Kaposi sarcoma and paracoccidioidomycosis in the same fragment of oral mucosa biopsy: a rare association in human immunodeficiency virus-positive patient. A case report

The immunossuppression caused by HIV infection makes the affected individuals more susceptible to some diseases including infections, neoplasms, or even the association between them. Kaposi sarcoma (KS) is the most common AIDS-related neoplasm, featured as an angioproliferative disorder. Its cause seems to be related to the human herpesvirus type 8 and it is usually associated with lower CD4+ T cell count. Oral involvement is frequent, presenting red to blue-purplish plaques, maculaes, and nodules. On the other hand, paracoccidioidomycosis (PCM) is a systemic mycosis, endemic in Latin America, caused by Paracoccidioides brasiliensis. This mycosis is not commonly related to human immunodeficiency virus (HIV) infection, although PCM can be present in immunosuppression cases. Oral lesions, as granulomatous ulcers, are often identified in seropositive patients with PCM. A rare case, in which a male HIV-positive patient presented simultaneously Kaposi sarcoma and PCM in the same fragment of oral mucosa biopsy, is described. To the best of our knowledge, this concomitant association had not been previously described. (C) 2011 Elsevier Inc. All rights reserved.

Untreated Dental Caries in a Brazilian Paediatric AIDS Patient Population

Purpose: The objective of the present study was to assess the prevalence of untreated caries in a Brazilian paediatric acquired immunodeficiency syndrome (AIDS) patient population and its association with sociodemographic, behavioural and clinical characteristics. Materials and Methods: The study group was comprised of 125 HIV-infected patients (aged 3 to 15 years) who had already manifested AIDS and were assisted in a specialised health care unit. Dental examinations followed the World Health Organization`s guidelines for oral health surveys. Family caregivers provided information about the socioeconomic standing and the behaviour of their children. Patients` medical records in the hospital provided information on the clinical status of patients. A Poisson regression analysis was used for assessing the covariates for the prevalence of untreated dental caries, as adjusted by age. Results: The prevalence of untreated caries was 58%; a higher prevalence was found in younger children with primary and mixed dentition. The prevalence of untreated caries associated significantly with lower socioeconomic status (household crowding and schooling of the caregiver), dietary habits (higher frequency of sugar consumption) and poorer clinical status (HIV viral load and symptom severity). Conclusions: The high burden of untreated caries on paediatric AIDS patients reinforced the importance of integrating the clinician with the interdisciplinary health care team that assisted these children. The identification of socioeconomic and behavioural factors associated with caries experience reinforced the importance of the attention that children with AIDS received within their own households for the prevention of dental disease, particularly a proper nutritional advisement and monitoring of dental hygiene.

Emerging technologies for the prevention of dental caries. Are current methods of prevention sufficient for the high risk patient?

Fluorides and chlorhexidine are technologies that are 65 and 40 years old, respectively. This overview argues that current methods of caries prevention are not effective for the high caries risk patient. In this review examples, arguments and recommendations are provided to address the high caries risk patient that include: failure of comprehensive chemical modalities treatments to address the high caries risk patient; ecological alteration - would this be an effective approach?; and biomaterials and oral microbiome research to address the high caries risk patient.

Monostotic fibrous dysplasia: a 23-year follow-up of a patient with spontaneous bone remodeling

Fibrous dysplasia is a benign fibro-osseous disease that affects one or more bones. Although its etiology has been defined, the mechanism of spontaneous resolution is still unclear. There is strong evidence indicating the occurrence of stabilization when bone maturation is completed. Deformities that lead to esthetic and functional disorders are observed in almost all cases. Plastic surgery is often recommended when the maxilla and mandible are involved. In the case of mild deformities, careful follow-up during skeletal growth is recommended. We describe here the 23-year follow-up of a patient with monostotic fibrous dysplasia whose disease had stabilized by 13 years of follow-up. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 229-234)

Odontogenic keratocyst and multiple supernumerary teeth in a patient with Ehlers-Danlos syndrome - A case report and review of the literature

Ehlers-Danlos syndrome (EDS) is a hereditary disorder of the connective tissue related to collagen metabolism. Deficiency or alteration of the collagen present in the tissues results in some classic signs such as skin hyperelasticity, articular hypermobility, and vascular fragility, among others. In addition, EDS oral manifestations are rarely cited in the literature. The aim of this article is to report a rare case of a young female patient with EDS who presented supernumerary teeth and an odontogenic keratocyst. There is no report in the literature of the simultaneous occurrence of these alterations. The article further highlights the importance of EDS diagnosis in patients who need dental treatment and the due care for their assistance.