Oral Medicine & Pathology from A-Z E-Book

Henning Lehmann Bastian

• Herausgeber: Books on Demand
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 102

Veröffentlichungsjahr: 2015

Beschreibung

"Oral Medicine and Pathology from A-Z" is an important part of the image of the dentist as a medical practitioner. I have attempted to describe the individual disorders briefly following the same concept: definition, aetiology, symptoms, clinical features, diagnosis, treatment and differential diagnoses. In some cases, there is a slight overlap, so a disorder is referred to twice under different names. I have included extensive images that will facilitate the clinician‘s ability to perform rapid diagnostics, but also fulfill some colleagues‘ desire for illustration of the various disorders of the patient. It is my hope that the book‘s form using text and associated images in the same spread will facilitate the use of the book by clinicians and that it will become an indispensable part of the clinic‘s library.

Leseprobe

Foreword

The book is intended as a clinical guide for the practising dentist, but dentistry students, practitioners and ear, nose and throat doctors will also be able to make use of the book as a reference. The book has included in the form of a lexicon only the most common conditions in Oral Medicine and Pathology. If you are interested and would like to go deeper into each topic, you are recommended to visit the major electronic search engines such as PubMed and Grateful Med.

At the back of the book there is a so-called "diagnostic tree" by which on the basis of symptoms and clinical signs it is possible to achieve an approximate diagnosis in the particular case in oral medicine. In addition, there is also a text on electronic search for the benefit of students.

Constructive criticism and suggestions for improvement are welcome. Also interesting clinical profiles. Contact: [email protected].

Copenhagen 1/12–2014

Henning Lehmann Bastian

About the Author

Henning Lehmann Bastian is a trained dentist with further training as a specialist in oral- and maxillofacial surgery. He was for many years head of the Department of oral- and maxillofacial surgery at Odense University and a lecturer at the Aarhus School of Dentistry in the subject Oral Medicine and Pathology. He has for many years been an external examiner in the subject Oral surgery, medicine and pathology at the two dental schools in Denmark. He is the specialist editor of the website www.tandogmund.dk. He also worked as a forensic odontologist in cooperation with the Forensic Medicine Institute, Odense University from 1974–2013.

The author has been a leader in the study of implants in Denmark and in 1998 started up the Danish section of the ITI of which he was Chairman until 2008. Since 2009, he has been a member of the "international expert committee" for Camlog.

He has previously published the books "Teeth leave traces", "Oral Medicine" and the children's books "Tandsylvania" and "Tandsylvania Zoo". In addition, he has written a chapter in the book "Wounds" and in the online version of "General practice" for practitioners. He has also written more than a hundred professional articles, mainly in Danish, but also in foreign, journals.

Content

1. Abrasio dentium

2. Abscessus parodontalis

3. Abscessus periapikalis

4. Acromegalia

5. Actinomycosis cervico-facialis

6. Acute necrotizing gingivitis

7. Adenoma pleomorphicum

8. AIDS and HIV

9. Amalgam tattoo

10. Ambustio

11. Ameloblastoma

12. Amelogenesis imperfecta

13. Amyloidosis

14. Anaemia perniciosa

15. Anaemia sideropenica

16. Aneurysmal bone cyst

17. Aphthous stomatitis

18. Aplasia dentis

19. Arthritis – Rheumatoid arthritis

20. Arthrosis

21. Atrofia processus alveolaris

22. Attrition

23. Bad breath, foetor ex ore, halitosis

24. Behcet's syndrome

25. Bells palsy

26. Benign mucous membrane pemfigoid (Pemfigoidea)

27. Bisphosphonate-associated osteonecrosis of the jaw (BON)

28. Burkitt's tumour

29. Burning Mouth Syndrome

30. Calculus dentalis

31. Cancer Linguae

32. Candidiasis oralis

33. Carcinoma adenocysticum

34. Caries dentium

35. Cementoma

36. Cheilitis angularis

37. Cheilognathopalatoscisis

38. Chondrodystrofia calcificans congenita

39. Chondroma

40. Chondrosarcoma

41. Condyloma acuminatum

42. Cysts, intrabony jaw cysts

43. Cystis dermoides

44. Cystis haemorragica

45. Cystis mucosae oris

46. Cystis nasolabialis

47. Deformatio radicis

48. Dens in dente (dens invaginatus)

49. Dental fluorosis

50. Dentes aggregati

51. Dentes concreti

52. Dentes confusi

53. Dentes decidui persistentes

54. Dentes geminati

55. Dentes supernumerarii

56. Dentinogenesis imperfecta

57. Dentitio difficilis

58. Dentitio tarda

59. Denture-related mucosal disease

a) Ulcus Decubitale

b) Hyperplasia Irritationis

c) Stomatitis prothetica

60. Dermatitis herpetiformis

61. Discoloratio dentis

62. Discoloratio mucosae oris

63. Dysostosis cleidocranialis

64. Dysplasia ectodermalis

65. Dysplasia fibrosa

66. Emphysema subcutaneum iatrogenica

67. Epstein's pearls

68. Epulis fibromatosum

69. Epulis gravidarum

70. Erythema multiforme exudativum

71. Erythroplakia mucosae oris

72. Fibroma

73. Fibromatosis gingivae

74. Fibrosarcoma

75. Fistula

76. Fordyce's spots

77. Frenulum anomale labii superioris

78. Frenulum anomale linguae

79. Gingivitis

80. Gingivitis hyperplastica

81. Gingivitis nekroticans

82. Glossitis rhombica mediana

83. Gorlins syndrome

84. Granuloma pyogenicum

85. Haemangioma

86. Haematoma

87. Hairy tongue

88. Herpes Zoster

89. Herpetic gingivostomatitis, herpes labialis

90. Hyperplasia epitelialis focalis

91. Hyperplasia mucosae oris

92. Hypertrofia musculus masseterica

93. Hypoplasia enameli externa

94. Hypoplasia enameli interna

95. Jaw diseases, odontogenic tumours

96. Keratoacantoma

97. A. Leiomyoma/B. Leiomyosarcoma

98. Leukaemia

99. Leukoedema

100. Leukoplakia mucosae oris

101. Lichen ruber planus oralis

102. Lingua crenata (lingua indentata)

103. Lingua fissurata

104. Lingua geografica

105. Lipoma

106. Lupus erythematosus, discoid

107. Lymphangioma

108. Lymphoma malignant (non-Hodgkin's lymphoma)

109. Melkersson-Rosenthal syndrome

110. Morbus Osler

111. Morsicatio buccarum

112. Mouth cancer (Cancer in cavum oris)

113. Multiple myeloma

114. Myoblastoma granulare

115. Myxoma odontogenica

116. Naevus albus spongiosus: (White sponge naevus)

117. Neurofibromatosis

118. Neutropenia cyclica

119. Ossifying fibroma

120. Osteoma

121. Osteomyelitis

122. Papilloma

123. Pemphigus

124. Perimylolysis

125. Periodontitis (periodontal disease)

126. Quincke's oedema

127. Ranula

128. Sarcoidosis

129. Scleroderma

130. Sequestrum

131. Sialolithiasis

132. Smoker's palate (stomatitis nicotina palati)

133. Steven-Johnson syndrome

134. Stomatitis aphtosa recurrens cicatricicans

135. Stomatitis e radiatione

136. Thrombocytopenia

137. Torus mandibularis

138. Torus palatinus

139. Tumor mucoepidermoides

140. Wegener's granulomatosis

141. Wisdom teeth (pericoronitis)

142. Xerostomia (dry mouth)

143. Other specialties

a) Do it yourself treatment

b) Fellatio

c) Self-mutilation

Electronic literature search

Diagnostic tree from A to D

1. Abrasio dentium

Definition: Wear of enamel/dentin caused otherwise than by tooth contact.

Aetiology: Abrasion has a variable pattern, depending on the cause of the wear. Typically toothbrush damage at the transition between enamel and dentine Fig. 1.1. Abrasion is also seen on the incisal edge e.g. after use of the teeth to hold pins, wire, nails etc.. There is also the well-known abrasion from the mouthpiece in habitual pipe smokers Fig. 1.2. Sustained use of toothpicks may result in atypical approximal wear.

Symptoms: Since abrasion develops over a long time there is seldom dentine hypersensitivity, due to the formation of secondary dentine.

Clinical features: It is easy to recognise the damage by ordinary visual examination. Fig. 1.3.

Diagnosis: The diagnosis is performed clinically

Treatment: The treatment will be the correction of the unfortunate dental care habits and conservative dentistry, possibly reconstruction.

Differential diagnosis: Erosions.

Fig. 1.1.

Fig. 1.2.

Fig. 1.3.

2. Abscessus parodontalis

Definition: An abscess has occurred in an existing periodontal pocket.

Aetiology: The abscess occurs when the degradation of the bone around a tooth has resulted in the formation of a deep periodontal pocket, and the secretion of pus from it is blocked. Through the closure of the pocket pus accumulates and an abscess forms. The condition can also result from changes in the bacterial flora in the pocket, an impaired immune system or a combination of these factors. Most frequently seen in adults. In children, it can be seen in cases of cutting of teeth.

Symptoms: Strong throbbing pain, aggravated by chewing and pressure on the tooth. Causes bad breath. In acute cases there is swelling and tenderness of proximal lymph nodes and fever. The responsible tooth can be easily identified and in addition to the pain the tooth is often loose to a greater or lesser degree.

Clinical features: Gums are erythematous and oedematous with a raised red surface. By probing into the pocket the pus can be expressed. Fig.2.1.

Diagnosis: The diagnosis can be performed clinical, radiological and possibly by swab.

Treatment: The acute treatment includes incision, drainage and antibiotic therapy. The further treatment may take the form of extraction, or parodontal surgical intervention in order to preserve the tooth.

Differential diagnosis: Pyogenic granuloma. Apical abscess. Gingiva cyst.

Fig. 2.1.

3. Abscessus periapikalis

Definition: An abscess has occurred in the root tip of an avital tooth.

Aetiology: Pulp necrosis. The chronic periapical process can develop into a parulis or radicular cyst.

Symptoms: The chronic form is asymptomatic. The acute form is particularly characterized by pain.

Clinical features: Submucosal swelling and possibly fluctuation produces a tooth abscess, parulisFig.3.1. The vast majority of dental abscesses perforate the cheek. In the upper jaw they can also perforate the palate Fig.3.2. In the molars in the lower jaw, in rare cases, the development of a gravity abscess can be seen with the risk of airway obstruction, requiring hospitalisation. The unilateral maxillary sinusitis almost always comes from a tooth root. If a patient develops an abscess at the lower pole of the tonsil it may come from the wisdom tooth on the same side. In rare cases osteomyelitis may develop, Fig.3.3.

Diagnosis: Diagnosis is performed on the clinical, radiological image and possibly swab.

Treatment: The tooth abscess incised and drainage maintained for a few days. There is trepanning of the tooth pulp and a drain is created. Similarly antibiotic therapy is commenced, often 2-drug therapy. Root canal treatment or removal of the tooth.

Fig. 3.1.

Fig. 3.2.

Fig. 3.3.

4. Acromegalia

Definition: Extra growth of the face, hands and feet after epiphyseal closure.

Aetiology: Overproduction of growth hormone, most often due to a pituitary adenoma.

Symptoms: Headache, hypertension, heart disease, hyper- hidrosis, arthritis and peripheral neuropathy. Typically, an enlargement of the head - the patient has to wear a larger hat. The nose, lips, zygomatic arch and eyebrows also grow. Intraorally that is growth of the maxilla and especially mandible with progenism as a result. Spreading of the teeth, often exacerbated by the pressure from the enlarged tongue.

Clinical features: The clinical features will be characterised by the above symptoms. A prognathic mandible and spreading is often an early sign. Fig.4.1 shows a relatively young man who has received implants before the disease began. It is seen how the jaw has grown but the ancylosed implants have not followed Fig.4.2. On the X-ray image in Fig.4.3 implants can be seen to "hang" high in the bone.

Diagnosis: X-ray and blood tests will provide the answer.

Treatment: A curative therapy is the removal of the adenoma or rays. The oral problems can be treated by a orthognate surgical intervention, but it is necessary ensure that the growth is finished.

Fig. 4.1.

Fig. 4.2.

Fig. 4.3.

5. Actinomycosis cervico-facialis

Definition: A chronic granulomatous infection.

Aetiology: The infection is caused by actinomyces israelii. Often you will find accompanying flora with streptococci or staphylococci. Actinomyces is found occasionally in the saliva.

Symptoms: Actinomycose seldom causes pain, but often trismus. It presents itself as a board hard, red or purple swelling on the skin. In the typical case there are multiple fistulas with small yellow sulphur grains and small abscesses.

Clinical features: The infection is seen as a chronic, slowly growing process Fig.5.1. Actinomycose should be considered if the infection with extraoral swelling does not respond within two weeks to conventional treatment with antibiotics and targeted therapy Fig.5.2. The number of cases peaks in May and November.

Diagnosis: Small abscesses and clearance of sulphur granules in the pus from an abscess is diagnostic of Actinomycose. Fig.5.3 shows the yellow sulphur granules in the pus. The diagnosis is performed by anaerobic culture of the material from an abscess or biopsy. Many prefer a fine needle aspirate.

Treatment: Drainage is often disappointing. Metronidazole for 10 days, for example 500 mg. 3 times/day and Penicillin for 4–6 weeks. Targeted therapy.

Differential diagnosis: Classic absces.

Fig. 5.1.

Fig. 5.2.

Fig. 5.3.

6. Acute necrotizing gingivitis

Definition: Specific gingival infectious disease in younger people.

Aetiology: