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Oral signs of sclerodermia and dental implications are described. The disease can be classified among the collagenopathies and its onset often involves dermatological signs prior to involving other organs and systems.
Oral manifestations were studied in 305 adult Nigerians with HIV infection. Data collected were demographic (age, sex, marital status, educational status and occupation) and clinical (mode of transmission, general manifestations and oral manifestations of HIV infection). The chi- square test was used in test for significance between variables and p values less than 0.05 were regarded as significant. A total of 47.5% patients had oral manifestations. There were 67.6% females and 32.4% males (p <0.001). The patients ranged in age from 19-70 years. Heterosexual contact with multiple sex partners was the most common mode of transmission of infection (42.9% in females and 74.5% in males, p < 0.05). Candidiasis was the most common oral manifestation (78.6% in females and 78.7% in males p >0.05). The study concluded that similar demographic and clinical characteristics were observed in the occurrence of oral manifestations of HIV infection in both male and female Nigerians.
Many systemic diseases have oral manifestations. The oral cavity might well be thought of as the window to the body because oral manifestations accompany many systemic diseases. These oral manifestations must be properly recognized if the patient is to receive appropriate diagnosis and referral for treatment. We have reviewed a series of recent articles and summarized known and newly described oral manifestations of several systemic diseases. The lesions of the oral mucosa, tongue, gingiva, dentition, periodontium, salivary glands, facial skeleton, extraoral skin and other related structures caused by some of the more common systemic diseases are highlighted.
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Oral manifestations of endocrine dysfunction often may be observed initially by the dentist. Objective manifestations, such as ophtalmos in hyperthyroidism, signs of hypersecretion of GH in acromegaly, are easily recognized. Dentists should have some knowledge of many other diseases in this category that occasionally come in our attention. The present article will discuss the effects of over and under-secretion of each endocrine gland separately, showing its influence on the development and maintenance of the health of the teeth and supporting structures. Diabetes mellitus is the most common endocrinological disease, with an incidence of 3%. Periodontitis risk is three time greater in diabetic patients than in general population and it may worsen the diabetes evolution. Periodontitis in diabetic patients needs an rapid diagnosis and treatment. We also presents the oral aspects of thyroid, parathyroid, suprarenalian, growth hormone and female hormones pathology. The incidence of these troubles is less important, but oral manifestations may reveal an endocrine disfunction.
An oral clinical and radiologic study of twenty-one patients suffering from scleroderma revealed that in one half of the patients the blood sedimentation rate and the antinuclear factor were elevated. When both these laboratory findings were present at the same time, they proved to be well correlated. The majority of the patients had limited mouth opening. Gross jawbone changes affecting the mandibular condyle, coronoid process, and posterior part of the ascending ramus occurred in four patients. There was no correlation in these four patients with regard to the bone changes and clinical and laboratory findings or to age and duration of illness. Widening of the periodontal ligament space, as measured in a meticulous manner, was a feature in all twenty-one patients and in all teeth.
Oral manifestations of HIV infection in children include oral candidiasis, herpetic stomatitis, oral hairy leukoplakia, parotid gland swelling, and other bacterial, viral and mycotic infections. The frequency and natural history of those disorders are not fully defined. The purpose of this work is to inform the oral findings in 57 HIV infected children studied at the Hospital Infantil de Mexico. All 57 patients presented nonspecific gingivitis; however it was not feasible to associate it with the HIV infection; in 28 oral candidiasis was observed, and in 3 cases herpetic stomatitis was documented. Oral candidiasis was found regardless the patient's sex, age, clinical stage, treatment, and mode of transmission of the HIV infection. It has been considered that oral candidiasis is a good marker of immunodeficiency; however, in our patients this correlation was not observed. Also, other HIV-associated oral manifestations were not observed in these cases. The severity and rapid clinical course presented by our patients, may explain both, the lack of correlation between candidiasis and immunodeficiency as well as the absence of other lesions.
BACKGROUND: Oral manifestations of chronic graft-vs.-host disease (cGVHD) can significantly affect the quality of life and severity often does not correlate with systemic manifestations. We evaluated the use of topical corticosteroids and the intraoral application of psoralen-UVA (PUVA) for treatment of oral manifestations of cGVHD. METHODS: Overall, 18 patients with oral manifestations of cGVHD were treated with either intraoral PUVA (n=7) or with topical corticosteroids (n=16). Four patients received intraoral PUVA after failure of topical steroids and one patient was treated with topical corticosteroids after failing treatment with intraoral PUVA. A glass fiber extension of an UVA source was used for manual intraoral application. Treatment with topical corticosteroids consisted of 0.1 mg/ml dexamethasone mouth wash four times a day in combination with antifungal prophylaxis. RESULTS: Four patients showed complete local response (CR) due to intraoral PUVA, two improved and one did not respond. Topical corticosteroids resulted in nine patients in CR, two improved and five did not respond. CONCLUSION: Intraoral PUVA as well as topical corticosteroids are effective in treatment of oral manifestations of oral GVHD with few side-effects and improve quality of life in patients with cGVHD.
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.
The oral manifestations of human immunodeficiency virus infection have changed drastically since the introduction of the highly active anti-retroviral therapy (HAART) in developed countries. Recent studies have documented significant reductions in morbidity and mortality rates among HIV-infected patients on HAART. This article focuses on the latest information about the oral manifestations of HIV infection and will discuss the impact of HAART.
The criteria for diagnosis of HIV-related oral lesions in adults are well established, but corresponding criteria in the pediatric population are not as well defined. The Collaborative Workgroup on the Oral Manifestations of Pediatric HIV infection reached a consensus, based upon available data, as to the presumptive and definitive criteria to diagnose the oral manifestations of HIV infection in children. Presumptive criteria refer to the clinical features of the lesions, including signs and symptoms, whereas definitive criteria require specific laboratory tests. In general, it is recommended that definitive criteria be established whenever possible. Orofacial manifestations have been divided into three groups: 1) those commonly associated with pediatric HIV infection; 2) those less commonly associated with pediatric HIV infection; and 3) those strongly associated with HIV infection but rare in children. Orofacial lesions commonly associated with pediatric HIV infection include candidiasis, herpes simplex infection, linear gingival erythema, parotid enlargement, and recurrent aphthous stomatitis. In contrast, orofacial lesions strongly associated with HIV infection but rare in children include Kaposi's sarcoma, non-Hodgkin's lymphoma, and oral hairy leukoplakia. Treatment recommendations, specific for this age group, have been included for some of the more common HIV-related orofacial manifestations.
BACKGROUND: Few studies concerning oral manifestations of aplastic anemia (AA) in children have been reported. The purpose of the authors' study was to describe oral lesions in children with AA. METHODS: The authors conducted a retrospective review using medical records of children diagnosed with AA who were treated at the Pediatric Service of the Regional Hospital of Concepción, Chile, between March 1996 and May 2001. They recorded episodes of oral mucosal lesions and assessed platelet and neutrophil counts at the time the oral lesions appeared. RESULTS: Twelve children (nine boys and three girls) were diagnosed with AA. Their age range was 3 to 12 years (median age, 7 years). Nine subjects were receiving immunosuppressive therapy, and three received only supportive care. The most common oral manifestation of the disease was hemorrhage, which developed most often in patients with platelet counts less than 25 x 10(9) cells/liter. The second and third most common oral manifestations were candidiasis and viral infection, respectively. CONCLUSIONS: Children with AA frequently exhibit oral manifestations of the condition. Prevention, early diagnosis and proper treatment of oral complications are essential to diminish morbidity and avoid a possible fatal outcome. CLINICAL IMPLICATIONS: Oral lesions can be the first manifestation of AA; consequently, dentists should be aware of these manifestations so that an early diagnosis of the disease can be made.
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To assess the prevalence and prognostic significance of the history of oral manifestations in children with human immunodeficiency virus infection (HIV), a cohort study of 73 children with vertical HIV infection was conducted. The study subjects were examined every 6 months for oral manifestations. The period prevalence of oral manifestations ranged from a low of 1% for submandibular enlargement and 3% for hairy leukoplakia to a high of 36% for xerostomia and 51% for cervical lymphadenopathy. The occurrence of oral manifestations did not change significantly over time from 1995 to 1998. Finally, the odds of occurrence of cervical lymphadenopathy, xerostomia, and oral candidiasis were greater among children in whom these manifestations had been diagnosed in the preceding 6-18 months than in children without prior diagnosis. Oral manifestations are significant clinical outcomes in pediatric vertical HIV infection, particularly for children diagnosed previously with an oral manifestation.
Oral manifestations were studied in 87 HIV-positive Thai adults (study 1), 45 HIV-positive children (study 2) and 101 HIV-positive (study 3). In study 1, 48% of patients had oral lesions; 23% had one and 13.8% two oral manifestations. Oral pseudomembranous candidiasis was found in 10.3%, erythematous candidiasis in 6.9%, and hairy leukoplakia (HL) in 11.5% of the patients. In study 2, 24.4% of children revealed one, 17.8% two and 6.6% three oral lesions; erythematous candidiasis was seen in 17.8%, and HL in 6.7% of the children. Fifteen patients (33.3%) received antiretroviral therapy. In study 3, pseudomembranous candidiasis was found in 52.5%, HL in 35.6% and necrotizing gingivo-periodontitis in 27.7%. Only 10% of patients were without oral lesions. The present three studies among HIV-infected Thai and Cambodians indicated a high prevalence of oral lesions, particularly variants of oral candidiasis such as pseudomembranous and erythematous candidiasis. Also, oral HL was a common finding, more so in patients with AIDS-associated diseases as represented by patients of study 3. Oral candidiasis and oral HL also seem to be quite prevalent in pediatric HIV-infected patients. In the absence of parameters indicating the degree of immunosuppression (CD4(+) cell counts and viral load) these oral lesions may be considered strong indicators of HIV-associated immunodeficiency.
Oral manifestations of HIV infection are sometimes the first sign of the disease and often indicate its progression to acquired immune deficiency syndrome (AIDS), thus it is important for health professionals (physicians and dentist) to possess adequate knowledge of these lesions. Improvements in antiretroviral treatments, especially with the incorporation of HAART therapy, have produced a gradual reduction in the prevalence of HIV-associated oral lesions. On the other hand, the increased life expectancy of HIV-positive patients has led to their greater presence at our clinics, implying the need for continuous updating in the diagnosis and treatment of these processes. Using the consensus classification (EEC-Clearinghouse, 1993) we reviewed the diagnostic criteria and current treatment protocols for the different HIV infection related oral lesions in both adults and children.
OBJECTIVE: To evaluate in detail the oral complications of leukemia at initial presentation. Associations between oral manifestations and laboratory data were also investigated. STUDY DESIGN: A retrospective study of 230 cases was conducted to investigate the nature and incidence of oral manifestations at initial presentation. The following data were determined for each patient: age, sex, haemogram at diagnosis (which included haemoglobin, red blood cell counts, differential white blood cell counts, platelet counts), classification of the type of leukemia's systemic symptoms and oral manifestations at the initial physical examination including the dental consultation. RESULTS: It was revealed that the type of leukemia diagnosed, except with CML, is related to the age prediliction of patients. The incidence of leukemia is higher in males than in females. The most common manifestations of leukemia are lymphadenopathy (71.4% in ALL; 45% in AML), laryngeal pain (52.7% in ALL; 37.3% in AML), gingival bleeding (43.2% in AML; 28.6% in ALL), oral ulceration, and gingival enlargement. Fever (92.2%) was the most common symptom in patients with all types of leukemia. Platelet counts from 25,000 mm-3 to 60,000 mm-3 are at sufficiently low levels to result in spontaneous bleeding. Most of the patients had WBC counts of greater than 10,000 mm-3. Only 12.6% of patients had normal WBC counts. CONCLUSIONS: It was concluded that the age prediliction and prevalence of oral manifestations are closely related to the type of leukemia.