Endoscopic surgery is a safe and effective treatment for paranasal sinuses FB. A proper imaging study by MR and/or CT can address diagnosis, which is based upon detection of fungal hyphae at histology.

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Objectives To date, scarce evidence exists around the application of subgingival air polishing during treatment of severe periodontitis. The aim of this study was to evaluate the benefits of subgingival air polishing during non-surgical treatment of deep bleeding pockets in stages III-IV periodontitis patients Materials and methods Forty patients with stages III-IV periodontitis were selected, and pockets with probing depth (PD) 5-9 mm and bleeding on probing (BoP) were selected as experimental sites. All patients underwent a full-mouth session of erythritol powder supragingival air polishing and ultrasonic instrumentation. Test group received additional subgingival air polishing at experimental sites. The proportion of experimental sites shifting to PD ≤ 4 mm and no BoP at 3 months (i.e., nonbleeding closed pockets, NBCPs) was regarded as the primary outcome variable. Results The proportion of NBCP was comparable between test and control group (47.9 and 44.7%, respectively). Baseline PD of 7-9 mm, multi-rooted teeth and the presence of plaque negatively influenced the probability of obtaining NBCP. Conclusions The additional application of subgingival air polishing does not seem to provide any significant clinical advantage in achieving closure at moderate to deep bleeding pockets in treatment of stages III-IV periodontitis patients. The study was registered on Clinical Trials.gov (NCT04264624). Clinical relevance While air polishing can play a role in biofilm removal at supragingival and shallow sites, ultrasonic root surface debridement alone is still the choice for initial treatment of deep bleeding periodontal pockets.

The oral cavity is the natural habitat of a heterogeneous population of bacteria. 1 Both soft and hard surfaces are the substrate where microorganisms adhere and grow, forming the oral biofilm. 1,2 Biofilm quantity and complexity increase with time and affect the environment, leading to the development of caries, gingivitis 2,3 and periodontitis, 4 according to individual susceptibility and risk factors. Vice versa, the environment and local factors can influence the growth of biofilm, leading to its diversification in distinct areas even of the same tooth. 2 The regular disruption of biofilm through professional mechanical plaque removal and home oral hygiene is a critical point in the prevention of caries and periodontal disease. 5-8 Professional mechanical plaque removal in cariology involves biofilm and calculus removal from the supra-gingival area while, in periodontology, it extends to the sub-marginal space. 8 While manual and ultrasonic instrumentation constitutes the traditional professional mechanical plaque removal procedure, air-polishing with low-abrasiveness