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1.
Rev Med Suisse ; 15(672): 2131-2136, 2019 Nov 20.
Artigo em Francês | MEDLINE | ID: mdl-31746569

RESUMO

Many diseases affect the oral cavity. Therefore, the mouth is an organ that internists should observe carefully. Hereafter we present five illustrations of oral semiology that reflect a systemic condition: a strawberry tongue, an ulceration, a labial lesion, a gingival hyperplasia and a gingival hyperpigmentation. Each time, a differential diagnosis is to be considered, potentially allowing the identification of severe diseases.


Assuntos
Medicina Interna/métodos , Doenças da Boca/complicações , Doenças da Boca/diagnóstico , Boca/patologia , Diagnóstico Diferencial , Humanos , Doenças da Boca/patologia , Mucosa Bucal/patologia
2.
Stomatologiia (Mosk) ; 98(4): 48-50, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31513149

RESUMO

The aim of the study was to study hemodynamic parameters in patients with a local form of odontogenic infection (LFOI) in the presence of diseases of the cardiovascular system and without background pathology. 5 groups were formed: group 1 - patients with LFOI without background diseases (49 patients, mean age 29 [25; 37] years); group 2 - healthy individuals (25 people, mean age 24.7±0.76 years); group 3 - patients with LFOI and diseases of the cardiovascular system (34 patients, mean age 51.2±2.37 years); group 4 - patients without LFOI with diseases of the cardiovascular system (25 patients, mean age - 46 [43; 50] years); group of patients with LFOI without background pathology, comparable in age and sex composition with group 3 (group 5, 28 patients, mean age 48.9±2.30 years). The presence of LFOI in the patient in the absence of background pathology determines the heart rate (78 [72; 82] in 1 min) in comparison with the control group of healthy individuals (68.0±0.85 in 1 min), the values of minute volume of blood circulation (5.25±0.14 l/min) and systolic index (2.87 [2.56; 3.35]) l·m-2·min-1. The development of LFOI in patient with hypertension/ischemic heart disease was not associated with increased blood circulation features, such as the increase in resting heart rate values, the values of minute volume of blood circulation and systolic index.


Assuntos
Sistema Cardiovascular , Hemodinâmica , Hipertensão , Doenças da Boca , Adulto , Sistema Cardiovascular/fisiopatologia , Doença Crônica , Frequência Cardíaca , Humanos , Hipertensão/complicações , Pessoa de Meia-Idade , Doenças da Boca/complicações , Doenças da Boca/microbiologia , Adulto Jovem
3.
Lancet ; 394(10194): 249-260, 2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31327369

RESUMO

Oral diseases are among the most prevalent diseases globally and have serious health and economic burdens, greatly reducing quality of life for those affected. The most prevalent and consequential oral diseases globally are dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity. In this first of two papers in a Series on oral health, we describe the scope of the global oral disease epidemic, its origins in terms of social and commercial determinants, and its costs in terms of population wellbeing and societal impact. Although oral diseases are largely preventable, they persist with high prevalence, reflecting widespread social and economic inequalities and inadequate funding for prevention and treatment, particularly in low-income and middle-income countries (LMICs). As with most non-communicable diseases (NCDs), oral conditions are chronic and strongly socially patterned. Children living in poverty, socially marginalised groups, and older people are the most affected by oral diseases, and have poor access to dental care. In many LMICs, oral diseases remain largely untreated because the treatment costs exceed available resources. The personal consequences of chronic untreated oral diseases are often severe and can include unremitting pain, sepsis, reduced quality of life, lost school days, disruption to family life, and decreased work productivity. The costs of treating oral diseases impose large economic burdens to families and health-care systems. Oral diseases are undoubtedly a global public health problem, with particular concern over their rising prevalence in many LMICs linked to wider social, economic, and commercial changes. By describing the extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy, we aim to highlight the urgent need to address oral diseases among other NCDs as a global health priority.


Assuntos
Saúde Global , Doenças da Boca/epidemiologia , Saúde Pública , Efeitos Psicossociais da Doença , Cárie Dentária/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Doenças da Boca/complicações , Doenças da Boca/economia , Doenças da Boca/terapia , Neoplasias Bucais/epidemiologia , Doenças Periodontais/epidemiologia , Prevalência , Fatores Socioeconômicos
4.
Adv Emerg Nurs J ; 41(3): 229-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31356248

RESUMO

The opioid public health crisis necessitates that health care providers seek alternatives to opioid pain control. For patients presenting with dental pain, a dental nerve block provides effective, long-lasting pain relief without the use of opioid pain medications. This article presents the techniques required to safely and effectively administer 3 types of dental nerve blocks, allowing the emergency nurse practitioner to provide effective pain control to patients with dental pain.


Assuntos
Doenças da Boca/complicações , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor/etiologia , Dor/prevenção & controle , Analgésicos Opioides/uso terapêutico , Serviço Hospitalar de Emergência , Humanos , Doenças da Boca/enfermagem , Bloqueio Nervoso/enfermagem , Dor/enfermagem , Manejo da Dor/enfermagem
5.
Bull Cancer ; 106(9): 776-783, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31178070

RESUMO

Mucositis, an acute inflammation of the digestive mucosa, is one of the main toxicities secondary to oncological treatments. Among its consequences, mucositis-related pain is an important complication due to its intensity and repercussion, especially on quality of life. Treatment of pain plays a central role in management of mucositis. It must be multimodal, combining local and general opioid or non-opioid treatments, adapted to pain intensity and based on international recommendations updated in 2014. A systemic analgesic treatment with morphine with a patient-controlled analgesia device is often necessary in severe mucositis. In case of insufficient analgesia, use of co-analgesics (paracetamol, ketamine, anticonvulsants, and antidepressants) can improve analgesic control and reduce morphine doses. Non-drug strategies (distraction, relaxation, hypnosis) and preventive measures must be a major concern. Among them, laser therapy using a low power athermal laser beam, is a promising therapeutic strategy whose effectiveness is based on its analgesic, anti-inflammatory, and healing properties. Despite many available studies, there is a limited number of clinically effective therapies. New therapeutic agents for the prevention and treatment of mucositis and its pain, based on the biological phenomena involved, must be further developed to improve the efficacy of analgesia.


Assuntos
Analgésicos/uso terapêutico , Mucosite/complicações , Manejo da Dor/métodos , Dor/etiologia , Analgesia Controlada pelo Paciente , Analgésicos Opioides/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Humanos , Terapia a Laser , Terapia de Alvo Molecular , Morfina/uso terapêutico , Doenças da Boca/complicações , Doenças da Boca/terapia , Mucosite/terapia , Neoplasias/terapia , Medição da Dor/métodos , Guias de Prática Clínica como Assunto
6.
Vnitr Lek ; 65(4): 314-320, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31091953

RESUMO

In this paper, the authors summarize current findings on the relationship between diabetes mellitus (DM) and oral tissue diseases. They study the effect of diabetes on the condition of hard dental tissues, oral mucosa and salivary glands and explain how these undesirable changes occur. They focus primarily on the bilateral relationship between diabetes and periodontitis, common pathogenetic traits of both diseases and on the effect of periodontal treatment on basic metabolic diseases. They show that diabetes not only negatively affects the condition of periodontal tissues, but inflammatory disease of periodontium is also a risk factor for hyperglycemia. The authors point to the emerging closer co-operation between diabetologists and parodontologists (Perio-Diabetes Workshop in 2017) and consider possibilities of effective prevention and better motivation of diabetics for oral health care.


Assuntos
Diabetes Mellitus , Hiperglicemia , Doenças da Boca , Periodontite , Diabetes Mellitus/classificação , Humanos , Hiperglicemia/complicações , Hiperglicemia/etiologia , Doenças da Boca/complicações , Saúde Bucal , Periodontite/complicações
7.
Intern Med ; 58(15): 2251-2255, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30996173

RESUMO

We herein report a patient with syphilitic cervicitis and cervical cancer presenting as oropharyngeal syphilis. A 31-year-old Japanese woman with a history of unprotected vaginal and oral sex visited our hospital with right submandibular adenomas and erythema in the extremities. The fornix uteri was red, with a nodule noted. The rapid plasma reagin ratio was 1:3. She was diagnosed with syphilitic cervicitis and treated with amoxicillin for four weeks. Initial cervical cytology showed cells with mild nuclear enlargement, which was thought to be metaplasia associated with syphilis. Repeated cytology a month later showed a high-grade squamous intraepithelial lesion. A punch biopsy of the lesion led to the pathological diagnosis of cervical carcinoma in situ. We performed cervical conization, and no recurrence occurred. Human papillomavirus (HPV) immunostaining was positive in the lesion. Mucosal lesions are an infrequently reported symptom of syphilis. When oropharyngeal lesions are found, the sexual history should be ascertained, and the patient should be screened for sexually transmitted diseases. HPV is especially significant because of its association with cervical cancer. Coinfection of HPV with cervical cancer must be ruled out during follow-up for women when oropharyngeal syphilis involves genital lesions.


Assuntos
Doenças da Boca/complicações , Doenças Faríngeas/complicações , Sífilis/complicações , Neoplasias do Colo do Útero/complicações , Cervicite Uterina/complicações , Adulto , Amoxicilina , Biópsia , Citodiagnóstico , Feminino , Humanos , Doenças da Boca/microbiologia , Recidiva Local de Neoplasia/patologia , Infecções por Papillomavirus/complicações , Doenças Faríngeas/microbiologia , Sífilis/tratamento farmacológico , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Cervicite Uterina/microbiologia
8.
Cient. dent. (Ed. impr.) ; 16(1): 17-25, ene.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183377

RESUMO

La enfermedad o disfunción hepática puede deberse a numerosas causas como infecciones adquiridas, patologías congénitas o el abuso de drogas. Cuando esta disfunción y el daño hepático se prolongan a lo largo del tiempo, puede desembocar en una cirrosis hepática, cuadro irreversible y de graves repercusiones para el enfermo. Las dos patologías hepáticas más frecuentes y principales causas de la cirrosis son la hepatitis o inflamación hepática, la cual se puede deber a numerosos factores siendo el más frecuente las infecciones por virus, y la enfermedad hepática alcohólica, provocada por el abuso de alcohol continuado durante un largo período de tiempo. El manejo odontológico de un paciente con alteraciones hepáticas supone un verdadero reto, ya que el hígado juega un papel vital en numerosas funciones metabólicas, como la secreción de bilis o la excreción de bilirrubina procedente del metabolismo de la hemoglobina. Un fallo en la función hepática puede suponer alteraciones en el metabolismo de aminoácidos, amoníaco, proteínas, hidratos de carbono y triglicéridos. Un paciente con patología hepática tendrá un metabolismo alterado de numerosos fármacos empleados habitualmente por el dentista, tendrá un mayor riesgo de hemorragia debido a anomalías en la síntesis de diferentes factores de coagulación, siendo además un paciente con mayor riesgo de infecciones. La gran repercusión de la enfermedad hepática, así como el notable desconocimiento de muchos profesionales odontólogos en su manejo, justifican este artículo donde se talla tanto las generalidades más importantes de esta entidad como sus principales manifestaciones orales y consideraciones en el manejo odontológico


Liver disease or dysfunction may be due to numerous causes such as acquired infections, congenital pathologies or drug abuse. When this dysfunction and liver damage are prolonged overtime, it can lead to hepatic cirrhosis, an irreversible condition and serious repercussions for the patient. The two most frequent liver diseases and major causes of cirrhosis are hepatitis or hepatic inflammation, which may be due to numerous factors being the most frequent virus infections, and alcoholic liver disease, caused by alcohol abuse continued during A long period of time. The dental management of a patient with liver disorders is a real challenge, since the liver plays a vital role in many metabolic functions, such as bile secretion or excretion of bilirubin from hemoglobin metabolism. A failure in liver function can lead to alterations in the metabolismof amino acids, ammonia, proteins, carbohydrates and triglycerides. A patient with liver disease will have an altered metabolism of numerous drugs commonly used by the dentist, will have a greater risk of hemorrhage due to abnormalities in the synthesis of different coagulation factors, being also a patient with a higher risk of infections. The great repercussion of liver disease, as well as the remarkable lack of knowledge of many dental professionals in its management, justify this article where it is detailed both the most important generalities of this entity as its main oral manifestations and considerations in dental management


Assuntos
Humanos , Hepatite Viral Humana/complicações , Hepatite Crônica/complicações , Hepatopatias Alcoólicas/complicações , Doenças da Boca/complicações , Doenças da Boca/terapia , Assistência Odontológica para Doentes Crônicos/métodos , Odontopatias/complicações , Odontopatias/terapia
9.
Rev. cuba. estomatol ; 56(1): e1495, ene.-mar. 2019. graf
Artigo em Português | LILACS | ID: biblio-1003872

RESUMO

Introdução: Pacientes submetidos à radioterapia para tratamento de neoplasias malignas na região de cabeça e pescoço são propensos a desenvolver complicações orais como a cárie de radiação, que evolui rapidamente e é altamente destrutiva.É reconhecido que o seu desenvolvimento está associado a alterações pós-radioterápicas nas glândulas salivares maiores, o que resulta em hipossalivação e alteração nos constituintes salivares. No entanto, tem sido aceito que danos diretos causados pela radiação à estrutura dentária podem acelerar a progressão da cárie e estudos têm demonstrado alterações morfológicas e físicas em dentes humanos após radioterapia. Objetivo: Propõe-se apresentar um caso de cárie de radiação e os efeitos diretos da radioterapia na estrutura dentária. Relato de caso: Paciente masculino, 60 anos de idade, com queixa principal de fragilidade dentária; relatou história de carcinoma epidermóide em língua há 18 meses e que o protocolo de tratamento aplicado foi quimioterapia (38 sessões), radioterapia (38 sessões) e cirurgia. Ao exame físico, dentre as alterações observadas, destacou-se a presença de regiões cervicais dentárias enegrecidas com coroas bastante fragilizadas em todos os dentes remanescentes, características de cárie de radiação. Foi realizado um tratamento atraumático, que está em acompanhamento. Conclusões: A cárie de radiação tem como principal fator etiológico alterações salivares qualitativas e quantitativas. A discussão sobre os efeitos diretos da radioterapia sobre a estrutura dentária ainda é bastante polêmica na literatura odontológica. Desta forma, sugere-se que mais estudos sejam realizados de forma sistemática, de maneira mais completa e padronizada(AU)


Introducción: Los pacientes sometidos a radioterapia para el tratamiento de tumores malignos en la cabeza y el cuello son propensos a desarrollar complicaciones bucales, tales como caries de radiación que evoluciona rápidamente y es altamente destructiva. Se reconoce que el desarrollo se asocia con cambios posradioterapia en las glándulas salivales, que resulta en hiposalivación y el cambio en los componentes salivales. Sin embargo, se ha aceptado que los daños por radiación directa a la estructura dental puede acelerar la progresión de la caries y los estudios han demostrado cambios morfológicos y físicos en los dientes humanos después de la radioterapia. Objetivo: presentar un caso de caries de radiación y los efectos directos de la radiación en la estructura dental. Presentación del caso: Paciente masculino de 60 años de edad, se quejaba de fragilidad dental, con historia notificada de carcinoma de células escamosas en la lengua hace 18 meses y con protocolo de tratamiento aplicado de quimioterapia (38 sesiones), terapia de radiación (38 sesiones) y cirugía. En el examen físico, de los cambios observados, se destacó la presencia de regiones cervicales dentarias negruzcas con coronas bastante frágiles en todos los dientes restantes, características de caries de radiación. El tratamiento atraumático se realizó y el paciente está bajo observación. Conclusiones: los cambios cuantitativos y cualitativos salivales actúa como el factor causal principal de la caries por radiación. La discusión acerca de los efectos directos de la radiación sobre la estructura del diente es todavía muy controvertido en la literatura dental. Por lo tanto, se sugiere que se realicen estudios adicionales de manera sistemática, más completa y estandarizada(AU)


Introduction: Patients undergoing radiotherapy as treatment for malignant head and neck tumors are prone to develop oral complications such as radiation caries, which evolves rapidly and is highly destructive. Such development is known to be caused by post-radiotherapy alterations in salivary glands resulting in hyposalivation and changes in salivary components. However, it has been accepted that damage by direct radiation to the dental structure may hasten the progress of caries development, and studies have shown the morphological and physical changes occurring in human teeth after radiotherapy. Objective: Present a case of radiation caries and the direct effects of radiation on dental structure. Case presentation: A 60-year-old male patient complains of dental fragility. The patient was diagnosed with squamous-cell carcinoma of the tongue 18 months ago and indicated chemotherapy (38 sessions), radiotherapy (38 sessions) and surgery. Physical examination revealed among other changes the presence of blackish cervical areas with quite fragile crowns in all remaining teeth, which are characteristic of radiation caries. Non-traumatic treatment was performed and the patient is now under observation. Conclusions: Salivary quantitative and qualitative changes are the main cause of radiation caries. Discussion about the direct effects of radiation on dental structure is still quite controversial in the literature on the topic. It is therefore suggested to conduct further studies in a more systematic, complete and standardized manner(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Suscetibilidade à Cárie Dentária/efeitos da radiação , Doenças da Boca/complicações , Neoplasias da Língua/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia
10.
Rev. cuba. estomatol ; 56(1)ene.-mar. 2019. graf
Artigo em Português | CUMED | ID: cum-74127

RESUMO

Introdução: Pacientes submetidos à radioterapia para tratamento de neoplasias malignas na região de cabeça e pescoço são propensos a desenvolver complicações orais como a cárie de radiação, que evolui rapidamente e é altamente destrutiva.É reconhecido que o seu desenvolvimento está associado a alterações pós-radioterápicas nas glândulas salivares maiores, o que resulta em hipossalivação e alteração nos constituintes salivares. No entanto, tem sido aceito que danos diretos causados pela radiação à estrutura dentária podem acelerar a progressão da cárie e estudos têm demonstrado alterações morfológicas e físicas em dentes humanos após radioterapia. Objetivo: Propõe-se apresentar um caso de cárie de radiação e os efeitos diretos da radioterapia na estrutura dentária. Relato de caso: Paciente masculino, 60 anos de idade, com queixa principal de fragilidade dentária; relatou história de carcinoma epidermóide em língua há 18 meses e que o protocolo de tratamento aplicado foi quimioterapia (38 sessões), radioterapia (38 sessões) e cirurgia. Ao exame físico, dentre as alterações observadas, destacou-se a presença de regiões cervicais dentárias enegrecidas com coroas bastante fragilizadas em todos os dentes remanescentes, características de cárie de radiação. Foi realizado um tratamento atraumático, que está em acompanhamento. Conclusões: A cárie de radiação tem como principal fator etiológico alterações salivares qualitativas e quantitativas. A discussão sobre os efeitos diretos da radioterapia sobre a estrutura dentária ainda é bastante polêmica na literatura odontológica. Desta forma, sugere-se que mais estudos sejam realizados de forma sistemática, de maneira mais completa e padronizada(AU)


Introducción: Los pacientes sometidos a radioterapia para el tratamiento de tumores malignos en la cabeza y el cuello son propensos a desarrollar complicaciones bucales, tales como caries de radiación que evoluciona rápidamente y es altamente destructiva. Se reconoce que el desarrollo se asocia con cambios posradioterapia en las glándulas salivales, que resulta en hiposalivación y el cambio en los componentes salivales. Sin embargo, se ha aceptado que los daños por radiación directa a la estructura dental puede acelerar la progresión de la caries y los estudios han demostrado cambios morfológicos y físicos en los dientes humanos después de la radioterapia. Objetivo: presentar un caso de caries de radiación y los efectos directos de la radiación en la estructura dental. Presentación del caso: Paciente masculino de 60 años de edad, se quejaba de fragilidad dental, con historia notificada de carcinoma de células escamosas en la lengua hace 18 meses y con protocolo de tratamiento aplicado de quimioterapia (38 sesiones), terapia de radiación (38 sesiones) y cirugía. En el examen físico, de los cambios observados, se destacó la presencia de regiones cervicales dentarias negruzcas con coronas bastante frágiles en todos los dientes restantes, características de caries de radiación. El tratamiento atraumático se realizó y el paciente está bajo observación. Conclusiones: los cambios cuantitativos y cualitativos salivales actúa como el factor causal principal de la caries por radiación. La discusión acerca de los efectos directos de la radiación sobre la estructura del diente es todavía muy controvertido en la literatura dental. Por lo tanto, se sugiere que se realicen estudios adicionales de manera sistemática, más completa y estandarizada(AU)


Introduction: Patients undergoing radiotherapy as treatment for malignant head and neck tumors are prone to develop oral complications such as radiation caries, which evolves rapidly and is highly destructive. Such development is known to be caused by post-radiotherapy alterations in salivary glands resulting in hyposalivation and changes in salivary components. However, it has been accepted that damage by direct radiation to the dental structure may hasten the progress of caries development, and studies have shown the morphological and physical changes occurring in human teeth after radiotherapy. Objective: Present a case of radiation caries and the direct effects of radiation on dental structure. Case presentation: A 60-year-old male patient complains of dental fragility. The patient was diagnosed with squamous-cell carcinoma of the tongue 18 months ago and indicated chemotherapy (38 sessions), radiotherapy (38 sessions) and surgery. Physical examination revealed among other changes the presence of blackish cervical areas with quite fragile crowns in all remaining teeth, which are characteristic of radiation caries. Non-traumatic treatment was performed and the patient is now under observation. Conclusions: Salivary quantitative and qualitative changes are the main cause of radiation caries. Discussion about the direct effects of radiation on dental structure is still quite controversial in the literature on the topic. It is therefore suggested to conduct further studies in a more systematic, complete and standardized manner(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Suscetibilidade à Cárie Dentária , Doenças da Boca/complicações , Neoplasias da Língua , Neoplasias de Cabeça e Pescoço/radioterapia
11.
Clin Oral Investig ; 23(7): 2921-2927, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30623306

RESUMO

OBJECTIVES: Aim of this study was to investigate conditions and predisposing factors for head and neck infection progress regarding the length of stay (LOS) in hospital, with special emphasis on the time of removal of the odontogenic infection focus. MATERIAL AND METHODS: A 3-year retrospective study reviewed hospital records of 248 subjects who were treated under inpatient conditions with severe odontogenic infections who received surgical incisions, drainage, and intravenous (IV) antibiotics. Outcomes measured included age, gender, involved fascial spaces, LOS, number of infected spaces, antibiotics administered, and comorbidities. We precisely recorded the time between abscess incision and focus extraction. RESULTS: Removal of infection focus (tooth) in the same stay (1 stay, n = 106; group 1; mean 6.5 days ± 3) showed significantly higher (p = 0.042) LOS than extraction in a second stay (2 stays, n = 46; group 2; 5.3 ± 3.1). Group 3 patients showed infection after removal of teeth in outpatient management (1 stay ex-op, n = 96) and presented significantly lower LOS (5.6 ± 2.5) compared to group 1 (p = 0.0216). LOS of group 3 to group 2 patients showed no significance (p = 0.668). Infection expansion and diabetes showed a significant increase of LOS. CONCLUSION: Simultaneous removal of infection focus and abscess incision leads to the lowest LOS. If tooth extraction is performed after incision, subsequent focus extraction performed in a second stay shows lower overall-LOS than extraction at the same stay at later stage. CLINICAL RELEVANCE: Multiple factors tend to increase the LOS of patients with severe head and neck infections of odontogenic origin. Our data reveals the role of removal of odontogenic focus and additionally ranks further parameters that influence the LOS. Based on our findings, decisions regarding the surgical treatment can be recommended.


Assuntos
Cabeça , Tempo de Internação , Pescoço , Abscesso/cirurgia , Criança , Cabeça/microbiologia , Humanos , Doenças da Boca/complicações , Pescoço/microbiologia , Estudos Retrospectivos
12.
Adv Clin Exp Med ; 28(4): 547-554, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30079996

RESUMO

Systemic sclerosis (SSc) is a chronic, generalized disorder of the connective tissue. It is characterized by immune disorders, abnormalities of morphology and functions of small blood vessels, and the presence of inflammatory process. The pathogenesis of this disorder has not yet been fully understood. The classification criteria were established by The American College of Rheumatology (ACR). A number of clinical types are distinguished due to the diversity of the clinical picture. These types are characterized by a different course, presence of organ complications and prognosis. Connective tissue disorders are interdisciplinary conditions and, therefore, the subject of interest of different medical specialties, including dentistry. The oral cavity may be the place of pathological manifestations within soft and hard tissues. Such manifestations are the results or the primary symptom of systemic diseases. The relationship between the health of the oral cavity and systemic diseases has been frequently reported in the literature. Lesions in the oral cavity in patients with SSc are discussed in detail in the present paper. Management includes the administration of drugs that prevent tissue ischemia and post-ischemic consequences as well as drugs that inhibit inflammatory-immune processes and excessive collagen production.


Assuntos
Doenças da Boca/complicações , Saúde Bucal , Escleroderma Sistêmico/complicações , Odontopatias/complicações , Humanos , Estados Unidos
13.
J Craniofac Surg ; 30(1): 188-192, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30444789

RESUMO

BACKGROUND: Speech issues in microtia patients have been historically attributed to poor hearing. However, the authors have noted that almost all patients with microtia have palatal dysfunction. The aim of this study is to determine the prevalence of soft palate dysfunction (SPD) and velopharyngeal insufficiency (VPI) in microtia patients. METHODS: A prospective cohort study was performed on consecutive microtia patients from March to June 2017. Clinical characteristics were collected. Palate movement was rated by oral examination and degree of nasal escape by the mirror-fogging test. Correlations between clinical characteristics of microtia and SPD were determined. RESULTS: Ninety-seven (40 unilateral, 27 bilateral, and 30 control) children met inclusion criteria. Among all 67 patients with microtia, 96% (64 patients) showed SPD. Twenty-four unilaterals (60%) and 23 bilaterals (85%) had observable VPI by mirror examination. Of these patients, nasality was noticeable to the examiners in 14 unilaterals (58%) and 21 bilaterals (91%). Sixteen of the 27 bilaterals (59%) showed almost no movement of the soft palate. There was a significant correlation between SPD and mirror-fogging. A less developed middle ear as determined by computed tomography scan was associated with palatal dysfunction (P = 0.007). The severity of mandibular shift (P = 0.048) and presence of a syndrome (P = 0.045) were associated with grade of VPI. The severity of the ear deformity (P = 0.007) and presence of a syndrome (P = 0.034) were also correlated with the presence of SPD. CONCLUSIONS: This is the first study that documents the presence of VPI due to soft palate dysfunction in patients with isolated and nonisolated microtia.


Assuntos
Microtia Congênita , Doenças da Boca , Palato Mole/fisiopatologia , Insuficiência Velofaríngea , Criança , Microtia Congênita/complicações , Microtia Congênita/epidemiologia , Humanos , Doenças da Boca/complicações , Doenças da Boca/epidemiologia , Estudos Prospectivos , Insuficiência Velofaríngea/complicações , Insuficiência Velofaríngea/epidemiologia
14.
Clin Oral Investig ; 23(1): 123-131, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29549441

RESUMO

OBJECTIVES: This study aimed to assess the maxillary sinus mucosal thickening and to associate them with odontogenic conditions using cone-beam computed tomographic (CBCT) images. MATERIALS AND METHODS: CBCT images of 294 patients (143 female, 151 males; age range 18-78 years) with 588 maxillary sinuses were evaluated retrospectively. The anatomic relationship between maxillary sinuses and teeth was determined and classified. The presence of root canal fillings and the periapical lesions of these teeth was also recorded. Sinus mucosal thickenings were classified as grade 1 (normal) (< 2 mm), grade 2 (moderate) (2-10 mm), and grade 3 (severe) (> 10 mm). Alveolar bone loss was measured on all maxillary premolar/M teeth. RESULTS: More than 2-mm mucosal thickening (grade 2 and grade 3) in either one or both maxillary sinuses was found in 172 (58.5%) of the patients. The prevalence of mucosal thickening (> 2 mm) for maxillary sinuses with and without any periapical lesions was 42.1 and 53.6%, respectively (p < 0.05). The prevalence of mucosal thickening increased in patients with periodontal alveolar bone loss (p < 0.05). There was a significant correlation between mucosal thickening with age, gender and missing teeth (p < 0.05). CONCLUSIONS: Multiple conditions, including periapical infection, root canal treatment, and close relationship maxillary teeth and sinus, may have a precursor effect on the occurrence of mucosal thickening in the maxillary sinus. Periodontal status and its role as a risk factor in triggering maxillary sinus infections should be also considered by not only dental professionals but also the medical professionals to plan for the treatment of maxillary sinus lesions. CLINICAL RELEVANCE: Maxillary sinuses are significantly influenced by various odontogenic conditions, including periodontal bone loss, periapical lesions, and missing teeth, which may result in thickening of the maxillary sinus mucosa.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Doenças da Boca/complicações , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
15.
BMJ Case Rep ; 11(1)2018 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-30593526

RESUMO

Syphilis is a sexually transmitted disease that can affect multiple organ systems, with central nervous system involvement at any stage. We present a 53-year-old woman with an unusual truncal rash with painful anogenital lesions, accompanied by patchy alopecia, oral lesions, photophobia and hoarseness. She was found to have positive serological tests for syphilis with cerebrospinal fluid findings suggestive of neurosyphilis. She underwent a 14-day course of intravenous penicillin G and exhibited successful resolution of painful anogenital lesions as well as marked improvement in dermatological, oropharyngeal, laryngeal, and neurological symptoms.


Assuntos
Rouquidão/diagnóstico , Neurossífilis/diagnóstico , Sífilis Cutânea/diagnóstico , Alopecia/complicações , Alopecia/diagnóstico , Alopecia/tratamento farmacológico , Alopecia/patologia , Antibacterianos/uso terapêutico , Doenças do Ânus/complicações , Doenças do Ânus/diagnóstico , Doenças do Ânus/tratamento farmacológico , Doenças do Ânus/patologia , Feminino , Cefaleia/etiologia , Rouquidão/tratamento farmacológico , Rouquidão/etiologia , Humanos , Doenças da Laringe/complicações , Doenças da Laringe/diagnóstico , Doenças da Laringe/tratamento farmacológico , Pessoa de Meia-Idade , Doenças da Boca/complicações , Doenças da Boca/diagnóstico , Doenças da Boca/tratamento farmacológico , Doenças da Boca/patologia , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/complicações , Neurossífilis/tratamento farmacológico , Palato Duro , Penicilina G/uso terapêutico , Fotofobia/etiologia , Sífilis Cutânea/tratamento farmacológico , Sífilis Cutânea/patologia , Doenças da Vulva/complicações , Doenças da Vulva/diagnóstico , Doenças da Vulva/tratamento farmacológico , Doenças da Vulva/patologia
16.
Oral Health Prev Dent ; 16(6): 509-516, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30574605

RESUMO

PURPOSE: To compare the oral health of patients with bipolar disorder (BD) with a control group of subjects. MATERIALS AND METHODS: The study sample comprised 242 patients with BD and a mean age of 35.8 years. The control group comprised 187 subjects and a mean age of 37.3 years. Oral health was assessed through clinical examination by the Decayed, Missing, and Filled Teeth (DMFT) Index, the Community Periodontal Index (CPI), and the Simplified Oral Hygiene Index (OHI-S). RESULTS: Patients with BD had higher caries prevalence, poorer periodontal health, and poorer oral hygiene than control group subjects. The average DMFT index score was 10.0 (SD = 5.7) in the BD group and 8.1 (SD = 5.2) in the control group (p = 0.002). The mean value of decayed teeth in patients with BD (4.5) was significantly higher than that of the control group (2.3) (p < 0.001). Periodontal diseases were significantly more prevalent among patients with BD (p < 0.001), particularly regarding shallow and deep pockets (47.1% vs. 16.6%). Oral dryness (xerostomia) and severe tooth wear were also more prevalent among patients with BD (p < 0.001). Statistically significant risk factors for higher DMFT scores were: older age and having BD; CPI scores of 3 or 4; having BD, male gender, older age, and lower educational level. CONCLUSION: Poorer oral health among patients with BD is represented mostly as caries and advanced periodontal disease. The results of this study highlight the necessity to intensify preventive dentistry in this vulnerable population.


Assuntos
Transtorno Bipolar/complicações , Cárie Dentária/complicações , Doenças da Boca/complicações , Saúde Bucal , Adulto , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Doenças da Boca/epidemiologia , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia
17.
Oral Maxillofac Surg ; 22(4): 429-433, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30298214

RESUMO

PURPOSE: We aimed to compare the histomorphological features of oral lymphoepithelial cysts (OLC) in different locations of the oral cavity and to verify the association between oral lymphoepithelial cysts and subgemmal neurogenous plaque (SNP) on biopsies from the lateral border of the tongue. METHODS: All cases diagnosed as OLC from the Oral Pathology Service at the School of Dentistry/University of São Paulo were retrieved. For all the cysts located in the tongue, their association to SNP was analyzed. Immunohistochemical staining against S100 was performed to confirm the diagnosis of SNP. RESULTS: Thirty-one cases were selected for morphological analysis and SNP was identified in 40% of cases, all of them positive for S100. In these cases, macroscopic analysis demonstrated two independent fragments. Microscopic analysis showed that cysts located in the floor of the mouth and ventral surface of the tongue showed less intense exocytosis, less formation of lymphoid follicles, and predominantly a moderate inflammatory infiltrate. CONCLUSIONS: OLC have a similar histological pattern regardless the location within the oral cavity and. In some cases, the biopsy specimen may be accompanied by a SNP as an adjacent independent structure.


Assuntos
Branquioma/patologia , Doenças da Boca/diagnóstico , Neoplasias Bucais/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Branquioma/complicações , Criança , Feminino , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Boca/patologia , Doenças da Boca/complicações , Doenças da Boca/patologia , Neoplasias Bucais/complicações , Estudos Retrospectivos , Adulto Jovem
18.
Stomatologiia (Mosk) ; 97(5): 8-10, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30346413

RESUMO

Purpose of the study was to identify dental risk factors for complications at the stage of rehabilitation adaptation in patients with diffuse liver lesions. The study included 52 patients with diffuse liver lesions aged 25-55 years, who were divided between two groups of 26 persons with different dental status, depending on the main disease stage of treatment. RESEARCH METHODS: Clinical, x-ray, morphological, analytical, statistical. RESULTS: It has been reliably established that low level of oral hygiene, high intensity and prevalence of caries and its complications (foci of odontogenic infection), inflammatory periodontal diseases joined with severe teeth hyperesthesia, dominate in patients before liver transplantation, which confirms low level of sanitation on stages of preparation for surgical treatment. Chronic odontogenic infection in periodontal tissues with phenomena of epithelial cells dystrophy, candidiasis of the oral mucosa, foci of odontogenic infection, low level of oral hygine, tendency to precancerous diseases development are the risk factors for complications arise on the stage of rehabilitation adaptation in patients with diffuse liver lesions. CONCLUSION: The revealed relationship between diffuse liver lesions and dental status of patients, at the stages of preparation and after liver transplantation indicates, that a low level of oral cavity sanitation, the presence of odontogenic infection and periodontal disease worsen the course of the main disease, increase the risk of transplant rejection and require the creation of a dental rehabilitation system for this category of patients.


Assuntos
Cárie Dentária , Transplante de Fígado , Doenças da Boca , Doenças Periodontais , Adulto , Cárie Dentária/complicações , Humanos , Fígado , Hepatopatias/complicações , Hepatopatias/cirurgia , Pessoa de Meia-Idade , Doenças da Boca/complicações , Higiene Bucal , Doenças Periodontais/complicações
20.
BMJ Case Rep ; 20182018 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-30262529

RESUMO

A 13-year-boy presented with painless swelling of upper and lower lips accompanied with gingival enlargement. The aetiology for these symptoms included vast pathological varieties but none of them could fit in. Clinical features were similar to orofacial graulomatosis but histopathological examination revealed chronic non-specific infection. Therefore, the final diagnosis was made as idiopathic macrocheilia through exclusion criteria. Management with intralesional triamcinolone acetonide 40 mg, twice a week for 3 weeks, resulted in significant remission in lip swelling without recurrence after a 6-month follow-up.


Assuntos
Lábio , Síndrome de Melkersson-Rosenthal/diagnóstico , Doenças da Boca/diagnóstico , Doenças da Boca/terapia , Doenças Raras/diagnóstico , Adolescente , Anti-Inflamatórios/administração & dosagem , Edema/etiologia , Gengiva/patologia , Gengiva/cirurgia , Humanos , Injeções Intralesionais , Lábio/diagnóstico por imagem , Lábio/cirurgia , Masculino , Síndrome de Melkersson-Rosenthal/complicações , Síndrome de Melkersson-Rosenthal/terapia , Doenças da Boca/complicações , Doenças Raras/complicações , Doenças Raras/terapia , Triancinolona Acetonida/administração & dosagem
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