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Table of Contents Vol:21 Issue 2/2017

EFFICIENT MEASURES FOR BURNOUT PREVENTION IN PALLIATIVE CARE
Cristina DOBRE1, Letiţia DUCEAC2, Carmen GRIEROSU2, Dana MIHAI1, Agripina ZAHARIA3, Liviu STAFIE4, Carmen STADOLEANU5

NEGATIVE PRESSURE THERAPY IN ABDOMINAL COMPARTMENT SYNDROME – A CASE REPORT
Bogdan Mihnea CIUNTU¹, Mihaela BLAJ², Sorin UNGURIANU³, Lucian AMBROZIE4, Ana-Maria TROFIN¹, Mihai ZABARA4, Ştefan GEORGESCU5, Irina TRIFESCU¹, Lidia IONESCU6

ZIRCONIUM ALLERGIES CAUSED BY ORAL DENTAL MATERIALS. A GENERAL REVIEW
Georgeta SINIŢCHI1,2

DENTAL MATERIAL BIOCOMPATIBILITY: A CROSS-SECTIONAL STUDY
Carmen SAVIN1, Alice MURARIU1, Bogdan DRAGOMIR2, Laura GAVRILĂ2, Adriana BALAN3

THE RELIABILITY CRITERION IN MICROBIOLOGICAL DIAGNOSIS
Daniela Luminiţa ICHIM1, Cristina MORARIU2, Oana Maria DARABĂ1, Laura ROMILA1, Carmen STADOLEANU3, Vasile BURLUI3

MONITORIZATION OF THERAPEUTICAL ACT PERFORMANCE IN THE DIGITALIZED ERA - DETERMINATION OF PATIENT’S SATISFACTION -
Mihai LUCHIAN1, Carmen STADOLEANU2, Cătălin IOV3, Laura ROMILA3, Laura Sabina LUCHIAN4, Sever Matei STADOLEANU4, Vasile BURLUI2

NEW DATA ON THE CLINICAL AND THERAPEUTIC MANAGEMENT OF OCCLUSAL CARIES (III)
Sorin ANDRIAN1, Andrei GEORGESCU2, Simona STOLERIU3, Emilia DÎMBU4

PROVIDING DENTAL CARE FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS
Diana MURARU1, Tudor CIUHODARU2, Magdalena IORGA3

MUNCHAUSEN SYNDROME BY PROXY IN PEDIATRIC DENTISTRY: MYTH OR REALITY?
Veronica PINTILICIUC-ŞERBAN1, Ana PETCU1, Gheorghe G. BĂLAN2, Adriana BĂLAN3

BACTERIAL PROFILES FOR CHRONIC AND AGGRESSIVE PERIODONTITIS IN A SAMPLE POPULATION GROUP. A CROSS-SECTIONAL STUDY
Alexandra-Cornelia TEODORESCU1, Liviu ZETU2, Silvia TESLARU1, Irina Georgeta ŞUFARU1, Cristina Gena DASCĂLU3, Sorina SOLOMON4, Silvia MÂRŢU5

ADVANTAGES AND DISADVANTAGES OF THE SONICFILL™ METHOD FOR LATERAL FILLINGS
Smaranda NAZARIE1, Nicolae BARANOV2, Adrian VIZITIU2, Corina POPOVICI2, Agripina ZAHARIA3, Constanţa MOCANU4

EFFICIENT MEASURES FOR BURNOUT PREVENTION IN PALLIATIVE CARE

Cristina DOBRE1, Letiţia DUCEAC2, Carmen GRIEROSU2, Dana MIHAI1, Agripina ZAHARIA3, Liviu STAFIE4, Carmen STADOLEANU5    << Back to contents

Abstract
The term burnout, meaning ”professional exhaustion”,
was introduced by Herbert Freudenberger in 1974. On May
21, 2014 , the World Health Assembly, the decisional organ
of the World Health Organization, voted the resolution for
the integration and development of the capacity of
palliative care services as a constituent part of the health
systems. The resolution represents a major pace in the
development of palliative care at world level, once the
ministers responsible for the field took upon themselves
- by means of information and training programs - the task
of services’ development, mainly at community level, the
support from the part of the next of kins, the elaboration
of educational programs, of guides and clinical protocols
for specialists, of instruments for the monitorization of the
quality of services provided, an easier access of patients to
medication, as well as partnerships with the civil society.
Burnout is a state of emotional, mental and physical
overfatigue caused by excessive and prolongued stress. It
is installed mainly when the person affected with it feels
care-worn and uncapable of fulfilling his/her usual duties.
As the stress continues, he/she will come to lose the
interest or motivation which made him/her assume a
certain position in the organizational hierarchy. The
burnout phenomenon includes three components:
emotional exhaustion, depersonalization and lack of
professional accomplishment. The main observations on
the phenomenon indicate that, apparently, the burnout
level in palliative care is not higher than in other services,
such as intensive therapy or surgery. Nevertheless,
mention should be made of a characteristic of the palliative
care services which influences the burnout level, namely
the emotional relation created between the patient and the
medical team, as a result of the prolongued duration of the
care services.
Keywords: burnout syndrome, occupational duties, work–
personal life interference, medical staff.

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NEGATIVE PRESSURE THERAPY IN ABDOMINAL COMPARTMENT SYNDROME – A CASE REPORT

Bogdan Mihnea CIUNTU¹, Mihaela BLAJ², Sorin UNGURIANU³, Lucian AMBROZIE4, Ana-Maria TROFIN¹, Mihai ZABARA4, Ştefan GEORGESCU5, Irina TRIFESCU¹, Lidia IONESCU6    << Back to contents

Abstract
The abdominal vacuum-assisted closure (VAC) system
has been introduced, providing a new possibility to treat
an open abdomen. Abdominal compartment syndrome has
a great relevance in surgical practice and patient care in
critical condition, due to the effects of increased pressure
in the enclosed space of the abdomen, possibly leading to
multiple organ failure. We present a case of a 53 year-old
woman with acute severe pancreatitis, admitted to
intensive care unit with increasing abdominal pressure and
rapid development of the compartment syndrome which
overcame non-surgical manoeuvres, so that emergency
surgery was imposed. The surgical procedure implied a
laparostoma managed through negative pressure therapy.
Severe cases of acute pancreatitis are associated with high
mortality rate, secondary to early and late complications
that develop as a consensus of the progression of the
inflammatory and necrotic process.
Keywords: negative pressure therapy, compartment
syndrome, acute pancreatitis.

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ZIRCONIUM ALLERGIES CAUSED BY ORAL DENTAL MATERIALS. A GENERAL REVIEW

Georgeta SINIŢCHI1,2    << Back to contents

Abstract
Dental materials may provoke general or local
pathologies and various immune-allergic manifestations.
For example, metal allergies are triggered by environmental
or – mainly – occupational factors, being more numerous
in recent years, particularly through the introduction, in
dentistry, of new types of dentures and implants. Zirconium
is a transition metal with several beneficial effects, namely:
biocompatibility, good aesthetics, slightly translucent
fitting, efficient cohesion with ceramics. Pathological
effects of zirconium: systemic toxicity (carcinogenic
potential), raising syndrome oral allergic dermatitis.
Allergists recommend a thorough knowledge on the
medical history of patients, on the data of personal and
hereditary allergic investigations confirming a possible
sensitivity. General and specific allergic investigations for
establishing a possible sensitivity to zirconium are:
epicutaneous tests, serological tests (TTL) and, and
confirmation of allergenic eviction. Equally, balancing of
the benefit/cost ratio should be calculated.
Keywords: zirconium, oral allergic syndrome, dental
medicine.

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DENTAL MATERIAL BIOCOMPATIBILITY: A CROSS-SECTIONAL STUDY

Carmen SAVIN1, Alice MURARIU1, Bogdan DRAGOMIR2, Laura GAVRILĂ2, Adriana BALAN3    << Back to contents

Abstract
The aim of this study is to assess the knowledge of the
students in the Faculty of Dental Medicine of Iasi on the
biocompatibility of the dental materials used in current
practice. To this end, we elaborated our own questionnaire,
including 10 questions to which 92 students from the last
2 years of study answered. The questionnaire cotains
assertions on the potential toxic reactions of the most
frequently used dental materials. The students answered
correctly to the questions related to the biocompatibility of
certain dental materials, such as glass-ionomer cement and
calcium hydroxide, and they recognized that allergic
reactions determined by acrylic resins may occur. We also
noticed the lack of knowledge referring to the irreversible
modifications produced by the tooth whitening substances
on the enamel and dentin, as well as to the side effects
produced by dental amalgam.
Keywords: students’ knowledge, dental materials,
biocompatibility.

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THE RELIABILITY CRITERION IN MICROBIOLOGICAL DIAGNOSIS

Daniela Luminiţa ICHIM1, Cristina MORARIU2, Oana Maria DARABĂ1, Laura ROMILA1, Carmen STADOLEANU3, Vasile BURLUI3    << Back to contents

Abstract
The control of quality assumes a set of procedures
elaborated and applied by the staff of the Laboratory of
medical analyses for the continuous evaluation of the
activity and for granting the quality of the results obtained,
namely a correct reflection of patients’ health condition.
Management of quality should consider the general and
specific standards of quality and competence established
by SR EN ISO 15189:2013 for the Laboratories of medical
analyses. The risk of error exists in any medical action, the
microbiological diagnosis included. Organization of the
internal control of quality is the responsibility of the chief
of the Laboratory of medical analyses, while its legal
representative has the obligation to assure the resources
necessary in this respect. The internal control of quality is
performed on a regular basis and whenever necessary. The
results of the the internal control are analyzed by the
specialist in charge with it, who decides the acceptance or
rejection of the obtained results. The laboratory of medical
analyses should periodically participate to programs of
external evaluation of quality. The (internal and external)
control of quality contributes to reducing the number of
erroneous microbiological results.
Keywords: laboratory of medical analyses, management of
quality, internal quality control, external quality control,
reference strains.

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MONITORIZATION OF THERAPEUTICAL ACT PERFORMANCE IN THE DIGITALIZED ERA - DETERMINATION OF PATIENT’S SATISFACTION -

Mihai LUCHIAN1, Carmen STADOLEANU2, Cătălin IOV3, Laura ROMILA3, Laura Sabina LUCHIAN4, Sever Matei STADOLEANU4, Vasile BURLUI2    << Back to contents

Abstract
Improvement of a patient’s health condition assumes
the application, in the most convenient moment of time,
of complete therapeutical actions based on a doubtless
diagnosis. Such services are appreciated by the patient
in most varied ways, and compared with the health
services administered or provided by similar medical
structures. Any manifested discontent may have
immediate or latent repecussions upon the dignity,
professional image and, equally, upon the economic
efficiency of the medical structure involved. The system
of performance indices refers directly and pragmatically
to a quasi-objective quantification of the quality of the
therapeutical acts administered, within some time
interval, by the medical structure in charge with this.
Analysis of qualiy criteria attainment involves a
relatively complex graph of activities, among which
mandatory are: identification and elimination of the
causes of insatisfaction, establishment of corrective
measures and directions when problems do appear,
interrogation of patients as to their expressed
discontents (as well as comparatively with their
expectations), total involvement of all members of the
medical team in solving patients’ needs. Critical
analysis and periodical elaboration of new performance
standards capable of assuring a high level of health
services’ quality and, implicitly, of the satisfaction level
expected by patients.
Keywords: systems of indices, quality indices,
performance, level of satisfaction, quality of the therapeutical
act, control of quality, quality of human life.

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NEW DATA ON THE CLINICAL AND THERAPEUTIC MANAGEMENT OF OCCLUSAL CARIES (III)

Sorin ANDRIAN1, Andrei GEORGESCU2, Simona STOLERIU3, Emilia DÎMBU4    << Back to contents

Abstract
In the control of occlusal caries, the major challenges
are related not only to the detection of non-cavitary lesions,
but also to the establishment of the treatment strategies to
be subsequently applied. Considering the objective of each
treatment, that of helping the patient, it is essential to
control the progression of carious lesions by means of nonsurgical,
preventive/therapeutical methods, whenever
necessary. The new strategies applied in caries management
are based on the evaluation and predictibility of possible
risks, a major aspect in the daily taking of therapeutical
decisions. The management plan should include: (I)
patient’s level of risk, (II) patient’s activity level and (III)
severity of the lesion. Various strategies for a most efficient
management of patient’s problems, as well as of the carious
lesions, have been elaborated by specialized medical
organisms, such as: strategies established within ICDAS,
CAMBRA, strategies of the caries management system
(SMC) and protocols indicated by the system of caries
classification according to ADA (American Dental
Association). The mission of any new model of caries
management is first of all to preserve the dental tissues,
and to restore them when only recommended – an idea to
guide the decisions of practitioners, starting with the
moment of anamnesis, clinical examination and
estabishment of diagnosis, until the end of the treatment.
Keywords: occlusal caries, clinical management,
therapeutical strategies.

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PROVIDING DENTAL CARE FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

Diana MURARU1, Tudor CIUHODARU2, Magdalena IORGA3    << Back to contents

Abstract
Given the increasing prevalence of autism spectrum
disorders, it is realistic to assume that dental professionals
are likely to treat individuals with this diagnosis.
Understanding the complexities of this disorder and its
behavioral manifestations is indispensable for dentists.
The present article presents several characteristics of
autism spectrum disorder that impact dental
interventions, along with medical and behavioral
alternatives to better manage the dental problems of
children with autism spectrum disorder. A
multidisciplinary approach and family support are
important for planning a dental intervention for these
patients in order to avoid anxiety. Knowledge on autism,
the dentist-patient relationship and the individual
preparation for dental interventions is useful for
constructing a controllable medical experience.
Keywords: autism spectrum disorder, dental care, dental
professionals.

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MUNCHAUSEN SYNDROME BY PROXY IN PEDIATRIC DENTISTRY: MYTH OR REALITY?

Veronica PINTILICIUC-ŞERBAN1, Ana PETCU1, Gheorghe G. BĂLAN2, Adriana BĂLAN3    << Back to contents

Abstract
Background and aims: Munchausen syndrome by
proxy is a condition traditionally comprising physical and
mental abuse and medical neglect as a form of psychogenic
maltreatment of the child, secondary to fabrication of a
pediatric illness by the parent or guardian. The aim of our
paper is to assess whether such condition occurs in current
pediatric dental practice and to evidence certain situations
in which the pediatric dentist should suspect this form of
child abuse. Problem statement: Munchausen syndrome
by proxy in pediatric dentistry may lead to serious chronic
disabilities of the abused or neglected child, being one of
the causes of treatment failure. Discussion: Prompt
detection of such condition should be regarded as one of
the duties of the practitioner who should be trained to
report the suspected cases to the governmental child
protective agencies. This should be regarded as a form of
child abuse and neglect, and the responsible caregiver
could be held liable when such wrongful actions cause
harm or endanger child’s welfare. Conclusion: Munchausen
syndrome by proxy should be regarded as a reality in
current pediatric dental practice and dental teams should
be trained to properly recognize, assess and manage such
complex situations.
Keywords: child abuse, dental neglect, child welfare.

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BACTERIAL PROFILES FOR CHRONIC AND AGGRESSIVE PERIODONTITIS IN A SAMPLE POPULATION GROUP. A CROSS-SECTIONAL STUDY

Alexandra-Cornelia TEODORESCU1, Liviu ZETU2, Silvia TESLARU1, Irina Georgeta ŞUFARU1, Cristina Gena DASCĂLU3, Sorina SOLOMON4, Silvia MÂRŢU5    << Back to contents

Abstract
Aim. The study aims at determining some possible
significant differences in the subgingival microbial profiles
of patients with generalized chronic periodontitis (GCP)
and generalized aggressive periodontitis (GAP), as a tool
in helping with differential diagnostic. Materials and
methods. 20 subgingival fluid samples (10 from GAP and
10 from GCP patients) were subjected to a Real-Time
Polymerase Chain Reaction technique in order to determine
the prevalence and the counts of 9 periodontal pathogens
(Aggregatibacter actinomycetemcomitans, Porphyromonas
gingivalis, Treponema denticola, Tanerella forsythia, Prevotella
intermedia, Peptostreptococcus micros, Fusobacterium
nucleatum, Eubacterium nodatum and Capnocytophaga
gingivalis). Results and discussion. Fusobacterium
nucleatum was singnificantly correlated with the aggressive
periodontitis group, but no significant differences were
found for the other 8 periodontal bacteria. Conclusions.
The prevalence or count of some periodontal pathogens
could help clinicians make an easier differential diagnostic
between GCP and GAP, however further studies, conducted
on larger population samples, are still needed.
Keywords: aggressive periodontitis, chronic periodontitis,
subgingival profile, Real-Time PCR.

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ADVANTAGES AND DISADVANTAGES OF THE SONICFILL™ METHOD FOR LATERAL FILLINGS

Smaranda NAZARIE1, Nicolae BARANOV2, Adrian VIZITIU2, Corina POPOVICI2, Agripina ZAHARIA3, Constanţa MOCANU4    << Back to contents

Abstract
The aim of the study was to evaluate the advantages
and disadvantages of bulk-fill type fillings realized with
SONICFill™ over an 18 month interval, on a batch of
patients with different ages and occupations. Materials
and methods: the study was performed on a batch of 73
patients who addressed the Clinical of Odontology-
Endodontics within the Platform of Practical Training (PIP)
of the Faculty of Dental Medicine of the ”Apollonia”
University of Iaşi, between Octomber 1, 2014 - May 1, 2016,
subjected to 91 bulk-fill fillings with SonicFill™ on the
posterior teeth. Results and discussion: out of the total
number of 73 patients, 56 came from the urban environment,
and 17 - from the rural medium, the highest ratio being
represented by the 21-30 year age group (45%), closely
followed by the 31-40 year one (40%). As for gender
distribution within the batch, nearly two-thirds are women,
the rest being men. The education level influenced patients’
decision – that of accepting a new method of filling
application. As to the types of teeth to which restorations
were applied, the highest ratio is represented by lower
molars (41%), followed by upper molars (23%) and
mandibular premolars (20%), the lowest number of
restorations being applied to maxillary premolars. Out of
the total number of 91 bulk-fill restorations, 28 were
applied over a base filling while, in 63 restorations, the
basic filling was absent. Conclusions: The SonicFill ™
system for bulk-fill posterior restorations has a number of
advantages, such as: high photopolymerization depth,
significant reduction of setting contraction, better
composite adaptation to the cavity walls, long-term
predictable clinical results.
Keywords: caries, sonically activated composite
restorations.

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