• Title/Summary/Keyword: Oral manifestations

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Extensive gingival necrosis and sequestration of the alveolar bone caused by methimazole-induced neutropenia and three-year follow-up

  • Kim, Eun-Cheol;Park, Joon Bong;Hong, Ji-Youn;Kang, Kyung Lhi
    • Journal of Periodontal and Implant Science
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    • v.45 no.2
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    • pp.76-80
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    • 2015
  • Purpose: Methimazole is an anti-thyroid drug that can cause life-threatening neutropenia in rare situations. The aim of this case report is to describe a set of oral complications associated with methimazole-induced neutropenia and the healing of the gingiva after proper treatment. Methods: A 31-year-old female patient hospitalized for systemic symptoms of sore throat and fever and showing extensive gingival necrosis with pain was referred to the Department of Periodontics from the Department of Endocrinology. Methimazole-induced neutropenia was diagnosed based on blood test results and her medical history. Methimazole was discontinued and a range of treatments was administered, including the injection of granulocyte colony stimulating factor. Results: After systemic treatment, the gingiva began to heal as the neutrophil count increased. Approximately one year later, the gingiva had returned to a normal appearance. Twenty-one months after treatment, sequestra of the alveolar bone that had broken through the gingiva were removed. Periodic supportive periodontal treatment has been continued uneventfully. Conclusions: The oral manifestations of gingival necrosis and ulcerations, in combination with systemic symptoms such as fever and sore throat, are the critical signs presented in the early stages of drug-induced neutropenia. Therefore, dentists need to be aware of these oral complications in order to make an accurate diagnosis and to ensure that prompt medical intervention is provided.

LEUKOCYTE ADHESION DEFICIENCY TYPE I: CASE REPORT (Leukocyte adhesion deficiency type I 환자의 치험례)

  • Yoon, Eun-Young;Lee, Nan-Young;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.586-590
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    • 2009
  • Leukocyte adhesion deficiency is rare inherited defect on phagocytic function resulting lack of leukocyte cell surface expression of $\beta2$ integrin molecule that are essential for leukocyte adhesion to endothelial cells and chemotaxis. Clinical features of patients with leukocyte adhesion deficiency type I include recurrent necrotic infection of the skin mucous membranes, and intestinal tract with septicemia, and omphalitis arising from delayed umbilical cord separation. Oral manifestations are severe progressive periodontitis with alveolar bone loss, periodontal pockets, and partial and total premature loss of the deciduous and permanent dentitions. We report a case of leukocyte adhesion deficiency type I in a 5-year-old child with severe periodontitis. In order to prevent local and systemic infection, we controlled periodontal disease with periodic oral prophylaxis. Oral swabs and blood cultures were perfomed for suspected infection, so that optimal measures were taken through the use of appropriate antibiotics.

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Minimizing the risk of perioperative cardiovascular complications in homozygous familial hypercholesterolemia: a case report

  • Khan, Saad;Min, Samuel;Willard, Garrett;Lo, Iris;D'Souza, Rachael;Park, Aaron
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.1
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    • pp.39-44
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    • 2020
  • Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

Recent Advances in the Seborrheic Dermatitis (지루성 피부염의 최신 지견)

  • Cha, Jae-Hoon;Nam, Hae-Jeong;Kim, Hee-Jeong;Park, Owe-Suk;Kim, Keoo-Seok;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.3 s.31
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    • pp.118-133
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    • 2006
  • Seborrheic dermatitis is characterized by the appearance of red, flacking, greasy lesions in regions rich in sebaceous glands. There are various opinions about the relation between seborrheic dermatitis and dandruff. Considering all available data, we consider seborrheic dermatitis and dandruff to be differing severity manifestations of similar origin. The known etiologies of seborrheic dermatitis are the abnormality of lipid and hormnes, Malassezia species, immune response. We recently focus on the relation between seborrheic dermatitis and HIV positive and AIDS patients, seborrheic dermatitis and neurological disease. The treatments of seborrheic dermatitis include topical treatments, oral treatments. There are non-specific agents, antifungal medication, corticosteroids in the topical treatments. Narrow band UVB and oral medications are known as the prophylaxis of seborrheic dermatitis but we need further study. In traditional korean medicine, the literature studies and case reports have been published. But we don't know what herbal medicine has antifungal effect against Malassezia species. So we should discriminate herbal medicines which have antifungal effect against Malassezia specieses. Then we could treat seborreic dermatitis by traditional korean medicine effectively.

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Magnetic resonance imaging findings of the retrodiskal tissue in TMJ internal derangement (측두하악관절 내장증에서의 관절원판 후조직의 자기공명영상)

  • Cho Bong-Rae
    • Imaging Science in Dentistry
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    • v.33 no.2
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    • pp.63-70
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    • 2003
  • Purpose: To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. Materials and Methods: One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. Tl-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. Results: A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p<0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment(TPA) were correlated neither with clinical, nor with other MRI findings. Conclusion: This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.

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Surgical Treatment of Plummer - Vinson Syndrome with Carcinoma in Situ - One case report - (상피내암종으로 발전한 Plummer - Vinson 증후군의 수술적 치험 - 1례 -)

  • 최주원;장운하;박찬필;오태윤
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.495-499
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    • 2002
  • Plummer-Vinson syndrome(Paterson-Kelly syndrome) is characterized by dysphagia due to upper esophageal or hypopharyngeal web, iron deficiency anemia, and atropic oral and glossal mucosa. This syndrome is usually known as precancerous lesion that develops into postcricoid carcinoma. Universally, the clinical manifestations of this syndrome were markedly improved after oral iron replacement therapy or endoscopic balloon or electrocautery treatment. 63 year-old woman was received a short segment, free jejunal transfer to be released from esophageal stricture. After the operation, the stenotic lesion proved to be Plummer-vinson syndrome with carcinoma in situ by pathologic study.

Radiographic manifestations of fibroblastic osteosarcoma: A diagnostic challenge

  • Tahmasbi-Arashlow, Mehrnaz;Barnts, Kelcie Louise;Nair, Madhu K.;Cheng, Yi-Shing Lisa;Reddy, Likith V.
    • Imaging Science in Dentistry
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    • v.49 no.3
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    • pp.235-240
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    • 2019
  • Osteosarcoma is the most common primary bone tumor after plasma cell neoplasms. Osteosarcoma has diverse histological features and is characterized by the presence of malignant spindle cells and pluripotent neoplastic mesenchymal cells that produce immature bone, cartilage, and fibrous tissue. Osteosarcoma most frequently develops in the extremities of long bones, but can occur in the jaw in rare cases. The clinical and biological behavior of osteosarcoma of the jaw slightly differs from that of long-bone osteosarcoma. The incidence of jaw osteosarcoma is greater in the third to fourth decades of life, whereas long-bone osteosarcoma mostly occurs in the second decade of life. Osteosarcoma of the jaw has a lower tendency to metastasize and a better prognosis than long-bone osteosarcoma. Radiographically, osteosarcoma can present as a poorly-defined lytic, sclerotic, or mixed-density lesion with periosteal bone reaction response. Multi-detector computed tomography is useful for identifying the extent of bone destruction, as well as soft tissue involvement of the lesion. The current case report presents a fibroblastic osteosarcoma involving the left hemimandible with very unusual radiographic features.

Persistent pain after successful endodontic treatment in a patient with Wegener's granulomatosis: a case report

  • Ricardo Machado;Jorge Aleixo Pereira;Filipe Colombo Vitali;Michele Bolan;Elena Riet Correa Rivero
    • Restorative Dentistry and Endodontics
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    • v.47 no.3
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    • pp.26.1-26.10
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    • 2022
  • Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

EARLY DETECTION OF BEHCET'S DISEASE (베체트병의 조기 진단)

  • Kim, Seung-Hye;Song, Je-Seon;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.575-579
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    • 2009
  • Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

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Association with oral symptom experiences by level of subjective stress recognition in the Korean adolescents (우리나라 청소년의 주관적 스트레스의 인지수준에 따른 구강증상경험과의 관련성)

  • Han, Yeo-Jung;Kim, Han-Soo;Ryu, So-Yeon
    • Journal of Korean society of Dental Hygiene
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    • v.17 no.3
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    • pp.465-478
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    • 2017
  • Objectives: The purpose of this study was to investigate the relationship between the level of subjective stress recognition and oral symptom experiences including toothache, gum diseases, and oral soft tissue diseases in the Korean adolescents. Methods: The subjects were 68,043 adolescents recruited using a web-based survey, National Korean Youth Risk Behavior in 2015 by the Korean Center for Disease Control. For statistical analysis, SPSS 21.0 for Windows was used. Descriptive analysis and a Chi-square test were conducted to determine the factors associated with general characteristics, health behaviors, oral health behaviors, and level of subjective stress recognition. Finally, to investigate the relationship between the level of subjective stress recognition and oral symptom experiences, logistic regression analysis was performed. Results: Toothache related subjective stress recognition level was significantly higher in the moderate group with the score of 1.59 (95% CI; 1.49-1.68), and was greater in the high group with 2.38 (95% CI; 2.24-2.53) compared to the low group. Gum disease related subjective stress recognition level was significantly higher in the moderate group with 1.41 (95% CI; 1.32-1.51), and was greater in the high group with 1.99 (95% CI; 1.86-2.13). Oral soft tissue disease related subjective stress recognition level was significantly higher in the moderate group with 1.59 (95% CI; 1.45-1.74), and was greater in the high group with 2.55 (95% CI; 2.33-2.79). Bad breath related subjective stress recognition level was significantly higher in the moderate group with 1.48 (95% CI; 1.39-1.57), and was greater in the high group with 2.10 (95% CI; 1.97-2.25). Conclusions: Higher subjective stress recognition level was found to affect the oral symptoms experienced. Therefore, the stress management plan should be prepared through the cause identification of the main stress in the adolescents. Practical and systematic education is needed for oral health management in the schools.