Oral Health and Dental Management

Histopathological changes in gingival tissue of patients having pulmonary tuberculosis (TB) in pakistan

2^nd International Conference and Exhibition on Dental & Oral Health

April 21-23, 2014 Crown Plaza Dubai, UAE

Sunnaeyah Waris, Nadia Naseem and A. H Nagi

Posters: Oral Health Dent Manag

Abstract:

Dataregarding oral lesions in pulmonary tuberculosis TB patients is very scanty but the most reported ones include ulcers, erythematous patch, granuloma and amyloidosis. No such study has been reported in Pakistan. This study determines the histopathological changes in gingival tissue of patients with pulmonary TB. Gingival biopsies of100 patients already diagnosed with pulmonary TB were taken and microscopic changes were observed after staining with H&E, ZiehlNeelsen (ZN), Kinyoun and CongoRedstains. Culture of gingival biopsies was also done using Bactec MGIT 960. Mean age of the patients was 32.31? 13.27 years. Male to female ratio was 2:1(32%males, 68% females). Most (85%) patients belonged tolow socioeconomic status. The patients presented with fever (99%), cough (97%), sputum (86%), weight loss (72%) and hemoptysis(9%). On clinical examination mucositis was present in 95%, periodontitisin 14% and ulceration in 3% cases. On microscopy, acanthosis(100%), basal atypia(62%), loss of maturation and superficial neutrophilic abscesses (4% each) were observed. The connective tissue showed hyalinized collagen (100%), neovascularization (69%), fibrinoid necrosis (12%) and calcification (2%). Chronic nonspecific inflammation was observed in 54% cases with epitheloid cellsseen in only one case. Stromal amyloid confirmed by Congo Red stain and polarized microscopy wasobserved in 35% cases whileZN and Kinyouns stain as well as culture did not yield any acid fast bacilli in the gingival tissue. When the clinicopathological variables were compared, significantly increased (p=0.03)frequency of oral ulcers was found in males while mucositis, inflammation and amyloid were found to be on an average 1.5-10 times more frequent in females as compared to males. The frequency of oral lesions increased with an increase in ESR levels, withits significant associationwith mucositis(p=0.03). All other variables yielded insignificant association. Oral mucosal changes predominantly mucositisas well as clinically undetectable localized gingival amyloidosiswas observed in patients with pulmonary tuberculosis. Increased ESR levels can be areliable predictor for development of oral lesions.

Biography :

Sunnaeyah Waris is a postgradute trainee in Oral Pathology at University of Health Sciences, Lahore, Pakistan. She has completed her M. Phil research thesis titled ?Gingival Changes In Patients Having Pulmonary Tuberculosis?. She has done a poster presentation in 24th National Dental Conference conducted by Pakistan Dental Association in 2008. Earlier she acquired Bachelors in Dental Surgery in2006. She has worked for 3 years as a junior lecturer in the departments of Oral Pathology and Periodontology and Orthodontics in FMH College of Dentistry Lahore, Madina University Medical College and Punjab Medical College, Faisalabad, Pakistan.