Alina Adumitroaie

Exploring the oxidative stress markers involved in inflammation-driven processes and gingivo-periodontal alterations in healthy children and, in particular, in children with leukemia is insufficiently addressed in the current literature. The objective of this study was to develop an oxidative stress variable in order to explore the relationship between local and systemic SOD (superoxide dismutase) levels and gingival and periodontal alterations in a juvenile population with leukemia. Out of 97 children included in our investigation, 47 were diagnosed with this hematologic malignancy and 50 children without this pathology represented the control batch. Gingival crevicular fluid (GCF) and plasma samples were collected and the levels of SOD, MDA (malondialdehyde) and 8-OHdG (8-hydroxy-2’-deoxyguanosine) were quantified using ELISA (enzyme-linked immunosorbent assay) techniques. An oxidative stress variable was constructed, based on the arithmetic average of the two biomarkers (MDA and 8-OHdG), then compared to SOD values and analyzed for a potential antioxidant role in the cascade of oxidative stress on gingival and periodontal tissues, both locally in GCF and systemically in plasma. The statistical analysis was based on Pearson correlation tests and linear regression analysis, using SPSS software (IBM SPSS Statistics 26). The findings of the present study suggest alterations in the oxidative status at both the local and systemic levels in children with leukemia, without supporting a significant antioxidant role of SOD within the complex cascade of oxidative and antioxidant changes associated with this oncologic condition.

Background/Objectives: Oral health-related quality of life (OHRQoL) is a complex topic, encompassing the medical, functional and psychosocial aspects of well-being, especially in the context of systemic conditions that can trigger oral cavity impairment. While this subject has been extensively investigated in adults, evidence remains limited in pediatric populations, particularly in children with leukemia who are at high risk for oral complications related to the disease itself and its treatment. Moreover, children and parent perceptions of oral health are essential for guiding preventive and personalized therapeutic strategies, yet they are poorly explored in this clinical context. The objective of this study was to assess OHRQoL in children with leukemia and gingival inflammation, and compare it with that of children without this systemic condition. Methods: This observational, cross-sectional, case–control study was conducted on 99 subjects, divided into two groups: the study group n = 49 leukemia subjects and the control group n = 50 subjects without oncologic pathology. Clinical examination of all subjects was performed and oral health status was evaluated using Oral Health Index-Simplified (OHI-S) and Gingival Index (GI). Parents filled out a personalized exploratory questionnaire, adapted after established scales, designed to capture the child’s perceived impact of certain leukemia-related gingivo-periodontal alterations, including pain, ulcerations, gingival bleeding and xerostomia. Data were analyzed using descriptive statistics, Pearson’s Chi-square test and comparative graphical analyses (IBM SPSS Statistics 26). Results: Children with leukemia reported higher frequencies of xerostomia, ulcerations and gingival bleeding compared to children in the control group, with xerostomia showing a suggestive association to gingival inflammation. Oral hygiene status of children in the leukemia group was generally better among children receiving parental assistance during brushing or those practicing dental flossing. Comparative graphical analyses showed differences in symptom reporting and oral hygiene support between groups. Conclusions: The results suggest that xerostomia seemed to align with gingival inflammation in children with leukemia, while parental assistance and dental flossing seemed to be associated with better oral hygiene status. Our findings also support the need for developing standardized, disease-oriented scales of evaluating OHRQoL, as well as individualized oral care and continuous monitoring in order to improve oral health-related quality of life in this vulnerable pediatric population.

Aim: This review examines the challenges faced by dental professionals when treating patients with disabilities, both developmental and acquired, and proposes evidence-based recommendations to optimize care and patient-provider trust. Materials and method: A comprehensive review of the literature was conducted, focusing on behavioral, sensory, and procedural barriers in dental treatment for individuals with disabilities. Studies addressing clinical strategies, caregiver involvement, and environmental adaptations were analyzed to develop practical guidelines for effective management. Results: Patients with disabilities often exhibit communication difficulties, heightened anxiety, and sensory sensitivities, which can complicate routine dental procedures. Effective management strategies include individualized care plans, structured and predictable appointments, caregiver collaboration, and tailored behavior guidance techniques. Environmental adaptations, such as reducing sensory stimuli and using visual supports, along with positive reinforcement and pre-visit preparation, were consistently identified as critical factors in facilitating cooperation and building trust. Conclusions: Implementing structured, patient-centered strategies enables dental professionals to provide safe, effective, and compassionate care for patients with disabilities. Adopting these evidence-based guidelines enhances treatment outcomes, improves patient satisfaction, and fosters confidence in both patients and caregivers, supporting the broader goal of enabling individuals with disabilities to achieve optimal oral health and overall quality of life.

Background/Objectives: This study aimed to investigate specific biomarkers of oxidative stress within gingival crevicular fluid (GCF) and plasma obtained from children with leukemia compared to healthy subjects, in relation to the oral hygiene status and gingival inflammatory status, in order to identify a possible association linking childhood leukemia with gingival inflammation. Methods: The study comprised biomarker analysis from 97 children divided into two groups: 47 leukemia subjects and 50 systemically healthy children in the control group. The GCF and plasma specimens were analyzed to determine values of 8-OHdG (8-hydroxydeoxyguanosine) and SOD (superoxide dismutase) using ELISA (enzyme-linked immunosorbent assay) techniques, while MDA (malondialdehyde) values were measured through colorimetry. Results: We found elevated plasma expressions of all investigated biological parameters among leukemic children relative to the control group. GCF measurements highlighted raised 8-OHdG and SOD in leukemic individuals, while MDA recorded no significant shift between the groups. The statistical analysis also revealed a possible GCF and plasma SOD levels associated with the oral hygiene and gingival inflammatory status. Conclusions: The increased expression of oxidative stress markers we found in children with leukemia underlines the heightened inflammatory and oxidative burden in this category of population, yet additional studies are needed to clarify the intricate relation between systemic oxidative stress, oral biomarkers and gingival health outcomes in children, especially in children with critical systemic alterations such as leukemia.

Aim of the study The aim of this study was to monitor and assess the periodontal changes in a group of children diagnosed with Insulin-Dependent Diabetes Mellitus (IDDM), by correlating their periodontal status with the level of metabolic control of the disease, in order to highlight the impact of diabetes on oral health during childhood. Materials and methods The clinical study included two groups of children aged between 4 and 18 years. The control group consisted of 30 healthy patients with no systemic pathologies. The study group comprised 30 children diagnosed with IDDM, under medical supervision in the "Nutrition Disorders" Department of the “Sf. Maria” Emergency Clinical Hospital for Children in Iași. The clinical examination focused on evaluating three periodontal health parameters: the plaque staining index (QH), the gingival inflammation index (GI), the papillary bleeding index (PBI), and the level of clinical attachment loss (CAL). Periodontal diagnosis was performed according to internationally accepted standardized criteria. Results The results showed significantly increased values of all analyzed indicators in the study group with poorly controlled metabolic IDDM children, compared to the control group. Gingival inflammation was particularly pronounced in diabetic patients, suggesting increased vulnerability of the periodontal tissues in the context of diabetes mellitus. Conclusions Children diagnosed with Insulin-Dependent Diabetes Mellitus are at significantly increased risk of periodontal involvement, with clinical manifestations being more severe in those with poor metabolic control. These results highlight the need for rigorous monitoring and interdisciplinary collaboration between the diabetologist and the pediatric dentist, in order to optimize the oral health of these patients and prevent the periodontal complications commonly seen in diabetic adults.

Background/Objectives: Our study aimed to evaluate the oral health status associated with levels of certain inflammatory biomarkers in the gingival crevicular fluid (GCF) and plasma of children and adolescents with leukemia, in comparison to healthy subjects, in order to assess the correlation between pediatric leukemia and gingivo-periodontal alterations. Methods: The study was conducted on 97 subjects, divided into two groups: the study group, n = 47 leukemia subjects, and the control group, n = 50 healthy subjects. The collected GCF and plasma samples were analyzed for interleukins IL-1β, IL-6 and IL-17α and transforming growth factor TGF-β1 values using ELISA (enzyme-linked immunosorbent assay) techniques. Results: IL-6, IL-17α, and TGF-β1 recorded higher values for leukemia subjects, both in the GCF and plasma, compared to healthy subjects. Our results also pointed out higher gingival fluid IL-1β values in children with leukemia compared to the control group. Conclusions: Elevated expressions of IL-1β in the GCF and IL-6, IL-17α, and TGF-β1, both systemic and local, in the GCF of children with leukemia were associated with oral hygiene status and gingival inflammation, respectively. All inflammatory biomarkers generally tended to rise in close correlation with oral hygiene worsening and gingival inflammation extension; however, IL-1β in the GCF and plasma, plasma IL-6, and gingival fluid IL-17α pointed out a stronger correlation with gingival inflammation status.

Aim: This study examines the impact of dental caries on children's daily activities based on parental perceptions. By utilizing the Parent-Caregiver Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS), the study evaluates the effects of dental caries on physical, emotional, social, and functional well-being, as well as family dynamics. Material and Methods: A total of 150 parents, aged 27 to 43, from urban and rural areas, completed the survey, providing insights into their children's oral health-related quality of life. The data was collected using the P-CPQ and FIS, then analyzed using SPSS version 20 to assess statistical correlations. Results: The findings indicate that 42% of parents rated their child's oral health as "very good," while 4% considered it "excellent." Additionally, 34% of parents acknowledged that their child's overall well-being was "somewhat" affected by oral health issues. Statistical analysis revealed significant correlations between oral health and school absenteeism, concentration difficulties, social interactions, and emotional distress. Moreover, family well-being was impacted, with notable associations between children's dental symptoms and parental stress, sleep disruptions, and financial burdens. Conclusions: This study underscores the significant impact of dental caries on children's daily lives, as perceived by their parents. Poor oral health was found to be closely linked to school absenteeism, concentration difficulties, social challenges, and emotional distress. Additionally, the effects extended beyond the child, influencing overall family well-being by contributing to parental stress and sleep disruptions. These findings highlight the need for preventive oral health strategies and early interventions to improve children's quality of life and reduce the broader impact on their families.

The aim of the study is to identify the dental somato-facial anomalies in young patients with early loss of temporary teeth, with the identification of crowding and other present clinical entities. The study was carried out on a working batch of 635 subjects who referred to the Pediatric Dentistry Clinic in Iasi and the private dental practice for various dental treatments, without any obvious dysfunctional subjective symptomatology. Out of 635 subjects,254 were female (40%) and 381 male patients (60%), distributed in the rural area (n=157; 24.7%) and urban area (n=478; 75.3%). By applying the selection criteria, the aim was to avoid issues of differential diagnosis with other disorders of the orofacial system. The mean age of the girls in the group was 8.26±1.840 years and the mean age of the boys was 8.77±1.856 years; the mean age of the rural children was 8.88±1.962 years, with an average of 8.46±1.823 years for the urban children. Dental malocclusions represent complex clinical entity, capable of producing functional, aesthetic and psychological disharmonies. Malocclusions can be caused by a combination of factors, in which the early loss of temporary teeth, the frequency of vicious habits, without excluding genetic determinism, are particularly important. The disorders that occur in the case of malocclusion may be aesthetic, masticatory, speech impairments, temporomandibular joint dysfunctions and social integration disorders.