Risk factors associated with tongue lesions: a propensity score-matched case-control study

Background: to analyse the potential risk factors of tongue lesions, comparing the results with a control group. Material and Methods: An observational, case-control study was designed. The study included a case group comprising 336 patients with tongue lesions and 336 sex and age-matched controls. We recorded tobacco/alcohol habits, presence of dentures, allergies, medical conditions, and medications. Statistical analysis was performed via logistic regression models to estimate the odds ratio (OR) adjusted for gender, age, tobacco, and alcohol using propensity score-matching analysis (PSM). Results: According to the final PSM model, patients with tongue lesions were more likely to suffer from allergies (OR 2.13; 1.27-3.66) or medical conditions (OR 2.14; 1.19-3.85), and more likely to take medication (OR 1.99; 1.11-3.57). Elderly individuals were more prone to hairy tongue (OR 3.82; 1.53-10.47). Smoking was associated with coated tongue (OR 2.05; 1.12-3.63), hairy tongue (OR 3.77; 1.52-9.22) and median rhomboid glossitis (OR 40.49; 5.84-860.43). Allergic individuals were more likely to exhibit sublingual varices (OR 1.73; 1.02-2.88). Medical conditions increased the chances of having coated tongue (OR 2.44; 1.36-4.64) or crenated tongue (OR 2.70; 1.42-5.30). Arterial hypertension was associated with median rhomboid glossitis (OR 5.85; 1.08-34.18). Individuals on medication showed a higher risk of fissured tongue (OR 1.87; 1.20-2.94) and varices (OR 2.42; 1.58-3.80). Agents acting on the alimentary tract and metabolism increased the probability of fissured tongue (OR 2.31; 1.42-3.79). Conclusions: As far as we are aware, this is the first study on lingual pathology to include a PSM analysis. The results suggest that a history of allergies, the presence of medical conditions, and the use of medication are associated with increased probability of tongue lesions. The analysis of diseases and medications by subgroups requires studies matched by habits with larger sample sizes, in order to corroborate our observations.(AU)

Study of factors influencing preoperative detection of alveolar antral artery by CBCT in sinus floor elevation.

This study aimed at assessing the prevalence of alveolar antral artery (AAA) detection by CBCT, its related variables, and at describing explanatory models useful in surgical planning, by retrospective evaluation of CBCT explorations. The modelling of the probability for detecting AAA was undertaken using logistic generalized additive models (GAM). The capacity for discriminating detection/no detection was assessed by receiver operating characteristic curves. A total of 466 sinuses were studied. Univariate models showed detection probability was linked to sinus width and thickness of the lateral bony wall, together with the shape and height of the osseous crest. AAA detection probability increased steadily until the thickness of the bony wall reached 6 mm. Multivariate models resulted good discriminators for AAA detection, particularly for females, showing an area under the curve (AUC) of 0.85. Models considering patients altogether, and those including only males offered slightly lower values (AUC = 0.79). The probability of AAA detection by CBCT was influenced by gender (higher in males and for narrow sinuses) and increases with the thickness of the sinus lateral bony wall and the height of the residual alveolar ridge. Besides, and particularly for women, the thickness of the ridge at the basal level seems to improve the explanatory model for AAA detection.

Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review

Background: The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. Material and Methods: The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. Results: After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. Conclusions: In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis

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Association between geographic tongue and psoriasis: A systematic review and meta-analyses.

Geographic tongue (GT) has been described as a predictor of psoriasis. The objective of this study was to analyse the prevalence of GT in psoriatic and non-psoriatic patients. For this purpose, we conducted a systematic review and meta-analysis. A literature search was performed on PubMed, Embase, Web of Science and the Cochrane Database of Systematic Reviews. The search and selection process was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. Only case-control studies were selected, and the prevalence of GT in both groups was compared. Eleven articles met the inclusion criteria, and the frequency of GT was statistically associated with psoriasis in ten studies. The pooled odds ratio (OR) was 3.53 (95% confidence interval [CI] 2.56-4.86). There were no significant differences between the presence of GT and the clinical form. However, the Psoriasis Area and Severity Index (PASI) score was statistically higher in patients affected by GT in three of four studies. Psoriatic patients with GT also exhibited less improvement in the PASI score after treatment. One study found an association between GT and a negative impact on patients' quality of life. Nevertheless, age, gender, toxic habits, psoriasis onset and duration of the disease were not clearly associated. The results support the concept of GT as a manifestation of psoriasis. Future research should focus on the repercussions of GT in psoriatic patients, due to the negative consequences on severity and treatment response.

Tratamiento del liquen plano oral. Revisión sistemática y protocolo de actuación / Treatment of oral lichen planus. Systematic review and therapeutic guide

En la presente revisión sistemática se analizaron 55 artículos estructurados sobre la eficacia terapéutica frente al dolor y a los signos clínicos del liquen plano oral (LPO). La búsqueda bibliográfica se elaboró siguiendo los criterios del sistema PRISMA, seleccionando los ensayos realizados mediante alguno de los siguientes diseños metodológicos: entre fármaco (principio activo) vs. mismo fármaco en diferente excipiente o concentración, fármaco vs. diferente principio activo, fármaco vs. fitoterapia y fármaco vs. tratamiento con fototerapia. Basándonos en los resultados se propone un algoritmo que sirva de guía para establecer el tratamiento del LPO en sus formas clínicas atrófica y erosiva. Se destaca el empleo del propionato de clobetasol al 0,025-0,05% de aplicación tópica como primera alternativa terapéutica. En segundo lugar, el tacrolimús al 0,1% y pimecrolimús al 1% también formulado para su pauta tópica. Y, finalmente, se aborda el empleo de corticosteroide sistémico y la aplicación de láser de diodo (AU)

In this systematic review, 55 structured articles on the therapeutic efficacy against pain and clinical signs of oral lichen planus (OLP) were analysed. The literature search was developed according to the criteria of the PRISMA system, selecting the tests performed using one of the following methodological designs: drug (active ingredient) vs. drug in different excipient or concentration, drug vs. different active principle, drug vs. phytotherapy and drug vs. treatment with phototherapy. Based on the results, an algorithm is proposed to guide the treatment of OLP in its atrophic and erosive clinical forms. The use of clobetasol propionate at 0.025-0.05% of topical application as the first therapeutic alternative is highlighted. Secondly, 0.1% tacrolimus and 1% pimecrolimus also formulated for its topical regimen. And finally, we address the use of systemic corticosteroids and the application of diode lasers (AU)

Treatment of oral lichen planus. Systematic review and therapeutic guide. / Tratamiento del liquen plano oral. Revisión sistemática y protocolo de actuación.

In this systematic review, 55 structured articles on the therapeutic efficacy against pain and clinical signs of oral lichen planus (OLP) were analysed. The literature search was developed according to the criteria of the PRISMA system, selecting the tests performed using one of the following methodological designs: drug (active ingredient) vs. drug in different excipient or concentration, drug vs. different active principle, drug vs. phytotherapy and drug vs. treatment with phototherapy. Based on the results, an algorithm is proposed to guide the treatment of OLP in its atrophic and erosive clinical forms. The use of clobetasol propionate at 0.025-0.05% of topical application as the first therapeutic alternative is highlighted. Secondly, 0.1% tacrolimus and 1% pimecrolimus also formulated for its topical regimen. And finally, we address the use of systemic corticosteroids and the application of diode lasers.

The development of proliferative verrucous leukoplakia in oral lichen planus. A preliminary study

BACKGROUND: Was to describe 14 cases of a proliferative verrucous leukoplakia as a clinical evolution of oral lichen planus. MATERIAL AND METHODS: The clinical and histopathological characteristics of 14 cases of OLP that progress towards a plaque-like and verrucous form were indicated, with monitoring over a period of six to 24.3 years. RESULTS: The female/male ratio was 11/3, (78.6 and 21.4%). The mean age when the first biopsy was undertaken was 56.4 years old. None of the patients smoked during the study. As bilateral reticular was clinically diagnostic criterion, the second most frequent clinical form was the plaque form (n=10; 71.4%), followed by the atrophic (n=6; 42.8%), and erosive forms (n=4; 28.5%). Clinically it spread towards attached gingival mucosa and the hard palate. In the histopathologic study, there were a predominance of hyperkeratosis and verrucous epithelial hyperplasia. Three of the cases progressed to a squamous cell carcinoma, and one patient developed two verrucous carcinoma. CONCLUSIONS: Further research is needed to demonstrate if proliferative multifocal oral lichen planus and proliferative multifocal oral leukoplakia are the same disorder but have different behaviour of malignancy for reasons of origin

Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study.

BACKGROUND: Thyroid disease has been mentioned to have a possible relation to the development of oral lichen planus (OLP). OBJECTIVE: Because goiter is considered endemic in many countries, we proposed to determine whether thyroid disease constitutes a comorbidity of OLP. METHODS: Two hundred and fifteen patients diagnosed as having OLP were evaluated concerning their serum thyroid-stimulating hormone and thyroxine (T4) levels. The results were contrasted with those obtained in control series of the same number of subjects matched for age and sex. RESULTS: Diagnosis of thyroid disease was present in 15.3% of OLP patients (33/215) and in 5.2% (12/215) of the control group. In relation to OLP patients, the odds ratio of presence of thyroid disorders was 3.06 and that of using levothyroxine medication 3.21. CONCLUSIONS: In the present study, OLP patients were associated with thyroid disease, specifically with hypothyroidism. Because most thyroid patients need T4 treatment, our findings confirmed that OLP and thyroid disease could be comorbidities.

Prevalence of black stain and associated risk factors in preschool Spanish children.

BACKGROUND: In pediatric clinical practice, it is common to be asked about the presence of black stains on teeth in children and teenagers. According to controversial etiology, it is known to be related to a low rate of caries. The aim of this study was to determine the prevalence of black stain and associated risk factors in Spanish preschool children. METHODS: A total of 3272 children aged 6 years old (3058 non-emigrant and 214 immigrant children) living in Oviedo (Spain), were enrolled in the present study. RESULTS: The prevalence of black stain was 3.1% in the whole group. The index of primary decayed, missing, and filled teeth (dmft index) associated with black stain was 0.35 ± 1.123. A statistical association between black stain and the consumption of iron supplements was noted. CONCLUSIONS: The regular consumption of foods rich in iron and the use of iron supplements during pregnancy and early childhood, could favor the development of chromogenic microbiota. The prevalence of black stain did not differ significantly between non-emigrant and immigrant children in Spain.

Oral and facial piercing: associated complications and clinical repercussion.

OBJECTIVES: To investigate the complications of oral and facial piercing and its frequency in an extensive series of cases. METHOD AND MATERIALS: A sample of 2,266 consecutive patients requiring dental care over a period of 1 year was included in this cross-sectional observational study. A total of 83 piercing wearers were identified. Demographics, piercing site, clinical complications, adverse effects of piercing, motivation, and setting of piercing were determined through an interview and intraoral examination. RESULTS: The 18- to 27-year age bracket showed a significantly higher prevalence of piercing wearers (mean years of wear 2.9 +/- 3.8). Esthetic reasons were the most frequent stimulus for piercing insertion (86.7%). Up to an 80.8% of the devices were inserted in a tattooing studio. Forty-nine patients (59.0%) reported postoperative or late piercing complications. Postoperative pain (40.9%; 95% CI = 29.7 to 52.1) was significantly more frequent than infection (10.8%; 95% CI = 3.5 to 18.1) or postpiercing bleeding (7.2%; 95% CI = 1.0 to 13.4). When oral locations were compared to facial sites, the former had caused significantly more problems (X2 = 10.1; P = .001), pain (OR = 0.96; 95% CI = 0.08 to 0.97) and swelling (OR = 0.20; 95% CI = 0.06 to 0.68) being the most frequent undesirable effects associated with oral piercing. CONCLUSIONS: Complications associated with oral and facial piercing are frequent, and many of them might well be avoided if effective legal and hygienic measures were adopted. Educational interventions targeted to the population between 18 and 27 years of age are advisable, particularly when dealing with oral piercing.

Oral lichen planus: a clinical and morphometric study of oral lesions in relation to clinical presentation.

Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical presentations that can be classified as reticular or atrophic-erosive. Sixty-two OLP patients were studied to evaluate the clinical-pathologic characteristics of their OLP lesions and to investigate possible differences in their biological behavior. The most common clinical presentation was the reticular type (62.9% vs 37.1%). Atrophic-erosive presentations showed significantly longer evolution (chi square=4.454; p=0.049), more extensive lesions (chi square=16.211; p=0.000) and more sites affected than reticular ones (chi square=10.048; p=0.002). Atrophic-erosive OLP was more frequently found on the tongue, gingiva and floor of the mouth. No statistically significant differences could be identified between reticular and atrophic-erosive clinical presentations in terms of age, sex, tobacco habit, plasma cortisol level and depth of inflammatory infiltrate. We concluded that the classification of OLP lesions as reticular vs atrophic-erosive is a simple, easy to use classification that can identify clinical presentations with different biological behavior.

Oral lichen planus: a clinical and morphometric study of oral lesions in relation to clinical presentation

O liquen plano oral (LPO) é uma doença inflamatória crónica com diferentes apresentações clínicas que podem ser classificadas como reticuladas ou atrófico-erosivas. Sessenta e dois pacientes com LPO foram estudados para avalidar as características clínicas/patológicas das suas lesões de LPO e investigar possíveis diferenças no seu comportamento biológico. A forma clínica mais comum foi a de tipo reticular (62,9% vs 37,1%). As formas atrófico-erosivas apresentaram um tempo de evolução significativamente maior (chi quadrado=4,454; p=0,049), lesões mais extensas (chi quadrado=16,211; p=0,000) e afetaram a mais localizações em comparação com as lesões reticulares (chi quadrado=10,048; p= 0,002). A forma atrófico-erosiva de LPO foi encontrada mais frequentemente na língua, gengiva e pavimento da boca. Não foram encontradas diferenças significativas entre as formas reticular e atrófico-erosivas em termos de idade, sexo, hábito tabágico, niveis plasmáticos de cortisol e profundidade de infiltrado inflamatório. Concluímos que a classificaçao de lesões de LPO como reticular vs atrófico-erosivo é uma classificaçao simples e facil de usar, que pode identificar apresentações clínicas com diferentes comportamentos biológicos.

Prevalencia de diabetes mellitus en pacientes con liquen plano oral (U0). Características clínico patológicas / Prevalence of diabetes mellitus amongst oral lichen planos patients. Clinical and pathological characteristics

Objetivos: La intención del presente estudio fue definir la prevalencia de diabetes mellitus en pacientes con liquen plano oral (LPO), siguiendo los criterios ADA-97, y estudiar las diferencias clínico-patológicas entre dos grupos de pacientes con LPO (asociados o no con diabetes mellitus). Diseño: Se han reunido 62 pacientes diagnosticados clínica y patológicamente de LPO. Se han considerado los criterios para el diagnóstico de diabetes mellitus establecidos por la Asociación Americana de Diabetes (ADA-1997). Lasvariables estudiadas para cada caso fueron edad, sexo, forma clínica, extensión de las lesiones, localización, número de localizaciones, colonización por Candida albicans y densidad del infiltrado inflamatorio subepitelial. Resultados: El 27,4 por ciento de los LPO se encuentran asociados a diabetes mellitus tipo 2 y el 17,7 por ciento se asocian a un metabolismo alterado de la glucosa (MAG). La edad media del grupo de LPO asociado a diabetes fue significativamente mayor que el grupo de no diabéticos. No se han evidenciado diferencias significativas entre las características clínicas y patológicas entre ambos grupos. Conclusión: La alta prevalencia de trastornos del metabolismo hidrocarbonado en pacientes con LPO justifica la utilización de la glucosa basal plasmática (GBP) para la selección de diabetes tipo 2 en pacientes con esta patología (AU)

Estudio clínico comparativo de la eficacia de Azitromicina frente a Amoxicilina/Ac. Clavulánico en el tratamiento de infecciones orales agudas / Comparative clinical study about the efficacy of Azithromycin vs Amoxicilin/clavunalate in the treatment of acute oral infections

Fundamentos: el objetivo de este estudio fue comparar la eficacia, seguridad y tolerancia de la azitromicina frente a amoxicilina/ac. clavulánlco en el tratamiento de pacientes con infecciones bucales agudas de origen odontogénlco. Pacientes y Metodo: en este estudio abierto, comparativo y multicéntrico, se incluyeron 208 pacientes con infección bucal aguda de origen odontogénlco, asignados aleatoriamente a dos grupos; 102 pacientes recibieron azitromicina, y 106 pacientes recibieron amoxicillna/ac clavulánico. Se realizaron una historia clínica y una exploración física, y se tomaron muestras cie sangre y orina. En cada una de las visitas, se recogieron los signos y síntomas característicos de la Infección. Resultados el nivel de respuesta fue similar en ambos grupos terapéuticos, obteniéndose un porcentaje de curación o mejoría superior al 90 por ciento Azitromicina fue mejor tolerada y tuvo mejor cumplimiento que Amoxicilina/Ac clavulánico. Los efectos adversos fueron en su mayoría gastrointestinales. Conclusion:Azitromicina y amoxicilina/clavulánico fueron igualmente efectivos en el tratamiento de infecciones agudas de origen odontogénico (AU)