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Ardeshna A, Gupta S, Rossouw PE, Valiathan M. Systemic Factors Affecting Orthodontic Treatment Outcomes and Prognosis-Part 2. Dent Clin North Am 2024; 68:707-724. [PMID: 39244252 DOI: 10.1016/j.cden.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
This article explores the various challenges systemic conditions can pose before and during orthodontic treatment. Cardiovascular conditions like infective endocarditis require antibiotic prophylaxis before certain orthodontic procedures are started. Patients with bleeding disorders require special considerations in regards to viral infection risk and maintenance of excellent atraumatic oral hygiene. Orthodontists play an important role in early identification of signs and symptoms of eating disorders and should deal with these patients sensitively. Congenital disorders, craniofacial anomalies, and nutritional deficiencies require special considerations and should be addressed appropriately before orthodontic treatment is started.
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Affiliation(s)
- Anil Ardeshna
- Department of Orthodontics, Rutgers School of Dental Medicine, Newark, NJ, USA.
| | - Sumit Gupta
- Private Practice, Rak Dental Care & Implant Centre, Ras Al Khaimah, United Arab Emirates
| | - Paul Emile Rossouw
- Division of Orthodontics and Dentofacial Orthopedics, University of Rochester, Eastman Institute for Oral Health
| | - Manish Valiathan
- Department of Orthodontics, Case Western Reserve University, 9601 Chester Avenue, Cleveland, OH 44106, USA
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2
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Zheng F, Annamma LM, Harikrishnan SS, Lee DJ. Systemic Factors Affecting Prognosis in Restorative and Prosthetic Dentistry: A Review. Dent Clin North Am 2024; 68:751-765. [PMID: 39244255 DOI: 10.1016/j.cden.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
The field of restorative and prosthetic dentistry focuses on restoring lost tooth structures and replacing missing teeth and lost tissue to restore or improve esthetics and oral health. Many systemic factors such as metabolic, bone, autoimmune, cardiovascular, and endocrine disorders can affect healing procedures, and bone density and impact oral health. Hence patients suffering from systemic disease when treated for prosthodontic rehabilitation can have negative prognostic outcomes. The commonest prosthodontic treatments that can be affected include dental implants, fixed prostheses, and removable prostheses. Understanding and managing these systemic factors play a key role in the success of prosthodontic treatment.
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Affiliation(s)
- Fengyuan Zheng
- Advanced Education Program in Prosthodontics, Department of Restorative Sciences, Division of Prosthodontics, University of Minnesota School of Dentistry, 9-176 Moos Tower, 515 Delaware Street Southeast, Minneapolis, MN 55455, USA
| | - Lovely Muthiah Annamma
- College of Dentistry, Ajman University, PO Box 346, University Street Al Jeft 1, Ajman, United Arab Emirates
| | | | - Damian J Lee
- Department of Prosthodontics, Tufts University School of Dental Medicine, 1 Kneeland Street, DHS 220; Boston, MA 02111, USA.
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3
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Papadopoulou CI, Sifakakis I, Tournis S. Metabolic Bone Diseases Affecting Tooth Eruption: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:748. [PMID: 38929327 PMCID: PMC11202066 DOI: 10.3390/children11060748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
Tooth eruption is an essential process for the development of the oral and maxillofacial system. Several inherited and acquired diseases might affect this tightly regulated process, resulting in premature, delayed, or even failed tooth eruption. The purpose of this article is to review the literature and the clinical parameters of metabolic bone diseases that affect tooth eruption. It examines the physiological aspects of tooth eruption and the pathophysiological changes induced by metabolic bone diseases, including changes in bone metabolism, density, and structure. The search strategy for this review included an electronic search in PubMed, Google Scholar, Medline, Scopus, and the Cochrane Library using the following keywords: "metabolic bone diseases", "tooth eruption", "delayed tooth eruption", and each reported disease in combination with "tooth eruption disorders", covering publications up to March 2024 and limited to English-language sources. Understanding the influence of metabolic bone diseases on tooth eruption is crucial for managing both dental and skeletal manifestations associated with these disorders. This review suggests that a multidisciplinary approach to treatment may significantly improve oral outcomes for patients suffering from such conditions. Clinicians should be aware of the specific dental abnormalities that may arise and consider comprehensive evaluations and individualized treatment plans. These findings underscore the need for further research into targeted therapies that address these abnormalities.
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Affiliation(s)
| | - Iosif Sifakakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Symeon Tournis
- Laboratory for the Research of Musculoskeletal System “Th. Garofalidis”, School of Medicine, National and Kapodistrian University of Athens, 14561 Athens, Greece;
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4
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Al-Ansari S, Stolze J, Bresters D, Brook AH, Laheij AMGA, Brand HS, Dahllöf G, Rozema FR, Raber-Durlacher JE. Late Complications in Long-Term Childhood Cancer Survivors: What the Oral Health Professional Needs to Know. Dent J (Basel) 2024; 12:17. [PMID: 38275678 PMCID: PMC10813876 DOI: 10.3390/dj12010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/12/2024] [Indexed: 01/27/2024] Open
Abstract
With diagnostic and therapeutic advances, over 80% of children diagnosed with cancer become long-term survivors. As the number of childhood cancer survivors (CCS) continues to increase, dental practitioners become more likely to have CCS among their patients. CCS may develop late complications from damage caused by their cancer treatment to endocrine, cardiovascular, musculoskeletal, and other organ systems. These complications may surface decades after the completion of treatment. Adverse outcomes of childhood cancer treatment frequently involve oral and craniofacial structures including the dentition. Tooth development, salivary gland function, craniofacial growth, and temporomandibular joint function may be disturbed, increasing oral health risks in these individuals. Moreover, CCS are at risk of developing subsequent malignancies, which may manifest in or near the oral cavity. It is important that dental practitioners are aware of the childhood cancer history of their patients and have knowledge of potential late complications. Therefore, this narrative review aims to inform dental practitioners of late oral complications of cancer treatment modalities commonly used in pediatric oncology. Furthermore, selected common non-oral late sequelae of cancer therapy that could have an impact on oral health and on delivering dental care will be discussed.
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Affiliation(s)
- Sali Al-Ansari
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Department Maxillofacial Surgery, Fachklinik Horneide, 48157 Münster, Germany
| | - Juliette Stolze
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (J.S.); (H.S.B.)
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
- Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;
| | - Alan Henry Brook
- Adelaide Dental School, University of Adelaide, Adelaide 5005, Australia;
- Institute of Dentistry, Queen Mary University of London, London E12AD, UK
| | - Alexa M. G. A. Laheij
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Henk S. Brand
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (J.S.); (H.S.B.)
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry, Karolinska Institutet, 14152 Huddinge, Sweden;
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), 100098 Trondheim, Norway
| | - Frederik R. Rozema
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Judith E. Raber-Durlacher
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (S.A.-A.); (A.M.G.A.L.)
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 HZ Amsterdam, The Netherlands
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5
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Aldosary SN, Mirfendereski P, Mupparapu M. A Patient with Hypothyroidism in Need of Periodontal Connective Tissue Graft Surgery. Dent Clin North Am 2023; 67:601-603. [PMID: 37714604 DOI: 10.1016/j.cden.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Hypothyroidism is a condition characterized by thyroid hormone deficiency and can be caused by a variety of factors. Untreated or chronic hypothyroidism can present in adult patients as myxedema, which is characterized by symptoms including fatigue, generalized slower metabolism, weight gain, depressed mood, dry skin, and brittle hair. Hypothyroidism can have various oral manifestations, particularly in children, in whom it can delay the eruption of the dentition. Dental management of patients with hypothyroidism depends on the etiology and status of the disease and requires the consideration of other organ systems affected.
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Affiliation(s)
- Sara N Aldosary
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Payam Mirfendereski
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Borzouei S, Bawand R, Salimbahrami S, Sheikh V. Comparison of clinical efficacy of antithyroid drugs, radioactive iodine, and thyroidectomy for treatment of patients with graves' disease, toxic thyroid adenoma, and toxic multinodular goiter. BIOMEDICAL AND BIOTECHNOLOGY RESEARCH JOURNAL (BBRJ) 2022. [DOI: 10.4103/bbrj.bbrj_99_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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7
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Wu CC, Islam MM, Nguyen PA, Poly TN, Wang CH, Iqbal U, Li YCJ, Yang HC. Risk of cancer in long-term levothyroxine users: Retrospective population-based study. Cancer Sci 2021; 112:2533-2541. [PMID: 33793038 PMCID: PMC8177794 DOI: 10.1111/cas.14908] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 12/30/2022] Open
Abstract
Levothyroxine is a widely prescribed medication for the treatment of an underactive thyroid. The relationship between levothyroxine use and cancer risk is largely underdetermined. To investigate the magnitude of the possible association between levothyroxine use and cancer risk, this retrospective case‐control study was conducted using Taiwan’s Health and Welfare Data Science Center database. Cases were defined as all patients who were aged ≥20 years and had a first‐time diagnosis for cancer at any site for the period between 2001 and 2011. Multivariable conditional logistic regression models were used to calculate an adjusted odds ratio (AOR) to reduce potential confounding factors. A total of 601 733 cases and 2 406 932 controls were included in the current study. Levothyroxine users showed a 50% higher risk of cancer at any site (AOR: 1.50, 95% CI: 1.46‐1.54; P < .0001) compared with non–users. Significant increased risks were also observed for brain cancer (AOR: 1.90, 95% CI: 1.48‐2.44; P < .0001), skin cancer (AOR: 1.42, 95% CI: 1.17‐1.72; P < .0001), pancreatic cancer (AOR: 1.27, 95% CI: 1.01‐1.60; P = .03), and female breast cancer (AOR: 1.24, 95% CI: 1.15‐1.33; P < .0001). Our study results showed that levothyroxine use was significantly associated with an increased risk of cancer, particularly brain, skin, pancreatic, and female breast cancers. Levothyroxine remains a highly effective therapy for hypothyroidism; therefore, physicians should carefully consider levothyroxine therapy and monitor patients’ condition to avoid negative outcomes. Additional studies are needed to confirm these findings and to evaluate the potential biological mechanisms.
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Affiliation(s)
- Chieh-Chen Wu
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei, Taiwan.,Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan
| | - Md Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Phung-Anh Nguyen
- International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei, Taiwan
| | - Tahmina Nasrin Poly
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ching-Huan Wang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Usman Iqbal
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Jack Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Wan Fang Hospital, Taipei, Taiwan
| | - Hsuan-Chia Yang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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8
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Kwon M, Jeong YJ, Kwak J, Jung KY, Baek SK. Association between oral health and thyroid disorders: A population-based cross-sectional study. Oral Dis 2021; 28:2277-2284. [PMID: 33930233 DOI: 10.1111/odi.13895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/29/2021] [Accepted: 04/23/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES In this study, we aimed to determine the relationship between oral health status and thyroid dysfunction. METHODS A population-based cross-sectional analysis using data from the Korean National Health and Nutrition Examination Survey (KNHNES) was performed. We investigated the association between oral health-related parameters and the prevalence of thyroid diseases. In addition, the relationship between oral health status and thyroid function test (TFT) results was analyzed. One-way analysis of variances or chi-square test was used for comparisons between oral health-related parameters and presence of thyroid diseases. Univariable and multivariable logistic regression analyses were conducted to evaluate the associations between participants' characteristics including oral health-related parameters and the abnormal results of TFTs. RESULTS A total of 18,034 adults were surveyed. Histories of thyroid diseases were found to be more common in people who brushed their teeth frequently or used oral hygiene products. However, histories of periodontitis and community periodontal index (CPI) did not show significant associations with histories of thyroid diseases. Among 14,860 participants without history of thyroid disorders, people having higher CPI values demonstrated higher probabilities of abnormal TFTs (OR 1.381, 95% CI 1.241-1.537, p < .0001); however, statistical significance was not found after adjusting for the other variables. CONCLUSIONS Our study demonstrated that good oral health-related behavior was associated with more frequent thyroid disease history. High CPI showed a significant association with TFT abnormalities; however, the significance of this association became lower when other variables such as age and sex were adjusted. Further studies will be needed to determine how the control of oral health-related conditions actually has a causal relationship with thyroid disease/dysfunction through prospective cohort studies.
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Affiliation(s)
- Minsu Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yu-Jin Jeong
- Biostatistics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jiwon Kwak
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kwang-Yoon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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9
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Alawsi F, Sawbridge D, Fitzgerald R. Orthodontics in patients with significant medical co-morbidities. J Orthod 2020; 47:4-24. [PMID: 32985344 DOI: 10.1177/1465312520949881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A wide variety of patients with medical co-morbidities may present to general orthodontic practice. It is important for the treating clinician to have a general understanding of key medical conditions that may impact upon the treatment and management options. This clinical supplement provides a treatment-focused summative update for the orthodontist regarding significant medical co-morbidities, their general prevalence and an exploration of potential impacts upon orthodontic treatment. This review also discusses the significance of key medications and provides suggestions for the safe provision of orthodontic treatment.
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Affiliation(s)
- Fahad Alawsi
- Orthodontic Department, Royal Preston Hospital, Preston, UK
| | - David Sawbridge
- Intestinal Failure Unit, Salford Royal NHS Foundation Trust, Salford, UK
| | - Rhian Fitzgerald
- Orthodontic Department, Royal Preston Hospital, Preston, UK.,Alder Hey Children's Hospital, Liverpool, UK
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10
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Alqahtani H. Medically compromised patients in orthodontic practice: Review of evidence and recommendations. Int Orthod 2019; 17:776-788. [PMID: 31471239 DOI: 10.1016/j.ortho.2019.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Due to advances in the field of medicine, early diagnosis and high-quality medical management has become available for medically compromised patients. This increases their life expectancy and improves their quality of life. Therefore, orthodontic treatment can be provided to these patients whose medical conditions are well controlled. OBJECTIVE This article will discuss some medical conditions that might be seen by orthodontists. Also, recommendations and modifications of the orthodontic treatment plan will be discussed thoroughly. MATERIALS AND METHODS A computerized electronic search of the literature was conducted in Google Scholar and PubMed and was limited to publications in English. RESULTS Orthodontic management was studied in cases of Infective endocarditis (IE), Thrombocytopenia, Hemophilia, Sickle cell anemia, Thalassemia, Diabetes mellitus (DM), Thyroid Disorders, Asthma, DiGeorge Syndrome, HIV/AIDS, Organ transplantation, Orthodontic management, Juvenile idiopathic arthritis (JIA), Seizure disorders, Autism Spectrum Disorder (ASD), Mood disorders, Schizophrenia and Eating disorders.
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Affiliation(s)
- Hamad Alqahtani
- Orthodontic department, dental school, King Abdulaziz University,Jeddah, Saudi Arabia.
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11
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Farag AM. Head and Neck Manifestations of Endocrine Disorders. Atlas Oral Maxillofac Surg Clin North Am 2018; 25:197-207. [PMID: 28778308 DOI: 10.1016/j.cxom.2017.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Arwa M Farag
- Division of Oral Medicine, Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, DHS #638, Boston, MA 02111, USA; Department of Oral Medicine, Faculty of Dentistry, King AbdulAziz University, 1 Umm Al Muminin Road, Jeddah 21589, Kingdom of Saudi Arabia.
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12
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An overview of the contribution of acupuncture to thyroid disorders. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 16:375-383. [PMID: 30341025 DOI: 10.1016/j.joim.2018.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/27/2018] [Indexed: 02/06/2023]
Abstract
Thyroid dysfunction, affecting people of all ages, not only damages human growth and energy metabolism but is also comorbid with other illnesses such as cardiovascular disease, kidney disease and gastrointestinal disorders. With the increasing acceptance of alternative and complementary therapies, acupuncture, a traditional Chinese medical practice, has also been employed to address this problem. Analysing 29 clinical projects that were retrieved from 29 major digital databases and include 1757 patients aged 7-79 years from China, Italy, Korea, Macedonia and Russia, this narrative review offers an overview of the efficacy, and evaluated the safe and cost-effective use of acupuncture against hyperthyroidism, hypothyroidism and thyroid-relevant illnesses. Findings indicated reductions in patient symptoms and improvements in biomarkers where acupuncture was used alone or in combination therapy. In addition to showing the role of acupuncture as an alternative and complementary medicine or as an adjunctive therapy for curative and rehabilitative purposes, more well-designed researches are needed to achieve reliable data.
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Bhattarai KR, Junjappa R, Handigund M, Kim HR, Chae HJ. The imprint of salivary secretion in autoimmune disorders and related pathological conditions. Autoimmun Rev 2018; 17:376-390. [DOI: 10.1016/j.autrev.2017.11.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/16/2017] [Indexed: 12/11/2022]
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14
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Kshirsagar MM, Dodamani AS, Karibasappa GN, Vishwakarma PY, Vathar JB, Sonawane KR. Assessment of Oral Health Status and Treatment Needs among Individuals with Thyroid Dysfunction in Nashik City (Maharashtra): A Cross-Sectional Study. Contemp Clin Dent 2018; 9:619-624. [PMID: 31772474 PMCID: PMC6868612 DOI: 10.4103/ccd.ccd_574_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: The objective of the study is to assess the prevalence of dental caries and periodontal health status among individuals suffering from thyroid dysfunction in Nashik. To compare the prevalence of thyroid dysfunction between males and females. Materials and Methods: The present study is cross-sectional in nature. The study group comprised of randomly selected 100 individuals diagnosed as suffering from thyroid dysfunction and fulfilling eligibility criteria, visiting endocrinology center in Nashik city. Type III clinical examination was used for the assessment of oral health status. Control group was selected from the neighborhood in general population who had matched with the eligibility criteria of the study group. Oral hygiene status was assessed by using the WHO pro forma, 2013. Collected data were compiled into MS-Excel and subjected to statistical analysis using appropriate statistical tests. Results: Severity of dental caries status and periodontal destruction was found more in study group as (P < 0.05). The prevalence of thyroid dysfunction, severity of dental caries status and periodontal destruction was seen more in females as compared to males. Conclusion: Thyroid dysfunction has an impact on general and oral health as well. It is necessary to identify it early so as to prevent further progression of disease and destruction of oral tissues. It is also necessary to modify treatment plan if the patient is diagnosed with thyroid dysfunction to prevent further complications.
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Affiliation(s)
| | - Arun Suresh Dodamani
- Department of Public Health Dentistry, ACPM Dental College, Dhule, Maharashtra, India
| | | | | | | | - Kapil Ramesh Sonawane
- Department of Public Health Dentistry, Sinhgadh Dental College, Pune, Maharashtra, India
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15
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Weinstock RJ, Johnson MP. Review of Top 10 Prescribed Drugs and Their Interaction with Dental Treatment. Dent Clin North Am 2017; 60:421-34. [PMID: 27040293 DOI: 10.1016/j.cden.2015.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The proportion of people over age 60 is growing faster than any other group. Many patients take several medications to manage multiple chronic medical conditions. Poor oral health is common and dental visits by patients over the age of 65 are increasing. The dentist must recognize that these medications may interact with dental treatment. This article reviews the top 10 prescribed drugs as listed in the IMS Institute national prescription audit in January 2015 and reviews the interactions between these medications and dental treatment. The medications reviewed include levothyroxine, acetaminophen/hydrocodone, lisinopril, metoprolol, atorvastatin, amlodipine, metformin, omeprazole, simvastatin, and albuterol.
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Affiliation(s)
- Robert J Weinstock
- Private Practice, 87 State Street, Guilford, CT 06437, USA; Oral and Maxillofacial Surgery, Yale-New Haven Hospital, 20 York Street, New Haven, CT 06510, USA.
| | - Michael P Johnson
- Private Practice, 87 State Street, Guilford, CT 06437, USA; Oral and Maxillofacial Surgery, Yale-New Haven Hospital, 20 York Street, New Haven, CT 06510, USA
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16
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Ruokonen HMA, Juurikivi A, Kauppila T, Heikkinen AM, Seppänen-Kaijansinkko R. High percentage of oral lichen planus and lichenoid lesion in oral squamous cell carcinomas. Acta Odontol Scand 2017; 75:442-445. [PMID: 28562162 DOI: 10.1080/00016357.2017.1332777] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Oral lichen planus (OLP) and lichenoid lesions (OLL) are regarded as precursor lesions of oral squamous cell carcinoma (OSCC) with potential for malignant transformation. This potential is not clear due to difficulties in diagnosis of OLP and OLL. Our aim was therefore to evaluate previously identified OLP and OLL as precursor lesions in OSCC and to identify cancer related etiological factors such as smoking and alcohol consumption. MATERIAL AND METHODS We retrospectively reviewed all cases (total 323, comprising 164 females and 159 males) with OSCC treated at the Department of Oral and Maxillofacial Diseases and Surgery, Helsinki University Hospital during 2015. Confirmed by histopathological biopsy, 58 (17.9%) had OLP and 13 had OLL (4.0%) as precursor lesion. RESULTS Patients with OLP were slightly older than those without it. OLP was more common in females than in males (p < .0001). TN class 1 tumors were more prevalent among patients with OLP or OLL (p = .006) and cancer relapses less common (p = .005). Smoking was less frequent in patients with OLP and OLL (p < .0001). Also alcohol abuse was less frequent among these patients (p < .001). CONCLUSION Our findings confirm the importance of active follow-up of all patients with OLP and OLL even in patients who do not fit a traditional high-risk category for OSCC.
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Affiliation(s)
- Hellevi M. A. Ruokonen
- Department of Oral and Maxillofacial Diseases and Surgery, Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aino Juurikivi
- Department of Oral and Maxillofacial Diseases and Surgery, Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Kauppila
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of General Practice and Primary Healthcare, Institute of Clinical Medicine, Helsinki, Finland
| | - Anna Maria Heikkinen
- Department of Oral and Maxillofacial Diseases and Surgery, Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riitta Seppänen-Kaijansinkko
- Department of Oral and Maxillofacial Diseases and Surgery, Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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17
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Vucic S, Korevaar TIM, Dhamo B, Jaddoe VWV, Peeters RP, Wolvius EB, Ongkosuwito EM. Thyroid Function during Early Life and Dental Development. J Dent Res 2017; 96:1020-1026. [PMID: 28489513 DOI: 10.1177/0022034517708551] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children with low levels of thyroid hormones (hypothyroidism) have delayed tooth eruption, enamel hypoplasia, micrognathia, and anterior open bite, whereas children with hyperthyroidism may suffer from accelerated tooth eruption, maxillary, and mandibular osteoporosis. However, it is still unknown whether thyroid function variations within the normal or subclinical range also have an impact on hard dental tissues in healthy children. The objective of this study was, therefore, to investigate the association between thyroid function from the fetal period until early childhood and dental development at school age. This study is embedded in the Generation R Study, a population-based cohort study established in Rotterdam, the Netherlands. Maternal thyroid function (thyroid-stimulating hormone [TSH], free thyroxine [FT4], and thyroid peroxidase antibody [TPOAb] concentrations) was measured during early pregnancy, and thyroid function of the offspring (TSH and FT4) was measured in cord blood at birth and in early childhood (6 y). Dental development was assessed from panoramic radiographs of children of school-going age (9 y). In total, 2,387 to 2,706 subjects were available for the multivariable linear regression analysis, depending on the point in time of thyroid function measurement. There was an inverse association between cord blood and early childhood TSH concentrations with dental development, with a -0.06 lower standard deviation (SD) per 1 mU/L of TSH (95% confidence interval [CI], -0.11 to -0.01) and a -0.06 lower SD per 1 mU/L of TSH (95% CI, -0.11 to 0.00), respectively. There was no association between the maternal thyroid function during pregnancy and the dental development score of the child. However, TPOAb-positive mothers had children with a -0.20 SD (adjusted 95% CI, -0.35 to -0.04) lower dental development score compared with TPOAb-negative mothers. The findings of this study suggest that the thyroid hormone is involved in the maturation of teeth from the early stages of life onward.
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Affiliation(s)
- S Vucic
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,2 Department of Oral & Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - T I M Korevaar
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,3 Department of Internal Medicine and Rotterdam Thyroid Center, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - B Dhamo
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,2 Department of Oral & Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - V W V Jaddoe
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,4 Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - R P Peeters
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,3 Department of Internal Medicine and Rotterdam Thyroid Center, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - E B Wolvius
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,2 Department of Oral & Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - E M Ongkosuwito
- 1 The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, the Netherlands.,2 Department of Oral & Maxillofacial Surgery, Special Dental Care, and Orthodontics, Erasmus University Medical Centre, Rotterdam, the Netherlands
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18
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Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. Int J Endocrinol 2017; 2017:2549491. [PMID: 28293260 PMCID: PMC5331475 DOI: 10.1155/2017/2549491] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/27/2016] [Accepted: 11/21/2016] [Indexed: 01/06/2023] Open
Abstract
Clinical evidences have highlighted the efficacy of myo-inositol and selenium in the treatment of autoimmune thyroiditis. Aim of this study was to further analyze the role of myo-inositol plus selenium (Myo-Ins-Se) in restoring a normal thyroid function of Hashimoto's patients with subclinical hypothyroidism. Eighty-six patients with Hashimoto's thyroiditis having thyroid-stimulating hormone (TSH) levels between 3 and 6 mIU/L, elevated serum antithyroid peroxidase (TPOAb) and/or antithyroglobulin (TgAb), and normal free thyroxine (fT4) and free triiodothyronine (fT3) levels were enrolled in the study: one hyperthyroid subject with TSH about 0.14 μU/ml was included in this trial as a single case. Patients were assigned to receive Myo-Ins-Se. TSH, TPOAb, and TgAb levels were significantly decreased in patients treated with combined Myo-Ins-Se after 6 months of treatment. In addition, a significant fT3 and fT4 increase, along with an amelioration of their quality of life, was observed. Remarkably, TSH values of the hyperthyroid patient increased from 0.14 μU/ml up to 1.02 μU/ml, showing a complete restoration of TSH values at a normal range. In conclusion, the administration of Myo-Ins-Se is significantly effective in decreasing TSH, TPOAb, and TgAb levels, as well as enhancing thyroid hormones and personal wellbeing, therefore restoring euthyroidism in patients diagnosed with autoimmune thyroiditis.
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Affiliation(s)
- Maurizio Nordio
- Department of Experimental Medicine, University “Sapienza”, Rome, Italy
| | - Sabrina Basciani
- Department of Experimental Medicine, University “Sapienza”, Rome, Italy
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19
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Gecgelen Cesur M, Cesur G, Ogrenim M, Alkan A. Do prenatal and postnatal hypothyroidism affect the craniofacial structure?: An experimental study. Angle Orthod 2016; 86:854-61. [PMID: 26756376 DOI: 10.2319/080315-521.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the effect of experimental prenatal and postnatal hypothyroidism (HT) on the craniofacial structure in rats. MATERIALS AND METHODS Female Wistar albino rats were mated with males for fertilization. Pregnant rats were divided into three groups. Group 1 (methimazole [MMI]-induced prenatal hypothyroidism group) mother rats were given MMI water during and after pregnancy. Group 2 (MMI-induced postnatal hypothyroidism group) mother rats were given MMI water after pregnancy. After the breast-feeding period, group 1 and 2 rat pups received the same water as their lactating mothers drank. Group 3 (control group) pregnant rats and rat pups were given normal tap water. When the rat pups were 90 days of age, lateral cephalometric and posteroanterior films were taken under anesthesia. RESULTS Posteroanterior radiographs revealed that palatal, cranial, bizygomatic arch, and bigonial width measurements were significantly shorter in prenatal HT and postnatal HT groups compared to the control group (P < .001). Intragroup comparisons in lateral cephalometric radiographs showed that, nearly all of the comparisons were statistically significant (P < .05), with the exception of the Co-Gn, E-Pg/S-Gn measurements between the prenatal and postnatal HT groups. CONCLUSIONS Sagittal and transverse measurements showed that untreated HT has detrimental effects on the growth of the maxilla and mandible.
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Affiliation(s)
- Mine Gecgelen Cesur
- a Assistant Professor, Adnan Menderes University, Faculty of Dentistry, Department of Orthodontics, Aydın, Turkey
| | - Gokhan Cesur
- b Associate Professor, Adnan Menderes University, Faculty of Medicine, Department of Physiology, Aydın, Turkey
| | - Mert Ogrenim
- c Research Assistant, Adnan Menderes University, Faculty of Dentistry, Department of Orthodontics, Aydın, Turkey
| | - Afra Alkan
- d Research Assistant, Yıldırım Beyazıt University, Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
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20
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Ghaemi N, Bagheri S, Elmi S, Mohammadzade Rezaee S, Elmi S, Erfani Sayyar R. Delayed Diagnosis of Hypothyroidism in Children: Report of 3 Cases. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e20306. [PMID: 26734478 PMCID: PMC4698140 DOI: 10.5812/ircmj.20306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Revised: 04/23/2015] [Accepted: 05/11/2015] [Indexed: 01/30/2023]
Abstract
Introduction: Hypothyroidism is the most common endocrine disorder in children and presented with various sign and symptoms; its diagnosis needs a high index of suspicion. Case Presentation: We report 3 cases with unusual presentations of hypothyroidism and with delay in diagnosis that referred to Pediatric Endocrine Outpatient Clinic in Mashhad University of Medical Sciences, Mashhad, Iran with different clinical manifestations. They had decreased Thyroxin (T4) and increased thyroid stimulating hormone (TSH) levels. One case had mental retardation and deafness, but the other two cases had normal neurodevelopment. Some additional interesting findings were as follows: short stature, delayed bone age, teeth eruption impairment, hair loss, anemia and hypercholesterolemia, persistent and long-term constipation that had led to several abdominal surgeries. After a year of hormonal replacement therapy, their growth parameters and hematological values improved. Conclusions: We recommend thyroid hormonal evaluation for any children with short stature, especially with delayed bone age, in order to detect and treat hypothyroidism at the right time. It seems that more attention to pediatric growth is necessary.
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Affiliation(s)
- Nosrat Ghaemi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Sepideh Bagheri
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Saghi Elmi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
- Corresponding Author: Saghi Elmi, Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-9155181130, Fax: +98-5137273943, E-mail:
| | - Saber Mohammadzade Rezaee
- Department of Pediatrics, School of Medicine, Birjand University of Medical Sciences, Birjand, IR Iran
| | - Sam Elmi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | - Reza Erfani Sayyar
- Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
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21
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Madani FM, Kuperstein AS. Normal variations of oral anatomy and common oral soft tissue lesions: evaluation and management. Med Clin North Am 2014; 98:1281-98. [PMID: 25443677 DOI: 10.1016/j.mcna.2014.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Examination of the oral cavity can provide significant diagnostic information regarding the general health of the patient. The oral cavity is affected by a multitude of pathologic conditions of variable cause and significance; however, there are numerous normal variations of oral soft tissue structures that may resemble a pathologic state. Understanding these variations assists practitioners to discriminate between normal versus abnormal findings and determine the appropriate course of management, if necessary.
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Affiliation(s)
- Farideh M Madani
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Arthur S Kuperstein
- Oral Medicine Clinical Services, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
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22
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Dudhia SB, Dudhia BB. Undetected hypothyroidism: A rare dental diagnosis. J Oral Maxillofac Pathol 2014; 18:315-9. [PMID: 25328321 PMCID: PMC4196309 DOI: 10.4103/0973-029x.140922] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 07/07/2014] [Indexed: 11/25/2022] Open
Abstract
Thyroid dysfunction is the second most common glandular disorder of the endocrine system, which may rear its head in any system in the body including the mouth. The oral cavity is adversely affected by either an excess or deficiency of thyroid hormone. Childhood hypothyroidism known as cretinism is characterized by thick lips, large protruding tongue (macroglossia), malocclusion and delayed eruption of teeth. Neonatal screening for congenital hypothyroidism is not performed in all countries and not every affected patient might be determined by neonatal screening alone. The dentist by detecting the early signs and symptoms of hypothyroidism can refer the patient for medical diagnosis and treatment and avoid potential complications of treating patients with uncontrolled disease. Herein, we present a case of undetected hypothyroidism in a 13-year-old female patient based on dental features by oral medicine specialists.
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Affiliation(s)
- Sonal B Dudhia
- Department of Oral Diagnosis, Oral Medicine and Dental Radiology, College of Dental Science, Ahmedabad, Gujarat, India
| | - Bhavin B Dudhia
- Department of Oral Diagnosis, Oral Medicine and Dental Radiology, Ahmedabad Dental College and Hospital, Gandhinagar, Gujarat, India
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23
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Ferrazzo KL, Payeras MR, Ferrazzo VA, Mezomo MB. Craniofacial and dental manifestations of triple X syndrome associated with congenital hypothyroidism: a case report. SPECIAL CARE IN DENTISTRY 2013; 34:156-9. [PMID: 24117978 DOI: 10.1111/scd.12050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Triple X syndrome (47,XXX) is a numerical chromosomal alteration that affects 1/1,000 women, in which the woman is born with an extra X chromosome. Some oral changes have been reported in the literature, as hypodontia, influence on deposition of crown enamel and discrepancies in cephalometric measurements. Other systemic complications may lead to oral abnormalities similar to those seen in triple X patients, such as congenital hypothyroidism (CH). This paper reports a triple X syndrome case associated with CH later treated. Besides delay in cognitive and intellectual development, the patient had changes in teeth development and in cephalometric measurements with deficiencies in the maxilla and mandible. This is the first report of a triple X syndrome associated with CH. Both conditions may result in changes in dentofacial development.
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Affiliation(s)
- Kívia Linhares Ferrazzo
- Professor of Oral Medicine, School of Dentistry, Franciscan University Center, Santa Maria/Rio Grande do Sul, Brazil
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24
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Sabih DE, Inayatullah M. Managing thyroid dysfunction in selected special situations. Thyroid Res 2013; 6:2. [PMID: 23379325 PMCID: PMC3626556 DOI: 10.1186/1756-6614-6-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 01/30/2013] [Indexed: 01/16/2023] Open
Abstract
Managing thyroid dysfunction is simple at first glance, the idea is to bring hormone levels in the euthyroid range, treat with antithyroid drugs, radio-iodine or surgery if toxic and replace with thyroxine or T3 if hypothyroid. Complexities arise when there are coexisting conditions that affect the thyroid or are affected by thyroid dysfunction and this review will deal with the special situations that need care when correcting thyroid hormone levels.
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Affiliation(s)
- Durr E Sabih
- Multan Institute of Nuclear Medicine and Radiotherapy, Nishtar Hospital, Multan 60000, Pakistan.
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25
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Abstract
The thyroid is the major regulator of metabolism and affects all of the bodily functions. Thyroid dysfunction is the second most common glandular disorder of the endocrine system which may rear its head in any system in the body including the mouth. The oral cavity is adversely affected by either an excess or deficiency of these hormones. Before treating a patient who has thyroid disorder, the endocrinologist needs to be familiar with the oral manifestations of thyroid dysfunctions. The patient with a thyroid dysfunction, as well as the patient taking medications for it, requires proper risk management before considering dental treatment by the dentist. Thus, communication of dentist with endocrinologist must be bidirectional, to maintain patient's oral and thyroid health.
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Affiliation(s)
- Shalu Chandna
- Department of Periodontics, MM College of Dental Sciences and Research, Ambala, Haryana, India
| | - Manish Bathla
- Department of Psychiatry, MM College of Dental Sciences and Research, Ambala, Haryana, India
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26
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Scardina GA, Messina P. Modifications of interdental papilla microcirculation: a possible cause of periodontal disease in Hashimoto's thyroiditis? Ann Anat 2008; 190:258-63. [PMID: 18407481 DOI: 10.1016/j.aanat.2007.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 12/22/2007] [Accepted: 12/23/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hypothyroidism is defined by a decrease in thyroid hormone production and thyroid gland function. The aim of the present research has been to evaluate the morphologic interdental papilla microcirculation of patients suffering from Hashimoto thyroiditis (HT) and to evaluate a possible correlation with the associated periodontal disease. METHODS Fifteen healthy subjects and 15 patients suffering from HT were examined. The patients who showed conditions known to compromise microcirculation, such as diabetes, hypertension and pharmacological treatments, were not included in the group of healthy patients. All patients were non-smokers. Gingival capillaroscopy was used to investigate the characteristics of microcirculation. Visibility, course, tortuosity, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. RESULTS An interdental papilla vascular modification results in HT. In patients suffering from HT, it was possible to observe a reduced caliber of capillaries, as well as a greater number and tortuosity of capillary loops. CONCLUSIONS This study shows that capillary alterations in patients suffering from HT occur in gingival microcirculation.
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Affiliation(s)
- Giuseppe Alessandro Scardina
- Department of Oral Sciences G. Messina, University of Palermo, Dr. Scardina Giuseppe Alessandro via Del Vespro, 129-90127 Palermo, Italy.
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Johansson Cahlin B, Samuelsson N, Dahlström L. Utilization of pharmaceuticals among patients with temporomandibular disorders: a controlled study. Acta Odontol Scand 2006; 64:187-92. [PMID: 16809198 DOI: 10.1080/00016350600573191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Pharmaceuticals are among factors that might be associated with temporomandibular disorders (TMDs), but knowledge about their utilization is limited. The purpose was to systematically register the regular use of medication in general among TMD patients and matched controls to enable comparisons to be made. MATERIAL AND METHODS Three hundred consecutive patients referred for diagnosis and treatment of TMDs and fulfilling the Research Diagnostic Criteria were examined prospectively and any medication recorded. Matched controls were registered parallel in time. The pharmaceuticals used were categorized according to the Anatomical Therapeutic Chemical Classification System (ATC). RESULTS Forty-four percent of the patients received a main diagnosis of "muscle disorder", 39% "disk disorder", and 17% "joint disorder". Fifty-one percent of all patients used some medication on a regular basis compared to 36% of the controls (p<0.001). The average number of ATC categories used among all patients was 0.9 and among controls 0.5 (p<0.001). Of the female patients with the diagnosis "muscle disorder", 23% used antidepressants (N06A), 6% tranquilizers (N05B), and 7% sleep medication or sedatives (N05C) significantly more frequently than controls. Of the female patients diagnosed with a "joint disorder", 26% used antidepressants (N06A) significantly more frequently than controls. All other ATC categories differed non-significantly. CONCLUSIONS The results suggest that the use of pharmaceuticals differs between patients and controls. TMD patients, particularly women diagnosed with "muscle" or "joint" disorders, appear to use drugs for depression more frequently than ordinary dental patients.
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