1. ASSIGNMENT ON DISEASE OF THE ORAL MUCOSA
GROUP 3 PRESANTATION
10/06/GS/2989
10/06/PS/3203
10/06/GS/2998
10/06/PS/3232
10/06/GS/3006
10/06/PS/3221

2. 10/06/GS/2989 Recurrent aphthous ulcerations
An aphthous ulcer is a type of mouth ulcer which presents as painful sore inside the mouth or Upper throat .it is characterized by a break in the mucous membrane.
AETIOLOGY
The exact cause of recurrent aphthous ulcers is unknown , but can be associated with
Citrus fruit (orange)
Physical trauma
Stress
Lack of sleep
Food allergies
Immune system reaction
Deficiencies in B12 , iron and folic acid
reference : (wikepedia .com , MedecineNet.com)

3. CLINICAL FEATURES
-Burning sensation
-red spot in case of an open ulcer
-white spot appearance at the inflamed site
-extremely painful
-painful swelling of lymph nodes below the jaw
-toothache
-fever
Reference : (wikipedia .com)

5. PATHOGENESIS
Several factors can affect the etiopathogenesis of this disease include :
Host immune system and family history.
-In immune system the role of T-lymphocytes in the pathogenesis of aphthous Ulcers is to establish an immune system dysfunction in which cytokine cause destruction of endothelial cells adhesion (desmosomes) then the extra cellular fluid begin to penetrate inside of those endothelial cells. after that the cells increase in size and end up by bursting which result to the aphthous ulceration.
-family history , When both parents are affected by aphthous ulcers they confer a 90% of risk to their children.
Reference : (by james j.sciubba,DMD,PhD features in general dentistry ,jully/august 2007)

6. DIAGNOSIS The diagnosis of recurrent aphthous ulcerations is
made on the basis of history and clinical criteria since there are no specific-
Laboratory tests available.
Reference : (the journal of the American dental Association,february1,2003 vol.134 no.2 2oo-207)

7. Use analgesics, anesthetics agent, antiseptic,steroids,tetracycline.
MANAGEMENT
Use analgesics, anesthetics agent, antiseptic,steroids,tetracycline.
Avoiding spicy food
Rinsing with salty water or mouth wash
Proper oral hygiene
Active ingredients
Reference : (wikepedia .com)

8. 10/06/PS/3203 HERPETIC GINGIVOSTOMATITIS
It is known as primary herpetic gingivostomatitis ,which is a combination of gingivitis and stomatitis on an inflammation of the oral mucosa.
AETIOLOGY
It is caused by herpes simplex virus which results in the transmission of an infectious agent by person – to - person in the following ways:
-saliva, air ,cough , fecal oral route, blood, needles, blood transfusions,
Sexual contact, mother to foetus .
Reference : (wikepedia.com)

9. CLINICAL FEATURES
- mouth pain
- malaise
- lethargy (unusual lack of energy)
Anorexia
Irritability
- mouth ulcers
- tongue ulcers
Reference : (wikepedia.com)

11. PATHOGENESIS
The clinical manifestation of mucocutaneous HSV-1 disease are due to tissue-
destruction consequences of viral replication and cell lysis.
Inoculation of HSV-1at mucosal surfaces or skin sites permits entry of virus
Into sensory and anatomic nerve endings through which it is transported to the
Cell nuclei where it remains latent and reactivation results in recurrent
HSV disease like herpes gingivostomatitis or herpes labials.
Reference : (wikepedia.com)

12. DIAGNOSIS Laboratory studies are : -viral culture and -special stains
They can help the diagnosis of this condition.
Reference : (wikepedia.com)

13. MANAGEMENT
-The herpetic gingivostomatitis is treated by using acyclovir family of anti-viral medications.
-when the mouth is very sore the child should be put on mostly liquid diet of cool to cold
-non acidic drinks
-in severe pain oral topical anesthetics is needed.
Reference : (wikepedia.com)

14. 10/06/GS/2998 ORAL CANDIDIASIS
-oral candidiasis is an opportunistic infection of yeast fungi of the genus Candida on the mucous membrane of the mouth
AETIOLOGY
Oral candidiasis is caused by Candida albicans or less commonly by
Candida glabrata or Candida tropicalis .
Reference : (wikepedia.com)

15. CLINICAL FEATURES
-Thick white deposits on mucosal surfaces such as the
tongue ,inner cheeks,gums,tonsils and palate.
-the inflamed mucosa may appear red and slightly raised.
-the lesions can be painful ,tender and bleed once rubbed or scrapped.
- Difficult to swallow
-temporary loss of taste.
Reference : (wikepedia.com)

17. PATHOGENESIS
Candida albicans is the most common and invasive fungi organism present in the oral cavity and causes both systemic and superficial infections where it adheres to human buccal epithelial cells using adhesins,and produces certain enzymes such as: hydrolases , phospholipases , protease.
it has an ability for changing its colony morphology in order to resist to the host defense mechanism .
In more severe cases the infection can spread down the esophagus and cause difficulty to swallow , this is referred to as esophageal candidiasis.
The infection can spread beyond the esophagus to other body parts , such as the lungs ( systemic candidiasis)
Reference : (the journal of infectious diseases,dec,1930)

18. DIAGNOSISIS
- It is diagnosed by examining the infected mouth by looking for the distinctive
lesions on your mouth ,tongue or cheeks.
-microscopic examination of tissue from a lesion.
-when extend into the esophagus it requires test such as: taking a throat culture
(swabbing the back of your throat with sterile cotton and studying the microorganism under a microscope.
Reference : (wikepedia.com)

19. MANAGEMENT Can be treated with topical anti fungi drugs such as:
nystatin,
Miconazole
Gentian violet
Amphotericin B
Reference : (wikepedia.com)

20. 10/06/PS/3232 ORAL TUBERCULOSIS
Tuberculosis is a chronic infectious disease that can affect any part of the
The body including the mouth.
AETIOLOGY
- it is caused by inhaling droplets contaminated by mycobacterium tuberculosis
-ingesting unpasteurized cow’s milk that is infected by mycobacterium –
tuberculosis (wikepedia.com).

21. CLINICAL FEATURES (ORAL MANIFESTSTIONS OF TB)
-superficial ulcers
-patches
-Indurated soft –tissue lesion
-lesions within the jaw that may be in the form of TB osteomyelitis.
Reference : (wikepedia.com)
Indurate= Become hard or harder

23. PATHOGENESIS
Self inoculation with infected sputum resulting from coughing up of bacteria that invade the oral tissue then hematogenous spread of TB bacteria occurs.
Small tears in the mucosa caused by chronic irritation or inflammation
May be favor sites for the colonization of organisms .
Since injured or inflamed tissues tend to colonize blood borne bacteria
Minimal trauma to the new epithelium at the area of the missing second molar or the dental extraction could have been responsible. (wikepedia.com)

24. DIAGNOSIS Look sign and symptoms of pulmonary tuberculosis
Conducting a complete physical examination and performing a biopsy
Histopathologic study to exclude carcinomatous changes and to confirm a diagnosis of TB.
Acid fast –stain (Ziehl –Nielsen stain) and culture obtained from the tissue specimen is used to confirm the diagnosis of TB
Reference : (wikepedia.com)

25. MANAGEMENT it is treated using the following medications: -isoniazid
-rifampicin
-pyrazinamid
-Ethambutol
Reference ; (wikepedia.com)

26. 10/06/GS/3006 BENIGN TUMOR OF THE ORAL MUCOSA
A benign tumor is a tumor that lacks the ability to metastasize (can not spread
to the surrounding tissue.) and usually harmless to human oral mucosa
AETIOLOGY
-tobacco use and alcohol
-sunlight exposure
-chemical substance
-human papilloma virus

27. CLINICAL FEATURES
-painless -soft to the touch -slight mobility under the tongue -common in adult especially older adult (40-60) age

29. PATHOGENESIS
-Normal cells undergo a transformation where they grow and multiply without normal control . As the cells multiply they form small abnormalities Called lesions which will eventually form a mass called tumor. They may grow and penetrate below the surface layer of tissue but do not Spread to the other part of the body and they referred to as benign tumor. Reference : ( eMedicineNet.com)

30. DIAGNOSIS
-biopsy of the lesion -diagnose the disease by examining cells and tissues

31. TREATMENT
-can be removed by physician with minor incision ( once removed they do not grow back). Reference : ( eMedicineNet.com)

32. 10/06/PS/3221 ORAL CANCER
Oral cancer is a part of a group of cancers called head and neck cancers Oral cancer can develop in any part of the oral cavity or oropharynx. Most oral cancer begin in the squamous cells that cover the surfaces of the mouth ,tongue and lips. These cancers are called squamous cell carcinomas. AETIOLOGY -tobacco and alcohol use -sun exposure -being infected with human papilloma virus -chemical substances

33. CLINICAL FEATURES White patches (leukoplakia) become malignant
Mixed red and white patches(erythroleukoplakia)more often become malignant
Red patches(erythroplakia) become malignant
Bleeding in your mouth
Loose teeth
Difficult or pain in swallowing
Sore in your lip or mouth that won’t heal
Difficulty wearing dentures
earache

35. PATHOGENESIS
Cancer begins in cells , normally cells grow and divide to form new cells as the body needs them . When cells grow old they die and new cells take place.
sometimes these process goes wrong ,new cells grow when the body doesn’t need them and older cells do not die. These cells can form a mass of tissue called growth or tumor which present in two forms:
-benign tumor which is harmless and malignant tumor which is harmful ,can spread to the other part of the body and may grow back once removed.

36. TREATMENT Surgical treatment Radiation therapy Chemotherapy
Nutrition therapy
Counseling
Dental therapy
Reference : (eMedicineNet .com)

37. DIAGNOSIS
the doctor or the dentist checks your mouth and throat for red or white patches ,swelling or other problems.
Looking carefully at the roof of your mouth ,back of your throat and inside the cheeks and lips.
Pulls out your tongue to be checked on the sides
Check the floor of your mouth and lymph nodes in your neck
If an exam shows an abnormal area ,biopsy is recquied.
Reference : eMedicineNet.com