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Oral Cavity By Dr. Ehab M. Oraby.

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Presentation on theme: "Oral Cavity By Dr. Ehab M. Oraby."— Presentation transcript:

1 Oral Cavity By Dr. Ehab M. Oraby

2 Congenital Anomalies:
Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue Cancer cheek Other conditions: Jaw swellings Odontomes Dr. Ehab M. Oraby

3 Congenital Anomalies: Cleft Lip:
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip: Failure of fusion between frontonasal process and maxillary process Cleft = discontinuity of skin, mucosa and orbicularis oris muscle Types: Unilaterl (left) or bilateral Parial or complete (to nasal floor) Isolated or associated with cleft palate Problem: cosmetic Abnormal dentition Treatment: Repair 3-6 months old

4 Congenital Anomalies: Cleft Lip Cleft Palate
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Failure of fusion between: 2 palatal processes Nasal septum ± Premaxilla Types: Isolated or associated with cleft lip Cleft uvula, cleft soft palate, cleft soft and hard palate, bipartite and tripartite Problem: suckling, reflux Abnormal dentition Ear problems Speech problems Distortion of facial growth

5 Congenital Anomalies: Cleft Lip Cleft Palate Treatment: Repair
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Treatment: Repair 12-18 months old (obturators) Preparation: feeding, chest problems Aim: to obtain a competent velopharyngeal sphincter Post-operative: speech therapy, orthodontic treatment

6 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Aglossia Bifid tongue Ankyloglossia: (tongue frenulum is thick and short) Lingual thyroid: red mass behind foramen cecum Tc scanning before excision Congenital furrowing: “transverse” Geographic tongue: (?? Congenital heart disease)

7 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue Cancer cheek Other conditions: Jaw swellings Odontomes

8 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Cancrum Oris: Infective gangrene Mixed infection in malnourished patients Full thickness gangrene in cheek Treatment: Penicillins Debridement and irrigation Plastic reconstruction Monilial Stomatitis: Fungal infection Debilitated patients Treatment: gentian violet + antifungal medications

9 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Acute Glossitis: Superfiscial type: by scalds or infection Parenchymatous type: strept infection, after wasp sting Chronic glossitis: Non-Specific: Thick indurated tongue With colored patches: white (leukoplakia) Red glazed tongue Specific: TB Syphilis

10 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and Osteomyelitis Alveolar abcess: 2ry to necrotic pulp Acute Osteomyelitis Chronic Osteomyelitis Fever Painful jaw swelling Bone necrosis Sequestration New bone formation

11 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue Cancer cheek Other conditions: Jaw swellings Odontomes

12 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Predisposing Factors: Ultraviolet Rays Smoking, hot tobacco, pipes Pathology: Squamous cell carcinoma C/P: Ulcer resistant to conservative treatment more than 2 weeks Treatment: Lesion  excision L.N.  neck dissection

13 Predisposing Factors: Smoking, hot tobacco, pipes Spices
♂ > ♀, >60 years old Predisposing Factors: Smoking, hot tobacco, pipes Spices Precancerous lesions: Leukoplakia, erythroplakia Chronic superfiscial glossitis Syphilis Pathology: Squamous cell carcinoma 90% Lateral side 50% Post 1/3  20% Gross: Localized lesion: ulcer, fissure, plaque, nodule Diffuse infiltrating lesion  wooden tongue Spread: local, lymphatic, blood Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue

14 Ulcer resistant to conservative treatment more than 2 weeks
C/P: Ulcer resistant to conservative treatment more than 2 weeks Pain in tongue referred to ear or temple Salivation, difficult articulation and ankyloglossia Complications: hge, cachexia, chest problems (aspiration, asphyxia) Diagnosis: Biopsy (lesion, L.N.) CT neck and mandible Treatment: Surgery = radiotherapy in T1 &T2 Surgical excision with: Small lesion Near bone After leukoplakia Failure of radiotherapy L.N.  neck dissection Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue

15 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue DD Tongue ulcers: Traumatic: dental, post pertussis Inflammatory: Acute ulcers: Dyspeptic ulcer: (multiple, small, painful) Lichen planus Herpes Chronic ulcers: TB: small, multiple, painful Syphilis: 2ry or tertiary syphilis Malignant

16 Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies: Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue Cancer cheek Other conditions: Jaw swellings Odontomes Gums = mucoperiosteum Epulis: Fibrous epulis: chronic irritation, intact mucosa Granulomatous epulis: granuloma, not covered with mucosa Myeloid epulis: deep lesion from periosteum Sarcomatous epulis Carcinomatous epulis

17 Congenital Anomalies:mor Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies:mor Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue Cancer cheek Other conditions: Jaw swellings Odontomes Cystic swellings of floor of mouth Tooth related swellings Dental cyst: Pulpless tooth (grey tooth) Upper jaw Dentigerous cyst: With unerupted tooth Lower jaw Adamantinoma: Basal cell carcinoma Locally malignant tumor

18 Congenital Anomalies:mor Cleft Lip Cleft Palate Tongue Anomalies
Dr. Ehab M. Oraby Congenital Anomalies:mor Cleft Lip Cleft Palate Tongue Anomalies Inflammatory conditions: Stomatitis Glossitis Alveolar abcess and osteomyelitis Tumors: Cancer lip Cancer tongue Cancer cheek Other conditions: Jaw swellings Odontomes Cystic swellings of floor of mouth Retention cyst of minor salivary gland Ranula: Sublingual gland Translucent, bluish cyst On one side Above mylohyoid muscle Treatment: marsupilization Demoid cyst: Lingual or sublingual Above or below mylohyoid muscle Opaque cyst Median Usually appear after puberty Treatment: excision

19 Dr. Ehab M. Oraby Thank you

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