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52 result(s) for "Hedeșiu, Mihaela"
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Imaging Modalities in Medication-Related Osteonecrosis of the Jaw: A Narrative Review of Diagnostic Findings and Staging
Background and Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication of antiresorptive and antiangiogenic therapies. Early and accurate imaging is crucial for diagnosis and management. This review summarizes the current evidence on MRONJ imaging findings across modalities and identifies gaps for future research. Materials and Methods: This narrative review analyzed 32 studies (2010–2024) retrieved from PubMed and EBSCO examining imaging findings and diagnostic patterns of medication-related osteonecrosis of the jaw across different modalities. Two independent reviewers screened all articles, extracted data, and assessed methodological quality. Results: Early-stage MRONJ findings included osteosclerosis, lamina dura thickening, and increased prominence of the inferior alveolar canal, while late-stage findings included periosteal reactions, sequestration, and cortical erosion. CBCT and MRI were most sensitive for early detection and lesion extent. However, substantial variability in imaging protocols limited direct comparisons between studies. Conclusions: This review highlights the variable imaging findings of MRONJ and the need for standardized protocols. Advanced imaging techniques and quantitative indices hold promise for improving early diagnosis, staging, and management.
Changes in the Position of Anatomical Points, Cranio-Cervical Posture, and Nasopharyngeal Airspace Dimensions in Complete Denture Wearers—A Cephalometric Pilot Study
Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine.
Pediatric Versus Adult Nasopharyngeal Cancer in Diffusion-Weighted Magnetic Resonance Imaging
Background: This study aimed at evaluating apparent diffusion coefficient (ADC) values of nasopharyngeal carcinoma (NPC) in the pre-treatment stages of NPC for establishing comparative quantitative parameters between children and adolescents compared to adults. Methods: A retrospective multicentric imaging study was conducted in three medical centers by collecting patient data over a 5-year timeframe. Patients were included in the study based on the following criteria: histopathologically proven carcinoma of the nasopharynx with all available medical records. The total sample included 20 patients (6 pediatric patients and 14 adults). A quantitative analysis of the ADC maps was performed. Two radiologists manually drew the region of interest (ROI) on ADC maps using the whole tumor on all magnetic resonance imaging (MRI) slices. The mean ADC was extracted for each patient and each radiologist’s evaluation. Differences in ADC values between pediatric and adult patients were evaluated using an independent samples t-test, with normality and variance assumptions tested via the Shapiro–Wilk and Levene’s tests, respectively. p-values less than 0.05 were considered statistically significant. Results: The mean ADC values extracted from the initial pre-treatment diffusion-weighted imaging (DWI) data from magnetic resonance imaging (MRI) in children were 712.22 × 10−6 mm2/s, compared to adults in whom the mean ADC values were 877.34 × 10−6 mm2/s. We found a statistically significant difference between the mean ADC values of pediatric patients and adult patients, t (17.44) = −3.15, p = 0.006, with the mean ADC values of pediatric patients (M = 712.22, standard deviation [SD] = 57.03) being lower, on average, than the mean ADC values of adult patients (M = 877.34, SD = 175.25). Conclusions: Our results showed significantly lower ADC values in pediatric patients than in adults, independent of tumor T-stage. Additionally, early-stage tumors, particularly in children, tended to exhibit even lower ADC values, suggesting potential biological distinctions across age groups.
Salivary Exosomal MicroRNA-486-5p and MicroRNA-10b-5p in Oral and Oropharyngeal Squamous Cell Carcinoma
Background and Objectives: The research aimed at evaluating the capacity of salivary exosomal miR-10b-5p and miR-486-5p for oral and oropharyngeal cancer detection. Materials and Methods: The saliva samples were harvested from histopathological diagnosed oral and oropharyngeal squamous cell carcinoma patients and healthy volunteer subjects. The exosomes were isolated by differential ultracentrifugation and quantified by Nano Track Analysis. The microRNAs were extracted and quantified from salivary exosomes by quantitative Real-Time Polymerase Chain Reaction. Results: This research comprised fifty participants. When compared to healthy controls, salivary exosomal miR-486-5p was elevated and miR-10b-5p was reduced in oral and oropharyngeal squamous cell carcinoma. Moreover, miR-486-5p had a high expression level in stage II of cancer in comparison to the other cancer stages. The cancer samples presented an increased exosome dimension compared to the control samples. Conclusions: Salivary exosomal miR-10b-5p and miR-486-5p have an altered expression in oral and oropharyngeal cancer.
Evaluation of the Mandibular Condyle Morphologic Relation before and after Orthognathic Surgery in Class II and III Malocclusion Patients Using Cone Beam Computed Tomography
This study aimed at evaluating the mandibular condyle position changes before and after bimaxillary orthognathic surgery in class II and III malocclusion patients. CBCT scans from patients who underwent bimaxillary orthognathic surgery were analyzed: Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). Both condyles were independently assessed for their largest anterior and posterior joint spaces, smallest medial joint spaces, and condyle angles concerning the transverse line. In the sagittal plane, the minimum size of the anterior and posterior joint spaces was measured. In the coronal plane, the smallest medial joint space was measured. The position of the condyle within the glenoid fossa was determined before and after surgery. A total of 56 TMJs from 28 patients were studied. Following orthognathic surgery, the anterior and posterior space in class II increased. Postoperatively, the anterior joint space in class III decreased. In 42.85% of malocclusion class II patients and 57.14% of malocclusion class III patients, the pre-and post-surgical position of the condyle changed, the condyle was anteriorly positioned (42.85%) in class II patients and centrically positioned (71.4%) in class III patients. Significant changes in the joint space, condylar position, and condyle angle were found in the class II and class III subjects.
Three-Dimensional Finite Element Analysis on Mandibular Biomechanics Simulation under Normal and Traumatic Conditions
The main objective was to examine the biomechanical behavior of the mandible under standardized trauma and to develop models of biomechanical responses when the mandible is subjected to various simulated impacts. A homogenous model based on the bone’s average mechanical properties was used. To simulate external loads on the mandible, forces on the chin, forces in an anteroposterior direction, and forces from the basilar edge were applied. To simulate mandibular biomechanics, we employed a model created in the ANSYS v19.0 software. The skull with the temporomandibular joint (TMJ) from the Grabcad website was used as the geometric mandibular model. We attempted to simulate the stresses developed in the mandible by impact forces. The amount of force (F) corresponded to the fall of a five-kilogram body (the head), from a height of two meters (F = 6666.7 N). The impact force was applied perpendicular to an arbitrary surface of an area of 10−3 m2. Impact on the chin region and lateral impact on the mandible, from the basilar edge to the gonion were examined. The investigated clinical situations were mandibular complete dentition; jaw with missing mandibular molars; missing third molar and first and second premolars; missing canine, third molar, first and second premolars, and complete edentation. In a normal bite, the highest stress was on the TMJ area. In case of impact on the chin, in complete edentation, a mandibular fracture occurred; in case of impact on the gonion, all stress values exceed the limit value above which the mandible in the condyle area may fracture.
Automating Dental Condition Detection on Panoramic Radiographs: Challenges, Pitfalls, and Opportunities
Background/Objectives: The integration of AI into dentistry holds promise for improving diagnostic workflows, particularly in the detection of dental pathologies and pre-radiotherapy screening for head and neck cancer patients. This study aimed to develop and validate an AI model for detecting various dental conditions, with a focus on identifying teeth at risk prior to radiotherapy. Methods: A YOLOv8 model was trained on a dataset of 1628 annotated panoramic radiographs and externally validated on 180 radiographs from multiple centers. The model was designed to detect a variety of dental conditions, including periapical lesions, impacted teeth, root fragments, prosthetic restorations, and orthodontic devices. Results: The model showed strong performance in detecting implants, endodontic treatments, and surgical devices, with precision and recall values exceeding 0.8 for several conditions. However, performance declined during external validation, highlighting the need for improvements in generalizability. Conclusions: YOLOv8 demonstrated robust detection capabilities for several dental conditions, especially in training data. However, further refinement is needed to enhance generalizability in external datasets and improve performance for conditions like periapical lesions and bone loss.
Botulinum Toxin Injection into the Digastric Muscle: Current Clinical Use and a Report of Five Cases
The present research aimed to review the clinical applications of botulinum toxin-A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM) and to highlight the potential role of the BTX-A injection into ABDM in preventing postsurgical relapse. Five Class II malocclusion patients who underwent orthognathic surgery received BTX-A injections into both ABDM for the prevention of postoperative relapse. The relapse was evaluated using lateral cephalometric radiographs by comparing the postoperative cephalometric analyses at two different time points, postoperatively at 2 weeks (T1), and long-term, at 9 months after the surgical intervention (T2). The results demonstrated no significant differences between T2 and T1 for the Selle-Nasion-point A (SNA) angle, Selle-Nasion-point B (SNB) angle, point A-Nasion-point B (ANB) angle, mandibular length, and sagittal mandibular position. The patients exhibited stable occlusion without any signs of relapse after the surgery. A single BTX-A injection into the ABDM can effectively prevent postoperative relapse in Class II malocclusion patients, following orthognathic surgery. From a clinical perspective, in case of optimal dosage and procedure, BTX-A injection could be considered as the primary option for the prevention of postsurgical relapse for Class II malocclusion patients.
Real-Time Motion Compensation for Dynamic Dental Implant Surgery
Background: Accurate and stable instrument positioning is critical in dental implant procedures, particularly in anatomically constrained regions. Conventional navigation systems assume a static patient head, limiting adaptability in dynamic surgical conditions. This study proposes and validates a real-time motion compensation framework that integrates optical motion tracking with a collaborative robot to maintain tool alignment despite patient head movement. Methods: A six-camera OptiTrack Prime 13 system tracked rigid markers affixed to a 3D-printed human head model. Real-time head pose data were streamed to a Kuka LBR iiwa robot, which guided the implant handpiece to maintain alignment with a predefined target. Motion compensation was achieved through inverse trajectory computation and second-order Butterworth filtering to approximate realistic robotic response. Controlled experiments were performed using the MAiRA Pro M robot to impose precise motion patterns, including pure rotations (±30° at 10–40°/s), pure translations (±50 mm at 5–30 mm/s), and combined sinusoidal motions. Each motion profile was repeated ten times to evaluate intra-trial repeatability and dynamic response. Results: The system achieved consistent pose tracking errors below 0.2 mm, tool center point (TCP) deviations under 1.5 mm across all motion domains, and an average latency of ~25 ms. Overshoot remained minimal, with effective damping during motion reversal phases. The robot demonstrated stable and repeatable compensation behavior across all experimental conditions. Conclusions: The proposed framework provides reliable real-time motion compensation for dental implant procedures, maintaining high positional accuracy and stability in the presence of head movement. These results support its potential for enhancing surgical safety and precision in dynamic clinical environments.
Blood Cell Count Inflammatory Markers as Prognostic Indicators of Periodontitis: A Systematic Review and Meta-Analysis
(1) Background: Our study aimed to assess the association between the neutrophil to lymphocyte ratio (NLR), platelet to leukocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), red cell distribution width (RDW), and systemic immune inflammation index (SII) and periodontitis. (2) Methods: We searched PubMed, Embase, Scopus, Web of Science, and LILACS databases, identifying observational studies. The Newcastle Ottawa scale was used to evaluate the quality of the included studies. The principal summary outcome measure in our random effects meta-analysis was the mean difference (MD). (3) Results: After screening 682 search results, a total of 10 studies including 3164 subjects were selected for quantitative assessment. We found a higher mean NLR, PLR, and LMR in the periodontitis group compared to the control group (0.41 (95% CI 0.12–0.7), p = 0.006; 7.43 (95% CI 0.31–14.54), p = 0.04; 2.05 (95% CI 0.27–3.83), p = 0.024). No differences were observed for RDW. (4) Conclusions: We found an association between NLR, LMR, and PLR and periodontitis, which might be thought of as emerging blood cell count inflammatory biomarkers that could shed light on the link between periodontitis and systemic disbalances, as well as for periodontitis prognosis and grading.