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

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

3. Disorders of Gingiva and Periodontium

4. Connective Epithelium

6. 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

7. 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

8. 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