The present study aimed to determine the frequency of herpesviruses in gingival fluid samples in patients with periodontitis HIV compared to HIV-negative subjects. Gingival crevicular fluid samples were obtained from 28 patients with HIV-positive periodontitis and from 14 patients with HIV seronegative periodontitis. Herpesviruses have been identified by PCR amplification methods. In HIV-positive patients, the most prevalent herpes virus was HCMV, followed by HHV-6 and HHV-7. In non-HIV-related periodontitis, HCMV was identified in 11 samples and EBV-1 in 8 samples, followed by HSV (7 samples). HIV seropositive samples showed an average of 4.0 herpesviruses and HIV-seronegative individuals averaging 1.4 herpesviruses. EBV-2 and HHV-8 were detected exclusively in subgingival samples from HIV-positive patients. HIV-induced activation of herpes viruses may be a stimulating factor for rapid periodontal destruction. Patients with severe immunosuppression may experience herpesvirus-mediated gingival necrosis. The hypothesis that HIV periodontitis is the result of a combined infection of herpesviruses and bacterial pathogens should be studied further.
This study used a real-time PCR analysis to determine possible correlations between periodontal presence of human cytomegalovirus, Epstein-Barr virus and various putative parodontopathogenic bacteria. The study included 18 patients (aged 18-38 years) with aggressive periodontitis, 12 patients (ages 37 to 62) with chronic periodontitis and 30 periodontally healthy subjects (aged 21-54 years). Clinical periodontal evaluation included plaque index, gingival index, percentage of bleeding on probing sites, and probing depth. In each patient, a subgingival bacterial plaque sample was obtained from the deepest periodontal pocket. The real-time fluorogenic PCR detection system was used to determine the number of infectious agents. Human cytomegalovirus was detected in 17 sites with periodontal lesions and in two healthy periodontal sites, and the Epstein-Barr virus was detected in 19 sites with periodontal lesions and in 3 normal periodontal sites. Positive correlations were found between human cytomegalovirus and P. gingivalis, T. forsythia and C. rectus. The Epstein-Barr virus positively correlated with P. gingivalis and T. forsythia. Unfavorable changes in environmental exposure or alteration of the immune system genes can periodically suppress the host�s defence against periodontal aggression, which can then result in reactivation of resident herpesviruses and increased pro-inflammatory mediators followed by an increase in pathogenic bacteria.
Considered as one of the most common traumatic injuries of the maxillofacial region, mandibular fractures remain among the complex causes of temporomandibular joint disorders (TMDs). Due to the complexity of the temporomandibular joint, the management of TMDs represents a challenge in real-life practice; although many treatment modalities have already been proposed, ranging from conservative options to open surgical procedures, a consensus is still lacking in many aspects. Furthermore, despite continuous improvement of the management of mandible fractures, the duration of immobilization and temporary disability is not reduced, and the incidence of complications remains high. The aim of the present study is to (i) review anatomophysiological components of temporomandibular joint; (ii) review concepts of temporomandibular joint fractures; and (iii) describe methods of the recovery of the temporomandibular joint after mandibular fracture immobilization.
The pathology of the oro-maxilo-facial territory comprises a vast chapter of diseases with primary or secondary infectious etiology, the mouth being the natural cavity of the organism with the most varied and variable flora of bacterial contamination. By the continuity solutions created by the mechanical act of mastication, decubitus of defective prosthetic works, local dento-periodontal infectious processes, but especially of dental or small-scale interventions, open gates and possibilities of penetration into the blood circulation of the microorganisms, which cause the transient bacteria. The study included 243 randomly selected patients, with the address of the Oral and Maxillofacial Surgery Clinic in the period 2016-2018. The inoculation of microorganisms in the oral cavity in circulating blood as a result of oral surgery or dental care procedures is much more common than in other areas of the body. Aggressive dental maneuvers that create solutions of continuity of oral mucosa, gingiva, periodontal surgery, periodontal surgery techniques can cause bacteria.
Post-operative alveolitis is a topical issue in dental practice, which is also reflected by the etiopathogenic aspects. The conservative principle requires the maintenance of dento-periodontal units in the arch for as long as possible, but there are situations where dental extraction is required. The healing process of the post-surgical wound is complex and involves processes of gingival mucosal regeneration and bone reshaping, involving several local factors: wound size, presence of infection, alveolar vascularization, intraalveolar foreign bodies, and general factors, especially general condition, age and body reactivity. The quality, structure, maintenance, and retraction of the clot are key factors in the formation of connective tissue during the healing of the post-extraction would. At the Oral and Maxillofacial Surgery Clinic of Gala�i, during a 2-year period between January 2015 and December 30, 2016, 2780 patients that required surgery - dental extraction were consulted and diagnosed. We found that among those 2780 patients with dental extractions 105 (3.77%) had post-treatment alveolitis. No post-surgical alveolitis from the case study was complicated by osteomyelitis of the jaws or by suppurations of the superficial or deep compartments of the face. The prophylactic measures in each dental extraction, together with the correct and timely curative treatment, combined with the dentist�s competence and responsibility, can shorten the time of suffering, actively combating the risk factor and accelerating the social reintegration of the patient with post-treatment alveolitis.
Obstructive sleep apnea syndrome (OSAS) is the most common breathing-related sleep disorder. It is characterized by recurrent episodes of partial or complete airway obstruction during sleep, resulting in a reduction in or the total cessation of airflow, despite ongoing respiratory efforts, leading to oxygen desaturation and arousal. The purpose of this literature review is to evaluate the most common characteristics of this pathology, as well as to investigate the most effective treatment options, providing an update on the management of OSA patients.
Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prognosis and treatment vary according to the cause. DG may inflict significant oral discomfort, which is why patients typically present to the dentist for a first consultation, rendering it important for these specialists to be informed about this condition. Our paper aims to review the ethiopatogenesis and diagnostic approach of DG, focusing on the most common underlying disorders (autoimmune bullous dermatoses and lichen planus) and on the management of these patients. Potential etiological agents leading to an inflammatory immune response in the oral mucosa and DG appearance include genetic predisposition, metabolic, neuropsychiatric, infectious factors, medication, dental materials, graft-versus-host reaction and autoimmunity. A thorough anamnesis, a careful clinical examination, paraclinical explorations including histopathological exam and direct immunofluorescence are necessary to formulate an appropriate diagnosis. Proper and prompt management of these patients lead to a better prognosis and improved quality of life, and must include management in the dental office with sanitizing the oral cavity, instructing the patient for rigorous oral hygiene, periodic follow-up for bacterial plaque detection and removal, as well as topical and systemic therapy depending on the underlying disorder, based on treatment algorithms. A multidisciplinary approach for the diagnosis and follow-up of DG in the context of pemphigus vulgaris, bullous pemphigoid, cicatricial pemhigoid or lichen planus is necessary, including consultations with dermatologists, oral medicine specialists and dentists.
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