Gingivitis in calves: longitudinal hematological and metabolic profiles- and salivary buffering capacity in animals treated with virginiamycin / Gengivites em bezerros: perfis longitudinais hematológicos, metabólicos e capacidade tamponante salivar em animais tratados com virginiamicina

Gingivitis is an infectious inflammatory process that generates local and systemic conditions, compromising the masticatory capacity of animals. Virginiamycin controls and prevents gingivitis and necrotizing gingivitis in cattle. However, the interaction and effect with different sera and salivary elements remain unknown. The present 6-month longitudinal study evaluated the hematological, metabolic, and salivary buffering capacity profiles of calves with gingivitis treated with virginiamycin. Ten calves were divided into two groups: control and virginiamycin (n = 5 each). Calves in the virginiamycin group had a lower occurrence of gingivitis (P < 0.01, Student's t-test). The animals that developed gingivitis in both experimental groups had higher salivary levels of alkaline phosphatase (P = 0.01915) and lower serum levels of albumin (P = 0.0028). Additionally, animals receiving virginiamycin had higher serum levels of magnesium (P = 0.008), albumin (P = 0.0008), urea (P = 0.008), alkaline phosphatase (P = 0.008), total proteins (P = 0.008), and plasma protein (P = 0.018). Salivary buffering capacity was negatively correlated with salivary variables such as calcium, magnesium, albumin, total protein, and aspartate aminotransferase and serum variables such as albumin and aspartate aminotransferase. Results of the present study suggested that the occurrence of periodontopathies in episodes is reflected in the local and systemic alterations in animals. In this context, clinical periodontal monitoring also showed the benefits of virginiamycin supplementation on gingival conditions and systemic health markers, in addition to controlling the two precursor forms of periodontitis.

Gengivites são processos infecto-inflamatórios que geram quadros locais e sistêmicos, com comprometimento da capacidade mastigatória dos animais. A virginiamicina controla e previne a gengivite e a gengivite necrosante em bovinos; no entanto, a interação e efeito com diferentes elementos séricos e salivares permanecem desconhecidos. O presente estudo teve como objetivo avaliar, em um estudo longitudinal com duração de seis meses, os perfis hematológicos, metabólicos e de capacidade tamponante salivar de bezerros com gengivite e tratados com virginiamicina. Foram utilizados 10 bezerros divididos em dois grupos: grupo controle (n = 5) e grupo virginiamicina (n = 5). Os bezerros do grupo virginiamicina apresentaram menor ocorrência de gengivite (P < 0,01, teste T - Student). Os animais que desenvolveram gengivite, de ambos os grupos experimentais, apresentaram níveis salivares mais elevados de fosfatase alcalina (P = 0,01915) e níveis séricos menores de albumina (P = 0,0028). Observou-se também que os animais que receberam virginiamicina apresentaram níveis séricos mais elevados de magnésio (P = 0,008), albumina (P = 0,0008), ureia (P = 0,008), fosfatase alcalina (P = 0,008), proteínas totais (P = 0,008) e proteína plasmática (P = 0,018). As análises de capacidade tamponante salivar foram correlacionadas negativamente às variáveis salivares como cálcio, magnésio, albumina, proteína total e aspartato aminotransferase e às variáveis séricas como a albumina e aspartato aminotransferase. Os resultados do presente estudo sugerem que a ocorrência em episódios das periodontopatias refletem-se em alterações locais e sistêmicas nos animais. Neste contexto, o monitoramento clínico periodontal também evidenciou os benefícios do emprego de suplementação pela virginiamicina sobre as condições gengivais e marcadores sistêmicos de saúde, além do controle das duas formas precursoras de periodontites.

Gingivitis descamativa crónica: una manifestación gingival del liquen plano bucal / Chronic desquamative gingivitis: a gingival manifestation of oral lichen planus

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.

Clinical and immunological features of chronic ulcerative stomatitis: A systematic review.

Chronic ulcerative stomatitis (CUS) is a rare disease of the mucous membranes with characteristics similar to other autoimmune diseases. The aim of this study was to conduct a systematic review of the literature to recover all reported cases of CUS in order to summarize what are the clinical, demographic, microscopic, immunological features of CUS and its therapeutic response to different drugs. A systematic review of the literature was carried out following the statements of preferred reporting items for systematic reviews and meta-analyses (PRISMA). The searches were performed in the electronic databases PubMed, Scopus, EMBASE, LILACS, Opengrey, and Google scholar. Inclusion criteria were articles or abstracts reporting at least one case with a final diagnosis of CUS. A total of 696 records were identified through databases, and 25 studies were selected reporting 81 cases. CUS affects more females (92%), and a greater number of cases are reported in Caucasian patients (53%). The age of patients ranged from 20 to 86 years with a mean age of 60 years (±13.86), and 15% of cases reported concomitantly skin lesions. The clinical and histopathological characteristics of CUS are very similar to those of oral lichen planus. The direct immunofluorescence (DIF) remains the gold-standard diagnostic resource and was performed in 69 cases, revealing a dotted pattern of deposition of stratified epithelium-specific antibodies (SES-ANA). The serum of 38 patients was collected for the performance of the indirect immunofluorescence (IIF), and the use of epithelial substrates such as monkey and guinea pig esophagus often resulted in positive SES-ANA IgG. Most patients were treated with antimalarials, and the treatment of choice that proved to be effective is hydroxychloroquine (HCQ). This entity must be considered in the differential diagnosis of other autoimmune diseases, as it may be underreported.

Estado de Salud Oral de una Muestra de Enfermos con COVID 19 del Hospital Dr. Sótero del Río, Santiago de Chile / Oral Health Status of a Sample of COVID 19 patients from the Dr. Sótero del Río Hospital, Santiago de Chile

Con el objetivo de conocer la presencia de manifestaciones clínicas específicas de COVID-19 en la cavidad oral y describir el estado de salud oral de los enfermos se realizó un examen de la cavidad oral básico a 99 personas con COVID-19 internados en la Unidad de Paciente Crítico (UPC) y en otras dependencias del Hospital Dr. Sótero del Río en Santiago de Chile, durante julio 2020. Del total de enfermos 51 estaban en estado crítico con ventilación mecánica invasiva (VMI), edad promedio 55 años y 48 se encontraban sin VMI, con 66 años en promedio, la mayoría era de sexo masculino, con 25,5 % de mujeres con VMI y 37 % entre los sin VMI, la Hipertensión arterial fue la comorbilidad sistémica más frecuente entre los enfermos seguida por Diabetes mellitus y Obesidad tanto entre los en VMI como sin ella. Respecto a salud oral se observó un predominio de lesiones ulcerativas y erosivas en 57 % de las personas en VMI, el número de estas y su patrón clínico sin embargo pareció inespecífico, también destacó la alta frecuencia de sequedad de la cavidad oral, alcanzando un 54 % en los enfermos en estado crítico y un 34 % en los de menor gravedad, llamó la atención la palidez presente en las mucosas y el aspecto clínico de la lengua. La presencia de Inflamación periodontal se pudo evidenciar clínicamente, pero no fue posible determinar el nivel de inserción, ni evaluar con radiografías a los enfermos, siendo solo un dato aproximado. Los dientes se encontraban en general en regular estado concordante a lo que se observa en grupos poblacionales similares en Chile. No se pudo determinar la presencia de lesiones específicas de COVID-19 en este grupo estudiado.

In order to know the presence of specific clinical manifestations of COVID-19 in the oral cavity and describe the oral health status of the patients, a basic oral examination was performed on 99 patients with COVID-19 admitted to the Critical Patient Unit (UPC) and in other facilities of the Dr. Sótero del Río Hospital in Santiago during July 2020. Of the total of patients, 51 were in critical condition with mechanical ventilation (IMV), average age 55 years and 48 were without IMV, with 66 years on average, the majority were male, with 25.5 % of women with IMV and 37 % without IMV, Hypertension was the most frequent systemic morbidity among patients followed by Diabetes Mellitus and Obesity both among those in IMV and without it. With regard to oral health, the predominance of ulcerative and erosive lesions was observed in 57 % of people in IMV, however, the number of lesions and their clinical pattern, was nonspecific. The high frequency of dry mouth also stands out, reaching 54 % in critically ill patients and 34 % in less serious ones, the paleness of the mucous membranes and the clinical appearance of the tongue were striking. The presence of periodontal inflammation could be clinically seen, but it was not possible to determine the level of insertion, nor evaluate the patients, with X-rays being only an approximate fact. The teeth were generally in regular state coinciding to what is seen in this population group in Chile. The presence of specific COVID-19 lesions could not be determined in this study group.

Covid-19 and oral diseases: Crosstalk, synergy or association?

The coronavirus disease 2019 (Covid-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that clinically affects multiple organs of the human body. Cells in the oral cavity express viral entry receptor angiotensin-converting enzyme 2 that allows viral replication and may cause tissue inflammation and destruction. Recent studies have reported that Covid-19 patients present oral manifestations with multiple clinical aspects. In this review, we aim to summarise main signs and symptoms of Covid-19 in the oral cavity, its possible association with oral diseases, and the plausible underlying mechanisms of hyperinflammation reflecting crosstalk between Covid-19 and oral diseases. Ulcers, blisters, necrotising gingivitis, opportunistic coinfections, salivary gland alterations, white and erythematous plaques and gustatory dysfunction were the most reported clinical oral manifestations in patients with Covid-19. In general, the lesions appear concomitant with the loss of smell and taste. Multiple reports show evidences of necrotic/ulcerative gingiva, oral blisters and hypergrowth of opportunistic oral pathogens. SARS-CoV-2 exhibits tropism for endothelial cells and Covid-19-mediated endotheliitis can not only promote inflammation in oral tissues but can also facilitate virus spread. In addition, elevated levels of proinflammatory mediators in patients with Covid-19 and oral infectious disease can impair tissue homeostasis and cause delayed disease resolution. This suggests potential crosstalk of immune-mediated pathways underlying pathogenesis. Interestingly, few reports suggest recurrent herpetic lesions and higher bacterial growth in Covid-19 subjects, indicating SARS-CoV-2 and oral virus/bacteria interaction. Larger cohort studies comparing SARS-CoV-2 negative and positive subjects will reveal oral manifestation of the virus on oral health and its role in exacerbating oral infection.

Factores predictivos en la aparición de la estomatitis subprótesis / Predictive factors in the occurrence of subprosthesis stomatitis

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.

Feline lymphoplasmacytic gingivostomatitis: clinical and anatomopathological aspects

Background: Feline lymphoplasmacytic gingivostomatitis (FLPG) is an idiopathic, multifactorial and highly challengingcondition, since the results of the available treatments are partial and transitory. A set of lesions triggered by inflammatoryreaction is observed, sometimes with ulcerations in the oral mucosa, leading to algia and discomfort. Histopathologicalexamination figures as the definitive diagnostic tool, presenting distinct cellular elements. The present study aims to reportthree cases of FLPG, firstly addressing the anatomopathological findings, as well as the therapeutic approach used andthe results obtained in each case.Cases: Case 1- Occurred in a feline Siamese male 15-year-old, weighing 3.8 kg, which was admitted at a local clinic, underthe complaint of prostration, dysphagia, and weight loss, signs that were noticed approximately 5 days before. Clinicalevaluation revealed multiple proliferative and ulcerative lesions, extending until the isthmus of the fauces, erythematousareas around the teeth and multifocal gingival reabsorption. Once the clinical signs and lesions were observed, samples werecollected for histopathological examination and sent to the Laboratory of Animal Pathology (LAP) of Faculty of Agronomyand Veterinary Medicine of the University of Passo Fundo (FAVM-UPF). Histologically, both fragments presented lymphoplasmacytic infiltration, with large and intensely eosinophilic cytoplasm, often with granular aspect, central to lateralizedhyperchromatic nuclei, located predominantly in lamina propria and mucosa, as well as a discrete Mott cell infiltrate. Itwas also observed the presence of diffuse suppurative chronic inflammatory infiltrate, predominantly in lamina propriaand mucosa, as well as foci of edema and hemorrhage, in addition to loss of tissue architecture establishing the definitivediagnosis of...(AU)

Chronic ulcerative stomatitis: A systematic review of the clinical and microscopic features.

BACKGROUND: the purpose of this study was to perform a systematic review regarding clinical and histopathological characteristics, immunopathological findings, and treatment for chronic ulcerative stomatitis (CUS). MATERIAL AND METHODS: articles in English, published from January 1962 up to November 2017, assessing clinical and immunological features, treatment, and follow-up of patientes with CUS, were retrieved from three databases (PubMed, Cochrane Library and SCOPUS). A manual literature search was also conducted. A total of 12 studies met inclusion criteria, therefore, were analyzed in this review. RESULTS: CUS shares similiar clinical and microscopic features to those found in oral lichen planus (OLP) and oral lichenoid lesions (OLL). Hence, direct immunofluorescence (DIF) is indispensable to define a final diagnosis. Due to the poor sample availability in the current literature, it is not possible to accurately confirm the prevalence and features of CUS. CONCLUSION: in order to better evaluate this condition's findings, further studies with a greater amount of similar immune-mediated diseases should be performed.

Feline lymphoplasmacytic gingivostomatitis: clinical and anatomopathological aspects

Background: Feline lymphoplasmacytic gingivostomatitis (FLPG) is an idiopathic, multifactorial and highly challengingcondition, since the results of the available treatments are partial and transitory. A set of lesions triggered by inflammatoryreaction is observed, sometimes with ulcerations in the oral mucosa, leading to algia and discomfort. Histopathologicalexamination figures as the definitive diagnostic tool, presenting distinct cellular elements. The present study aims to reportthree cases of FLPG, firstly addressing the anatomopathological findings, as well as the therapeutic approach used andthe results obtained in each case.Cases: Case 1- Occurred in a feline Siamese male 15-year-old, weighing 3.8 kg, which was admitted at a local clinic, underthe complaint of prostration, dysphagia, and weight loss, signs that were noticed approximately 5 days before. Clinicalevaluation revealed multiple proliferative and ulcerative lesions, extending until the isthmus of the fauces, erythematousareas around the teeth and multifocal gingival reabsorption. Once the clinical signs and lesions were observed, samples werecollected for histopathological examination and sent to the Laboratory of Animal Pathology (LAP) of Faculty of Agronomyand Veterinary Medicine of the University of Passo Fundo (FAVM-UPF). Histologically, both fragments presented lymphoplasmacytic infiltration, with large and intensely eosinophilic cytoplasm, often with granular aspect, central to lateralizedhyperchromatic nuclei, located predominantly in lamina propria and mucosa, as well as a discrete Mott cell infiltrate. Itwas also observed the presence of diffuse suppurative chronic inflammatory infiltrate, predominantly in lamina propriaand mucosa, as well as foci of edema and hemorrhage, in addition to loss of tissue architecture establishing the definitivediagnosis of...

Correlation of feline immunodeficiency virus status and the severity of feline chronic gingivostomatitis / Correlação do status sorológico para FIV e a gravidade da gengivoestomatite crônica felina

Feline chronic gingivostomatitis (FCGS) is a challenge for the veterinary practitioner since its etiology and treatments are still undefined. The present paper investigated the role of the feline immunodeficiency virus (FIV) in the severity of the FCGS. Oral mucosal biopsies obtained from 19 cats with FCGS were divided into two groups according to their FIV serology status. Later, the clinical lesion score was correlated with the histopathological grade of FCGS lesions and the degree of immunostaining in both groups. Most of the animals had significant histological changes; however, no correlation with FIV immunostaining intensity was observed. It was concluded that the presence of FIV infection or the animal's seropositivity status does not seem to interfere with the severity of clinical signs nor the degree of histopathological changes when compared to the seronegative group.(AU)

A gengivoestomatite crônica felina (FCGS) é um desafio para o veterinário, uma vez que a sua etiologia e tratamentos permanecem indefinidos. O presente trabalho investigou o papel do vírus da imunodeficiência felina (FIV) na gravidade do FCGS. Biópsias da mucosa oral de 19 gatos com FCGS foram divididas em dois grupos de acordo com o status sorológico de FIV. Mais tarde, o escore de lesão clínica foi correlacionado com o grau histopatológico das lesões FCGS e o grau de imunocoloração em ambos os grupos. A maioria dos animais apresentou alterações histológicas significativas, porém não foi observada correlação com a intensidade de imunocoloração para FIV. Concluiu-se que a presença de infecção por FIV ou o estado soropositivo dos animais não parece interferir com a gravidade dos sinais clínicos nem com o grau de alterações histopatológicas quando comparado ao grupo soronegativo.(AU)

Correlation of feline immunodeficiency virus status and the severity of feline chronic gingivostomatitis / Correlação do status sorológico para FIV e a gravidade da gengivoestomatite crônica felina

Feline chronic gingivostomatitis (FCGS) is a challenge for the veterinary practitioner since its etiology and treatments are still undefined. The present paper investigated the role of the feline immunodeficiency virus (FIV) in the severity of the FCGS. Oral mucosal biopsies obtained from 19 cats with FCGS were divided into two groups according to their FIV serology status. Later, the clinical lesion score was correlated with the histopathological grade of FCGS lesions and the degree of immunostaining in both groups. Most of the animals had significant histological changes; however, no correlation with FIV immunostaining intensity was observed. It was concluded that the presence of FIV infection or the animal's seropositivity status does not seem to interfere with the severity of clinical signs nor the degree of histopathological changes when compared to the seronegative group.(AU)

A gengivoestomatite crônica felina (FCGS) é um desafio para o veterinário, uma vez que a sua etiologia e tratamentos permanecem indefinidos. O presente trabalho investigou o papel do vírus da imunodeficiência felina (FIV) na gravidade do FCGS. Biópsias da mucosa oral de 19 gatos com FCGS foram divididas em dois grupos de acordo com o status sorológico de FIV. Mais tarde, o escore de lesão clínica foi correlacionado com o grau histopatológico das lesões FCGS e o grau de imunocoloração em ambos os grupos. A maioria dos animais apresentou alterações histológicas significativas, porém não foi observada correlação com a intensidade de imunocoloração para FIV. Concluiu-se que a presença de infecção por FIV ou o estado soropositivo dos animais não parece interferir com a gravidade dos sinais clínicos nem com o grau de alterações histopatológicas quando comparado ao grupo soronegativo.(AU)

Estomatitis Urémica como Complicación Oral de Insuficiencia Renal Crónica: Reporte de Caso y Revisión de la Literatura / Uremic Stomatitis as an Oral Complication of Chronic Renal Failure: Case Report and Literature Review

RESUMEN: La Estomatitis Urémica es una lesión oral poco frecuente que se presenta generalmente en pacientes con insuficiencia renal crónica avanzada o no tratada. A continuación, se reporta un caso clínico de un paciente masculino de 22 años de edad que acude a un servicio de urgencia con la presencia de placas blanquecinas indoloras en piso de boca, cara interna de mejilla, y lengua. Las probables causas, presentaciones clínicas, y manejo odontológico son discutidos.

ABSTRACT: Uremic stomatitis is a rare oral lesion that usually occurs in patients with advanced or untreated chronic renal failure. Here we report a case of a 22-year-old male patient who comes to an emergency department with the presence of painless whitish plaques on the floor of the mouth, internal cheek face, and tongue. Probable causes, clinical presentations, and dental management are discussed.

Identification of bacteria present in ulcerative stomatitis lesions of captive sea turtles Chelonia mydas.

Anthropogenic activities, predation, and diseases have contributed to a decrease in the sea turtle population in recent years. Ulcerative stomatitis is a condition that occurs in both wild and captive populations. The etiology of this condition is associated with bacteria such as E. coli, Citrobacter diversus, Klebsiella spp., Pseudomonas spp., Flavobacter calcoaceticus, Staphylococcus spp., and Flavobacterium spp. Some of these microorganisms are part of the oral microbiota of turtles, but alterations in the immune response can disturb the homeostatic relationship and cause an increase in the population of microorganisms, which in turn can cause disease. This work presents results on the isolation and identification of bacteria present in ulcerative stomatitis lesions in captive C. mydas turtles. Oral mucosa samples from 20 clinically healthy turtles and ten animals with ulcerative stomatitis lesions were studied. The samples were cultivated in enriched and differential media, and the identification was made using an automated method. The results showed a great diversity of bacteria in animals with ulcerative stomatitis with a higher prevalence of S. lentus and C. braakii was higher (60 and 50%, respectively) than in healthy animals. E. faecium was identified in 40% of diseased animals and 55% healthy animals. Turtles in this study had a diverse oral microbiota, and S. lentus and C. braakii may be involved in the etiopathogenesis of ulcerative stomatitis.

Manifestaciones de la cavidad bucal por infección del virus de la inmunodeficiencia humana: reporte de caso clínico / Oral manifestations of the HIV virus: report of a clinical case

Las manifestaciones orales por la infección del virus de la inmunode-ficiencia humana son en ocasiones el primer signo de la enfermedad yen muchos casos un indicador de la progresión de la infección hacia elsíndrome de inmunodeficiencia adquirida. Las ulceraciones indoloras,diferentes tipos de gingivitis agresivas y la leucoplasia vellosa, se desarrollan muy fácilmente en individuos cuyo sistema inmunológico está comprometido, como el de los pacientes que sufren del virus deinmunodeficiencia adquirida.

Oral manifestations caused by the human immunodefi ciency virusare often the fi rst indication that the person is infected and oftenan indicator of its progression into AIDS. Painless ulcers, assortedtypes of aggressive gingivitis, and hairy leukoplakia develop easilyin individuals whose immune system is compromised, such as thoseinfected with HIV.

Clinical diagnosis and treatment of necrotizing ulcerative gingivitis in the orthodontic patient: a case report / Diagnóstico clínico y tratamiento de la gingivitis ulcerativa necrotizante en el paciente ortodóntico: reporte de un caso

Abstract: Introduction: about 0.1 percent of the population suffers from necrotizing ulcerative gingivitis, a disease of rapid progression and acute manifestation, which may progress to necrotizing ulcerative periodontitis and eventually to bone sequestration and loss of gingival tissue. Case report: A 21-year-old female patient undergoing orthodontic treatment for six months, diagnosed with necrotizing ulcerative gingivitis due to acute pain in the gingival tissue, spontaneous bleeding, halitosis and abundant plaque. The treatment was conservative and effective, obtaining total remission of the lesion after seven days and three months of postoperative follow-up. Conclusion: Today there are no epidemiological or clinical reports that support the relationship of necrotizing ulcerative gingivitis and orthodontic treatment. Prevention is critical to the success of the treatment, which is why the dentist should recognize the clinical features of necrotizing ulcerative gingivitis to raise awareness of its risks in the orthodontic patient.

Resumen: Introducción: alrededor del 0.1 por ciento de la población padece de gingivitis ulcerativa necrotizante, una enfermedad de progresión rápida y de presentación aguda que puede progresar a periodontitis ulcerativa necrotizante llegando a desarrollarse secuestros óseos y la pérdida de tejido gingival. Reporte del caso: Paciente femenino de 21 años de edad bajo seis meses de tratamiento ortodóntico, quien fue diagnosticada con gingivitis ulcerativa necrosante, debido a dolor agudo en el tejido gingival, sangrado espontáneo, halitosis y abundante placa bacteriana. El tratamiento fue llevado a cabo de manera conservadora y efectiva, obteniendo la remisión total de la lesión al término de siete días y los tres meses de seguimiento postoperatorio. Conclusión: Hoy en día no existen reportes epidemiológicos ni clínicos que sustenten la relación de la gingivitis ulcerativa necrotizante y el tratamiento ortodóntico. La prevención es decisiva para el éxito del tratamiento, es por ello que el odontólogo debe conocer las características clínicas de la gingivitis ulcerativa necrotizante para hacer conciencia en el paciente ortodóntico.

Periodontite agressiva avançada localizada, combinada com gengivite ulcerativa necrosante: dez anos de acompanhamento de um tratamento multidisciplinar / Severe localized aggressive periodontitis combined with necrotizing ulcerative gingivitis: a 10-year follow-up of a multidisciplinary treatment

Este relato de caso descreve o tratamento de um caso de periodontite agressiva avançada localizada, combinada com gengivite ulcerativa necrosante. A paciente apresentava migração patológica dos incisivos superiores com inclinação para vestibular, que exigiu uma abordagem multidisciplinar. Após a conclusão do tratamento periodontal, a terapia ortodôntica foi realizada. O tratamento desta paciente vem sendo conduzido com sucesso ao longo dos últimos dez anos.

Epidemiologia e distribuição de lesões extrarrenais de uremia em 161 cães / Epidemiology and distribution of extrarenal lesions of uremia in 161 dogs

Com o objetivo de determinar a epidemiologia e as características morfológicas, incluindo a localização anatômica, das lesões extrarrenais de uremia, bem como determinar as principais lesões do sistema urinário associadas à ocorrência de uremia, foram revisados os protocolos de necropsias de cães realizadas no Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria de janeiro de 1996 a dezembro de 2012 (17 anos). Nesse período foram necropsiados 4.201 cães, sendo que 161 (3,8%) apresentaram lesões extrarrenais de uremia. Em 134 cães (83,2%) foram descritos sinais clínicos associados à uremia. As lesões extrarrenais mais frequentes, em ordem decrescente, foram: gastrite ulcerativa e hemorrágica (56,5%), mineralização de tecidos moles (55,9%), edema pulmonar (47,2%), estomatite e/ou glossite ulcerativa (30,4%), endocardite/trombose atrial e aórtica (28,6%), hiperplasia das paratireoides (9,3%), osteodistrofia fibrosa (8,1%), anemia (6,2%), laringite ulcerativa (5%), enterite ulcerativa/hemorrágica (3,7%), esofagite fibrinonecrótica (1,9%) e pericardite fibrinosa (1.9%). Na maioria dos casos as lesões extrarrenais de uremia foram decorrentes de azotemia prolongada por lesões renais graves, sendo as mais prevalentes a nefrite intersticial e a glomerulonefrite.

The aim of this study was to determine the epidemiology and the morphological characteristics (including the anatomic localization) of the extrarenal uremic lesions, as well as to describe the main lesions of the urinary system associated with the occurrence of uremia, through analysis of the protocols of necropsies performed in dogs from January 1996 to December 2012 (17 years) at the Laboratório de Patologia Veterinária of the Universidade Federal de Santa Maria. A total of 4,201 dogs were necropsied and 161 (3.8%) had extrarenal uremic lesions. In 134 dogs (83.2%) clinical signs associated with uremia were reported. The extrarenal lesions more often observed, in descending order of prevalence, were ulcerative and hemorrhagic gastritis (56.5%), soft-tissue mineralization (55.9%), pulmonary edema (47.2%), ulcerative stomatitis and/or glossitis (30.4%), endocarditis/atrial and aortic thrombosis (28.6%), parathyroid hyperplasia (9.3%), fibrous osteodystrophy (8.1%), anemia (6.2%), ulcerative laryngitis (5%), ulcerative and hemorrhagic enteritis (3.7%), fibrinonecrotic esophagitis (1.9%), and fibrinous pericarditis (1.9%). In most of the cases, the extrarenal lesions of uremia were due to prolonged azotemia secondary to severe renal lesions, such as interstitial nephritis and glomerulonephritis (the most prevalent ones).

Epidemiologia e distribuição de lesões extrarrenais de uremia em 161 cães / Epidemiology and distribution of extrarenal lesions of uremia in 161 dogs

Com o objetivo de determinar a epidemiologia e as características morfológicas, incluindo a localização anatômica, das lesões extrarrenais de uremia, bem como determinar as principais lesões do sistema urinário associadas à ocorrência de uremia, foram revisados os protocolos de necropsias de cães realizadas no Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria de janeiro de 1996 a dezembro de 2012 (17 anos). Nesse período foram necropsiados 4.201 cães, sendo que 161 (3,8%) apresentaram lesões extrarrenais de uremia. Em 134 cães (83,2%) foram descritos sinais clínicos associados à uremia. As lesões extrarrenais mais frequentes, em ordem decrescente, foram: gastrite ulcerativa e hemorrágica (56,5%), mineralização de tecidos moles (55,9%), edema pulmonar (47,2%), estomatite e/ou glossite ulcerativa (30,4%), endocardite/trombose atrial e aórtica (28,6%), hiperplasia das paratireoides (9,3%), osteodistrofia fibrosa (8,1%), anemia (6,2%), laringite ulcerativa (5%), enterite ulcerativa/hemorrágica (3,7%), esofagite fibrinonecrótica (1,9%) e pericardite fibrinosa (1.9%). Na maioria dos casos as lesões extrarrenais de uremia foram decorrentes de azotemia prolongada por lesões renais graves, sendo as mais prevalentes a nefrite intersticial e a glomerulonefrite.(AU)

The aim of this study was to determine the epidemiology and the morphological characteristics (including the anatomic localization) of the extrarenal uremic lesions, as well as to describe the main lesions of the urinary system associated with the occurrence of uremia, through analysis of the protocols of necropsies performed in dogs from January 1996 to December 2012 (17 years) at the Laboratório de Patologia Veterinária of the Universidade Federal de Santa Maria. A total of 4,201 dogs were necropsied and 161 (3.8%) had extrarenal uremic lesions. In 134 dogs (83.2%) clinical signs associated with uremia were reported. The extrarenal lesions more often observed, in descending order of prevalence, were ulcerative and hemorrhagic gastritis (56.5%), soft-tissue mineralization (55.9%), pulmonary edema (47.2%), ulcerative stomatitis and/or glossitis (30.4%), endocarditis/atrial and aortic thrombosis (28.6%), parathyroid hyperplasia (9.3%), fibrous osteodystrophy (8.1%), anemia (6.2%), ulcerative laryngitis (5%), ulcerative and hemorrhagic enteritis (3.7%), fibrinonecrotic esophagitis (1.9%), and fibrinous pericarditis (1.9%). In most of the cases, the extrarenal lesions of uremia were due to prolonged azotemia secondary to severe renal lesions, such as interstitial nephritis and glomerulonephritis (the most prevalent ones).(AU)