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PubMed1988

Diagnosis and management of the oral manifestations of HIV infection and AIDS.

The oral manifestations of HIV infection present as a variety of opportunistic infections, neoplasms, and other lesions. Some of these are common, perhaps the most common, features of HIV disease and are highly predictive of the development of AIDS. Clinicians caring for HIV-infected persons should become familiar with the diagnosis and management of this group of conditions. The oral lesions of HIV infection present challenges of diagnosis and therapy. As the epidemic progresses, it can be expected that further lesions will be observed and that additional rational and effective therapeutic approaches will be developed.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Oral manifestations in patients with aplastic anemia.

OBJECTIVE: The aim of the present study was to characterize the prevalence and risks of oral complications in aplastic anemia (AA). STUDY DESIGN: Approximately 79 patients with AA (age, 37 +/- 17 years) and 66 control patients with schizophrenia (age, 33 +/- 12 years) were examined. Records were reviewed for demographic, clinical, and radiographic information. Prior medical therapy, laboratory values, disease duration, and medical treatment response were noted for patients with AA. Odds ratios (OR) and 95% CI were calculated for oral manifestations in cases and in control subjects. Univariate analysis identified important variables for logistic regression. RESULTS: Patients with AA presented more frequently with oral petechiae (OR = 49; 95% CI, 2.9-825), gingival hyperplasia (OR = 27; 95% CI, 1.6-463.5), spontaneous gingival bleeding (OR = 27; 95% CI, 1.6-463.5), and herpetic lesions (OR = 27; 95% CI, 1.6-463.5). Prior cyclosporine use was associated with gingival hyperplasia (P =.0001). No other predictors for oral manifestations or treatment outcomes were found. CONCLUSIONS: Oral soft tissue changes and infections were more common in patients with AA. Prior cyclosporine use was predictive of the presence of gingival hyperplasia.

Adult↗
PubMed1989

Oral manifestations of drug therapies in the geriatric patient.

Oral manifestations of drug therapies in the geriatric patient must be considered in a multifactorial approach. A logical pattern of individual "normality" must be perceived, and variation from this pattern, with the aid of both physical examination and adequate drug history, will enable the clinician to interpret protean manifestations of untoward actions of chemotherapeutic agents in and about the oral cavity.

Aged↗
PubMed1993

Oral manifestations of menopause.

Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation. It is the result of irreversible changes in the hormonal and reproductive functions of the ovaries. Menopause is accompanied by a number of characteristic physical changes; some of which occur in the oral cavity. The two most common oral manifestations of menopause are: oral discomfort, including pain, a burning sensation, dryness, and altered taste perception; and alveolar bone loss as a result of osteoporosis. Although menopause has been recognized for centuries, it has only been recently that the study of menopause has gained much attention. The purpose of this article is to review the basic physiology of menopause, and to present the etiology of the oral manifestations associated with menopause.

Alveolar Bone Loss↗
PubMed2005

Oral manifestations of HIV infection in 36 Nigerian children.

Oral manifestations of HIV/AIDS are early and common clinical indicators of HIV infection. There has been no report on the clinical prevalence of oral lesions associated with HIV infection in children in sub-Saharan Africa. We report the findings of a cross sectional study of 36 Nigerian children seen at the Pediatrics Infectious Disease Clinic of the AIDS Prevention Initiative in Nigeria (APIN), Jos University Teaching Hospital (JUTH) Jos, Nigeria.

Adolescent↗
PubMed2000

Frequency of oral manifestations in children infected with human immunodeficiency virus.

OBJECTIVE: The main objective of this study was to investigate the frequency of oral manifestations in children with acquired immunodeficiency syndrome. It also attempted to correlate the presence of lesions with the patient's degree of immunosuppression, as measured by the T4/T8 ratio. METHOD AND MATERIALS: Oral examinations were performed in 51 children with acquired immunodeficiency syndrome for a 2-year period. A questionnaire used in this investigation was based on the children's classification proposed by the Centers for Disease Control in 1987. The children's T4/T8 ratios were obtained from their medical files. RESULTS: Pseudomembranous candidiasis was the most common lesion, found in 21.57% of the children. Salivary gland disease was present in 19.61% of patients. Erythematous candidiasis was observed in 5.88%, and linear gingival erythema and oral hairy leukoplakia were both observed in 1.96% of children. Children with a T4/T8 ratio < 0.5 were more prone to development of pseudomembranous candidiasis. CONCLUSION: Pseudomembranous candidiasis was the most common type of oral lesion in human immunodeficiency virus-positive children with acquired immunodeficiency syndrome. There was a relationship between the frequency of oral manifestations and the patient's T4/T8 ratio.

AIDS-Related Opportunistic Infections↗
PubMed1991

Oral manifestations of AIDS-associated non-Hodgkin's lymphomas.

While B-cell lymphomas are frequently found in AIDS patients, reports on oral manifestations are rare. Among a group of 465 HIV-infected patients 5 presented with primary oral manifestations of a malignant B-cell lymphoma. The primary site of manifestation was the maxilla in 3 cases and the mandible in 2 cases. Based on the histological and immunohistochemical examination the tumors were differentiated as Burkitt's lymphoma (n = 1), as anaplastic large cell (ALC) lymphoma of the B-cell type (n = 1), as high-grade non-Hodgkin's lymphoma not classifiable according to the Kiel classification (n = 1), as immunoblastic-plasmoblastic lymphoma (n = 1), and as centroblastic lymphoma (n = 1). Serum samples were negative for HTLV-I antibodies in 5/5 cases.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Oral manifestations of renal osteodystrophy: case report and review of the literature.

Renal osteodystrophy, characterized by uneven bone growth and demineralization, is described. Oral manifestations of the disorder are described, and the value of dental radiographs in early detection of renal osteodystrophy is noted. A case report of a patient with severe oral complications, which resulted from long-standing end-stage renal disease and secondary hyperparathyroidism, is presented. Giant cell lesions of hyperparathyroidism, referred to as brown tumors (which may be associated with pain and swelling), are the key clinical oral manifestations and are the most dramatic dental radiographic finding in patients with renal osteodystrophy. Bone changes may include loss of lamina dura, giant cell lesions of hyperparathyroidism, and bone demineralization. The dentist's role in detection, assessment, and treatment is stressed.

Chronic Kidney Disease-Mineral and Bone Disorder↗
PubMed1999

[Oral manifestations of Lpngerhans' cell histiocytosis. Therapeutic strategies involving oral and maxillofacial surgery].

The definition of Langerhans' cell histiocytosis (formerly known as histiocytosis X) includes the clinical syndromes Hand-Schüller-Christian syndrome, Abt-Letterer-Siwe syndrome and eosinophilic granuloma, which in the past were considered separate entities. The prognosis of this disease varies between "favorable" and "infaust", depending on the age of the patient at first manifestation and the number of the organs involved. With the aid of various prospective clinical studies, suitable therapeutic schemes are currently being sought for. In the course of this search chemotherapy is gaining in significance and radiation therapy is merely playing a minor role. The surgical status has not changed inasmuch as it concerns solitary "operable" lesions. Based on three case reports from our clinic, different courses of illness are described. Oral manifestations of a Langerhans' cell histiocytosis have to be considered, especially with regard to therapy-resistant parodontopathies or with radiologically conspicuous, unexplained osteolysis. The immunohistological and electronic microscopic examinations confirm the diagnosis. The etiology of the disease has still not been clarified.

Adolescent↗
PubMed2001

Oral manifestations in HIV-positive adults from Northern Thailand.

Eighty-seven HIV-infected patients in a provincial hospital in Northern Thailand were examined for oral manifestations of HIV disease and AIDS. The median age was 31.3 years. Seventy-four of the patients were women, 13 were men. 96.6% had a history of heterosexual transmission. Sixty-one patients were CDC-category A, 20 were category B and 6 were category C (AIDS). Thirty-eight percent of the patients revealed oral lesions; 23% had one oral lesion and 13.8% had two oral lesions. Common lesions were oral candidiasis (10.3% pseudomembranous candidiasis, 6.9% erythematous candidiasis and 3.4% both forms), oral hairy leukoplakia (11.5%) and exfoliative cheilitis (6.9%). Gingival linear erythema was seen in 8% of the patients; periodontal lesions and necrotising ulcerative gingivitis were not observed. Men were more commonly affected by oral manifestations than women (P < 0.004). The spectrum of oral lesions is comparable to other studies from the region, although most of these reported more men than women. Also, the degree of immunosuppression was more marked (AIDS).

AIDS-Related Opportunistic Infections↗
PubMed1984

Oral manifestations of chronic graft-v-host disease.

Sixty patients were studied 180 to 500 days after allogeneic marrow transplantation to determine if late oral abnormalities were associated with the presence of chronic graft-v-host disease (GVHD). Lip and intraoral mucosal surfaces were evaluated for color, keratinization, atrophy, and erythema. Subjective complaints of oral pain and xerostomia were also recorded. Abnormalities were scored on a scale of 0 to 3 and tested for association with GVHD by chi 2 test. Oral manifestations most strongly associated with chronic GVHD included atrophy and erythema or lichenoid lesions of the buccal and labial mucosa and oral pain. Oral manifestations resembled several naturally occurring autoimmune disorders. Recognition of these changes can aid in the clinical diagnosis and assessment of established chronic GVHD.

Adolescent↗
PubMed1976

Hereditary epidermolysis bullosa: oral manifestations and dental therapy.

The oral and dental manifestations of epidermolysis bullosa hereditaria were evaluated in seventeen patients with this disorder. Clinical findings were correlated with the electron microscope--documented diagnosis of each variant of epidermolysis bullosa hereditaria. Significant differences in the dental and oral presentations of each variant indicate the importance of considering these findings in differential diagnosis of the variants and in treatment planning for dental disease in these patients. A rationale for surgical and restorative intervention based on experience with these seventeen patients is presented.

Adolescent↗
PubMed1991

Oral manifestations of Crohn's disease. An analysis of 79 cases.

We report four new cases of oral manifestation in Crohn's disease (CD) and evaluate 75 reported cases for morphology and site of oral and intestinal manifestations of CD, clinical manifestation, and treatment. Oral CD was the presenting symptom in 43 of 72 (60%) patients and relapsed in 34 of 60 (57%). Median age at presentation was 22 (range 6-57) years, and males were affected more often (1.85:1, male:female ratio). From a total of 228 oral lesions in 79 patients, lips (57 lesions), gingiva (40 lesions), vestibular sulci (31 lesions), and buccal mucosa (25 lesions) were the sites most frequently affected. Edema (62 lesions), ulcers (57 lesions), and polypoid papulous hyperplastic mucosa (45 lesions) were the most common type of lesions. The rate of granuloma detection was high in oral (67-77%) and intestinal lesions (45-71%). A total of 66 courses of drug therapy in 51 patients were analyzed. Complete remission of oral symptoms was achieved by systemic steroids and/or azathioprine in 13 of 26 (50%) patients, whereas strictly topical treatment with steroids resulted in complete remission of oral symptoms in 7 of 12 (58%). We conclude that oral CD exhibits a characteristic morphologic appearance, as often as not preceding intestinal symptoms in adolescents and young adults. Thus, patients with orofacial granulomatosis CD should be vigorously searched for by complete gastrointestinal endoscopic investigation. Oral CD may cause disabling pain and facial distortion, and results of treatment remain unrewarding. In the absence of data from controlled therapeutic trials, systemic steroids and/or azathioprine are recommended if topical treatment has failed to control symptoms.

Adolescent↗
PubMed1975

Oral manifestations of Crohn's disease without demonstrable gastrointestinal lesions.

The literature relating to oral manifestations of Crohn's disease is reviewed and a case is reported in which clinical and histopathologic features of oral Crohn's disease are present without demonstrable gastrointestinal lesions. It is suggested that it is reasonable to make a firm diagnosis of the condition on this evidence alone and to monitor the patient for subsequent gastrointestinal symptoms, so that treatment can be instituted at an early stage.

Administration, Topical↗
PubMed2002

Oral manifestations of an HIV positive cohort in the era of highly active anti-retroviral therapy (HAART) in South London.

BACKGROUND: Human Immunodeficiency Virus (HIV) infection is associated with oral manifestations of diagnostic and prognostic importance. With the advent of Highly Active Anti-retroviral Therapy (HAART) there is anecdotal evidence to suggest that the prevalence of oral lesions has declined. The number of prevalence studies, carried out in the era of HAART is, however, meagre. Our aim was to study the prevalence of the oral manifestations of HIV in a population, predominantly on HAART, attending a Genito-Urinary Medicine Centre in South London. METHODS: This cross sectional study included 203 adult volunteers, comprising 76% males and 24% females. One third of the subjects were from the predominantly African or Afro- Caribbean ethnic minority groups resident in London. The relationship between the prevalence of oral lesions and demographic variables, therapeutic regimes, viral load and CD4 counts were evaluated. RESULTS: One hundred (49%) of the patients had no detectable oral lesions. Oral lesions detected most frequently included oral hairy leukoplakia (9.9%), HIV associated periodontal diseases (9.9%) and oral candidiasis (4.9%). Three subjects had multiple papillomatous growths. Most cases (n = 17/20) of oral hairy leukoplakia were in individuals with a detectable (> 400 copies/ml) plasma RNA viral load. The majority (n = 8/10) of our patients with oral candidiasis had a plasma RNA viral load > 10,000 copies/ml and half (n = 5/10) had a CD4 count < 200 cells/mm3. Logistic regression analysis suggested that the presence of an oral lesion was not associated with any demographic features except for periodontal diseases which were associated with tobacco smoking (P = 0.023). CONCLUSIONS: The prevalence of so called 'strongly associated' oral lesions of HIV is low in this South London HIV-infected population on HAART, and the relative frequency is different from that cited in the literature from the pre-HAART era. The oral lesions detected were found mostly in people with low CD4 counts and high HIV-1 RNA viral loads, suggesting they were very immunocompromised, not on, or declining therapy, or that their therapy was failing.

Adult↗
PubMedDate not supplied

The oral manifestations of Apert syndrome.

As part of an ongoing study of 119 patients with the Apert syndrome, extensive data were available for the analysis of oral manifestations, including mouth shape, lip posture, palatal morphology, dental anomalies, and malocclusion. Findings included a characteristic trapezoidal-shaped mouth. Cleft soft palate or bifid uvula was found in approximately 75%. A Byzantine-arch shaped palate was recorded in almost all patients. Dental anomalies included severely delayed eruption, ectopic eruption, and shovel-shaped incisors. Malocclusion tended to be severe with mesial molar occlusion, mandibular overjet, anterior and posterior crossbites, and severe crowding of teeth. The oral manifestations of Apert syndrome are compared and contrasted with those of Crouzon syndrome.

Acrocephalosyndactylia↗
PubMed2003

Oral manifestations of paracoccidioidomycosis. Report of 21 cases from Argentina.

The present study describes 21 Argentinian patients living in the province of Corrientes, who had developed oral manifestations due to Paracoccidioides brasiliensis infection. Of these, 20 patients were men and one a woman. Patients were of an average age of 39 years (range 25 to 72 years). Approximately, 76.2% of the patients were farmers. Gingival lesions were observed in 76%. Also, the tongue (71%) and the lips (62%) were frequently affected. Cytological smears and histopathology showed the characteristic fungal cells with the characteristic granulomatous inflammatory reaction consisting of lymphocytes, epithelioid cells and giant cells of the Langhans type. All patients except one had detectable pulmonary involvement. Therapy consists of long-term administration of itraconazole. Oral manifestations of paracoccidioidomycosis are characteristic in their clinical presentation. Early diagnosis and adequate therapy may prevent extensive tissue destructions. Long-term follow-up is mandatory.

Adult↗