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Oral Medicine & Pathology: A Guide to Diagnosis and Management
Saman Warnakulasuriya, WM Tilakaratne
CHAPTER 1:
Anomalies of Teeth
INTRODUCTION
DEVELOPMENTAL ABNORMALITIES OF ENAMEL
Amelogenesis Imperfecta
Nonsyndromic Amelogenesis Imperfecta
Syndromic Amelogenesis Imperfecta
Environmental Enamel Hypoplasia
Nonspecific Abnormalities
Turner Hypoplasia
Molar Incisor Hypomineralization
Dental Fluorosis
DEVELOPMENTAL ABNORMALITIES OF DENTINE
Dentinogenesis Imperfecta
Nonsyndromic Dentinogenesis Imperfecta (Types II and III)
Syndromic Dentinogenesis Imperfecta
Dentine Dysplasia
Dentine Dysplasia Type I
Dentine Dysplasia Type II
Dentine Dysplasia Associated with Other Conditions
DEVELOPMENTAL ABNORMALITIES OF ENAMEL AND DENTINE
Syndromic Composite Abnormalities of Enamel and Dentine
Regional Odontodysplasia
DEVELOPMENTAL ABNORMALITIES OF CEMENTUM
DEVELOPMENTAL ABNORMALITIES OF NUMBER OF TEETH
Hyperdontia
Hypodontia
DEVELOPMENTAL ABNORMALITIES OF ERUPTION OF TEETH
Early Eruption Including Natal Teeth
Delayed or Failure of Eruption of Teeth
DEVELOPMENTAL ABNORMALITIES RESULTING IN EARLY LOSS OF TEETH
DEVELOPMENTAL ABNORMALITIES OF TOOTH FORM AND SIZE
Microdontia and Macrodontia
Dens Invaginatus
Dens Evaginatus and Enamel Pearls
Taurodontism
Gemination
Fusion
Concresence
BASIC PRINCIPLES AND MANAGEMENT OF PATIENT WITH DEVELOPMENTAL ANOMALIES OF TEETH
ACQUIRED ABNORMALITIES OF TEETH
Attrition
Abrasion
Erosion
Abfraction
INTERNAL AND EXTERNAL ROOT RESORPTION
Internal Root Resorption
External Root Resorption
TOOTH DISCOLORATION AND STAINING
Intrinsic Discoloration
Extrinsic Staining
Internalized Staining
SELF-ASSESSMENT QUESTIONS
CHAPTER 2:
Pathology of Dental Caries
INTRODUCTION
ETIOLOGY AND MICROBIOLOGY OF DENTAL CARIES
CARIES OF ENAMEL
Basic Enamel Structure
Macroscopic Features
Pit and Fissure Caries
Smooth Surface Caries (Interproximal Caries)
Microscopic Features
Ultrastructural Changes in Enamel
CARIES OF DENTINE
Basic Dentine Structure
Macroscopic Features
Microscopic Features
CARIES OF CEMENTUM OR ROOT SURFACE CARIES
Basic Cementum Structure
Macroscopic Features
Microscopic Features
RESPONSE OF THE PULPODENTINAL COMPLEX TO CARIES PROGRESSION
PATHOPHYSIOLOGIC DYNAMICS OF THE CARIOUS PROCESS
ARREST OF THE CARIOUS LESION
RAMPANT CARIES
PATHOLOGY OF THE PULP AND PULP REACTION
Acute Pulpitis and Pulp Abscess
Chronic Pulpitis
Chronic Hyperplastic Pulpitis, Pulp Polyp
PERIAPICAL INFLAMMATION OF TEETH
DETECTION AND ASSESSMENT OF DENTAL CARIES
Detection of Dental Caries
Assessment of Dental Caries
Caries Indices
Microbiological Tests to Predict Caries Activity
APPROACHES FOR PREVENTING DENTAL CARIES INCLUDING DENTAL CARIES VACCINES
SELF-ASSESSMENT QUESTIONS
CHAPTER 3:
Periodontal Diseases
INTRODUCTION
EPIDEMIOLOGY OF PERIODONTAL DISEASE
HISTORY, EXAMINATION AND ASSESSMENT OF RISK FACTORS
History
Examination
Risk Factor Assessment
DIAGNOSIS, TREATMENT PLANNING AND EMPOWERING THE PATIENT
GINGIVITIS
PERIODONTAL DISEASES
Chronic Periodontitis
Aggressive Periodontitis
MICROBIOLOGY, HISTOLOGY AND PATHOGENESIS
Microbiology
Histology and Pathogenesis
Direct Injury by Plaque Bacteria
Host Derived Inflammatory Mediators
Cytokines
Interleukin-1β
Tumor Necrosis Factor-α
Interleukin-6
Interleukin-1α
Interleukin-1 Receptor Antagonist
Prostaglandins
Matrix Metalloproteinases
Pathogenesis and Clinical Signs of Disease
PERIODONTAL—SYSTEMIC INTERFACE
Diabetes
Coronary Heart Disease
Pregnancy Outcomes
TREATMENT OF PERIODONTAL DISEASE
Plaque Control
Manual Toothbrush
Single Tufted Toothbrush
Powered Brush
Dental Floss
Bottle Brushes
Toothpastes
Mouthrinses
Root Surface Debridement (RSD)
Adjunctive Treatments
Risk Factor Management
Maintenance Care
Surgical Therapy
Periodontal Flap Surgery
Crown Lengthening
Gingivectomy
Guided Tissue Regeneration/Guided Bone Regeneration (GTR/GBR)
Mucogingival Surgery
SELF-ASSESSMENT QUESTIONS
CHAPTER 4:
Inflammatory Disorders of Jaws including Necrosis
INTRODUCTION
OSTEONECROSIS
Bisphosphonate-associated Ostenecrosis (BONJ-Osteochemonecrosis)
Definition and Diagnostic Criteria
Epidemiology
Etiopathogenesis
Risk Factors
Clinical Features
Histopathology
Imaging
Treatment
Prognosis
OSTEOCHEMONECROSIS ASSOCIATED WITH MEDICATIONS OTHER THAN BISPHOSPHONATES
Radiotherapy-associated Osteonecrosis (ORN-Osteoradionecrosis)
Definition and Diagnostic Criteria
Epidemiology
Etiopathogenesis
Risk Factors
Clinical Features and Histopathology
Imaging
Management
Prevention
Therapy
Prognosis
Neuralgia-inducing Cavitational Osteonecrosis
Other Causes of Osteonecrosis
INFLAMMATORY DISEASES OF THE JAW BONES
Osteomyelitis
Definition
Etiology
Clinical Features
Pathogenesis
Diagnosis
Management
Complications
Chronic Osteomyelitis
Actinomycosis
Infantile Osteomyelitis
Chronic Recurrent Multifocal Osteomyelitis of Children
Proliferative Periostitis (Periostitis Ossificans)
Histology
Management
Chronic Sclerosing Osteomyelitis
Diffuse Chronic Sclerosing Osteomyelitis
Florid Osseous Dysplasia
Diffuse Sclerosing Osteomyelitis
Histology
Management
Primary Chronic Osteomyelitis
Histology
Management
Chronic Tendoperiostitis
Histology
Management
Condensing Osteitis(Focal Sclerosing Osteomyelitis)
Management
Alveolar Osteitis (Dry Socket, Fibrinolytic Alveolitis)
Management
SELF ASSESSMENT QUESTIONS
CHAPTER 5:
Cysts of the Oral and Maxillofacial Region
INTRODUCTION
ODONTOGENIC CYSTS
Radicular Cyst
Clinical Features
Radiological Features
Histopathology
Treatment
Lateral Periodontal Cyst
Residual Cyst
Paradental Cyst
Clinical and Radiological Features
Histopathology
Dentigerous Cyst
Clinical and Radiological Features
Histopathology
Treatment and Prognosis
Eruption Cyst
Clinical Features
Histopathological Features
Treatment
Odontogenic Keratocyst (Keratocystic Odontogenic Tumor)
Clinical and Radiological Features
Histopathology
Treatment
Nevoid Basal Cell Carcinoma Syndrome
Orthokeratinized Odontogenic Cyst
Clinical and Radiological Features
Histopathology
Treatment
Gingival Cyst of Newborn
Clinical Features
Histopathology
Treatment
Gingival Cyst of Adults
Clinical and Radiological Features
Histopathology
Lateral Periodontal Cyst and Botryoid Odontogenic Cyst
Clinical and Radiological Features
Histopathology
Treatment
Glandular Odontogenic Cyst (Sialo-odontogenic Cyst)
Clinical and Radiological Features
Histopathology
Treatment
Malignant Transformation in Odontogenic Cysts
NONODONTOGENIC CYSTS
Nasopalatine Cyst (Incisive Canal Cyst)
Clinical and Radiological Features
Histopathology
Treatment
Nasolabial Cyst
Clinical and Radiological Features
Histopathology
Treatment
Aneurysmal Bone Cyst
Clinical and Radiological Features
Histopathology
Treatment
Solitary Bone Cyst (Simple Bone Cyst, Traumatic Bone Cyst, Hemorrhagic Bone Cyst, Unicameral Bone Cyst)
Clinical and Radiological Features
Histopathology
Treatment
Surgical Ciliated Cyst of the Maxilla (Postsurgical Maxillary Cyst)
Clinical and Radiological Features
Histopathology
Treatment
Oral Lymphoepithelial Cyst
Treatment
Cervical Lymphoepithelial Cyst (Branchial Cleft Cyst)
Dermoid and Epidermoid Cyst
Histopathology
Thyroglossal Duct Cyst
Developmental Cysts of Foregut Origin (Gastrointestinal Choristomal Cysts, Heterotopic Gastrointestinal Cysts, Oral Alimentary Tract Cyst, Foregut Duplication Cyst)
Cystic Hygroma
Parasitic Cysts
SELF-ASSESSMENT QUESTIONS
CHAPTER 6:
Odontogenic Tumors
INTRODUCTION
AMELOBLASTOMA
Solid/Multicystic Type
Clinical Features
Radiological Features
Histopathological Features
Pathogenesis
Treatment
Extraosseous/Peripheral Type
Clinical Features
Radiological Features
Histopathological Features
Desmoplastic Type
Unicystic Type
SQUAMOUS ODONTOGENIC TUMOR
CALCIFYING EPITHELIAL ODONTOGENIC TUMOR
ADENOMATOID ODONTOGENIC TUMOR
KERATOCYSTIC ODONTOGENIC TUMOR
AMELOBLASTIC FIBROMA
AMELOBLASTIC FIBRO-ODONTOMA
ODONTOMAS
CALCIFYING CYSTIC ODONTOGENIC TUMOR
DENTINOGENIC GHOST CELL TUMOR
ODONTOGENIC FIBROMA
ODONTOGENIC MYXOMA
BENIGN CEMENTOBLASTOMA
MALIGNANT AMELOBLASTOMA (METASTASIZING AMELOBLASTOMA)
AMELOBLASTIC CARCINOMA
PRIMARY INTRAOSSEOUS SQUAMOUS CELL CARCINOMA
Solid Type
Clinical Features
Radiological Features
Histopathological Features
Derived from Keratocystic Odontogenic Tumor
Clinical Features
Radiological Features
Histopathological Features
Treatment
Derived from Odontogenic Cyst Lining
Clinical Features
Radiological Features
Treatment
CLEAR CELL ODONTOGENIC CARCINOMA
GHOST CELL ODONTOGENIC CARCINOMA
AMELOBLASTIC FIBROSARCOMA
AMELOBLASTIC FIBRODENTINOSARCOMA AND FIBRO-ODONTOSARCOMA
SELF-ASSESSMENT QUESTIONS
CHAPTER 7:
Fibrocemento-osseous Lesions and Related Conditions
INTRODUCTION
CLASSIFICATION
Cemento-osseous Dysplasias
Nonhereditary
Hereditary
Fibrocemento-osseous Neoplasms
Fibrous Dysplasia
CEMENTO-OSSEOUS DYSPLASIAS
Periapical Cemental Dysplasia (Periapical Cemento-osseous Dysplasia)
Clinical and Radiological Features
Histopathological Features
Differential Diagnosis
Treatment and Prognosis
Focal Cemento-osseous Dysplasia
Clinical and Radiological Features
Histopathological Features
Differential Diagnosis
Treatment and Prognosis
Florid Cemento-osseous Dysplasia
Clinical and Radiological Features
Histopathological Features
Differential Diagnosis
Treatment and Prognosis
Familial Gigantiform Cementoma (Familial Florid Cemento-osseous Dysplasia)
FIBROUS DYSPLASIA
Monostotic Fibrous Dysplasia and Craniofacial Fibrous Dysplasia
Polyostotic Fibrous Dysplasia; Polyostotic Fibrous Dysplasia with Endocrinopathy (McCune-Albright Syndrome); Polyostotic Fibrous Dysplasia with Pigmentation (Jaffe-Lichtenstein Syndrome)
Clinical and Radiological Features
Histopathological Features
Differential Diagnosis
Treatment and Prognosis
CEMENTO-OSSIFYING FIBROMA
Conventional Cemento-ossifying Fibroma
Clinical and Radiological Features
Histopathological Features
Differential Diagnosis
Treatment and Prognosis
Juvenile Aggressive Cemento-ossifying Fibroma
Juvenile Trabecular Cemento-ossifying Fibroma (JTOF)
Clinical and Radiological Features
Histopathological Features
Treatment and Prognosis
Juvenile Psammomatoid Cemento-Ossifying Fibroma (JPOF)
Clinical and Radiological Features
Histopathological Features
Differential Diagnosis
Treatment and Prognosis
RELATED CONDITIONS
Cherubism
Clinical and Radiological Features
Histopathological Features
Treatment and Prognosis
Paget's Disease
Clinical Features
Radiological Features
Histopathological Features
Treatment and Prognosis
Central Giant Cell Granuloma
Clinical Features
Radiological Features
Histopathological Features
Treatment and Prognosis
Osteopetrosis (Marble Bone Disease, Albers-Schonberg Disease)
Clinical Features
Radiological Features
Histopathological Features
Treatment and Prognosis
Other Conditions
SELF-ASSESSMENT QUESTIONS
CHAPTER 8:
Soft Tissue and Bone Tumors
INTRODUCTION
SOFT TISSUE TUMORS AND TUMOR-LIKE LESIONS
REACTIVE LESIONS
Epulides
Fibrous Epulis
Histopathology
Pyogenic Granuloma
Histopathology
Peripheral Giant Cell Granuloma (Giant Cell Epulis)
Histopathology
Management
FIBROUS LESIONS
Fibroepithelial Polyp
Histopathology
Denture-induced Fibroepithelial Hyperplasia
Histopathology
Management
Papillary Hyperplasia of the Palate
Histopathology
Management
Squamous Papilloma
Histopathology
Management
Focal Epithelial Hyperplasia (Heck's Disease)
Histopathology
Management
Nodular Fasciitis
Histopathology
Management
VASCULAR LESIONS
Pyogenic Granuloma
NEURAL LESIONS
Traumatic Neuroma
Histopathology
Management
OTHER REACTIVE LESIONS
Oral Focal Mucinosis
Histopathology
Management
Verruciform Xanthoma
Histopathology
Management
BENIGN AND MALIGNANT TUMORS
FIBROUS TUMORS
Myofibroma/Myofibromatosis
Histopathology
Management
Myofibrosarcoma
Histopathology
Management
Fibromatosis (Desmoid Tumor, Aggressive Fibromatosis)
Histopathology
Management
Fibrosarcoma
Histopathology
Management
Fibrous Histiocytoma
Histopathology
Management
Malignant Fibrous Histiocytoma (Undifferentiated Pleomorphic Sarcoma, Pleomorphic Fibrosarcoma)
Histopathology
Management
VASCULAR TUMORS
Hemangioma
Histopathology
Management
Sturge-Weber Syndrome (Encephalotrigeminal Angiomatosis)
Lymphangioma
Histopathology
Management
Angiosarcoma
Histopathology
Management
Kaposi's Sarcoma
Histopathology
Management
NEURAL TUMORS
Granular Cell Tumor
Histopathology
Management
Neurofibroma
Histopathology
Management
Schwannoma (Neurilemmoma)
Histopathology
Management
Neuromas of the MEN Syndrome
Histopathology
Management
Malignant Peripheral Nerve Sheath Tumor
Histopathology
Management
ADIPOSE TUMORS
Lipoma
Liposarcomas
Muscle Tumors
Leiomyomas
Leiomyosarcomas
Rhabdomyomas
Histopathology
Management
Rhabdomyosarcomas
Histopathology
Management
BONE TUMORS AND TUMOR-LIKE LESIONS
Tori and Exostoses
Histology
Management
Osteoma
Gardner's Syndrome
Histopathology
Management
Osteochondroma
Histopathology
Osteoblastoma
Histopathology
Management
Osteosarcoma
Histopathology
Management
CARTILAGE-FORMING TUMORS
Chondroma
Histopathology
Management
Chondrosarcoma
Histopathology
Management
OTHER TUMORS OF BONE
Hemangiomas
Ewing's Sarcoma
Histopathology
Management
Langerhans Cell Histiocytosis
Histopathology
Management
Myeloma
Histopathology
Management
Metastatic Tumors
Histopathology
Management
SELF-ASSESSMENT QUESTIONS
CHAPTER 9:
Diseases of the Maxillary Antrum
INTRODUCTION
GROWTH AND ANATOMY OF THE MAXILLARY SINUSES
ACUTE AND CHRONIC MAXILLARY SINUSITIS
FUNGAL INFECTIONS OF THE MAXILLARY SINUSES
Aspergillosis
Clinical and Pathological Features
Treatment
Blastomycosis
Cryptococcosis
Actinomycosis
MUCOCELES AND ANTRAL PSEUDOCYSTS
Mucoceles
Treatment
Antrochoanal Polyps
Clinical and Pathological Features
Treatment
Antroliths
Clinicopathological Features
Treatment
TUMORS OF THE MAXILLARY ANTRUM
Benign Tumors of the Maxillary Sinuses
Schneiderian Papillomas
Fungiform (Epithelial Papilloma)
Clinicopathological Features
Treatment
Inverted Papilloma
Clinicopathological Features
Treatment
Oncocytic Papilloma (Cylindrical Cell Papilloma)
Clinicopathological Features
Treatment
MALIGNANT TUMORS OF THE MAXILLARY ANTRUM
Squamous Cell Carcinoma
Clinicopathological Features
Treatment
Adenoid Cystic Carcinoma
Clinicopathological Features
Treatment
Adenocarcinoma and Variants
Clinicopathological Features
Treatment
Malignant Melanoma
Clinicopathological Features
Treatment
Verrucous Carcinoma
Clinicopathological Features
Treatment
Lymphomas and Related Tumors
Sarcomas
Metastatic Tumors to the Maxillary Sinus
SINONASAL NEUROENDOCRINE TUMORS
Esthesioneuroblastoma
Sinonasal Undifferentiated Carcinoma
Small Cell Neuroendocrine Carcinoma
SELF-ASSESSMENT QUESTIONS
CHAPTER 10:
Salivary Gland Disorders
INTRODUCTION
NON-NEOPLASTIC SALIVARY DISORDERS
Developmental Disorders
INFLAMMATORY/INFECTIVE DISEASES
Acute Suppurative Sialadenitis
Clinical Features
Histopathology
Treatment and Prognosis
Recurrent Parotitis (Juvenile Parotitis)
Clinical Features
Histopathology
Treatment and Prognosis
Chronic Obstructive Sialadenitis and Sialolithiasis
Clinical Features
Histopathology
Diagnosis and Treatment
Postirradiation Sialadenitis
VIRAL DISEASES
Mumps
HIV-associated Salivary Gland Disease
Clinical Features
Histopathology
Treatment and Prognosis
Other Viral Infections of Salivary Glands
MUCOCELES
Extravasation Mucoceles
Retention Mucoceles (Mucus Retention Cysts)
Treatment and Prognosis
NECROTIZING SIALOMETAPLASIA
SIALOSIS (SIALADENOSIS)
AUTOIMMUNE DISORDERS
Sjögren's Syndrome
Clinical Features
Diagnosis
Histopathology
Treatment and Prognosis
NEOPLASTIC SALIVARY DISORDERS
BENIGN NEOPLASMS
Pleomorphic Adenoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Warthin's Tumor
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Canalicular Adenoma
Clinical Features
Histological Features
Differential Diagnosis
Treatment and Prognosis
Basal Cell Adenoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
MALIGNANT NEOPLASMS
Acinic Cell Carcinoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Mucoepidermoid Carcinoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Adenoid Cystic Carcinoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Polymorphous Low-grade Adenocarcinoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Epithelial-myoepithelial Carcinoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Salivary Duct Carcinoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
Carcinoma Ex-pleomorphic Adenoma
Clinical Features
Histopathology
Differential Diagnosis
Treatment and Prognosis
SELF-ASSESSMENT QUESTIONS
CHAPTER 11:
Xerostomia
INTRODUCTION
SALIVA
Physiology of Salivary Secretion
Constituents of Saliva
Functions
XEROSTOMIA
Signs and Symptoms
Etiopathogenesis
Clinical Assessment
Investigations
Management
SUMMARY
SELF-ASSESSMENT QUESTIONS
CHAPTER 12:
Potentially Malignant Disorders
INTRODUCTION
LEUKOPLAKIA
Demography
Epithelial Dysplasia and Malignant Transformation
Mild Dysplasia
Moderate Dysplasia
Severe Dysplasia
Lichenoid Dysplasia
Cell and Molecular Markers
Ploidy Status of Oral Leukoplakia
Clinical Features
Differential Diagnosis
Risk Factors
ERYTHROPLAKIA
DIAGNOSIS AND ADJUNCTIVE TECHNIQUES
SCREENING FOR ORAL LEUKOPLAKIA AND ERYTHROPLAKIA
Management
ORAL LICHEN PLANUS
Etiology and Immunopathogenesis
Clinical Types of OLP
Reticular Type
Papular Type
Plaque Type
Atrophic Type
Ulcerative (Erosive) Type
Bullous Type
Desquamative Gingivitis
Oral Lichenoid Lesions
Systemic Diseases of Interest
Diagnosis and Histopathology
Management
Biologics
Malignant Transformation
ORAL SUBMUCOUS FIBROSIS
Pathogenesis
Clinical Features
Grading of OSF
Histopathology
Malignant Transformation
Management
CONCLUSION
ACKNOWLEDGMENTS
SELF-ASSESSMENT QUESTIONS
CHAPTER 13:
Oral Cancer
INTRODUCTION
GLOBAL EPIDEMIOLOGY
Incidence
Prevalence
Mortality
Survival
RISK FACTORS
CLINICAL PRESENTATION
METASTASIS
Regional Spread
Bone Invasion
Distant Metastasis
STAGING
INVESTIGATIONS THAT AID DIAGNOSIS
PATHOLOGY
Histopathological Features of OSCC
Pathological Grading
Features of Metastasis
Carcinoma In Situ
Early Invasion
PATHOLOGICAL SUBTYPES OF ORAL SQUAMOUS CELL CARCINOMA
Verrucous Carcinoma
Carcinoma Cuniculatum
Papillary Squamous Cell Carcinoma
Adenosquamous Carcinoma
Basaloid Squamous Cell Carcinoma
Spindle Cell Carcinoma
Giant Cell Carcinoma
MOLECULAR PATHOLOGY
PROGNOSIS OF ORAL SQUAMOUS CELL CARCINOMA
TREATMENT
SCREENING AND PREVENTION
ACKNOWLEDGMENTS
SELF-ASSESSMENT QUESTIONS
CHAPTER 14:
Recurrent Oral Ulceration
INTRODUCTION AND CLASSIFICATION
RECURRENT APHTHOUS ULCERATION/RECURRENT APHTHOUS STOMATITIS
Clinical Aspects
Etiology
SYSTEMIC DISEASES ASSOCIATED WITH RECURRENT ORAL ULCERATION
Behçet's Disease
Immunobullous and Systemic Diseases with ROU
Anemia and Vitamin Deficiencies
GI Tract Diseases
HIV-associated ROU
CHRONIC ULCERATIVE STOMATITIS
SYNDROMES ASSOCIATED WITH ROU
DRUG-INDUCED RECURRENT ORAL ULCERATION
MANAGEMENT
Topical Agents
Systemic Therapy
Systemic Corticosteroids
Pentoxifylline
Colchicine
Azathioprine
Thalidomide
Levamisole
Other Therapies
SELF-ASSESSMENT QUESTIONS
CHAPTER 15:
Vesiculobullous Disorders
INTRODUCTION
DISEASES CHARACTERIZED BY INTRAEPITHELIAL SEPARATION
Pemphigus
Pemphigus Vulgaris
Clinical Features
Diagnosis
Histopathology
Pathogenesis
Management
Paraneoplastic Pemphigus
Clinical Features
Histopathology and Pathogenesis
Management
Other Variants of Pemphigus: Pemphigus Foliaceous
IgA Pemphigus
DISEASES CHARACTERIZED BY SUBEPITHELIAL SEPARATION
Bullous Pemphigoid
Clinical Features
Histopathology and Pathogenesis
Management
Mucous Membrane Pemphigoid
Clinical Features
Variants
Histology
Pathogenesis
Management
Epidermolysis Bullosa
Epidermolysis Bullosa Aquisita
Clinical Features
Histology
Management
Dermatitis Herpetiformis
Clinical Features
Histopathology
Pathogenesis
Management
LINEAR IgA DISEASE
ANGINA BULLOSA HEMORRHAGICA
ERYTHEMA MULTIFORME
Erythema Multiforme Minor
Erythema Multiforme Major
STEVENS-JOHNSON SYNDROME
TOXIC EPIDERMOLYSIS NECROSIS SYNDROME
HERPES ASSOCIATED ERYTHEMA MULTIFORME
SELF-ASSESSMENT QUESTIONS
CHAPTER 16:
Infections of the Oral Mucosa
INTRODUCTION
FUNGAL INFECTIONS OF THE ORAL MUCOSA
ORAL CANDIDIASIS
Pseudomembranous Candidiasis
Clinical Features
Microbiology and Pathology
Management
Erythematous (Atrophic) Candidiasis
Clinical Features
Microbiology
Management
Hyperplastic Candidiasis (Candidal Leukoplakia)
Microbiology and Histopathology
Management
CANDIDA-ASSOCIATED LESIONS
Candida-associated Denture Stomatitis
Clinical Features
Etiology
Microbiology and Histopathology
Management
Angular Stomatitis (Perleche, Angular Cheilitis)
Clinical Features
Microbiology
Treatment
Median Rhomboid Glossitis
Linear Gingival Erythema
CANDIDIASIS AND IMMUNOCOMPROMISED HOSTS
ORAL CANDIDIASIS IN HIV DISEASE
Laboratory Diagnosis
EXOTIC FUNGAL INFECTIONS OF THE ORAL MUCOSA
Aspergillosis
Oral Considerations
Diagnosis and Management
Blastomycosis
Oral Considerations
Diagnosis and Management
Coccidioidomycosis
Oral Considerations
Diagnosis and Management
Cryptococcosis
Oral Considerations
Diagnosis and Management
Fusariosis
Oral Considerations
Diagnosis and Management
Geotrichosis
Oral Considerations
Diagnosis and Management
Histoplasmosis
Oral Considerations
Diagnosis and Management
Mucormycosis (Zygomycosis; Phycomycosis)
Oral Considerations
Diagnosis and Management
Paracoccidioidomycosis (South American Blastomycosis)
Oral Considerations
Diagnosis and Management
Penicilliosis
Oral Considerations
Diagnosis and Management
Sporotrichosis
Oral Considerations
Diagnosis and Management
ORAL VIRAL INFECTIONS
Primary Herpes Simplex Infection: Herpetic Stomatitis (HHV-1, HHV-2)
Clinical Features
Secondary Herpes Simplex Infection: Herpes Labialis (HHV-1, HHV-2)
Herpetic Dermatitis and Herpetic Whitlow (HHV-1 and HHV-2)
Laboratory Diagnosis of Herpetic Infection
Direct Examination and PCR Technology
Culture
Serology
Management
Varicella and Zoster (HHV-3)
Chickenpox
Oral Manifestations
Shingles (Zoster)
Oral Manifestations
Management
Epstein–Barr Virus (Human Herpesvirus 4)
Infectious Mononucleosis
Incubation Period
Signs and Symptoms
Chronic, Persistent or Reactivated EBV Infection
Epidemiology
Diagnosis
Treatment
Burkitt's Lymphoma
Nasopharyngeal Carcinoma
Hairy Leukoplakia
Cytomegalovirus (Human Herpesvirus 5; HHV-5)
Clinical Disease
Epidemiology
Diagnosis and Treatment
Oral Manifestations of Other Herpesviruses (HHV-6 to HHV-8)
Coxsackie Virus Infections
Oral Manifestations of Herpangina
Paramyxovirus Infections
Human Papillomavirus Infections
BACTERIAL INFECTIONS OF THE ORAL MUCOSA
Tuberculosis of the Oral Mucosa
Diagnosis
Syphilis
Primary Syphilis
Diagnosis
Secondary Syphilis
Diagnosis
Tertiary Syphilis
Diagnosis
Gonorrhea
Diagnosis
Other Bacterial Infections
PARASITIC INFECTIONS OF THE ORAL MUCOSA
Mucocutaneous Leishmaniasis
Diagnosis
Myiasis
Treatment
SELF-ASSESSMENT QUESTIONS
CHAPTER 17:
Connective Tissue Diseases
INTRODUCTION
SOFT TISSUE CONDITIONS
Systemic Lupus Erythematosus
Epidemiology
Etiology
Signs and Symptoms
Diagnostic Investigations
Therapies
Drug Induced Lupus
Outlook
Oral Care Importance
Antiphospholipid (Hughes) Syndrome
Systemic Sclerosis or Scleroderma (Greek—Hard Skin)
Etiology
Signs and Symptoms
Diagnostic Investigations
Therapies
Outlook
Oral Care Importance
Dermatomyositis and Polymyositis Group of Conditions
Etiology
Signs and Symptoms
Diagnostic Investigations
Therapies
Outlook
MIXED CONNECTIVE TISSUE DISEASE
Sjögren's Syndrome
SYSTEMIC VASCULITIS
RAYNAUD'S DISEASE AND PHENOMENON
HARD TISSUE DISORDERS/ARTHRITIDES
Osteoarthritis
Etiology
Signs and Symptoms
Diagnostic Investigations
Therapies
Oral Care Importance
Rheumatoid Arthritis
Etiology
Signs and Symptoms
Diagnostic Investigations
Therapies
Outlook
Oral Care Importance
ACKNOWLEDGMENTS
SELF-ASSESSMENT QUESTIONS
CHAPTER 18:
Chronic Facial Pain
INTRODUCTION
PAIN
Definition
Pathogenesis
CHRONIC PAIN
NEUROPATHIC PAIN
Trigeminal Neuralgia
Clinical Features
Differential Diagnosis
Treatment and Prognosis
Postherpetic Neuralgia
Clinical Features
Differential Diagnosis
Treatment and Prognosis
VASCULAR PAIN
Cluster Headaches
Clinical Features
Differential Diagnosis
Management and Prognosis
CHRONIC IDIOPATHIC FACIAL PAIN
Myofacial Pain
Clinical Features
Differential Diagnosis
Treatment and Prognosis
Atypical Facial Pain
Differential Diagnosis
Treatment and Prognosis
Atypical Odontalgia
Treatment and Prognosis
BURNING MOUTH SYNDROME
SELF-ASSESSMENT QUESTIONS
CHAPTER 19:
Temporomandibular Joint Disorders
INTRODUCTION
EPIDEMIOLOGY
INITIAL CONSULTATION
History
Pain
Joint Noises
Locking
Restriction of Opening
Other Joint Disorders
Joint Dislocation
Disturbance of the Bite
Clinical Examination
Palpation of the Joint
Palpation of the Masseter and Temporalis
Use of a Tongue Spatula
Measurement of Interincisal Opening
Observation of Opening Path
Interdigitation of the Teeth (Dental Occlusion)
Investigations
Differential Diagnosis
MYOFASCIAL PAIN AND INTERNAL DERANGEMENT
Initial Management
Management in Specialist Centers
OTHER DISORDERS OF THE TEMPOROMANDIBULAR JOINT
Congenital
Hemifacial Microsomia
Condylar Hyperplasia
Traumatic
Infective TMJ Disorders
Inflammatory Disease
Neoplastic Disease
Degenerative Disease (Osteoarthrosis)
Iatrogenic/Idiopathic
SURGICAL MANAGEMENT
CONCLUSION
SELF-ASSESSMENT QUESTIONS
CHAPTER 20:
Oral Manifestations of Systemic Disease
INTRODUCTION
GASTROINTESTINAL DISEASES
Crohn's Disease
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
Orofacial Granulomatosis
Etiology
Clinical Features
Histopathological Features
Treatment
Ulcerative Colitis
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
Celiac Disease
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
GRANULOMATOUS DISEASES
Tuberculosis
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
Sarcoidosis
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
Wegener's Granulomatosis
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
HEMATOLOGICAL CONDITIONS
Amyloidosis
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
ENDOCRINE ABNORMALITIES
Addison's Disease
Etiology
Clinical Features
Oral Manifestations
Treatment
Gigantism and Acromegaly
Etiology
Gigantism
Acromegaly
Oral Manifestations
Treatment
HUMAN IMMUNODEFICIENCY VIRUS INFECTION
ORAL MANIFESTATIONS STRONGLY RELATED TO HIV
Candidiasis
Pseudomembranous Candidiasis (Thrush)
Erythematous Candidiasis
Angular Cheilitis
Chronic Hyperplastic Candidiasis
Oral Hairy Leukoplakia
HIV-related Periodontal Disease
Necrotizing Ulcerative Gingivitis
Necrotizing Ulcerative Periodontitis
Kaposi's Sarcoma
Non-Hodgkin's Lymphoma
Human Papillomavirus Infection
Treatment of HIV
Immune Reconstitution Inflammatory Syndrome
Clinical Features
Pathogenesis of IRIS
CONNECTIVE TISSUE DISEASES
Systemic Lupus Erythematosus
Etiology
Clinical Features
Oral Manifestations
Treatment
Discoid Lupus Erythematosus
Etiology
Clinical Features
Oral Manifestations
Histopathological Features
Treatment
SYNDROMES
Behçet's Disease
Etiology
Histopathological Features
Clinical Features
Oral Manifestations
Treatment
Gardner's Syndrome
Peutz-Jegher's Syndrome
Plummer-Vinson Syndrome
SELF-ASSESSMENT QUESTIONS
CHAPTER 21:
Forensic Dentistry
INTRODUCTION
Definitions
The Roles of a Forensic Odontologist
Forensic Dentistry Training and Career
A Few Famous Cases Involving Forensic Odontology
Ted Bundy Case
Savitri Case
Tsunami Identifications
History of Forensic Dentistry
IDENTIFICATION
Definitions and the Theoretical Framework
Definitions
Theoretical Framework
Different Scenarios and Approaches to Identification
Scenarios
Approaches to Identification
Forensic Odontology Method of Identification
Method
Dental Features Useful in Identification
Teeth
Missing Teeth
Tooth Type
Maxilla and Mandible
Other Pathologic Processes/Jaw Bones
BITEMARKS ANALYSIS
MEDICOLEGAL ASPECTS OF DENTAL AND FACIAL INJURIES
Medicolegal Aspects of Facial Injuries
DENTAL FRAUD
ILLEGAL DENTAL PRACTICE
DENTAL NEGLIGENCE AND DENTAL MALPRACTICE
AGE ESTIMATIONS
General Identification Purposes
DENTAL SURGEON AS AN EXPERT WITNESS
FORENSIC DENTAL EXTENSIONS
SELF-ASSESSMENT QUESTIONS
CHAPTER 22:
Laboratory Investigations and their Interpretation
INTRODUCTION
HEMATOLOGY
Blood Film
Hemoglobin
Disorders of Hemoglobin Anemia
Thalassemia
β-Thalassemia Minor
β-Thalassemia Major
α-Thalassemia
Sickle Cell Anemia
Porphyria
Hematocrit or Packed Cell Volume
Red Blood Cell Count
Polycythemia
Primary Polycythemia
Laboratory findings
Secondary Polycythemia
Laboratory findings
Mean Cell Volume
Mean Corpuscular Hemoglobin and Concentration
Red Cell Distribution Width
White Blood Cells (Leukocytes)
Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
White Blood Cell Count and Differential Count
Myelodysplastic Syndromes
Leukemia
Tests of Clotting Function
Platelets
Reduced Platelet Numbers
Blood Clotting Cascade
Anticoagulation Therapy
Erythrocyte Sedimentation Rate
CLINICAL BIOCHEMISTRY
Hematinics
Iron
Vitamin B12 and Folate
Vitamin B12
Pernicious Anemia
Schilling Test
Folate
Blood Glucose Measurement
Urea and Electrolytes (Us and Es)
Sodium and Potassium
Urea and Creatinine
Estimated Glomerular Filtration Rate and Creatinine Clearance
Tests of Liver Function
Bilirubin
Alkaline Phosphatise
Alanine Transferase and Aspartate Transferase
Gammaglutamyl Transferase
Total Proteins
Bone Profile
C-reactive Protein
Thyroid Function Tests
Thyroid Antibody Tests
Angiotensin Converting Enzyme (ACE)
Dipstick Urine Testing
IMMUNOLOGY
B Lymphocytes (B Cells)
T Lymphocytes (T Cells)
Natural Killer Lymphocytes
Autoimmunity
Antinuclear Antibody Test
Extractable Nuclear Antigen Test
Antineutrophil Cytoplasmic Antibody Test
Tests for the Diagnosis of Celiac Disease
BLOOD TESTS IN MONITORING TOXICITY TO DRUG TREATMENT
Azathioprine
Dapsone and Sulfamethoxypyridazine
ACKNOWLEDGMENTS
SELF-ASSESSMENT QUESTIONS
CHAPTER 23:
Imaging for Diagnosis of Oral and Maxillofacial Diseases
INTRODUCTION
PLAIN RADIOGRAPHS
Periapical Radiography
Bitewing Radiography
Occlusal Radiography
Panoramic Radiography
Skull Radiography
Digital Imaging
Limitations of Digital Imaging
COMPUTED TOMOGRAPHY
CONE BEAM COMPUTED TOMOGRAPHY
Applications of Cone Beam Computed Tomography
Complex Cases of Skeletal Abnormalities Requiring Orthodontic and Surgical Management
Dentoalveolar Trauma (Figs 23.36A to C)
Facial Trauma
MAGNETIC RESONANCE IMAGING
Clinical Applications of MRI
ULTRASOUND
SIALOGRAPHY
Applications of Sialography
Advantages of Sialography
Disadvantages of Sialography
SIALOENDOSCOPY
Applications of Sialoendoscopy
ACKNOWLEDGMENT
SELF-ASSESSMENT QUESTIONS
CHAPTER 24:
Tobacco Use Prevention and Cessation
INTRODUCTION
UNDERSTANDING ‘TOBACCO USE DISEASE’
Psychological Tobacco Use Dependence
Physical Addiction to Nicotine
TOBACCO USE CESSATION
Methods for Tobacco Use Cessation
CATEGORIES OF CARE
Basic Care: Tobacco Use Brief Interventions
Ask
Assess
Brief Motivational Interviewing
Intermediate Care: Behavior Support for Tobacco Use Cessation
Assist
Step-by-step Protocol
Step 1: Ask the Patient to Fill in the Tobacco Use Journal
Step 2: Evaluate the Tobacco Use Journal
Step 3: Behavioral Changes and Nicotine Dependence
Note the Replacements Identified
Step 4: Quit Date
Arrange
Pharmacotherapy for Tobacco Use Cessation
Nicotine Replacement Therapy
Bupropion SR
Varenicline
Advanced Care
DETERMINANTS OF BEHAVIOR CHANGE
Fear to Relapse
Fear to Gain Weight
BARRIERS TO BE OVERCOME BY THE DENTAL TEAM
SELF-ASSESSMENT QUESTIONS
INDEX
TOC
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