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Background: The main advantages of trans-oral (TOA) removal of submandibular gland (SM) are to eliminate the potentiality of remnant duct disease since the entire duct and papillae are removed and avoid cervical scar. The aim of this work was to assess the feasibility and outcome of TOA for removal of the submandibular gland (SMG) in comparison to the standard transcervical (TCA) approach. Methods: This study was applied on 18 patients with benign SMG swelling indicated for gland excision.9 patients were operated via the standard TCA and 9 patients were operated via the recent TOA. Then the patients were followed up and assessed for postoperative pain, edema, nerve deficits, scar and complication. Results: All patients complained of intermittent pain and swelling in the submandibular area. TOA take longer operative duration than TCA.TOA led to more severe early postoperative symptoms than the TCA, including postoperative pain in all patients, salivary pooling in six cases (66.7%), temporary tongue numbness and hypoesthesia that was reported in all cases, tongue deviation on protrusion was documented in one case (11.1%), and mouth floor infection was detected in 2 cases. All these symptoms resolved after one week and did not leave permanent sequela. Non-disfiguring visible neck scar was seen in all the TCA cases without reported complication of the scar. Conclusion: Even though, the TOA for excision of the SMG is not easy and takes a longer duration and most patients temporarily complained of neurologic problems of the lingual nerve, but these were completely resolved within 2 months after surgery. [ABSTRACT FROM AUTHOR]

The Archaea domain was recognized as a separate phylogenetic lineage in the tree of life nearly 3 decades ago. It is now known as part of the human microbiome; however, given that its roles in oral sites are still poorly understood, this review aimed to establish the current level of evidence regarding archaea in the oral cavity to guide future research, providing insights on the present knowledge about the human oral archaeome. A scoping review was conducted with the PRISMA Extension for Scoping Reviews checklist. Five electronic databases were searched, as well as gray literature. Two independent reviewers performed the selection and characterization of the studies. Clinical studies were included when the target population consisted of humans of any age who were donors of samples from the oral cavity. A qualitative analysis was performed, based on the type of oral site and by considering the methods employed for archaeal identification and taxonomy, including the DNA extraction protocols, primers, and probes used. Fifty articles were included in the final scoping review, published from 1987 to 2019. Most studies sampled periodontal sites. Methanogens were the most abundant archaea in those sites, and their presence could be associated with other periodontal pathogens. No consistent relationship with different disease conditions was observed in studies that evaluated the microbiota surviving in endodontic sites. Few articles analyzed the presence of archaea in dental caries, saliva, or tongue microbiota, as well as in archaeologic samples, also showing a relationship with healthy microbiota. Archaea have been detected in different oral niches of individuals from diverse geographic locations and clinical conditions, suggesting potential roles in oral diseases. Methodological limitations may hamper our current knowledge about archaeal diversity and prevalence in oral samples, and future research with diversified methodological approaches may lead to a better comprehension of the human oral archaeome. [ABSTRACT FROM AUTHOR]

Copyright of Iraqi Journal of Science is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diabetes mellitus is the most prevalent endocrine disease, comprising the third highest cause of disability and morbidity in the Western world. In the past, implant placement was contraindicated in diabetic patients because of increased risk for implant failure and infection. Publications in recent years have shown success rates for dental implants in diabetic patients resembling those of the general population. Other studies, in diabetic patients, as well as in animal models, have shown an increased risk for implant failure. These results raise the question of whether diabetic patients are suitable for dental implant rehabilitation. This article reviews the literature and presents the factors used in assessing the severity of diabetes and its complications, as well as the considerations for rehabilitation planning in these patients. Integration of these factors by the dentist dictates whether as well as what type of implant-supported restoration should be preformed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the cumulative survival rates of dental implants placed in a private periodontal practice and the effects of periodontal disease and immediate placement on implant survival. Materials and Methods: A retrospective chart review was conducted on 149 consecutive patients. Each patient had a single implant placed. For the purpose of analysis, patients were divided into 2 groups: those who were periodontally healthy and those who had periodontal disease. Implants were placed into available bone either immediately or after a healing period. All failed implants were removed and recorded. The effects of periodontal status and placement time on implant survival were evaluated using Cox proportional hazards regression and log-rank tests. Results: Of the 149 implants in the study, 22 failed during the observation period. The 127 censored cases (ie, implants that had not failed at the end of the observational period) were observed for a mean of 943 days (SD 932, range 35 to 4,030). Failed implants were observed for a mean of 722 days (SD 1,026, range 18 to 3,548). The presence of periodontal disease appeared to be associated with a greater failure rate, but there was no observed effect associated with time of placement. The percentages of censored immediate placement cases and delayed placement cases were nearly identical. Among the 77 implants associated with periodontal disease, placement time was not strongly associated with percentage censored. Forty-three of the 55 immediately placed implants (78.18%) and 18 of the 22 implants (81.18%) whose placement was delayed were censored. Both Cox proportional hazards regression and log-rank tests established that survival was adversely affected by periodontal disease (P < .05) but unaffected by time of placement (P > .50). The lower 1-sided 95% confidence limit for median survival time was 3,548 days for patients without periodontal disease and 1,799 days for patients with disease. Discussion and Conclusion: Implant survival was compromised by a history of periodontitis but not affected by immediate or delayed placement. [ABSTRACT FROM AUTHOR]

Before new treatment concepts can be used in daily practice, a critical analysis of the present scientific literature is necessary. The concept of full-mouth disinfection (FMD) was introduced as a new alternative treatment for the non-surgical therapy of inflammatory periodontal diseases, and is becoming more and more popular in dental practice. The following article provides a short survey and evaluation of the present scientific evidence about full-mouth disinfection. The concept of full-mouth disinfection includes scaling and root planing within 24 hours combined with an adjunctive chlorhexidine chemotherapy aimed to eliminate bacterial reservoirs in eriodontal pockets and in all oral niches. Scaling and root planing within 24 hours but without the adjunctive chemotherapy - called full-mouth scaling (FMS) - is another newly introduced strategy for the treatment of periodontitis. For the present review, 9 original publications of clinical studies were analyzed, in which a total of 118 patients with chronic or aggressive periodontitis were treated. Bleeding upon probing, the reduction of probing depths, changes of attachment level, and analysis of the bacterial microflora were used as markers to compare the different treatment modalities. Based on the present review, no evidence was found that full-mouth disinfection or full-mouth scaling could improve the clinical results of periodontal treatment compared to conventional scaling and root planing. Currently there exists no evidence for a change in a paradigm in periodontal treatment from conventional non-surgical therapy to full-mouth disinfection. [ABSTRACT FROM AUTHOR]

Objectives: To see if dentures contaminated with Staphylococcus aureus, Pseudomas aeruginosa, Bacillus cereus, Candida albicans, and herpes simplex virus 1 could be effectively decontaminated by using Medical Tabs tor Dentures. Method and materials: Ten methylmethacrylate dentures with processed soft liners (soft-liner dentures) and 10 methylmethacrylate dentures without processed soft liners (hard dentures) were aseptically fragmented and individually incubated with a target microorganism. Test denture fragments were immersed in Medical for 5 minutes, vortexed for 5 minutes, and serially diluted onto media. The control denture fragments were similarly treated in sterile water. For virus contamination, denture fragments were contaminated with 1.2 x 10' tissue culture infective dose (TCID)50/mL. They were treated with either Medical for 5 minutes (test fragments) or water {controls) for 5 minutes. Serial dilutions were performed and viral (TCID}50/mL liters were calculated using the Reed-Muench method. Results: Medical treatments effectively eliminated C albicans. S aureus, and P aeruginosa from soft-liner dentures. Treatment of hard dentures eradicated C albicans and reduced the numbers of S aureus and P aeruginosa to < 10, B cereus showed a reduction of 10 microorganisms in hard dentures while the soft-liner dentures did not show an appreciable reduction. Viral analyses found that both types of dentures retained large amounts of virus when washed with water, but no virus was recovered from any of the 40 samples treated with Medical. Conclusion: A single use of Medical Tabs tor Dentures is effective in eliminating certain species of microorganisms, including selected viruses, in vitro. [ABSTRACT FROM AUTHOR]

Purpose: Dental implants with a reduced diameter are designed for specific clinical situations, such as placement of implants where bone width is narrow or between adjacent teeth that have only a narrow space between them. They are particularly useful when replacing small teeth such as lateral maxillary and mandibular incisors. The aim of the present study was the clinical evaluation of 2-part ITI implants (full-body screws with a 3.3-mm diameter). Materials and Methods: One hundred forty-nine partially or completely edentulous patients received a total of 298 2-part ITI implants over a 10-year period. After a standard healing period (3 to 6 months), the implants were restored with fixed restorations such as single crowns or fixed partial or complete prostheses or overdentures. Complete prosthesis or overdenture in the edentulous jaw was the predominant type of restoration. All patients followed a strict maintenance program, with regular recalls at least once a year. The survival rate of the implants was analyzed, and prosthetic complications were assessed. Results: Three implants were lost during the healing phase on account of peri-implant infection. Two implant body fractures with an osseous length of 8 mm were observed (one after 2 years of observation, the other after 6 years). Four implants exhibited transient peri-implant inflammation that was treated successfully by interceptive therapy. The cumulative 5-year survival rate of the implants was 98.7% (96.6% after 6 years). Prosthetic complications were mostly limited to loose occlusal screws and sore spots caused by the denture base. Discussion: Within the limited observation period, failures of small-diameter implants were infrequent. Prosthetic complications were not dependent on the use of small-diameter implants. Conclusion: The use of 3.3-mm ITI implants appears to be predictable if clinical guidelines are followed and appropriate prosthetic restorations are provided. However, fatigue fracture may occur after a long period of function. [ABSTRACT FROM AUTHOR]

Oral infection caused by the herpes simplex virus represents one of the more common conditions the dental practitioner will be called upon to manage. Unique in its ability to establish latency and undergo subsequent recurrence, it is an ubiquitous infectious agent for which a cure does not exist. For the immunocompetent patient, herpes virus simplex infection typically represents nothing more than a nuisance. However, for the immunocompromised patient, this infection is associated with increased morbidity and mortality. Recently introduced antiviral drug regimens may reduce the morbidity and potential mortality of the herpes simplex virus, especially in immunocompromised patients The value of antiviral therapy in the management of recurrent herpes simplex virus infection in the immunocompetent patient remains an area of contentious debate (Quintessence Int 2003;34:453-467) [ABSTRACT FROM AUTHOR]

In 21 patients, 28 maxillary teeth were extracted because of periapical or periodontal infection, root fracture, or untreatable caries. A rotated palatal flap procedure was used to achieve primary soft tissue closure over extraction sites. At 5 to 7 weeks postextraction, 28 implants were placed. Buccal dehiscence-type defects were treated with guided bone regeneration procedures using bovine bone mineral and resorbable collagen membranes. Mean defect area at the time of implant placement (23.7 mm2, SD 11.49) was significantly reduced at uncovering (0.7 mm2, SD 0.99). The mean percentage of defect reduction (clinical bone fill) was 97% (SD 4.26). Implants placed in compromised sites shortly postextraction according to the presented 2-stage protocol gave good short-term clinical results. [ABSTRACT FROM AUTHOR]

Introduction: Both Actinomyces and Nocardia are Gram‐positive microbes characterized by a filamentous morphology. Both can be causative agents in slowly progressive, localized, or disseminated infections that are rare and typically occur in immunocompromised patients. Oral infections involving both microorganisms are very rare. Case Presentation: A black male with a history of Type 2 diabetes was referred with a chief complaint of a persistent 3 mm × 3 mm swelling facial to the mandibular central incisors. The swelling was asymptomatic except for occasional discharge of purulent exudate. Examination revealed 5‐ to 6‐mm mesio‐lingual and mid‐lingual probing depths. Radiographs revealed a well‐defined radiolucency between the roots of teeth #24 and #25. A full‐thickness gingival flap was reflected exposing an oval‐shaped bony defect, which was debrided and the contents submitted for microscopic examination. The resulting defect was filled with demineralized freeze‐dried bone allograft (DFDBA) and capped with calcium sulfate. The patient was prescribed amoxicillin and 0.12% chlorhexidine gluconate mouthrinse. Examination of the biopsied tissue revealed both Actinomyces and Nocardia microorganisms. The patient was followed for 24 months and remains symptom‐free with noted radiographic evidence of bone fill in the lesion area. Conclusions: This may be the first published report of an oral infection featuring both Actinomyces and Nocardia. The case reinforces the importance of microscopic examination of biopsy material removed from unusual and persistent pathologic lesions that are destructive of bone. [ABSTRACT FROM AUTHOR]

This article concerns one of the major problems of all implants: the risk for latent potential infections. A case report involving latent infection of a mandibular implant is presented. [ABSTRACT FROM AUTHOR]

Context:Herbal therapies are used worldwide to treat health conditions. In Mexico, generations have used them to treat gingivitis, periodontitis, mouth infections, and discoloured teeth. However, few studies have collected scientific evidence on their effects. Objective:This study aimed at searching and compiling scientific evidence of alternative oral and dental treatments using medicinal herbs from Mexico. Methods:We collected various Mexican medicinal plants used in the dental treatment from the database of the Institute of Biology at the National Autonomous University of Mexico. To correlate with existing scientific evidence, we used the PubMed database with the key term ‘(scientific name) and (oral or dental)’. Results:Mexico has various medical herbs with antibacterial and antimicrobial properties, according to ancestral medicinal books and healers. Despite a paucity of experimental research demonstrating the antibacterial, antimicrobial, and antiplaque effects of these Mexican plants, they could still be useful as an alternative treatment of several periodontal diseases or as anticariogenic agents. However, the number of studies supporting their uses and effects remains insufficient. Discussion and conclusion:It is important for the health of consumers to scientifically demonstrate the real effects of natural medicine, as well as clarify and establish their possible therapeutic applications. Through this bibliographical revision, we found papers that testify or refute their ancestral uses, and conclude that the use of plants to treat oral conditions or to add to the dental pharmacological arsenal should be based on experimental studies verifying their suitability for dental treatments. [ABSTRACT FROM PUBLISHER]

Our aim was to find out if it is possible to correlate the duration of stay in hospital, the severity of infection, involvement of particular anatomical spaces, white cell count, efficacy of surgical treatment, and fever with C-reactive protein (CRP) concentrations on admission. One hundred patients met our inclusion criteria. After their notes had been examined they were subdivided according to whether the infection of the main facial space involved was less severe, moderately severe, or very severe. The relations between degree of severity and CRP concentration on admission (<100 mg/L compared with 100+), age (years), sex, and duration of hospital stay (days) were examined using Poisson regression (because the distribution of characteristics, and particularly the duration of stay, were skewed). The overall model was significant (p = 0.003). Pearson and deviance chi square tests did not indicate overdispersion (p = 0.97 in both cases), which suggested that the assumptions about the Poisson distribution were valid. Log-rank chi square tests indicated that only severity had a significant effect (p = 0.0001), and C-reactive protein concentration was not significantly associated with group on admission, age, or sex. The moderately and very severe groups had longer median (range) durations of stay than the less severe group (5 (2-8) compared with 3 (1-8) days, respectively). CRP concentration was not a prognostic factor for the extent of odontogenic infections or presumed duration of stay, but severity scoring was a significant factor in the prediction of duration of stay in hospital. [ABSTRACT FROM AUTHOR]

Chronic suppurative osteomyelitis still constitutes a significant oral health burden in developing countries. However, it is a relatively rare complication of odontogenic infections in the United States. This case report serves to heighten awareness of suppurative osteomyelitis as an important, albeit uncommon, sequela of long-standing infection of the jaw in a healthy U.S. adult with no known predisposing factors. We describe a case of chronic suppurative osteomyelitis that presented in a healthy, young, adult female with no predisposing factors besides smoking 11 years post-endodontic therapy. [ABSTRACT FROM AUTHOR]

Background: Oral health and frailty might be linked through several pathways, but previous studies are scarce. This study examined the association between oral health and components of Fried's frailty phenotype.Methods: This cross-sectional analysis was based on a sample of 992 community-dwelling persons aged 73 to 77 years observed in the 2011 follow-up of the Lausanne 65+ cohort (Lc65+) study. Data were collected through annual mailed questionnaires, interview and physical examination. Oral health was assessed according to self-reported oral pain and masticatory ability. Frailty was defined as meeting at least one criterion of the Fried's phenotype.Results: Oral pain was reported by 14.8% and chewing problems by 9.7%. Impaired masticatory ability (IMA) was more frequent in subjects with missing teeth or removable dentures (13.5%) than among those with full dentition or fixed dental prostheses (3.2%). In logistic regression analyses adjusting for demographics, alcohol consumption, smoking, comorbidity and financial difficulties, persons with oral pain and those with chewing problems had significantly higher odds of being frail (adjusted ORpain = 1.72; 95% CI 1.17-2.53 and adjORIMA1.70; 1.07-2.72, respectively). Lack of endurance was associated with both oral pain (adjOR = 3.61; 1.92-6.76) and impaired masticatory ability (adjOR = 2.20; 1.03-4.72). The latter was additionally linked to low physical activity (adjOR = 2.35; 1.29-4.28) and low gait speed (adjOR = 3.12; 1.41-6.90), whereas oral pain was associated with weight loss (adjOR = 1.80; 1.09-2.96) and low handgrip strength (adjOR = 1.80; 1.17-2.77).Conclusion: Self-reported oral pain and chewing impairment had a significant relation with frailty and its components, not only through a nutritional pathway of involuntary weight loss. Longitudinal analyses are needed to examine whether a poor oral condition might be a risk factor for the onset of frailty. [ABSTRACT FROM AUTHOR]

Background: Leukaemia represents 30-40% of all paediatric malignant tumours and is the main cause of death in patients aged <15 years. One of the main complications in these patients is infection, which may often occur in the oral cavity. Chemotherapy-related oral health problems may be reduced by oral healthcare strategies based on the International Caries Detection and Assessment System (ICDAS) and Caries Management by Risk Assessment (CABRA). Case report: A case is reported of a 14-year-old girl treated for leukaemia who presented with established dental caries lesions which were classified and treated according to ICDAS and CABRA protocols. After three, no new caries was observed. Follow-up and conclusion: ICDAS and CAMBRA provide useful and effective guidance for the avoidance of dental and systemic problems. Their introduction into standard practice could reduce the legal difficulties derived from dental treatment in these patients. [ABSTRACT FROM AUTHOR]

Oral infections are among the most common diseases worldwide. Many protocols for the prevention and treatment of oral infections have been described, yet no golden standard has been developed so far. The antiseptic chlorhexidine and antibiotics are often used in these treatment procedures. However, long-term use of chlorhexidine can lead to side effects and extensive use of antibiotics can promote the development of antibiotic-resistant bacteria, which in turn can compromise the effectiveness of the treatment. Consequently, it remains important to search for new antibacterial agents for the treatment of oral infections. In this study, we report on the antibacterial activity of the antiasthma drug zafirlukast against oral pathogens Porphyromonas gingivalis and Streptococcus mutans. Furthermore, its activity against oral biofilms grown on titanium surfaces was confirmed. In addition, we demonstrated that zafirlukast displays no cytotoxicity against human osteoblasts. Combined, this study paves the way for further research to determine the potential of zafirlukast to be used as a new antibiotic against oral pathogens. [ABSTRACT FROM AUTHOR]

Copyright of Annals of African Medicine is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The majority of serious dental infections can be prevented by early treatment of the local pathology. Patients with potentially life-threatening neck space infections arising from the oral cavity may, however, still present in dental practice. This paper outlines the pertinent surgical anatomy and pathophysiology, signs and symptoms, and key early-stage management of these severe infections. [ABSTRACT FROM AUTHOR]

The article presents excerpts from several research papers which appeared in previous issues of the journal, and it mentions articles about the adhesion of acrylic filling materials to enamel surfaces, the relationship between oral infection and mental disease, and a human mandible growth pattern.

Named cells refer to cells that are associated with the name of the scientist who first described them. These cells can be either seen in normal tissues or may be noticed in pathological conditions, including infections, inflammatory conditions, neoplasms, and in certain metabolic disorders. This article lists some named cells seen in routine histopathological practice with a brief description about their morphology and staining reactions. [ABSTRACT FROM AUTHOR]

What appears to be a decorative fad, pursued by people of all ages, is, for the most part, an invasion of the body by poorly trained individuals. Simple-to-complex, the insertion of body jewelry is embarked upon on a whim with little concern for health, including the possibility of infection. Many of those who opt for piercings have outcomes that are unremarkable and relatively trouble free. Others, less fortunate, end up with irreversible scars, serious infections, torn anatomic structures and teeth that are fractured, disfigured or have drifted out of line. [ABSTRACT FROM AUTHOR]

Objectives: Denosumab, a human monoclonal antibody (mAb) that neutralizes receptor activator for nuclear factor κB ligand (RANKL), is associated with osteonecrosis of the jaw. However, the effect of denosumab on oral wounds is unclear. The aim was to determine the effect of anti-RANKL mAb on oral wounds and bone marrow. Materials and methods: The direct effect of the mAb on fibroblasts, macrophages, and osteoclasts were assessed in vitro. In vivo, mouse anti-RANKL mAb was administered to mice for 9 weeks prior to palatal bone denudation surgery. Mice were euthanized 3 weeks post-surgery, and wound healing was histomorphometrically analyzed. Long bones were assessed using micro-computed tomography, quantitative real-time polymerase chain reaction, and flow cytometry. Results: The mAb had no effect on macrophages and fibroblasts but significantly suppressed osteoclast proliferation in vitro. The mAb treatment significantly increased bone mass by suppressing osteoclasts in vivo. The expression of pro-osteoclastic genes was promoted in the bone marrow of the mAb-administered animals. Consistently, the mAb significantly induced the development of tartrate-resistant acid phosphatase (TRAP)-positive mononuclear cells (MNCs) but not osteoclasts in bone marrow. The mAb treatment had no effect on gross healing of the palatal wounds. However, significant inflammation was retained in the connective tissue facing the once denuded bone surface. Conclusions: Repair of the damaged palate was delayed, and significant inflammation was sustained in the connective tissue by anti-RANKL mAb treatment. Clinical relevance: Denosumab impairs osteoclastic bone repair. Care should be exercised to minimize osseous trauma when invasive procedures are performed on patients taking denosumab. [ABSTRACT FROM AUTHOR]

Background: Human papilloma virus oral infection can be related to several factors including HIV infection, cigarette smoking, marijuana consumption and number of sexual partners. We conducted a study on oral HPV prevalence and clearance among the hosts of the San Patrignano community, a population considered at "high-risk" for HPV due to their previous habits.Methods: From March 2007 to September 2010 all subjects were submitted to oropharyngeal brushing and saliva collection at baseline, after 6, 12 and 48 months (for subjects HPV positive at baseline). Samples were analyzed to detect HPV DNA and virus genotypes. The correlation between HPV prevalence and demographic, behavioral or immunological characteristics was assessed.Results: Among 194 subjects, 30 (15%) were HPV positive with 25 (13%) high-risk (HR)-HPV at baseline brushing. At 12 months HPV infection was cleared in all cases. However at 48 months HPV was newly detected in 33% of subjects. A correlation between time spent in the community and increase in the ratio of "low-risk" (LR) HPV and HR-HPV was observed. HPV infection was not associated with age, gender, HIV status, HCV, alcohol and/or drug exposure, number of years spent in community, sex with drug-addicts and condom use. Only AIDS under antiretroviral treatment was inversely correlated with the risk of infection.Conclusions: At 1 year a complete HPV clearance was observed which could be related to adoption of healthier lifestyles of participants. New HPV infections were detected even in the absence of the recognized and declared risky behavioral factors, suggesting a re-expression from a latent infection. [ABSTRACT FROM AUTHOR]

Although several epidemiologic studies reported plausible and potentially causal associations between oral infections and cardiometabolic diseases (CMDs), controversy still lingers. This might be due to unrecognized confounding from metabolic inflammation and genetics, both of which alter the immune responses of the host. Low-grade inflammation termed metainflammation is the hallmark of obesity, insulin resistance, type 2 diabetes, and CMDs. According to the common soil theory, the continuum of obesity to CMDs is the same pathology at different time points, and early metainflammations, such as hyperglycemia and obesity, display many adverse cardiometabolic characteristics. Consequently, adipose tissue is now considered a dynamic endocrine organ that expresses many proinflammatory cytokines such as TNF-α, IL-6, plasminogen activator inhibitor 1, and IL-1β. In metainflammation, IL-1β and reactive oxygen species are generated, and IL-1β is a pivotal molecule in the pathogenesis of CMDs. Note that the same cytokines expressed in metainflammation are also reported in oral infections. In metabolic inflammation and oral infections, the innate immune system is activated through pattern recognition receptors—which include transmembrane receptors such as toll-like receptors (TLRs), cytosolic receptors such as nucleotide-binding oligomerization domain–like receptors, and multiprotein complexes called inflammasome. In general, TLR-2s are presumed to recognize lipoteichoic acid of Gram-positive microbes—and TLR-4s, lipopolysaccharide of Gram-negative microbes—while nucleotide-binding oligomerization domain–like receptors detect both Gram-positive and Gram-negative peptidoglycans on the bacterial cell walls. However, a high-fat diet activates TLR-2s, and obesity activates TLR-4s and induces spontaneous increases in serum lipopolysaccharide levels (metabolic endotoxemia). Moreover, genetics controls lipid-related transcriptome and the differentiation of monocyte and macrophages. Additionally, genetics influences CMDs, and this creates a confounding relationship among oral infections, metainflammation, and genetics. Therefore, future studies must elucidate whether oral infections can increase the risk of CMDs independent of the aforementioned confounding factors. [ABSTRACT FROM AUTHOR]

Mouth is an important source of infections and oral infections such as Candida infections increase the risk of mortality. Our purpose was to investigate differences in proteolytic activity of non- albicans Candida albicans (non- albicans Candida) between clinical isolates and laboratory samples. The second aim was to assess the concentration of pro- and anti-inflammatory cytokine levels IL-1β, IL-10, and TNF-α in saliva of patients with the non- albicans Candida and Candida-negative saliva samples. Clinical yeast samples from our laboratory were used for analyses. Candida strains were grown in YPG at 37 °C for 24 h in water bath with shaking. The activity of Candida proteinases of cell and cell-free fractions were analyzed by MDPF-gelatin zymography. The levels of IL-1β, IL-10, and TNF-α were measured from saliva with ELISA. The study showed differences in the proteolytic activity among the non- albicans Candida strain s. C. tropicalis had higher proteolytic activity when compared to the other strains. Significant difference was found in salivary IL-1β levels between the non- albicans Candida and control strains ( P < 0.002). The present findings showed differences in proteolytic activity among the non- albicans Candida strains. The increased IL-1β concentration may be one of the host response components associated with non- albicans Candida infection. [ABSTRACT FROM AUTHOR]

The specific aim of this study was to assess sintered porous-surfaced ( SPS) implant system from a biological point of view, through a prospective study of the health status and the evolution of the peri-implant tissues over time and analysis of the changes observed in the various peri-implant parameters. Material and Methods Hundred and fifty-one patients were treated consecutively from 2005 to 2007 using 280 SPS implants, which were restored with a single crown or a partial fixed denture. To accurately monitor the health and biological evolution of peri-implant soft and hard tissues, a number of clinical parameters were adopted, such as the modified Plaque Index ( mPI), the modified sulcus Bleeding Index ( mBI), Peri-implant Probing Depth (PPD), and Crestal Bone Level (CBL). Clinical and radiographic examinations were scheduled over a 36-month follow-up of functional loading according to a well-established protocol generally applied to determine implant success rates and Peri-implant Bone Loss (PBL). Statistical analysis was used to determine any significant differences or correlations ( P = 0.05). Results A total of 259 SPS implants in 136 patients were followed up for 36 months. According to Buser's success criteria, the overall implant-based success rate was 98.1% and the mean PBL was 0.48 ± 0.29 mm. MBI and mPI mean values showed statistically significant differences between baseline and follow-up analyses ( P < 0.001). No statistically significant differences in mean PPD values were found between baseline and control analyses ( P = 0.060). Conclusion This prospective cohort study revealed that the biological behavior of SPS implant system was characterized by high tissue stability during the observation period, both as regards soft and hard tissues. In particular, the crestal bone remodeling pattern was very similar to that reported in other studies, confirming that the bone loss around SPS implants, at least at 36 months, seems to be predictable. [ABSTRACT FROM AUTHOR]

The article presents a quiz related to chronic lymphocytic leukemia and mouth disease caused by coxsackievirus A6 (CVA6).

Enteropathogenic Escherichia coli (EPEC), a leading cause of infant diarrhea, is an important public health problem in Brazil and other developing countries. In vitro assays of bacterial adhesion to cultured cells are important tools for studying bacterial pathogenicity but do not reproduce all the events that occur in natural infections. In this study, the effects of oral infection with EPEC on mice selected for their minimal acute inflammatory response (AIRmin) were evaluated. Mice were orally infected with EPEC and variations in body weight, bacterial shedding and antibody production observed. The infected animals developed seric and secretory anti-EPEC antibodies; however, neither mortality nor diarrhea was observed. Light microscopy of their intestines demonstrated histological modifications that were not present in controls. However, electron microscopy did not show bacteria attached to the intestinal epithelia to form attaching and effacing lesions, characteristic of EPEC in humans. The bacteria were detected in Peyer's patches and intestinal contents up to 5 hr post-infection. When human anti-EPEC secretory immunoglobulin A or avian immunoglobulin Y antibodies were administered to infected animals, they developed minor histological alterations compared with non-treated animals. In summary, it was found that EPEC triggers immune responses and intestinal histological alterations but does not produce evidence of diarrheal disease in mice infected by the oral route. This study of EPEC experimental infection provides a better understanding of the effects of antibodies on bacterial infections and may provide a suitable model for the design and testing of immunobiological products for active or passive immunization. [ABSTRACT FROM AUTHOR]

Aim To measure glycosylated haemoglobin ( Hb A1c) in a diabetic model as a means of investigating apical periodontitis and periodontal disease for their effects on both blood glucose concentrations and long-term glycaemic control. Methodology Wistar rats ( n = 80) were assigned to one of eight groups (10 animals/group): control ( G1), apical periodontitis ( G2), periodontal disease ( G3), apical periodontitis and periodontal disease ( G4), diabetic ( G5), diabetic with apical periodontitis ( G6), diabetic with periodontal disease ( G7) and diabetic with apical periodontitis and periodontal disease ( G8). A diabetic state was induced with streptozotocin. Apical periodontitis was induced by dental exposure to the oral environment. Periodontal disease was induced by periodontal ligature. Blood glucose concentrations were measured at 0, 6, 30 and 60 days. After euthanization, rat maxillae were excised and processed for histopathology and for measurement of Hb A1c levels by ion exchange chromatography. Data were tabulated and subject to statistical analysis ( P < 0.05). Results The inflammatory infiltrate and alveolar bone resorption were more severe in diabetic rats ( P < 0.05). Diabetic rats exhibited higher levels of Hb A1c independent of apical periodontitis or periodontal disease ( P < 0.05). However, the presence of oral infections in diabetic rats was associated with increased blood glucose concentrations ( P < 0.05). Conclusions Oral infections affect glycaemic conditions in diabetic rats and increase Hb A1c levels in normoglycaemic or diabetic rats. [ABSTRACT FROM AUTHOR]

Purpose: Oral infection may be a source of bacteremia in patients undergoing hematopoietic stem cell transplant (HSCT). The aim of this study was to evaluate the relationship between patients with poor periodontal status and complications after HSCT. Methods: A cohort of patients with hematological malignancies candidates for autologous HSCT was observed before and during the neutropenic phase of HSCT. A primary evaluation was performed before the HSCT procedure, including medical and socio-demographic data and physical examination (number of teeth and decayed, missing and filled teeth index (DMFT), oral mucosa, and full mouth periodontal assessment). During the neutropenic phase, data regarding the development of febrile neutropenia, bacteremia, and mucositis were also prospectively obtained. Results: Forty-eight patients were included. The most common baseline disease was multiple myeloma (70 %). In the primary evaluations, the median DMFT was 13 (ranging 0–27), and periodontitis and gingivitis were present in 29 and 60 % of the patients, respectively. During the neutropenic phase of HSCT, fever occurred in 96 % of patients, and bacteremia was documented in 29 %. Coagulase-negative Staphylococcus was the most common isolated bacteria. Patients who developed bacteremia had a higher frequency of oral disorders compared with those without bacteremia, but it was not statistically significant. Oral mucositis affected 89.6 % of the patients, and patients with gingivitis or periodontal disorders had a high frequency of mucositis. Conclusions: The prevalence of oral pathologic conditions previous to HSCT procedures was very high in the studied population. A possible association was noted between previous gingivitis and the development of mucositis during the neutropenia of HSCT. [ABSTRACT FROM AUTHOR]

Summary: The prion protein gene (Prnp) plays a crucial role in the susceptibility of sheep to scrapie in terms of attack rate and/or incubation period. However, the influence of Prnp on the pathogenesis of the disease, specifically the involvement of tissues of the lymphoreticular system (LRS), pathways of neuroinvasion and neuropathological phenotypes, remains controversial. This study reports the onset and progression of disease-associated prion protein (PrPd) accumulation in the LRS and nervous tissues of sheep of six different Prnp genotypes infected by oral administration of the same mixed scrapie brain homogenate. Sheep homozygous for glutamine (Q) at codon 171 of PrP, with either valine (V) or alanine (A) at codon 136 (i.e. VRQ/VRQ, VRQ/ARQ and ARQ/ARQ), showed early and consistent PrPd accumulation in LRS tissues of the pharynx and gut. In contrast, LRS involvement was minimal, inconsistent and occurred late in the incubation period in sheep heterozygous for arginine (R) at codon 171 (i.e. VRQ/ARR and ARQ/ARR). Despite this difference, all five groups were susceptible to infection and developed clinical disease, albeit with significantly different incubation periods (shortest in VRQ/VRQ and longest in ARQ/ARR sheep). The remaining group of ARR/ARR homozygous sheep did not show evidence of infection at the end of the experiment or at previous predetermined time points. As for LRS tissues, the sites of initial PrPd accumulation in the brain were determined immunohistochemically. These were the same in all susceptible sheep (except for ARR/ARR sheep), regardless of their Prnp genotype which, together with an early and consistent accumulation of PrPd in circumventricular organs and a late or inconsistent involvement of the enteric and autonomic nervous system and of the spinal cord, suggests neuroinvasion occurring via the blood. The neuropathological phenotype (PrPd profile in the central nervous system) of clinically affected sheep was similar in the three V136 carrier groups, but showed some differences in the two A136 homozygous groups, suggesting a codon 136-driven selection of different strains from the mixture contained in the inoculum. ARQ/ARR sheep showed an irregular distribution of brain PrPd, contrasting with the more widespread distribution of the other four groups. The results indicate that (1) ARQ/ARR sheep are more susceptible to oral scrapie infection than would be predicted from incidence figures in natural disease, (2) amplification and accumulation of PrPd in LRS tissues is host genotype dependent, but does not necessarily have a marked effect on the outcome of the infection and (3) the neuropathological phenotype of scrapie is related to the host genotype, but possibly in combination with the infecting source. [ABSTRACT FROM AUTHOR]

Background.Vitis vinifera vitis(grape) cultivar Sultana is a causative agent of oral allergy syndrome (OAS) in Iran. In this study, the IgE-reactive proteins of this cultivar were characterised.Methods. IgE-reactivity of sera from patients with history of OAS to grape and positive skin prick test (SPT) were evaluated. Grape immunoreactive components were also purified and characterised.Results. The purified 10 kDa allergen showed the highest immunoreactivity in component-resolved ELISA and the results were in correlation with SPT results. The patients' sera were mostly reactive with 10, 28 and 60 kDa allergens; meanwhile, a 16 kDa protein can be considered as a novel marker for OAS to grape. The 24, 28 and 30 kDa allergens were identified as thaumatin-like protein, class IV chitinase and beta-1,3-glucanase, respectively.Conclusion. The Sultana cultivar showed a rather similar pattern of IgE reactivity with other cultivars. Several allergens play role in OAS to grapes, however, the 10 kD protein is the main allergen. [ABSTRACT FROM AUTHOR]

Oral infections are infections that occur in or around the mouth and are caused by Bacteria and viruses. Oral infections are very common and may be a sign of an illness involving other parts of the body. Although most of these infections can be controlled by oral hygiene measures, these infections are directly related to the immunity and health status of an individual. Keeping these main health issues in mind, the common oral infections like tooth cavities, cold sores, oral thrush, periodontal disease, etc have been described here. The main factors affecting these infections have been listed here. Preventive measures available for these disease conditions and therapeutic treatment recommended for each type of infection including new delivery systems are discussed in this article. With a general awareness about these infections, proper oral hygiene and medical attention the increased prevalence of the oral infections can be controlled and overall health of an individual can be improved. [ABSTRACT FROM AUTHOR]

Herpes simplex virus type 1 is one of the most frequent causes of oral infection in humans, especially during early childhood. Several experimental models have been developed to study the pathogenesis of this virus but all of them employed adult animals. In this work, we developed an experimental model that uses mice younger than 4 days old, to more closely resemble human infection. Mice were infected subcutaneously with the prototype strain Mc Intyre of Herpes simplex-1, and the progression of infection was studied by immunoperoxidase. All animals died within 24-72 h post-infection, while viral antigens were found in the oral epithelium, nerves and brain. The most striking result was the finding of viral antigens in the nucleus and cytoplasm of cells belonging to striated muscles. Organotypic cultures of striated muscles were performed, and viral replication was observed in them by immunocytochemistry, electron microscopy and viral isolation. We conclude that the infection of striated muscles is present from the onset of oral infection and, eventually, could explain some clinical observations in humans. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this review was to summarize recent developments regarding photodynamic therapy (PDT) in the field of dentistry. Materials and methods: A review of pertinent literature was carried out in PubMED to determine the current position of PDT applications in dentistry. One hundred thirteen relevant articles were retrieved from PubMED by inserting the keywords 'photodynamic therapy', 'dentistry', 'periodontology', 'oral surgery', and 'endodontics'. It is anticipated that this overview will create a specific picture in the practitioner's mind regarding the current status and use of PDT. Results: In spite of different results and suggestions brought about by different researchers, PDT can be considered as a promising and less invasive technique in dentistry. Conclusion: PDT seems to be an effective tool in the treatment of localized and superficial infections. Within the limitations of the present review, it can be concluded that although PDT cannot replace antimicrobial therapy at its current stage, it may be used as an adjunctive tool for facilitating the treatment of oral infections. Clinical relevance: Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry. [ABSTRACT FROM AUTHOR]

Thymic atrophy is known to occur during infections; however, there is limited understanding of its causes and of the cross-talk between different pathways. This study investigates mechanisms involved in thymic atrophy during a model of oral infection by Salmonella enterica serovar Typhimurium ( S. typhimurium). Significant death of CD4+ CD8+ thymocytes, but not of single-positive thymocytes or peripheral lymphocytes, is observed at later stages during infection with live, but not heat-killed, bacteria. The death of CD4+ CD8+ thymocytes is Fas-independent as shown by infection studies with lpr mice. However, apoptosis occurs with lowering of mitochondrial potential and higher caspase-3 activity. The amounts of cortisol, a glucocorticoid, and interferon-γ (IFN-γ), an inflammatory cytokine, increase upon infection. To investigate the functional roles of these molecules, studies were performed using Ifnγ−/− mice together with RU486, a glucocorticoid receptor antagonist. Treatment of C57 BL/6 mice with RU486 does not affect colony-forming units ( CFU), amounts of IFN-γ and mouse survival; however, there is partial rescue in thymocyte death. Upon infection, Ifnγ−/− mice display higher CFU and lower survival but more surviving thymocytes are recovered. However, there is no difference in cortisol amounts in C57 BL/6 and Ifnγ−/− mice. Importantly, the number of CD4+ CD8+ thymocytes is significantly higher in Ifnγ−/− mice treated with RU486 along with lower caspase-3 activity and mitochondrial damage. Hence, endogenous glucocorticoid and IFN-γ-mediated pathways are parallel but synergize in an additive manner to induce death of CD4+ CD8+ thymocytes during S. typhimurium infection. The implications of this study for host responses during infection are discussed. [ABSTRACT FROM AUTHOR]

We report here a case of oral myiasis in the Republic of Korea. The patient was a 37-year-old man with a 30-year history of Becker's muscular dystrophy. He was intubated due to dyspnea 8 days prior to admission to an intensive care unit (ICU). A few hours after the ICU admission, 43 fly larvae were found during suction of the oral cavity. All maggots were identified as the third instars of Lucilia sericata (Diptera: Calliphoridae) by morphology. We discussed on the characteristics of myiasis acquired in Korea, including the infection risk and predisposing factors. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine the effect of isopod parasite Catoessa boscii (C. boscii) on Carangoides malabaricus (C. malabaricus). Methods: The host fish C. malabaricus infested by C. boscii were collected directly from the trawlers landed at Parangipettai coast during December 2008 to November 2009. Data regarding the total length, width, weight and sex of the host fish were recorded. Effect of infestation on C. malabaricus, the length and weight data were analysed and host specificity of isopods was also examined. Results: During the sampling period, 585 C. malabaricus were examined. Among them, 218 specimens were found to carry 243 parasites. Three pairs of isopods (one male with one female) were recorded from the host fish and each pair was attached to the tongue in the buccal cavity of the host. Another pair was also found where the male and male, female and female isopod had settled on the tongue in the buccal cavity. Gross lesions observed in the buccal cavity of infested fish showed small pin-holes in the tongue region, through which dactyls of pereopod''s penetrating claws dig into the host tissues. The maximum weight loss was reported in females (5.43%) than in males (3.75%) of C. malabaricus. Due to infestation of different isopod parasites in both male and female fish, the effects on the length-weight relationship of C. malabaricus were compared. The rate of increased growth in weight in uninfested female fish was found to be higher than that of the infested. The weight gain is faster in uninfested fish than in the infested fish. Conclusions: From the above mentioned observations, it is clear that the worst of fish on account of the infestation of isopods are the C. malabaricus succumbed to the attack of isopod parasites. Although, the infestation did not cause immediate death, it had affected the normal growth of the host fish. [Copyright &y& Elsevier]

It has been shown that 40-60% of the bacteria found in different healthy and diseased oral sites still remain to be grown in vitro, phenotypically characterized, and formally named as species. The possibility exists that these as-yet-uncultivated bacteria play important ecological roles in oral bacterial communities and may participate in the pathogenesis of several oral infectious diseases. There is also a potential for these as-yet- uncultivated oral bacteria to take part in extra-oral infections. For a comprehensive characterization of physiological and pathogenic properties as well as antimicrobial susceptibility of individual bacterial species, strains need to be grown in pure culture. Advances in culturing techniques have allowed the cultivation of several oral bacterial taxa only previously known by a 16S rRNA gene sequence signature, and novel species have been proposed. There is a growing need for developing improved methods to cultivate and characterize the as-yet-uncultivated portion of the oral microbiome so as to unravel its role in health and disease. [ABSTRACT FROM AUTHOR]

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Abstract: Oral infections have been associated with an increased risk for myocardial infarction (MI) and other cardiovascular diseases (CVD). Conversely, low, regular alcohol consumption is associated with a lower association of CVD. The objective was to test the novel hypothesis that oral infections are modified by regular alcohol drinking which has the effect of lowering the incidence of MI’s. The effect has been observed where tooth extractions where carried out due to infections and compared with extractions unconnected to infections. Oral infections and in particular periodontal infections impose an infectious load on the health in many people. In its advanced forms (periodontal pockets ⩾6mm) periodontitis affects ∼10–15% of adults. The infection runs a chronic course with exacerbations. The bacteria cause local infection destructive to the supporting tissues of the teeth and have been detected in systemic diseases through bacterial products and bacteria entering the circulation. The often persistent, long term history of chronic periodontal infection in individuals is a challenge to the immune system. Over 700 oral bacteria and other microorganisms have been identified, many of which are virulent. Control of the level of oral microbiota is through well known oral hygiene measures. Alcohol by being bactericidal is a factor that may reduce the bacterial level in the oral cavity. If this effect truly exists, it should be observed through reduction of infections in the mouth. Tooth extraction is the ultimate consequence of periodontal and dental infections and a reduction of tooth extraction due to infections should therefore be observed. The hypothesis was tested using the screening data of the Oslo II-study in a cross sectional analysis. The Oslo-study included men aged 48–67years. The main finding was that the effect of a drinking pattern of 2–7 times per week reduced the risk of MI among men who had a history of tooth extractions due to infections versus tooth extraction for other causes or no extractions. This hypothesis supports an explanation as to why oral infection is a weaker independent risk factor for CVD in some studies. It also gives an indication of the reason for an added benefit by a regular drinking pattern as part of the Mediterranean diet. The important consequence of this hypothesis is the added importance of optimal oral hygiene for the prevention of CVD as well as for the benefit of good oral health. [Copyright &y& Elsevier]

Background. Genome analysis indicated that the new species Brucella microti possesses a potentially functional glutamate decarboxylase (GAD) system involved in extreme acid resistance in several foodborne bacteria. The contribution of this system in adaptation of B. microti to an acidic environment, including the intracellular vacuole and stomach, was investigated.Results. B. microti was GAD positive and able to export its product, γ-aminobutyrate, to the extracellular medium. The resistance of B. microti to acid stress (pH 2.5) was glutamate dependent. Mutants affected in the GAD system lost this resistance, demonstrating its direct involvement in survival under these conditions. The reciprocal heterologous complementation of mutants with the GAD systems of Escherichia coli or B. microti confirmed conserved functions in both bacterial species. A gad mutant was not attenuated during infection of macrophages, where Brucella resides in an acidified vacuole at a pH of 4–4.5 during the early phase of macrophage infection, but GAD contributed to the survival of B. microti in a murine model following oral infection.Conclusions. This work provides first evidence that the GAD system might play an essential role in the resistance of an environment-borne, pathogenic Brucella species to extreme acid shock and during passage through the host stomach following oral infection. [ABSTRACT FROM PUBLISHER]

Objective To study the link of Helicobacter pylori salive test cassette (HPS) and 13C-urea breath test (13C-UBT) on detecting Helicobacter pylon infection of stomach, and the sensitivity as well as specificity should be determined. Methods A screening trial of 13C-UBT and HPS tests was carried out 130 patients included 106 positive and 24 negative results of 13C-UBT. As gold standards of 13C-UBT, a comparison study with HPS was evaluated using Bayes formula. Results The sensitivity, specificity, accuracy, positive and negative predictive value of HPS was 68.87%, 58.33%, 66.92%, 87.95%, 29.79% respectively. The coincidence was 66.92%. Conclusion There is a correlation between results of 13C-UBT and HPS. Combination of 13C-UBT and HPS may compensate the blind zone of 13C-UBT in detecting oral Helicobacter pylon infection. 13C-UBT could not be used as a gold standard to judge the validation of HPS in detecting Helicobacter pylon oral infection. The methods can be used at the same time in clinic. [ABSTRACT FROM AUTHOR]

Abstract: Aims: Periodontitis is an oral infection affecting the tooth- supporting tissues. Although the prime etiology for this condition is bacterial plaque, the host immune response also has substantial contribution to the destruction of the periodontal apparatus. Periodontitis elicits a “low grade systemic inflammation”. Diabetes mellitus is intricately related to the development, progression and severity of periodontitis. The literature is abundant with studies depicting this association. Periodontal therapy (PT) involves removal of bacterial component leading to the resolution of clinical signs and symptoms of disease. This review aims to create awareness amongst the medical professionals regarding the two-way relationship between diabetes and periodontitis, emphasizing on the positive effects of PT. Material and methods: Studies addressing the effects of PT on glycemic control in type 2 Diabetes (T2DM) subjects were identified using PubMed search with key search terms such as “Glycemic control”, “Periodontitis”, “Periodontal therapy”, “Type 2 diabetes mellitus”. The review has been prepared by screening PUBMED database from January 1990 to March 2012. Results: PT bears an unexplored potential and can serve as an adjuvant to the conventional treatment for diabetes. Conclusion: A major conclusion of this review is that PT instituted in type 2 diabetic human subjects assists in amelioration of the inflammatory biomarker levels and glycemic status. There is a wide scope for further studies to highlight the beneficial effects of PT in diabetic subjects and the dire need for periodontal screening of these individuals for glycemic maintenance. [Copyright &y& Elsevier]

Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. This paper describes various etiologic factors although they often are contradictory, diagnosis and its management. A psychogenic factor which includes anxiety and depression seems to be the most common etiological factor affecting patients with BMS. Lack of success in explaining and treating BMS is because the features of BMS have not been rigidly characterized but can provide symptomatic relief if the cause of BMS is recognized. [ABSTRACT FROM AUTHOR]