Diabetes and periodontitis are two of the most prevalent diseases worldwide that negatively impact the quality of life of the individual suffering from them. They are part of the chronic inflammatory disease group or, as recently mentioned, non-communicable diseases, with inflammation being the meeting point among them. Inflammation hitherto includes vascular and tissue changes, but new technologies provide data at the intracellular level that could explain how the cells respond to the aggression more clearly. This review aims to emphasize the molecular pathophysiological mechanisms in patients with type 2 diabetes mellitus and periodontitis, which are marked by different impaired central regulators including mitochondrial dysfunction, impaired immune system and autophagy pathways, oxidative stress, and the crosstalk between adenosine monophosphate-activated protein kinase (AMPK) and the renin-angiotensin system (RAS). All of them are the shared background behind both diseases that could explain its relationship. These should be taken in consideration if we would like to improve the treatment outcomes. Currently, the main treatment strategies in diabetes try to reduce glycemia index as the most important aspect, and in periodontitis try to reduce the presence of oral bacteria. We propose to add to the therapeutic guidelines the handling of all the intracellular disorders to try to obtain better treatment success.

The prevalence of undiagnosed diabetes was estimated to increase with age and can reach 3.5%. The purpose of the study was to evaluate the prevalence of undiagnosed diabetes and prediabetes in the elderly patients who attended a dental clinic and to find common risk factors. Male patients, older than 50 years, attended their first dental visit to the School of Dentistry for a period of two years, and it was proposed to evaluate undiagnosed type 2 diabetes mellitus. Periodontal, biochemical, microbiological examinations, nutritional profile, and physical activity were performed. A total of 106 patients were examined, 6 (5.6%) had diabetes, and 37 (34.9%) had prediabetes without prior diagnosis. The severity of periodontitis was greater in patients with diabetes. Most of the patients were overweight and had increased systolic blood pressure. Patients with prediabetes and periodontitis had a low adherence to the Mediterranean diet. Tannerella forsythia was present in more patients with periodontitis, and the prevalence of Aggregatibacter actinomycetemcomitans is practically absent in groups with periodontitis, except for the group with diabetes. In the population studied, the prevalence of patients without a diagnosis of diabetes and prediabetes was very high and underestimated. The increased severity of periodontitis in patients with diabetes and in conjunction with the high level of cortisol seen in patients with periodontitis, especially those with diabetes, emphasize the dysregulation of the immunoinflammatory system. It is essential to add all this data to our dental practice to cover patient health with a broader landscape.

Objetivo: relatar um caso de cisto dermóide abordando os critérios de diagnóstico clínico e histopatológico. Relato de caso: paciente de dezessete anos com aumento de volume no assoalho da boca. Uma biópsia foi realizada e o diagnóstico foi cisto dermóide. A enucleação intraoral da lesão foi realizada e não houve recidiva após 18 meses de seguimento. Conclusão: apesar de algumas características clínicas e exames de imagem sugerirem esse diagnóstico, apenas o exame histopatológico pode confirmá-lo. Assim, é importante que o cirurgião dentista conheça a lesão e as possíveis morbidades que pode causar, possibilitando um diagnóstico preciso e um comportamento adequado, beneficiando o paciente.

Calcifying odontogenic cyst is an uncommon oral lesion, accounting for less than 1% of all odontogenic cysts. We report a case of a 28-year-old female with a complaint of a painless swelling on the anterior mandible area. Panoramic radiography and computed tomography showed a well-defined unilocular radiolucency with a radiopaque focal area, extending from the apical region of teeth 34 to 43. An incisional biopsy showed a cystic lesion lined by ameloblastoma-like epithelium with the presence of ghost cells and calci- fying material consistent with the diagnosis of calcifying odontogenic cyst. The treatment of choice was decompression with posterior enucleation of the lesion, and the region was filled-up with L-PRF membrane (Leukocyte – Platelet Rich Fibrin) and lyophilized bovine bone graft (Bio-Oss®). A two-stage treatment starting with decompression allows the prevention of some complications, such as fracture of the jaw or injury of noble structures and consequently, decreases the chances of recurrence. To the best of our knowledge, there are few published cases of COC treated by decompression followed by enucleation. The patient remains on follow-up and after 14 months, there is no sign of recurrence.