A rare case of temporal arteritis with rheumatoid arthritis and interstitial lung disease mimicking pulpo-periodontal pathology.

A 75-year-old male patient was planned for dental treatment due to pain of suspected pulpo-periodontal origin in relation to right maxillary first molar. Careful evaluation revealed the pain to be non-odontogenic in nature and led to the diagnosis of temporal arteritis with rheumatoid arthritis along with interstitial lung disease (ILD). Characteristic findings of temporal arteritis include headache, jaw claudication, visual loss, and constitutional symptoms (malaise, fever, weight loss, loss of appetite). Temporal artery biopsy (TAB) remains the gold standard for diagnosis. Additional diagnostic tests include blood tests (ESR, CRP). This article reports and discusses how the orofacial manifestations can lead to misdiagnosis of temporal arteritis. Hence, temporal arteritis should be included in the differential diagnosis of orofacial pain in the elderly especially to prevent complications like vision loss.

Periodontal management of sturge-weber syndrome.

Sturge-Weber syndrome (SWS) is a sporadic disorder and is frequent among the neurocutaneous syndromes specifically with vascular predominance. This syndrome consists of constellation of clinical features like facial nevus, seizures, hemiparesis, intracranial calcifications, and mental retardation. It is characterized by focal port-wine stain, ocular abnormalities (glaucoma), and choroidal hemangioma and leptomeningeal angioma most often involving occipital and parietal lobes. The present paper reports three cases of SWS with oral manifestations and periodontal management, which included thorough scaling and root planing followed by gingivectomy with scalpel and laser in cases 1 and 3 consecutively to treat the gingival enlargement. However, the treatment in case 2 was deferred as the patient was not a candidate for periodontal surgery.

Evaluation of gingival inflammation in patients using ovulation induction drugs before and after scaling.

OBJECTIVES: To determine and correlate the effect of clomiphene citrate, Letrozole in women undergoing infertility treatment on the gingival inflammatory status. MATERIALS AND METHODS: The present study is a randomized controlled clinical trial which consisted of 26 women using CC for three menstrual cycles, 26 women using CC for more than three cycles, 26 women using Letrozole. All subjects were clinically examined for plaque levels (Plaque Index), gingival inflammation, bleeding on probing (Gingival Index, Sulcus Bleeding Index). Scaling was done to all patients and all periodontal parameters were reassessed 1 month after scaling. The results were compared with a control group of 26 women matched for age, educational status and professional level, and oral habits and who had never used ovulation drugs. RESULTS: Baseline scores of all the test groups showed higher amount of plaque levels and inflammation compared to control. (p < 0.05). After scaling a significant reduction in inflammation was observed in all the test groups along with the control group (p < 0.0001), but women using the drugs showed persistence of inflammation compared to control (p < 0.01). CONCLUSION: It can be concluded from the present study that the presence of elevated levels of hormones due to the effect of ovulation induction drugs may be the reason for the gingival inflammation in test groups.