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[Oral cavity manifestations of gastroesophageal reflux disease].

The aim of the study was to investigate changes in the oral cavity and the gastroesophageal zone of the patients receiving rabeprazol, a proton pump inhibitor (PPI). The subjects were 88 patients with gastroesophageal reflux disease (GERD), who had changes in the oral cavity typical of this disease. The patients were divided into four groups. Group I included patients with non-erosive reflux disease; the other three groups were formed according to the degree of the severity of reflux esophagitis in accordance with Los Angeles classification of GERD: A, B, and C. The patients were administered rabeprazol as a PPI. The study found that oral cavity changes are associated with the degree of the gastroesophageal reflux. The study demonstrated high efficacy of rabeprazol in GERD patients with oral cavity changes.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Gingival telangiectases: an underappreciated physical sign of juvenile dermatomyositis.

BACKGROUND: MEDLINE searches (1966-June 1969) failed to identify references that give detailed descriptions of the oral manifestations of dermatomyositis (DM). However, several reports predating MEDLINE provided more complete descriptions of oral lesions associated with DM. OBSERVATIONS: We describe 5 cases of juvenile DM with oral manifestations, primarily in the form of gingival telangiectases. These findings are compared with those descriptions found in earlier reports. CONCLUSIONS: Oral lesions in juvenile DM have rarely been reported. Mucous membrane involvement associated with DM may include telangiectases, edema, erosions, ulcers, and leukoplakia-like areas. In cases of DM, gingival telangiectases likely represent an underappreciated diagnostic finding analogous to nail-fold telangiectases.

Child↗

Dental treatment of a child with Rubinstein-Taybi syndrome.

Rubinstein-Taybi syndrome (RTS) is a human genetic disorder characterized by mental retardation and physical abnormalities including broad thumbs, big and broad toes, short stature, and craniofacial anomalies. The oral manifestations include small oral opening, pouting lower lip, retro/micrognathia. and higher arched, narrow palate. The purpose of this case report was to demonstrate the complicated dental treatment of a 12-year-old, developmentally disabled girl, living with a foster family, who suffered from RTS, extensive caries, and very poor oral hygiene. The patient demonstrated total lack of cooperation. The dental treatment had been carried out under general anesthesia (GA). Possible problems during GA in such patients are described. Fiberoptic video-assisted bronchoscope was prepared for the GA in case of airway emergency and/or difficult intubation. The GA process was uneventful, despite the extensive treatment delivered to the patient. Prospects for future good oral and dental status in this patient are questionable because of her extreme lack of cooperation.

Anesthesia, Dental↗

Systemic lupus erythematosus.

Desquamative gingival lesions are non-plaque induced inflammatory gingival lesions. It is a clinical description and not a diagnosis. These desquamative lesions represent oral manifestations of various dermatoses. Systemic lupus erythematous (SLE), one of the rare dermatoses shows desquamative lesions as the oral manifestation. We here with report a case of SLE with oral lesions involving gingiva of a 36 year old female patient. The clinical presentation, histological features, and investigatory findings are discussed.

Adult↗

The effect of budesonide mouthwash on oral chronic graft versus host disease.

Oral chronic graft versus host disease (cGVHD) is common and a major cause of morbidity and loss of quality of life in long term survivors. Cyclosporine with prednisone remains the first line therapy for oral manifestations of cGVHD. However, even with routine administration of systemic agents, many patients with oral manifestations of cGVHD do not have resolution of their disease and may benefit from incorporation of local therapy. Budesonide is a highly potent steroid which has minimal systemic side effects and being used for oral cGVHD. We designed a retrospective study to compare treatment results of patients with oral cGVHD who received topical budesonide in addition to systemic therapy that consists of combined prednisone and cyclosporine (Group A, n = 12), with the treatment results of patients who were administered the same systemic therapy alone (Group B, n = 11) to determine whether budesonide mouthwash had any advantage on response rates. Three mg topical budesonide/10 ml saline was used 3-4 times a day for up to 6 months in group A. Diagnosis, clinical staging, and treatment response scoring for cGVHD were performed according to National Institutes of Health (NIH) consensus criteria. At the baseline examination, there were no statistically significant differences in terms of median oral cGVHD examination scores between two groups. After treatment, there was statistically significant decrease in median oral cGVHD examination scores compared to baseline (P < 0.001 and 0.021), and significant differences were found between two groups (P < 0.032). Overall response rate was 83% and 36% for group A and B, respectively (P = 0.036). However, no statistically significant differences were found between median pain scores of two groups before and after treatment (P = 0.740 and P = 0.091). No major systemic side effects and oral candidiasis were observed in two groups of patients. We concluded that topical budesonide might be added to systemic therapy to obtain better response rates in patients with oral cGHVD.

Adult↗

Oral mucosa manifestations in 100 pregnant versus non-pregnant patients: an epidemiological observational study.

The effect of pregnancy on the oral mucosa is not clear. A study was designed to contrast the number and the type of oral mucosa lesions present in pregnant (study group) and non-pregnant women (control group). A total of 200 women, of whom 100 were pregnant and 100 non-pregnant controls with similar age distribution were chosen at random from obstetrics and dermatology departments, Fatih University Hospital. Oral mucosa lesions were documented in both groups. The data were presented as percentages and comparisons were made based on the chi-square test. The frequency of oral mucosa lesions was greater among the pregnant women than in control group (71.0% versus 29.0%). Cheek biting and oral candidiasis were seen more frequently in pregnant women than the control group. Pregnant women with cheek biting presented in 31 patients (31%) and in control 5 (5%) which was statistically significant, p < 0.001. Oral candidiasis presented in 15 (15%) pregnant versus 5 (5%) in control, which was also statistically significant, p = 0.018. Pregnant women with vomiting were more frequently seen with oral mucosa lesions than pregnant women without vomiting (35 (77.8%) versus 27 (49.1%)), which was statistically significant (p = 0. 003). We concluded that cheek biting and oral candidiasis were the oral mucosa lesions with the greatest prevelances during pregnancy. Pregnant women who visit dermatology clinics should be routinely examined for oral mucosa lesions.

Adolescent↗

Psoriasis-associated periodontitis: a case report.

Psoriasis with oral manifestations is rarely seen. It has been reported in the past either as an oral manifestation of this skin disease or lichen planus accompanying psoriasis. Very few periodontal lesions associated with dermatologic psoriasis have been reported in the literature. This report describes a case of psoriasis in which exacerbation of the cutaneous disease was accompanied by gingival epithelial changes and periodontal bursts, together with a report on the light microscopy of biopsies from periodontal lesions.

Adult↗

Diagnosis and management of commonly occurring oral vesiculoerosive disorders.

Vesiculoerosive disorders are often difficult to diagnose and manage. The oral cavity is often overlooked as a source of diagnostic signs of dermatologic disease. In some disorders, oral manifestations precede cutaneous signs by as much as one year. The authors describe the oral presentation and management of lichen planus, allergic stomatitis, pemphigus vulgaris, and cicatricial pemphigoid, to enable the physician to recognize, diagnose, and treat commonly encountered oral manifestations of dermatologic disease.

Adult↗

Increased prevalence of joint manifestations in patients with recurrent aphthous stomatitis (RAS)

OBJECTIVE: To characterize the systemic manifestations and joint disease in patents with recurrent aphthous stomatitis (RAS). METHODS: The presence and features of extra-oral manifestations were determined by a rheumatologist, who examined and interviewed 64 patients, referred during 1993 to the oral medicine clinic for treatment of RAS. Controls were 65 medical staff members of a military clinic associated with the hospital. RESULTS: Based on the rheumatologist's findings and published criteria, the patients were diagnosed as suffering from RAS alone (24 patients), Reiter's syndrome (8), Behçet disease (8), familial Mediterranean fever (1), or RAS with undiagnosable extra oral manifestations (23). Thirteen patients in the last group had joint disease (p < 0.01 compared to the controls), characterized by recurrent mono- or oligoarthritis/arthralgia of short duration, affecting mostly the large joints. Conjunctivitis, pustular rash, lower back pain and urethritis/cervicitis were also common in RAS patients, but only the latter was significantly more frequent in RAS patients than in controls (p < 0.02). CONCLUSION: These findings suggest that patients with RAS have an increased frequency of a palindromic type joint disease.

Adolescent↗

Prognostic significance of HIV-associated oral lesions and their relation to therapy.

The oral manifestations of HIV infection have been considered to be of value in assessing disease progression in the developed world. However, the potential use of oral lesions as prognostic markers in resource-poor countries has yet to be fully investigated. There is reasonably compelling evidence in the developed world for an association between oral lesions and viral load. However, the true nature of this association is less clear and there are few data available from the developing world. With the introduction of HAART, a change in prevalence of the oral manifestations of HIV infection has been observed, including regression of oral candidiasis, Kaposi's sarcoma and oral hairy leukoplakia. However, oral condylomata and herpes simplex virus infection appear to persist with HMRT therapy. Further research in partnership with resource-poor countries is required to document disease progression and the associated oral lesions in both adults and children.

AIDS-Related Opportunistic Infections↗