Abstract
Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.
Highlights
Oral and maxillo-facial manifestations of systemic diseases represent an extensive and fascinating study, which is mainly based on the knowledge that many signs and symptoms as numerous systemic disorders may first present as or may be identified by head and neck tissue changes
Human papillomavirus infection may cause several benign clinically papillary lesions in the oral cavity, such as squamous papilloma, (Figure 3a,b) condyloma acuminatum, verruca vulgaris, and multifocal epithelial hyperplasia (Heck’s disease), and it could be associated to the occurrence of potentially malignant lesions and oro-pharyngeal squamous cell carcinoma [18,19,20,21,22,23,24]
Common intraoral findings in Graft Versus Host Disease (GVHD) patients are essentially lichenoid changes of the oral mucosa, erythematous or ulcerated lesions, hyperkeratotic or atrophic mucosal patches, mostly resembling lichen planus and proliferative verrucous leukoplakia (Figure 11a,b) [97,98], Limited mouth opening or salivary gland dysfunction may be related to direct organ involvement and/or to fibrotic or sclerotic involvement of tissues, resembling several autoimmune diseases with oral and maxillofacial manifestations, including SS and scleroderma [96,97,98]
Summary
Oral and maxillo-facial manifestations of systemic diseases represent an extensive and fascinating study, which is mainly based on the knowledge that many signs and symptoms as numerous systemic disorders may first present as or may be identified by head and neck tissue changes. Dentists and general practitioners play a key role in such early identification; the clinical examination of the oral cavity should be performed accurately avoiding unexplored sites and a detailed medical history mandatorily collected. A cytological scrape or an incisional biopsy of suspicious lesions or a fine needle aspiration of doubtful swellings with subsequent cyto-histological examination must be performed whenever deemed necessary to obtain a definitive diagnosis. We review the most common and changeling oral and maxillo-facial findings possibly associated to or manifested at the onset of systemic diseases in adult and pediatric patients, along with diagnostic criteria and indications about differential diagnoses
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