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The aim of this paper was to provide an update on necrotizing periodontal disease (NPD). Original papers on this subject published in English from January 2002 until December 2007 were located in MEDLINE/PubMed database. Other sources were taken from the references of the selected papers. The clinical features of NPD include necrosis and ulceration of the gingival margin and the interdental papilla. These signs are usually associated to halitosis, pain, spontaneous gingival bleeding, malaise and sometimes fever. NPD usually occurs in developing countries, but few cases have also been reported in industrialized nations. The predisposing factors associated with the onset and progression of NPD include immunodeficiency, malnutrition, stress, smoking and poor oral hygiene. The treatment of NPD is dependent on the presence of pain and gingival necrosis. Systemic antibiotic therapy is recommended when a systemic disease is suspected.

The present paper reviews relationship between chronic periodontitis and cardiovascular diseases. Original papers on this subject, published in English in the period between 2001 and the first semester 2006, were located in the MEDLINE/PubMed database. Additional studies were obtained by searching reference lists of previously published papers. Periodontal infection provides a chronic reservoir of inflammatory mediators and cytokines, lipopolysaccharide, which contribute to the formation of atheroma. Moreover, periodontal pathogens can penetrate the epithelial barrier of the periodontal tissues and reach the blood stream, carrying out a local atherogenic activity. Some studies indicated that periodontal treatment could result in reduction of cardiovascular events. If these results are confirmed in further intervention studies, the prevention and the treatment of periodontitis should be considered as factors able to avoid or reduced the onset and/or evolution of cardiovascular diseases.

The aim of this paper was to provide a systematic review of the literature on the root resorption caused by orthodontic treatment. Original papers on this subject, published in English from January 2000 until December 2005, were located in the MEDLINE/PubMed database. Other sources were taken from the references of the selected papers. Root resorption is the most common sequela of the orthodontic treatment. It is an inflammatory process that leads to an ischemic necrosis localized in the periodontal ligament when the orthodontic force is applied. The onset and progression of root resorption are associated with risk factors related to the orthodontic treatment such as the duration of treatment, the magnitude of the force applied, the direction of the tooth movement, the method of force application (continuous versus intermittent), the orthodontic movement. Patient-related risk factors are the individual susceptibility on a genetic basis, some systemic diseases, anomalies in root morphology, dental trauma, and previous endodontic treatment. The prevention of root resorption during the orthodontic treatment may be performed controlling the risk factors. The periodic radiographic control during the treatment is necessary in order to detect the occurrence of root damages and quickly reassess the treatment goals.

The aim of this paper was to review the relationship between periodontitis and preterm delivery (PTD). Original papers on this subject, published in English until the first quarter of 2004, were located in the MEDLINE/PubMed database. Additional papers were obtained by searching reference lists of previously published review papers. Case control studies pointed to an association between periodontitis and increased rates of PTD of low birth-weight (LBW) infants. Longitudinal studies showed that the incidence or progression of periodontitis during pregnancy may be an independent risk factor for PTD and LBW. Microbiological, immunological and animal model studies suggested that periodontal pathogens and their products may translocate to the fetal-placental unit resulting in PTD or fetal growth restriction. Maternal periodontal infection may also provide a chronic reservoir of inflammatory mediators and cytokines (TNF-alpha, IL-1, IL-6, PGE2) that could adversely affect pregnancy outcome. Randomized controlled studies published indicated that periodontal treatment significantly reduces the risk of PTD and LBW infants. If these results are confirmed in further intervention studies, then prevention and treatment of periodontitis should be considered as a necessary part of prenatal care.

Background: The organisation of periodontal health prevention programmes must take into account the public level of awareness of the periodontal diseases. The aim of the present investigation was to assess the relationships between the request of dental care and the periodontal treatment needs in a population sample of Palermo., Methods: The study population consisted of 554 out-patients, consecutively examined during 18 months (January 1999 to June 2000) at the Palermo University Department of Oral Sciences. All participants answered a written questionnaire concerning the cause for the request of dental care and periodontal symptoms. Periodontal treatment needs were assessed using the Community Periodontal Index of Treatment Needs (CPITN)., Results: Statistical analysis (Chi-Square Test, Fisher's Exact Test) showed significant discrepancies between the request of dental care and the periodontal treatment needs, poor awareness of periodontal diseases and low perception of their symptoms by the patients., Conclusions: These findings showed that the awareness of periodontal diseases by the population examined is poor. This could be due either to the lack or failure of public education programmes on periodontal health. Yet, it could be related to an inadequate dentists' awareness of the periodontal diseases. Such findings should be considered in the planning of periodontal health programmes in relation to the population of Palermo.