Drug-Induced Gingival Enlargement: A Review of Diagnosis and Current Treatment Strategies.

Drug-induced gingival enlargement (DIGE) is a biofilm-mediated gingival inflammatory condition associated with pharmacological agents. Specifically, calcium channel blockers, immunosuppressants, and anticonvulsants are among the primary medications associated with DIGE. Modifiable risk factors for DIGE include drug dose and dental biofilm, and the use of concomitant inducing medications. Although the clinical presentation of DIGE depends on these and patient-specific variables, its classical appearance is described as fibrotic, pink, bulbous, or mulberry-shaped overgrowths of the attached gingiva and dental papillae, with no bleeding on probing. The clinical manifestations of DIGE may worsen as the disease increases in severity. Likewise, the treatment strategies become more complex. The dental management of DIGE includes nonsurgical, surgical if necessary, and maintenance therapies. Drug substitutions, which may only be considered in consultation with the patient's family physician or primary healthcare provider, are a form of nonsurgical therapy. DIGE can be extremely debilitating, especially in its advanced stages, and make oral hygiene cumbersome, which translates to poorer oral and periodontal health outcomes. Therefore, DIGE must be properly identified and treated accordingly to re-establish a healthy and maintainable periodontium.

Medical Management, Orofacial Findings, and Dental Care for the Patient with Parkinson's Disease.

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in North America, next to Alzheimer's disease. Patients who suffer from PD typically present with neuromuscular, cognitive, postural and psychiatric deficits, which make oral hygiene challenging, but extremely important. Although the cardinal signs of PD are movement-related, manifestations in the orofacial complex are ubiquitous. Weakened facial musculature, gaunt appearance, tremors of the tongue, lips and eyes, erratic mandibular movements, bruxism, xerostomia, sialorrhea, dysphagia, dysgeusia and glossitis are examples of the plethora of atypical orofacial findings associated with PD. Further complications, including angular cheilosis, attrition, temporomandibular joint disorders, burning mouth syndrome, hyposmia and hypophonia, may arise as a consequence of these orofacial manifestations. The effects of PD on the orofacial complex may result in poor nutritional habits, which can exacerbate weight loss and contribute to a negative impact on physical, psychosocial and emotional health. Dentists should be able to identify signs of PD systemically, including but not limited to the orofacial region, to optimize the management of PD patients. Here, we report practical recommendations for the medical and dental management of patients with PD in accordance with the most recently published clinical practice guidelines.

Brain Imaging Using Hyperpolarized 129Xe Magnetic Resonance Imaging.

Hyperpolarized (HP) 129Xe magnetic resonance imaging (MRI) is a novel iteration of traditional MRI that relies on detecting the spins of 1H. Since 129Xe is a gaseous signal source, it can be used for lung imaging. Additionally, 129Xe dissolves in the blood stream and can therefore be detectable in the brain parenchyma and vasculature. In this work, we provide detailed information on the protocols that we have developed to image 129Xe within the brains of both rodents and human subjects.

Cyclodextrin-Based Pseudorotaxanes: Easily Conjugatable Scaffolds for Synthesizing Hyperpolarized Xenon-129 Magnetic Resonance Imaging Agents.

Hyperpolarized (HP) xenon-129 (Xe) magnetic resonance (MR) imaging has the potential to detect biological analytes with high sensitivity and high resolution when coupled with xenon-encapsulating molecular probes. Despite the development of numerous HP Xe probes, one of the challenges that has hampered the translation of these agents from in vitro demonstration to in vivo testing is the difficulty in synthesizing the Xe-encapsulating cage molecule. In this study, we demonstrate that a pseudorotaxane, based on a γ-cyclodextrin macrocycle, is easily synthesized in one step and is detectable using HyperCEST-enhanced 129Xe MR spectroscopy.