Allergic reactions sometimes participate in the development of perioral and oral diseases, indicating the need for appropriate allergen assessment. This review discusses current knowledge on the ...potential allergic reactions to different dental materials in patients with oral and perioral diseases. Aside from allergies to various dental materials, similar non-allergic, non-immune contact reactions (irritant or toxic) can occur. Among dental materials, the most frequent allergens are alloys, followed by rubber materials, polymers and acrylates. Allergic reactions to dental alloys that contain nickel, cobalt and amalgam are especially frequent since dentists use them for prosthetic and other restorations. There is a broad spectrum of clinical presentations of oral and perioral diseases possibly related to allergies, such as lichenoid reactions, cheilitis, perioral dermatitis, burning sensations, etc. Despite some limitations, patch test is crucial in the diagnosis and recognition of causative allergens because it reveals contact allergies, and is still superior in differentiating allergic and irritant contact reactions. It is important to examine patient medical histories (e.g., occurrence of symptoms after dental therapy or food consumption), and in consultation with their dentist, carry out allergy tests to specific dental allergens which are used or planned to be used in subsequent treatment.
To investigate the epidemiological and clinical characteristics of oral lichen planus (OLP) in a group of Croatian patients seen between 2006 and 2012.
A group of 563 patients with a diagnosis of OLP ...was retrospectively reviewed in our clinic. Data regarding age, gender, medical history, drugs, smoking, alcohol, chief complaint, clinical type, localization, histology, treatment and malignant transformation were registered.
Of the 563 patients, 414 were females and 149 were males. The average age at the diagnosis was 58 (range 11-94). The most common site was buccal mucosa (82.4%). Most of our patients did not smoke (72.5%) or consume alcohol (69.6%). Patients reported oral soreness (43.3%), mucosal roughness (7%), xerostomia (3%), gingival bleeding (2%) and altered taste (0.5%) as the chief complaint, while almost half of them were asymptomatic (44.2%). The most common types of OLP were reticular (64.8%) and erosive (22.9%). Plaque-like (5.7%) atrophic/erythemtous (4.3%) and bullous (2.3%) type were also observed. Malignant transformation rate of 0.7% was recorded.
OLP mostly affects non-smoking middle-aged women. Buccal mucosa is the most commonly affected site. In almost half of the cases patients are asymptomatic. In spite of the small risk for malignant transformation all patients should be regularly monitored.
Allergic reactions sometimes participate in the development of perioral and oral diseases, indicating the need for appropriate allergen assessment. This review discusses current knowledge on the ...potential allergic reactions to different dental materials in patients with oral and perioral diseases. Aside from allergies to various dental materials, similar non-allergic, non-immune contact reactions (irritant or toxic) can occur. Among dental materials, the most frequent allergens are alloys, followed by rubber materials, polymers and acrylates. Allergic reactions to dental alloys that contain nickel, cobalt and amalgam are especially frequent since dentists use them for prosthetic and other restorations. There is a broad spectrum of clinical presentations of oral and perioral diseases possibly related to allergies, such as lichenoid reactions, cheilitis, perioral dermatitis, burning sensations, etc. Despite some limitations, patch test is crucial in the diagnosis and recognition of causative allergens because it reveals contact allergies, and is still superior in differentiating allergic and irritant contact reactions. It is important to examine patient medical histories (e.g., occurrence of symptoms after dental therapy or food consumption), and in consultation with their dentist, carry out allergy tests to specific dental allergens which are used or planned to be used in subsequent treatment. Key words: Allergy; Burning mouth syndrome; Cheilitis; Gingivostomatitis; Oral disease; Oral lichenoid reactions; Patch test Alergijske reakcije ponekad sudjeluju u razvoju perioralnih i oralnih bolesti, to ukazuje na potrebu odredivanja potenci-jalnih alergena. Ovaj pregledni clanak govori o trenutnim saznanjima o potencijalnim alergijskim reakcijama na razlicite dentalne materijale u bolesnika s oralnim i perioralnim bolestima. Uz alergije na razne dentalne materijale mogu se pojaviti slicne nealergijske, neimunske kontaktne reakcije (nadraujuce ili toksicne). Medu zubnim materijalima zubne legure najceci su alergeni, a slijede ih gumeni materijali, polimeri i akrilati. Alergijske reakcije na zubne legure koje sadre nikal, kobalt i amalgam osobito su ceste, jer ill stomatolozi koriste za proteticke i druge restauracije. Postoji irok spektar oralnih i perioralnih bolesti koje su vjerojatno povezane s alergijama, poput lihenoidnih reakcija, heilitisa, perioralnog dermatitisa, osjecaja pecenja itd. Unatoc odredenim ogranicenjima epikutani test je presudan u dijagnozi i prepoznavanju uzrocnih alergena, jer otkriva kontaktne alergije i jo je superiorniji u razlikovanju alergijskihi iritativnih kontaktnih reakcija. Vanoje uzeti detaljnu anamenzu bolesnika (npr. pojavu simptoma nakon stomatoloke terapije ili konzumiranja hrane) i uz savjetovanje sa stomatologom provesti alergoloko testiranje na specificne stomatoloke alergene koji se koriste ili se planiraju koristiti u sljedecem lijecenju. Kljucne rijeci: Alergija; Sindrom pecenja usta; Heilitis; Gingivostomatitis; Bolesti usne upljine; Oralne lihenoidne reakcije; Epikutani test
Alergijske reakcije ponekad sudjeluju u razvoju perioralnih i oralnih bolesti, što ukazuje na potrebu određivanja potencijalnih alergena. Ovaj pregledni članak govori o trenutnim saznanjima o ...potencijalnim alergijskim reakcijama na različite dentalne materijale u bolesnika s oralnim i perioralnim bolestima. Uz alergije na razne dentalne materijale mogu se pojaviti slične nealergijske, neimunske kontaktne reakcije (nadražujuće ili toksične). Među zubnim materijalima zubne legure najčešći su alergeni, a slijede ih gumeni materijali, polimeri i akrilati. Alergijske reakcije na zubne legure koje sadrže nikal, kobalt i amalgam osobito su česte, jer ih stomatolozi koriste za protetičke i druge restauracije. Postoji širok spektar oralnih i perioralnih bolesti koje su vjerojatno povezane s alergijama, poput lihenoidnih reakcija, heilitisa, perioralnog dermatitisa, osjećaja pečenja itd. Unatoč određenim ograničenjima epikutani test je presudan u dijagnozi i prepoznavanju uzročnih alergena, jer otkriva kontaktne alergije i još je superiorniji u razlikovanju alergijskih i iritativnih kontaktnih reakcija. Važno je uzeti detaljnu anamenzu bolesnika (npr. pojavu simptoma nakon stomatološke terapije ili konzumiranja hrane) i uz savjetovanje sa
stomatologom provesti alergološko testiranje na specifične stomatološke alergene koji se koriste ili se planiraju koristiti u sljedećem liječenju.
Oral cavity and perioral area are constantly exposed to a variety of antigens, including food and additives, which have a potential role in the development of different oral mucosal and perioral ...cutaneous diseases since they can cause hypersensitivity reactions. Oral and perioral diseases mainly include angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reactions, and perioral dermatitis. Previous studies were focused on delayed-type oral allergies by performing patch testing but did not include tests for immediate-type allergic reactions.Therefore, the objective of this study was to determine common nutritive and additive allergens in the prevalent oral and perioral diseases by using skin prick tests. Our study evaluated 230 participants, i.e. 180 patients with oral/perioral diseases (angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reactions, and perioral dermatitis), and 50 healthy control subjects. The results of skin prick tests showed that immediate-type allergic reactions to food and additives were mostly seen in patients with burning mouth syndrome (40%) and cheilitis (33.3%), whereas allergies were least frequently observed in perioral dermatitis (10%) and gingivostomatitis (20%). Fruits, mushrooms, and vegetables were the most frequent causes of nutritive allergies in oral and perioral diseases. The most commonly identified additive allergens were glutaraldehyde, citric acid, and sodium glutamate. Study results suggest the possible association with nutritive and additive allergies be considered in cases of persistent oral mucosal or perioral skin disease accompanied by respective medical history. Key words: Additives; Allergy; Food; Oral diseases; Perioral diseases; Skin prick test; Patch test; Skin; Angioedema
Confidentiality and privacy have always been a vital part of the health care provider‐patient relationship. The aim of this study was to identify and analyze the knowledge, attitudes, and awareness ...of dentists in Croatia concerning patients’ confidentiality and privacy and to determine the degree to which they were protecting patients’ confidentiality and privacy in everyday practice. Survey data were collected from seventy of the approximately 4,000 dentists in Croatia who had been randomly selected using the registry of the Croatian Chamber of Dental Medicine. Our strategy for data collection included visits to the dental offices and clinics. The data showed that dentists displayed a lack of awareness and had a poor attitude toward respecting patients’ rights to confidentiality and privacy. This study indicated the need to educate dentists about their responsibilities and legal obligations.
We report a case of propolis allergy in an 18-year-old female patient. Medical history revealed self-prescribed topical use of propolis spray as a medication for gingival swelling caused by ...orthodontic molar bands. After 24 hours, the patient developed lip edema and erythema of the perioral skin accompanied by burning pain in her lips. Discrete erosions were present in the corners of her lips. Erythema of the right infraorbital region was also observed. The patient was prescribed betamethasone propionate cream two times daily. Complete recovery was observed after 10 days. Propolis allergy was confirmed by a patch test. We believe that the use of propolis for the treatment of oral diseases should be avoided due to sparse evidence of its efficacy and numerous cases of allergic reactions.
Objectives: Propolis, a resinous substance produced by bees, has been used in popular medicine for more than 2000 years. Material and methods: Numerous compounds of propolis can act as potent ...sensitizers. Topical application of propolis can induce oral lesions. Patients with oral lesions due to topical propolis are presented. Basic demographic (age, gender) and clinical data (appearance and localization of the lesions, symptoms onset, treatment and healing time) were recorded. Results: Twenty two patients with propolis-induced lesions were evaluated. The most common occurring presentation was erosive stomatitis. Symptoms tended to appear 2.5 days after propolis use although some lesions occurred immediately after utilization. Majority of patients (21/22) were successfully treated with topical corticosteroids. Six patients underwent patch testing, 3 patients were positive and 3 were negative. Conclusion: Topical propolis can have serious oral side effects. Current knowledge does not support its widespread use in the treatment of oral diseases. Key words Cutaneous Fistula; Dental Pulp Necrosis; Root Canal Preparation Uvod: Propolis, smolasta tvar koju proizvode pcele, uporablja se u narodnoj medicini vise od dvije tisuce godina. No, njegovi mnogobrojni sastojci mogu djelovati kao potencijalni antigen. To-pikalna primjena moze uzrokovati nuspojave u usnoj supljini. Materijali i metode: Retrospektiv-nom studijom bili su obuhvaceni pacijenti s oralnim lezijama zbog topikalne uporabe propolisa. Pritom su koristeni podaci iz medicinske dokumentacije pacijenata: izgled i lokalizacija lezija, kada su se pojavili simptomi, terapija i vrijeme cijeljenja te osnovni demografski podaci (dob, spol). Rezultati: Sudjelovalo je dvadeset dvoje pacijenata s lezijama uzrokovanima koristenjem propo-lisa. Najcesca klinicka slika bila je erozivni stomatitis. Simptomi su se obicno pojavljivali dva i pol dana nakon uporabe propolisa, iako su se neke lezije pojavile odmah. Vecina pacijenata (21/22) uspjesno je lijecena topikalnim kortikosteroidima. Sestero je bilo podvrgnuto alergoloskom testiranju-troje je bile pozitivno, a troje negativno. Zakljucak: Topikalni preparati propolisa mogu prouzrociti teske oralne nuspojave. Dosadasnje spoznaje ne podupiru njegovu siroku primjenu u terapiji bolesti usta. Kljucne rijeci kozna fistula; zubna pulpa, nekroza; korijenski kanal, preparacija
Thirty three patients admitted to the University Department of Dermatology and Venereology, Sestre milosrdnice University Hospital, were included in the study. The purpose of the study was to compare ...data on age and gender, habits, lesion localization, onset of symptoms and therapy between patients with pemphigus vulgaris and those suffering from bullous pemphigoid. Based on clinical presentation, histopathologic analysis, direct and indirect immunofluorescence, Tzanck smear and desmogleins, 15 cases of pemphigus vulgaris and 18 cases of bullous pemphigoid were diagnosed. The results obtained indicated an increased prevalence of pemphigus vulgaris in middle-aged patients (46.6% of patients were aged between 50 and 70), while bullous pemphigoid predominantly affected elderly individuals (83.3% of patients were older than 70). Pemphigus vulgaris showed a female predominance (female 66.6% vs. male 33.4%), while no sex difference was recorded for bullous pemphigoid. Patients with both diseases presented with cutaneous and/or oral lesions. The majority of patients with pemphigus vulgaris had skin lesions with oral manifestations (86.6%), whereas in 40% of cases oral lesions were preceded by the cutaneous ones. Mucosal erosions were found in only 16.6% of patients with bullous pemphigoid. The majority of patients were administered systemic and topical corticosteroid therapy with adjuvant systemic immunosuppressant therapy. Timely recognition of pemphigus vulgaris and bullous pemphigoid and appropriate treatment are important for the prognosis of these autoimmune bullous disorders.
Forty patients with lichen planus admitted to University Department of Dermatology and Venereology, Sestre milosrdnice University Hospital in Zagreb during the 2004-2006 period were assigned to this ...retrospective study. In these 40 patients (27 female and 13 male), lichen planus was diagnosed on the basis of clinical presentation, laboratory findings and histopathologic analysis. The results obtained indicated an increased prevalence of lichen planus in middle-aged patients (40% of patients were aged 40-60), with a significant female predominance (67.5% vs. 32.5%). The majority of patients with lichen planus presented with both cutaneous and oral lesions (62.5%), one third of cases had only cutaneous lesions (35%), and only one patient had isolated oral lesions (2.5%). The initial symptoms in patients with lichen planus usually manifested on the skin (82.5%), in oral cavity (5%), or both simultaneously. Oral lesions usually developed on buccal mucosa (88.5%) in the form of Wickham's striae. All patients were administered topical therapy (corticosteroids, keratolytics), while 55% of patients were given both systemic and topical therapy (corticosteroids, retinoids). Phototherapy was used in 27.5% of patients. The management of patients with oral lichen planus lesions requires multidisciplinary approach including dermatologists and oral pathologists, general practitioners, as well as ENT specialists, internal medicine specialists, and others.
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