Aspects of HIV disease relevant to dentistry in the 21st century.

UNLABELLED: HIV disease remains a significant health concern in Europe and the rest of the world. The present article details the epidemiological shifts, changes in therapy and oral manifestations of HIV disease of relevance to all oral healthcare professionals. CLINICAL RELEVANCE: Knowledge regarding the oral and dental aspects of HIV infection remain of importance to all dental healthcare professionals.

Amyloidosis: an unusual case of persistent oral ulceration.

We report a case of systemic amyloidosis, with an unusual oral presentation, in a 70-year-old patient suffering from light chain myeloma. The patient presented with extensive ulceration of the tongue and alveolar ridges, and a large swelling in the floor of mouth. Incisional biopsies of the tongue and floor of mouth confirmed amyloid deposition within the tissues with evidence of necrotic ulceration. Amyloid deposition in the oral cavity usually manifests as macroglossia, however it can present elsewhere in the mouth as nodular or plaquelike lesions. Ulceration is a rare finding. This case highlights the variable nature of this condition, and how it can present a challenge to clinicians in terms of diagnosis and treatment.

Oral complications of HIV disease.

Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS.

Dyskeratosis congenita: a case report.

Dyskeratosis congenita (DC) is a rare inherited condition, first described in 1960 as Zinsser-Engmann-Cole syndrome. The condition presents with a classic triad: nail dystrophy, reticulate skin pigmentation over the trunk and neck, and white plaques typically in the oral cavity. White plaques may also affect, although less frequently, the mucosal surfaces of the urethra and vagina. Variable somatic abnormalities may be present; these include: pulmonary, gastrointestinal, genitourinary, cerebral, and dental complications. Pancytopenia eventually develops, progressing to bone marrow failure; the most common cause of death. In the X-linked form, which affects mainly males, mutations arise in the DKC-1 gene which encodes for the protein dyskerin. This report details a variant case of DC affecting a 9-year-old boy. The disease progression did not follow the "classic triad" typically seen in the condition. Longstanding nail dystrophy and oral ulceration were the sole presenting features. The details of the challenges encountered during diagnosis and treatment are further discussed.

Darier disease affecting the gingival and oral mucosal surfaces.

Darier disease is an uncommon genodermatosis reflecting defective desmosomal structure and function. The present report details the oral features of a patient with well-characterized Darier disease and reviews current knowledge of the genetic basis of this genodermatosis that can often affect the craniofacial tissues.

Current trends of HIV disease of the mouth.

HIV infection affects residents of all countries of the world, but the greater majority of affected individuals reside in the developing world. In the past decade there have been substantial changes in the management of HIV disease, particularly the introduction of highly active antiretroviral therapy (HAART). Such agents have reduced significantly the morbidity and mortality associated with HIV disease, however, they are not available for most HIV-infected individuals in the developing world. There is now considerable understanding of the molecular epidemiology, transmission and therapy of the common opportunistic oral infections of HIV disease, and as a consequence of improved anti-HIV strategies, the frequency and severity of oral disease associated with HIV infection have reduced considerably, although HAART may predispose to human papilloma virus infection of the mouth and potentially increase the risk of later oral squamous cell carcinoma. Despite advances in clinical care the majority of individuals with HIV disease worldwide will continue to develop oral disease, as they are resident in the developing world and do not have ready access to even simple therapies.

Oral complications of HIV disease: [review]

Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS.