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26 Cards in this Set
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Terminology: Erosive Lesions
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Denuded areas that occur above the basal cell layer of the epithelium
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Terminology: Ulcer
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Lesion penetrates the epithelium and extends into dermis:
-- Often exhiit a red halo/border w/ yellow center (fibrinous exudate covering ulcer) -- often caused by trauma |
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Traumatic Ulcers
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* Location: Localized to area of trauma
* Description: Have a crater-like appearances with some fibrinous exudate * Repeated injury may produce scar or thickened, keratinized, white tissue. * Treatment: remove source of injury * Types of trauma: Factitial (self-induced) latrogenic (treatment caused) injury |
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Traumatic Ulcers: Necrotizing Sialometaplasia
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* Salivary gland ischemia causing necrosis of tissue
* cause: usually trauma in the area (ie. surgery or local anesthesia) * Location: junction of hard and soft palate * treatment: only for pain * will heal in several weeks-months * may be confused w/ carcinoma. |
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Ulcers from Infectious Agents: Syphilis
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*Cause: Spirochete Trepenema Pallidem Through Direct Contact w/ Primary Lesion.
* 3 Stages: -- primary stage - chancre -- secondary stage - mucous patches and flu-like symptoms -- tirtiary stage - gummatous lesion * Treatment: Penicillin |
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Ulcers from Infectious Agents: Gonorrhea
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* Cause: Bacterium Neisseria gonorrhoeae
* Location: genital tract, mouth, rectum, oral pharynx (most common site), tonsils (pustular lesions), and tongue. * Stinging and burning may occur on tongue. * Treatment: Antibiotics |
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Ulcers from Infectious Agents: Actinomycosis
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* Cause: Chronic bacterial disease.
* Description: an abscess and yellow pus-like drainage w/ sulfur granules, sometimes draining externally. * Develops in relation to trauma, surgery, or other dental procedures. * Treatment: Penicillin |
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Ulcers from Infectious Agents: Necrotizing Ulcerative Gingivitis (NUG)
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* AKA: " Trench Mouth"
* Cause: Spirochetes, fusobacteria and streptococi. * This causes: bleeding, ulceration, tissue necrosis, and pain. * Description: Grey psudomembrane that forms over necrotic gingiva. * contributors to severity: stress, improper nutrition, and poor oral hygiene. * Distinguishing Factor: Fetid Odor * Treatment: Debridement, proper diet, rest, stress reduction, and antibiotics. * Oral Irrigating devices and ultrasonic instrumentation are contraindicated. |
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Deep Fungal Infections
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* Occur through tears in tissue
* Affect people w/ compromised immune systems and lowered resistance to pathogens * Diagnosis: requires testing - refer * Extraoral - usually ulcerative * Intraoral - ulcerative w/ indurated lesions |
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Immune System Disorders: Aphthous Ulcers
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* Etiology: Still questioned
* Factors: stress, trauma, food allergies, genetic predisposition, V B12 deficiencies, and hormonal fluctuations. * Cause: may be hypersensitivity reaction, autoimmune response, and trauma w/ chemical mediators involved. * Location: Nonkeratinized tissue (buccal/labial mucosa, ventral tongue, floor of mouth), soft palate and oropharynx * More common in non-smokers. |
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Recurrent Aphthous Ulcers
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Type 1: RAU minor
Type 2: RAU major Type 3: Herpetiform RAU * Classified by lesion size and dispersion * NOT contagous * AKA canker sore * MOST COMMONLY SEEN oral lesion |
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RAU Minor
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* Most common of the 3
* Tingling or burning sensation reported * Develop w/in 24-48hrs * Last 7-10 days * Painful * Crater-like ulcer w/ white or yellow fibrinous membrane w/ red halo less than 1cm |
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RAU Major
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* Lesions are much larger, 1-3 cm
* Deeper and more crater-like w/ irregular border. May last several years. * Extensive lesion causes scarring * aka "Sutton's Disease" |
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Herpetiform RAU
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* Smaller, 1-3mm in cluster formation (10-100)
* More frequent in women and later in life. * Usually on non-keratinized surfaces. |
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Treatment for / durations of Aphthus Ulcers
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* Chlorhexidine Gluconate Rinse:
* Topical Corticosteroid gels (kenalog or orabase) * Tetracycline rinses * usually last 7-10 days regardless of treatment * Major may last several weeks w/ scarring |
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Behcet Synderome
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*Inflammatory disorder of unknown cause
* occur in 30-40 year olds * Triad lesions: RAU minor, Genital ulcers, and ocular lesions. * Similar to aphthus ulcer * recurrent, painful lesions * Treatment: topical steroids and Cyclosporine |
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Reiter's Synderome
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* Develops after exposure to VD or GI infection
* Affects men more than women * Triad: arthritis, urethritis, conjunctivitis * One half Pts have oral ulcers. * Treatment: Non-steroidal agents |
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Erythema Multiforme (EM)
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* TARGET LESIONS
* Associated with exposure to: -- HSV -- TB -- Histoplasmosis -- Other fungal infections -- Medications such as sulfonamides, penicillin and barbiturates. |
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Steven Johnson Synderom
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* Severe Form of Erythema Multiform
* Locations: Oral cavity Conjunctiva, Genitalia, and skin (erythematous papules that enlarge to vesicles or bulla |
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Hypersensitivity Reactions: Stomatitis venenata
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* Mucosal Version of contact dermatitis
* Symptoms: ulcers, srythema or swelling occuring w/in 24-48 hours of contact |
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Hypersensitivity Reactions: Stomatitis Medicamentosis
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* Reaction to medications such as penicillin
* aka: fixed drug reaction * Symptoms: ulcers, vsicles, skin rashes and lymphadenopathy |
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Hypersensitivity Reactions:
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* Caused by new/previously used products
* Majority are delayed reactions mediated by sensitized T lymphocytes * Intraoral symptoms: ulcers, erythema, vesicles, or tissue sloughing other symptoms: urticaria (hives) and edema |
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Lupus Erythematosus
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Autoimmune disease and type III Hypersesneitivity reaction
* Cause: sunlight, hormones, cigerettes, certain medications, viruses (ie, epstein-barr) * Affects: skin, organs (mainly kidneys) joints, and serous membranes * may be extremely erythematic and painful * oral lesions present in all forms in in 25-40% |
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Chrohn Disease
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* Chronic GI desase
* associated w/ aphthus ulcers and pyostomatitis vegetans * Genetic component (etiology unknown) * Intestinal discomfort weight loss, and fever w/ periods of remission * Vit. D deficiency association * colon cancer risk * poor absorption of vit. B, Folic acid, iron, and other nutrients |
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Squamous cell carcinoma: factors
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* Lifestyle choices
* Environmental influences * Genetic factors * infections, particularly by viruses * Sunlight, alcohol, diet, stress, chemical exposure * Infections including syphilis, candidiasis, and HPV * Chronic inflammation in the body |
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Squamous Cell Carcinoma (SCC)
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* Tonsillar cancer implicated w/ HPV 16
* Base of tongue and tonsil crypts make visualization difficult * May be erythroplakia, speckled erythroleukoplakia, or field carcinogenesis. |