1/5. Complete dentures and the associated soft tissues.Some of the conditions of the soft tissues related to complete dentures encountered during a period of 25 years at a university clinic were presented and discussed from the standpoint of the clinical prosthodontist. During this time, over 1,000 denture patients were treated each year. For some conditions, a method of management was offered with treatment by sound prosthodontic principles rather than unneccessary medication. That denture fabrication involves much more than mere mechanical procedures is an understatement. Complete dentures are foreign objects in the oral cavity that are accepted and tolerated by the tissue to a degree that is surprising. As prosthodontists, we can gain satisfaction from the realization that the incidence of oral cancer due to dentures is less than extremely low. At the same time, we must be ever mindful of the statement by Sheppard and associates. "Complete dentures are not the innocuous devices we often think they are." Every dentist must remember that one of his greatest missions is to serve as a detection agency for cancer. The information discussed indicates (1) the need for careful examination of the mouth, (2) the value of a rest period of 8 hours every day for the supporting tissues, and (3) the importance of regular recall visits for denture patients. Robinson stated that while the dental laboratory technician can be trained to aid the dentist in the fabrication of prosthetic devices, his lack of knowledge of reactions and diseases of the oral tissues limits him to an auxiliary role. Complete prosthodontics is a highly specialized health service that greatly affects the health, welfare, and well-being of the patient. It can be rendered only by the true professional who is educated in the biomedical sciences.- - - - - - - - - - ranking = 1keywords = oral cavity (Clic here for more details about this article) |
2/5. Orofacial granulomatosis with gingival onset.BACKGROUND, AIMS: Orofacial granulomatosis (OFG) is a descriptive term used for granulomatous disorders of the face and oral cavity that may occur for a variety of reasons, some of which result in significant morbidity and mortality. Although rarely, a granular enlargements of the gingiva may be the first clinical manifestation of OFG, preceding other local or systemic manifestations. METHOD: We will report a case of OFG that showed an atypical and monosymptomatic onset with a generalized hyperplastic gingivitis that preceded other facial and mucosal features by several weeks. RESULT: Considering the variable clinical onset of OFG and its apparent increase in incidence, we emphasize that in some cases, the periodontologist, as first consulted health care professional, plays an important role to detect this disorder. early diagnosis of OFG is a crucial step to prevent and cure its unsightly sequelae and sometimes avoid progression of systemic potentially life-threatening OFG-related diseases. CONCLUSION: Thus, when none of the common causes of gingival enlargement can be detected, OFG diagnosis should be suspected.- - - - - - - - - - ranking = 1keywords = oral cavity (Clic here for more details about this article) |
3/5. Eruptive cheilitis: a new adverse effect in reactive HIV-positive patients subjected to high activity antiretroviral therapy (HAART). Presentation of six clinical cases.A variety of exfoliative cheilitis has been observed in reactive hiv-1 patients subjected to high activity antiretroviral therapy (HAART). The lesions exhibit exfoliation, crater formation, fissuring, erosions and/or the formation of papules, vesicles and blisters associated to erythema and edema. The condition is not included in the 1993 EEC Clearinghouse classification (1) of oral lesions associated with HIV infection. In an earlier series of 1899 patients (2), we failed to observe this pathology and have only found one similar case described in the literature to date (3). OBJECTIVE: We present a series of 6 patients with HIV infection and morpho-histological alterations of the labial semimucosa, subjected to HAART. MATERIALS AND methods: The 6 patients were selected from among 20 HIV-positive individuals treated in our Infectious Diseases Unit with a combination of nucleoside and non-nucleoside reverse transcriptase inhibitors and protease inhibitors requiring stomatological care for painful lesions of the lips and oral cavity. The study was conducted over a 6-month period between May and October 1998. An analysis was made of the case histories, CD4-positive cell counts and viral load. The stomatological explorations were completed with biopsies, hematoxylin-eosin staining and immunohistochemical studies involving AE1 and AE3 monoclonal antibodies, vimentin, protein s-100, carcinoembryonic antigen (CEA), laminin, CD8, HLA-DR, BM-1 and CD31 markers. At the time of detection of the oral lesions, the patients had received different combinations of the following antiretroviral treatments: stavudine (D4T), zalcitabine (DDC), didanosine (DDI), zidovudine (AZT), lamivudine (3TC), nelfinavir (NFV), saquinavir (SQV), ritonavir (RTV), hydroxyurea (HU), indinavir (IDN) and efavirenz (EFV). RESULTS: There were four males and two females (age range 31-42 years). The CD4-positive and viral load ranges were 70-330 cells/mm3 and 200-500,200 copies, respectively. Stomatologic manifestations: The oral clinical manifestations consisted of desquamation, cracks, fissures, scabs, ulcerations, edema, erythema, multiple punctate xanthomas (1 case), dryness and labial semimucosal thickening. Microscopic study: Microscopically, the lesions consisted of ulcerations with adjacent hyperkeratosis and suprabasal vacuolization accompanied by a dense lymphocyte infiltrate within the chorion. Inmunohistochemistry: The immunohistochemical study in turn revealed surface epithelial alterations with AE1-AE3 monoclonal antibody labeling. Membrane glycoprotein activation (laminin) was detected, along with the presence of cytotoxic lymphocytes (CD8) and activated lymphocytes (BM-1). CD31 labeling in turn indicated endothelial activation.- - - - - - - - - - ranking = 1keywords = oral cavity (Clic here for more details about this article) |
4/5. Multiple suppurative cystic lesions of the lips and buccal mucosa: a case of suppurative stomatitis glandularis.cheilitis glandularis (CG) is a rare inflammatory salivary gland disease that usually affects the lips. Although the etiology of CG is still unknown, it is believed to be a hereditary disease with an autosomal dominant pattern of inheritance. Three clinical presentations of CG are described in the literature: simple, superficial suppurative, and deep suppurative. A case of deep suppurative CG that extended to the buccal mucosa has been previously reported as suppurative stomatitis glandularis (SSG). Here we report a case of SSG in a 64-year-old white female with a history of bilateral renal transplants for adult polycystic kidney disease, who presented with painful swollen lips and bilateral buccal mucosal lesions. The diagnosis and management of the case is discussed. To the best of our knowledge, this is the second report of SSG, a rare condition affecting the minor salivary glands in the oral cavity.- - - - - - - - - - ranking = 1keywords = oral cavity (Clic here for more details about this article) |
5/5. cheilitis glandularis: a clinical marker for both malignancy and/or severe inflammatory disease of the oral cavity.We report the case of an 84-year-old white male who underwent vermilionectomy for removal of a tumor, which proved to be squamous cell carcinoma. Chelitis glandularis related to marked actinic damage was noted at a subsequent visit. The presence of chelitis glandularis should be investigated for the presence of neoplasia, immunosuppression, or inflammatory diseases related to extremely poor oral hygiene.- - - - - - - - - - ranking = 4keywords = oral cavity (Clic here for more details about this article) |