©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Oral Pathology Chapter 26

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Introduction Antigenic –Capable of causing antibody production Palpate –Feel with fingers

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Introduction Biopsy –Surgical removal of tissue Etiology –Cause of disease

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Inflammation Redness Heat Swelling Pain

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnosing Oral Pathology Radiographs Examination Genetic history Surgical procedures Microscopic examinations (biopsy) Lab, differential, and therapeutic diagnoses

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Oral Lesions Four classifications: –Above surface of oral mucosa –Below surface of oral mucosa –Even or flat with surface of oral mucosa –Flat or above surface of oral mucosa

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Lesions Above the Surface Blister Bulla Hematoma Papule Plaque Pustule Vesicles

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Lesions Below the Surface Abscess Cyst Erosion Ulcer

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Lesions Even or Flat with the Surface Ecchymosis Macule Patch Petechiae Purpura

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Lesions Flat with or Above the Surface Granuloma Neoplasm Nodule

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check What type of lesion is a macule? –Even or flat with the surface

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Biological Agents Actinomycosis –Infection caused by bacterium –Painful swelling, pus, and discharge –Poor oral hygiene

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Biological Agents Herpes simplex –Cold sores –Genital herpes –Herpetic whitlow Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Biological Agents Aphthous ulcers –Canker sores Herpes zoster Syphilis –Three stages Thrush Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Physical Agents HyperplasiaAmalgam tattoo Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Physical Agents Radiation overdose –Under-developed teeth –Pigmented tissue –Spider-like vessels –Necrosis

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Physical Agents Oral piercing and tongue splitting Both images courtesy of the University of Washington School of Dentistry

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check If cotton rolls become dry and then are removed quickly, what type of disorder/injury could be caused? –Gingival ulcer

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chemical Agents Aspirin burnNicotine stomatitis Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chemical Agents Chewing tobacco (snuff) lesion Hairy tongue

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chemical Agents Gingival hyperplasia Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hormonal Disturbances Pregnancy gingivitis –Inflamed gum tissues Pyogenic granuloma –Pregnancy tumor –Found in others, as well Puberty gingival enlargement –Inflamed gum tissues

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Tooth Development Disturbances Amelogenesis imperfecta –Enamel discolored, partially missing, or thin Ankylosis –Tooth, cementum, or dentin fuses with bone

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Tooth Development Disturbances Anodontia –Congenitally missing teeth Dentinogenesis imperfecta –Opalescent enamel and chips away

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Tooth Development Disturbances Fusion –Teeth joined together Gemination –Tooth bud attempts to divide

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Tooth Development Disturbances Macrodontia –Abnormally large teeth Microdontia –Abnormally small teeth

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Tooth Development Disturbances Neonatal teeth –Present at time of birth Supernumerary teeth –Extra teeth Twinning –Two separate teeth from one bud

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Developmental Disturbances Oral tori –Boney outgrowths of tissue –20 percent of population Exostoses –Enlargement or nodular outgrowth

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Developmental Disturbances Oral tori Both images courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Developmental Disturbances Fordyce spots –Granules in oral cavity –80 percent of population Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Developmental Disturbances Fissured tongue Bifid tongue –Extra tag of muscle Ankyloglossia –Also known as tongue-tied Both images courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check Enamel that appears opalescent and easily chips away is a characteristic of which disorder? –Dentinogenesis imperfecta

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Nutritional Disturbances Angular cheilitis –Deficiency of vitamin B –Lesions in corners of mouth Glossitis –Deficiency of vitamin B –Inflammation of tongue

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Neoplasms Medical term for tumor –Benign –Malignant Great potential to become malignant Inform dentist –Without alarming patient

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Oral Cancer Warning Signs Sores Lumps and swelling White or rough lesions Mouth dryness

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Oral Cancer Warning Signs Numbness Burning sensation Difficulty speaking, chewing, or swallowing Repeated bleeding in same area

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types of Neoplasms Leukoplakia –White, leathery patch that cannot be identified as any other white lesion –Biopsy required for further identification Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types of Neoplasms Lichen planus –Initially appear on lower leg or ankle –Oral lesions begin as small, white papules that group and form interlacing white lines Wickham’s striae Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types of Neoplasms Erythroplakia –Red patch of tissue –Very dangerous Squamous cell carcinoma –Cancer of squamous epithelium –Benign form called papilloma

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types of Neoplasms Basal cell carcinomaPapilloma Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types of Neoplasms Fibroma Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Oral Lesions Related to AIDS and HIV Candida albicans –Fungal infection

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Oral Lesions Related to AIDS and HIV Kaposi’s sarcomaHairy leukoplakia Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Miscellaneous Disorders ANUGMucocele Courtesy of Joseph L. Konzelman, Jr., DDS

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Miscellaneous Disorders Varix –Weakened blood vessels Geographical tongue –Inflammatory patches on tongue –Resembles map of world

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Miscellaneous Disorders Anorexia/bulimia –Decalcified teeth –Eroded enamel –Deterioration of existing restorations –Rampant caries –Enlargement of parotid glands

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Miscellaneous Disorders Bell’s Palsy –Temporary paralysis on one side of face