Oral Lesions in Autoimmune Bullous Diseases:An Overview of Clinical Characteristics and Diagnostic Algorithm

Autoimmune bullous diseases are a group of chronic inflammatory disorders caused by autoantibodies targeted against structural proteins of the desmosomal and hemidesmosomal plaques in the skin and mucosa, leading to intra-epithelial or subepithelial blistering. The oral mucosa is frequently affected in these diseases, in particular, in mucous membrane pemphigoid, pemphigus vulgaris, and paraneoplastic pemphigus. The clinical symptoms are heterogeneous and may present with erythema, blisters, erosions, and ulcers localized anywhere on the oral mucosa, and lead to severe complaints for the patients including pain, dysphagia, and foetor. Therefore, a quick and proper diagnosis with adequate treatment is needed. Clinical presentations of autoimmune bullous diseases often overlap and diagnosis cannot be made based on clinical features alone. Immunodiagnostic tests are of great importance in differentiating between the different diseases. Direct immunofluorescence microscopy shows depositions of autoantibodies along the epithelial basement membrane zone in mucous membrane pemphigoid subtypes, or depositions on the epithelial cell surface in pemphigus variants. Additional immunoserological tests are useful to discriminate between the different subtypes of pemphigoid, and are essential to differentiate between pemphigus and paraneoplastic pemphigus. This review gives an overview of the clinical characteristics of oral lesions and the diagnostic procedures in autoimmune blistering diseases, and provides a diagnostic algorithm for daily practice.</p

Malignant neoplasms of the lips, oral cavity and pharynx – state of the problem

The aim: to consider the existing methods of diagnosis, clinical course and treatment of most common malignant tumors of soft tissues of maxillofacial area and oral cavity. Materials and methods. Method of economical analysis, method of system analysis, medical – statistical method, mathematical modeling method, information-analytical method. Results. Types and clinic of the most widespread tumors of the specified area are considered. The technique of examination at the specified pathology with use of auxiliary methods of diagnostics is described. The main methods of special treatment of cancer patients are mentioned. The clinical course of four stages of maxillofacial cancer was analyzed on the example of lip cancer. It is confirmed that morphological methods are the most informative of all currently available diagnostic tools and their brief description is given. Conclusions. Early diagnosis of malignant neoplasms, timely recognition and treatment of precancerous conditions against which cancer develops, is the main task of a general practitioner for the prevention of cancer. The dentist at the stage of planned rehabilitation of the oral cavity should pay attention to all changes in the mucous membrane. The formation of high-risk cancer groups and their in-depth examination can increase and detect precancerous diseases and malignant neoplasms in the early stages, which can serve as a real basis for the prevention of cancer of the maxillofacial region, oral mucosa, tongue and lips

Oral Ulcers Presentation in Systemic Diseases: An Update

BACKGROUND: Diagnosis of oral ulceration is always challenging and has been the source of difficulty because of the remarkable overlap in their clinical presentations. AIM: The objective of this review article is to provide updated knowledge and systemic approach regarding oral ulcers diagnosis depending upon clinical picture while excluding the other causative causes. METHODS: For this, specialised databases and search engines involving Science Direct, Medline Plus, Scopus, PubMed and authentic textbooks were used to search topics related to the keywords such as oral ulcer, oral infections, vesiculobullous lesion, traumatic ulcer, systematic disease and stomatitis. Associated articles published from 1995 to 2019 in both dental and medical journals including the case reports, case series, original articles and reviews were considered. RESULTS: The compilation of the significant data reveals that ulcers can be classified according to (i) duration of onset, (ii) number of ulcers and (iii) etiological factors. Causation of oral ulcers varies from slight trauma to underlying systemic diseases and malignancies. CONCLUSION: Oral manifestations must be acknowledged for precise diagnosis and appropriate treatment

Medical microbiology in dentistry

МИКРОБИОЛОГИЯСТОМАТОЛОГИЯСТОМАТОГНАТИЧЕСКИЕ БОЛЕЗНИУЧЕБНЫЕ ПОСОБИЯВключены разделы с информацией о наиболее распространенных стоматологических болезнях, ассоциированных с инфекциями, их патогенезе, лабораторной диагностике, профилактике и лечении

Therapeutic evaluation of homeopathic treatment for canine oral papillomatosis

Aim: A study was conducted to evaluate the ameliorative potential of homeopathic drugs in combination (Sulfur 30C, Thuja 30C, Graphites 30C, and Psorinum 30C) in 16 dogs affected with oral papillomatosis which was not undergone any previous treatment. Materials and Methods: Dogs affected with oral papillomatosis, which have not undergone any initial treatment and fed with a regular diet. Dogs (total=16) were randomly divided into two groups, namely, homeopathic treatment group (n=8) and placebo control group (n=8). Random number table was used for allocation. Homeopathic combination of drugs and placebo drug (distilled water) was administered orally twice daily for 15 days. Clinical evaluation in both groups of dogs was performed by the same investigator throughout the period of study (12 months). Dogs were clinically scored for oral lesions on days 0, 5, 7, 10, 15, 20, 25, 30, 45, 60, 90, 120, and 150 after initiation of treatment. Results: The homeopathic treatment group showed early recovery with a significant reduction in oral lesions reflected by clinical score (p<0.001) in comparison to placebo-treated group. Oral papillomatous lesions regressed in the homeopathic group between 7 and 15 days, whereas regression of papilloma in the placebo group occurred between 90 and 150 days. The homeopathic treated group was observed for 12 months post-treatment period and no recurrence of oral papilloma was observed. Conclusion: The current study proves that the combination of homeopathy drugs aids in fastening the regression of canine oral papilloma and proved to be safe and cost-effective

Keratoprostheses for corneal blindness: a review of contemporary devices

According to the World Health Organization, globally 4.9 million are blind due to corneal pathology. Corneal transplantation is successful and curative of the blindness for a majority of these cases. However, it is less successful in a number of diseases that produce corneal neovascularization, dry ocular surface and recurrent inflammation, or infections. A keratoprosthesis or KPro is the only alternative to restore vision when corneal graft is a doomed failure. Although a number of KPros have been proposed, only two devices, Boston type-1 KPro and osteo-odonto-KPro, have came to the fore. The former is totally synthetic and the latter is semi-biological in constitution. These two KPros have different surgical techniques and indications. Keratoprosthetic surgery is complex and should only be undertaken in specialized centers, where expertise, multidisciplinary teams, and resources are available. In this article, we briefly discuss some of the prominent historical KPros and contemporary devices

ENDOSCOPIC TYPMPANOMASTOID EXPLORATION [FUNCTIONAL ENDOSCOPIC EAR SURGERY-FEES]

Tympano mastoidectomy is usually performed using operating microscope. This study reports a case series of tympanomastoidectomy which was performed using an endoscope.Endoscopic Tympanomastoidectomy for atticoantral type of CSOM is an excellent technique for complete removal of cholesteatoma especially from inaccessible areas of middle ear cleft including facial recess, sinustympani Transmeatal removal of disease from mastoid antrum and even tip cells is possible withendoscopes. Preservation of as much of normal mucosa of the middle ear cleft is possible with thistechnique, which promotes early reaeration of the mastoid cavity leading to better hearing outcome.Soft wall reconstruction has distinctive advantage of short additional time for reconstruction procedures, restoration of self cleaning EAC, early post operative epithelisation of tympanicmembrane and the EAC. Limitation of endoscopic technique: The endoscopic technique of tympanomastoidectomy with softwall reconstruction is not possible in cases with large mastoid cavity and in ears where a thin lateral rim of bony meatal wall (that can support soft wall) is retained, because of extensive disease.Like Functional Endoscopic sinus surgery (FESS) for nose, Endoscopes have changed thetreatment concept of atticoantral disease, with complete removal of the disease andpreservation of normal mucosa, that restores the normal physiology of middle ear cleft. Thishas led to the development of new concept of Functional Endoscopic Ear Surgery (FEES) foratticoantral type of CSOM.

Oral autoimmune vesicobullous diseases: Classification, clinical presentations, molecular mechanisms, diagnostic algorithms, and management

Mucocutaneous blistering autoimmune diseases are a group of systemic, rare, chronic disorders characterized by humoral-mediated immunologic mechanisms against epithelial, basement membrane, and subepithelial tissues. Morbidity and mortality can be completely different among these diseases, with outcome being dependent on an early and accurate diagnosis, systemic comorbidities, and the patient's response to treatment. Definitive diagnosis is based on clinical and histopathologic findings. Because clinical presentations among these diseases are often similar, different immunofluorescence tests and ELISAs are used to confirm the specific diagnosis. Oral mucosa may often be the first site of clinical manifestation from which the disease spreads to other mucosal surfaces and skin. Thus, often dentists and oral medicine specialists may be the first to encounter patients with such diseases. In this review we discuss the most frequent autoimmune vesicobullous disorders, namely pemphigus vulgaris, mucous membrane pemphigoid, bullous pemphigoid, and linear IgA disease

Diagnosis of oral lichen planus from analysis of saliva samples using terahertz time-domain spectroscopy and chemometrics

The ability to diagnose oral lichen planus (OLP) based on saliva analysis using THz time-domain spectroscopy and chemometrics is discussed. The study involved 30 patients (2 male and 28 female) with OLP. This group consisted of two subgroups with the erosive form of OLP (n  =  15) and with the reticular and papular forms of OLP (n  =  15). The control group consisted of six healthy volunteers (one male and five females) without inflammation in the mucous membrane in the oral cavity and without periodontitis. Principal component analysis was used to reveal informative features in the experimental data. The one-versus-one multiclass classifier using support vector machine binary classifiers was used. The two-stage classification approach using several absorption spectra scans for an individual saliva sample provided 100% accuracy of differential classification between OLP subgroups and control group

Modern methods of surgical treatment of cysts of jaws

Навчальний посібник присвячений актуальній проблемі сучасної хірургічної стоматології та щелепно-лицьовій хірургії – діагностиці та лікуванню кіст щелеп. В посібник увійшли питання класифікації, особливостей клініки та діагностики, лікування кіст щелеп. Кісти щелеп є дуже розповсюдженою патологією в щелепно-лицевій ділянці. Ця пухлиноподібна патологія нерідко призводить до серйозних наслідків. Для її діагностики і лікування потрібний комплексний підхід, з урахуванням усього різноманіття кістоутворення в щелепних кістках. Зміст посібника орієнтований на вимоги ОКХ та ОПП з фаху «стоматологія», що до набуття практичних навичок з діагностики та лікування хворих з кістами щелеп. Посібник призначений для студентів стоматологічних факультетів, лікарів-інтернів, магістрів, клінічних ординаторів, хірургів-стоматологів; Учебное пособие посвящено актуальной проблеме современной хирургической стоматологии и челюстно-лицевой хирургии - диагностике и лечению кист челюстей. В пособие вошли вопросы классификации, особенностей клиники и диагностики, лечения кист челюстей. Кисты челюстей очень распространенная патология в челюстно-лицевой области. Эта опухолеподобная патология нередко приводит к серьезным последствиям. Для ее диагностики и лечения требуется комплексный подход, с учетом всего многообразия кистообразования в челюстных костях. Содержание пособия ориентировано на требования ОКХ и ОПП по специальности «стоматология», что в приобретение практических навыков по диагностике и лечению больных с костями челюстей. Пособие предназначено для студентов стоматологических факультетов, врачей-интернов, магистров, клинических ординаторов, хирургов-стоматологов; he manual is devoted to the actual problem of modern surgical stomatology and maxillofacial surgery - diagnosis and treatment of jaw cysts. The manual includes issues of classification, clinical features and diagnosis, treatment of jaw cysts. Jawbones are a very common pathology in the maxillofacial area. This tumor-like pathology often leads to serious consequences. For its diagnosis and treatment, an integrated approach is required, taking into account the diversity of cyst formation in the maxillary bones. The content of the manual is oriented on the requirements of the OCh and OPP for the specialty "Dentistry", which, before acquiring practical skills in the diagnosis and treatment of patients with jaw cysts. The manual is intended for students of stomatological departments, interns, masters, clinical residents, surgeons, dentists