Unusual presentation of actinomycosis misdiagnosed as severe periodontal destruction

Actinomycosis is an infiltrative disease caused by Actinomyces species that frequently has chronic granulomatous and suppurative lesions. The present case reports an adult female patient with a diffuse and atypical actinomycotic lesion which had a large desquamation and subsequent exposure of the alveolar bone in the region of the maxillary left first and second molars. Diagnosis was based on histopatholigical examination. Due to the opportunistic characteristics of the actinomycotic infection, early diagnosis of the lesion, together with the adequate therapy and management are of great importance to prevent the spread of the disease. Proper knowledge of the different types of periodontitis is essential to distinguish any atypical presentation of tissue destruction

Adverse effects of removable partial dentures on periodontal status and oral health of partially edentulous patients

To compare differences in caries and periodontal scores between removable partial denture wearers and non wearers; abutment with non-abutment teeth in the wearers and wearers with "satisfactory" to those with "unsatisfactory" dentures. Ninety-six partially dentate patients were included in this study. Teeth were examined for caries and periodontal diseases. Removable partial dentures were evaluated for material, stability, retention and occlusion. Comparisons were made between wearers versus non-wearers regarding abutment versus non-abutment teeth and wearers with satisfactory dentures versus with problematic [or unsatisfactory] dentures. Significant differences in mean values were determined using a paired t-test, General Linear Model and Analysis of Variance. Level of significance was set at 0.05. There were 38 [39.6%] partially edentulous with no removable partial denture experience and 58 [60.4%] denture wearers [32 [33.3%] with unsatisfactory, 26 [27.1%] with satisfactory dentures]. Removable partial denture wearers had significantly more coronal caries [p<0.05] and root surface caries [p<0.001] compared to non-wearers. However, Subjects who had problem complaints of their dentures had significantly more attachment loss and pocket depth compared to those who wore satisfactory dentures [p<0.05]. In partial denture wearers, abutment teeth had significantly more levels of caries and periodontal diseases when compared to non-abutment teeth. Abutment teeth of subjects wearing satisfactory dentures had significantly greater scores of caries [p<0.0001] compared to those of non-wearers; and lesser scores of gingival recession [p<0.05] and attachment loss [p<0.01] compared to those of wearers with unsatisfactory dentures. In addition, abutment teeth of wearers with problem dentures had significantly higher scores of caries and periodontal diseases compared to non-wearers. Wearing removable partial dentures increased the likelihood of coronal and root surface caries and to a lesser extent adversely affected the periodontal status. Abutment teeth appeared to suffer the most deleterious effects

Oral health status and dental treatment needs among Non-Institutionalized psyciatric patients

To describe the oral health status among non-institutionalized patients with chronic psychiatric illnesses receiving long-term anti-psychotic and anti-depressant medications and to compare the oral health satus whith a matched group without such history. Forty psychiatric outpatients were selected as astudy group based on having chronic psychotic illness and on neuroleptic medications for at least two years. The control group consisted of 40 healthy dental patients who were selected to match the study group by age and gender, and for both groups 20 teeth excluding the third molars should be present. Demographic characteristics, smoking and brushing habits in addition to dental examination including decayed, missed filled teeth, plaque index and periodntal treatment needs according to the Community Periodontal Index of Treatment Needs were recorded for each patient in both groups. Psychiatric diagnosis for the study group revealed that 57% were having schizophrenia and 43% mood disorders, the mean duration of illness was 11 years. The mean age was 34.8 years for the study group and 34.6 years for the control group with a male female ratio of 1:1 in both groups. Dry mouth was the chief complaint among 40% of the psychiatric patients while dental pain was the main complaint among 60% of the control group. The mean indices for the study vs. control groups were as follows, [9.07 vs 8.65] for the decayed-missed-filled-teeth, [1.96 vs. 1.55] for the plaque index and [2.3 vs. 1.97] for the periodontal treatment needs. Filled teeth and plaque index score-0 were significantly greater in the control group, while plaque index score-3 and periodontal treatment need sore-1 were significantly greater in the study group. About 47.5% of the psychiatric patients were smokers compared to 30% of the control group. Regarding brushing habits, 50% of the psychiatric patients never brushed their teeth while 60% of the control groups brush their teeth once or twice daily. Oral health status of chronic psychiatric outpatiens seems to be worse than that of the mentally healthy population. Mental health professionals should pay more attention to dental care and oral health needs of the psychiatric outpatients