Cătălina Murariu-Măgureanu

Background/Objectives: Temporomandibular dysfunction (TMD) has a multifactorial aetiology, and the contribution of dental occlusion remains controversial. The objectives of the study were to estimate the proportion of students at the Faculty of Dentistry in Craiova with Fonseca Anamnestic Index (FAI) scores suggestive of TMD-related manifestations and to highlight possible associations between dental occlusion and FAI scores in a selected subset. Methods: A total of 106 students completed the Romanian version of the FAI. Three participants declined further participation after completing the questionnaire and before FAI scoring; their responses were not scored. The remaining 103 questionnaires were included in the FAI analysis. Following the screening, a study group of 20 students was selected from the upper end of the recorded score distribution, and a control group of 20 was selected from the lower end; 17 controls scored zero and three scored five. Static and dynamic occlusal parameters were assessed with T-Scan III where valid recordings were available. Between-group comparisons and Spearman correlations were performed, with Benjamini–Hochberg false discovery rate adjustment within defined exploratory test families. Results: The study showed that 43 of 103 students (41.75%) had FAI scores suggestive of TMD-related manifestations after the discrepant totals had been reconciled with the source questionnaires. In the selected groups, maximum intercuspation occlusion time (p < 0.001; q = 0.015), protrusive disclusion time (p = 0.003; q = 0.020), and active premature contacts during right and left lateral excursions (both p = 0.002; q = 0.015) differed after adjustment. Conclusions: Occlusal assessment with the T-Scan III System showed that differences between the selected study and control groups were more evident for dynamic parameters than for static occlusal-force distribution. The FAI does not establish a clinical TMD diagnosis, and the exploratory cross-sectional design does not support causal or therapeutic conclusions.

Background/Objectives: Complete denture rehabilitation in edentulous patients presents functional and biomechanical challenges. Mini-implant-supported overdentures improve retention, stability, function, and comfort, particularly in complex class II or class III mandibulo-maxillary relationships. However, mechanical complications such as ball abutment wear may compromise long-term success. This case report aims to describe the clinical context, methods employed to manage ball abutment wear, and related complications in a patient with a mandibular mini-implant overdenture. Methods: This retrospective case report presents two approaches to managing abutment wear and enhancing overdenture retention: silicone matrices (Retention.Sil, Bredent Medical GmbH & Co.KG, Senden, Germany) and abutment reconstruction using prefabricated cemented spheres (Concave Reconstructive Sphere, Rhein83, Bologna, Italy). Results: A significant mechanical complication associated with mini-implant overdentures is the wear of ball abutments, which may develop over time as a result of continuous interaction between the O-ring system and the abutment surfaces. Both techniques effectively preserved mini-implants while enhancing denture retention, function, and comfort. Conclusions: Mechanical complications, such as ball abutment wear, may compromise the retention and functional performance of mandibular overdentures. Alternatives like silicone matrices and reconstructive spheres address abutment wear in mandibular overdentures, ensuring long-term retention and sustainable, patient-centered care for the elderly.

Background/Objectives: Occlusal trauma does not initiate periodontitis but may accelerate its progression when inflammation is present. Chlorhexidine (CHX) mouthwash is widely used as an adjunct to periodontal therapy, although its effectiveness in patients with occlusal trauma is insufficiently documented. This study aimed to evaluate the effect of CHX mouthwash on periodontal status in patients with deflective occlusal contacts, in the absence of occlusal adjustments. Materials and Methods: This observational prospective study analyzed data from 52 patients (20 males, 32 females; mean age 41.35 years). Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) at baseline, 3 months, and 6 months. Patients were divided into groups based on CHX use and concentration. Statistical analysis evaluated intra- and intergroup variations. Results: Patients using CHX demonstrated statistically significant improvements in CPITN scores at 3 months for all sextants except sextant 5 (p < 0.05). Between 3 and 6 months, further significant improvement was observed only for sextant 6 and for the overall score. In contrast, patients without CHX showed a slight trend toward worsening CPITN values, with no statistically significant differences over the same period. Conclusions: CHX mouthwash significantly improved periodontal parameters in patients with occlusal trauma during the first three months of use. However, improvements plateaued after this period, highlighting the short-term benefits and limitations of CHX. These findings support the adjunctive role of CHX in managing periodontal disease associated with occlusal trauma but reinforce the necessity of mechanical occlusal correction for long-term stability. The CPITN index provides moderate clinical utility compared with full-mouth clinical periodontal measurements.

Background/Objectives: This retrospective observational study evaluated associations among dentition type, age, systemic conditions, and oral pathology in pediatric patients. Methods: A six-month retrospective analysis was conducted in a specialized pediatric hospital. Patients (n = 155; 0–18 years) were grouped as clinically healthy with oro-maxillofacial diseases or with systemic diseases. Data included dental/periodontal status, anomalies, gingival bleeding index, IOTN score and oral mucosal conditions. Statistical tests (chi-square, ANOVA, and correlations) were applied. Results: Chronic gingivitis was most frequently associated with primary dentition. Caries and root debris were more frequent in ages 4–6, while acute gingivitis appeared in younger children. Orthodontic treatment need increased with age, especially in mixed dentition. Periodontal diseases were most often linked to digestive pathologies. Conclusions: Oral health in children showed associations with age, dentition type, and systemic conditions. Findings highlight associations rather than causation, underscoring the importance of prevention, early monitoring, and age-appropriate interdisciplinary management.

Aim: To evaluate whether maximum occlusal loading and periodontal status are different between teeth presenting deflective occlusal contacts and those without such contacts, specifically adjacent and homologous teeth. Method: A cross-sectional study was conducted using OccluSense to detect deflective contacts and quantify occlusal load per tooth. For group comparisons, the Kruskal–Wallis, Friedman, Cochran’s Q, and chi-squared tests were used. Results: A total of 493 teeth with deflective contacts were compared to 473 adjacent (first control group) and 457 homologous teeth (second control group). Teeth with deflective contacts showed significantly higher occlusal loading (mean value: 208) than adjacent (72) and homologous teeth (97) (p < 0.05). They also exhibited more advanced periodontal damage, including deeper probing depths, greater gingival recession, alveolar bone loss, and a wider periodontal ligament space. Deflective contacts in centric relation were more strongly linked to periodontal deterioration than those in protrusive or lateral mandibular movements, despite similar occlusal forces. Conclusions: Within this study’s limitations, deflective occlusal contacts are associated with increased occlusal forces and more severe periodontal damage, suggesting a biomechanical factor in periodontal disease progression.

Background/Objectives: Among the complications of endodontic treatment, root fractures are the most severe and may require tooth extraction. The objective of this study was to develop virtual models of mandibular molars with different endodontic restorations to assess the stress distribution in tooth structures based on the type of corono-radicular restoration, compared with the model of an intact molar. Methods: Four virtual models of a mandibular molar were created: (1) an intact molar with preserved enamel, dentin, dental pulp and cementum; (2) an endodontically treated molar restored with a composite filling; (3) a molar restored with a fiberglass post and monolithic zirconia crown; (4) a molar restored with a metal cast post and monolithic zirconia crown. External force loads from 0 to 800 N were simulated using Finite Element Method (FEM). Results: The highest displacement, strain and stress values were observed in the molar restored with a composite filling, whereas the lowest values were recorded in the molar restored with a fiberglass post and zirconia crown. Critical stresses were primarily concentrated on the pulp chamber floor. Conclusions: The pulp chamber floor was identified as the most vulnerable area for fracture. This underscores the importance of preserving tooth structure to enhance the strength and durability of molars throughout and beyond endodontic treatment.

Aims: The aim of this study is to identify methods for the digital analysis of the closest speaking space in dentates and to assess certain particularities using digital analysis. Method: For the adult patients included in this study, traditional dental casts were fabricated, and interocclusal registrations of the maximal intercuspal position and of the closest speaking space were taken using polyvinyl siloxane. Dental casts in both positions were scanned using a dental laboratory scanner, and digital analysis was conducted using the 3Shape 3D Viewer. Results: The interocclusal distance corresponding to the closest speaking space can be easily and precisely measured digitally or assessed using occlusion maps, at the level of all teeth. The interocclusal distance was variable across the dental arch, central incisors, and second molars, registering the smallest values, and was asymmetrical, with mandibular lateral deviation being suggested. The assessment of the range of motion of the mandible during the speaking test, recorded based on tooth movement, was conducted using superimpositions. The movement of the tooth was the largest in central incisors and decreased progressively as the tooth was more distal, and, in all cases, mandibular deviation occurred, more frequently to the left. Conclusions: Digital methods for the analysis of the closest speaking space have the advantages of increased precision and a broader range of analysis and application, showing research and clinical value.

The aim of this study was to evaluate the biomechanical impact, in terms of stress and displacement, at the level of a mandibular overdenture, on four mini dental implants (MDIs) after the loss of an implant. A three-dimensional virtual model was obtained by scanning the overdenture, and a biomechanical analysis was carried out, using the finite element method (FEM). The displacements of the overdenture and the equivalent von Mises stresses were evaluated using logarithmic scales. In the case of a mandibular overdenture on four MDIs inserted in the interforaminal area, the frontal loading generated the lowest values for the von Mises stresses, and the bilateral loading generated the least displacement when two implants were inserted in the canine area and two in the molar area. The highest von Mises stress was observed during frontal loading in the situation of the mandibular overdenture on four MDIs, two of which were inserted in the canine area and two in the molar area, following the loss of an implant in the canine area. The largest displacement was noted in the mandibular overdenture on four interforaminal MDIs during unilateral loading, following the loss of a distally inserted implant. The FEM analysis showed aspects that correlated with clinical observations, with predictive value. The concentration of von Mises stresses, and the occurrence of some displacements of the prosthodontic restoration, can explain the emergence of some complications in the overdenture’s biodynamics, and the increased risk of fracture. Complications can be prevented by choosing a certain number of implants and a topographical distribution correlated with biomechanical aspects, and by proposing a correct occlusal scheme with optimal functional loading.

The objective of this study is to evaluate food bolus properties (mass, moisture content and food comminution) in patients wearing fixed or removable dental prostheses. Methods: A cross-sectional study was conducted on a convenience sample of patients aged at least 55 years old. Patients chewed a 10 g sample of fresh raw carrot until they felt ready to swallow. The mass of the food bolus was determined as collected and after drying. Food comminution was assessed by the multiple sieve method. Results: Patients with fixed prostheses compared to those with removable prostheses registered a similar mass of food bolus as collected (4.40 g vs. 4.60 g; p = 0.856); a higher mass of dried food bolus (3.46 g vs. 0.86 g; p < 0.001); lower moister of food bolus (24.65% vs. 82.35%; p < 0.001); and better food comminution (mass of smaller particles, of size below 2 mm, represented 65.93% vs. 20% of dried food bolus). In removable denture wearers, food comminution was slightly better in partially than in completely edentulous patients, and rather similar in completely edentulous patients with either implant overdenture or complete denture in the mandible, and complete denture in the maxilla. Conclusions: The current results suggest that food bolus properties are dependent on the dentate and prosthetic status.