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Porter S, Johnson NW, Fedele S. Challenges of the interface of oral medicine and periodontology: Some lessons for the future? Periodontol 2000 2019; 80:225-228. [DOI: 10.1111/prd.12307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Newell W. Johnson
- Dental Research Griffith University Brisbane Queensland Australia
- Oral Health Sciences Faculty of Dentistry, Oral and Craniofacial Sciences King's College London London UK
| | - Stefano Fedele
- Oral Medicine UCL Eastman Dental Institute London UK
- Oral Medicine UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre London UK
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2
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Porter SR, Mercadante V, Fedele S. Oral manifestations of systemic disease. Br Dent J 2018; 223:683-691. [PMID: 29123296 DOI: 10.1038/sj.bdj.2017.884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 12/17/2022]
Abstract
While the majority of disorders of the mouth are centred upon the direct action of plaque, the oral tissues can be subject to change or damage as a consequence of disease that predominantly affects other body systems. Such oral manifestations of systemic disease can be highly variable in both frequency and presentation. As lifespan increases and medical care becomes ever more complex and effective it is likely that the numbers of individuals with oral manifestations of systemic disease will continue to rise. The present article provides a succinct review of oral manifestations of systemic disease. In view of this article being part of a wider BDJ themed issue on the subject of oral medicine, this review focuses upon oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease.
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Affiliation(s)
- S R Porter
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD
| | - V Mercadante
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD
| | - S Fedele
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD.,UCL NIHR Biomedical Research Centre
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Hejlesen J, Underbjerg L, Gjørup H, Bloch-Zupan A, Sikjaer T, Rejnmark L, Haubek D. Dental Findings in Patients With Non-surgical Hypoparathyroidism and Pseudohypoparathyroidism: A Systematic Review. Front Physiol 2018; 9:701. [PMID: 29971010 PMCID: PMC6018410 DOI: 10.3389/fphys.2018.00701] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/18/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Dental aberrations have been mentioned in relation to non-surgical hypoparathyroidism (Ns-HypoPT) and pseudohypoparathyroidism (PHP). However, a systematic review of dental characteristics have not been performed. The present systematic review describes the dental findings in patients with Ns-HypoPT and PHP. Methods: Studies on Ns-HypoPT and PHP reporting dental features were eligible. A systematic literature search was conducted using four bibliographic databases (Web of Science, Scopus, Pubmed, and Embase) and was limited to studies written in English. Reviews, meta-analyses and letters were excluded. Both the research and reporting of results were based on PRISMA (preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Results: Of 88 studies included, nine were cross-sectional, one was a prospective cohort study, 26 were case series, and 52 were case reports. The most frequently reported findings in patients with Ns-HypoPT were enamel opacities, enamel hypoplasia, hypodontia, and eruption disturbances. In patients with PHP, enamel hypoplasia, eruption disturbance, and deviation of the root morphology were the most frequently reported findings. Conclusion: An association between enamel hypoplasia and Ns-HypoPT and PHP is likely. The results should, however, be interpreted cautiously due to the limited number of high-quality studies. The present review confirms the need of further well-designed studies, such as large-scale studies, e.g., multicenter studies, to conclude on the reported associations between Ns-HypoPT/PHP and enamel hypoplasia.
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Affiliation(s)
- Jane Hejlesen
- Section for Pediatric Dentistry, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
| | - Line Underbjerg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Gjørup
- Center for Oral Health in Rare Diseases, Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Agnes Bloch-Zupan
- Faculté de Chirurgie Dentaire, Institut d'Etudes Avancées, USIAS, FMTS, RARENET Interreg V, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et Chirurgie Bucco-Dentaires, Centre de Référence des Maladies Rares Orales et Dentaires, O-Rares, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire and Cellulaire, Centre Européen de Recherche en Biologie et en Médecine, Université de Strasbourg, Centre National de la Recherche Scientifique UMR7104, Institut National de la Santé et de la Recherche Médicale U964, Illkirch, France
| | - Tanja Sikjaer
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Dorte Haubek
- Section for Pediatric Dentistry, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
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4
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COLEMAN R, HAY R. Chronic mucocutaneous candidosis associated with hypothyroidism: a distinct syndrome? Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1997.d01-1137.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Superficial Candida infection includes several common conditions, most often related to some underlying local or systemic predisposition. Appropriate identification of the pathogen is important in the management of candidiasis as the result of differences in susceptibility among species and strains of Candida to different antifungal drugs. Treatment options are reviewed for oropharyngeal candidiasis, vaginal candidiasis, cutaneous candidiasis, paronychia and onychomycosis, and chronic mucocutaneous candidiasis. Because of the importance of predisposing conditions for candidiasis, adjunctive measures to abate these may be useful, although they are seldom effective in immunocompromised patients.
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Affiliation(s)
- R J Hay
- St John's Institute of Dermatology, Guy's Hospital, London, United Kingdom
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6
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Perniola R, Tamborrino G, Marsigliante S, De Rinaldis C. Assessment of enamel hypoplasia in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED). J Oral Pathol Med 1998; 27:278-82. [PMID: 9707281 DOI: 10.1111/j.1600-0714.1998.tb01956.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The features of enamel hypoplasia in a small group of patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are described. Using a recently developed method, the authors evaluated quantitatively the amount of defect in each tooth by measuring the width of the hypoplastic lesions and dividing the value by the crown height. They then assessed the degree of damage in each tooth type (from central incisors to second premolars) and patient. Canines were the most severely affected among maxillary and mandibular teeth, but all tooth types were involved. Analysing both the differences between patients and their age at the beginning of the defect, the authors observe that hypoparathyroidism is not responsible for the onset of enamel hypoplasia in APECED, although it may contribute to the damage.
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Affiliation(s)
- R Perniola
- Pediatric Unit, ASL Vito Fazzi Hospital, Lecce, Italy
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Firth NA, O'Grady JF, Reade PC. Oral squamous cell carcinoma in a young person with candidosis endocrinopathy syndrome: a case report. Int J Oral Maxillofac Surg 1997; 26:42-4. [PMID: 9081252 DOI: 10.1016/s0901-5027(97)80845-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Candidosis endocrinopathy syndrome is a rare condition characterized by mucocutaneous candidosis and multiple endocrinal abnormalities. This case reports a patient with the syndrome who also developed an oral mucosal squamous cell carcinoma at the age of 21.
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Affiliation(s)
- N A Firth
- School of Dental Science, University of Melbourne, Australia
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8
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COLEMAN R, HAY R. Chronic mucocutaneous candidosis associated with hypothyroidism: a distinct syndrome? Br J Dermatol 1997. [DOI: 10.1111/j.1365-2133.1997.tb08741.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Field EA, Millns B, Pearce PK, Martin MV, Parkinson T, Hitchcock CA. Fluconazole therapy of oropharyngeal candidiasis in a patient with multiple endocrine failure does not correlate with Candida albicans susceptibility to fluconazole in vitro. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1996; 34:205-8. [PMID: 8803802 DOI: 10.1080/02681219680000341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We report a case of oropharyngeal and oesophageal candidiasis in a 23-year-old man with endocrinopathy syndrome. Multiple episodes of infection were treated with topical miconazole, oral ketoconazole (200 mg daily) or oral fluconazole (50 mg daily) over a period of 7 years. The final episode failed to respond to ketoconazole (200 mg daily) or fluconazole (200 mg daily), but was treated successfully by increasing the fluconazole dose to 400 mg daily for 6 months. The patient was maintained on fluconazole 200 mg daily without relapse. Serial Candida albicans isolates from the oral cavity were clonally related by RFLP analyses of genomic DNA, and were resistant to fluconazole, ketoconazole and itraconazole in vitro. We conclude that fluconazole 400 mg daily is effective against oropharyngeal and oesophageal candidiasis in a patient with endocrinopathy syndrome, despite the infecting Candida albicans strains being resistant to azole antifungals in vitro.
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Affiliation(s)
- E A Field
- Department of Clinical Dental Sciences, University of Liverpool, UK
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Abstract
Oral candidosis is a diagnosable and treatable mucosal disease that may be complicated by various other local or systemic disease conditions. Dependable diagnosis always should include a combination of clinical signs and symptoms suggestive of candidal disease as well as positive cytologic or direct culture results. The management of candidal infections should be individualized for each patient, with concern for interactions with current medications, immune status, other concurrent mucosal diseases, and exogenous infectious sources. In selecting the appropriate therapeutic agent(s) the clinician should consider patient health factors, location and severity of infection, and the probability of chronicity.
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Affiliation(s)
- P G Fotos
- Department of Oral Pathology, Radiology, and Medicine, University of Iowa College of Dentistry, Iowa City, USA
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Porter SR, Scully C. Orofacial manifestations in the primary immunodeficiency disorders. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1994; 78:4-13. [PMID: 8078661 DOI: 10.1016/0030-4220(94)90109-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Primary immunodeficiencies are increasingly recognized yet there is little data concerning the oral manifestations of such disorders. This article reviews the current literature and details the oral aspects of well-characterized primary immunodeficiencies.
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Affiliation(s)
- S R Porter
- Eastman Dental Institute for Oral Healthcare Sciences, London, UK
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12
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Porter SR, Scully C. Orofacial manifestations in primary immunodeficiencies: polymorphonuclear leukocyte defects. J Oral Pathol Med 1993; 22:310-1. [PMID: 8229868 DOI: 10.1111/j.1600-0714.1993.tb01079.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The orofacial manifestations of 17 children with primary defects of polymorphonuclear leukocyte function are reported. Oral disease was commonly found and included recurrent oral ulceration (35% of patient group), oral candidiasis (29%), recurrent herpes labialis (12%), enamel hypoplasia (18%) and delayed tooth eruption (12%). Only 3 children had no orofacial disease. Cervical lymph node enlargement was present in 41% of the children.
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Affiliation(s)
- S R Porter
- University Department of Oral Medicine, Pathology and Microbiology, Bristol Dental School and Hospital, England
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Shikata A, Sugimoto T, Kosaka K, Tehara T, Kido SO, Matsuo H, Sawada T, Berdon WE, Herrod HG, Parvey L. Thoracic aortic calcification in 3 children with candidiasis-endocrinopathy syndrome. Pediatr Radiol 1993; 23:100-3. [PMID: 8516027 DOI: 10.1007/bf02012395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Three cases are reported of the association of childhood onset of thoracic aortic calcification with mucocutaneous candidiasis, endocrine dysfunction and recurrent non-fungal pulmonary disease. The aortic calcification affects the thoracic aorta and the low lumbar aorta and common iliac arteries, sparing the mid-lumbar aorta and its major branches. Ischemic signs and symptoms of the head and neck and lower limbs are absent. This peculiar, slowly progressive vascular calcification, although unexplained to date, appears to be a non-random part of the more common candidiasis-endocrinopathy syndrome.
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Affiliation(s)
- A Shikata
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan
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14
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Porter SR, Haria S, Scully C, Richards A. Chronic candidiasis, enamel hypoplasia, and pigmentary anomalies. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1992; 74:312-4. [PMID: 1407992 DOI: 10.1016/0030-4220(92)90065-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This report describes a young male patient who had enamel hypoplasia, persistent oral candidiasis, skin hyperpigmentation, and vitiligo, and was thus suspected of having candidiasis endocrinopathy syndrome. The clinical and laboratory investigations employed to confirm the diagnosis are detailed.
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Affiliation(s)
- S R Porter
- Centre for the Study of Oral Disease, Bristol Dental Hospital and School, England
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Kanaan Y, Attenberger T, Bogner U, Maier M. Electric field effects on persistent spectral holes: Perylene in the polar polymer polyvinylbutyral. ACTA ACUST UNITED AC 1990. [DOI: 10.1007/bf00348970] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Herrod HG. Chronic mucocutaneous candidiasis in childhood and complications of non-Candida infection: a report of the Pediatric Immunodeficiency Collaborative Study Group. J Pediatr 1990; 116:377-82. [PMID: 2308026 DOI: 10.1016/s0022-3476(05)82824-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We reviewed the clinical course in 43 patients from eight medical centers who were given the diagnosis of chronic mucocutaneous candidiasis, a rare disorder of unknown cause that may occur in childhood. Recurrent or severe infections with organisms other than Candida were seen in 80% of the patients. There were nine cases of septicemia. Seven patients have died; six of these deaths were directly related to non-Candida infectious complications. Endocrine dysfunction, including Addison disease (11 patients) and hypothyroidism (9 patients), was seen in 19 of 43 patients. Immunologic studies failed to reveal a consistent abnormality, although two of five patients with reversed T4/T8 ratios are among those who have died. Ketoconazole was effective in controlling symptoms of candidiasis in most patients. The findings from this study indicate that non-Candida infections cause serious morbidity and may result in death in patients with chronic mucocutaneous candidiasis.
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Affiliation(s)
- H G Herrod
- Department of Pediatrics, University of Tennessee, Memphis 38163
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Affiliation(s)
- B I Ro
- Department of Dermatology, College of Medicine, Chung Ang University, Seoul, Korea
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18
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MacLeod RI, Bird AG. Chronic mucocutaneous candidosis in monozygotic twins. J Oral Maxillofac Surg 1987; 45:616-8. [PMID: 3474377 DOI: 10.1016/0278-2391(87)90273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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