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"Burlibasa, Mihai"
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Nanofeatured Titanium Surfaces for Dental Implants: A Systematic Evaluation of Osseointegration
by
Căminișteanu, Florentina
,
Șerbănescu, Cristina Maria
,
Popescu, Mircea
in
Analysis
,
Animal experimentation
,
Animal models
2025
Background: Whether nanoengineered titanium surfaces confer superior implant stability beyond modern microrough controls remains uncertain. Methods: This systematic review followed PRISMA 2020 guidance: comprehensive multi-database searching with de-duplication; dual independent screening, full-text assessment, and standardized data extraction for predefined outcomes (implant stability quotient [ISQ], mechanical anchorage by removal/push-out/pull-out torque, and histologic bone-to-implant contact). Risk of bias was appraised with RoB 2 for randomized trials, ROBINS-I for non-randomized clinical studies, and CAMARADES (animal experimentation). The certainty of clinical evidence was summarized using GRADE. Results: Across animal models, nanoengineered surfaces consistently improved early osseointegration indices (higher removal torque and bone-to-implant contact at initial healing). In clinical comparative studies, nanoengineered implants showed modest, time-limited gains in early stability (ISQ) versus microrough titanium. By 3–6 months, between-group differences typically diminished, and no consistent advantages were demonstrated for survival or marginal bone outcomes at later follow-up. Methodologic heterogeneity (surface chemistries, timepoints, outcome definitions) and small clinical samples limited quantitative synthesis. Overall, risk-of-bias concerns ranged from some concerns to high in non-randomized studies; the certainty of clinical evidence was low. Conclusions: Nanofeatured titanium surfaces improve early osseointegration but do not demonstrate a consistent long-term advantage over modern microrough implants. Current evidence supports an early osseointegration benefit without clear long-term clinical advantage over contemporary microrough implants. Adequately powered, head-to-head trials with standardized stability endpoints and ≥12-month follow-up are needed to determine whether early gains translate into patient-important outcomes.
Journal Article
COVID-19 and flu vaccination in Romania, post pandemic lessons in healthcare workers and general population
2024
Influenza and corona viruses generate vaccine preventable diseases and have pandemic potential, frequently dramatic. A co-infection with these viruses, may be a new worldwide threat, researchers name it flurona. The aim of our study is to assess flu and COVID-19 Romanian vaccination for 2022-2023 season and the factor associated with higher odds to receive flu and COVID-19 vaccine.
An analytical cross-sectional observational survey was conducted in the general population; a self-administered questionnaire was used.
1056 responders were analyzed, mean age 32.08 ±13.36 years (limits:18-76), majority, 880 (83.33%), from urban areas, 608 (57.58%), high school graduated, 400 (37.88%) parents. More than half of the responders were healthcare workers, 582 (55.11%), also considered study population. In the study group, 796 (73.37%) responders consider flurona vaccination useful; and 872 (82.57%) responders consider that no sanctions are needed for not flurona vaccinating. In the 2022-2023 season, 162 (15.34%) responders vaccinated against the flu and 300 (28.41%) against COVID-19. The factor associated with higher odds to receive flu and COVID-19 vaccine was the habit of flu vaccination: for flu (OR = 58.43; 95% CI: (34.95-97.67)) and for COVID-19 (OR = 1.67; 95% CI: (1.21-2.31)). Other factors such as having university degree (OR = 1.46; 95% CI: (1.08-1.98)) and being a healthcare worker, (OR = 1.41; 95% CI: (1.07-1.87)) were influencing factors only for adult COVID-19 vaccination in the 2022-2023 season. In the parents' group, in 2022-2023 season, only 48 (12%) vaccinated their children against the flu and 68 (17%) against COVID-19, mostly parents that vaccinated themselves, p<0.001. In the 2022-2023 season, there were only 82 (7.65%) responders vaccinated against both diseases. Logistic regression analysis showed that no factor analyzed influenced the flurona vaccinated parent's decision to vaccinate their children for flu and for COVID-19.
In the season 2022-2023, in Romania, the vaccination against flu and COVOD-19 is low, in adults and children as well. More efforts must be done to increase flurona vaccination, public health educational programs are strongly needed. Children, that are at greater risk when co-infecting with these viruses, must be vaccinated, school vaccination programs should be considered.
Journal Article
The Evaluation of Restored Proximal Contact Areas with Four Direct Adherent Biomaterials: An In Vitro Study
by
Căminișteanu, Florentina
,
Marcov, Narcis
,
Ștețiu, Maria Antonia
in
adherent biomaterials
,
Analysis
,
Biological products
2025
The aim of this study was to compare the interproximal contact tightness of lateral teeth after restoring adjacent proximal walls with four types of direct adherent biomaterials. Distal and mesial boxes were prepared on 160 artificial right first and second upper molars. Each set of 40 pairs of boxes was restored using one bulk biomaterial: Equia Forte Fil HT (GC), Cention® Forte (IVOCLAR VIVADENT), Admira Fusion x-tra (VOCO), or 3MTMFiltekTM One Bulk Fill. The mean difference in the passing-through force varied from sound to restored surfaces immediately after application, as well as at 7 and 14 days after: Equia Forte Fil HT—4.07 ± 0.01, 4.08 ± 0.01, and 4.11 ± 0.01; Cention® Forte—3.30 ± 0.01, 3.50 ± 0.01, and 3.56 ± 0.01; Admira Fusion x-tra—4.10 ± 0.01, 4.13 ± 0.01, and 4.13 ± 0.01; 3MTMFiltekTM One Bulk Fill—4.08 ± 0.01, 4.09 ± 0.01, and 4.07 ± 0.01 (p < 0.05). The passing-through force of the restored contact areas showed significantly higher values when compared to those for the sound surfaces, and among them, all biomaterials presented similar values, except for Cention® Forte. The potential clinical relevance of this study relates to better knowing the most appropriate restorative material for large proximal caries on adjacent surfaces from the outset of the treatment protocol.
Journal Article
Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review
by
Ștețiu, Maria Antonia
,
Popescu, Mircea
,
Drăguș, Andi Ciprian
in
3-D printers
,
Bias
,
Clinical outcomes
2025
Objectives: This systematic review aimed to evaluate the cost, production time, clinical performance, and patient satisfaction of 3D printing workflows in prosthodontics compared to conventional and subtractive methods. Methods: Following PRISMA guidelines, a systematic search of electronic databases was performed to identify studies published between 2015 and 2025 that directly compared digital additive workflows with analogue or subtractive workflows. Studies were eligible if they included prosthodontic treatments such as dentures, crowns, or implant-supported prostheses and reported at least one relevant outcome. The primary outcomes were cost, time efficiency, clinical accuracy (e.g., marginal adaptation, fit), and patient satisfaction. Included studies were methodologically evaluated using MINORS scale and the risk of bias was assessed using ROBINS-I and RoB 2 tools. Results: Seven studies met the inclusion criteria. Overall, 3D printing workflows demonstrated reduced production time and cost in comparison to conventional or subtractive methods. Clinical outcomes were generally comparable or superior, particularly regarding adaptation and fit. Patient satisfaction was favourable in most studies, although reporting varied. Long-term follow-up was limited, which constrains the interpretation of sustained clinical performance. Conclusions: These findings suggest that 3D printing can serve as an efficient and cost-effective alternative in prosthodontic fabrication, with clinical results comparable to those already established. Further research is needed to assess long-term clinical performance and cost-effectiveness in various clinical scenarios.
Journal Article
Assessing the Genotoxic Impact of Ni-Cr Alloys in Dental Prosthodontics: A Preliminary Comparative Analysis with and Without Beryllium
by
Caministeanu, Florentina
,
Burlibasa, Mihai
,
Popa, Andrei Sabin
in
Alloys
,
Beryllium
,
Biomedical materials
2025
Objective: This study aims to evaluate cell proliferation capacity and micronuclei incidence in the presence of nickel–chromium (Ni-Cr)-based dental alloys, with and without the addition of beryllium (Be). The use of these alloys in dental prosthetics is widespread; however, the potential risks associated with their genotoxicity and cytotoxicity require further investigation. The study seeks to provide insight into the safety of these materials and their long-term impact on the health of both patients and dental professionals. Methods: The study was conducted through a comparative analysis of genotoxicity and cytotoxicity using human lymphocyte cultures exposed to two types of Ni-Cr-based dental alloys, one containing beryllium and the other without beryllium. The evaluations were performed according to the OECD Test No. 487 guideline, employing the micronucleus assay and cell proliferation assay. Lymphocytes were exposed to three different alloy concentrations (5 mg/mL, 10 mg/mL, and 20 mg/mL), and the effects on genetic material were analyzed microscopically. Descriptive statistics (mean, standard deviation, and variance) were calculated, and one-way ANOVA was used to assess statistical significance between groups, with a significance threshold of p < 0.05. Results: A significant increase in cytotoxicity and micronuclei incidence was observed in the samples containing beryllium compared to those without beryllium. Statistical analysis revealed significant differences (p < 0.001) between the test and control groups and between different concentrations. Additionally, a direct proportional relationship was noted between alloy concentration and the intensity of genotoxic effects. Microscopic analysis confirmed genetic material damage, indicating a potentially increased risk associated with the use of this type of dental material. Conclusions: The data obtained suggest that Ni-Cr-based dental alloys containing beryllium may present a significant risk of genotoxicity and cytotoxicity. Therefore, the selection of materials used in dental prosthetics should be based on solid scientific evidence, and the use of these alloys should be approached with caution. The study highlights the need for further research to better understand the long-term impact of these materials on human health.
Journal Article
Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software
by
Cristache, Gheorghe
,
Cristache, Corina Marilena
,
Burlibasa, Mihai
in
anaplastology
,
Data processing
,
Defects
2021
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories.
Journal Article
Could Pro-Inflammatory Cytokines Levels IL-6, IL-8, TNFα, Total Antioxidant Status and Lactate Dehydrogenase Be Associated with Peri-Implant Bone Loss? A Pilot Study
by
Cristache, Corina Marilena
,
Burlibasa, Mihai
,
Petre, Alexandru Eugen
in
Antibodies
,
Antioxidants
,
Cytokines
2021
Background: The mechanisms of periimplantitis are mostly based on biofilm-induced inflammatory lesions around dental implants. However, the host reaction, reflected by the intensity of the inflammatory response to bacterial products, is crucial for peri-implant bone destruction. The aim of this pilot study was to measure total antioxidant status (TAS), the amount of IL-6, IL-8 and TNF-α (tumor necrosis factor), salivary lactate dehydrogenase (LDH) levels and the correlation with one-year peri-implant bone loss. Methods: Seven consecutive patients (Group 1), with the presence of at least one prior inserted dental implant, and three healthy individuals, fully dentate (Group 0), were enrolled. IL-6, IL-8, TNF-α, TAS and LDH were determined in saliva of both groups. Peri-implant marginal bone loss (MBL) at one year compared to baseline was evaluated for Group 1. Results: A statistically significant positive correlation was found in Group 1 between MBL and the IL-8 (p = 0.033) and a strong negative correlation between MBL and TAS (p = 0.002), but no statistically significant differences of the assessed parameters were found between the two groups. Conclusions: In the limits of the present preliminary study, salivary TAS and proinflammatory cytokines could be associated with the risk of peri-implant bone loss over time.
Journal Article
Clinical versus Dental Laboratory Survey Regarding Modern Fixed Implant Supported Prosthetic in Romania
by
Gagiu, Catalin
,
Burlibasa, Mihai
,
Panaitescu, Eugenia
in
dental education
,
dental materials
,
Design
2022
(1) Background: The success of prosthetic treatment with implant support depends on the combined effort of the team doctor-technician, each of them being responsible for the validation of execution stages. (2) Methods: we composed an online questionnaire with 18 multiple choice questions, using the Google Forms application. It was filled out by an equal number of prosthodontic specialists and dental technicians. Differences and associations were evaluated by Likelihood Ratio test, Linear by Linear association test, Kruskal-Wallis H test, Pearson Chi-Square test and the Fisher’s Exact test. (3) Results: Differences and similarities were found between the statements of prosthodontic specialists and dental technicians. Years of experience are correlated with the number of restorations, impression techniques and types of restoration (p ≤ 0.05). Similar answers for both groups were registered for preferred screw retained type of prosthetic abutment and most frequently reported complications. (4) Conclusions: The different perspectives of the two members of the prosthodontic team regarding the leading role in the treatment plan, type of abutment, impression technique and prosthetic design of implant fixed restorations has been revealed in our study. Similar education curricula and standards for continuing training courses after graduation are necessary for prosthodontic specialists and technicians in Romania.
Journal Article
Case Report: Digitally driven tooth autotransplantation using surgical templates and three-dimensional printed donor tooth replica
by
Diaconeasa, Marius Ștefan
,
Perieanu, Viorel Ștefan
,
Burlibașa, Mihai
in
3-D printers
,
Adaptation
,
case report
2025
Tooth autotransplantation is a procedure involving the surgical repositioning of a tooth or dental germ from one site in the mouth to another within the same individual. A successful procedure requires a donor tooth with healthy cementum and periodontium, gentle surgical maneuvers, a well-fitted neoalveolus, and a short extraalveolar time of the donor tooth. Digital technology increases the accuracy and predictability of the tooth autotransplantation procedure. Surgical templates generate a more precise neoalveolus, with good stability of the donor tooth, and decrease the surgical time. Using a donor tooth replica ensures an optimal morphology of the new alveolus, thus reducing the injury of the root and the extraoral time of the donor tooth. This case report presents the tooth autotransplantation technique, that was employed to reposition a maxillary premolar with two fused roots on a mandibular recipient site. Digital planning, two surgical guides (one for each root), and a 3D printed tooth replica were used to ensure good accuracy, prognosis, and reduced treatment time. The procedure is conservative and offers considerable advantages to the patient, such as retaining natural teeth and proprioception.
Journal Article
Are Nano TiO2 Inclusions Improving Biocompatibility of Photocurable Polydimethylsiloxane for Maxillofacial Prosthesis Manufacturing?
by
Cristache, Corina Marilena
,
Burlibasa, Mihai
,
Totu, Eugenia Eftimie
in
3D printing
,
Biocompatibility
,
Cell division
2021
(1) Background: The development of a biocompatible material for direct additive manufacturing of maxillofacial extraoral prosthesis is still a challenging task. The aim of the present study was to obtain a photocurable PDMS, with nano TiO2 inclusions, for directly 3D printing of extraoral, maxillofacial prosthesis. The biocompatibility of the newly obtained nanocomposite was also investigated; (2) Methods: 2.5% (m/m) titania nanoparticles (TiO2) oxide anatase and a photoinitiator, benzophenone (BF) 4.5% were added to commercially available PDMS for maxillofacial soft prostheses manufacturing. The three different samples (PDMS, PDMS-BF and PDMS-BF-TiO2) were assessed by dielectric curing analysis (DEA) based on their viscosities and curing times. In vitro micronucleus test (MNvit) was performed for genotoxicity assessment and three concentrations of each compounds (2 mg/L, 4 mg/L and 8 mg/L) were tested in duplicate and compared to a control; (3) Results: The nanocomposite PDMS-BP-TiO2 was fully reticulated within a few minutes under UV radiation, according to the dielectric analysis. PDMS-BF-TiO2 nanocomposite showed the lowest degree of cyto- and genotoxicity; (4) Conclusions: In the limits of the present study, the proposed ex situ preparation of a PDMS-BP-TiO2 offers an easy, simple, and promising technique that could be successfully used for 3D printing medical applications.
Journal Article