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Herpes zoster in HIV infection with osteonecrosis of the jaw and tooth exfoliation.

BACKGROUND: Herpes zoster (HZ) infection of the trigeminal nerve is associated with complications such as postherpetic neuralgia, facial scarring, loss of hearing ability and conjunctivitis. Until 2005, postherpetic alveolar necrosis and spontaneous tooth exfoliation have been described in 20 cases unrelated to HIV infection. OBJECTIVE: The aim of this study was to describe HIV infection in patients (two women, two men, average age 30 years) who suffered from HZ attacks to their trigeminal nerves. MAIN OUTCOME MEASURES: None of the patients had received antiherpetic medications or antiretroviral therapy. HIV infection was only diagnosed after the development of HZ. Facial scarring with depigmentation and hyperesthesia (postherpetic neuralgia) was diagnosed in all four patients. Oral findings consisted of spontaneous loss of both maxillary or mandibular teeth. Osteonecrosis of varying extent was also found. Treatment consisted of extractions of teeth and administration of antibiotics and analgesics. Healing of alveolar wounds was unremarkable. CONCLUSION: Complications affecting the alveolar bone and teeth seem to be rare in HIV-infected patients.

Adult↗

Predictors of chewing difficulty onset among dentate adults: 24-month incidence.

OBJECTIVES: Chewing ability is an important measure of health-related quality of life, yet few studies have examined predictors of chewing difficulty in community-based samples. This study describes longitudinal patterns of chewing difficulty and identifies predictors of chewing difficulty onset. METHODS: The Florida Dental Care Study (FDCS) was a longitudinal study of oral health and related behaviors. Interviews and a clinical exam were conducted with a sample that included persons who had at least one tooth and were aged 45 years or older (n = 873). The five-item chewing index of Leake (1990), with minor revision, was the outcome of interest. RESULTS: Approximately 21 percent of baseline participants reported chewing difficulty and about 34 percent reported difficulty during the study. Having infected or sore gums, loose tooth, loose crown or bridge, toothache pain, lower numbers of opposing pairs of teeth, dry mouth, and being female were significant predictors of incident chewing difficulty. CONCLUSIONS: Self-reported oral disease and tissue damage and toothache pain were strong predictors of decline in chewing ability. Additionally, women were identified as a high-risk group for incident chewing difficulty. Future research should elaborate further the pathways through which these factors affect oral function.

Aged↗

Early tooth loss due to cyclic neutropenia: long-term follow-up of one patient.

In young patients with abnormal loosening of teeth and periodontal breakdown, dental professionals should consider a wide range of etiological factors/diseases, analyze differential diagnoses, and make appropriate referrals. The long-term oral and dental follow-up of a female patient diagnosed in early infancy with cyclic neutropenia is reviewed, and recommendations for care are discussed.

Adult↗

Loss of upper permanent central incisor teeth. Case report.

A case is reported in which elastic bands caused irreversible periodontal destruction around upper central incisor teeth. Every practitioner should be aware of the hazards associated with the use of elastic bands in minor tooth movement.

Alveolar Process↗

Clinical signs and treatment of aged sheep with loose mandibular or maxillary cheek teeth.

Five cases of loose mandibular or maxillary cheek teeth in sheep are described. All the sheep showed loss of condition but excessive salivation was not a consistent feature. Two had high helminth egg counts, one a facial abscess and three loose rostral teeth. Blood biochemical results showed raised creatine phosphokinase (three cases), low glucose (three) and marginally low calcium levels (two). Diagnosis was based on digital palpation of the teeth during sedation. Treatment by extraction of loose teeth allowed a further litter of lambs from pregnant ewes and an extra tupping season from a ram.

Aging↗

Spontaneous correction of pathologic tooth migration and reduced infrabony pockets following nonsurgical periodontal therapy: a case report.

This case report describes the spontaneous correction of pathologic tooth migration and reduced infrabony pockets after nonsurgical periodontal therapy. A 3-mm diastema between the maxillary incisors was closed completely, and the mandibular teeth, which had migrated pathologically, returned to the optimal position. Clinical evaluation showed a significant reduction in probing depth, with increased clinical attachment and bone deposition demonstrated radiologically.

Alveolar Bone Loss↗

Expression of mRNAs encoding for alpha and beta integrin subunits, MMPs, and TIMPs in stretched human periodontal ligament and gingival fibroblasts.

The biological mechanisms of tooth movement result from the cellular responses of connective tissues to exogenous mechanical forces. Among these responses, the degradation of the extracellular matrix takes place, but the identification of the molecular basis as well as the components implicated in this degradation are poorly understood. To contribute to this identification, we subjected human fibroblasts obtained from the periodontal ligament (PDLs) and from the gingiva (HGFs) to a continuous stretch to quantify the mRNAs encoding for various metalloproteinases (MMPs), their tissue inhibitors (TIMPs), and alpha and beta integrin subunits. Both cell lines reacted by inducing the expression of the mRNAs encoding for MMP-1, MMP-2, TIMP-1, and TIMP-2, while other mRNAs did not vary (MT1-MMP, TIMP-3) or were not expressed (MMP-9). PDLs expressed selectively the mRNAs encoding for alpha4 and alphav, with no difference measurable under stretching, while the mRNAs encoding for alpha6 and beta1 were increased and the one encoding for alpha5 was decreased. HGFs increased the mRNAs encoding for alpha2, alpha6, beta1, and beta3 and decreased the one encoding for alpha3. Analysis of our data indicated that stretched HGFs and PDLs induced the same pattern of mRNAs encoding for MMPs and TIMPs but differed for those encoding various integrin subunits, known to act as protein receptors in mechanotransduction.

Cells, Cultured↗