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