atrofi mukosa.ppt

7/25/2019 Atrofi Mukosa.ppt

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ATROFI

Pengurangan dr luar thd masargan atau !aringan "g dise#a#kankrn $enurunan !umlah dan ukuransel unsur%unsurn"a &hi$$lasia'

HIPOPLA(IA :ketidakmam$uan)kegagalan rgan

utk #erkem#ang sam$ai ukurannrmal

KULIAH DMF2 2


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Atrofi ada 2: Fisiologik !atologik

FI(IOLO*IK: +nt $d dinding uteri stl melahirkan,senil atr-i%%$eru# -isilgi "g #erhu# dgmeningkatn"a usia . menurunn"a akti/itas rganendkrin0

PATOLO*IK ada 2:umum . lkal, Umum, dihu# dg kekurangan mak,$en" krnis .

keganasan Lokal,disuse atr-i $d tt "g !arang digunakan,krn

trauma,$limielitis,r0artritis Akumulasi sekresi $d duktus krn tersum#at #atu

atr-i tekanan $d kl! sali/a,$ankreas,gin!al

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MUKOSA LIDAH

Oral mu+sal lesins ma" #e+lassi-ied a++rding t di--erent

+hara+teristi+s0 This +ha$ter des+ri#es disrders -

the ral mu+sa that +lini+all"a$$ear either red r white0

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Oral "#$osal l%sio&s "a' (% $lassifi%d

a$$ordi&g to diff%r%&t $)ara$t%risti$s*

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The ral e$ithelium ma" #e stimulated tan in+reased $rdu+tin - keratin &h"$erkeratsis,

5m$sitin 1'


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a& a(&or"al (#t (%&ig& t)i$k%&i&g of

strat#" s+i&os#" a$a&t)osis, -o"+ositio& 2.

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I&tra$%ll#lar/-o"+ositio& 0.

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N%$rosis, "a' o$$#r 1)%& t)% oral "#$osa is %+os%d to toi$

$)%"i$als* Mi$ro(%s, +arti$#larl' f#&gi, $a& +rod#$% 1)itis)

+s%#do"%"(ra&%s $o&sisti&g of slo#g)%d %+it)%lial

$%lls,f#&gal "'$%li#", a&d &%#tro+)ils, 1)i$) ar% loos%l'

atta$)%d to t)% oral "#$osa -o"+ositio& 3.

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A r%d l%sio& of t)% oral "#$osa "a' d%4%lo+ as t)% r%s#lt

of atro+)i$ %+it)%li#" -o"+ositio& 5.

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$)ara$t%ri6%d (' a r%d#$tio& i& t)% "(%r of %+it)%lial $%lls

-o"+ositio& 7. or i&$r%as%d 4as$#lari6atio&*

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Oral Candidiasis

The mst $re/alent $$rtunisti+in-e+tin a--e+ting the ral mu+sa

The lesins are +aused #" the "eastCandida albicans. The $athgenesis is nt -ull"

understd%% $redis$sing -a+trs

from the normal cmmensal -lra&sa$r$h"ti+ stage' t a $athgeni+rganism &$arasiti+ stage'0

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Lo$al +r%dis+osi&g fa$tors

Denture wearing (mking

At$i+ +nstitutin Inhalatin sterids T$i+al sterids

H"$erkeratsis Im#alan+e - the ral mi+r-lra ;ualit" and


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8%&%ral +r%dis+osi&g fa$tors

Immunsu$$ressi/e diseases Im$aired health status

Immunsu$$ressi/e drugs 5hemthera$" =nd+rine disrders

Hematini+ de-i+ien+ies

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Etiology and Pathogenesis

T in/ade the mu+sal lining, themi+rrganisms must adhere t thee$ithelial sur-a+e> strains $otential are

more pathogenic The "easts? $enetratin is -a+ilitated #"

their $rdu+tin - li$ases,-r the "easts tremain within the e$ithelium, the" must

/er+me +nstant des


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-lassifi$atio& of Oral -a&didiasis :

!ri"ar' Oral -a&didiasis S%$o&dar'

The l+al $redis$sing -a+tr area#le t $rmte grwth - Candidaor to affect the immune response ofthe ral mu+sa0

*eneral $redis$sing -a+trs are-ten related t the $atient?s

immune and end+rine status

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-lassifi$atio& of Oral -a&didosis

A+ute : A+ute Pseudmem#raneus&thrush'

A+ute Athr$i+ +andidsis

Anti#iti+ sre muth5hrni+ :5hr0Athr$i+ +andidsis

Denture stmatitis &denturesre%muth'

Angular +heilitisMedian rhm#id glssitis

5hr0 hi$er$lasti+ +andidsis

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Clinical Findings

The acute pseudomembranous

candidiasis (thrush)

The in-e+tin $redminantl" a--e+ts $atients

medi+ated anti#iti+s,immunsu$$ressantdrugs, r a disease that su$$resses theimmune s"stem0

The in-e+tin t"$i+all" $resents with lsel"

atta+hed mem#ranes +m$rising -ungalrganisms and +ellular de#ris,whi+h lea/es anin-lamed, smetimes #leeding area i- the$seudmem#rane is rem/ed

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!s%#do"%"(ra&o#s $a&didiasis

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Erythematous Candidiasis.

The erythematous form of $a&didiasis 1as

+r%4io#sl' r%f%rr%d to as atrophic oral candidiasis

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Chronic Plaque-Type and

Nodular Candidiasis.

candidal leukoplakia, the typical clinicalpresentation is +hara+teri@ed #" a white$la


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-)ro&i$ +la9#%/t'+% $a&didiasis

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-)ro&i$ &od#lar $a&didiasis i& t)%

l%ft r%tro$o""iss#ral ar%a

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Angular Cheilitis.

infected fissures of the $o""iss#r%s of t)% "o#t),

oft%& s#rro#&d%d (' %r't)%"a

KULIAH DMF2 2


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Median Rhomboid Glossitis

Atr$h" - the -ili-rm $a$illae0The etilg" miBed#a+terial)-ungal mi+r-lra

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Benign Migratory Glossitis (Geographic

Tongue)$ir$#"f%r%&tiall' "igrati&g as %r't)%"ato#s ar%a

r%fl%$ti&g atro+)' of t)% filifor" +a+illa%*

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K%l%&ar sali4a

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K%l%&ar sali4a

There are three ma!r sali/ar" glands: the$artid, su#mandi#ular, and su#lingual0These are $aired glands The minr sali/ar"

glands dis$ersed thrughut the ral +a/it" ("m$tms in the $atient with sali/ar" gland

h"$-un+tin are related t de+reased -luid inthe ral +a/it" and the e--e+ts this has nmu+sal h"dratin and ral -un+tins0

D"s-un+tin - the sali/ar" glands, the mst+mmn - +m$laints - dr" muth :Berstmia


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!%&'akit +ada K%l%&ar Sali4a

INFEKSI

A0 In-eksi Cirus

0 In-eksi akteri In-eksi Cirus, +nth : Mumps&e$idemi+ $artitis'

dise#a#kan : $aram"B/irus Penularan : kntak langsung,

makanan dan minuman

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Men"erang : kelen!ar sali/a &$rimer#isa mem$engaruhi gnads, 5E(,kelen!ar th"rid, $an+reas danm"+ard0ila men"erang gnad t!dsterilitas

Insiden menurun se!ak ditemukan

/aksin MM &measles, mum$s0u#ella'

KULIAH DMF2


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Ma&if%stasi kli&is:

Pem#engkakan mendadak dan tdk ditemukan $us $adamuara kelen!ar, $em#engkakan terus mem#esar selama2% hari dan sem#uh hari ke 70 Pem#engkakan sakit #iladisentuh dan n"eri #ila makan makanan asam0 Kulitsekitar, muara kelen!ar $artis &stensen du+t' in-lamasi0

*e!alasistemik :demam, malaise, anreksia, heada+he,$ada rang dewasa ge!ala sistemik ini le#ih $arahdari$ada anak%anak0

Ke#an"akan $ada kelen!ar $artis0 Eamun kelen!arsu#mandi#ular !uga #isa namun tidak #egitu sakit0

iasa men"erang satu sisi le#ih dahulu 23%38 !am Pen"akit ini sel- limiting0

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Ko"+likasi

Or+hitis Dea-ness:

Meningitis: O$hritis

&radang$ada/arium',$an+reatitis,m"+arditis, $en"akit s"ara- s$tells $als" dan*uillain%arrG s"ndrme'

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http://www.medicinenet.com/script/main/art.asp?articlekey=1971http://www.medicinenet.com/script/main/art.asp?articlekey=1971


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In-eksi /irus "ang lain "ang da$atmen"e#a#kan $em#engkakan $adakelen!ar sali/a adalah =$stein%arr/irus &=C', +"tmegal/irus &5MC', 5Bsa+kie/irus, and the humanimmunde-i+ien+" /irus &HIC'0,

KULIAH DMF2
http://www.webmd.com/a-to-z-guides/cytomegalovirus-infectionhttp://www.webmd.com/hiv-aids/default.htmhttp://www.webmd.com/hiv-aids/default.htmhttp://www.webmd.com/a-to-z-guides/cytomegalovirus-infection


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;* I&f%ksi(akt%ri: ak#t kro&is

Bacterial Sialadenitis cute suppurati!e parotitis0

Men"e#a#kan $enurunan -lw sali/a $ada

$asien "ang lemah0 Pasien #iasan"a dewasa0Pada anak%anak

sering kem#uhan dan sem#uh $ada usia 2tahun

Pen"e#a# : sta$h"l+++us aureus "angresisten terhada$ $eni+illin0

KULIAH DMF2 3


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A$#t% (a$t%rial sialad%&itis a&d +#r#l%&t

dis$)arg% fro" St%&s%&


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Ma&if%sitasiKli&is

asa sakit ti#a2 $ada sudut rahang "angmem#uruk saat $enderita mem#uka mulutmakan dan #i+ara0 asa sakit "ang sangat

#isa ter!adi #ila +a$sule $artis terkena0 Pemeriksaan klinis kelen!ar mem#esar dan

$eka0kulit diatasn"a merah danhangat0 Diagnisis ditegakkan dg adan"a $us "ang

keluar melalui muara du+tus stenni #ilakelen!ar ditekan0

KULIAH DMF2 6


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erstmia &dr" muth' is nt a disease, a s"m$tm -

/arius medi+al +nditins, a side e--e+t - a radiatin t the head

and ne+k, a side e--e+t - a wide /ariet" -

medi+atins0

KULIAH DMF2 7


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KULIAH DMF2 8

It ma" r ma" nt #e ass+iated withde+reased sali/ar" gland -un+tin0

erstmia a--e+ting a$$rBimatel" 2

$er+ent - the elderl"0 ertmia des nt a$$ear t #e related

t age itsel- as mu+h as t the $tential-r elderl" t #e taking medi+atins that

+ause Berstmia as a side e--e+t0


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KULIAH DMF2 9

Functions of saliva

(ali/a $ssesses man" im$rtant -un+tinsin+luding antimi+r#ial a+ti/it",me+hani+al +leansing a+tin, +ntrl - $H, rem/al - -d de#ris -rm the ral +a/it", lu#ri+atin - the ral +a/it",

reminerali@atin andmaintaining the integrit" - the ral mu+sa0


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KULIAH DMF2 3

Signs and syptos

$r#lems with eating, s$eaking,swallwing and wearing dentures0

Dr", +rum#l" -ds, su+h as +ereals and+ra+kers, ma" #e $arti+ularl" di--i+ult t

+hew and swallw0 Denture wearers ma" ha/e $r#lems with

denture retentin, denture sres and thetngue sti+king t the $alate0


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KULIAH DMF2 31

Patients with Berstmia -ten +m$lain- taste disrders &d"sgeusia',

a $ain-ul tngue &glssd"nia' and an in+reased need t drink water,

es$e+iall" at night


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KULIAH DMF2 32

erstmia +an lead t in+reased dental +aries, $artid gland enlargement,

in-lammatin and -issuring - the li$s&+heilitis', in-lammatin r ul+ers - the tngue and

#u++al mu+sa, ral +andidiasis,

sali/ar" gland in-e+tin &sialadenitis', halitsis and +ra+king and -issuring - the ral mu+sa0


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KULIAH DMF2 3

Coplications associated !ith

"erostoia

erstmia is -ten a +ntri#uting -a+tr-r #th minr and serius health$r#lems0 It +an a--e+t nutritin and

dental, as well as $s"+hlgi+al, health0 (me +mmn $r#lems in+lude a +nstant sre thrat, #urning sensatin, di--i+ult" s$eaking and swallwing,

harseness and)r dr" nasal $assages0


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KULIAH DMF2 33

erstmia is an riginal hidden +ause -gum disease and tth lss in three ut -e/er" 1 adults0

I- le-t untreated, Berstmia de+reasesthe ral $H0


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KULIAH DMF2 34

Coon causes of "erostoia #

$% Medications

The mst $re/alent +ause A--e+t the


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KULIAH DMF2 36

Other drug in+lude antiemeti+s,antianBiet" agents, de+ngestants,analgesi+s, antidiarrheals, #rn+hdilatrs

and skeletal mus+le relaBants0 these e--e+ts are generall" nt

$ermanent0


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KULIAH DMF2 37

&% 'iseases and other conditions

"S#$%ren&s s'ndrome (SS) a +hrni+ in-lammatr" autimmune disease

that ++urs $redminantl" in $stmen$ausalwmen0

It is estimated that as man" as $er+ent -Ameri+ans su--er -rm (!grenJs s"ndrme,with 9 $er+ent - these $atients #eingwmen with a mean age at diagnsis - 4"ears0

(( is +hara+teri@ed #" l"m$h+"ti+ in-iltratin- sali/ar" and la+rimal glands, resulting inBerstmia and Ber$hthalmia0


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KULIAH DMF2 38

This +m#inatin is +alled the si++a+m$leB0

=nlargement - ma!r sali/ar" glands

++urs in a#ut ne%third - $atients with((0 There is n +ure -r the disease0 Thegal - thera$" is t manage s"m$tms0


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KULIAH DMF2 39

5mmn s"m$tms ass+iated with ((,in additin t Berstmia andBer$hthalmia, in+lude #lurred /isin,re+urrent e"e and muth in-e+tins,d"s$hagia r di--i+ult" swallwing, ralsreness, smell and taste alternatins,-issures n the tngue and li$s, -atigue,dr" nasal $assages and thrat,

+nsti$atin and /aginal dr"ness0


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KULIAH DMF2 4

0 (ar+idsis and am"lidsis are ther+hrni+ in-lammatr" diseases that +auseBerstmia0 In sar+idsis, granulmas insali/ar" glands result in redu+ed sali/ar"

-lw0 In am"lidsis, am"lid de$sits inthe sali/ar" glands result in de/el$ment- Berstmia0&2'


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KULIAH DMF2 41

+0 HIC%sali/ar" gland disease ++urs in smeindi/iduals in-e+ted with HIC, mainl" in+hildren0 This disease results inenlargement - the $artid glands and,++asinall", the su#mandi#ular glands,resulting in Berstmia0 The T%l"m$h+"tein-iltrate is mainl" +m$rised - 5D8+ells, as +m$ared with (( where 5D3

+ells $redminate0


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KULIAH DMF2 42

D0 Other s"stemi+ diseases in+lude rheumatid arthritis, s"stemi+ lu$us

er"thematsus, s+lerderma, dia#etesmellitus, h"$ertensin, +"sti+ -i#rsis, #nemarrw trans$lantatin, end+rine disrders,

nutritinal de-i+ien+ies, ne$hritis, th"ridd"s-un+tin and neurlgi+al diseases su+has ellJs $als" and +ere#ral $als"0

H"$se+retr" +nditins, su+h as $rimar"#iliar" +irrhsis, atr$hi+ gastritis and

$an+reati+ insu--i+ien+", ma" als +auseBerstmia0


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KULIAH DMF2 4

Deh"dratin resulting -rm im$airedwater intake, emesis, diarrhea r$l"uria0

Ps"+hgeni+ +auses, su+h asde$ressin, anBiet", stress r -ear,0

Al@heimerJs disease r strke ma" alterthe a#ilit" t $er+ei/e ral sensatins0

h"$er/entilatin, #reathing thrugh themuth, smking r drinking al+hl0


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KULIAH DMF2 43

Trauma t the head and ne+k area +andamage the ner/es su$$l"ingsensatin t the muth, im$airing thenrmal -un+tin - the sali/ar" glands0

erstmia ma" als ++ur duringgra-t%/s0%hst disease0 hen dnrl"m$h+"tes $rli-erate and in-iltratethe re+i$ientJs sali/ar" glands andther tissues, +hanges +an ++ur in a

+lini+al $attern resem#ling thse seenin (!grenJs s"ndrme02


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KULIAH DMF2 44

% Cancer therapy

erstmia is the mst +mmn tBi+it"ass+iated with standard -ra+tinatedradiatin thera$" t the head and ne+k0

A+ute Berstmia -rm radiatin is due tan in-lammatr" rea+tin,

late Berstmia, whi+h +an ++ur u$ tne "ear a-ter radiatin thera$", results

-rm -i#rsis - the sali/ar" gland and isusuall" $ermanent0


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KULIAH DMF2 46

adiatin +auses +hanges in the serusse+retr" +ells, resulting in a redu+tin insali/ar" ut$ut and in+reased /is+sit" -the sali/a0

A +mmn earl" +m$laint -llwingradiatin thera$" is thi+k r sti+k" sali/a0

The degree - $ermanent Berstmiade$ends n the /lume - sali/ar" gland

eB$sed t radiatin and the radiatindse0


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KULIAH DMF2 47

hen the ttal radiatin dse eB+eeds4,2 +*", sali/ar" -lw is redu+ed, andlittle r n sali/a is eB$ressi#le -rm the

sali/ar" du+ts0 These +hanges aret"$i+all" $ermanent0

5ertain +an+er +hemthera$euti+ drugs

+an als +hange the +m$sitin and -lw- sali/a, resulting in Berstmia, #utthese +hanges are usuall" tem$rar"


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KULIAH DMF2 48

Patients eB$erien+ing Berstmia -rmradiatin thera$" r +an+er +hemthera$"are at $arti+ular risk - in-e+tins -rmnrmal ral -lra0 Oral ul+eratins +an#e+me in/asi/e gram%$siti/e and gram%negati/e in-e+tins, and $$rtunisti+in-e+tins with -ungal rganisms su+h as5andida +an ++ur0


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atrofi mukosa.ppt

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