Extensive Palatal Necrosis Secondary to Chrysomya bezziana Myiasis: A Case Report

Oral myiasis, a rare condition caused by the infestation of live maggots in the oral cavity, can present unique challenges in immunocompromised individuals. This case report presents a unique case of oral myiasis in an immunocompromised adult undergoing chemotherapy. A 67-year-old female suffering from metastatic carcinoma of the ovary was undergoing chemotherapy treatment at the time of presentation. Prompt diagnosis and management, including larval removal, wound care, and systemic antibiotics, were initiated. This case highlights the susceptibility of immunocompromised individuals to uncommon complications, such as oral myiasis, due to their compromised immune system. It also emphasizes the need for heightened vigilance in the oral care and monitoring of immunocompromised patients undergoing chemotherapy, as well as the importance of early intervention to prevent potential complications associated with oral myiasis. In this article, we have also included a comprehensive treatment protocol for treating this condition based on our clinical experience.

Gap in Dental Care Can Lead to Diabetes, Other Disease Conditions

The importance of oral hygiene for patients on mechanical ventilation.

One of the most important reasons of dental caries appearance in children is improper oral hygiene which results in the accumulation of plaque containing significant amount of pathogenic microflora. Its vital activity products cause demineralization of tooth hard tissues. This is relevant for children of all ages but the most important in first years after teething as teeth are poorly mineralized and have tendency to the appearance of carious process.
 Totally 412 children aged 6 to 16 years old attending organized children's collectives (schoolchildren from 1st to 11th year of studying) were examined. Oral cavity examination was carried out according to the generally accepted method. The level of oral hygiene was determined by Fedorov-Volodkina’s and Green-Vermillion’s indices. The research was conducted in the each age period separately and in age groups corresponding to 6-9 years (group I - elementary school), 10-13 years (group II - secondary school), 14-16 years (group III - high school). Statistical processing of the obtained data was carried out using the Student’s method. The results were considered significant at p <0.05.
 Analysis of oral hygiene level according to Fedorov-Volodkіna’s technique revealed that children aged 6 to 9 years (I group) had “unsatisfactory” oral hygiene level. The research of each age period reveals that only children of 9 years old take care after their oral cavities properly. We have detected significant differences of oral hygiene level of children with caries and with intact teeth. The worst oral hygiene level was observed in children of 6 years old affected by caries.
 In children 10-13 years old (Group II) the average index of oral hygiene is 2.20 ± 0.08 points which corresponds to unsatisfactory level. This is a slightly better index comparing to the previous age group. At the every age, the hygiene index in children affected by caries is worse comparing to those who aren’t affected by it (p <0,05). In children from the high school affected by caries the level of of the oral cavity hygiene ranges from 2,27 ± 0,09 in 11 years to 2,60 ± 0,21 in 10 years. These results correspond to the unsatisfactory level, but probable age differences were not discovered. Children without caries have “satisfactory” level of oral hygiene in 10 years and 11 years old and “good” level at 12 and 13 years. Thus, we observe the improvement of oral hygiene level in children with increasing of their age, especially for those with intact teeth comparing to the primary schoolchildren.
 High school children (Group III) also had an unsatisfactory average hygiene index (2.34 ± 0.10 points) and unsatisfactory rates of caries for children, which corresponded to the indices of I and II observed groups. In children who had no carious lesions detected the level o oral f hygiene at 14, 15 and 16 years was “good”. This fact indicates improvement of manual skills on oral health care of high school children.
 For more objective study concerning the oral hygiene cavity of different children, the Green-Vermillion’s index was also used. It makes possible assessment the state of the entire oral cavity.
 The average index of oral hygiene in children of the Ist group corresponds to the average value and is evaluated as “satisfactory” state of oral hygiene (Table 2). In children with caries (1.29 ± 0.09 points) and with intact teeth (0.99 ± 0.04 points) we observe the corresponding clinical situation. Significant changes were found in children of 9 years with intact teeth comparing to 6, 7 and 8 years old children. Thus, we observe an improvement of oral hygiene skills in children from elementary school.
 Children without caries lesions of the ІІnd and ІІІrd research groups have “satisfactory” and “good” of oral hygiene level. For those with caries in all age periods the result is “satisfactory”. The index of oral hygiene for children with and without caries have significant difference.
 In order to assess the level of oral hygiene objectively the preference should be given to Green-Vermillion’s index. Particular attention should be paid to the level of oral hygiene of children from elementary school pupils, since it is worse comparing to the oral hygiene level of children from secondary and high school. We do not observe a significant improvement in oral hygiene in senior children comparing to ones from secondary school. This causes the necessity in constant education and control over oral cavity care in schoolchildren.

Myiasis is a disease caused by the invasion of tissues by larvae of flies. The aim of this study was to carry out a review of reported cases of oral and maxillofacial myiasis in older adults and to show a case report of oral myiasis in a 95-year-old frail man with severe Alzheimer's disease from Brazil. Between 1988 and 2017, 35 oral and maxillofacial myiasis cases were reported in older adults in English-language studies from PubMed and Lilacs databases. Oral and maxillofacial myiasis in older adults showed low incidence and good prognosis of cure, when there were no systemic complications. Weakness, frailty, dementia, oral lesions, labial incompetence, poor oral hygiene, and bad breath were associated with this disease in reported cases. Preferential therapy choices were debridement alone or combined with Ivermectin. In this case report, debridement and Ivermectin prescription was an effective therapy for an older adult with severe Alzheimer's disease.

ABSTRACTOral myiasis is a rare disease caused by infestation of larvae of certain dipteran flies. It is reported mostly in developing, tropical countries. The warm and humid climate along with local factors, such as poor oral hygiene and neglect forms a conducive environment for larvae and predisposes toward the disease. This disease often manifests in patients with low socioeconomic backgrounds, debilitating condition, and poor living conditions. Herein, we describe a series of three cases of different presentations of oral and facial myiasis and also discuss the predisposing factors and challenges in the treatment by reviewing a list of 62 cases in recent literature.Through this review and reports, we hope to spread awareness regarding the not so uncommon, but easily preventable disease of oral myiasis and initiate proper research in this neglected section of disease.How to cite this articleNatarajan S, Mistry YA, Mistry T, Kokal S. Oral Myiasis—A Pauper's Affection: Case Reports and a Review of 62 Cases. J Contemp Dent 2017;7(1):62-70.

Myiasis is an infestation of vertebrates with dipteran larvae. In humans myiasis of cutaneous wound is common and that of the oral cavity is less common. Oral myiasis occurs due to deposition of eggs by the female fly belonging to Chrysomyabezziana. The condition is common in patients unable to maintain proper oral hygiene such as mentally challenged individuals, epileptic patients, patients with cerebrovascular accidents and those with non-healing oral ulcers. Predisposing factors include mouth breathing, incompetent lip seal, alcoholism, halitosis, poor oral hygiene, disability, senility, facial trauma, periodontal diseases and oral extraction wounds. Presence of oral myiasis in patients who are medically stable and able to maintain good oral hygiene is rare. Due to increasing incidence of alcoholism, myiasis can also occur in those who cannot maintain a lip seal. Here we present a case of oral myiasis in a medically stable male individual with chronic alcoholism and discuss the entomological aspect, identification and management. Key Words: Screw Worm Infection; oviposition; larva; diptera

Oral myiasis is a rare condition caused due to larvae infestation within the oral cavity. This can be caused by several species of fly larvae and is usually secondary to severe uncontrolled physical or mental illness. Common predisposing factors for oral myiasis are incompetent lips, poor oral hygiene, anterior open bite, mouth breathing, facial trauma and oral carcinoma in a mentally challenged patient. In this case report we describe a case of oral myiasis of the anterior palate in a hemiplegic patient harbouring more than 100 larvae.

Nieweglowska Anna, Borkowska Karolina, Osica Piotr, Janas-Naze Anna. Evaluation of patients' knowledge and awarness of oral cavity hygiene's influence on cardiovascular diseases. Journal of Education, Health and Sport. 2017;7(11):281-287. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1069594 http://ojs.ukw.edu.pl/index.php/johs/article/view/5079 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.11.2017. Revised: 21.11.2017. Accepted: 30.11.2017. EVALUATION OF PATIENTS' KNOWLEDGE AND AWARNESS OF ORAL CAVITY HYGIENE'S INFLUENCE ON CARDIOVASCULAR DISEASES Anna Nieweglowska, Karolina Borkowska, Piotr Osica, Anna Janas-Naze Anna Nieweglowska Dr, Karolina Borkowska Dr, Piotr Osica PhD, Anna Janas-Naze PhD Assoc. Prof. Anna Nieweglowska ORCID ID: 0000-0003-4504-5037, e-mail: karoborkowska@wp.pl Karolina Borkowska ORCID ID: 0000-0003-0310-8300 Piotr Osica ORCID ID:0000-0002-6436-5442 Anna Janas- Naze ORCID ID:0000-0001-6885-4457 Department of the Oral Surgery, Central Clinical Hospital, Medical University of Lodz Head of the Department: Anna Janas- Naze, PhD, Assoc. Prof. Corresponding author: Piotr Osica Department of Oral Surgery, Medical University of Lodz 92-213 Łodź, ul. Pomorska 251, tel. 42 675 75 29 The article is financed by Medical University of Lodz as a part of stautory activity nr 503/2-163-01/503-01 Abstract: Introduction: Cardiovascular diseases including heart attack and stroke are the main cause of death in Poland. Out of the numerous bacteria that inhabit oral cavity, some are responsible for periodontitis. There is a confirmed correlation between chronic inflammation and cardiovascular disease. Aim of the study: The aim of study is evaluation of patients’ knowledge and awareness of the correlation between the oral health and the occurrence and development of cardiovascular diseases, especially atherosclerosis. Materials and Methods : The study included 150 patients from three locations in Lodz: Electrocardiology Clinic of Medical University of Lodz, a multi-profile clinic in Lodz and Oral Surgery Department of Medical University of Lodz. Each patient filled a questionnaire which contained demographic data (age, sex, place of residence, education), questions related to the oral cavity (a subjective estimate of the patient’s own oral hygiene, frequency of teeth brushing, last visit to the GDP), and five questions about the influence of the oral hygiene on the cardiovascular system with three options: Yes, No, and I don’t know. Results : Most patients realize that decayed teeth can cause inflammation in the body and influence the development of cardiovascular diseases. On the other hand, only less then half of the patients have knowledge about correlation between oral health and development of atherosclerosis. Conclusion : Increasing patients’ knowledge about the oral health and hygiene, the condition of the dentition and gums, and the overall health, including heart diseases, is a very important aspect of dentists’, general practitioners’ and cardiologists’ work. Patients are aware of the influence of the oral hygiene on their health but their knowledge needs to be deepened and systematized. Key words: oral hygiene, cardiovascular diseases, atherosclerosis

Objective To understand the real experience of oral hygiene care of perioperative oral cancer patients. Methods Qualitative descriptive research was adopted. Semi-structure in depth interviews were conducted among 17 postoperative oral cancer patients. NVivo 11 was used to manage and sort out the original data, data was analyzed with the content analysis of Colaizzi. Results Six themes regarding oral hygiene care was extracted, including the diversity of methods of oral hygiene and the care provider, patients have limited knowledge about oral hygiene care and the relative education is lacking, the change of function, structure and the degree of comfort of mouth impact the oral hygiene care, patients′ feedback on oral hygiene care is complicated, patients′ oral care related emotional experience is rich, oral hygiene care experience of elderly and non-elderly patients with oral cancer has few difference. Conclusions The oral hygiene care of perioperative oral cancer patients needs to be further standardized, the instruction of patients′ oral hygiene care needs to be enhanced, more attention should be paid to the popularization of disease knowledge, so as to optimize patients care and do a good job in disease prevention. Key words: Oral neoplasm; Perioperative period; Oral care; Qualitative study

Myiasis is a rare disease primarily caused by the invasion of tissue by larvae of certain dipteran flies. Oral myiasis is still more “rare” and “unique” owing to the fact that oral cavity rarely provides the necessary habitat conducive for a larval lifecycle. Common predisposing factors are poor oral hygiene, halitosis, trauma, senility, learning disabilities, physically and mentally challenged conditions. Oral myiasis can lead to rapid tissue destruction and disfigurement and requires immediate treatment. Treatment consists of manual removal of maggots from the oral cavity after application of chemical agents. Good sanitation, personal and environmental hygiene and cleanliness and special care for debilitated persons are the best methods to prevent oral myiasis. This case report describes the presentation of oral myiasis caused by musca nebulo (common house fly) in a 40-year-old male patient, with recent maxillofacial trauma. The patient was treated by manual removal larvae by topical application of turpentine oil, followed by surgical debridement of the wound and open reduction and internal fixation of the fracture.

Myiasis is considered a dermatozoonosis infestation caused by infestation of dipteran larvae in tissues or organs, which lay their eggs in humans or animals, which for a certain period feed on living or dead tissues of the host the occurrence of myiasis in the oral cavity can be considered a rare thing. This type of disease most often affects people of low socioeconomic status, immunocompromised, bedridden elderly and with psychiatric disorders. Due to its great destructive potential, a timely and important appropriate prevention and treatment, there is also little knowledge of the dental professional for the diagnosis and treatment of such pathology, For this reason, the present study reports a clinical case of oral myiasis in an elderly person bedridden with a history of malignant laryngeal/glottal neoplasia injury, presenting physical and mental weakness and inadequate body hygiene and lack of lip sealing that led to the infestation of larvae in the tongue. The diagnosis was clinically established based on observation of tongue bleeding, tissue detachment, and presence of larvae that were between the second and third stages of development. Treatment was initiated as hospitalization of the patient for debridement of necrotic tissues and removal of larvae and prescription of ivermectin. Bedridden patients with physical and metal weakness constitute a risk group for oral myiasis, and it is of great importance to guide caregivers and family members in relation to dental care in order to prevent this pathology. However, the lack of a consensus on the best therapeutic approach for cases of oral myiasis was taken as therapeutic conduct for the disease the mechanical removal of larvae and institution of oral use of ivermectin.

The study aimed to evaluate school-based hygiene education, protective and psychosocial factors associated with suboptimal (not always) hand hygiene (SHH) and suboptimal (not always) oral hygiene (SOH) among school-aged adolescents in the Philippines. The 2019 national Philippines Global School-based Student Health Survey (GSHS) provided the study’s data. In order to determine the variables associated with SOH, SHH before meals, SHH after toilet use and SHH with soap, the study used bivariate and multivariable logistic regression analysis. The prevalence of SOH was 18.5%, SHH before meals 41.2%, SHH after toilet use 27.9%, and SHH with soap 48.5%. Regression results showed that taught on personal hygiene and taught on healthy eating were protective against SOH, SHH before meals, and SHH after toilet use, and taught on personal hygiene was inversely associated with SHH with soap. Furthermore, high parental and peer support were both negatively associated with SOH, SHH before meals, SHH after toilet use, and SHH with soap. In addition, several psychosocial and sociodemographic factors were found associated with SOH and SHH indicators. The survey showed suboptimal oral and hand hygiene practices. Hygiene education was protective against SOH and SHH after toilet use, SHH before meals, SHH with soap. Further factors associated with SOH and/or SHH included lack of parental and peer support, and several health risk behaviours, which can be targeted in hygiene promotion among adolescents in the Philippines.

Myiasis is an infestation of live humans or animals with dipterous larvae that feed on the host's live or dead tissue. The incidence of oral myiasis is rare and even less common in children. Poor oral hygiene, neurological disabilities, bedridden or locomotor disabilities, low socioeconomic status, malnutrition, etc., are shown as important predisposing factors. A 6-year-old female child reported a chief complaint of swelling, pain, and bleeding in the upper front teeth region for 1 day. Extraoral examination showed swelling of the right anterior region involving the upper lip and persistent mouth opening. Intraoral examination revealed ulceration on the anterior labial gingiva and crawling of maggots on the anterior labial aspect with seeming communication with the palatal aspect. Mechanical removal of maggots and debridement followed by antibiotic application and resorbable suture placement was done. Fourteen-day follow-up showed satisfactory healing. Myiasis is a serious condition that requires public measures aimed at controlling flies, along with the implementation of basic sanitation and maintaining good oral and personal hygiene, for its eradication. Oral myiasis is a rare condition. The mean age of affected individuals at diagnosis is usually 41.9 ± 27.2 years. The age of the patient in this case report is 6 years with a comorbidity of cerebral palsy. Gudipati M, Jampanapalli SR. Oral Myiasis in a 6-year-old Child with Cerebral Palsy: A Case Report. Int J Clin Pediatr Dent 2024;17(11):1281-1284.

Myiasis is a rare disease caused by invasion of tissue by larvae of certain dipteran flies. It is more common in countries with tropical climate. Oral myiasis is not a very common condition and many clinicians are unaware of its diagnosis. Common predisposing factors are poor oral hygiene, halitosis, trauma, senility, learning disabilities, physically and mentally challenged conditions. Oral myiasis can lead to rapid tissue destruction and disfigurement and requires immediate treatment. Treatment consists of manual removal of maggots from oral cavity after application of chemical agents. Use of antibiotics reduces the duration of infection and hastens the recovery period. Good sanitation, personal and environmental hygiene and cleanliness and special care for debilitated persons are the best methods to prevent oral myiasis.