Mandibular Lesion in an HIV-Positive Patient

Abstract

patient’s CD4 cell count was 58 cells/mm 3 and his viral load was 13,000 copies/mL, his antiretroviral treatment had been changed to zidovudine, didanosine, and nevirapine. An oral examination showed a papillomatous lesion in the alveolar mucosa and interdental papilla, between the lower right canine and first premolar. The lesion was histologically diagnosed as condyloma acuminatum. The lower left first and second premolars had increased mobility, which was also observed in the adjacent alveolar bone. Although the surrounding gingival and alveolar mucosae were erythematous, painful, and swollen, no periodontal pocket was observed during periodontal probing or on panoramic radiographs. The hypothesis of alveolar bone fracture was rejected, because the patient denied any trauma to the affected region (Figs 1A,B). Periapical radiographs showed a radiolucent line that enveloped both the lower left canine and first premolar, from the alveolar ridge to the apical region (Figs 1C,D). Laboratory tests were performed. The levels of lipoproteins, cholesterol, triglycerides, glycemia, bilirubin, and antiphospholipid antibodies were normal, as was the platelet count. Although the patient presented with mild anemia, blood-coagulation tests and a complete blood count were within the reference range. Liver and renal function tests were normal, and his venereal disease research laboratory was negative.