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Head and Neck Pathology Dec 2017A 44-year-old female presented to her general dentist with the chief complaint of a painful mouth sore of 2 weeks duration. Clinical examination revealed an irregularly...
A 44-year-old female presented to her general dentist with the chief complaint of a painful mouth sore of 2 weeks duration. Clinical examination revealed an irregularly shaped ulcer of the buccal and lingual attached gingiva of the anterior mandible. A biopsy was performed and microscopic evaluation revealed histoplasmosis. Histoplasmosis, caused by Histoplasma capsulate, is the most common fungal infection in the United States. Oral lesions of histoplasmosis are generally associated with the disseminated form of histoplasmosis and may present as a fungating or ulcerative lesion of the oral mucosa. The histologic findings and differential diagnosis for oral histoplasmosis are discussed.
Topics: Adult; Female; Histoplasmosis; Humans; Mouth Diseases
PubMed: 28220360
DOI: 10.1007/s12105-017-0797-y -
In Vivo (Athens, Greece) 2019Reactive oxygen species (ROS) and free radicals are physiologically produced during cellular metabolism. When their balance is disrupted in favor of ROS, a condition... (Review)
Review
BACKGROUND
Reactive oxygen species (ROS) and free radicals are physiologically produced during cellular metabolism. When their balance is disrupted in favor of ROS, a condition called oxidative stress occurs. Oxidative stress represents a widespread phenomenon involved in several pathological conditions. The aim of the present review was to report current knowledge on oxidative stress related to oral mucosal diseases.
MATERIALS AND METHODS
Articles from 2000 to 2018 were selected for relevance, validity and quality, from results obtained in PubMed, MEDLINE and Google Scholar using the following search terms: oxidative stress and oral lichen, oral pemphigus, aphthous stomatitis, oral leukoplakia, oral cancer, oral squamous cell carcinoma and oral carcinoma. All articles were independently screened for eligibility by the authors.
RESULTS
This narrative review integrates extensive information from all relevant published studies focusing on oxidative stress in oral mucosal diseases. We outline the pathogenetic function of oxidative stress in the most frequent inflammatory, potentially malignant and malignant diseases of the oral mucosa and provide detailed findings from human research.
CONCLUSION
Although variability in findings between individual studies exists, it justifies the conclusion that oxidative stress is a significant process in the oral mucosal diseases pathogenesis.
Topics: Free Radicals; Humans; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Oxidative Stress; Reactive Oxygen Species
PubMed: 30804105
DOI: 10.21873/invivo.11474 -
BMC Oral Health 2015This paper is a summary document of the Prevention in Practice Conference and Special Supplement of BMC Oral Health. It represents the consensus view of the presenters... (Review)
Review
BACKGROUND
This paper is a summary document of the Prevention in Practice Conference and Special Supplement of BMC Oral Health. It represents the consensus view of the presenters and captures the questions, comments and suggestions of the assembled audience.
METHODS
Using the prepared manuscripts for the conference, collected materials from scribes during the conference and additional resources collated in advance of the meeting, authors agreed on the summary document.
RESULTS
The Prevention in Practice conference aimed to collate information about which diseases could be prevented in practice, how diseases could be identified early enough to facilitate prevention, what evidence based therapies and treatments were available and how, given the collective evidence, could these be introduced in general dental practice within different reimbursement models.
CONCLUSIONS
While examples of best practice were provided from both social care and insurance models it was clear that further work was required on both provider and payer side to ensure that evidence based prevention was both implemented properly but also reimbursed sufficiently. It is clear that savings can be made but these must not be overstated and that the use of effective skill mix would be key to realizing efficiencies. The evidence base for prevention of caries and periodontal disease has been available for many years, as have the tools and techniques to detect, diagnose and stage the diseases appropriately. Dentistry finds itself in a enviable position with respect to its ability to prevent, arrest and reverse much of the burden of disease, however, it is clear that the infrastructure within primary care must be changed, and practitioners and their teams appropriately supported to deliver this paradigm shift from a surgical to a medical model.
Topics: Dental Care; Humans; Mouth Diseases; Oral Health; Preventive Dentistry; Workforce
PubMed: 26391906
DOI: 10.1186/1472-6831-15-S1-S12 -
BMJ Case Reports May 2020
Topics: Adult; Female; Glucocorticoids; Humans; Mouth Diseases; Pemphigus; Prednisolone
PubMed: 32404374
DOI: 10.1136/bcr-2020-235410 -
Swiss Dental Journal 2017Crohns disease (CD) is a chronic inflammatory bowel disease whose oral features remain underrated at clinical examination. The aim of the study was to report...
Crohns disease (CD) is a chronic inflammatory bowel disease whose oral features remain underrated at clinical examination. The aim of the study was to report forerunner orofacial presentations leading to diagnosis of CD among nine patients of mean age 23 between 2008 and 2015. Linear ulcerative buccal lesions, cobblestoning, mucosal tags and perioral erythema are highly evocative and might precede intestinal signs for several years. Oral biopsies revealed highly suggestive lesions of CD for 45% of patients before any intestinal symptom or digestive investigation. Mean time to diagnosis was 14 months. Immunomodulatory therapy (azathioprine, infliximab, adalimumab) was introduced alone or in association for 89% of patients. Early diagnosis could lead to specific therapy, often necessary to reduce severity of lesions and improve quality of life.
Topics: Adolescent; Adult; Crohn Disease; Diagnosis, Differential; Female; Gingiva; Gingival Diseases; Humans; Lip Diseases; Male; Mouth Diseases; Mouth Mucosa; Prodromal Symptoms; Skin; Young Adult
PubMed: 28752504
DOI: No ID Found -
Frontiers in Immunology 2019The maxillofacial skeleton is highly dynamic and requires a constant equilibrium between the bone resorption and bone formation. The field of osteoimmunology explores... (Review)
Review
The maxillofacial skeleton is highly dynamic and requires a constant equilibrium between the bone resorption and bone formation. The field of osteoimmunology explores the interactions between bone metabolism and the immune response, providing a context to study the complex cellular and molecular networks involved in oro-maxillofacial osteolytic diseases. In this review, we present a framework for understanding the potential mechanisms underlying the immuno-pathobiology in etiologically-diverse diseases that affect the oral and maxillofacial region and share bone destruction as their common clinical outcome. These otherwise different pathologies share similar inflammatory pathways mediated by central cellular players, such as macrophages, T and B cells, that promote the differentiation and activation of osteoclasts, ineffective or insufficient bone apposition by osteoblasts, and the continuous production of osteoclastogenic signals by immune and local stromal cells. We also present the potential translational applications of this knowledge based on the biological mechanisms involved in the inflammation-induced bone destruction. Such applications can be the development of immune-based therapies that promote bone healing/regeneration, the identification of host-derived inflammatory/collagenolytic biomarkers as diagnostics tools, the assessment of links between oral and systemic diseases; and the characterization of genetic polymorphisms in immune or bone-related genes that will help diagnosis of susceptible individuals.
Topics: Allergy and Immunology; Facial Bones; Humans; Mouth Diseases; Pathology, Oral; Translational Research, Biomedical
PubMed: 31379856
DOI: 10.3389/fimmu.2019.01664 -
Minerva Stomatologica Oct 2009Pemphigus is a group of potentially life-threatening autoimmune diseases characterized by cutaneous and/or mucosal blistering, due to the presence circulating IgG...
Pemphigus is a group of potentially life-threatening autoimmune diseases characterized by cutaneous and/or mucosal blistering, due to the presence circulating IgG antibodies directed against desmoglein 1 and 3 (Dsg 1 and 3). Differences in the particular distribution of these result in different clinical manifestations of the disease. The most common variant is pemphigus vulgaris (PV). There is a fairly strong genetic background to pemphigus with linkage to HLA class II alleles and ethnic groups such as Ashkenazi Jews and those of Mediterra-nean and Indian origin are especially liable. Oral lesions are commonly characterized by the presence of vesiculobullous and ulcerative lesions. Diagnosis is achieved via three different parameters: perilesional tissue biopsy, histological and immunological examinations. Serum autoantibodies to either Dsg1 or Dsg3 are best detected using both normal human skin and monkey esophagus or by enzyme-linked immunosorbent assay. The main aim of treatment is to reduce inflammatory re-sponse and autoantibody production, in order to achieve disease remission in a short time. Before the advent of corticosteroids, PV was typically fatal due to dehydration or secondary systemic infections. Current treatment is largely based on systemic immunosuppression using corticosteroids, with azathioprine or other adjuvants or alternatives. Nonetheless, newer therapies, such as intravenous immunoglobulins (IVIg) or anti-CD20 monoclonal antibodies (Rituximab), with potentially fewer adverse effects also appear promising.
Topics: Humans; Mouth Diseases; Pemphigus
PubMed: 19893475
DOI: No ID Found -
Acta Dermatovenerologica Alpina,... Mar 2018Autoimmune diseases may also be reflected in changes in the oral cavity that represent the first sign of the disease, or they may occur simultaneously with or later in... (Review)
Review
Autoimmune diseases may also be reflected in changes in the oral cavity that represent the first sign of the disease, or they may occur simultaneously with or later in the course of the disease. Oral findings are mostly non-specific, and therefore further investigations are needed to exclude or confirm possible diagnoses. This article presents the most important diseases in this research area, divides them into meaningful groups, and highlights the importance of examining the oral cavity for possible manifestations.
Topics: Autoimmune Diseases; Female; Hereditary Autoinflammatory Diseases; Humans; Incidence; Male; Mouth Diseases; Mouth Mucosa; Risk Assessment; Severity of Illness Index; Slovenia
PubMed: 29589639
DOI: No ID Found -
Journal of the National Cancer... Aug 2019The increasing clinical indications for hematopoietic stem cell transplantation (HSCT) and improved clinical care throughout and following HSCT have led to not only... (Review)
Review
The increasing clinical indications for hematopoietic stem cell transplantation (HSCT) and improved clinical care throughout and following HSCT have led to not only long-term survival but also to an increasing incidence and prevalence of graft-versus-host disease (GVHD). Chronic GVHD (cGVHD) affects almost 50% of adult patients post-HSCT, with increasing incidence in pediatric patients as well. Oral cGVHD specifically has a reported prevalence ranging from 45% to 83% in patients who develop cGVHD and is more extensive in adult patients than in children. Oral cGVHD affects patients through clinically significant oral symptoms that may lead to significantly decreased caloric intake, oral infections, and increased health service utilization, and may thus affect overall health and survival. The most commonly used therapy for mucosal involvement of oral cGVHD is topical high-dose and ultra-high potency corticosteroids, and calcineurin inhibitors. This review of oral complications of cGVHD presents the clinical significance of oral cGVHD to HSCT survivors, our current understanding of the pathobiology of oral cGVHD and gaps in this evidence, and the global targeted interdisciplinary clinical research efforts, including the National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease. Current challenges regarding the management of oral cGVHD and strategies to advance our scientific understanding of this clinically significant chronic oral disease are presented.
Topics: Animals; Chronic Disease; Disease Management; Disease Susceptibility; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Mouth Diseases; Neoplasms; Phenotype; Severity of Illness Index; Symptom Assessment; Translational Research, Biomedical
PubMed: 31425593
DOI: 10.1093/jncimonographs/lgz007 -
Australian Dental Journal Sep 2010Saliva plays an important protective role in the oral environment, and reductions in saliva quantity are known to increase the risk of oral diseases. Importantly,... (Review)
Review
Saliva plays an important protective role in the oral environment, and reductions in saliva quantity are known to increase the risk of oral diseases. Importantly, xerostomia or the perception of a dry mouth is now being recognized as an important risk factor for dental diseases. Furthermore, the subjective sensation of a dry mouth is a debilitating condition in itself that impacts on the quality of life of sufferers. With approximately 1 in 5 people reporting some form of dry mouth, and an increasing prevalence in the elderly, it is important for clinicians to have a thorough understanding of this problem. The aim of this paper is to review some of the literature relating to xerostomia in order to provide an evidence based update for clinicians.
Topics: Humans; Mouth Diseases; Oral Health; Quality of Life; Risk Factors; Saliva; Tooth Diseases; Xerostomia
PubMed: 20887509
DOI: 10.1111/j.1834-7819.2010.01229.x