RESUMO
BACKGROUND: People living with HIV (PLWH) are more likely to smoke and harbor oral human papillomavirus (HPV) infections, putting them at higher risk for head and neck cancer. We investigated effects of HIV and smoking on oral HPV risk. METHODS: Consecutive PLWH (nâ =â 169) and at-risk HIV-negative individuals (nâ =â 126) were recruited from 2 US health centers. Smoking history was collected using questionnaires. Participants provided oral rinse samples for HPV genotyping. We used multivariable logistic regression models with interaction terms for HIV to test for smoking effect on oral HPV. RESULTS: PLWH were more likely to harbor oral HPV than HIV-negative individuals, including α (39% vs 28%), ß (73% vs 63%), and γ-types (33% vs 20%). HIV infection positively modified the association between smoking and high-risk oral HPV: odds ratios for smoking 3.46 (95% confidence interval [CI], 1.01-11.94) and 1.59 (95% CI, .32-8.73) among PLWH and HIV-negative individuals, respectively, and relative excess risk due to interaction (RERI) 3.34 (95% CI, -1.51 to 8.18). RERI for HPV 16 was 1.79 (95% CI, -2.57 to 6.16) and 2.78 for ß1-HPV (95% CI, -.08 to 5.65). CONCLUSION: Results show tobacco smoking as a risk factor for oral HPV among PLWH.
Assuntos
Infecções por HIV/complicações , Doenças da Boca/epidemiologia , Infecções por Papillomavirus/epidemiologia , Fumar Tabaco/efeitos adversos , Adulto , DNA Viral/genética , DNA Viral/isolamento & purificação , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/patologia , Doenças da Boca/virologia , Papillomaviridae/classificação , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Estudos Prospectivos , Fatores de Risco , Estados UnidosRESUMO
Langerhans cell histiocytosis X is a clonal proliferation of dendritic cells of the immune system, which can affect multiple organ systems and range in behavior from a benign inflammatory process to a much more aggressive process. Only few isolated cases have been reported in the jaws. This case represents an example of Langerhans cell histiocytosis X in the mandible, which resolved following incisional biopsy without any further surgical intervention.
Assuntos
Granuloma Eosinófilo/patologia , Doenças Mandibulares/patologia , Adolescente , Biópsia , Tomografia Computadorizada de Feixe Cônico , Diagnóstico Diferencial , Granuloma Eosinófilo/diagnóstico por imagem , Humanos , Masculino , Doenças Mandibulares/diagnóstico por imagem , Radiografia Panorâmica , Remissão EspontâneaRESUMO
UNLABELLED: The purpose of this study was to compare cone-beam computer tomography (CBCT) and multi-slice spiral computed tomography (MSCT) bone density measurements in the maxilla and mandible to determine whether any discrepancies between imaging modalities exist. MATERIAL & METHODS: 33 sets of CBCT and MSCT scans were evaluated using Simplant software. Density measurements were made in eight regions of interest on each scan and were compared and analyzed. RESULTS: Correlation of density measurements at specific regions of interest between CBCT and MSCT was only fair and ranged from 0.61-0.86. High-density areas, such as the anterior mandible, showed a higher correlation between imaging modalities than low-density regions, such as the posterior maxilla. CONCLUSION: Care should be taken when relying upon CBCT to determine bone density, especially in low-density regions such as the posterior maxilla.
Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Processo Alveolar/diagnóstico por imagem , Anatomia Transversal , Densidade Óssea/fisiologia , Dente Canino/diagnóstico por imagem , Arco Dental/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Dente Molar/diagnóstico por imagemRESUMO
We evaluated the risk factors associated with oral human papillomavirus (HPV) infection and oral lesions in 161 human immunodeficiency virus (HIV)-positive patients and 128 HIV-negative patients presenting for oral examination at 2 urban healthcare centers. Patients were interviewed on risk factors and provided oral-rinse samples for HPV DNA typing by polymerase chain reaction. Statistical associations were assessed by logistic regression. Oral HPV was prevalent in 32% and 16% of HIV-positive patients and HIV-negative patients, respectively, including high-risk HPV type 16 (8% and 2%, respectively; P = .049) and uncommon HPV types 32/42 (6% and 5%, respectively; P = .715). Among HIV-negative patients, significant risk factors for oral HPV included multiple sex partners (≥21 vs ≤5; odds ratio [OR], 9.1; 95% confidence interval [CI], 1.7-49.3), heavy tobacco smoking (>20 pack-years vs none; OR, 9.2; 95% CI, 1.4-59.4), and marijuana use (OR, 4.0; 95% CI, 1.3-12.4). Among HIV-positive patients, lower CD4(+) T-cell count only was associated with oral HPV detection (≤200 vs ≥500 cells/mm(3); OR, 4.5; 95% CI, 1.3-15.5). Detection of high-risk HPV was also associated with concurrent detection of potentially cancerous oral lesions among HIV-negative patients but not among HIV-positive patients. The observed risk factor associations with oral HPV in HIV-negative patients are consistent with sexual transmission and local immunity, whereas in HIV-positive patients, oral HPV detection is strongly associated with low CD4(+) T-cell counts.
Assuntos
Infecções por HIV/complicações , Doenças da Boca/epidemiologia , Doenças da Boca/patologia , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , DNA Viral/genética , DNA Viral/isolamento & purificação , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/virologia , Papillomaviridae/classificação , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Reação em Cadeia da Polimerase , Prevalência , Fatores de Risco , Adulto JovemRESUMO
Radiolucencies of the jaws are a common finding. Mostly, they are isolated findings associated with inflammatory processes and consistent with inflammatory periapical disease, such as periapical cysts and periapical granulomas. If associated with the crowns of unerupted teeth, they may represent dentigerous cysts. However, occasionally, larger lytic/radiolucent lesions are identified; even more infrequently, these radiographic findings may be multiple and concurrent. The purpose of this report is to present the case of a 6-year-old female patient with no known concomitant syndrome who presented with multiple intraoral swellings and to discuss the treatment of multiple, bilateral mandibular and maxillary radiolucencies.
Assuntos
Cisto Dentígero/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Doenças Maxilares/diagnóstico por imagem , Criança , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Granuloma Periapical/diagnóstico , Cisto Radicular/diagnóstico , Radiografia Panorâmica , Mantenedor de Espaço em Ortodontia/instrumentação , Erupção Dentária/fisiologia , Dente não Erupcionado/diagnóstico por imagemRESUMO
The buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst of unknown etiology. It typically develops on the buccal aspect of the permanent mandibular first molar and occasionally on the permanent mandibular second molar in children 4 to 14 years old. Distinct clinical findings of the BBC include involvement of a vital partially or fully erupted mandibular first or second molar, swelling in the affected mandibular molar region, delayed or altered eruption pattern of the involved tooth, and an increase in periodontal pocket depth when the affected tooth is partially erupted. Specific radiographic features include a radiolucent lesion on the buccal aspect of the tooth involving the roots to a variable extent, tilting of the involved molar so that the root apices are toward the lingual cortical plate, an intact periodontal ligament space and lamina dura, a periosteal reaction on the buccal surface, and an intact inferior border of the mandible. The histopathology of the lesion has been described as similar to a radicular or inflammatory odontogenic cyst. Most of the current literature supports simple enucleation and curettage of the cyst without extraction of the involved tooth as the treatment of choice. This report presents 3 cases of BBCs that were treated with enucleation and curettage without extraction of the involved tooth, in addition to a bone graft placed primarily or secondarily as an adjunctive treatment approach to the current therapies.
Assuntos
Transplante Ósseo/métodos , Curetagem/métodos , Doenças Mandibulares/cirurgia , Dente Molar/patologia , Cisto Periodontal/cirurgia , Implantes Absorvíveis , Matriz Óssea/transplante , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Seguimentos , Humanos , Masculino , Membranas Artificiais , Dente Molar/diagnóstico por imagem , Radiografia Panorâmica/métodos , Raiz Dentária/diagnóstico por imagemRESUMO
The use of autogenous cortical cancellous block grafts to augment the premaxilla is a safe and effective technique to provide adequate bone height and width when reconstructing patients with atrophic premaxilla ridge when endosteal implants are planned. Intraoral bone graft harvests have the advantages of proximity of the donor site to the graft site, convenient surgical access, minimal operative time, and ease of performance in an office setting. The major limitation of these donor sites is the smaller quantity of graft obtainable compared with iliac crest bone harvest sites.