Search Results (248)

Objective: To analyze the composition of the oral microbiome in periodontal pocket lesions and on the tongue dorsum of patients with Helicobacter pylori-associated gastric disease. Materials and Methods: Patients diagnosed with gastric disease and H. pylori (HP+) were evaluated in comparison to a control group of H. pylori-negative patients without gastric disease (HP−). Periodontal and oral health clinical parameters (PPD, BoP, PSE, plaque score and modified DMFT) were assessed for each patient. Microbiological samples were collected from the deepest periodontal pockets and tongue dorsum, followed by DNA extraction, 16S rRNA PCR amplification, and Next-Generation-Sequencing (NGS) analyses. Results: Sixty-seven patients (27F; 40M, aged 35–85 years) were enrolled. Of these, 52 were HP+ and 15 were HP−. HP+ patients exhibited a significantly higher presence of decayed teeth (p < 0.05) and slightly fewer missing teeth (p > 0.05). The plaque score was significantly higher in HP+ patients (p < 0.05), while PPD and BoP showed no significant differences (p > 0.05). NGS analysis revealed no presence of H. pylori in any samples of both periodontal and tongue sites. HP+ patients showed a distinct microbial composition, including higher prevalence of Capnocytophaga, Fusobacterium, and Peptostreptococcus genera in both locations (pockets and tongue dorsum). Conclusions: The study demonstrated that HP+ patients exhibit distinct oral microbial profiles compared to HP− patients, especially in areas with deeper periodontal pockets. H. pylori was not detected in the oral microbiomes of either group. Full article

Background: Spinal muscular atrophy (SMA) is a neuromuscular disorder that frequently affects bulbar function, including feeding and swallowing. Although disease-modifying therapies have improved motor outcomes, little is known about the persistence of oromotor difficulties, particularly with regard to solid food intake. Objective: This study aimed to evaluate mastication and swallowing performance in children with SMA undergoing treatment, and to investigate the association between tongue strength and feeding efficiency. Methods: Twenty-two children with SMA types 1–3 were assessed using the Test of Masticating and Swallowing Solids in Children (TOMASS-C) and the Iowa Oral Performance Instrument (IOPI). Key TOMASS-C outcomes included the number of bites, chewing cycles, swallows, and total eating time. Tongue strength was measured in kilopascals. Results: Most participants showed deviations from age-specific normative values in at least one TOMASS-C parameter. Tongue strength was significantly lower than reference values in 86% of participants and correlated negatively with all TOMASS-C outcomes (p < 0.001). Children with weaker tongue pressure required more swallows, more chewing cycles, and longer eating times. Conclusions: Despite pharmacological treatment, children with SMA experience persistent difficulties in eating solid foods. Tongue strength may serve as a non-invasive biomarker for bulbar dysfunction and support dietary decision-making and therapeutic planning. Full article

Secukinumab (SEC) is a recombinant, fully human monoclonal antibody that is selective for interleukin-17A (IL-17A). SEC may increase the risk of developing infections such as oral herpes and oral candidiasis. The aim of this case report and literature review was to describe chronic hyperplastic candidiasis (CHC) in a patient with psoriasis (PsO) and psoriatic arthritis (PsA) treated with SEC. CHC is a rare and atypical clinical entity. A definitive diagnosis requires biopsy of the oral mucosa for histopathological diagnosis (PHD). The differential diagnosis includes hairy tongue, hairy leukoplakia, oral lichen planus (OLP), oral lichenoid reaction (OLR), leukoplakia, frictional keratosis, morsication, oral psoriasis, syphilis, and oral lesions associated with coronavirus disease (COVID-19). In addition to the usual factors (xerostomia, smoking, antibiotics, vitamin deficiency, immunosuppression, comorbidities), the new biological therapies/immunotherapies are a predisposing factor for oral candidiasis. The therapeutic approach must be multidisciplinary and in consultation with a clinical immunologist. Dentists and specialists (oral medicine, dermatologists, rheumatologists) must be familiar with the oral adverse events of the new biological therapies. Simultaneous monitoring of patients by clinical immunology and oral medicine specialists is crucial for timely diagnosis and therapeutic intervention to avoid possible adverse events and improve quality of life (QoL). Full article

Obstructive sleep apnea (OSA) is a prevalent disorder linked to metabolic complications such as diabetes and cardiovascular disease. By fragmenting normal sleep architecture, OSA perturbs the growth hormone/insulin-like growth factor (GH/IGF) axis and alters circulating levels of IGF-binding proteins (IGFBPs). A prior clinical observation of elevated IGFBP4 in OSA patients motivated the present investigation in a controlled animal model. Building on the previously reported protocol, OSA was induced in male C57BL/6 mice (9–12 weeks old) through intralingual injection of polytetrafluoroethylene (PTFE), producing tongue hypertrophy, intermittent airway obstruction, and hypoxemia. After 8–10 weeks, the study assessed (1) hypoxia biomarkers—including HIF-1α and VEGF expression—and (2) neurobehavioral outcomes in anxiety and cognition using the open-field and novel object recognition tests. PTFE-treated mice exhibited a significant increase in circulating IGFBP4 versus both baseline and control groups. Hepatic Igfbp4 mRNA was also upregulated. Behaviorally, PTFE mice displayed heightened anxiety-like behavior and impaired novel object recognition, paralleling cognitive deficits reported in human OSA. These findings validate the PTFE-induced model as a tool for studying OSA-related hypoxia and neurocognitive dysfunction, and they underscore IGFBP4 as a promising biomarker and potential mediator of OSA’s systemic effects. Full article

The involvement of oral bacteria in the pathogenesis of distant organs, such as the heart, lungs, brain, liver, and intestine, has been shown. We analyzed the distribution of bacterial species in the resected aortic valve by 16S rRNA metagenomic analysis and directly compared their gene sequences with those in the oral cavity. Thirty-two patients with aortic stenosis or aortic regurgitation who underwent aortic valve replacement were enrolled in this study. Antibody titer against periodontal pathogenic bacteria in the patient’s serum was analyzed. The genetic background and distribution of bacterial species on subgingival plaque, the dorsal surface of the tongue, and the resected aortic valve were analyzed. Patients with aortic valve disease were shown to have more severe periodontal disease by the detection of antibodies against Socransky’s red-complex bacteria of periodontitis. Bacterial DNA was detected in the aortic valves of 12 out of 32 patients. The genomic sequences of the V3-V4 region of the 16S rRNA in some bacteria isolated from the aortic valves of six patients who underwent metagenomic analysis were identical to those found in the oral cavity. The findings indicate that bacteria detected in the aortic valve may be introduced through oral dysbiosis, a condition characterized by an imbalance in the oral microbiota that increases the risk of periodontal disease and dental caries. Oral dysbiosis and the resulting potential bacteremia are associated with the pathogenesis of aortic valve diseases. Full article

Background: Poststroke dysphagia is a common condition that can lead to complications such as aspiration pneumonia and malnutrition, significantly affecting the quality of life. Most patients recover their swallowing function spontaneously, but in others difficulties persist beyond six months. Can we predict this in advance? On the other hand, there have been recent attempts to use machine learning to predict disease prognosis. Therefore, this study aims to investigate whether machine learning can predict the long-term prognosis for poststroke dysphagia using early videofluoroscopic swallowing study (VFSS) data. Methods: Data from VFSSs performed within 1 month of onset and swallowing status at 6 months were collected retrospectively in patients with dysphagia who experienced their first acute stroke at a university hospital. We selected 14 factors (lip closure, bolus formation, mastication, apraxia, tongue-to-palate contact, premature bolus loss, oral transit time, triggering of pharyngeal swallow, vallecular residue, laryngeal elevation, pyriform sinus residue, coating of the pharyngeal wall, pharyngeal transit time, and aspiration) from the VFSS data, scored them, and analyzed whether they could predict the long-term prognosis using five machine learning algorithms: Random forest, CatBoost classifier, K-neighbor classifier, Light gradient boosting machine, Extreme gradient boosting. These algorithms were combined through an ensemble method to create the final model. Results: In total, we collected data from 448 patients, of which 70% were used for training and 30% for testing. The final model was evaluated using accuracy, precision, recall, F1-score, and Area Under the Receiver Operating Characteristic Curve (AUC), resulting in values of 0.98, 0.94, 0.84, 0.88, and 0.99, respectively. Conclusions: Machine learning models using early VFSS data have shown high accuracy and predictive power in predicting the long-term prognosis of patients with poststroke dysphagia, and they are likely to provide useful information for clinicians. Full article

Background/Objectives: We aimed to evaluate the clinical course, demographic characteristics, and risk factors in Polish patients with geographic tongue (GT). Methods: The analysis was based on medical records of 100 patients with GT referred to the outpatient clinic of Poznań University of Medical Sciences (PUMS) from 2013 to 2023. Data regarding age, gender, medical history, habits, subjective complaints, clinical features, localization, histology, and treatment were considered. Results: Patients with GT constituted 11.3% of 887 individuals admitted to the outpatient clinic in the analyzed period. The female-to-male ratio was 52:48. The average age at diagnosis was 51.6 years. Thirteen patients reported smoking, and 2.0% admitted to consuming alcohol excessively. Subjective complaints were reported by 85.0% of patients and mainly included a burning sensation (57.0%), pain (39.0%), xerostomia (22.0%), bleeding (4.0%), and taste disturbance (3.0%), while 15.0% of GT patients were asymptomatic. Comorbidities were found in 76.0% of subjects with GT, and included cardiovascular disorders (37.0%), gastrointestinal and thyroid gland diseases (24.0% and 18.0%), and type II diabetes (15.0%). Psoriasis was observed in one case only. Conclusions: The frequency of GT in a Polish cohort of patients was high and comparable in both genders. The majority of participants reported subjective complaints, and most of the patients were non-smokers. Comorbidities were found in 76.0% of subjects with GT and mainly included cardiovascular and gastrointestinal diseases. GT was often accompanied by other oral conditions, like candidiasis, recurrent aphthous stomatitis, and lichen planus. GT screening should include cardiovascular and gastrointestinal evaluation. Full article

An increasing number of patients are being diagnosed with tongue cancer despite lacking traditional risk factors such as tobacco, alcohol, or betel nut use. The potential role of human papillomavirus (HPV) in these cases has drawn attention, although its prognostic significance remains unclear. This retrospective cohort study, conducted in Southern Thailand, aimed to investigate the association between HPV status and overall survival in tongue cancer. Medical records of 186 patients treated between 2012 and 2021 were reviewed. HPV status was determined, and patients were categorized into HPV-negative, HPV-positive with other risk factors, and HPV-positive without known behavioral risk factors. Survival outcomes were compared using the log-rank test, and independent prognostic factors were analyzed using multivariable Cox regression. The overall prevalence of HPV infection was 9.6%, predominantly HPV16, HPV33, and HPV18. Although no significant differences were observed in 3-year overall survival, disease-specific survival, or recurrence-free survival among the groups, multivariable analysis revealed that HPV-positive patients without known behavioral risk factors (tobacco, alcohol, or betel nut use) had poorer overall survival (hazard ratio 3.54, p = 0.045). The observed associations warrant further research into the prognostic role of HPV in tongue cancer among non-smoking, non-drinking populations. Full article

Background/Objectives: Vascular anomalies represent a complex group of conditions including vascular malformations and haemangiomas. Haemangiomas are benign tumours that have an endothelial origin. In contrast, vascular malformations are characterized by the abnormal dilation of vessels without proliferation. Depending on the extension of the disease, there is a higher risk of life-threatening haemorrhages that may occur during simple dental procedures. The aim of this case report is to present the interdisciplinary treatment for patients with venous malformation and to discuss the possible dental management of these patients. Methods: A 66-year-old male patient with an extensive venous malformation of the head and neck was referred for a tooth extraction. The venous malformation involved lips, buccal mucosa, tongue, and floor of the oral cavity. Its proximity to the tooth requiring extraction was associated with a high risk of severe bleeding. Results: Prior to the treatment, CBCT and CT scans were performed to confirm the extensions of the lesion and visualise its margins. Considering the possible risks related with venous malformation, the procedure consisted of tooth removal in a hospital setting with control over severe bleeding complications. Conclusions: The presence of an extensive vascular malformation in the head and neck region is burdened with a higher risk of haemorrhages during simple dental procedures. The radiological and clinical planning enables the choice of an accurate treatment strategy to avoid possible difficulties. In cases where such complications cannot be avoided, it is important to perform the treatment in a hospital setting with the cooperation of maxillofacial surgeons. Full article

It remains unclear how sleep health has developed in the general population after the COVID-19 pandemic. This study aimed to (1) investigate the prevalence of sleep problems and poor sleep quality and (2) explore the associated sociodemographic and health-related factors in South Tyrol, Italy. A cross-sectional, population-based survey was conducted with a stratified probabilistic sample of 4000 adults aged ≥ 18 years. Sleep quality was assessed using the brief version of the Pittsburgh Sleep Quality Index. Descriptive and logistic regression analyses were performed to analyze the data. A total of 2090 adults (53%) completed the survey. Poor sleep quality was reported by 17.8%, with 28.2% of participants reporting insufficient sleep duration (i.e., six hours or less), 12.7% having problems staying asleep (i.e., waking up to 3–4 times a week and unable to fall asleep again), and 8.7% having problems falling asleep (i.e., >30 min). Sleep problems and poor sleep quality were associated with sociodemographic and health-related factors, including gender, age, mother tongue, chronic disease, and sleep hygiene. Notably, Italian-speaking participants reported poorer sleep quality and greater difficulty staying asleep compared to German-speaking participants, highlighting potential sociocultural influences on sleep health. This study contributes to understanding the unique sleep health challenges in a multilingual region, highlighting the role of sociocultural factors in sleep quality differences between language groups. Full article

Background/Objectives: Bleomycin electrosclerotherapy (BEST), which combines intralesional bleomycin administration with electroporation, enhances drug uptake and has shown efficacy in treating vascular malformations resistant to conventional therapies. While BEST is increasingly used in various anatomical sites, its application in the upper aerodigestive tract remains underexplored. This study evaluates the safety and effectiveness of BEST in managing slow-flow vascular malformations of the oral cavity, tongue, larynx, and hypopharynx. Methods: In this retrospective, multicenter study, 20 patients with symptomatic slow-flow vascular malformations of the upper aerodigestive tract were treated with BEST. Clinical and radiological assessments were used to evaluate the treatment response, categorized as “significantly reduced”, “reduced”, “stable disease”, or “lesion growth”. Postprocedural complications and functional outcomes were systematically recorded. Results: A total of 29 BEST sessions were performed. Lesions of the tongue (n = 8) and combined oral cavity and tongue (n = 6) showed the highest response rates, with significant symptom reduction in five out of eight and five out of six patients, respectively. Among isolated oral cavity lesions (n = 4), one out of four demonstrated a significant reduction. In contrast, laryngeal and hypopharyngeal lesions (n = 2) had limited response, with one case showing partial reduction and the other remaining stable. Severe complications, including bleeding and dyspnea requiring tracheostomy, limited further treatment in these locations. No systemic adverse events, such as pulmonary toxicity, were observed. Conclusions: BEST is effective for treating vascular malformations of the upper aerodigestive tract, particularly in the tongue and oral cavity, but presents significant risks in laryngeal and hypopharyngeal lesions. A multidisciplinary approach is required to optimize treatment protocols for these challenging locations. Full article

Background/Objectives: Coated tongue is a common oral condition with notable clinical relevance, often overlooked due to its asymptomatic nature. Its presence may reflect poor oral hygiene and can serve as an early indicator of underlying systemic diseases. This study aimed to develop a robust diagnostic model utilizing convolutional neural networks and machine learning classifiers to improve the detection of coated tongue lesions. Methods: A total of 200 tongue images (100 coated and 100 healthy) were analyzed. Images were acquired using a DSLR camera (Nikon D5500 with Sigma Macro 105 mm lens, Nikon, Tokyo, Japan) under standardized daylight conditions. Following preprocessing, feature vectors were extracted using CNN architectures (VGG16, VGG19, ResNet, MobileNet, and NasNet) and classified using Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and Multi-Layer Perceptron (MLP) classifiers. Performance metrics included sensitivity, specificity, accuracy, and F1 score. Results: The SVM + VGG19 hybrid model achieved the best performance among all tested configurations, with a sensitivity of 82.6%, specificity of 88.23%, accuracy of 85%, and an F1 score of 86.36%. Conclusions: The SVM + VGG19 model demonstrated high accuracy and reliability in diagnosing coated tongue lesions, highlighting its potential as an effective clinical decision support tool. Future research with larger datasets may further enhance model robustness and applicability in diverse populations. Full article

The objective of the study was to determine the relationship between burning, xerostomia, dysgeusia and other subjective symptoms in patients with burning mouth syndrome (BMS). This cross-sectional study was conducted at the Dental Polyclinic Split, Split, Croatia. A total of 71 patients with BMS, i.e., 60 women and 11 men, were included in the study. The patients were divided into four subgroups: burning (B), burning and xerostomia (BX), burning and dysgeusia (BD), burning, xerostomia and dysgeusia (BXD). The following data were collected from all patients: sociodemographic status, comorbidities, medications, characteristics of the burning, presence of other subjective symptoms, topography of the burning. The majority of patients with BMS were women (86.0%) with an average age of about 65 years. Gastrointestinal diseases were the most common comorbidity (48.35%), and the most commonly used medications were proton pump inhibitors (PPIs) (29.8%). In the largest number of patients (N = 34), the burning symptom worsened in the evening hours (p = 0.059). The majority of BMS patients suffered from burning symptoms that occurred continuously (N = 54, 75.13%) and from an improvement (reduction/cessation) of symptoms during meals (N = 54, 76.65%). Of the other subjective symptoms, changes in the morphology of the tongue (10.6%) and a feeling of swelling (9.1%) were the most common. The tongue was the most common localization (67.35%). The multivariable logistic regression analysis showed a statistically significant effect of female gender (p = 0.049) as a potential positive predictor in subgroup B. The sociodemographic and medical data collected cannot explain the different occurrence of symptoms in the four subgroups of patients with BMS. Full article

Active and passive surveillance, followed by gene sequencing, continue to be used to identify a diverse range of novel bacteria, viruses, and other microorganisms in ticks with the potential to cause disease in vertebrate hosts following tick bite. In this study, we describe the isolation and characterization of a novel virus from Bothriocroton hydrosauri ticks collected from a blotched blue-tongue, Tiliqua nigrolutea. In an attempt to isolate rickettsia, the inoculation of Vero cell cultures with tick extracts led to the isolation of a virus, identified as a novel tick Orthomyxovirus by electron microscopy and gene sequencing. Transmission electron microscopic analysis revealed that B. hydrosauri tick virus-1 (BHTV-1) is a spherical orthomyxovirus, 85 nm in size. Multiple developmental stages of the virus were evident in vitro. Analysis of putative BHTV-1 amino acid sequences derived from a genomic analysis of virus-infected host cell extracts revealed the presence of six putative RNA segments encoding genes, sharing the closest sequence similarity to viral sequences belonging to the arthropod-borne Thogotovirus genus within the Orthomyxoviridae. Thogotoviruses are an emerging cause of disease in humans and animals following tick bite. The detection of this new thogotovirus, BHTV-1, in B. hydrosauri, a competent vector for human tick-borne infectious diseases, warrants follow-up investigation to determine its prevalence, host range, and pathogenic potential. Full article

Despite advances in treatment, recurrence rates in oral squamous cell carcinoma (OSCC) remain high. Prognostic outcomes vary in terms of local recurrence, metastasis, and overall survival. A retrospective cohort analysis was conducted on OSCC patients who underwent primary surgery at the Department of Craniomaxillofacial and Facial Plastic Surgery, University Medical Center Frankfurt, between January 2014 and December 2020. Demographic data, tumor characteristics, surgical details, intraoperative frozen section results, and recurrence patterns were first assessed for availability. Subsequently, the available data relevant to each endpoint were analyzed. A total of 169 patients were analyzed (mean age: 64 years). The tongue was the most affected site and had the highest recurrence rate, followed by the floor of the mouth. Overall, 24.3% of patients experienced recurrence, with most cases occurring within the first year. T2 tumors had the highest recurrence rates. Between patients with and without adjuvant therapy, recurrence rates were comparable. Positive surgical margins were more common in recurrence cases, but no significant correlation was found between margin status and recurrence in patients without adjuvant therapy. Based on the analyzed data, achieving recurrence-free survival in OSCC does not solely depend on surgical technique or adjuvant therapy. Instead, early recognition of individual tumor characteristics and even tumor biology should guide personalized treatment planning. Notably, tumors of the tongue and floor of the mouth exhibited high recurrence rates regardless of disease stage, raising the question of whether primary chemoradiotherapy (CRT) could achieve better outcomes than surgery. Further studies are needed to evaluate the role of CRT as a first-line treatment for OSCC in these locations. Full article