ANALYSIS OF RADIOMORPHOMETRIC INDICES IN POSTMENOPAUSAL PATIENTS WITH OSTEOPOROSIS: CASE REPORT AND LITERATURE REVIEW

Objectives. The aim of this case report is to present a single patient case superimposed on the literature knowledge in regard to mophometric mandibular variations observed on dental panoramic radiography and used to identify patients with low bone mass density (BMD). Case presentation. A 62 years old female patient reported to the Blident Help Dental Clinic, for specific visits and treatments, 3 years apart. Based on the digital panoramic radiography and DXA measurement, an osteoporosis evaluation with radiomorphometric indices was performed. Values for maximum condylar height, maximum coronoid height, projective height of the mandibular ramus, minimum ramus breadth and antegonial angle are higher on both sides. the values decreased for gonial angle, gonial index, mandible cortical width (MCW), superior and inferior mental height and panoramic mandibular indices on both sides. Bigonial distance also dicreased and the mandibular cortical index (MCI) changed from C2 category in 2017 to C3 category in 2020. Discussions. This postmenopausal pacient had a decline in MCW values which were lower than 3 mm (threshold to differentiate normal) on panoramic radiographs of women with low BMD. Antegonial Index had a decreased value and could be used as a prediction index for osteoporosis. MCI index changed from C2 to C3 in correlation with the changes of bone mass density in lumbar spine. Conclusions. MCI, MCW, antegonial index and bone density played an important role in determining significance of effects of lower BMD at postmenopausal on the mandibular ramus region

THE IMPACT OF DENTAL ANXIETY ON PERIODONTAL DISEASE

Aim of the study. Dental anxiety has an important role in the development of the periodontal disease. The aim of the current study is to investigate the relationship between dental anxiety and periodontal disease. Material and methods: Data was collected between 2022 and 2023 using a self-reporting questionnaire created with the Google Forms platform. Results: High dental anxiety is correlated both with poor periodontal health (p=2.11E-86) and with strong psychosocial impact that dental aesthetics has on the quality of life (p=4.46E-56). These directly influence the frequency of visits to the dentist (P values: 4.89E-07, 9.53E-17 and 5.29E-07), as well as the time elapsed since the last professional dental hygienization (P values: 0.0008, 1.57E-17 and 5.62E-10). These three are also interconnected with general health (P values: 0.015, 3.73E-09 and 1.95E-05) and stress (P values: 5.09E-10, 1.64E-08 and 9.87E-07). In addition, BMI shows a direct relationship with dental anxiety (p=0.020), as well as with periodontal health, along with the quality of eating habits (p=0.017 and p=0.001). Conclusion: the results indicated that the severity of the periodontal disease is a result of dental anxiety, and vice versa. Therapy should be personalized for each individual following a comprehensive evaluation and should be based on the experience and expertise of the dentist, the intellectual capacity of the patient, age, cooperation, and clinical situation of the patient

ORAL MANIFESTATIONS OF VIRAL INFECTIONS IN IMMUNOCOMPROMISED CANCER PATIENTS

Immunodeficiencies induced by chemotherapy make cancer patients vulnerable to to reactivation of latent viruses and to primary viral infections caused by exposure to environmental factors, such as air, water, microbial flora and debris. Patients with hematological cancers are more prone than patients with solid tumors to develop viral infections that affect the oral cavity due to high-dose chemotherapy regimens and prolonged immunosuppression. Viruses of the Herpetoviridae family (herpes simplex, varicella, cytomegalovirus, Epstein-Barr) and human papillomavirus cause mouth pain with difficulties in eating and oral ulcerations that can spread, leading to life-threatening systemic infection. Therapeutic approaches for the more severe and atypical oral manifestations seen in cancer immunosuppressed patients include inhibitors of virus replication, antivirals, surgical excision and analgesics, but the painful oral lesions are associated with longer healing times. The differential diagnosis of a oral ulcers in cancer patients is broad, but it should include various viral infections