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Dental Diseases
Priya Verma Gupta
SECTION 1: DENTAL DISEASES
CHAPTER 1:
Morphology of Primary Dentition
INTRODUCTION
Importance of Primary Dentition
MORPHOLOGICAL DIFFERENCES BETWEEN PRIMARY AND PERMANENT DENTITION (FIGS 1.1 AND 1.2)
The Crown
THE PULP
THE ROOT
MORPHOLOGY OF INDIVIDUAL TEETH
Maxillary Central Incisor (Figs 1.3A and B)
Labial Aspect
Lingual Aspect
Mesial and Distal Aspects
Incisal Edge
Root
Pulp Cavity
MAXILLARY LATERAL INCISOR (FIGS 1.4A TO D)
Root
MAXILLARY DECIDUOUS CANINE (FIGS 1.5A TO D)
Labial Aspect
Contact Areas
Lingual Aspect
Mesial and Distal Surfaces
Incisal Aspect
Root
Pulp Cavity
MAXILLARY FIRST MOLAR (FIGS 1.6A TO D)
Labial Aspect
Lingual Aspect
Mesial Surface
DISTAL ASPECT
Occlusal Aspect
Pulp Cavity
Root
MAXILLARY SECOND MOLAR (FIGS 1.7A TO D)
Buccal Aspect
Palatal Aspect
Mesial Aspect
Distal Aspect
Occlusal Aspect
Root
MANDIBULAR CENTRAL INCISOR (FIGS 1.8A TO D)
Labial Aspect
Lingual Aspect
Mesial Aspect
Distal Aspect
Pulp Cavity
MANDIBULAR LATERAL INCISOR (FIGS 1.9A TO D)
Labial Aspect
Root
MANDIBULAR CANINES (FIGS 1.10A TO D)
Labial Aspect
Lingual Aspect
Mesial and Distal Surfaces
Incisal Aspect
Pulp Cavity
Root
MANDIBULAR FIRST MOLAR (FIGS 1.11A TO D)
Buccal Aspect
Lingual Aspect
Mesial Aspect
Distal Aspect
Occlusal Surface
Pulp Cavity
MANDIBULAR SECOND MOLAR (FIGS 1.12A TO D)
Buccal Aspect
Lingual Aspect
Mesial Aspect
Distal Aspect
Occlusal Aspect
Pulp Cavity
CHAPTER 2:
Developmental Disturbances of Teeth
CHAPTER 3:
Pain
INTRODUCTION
Terms used to Describe Pain
MECHANISMS OF NEURAL PAIN PERCEPTION
Specificity Theory
Summation Theory
Sensory Interaction Theory
Pain Receptors
Free (Uncapsulated) Receptors
Proprioreceptor
Exteroceptors
Interoceptors
Central Connection of Pain
Chemical Mediators
Mechanics of Pain
Gate Theory
Orofacial Pain
Secondary Effects of Pain
Referred Pain
Etiology of Pain
Inflammation
Musculoskeletal Pain
Vascular Pain (e.g. Migraine)
Neural Pain
OTHER CAUSES OF PAIN
Categories of Facial Pain
Clinical Features
Procedures for Control of Pain
CHAPTER 4:
Pulp
INTRODUCTION
ANATOMY OF THE PULP
General Features
Apical Foramen
Accessory Canals
Radiographically
Embryologically
Gross Morphology of the Dental Pulp
SPECIAL ENVIRONMENT OF DENTAL PULP
HISTOLOGY
Structural Elements of Dental Pulp
Cells Fibroblasts
Fibroblast
Reserve Cells
Defense Cells
Macrophage
Lymphocytes and Eosinophils
Plasma Cells
Dendritic Cells (Immunocompetent Cells)
Metabolism
Odontoblast
Odontoblastic Process
Intercellular Components
Collagen Fibers
Van Hassel
Systemic Factors affecting Pulp
Functions of Pulp
Basic Function
Terminal Arteriole
Intra Pulpal Pressure
Theories of Pulpo-Dentinal Pain Fiber Excitation
CLASSIFICATION AND FUNCTIONS OF FIBERS IN PERIPHERAL NERVES
PAIN FIBERS IN PULP (NOCICEPTIVE)
RESPONSE OF A, B AND C NERVE FIBRES TO SPECIAL STIMULUS
Pain Associated with
Response Faster to Cold than Heat
Outward Flow can be Minimized by
Reflex Phenomenon
Role of Neuropeptides
Plasticity of Inter Dental Nerve Fibers
Defense Function
Regulation of Pulpal Blood Flow
Rates of Blood Flow
CLASSIFICATION OF PULPAL PATHOSIS
Role of Dentinoblasts
HISTOPATHOLOGY OF INFLAMMATION
ULTRA STRUCTURAL OF PULPAL INFLAMMATION
DIFFERENTIAL DIAGNOSIS OF POTENTIALLY REVERSIBLE AFFECTED PULP
Acute Inflammation: Effects of Nerve Factors with Tissue Injury Factors
Retrogressive and Age Changes of Dental Pulp
Blood Vessels
Nerves
Formation of Secondary Dentin
Formation of Reparative Dentin
Deep Cavity
In Root Canals
Atrophy (Pulposis)
Advance Age
From Caries and Operative Procedure
From Periodontal Disease
Dystrophic Mineralization
Aging
Due to Caries, Periodontal Disease and Trauma
Denticles (Pulp Stones)
HYPERACTIVE PULPALGIA
HYPERSENSITIVITY
HYPEREMIA
ACUTE PULPALGIA
Moderate Acute Pulpalgia
Advanced Acute Pulpalgia
CHRONIC PULPALGIA
HYPERPLASTIC PULPITIS
Necrotic Pulp
INTERNAL RESORPTION
TRAUMATIC OCCLUSION
SPLIT TOOTH OR INCOMPLETE FRACTURE
CHAPTER 5:
Dental Caries
EARLY THEORIES OF CARIES
Worms
Guy De Cahuliac
Humors
Vital Theory
Chemical Theory
Parasitic or Septic Theory
Chemo—Parasitic Theory
Proteolytic Theory
PROTEOLYSIS—CHELATION THEORY
ETIOLOGY
Caries has Multifactor Etiology (Figs 5.2A and B)
Host Factors: Saliva
Xerostomia (Greek Xeros = Dry, Stoma = Mouth)
Host Factors: Tooth
Tooth Morphology and Arch Form
Tooth Composition
Role of Specific Microflora
Streptococcus Mutans
ORAL LACTOBACILLI
Lactobacilli and its Role in Caries
Oral Actinomyces
Classification of Dental Caries
Depending upon the Origin Dental Caries can be Classified as:
Depending on the Rapidity of Progress
Depending on the Location
Proximal Caries—Susceptible zone
According to the Pathway of Dental Caries
Depending upon the Patient's Age
Infancy (Early Childhood or Nursing Bottle) Caries (Figs 5.15A and B)
Adolescent Caries
Senile Caries
Classification based on GV Black's Treatment and Restorative Design
Radiographic Caries Classification
CRITERIA FOR DIAGNOSIS
CONDITIONS RESEMBLING CARIES
CHAPTER 6:
Dental Stains and Discolorations
EXTRINSIC STAINS
Yellow Stains
Green Stains
D/ D for Green Stains
Black Stains
Tobacco Stains (Fig. 6.1)
Orange and Red Stains
Metallic Stains: Occurring due to
Metal Present in Drugs
Metals from Metal Industry
Other Exogenous Brown Stains
Stannous Fluoride
Brown Pellicle
Food Pigments
Chlorhexidine Mouth Rinses
Betel Leaf (Fig. 6.2)
Endogenous Intrinsic Stains
Drugs
Tetracycline Stains (Fig. 6.3)
Pulpless Tooth/Non Vital Tooth
Developmental Defects of the Teeth
Developmental Defects Occurring due to Genetic Factors
According to Schulze
Dentinogenesis Imperfecta (Fig. 6.5)
Enamel Hypoplasia/Enamel Hypocalcification (Fig. 6.6)
Systemic/Prenatal Hypoplasia
Local/Postnatal Hypoplasia
Hypoplasia may Result due to Multiple Reasons
Colorado Stains/Brown Stains (Fig. 6.7)
Exogenous Intrinsic Stains
CHAPTER 7:
Gingival Enlargement and its Management
INFLAMMATORY ENLARGEMENT
ENLARGEMENT ASSOCIATED WITH SYSTEMIC DISEASES
Conditional Enlargement
Systematic Diseases causing Gingival Enlargement
NEOPLASTIC GINGIVAL ENLARGEMENT
False Enlargement
GRADING OF GINGIVAL ENLARGEMENT
INFLAMMATORY ENLARGEMENT
Clinical Features
Mouth Breathing
ACUTE INFLAMMATORY ENLARGEMENT
Gingival Abscess
Periodontal Abscess
DRUG-INDUCED GINGIVAL ENLARGEMENT
ANTICONVULSANTS
IMMUNOSUPPRESSANTS
Calcium Channel Blockers
Clinical Manifestation
IDIOPATHIC GINGIVAL ENLARGEMENT
Familial Fibromatosis
Etiology
ENLARGEMENT IN PREGNANCY
Marginal Enlargement
Pregnancy (Granuloma) Tumor/Lobular Capillary Hemangioma/Angiogranuloma
Clinical Features
Etiology
ENLARGEMENT IN PUBERTY
ENLARGEMENT IN VITAMIN C DEFICIENCY/SCURVY
Clinical Features
PLASMA CELL GINGIVITIS
Clinical Features
PYOGENIC GRANULOMA
ETIOLOGY
Clinical Features
LEUKEMIC GINGIVAL ENLARGEMENT
Clinical Features
WEGENER'S GRANULOMATOSIS
Oral Manifestations
Sarcoidosis
Oral Manifestations
Crohn's Disease
Clinical Features
Oral Manifestations
NEOPLASTIC GINGIVAL ENLARGEMENT
Fibroma
Clinical Features
Papilloma
Peripheral Giant Cell Granuloma
Gingival Cyst
Squamous Cell Carcinoma
FALSE ENLARGEMENT
Osseous Lesion
UNDERLYING DENTAL TISSUES
CHAPTER 8:
Halitosis
DEFINITIONS
CLASSIFICATION
Based on Etiology
Dominic et al (1982) Categorized Halitosis as follows:
Bogdasarian (1986) Classification based on Etiology
Dayan et al (1982) Divided Foul Odor into Three Groups Namely
Based on Patients Criteria
Iwakuru et al (1994) Classified Halitosis as:
Halitosis due to Local Factors of Pathologic Origin
Halitosis due to Local Factors of Non-pathologic Origin
Halitosis due to Systemic Factors of Pathologic Origin
Halitosis due to Systemic Factors of Non-pathologic Origin
Halitosis due to Systemic Administration of Drugs
Due to Systemic Administration (Table 8.1)
Halitosis due to Xerostomia
Morning Breath
Exogenous Malodor
True Oral Malodor (Endogenous Malodor)
Psychogenic Malodor
EXAMINATION
Physical Examination
Extraoral Examination
Intraoral Examination
Mechanical Methods
Chemical Methods
CHAPTER 9:
Oral Ulcers
TUBERCULOUS ULCER
PRIMARY SYPHILIS
ORAL MANIFESTATIONS OF SYPHILIS
HISTOPLASMOSIS
BLASTOMYCOSIS
MUCOMYCOSIS
PRIMARY HERPETIC GINGIVOSTOMATITIS
Clinical Features
ERYTHEMA MULTIFORMAE
EPIDERMOLYSIS BULLOSA (FIGS 9.2 TO 9.4)
APHTHOUS STOMATITIS
REITER'S SYNDROME
BEHÇET'S SYNDROME
CICATRICIAL PEMPHIGOID
NOMA
MALIGNANT ULCER (FIG. 9.5)
CHAPTER 10:
Radiolucencies of Jaw
PERIAPICAL RADIOLUCENCIES
Periapical Cyst (Fig. 10.4)
Radicular Cyst (Fig. 10.5)
Cholesteatoma
Osteomyelitis
Periapical Cementomas
Traumatic Bone Cyst
Non-radicular Cyst
Malignant Tumors
PERICORONAL RADIOLUCENCIES
Follicular Space (Fig. 10.6)
Dentigerous Cyst
Unicystic Ameloblastoma
Calcifying Odotogenic Cyst
Adenoameloblastoma
Ameloblastic Fibroma
Solitary Cyst like Radiolucencies not Necessarily Contacting Teeth
Maxillary Sinus
Early Stage of Tooth Crypts (Fig. 10.7)
Post Extraction Socket
Residual Cyst
Traumatic Bone Cyst
Primordial Cyst
Stafne's Cyst
Odontogenic Keratocyst
Ameloblastoma
Multilocular Radiolucencies
Multilocular Cyst
Central Giant Cell Granuloma
Hyperparathyroidism
Cherubism
Odontogenic Myxoma
Odontogenic Keratocyst
Metastatic Tumor of Jaw
Central Hemangioma of Bone
Solitary Radiolucencies with Ragged and Poorly Defined Borders
Chronic Alveolar Abscess
Chronic Osteomyelitis
Squamous Cell Carcinoma
Fibrous Dysplasia
Malignant Salivary Gland Tumor
Osteogenic Sarcoma
CHAPTER 11:
Diseases of Jaw
PAGET'S DISEASE
Clinical Features
Radiological Features
OSTEOGENSIS IMPERFECTA
Radiological Features
CLEIDOCRANIAL DYSPLASIA
Clinical Features
Radiological Features
HYPOPLASIA OF MANDIBULAR CONDYLE
Clinical Features
Rheumatoid Mandibular Joint
Clinical Features
Radiological Features
MYOFACIAL PAIN DYSFUNCTION SYNDROME
Clinical Features
CHAPTER 12:
Diseases of Salivary Glands
CHAPTER 13:
Disorders of Taste
NON NEUROPATHIC ORIGIN
NON PATHOGENIC DYSGEUSIA OF CENTRAL ORIGIN
ANOMALIES OF TASTE RECEPTORS
LESIONS OF LINGUAL NERVE
LESIONS OF GLOSSOPHARANGEAL NERVE
CHAPTER 14:
Diseases of Tongue
PAINFUL TONGUE
Pain of the Surface of Tongue
Pain Underneath Tongue
CHAPTER 15:
Diseases of Paranasal Sinuses
CHAPTER 16:
Endocrine Disorders Affecting Oral Cavity
ORAL MANIFESTATIONS
Hypopituitarism
CLINICAL FEATURES
ORAL MANIFESTATIONS
Hyperthyroidism
CLINICAL FEATURES
ORAL MANIFESTATIONS
Hypothyroidism
CLINICAL FEATURES
MYXEDEMA
CRETINISM
Hypoparathyroidism
Clinical Features
ORAL MANIFESTATIONS
Hyperparathyroidism (Figs 16.3A and B)
Clinical Features
RADIOLOGICAL FEATURES
Diabetes Mellitus
CLINICAL FEATURES
ORAL MANIFESTATION
Addison's Disease
CLINICAL FEATURES
ORAL MANIFESTATIONS
Cushing's Syndrome
CLINICAL FEATURES
ORAL MANIFESTATIONS
CHAPTER 17:
White and Red Lesions
PRECANCEROUS LESIONS
Leukoplakia
Erythroplakia
Carcinoma In Situ
Bowen's Disease
Oral Submucous Fibrosis
Discoid Lupus Erythematosis
Lichen Planus
Lichenoid Reaction
CHAPTER 18:
Benign Neoplasm of Oral Cavity
BENIGN NEOPLASM OF BONE
Osteoma
Clinical Features
BENIGN NEOPLASM OF CARTILAGE TISSUE
Chondroma
Clinical Features
Chondroblastoma
Clinical Features
CHAPTER 19:
Malignant Neoplasm of Epithelial Tissue
MYXOMA (FIG. 19.6)
Clinical Features
LIPOMA (FIG. 19.7)
Clinical Features
HEMANGIOMA
Clinical Features
Lymphangioma
Clinical Features
BENIGN NEOPLASM OF MUSCLES
Leiomyoma
Clinical Features
Rhabdomyoma (Fig. 19.8)
TUMORS OF NEURAL TISSUES
Schwannoma
Clinical Features
Neurofibroma
Clinical Features
MALIGNANT NEOPLASM OF ORAL CAVITY
Osteosarcoma (Fig. 19.9)
Clinical Features
Radiological Findings
Non-Hodgkin's Lymphoma
Clinical Features
Radiological Findings
Hodgkin's Lymphoma
Clinical Features
Multiple Myeloma
Clinical Features
Rhabdomyosarcoma
Clinical Features
Neurogenic Sarcoma
Clinical Features
Metastatic Tumors of Jaw
Clinical Features
Fibrosarcoma
Clinical Features
Hemangioendothelioma
Clinical Features
Kaposi's Sarcoma
Clinical Features
Ewing's Sarcoma
Clinical Features
Radiological Features
Chondrosarcoma
Clinical Features
Radiological Features
CHAPTER 20:
Sequel of Radiation on Oral Tissues
CHAPTER 21:
Chronic Orofacial Nerve Pain
CHAPTER 22:
Fever
CHAPTER 23:
Cheilitis
GRANULOMATOUS CHEILITIS
Clinical Features
GLANDULAR CHEILITIS
Clinical Features
ANGULAR CHEILITIS
CHAPTER 24:
Vitamins and Oral Lesions
FAT SOLUBLE VITAMINS
WATER SOLUBLE VITAMINS
VITAMIN A
FUNCTIONS
SOURCES (TABLE 24.1)
DEFICIENCY
ORAL MANIFESTATIONS
VITAMIN D
DAILY REQUIREMENTS
DEFICIENCY
Oral Manifestations
Vitamin C
Functions
Sources (Figs 24.1 and 24.2)
Deficiency
Thiamine (Vitamin B1)
SOURCES (TABLE 24.4)
DEFICIENCY
Wet Beri Beri
Dry Beri Beri
Infantile Beri Beri
Clinical and Oral Manifestations
RIBOFLAVIN (VITAMIN B2)
Oral Manifestations
Pyridoxine (Vitamine B6)
CYANOCOBALMINE (VITAMIN B12)
CHAPTER 25:
Oral Manifestations of Bleeding Disorders
CHAPTER 26:
Oral Implications of Medication
CHAPTER 27:
Oral Changes in Old Age
CHAPTER 28:
Syndromes of Oral Cavity
SECTION 2: CAUSES OF DENTAL SIGNS AND SYMPTOMS
SECTION 3: DIFFERENTIATING TABLES
INDEX
TOC
Index
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