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Minerva Dental and Oral Science Oct 2023The aim of this study was to investigate oral mucosal changes in patients with confirmed moderate-scale severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)...
BACKGROUND
The aim of this study was to investigate oral mucosal changes in patients with confirmed moderate-scale severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
METHODS
We analyzed 85 COVID-19 patients (50 males, 35 females) with an average age of 53.6 years, treated at the prehospital infectious disease center and Aldent University Clinic in Tirana, Albania, from May 2021 to June 2022.
RESULTS
Elevated C-reactive protein levels were observed in 82 patients (±44.20), with 20 patients showing significant fibrinogen increase (mean ± 5.85 g/L), and 22 patients having elevated D-Dimer (mean ± 336.6 mg/mL). Despite the absence of anticoagulant history, 13 patients exhibited bleeding. Xerodermia, xerostomia, and angular cheilitis were noted, with 41 patients displaying angular cheilitis. In 82 patients, oral mucosal and tongue examinations revealed color changes from white to bright yellow, with brown edema. Pigmentation in the fixed gingiva of upper and lower front teeth was observed in 35 patients.
CONCLUSIONS
Oral mucosal changes during COVID-19 appear more influenced by drug treatment and disease progression than the infection itself, suggesting that secondary factors play a significant role. Despite the oral cavity's potential for viral entry, these changes seem connected to other underlying causes.
PubMed: 37878242
DOI: 10.23736/S2724-6329.23.04870-2 -
Medicine Apr 2020To observe the clinical manifestations and salivary secretion of xerostomia patients in submariners who engaged in a three-month deployment. The general conditions and... (Observational Study)
Observational Study
To observe the clinical manifestations and salivary secretion of xerostomia patients in submariners who engaged in a three-month deployment. The general conditions and clinical examination of the 136 submariners were evaluated, by which the patients with xerostomia were screened out and their clinical manifestations were recorded. Besides, the flow rate of unstimulated saliva and stimulated saliva was measured and calculated. Subsequently, the related factors of xerostomia were quantitatively classified and statistically analyzed. In all the involved submariners, 42 were diagnosed to have xerostomia by physical examination after they returned from the task, among which 71.4% showed a decrease in unstimulated salivary flow rate and it was significantly correlated with the accompanying symptoms and their general conditions. Therefore, it was concluded that the occurrence of xerostomia could be related to the service life and job responsibilities of the submariners. The main manifestations were the reduction of unstimulated salivary secretion and the accompanying clinical symptoms such as cheilosis and angular cheilitis. Noticeably, the high psychological pressure and harsh living conditions need to be concerned, and further study should place more concentrations on these comprehensive influence factors and preventive actions of xerostomia.
Topics: Adult; China; Humans; Male; Middle Aged; Military Personnel; Occupational Health; Salivation; Severity of Illness Index; Submarine Medicine; Xerostomia
PubMed: 32332601
DOI: 10.1097/MD.0000000000019523 -
Revista Alergia Mexico (Tecamachalco,... 2020Melkersson-Rosenthal syndrome is a rare disorder that is characterized, in its full form, by recurrent facial nerve palsy, fissured tongue, and orofacial edema. Most...
BACKGROUND
Melkersson-Rosenthal syndrome is a rare disorder that is characterized, in its full form, by recurrent facial nerve palsy, fissured tongue, and orofacial edema. Most cases present as oligosymptomatic or monosymptomatic forms. Its etiology is still unknown and its course is chronic and it may be progressive.
CASE REPORT
We present the case of a nine-year-old girl with recurrent episodes of peripheral facial nerve palsy. During the study, lip edema, benign migratory glossitis, and angular cheilitis were observed, which is why a clinical diagnosis of Melkersson-Rosenthal syndrome was made.
CONCLUSIONS
This syndrome must be considered in the differential diagnosis with the presence of acute peripheral facial nerve palsy and/or facial edema due to its behavior and progressive evolution.
Topics: Child; Diagnosis, Differential; Edema; Facial Nerve; Female; Humans; Melkersson-Rosenthal Syndrome; Paralysis
PubMed: 33631910
DOI: 10.29262/ram.v67i4.791 -
European Journal of Medical Research Aug 2023The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in...
BACKGROUND
The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in hospital. Understanding the cause-and-effect relationships may allow for individual adjustment of oral care recommendations during Covid-19 disease. The study's objective was to assess Covid-19 patients' oral health status under hospital treatment due to pulmonary adverse Covid-19 outcomes.
MATERIAL AND METHODS
Covid-19 patients (mean age 74.4 ± 15.4; n = 120, male n = 50/female n = 70) were admitted to hospital in the acute phase of Covid-19 between January and March 2022 who required oxygen therapy due to pneumonia, rapid respiratory failure, low saturation. Blood and radiological tests were taken according to National Health Fund guidelines. The condition of teeth (Decayed, Missing, Filled teeth as DMFT index), dental hygiene (Plaque Control Record as PCR index), periodontal status (probing depth PD, clinical attachment CAL, bleeding on probing BOP) and oral mucosa (BRUSHED and Beck scores) were examined.
RESULTS
Charateristics of the teeth (dental caries 35.2%, DMFT Median 22), plaque retention (83.4%), advanced periodontitis (48.3%), xerostomia (74.2%), oral mucosa inflammation (80.8%), angular cheilitis (53.3%), hemorrhagic (21.7%) showed a high incidence of harmful oral conditions. BRUSHED model and Beck score indicated moderate oral dysfunction and need for oral care every 8 h. Spearman's analysis revealed a significant positive correlation between pneumonia and neutrophile, interleukin-6 IL-6, C-reactive protein CRP (p = 0.01, p < 0.001, p < 0.001), negative to lymphocyte count (p < 0.001). Multiple and logistic regressions selected the following risk predictors for pneumonia as IL-6, CRP, obesity and for severe COVID-19 symptoms D-dimer level and a lack of targeted vaccination (p < 0.001). Among oral predictors, the PCR index and Beck score were significant for both outcomes (respectively p < 0.001, p < 0.012). Patients who received oxygen therapy with face masks had more often angular heilitis and debris (p = 0.025, p = 0.035).
CONCLUSIONS
COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.
Topics: Humans; Female; Male; Middle Aged; Aged; Aged, 80 and over; Noninvasive Ventilation; Prevalence; Dental Caries; Interleukin-6; COVID-19; SARS-CoV-2; Oxygen
PubMed: 37608339
DOI: 10.1186/s40001-023-01273-6 -
Journal of Dental Research Nov 2021This is the first update of the previously published living systematic review that summarized evidence on the prevalence of oral signs and symptoms in patients with... (Meta-Analysis)
Meta-Analysis
This is the first update of the previously published living systematic review that summarized evidence on the prevalence of oral signs and symptoms in patients with COVID-19. Hitherto, 183 studies were included, reporting data from 64,876 patients with COVID-19 worldwide. The overall prevalence of taste disorders was 38% (95% CI = 22% to 56%, = 98%). Hypogeusia, dysgeusia, and ageusia were also evaluated by a meta-analysis, and the pooled prevalence was 34% for hypogeusia, 33% for dysgeusia, and 26% for ageusia. Taste disorders were associated with a positive COVID-19 test (odds ratio [OR] = 7.54, 95% CI = 5.24 to 10.86, = 93%, < 0.00001), showing high certainty of evidence. However, the association between taste disorders and mild/moderate severity of COVID-19 (OR = 1.63, 95% CI = 1.33 to 1.99, = 69%, < 0.0001) and female patients with COVID-19 (OR = 1.77, 95% CI = 1.26 to 2.48, = 79%, = 0.001) presented low certainty of evidence. Xerostomia was a new feature of this update, and the pooled data demonstrated a prevalence of 43% (95% CI = 36% to 50%, = 71%) in patients with COVID-19. Regarding oral mucosal lesions, the most common clinical pattern was aphthous like, followed by herpes-like lesions, candidiasis, glossitis/depapillation/geographic tongue, parotitis, and angular cheilitis. Oral lesions were more frequent in the tongue, lips, and palate, presenting miscellaneous clinical aspects that are more likely to represent coinfections. Therefore, the reanalysis of current evidence suggests the triad xerostomia, taste dysfunction, and oral mucosal lesions as common manifestations in patients with COVID-19. However, these outcomes are under discussion, and more studies will be necessary to confirm their association with direct SARS-CoV-2 infection in the oral cavity.
Topics: Ageusia; COVID-19; Female; Humans; Prevalence; SARS-CoV-2; Taste Disorders
PubMed: 34324825
DOI: 10.1177/00220345211029637 -
Journal of Immunotherapy and Precision... Feb 2024Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, their oral toxicity profile is not well elucidated. This review aimed to investigate... (Review)
Review
Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, their oral toxicity profile is not well elucidated. This review aimed to investigate the prevalence of oral toxicities including xerostomia, mucositis/stomatitis, dysgeusia, dysphagia, oral/oropharyngeal pain, oral infections, angular cheilitis, osteonecrosis, osteomyelitis, and oral mucosal reactions with ICIs. A review protocol was registered with PROSPERO (ID: CRD42023391674). A systematic search of ClinicalTrials.gov was conducted as of April 10, 2022. Studies were selected, assessed, and data extracted using PRISMA guidelines. Oral toxicity data were extracted from study arms using a single immunotherapy drug. Meta-analyses were conducted to summarize prevalence of oral toxicities using random-effects models. Of 750 screened records, 95 trials were included in the meta-analysis with published results. Time between study completion and first publication on ClinicalTrials.gov was 1 to 146 months (mean = 20.3, SD = 18.4). Weighted pooled prevalence was 5% (95% CI: 4-6%) for xerostomia, 3% (95% CI: 3-4%) for mucositis/stomatitis, 3% (95% CI: 2-3%) for dysgeusia, 2% (95% CI: 1-2%) for dysphagia, 3% (95% CI: 2-4%) for oropharyngeal/oral pain, 2% (95% CI: 1-3%) for oral candidiasis, and 2% (95% CI: 0-4%) for angular cheilitis. Subgroup differences based on ICI drugs were minimal. No trials reported lichenoid or pemphigoid mucosal reactions. Meta-analysis results revealed low prevalence of oral toxicities with ICIs; however, data reporting was limited and inconsistent. Limitations of study dataset reveal a significant need for systematic collection of oral morbidity data as well as improved consistency and compliance of reporting results on ClinicalTrials.gov.
PubMed: 38327757
DOI: 10.36401/JIPO-23-14 -
European Journal of Medical Research Mar 2022Angular cheilitis, an infection mainly caused by Candida yeasts, is featured by the appearance of inflammatory lesions at the bilateral corners of the mouth,...
BACKGROUND
Angular cheilitis, an infection mainly caused by Candida yeasts, is featured by the appearance of inflammatory lesions at the bilateral corners of the mouth, particularly in patients with poor oral hygiene, ill-fitting dentures and old age. The first isolation of an atypical yeast, Cystobasidium calyptogenae, from oral samples of a patient presenting with angular cheilitis is discussed in this study.
CASE PRESENTATION
Angular cheilitis was diagnosed in a 60-year-old denture-wearing woman who presented with an irritation fibroma on her right lower buccal sulcus over the premolar region. Primary cultures of her oral swab and oral rinse samples grew a pure culture of an uncommon yeast strain resembling Rhodotorula sp. Sequence analysis of the yeast internal transcribed spacer (ITS) gene region and D1D2 domain showed highest similarity (99.6% and 100%, respectively) to C. calyptogenae CBS 9125 type strain. Following 2 weeks of treatment with miconazole/fusidic acid and mouthwash, the oral lesion showed improvement with less erythema. C. calyptogenae was not isolated from the patient's oral samples upon repeat sampling.
CONCLUSION
This is the first report on the isolation of C. calyptogenae from human oral samples. The ability of C. calyptogenae to grow at 37 °C and the fact that it was the only yeast species isolated from the patient's oral samples suggests its pathogenic potential and possible involvement in angular cheilitis. The ubiquitous nature of the Cystobasidium yeast is believed to increase the likelihood of opportunistic infections among immunocompromised individuals. As Cystobasidium is phenotypically indistinguishable from Rhodotorula, an emerging opportunistic pathogen, surveillance using molecular identification in clinical settings is essential in providing accurate diagnosis and treatment of uncommon yeast infections.
Topics: Basidiomycota; Candida; Cheilitis; Female; Humans; Middle Aged
PubMed: 35346364
DOI: 10.1186/s40001-022-00671-6 -
Dental Research Journal 2021COVID-19 outbreak in 2019 took the entire world by a storm with the medical fraternity struggling to understand and comprehend its complex nature. A number of patients...
BACKGROUND
COVID-19 outbreak in 2019 took the entire world by a storm with the medical fraternity struggling to understand and comprehend its complex nature. A number of patients who are COVID positive have reported oral lesions. However, there is still a lingering question, whether these lesions are because of coronavirus infection or they are secondary to the patient's systemic condition. This article aims to report the oral findings of an observational study of 713 patients diagnosed with COVID-19.
MATERIALS AND METHODS
A singlssswe-institution, short-term observational study was conducted on patients admitted to Symbiosis University Hospital and Research Centre, Lavale, Pune who were positive to coronavirus, who presented varied oral findings such as herpes simplex, candidiasis, geographic tongue, and aphthous ulcer.
RESULTS
A total of 713 patients, 416 males and 297 females, who were positive to coronavirus, were screened from April 2020 to June 30, 2020, for oral ulcers. In this group, nine patients reported oral discomfort due to varied forms of oral lesions ranging from herpes simplex ulcers to angular cheilitis (1.26%).
CONCLUSION
This study supports the hypothesis that oral manifestations in patients diagnosed with COVID-19 could be secondary lesions resulting from local irritants or from the deterioration of systemic health or could be just coexisting conditions. No specific pattern or characteristic oral lesions were noted in a study of 713 COVID-positive patients in our study to qualify these lesions as oral manifestations of SARS-CoV-2 infection.
PubMed: 34584645
DOI: No ID Found -
Special Care in Dentistry : Official... Sep 2022Autoimmune polyglandular syndrome type I (APS-I) is a rare condition of autosomal recessive and monogenic inheritance, which is characterized clinically by at least two...
AIMS
Autoimmune polyglandular syndrome type I (APS-I) is a rare condition of autosomal recessive and monogenic inheritance, which is characterized clinically by at least two signs of the classic triad: mucocutaneous candidosis, hypoparathyroidism, and Addison's disease. This study aims to report the oral manifestations of APS-I in a 42-year-old woman, who attended the Special Care Dentistry Center.
METHODS AND RESULTS
The patient presented with hypoparathyroidism, diabetes mellitus, and autoimmune hepatitis. Chronic hyperplastic candidosis (CHC) was the main oral manifestation and it was diagnosed based on clinical and cytologic characteristics. Microstomia, angular cheilitis, xerostomia, enamel hypoplasia, and microdontia were also present.
CONCLUSIONS
CHC was treated with topical nystatin and oral fluconazole, resulting in a significant improvement of the lesions.
Topics: Addison Disease; Adult; Candidiasis, Chronic Mucocutaneous; Dental Enamel Hypoplasia; Female; Humans; Hypoparathyroidism; Polyendocrinopathies, Autoimmune
PubMed: 35182449
DOI: 10.1111/scd.12703 -
Acta Medica (Hradec Kralove) 2020Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms...
INTRODUCTION
Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations.
METHODS
250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken.
RESULTS
250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%).
CONCLUSION
The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.
Topics: Adult; Czech Republic; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Malnutrition; Mouth Diseases; Practice Patterns, Dentists'; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 33002395
DOI: 10.14712/18059694.2020.25