History Of Systemic Diseases Research Articles

A case report: Coronally advanced flap using connective tissue graft for root coverage in gingival recession

Background: Aesthetics is becoming more of a concern for patients in the current era of dentistry. Gingival recession is a clinical condition related to patient aesthetics and frequently encountered complaints. Gingival recession is a condition where the root surface is exposed due to apical migration from the gingival tissue margin to the cementoenamel junction. There are various types of treatments to treat patient’s complaints of gingival recession, both non-surgical and surgical. One of the treatments that can be chosen is the coronally advanced flap technique using a graft originating from the patient himself, which will be discussed further in this case report. Purpose: The purpose of writing this article is to describe a coronally advanced flap technique using a connective tissue graft for root coverage in gingival recession Case: A 21-year-old male patient came to the periodontics specialist clinic of RSGM Universitas Airlangga Surabaya complaining of wanting to treat the upper right gum that looked raised and sometimes felt sore. The patient had used braces and had them removed about 1 year ago. The patient brushes his teeth in the morning when taking a shower and at night before going to bed. The patient does not smoke, has no history of systemic diseases, and has no allergies. Case Management: The treatment plan involved dental health education, scaling root planning, and evaluation, followed by coronally advanced flap + CTG. After surgical therapy, the maintenance phase was continued with periodic checks.

Prevalence of Oral Ulcers among a Sample of Patients in Aden City, Yemen

Background: Oral ulcers are generally painful lesions that related to various conditions developing within the oral cavity. The main aim of this study is determining the prevalence of oral ulcer among Sample of Patients in Aden City, Yemen. Methodology: This cross-sectional study was carried out among 11-65 years old patients. The data was collected using convenience sampling technique and 841 patients were surveyed, the sampling was collected from dental patients at Aden University and University of Science and Technology and other public health centers from June 2021 to July 2022. The data were collected using a self-reported questionnaire; the questionnaires adapted from other studies on the same topic and had two sections. Results: The study sample was 841 patients, about 369 patients of the total sample were had oral ulcers, this makes the overall prevalence (43.9%). Males were 388 (46.1 %) cases less than females 453 (53.9%) with statistically significant difference (P=0.043), most of the study participants were single (651, 77.4%, P=0.001). Regarding the systematic diseases, 151 (18.0%) of the patients reported that they had a history of systemic diseases (P=0.009). History of using drugs was reported by 130 (15.5%) of the cases (P=0.001). Conclusion: the prevalence of oral recurrent ulcers among the patient of Aden City, Yemen was high. Females were more commonly affected than males. The most common site was gingiva followed by lips and tongue. Gender, marital status, using medications, and systemic diseases were the associated factors for occurrence.

A cross-sectional study of tongue disorders among dental outpatients

PurposeThe tongue is a complex organ that can provide insight into oral and systemic conditions. A variety of disorders, such as geographic tongue, hairy tongue, fissured tongue, macroglossia, microglossia, and others, can be observed. The objective of this cross-sectional study, conducted on a cohort of dental patients, was to examine the prevalence of tongue disorders and their relationship with factors such as demographic data, oral hygiene practices, history of systemic diseases, and bad habits. MethodThe tongues of 772 dental outpatients, comprising 355 males and 417 females, were examined in detail, and the factors associated with tongue disorders were noted. ResultsThe prevalence of tongue disorders was 32.6 %. The remaining tongue disorders were as follows: fissured tongue (12.1 %), macroglossia (7.1 %), geographic tongue (3.4 %), hairy tongue (3.6 %), coated tongue (3.4 %), median rhomboid glossitis (0.5 %), ankyloglossia (0.4 %), glossitis (0.4 %), and microglossia (0.1 %). The most prevalent tongue disorder observed in the study cohort was fissured tongue, while both bifid tongue and idiopathic burning tongue syndrome were absent. The prevalence of macroglossia, fissured tongue, and hairy tongue was significantly higher in males than in females (p < 0.05, p < 0.05, p < 0.05, p < 0.005, respectively). A statistically significant difference was observed in the frequency of macroglossia, furred tongue, hairy tongue, and glossitis between age groups. ConclusionThe findings of this study identified the most common tongue disorders and their relationship with factors such as systemic history, demographic factors, oral hygiene care, bad habits, and systemic diseases. The significance of tongue appearance in providing insight into the systemic and oral condition of the patient has once again been demonstrated.

Clinicodemographic Features of Plica Neuropathica: A Cross-Sectional Prospective Study.

Plica neuropathica (PN) is an acquired hair disorder characterized by sudden onset, irreversible hair matting, which seems to be a compact hair mass with irregular twists. This study aimed to evaluate the clinicodemographic features of PN. This study was a cross-sectional prospective clinical research that included patients with PN. All the included patients were subjected to a detailed history of clinicodemographic data and clinical with trichoscopic examinations of the affected hair and scalp. This study included 18 female patients with PN, with a mean age of 23.94 ± 7.9 years. All the patients presented with PN had acute onset and progressive course, psychological stressful factors preceding PN, negligence of hair care, no history of hair care product use, no history of hair straightening, no previous treatment preceding PN, and no history of systemic diseases. Recurrence of PN was reported in 4 (22.2%) patients. On trichoscopic evaluation, all patients were presented with normal scalp and matting of hair shaft with honey-colored concretions mimicking the "wrangled mesh of wires" appearance. Sixteen (88.9%) patients were treated with cutting hair mass. Most of the included patients reported very large and extremely large effects on the quality of life. This study concluded that PN is an uncommon acquired hair matting disorder prevalent in young age females. It is associated with marked impairment of the patient's quality of life. Psychological stressful factors and negligence of hair care are the main risk factors for PN. Regular hair care measures are essential to prevent hair matting.

Clinical Features and Histopathological Analysis of Oral Lichen Planus: An Analysis of 105 Chinese Patients.

To study the clinical and pathological characteristics of oral lichen planus (OLP) in a large sample. A comprehensive analysis was conducted on 105 patients with oral lichen planus (OLP), considering various factors including sex, age, disease site, lesion type, lesion area, morphological characteristics, self-reported symptoms, and history of systemic diseases. Histopathological examination was performed for each patient, and the pathology results were analysed according to sex and age group. 70.5% of the OLP patients were female, and OLP was most likely to occur in the cheek, followed by the tongue, lips, gums and palate. The patients with moderate pain according to the VAS score accounted for 60%. Thirty-nine percent of the OLP patients had a systemic disease, and the most common clinical type of OLP was nonerosive. Most of the pathological results showed liquefaction degeneration of basal cells and infiltration of lamina propria lymphocytes. There was no statistically significant difference in pathological manifestations between male and female patients, and there were statistically significant differences in pathological manifestations among different ages patients. This study analysed the sociodemographic data and clinical manifestations of 105 OLP patients to guide follow-up treatment planning and disease monitoring. Moreover, pathological manifestations should be analysed to avoid delayed treatment and to monitor for carcinogenesis. Furthermore, the correlation of pathological manifestations among OLP patients with different sexes and ages is conducive to further research on the specific differential manifestations and possible underlying mechanisms involved.

Basics of Diagnosis and Treatment of Dry Eye Syndrome During Refractive Surgery

Given the prevalence of refractive surgery in modern ophthalmological practice, when preparing a patient for this type of surgery, it is important to understand the multifactorial mechanism of the development of dry eye syndrome in this group of patients. Analysis of the literature data made it possible to identify key factors in the disruption of the tear formation process after refractive surgery, which include the intersection of the nerve endings of the cornea, which in turn reduces the frequency of blinking and the distribution of the tear film over the ocular surface, and also causes a violation regarding neurotrophic factors secreted by the nerve endings of the cornea . The presence of a postoperative inflammatory reaction, which has a specific course, manifested in a change in the biochemical properties of the tear, damage to the goblet cells of the conjunctiva during the creation of a vacuum during LASIK and SMILE, leading to a subsequent deficiency of mucin in the tear, changes in the curvature of the cornea caused by laser refractive surgery are factors influencing the development of dry eye syndrome after refractive surgery. When preparing a patient for refractive surgery, to reduce the risk of developing severe forms of dry eye syndrome, including corneal ulceration, it is necessary to take into account a history of systemic diseases and allergic reactions, especially in patients with high myopia. The influence of cosmetic procedures, such as eyelash extensions, eyelid tattooing, blepharoplasty, and the use of botulinum toxin in the periorbital area on the course of the postoperative period during refractive surgery, has been poorly studied. Research in this area opens up a new range of opportunities to reduce the incidence of dry eye syndrome in patients after refractive surgery and improve the quality of life of patients and patient satisfaction with the surgical intervention.

REGENERATIVE PERIODONTAL TREATMENT AS MANAGEMENT OF CHRONIC PERIODONTITIS: A CASE REPORT

Introduction: Chronic periodontitis is a chronic inflammatory disease induced by microbes beginning with inflammation of the gingiva and progressing to progressive damage to the tooth supporting structures. Various approaches have been made to treat chronic periodontitis, one of which is regenerative periodontal treatment using bone grafts and platelet-rich fibrin (PRF). History and Clinical Findings: A 32-year-old man came to the Periodontology Department of the Dental and Oral Education Hospital with chief complaints mobility of upper and lower teeth. Clinical examination showed that patient did not have a history of systemic diseases and the patient did not smoke. Intraoral examination showed that the maxillary front teeth grade 1 mobility and the average pocket depth in the maxillary and mandibular anterior teeth was 5 mm. Case Management: Case management includes initial therapy followed by surgical treatment which includes open flap, placement of bone graft and PRF, followed by frenectomy, then suturing and application of a periodontal pack. At 1 month after treatment, the surgical flap phase was continued for the mandibular anterior teeth using a combination of bone graft and membrane placement. Discussion: Bone graft and PRF are used to regenerate furcation defects and their ability to regenerate hard and soft tissue is due to the release of various growth factors. Conclusion: Regenerative surgical treatment in chronic periodontitis patients provides effective results in alveolar bone regeneration and decrease pocket depth.

Genetic underpinnings explored: OPA1 deletion and complex phenotypes on chromosome 3q29

BackgroundCopy number variations (CNVs) have emerged as significant contributors to the elusive genetic causality of inherited eye diseases. In this study, we describe a case with optic atrophy and a brain aneurysm, in which a de novo CNV 3q29 deletion was identified.Case presentationA 40-year-old female patient was referred to our department after undergoing aneurysm transcatheter arterial embolization for a brain aneurysm. She had no history of systemic diseases, except for unsatisfactory best-corrected visual acuity (BCVA) since elementary school. Electrophysiological tests confirmed the findings in retinal images, indicating optic nerve atrophy. Chromosomal microarray analysis revealed a de novo deletion spanning 960 kb on chromosome 3q29, encompassing OPA1 and six neighboring genes. Unlike previously reported deletions in this region associated with optic atrophy, neuropsychiatric disorders, and obesity, this patient displayed a unique combination of optic atrophy and a brain aneurysm. However, there is no causal relationship between the brain aneurysm and the CNV.ConclusionIn conclusion, the optic atrophy is conclusively attributed to the OPA1 deletion, and the aneurysm could be a coincidental association. The report emphasizes the likelihood of underestimating OPA1 deletions due to sequencing technology limitations. Recognizing these constraints, healthcare professionals must acknowledge these limitations and consistently search for OPA1 variants/deletions in Autosomal Dominant Optic Atrophy (ADOA) patients with negative sequencing results. This strategic approach ensures a more comprehensive exploration of copy-number variations, ultimately enhancing diagnostic precision in the field of genetic disorders.

Umbilical Cord Wraps around a Newborn's Legs like Ankle Shackles.

A 36-year-old woman, gravida 3, para 1 (previous cesarean section), with one medical abortion, and no history of systemic diseases presented an unremarkable medical history during prenatal visits. The final prenatal ultrasound at 38 weeks of gestation showed a vertex presentation, a weight of 2600 g, a normal amniotic fluid level, and the placenta located on the posterior wall of the uterus. Fetal cardiotocography conducted before delivery reported a reactive heart rate without decelerations. The Doppler wave analysis of the fetal umbilical artery was normal (the ratio of peak-systolic flow velocity to the end-diastolic flow velocity was 2.5) without the absence or reversal of end-diastolic velocity. The total score of the fetal biophysical profile by ultrasound was 8. The night before the scheduled cesarean section, she experienced heightened anxiety and was unable to sleep, noting "crazy" fetal movements throughout the night. During the cesarean section, it was discovered that the umbilical cord was wrapped around the newborn's legs, resembling ankle shackles. The fetal weight was 2740 g, and Apgar scores were 9 at the first minute and 10 at the fifth minute. The motility of the neonatal legs was normal without cyanosis or neurological adverse outcomes.

Association Between Oral Behaviors and Painful Temporomandibular Disorders: A Cross-Sectional Study in the General Population.

Studies have reported correlations between various oral behaviors and painful temporomandibular disorders (TMD), yet comprehensive research on the independent effects of each oral behavior within the general population remains sparse. This cross-sectional study aimed to investigate the association between painful TMD (PT) and various oral behaviors in general population. A questionnaire survey was conducted with participants to collect data encompassing demographic characteristics, eight specific oral behaviors, and the 5 major TMD symptoms(5Ts) checklist. Participants were categorized into PT and non-PT (NPT) groups based on their responses to the 5Ts checklist. Those reporting TMJ/facial pain or headaches were assigned to the PT group, while all other participants constituted the NPT group. Both univariate and multivariate logistic regression analyses were employed to evaluate the association between individual oral behavior and the presence of PT, controlling for demographic confounders including age, sex, systemic diseases, and dental treatments history. A total of 441 valid questionnaires were received, including 156 males and 285 females. The prevalence of PT was identified to be 33.33%, with 61.00% of participants engaging in one or more types of oral behaviors. Each oral behavior was more frequently reported in the PT group compared to the NPT group. The univariate logistic regression analysis identified positive correlations between all eight oral behaviors and PT. In the multivariate logistic regression analysis, these associations persisted after adjustment for demographic confounders including age, sex, history of systemic diseases and dental treatments (P<0.01). The behaviors most strongly associated with PT were "Hold or jut jaw forward/to the side" (OR:4.478), "Hold, tighten or tense muscles without clench" (OR:3.343) and "Hold jaw in rigid or tense position" (OR:3.209). The presence of oral behaviors has significant association with PT. Individuals exhibiting multiple oral behaviors are more likely to experience PT. Additional studies are needed to clarify the effects of reducing oral behaviors on pain-related symptoms.

Symptoms, Electrolyte Disturbances and Serum Albumin Levels in Palliative Oncology Patients Admitted Through Emergency: Characteristics and Survival Outcomes.

Our research aimed to examine the characteristics of palliative oncology patients hospitalised through an emergency to look for the symptom profile, characteristics of dyselectrolytemia and blood investigations, and possible associations with mortality. After institutional review board approval, a retrospective, observational study of patients hospitalised in our tertiary care specialty oncology hospital was undertaken. Records of hospitalised cancer patients admitted from the emergency department under palliative care from January 2019 to October 2021 were examined. As all admissions during this period were through emergency due to institution COVID-19 protocols, all elective admissions were excluded from the study. Data collected included patient characteristics, blood investigations, and comorbid history of systemic diseases and factors that could be associated with electrolyte imbalance. There were 157 emergency admissions during the study period. A majority were patients with solid tumours (92.4%). Pain was the most frequent cardinal symptom, along with other symptoms (68/157) or in isolation (33/157), followed by reduced oral intake (32/157) and altered sensorium (24/157). sixty-six patients died within the hospitalisation period. On long-term follow-up, only 8 (5.1%) were surviving. Hyponatraemia (43%), Hypoalbuminaemia (66%), and altered renal function (33.1%) were prevalent. We observed a weak positive correlation between sodium levels and outcome (r = 0.199, P = 0.016) and a strong positive correlation between albumin levels and survival outcomes (r = 0.329, P = 0.000). Patients with normal albumin had a higher chance of survival (odds ratio: 33.1225, 95% confidence interval: 3.415-321.20, P = 0.003). Pain-reduced oral intake and altered sensorium are common emergency symptoms in oncology palliative care. Mortality is high in these patients. Hyponatraemia, hypoalbuminaemia, and deranged renal functions were commonly seen. Normal sodium and albumin levels were associated with higher chances of survival, and the association was strong for serum albumin levels. This may have prognostic utility.

Ocular Manifestations among Hospitalized COVID-19 Patients in the Southeast of Iran

Background: COVID-19 has a range of manifestations among different patients. Knowing the various manifestations of COVID-19 could help in better managing the infection. This study aimed to investigate the ocular manifestations of hospitalized COVID-19 patients. Methods: In this study, 379 PCR-positive COVID-19 patients hospitalized in Afzalipour hospital, a tertiary care academic medical center in Kerman city, were recruited. Demographic variables (age and sex), history of systemic diseases (diabetes mellitus and arterial hypertension), systemic COVID-19 signs and symptoms (respiratory, gastrointestinal, neurologic, and sensory), and the severity of the disease were evaluated. Patients were asked about ophthalmic symptoms. If a patient had serious ocular complaints, such as ocular pain or vision loss, and needed specialized examination, an ophthalmologist examined the patient. Results: The patients’ mean (standard deviation) age was 54.2 (15.8) years. Overall, 46 patients (12.1%, 95% confidence interval: 9.0–15.8) showed at least one ocular manifestation. The most common signs and symptoms among those with ocular manifestations were redness (n=37, 80.4%), discharge (n=35, 76.1%), lacrimation (n=31, 67.4%), itching (n=15, 32.6%), and dry eye sensation (n=15, 32.6%). Ocular manifestations were more prevalent among those≥60 years old, those with hospitalization days&gt;7 days, those with more severe respiratory system involvement, and diabetic patients. Conclusion: One out of eight COVID-19 inpatients showed at least one ocular manifestation. As tear and ocular secretions are considered a route for coronavirus transmission, it is essential to pay attention to the early detection of ocular manifestations.

Cardiovascular diseases, risk factors, and ulcer relapse in older adults with aphthous stomatitis.

To test the hypothesis that cardiovascular diseases and risk factors are associated with ulcer relapse in after-retirement patients with recurrent aphthous stomatitis. This retrospective cohort study analyzed the data of 40 minor recurrent aphthous stomatitis patients aged 55-75 years, admitted to Oral Medicine Clinic at one university hospital in China between 2016 and 2018. The diagnosis of minor recurrent aphthous stomatitis was made based on the history and manifestation of oral ulcers. The ulcer relapse was evaluated after a 5-week anti-inflammatory treatment, and the history of systemic diseases was collected. cardiovascular disease/metabolic risk referred to the presence of any cardiovascular diseases and metabolic cardiovascular disease risks. Associations among cardiovascular diseases, risk factors, and ulcer relapse were evaluated. The mean age of 40 patients with minor recurrent aphthous stomatitis was 62.4 years (SD 5.1), and 60% were women. The ulcer relapse rate was 37.5% (95% CI, 0.242-0.530). The proportion of cardiovascular disease/metabolic risk was higher in the relapse group than in the no-relapse group after 5-week anti-inflammatory treatment (Fisher's exact test, p = 0.041). According to this single-center experience, older patients with cardiovascular disease/metabolic risk may be more prone to oral ulcer recurrence. Nevertheless, larger prospective studies are needed to confirm our findings.

Differential Diagnostic Indicators for the Appointment of Non-Steroidal Anti-Inflammatory Therapy in the Treatment of Red Eye Syndrome at the Stage of Primary Outpatient Admission. Part 2

In recent years, the Delphi method (DMt) has been widely used in scientific practice. It is based on an expert assessment of the object under study, which is formed on the basis of a survey of a group of experts in a particular field. The application of the Delphi method in various areas of ophthalmological practice has made it possible to develop practical recommendations for the diagnosis of visual stress, methods for diagnosing and treating keratoconus, to develop clinical guidelines for the diagnosis and treatment of patients with Sjögren’s syndrome, to classify the signs and symptoms of dry eye syndrome in accordance with the main mechanism of its occurrence and etc. A survey ophthalmologist expert conducted during the study, performed in accordance with the Delphi method, aimed at developing a differential algorithm in the treatment of patients with one of the most common pathologies among diseases belonging to the category of “red eye syndrome” — conjunctivitis, allowed identify key symptoms for prescribing different groups of drugs. In accordance with the clinical guidelines developed by the Russian Association of Ophthalmologists, the following groups of drugs are recommended for use: antibacterial, antiseptic, antihistamine, non-steroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs, antiviral drugs. This article presents the results obtained in determining the indications for the use of non-steroidal anti-inflammatory therapy in the treatment of conjunctivitis. These include: the presence of a history of systemic diseases, the duration of inflammation for more than 7 days, the absence or presence of mucous discharge, complaints of a feeling of pain, discomfort in the eyes, their redness, as well as biomicroscopic signs of inflammation, which manifest themselves as mild to moderate conjunctival hyperemia expressiveness. The result obtained is of fundamental practical importance for primary outpatient ophthalmologists for choosing rational drug therapy in the treatment of one of the most common pathologies encountered in ophthalmic practice — conjunctivitis. A differentiated approach in choosing the volume and type of drug therapy based on the severity of the inflammatory process will reduce the drug load on the ocular surface. In accordance to the data presented in the first part of this article, it will lead to a decrease the risk of developing signs of dry eye syndrome against the background of a stopped inflammatory process in the long-term period and improving the quality of life in patients.

Medical therapy for conjunctivitis. Literature review

Conjunctivitis, according to various studies, is the most common reason for going to the initial outpatient appointment and can be caused by several factors at the same time. Treatment is carried out comprehensively, depending on the clinical picture, somatic status and anamnesis data. In accordance with the clinical guidelines developed by the Russian Association of Ophthalmologists, the following groups of drugs are recommended for use: antibacterial, antiseptic, antihistamine, nonsteroidal anti-inflammatory drugs.Purpose: to analyze the use of the above groups of drugs in the treatment of conjunctivitis in order to recommend a reasonable prescription of the necessary therapy.Materials and methods. The literature data on the study of the features of the action of the above pharmacological groups in the treatment of conjunctivitis, obtained on the resources of PubMed, eLibrary, Crossref Metadata, mainly over the past 20 years, are presented.Results. The presence of signs of an allergic reaction involves the appointment of antiallergic drugs with multiple pharmacological effects – blockade of histamine receptors, stabilization of mast cell membranes and suppression of eosinophil filtration. Given the different mechanisms of action within this group of drugs, it is necessary to select them individually. When prescribing tablet forms of antihistamines, it must be remembered that with prolonged use, they can cause patients to feel dry in their eyes. In cases where the above antiallergic drugs do not adequately control the allergic inflammatory process, anti-inflammatory drugs are used. Nonsteroidal and steroid anti-inflammatory drugs are used as anti-inflammatory drugs. Usually nonsteroidal anti-inflammatory drugs are recommended for use in chronic conjunctivitis and patients with a history of systemic diseases. Steroid drugs are indicated for severe forms of manifestation of the allergic process on the eyes, as well as the appointment of steroid anti-inflammatory drugs is recommended for use in short courses (up to 2 weeks), and with their longer use, control of intraocular pressure is necessary. Literature data indicate the lack of efficacy of antiviral drugs such as acyclovir and others from this group in the treatment of conjunctivitis of adenoviral etiology. Drugs with an immunomodulatory effect based on interferon or inducers of interferon synthesis are widely used. The prescription of antibiotics should be justified, since in recent years the level of resistance to them has significantly increased. Antiseptics that have a wide spectrum of action (bacteria, viruses, fungi and protozoa) are an alternative to antibiotics, but it must be remembered that this group of drugs often causes allergic reactions.Conclusion. The treatment of conjunctivitis must be approached carefully, taking into account not only the etiology of the disease, but also the somatic and immune status of the patient. To avoid the negative effects of the use of antibiotics, replace them with alternative drugs and do not use them in the treatment of conjunctivitis of a non-bacterial nature.

Surgical Root Coverage of Miller’s Class III Using Free Gingival Autograft (A Case Report)

Background: Gingival recession is a condition where the root surface of the tooth is exposed due to migration of the gingival margin and junctional epithelium in an apical direction. The problem that patients often complain about due to gingival recession is an aesthetic problem, especially if the recession occurs in the upper anterior teeth. In addition, gingival recession can also cause dentine hypersensitivity due to the exposure of the root surface that was previously covered by the gingiva. One of the treatment options for patients with gingival recession is free gingival autograft surgery. Purpose: The goal of this article is to explain how to manage gingival recession therapy with free gingival autograft surgery in patients with Miller Class III recession. Case: A 29-year-old female patient came to RSGM Airlangga University with complaints of hypersensitivity in the front teeth at the lower jaw. The last scaling took place about 6 months ago. The patient does not have a history of systemic diseases, such as hypertension and diabetes, and the patient does not have allergies to either drugs or food. Case Management: Based on the examination that has been carried out, the treatment option for Miller's class III gingival recession in the tooth region 41 is agreed to be a free gingival autograft. Conclusion: One of the root coverage treatment options is free gingival autograft, where this procedure can also increase the width of the attached gingiva.

Candida-related lesions dalam rongga mulut: diagnosis dan strategi penatalaksanaanya

Background: Candida–related lesions can present as denture sore mouth intraorally and cheilitis angular extra orally. Some predisposing factors include ill-fitting dentures, malnutrition, and poor oral hygiene. Objective: To determine the proper diagnosis and management of sore mouth dentures and cheilitis angular in patients with ill-fitting dentures and bad oral hygiene. Case report: A 59-year-old male patient presented with a burning sensation on the hard palate and sores at the corners of the lips, which were aggravated by the meal and opening of the mouth. No history of systemic diseases was found. Extra-orally erythema fissure lesions were found surrounded by multiple white areas at the corners of the lips bilaterally and were painful. Intra-oral examination showed erythema macular lesions that extend to the gingiva and palate mucosa that contact the denture base. Nystatin oral suspension combined with fluconazole, and multivitamins as supportive therapy. Educational suggestions such as the replacement of dentures and improve oral hygiene conditions were given. Conclusion: Denture sore mouth and cheilitis angular in this case are caused by Candida albicans related to the insufficient denture and poor oral hygiene. Management for this case by providing causative treatment with single or combine antifungal drugs along with proper communication, instructions, and education regarding the diseases.

Radiosynovectomy of the hip joint - preliminary experience.

Radiosynovectomy (RSV) is a minimally invasive method of treating and controlling joint inflammation refractory to conventional pharmacotherapy. It consist in intraarticular injection of radioactive colloids which irradiate the inflamed synovial membrane to cause its subsequent involution. Despite the fact that hip joint involvement is quite common in systemic inflammatory arthropathies, hip joint RSVs are rarely performed. The aim of this paper is to assess to safety and efficacy of hip joint radioisotope treatment. We retrospectively analyzed the effects of 21 hip joint RSVs performed in 14 patients (10 female, 4 male; aged 8 to 79; mean age 48 years). Before the RSV, all the patients underwent clinical and ultrasound examination. The radiosynovectomies were performed using rhenium-186 sulfide under ultrasound guidance. Each patient underwent post-therapeutic scintigraphy to assess intraarticular distribution of the radiopharmaceutical. The effects of the treatment were assessed clinically and ultrasonographically during at least 2 follow-up visits 3 and 6 months after the RSV. In 9 cases, we observed complete resolution of symptoms 3 and 6 months after the RSV. Four patients had only a partial response and required repeated treatment, and all responded well to the second RSV. In 4 patients the treatment had no significant effect, and no repeated treatment attempt was made. All the responders suffered from inflammatory arthropathies; the non-responders had osteoarthritis, with no history of systemic diseases. In all the patients, no significant adverse effects were observed; in particular there were no radiation burns or infections. All post-therapeutic scintigrams showed proper, intraarticular distribution of the radiopharmaceutical. Radiosynovectomy of the hip joint in systemic joint diseases, especially performed using ultrasound-guidance, is a safe and effective treatment modality.

Sedation Quality of Low – Dose Ketamine Combined with Dexmedetomidine versus Propofol in Phacoemulsification under Local Anesthesia: A Triple-Blinded Randomized Clinical Trial

Purpose: To compare the hemodynamic effects of low-dose ketamine combined with dexmedetomidine versus propofol in phacoemulsification under local anesthesia. Place and Duration of Study: School of Medicine, Isfahan University of Medical Sciences during 2020-2021. Methods: Sixty patients admitted for cataract surgery were included. Those with history of systemic diseases, insufficient pupil dilation, sensitivity to drugs and uncooperative patients were excluded. Participants were randomly allocated to two groups; group which was administered ketamine with dexmedetomidine (Ketodex) and group which was given ketamine with propofol (Ketofel). Effect on blood pressure, pulse and sedation was recorded. Results: Mean age was 65 ± 9.9 years. Sixty-five were females. Ketodex increased the risk of hemodynamic disorders compared to Ketofel (P = 0.04). The risk of nausea and vomiting was higher in the Ketodex group although not significant. The effect of drug course on heart rate, blood pressure and sedation was significant in both groups (P &lt; 0.05). Neither at baseline, nor in the 1st and 5th minutes of surgery, was the mean arterial pressure (MAP) was significantly different between the two groups. From 10th minute of surgery until the end of surgery and from the beginning of recovery until the 30th minute of recovery, the MAP and pulse rate were higher in Ketofol group. Sedation effect during surgery was higher in the Ketodex group compared to the Ketofol group, and the difference was statistically significant at minutes 10, 20 and 30 of surgery. Conclusion: There is higher effect of sedation and fewer side effects of ketamine-dexmedetomidine combination compared to the ketamine-propofol combination.

ORAL LYMPHANGIOMA: A CASE REPORT

Lymphangioma is a rare, benign, and congenital malformation of lymphatic vessels, usually occurring in the first two decades of life, without spontaneous regression. A 12-year-old brown male patient, with no history of systemic diseases, complained of an asymptomatic lesion on the tongue that disappeared and appeared every two months, with an evolution of approximately one year. Physical examination revealed a lesion on the dorsum of the tongue on the right side, of unknown cause, with a nodular aspect, irregular surface, sessile implantation and purplish-red appearance. An excisional biopsy was performed, with a histopathological diagnosis of lymphangioma. The patient remains without recurrence of the lesion. The present case emphasizes the importance of understanding rare congenital lesions that may present oral manifestations. Lymphangioma is a rare, benign, and congenital malformation of lymphatic vessels, usually occurring in the first two decades of life, without spontaneous regression. A 12-year-old brown male patient, with no history of systemic diseases, complained of an asymptomatic lesion on the tongue that disappeared and appeared every two months, with an evolution of approximately one year. Physical examination revealed a lesion on the dorsum of the tongue on the right side, of unknown cause, with a nodular aspect, irregular surface, sessile implantation and purplish-red appearance. An excisional biopsy was performed, with a histopathological diagnosis of lymphangioma. The patient remains without recurrence of the lesion. The present case emphasizes the importance of understanding rare congenital lesions that may present oral manifestations.