RESUMEN
Crohn's disease and ulcerative colitis are chronic inflammatory diseases of the gastrointestinal tract. In addition to bowel symptoms, patients may also have oral manifestations. This thesis investigated potential associations between disease activity in the gut, oral health, salivary gland function, and saliva composition. Patients with Crohn's disease had a significantly higher DMFT index, but showed no difference in periodontal diseases compared to a healthy control group. The saliva composition in patients with active bowel disease differed from that in patients with inactive bowel disease, suggesting that saliva analysis could potentially be used in the future to determine the degree and severity of bowel disease. The knowledge of gastroenterologists and dentists regarding oral manifestations of bowel diseases was found to be limited. Gastroenterologists and dentists valued interdisciplinary patient consultation as very useful, but the frequency of consultation was considered insufficient.
Asunto(s)
Salud Bucal , Humanos , Saliva/química , Saliva/metabolismo , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedad de Crohn/complicaciones , Enfermedades de la Boca/etiología , Enfermedades Periodontales/etiología , Colitis Ulcerosa/complicaciones , Glándulas SalivalesRESUMEN
Salivary stones are hardened, stony calcifications that primarily develop in the drainage duct of a salivary gland. They can lead to obstruction of the saliva flow, resulting in swelling and pain. Since the aetiology of salivary stones remains largely unclear, this was further investigated in this PhD study. A case-control review of patient records showed that systemic diseases and lifestyle factors most likely do not play a role in their occurrence. The biochemical composition of salivary stones removed by oral-maxillofacial surgeons was examined, revealing that large salivary stones have a different inorganic composition than small salivary stones. Several salivary proteins were detected in submandibular salivary stones, including lysozyme, s-IgA, and -amylase. Clumping together of these proteins may play a role in the initial formation of salivary stones.
Asunto(s)
Cálculos de las Glándulas Salivales , Humanos , Estudios de Casos y Controles , Cálculos Salivales , Proteínas y Péptidos Salivales/análisis , Saliva/químicaRESUMEN
A 12-year-old boy was referred with a painless swelling of the labial gingiva. The swelling was caused by the antihypertensive amlodipine, which he used because of arterial hypertension due to a chronic kidney disease. The treatment consisted of discontinuation of the causative drug after which the swelling of the gingiva slowly subsided.
Asunto(s)
Amlodipino , Encía , Niño , Humanos , Masculino , Amlodipino/efectos adversos , Encía/patología , Insuficiencia Renal Crónica/tratamiento farmacológico , Hipertensión/tratamiento farmacológicoRESUMEN
To gain insight into the current knowledge of oral care providers in the Netherlands on facial skin lesions, a survey was distributed to 7,670 oral care providers. Their knowledge was tested by means of 4 multiple-choice questions and on the basis of 5 cases. The survey was completed in full by 90 respondents. The median age was 50.3 years and 62.2% were female. During dental check-ups, 55.6% always examined the face and 41.1% sometimes did so. Compared to the group 41 years old and older, the group 21-40 years of age alerted their patients more often to skin lesions (p = 0.017), was more afraid a specialist would find the referral useless (p < 0.001) and was more in need of a guideline (p = 0.049). The respondents scored 1.90 out of 4 correct answers to the knowledge questions. On the case studies, they scored 1.46 out of 5 for the correct diagnosis, 3.48 out of 5 for the correct choice of policy and 1.01 out of 5 for the combination correct diagnosis and correct policy. The total score was 2.91 out of 9. The results indicate that knowledge on aspects of skin lesions is limited and additional training and the availability of a guideline are necessary.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Derivación y Consulta , Humanos , Femenino , Persona de Mediana Edad , Adulto , Masculino , Países Bajos , Encuestas y CuestionariosRESUMEN
White lesions of the oral mucosa may be caused by various disorders. In most instances of white lesions, diagnoses can be made solely on clinical grounds. When the clinical diagnosis is not compatible with a known disease, the term leukoplakia is used. This is of importance since the yearly malignant transformation rate of oral leukoplakia into a squamous cell carcinoma is 2-4%. The presence and degree of epithelial dysplasia is the most important predictor for malignant transformation.
Asunto(s)
Carcinoma de Células Escamosas , Lesiones Precancerosas , Humanos , Mucosa Bucal/patología , Leucoplasia Bucal/diagnóstico , Leucoplasia Bucal/patología , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Transformación Celular Neoplásica/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patologíaRESUMEN
Ulceration is a common presenting sign of a wide spectrum of diseases of the oral cavity involving many etiologic factors, such as trauma, infection, neoplasms, medication, and immune related disorders, ranging from self-limited lesions to life-threatening diseases. In most cases, a proper diagnosis can be established based on medical history and clinical features only. Early diagnosis is important as oral ulcerations might be a manifestation of a systemic disease or sometimes even due to a malignant process.
Asunto(s)
Mucosa Bucal , Úlceras Bucales , Humanos , Mucosa Bucal/patología , Úlceras Bucales/diagnóstico , Úlceras Bucales/etiología , Úlceras Bucales/patologíaRESUMEN
A 41-year-old patient presented with a sore tip of the tongue. The anterior side of the tongue had a red appearance showing a number of pronounced fungiform papillae and there were tooth impressions on the lateral sides of the tongue. This clinical picture is consistent with transient lingual papillitis. It has an unknown etiology. Local irritation might be a contributing factor. Transient lingual papillitis regresses spontaneously within a few weeks. Chronic lingual papulosis is a variant and shows enlarged filiform papillae; it can persist for years and is rarely painful. The cause of chronic lingual papulosis is similarly often unclear. Both conditions are very common, but often not recognized.
Asunto(s)
Papiledema , Lengua , Adulto , Humanos , Dolor , Lengua/patologíaRESUMEN
In a cross-sectional study, dental records of 149 individuals visiting an Academic Dental Clinic in Amsterdam who reported recreational ecstasy use, defined as no more than twice a week, were systematically analyzed and compared to a group of age- and sex-matched non-drug-users. The parameters retrieved from the dental records were decayed, missing, and filled permanent teeth-index (DMFT-index), number of endodontically treated teeth, presence of active caries lesions, periodontitis, tooth wear, xerostomia, and self-reported use of oral hygiene devices. Periodontitis, active caries lesions, and xerostomia were statistically significantly more present in ecstasy-users. Ecstasy-users brush their teeth significantly less frequent per day than non-recreational-drug-users. There were no significant differences in DMFT-index and in the devices used for brushing and interdental cleaning, and frequency of use of these interdental devices between both groups. We conclude that periodontitis, active caries lesions, and xerostomia, are more frequently present in recreational ecstasy-users compared to age- and sex-matched non-users.
Asunto(s)
N-Metil-3,4-metilenodioxianfetamina , Xerostomía , Humanos , Salud Bucal , Estudios Transversales , Higiene Bucal , Xerostomía/inducido químicamente , Xerostomía/epidemiologíaRESUMEN
BACKGROUND: Knowledge of oral mucosal lesions (OMLs) among dentists is relevant in diagnosing potentially malignant diseases and oral cancer at an early stage. The aim of this survey was to explore dentists' knowledge about OMLs. MATERIAL AND METHODS: Respondents to a web-based questionnaire, containing 11 clinical vignettes representing patients with various OMLs, provided a (differential) diagnosis and management for each. Information about demographics and clinical experience of the participants was acquired as well. Descriptive statistics were performed and T-tests were used to test for significant (p<0.05) differences in mean scores for correct diagnosis and management between subgroups based on demographic variables. RESULTS: Forty-four of 500 invited dentists completed the questionnaire. For (potentially) malignant OMLs, the number of correct diagnoses ranged from 14 to 93%, whilst the number of correct management decisions ranged from 43 to 86%. For benign OMLs, the number of correct diagnoses and management decisions ranged from 32 to 100% and 9 to 48%, respectively. For 11 clinical vignettes, mean scores for correct diagnosis, correct management and correct diagnosis and management were respectively 7.2 (±1.8), 5.7 (±1.5), and 3.8 (±1.7). CONCLUSIONS: The results show that dentists in the Netherlands do not have sufficient knowledge to accurately diagnose some OMLs and to select a correct management. This may result in over-referral of benign OMLs and under-referral for (potentially) malignant OMLs. Clinical guidelines, that include standardized criteria for referral, and continuing education, may improve dentists' ability to correctly diagnose and accurately manage OMLs.
Asunto(s)
Neoplasias de la Boca , Humanos , Países Bajos , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/terapia , Derivación y Consulta , Diagnóstico Diferencial , Odontólogos , Encuestas y CuestionariosRESUMEN
A 28-year-old woman was referred by her dentist to an oral and maxillofacial surgeon for white lesions of the lower lip and lateral tongue borders on both sides. The diagnoss morsicatio labiorum and linguarum was made. Cheek, tongue, and lip biting occurs with some regularity and often patients are unaware of this habit. The diagnosis of morsicatio is based on clinical appearance and additional diagnostics are unnecessary. The condition belongs to a subcategory of obsessive-compulsive disorders. Treatment is not always necessary, but may consist of making the patient aware of the cause, possibly combined with symptomatic and/or causal therapy, for instance with an occlusal splint or cognitive behavioral therapy.
Asunto(s)
Enfermedades de la Boca , Enfermedades de la Lengua , Femenino , Humanos , Adulto , Labio , Lengua/patología , Enfermedades de la Boca/etiología , Enfermedades de la Lengua/diagnóstico , MejillaRESUMEN
A periapical radiolucency, radiopacity or mixed lesion identified on a radiograph is usually caused by an inflammation of endodontic origin. However, a periapical lesion is sometimes caused by primary bone pathology, predominantly manifesting at the apices of the teeth. Various intraosseous lesions can also be projected across the apices, creating the impression of a causal relation with these teeth. An incorrect diagnosis can lead to 1 or more endodontic treatments being carried out unjustifiably. A thorough and detailed anamnesis, a complete extra- and intraoral clinical examination and the careful study of the radiographic imaging leads to a correct diagnosis in most cases. In this regard, knowledge of the differential diagnosis of periapical lesions is essential. In this article, the focus is on apparent periapical radiopacities and how they can be differentiated from each other.
Asunto(s)
Diente , Diagnóstico Diferencial , Humanos , InflamaciónRESUMEN
A 23-year-old man presented with an irritating sensation at the third molar on the left side of the mandible and a bad taste in his mouth. Radiographic and histopathological examination revealed the abnormality was caused by a paradental cyst. The paradental cyst is located distal to a lower third molar and, together with the mandibular buccal bifurcation cyst, belongs to the inflammatory collateral cysts. Treatment consists of enucleation of the cyst and removal of the lower third molar. Recurrences do not occur.
Asunto(s)
Enfermedades Mandibulares , Quiste Periodontal , Adulto , Cara , Humanos , Masculino , Mandíbula , Enfermedades Mandibulares/diagnóstico , Tercer Molar/cirugía , Quiste Periodontal/diagnóstico , Quiste Periodontal/patología , Adulto JovenRESUMEN
A radiolucency, radiopacity or mixed lesion identified on a radiograph is usually the result of an inflammation of endodontic origin. However, a periapical lesion is sometimes caused by primary bone pathology, predominantly manifesting at the apices of the teeth. Various intraosseous lesions can be projected across the apices, creating the impression of a causal relation with these teeth. An incorrect diagnosis can lead to 1 or more endodontic treatments being carried out unjustifiably. A thorough and detailed anamnesis, a complete extra- and intraoral examination, and a careful examination of the radiological imaging will result in a correct diagnosis in most cases. Knowledge of the differential diagnosis of periapical lesions is essential. This article focuses on periapical radiolucencies due to overprojection of neoplastic pathology.
Asunto(s)
Diente , Diagnóstico Diferencial , Humanos , Inflamación/diagnósticoRESUMEN
BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disorder with increased risk for malignant transformation. Biomarker validation is a pivotal step in moving newly discovered biomarkers towards clinical implementation. We performed a systematic review of studies on biomarkers related to OLP, wherein biomarkers have been described in at least two independent studies. Our aim was to determine whether any of these biomarkers might be promising in predicting the increased risk of malignant transformation of OLP. MATERIAL AND METHODS: We searched the following databases until August 2021: PUBMED, EMBASE, and Web of Science. Due to high heterogeneity, a qualitative rather than quantitative assessment was conducted. Only proteins that consistently showed a significantly high level of expression in neoplastic tissues versus OLP in two or more publications were considered as promising markers. RESULTS: Initial database researches identified 1671, of which 24 articles were included in the final analysis. The most frequently reported proteins were p53, Bcl-2 and Ki-67, though there were controversies. PCNA and P21 were the only proteins that showed consistent evidence of clinical usefulness as cancer predictors to be considered as promising markers. Extensive methodological variations in the evaluation of expressions and statistical analyses of the included markers were observed, which hampered comparisons of the results. CONCLUSIONS: Multiple levels of heterogeneity with a scarcity of high-quality studies were identified. PCNA and P21 were identified as promising predictive markers for evaluating the risk of malignant transformation of OLP, but they require further validation. The focus of future research on validation of predictive biomarkers of OLP should be considered as a high priority because it will accelerate the introduction of newly discovered markers into the clinical setting.
Asunto(s)
Liquen Plano Oral , Neoplasias de la Boca , Biomarcadores , Transformación Celular Neoplásica/metabolismo , Transformación Celular Neoplásica/patología , Humanos , Inmunohistoquímica , Liquen Plano Oral/patología , Neoplasias de la Boca/patología , Antígeno Nuclear de Célula en ProliferaciónRESUMEN
Allogeneic stem cell transplantation can cause chronic graft versus host disease (cGVHD). A number of patients manifest cGVHD in and around the mouth. It can present itself as clinically as mucosal lesions and/or salivary gland dysfunction and/or sclerotic changes. Cheeks and tongue are most commonly affected, but the palate, gingiva and lips can also be impacted. Oral cGVHD is associated with mucosal sensitivity, pain, (severe) oral dryness, altered taste, restricted mouth opening and difficulty swallowing, all of which may contribute to a significant decrease of the patient's quality of life. Patients also run an increased risk of developing squamous cell carcinoma of the oral mucosa. The diagnosis of cGVHD is almost always based on the patient's medical history and clinical picture. Treatment of symptoms is based on the patient's problem(s). Dental professionals can provide patients with supportive preventive care aimed at reducing symptoms and preventing further deterioration of oral health.
Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Enfermedades de la Boca , Enfermedad Crónica , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Enfermedad Injerto contra Huésped/etiología , Enfermedad Injerto contra Huésped/patología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/etiología , Enfermedades de la Boca/terapia , Mucosa Bucal/patología , Calidad de VidaRESUMEN
A 25-year-old man presented with a milky-white abnormality of the buccal mucosa on either cheek. Clinical examination revealed underlying leukoedema. Leukoedema is a clinical diagnosis confirmed when the white appearance of the buccal mucosa virtually disappears when it is stretched. The abnormality falls within the normal variation of the buccal mucosa and a biopsy and/or treatment are not necessary.
Asunto(s)
Mucosa Bucal , Adulto , Mejilla , Humanos , Masculino , Mucosa Bucal/patologíaRESUMEN
A radiolucency, radiopacity or mixed lesion, identified on a radiograph is usually the result of an inflammation of endodontic origin. However, a periapical lesion is sometimes caused by primary bone pathology, predominantly manifesting at the apices of the teeth. Various intraosseous lesions can be projected across the apices, creating the impression of a causal relation with these teeth. An incorrect diagnosis can lead to 1 or more endodontic treatments being carried out unjustifiably. A thorough and detailed anamnesis, a complete extra- and intraoral examination, and a careful examination of the radiological imaging will result in a correct diagnosis in most cases. Knowledge of the differential diagnosis of periapical lesions is essential. This article focuses on apparent periapical radiolucencies caused by overprojection of non-neoplastic pathology.
Asunto(s)
Diente , Diagnóstico Diferencial , Humanos , InflamaciónRESUMEN
A radiolucency, radiopacity or mixed lesion, identified on a radiograph is usually the result of an inflammation of endodontic origin. However, a periapical lesion is sometimes caused by primary bone pathology, predominantly manifesting at the apices of the teeth. Various intraosseous lesions can be projected across the apices, creating the impression of a causal relation with these teeth. An incorrect diagnosis can lead to 1 or more endodontic treatments being carried out unjustifiably. A thorough and detailed anamnesis, a complete extra- and intraoral examination, and a careful examination of the radiological imaging will result in a correct diagnosis in most cases. Knowledge of the differential diagnosis of periapical lesions is essential. In this article, the focus will be on periapical radiolucencies and how they can be distinguished from each other.
Asunto(s)
Diente , Diagnóstico Diferencial , Humanos , Inflamación/diagnóstico por imagenRESUMEN
Recently, the Dutch National Immunization Programme has started to offer the human papillomavirus (HPV) vaccination to boys as well as girls from the age of 10. The vaccine protects against long-term HPV infection, which can lead to cervical, anogenital and oropharyngeal cancer. Besides malignant disorders, a HPV infection can also lead to certain disorders of the skin and oral cavity. Since the national HPV vaccination campaign has probably resulted in more awareness among patients about the relation between HPV and oropharyngeal cancer, patients may consult oral healthcare professionals with questions about HPV infection. Oral healthcare professionals are thus able to play a role in preventing HPV related disorders by counseling their patients on HPV. They can also contribute to early diagnosis of HPV related oral and oropharyngeal disorder, although the possibility of detecting oropharyngeal cancer during routine dental examination is limited.
Asunto(s)
Alphapapillomavirus , Neoplasias Orofaríngeas , Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Femenino , Personal de Salud , Humanos , Masculino , Neoplasias Orofaríngeas/prevención & control , Infecciones por Papillomavirus/prevención & control , Vacunación/métodosRESUMEN
BACKGROUND: Data regarding the inter- and intraobserver variability in the radiological assessment of sialolithiasis using cone beam computed tomography are missing in the current literature. This study assessed the inter- and intraobserver variability in the radiological assessment of sialolithiasis using cone beam computed tomography (CBCT). MATERIAL AND METHODS: In 107 patients, 130 salivary glands (65 parotid and 65 submandibular) with clinical signs of obstruction were assessed by four independent observers; 2 residents OMFS and 2 experienced OMFS. The observers analyzed the CBCT images and determined the absence or presence of one or more salivary stones in the affected gland. This procedure was repeated after three months. RESULTS: Interobserver agreements showed kappa values of 0.84 for the parotid gland, and 0.93 for the submandibular gland. Intraobserver agreements for the whole group reported kappa values between 0.83 - 0.95. There was no significant difference between residents and experienced OMFS. CONCLUSIONS: Due to the good inter- and intraobserver agreement, CBCT appears to be a reproducible imaging modality for detecting salivary stones in patients with signs and symptoms of obstructed parotid and submandibular glands.