Lepromatous leprosy: a review and case report

Leprosy is a contagious and chronic systemic granulomatous disease caused by Mycobacterium leprae (Hansen s bacillus). It is transmitted from person to person and has a long incubation period (between two and six years). The disease presents polar clinical forms (the multibacillary lepromatous leprosy and the paucibacillary tuberculoid leprosy), as well as other intermediate forms with hybrid characteristics. Oral manifestations usually appear in lepromatous leprosy and occur in 20-60% of cases. They may take the form of multiple nodules (lepromas) that progress to necrosis and ulceration. The ulcers are slow to heal, and produce atrophic scarring or even tissue destruction. The lesions are usually located on the hard and soft palate, in the uvula, on the underside of the tongue, and on the lips and gums. There may also be destruction of the anterior maxilla and loss of teeth. The diagnosis, based on clinical suspicion, is confirmed through bacteriological and histopathological analyses, as well as by means of the lepromin test (intradermal reaction that is usually negative in lepromatous leprosy form and positive in the tuberculoid form). The differential diagnosis includes systemic lupus erythematosus, sarcoidosis, cutaneous leishmaniasis and other skin diseases, tertiary syphilis, lymphomas, systemic mycosis, traumatic lesions and malignant neoplasias, among other disorders. Treatment is difficult as it must be continued for long periods, requires several drugs with adverse effects and proves very expensive, particularly for less developed countries. The most commonly used drugs are dapsone, rifampicin and clofazimine. Quinolones, such as ofloxacin and pefloxacin, as well as some macrolides, such as clarithromycin and minocyclin, are also effective. The present case report describes a patient with lepromatous leprosy acquired within a contagious family setting during childhood and adolescence.     

Talon cusp: a review and case report

A case of bilateral talon cusp in maxillary lateral incisors, a relatively rare condition, is presented. The aetiology and clinical problems are discussed.     

Ludwig's angina: a case report and review

A case of Ludwig's angina which developed after mandibular fractures in a 14-year-old male patient is reported. We emphasise the serious nature of this condition and the aggressive treatment it requires. It is important to recognise cases of Ludwig's angina at an early stage, as well as cases which are at risk of developing into true Ludwig's angina if treatment is delayed. Management should be aimed at maintaining an open airway by nasotracheal intubation or cricothyroidotomy, together with treatment of the infection by removal of the source, drainage of pus and parenteral antibiotic therapy. In addition, investigation and management of contributing medical conditions and timely specialist consultation are essential.     

Xeroderma pigmentosum: review and report of a case

Xeroderma pigmentosum is a rare inherited dermatosis that provides insight into the basic mechanism of carcinogenesis. It is a model disorder linking defective DNA repair with clinical abnormalities and neoplasia. UV light-induced damage to the skin begins early and results in multiple benign and malignant skin tumors, especially in sun-exposed areas of the head and neck. Oral cancers, primarily squamous cell carcinomas of the anterior third of the tongue, occur with greatly increased frequency. A patient with multiple facial neoplasia and oral manifestations of xeroderma pigmentosum is presented. The role of the dentist in surveillance of oral and perioral structures is emphasized. The dentist is advised against the use of UV light-curing units in these patients because UV-induced epithelial damage may cause dysplasia when DNA repair mechanisms are dysfunctional.     

Riga-Fede disease: report of a case and review

Self-mutilation of tongue is a type of self-injurious behavior. Ulcers of the lingual frenum in neonates with natal lower incisors are referred to as Riga-Fede disease. In this paper a case of Riga-Fede disease in a ten-month infant male with lower central incisors is reported. The ulcer resolved after the sharp incisal edges were smoothened and topical triameinolone was applied. As this lesion may be confused or associated with other serious disorders, a review of medical and dental literature was included.     

Hypohidrotic ectodermal dysplasia: a review and case report

A case involving a 5-year-old girl with hypohidrotic ectodermal dysplasia is presented. A review of the disease and the treatment options for patients is discussed.     

Oral myiasis: a case report and literature review

Myiasis is the infestation of tissues and organs of animals and humans by certain Dipteran fly larvae. This phenomenon is well documented in the skin, especially among animals and people in tropical and subtropical areas. Oral myiasis is a rare condition and can be caused by several species of Dipteran fly larvae and may be secondary to serious medical conditions. Upon removal of the larvae, the tissues seem to recover with no subsequent complications and with no need for further treatment. Here we describe a case of oral myiasis within the gingiva of a healthy young man caused by the larvae of Wohlfahrtia magnifica (Family Sarcophagidae), in which infection may have been due to ingestion of infested flesh. Reviewing the literature revealed that most cases of oral myiasis tend to be multiple and to occur in anterior segments of the jaws rather than in posterior segments as in the case we describe here.     

Hereditary angioedema: a case report and literature review

Hereditary angioedema is an autosomal dominant condition with a typical presentation of diffuse edematous, painless, and nonpitting swelling of the soft tissues. The disease manifests itself primarily in the extremities, face, airway, and abdominal viscera. Proper diagnosis and treatment are essential as this condition has the capacity of becoming life-threatening due to potential airway embarrassment. This case report demonstrates the complexity of diagnosing and treating hereditary angioedema. Hereditary angioedema often is overlooked on a differential diagnosis of patients suffering from diffuse swelling and/or abdominal discomfort. Nonetheless, the diagnosis of hereditary angioedema should be included when assessing patients who display the proper symptomology and familial history of the condition.     

传染性单核细胞增多症一例及文献复习

传染性单核细胞增多症（IM）是一类常见的由EB病毒感染所引起的急性传染性疾病,由于临床表现缺乏特异性,常被误诊。本文报道1例以颈部淋巴结肿大为首发症状的IM,结合文献对该疾病的临床表现、病原学诊断、抗病毒治疗及激素治疗方面进行讨论、分析。     

Phantom bite: a case report and literature review

Objective:

Phantom bite is a rare and challenging condition that dentists may encounter in their daily clinical practice. Patients with phantom bite typically present with many failed repeated occlusal treatments, such as full-mouth prosthetic reconstructions and orthodontic treatments, to overcome their distressing symptoms.

Method and result:

A 55-year-old female with no history of medical problems presented with bite discomfort. She complained of discomfort from a “bite” and pressure-like feeling in her right upper three maxillary posterior teeth. Examination revealed no temporomandibular disorder (TMD) abnormalities. A thorough evaluation of her oral structures revealed no dental, periodontal, or mucosal pathologies.

Conclusion:

Owing to the great potential of conditions for financial loss and litigation problems, dentists, particularly those who perform bite-changing procedures, should be aware of this condition. This case is presented to highlight many of the clinical characteristics of phantom bite.     

Erythema multiforme: a literature review and case report

Erythema multiforme is a florid mucocutaneous disease characterized by oral, cutaneous, and ocular manifestations. The cutaneous lesions are pathognomonic because of their unique "target-like" appearance. A severe form of EM has been termed "Stevens-Johnson Syndrome". Although the etiology of EM is unknown, much of the research suggests an immunological association with HSV. The diagnosis of EM is based on signs and symptoms, and a differential diagnosis should include other ulcerative, mucocutaneous diseases, such as erosive lichen planus, pemphigus, varicella zoster, ANUG, TEN, aphthous stomatitis, and primary HSV. Therapeutic measures are palliative, including a soft bland diet, topical anesthetics, and corticosteroids. A case of EM is described which underscores the appearance of the disease and its clinical course.     

Plasma cell mucositis: a review and case report

The simultaneous involvement of the mucous membranes of the oral cavity and upper aerodigestive tract by lesions characterised clinically by an intensely erythematous, lobulated surface and histologically by a dense connective tissue infiltrate composed of non-neoplastic plasma cells may be called plasma cell mucositis. We present a review of the literature, consisting of 14 cases, outlining the multifocal site distribution, chronicity and systemic background that distinguish this entity and report a single case with confirmation of the polyclonal nature of the plasma cell infiltrate using gene rearrangement studies.     

Osteoplastic ameloblastoma: a case report and literature review

Ameloblastoma with bone formation is rare. We report a case of a 55-year-old woman with ameloblastoma accompanied by prominent osteoplasia. Histopathological examination exhibited an abundant stromal component between tumor nests. Therefore, she was diagnosed as the desmoplastic variant, except for the numerous bone trabeculae. The distinction between new bone formation and invasion of the bone marrow poses a problem. A thin rim of fibrous bone that can be accentuated by Masson-trichrome staining suggests the former.     

Endodontic-related paresthesia: a case report and literature review

Introduction

Endodontic-related paresthesia is a potential complication despite the development of endodontic materials and techniques. We describe a case of periapical lesion-induced paresthesia that was successfully treated endodontically. The literature review of endodontic-related paresthesia is also presented.

Methods

The patient sought treatment from a general practitioner for lower lip paresthesia as the only symptom. Paresthesia was present on the left side of the lower lip extending from the mandibular midline to the second premolar both extraorally and intraorally in the area of mental nerve stem. Apical lesion of an endodontically treated second premolar with short obturation was observed radiographically. Retreatment was unsuccessful at reaching the apex; instead, swelling, pain, and extension of numbness on the region resulted, and the patient was referred to an endodontist.

Results

The root canal chemomechanical debridement was completed, and calcium hydroxide was placed for the follow-up. Two months later the symptoms had significantly improved, the radiograph indicated partial healing, and the tooth was obturated. The healing progressed so that the symptoms completely resolved within a year after the treatment.

Conclusions

Periapical pathosis might cause paresthesia with a good potential for healing after appropriate endodontic treatment. Complications might be prevented by careful preoperative examination, good quality radiographs, and good instrumentation, irrigation, and obturation techniques. However, according to the literature paresthesia might still occur. In case of treatment-related paresthesia in which apical extrusion of endodontic materials is observed, the need for surgical debridement (especially in cases of extrusion of obturation materials) should be considered within 48 hours.     

Class II barodontalgia: review and report of a case

Barodontalgia is a rarely reported condition involving changes in ambient pressure resulting in tooth pain. According to Ferjentsik and Aker, Class II barodontalgia is observed in teeth that have pre-existing pulpal disease and an ultimate diagnosis of irreversible pulpitis.1 This article describes a case of Class II barodontalgia that was experienced on a commercial airline flight and reviews current knowledge regarding this phenomenon, including proposed etiologic mechanisms.     

Paraneoplastic pemphigus: a case report and review of literature

Paraneoplastic pemphigus (PNP) is an autoimmune mucocutaneous disease frequently associated with lymphoproliferative disorders. The rare combination of the disease with other malignancies such as different types of carcinomas, sarcomas, melanoma and skin tumours has also been reported. Most patients develop very severe oral ulceration and conjunctival ulceration with or without genital ulceration resembling the features of Steven's Johnson's syndrome or most severe forms of drug eruptions. The possibility of PNP should be borne in mind when a patient presents with extensive oral ulceration if clinical, histopathological and results of direct immunofluorescence are not pathognomonic for a specific diagnosis. The issue becomes even more important as some patients with PNP have no diagnosed malignancy at the time of presentation. We document a case of PNP in a 29-year-old female who suffers from non-Hodgkin's lymphoma.     

Juvenile dermatomyositis: literature review and report of a case

Dermatomyositis is a rare disease of unknown origin, which affects both children and adults. In the juvenile form, dermatomyositis is a multisystem disease, characterized by myositis; an erythematous rash over the bridge of the nose, around the eyes, and on the trunk and limbs; vasculitis; and dilatation of the capillaries in the nail beds and gum margin. Late development of calcinosis is seen in approximately two-thirds of the patients. This case describes a 5-year-old dental patient diagnosed with dermatomyositis. This article includes the clinical manifestations of dermatomyositis in the body and in the oral cavity as well as the considerations that should be taken when treating these patients.