ABSTRACT
RESUMEN El término de gingivitis descamativa ha evolucionado con el decursar de los años. La clasificación de la enfermedad periodontal vigente en Cuba la incluye dentro de los procesos inflamatorios crónicos superficiales. La Academia Americana de Periodontología y la Federación Europea de Periodoncia, han destinado un apartado para esta enfermedad denominado: alteraciones inflamatorias e inmunes. Se presentó una paciente de 27 años de edad, con ardor, sangramiento gingival y molestias al cepillado, la cual acudió a la consulta de Estomatología General Integral. Durante el examen clínico se constató la presencia de zonas eritematosas a nivel de encía marginal e insertada, con exposición del tejido conectivo. Luego de concluida la atención primaria en Periodoncia, la paciente fue remitida a la atención secundaria donde se le diagnosticó un liquen plano bucal con manifestaciones gingivales. Se instauró el tratamiento adecuado hasta la desaparición de las lesiones.
ABSTRACT The term desquamative gingivitis has evolved over the years. The current classification of periodontal disease in Cuba includes it among chronic superficial inflammatory processes. The American Academy of Periodontology and the European Federation of Periodontology have assigned a section for this disease called inflammatory and immune alterations. We present a 27-year-old female patient with burning, gingival bleeding and discomfort when brushing, who came to the General Comprehensive Dentistry consultation. Erythematous areas were observed during clinical examination, at the level of the inserted and marginal gingiva, with exposure of the connective tissue. After the completion of primary periodontal care, the patient was referred to secondary care where she was diagnosed with oral lichen planus with gingival manifestations. Appropriate treatment was instituted until the lesions disappeared.
Subject(s)
Gingivitis, Necrotizing Ulcerative , Lichen Planus, Oral , GingivitisABSTRACT
RESUMEN La estomatitis subprótesis es una de las lesiones más frecuentes encontradas en la consulta de Estomatología. Es una enfermedad comúnmente asintomática, cuya génesis es multifactorial, y tiene una alta prevalencia en pacientes portadores de prótesis removibles. Predecir su aparición resultaría muy oportuno pues permitiría alcanzar beneficios económicos y para la salud del individuo. Por ello, es importante desarrollar un modelo predictivo del riesgo a padecer estomatitis subprótesis. Se realizó este estudio en los pacientes que acudieron a la consulta de prótesis de la Clínica Estomatológica «Victoria de Santa Clara¼. Dicha investigación se caracterizó por la obtención de un modelo predictivo de la enfermedad. Los principales factores predictivos de la enfermedad fueron: la higiene bucal deficiente y la mala calidad de las prótesis. Se confeccionó una ecuación logística y se obtuvo un modelo predictivo con el propósito de conocer los pacientes con más probabilidades de padecer dicha enfermedad.
ABSTRACT Subprosthesis stomatitis is one of the most frequent lesions found in a dental consultation. It is a commonly asymptomatic disease, whose origin is multifactorial, and has a high prevalence in patients with removable prostheses. Predicting its appearance would be very timely as it would allow reaching economic benefits and benefits for individual's health. Therefore, it is important to develop a predictive model of the risk of suffering from subprosthesis stomatitis. This study was carried out on patients who came to the prosthesis consultation at "Victoria de Santa Clara" Dental Clinic. It was characterized by the elaboration of a predictive model of the disease. Poor oral hygiene and poor quality of the prosthesis were the main predictive factors of the disease. A logistic equation was made and a predictive model was obtained in order to know the patients with more probabilities of suffering from this disease.
Subject(s)
Risk Factors , Dental Implantation , Gingivitis, Necrotizing UlcerativeABSTRACT
A 40-year-old female patient was admitted to the Department of Oral Medicine due to oral ulcerations. Oral ulcerations were present on vestibular mucosa above teeth 21, 22, 25 and 26 and were 1 cm in diameter, and also around teeth 45 and 46. The patient had prolonged neutropenia due to therapy-related myelodysplastic syndrome that progressed to therapy-related acute myeloid leukemia. Initially, the patient was successfully treated with polychemotherapy for non-Hodgkin lymphoma. Unfortunately, many toxic complications ensued, such as peripheral neuropathy, dilated cardiomyopathy and therapy-related myelodysplastic syndrome/therapy-related acute myeloid leukemia. The onset of therapy-related myelodysplastic syndrome was less than six months after initiation of chemotherapy treatment, which was rather early, but cytogenetic changes (monosomy 5 and 7) were consistent with the diagnosis. Upon admission to our Department, microbiological swabs were obtained and were all negative, while x-ray finding showed that ulcerations did not have dental cause. Biopsy was not obtained as the patient had severe neutropenia and thrombocytopenia. While viral and fungal swabs were negative, Stenotrophomonas maltophilia was cultured from the oral cavity. Thus, differential diagnoses are listed in this report. Neutropenic ulcerations did not heal albeit extensive medicamentous oral and systemic treatments were applied and the patient died.
Subject(s)
Azacitidine/therapeutic use , Gingival Diseases/drug therapy , Gingival Diseases/etiology , Gingival Diseases/physiopathology , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/physiopathology , Adult , Fatal Outcome , Female , Gingival Diseases/mortality , Humans , Leukemia, Myeloid, Acute/mortalityABSTRACT
Necrotizing ulcerative stomatitis (NUS) refers to ulceration of the oral mucosa that precedes rapid orofacial soft- and hard-tissue destruction. NUS on the upper lip is considered a reconstructive challenge because of the functional importance and complex multidimensional structure of the facial units that are involved, and is most commonly found in developing countries. Therefore, few studies have been conducted on NUS. Moreover, reconstruction options vary from local regional flaps to free-tissue transfers. We report a very interesting case in which we performed regional flap surgery using bilateral cheek advancement in a patient with NUS. A 75-year-old woman with a history of diabetes mellitus and hypertension, but no other immunological diseases, presented with skin necrosis on the upper lip. At presentation, necrotic tissue covered the upper lip and philtrum, but it had not invaded the nose or lower lip. After debridement of the necrotic tissue, approximately 70% of the upper lip was missing. We therefore designed a bilateral cheek advancement and rotation flap, in which the flap was sutured in 3 layers. There was no need to perform additional procedures, as the flap healed well and showed no other complications or recurrence. The patient exhibited good voluntary muscle control and oral competence while eating and drinking, and she was also very satisfied with the cosmetic results. Thus, regional flap surgery using a simple advancement flap may result in good recovery of both functional and aesthetic units in patients with NUS.
