Editorial

The surgical concept associated with the practical approach to the treatment of pathologies is based upon an essentially reparative approach of our approach to diagnosis and therapy. It is undeniable that this strategy is acknowledged to be effective, benefiting from the spectacular technological advances that guarantee perfectly acceptable results.

Whole areas of medicine have been affected by major changes in terms of views and treatments. Surgery is giving ground to medicine and when surgery is used, it is less and less invasive. Progress in biological science has clarified the physiopathology of the major disease processes, opening the way for the use of more precisely targeted bioactive molecules and the reduction of unwanted side effects. In the same way, prevention will, in future, be applied to more clearly defined risk factors. The identification of these factors will involve epidemiological concepts and a better command of public health issues and of the increasingly specific biological markers. A study of infection leads us to a more holistic approach to the patient. Surgery has benefited in recent years from the rapid evolution of technology. It is practiced on tissues well understood to the practitioner, using minimal trauma thanks to miniaturisation of equipment, better lighting, improved magnification and micro-instruments that are more and more precise.

Which areas of pathology within the sphere of competency of dental surgeons are affected by this evolution ? This is the question that this special issue must respond to. In the diagnostic domain, Roger Monteil and his team show us how progress in physiopathology allows us to refine our histopathological approach to desquamative gingivitis, following the example of new approaches to the diagnosis of skin and mucosal lesions. Contemporary biology and epidemiology leads us to review our conceptions of oral pathology in comparison to other pathologies or behaviours. Michel Uzan and collaborators review the topic of diabetes and periodontal diseases which gives rise to the necessity for coordination that must take place between the dental surgeon and physician. Tudor Vaïdeanu, Denis Duboc, Marc Danan and Monique Brion take a novel approach to the links between periodontal and cardiovascular diseases. Have we returned to a modern version of focal infection ? Jean-François Michel and Guy Cathelineau review the question of viral infections using a holistic approach to the patient as well as proposing diagnostic and treatment methodologies.

Bruno Gogly and Myriam Dridi deal with the effects of tobacco use on the oral tissues and debate this as a risk factor for periodontal diseases.

Finally, Charles-Daniel Arreto illustrates the recent renewed success in developing very targeted anti-inflammatory agents that limit the deleterious effects of inflammation on the periodontal tissues.

Recognising that oral pathologies have the same or comparable mechanisms as those affecting other tissues, it is no longer possible to separate them from the wider context, either in their identification, effects, aetiology or in the approach to their treatment.