Talk – Dentistry Oral cavity – disorders of soft tissues Petr Maršálek Dept pathological physiology 1.Med. F. CUNI

Outline Oral mucosa Periodontal mucosa Salivary glands and neighbor tissues Oral manifestations of systemic disorders

Disorders of Gingiva and Periodontium

Connective Epithelium

Disorders of Gingiva and Periodontium Gingivitis - erythema, edema, and roughness of the interdental papillae, without bone loss Predisposing factors - poor oral hygiene, tobacco use, diabetes Periodontitis - chronic infection of connective tissue, periodontal ligament and alveolar bone Long-term periodontitis is associated with increased risk of diabetes, heart disease, stroke and preterm birth birth control pills, diabetes, steroids, Down syndrome, Langerhans cell histiocytosis, HIV predispose to periodontitis Juvenile periodontitis is associated with genetic defects in leukocyte chemotaxis Cathepsin C deficiency – autosomal recessive disorder (Papillon-Lefevre syndrome) – periodontitis and keratoderma - severe and destructive periodontal disease, with exfoliation of the deciduous and permanent teeth

Disorders of Gingiva and Periodontium Erosive gingivostomatitis (desquamative gingivitis)- inflammation and erythema of the gingiva, non-specific reaction pattern, may be due to viral infection, autoimmune, inflammatory and blistering disorders Lichen planus - painful or asymptomatic ornamental white patches, plaques or papules, often with erosions and ulcerations Lichenoid mucositis – effects of various medications: non-steroidal anti-inflammatory drugs, antihypertensive medications, contact allergy, graft-versus-host disease

Disorders of Gingiva and Periodontium Acute necrotizing ulcerative gingivitis (trench mouth, vincent disease) Punched- out ulcers of the interdental papillae, gingival hemorrhage, severe pain, foul odor Fever and lymphadenopathy are common Precipitating factors - poor oral hygiene, nutritional deficiency, alcohol and tobacco use, Immunosuppression Etiologic agents- Treponema, Selenomonas, Bacteroides, Prevotella and Borrelia vincentii