Search Results (199)

Objectives: This study aimed to assess the knowledge, attitudes, and self-confidence of physicians and dentists in Croatia regarding the relationship between oral and systemic health, focusing on periodontal disease and oral manifestations of systemic diseases. Methods: A cross-sectional, web-based survey was conducted among physicians and dentists in Croatian primary healthcare. The questionnaire addressed six thematic domains, including demographic information, knowledge, self-assessment, and clinical practice. Descriptive and comparative statistical analyses were performed. Results: A total of 529 respondents were included (291 physicians and 238 dentists). The mean knowledge score for the association between periodontitis and systemic diseases was 6.8 ± 3.6 out of 15, indicating limited knowledge. For oral manifestations of systemic diseases, the mean score was 10.0 ± 3.8 out of 16, reflecting moderate proficiency. Dentists scored higher than physicians in both domains, though not significantly (p > 0.05). Routine oral mucosal examinations were reported by 89.5% of dentists and 43.0% of physicians (p ≤ 0.001). Only 21.3% of physicians correctly identified the link between periodontitis and adverse pregnancy outcomes, compared to 58.8% of dentists. The primary barriers to effective clinical management were a lack of experience (52.7%) and inadequate education. While 68.3% of dentists felt adequately educated on oral–systemic links, only 22.7% of physicians reported the same. Conclusions: Significant gaps in knowledge and confidence were observed, particularly among physicians. These findings underscore the need to integrate oral–systemic health topics into medical education and to promote interprofessional collaboration to improve patient outcomes. Full article

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

Objectives: Anisakidosis is an emerging, cosmopolitan, and underdiagnosed parasitic disease caused by the accidental ingestion of third-stage anisakid larvae when consuming raw or improperly prepared seafood. Within hours to days of consuming infected raw seafood, patients may develop acute gastrointestinal symptoms including pain, nausea, vomiting, diarrhea and/or constipation, as live anisakid larvae attach to the gastric, or more rarely, the intestinal mucosa. Cases have been reported in which the nematodes succeed at migrating from the stomach upwards to the esophagus and then the oral cavity. Therefore, the purpose of the present literature review is to collect, analyze, summarize and present the relevant epidemiological, clinical, diagnostic, parasitological, therapeutic, and prognostic data concerning anisakidosis localized inside the oral cavity. Methods: An electronic search of the PubMed, Scopus, and Ovid databases was performed with them being accessed for the last time on 29 March 2025. Results: The present literature review identified 13 individual case reports of oral mucosa anisakidosis, which were published in the period 1971–2022. Conclusions: Our review aims to summarize the relevant epidemiological, clinical, diagnostic, parasitological, therapeutic, and prognostic data regarding the oral localization of anisakidosis, a helminthic infection caused by the accidental ingestion of live anisakid larvae and which manifests mainly with gastrointestinal symptoms. Its localization in the oral mucosa appears to be exceptionally rare and, in most cases, occurs with a characteristic clinical picture, defined by the onset of acute mouth or throat pain immediately after the consumption of raw seafood and by the observation of one or more larvae, either lying on or penetrating the oral mucosa. Despite its rarity, dental health professionals and other clinicians should be aware of this disease and the possibility of its intraoral localization, since environmental factors on the one hand, and the adoption of foreign dietary habits on the other, will likely make anisakidosis a much more common disease worldwide in the near future. Full article

Background and Clinical significance: Acute leukemias are neoplasms of the hematopoietic system that are caused by the extensive proliferation of immature precursor cells (‘blasts’), mainly in the bone marrow. They frequently manifest with vague and non-specific clinical symptoms, making early diagnosis particularly challenging. Case Presentation: This case report describes the clinical course of a female patient who initially sought dental care due to a persistent toothache—an atypical and misleading symptom. Subsequent investigations revealed a diagnosis of acute leukemia. Although the malignancy was identified promptly and the appropriate therapeutic measures were initiated, the disease progressed with alarming rapidity. The patient ultimately developed a massive intracerebral hemorrhage—a devastating complication likely related to leukemia-associated coagulopathy. Despite emergent neurosurgical intervention, the hemorrhage proved fatal. Conclusions: This case highlights the critical need for heightened clinical suspicion in the presence of unusual symptoms and illustrates the complex interplay between hematologic malignancies and coagulopathic complications. Full article

Background: The aim of this study was to assess the experiences and attitudes of dentists toward treating patients with mental disorders and to investigate how these attitudes correlate with factors such as sex, age, and years of clinical experience. Methods: A cross-sectional pilot study was conducted from March to July 2021 via an online questionnaire. The questionnaire consisted of four sections: demographic information, self-assessment of experiences and attitudes toward treating patients with mental disorders, knowledge of psychotropic drugs and their interactions, and personal experiences with patient care. Results: Overall, 101 dentists, mostly females (78.22%), completed the questionnaire, of which 65.35% consistently checked whether their patients were taking psychotropic drugs and 48.51% inquired about mental disorders when taking medical history. Still, 39.60% reported unpleasant experiences when treating such patients—mostly female dentists—and as many as 14.85% of all dentists refused to treat them. More than 94% of dentists recognized that patients with mental disorders are at greater risk for poor oral health and in need of early referral and professional support. Older dentists demonstrated better knowledge of oral manifestations and drug interactions relevant to dental treatment. Conclusions: Our findings highlight the need for improved training, an interdisciplinary approach, and greater dissemination of new scientific evidence for managing patients with mental disorders in dental practice. Considering that this is a pilot study using a combination of non-probabilistic convenience and snowball sampling method, the findings should be considered preliminary and interpreted with caution, as the sampling method limits the ability to make statistical inferences. Full article

Background: Health issues among school-age children have emerged as a global public health concern. These conditions often do not occur in isolation but tend to cluster, indicating a widespread issue of multimorbidity among this population. This study examined the prevalence and clustering of multimorbidity among school-aged school students in the Yangzhou district. Methods: A repeated cross-sectional analysis was conducted from 2019 to 2024, including 22,512 students aged 6–18 years. Common diseases, under national key monitoring, including myopia, dental caries, obesity, elevated blood pressure, and growth disorders, were assessed. Multimorbidity patterns were identified using association rule mining (Apriori algorithm) with predefined thresholds (support ≥ 2.0%, confidence ≥ 20.0% and lift > 1). Results: The multimorbidity prevalence among school-age students in the Yangzhou district is 53.95%. The most frequent multimorbidity was found in dental caries and myopia, while the most common ternary pattern was found in obesity, dental caries, and myopia. The following gender differences were observed: boys had a higher multimorbidity prevalence (56.4%) compared to girls (51.2%), with boys more likely to exhibit obesity and dental caries, while girls showed a higher prevalence of myopia-related multimorbidity. By educational stage, primary school students showed a multimorbidity rate of 50.3%, junior high showed a rate of 54.6%, and senior high showed a rate of 57.9%, indicating a rising trend across age groups. Patterns of multimorbidity varied but were interrelated. Conclusions: From 2019 to 2024, the prevalence of multimorbidity among school-aged children in Yangzhou remained relatively high, primarily manifesting as co-occurring myopia and other health issues. Patterns of multimorbidity across gender and educational stage varied but were interrelated. Full article

Background/Objectives: Dental anomalies can manifest as a consequence of developmental defects and/or genetic influences, which disrupt the normal functioning of the oral cavity and present in various forms. Cases of fusion, gemination and concrescence are rare dental anomalies which are seen in the area of the mandibular molars. Case report: This case report concerns a 69-year-old Greek male patient who presented in the dental office asking for comprehensive oral treatment. During the clinical examination, a morphologically atypical molar was identified in the area of #37–38 presented with a large crown in the mesio-distal dimension (‘double’ crown). Panoramic and periapical radiographs offered valuable insights on the morphology of the irregular tooth, as they revealed the crown and root morphology, including the two pulp chambers and the three parallel roots of the tooth. Discussion: A plausible hypothesis identifies the atypical tooth as a third molar exhibiting morphological variation, a common characteristic of third molars. Additional diagnostic considerations—while supposing the existence of a supernumerary fourth molar—include the developmental anomalies of gemination, concrescence and fusion, as the clinical and radiographic features of the tooth display elements associated with all three. Conclusions: Considering the patient’s history, clinical and radiographic findings and the relevant literature, fusion is determined to be the most probable diagnosis. Early identification of the atypical tooth is essential to facilitate the implementation of appropriate preventive measures and to support informed treatment planning, should invasive procedures such as endodontic or surgical intervention be required in the future. Full article

Non-tuberculous mycobacteria (NTM) are saprophytes of both soil and water that may cause infection with a high risk of dissemination, mainly in immunocompromised patients. Most NTM infections occur in the lungs, while uncommon localizations are the skin, soft tissues, musculoskeletal apparatus, and lymphatic system. The possible relationship between NTM infections and dental procedures is still unclear. The authors reported a rare manifestation of NTM infection occurring in a 6-year-old girl who developed sub-mandibular swelling related to a necrotic tooth, thus mimicking an abscess of odontogenic origin. Fine-needle aspiration biopsy of the sub-mandibular swelling and the following microbiologic investigation showed infection sustained by the Mycobacterium fortuitum complex. After the medical and surgical treatment, the patient completely recovered after 8 months. A review of the relevant literature was carried out to deepen the clinical and microbiological aspects of such a rare occurrence. Full article

Background/Objectives: Acromegaly is a rare chronic disease caused by excess growth hormone (GH) and insulin-like growth hormone 1 (IGF-1) due to a pituitary adenoma. In acromegaly patients, oral and facial manifestations, such as mandibular growth, macroglossia, and dental malocclusion, are common and can affect quality of life. The aims of the present study were to evaluate the diagnostic path of these patients, the impact that acromegaly had on their oral health, the medical figures involved, and the role played by their dentist. Methods: The data were collected via an anonymous questionnaire to study dental health, dental care, and acromegaly diagnosis and history and via validated questionnaires. The validated questionnaires used were the ESS (Epworth Sleepiness Scale) to assess daytime sleepiness, OHIP-14 (Oral Health Impact Profile-14) to study perceptions of oral health, and AcroQoL to explore quality of life. Results: We enrolled 90 acromegaly patients: 48% of the patients reported acromegaly oral manifestations and 73% reported facial changes. The most frequent oro-facial manifestations reported by the patients were jaw growth (41%), diastema (40%), macroglossia (39%), and increased size of cheekbones (35%). The median OHIP-14 value was 5 (min 0–max 43), and the highest values were recorded in the questions relating to pronunciation difficulties and problems eating due to dental problems, as well as discomfort with dental aesthetics. The patients’ sleep quality was rated as good by 33% of patients, decent by 47%, and bad by 20%. The median ACROQol score achieved by the patients was 69 (min 19, max 98). An inverse and statistically significant correlation was observed between OHIP-14 and AcroQoL scores (Spearman correlation coefficient—0.44, p = 0.0002). Conclusions: Oro-facial changes significantly affect quality of life in cases of acromegaly, yet dental professionals’ involvement in diagnosis and management is limited. Greater awareness among and integration of dental professionals could support earlier detection and improve patient outcomes. Full article

This study aimed to evaluate the adverse effects of using Oxycide™ (Ecolab, Copenhagen, Denmark) disinfectant in dental practices and assess the need for improved safety measures. Materials and methods: An observational study was conducted in dental offices, evaluating 200 dental assistants exposed to Oxycide™ disinfectant. Data on disinfectant use practices, personal protective equipment, and reported symptoms were collected through an online questionnaire. Results: 63% (126 out of 200) of staff experienced symptoms including respiratory irritation, eye irritation, and skin reactions after Oxycide™ exposure. Inconsistent use of personal protective equipment and improper application techniques were observed. In conclusion, the use of Oxycide™ disinfectant in dental offices has been associated with a wide range of respiratory and cutaneous symptoms among staff, ranging from mild irritative manifestations to severe allergic reactions. Improved protocols, staff training, and consideration of safer alternatives are needed to protect dental personnel while maintaining infection control standards. For a sustainable dental practice, it is essential to balance effective disinfection with staff safety. While high-level disinfectants like Oxycide™ are effective against pathogens, their repeated use—especially in poorly ventilated areas—can lead to respiratory discomfort and skin reactions. To mitigate these risks, clear preventive measures should be implemented: adherence to manufacturer guidelines, proper ventilation, consistent use of personal protective equipment, and ongoing staff training. These steps are crucial to reducing exposure to irritants and ensuring a safe and efficient working environment. Full article

The aim of this study was to analyze the spectrum of Candida manifestations in the orofacial region to address the lack of comprehensive data in the diverse pediatric population. This retrospective study included all positive Candida findings in patients aged 0–18 years treated between 2014 and 2023 at a university maxillofacial department in Germany and evaluated associated risk profiles, comorbidities and species distributions. Candida infection sites included oral mucosa, dental abscesses and otitis media. Candida was more frequent in children with pre-existing conditions, particularly immunosuppression, neuromuscular disorders and facial deformities. Tympanostomy tubes and recent antibiotic use were significant risk factors for Candida in otitis media. Whereas in dental abscesses, Candida had a significant proportion independent of prior antibiotic use. Non-albicans subspecies, particularly Candida parapsilosis, were notably more prevalent in the middle ear compared to oral and dental infections. Candida manifests in various forms in the orofacial region, with different characteristics and species distributions. Further investigations are needed to better understand the role of Candida as a symptom or a contributor to an underlying condition. Full article

Backgrounds and objective: Disorders in the stomatognathic system and otorhinolaryngologic manifestations are frequently observed in individuals living with HIV. Ear, neck, and throat (ENT) signs and symptoms often serve as critical markers of treatment failure, particularly in the advanced stages of HIV infection. This article aims to evaluate and consolidate recent developments in the treatment and management of otorhinolaryngological manifestations in HIV-positive patients. Materials and methods: We carried out a retrospective clinical investigation of patients admitted with HIV/AIDS in the northeastern region of Romania, hospitalized in the “St. Parascheva” Clinical Hospital of Infectious Diseases in Iasi. We followed the viro-immunological status correlated with patients’ otolaryngology and dental symptomatology, aiming to emphasize the comorbidities of HIV/AIDS cases. The study period spanned from 1 January 2020 to 30 November 2024. Results: There were a total of 552 recorded cases of oropharyngeal manifestations in patients with HIV. They were more frequent in men (358 cases, 64.85%) than women (194 cases, 35.15%). The majority of cases were young adults, aged 30 to 39 years, comprising 255 patients (46.19%), and most cases (36.85%) had CD4+ T-lymphocyte values between 200 and 499 cells/μL. The most frequent diagnosis was oral candidiasis, recorded in 335 male and 174 female cases (509, 92.21% total). Other notable conditions included gingivitis/periodontitis, sinusitis/rhinosinusitis, mastoiditis, and dental abscesses, albeit at lower frequencies. Notably, antifungal therapy with fluconazole was the most frequently employed treatment, followed by aminopenicillins and fluoroquinolones. With respect to the antiretroviral treatment, 83.69% of cases were prescribed a single-pill regimen. Conclusions: The key to the management of HIV-positive patients is a multidisciplinary approach, including an ENT specialist and access to antiretroviral therapy. Full article

Gorlin-Goltz syndrome (GGS) is also known as Nevoid basal cell carcinoma syndrome (NBCCS). In the most common manifestation, GGS is diagnosed based on multiple cysts in the jaw bones, namely OKCs (odontogenic keratocysts). Other features might include major and minor clinical and radiological criteria to confirm this syndrome. Quite commonly, BCCs (basal cell carcinomas), bifid ribs, palmar and plantar pits, and ectopic calcification of the falx cerebri can be found in the majority of patients. Currently, the mutation of the PTCH1 gene seems to be responsible for GGS occurrence, while the male-to-female ratio is 1:1. The following radiological study based on OPGs and CBCT confirmed multiple cystic lesions in jaw bones, confirmed to be OKCs in the histopathological evaluation with an occurrence of numerous skin BCC lesions. In cases of most oral OKC cystic lesions, either surgical removal, curettage, or enucleation with or without any bone grafting can be used with a good amount of success. Rarely, some stable bone osteosynthesis procedures have to be carried out to avoid pathological bone fractures after cyst removal. A special consideration should include the temporomandibular joint. TMJ surgery and the replacement of the joint with an alloplastic material can be performed to improve biting, chewing, proper mouth opening, and maintain good patient occlusion. The authors want to present how effective and simple a standard dental panoramic radiograph combined with CBCT is and how it is suitable for GGS detection. They also want to underline how a standard TMJ prosthesis can be used as an alternative to a custom-made prosthesis. Full article

Background: Ectodermal dysplasia (ED) encompasses a heterogeneous group of genetic disorders affecting ectoderm-derived structures such as hair, teeth, nails, and sweat glands. Among these, variants in TSPEAR (Thrombospondin-type laminin G domain and epilepsy-associated repeats) have been implicated in autosomal recessive ED type 14 (OMIM 618180), predominantly manifesting with dental anomalies and hair dysplasia. However, the mutational spectrum of TSPEAR remains incompletely characterized. Methods: Two female siblings (ID#1 and ID#4) were clinically evaluated for ED. Genetic analysis, including next-generation sequencing (NGS) and Sanger validation, was conducted to identify TSPEAR variants. A segregation study confirmed inheritance patterns within the family. Results: Both affected siblings exhibited hallmark features of TSPEAR-related ED14, including oligodontia with dysmorphic, pointed maxillary central incisors. Hair thinning and cutaneous angiomas were predominant in ID#4. Genetic analysis identified two compound heterozygous variants in TSPEAR: c.543-1G>A, a splice-site variant likely to disrupt mRNA processing, and NM_144991.2:c.1251G>C(p.Gln417His), a missense variant with predicted deleterious effects. Segregation analysis confirmed maternal and paternal inheritance of the respective variants. A third sibling, ID#5, was identified as a heterozygous carrier without clinical manifestations. Conclusions: This study contributes to the expanding understanding of TSPEAR-related ED14 by providing novel genotype–phenotype correlations. Full article

Background: Sjögren’s syndrome (SS) is an autoimmune disorder characterized by sicca syndrome and/or systemic manifestations. In this study, non-obese diabetic (NOD) mice were used as an animal model for studying SS, to evaluate the optimal administration route and dose range of dental pulp stem cells (DPSCs) in the treatment of sialadenitis caused by SS. Methods: Different doses of DPSCs were transplanted into the submandibular glands (SMGs) of 14-week-old NOD mice through two different methods: injection or retrograde perfusion through the catheter orifice into the SMG. At 21 weeks of age, the saliva flow rate (SFR), ectopic lymphocytes, and CD4⁺ T-cell infiltration were measured. Tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ) in the glandular tissues were also quantitatively detected. Results: Compared with untreated and PBS-injected controls, different-dose groups of the two administration methods showed an increased saliva flow rate of NOD mice to varying degrees, reduced infiltration of lymphocytes and CD4⁺ T cells in the SMG, and decreased IFN-γ/TNF-α levels. Finally, we compared these two administration routes and found that the perfusion of 2 × 10⁵ DPSCs presents good therapeutic effects. Conclusions: DPSC perfusion through the catheter orifice is a simple and effective treatment method, which is worthy of further investigation through clinical trials. Full article