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Published: 8 May 2021
Applied Sciences, Volume 11; doi:10.3390/app11094271

Abstract:
Orthognathic surgery is a branch of maxillo-facial surgery increasingly in demand, which deals with the correction of skeletal deformities. The aim of the present study is to identify the most common post-operative complications following orthognathic bimaxillary surgery performed by means of Piezosurgery®. Furthermore, through an examination of the available scientific literature, we wanted to establish whether the frequency of postoperative complications were consistent with those already reported.
A
retrospective study on 58 patients who underwent orthognathic surgery with a bilateral sagittal osteotomy (BSSO) of the mandibular bone branch, maxillary surgery with Le Fort I mono-segmented or multi-segmented approach, and genioplasty technique using Piezosurgery®. The complications taken into consideration were disorders of the temporomandibular joint (TMJ), paraesthesia and hypoesthesia, asymmetries, nose
enlargement
, nasal septum deviation, nasal obstruction, dental discolorations, pulpal necrosis, occlusion and masticatory efficiency,
gingival
recession, periodontal problems, dysgeusia, nausea and vomiting, weeping alterations, hearing problems, delayed healing, superinfection, removal of synthesis means, reoperation, cicatricial outcome, and bilateral pneumothorax. It has been highlighted that a number and type of postoperative complications matched those reported by the most recent literature
reviews
. Temporomandibular disorders and paraesthesia were the most common ones. The only complication rate that differed from the literature was nerve damage, which was significantly lower. Post-surgical complications depend on the used surgical techniques, clinical work, and treatment methods. The use of piezoelectric devices in orthognathic surgery operations provides an innovative, safe, and effective technique compared to traditional methods.
Namala Anuja, Halerolli Dyamavva, Poonja Preethi
A
, Kumar Rao Prasanna, Kini Raghavendra
Journal of Dental Problems and Solutions, Volume 8, pp 029-031; doi:10.17352/2394-8418.000100

, Sarah F. Smithson, Ingrid J. Scurr, Julia Baptista, Anirban Majumdar, Germaine Pierre, Maggie Williams, Lindsay B. Henderson, Ingrid M. Wentzensen, Heather McLaughlin, Lisette Leeuwen, Marleen E. H. Simon, Ellen van Binsbergen, Mary Beth P. Dinulos, Julie D. Kaplan, Anne McRae, Andrea Superti-Furga, Jean-Marc Good,
European Journal of Human Genetics pp 1-12; doi:10.1038/s41431-021-00818-9

Abstract:
Decreased or increased activity of potassium channels caused by loss-of-function and gain-of-function (GOF) variants in the corresponding genes, respectively, underlies a broad spectrum of human disorders affecting the central nervous system, heart, kidney, and other organs. While the association of epilepsy and intellectual disability (ID) with variants affecting function in genes encoding potassium channels is well known, GOF missense variants in K+ channel encoding genes in individuals with syndromic developmental disorders have only recently been recognized. These syndromic phenotypes include Zimmermann–Laband and Temple–Baraitser syndromes, caused by dominant variants in KCNH1, FHEIG syndrome due to dominant variants in KCNK4, and the clinical picture associated with dominant variants in KCNN3. Here we
review
the presentation of these individuals, including five newly reported with variants in KCNH1 and three additional individuals with KCNN3 variants, all variants likely affecting function. There is notable overlap in the phenotypic findings of these syndromes associated with dominant KCNN3, KCNH1, and KCNK4 variants, sharing developmental delay and/or ID, coarse facial features,
gingival
enlargement
, distal digital hypoplasia, and hypertrichosis. We suggest to combine the phenotypes and define a new subgroup of potassium channelopathies caused by increased K+ conductance, referred to as syndromic neurodevelopmental K+ channelopathies due to dominant variants in KCNH1, KCNK4, or KCNN3.
Sajad Ahmad Buch, Renita Lorina Castelino, Anusha Rangare Laxmana
Published: 1 January 2021
Current Medical Issues, Volume 19; doi:10.4103/cmi.cmi_136_20

The publisher has not yet granted permission to display this abstract.
, Ioannis
A
. Ziogas, Dimitrios Giannis, Aikaterini-Elisavet Doufexi
Clinical Oral Investigations; doi:10.1007/s00784-020-03682-x

The publisher has not yet granted permission to display this abstract.
Nehal F. Hassib, Mona
A
. Shoeib, Hoda
A
. ElSadek, Mona E. Wali, Mostafa I. Mostafa,
Published: 1 November 2020
European Journal of Medical Genetics, Volume 63; doi:10.1016/j.ejmg.2020.104045

The publisher has not yet granted permission to display this abstract.
, Salma Kabbashi, Manogari Chetty
Published: 19 October 2020
Abstract:
Background: Enamel Renal Syndrome (ERS) (OMIM # 204690) is a rare autosomal recessive disorder characterized by hypoplastic amelogenesis imperfecta (AI), failed tooth eruption, intra-pulpal calcifications,
gingival
enlargement
and nephrocalcinosis. The rarity of the condition and the variability of the phenotype has led to ERS not being fully characterized. This scoping
review
aims to account for the range and current state of knowledge on ERS and synthesize these findings into a comprehensive summary, focusing on the pathophysiology, genotype-phenotype correlations and patient management from a dental perspective.Methods: The authors will conduct a systematic search of PubMed (MEDLINE), BioMed Central, EbscoHost Web, Web of Science and WorldCat. We will include all studies with human participants with a confirmed diagnosis of ERS. Articles will be screened in two stages i.e. initially by title and abstract screening and then full-text screening by two independent
reviewers
. Data extraction will be conducted using a customised electronic data extraction form. We will provide a narrative synthesis of the findings from the included studies. We will structure the results according to themes.Discussion: Dentists should be able to identify patients with clinical features of ERS so that they receive appropriate referrals for renal evaluation, genetic counselling and oral rehabilitation to increase the patient’s quality of life.
A
scoping
review
is the most appropriate method to conduct this comprehensive exploration of the current evidence which may be sparse due to the rarity of the condition. It will also enable us to identify gaps in the research.Registration: This study is registered with the Open Science Framework (OSF) (https://osf.io/cghsa).
N.V. Yanko, L.F. Kaskova, I.Yu. Vashchenko, S.Ch. Novikova, O.S. Pavlenkova
Ukrainian Dental Almanac pp 69-74; doi:10.31718/2409-0255.3.2020.11

Abstract:
Viral diseases with oral manifestations are common in the practice of pedodontist, however, sometimes their diagnosis is complicated due to the similar clinical manifestations.
A
huge number of viruses are present in oral cavity, especially from Herpesviridae family, however, the most of them are asymptomatic. Cold, systemic diseases and stress provoke the activation of viruses with different clinical manifestations. Therefore, a dentist can be the first who diagnoses not only herpetic gingivostomatitis, but also other viral diseases. The aim of the article was to analyse the oral manifestations of viral diseases in children in order to optimize their diagnostics. This article analyses clinical cases and
reviews
of diseases in English in Google database from 2011 to May 2020 (and earlier publications) by Keywords: «herpetic gingivostomatitis», «recurrent aphthous stomatitis», «oral manifestations of infectious mononucleosis», «herpetic angina», «oral manifestations of cytomegalovirus infection», «recurrent herpetic gingivostomatitis», «oral manifestations of varicella virus», «oral manifestations of herpes zoster», «roseola infantum», «herpangina», «hand, foot and mouth disease», «oral manifestations of measles», «rubella», «oral manifestations of papillomavirus», and «oral manifestations of human immunodeficiency virus». Viruses which have oral manifestations were characterized by transmission. Mostly airborne viruses are represented by Herpesviridae family. The differential diagnosis of primary herpetic gingivostomatitis includes recurrent aphthous stomatitis which forms ulcers on non-keratinised oral mucosa without a vesicle phase. Recurrent herpetic infection doesn’t have difficulties in diagnostics, but could be complicated by erythema multiform with clear target lesions. Vesicles, erosions in oral cavity associated with vesicles on hear part of head help to distinguish chickenpox from herpetic infection. Compared to Herpes simplex virus infection, Herpes zoster has a longer duration, a more severe prodromal phase, unilateral vesicles and ulceration, with abrupt ending at the midline and postherpetic neuralgia. Roseola is characterized by small papules on skin and palate which appears when severe fever in prodromal period subsides and disappears after 1-2 days. Oral vesicles associated with foot and hand rush differentiate enterovirus stomatitis from chickenpox and roseola. The distribution of the lesions of herpangina (palate, tonsils) differentiates it from primary herpetic gingivostomatitis, which affects the gingivae. Comparing with roseola and rubella, measles has a bigger size of rush and specific oral localization on buccal mucosa. Mild fever and skin rush which appears on face and extensor surfaces of body and extremities help to distinguish rubella from measles and roseola. Viruses transmitted through biological liquids are represented in oral cavity by infectious mononucleosis and cytomegalovirus. The vesicles and ulcers on the tonsils and posterior pharynx in case of these infections can resemble herpetic stomatitis, but liver and spleen
enlargement
allows to exclude this diagnose; also cytomegalovirus erosions heal for long time. Cervical lymphoadenopathy differentiates them from herpetic angina. Laboratory diagnostics is based on detection of antibodies to virus or virus DNA in blood helps to make diagnosis of infectious mononucleosis and cytomegalovirus infections. Viruses transmitted through direct contact with mucosa and biological liquids represented by human papillomavirus (HPV) and human immunodeficiency virus (HIV). HPV in oral cavity represent by benign epithelial hyperplasia which might persist and transform to malignant. Therefore, histological examination plays important role in diagnostics of HPV. Oral manifestations such as candidiasis, herpes labialis, and aphthous stomatitis represent some of the first signs of HIV immunodeficiency. Oral lesions also associated with HIV in children are oral hairy leukoplakia, linear
gingival
erythema, necrotizing ulcerative
gingivitis
, and Kaposi’s sarcoma. Rapid necrotization and long-term healing of oral lesions help to suspect HIV and prescribe the blood test for the detection of antibodies to the virus. Oral mucosa is often the first to be affected by viral infections.
A
thorough anamnesis and examination is the key to accurate diagnostics of the most oral viral lesions and their adequate treatment. Biopsy, examination of antibodies to the virus in the blood or polymeraze-chain reaction to the virus in the bioptate or blood are performed in case of diagnostic difficulties. Laboratory methods had to use more widely for the diagnostics of recurrent or unclear lesions of the oral mucosa in children.
Vittoria Esposito, Giuseppe Sileno, Silvio Abati, Marco Colucci, Massimo Torreggiani, Fabrizio Grosjean,
Journal of Nephrology, Volume 33, pp 653-655; doi:10.1007/s40620-020-00779-0

Abstract:
Gingival
overgrowth mainly affecting the anterior teeth, more pronounced on the labial surface (Fig. 1
a
) but also present on the anterior palate (Fig. 1b) is an adverse effect of the systemic administration of certain drugs such as phenytoin, calcium channel blockers and cyclosporine
A
[1]. Its incidence was particularly elevated two decades ago when cyclosporine was the most common immunosuppressive drug prescribed to kidney transplanted recipients to prevent acute rejection, with incidence rates ranging from 13 to 84%. The effect of cyclosporine on
gingival
growth is amplified by the association with calcium channel blockers [2]. Age, gender, smoking habits, age at transplantation, duration of therapy and Cy
A
dosage and poor oral hygiene represent risk factors for the development and the severity of
gingival
overgrowth.
Gingival
hypertrophy is histologically characterized by an increase in matrix deposition with proliferation of fibroblasts and inflammatory cells. It is well known that cyclosporine stimulates the deposition of matrix components [3]. At gum level it appears to promote
gingival
fibroblast IL-6 synthesis which increases collagen production. The susceptibility to
gingival
overgrowth seems to be increased by polymorphisms of MDR1 gene, encoding for P-glycoprotein. P-glycoprotein is part of ABC family of transporters and is expressed in the ducts of salivary gland having a role in excretion of certain drugs.
A
mutation of the MDR1 gene could reduce the excretion of cyclosporine, increasing its salivary concentration and its effects on
gingival
cells [4]. Poor oral hygiene with dental plaques (Fig. 1d, arrows) may contribute to
gingival
overgrowth triggering inflammatory changes and, through the release of mediators of inflammation, favor
gingival
growth. Oral hygiene is the first of several approaches proposed for the management of
gingival
overgrowth [5]. Surgical treatment including scalpel gingivectomy as shown in Fig. 1c, flap surgery and laser gingivectomy should be carefully assessed since they may not be free from risks, especially infections. Furthermore relapses are not uncommon. The best therapeutic option is the withdrawal of the causative agent. Fortunately we have now alternative antirejection and antyhypertensive drugs for kidney transplant recipients. Tacrolimus causes fewer side effects than cyclosporine and as shown in our patient (Fig. 1e), it took just a few months after shifting from cyclosporine to tacrolimus and stopping nifedipine, for the
gingival
overgrowth to almost completely regress. Our patient’s renal function remains stable 4 years after shifting to tacrolimus. Beyond the smile,
gingival
overgrowth interferes with dental occlusion and speech. Furthermore it also makes oral hygiene very complicated due to frequent bleeding and pain. It makes the quality of life and relationships of the affected patients very poor. Kidney transplant is the best treatment for end stage kidney disease. With the kidney transplant program we want to give our patients an almost normal kidney function allowing them a better quality of life but we also want them to enjoy little things every day and smile. Kataoka M, Kido J-i, Shinohara Y, Nagata T (2002) Drug-induced
gingival
overgrowth-
a
review
. Biol Pharm Bull 28:1817–1821 Article Google Scholar Nanda T, Singh B, Sharma P, Singh Arora K (2019) Cyclosporine
A
and amlodipine induced
gingival
overgrowth in a kidney transplant recipient: case presentation with literature
review
. BMJ Case Rep 12:e229587 Article Google Scholar Esposito C, Foschi
A
, Parrilla B, Cornacchia F, Fasoli G, Plati AR, De Mauri
A
, Mazzullo T, Scudellaro R, Dal Canton
A
(2004) Effect of calcineurin inhibitors on extracellular matrix turnover in isolated human glomeruli. Tranpl Proc 36:695–697 CAS Article Google Scholar De Iudicibus S, Castronovo G, Gigante
A
, Stocco G, Decorti G, Di Lenarda R, Bartoli F (2008) Role of MDR1 gene polymorphisms in
gingival
overgrowth induced by cyclosporine in transplant patients. J Periodont Res 43:665–672 Article Google Scholar Chang CC, Lin TM, Chan CP, Pan WL (2018) Nonsurgical periodontal treatment and prosthetic rehabilitation of a renal transplant patient with
gingival
enlargement
: a case report with two years follow-up. BMC Oral Health 18:140 Article Google Scholar Download references Nephrology and Dialysis Unit, ICS Maugeri Sp
A
SB, Pavia, Italy Vittoria Esposito, Giuseppe Sileno, Marco Colucci, Massimo Torreggiani & Ciro Esposito Dental Clinic, IRCCS San Raffaele, Segrate, Italy Silvio Abati Nephrology and Dialysis Unit, Policlinico San Matteo, Pavia, Italy Fabrizio Grosjean Nephrology and Dialysis Unit, University of Pavia, Via Maugeri 10, 27100, Pavia, Italy Ciro Esposito You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to Ciro Esposito. On behalf of all authors, the corresponding author states that there is no conflict of interest. All procedure performed in the present study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from the patient. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source,...
, Prasenjit Das, Arvind Kairo, Shashank S. Kale
Journal of Neurosciences in Rural Practice, Volume 11, pp 349-352; doi:10.1055/s-0040-1709249

Abstract:
Drug-induced
gingival
overgrowth (DIGO) secondary to chronic phenytoin intake for seizure control is a well-recognized phenomenon. Phenytoin-induced
gingival
overgrowth (PIGO) usually resolves gradually following cessation of phenytoin intake. It is usually seen throughout the dentate regions of the maxillary and mandibular dental arches, but more severely affect their anterior portions exposed to atmosphere. We report a rare case of PIGO predominantly involving hard palate and floor of oral cavity, which has not been reported in English literature till date.
Journal of Oral Biology and Craniofacial Research, Volume 10, pp 214-219; doi:10.1016/j.jobcr.2019.12.005

The publisher has not yet granted permission to display this abstract.
, , Deepu George Mathew
Published: 26 March 2020
Case Reports in Dentistry, Volume 2020, pp 1-8; doi:10.1155/2020/5680535

Abstract:
Background. Ligneous periodontitis or destructive membranous periodontal disease is a rare condition involving
gingival
tissues, which is due to plasminogen deficiency and fibrin deposition. Plasminogen deficiency is an ultrarare autosomal recessive disease. The disease is characterized by
gingival
enlargement
and periodontal tissue destruction that leads to rapid tooth loss despite treatment attempts.
A
defect in fibrinolysis and abnormal wound healing are the main pathogenesis of this condition. It is caused by mutations inPLG, the gene coding for plasminogen, which results in decreased levels and functional activity.Case Presentation. In this case report, clinical and histopathological findings of a 26-year-old male patient who presented with generalized membranous
gingival
enlargement
are presented. He was the third child of consanguineous parents and had multicystic congenital hydrocephalus at birth. Besides the
gingival
enlargement
, he also presented ligneous conjunctivitis since childhood. The intraoral examination revealed generalized periodontal breakdown. Radiographs showed alveolar bone loss present in every quadrant. All blood investigations were normal except for plasminogen deficiency.
A
biopsy sample was excised from affected gingiva and a series of histopathological evaluation was performed. Based on clinical and histopathological evidence, a diagnosis of destructive membranous periodontal disease or ligneous periodontitis was made.
A
clinical exome assay for the PLG gene was also done. It was confirmed as Type 1 plasminogen deficiency.Conclusion. Ligneous periodontitis has been rarely reported in India. The reasons could be because of the rarity of the disease or missed diagnosis. The need to take a proper history and perform a proper clinical examination and histopathologic evaluation has to be stressed when diagnosing and treating
gingival
enlargements
. If a genetic condition is suspected, genetic screening is also needed. All these will help the clinician in correctly diagnosing the disease and formulating a proper treatment plan for managing the condition.
Irena Georgieva, Iva Yordanova
Varna Medical Forum, Volume 9, pp 99-106; doi:10.14748/vmf.v9i1.6567

Andreea Cristiana Didilescu, Adelina Lazu, Corien Pronk, Raluca Paula Vacaru, Henk S. Brand
British Dental Journal, Volume 228, pp 108-116; doi:10.1038/s41415-020-1196-4

The publisher has not yet granted permission to display this abstract.
, Mohamed Nuzaim M. Nizam, Abdulsalam Alshammari
The Open Dentistry Journal, Volume 13, pp 430-435; doi:10.2174/1874210601913010430

Abstract:
Background: Phenytoin induced
gingival
overgrowth, a side effect with multifactorial aetiology, is characterized by an increase in the volume of extracellular tissues, particularly collagenous components, with varying degrees of inflammation. Objective: The aim of this paper is to
review
the available literature regarding the pathophysiological mechanisms of phenytoin induced
gingival
overgrowth. Methods:
A
thorough literature search of the PubMed/ Embase/ Web of science/ Cochrane central database was conducted to identify the mechanisms involved in the process of phenytoin-induced
gingival
overgrowth using the following keywords: Phenytoin; Anticonvulsant;
Gingival
Overgrowth;
Gingival
Enlargement
,
Gingival
Hyperplasia; Drug Induced
Gingival
Enlargement
; Drug Induced
Gingival
Overgrowth Results: According to the available evidence, several mechanisms have been proposed addressing the pathophysiological mechanism of phenytoin induced
gingival
overgrowth both at a cellular and molecular level. Evidence suggests that the inflammatory changes in the
gingival
tissues orchestrate the interaction between phenytoin and fibroblasts particularly resulting in an increase in the extracellular matrix content. Conclusion: However, the mechanism of production of inflammatory mediators is not fully understood. This, together with the high prevalence of Phenytoin induced
gingival
overgrowth, warrants further research in this area in order to develop treatment and preventive strategies for the management of this condition.
A
. M. Sherene Christina Roshini, N. Aravindha Babu, R. Jayasrikrupaa, K. M. K. Masthan
Indian Journal of Public Health Research & Development, Volume 10; doi:10.37506/v10/i12/2019/ijphrd/192399

The publisher has not yet granted permission to display this abstract.
Ibrahim O Bello, Ahmed Qannam
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 128; doi:10.1016/j.oooo.2019.02.047

The publisher has not yet granted permission to display this abstract.
, Geraldine Moses, Michael John McCullough
Published: 13 June 2019
by Wiley
Journal of Oral Pathology & Medicine, Volume 48, pp 626-636; doi:10.1111/jop.12911

The publisher has not yet granted permission to display this abstract.
Tarun Nanda, Baljeet Singh, Parul Sharma,
Published: 28 May 2019
by BMJ
BMJ Case Reports, Volume 12; doi:10.1136/bcr-2019-229587

The publisher has not yet granted permission to display this abstract.
Ольга Садыкова, Сергей Жолудев, Вячеслав Никольский, , Svetlana Andreeva, Дмитрий Дьяконов, , Наталья Падерина, Sergey Zholudev, Natalia Paderina, Ol'ga Sadykova, Светлана Андреева
Actual problems in dentistry, Volume 15; doi:10.18481/2077-7566-2019-15-1-117-123

The publisher has not yet granted permission to display this abstract.
Lin Sun, Chengxin Wang, Shugang Xi, Tong Zhou, Guixia Wang, Xiaokun Gang
Experimental and Therapeutic Medicine, Volume 17, pp 3399-3402; doi:10.3892/etm.2019.7376

Abstract:
Gingival
overgrowth (GO) includes
gingival
enlargement
and hyperplasia and may be induced by certain drugs, including calcium channel blockers (CCBs), particularly first-generation CCBs. However, to date, only few cases of GO induced by second- or third-generation CCBs have been reported. The present study reports on a case of a 48-year-old diabetic male who was admitted to the First Hospital of Jilin University (Changchun, China) due to poor blood glucose control. This patient was diagnosed with GO.
Review
of the patient's medical history revealed diagnoses of type 2 diabetes and hypertension, as well as the use of felodipine, a second-generation CCB, to control hypertension. The hypertensive drugs were replaced and the new drugs helped the patient control his blood glucose levels. Additionally, the patient was instructed on methods he could use to improve his oral hygiene, including rinsing of the teeth following each meal and increasing the frequency of tooth brushing per day. After 3 months, the clinical symptoms of GO were relieved. The relevant literature was also
reviewed
to gain an improved understanding of the correlation between GO and CCBs, as well as diabetes and poor oral hygiene.
Subraj J Shetty, , Rajiv S Desai
Journal of Cancer Research and Therapeutics, Volume 15, pp 725-728; doi:10.4103/jcrt.JCRT_1044_16

The publisher has not yet granted permission to display this abstract.
, L. K. Surej Kumar, S. Dilna
Published: 1 January 2019
Annals of Maxillofacial Surgery, Volume 9, pp 415-418; doi:10.4103/ams.ams_12_19

Abstract:
Cherubism is an inherited, autosomal dominant disorder that affects the jaws of children. The disease is usually obvious as a painless bilateral swelling in which bone is replaced with fibrous tissue. Affected children appear normal at birth. Swelling of the jaws usually occurs between 2 and 7 years of age and relapses as age progresses leaving a few facial deformities and malocclusion. The disease is microscopically indistinguishable from other giant cell lesions. The association of cherubism with
gingival
fibromatosis, epilepsy, mental retardation, stunted growth, and hypertrichosis is referred to as a rare case of possible Ramon syndrome with extraordinary tissue
enlargement
over the teeth. Here, we present a case of Ramon syndrome in a 6-year-old girl describing the clinical and radiographic features successfully treated with a brief
review
of literature.
, Martin Giorgio Campolongo, Matteo Val, Enrica Capelletto, Paolo Bironzo, Monica Pentenero
Published: 1 January 2019
Frontiers in Physiology, Volume 10; doi:10.3389/conf.fphys.2019.27.00065

Abstract:
Aim. Oral metastases are rare and represent about 1% of all oral malignancies. Oral metastatic lesions mainly involve jawbone with the molar and premolar region of the mandible representing the most common location. The gingiva and alveolar mucosa, followed by the tongue, are the most common sites when soft tissues are involved. Oral metastases are mainly observed in presence of primaries affecting breast, lung, kidney, thyroid and prostate. Breast cancer is the most frequent origin of oral metastases in females, lung and prostate cancer in males. In the European Union, lung cancer is the fourth most common cancer, with more than 312,000 incident cases a year and it is the main cause of cancer deaths. Late diagnosis is the main reason for this high mortality rate. Lung cancer is basically classified in non-small cell carcinoma (squamous cell carcinoma, adenocarcinoma and large cell carcinoma) accounting for about 85% of patients, small cell carcinoma (SCLC) accounting for about 10-15% patients and lung carcinoid tumours, in 5% of patients. We present a retrospective monocentric longitudinal study investigating the incidence of oral metastasis from lung cancer. Data on clinical/histopathological features, time to onset from the diagnosis of lung cancer and survival were recorded. Materials and Methods.
A
retrospective chart
review
was performed addressing the digital medical record of 2,057 patients referred to the Lung Cancer Unit of out hospital from 2014 to 2018. Cases with oral metastases were retrieved looking for the following keywords: “metastatic” or “metastases” or “metastasize” or “metastasizing” or “secondary” or “oral cavity” or “mouth” or “oral mucosa” or “mandible” or “maxilla” or “tongue” or “gingiva” or “palate” or “retromolar pad” or “lip” or “alveolar ridge”. All oral metastases from primary tumours of the lung involving jaw bones or/and soft tissues were included in the study. Other neoplastic entities of oral cavity arising in patients with lung cancer were excluded. Additional inclusion criteria were: 1) a proved primary lung cancer with histologic confirmation; 2) oral metastatic lesions with histologic diagnosis; 3) histologic correlation of the oral metastasis with the primary lung malignancy. Clinical data (age, sex, oral site, previous history of malignancy, imaging, treatment) and the histophatological data (tumour subtype and immunohistochemical stains) were collected from the charts. Results. The search strategy identified three cases of oral metastases from lung tumours. Oral metastases constituted 0.14% of total cases (3 out of 2,057 patients), attesting to the rarity of metastases to the oral cavity. Patients were males aged between 54 and 64 (mean age at the onset of metastasis was 57.67 ± 2.62 years), one current smoker and two former smokers. As resulted from the computerized database, the oncologists referred the patients to our clinic following the onset of an “oral lesion”. At intraoral examination all the 3 patients had
gingival
fast-growing, firm, fixed ulcerated mass, with a baseline surface area > 2 cm. The patients complained local pain and oral discomfort. The imaging showed an associated evident bone involvement in just one case. Metastatic lesions were located on the posterior mandibular gingiva and on the left maxillary mucosa of edentulous ridge. Three different histotypes of lung neoplasms were detected: a poorly differentiated small cell carcinoma, an adenocarcinoma and an undifferentiated non-small cell carcinoma. In all cases, the primary tumour was already known before the oral metastatic lesion appeared and the histomorphological features of the metastasis was consistent with the first diagnosis. All the patients had additional distant metastases other than in the oral cavity. Histologic examination of tissue sections from oral metastasis of lung adenocarcinoma showed islands and cords of round to polygonal cells with
enlarged
hyperchromatic nuclei and eosinophilic granular cytoplasm. Upon immunostaining the tumour cells were positive for thyroid transcription factor 1 (TTf-1) and cytokeratin-7 and negative for cytokeratin-20. The small cell lung carcinoma metastasis presented small cells with scant cytoplasm and hyperchromatic nuclei; immunohistochemical stains revealed reactivity for chromogranin
A
and poor positivity for cytokeratins.
A
dense infiltrate of large anaplastic cells with pleomorphic nuclei and abundant, eosinophilic cytoplasm were observed in biopsy sections of
gingival
metastasis from undifferentiated non-small cell carcinoma. The average time between the diagnosis of primary lung tumour and the appearance of the oral metastases was 1,33±0,47 months. The mean survival time since the diagnosis of oral metastases was 2 months. Discussion. Lung carcinoma is responsible for more than one third of all oral soft tissue metastases in men, followed by renal carcinoma. Clinically,
gingival
lesions often resemble reactive lesions as hemangioma, pyogenic granuloma, peripheral giant-cell granuloma or peripheral fibroma, but differently from such entities, metastases are characterized by rapid and progressive growth. The literature reports that
gingival
metastases are most often located in the upper jaw, whereas in this series mandible was the most interested location. Bone metastases usually do not involve the overlying mucosa. In the present study one case showed an involvement of both gingiva and bone, with a vertical bone loss around the dental implant. Some authors suggest that the cancer cells first directly metastasize to the gingiva and then invade the underlying bone. The mechanism of most oral metastases is through hematogenous dissemination: lung cancer is more likely to develop hematogenous metastases...
Davide Bartolomeo Gissi
Published: 1 January 2019
Frontiers in Physiology, Volume 10; doi:10.3389/conf.fphys.2019.27.00077

Abstract:
An adverse drug reaction (ADR) is defined by WHO as
“a
response to a drug which is noxious and unintended, and which occurs at dose normally used in man for the prophylaxis, diagnosis, therapy of disease or for the modification of physiological function" (1972). ADRs have been classified into two types. Type
A
reactions represent about 80% of the cases. They are dose dependent and predictable and are also associated with the pharmacology of drug. Pharmacology can be divided into two subgroups as primary and secondary. Type
A
primary reactions are characterized as abnormal reactions due to excessive action of the primary pharmacology of the drug. Oral mucosal bleeding after the use of anticoagulant agents is an example of primary reaction, whereas dysgeusia during the use of anti-hypertension drugs is a classical type of a secondary reaction related to drug intake. About 20% of ADRs are caused by an unpredictable reaction to drug which are known as type B reactions and are usually non-dose-related. Type B reactions are also divided into two subgroups, immunological and non-immunological reactions. Most of these reactions are immune-mediated side effects like hypersensitivity responses (Bakhtiari et al., 2018).
A
wide spectrum of drugs can sometimes give rise to numerous adverse reactions in the oral cavity (Scully and Bagan, 2004). For example, Medication-related osteonecrosis of the jaw (MRONJ) is a typical example of a widely described ADR in the orofacial region, for which dose and time are known to be relevant risk factors (Nicolatou-Galitis et al., 2018).
A
classification of ADRs in the oral cavity is difficult to generate due to the multiplicity of involved classes of drugs and substances, the variety of involved tissues and functions, the different type of lesions and the complexity of pathogenetic mechanisms (Lo Russo et al., 2012). For example, Xerostomia is considered the most common adverse drug reaction affecting the oral cavity but is associated with over 500 drugs (Sultana N.;Yuan and Woo, 2015). Indeed, in a systematic
review
in USA, xerostomia was found as a secondary effect in 80-100% of prescribed drugs (Zavras et al., 2013). Different authors classified ADRs in the oral cavity or in orofacial region into 4 main groups as follows (Bakhtiari et al., 2018): 1. Saliva and salivary glands involvement: Xerostomia, Ptyalism, Salivary gland
enlargement
, Salivary gland pain, Discoloration of saliva 2. Soft tissue (mucosal) involvement: Lichenoid reaction, Erythema multiform, Pemphigoid, Lupus erythematous, Fixed drug eruption, Angioedema, Mucous membrane pigmentation, Drug induced
gingival
enlargement
3. Hard tissue involvement: Medication-related osteonecrosis of the jaw, Dental caries, Dry socket, Tooth discoloration 4. Non-specific conditions: Taste disorders, Halitosis (malodor), Neuropathies, Movement disturbance, Infection. Furthermore, several orofacial adverse reactions related to target therapies have been recently reported in literature (Watters et al., 2011;Georgakopoulou et al., 2018). Indeed, over the past decade, as cancer treatment protocols evolve, Target therapies have significantly changed the treatment of cancer. These drugs are now a component of therapy for many common malignancies including breast, colorectal, lung, and pancreatic, cancers, as well as lymphoma, leukemia and multiple myeloma (Harris, 2004;John et al., 2004;Basu and Eisen, 2010;Moon et al., 2010;Mukai, 2010). Targeted therapies owe their name to their ability of targeting specifically dysregulated signaling pathways in cancer cells. These treatments include anti-tumor monoclonal antibodies (mAbs), small molecules, signal transduction receptor inhibitors, and cancer vaccines (Harris, 2004;Watters et al., 2011). The enhanced discrimination of target therapies between tumor and normal cells is a more promising and efficacious approach to cancer treatment than conventional cytotoxic chemotherapy. Indeed, conventional cancer chemotherapeutics are designed to destroy malignant cells but also harms normal proliferating tissues mainly in bone marrow and mucocutaneous sites, with a heavy toxicity burden. Nevertheless, targeted therapies are not free from side effects, and some manifest in the oral cavity (Zavras et al., 2013;Vigarios et al., 2017;Georgakopoulou et al., 2018). Adverse reactions of target therapies are considered to be mild to moderate and in most cases are substantially less damaging than conventional cancer chemotherapy. Interestingly, the majority of oral adverse events related to target therapy were unexpected in the preclinical setting. ADRs of target therapy actually have been mainly reported in case reports and case series (Watters et al., 2011;Georgakopoulou and Scully, 2015). Initial studies have indicated as oral complications of target therapy mucosal inflammation and ulceration, dry mouth and taste change. Prospective studies with patient reported oral symptoms and function using validated instruments and specific clinical evaluation of the oral cavity and oral function are thus warranted. Risk factors related to appearance of an ADR The presence and severity of ADRs are related to patient and drug-dependent factors (Lo Russo et al., 2012). Patient’s risk factors include gender (more common in women), age (frequently in neonates and elderly), underlying diseases (more common in patients with hepatic disease and renal failure) and genetics. Drug factors include route of administration, duration, dosage and variation in metabolism. An important factor related to the appearance of an ADR was the drug-drug interaction in patients with multiple medications (poly pharmacy). For example many authors demonstrated that middle-aged and older patients with multiple medications may develop a common adverse reaction as dry mouth because of synergic effects of these drugs (Femiano et al., 2008). Finally, it is important to remember that an ADR may be the result of
a
...
Nansi López-Valverde, Rafael Gómez-De Diego, Juan M. Ramírez, Javier Flores-Fraile, Jorge Muriel-Fernández, Antonio López-Valverde
Journal of Clinical and Experimental Dentistry, Volume 11; doi:10.4317/jced.56214

Abstract:
We study the prevalence of acute myeloid leukemia (AML) among patients with severe
gingival
enlargement
. We retrospective
reviewed
the clinical records of patients with severe
gingival
enlargement
, between 2011 and 2018. The Saxer and Mühlemann index were used to measure inflammation and
gingival
bleeding. The degree of dental mobility was measured by the Nyman and Lindhe technique.
A
correlation analysis was carried out to test whether there were any associations among the different variables. In the sample of 117 patients the mean
gingival
bleeding index was ≥3 and the degree of dental mobility ≥2.3. 1.7% of patients, with severe
gingival
hyperplasia were diagnosed with AML. We found a significant association between
gingival
bleeding and aging (p<0.001) and a trend (0.54) between bleeding and suffering from AML. Severe
gingival
enlargement
, abundant
gingival
bleeding, and dental mobility could be early manifestations of a blood dyscrasia. Key words:Acute myeloblastic leukemia,
gingival
hyperplasia, bleeding, tooth motility, oral health.
, Lluís Brunet-Llobet,
The Open Dentistry Journal, Volume 12, pp 520-528; doi:10.2174/1874210601812010520

Abstract:
Orofacial pain of periodontal origin has a wide range of causes, and its high prevalence and negative effect on patients' quality of life make intervention mandatory. This
review
provides a periodontological overview of the field of orofacial pain, focusing on the entities which involve the periodontal tissues and may be the cause of this pain or discomfort. The study comprised a literature search of these pathologies conducted in the MEDLINE/PubMed Database. Acute infectious entities such as
gingival
and periodontal abscesses are emergencies that require a rapid response. Periodontitis associated with endodontic processes, necrotizing periodontal disorders, desquamative
gingivitis
,
gingival
recession, and mucogingival herpetic lesions, cause mild to severe pain due to tissue destruction and loss. Other lesions that lead to periodontal discomfort include
gingival
enlargement
and periodontal ligament strains associated with occlusal trauma, parafunctional habit and the impaction of food or foreign bodies.
A
range of therapeutic, pharmacological and surgical alternatives are available for the management of these injuries. However, the wide variety of causes of orofacial pain or periodontal discomfort may confuse the clinician during diagnosis and may lead to the wrong choice of treatment.
, Brian L. Mealey, Angelo Mariotti, Iain L.C. Chapple
Published: 21 June 2018
by Wiley
Journal of Periodontology, Volume 89; doi:10.1002/jper.17-0095

The publisher has not yet granted permission to display this abstract.
, Brian L. Mealey, Angelo Mariotti, Iain L.C. Chapple
Published: 20 June 2018
by Wiley
Journal of Clinical Periodontology, Volume 45; doi:10.1111/jcpe.12937

Abstract:
Objective This
review
proposes revisions to the current classification system for
gingival
diseases and provides a rationale for how it differs from the 1999 classification system. Importance
Gingival
inflammation in response to bacterial plaque accumulation (microbial biofilms) is considered the key risk factor for the onset of periodontitis. Thus, control of
gingival
inflammation is essential for the primary prevention of periodontitis. Findings The clinical characteristics common to dental plaque–induced inflammatory
gingival
conditions include:
a
) clinical signs and symptoms of inflammation that are confined to the gingiva: b) reversibility of the inflammation by removing or disrupting the biofilm; c) the presence of a high bacterial plaque burden to initiate the inflammation; d) systemic modifying factors (e.g., hormones, systemic disorders, drugs) which can alter the severity of the plaque‐induced inflammation and; e) stable (i.e., non‐changing) attachment levels on a periodontium which may or may not have experienced a loss of attachment or alveolar bone. The simplified taxonomy of
gingival
conditions includes: 1) introduction of the term “incipient
gingivitis;”
2) a description of the extent and severity of
gingival
inflammation; 3) a description of the extent and severity of
gingival
enlargement
and; 4) a reduction of categories in the dental plaque–induced
gingival
disease taxonomy. Conclusions Dental plaque–induced
gingival
inflammation is modified by various systemic and oral factors. The appropriate intervention is crucial for the prevention of periodontitis.
Laura Vanessa Cañas Díaz, María Isabel Pardo Silva, Silie Soad Arboleda Salaimán
Universitas Odontologica, Volume 36; doi:10.11144/javeriana.uo36-77.agim

Abstract:
RESUMEN. Antecedentes: el agrandamiento
gingival
inducido por medicamentos es una condición clínica frecuente en pacientes que ingieren anticonvulsivantes, inmunosupresores y bloqueadores de los canales de calcio. La prevalencia de agrandamiento
gingival
inducido por medicamentos es de 3 - 20 % en comparación con otras condiciones
gingivales
inflamatorias. Todos estos medicamentos producen lesiones clínicas y características histológicas indistinguibles unas de otras, que llegan a comprometer la función y la estética de los pacientes afectados. Propósito: Describir el manejo terapéutico integral y el seguimiento a 12 meses de una paciente con agrandamiento
gingival
inducido por tacrolimus y amlodipino. Descripción del caso: Paciente de 22 años con discapacidad mental limítrofe, receptora de trasplante renal fue remitida al servicio de Odontología del Hospital Infantil Universitario de San José (Bogotá, Colombia) por presentar agrandamiento
gingival
. El examen clínico mostró un índice de placa de O’Leary del 84,3 %, inflamación generalizada y bolsas
gingivales
de 4 a 6 mm. El protocolo de tratamiento periodontal fue revisado por el equipo de trasplante renal e incluyó: trabajo con la familia para red de apoyo, diseño de un programa personalizado de higiene oral, gingivectomía y mantenimientos periodontales periódicos. Esta estrategia terapéutica permitió reducir el índice de placa y lograr un resultado clínico favorable. Conclusión: La condición sistémica y psicológica de la paciente determinó desarrollar un plan de tratamiento ajustado a sus necesidades. Pacientes susceptibles deben ser instruidos sobre la importancia de tener unas prácticas adecuadas de higiene oral y ameritan ser incluidos en un programa de mantenimiento periodontal. Background: drug-influenced
gingival
enlargement
, is a frequent clinical condition in patients who ingest anticonvulsant, immunosuppressant and calcium channel blockers. The prevalence of
gingival
overgrowth due to prescribed medications ranges from 3% to 20% in comparison to other
gingival
inflammatory conditions. These drugs produce clinical lesions and histological characteristics that are indistinguishable from one another, which compromise the function and aesthetics of the affected patients. Purpose: To describe the total therapeutic management and the clinical follow up at 12-months from a patient with
gingival
enlargement
induced by tacrolimus and amlodipine. Case description:
A
22-year-old patient with borderline mental disability who received a kidney transplant was referred to San Jose Hospital - Medical Dental Unit (Bogotá, Colombia) presenting
gingival
enlargement
. The clinical examination revealed an O'Leary plaque index of 84.3%, generalized inflammation, and
gingival
pockets of 4 to 6 mm. The periodontal treatment protocol was
reviewed
by the transplant team and included: family engagement to create a network for support, design of a personalized program for oral hygiene, gingivectomy and periodic periodontal maintenance. This therapeutic strategy allowed to reduce the plaque index and achieve favorable clinical result. Conclusion: The systemic and psychological condition of the patient established the development of a treatment plan adjusted to her needs. Susceptible patients need to be instructed about the importance of adequate oral hygiene practices and should be included in a maintenance periodontal program.
, Shruti Tandon, Arundeep Kaur Lamba, Farrukh Faraz
Journal of Oral and Maxillofacial Pathology : JOMFP, Volume 22; doi:10.4103/jomfp.jomfp_205_17

Abstract:
The oral cavity manifests signs of various systemic diseases. This entails thorough examination of the oral mucosa, gingiva, teeth, tongue and other oral tissues. Occasionally, oral signs can be an expression of systemic conditions such as endocrine imbalance, nutritional deficiencies and blood disorders. Leukemia is a malignancy of white blood cells, which may result in significant morbidity and mortality. Oral changes maybe the first and only presenting features in leukemia patients, making it imperative for the dentist to diagnose the disease accurately.
BMC Oral Health, Volume 17, pp 139-139; doi:10.1186/s12903-017-0435-9

Abstract:
A
cervical cystic mass is associated with a number of pathologies that present with similar symptoms. These conditions are difficult to differentiate using fine-needle aspiration (FNA), ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). Another dilemma in the differential diagnosis of cervical cystic masses is due to the controversies associated with the existence of branchiogenic carcinoma (BC). BC is an extremely rare disease that must be differentiated from other conditions presenting with cervical cystic masses, especially cystic metastasis from occult primary lesions. We present a case report of a right cervical cystic metastasis from a significantly small squamous cell carcinoma primary
gingival
lesion misdiagnosed as BC by histopathology.
A
62-year-old female presented with a painless progressively
enlarging
cervical mass at the anterior edge of the sternocleidomastoid muscle in the right submandibular region. Preoperative MRI and US revealed a well-defined cystic round mass. Postoperative histological examination indicated BC. Positron emission tomography/computed tomography (PET/CT) revealed high 18F–FDG (18F 2-fluoro-2-deoxy-D-glucose) uptake in surgical regions with a SUV (standard uptake value) max 4.0 and ipsilateral nasopharynx with a SUVmax 4.4, without any distant metastasis. Pathologic results revealed nasopharyngeal lymphadenosis. Considering the low incidence of BC and the limitation of diagnosis in one institution, the patient was referred to another hospital. Physical examination detected a significantly small neoplasm (~3 mm diameter) in the right lower gingiva. Histopathological examination of the neoplasm revealed a well-differentiated squamous cell carcinoma. Surgery, including a partial mandibulectomy and modified neck dissection (neck level I–V and submental lymph nodes) were undertaken. Postoperative histopathological results revealed a well-differentiated squamous cell carcinoma of right lower gingiva and two metastatic lymph nodes in the 18 lymph nodes of level II.
A
month later, recurrence occurred in the right cervical level II. The patient was placed on postoperative concurrent chemo-radiotherapy and supportive care. The patient suffered from cachexia and survived for only six months after surgery. In cases of cervical cystic masses that appear after the age of 40, clinicians should bear in mind that occult primary lesions should be excluded and examination of the gingiva should be undertaken. PET/CT has a limited role in identifying small occult primary lesions and a comprehensive physical examination must be carefully performed.
Sandra Olivia Kuswandani, Yuniarti Soeroso, Sri Lelyati C. Masulili
Dental Journal (Majalah Kedokteran Gigi), Volume 50, pp 154-159; doi:10.20473/j.djmkg.v50.i3.p154-159

Abstract:
Background: Acute myeloid leukemia (AML) is a bone marrow cancer, a malignant disease that triggering the cells develops into different types of blood cells. It is widely recognized that the main manifestation of AML could be
gingival
hyperplasia and bleeding. Occasionally, an initial diagnosis of leukemia is made after a dental examination. In relation to systemic diseases,
gingival
enlargement
could constitute the intensification of an existing inflammation initiated by dental plaque, or a manifestation of the systemic disease independent of the inflammatory condition of the gingiva.
Gingival
enlargement
negatively affects the quality of life, especially nutritional intake. Purpose: This study aimed to report on
gingival
enlargement
in AML patients, dental management of this condition and considerations when treating patients. Case:
A
46 year-old woman diagnosed with AML who chiefly complained of
gingival
enlargement
in all parts of the mouth which restricted her nutritional intake. Case management: The subject attended the clinic twice where nonsurgical treatment for the
gingival
enlargement
, supragingival scaling and dental health education to maintain her oral hygiene was carried out. Unfortunately, she did not return for follow-up appointments due to having already passed away. Information about AML and its relation to
gingival
enlargement
contained in the literature is also
reviewed
. Conclusion: In conclusion,
gingival
enlargement
represents one oral manifestation of AML. This condition is related to and affects the nutritional intake of the patient.
, Pernilla Lundberg, Franziska Malfait,
Published: 25 September 2017
by Wiley
Journal of Clinical Periodontology, Volume 44, pp 1088-1100; doi:10.1111/jcpe.12807

The publisher has not yet granted permission to display this abstract.
S. Noriega, Facultad De Odontología. Valencia Universidad De Carabobo, Gabriela Acosta De Camargo, Ma Ortega, C. Uviedo
Published: 30 June 2017
Kiru, Volume 14, pp 58-67; doi:10.24265/kiru.2017.v14n1.08

The publisher has not yet granted permission to display this abstract.
, Philip Kang
The Journal of the American Dental Association, Volume 148, pp 179-184; doi:10.1016/j.adaj.2016.10.009

The publisher has not yet granted permission to display this abstract.
Renzo G. Bassetti, Alexandra Stähli, Mario
A
. Bassetti, Anton Sculean
Clinical Oral Investigations, Volume 21, pp 53-70; doi:10.1007/s00784-016-2007-9

The publisher has not yet granted permission to display this abstract.
Renzo G. Bassetti, Alexandra Stähli, Mario
A
. Bassetti, Anton Sculean
Clinical Oral Investigations, Volume 20, pp 1369-1387; doi:10.1007/s00784-016-1815-2

The publisher has not yet granted permission to display this abstract.
, L. Moneghini, V. Capilupi, T. Anello, E. Corsi,
A
. Tregambi, D. Palombo, M. Chiapasco
Published: 1 April 2016
Dental Cadmos, Volume 84, pp 202-210; doi:10.1016/s0011-8524(16)30046-0

The publisher has not yet granted permission to display this abstract.
Clement Chinedu Azodo, Patrick I Ojehanon
Published: 1 January 2016
Journal of Oral Research and Review, Volume 8; doi:10.4103/2249-4987.182492

The publisher has not yet granted permission to display this abstract.
Anish Ashok Gupta, Sahana Ashok, K. P. Ashok, Shubhangi Ashok Mhaske
Published: 1 January 2016
Indian Journal of Dentistry, Volume 7, pp 141-143; doi:10.4103/0975-962X.186701

Abstract:
Focal
gingival
enlargements
are a diverse group of lesions with almost similar clinical presentation but varied etiology and histopathology. The actual cause of peripheral ossifying fibroma (POF) has been debated over many years. POFs are usually seen in childhood and younger ages. There is a slight female predilection. It is usually localized, rarely generalized. Usually, the treatment option is only surgical excision with minimal chances of recurrence. Here, we report a case of POF of the right maxillary posterior region with a
review
of literature.
Pitchai Balakumar, Muthu Kavitha, Suresh Nanditha
Published: 1 December 2015
Pharmacological Research, Volume 102, pp 81-89; doi:10.1016/j.phrs.2015.09.007

The publisher has not yet granted permission to display this abstract.
Antonio Bascones-Martínez, Marta Muñoz-Corcuera, Cristina Bascones-Ilundain
Published: 1 February 2015
Medicina Clínica (English Edition), Volume 144, pp 126-131; doi:10.1016/j.medcle.2015.05.004

The publisher has not yet granted permission to display this abstract.
, J. Mohanlakshmi, P. Suresh Kumar, Y. Pavan Kumar
Published: 1 January 2015
Contemporary Clinical Dentistry, Volume 6, pp 432-436; doi:10.4103/0976-237X.161912

Abstract:
Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by proliferation of bone marrow derived Langerhans cells and mature eosinophils. Their clinical features simulate common oral findings such as
gingival
enlargement
, oral ulcers, and mobility of teeth, along with nonspecific radiographic features; hence, diagnosing such lesions becomes difficult for the oral physicians. These lesions are commonly seen in childhood; however, we are reporting a case of LCH in 29-year-old adult male.
A
provisional diagnosis of giant cell granuloma was considered based on history and examination, although the lesion was histologically proven to be LCH and was confirmed with immunohistochemical staining of S100 protein and CD1
a
antigen. The purpose of this paper is to enhance the understanding of diverse, nonpathognomical oral presentation of LCH that is easily misdiagnosed and overlooked by dentist.
Amit Arvind Agrawal
World Journal of Clinical Cases, Volume 3, pp 779-788; doi:10.12998/wjcc.v3.i9.779

Abstract:
Gingival
enlargement
is one of the frequent features of
gingival
diseases. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Based on the existing knowledge and clinical experience, a differential diagnosis can be formulated. Subsequently, after detailed investigation, clinician makes a final diagnosis or diagnosis of exclusion.
A
perfect diagnosis is critically important, since the management of these lesions and prevention of their recurrence is completely dependent on it. Furthermore, in some cases where
gingival
enlargement
could be the primary sign of potentially lethal systemic diseases, a correct diagnosis of these
enlargements
could prove life saving for the patient or at least initiate early treatment and improve the quality of life. The purpose of this
review
article is to highlight significant findings of different types of
gingival
enlargement
which would help clinician to differentiate between them.
A
detailed decision tree is also designed for the practitioners, which will help them arrive at a diagnosis in a systematic manner. There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. By knowing the existence of common and rare presentations of
gingival
enlargement
, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized
gingival
enlargement
.
Shahabe Saquib, Varsha Jadhav, Joel Koshi, Mahesh Ahire
Published: 1 January 2015
Journal of Dental Research and Review, Volume 2; doi:10.4103/2348-2915.176684

Abstract:
Idiopathic
gingival
enlargement
is a rare entity with unknown etiology. Diagnosis of the case is of utmost important for the comprehensive treatment planning. In the present case, the clinical presentation and intervention of the patient reported with diffuse firm and nonedematous
enlargement
, disfigurement of the face, difficulty in speech, and mastication. Periodontal status showed severe attachment loss with minimal local factors, which is typical for generalized aggressive periodontitis. Timely detection of the disease with the critical planning of treatment and routine follow-up with good oral hygiene practices are good enough to combat the morbidity of this disease.
, Zvi Rafe, Haim Sarnat,
Published: 25 June 2014
Pediatric dentistry, Volume 36

The publisher has not yet granted permission to display this abstract.
M. G. Triveni,
A
. B. Tarun Kumar, D. S. Mehta, V. Priyadharshini, Vinita V. Belure
Published: 1 January 2014
Contemporary Clinical Dentistry, Volume 5, pp 268-71; doi:10.4103/0976-237x.132365

Abstract:
Medication-related
gingival
enlargement
is a common reactionary phenomenon that occurs with the use of several types of therapeutic agents, including antiepileptic drugs (
AEDs
). This disorder has been documented since 1939, shortly after the introduction of phenytoin. In the present case, a concise
review
of literature concerning the etiopathogenesis and management of
AEDs
(phenobarbitone and phenytoin) induced
gingival
enlargement
has been described. It is vital that not only the periodontist, but also dental surgeons and medical practitioners should become aware of the potential etiologic agents, characteristic features, and the differential diagnosis of drug induced
gingival
enlargement
in order to be able to prevent, diagnose and successfully manage the condition.
Muzafar Ahmad Bhat, Roobal Behal, Suhail Majid Jan, Fayiza Youqoob Khan
Journal of Indian Society of Periodontology, Volume 18, pp 632-636; doi:10.4103/0972-124X.142460

Abstract:
Tuberculosis (TB) is a chronic specific granulomatous disease and a major cause of death in developing countries. The clinical presentation of TB lesions of the oral cavity varies widely and can manifest as ulcerations, diffuse inflammatory lesions, granulomas and fissures. Oral lesions generally appear secondary to primary TB infection elsewhere, although primary infection of the oral mucosa by Mycobacterium tuberculosis has also been described. We hereby report a case of primary TB of the gingiva manifesting as
gingival
enlargement
. Diagnosis was based on histopathological examination, complete blood count, X-ray chest and immunological investigations with detection of antibodies against M. tuberculosis. Anti-tuberculous therapy was carried out for over 6 months and was followed by surgical excision of the residual
enlargement
under local anesthesia. After 1-year follow-up, there was no recurrence of the disease. This case report emphasizes the need for dentists to include TB in the differential diagnosis of various types of
gingival
enlargements
.
Bagavad Gita, Sajja Chandrasekaran, Prakash Manoharan, Garima Dembla
Published: 1 January 2014
Contemporary Clinical Dentistry, Volume 5, pp 260-263; doi:10.4103/0976-237X.132387

Abstract:
Gingival
fibromatosis is characterized by
gingival
tissue overgrowth of a firm and fibrotic nature. The growth is slow and progressive and is drug-induced, idiopathic, or hereditary in etiology. It occurs isolated or frequently as a component of various syndromes. Our patient presented with the complaint of
gingival
enlargement
associated with progressive deafness, characteristic of Jones syndrome. This case report is important and unique since it is the first known one to have a Jones syndrome-like presentation without a family history.
A
male patient aged 14 years reported with the chief complaint of swelling of gums and progressive hearing loss in both ears for the past one year. There was no family history or history of drug intake.
Enlargement
was generalized, fibrotic and bulbous, involving the free and attached gingiva, extending up to the middle 1/3rd of the crown. Investigations such as pure tone audiogram, impedance audiometry, and Tone decay test concluded that there was severe right and moderate left sensorineural hearing loss. The case was diagnosed to be idiopathic, generalized
gingival
fibromatosis with progressive hearing loss. The
gingival
overgrowth was managed by gingivectomy and periodic
review
. The patient was advised to use high occlusion computer generated hearing aids for his deafness as it was not treatable by medicines or surgery. This unique case report once again emphasizes the heterogeneity of
gingival
fibromatosis, which can present in an atypical manner.
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