https://www.spreaker.com/podcast/oral-pathology--5536791enCoursesCopyright The Gulfie Dentisthttps://d3wo5wojvuv7l.cloudfront.net/t_rss_itunes_square_1400/images.spreaker.com/original/a368ba56e2422b82771df920bd85c41a.jpghttps://www.spreaker.com/podcast/oral-pathology--5536791Sat, 30 Aug 2025 13:45:28 +0000The Gulfie DentistThe Gulfie Dentistthegulfiedentist@gmail.comfalseepisodichttps://www.spreaker.com/episode/1-op-intro--49566126https://api.spreaker.com/episode/49566126Wed, 27 Apr 2022 08:13:02 +0000The Gulfie Dentist74falsefullhttps://www.spreaker.com/episode/2-development-disorders--49566128Developmental conditions are soft tissue or hard tissue defects that occur during the development of the individual, either before or after birth.

LIP PITS
- Depressions or concavities seen on lip
- Seen with Van Der Wood syndrome along with cleft lip

FORDYCES GRANULES
- Ectopic sebaceous glands
- On buccal mucosa
- Usually seen as Bilaterally symmetrical

LEUKOEDEMA
- White or whitish grey edematous (fluid) lesion of buccal mucosa
- It dissssipiates when cheek is stretched

ANGIOMAS
- ANGIO - VESSELA OMA - TUMOR
- TUMORS composed of blood vessels or lymph vesseLs
- A salivary gland tumor that mestasises to bone

CENTRAL HEMANGIOMA – IV
- Commonly in upper lip
- There is congenital focal proliferation of capillaries
- Absolute contradiction – extraction of a tooth**
- Multilocular radiolucency lesion
- Associated syndrome – Struge Weber Syndrome
- Port wein steins + calcification of duramatter
- Strawberry appearance of skin – capillary hemangioma
Other variants
- Strawberry appearance of gingiva – warners granulomatosum
- Strawberry appearance of tongue (white coated tongue with red inflamed fungiform papilla)– scarlet fever (bacterial infection)
- Raspberry appearance of plate – papillary hyperplasia(denture)

LYMPHANGIOMA

CONGENITAL FOCAL PROLIFERATION OF LYMPH VESSELS
-Oral lymphangiomas are very rare
- appear as purple spots on tongue


DEVELOPMENTAL SOFT TISSUE CYST - DERMOID CYST
- Mass in the midline of the body – intraoral or extra oral
- Intraorally – floor of the mouth if above mylohyoid
- Mass will be seen in the upper neck if it forms below the mylohyoid
- Contains hair, sebaceous glands etc – doughy consistency

BRANCHIAL CYST
- Lateral neck cyst
- Epithelial cyst within lymph node of neck

PSEUDOCYSTS OF JAW

STAFNE / STATIC BONE CYST
- Radiolucency in the post mandible below the mandibular canal
- Its is not a cyst- just a picture caused due to lingual concavity of the jaw, ie. An invagination in the lingual surface of the jaw - just variation of normal anatomy.

NASOPALATINE / MEDIAN PALATINE / Incisive canal cyst CYST
- Seen b/w roots of Central incisors
- R/F - Divergence of roots
- The nasopalatine cyst appears as a well-defined, round radiolucency in the midline of the anterior maxilla
- Sometimes it appears to be ‘heart-shaped’ because of superimposition of the anterior nasal spine.
- Radiological assessment should include examination of the lamina dura of the central incisors (to exclude a radicular cyst) and assessment of size (the nasopalatine foramen may reach a width of as much as 10 mm).

- Qn. Pt. came to the clinic complaining from pain related to swelling on maxillary central incisor area with vital (under percussion) - nasopalatine cyst
- Qn. 40-60y, Male, in maxilla in the midline between the roots of upper central incisors which are vital.
- Intra-osseous lesion is well circumscribed rounded or Heart-shape RL. area (due to superimposition of nasal spine)

GLOBULOMAXILLARY CYST
- Seen between Lateral incisor and Canine
- Inverted pear shape
- Variant of OKC or lateral periodontal cyst
- Vital tooth bilateral

SOLITARY BONE CYST – Haemorrhagic /Simple / Traumatic bone cyst
- A pseudocyst- ie. No epithelial lining
- Kids doing sports- injury
- R/F – scalloped border around teeth***
- Treatment is curettage and closure]]>https://api.spreaker.com/episode/49566128Wed, 27 Apr 2022 08:12:57 +0000The Gulfie DentistDEVELOPMENTAL CONDITIONS Developmental conditions are soft tissue or hard tissue defects that occur during the development of the individual, either before or after birth. LIP PITS - Depressions or concavities seen on lip - Seen with Van Der...Developmental conditions are soft tissue or hard tissue defects that occur during the development of the individual, either before or after birth.

LIP PITS
- Depressions or concavities seen on lip
- Seen with Van Der Wood syndrome along with cleft lip

FORDYCES GRANULES
- Ectopic sebaceous glands
- On buccal mucosa
- Usually seen as Bilaterally symmetrical

LEUKOEDEMA
- White or whitish grey edematous (fluid) lesion of buccal mucosa
- It dissssipiates when cheek is stretched

ANGIOMAS
- ANGIO - VESSELA OMA - TUMOR
- TUMORS composed of blood vessels or lymph vesseLs
- A salivary gland tumor that mestasises to bone

CENTRAL HEMANGIOMA – IV
- Commonly in upper lip
- There is congenital focal proliferation of capillaries
- Absolute contradiction – extraction of a tooth**
- Multilocular radiolucency lesion
- Associated syndrome – Struge Weber Syndrome
- Port wein steins + calcification of duramatter
- Strawberry appearance of skin – capillary hemangioma
Other variants
- Strawberry appearance of gingiva – warners granulomatosum
- Strawberry appearance of tongue (white coated tongue with red inflamed fungiform papilla)– scarlet fever (bacterial infection)
- Raspberry appearance of plate – papillary hyperplasia(denture)

LYMPHANGIOMA

CONGENITAL FOCAL PROLIFERATION OF LYMPH VESSELS
-Oral lymphangiomas are very rare
- appear as purple spots on tongue


DEVELOPMENTAL SOFT TISSUE CYST - DERMOID CYST
- Mass in the midline of the body – intraoral or extra oral
- Intraorally – floor of the mouth if above mylohyoid
- Mass will be seen in the upper neck if it forms below the mylohyoid
- Contains hair, sebaceous glands etc – doughy consistency

BRANCHIAL CYST
- Lateral neck cyst
- Epithelial cyst within lymph node of neck

PSEUDOCYSTS OF JAW

STAFNE / STATIC BONE CYST
- Radiolucency in the post mandible below the mandibular canal
- Its is not a cyst- just a picture caused due to lingual concavity of the jaw, ie. An invagination in the lingual surface of the jaw - just variation of normal anatomy.

NASOPALATINE / MEDIAN PALATINE / Incisive canal cyst CYST
- Seen b/w roots of Central incisors
- R/F - Divergence of roots
- The nasopalatine cyst appears as a well-defined, round radiolucency in the midline of the anterior maxilla
- Sometimes it appears to be ‘heart-shaped’ because of superimposition of the anterior nasal spine.
- Radiological assessment should include examination of the lamina dura of the central incisors (to exclude a radicular cyst) and assessment of size (the nasopalatine foramen may reach a width of as much as 10 mm).

- Qn. Pt. came to the clinic complaining from pain related to swelling on maxillary central incisor area with vital (under percussion) - nasopalatine cyst
- Qn. 40-60y, Male, in maxilla in the midline between the roots of upper central incisors which are vital.
- Intra-osseous lesion is well circumscribed rounded or Heart-shape RL. area (due to superimposition of nasal spine)

GLOBULOMAXILLARY CYST
- Seen between Lateral incisor and Canine
- Inverted pear shape
- Variant of OKC or lateral periodontal cyst
- Vital tooth bilateral

SOLITARY BONE CYST – Haemorrhagic /Simple / Traumatic bone cyst
- A pseudocyst- ie. No epithelial lining
- Kids doing sports- injury
- R/F – scalloped border around teeth***
- Treatment is curettage and closure]]>534falsefullhttps://www.spreaker.com/episode/3-teeth-anomalies--49566127DUE TO DEFECT IN THE INITIATION AND PROLIFERATION

FUSION AND GEMINATION
- Differentiated by radiography only


DILACERATION
- Cause – mild trauma during root formation stage
- Bending of crown / root

TAURODONTISM
- Bull teeth (elongation of root trunk)
- Syndrome – Klinfilter Syndrome

Dens In Dente / Dense Invagination

- R/F – teeth inside the pulp of a tooth
- Most common with upper lateral incisor

ENAMEL PEARL
- After extraction a molar you found a hard tissue at the furcation like pearl.
- Tooth # 36 planned to extraction on x-ray no PDL after extraction u found lesion like pearl on furcation

SUPERNUMERARY TEETH
- Most common – mesiodense
- Condition where multiple impacted teeth
- Cleido cranial dysplasia
- Gardner’s syndrome
- Trecher Collin’s syndrome
- Cleft lip and palate

HYPODONTIA
- Young female patient with skeletal class 1 there is spacing present in anterior teeth. Her mother also have mild spacing due to missing upper lateral. What is cause of spacing in patient - HYPODONTIA

ANODONTIA
- Syndrome – ectodermal Dysplasia]]>https://api.spreaker.com/episode/49566127Wed, 27 Apr 2022 08:12:32 +0000The Gulfie DentistTEETH ANOMALIES DUE TO DEFECT IN THE INITIATION AND PROLIFERATION FUSION AND GEMINATION - Differentiated by radiography only DILACERATION - Cause – mild trauma during root formation stage - Bending of crown / root TAURODONTISM -...DUE TO DEFECT IN THE INITIATION AND PROLIFERATION

FUSION AND GEMINATION
- Differentiated by radiography only


DILACERATION
- Cause – mild trauma during root formation stage
- Bending of crown / root

TAURODONTISM
- Bull teeth (elongation of root trunk)
- Syndrome – Klinfilter Syndrome

Dens In Dente / Dense Invagination

- R/F – teeth inside the pulp of a tooth
- Most common with upper lateral incisor

ENAMEL PEARL
- After extraction a molar you found a hard tissue at the furcation like pearl.
- Tooth # 36 planned to extraction on x-ray no PDL after extraction u found lesion like pearl on furcation

SUPERNUMERARY TEETH
- Most common – mesiodense
- Condition where multiple impacted teeth
- Cleido cranial dysplasia
- Gardner’s syndrome
- Trecher Collin’s syndrome
- Cleft lip and palate

HYPODONTIA
- Young female patient with skeletal class 1 there is spacing present in anterior teeth. Her mother also have mild spacing due to missing upper lateral. What is cause of spacing in patient - HYPODONTIA

ANODONTIA
- Syndrome – ectodermal Dysplasia]]>335falsefullhttps://www.spreaker.com/episode/4-mucosal-reactive-lesions--49566131Trauma and chemicals are frequent causes of oral lesions. Some of these lesions have an iatrogenic cause (i.e., caused by the dental practitioner).

FRICTIONAL KERATOSIS
- BUCCAL MUCOSA, TONGUE,
- CAUSES
- CHRONIC BITING
- A SHARP CUSP
- OVER EXTENDED DENTURE
- ORTHO APPLIANCE

LINEA ALBA
- White line in the buccal mucosa

NICOTINA STOMATITIS
- Red dots, which are inflamed minor salivary duct openings
- histology of nicotina stomatitis : hyperkeratosis and acanthosis
- only premalignant in smokers

TRAUMATIC ULCER
- Very common
- Due to constant rubbing against sharp tooth surface

HAIRY TONGUE
- Will discuss in tongue lesions]]>https://api.spreaker.com/episode/49566131Wed, 27 Apr 2022 08:12:22 +0000The Gulfie DentistMUCOSAL – REACTIVE LESIONS Trauma and chemicals are frequent causes of oral lesions. Some of these lesions have an iatrogenic cause (i.e., caused by the dental practitioner). FRICTIONAL KERATOSIS - BUCCAL MUCOSA, TONGUE, - CAUSES - CHRONIC...Trauma and chemicals are frequent causes of oral lesions. Some of these lesions have an iatrogenic cause (i.e., caused by the dental practitioner).

FRICTIONAL KERATOSIS
- BUCCAL MUCOSA, TONGUE,
- CAUSES
- CHRONIC BITING
- A SHARP CUSP
- OVER EXTENDED DENTURE
- ORTHO APPLIANCE

LINEA ALBA
- White line in the buccal mucosa

NICOTINA STOMATITIS
- Red dots, which are inflamed minor salivary duct openings
- histology of nicotina stomatitis : hyperkeratosis and acanthosis
- only premalignant in smokers

TRAUMATIC ULCER
- Very common
- Due to constant rubbing against sharp tooth surface

HAIRY TONGUE
- Will discuss in tongue lesions]]>197falsefullhttps://www.spreaker.com/episode/5-mucosal-viral-infections--49566135Oral infections are viral, bacterial, or fungal in nature. The most commonly encountered infections are viral, usually herpes simplex virus (HSV) infections.

Clinical presentation of viral infections depends on viral type: herpes causes mucosal ulceration (preceded by vesicles), human papillomavirus (HPV) typically induces a verruciform (warty) lesion, and Epstein-Barr virus (EBV) causes a white lesion (hairy leukoplakia).

Most bacterial and fungal infections manifest as chronic ulcers. The fungus Candida albicans can cause either white or red lesions.


VIRAL INFECTIONS

HERPES SIMPLEX VIRUS– stress /exam
PRIMARY
- Majority of primary herpetic infections are asymptomatic
- It affects pan-orally means anywhere in and around the mouth
- It is self-limiting- will go away on its own usually
- Common in childhood
- Treatment – palliative, painkillers usually

RECURRENT
- The HSV stays latent in trigeminal ganglion
- Triggered if body is highly stressed out. Or sunlight. Or is under immunosuppressives.
- Site – multiple ulcers 🡪 only on kertinized tissue ie. Attached gingiva, hard palate, vermillion border, etc – distinguishing factor from primary & secondary
- C/F – herpetic whitlow on finger tip of examined doc- so it is advised that dentist should not touch patient until it resides
- Herpes labialis 🡪 vermillion border
- Itching and vesicle appearance every year **
- Qn. Child came with pain and fatigue + multiple vesicles on hard palate (last year he had the same and went away after one week). – recurrent herpex simplex
- Rx - % acyclovir cream

VARICELLA ZOSTER – CHICKEN POX
- Chickenpox in childhood
- Itchy vescicles.
- Latent in trigeminal ganglion VZV
- Recurrent – HERPES ZOSTER / SHINGLES

SYNDROME RAMSY HUNT SYNDROME
- Herpes zoster reccurent inf In geniculate ganglion affecting cranial nerves 7 (facial) & 8 (vestibulopharyngeal) 🡪 facial paralysis, vertigo-dizziness, deafness-
- C/F : Herpes Zoster Rashes usually do not cross the midline, and is primarily in the thoracic region.
- Treatment - acyclovir

COCKSAKIE VIRUS – HERPANGINA
- Caused by COK SACKIE VIRUS
- Below 5 years children
- Hand-Foot-Mouth Disease
- Causes herpangina at Sites – post part of oral cavity 🡪 Soft palate, tonsil, uvula
- C/F – facial pallor, sore throat

MEASLES- Rubeola
- Viral infection – rubella virus
- Primary is self limiting
- mostly affecting children
- Koplik’s sign ***
- Bluish white spots on buccal mucosa
- Present before the onset of classical skin rash of measles as a sign
- Rx – Acyclovir

EPSTEIN BAR VIRUS EBV
- Oral hairy leukoplakia
- White patch on lateral tongue that does not wipe of
- Opportunistic infection
- Usually associated with HIV and the immunosuppression associated with that
EBV*** causes diseases like :
- Burkits lymophoma
- Nasopharyngeal carcinoma } cancers
- Infectious mononucleosis
- Oral hairy leaukoplakia } infection


Additional Notes:
HUMAN IMMUNODEFICIENCY VIRUS HIV – AIDS
- Slim disease
- Caused by retro virus(P24 antigen)
- Oral manifestationof HIV in a child – herpetic gingivostomatitis****
- Incubation period – 9-11 years***** (Hep B incubation period is 4 months)
- Most common cancer – Kapossi’s sarcoma

4 stages
Stage 1 — symptomatic
Stage 2 — asymptomatic
Stage 3 — T-cells damaged — thymus and lymphoid nodes affected ,Persistant generalised lymphadenopathy
Stage 4 — AIDS occurs — Body is completely weak and aquires infection


Scenario
Qn. A child born to an HIV +ve mother takes nystatin drop, diagnosis is candidiasis/oral thrush
- Prophylaxis if needle prick dentist
- Rx – 1 NRT + 2 NNRT for 4 weeks (for doctor)
Investigation
+ Screening test – ELISA
+ Confirmation — western Blot
+ Best investigation – PCR
+ Saliva in HIV is not contagious
+ Saliva in Hep B is contagious

HUMAN PAPILLOMA VIRUS
- Causes papilloma / wart
- Benign epithelial pedunculates/ sessile proliferation of skin or mucosa]]>https://api.spreaker.com/episode/49566135Wed, 27 Apr 2022 08:12:15 +0000The Gulfie DentistMUCOSAL – INFECTIONS Oral infections are viral, bacterial, or fungal in nature. The most commonly encountered infections are viral, usually herpes simplex virus (HSV) infections. Clinical presentation of viral infections depends on viral type:...Oral infections are viral, bacterial, or fungal in nature. The most commonly encountered infections are viral, usually herpes simplex virus (HSV) infections.

Clinical presentation of viral infections depends on viral type: herpes causes mucosal ulceration (preceded by vesicles), human papillomavirus (HPV) typically induces a verruciform (warty) lesion, and Epstein-Barr virus (EBV) causes a white lesion (hairy leukoplakia).

Most bacterial and fungal infections manifest as chronic ulcers. The fungus Candida albicans can cause either white or red lesions.


VIRAL INFECTIONS

HERPES SIMPLEX VIRUS– stress /exam
PRIMARY
- Majority of primary herpetic infections are asymptomatic
- It affects pan-orally means anywhere in and around the mouth
- It is self-limiting- will go away on its own usually
- Common in childhood
- Treatment – palliative, painkillers usually

RECURRENT
- The HSV stays latent in trigeminal ganglion
- Triggered if body is highly stressed out. Or sunlight. Or is under immunosuppressives.
- Site – multiple ulcers 🡪 only on kertinized tissue ie. Attached gingiva, hard palate, vermillion border, etc – distinguishing factor from primary & secondary
- C/F – herpetic whitlow on finger tip of examined doc- so it is advised that dentist should not touch patient until it resides
- Herpes labialis 🡪 vermillion border
- Itching and vesicle appearance every year **
- Qn. Child came with pain and fatigue + multiple vesicles on hard palate (last year he had the same and went away after one week). – recurrent herpex simplex
- Rx - % acyclovir cream

VARICELLA ZOSTER – CHICKEN POX
- Chickenpox in childhood
- Itchy vescicles.
- Latent in trigeminal ganglion VZV
- Recurrent – HERPES ZOSTER / SHINGLES

SYNDROME RAMSY HUNT SYNDROME
- Herpes zoster reccurent inf In geniculate ganglion affecting cranial nerves 7 (facial) & 8 (vestibulopharyngeal) 🡪 facial paralysis, vertigo-dizziness, deafness-
- C/F : Herpes Zoster Rashes usually do not cross the midline, and is primarily in the thoracic region.
- Treatment - acyclovir

COCKSAKIE VIRUS – HERPANGINA
- Caused by COK SACKIE VIRUS
- Below 5 years children
- Hand-Foot-Mouth Disease
- Causes herpangina at Sites – post part of oral cavity 🡪 Soft palate, tonsil, uvula
- C/F – facial pallor, sore throat

MEASLES- Rubeola
- Viral infection – rubella virus
- Primary is self limiting
- mostly affecting children
- Koplik’s sign ***
- Bluish white spots on buccal mucosa
- Present before the onset of classical skin rash of measles as a sign
- Rx – Acyclovir

EPSTEIN BAR VIRUS EBV
- Oral hairy leukoplakia
- White patch on lateral tongue that does not wipe of
- Opportunistic infection
- Usually associated with HIV and the immunosuppression associated with that
EBV*** causes diseases like :
- Burkits lymophoma
- Nasopharyngeal carcinoma } cancers
- Infectious mononucleosis
- Oral hairy leaukoplakia } infection


Additional Notes:
HUMAN IMMUNODEFICIENCY VIRUS HIV – AIDS
- Slim disease
- Caused by retro virus(P24 antigen)
- Oral manifestationof HIV in a child – herpetic gingivostomatitis****
- Incubation period – 9-11 years***** (Hep B incubation period is 4 months)
- Most common cancer – Kapossi’s sarcoma

4 stages
Stage 1 — symptomatic
Stage 2 — asymptomatic
Stage 3 — T-cells damaged — thymus and lymphoid nodes affected ,Persistant generalised lymphadenopathy
Stage 4 — AIDS occurs — Body is completely weak and aquires infection


Scenario
Qn. A child born to an HIV +ve mother takes nystatin drop, diagnosis is...]]>701falsefullhttps://www.spreaker.com/episode/6-mucosal-inf-bacterial-fungal--49566134
SYPHILIS
- Treponema palladium** (spirochetes),
- Sexually transmitted disease (STD)
- Primary 🡪secondary 🡪 tertiary 🡪 death
- WASSERMANS TEST

PRIMARY SYPHILIS
- Chancre – infectious ulcer – painless and indurated(not cancerous)
- Remember syphilis first appers as ulcer***
- Non contagious
- Site – dorsal surface of tongue

SECONDARY SYPHILIS
- Highly contagious
- Mucocutaneous lesion 🡪 split ulcer
- Eg: condyloma lacta 🡪 snail track ulcer

TERTIARY SYPHILIS
- Oral manifestation – gummatous ulcer in palate
- CNS involved, CVS also involed 🡪 becomes a systemic problem

CONGENITAL SYPHILIS
- In the baby who is born to a mother with syphilis
- Hutchinsons triad ∆ -- hearing loss, mulberry molars— screwdriver inciors, notched incisors . bulbous molar, ocular keratitis ( CORNEAL SCARRING), copper stained lesions.

- Egaw menosky ***
(thickening of clavicle) — facial VII nerve palsy + deafness
(not a feature of triad) — interstitial hyperkeratosis
- Rx – penicillin for 10 days
- Qn. 8years Patient came to your clinic has impaired hearing, upon examination his mouth you found copper color lesion, notched incisor and mass on the occlusal surface of the molars.

TUBERCULOSIS
- Caused by inhaling mycobacterium Tuberculosis
- Oral non-healing chronic ulcers, after lung infections
- PRIMARY 🡪 Ghon’s complex

SCARLET FEVER
- Caused by streptococcus pyogenes
- Candisiasis may be Seen on scarlet fever patients who are on continuos antibiotics****
- Strawberry appearance of tongue (white coated tongue with red inflamed fungiform papilla)– scarlet fever (bacterial infection)
- Treatment - pencillin

FUNGAL INFECTIONS

Candidiasis - ORAL THRUSH
- Fungal / poor oral hygiene
- Seen on scarlet fever patients who are on continuous antibiotics****
- Pseudomembraneous 🡪 white plaque that rubs off
- Ie. Scrapable , leaving erythmatic area. Basically looks like fungal dirt that you can remove by cleaning your tongue!!!
- Median rhomboid glossitis – seen in patients wearing denture –or renal pts **
- Nystatin topical or go for systemic nystatin
- But if pt has been on long term antibiotics – go for fluconazole. ****
- Child 3 yrs old with oral candidiasis ? Nystatin oral suspension************]]>https://api.spreaker.com/episode/49566134Wed, 27 Apr 2022 08:12:08 +0000The Gulfie DentistBACTERIAL INFECTIONS SYPHILIS - Treponema palladium** (spirochetes), - Sexually transmitted disease (STD) - Primary 🡪secondary 🡪 tertiary 🡪 death - WASSERMANS TEST PRIMARY SYPHILIS - Chancre – infectious ulcer – painless and...
SYPHILIS
- Treponema palladium** (spirochetes),
- Sexually transmitted disease (STD)
- Primary 🡪secondary 🡪 tertiary 🡪 death
- WASSERMANS TEST

PRIMARY SYPHILIS
- Chancre – infectious ulcer – painless and indurated(not cancerous)
- Remember syphilis first appers as ulcer***
- Non contagious
- Site – dorsal surface of tongue

SECONDARY SYPHILIS
- Highly contagious
- Mucocutaneous lesion 🡪 split ulcer
- Eg: condyloma lacta 🡪 snail track ulcer

TERTIARY SYPHILIS
- Oral manifestation – gummatous ulcer in palate
- CNS involved, CVS also involed 🡪 becomes a systemic problem

CONGENITAL SYPHILIS
- In the baby who is born to a mother with syphilis
- Hutchinsons triad ∆ -- hearing loss, mulberry molars— screwdriver inciors, notched incisors . bulbous molar, ocular keratitis ( CORNEAL SCARRING), copper stained lesions.

- Egaw menosky ***
(thickening of clavicle) — facial VII nerve palsy + deafness
(not a feature of triad) — interstitial hyperkeratosis
- Rx – penicillin for 10 days
- Qn. 8years Patient came to your clinic has impaired hearing, upon examination his mouth you found copper color lesion, notched incisor and mass on the occlusal surface of the molars.

TUBERCULOSIS
- Caused by inhaling mycobacterium Tuberculosis
- Oral non-healing chronic ulcers, after lung infections
- PRIMARY 🡪 Ghon’s complex

SCARLET FEVER
- Caused by streptococcus pyogenes
- Candisiasis may be Seen on scarlet fever patients who are on continuos antibiotics****
- Strawberry appearance of tongue (white coated tongue with red inflamed fungiform papilla)– scarlet fever (bacterial infection)
- Treatment - pencillin

FUNGAL INFECTIONS

Candidiasis - ORAL THRUSH
- Fungal / poor oral hygiene
- Seen on scarlet fever patients who are on continuous antibiotics****
- Pseudomembraneous 🡪 white plaque that rubs off
- Ie. Scrapable , leaving erythmatic area. Basically looks like fungal dirt that you can remove by cleaning your tongue!!!
- Median rhomboid glossitis – seen in patients wearing denture –or renal pts **
- Nystatin topical or go for systemic nystatin
- But if pt has been on long term antibiotics – go for fluconazole. ****
- Child 3 yrs old with oral candidiasis ? Nystatin oral suspension************]]>488falsefullhttps://www.spreaker.com/episode/7-mucosal-autoimmune--49566129These conditions are related to autoimmune (when our immune system attacks our own body) or hyperimmune (immune system just over reacts) reactions to some stimuli. Clinical manifestations include vesicles or bullae, ulcers, erythema, and white patches
They are treated with steroids !!

APHTHOUS ULCER
- Main cause Is stress
Site
- Present only in non keratinized tissue (opp to hsv infection)
- Ie; soft palate, buccal mucosa, ventral surface of tongue, labial mucosa,

Clinical Types of Aphthous Ulcers : MINOR & MAJOR

MINOR APHTHOUS ULCERS
- One to several painful oval ulcers 0.5 cm
- Very painful and may be debilitating
- May take several weeks to heal, even 21 days
- Will heal with scarring
- Rx Corticosteroids (triamcinolone ointment)
- Rx – Triamcinolone ointment or kenakort

Syndromes with Aphthous:
- Behcet syndrome – multiple aphthous ulcer + vasculitis
- Reiter syndrome – multiple aphthous ulcer + arthritis + urethritis + conjunctivitis

ERYTHEMA MULTIFORME
- Lesions seen on skin and mouth
- BULL’S EYE or Target or IRIS RIM lesion
- Allergic to medication like sulfa allergie, penicillin , barbiturate
- Infection like HSV + Mycoplasma
- Associated with Steven-Johnson Syndrome
- Type III hypersensitivity reaction
- Skin lesion + oral lesion + conjunctivitis + urethritis
- And Bull’s eye ulcers
- QN 🡪 the patient will have bulls eye on the skin and oral ulcers

LICHEN PLANUS
- Autoimmune disease of skin and mucous membrane
- Precipitating factors – stress + hep C***
- Site – skin + oral mucous membrane
- Variants – retricular lichen planus- most common
- Wickham’s striae
- H/F – civette bodies, rete pegs
- Grin’s span syndrome – hypertension + diabetes mellitus + lichen planus
- Rx – steroids (autoimmune na**)
- Long case picture shown white patches in buccal mucosa 15 yr old child had exams last week. Histopatholgy civatte bodies , hyperkeratosis etc
-Qn. Case 14 years old patient presents with white lace pattern lesions on skin and buccal mucosa, stressed, history of hep C 🡪lichen planus
- Rx corticosteroids

SYSTEMIC LUPUS ERYTHOMATOSIS
- Another auto immune disease
- Multiple organ involved
- Characteristic feature – BUTTERFLY RASH
- Rx corticosteroids

PEMPHIGUS VULGARIS
- Autoimmune – Ig G present
- Immune fluorescent test : +ve
- Most commonly affected site buccal 🡪 palatal 🡪lingual 🡪 labial
- Gingiva is least commonly affected site
- Auto antibodies against desmosomes**
- Rx – Steroids
C/F
- 1st Bullae + then painful vesicle
- Suprabasilar split**
- Acantholysis
- Intra epidermal
- Nickolskys sign +ve (also seen in Hailey – Hailey disease, toxic epidermolysis bullae)
Ie. When rubbing the affected skin 🡪 results in exfoliation of the skin
- Histopathology – Tzanck cells seen**

QN - The right corticosteroid daily dose for pemphigus vulgaris is: 50-100mg

STEROIDS - 100mg hydrocortisone. (Max. is 120mg. daily prednisone) 1-2 mg/kg/daily.
(max. is 120 mg. daily prednisone).

BULLOUS PEMPHIGOID
- Autoimmune – Ig G present
- Immune fluorescent test : +ve
- Auto antibodies against basement membrane**
- Rx – steroids
C/F
- Bullae + vesicle ( Remember it as BULLOUS PEMPHIGOID )
- Sub basilar split
- Sub epidermal bullae
- Nickolsky’s sign - -ve
- Desquamative gingivitis + skin lesion]]>https://api.spreaker.com/episode/49566129Wed, 27 Apr 2022 08:12:01 +0000The Gulfie DentistMUCOSAL – IMMUNOLOGIC These conditions are related to autoimmune (when our immune system attacks our own body) or hyperimmune (immune system just over reacts) reactions to some stimuli. Clinical manifestations include vesicles or bullae, ulcers,...These conditions are related to autoimmune (when our immune system attacks our own body) or hyperimmune (immune system just over reacts) reactions to some stimuli. Clinical manifestations include vesicles or bullae, ulcers, erythema, and white patches
They are treated with steroids !!

APHTHOUS ULCER
- Main cause Is stress
Site
- Present only in non keratinized tissue (opp to hsv infection)
- Ie; soft palate, buccal mucosa, ventral surface of tongue, labial mucosa,

Clinical Types of Aphthous Ulcers : MINOR & MAJOR

MINOR APHTHOUS ULCERS
- One to several painful oval ulcers 0.5 cm
- Very painful and may be debilitating
- May take several weeks to heal, even 21 days
- Will heal with scarring
- Rx Corticosteroids (triamcinolone ointment)
- Rx – Triamcinolone ointment or kenakort

Syndromes with Aphthous:
- Behcet syndrome – multiple aphthous ulcer + vasculitis
- Reiter syndrome – multiple aphthous ulcer + arthritis + urethritis + conjunctivitis

ERYTHEMA MULTIFORME
- Lesions seen on skin and mouth
- BULL’S EYE or Target or IRIS RIM lesion
- Allergic to medication like sulfa allergie, penicillin , barbiturate
- Infection like HSV + Mycoplasma
- Associated with Steven-Johnson Syndrome
- Type III hypersensitivity reaction
- Skin lesion + oral lesion + conjunctivitis + urethritis
- And Bull’s eye ulcers
- QN 🡪 the patient will have bulls eye on the skin and oral ulcers

LICHEN PLANUS
- Autoimmune disease of skin and mucous membrane
- Precipitating factors – stress + hep C***
- Site – skin + oral mucous membrane
- Variants – retricular lichen planus- most common
- Wickham’s striae
- H/F – civette bodies, rete pegs
- Grin’s span syndrome – hypertension + diabetes mellitus + lichen planus
- Rx – steroids (autoimmune na**)
- Long case picture shown white patches in buccal mucosa 15 yr old child had exams last week. Histopatholgy civatte bodies , hyperkeratosis etc
-Qn. Case 14 years old patient presents with white lace pattern lesions on skin and buccal mucosa, stressed, history of hep C 🡪lichen planus
- Rx corticosteroids

SYSTEMIC LUPUS ERYTHOMATOSIS
- Another auto immune disease
- Multiple organ involved
- Characteristic feature – BUTTERFLY RASH
- Rx corticosteroids

PEMPHIGUS VULGARIS
- Autoimmune – Ig G present
- Immune fluorescent test : +ve
- Most commonly affected site buccal 🡪 palatal 🡪lingual 🡪 labial
- Gingiva is least commonly affected site
- Auto antibodies against desmosomes**
- Rx – Steroids
C/F
- 1st Bullae + then painful vesicle
- Suprabasilar split**
- Acantholysis
- Intra epidermal
- Nickolskys sign +ve (also seen in Hailey – Hailey disease, toxic epidermolysis bullae)
Ie. When rubbing the affected skin 🡪 results in exfoliation of the skin
- Histopathology – Tzanck cells seen**

QN - The right corticosteroid daily dose for pemphigus vulgaris is: 50-100mg

STEROIDS - 100mg hydrocortisone. (Max. is 120mg. daily prednisone) 1-2 mg/kg/daily.
(max. is 120 mg. daily prednisone).

BULLOUS PEMPHIGOID
- Autoimmune – Ig G present
- Immune fluorescent test : +ve
- Auto antibodies against basement membrane**
- Rx – steroids
C/F
- Bullae + vesicle ( Remember it as BULLOUS PEMPHIGOID )
- Sub basilar split
- Sub epidermal bullae
- Nickolsky’s sign - -ve
- Desquamative gingivitis + skin lesion]]>752falsefullhttps://www.spreaker.com/episode/8-steroids--49566130
Examples are (usually taken 1mg/kg/day)
- Hydrocortisone
- Prednisolone
- Betamethasone
- Dexamethasone

INDICATION – AUTOIMMUNE DISEASES
- Sjogren’s syndrome
- Lichen planus
- Pemphigus + pemphigoid
- SLE+DLE
- OSMF
- Apthous ulcer
- Addisons disease – no adrenal glands
- Leukoplakia ∴ will be on long term steroid therapy


CONTRAINDICATION
- Viral infection
- D M
- Peptic Ulcer

STEROID SCENARIOS (long term steroid patients)
- QN Patient has adrenal insufficiency come to your clinic and start developing signs of adrenal crisis you would administer: 2 ml. (100 mg.) hydrocortisone

In a clinical scenario, there are 2 cases:
- If Patient takes steroid dose of 30-50 mg 🡪 * Double the dose of steroid just before the procedure on that day only, later follow normal dosage
- If pt taking above 50 mg 🡪 Follow same dosage , no changes required]]>https://api.spreaker.com/episode/49566130Wed, 27 Apr 2022 08:11:37 +0000The Gulfie DentistSTEROIDS Examples are (usually taken 1mg/kg/day) - Hydrocortisone - Prednisolone - Betamethasone - Dexamethasone INDICATION – AUTOIMMUNE DISEASES - Sjogren’s syndrome - Lichen planus - Pemphigus + pemphigoid -...
Examples are (usually taken 1mg/kg/day)
- Hydrocortisone
- Prednisolone
- Betamethasone
- Dexamethasone

INDICATION – AUTOIMMUNE DISEASES
- Sjogren’s syndrome
- Lichen planus
- Pemphigus + pemphigoid
- SLE+DLE
- OSMF
- Apthous ulcer
- Addisons disease – no adrenal glands
- Leukoplakia ∴ will be on long term steroid therapy


CONTRAINDICATION
- Viral infection
- D M
- Peptic Ulcer

STEROID SCENARIOS (long term steroid patients)
- QN Patient has adrenal insufficiency come to your clinic and start developing signs of adrenal crisis you would administer: 2 ml. (100 mg.) hydrocortisone

In a clinical scenario, there are 2 cases:
- If Patient takes steroid dose of 30-50 mg 🡪 * Double the dose of steroid just before the procedure on that day only, later follow normal dosage
- If pt taking above 50 mg 🡪 Follow same dosage , no changes required]]>166falsefullhttps://www.spreaker.com/episode/9-premalignant-lesion-condition--49566141
PRE MALIGNANT LESIONS AND CONDITIONS
Pre- malignant lesion – the lesion will become cancerous if the cause is not stopped / removed.
Pre – malignangt condition – the condition may become cancerous if the cause is not stopped / removed
Usually these lesions develop into SQCC.

LEUKOPLAKIA
- Most common pre – malignant lesion and condition
- White lesion
- Cause – tobacco
- Most common leukoplakia – Homogenous L
- Most dangerous leukoplakia – Verrucous L(growth present)
Rx
- Stop tobacco
- Vit .A, Steroids, Vit.E = adjunct therapy

ERYTHROPLAKIA
- Red lesion – ie. will become carcinoma
- Pre – malignant lesion
- 90% becomes cancer


DIFF BTWN WHITE LESION OF ORAL CAVITY :

Leukoplakia
- White colour
- Cause – Tobacco
- C/F – non scrapable
- Rx – stop tobacco

White Sponge Nevus
- White colour
- Familial or hereditary
- Scrapable, no erythema left
- No Rx.

OSMF - Oral submucosal fibrosis
- Cause – arecanut chewing
C/F
- Trismus
- Vertical band in buccal mucosa
- Burning sensation
- Rx for mild to moderate
- Hyaluronidase inj + steroids, xylocaine
Rx for severe cases – excision of bands]]>https://api.spreaker.com/episode/49566141Wed, 27 Apr 2022 08:11:22 +0000The Gulfie DentistMUCOSAL – PREMALIGNANT PRE MALIGNANT LESIONS AND CONDITIONS Pre- malignant lesion – the lesion will become cancerous if the cause is not stopped / removed. Pre – malignangt condition – the condition may become cancerous if the cause is not...
PRE MALIGNANT LESIONS AND CONDITIONS
Pre- malignant lesion – the lesion will become cancerous if the cause is not stopped / removed.
Pre – malignangt condition – the condition may become cancerous if the cause is not stopped / removed
Usually these lesions develop into SQCC.

LEUKOPLAKIA
- Most common pre – malignant lesion and condition
- White lesion
- Cause – tobacco
- Most common leukoplakia – Homogenous L
- Most dangerous leukoplakia – Verrucous L(growth present)
Rx
- Stop tobacco
- Vit .A, Steroids, Vit.E = adjunct therapy

ERYTHROPLAKIA
- Red lesion – ie. will become carcinoma
- Pre – malignant lesion
- 90% becomes cancer


DIFF BTWN WHITE LESION OF ORAL CAVITY :

Leukoplakia
- White colour
- Cause – Tobacco
- C/F – non scrapable
- Rx – stop tobacco

White Sponge Nevus
- White colour
- Familial or hereditary
- Scrapable, no erythema left
- No Rx.

OSMF - Oral submucosal fibrosis
- Cause – arecanut chewing
C/F
- Trismus
- Vertical band in buccal mucosa
- Burning sensation
- Rx for mild to moderate
- Hyaluronidase inj + steroids, xylocaine
Rx for severe cases – excision of bands]]>234falsefullhttps://www.spreaker.com/episode/10-mucosal-malignancy--49566132The various types of carcinomas can manifest as non-healing ulcers, red patches, or irregular surface masses.
- Carcinoma 🡪 epithelial
- Sarcoma 🡪 mesenchymal / Connective tissue
- Melanomas manifest as abnormally pigmented surface lesions that start at the junction of the epithelium and submucosa.


SQUAMMOUS CELL CARCINOMA
- QN - Stage of squamous cell carcinoma T2 N0 M0.
- The most common malignant tumor of oral cavity -mostly affecting lateral surface of the tongue, secondarily the hard palate.
- Associated with fixed and firm lymph nodes.
- Its primary stage is red patch/ plaque
- Most commonly seen intra orally
- Least common – nasopharynx
- Associated with Firm, fixed neck nodes

LIP SCC
- Reasons or Risk Factors:
+ Sunlight exposure
+ Human papilloma Virus (HPV)
+ Gene mutation
+ Tobacco chewing
- Usually has good prognosis
- If ulcer (SCC) is well differentiated– which is also the most common type – and shows late metastasis – therefore better prognosis
- If ulcer has already metastasised – then poor prognosis
- Plummer Vincent syndrome – mucosal atrophy + dysphagia + iron deficiency anemia + increased risk of ral cancer ie SQCC
- Qn. 21 y old pt who has iron deficiency anemia + difficulty swallowing(dysphagia) with examination of barium sulphate you found : SQCC

TONGUE SCC
- Lateral border of tongue – most common SQCC
- Usually metastasises fast ∴ poor prognosis
- High reccurrence
- Best biopsy for Sq. C C – INCISIONAL BIOPSY
- During biopsy – tongue secured to suture or towel clip + clip
- During examination – tongue secured by guaze piece

VERRUCOUS CARCINOMA
- It is a well differentiated form of SQCC
- It shows cauliflower shaped lesions on both sin & mucosa**
- Associated with betel nut chewing
- It is a malignant type of lesion
- Rx – surgical excision

BASAL CELL CARCINOMA
-Rodent ulcer
- Due to sun exposure

MALIGNANT MELANOMA
- Most dangerous tumor
- Malingnancy of melanocytes
- Most common intra oral site – gingiva – anteriorly & palate
- Least common – acral lentigo melanoma*
- Blackish discolouration
- Always originates from Nevus cells of connective Tissue

NOTE: Melanotic Pigmented intra – oral lesions:
- Malignant melanoma – black
- Addison’s disease – seen in steroid d
- Peutz Jagher’s Syndrome]]>https://api.spreaker.com/episode/49566132Wed, 27 Apr 2022 08:11:12 +0000The Gulfie DentistMUCOSAL – MALIGNANCIES The various types of carcinomas can manifest as non-healing ulcers, red patches, or irregular surface masses. - Carcinoma 🡪 epithelial - Sarcoma 🡪 mesenchymal / Connective tissue - Melanomas manifest as abnormally...The various types of carcinomas can manifest as non-healing ulcers, red patches, or irregular surface masses.
- Carcinoma 🡪 epithelial
- Sarcoma 🡪 mesenchymal / Connective tissue
- Melanomas manifest as abnormally pigmented surface lesions that start at the junction of the epithelium and submucosa.


SQUAMMOUS CELL CARCINOMA
- QN - Stage of squamous cell carcinoma T2 N0 M0.
- The most common malignant tumor of oral cavity -mostly affecting lateral surface of the tongue, secondarily the hard palate.
- Associated with fixed and firm lymph nodes.
- Its primary stage is red patch/ plaque
- Most commonly seen intra orally
- Least common – nasopharynx
- Associated with Firm, fixed neck nodes

LIP SCC
- Reasons or Risk Factors:
+ Sunlight exposure
+ Human papilloma Virus (HPV)
+ Gene mutation
+ Tobacco chewing
- Usually has good prognosis
- If ulcer (SCC) is well differentiated– which is also the most common type – and shows late metastasis – therefore better prognosis
- If ulcer has already metastasised – then poor prognosis
- Plummer Vincent syndrome – mucosal atrophy + dysphagia + iron deficiency anemia + increased risk of ral cancer ie SQCC
- Qn. 21 y old pt who has iron deficiency anemia + difficulty swallowing(dysphagia) with examination of barium sulphate you found : SQCC

TONGUE SCC
- Lateral border of tongue – most common SQCC
- Usually metastasises fast ∴ poor prognosis
- High reccurrence
- Best biopsy for Sq. C C – INCISIONAL BIOPSY
- During biopsy – tongue secured to suture or towel clip + clip
- During examination – tongue secured by guaze piece

VERRUCOUS CARCINOMA
- It is a well differentiated form of SQCC
- It shows cauliflower shaped lesions on both sin & mucosa**
- Associated with betel nut chewing
- It is a malignant type of lesion
- Rx – surgical excision

BASAL CELL CARCINOMA
-Rodent ulcer
- Due to sun exposure

MALIGNANT MELANOMA
- Most dangerous tumor
- Malingnancy of melanocytes
- Most common intra oral site – gingiva – anteriorly & palate
- Least common – acral lentigo melanoma*
- Blackish discolouration
- Always originates from Nevus cells of connective Tissue

NOTE: Melanotic Pigmented intra – oral lesions:
- Malignant melanoma – black
- Addison’s disease – seen in steroid d
- Peutz Jagher’s Syndrome]]>438falsefullhttps://www.spreaker.com/episode/11-ct-benign-tumors--49566136Connective tissue tumors manifest as masses (lumps or bumps) within the submucosa. Overlying epithelium is generally intact, unless ulceration occurs because of trauma to the lesion. These tumors generally fall into one of two groups: reactive or neoplastic.

A. REACTIVE

FIBROMA
- Traumatic fibroma
- Most common benign tumor in the oral cavity
- There is fibrous hyperplasia of the oral mucosa that is being traumatized
- Case picture lesion, patient all fine but he had traumatically bit the area
- Case of lesion in inner surface of lower lip n history of trauma

PAPILARY HYPERPLASIA
- Hyperplasia- overgrowth of soft tissue
- Below the denture
- Seen on the palate of denture wearing patients with poor hygine / denture over use / ill-fitting denture.

GINGIVAL HYPERPLASIA
- Talked about in Perio notes.

B. NEOPLASMS
Not asked in gulf exams usually.
- NEUROFIBROMA
- SCHWANOMMA /NEUROLEMMOMMA
- LIPOMA]]>https://api.spreaker.com/episode/49566136Wed, 27 Apr 2022 08:11:04 +0000The Gulfie DentistCT- BENIGN TUMORS Connective tissue tumors manifest as masses (lumps or bumps) within the submucosa. Overlying epithelium is generally intact, unless ulceration occurs because of trauma to the lesion. These tumors generally fall into one of two...Connective tissue tumors manifest as masses (lumps or bumps) within the submucosa. Overlying epithelium is generally intact, unless ulceration occurs because of trauma to the lesion. These tumors generally fall into one of two groups: reactive or neoplastic.

A. REACTIVE

FIBROMA
- Traumatic fibroma
- Most common benign tumor in the oral cavity
- There is fibrous hyperplasia of the oral mucosa that is being traumatized
- Case picture lesion, patient all fine but he had traumatically bit the area
- Case of lesion in inner surface of lower lip n history of trauma

PAPILARY HYPERPLASIA
- Hyperplasia- overgrowth of soft tissue
- Below the denture
- Seen on the palate of denture wearing patients with poor hygine / denture over use / ill-fitting denture.

GINGIVAL HYPERPLASIA
- Talked about in Perio notes.

B. NEOPLASMS
Not asked in gulf exams usually.
- NEUROFIBROMA
- SCHWANOMMA /NEUROLEMMOMMA
- LIPOMA]]>163falsefullhttps://www.spreaker.com/episode/12-ct-malignant-tumors--49566139
Sarcoma 🡪 mesenchymal / Connective tissue
Not asked in gulf exams usually.

a. FIBRES - FIBROSARCOMMA
b. NERVES - NEUROSARCOMMA
c. VASCULAR - KAPOSI’S SARCOMA

KAPOSI’S SARCOMA
- Malignant proliferation of endothelial cells.
- Characteristic Purple lesion
- Human herpes virus HHV-8 has etiologic role.
- Most commonly seen as a complication of AIDS
- May also be seen as endemic African type or classic Mediterranean type – where AIDS ratio is usually high.]]>https://api.spreaker.com/episode/49566139Wed, 27 Apr 2022 08:10:48 +0000The Gulfie DentistCT – TUMORS – MALIGNANT Sarcoma 🡪 mesenchymal / Connective tissue Not asked in gulf exams usually. a. FIBRES - FIBROSARCOMMA b. NERVES - NEUROSARCOMMA c. VASCULAR - KAPOSI’S SARCOMA KAPOSI’S SARCOMA - Malignant proliferation of...
Sarcoma 🡪 mesenchymal / Connective tissue
Not asked in gulf exams usually.

a. FIBRES - FIBROSARCOMMA
b. NERVES - NEUROSARCOMMA
c. VASCULAR - KAPOSI’S SARCOMA

KAPOSI’S SARCOMA
- Malignant proliferation of endothelial cells.
- Characteristic Purple lesion
- Human herpes virus HHV-8 has etiologic role.
- Most commonly seen as a complication of AIDS
- May also be seen as endemic African type or classic Mediterranean type – where AIDS ratio is usually high.]]>85falsefullhttps://www.spreaker.com/episode/13-salivary-gland-disorders--49566133
SUBMANDIBULAR GLAND
- Main contribution to saliva
- Salivary gland is functionally more important in swallowing
- Main site for sialolithiasis
- Predominantly serous(mixed)
- Warthons duct
- Open into the sublingual caruncle which is present on either side of lingual frenum.
- Corda Tympani branch of facial nerve VII

PAROTID GLAND
- Main site for pleomorphic adenoma
- Purely serous (other two are mixed though)
- Stensons duct
- Opens opp to Max 2nd Molar
- Glossopharyngeal nerve

SUBLINGUAL GLAND
- Ranula occurs
- Predominantly mucous (mixed)
- Bartholins duct or Duct of Ranvier
- Corda tympani branch of facial nerve VII

PHYSIOLOGICAL COMPOSITION OF SALIVA
- Ig A present – func: prevents colonisation of bacteria
- Saliva produced in gland is in itself isotonic to blood actualy
- But while it passes through the duct Na gets reabsorbed and becomes hypotonic
- This re-absorbtion is done by striated duct


PATHOLOGIES OF SALIVARY GLANDS

SIALOLITHIASIS
- Salivary gland duct stone or calculus
- Mainly in submandibular gland duct – Warthons
- Discomfort in the floor of mouth or the check which moves while eating
- Causes – high saliva content get mineralised high Ca+,P etc
- Anatomical position
- Torturous path of canal
- Investigations
--- Sialography
--- Occlusal radiograph
- Rx stone in duct 🡪 Incision
- Rx stone in gland 🡪 Excision
- Other 🡪 LithotripsY (Milking of duct)

FREY’S SYNDROME
- Due to nerve damage – auriculotemporal Nerve
- History of parotid / TMJ injury
- Pt c/o gustatory swelling while seeing food

NICOTINA STOMATITIS
- Red dots, which are inflamed minor salivary duct openings
- histology of nicotina stomatitis : hyperkeratosis and acanthosis
- only premalignant in smokers

XEROSTOMIA
- Reduced salivary production
- Ie;]]>https://api.spreaker.com/episode/49566133Wed, 27 Apr 2022 08:10:29 +0000The Gulfie DentistSALIVARY GLAND SUBMANDIBULAR GLAND - Main contribution to saliva - Salivary gland is functionally more important in swallowing - Main site for sialolithiasis - Predominantly serous(mixed) - Warthons duct -...
SUBMANDIBULAR GLAND
- Main contribution to saliva
- Salivary gland is functionally more important in swallowing
- Main site for sialolithiasis
- Predominantly serous(mixed)
- Warthons duct
- Open into the sublingual caruncle which is present on either side of lingual frenum.
- Corda Tympani branch of facial nerve VII

PAROTID GLAND
- Main site for pleomorphic adenoma
- Purely serous (other two are mixed though)
- Stensons duct
- Opens opp to Max 2nd Molar
- Glossopharyngeal nerve

SUBLINGUAL GLAND
- Ranula occurs
- Predominantly mucous (mixed)
- Bartholins duct or Duct of Ranvier
- Corda tympani branch of facial nerve VII

PHYSIOLOGICAL COMPOSITION OF SALIVA
- Ig A present – func: prevents colonisation of bacteria
- Saliva produced in gland is in itself isotonic to blood actualy
- But while it passes through the duct Na gets reabsorbed and becomes hypotonic
- This re-absorbtion is done by striated duct


PATHOLOGIES OF SALIVARY GLANDS

SIALOLITHIASIS
- Salivary gland duct stone or calculus
- Mainly in submandibular gland duct – Warthons
- Discomfort in the floor of mouth or the check which moves while eating
- Causes – high saliva content get mineralised high Ca+,P etc
- Anatomical position
- Torturous path of canal
- Investigations
--- Sialography
--- Occlusal radiograph
- Rx stone in duct 🡪 Incision
- Rx stone in gland 🡪 Excision
- Other 🡪 LithotripsY (Milking of duct)

FREY’S SYNDROME
- Due to nerve damage – auriculotemporal Nerve
- History of parotid / TMJ injury
- Pt c/o gustatory swelling while seeing food

NICOTINA STOMATITIS
- Red dots, which are inflamed minor salivary duct openings
- histology of nicotina stomatitis : hyperkeratosis and acanthosis
- only premalignant in smokers

XEROSTOMIA
- Reduced salivary production
- Ie;]]>814falsefullhttps://www.spreaker.com/episode/14-sg-reactive-benign-malignant-all--49566143
MUCOCELE
- site – minor salivary glands of lower lip
- Cause – trauma
- C/F - Translucent swelling
- Rx – excision

RANULA
- Mostly in sublingual gland
- Blue dome shaped swelling on the floor of mouth
- Rx – Marsupialization
- Excision only for recurrent ranula

NECROTISING SIALOMETAPLASIA
- Cause – ischemia to minor salivary glands, causing necrosis to it
- Common site – hard palate
- C/F – necrotized soft tissue due to ill-fitting denture
- Rx – correct the denture
- Lesion usually seen at the junction between hard & soft palate & surround by psudoepithelium hyperplasia in salivary gland.

MUMPS – virus
- Bilateral enlargement of parotid
- Pancreatitis
- Oopheritis/ orchitis
- Rx – acyclovir, 800mg/ 4 times a day

SARCOIDOSIS

SG – BENIGN TUMORS

PLEOMORPHIC ADENOMA
- Commonly associated with parotid gland
- Most common benign tumor of salivary glands as a whole.
- Slow growing swelling – ie. over 5 years also.
- Rx – superficial parotidectomy (to save facial Nerve)
Scenario
- Female patient c/o swelling, gives history of swelling being very slow ( 5 years back)
- A female patient who was earlier affected by a benign tumor in the neck , so the tumor in her parotid gland is pleomorphic( major benign)*

WARTHIN’S TUMOR

SG – MALIGNANT TUMORS

MUCOEPIDERMOID CARCINOMA
- Another carcinoma of salivary gland
- That metastasises to bone
- The most common malignant salivary gland tumor regarding major glands

ADENOID CYSTIC CARCINOMA
- The most common malignant salivary gland tumor regarding minor glands is adenoid cystic carcinoma.
- Slow growing with perineural invasion
- Histopathology – Under microscope there is basophilic islands of Swiss cheese appearance
- Perineural invasion present (metastasis)
- Spreads through nerve and reaches brain

LYMPHOID NEOPLASMS
- HODGEKINS LYMPHOMA
- NON HODGEKINS LYMPHOMA
- MULTIPLE MYOLEMMA
Primarily bone tumor (so see bone tumors)


LEUKEMIA

Case about child got fever with ulceration & many symptoms i forgot & asked about condition?
A- Acute myeloid leukemia
B- Acute lymphocytic leukemia**
C- Chronic lymphocytic leukemia]]>https://api.spreaker.com/episode/49566143Wed, 27 Apr 2022 08:10:20 +0000The Gulfie DentistSALIVARY GLANDS - REACTIVE MUCOCELE - site – minor salivary glands of lower lip - Cause – trauma - C/F - Translucent swelling - Rx – excision RANULA - Mostly in sublingual gland - Blue dome shaped swelling on the floor of mouth...
MUCOCELE
- site – minor salivary glands of lower lip
- Cause – trauma
- C/F - Translucent swelling
- Rx – excision

RANULA
- Mostly in sublingual gland
- Blue dome shaped swelling on the floor of mouth
- Rx – Marsupialization
- Excision only for recurrent ranula

NECROTISING SIALOMETAPLASIA
- Cause – ischemia to minor salivary glands, causing necrosis to it
- Common site – hard palate
- C/F – necrotized soft tissue due to ill-fitting denture
- Rx – correct the denture
- Lesion usually seen at the junction between hard & soft palate & surround by psudoepithelium hyperplasia in salivary gland.

MUMPS – virus
- Bilateral enlargement of parotid
- Pancreatitis
- Oopheritis/ orchitis
- Rx – acyclovir, 800mg/ 4 times a day

SARCOIDOSIS

SG – BENIGN TUMORS

PLEOMORPHIC ADENOMA
- Commonly associated with parotid gland
- Most common benign tumor of salivary glands as a whole.
- Slow growing swelling – ie. over 5 years also.
- Rx – superficial parotidectomy (to save facial Nerve)
Scenario
- Female patient c/o swelling, gives history of swelling being very slow ( 5 years back)
- A female patient who was earlier affected by a benign tumor in the neck , so the tumor in her parotid gland is pleomorphic( major benign)*

WARTHIN’S TUMOR

SG – MALIGNANT TUMORS

MUCOEPIDERMOID CARCINOMA
- Another carcinoma of salivary gland
- That metastasises to bone
- The most common malignant salivary gland tumor regarding major glands

ADENOID CYSTIC CARCINOMA
- The most common malignant salivary gland tumor regarding minor glands is adenoid cystic carcinoma.
- Slow growing with perineural invasion
- Histopathology – Under microscope there is basophilic islands of Swiss cheese appearance
- Perineural invasion present (metastasis)
- Spreads through nerve and reaches brain

LYMPHOID NEOPLASMS
- HODGEKINS LYMPHOMA
- NON HODGEKINS LYMPHOMA
- MULTIPLE MYOLEMMA
Primarily bone tumor (so see bone tumors)


LEUKEMIA

Case about child got fever with ulceration & many symptoms i forgot & asked about condition?
A- Acute myeloid leukemia
B- Acute lymphocytic leukemia**
C- Chronic lymphocytic leukemia]]>394falsefullhttps://www.spreaker.com/episode/15-tongue-physiology--49566140DEVELOPMENT OF TONGUE

Tongue develops from 1st ,3rd & 4th branchial arch not from 2nd arch
Anterior 2/3rd develops from Tuberculum Impar + Lingual swelling

BRANCHIAL ARCHES
- Mandibular N
- Facial N VII
- Glossopharyngeal N
- Vagus N X
- Rudimentary- disappears immediately after formation
- Vagus N

Muscles:
- Muscles of mastication – by arch 1
-Muscles of facial expression – by arch 2

MUSCLES OF MASTICATION (picture)


MUSCLES OF TONGUE
- Genioglossus
- Hyoglossus
- Styloglossus
- Palatoglossus

MOTOR N & SENSORY NERVES

MOTOR
- Palatoglossus – Vagus N X
- Other muscles – hypoglossal XII

SENSORY
- Post 1/3rd – Glossopharyngeal N
- Ant 2/3rd – Lingual branch of facial N

TASTE
- Post 1/3rd - Glossopharyngeal
- Ant 2/3rd – Chorda tympani branch from lingual branch of facial nerve

CRANIAL NERVES
CN I – OLFACTORY N
CN II – OPTIC N
CN III – OCCULOMOTOR N
CN IV – TROCHLEAR N
CN V – TRIGEMINAL N
CN VI – ABDUCENS N
CN VII – FACIAL N
CN VIII – VESTIBULOPHARYNGEAL N
CN IX – GLOSSOPHARYNGEAL N
CN X – VAGUS N
CN XI – SPINAL ACCESSORY N
CN XII – HYPOGLOSSAL N


PAPILLAE OF TONGUE:

FILLIFORM PAPILLA
- Most numerous
- Does not contain taste buds
- 1st to disappear in tongue disease
- Eg: geographic tongue

Fungiform papillae (sweet)
- Most numerous at the tip of the tongue
- Inflamed fungiform papillae – strawberry tongue
- Elongates in hairy tongue

Foliate papilla (salt + sour)
- Present in the lateral border of the tongue
- Circumvallate papilla (bitter)
- Seen anterior to the sulcus terminale
- Contains Von Ebner glands(minor salivary) that produces Gusten – taste proteins

TASTE SENSATIONS
- Tip – sweet
- Anterior anterior lateral – salt
- Posterior posterior lateral – sour
- Posterior most – bitter]]>https://api.spreaker.com/episode/49566140Wed, 27 Apr 2022 08:10:05 +0000The Gulfie DentistTONGUE DEVELOPMENT OF TONGUE Tongue develops from 1st ,3rd & 4th branchial arch not from 2nd arch Anterior 2/3rd develops from Tuberculum Impar + Lingual swelling BRANCHIAL ARCHES - Mandibular N - Facial N VII - Glossopharyngeal N -...DEVELOPMENT OF TONGUE

Tongue develops from 1st ,3rd & 4th branchial arch not from 2nd arch
Anterior 2/3rd develops from Tuberculum Impar + Lingual swelling

BRANCHIAL ARCHES
- Mandibular N
- Facial N VII
- Glossopharyngeal N
- Vagus N X
- Rudimentary- disappears immediately after formation
- Vagus N

Muscles:
- Muscles of mastication – by arch 1
-Muscles of facial expression – by arch 2

MUSCLES OF MASTICATION (picture)


MUSCLES OF TONGUE
- Genioglossus
- Hyoglossus
- Styloglossus
- Palatoglossus

MOTOR N & SENSORY NERVES

MOTOR
- Palatoglossus – Vagus N X
- Other muscles – hypoglossal XII

SENSORY
- Post 1/3rd – Glossopharyngeal N
- Ant 2/3rd – Lingual branch of facial N

TASTE
- Post 1/3rd - Glossopharyngeal
- Ant 2/3rd – Chorda tympani branch from lingual branch of facial nerve

CRANIAL NERVES
CN I – OLFACTORY N
CN II – OPTIC N
CN III – OCCULOMOTOR N
CN IV – TROCHLEAR N
CN V – TRIGEMINAL N
CN VI – ABDUCENS N
CN VII – FACIAL N
CN VIII – VESTIBULOPHARYNGEAL N
CN IX – GLOSSOPHARYNGEAL N
CN X – VAGUS N
CN XI – SPINAL ACCESSORY N
CN XII – HYPOGLOSSAL N


PAPILLAE OF TONGUE:

FILLIFORM PAPILLA
- Most numerous
- Does not contain taste buds
- 1st to disappear in tongue disease
- Eg: geographic tongue

Fungiform papillae (sweet)
- Most numerous at the tip of the tongue
- Inflamed fungiform papillae – strawberry tongue
- Elongates in hairy tongue

Foliate papilla (salt + sour)
- Present in the lateral border of the tongue
- Circumvallate papilla (bitter)
- Seen anterior to the sulcus terminale
- Contains Von Ebner glands(minor salivary) that produces Gusten – taste proteins

TASTE SENSATIONS
- Tip – sweet
- Anterior anterior lateral – salt
- Posterior posterior lateral – sour
- Posterior most – bitter]]>496falsefullhttps://www.spreaker.com/episode/16-tongue-pathology--49566138
GEOGRAPHIC TONGUE
- Erythema migrans / Benign migratory glossitis – other names
- Systemic disease associated
- Psoriasis
- DM****
- Iron deficiency anaemia
- Papilla missing - filliform papilla
- C/F – fissured (scrotal tongue is seen)
- Rx – no Rx required

FISSURED TONGUE
- MELKERSEN – ROSANTHAL SYNDROME
- Facial nerve palsy + fissured tongue + chelitis granulomatosum
- C/F –
- Lip deviates to opp/ unaffected side
- Wide opening of eye on normal side

MEDIAN RHOMBOID GLOSSITIS
- On the midline of tongue
- Seen in chronic candidiasis condition
- Rx – topical nystatin application
- Organism – candida albicans infection

HAIRY TONGUE – HAIRY TRICHOGLOSSIA
- It is a type of reactive lesion on the tongue. This is temporary.
- Elongation of filiform papilla
- Trichosmatosis / Lingua villosa – other names
- Causative factors
- Heavy smoking
- Corticosteroids
- Extended use of Broad spectrum antibiotics
- Hydrogen Peroxide Mouthwash
- Causes lengthening of papilla ans staining from bacteria, yeast, food, tobacco.
- Cauasitve organisms are bacterial or fungal here.
- Gives black or green furry appearence
- Poor oral hygiene
- Chromogenic bacteria

ORAL HAIRY LEUKOPLAKIA
- This is not hairy tongue.
- Commonly seen with – HIV infected patients
- Caused by – Epstein Bar Virus (EBV)
- White lesion mostly
- EBV*** causing other diseases are:
+ Burkits lymophoma
+ Nasopharyngeal carcinoma } cancers
+ Infectious mononucleosis
+ Oral hairy leaukoplakia } infection]]>https://api.spreaker.com/episode/49566138Wed, 27 Apr 2022 08:09:51 +0000The Gulfie DentistPATHOLOGIES OF TONGUE GEOGRAPHIC TONGUE - Erythema migrans / Benign migratory glossitis – other names - Systemic disease associated - Psoriasis - DM**** - Iron deficiency anaemia - Papilla missing - filliform papilla - C/F –...
GEOGRAPHIC TONGUE
- Erythema migrans / Benign migratory glossitis – other names
- Systemic disease associated
- Psoriasis
- DM****
- Iron deficiency anaemia
- Papilla missing - filliform papilla
- C/F – fissured (scrotal tongue is seen)
- Rx – no Rx required

FISSURED TONGUE
- MELKERSEN – ROSANTHAL SYNDROME
- Facial nerve palsy + fissured tongue + chelitis granulomatosum
- C/F –
- Lip deviates to opp/ unaffected side
- Wide opening of eye on normal side

MEDIAN RHOMBOID GLOSSITIS
- On the midline of tongue
- Seen in chronic candidiasis condition
- Rx – topical nystatin application
- Organism – candida albicans infection

HAIRY TONGUE – HAIRY TRICHOGLOSSIA
- It is a type of reactive lesion on the tongue. This is temporary.
- Elongation of filiform papilla
- Trichosmatosis / Lingua villosa – other names
- Causative factors
- Heavy smoking
- Corticosteroids
- Extended use of Broad spectrum antibiotics
- Hydrogen Peroxide Mouthwash
- Causes lengthening of papilla ans staining from bacteria, yeast, food, tobacco.
- Cauasitve organisms are bacterial or fungal here.
- Gives black or green furry appearence
- Poor oral hygiene
- Chromogenic bacteria

ORAL HAIRY LEUKOPLAKIA
- This is not hairy tongue.
- Commonly seen with – HIV infected patients
- Caused by – Epstein Bar Virus (EBV)
- White lesion mostly
- EBV*** causing other diseases are:
+ Burkits lymophoma
+ Nasopharyngeal carcinoma } cancers
+ Infectious mononucleosis
+ Oral hairy leaukoplakia } infection]]>314falsefullhttps://www.spreaker.com/episode/17-nerve-diseases-infections-1-of-2--49566890
TRIGEMINAL NEURALGIA
- Lancinating pain unilaterally when trigger zone is stimulated
- Nerve involved is the 5th cranial nerve ie. trigeminal nerve
- Maxillary division V2 has shown highest involvement
- Then mandibular division V3
- Least involvement is seen with ophthalmic nerve V1
- V2> V3> V1
Rx
+ Carbamazepine (antiepileptic) + Beclofen
+ Maximum dose = 1200mg/ day*****
+ Starting dose = 50mg/ day

QN - Trigeminal neuralgia treated by carbamazepine, the dose per day divided in doses is:600-1200 mg ...At least once every 3 months
a. Initial: On the 1st day, 100 mg b.i.d. for a total daily dose of 200 mg. may increase to i. 200 mg/day
b. Maintenance: Control of pain can be in most patients with 400 to 800 mg daily.
c. However, 1200 mg daily. At least once every 3 months

BELL’S / FACIAL NERVE PALSY
- Facial nerve foramen – stylomastoid foramen
- Bells / Facial palsy – due to ischemia to facial nerve in the parotid capsule
- Facial nerve palsy + loss of taste sensation to anterior 2/3rd of tongue🡪 due to injury to the upper part of facial nerve, –ie. before origin of chorda tympani]]>https://api.spreaker.com/episode/49566890Wed, 27 Apr 2022 08:09:38 +0000The Gulfie DentistNERVE DISEASES TRIGEMINAL NEURALGIA - Lancinating pain unilaterally when trigger zone is stimulated - Nerve involved is the 5th cranial nerve ie. trigeminal nerve - Maxillary division V2 has shown highest involvement - Then mandibular...
TRIGEMINAL NEURALGIA
- Lancinating pain unilaterally when trigger zone is stimulated
- Nerve involved is the 5th cranial nerve ie. trigeminal nerve
- Maxillary division V2 has shown highest involvement
- Then mandibular division V3
- Least involvement is seen with ophthalmic nerve V1
- V2> V3> V1
Rx
+ Carbamazepine (antiepileptic) + Beclofen
+ Maximum dose = 1200mg/ day*****
+ Starting dose = 50mg/ day

QN - Trigeminal neuralgia treated by carbamazepine, the dose per day divided in doses is:600-1200 mg ...At least once every 3 months
a. Initial: On the 1st day, 100 mg b.i.d. for a total daily dose of 200 mg. may increase to i. 200 mg/day
b. Maintenance: Control of pain can be in most patients with 400 to 800 mg daily.
c. However, 1200 mg daily. At least once every 3 months

BELL’S / FACIAL NERVE PALSY
- Facial nerve foramen – stylomastoid foramen
- Bells / Facial palsy – due to ischemia to facial nerve in the parotid capsule
- Facial nerve palsy + loss of taste sensation to anterior 2/3rd of tongue🡪 due to injury to the upper part of facial nerve, –ie. before origin of chorda tympani]]>275falsefullhttps://www.spreaker.com/episode/18-hormonal-diseases--49566885Thyroid & parathyroid are 2 endocrine glands in our body. Thyroid glands you see the lobes on either side, whereas the parathyroid glands are four tiny glands located behind the thyroid gland
The thyroid gland uses iodine from food to make two thyroid hormones that regulate the way the body uses energy, ie. the metabolism of the body.
The parathyroid glands produce a parathyroid hormone that helps control the calcium ion levels in the blood

HYPERTHYROIDISM
Hyperthyroidism is excess production of thyroxine hormone thus increasing the metabolism !!
C/F are
- Weight loss
- Rapid/irregular heartbeat
- Sweating & Feeling hot
- Irritability
- Forgetfulness
- Difficulty in focusing
- Bulging eyes
- Fatser metabolism
- Infertility
- Insomnias
- Gastritis
- Goiter (swelling in neck) (enlarged thyroid)

HYPOTHYROIDISM
In children – Cretinism
In adults – Myxodema
C/F
- Weight gain
- Puffy face
- Constipation
- Depression
- Dry skin
- Cold intolerance
- Brittle nails
- Heavy menstruation
- Memory loss
- Muscle aches
- Arthritis
- Slow heartbeat

If growth hormone decrease in children – Dwarfism
If growth hormone decrease in adult — GHD (Growth Hormone Deficiency)
If growth hormone increase in children – Gigantism
If growth hormone increase in adults – Acromegaly


HYPERPARATHYROIDISM
- Secretes too much parathyroid hormone (PTH)
- Increase in Calcium levels in blood- causing HYPERCALCEMIA
C/F mouth
- Hypercalcemia may result in sialolithiasis
- Mandibular tori may be seen
- BROWN TUMOR of the jaw bone showing Multiple radiolocencies and histopathology showing multinucleated giant cells
- Dental findings
+ early eruption of permanent teeth
+ Teeth become tender on percussion
+ loss/absence of lamina dura
+ floating teeth

C/F – stones – bones – moans – groans
- Pain in bone
- Abdominal
- Renal stone****
- Psychic moan
- Von Recklinghans disease of bone
- Menopause
- Endocrine disorder
- Rx – resection of parathyroid gland

CASE SCENARIOS
- Patient with mental confusion, renal calculi ,and high alkaline phosphatase
- Image of floating teeth
- Multiple fractures , multiple radiolucencies at the angle of mandible , usually associated with Renal Failure***
- Patient with renal dialysis- the best time of dental treatment 🡪 1 day after dialysis.]]>https://api.spreaker.com/episode/49566885Wed, 27 Apr 2022 08:09:13 +0000The Gulfie DentistHORMONAL DISEASES Thyroid & parathyroid are 2 endocrine glands in our body. Thyroid glands you see the lobes on either side, whereas the parathyroid glands are four tiny glands located behind the thyroid gland The thyroid gland uses iodine from...Thyroid & parathyroid are 2 endocrine glands in our body. Thyroid glands you see the lobes on either side, whereas the parathyroid glands are four tiny glands located behind the thyroid gland
The thyroid gland uses iodine from food to make two thyroid hormones that regulate the way the body uses energy, ie. the metabolism of the body.
The parathyroid glands produce a parathyroid hormone that helps control the calcium ion levels in the blood

HYPERTHYROIDISM
Hyperthyroidism is excess production of thyroxine hormone thus increasing the metabolism !!
C/F are
- Weight loss
- Rapid/irregular heartbeat
- Sweating & Feeling hot
- Irritability
- Forgetfulness
- Difficulty in focusing
- Bulging eyes
- Fatser metabolism
- Infertility
- Insomnias
- Gastritis
- Goiter (swelling in neck) (enlarged thyroid)

HYPOTHYROIDISM
In children – Cretinism
In adults – Myxodema
C/F
- Weight gain
- Puffy face
- Constipation
- Depression
- Dry skin
- Cold intolerance
- Brittle nails
- Heavy menstruation
- Memory loss
- Muscle aches
- Arthritis
- Slow heartbeat

If growth hormone decrease in children – Dwarfism
If growth hormone decrease in adult — GHD (Growth Hormone Deficiency)
If growth hormone increase in children – Gigantism
If growth hormone increase in adults – Acromegaly


HYPERPARATHYROIDISM
- Secretes too much parathyroid hormone (PTH)
- Increase in Calcium levels in blood- causing HYPERCALCEMIA
C/F mouth
- Hypercalcemia may result in sialolithiasis
- Mandibular tori may be seen
- BROWN TUMOR of the jaw bone showing Multiple radiolocencies and histopathology showing multinucleated giant cells
- Dental findings
+ early eruption of permanent teeth
+ Teeth become tender on percussion
+ loss/absence of lamina dura
+ floating teeth

C/F – stones – bones – moans – groans
- Pain in bone
- Abdominal
- Renal stone****
- Psychic moan
- Von Recklinghans disease of bone
- Menopause
- Endocrine disorder
- Rx – resection of parathyroid gland

CASE SCENARIOS
- Patient with mental confusion, renal calculi ,and high alkaline phosphatase
- Image of floating teeth
- Multiple fractures , multiple radiolucencies at the angle of mandible , usually associated with Renal Failure***
- Patient with renal dialysis- the best time of dental treatment 🡪 1 day after dialysis.]]>441falsefullhttps://www.spreaker.com/episode/19-odontogenic-infections--49566866
LUDWIG’S ANGINA
- Often from odontogenic infection that spreads into the facial spaces.
- All 3 facial Spaces involved bilaterally
+ Sub mental
+ Sub lingual
+ Sub mandibular
C/F
- Bilateral swelling of neck – diffuse (BULL NECK)
- Tongue raised
- Slight opened mouth
- Trismus
- Grossly decayed mandibular molars
Complication
- Respiratory obstruction + dehydration
Rx
- Incision and Drainage – cricothyroidectomy
- Penicillin + gentamycin

CELLULITIS
- Caused by necrotic primary / permanent tooth.
- Swelling of face & neck.
- Causative organism – Streptococcus & Staphylococcus
- Called as Ludwig’s angina if spreading to the three spaces
- Which is much sever and can even prove to be fatal due to breathing restriction
- Seen in children also, and is harder to treat in children due to faster dehydration than adults.
- Rx – penicillin

PERICORONITIS (take down notes, PLEASE IGNORE THE AUDIO OF THIS PART)
- Caused by – food impaction
- bite trauma from opposing tooth
- C/F – inflamed tissue
- Rx – irrigation, periodontal currettage, operculectomy
- Rx for recurrent caries – extraction of mandibular 3rd molar (NOT UPPER OKAY)]]>https://api.spreaker.com/episode/49566866Wed, 27 Apr 2022 08:07:36 +0000The Gulfie DentistODONTOGENIC INFECTIONS LUDWIG’S ANGINA - Often from odontogenic infection that spreads into the facial spaces. - All 3 facial Spaces involved bilaterally + Sub mental + Sub lingual + Sub mandibular C/F - Bilateral swelling of neck –...
LUDWIG’S ANGINA
- Often from odontogenic infection that spreads into the facial spaces.
- All 3 facial Spaces involved bilaterally
+ Sub mental
+ Sub lingual
+ Sub mandibular
C/F
- Bilateral swelling of neck – diffuse (BULL NECK)
- Tongue raised
- Slight opened mouth
- Trismus
- Grossly decayed mandibular molars
Complication
- Respiratory obstruction + dehydration
Rx
- Incision and Drainage – cricothyroidectomy
- Penicillin + gentamycin

CELLULITIS
- Caused by necrotic primary / permanent tooth.
- Swelling of face & neck.
- Causative organism – Streptococcus & Staphylococcus
- Called as Ludwig’s angina if spreading to the three spaces
- Which is much sever and can even prove to be fatal due to breathing restriction
- Seen in children also, and is harder to treat in children due to faster dehydration than adults.
- Rx – penicillin

PERICORONITIS (take down notes, PLEASE IGNORE THE AUDIO OF THIS PART)
- Caused by – food impaction
- bite trauma from opposing tooth
- C/F – inflamed tissue
- Rx – irrigation, periodontal currettage, operculectomy
- Rx for recurrent caries – extraction of mandibular 3rd molar (NOT UPPER OKAY)]]>214falsefullhttps://www.spreaker.com/episode/20-odontogenic-cysts--49566144
Radicular cyst
- Most common odontogenic cyst – Radicular / periapical cyst
- Periapical cyst or radicular cyst- CELL RESTS OF MALASSEZ
- A well-defined, round or ovoid radiolucency is associated with the root apex or, less commonly in the lateral position, of a heavily restored or grossly carious tooth.
- A corticated margin is continuous with the lamina dura of the root of the affected tooth.
- The appearances are similar to those of an apical granuloma, but lesions with a diameter exceeding 10 mm are more likely to be cystic

DENTIGEROUS CYST / PERICORONAL CYST
- Pericoronal radiolucency greater than 3–4 mm in width
- Cyst formation is in the dental follicle.
- The well-defined, corticated radiolucency is associated with the crown of an unerupted/ impacted tooth.
- Classically the associated crown of the tooth lies centrally within the cyst, but lateral types occur
- Has clear golden yellow fluid on aspiration***?
- FNAC needle size – 19 guage
- ORIGIN : Reduced enamel epithelium**🡪 But after formation, cyst lined by stratified squamous epithelium

CASE SCENARIO
- Radiolucency associated with impacted tooth, only crown involved
- Case 12 yr old child swelling in area 44 45 (missing 45) xray radiolucency around crown 45 + radio-opaque specks.
- TREATMENT : Marsupialization

LATERAL PERIODONTAL cyst
BOTRIOD CYST
- Polycystic lateral periodontal cyst*******

GINGIVAL CYST IN NEWBORN

Bohns
- Seen scattered all over the hard palate, mainly at the junction of hard palate and soft palate
- Also seen on gum pads as well.

Epstein Pearls
- Seen in only the mid palatal raphae
- 45 days baby during examination we find asymptomatic white, multiple nodules the midline of the palate
- No Rx required, heads by itself

OKC - Odontogenic keratocyst
- There is a well-defined radiolucency in Odontogenic keratocysts, often with densely corticated margins. The shape margins may be ‘scalloped’ in shape.
- Occasionally, there is a multilocular appearance. Expansion typically limited, with a propensity to grow along the medullary cavity
- Site – posterior body of mandible ie. Ramus area
- Root will be seen in the radiolucent site
- Recently classifies by WHO as odontogenic tumour as KOT(keratocystic odontogenic tumor)
- Highest recurrence rate in cysts / tumor (odontogenic) (broad entity)
- Why recurrence –
+ due to keratinized epithelial lining
+ Presence of daughter cysts that may be left out due to incomplete removal of the original cyst lining.
- Origin – cell rest of serres
- Rx – enucleation + chemical + resection
+ Curettage
- Associated syndrome – Nevoid basal cell carcinoma syndrome]]>https://api.spreaker.com/episode/49566144Wed, 27 Apr 2022 08:07:29 +0000The Gulfie DentistODONTOGENIC CYSTS Radicular cyst - Most common odontogenic cyst – Radicular / periapical cyst - Periapical cyst or radicular cyst- CELL RESTS OF MALASSEZ - A well-defined, round or ovoid radiolucency is associated with the root apex or, less...
Radicular cyst
- Most common odontogenic cyst – Radicular / periapical cyst
- Periapical cyst or radicular cyst- CELL RESTS OF MALASSEZ
- A well-defined, round or ovoid radiolucency is associated with the root apex or, less commonly in the lateral position, of a heavily restored or grossly carious tooth.
- A corticated margin is continuous with the lamina dura of the root of the affected tooth.
- The appearances are similar to those of an apical granuloma, but lesions with a diameter exceeding 10 mm are more likely to be cystic

DENTIGEROUS CYST / PERICORONAL CYST
- Pericoronal radiolucency greater than 3–4 mm in width
- Cyst formation is in the dental follicle.
- The well-defined, corticated radiolucency is associated with the crown of an unerupted/ impacted tooth.
- Classically the associated crown of the tooth lies centrally within the cyst, but lateral types occur
- Has clear golden yellow fluid on aspiration***?
- FNAC needle size – 19 guage
- ORIGIN : Reduced enamel epithelium**🡪 But after formation, cyst lined by stratified squamous epithelium

CASE SCENARIO
- Radiolucency associated with impacted tooth, only crown involved
- Case 12 yr old child swelling in area 44 45 (missing 45) xray radiolucency around crown 45 + radio-opaque specks.
- TREATMENT : Marsupialization

LATERAL PERIODONTAL cyst
BOTRIOD CYST
- Polycystic lateral periodontal cyst*******

GINGIVAL CYST IN NEWBORN

Bohns
- Seen scattered all over the hard palate, mainly at the junction of hard palate and soft palate
- Also seen on gum pads as well.

Epstein Pearls
- Seen in only the mid palatal raphae
- 45 days baby during examination we find asymptomatic white, multiple nodules the midline of the palate
- No Rx required, heads by itself

OKC - Odontogenic keratocyst
- There is a well-defined radiolucency in Odontogenic keratocysts, often with densely corticated margins. The shape margins may be ‘scalloped’ in shape.
- Occasionally, there is a multilocular appearance. Expansion typically limited, with a propensity to grow along the medullary cavity
- Site – posterior body of mandible ie. Ramus area
- Root will be seen in the radiolucent site
- Recently classifies by WHO as odontogenic tumour as KOT(keratocystic odontogenic tumor)
- Highest recurrence rate in cysts / tumor (odontogenic) (broad entity)
- Why recurrence –
+ due to keratinized epithelial lining
+ Presence of daughter cysts that may be left out due to incomplete removal of the original cyst lining.
- Origin – cell rest of serres
- Rx – enucleation + chemical + resection
+ Curettage
- Associated syndrome – Nevoid basal cell carcinoma syndrome]]>471falsefullhttps://www.spreaker.com/episode/21-odontogenic-tumors--49566142
AMELOBLASTOMA
- R/F – tennis net, honey comb, soap bubble
- Site – post body of mandible 🡪 Molar region
- Root is not present in the radiolucency because this is a tissue mass, so root is resorbed or displaced
- Seen above 40 years age
- 1st WHO odontogenic classifies tumor
- Most common variant – follicular ameloblastoma
- Most aggressive – granular A
- Highest recurrence odontogenic tumor
Origin
- Reduced enamel epithelium
- Arises from walls of dentigerous cyst
- Review atleast for 10 years for any recurrence
Rx
- For unilocular A – enucleation
- For multilocular A – Enblock resection or hemimandibulectomy with reconstruction plates

CEOT
- Pindbord tumor
- Calcifying epithelial odontogenic tumor
- Ghost cells present Histologic imaging – CEOT
- Most common – posterior mandible

ADENOMATOID ODONTOGENIC TUMOR (AOT)
- It occurs in anterior maxilla or mandible usually associated with an impacted canine

ODONTOMA – Tumor of tooth
- Hamartomas of Odontogenic epithelium and mesenchyme
- Usually found between ages 10 and 20 years
- It is only benign n simply needs to be removed.
- Develop like surrounding teeth with initial (crypt-like) radiolucent phase, intermediate stage of mixed radiolucency, finally densely radiopaque
- Rx – enucleation

COMPLEX ODONTOMA
- Irregular mass like appearance
- Seen in posterior mostly – PM MOLAR REGION

COMPOUND ODONTOMA
- Round symmetrical appearance
- Seen in anterior and PMs
- Single rooted tooth

CEMENTOBLASTOMA
- Tumor of cementum
- Slow growing Radiopaque surrounded by radiolucent margin but no caries associated & tooth is Vital
- Causes expansion of the bony cortex.

HYPERCEMENTOSIS
- Just excess deposition of cementum.
- Protective mechanism to bruxism, Paget’s disease & Down’s syndrome.

CONDENSING OSTEITIS
- Caries/ deep rests
- Vital / non – vital
- Mixed with radiolucency of PDL separating]]>https://api.spreaker.com/episode/49566142Wed, 27 Apr 2022 08:07:23 +0000The Gulfie DentistODONTOGENIC TUMORS AMELOBLASTOMA - R/F – tennis net, honey comb, soap bubble - Site – post body of mandible 🡪 Molar region - Root is not present in the radiolucency because this is a tissue mass, so root is resorbed or displaced - Seen...
AMELOBLASTOMA
- R/F – tennis net, honey comb, soap bubble
- Site – post body of mandible 🡪 Molar region
- Root is not present in the radiolucency because this is a tissue mass, so root is resorbed or displaced
- Seen above 40 years age
- 1st WHO odontogenic classifies tumor
- Most common variant – follicular ameloblastoma
- Most aggressive – granular A
- Highest recurrence odontogenic tumor
Origin
- Reduced enamel epithelium
- Arises from walls of dentigerous cyst
- Review atleast for 10 years for any recurrence
Rx
- For unilocular A – enucleation
- For multilocular A – Enblock resection or hemimandibulectomy with reconstruction plates

CEOT
- Pindbord tumor
- Calcifying epithelial odontogenic tumor
- Ghost cells present Histologic imaging – CEOT
- Most common – posterior mandible

ADENOMATOID ODONTOGENIC TUMOR (AOT)
- It occurs in anterior maxilla or mandible usually associated with an impacted canine

ODONTOMA – Tumor of tooth
- Hamartomas of Odontogenic epithelium and mesenchyme
- Usually found between ages 10 and 20 years
- It is only benign n simply needs to be removed.
- Develop like surrounding teeth with initial (crypt-like) radiolucent phase, intermediate stage of mixed radiolucency, finally densely radiopaque
- Rx – enucleation

COMPLEX ODONTOMA
- Irregular mass like appearance
- Seen in posterior mostly – PM MOLAR REGION

COMPOUND ODONTOMA
- Round symmetrical appearance
- Seen in anterior and PMs
- Single rooted tooth

CEMENTOBLASTOMA
- Tumor of cementum
- Slow growing Radiopaque surrounded by radiolucent margin but no caries associated & tooth is Vital
- Causes expansion of the bony cortex.

HYPERCEMENTOSIS
- Just excess deposition of cementum.
- Protective mechanism to bruxism, Paget’s disease & Down’s syndrome.

CONDENSING OSTEITIS
- Caries/ deep rests
- Vital / non – vital
- Mixed with radiolucency of PDL separating]]>409falsefullhttps://www.spreaker.com/episode/22-bone-lesions-fibrous-giant-cell--49566856
OSSIFYING FIBROMA
- Seen around lower molar tooth, it is discovered during check-up & no bone expansion, associated with vital tooth 🡪 curettage

FIBROUS DYSPLASIA
- During bone formation more collagen fibres are formed rather than mineralization.
- Two types – monostotic, polyostotic
- Monostotic – one bone affected , maxilla
- Polyostotic – multiple bone affected
- Coffee brown discolouration – Café au laite spots
- Other lesions where these spots are seen:
- Neurofibromatosum
- Peutz Jegher syndrome
- Rx – ground glass radio opaque
Syndrome – McCune Albright syndrome
- Polyostotic fibrous dysplasia
- Café au laite
- Endocrine disturbances

BONE LESIONS – GIANT CELL
- PERIAPICAL GIANT CELL GRANULOMA
- CENTRAL GIANT CELL GRANULOMA
- ANEURYSMAL BONE CYST

ANEURYSMAL BONE CYST
- Typically presents as a fairly well-defined radiolucency.
- Sometimes it has a multilocular appearance because of the occurrence of internal bony septa and opacification.
- Marked expansion is a feature.

HYPERPARATHYROIDISM
(Mentioned in hormones section)

CHERUBISM
- Common finding in children
C/F
- Firm painless bilateral swelling of face
- Angel like face
- Eyes to heaven / depressed lower eyelids
-Displacement of teeth
- Delayed eruption of permanent teeth
R/F
- multilocular radiolucency****
- multiple/supernumerary impacted teeth
Blood investigation - All normal : Ca+, P, alkaline phosphate
Rx
- Cosmetic reconstruction

CASE SCENARIO
- 9 yrs old patient with bilateral swelling in the mandible withmultilucular radiolocency.
Painless, bilateral swelling of mandible which is firm, multiple Radiolucency in early childhood .
- 6 year old child presents with bilateral facial swelling in ramus x ray shows well defined multilocular radiolucency and molars are anteriorly displaced
- Pt. with bilateral swelling of mandible , profound swilling of maxilla , cheeks are stroked, with lower eye line depressed , x-ray radiolucent lesion with ↓ bone trabecular displacement of anterior teeth

LANGERHAN’S GRANULOMA

PAGET’S DISEASE / OSTITIS DEFORMANS
- Persons above middle age affected
- MAXILLA occasionally, but mandible rarely affected
Other C/F –
- Teeth may show gross irregular multiple hypercementosis & ankylosis
- Enlargement of skull – Prominent forehead
- Facial nerve palsy due to constriction of stylomastoid foramen due to enlarged bone
- Blindness – optic canal closed by enlarged bone
- Deafness
- Thickening but weakness of long bones and bone pain are typical of severe disease
- Bowing of legs
- Blood investigation
+ Normal Ca+ and phosphate
+ But very high alkaline phosphate*****
- Histologically- irregular resorption and apposition leaves jigsaw puzzle (‘mosaic’) pattern of reversal lines
R/F
- Scattered radio opaque lines seen**
- Patchy sclerosis and resorption gives this Cotton wool appearance
- Thickened mandible
- Multiple radioopacities
- Complication – leads to osteosarcoma, osteomyelitis, bone sclerosis, jaw fracture
Rx – Bisphosphonates

- Scenario 1 🡪 Pt c/o repeated denture change, and has bowed legs and investigation shows high alkaline phosphate
- Scenario 2 🡪 Pateint present with bony expansion and a prominent forehead, and upon dental examination, there is spacing between teeth with Hypercementosis
- Scenario 3 🡪 A case about an old woman with thickened mandible and multiple radioopacities]]>https://api.spreaker.com/episode/49566856Wed, 27 Apr 2022 08:07:16 +0000The Gulfie DentistBONE LESIONS- FIBROUS OSSIFYING FIBROMA - Seen around lower molar tooth, it is discovered during check-up & no bone expansion, associated with vital tooth 🡪 curettage FIBROUS DYSPLASIA - During bone formation more collagen fibres are formed...
OSSIFYING FIBROMA
- Seen around lower molar tooth, it is discovered during check-up & no bone expansion, associated with vital tooth 🡪 curettage

FIBROUS DYSPLASIA
- During bone formation more collagen fibres are formed rather than mineralization.
- Two types – monostotic, polyostotic
- Monostotic – one bone affected , maxilla
- Polyostotic – multiple bone affected
- Coffee brown discolouration – Café au laite spots
- Other lesions where these spots are seen:
- Neurofibromatosum
- Peutz Jegher syndrome
- Rx – ground glass radio opaque
Syndrome – McCune Albright syndrome
- Polyostotic fibrous dysplasia
- Café au laite
- Endocrine disturbances

BONE LESIONS – GIANT CELL
- PERIAPICAL GIANT CELL GRANULOMA
- CENTRAL GIANT CELL GRANULOMA
- ANEURYSMAL BONE CYST

ANEURYSMAL BONE CYST
- Typically presents as a fairly well-defined radiolucency.
- Sometimes it has a multilocular appearance because of the occurrence of internal bony septa and opacification.
- Marked expansion is a feature.

HYPERPARATHYROIDISM
(Mentioned in hormones section)

CHERUBISM
- Common finding in children
C/F
- Firm painless bilateral swelling of face
- Angel like face
- Eyes to heaven / depressed lower eyelids
-Displacement of teeth
- Delayed eruption of permanent teeth
R/F
- multilocular radiolucency****
- multiple/supernumerary impacted teeth
Blood investigation - All normal : Ca+, P, alkaline phosphate
Rx
- Cosmetic reconstruction

CASE SCENARIO
- 9 yrs old patient with bilateral swelling in the mandible withmultilucular radiolocency.
Painless, bilateral swelling of mandible which is firm, multiple Radiolucency in early childhood .
- 6 year old child presents with bilateral facial swelling in ramus x ray shows well defined multilocular radiolucency and molars are anteriorly displaced
- Pt. with bilateral swelling of mandible , profound swilling of maxilla , cheeks are stroked, with lower eye line depressed , x-ray radiolucent lesion with ↓ bone trabecular displacement of anterior teeth

LANGERHAN’S GRANULOMA

PAGET’S DISEASE / OSTITIS DEFORMANS
- Persons above middle age affected
- MAXILLA occasionally, but mandible rarely affected
Other C/F –
- Teeth may show gross irregular multiple hypercementosis & ankylosis
- Enlargement of skull – Prominent forehead
- Facial nerve palsy due to constriction of stylomastoid foramen due to enlarged bone
- Blindness – optic canal closed by enlarged bone
- Deafness
- Thickening but weakness of long bones and bone pain are typical of severe disease
- Bowing of legs
- Blood investigation
+ Normal Ca+ and phosphate
+ But very high alkaline phosphate*****
- Histologically- irregular resorption and apposition leaves jigsaw puzzle (‘mosaic’) pattern of reversal lines
R/F
- Scattered radio opaque lines seen**
- Patchy sclerosis and resorption gives this Cotton wool appearance
- Thickened mandible
- Multiple radioopacities
- Complication – leads to osteosarcoma, osteomyelitis, bone sclerosis, jaw fracture
Rx – Bisphosphonates

- Scenario 1 🡪 Pt c/o repeated denture change, and has bowed legs and investigation shows high alkaline phosphate
- Scenario 2 🡪 Pateint present with bony expansion and a prominent forehead, and upon dental examination, there is spacing between teeth with Hypercementosis
- Scenario 3 🡪 A case about an old woman with thickened mandible and multiple radioopacities]]>626falsefullhttps://www.spreaker.com/episode/23-bone-inflammatory-malignant--49566145
ACUTE OSTEOMYLITIS :
- moth eaten appearance .,
- caused by Staph aureous***

CHRONIC OSTEOMYLITIS :
- cotton wool appearance or onion peal appearance.

CODENSING OSTEITIS OR FOCAL SCLEROSING OSTEOMYELITIS:
- Commonly seen in children and young adults
- associated with a large carious cavity which is asymptomatic tooth
- Radiographic presentation of this process shows localized radiodensity around teeth roots as well as a thickening of the associated periodontal ligament.
- The teeth most often affected are the mandibular premolars and molars.


BONE - MALIGNANT

OSTEOSARCOMA
- Most common bone tumor
- Primary bony tumor of long bones
- Tumors rapid growing
- Intra oral sites: mandible
R/F –
- Bone resorption of mandible / jaw
- Bone is resorbing and Ca+ get deposited to nearly soft tissue giving Sun Burst or Sun Rise appearance
- Ill-defined radiographic feature.
C/F –
- Parethesia of lip if it is affecting area containing a nerve especially at angle of mandible and Inf. alveolar Nerve.
- Swelling of adjacent soft tissue with numb feeling on palpation
- CODMAN’S TRIANGLE
- CASE SCENARIO: A rapid growing, ill-defined having sunray appearance causing paresthesia.

METASTATIC BONE TUMOR - I
EWING’S SARCOMMA
CHONDROSARCOMMA
BURKIT’S LYMPHOMA

MULTIPLE MYOLEMMA
- It is primarily a bone tumor, secondarily lymphoid.
- Tumor occur within bone –ie. from bone marrow
- Commonly seen in flat bone
- Multiple punched out radiolucency of skull
- Bence – Jones protein seen in urine – Lab report]]>https://api.spreaker.com/episode/49566145Wed, 27 Apr 2022 08:01:24 +0000The Gulfie DentistBONE – INFLAMMATORY ACUTE OSTEOMYLITIS : - moth eaten appearance ., - caused by Staph aureous*** CHRONIC OSTEOMYLITIS : - cotton wool appearance or onion peal appearance. CODENSING OSTEITIS OR FOCAL SCLEROSING OSTEOMYELITIS: -...
ACUTE OSTEOMYLITIS :
- moth eaten appearance .,
- caused by Staph aureous***

CHRONIC OSTEOMYLITIS :
- cotton wool appearance or onion peal appearance.

CODENSING OSTEITIS OR FOCAL SCLEROSING OSTEOMYELITIS:
- Commonly seen in children and young adults
- associated with a large carious cavity which is asymptomatic tooth
- Radiographic presentation of this process shows localized radiodensity around teeth roots as well as a thickening of the associated periodontal ligament.
- The teeth most often affected are the mandibular premolars and molars.


BONE - MALIGNANT

OSTEOSARCOMA
- Most common bone tumor
- Primary bony tumor of long bones
- Tumors rapid growing
- Intra oral sites: mandible
R/F –
- Bone resorption of mandible / jaw
- Bone is resorbing and Ca+ get deposited to nearly soft tissue giving Sun Burst or Sun Rise appearance
- Ill-defined radiographic feature.
C/F –
- Parethesia of lip if it is affecting area containing a nerve especially at angle of mandible and Inf. alveolar Nerve.
- Swelling of adjacent soft tissue with numb feeling on palpation
- CODMAN’S TRIANGLE
- CASE SCENARIO: A rapid growing, ill-defined having sunray appearance causing paresthesia.

METASTATIC BONE TUMOR - I
EWING’S SARCOMMA
CHONDROSARCOMMA
BURKIT’S LYMPHOMA

MULTIPLE MYOLEMMA
- It is primarily a bone tumor, secondarily lymphoid.
- Tumor occur within bone –ie. from bone marrow
- Commonly seen in flat bone
- Multiple punched out radiolucency of skull
- Bence – Jones protein seen in urine – Lab report]]>188falsefullhttps://www.spreaker.com/episode/24-hereditary-miscellaneous--49566137
WHITE SPONGE NEVUS
- Familial or hereditary
SITES
- Buccal mucosa
- Ventral surface of tongue
- Labial mucosa
- Alveolar ridge
- Floor of the mouth
- Scrapable, no erythema left
- No Rx.

AMELOGENESIS IMPERFECTA – ectodermal defect
- Hereditary autosomal dominant defect
- When defect occurs during the histo-differentiation stage.

Stages of tooth formation –
- Initian/ proliferation – oligodontia
- Histo differentiation – DI, AI
- Morphodifferentiation – Hutchinson’s incisors ******
- Apposition – enamel hypoplasia
- Maturation

- Clinically – yellowish + brown discolouration
- Rx – crown , ie prosthetic rehabilitation


DENTINOGENESIS IMPERFECTA – mesodermal defect
- C/F – Opalescent colour (opalascent dentine) ie. mixed grey-blue-red hue
- Stages affected — histo differentiation
- Odontogenic infections – facultative organisms
Three types of DI :
Type I
- Osteogenesis imperfecta (blue sclera + bone fractures)
- Primarty teeth more affected than permanent
Type II
- Only dentine problems no bone involvement
- Hereditary opalescent dentine
- Both primary and permanent
Type III
- BRADYWINE TYPE
- Only dentine abnormality
- BLUE SCLERA

BLUE SCLERA ALSO SEEN IN:
+ Osteogenesis imperfecta OR broken bone disease
+ Marfans syndrome
+ Ehler’s Danlose syndrome
+ Type III Dentinogenesis Imperfecta

REGIONAL ODONTODYSPLASIA
- All 3 layers affected – enamel + dentin + pulp
- R/F – ghost tooth appearance
- Dentinogenesis imperfecta+ amelogenesis imperfecta —single tooth.


MISCELLANEOUS

VIT D DEFICIENCY
- Children 🡪 rickets
- Adults 🡪 osteomalacia

DELAYED ERUPTION SEEN IN
- Cherubism
- Cleidocranial dysplasia
- Down’s syndrome
- Hypoparatgyroidism
- Hypothyroidism
- Dwarfism

EARLY ERUPTION OF PERMANENT
- Hyperparathyroidism

LUGOL DYE
- Used with toludene blue to differentiate between cancer and normal cells –- question about a dye to detect the presence of cancer in the floor of the mouth and ask about what the other material associated with it to make it more effective.

Residual cyst
- The residual cyst has a well-defined, round/ovoid radiolucency in an edentulous area.Occasionally flecks of calcification may be seen.

Eruption cyst
- The extra-bony position of the eruption cyst means that the only radiological sign is likely to be a soft-tissue mass.

KERATOACANTHOMA
- Clinical scenario of 45 year old male who has lesion in oral cavity. Social History When taken from him he explained he has been working in the Sun** most of his life

[Additional Notes]

ENUCLEATION IS CONTRA INDICATED
- Presence of vital structure
- Cyst surrounding at tooth that need to erupt
- Large cyst next to perforation

Other than enucleation
- Marsupialization – dentigerous cyst & ranula
- Excision – mucocele
- Induce bleeding – traumatic bone cyst
- Marsupialisation + enucleation = Partsch II operation
- Enucleation – OKC, odontoma, ameloblastoma

MULTILOCULAR RADIOLUCENCY
- Ameloblastoma
- OKC
- Cherubism
- Amelogenesis I
- Dentinogenesis I
- Myxoma

Facial hemihypertrophy
- A 22 year old sudden swelling of one side of face , there is also condylar hyperplasia, severe malocclusion n spaces in teeth & partial macroglossia]]>https://api.spreaker.com/episode/49566137Wed, 27 Apr 2022 08:01:10 +0000The Gulfie DentistHEREDITARY CONDITIONS WHITE SPONGE NEVUS - Familial or hereditary SITES - Buccal mucosa - Ventral surface of tongue - Labial mucosa - Alveolar ridge - Floor of the mouth - Scrapable, no erythema left - No Rx. AMELOGENESIS...
WHITE SPONGE NEVUS
- Familial or hereditary
SITES
- Buccal mucosa
- Ventral surface of tongue
- Labial mucosa
- Alveolar ridge
- Floor of the mouth
- Scrapable, no erythema left
- No Rx.

AMELOGENESIS IMPERFECTA – ectodermal defect
- Hereditary autosomal dominant defect
- When defect occurs during the histo-differentiation stage.

Stages of tooth formation –
- Initian/ proliferation – oligodontia
- Histo differentiation – DI, AI
- Morphodifferentiation – Hutchinson’s incisors ******
- Apposition – enamel hypoplasia
- Maturation

- Clinically – yellowish + brown discolouration
- Rx – crown , ie prosthetic rehabilitation


DENTINOGENESIS IMPERFECTA – mesodermal defect
- C/F – Opalescent colour (opalascent dentine) ie. mixed grey-blue-red hue
- Stages affected — histo differentiation
- Odontogenic infections – facultative organisms
Three types of DI :
Type I
- Osteogenesis imperfecta (blue sclera + bone fractures)
- Primarty teeth more affected than permanent
Type II
- Only dentine problems no bone involvement
- Hereditary opalescent dentine
- Both primary and permanent
Type III
- BRADYWINE TYPE
- Only dentine abnormality
- BLUE SCLERA

BLUE SCLERA ALSO SEEN IN:
+ Osteogenesis imperfecta OR broken bone disease
+ Marfans syndrome
+ Ehler’s Danlose syndrome
+ Type III Dentinogenesis Imperfecta

REGIONAL ODONTODYSPLASIA
- All 3 layers affected – enamel + dentin + pulp
- R/F – ghost tooth appearance
- Dentinogenesis imperfecta+ amelogenesis imperfecta —single tooth.


MISCELLANEOUS

VIT D DEFICIENCY
- Children 🡪 rickets
- Adults 🡪 osteomalacia

DELAYED ERUPTION SEEN IN
- Cherubism
- Cleidocranial dysplasia
- Down’s syndrome
- Hypoparatgyroidism
- Hypothyroidism
- Dwarfism

EARLY ERUPTION OF PERMANENT
- Hyperparathyroidism

LUGOL DYE
- Used with toludene blue to differentiate between cancer and normal cells –- question about a dye to detect the presence of cancer in the floor of the mouth and ask about what the other material associated with it to make it more effective.

Residual cyst
- The residual cyst has a well-defined, round/ovoid radiolucency in an edentulous area.Occasionally flecks of calcification may be seen.

Eruption cyst
- The extra-bony position of the eruption cyst means that the only radiological sign is likely to be a soft-tissue mass.

KERATOACANTHOMA
- Clinical scenario of 45 year old male who has lesion in oral cavity. Social History When taken from him he explained he has been working in the Sun** most of his life

[Additional Notes]

ENUCLEATION IS CONTRA INDICATED
- Presence of vital structure
- Cyst surrounding at tooth that need to erupt
- Large cyst next to perforation

Other than enucleation
- Marsupialization – dentigerous cyst & ranula
- Excision – mucocele
- Induce bleeding – traumatic bone cyst
- Marsupialisation + enucleation = Partsch II operation
- Enucleation – OKC, odontoma, ameloblastoma

MULTILOCULAR RADIOLUCENCY
- Ameloblastoma
- OKC
- Cherubism
- Amelogenesis I
- Dentinogenesis I
- Myxoma

Facial hemihypertrophy
- A 22 year old sudden swelling of one side of face , there is also condylar hyperplasia, severe malocclusion n spaces in teeth & partial macroglossia]]>464falsefullhttps://www.spreaker.com/episode/25-syndromes--49566052
CLIEDO – CRANIAL DYSPLASIA
- No clavicle, so patient can bring his shoulder to midline
- Multiple impacted supernumerary teeth**
- Permanent tooth roots are mostly short
- Wormian bone present
- Small cranium
- Rare genetic disorder
- Delayed closure of fontanelles and open skull sutures and plugging forehead
- Sometimes many Dentigerous cysts
- the patient looks smaller than his relatives and shorter than his relatives

GARDNER’S SYNDROME
- Multiple osteoma
- Dermoid** tumor
- Multiple intestinal polyps
- Multiple impacted supernumerary teeth**

CROUZEN SYNDROME
- Cranio – facial dysostosis/ synostosis
- Exophthalmos + strabysmus (crossed eye – kon kannu)
- Parrot beak nose
- Class III retrognathic maxilla**
- Mentally retarded

TREACHER COLLINS SYNDROME
- Hypoplasia of the facial, especially malar- deformity in zygoma (cheek) & mandibular bones
- Mandible involved – class II retrognathic mandible open bite
- Supernumerary tooth
- Microstomia & oral fistulas Cleft palate
- Eye drop down, cleft eyelid
- External ear deformity with hearing loss
- But he is mentally normal - No retardation

VAN DE WAND SYNDROME : Same as treacher Collins but
- Genetic disorder
- Lip pits – invaginations at commissures or near midline
- Cleft lip with or without cleft palate
- Hypodontia or total anodontia.
- Normal intelligence

DOWN SYNDROME
- Trisomy 21
- Class III retrognathic maxilla
- Hypercementosis
- No caries Rx required ie preventive also
- Cause high salivation
- But because of “, perio problems are high and thus periodontal Rx is necessary
- Infective endocarditis prophylaxis required
- Low carious index , fluoride application is by varnish , inability to learn ,
- Some have cerebral palsy.
- QN - 10 yrs. old child, who is unable to differentiate the colors, and can’t tell his name or address. He is acting like: 3 years old.

RAMSAY - HUNT SYNDROME
- Facial nerve palsy + ulcer of pinna
- Ulcer in oral cavity that doesn’t cross midline
- Virus involved – varicella zoster

MELKERSEN – ROSANTHAL SYNDROME
- Facial nerve palsy + fissured tongue + chelitis granulomatosum
C/F –
- lip deviates to opp/ unaffected side
- Wide opening of eye on normal side

ECTODERMAL DYSPLASIA***
- Patient old looking.
- With hair loss or faint hair
- Having missing teeth - anodontia
- Patient came to clinic with wrinkled skin and white shiny hair, with pegged laterals teeth!!

Gorlin-Goletz ( multiple basal cell nevi syndrome Nevoid BCC syndrome)
- Multiple OKC of jaws - BCC of skin - epidermoid cysts (milia) of skin
- Bifid rib - Calcification of the falx cerebi
- Palmer& planter dyskeratosis
- Frontal bossing - Hypertelorism
- Nevi on neck and scalp

MCune Albright :
- Multiple nevi on neck and head ,
- Multiple bone deformities
- Polyostotic fibrous dysplasia of bone,
- Café-au-lait spots on the skin,
- Endocrine disturbances, e.g. Precocious puberty.

PAPPILON LE FEVRE SYNDROME :
- Hand and foot – Palmar keratosis
- Periodontitis affecting both dentitions
- early teeth loss
- generalized bone destruction

Reiters ( or reiter arthritis or reactive arthritis )
- TRIAD ; conjunctivitis + arthritis + urethritis
- TMJ inflammation.
- Addison disease : have oral melanosis

OSTEOGENESIS IMPERFECTA :
- Blue sclera , teeth wear and multiple fractures- Brittle bone

KLIENFELTER SYNDROME
- 46 + X condition
- Taurodontism
- XXY

CHRONIC MYELOID LEUKEMIA
- Philadelphia chromosome
- 9 chrom 🡪 22 chromosome
- Maroteux Lami syndrome
- RADIO – OPAQUE CYST
- Rx – marsupialization]]>https://api.spreaker.com/episode/49566052Wed, 27 Apr 2022 06:07:01 +0000The Gulfie DentistSYNDROMES CLIEDO – CRANIAL DYSPLASIA - No clavicle, so patient can bring his shoulder to midline - Multiple impacted supernumerary teeth** - Permanent tooth roots are mostly short - Wormian bone present - Small cranium - Rare genetic...
CLIEDO – CRANIAL DYSPLASIA
- No clavicle, so patient can bring his shoulder to midline
- Multiple impacted supernumerary teeth**
- Permanent tooth roots are mostly short
- Wormian bone present
- Small cranium
- Rare genetic disorder
- Delayed closure of fontanelles and open skull sutures and plugging forehead
- Sometimes many Dentigerous cysts
- the patient looks smaller than his relatives and shorter than his relatives

GARDNER’S SYNDROME
- Multiple osteoma
- Dermoid** tumor
- Multiple intestinal polyps
- Multiple impacted supernumerary teeth**

CROUZEN SYNDROME
- Cranio – facial dysostosis/ synostosis
- Exophthalmos + strabysmus (crossed eye – kon kannu)
- Parrot beak nose
- Class III retrognathic maxilla**
- Mentally retarded

TREACHER COLLINS SYNDROME
- Hypoplasia of the facial, especially malar- deformity in zygoma (cheek) & mandibular bones
- Mandible involved – class II retrognathic mandible open bite
- Supernumerary tooth
- Microstomia & oral fistulas Cleft palate
- Eye drop down, cleft eyelid
- External ear deformity with hearing loss
- But he is mentally normal - No retardation

VAN DE WAND SYNDROME : Same as treacher Collins but
- Genetic disorder
- Lip pits – invaginations at commissures or near midline
- Cleft lip with or without cleft palate
- Hypodontia or total anodontia.
- Normal intelligence

DOWN SYNDROME
- Trisomy 21
- Class III retrognathic maxilla
- Hypercementosis
- No caries Rx required ie preventive also
- Cause high salivation
- But because of “, perio problems are high and thus periodontal Rx is necessary
- Infective endocarditis prophylaxis required
- Low carious index , fluoride application is by varnish , inability to learn ,
- Some have cerebral palsy.
- QN - 10 yrs. old child, who is unable to differentiate the colors, and can’t tell his name or address. He is acting like: 3 years old.

RAMSAY - HUNT SYNDROME
- Facial nerve palsy + ulcer of pinna
- Ulcer in oral cavity that doesn’t cross midline
- Virus involved – varicella zoster

MELKERSEN – ROSANTHAL SYNDROME
- Facial nerve palsy + fissured tongue + chelitis granulomatosum
C/F –
- lip deviates to opp/ unaffected side
- Wide opening of eye on normal side

ECTODERMAL DYSPLASIA***
- Patient old looking.
- With hair loss or faint hair
- Having missing teeth - anodontia
- Patient came to clinic with wrinkled skin and white shiny hair, with pegged laterals teeth!!

Gorlin-Goletz ( multiple basal cell nevi syndrome Nevoid BCC syndrome)
- Multiple OKC of jaws - BCC of skin - epidermoid cysts (milia) of skin
- Bifid rib - Calcification of the falx cerebi
- Palmer& planter dyskeratosis
- Frontal bossing - Hypertelorism
- Nevi on neck and scalp

MCune Albright :
- Multiple nevi on neck and head ,
- Multiple bone deformities
- Polyostotic fibrous dysplasia of bone,
- Café-au-lait spots on the skin,
- Endocrine disturbances, e.g. Precocious puberty.

PAPPILON LE FEVRE SYNDROME :
- Hand and foot – Palmar keratosis
- Periodontitis affecting both dentitions
- early teeth loss
- generalized bone destruction

Reiters ( or reiter arthritis or reactive arthritis )
- TRIAD ; conjunctivitis + arthritis + urethritis
- TMJ inflammation.
- Addison disease : have oral melanosis

OSTEOGENESIS IMPERFECTA :
- Blue sclera , teeth wear and multiple fractures- Brittle bone

KLIENFELTER SYNDROME
- 46 + X condition
- Taurodontism
- XXY

CHRONIC MYELOID LEUKEMIA
-...]]>524falsefull