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Head and Neck

Head and Neck . CariesMCC of tooth loss before age 35result of bacterial fermentation of sugars into acid products which dissolve the tooth structureGingivitisinflammation of the gingiva due to lack of proper oral hygieneLesions are Dental plaque

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Head and Neck

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    1. Head and Neck

    3. Caries MCC of tooth loss before age 35 result of bacterial fermentation of sugars into acid products which dissolve the tooth structure Gingivitis inflammation of the gingiva due to lack of proper oral hygiene Lesions are Dental plaque & Calculus Periodontitis Inflammation of supporting structures of the teeth lead to Loosening and eventual loss of teeth Pathogenesis (anaerobic and microaerophilic gram-negative bacteria- Actinobacillus, Porphyromonas, Prevotella) Associated disorders (AIDS, leukemia, Crohn disease, diabetes mellitus)

    4. Head and Neck

    5. Fibrous Proliferative Lesions MC is Irritation Fibroma (61%) Aphthous Ulcers (canker sores) Affect up to 40% of the population in the US Painful, recurrent & familial. Single or multiple, shallow ulcers rimmed by a narrow zone of hyperemia Etiology is not known Associated with Behcet’s syndrome (keratoconjunctivitis, optic atrophy and ulcers in mouth and ext. genitalia Glossitis beefy-red tongue Causes Plummer-Vinson or Paterson-Kelly syndrome deficiencies of vitamin B12 (pernicious anemia), riboflavin, niacin, or pyridoxine

    6. Head and Neck

    7. Infections 1) Herpetic Stomatitis Caused by HSV-1 (genital herpes is HSV-2) “cold sores” - Severe diffuse gingivostomatitis with clusters of vesicles & shallow ulcers. The virus becomes reactivated when exposure to cold or Sunlight Tzanck smears- show multinucleate giant cells 2) oral Thrush pseudomembranous candidiasis superficial, curdy, gray to white inflammatory membrane Immunosuppression – risk factor 3) Hairy Leukoplakia Seen only in AIDS patients White confluent patches of fluffy (“hairy”) thickening at the side of the tongue EBV, HPV & HIV seen in the lesion. Superimposed candidal infection adds to the “hairiness” of the leukoplakia.

    8. Herpetic Stomatitis

    9. Oral thrush

    10. Head and Neck

    11. Leukoplakia= “carcinoma in situ” (? 5% risk of squamous cell carcinoma.) Erythroplakia = Dysplastic leukoplakia Precancerous Lesion A red area, level with the mucosal surface or slightly depressed. Marked epithelial dysplasia Indicative of a high malignant potential (50%). A white patch of oral mucous membrane that Cannot be wiped off Related primarily to tobacco smoking or chewing Biopsy is mandatory

    12. Leukoplakia

    13. Erythroplakia

    14. Squamous Cell Carcinoma Often occur in floor, rarely on lips women; age: 50 -70 years Risk factors are tobacco (smoking and chewing) and alcohol. HPV found in many tumors. Pathogenesis: ulcer with elevated rolled borders , central necrosis Histology: Range from keratinizing well differentiated to anaplastic tumors. Prognosis:5-year survival 90% for carcinoma of lips (good), 20-30% for the floor of the mouth (bad) MCC site of carcinoma of tongue ? ICM -Q

    15. Squamous Cell Carcinoma

    16. Head and Neck

    17. Odontogenic Cysts & Tumors 1) Dentigerous cyst - most often associated with impacted third molar (wisdom) teeth 2)Odontogenic keratocyst - Multiple in nevoid basal cell carcinoma syndrome (Gorlin syndrome) 3) Ameloblastoma -invasive but benign course 4) Odontoma -most common type of odontogenic tumor

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