Thermal Imaging of the Tongue Surface as a Predictive Method in the Diagnosis of Type 2 Diabetes Mellitus.

Over the past 20 years, the high prevalence of diabetes has become a global public health problem. BACKGROUND: The objective of this study was to develop a non-invasive screening method for diabetes which will enable the detection of the disease at an early stage. METHODS: This study included 63 adult patients of both sexes: 30 patients with type 2 diabetes (t2DM) and 33 healthy volunteers. The temperature distribution on the tongue's dorsum and apex surface was studied in patients after a mouth-cooling procedure had been introduced. The study used an FLIR T540 thermal imaging camera. An analysis of the correlation between the ∆T values of the tongue dorsum and apex and the glycated hemoglobin (HbA1c) level was performed. RESULTS: The median of the average dorsum temperature measured 10 min after mouth rinsing was almost 0.8 [°C] lower than for healthy individuals. Also, studies showed a positive average correlation with a Pearson coefficient of r = 0.46 between the HbA1c level and the ∆T of the tongue dorsum. CONCLUSIONS: Tongue temperature measured using the IRT showed a correlation with standard biochemical parameters; it may also differentiate patients and constitute a specific screening method for patients with t2DM.

Bony Canal Method of Dexamethasone Injections in Aggressive Form of Central Giant Cell Granuloma-Case Series.

Central Giant Cell Granuloma constitutes approximately 7% of benign tumors of the jaws. The aggressive form of CGCG clinically behaves like a classic semi-malignant neoplasm. In the literature, the suggested method of treatment of aggressive forms of CGCG is curettage or resection with the margin of 0.5 cm. Surgical treatment, especially in the developmental age, entails disturbances in the growth and differentiation of tissues and deforms and disturbs the functioning of the stomatognathic system. Alternative treatment methods of the CGCG presented in this article lead to the patient avoiding a mutilating procedure and improve their quality of life. The aim was to present alternative method of treatment of aggressive forms of Central Giant Cell Lesion of the jaws-injections of dexamethasone into the tumor mass through drilled bony canals. Here, we present the three cases of aggressive forms of CGCG of jaws treated with dexamethasone injections into the tumor mass. Two cases resulted in regression of the tumor, which was confirmed in histologic evaluation after remodeling surgery. Those two patients were uneventful and showed no signs of tumor recurrence at 8 and 9 years of thorough follow-up, respectively. The third patient was qualified for the mandible resection due to the enlargement of the lesion and destruction of the cortical bone. According to our observations, if the proper patient discipline, and thorough, careful clinical and radiological examinations are provided, the dexamethasone injections could be a recommended method of treatment of intraosseous giant cell granuloma. The indication is restricted to the cases with preserved bony borders despite deformation. Additionally, leaving vital teeth in the lesion is also possible.

Comparison of Physicochemical, Mechanical, and (Micro-)Biological Properties of Sintered Scaffolds Based on Natural- and Synthetic Hydroxyapatite Supplemented with Selected Dopants.

The specific combinations of materials and dopants presented in this work have not been previously described. The main goal of the presented work was to prepare and compare the different properties of newly developed composite materials manufactured by sintering. The synthetic- (SHAP) or natural- (NHAP) hydroxyapatite serves as a matrix and was doped with: (i) organic: multiwalled carbon nanotubes (MWCNT), fullerenes C60, (ii) inorganic: Cu nanowires. Research undertaken was aimed at seeking novel candidates for bone replacement biomaterials based on hydroxyapatite-the main inorganic component of bone, because bone reconstructive surgery is currently mostly carried out with the use of autografts; titanium or other non-hydroxyapatite -based materials. The physicomechanical properties of the developed biomaterials were tested by Scanning Electron Microscopy (SEM), Dielectric Spectroscopy (BSD), Nuclear Magnetic Resonance (NMR), and Differential Scanning Calorimetry (DSC), as well as microhardness using Vickers method. The results showed that despite obtaining porous sinters. The highest microhardness was achieved for composite materials based on NHAP. Based on NMR spectroscopy, residue organic substances could be observed in NHAP composites, probably due to the organic structures that make up the tooth. Microbiology investigations showed that the selected samples exhibit bacteriostatic properties against Gram-positive reference bacterial strain S. epidermidis (ATCC 12228); however, the property was much less pronounced against Gram-negative reference strain E. coli (ATCC 25922). Both NHAP and SHAP, as well as their doped derivates, displayed in good general compatibility, with the exception of Cu-nanowire doped derivates.

[The role of selected cytokines in the serum of patients with oral cancer as a cancer marker. preliminary report].

Generally, oral squamous cell carcinoma is characterized by a high degree of local invasion and high frequency of cervical lymph node metastases. The invasion and metastasis process consists of many interconnected host and tumor relationships. The prognosis depends on their early diagnosis and appropriate treatment, which is why it is important to capture the initial symptoms of cancer. The advancement of the cancer process at the moment of reporting the patient to treatment in most cases does not give a chance to obtain satisfactory results, despite the introduction of modern methods and techniques to fight the disease. The severity of symptoms in the early stage of the disease, significant invasiveness and the ability to metastasis to regional lymph nodes prompts for the search for sensitive markers that could be used in screening patients in groups with a high risk of OSCC incidence.

The Influence of Toothpaste Containing Australian Melaleuca alternifolia Oil and Ethanolic Extract of Polish Propolis on Oral Hygiene and Microbiome in Patients Requiring Conservative Procedures.

The study was based on the use of a toothpaste with antiphlogistic activity, containing Australian Melaleuca alternifolia oil (tea tree oil-TTO) and ethanolic extract of Polish propolis (EEP). Fifty-one patients with varying conditions of the gingiva were divided into two groups. The study group received the toothpaste with TTO and EEP, while the control group received the same toothpaste but without TTO and EEP. Approximal plaque index (API), simplified oral hygiene index (OHI-s) and modified sulcus bleeding index (mSBI) were assessed in three subsequent stages. During each examination, swabs were employed for microbiological inoculation. During the period of use of toothpastes with TTO and EEP, a significant reduction of the API was observed, as assessed upon the control visit after 7 days and after 28 days, compared to baseline. A statistically significant reduction of mSBI was observed after 7 and 28 days of using the toothpaste with TTO and EEP, as compared to the value upon the initial visit. Statistically significant differences in the OHI-s value were observed in the study group, which was using the active toothpaste. The use of a toothpaste containing TTO and EEP helps to maintain microbiome balance. The observed stabilisation of bacterial microflora confirms the beneficial activity of toothpaste containing EEP and TTO compared to the control group, where the lack of these substances contributed to the emergence of qualitative and quantitative changes in oral microbiome.

The odontogenic-related microinflammation in patients with chronic kidney disease.

OBJECTIVES: This study estimated plasma levels of interleukin IL-1ß, IL-6, tumour necrosis factor-α (TNF-α), interferon-γ (INF-γ) in chronic kidney disease (CKD) patients with a single odontogenic pathology. MATERIAL AND METHODS: Forty-nine selected adult CKD patients with single odontogenic pathology based on clinical and X-ray examination: patients after proper root canal treatment, without periapical lesions (n = 12), with pulp necrosis (n = 7), with asymptomatic periapical lesions (n = 22), with periodontal disease (n = 8), and 14 with healthy teeth were enrolled. Patients with coexisting different dental pathologies and the evidence of other infection were excluded. In all patients plasma concentrations of CRP, IL-1ß, IL-6, TNF-α, and INF-γ were measured. RESULTS: Patients with periodontitis were characterized by increased concentrations of IL-6 and TNF-α. Those with pulp necrosis had significantly more frequently serum CRP level over 2 mg/L and presented significantly elevated IL-6, but decreased TNF-α concentration than in the subjects with healthy teeth. In patients with periapical lesions and patients after root canal therapy, the concentrations of cytokines did not indicate for the systemic inflammation. CONCLUSIONS: Periodontitis and pulp necrosis are important sources of systemic microinflammation in CKD patients. Plasma concentrations of IL-6 and TNF-α appear to be more sensitive markers of odontogenic inflammation in CKD patients than CRP.

Registration of thermal images of dead teeth to identify odontogenic infection foci.

Infrared thermal imaging (IRT) remotely and contactless maps the temperature on the examined surface, recording the distribution of infrared radiation emitted by each body whose temperature is higher than absolute zero. The aim of the study was to evaluate the usefulness of thermography in the assessment of asymptomatic infection foci in patients with high systemic infection. The 150 cases diagnosed based on roentgenograms, divided into 6 groups of diagnosed odontogenic lesions, along with a control group. Thermal imaging was performed with a FLIR Systems T1020 thermal camera. Thermal image analysis was performed using ThermaCAM Researcher Pro 2.10, MS Office Excel 2022 and Statistica 10. The periapical areas of selected dead teeth were selected as areas of interest. The Mann Whitney's U test showed statistically significant (p < 0.001) differences in average temperature between each patient's and healthy group. Depper's analysis showed statistical significance also between the ZM and BZ groups (p = 0.004). Moreover, obtained results may also suggest that thermal imaging can be useful in identify odontogenic infection foci. The thermal asymmetry of periapical tissues of teeth differentiates dead from living teeth, as well as individual pathologies related to the process of gangrenous pulp decay. Thermographic mapping is a promising diagnostic technique that can detect asymptomatic inflammations that carry the risk of infection of the entire body.

Influence of Method of Treatment of Mandibular Condylar Fractures on Range of Articular Path Measured by Cadiax Device.

Background/Objectives: The aim of this study was to evaluate the function of the treated temporomandibular joint based on the analysis of the image of the articular path using the Cadiax device depending on the choice of treatment method for unilateral condylar fracture of the mandible. Methods: Sixty patients who were treated for condylar fractures of the mandible at the Maxil-lofacial Surgery Department in Katowice were qualified for the analysis of the range of movements of the mandibular heads using the Cadiax device. From the group of patients who suffered fractures of the mandible, including condylar processes, patients were finally qualified for the measurement of the articular path of the injured and healthy joint according to strict criteria. Results: The condylar examination was performed in 20 patients who had conservative condylar fracture treatment and 40 patients who underwent various surgeries in the course of a single condylar fracture. The control group consisted of 20 patients whose mean values for the articular pathway measured for both sides were 12.73 and 12.69 and fell within the standard developed for healthy joints tested with the Cadiax device. Conclusions: We have achieved an almost ideal treatment for condylar fractures. We are also beginning to notice the need for rehabilitation of patients after this type of surgery.

Thermal Imaging of Tongue Surface as a Prognostic Method in the Diagnosis of General Diseases-Preliminary Study.

The aim of this work was to develop an original method of thermographic measurement of tongue temperature as a prognostic method in the diagnosis of general diseases. This study examined the temperature distribution on the dorsal and apical surfaces of the tongue in patients with various general diseases and introduced a procedure for cooling the oral cavity. Patients with a high risk of systemic infections were referred to the Oral and Maxillofacial Surgery Outpatient Clinic of the Medical University of Silesia (SUM) in Katowice to identify potential foci of dental infections. They underwent an evaluation of their dentition as well as a prognostic tongue examination using the thermal camera FLIR T540 with a sensitivity of <0.03 K. The obtained results revealed statistically significant differences in the tongue average temperature parameters between the two study groups-healthy patients and patients with disorders. We obtained median temperatures for tongue dorsum (TD) of 35.8 °C and 35.2 °C for healthy patients and patients with disorders, respectively. Also, statistical differences have been obtained for tongue apex (TA) average temperatures. They were 35.5 °C and 34.0 °C for healthy and patients, respectively (p = 0.0001). Similar statistical results presented significant differences in the temperature difference (defined as DT = average temperature 10 min - average temperature 2 min after rinsing of the mouth) of the examined areas of the tongue between the healthy temperature and the unhealthy patient's temperature. It seems that thermal imaging has potential in the prevention and diagnosis of general diseases.

The Role of Full-Thickness Skin Grafts in Patient's Rehabilitation after Maxillectomy and Midface Defects.

(1) Background: Nowadays, microvascular grafts are the gold standard in the reconstruction of midface defects after maxillectomy, however, not all patients may qualify for this type of surgery. The purpose of present study is to evaluate the benefits of alternative reconstruction methods such as full-thickness skin grafts for these conditions. (2) Methods: The research group consisted of 37 patients who underwent maxillectomy due to cancer of the mid-face and had full-thickness skin graft reconstruction. The study covered the period from 2011 to 2020. (3) Results: Based on the clinical examination and the subjective assessment of patients, a positive effect of the use of free skin grafts on their convalescence and rehabilitation was found. In particular, they contributed to the reduction in postoperative pain and pain associated with prosthetic stages (VAS Scale). (4) Conclusion: Full-thickness skin grafts in combination with individual prosthetic restorations are a good alternative to rehabilitation in patients who do not qualify for microsurgical treatment.

Evaluation of the Proximal Tibia as a Donor Site of Cancellous Bone for Intraoral Grafting Procedures-A Retrospective Study.

BACKGROUND: Autogenous bone grafts remain the "gold standard" in maxillofacial reconstructive procedures. The objective of this study was to evaluate the proximal tibia as a donor site of cancellous bone for bone grafting procedures of the mandible on the basis of intraoperative parameters and clinical observations. METHODS: The study was based on a medical record search of 40 patients who underwent surgical procedures because of benign pathological lesions of the jaws resulting in 3-wall bone defects of the mandible and qualified for surgical removal of the lesion with simultaneous bone grafting of the defect with autogenous cancellous bone harvested from the proximal tibia. RESULTS: The use of the proximal tibia for bone grafting procedures enables large amounts of cancellous bone (15.09 cc in average) to be obtained. The procedure is characterized by a low risk of early and late complications, which include excessive bleeding, wound infection, lengthy healing time, scars, a loss of sensation around the scars, aching, a dip in bone, swelling and tenderness. CONCLUSIONS: The ability to obtain large amounts of cancellous bone and a low risk of intra- and postoperative complications make the proximal tibia an attractive donor site for the bone grafting procedures in maxillofacial surgery.

Analysis of the Validity of Perioperative Antibiotic Prophylaxis in Maxillofacial Surgery.

Perioperative antibiotic prophylaxis is the standard in surgical departments. The type of operation, the duration of the procedure, the degree of microbiological purity of the operating field and the current clinical condition of the patient determine its administration. The aim of this study was to validate the antibiotic prophylaxis used in a Maxillofacial Surgery Department for a group of trauma and non-trauma patients. To that end, an observational prospective cohort study was carried out. The study was conducted on a group of 83 patients of the Department of Cranio-Maxillo-Facial Surgery who were divided into a group of trauma patients (n = 43) and one of non-trauma patients (n = 40). In both groups, the classic microbiological tests were carried out, and the results were analyzed in relation to: the study group, age, sex, duration of surgery, type of surgical access. Most bacterial strains were isolated at the initial stage of the operation. Gram (+) cocci were isolated more often in the trauma group and Gram (-) rods in the non-trauma group. Significantly more often, strains of fungi were noted in the initial stage of the procedure in the trauma group. We conclude that the use of perioperative antibiotic prophylaxis in the Maxillofacial Surgery Departments is justified.

Is Thermal Imaging a Helpful Tool in Diagnosis of Asymptomatic Odontogenic Infection Foci-A Pilot Study.

Since the identification of periapical lesions typically requires invasive testing that may adversely affect individuals suffering from concomitant disease, the diagnosis of apical periodontitis remains a challenge. This study aimed to determine the effectiveness of infrared thermal imaging for the detection of asymptomatic odontogenic inflammatory response in patients with a high risk of systemic infections. The examinations were performed using the FLIR T1020 thermal camera. The acquired images were analyzed with a ThermaCAM TM Researcher Pro 2.8 SR-3. Statistical analyses were conducted using the Statistica 10 software. The Mann-Whitney U test was used for data that were not normally distributed or did not meet the assumption of homogeneity of variance, while normally distributed data were analyzed with the t-test. The mean temperature difference between the periapical regions of the suspect and contralateral teeth was found to be greatest at 30 s of mouth opening. This is a preliminary study conducted to evaluate the potential of infrared thermal imaging as a diagnostic tool for the identification and elimination of odontogenic infection foci. Thermography seems to facilitate the quantitative assessment of inflammation by displaying temperature differences between the affected and unaffected regions.

Temporomandibular Joint Prostheses: Optimal Materials for the Optimal Stomatognathic System Performance-Preliminary Study.

The aim of this study was to quantitatively evaluate alloplastic Temporomandibular Joint (TMJ) Prostheses against other treatment modalities regarding the jaw kinematics. Six patients with Temporomandibular Joint Prostheses, four with mandibular ramus Patient-Specific Implant (PSI) with condylar head preservation, and four after mandibular condylectomy were evaluated by the means of axiography (Cadiax Compact 2), which is the noninvasive three-dimensional study of condylar movements. The patients were also evaluated clinically for the mandibular movements. The study revealed that the significant movement limitations occurred bilaterally in patients fitted with TMJ prosthesis. For the protrusion movement, the vector length of the movement (L) for the TMJ prosthesis was 0.31 vs. 3.01 mm for the PSI (Kruskal-Wallis chi-squared = 9.1667, df = 2, p-value = 0.01022, post hoc Dunn p-value = 0.015) and for the laterotrusion to the operated side, the length of the vector (L) was 0.66 vs. 3.35 mm, respectively. Statistically significant differences between groups were most frequent for the laterotrusion to the unoperated side. The study shows that a further development on TMJ Prostheses geometry and materials is needed.

Type 1 Diabetic Patients After Simultaneous Pancreas and Kidney Transplantation Have Less Intense Periodontal Inflammation Compared to Kidney Recipients Treated with Insulin.

BACKGROUND Long-term diabetes predisposes to pathological changes in periodontal tissues. Improvement in this respect can be expected in patients after pancreas transplantation. The aim of this study was to assess and compare the intensity of periodontium pathological lesions and inflammation markers concentration in gingival crevicular fluid (GCF) in patients with type 1 diabetes (T1D) after kidney (KTx) or simultaneous pancreas and kidney transplantation (SPK). MATERIAL AND METHODS The study included 20 T1D patients after SPK and 16 after KTx, and 15 non-diabetic kidney recipients (control). Periodontal clinical parameters and concentration of selected biochemical markers of inflammation in GCF were assessed. The following tests were used in statistical data analysis: Shapiro-Wilk test, the t test, the Mann-Whitney U tests, one-way ANOVA with Tukey's post hoc test, and χ² test (also with Yate's correction). Moreover, linear regression and Pearson or Spearman correlation coefficient was used. RESULTS There were no differences in modified Sulcus Bleeding Index (mSBI) and GCF volume between the SPK group and control group, whereas values of these parameters in the KTx group were higher than in the SPK and control groups. Maximal clinical attachment loss and pocket depth and Periotest values were higher in diabetic recipients compared to controls, and did not differ between SPK and KTx. The concentration of IL-1ß, MMP-8, resistin, TNFalpha, and YKL40 in the GCF in the KTx group was higher than in the SPK and control groups. In the combined group of T1D patients, there was a correlation between blood HbA1c and mSBI, GCF volume, and resistin, TNF-alpha and YKL40 concentrations, and between resistin concentration and mSBI. CONCLUSIONS T1D patients after SPK show lower levels of inflammatory markers in GCF and present reduced intensity of periodontitis compared to kidney recipients treated with insulin. The severity of morphological changes in periodontium in T1D patients after KTx or SPK is higher than in non-diabetic kidney recipients.

Effectiveness of hyperbaric oxygen therapy in mandibular osteoradionecrosis shown by thermography monitoring.

BACKGROUND: Osteoradionecrosis (ORN) of the mandible is the most serious and severe side effect of combined treatment of head and neck tumors. Due to frequent failure of its conventional management, new methods are being sought and tested, including hyperbaric oxygen therapy (HBO); however, effective methods of monitoring HBO results are not yet available. The purpose of our study was to assess thermographic records of ORN patients in different stages of hyperbaric oxygen therapy. MATERIAL/METHODS: In the years 2003-2008, hyperbaric oxygen was used as an adjunct in the conventional management of 4 patients with progressive osteoradionecrosis of the mandible. The effects of the treatment were evaluated based on the clinical, radiological, and thermographic examinations. In each patient thermograms were obtained before and after HBO. RESULTS: Clinical examination showed ORN remission following 30 exposures in a hyperbaric chamber at 2.5 atmospheres for 90 minutes. Follow-up thermograms obtained after 35-60 exposures revealed a marked warming of the osteoradionecrotic area of the mandible resulting from an increase in blood supply and tissue metabolism increase. In 1 case of therapy cessation, just 5 sessions of HBO therapy was associated with a decrease in acute inflammation, as manifested by local cooling seen in a follow-up thermogram. CONCLUSIONS: Thermography is an effective method of monitoring HBO results in patients with osteoradionecrosis. However, thermograms should be interpreted in combination with the corresponding clinical picture and radiological findings.

Simultaneously Transplanted Pancreas Improves Salivation and Reduces Oral Fungal Infections Incidence in Type 1 Diabetic Renal Transplant Recipients.

BACKGROUND: Long-lasting diabetes mellitus may lead to numerous pathologies in the oral cavity. The aim of the study was to assess the condition of the oral cavity, caries intensity, salivary parameters, and incidence of oral fungal infections in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD) after kidney transplantation (KTx) or simultaneous kidney and pancreas transplantation (SPK). METHODS: Twenty-one patients after SPK, 18 T1D patients after KTx, and 14 kidney recipients without diabetes (control group) were included in the study. Donor sources complied with Helsinki Congress and the Declaration of Istanbul. RESULTS: Approximal plague index in SPK (80% [68%-90%]) was comparable to KTx (80% [37.5%-92.5%]) but higher than in control group (46% [35%-50%]). All 3 groups did not differ in terms of decayed-missing-filled tooth index: 22.3 ± 4.8 vs 22.5 ± 4.5 vs 19.1 ± 4.9, respectively. Normal saliva resting secretion and consistency were more common in SPK (71.4% and 52%, respectively) than in KTx (27.8% and 50.0%, respectively). Stimulated saliva volume in the SPK, KTx and controls, pH value, and buffering capacity were comparable. In KTx higher incidence of Candida albicans infection (55.6%) compared with SPK (23.8%) and controls (no infection) was observed. CONCLUSIONS: Simultaneously transplanted pancreas improves salivation and reduces the incidence of oral fungal infections in T1D kidney recipients. The severity of caries is higher and oral hygiene is worse in T1D kidney recipients compared with patients after KTx without diabetes.

The effect of chronic periodontitis on the development of atherosclerosis: review of the literature.

Although research has demonstrated that odontogenic foci of infection can be dangerous to the function of other organs, a direct relationship between orofacial infections and systemic health has not been proved. Recently, bacterial and viral organisms involved in chronic inflammatory processes have also been regarded as risk factors for atherosclerosis. Periodontitis is one of the most common chronic bacterial infections. One of the first researchers to indicate a relationship between orofacial infections and atherosclerosis were Mattila et al. In 1989 they published a paper which identified periodontal disease as an independent predictor of the risk of myocardial infarction. For over ten years several authors have discussed the correlation between oral infections, and periodontal disease in particular, and the occurrence of coronary heart disease, myocardial infarction, and ischemic stroke. A review of the knowledge of the effects of periodontal disease on the development of atheromatous plaque is presented here. No scientific evidence was found to prove a direct association between odontogenic infections and atherosclerosis. However, such a relationship is probable in the light of the reviewed articles. Reliable markers should be sought which could accurately indicate the effect of periodontal disease on the condition of the arteries.

[Epuli--the inflammatory or neoplastic tumor]. / Nadziaslak--guz zapalny czy nowotworowy.

Epuli (granulomas) are the most frequently observed gingival tumours. The etiopathogenesis of the hyperplasia is not yet clear, and classification inconsistent. Literature on the subject presents considerable discrepancies regarding the tumours origin. The factors determining their development, growth rate, and tendency to recur are still unknown although several options have been considered, i.e., type of injury or inflammatory process, hygiene, nutrition, alcohol, nicotine, pharmacotherapy, hormonal status, and immune efficiency. The opinions of authors of the literature on etiopathogenetic, the classification, the clinical images and the treatment of epulides are represented.

[Langerhans' cell histiocytosis--diagnostic and treatment difficulties]. / Histiocytoza komórek Langerhansa--trudnosci diagnostyczne i terapeutyczne.

UNLABELLED: Langerhans' cell histiocytosis [(LCH), histiocytosis X] is a very rare disease, which can involve any side and organ of the body. LCH may appear as an isolated leasion or as a widespread systemic disease. Focus in the bone as eosinophilic granuloma can be separate or be involved only as a part of generalized disease. The aim of this study was describe diagnostic and treatment difficulties in two patients suffering from LCH. The first patient was 28-years-old man who had been treated by reason of tumor on the left angle of mandible in 2005 year. The second patient was a 2-years-old-child who had directed because of gomphiasis deciduous molar teeth in lower and upper jaws in 2005 year. After diagnosis child was treatment by chemotherapy and stay in remission. CONCLUSIONS: 1. In differential diagnosis of infiltrations and osteolytic losses of maxilla and mandible one should take into account LCH. 2. Differential localization and non characteristic symptoms can cause the late diagnosis and aggravate the prognosis of this severe disease. 3. Dentist in his practice should keep oncological vigilance because of the fact that he may be the first doctor for patients with LCH.