Oral manifestations of vitamin B12 deficiency associated with pernicious anemia: A case report.

INTRODUCTION AND IMPORTANCE: Vitamin B12 deficiency can manifest through various oral manifestations such as glossitis, glossodynia, recurrent ulcers, cheilitis, dysgeusia, lingual paresthesia, burning sensations, and pruritus. These oral signs can serve as early indicators of systemic conditions such pernicious anemia. CASE PRESENTATION: A 67 year old northern African female presented at the oral surgery service with complaints of a sore mouth and difficulty eating certain types of food. Her medical history revealed hypothyroidism and no history of gastrectomy. She was diagnosed with pernicious anemia in 2014 and is under hydroxocobalamin injection 5000µg/month since then. Dental history indicated extraction of all teeth, and in 2014, the patient was diagnosed with oral lichen planus. There were no contributory oral habits. Intraoral examination revealed a band like erythematous lesion on the palate with two superficial ulcerations, diagnosed as related to her pernicious anemia. The patient was prescribed a mouthwash containing sodium bicarbonate and corticosteroid to reduce inflammation and alleviate pain. A low level laser therapy was also considered to reduce the burning sensations. CLINICAL DISCUSSION: Pernicious anemia (PA) is an autoimmune disease characterized by the gradual atrophy of the gastric mucosa, predominantly affecting the body and fundus of the stomach, leading to vitamin B12 deficiency. Its insidious onset often masks its presence. Patients have no anemic symptoms. However, they can present with oral manifestations related to vitamin B12 deficiency. Those oral signs can precede hematological symptoms helping in early diagnosis of PA. CONCLUSION: Dentists and other oral health care providers must be aware of this condition and its oral manifestations. Investigating vitamin B12 levels should be considered in patients presenting with oral ulcers, oral erythema or burning sensations without an apparent origin.

Brown tumor of the jaw as a rare manifestation of hyperparathyroidism: Two case reports and literature review.

INTRODUCTION AND IMPORTANCE: Brown tumor is a giant cell focal lesion of bone associated with hyperparathyroidism, even primary or secondary. Differential diagnosis of these lesions from others giant cell lesions of the jaw bone is mandatory for the correct treatment of the patient. CASE PRESENTATION: We present here two cases of brown tumor affecting the jaws by describing their clinical aspects and radiographic features, diagnostic criteria and treatment of this disease. CLINICAL DISCUSSION: Brown tumor is one of the lesions that develop in patients with hyperparathyroidism or renal failure. Skeletal bones including maxillo-facial ones can be the site of this lesion, also radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests and radiographic examination. CONCLUSION: Dental surgeon should be aware of oral manifestations associated with systemic diseases, hence the importance of careful physical examination and thorough investigation for the diagnosis and treatment success. This article aims to illustrate the management strategy to aid clinicians in suspected cases of brown tumor.

Late dental effects in children submitted to chemotherapy: A case report.

Chemotherapy may have many effects on teeth such a microdontia, hypoplasia and V shaped roots. The incidence and severity of dental abnormalities depend on the age at the diagnosis, the type of chemotherapeutic agent used. Therefore, it is important that general and pediatric dentists be aware of the late adverse effects of cancer therapy in children, especially in the oral cavity. This article intends to document a case illustrating different dental anomalies secondary to chemotherapy in 20 years old boy who had a history of chemotherapy in childhood.

[Enlargement of mandibular canal and lower lip hypoesthesia revealing non-Hodgkin's lymphoma of the mandible]. / Elargissement du canal mandibulaire et hypo-esthésie labiale révélant in lymphoma non-hodgkinien mandibulaire de phenotype B.

Introduction: Primary lymphoma of the mandible are rare and most often revealed by painless swelling. They are often confused with odontogenic lesions. Hence, their diagnosis is delayed. The authors report the case of an isolated mandibular lymphoma revealed by hypoesthesia of the lower lip and enlargement of the left mandibular canal. Case Report: A 35-year-old woman patient consulted for hemi-mandibular pain with episodes of left labial hypoesthesia. Clinically, we noted the presence of a vestibular tumor in front of tooth 34. A panoramic radiograph revealed that the left mandibular canal was widely enlarged, extending from the mandibular foramen to the mental foramen. The biopsy revealed a B-cell lymphoma. No other localization was found. After treatment with seven courses of a chemotherapy based on R-CHOP followed by local radiotherapy, the patient was in remission eighteen months after treatment. Discussion: Primitive lymphoma of the mandible are rare; they represent about 0.6% of extra-nodal non-Hodgkin lymphoma. They occur at any age and mainly affect males. They most often come out as a painless swelling, sometimes ulcerated in the mouth. They are often misdiagnosed as a dental problem. Treatment combines variably radiotherapy and/or chemotherapy. The prognosis of bone lymphoma is more favorable than others malignancies bone, with a survival rate of 40-50% at five years.

[Prevalence and clinical characteristics of oral bony outgrowth in a Moroccan population]. / Prévalence et caractéristiques cliniques des hypertrophies osseuses buccales dans une population marocaine.

OBJECTIVES: Oral bony outgrowths (OBOs) are localized bony protuberances that arise from the cortical plate. Various types of OBOs have been described, the precise designation of which depends on anatomic location such as torus palatinus, torus mandibularis, buccal exostosis, or palatal exostosis. We had for aim to determine the prevalence and clinical characteristics of OBOs in a Moroccan population. METHODS: This cross-sectional study was conducted between March 15 and June 30, 2011 at the Rabat-Salé teaching hospital dental consultation and treatment center, in Morocco. Three hundred and fifty-three patients (160 female and 193 male patients), 11 to 82 years of age, were examined clinically and radiologically to determine the presence of OBO. RESULTS: Twenty-four patients (6.8%) presented with OBOs. The prevalence for exostosis, torus mandibularis, torus palatinus, and associated OBOs was 3.1%, 2%, 0.8%, and 0.9% respectively. There was a significant difference (P=0,01) between the average age for patients presenting with OBO (43.2±12 years of age) and the average age for patients without any OBO (36.5±16 years of age). The prevalence of OBOs in female patients (7.3%) was higher than in male patients (6.3%) but the difference was not significant (P=0.439). Patients with occlusal parafunctional activity presented with significantly more OBO (P=0.016). DISCUSSION: The reported prevalence of OBO is extremely variable, according to age, gender, and ethnic group. The occurrence of OBO could be triggered by genetic factors associated with environmental factors.

[Oral Burkitt lymphoma in an immunocompetent patient]. / Lymphome de Burkitt buccal chez une enfant immunocompétente.

We report a case of Burkitt lymphoma of the jaws in an immunocompetent adolescent, revealed by intraoral swelling. An orthopantomogram showed multiple osteolytic lesions. Biopsy revealed Burkitt lymphoma. The disease was treated with chemotherapy. Complete remission was attained 15 months after the end of treatment. Burkitt lymphomas accounts for 30-40% of all non-Hodgkin lymphomas in children, with diagnosis confirmed by histology. Immunophenotyping completes the diagnosis by identifying the presence of B markers. Chemotherapy is currently the main treatment of BL, because of the high chemosensitivity of the tumor and its low radiosensitivity. Overall survival in localized stages is close to 100%.

[Alveolitis: review of the literature]. / Les alvéolites: revue de littérature.

Alveolitis are infectious complications following the dental extraction. They appear under two forms: dry, characterized by a painful syndrome and uninhabited alveolus, and suppurative, which becomes identified by provoked pain and alveolus filled. Their etiopathogenesis remain a subject of interrogation because of the rarity of studies concerning this complication. Nevertheless, treatment is mainly favorable by a sedation of the pain and the startup of a physiological healing. From this article, we are going to review their clinical forms, their etiology as well as the followed treatment.

[Dental status in 42 chronically hemodialyzed patients]. / L'état buccodentaire chez les hémodialysés chroniques: 42 cas.

INTRODUCTION: Hemodialyzed patients often present with a deficient dental state. The objective of this study was to assess the oral state and dental hygiene of chronically hemodialyzed patients. METHODS: Forty-two chronically hemodialyzed patients were followed at the dental consultation and treatment centre. Clinical and radiographic data was assessed (panoramic and retro alveolar x-ray). RESULTS: The patients' mean age was 41.7 years. The sex ratio was 16/26. 11.9% of patients were toothless. Dental hygiene was bad in 45.9% of the cases. 78.5% of patients brushed their teeth 35.1% of whom once a day. Periodontitis was noted in 73% of the cases and gingival bleeding in 48.6%. 89.2% of patients presented with caries and 78.4% were missing teeth. Nineteen percent of the patients used a prosthesis. Chewing was adequate for 47.6% of patients. The paleness of mucosal membranes and xerostomia was noted respectively in 40.5% and 21.4% of patients. The radiological exam findings were pathological for ten patients (23,6%). The mean plaque index was 1.9±0.84 and gingival index 1.8±0.87. 71.4% of patients consulted an odontologist in the year before the study. DISCUSSION: The dental status of chronically hemodialyzed patients is bad. They must be managed as early as possible.

[Botryoid odontogenic cyst]. / Kyste odontogène botryoïde.

INTRODUCTION: The botryoid odontogenic cyst (BOC) is a developmental cyst of odontogenic epithelial origin considered as a rare multilocular variety of lateral periodontal cyst (WHO 1992). This cystic lesion site is in the periodontal space of vital teeth. OBSERVATION: A 21-year-old woman consulted for a swelling of the anterior maxillary region. The clinical examination revealed bucal swelling extending from the left central incisor to the first left premolar. The mucosa was normal. The adjacent teeth were vital. X-ray revealed a bilocular radiolucency extending between the roots of teeth 21 and 24. The lesion was enucleated, under local anaesthesia via a vestibular approach. Histology was typical of a BOC with cystic spaces lined by squamous epithelium with thickening and clear cells. Forty-eight months after surgery, there was sign of recurrence. DISCUSSION: BOC is known to be a recurrent odontogenic cyst. Several cases of multiple recurrences have been reported up to nine years after the initial surgery. Long-term follow-up is thus mandatory.

[Odontogenic myxoma of the maxillary]. / Myxome odontogène des maxillaires.

INTRODUCTION: Odontogenic myxoma is a rare benign tumor that arises from the mesenchymal portion of the tooth germ. It has a va-riable non-specific clinical and radiological appearance, and may be confused with other lesions such as ameloblastoma. CASE REPORT: We describe the case of a young, African male patient with a large odontogenic myxoma of the maxillary. The patient presented a painless firm swelling of the left maxillary. The radiograph showed a radiolucent lesion that was compatible with several diagnoses. DISCUSSION: The diagnosis was based on clinical, radiographic and histopathologic features. This tumor is locally aggressive, inducing important facial deformation and tooth displacement. Radical treatment with surgery or prosthesis is needed due to the high rate of recurrence.

Tumeur brune maxillaire revelant une hyperparathyroidie primitive: a propos d'un cas

Les tumeurs brunes des maxillaires sont des manifestations osseuses classiques des hyperparathyroidies. Elles surviennent habituellement lors des formes severes accompagnees de signes de resorption osseuse sousperiostee. Le diagnostic repose sur l'association des signes cliniques; radiologiques et biologiques. Le traitement est celui de la cause. Cet article decrit un cas de tumeur brune touchant les deux maxillaires et revelant la presence d'un adenome parathyroidien dont l'exerese a entraine la regression de la tumeur