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Background: Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphomas that remains a major diagnostic challenge due to the variety of its clinical presentations. This case highlights the importance of early biopsy of oral lesions without tendency to heal to attain the diagnosis more quickly. To the best of our knowledge, this study is the first to focus on both oral and pulmonary involvements in a patient with diffuse large B-cell lymphoma. Case presentation: The presented case describes an Iranian 18-year-old girl with chronic cough and dyspnea referred for evaluation of the upper jaw due to bone exposure, bone loss, and soft tissue ulceration. Her medical history revealed mediastinal mass, cavitary lesion, and mediastinal lymphadenopathy. However, cytologic and immunohistochemical analysis did not show any evidence of malignancy. In this case a lymphoproliferative disease was suspected but ultimately the oral biopsy diagnosed diffuse large B-cell lymphoma and chemotherapy could be started. Conclusions: Systemic conditions should be considered as a possible cause of oral lesions and a biopsy should also be performed immediately if there is any doubt concerning the nature of the lesion. Moreover, some conditions necessitate multiple biopsies to attain an accurate diagnosis. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Materials and Methods Results Conclusions Trial Registration This study examined the prevalence of oral signs and symptoms in paraneoplastic syndromes.A systematic search on oral paraneoplastic syndromes was conducted in MEDLINE/PubMed, Ovid, and Scopus databases from inception to April 1, 2024. Risk of bias was evaluated using the MURAD or Quality in Prognosis Studies tools, and a random‐effects meta‐analysis was performed. Evidence quality was rated using the GRADE approach.The study sample comprised 811 participants from 487 studies. Oral manifestations predominantly affected patients with paraneoplastic pemphigus, mucous membrane pemphigoid, and acanthosis nigricans. Palate is the most frequently affected site (18.2%; 95% confidence interval [CI] 14.7–21.9), while erosion was the most common lesion type (83.3%; 95% CI 72.2–92.0) associated with the underlying malignancy. The prevalence of death in people with paraneoplastic syndromes was 50.9% (95% CI 39.9–61.7), while the prevalence of remission after neoplasm treatment was 63.4% (95% CI 49.9–76.0). GRADE assessment revealed uniformly low to very low certainty for all outcomes studied.Further research is needed to understand the mechanisms behind these oral manifestations, which is crucial for earlier paraneoplastic syndrome diagnosis and optimal patient management.PROSPERO number: CRD42022328921 [ABSTRACT FROM AUTHOR]

Introduction: Almost all cases of malignant acanthosis nigricans with oral manifestations occurred in older age groups. Here, we report a case of malignant acanthosis nigricans in a young female presented with chief complaints of oral mucosal hyperplasia, who had previously been diagnosed with allergies. Case presentation: A 30-year-old female developed oral hyperplasia and rash following seafood consumption, with subsequent resolution of the rash but persistent oral lesions and the appearance of pigmentation on her hands, neck, and axillae. Clinical examination revealed papillomatosis, hyperemia, and velvety hyperplasia in the oral cavity. Biopsy results confirmed papillary hyperplasia. Despite the patient’s belief in good health, she was advised to undergo further systemic examinations. Elevated serum tumor markers and histologic analysis of an endoscopic biopsy confirmed gastric cancer with duodenal infiltration, leading to the diagnosis of malignant acanthosis nigricans. Unfortunately, the patient passed away due to heart failure during chemotherapy treatment. Conclusions: The majority of patients with malignant acanthosis nigricans present with oral lesions before the underlying malignancy is detected, emphasizing the importance of timely comprehensive systemic examination. Furthermore, our case suggests that age may not be a restrictive factor for the development of malignant acanthosis nigricans, and the presence of a rash can potentially obscure the cutaneous manifestations associated with this condition. [ABSTRACT FROM AUTHOR]

Chronic graft-versus-host disease (cGvHD) is a multisystem disorder that occurs in recipients of allogeneic hematopoietic (alloHCT) stem cell transplants and is characterized by both inflammatory and fibrotic manifestations. It begins with the recognition of host tissues by the non-self (allogeneic) graft and progresses to tissue inflammation, organ dysfunction and fibrosis throughout the body. Oral cavity manifestations of cGVHD include mucosal features, salivary gland dysfunction and fibrosis. This review synthesizes current knowledge on the pathogenesis, diagnosis and management of oral cGVHD, with a focus on emerging trends and novel therapeutics. Data from various clinical studies and expert consensus are integrated to provide a comprehensive overview. [ABSTRACT FROM AUTHOR]

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Objectives: X‐linked hypophosphatemia (XLH) is a rare genetic disease that disturbs bone and teeth mineralization. It also affects craniofacial growth and patients with XLH often require orthodontic treatment. The aim of this study was to describe changes in the dental health of XLH children during orthodontic treatment compared with those in matched controls undergoing similar orthodontic procedures. Materials and Methods: For this retrospective case–control study, we included all individuals less than 16 years old diagnosed with XLH, orthodontically treated in our centre from 2016 to 2022 and pair‐matched them to patients with no chronic or genetic conditions. Clinical and radiological parameters concerning their malocclusion, craniofacial discrepancy and the characteristics and iatrogenic effects of their orthodontic treatment were analysed. Results: Fifteen XLH patients (mean age: 11.3 ± 2.1), pair‐matched to 15 control patients were included. Orthodontic treatment was successfully conducted in XLH patients with slightly shorter duration and similar iatrogenic effects as in the control group, except for the occurrence of dental abscess during and after orthodontic tooth movement. XLH patients did not show more relapse than the controls. Conclusion: Despite the presence of oral manifestations of XLH such as spontaneous abscesses, XLH patients can undergo orthodontic treatment with no obvious additional iatrogenic effects. [ABSTRACT FROM AUTHOR]

Purpose: Celiac disease (CD) may be frequently undiagnosed due to the absence of characteristic gastroenterologic symptoms in many CD patients. Our objective was to diagnose CD by utilizing documented oral manifestations such as Recurrent Aphthous Stomatitis (RAS) and Molar-Incisor Hypomineralization (MIH). Methods: The study comprised sixty children who presented with complaints of RAS lesions. The MIH group consisted of 40 children, while the control group comprised 20 children without MIH lesions, ranging in age from 7 to 13 years. After the dental examination, all children were given a questionnaire to assess whether they had any previous history of general symptoms related to CD. Following that, diagnostic testing for celiac disease were conducted, including serological tests such as Tissue transglutaminase IgA (tTG-IgA), Endomysium Antibody (EMA), and Total IgA, as well as genetic tests for HLA-DQ2 and HLA-DQ8. Results: The statistical analysis, conducted using Fisher's Exact, Yates' Continuity Correction, Fisher Freeman Halton, and Student's t tests, revealed no significant differences between the groups (p < 0.05). Within the MIH group, 3 children exhibited border tTG-IgA values, while another 3 had positive tTG-IgA results. Two of these 6 children had also positive EMA and HLA results. Following a biopsy procedure, these two children were ultimately diagnosed with celiac disease (CD). Conclusions: In this study, while children initially presented to the clinic with complaints of recurrent aphthous stomatitis (RAS), 2 children (5% of the MIH group) were diagnosed with CD shortly after the onset of MIH lesions. CD enhanced the likelihood of observing some oral manifestations particularly recurrent aphtous stomatitis and developmental enamel defects. We recommend that dentists be cautious about diagnosing CD when RAS lesions and DEDs and/or MIH lesions are present, whether or not other indications of this systemic disease exist. [ABSTRACT FROM AUTHOR]

Background: Congenital Zika Syndrome (CZS) comprises congenital anomalies that occur in individuals, embryos or fetuses exposed to Zika virus infection during pregnancy and can result in systemic manifestations as well as alterations in the oral cavity of these children. The aim of this study was to conduct a systematic literature review of the most frequent oral and craniofacial manifestations in children aged 0 to 6 years with CZS compared to neurotypical children without CZS. In this review, a search was conducted in the PubMed, Medline, Embase, Web of Science databases and grey literature, as well as a manual search of the reference lists of the included articles, without restriction on year or language. Inclusion criteria were studies reporting oral alterations in children up to six years old or newborns with CZS, with or without a control group. Methodological quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). Twenty-seven articles were retrieved, 19 quantitative non-randomized and 09 quantitative descriptive studies. Three studies presented a high risk of bias. The main reported manifestations were delayed eruption (51,8%), dental enamel defects (25,9%), deep palate (29,6%), number alterations (14,8%), bruxism (29,6%), and malocclusion (25,9%). Short conclusion: CZS can lead to several manifestations of dental interest and may interfere with the individual's oral health. The pediatric dentistry thus requiring the dentist to be attentive to these changes to offer the best and comprehensive treatment to this patient. [ABSTRACT FROM AUTHOR]

Oral findings such as inflammation, ulcerations, or lesions can indicate serious systemic diseases and should prompt suspicion of acquired chronic conditions or inborn errors of immunity (IEIs). Currently, there are approximately 500 disease entities classified as IEIs, with the list expanding annually. The awareness of the existence of such conditions is of paramount importance, as patients with these disorders frequently necessitate the utilization of enhanced diagnostic techniques. This is exemplified by patients with impaired antibody production, in whom conventional serological methods may prove to be undiagnostic. Patients with IEI may require distinct therapeutic approaches or antimicrobial prophylaxis throughout their lives. An accurate diagnosis and, more importantly, early identification of patients with immune deficiencies is crucial to ensure the quality and longevity of their lives. It is important to note that the failure to establish a proper diagnosis or to provide adequate treatment could also have legal implications for medical professionals. The article presents IEIs, which may manifest in the oral cavity, and their diagnosis alongside therapeutic procedures. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the prevalence and types of oral adverse events following immunization (AEFIs) in people who received at least one dose of any type of vaccine. Materials and Methods: We conducted a bibliographic search about oral AEFIs in MEDLINE, Embase, PubMed, and Ovid from database inception to November 07, 2022. Risk of bias was assessed using the MURAD or the Quality In Prognosis Studies tools. Random‐effects proportional meta‐analysis was applied. Results: A total of 119 studies involving 343 people were eligible. These reported AEFIs occurred following administration of the coronavirus disease 2019 vaccine, anti‐influenza vaccine, hepatitis B vaccine, and anti‐smallpox vaccine. The most common to be affected in vaccinated people were buccal mucosa (63.1%; 95% confidence interval (CI) 33.4–88.2) and lips (55.7%; 95% CI, 41.1–69.8). The most prevalent oral AEFIs were ulceration (55.2%; 95% CI 24.4–84.0), swelling (65.2%; 95% CI 34.9–89.8), and burning sensation (18.3%; 95% CI 7.9–31.8). Conclusions: The mechanisms underlying oral AEFIs should be further investigated to promptly recognize oral manifestations and provide optimal management for people undergoing vaccination. [ABSTRACT FROM AUTHOR]

Objective: To provide a review on acromegaly and its orofacial manifestations, with a focus on associated arthropathies and temporomandibular joint disorders (TMD). Methods: A review of current literature was performed through an electronic search of three databases: PubMed, ScienceDirect, and Google Scholar. The literature review was focused on the following topics of interest: etiology, diagnosis, and management of acromegaly, orofacial manifestations of acromegaly, acromegalic arthropathies, and acromegaly‐associated TMD. Results: Acromegaly is a chronic multisystem condition in which excessive production of growth hormone in adults, most commonly caused by benign pituitary adenomas, leads to somatic overgrowth. Orofacial changes are considered hallmarks of the disease. It is important for dentists to recognize signs and symptoms of acromegaly, as this may help to achieve early diagnosis and improve overall disease prognosis. Acromegalic arthropathies typically involve large joints, however, the temporomandibular joints (TMJ) can be affected. TMD associated with acromegaly is under‐recognized and poorly characterized in current literature. Conclusion: In the appropriate clinical context, acromegaly should be considered as part of the differential diagnosis for patients presenting with TMD. Further studies are needed to better characterize the nature of TMD associated with acromegaly and to define the role of TMJ involvement in early diagnosis. [ABSTRACT FROM AUTHOR]

This manuscript critically examines the current classification of oral potentially malignant disorders, questioning the practicality and implications of labeling such a large population as precancerous, given that the actual progression to oral cancer is significantly low for most disorders. The paper advocates for a revised classification system that accurately reflects the varying malignancy risks associated with different disorders. It suggests a reassessment of the diagnostic and management approaches to mitigate overdiagnosis and alleviate patient burdens. We propose categorizing diseases with oral malignant potential as follows: Oral Precancerous Diseases, encompassing high‐risk lesions and conditions like erythroplakia, non‐homogeneous leukoplakia, proliferative leukoplakia, and actinic keratosis; Oral Potentially Premalignant Diseases, covering lesions, conditions, and systemic diseases with distinct oral manifestations harboring a limited or undefined risk of transformation, such as homogeneous leukoplakia, oral submucous fibrosis, oral lichenoid diseases, chronic hyperplastic candidosis, keratosis of known aetiology (smokeless tobacco, khat), palatal lesions in reverse smokers, and dyskeratosis congenita; and Systemic Conditions with Oral Malignant Potential including Fanconi's anemia, xeroderma pigmentosum, and chronic immunosuppression (including patients post‐bone marrow transplantation), which are associated with an increased risk of oral cancer without preceding precursor lesions. We provide illustrative examples to demonstrate how this framework offers practical guidance for research, policy‐making, and clinical practice. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is an autoimmune disorder that varies in clinical presentation and disease course. SLE has a strong female predilection and is more common in certain racial groups than others. There is no single set of universally accepted diagnostic criteria for SLE, which can make the disease challenging to diagnose. The disorder has the potential to affect nearly every organ system in the body, including the oral cavity. A complete understanding of the etiology and pathophysiology of SLE continues to evade the medical profession; however, advances in this area of research have drastically improved the quality of life of SLE patients. There currently is no cure for this condition, so present-day therapies aim to control patient symptoms and reduce SLE flare-ups. This article discusses the pathophysiology, diagnosis, oral and systemic manifestations, therapeutic interventions, and dental management of SLE patients. [ABSTRACT FROM AUTHOR]

Background: Pyodermatitis-pyostomatitis vegetans (PPV) is a rare mucocutaneous disease characterized by multiple pustules and it is considered a marker for inflammatory bowel disease (IBD). The oral manifestations of this condition are referred to as pyostomatitis vegetans (PSV). Purpose: To investigate which features could help in establishing the diagnosis of PSV, with or without cutaneous lesions, based on information retrieved from all cases of PSV described in the literature. A case of PV from the authors was also included in the analysis. Methods: An electronic search was undertaken, last updated in August 2022. Inclusion criteria included publications reporting cases of PSV, with the diagnosis confirmed by the pathological examination of oral or skin lesions, and presence of IBD. Results/Conclusions: Sixty-two publications with 77 cases of PSV and an associated IBD were included. Features that are helpful in establishing the diagnosis of PSV are snail track appearance of oral lesions, an associated IBD (which is not always symptomatic), evidence of intraepithelial clefting on microscopic examination of oral lesions, and peripheral blood eosinophilia. A gold standard for the management of PSV does not exist and high-level evidence is limited. There is no established therapeutic protocol for PSV and management primarily consists of topical and/or systemic corticosteroids, antirheumatic drugs (sulfasalazine, mesalazine), monoclonal antibody (infliximab, adalimumab) immunosuppressives (azathioprine, methotrexate), antibiotics (dapsone), or a combination of these. The risk of recurrence of oral lesions is considerable when the medication dose is decreased or fully interrupted. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) in children presents multifaceted challenges, impacting various aspects of health, including oral health. This narrative review provides a comprehensive synthesis of literature focusing on the oral health status of pediatric CKD patients, encompassing oral manifestations, dental considerations, and management challenges associated with hemodialysis and kidney transplantation. A comprehensive search strategy was employed, utilizing databases such as PubMed, Scopus, Web of Science, and Google Scholar, to identify relevant literature on oral manifestations in children with CKD, including those undergoing hemodialysis or renal transplantation. Search terms were carefully selected to capture studies examining enamel hypoplasia, dental caries, delayed tooth eruption, gingival diseases, periodontal diseases, radiographic alterations, craniofacial development, dry mouth, and changes in the oral mucosa. Our narrative review meticulously selected articles through a systematic process. Ultimately, 12 studies meeting the inclusion criteria were included in the review. Relevant data from each included study were independently extracted and synthesized, focusing on oral manifestations and their implications in pediatric CKD patients. The synthesized findings were organized and presented in a structured manner within the review article, considering their clinical implications and informing recommendations for dental management of children with CKD. This article highlights the importance of a coordinated effort between nephrologists, dentists, and other healthcare professionals in providing holistic care for pediatric CKD patients. A comprehensive understanding of the oral health status of these children, along with proactive dental management strategies, contributes to improved overall health outcomes and a better quality of life. This review aims to serve as a valuable resource for the oral healthcare providers involved in the care of pediatric CKD patients. [ABSTRACT FROM AUTHOR]

Purpose: Fanconi anemia is a rare inherited genetic disorder that is characterized by all three defective blood cell lines such as reduced red blood cells, platelets, and white blood cells. This makes the individual susceptible to spontaneous oral bleeding and prone to oral infections including periodontal diseases. Method: Dental management of individuals with Fanconi anemia can be a difficult task as these individuals have a tendency for uncontrolled hemorrhage and infections after any simple dental procedure. This case report highlights the oral manifestations and management of the same in such individuals taking into consideration the complications in such rare diseases. Result: In this case report, the individuals' oral manifestations and spontaneous oral bleeding were successfully managed by preventive single-donor platelet transfusion, factor VII transfusion, and local tranexamic acid usage during the dental interventions along with parental counseling. Conclusion: Fanconi anemia being a rare inherited disorder is often difficult to manage due to a lack of knowledge and awareness among the dental clinicians. This case report attempts in highlighting the same and spreading awareness among the clinicians. [ABSTRACT FROM AUTHOR]

Background and Aims: Multiple sclerosis (MS) is an autoimmune disease. Oral manifestations in these patients include paralysis or spasm of facial muscles, temporomandibular joint disorders (TMJ), trigeminal neuralgia, dysphagia, or dysarthria. The aim of the study was to investigate the characteristics of orofacial pain in patients with MS. Materials and Methods: The current cross-sectional study was conducted on 250 patients with a definite diagnosis of MS referred to Iran MS Association and Iran MS Research Center. The patients were in the age group of 17 to 57 years and were selected completely randomly. Data were obtained based on two checklists and clinical examination. Finally, DC/TMD criterion was used to check TMD problems. Then the data was analyzed by SPSS version 26 software and by Fisher's Test. Results: The prevalence of MS disease was higher in women and the average age of patients was 37 years and the average duration of MS disease among patients was 8 years. The most common pain was related to shooting and shock-like pain with a frequency of 40.4% and the lowest quality was related to dull and diffuse pain with a frequency of 5.3%. In total, 24.5% of patients with buccaloral pain had TMD, and in this case, the DC/TMD criterion was used. Conclusion: Temporomandibular disorders and shooting and shock-like pains are usually observed in a number of patients with MS. As a result, dentists should be aware of the presence of these pains in the patient, the pain trigger, and the drugs used by the patients, in order to provide medical services and being aware of drug interactions. [ABSTRACT FROM AUTHOR]

Background: Craniosynostosis (CS), premature fusion of one or more cranial sutures, leads to abnormal skull development, impacting both facial esthetics and oral function. This study aimed to evaluate the specific orofacial and oral health characteristics, including masticatory performance, in Thai patients with CS. Methods: A comparative study was conducted with Thai CS patients aged 6–17 years and a control group of healthy individuals with similar age distribution. Assessments included craniofacial morphology, oral health status, and masticatory performance. Intergroup comparisons utilized appropriate statistical tests. Results: The study included 24 CS patients with a mean age of 10.11 ± 2.98 years and 30 controls. CS patients exhibited a significantly higher prevalence of various oral conditions compared to controls: cleft palate (20.8%), anterior open bite (41.7%), anterior crossbite (54.2%), posterior crossbite (50%), combined anterior–posterior crossbite (45.8%), dental crowding in both maxilla and mandible (50% and 45.8% respectively), congenitally missing teeth (50%), supernumerary teeth (12.5%), and eruption failure (54.2%). Furthermore, CS patients exhibited significantly higher caries prevalence and susceptibility, alongside poorer oral hygiene, compared to controls. Regarding jaw relationships, CS patients exhibited a significantly higher proportion of Angle's Class III malocclusion (50%) compared to the control group, where Class I malocclusion was predominant (50%). Masticatory performance, assessed using the two-color gum mixing ability test, showed significantly higher hue variance in CS patients (0.12 ± 0.07) compared to the control group, indicating reduced chewing performance. Conclusion: This study underscores the significant orofacial and oral health challenges faced by children with CS, including a high prevalence of malocclusions, dental anomalies, elevated caries experience, and compromised masticatory function. These findings emphasize the importance of tailored interventions and comprehensive oral healthcare strategies to address the unique needs of this population and improve their overall quality of life. [ABSTRACT FROM AUTHOR]

It is known that COVID-19 patients show many clinical oral symptoms due to the immunological mechanisms triggered by the virus. Aim of this study is to analyze the antibody response to SARS-CoV-2, and to evaluate the oral health status of hospitalized patients. 160 patients with COVID-19 confirmed by SARS-CoV-2–specific RT-PCR testing and 160 healthy volunteers (HI) with similar age, gender and systemic status were included to compare the bio-chemical and oral manifestations. Oropharyngeal swab specimens were collected to evaluate the salivary interleukins (IL-1, IL-6, IL-10) and immunoglobulins (sIgA, sIgG, sIgM). Oral findings (DMFT, plaque index, salivary flow rate), socio-demographic information and systemic conditions were also recorded. Chi-square, Mann–Whitney U and Spearman's ratio tests were applied to determine the possible correlations between the factors (P = 0.05). The mean DMFT scores of COVID-19 patients (12.71 ± 7.3) were significantly higher than the HI (7.39 ± 2.8), whereas cases of total or partial edentulism were more common among COVID-19 patients (P < 0.05). While plaque index scores were similar for both groups (P > 0.05), salivary parameters were found statistically different (P < 0.05). Severe and moderate cases showed higher proinflammatory interleukin levels (IL-1 = 68.74 pg/ml, IL-6 = 53.31 pg/ml) amongst all (P < 0.05). While secretory immunoglobulins were almost depleted at baseline, (sIgA = 0.11 mg/ml, sIgG = 0.21 mg/ml, sIgM = 0.08 mg/ml) they reached to threshold levels after 4 weeks. Higher proinflammatory interleukin levels indicated that traces of ongoing "Cytokine Storm" in COVID-19 patients which can also be observed in oral environment. Poor oral hygiene and malnutrition due to edentulism can pave the way for having a severe COVID-19 infection. [ABSTRACT FROM AUTHOR]

Although rare, oral manifestations of hypersensitivity reactions in orthodontic patients pose a significant clinical challenge due to their heterogeneous presentations, and can cause discomfort and pain, possibly impacting patients' quality of life and orthodontic treatment duration and outcomes. This comprehensive review aimed to elucidate the oral, perioral, and systemic manifestations of hypersensitivity reactions in orthodontic subjects, focusing on patients with fixed appliances, removable appliances, and clear aligners, and detailing their epidemiology, macroscopic and microscopic features, allergy testing, clinical implications, and specific management strategies. Oral and extra-oral manifestations of (immediate and delayed) hypersensitivity reactions occur rarely and are due to the release of metal and non-metal ions from orthodontic appliances. They typically present as erythema, erosive–ulcerative lesions, and gingival hyperplasia, with histopathological findings showing inflammatory infiltrates. Nickel is a significant allergen, and diagnostic tests like patch tests are essential for managing these reactions. Likely due to prolonged contact with oral tissues, fixed orthodontic appliances pose a higher risk compared to removable appliances and clear aligners. Early identification and removal of allergenic materials, combined with effective treatments, can resolve symptoms and prevent recurrence. Keeping dental and medical records updated and knowing family and personal medical histories helps clinicians choose appropriate materials and counsel patients about potential risks. Proper patient education, regular monitoring, and using hypoallergenic materials are key strategies for managing these reactions. [ABSTRACT FROM AUTHOR]

This study aimed to describe a case of oral manifestations in a pregnant woman with beta-thalassemia major for multidisciplinary management. Case: A 27-year-old woman, suffering from beta thalassemia major who is undergoing therapy in the form of routine blood transfusions every month and taking anti-chelation drugs but is currently stopping this because she is pregnant, currently 16 weeks pregnant, complains complained of swollen gums, bleeding, and bad breath. Extraoral examination revealed dry, exfoliative lips. Intraoral examination revealed gingival hyperplasia with erythema, soft consistency, dark red rounded gingival margins, bleeding, true pockets and pain throughout the labial, buccal, palatal, and lingual. There was no history of systemic disease in this patient. Patient has never visited a dentist, either before or now, with complaints about her oral cavity. Hematological parameters showed abnormalities, and peripheral blood examination revealed an infection. The oral diagnoses included gingival enlargement and chronic periodontitis associated with pregnancy and β- thalassemia major. Case Management: Dental management consisted of spooling with 3% hydrogen peroxide (H2O2) spooling, chlorine dioxide spray mouthwash, antibiotics, calculus removal, and oral hygiene instructions. Blood transfusions were administered once a month, and anti-chelation therapy was stopped during pregnancy. After three months of multidisciplinary management, the results were satisfactory. Conclusion: Multidisciplinary, collaborative dental and medical management with non-surgical therapy of oral manifestations in pregnant women with beta-thalassemia major showed satisfactory results. [ABSTRACT FROM AUTHOR]

Objectives: Oro‐dental manifestations of hyperoxaluria and dental management of affected patients are rarely reported in the literature. We describe a new oral presentation of primary hyperoxaluria (PH) and review relevant literature about oro‐dental manifestations and management of dental complications of hyperoxaluria. Methods: A case report of a 44‐year‐old female who presented with symptoms of temporomandibular joint dysfunction due to hyperoxaluria was described according to the CARE guidelines. In addition, an extensive search of biomedical databases (PubMed, Medline, Google Scholar, and Embase) for articles describing oro‐dental manifestations and/or dental management in patients with hyperoxaluria was performed using the key words ("oral" and/or "hyperoxaluria" and/or "dental" and/or "oxalosis"). Included articles were reviewed and data about patient demographics, disease type and stage, oral and dental manifestations, and dental treatment outcome were retrieved and analyzed. Results: A total of 14 articles describing the oral and dental manifestations in 15 patients with hyperoxaluria were included. Tooth mobility, root resorption, and radiographic alterations were consistently described in all cases. Oral manifestations were described mainly in PH at late stages, and only after the onset of chronic renal disease. Dental management in all reported cases was palliative and aimed to relive pain and treat periodontal infection. Tooth loss due to extraction or uncontrolled mobility was the ultimate outcome in almost all reported cases. Conclusion: Oral and dental manifestations in hyperoxaluria are rarely reported in the literature. Management of tooth mobility and root resorption in hyperoxaluria is challenging and clinical guidelines and evidence‐based recommendations are lacking. Early diagnosis and treatment of hyperoxaluria might be the only effective approach to prevent dental and periodontal complications of the disease. [ABSTRACT FROM AUTHOR]

The aim of this study is to report a case in which a patient with nephrotic syndrome underwent surgery to remove fibrous gum tissue (ulectomy). An 8‐year‐old patient, diagnosed with early onset nephrotic syndrome due to a mutation in the NUP107 gene, had received a kidney transplant and was therefore taking various medications, including immunosuppressants. On oral examination, the patient was found to have a fibrous gingiva that was preventing the eruption of the upper permanent central incisors. A ulectomy was performed and the gingival tissue was sent for histopathological analysis, which showed normal aspects. The upper right central incisor was seen in the oral cavity 15 days after surgery. A second procedure was carried out to facilitate the eruption of the upper left incisor, which was visualized in the oral cavity 30 days later. In addition, oral manifestations such as maxillary atresia, ogival palate and mouth breathing were observed. Therefore, the role of the dental surgeon in the lives of transplanted children is considered important, as they often take various medications that can affect their oral health. Thus, early diagnosis and effective treatment will be essential to prevent future malocclusions and thus improve the quality of life of these patients. [ABSTRACT FROM AUTHOR]

Jalili syndrome (JS) (MIM#217080) is a rare autosomal recessive disorder with oculo‐dental malformations. The clinical phenotype is characterized by the presence of Cone‐Rod Dystrophy (CRD) and Amelogenesis Imperfecta (AI). Genetic mechanism entails a mutation in the CNNM4, a metal transporter gene located on Chromosome 2q11.2. A high fluoride concentration in groundwater has also been identified as an epigenetic factor in this syndrome. JS draws the attention of dentists due to its distinct oral manifestations. To the best of our knowledge, this is the first genetically confirmed pediatric case report from the Indian subcontinent emphasizing the clinical and radiographic features of this condition and its management in a 6‐year‐old child. [ABSTRACT FROM AUTHOR]

Oral manifestations of mucocutaneous inflammatory diseases such as lichenoid dermatoses often affect the patient's quality of life through the symptoms of pain and burning sensation. In this case report, a patient with known lichen planus pigmentosus (LPP), a variant of lichenoid dermatoses that rarely affect oral mucosa, presented with chronic pain in the oral cavity for 2 months. Her intraoral examination revealed multiple pseudomembranous ulcers with erythematous areas and white striae similar to erosive lichen planus. The histological assessment revealed chronic mucositis, while the direct immunofluorescent examination showed negative results, contradicting the diagnosis of both lichen planus and LPP. Thus, the diagnosis was given as chronic mucositis, and the topical steroid was given. After 6 weeks of steroid application, the lesion resolved. To the best of our knowledge, this is the first report of chronic mucositis in LPP patients. This report could raise the awareness of clinicians to carefully take history as the patient with LPP may suffer from chronic mucositis in the oral cavity as well. [ABSTRACT FROM AUTHOR]

Human Immunodeficiency Virus (HIV) infection has been a global concern since its discovery in 1984 due to its high morbidity and mortality rates. Currently, over 75 million people worldwide have been infected with HIV, and 37 million individuals are living with the virus. Oral manifestations may serve as significant diagnostic and prognostic indicators for HIV/AIDS patients. This study was conducted to analyze research articles on oral manifestations in HIV/AIDS patient using visual mapping methods from 1987 to 2023. Articles were extracted from Scopus and screened using advanced search with keywords "Human Immunodeficiency Virus" and "oral manifestation line". The contributions made by authors, journals, institutions, and countries were described using Microsoft Excel 2010 and VOSviewer. A total of 1574 articles were collected between 1987 and 2023. Countries that published the most articles were United States, India and Brazil. The top three authors are Deborah Greenspan, John S Greenspan, and Lauren L Patton, from United States with number of articles respectively 43, 39, and 23. Oral Surgery and the Journal of Oral Pathology & Medicine ranked as the top two, with 92 and 78 articles respectively. The central themes of the articles are oral candidiasis and oral hairy leukoplakia, followed by periodontal disease, Kaposi's sarcoma, and xerostomia. Oral manifestations in HIV/AIDS patients continue to be a persistent issue, particularly in countries with high prevalence, such as Africa and Asia. The limited coverage of certain topics in existing articles presents potential research opportunities for the future. [ABSTRACT FROM AUTHOR]

Among the various manifestations of oral cavity cancer, tongue squamous cell carcinoma (TSCC), is the most common form of this condition. TSCC represents a major challenge in the field of cancer treatment. The emergence of small interfering RNAs (siRNAs) has opened new avenues for therapeutic intervention in TSCC. This research provides an overview of siRNA-mediated mechanisms and emphasizes their complex involvement in modulating key signaling pathways associated with TSCC progression. Relevant articles from 2004 to 2023 were conducted by using different keywords, such as "Interfering RNA " and "Small Interfering ". The search was following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines based on inclusion and exclusion criteria. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. The selected studies (n=17) were subjected to perform comprehensive analysis. We concluded that the PI3K/AKT and ERK pathways, one of oncogenic signaling cascades in TSCC is notable. siRNAs and their role in targeting specific signaling pathways help us understand the molecular mechanisms underlying TSCC that may lead to the development promising therapies for TSCC. These therapies have the advantage of personalization and precision, targeted delivery, and the potential to overcome drug resistance. Therefore, the study enhances our comprehension of siRNA-based interventions' clinical potential in TSCC. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) frequently presents with oral manifestations, including gingival inflammation, loose teeth, and mouth ulcers; however, the causal connections between these conditions remain unclear. This study aims to explore the genetic correlations and causal relationships between RA and prevalent oral phenotypes. Methods: Using summary data from genome-wide association studies of European populations, a cross-trait linkage disequilibrium score regression was conducted to estimate the genetic correlations between RA and six oral phenotypes. Subsequently, a two-sample Mendelian randomization (MR) approach was employed to assess the causal relationships, corroborated by various sensitivity analyses. Heterogeneity was addressed through the RadialMR method, while potential covariates were corrected using the multivariable MR approach. Results: A significant negative genetic correlation was detected between RA and denture usage (rg = −0.192, p = 4.88 × 10−8 ). Meanwhile, a heterogenous causal relationship between RA and mouth ulcers was observed (OR = 1.027 [1.005–1.05], p = 0.016, Pheterogeneity = 4.69 × 10−8 ), which remained robust across sensitivity analyses. After excluding outlier variants, the results demonstrated robustly consistent (OR = 1.021 [1.008–1.035], p = 1.99 × 10−3, Pheterogeneity = 0.044). However, upon adjusting for covariates such as smoking, alcohol consumption, body mass index, and obesity, the significance diminished, revealing no evidence to support independent genetic associations. Conclusion: Genetically predicted RA increases the risk of mouth ulcers, and a negative genetic correlation is identified between RA and denture use. The observed heterogeneity suggests that shared immunological mechanisms and environmental factors may play significant roles. These findings highlight the importance of targeted dental management strategies for RA patients. Further clinical guidelines are required to improve oral health among vulnerable RA patients. [ABSTRACT FROM AUTHOR]

Purpose: Chagas disease (CD) a Neglected Tropical Diseases is an important public health issue in countries where is still endemic, included in the Sustainable Development Goals (SDG). Traditionally restricted to rural areas with diverse routes of transmissions from vectorial to oral with acute manifestations but being more common diagnosed in chronic stages. The aim of this investigation was to characterize the Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD) in two rural settlements of the Colombian Caribbean with previous records of the disease and/or the parasite. Methods: A cross-sectional descriptive study was made in two rural settlements in Colombia and surveillance instrument was developed to measure Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD). Results: In a population with > 60% women and access to social security around 66.5%; 81,6% were homeowners with access to water and electricity > 90% but only 9% of sewerage. The level of knowledge about CD was around 62% but lack of specificity about comprehension of transmission routes (74,6%), and symptoms (85,3%) were found; concluding that 86% of the surveyed sample had very poor level of knowledge about the disease despite preventive campaigns carried out in the two communities studied. Conclusions: Despite of a low frequency of CD in this Caribbean areas, the presence of vector, risk factors plus poor level of knowledge about the disease justify that public health intervention strategies should be implemented and monitored over time to maintain uninterrupted surveillance of Chagas Disease. [ABSTRACT FROM AUTHOR]

Objectives: this study aimed to investigate the relationship between oral manifestations and depression, anxiety, and stress among covid-19 patients. Methods: This cohort study investigated 125 Covid-19 patients hospitalized at Covid-19 wards at Kashan Shahid Beheshti Hospital., After hospitalization, the patients were subjected to an oral examination and filled out the DASS-21 questionnaire to measure Psychological disorders at the beginning of hospitalization, one month and two months after discharge. Then we calculated the occurrence of oral manifestations and their relationship with depression, anxiety and, stress in the patients. Results: On the day of admission, 98.4% of patients had at least one type of oral manifestation. Coated tongue (75.2%), scallop tongue (67.2%) and xerostomia (66.4%) were the most common oral manifestations, respectively. As the severity of depression, anxiety and stress increased, the incidence of oral manifestations also did. However, we found no statistically significant relationship between these two factors (P<0.05); Temporomandibular disorders, xerostomia, changes in smell and taste were significantly related to Psychological disorders in some follow-ups (P<0.05). Conclusion: The study showed no statistically significant relationship between the severity of depression, anxiety and, stress with oral manifestations at any time, but with the increase in the severity of Psychological disorders, the incidence of oral manifestations also increased. A separate examination of the manifestations showed a statistically significant relationship between depression, anxiety and stress with xerostomia, temporomandibular disorders, changes in smell and taste at some follow-up times. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to determine the occurrence of oral manifestations in patients with COVID-19 hospitalized with 4 months of follow-up. Material and methods: This research surveyed the patients admitted to Shahid Beheshti Hospital in Kashan. Patients admitted to the hospital were asked to fill a questionnaire containing questions about the amount of xerostomia, changes in their sense of smell and taste compared to the past, the appearance of a new white or red area in their mouth, the occurrence of ulcers or burning in the mouth. Then, photographs of the palate, tongue region, buccal region on both sides, floor of the mouth and teeth from the patient's front view were taken. The patient was followed weekly in the hospital. The first outside of the hospital follow-up was done two weeks after their discharge and then monthly up to 4 months. Finally, all the photos were reviewed and compared by an oral disease specialist. Results: Out of 304 patients, only 5 patients (1.6%) had no symptoms in their oral on the day of admission. The most common oral manifestation was coated tongue (77%) followed by xerostomia (70.1%). Also, 45.1% gustatory disorders and 43.1% olfactory disorders were reported. With increasing age, the occurrence of oral manifestations increased (p<0.05), but the occurrence of oral manifestations was not related to gender (p>0.05). The results of generalized estimating equation analysis showed a decrease in oral manifestations during the study (p<0.001). Conclusion: Coated tongue, xerostomia and gustatory disorders were among the most prevalent oral manifestations reported in this study. Older patients had more oral manifestations. The occurrence of manifestations was not related to gender. By recovering from the disease, the occurrence of oral manifestations also decreased. Clinical Significance: Diagnosing and treating oral manifestations can cause to diagnose and treat COVID-19 disease. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 6-year-old child diagnosed with scurvy, evidenced by oral manifestations such as gingival overgrowth and palatal ecchymosis. Topics discussed include the patient's medical history, the role of vitamin C deficiency in the condition, and the effective treatment regimen involving vitamin C supplementation that led to a significant improvement in the child's symptoms.

Background: Epidemiological studies have provided evidence suggesting an association between Alzheimer’s disease (AD) and various oral manifestations. However, conflicting conclusions have been drawn, and whether a causal association truly exists remains unclear. Methods: In order to investigate the potential causal association between AD and prevalent oral diseases, we conducted a bi-directional two-sample Mendelian randomization analysis based on summary statistics from genome-wide association studies of AD (N = 63,926), as well as mouth ulcer (N = 461,103), oral cavity cancer (N = 4,151), and periodontal disease (N = 527,652). Results: We identified that one standard increase in the risk of AD was causally associated with a reduced risk of oral cavity cancer (OR = 0.76, 95% CI: 0.63–0.92, p = 3.73 × 10−3). In the opposite direction, oral conditions were not causally associated with risk of AD. Conclusion: The present findings contributed to a better understanding of the correlation between AD and oral conditions, specifically oral cavity cancer. These results also identified new avenues for exploring the underlying mechanisms of oral cavity cancer. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the knowledge of senior dental students and newly graduated dentists about the prevention, diagnosis and treatment of oral manifestations of syphilis. Materials and Methods: A 32‐question questionnaire was designed with three domains: (I) demographic, academic and professional data of the participants, (II) attitudes, practices and self‐perception regarding training about syphilis and (III) knowledge about syphilis. All knowledge responses were classified as correct or incorrect. Scores ranging from 1 to 14 were calculated, and grades were assigned to each participant according to their level of knowledge. Results: The sample comprised 408 dental students and 339 newly graduated dentists. The mean score was 7.70 ± 3.35 for undergraduates and 9.09 ± 3265 for dentists. The highest frequency of correct answers (>70%) was attributed to questions about the aetiology, transmission and treatment of syphilis. The questions with the lowest frequency of correct answers (<50%) were about the identification of oral manifestations and stages of syphilis. Conclusions: The knowledge of dental practitioners and academics about the oral manifestations of syphilis was unsatisfactory. The lack of understanding of these aspects can delay the diagnosis and treatment of patients with this disease, which is concerning given the steady increase in cases in recent years. [ABSTRACT FROM AUTHOR]

Background: Dendritic cells participate in the pathophysiology of lupus erythematosus (LE), which are studied in systemic and cutaneous forms; however, little is known about their oral manifestations. Methods: The expressions of dendritic cell markers (including CD1a, CD21, CD123, and langerin) were investigated by immunohistochemistry technique. Sixty intraoral and lower lip LE lesions, and additional 10 control samples were collected from 2003 to 2019. They were topographically analyzed in the epithelium (EP), lamina propria (LP), epithelial junction (JUN), and deep perivascular (PV) areas. Results: The expression of CD1a was decreased in the EP (p = 0.003) and increased in the deep PV area (p = 0.002). Langerin immunostaining showed no significant decrease in EP (p = 0.944); however, it increased in LP (p = 0.012) and JUN (p = 0.006). CD21 was expressed in only two specimens (EP, p = 0.012; LP, p < 0.001; deep PV area, p = 0.018). CD123 expression increased in all topographies (EP, p < 0.005; LP, p < 0.001, JUN, p < 0.001; deep PV, p < 0.001). The comparison between vermilion and intraoral mucosa LE lesions suggested that sun‐exposed sites showed higher expression of CD123 (EP, p = 0.024; LP, p = 0.047; JUN, p = 0.001). Conclusions: CD1a, langerin, and CD123 expressions were detected coincidently surrounding the inflammatory infiltrate in oral LE, suggesting that these cells may play an important role in immune response. Interestingly, plasmacytoid dendritic cells showed increased CD123 expression in sun‐exposed site lesions, which point out a possible function in their pathogenesis. Further studies are needed to confirm this hypothesis. [ABSTRACT FROM AUTHOR]

This article discusses a study conducted in Egypt that examined the oral manifestations in patients with COVID-19. The study used a questionnaire to collect data on symptoms such as loss of taste and smell, dry mouth, bad breath, and oral lesions. The study found that a significant number of COVID-19 patients experienced complete loss of taste and smell. Some patients also reported dry mouth, bad breath, and oral lesions such as ulcers, tongue changes, and inflammation of the lip commissures. These oral manifestations were observed both during and after the COVID-19 infection. The study also compared the oral lesions in COVID-19 patients to those in non-infected participants and found similar trends. [Extracted from the article]

Objectives: To determine the frequency of head and neck lymphadenopathy (LAP) and intraoral findings (non‐dental/dental) in patients with newly diagnosed acute leukemia (AL). Subjects and methods: Twenty‐eight (52.8%) females and 25 (47.2%) males in a total of 53 patients with newly diagnosed AL with a mean age of 46 years were included in the study. Personal information, the type of AL (AML [acute myelogenous leukemia]/ALL [acute lymphocytic leukemia]), and hematological findings (anemia, neutropenia, and thrombocytopenia) were obtained from medical records. One of two calibrated oral diagnosis and maxillofacial radiology specialists performed extraoral (head and neck LAPs) and intraoral (non‐dental and dental) clinical examinations. The Chi‐square (χ2) test was used to evaluate categorical variables. Results: LAP was observed in 22.6% and intraoral findings in 30.2% of the patients. LAP was most commonly observed in the neck and none in the parotid glands. The most intraoral findings were gingival/mucosal bleeding and oral petechiae/ecchymosis. While there was no statistical difference between AML and ALL patients in terms of LAP (p >.05), intraoral findings were observed more in patients with AML (p <.05). Only two (3.8%) patients had dental findings. With a slight difference, intraoral findings were more with thrombocytopenia and LAP with neutropenia. Conclusion: In AL, especially non‐dental intraoral findings are common. The fact that dentists working in the oral cavity are often the first specialists to encounter the oral manifestations of AL imposes an important role in early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Individuals living with human immunodeficiency virus (HIV) face a heightened risk of developing oral diseases. As such, antiretroviral therapies are crucial for treating HIV, as they help restore immune system functionality. Oral health issues can be not only painful and bothersome but can also lead to further complications. Therefore, the aim of this research is to conduct a thorough analysis of oral health in HIV patients, providing them with vital information and timely preventive measures. The methodology employed is descriptive analysis, which involves collecting specific data to gain a deeper understanding of oral health challenges faced by HIV patients. The findings indicate that periodontitis, gingivitis, hairy leukoplakia, and candidiasis are the most common oral conditions in these patients and may serve as early indicators of HIV/AIDS infection. Moreover, the manifestation of oral diseases can vary depending on age, genetics, endemic factors, or lifestyle choices. In summary, the emergence of oral diseases in HIV patients is influenced by a myriad of internal and external factors. Further research is essential to refine treatment strategies for HIV and associated oral diseases, ultimately improving the quality of life for immunocompromised individuals. [ABSTRACT FROM AUTHOR]

Background: Tobacco use has emerged as a major public health issue with increasing tobacco-related morbidity and mortality. Despite evidence that even brief tobacco counseling by health care professionals is effective in motivating a tobacco user to quit, there was a lack of customized tobacco counseling training module (TCTM) for students of dentistry in their existing curriculum. This study was undertaken to evaluate the effectiveness of a customized TCTM in improving KAASS in tobacco counseling among undergraduate dental students. Methods: TCTM that was previously pilot tested was implemented as a value addition in Public Health Dentistry for two academic years. Changes in knowledge, attitude, ability to identify oral manifestations, self-confidence, and skills (KAASS) in tobacco counseling were assessed before and after implementation of TCTM. Mean pre and post intervention scores were compared. Results: Mean scores for knowledge, attitude, ability to identify oral manifestations, and self-confidence (KAAS) at baseline were 4.4 ± 0.9, 5.1 ± 0.7, 4.5 ± 1.1, and 1.3 ± 0.4, respectively. Mean KAAS scores post intervention were 13.5 ± 1.0, 8.7 ± 0.4, 9.4 ± 0.7, and 3.5 ± 0.5, respectively. There was a significant improvement in the mean KAAS score post intervention compared to baseline. Tobacco counseling skills also significantly improved among the participants following implementation of the training module (68.8%) did well compared to the baseline (0%). Conclusion: TCTM was effective in enhancing knowledge, attitude, ability to identify oral manifestations, and self-confidence in tobacco counseling among undergraduate dental students. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the oral health status among allogeneic transplant recipients who were seen in a multidisciplinary graft‐versus‐host disease paediatric clinic at the University of California, San Francisco (UCSF). Methods: This was a retrospective cohort study of patients who underwent allogeneic transplants and were seen in the graft‐versus‐host disease paediatric clinic between January 2010 and September 2021. Demographic, medical and oral health data were recorded and analysed using descriptive statistics. Results: A total of 25 patients were seen in the paediatric graft‐versus‐host disease clinic (68% males) with a median age of 12 years at the time of transplant were included. Among them, 12 patients (48%) were diagnosed with oral chronic GVHD, 11 (44%) with dry mouth, four (16%) with oral pseudomembranous candidiasis, one (4%) with recrudescent Herpes Simplex Virus (HSV) infection and one (4%) with mammalian target of rapamycin‐inhibitor stomatitis and were managed by the oral medicine team, accordingly with medications, such as topical steroids (44%) and anti‐fungal (20%). Conclusions: HSCT recipients may present with a variety of oral complications. Patients may benefit by a multi‐disciplinary approach including a dental specialist as part of the cancer care team. [ABSTRACT FROM AUTHOR]

Introduction: Obstructive Sleep Apnoea (OSA) is the most common sleep-related breathing disorder seen in all age groups. The aetiology is multifactorial, including factors such as obesity, aging, stress, and a sedentary lifestyle. Poor knowledge about diagnostic options, management, and consequences of improper treatment may contribute to morbidity and mortality. Berlin Questionnaires (BQ) are simple, low-cost, non-invasive tools that can be used to assess the risk of OSA. Screening subjects using questionnaires and oral examinations for a multidisciplinary approach to treat OSA is essential. Aim: To assess the risk of OSA symptoms and their association with oral manifestations among students. Materials and Methods: This cross-sectional study was conducted among medical students aged between 18 and 24 years. Three hundred medical students (171 males, 129 females) willing to participate in the study were included. Responses to the Berlin and oral health questionnaires were collected, and oral examinations were performed. Statistical analysis was conducted using Epi Info software. Kruskal-Wallis H test and one-way Analysis Of Variance (ANOVA) were carried out to evaluate significance in different groups and to examine associations between OSA, oral health, and other variables. Results: The collected data were statistically analysed. In the present study, 35 subjects (11.67%) were classified as highrisk and 265 subjects (88.33%) as low-risk by the BQ. The prevalence of OSA in the present study was 12.87% in males and 10.08% in females. High-risk subjects were educated, motivated, and referred for confirmatory diagnostic tests and early treatment. Conclusion: The prevalence of OSA in the present study was 12.87% in males and 10.08% in females. Emphasis should be placed on highlighting the clinical aspects related to OSA and its relation to oral health. There is a great need to educate and motivate dental and medical students and professionals about OSA by conducting health education programs. [ABSTRACT FROM AUTHOR]

Human herpes virus is a family of DNA viruses that includes herpes simplex virus (HSV) and varicella zoster virus (VZV). HSV-1 and HSV-2 are fairly common and result in oral and genital lesions. Recurrent infections of herpes include lesions on the lips resulting in pain and possibly societal stigma. VZV is the cause of chicken pox and shingles. Acyclovir and other nucleoside analogues have been used to treat HSV and VZV, but newer, more effective treatments are being developed, which is beneficial regarding the issue of resistance to standard antivirals. Human papillomavirus (HPV) is also a DNA virus with different subtypes that result in four common oral benign lesions. The significance and treatments of HSV, VZV, and HPV are discussed, along with certain developing treatments of herpes labialis. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is an airborne infection caused by Mycobacterium tuberculosis complex and is highly infectious. Therefore, precautionary measures should be implemented prior to dental treatment to reduce the risk of infection to staff and other patients. Dental history and examination have a role in identification of TB infection. Complex medical history poses a challenge to safe patient management in a dental setting, and close liaison between different disciplines in managing these patients is of paramount importance. This article explores the classical clinical features of pulmonary TB, its oral manifestations and the dental management of patients with active and latent TB. CPD/Clinical Relevance: Clinicians should be aware of the clinical features and dental management of patients with active and latent TB. [ABSTRACT FROM AUTHOR]

Background: Anemia is a decrease in the amount of hemoglobin, or red blood cells, in the blood. Slow-onset symptoms, such as dyspnea, exhaustion, weakness, or impaired exercise capacity, are frequently nonspecific. Red blood cells' capacity to carry oxygen is limited by anemia. This suggests that the body's tissues and organs take less oxygen from the blood. Objective: To determine the effect of anemia on oral cavity in addition hematological assessments and compare them with healthy controls. Patients and Methods: Among 80 people, a cross-sectional study was conducted. Twenty healthy control participants (9 male and 11 female) and sixty patients with anemia (22 male and 38 female) made up the study samples. Study was directed in September 2023 in Alkhalis hospital- Diyala. Results: Level of hemoglobin in the control group showed a statistically highly significant increase with mean ± SE (14.12 ±0.35) as compared with patients' group. The white blood cell counts showed an increase in the control group with mean ± SE (9.92 ±0.54) as compared with patients' group, with a statistically highly significant correlation. Out of 60 patients, 2 (3.33%) were complaining from angular cheilitis, 6 (10%) were complaining from burning mouth syndrome, 5 (8.33%) were complaining from recurrent aphthous stomatitis, and 13 (21.67%) were complaining from atrophic glossitis, with a statistically highly significant relationship. Conclusion: Differences in white blood cell counts in patients with anemia and healthy control. Many oral manifestations associated with anemia such as atrophic glossitis, burning mouth syndrome, angular cheilitis, and recurrent aphthous stomatitis. [ABSTRACT FROM AUTHOR]

Bullous pemphigoid (BP) is a common immune-mediated blistering disorder with predominant skin involvement and occasionally oral manifestations. Vesiculobullous lesions of the oral mucosa present with similar clinical features, and hence arriving at a clinical diagnosis is aided by a valuable chairside investigation, exfoliative cytology. Cytology done in the present case ruled out pemphigus because of the absence of Tzanck cells in the smear. Biopsy and direct immunofluorescence further confirmed the diagnosis of BP. Treatment initiated with systemic steroids and immunomodulators, along with oral topical application of triamcinolone acetonide resulted in complete remission in 2 months. This case report highlights the role of cytology in the diagnosis of vesiculobullous lesions and management protocol for BP patients presenting with simultaneous skin and oral lesions. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a serious infectious disease with significant mortality and most commonly affects the pulmonary system and rarely the oral cavity. Because oral tuberculosis is a rare disease, it is often overlooked in the differential diagnosis of oral lesions. Despite the recent decline in the incidence of tuberculosis, it remains a highly contagious and serious public health problem, thus requiring early diagnosis and rapid intervention. Extrapulmonary tuberculosis (EPTB) is defined as any bacteriologically confirmed or clinically diagnosed case of tuberculosis (TB). A 17-year-old girl reported at the outpatient Department of Dentistry with the chief complaint of a swelling at the backside of mouth along with pus discharge. She noticed these symptoms approximately one month after the extraction of the left mandibular first molar. The patient was referred to the Department of Pulmonary Medicine for further investigation and treatment. Subsequently, diagnosis of EPOTB was reached on the basis of the histopathological findings and the previous personal as well as family history. Drastic improvement was observed in the general condition and a complete resolution of the oral lesion after four weeks of ATT and the patient was completely free of all the symptoms after six months of follow-up period. This case demonstrated the importance of oral manifestation of oral tuberculosis for dentist who may be the first healthcare provider to encounter a variety of oral lesions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Mucopolysaccharidosis (MPS) is a group of lysosomal storage disorders that cause the deposition of polysaccharides in cells. This causes systemic and oral manifestations, which can be observed clinically and radiographically. The present study aimed to assess dental caries, the effect of salivary pH, and the change of microflora on teeth in patients diagnosed with MPS. Materials and Methods: The study included children affected with mucopolysaccharidosis (n = 50) and healthy children (n = 50) in the control group between 3 and 15 years of age. The pH of saliva and decayed, missing, and filled teeth/decayed extracted and filled teeth index were noted and recorded. For the microbial analysis, saliva was inoculated into blood agar, MacConkey agar, Candida CHROMagar, and Mitis Salivarius agar, then inspected for colony‑forming units, which were counted and recorded based on the colony characteristics and gram staining. Statistical Analysis: Intergroup comparison of the test parameters was done using the Mann–Whitney test. P < 0.05 was considered statistically significant. Results: The results showed significantly higher total microbial load (P = 0.00008), streptococcus viridans species (P = 0.00001), and Candida species (P = 0.0038) in the study group. The caries incidence was also higher in the study group for both primary (P = 0.0096) and permanent dentition (P = 0.0251), and salivary pH was more acidic (P = 0.00001) in the patients diagnosed with MPS. Interpretation and Conclusion: Patients diagnosed with MPS have a higher microbial load, more acidic saliva, and subsequently, a higher caries incidence than normal healthy children. Hence, regular dental evaluation, prevention, and treatment must be integrated into their health‑care regimen. [ABSTRACT FROM AUTHOR]

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Vitamins play a vital role in human health, particularly in the development and maintenance of oral health in children. These nutrients are broadly categorized into fat-soluble and water-soluble types, crucial for children's well-being. The objective of this study is to investigate the impact of vitamin deficiencies on the oral health of children, focusing on how these deficiencies contribute to various oral health issues and determining the relationship between specific vitamin shortages and oral diseases. Findings indicate that shortages in vitamins A and D lead to enamel issues and a higher susceptibility to dental diseases, vitamin E assists in treating oral mucositis, and vitamin K is essential for blood clotting in dental surgeries. Deficits in B-complex and vitamin C result in enamel hypomineralization and soft tissue ailments, including aphthous stomatitis and gingival petechiae. Additionally, a lack of vitamin B7 compromises the immune response, increasing oral candidiasis risk. Therefore, vitamin deficiencies markedly affect children's oral health, highlighting the need for joint efforts between dental professionals and caregivers for effective pediatric care. Addressing vitamin deficiencies through supplementation and tailored dental care emphasizes the significance of nutritional health in children's overall and dental well-being, advocating for a collaborative approach to achieve optimal health outcomes. [ABSTRACT FROM AUTHOR]

Background and objectives: The literature about oral manifestations and dental management in maple syrup urine disease (MSUD) is sparse. The aim of this report is to present a new case of MSUD with special emphasis on oral findings and to review the relevant literature. Method: A case report of a 4-year-old boy with MSUD was described according to the CARE guidelines for describing case reports. Scoping review of relevant literature was performed, according to the PRISMA-ScR guidelines, by searching PubMed, Medline, Embase, and the grey literature for articles describing dental management and/or oral manifestations in MSUD. Results: The initial search identified 219 articles, but only 4 met the inclusion criteria. Rampant caries and plaque induced gingivitis were the main oro-dental findings in MSUD. Other oral findings included enamel hypoplasia, skeletal abnormalities, and abnormal oral behaviors. Disease-related factors appeared to play a major role in the development of the observed oral phenotype. Conclusion: Oral health in MSUD seems to be influenced by the reliance on semi-synthetic diet and associated neurocognitive complications. Tailored oral health promotional interventions should be included in the multidisciplinary management of patients with MSUD. [ABSTRACT FROM AUTHOR]