About 50% of tooth loss is caused by either endodontic infection, periodontal disease or the combination of the two in the form on endo-perio lesions (EPL). Combined EPL develop due to the intimate anatomic and functional relation between endodontic and periodontal tissues. Both the pulp and periodontium share the same embryologic and anatomic origin. The various pathways connecting the two, added up to the extremely alike microorganisms in both illnesses’ etiology, create a complex condition in which interdisciplinary approach is required. Despite numerous decades of literature describing these lesions, they remain a continuous challenge for practitioners in both diagnosing and managing. The purpose of this article is to present a comprehensive review of various aspects of the combined EPL and to emphasize the importance of making a correct diagnosis and adopting the appropriate treatment method in the management of these challenging situations.

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Although treatment with fixed or mobile appliances has become an important part of modern orthodontics, side effects such as white spot lesions (WSLs) have a negative impact on the aesthetic outcome of orthodontic treatment. The purpose of this article was to review current evidence on the diagnosis, risk assessment, prevention, management and post-orthodontic treatment of these lesions. Data collection was performed electronically, and the initial search using the keywords “white spot lesions”, “orthodontics”, “WSL”, “enamel” and “demineralization” in different combinations resulted in 1032 articles for the two electronic databases used. Ultimately, a total of 47 manuscripts were considered relevant to the aim of this research and included in this review. The results of the review indicate that WSLs remain a significant problem during orthodontic treatment. According to studies in the literature, the severity of WSLs correlates to the duration of treatment. Using toothpaste with more than 1000 ppm fluoride at home reduces the frequency of WSL separation and regular application of varnishes in the office reduces the frequency of the occurrence of WSLs only in the context of maintaining a strict hygiene regime. The old hypothesis that elastomeric ligatures retain more dental plaque than metal ones has been refuted. There are no differences in the appearance of WSLs between conventional brackets and self-ligating brackets. Clear aligner mobile devices develop fewer WSLs but are more extensive as opposed to conventional fixed devices, while lingual orthodontic appliances have a lower incidence of WSLs, and the most effective device for preventing these lesions is WIN, followed by Incognito.

Developmental disabilities exist in children and adolescents, enabling them to live an independent and self-governing life, requiring special health related services. We are intended to inform dental professionals in planning and implementing a dental treatment for people with developmental disabilities. Cerebral palsy is defined as being a group of motor abnormalities and functional impairments that affect muscle coordination, and characterized by uncontrolled body movements, intellectual disabilities, balance-related abnormalities or seizure disorders. These patients can be successfully treated in normal dental practices, but because they have problems with movements, care must be tailored accordingly. Down syndrome, a very common genetic disorder, is usually associated with different physical and medical problems, intellectual disabilities, and a developmental delay. These patients can be treated with success in dental offices, this way making a difference in the medical care for people with special needs. Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication and by restricted and repetitive behavior. Self-injurious behavior, obsessive routines and unpredictable body movements can influence dental care. Because of the coexisting conditions (epilepsy or intellectual disability), one can find this people among the most challenging to treat. There is a need of greater awareness, focus and education in the field of the unique and complex oral health care that people with disabilities need. Making a difference their oral health positively influences an already challenged existence. According to the ethical principles, patients with developmental disabilities should be treated equitably depending on their necessities.

Polymerase chain reaction (PCR) shows a high specificity and allows us to identify pathogenic periodontal bacteria. We chose 45 patients wich were divided into three groups with various types of treatment: (I) - SRP; (II) - SRP, followed by topical application of antiseptics (SRP + local); (III) - SRP followed by systemic administration of antimicrobial agents (SRP + systemic). We collected samples from the initial time (TO) and one month after the treatment (T1) for each patient. For the microbiological assessment of periodontal therapy, we analyzed 90 subgingival plaque samples using PCR technique which provides qualitative data on five periodontopathogenic bacteria species: A. actinomycetemcomitans, P.gingivalis, P.intermedia, T.forsythia, and T.denticola. The treatment was followed by a qualitative change of the bacteria detected previously in a different ratio depending on the treatment. We found the inefficiency of mechanical treatment regarding the reduction of periodontal bacteria in patients belonging to group I, an improvement in the results of group II, while the treatment in group III proved to be the most effective . In patients detected A.a+ and/ or P.g+ a systemic antibiotic treatment is required because these periodontal bacteria penetrate the tissue and mucosal surfaces of the oral cavity.