The tongue is able to quickly reflect the state of health or disease of the human body. Tongue inspection is an important diagnostic approach. It is a unique method that allows to explore the pathogenesis of diseases based on the guiding principles of the holistic concept that involves the observation of changes in the lining of the tongue in order to understand the physiological functions and pathological changes of the body. It is a potential method of screening and early detection of cancer. However, the subjective inspection of the tongue has a low reliability index, and therefore computerized systems of acquisition of diagnostic bioinformation have been developed to analyze the lining of the tongue. Next-generation sequencing technology is used to determine the V2–V4 hypervariable regions of 16S rRNA to study the microbiota. A lot of neoplasms are identified only at an advanced phase, while in the early stages, many subjects remain in an asymptomatic form. On the contrary, the early diagnosis is able to increase the prognosis of cancer and improve the survival rates of subjects. Evidently, it is necessary to develop new strategies in oral medicine for the early diagnosis of diseases, and the diagnosis of the tongue as a minimally invasive method is certainly one of them.
Patients undergoing in fixed orthodontic treatment could have higher risk in periodontal/gum disease development, such as gingival hypertrophies. [...]
Background:
Supernumerary teeth are present in 0,2-3% of the population. Multiple supernumeraries are often associated with syndromes such as cleidocranial dysplasia and Gardner's syndrome. They often hinder the permanent eruption’s teeth, causing cavities, periodontal lesions, pulp necrosis, and in some cases follicular cysts. Reactive lesions such as fibroma, local fibrous hyperplasia, pyogenic granuloma, and peripheral ossifying fibroma are frequent gingival lesions.
Materials and Methods:
We reported a case of a 9 years old patient with the missed eruption of a permanent element caused by a supernumerary tooth, associated with an exophytic palatine lesion. The deciduous incisor was still present and the supernumerary included. It was decided to proceed with the extraction of the deciduous and to wait for scheduling checks every two months. After a few months, the conoid shape supernumerary tooth erupted in the maxillary arch, so a fixed orthodontic therapy was performed to create the space for the central incisor’s eruption.
Results:
After a few months, the tooth began to erupt in the arch thanks to orthodontic traction. The patient was instructed to correct and specific oral hygiene maneuvers to lower the plaque index and try to reduce gingival hypertrophy.
Conclusion:
Supernumerary teeth often hinder the eruption and development of the related permanent tooth causing localized periodontal problems. Corrective fixed orthodontics requires more strict oral hygiene to avoid periodontal complications.
Gum hypertrophy is a very frequent condition linked to orthodontic treatment, especially in teenagers, and the same time, about 80% of young adults are affected by acne vulgaris, a chronic inflammatory skin disease, typically treated with antibacterial therapy. The use of probiotics has gained popularity in the medical field, and many studies have demonstrated its effectiveness, such as the positive effects of some bacterial strains belonging to Lactobacillus species. The aim of this study is to document the effect of Lactobacillus reuteri (L. reuteri) on facial skin that was randomly observed in two orthodontic patients. We present two case reports of a 14-year-old female patient and a 15-year-old male patient suffering from acne vulgaris who, during fixed orthodontic treatment, showed clinical signs of gingivitis with high values of Full Mouth Plaque Score (FMPS) and Bleeding on Probing (BOP). The patients were treated first with professional oral hygiene sessions and Scaling and Root Planing (SRP) procedures, and then with the administration of a formulate containing L. reuteri as a probiotic. The follow-up was made at four weeks. During the follow-up analysis, both patients showed a significant clinical remission for gum hypertrophy and skin acne vulgaris.
Skeletal complications caused by osteoporosis or bone metastases are associated with considerable pain, increased mortality and reduced quality of life. Agents that prevent bone resorption, such as bisphosphonates or denosumab, can reduce the risk of fractures and are widely used in patients with osteoporosis or bone cancer metastases. Drug-related osteonecrosis of the jaw (MRONJ) is a rare but potentially serious adverse event associated with cumulative high doses of bisphosphonates or denosumab. MRONJ is a known potential side effect of long-term bisphosphonate therapy. Other risk factors for osteonecrosis of the jaw (ONJ) include the use of glucocorticoids, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, dental prostheses, and other medications, including antiangiogenic agents. Prevention strategies for elimination and stabilization of oral disease include completion of necessary oral surgery prior to initiation of antiresorptive drug therapy, use of antibiotics before and / or after the procedure, and rinsing of the mouth with chlorhexidine antimicrobial, adequate wound healing after tooth extraction and maintenance of good oral hygiene. The primary goal of treatment should be to improve the patient's quality of life by managing pain and infections, preventing the development of new lesions and slowing the progression of the disease. As a multi-professional team, dentists and dental hygienists play a key role in the primary prevention of MRONJ. However, the need for a standardized multidisciplinary approach, with a sustained dialogue between the specialists involved, should always be adopted in order to improve the effectiveness of preventive strategies and improve the patient's quality of life.
This treatise describes the preventive treatment and management of patients with this condition.
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