We need tough teachers!

Dear Readers,
Following the classical set up of a university according to Humboldt, a University Professor should teach, perform research and service (in practically oriented professions). Teaching is divided in the undergraduate level and graduate level. Both are academic categories of education with the inherent objective that an academic should have the knowledge of his/her profession to be able to participate in the profession’s development in the future. This is why in many nations, especially for the so called liberal professions (Physicians, Pharmacists, Lawyers, Architects and Engineers) professional organizations are allowed to participate or even to create and enforce their own professional laws. At graduate level the objective is to train future professors. If no one else, then they should be the ones with the deep knowledge to guide the profession into the future based on the results of their research[…]

Jean-François Roulet

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Laudation in Celebration of our Mentor on his 55th birthday, Professor Georgios E. Romanos

Professor Romanos is a fascinating personality, globally renowned for his qualifications and skills in Periodontology, Oral Surgery, Implant Dentistry, Prosthodontics and Laser dentistry. He is an example of an internationally oriented leader in clinical dental sciences and related research. He got his DDS degree in Greece (1987); he then joined the Free University of Berlin, for advanced training in Periodontology and completion of his Doctoral degree (magna cum laude) on the distribution of collagen types in the healthy periodontal tissues of rats and monkeys (Marmoset)[…]

Fawad Javed, Rafael Delgado-Ruiz
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Effect of acidic/alcoholic beverages on surface roughness of composite resins light-cured in different times

Resin-based composits (RBC) are successfully used for the direct restoration of anterior and posterior teeth due to their simplified adhesive protocols, improved esthetic and adequate physical properties. Moreover, patients’ priorities have shifted to highly esthetic restorations in both the anterior and posterior region[…]

Günçe Ozan, Meltem Mert Eren, Sevda Ozel Yildiz, Hande Şar Sancaklı, Esra Yildiz


(abstract)Introduction: The purpose of this study was to evaluate the surface roughness values of various resin-based composites (RBC) regarding exposure time and immersion in alcoholic and acidic beverages. Methodology: A total of 240 disc-shaped specimens (8×2 mm) were prepared from two microhybrid, one nanofilled and one nanohybrid RBC. Specimens were divided into two groups, according to the exposure time; 20 or 40 seconds and immersed for 10 min/day during one month in either nonalcoholic (Coca Cola), alcoholic (red wine) beverages, or distilled water (n=10). Surface roughness was measured after 24 hours, one week, and one month. Results were analyzed statistically using parametric and nonparametric test. Results: The roughness values (Ra) measured at 1-month immersion were significantly higher than those measured at 24 hours. There was no statistically significant difference due to exposure time (20 or 40 seconds) (p>0.05). Structure of RBCs, presence of alcohol, and phosphoric acid in the immersion solutions caused a statistically significant difference among baseline and 1-month immersion intervals (p<0.05). Among all RBCs, lowest Ra was observed in the microhybrid RBC Charisma Classic group. Conclusion: Immersion in both acidic and alcoholic beverages altered the surfaces of all RBCs and generated significant surface roughness changes. All analyzed RBCs showed unacceptable changes in surface roughness. Keywords: Resin-Based Composites; Exposure Time; Surface Roughness; Aging.
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The influence of saliva contamination on universal adhesive bonding to enamel and dentin

Adhesion is the attraction of two different surfaces placed into direct tight contact determined by intermolecular forces that act at a relatively low distance [1]. The name adhesive indicates a material, most frequently a viscous fluid that joins (bonds) together two substrates and favours the transfer of forces from one surface to another [2]. […]

Simona Stoleriu, Gianina Iovan, Irina Nica, Galina Pancu, Sorin Andrian


(abstract)Introduction: The aims of the study were to investigate the enamel and dentin marginal seal of a universal adhesive system applied with etch and rinse and self-etch strategy and to evaluate the enamel and dentin marginal microleakage in case of saliva contamination on different steps of the adhesive application by dye penetration assessment. Methodology: Thirty class V cavities were prepared on the buccal face (group I- etch and rinse application of universal adhesive system) and the lingual face (group II- self-etch application of universal adhesive system) of molars and bicuspids. In each group 3 subgroups were created according to the moment of the saliva contamination: subgroup 1- no contamination, subgroup 2- contamination before light curing the adhesive, subgroup 3- contamination after light curing the adhesive. The dye penetration at the adhesive interface was evaluated according to a 4-score scale. Results: In both groups increased enamel and dentine microleakage was recorded in subgroups 2 and 3 when comparing to subgroup 1. In group I saliva contamination before and after light curing the adhesive resin led to similar mean value of dentin microleakage. Increased values of microleakage were recorded in group II when comparing to group I in the subgroups where contamination with saliva was done before light curing the adhesive resin. Conclusions: Saliva contamination of the adhesive system after light curing increased enamel microleakage only when the adhesive system was applied with etch and rinse strategy. Increased dentin microleakage after contamination was recorded with both strategies of universal adhesive system application. Keywords: Universal Adhesive System; Adhesion; Saliva Contamination; Etch and Rinse; Self-Etch.
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Smoking and recurrent aphthous stomatitis

Recurrent aphthous stomatitis (RAS) is a very common disease of the oral mucosa. It is called minor aphthous ulcers, herpetiform ulcers, aphthosis and many other names. Aphthous ulcers can occur alone or as part of a syndrome [1]. RAS occurs only in non-keratinized mucosa as painful, shallow round ulcers with an erythematous halo covered by a membranous layer […]

Radmila Radisa Obradovic, Marija LJ Igic, Aleksandar D Mitic, Ana S Pejcic, Kosta M Todorovic, Zana Popovic


(abstract) Introduction: Recurrent aphthous stomatitis (RAS) is one of the most usual inflammatory diseases of the oral mucosa. The clinical characteristics of RAS are well defined, but the exact etiology and pathogenesis of the disease are not. Several investigations have noticed cigarette smoking to have a protective effect on RAS. The aim of the study is to investigate the association between cigarette smoking and RAS in order to improve the current knowledge on this issue. Methodology: 68 patients with RAS participated in the study. A full mouth clinical examination was performed and an anamnesis was taken for each patient. The statistical analysis was performed using Student t-test. Results: While 6 (8.9%) of patients with RAS were smokers, a significantly higher percentage (24.9%) among the subjects with RAS were not smokers. Conclusion: The negative association between smoking and RAS indicated by this investigation is not meant to encourage people to smoke nor to spare them from the intention to quit their habit. These conclusions should be used to clear up the cause and pathogenesis of the RAS and to identify better prevention and treatment. Keywords: Oral Health; Mouth; Aphthae; Recurrent Aphthous Stomatitis; Smoking
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Evaluation of bone mineral density using Cone Beam Computed Tomography

The amount of bone tissue is called bone mineral density (BMD)[1]. Assessment of BMD is necessary in many clinical conditions such as oral systemic diseases, implant planning and it also has an important role for the stability of mini-implants as anchorage [2,3]. Computed tomography (CT) is a diagnostic method before performing dental implant. It allows accurate three-dimensional evaluation of anatomical structures of the bone[…]

Mohammad Sadegh Nazari, Ahmad Reza Tallaeipoor, Ludovica Nucci, Amir Ali Kramifar, Abdolreza Jamilian, Letizia Perillo


(abstract) Introduction: Bone mineral density (BMD) is an important factor in the use of anchorage device. This study assessed the amount of bone density in the areas from 2.5 and 8.11 mm from maxillary alveolar to basal bone in Hounsfield units. Methodology: The samples included 30 unilateral cleft palate (15 males and 15 females) with the mean age of 14.23±2.5 years and 30 non-clefts (15 males and 15 females) with the mean age of 14±2.59 years. CBCT was used to estimate the values of bone density in Hounsfield units in the cleft and noncleft patients. BMD was measured in 4 heights (2-5-8-11mm) from alveolar bone to basal bone in mesio-distal and bucco-lingual slices in the upper jaw. T-test was used to analyze the bone density values between the cleft and noncleft. Results: The highest alveolar bone density in the mesio-distal slice was 1004±6 HU between the right and left centrals in the upper jaw in height of 11 mm in non-cleft patients. The least amount of alveolar bone density in the mesio-distal slice was 259±29 HU in tuberosity in height of 11 mm in cleft patients. In non-cleft patients, the most amount of bone density was found 1639± 11 HU between the centrals in height of 11 mm in the bucco-lingual slice. Conclusions: Bone density in cleft patients was lower than in non-cleft patients in all areas and maxillary tuberosity showed the lowest bone density in cleft and non-cleft patients. Keywords: Cone Beam Computed Tomography; Bone Mineral Density; Dental Implants; Single-Tooth; Orthodontics.
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Role of the maxillary tuberosity in periodontology and implant dentistry: a review

The maxillary tuberosity (MT) is a bony region located bilaterally on the upper jaw that is posterior to the most distal molar roots. It is often characterized by its prominent rounded appearance that bulges outward from the face of the maxillary bones around the maxillary sinus. The tuber region is comprised primarily of spongy cancellous osseous tissue – specifically categorized as a combination of type III and IV bone with abundant marrow [1,2][…]

Nicholas Montanaro, José Carlos Martins da Rosa, Luis Antonio Violin Pereira, Georgios Romanos


(abstract)Background: The maxillary tuberosity in implant dentistry presents the clinical location for clinicians with respect to the periodontal, surgical, prosthetic, implantological and mechanical aspects. Objective: The aim of this paper was to evaluate the role of the maxillary tuberosity based on the literature and to enhance the role of tilted implants placed in the maxillary tuberosity as an anchorage to the most posterior end of prostheses in order to avoid biomechanical complications from distal cantilevers. Data Sources: Information was obtained mainly from the PubMed and MEDLINE databases, online books managed by the National Center for Biotechnology Information, and non-indexed sources. Previous studies have demonstrated more than 94% survival rates of implants placed in the maxillary tuberosity despite the usage of varied implant designs and surgical protocols. Data Extraction and Synthesis: The web search included the following keywords: bone, dental implant, dental implantation, maxillary osteotomy, osseointegration for period 1980 to 2017. Proper insertion of tapered implants with adequate bone condensation of the local cancellous bone is effective in generating the required primary stability and eventual osseointegration required for long-term success. In cases where implant placement in the maxillary tuberosity provides no immediate restorative benefit, various hard and soft tissues of the region can be harvested for autogenous grafting to address distant constraints. Usage of the maxillary tuberosity for implant placement or as a grafting source can provide increased options for clinicians to restore a patient’s dentition to a higher quality without the requirement of more numerous, costlier and complicated surgical restorative procedures. Keywords: Bone; Dental Implant; Dental Implantation; Maxillary Osteotomy; Osseointegration.
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fig 5-oralimplanto



Digital workflow for virtually designing and pressing ultra-thin lithium disilicate veneers for esthetic rehabilitation of fractured maxillary incisors – a case report

Working with ceramic restorations in the anterior region is still a great challenge. The number and variety of ceramic materials are increasing, offering thinner wall thicknesses with better physical and optical properties and a wide range of options when a patient needs an esthetic rehabilitation of the maxillary anterior teeth and smile. On the other hand, the patients’ expectations are growing regarding not only the esthetics of the restoration but also the predictability and visualization of the treatment plan […]

Mariann Dankó, Attila Böröczky, Zoltán Imre Kovács, Judit Borbély, Péter Hermann


(abstract)Aim: This case report aims to explain the clinical and laboratory procedures for fabricating ultra-thin lithium disilicate pressed veneers using a mixed analog/digital workflow. Summary: Ultra-thin pressed lithium disilicate veneers were produced for maxillary incisors via virtual smile design, digital wax-up and intraoral mock-up. With initial photos from the patient, the smile design could be performed considering the patient’s individual face shape. An intraoral scan was taken for the digital wax-up, guided by the contour line of smile design on the face photo. A printed model and deep-drawing template were manufactured for the mock-up. After a guided minimally invasive preparation and digital impression, the final veneers were designed as an exact copy of the mock-up. A wax pattern was designed on the computer and fabricated by milling machine. Lithium disilicate veneers were pressed, individualized and cemented using an adhesive technique. Key learning points: 1. digital workflow is convenient for a predictable procedure making lithium disilicate pressed veneers. 2. the virtual smile design – digital wax-up – intraoral mock-up scheme presents an opportunity for effective communication with the patient. 3. smile design software recommends an ideal smile curve for the patient via reference points and lines on the face. 4. guided preparation through mock-up preserves the greatest amount of enamel structure, which is important with respect to adhesive cementation. 5. when pressing lithium disilicate veneers, a mixed analog/digital workflow using CAD and a milled wax pattern results in better physical properties and marginal fit than digitally milled veneers. Keywords: Smile Design; Digital Impression; Lithium Disilicate; Pressed Veneers; Adhesive Cementation.
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Gold Standard in Occlusion Control – OccluSense®
by Dr. Jean Bausch GmbH & Co. KG.

While attending the 2019 IDS I had the opportunity to get direct knowledge of the most advanced instruments, devices and appliances for dental practice.
At the stand of Dr. Jean Bausch GmbH & Co. KG, the owner of the company, André Bausch and his daughter, presented to me and my father the new OccluSense® BK 5000 system for instrumental occlusal analysis. The OccluSense® system combines traditional and digital recording of the distribution of masticatory forces on occlusal surfaces […]

Florin-Eugen Constantinescu
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Contemporary Oral and Maxillofacial Surgery

James R Hupp, Edward Ellis III, Myron R. Tucker

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Contemporary Oral

Textbook of Endodontology

Lars Bjørndal, Lise-Lotte Kirkevang, John Whitworth

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Textbook of Endodontology