Pathological Basis of Oral and Maxillofacial Diseases E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1422

Veröffentlichungsjahr: 2024

Beschreibung

A comprehensive guide for integrating pathology into a clinical setting.

Pathological Basis of Oral and Maxillofacial Diseases presents the basic principles involved in disease mechanisms in an easy-to-understand way. By integrating recent advances in molecular, immunologic, and genetic understanding of oral disease, the book helps readers enhance their knowledge and its application in a clinical setting.

This book is divided into nine sections, covering key topics such as inflammation, genetic diseases, and neoplasia, with contributions from over 50 international authors. Diagrams, clinical, radiographic, and histopathology images and tables supplement the text, and the editors have ensured a consistent approach throughout.

Topics covered in Pathological Basis of Oral and Maxillofacial Diseases include:

• The influences of nutrition and the environment
• Cellular structure and function, causes and mechanisms of cellular pathology.
• Immunity and host defence mechanisms, immune dysfunctions affecting the oro-facial complex.
• Inflammation and inflammatory diseases of the oro-facial complex
• Human microbiome, with reference to dysbiosis in dental caries and periodontal diseases
• Oral manifestations of systemic diseases and the oral-systemic link and its impact on general and oral health
• Oral potentially malignant and malignant disorders that are a major threat to global public health.

Bridging the gap in dental training programs from basic medical science in the initial years to clinical practice, Pathological Basis of Oral and Maxillofacial Diseases is an essential reference for dental students, trainees and practitioners seeking to grasp the pathological basis of disease and apply that knowledge to the oral and maxillofacial regions.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

Dedication Page

About the Editor

List of Contributors

Foreword

Preface

Section 1: Pathology as the Foundation of Medicine

1 Introduction to Pathology

1.1 Introduction

1.2 History of Pathology

1.3 Study of Pathology

1.4 Specialities and Subspecialties of Pathology

1.5 Laboratory Medicine (Clinical Pathology)

1.6 Molecular Pathology

1.7 Genetic Pathology

1.8 Oral and Maxillofacial Pathology

1.9 Forensic Pathology

1.10 Digital Pathology

1.11 Summary

References

2 Global Scenario, Aetiology and Risk Factors Associated with Oral and Maxillofacial Diseases: An Overview

2.1 Introduction

2.2 Global Prevalence and Aetiology of Common Oral Diseases

2.3 Oral Potentially Malignant Disorders

2.4 Risk Factors for Oral Diseases

2.5 Global Trends in the Prevalence of Oral Diseases Over the Past Three Decades

2.6 Trends of Oral Diseases in Developing and Developed Countries

2.7 Summary

References

3 The Role of Laboratory Diagnosis in Oral and Maxillofacial Pathology: An Overview

3.1 Introduction

3.2 The Need for a Diagnosis

3.3 Summary of Pathology Common to Oral and Maxillofacial Region

3.4 Clinicopathological Correlation

3.5 Macroscopic Assessment

3.6 Photographs and Radiographs

3.7 Microscopic Assessment

3.8 Molecular Testing and Cytogenetics

3.9 Conveying Diagnoses and Uncertainty: The Limitations of a Diagnosis

3.10 Summary

References

Section 2: Homeostasis and Cellular Pathology

4 Homeostasis and Influences of Environment and Nutrition

4.1 Introduction

4.2 Homeostasis at the Cellular, Tissue and Organ Level

4.3 Regulation and Mechanisms of Homeostasis

4.4 Role of Nervous and Endocrine Systems in Homeostasis

4.5 Homeostasis and Ageing

4.6 Environment and Homeostasis

4.7 Nutrition and Homeostasis

4.8 Oral Homeostasis

4.9 Summary

References

5 Cellular Structure and Function

5.1 Introduction

5.2 Cell Structure and Function

5.3 Intercellular Junctions

5.4 Cell Communication and Signalling Pathways

5.5 Interactions with the Extracellular Matrix

5.6 The Cell Cycle

5.7 Control and Regulation of the Cell Cycle

5.8 Stem Cells and Differentiation

5.9 Summary

References

6 Cell Injury: Causes, Mechanisms and Responses

6.1 Introduction

6.2 Causes of Cell Injury

6.3 Mechanisms of Cell Injury

6.4 Responses to Cell Injury

6.5 Cell Death

6.6 Cellular Adaptations

6.7 Cellular Degenerations

6.8 Pathologic Calcification

6.9 Summary

References

7 The Structure and Function of the Oral Mucosa

7.1 Introduction

7.2 Classification

7.3 Oral Epithelium: General Features

7.4 Stratified Squamous Epithelium

7.5 Other Structural Features of Significance

7.6 Non‐keratinocytes in the Oral Epithelium

7.7 Self‐renewal and Turnover Time of Epithelia

7.8 The Epithelial and Connective Tissue Junction

7.9 Connective Tissue: Lamina Propria and Submucosa

7.10 Blood Supply of Oral Mucosa

7.11 Sensory Nerves and Receptors

7.12 Structural Variations in Oral Mucosa

7.13 Age Changes in the Oral Mucosa

7.14 Functions of Oral Mucosa

7.15 Summary

References

8 Cellular Mechanisms of Ageing of Oral Tissues

8.1 Introduction

8.2 Hallmarks of Ageing

8.3 Cellular, Molecular and Physiological Mechanisms of Age‐related Changes in Teeth and Periodontal Tissues

8.4 Cellular, Molecular and Physiological Mechanisms of Age‐related Changes in Oral Mucosal Tissues and Salivary Glands

8.5 Microbiological Changes of the Ageing Oral Mucosa

8.6 Age‐related Changes of Innate Antimicrobial Factors at Oral Mucosa

8.7 Cellular, Molecular and Physiological Changes in the Craniofacial Muscles During Ageing

8.8 Cellular, Molecular and Physiological Changes in the Craniofacial Bones During Ageing

8.9 The Crosslink Between Ageing and Systemic Diseases and Conditions in Oral Mucosal Tissues

8.10 The Impact of Ageing on Oral Health

8.11 Conclusion and Summary

References

9 Endocrine and Metabolic Dysfunction and Oro‐Facial Diseases

9.1 Introduction

9.2 An Overview of the Endocrine System

9.3 Pituitary Functions in Health

9.4 Pituitary Dysfunction and Its Oro‐facial Manifestations

9.5 Thyroid Functions in Health

9.6 Thyroid Dysfunction and Its Oro‐facial Manifestations

9.7 Parathyroid Functions in Health

9.8 Parathyroid Dysfunction and Its Oro‐facial Manifestations

9.9 Adrenal Functions in Health

9.10 Adrenal Dysfunction and Its Oro‐facial Manifestations

9.11 Carbohydrate Metabolism in Health

9.12 Carbohydrate Metabolism Disorders and Their Oro‐facial Manifestations

9.13 Mucopolysaccharidosis

9.14 Protein Metabolism in Health

9.15 Protein Metabolism Disorders and Their Oro‐facial Manifestations

9.16 Lipid Metabolism in Health

9.17 Lipid Metabolism Disorders and Their Oro‐facial Manifestations

9.18 Disorders of Micronutrients and Their Oro‐facial Manifestations

9.19 Vitamins

9.20 Inborn Errors of Metabolism and Their Oro‐facial Manifestations

9.21 Hypophosphatasia

9.22 Summary

References

Section 3: Defence Mechanisms Against Disease

10 Immunity and Host Defence Mechanisms in Oral Health and Disease

10.1 Immunity and Host Defence Mechanisms in the Oral Cavity

10.2 Hypersensitivity

10.3 Summary

Abbreviations

References

11 Immune Dysfunctions Affecting the Oro‐Facial Complex

11.1 Introduction

11.2 Hypersensitivity Disorders

11.3 Immunodeficiency Disorders

11.4 Autoimmune Erosive and Vesiculobullous Disorders

11.5 Summary

References

12 Pathology of Inflammation and Inflammatory Diseases of the Oro‐Facial Complex: An Overview

12.1 Introduction

12.2 Aetiology

12.3 Cellular Responses in Inflammation

12.4 Cell‐derived Inflammatory Mediators in Inflammation

12.5 Plasma‐derived Inflammatory Mediators in Inflammation

12.6 Pro‐inflammatory Cytokines

12.7 Cardinal Signs of Inflammation

12.8 Classification of Inflammation

12.9 Morphologic Patterns of Inflammation

12.10 Clinical Considerations: Organ‐specific Inflammatory Responses

12.11 Inflammatory Lesions of the Oro‐facial Complex

12.12 Summary

References

13 Cellular and Molecular Mechanisms of Healing of Cutaneous and Oral Mucosal Wounds

13.1 Introduction

13.2 Tissue Architecture and Microenvironment in Skin and Oral Mucosa

13.3 Wound Healing in Skin and Oral Mucosa

13.4 Summary

References

14 Healing of the Dental Pulp and Periodontal Tissues, Extraction Socket and Bone Fracture

14.1 Introduction

14.2 Healing of Dental Pulp

14.3 Healing of Periodontal Tissue

14.4 Healing of Extraction Socket

14.5 Healing of Bone Fractures

14.6 Summary

References

Section 4: Clinical Genetics and Developmental Pathology

15 The Human Genome and Inheritance: Key Concepts

15.1 Introduction

15.2 The Human Genome

15.3 The Basics of Inheritance

15.4 Milestones of Genome Studies

15.5 Diagnostic and Research Tools in Genetics

15.6 Summary

References

16 Heritable Diseases with Examples Involving the Oro‐Facial Complex

16.1 Introduction

16.2 Heritable Diseases Affecting the Dentition

16.3 Heritable Diseases Affecting the Oro‐Facial Soft Tissue

16.4 Heritable Diseases Affecting the Oro‐Facial Hard Tissue

16.5 Summary

Acknowledgement

References

17 Non‐heritable Developmental Disorders with Examples Involving the Oral‐Maxillofacial Complex

17.1 Introduction

17.2 Acquired Non‐heritable Developmental Pathologies of the OMF

17.3 Congenital Non‐acquired Non‐exogenous/Environmental Developmental Defects of the OMF

17.4 Summary

References

Section 5: Infectious and Systemic Diseases

18 Human Microbiome in Health and Disease with Reference to Dysbiosis in Dental Caries and Periodontal Diseases

18.1 Introduction to Human Microbiome

18.2 Understanding the Terminology Used in Microbiome Research

18.3 Oral Microbiome Associated with Dental Caries

18.4 Future Directions in Oral Microbiome Research and Clinical Implications

References

19 Pathology of Infection and Infectious Diseases of the Oro‐Facial Complex

19.1 Introduction

19.2 Mechanisms of Tissue Injury Caused by Microorganisms: An Overview

19.3 Summary

References

20 Oral‐systemic Link and Its Impact on General and Oral Health

20.1 Introduction

20.2 Infective Endocarditis

20.3 Periodontitis and Systemic Disease

20.4 Periodontitis and Its Relationship with Systemic Diseases

20.5 Summary

References

21 Orofacial Manifestations of Systemic Diseases: An Overview

21.1 Introduction: Historical Background

21.2 Skin Disease

21.3 Gastrointestinal Disease

21.4 Salivary Gland Disease

21.5 Oral Mucosal Ulceration from Mineral or Vitamin Deficiency

21.6 Infective Disease

21.7 Haematological Disease

21.8 Endocrine Disease

21.9 Neurological Disease

21.10 Bone Disease

21.11 Connective Tissue Disease

21.12 Liver Disease

21.13 Renal Disease

21.14 Pulmonary Disease

21.15 Cardiovascular Disease

21.16 Summary

References

22 Adverse Drug Reactions in the Orofacial Complex

22.1 Introduction

22.2 Salivary Gland Involvement

22.3 Oral Soft Tissue Involvement

22.4 Hard Tissue Involvement

22.5 Non‐specific Reactions

22.6 Summary

References

Section 6: Disorders of Cell and Tissue Growth

23 Neoplasia: Basic Concepts

23.1 Introduction

23.2 Nomenclature

23.3 Benign Tumours

23.4 Malignant Tumours

23.5 Features of Benign and Malignant Neoplasms

23.6 Summary

References

24 Molecular Basis of Cancer

24.1 Introduction

24.2 Hallmarks of Cancer

24.3 Sustaining Proliferative Signalling

24.4 Evading Growth Suppressors

24.5 Resisting Cell Death

24.6 Enabling Replicative Immortality

24.7 Inducing/Accessing Vasculature

24.8 Activating Invasion and Metastasis

24.9 Reprogramming Cellular Metabolism

24.10 Avoiding Immune Destruction

24.11 Genomic Instability

24.12 Tumour‐Promoting Inflammation

24.13 Emerging Hallmarks and Enabling Characteristics

24.14 Emerging Enabling Characteristics

24.15 Summary

References

25 Host Defences Against Cancer

25.1 Introduction

25.2 Cancer Immunosurveillance and Immunoediting

25.3 Tumour Antigens

25.4 Cellular Immunity

25.5 Humoral Immunity

25.6 Conclusions

Acknowledgements

References

26 WHO Classification of Tumours: An Overview

26.1 Introduction

26.2 Developmental Tumours

26.3 Reactive Inflammatory and Infective Tumours

26.4 Tumours with Immune‐mediated Pathogenesis

26.5 Neoplastic Tumours

26.6 Tumours with Metabolic and Hormonal Pathogenesis

26.7 Summary

References

27 Dysplasia, Precancer and Oral Potentially Malignant Disorders

27.1 Introduction

27.2 Oral Epithelial Dysplasia: Definition, Aetiology, Clinical Presentation and Natural History

27.3 Histopathology

27.4 Cytological Features

27.5 The Spectrum of Dysplasia and Dysplasia Patterns

27.6 Grading of Oral Epithelial Dysplasia

27.7 Imitates of Oral Epithelial Dysplasia

27.8 Biomarkers

27.9 The Role of MicroRNAs

27.10 Hypoxia in Oral Potentially Malignant Disorders

27.11 Aneuploidy and Loss of Heterozygosity

27.12 Microbiological Influences and Associations

27.13 Dysbiosis

27.14 Genetic Disease and Immunosuppression

27.15 Role of Nutrition

27.16 Prediction of Malignant Transformation

27.17 Summary

References

Section 7: Neoplastic Diseases of the Oral Mucosa and Salivary Glands

28 Global Burden, Risk factors and Pathobiology of Malignant Neoplasms of the Oral Mucosa and the Oropharynx

28.1 Introduction

28.2 Epidemiology

28.3 Risk Factors for Cancers of the Oral Mucosa

28.4 Risk Factors for Cancers of the Oropharynx

28.5 Pathogenesis of HPV‐associated Cancers

28.6 Pathogenesis of HPV‐independent Oral and Oropharyngeal Cancers

28.7 Summary

References

29 Presentation, Diagnosis and Prognosis of Squamous Cell Carcinomas of the Oral Mucosa and Oropharynx

29.1 Introduction

References

30 Global Burden, Classification, Pathobiology, Genetics and Prognosis of Salivary Gland Neoplasms

30.1 Introduction

30.2 Epidemiology

30.3 Risk Factors for Salivary Gland Neoplasms

30.4 Pathogenesis of Salivary Gland Neoplasms

30.5 Diagnostic Challenges

30.6 Histologic Grading of Malignant Salivary Gland Tumours

30.7 Histologic and Clinical Prognostic Indicators of Malignant Salivary Gland Tumours

30.8 Immunohistochemical Markers of Diagnosis and Prognosis

30.9 Molecular Markers for Diagnosis and Prognosis

30.10 Cytopathology

30.11 Treatment Modalities

30.12 Summary and Conclusions

References

Section 8: Diseases of the Oral and Maxillofacial Skeleton

31 Classification and Pathogenesis of Odontogenic and Non‐odontogenic Jaw Cysts

31.1 Introduction

31.2 Classification of Odontogenic Cysts

31.3 Classification of Non‐odontogenic Jaw Cysts

31.4 Frequency and Epidemiology of Jaw Cysts

31.5 Pathogenesis of Cysts

31.6 An Overview of the Diagnostic Process

31.7 Summary

References

32 Global Burden, Pathobiology, Genetics and Behaviour of Odontogenic Neoplasms

32.1 Introduction

32.2 Odontogenic Tissues in Health and Disease

32.3 Pathogenesis of Odontogenic Tumours

32.4 Classification of Odontogenic Neoplasms

32.5 Global Burden of Odontogenic Tumours

32.6 Treatment and Behaviour of Odontogenic Neoplasms

32.7 Summary

References

33 Pathogenesis and Behaviour of Fibro‐osseous and Giant‐Cell Lesions of the Jaw Bones

33.1 Fibro‐osseous Lesions of Jaw Bones

33.2 Giant Cell Lesions of Jaw Bones

33.3 Summary

References

Section 9: Pain Disorders

34 Pathophysiology of Orofacial Pain

34.1 Introduction

34.2 General Features of Pain and Characteristics of Orofacial Pain

34.3 Neuroanatomy and Neurophysiology

34.4 Mechanisms Underlying Acute and Chronic Orofacial Pain

34.5 Genetic and Environmental Factors

34.6 Conclusion/Summary

References

35 Genetics, Lifestyle and Psychosocial Considerations in Orofacial Pain

35.1 Introduction

35.2 Genetic Considerations

35.3 Lifestyle Considerations

35.4 Psychosocial Considerations

35.5 Summary

References

Index

End User License Agreement

List of Tables

Chapter 3

Table 3.1 Some of the commonly used special stains and their uses.

Table 3.2 Examples of IHC used for tumour differentiation determination.

Chapter 6

Table 6.1 Morphological findings in reversible and irreversible cell injury...

Chapter 7

Table 7.1 Types of oral mucosa (1, 2).

Table 7.2 Turnover time of epithelia of different regions.

Table 7.3 The three zones of basal lamina (1).

Table 7.4 Blood supply to the oral mucosa.

Table 7.5 Nerve supply of the oral mucosa.

Chapter 9

Table 9.1 Craniofacial manifestations of hypo and hyperpituitarism.

Table 9.2 Craniofacial manifestations of hypo and hyperthyroidism.

Table 9.3 Craniofacial manifestations of hypo and hyperparathyroidism.

Chapter 12

Table 12.1 Describes the characteristics and location of cells involved in ...

Table 12.2 Inflammatory lesions of the oro‐facial complex.

Chapter 16

Table 16.1 Classification of heritable diseases affecting the oro‐facial co...

Table 16.2 Diagnostic criteria for NF‐1 according to NIH consensus developm...

Table 16.3 Diagnostic criteria for NBCCS adapted from the first internation...

Chapter 17

Table 17.1 Developmental defects and cysts in the oral‐maxillofacial (OMF) ...

Chapter 18

Table 18.1 Terminologies used in microbiome research.

Chapter 20

Table 20.1 Predisposing risk factors for endocarditis.

Chapter 22

Table 22.1 Classification of adverse drug reactions.

Table 22.2 Drug commonly associated with oral dryness.

Table 22.3 Drugs associated with sialorrhoea.

Table 22.4 Drugs associated with oral lichenoid reactions.

Table 22.5 Drug implicated in EM, SJS and TEN.

Table 22.6 Drugs commonly associated with pemphigus.

Table 22.7 Drugs associated with pemphigoid.

Table 22.8 Drugs associated with lupus‐like reactions.

Table 22.9 Drugs associated with fixed drug eruption.

Table 22.10 Drugs associated with angioedema.

Table 22.11 Drugs associated with oral mucosa pigmentation.

Table 22.12 Drugs commonly associated with gingival enlargement.

Table 22.13 Drugs commonly associated with MRONJ.

Table 22.14 Drugs implicated in taste disorders.

Table 22.15 Drugs commonly associated with halitosis.

Table 22.16 Drugs associated with orofacial pain.

Table 22.17 Drugs implicated in movement disorders.

Chapter 24

Table 24.1 Proto‐oncogenes with a role in the regulation of cell growth sig...

Table 24.2 Tumour suppressor genes and their associated function.

Table 24.3 Examples of known angiogenic factors.

Chapter 25

Table 25.1 Overview of some cancer antigens related to head and neck cancer...

Chapter 28

Table 28.1 A table listing the risk factors for OSCC.

Chapter 29

Table 29.1 Presenting clinical signs and symptoms of OPSCC according to HPV...

Chapter 30

Table 30.1 Immunohistochemistry markers used in the diagnosis of salivary g...

Table 30.2 The molecular landscape of salivary gland neoplasms.

Table 30.3 The main findings in the cytopathology analysis of salivary glan...

Chapter 31

Table 31.1 Estimates of the relative frequencies of odontogenic cysts and a...

Table 31.2 Sources of the epithelial lining of the odontogenic and non‐odon...

Table 31.3 Age, gender and localisation preferences of odontogenic and non‐...

Table 31.4 Characteristic radiological and histological features that assis...

Chapter 32

Table 32.1 Age, gender and localisation preferences of odontogenic tumours....

Table 32.2 The most common radiological, histological features and molecula...

Chapter 34

Table 34.1 Hallmarks of chronic orofacial pain.

Chapter 35

Table 35.1 Nutrition for chronic orofacial pain conditions.

Table 35.2 Sleep hygiene strategies.

Table 35.3 Social support services in Australia – web‐based resources and p...

Table 35.4 The diagnostic criteria for temporomandibular disorders Axis II ...

List of Illustrations

Chapter 1

Figure 1.1 Ameloblastoma of the mandible. Gross pathology of a surgical spec...

Figure 1.2 Cytological smear showing individual cells.

Chapter 2

Figure 2.1 Incidence of all cancers of the lip and oral cavity in 2020 (GLOB...

Figure 2.2 Mortality rates due to all cancers of the lip and oral cavity in ...

Figure 2.3 Age‐standardised prevalence of periodontal disease from 1990 to 2...

Figure 2.4 Age‐standardised prevalence of tooth loss from 1990 to 2019 accor...

Chapter 3

Figure 3.1 Left hemiglossectomy; (a) Superficial view, (b) Deep view. The su...

Figure 3.2 Right partial maxillectomy; (a) inferior view, (b) superior view....

Figure 3.3 Orientated en‐bloc left neck dissection. As part of patient treat...

Figure 3.4 Examples of special stains used in oral pathology. (a) PASD stain...

Figure 3.5 (a) An example of the intercellular IgG pattern (chicken wire pat...

Figure 3.6 Examples of how IHC is used in diagnostic practice. (a) An H&E st...

Chapter 4

Figure 4.1 Positive feedback loop. Normal childbirth is driven by a positive...

Chapter 5

Figure 5.1 Cell structures and organelles (created in BioRender).

Figure 5.2 Types of cell junctions.

Figure 5.3 Cell cycle (created in BioRender).

Chapter 6

Figure 6.1 Types of hypersensitivity responses.

Figure 6.2 Normal cell and the changes in reversible and irreversible cell i...

Chapter 7

Figure 7.1 Main tissue components of the oral mucosa.

Figure 7.2 Main types of maturation in human oral epithelium. (a) Ortho‐kera...

Figure 7.3 Principal structural features of epithelial cells in successive l...

Figure 7.4 Tonofilaments and tonofibrils.

Figure 7.5 Lamina propria. The historical section of palatal mucosa showing ...

Chapter 8

Figure 8.1 New hallmarks of ageing.

Chapter 9

Figure 9.1 (a) The facial appearance of a child with an accumulation of oede...

Figure 9.2 Exophthalmos secondary to hyperthyroidism.

Figure 9.3 Brown tumour in hyperparathyroidism presenting as an intraoral sw...

Figure 9.4 (a–c) Occlusal radiograph demonstrating expansion of the lingual ...

Figure 9.5 (a, b). Hyperpigmented macules of the lower lip mucosa and left b...

Figure 9.6 Cushingoid facies secondary to hypercortisolism.

Figure 9.7 Hyposalivation and atrophic glossitis in a patient with type 2 DM...

Chapter 10

Figure 10.1 (a) Gingiva with periodontal health; (b) periodontal microbiome ...

Figure 10.2 (a) Oral pemphigus vulgaris with buccal and palatal ulcerations,...

Figure 10.3 (a and b) Sjögren's syndrome: severe dental and periodontal path...

Figure 10.4 (a) Patient with oral lichen planus showing linear white papular...

Chapter 11

Figure 11.1 Lesions of systemic lupus erythematosus presenting on the right ...

Figure 11.2 Lesions of systemic lupus erythematosus presenting on the left ...

Figure 11.3 Lesions of systemic lupus erythematosus presenting on the palate ...

Figure 11.4 Lesions of systemic lupus erythematosus presenting on the right ...

Figure 11.5 A lesion of contact lichenoid metal reaction with ulceration ove...

Figure 11.6 Histopathology of a lichenoid contact metal reaction shows basal...

Figure 11.7 Histopathology of a lichenoid contact metal reaction also shows ...

Figure 11.8 A linear fissure of the oral mucosa in a patient with Crohn’s di...

Figure 11.9 Histopathology of the linear fissure of Crohn’s disease demonstrating ...

Figure 11.10 Histopathology of the linear fissure of Crohn’s disease demonstrating ...

Figure 11.11 Histopathology of the terminal ileum in Crohn’s disease demonst...

Figure 11.12 Right buccal mucosa with inflammation and abscess associated wi...

Figure 11.13 Histopathology of the embedded suture material with surrounding...

Figure 11.14 Acantholysis and intraepithelial clefting in pemphigus vulgaris...

Figure 11.15 Acantholytic Tzanck cells in pemphigus vulgaris.

Figure 11.16 Direct immunofluorescence demonstrating IgG at cell membrane of...

Figure 11.17 Direct immunofluorescence demonstrating C3 at cell membrane of ...

Figure 11.18 Early lesions of desquamative gingivitis in a patient with muco...

Figure 11.19 Symblepharon formation in a patient with ocular mucous membrane...

Figure 11.20 Biopsy of perilesional tissue shows a subepithelial clefting pr...

Figure 11.21 The subepithelial clefting process results in separation of the...

Figure 11.22 Direct immunofluorescence shows a linear patern of reactivity o...

Figure 11.23 Direct immunofluorescence shows basement membrane deposits of c...

Figure 11.24 Annular lesions of lichen planus on the buccal mucosa.

Figure 11.25 Erosive lichen planus on the gingiva.

Figure 11.26 Lesions of erosive lichen planus on the palatal gingiva. Note t...

Figure 11.27 Lesions of lichen planus may show hyperkeratosis with variable ...

Figure 11.28 Basal cell degeneration gives the epithelial rete ridges a sawt...

Figure 11.29 Eosinophilic colloid/Civatte bodies are seen in the basal epith...

Figure 11.30 Direct immunofluorescence shows shaggy deposits of fibrinogen a...

Figure 11.31 Histopathology of a case of lichen planus pemphigoides showing ...

Figure 11.32 Frozen section stained with haemotoxylin and eosin stains shows ...

Figure 11.33 This frozen section stained with haemotoxylin and eosin is anot...

Figure 11.34 Direct immunofluorescence study shows linear deposit of IgG at ...

Figure 11.35 Direct immunofluorescence study shows linear deposits of C3 at ...

Figure 11.36 Direct immunofluorescence study shows shaggy deposits of fibrin...

Figure 11.37 Right buccal mucosa shows erosive and ulcerated lesion of chron...

Figure 11.38 Direct immunofluorescence study shows deposits of IgG in the nu...

Chapter 12

Figure 12.1 Acute inflammation showing polymorphonuclear cell infiltrate and...

Figure 12.2 Subacute inflammatory response in granulation tissue showing mix...

Figure 12.3 Chronic inflammation shows mixed lymphocytic and plasma cell inf...

Figure 12.4 Foreign‐body granuloma. Distinct foreign‐body material is seen w...

Chapter 13

Figure 13.1 Graphical illustration of skin (left) and oral mucosa (right) ti...

Figure 13.2 Graphical illustration of wound healing in phases: haemostasis, ...

Chapter 14

Figure 14.1 Pulpal wound healing: The function of the necrotic layer.

Figure 14.2 Role of pulp vasculature in pulpal inflammation.

Figure 14.3 Involvement of nerves in controlling pulp inflammation.

Figure 14.4 Pulp healing by dental procedures.

Figure 14.5 Stages of extraction socket healing.

Chapter 15

Figure 15.1 DNA replication, transcription and translation.

Figure 15.2 DNA packaging.

Figure 15.3 Genetic variations.

Figure 15.4 Euchromatin and heterochromatin structure.

Figure 15.5 Histone modifications.

Figure 15.6 Genetic disorders' classification.

Figure 15.7 Single gene inheritance models.

Figure 15.8 Non‐classical inheritance models.

Figure 15.9 Diagnostic and research techniques in genetic testing.

Chapter 16

Figure 16.1 Clinical appearance of amelogenesis imperfecta showing chalky fe...

Figure 16.2 Panoramic radiograph of a patient with amelogenesis imperfecta s...

Figure 16.3 Panoramic radiograph showing dentinogenesis imperfecta. Note the...

Figure 16.4 Panoramic radiograph showing dentine dysplasia with bulbous crow...

Figure 16.5 A patient with dentinogenesis imperfecta affecting the secondary...

Figure 16.6 Panoramic radiograph of a 17‐year‐old female with ectodermal dys...

Figure 16.7 Young female patient known with cleidocranial dysplasia displayi...

Figure 16.8 Panoramic radiograph of a male patient with CCD showing multiple...

Figure 16.9 A patient with hereditary gingival fibromatosis.

Figure 16.10 Patient with neurofibromatosis involving the right peri‐orbital...

Figure 16.11 Panoramic radiograph of another patient showing neurofibroma in...

Figure 16.12 Basal cell carcinoma on the patient's trunk with NBCCS.

Figure 16.13 Panoramic radiograph showing multiple radiolucencies of the OKC...

Figure 16.14 Cropped chest radiograph showing bifid rib (arrow) in patient w...

Figure 16.15 Panoramic radiograph of a young patient with cherubism showing ...

Figure 16.16 Axial and 3D cone beam computed tomography of the same patient ...

Figure 16.17 Panoramic radiograph of a patient with osteopetrosis showing in...

Figure 16.18 Panoramic radiograph of a patient with Gardner syndrome display...

Figure 16.19 Four‐year‐old female with Apert syndrome showing brachycephaly,...

Figure 16.20 The same patient in Figure 16.19 with symmetric syndactyly of t...

Figure 16.21 3D computed tomography of the same patient in figure showing ea...

Figure 16.22 Patient with Treacher Collins syndrome displaying malar hypopla...

Chapter 17

Figure 17.1 (a–l) Lingual choristomas. (a) large dilated cystic space lined ...

Chapter 19

Figure 19.1 Acute inflammation. H&E‐stained image showing a dense infiltrate...

Figure 19.2 Chronic inflammation. H&E‐stained image showing a dense infiltra...

Figure 19.3 Granulomatous inflammation. H&E‐stained image showing granulomas...

Figure 19.4 Granulomatous inflammation. H&E‐stained image showing granulomas...

Figure 19.5 Ludwig's Angina. Clinical appearance with bilateral involvement ...

Figure 19.6 H&E image exhibiting filamentous organisms, dead bone and infilt...

Figure 19.7 Clinical photograph showing periodontal abscess in relation to #...

Figure 19.8 Clinical photograph showing punched‐out interdental papillae.

Figure 19.9 Primary herpetic gingivostomatitis presenting as erythema and pa...

Figure 19.10 Secondary herpes presenting as grouped ulceration on the palate...

Figure 19.11 Herpes labialis presenting as grouped vesicles on the left lip....

Figure 19.12 Herpes labialis presenting as a bulla and swelling on the left ...

Figure 19.13 Shingles presenting as unilateral painful ulceration on the pal...

Figure 19.14 Herpangina. Shallow ulcers on the soft palate in a patient with...

Figure 19.15 (a) Hand foot and mouth disease. Rash on the hand and feet of a...

Figure 19.16 Papilloma in the right hard palate.

Figure 19.17 Papilloma in the lateral tongue.

Figure 19.18 Condyloma in the floor of the mouth in an immunocompromised adu...

Figure 19.19 Pseudomembranous candidiasis presenting as wipeable white plaqu...

Figure 19.20 Erythematous candidiasis in a denture wearer.

Figure 19.21 Angular cheilitis showing as an erythematous area at the commis...

Figure 19.22 Central papillary atrophy is noted as the erythematous area on ...

Chapter 20

Figure 20.1 Pathophysiology of IE: (a) A healthy endocardium is lined with e...

Figure 20.2 Periodontitis is characterised by the formation of a dysbiotic d...

Figure 20.3 Mechanisms by which periodontitis can cause systemic disease: (1...

Figure 20.4 Trained immunity in bone marrow stem and progenitor cells: perio...

Figure 20.5 Cellular and molecular mechanisms by which periodontitis may acc...

Chapter 22

Figure 22.1 Model of parasympathetic and sympathetic innervation of the adul...

Chapter 23

Figure 23.1 Photomicrograph of pleomorphic adenoma of minor salivary gland. ...

Figure 23.2 Atypical mitoses. Note the significant variations in cell and nu...

Chapter 24

Figure 24.1 Hallmarks of cancer.

Figure 24.2 Key steps of metastasis.

Chapter 25

Figure 25.1 Cancer immunoediting involves three key phases. Elimination corr...

Chapter 27

Figure 27.1 Clinical presentations of oral potentially malignant disorders. ...

Figure 27.2 Photomicrographs of oral epithelial dysplasia. (a) Mild dysplasi...

Figure 27.3 Photomicrograph of mild dysplasia showing dysmature basaloid cel...

Figure 27.4 Photomicrograph of moderate dysplasia showing remarkable loss of...

Figure 27.5 Photomicrograph of severe dysplasia showing remarkable nuclear p...

Figure 27.6 World Health Organisation classification system of Oral Epitheli...

Figure 27.7 The binary classification system of oral epithelial dysplasia wa...

Chapter 28

Figure 28.1 A heat map of global incidence and mortality rates for OSCC. Top...

Figure 28.2 A heat map of global incidence and mortality rates for OPSCC. To...

Chapter 29

Figure 29.1 Histomorphology of OPSCC. Typical appearance of HPV

−

ve OPS...

Figure 29.2 HPV+veOPSCC. Whole mount view of coronal slice of HPV+veOPSCC ((...

Figure 29.3 HPV testing. Strong and diffuse p16 IHC is considered a positive...

Figure 29.4 HPV testing algorithm. All OPSCCs should undergo a first‐tier te...

Figure 29.5 Mechanisms of radiosensitivity in HPV+veOPSCC. Potential mechani...

Chapter 30

Figure 30.1 Anatomy and histology of the major components of the salivary gl...

Figure 30.2 Clinical and histopathological aspects of pleomorphic adenoma. (...

Figure 30.3 Clinical, histopathological and cytological aspects of Warthin t...

Figure 30.4 Clinical, histopathological and histochemical aspects of mucoepi...

Figure 30.5 Clinical, histopathological and cytological aspects of adenoid c...

Figure 30.6 Clinical, histopathological and immunohistochemical aspects of p...

Figure 30.7 Risk factors for salivary gland neoplasm development.

Figure 30.8 Theories of pathogenesis of salivary gland neoplasms.

Figure 30.9 Classification of salivary gland neoplasms.

Figure 30.10 Native histopathological stratification of salivary gland malig...

Chapter 31

Figure 31.1 A schematic depiction of a radicular cyst. Originating from the ...

Figure 31.2 A demonstrative illustration of the epithelial sources involved ...

Figure 31.3 Gross and histopathological samples of odontogenic cysts. (a,b) ...

Figure 31.4 Cropped panoramic X‐rays show different cyst features important ...

Chapter 32

Figure 32.1 Tooth development and ameloblastoma share morphology and molecul...

Figure 32.2 Main molecular pathways activated in ameloblastoma: MAPK, Hedgeh...

Figure 32.3 Four different odontogenic tumour images from cropped panoramic ...

Figure 32.4 Histopathological images of four different odontogenic tumours. ...

Chapter 33

Figure 33.1 Photomicrograph showing typical features of a fibro‐osseous lesi...

Figure 33.2 Radiographic examples of benign fibro‐osseous lesions. (a) Panor...

Figure 33.3 Photomicrograph showing characteristic histological features of ...

Figure 33.4 Radiographic examples of central giant cell lesions. (a) The cen...

Chapter 34

Figure 34.1 The biopsychosocial model of pain and the factors that impact th...

Figure 34.2 Pathways in the CNS that carry sensory information from the orof...

Figure 34.3 Some intrinsic pain‐modulatory pathways. The periaqueductal grey...

Figure 34.4 Glutamatergic and dopaminergic circuitry in the brain reward net...

Figure 34.5 Trigeminal central sensitisation reflected through extensive mec...

Figure 34.6 Differences in trigeminal central sensitisation in AJ and C57BL6...

Chapter 35

Figure 35.1 Psychological distress and pain amplification in the onset and p...

Guide

Cover Page

Table of Contents

Title Page

Copyright Page

Dedication Page

About the Editor

List of Contributors

Foreword

Preface

Begin Reading

Index

WILEY END USER LICENSE AGREEMENT

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Pathological Basis of Oral and Maxillofacial Diseases

Edited by

S. R. Prabhu

BDS, MDS (Oral Path), FFDRCSI (Oral Med), FDSRCS (Edin), FDSRCPS (Glasgow), FDSRCS (Eng), FFGDP RCS (UK), MOMed RCS (Edin), FICD

The University of Queensland School of Dentistry, Brisbane, Australia

Syed Ali Khurram

BDS, MSc., PhD., MFDS RCS (Edinburgh), CiLT, FHEA, FRC Path.

Unit of Oral and Maxillofacial Pathology

School of Clinical Dentistry, The University of Sheffield, Claremont Crescent, Sheffield, UK

Omar Kujan

BDS, DipOPath, MDSc, PhD, MFDS RCPS (Glasgow), FRCPath (UK), FFOMP RCPA (Australasia)

Merva Soluk Tekkesin

DDS, PhD.

Department of Oral Pathology, Faculty of Dentistry,Istanbul University, Türkiye

This edition first published 2025© 2025 John Wiley & Sons Ltd

All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of S. R. Prabhu, Syed Ali Khurram, Omar Kujan and Merva Soluk Tekkesin to be identified as the authors of the editorial material in this work has been asserted in accordance with law.

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Library of Congress Cataloging‐in‐Publication DataNames: Prabhu, S. R., editor. | Khurram, Syed Ali, editor. | Kujan, Omar, editor. | Soluk Tekkesin, Merva, editor.Title: Pathological basis of oral and maxillofacial diseases / edited by S R Prabhu, Syed Ali Khurram, Omar Kujan, Merva Soluk Tekkesin.Description: First edition. | Hoboken, NJ : Wiley‐Blackwell 2025. | Includes index.Identifiers: LCCN 2024025361 (print) | LCCN 2024025362 (ebook) | ISBN 9781119989202 (paperback) | ISBN 9781119989219 (adobe pdf) | ISBN 9781119989226 (epub)Subjects: MESH: Stomatognathic Diseases–pathologyClassification: LCC RK301 (print) | LCC RK301 (ebook) | NLM WU 140 | DDC 617.5/22–dc23/eng/20240807LC record available at https://lccn.loc.gov/2024025361LC ebook record available at https://lccn.loc.gov/2024025362

Cover Design: WileyCover Images: Courtesy of Soluk Tekkesin, Courtesy of Hannah Walsh, Courtesy of Nagamani Narayana, Courtesy of Omar Kujan

This book is dedicated to the memory of Newell W Johnson for his enormous contribution to Oral and Maxillofacial Pathology.

About the Editor

S. R. Prabhu. BDS, MDS (Oral Path), FFDRCSI (Oral Med), FDSRCS (Edin), FDS RCPS (Glasgow), FDSRCS (Eng), FFGDP RCS (UK), MOMed RCS (Edin), FICD.

S. R. Prabhu is an honorary associate professor at the University of Queensland School of Dentistry, Brisbane, Australia. His expertise is in oral and maxillofacial pathology and oral medicine, with a particular interest in tropical oral diseases. Professor Prabhu, formerly a Commonwealth Medical Scholar, held senior academic positions in oral medicine and oral pathology at university dental schools in India, Kenya, Sudan, Trinidad and Tobago, Malaysia, Saudi Arabia and the UAE and administrative positions as Director and Dean of Dental Schools in Trinidad and Tobago and the UAE, respectively. He is a Fellow of the dental faculties of the Royal Surgical Colleges in the United Kingdom and Ireland and the International College of Dentists. Professor Prabhu has conducted workshops on HIV/AIDS for oral healthcare professionals in the Asian and Caribbean regions. He has published several papers in refereed journals and edited and authored over 15 books on oral pathology, oral medicine, general pathology, and general medicine topics, primarily targeted at undergraduate dental students. Professor Prabhu serves on the International Dental Journal (IDJ) Editorial Board, published by the FDI World Dental Federation, Geneva.

Syed Ali Khurram. BDS, MSc, PhD, MFDS RCS (Edinburgh), CiLT, FHEA, FRC Path.

Syed Ali Khurram is a professor and honorary consultant pathologist at the University of Sheffield. Following his graduation, he pursued a master’s degree in experimental oral pathology at Queen Mary University, London, and continued his academic training by completing a PhD from the University of Sheffield. After numerous years as a junior trainee in oral and maxillofacial pathology, medicine, and surgery, he gained an NIHR‐funded academic clinical lecturer training post, culminating in an FRCPath fellowship in 2016. He has held a consultant post in Sheffield since then. Professor Khurram has published extensively, and his research interests include oral cancer and oral potentially malignant disorders. Alongside his research and clinical work, Professor Khurram has founded a research group called NEOPATH (neopath.org.uk) that looks at the application of artificial intelligence to head and neck pathology, as well as understanding the biological processes behind head and neck cancers and dysplasia. Professor Khurram is the Secretary of the British Society for Oral and Maxillofacial Pathology (BSOMP).

Omar Kujan. BDS, DipOPath, MDSc, MFDS, RCSP (Glas), PhD, FHEA, FRCPath, FFOMP RCPA.

Omar Kujan is an associate professor and the discipline lead in Oral Pathology at UWA Dental School. He has advanced experience in the field of oral pathology. Dr. Kujan received his PhD from the University of Manchester (UK) and a fellowship from the Royal College of Pathologists (UK). He published many highly cited publications on oral epithelial dysplasia, oral potentially malignant disorders and oral cancer, including the latest 2021 classification by the WHO Collaborating Group for Oral Cancer. He is a co‐author of the 2022 WHO Blue Book on Head and Neck Tumours Classification. Dr. Kujan has authored over 145 peer‐reviewed publications in high‐impact journals and several book chapters. Dr. Kujan is the lead of the oral and maxillofacial biology and diseases research stream at UWA Dental School, and he has achieved a remarkable track record, as demonstrated by his successful research grant applications and publication of high‐impact research papers. He supervised the completion of several PhD and MSc students. He is an associate editor of the Journal of Oral Pathology and Medicine and Frontiers in Oncology. His research expertise areas fall in the fields of oral cancer screening, oral potentially malignant disorders, epithelial dysplasia, diagnostic, prognostic and predictive biomarkers, molecular pathology, oral carcinogenesis and chemopreventive approaches.

Merva Soluk Tekkesin. DDS, PhD.

Merva Soluk Tekkesin is an Oral and Maxillofacial Pathology Professor at Istanbul University, Türkiye. She completed her dental school training in 2003, her residency in oral and maxillofacial pathology, and her PhD in tumour pathology at the Institute of Oncology, Istanbul University, in 2010. Professor Soluk Tekkesin was an overseas training fellow registered with the General Dental Council (GDC) at King’s College London, Guy’s Hospital, and the Department of Head and Neck and Oral Pathology in 2009, and she was the first Tier 5 International Training Fellow to complete training in the United Kingdom. She served as the European Councillor of the International Association of Oral and Maxillofacial Pathologists (IAOP) from 2014 to 2020. She is the first digital communication officer of the IAOP, a position she will hold until 2026. Professor Soluk Tekkesin was the secretary of both the Head and Neck Working Group (2010–2014) and the Informatics Working Group (2021–2023) of the Federation of Turkish Pathology Societies in Türkiye. Her main research interests include odontogenic lesions, fibro‐osseous lesions, potentially malignant oral disorders, digital pathology and AI. She has numerous high‐quality publications and book chapters, including contributions to the fourth and fifth editions of the WHO Classification of Head and Neck Tumors. In 2019, she was honoured with the Turkish Academy of Science Outstanding Young Scientist Award in medical sciences.

July 2024

List of Contributors

José M. Aguirre‐UrizarDepartment of StomatologyUniversity of the Basque Country UPV/EHULeioaSpain

Philip AtkinOral Medicine, School of DentistryCardiff UniversityCardiffUnited Kingdom

Preethi BalanSingapore Oral Microbiomics InitiativeNational Dental Research InstituteSingapore, National Dental CenterSingapore

Ramesh BalasubramaniamDiscipline of Oral Medicine, UWADental SchoolThe University of Western AustraliaCrawley, Western AustraliaAustralia

Daniel J. BrierleyUnit of Oral and MaxillofacialPathology, School of DentistryUniversity of SheffieldSheffieldUK

Andreia BufalinoOral Medicine, Department of Diagnosis andSurgery, School of DentistrySão Paulo State University – UNESPAraraquara, São PauloBrazil

John CaseyDepartment of Oral BiologyUniversity of NebraskaMedical Centre, NebraskaUSA

A. V. Chalapathi RaoDepartment of PathologyThe University of the West IndiesSt. AugustineTrinidad and Tobago

Pradeep ChirravurDepartment of AnesthesiologyApollo HospitalsChennaiIndia

Prazwala ChirravurDepartment of Oral and MaxillofacialDiagnosticsUConn HealthConnecticutUSA

Lisette CollinsHead and Neck PathologyGuy's & St Thomas' NHS Foundation TrustLondonUK

Yucel ErbilginDepartment of GeneticsAziz Sancar Institute of ExperimentalMedicine, Istanbul UniversityIstanbulTürkiye

Agnieszka FrydrychUWA Dental SchoolThe University of Western AustraliaPerth, Western AustraliaAustralia

Sarah Jane GeorgeBristol Medical SchoolUnivesrity of BristolBristolUK

Susan GibbsAcademic Center for DentistryAmsterdam (ACTA)AmsterdamNetherlands

Guru O.Doctor of Clinical Dentistry (Oral Medicine)Candidate, UWA Dental SchoolThe University of Western AustraliaNedlandsWestern Australia

Paul HankinsonUnit of Oral and MaxillofacialPathology, School of DentistryUniversity of SheffieldSheffieldUK

Keith HunterLiverpool Head and Neck Centre, Molecularand Clinical Cancer MedicineUniversity of LiverpoolUK

H. Ibrahim KorkmazMolecular Cell Biology and ImmunologyAmsterdam University Medical CentreAmsterdamNetherlands

Nesa Aurlene JayadhasDentistry and Oral Health, Latrobe RuralHealth SchoolLa Trobe UniversityBendigo, VictoriaAustralia

Adam JonesCardiff Dental HospitalCardiff and Vale NHS TrustUK

Suheyla KayaDepartment of PeriodontologyFaculty of DentistryIstanbul University‐CerrahpaşaTürkiye

Syed Ali KhurramUnit of Oral and MaxillofacialPathology, School of DentistryUniversity of SheffieldSheffieldUK

Omar KujanUWA Dental SchoolThe University of Western AustraliaPerth, Western AustraliaAustralia

Jeremy LauUWA Dental SchoolThe University of Western AustraliaPerth, Western AustraliaAustralia

Richard LoganAdelaide Dental School, Faculty of Health andMedical SciencesThe University of AdelaideAdelaideAustralia

Marcio Ajudarte LopesPiracicaba Dental SchoolUniversity of Campinas (UNICAMP)Sao PauloBrazil

Irene Lafuente‐Ibáñez de MendozaDepartment of StomatologyUniversity of the Basque CountryUPV/EHULeioaSpain

Nagamani NarayanaDepartment of Oral BiologyUniversity of Nebraska Medical CentreNebraskaUSA

Johan OppermanDepartment of Oral and MaxillofacialPathology, Faculty of Dentistry and WHOCollaborating CenterUniversity of the Western Cape and NationalHealth Laboratory ServiceCape TownSouth Africa

John Anthony OzolekDepartment of PathologyAnatomy, and Laboratory MedicineWest Virginia UniversityMorgantown, WVUSA

Suja PillaiFaculty of MedicineUniversity of QueenslandBrisbane, QueenslandAustralia

S. R. PrabhuSchool of DentistryUniversity of QueenslandBrisbane, QueenslandAustralia

Janani RavichandranDoctor of Clinical Dentistry(Oral Medicine) Candidate, SydneyDental SchoolThe University of SydneyCamperdownNSW

Yeshwant RawalOral and Maxillofacial PathologySchool of DentistryMarquette UniversityMilwaukee, WIUSA

Gargi SarodeDepartment of Oral and MaxillofacialPathologyDr. D. Y. Patil Dental College and HospitalPuneIndia

Sachin SarodeDepartment of Oral and MaxillofacialPathologyDr. D. Y. Patil Dental College and HospitalPuneIndia

Muge SayitogluDepartment of GeneticsAziz Sancar Institute of ExperimentalMedicine, Istanbul UniversityIstanbulTürkiye

Chaminda Jayampath SeneviratneCOR3 Research Group, School of DentistryThe University of QueenslandBrisbaneAustralia

Barry SessleFaculty of Dentistry and Department ofPhysiology, Temerty Faculty of Medicine, andCentre for the Study of PainUniversity of TorontoToronto, OntarioCanada

Dáire ShanahanBristol Dental SchoolUniversity of BristolBristolUK

Philip SloanSchool of Dental SciencesNewcastle UniversityNewcastle upon TyneUK

Lucas Lacerda de SouzaPiracicaba Dental SchoolUniversity of Campinas (UNICAMP)Sao PauloBrazil

Paul M. SpeightEmeritus Professor, Unit of Oral andMaxillofacial Pathology, School of DentistrySheffield UniversitySheffieldUK

Santosh Kumar TadakamadlaDentistry and Oral Health, Latrobe RuralHealth SchoolLa Trobe UniversityBendigo, VictoriaAustralia

Merva Soluk TekkesinDepartment of Oral Pathology, Faculty ofDentistryIstanbul UniversityIstanbulTürkiye

Selvam ThavarajFaculty of DentistryKing's CollegeLondonUK

Davis C. ThomasDepartment of Diagnostic Sciences, RutgersSchool of Dental MedicineRutgers UniversityNewark, NJUSA

Fadi TitinchiDepartment of Maxillofacial and OralSurgery, Faculty of Dentistry and WHOCollaborating CenterUniversity of the Western CapeCape TownSouth Africa

Lalima TiwariUWA Dental SchoolThe University of Western AustraliaPerth, Western AustraliaAustralia

Nadeeka UdawatteCOR3 Research Group, School of DentistryThe University of QueenslandBrisbaneAustralia

Pablo Agustin VargasPiracicaba Dental SchoolUniversity of Campinas (UNICAMP)Sao PauloBrazil

Kavitha VeguntaFaculty of Medicine and HealthSydney Medical SchoolThe University of SydneyCamperdown, New South WalesAustralia

Hannah WalshUnit of Oral and MaxillofacialPathology, School of DentistryUniversity of SheffieldSheffieldUKLasanthini WeerakkodyDiscipline of Oral MedicineUWA Dental SchoolThe University of Western AustraliaCrawley, Western AustraliaAustralia

Muhammed YakinAdelaide Dental School, Faculty of Health andMedical SciencesThe University of AdelaideAdelaideAustralia

Sue‐Ching YeohSydney Dental SchoolThe University of SydneyCamperdown, NSWAustralia

Foreword

Teaching methodology in the dental school curriculum continues to evolve as we search for the best ways to educate our students. The traditional curriculum has been heavily weighted with numerous individual basic science courses (anatomy, histology, microbiology, biochemistry, physiology, pathology etc.) during the first years of dental school, which are followed in subsequent years by courses primarily related to direct clinical patient care. Obviously, such an approach is quite logical because it provides students with the critical baseline scientific knowledge necessary to diagnose and treat their patients. However, this type of curriculum sometimes leads to a “disconnect” between the knowledge being learned in various individual courses as well as the application of this knowledge in the clinical arena. In an effort to bridge this gap, many basic science courses now include crossover “enrichment” lectures from clinical faculty members in an effort to demonstrate the clinical relevance of the basic science principles being introduced. Some dental schools today have taken this approach one step further by developing interdisciplinary “systems‐based” curricula that attempt to integrate various aspects of the basic and clinical sciences into separate teaching modules based on organ systems (e.g., cardiovascular, gastrointestinal etc.).

Because oral and maxillofacial pathology sits at the crossroads of the basic and clinical sciences, our discipline is ideally suited for incorporation into an integrated approach to dental education. With this ambitious textbook, Drs. S. R. Prabhu, S. Ali Khurram, Omar Kujan and Merva Soluk Tekkesin, in collaboration with a talented international group of contributing authors, have attempted to bridge this gap in recognition of our burgeoning knowledge about oral disease conditions, Pathological Basis of Oral and Maxillofacial Diseases presents a broader view of oral pathology, including information on epidemiologic, hereditary, pathophysiologic, immunologic and molecular factors involved in various pathologic processes of the head and neck region. I feel confident that the scope of this book will serve as a valuable resource of information for students, clinicians and teachers alike.

Brad W. Neville, DDS

Director of Oral and Maxillofacial Pathology

HCA South Atlantic Division

Trident Medical Center

Charleston, South Carolina, USA

Preface

In most dental schools, general pathology is traditionally taught as part of the basic medical science curriculum in the initial years of dental training. This is followed in the early years of clinical training by taught courses in oral pathology/oral medicine and oral surgery. Students, particularly undergraduates, find this compartmentalised approach daunting and often miss the relevance of basic pathologic principles in the pathogenesis of diseases affecting the oral and maxillofacial regions. The time gap between general pathology and oral pathology/oral medicine training also leads to some loss of basic pathology knowledge when students enter clinical years. In addition, we have also witnessed widespread advances in the molecular, immunologic and genetic basis of diseases that have enhanced our understanding of the pathogenesis of diseases, including those of the oral and maxillofacial regions. However, there is a lack of this knowledge being adequately compiled and presented in a manner that reaches dental students. Pathological Basis of Oral and Maxillofacial Diseases attempts to address this need, integrate pathological principles into oral and maxillofacial diseases and present the knowledge to make the student learning process more meaningful.

This book has 9 sections comprising 35 chapters contributed by over 50 international authors. Section titles include pathology as the foundation of medicine, homeostasis and cellular pathology, defence mechanisms against disease, clinical genetics and developmental pathology, infectious and systemic diseases, disorders of cell and tissue growth, neoplastic diseases of the oral mucosa and salivary glands, diseases of the oral and maxillofacial skeleton and pain disorders. Diagrams, clinical, radiographic and histopathology images and tables supplement the text. Variability in length, style and depth of coverage can be expected in a multiauthor work such as this. However, editors have tried to maintain a coherent approach without unduly restricting chapter contributors, who have been drawn from different parts of the world.

Editors hope the Pathological Basis of Oral and Maxillofacial Diseases will enable undergraduate and postgraduate dental students, trainee pathologists and clinicians to grasp the essential features of the pathological basis of diseases and apply that knowledge to diseases of the oral and maxillofacial regions.

July 2024

S. R. Prabhu, BrisbaneSyed Ali Khurram, SheffieldOmar Kujan, PerthMerva Soluk Tekkesin, Istanbul

Section 1Pathology as the Foundation of Medicine

1Introduction to Pathology

S. R. Prabhu1 and Suja Pillai2

1 School of Dentistry, University of Queensland, Brisbane, Queensland, Australia

2 Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia

1.1 Introduction

Pathology is the medical speciality concerned with the scientific study of the nature and causes of diseases. It bridges science and medicine and supports every aspect of patient care, from diagnostic testing, treatment and advice to disease prevention. The origin of the term (etymology) ‘pathology’ is derived from the Greek words ‘Pathos’ and ‘logy’, meaning the study of suffering (1). ‘Disease’ refers to a definable deviation from normal phenotypic observable characteristics evident via patient symptoms and signs (2). The cause of the disease is referred to as its aetiology. One disease entity can have more than one aetiology, and it is also possible that one aetiology can lead to more than one disease. Sometimes, the affix pathy indicates a disease state in both physical ailments, such as cardiomyopathy, and psychological conditions, such as psychopathy (3). Each disease develops through physical, chemical and cellular events. This stepwise process of disease development is called its pathogenesis – a Greek word meaning generation of suffering (2). It leads to cellular and tissue function changes. A pathologist is a specialist in pathology who offers diagnosis using observations at the clinical, gross, body fluid, light microscopic, immunophenotypic, ultrastructural, cytogenetic and molecular levels (4). Pathologists diagnose disease by generating a differential diagnosis and then finding the best fit for the clinical presentation, the radiographic appearance and the pathologic (clinical lab and morphologic) findings (2). The presentation of a disease to a clinician is in the form of a human patient with variably specific complaints (symptoms).