Oral conditions and salivary analysis in HIV-uninfected subjects using preexposure prophylaxis

Background: New prevention strategies have been advocated to control the progression of HIV/AIDS, such as preexposure prophylaxis (PrEP). The aim of this study is to evaluate the potential changes in the oral and salivary conditions of HIV-uninfected subjects using PrEP. Material and Methods: Subjects were evaluated before beginning the medication (T0), at the first follow-up (T1), and at the second follow-up (T2). Xerostomia, presence of untreated cavitated caries, oral hygiene habits, taste, gingival and plaque index, stimulated salivary flow rate (SSFR), and salivary concentrations of calcium, glucose, urea, and total proteins were evaluated. Data obtained were analyzed using statistical tests (p<0.05). Results: Forty-seven participants (41 men; 6 women) were evaluated at T0. Thirty (28 men; 2 women) and 17 men were reassessed at T1 and T2, respectively. There was no difference between the SSFR and oral and salivary conditions between T0, T1, and T2 (p>0.05), except for the salivary calcium concentration, that increased at T2 compared to T1 (p=0.02). There was significant difference between taste and xerostomia at T1 (p=0.017), and the need to drink to swallow at T2 (p=0.015). There was significant correlation between the reported amount of saliva and taste (p=0.039, r=-0.378) at T1. Conclusions: The prolonged use of PrEP seems to be associated with reports of dry mouth and worsening of taste, possibly associated with increased salivary calcium concentration.(AU)

Inflammatory cytologic alterations in the oral epithelium associated with HIV pre-exposure prophylaxis: a preliminary study.

OBJECTIVE: The objective of this study was to assess inflammatory cytologic alterations in the oral epithelium of patients on human immunodeficiency virus pre-exposure prophylaxis (PrEP). MATERIAL AND METHODS: Epithelial cells from the buccal mucosa of 30 patients were collected by exfoliative cytology and were evaluated according to inflammatory cellular alterations: karyomegaly, bi- or multinucleation, karyopyknosis, karyorrhexis, perinuclear halo formation, metachromasia, cytoplasmic vacuolization, indistinct cytoplasmic border, keratinization, and atrophy. Epithelial cells were collected initially before PrEP onset (T1) and then after 30 days of PrEP use (T2). Two experienced cytopathologists independently analyzed the slides. RESULTS: The nonparametric Wilcoxon test showed that there was a statistically significant increase in the number of cells with karyomegaly at T2 compared to T1 (P = .033). The other cellular alterations did not present with statistically significant differences between the 2 moments of evaluation (P > .05). CONCLUSION: The increased number of oral epithelial cells with karyomegaly after 30 days of using PrEP suggests the presence of inflammatory alterations at this site.

Marsupialization of a Large Radicular Cyst with Extensive Maxillary Tooth Displacement: Eight-Year Follow-Up.

Radicular cysts arising from primary teeth are uncommon and, when present as large lesions, may adversely affect the underlying permanent teeth. The purpose of this paper is to describe the management of a very large atypical radicular cyst involving the primary dentition of a nine-year-old boy and causing extensive tooth displacement with transposition of the permanent maxillary left canine between the bicuspids. The root apex of the canine was close to the median level of the lateral border of the nasal cavity and showed incomplete root formation and signs of dilacerations in its apical third. Marsupialization was successfully performed, followed by long-term orthodontic treatment. This interdisciplinary management facilitated the lesion resolution for repositioning of the canine into functional occlusion. (J Dent Child 2019;86(1):64-8)
Received October 23, 2018; Last Revision January 10, 2019; Accepted January 11, 2019.