ABSTRACT
OBJECTIVES: The purpose of this multicentre study was to determine the incidence of oral candidiasis in patients treated with topical steroids for oral lichen planus (OLP) and to determine whether the application of a concurrent antifungal therapy prevented the development of an oral candidiasis in these patients. MATERIALS AND METHODS: Records of 315 patients with OLP seen at four Oral Medicine practices treated for at least 2 weeks with steroids with and without the use of an antifungal regimen were retrospectively reviewed. RESULTS: The overall incidence of oral fungal infection in those treated with steroid therapy for OLP was 13.6%. There was no statistically significant difference in the rate of oral candidiasis development in those treated with an antifungal regimen vs those not treated prophylactically (14.3% vs 12.6%) (P = 0.68). CONCLUSIONS: Despite the use of various regimens, none of the preventive antifungal strategies used in this study resulted in a significant difference in the rate of development of an oral candidiasis in patients with OLP treated with steroids.
Subject(s)
Antifungal Agents/therapeutic use , Candidiasis, Oral/prevention & control , Glucocorticoids/administration & dosage , Lichen Planus, Oral/drug therapy , Administration, Topical , Adolescent , Adult , Aged , Aged, 80 and over , Betamethasone/administration & dosage , Candidiasis, Oral/diagnosis , Candidiasis, Oral/epidemiology , Clotrimazole/administration & dosage , Dexamethasone/administration & dosage , Drug Combinations , Drug Therapy, Combination , Female , Fluocinonide/administration & dosage , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Osteonecrosis of the jaws is a major complication associated with long-term use of bisphosphonates. While osteonecrosis can arise from other precipitating conditions, bisphosphonate-induced jaw osteonecrosis (BJON) is highly associated with long-term administration of pamidronate (Aredia) and zoledronic acid (Zometa), which are two intravenous bisphosphonate formulations. The underlying pathogenesis of BJON and its site-specific presentation still remain to be fully elucidated. This review will discuss clinically available bisphosphonates, current opinions, pathogenesis, and management guidelines for bisphosphonate-induced jaw osteonecrosis.
Subject(s)
Bone Density Conservation Agents/adverse effects , Diphosphonates/adverse effects , Jaw Diseases/chemically induced , Osteonecrosis/chemically induced , Animals , Apoptosis , Bone Density Conservation Agents/pharmacokinetics , Bone Remodeling/drug effects , Contraindications , Diphosphonates/pharmacokinetics , Humans , Jaw/blood supply , Jaw/metabolism , Jaw Diseases/metabolism , Jaw Diseases/prevention & control , Neovascularization, Physiologic/drug effects , Oral Hygiene , Oral Surgical Procedures , Osteoclasts/drug effects , Osteonecrosis/metabolism , Osteonecrosis/prevention & control , RANK Ligand/antagonists & inhibitorsABSTRACT
Elephantiasis nostras (EN) is a clinical entity that usually presents as a persistent swelling of the lower extremities. It has been related to recurrent lymphangitis of bacterial origin that causes a fibrosis and thickening of both epidermal and connective tissue. Although very rare, EN has been previously reported in the lips. This is the first case reported in the oral medicine literature that describes EN involving the lips. We describe the clinical features and a differential diagnosis of the lip lesions and a treatment protocol to which this patient has responded. A diagnosis of EN should be entertained in patients with chronically edematous, scaling lip lesions.
Subject(s)
Elephantiasis/pathology , Lip Diseases/pathology , Adult , Anti-Bacterial Agents/therapeutic use , Antipruritics/therapeutic use , Bacterial Infections , Clindamycin/therapeutic use , Connective Tissue/pathology , Diagnosis, Differential , Dicloxacillin/administration & dosage , Dicloxacillin/therapeutic use , Doxepin/therapeutic use , Drug Therapy, Combination/therapeutic use , Edema/pathology , Elephantiasis/drug therapy , Epidermis/pathology , Erythema/pathology , Erythromycin/therapeutic use , Female , Fibrosis , Follow-Up Studies , Humans , Lip Diseases/drug therapy , Lymphangitis/microbiology , Penicillins/therapeutic use , RecurrenceABSTRACT
Some special patients are unable to tolerate dental care in outpatient dental offices. Providing dental care under general anesthesia in an operating room setting involves various medical, dental, and hospital issues and procedures that differ from outpatient care. This article reviews pertinent information for the dental management of patients who require general anesthesia.
