Outcome measurements in studies on the association between osteoporosis and periodontal disease.

BACKGROUND: The present study aims to compare different diagnostic criteria for periodontal disease that were used to study the association between periodontal disease and osteoporosis. METHODS: A database from a case-control study was used. The present study included sociodemographic, lifestyle, and health-condition data; panoramic radiographs; and clinical measurements on periodontal conditions from 139 postmenopausal women. Each participant was classified with regard to the diagnosis of periodontal disease using five different criteria for the outcome measurement (OM) found in the literature in studies on the association between osteoporosis and periodontal disease (OM1 through OM5). The frequency of periodontal disease and diagnostic values were calculated taking OM5 as the gold standard and the main association measurement for all criteria using odds ratios. RESULTS: The frequency of periodontal disease varied from 24.5% to 98.6% depending on the OM used. OM4 and OM3 presented the highest specificity (98.9% and 94.5%, respectively), whereas OM2 and OM1 presented the highest sensitivity (100% and 77.1%, respectively). The association measurements with adjustments for age and smoking varied significantly according to the OM over a range from 1.87 to 3.75, and there were also variations in the statistical significance of the associations found. CONCLUSIONS: The results of this study emphasize that the frequency of periodontal disease may be influenced by different OMs and indicated variations outside of the association between osteoporosis and periodontal disease. Therefore, there is a need for prior selection of a precise measurement of periodontal disease in investigations on this topic.

Amelogenesis imperfecta, rough hypoplastic type, dental follicular hamartomas and gingival hyperplasia: report of a case from Central America and review of the literature.

We report on a black male patient from Central America with amelogenesis imperfecta, rough hypoplastic type, dental follicular hamartomas, and gingival hyperplasia. Although previous reports have described this association of amelogenesis imperfecta with hyperplastic follicular hamartomas or central odontogenic fibroma-like lesions in blacks from South Africa, we have noticed non-black patients in the literature with similar findings.

Severe phenytoin-induced gingival enlargement associated with periodontitis.

The potential of phenytoin to induce gingival hyperplasia has been well-established. High levels of dental plaque and calculus have been reported as a critical co-factor for the development and severity of phenytoin-induced gingival hyperplasia. This article documents a severe gingival enlargement associated with periodontitis (in a patient under combined anti-epileptic therapy) and provides a rational model for its clinical management. Initially, full-mouth scaling and root planing, oral hygiene instructions, and phenytoin withdrawal were performed; however, clinical results demonstrated partial resolution of maxillary gingival hyperplasia. Subsequently, surgical therapy was indicated for the maxillary teeth. Complete reduction of gingival enlargement and improvement of clinical periodontal parameters were observed after the surgical therapy. This case report clearly describes the challenges that oral and medical health practitioners face when developing appropriate prevention and treatment programs for epileptic patients, particularly those with periodontal disease.

Manifestações bucais decorrentes do uso de medicamentos anti-hipertensivos / Oral manifestations of the antihypertensive drugs: literature review

A hipertensão arterial sistêmica é responsável por 40 por cento das morte por acidente vascular cerebral e por 25 por cento por doença coronariana no Brasil, portanto, o diagnóstico precoce e o controle da pressão arterial são fundamentais. Muitas entre as diversas classes de medicmentos anti hipertensivos causam alterações na cavidade bucal. A xerotomia é a mais prevalente, sendo relatada por pacientes tratados com diuréticos, inibidores adrenérgicos de ação central e inibidores de enzima de conversão de angiotensina. Outra manifestação comum é a hiperplasia gengival induzida pelos bloqueadores de canais de cãlcio. Este estudo pretendeu abordar a relação existente entre a terapia medicamentosa da hipertensão e as manifestações bucais decorrentes de seu uso, sugerindo medidas para ameniza-las e, assim, aumentar a aderência ao tratamento médico.

Amelogenesis imperfecta and unusual gingival hyperplasia.

BACKGROUND: Amelogenesis imperfecta (AI) is a group of hereditary conditions that primarily involves the defective formation and/or calcification of enamel. The association of AI with gingival enlargement-like lesions has also been reported. METHODS: This paper reports a case of a hypoplastic AI associated with unusual generalized gingival hyperplasia. RESULTS: Histological aspect of the gingival growth was characterized by a dense connective tissue with a mild mononuclear inflammatory infiltrate, calcified bodies, and islands of odontogenic epithelium. CONCLUSION: The present case represents a very interesting demonstration of the fact that, although rare, AI may be associated with generalized gingival enlargement.

Congenital generalized terminal hypertrichosis with gingival hyperplasia.

Congenital generalized terminal hypertrichosis is a rare disease, especially when associated with gingival hyperplasia. Congenital hypertrichosis can be a clinical feature of several syndromes, so these patients must be studied by a multidisciplinary team that should include a dermatologist, geneticist, psychologist, odontologist, and an endocrinologist. We report a 7-year-old girl with congenital generalized hypertrichosis and gingival hyperplasia, and analyze the clinical approach, differential diagnosis, and treatment.

Histocitose de células de Langerhans / Langerhans cell hystocytosis

O presente trabalho relata um caso de histocitose de células Langerhans em pacientes infantil e comenta as mais atuais informações relacionadas com esta entidade, tanto do ponto de vista de sua etiopatogenia, como o do seu tratamento. Destaca, também, os relatos de envolvimento das estruturas orais, cujas manifestações mais frequentes são esfoliação dentária, hiperplasias gengivais, sangramento e ulcerações gengivais e, áreas osteolíticas no osso alveolar merecendo, portanto, atenção especial por parte do cirurgião dentista no diagnóstico da entidade

Familial gingival hyperplasia: a case of pseudo-Laband syndrome.

Three siblings with familial gingival hyperplasia and abnormal feet are reported. Despite the resemblance to the Laband syndrome, where there are anomalies of the terminal phalanges, the abnormalities of the feet in these children were caused by the persistent wearing of "flip-flop" sandals. Care is required in the conduct of history and examination.