Excision of oral pyogenic granuloma in a diabetic patient with 940nm diode laser.

Pyogenic granuloma (PG) is a common, acquired, benign vascular reactive proliferation that typically develops as a small erythematous papule on the skin or oral mucosal surface. Oral PG is often caused by constant low-grade infection, minor trauma, poor oral hygiene, and due to hormonal disturbances. It shows a striking predilection for the gingiva. Lesions can be excised surgically with removal of the underlying causes. However, this modality may be associated with unnecessary complications. Recently, different laser wavelengths have been used for removal of oral PG. Herein, we present a case of gingival PG in a 51-year-old uncontrolled diabetic woman. The lesion was excised successfully with a 940nm diode laser as a conservative and non-stressful procedure that resulted in a bloodless surgical and post-surgical course with rapid healing, minimal pain, swelling, and scarring. The 940nm Diode laser offers a new efficient noninvasive tool for excising oral soft tissue lesions, especially in medically compromised patients.

Oral health considerations in cancer survivors.

Over the past decade, advances in cancer treatment have helped in prolonging the survival rate for cancer patients. However, the patients who undergo treatment for cancer are potentially at high-risk for developing a number of oral complications, including oral mucositis, infections, hyposalivation, dental caries, and jaw osteonecrosis. Cancer survivors may remain at life-long risk of developing oral complications, and therefore require long-term dental follow-up, well after completion of cancer therapy. Patients should typically undergo thorough oral examination prior to initiation of therapy, during and after therapy to identify any active infection. In addition, and in order to maintain adequate oral health throughout treatment, patients should continue normal oral hygiene with tooth brushing and interproximal cleaning. The aim of this review is to discuss potential oral complications as a result of cancer therapy, and the certain precautions we should be aware of these patients.

Characterization of Yemeni patients treated for oral and pharyngeal cancers in Saudi Arabia.

OBJECTIVE: To determine the relative frequency and rank of oral cancer (OC) and pharyngeal cancer (PC) among Yemeni cancer patients who were treated and registered in the Kingdom of Saudi Arabia (KSA) over 14 years, and to characterize these patients by different grouping factors. METHODS: In this retrospective study, the Saudi Cancer Registry, Riyadh, KSA officially provided the data regarding all Yemeni patients registered between 1994 and 2007. These data were reclassified and analyzed to present the cancer distribution by the main sites adopted by Globocan 2008. The OC and PC patients were statistically described and analyzed according to the demographic data and tumor details. This study was conducted at the Oral Medicine, Medically Compromised and Research Clinic, Department of Dentistry, Riyadh Military Hospital, Saudi Arabia between January and April 2011. RESULTS: There were 5862 Yemenis registered with malignancies. The OC ranked the eighth most common malignancy (215, 3.7%) with 1.65:1 male to female ratio, whereas PC ranked the seventh (245, 4.2%) with 2.06:1 male to female ratio. The most affected oral sub-site was the tongue (91, 42.3%) while the nasopharynx accounted for 79% (194) of PC. The PC patients were significantly younger than those with OC (45.88+/-16.72 versus 55.6+/-15.75). The squamous cell carcinoma was the most frequent morphological type (289, 63.5%) but significantly more frequent in OC. Approximately 56% (255 patients) were diagnosed at advanced stage, however, significantly more frequent in PC (155, 64.6%). CONCLUSION: The relative frequencies of oral and pharyngeal cancers in Yemen are quite high. The demographic and tumor characteristics of these cancers are obviously different.

Physicians' awareness of bisphosphonates-related osteonecrosis of the jaw.

OBJECTIVE: To assess the awareness and knowledge of physicians and dentists regarding bisphosphonates related osteonecrosis of the jaw (BRONJ). METHODS: A cross-sectional descriptive study was carried out in the Department of Dentistry, Riyadh Military Hospital, Kingdom of Saudi Arabia from June to September 2010. Data were collected through a self-administered questionnaire distributed among a sample of physicians and dentists at the hospital. RESULTS: A total of 222 valid completed responses were obtained (response rate: 82.2%). Less than one-third of the participants (31.5%) were aware of osteonecrosis of the jaw, while slightly more than half of them were treating patients with bisphosphonates (BP). None of the physicians had a correct response in all 4 knowledge questions. There were statistically significant associations between knowledge and qualification (p=0.019), years of experience (p=0.002), and specialty (p=0.034). CONCLUSION: We found that physicians and dentists have low awareness and deficient knowledge regarding BRONJ, although most of them do prescribe BP to their patients. Therefore, intervention to raise awareness and knowledge among healthcare providers is needed.