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1.
Stomatologiia (Mosk) ; 100(1): 55-59, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33528957

RESUMEN

THE AIM OF THE STUDY: Was to assess age-related changes in mouth opening and tongue mobility in children with various forms of epidermolysis bullosa (EB). Materials and methods. The study comprised 50 EB children (mean age 8.8±3.9 years). Oral slit width (the distance between mouth commissures at rest), mouth opening amplitude (the distance between incisive edges of the lower and upper incisors) were measured by orthodontic caliper. Tongue mobility was assessed using Bristol Tongue Assessment Tools (BTAT). The results were compared with 55 healthy age-matched controls (mean age 9.3±3.7 years). RESULTS: Mean moth opening in EB group was 22.6±11.1 mm which is twice lower than in controls (44.3±7.2 mm). The amplitude was progressively increasing in EB patients in the mixed dentition period but then dropped drastically in the permanent dentition because of oral fibrosis. Tongue mobility was lower in EB group when compared to controls even in cases with anatomically appropriate frenulum fixation sites. In permanent dentition maximal tongue raising was 8 times lower than in controls. Microstomia and ankyloglossia were very specific for dystrophic EB patients while in EB simplex, junctional EB and Kindler syndrome the values were similar to healthy controls. CONCLUSION: Microstomia, limited mouth opening and tongue mobility are typical oral features of dystrophic EB patients. Age-related dynamics shows progressive growth of the values in mixed dentition with significant lowering after so preventive measures for oral fibrosis are more feasible before permanent dentition phase.


Asunto(s)
Epidermólisis Ampollosa Distrófica , Epidermólisis Ampollosa , Enfermedades de la Lengua , Adolescente , Vesícula , Niño , Preescolar , Humanos , Lengua
2.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-33334753

RESUMEN

A 2-month-old full-term female infant with medical history of situs inversus totalis presented to the emergency department with congestion and abnormal breathing. She was discovered to have failure to thrive (FTT) and subsequently admitted. Investigations revealed a large vallecular mass at the base of her tongue which was noted to cause severe, intermittent airway obstruction. The mass underwent marsupialisation by otolaryngology (ENT) and pathology confirmed a diagnosis of vallecular cyst. The patient made a full recovery and is now growing and thriving. This case emphasises the need to consider anatomic airway abnormalities in the differential diagnosis of young infants with the constellation of respiratory symptoms and FTT. Such airway abnormalities can cause life-threatening airway obstruction if not discovered.


Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Quistes/diagnóstico , Insuficiencia de Crecimiento/etiología , Enfermedades de la Lengua/diagnóstico , Obstrucción de las Vías Aéreas/diagnóstico , Quistes/complicaciones , Quistes/cirugía , Insuficiencia de Crecimiento/diagnóstico , Femenino , Humanos , Lactante , Lengua/cirugía , Enfermedades de la Lengua/complicaciones , Enfermedades de la Lengua/cirugía , Resultado del Tratamiento
4.
J Prosthodont ; 29(8): 725-729, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32794594

RESUMEN

Amyloidosis of the tongue can result in significant and irreversible alterations of tooth position and function due to prolonged application of imbalanced force on the teeth by the enlarged tongue. Due to the rarity of this oral form of systemic disease, little has been elucidated on management of the resulting impaired oral function. While surgery can address the size of the tongue, it carries significant morbidities, enlargement can recur, and does not address adverse tooth positioning. Prosthetic rehabilitation can more aptly restore oral function but it also needs to be tailored based on the patient's expectations and goals as well as biologic and mechanical parameters of treatment. This report discusses an effective and noninvasive application of a tooth-supported, removable prosthesis with an onlay occlusal design to restore occlusion, speech, and esthetics in a patient with tongue-based amyloidosis.


Asunto(s)
Amiloidosis , Estética Dental , Enfermedades de la Lengua , Amiloidosis/complicaciones , Oclusión Dental , Humanos , Lengua/cirugía
5.
Rev. Asoc. Odontol. Argent ; 108(2): 57-62, mayo-ago. 2020. ilus
Artículo en Español | LILACS | ID: biblio-1121186

RESUMEN

Objetivo: Describir la importancia del reconocimiento oportuno del trauma crónico de la mucosa bucal producido por un elemento dentario que generó una lesión erróneamente diagnosticada como neoplasia maligna. Caso clínico: Una paciente de sexo femenino, de 79 años de edad, realizó una consulta estomatológica por una lesión lingual con un diagnóstico presuntivo de cáncer. Tras la inspección de la cavidad bucal y el estudio anatomopatológico se diagnosticó úlcera asociada a trauma dentario. La intervención terapéutica odontológica (eliminación del trauma) resolvió el cuadro cínico. Conclusión: El trauma crónico en la mucosa bucal puede generar lesiones sobre mucosa sana o bien complicar una patología preexistente. En el presente caso, la inspección de la cavidad bucal con la identificación y la eliminación del trauma lograron la reparación de la lesión. El estudio anatomopatológico precisó el diagnóstico de ulceración asociada a trauma dentario (AU)


Aim: The aim of this case report is to show the importance of the early diagnosis of a traumatic lesion of the oral mucosa arising from a posterior broken tooth that was initially misdiagnosed as oral cancer. Case report: A 79-year-old female attends an appointment with the oral medicine specialist for a lesion on the lateral side of the tongue with a presumptive diagnosis of oral cancer. The examination of the oral cavity and the anatomopathological diagnosis confirmed the presence of an ulcer associated with dental trauma. The lesion healed completely with the elimination of the trauma. Conclusion: Chronic trauma in the oral cavity can produce lesions in the oral mucosa or exacerbate preexisting lesions. In this case report a thorough oral examination showed a broken tooth as the cause of trauma and after its removal the lesion healed completely. The result of the biopsy confirmed the diagnosis of an oral ulcer associated with dental trauma (AU)


Asunto(s)
Humanos , Femenino , Anciano , Enfermedades de la Lengua/diagnóstico , Úlceras Bucales/diagnóstico , Diagnóstico Diferencial , Errores Diagnósticos , Extracción Dental , Raíz del Diente/patología , Biopsia
8.
Medicine (Baltimore) ; 99(29): e20471, 2020 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-32702810

RESUMEN

Traditional Chinese medicine tongue diagnosis can mirror the status of the internal organ, but evidence is lacking regarding the accuracy of tongue diagnosis to gastroesophageal reflux disease (GERD). This study was to investigate the association between GERD and tongue manifestation, and whether tongue imaging could be initial diagnosis of GERD noninvasively.We conducted a cross-sectional, case-controlled observational study at Kaohsiung Chang Gung Memorial Hospital in Taiwan from January 2016 to September 2017. Participants aged over 20 years old with GERD were enrolled and control group without GERD were matched by sex. Tongue imaging were acquired with automatic tongue diagnosis system, then followed by endoscope examination. Nine tongue features were extracted, and a receiver operating characteristic (ROC) curve, analysis of variance, and logistic regression were used.Each group enrolled 67 participants. We found that the saliva amount (P = .009) and thickness of the tongue's fur (P = .036), especially that in the spleen-stomach area (%) (P = .029), were significantly greater in patients with GERD than in those without. The areas under the ROC curve of the amount of saliva and tongue fur in the spleen-stomach area (%) were 0.606 ±â€Š0.049 and 0.615 ±â€Š0.050, respectively. Additionally, as the value of the amount of saliva and tongue fur in the spleen-stomach area (%) increased, the risk of GERD rose by 3.621 and 1.019 times, respectively. The tongue fur in the spleen-stomach area (%) related to severity of GERD from grade 0 to greater than grade B were 51.67 ±â€Š18.72, 58.10 ±â€Š24.60, and 67.29 ±â€Š24.84, respectively.The amount of saliva and tongue fur in the spleen-stomach area (%) might predict the risk and severity of GERD and might be noninvasive indicators of GERD. Further large-scale, multi-center, randomized investigations are needed to confirm the results.Trial registration: NCT03258216, registered August 23, 2017.


Asunto(s)
Reflujo Gastroesofágico/diagnóstico , Reflujo Gastroesofágico/patología , Enfermedades de la Lengua/diagnóstico por imagen , Enfermedades de la Lengua/patología , Adulto , Anciano , Estudios de Casos y Controles , Estudios Transversales , Endoscopía/métodos , Femenino , Reflujo Gastroesofágico/complicaciones , Humanos , Masculino , Medicina China Tradicional/métodos , Persona de Mediana Edad , Saliva/fisiología , Índice de Severidad de la Enfermedad , Taiwán/epidemiología , Lengua , Enfermedades de la Lengua/etiología
11.
Dentomaxillofac Radiol ; 49(7): 20190318, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-32364758

RESUMEN

OBJECTIVES: Ultra-high frequency ultrasound (UHFUS) is a recently developed diagnostic technique involving the use of ultrasound frequencies up to 70 MHz, allowing to obtain 30 µm resolution of targets located within 1 cm from the surface. Oral mucosa can be affected by diverse pathological conditions, which are currently investigated by means of clinical examination. In this scenario, intraoral UHFUS can provide additional information and support clinical assessment of oral mucosa. In this preliminary study, typical features of normal oral mucosa are described, in order to set a benchmark for the future identification of oral soft tissue alterations. METHODS: Twenty healthy subjects (10 males and 10 females, mean age 30 years) were enrolled and underwent intraoral UHFUS examination. In all the subjects, tongue, buccal mucosa, gingiva, lip mucosa, and palate were scanned, and images acquired. Intraoral UHFUS scan included Brightness-mode and Doppler mode acquisitions performed with a standardized protocol. UHFUS images were postprocessed and analyzed using a dedicated software. UHFUS-based biomarkers (epithelial thickness, echogenicity, and vascularization) were employed for image description. RESULTS: Normal oral anatomy of the different sites analyzed was described. For all the sites, UHFUS biomarkers were characterized, and information on typical aspect of oral mucosa was retrieved. CONCLUSIONS: In this explorative study, we suggest a potential role for intraoral UHFUS in the study of oral mucosa, giving insights into the possibility to improve the assessment, diagnosis, and management of the conditions involving oral mucosa. UHFUS seems a promising tool, which could potentially support clinical examination in daily oral medicine practice.


Asunto(s)
Mucosa Bucal/diagnóstico por imagen , Enfermedades de la Lengua , Adulto , Femenino , Encía , Humanos , Masculino , Ultrasonografía , Ultrasonografía Doppler
12.
Spec Care Dentist ; 40(3): 285-290, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32441821

RESUMEN

AIM: Tongue bites frequently occur during seizures in epilepsy patients. We report two cases of cognitively impaired Lennox-Gastaut syndrome patients with reactive lesions on the tongues. CASE PRESENTATIONS: Case 1 was a 30-year-old man whose chief complaint was mouth pain. Local finding was a small bean-sized pedunculated mass on the tongue, histopathologically diagnosed as inflammatory fibrous hyperplasia. Case 2 was a 45-year-old man whose chief complaint was bleeding from the mouth. His clinical finding was blood loss anemia. Local finding was a 20-mm-diameter pedunculated mass on the tongue, histopathologically diagnosed as pyogenic granuloma. CONCLUSION: These mass lesions were believed to be reactive, caused by repetitive minor damage involving reparative fibrous tissue response. Therefore, the two cases may have involved reparative responses to mucosal injury incurred by accidental bites during epileptic seizures. Intellectual disability made medical treatment difficult and had allowed the massive lesions to form. It is necessary for cognitively impaired epilepsy patients to undergo regular dental examinations in order to get used to dental checks and to increase the number of intraoral observations in the context of close cooperation between dentists and epilepsy therapists.


Asunto(s)
Epilepsia , Discapacidad Intelectual , Enfermedades de la Lengua , Adulto , Humanos , Masculino , Persona de Mediana Edad , Lengua
13.
Ned Tijdschr Tandheelkd ; 127(4): 231-235, 2020 Apr.
Artículo en Holandés | MEDLINE | ID: mdl-32459218

RESUMEN

An 18-year old woman was referred to the department of oral and maxillofacial surgery with 1 to 2 week episodes of tongue ulcerations that had lasted for a year. Food intake was limited due to pain, resulting in a loss of 10 kg during the previous year. Following a clinical diagnosis of 'aphthous ulcers', she was treated with tetracycline and clobetasol mouthwash, which had little effect. An injection with triamcinolone acetonide did not prove effective either. Some time later, the patient reported at the emergency department with a deep, ulcerative wound to the tongue with characteristic features of bite trauma. She said she had consistently worn her protective mouthguard. The symptoms suggested self-mutilation. The patient was admitted to a psychiatric department, where a diagnosis of anxiety disorder and self-mutilation was reached.


Asunto(s)
Úlceras Bucales , Automutilación , Enfermedades de la Lengua , Adolescente , Femenino , Humanos , Antisépticos Bucales , Lengua
14.
JMIR Mhealth Uhealth ; 8(7): e16018, 2020 07 09.
Artículo en Inglés | MEDLINE | ID: mdl-32459647

RESUMEN

BACKGROUND: There is a growing trend in the use of mobile health (mHealth) technologies in traditional Chinese medicine (TCM) and telemedicine, especially during the coronavirus disease (COVID-19) outbreak. Tongue diagnosis is an important component of TCM, but also plays a role in Western medicine, for example in dermatology. However, the procedure of obtaining tongue images has not been standardized and the reliability of tongue diagnosis by smartphone tongue images has yet to be evaluated. OBJECTIVE: The first objective of this study was to develop an operating classification scheme for tongue coating diagnosis. The second and main objective of this study was to determine the intra-rater and inter-rater reliability of tongue coating diagnosis using the operating classification scheme. METHODS: An operating classification scheme for tongue coating was developed using a stepwise approach and a quasi-Delphi method. First, tongue images (n=2023) were analyzed by 2 groups of assessors to develop the operating classification scheme for tongue coating diagnosis. Based on clinicians' (n=17) own interpretations as well as their use of the operating classification scheme, the results of tongue diagnosis on a representative tongue image set (n=24) were compared. After gathering consensus for the operating classification scheme, the clinicians were instructed to use the scheme to assess tongue features of their patients under direct visual inspection. At the same time, the clinicians took tongue images of the patients with smartphones and assessed tongue features observed in the smartphone image using the same classification scheme. The intra-rater agreements of these two assessments were calculated to determine which features of tongue coating were better retained by the image. Using the finalized operating classification scheme, clinicians in the study group assessed representative tongue images (n=24) that they had taken, and the intra-rater and inter-rater reliability of their assessments was evaluated. RESULTS: Intra-rater agreement between direct subject inspection and tongue image inspection was good to very good (Cohen κ range 0.69-1.0). Additionally, when comparing the assessment of tongue images on different days, intra-rater reliability was good to very good (κ range 0.7-1.0), except for the color of the tongue body (κ=0.22) and slippery tongue fur (κ=0.1). Inter-rater reliability was moderate for tongue coating (Gwet AC2 range 0.49-0.55), and fair for color and other features of the tongue body (Gwet AC2=0.34). CONCLUSIONS: Taken together, our study has shown that tongue images collected via smartphone contain some reliable features, including tongue coating, that can be used in mHealth analysis. Our findings thus support the use of smartphones in telemedicine for detecting changes in tongue coating.


Asunto(s)
Medicina China Tradicional , Fotograbar , Teléfono Inteligente , Telemedicina , Enfermedades de la Lengua/diagnóstico , Infecciones por Coronavirus , Técnica Delfos , Humanos , Variaciones Dependientes del Observador , Pandemias , Neumonía Viral , Reproducibilidad de los Resultados
15.
J Oral Maxillofac Surg ; 78(9): 1572-1582, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32442425

RESUMEN

PURPOSE: Localized amyloidosis of the tongue is a benign condition in which surgical management may be considered. The aim of the study was to review the current literature and report a case. MATERIALS AND METHODS: We searched the PubMed database for all relevant articles reporting cases of localized tongue amyloidosis published between 1980 and February 2020. In addition, we updated 1 case diagnosed and treated in our department. RESULTS: A 49-year-old male patient presented with an asymptomatic tongue nodule of the dorsum mimicking median rhomboid glossitis. The results of an incisional biopsy showed an amyloid on Congo red staining and positive findings for the κ light chain by immunohistochemical analysis. The findings of the systemic workup were negative. Therefore, a diagnosis of localized κ light-chain amyloidosis was made. The patient underwent a resection of the lesion, and no recurrence or progression was observed during a period of 18 months. The literature review showed 12 reports describing 21 patients (11 men, 52.3%) with localized tongue amyloidosis. The most common clinical presentation was nodular with a single lesion of the tongue dorsum (15 patients, 71.4%). All cases showed positive findings on Congo red staining. Immunohistochemical analysis findings were available for only 9 patients (42.8%) and showed light-chain amyloidosis. No case showed any systemic involvement or the development of systemic disease. Surgical excision was performed in 9 cases, with recurrence at the site of operation in 2 cases. CONCLUSIONS: Localized amyloidosis of the tongue is a rare disease in which surgical excision may be therapeutic when a multidisciplinary evaluation does not show any systemic disease. We recommend an excision when the lesion is persistent or shows an enlargement or when discomfort is reported. In the case of any further local recurrence, resection may be repeated.


Asunto(s)
Amiloidosis , Enfermedades de la Lengua , Amiloide , Amiloidosis/diagnóstico , Amiloidosis/cirugía , Biopsia , Humanos , Masculino , Persona de Mediana Edad , Lengua/cirugía , Enfermedades de la Lengua/diagnóstico , Enfermedades de la Lengua/cirugía
16.
Br J Oral Maxillofac Surg ; 58(5): 520-524, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32143935

RESUMEN

Oromandibular dystonia (OMD) is characterised by sustained or repetitive involuntary movements of the jaw, face, and tongue. People with the condition may present to their dentist, general practitioner, or a secondary care specialist with non-specific symptoms including jaw or facial pain, bruxism, subluxations or dislocations of the jaw; fractured teeth or dental restorations, or both; or jaw tremor. Many clinicians are not aware of the disorder and this can lead to delayed diagnoses, unnecessary complications, and inappropriate treatment. OMD is an important diagnosis not to miss because referral for specialist management can provide good long-term results. To aid early, accurate diagnosis, this paper focuses on the key clinical features of the disorder and its dental and medical mimics.


Asunto(s)
Discinesias , Distonía , Enfermedades de la Lengua , Distonía/diagnóstico , Humanos
18.
J Craniofac Surg ; 31(4): 973-975, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32176011

RESUMEN

Microglossia is an extremely rare developmental condition that might impact the patient's respiratory, feeding and speech functions, in addition to other intraoral structures. Embryologically, the tongue has 2 origins, which when affected, will determine whether the patient has microglossia or aglossia. A multidisciplinary team should adopt an organized approach based on confirmation by direct laryngoscopy, determination whether associated airway anomalies, mandibular deformities are present; followed by assessment of the ventilatory and feeding status. The involvement of multiple factors, the presence of several anatomical anomalies and the growth exerted by patients, confer microglossia a rather dynamic clinical entity. Two cases of microglossia depicting these features are presented along with review of the literature and a management algorithm.


Asunto(s)
Enfermedades de la Lengua/diagnóstico por imagen , Cara/diagnóstico por imagen , Femenino , Humanos , Recién Nacido , Desarrollo Maxilofacial , Tomografía Computarizada por Rayos X
19.
Artículo en Inglés | MEDLINE | ID: mdl-32044267

RESUMEN

OBJECTIVE: The aim of this study was to determine the prevalence and the factors associated with symptomatic oral lichen planus (OLP). STUDY DESIGN: Patients with OLP seen for an initial visit were assessed retrospectively. Initial visit data included demographic characteristics; social, medical, and OLP treatment histories; medications; chief complaints, 0 to 10 pain level; OLP duration and symptoms; OLP type and location; total OLP lesion size (mm2); total ulcer size (mm2); and fungal infection and its management. Follow-up data included 0 to 10 pain level and total lesion and ulcer sizes. RESULTS: We assessed 205 patients: 154 (75%) were women, and the mean (standard deviation [SD]) age was 62.5 (11.5) years. The mean (SD) current pain level was 1.6 (2.2) at the initial visit. A total of 125 patients (61%) were classified as symptomatic, including 85 (41%) patients reporting a pain level of 1 or greater and another 40 patients (20%) who had symptoms not described as pain at the initial visit. The following increased the odds of OLP symptoms at the initial visit: tongue location (× 2.3), erosive/erythematous type (× 2.3), female sex (× 2.9), topical steroid use before initial visit (× 2.1), and number of medical conditions (× 1.2). CONCLUSIONS: Most patients with OLP in the present cohort were symptomatic at the initial visit, with location, type, sex, steroid use and medical conditions being predictors of symptomatic OLP. Despite improvement in OLP symptoms in most patients over time, 25% of patients who are asymptomatic at the initial visit present with symptomatic OLP at a future visit.


Asunto(s)
Liquen Plano Oral , Micosis , Enfermedades de la Lengua , Femenino , Humanos , Estudios Retrospectivos , Esteroides
20.
AJR Am J Roentgenol ; 214(5): 1008-1018, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32069081

RESUMEN

OBJECTIVE. The purpose of this article is to discuss imaging techniques and provide a pictorial review of pediatric tongue lesions. CONCLUSION. Pediatric tongue lesions represent an often-overlooked collection of abnormalities with a variety of clinical and radiologic features. The location of these lesions places the patient at risk for airway compromise. Systematic imaging evaluation of pediatric tongue lesions can help the radiologist arrive at a correct and timely diagnosis, thus improving and expediting patient care.


Asunto(s)
Enfermedades de la Lengua/diagnóstico por imagen , Lengua/anomalías , Niño , Diagnóstico Diferencial , Humanos
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