Diagnosis and rehabilitation of an infant with palatal mucormycosis: A clinical report and systematic literature review.

STATEMENT OF PROBLEM: Oral mucormycosis is uncommon in pediatric patients with hematolymphoid diseases. Prosthetic rehabilitation is challenging, and protocols are scarce in the literature. PURPOSE: The purpose of this clinical report and systematic literature review of case reports and case series was to describe the clinicopathologic aspects of oral mucormycosis and the interim prosthetic rehabilitation of an affected infant. MATERIAL AND METHODS: The clinical lesions were ulcerative and necrotic with underlying bone exposure that affected the hard palate. The affected area underwent surgical debridement, and histopathologic analysis was performed. A literature search in PubMed/MEDLINE, Embase, Scopus, and Web of Science up to October 2023 was performed. RESULTS: The histopathological features were consistent with mucormycosis. Topical and systemic antifungals were prescribed. Tooth eruption was insufficient, and an acetate plate without clasp retention, but still with adequate retention, was fabricated. Articulatory, masticatory, and swallowing functions were restored, preventing the passage of food and fluids into the oroantral cavities. Twenty-five articles describing 26 patients with oral mucormycosis related to hematolymphoid disorders affecting the pediatric population were identified. None of the authors of these articles provided information about oral rehabilitation. CONCLUSIONS: Early diagnosis and treatment are essential to increasing the chances of survival for infants affected by oral mucormycosis. Custom-made rehabilitation should be provided to restore oral function and improve the patient's general health.

Clinical, immunological, and microbiological analysis of the association between periodontitis and COVID-19: a case-control study.

PURPOSE: Periodontitis and coronavirus disease (COVID-19) share risk factors and activate similar immunopathological pathways, intensifying systemic inflammation. This study investigated the clinical, immunological and microbiological parameters in individuals with COVID-19 and controls, exploring whether periodontitis-driven inflammation contributes to worsening COVID-19 endpoints. METHODS: Case (positive RT-PCR for SARS-CoV-2) and control (negative RT-PCR) individuals underwent clinical and periodontal assessments. Salivary levels of TNF-α, IL-6, IL-1ß, IL-10, OPG, RANKL, neutrophil extracellular traps, and subgingival biofilm were analyzed at two timepoints. Data on COVID-19-related outcomes and comorbidity information were evaluated from medical records. RESULTS: Ninety-nine cases of COVID-19 and 182 controls were included for analysis. Periodontitis was associated with more hospitalization (p = 0.009), more days in the intensive care unit (ICU) (p = 0.042), admission to the semi-ICU (p = 0.047), and greater need for oxygen therapy (p = 0.042). After adjustment for confounders, periodontitis resulted in a 1.13-fold increase in the chance of hospitalization. Salivary IL-6 levels (p = 0.010) were increased in individuals with COVID-19 and periodontitis. Periodontitis was associated with increased RANKL and IL-1ß after COVID-19. No significant changes were observed in the bacterial loads of the periodontopathogens Porphyromona gingivalis, Aggregatibacter actinomycetemcomitans, Tanerella forsythia, and Treponema denticola. CONCLUSIONS: Periodontitis was associated with worse COVID-19 outcomes, suggesting the relevance of periodontal care to reduce the burden of overall inflammation. Understanding the crosstalk between SARS-CoV-2 infection and chronic conditions such as periodontitis that can influence disease outcome is important to potentially prevent complications of COVID-19.

Cheilitis glandularis: case report and systematic literature review.

Cheilitis glandularis (CG) is a rare inflammatory disease of unknown etiology that affects the minor salivary glands predominantly in the lower lip. In this article, we report the case of an 18-year-old black woman who presented with a deep suppurative type of CG in both lips. In addition, we performed a systematic literature review in five databases (PubMed, Scopus, Web of Science, Ovid, and Embase) to identify CG case reports or case series. A total of 360 references were retrieved in the electronic databases. Thirty-four articles met the inclusion criteria, and six were retrieved through manual search, totaling 40 articles included in the systematic review. Thirty-nine (68.4%) cases occurred in male individuals and 18 (31.6%) in female individuals. The mean age of affected individuals was 40.9 years. Different clinical manifestations ranging from no symptoms to discomfort, pain, swelling, erythema, eversion of the lip, dilated ductal openings, ulcers, and crust have been reported. Among the included CG cases, 41 affected exclusively the lower lip (71.9%). In four cases, the CG only affected the upper lip (7.0%). In 12 cases, the lesion affected both the lower and upper lips (21.1%). Different treatment modalities were adopted in the management of CG. Although the surgical treatment was indicated (42.1%), the conservative treatment with topical medications, as in the present case, resulted in resolution in 21.0% of cases.

Safety protocols for dental care during the COVID-19 pandemic: the experience of a Brazilian hospital service.

The coronavirus disease (COVID-19) has been prioritized in relation to other illnesses considered critical, such as cancer, cardiovascular diseases/stroke, diabetes, and autoimmune diseases. The management of patients with these diseases involves dental care to reduce systemic complications caused by odontogenic infections, and/or to treat oral manifestations of systemic comorbidities. In this regard, the dental care of these individuals must be guaranteed during the pandemic. Although a high risk of exposure to and catching of COVID-19 is expected to befall dental professionals, biosafety guidelines reduce the likelihood of infection. Thus, the current scenario poses challenges, and offers decision-making approaches and tools that facilitate the management of individuals with oral manifestations of chronic and/or critical diseases, using hospital-based services. This article presents an overview for hospital service providers who are at the forefront of COVID-19 care, including a secure protocol, and clinical guidelines based on the experience of the Hospital das Clínicas in Belo Horizonte, a public referral service, supported by the Brazilian National Health System.

Leukaemic infiltration in the oral and maxillofacial region: An update.

BACKGROUND: The purpose of this study was to integrate the available data published on leukaemic infiltration in the oral and maxillofacial region into a comprehensive analysis of its clinical manifestations, imaginological characteristics, management and survival. MATERIALS AND METHODS: An electronic search with no publication date restriction was undertaken in October 2020 in the following databases: PubMed, Web of Science, Scopus and Embase. Overall survival was calculated by survival analysis with the Kaplan-Meier test. A critical appraisal of included articles was performed using the Joanna Briggs Institute tool. RESULTS: A total of 63 studies including 68 patients were selected for data extraction. The most common haematologic diagnosis was acute myeloid leukaemia (47%). The most affected individuals were 40 to 49 years old (20.9%). The male-to-female ratio was 1.2:1. The gingiva was the most affected site (37%). Swelling/mass/oedema (33.7%) and enlargement/hyperplasia/hypertrophy (25.5%) were the main clinical findings. Osteolytic lesions with bone destruction were the main imaginological characteristics among the reported cases. Follow-up was available for 36 patients. Overall, within the 21-month follow-up, the survival probability dropped to 14.3%. CONCLUSION: A considerable number of studies reported oral manifestations mainly in individuals with the acute form of leukaemia. Children and adults were affected, but the fifth decade of life was the most common. Dentists should be vigilant since these manifestations may be important for a diagnosis and for the monitoring of the treatment response and recurrence of haematological neoplasia.

Safety protocols for dental care during the COVID-19 pandemic: the experience of a Brazilian hospital service

Abstract The coronavirus disease (COVID-19) has been prioritized in relation to other illnesses considered critical, such as cancer, cardiovascular diseases/stroke, diabetes, and autoimmune diseases. The management of patients with these diseases involves dental care to reduce systemic complications caused by odontogenic infections, and/or to treat oral manifestations of systemic comorbidities. In this regard, the dental care of these individuals must be guaranteed during the pandemic. Although a high risk of exposure to and catching of COVID-19 is expected to befall dental professionals, biosafety guidelines reduce the likelihood of infection. Thus, the current scenario poses challenges, and offers decision-making approaches and tools that facilitate the management of individuals with oral manifestations of chronic and/or critical diseases, using hospital-based services. This article presents an overview for hospital service providers who are at the forefront of COVID-19 care, including a secure protocol, and clinical guidelines based on the experience of the Hospital das Clínicas in Belo Horizonte, a public referral service, supported by the Brazilian National Health System.