Safety and tolerance of combination of monoamine oxidase inhibitors and direct dopamine agonists in adults and older adults with highly resistant depression

INTRODUCTION

Dopamine (DA) is likely to be involved in some depressive dimensions, such as anhedonia and amotivation, which account for a part of treatment-resistant forms. Monoamine oxidase inhibitors (MAOI) and direct D2 and D3 receptors agonists (D2/3r-dAG) are known to help, but we lack safety data about their combined usage. We report on safety and tolerance of the MAOI+D2r-dAG combination in a clinical series.

METHOD

All patients referred to our recourse center for depression between 2013 and 2021 were screened to select those who did receive the combo. Data were extracted from clinical files.

RESULTS

Sixteen patients of 60±17 years of age (8 women, 7 with age>65years, all suffered from treatment resistant depression, 7 with bipolar disorder) received the combo. There were no life-threatening adverse effects (AE). However, AE were reported by 14 patients (88%) most of which were mild and consisted of insomnia, nausea, nervousness, confusion, impulse control disorder and/or "sleep attacks". One patient presented a serious AE requiring a short hospitalization for confusion. Intolerance led to failure to introduce treatment in two patients (13%). The retrospective non-interventional design, the variety of molecules, and the modest sample size limited the scope of these results.

CONCLUSION

There was no life-threatening safety issue in combining MAOI and D2/3r-dAG, especially regarding cardiovascular side effects. The systematic screening of AE might account for their frequency, but these precluded the treatment in only two patients. Comparative studies are needed to assess the efficacy of this new combination.

Hypothalamic-pituitary-adrenal axis hyperactivity is normalized after successful intermittent theta-burst stimulation in resistant depressed patients

The present pilot study assessed the effects of multi-session intermittent theta-burst stimulation (iTBS) applied to the left dorsolateral prefrontal cortex in 17 treatment resistant depressed inpatients (TRDs) showing cortisol non-suppression to the overnight dexamethasone suppression test (DST) at baseline (i.e., maximum post-DST cortisol [CORmax] level > 130 nmol/L). After 20 iTBS sessions, the DST was repeated in all TRDs. At baseline, post-DST CORmax levels were higher in TRDs compared to healthy control subjects (HCs; n = 17) (p < 0.0001). After 20 iTBS sessions, post-DST CORmax levels decreased from baseline (p < 0.03) and were comparable to HCs. Decreases in post-DST CORmax levels were related to decreases in 17-item Hamilton Depression Rating Scale (HAMD-17) scores (ρ = 0.53; p < 0.03). At endpoint, 10 TRDs showed DST normalization (among them 7 were responders [i.e., HAMD-17 total score > 50% decrease from baseline]), and 7 did not normalize their DST (among them 6 were non-responders) (p < 0.05). Our results suggest that successful iTBS treatment may restore normal glucocorticoid receptor feedback inhibition at the pituitary level.

Potential efficacy of dopaminergic antidepressants in treatment resistant anergic-anhedonic depression results of the chronic anergic-anhedonic depression open trial - CADOT

Introduction

Among treatment-resistant depression (TRD), we identified anergic-anhedonic clinical presentations (TRAD) as putatively responsive to pro-dopaminergic strategies. Based on the literature, non-selective monoamine oxidase inhibitors (MAOI) and dopamine D2 receptor agonists (D2RAG) were sequentially introduced, frequently under the coverage of a mood stabilizer. This two-step therapeutic strategy will be referred to as the Dopaminergic Antidepressant Therapy Algorithm (DATA). We describe the short and long-term outcomes of TRAD managed according to DATA guidelines.

Method

Out of 52 outpatients with TRAD treated with DATA in a single expert center, 48 were included in the analysis [severity - QIDS (Quick Inventory of Depressive Symptomatology) = 16 ± 3; episode duration = 4.1 ± 2.7 years; Thase and Rush resistance stage = 2.9 ± 0.6; functioning - GAF (Global Assessment of Functioning) = 41 ± 8]. These were followed-up for a median (1st - 3rd quartile) of 4 (1-9) months before being prescribed the first dopaminergic treatment and remitters were followed up 21 (11-33) months after remission.

Results

At the end of DATA step 1, 25 patients were in remission (QIDS <6; 52% [38-66%]). After DATA step 2, 37 patients were in remission (77% [65-89%]) to whom 5 patients with a QIDS score = 6 could be added (88% [78-97%]). Many of these patients felt subjectively remitted (GAF = 74 ± 10). There was a significant benefit to combining MAOI with D2RAG which was maintained for at least 18 months in 30 patients (79% [62-95%]).

Conclusion

These results support TRAD sensitivity to pro-dopaminergic interventions. However, some clinical heterogeneities remain in our sample and suggest some improvement in the description of dopamine-sensitive form(s).

The Role of Natural Compounds in Optimizing Contemporary Dental Treatment-Current Status and Future Trends

For a long period of time, natural remedies were the only ailment available for a multitude of diseases, and they have proven effective even after the emergence of modern medicine. Due to their extremely high prevalence, oral and dental disorders and anomalies are recognized as major public health concerns. Herbal medicine is the practice of using plants with therapeutic characteristics for the purpose of disease prevention and treatment. Herbal agents have made a significant entry into oral care products in recent years, complementing traditional treatment procedures due to their intriguing physicochemical and therapeutic properties. There has been a resurgence of interest in natural products because of recent updates, technological advancements, and unmet expectations from current strategies. Approximately eighty percent of the world's population uses natural remedies, especially in poorer nations. When conventional treatments have failed, it may make sense to use natural drugs for the treatment of pathologic oral dental disorders, as they are readily available, inexpensive, and have few negative effects. The purpose of this article is to provide a comprehensive analysis of the benefits and applications of natural biomaterials in dentistry, to gather relevant information from the medical literature with an eye toward its practical applicability, and make suggestions for the directions for future study.

Hypothalamic-prolactin axis regulation in major depressed patients with suicidal behavior

BACKGROUND

So far, little is known about the control of hypothalamic-prolactin axis activity by dopamine (DA) and thyrotropin-releasing hormone (TRH) in depressed patients with suicidal behavior disorder (SBD).

METHODS

We evaluated prolactin (PRL) responses to apomorphine (APO; a DA direct receptor agonist) and 0800 h and 2300 h protirelin (TRH) tests in 50 medication-free euthyroid DSM-5 major depressed inpatients with SBD (either current [n = 22], or in early remission [n = 28]); and 18 healthy hospitalized controls (HCs).

RESULTS

Baseline (BL) PRL levels were comparable across the three diagnostic groups. SBDs in early remission did not differ from HCs regarding PRL suppression to APO (PRLs), PRL stimulation to 0800 h and 2300 h TRH tests (∆PRL), and ∆∆PRL values (difference between 2300 h-∆PRL and 0800 h-∆PRL values). Current SBDs showed lower PRLs and ∆∆PRL values than HCs and SBDs in early remission. Further analyses revealed that current SBDs with a history of violent and high-lethality suicide attempts were more likely to exhibit co-occurrence of low ∆∆PRL and PRL_S values.

CONCLUSIONS

Our results suggest that regulation of the hypothalamic-PRL axis is impaired in some depressed patients with current SBD, particularly those who have made serious suicide attempts. Considering the limitations of our study, our findings support the hypothesis that decreased pituitary D2 receptor functionality (possibly adaptive to increased tuberoinfundibular DAergic neuronal activity) together with decreased hypothalamic TRH drive might be a biosignature for high-lethality violent suicide attempts.

Thyroid axis activity and dopamine function in depression

BACKGROUND

Several lines of evidence suggest alterations in both hypothalamic-pituitary-thyroid (HPT) axis and dopamine (DA) function in depressed patients. However, the functional relationships between HPT and DA systems have not been well defined.

METHODS

We examined thyrotropin (TSH) response to 0800 h and 2300 h protirelin (TRH) challenges, and adrenocorticotropic hormone (ACTH), cortisol and growth hormone (GH) responses to apomorphine (APO, a DA receptor agonist), in 58 drug-free DSM-IV major depressed inpatients without a suicidal behavior, and 22 healthy hospitalized controls.

RESULTS

Compared with controls, patients showed 1) lower basal serum 2300 h-TSH, 2300 h-∆TSH, and ∆∆TSH (difference between 2300 h-∆TSH and 0800 h-∆TSH) levels, and 2) lower cortisol response to APO (∆COR). A negative relationship between ∆∆TSH values and hormonal responses to APO was observed in the depressed group, but not in the control group. When patients were classified on the basis of their ∆∆TSH status, patients with reduced ∆∆TSH values (< 2.5 mU/L) showed hormonal APO responses comparable to those of controls. Patients with normal ∆∆TSH values exhibited lower ∆ACTH, ∆COR, and ∆GH values than patients with reduced ∆∆TSH values and controls.

CONCLUSION

Taken together, these results suggest that hypothalamic DA function is unaltered in depressed patients with HPT dysregulation (i.e., increased hypothalamic TRH drive leading to altered TRH receptor chronesthesy on pituitary thyrotrophs). Conversely, hypothalamic DA-receptor function is decreased in patients with normal HPT axis activity. These findings are discussed in the context of the role of TRH as a homeostatic neuromodulator in depression.

Neuroendocrine Assessment of Dopaminergic Function during Antidepressant Treatment in Major Depressed Patients

The effects of antidepressants on dopamine (DA) receptor sensitivity in the mesolimbic–hypothalamic system have yielded contradictory results. The postsynaptic DA receptor function was evaluated by the cortisol response to apomorphine (APO; 0.75 mg SC) in 16 drug-free DSM-5 major depressed inpatients and 18 healthy hospitalized control (HC) subjects. Cortisol response to the dexamethasone suppression test (DST) was also measured. After two and four weeks of antidepressant treatment (ADT), the DST and APO test were repeated in all patients. Cortisol response to APO (∆COR) was not influenced by the hypothalamic–pituitary–adrenal (HPA) axis activity, as assessed by the DST. Pre-treatment ∆COR values did not differ significantly between patients and HCs. During ADT, ∆COR values were lower than in HCs at week 2 and 4. After four weeks of treatment, among the eight patients who had blunted ∆COR values, seven were subsequent remitters, while among the eight patients who had normal ∆COR values, seven were non-remitters. Considering the limitations of our study, the results suggest that following chronic ADT, the desensitization of postsynaptic DA receptors connected with the regulation of the HPA axis at the hypothalamic level is associated with clinical remission. These results could reflect increased DA levels in the mesolimbic pathway.

Are the thyroid and adrenal system alterations linked in depression?

BACKGROUND

Disturbances in the hypothalamic-pituitary-thyroid (HPT) and hypothalamic-pituitary-adrenal (HPA) axes have been frequently found in major depression. Given that glucocorticoids may inhibit thyrotropin (TSH) and thyrotropin-releasing hormone (TRH) secretion, it has been hypothesized that hypercortisolemia could lead to HPT axis abnormalities. So far, data on interactions between the HPA and HPT axes in depression remain inconclusive.

METHODS

In order to investigate this issue, we examined circadian rhythms of serum TSH and cortisol (sampled at 4 -hly intervals throughout a 24 -h span), TSH responses to 0800 h and 2300 h protirelin (TRH) tests and cortisol response to dexamethasone suppression test (DST) in 145 unmedicated inpatients meeting DSM-IV criteria for major depressive disorder (MDDs) and 25 healthy hospitalized control subjects (HCs).

RESULTS

The secretion of TSH and cortisol exhibited a significant circadian rhythm both in HCs and MDDs. However, compared to HCs, MDDs showed: 1) reduced TSH mesor and amplitude values; 2) blunted 2300 h-ΔTSH and ΔΔTSH values (i.e. differences between 2300 h and 0800 h TRH-TSH responses); and 3) increased cortisol mesor and post-DST cortisol values. DST nonsuppresssors (n = 40, 27 %) showed higher cortisol mesor than DST suppressors (n = 105, 73 %). There was no difference between DST suppressors and nonsuppressors in their TSH circadian parameters and TRH-TSH responses. In addition, cortisol values (circadian and post-DST) were not related to TRH test responses.

CONCLUSION

Our results do not confirm a key role for hypercortisolemia in the HPT axis dysregulation in depression.

Contribution of Pathology in Surgical Oncology in Malignant Tumors of the Salivary Glands

The practice of oncology continues to be an area of continuous renewal. The volume of knowledge in the field of cancer therapy is increasing rapidly compared to any other medical discipline, constraining the need for permanent information. The first data on malignancies are linked to the 11th century BC. The concerns of physicians were attracted to the cancerous disease, the observations and hypotheses regarding it being mentioned in different writings of the time. The increased frequency of cancer in the oro-maxillofacial region is favored by a number of factors: the great diversity of maxillofacial structures and the very important changes in the phylogenesis and ontogeny of these structures; the embryonic existence of the branchial arches, with the possibility of remaining residues in this stage; function of the intense quality of the face region and the oral region, as the first segment of the matter import apparatus; the multitude of irritant factors, which play an important role in the occurrence of cancer ( temperature, food hardness, dust, chemical noxiousness). The improvement of the methods and techniques of the surgical operations performed on the maxillofacial region had a decisive influence on the treatment of this region. In patients whose pathologic (bleeding diathesis, heart disease, liver disease, diabetes, etc.) can lead to various complications (local and general), interventions of oral and maxillofacial surgerycan perform as a preparation prior appropriate. The study includes a sample of 48 patients with malignant tumors of the salivary glands. The treatment of malignant tumors of the salivary gland have to be as wide early and surgically, with radiotherapy and / or multi-agent chemotherapy. Radiotherapy alone is insufficient, indicated only as palliative treatment.

Dopaminergic, Noradrenergic, Adrenal, and Thyroid Abnormalities in Psychotic and Affective Disorders

BACKGROUND

This study aimed to assess hypothalamic-pituitary dopaminergic (DA), noradrenergic (NA), thyroid (HPT), and adrenal (HPA) activity in schizophrenia, in schizoaffective disorder, and in bipolar disorder.

METHOD

We investigated a combined approach of hormone responses to (1) apomorphine (APO), a short-acting DA receptor agonist which decreases prolactin secretion (PRL), and stimulates secretion of growth hormone (GH), adrenocorticotropin (ACTH), and cortisol; (2) clonidine (CLO), an alpha 2-adrenoceptor agonist which stimulates GH secretion; (3) 8 AM and 11 PM protirelin (TRH) which stimulates thyrotropin (TSH) secretion; and (4) dexamethasone which suppresses cortisol secretion, in 13 hospitalized healthy male controls and 39 untreated male inpatients: 13 with DSM-IV paranoid schizophrenia, 13 with DSM-IV schizoaffective disorder (bipolar subtype, depressed at the time of the study), and 13 with DSM-IV bipolar disorder (depressed).

RESULTS

Compared to controls, paranoid schizophrenic patients showed (1) lower APO-induced ACTH and cortisol stimulation, and (2) higher post-dexamethasone cortisol values. Compared to controls, schizoaffective and bipolar patients showed (1) lower ΔΔTSH values (i.e., difference between 11 PM and 8 AM TRH-TSH responses), (2) lower APO-induced PRL suppression, (3) lower CLO-induced GH stimulation, and (4) higher post-dexamethasone cortisol values.

CONCLUSIONS

Although results must be interpreted with caution because of the small sample, this preliminary study suggests that depressed bipolar and schizoaffective patients share common biological dysregulations, distinct from that of paranoid schizophrenic patients. From a pathophysiological viewpoint, paranoid schizophrenic patients can be characterized by hyposensitivity of the hypothalamic DA receptors (possibly resulting from an increase in presynaptic DA release) associated with increased HPA axis activity, while depressed bipolar and schizoaffective patients can be characterized by hyposensitivity of the pituitary TRH and DA-D₂ receptors (possibly linked to the activation of the hypothalamic TRH and tuberoinfundibular DA neurons, respectively), together with subsensitive postsynaptic α₂-adrenoreceptors at the hypothalamic level (possibly secondary to an erratic release of NA) and increased HPA axis activity.

Inflamatory Chemistry and Organic Surgery in the Maxilar Compression

The morphology and physiology of odonto-periodontal units, muscles, temporomandibular joints, maxillary bones, ligaments are in a constant balance, even if all these components are subject to continuous transformation. Affecting a systemic element will attract imbalances to other levels, and the therapeutic solution will require knowledge and understanding of the ensemble. A complete dental exam must allow identification of all factors responsible or likely to cause imbalance in the stomatognat system. The maxillary compression is an abnormality characterized by a transversal developmental deficiency in the upper jaw and / or the mandibular, showing morpho-functional changes that denote a complex disruption in the development of the dento-maxillary apparatus. The common modification of all the fractured cases is the insufficient development in a transversal sense, dental arcades (mono - or bimaxilar), along with facial and maxillary bone changes, disturbances of inter - maxillary or occlusion blocking, functional deficits and disturbances. The strictly mandibular compression situation is very rare and addresses cases by affecting growth at the condylian level. The study includes 27 cases with jaw compression and benefited from orthognat surgery in the Maxillofacial Surgery Clinic between 2015 - 2018. If untreated, the abnormality determines the appearance of many cavities especially in the front teeth, difficulty in performing dental hygiene will lead to chronic marginal periodontitis, the occurrence of abnormal contact between teeth with joint pain, decreased chewing field. The jaw compression is revealed by multiple facial and oral signs, as well as by functional changes. Orthognatic surgery is the only effective treatment for many patients in jaw compression.

The Importance of Risk Factors and the Chemistry of Anestetics in the Occurence of Medical Emergencies in Dental Surgery

In the dental practice or in the ambulatory of oral and maxillo-facial surgery, there may be real medical emergencies, emergencies in which the speed of effective measures is essential. A good knowledge of the things to be done in the practice, as first representatives of the medical shield in defence against the inexorable secures the winning of precious seconds. Medical care in dentistry and dentoalveolar surgery involves two seemingly different aspects: a well-defined technical one, of strict specialty, and another less well defined, which practically includes all the particularities of the patient coming to the dental practice. However precise the dental technique and the practitioner�s skill are, if the specific conditions of each patient are not taken into account, the medical benefit cannot rise to a high level, and the final result may be compromised by complications with unforeseen risks. The study included 7,996 patients resolved in the Oral and Maxillo-facial Surgery Clinic (Ambulatory), in the period from 1.02.2014 to 31.12.2018. The superficiality of a seemingly healthy patient approach may lead to the disregard of some important aspects with a predictive role in the triggering of a medical emergency, as an informational history must be more than an orderly list of symptoms. You always gain something by listening to patients and observing the way they talk about their symptoms. The crossed statistical deductions on the explored data revealed, based on the majority percentages obtained on each studied index, that the following have an extremely important aspect for the dental practice and dentoalveolar surgery: the dental anxiety level as well as the patient�s general status are the landmarks that require the greatest attention from the practitioner for the purpose of preventing medical emergencies.

The Implications of Hyperglycemia in Maxilo-Facial Surgery

In surgical practice, the problems raised by diabetics are extremely complex and require for solving the knowledge of both the physiopathological disorders characteristic of these disease and the changes caused on this pathological field by various dental aggressions. Sometimes, patients with complications of undiagnosed diabetes mellitus are present in the dentistry where all problems of dental and metabolic therapeutics must be solved by the dentist. The lack of knowledge of the general pathophysiology data of the diabetic mellitus disease and of the metabolitical rebalancing methods of these patients on dental aggressions as well as the lack of early knowledge of the events that precede the installation of real metabolic dramas can lead to disaster. The diabetic patient may present in time various dental conditions, some of which are directly or indirectly related to diabetic disease - lesions in the oral cavity are polymorphic and physiologically interpreted in a very different way. The oro-dental changes in diabetes mellitus have as substrate the degenerative arterial involvement in the context of early tissue aging. The hypoglycemia is a factor that makes doctors reluctant to maintain normal blood sugar levels in diabetic anesthetized patients. Hyperglycemia leads to glucosuria, then polyuria, which in turn causes dehydration of the patient through osmotic diuresis. Hyperglycemia decreases the patient�s ability to resist infections.During a period of 6 years, 2011-2016, we observed, treated and monitored a number of 75 patients with diabetes mellitus. Of these, 45 were men and 30 women and the age was between 18-65 years, with the highest incidence between 45-60 years.The importance of diabetic mellitus field in dental practice is not only determined by the high frequency of complications requiring surgery, but also that in these patients any aggression, even limited, can cause entry into a vicious circle where the local lesion aggravates the diabetic state and in turn it worsens the local development of the lesions. The appropriate premedication, protective antibiotic therapy, quality loco-regional anesthesia, rigorous applying of aseptic and antisepsic rules, soft, non-traumatic maneuvers, are mandatory measures addressed to the diabetic patient for performing risk-free surgery.

Semiology of the Pain Syndrome - Identifying the Ideal Methods of Locoregional Anesthesia Based on Their Rationale and Features

Anesthesia and the degree of control over the perception of pain depends on the personality of the individual, the socio-economic conditions, potential previous painful experiences and, last but not least, on fatigue and fear of the dentist. The perception of pain in patients is closely connected to their mental state. Pain is defined as a sensation of discomfort, with wide variations, both in quality and intensity, for different people in seemingly identical conditions; an unpleasant sensitive and emotional phenomena connected to the threat of a wound or caused in the tissues or described in the terms of this disease. The essential element of any type of anesthesia is analgesia, an effect which in some cases cannot be achived, due to the patient�s particularities or the physician�s lack of experience in anesthesia. Locoregional anesthesia (LRA) represents the blocking of the nociceptive sensitive and sympathetic autonomic afferents as well as that of motor efferents at the level of peripheral nerves� axons, by means of local anesthetic. To achieve the set purpose, we carried out a study on a representative human sample comprised of 10.123 patients treated in the Oral and Maxillofacial Surgery Clinic (Ambulatory) from the County Clinic Emergency Hospital St. Spiridon Iasi, between 01.01.2015-31.12.2016. The reason for the exclusion of certain categories of patients in the reseach was: the patients with a special conditions background require individual pre-anesthesia schemes, personalised for the nature of the pre-existing general condition, which must be further approved by the attending specialist physician : cardiologist, internist, diabetologist; children under 18 years old, with a high degree of anxiety; a high precentage of elderly patients, over 60 years old, possess a combination of general issues, thus requiring a special approach. The thoroughness lying at the core of the anesthetic practice, most especially the safegurading of a technical accuracy in the performance of anesthesia [12,], instead of improvisations, the lack of anatomical and stomatological training in general and the resulting inefficiency as such, is the underlying in-depth structuring element of this paper.

The Effects of Insulin and Strontium Ranelate on Guided Bone Regeneration in Diabetic Rats

The aim of this study was to investigate the effect of insulin and strontium ranelate treatment on guided bone regeneration in diabetic rats. This study was carried out on 30 adult Wistar rats with an average weight of 250-300 grams. The animals underwent a unilateral osteotomy of the left proximal tibia followed by bone augmentation with collagenized porcine bone xenografts (Osteobiol� mp3, Tecnoss Dental s.r.l., Torino, Italy) and then were randomized into five groups: healthy (H), diabetes (D), diabetes with insuline (DI), diabetes with strontium ranelate (DS) and diabetes with insuline and strontium ranelate (DIS). Histomorphometric analysis was performed at the end of this study.

Ultrastructural Analysis by Scanning Electron Microscopy of Dental Structures Conditioning with Ortophosphoric Acid and ER.CR: YSGG Laser Irradiation

This study evaluated the ultra-morphological effects of ortophosforic acid and Er.Cr: YSGGLASER on human dentin by means of a field emission in-lens scanning electron microscope. The study was conducted in vitro on human teeth extracted for orthodontic or periodontal reasons, after obtaining informed consent of patients. The samples were sectioned mesial-distal in the longitudinal direction (diamond discs) finished 400, 600, 1200 and 2400 grit SiC paper, polished with gums and abrasive paste 6, 3, 1 and 0,25 mm under continuous irrigation. The samples were divided in five groups depending on the type of conditioning as follows: GR.1= 5 s; GR.2= 10 s; GR.3= 15 s; GR.4= 20 s; GR.5= Er,Cr: YSGGlaser irradiating at 30% water and 60% air at 3W/15 Hz. The materials used for conditioning the teeth were SE�35% (Scotchbond� Etchant Phosphoric Acid -3M ESPE-Seefeld, Germany) and MG6-MZ6 tipswith Er, Cr: YSGGlaser (Biolase Waterlase-MD), according to manufacturer�s instructions. The specimens were prepared for observation under SEM with �1,000 and �4,000 magnifications. The acid type, concentration and time of action determines dentin demineralization and modifying or removing smear layer. Er.Cr: YSGG laser treatment of non-carious dentin, a laser power of 3 W is found to be the optimal to improve the micromorphology of dentin.

The Role of Pathology and Oncology in the Anatomic-clinical and Biochemical Particulars of the Oral Tumours

Malign tumours of the oral cavity is one of the most frequent types of cancer,1 mostly in developing regions either in the developed world. The Romanian authorities said that the second cause of death in the world is cancer, as it is only overtaken by cardiovascular diseases. Cancer causes more than 6 million deaths per year (O.S.) � or more than 10% of all deaths in the world. In Romania, cancer mortality has been around12-15% of the total number of deaths of various causes over the last decade. After the age of 60, almost one in four people died through cancer.Of all cancers, oral cancer accounts for about 4,5% and causes 4,2% of deaths, a percentage that is constantly increasing (PARKIN, STJERNSWARD and MUIR). Oncology is a medical specialty that deals with the diagnosis, treatment and prevention of the disease of human cancer. The oncological examination may suggest the malignant disease (some changes in the history and physical examination of the patient) and the laboratory analysis (markers of tumour) and imaging (mammography, ultrasound, CT, MRI, endoscopy) may bring additional information regarding the presence of the neoplastic process. For the dental pathologyit is indispensable the pathological anatomy for a correct diagnosis and to establish a correct treatment. Although oral cavity is an easily accessible area for clinical examination and more than 80% of the population often benefit from dental examination, a large part of the cancers developing at this level are diagnosed relatively late to sometimes even considerable size when their treatment is already ineffective. The patients presentthemselves very late for dental clinical examination, in most cases without any symptoms because of the character of the disease in the early stages. Finding the early lesions with carcinogen risk save lives and is correlated with decreased range of risks and best prospective results. We�ve made this study in the Oral and Maxillo-Facial Surgery Clinic and in the Oncology Clinic in a period of 2 years, between 2017-2019, a number of 146 cases with different oral tumours were solved and followed; of these 49.27% were men and 50.73% women.The age average was between 18-65 years and the highest incidence was between 45-62 years. Systemic treatments were administrated and evaluated in all patients.