Sapienza University, Rome, Italy
Dr. Romeo is Associate Professor in Oral Pathology of Sapienza University of Rome. He is specialist in Oral Surgery, Director of European Master Degree on Oral Laser applications (EMDOLA) of Sapienza University of Rome and Academic Coordinator for International Mobility Erasmus+ Faculty of Medicine and Dentistry.
Dr. Romeo is Board Member of World Federation Laser in Dentistry (WFLD) and
Country Representative of Italian Society of Laser in Dentistry (SILO). He is active member and Board Member of SIPMO (Italian Society of Oral Pathology and Oral Medicine) and Member of EAOM (European association Oral Medicine). He has published several scientific articles in national and international journals.
The oral soft tissue lesions could be divided in surface and exophitic lesions. The surface lesions of oral mucosa consist of lesions that involve the epithelium and/or superficial connective tissue; generally they don’t exceed 2-3 mm in thickness. Clinically, surface lesions are flat or slightly thickened and white, pigmented or with vesicular-ulcerated-erythematous. On the other side, the exophitic oral lesions are characterized as pathologic growths projecting above the normal contours of the oral mucosa. There are several underlying mechanisms responsible for oral exophytic lesions such as hypertrophy, hyperplasia, neoplasia, and pooling of the fluid.
Both superficial and exophytic lesions are sometimes difficult to deal with clinically. The Author through the clinical presentations of several cases describe the advantages and the limit to approach them with different laser wavelengths.
Osteonecrosis of the jaws (ONJ) is an uncommon but severe bone disease, can be related to various medicaments including bisphosphonates, antiangiogenic and antiresorptive medicaments such as Denosumab, human monoclonal antibody to the receptor activator of nuclear factor-kB ligand. For this reason, the term ONJ was currently replaced by Medication Related Osteonecrosis of the jaws (MRONJ). The rise in number in the latest years can be explained with many patients treated with all these drugs, assumed for osteometabolic (i.e osteoporosis, osteogenesis imperfecta) or neoplastic diseases (multiple myeloma, metastatic breast, prostate and renal cancer). The onset mechanism of MRONJ is not entirely understood, probably different mechanisms are involved, such as inhibition of the osteoclasts differentiation and function, decrease of the angiogenesis and inflammation/infection of the jaw bones. The author, through the presentations of some clinical cases, describes the diagnostic and clinical aspects of MRONJ and explains how is possible to prevent or to manage the MRONJ.