Endo-perio lesions are lesions involving pulp tissue with periodontal tissue. The bacterial infection of the pulp can spread to the furcation area through the accessory canal, causing damage to the furcation area. Regeneration therapy has good success when performed with flap surgery and is performed in cases of Grades I and II furcation involvement. Demineralized freeze-dried bone allograft (DFDBA) is a regenerating material that has osteoinductive and osteoconductive abilities. It has the advantage of successful treatment of bone defects. Biodentine is an agent used for direct pulp capping, root perforation and furcation repair, and apexification. It can bind and enter the dentinal tubules and create interlocking crystals with dentin. This case report presents the treatment of furcation involvement Grade II originating from endo-perio lesions by using DFDBA and Biodentine as regeneration materials with 6 months of follow-up.

Counting growth layers in dentine and/or secondary cementum is widely used for age determination in wild mammals but the underlying seasonal changes in the structure and degree of mineralisation of dental tissue have not been well characterised. We embedded first (m1) and second (m2) mandibular permanent molar teeth from a 12-year-old female Svalbard reindeer (Rangifer tarandus platyrhynchus) in PolyMethylMethAcrylate (PMMA), prepared cut and polished surfaces coated with evaporated carbon and used 20 kV back-scattered electron imaging in a scanning electron microscope (BSE-SEM) to study aspects of dental tissue structure which depend on the degree of mineralisation at the micron and sub-micron scale. BSE-SEM revealed differences between the mineral content of growth layers (annulations) in the secondary cementum and the primary and secondary dentine, the latter, incidentally, still forming at death in m1. Wide bands of less well mineralised tissue formed in the cementum during active appositional phases. Thin, denser bands formed by maturation-mineralisation of existing tissue when growth slowed in winter. This maturation mimics the processes seen in lamellar bone and articular cartilage. Counter to previous suggestions, there was evidence of substantial resorption and repair of the secondary cementum and of formation of dentine throughout life. Secondary dentine is layered by mineral content like cementum. In the crown, this was mainly tubular dentine with well-marked interglobular dentine layers. In the lower pulp chamber and root, it was largely without tubules. Substantial non-mineralised spaces found at the cement-dentine junction in the root apical regions in m2 represent inclusions of the Hertwig\'s Epithelial Root Sheath (HERS) or the Epithelial Rests of Malassez (ERM) between the two tissues, a phenomenon which has previously only been identified in Muridae. The anatomical changes which result in the formation of the incremental lines (annulations) in dental tissues of reindeer, identified here for the first time at the micrometre level, are likely to be common across most if not all long-lived species of mammals living in seasonal environments.

Introduction Periodontitis is a complex condition influenced by various factors involving interactions between the host and bacterial plaque. Porphyromonas gingivalis, an anaerobic gram-negative bacterium, is commonly linked with periodontal disease. Aim This study aimed to examine the occurrence of P. gingivalis in individuals diagnosed with chronic periodontitis (CP) compared to those who show no clinical indications of periodontal disease. Methodology Patients diagnosed with CP (including both severe and moderate cases) and individuals without any signs of periodontal disease were recruited for this study. Samples were collected from the gingival pockets using curettes and were subsequently subjected to anaerobic culturing. Results A group of 30 patients, divided into moderate and severe CP, along with 30 healthy individuals serving as controls, were examined. In individuals with CP, P. gingivalis was found in 23 (78%) of cases, while in healthy individuals, the prevalence was 10 (34%). The presence of P. gingivalis was notably higher in those with periodontal diseases compared to healthy subjects, with rates of 23 (78%) vs. 10 (34%), respectively. Conclusion P. gingivalis is frequently found in individuals with periodontal diseases as well as in those without such conditions, albeit in smaller quantities. Consequently, the existence of P. gingivalis raises the probability of developing periodontal disease and may be regarded as a notable potential contributor to its initiation.

BACKGROUND: Mineral metabolism is critical for proper development of hard tissues of the skeleton and dentition. The dentoalveolar complex includes the following 4 mineralized tissues: enamel, dentin, cementum, and alveolar bone. Developmental processes of these tissues are affected by inherited disorders that disrupt phosphate and pyrophosphate homeostasis, although manifestations are distinct from those in the skeleton.
METHODS: The authors discuss original data from experiments and comparative analyses and review articles describing effects of inherited phosphate and pyrophosphate disorders on dental tissues. A particular emphasis is placed on how new therapeutic approaches for these conditions may affect oral health and dental treatments of affected patients.
RESULTS: Disorders of phosphate and pyrophosphate metabolism can lead to reduced mineralization (hypomineralization) or inappropriate (ectopic) calcification of soft tissues. Disruptions in phosphate levels in X-linked hypophosphatemia and hyperphosphatemic familial tumoral calcinosis and disruptions in pyrophosphate levels in hypophosphatasia and generalized arterial calcification of infancy contribute to dental mineralization defects. Traditionally, there have been few options to ameliorate dental health problems arising from these conditions. New antibody and enzyme replacement therapies bring possibilities to improve oral health in affected patients.
CONCLUSIONS: Research over the past 2 decades has exponentially expanded the understanding of mineral metabolism, and has led to novel treatments for mineralization disorders. Newly implemented and emerging therapeutic strategies affect the dentoalveolar complex and interact with aspects of oral health care that must be considered for dental treatment, clinical trial design, and coordination of multidisciplinary care teams.

The masticatory organ is at the center of dental practice. Tooth loss, regarded as an organ failure, is a core dispute in our profession, as it more often than not does not happen spon-taneously but is influenced by the dentist\'s treatment plan. Despite the prosthetic possibili-ties of tooth replacement, efforts should be made to preserve as many teeth as possible. Decisions between tooth preservation and extraction are complex and have far-reaching consequences. This article discusses this problem using a clinical case study of a 43-year-old female patient with pronounced localized periodontitis. After a comprehensive diagnosis and treatment planning, a daring regenerative therapy was carried out to try to preserve the tooth. The case shows that even seemingly hopeless teeth can be successfully treated syn-chronously using modern therapeutic approaches. Initial literature data supports the possi-bility of preserving severely compromised teeth in the long term in compliant patients. An integrative treatment approach based on individual patient factors and modern regenerative techniques may well be a viable alternative to tooth extraction and prosthetic restoration, albeit not inexpensive and uncomplicated. This communication emphasizes the need for precise diagnostics, a comprehensive treatment plan, and honest communication with pa-tients about the prospects of success and possible risks, and highlights the strengths of con-sistent tooth preservation.
Das Kauorgan steht im Mittelpunkt der zahnärztlichen Praxis. Zahnverlust wird als Organver-sagen betrachtet und stellt ein bedeutendes Problem dar. Trotz prothetischer Möglichkeiten sollte der Erhalt möglichst vieler Zähne angestrebt werden. Entscheidungen zwischen Zahn-erhalt und Extraktion sind komplex und haben weitreichende Folgen. Dieser Artikel behan-delt das Thema anhand eines klinischen Falls einer 43-jährigen Patientin mit ausgeprägter lokalisierter Parodontitis. Nach umfassender Diagnose und Behandlungsplanung wurde eine regenerative Therapie durchgeführt, um den Zahn zu erhalten. Der Fall zeigt, dass auch scheinbar hoffnungslose Zähne mit modernen Therapiemethoden bei zu guter Mundhygiene motivierbaren Patienten erfolgreich behandelt werden können. Erste Literaturdaten unter-stützen die Möglichkeit, stark beeinträchtigte Zähne langfristig zu erhalten. Ein integrativer Behandlungsansatz, basierend auf individuellen Patientenfaktoren und modernen Regenera-tionstechniken, kann eine Alternative zur Extraktion und prothetischen Versorgung sein, ob-wohl er kostspielig und kompliziert ist. Dieser Artikel betont die Notwendigkeit präziser Di-agnostik, umfassender Behandlungspläne und ehrlicher Kommunikation mit den Patienten über Erfolgsaussichten und Risiken sowie die Stärken des konsequenten Zahnerhalts.

The pathological teeth migrations require correct multidisciplinary treatment which consists of periodontal surgery associated with early or late orthodontic treatment. The aim of this study was to know which of the two orthodontic treatments would have a better periodontal response.
Two parameters, radiological (the height of the alveolar bone) and clinical (the depth of the periodontal pocket), were used to meet the objective of this work. Eighteen patients received early orthodontic treatment (straight wire appliance) after periodontal flap debridement surgery and eighteen others late orthodontic treatment (straight wire appliance).
The results showed the absence of significant difference between the two early and late orthodontic treatments after periodontal flap debridement surgery.
Orthodontic treatment can be started early seven to ten days after periodontal surgery.
Les migrations dentaires pathologiques exigent un traitement pluridisciplinaire correct qui consiste en une chirurgie parodontale associée à un traitement orthodontique précoce ou tardif. Le but de cette étude était de connaître lequel des deux traitements orthodontiques aurait une meilleure réponse parodontale.
Deux paramètres, radiologique (la hauteur du défaut osseux) et clinique (la profondeur de la poche parodontale), ont été utilisés afin de répondre à l’objectif de ce travail. Dix-huit patients ont reçu, après la chirurgie parodontale par un lambeau d’assainissement, un traitement orthodontique précoce (technique d’arc droit) et dix-huit autres un traitement orthodontique tardif (technique d’arc droit).
Les résultats ont montré l’absence de différence significative entre les deux traitements orthodontiques, précoce et tardif, après la chirurgie parodontale par un lambeau d’assainissement.
Le traitement orthodontique peut débuter précocement dès sept à dix jours après la chirurgie parodontale.

OBJECTIVE: To update the competences and learning outcomes and their evaluation, educational methods and education quality assurance for the training of contemporary specialists in periodontology, including the impact of the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions (2018 Classification hereafter) and the European Federation of Periodontology (EFP) Clinical Practice Guidelines (CPGs).
METHODS: Evidence was gathered through scientific databases and by searching for European policies on higher education. In addition, two surveys were designed and sent to program directors and graduates.
RESULTS: Program directors reported that curricula were periodically adapted to incorporate advances in diagnosis, classification, treatment guidelines and clinical techniques, including the 2018 Classification and the EFP CPGs. Graduates evaluated their overall training positively, although satisfaction was limited for training in mucogingival and surgical procedures related to dental implants. Traditional educational methods, such as didactic lectures, are still commonly employed, but they are now often associated with more interactive methods such as case-based seminars and problem-based and simulation-based learning. The evaluation of competences/learning outcomes should employ multiple methods of assessment.
CONCLUSIONS: An update of competences and learning outcomes of specialist training in periodontology is proposed, including knowledge and practical application of the 2018 Classification and CPGs. Harmonizing specialist training in periodontology is a critical issue at the European level.

UNASSIGNED: In the case of mucous membrane pemphigoid with gingival expression (gMMP), the complete healing of the gingiva is generally not achieved despite medical treatment. Therefore, patients\' oral comfort is impaired. The dysbiotic periodontal microbiota, generated by a lack of oral hygiene associated with persistent gingival pain, could the immunopathological mechanism to persist. The main objective of this study was to characterize the subgingival microbiota of the gMMP patients, and to highlight a potential link between this microbiological data and the clinical data.
UNASSIGNED: Subgingival biofilm was collected from 15 gMMP patients, medically treated or not, but not receiving periodontal treatment. The usual clinical periodontal parameters were recorded. The biofilm was analyzed by polymerase chain reaction quantitative. The risk factors of severe erosive gingivitis and severe periodontitis were assessed using Chi-square or Fischer\'s exact test were used.
UNASSIGNED: Whatever the medical and periodontal conditions of the patients, the results showed the existence of three main communities of periodontopathic, dysbiotic bacteria. The first including Tannnerella forsythia, Peptostreptococcus micros, Fusobacterium nucleatum, and Campylobacter rectus, was found in 100% of the patients, the second enriched with Treponema denticola in 60% and the third enriched with Porphyromonas gingivalis and Prevotella intermedia in 26%. Furthermore, there was a significant positive link between the duration of gMMP and the severity of erosive gingivitis (p = 0.009), and the loss of deep periodontal tissue (p = 0.04).
UNASSIGNED: This pilot study suggests a high periodontal risk in gMMP patients. The pathological processes, autoimmune on the one hand and plaque-induced on the other, may amplify each other. The application of periodontal therapy is therefore necessary in parallel with medical treatment. Nevertheless, further controlled studies are required to validate and complement these preliminary results.

In recent years, significant advancements in dental and periodontal diagnostics have paved the way for improved care. Among the available approaches, laser fluorescence (LF) is a promising method. This case report explores the utilization of a 405 nm diode laser as a diagnostic tool in the non-surgical treatment of biofilm-induced gingivitis, as well as its application in routine daily practice for diagnosing restorations and dental caries. A 24-year-old male patient and a 21-year-old female patient were included. A 405 nm diode laser (Smart M, Lasotronix, Poland) was used as a diagnostic tool with a tip diameter of 8 mm. In case one, the utilization of the 405 nm diode laser enhanced the patient\'s ability to perceive the presence and extent of plaque and calculus, aiding in motivation and education regarding supra-gingival dental biofilm control and it assisted the operator in precisely localizing plaque and calculus, thereby enabling more effective mechanical debridement and ultimately improving treatment outcomes. In the second case, the utilization of the laser facilitated the detection of defective composite fillings aiding in both accurate diagnosis for the operator and effective communication with the patient regarding the need for re-treatment. This study illustrates the potential of the relatively new 405 nm diode laser as a promising diagnostic tool in the daily management of periodontal patients and the detection of defective dental fillings in daily practice.

BACKGROUND: Periodontal disease is an infectious syndrome presenting inflammatory aspects. Radiographic evaluation is an essential complement to clinical assessment but has limitations such as the impossibility of assessing tissue inflammation. It seems essential to consider new exploration methods in clinical practice. Ultrasound of periodontal tissues could make it possible to visualize periodontal structures and detect periodontal diseases (periodontal pocket measurement and the presence of intra-tissue inflammation). Clinical Innovation Report: An ultrasound probe has been specially developed to explore periodontal tissues. The objective of this clinical innovation report is to present this device and expose its potential.
CONCLUSIONS: Various immediate advantages favor using ultrasound: no pain, no bleeding, faster execution time, and an image recording that can be replayed without having to probe the patient again. Ultrasound measurements of pocket depth appear to be as reliable and reproducible as those obtained by manual probing, as do tissue thickness measurements and the detection of intra-tissue inflammation.
CONCLUSIONS: Ultrasound seems to have a broad spectrum of indications. Given the major advances offered by ultrasound imaging as a complementary aid to diagnosis, additional studies are necessary to validate these elements and clarify the potential field of application of ultrasound imaging in dentistry.