Introduction: an oro-antral communication is defined as a permanent pathological connection between the maxillary sinus and the septic oral cavity. Several flaps can be used for the closure (buccal flap, palatal flap, combination techniques) but relapses occur often in case of a large defects and underlying general conditions. Bichat fad pad flap is a multipotent pedicled fatty tissue that is easily accessible from the oral cavity that can be used for the closure of medium-sized defects, even in immunocompromised patients due to its stem cell capacity. Materials and methods: the medical information of the patients diagnosed with oro-antral communications who were admitted and treated in the Oral and Maxillo-Facial Clinic Targu Mures, between 2013 and 2020 were analyzed. A database containing general information, reported causes, associated diseases, surgical methods used during admission, and relapses, was created. The information was statistically processed. The written consent and ethical approval were obtained. Results: the study shows that from a total of 140 cases, 72 were treated using buccal advancement flap, 49 using Bichat fat pad flap, and 19 using palatal flaps. The dimensions of the communications ranged between 0.3 cm and 1.5 cm. Several statistically significant results could be found when comparing the surgical methods. Of the 72 patients treated with buccal advancement flaps, 25 presented relapses as opposed to the patients treated with Bichat fat pad flaps who showed no complications, p < 0.05. Analysing this aspect further, all large defects (10 cases) ranging from 0.6 cm to 1.5 cm treated with advancement buccal flaps (Rehrmann flaps) showed relapses (p < 0.05). Considering the general conditions, out of 7 patients who received radiotherapy 4 presented relapses, as opposed to the healthy patients, p < 0.05. Regarding the reintervention for the relapsed cases, the majority of the cases treated a second time with buccal advancement flap (5 out of 7 cases) failed as opposed to the Bichat fat pad flap with no further relapses (p < 0.05). Conclusions: the most frequently used surgical treatment is the buccal flap, which also has the highest relapse rate. Both primary treatment with Bichat fat-pad flap and re-treatment of relapses using this flap have had 100% success rates, even in patients with general associated conditions, in contrast with patients treated by using the buccal flap. The dimensions of the oro-antral communication and general conditions are crucial factors for the success of the surgical treatment.

BackgroundOur aim was to determine whether low level laser therapy (LLLT) can decrease the time between extraction/socket graft and implant placement, by evaluating histological changes in sockets grafted with a particulate allograft material and treated with LLLT.MethodsThirty patients had a socket grafted with a particulate allograft material (MinerOss) covered with a resorbable collagen wound dressing. The patients were then randomly divided into two equal groups (n = 15): test group receiving postoperative LLLT treatment, and control group without postoperative laser treatment. The assessment of bone formation was carried out in both groups at well-determined time intervals after surgery by histostomorphometric analysis.ResultsThe histological results of the site treated with LLLT for 21 days, harvested at 60 days after grafting showed abundant new bone formation without any sign of inflammation. The same results were obtained in the control group not before 120 days post-surgery.ConclusionsIt can be concluded that LLLT photobiomodulation can reduce the healing time after grafting the extraction socket. Histological evidence suggests that new bone formation in the sockets appeared within 60 days after LLLT treatment compared to a minimum of 120 days in the control group.

Our objective was to investigate immunological changes that occur in saliva of subjects with type 2 diabetes mellitus (T2DM) without signs of periodontal disease and to establish if salivary inflammatory cytokines are a possible link between diabetes mellitus and periodontal breakdown.Material and methods. Twenty T2DM subjects with no periodontal disease and twenty healthy controls were registered for the present study. TNF-α and IL-6 level from saliva and serum were measured. Periodontal tissue samples were histologically examined.Results: TNF-α and IL-6 levels were higher in T2DM subjects compared to controls, with an extremely significant difference in saliva (p<0.001). Significant inflammation, affecting both epithelial and connective tissues was present in periodontal biopsies.Conclusions: The subjects showed an increased TNF-α and IL-6 levels, both in serum and -mostly in -saliva of diabetics without signs of periodontal disease, confirming the hypothesis of immunological implication, as a correlation between periodontal disease incidence and diabetes mellitus. Histologic alterations, suggesting a local inflammatory state, were present in periodontal tissue of diabetics, confirming the above hypothesis. The study reveals that saliva analysis is a quite efficient method in testing the periodontal breakdown progression in the subjects with T2DM.

The purpose of this study was to evaluate the behavior of four restorative materials in non-carious cervical lesions when subjected to exterior stresses of different magnitude. A plane model reproducing a vestibular and lingual section of the lower canine was created. The finite elements are of a two- dimensional type (2D) - quadrilater. Four restorative materials were used: Vitrebond, Dyract AP, Vitremer, Fuji IX. All materials were considered to be isotropic and elastic. Nodal charges were of 40 degrees to vertical, applied on the vestibular side at h=8.993mm to gingival crest, of increasing magnitudes:20, 40, 60, 80, 100, 120, 140, 160 N. The results of this study showed that after restoration stress values in all the elements are (with minimal differences) similar to those in the healthy tooth; a correct restoration leads to normal functioning of the tooth. It can be considered that particular types of restoring materials should be used in particular lesions to be restored, depending on the location of the lesion and the elastic characteristics of the materials and tooth structure. A correct restoration leads to normal functioning of the tooth.

Oral malodour is the general term used to describe disagreeable odor in expired air with psychological component in patients with special needs. The aim of this study is to evaluate the effect of essential oil mouthwash on oral halitosis and periodontal status of patient with special needs. 26 patients aged between 16-45 were enrolled in this single-blind, parallel-group study. Informed consent was obtained. The following parameters were recorded: gingival index, plaque index, organoleptic breath assessment, and BANA test from tongue coating samples prior to treatment with essential oil mouthwash (group 1) or a placebo (group 2) at baseline and 28 days after the start of treatment. There were significant differences (p[0.05) in plaque and gingival index after treatment with essential oil mouthwash compared to the placebo. The results provide a statistically significantly greater level of efficacy in controlling established plaque and gingival index after use of essential oil mouthwash. Therefore, it can be recommended in halitosis therapy in order to maintain a good periodontal status.