Ulcerated White Lesion of Tongue in a 7-Year-Old Child: A Diagnostic Dilemma

Tongue is a complex organ associated with functions of taste, speech, mastication, deglutition, and development of jaws. It is considered the mirror of physical health as it can be the site of infections, immunological and drug-induced reactions, neoplasms and systemic diseases. This paper aims to present challenges in diagnosing a case of a 7-year-old male child who presented with ulceration and extensive white coating on the dorsum of tongue accompanied by fever, chills, tonsillitis, and submandibular lymphadenopathy. Despite symptomatic treatment done, the white coating with patches of depapillation lasted for a relatively long time. This may be the first reported case in the literature with such unusual tongue lesions in a child till date. Thus, pediatric dentists should have sound knowledge of the commonly encountered oral soft tissue lesions along with the rarer lesions and unusual presentation of common lesions for timely diagnosis, appropriate treatment, and referral if necessary.

Oral soft-tissue sarcomas diagnosed in an oral pathology service: a 16year experience

Objective: This study analyzed the prevalence and clinic-pathological features of soft-tissue sarcomas diagnosed in a single-center of oral pathology from a School of Dentistry in Brazil. Materials and methods: All consecutive cases of intra-oral soft-tissue sarcomas diagnosed between January of 2002 and December of 2018 were retrieved from the files; patient data (sex, age and race) and characteristics of the lesions (site, size, clinical aspect and duration of injury) were collected. Results: Among a total of 62,255 biopsies diagnosed in the studied period, soft-tissue oral sarcomas comprised 76 cases (0.12%). Kaposi sarcoma, rhabdomyosarcoma, leiomyosarcoma encompassed 64.5% of the cases, and 53% of these were diagnosed as Kaposi Sarcoma. Male patients were more affected (59.2%) and white patients comprised 50%. In general, 39.4% of the patients were between 21-40yo. Conclusion: Soft-tissue sarcomas are rare in oral soft-tissue and in our pathology service, they comprised only 0.12% of all diseases diagnosed in the studied period. Kaposi sarcoma was the most frequent, followed by leiomyosarcoma and rhabdomyosarcoma. Thus, it is important for stomatologists and pathologists to be aware of their characteristics when examining oral mucosa, mainly their peculiarities regarding patient’s age, clinical appearance, and site of occurrence.

Evaluation of computed tomography settings in the context of visualization and discrimination of low dose injections of a novel liquid soft tissue fiducial marker in head and neck imaging

Background Intraoperative incorporation of radiopaque fiducial markers at the tumor resection surface can provide useful assistance in identifying the tumor bed in postoperative imaging for RT planning and radiological follow-up. Besides titanium clips, iodine containing injectable liquid fiducial markers represent an option that has emerged more recently for this purpose. In this study, marking oral soft tissue resection surfaces, applying low dose injections of a novel Conformité Européenne (CE)-marked liquid fiducial marker based on sucrose acetoisobutyrate (SAIB) and iodinated SAIB (x-SAIB) was investigated. Methods Visibility and discriminability of low dose injections of SAIB/x-SAIB (10 µl, 20 µl, 30 µl) were systematically studied at different kV settings used in clinical routine in an ex-vivo porcine mandible model. Transferability of the preclinical results into the clinical setting and applicability of DE-CT were investigated in initial patients. Results Markers created by injection volumes as low as 10 µl were visible in CT imaging at all kV settings applied in clinical routine (70–120 kV). An injection volume of 30 µl allowed differentiation from an injection volume of 10 µl. In a total of 118 injections performed in two head and neck cancer patients, markers were clearly visible in 83% and 86% of injections. DE-CT allowed for differentiation between SAIB/x-SAIB markers and other hyperdense structures. Conclusions Injection of low doses of SAIB/x-SAIB was found to be a feasible approach to mark oral soft tissue resection surfaces, with injection volumes as low as 10 µl found to be visible at all kV settings applied in clinical routine. With the application of SAIB/x-SAIB reported for tumors of different organs already, mostly applying relatively large volumes for IGRT, this study adds information on the applicability of low dose injections to facilitate identification of the tumor bed in postoperative CT and on performance of the marker at different kV settings used in clinical routine.

Evaluation of prevalence of oral soft tissue lesions in a public sector oral health facility of Karachi, Pakistan.

Objective: The aim of this study is to determine the prevalence of oral soft tissue lesions in patients attending the outpatient department. Study Design: Cross Sectional, Observational study. Setting: Department of Oral and Medicine DUHS. Period: October 2019 to March 2020. Material & Methods: A total of three hundred and eighty five (385) patients were enrolled in the study. Detailed history and thorough intra and extra oral examination of each patient were done. Results: The overall prevalence of oral mucosal lesions was found to be 58.7%. The most frequent oral mucosal lesions were reported as white with 58% of all soft tissue lesions, while the most common site was observed as buccal mucosa with 58% of all sites. As far as texture was concerned, soft texture (47%) was recorded as most frequent. Conclusion: Early detection and identification of oral mucosal lesions is crucial, especially in a population where multifaceted tobacco consumption, oral precancerous and cancerous lesions are reported as one of the highest in the world. The high prevalence of oral mucosal lesions, as reported in our study and their potential for malignant transformation necessitates extensive soft tissue examination of the oral cavity, in adjunct to routine dental checkup.

Profil lesi jaringan lunak rongga mulut anak stunting kategori pendek dan sangat pendekProfile of oral soft tissue lesions in stunted and severely stunted children

Pendahuluan: Stunting adalah keadaan kekurangan gizi kronis yang dipresentasikan secara antropometri berdasarkan nilai Z-score tinggi badan kurang dari -2 standar deviasi (SD) WHO Child Growth Standards pada kelompok umur dan jenis kelamin yang sama. Salah satu faktor utama penyebab stunting adalah defisiensi mikronutrien kronis pada 1000 hari pertama kehidupan secara spesifik pada vitamin B2, vitamin B6, zinc, dan zat besi Di sisi lain, defisiensi tersebut pun dapat menyebabkan berbagai lesi pada rongga mulut. Anak stunting memiliki risiko lebih tinggi pada lesi, penyakit bahkan kematian terutama pada anak stunting kategori sangat pendek. Tujuan penelitian untuk mengetahui profil lesi jaringan lunak rongga mulut pada anak stunting kategori pendek dan sangat pendek. Metode: Jenis penelitian observasional deskriptif dengan pendekatan cross sectional. Teknik pengambilan sampel dengan purposive sampling. Penelitian ini menggunakan data sekunder berupa data rekap bulanan status gizi berdasarkan Z-score oleh Puskesmas Jelbuk dan data primer berupa hasil pemeriksaan rongga mulut pada anak stunting. Hasil: Lesi jaringan lunak rongga mulut pada anak stunting kategori pendek adalah; Glositis (41,9%), Angular cheilitis (16,1%), Ulser (9,6%), Recurrent Apthous Stomatitis (6,4%), Oral Candidiasis (3,3%). Anak stunting kategori sangat pendek: Glositis (53,5%), Angular cheilitis (17,8%), Ulser (3,5%), Recurrent Apthous Stomatitis (7,1%), Oral Candidiasis (3,5%). Simpulan: Lesi jaringan lunak rongga mulut dengan prevalensi terbesar pada kedua kelompok kategori stunting adalah Athropic glossitis. Hal ini perlu mendapat perhatian khusus oleh praktisi kesehatan maupun pemerintah setempat karena kesehatan rongga mulut secara utuh akan memengaruhi asupan nutrisi bagi anak dan sebaliknya.Kata kunci: stunting; jaringan lunak rongga mulut; anak; lesiABSTRACTIntroduction: Stunting is a condition of chronic malnutrition presented anthropometrically based on the Z-score of height less than -2 standard deviations (SD) of the WHO Child Growth Standards in the same age and sex group. One of the main factors of stunting is chronic micronutrient deficiency in the first 1000 days of life, specifically of vitamin B2, vitamin B6, zinc, and iron. On the other hand, these deficiencies can also cause various lesions in the oral cavity. Stunting children have a higher lesion risk, disease, and even death, especially in severely stunted children. This study was aimed to examine the profile of oral soft tissue lesions in stunted and severely stunted children. Methods: The type of research used was descriptive observational research with a cross-sectional approach. The sampling technique used was purposive sampling. This study uses secondary data in the form of monthly recap data on the nutritional status based on Z-score by Jelbuk Health Center and primary data in oral cavity examination results in stunted children. Results: Oral soft tissue lesions in stunted children were glossitis (41.9%), angular cheilitis (16.1%), ulcer (9.6%), recurrent aphthous stomatitis (6.4%), and oral candidiasis (3.3%). Severely stunted children: Glossitis (53.5%), angular cheilitis (17.8%), ulcer (3.5%), recurrent aphthous stomatitis (7.1%), oral candidiasis (3.5%). Conclusions: The oral soft tissue lesion with the highest prevalence in both groups of stunting children was atrophic glossitis. This condition needs special attention from health practitioners and local governments because oral health will affect nutritional intake for children and vice versa.Keywords: stunting, oral soft tissue; children; lesion

A Comparison of Manual Nylon Bristle Toothbrushes versus Thermoplastic Elastomer Toothbrushes in Terms of Cleaning Efficacy and the Biological Potential Role on Gingival Health

Background: It is well-known that toothbrushing might be associated with the development of oral soft tissue lesions. There is currently a continuing increase in the demand for new safety and performing materials in daily homecare oral hygiene including soft and extra-soft toothbrush bristles that tend to be safer. The aim of this study was to compare the efficacy of plaque control and the potential effects on gingival health of two different toothbrush bristle models. Methods: In a three-month period, a total of forty subjects were evaluated for Oral Hygiene Index (OHI), Gingival Index (GI) and Plaque Index (PI) scores as well the Gingival Abrasion Assessment (GAA) between a toothbrush entirely made from a rubber-like material called thermoplastic elastomer (TPE) and a soft toothbrush (standard control with nylon bristles) in a clinical, single-blind, controlled, parallel-group trial. Results: The use of the TPE toothbrush allows a reduction in the PI, improves the OHI and modifies the GAA in the TPE group over a period of three months compared with a conventional soft bristle toothbrush applied for the same period, leading in this way evidence for a good influence of the TPE bristles on overall oral hygiene conditions. Conclusions: From the comparison between our data and the literature studies, we can state that the material and shape of the bristles of the toothbrush affect the home practice of oral hygiene. The TPE bristles reduce the presence of plaque formation and gingival bleeding, oral soft tissue injuries acquired during homecare oral hygiene.