1. ©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

2. ©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

3. ©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

4. ©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

5. ©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

6. ©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

7. ©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

8. ©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

9. ©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

10. ©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

11. ©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

12. ©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

13. ©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

14. ©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

15. ©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

16. ©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

17. ©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

18. ©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

19. ©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

20. ©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

21. ©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

22. ©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

23. ©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

24. ©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

25. ©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

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. Tooth Development Disturbances Macrodontia –Abnormally large teeth Microdontia –Abnormally small teeth

27. ©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

28. ©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

29. ©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

30. ©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

31. ©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

32. ©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

33. ©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

34. ©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

35. ©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

36. ©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

37. ©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

38. ©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

39. ©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

40. ©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

41. ©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

42. ©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

43. ©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

44. ©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

45. ©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

46. ©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

47. ©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