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Flashcards in practical dental Deck (60):
1

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dental anatomy

2

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amelogenesis imperfecta

HEREDITARY ENAMEL DYSPLASIAS !! = AMELOGENESIS IMPERFECTA (A. I.)

Ectodermal anomaly – dysfunction of the adamantine organ (of the ameloblasts)

It doesn’t involve the dentin (mesodermal origin)

Genetically inherited: AD (most frequent), AR, X-linked 

Involves the enamel of all the teeth

HYPOPLASTIC A.I. – two forms: 

ENAMEL APLASIA :

The teeth which remain included are often resorbed

If the teeth erupt :

No enamel deposits (Rx)

Covered with dentin

Yellow-brown colour

Rough surface

ENAMEL HYPOPLASIA :

Reduced production of protein matrix 

Normal degree of mineralization

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dentinogenesis imperfecta

NTINOGENESIS IMPERFECTA = Dentinogenesis imperfecta (DI) is a genetic disorder (AD) of tooth development. This condition is a type of dentin dysplasia that causes teeth to be discolored (most often a blue-gray or yellow-brown color) and translucent giving teeth an opalescent sheen.[1] Teeth are also weaker than normal, making them prone to rapid wear, breakage, and loss.

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Internal resorbtion

NTERNAL RESORBTION:

Rare

Causes: 

Pulp traumas

Pulpitis secondary to caries

Pulpotomy

Starts in the pulp and evolves towards the surface of the cementum or the crown => until it produces a communication between the pulp and the periodontal space or the external surface of the crown

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external resorbtion

RESORBTION= Loss of dental tough subtance on the surfaces which are not exposed to the outside.

In contact with the pulp region  (crown, roots)

In contact with the periodontal ligament (roots)

EXTERNAL RESORBTION:

Much more frequent 

Starts at the surface of the tooth, in contact with the periodontal ligament

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enamel carious lesion

3. Enamel caries: white plaque, cavitary lesion

 

Enamel 95% of hydroapatite – very hard tissue. Due to the action of proteolytic enzymes and cariogenic acids > succession of demineralization and remineralization phases. The enamel caries start below the bacterial plaque.  Plaque... strep lactob...

Cavitary lesion due to a slow dissolution of the enamel, along the prisms and the  interprismatic areas.

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''white spot''

demineralization

Enamel caries: white plaque, cavitary lesion

 

Enamel 95% of hydroapatite – very hard tissue. Due to the action of proteolytic enzymes and cariogenic acids > succession of demineralization and remineralization phases. The enamel caries start below the bacterial plaque.  Plaque... strep lactob...

Cavitary lesion due to a slow dissolution of the enamel, along the prisms and the  interprismatic areas.

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enamel caries

Enamel caries: white plaque, cavitary lesion

 

Enamel 95% of hydroapatite – very hard tissue. Due to the action of proteolytic enzymes and cariogenic acids > succession of demineralization and remineralization phases. The enamel caries start below the bacterial plaque.  Plaque... strep lactob...

Cavitary lesion due to a slow dissolution of the enamel, along the prisms and the  interprismatic areas.

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tubule invasion by bacteria

dentinal caries

DENTIN CARIES:

Secondary to enamel caries (coronal caries) or cementum caries (cervical caries)

Evolves more rapidly

Large amount of organic substances in the dentin -30% 

Dentin is injured  

Initially by the bacterial cariogenic acids

Different bacterial species than the ones for enamel: 

Role of anaerobes (lactobacilli) is more important

Later, bacteria penetrate the dentinal tubules 

As a result, the organic component is demineralized and then liquefied

Dentin caries are cone shaped, with the tip pointing towards the pulp chamber

LAYERS: 

NECROTIC (surface)

INFECTED / AFFECTED 

SCLEROTIC (DEEP) 

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infected layer

bulbs and caves

DENTIN CARIES:

Secondary to enamel caries (coronal caries) or cementum caries (cervical caries)

Evolves more rapidly

Large amount of organic substances in the dentin -30% 

Dentin is injured  

Initially by the bacterial cariogenic acids

Different bacterial species than the ones for enamel: 

Role of anaerobes (lactobacilli) is more important

Later, bacteria penetrate the dentinal tubules 

As a result, the organic component is demineralized and then liquefied

Dentin caries are cone shaped, with the tip pointing towards the pulp chamber

LAYERS: 

NECROTIC (surface)

INFECTED / AFFECTED 

SCLEROTIC (DEEP) 

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dentinal caries 

transverse view

DENTIN CARIES:

Secondary to enamel caries (coronal caries) or cementum caries (cervical caries)

Evolves more rapidly

Large amount of organic substances in the dentin -30% 

Dentin is injured  

Initially by the bacterial cariogenic acids

Different bacterial species than the ones for enamel: 

Role of anaerobes (lactobacilli) is more important

Later, bacteria penetrate the dentinal tubules 

As a result, the organic component is demineralized and then liquefied

Dentin caries are cone shaped, with the tip pointing towards the pulp chamber

LAYERS: 

NECROTIC (surface)

INFECTED / AFFECTED 

SCLEROTIC (DEEP) 

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reactive tetriary dentine

rtiary dentin is dentin formed as a reaction to external stimulation such as cavities

ENTIN CARIES:

Secondary to enamel caries (coronal caries) or cementum caries (cervical caries)

Evolves more rapidly

Large amount of organic substances in the dentin -30% 

Dentin is injured  

Initially by the bacterial cariogenic acids

Different bacterial species than the ones for enamel: 

Role of anaerobes (lactobacilli) is more important

Later, bacteria penetrate the dentinal tubules 

As a result, the organic component is demineralized and then liquefied

Dentin caries are cone shaped, with the tip pointing towards the pulp chamber

LAYERS: 

NECROTIC (surface)

INFECTED / AFFECTED 

SCLEROTIC (DEEP) 

13

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tertiary dentin in response to stimuli

twisting tubes

ENTIN CARIES:

Secondary to enamel caries (coronal caries) or cementum caries (cervical caries)

Evolves more rapidly

Large amount of organic substances in the dentin -30% 

Dentin is injured  

Initially by the bacterial cariogenic acids

Different bacterial species than the ones for enamel: 

Role of anaerobes (lactobacilli) is more important

Later, bacteria penetrate the dentinal tubules 

As a result, the organic component is demineralized and then liquefied

Dentin caries are cone shaped, with the tip pointing towards the pulp chamber

LAYERS: 

NECROTIC (surface)

INFECTED / AFFECTED 

SCLEROTIC (DEEP) 

14

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reversiple pulpitis or pulp hyperemia

REVERSIBLE PULPITIS (PULP HYPEREMIA): Reversible pulpitis is generally characterized by sharp sensitivity to cold, sometimes to sweets and sometimes to biting.

The initial stage of pulp inflammation

Closed  

Partial – the tissue zone is expanded only a little

Aseptic

Acute

Causes: 

Deep, but closed caries 

Large, incorrect metallic obturations 

Evolution : 

Healing after the disappearance of irritant factors

Towards a total acute pulpitis if the agression persists

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dentinal caries

closed acute pulpitis and abcess

ACUTE IRREVERSIBLE PULPITIS: Irreversible pulpitis is generally characterized by prolonged sensitivity to cold and/or heat, and sometimes to sweets. Swelling may be present.

Etiopathogenesis:

Exacerbation of a reversible pulpitis by opening the pulp chamber

 

 

Periapical abscess

PERIAPICAL ABSCESS (ACUTE PERIAPICAL PERIODONTITIS) = collection of pus usually caused by an infection that has spread from a tooth to the surrounding tissues.

Well delimited purulent inflammation located at the apex of a tooth

EVOLUTION :

DRAINAGE OF PUS TOWARDS THE GINGIVA: 

FISTULIZATION → the symptoms disappear 

 

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opened dentine pulpitis and pulpal abcess

CUTE IRREVERSIBLE PULPITIS: Irreversible pulpitis is generally characterized by prolonged sensitivity to cold and/or heat, and sometimes to sweets. Swelling may be present.

Etiopathogenesis:

Exacerbation of a reversible pulpitis by opening the pulp chamber

Activation of a chronic pulpitis

 

Periapical abscess

PERIAPICAL ABSCESS (ACUTE PERIAPICAL PERIODONTITIS) = collection of pus usually caused by an infection that has spread from a tooth to the surrounding tissues.

Well delimited purulent inflammation located at the apex of a tooth

EVOLUTION :

DRAINAGE OF PUS TOWARDS THE GINGIVA: 

FISTULIZATION → the symptoms disappear 

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CHRONIC PULPITIS:

Can appear directly, spontaneously

After an acute pulpitis, when the pus is drained through the carious orifice

 

CHRONIC HYPERPLASTIC PULPITIS  (PULP POLYP): A pulp polyp, also called as Chronic Hyperplastic Pulpitis, is found in an open carious lesion, fractured tooth or when a dental restoration is missing. Due to lack of intrapulpal pressure in an open lesion pulp necrosis does not take place as would have occurred in a closed caries case.

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chronic sclerosing pulpitis

CHRONIC PULPITIS:

Can appear directly, spontaneously

After an acute pulpitis, when the pus is drained through the carious orifice

19

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Apical granuloma

PERIAPICAL GRANULOMA

(CHRONIC APICAL PERIODONTITIS) = A periapical granuloma is a mass of chronically inflamed granulation tissue that forms at the apex of the root of a nonvital (dead) tooth. However, a periapical granuloma does not contain granulomatous inflammation, and therefore is not a true granuloma.

Etiology:

Apical defense reaction to the presence of bacteria and their toxins in the root canal

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apical cyst

PICAL PERIODONTAL CYST = APICAL RADICULAR CYST = The periapical cyst (also termed radicular cyst, and to a lesser extent dental cyst) is the most common odontogenic cyst. It is caused by pulpal necrosis secondary to dental caries or trauma. The cyst lining is derived from the cell rests of Malassez. Usually, the periapical cyst is asymptomatic, but a secondary infection can cause pain.

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Apical abcess

PERIAPICAL ABSCESS (ACUTE PERIAPICAL PERIODONTITIS) = collection of pus usually caused by an infection that has spread from a tooth to the surrounding tissues.

Well delimited purulent inflammation located at the apex of a tooth

EVOLUTION :

DRAINAGE OF PUS TOWARDS THE GINGIVA: 

FISTULIZATION → the symptoms disappear 

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acute gingivitis

CUTE GINGIVITIS =  

Initial form of a periodontopathy  

The acute nature is established by the intensity of the local irritation: 

Sulcular plaque  

The patient’s immune resistance 

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chronic gingivitis

HRONIC GINGIVITIS = gingivitis is a non destructive periodontal disease.

An inflammatory process of reduced intensity, without symptoms 

Elderly people 

Causes: 

A. From the start 

Defective hygiene – chronic accumulation of bacterial plaque

Mechanical and chemical irritation 

B. Evolution of an acute gingivitis 

C. Down syndrome, diabetes mellitus, increased progesterone levels (pregnancy)

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chronic periodontitis

''pouch''

DULT CHRONIC PERIODONTITIS = Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque. Redness + bleeding, gum swelling, halitosis, gingival recession, deep periodontal pockets, loose teeth.

The most frequent cause of dental loss

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chronic periodontitis suboceous pouch

ADULT CHRONIC PERIODONTITIS = Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque. Redness + bleeding, gum swelling, halitosis, gingival recession, deep periodontal pockets, loose teeth.

The most frequent cause of dental loss

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periodontal abcess

LATERAL PERIODONTAL ABSCESS = is a localized collection of pus (i.e. anabscess) within the tissues of the periodontium. It is a type of dental abscess.

Complication of a chronic periodontitis

Cause: 

Closure of the periodontal pocket in the superior gingival region

Inside the closed pocket:

Foreign bodies can be found 

Fish bones, food

Bacteria multiply, sometimes even change their composition

Pus is formed = lateral abscess of the root 

27

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herpes

Gingivostomatitis (also known as primary herpetic gingivostomatitis or orolabial herpes) is a combination of gingivitis and stomatitis, or an inflammation of the oral mucosa and gingiva. Herpetic gingivostomatitis is often the initial presentation during the first ("primary") herpes simplex infection. It is of greater severity than herpes labialis (cold sores), which is often the subsequent presentation. Primary herpetic gingivostomatitis is the most common viral infection of the mouth.

HSV-1:

The most frequent viral infection of the oral mucosa

Involves the oral cavity, lips, pharynx, eyes, the skin of the upper body

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candidosis in silver stain

PSEUDOMEMBRANOUS CANDIDOSIS = Acute pseudomembranous candidiasis is a classic form of oral candidiasis,[6] commonly referred to as thrush. It is characterized by a coating or individual patches of pseudomembranous white slough that can be easily wiped away to reveal erythematous, and sometimes minimally bleeding mucosa beneath.[7] These areas of pseudomembrane are sometimes described as "curdled milk",[4] or "cottage cheese".[7] The white material is made up of debris, fibrin, and desquamated epithelium that has been invaded by yeast cells and hyphae that invade to the depth of the stratum spinosum.[4]

APPEARS in: Newborns, Malnourished infants

Adults: HIV infection, antibiotics, chemotherapy, radiotherapy, leukemia

Debilitated older people

LOCATION: jugal mucosa, dorsum of the tongue, palate, oropharynx

ANATOMIC - CLINICAL:

MACRO: 

White, soft, creamy aspect  (like coagulated milk) 

They are adherent, but can be easily removed by friction or scraping

The underlying mucosa is normal or erythematous

Rarely with hemorrhage (in anticancer treatment)

EVOLUTION : 

Acute

After antibiotic treatment 

Chronic 

Depressed immunity 

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giant cell granulloma

GIANT CELL PERIPHERAL GRANULOMA (EPULIS WITH MYELOPLAXES)

DEF. : 

Gingival pseudotumor due to a deep gingival irritation

PREDISPOSING FACTORS :

Dental extraction, dental fracture

Periodontal treatments

Irritation given by prostheses

Chronic infections

EVOLUTION :

Slowly, towards fibrosis

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mucocel retention

MUCOCELE :

CYSTIC LESION OF OBSTRUCTIVE ORIGIN:

Characteristic for minor salivary glands, rarely in major ones

MUCOCELE DUE TO EXTRAVASATION :

Def: retention of saliva in the surrounding connective tissue due to a traumatic rupture of the excretory canal of a salivary gland, which is:

Minor

Or major – in the case of ranula 

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mucocel extravation

MUCOCELE :

CYSTIC LESION OF OBSTRUCTIVE ORIGIN:

Characteristic for minor salivary glands, rarely in major ones

MUCOCELE DUE TO EXTRAVASATION :

Def: retention of saliva in the surrounding connective tissue due to a traumatic rupture of the excretory canal of a salivary gland, which is:

Minor

Or major – in the case of ranula 

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chronic sialdenitis

CHRONIC SCLEROSING SIALADENITIS:

CAUSES : sialolithiasis

In adults, more frequent in males 

MACROSCOPY/CLINICAL

Swelling and recurrent pain in a gland

Usually the submandibular gland, which has an increased volume and is tough – called KÜTNER’S TUMOR

MICROSCOPY :

In easy/medium cases : 

Periductal and intralobular  inflammation, with a moderate acinar atrophy

In severe cases : 

Acinar destruction with fibrous replacement + ductal ectasia  

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pleomorphic edenoma

PLEIOMORPHIC ADENOMA (mixed tumor of the salivary glands) = is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland.

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folicular ameloblastoma

AMELOBLASTOMA = is a rare,benign tumor of odontogenic epithelium much more commonly appearing in the lower jaw than the upper jaw. While these tumors are rarely malignant or metastatic, and progress slowly, the resulting lesions can cause severe abnormalities of the face and jaw.

The most frequent odontogenic tumor (equal to all the others combined)

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compound odontoma

COMPOUND ODONTOMA = A compound odontoma still has the three separate dental tissues (enamel, dentin and cementum), but may present a lobulated appearance where there is no definitive demarcation of separate tissues between the individual "toothlets" (or denticles). It usually appears in the anterior maxilla.

 

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complex odontoma

COMPLEX ODONTOMA = The complex odontoma is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities. It usually appears in the posterior maxilla or in the mandible. Osteosarcoma is the most common histological form of primary bone cancer. It is most prevalent in children and young adults

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''red tooth''

internal resorbion

RESORBTION= Loss of dental tough subtance on the surfaces which are not exposed to the outside.

In contact with the pulp region  (crown, roots)

In contact with the periodontal ligament (roots)

 

INTERNAL RESORBTION:

Rare

Causes: 

Pulp traumas

Pulpitis secondary to caries

Pulpotomy

Starts in the pulp and evolves towards the surface of the cementum or the crown => until it produces a communication between the pulp and the periodontal space or the external surface of the crown

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pulp polyp

CHRONIC PULPITIS:

Can appear directly, spontaneously

After an acute pulpitis, when the pus is drained through the carious orifice

 

CHRONIC HYPERPLASTIC PULPITIS  (PULP POLYP): A pulp polyp, also called as Chronic Hyperplastic Pulpitis, is found in an open carious lesion, fractured tooth or when a dental restoration is missing. Due to lack of intrapulpal pressure in an open lesion pulp necrosis does not take place as would have occurred in a closed caries case.

39

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Apical cyst

APICAL PERIODONTAL CYST = APICAL RADICULAR CYST = The periapical cyst (also termed radicular cyst, and to a lesser extent dental cyst) is the most common odontogenic cyst. It is caused by pulpal necrosis secondary to dental caries or trauma. The cyst lining is derived from the cell rests of Malassez. Usually, the periapical cyst is asymptomatic, but a secondary infection can cause pain.

 

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apical cyst

APICAL PERIODONTAL CYST = APICAL RADICULAR CYST = The periapical cyst (also termed radicular cyst, and to a lesser extent dental cyst) is the most common odontogenic cyst. It is caused by pulpal necrosis secondary to dental caries or trauma. The cyst lining is derived from the cell rests of Malassez. Usually, the periapical cyst is asymptomatic, but a secondary infection can cause pain.

 

41

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apical cyst

APICAL PERIODONTAL CYST = APICAL RADICULAR CYST = The periapical cyst (also termed radicular cyst, and to a lesser extent dental cyst) is the most common odontogenic cyst. It is caused by pulpal necrosis secondary to dental caries or trauma. The cyst lining is derived from the cell rests of Malassez. Usually, the periapical cyst is asymptomatic, but a secondary infection can cause pain.

 

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apical abcess

ERIAPICAL ABSCESS (ACUTE PERIAPICAL PERIODONTITIS) = collection of pus usually caused by an infection that has spread from a tooth to the surrounding tissues.

Well delimited purulent inflammation located at the apex of a tooth

EVOLUTION :

DRAINAGE OF PUS TOWARDS THE GINGIVA: 

FISTULIZATION → the symptoms disappear 

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acute gingivitis-tartar

ACUTE GINGIVITIS =  

Initial form of a periodontopathy  

The acute nature is established by the intensity of the local irritation: 

Sulcular plaque  

The patient’s immune resistance 

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chronic gingivitis hiv related

CHRONIC GINGIVITIS = gingivitis is a non destructive periodontal disease.

An inflammatory process of reduced intensity, without symptoms 

Elderly people 

Causes: 

A. From the start 

Defective hygiene – chronic accumulation of bacterial plaque

Mechanical and chemical irritation 

B. Evolution of an acute gingivitis 

C. Down syndrome, diabetes mellitus, increased progesterone levels (pregnancy)

45

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drug related gingival hyperplasia

DRUG RELATED GINGIVAL HYPERPLASIA = Drug-related gingival hyperplasia is a cutaneous condition characterized by enlargement of the gums noted during the first year of drug treatment.[1] There are three drug classes that are associated with this condition namely, anticonvulsants (such as phenyotoin and phenobartibal), calcium channel blocker( such as amlopidine, nifedipine and verapamil) and cyclosporine, an immunosuppressant.

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gingival fibromatosis

Hereditary gingival fibromatosis (HGF), also known as idiopathic gingival hyperplasia, is a rare condition of gingival overgrowth.[1] HGF is characterized as a benign, slowly progressive, nonhemorrhagic, fibrous enlargement of keratinized gingiva. It can cover teeth in various degrees, and can lead to aesthetic disfigurement.[2] Fibrous enlargement is most common in areas of maxillary and mandibular tissues of both arches in the mouth.[1

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chronic periodontitis

ADULT CHRONIC PERIODONTITIS = Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque. Redness + bleeding, gum swelling, halitosis, gingival recession, deep periodontal pockets, loose teeth.

The most frequent cause of dental loss

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hiv related periodontitis

ulcerative necrotic

Patients with severe immunosuppression as a consequence of infection by human immunodeficiency virus (HIV) are at risk for a number of severe periodontal diseases. HIV-associated gingivitis and HIV-associated periodontitis (HIV-P) are seen exclusively in HIV-infected persons. In some cases HIV-P may extend into adjacent soft tissue and bone, resulting in necrotizing stomatitis of periodontal origin. In addition, acute necrotizing ulcerative gingivitis has also been reported to have an increased prevalence in HIV-infected patients.

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periodontal abcess

LATERAL PERIODONTAL ABSCESS = is a localized collection of pus (i.e. anabscess) within the tissues of the periodontium. It is a type of dental abscess.

Complication of a chronic periodontitis

Cause: 

Closure of the periodontal pocket in the superior gingival region

Inside the closed pocket:

Foreign bodies can be found 

Fish bones, food

Bacteria multiply, sometimes even change their composition

Pus is formed = lateral abscess of the root 

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periodontal abcess

fistula

LATERAL PERIODONTAL ABSCESS = is a localized collection of pus (i.e. anabscess) within the tissues of the periodontium. It is a type of dental abscess.

Complication of a chronic periodontitis

Cause: 

Closure of the periodontal pocket in the superior gingival region

Inside the closed pocket:

Foreign bodies can be found 

Fish bones, food

Bacteria multiply, sometimes even change their composition

Pus is formed = lateral abscess of the root 

51

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herpes+hiv

linical Features of Genital Herpes in HIV-Infected Patients5,6

Lesions may appear as ulcers, “cracks,” or linear fissures

Lesions may be larger and/or more numerous and may heal slowly

Lesions may be coinfected with other pathogens

 

Lesions caused by resistant virus may be especially atypical, more severe, larger, and slower to heal

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minor aphthe

MINOR APHTHS = Minor aphthous ulcers are the most common (8 in 10 cases). They are small, round, or oval, and are less than 10 mm across. They look pale yellow, but the area around them may look swollen and red. Only one ulcer may develop, but up to five may appear at the same time. Each ulcer lasts 7-10 days, and then goes without leaving a scar. They are not usually very painful.

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major apthe

MAJOR APHTHS (oral aphthosis) = Major aphthous ulcers occur in about 1 in 10 cases. They tend to be 10 mm or larger across. Usually only one or two appear at a time. Each ulcer lasts from two weeks to several months, but will heal leaving a scar. They can be very painful and eating may become difficult.

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pseudomembranous candidiosis

PSEUDOMEMBRANOUS CANDIDOSIS = Acute pseudomembranous candidiasis is a classic form of oral candidiasis,[6] commonly referred to as thrush. It is characterized by a coating or individual patches of pseudomembranous white slough that can be easily wiped away to reveal erythematous, and sometimes minimally bleeding mucosa beneath.[7] These areas of pseudomembrane are sometimes described as "curdled milk",[4] or "cottage cheese".[7] The white material is made up of debris, fibrin, and desquamated epithelium that has been invaded by yeast cells and hyphae that invade to the depth of the stratum spinosum.[4]

APPEARS in: Newborns, Malnourished infants

Adults: HIV infection, antibiotics, chemotherapy, radiotherapy, leukemia

Debilitated older people

LOCATION: jugal mucosa, dorsum of the tongue, palate, oropharynx

ANATOMIC - CLINICAL:

MACRO: 

White, soft, creamy aspect  (like coagulated milk) 

They are adherent, but can be easily removed by friction or scraping

The underlying mucosa is normal or erythematous

Rarely with hemorrhage (in anticancer treatment)

EVOLUTION : 

Acute

After antibiotic treatment 

Chronic 

Depressed immunity 

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candidose-central papilary atrophy

ENTRAL PAPILLARY ATROPHY : (median rhomboid glossitis)

Initially considered a malformation 

Chronic evolution, without symptoms 

Macroscopy

On the median line of the dorsum of the tongue, posterior region 

A red, swollen, rhomboid, well delineated area 

The surface is smooth or lobulated

Loss of filiform papillae 

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pregnancy tumor

pyogrnic granuloma

YOGENIC GRANULOMA = is a vascular lesion that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma or hormonal factors.

DEF. : 

A pseudotumor produced due to irritation and trauma in the presence of a special oral microbial flora

More frequent  

In children, adolescents and pregnant women

Appears in the first semester of pregnancy, grows until birth and then decreases in size = PREGNANCY TUMOR

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giant cel-epulis

GIANT CELL PERIPHERAL GRANULOMA (EPULIS WITH MYELOPLAXES)

DEF. : 

Gingival pseudotumor due to a deep gingival irritation

PREDISPOSING FACTORS :

Dental extraction, dental fracture

Periodontal treatments

Irritation given by prostheses

Chronic infections

EVOLUTION :

Slowly, towards fibrosis

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squamus cell carcinoma

ulcerative 

at mouth floor

MOUTH  FLOOR CARCINOMA :

35% of oral cancers  

Growing frequency in women

Predisposing factors :

Leukoplakia, erythroplakia 

Secondary neoplasm 

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squamus cell carcinoma

ulcerative

alveolar boarder

0% of oral cancers

Location : posterior mandible

On an area of keratosis

In the beginning :

Can mimic a dental inflammation

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squamus cell carcinoma

ulcerative

lateral margin of tongue

CARCINOMA OF THE TONGUE :

40% of all oral cancers (without the lips)

Nodule or painless ulceration 

Location : 

2/3 on the posterior margin

20% on the anterior-lateral and  ventral surfaces of the tongue

4% on the dorsal surface of the base of the tongue (on syphilitic lesions)

The ones at the tongue base – the most malignant