1. Tuberculosis

2. oral Tuberculosis a chronic infectious disease caused by………
Mycobacterium tuberculosis.
Worldwide, more than 2 billion people are infected
with 9 million new cases and 3 million deaths per year
Most infections are the result of direct person-to-person spread through
airborne droplets from a patient with active disease

3. Primary tuberculosis……
occurs in previously unexposed people almost always involves the lungs.
a nonspecific, chronic inflammatory reaction
a localized, fibrocalcified nodule at the initial site of involvement.
usually asymptomatic.
Occasionally, fever and pleural effusion

4. secondary tuberculosis.
Only about 5% to 10% of patients with tuberculosis progress from
infection to active disease ( an immunosuppression often is responsible.)
old age
poverty
crowded living
secondary tuberculosis.
Extrapulmonary tuberculosis
Any organ system may be involved……….
lymphatic system, skin, skeletal system, central nervous system, kidneys, gastrointestinal tract.

5. Oral Tuberculosis
uncommon,
most cases …………..a chronic painless ulcer.
Less frequent presentations include ………
nodular, granular,or (rarely) firm leukoplakic areas.

6. 1.Primary oral tuberculosis
without pulmonary involvement is rare
(almost always involves the lungs)
Gingiva
mucobuccal fold
areas of inflammation adjacent to teeth
in extraction sites.

7. 2.secondary oral lesions
Tongue (most)
palate and lip

8. Area of granularity and ulceration of the lower alveolar ridge and floor of mouth

10. the differential diagnoses
The chronic ulcerative form is the most common of these oral lesions
the differential diagnoses
Malignancies
sarcoidosis
syphilis
aphthous lesion
mycotic infection
traumatic injury.

11. Histopathologic Features
cell-mediated hypersensitivity reaction
Granulomas infection……..
circumscribed collections of epithelioid histiocytes, lymphocytes, and multinucleated giant cells(langhans) often with caceous necrosis ( amorphous eosinophilic substance)

12. caceous necrosis

13. tubercles
one of these granulomas is called a tubercle.

14. 1-Langhans giant cell 2-Epitheloid cells