Download Talk – Dentistry Oral cavity – disorders of soft tissues

Talk – Dentistry
Oral cavity – disorders of soft tissues
Petr Maršálek
Dept pathological physiology
1.Med. F. CUNI
Outline
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Oral mucosa
Periodontal mucosa
Salivary glands and neighbor tissues
Oral manifestations of systemic disorders
Disorders of Gingiva and Periodontium
Connective Epithelium
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
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
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