[Abnormalities of the buccal frena].
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Congenital Abnormalities↗
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Mouth breathing and its relationship to malocclusion and facial abnormalities.
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Malocclusion↗
[Burning mouth].
BACKGROUND: The complaint of burning mouth is fairly common. Epidemiological studies suggest a prevalence of around 15% in postmenopausal women and between 0,7 and 7,9% for the general population. PURPOSE: The purpose of this article is to present a review of the literature on epidemiology, clinical symptoms, etiology, diagnosis, treatment and prognosis of burning mouth and burning mouth syndrome. RESULTS AND CONCLUSIONS: Potential causal factors have been extensively studied and reviewed, suggesting a multifactorial aetiology, that apparently includes local, systemic and psychogenic factors. However, reports of their relative importance are conflicting. Consequently this lack of evidence is reflected in inconsistent guidelines for diagnosis and treatment. Most of the authors emphasize the importance of history taking and clinical intraoral examination for diagnosis. The symptom of burning mouth associated with clinical mucosal abnormality has to be differentiated from burning mouth syndrome (BMS), a condition in which no mucosal abnormality is evident on examination. Whereas the symptom of burning mouth associated with clinical mucosal signs is described to be often manageable by eliminating possible causal factors, the background of most of the proposed treatments for BMS is empiric or even purely anecdotal. Only a few randomised controlled studies have been performed on treatment outcome. Their differing results are presented in a short overview.
Burning Mouth Syndrome↗
MOUTH BREATHING AS THE CAUSE OF MALOCCLUSION AND OTHER FACIAL ABNORMALITIES.
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Humans↗
A new dominant branchiogenic-deafness syndrome with internal auditory canal hypoplasia and abnormal extremities.
Two sibs from one Lebanese family presented with congenital hearing loss, meatal atresia, preauricular tags and pits, branchial cysts or fistulae, strabismus, difficulty in opening the mouth wide enough, abnormal fifth fingers, somewhat short stature, and learning disability and patchy skin depigmentation in one. Temporal bone abnormalities identified on computed tomography included atresia of the external auditory canal with reduction in size of the middle ear, malformed ossicles, and unilateral internal auditory canal hypoplasia. Hand radiographs showed pointed phalanges of the 5th fingers with osseous erosions. Their father, his sister, and his half-brother had unilateral auricular pits and/or branchial cysts. Results of all laboratory investigations including sequencing of the EYA1 gene were normal. Differential diagnosis is discussed and the possibility of the report of a new autosomal dominant type of branchiogenic-deafness syndrome with variable expressivity is raised.
Abnormalities, Multiple↗
A new arthrogryposis syndrome with facial and limb anomalies.
A new familial syndrome of facial and limb anomalies was shown in a 4-month-old girl. Small mouth and jaw with limited jaw movement were seen in infancy, with growth to relatively normal size and movement in adulthood, but with a persistent, deep, horizontal depression just above the chin. Mild short stature and microcephaly as well as large ears with lack of the anthelix were present in family members. Severe flexion contractures of the hands and feet were present and led to subluxation of fingers and club feet in the most severely affect child. Marked variability among family members was seen, but a dominant inheritance seems likely.
Abnormalities, Multiple↗
Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases.
The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and 18 with spondyloarthropathy (SPA). They were clinically examined, and panoramic tomography, lateral panoramic radiography and MRI of the TMJ were performed. MRI showed reduced articular cartilage in 25% (4/16) of RA, 0% (0/15) of MCTD, 17% (3/18) of AS and 17% (3/18) of SPA patients. Condylar changes included erosion, osteophytes and abnormal shape. Disc alterations included perforation, abnormal anterior position and decreased movement. These abnormalities were most frequent in RA patients, and least frequent in MCTD and SPA patients. Crepitation and reduced maximum opening of the mouth correlated with abnormalities of the disc and articular cartilage as shown by MRI. Severe condylar erosion in panoramic tomograms significantly correlated with MRI findings of condylar erosion (P<0.01), diminished thickness of condylar cartilage, abnormal condylar shape, and abnormal shape of the temporal surface of the TMJ (P< or =0.001). The presence of crepitation, limited mandibular movement and/or pain on movement of the jaw often indicated structural damage to the TMJ. Panoramic radiographs provide an alternative method to MRI but, to obtain a more detailed anatomic picture, MRI is recommended for patients with acute unexplained pain or as part of preoperative work up. A panoramic recording is not indicated when MRI is planned.
Adult↗
Abnormal muscle of the floor of the mouth.
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Humans↗
Lip component of burning mouth syndrome.
To our knowledge there has been no previous study of factors specifically involved in the pathogenesis of patients who complain of burning sensation of the lips when the lips appear clinically normal. The complaint is akin to patients who complain of a burning sensation of the mouth when it appears clinically normal, a condition known as burning mouth syndrome. This study therefore studied precipitating factors in patients with burning mouth syndrome who reported lip involvement. Previous studies have shown that the lips are the third most common site reported as involved in patients who have burning mouth syndrome. Indeed patients with burning mouth syndrome often report multiple oral site involvement. To investigate the precipitating factors involved in the lip component of burning mouth syndrome, we studied 104 patients who reported the lips as a site affected by the condition from a total population of 312 patients with burning mouth syndrome. Hematologic, biochemical, and microbiologic parameters were studied in these patients. Sialometry, patch testing, psychological testing, and examination of denture status as well as questioning of parafunctional habits were also undertaken. No clear differences were noted in relationship to the frequency of abnormalities in burning mouth syndrome alone or burning mouth syndrome with lip involvement suggesting that similar precipitating factors apply. The precipitating factors in patients with lip involvement were found to be the same as burning mouth syndrome in general. Treatment of patients with lip involvement alone in burning mouth syndrome or lip involvement in burning mouth syndrome in conjunction with other intraoral sites gave an equally good response.(ABSTRACT TRUNCATED AT 250 WORDS)
Bruxism↗
Malocclusion associated with abnormal posture.
Growth and development of maxillofacial morphology and oral function are closely interrelated. Oral function is comprised of articulation, swallowing, and chewing. Malocclusion may be caused by abnormal functions such as mouth breathing, tongue thrust swallowing, and unilateral chewing and by abnormal postures of oral circumferential muscles such as forward tongue thrust, tongue biting, and low tongue at rest. Forces from unintentional and habitual behaviors constantly acting on the maxillofacial and alveolar regions can cause the bony structures to generally deform, resulting in jaw deformity and malocclusion. Oral function also plays a vital role in maintaining body posture. In this study, clinical observations of oral postures examined maxillary protrusion and open bite, anterior crossbite and facial asymmetry. The unstable forces induced by abnormal posture were correlated with the varieties of malocclusion. Morphology, function, and posture were shown to be closely interrelated and to influence each other.
Child↗
Oral disease in terminally ill cancer patients with xerostomia.
Xerostomia is common among patients with advanced cancer and is likely to contribute to oral disease. This study determined the prevalence of oral signs and symptoms among a group of 70 terminally ill cancer patients [25 male, 45 female; age range 42-88 (mean 66) years] complaining of oral dryness, and examined the associated oral microflora. Imprint cultures for yeasts, coliforms and staphylococci were collected from the tongue and, in denture wearers, from the plate and denture fitting surface. A swab was collected for culture of herpes simplex virus. 68 patients (97%) complained of oral dryness during the day and 59 patients (84%) complained of oral dryness at night. Oral soreness was reported by 22 patients (31%). 46 patients (66%) had difficulty talking and 36 (51%) reported difficulty eating. Of the 56 denture wearers, 40% complained of denture problems. On examination, 63 (90%) of the patients had clinically dry mouths. Oral mucosal abnormalities were detected in 45 patients (65%), most commonly erythema (20%), coated tongue (20%), atrophic glossitis (17%), angular cheilitis (11%) and pseudomembraneous candidosis (9%). 47 (67%) of the patients carried yeasts, 18 (26%) were carriers of Staphylococcus aureus and 13 (19%) carried coliforms. Herpes simplex virus was isolated from 5 patients, of whom 2 had herpetic stomatitis. Oral complications and abnormalities of the oral microflora can be detected among significant numbers of terminally ill cancer patients with xerostomia.
Adult↗
MR grading of temporomandibular joint fluid: association with disk displacement categories, condyle marrow abnormalities and pain.
The purpose of this study was to investigate temporomandibular joint (TMJ) effusion on magnetic resonance (MR) images, and its association with specific categories of disk displacement, bone marrow abnormalities and pain. From a series of 523 consecutive TMJ MR imaging studies of patients referred to imaging because of pain and dysfunction, those with TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers, were analysed. The selected patients were reassessed and the amount of TMJ fluid was graded bilaterally according to a set of reference films. Other parameters recorded included disk displacement categories and condyle marrow abnormalities. Pain self-records were obtained from the patients immediately before MR imaging. The association between the recorded parameters and TMJ pain was analysed with t-tests and regression analysis. Of the 523 patients, 70 (13%) had TMJ effusion, which was unilateral in 61%. Only 9% of the 70 patients had effusion bilaterally, whereas bilateral disk displacement was found in 80%. In the 76 joints with effusion, 83% showed two specific categories of disk displacement at closed mouth. Condyle marrow abnormalities were found in 31% of the 70 patients, mostly on one side, and in 24% of the 76 joints. An in-patient regression analysis of the side difference in TMJ pain showed that effusion and condyle marrow abnormalities were significant pain-increasing factors. In conclusion, patients with TMJ effusion represent a subgroup with pain and dysfunction with more severe intra-articular pathology than those with disk displacement but no other joint abnormalities.
Adolescent↗
Clinical evaluation of taste.
Partial loss of taste function can take a variety of forms. Losses can be specific to one taste quality or to one tongue locus. In addition, the shapes of psychophysical functions can be altered so that taste intensity no longer grows normally with concentration. Magnitude matching, an efficient psychophysical scaling method (based on magnitude estimation of stimuli from two sensory continua), can provide a relatively quick assessment of a patient's ability to taste the four taste qualities--sweet, salty, sour, and bitter. When taste intensity and loudness are scaled in the same session, a person with normal hearing who has taste loss will match taste intensities to abnormally weak sounds. Spatial losses are detected by placing pieces of filter paper soaked in taste solutions on specific tongue loci. Dysgeusia, the presence of a chronic taste in the mouth, can result from abnormal substances in the mouth (e.g., via saliva or from poor oral hygiene) or can reflect disorders of the central nervous system.
Humans↗
A new case of the trisomy 9P syndrome. Report of a patient with unusual chromosome findings (46,XX/47,XX, + i (9p) and a peculiar congenital heart defect.
A girl is described for whom an unusual chromosome constitution was found and who had a peculiar congenital heart defect. The girl showed the main clinical features of the trisomy 9p syndrome, such as psychomotor retardation, microcephaly and brachycephaly, enophthalmos, antimongoloid eye slant, hypertelorism, abnormal ears, a globulous nose, downward slanting mouth, hypoplasia of phalanges and abnormal palmar creases. In addition, the girl had an incomplete harelip, a cleft palate and a peculiar congenital heart defect, a ventricular septal defect with pulmonary valve stenosis and a marked hypoplasia of the pulmonary trunk, including the bifurcation. Chromosome analysis revealed a mosaicism with normal and abnormal mitoses (47 chromosomes). The extra chromosome was a metacentric E16-like chromosome, which on the basis of the G, R, Q and Giemsa-11-banding could be identified as an isochromosome of the short arm of chromosome 9 (46,XX/47,XX, +i (9) (pter leads to cen leads to pter)). The patient consequently had a partial tetrasomy of the short arm of chromosome 9.
Abnormalities, Multiple↗
Incidence of physician-diagnosed primary Sjögren syndrome in residents of Olmsted County, Minnesota.
OBJECTIVES: To estimate the incidence of physician-diagnosed primary Sjögren syndrome (SS) among residents of Olmsted County, Minnesota, in the setting of usual medical care and to determine how often objective criteria are available in the medical records of such patients. PATIENTS AND METHODS: We reviewed all medical records of residents in Olmsted County with physician-diagnosed SS from 1976 to 1992 to determine whether they had undergone objective tests for keratoconjunctivitis sicca, salivary dysfunction, or serologic abnormality. Confounding illnesses were excluded. To identify misclassified cases, all records from patients with xerostomia or keratoconjunctivitis sicca were also reviewed. The average annual SS incidence rates were calculated by considering the entire population to be at risk. RESULTS: Of 75 patients with onset of SS during the study period, 53 had primary SS. All patients were white, 51 (96.2%) were women, and the mean +/- SD age was 59+/-15.8 years. The age- and sex-adjusted annual incidence was 3.9 per 100,000 population (95% confidence interval, 2.8-4.9) for patients with primary SS. Eleven patients (20.8%) with physician-diagnosed SS had no documentation of objective eye, mouth, or laboratory abnormalities. Objective evaluations performed most frequently were laboratory and ocular tests and least often were investigations of xerostomia. CONCLUSIONS: The average annual incidence rate for physician-diagnosed primary SS in Olmsted County is about 4 cases per 100,000 population. These data probably underestimate the true incidence because they are based on usual medical care of patients with SS in a community setting, rather than on a case-detection survey. In the future, a true incidence may be possible with a higher index of suspicion, greater attention to objective tests, and increased awareness of new classification criteria for SS. For epidemiological studies based on existing data, application of current criteria may not be feasible, and consensus on criteria for such studies would be useful.
Adult↗
Hypoglossia-hypodactylia (Hanhart's) syndrome with sensorineural hearing loss.
Hanhart's syndrome, an uncommon disorder characterized by severe micrognathia, hypoglossia and absence of the extremities, belongs to the oromandibular-limb hypogenesis group of diseases. Our patient was admitted with the complaints of abnormality of the mouth and absence of the upper extremities. Physical examination revealed severe micrognathia, a small tongue adhered to the base of the mouth, absence of bone, muscle and skin tissue at the lower edge of the right humerus and at the middle zone of the left ulna and radius. According to these findings, the diagnosis of hypoglossia-hypodactylia (Hanhart's) syndrome was made. At the age of 1 1/2 years, tympanometric examination revealed conductive hearing loss due to dysfunction of the eustachian tube. Auditory brainstem responses also revealed bilateral severe sensorineural hearing loss. A literature search revealed two cases of Hanhart's syndrome with conductive hearing loss, but no report of sensorineural hearing loss as part of this entity. Therefore, we present this case of Hanhart's syndrome with severe sensorineural hearing loss.
Abnormalities, Multiple↗
Craniometaphyseal dysplasia. Report of a case.
Craniometaphyseal dysplasia, often referred to as Pyle's disease, is a hereditary disease involving the expansion of the metaphyses of the long bones, giving the appearance of an Erlenmeyer flask. There is diffuse hyperostosis of the entire cranial vault, along with absence or decreased development of the paranasal sinuses. In the case presented here the mouth demonstrated an abnormality wide maxilla with a slight palatal vault. Genetically, this appeared to be a dmoninant form of dysplasia.
Bone Diseases, Developmental↗
Recurrent genital ulcers in an adolescent as a manifestation of Behçet's disease.
An adolescent with a history of recurrent genital ulcers had a negative evaluation for sexually transmitted diseases. A clinical suspicion of Behçet's disease was supported by a biopsy of one lesion. The condition may be more frequent than suspected as the signs (arthritis, mouth ulcers, neurologic abnormalities) may be so mild or separate in time that they could be easily overlooked.
Adolescent↗