ppt materi om 1
TRANSCRIPT
-
8/18/2019 PPT MATERI OM 1
1/36
WHITE LESION
-
8/18/2019 PPT MATERI OM 1
2/36
Cheek chewing
Oral candidiasis
Chemical burn
Pseudomemb
Erythem
Denture Sto
ngular C
Median RhGlos
Hyperp
-
8/18/2019 PPT MATERI OM 1
3/36
-
8/18/2019 PPT MATERI OM 1
4/36
HISTOPATHOLOGIC FEATURES• Extensive hyperkeratosis• Clusters of vacuolated cells are present in the surface of Prickle cell layer
TREATMENT• No treatment required• For patient who desire treatment : oral acrylic shield• Several authors have suggested psychoteraphy as treatment of choice
-
8/18/2019 PPT MATERI OM 1
5/36
-
8/18/2019 PPT MATERI OM 1
6/36
CLINICAL FEATURES• Most causatic agents produce similar damage• Short exposures : superficial white, wrinkled appereance• Long exposures : epithelium becomes separated from underlying tissue and can be
descuamated easily -> red, bleeding, yellowish, fibripurulent membrane• Very painful
HISTOPATHOLOGIC FEATURES•
Coagulative necrosis of epithelium with only the outline of the individual epithelialcells and nuclei remaining• Underlying connective tissue contains acute and chronic inflammatory cells
-
8/18/2019 PPT MATERI OM 1
7/36
TREATMENT• The best treatment is prevention : potentially caustic drugs -> instruct the patient
to swallow not allow it to remain in oral cavity• Temporary protections : protective emollient paste or hydroxyprophyl cellulose
film• Temporary pain relief : Topical dyclonine HCL• Large area of necrosis : surgical debridement & antibiotics
-
8/18/2019 PPT MATERI OM 1
8/36
-
8/18/2019 PPT MATERI OM 1
9/36
-
8/18/2019 PPT MATERI OM 1
10/36
-
8/18/2019 PPT MATERI OM 1
11/36
-
8/18/2019 PPT MATERI OM 1
12/36
PATHOGENESIS
C. Albicans, C. Tropicalis, C. Glabrata
Adhere and penetrate to ephitelial surface facilitated by lipases
-
8/18/2019 PPT MATERI OM 1
13/36
LOCAL PREDISPOSING FACTORS
-
8/18/2019 PPT MATERI OM 1
14/36
CLINICAL FEATURES
• Painful elevated plaques that can be wiped off• Leaving eroded• Bleeding surface• Associated with poor hygene, systemic antibiotics, systemic diseases,
debilitations, reduced immune response• Chronic infections may result in erythematous mucosa without obviouswhite colonies
-
8/18/2019 PPT MATERI OM 1
15/36
-
8/18/2019 PPT MATERI OM 1
16/36
SYMPTOMS• Burning sensation• Foul taste
COMMON SITES• Buccal mucosa, Tongue , Palate
ASSOCIATED FACTORS• Antibiotic therapy• Immunosupressio
DD :• Lichen Planus, hairy leukoplakia, leukoplakia, fordyce granules
MANAGEMENT :• Treat any predisposing cause and reduce smoking;• Antifungals such as nystatin oral suspension, pastilles, amphotericin lozenges, miconazole g
or tablets, or fluconazole tablets
-
8/18/2019 PPT MATERI OM 1
17/36
-
8/18/2019 PPT MATERI OM 1
18/36
b. Erythematous Candidiasis• Red patch persistent lesion of candidiasis• Usually asymptomatic and chronic
APPEARANCE & SYMPTOMS• White component is not in a prominent feature• Red macules• Burning sensations• Reddened “bald” appereance of the tongue• Erythematous surface reflects atrophy and increased vascularization
COMMON SITESPosterior hard palate, buccal mucosa , dorsal tongue
ASSOCIATED FACTORSAntibiotic therapy. xerostomia. immunosuppression, idiopathic
-
8/18/2019 PPT MATERI OM 1
19/36
PREDISPOSING FACTORS• Broad spectrum antibiotic therapy• Smoking•
Iron deficiency anemia• Inhalation steroids• HIV
DD• Erythroplakia
MANAGEMENT• Treat any predisposing cause;• Antifungals such as nystatin oral suspension, pastilles, amphotericin lozenges, miconazole
gel, tablets or fluconazole tablets
-
8/18/2019 PPT MATERI OM 1
20/36
-
8/18/2019 PPT MATERI OM 1
21/36
c. Denture Stomatitis• Is a varying degrees of erythema, sometimes accompanied by petechial hemorrage, localiz
to the denture-bearing areas of maxillary removable prothesis• Usually patients admits to use the denture, but periodically to clean it• Can be used by microorganism living beneath the denture of improper design of the dentu
allergy to denture base, or inadequate curing of denture
APPEARANCE & SYMPTOMS• Red• Asymtomatic
COMMON SITESConfined to palatal denture-breading mucosa
ASSOCIATED FACTORSProbably not true infection : Denture often is positive on culture but mucosa not
-
8/18/2019 PPT MATERI OM 1
22/36
DD• Erythematous candidiasis
TREATMENT• CIE : Improve denture hygene, not to use dentusre while sleeping,, store the denture in
antimicrobial solutions• Antifungal treatment
-
8/18/2019 PPT MATERI OM 1
23/36
-
8/18/2019 PPT MATERI OM 1
24/36
-
8/18/2019 PPT MATERI OM 1
25/36
DD• Exfoliative cheilitis• Actinic cheilitis
MANAGEMENTAntifungal cream (usually miconazole) or other antifungal therapy, repair of denture, appsmoisturizing cream, a course of oral iron or vit B supplements may be helpful
-
8/18/2019 PPT MATERI OM 1
26/36
-
8/18/2019 PPT MATERI OM 1
27/36
e. Median Rhomboid GlossitisClinically characterized by an erythematous lesion inthe center of posterior part of thedorsum of the tongue
The area of erythema resulting from atrophy of the filiform papillae and the surface may blobulatedEtiology not fully clarifiedSmokers, denture weares, and patient who use inhalation steroids has an increased risk
CLINICAL FEATURES• erythematous lesion inthe center of posterior part of the dorsum of the tongue or• Depapillated rhomboidal area in the center of the dorsum of tongue anterior to
circumvallate papillae• Flat or nodular, red, or red and white• Lesion -> oval configuration• Asymptomatic
-
8/18/2019 PPT MATERI OM 1
28/36
DD• Geographic tongue
MANAGEMENT• Elimination of predisposing factors• Antifungal therapy• Cyrosurgery
-
8/18/2019 PPT MATERI OM 1
29/36
-
8/18/2019 PPT MATERI OM 1
30/36
f. Hyperplastic Candidiasis
CLINICAL FEATURES• White plaques that are not removable, irregular• Asymtomatic• Histopathologic -> epithelial hiperplasia
COMMON SITES• Anterior buccal mucosa, but also can be found at dorsum of the tongue, palate, labial
commisures
PREDISPOSING FACTORS• Smoking• Nutrition deficiency• Immunodeficiency• Denture-wearers• HIV patient• Chronic iritations
-
8/18/2019 PPT MATERI OM 1
31/36
• Diagnosis must be made by biopsy
DD• Leukoplakia• Candidiasis pseudomembranous• Lichen planus
MANAGEMENT• Elimination of predisposing factors• Consumption of vegetable and fruits• Vitamin A• Antifungal therapy
-
8/18/2019 PPT MATERI OM 1
32/36
-
8/18/2019 PPT MATERI OM 1
33/36
-
8/18/2019 PPT MATERI OM 1
34/36
-
8/18/2019 PPT MATERI OM 1
35/36
recipes
Systemic antifungal
R/ Ketoconazole tab 200mg No. XS 1 dd 1 tab 1 p.c
Topical antifungal
R/ Nystatin oral suspension fl no. IIIS 4 dd 1 ml
Vitamin A
R/ Vitamin A 10000 IU tab no. XXXS 1 dd 1
-
8/18/2019 PPT MATERI OM 1
36/36