Mechanisms underlying sex bias in oral immune-mediated conditions, an insight

Children and adolescents assisted in a referral oral medicine diagnostic service: 20 years of experience in Brazil

BACKGROUND

Several lesions can affect the oral and maxillofacial region, with trends influenced by lifestyle and age.

AIM

To investigate the occurrence of oral and maxillofacial lesions in paediatric patients assisted in an oral medicine diagnostic service in Brazil over 20 years.

DESIGN

A retrospective cross-sectional study was performed in an oral medicine diagnostic service (1999-2019). Data included sex, age, anatomic site, and diagnosis from clinical records of children (0-9 years) and adolescents (10-19 years). Lesions were diagnosed through clinical examination. Biopsy and histopathologic examination were performed when necessary.

RESULTS

Among 10 530 records, 702 (6.67%) were from patients aged 0-19 years diagnosed with oral or maxillofacial lesions. A high frequency of females was observed (58.1%). Reactive/inflammatory lesions were the most common group of lesions (45.2%), followed by abnormalities of teeth/developmental defects (17.8%) and pulpal and periapical diseases (8.5%). Mucocele/ranula was the most common lesion in children (29.3%) and adolescents (25.3%). Lips were the most affected anatomic sites.

CONCLUSION

Most lesions were benign, and mucocele/ranula was the most frequent. Our results did not differ from those of histopathological-based studies, but they provided information on the occurrence of oral and maxillofacial lesions to dentists and paediatricians.

Laboratory investigation of the association between oral lichen planus and Hashimoto's thyroiditis

BACKGROUND

Previous studies have shown some relationship between oral lichen planus (OLP) and certain systemic comorbidities. The aim of this study was to investigate laboratory parameters between cases of Hashimoto's thyroiditis (HT) concomitant with OLP and cases of HT only.

METHODS

This case-control study comprised 59 HT patients with OLP and 76 without OLP, all of whom had 5 serum thyroid-related indicators, including thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4).

RESULTS

Compared to cases of HT only, female predominance, presence of thyroid nodules, positive TGAb, and higher FT3/FT4 ratio were mainly observed in cases of HT concomitant with OLP (all P < 0.05). Multivariate regression analysis revealed that presence of thyroid nodules (odds ratio [OR], 10.328; 95% confidence interval [CI], 2.564-41.604), positive TGAb (OR, 6.936; 95%CI, 2.024-23.765), and higher FT3/FT4 ratio (OR, 2.577; 95%CI, 1.377-4.823) were associated significantly (all P < 0.005) with higher risk of OLP occurrence in 135 HT patients. Notably, these significant associations were not found among 30 male patients but did among 105 female patients in regression analysis.

CONCLUSION

This retrospective study revealed that presence of thyroid nodule, positive TGAb, and high FT3/FT4 ratio as risk factors were significantly associated with OLP occurrence risk in female patients with HT. This suggests that female patients suffering from HT, particularly who presented with the risk factors, should be informed about the risk of OLP development and the need for oral mucosal examination to screen for lichen lesions.

Analysis of a Combination Therapy Protocol for the Treatment of Oral Mucous Membrane Pemphigoid: A Retrospective Case Series Study

Mucous membrane pemphigoid (MMP) is an autoimmune-based bullous disease affecting the mucous membranes, mainly oral and ocular. One of the most common clinical manifestations is desquamative gingivitis (DG), characterized by intense symptoms and functional limitations. The dentist is among the first specialists to observe DG and, therefore, must be able to diagnose it. In this regard, the purpose of the present study was to evaluate the efficacy and safety of a clinical protocol for the topical management of patients with DG and MMP buccal lesions. Thirteen patients with clinical and histologic diagnoses of MMP-localized DG in the oral cavity were retrospectively enrolled. Each patient received topical treatment with clobetasol propionate oral gel 0.05%; nicotinamide; oral probiotic (contains Bifidobacterium lactis HN019, Kluyveromyces marxianus fragilis B0399, colostrum, and biotin); and doxycycline. Before and after 3 months of therapy, clinic records were collected for each patient. Seven patients (53.8%) had a complete response to treatment; four patients (30.8%) had a partial response to treatment; and, finally, two patients (15.4%) had no benefit from therapy. Dental management of patients presenting solely with oral manifestations of MMP may involve the use of topical corticosteroids, doxycycline, vitamin supplements, and probiotics and associating professional oral hygiene procedures.