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PubMed2003

Oral manifestations of systemic disease.

Most systemic diseases can affect the oral cavity. Some oral changes are nonspecific, whereas others directly lead to the diagnosis of a particular disorder. A systems approach is used here to catalog these oral changes. In some instances it is difficult to separate the oral manifestations of pharmacotherapy for a particular disease from that entity. The oral manifestations of pharmacotherapy are presented for selected disease processes. This article introduces the most common oral manifestations of systemic disease.

Bone Diseases↗
PubMed2006

Complex oral manifestations of an HIV-seropositive patient.

A complex manifestation of characteristic oral lesions occurring simultaneously in an HIV-seropositive patient is presented. Necrotizing ulcerative gingivitis (NUG), necrotizing ulcerative periodontitis (NUP), oral-facial herpes infection, pseudomembranous candidiasis and atypical oral ulceration are discussed. In spite of extremely low CD4+ T-cell counts of 3 x 10(6)/L and lack of anti-retroviral therapy, an AIDS patient responded favourably to standard periodontal therapy. In the follow-up period of 3 months, no recurrence of any of the oral lesions initially present occurred and no special prophylactic regimes were needed to maintain oral health. This case illustrates that appropriate management of the oral manifestations contributes significantly to improvement of the quality of life of patients in the terminal stage of HIV-AIDS.

AIDS-Related Opportunistic Infections↗
PubMed2000

Oral manifestations of primary immunological diseases.

BACKGROUND: Primary immunodeficiencies have many oral manifestations. The clinical presentation of these diseases demonstrates the roles of different immune cells for the maintenance of oral health. METHODS: The authors reviewed selected literature describing systemic and oral manifestations of the primary immunodeficiencies published between 1966 and 1999. RESULTS: The authors found that oral candidiasis and herpetic infections are seen frequently in patients with T-cell deficiencies, while patients with B-cell deficiencies are most susceptible to bacterial infections. Periodontitis and oral candidiasis are found in some, but not all, phagocyte deficiencies. CONCLUSIONS: These findings demonstrate that T cells, B cells and phagocytes all have roles in oral immunity. CLINICAL IMPLICATIONS: Acquired conditions that affect the immune system such as diabetes, alcoholism and acquired immunodeficiency syndrome, as well as certain medications, will affect oral defense mechanisms. The effects that acquired immunodeficiencies will have on oral health can be predicted from the oral manifestations of primary immunodeficiencies.

B-Lymphocytes↗
PubMed2001

The effect of antiretroviral therapy on the prevalence of oral manifestations in HIV-infected patients: a UK study.

OBJECTIVE: The purpose of this study was to compare the prevalence of oral manifestations in human immunodeficiency virus (HIV)-infected patients on monotherapy, dual therapy, or triple therapy with the prevalence of those not on antiretroviral therapy (ART). STUDY DESIGN: A cross-sectional study of the oral manifestations of HIV was carried out on 284 HIV-infected patients, 89 of whom were undergoing ART (12 on monotherapy, 41 on dual therapy, and 36 on triple therapy) and 195 who were not undergoing ART. Oral manifestations were recorded by using established presumptive clinical criteria. Chi-square statistical tests and separate bivariate analyses were conducted by using the Spearman rank correlation to describe the relationship between the prevalence of oral lesions and ART. RESULTS: The detection of oral manifestations was significantly decreased in subjects on dual therapy and subjects on triple therapy in comparison with patients on monotherapy (P <.05) and those on no ART regimen (P =.014). Oral manifestations were also significantly increased, with CD4 counts <200 cells/mm(3) and a viral load >3000 copies/mL (P <.001). CONCLUSIONS: Compared with the non-ART group, subjects on combination ART had significantly fewer HIV-related oral manifestations-probably as a result of an expression of their reconstituted immune system.

Adolescent↗
PubMed2001

Oral manifestations related to immunosuppression degree in HIV-positive children.

Oral manifestations often found in HIV-infected children are frequently the first clinical sign of the infection. This article aims to report the prevalence of oral manifestations in soft tissues and their relationship with the degree of immunosuppression in 80 HIV-infected patients (average age 6.30 +/- 3.32 years old) at the IPPMG-UFRJ. Thirty children (38%) presented some type of oral lesion and the percentage of CD4 was lower than that found in lesion-free children (p < 0.05); 22.5% presented candidiasis, 17.5% gingivitis, 8.8% enlargement of parotids, 1.3% herpes simplex and 1.3% hairy leukoplakia. Of the 30 children with lesions, 70% showed severe immunosuppression, 23.3% moderate immunosuppression and in only 6.7% was immunosuppression absent. Oral manifestations were directly related to the degree of immunosuppression and such lesions can be considered as indicators of the progression of the HIV infection in children.

AIDS-Related Opportunistic Infections↗
PubMed1993

Oral manifestations in HIV-infected patients: diagnosis and management.

Oral lesions have been observed since the beginning of the AIDS epidemic. The number of HIV-infected patients is still increasing, especially in the heterosexual population. Oral diseases in HIV-infected patients are often more difficult to diagnose because the clinical presentations may differ from the same diseases in HIV-negative patients. HIV-associated oral lesions have diagnostic, prognostic, and therapeutic impact. Approximately 10% of the HIV-infected population will have oral manifestations as a first sign of their disease. In HIV-infected men oral hairy leukoplakia and oral candidiasis are useful markers for disease progression. This article summarizes the oral manifestations and the management of oral health in persons with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Laser palliation of oral manifestations of human immunodeficiency virus infection.

BACKGROUND: The author describes the use of lasers to palliate the oral manifestations of the human immunodeficiency virus, or HIV, infection. He discusses the advantages to both patients and dentists, but he does not address the use of lasers as a modality to treat or cure HIV infection. CASE DESCRIPTION: Many oral manifestations of HIV infection can be used as markers for degree of immunosuppression. These manifestations may be treated with antibiotics, analgesics and antineoplastics, which may interact and interfere with antiviral agents used to treat the disease and possibly may exacerbate it. The author describes laser palliation of the oral manifestations of three HIV-positive patients. CLINICAL IMPLICATIONS: Dentists will see more patients living longer with HIV as the disease becomes more treatable. Lasers have been shown to be effective instruments in palliation of oral manifestations of HIV infection.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Oral manifestations of acute leukemia].

The oral manifestation of leukemias is in some cases, the first clinical sign of the disease, being its recognition by the Dentist of capital importance to the adequate orientation of patient. In this manifestation had been shown, and the function of Dentist in the control and maintenance of oral health of leukemic patients in treatment had been emphasized.

Antineoplastic Agents↗
PubMed1975

Gonorrhea--its natural history, oral manifestations, diagnosis, treatment, and prevention.

The oral cavity can be involved in a gonococcal infection, either directly or indirectly. Both types of involvement are dangerous to the patient so affected and to the other patients who follow the one so affected, as well as to the dental practitioner himself. Because we are presently in the midst of a gonorrheal epidemic, an awareness of this infectious process is definitely indicated. The clinical features, oral manifestations, diagnosis, treatment, and prevention are described in detail to assist the practitioner in the proper management of this disease.

Female↗
PubMed1991

Oral manifestations of recently described viral infections, including AIDS.

Oral viral diseases secondary to human immunodeficiency virus-1 infection are not commonly observed, except for Epstein-Barr virus infection. For the most part, members of the herpes virus group and the human papilloma viruses are involved. With the introduction of techniques like the polymerase chain reaction, the level of detection has been changed considerably. However, the application of these techniques may also result in difficulties of interpretation, such as is the case with the detection of human papilloma virus in human immunodeficiency virus-associated Kaposi's sarcoma, as recently described. The possible association of "new" viruses with well-known diseases such as Sjögren's syndrome or Paget's disease are of great interest; but the etiologic role of these particles in the disease process has yet to be determined (Scully, in Millard and Mason, eds. Perspectives on 1988 World Workshop on Oral Medicine. YearBook Publishing, 1989, pp 179-182). Oral manifestations in the course of human immunodeficiency virus disease and acquired immunodeficiency syndrome are numerous and have long been considered important for clinical diagnostic reasons. The present review is focused on viral diseases with oral manifestations associated with human immunodeficiency virus infection as well as with some "new" viral diseases that may also produce orofacial symptoms.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Hunter's syndrome and oral manifestations: a review.

Review of the literature on Hunter's syndrome and oral manifestations in pediatric dental patients including the primary and secondary systemic manifestations are presented. Numerous oral manifestations are presented as well. Based on the cases presented in the reviewed studies, little information is available on oral considerations and treatment of these children. Early restoration of the oral cavity is important prior to treatment of the disease itself.

Bone Marrow Transplantation↗
PubMed2002

[Primary oral manifestation of Crohn disease].

We present a case of primary and histologically verified oral manifestation of Crohn's disease in a 26-year-old man, with bilateral, non-healing granulomatous ulcerations in the inferior alveolobuccal sulcus, following the use of tooth protection during the practice of martial arts. Typical gastrointestinal symptoms followed approximately two months the onset debut of oral manifestations. The results of rectum biopsy, radiological bowel examinations, and blood sampling were typical of Crohn's disease. Oral manifestations and gastrointestinal symptoms responded well to standard treatment. We direct attention to this disease in patients with non-healing oral oedema, ulceration, or granulation.

Adult↗
PubMed1997

Oral manifestations of HIV infection.

The oral manifestations of HIV infection are reviewed along with evidence supporting the need for training of health-care professionals in the recognition of oral lesions. The diagnosis, prevalence, pathogenesis, and management of the most common oral lesions observed in HIV infection are described. Oral candidiasis and hairy leukoplakia are two oral lesions that have been demonstrated to have important prognostic significance. The diagnosis and management of periodontal disease in seropositive patients is emphasized, and a preventive protocol for patients at risk for periodontal pathology is recommended.

Adult↗
PubMed1996

Oral manifestations of infectious diseases.

The oral manifestations of infectious diseases is a major topic since the prevalence rate has increased, and usually poses diagnostic and therapeutic dilemmas to the oral clinician. The clinical features of the most common and important oral infectious diseases are discussed.

Actinomycosis, Cervicofacial↗
PubMed1989

[Oral manifestations of anorexia nervosa].

The oral manifestations of anorexia nervosa are presented with the help of published articles from the last fifteen years. After a brief history of the disease, the epidemiology and etiology are dealt with in detail. The clinical, systemic and oral symptoms are described. Finally, the various systemic, psychological and dental treatments are discussed.

Adolescent↗
PubMed1995

Oral manifestations of infantile systemic hyalinosis.

Oral manifestations of infantile systemic hyalinosis in a child of Asian origin are presented. Infantile systemic hyalinosis is a rare fatal condition with probably an autosomal recessive mode of inheritance. The symptoms become apparent soon after birth and death usually occurs before the age of two years. The systemic features are essentially due to widespread deposition of hyaline material in tissues. These include thickening and nodularity of skin, growth failure, joint contractures, osteoporosis, diarrhoea and recurrent infections. The oral changes in the case reported here included thickening of the oral mucosa, extensive overgrowth of gingival tissue, osteoporosis, marked curvature of the dental roots, and replacement of periodontal ligament by hyaline fibrous material. Immunohistochemistry revealed widespread presence of Type VI collagen in the connective tissue with particularly intense staining in the hyaline material.

Child, Preschool↗
PubMed1983

The oral manifestations of 4p- syndrome.

The oral manifestations of 80 reported cases of 4p- syndrome are analyzed and a new case is reported. Results indicate that the common pattern of cheilognathopharyngeal disorders in 4p- syndrome is an isolated cleft palate or a high-arched palate with micrognathia. Cases of cleft lip are only about 10% of the total. The significance of other reported aberrant phenomena cannot yet be estimated.

Abnormalities, Multiple↗
PubMed2000

Oral manifestations and dental status in paediatric HIV infection.

OBJECTIVE: To describe the incidence and prevalence of oral manifestations of HIV infection in a population of perinatally infected children. DESIGN: Retrospective and prospective study of a cohort of perinatally HIV-infected children. SETTING: Community hospital and community-based paediatric clinic. SAMPLE AND METHODS: Forty perinatally HIV-infected children with a median age of 12 months were eligible and selected for the study, which included a medical chart review from birth and prospective follow-up. Each child was examined quarterly for oral manifestations, tooth eruption, and for 27 children, caries and periodontal status. RESULTS: The incidence of pseudomembranous candidiasis was 43% (95% CI, 27-58%) within 6 months of birth. Oral candidiasis (defined as pseudomembranous or erythematous) was positively associated with low CD4 counts and the occurrence of plaque. Children with low CD4 counts were also found to have fewer teeth than children with high CD4 counts, after adjusting for age. CONCLUSIONS: Oral manifestations are common in paediatric HIV infection and are possible predictors of HIV disease progression. Primary care of HIV-infected children should include periodic oral examinations to monitor their HIV disease progression and to alleviate symptoms associated with oral opportunistic infections.

AIDS-Related Opportunistic Infections↗