• Journal of Oral Medicine and Pain
• /
• 제42권2호
• /
• pp.49-52
• /
• 2017

Leukemia is a malignant disease characterized by uncontrolled clonal proliferation of white blood cells. It is classified depending on clinical course of disease (acute or chronic) and the primary hematopoietic cell line affected (myeloid or lymphoid). Leukemia is often associated with orofacial manifestations, such as oral bleeding, petechiae, oral ulceration, gingival enlargement, mucosal pallor and mental nerve neuropathy. However, trismus has been rarely reported as a sign of leukemia. We present a case of trismus caused by acute lymphoblastic leukemia and emphasize the importance of orofacial manifestations in the early diagnosis of leukemia.

• 대한치과교정학회지
• /
• 제43권5호
• /
• pp.248-260
• /
• 2013

Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals, is mainly caused by mutations in Runx2, a gene required for osteoblastic differentiation. It is generally characterized by hypoplastic clavicles, narrow thorax, and delayed or absent fontanel closure. Importantly, its orofacial manifestations, including midfacial hypoplasia, retained primary teeth, and impacted permanent and supernumerary teeth, severely impede the well-being of affected individuals. Successful treatment of the orofacial problems requires the combined efforts of dental specialists. However, only a few successfully treated cases have been reported because of the rarity of CCD and complexity of the treatment. This article presents the University of California, San Francisco (UCSF) treatment protocol for the dentofacial manifestations of CCD based on two treated and 17 diagnosed cases. The records of two patients with CCD who had been treated at the UCSF School of Dentistry and the treatment options reported in the literature were reviewed. The UCSF treatment protocol produced a successful case and a partially successful one (inadequate oral hygiene in the retention stage resulted in decay and loss of teeth). It provides general guidelines for successfully treating the orofacial manifestations of CCD.

• Journal of Oral Medicine and Pain
• /
• 제42권1호
• /
• pp.25-27
• /
• 2017

Crohn's disease is an inflammatory bowel disease which affects whole gastrointestinal tract from mouth to anus. Crohn's disease may present both oral manifestation and gastrointestinal symptom-abdominal pain, diarrhea, weight loss, anorexia, fever, and growth failure. The prevalence rate of oral manifestation is approximately between 0.5% and 20%. The oral lesion could be the first sign of Crohn's disease. We present a case of Crohn's disease in a patient who did not show typical oral manifestations but had nonspecific aphthous like ulceration and burning sensation for many years. Through this case, we suggest approaches for the diagnosis and treatment of the oral lesion of Crohn's disease.

• Journal of Oral Medicine and Pain
• /
• 제44권3호
• /
• pp.118-122
• /
• 2019

Paraneoplastic pemphigus (PNP) is a rare and often fatal autoimmune blistering disease accompanied by both benign and malignant neoplasms. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by PNP patients. Oral ulcers are initial lesions in various autoimmune diseases like pemphigus, bullous pemphigoid, erythema multiforme, graft-versus-host, lichen planus, it does not improved despite of high-dose steroid therapy. We report a-35-year-old female who presented oral ulceration, lip crust and skin lesions. By doing several examinations, such as enzyme-linked immunosorbent assay, incisional biopsy with indirect immunofluorescence, she was diagnosed PNP with non-Hodgkin's lymphoma on pancreas.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제20권5호
• /
• pp.263-269
• /
• 2020

Fibromyalgia is a syndrome characterized by chronic pain in the skeletal system accompanied by stiffness, sleep disturbance, fatigue, and psychiatric problems, such as anxiety and depression. Fibromyalgia commonly affects orofacial health, presenting with a variety of oral manifestations, including temporomandibular disorder, xerostomia, glossodynia, and dysgeusia. Therefore, oral healthcare providers need to be aware of this clinical entity to effectively manage oral symptoms and provide proper oral self-care modification and education on the nature of fibromyalgia. This review focuses on the epidemiology, pathophysiology, clinical manifestation, diagnosis, orofacial concerns, and treatment of fibromyalgia.

• Journal of Oral Medicine and Pain
• /
• 제47권1호
• /
• pp.62-66
• /
• 2022

Recent case studies raised the possibility that cutaneous and oral mucosal manifestations may be associated with the coronavirus disease 2019 (COVID-19) vaccination. A healthy 43-year-old male presented an acute aphthous stomatitis following Moderna COVID-19 vaccination. This rare case draws attention to a potential etiologic effect for oral mucosal manifestation from COVID-19 vaccination. Further investigation to shed light on prevalence and pathophysiologic association of this oral lesion and COVID-19 vaccination deserve attention.

• Journal of Oral Medicine and Pain
• /
• 제40권3호
• /
• pp.130-134
• /
• 2015

$Sj{\ddot{o}}gren's$ syndrome (SS) is an autoimmune disease characterized by an autoimmune exocrinopathy involving mainly salivary and lacrimal glands. Apart from manifestations due to involvement of exocrine glands, patients with SS can present with muscular and neurological manifestations. Here, we report a rare case of a 59-year-old woman with primary SS, who presented with severe general toothache and masticatory muscle myalgia successfully treated with clonazepam. Although it was not certain that these symptoms could be originated from focal muscle dystonia or neurological changes that are associated with primary SS, our case suggested that comprehensive evaluation including neuromuscular examinations in the oral and maxillofacial area is needed in patients with SS.

• Journal of Oral Medicine and Pain
• /
• 제25권2호
• /
• pp.159-165
• /
• 2000

Subsequent to an allogenic stem cell transplantation(ASCT) on patients with hematologic malignancy(AML, ALL, CML, multiple myeloma, lymphoma etc.), chronic GVHD(graft versus host disease), which is an immunological reaction, occurs. With treatment results from patients who were diagnosed with ALL(acute lymphocytic leukemia), undergone BMT(bone marrow transplantation) and showed oral and skin lesions due to GVHD, treatment of oral manifestations of leukemia and its general management were studied. 90% of patients with chronic GVHD show change in the oral mucosa causing oral manifestations such as leukoplakia, lichenoid change of the oral mucosa, mucosal atrophy, erythema, ulceration and xerostomia. In treating GVHD, extensive systemic immunosuppression cause bacterial, viral, fungal infection that are fatal, and even if the treatment is successful, the patient is already in a severe immunosuppressed state. Therefore, localized target therapy is preferred. In another words, topical application(rinse, cream, ointment etc.) of cyclosporin and steroid in treating oral chronic GVHD is highly recommended, and the use of PUVA(Psoralen Ultraviolet A) and thalidomide is reported to be effective. In treating such diseases, dental treatment to control pain and prevent secondary infection of oral manifestations is very important. To those patients with systemic diseases who show limited effect by general dental treatment, non-invasive treatment such as the dental laser, in addition to the use of drugs, may be necessary to actively treat pain and help the healing process. For greater results, new effective methods are to be developed for treatment.

• Journal of Oral Medicine and Pain
• /
• 제33권4호
• /
• pp.375-382
• /
• 2008

구강안면 운동장애에 관한 진단 및 치료에 관한 기초를 수립하기 위하여 2007년 9월부터 2007년 12월까지 조선대학교 치과병원 구강내과에 내원한 33명의 구강안면 운동장애 환자의 연령, 성별, 전신병력 및 주소에 관한 진단명, 자각여부, 구강안면 운동의 유형 등을 분석한 결과 다음과 같은 결과를 얻었다. 1. 여자가(81.82%)가 남자(18.18%)보다 구강안면 운동장애에 많이 이환되었으며, 평균 연령은 72.78($56{\sim}87$)세였다. 2. 대부분 전신질환에 이환되어 있었고(81.82%), 가장 높은 빈도를 보인 전신질환은 고혈압(22.41%)이었으며, 당뇨(17,24%), 우울증(8.62%), 위염(8.62%)순이었다. 3. 임상증상을 분석한 결과, 측두하악장애가 17명(33.33%)으로 가장 많았으며, 연조직질환(11명, 21.57%), 구강작열감증후군(9명, 17.65%), 구강운동(8명, 15.69%), 광범위한 안면통증(6명, 11.76%) 순이었다. 4. 특정한 원인 없이 증상이 발현한 경우가 72.73%로 가장 많았으며, 보철치료 후 증상이 발현된 경우가 24.24%, 우울증약 복용과 관련이 있는 경우가 3.03%이었다. 5. 구강안면운동의 유형을 평가한 결과, 폐구형(close)이 가장 많았으며(9명, 50%), 측방형(6명, 33.33%), 개구형(3명, 16.67%) 순이었다. 6. 구강안면운동를 자각하고 있지 못하는 경우가(54.55%) 자각하고 있는 경우(45.45%)보다 더 많았다. 따라서 치과의사는 구강안면통증 환자를 치료하는데 있어 구강안면 운동장애의 가능성을 항상 염두에 두어야 한다. 또한 정확한 진단 및 처치를 통해 불필요하고 비가역적인 치료를 최소한으로 줄이고자 항상 노력을 기울여야 할 것이다.

• Journal of Oral Medicine and Pain
• /
• 제38권2호
• /
• pp.103-108
• /
• 2013

Pachyonychia congenita는 케라틴 유전자의 돌연변이로 발생하며, 상염색체 우성으로 유전되는 매우 드문 유전성 피부질환이다. 주로 손톱과 발톱, 발바닥, 구강점막 등에 이환되며, 주된 증상으로는 손발톱구만증, 손과 발의 과각화증, 소포성 각화증, 구강점막의 백색각화증 등이 있다. 구강점막의 조직학적 소견으로는 과각화증, 극세포증, 상피세포의 핵 주위 세포질내 공포 형성이 나타난다. 피부병소의 치료법으로는 수술적 요법, 기계적인 방법의 치료, 화학적 요법, 약물요법 등이 이용되고 있으며, 구강병소는 대개 치료를 필요로 하지는 않지만 환자의 불편함이 발생하면 대증요법을 시행한다. 피부병소와 구강병소가 동반되는 환자의 경우 면밀한 관찰을 통해 손톱과 발톱의 이영양증, 발바닥의 과각화, 구강점막의 백색각화증 등의 특징적인 병소가 나타나면 조직 생검을 시행하여 이를 확진할 수 있어야 하며, 환자가 호소하는 불편감에 따른 적절한 치료를 시행하여야 한다.