Diffuse Kaposi sarcoma with oral involvement in a person diagnosed with human immunodeficiency virus/acquired immune deficiency syndrome: A case report.

Kaposi's sarcoma is a well-known multifocal vascular tumor initially described by pathologist Moritz Kaposi. This report presents the case of a 38-year-old bisexual male who consulted the infectious diseases department with non-itchy maculopapular and purpuric lesions on the skin with the involvement of the oral mucosa, suggesting a diagnosis of Kaposi's sarcoma. Biological and radiological investigations were performed. The patient was found to be human immunodeficiency virus positive with a viral load of 251.000/mL and a CD4 count of 182/mm3. In addition, secondary syphilis was diagnosed. Histopathological examinations confirmed HHV-8 KS. The patient was treated with Extencilline® and antiretroviral therapy. After 10 months of chemotherapy, a favorable outcome was noted with complete resolution of skin and oral mucosa lesions.

Role of teledentistry in enabling improved oral care outcomes.

Nowadays, the link between oral health and general health is clearly understood and supported by many global bodies, including the World Health Organisation. Yet, oral diseases remain prevalent worldwide, necessitating a practical approach. This opinion paper seeks to clarify the role of teledentistry as an adjunct for improving oral health when access to oral care services is one of the major concerns.While prevention is the best option, many people lack regular oral care access, missing vital maintenance for mouth and body health. Limited evidence-based education further hinders effective oral hygiene routines. This holds true for remote/rural populations, low socioeconomic groups and individuals with physical/mental disabilities which could make visiting a dental practice more difficult.We examined recent teledentistry publications, highlighting outcomes and suggesting evidence-backed oral health guidance via tailored teledentistry models. Two virtual roundtables were conducted with a global working group experienced in teledentistry and dental access barriers. This panel was made up of representatives from the UK, Belgium, Vietnam, Indonesia, Bangladesh, Ghana and Tunisia.We conclude that teledentistry effectively aids dental referrals, early disease detection, treatment planning, compliance and viability, particularly in regions with limited dental access. The advantage of teledentistry lies in expanding the reach of care. Telehealth and teledentistry are value-driven, yet larger, standardised research is needed to fully harness the potential of teledentistry in bridging underserved populations with oral care experts, ultimately fostering optimal oral health. Education on the capabilities and benefits of teledentistry should become part of the curriculum of future dental professionals and broadly leveraged on continuing education platforms.

Salivary biochemical parameters in people living with HIV on ART and dental caries: a cross-sectional study in Monastir, Tunisia.

BACKGROUND: Studies regarding salivary biochemical parameters and dental caries in adult people living with HIV/AIDS (PLWHA) are scanty. AIM: To investigate salivary biochemical parameters and dental caries in adult PLWHA who are on antiretroviral therapy (ART) and compare the findings with people negative for HIV infection. METHODS: The study included 50 HIV positive individuals as a test group (TG) and 50 HIV negative individuals as a control group (CG). Dental examination was performed according to WHO guidelines to assess DMFT. Digital panoramic radiographs were taken to detect additional infectious foci. Non-stimulated saliva was collected between 9 and 12 a. m for 5 min to evaluate 18 biochemical parameters and salivary flow rate (SFR). Parametric and non parametric tests were used according to data distribution. The level of significance was set at p < 0.05%. RESULTS: Patients' mean ages and M/F sex ratios for TG and CG were 38.80 ± 9.69 y/o. vs. 37.98 ± 13.47 y/o. and 3.54 vs. 2.33, respectively. Higher means of decayed teeth were recorded in TG, 4.47 ± 3.00 vs. 3.88 ± 2.81 in CG with no significant difference (p = 0.41). Means of filled teeth were significantly lower in TG 2.38 ± 2.16 vs. 4.16 ± 3.35 in CG (p = 0.01), respectively. No statistical significant difference was noted in DMFT indices between the 2 groups (8.04 ± 6.90 vs. 8.52 ± 6.24, p = 0.71). The following salivary parameters were significantly lower in TG compared to CG, respectively: mean SFR 0.44 ± 0.18 ml/min vs. 0.61 ± 0.26 ml/min; median levels of sodium and chlorides, 4 mmol/L and 13.5 mmol/L vs. 9 mmol/L and 19 mmol/L (p < 0.001) and uric acid, 103.50 mmol/L vs. 163 (p = 0.009). However, higher median levels were recorded with calcium, 1.09 mmol/L vs. 0.54 (p < 0.001) and sIgA 23 mg/dl vs. 5 mg/dl (p < 0.001). In TG, a positive correlation was found between DC, potassium, urea, and chlorides (p < 0.05). Salivary renal and hepatic biomarkers were comparable between the two groups. CONCLUSIONS: PLWHA have shown an alteration in some salivary parameters, more decayed teeth and less filled teeth. Preventive measures should be implemented to lower dental caries and enhance accessibility to oral care services. In addition, saliva can be utilized to monitor oral and general health status among PLWHA on ART.

Impact of Protracted War Crisis on Dental Students: A Comparative Multicountry Cross-sectional Study.

BACKGROUND: The impact of conflict and war crisis on dental students is poorly understood. Given the prolonged conflicts and political instability in the Arabic-speaking countries, it is crucial to investigate the effect of these conditions on dental students. This study aimed to assess the impact of protracted war on dental students by comparing the personal, university, and wider context challenges they face across war-affected and unaffected countries. METHODS: A cross-sectional study was conducted including a convenience sample of dental students from 13 universities in 12 Arabic-speaking countries. Respondents were those at entry and exit points of their undergraduate dental training. A self-administered paper questionnaire collected anonymized data on sociodemographics, and personal, university, and wider context challenges that students were facing. Multivariable Poisson regression analyses were carried out. RESULTS: The overall response rate was 64.8%. The mean age was 21.2 (standard deviation = 2.1) years, with 68% of participants being female. After adjusting for age and sex, dental students in Arabic-speaking countries affected by protracted war crisis were significantly more likely to report wider context challenges compared to their counterparts in unaffected countries (n = 2448; beta = 1.12; 95% confidence interval: 1.10-1.13; P < 0.001). DISCUSSION: Dental students in Arabic-speaking countries affected by protracted war crisis were more likely to suffer from wider context challenges such as difficulties in attendance due to the deterioration of security and lack of flexibility of teaching time to accommodate the different circumstances induced by the war crisis. Supporting dental students in areas affected by protracted war crises is needed and may include developing online dental education programs.

Quality of Life of People Living with HIV on Antiretroviral Therapy: A Cross-Sectional Study in Monastir, Tunisia.

Introduction: Despite the benefits of an efficient antiretroviral therapy (ART), HIV/AIDS epidemic still represents the most seriousaffection worldwide that negatively impacts people's quality of life (QoL). As no studies exist on QoL in Tunisia, the aim of the present work was i: to assess, based on WHOQOL-HIV BREF tool, the perception of QoL of people living with HIV (PLHIV) receiving ART and ii: to investigate the relationship between socio-demographic features, disease-related variables and QoL domains' mean scores. Methods: This cross-sectional study was conducted at the department of infectious diseases of F. Bourguiba Teaching Hospital in Monastir, Tunisia. One hundred and five participants receiving ART were involved. QoL assessment was based on the WHOQOL-HIV Bref including six domains with 29 items with scores ranged from the lowest (4) to the highest (20). Results were reported as frequencies and means (±SD). The Student's t-test for independent samples and the one-way ANOVA were performed to assess differences in QoL mean scores. Linear regression analysis was used to investigate predictors of QoL. The confidence interval was set at 95%. Results: Clients' mean age was 39.20±10.18 years old with a male to female sex ratio of 3.12. Low mean scores were seen with the environment (12.34±2.90), social relations (12.58±3.94) and psychological domains (12.76±3.31), and moderate mean scores were noted for the physical (14.11±3.52), the spiritual (14.05±3.78) and the level of independence (13.98±3.57) domains. Regression analysis showed that health status and feeling healthy were related to all QoL domains and that profession, marital status and the presence of a confident person were related to environment and spiritual domains. Conclusion: QoL of PLHIV on ART is affected. Concrete measures and strategies should be undertaken by healthcare stakeholders to improve QoL determinants.

Juvenile recurrent parotitis in a 4-year-old patient: a case report.

Juvenile recurrent parotitis (JRP) is a rare disease. It is most commonly occurring between the ages of 3 and 5 years, that classically resolves at adolescence. It is characterized by recurrent non-suppurative parotitis, with several acute inflammatory episodes per year. The parotid´s swelling tends to be unilateral, but it can occur bilaterally, with a more predominant side. The aim of this work was to present a case report that highlights signs and symptoms of this unusual condition and to stress on the value of ultrasonography as an aid to diagnosis.

Two Lip Carcinomas following Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report and Literature Review.

BACKGROUND: Secondary solid cancers are severe complications in patients who have undergone allogeneic hematopoietic stem cell transplantation (AHSCT) for malignant and nonmalignant lymphohematopoietic diseases. OBJECTIVE: The aim of this work was to report a case of two lip carcinomas following AHSCT and to warn doctors about the importance of regular check-ups of patients who have received HSCT. Observation. A 57-year-old man was referred by the dermatology department for the management of exophytic budding lesions on the lower lip evolving since 5 months. The patient was in complete remission following allogeneic bone marrow transplantation for acute myeloid leukemia since five years. Clinical and histological findings confirmed the diagnosis of a squamous cell carcinoma of the two lesions. CONCLUSION: It is of paramount importance to seek an oral squamous cell carcinoma in the presence of persistent lesions in HSCT recipients.

The Accuracy of CBCT in the Detection of Dens Invaginatus in a Tunisian Population.

OBJECTIVE: To assess the prevalence and characteristics and to classify the type of dens invaginatus (DI), in anterior teeth, basing on 200 Tunisian patients' cone-beam computed tomography. Material and Methods. A retrospective study was performed using CBCT images of 200 Tunisian patients. Maxillary and mandibular anterior teeth were evaluated for the presence and characteristics of dens invaginatus. Results were reported as frequencies, means ± SD. Statistical evaluation of the presence of DI related to gender was performed by the Pearson chi-square test. RESULTS: Dens invaginatus was observed in 42 out of 4945 examined teeth, with a prevalence of 0.85%.The anomaly affected especially maxillary lateral incisors (p ≤ 0.001). DI location was unilateral in 36% and bilateral in 64%. Type II DI was the most commonly observed (47.61%), followed by type I (30.95%) and type III (21.42%). Apical periodontitis (AP) was mostly seen in type III DI, with a periapical index (PAI) varying from 3″ to 5 E″.The maxillary lateral incisors seem to be the most affected anterior teeth. The symmetric occurrence of DI was observed with a statistically significant difference (p ≤ 0.001). CONCLUSION: Within the limits related to the present study, DI detected by CBCT is a rare anomaly that could be associated with AP. Maxillary anterior teeth should be bilaterally examined for DI in the absence of clinical symptoms.

Motivation and attitudes of Tunisian students for choosing the dental profession.

BACKGROUND: The right motivation for choosing the future profession is crucial. Focusing on students' motivation for choosing dentistry as a career is very important in order to understand the reasons behind this decision. AIM: To determine the current motivations of first year dental students and the reasons for choosing dental medicine at the university of Monastir. METHODS: This was a cross-sectional and descriptive study led among the students registered at the faculty of dental medicine during the academic year 2016/2017. Foreign students as well as those repeating the year were not included in the present study. Information on the socio-demographic profile and motivation for choosing dentistry was collected using a self-administered questionnaire written in English. RESULTS: One hundred and sixty-nine students participated in the survey, representing a 77.9% response rate. One questionnaire was excluded because of incomplete answers. The majority of the students (69.6%) were self-motivated to study dentistry. A difference according to gender (54.8% and 73% respectively among males and females, p=0.04) was noted. Over half of them (53.6%) had relatives in the medical profession. The majority of dental students (64.9%) would have preferred to study medicine. The financial motive was the first (69.6%) for choosing dentistry and the profession's prestige was the second (61.3%). The majority of the respondents indicated that the chosen profession is prestigious (57.7%) and provides good income (63.1%). CONCLUSIONS: The right motivation for choosing the future profession is very important. The focusing on students' motivation for choosing dentistry as a career is very important in order to understand the reasons behind this decision.

Outcome of Initial Endodontic Treatment Performed, by One Specialist, in 122 Tunisian Patients: A Retrospective Study.

OBJECTIVE: To assess the 6- to 24-month outcome of endodontic treatments performed, by one specialist, and to identify prognostic factors that may influence initial endodontic treatment outcome (IETO). METHODS: One hundred and forty-six patients out of 163 were included. A number of 201 teeth were endodontically treated, and an overall number of 408 canals were obturated. Of these, 165 teeth received initial endodontic treatment (IET). The criteria of the European Society of Endodontology were used to assess the IETO. The level of significance was set at p < 0.05%. RESULTS: Apical periodontitis (AP) was present in 42.5% of all cases, with a PAI >3 in 28.5%. The success rate (SR) was 91.5%. It was significantly higher in vital teeth (97%) than in devital teeth (87.7%) (p=0.04); however, a lower SR was recorded in teeth with AP (p=0.02). The lesion healed in 60 teeth (85.7%), decreased in size in 4 teeth (5.7%), and increased in size in 6 teeth (8.5%). A higher SR was obtained when a permanent restoration was present (94%) than absent (68.7%) (p=0.005). CONCLUSION: Within the limitations of the study, pulp and periapical status and permanent restoration are found to be strong outcome predictors.

Oral health effects associated with narghile use.

Background - As dentists are certain to encounter narghile-smokers amongst their patients, it is important to inform them of the possible detrimental impacts of narghile-use on oral-health. Objective - To review the literature on the oral-health effects of narghile-use. Methods - Data Sources - We made a search on pubmed until June 30th, 2015 for the chronic oral-health effects of narghile-use using the terms "oral-lesions" or "oral-cancer" or "dry-socket" or "periodontium" and 'narghile' or its different synonyms. Study selection - Only original studies and case reports or series focusing on clinical human studies were included. Sixteen studies met the selection criteria and 14 were retained. Data extraction - Data were abstracted by two authors and summarized into tables. Abstracted data, including study type and results, were analyzed jointly by four authors. Results - Data synthesis. Narghile-use has harmful effects on oral-cavity including periodontal diseases, dry-sockets and oral-mucosa lesions. Conclusion - Narghile-use is associated with a variety of adverse long-term oral-health effects that should reinforce the need for stronger regulation. Key-words - Tobacco - Oral lesions - Oral cancer - Periodontium - Dry-socket.

Acute treatment of a concomitant horizontal root fracture and luxation of the coronal fragment of the right upper central incisor: a case report.

We report a case of a horizontal intra-alveolar root fracture between the middle and apical third of the upper right central incisor associated with an extrusive luxation of the coronal fragment, in a 24-year-old male patient. Twenty minutes after being accidentally hit by a metallic device, the patient's coronal portion was repositioned and splinted under local anesthesia. After that, we lost sight of the patient. One year later, the patient showed up. The splint was lost, the tooth showed physiological mobility and responded to pulp testing. Radiographs showed healing of the horizontal fracture and normal periodontal ligament.