Background/Aim. Epidermolysis bullosa is a group of rare, genetic connective tissue diseases that cause blisters in the skin and mucosal membranes. The aim of this study was to evaluate the oral health status of patients with epidermolysis bullosa dystrophica and level of knowledge and opinion of parents about the implementation of preventive measaures and quality of dental care of affected children. Methods. This study included a group of 17 patients from Serbia suffering from dystrophic epidermolysis bullosa and matched control group. Dental caries status was assessed using the Klein-Palmer index. Oral hygiene status was verified with oral hygiene indices, simplified plaque index, and calculus index as described by Green and Vermillion. The gingiva was assessed as healthy or inflamed (gingivitis) on the basis of any changes in color, shape, size and surface texture. The condition of oral mucosa has been registered on the basis of inspection of the lips, tongue, a floor of the mouth, mouth vestibule and palate. The level of knowledge and the impressions of parents about the application of preventive measures were investigated through two questionnaires specifically designed for this study. Results. In both dentitions, there was the highest percentage of caries teeth. In primary dentition average value of the modified plaque index was 1.4 ? 1.14 and modified calculus was 0.7 ? 1. On permanent teeth average plaque index was 2 ? 0.4, and average calculus 1.6 ? 0.6. Statistically, significant higher values were found in permanent dentition in percentage distribution of decayed, missing, filled teeth and also for plaque and calculus indices between affected children and the control group. Most common findings on mucosa were microstomia (76.5%) and ankyloglossia (88.2%). Conclusion. The absence of protocol between the treating physician and the dentist and not sufficiently informed parents are leading to inadequate dental care. The implementation of preventive measures is of most importance to decrease the risk of severe complications that are difficult to be managed.
Background/Aim. Numerous oral manifestations may occur within dystrophic epidermolysis bullosa (DEB). Aim of the study was to examine oral and perioral soft tissues and oral functions in DEB patients over a period of one year. Methods. Twenty-four patients (1 month to 36 years old), were clinically examined initially (T0), after 6 months (T6) and after 12 months (T12). Appearance and localization of perioral and oral bullae and scars, maximum mouth opening, reduced vestibule depth, absence of lingual papillae and palatal rugae and restricted tongue movement due to scarring were monitored. The values of maximum mouth opening at the initial examination were compared to those measured in healthy control group of the same age. The age of patients and differences between dominant and recessive subtype of DEB were analyzed. Results. Average maximum mouth opening was significantly lower in DEB patients compared to healthy individuals. Oral and perioral bullae and scars, microstomia, and reduced vestibule depth were very common, with no statistically significant difference among T0, T6, and T12. The prevalence of restricted tongue movement due to scarring and the absence of lingual papillae and palatal rugae increased significantly over one year. Patients with microstomia, vestibule depth, and restricted tongue movement due to scarring were significantly older than patients without these characteristics. Lingual papillae and palatal rugae were more frequently absent in recessive than in dominant DEB. Conclusion. DEB causes significant changes in oral and perioral soft tissues and oral functions impairment.
Introduction/Objective. The aim of this paper is to point out the prevalence and severity of oral diseases in patients in the period before and after the transplantation of solid organs and hematopoietic stem cells. Methods. MEDLINE literature search was done via PubMed. Results. The development and improvement of transplantation medicine in specialized centers lead to an increasing number of patients, both adults and children, with transplanted solid organs and hematopoietic stem cells. Despite the success of therapy, numerous changes and complications can be observed on other organs in patients undergoing transplantation of solid organs and hematopoietic stem cells in the pre and post-transplant phase. Systemic diseases and conditions related to organ and cell transplantation, which are accompanied by numerous oral manifestations. The most common oral changes are gingival enlargement, desquamation of the oral epithelium, very painful ulcerations, polypoid and granulomatous changes in the oral mucosa, hard dental tissues with frequent complications, developmental anomalies of teeth in younger children, and in the later stage also the occurrence of oral cancer. After transplantation of solid organs and hematopoietic changes in the oral cavity and other organs occur depending on the patient?s post- transplantation period as well as on the applied immunosuppressive therapy. Conclusion. Oral changes development pre and post transplantation of solid organ and hematopoietic stem cells points to the importance of timely and good cooperation between the dentist and the doctor who treats the underlying disease.
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