Curaden

Global increase in aging population, retention of dentition and increased rehabilitation with complex implant supported restorations will soon increase demand for prevention and maintenance. Are the “tools and potions” for prevention and maintenance we have so far sufficient to satisfy demands of future patients? Mechanical biofilm control is mainstream in prevention of most common oral diseases; however, chemical biofilm control may be necessary to implement as an adjunct in certain cases.

Complex perio-prosthetic cases that require multidisciplinary therapy often result in compromised aesthetics. Traditional treatment planning philosophies, as well as existing interdisciplinary relational patterns, do not promote the achievement of predictable aesthetic results. Implementation of a restorative-driven approach requires the development of an aesthetic blueprint that will serve as a guide through treatment. This lecture describes a team approach for periodontal and restorative treatment intended to produce a predictable, biologically sound outcome that preserves more supporting bone and restores carious and broken down teeth. The goal of periodontal treatment, when performed in conjunction with restorative dentistry, is to provide restorative dentists with a high percentage of tooth structure that allows for a supragingival margin.

Periodontal disease has consistently ranked high among the global burden of diseases. Its diagnosis and management however remain significant challenges. Its classification has perplexed oral health practitioners. For nearly two decades however, the preceding classification of periodontal diseases remained without revision.

Management of type 1 diabetes patients in dentistry can be a challenge. Tailored dental care programme makes a difference. The main goal of the insulin-dependent diabetes care programme is to early classify the high-risk groups to improve general oral health and thus improve the quality of life of our patients.

Periodontal disease and diabetes share some life-style risk factors, like smoking, and there is a two-way relationship: patients with uncontrolled diabetes have a 3-fold higher risk to develop advanced periodontitis, while untreated periodontitis further dysregulates glycemic balance.

In patients with type 2 diabetes an inflammatory process is present. This inflammation is due to a pathological activation of the innate immune system, caused by metabolic stress and is partly governed by IL-1 signaling. We identified the role of IL-1β and insulin in the regulation of metabolism and immunity in response to food intake. Yet, as it becomes chronic, activation of auto-inflammatory processes may then become deleterious.

Despite all efforts of dental professionals the prevalence and incidence of total edentulism is still increasing on a global scale. Second observation from a recent meta review in JDR (2020) was that total tooth loss is decreasing in low-income countries while, on the other hand, it is increasing in upper- or middle-income countries. Is periodontal disease the main responsible for this evolution?

Dental professionals must frequently draw upon their knowledge of pharmacology for optimal care of today’s medically complex geriatric dental patients. However, armed with relatively brief exposure to such a vast subject during formal education and faced with ever-changing medication therapy guidelines, many dental professionals simply cannot keep up with the latest trends in disease state management.

Across the globe the population is ageing. Whilst increasing numbers of older people retain natural teeth, a sizable proportion of older people are still edentate. Replacement of missing teeth is important for function, aesthetics and to facilitate social inter-actions. This lecture will discuss treatment for edentate and partially dentate older adults including planning for removable and fixed prosthodontics.

Cancer treatment is by its very nature highly cytotoxic. In this way, cells and tissues are affected in different ways and patients may experience different reactions and adverse effects. The mouth is a site often affected in treatment and therefore the dentist should be involved in preventing and treating possible complications, before, during and after the end of cancer treatment.