Sliznici dutiny ústní postihuje řada chorob různého původu, charakteru a závažnosti. Může se jednat o chorobyzcela benigní i nejrůznější závažná onemocnění, včetně maligních nádorů. Jednou skupinou chorob s projevy v dutině ústní jsou puchýřnaté choroby autoimunitního původu, označované též jako choroby mukokutánní. Klinicky se i v dutině ústní projevují primárně vznikem puchýřů, které však záhy praskají a mizí, a mění se tak ve slizniční defekty –eroze až ulcerace doprovázené různě intenzivními subjektivními obtížemi. Tyto choroby mají obvykle plíživý průběh anebývají provázeny výraznějšími projevy typu celkové alterace zdravotního stavu, jimiž rozumíme zvýšenou tělesnou teplotu, reaktivním zánětem postižené a zvětšené regionální mízní uzliny. Na druhou stranu jsou dosti často provázeny déletrvajícím ztíženým, omezeným příjmem potravy a s ním spojeným výraznějším úbytkem tělesné hmotnosti v relativně krátké době několika měsíců. Sliznice dutiny ústní je mnohdy prvním místem výsevu projevů autoimunitních puchýřnatých mukokutánních chorob, předcházejícím postižení kůže, včetně kštice, a také jiných sliznic (konjunktiva, dutina nosní, hltan, hrtan, jícen, genitál aanus). V některých případech je postižení ústní sliznice dlouhodobě jediným projevem choroby. Diagnostika těchto chorob je často pozdní, neboť jejich klinický obraz může být zaměněn v důsledku ne zcela optimální znalosti této problematiky s jinými slizničními defekty odlišného původu, jako jsou recidivující afty, multiformní erytém, virová amykotická onemocnění, dlaždicobuněčné karcinomy ústní sliznice. Včasná diagnostika iniciálních projevů těchto chorob je však velice důležitá pro jejich prognózu a terapii.

The oral mucosa can be affected by many diseases of different origin, nature and severity. These diseases can becompletely benign or serious, including malignant tumors. One group of diseases with manifestations in the oral cavity are vesicular diseases of autoimmune origin, also known as mucocutaneous diseases. These are manifested in the oral cavity primarily by the formation of blisters, which soon rupture and disappear, turning into mucosal defects – erosions to ulcerations, accompanied by variously intense subjective discomfort. These diseases usually have a subacute course and are not accompanied by general symptoms such as fever, reactive inflammation or enlarged regional lymph nodes. On the other hand, they are quite often accompanied by prolonged, restricted food intake and associated with significant weight loss over a relatively short period of several months. The mucosa of the oral cavity is often the first site of the manifestations of autoimmune blistering mucocutaneous diseases, preceding the involvement of the skin, including the hair, and other mucous membranes (conjunctiva, nasal cavity, pharynx, larynx, esophagus, genitalia and anus). In some cases, oral mucosal involvement is the onlymanifestation of the disease. Diagnosis of these diseases is often late, as their clinical picture may be confused with other mucosal defects of different origin, such as recurrent aphthae, erythema multiforme, viral and fungal diseases,and squamous cell carcinomas of the oral mucosa, due to less than optimal knowledge of the subject. However, early diagnosis of the initial manifestations of these diseases is very important for their prognosis and therapy.

• Klíčová slova
• puchýřnatá onemocnění ústní dutiny,
• MeSH
• autoimunitní nemoci MeSH
• benigní pemfigoid sliznice diagnóza   farmakoterapie   patologie   MeSH
• lichen planus imunologie   patologie   MeSH
• lidé MeSH
• nemoci úst * diagnóza   patologie   terapie   MeSH
• pemfigus diagnóza   patologie   terapie   MeSH
• puchýř * diagnóza   patologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) can induce serious oral complications, including oral mucositis (OM). The presence of periodontal inflammation before HSCT is believed to be associated with OM. The aim of our study was to determine the prevalence and severity of OM in patients undergoing HSCT and its relation to periodontal status. PATIENTS AND METHODS: This is a retrospective study of patients who underwent HSCT and a detailed dental examination between 2007 and 2015. The dental and periodontal status of all patients was evaluated by clinical and radiographic examination prior to HSCT. Oral health was assessed with the gingival index, the the community periodontal index, presence of plaque-related gingivitis, and marginal periodontitis. During the HSCT period, patients were examined daily for the presence of OM, which was graded according to World Health Organization (WHO) classification if present. The patients were assigned to the groups according to type of transplantation: autologous HSCT, myeloablative allogeneic HSCT, and non-myeloablative allogeneic HSCT. RESULTS: A total of 496 patients were included in the study. OM was present in 314 of 496 patients (63.3%): 184/251 (73.3%) in the autologous group, 100/151 (66.2%) in the myeloablative allogeneic group, and 30/94 (31.9%) in the nonmyeloablative allogeneic group. Significantly more patients suffered from OM in the autologous and myeloablative groups versus the nonmyeloablative conditioning group (p < 0.001). The presence of periodontal inflammation did not significantly differ among the groups. There was only a borderline trend for the higher prevalence of OM in the non-myeloablative allogeneic nonmyeloablative group when periodontal inflammation was present (0.073939). CONCLUSIONS: Oral mucositis prevalence and severity after stem cell transplantation is not widely affected by the oral hygiene and periodontal disease presence before HSCT. We confirmed the wide-known connection of the conditioning regimen intensity to the prevalence of OM.

• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Oral lichen planus (OLP) is a chronic inflammatory disease with an unknown etiology rating among oral potentially malignant disorder. The aim of the study was to determine the epidemiological and clinical characteristics of the patients with OLP and rate of malignant transformation. PATIENTS AND METHODS: Data were obtained from the medical records of 271 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové diagnosed with oral lichen planus in the period of 2003-2020. The records were retrospectively analyzed. The following clinical data were retrieved from the medical charts: gender, age, systemic diseases, alcohol and tobacco consumption, localization/clinical appearance of lesions, distribution of the lesions, presence of the symptoms, treatment provided and malignant transformation. RESULTS: A total of 271 charts of patients with confirmed diagnosis of OLP were retrospectively analyzed, of whom, 66.4% (180/271) were women and 33.6% (91/271) were men. The mean age of the patients was 56.0 (18.2-85.0) years. The median follow-up of all patients was 15.2 months. Overall, 2 patients (2/271, 0.74%) meeting the above-mentioned criteria for malignant transformation were identified during the follow-up period. Both patients suffered from erosive type OLP and developed squamous cell carcinoma of the tongue. CONCLUSIONS: This retrospective study is in concordance with other studies showing the similar profile and clinical features of the patients with OLP. Malignant transformation rate was 0.74%.

• MeSH
• lichen planus orální * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádorová transformace buněk MeSH
• nádory úst * epidemiologie   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spinocelulární karcinom * epidemiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Lichen planus (LP) is a chronic inflammatory disorder that especially affects the skin, mucous membranes, or both. The aim of the study was to determine the clinical characteristics of patients with LP in the oral cavity and concomitant cutaneous lesions and compare their outcomes with those without cutaneous lesions. 253 records of patients with confirmed diagnosis of oral lichen planus (OLP) were retrospectively analyzed. The following clinical data were obtained from the medical charts: sex, age, clinical presentations of OLP, distributions of the lesions, presence of symptoms, extra oral manifestations of lichen planus, presence of systemic diseases, and treatment provided. The group of patients with cutaneous manifestations was compared for possible clinical differences to those without. Cutaneous lesions were present in 18.2% (46/253) of patients. Significantly more patients with cutaneous lesions had other extra oral manifestations (26.1% versus 1.0%, P<0.00001). Lips were significantly more affected in patients with cutaneous presentation (41.3% versus 16.9%, P=0.00006). Ulcerative OLP was more frequent in patients with cutaneous lesions (23.9% versus 10.6%, P=0.0266). Patients with cutaneous manifestations needed significantly more systemic treatment with systemic steroids (10.9% versus 3.4%, P=0.0466). Patients with cutaneous lesions were more symptomatic and tended to require more treatment than patients with OLP who only had oral involvemen.

• MeSH
• kůže MeSH
• lichen planus orální * komplikace   epidemiologie   MeSH
• lichen planus * komplikace   epidemiologie   MeSH
• lidé MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Infekční choroby s projevy v dutině ústní představují pestrý soubor chorob různé závažnosti. Klinicky se projevují zejména jako slizniční eroze u chorob virového původu, bělavé povlaky na zarudlé sliznici u mykotických infekcí a ulcerace při chorobách bakteriálního původu. Většinou se jedná o náhle vzniklá postižení, doprovázená různě intenzivními subjektivními obtížemi – někdy spojenými s projevy celkové alterace a s postižením kůže a dalších sliznic. Diagnostika a terapie těchto chorob je velice různá, mnohdy výrazně související s celkovým zdravotním stavem.

Infectious diseases of oral cavity represent wide variety of disorders with possible manifestation in oral region. Viral infections are presented especially as erosive or erythematous lesions, fungal infections as white patches and bacterial infections as ulcers or swelling. Affections usually develop very fast and are accompanied by concurrent symptoms like tenderness, pain, swallowing difficulties and many others. Systemic symptoms are also very frequent and are represented especially by but not limited to malaise, weakness, regional lymph nodes enlargement, fever of other skin efflorescences. Oral manifestations of infections are relatively common and typical. Proper diagnosis can be usually established by complete history a physical oral examination only. Oral infectious symptoms may also reveal unrecognized underlying condition.

• MeSH
• bakteriální infekce diagnóza   terapie   MeSH
• lidé MeSH
• mykózy diagnóza   terapie   MeSH
• ústní sliznice * mikrobiologie   patologie   MeSH
• virové nemoci diagnóza   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

The clinical presentation of iron deficiency can be very heterogeneous, including various oral and other mucosal problems. Here, in this case, we report the patient with burning mouth and dysphagia symptoms where iron deficiency was found to be the underlying cause after several months of investigations. This clinical syndrome is called Plummer-Vinson syndrome. It is sporadic with an incidence less than 0.1% of patients suffering from iron deficiency anemia.

• MeSH
• anemie z nedostatku železa diagnóza   etiologie   MeSH
• diferenciální diagnóza MeSH
• ezofágus * MeSH
• lidé MeSH
• management péče o pacienta metody   MeSH
• nemoci úst MeSH
• Plummerův-Vinsonův syndrom * MeSH
• poruchy polykání * MeSH
• senioři MeSH
• stopové prvky terapeutické užití   MeSH
• výsledek terapie MeSH
• železo * MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations. METHODS: 250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken. RESULTS: 250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%). CONCLUSION: The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.

• MeSH
• dospělí MeSH
• kyselina listová krev   MeSH
• lidé MeSH
• nedostatek kyseliny listové * MeSH
• nedostatek vitaminu B12 * MeSH
• nemoci úst * MeSH
• podvýživa MeSH
• sexuální faktory MeSH
• vitamin B 12 krev   MeSH
• vzorové postupy ve stomatologii statistika a číselné údaje   MeSH
• železo * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVE: Periodontal disease is a possible contributing factor to preterm delivery. The aim of this study was to compare the periodontal status of women with preterm prelabour rupture of membranes (PPROM) and women with uncomplicated singleton pregnancies. PATIENTS AND METHODS: Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks and 77 healthy women with uncomplicated pregnancies, matched for gestational age at sampling without preterm birth, were included in this study. All women underwent evaluation of periodontal and oral hygiene status. RESULTS: Women with PPROM had higher gingival and plaque indexes in crude analysis (gingival index: median 0.80 versus 0.20; p < 0.0001; plaque index: median 0.80 versus 0.10; p < 0.0001), even after adjustment for smoking status (p < 0.0001 and p < 0.0001). Mean clinical attachment loss (CAL) and probing pocket depth (PPD) values were higher in women with PPROM in the crude analysis (CAL: median 2.3 mm versus 1.8 mm; p < 0.0001; PPD: median 2.3 mm versus 1.8; p < 0.0001), as well as after adjustment for smoking status (p < 0.0001 and p < 0.0001). CONCLUSIONS: Pregnant women with PPROM residing in central Europe had worse periodontal status than women with uncomplicated pregnancies.

• MeSH
• dospělí MeSH
• gestační stáří MeSH
• lidé MeSH
• mladý dospělý MeSH
• nemoci parodontu * MeSH
• novorozenec MeSH
• předčasný odtok plodové vody * MeSH
• předčasný porod * MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

OBJECTIVE: Periodontal disease is frequently suggested as a possible causal factor for preterm delivery. The link between periodontal disease and preterm delivery is a possible translocation of periopathogenic bacteria to the placenta and amniotic fluid as well as a systemic response to this chronic inflammatory disease. However, there is a lack of information on whether there is an association between clinical periodontal status in women with preterm prelabor rupture of membranes (PPROM) and the presence of microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation (IAI). Therefore, the main aim of this study was to evaluate the incidence and severity of periodontal disease in women with PPROM. The secondary aim was to characterize an association between periodontal status and the presence of intra-amniotic PPROM complications (MIAC and/or IAI). MATERIALS AND METHODS: Seventy-eight women with PPROM at gestational ages between 24 + 0 and 36 + 6 weeks were included in this study. The samples of amniotic fluid were obtained at admission via transabdominal amniocentesis, and amniotic fluid interleukin (IL)-6 concentrations were determined using a point-of-care test. All women had a full-mouth recording to determine the periodontal and oral hygiene status. Probing pocket depth and clinical attachment loss were measured at four sites on each fully erupted tooth. RESULTS: In total, 45% (35/78) of women with PPROM had periodontal disease. Mild, moderate, and severe periodontal disease was present in 19% (15/78), 19% (15/78), and 6% (5/78) of women, respectively. The presence of MIAC and IAI was found in 28% (22/78) and 26% (20/78) of women, respectively. Periopathogenic bacteria (2 × Streptococcus intermedius and 1 × Fusobacterium nucleatum) was found in the amniotic fluid of 4% (3/78) of women. There were no differences in periodontal status between women with MIAC and/or IAI and women without these intra-amniotic complications. CONCLUSIONS: The presence of MIAC and IAI was not related to the periodontal status of women with PPROM.

• MeSH
• chorioamnionitida mikrobiologie   MeSH
• dospělí MeSH
• lidé MeSH
• nemoci parodontu komplikace   epidemiologie   MeSH
• prospektivní studie MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Onemocnění sliznice dutiny ústní představují pestrý soubor chorob, které jsou různého původu a různé závažnosti. Typické jsou zejména bělavé změny, zarudnutí a eroze ústní sliznice. Setkat se ale můžeme i s tmavými afekcemi, tzv. orálními pigmentacemi, které bývají ve většině případů asymptomatické, avšak častěji vedou k obavám ze závažného onemocnění a kancerofobii. Většinou se jedná o benigní afekce, které mohou být různého původu. Jen zcela výjimečně se může jednat o maligní melanom v dutině ústní či projev systémové choroby. Praktický lékař může být první, který si těchto změn při vyšetření může všimnout, nebo může být pacientem cíleně tázán na jejich původ. Cílem tohoto sdělení je přiblížit lékařské veřejnosti problematiku tmavých změn vyskytujících se na sliznici dutiny ústní, jež je jinak doménou odborníků věnujících se orální medicíně a patologii.

Oral mucosal disorders are represented by diseases of various origin and severity. White lesions, redness and erosions are among the most frequent ones. Dark oral lesions can be observed less frequently. These lesions vary from asymptomatic oral pigmentations to serious cancers. Dark lesions frequently lead to patient´s anxiety and fear from cancer. The dark lesions are serious only infrequently and most often benign. The dark lesion can be also a sign of systemic disorder. General practitioner can bet he first physician to observe this kind of lesions or can be asked about the origin of the lesion by the patient. The aim of this review is to introduce the topic of dark oral lesions to general physicians.

• MeSH
• Addisonova nemoc diagnóza   patologie   MeSH
• diferenciální diagnóza MeSH
• lidé MeSH
• melanom diagnóza   klasifikace   MeSH
• melanóza diagnóza   klasifikace   MeSH
• Peutzův-Jeghersův syndrom diagnóza   patologie   MeSH
• pigmentový névus diagnóza   klasifikace   MeSH
• poruchy pigmentace * etiologie   chemicky indukované   klasifikace   MeSH
• ústa * patologie   MeSH
• zubní amalgam škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH