1/26. Immunopathological diagnosis of cicatricial pemphigoid with desquamative gingivitis. A case report.Cicatricial pemphigoid (CP) is a chronic subepidermal bullous dermatosis which primarily involves the mucous membranes. The oral cavity and the eye are most frequently involved. Since extension of the lesion into the pharynx and esophagus causes sore throat and dysphagia and progressive ocular lesions may cause blindness, early and valid diagnosis is very important. Here we present a case of cicatricial pemphigoid with onset at age 45 in a patient who manifested severe periodontal disease and showed the lesion on the mucous membranes of the mouth (desquamative gingivitis), skin, and eyes. Since definite diagnosis is very important, we describe how we made a differential diagnosis from other diseases which also accompany desquamative gingivitis. We examined the clinical manifestations, blood test results, HLA-genotype, histopathologic findings of the affected tissue, and immunological findings in relation to autoimmunity. Since many of the CP cases are first referred to periodontists or dentists, we believe that the diagnostic strategy described in the present study will be quite informative for making rapid and definite diagnoses of similar cases.- - - - - - - - - - ranking = 1keywords = oral cavity, mouth, cavity (Clic here for more details about this article) |
2/26. oral manifestations of congenital neutropenia or Kostmann syndrome.Infantile congenital agranulocytosis or Kostmann syndrome is a rare hereditary kind of severe neutropenia. The typical symptoms, which appear since the first days of life, are abscesses located on various parts of the body: ear, cutis, lung and oral cavity. These abscesses are due to an almost total disimmunity typical of the neutropenia. The aim of this article is to describe the most typical signs of this pathology in the oral cavity, reporting a case observed in our department in Florence, italy. On the basis of the personally observed case and of the review of the literature, it is possible to consider, as a characteristic finding in Kostmann syndrome, a typical very serious periodontal pathology, which is similar to the prepubertal periodontitis in deciduous dentition. At the age of 19 years the patient showed a dramatic compromise of the masticatory function. It is obvious that the lack of response of the host can obstruct the interaction between the host and the microbic flora, because the lack of neutrophils increases the susceptibility of the patient to every kind of infection, even to periodontitis. A periodontal prophylaxis, since the very first observations, followed by a rigorous maintenance with frequent and regular professional hygienic treatments could be effective in controlling the effects of periodontal disease and could reduce the tragic evolution. We need to recognise that it could be hard to monitor the oral situation correctly in these patients, as they have a continuously poor systemic condition. Finally in these cases the rehabilitative therapy is very problematical.- - - - - - - - - - ranking = 1.9124343236404keywords = oral cavity, cavity (Clic here for more details about this article) |
3/26. Periodontal lesions in lipoid proteinosis.Lipoid proteinosis is a rare autosomal recessive heritable disease. Clinical features are hoarseness starting in infancy and the formation of yellowish papules and plaques on the skin and mucous membranes of the nose, oral cavity, pharynx and larynx. light and electron microscopy demonstrates a subepithelial accumulation of PAS-positive (hyaline) material around blood vessels and in the dermis. This case is unusual in that the gingiva is also involved in the lipoid proteinosis.- - - - - - - - - - ranking = 0.95621716182019keywords = oral cavity, cavity (Clic here for more details about this article) |
4/26. Clinical, genetic and microbiological findings in a Brazilian family with aggressive periodontitis.BACKGROUND/AIM: aggressive periodontitis comprises a group of rapidly progressive forms of periodontitis. Besides bacteria, a high level of subject susceptibility must be involved in the expression of disease. In the present study, we report the clinical, microbiological and genetic profile of a 14-individual family with aggressive periodontitis. METHOD: PCR was utilized to detect pathogenic bacteria of affected sites. dna was obtained from epithelial cells through a mouthwash with 3% glucose and scrapping of the oral mucosa. RFLP-PCR was used to analyze cytokine genetic polymorphisms. RESULTS: Localized aggressive periodontitis was diagnosed for an 18-year-old systemically healthy non-smoking proband, with siblings displaying aggressive periodontitis. bacteroides forsythus and treponema denticola were the most frequent pathogens. The proband presented actinobacillus actinomycetemcomitans and detectable levels of porphyromonas gingivalis, bacteroides forsythus and treponema denticola. Allele 2 of IL-1alpha (-889) polymorphism was found in all individuals as well as allele 1 of the IL-1beta ( 3953) gene. alleles 1 and 2 (50 % each) of IL-1beta (-511), allele 1 of TNF-alpha (-308) and allele 2 (in homo or heterozygosity) of IL-RN (intron 2) gene were present. CONCLUSION: The results show that the present microbiological and genetic parameters were not relevant for the prediction of periodontitis susceptibility in this family.- - - - - - - - - - ranking = 0.043782838179808keywords = mouth (Clic here for more details about this article) |
5/26. Severe periodontitis in Marfan's syndrome: a case report.BACKGROUND: connective tissue disorders, such as some forms of ehlers-danlos syndrome, have been associated with severe periodontitis. methods: This report describes a case of Marfan's syndrome, an inherited disorder of connective tissue caused by mutations in the fibrillin-1 gene, in which the patient presented with severe periodontitis. RESULTS: At examination, an average full-mouth clinical attachment level loss of 5.6 /-2.1 mm, furcation involvement, and severe alveolar bone loss were observed in a 41-year-old Caucasian male. Tooth hypermobility was also present. CONCLUSIONS: This case appears to be the first documentation of severe periodontitis in a patient with Marfan's syndrome. It supports the hypothesis that a variety of connective tissue disorders may confer increased susceptibility to periodontal tissue breakdown.- - - - - - - - - - ranking = 0.043782838179808keywords = mouth (Clic here for more details about this article) |
6/26. Long-term effect of full-mouth tooth extraction on the responsiveness of peripheral blood monocytes.BACKGROUND: As some residual inflammation may remain after periodontal therapy, the present pilot study investigated the long-term effect of full-mouth tooth extraction therapy on the responsiveness of peripheral blood monocytes in a case with generalized terminal adult periodontitis. methods: Before and 3, 9, 20 and 32 months after therapy, venous blood was collected. Total and differential white blood cell counts were determined and whole blood cell cultures (WBCC) were incubated with lipopolysaccharide (LPS) to stimulate the production of inflammatory mediators by monocytes. RESULTS: After full-mouth tooth extraction, the numbers of total peripheral white blood cells and neutrophils decreased over time. The release of the chemokines interleukin (IL)-8 and macrophage chemoattractant protein (MCP)-1 in the cultures decreased twofold over time, whereas no changes were seen for the other studied cytokines, chemokines and prostaglandin E2. CONCLUSION: On the basis of previous studies and the present case, the high production of IL-8 and MCP-1 by monocytes in LPS-stimulated WBCC from periodontitis patients is most likely acquired, as their levels decrease over time when the periodontal infection is controlled. The possible connection between periodontitis and atherosclerosis through IL-8 and MCP-1 is discussed.- - - - - - - - - - ranking = 0.26269702907885keywords = mouth (Clic here for more details about this article) |
7/26. Submental cutaneous sinus tract as a result of progressive peri-implantitis: a case report.BACKGROUND: The aim of the present case report was to define diagnosis and treatment options of a submental cutaneous sinus tract as a result of a progressive peri-implantitis around mandibular dental implants in a patient with a history of oral squamous cell carcinoma. methods: Before the removal of the submental fistula, a panoramic radiograph and a computed tomography of the head and neck were assessed to identify the implants responsible for the cutaneous sinus tract and to exclude the presence of a tumor recurrence and lymph node metastases. The involved implants were removed, as there was a communication along them between the oral cavity and the cutaneous sinus tract resulting from progressive peri-implantitis. A histological examination of the excised fistula was carried out. RESULTS: The histological examination excluded a recurrence of the oral squamous cell carcinoma. The fistula completely consisted of granulation tissue without epithelialization. After affected implants were removed, the wound healing was uneventful. CONCLUSIONS: A panoramic radiograph is mandatory to identify the involved implants. Computed tomography, and excision of the fistula and a histological examination should be performed only in patients with a history of oral squamous cell carcinoma. Since the cutaneous sinus tract showed no epithelialization, it healed spontaneously after the removal of the responsible implants. Because of the large bony defect caused by progressive peri-implantitis leading to a communication of the oral cavity with the cutaneous sinus tract, more conservative treatment options with preservation of the implants could not be adopted in the present case.- - - - - - - - - - ranking = 1.9124343236404keywords = oral cavity, cavity (Clic here for more details about this article) |
8/26. Unilateral severe chronic periodontitis associated with ipsilateral surgical resection of cranial nerves V, VI, and VII.BACKGROUND: The central and peripheral nervous systems participate in several local physiological and pathological processes. There is experimental evidence that the inflammatory, local immune, and wound healing responses of a tissue can be modulated by its innervation. The aim of this clinical report is to present a case of unilateral severe periodontitis associated with ipsilateral surgical resection of the fifth, sixth, and seventh cranial nerves and to discuss the possible contribution of the nervous system to periodontal pathogenesis. methods: A 39-year-old female patient with a history of a cerebrovascular accident caused by a right pontine arteriovenous malformation and destruction of the right fifth, sixth, and seventh cranial nerves was diagnosed with severe chronic periodontitis affecting only the right maxillary and mandibular quadrants. The patient's oral hygiene was similar for right and left sides of the mouth. Percentages of tooth surfaces carrying dental plaque were 41% and 36% for right and left sides, respectively. Non-surgical and surgical periodontal therapy was performed, and the patient was placed on a regular periodontal maintenance schedule. RESULTS: Healing following initial periodontal therapy and osseous periodontal surgery occurred without complications. Follow-up clinical findings at 1 year revealed stable periodontal health. CONCLUSIONS: This case report suggests that periodontal innervation may contribute to the regulation of local processes involved in periodontitis pathogenesis. It also suggests that periodontal therapy can be performed successfully at sites and in patients affected by paralysis.- - - - - - - - - - ranking = 0.043782838179808keywords = mouth (Clic here for more details about this article) |
9/26. Oral post-surgical complications following the administration of bisphosphonates given for osteopenia related to malignancy.BACKGROUND: This case report seeks to illustrate the clinical consequences of the administration of bisphosphonate therapy to prevent osteopenia secondary to malignancy in one patient. methods: A 69-year-old white female with a history of breast cancer with metastasis presented with pain in the upper left quadrant and periodontal pocketing of at least 6 mm in each of the four quadrants of the oral cavity. One week following surgery on the lower right region, lingual bone exposure was noted, and several attempts at achieving healing over the course of 15 months proved unsuccessful. RESULTS: Upon referral to a surgeon at the louisiana State University Medical Center, new orleans, louisiana, a potential causative factor was finally identified. The drug zoledronic acid, a bisphosphonate given for prevention of osteoclastic activity of bone metastasis, secondary to breast cancer, was identified as the possible cause of inhibition of healing, most likely from regional vascular insufficiency. The drug was immediately discontinued. The patient is healing very slowly with the aid of hyperbaric therapy; she has been unable to achieve smoking cessation, which is deterring thorough healing of the exposed bony area on the lower right lingual side. CONCLUSIONS: physicians and dentists alike must become increasingly aware of impaired oral healing following the use of bisphosphonates given for malignancy-related osteopenia. A dental exam should be performed before bisphosphonate therapy, as recommended for radiation therapy related to malignancy.- - - - - - - - - - ranking = 0.029171247338745keywords = cavity (Clic here for more details about this article) |
10/26. Intraoral cytomegalovirus lesion and hiv-associated periodontitis in a patient with acquired immunodeficiency syndrome.Exposure to cytomegalovirus (CMV) is common in persons infected with the human immunodeficiency virus. autopsy studies have documented the presence of CMV in multiple organs, but CMV is seldom indicated as the causative agent in specific diseases. Few reports have described localized CMV infection in the oral cavity. This may be due to the occult histopathologic appearance during oral mucosal CMV infections and to a lack of awareness of CMV infection as a potential etiologic agent in nonspecific oral ulcerations and other oral disease entities. This report describes an intraoral ulceration with documented presence of a localized CMV infection in association with human immunodeficiency virus-associated periodontitis in a patient with acquired immunodeficiency syndrome. A causative relationship between these two entities, however, cannot be established or excluded.- - - - - - - - - - ranking = 0.95621716182019keywords = oral cavity, cavity (Clic here for more details about this article) |
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