There is disagreement as to whether it is safe to place implants in patients under bisphosphonates (BPs) therapy owing to the risk for developing BP-related osteonecrosis of the jaws (BRONJ). The American Association of Oral and Maxillofacial Surgeons recommends that dental implants should be avoided in oncologic patients treated with intravenous BPs. Conversely, for patients receiving oral BPs, dental implant placement is not explicitly contraindicated even if a cautious approach is suggested. The aim of the current study was to assess the risk level as related to adverse events such as implant failure and BRONJ in a large cohort of osteoporotic patients submitted to implant placement and concomitant application of plasma rich in growth factor (PGRF)-Endoret. The clinical charts of 235 middle-aged women under oral BPs therapy for osteoporosis, who underwent positioning of 1267 dental implants, were reviewed. The implants were always positioned in association with PRGF-Endoret. The outcomes were implant failure and BRONJ. A model based on personal risk factors distribution was used for risk assessment. Sixteen implants were lost in 16 patients up to 120 months of follow-up, leading to a survival of 98.7% and 93.2% on an implant basis and patient basis, respectively. No cases of BRONJ were reported. In line with the current literature, the present data show that the risk for developing BRONJ associated to dental implant surgery remains low for patients receiving oral BPs. The use of procedures that could enhance and support healing, such as platelet concentrates, should be recommended.

Diode laser is a laser, usually between 810 and 980 nm wavelength, able to work on hard and soft tissues, as periodontal tissues and bone. The use of Diode laser is recommended during oral surgery or periodontal therapy, when it is necessary to erase any periodontal bacteria evolved in periodontal disease, in combination with hydrogen peroxide (photodynamic therapy), and also, by its biostimulating effects, to improve the healing of the regenerative procedures, as sinus lift, bone crestal expansion or to assist implant surgery. This article shows two cases report in which diode lasers are evolved. Diode lasers in association with Hydrogen Peroxide on utilizing the decontaminant effects oh Photodynamic Therapy, and to prepare the area defects for a regenerative surgery.

The objective of this study was to evaluate the effectiveness of the temporomandibular joint (TMJ) osteoarthritis treatment through articular injections of plasma rich in growth factors (PGRF)-Endoret. Thirteen patients (median age, 47.64 y; SD, 7.51; range, 40-64 y; male-female ratio, 2:11) with osteoarthritis of TMJ associated to chronic pain have been selected. They were treated with articular injections of PRGF-Endoret, measuring the maximum mouth opening and pain level before the first injection (t0), 30 days after just before the second (t1), and after 6 months (t2). Data were analyzed using the paired Student's t-test data. The visual analogue scale score at t0 is 7.69 (range, 4-10; SD, 1.9), whereas that at t1 is 1.54 (range, 0-5; SD, 1.74) and that at t2 is 0.23 (range, 0-2; SD, 0.65). These differences in the results are statistically highly significant (P < 0.0001 comparison t0-t1 and t0-t2 and P < 0.01 comparison t1-t2). In terms of maximum mouth opening, it reduced from 30.15 mm at t0 (range, 26-40 mm; SD, 4.44) to 37.54 mm at t1 (range, 31-51 mm; SD, 5.10), with an increase of 7.38 mm (range, 4-11 mm; SD, 2.02) and a highly significant difference (P < 0.0001). At t2, it was 39.54 mm (range, 34-51; SD, 4.55) with an increase of 9.38 mm (range, 5-12 mm; SD, 2.21) compared with t0 and that of 2.00 mm compared with t1. Both differences in the results are statistically significant (P < 0.0001 and P < 0.01, respectively). The articular injections of PRGF-Endoret represent a very efficient method to control pain and to improve the TMJ mobility.

The main cause for the development of periodontitis is the accumulation of subgingival microbial deposits organized tightly to the porous surface of the tooth cementuni. The growth of the microbial populations and the immunological reaction of the host organism are responsible for the destruction of periodontal ligament apparatus. The primary goal in the treatment of periodontitis is the complete removal of subgingival bacterial deposits. The large amount of evidence establishing a microbial etiology for periodontitis (has been the basis for the development of antimicrobial treatment approaches. Photodynamic therapy (PDT) employs a non-toxic dye, termed a photosensitizer (PS), and low intensity visible light which, in the presence of oxygen, combine to produce cytotoxic species. In this in vitro protocol study it was tested the bactericidal efficacy of Diode laser (Oralia), of Hydrogen Peroxyde and the association Diode Laser-Peroxyd Hydrogen (PDT) on Prevotella intermedia, Peptostreptococcus micros and Fusobacterium nucleatum, three of the most aggressive bacteria envolved on periodontal disease.