Background: Thalassemia is a common inherited hemolytic disorder characterized by the absence or reduction of one of the globin chains. Beta thalassemia major generally has oral cavity manifestations. Patients with beta thalassemia major often require routine blood transfusion. However, this treatment has the side effect of accumulating iron in the salivary glands, which increase the risk of dental caries, gingivitis, and secondary infection from Candida albicans. Objective: The aim of this review is to explain the relationship of salivary iron levels and the effects of iron accumulation on dental caries, gingivitis, and Candida albicans infection. Methods: A comprehensive search was performed on PubMed, Scopus, and Google Scholar databases using the keywords beta thalassemia major, iron, dental caries, gingivitis, Candida albicans. Results: Iron is an essential micronutrient needed by Candida albicans for its growth and virulence. Blood transfusion in patients with beta thalassemia major can lead to a buildup of iron in the salivary glands and trigger the formation of non-transferrin bound iron (NTBI). NTBI can circulate in plasma and form a reactive oxygen species (ROS) that stimulate the formation of biofilms and increase dental caries. ROS may affect several genes associated with the inflammatory process and increase the incidence of gingivitis. It can also reduce salivary secretion in patients with thalassemia-β major that cause dysbiosis, which triggers an overgrowth of Candida albicans. Conclusion The excess iron in patients with beta thalassemia major increase the risk of dental caries, gingivitis, and Candida albicans infection.
beta thalassemia major ; iron ; dental caries ; gingivitis ; Candida albicans

Objective: To describe various local and systemic factors as the cause of gingivitis and to find out the main etiological factors of gingivitis in children with DS. Methods: We searched PubMed and Google Scholar for Indonesian and English references either in the form of textbook, research results, reviews, and internet articles on the topic. We screened and selected the relevant articles for inclusion into the review. Results: In children with DS, apart from poor oral hygiene, the increasing incidence of gingivitis is caused by changes in other local factors related to systemic factors, such as oral dysfunction, dental and gingival abnormalities, changes in the oral microbial profile, and salivary characteristics. Furthermore, systemic immunodeficiency, changes in inflammatory mediators and proteolytic enzymes, and intellectual subnormality are considered as systemic factors. Conclusion There is no main etiological factor of gingivitis in children with DS since various local and systemic factors are interrelated with each other causing gingivitis. The severity of gingivitis in children with DS presumably were caused by the systemic factors. Furthermore, good oral hygiene habits and the dentist's intervention in periodontal health can significantly reduce gingivitis in DS patients.
children ; Down syndrome ; gingivitis ; oral health

ABSTRACT Desquamative gingivitis is characterised by desquamation of the gingiva with painful erosion and ulceration. It is predominantly a manifestation of several vesiculobullous diseases. Delayed diagnosis or misdiagnosis often led to disease progression. Pemphigus vulgaris is a chronic, life-threatening autoimmune disease resulting in blistering of the mucosa and skin. Oral lesions normally preceded skin lesions. Early diagnosis and treatment are important to prevent involvement of the skin, as the treatment and prognosis varies with extraoral involvement. Clinical, histopathological examination and direct immunofluorescent are necessary for the diagnosis of pemphigus vulgaris. Treatment of desquamative gingivitis involves improving oral hygiene, reduce irritation to the lesions and specific therapy to the underlying disease. This paper describes a case of a patient with desquamative gingivitis for one year, whom is ultimately diagnosed as having pemphigus vulgaris.
Gingivitis--pathology ; Pemphigus

Report of the fourth national oral health survey showed that the prevalence of gingivitis and periodontitis stayed at a high level in Chinese population and the periodontitis was the most common cause of tooth loss in Chinese adults. Therefore, the examination of periodontal health status, disease condition and risk assessment are particularly important. The Society of Periodontology of the Chinese Stomatological Association organized experts of related disciplines to formulate the standard of basic periodontal examination and evaluation during oral diagnosis and treatment, aiming to emphasize the necessity and importance of periodontal health and to improve dental clinicians' abilities in understanding, diagnosis and treatment planning of periodontal disease. As a national and professional standard, it will play an important and practically significant role in conservation of natural teeth and improvement of people's oral health in China.
Adult ; China ; Diagnosis, Oral ; Gingivitis ; Humans ; Periodontal Diseases/therapy* ; Reference Standards

OBJECTIVE: To evaluate the effectiveness of periodontal endoscope as an adjuvant therapy for the non-surgical periodontal treatment of patients with severe and generalized periodontitis. METHODS: Patients (n=13) were divided into three groups: patients treated with conventional subgingival scaling and root planing (SRP) (n=7, 408 sites) (group A), SRP using periodontal endoscope (n=4, 188 sites) (group B) or SRP with periodontal endoscope 3 months after initial SRP (n=2, 142 sites) (group C). Two subgroups were divided into 2 subgroups according to PD at the baseline: 46 mm as subgroup 2. Probing depth (PD), attachment loss (AL), gingival recession (GR) and bleeding on probing (BOP) were recorded. RESULTS: The results of 3 months after treatment showed all PD, AL, and GR values in group A1 were less than those in group B1 (P<0.05), but no significant difference in BOP was found between the two groups. The decrease in PD, BOP in group B2 was more obvious than those in group A2 (P<0.000 1), and the GR values in group B2 were more than those in group A2 (P<0.000 1). But the improvement of AL showed no statistical difference between the two groups (P=0.296 8). In group C1, no significant difference in PD, AL, and GR was observed after endoscopy-assisted therapy, but it was more effective for BOP (P<0.000 1). In group C2, the improvement in PD and AL was significantly different from the improvement in SRP alone (P=0.000 5, P=0.000 2) and was accompanied by more GR (P=0.000 5). CONCLUSIONS In non-surgical treatment of severe and generalized periodontitis, SRP can achieve good therapeutic effect on sites with 4<
PD≤6 mm. For sites with PD>6 mm, the application of periodontal endoscopy can increase the effect, reducing PD and GR, which may be an effective supplement to the current non-surgical periodontal treatment.
Dental Scaling ; Endoscopes ; Follow-Up Studies ; Gingival Hemorrhage ; Humans ; Periodontal Attachment Loss ; Periodontal Index ; Periodontal Pocket ; Periodontitis ; Root Planing ; Treatment Outcome

BACKGROUND: The mandibular third molar (M3) is typically the last permanent tooth to erupt because of insufficient space and thick soft tissues covering its surface. Problems such as alveolar bone loss, development of a periodontal pocket, exposure of cementum, gingival recession, and dental caries can be found in the adjacent second molars (M2) following M3 extraction. The specific aims of the study were to assess the amount and rate of bone regeneration on the distal surface of M2 and to evaluate the aspects of bone regeneration in terms of varying degree of impaction. METHODS: Four series of panoramic radiographic images were obtained from the selected cases, including images from the first visit, immediately after extraction, 6 weeks, and 6 months after extraction. ImageJ software® (NIH, USA) was used to measure linear distance from the region of interest to the distal root of the adjacent M2. Radiographic infrabony defect (RID) values were calculated from the measured radiographic bone height and cementoenamel junction with distortion compensation. Repeated measures of analysis of variance and one-way analysis of variance were conducted to analyze the statistical significant difference between RID and time, and a Spearman correlation test was conducted to assess the relationship between Pederson’s difficulty index (DI) and RID. RESULTS: A large RID (> 6 mm) can be reduced gradually and consistently over time. More than half of the samples recovered nearly to their normal healthy condition (RID ≤ 3 mm) by the 6-month follow-up. DI affected the first 6 weeks of post-extraction period and only showed a significant positive correlation with respect to the difference between baseline and final RID. CONCLUSIONS: Additional treatments on M2 for a minimum of 6 months after an M3 extraction could be recommended. Although DI may affect bone regeneration during the early healing period, further study is required to elucidate any possible factors associated with the healing process. The DI does not cause any long-term adverse effects on bone regeneration after surgical extraction.
Alveolar Bone Loss ; Bone Regeneration ; Compensation and Redress ; Dental Caries ; Dental Cementum ; Follow-Up Studies ; Gingival Recession ; Molar ; Molar, Third ; Periodontal Pocket ; Retrospective Studies ; Tooth ; Tooth Cervix

OBJECTIVES: This study aimed to investigate factors related to the periodontal health of 12-year-old children.METHODS: In 2015, the Korean Children's Oral Health Survey from the Ministry of Health & Social Welfare conducted a nationwide representative sample comprised of 23,702 12-year-old children. The calibration-trained dentists examined the gingivitis and dental calculus of the children taking into consideration of the Löe and Silness gingival index to diagnose gingivitis with a modified gingivitis scale. We used questionnaires to collect data from the children on dental treatments, the experience of dental pain and gingival bleeding, self-perceived oral health, and oral health behaviors. Data were analyzed using a complex samples Chi-square test, general linear model, and logistic regression. Significance was determined at P < 0.05.RESULTS: The prevalence of gingivitis was higher among males (OR 1.57), among children with poor perception (OR 1.19), dental calculus (OR 3.68), or gingival bleeding experience (OR 2.00), and among children not using dental floss (OR 1.69) or tongue cleaner (OR 1.90). The prevalence of dental calculus was higher among children with gingivitis (OR 3.82) and among children who had not visited a dental clinic in the preceding year (OR 1.31). However, dental calculus was lower among children with a higher frequency of daily toothbrushing (OR 0.75), intake of cariogenic foods (OR 0.90), or a higher DMFT index (OR 0.91).CONCLUSIONS: Children with dental calculus and gingival bleeding who did not visit a dental clinic in the preceding year also had a higher prevalence of gingivitis and dental calculus. The prevalence of children's dental calculus was lower among children with a high frequency of daily toothbrushing.
Child ; Dental Calculus ; Dental Clinics ; Dental Devices, Home Care ; Dentists ; Gingivitis ; Hemorrhage ; Humans ; Linear Models ; Logistic Models ; Male ; Oral Health ; Periodontal Index ; Prevalence ; Social Welfare ; Tongue ; Toothbrushing

Necrotizing ulcerative stomatitis (NUS) refers to ulceration of the oral mucosa that precedes rapid orofacial soft- and hard-tissue destruction. NUS on the upper lip is considered a reconstructive challenge because of the functional importance and complex multidimensional structure of the facial units that are involved, and is most commonly found in developing countries. Therefore, few studies have been conducted on NUS. Moreover, reconstruction options vary from local regional flaps to free-tissue transfers. We report a very interesting case in which we performed regional flap surgery using bilateral cheek advancement in a patient with NUS. A 75-year-old woman with a history of diabetes mellitus and hypertension, but no other immunological diseases, presented with skin necrosis on the upper lip. At presentation, necrotic tissue covered the upper lip and philtrum, but it had not invaded the nose or lower lip. After debridement of the necrotic tissue, approximately 70% of the upper lip was missing. We therefore designed a bilateral cheek advancement and rotation flap, in which the flap was sutured in 3 layers. There was no need to perform additional procedures, as the flap healed well and showed no other complications or recurrence. The patient exhibited good voluntary muscle control and oral competence while eating and drinking, and she was also very satisfied with the cosmetic results. Thus, regional flap surgery using a simple advancement flap may result in good recovery of both functional and aesthetic units in patients with NUS.
Aged ; Cheek* ; Debridement ; Developing Countries ; Diabetes Mellitus ; Drinking ; Eating ; Female ; Gingivitis, Necrotizing Ulcerative* ; Humans ; Hypertension ; Immune System Diseases ; Lip* ; Mental Competency ; Mouth Mucosa ; Muscle, Skeletal ; Necrosis ; Noma ; Nose ; Reconstructive Surgical Procedures ; Recurrence ; Skin ; Surgical Flaps ; Ulcer*

With the increasing number of the orthodontic patients, the relationship between periodontal and orthodontic becomes increasingly close. Orthodontic treatment can improve periodontal status, but the adverse clinical problems of periodontal tissue during orthodontic treatment are relatively common. In this paper, we discuss the problems of soft tissue, including causes, prevention, and treatment of gingivitis, gingival enlargement, gingival recession, and gingival invagination in orthodontic treatment.
Gingiva ; Gingival Overgrowth ; therapy ; Gingival Recession ; therapy ; Gingivitis ; therapy ; Humans ; Tooth Movement Techniques

OBJECTIVES: Given that oral health is one of the major factors affecting the quality of life, it is necessary to measure the oral-health-related-quality-of-life dimension in order to value health. The aim of this study was to compare the dimensions of oral-health-related quality-of-life measured by a generic health measure [EuroQol-5D (EQ-5D)] and an oral health specific measure [Oral Health Impact Profile 14 (OHIP-14)]. METHODS: A questionnaire including EQ-5D, OHIP-14, self-rated general/oral health, and visual analog scale (VAS) was developed, and both patients and dentists participated in measuring the patient's oral health-related quality of life based on oral diseases. Data was collected from the Dental University Hospital from 2016 to 2017. For descriptive analysis, t-test, chi-square, ANOVA, Tukey HSD post-test, and Pearson correlation analysis were performed. To confirm the factors associated with EQ-5D, multiple regression analysis was conducted. RESULTS: A total of 305 subjects were selected for the final analysis excluding the partially missing questionnaires. EQ-5D and OHIP-14 showed a statistically significant correlation and a sensitive distribution of the values depending on the oral diseases. The values of EQ-5D and OHIP-14 ranged from highest to lowest in the following order of oral diseases: endodontic, TMJ, gingivitis, and tooth sensitivity. A 10-point increase in OHIP-14 was associated with a 0.34-point increase in EQ-5D. CONCLUSIONS: The result of this study proved to be consequential since both OHIP-14 and EQ-5D were good measures for oral health-related quality of life, and the oral disease status could also be measured in terms of health valuation weights. This increased the possibility of comparison with general health, and provided the loss of socioeconomic costs of individuals, families, and societies due to oral diseases.
Dentists ; Gingivitis ; Humans ; Oral Health ; Quality of Life ; Temporomandibular Joint ; Tooth ; Visual Analog Scale ; Weights and Measures