Lingual Ulcer Research Articles

A Case Series Analysis of Dental Extractions' Outcome in Cats with Chronic Gingivostomatitis Carrying Retroviral Disease.

Simple SummaryFeline chronic gingivostomatitis (FCGS) is a chronic, painful, oral inflammatory disease, which can be associated with retroviral disease comorbidity’s, namely feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). A total 111 case series of cats affected by this oral disease, treated with dental extractions, were analyzed retrospectively, considering if they carried or not one of these retroviral diseases. Cats with lingual ulcers, independently from their retroviral status, were 2.7 times more prone to have a worse response to dental extractions than cats without lingual ulcers. When compared with cats without retroviral disease, FeLV-positive cats presented less proliferative lesions and tended to have more lingual ulcers. Furthermore, these cats had a significantly worse outcome, with 7.5 times more chances of having no improvement.This study aims to evaluate and compare the clinical outcome after dental extractions of cats with FCGS infected with feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV). A retrospective case series included cats with diagnosis of FCGS, availability of detailed clinical records, full-mouth dental radiographs, and retroviral disease test results. Effectiveness of surgical treatment (EOT) was registered. Three groups were defined: control, FIV and FeLV. In this study, 111 cats were included: 60 controls, 29 FIV- and 22 FeLV-positive cats. When compared with control cases, FeLV-positive cats had significantly less proliferative stomatitis lesions, and they tended to have more lingual ulcers. Concurrently, FeLV-positive cats had significantly less tooth resorptive lesions. No other significant differences in FCGS clinical signs were found between groups. FeLV-positive cats had a significantly worse outcome after dental extractions compared to the other groups. In fact, FeLV-positive cats had 7.5 times more chances of having no improvement after dental extractions. This study concludes that the response to dental extractions in FeLV-positive cats is significantly worse, when comparing to cats that do not carry retroviral disease. Therefore, it is important to acknowledge the effect of FeLV status on the prognosis of these cats.

Lingual ulcer: An unusual clinical manifestation in lipoid proteinosis

Lingual ulcer: An unusual clinical manifestation in lipoid proteinosis

Natal and neonatal teeth: Clinically relevant findings in a retrospective analysis

BackgroundTeeth present at the time of birth are called natal teeth while the teeth which erupt within 30 days of birth are neonatal teeth. The natal and neonatal teeth are an uncommon occurrence causing extreme anxiousness among the parents because of various myths related to their occurrence in our society. MethodsA retrospective analysis of 12 patients who reported to the dental center between 2012 and 2015 with natal or neonatal teeth was carried out. ResultsOur study sample comprised of 12 patients. The age group ranged from 4 to 27 days in which there were eight male and four female infants. Out of 12 cases, eight cases had history of a physiologic delivery, while four were delivered by C-section. All the teeth were white to yellowish white in color, grade III mobile, and were devoid of roots. Except difficulty in feeding, only one case had a complication because of the tooth which was the development of a small lingual ulcer. Eleven cases were managed by extraction of the natal or neonatal teeth, and in one case, the parents did not consent for extraction. Six infants below 10 days of age were administered inj Vit K prior to the extraction. On follow-up of all the patients families reported that the child was feeding much better after the treatment and there were no complications. ConclusionNatal and neonatal teeth have been causing dilemmas in the minds of pediatricians and dentists world over. Thus, it is important to know the basics about such teeth so that proper guidance can be given to parents and a suitable case specific treatment plan can be formulated.

Relationship between Feline calicivirus Load, Oral Lesions, and Outcome in Feline Chronic Gingivostomatitis (Caudal Stomatitis): Retrospective Study in 104 Cats.

This study was performed to assess the relationship between oral Feline calicivirus (FCV) load and severity of lesions at the time of presentation of cats suffering from feline chronic gingivostomatitis (FCGS) (part 1) and treatment outcome after dental extractions (part 2). We hypothesized that a higher FCV viral load would be positively correlated with the severity of lesions at presentation and negatively correlated with treatment outcome. In addition, the effect of dental extractions on outcome and the influence of preoperative severity of lesions on the outcome were investigated. Cats with FCGS were included in the study if they had been diagnosed with caudal stomatitis, had been tested positive for FCV using a real-time reverse transcriptase-PCR test on oropharyngeal swab, and had dental extractions performed within the authors' department. General practitioners provided all previous medical treatments. Cats with recheck examinations were included in part 2 of the study. Multivariate statistical analysis was performed to assess the relationship between the different parameters. One hundred four cats met the requirements for part 1 and 56 cats for part 2 of the study. Data collected from patients' record included patient history, viral testing results, extent and severity of oral lesions, extent of teeth extraction. Signalment, history, preoperative treatment, and severity of caudal and alveolar stomatitis score were not associated with FCV load (P > 0.05). Presence of lingual ulcers was significantly correlated with FCV load (P = 0.0325). Clinical cure (32.1%) or very significant improvement (19.6%) was achieved in 51.8% of cats within 38 days. Concomitantly, 60.7% of the owners considered their cat cured (41.1%) or significantly improved (19.6%). Extent of teeth extraction was not found to influence the clinical outcome (P > 0.05). The results of this study did not support the hypothesis that FCV oral load is correlated with the severity of oral lesions or with the outcome following dental extractions. In addition, the severity of caudal inflammation was not correlated with healing time or achievement of cure.

Clinical features and histological description of tongue lesions in a large Northern Italian population.

BackgroundOnly few studies on tongue lesions considered sizable populations, and contemporary literature does not provide a valid report regarding the epidemiology of tongue lesions within the Italian population. In this report, the histopathological and clinical appearance of 1.106 tongue lesions from northern Italians are described and discussed.Material and MethodsThe case records of patients referred for the diagnosis and management of tongue lesions, from October 1993 to October 2013, were reviewed. Histological data were also obtained and blindly reexamined.ResultsFor instance, a biopsy performed on a lingual ulcer has a strong predicting association with a carcinoma, whereas a biopsy on a white lesion predicts for a leukoplakia or oral lichen planus. Moreover, a biopsy of erosion is representative of bullous diseases, whereas a biopsy on a verrucous-papillary lesion is significant for fibroma. Furthermore, carcinomas occur in the majority of cases on the lingual edge or pelvis, oral lichen planus is mainly seen on the edge, and fibromas mostly on the lingual tip.ConclusionsThe high frequency of tongue involvement of such different diseases emphasizes the importance of histological characterization and that some diseases occur more frequently than others, with a peculiar clinical aspect and a more common area. In fact our survey can help the clinician in advancing diagnostic hypothesis, on the basis of the elementary lesion and its site of involvement. Key words:Tongue lesions, clinical appearance, histological description.

A 6-Year-Old Girl with a Lingual Ulcer

Lingual ulceration is a rare symptom in the pediatric population, which makes it a diagnostic challenge. It is important to rule out any malignant cause of ulceration. Other causes include syphilitic, herpetic, and mycobacterial infections; physicochemical insults; and self-inflicted trauma (Table). Lingual ulceration has been reported in infants as the result of repetitive mucosal trauma by neonatal teeth (Riga-Fede disease) and in older children with orthodontic appliances.

저산소성 허혈성 뇌병변 환아에서 혀내밀기에 의해 발생된 혀 궤양의 치료: 증례 보고

1. 저산소성 허혈성 뇌병변 환아에서 뇌손상으로 인한 혀내밀기 습관에 의해 외상성 혀궤양이 발생할 수 있으며 Riga-Fede disease로 진단할 수 있다. 2. Riga-Fede disease의 종래의 치료 방법은 하악 유전치의 날카로운 부분을 갈아주는 것, 절단면의 복합레진 수복, 발치 등이 있으며 이번 보고에서는 보존적이며 가역적인 방법인 tongue protector를 제안하였고 혀궤양의 치료 및 혀내밀기습관 개선에 효과적인 것으로 나타났다. Hypoxic ischemic encephalopathy(HIE) is a condition that occurs when the entire brain is deprived of an adequate oxygen supply and associated in most cases with oxygen deprivation in the neonate due to birth asphyxia. Children with HIE develop problems such as cerebral palsy, mental retardation, learning difficulties, and other disabilities. We hereby report the case of treating a child patient with HIE whose chief complaint of severe lingual ulceration. A 12-month-old boy referred to our hospital to treat ulcers of ventral surface of tongue. He has been suffering from lingual ulceration due to persistent tongue thrusting. He has bitten his own tongue involuntary. The ulceration was apparently seemed to be not healed because of the constant irritation by lower incisors. So we designed tongue protector to prevent lingual ulcers. The appliance was proved to be effective to reduce tongue trauma by lower incisors and periodic follow-up is needed.

Pharmacological Protection From Radiation ± Cisplatin-Induced Oral Mucositis

To evaluate if two pharmacological agents, Tempol and D-methionine (D-met), are able to prevent oral mucositis in mice after exposure to ionizing radiation ± cisplatin. Female C3H mice, ∼8 weeks old, were irradiated with five fractionated doses ± cisplatin to induce oral mucositis (lingual ulcers). Just before irradiation and chemotherapy, mice were treated, either alone or in combination, with different doses of Tempol (by intraperitoneal [ip] injection or topically, as an oral gel) and D-met (by gavage). Thereafter, mice were sacrificed and tongues were harvested and stained with a solution of Toluidine Blue. Ulcer size and tongue epithelial thickness were measured. Significant lingual ulcers resulted from 5 × 8 Gy radiation fractions, which were enhanced with cisplatin treatment. D-met provided stereospecific partial protection from lingual ulceration after radiation. Tempol, via both routes of administration, provided nearly complete protection from lingual ulceration. D-met plus a suboptimal ip dose of Tempol also provided complete protection. Two fairly simple pharmacological treatments were able to markedly reduce chemoradiation-induced oral mucositis in mice. This proof of concept study suggests that Tempol, alone or in combination with D-met, may be a useful and convenient way to prevent the severe oral mucositis that results from head-and-neck cancer therapy.

A Survey of Equine Oral Pathology

Dental abnormalities in horses can lead to weight-loss, poor performance, pain, behavioral abnormalities, and illness. Despite this impact, the occurrence and type of dental disease in horse populations is infrequently reported in veterinary medicine. The purpose of this cross-sectional survey of horses presented for slaughter at a processing plant in Western Canada was to measure the prevalence of equine oral abnormalities, examine associations between the most common abnormalities, and consider the relationship between the age of horse and types of abnormalities observed. The horses used in this research consisted of a variety of ages, breeds, body conditions, and origins. Horses ranged in age from 18-months to 30-years (median = 11-years). The most common oral pathologies included sharp edges, buccal abrasions, calculus, lingual ulcers, gingival recession, periodontal pockets, ramps, and waves. Several types of pathology were strongly associated with other dental disorders. The prevalence of periodontal pockets, gingival recession, and waves was highest in older horses.

Prevention of Radiation-Induced Oral Mucositis after Adenoviral Vector–Mediated Transfer of the Keratinocyte Growth Factor cDNA to Mouse Submandibular Glands

The study aims to evaluate if human keratinocyte growth factor (hKGF), secreted after transduction of murine salivary glands with adenoviral vectors, can prevent oral mucositis resulting from radiation. Two serotype 5 adenoviral vectors encoding hKGF were constructed: AdEF1alpha-hKGF and AdLTR(2)EF1alpha-hKGF. Female C3H mice, 8 weeks old, were irradiated by single (22.5 Gy) or fractionated (5 x 8 Gy for 5 days) doses to induce oral mucositis (ulcers on tongue). One day before irradiation, the above viral vectors or an empty vector, Adcontrol, was given (10(10) particles per gland) to both submandibular glands by retrograde ductal instillation. Each experiment included five groups: no irradiation and irradiation (+/-Adcontrol, AdEF1alpha-hKGF, or AdLTR(2)EF1alpha-hKGF). Blood, saliva, submandibular glands, and tongue were collected on day 7 for single-dose studies or day 10 for fractionated dosing. hKGF levels were measured by ELISA. In three separate single-dose irradiation experiments, lingual ulcers were dramatically reduced after either KGF-expressing vector. Similarly, in two separate fractionated irradiation experiments, the hKGF-expressing vectors completely prevented ulcer formation. QPCR data indicated that approximately 10(7) to 10(8) particles of each vector remained in the targeted submandibular glands at the terminal time. Transgenic hKGF protein was found at high levels in saliva, serum, and submandibular gland extracts. hKGF gene transfer to salivary glands prevented radiation-induced oral mucositis in mice. This proof of concept study suggests that transgenic hKGF secreted from transduced salivary glands may be useful clinically to prevent oral mucositis caused by radiation.

Idiopathic lingual fossa ulcer in cattle in Iran

Summary Disease agents that principally target the tongue are relatively rare. It seems that type of food and roughage play an important role to predispose the animals to lingual ulcers. During a period of four years different aspects of cattle lingual fossa ulcer were studied in a semi-industrial dairy farm in Tehran. The affected animals showed various stages of ulcer formation in their lingual fossa. Histopathological examination revealed parakeratotic hyperkeratosis, spongiosis and hydropic degeneration of the epithelial lining. There were also coagulative necroses associated with heavy infiltration of neutrophils in muscle fibers of the tongues. Some cases showed granulomatous reaction with the proliferation of connective tissue. Progressive lingual ulcers were induced in three calves following close exposure to the affected animals. Based on these findings, the disease was diagnosed as idiopathic contagious lingual fossa ulcer in cattle.

Ulcerative Dermatitis, Thrombocytopenia, and Neutropenia in Neonatal Foals

This report describes transient ulcerative dermatitis, severe thrombocytopenia, and mild neutropenia in 6 foals from 4 mares from geographically diverse regions of the United States. The foals presented at <4 days of age with oral and lingual ulcers, and crusting and erythema around the eyes, muzzle, and perineal, inguinal, axillary, trunk, and neck regions. There was a severe thrombocytopenia (0-30,000 platelets/microL), leukopenia (1900-3200 white blood cells/microL), and mild neutropenia (500-1800 neutrophils/microL). Four of the 6 foals had petechiae and ecchymotic hemorrhages and 3 had bleeding tendencies. Results of examination of a bone marrow biopsy from 1 foal were normal and results of a platelet surface immunoglobulin test in another were negative. Histopathology of the skin in all foals showed subepidermal clefting with subjacent vascular dilation, dermal hemorrhage, and superficial papillary necrosis. The foals were treated supportively with broad-spectrum antibiotics (5/6), corticosteroids (3/6), gastric ulcer prophylaxis (6/6), whole-blood transfusion (4/6), and platelet-rich plasma (1/6). The skin lesions and thrombocytopenia (>50,000 platelets/microL) improved in 2 weeks (4/6). Two foals had a decline in their platelet counts when the steroids were decreased and needed protracted treatment. All foals survived and were healthy as yearlings. Two mares that had 2 affected foals each, upon subsequent pregnancies to different stallions, had healthy foals when an alternate source of colostrum was given. The findings in the cases in this report suggest a possible relationship between colostral antibodies or some other factor in the colostrum and the thrombocytopenia and skin lesions, although further investigation is warranted to confirm or refute this hypothesis.

Oral lesions in children with perinatally acquired human immunodeficiency virus infection.

Fifteen vertically HIV-infected children aged between 2 and 12 years were followed up for 1 year, weekly to monthly, to study the incidence of oral lesions. At the time of first examination, oral candidiasis (OC) was observed in nine children. Seven children presented with the erythematous type only and two with pseudomembranous oral candidiasis. Four cases of cheilitis were seen in association with the erythematous forms of oral candidiasis. One erythematous candidiasis progressed to pseudomembranous form. A second case of erythematous OC, after multiple recurrences in the form of erythematous OC, recurred as pseudomembranous OC. Another case of erythematous OC and one of pseudomembranous OC presented after multiple recurrences as a persistent, adherent pseudomembranous OC. An orofacial herpes-zoster infection, a hairy leukoplakia and a necrotic lingual ulcer were observed as second lesions and in association with oral candidiasis in three children. Erythematous oral candidiasis was the most frequent oral HIV-related lesion, was observed in different stages of HIV-infection, and in some cases progressed to pseudomembranous candidiasis. A different, selectively resistant, Candida clone was isolated in three cases of recurrent candidiasis.

UCN-1028A, a novel and specific inhibitor of protein kinase C, from Cladosporium.

Fluconazole, a triazole antifungal agent newly developed by Pfizer Inc.. was given orally to 4 patients with deep mycosis. Fluconazole was markedly effective against septicemia due to Candida and oral candidiasis accompanied with lingual ulcer in spite of seriousness of these underlying disease. In 2 patients with aspergilloma, eradication or contraction of fungus ball was observed and the drug was judged to be effective. In vitro MICs of fluconazole against clinically isolated Aspergillus spp. were much higher than its serum levels leaving a large discrepancy between in vitro activity and clinical efficacy. Although the dosage was 100-300 mg daily for 8 days to 6 months, neither adverse reactions nor laboratory parameter abnormalities were observed. The above results suggest that fluconazole is a useful agent in the treatment of fungal infections.

Experimental infections with feline caliciviruses (picornaviruses) in specific-pathogen-free kittens

Fifteen isolates of feline caliciviruses (picornaviruses) from Britain, the United States, and Australia have been compared with feline herpesvirus in their pathogenicity for SPF kittens in a gnotobiotic-type isolator system. Some isolates were apparently non-pathogenic, but the typical disease displayed transient fever, lingual ulcers, depressed appetite, and mild ocular and nasal discharge. Symptoms with the feline herpesvirus were more marked, but in no case was a disease comparable to that seen in the field produced. Pathologically at least 3 of the caliciviruses produced an interstitial pneumonia.

ARSENIC POISONING CAUSED BY A MOUTHWASH CONTAINING SOLUTION OF POTASSIUM ARSENITE

D. G., a white girl, aged 10 years, was admitted, July 20, 1932, with Vincent's infection of the mouth of eleven days' duration. Symptoms of note prior to admission included anorexia, fetor oris, fever and anuria. Bitter complaint of vomiting and gagging, continuous nausea and inability to retain anything, even water, was made by the mother. The patient had received an injection of Thio-Bismol (sodium bismuth thioglycollate) into the buttock, a local application of neoarsphenamine (0.4 Gm. in aqueous solution), and the following mouthwash: On admission the temperature, pulse and respiration were 98.6, 100 and 25, respectively. The blood pressure was 106 systolic, 70 diastolic. The prominent features on examination were a shallow lingual ulcer, moderate cervical lymphadenopathy and right-sided abdominal tenderness. The heart and lungs presented no abnormalities. There was no edema, and the eye-grounds were normal. The admission diagnoses were: (1) Vincent's infection and (2) anuria (of unknown