Oral lichen planus(OLP) is a chronic disease that worsens the quality of life of patients with risk of malignant potential. Treatment of OLP remains a significant challenge despite the recent advances in understanding the immunopathogenesis. The properties of Platelet-rich plasma (PRP) because of its growth factors, such as epidermal growth factor (EGF), fibroblast growth factor (FGF), Transforming growth factor(TGF β1) and keratinocyte growth factor (KGF) suggested its application in clinical practice for treatment of OLP patients that do not respond to conventional therapy. Hereby we report a case of erosive OLP resistant to conventional therapy efficiently treated with PRP.
Bisphosphonates are one of the most commonly prescribed drugs in bone-associated diseases. Medication-related osteonecrosis of the jaws (MRONJ) is a new term and the common side effect of long term bisphosphonate therapy; characterized by the presence of exposed necrotic bone and non-healing mucosa. Although there has been an increasing number of MRONJ cases; it is management is still a challenge for clinicians. In this case report, the management of MRONJ with buccal fat pad flap in an osteoporotic patient is described.
Objective: To report the case of a patient with Sickle cell disease (SCD) subjected to immediate load implant surgery (I) with a history of dental trauma (DT).
Case Report: A 15-year-old male patient attended the CVMT 3 years after DT, reporting aesthetic complaint and discomfort in the tooth 21 (E21). In anamnesis, reported that the adolescent had sickle cell anemia (SCA). Patient regular use of medication and follows up with a hematologist. Clinical and radiographic examination, observed a complete permanent dentition, biofilm control, absence of caries and E21 showed tooth remnant, with a corono-radicular fracture and extensive internal resorption. The initial approach was endodontic treatment of E21. After medical release, the extraction was performed, followed by installation of the I with immediate loading. A successful oral rehabilitation with osseiointegration after DT history. The continuity of dental care becomes to keep them free of problems that affect the oral cavity as well as improve their self-esteem.
Discussion: SCA presenting the most severe manifestations of SCD characterized by mutation of hemoglobin. Among the most common oral signs and symptoms are asymptomatic pulp necrosis, neuropathy, and mental nerve mandibular osteomyelitis caused by seizures that may also result in acute blockage of blood vessels in organ pulp. The advantage of the proposed treatment was the bone support maintenance for placing the dental implant and the prosthetic component to be monitored until the greatest age of the patient.
Conclusion: The occurrence of DT in patients with SCA can be a complicating factor for a good prognosis. DT can be minimized through preventive measures such as the use of mouth guards.
Background: Erythema multiforme (EM) manifests on the skin and mucosa surfaces such as the oral mucosa and the genitals as ulcerative lesions. The spectrum of clinical presentation underscores the importance of describing the clinical features observed in patients presenting in an oral medicine clinic for treatment.
Aim: To describe the epidemiology and the clinical features of patients presenting with erythema multiforme in the oral medicine clinic of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC).
Methodology: A retrospective study of cases diagnosed as EM in the Oral Medicine clinic of OAUTHC between August 2009 and August 2019. Patients’ hospital records were retrieved and reviewed. Information extracted included biodata, clinical findings, presence of co morbidity and treatment received. Diagnosis of EM was mostly clinical; some patients also had histopathologic and/or Direct Immunofluorescence (DIF) investigations. Data was analyzed using STATA 13 statistical software.
Results: Out of the total number of 923 patients seen in the clinic during the study period, 19 (2.08%) patients had EM. Nine males and 10 females were affected. The age ranged from 9 years to 73 years with mean age of 35.53± 16.20 years. EM minor was diagnosed in 17(89.47%) while EM major was diagnosed in 2(10.53%). The affected oral sites were upper and lower lips 16(84.21%), buccal mucosa 9(47.3%), hard and soft palate had 3(15.79%) and tongue 2(10.52%). Seven patients (36.84%) presented with target skin lesions. Seventeen patients (89.47%) had recurrence. Sixteen (84.47%) patients had no identifiable causative factor while one patient each presented with ciprotab® (5.26%), septrin® (5.26%) and sulphonamide (5.26%) as the implicating triggers. Two (10.53%) of the patients presented with oral and genital ulcers. The 2 patients had histopathology and Direct Immunofluorescence investigation. Patients were treated with steroids and other supportive therapy.
Conclusion: Erythema Multiforme appears to be an uncommon presentation in the oral medicine clinic, but may be associated with recurrent lesion in and around the oral tissue. The lips were the most common site of oral presentation. Drug reactions were identifiable etiological factor. Topical or systemic steroids were effective in patient management.
Aims: To describe the dental caries experience in preschool children in Harare and its contributing factors.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Frank Johnson, Lochinvar, Southerton, Chembira and Chengu Primary Schools in High Glen District, Harare between May, and June 2014.
Methodology: The study participants were 178 preschool children. High Glen District in Harare was randomly selected. Using stratified sampling, schools from high, medium, and low-density suburbs were categorized and Purposive sampling was use low and medium density suburbs and Convenience sampling was used to identify the two schools from the two main high-density suburbs.
Results: A sample size of 220, 95% confidence level and precision of 5% was used, the response rate was 80.9%. The caries prevalence of 75.8% with a distribution of 51.3% in males and 48.7% in females was obtained. The mean dmft was 3.88 which is high as the implication is on average 20% of a preschool child’s dentition is carious. Decayed teeth contributed 65.2%, missing teeth 34.8% to the dmft value and there were no filled teeth. An increase in dmft with age was noted, at 4 years dmft (25.1%), 5 years (29.9%) and at 6 years (45%). Only 12.7% of the participants had visited a dentist since birth. 93.9% of the study participants consumed sweets, and this occurred at an average of 4 times a week. 77.9% of parents and guardians had given their child something sweet to eat on the day data was collected.
Conclusion: The caries prevalence of preschool aged children in Harare is high and this requires attention. The early caries development seen in children from the all socio-economic classes reinforces the need for preventive programs through prenatal counselling to expectant mothers as early as prenatal counselling and implementation of Zimbabwe School Health Policy.