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result(s) for
"Mircea, Rivis"
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An epidemiological analysis of maxillofacial fractures: a 10-year cross-sectional cohort retrospective study of 1007 patients
2021
Background
Epidemiological data is providing vital indicators for organizing the financial resources related to a particular type of trauma, estimating expenses and training of dental practioners and ambulatory medical staff for collaboration with a certain pattern of patients. Knowing the etiology and epidemiology of a certain pathology is significant for approaching its means of prevention.
Methods
A 10-year retrospective statistical analysis of 1007 patients with maxillofacial fractures treated in a University Clinic of Oral and Maxillofacial Surgery in Romania was performed. The data were extracted from patients’ medical records. Statistical analysis was performed. A value of
p
< 0.05 was considered statistically significant.
Results
The incidence of maxillofacial fractures was high among patients in the 20–29 age group (35.9%). Male patients (90.57%, M:F = 9.6:1), having a low level of education (46.60%) and living in urban areas (53.50%) were more affected. The main cause of maxillofacial fractures was interpersonal violence (59.37%), both in the mandibular and midface topographic regions (
p
= 0.001,
p
= 0.002). In urban areas, fractures caused by interpersonal violence and road traffic accidents were predominant, while in rural areas, most of the fractures were due to interpersonal violence, domestic accidents, work accidents and animal attacks (
p
= 0.001).
Conclusions
Interpersonal violence is the main cause of maxillofacial fractures having epidemic proportions. Male patients aged 20–29 years with a low level of education represent the major risk category. Considering the wide area of interpersonal aggression, both the medical staff in the hospital and in the dental offices must be educated in order to collaborate with possible violent patients. Dentists must be prepared to work on a post-traumatic dento-periodontal field. Taking all measures to prevent inter-human aggression is imperative and will lead to a major decrease in maxillofacial fractures and an overall increase of oral health in a population.
Journal Article
Eugenol: In Vitro and In Ovo Assessment to Explore Cytotoxic Effects on Osteosarcoma and Oropharyngeal Cancer Cells
by
Dehelean, Cristina
,
Buzatu, Roxana
,
Marcovici, Iasmina
in
Angiogenesis
,
Antimitotic agents
,
Antineoplastic agents
2023
Cancer is a significant health problem worldwide; consequently, new therapeutic alternatives are being investigated, including those found in the vegetable kingdom. Eugenol (Eug) has attracted attention for its therapeutic properties, especially in stomatology. The purpose of this study was to investigate the cytotoxicity of Eug, in vitro, on osteosarcoma (SAOS-2) and oropharyngeal squamous cancer (Detroit-562) cells, as well as its potential irritant effect in ovo at the level of the chorioallantoic membrane (CAM). The data obtained following a 72 h Eug treatment highlighted the reduction in cell viability up to 41% in SAOS-2 cells and up to 37% in Detroit-562 cells, respectively. The apoptotic-like effect of Eug was indicated by the changes in cell morphology and nuclear aspect; the increase in caspase-3/7, -8 and -9 activity; the elevated expression of Bax and Bad genes; and the increase in luminescence signal (indicating phosphatidylserine externalization) that preceded the increase in fluorescence signal (indicating the compromise of membrane integrity). Regarding the vascular effects, slight signs of coagulation and vascular lysis were observed, with an irritation score of 1.69 for Eug 1 mM. Based on these results, the efficiency of Eug in cancer treatment is yet to be clarified.
Journal Article
Assessing the Sealing Performance and Clinical Outcomes of Endodontic Treatment in Patients with Chronic Apical Periodontitis Using Epoxy Resin and Calcium Salicylate Seals
by
Horhat, Razvan Mihai
,
Orel, Laura
,
Negrean, Rodica Anamaria
in
Abscesses
,
apical periodontitis
,
Bacteria
2023
Background and Objectives: Recognizing the significance of a hermetic apical seal for successful root canal treatment, the present investigation aimed to evaluate two sealing materials through an in vitro analysis, as well as to ascertain the clinical outcomes of patients treated with these two sealers in an in vivo setting. Materials and Methods: For the in vitro part of the study, two control groups of thirty monoradicular teeth were obturated with two sealers. Then, the sealers’ performance was tested based on a predefined protocol. Group A included 30 patients treated with an epoxy oligomer resin-based sealer (Adseal, MetaBiomed), while Group S comprised 30 patients treated with a polymeric calcium salicylate-based sealer (Sealapex, Kerr). Samples were sectioned and evaluated under the microscope to determine the sealer’s tightness by measuring the dye penetration into the root canal filling. For the in vivo part, a prospective study was designed to include 60 patients with chronic apical periodontitis in two endodontic treatment groups, using the same two sealers. Results: The in vitro analysis found that dye penetration in Group A was 0.82 mm (±0.428), while in Group S, the dye penetration was statistically significantly deeper, being 1.23 mm (±0.353). In the in vivo part of the study, the periapical index (PAI) significantly decreased 6 months after endodontic treatment, with 80.0% of patients in Group A having a PAI score of 2 compared to only 56.7% in Group S (p-value = 0.018). Similarly, tooth mobility scores significantly decreased after treatment, but with no difference between groups. The marginal bone loss decreased significantly more in the Adseal group compared to the Sealapex group (23.3% vs. 50.0%, p-value = 0.032). At the same time, 40.0% of patients in Group S had failed tooth healing compared to only 13.3% in Group A (p-value = 0.048). Conclusions: The in vitro study showed that Adseal had a better sealing capacity and a lower degree of dye penetration compared to Sealapex. However, on clinical evaluation in the in vivo study, both patient groups exhibited significant improvements in periapical index, tooth mobility scores, and pain reduction following endodontic treatment. Nevertheless, patients treated with Adseal showed a significantly greater improvement in PAI values, tooth mobility, and teeth healing after treatment. Overall, Adseal, as an endodontic sealer, may provide better sealing capabilities and enhanced clinical outcomes in the treatment of chronic apical periodontitis.
Journal Article
Complementarity of Photo-Biomodulation, Surgical Treatment, and Antibiotherapy for Medication-Related Osteonecrosis of the Jaws (MRONJ)
by
Roi, Ciprian Ioan
,
Duma, Virgil-Florin
,
Riviș, Mircea
in
Angiogenesis Inhibitors - adverse effects
,
Bacterial infections
,
Bisphosphonate-Associated Osteonecrosis of the Jaw - drug therapy
2021
Background and Objectives: Antiresorptive or anti-angiogenic agents may induce medication-related osteonecrosis of the jaws (MRONJ), which represents a challenge for clinicians. The aim of this study is to design and apply a composed and stage-approach therapy combining antibiotherapy, surgical treatment, and photo-biomodulation (PBM) for the prevention or treatment of MRONJ lesions. Materials and Methods: The proposed treatment protocol was carried out in the Department of Oral & Maxillofacial Surgery of the “Victor Babes” University of Medicine and Farmacy of Timisoara, in 2018–2020. A total of 241 patients who were previously exposed to antiresorptive or anti-angiogenic therapy, as well as patients already diagnosed with MRONJ at different stages of the disease were treated. A preventive protocol was applied for patients in an “at risk” stage. Patients in more advanced stages received a complex treatment. Results: The healing proved to be complete, with spontaneous bone coverage in all the n = 84 cases placed in an “at risk” stage. For the n = 49 patients belonging to stage 0, pain reductions and decreases of mucosal inflammations were also obtained in all cases. For the n = 108 patients proposed for surgery (i.e., in stages 1, 2, or 3 of MRONJ), a total healing rate of 91.66% was obtained after the first surgery, while considering the downscaling to stage 1 as a treatment “success”, only one “failure” was reported. This brings the overall “success” rate to 96.68% for a complete healing, and to 99.59% when downscaling to stage 1 is included in the healing rate. Conclusions: Therefore, the clinical outcome of the present study indicates that patients with MRONJ in almost all stages of the disease can benefit from such a proposed association of methods, with superior clinical results compared to classical therapies.
Journal Article
The Challenges of OSCC Diagnosis: Salivary Cytokines as Potential Biomarkers
by
Roi, Alexandra
,
Roi, Ciprian Ioan
,
Negruțiu, Meda Lavinia
in
Angiogenesis
,
Biomarkers
,
Biopsy
2020
Fast, economic, and noninvasive, molecular analysis of saliva has the potential to become a diagnostic tool of reference for several local and systemic diseases, oral cancer included. The diagnosis of Oral Squamous Cell Carcinoma (OSCC) can be performed using high specificity and sensibility biomarkers that can be encountered in the biological fluids. Recent advances in salivary proteomics have underlined the potential use of salivary biomarkers as early diagnosis screening tools for oral neoplasia. In this respect, over 100 salivary molecules have been described and proposed as oral cancer biomarkers, out of which cytokines are among the most promising. Besides being directly involved in inflammation and immune response, the role of salivary cytokines in tumor growth and progression linked them to the incidence of oral malignant lesions. This review summarizes the existing studies based on the use of salivary cytokines as potential oral cancer biomarkers, their involvement in the malignant process based on their type, and ther influence upon prognostic and metastatic rates.
Journal Article
The Implications of Titanium Alloys Applied in Maxillofacial Osteosynthesis
2020
Titanium alloys are known for their biological, mechanical and chemical properties, which have successfully expanded their use in the maxillofacial field. The internal fixation using titanium miniplates and screws offer a new perspective for the treatment of trauma and in orthognathic surgery and maxillofacial oncology. Although, titanium is highly recommended for its excellent biocompatibility, recent research has focused on identifying the potential local and general implications of the interactions between the human tissue and the metallic particles. This present review aims to outline the existing tissue changes, cellular alterations and future perspectives regarding the use of titanium-based alloys as osteosynthesis materials, taking into consideration the existing present debate whether the routinely removal of these materials should be an indication.
Journal Article
A Rare Case of Mandibular Chondrosarcoma Arising from Fibrous Dysplasia
2025
Fibrous dysplasia is an uncommon, intramedullary fibro-osseous lesion representing approximately 5% to 7% of benign fibro-osseous lesions. The incidence of malignant transformation of fibrous dysplasia is considered very rare. The aim of this case report is to present a rare case of a chondro-sarcomatous transformation of a case previously diagnosed with mandibular fibrous dysplasia, a patient who was initially referred for a gingival tumoral extirpation in the third quadrant. A 57-year-old female patient presented for a consultation and, after a biopsy, was diagnosed with fibrous dysplasia of the mandibular bone. After two interventions of surgical removal of the lesion, the malignant transformation of chondrosarcoma occurred, which was identified by radiologic and histopathologic investigations, with the overall AJCC staging being pT1N0M0, G3. Radical resection of the mandibular bone with free margins of tumor was performed. Malignant transformation of mandibular fibrous dysplasia is a very rare and challenging complication of this disease. Early recognition and proper surgical treatment must be the key actions from doctors and clinicians.
Journal Article
Systemic Immune–Inflammatory Index and Other Inflammatory Marker Variations in Oral Squamous Cell Carcinoma Management
2024
Background and Objectives: With the greatest rate of morbidity and death, OSCC is one of the world’s most critical public health problems. Being a complex pathology, the management process that includes diagnostic, surgical, and adjuvant treatments must as well take into account the involvement of the immune system. This study aims to evaluate various biomarkers such as neutrophils, lymphocytes, platelets, SII, and NLR in the different stages of OSCC treatment and in correlation with TNM stages, in order to observe the inflammatory response of the host. Materials and Methods: A total of 154 patients diagnosed with OSCC were included in the present retrospective study. Routine blood samples were collected from all patients both before and after surgery. Using the detected values of platelets, neutrophils, and lymphocyte count, the systemic immune–inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) were calculated. Based on the oncologist’s recommendation, 46 patients underwent adjuvant radiotherapy as part of their oncologic treatment plan. For these patients, additional blood samples were collected before the first and after the last radiotherapy session for determining the values of platelets, neutrophils, and lymphocyte count, and SII and NLR calculation. Results: Prior to the first radiotherapy session, neutrophils decreased slightly to 4.35, lymphocytes increased to 2.23, and platelets rose to 258.62. The SII and NLR were 641.02 and 2.19, respectively. Following the last radiotherapy session, neutrophils increased substantially to 10.30, while lymphocytes decreased to 1.21. Platelets showed a slight reduction to 227.08. Notably, the SII rose dramatically to 3084.19, and the NLR increased significantly to 15.49, suggesting an important immune and inflammatory response of the host. Conclusions: The host’s immunological and inflammatory responses are impacted by both surgery and adjuvant radiation administered following surgery. The parameters assessed—neutrophils, lymphocytes, platelets, SII, and NLR—qualify as significant variables that need to be monitored before, during, and following OSCC therapy. This study’s findings validated significant changes in immunological and inflammatory markers in the management of OSCC.
Journal Article
Circulating miRNA as a Biomarker in Oral Cancer Liquid Biopsy
2023
Oral cancer is currently challenging the healthcare system, with a high incidence among the population and a poor survival rate. One of the main focuses related to this malignancy is the urge to implement a viable approach for improving its early diagnosis. By introducing the use of liquid biopsy and the identification of potential biomarkers, aiming for a noninvasive approach, new advancements offer promising perspectives in the diagnosis of oral cancer. The present review discusses the potential of circulating miRNAs as oral cancer biomarkers identified in body fluids such as serum, plasma, and saliva samples of oral cancer patients. Existing results reveal an important implication of different miRNA expressions involved in the initiation, development, progression, and metastasis rate of oral malignancy. Liquid biomarkers can play a crucial role in the development of the concept of personalized medicine, providing a wide range of clinical applications and future targeted therapies.
Journal Article
Review of the Safety and Clinical Considerations of Vasoconstrictor Agents in Dental Anesthesia During Pregnancy
by
Rusu, Elena Lavinia
,
Riviș, Mircea
,
Nicoleta, Nicolae
in
Anesthesia in dentistry
,
Care and treatment
,
Clinical practice guidelines
2025
Background: The use of vasoconstrictors in dental anesthesia during pregnancy raises clinical concerns due to their potential effects on uteroplacental blood flow and fetal well-being. Despite widespread use, the safety profiles of agents such as epinephrine, levonordefrin, and felypressin remain insufficiently reviewed, particularly in isolation from local anesthetics. Methods: A systematic literature search was conducted using PubMed (MEDLINE) for studies published between January 2000 and May 2025, following PRISMA 2020 guidelines. Included studies assessed the use, pharmacokinetics, or outcomes of vasoconstrictor agents used in dental procedures during pregnancy. Articles were selected based on predefined inclusion criteria and synthesized narratively. Results: Out of 95 screened records, only six narrative reviews and three clinical guidelines met eligibility criteria. Epinephrine was the most frequently described agent, generally regarded as safe at low dental doses (1:100,000–1:200,000) when properly administered. Levonordefrin showed insufficient safety data and was associated with potential uterine vasoconstriction. Felypressin was contraindicated due to its oxytocic properties and high risk of inducing uterine contractions. Conclusions: Among vasoconstrictors, epinephrine remains the only agent with an acceptable safety profile in pregnancy when used correctly. Levonordefrin lacks adequate evidence, and felypressin poses clear risks. Until further clinical trials are available, individualized risk assessment and adherence to obstetric and dental guidelines are critical for ensuring maternal and fetal safety.
Journal Article