Diagnosis of Lingual Atrophic Conditions: Associations with Local and Systemic Factors. A Descriptive Review

Abstract: Atrophic glossitis is a condition characterised by absence of filiform or fungiform papillae on the dorsal surface of the tongue. Consequently, the ordinary texture and appearance of the dorsal tongue, determined by papillary protrusion, turns into a soft and smooth aspect. Throughout the years, many factors, both local and systemic, have been associated with atrophic glossitis as the tongue is currently considered to be a mirror of general health. Moreover, various tongue conditions were wrongly diagnosed as atrophic glossitis. Oral involvement can conceal underlying systemic conditions and, in this perspective, the role of clinicians is fundamental. Early recognition of oral signs and symptoms, through a careful examination of oral anatomical structures, plays a crucial role in providing patients with a better prognosis

Oral Signs and HLA-DQB1 1702 Haplotypes in the Celiac Paediatric Patient: A Preliminary Study.

Celiac disease (CD) diagnosis can be extremely challenging in the case of atypical patterns. In this context, oral signs seem to play a decisive role in arousing suspicion of these forms of the disease. At the same time, the different expressions of the HLA-DQB1 1702 allele apparently seem to facilitate the interpretation of signs and highlighted symptoms. The aim of this work was to verify whether it is possible to identify a correlation between the development of oral signs and different DQ2 haplotypes in celiac pediatric patients. 44 celiac patients with a medium age of 9.9 were studied. Oral examinations were performed in order to identify recurrent aphthous stomatitis (RAS) and dental enamel defects (DED). The diagnosis of DED resulted as being related to allele expression (P value = 0.042) while it was impossible to find a similar correlation with RAS. When both oral signs were considered, there was an increase in correlation with HLA-DQB1 1702 expression (P value = 0.018). The obtained results identified both the fundamental role that dentists can play in early diagnosis of CD, as well as the possible role of HLA haplotype analysis in arousing suspicion of atypical forms of the disease

Measurement issues in probing depth evaluation of periodontal pockets: An in vitro study concerning main sources of uncertainty

Measurement of periodontal pocket depth, a key step in detection and analysis of periodontal diseases, is frequently affected by substantial uncertainty. Estimation of distance between gingival margin and connective ligament, an apparently straightforward measurement task routinely performed with simple probes, entails a fairly complex pattern of single and combined effects. Layout of marks on probe affects readings, since, when interpolation is involved, operator’s experience comes into the picture. Compliance of tissues at pocket bottom implies dependence of probe penetration from insertion force, whose control again is affected by operator’s experience. Hazy definition of gingival margin further contributes to scatter in results, liable to lead to diagnostic mistakes and wrong therapeutic decisions. An investigation on measurement issues, aimed at identification of main factors affecting uncertainty in evaluation of pocket depth, was performed in vitro with an ad hoc device, developed in order to get traceability and evaluate reproducibility of measurements of pockets with different depths. Measurements were performed by operators with different experience and skill, using three types of periodontal probes currently in use. Results showed a different performance of the probes in terms both of bias and scatter. Occurrence of false positives and negatives were found to be strongly dependent upon operator experience