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The medical and dental fields are experiencing a significant shift in approach thanks to the integration of artificial intelligence (AI). With a vast influx of patient data, there is a pressing need for sophisticated software capable of organizing and preserving this information effectively. The emergence of AI-driven models and computer vision techniques for identifying patterns in clinical and histopathological images related to oral pathology lesions holds promise for enhancing diagnostic accuracy and prognostic predictions. While microscopic morphology remains the gold standard in diagnostic pathology, its reliance on individual pathologists introduces variability. Consequently, AI presents a potential solution for achieving consistent and more precise diagnoses. Moreover, by analyzing extensive data from the patients’ medical chart the artificial neural network could provide a presumptive diagnosis and an invaluable screening tool in predicting individual risk for oral pathology based on information regarding their risk factors, systemic diseases and conditions and clinical pathological data. Within oral and maxillofacial pathology, AI stands poised to elevate diagnostic accuracy, tailor treatment, and ultimately enhance patient outcomes. Nevertheless, the integration of AI in healthcare demands meticulous attention to ethical, legal, and regulatory complexities. Moreover, given the nascent nature of AI technology, prudence is paramount when deploying it in this specialized domain.

The orofacial region are often affected by a diverse spectrum of bacterial, viral, fungal, chlamydial, rickettsial, protozoal, and helminthic infections. Diagnosis of oral candidiasis is often made with a thorough history and the clinical examination findings. Some laboratory investigations can also be used as adjuncts to confirm the clinical presentation. Candida pathogens in a smear taken directly from the lesion are commonly identified using Gram staining or periodic acid Schiff staining, or by culturing the pathogen in Sabaraud’s dextrose agar. Regardless of the prevalence, incidence, and the advancement of treatment strategies, orofacial infections, either local or the manifestations of a generalized infection, may cause significant discomfort and suffering. Oral clinicians need to be equipped with up-to- date knowledge of the clinical pictures of new infections, approaches in accurate identification of orally limited infections vs oral manifestations of underlying systemic diseases. Treatment of oral candidiasis is primarily based on the identification of underlying predisposing factors and correcting them.

It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. Selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Patient education on oral hygiene is an important component of their overall treatment. Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. In conclusion, biofilm disruption mechanical methods integrated is indispensable for comprehensive oral healthcare.

Pregnancy is a unique physiological state characterized by hormonal fluctuations and immunological adaptations that can impact various aspects of maternal health, including oral health. The influence of pregnancy on periodontal status has been the subject of extensive research, with studies highlighting the association between gestation and changes in the oral cavity. Elevated levels of estrogen and progesterone during pregnancy have been implicated in the exacerbation of gingival inflammation and periodontal disease progression. Immunological changes, including alterations in immune cell function and cytokine production, further contribute to the heightened inflammatory response observed in the periodontium of pregnant individuals. While the precise mechanisms underlying the relationship between pregnancy and periodontal status continue to be elucidated, preventive measures such as oral hygiene education, regular dental check-ups, and timely periodontal treatment are crucial for promoting optimal oral health outcomes for both mother and child during gestation. Understanding the influence of pregnancy on periodontal status is essential for providing comprehensive prenatal care and ensuring the well-being of pregnant individuals and their offspring.

Clinical research documents causal relationships between periodontitis and depression. Furthermore, it has been revealed that clinical depression can also negatively affect periodontal treatment outcomes. The present study aimed to analyze subgingival microbial profiles in patients with periodontal disease and those with depression by qualitative and quantitative determination of 4 periodontal pathogens. Material and method. The study was carried out on a number of 40 patients between the ages of 20 and 48 within the Periodontology Clinic of the Faculty of Dental Medicine, within the “Grigore T. Popa” University of Medicine and Pharmacy Iași or in an office with private practice within the radius of the city of Iași. Analyzing the obtained results, it can be seen that the average age is significantly lower for the group of patients with periodontal disease compared to the average age of patients with periodontal disease and depression (p=0.02). Regardless of which method, the individualized determination of periodontal pathogens helps guide targeted systemic antibiotic therapy (individualization of the treatment plan). It limits self-medication or the possibility of developing bacterial resistance.

Periodontology has adapted over the years to demands for better healing, a more comfortable solution, treatment of marginal tissue recessions, and better aesthetics. This has become one of the main goals of this discipline. Platelet-enriched fibrin (PRF) is an autologous platelet concentrate similar to a scar matrix that guides the various cellular elements and releases growth factors and cytokines near the injury. It is an autogenous alternative to conjunctive grafting in treating gingival recession that would allow optimal healing quickly. This review presents the different types of PRF, the protocols for obtaining them, and the practical features of their surgical applications. The use of PRF in oral surgery signifies not just a trend but a fundamental shift towards patient-centered, evidence-based, and minimally invasive practices that redefine the boundaries of what is achievable in modern oral healthcare.

The interplay between oral health and systemic conditions continues to unfold, with an emerging focus on the association between periodontal disease and chronic kidney disease (CKD). Periodontal disease, a chronic inflammatory condition affecting the supporting structures of the teeth, has garnered attention beyond its oral implications. Recent research suggests a bidirectional link between periodontal health and CKD, with inflammatory mediators and immune responses serving as potential conduits for mutual influence. The review navigates through the current understanding of how periodontal disease may contribute to the progression of CKD and vice versa. Inflammatory pathways, oxidative stress, and microbial translocation are among the key elements linking these seemingly distinct entities. Recognizing periodontal disease as a potential modifiable risk factor in CKD emphasizes the importance of comprehensive oral health assessments in renal care. Furthermore, understanding the shared inflammatory cascades opens avenues for integrated preventive strategies that span both dental and nephrological disciplines. As research in this field advances, a holistic approach to patient care that considers both periodontal and renal health becomes paramount for effective prevention and management strategies.

This review article makes an effort to provide a comprehensive view of the relationship between osteoporosis and periodontitis, with a focus on clarifying how those risk factors in osteoporotic populations modify the alveolar bone homeostasis in the periodontitis niche. Periodontitis is a periodontal inflammatory condition that results from disrupted periodontal host–microbe homeostasis, manifested by the destruction of tooth-supporting structures, especially inflammatory alveolar bone loss. Osteoporosis is characterized by systemic deterioration of bone mass and microarchitecture. The roles of many systemic factors have been identified in the pathogenesis of osteoporosis, including endocrine change, metabolic disorders, health-impaired behaviors and mental stress. Recent studies suggest that individuals with concomitant osteoporosis are more vulnerable to periodontal impairment.

There is ample literature evidence to support that periodontal therapy has an impact on the local and systemic host immune responses, despite contradicting data from the literature reporting both a decrease and increase in systemic antibody levels following treatment. The clinical guidelines for the treatment of patients with periodontitis stages I–III published from the European Federation of after the patient has been informed about his/her condition, the first step in the treatment process is directed toward motivation, targeting behavioral changes to achieve adequate self-performed oral hygiene practices and controlling local and systemic modifiable risk factors. A systematic review indicates positive associations across patient-reported experiences, self-rated and objectively measured health outcomes in relation to a wide range of areas and settings. Despite patient-reported experiences and patient-reported outcomes of therapy being closely related, there are differences between the two concepts. Frequent re-evaluation of oral hygiene reinforcement outcomes is suggested, aiming to reinforce a patient’s motivation and keep the patient up to date with any changes that might occur in the periodontal status, enabling the patient to actively participate in the progress of the treatment plan. In conclusion, short-term perturbations of antibody responses occur during the active phase of periodontal therapy.

Medical devices that come into contact with sterile tissues or body fluids are considered critical items. In dentistry, conventional manual decontamination of medical device surfaces is used, and this requires a two-step procedure that includes rehydration of the surface followed by decontamination, for effective inactivation of bacteria and viruses on dry surfaces The most effective decontamination agents are ethanol in high concentration while sodium hypochlorite and hydrogen peroxide require a minimum concentration to be effective with little impact on human health. The bactericidal action of quaternaries has been attributed to inactivation of energy-producing enzymes, denaturation of essential cellular proteins, and disruption of the cell membrane. Sterilization destroys all microorganisms on the surface of an item or in a fluid to prevent the transmission of diseases associated with the use of that item Most medical and surgical devices used in medical facilities are made of materials that are heat stable and therefore undergo high temperature sterilization, primarily with steam.

Diabetes mellitus and periodontal disease are among the most common chronic diseases of mankind and, remarkably, they share many common features. The most common forms of periodontal diseases, gingivitis and periodontitis, are characterized by a microbially driven series of host responses that lead to periodontal tissue damage.The host response is central to the development of periodontitis, as it is to the development and progression of several human chronic diseases, including diabetes mellitus. In the next sections we will review the main features of diabetes mellitus, with the main focus being the association between type 2 diabetes mellitus and periodontitis. Peri-implant diseases are infectious conditions affecting dental implants, ranging from peri-implant mucositis, which is an inflammatory lesion of the peri-implant mucosa, to peri-implantitis, which also affects the supporting bone. As well as potentially sharing some similar risk factors, diabetes mellitus and periodontal disease patients have exceptionally similar tendencies to develop comorbidities that tend to cluster in the same individuals. Attention to the patient’s medical history is one of the cornerstones for efforts in the prevention of periodontal and peri-implant diseases.

The clinical guidelines for the treatment of patients with periodontitis stages I–III published from the European Federation of after the patient has been informed about his/her condition, the first step in the treatment process is directed toward motivation, targeting behavioral changes to achieve adequate self-performed oral hygiene practices and controlling local and systemic modifiable risk factors. Frequent re-evaluation of oral hygiene reinforcement outcomes is suggested, aiming to reinforce a patient’s motivation and keep the patient up to date with any changes that might occur in the periodontal status, enabling the patient to actively participate in the progress of the treatment plan. Periodontology in 2020, suggest treatment being provided to patients with periodontitis by a pre-established stepwise approach. The second step is focused on professional interventions to reduce and possibly eliminate subgingival biofilms and calculus. Promotes periodontal wound healing via reduction of tissue inflammation and shifts in the host responses.

In each study we have tried to illustrate typical scenarios encountered in the clinic that may be accompanied by complications and possibly even be induced by treatment errors, together with recommendations on how they can be avoided or how they can be rescued, based on the currently available evidence and on expert opinion. The interplay between the application of orthodontic forces to stimulate tooth movement and the reaction of the affected periodontal tissues is complex. While most of the time possible damage to the periodontal tissues is transient with no long-term detrimental effects on periodontal health, in some instances major undesirable consequences have been reported. In other situations, orthodontic therapy can be of benefit in solving problems caused by periodontitis. In conclusion, the present review has identified several areas of concern, in which orthodontic treatment, can have unwanted adverse effects on periodontal disease, but also areas with great potential for synergies between orthodontic and periodontal therapy.

Orthodontic treatment is performed in children and adolescents with healthy periodontal conditions. While clinical periodontal health and also the end points of successful periodontal therapy to establish periodontal health on a reduced periodontium are clearly defined, these may differ from how clinical success of orthodontic treatment is defined. While most of the time possible damage to the periodontal tissues is transient with no long-term detrimental effects on periodontal health, in some instances major undesirable consequences have been reported. In general, these treatment goals may be definedas achievement of oral health, esthetics, occlusion, function, and stability, although the treatment goals may vary among patients. It is obvious that all of these problems may have implications for the status of the periodontal tissues involved. In conclusion orthodontic treatment is considered successful when the treatment goal is achieved and the result remains stable.

Periodontitis patients are known to have increased circulating lipopolysaccharide activity and metabolic disturbances, which may be either the cause or effect of endotoxemia. This review approaches endotoxemia as a possible molecular mediator between periodontitis and increased risk of cardiometabolic disorders. Observations that bacteria disseminate into circulation after toothbrushing and periodontal procedures and assumptions that endotoxin may disseminate through inflamed periodontium and bleeding gums support the idea of endotoxemia in periodontitis. However, the evidence that periodontitis-associated dysbiosis contributes to endotoxemia is not as strong as in the case of gut microbiome dysbiosis. Although the causality is insufficiently demonstrated thus far, many studies have associated changes of the gut microbiome composition, function, and specific bacterial metabolites with cardiometabolic diseases, whereas research on the oral microbiome has severely fallen behind.

Oral and periodontal health impact systemic health, and vice versa. Special at-risk populations bring to bear this bidirectional relationship between oral and systemic health. Although bidirectional relationships are discussed, the potential for multiple comorbidities, relationships, and connections (multimodal relationships) also exists. Periodontal disease has been associated with diabetes, metabolic syndrome, obesity, eating disorders, liver disease, cardiovascular disease, Alzheimer disease, rheumatoid arthritis,adverse pregnancy outcomes, and cancer. Proposed mechanisms that mediate this connection between oral and systemic health in a susceptible host include predisposing and precipitating factors, such as genetic factors (gene polymorphisms), environmental factors (stress,habits—such as smoking and high-fat diets/consumption of highly processed foods), medications, microbial dysbiosis and bacteremias/ viremias, and an altered host immune response. These associations exist within a framework of bacteremias/viremias/microbemias, systemic inflammation, and/or disturbances of the immune system in a susceptible host.

Periodontitis patients are known to have increased circulating lipopolysaccharide activity and metabolic disturbances, which may be either the cause or effect of endotoxemia. This review approaches endotoxemia as a possible molecular mediator between periodontitis and increased risk of cardiometabolic disorders. Observations that bacteria disseminate into circulation after toothbrushing and periodontal procedures and assumptions that endotoxin may disseminate through inflamed periodontium and bleeding gums support the idea of endotoxemia in periodontitis. However, the evidence that periodontitis-associated dysbiosis contributes to endotoxemia is not as strong as in the case of gut microbiome dysbiosis. We describe the structure-function relationship of lipopolysaccharide, the local and systemic inflammatory and immunological responses caused by lipopolysaccharide, current knowledge on endotoxemia in periodontitis, factors affecting the levels of endotoxemia, and its relation to cardiometabolic disorders. They are physically, microbiologically, and biochemically connected to each other, and only crumbs of information are known about this connection. Although the causality is insufficiently demonstrated thus far, many studies have associated changes of the gut microbiome composition, function, and specific bacterial metabolites with cardiometabolic diseases, whereas research on the oral microbiome has severely fallen behind.

The aim of this review is to provide an overview of the current evidence of some popular food supplements and superfoods that might be of interest in periodontology. Although the number of publications investigating the effect of these products on human health and their possible use in medicine is increasing, only little is known so far regarding their effects on periodontal tissues and their possible use in periodontal treatment or medicine. In summary, an increasing number of studies have revealed aspects and effects of these so-called lifestyle or fitness supplements and superfoods that may have an impact on periodontal health and healing after treatment. However, some the current evidence is of a very low quality, and more validated scientific data are required before their possible use in prevention or treatment of periodontal diseases can be made.

Concerns about occlusal overload and the presumed consequences of occlusal trauma have led to meticulous replacement of missing teeth and the incorporation of a large number of supporting teeth into fixed dentures. For the experimental study of the state of tension and deformation that arises in the masticatory system during mastication, various methods are used, of which the most used in Romania are the methods that use resistive electrical tensometry, optical methods. Among the optical methods that provide the most commonly used qualitative and quantitative results are: the brittle varnish method and the holographic method. The obtained results are congruent with the results obtained by other researchers and through the conclusions drawn, the methodologies designed can be used for the experimental analysis of the state of tension and deformation in the masticatory system.

Studies in the biology of viral infection and clinical disease management have shown that differences in the prevalence and severity of COVID-19 are associated with the high affinity of Covid-19 S protein for ACE2, suggesting that populations with higher ACE2 expression may be more susceptible to the COVID-19 infection. Current information indicates that induced hyperglycaemia affects the phagocytic function of mononuclear and polymorphonuclear cells, contributing to the growth of aggressive pathogenic subgingival flora. As a result, periodontal infection can cause systemic inflammation by releasing cytokines and metalloproteinases (MMP) into the circulatory system derived from periodontal disease and destroying tissues, which can exacerbate or aggravate chronic insulin resistance. In the periodontitis – diabetes mellitus – COVID-19 triad, uncontrolled hyperglycaemia increases the risk of periodontitis and the onset of ACE2 overexpression, as well as decreased MMP activity in the periodontal tissue of patients with type 2 diabetes; these events could be essential for SARS-CoV-2 infection and COVID-19 development.

This article focuses on herpesviruses and major periodontopathic bacteria in the etiology of localized juvenile periodontitis. The joint association of herpesvirus with severe periodontitis and systemic diseases argues for a possible systemic involvement of periodontal herpesviruses in medical disorders and for periodontal therapy that targets both herpesviruses and bacterial pathogens. The etiopathogenesis of severe periodontitis includes active herpesviruses, specific bacterial pathogens, and pro-inflammatory cytokines. The inflamed periodontium constitutes an important reservoir of herpesviruses outside of the hematopoietic compartment. Several rationales prompted studies on periodontal herpesviruses. Severe periodontitis lesions can contain hundreds of millions of active herpesviruses and bacterial pathogens that may. Systemic and topical anti-herpesvirus therapy can neutralize active herpesviruses, and effective patient self-care can help prevent inflammatory cells containing latent herpesviruses from entering the periodontium.

Mucous membranes and skin the in the orofacial region are often affected by a diverse spectrum of bacterial, viral, fungal, chlamydial, rickettsial, protozoal, and helminthic infections. Such conditions may clinically appear as small, localized lesions to diffuse and invasive varieties that extend beyond natural barriers, often causing potentially life-threatening complications. Regardless of the prevalence, incidence, and the advancement of treatment strategies, orofacial infections, either local or the manifestations of a generalized infection, may cause significant discomfort and suffering. Thus, the recognition of the clinical presentation of these infections is paramount to their diagnosis, clinical management, and appropriate referral. The following sections describe orofacial manifestations of human herpesvirus and fungal infections.

The therapeutic efforts for controlling periodontal diseases focus on the removal of dental biofilm from the affected lesion, as active treatment centers on non-surgical mechanical debridement with antimicrobial and sometimes anti-inflammatory adjuncts. The surgical therapy aims at gaining access to the lesion and correcting unfavorable gingival ⁄ osseous contours to achieve a periodontal architecture that will provide for more efficient oral hygiene and periodontal maintenance. In addition, recent advances in tissue engineering have provided an efficient means to regenerate ⁄ repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors ⁄ biologic mediators. A systematic review confirmed that patients who are seen at regular intervals for supportive periodontal therapy experience less attachment loss and lose fewer teeth

Periodontology has been defined as the scientific study of the periodontium in health and disease. The objective of this overview of principles of periodontology is presentation of current and established concepts. Aspects of the history, classification and epidemiology of the most common periodontal diseases are discussed. People exhibiting periodontal abnormalities, for example impairments of tissue integrity or function, are said to have periodontal diseases. Periodontal diseases are arguably among the most ancient and common infectious diseases affecting humans, leading to permanent destruction of the supporting structures of the dentition and ultimately tooth loss. The new classification is complex and will take time to fully incorporate into patient care globally.

Periodontal diseases are arguably among the most ancient and common infectious diseases affecting humans, leading to permanent destruction of the supporting structures of the dentition and ultimately tooth loss. It has been established that dental biofilm (‘‘plaque’’), consisting of many microbial species and their products, is an etiological agent of periodontal disease. It is widely accepted that immunological and inflammatory responses to dental plaque via hostparasite interaction are manifested by clinical signs 40 Dentino et al. and symptoms of periodontal diseases.

Fluoridation plays a key role in the prevention and control of dental caries in general public health. However, this success is not without cost and has resulted in strong debates within the dental profession. Dental fluorosis is a cosmetic effect that ranges in appearance from scarcely discernible to a marked staining or pitting of the teeth in severe forms. It is caused by an elevated fluoride level in, or adjacent to, the developing enamel, usually from birth to approximately six to eight years of age. Dental fluorosis in an adult is a result of high fluoride exposure when the adult was a child or adolescent. In its mildest (and most common) form it may manifests barely noticeable whitish striations, while more severe forms involve confluent pitting and staining of the dental enamel. The American Dental Association (ADA) defines it as a hypomineralization of tooth enamel that results from excessive fluoride ingestion prior to tooth eruption (ADA Reports, 2005). An increase in the prevalence of dental fluorosis has been reported simultaneously in both fluoridated and non-fluoridated communities. Although most of fluorosis is mild or very mild, and has little or no impact on quality of life of affected people, a judicious use of fluoride to avoid moderate and severe fluorosis is needed. In order that the maximum benefit of fluoride for caries control can be achieved with a minimum risk of side effects, it is necessary to have a comprehensive understanding of the mechanisms by which fluoride promotes caries control, thus regulating the amount of fluoride intake is essential.

The specialized literature exhibits a multitude of studies that highlight the role of general factors, of some chronic systemic diseases, that can contribute to the appearance or modulation of periodontal disease, carious disease but also of other oral diseases. The oral cavity can be affected by diabetes, which can lead to several complications, including tooth decay, periodontal disease, disorders of the oral mucosa and dysfunction of saliva, which have a significant effect on the quality of life of diabetic patients. The importance of the host lies in the association of systemic diseases to the process of periodontal destruction of tissues in the oral cavity (periodontal tissues, dental tissues, tissues of the oral mucosa and salivary glands). The biomolecular and biocellular mechanisms involved in the pathology of the oral cavity in case of systemic diseases involve the mechanisms of local and systemic inflammation governed by proinflammatory cytokines (IL-6, IL-18, IL-17, IL-1B, IL-8, TNF- alpha and prostaglandins E2-PGE2, protein-2 inhibitory macrophages, MCP-1, interferon gamma, adipokines more common in diabetes. Inflammatory-mediated cytokines and proteins are practical markers of increased risk of cardiovascular disease, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor – alpha (TNF-α), fibrinogen.

Toothpaste formulas have evolved over time. Today they contain about 20 ingredients. Toothpastes normally contain: active ingredients, abrasives, surfactants, gelling agents, buffers, flavors and sweeteners, dyes and preservatives, water, moisturizers. Among these ingredients are compounds that fight and prevent the appearance of carious lesions, gingival diseases, halitosis, calculus, dental erosions, staining and dentinal hypersensitivity. Herbal toothpastes, which contain natural antibacterial agents, are a good alternative to reduce the risk of oral conditions in both children and adults.

Orthodontic treatment can successfully align pathologically migrated teeth leading to improved periodontal stability in patients with periodontal disease. Periodontal-orthodontic approaches have gained increasing attention in recent years. A considerable number of adult patients with periodontal disease are interested in orthodontics in order to improve the alignment of their teeth. However, the severity of periodontal disease and dental incongruence or demographic factors cannot be indicative of these. Elderly patients were significantly more frequently interested in orthodontic treatment. Most study participants were not provided with information on orthodontic treatment options for adults. Very importantly, this group of patients must be aware of the need to stabilize their periodontal condition, to maintain high standards of oral hygiene, before any orthodontic intervention. Therefore, practitioners need to be aware of the patient’s need, deliver patient-centered and provide them with relevant information and, if necessary, plan interdisciplinary treatment.

The aim of this study was to evaluate the influence of smoking on salivary RANKL and OPG levels in patients with generalized, stage III, grade B periodontitis. Material and methods: The salivary concentrations of RANKL and OPG were determined for 18 patients, aged between 23 and 50 years old, of which 8 were smokers, all presenting with a form of generalized, stage III, grade B periodontitis. Results: smokers had higher salivary levels of RANKL (p=0,0009) and a higher RANKL/OPG ratio (p=0,019), compared to non-smokers. OPG salivary levels did not differ much between smokers and non-smokers. Conclusions: Smoking has a higher impact on RANKL than on OPG salivary levels, for patients with generalized, stage III, grade B, periodontitis.

The influence of orthodontic treatment on periodontitis-susceptible patients is a subject of interest. Dental malposition caused by periodontal disease are often observed in this type of patients. Also, these patients often are undergoing orthodontic treatment in order to restore the esthetics and functions of the dental and periodontal apparatus. Thus, it is important to question and verify in what conditions and parameters the orthodontic treatment improves the status of the periodontium. This review analyses several studies concerning this important topic and highlights the parameters that influence the outcome of orthodontic treatment.

Worldwide the rate of edentulism due to an increasingly aging population is as high as 70%, according to region, country, socio-ecconomic status, etc. The habit of using a removable prosthesis, can alter the delicate ecological balance of the oral cavity can cause denture candidiasis. Chronic atrophic candidiasis, or denture candidiasis, is a common infection of the oral cavity caused by overgrowth of mainly Candida species and it affects mostly patients with an affected immune system. Risk factors for the development of this pathology can be divided in two, systemic or local. Drugs like steroids, broad spectrum antibiotics, immunosuppressives can increase the risk of oral candidiasis by suppressing cellular immunity and phagocytosis. Timely diagnosis of the ethiopathogenic pathogenic fungal microorganisms and the susceptibility to antifungal medication are crucial to the correct treatment of the infection and to implement preventive healthcare-associated strategies. Mirroring bacterial resistance, fungal infections, both non-Candida albicans but also antifungal resistant isolates have up-surged; thus, reliable diagnostic methods and new treatment modalities (utilizing novel antifungal agents or alternative therapies such as photodisinfection) are much sought-after in the management of candidiasis.

The health of periodontal tissues is the key to the long-term success of prosthetic restorations. A negative impact on it can have subgingival margins, an inaccurate marginal fit, materials that favor the accumulation of plaque and can suffer the corrosion process. All these characteristics can stimulate the appearance of a biological response, that can be translated by increased proinflammatory markers (interleukins, matrix metalloproteinases) in gingival crevicular fluid. The acquisition of the aspects that describe the relationship between the two elements mentioned above, could ensure a favorable prognosis of fixed prosthetic therapy.

Periodontal treatment of tissue defects which comprises guided tissue regeneration and mucosal plastic surgery still remains nowadays a challenge in the dental office due to the lack of absolute predictability. New treatment techniques and biomaterials have emerged in order to counteract the different risks generated by the periodontal surgical methods. 3D and 4D printing technologies offer new possibilities in terms of patient-tailored materials, with lower complications and trauma and with the promise of a more accurate treatment plan and success.

Lasers are used in oral surgery and periodontology liberally nowadays, however, solid therapeutic protocols are still lacking in some medical areas. An epulis is defined clinically as hyperplasia of the gingival tissues, usually situated in the proximity of the interdental papilla, however it may also occur in the edentulous ridges. Regarding the origin of this particular lesion the periodontun and the periosteum are considered principal components. In this case report we present an orthodontic patient with a recurrent fibrous epulis that was treated by ablation with a diode laser (940nm). This particular method was chosen due to the reduced treatment time and diminished intrasurgical bleeding. Furthermore, an improved gingival healing compared with classical scalpel blade surgical treatment was observed. We demonstrated that diode lasers are particularly useful tools in orthodontic patients that are predisposed to gingival hyperplasia and this treatment method has supplementary advantages compared to the classical scalpel regarding the presence and intensity of pain and postoperative discomfort

Maxillary sinusitis is a frequent pathology encountered in both otolaryngology but also in oro-maxillo-facial and dento-alveolar surgery. When it is of odontogen origin it can originate in a maxillary tooth infection, and/or endodontic treatment, periodontal bone loss and dental implants. Odontogenic maxillary sinusitis accounts for approximately 10%–41% cases of maxillary sinusitis and a routine radiologic examination can reveal its dental origin. The purpose of this review was to assess the association and influence between the various odontogenic conditions (endodontic periapical pathology, periodontal disease, bone loss, dental trauma, missing teeth, etc.) and the presence of maxillary sinus mucosal thickening reported in the literature. The thickness of the alveolar cortical plate and the roots of maxillary molars affect the spread of odontogenic infection, which, in turn, is the basis of treatment planning. Conclusion: Otolaryngologists are frequently involved in the treatment of patients with maxilary sinusitis. However, during treatment the odontogenic cause is often overlooked, leading to persistent symptoms in patients and an incomplete and a failure of sinusitis treatment. A collaborative approach to the diagnosis and treatment of suspected odontogenic maxillary sinusitis between otolaryngologists and dental practitioners may be an effective patient-centered strategy. The interdisciplinary management of sinusitis and the dental origin of the condition is essential in these cases.

RAGE has historically been studied in periodontitis associated with diabetes. Activation of RAGE generates pro-inflammatory signals through its interaction with glycated molecules present in the serum and tissues of diabetic patients. This process is described as the AGE / RAGE axis. A body of evidence tends to show the involvement of this same receptor in the pathophysiology of periodontitis alone (not associated with diabetes). At the tissue level, RAGE is overexpressed in sites affected by periodontitis concomitantly with its AGER1 antagonist, limiting its inflammatory action. Finally, the serum concentration of the cleaved soluble forms of RAGE is reduced in periodontal patients and is negatively correlated with the clinical parameters of periodontitis. The pathophysiology of periodontitis seems to have an impact on the concentration of this antioxidant biomarker. The variation in the serum concentration of RAGE is associated with many systemic pathologies.

Antibiotics represent an important adjunctive method in the complex and effective periodontal therapy. Moreover, beside the curative effects of antibiotics, antibiotic prophylaxis needs to be taken into account when particular cases of infectious risk patients need to be correctly approached. An important criterion in the antibiotic prohylaxis selection includes the physiopathological state of the patient: his general state of health, his immune status, his medical-surgical history, his comorbidities and his current medications. All this in order not to carry out contraindicated associations and to avoid the potentiation of undesirable effects. Compliance with these selection criteria maximizes therapeutic efficacy while limiting individual risks (hypersensitivity, adverse effects) but also collective risks with respect to the emergence of bacterial resistance. In summary, antibiotic therapy must be justified with the best efficacy, the best possible tolerance and at a reasonable cost. In addition, the methods of compliance and the duration of the treatment can direct towards preferred molecules.

The silent nature of osteoporosis makes it difficult to diagnose. Therefore, all healthcare professionals should participate in the identification of patients suffering from this disease. Dental x-rays can be considered a minimally invasive and convenient method in identifying osteoporosis. The repercussions of osteopenia / osteoporosis on the periodontium appear to be proven. Periodontal parameters (clinical loss of attachment, probing depth, gingival index, and bleeding on probing) show signs of greater tissue degradation. The relationship between periodontal disease and osteoporosis appears to be linked by the risk factors they share and by the mechanism of bone loss. The inflammatory nature of these two pathologies has been demonstrated, which could highlight a pathogenic link between them. The literature does not currently suggest any specific conduct or protocol in assessing the risk of low bone density and in the management of these patients. But osteopenic / osteeporotic patients require special attention and medical dental care.

The direct involvement of herpesviruses in the evolution of periodontitis can change the concepts of pathogenesis and disease management. A double periodontal infection of herpesviruses and pathogenic bacteria tends to be associated with more severe periodontitis than a periodontal infection involving only bacteria. Classical techniques in viral diagnosis use cell culture or antigenemia. These diagnostic techniques have been largely replaced by DNA and / or RNA-based tests, which possess superior technical performance and cost advantages. False-negative and false-positive PCR results are an inherent concern. Poor design of the PCR test, without optimization or validation of the PCR methodology, may lead to inaccurate findings and incompatible with those of other studies. The concept of viral infections of the diseased periodontium may introduce a new level of understanding of the importance of preventing and controlling periodontal disease for medical purposes

Oral infections and periodontal disease may be exacerbated during chemotherapy and represent an important risk due to the neutropenia that many of the patients develop during treatment. The main objectives of oral care during immunosuppression periods are maintaining the oral health status, evaluating and treating any side effects that may occur during chemotherapy and patient education regarding the importance of maintaining good oral hygiene in minimalizing the risk of oral complications and discomfort during the chemotherapy treatment. The aim of this study is to revise the means of treatment and prevention of the adverse effects of chemotherapy in oncology patients.

This study highlights the importance of regular periodontal control in orthodontics. Fix orthodontic treatment impairs a good hygiene and could lead to several complications. Materials and methods. In this study enrolled 20 subjects that met the inclusion and exclusion criteria. The informed consent was signed by all the patients. Results and Discussion. Bleeding on probing and hygiene were assessed before the placement of fixed orthodontic appliances and after. Comparing the values, we found that BOP values increased after placement of fixed orthodontic appliances. Hygiene was not found to be in an optimal level. Conclusions. The results found emphasize the need of regular periodontal control in order to detect and prevent any periodontal issues that could influence the periodontal status.

Diabetes is a systemic disease with a number of major complications that can adversely affect quality of life. The disease is characterized by an increased susceptibility to infection, poor wound healing and increased morbidity and mortality associated with the evolution of the disease. Periodontal disease has been reported as the sixth complication of diabetes, along with neuropathy, nephropathy, retinopathy, and micro and macrovascular damage. Diabetes not only increases the risk and prevalence of periodontal disease, but also increases the progression of periodontal destruction. Both periodontal disease and diabetes have major inflammatory components. Not only is diabetes a risk factor for periodontitis, but periodontitis could also have a negative effect on glycaemic control.

The number of patients undergoing hormone replacement therapy (HRT) to counterbalance hormonal changes is increasing. Patients follow HRT not only to avoid climatic symptoms but also to protect themselves from cardiovascular disease and osteoporosis. HRT is an option for women who need drug therapy to reduce the risk of osteoporosis, including women at high risk of fracture for the next 5-10 years. Oestrogen supplementation can modulate the periodontal destruction rate through mechanisms involving inhibition of matrix metalloproteinases (MMP-8 and MMP-13) and cytokines involved in bone resorption

The metabolic syndrome is a complex pathology, multisystemic, with numerous consequences that include: high blood sugar, hypertension, visceral obesity, dyslipidemia with high levels of triglycerides (TG) and low levels of HDL. Recent studies have published in the specialty literature, data that suggest the existence of a possible association between obesity and periimplantitis. The purpose of this report cases is to explore the possible relation between the metabolic syndrome and the development of periimplantitis. To reach the proposed objective we have evaluated the characteristics of periimplant tissues in patients that have a metabolic syndrome associated.

Local risk factors could influence directly the periodontium, the most often involved local risk factors being dental calculus, malocclusions, improper or aged and degraded dental or prosthetic treatments, orthodontic appliances, affecting also the masticatory, esthetical and phonetical function consequently decreasing the quality of life. A good domestic plaque control performed by the patient and its removal professionally may be insufficient for the resolution of periodontal inflammation, as the local/systemic risk factors may still favour plaque accumulation or cause a misbalance of the host immune response. Therefore, plaque removal should be always accompanied by a sustained effort of the dental practitioners’ team to correct, or to, at least, control the predisposing local and systemic risk factors.

Achievement of holistic oral health is dependent upon first carrying out a thorough examination, so as to establish a comprehensive diagnosis of patient etiologies, needs, and required therapies. Restorative therapy often includes splinting of mobile teeth, coverage of sensitive roots, and correction of occlusal abnormalities to improve periodontal prognoses. The components of a thorough clinical examination include periodontal probing depths, assessment of clinical attachment levels, hard – and soft – tissue examination, models, and face – bow records. However, it is important to realize that a complete examination begins with an open discussion with the individual patient, as a step in determining the patient’s needs and desires. In this way, treatment plans may be formulated that are in the best interest of the patient and represent a greater value for the patient. Conclussion. Simple and complex patients may be successfully treated in this periodontaly challenging context, with success being defined as long – term stability and maximization of patient comfort, function, and aesthetics.

Periodontal disease as a spectrum of diseases has a high prevalence all over the world, affecting all ages but even more so the elderly. Although the advancement of the medical field has made many breakthroughs in a multitude of diseases, still a specific and reliable treatment has not been discovered yet in this particular pathology. Periodontitis is an oral disease which affects the soft and hard tissues surrounding teeth and it causes the gradual attachment loss of dental structures, eventually leading to the complete expulsion of the dental unit. It is defined the formation of periodontal pockets accompanied, or not, by gingival recession. The etiological factor and the initiators of the disease are microorganisms and their by-products which cause dysbiosis and an exacerbated host inflammatory response. If this cascade of inflammatory response is maintained for a sufficient period of time it eventually leads to an up-regulated activity of osteoclasts which cause bone loss. Considering the worldwide health burden of this pathology and the many associations and interdependencies with a multitude of other systemic diseases epidemiological analysis have had a pivotal task in aiding the discovery and implication of risk factors for the disease. Furthermore, such studies further the field by assessing the treatment necessities of populations and can offer insight to health regulators.

The present resorbable and non-absorbable membranes act as a physical barrier to prevent the fall of the connective and epithelial tissue in defect, favouring the regeneration of periodontal tissues. These conventional membranes have many structural, mechanical and biofunctional limitations. It is clear that the “ideal” membrane for use in periodontal regenerative therapy has not yet been developed. Based on a biomaterial-based approach, it was assumed that a biologically designed and functionally sized nanofibre material closely mimicking native ECM could succeed as the next generation of GTR / GBR membranes for periodontal tissue engineering.

Biofilms that colonize tooth surfaces and epithelial cells lining the periodontal pocket ⁄ gingival sulcus (subgingival dental plaques) are among the most complex biofilms that exist in nature. Photodynamic therapy has been suggested as an alternative to chemical antimicrobial agents to eliminate subgingival species and treat periodontitis. Antimicrobial photodynamic therapy seems to be a unique and interesting therapeutic approach towards the treatment of periodontitis and peri-implantitis. The results of a number of in vitro studies clearly demonstrate the effective and efficient bactericidal effect of antimicrobial photodynamic therapy. Antimicrobial photodynamic therapy may hold promise as a substitute for currently available chemotherapy in the treatment of periodontal and peri-implant diseases.