Diagnosis, management and knowledge of halitosis among Polish and Lebanese dentists: Questionnaire-based survey.

BACKGROUND: Halitosis (fetor ex ore, malodor, bad breath) is defined as an unpleasant odor coming from the oral cavity, regardless of the cause: local or systemic. It affects 22-50% of the population worldwide, leading to a significant decrease in the overall quality of life, and can have oral and extra-oral etiologies. There is an increased interest in the management of halitosis. OBJECTIVES: This study aims to evaluate the patient-dentist communication on halitosis, the dentists' knowledge about the management and etiology of halitosis, and the treatment options used by dentists who practice in Poland and Lebanon. MATERIAL AND METHODS: An online questionnaire was sent to both Lebanese and Polish dentists using Google Forms (Google LLC, Mountain View, USA). In total, 205 dentists completed the questionnaire, of which 100 practiced in Poland (group P) and 105 practiced in Lebanon (group L). A multivariate analysis was conducted to determine differences between both groups and to identify parameters that could influence a dentist's management of halitosis. RESULTS: According to the questionnaire, 86% of group P members and 65.7% of group L members reported communicating with patients about halitosis. Regarding the knowledge of halitosis, 78% of dentists in group P and 85.7% of dentists in group L reported that there is a classification for halitosis. A significant majority of dentists in both groups revealed not having any tool to measure halitosis (67.6% and 68% from group P and group L, respectively). CONCLUSIONS: This study confirms the need for improved communication skills in Polish and Lebanese dentists, as well as for education on the subject among dentists in both countries, and for standardization in diagnosis, treatment modalities and management of halitosis.

Management of Medication-Related Osteonecrosis of the Jaw with Photobiomodulation and Minimal Surgical Intervention.

Medication-related osteonecrosis of the jaw (MRONJ) is a relatively common pathology occurring in around 5% of patients taking bisphosphate and other antiresorptive or anti-angiogenic medications. Despite the efforts, as of today there is still no consensus on its management. In this case report, the successful management of stage II MRONJ was performed for an eighty-three-year-old female patient suffering from pain and alteration in her normal oral functions (swallowing and phonation). The treatment consisted of three sessions of photobiomodulation therapy (PBM), followed by minimal surgical intervention and three other sessions of PBM. PBM was applied on the sites of osteonecrosis with the follow parameters: 4 J/cm2; a power of 50 mW; 8 mm applicator diameter; a continuous contact mode. Irradiation was performed on three points, including the vestibular, occlusal and lingual parts of each of the bone exposure areas. Each point was irradiated for 40 s, and, in total, nine points were made per session, and nine sessions were conducted. To assess the pain, a visual analogue scale was used in which zero represented no pain at all and ten represented the greatest pain. At the first session and before any intervention, the patient stated that her pain was 8 out of 10. At the end of the treatment, a significant reduction in VAS was noted (2/10) and, clinically, a healing of the soft tissue in the previously exposed bone was observed. This case report suggests that the combination of PBM with surgical intervention is promising in the management of MRONJ.

Efficacy of the Adjunct Use of Povidone-Iodine or Sodium Hypochlorite with Non-Surgical Management of Periodontitis: A Systematic Review and Meta-Analysis.

This systematic review sought to assess the efficacy of combining either sodium hypochlorite or povidone-iodine as disinfection solutions with non-surgical treatment of periodontitis. An electronic search was conducted through PubMed, Scopus, Web of Science, CENTRAL, and Google Scholar from inception until 10 September 2022. Outcomes included clinical outcomes (probing pocket depth, plaque index, clinical attachment level, relative-horizontal attachment level, bleeding on probing, gingival recession, the position of gingival margin) and biochemical (BAPNA level) properties. A subgroup analysis was conducted according to the assessment timepoint. Ten studies reporting the use of povidone-iodine and five studies reporting the use of sodium hypochlorite were included in this review. Overall, in the meta-analysis of povidone-iodine, no significant changes were noted in any of the assessed outcomes; however, minor changes were noted in probing pocket depth and clinical attachment level at a specific timepoint. Regarding sodium hypochlorite, a significant reduction in all clinical outcomes, except for bleeding on probing, was noted. In conclusion, the use of povidone-iodine does not result in an improvement in clinical outcomes, whereas sodium hypochlorite has promising properties that result in significant improvement in probing pocket depth and clinical attachment level. However, more studies are needed to confirm these observations.

Facial Aesthetic Laser-Assisted Protocol for the Management of Acne and Pigmentation: A Case Report.

The demand for aesthetic procedures is significantly increasing worldwide. In this case report, an in-office laser-assisted protocol coupled with rejuvenating concentrate serum (Gluage, TEBISKIN Gluage, SkinMed, Italy) was made. A 24-year-old female patient presented with a chief complaint of abundant facial acne and localized pigmentation. Clinical examination revealed the presence of abundant acne on the forehead and cheeks and the presence of localized pigmentation. Laser-assisted protocol coupled with rejuvenating concentrate serum was suggested. The protocol consisted of a thorough cleansing of the face followed by irradiation with a 980 nm diode laser (Smart M, Lasotronix, Poland), followed by a 405 nm diode laser (Smart M, Lasotronix, Poland), the application of rejuvenating concentrate serum (Gluage, TEBISKIN Gluage, SkinMed, Italy), and irradiation with the 635 nm diode laser (Smart M, Lasotronix, Poland). The protocol was made once per week for three weeks (three sessions in total), and a three-month follow-up was made after the end of the last session to confirm the effectiveness of the treatment. Stomatology 1 diode laser (Smart M, Lasotronix, Poland) was used in this case report as a 980 nm, 405 nm, and 635 nm diode laser (Smart M, Lasotronix, Poland). During the follow-up period, an almost total reduction of the acne was observed with the total disappearance of the localized pigmentation. This case report confirms the effectiveness of the proposed laser-assisted facial aesthetic treatment. We invite further studies to be made within the same suggested promising protocol.