Periodontal aspects of the juvenile form of paracoccidioidomycosis

Abstract

Three cases of the juvenile form of paracoccidioidomycosis are reported. Emphasis has been given to the oral manifestations, particularly the periodontal involvement. The main periodontal findings were: generalized and progressive alveolar bone destruction leading to gingival recession with exposure of the tooth roots, and spontaneous tooth losses. The gingival mucosa was predominantly smooth, erythematous and slightly swollen. These aspects, although rare, may be the earliest signs of the disease and sometimes its only manifestations.

Gingival Involvement in Oral Paracoccidioidomycosis

“…The gingiva may also appear smooth, erythematous, and slightly swollen, whereas lesions are often extensive and erosive 11 . The destruction of the gingiva may lead to periodontal bone loss and exposure of the tooth roots, and further progress to progressive tooth mobility and spontaneous tooth loss, even in adolescent patients, giving the impression of severe periodontitis 11 . These manifestations, however, are not accompanied by any increase in probing depths, regardless of the severity of periodontal involvement 11 .…”

“…The destruction of the gingiva may lead to periodontal bone loss and exposure of the tooth roots, and further progress to progressive tooth mobility and spontaneous tooth loss, even in adolescent patients, giving the impression of severe periodontitis 11 . These manifestations, however, are not accompanied by any increase in probing depths, regardless of the severity of periodontal involvement 11 . Delayed wound healing after tooth extraction because of apparent periodontal disease has also been reported as a presenting sign of oral paracoccidioidomycosis 13 …”

“…The significance of this deep mycosis stems from the fact that the mortality rate can be as high as 30% 5 . The disease frequently presents with oral involvement 2‐5,7,10,11 . The oral lesions, typically characterized by erythematous finely granular hyperplasia, speckled with pinpoint hemorrhages and a mulberry‐like surface called “moriforme” stomatitis, 12 are most of the time the first ones detected and the ones that lead to final diagnosis 3,10 .…”

Paracoccidioides brasiliensis causing a rib lesion in an adult AIDS patient

“…This disease is attributed to endogenous reactivation, which shows the importance of the epidemiologic risk factor in P brasiliensis infection late in adulthood [3]. Health care providers caring for HIV patients who live or have resided in areas where PCM is endemic must be aware of the possibility that this systemic mycosis may occur and have potentially severe consequences, especially in oral care [16,17].…”

Hair Mercury Levels in Periodontal Patients in Comparison with Healthy Individuals

“…Malnutrition, some systematic diseases, such as diabetes and smoking are the other important causes of periodontitis. [2][3][4][5][6][7][8][9][10][11][12] There are evidences that heavy metal exposure, such as mercury and its derivatives are connected to the oral health conditions and diseases. 12 Today the most widespread exposures to mercury are from three ways: Mercury vapor, methylmercury in sea foods and ethylmercury in the form of thimerosal used as a preservative in vaccines.…”