errors were within clinically acceptable thresholds, although torque accuracy remained suboptimal. Grouped trays generally exhibited greater precision than individual trays in several dimensions. Conclusions: These findings support the application of AI-assisted design tools to enhance digital workflows and improve consistency in appliance fabrication. Full article

Molar Incisor Hypomineralization (MIH) is a common dental condition that affects the mineralization of the enamel, primarily affecting the first permanent molars and often the incisors. This condition can lead to a wide range of clinical presentations, from mild opacities to severe post-eruptive breakdown, which can significantly impact a child’s oral health and quality of life. Background/Objectives: The prevalence and complex management of MIH have posed a significant challenge for dental practitioners. Our preceding investigation found that 14.3% of school-aged children have MIH. Based on this finding, we wanted to understand what other Romanian dental professionals think about this condition. Therefore, the aim of the present study was to assess the awareness, perception, and clinical management approaches of Romanian dentists toward MIH in order to inform future educational strategies and contribute to the development of dedicated preventive programs. Methods: To gain a comprehensive understanding of MIH in actual clinical settings, we developed and administered a questionnaire consisting of three distinct sections. Our objective was to capture the collective knowledge and perspectives of dental practitioners. We distributed the survey, which included 14 pertinent questions, to a large professional group of Romanian dentists. Results: This study collected responses from 219 Romanian dental practitioners (median age: 34 years) about their experiences with MIH. The vast majority (86.76%) had encountered MIH cases in their practice, with half reporting moderate prevalence among their patients. The most frequently observed complications were hypersensitivity (41.95%), pulp exposure (33.33%), and failed restorations (24.71%). While adhesive restorations were identified as the overall preferred treatment approach (70.00%), notable differences emerged in both clinical complications encountered and therapeutic approaches implemented across dental specialties. There was near-unanimous agreement on the importance of early MIH diagnosis (99.09%), and almost all participants (98.63%) expressed a desire for more information about this condition, demonstrating high awareness and concern about MIH among Romanian dental professionals. Conclusions: This study highlights that general dentists, endodontists, and pedodontists encounter MIH patients frequently in their practice, emphasizing the critical need to enhance awareness and education about MIH among both dental professionals and the general public. Full article

Background: This study aimed to analyze and compare the translucency and marginal adaptation of five resin-based materials used as occlusal sealants, both before and after simultaneous fatigue and thermocycling. Two null hypotheses were tested: (1) All tested materials allow the transillumination of sealed occlusal carious lesions. (2) There are no differences in marginal adaptation before and after simultaneous fatigue and thermocycling. Methods: Forty extracted human molars with early occlusal caries lesions were randomly divided into five equal groups. Near-infrared transillumination images of cleaned occlusal surfaces were captured before and after applying the following sealants: (I) OptiBond FL (adhesive alone), (II) OptiBond FL (primer and adhesive) (Kerr Corp., Brea, CA, USA), (III) Scotchbond Universal (3M, St. Paul, MN, USA) combined with OptiBond FL adhesive, (IV) Fissurit (VOCO GmbH, Cuxhaven, Germany), (V) Helioseal Clear (Ivoclar Vivadent AG, Schaan, Liechtenstein). A scanning electron microscope was used to assess marginal adaptation before and after simultaneous fatigue and thermocycling. The percentages of continuous margins (CMs) were quantified before and after the fatigue test and statistically compared (Shapiro–Wilk Normality test, two-way ANOVA with Fisher’s post hoc test). Results: Helioseal Clear and Fissurit were fully transparent under near-infrared transillumination. The percentage of closed margins significantly decreased after loading in one group: OptiBond FL primer application before adhesive application significantly reduced marginal adaptation. Conclusion: OptiBond FL (adhesive), Scotchbond Universal with OptiBond FL (adhesive), Fissurit, and Helioseal Clear provided excellent marginal adaptation. However, using OptiBond FL primer on enamel negatively impacted adaptation. Helioseal Clear and Fissurit, as transparent sealants, may allow lesion monitoring using an 850 nm transillumination camera. Full article

Background: Oral diseases represent a constant burden for health care and socio-economic systems as they are correlated to other non-communicable diseases. The aim of the proposed intervention is to test the effect of daily tooth brushing and oral health education on the oral health status of kindergarten children. Methods: The protocol will be conducted based on a previous epidemiological survey and conducted over 24 months; it has been developed on different levels. Dental hygienists will receive specific training to deliver oral health promotion to children and nursery educators. Training will focus on tailoring key messages to the specific age at visit; this will be outlined in the care pathway and offer practical preparation for delivering interventions and a toothpaste/toothbrush scheme. It will also, involving involve offering free daily tooth brushing to every 4–6-year-old child attending nursery. Data will be collected in four kindergartens in the capital or metropolitan areas, two kindergartens each in two large cities, and one kindergarten each in four villages from different geographic areas. Procedures used to assess the outcomes of each activity will be tailored to specific outcomes. Daily tooth-brushing activities will be monitored using qualitative research. A cost analysis including the distribution of necessary materials and correct delivery of products that shows price trends and percentage differences over the time span as well as consumer price index evaluation for the given time span will be conducted. Clinical outcomes will be evaluated using the caries incidence rate; this will be calculated for each tooth as the unit of analysis and evaluated using a multi-step approach. Discussion: Downstream oral health prevention interventions, like clinical prevention and oral health promotion, aim to enhance children’s quality of life. The program’s goal is to progress towards upstream interventions for a more significant impact. Full article

Amidst the rapid proliferation of mHealth applications, questions persist regarding their efficacy, usability, and integration into oral health practice. This review aims to inform practitioners and stakeholders in the field of oral health about the potential of digital technologies to transform healthcare delivery and promote healthy behaviors. Key terms included “dental”, “dentistry”, “oral health”, “dental treatment”, and “tooth care”. The Google Play Store search identified 130 applications, out of which 18 met our study objectives. Most apps (n = 13) focused on providing dental appointments, oral health education, and promotion. The Mobile Application Rating Scale (MARS) quality rating revealed that only 50% of these apps were of high quality. Engagement and information were the lowest scored subscales. This review highlights the many benefits that these digital tools provide, including online appointments, teleconsultations, and access to oral health educational resources. Nevertheless, despite their potential, the current state of dental health applications left substantial room for development, especially in the areas of user involvement and information quality. The lack of reliable and accurate information in many apps may be harmful to users’ health. To fully realize the potential of these digital technologies and to enhance oral health outcomes on a larger scale, coordinated actions involving stakeholders from the technology and dentistry sectors are imperative. Full article

Background/Objectives: Children with special healthcare needs (SHCNs) face various physical, developmental, sensory, behavioral, or cognitive challenges affecting oral health and highlighting the need for specialized and more accessible oral and dental care. Mobile health (m-health) applications have emerged as a promising solution to bridge oral health education gaps and improve dental care access. This narrative review aimed to examine the available dental m-health applications designed for children with cognitive and physical impairments, exploring the perspectives of children, parents/caregivers, and dentists regarding their use and potential contribution to oral health. Based on these insights, a concept for a tailored dental m-health app is proposed, considering the interactions between children, caregivers, and dentists to support oral care. Methods: A literature search was conducted using MEDLINE/PubMed, Scopus, and Web of Science to identify studies on the use of m-health apps in pediatric dentistry for SHCN children. Results: Six studies were included in this review. M-health applications helped manage anxiety, behavioral issues, and compliance in children and were generally well received by parents and caregivers, thus improving oral hygiene practices and regular dental visits, and having the potential to reduce oral health disparities in children with cognitive and physical impairments and their families. However, current apps designed for children are limited and may not fully accommodate the diverse sensory needs of these SHCN children. Conclusions: The development of a tailored dental m-health app that adapts to the individual characteristics of SHCN children could enhance oral health awareness and support better compliance among children, parents/caregivers, and dentists. Full article

In this modern era, in which interest in natural compounds is gaining more ground, Geranium robertianum L. (Gr), a species with long use in traditional medicine, stands out for its promising potential in managing a multitude of health issues. In this context, the present review aims to explore the main phytocompounds detected in various types of extracts, as well as the biological activity of Gr species. This review was conducted by analyzing data published up to February 2025 from peer-reviewed journals and databases including PubMed, Web of Science, and Google Scholar, using key words combinations such as Geranium robertianum L. and the searched phytocompound and biological effect. According to the literature the main phytochemical classes identified in different types of extracts include tannins, flavonoids, phenolic acids, and essential oils. The most important biological actions described in the literature are antioxidant, anti-inflammatory, antimicrobial, antiulcerative, neuroprotective, anti-cancer, and antidiabetic effects. However, knowledge about Gr is still relatively limited, requiring more detailed study regarding its pharmacological proprieties and the molecular mechanisms behind them. Full article

Introduction: In orthodontics, determining the parameters of tooth size and dental arch and conducting Bolton analysis is crucial for diagnosis, treatment planning, and patient outcomes. This study evaluates the accuracy and reliability of measuring dental-arch dimensions on digital models created using the CEREC Primescan intraoral scanner, compared to measurements taken from plaster models. Methods: The study included two types of dental models (plaster and intraoral scan) from sixty-three subjects. Impressions were taken to create plaster models, and the subjects’ mouths were scanned with the CEREC Primescan system (Dentsply Sirona, Charlotte, NC) to create digital models. Intra-arch measurements included tooth heights and widths, overjet, and overbite. The arch width and depth were examined at the first permanent upper or lower molar. The paired t-test and Bland–Altman plot were used to determine the accuracy, while intra-rater and inter-rater correlation coefficient values were calculated to assess the reliability of measurements from the intraoral scan compared to those from the plaster model. Results: For tooth heights, there was a statistically significant difference in only one measurement (tooth 34) between the plaster and digital models, with an average difference of 0.01 mm. For tooth widths, there was a statistically significant difference in only one measurement (tooth 15) with an average difference of 0.03 mm. The Bland–Altman plots of almost all of measurements of tooth heights and widths showed that differences between the two models were within the limits of agreement. The inter- and intra-rater correlation coefficient values for measurements on the digital model were found to be statistically insignificant. Conclusion: Measuring dental dimensions on digital models obtained through the Primescan intraoral digital system yielded similar results to those obtained from plaster models and showed excellent reliability, indicating its potential application in clinical practice. Full article

Background: This study aims to compare treatment time and patient satisfaction between digital and conventional impression techniques in single-tooth implant prosthetics. Materials and Methods: A controlled study was conducted on 22 patients with single-tooth loss in the posterior arch who underwent implant replacement. Impressions were taken using both conventional techniques (polyvinyl siloxane) and digital methods (3Shape Trios 3 Move scanner). Results: The digital impression technique significantly reduced treatment time compared to the conventional method. The total procedure time and individual steps in the digital process were notably shorter than those in the conventional process (p < 0.001). Patients who underwent digital impressions reported not only significantly higher satisfaction and comfort levels but also less pain, unpleasant taste, and level of nausea (p < 0.001). Conclusions: Digital impressions can be superior in reducing treatment time and improving patient satisfaction compared to conventional methods, highlighting their advantages in single-tooth implant prosthetics. However, further research, involving different digital systems and clinical evaluations, is required to fully validate these advantages. Full article

Background and Objectives: Severe early childhood caries (S-ECC) is a chronic infectious disease with a multifactorial etiology which has not been completely elucidated. Research on the role of oxidative stress in the etiopathogenesis of oral diseases suggests that the level of local antioxidants plays an important role in determining susceptibility to caries. This study aimed to demonstrate that the host’s redox imbalance, modified by genetic polymorphisms, may influence the onset and severity of S-ECC. Materials and Methods: A total of 110 patients were included in the study (59 diagnosed with S-ECC and 51 healthy controls). Upon initial appraisal, the DMFT (decayed-missing-filled teeth) index was determined, and epithelial cells were collected using oral swabs for genomic DNA extraction. Genotyping of SOD2 (rs4880) and GPX1 (rs1050450) was performed using TaqMan SNP genotyping assays and real-time polymerase chain reaction (PCR). Results: According to the results of the present study, there was a significant difference between the frequency of the reference genotype and variants for rs4880 (p = 0.0303). Subjects carrying the AG and GG variant genotype of rs4880 were significantly associated with a high DMFT value (p = 0.0005). However, no significant difference was found between the genotypes for rs1050450, nor was there an association with the severity of S-ECC. Conclusions: The AG and GG variant genotypes of the SOD2 polymorphism (rs4880) increase the severity of caries in preschoolers and predispose patients to develop carious lesions, especially when associated with certain feeding practices and infrequent toothbrushing. This observation emphasizes that host sensitivity to caries is a crucial factor in the onset and development of carious lesions in primary dentition, despite the main contributing factors to this pathology. The rs1050450 polymorphism was not associated with the severity of S-ECC. Full article

Background/Objectives: Although factors acting both prenatally and postnatally are taken into consideration, the etiopathogenesis of developmental defects of enamel (DDE) is not fully understood. Among the medications used for a variety of ailments, amoxicillin and cefaclor are indicated as having a part in the development of DDE. The objective of the present study was to reproduce DDE in the laboratory in rats by administering amoxicillin, ibuprofen, and cefaclor. These lesions were subsequently diagnosed using polarized light microscopy (PLM). Methods: This study was conducted on Wistar rats, which were given prenatally drugs possibly involved in the production of DDE. After macroscopic examination and identification of enamel defects, bright-field microscopy (BFM) and PLM examination were performed. Results: The group that received cefaclor was the most affected, according to the data gathered from this study. This group was followed by the groups that received amoxicillin in a double dose, ibuprofen, amoxicillin in a standard dose, and the control group. Conclusions: In the control group, DDE was identified in a reduced number, resulting in the fact that there are other factors involved, besides the drugs administered, in the development of DDE. Following this research, it was concluded that DDE in the form of demineralization was more frequently recorded in the cefaclor and ibuprofen groups, while DDE in the form of hypoplasia was more frequently recorded in the double-dose and standard-dose amoxicillin groups. Full article

Background: Periodontitis is characterized as a change in the total periodontal tissues that includes tissue loss, as evidenced by clinical loss of attachment, and radiographically determined alveolar bone loss, periodontal pockets, and gingival bleeding. Objectives: The aim of this study was to observe and analyze recent information from the literature on the effect of enamel matrix derivative proteins on the bony defects caused by periodontitis. Methods: Through using two major online databases and search engines, the literature was manually searched for papers published until May 2024. To find relevant studies, this research utilized a combination of target keywords, and the reference lists of manuscripts that were chosen for inclusion in this study were checked and analyzed in tabular form, enabling the collection and comparison of data. Results: According to the results, the average value of the probing depth gained was 4 mm for the EMD™ alone and 4.25 mm for the EMD combined with surgical techniques such as open-flap techniques, platelet derivatives, and growth factors. In regard to clinical attachment level (CAL) gaining, average values of 3.6 mm in EMD™ alone and 3.86 mm with EMD™ combined with other techniques were observed. Conclusions: It can be concluded that the healing propensity depends on the morphological structure of the bone defect represented by the wall stage, and there is a certain coherence and correlation between the values of probing depth (PD) and clinical attachment level (CAL), whether for the use of EMD alone or its use in combination with other materials. Full article