Unusual clinical presentation of oral pyogenic granuloma with severe alveolar bone loss:A case report and review of literature

BACKGROUND Pyogenic granuloma(PG)is a localized,reddish and vascularized hyperplastic lesion of the connective tissue which occurs in the oral cavity.In most cases,the presence of this lesion does not show alveolar bone resorption.The pathology is diagnosed clinically with some caution.However,the diagnosis and treatment are usually corroborated with histopathological evidence.CASE SUMMARY Three clinical cases of PG associated with bone loss were described in this study.The three patients presented tumor-like growth which bled on touch,and were associated with local irritant factors.Radiographs showed bone loss.All cases were treated with conservative surgical excision.The scarring was satisfactory,and there was no case of recurrence.The diagnoses were based on clinical findings,and were confirmed histopathologically.CONCLUSION The occurrence of oral PG with bone loss is unusual.Therefore,clinical and radiographic evaluations are important for the diagnosis.

Microsurgical management of radicular cyst using guided tissue regeneration technique:A case report

BACKGROUND Radicular cyst is a lesion of odontogenic origin that arises from epithelial remains due to periapical periodontitis caused by inflammatory reactions generated at the apex of affected teeth with infected or necrotic pulps.The therapeutic mana gement of radicular cysts is controversial.There is only one case report of enucleation of a radicular cyst managed with microsurgery and apicoectomy,but without the use of the guided tissue regeneration(GTR)technique in the same surgical procedure.The present clinical case describes the management of a radicular cyst with microsurgical approach,performance of an apicoectomy of the tooth associated with the entity,application of GTR technique,use of a resorbable membrane of type I bovine collagen,and bovine xenograft.CASE SUMMARY A 68-year-old patient presented with a radicular cyst from an upper lateral incisor.The microsurgical management used was aimed at enucleating the chemical membrane,performing apicoectomy of the tooth along with careful and precise retrograde filling,and implementing GTR technique using a resorbable collagen membrane and bovine xenograft.The diagnosis of radicular cyst was confirmed using histopathological analysis.The patient underwent follow-up evaluations at 10 and 30 d postoperatively.At 4 months postoperative evaluation,she remained asymptomatic,and radiographs showed significant periapical healing with adequate bone formation.CONCLUSION These results suggest that microsurgical management using the GTR technique with collagen membrane and xenograft,contributes to bone regeneration.

Diagnostic and therapeutic challenges of myeloid sarcoma in the oral cavity

Myeloid sarcoma(MS)is a rare neoplasm characterized by the proliferation of immature myeloid precursor cells outside the bone marrow.The pathogenesis of MS is complex and not completely understood.Moreover,it develops in any extramedullary site of the body.In this editorial,we discuss the article published by Li et al,which presents a clinical case involving a 32-year-old man who exhibited gingival inflammation in the maxillary region.It was initially diagnosed as periodontal disease.However,clinical evaluation revealed a firm,grayishwhite mass which underscored the need for comprehensive diagnostics to distinguish MS from other oral conditions.This article emphasizes the different clinical presentations of similar case studies in the literature,and highlights the difficulty in diagnosing oral MS due to its rarity and variability in clinical manifestation.The treatment of MS depends on the clinical presentation,tumor location,and the patient's response to conventional therapies.The various therapeutic options currently available are analyzed and discussed.Early intervention and multidisciplinary management are crucial for improving treatment outcomes.Increased awareness and education about the various clinical presentations of MS lead to earlier diagnosis and timely treatment,thereby enhancing patients'survival and quality of life.Continued research is essential for optimizing therapeutic strategies and addressing the challenges presented by this rare neoplasm.

Periodontal disease:A silent factor in the development and progression of diabetic retinopathy

The global increase in the prevalence of type 2 diabetes mellitus(T2DM)and its complications presents significant challenges to public health.Recently,periodontal disease(PD)was recognized as a factor that is likely to influence the progression of T2DM and its complications due to its potential to exacerbate systemic inflammation and oxidative stress.In this editorial,we comment on the article published by Thazhe Poyil et al in the very recent issue of the World Journal of Diabetes in 2024,which investigated the correlation between PD and diabetic retinopathy(DR)in T2DM patients,with emphasis on the association between periodontal swollen surface area,glycated hemoglobin(HbA1c),interleukin-6(IL-6),and lipoprotein(a).The findings by Thazhe Poyil et al are significant as they demonstrate a strong link between PD and DR in T2DM patients.This correlation highlights the importance of addressing periodontal health in diabetes management to potentially reduce the risk and severity of DR,a complication of diabetes.The integration of periodontal evaluation and treatment into diabetes care protocols may lead to improved glycemic control and better overall outcomes for T2DM patients.A few studies have established an interconnection between PD and diabetic complication,specifically DR,in T2DM patients,which we aim to highlight in this editorial.Emphasis was placed on the different mechanisms that suggest a bidirectional relationship between PD and T2DM,where the presence of periodontal inflammation negatively influenced glycemic control and contributed to the development and progression of DR through shared inflammatory and vascular mechanisms.This article highlights the importance of collaboration amongst diabetes specialists,ophthalmologists,periodontists,and public health professionals to advance the prevention,early detection,and treatment of PD and DR.This will improve the health and quality of life of T2DM patients.Moreover,the editorial highlights the need for further research on the specific molecular and immunological mechanisms that underlie the link between periodontitis and DR,with identification of common inflammatory biomarkers and signaling pathways.This is expected to facilitate effective direction of therapeutic objectives,thereby improving the management of diabetes and its complications through integrated care that incorporates oral health.

Gingival enlargement induced by cyclosporine in Medullary aplasia:A case report

BACKGROUND Cyclosporine is an immunosuppressive agent used effectively for treatment of a rare haematological disorder known as medullary aplasia.This drug prevents several side effects,including gingival enlargement(GE)which compromises aesthetics,phonetics and chewing,and also predisposes patients to periodontitis.CASE SUMMARY This clinical case reports a 41-year-old woman who presented with cyclosporineinduced GE with underlying periodontitis and medullary aplasia.The management of the disease was approached through multidisciplinary strategy which allowed for accurate diagnosis and a strategic treatment based on the systemic condition and severity of oral pathology.The diagnosis was confirmed through histopathological analysis.The treatment was carried out in phases:Initial(oral hygiene motivation,mechanical supragingival plaque control,and non-surgical therapy);systemic treatment,corrective treatment,and maintenance.CONCLUSION Multidisciplinary management of cyclosporine-induced GE and medullary aplasia allows for correct diagnosis and effective treatment of this pathological expression through a phased therapeutic approach.

Identification of BRAF V600E mutation in odontogenic tumors by high-performance MALDI-TOF analysis

Odontogenic tumors are rare lesions with unknown etiopathogenesis.Most of them are benign,but local aggressiveness,infiltrative potential,and high recurrence rate characterize some entities.The MAP-kinase pathway activation can represent a primary critical event in odontogenic tumorigenesis.Especially,the BRAF V600E mutation has been involved in 80%–90%of ameloblastic lesions,offering a biological rationale for developing new targeted therapies.The study aims to evaluate the BRAF V600E mutation in odontogenic lesions,comparing three different detection methods and focusing on the Sequenom MassARRAY System.81 surgical samples of odontogenic lesions were subjected to immunohistochemical analysis,Sanger Sequencing,and Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry(Sequenom).The BRAF V600E mutation was revealed only in ameloblastoma samples.Moreover,the presence of BRAF V600E was significantly associated with the mandibular site(ρ=0.627;P value<0.001)and the unicystic histotype(ρ=0.299,P value<0.001).However,any significant difference of 10-years disease-free survival time was not revealed.Finally,Sequenom showed to be a 100%sensitive and 98.1%specific,suggesting its high-performance diagnostic accuracy.These results suggest the MAP-kinase pathway could contribute to ameloblastic tumorigenesis.Moreover,they could indicate the anatomical specificity of the driving mutations of mandibular ameloblastomas,providing a biological rational for developing new targeted therapies.Finally,the high diagnostic accuracy of Sequenom was confirmed.

Impact of Local Application of Clindamycin in Preventing Dry Socket after Third Mandibular Molar Extraction

Extraction of third mandibular tooth is one of the most commonly performed surgical procedures in oral surgery. One of the most common complications following the extraction of third mandibular molar teeth is dry socket (alveolar osteitis). Dry socket is the delayed healing of the wound of the alveolar bone after dental extractions. The purpose of this study was to determine if the intra-alveolar application of Clindamycin could reduce the incidence of dry socket following the extraction of third mandibular molar tooth. Patients who qualified for the prospective, randomized, double-masked, placebo-controlled trial were randomly divided into 2 groups, each group 30 patients. The first group (30 patients) included smokers and the second group (30 patients) included non smokers. Both groups had the mandibular third molar extracted in both sides at the same time. In total, 120 third molars were extracted. The left site was a study group in which we applied the clindamycin and the right site was a control group. The patients were also divided by gender. Dry socket occurred in 3.3% of cases for patients whom were given Clindamycin, regardless of their smoking habits, as opposed to 31.7% for those who did not receive the antibiotic. Results clearly showed that Clindamycin had a huge impact on reducing dry socket regardless of smoking habits.

The Secular Tendency of the Age at Menarche in a Representative Sample of Mexican Girls from an Urban Zone in Central Mexico

Objective: To investigate the age at menarche, pubarche and telarche in a representative sample of residents of an urban zone of Leon, Guanajuato, Central Mexico and to evaluate the secular change of the age at menarche between 1985 and 2000. Methods: Using status quo and retrospective methods, menarcheal, pubarcheal and telarcheal status of girls 8 - 17 years of age (n = 1093) were determined. Multiple regression analysis and logistic regression were used to determine factors that were related to or predictive of age at menarche. Results: Median ages for menarche, pubarche and telarche in our studied sample were: 11.9 ± 0.04;11.13 ± 1.25 and 10.84 ± 1.34 years, respectively. A direct correlation was found between the age of menarche of adolescents and that of their mother (p p p = 0.001), but an indirect correlation was found with the girls’ hip circumference (p = 0.004). We demonstrated a clear secular tendency towards an earlier onset of menarche by comparing our results (11.9 ± 0.04) with data from 1985 (12.8 ± 1.3) for adolescents from the same city. Conclusion: We demonstrated a clear reduction in age at menarche of approximately 0.75 year/decade, higher than Tanner’s finding in 1962, but similar than that of Malina et al. in 2004.

Nevoid basal cell carcinoma: Case report

Nevoid basal cell carcinoma, known as Gorlin Goltz Syndrome, is a rare hereditary condition, characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. In this report, we discuss a case of a patient with Gorlin Goltz Syndrome, who was 16 years old when first admitted for an initial appointment. The patient was diagnosed, treated and followed up for 7 years to present day. This syndrome is associated with a broad spectrum of anomalies and neoplasms as basal cell carcinomas, odontogenic keratocysts, palmar and/or plantar pits, and ectopic calcifications of the falx cerebri. It affects multiple organ systems, which include skeletal, teeth, jaw, skin, eyes, reproductive organs, and neural system. All the features however, are rarely observed in a single patient. The following paper presents the significance of early diagnosis of Gorlin Goltz Syndrome and the importance of a multidisciplinary approach in providing proper treatment for the patient.

Dental Plaque Streptococci and Their Amoxicillin Resistance in Children with Congenital Heart Anomalies: Results of a Prospective Study

Children with congenital heart diseases (CHD) are considered to be at higher risk of development of a Bacterial Endocarditic (BE) from infectious diseases of the oral cavity and following dental treatments. They represent the largest group of patients with special medical needs who appear in the daily dental practice. Maintenance of oral health and oral hygiene is suitable to reduce the incidence of bacteremia. Oral hygiene is more important in reducing the risk of BE than the administration of antibiotic-prophylaxis before dental procedures. The purpose of this study was to identify the strains of streptococci viridians group from dental plaque and their amoxicillin resistance at children with congenital heart disease. The study was carried out in University Dentistry Clinical Center of Kosova, Department of Pediatric Dentistry in cooperation with the Micro-biologic Department. Participants in this study (n = 90) were children between 6 - 15 years old, divided in the control group of healthy children (n = 30), and two study groups, first group, children with CHD who have not taken antibiotics within last three months (n = 30) and second group, children with CHD who have taken antibiotics within three months (n = 30). The gram positive cocci were identified using the automated system, VITEK 2 (BioMerux), while for determining amoxicillin resistance cocci the disc diffusion method was used. By analyzing the three groups of children regarding isolated dental plaque streptococci, in general the Viridans group of streptococci (VGS) has dominated our results, with a higher percentage of streptococcus Mitis group (37.2%). The highest resistance of VGS against amoxicilin was in the group of children with CHD, which have been using antibiotics within 3 months (23.3%). In the other two groups the resistance against amoxicillin was found in a lower percentage (3.3%). Based on the results of our study we can conclude that frequent use of amoxicillin may result in an increasing antimicrobial resistance of streptococci.

Dysmorphic Concern Questionnaire: Greek Translation, Validation and Psychometric Properties

Aim of this study is to assess the reliability, validity and psychometric properties of the Greek language version of the Dysmorphic Concern Questionnaire (DCQ). Method: The Greek language version of the DCQ scale was presented to 88 healthy individuals (57 women and 31 men) and 32 subjects suffering from body dysmorphic disorder BDD (20 women and 12 men) matched for age and sex. All the BDD group subjects and 57 subjects from the healthy individual group were also assessed according to the following psychometric scales: Symptom Checklist-90-R (SCL-90) scale, Eysenck Personality Questionnaire (EPQ), State-Trait Anxiety Inventory (STAI 1 and STAI-2) and the Zung Self-Rating Depression scales. Results: Regarding the DCQ scale, the analysis revealed that one single factor was extracted that accounted for 71.4% of the total variance. Cronbach’s alpha was 0.933, indicating a high level of internal consistency. Comparison between groups, healthy individuals vs BDD patients, showed statistically significant differences in almost every item of the SCL-90 scale (p < 0.05). The Spearman correlations of DCQ score, the DCQ factor score and DCQ T factor with SCL-90, EPQ, as well as the ZUNG depressive scales present high correlation with most items of SCL-90 and ZUNG and STAI-2 (p < 0.005). Conclusion: The Greek version of the Dysmorphic Concern Questionnaire (DCQ) is a valid and reliable instrument, appropriate for both research and clinical settings where dysmorphic concern or body image is a variable which needs to be measured or screened for.

Link between caries,periodontitis,and pregnancy:The role of personalized oral hygiene

Optimal health during pregnancy is crucial for ensuring the well-being of the mother and the developing fetus.This article is focused on the impact of oral health and the role of personalized oral hygiene management in addressing prevalent dental issues among pregnant women,with particular emphasis on periodontal disease and dental caries.Despite the high prevalence of these dental problems and their association with obstetric complications such as pre-term birth and low birth weight,many pregnant women do not receive adequate dental care.This gap in care is often due to misconceptions about the safety of dental treat-ments during pregnancy and lack of awareness on the part of healthcare profes-sionals.Appreciations of the impacts of oral health and personalization of oral hygiene strategies such as tailored education and support,have proven effective in improving oral health in this population.Significant reductions in the incidence of caries and periodontal disease may be achieved by adapting care to the specific needs of each patient,thereby enhancing maternal and fetal health outcomes.Integration of personalized oral hygiene management into maternal health pro-grams and enhancement of ongoing education for pregnant women and healthcare professionals are essential steps in the reduction of pregnancy-related risks and improvement of maternal and neonatal well-being.Core Tip:In this article,we reviewed a recent study on the effects of personalized oral hygiene management on the oral health of pregnant women,as discussed in the article by Men et al.The study demonstrated that personalized oral hygiene interventions significantly improved oral health outcomes during pregnancy by reducing the prevalence of dental caries and periodontal disease.We emphasized the importance of individualized oral care programs that integrate education and tailored support,and we highlighted their significance in enhancing maternal and fetal health.This approach underscores the need for incorporating personalized oral hygiene management into routine prenatal care in order to optimize health outcomes.CONCLUSION This article emphasizes the critical role of personalized oral hygiene management in improving oral health during pregnancy.By tailoring oral care strategies to individual needs,significant improvements in dental health may be achieved,as evidenced by the reduced CAT scores observed in the experimental group in the study by Men et al[25].This personalized approach not only addresses common oral issues such as dental caries and periodontal disease but also underscores the broader implications for maternal and fetal health.Despite the positive results,there remains a gap in consistency in the application of oral health practices during pregnancy,partly due to misconceptions and lack of awareness among patients and healthcare providers.Future research should aim at validating these findings across diverse populations,investigating the impact of oral hygiene interventions at various stages of pregnancy,and evaluating their long-term effects on maternal and fetal health.Integrating personalized oral hygiene management into maternal health programs and promoting continuous education for pregnant women and healthcare professionals are essential steps toward enhancing overall health outcomes.By proactively managing oral health,the risks associated with pregnancy may be reduced while improving maternal and neonatal well-being.

Fabrication of GO-TiO_(2)/(Ca,Y)F_(2):Tm,Yb composites with highefficiency optical driving photocatalytic activity for degradation of organic dyes and bacteriostasis

Development of photocatalytic materials able to profit from the whole spectrum of sun for efficient organic pollution removal and bacterial elimination is a fascinating strategy in environmental engineering.In current work,GO-TiO_(2)/(Ca,Y)F_(2):Tm,Yb,a full-spectrum composite photocatalyst,was prepared via hydrothermal processing with TiO_(2)/(Ca,Y)F_(2):Tm,Yb particles deposited on the surface of graphene oxide(GO).The surface properties of GO-TiO_(2)/(Ca,Y)F_(2):Tm,Yb were characterized using various characterization techniques including X-ray diffraction(XRD),scanning electron microscopy(SEM),X-ray photoelectron spectroscopy(XPS)and Brunauer–Emmett–Teller(BET)surface area analyzer.Besides,ultraviolet–visible(UV–Vis)diffuse reflectance spectroscopy,electron spin resonance(ESR)and other methods were used to systematically explore the photocatalytic mechanism of GO enhancement of TiO_(2)/(Ca,Y)F_(2):Tm,Yb.In photocatalytic degradation study,the degradation rate of methyl orange(MO)was improved by 40%when GO was added into the TiO_(2)/(Ca,Y)F_(2):Tm,Yb system.In addition,the presence of GO also improves the antibacterial ability of TiO_(2)/(Ca,Y)F_(2):Tm,Yb against Escherichia coli and Staphylococcus aureus.All results reveal high efficacy of GOTiO_(2)/(Ca,Y)F_(2):Tm,Yb under full spectrum light irradiation,in which(Ca,Y)F2:Tm,Yb and TiO2 can improve its utilization of full spectrum sunlight,and GO can enhance adsorption ability of dye and electron–hole pair differentiation ability of TiO_(2)/(Ca,Y)F_(2):Tm,Yb.