Oral Diseases

An overall view of the global pandemic is given in a paper in this issue . This confirmed that according to the latest figures available from WHO, that approximately 38 million people worldwide were living with HIV infection and that since the beginning of the HIV global pandemic nearly the same number of people had died with HIV infection. Worldwide, the number of infections continues to increase, and some 1.7 million people became infected during the year 2018 according to the latest figures. Some 21 million of those currently living with HIV are women (19 million) and children (2 million). AIDS-related deaths globally amounted to 770,000 per year with over 100,000 of these deaths being in children. In the Asia-Pacific region, approximately 6 million people are estimated to be living with HIV (PLHIV), representing nearly 15% of the world total (Table ). India has over 2.1 million people living with HIV, a figure which has remained stable over the last 5 years (Paranjape & Challacombe, 2016) and there are over 440,000 in Thailand and

BACKGROUND: Eating disorders (ED) are a group of psychopathological disorders affecting patient relationship with food and her⁄his own body, which manifests through distorted or chaotic eating behavior; they include anorexia nervosa, bulimia nervosa and ED not otherwise specified and may be burdened with lifethreatening complications. As oral manifestations of ED can occur in many phases of disease progression, they play a significant role in assessment, characterization and prognosis of ED. METHODS: Mucosal, dental, and salivary abnormalities associated with ED have been reviewed. Relations between oral menifestations and pathogenesis, management and prognosis of ED have been critically analysed. RESULTS: Oral manifestations of ED include a number of signs and symptoms involving oral mucosa, teeth, periodontium, salivary glands and perioral tissues; differences exist between patients with anorexia and bulimia. Oral manifestations of ED are caused by a number of factors including nutritional deficiencies and consequent metabolic impairment, poor personal hygiene, drugs, modified nutritional habits and underlying psychological disturbances. CONCLUSION: Oral manifestations of ED can cause impairment of oral function, oral discomfort and pain, and an overall deterioration of aesthetics and quality of life. Their treatment can contribute to overall patient management and prognosis.

All living tissues require essential nutrients such as amino acids, fatty acids, carbohydrates, minerals, vitamins, and water. The skeleton requires nutrients for development, maintaining bone mass and density. If the skeletal nutritional requirements are not met, the consequences can be quite severe. In recent years, there has been growing interest in promotion of bone health and inhibition of vascular calcification by vitamin K2. This vitamin regulates bone remodeling, an important process necessary to maintain adult bone. Bone remodeling involves removal of old or damaged bone by osteoclasts and its replacement by new bone formed by osteoblasts. The remodeling process is tightly regulated, when the balance between bone resorption and bone formation shifts to a net bone loss results in the development of osteoporosis in both men and women. In this review, we focus on our current understanding of the effects of vitamin K2 on bone cells and its role in prevention and treatment of os...

OBJECTIVES: Field-cancerized tissue can give rise to second primary tumours, causing therapeutic failure. Boron neutron capture therapy (BNCT) is based on biological targeting and would serve to treat undetectable foci of malignant transformation. The aim of this study was to optimize BNCT for the integral treatment for oral cancer, with particular emphasis on the inhibitory effect on tumour development originating in precancerous conditions, and radiotoxicity of different BNCT protocols in a hamster cheek pouch oral precancer model. MATERIALS AND METHODS: Groups of cancerized hamsters were locally exposed to single or double (2 or 4 weeks apart) applications of BNCT at different dose levels, mediated by the boron compounds boronophenylalanine (BPA) or BPA and decahydrodecaborate (GB-10) administered jointly. Cancerized, sham-irradiated hamsters served as controls. Clinical status, tumour development from field-cancerized tissue and mucositis were followed for 8 months. RESULTS: A double application (4 weeks apart) of BNCT mediated by GB-10+ BPA at a total dose of 10 Gy in two 5-Gy doses rendered the best therapeutic advantage (63-100% inhibition of tumour development from fieldcancerized tissue), minimizing dose-limiting mucositis. CONCLUSION: BNCT can be optimized for the integral treatment for head and neck cancer, considering the implications for field-cancerized tissue.

Almost half of humanity suffers from digestive disorders so, it is
not surprising that people have developed treatments with plants for
these disorders. Today we have a wealth of information from all parts
of the world and from many diverse cultures. What is common in
this knowledge bank is the frequent occurrence of both bitter tasting
and aromatic plants for digestive disorders

lectures. Results: The mean age of the subjects was 58.8 years and they exhibited sundry psychiatric disorders and systemic comorbidities. Characteristics included 25.9% were illiterate; 55.6% were smokers; 74.1% had a toothbrush, although 91.7% did not perform oral hygiene; 80.6% had unfavorable oral health conditions; and 2.7% complained about their oral health. The DMF index was 38.5%, and 96.3% of the subjects needed partial or complete dentures. Conclusion: This patient sample had a high DMF index related to elevated tooth loss rate, inefficient prevention techniques, and poor promotion of oral health as well as a tendency toward dental mutilation.

Background: Oral Histopathology is the study of diseased tissues in a lifelike manner. Unfortunately biopsy tissue gives two dimensional and static images. Additionally the descriptions of such images are in three dimensional terms such as cords, arcading, organoid etc., which most of the time is confusing to the students and readers. Therefore it becomes very difficult to correlate the descriptions mentioned in the textbooks with the images viewed under microscope. Researchers have been trying to develop various softwares to convert two dimensional images into three dimensional but again such images would still be static. Therefore three dimensional animation videos which would depict the etiopathogenesis in life like manner, should be available at each university to promote e-learning especially for oral histopathology speciality, popularity of which has been vanishing day by day. Such videos are already available for other speciality of dentistry. With this concept, a preliminary...

The purpose of this systematic review was to evaluate the potential use of dental imaging assessment of trabecular bone structure in the maxillomandibular complex as an adjuvant screening tool to identify systemic disorders. Five electronic databases and grey literature were searched. Studies were included if they investigated subjects with altered trabecular bone determined by dental radiographs. The QUADAS-2 assessed the risk of bias (RoB) among the studies, while the GRADE determined the strength of evidence. A total of 14 studies that included 1,466 individuals were considered eligible for the qualitative analysis. All studies presented an overall low RoB and low concern regarding applicability. Systemic disorders such as osteoporosis, osteogenesis imperfecta, diabetes, and primary hyperparathyroidism, with their respective control groups, were analyzed among the included studies. Osteoporosis was the condition presenting the most significant results, and 72% of the studies dete...

lectures. Results: The mean age of the subjects was 58.8 years and they exhibited sundry psychiatric disorders and systemic comorbidities. Characteristics included 25.9% were illiterate; 55.6% were smokers; 74.1% had a toothbrush, although 91.7% did not perform oral hygiene; 80.6% had unfavorable oral health conditions; and 2.7% complained about their oral health. The DMF index was 38.5%, and 96.3% of the subjects needed partial or complete dentures. Conclusion: This patient sample had a high DMF index related to elevated tooth loss rate, inefficient prevention techniques, and poor promotion of oral health as well as a tendency toward dental mutilation.

New bioceramic calcium silicate endodontic cements have been recently introduced in the market. They are biocompatible materials that stimulate mineralization. Its dimensional stability is similar to the Fillapex MTA with greater thickness and solubility than AH Plus (Dentsply, DeTrey, Konstanz, Germany) as it is water based. Stored in dispensed syringe, it has a pre-mixed consistency. They are used with the single cone obturation technique because they have properties that are changed when heated. They were developed by inducing bioactivity on the surface of the material when in contact with tissue fluids. An improvement in the osteoblastic differentiation of the cells of the periodontal ligament, induction of remineralization of the dentin, and excellent antimicrobial properties have also been associated with these cements. These properties make these cements an excellent alternative in the attempt to obtain a three-dimensional obturation of the Root Canal System (SCR).

To evaluate educational strategies and ART-restoration impact on salivary physicochemical and microbiological characteristics. Two groups of 6-7-yr-old children were included: GART , with at least one decayed primary molar (n=36), submitted to 4 sessions of oral health educational strategy (OHES) and ART-restoration; GC , a paired caries-free group (n=36), submitted to 4 sessions of OHES. Three evaluations were carried out: baseline, one week after OHES and one month after OHES or ART, when biofilm and gingivitis frequencies, salivary flow, pH, buffer capacity, calcium and phosphorus concentrations were assessed. Total bacteria and S. mutans were quantified in unstimulated saliva (qPCR). Improvement in biofilm and gingivitis scores, salivary pH and buffering capacity after OHES was observed in GC , with a decrease in total bacteria and S. mutans counts. GART also showed changes in salivary parameters, even before ART-restoration was delivered, and total bacteria count remained lower...

As the AIDS pandemic has continued, our understanding of the events that occur during the entry and infection of conventional, susceptible cells has increased dramatically, leading to the development of control therapies for HIV infected individuals. However, an ongoing hole in our understanding is how HIV crosses the mucosal barriers to gain access to permissive cells, despite how important this information would be in developing successful vaccines and other preventative measures such as topical anti-HIV microbicides. In particular, our knowledge of the role that epithelial cells of the mucosal surfaces play in infection -both during early phases and throughout the life of an infected individual, is currently hazy at best. However, several studies in recent years suggest that HIV can bind to and traverse these mucosal epithelial cells, providing a reservoir of infection that can subsequently infect underlying permissive cells. Despite this interaction with epithelial cells, evidence suggests HIV-1 does not productively infect these cells, although they are capable of transferring surface-bound and transcytosed virus to other, permissive cells. Further, there appear to be key differences between adult and infant epithelial cells in the degree to which HIV can transcytose and infect the epithelium. Thus, it is clear that, whilst not primary targets for infection and virus replication, epithelial cells play an important role in the infection cycle and improving our understanding of their interactions with HIV could potentially provide key insights necessary to develop effective preventative therapies.

As the AIDS pandemic has continued, our understanding of the events that occur during the entry and infection of conventional, susceptible cells has increased dramatically, leading to the development of control therapies for HIV infected individuals. However, an ongoing hole in our understanding is how HIV crosses the mucosal barriers to gain access to permissive cells, despite how important this information would be in developing successful vaccines and other preventative measures such as topical anti-HIV microbicides. In particular, our knowledge of the role that epithelial cells of the mucosal surfaces play in infection -both during early phases and throughout the life of an infected individual, is currently hazy at best. However, several studies in recent years suggest that HIV can bind to and traverse these mucosal epithelial cells, providing a reservoir of infection that can subsequently infect underlying permissive cells. Despite this interaction with epithelial cells, evidence suggests HIV-1 does not productively infect these cells, although they are capable of transferring surface-bound and transcytosed virus to other, permissive cells. Further, there appear to be key differences between adult and infant epithelial cells in the degree to which HIV can transcytose and infect the epithelium. Thus, it is clear that, whilst not primary targets for infection and virus replication, epithelial cells play an important role in the infection cycle and improving our understanding of their interactions with HIV could potentially provide key insights necessary to develop effective preventative therapies.

All mucosal surfaces are lined by epithelial cells and are colonised by opportunistic microbes. In health, these opportunistic microbes remain commensal and are tolerated by the immune system. However, when the correct environmental conditions arise, these microbes can become pathogenic and need to be controlled or cleared by the immune system to prevent disease. The mechanisms that enable epithelial cells to initiate the ‘danger’ signals activated specifically by pathogenic microbes are critical to mucosal defence and homeostasis but are not well understood. Deciphering these mechanisms will provide essential understanding to how mucosal tissues maintain health and activate immunity, as well as how pathogens promote disease. This review focuses on the interaction of the human fungal pathogen Candida albicans with epithelial cells and the epithelial mechanisms that enable mucosal tissues to discriminate between the commensal and pathogenic state of this medically important fungus.

Background: Human identification can be reliably established by dental comparison; success is significantly impacted by inadequate antemortem information. Previous Australian research revealed suboptimal recording of features important for forensic dental identification and compliance with Dental Board of Australia guidelines. We hence created and evaluated an online education programme aimed at improving oral health practitioner recording. Methods: An Interactive Learning Module (ILM) was constructed and released to three focus groups representing practitioners with varying experience levels -Australian Society of Forensic Odontology members, third year dental students and the wider dental community. Pre-and post-participation perceptions were recorded, with percentage, mean, broad agreement, standard deviation and statistical significance between responses determined. Results: Improved recognition of importance of record keeping, knowledge, confidence, skill and motivation to learn was seen following ILM interaction. This was particularly significant for students, participants with 3-5 years of experience in their current occupation and those whose highest level of education was achieved in Australia. The ILM increased self-reported awareness, understanding and attitude of participants with different levels of case note recording experience; this can improve recording practices and aid forensic dental identification if utilised in undergraduate teaching and as a continuing professional development tool for dental practitioners.

BackgroundFibro‐osseous lesions of the jaws are a diagnostic challenge for the pathologist because histologically, they are not easily distinguishable. African data on the prevalence of these lesions are scarce. We present a 5‐year report of benign fibro‐osseous lesions at Mulago Hospital, Uganda, showing the frequency and distribution of these lesions.Materials and MethodsConfirmed fibro‐osseous lesions reports at the pathology department (2007–2012) were retrieved. Patients' clinical data including age, gender, anatomic location, and diagnosis were recorded. Descriptive statistics and simple proportion tests were carried out.ResultsWe retrieved 155 confirmed benign fibro‐osseous lesions over this period, 65% were females, 34% males, and the gender of one case was not specified. Fibrous dysplasia was the most prevalent lesion (n = 87, 56.1%) followed by ossifying fibroma (n = 50, 32.9%) and osseous dysplasia (n = 17, 10.9%). We neither found craniofacial nor polyostotic fibrous...

Objective. Inflammatory rheumatic conditions including rheumatoid arthritis and Sjögren's syndrome have been reported in individuals infected with human T cell lymphotropic virus type I (HTLV-I). Other chronic lymphotropic virus infections such as hepatitis C and human immunodeficiency virus are associated with fibromyalgia (FM). There are no reports about the association between HTLV-I infection and FM. We evaluated the association between FM and HTLV-I infection. Methods. We conducted a case-control study with prevalent cases. Ex-blood donation candidates with HTLV-I infection from a blood bank cohort, and healthy blood donors as a control group, were submitted to rheumatologic evaluation to compare the prevalence of FM. The following covariables were also evaluated: other rheumatic diseases, age, sex, personal income, level of education, and depression. Results. One hundred individuals with HTLV-I infection and 62 non-infected blood donors were studied. Thirty-eight (38%) HTLV-I infected individuals and 3 (4.8%) individuals from the control group presented the diagnosis of FM (OR 12.05, 95% CI 3.53-41.17). Other rheumatic diseases were also more prevalent in the infected group (37% vs 12.9%; OR 3.80, 95% CI 1. 63-8.86). In multivariate analysis adjusted by the covariables, the association between HTLV-I and FM was statistically significant (OR 9.14, 95% CI 2.42-34.52). Our study shows a greater prevalence of FM in HTLV-I infected individuals, suggesting that FM may be associated with this viral infection. (

Introduction: In this study, we sought to address changes in blood lymphocyte subpopulations and labial salivary gland (LSG) inflammation after belimumab treatment in patients with primary Sjögren's syndrome (pSS) and to identify predictors of response to treatment. Methods: Sequential blood lymphocyte subsets and LSG biopsies were analysed between week 0 (W0) and W28 in 15 patients with pSS treated with belimumab. Systemic response to treatment was defined as a decrease in the European League Against Rheumatism Sjögren's Syndrome Disease Activity Index score of ≥3 points at W28. Results: After belimumab, we observed a decrease in blood B lymphocytes primarily involving CD27-negative/ immunoglobulin D-positive naïve B cells (p=0.008). Lymphocytic sialadenitis (focus score >1) that was present in 12 patients (80.0 %) before belimumab treatment became negative in 5 of them after treatment (p=0.03). The median (interquartile range) LSG B-cell/T-cell ratio decreased from 0.58 (0.5-0.67) to 0.50 (0.5-0.5) (p=0.06). B-cell activating factor (BAFF) staining was detected in 11 (78.6 %) of 14 patients before belimumab treatment compared with 7 (50.0 %) of 14 after belimumab therapy (p=0.10). The median percentage of BAFF-positive cells in foci significantly decreased from 27.5 % (10-40) to 5 % (0-20) (p=0.03). A systemic response was achieved in six patients (40 %). The only predictor of response was the presence of a low number of natural killer (NK) cells, both in blood (8.5 % [7-10] vs 11 % [9-21]; p=0.04) and in LSG (20.6/mm 3 [20.0-21.4] vs 30.0/mm 3 [25.0-100.0], p=0.003). Serum BAFF levels did not influence response to treatment. Conclusions: Low blood and salivary NK cell numbers are associated with a better response to belimumab. This suggests that two distinct subsets of pSS may exist: one with a predominant type I interferon (IFN)-BAFF-B-cell axis, representing good responders to belimumab; and one with a predominant type II IFN-NK cell axis, representing non-responders.

Svrha rada: Zadatak je bio ocijeniti tijekom sistematičnih oralnih pregleda prevalenciju nekroze kostiju povezanu s bisfosfanatima (BP-ONJ) i zaštitnim čimbenicima od razvoja BP-ONJ-a kod pacijentica s rakom dojke i koštanim metastazama pod terapijom bisfosfanatima. Ispitanici i metode: Na Odjelu ginekologije klinike u Mainzu (Njemačka) bila je provedena retrospektivna studija. Sudjelovale su sve pacijentice s rakom dojke (n=51) pod terapijom bisfosfanatima u razdoblju od srpnja 2006. do rujna 2007. Primarni kriterij bio je razvoj BP-ONJ-a i traženje mogućih dodatnih "okidača" za njegov razvoj te eventualni čimbenici za izbjegavanje. Rezultati: Samo kod jedne od 51 pacijentice razvio se BP-ONJ (2,0%). Pretpostavlja se da bi se kao dodatni "okidač" mogla identificirati ekstrakcija zuba. Stupanj oralne higijene tih pacijentica bio je iznad prosjeka. Zaključak: U usporedbi s ostalim malignim bolestima, BP-ONJ se kod pacijentica s rakom dojke ne javlja često. Primarna bolest mogla bi utjecati na njegov razvoj. Vjeruje se da bi dobra oralna higijena mogla biti zaštitni čimbenik. bisfosfonati; osteonekroza; čeljust, bolesti; rak dojke; oralna higijena 1 Klinika za kirurgiju čeljusti i lica (direktor: sveuč. prof. dr.

Teledentistry is a synergistic combination of telecommunications technology; internet and dental practice which shows promising potential to be a highly effective mechanism for enhancing diagnosis and related treatment. To assess the knowledge and attitudes regarding teledentistry among dentists of Udaipur. A cross-sectional survey was conducted among the total of 105 dentists in Udaipur, India. A self administered structured questionnaire was used to assess their knowledge (8 items) and attitude (12 items) regarding teledentistry. The response format was based on 5-point Likert scale. Analysis of variance, t-test and multiple linear regression model was utilized for statistical analysis. Level of significance was fixed at p ≤ 0.05. The mean scores for knowledge and attitudes were 25.61 ± 3.197 and 38.61 ± 4.742 respectively. Bivariate analysis revealed that work experience was significantly associated with both knowledge and attitude means scores (p ≤ 0.05). Significant predictors ...

Background and Aim: Orofacial granulomatosis (OFG) comprises a group of diseas es characterized by non-caseating granulomatous inflammation affecting the soft tis sues of the oral and maxillofacial region. Wiesenfeld introduced the term orofacial granulomatosis in 1985 for the first time. The precise cause of OFG is unknown; however, some theories have been suggested including allergy, infection and genetic predisposition. The clinical presentation can be highly variable, making the diagnosis difficult to es tablish. The aim of this review was to define clinical features, differential diagnosis and treatment protocols of OFG. Materials and Methods: All English articles from 1950 to 2010 in Pubmed, InterScience, ScienceDirect, Google Scholar databases were searched using the key words: orofacial granulomatosis, approach, and treatment. Persian articles were also selected from Iran Medex. Because of the relatively nonspecific clinical findings asso ciated with a variety of granulomatous diseases, the diagnosis of orofacial granuloma tous often presents a dilemma for the clinician. The most common differential diagno sis includes Crohn's disease, sarcoidosis, and infection. However, a variety of other conditions may be associated with granuloma formation. Often an extensive clinical, microscopic, and laboratory evaluation may be required to reach to definite diagnosis and proper treatment.

clinical risk factors of leukoplakia in patients with a history of oral cancer is very important, because up to a third of oral cancer patients will develop a second oral malignancy (SOM), including tumor recurrence and second primary tumors, despite vigorous follow-up. Objective. To identify clinical indices that can be used to predict SOM development at treated cancer sites. Study design. We collected prospective clinical data on 74 patients with oral squamous cell carcinoma (SCC) or carcinoma in-situ (CIS) (treated with intent to cure) being followed in the Oral Dysplasia Clinic. Results. To date, 18 patients (24%) have developed an SOM at the treated cancer site (SOM group) within an average of 21 months. Follow-up time for the 56 patients who did not develop SOM (nonSOM group) is 32 months. There is no significant difference between the 2 groups with respect to demographic characteristics (age, gender), smoking history (% of smokers, average no. of pack-years, proportion of smokers who quit after diagnosis), and features of the primary oral cancer (TNM staging, histological grading and treatment, site of lesion). The presence of leukoplakia at the previous cancer site (mostly at the floor of mouth and ventrolateral tongue) significantly predicts cancer recurrence (78% in SOM group vs. 39% in nonSOM group, P = .0063), whereas the clinical appearance of the leukoplakia (P = 1.0), size of the leukoplakia (P = .717), and treatment of the lesions (82% surgery in SOM group vs. 78% in nonSOM group) did not. Conclusions. Presence of leukoplakia, even with homogeneous clinical appearance or small size, predicted tumor recurrence. The results suggest that, in cancer patients, the appearance of a leukoplakia at a previous cancer site should immediately provoke biopsy of the lesion even when the lesion seems clinically innocuous.

OBJECTIVE: Previous studies have shown that glucosyl‐transferase enzymes (Gtfs) of Streptococcus mutans adsorbed to saliva coated hydroxyapatite (sHA) have distinct properties from the same enzymes in solution. The purpose of the present study was to determine the effects on enzyme activity of polyclonal antibodies raised to Gtfs in a soluble form and bound to sHA.MATERIALS AND METHODS: Antiserum was raised in six New Zealand White rabbits using the purified glucosyl‐transferase enzymes (Gtfs) of S. mutans, GtfB, GtfC, or GtfD as soluble antigens or adsorbed to hydroxyapatite (HA, insolubilized). The antisera were examined for their ability to react to these Gtfs and Gtf from Streptococcus sanguis (GtfSs) in Western blot formats as well as inhibit enzyme activity in solution and insolubilized.RESULTS: Antibodies raised against GtfB or GtfC detected all Gtf enzymes examined in Western blots; antibodies raised to GtfD reacted strongly to GtfD and GtfSs, poorly to GtfC, and was non‐rea...

Objective:  Previous reports have suggested that gastrointestinal (GI) diseases may cause halitosis. The aim of this study was to evaluate the relationship between upper GI conditions, especially gastroesophageal reflux disease (GERD), and halitosis.Patients and methods:  One hundred and thirty two consecutive patients complaining of upper GI symptoms were included in the study. All the patients completed a validated questionnaire that was designed to characterize and measure the severity of their symptoms. The questionnaire also contained questions about awareness and severity of oral bad breath. Following the filling of the questionnaire, the patients were physically examined and subjected to an upper GI endoscopy.Results:  The final diagnosis among the 132 patients (M/F = 70/62, mean age 45.2 years, range 20–87 years) was GERD in 72 patients (55%), Functional dyspepsia in 52 (39%), Peptic ulcer in seven patients (5%) and gastric cancer in one patient (1%). Halitosis was significa...

Primordial odontogenic tumor (POT) is composed of variably cellular myxoid connective tissue, surrounded by cuboidal to columnar odontogenic epithelium resembling the inner epithelium of the enamel organ, which often invaginates into the underlying connective tissue. The tumor is delimited at least partially by a thin fibrous capsule. It derives from the early stages of tooth development. Syndecan-1 is a heparan sulfate proteoglycan that has a physiological role in several cellular functions, including maintenance of the epithelial architecture, cell-to-cell adhesion and interaction of cells with extracellular matrix, and with diverse growth factors, stimulating cell proliferation. Ki-67 is considered the gold standard as a cell proliferation marker. The aim of this study was to examine the expression of Syndecan-1 and Ki-67 proliferation index in POT and normal tooth germs to better understand the biological behavior of this tumor. Results showed that Syndecan-1 was more intensely ...

ObjectiveThe aim of this cross‐sectional study was to evaluate the association between periodontitis and different severities of chronic kidney disease (CKD) in predialytic patients.Materials and MethodsDemographic, socioeconomic, and medical data of 139 patients from the nephrology service of one university hospital in Porto Alegre, Brazil, were obtained through interview and clinical records. Full‐mouth six‐sites per tooth periodontal examinations were performed. Associations between periodontitis, stages of CKD, and estimated glomerular filtration rate (eGFR) were estimated by multivariable models adjusted for sex, smoking, vitamin D supplementation, physical activity, and renal treatment duration. CKD was classified based on eGFR (<60 ml/min/1.73 m2) estimated by the Chronic Kidney Disease Epidemiology Collaboration equation.ResultsPatients with severe periodontitis, compared to those without severe periodontitis, had 2.8 (95% CI: 1.25–6.62) and 3.4 (95% CI: 1.27–9.09) times ...

Growth hormone (GH) has significant effects on linear bone growth, bone mass and bone metabolism. The primary role of GH supplementation in children with GH deficiency, those born small for gestational age or with other types of disorders in somatic development is to increase linear growth. However, GH therapy seems to elicit varying responses in the craniofacial region. Whereas the effects of GH administration on somatic development are well documented, comparatively little is known of its effects on the craniofacial region. The purpose of this review was to search the literature and compile results from both animal and human studies related to the impact of GH on craniofacial growth.

Oral manifestations in HIV positive children were observed in thirty-eight HIV infected children that have received care at the Special Care Dentistry Center (SCDC) of the School of Dentistry, University of Sao Paulo. Results have shown that 52.63% of the children presented at least one oral manifestation related with HIV/AIDS. Angular cheilitis occurred in 28.94%, parotid gland bilateral enlargement, pseudomembranous candidiasis and erythematous candidiasis in 18.42%, conventional gingivitis in 13.15%, herpes simplex in 5.26%, hairy leukoplakia, recurrent aphthous ulcer and condyloma acuminatum in 2.63%. Although enamel hypoplasia occurred in 23.68%, this could not be attributed specifically to HIV infection.

ObjectivesThis study aimed to analyse Epstein–Barr virus (EBV) and human cytomegalovirus (HCMV) viral loads in symptomatic and asymptomatic apical periodontitis lesions, to determine levels of TNF‐α, IL‐1β and IL‐6 in these lesions and to investigate a possible correlation between herpesviral copy numbers and levels of proinflammatory cytokines.Materials and MethodsA total of 100 samples of apical periodontitis were subjected to HCMV and EBV copy numbers analysis by nested polymerase chain reaction (PCR) and TaqMan real‐time PCR. The concentrations of TNF‐α, IL‐1β and IL‐6 were determined by ELISA method. SPSS software was used for statistical analysis.ResultsThere were no significant differences in the occurrence of EBV and HCMV between symptomatic and asymptomatic periapical lesions (p = .686, p = .879, respectively). Only 12 of 74 EBV (16.2%) and four of 54 HCMV (13.5%) nested PCR‐positive samples showed increased viral copy numbers above the limit of 125 copies/ml. There was no ...

Background: Oral lichen planus (OLP) is associated with various other systemic conditions such as hypertension, diabetes mellitus (DM). This study evaluated the prevalence of OLP in DM patients compared with non-diabetic control subjects in a meta-analysis study. Methods: In this study from January 1973 to August 2016, we searched the studies in Web of Science, Medline/PubMed, Scopus, Science direct, SID (Scientific Information Database), Cochrane and Embase databases. Strategy search was the Medical Subject Heading (MeSH) term oral lichen planus or oral mucosa combined with diabetes in PubMed and this search in other databases. Heterogeneity between estimates was evaluated by the Q and I 2 statistic. Also, publication bias was assessed through funnel plot analysis with the Kendall's and Egger's tests. Results: From 831 studies were identified with different search strategies, 11 studies met the criteria to be included in meta-analysis (11 case-control studies). The overall prevalence of OLP in 11 studies with 4937 DM patients and 3698 control subjectswas 1.5% and 0.75%, respectively. In this meta-analysis, the OR in prevalence of OLP in DM patients compared with control subjects was 1.584 (95%CI1.013-2.477; P=0.044) with a low level of heterogeneity (I 2 = 0%) that the result showed the prevalence of OLP in DM patients is significantly more than control subjects. This meta-analysis study showed an association between OLP with DM, whereas this association was no significant in previous studies, it was probably because different selecting of age, sex, type of DM, medications and criteria. Totally, the meta-analysis showed the risk of OLP in DM was higher compared with control subjects.

OBJECTIVE: Hereditary defects in tooth enamel formation, amelogenesis imperfecta (AI), can be non-syndromic or syndromic phenotype. Integrins are signaling proteins that mediate cell-cell and cell-extracellular matrix communication, and their involvement in tooth development is well known. The purposes of this study were to identify genetic cause of an AI family and molecular pathogenesis underlying defective enamel formation. MATERIALS AND METHODS: We recruited a Turkish family with isolated AI and performed mutational analyses to clarify the underlying molecular genetic etiology. RESULTS: Autozygosity mapping and exome sequencing identified a novel homozygous ITGB6 transversion mutation in exon 4 (c.517G>C, p.Gly173Arg). The glycine at this position in the middle of the bI-domain is conserved among a wide range of vertebrate orthologs and human paralogs. Clinically, the enamel was generally thin and pitted with pigmentation. Thicker enamel was noted at the cervical area of the molars. CONCLUSIONS: In this study, we identified a novel homozygous ITGB6 mutation causing isolated AI, and this advances the understanding of normal and pathologic enamel development.

Scanning Electron Microscopy (SEM) coupled with Energy Dispersive Sperctroscopy (EDS) are two analysis techniques that are widely used to study all kinds of solid samples, from inorganic to biological. They are used to determine morphological features of interest at a micron and sub-micron level as well as to study the chemical composition of the samples in terms of the amount of each element present. Although these analytical techniques are "routine work" in many research areas, it is not the case of the dental area, mainly because the lack of this equipment in the dental research institutes and in dental schools. Therefore, in this chapter we show the SEM/EDS techniques applied to human dental samples when irradiated with a laser Er:YAG to prevent caries. The intention of this work is to show step by step this analysis showing the key variables to consider when working with this type of biological samples. We explain the SEM conditions to obtain satisfactory images especially when it is important to follow a sequence of steps of a treatment in-vitro that changes the morphological structure of the teeth surface. Also, we discuss the EDS analysis to semiquantitatively determine the elements and their abundance in the dental samples.

E-cigarette derived inhaled nicotine may contribute to the pathogenesis of periodontal and pulmonary diseases in particular via lung inflammation, injurious and dysregulated repair responses. Nicotine is shown to have anti-proliferative properties and affects fibroblasts in vitro, which may interfere in tissue myofibroblast differentiation in e-cig users. This will affect the ability to heal wounds by decreasing wound contraction. In periodontics, direct exposure to evapor has been shown to produce harmful effects in periodontal ligament and gingival fibroblasts in culture. This is due to the generation of reactive oxygen species/aldehydes/carbonyls from e-cig aerosol, leading to protein carbonylation of extracellular matrix and DNA adducts/damage. A limited number of studies regarding the effects of e-cig in oral and lung health are available. However, no reports are available to directly link the deleterious effects on e-cigs, inhaled nicotine, and flavorings aerosol on oral periodontal and pulmonary health in particular to identify the risk of oral diseases by e-cigarettes and nicotine aerosols. This mini-review summarizes the recent perspectives on e-cigarettes including inhaled nicotine effects on several pathophysiological events, such as oxidative stress, DNA damage, innate host response, inflammation, cellular senescence, pro-fibrogenic and dysregulated repair, leading to lung remodeling, oral submucous fibrosis and periodontal diseases.

Acute (primary) herpetic gingivostomatitis (AHGS) is the most common form of HSV-1 infection in the oral cavity. These infections are reported mostly in children, usually localized and asymptomatic but in adult patients and immunocompromised conditions tend to be more severe, last longer, and can lead to systemic viremia. Case: A 46-year-old male patient came to RSGM FKG UI with a complaint of painful sore mouth, especially on the tongue since 5 days ago with previous history of fever. Patients feel pain around the head and while swallowing. On the examination, there were multiple ulcers at the gingival margin, interdental papillae, mucobuccofold, lateral of tongue, and also marginal gingivitis. Based on anamnesis, clinical and laboratory examination, he was diagnosed with AHGS. Case Management: He was prescribed chlorhexidine gluconate 0.2% mouthwash and multivitamin. He was advised to increase fluid intake, nutritious food, adequate rest to minimize the duration and the severity of symptoms. He was also instructed to improve the oral hygiene and encouraged to restrict direct contact to prevent transmission. Complete healing was seen in the next visit. Conclusion: Acute (primary) herpetic gingivostomatitis can be found in all age groups, including adult and elders. Clinical features of multiple ulcers and erythematous of gingival margins can be a pathognomonic sign of this condition. Primary HSV-1 infection usually manifests in the oral cavity so it is important for the dentist to recognize the disease to prevent misdiagnosis and provide appropriate management to the patient.

Acute (primary) herpetic gingivostomatitis (AHGS) is the most common form of HSV-1 infection in the oral cavity. These infections are reported mostly in children, usually localized and asymptomatic but in adult patients and immunocompromised conditions tend to be more severe, last longer, and can lead to systemic viremia. Case: A 46-year-old male patient came to RSGM FKG UI with a complaint of painful sore mouth, especially on the tongue since 5 days ago with previous history of fever. Patients feel pain around the head and while swallowing. On the examination, there were multiple ulcers at the gingival margin, interdental papillae, mucobuccofold, lateral of tongue, and also marginal gingivitis. Based on anamnesis, clinical and laboratory examination, he was diagnosed with AHGS. Case Management: He was prescribed chlorhexidine gluconate 0.2% mouthwash and multivitamin. He was advised to increase fluid intake, nutritious food, adequate rest to minimize the duration and the severity of symptoms. He was also instructed to improve the oral hygiene and encouraged to restrict direct contact to prevent transmission. Complete healing was seen in the next visit. Conclusion: Acute (primary) herpetic gingivostomatitis can be found in all age groups, including adult and elders. Clinical features of multiple ulcers and erythematous of gingival margins can be a pathognomonic sign of this condition. Primary HSV-1 infection usually manifests in the oral cavity so it is important for the dentist to recognize the disease to prevent misdiagnosis and provide appropriate management to the patient.

This article overviews the signs, symptoms, diagnosis and other facets of SRBDs (sleep related breathing disorders. Snoring and EDS (excessive day time sleepiness) are the commonest signs of OSAs (obstructive sleep apneas). OSA are known to impact cvs, respiratory & metabolic balance. A new paradigm has evolved interconnecting SRBDs& chronic periodontitis. So as to help a dentist to diagnose & manage SRBDs in dental scenario.

Dental caries Gingivitis Periodontitis Odontogenic infections Oral mucosal infections Antibiotic resistance Microbe-related oral cancer KEY POINTS Educating dentists on the epidemiologic information of dental caries, gingivitis, periodontitis, odontogenic infections, oral mucosal infections, and microbial-related oral cancer. Predominant types of microbes associated with periodontal pockets and odontogenic infections. Treatment options and prevention strategies of methicillin-resistant Staphylococcus aureus for dental and oral surgery practice. Human papilloma virus (HPV)-associated oropharyngeal cancer rates in United States population. Prevalence of HPV-associated oropharyngeal cancer in human immunodeficiency virusinfected individuals in United States.

Introduction: Osseous dysplasias are benign fibro-osseous lesions in the group of non-odontogenic tumors of the maxillae. Periodontitis is an inflammatory pathology of multifactorial origin, which destroys the attachment system of the tooth. By its main etiological factor (dental plaque) and its evolution, periodontal disease constitutes comorbidity in osseous dysplasia and exposing the patient to an infectious risk. The objective of this work was to present, through an illustrated clinical case, a periodontal therapeutic approach in a patient with periapical bone dysplasia. Case Report: A 57-year-old woman, referred by her dentist for periodontal treatment, presented to our service with the chief complaint “loose teeth and presence of inter-dental spaces”. The clinical examination and the paraclinical assessment made it possible to make the diagnosis of severe generalized chronic periodontitis associated with periapical osseous dysplasia. Periodontal treatment has been instituted. ...

Objective:  Stem cells from human exfoliated deciduous teeth (SHED) are a population of highly proliferative postnatal stem cells capable of differentiating into odontoblasts, adipocytes, neural cells, and osteo‐inductive cells. To examine whether SHED‐mediated bone regeneration can be utilized for therapeutic purposes, we used SHED to repair critical‐size calvarial defects in immunocompromised mice.Materials and methods:  We generated calvarial defects and transplanted SHED with hydroxyapatite/tricalcium phosphate as a carrier into the defect areas.Results:  SHED were able to repair the defects with substantial bone formation. Interestingly, SHED‐mediated osteogenesis failed to recruit hematopoietic marrow elements that are commonly seen in bone marrow mesenchymal stem cell‐generated bone. Furthermore, SHED were found to co‐express mesenchymal stem cell marker, CC9/MUC18/CD146, with an array of growth factor receptors such as transforming growth factor β receptor I and II, fibrobla...

Objective: This review examined the comparative efficacy and safety of antifungal agents in preventing oral candidiasis among patients on cancer treatment. Methods: We performed a systematic review and network meta-analysis based on randomised controlled trials that compared antifungal agents to placebo or other antifungal agents used in patients undergoing cancer treatment. Relative ranking of antifungal agents was evaluated with surface under the cumulative ranking (SUCRA) probability score. A total of 20 randomised controlled trials (3,215 participants) comparing 11 interventions were included. Results: Compared with placebo, clotrimazole was ranked the best agent for preventing the incidence of oral candidiasis (risk ratio (RR), 0.21 [95% CI 0.08 to 0.55]; SUCRA = 0.89). Fluconazole was ranked the safest among other antifungal agents (SUCRA = 0.80), whereas clotrimazole (SUCRA = 0.36) and amphotericin B (SUCRA = 0.18) were ranked low for safety. Amphotericin B was associated with highest risk of adverse events (RR, 3.52 [95% CI 1.27 to 9.75]). Conclusion: Clotrimazole is the most effective in preventing oral candidiasis, whereas fluconazole has the most favourable risk-benefit profile in patients undergoing cancer treatment. However, we are unable to recommend clotrimazole as the best choice to prevent oral candidiasis due to unavailability of studies comparing clotrimazole with other antifungal agents.

ObjectiveTo describe the development of a platform for image collection and annotation that resulted in a multi‐sourced international image dataset of oral lesions to facilitate the development of automated lesion classification algorithms.Materials and MethodsWe developed a web‐interface, hosted on a web server to collect oral lesions images from international partners. Further, we developed a customised annotation tool, also a web‐interface for systematic annotation of images to build a rich clinically labelled dataset. We evaluated the sensitivities comparing referral decisions through the annotation process with the clinical diagnosis of the lesions.ResultsThe image repository hosts 2474 images of oral lesions consisting of oral cancer, oral potentially malignant disorders and other oral lesions that were collected through MeMoSA® UPLOAD. Eight‐hundred images were annotated by seven oral medicine specialists on MeMoSA®ANNOTATE, to mark the lesion and to collect clinical labels. ...

Objective.-This systematic review evaluated the efficacy of immunobiologics for management of oral disease in Sjögren's syndrome. Materials and Methods.-MEDLINE®, Embase, Scopus and the Cochrane Library were searched for evidence on the use of immunobiologics for management of glandular disease in Sjögren's syndrome. Primary outcomes were xerostomia and salivary gland dysfunction, assessed

Objective.-To assess the evidence for treatment of oral involvement of pemphigus and pemphigoid with biologics. Study Design.-This systematic review used a comprehensive search strategy to identify literature describing oral involvement of pemphigus or pemphigoid treated with a biologic agent. The primary outcome measures were efficacy and safety of biologic therapy. Results.-Inclusion criteria was met by 154 studies including over 1200 patients. Treatment of pemphigus with a total of 11 unique biologic agents and 3 unique combinations of agents is reported. Five randomized controlled trials (RCT) were included in the final analysis that

Optimal management of complex autoimmune diseases requires a multidisciplinary medical team including dentists to care for lesions of the oral cavity. In this review, we discuss the presentation, prevalence, diagnosis and treatment of oral manifestations in chronic Graft-versus-Host Disease (cGVHD) which is a major late complication in patients treated by allogeneic hematopoietic stem cell transplantation. We assess current general knowledge of systemic and oral cGVHD, and present general treatment recommendations based on literature review and our clinical experience. Additionally, we review areas where the understanding of oral cGVHD could be improved by further research, and address tools with which to accomplish the long-term goal of providing better health and quality-of-life to patients with cGVHD.