ORAL MEDICINE

Done By YOUSEF NASRAWI

* All the slides and images was given by Dr.aceil al-khatib in the lectures

CONTANTS

. White lesions

. Bacterial infections

. Viral infections

. Fungal infections

. Oral ulcerations

. Salivary glands

. Mucocutaneous diseases

. Methods of investigations

White Lesions

Candidal leukoplakia

Leukoplakia of the floor of the mouth

Erythroplakia

Actinic chelitis

Lichen planus

Benign leukoplakia

Malignant leukoplakia

VEL scope

Oral brush biopsy

Bacterial Infections

ANUG

Cancrum oris (noma)

Primary syphilis

Secondary syphilis

Condylomata lata (sec. syphilis)

Tertiary syphilis

Gumma on hard palate

Early congenital syphilis

Late congenital syphilis

Gonococcal Ophthalmia Neonatorum

Gonorrhea The main presentation is having sore throat or

pus discharge from gingiva

Reiter’s syndrome

Tuberculosis

Actinomycosis

Viral Infections

Primary herpetic gingivostomatitis

Recurrent Herpes

Herpetic whitlow

Varicella Zoster infections(Chicken pox)

Varicella zoster infections(Shingles)

Ramsay hunt syndrome

Infections mononucleosis

Burkitt’s Lymphoma

Hairy leukoplakia

Hand foot and mouth disease

Herpangina

Paramyxovirus infections(measles)

Mumps

Human papilloma virus

Fungal Infections

Candida albicans (IMPORTANT)

Pseudo membranous candidosis

Infant with candidosis

Hyper-plastic candidosis

Erythematous candidosis

Median Rhomboid Glossitis

Denture stomatitis (Type I,II,III)

Angular cheilitis

Chronic mucocutanuoes candidosis

Mucormycosis

Oral Ulcerations

Traumatic ulcer

Factitious ulcer

Minor aphthous ulceration

Major aphthous ulceration

Herpetiform ulceration

Histology of aphthous ulceration: (a) Aphthous ulcer of the lip defecting the epithelial layer (HE, 100).

(b) Magnified feature of the ulcer edge of the epithelial layer. The epithelial cells are surrounded by inflammatory infiltrates like

“Rosetta formation.”

Ulcerative Colitis

MAGIC syndrome

Sweet’s syndrome

Behcet’s disease

Pathergy Test (behcet’s disease)

Salivary Gland Disorders

Sublingual salivary glands

Submandibular glands

Parotid gland

Sialometry

Carlson-Crittenden Collector

Plain radiograph of the submandibular region in AP: (A) and lateral oblique (B) projection showing soft tissue

swelling associated with a small calculus (arrow) visible on lateral oblique view taken with depressed tongue

Axial CT scan of the neck showing a left parotid pleomorphic adenoma

CT scan of the left enlarged parotid gland

Accessory parotid gland with ectopic fistulous duct: The child was managed surgically by internalisation of the duct to

open into the buccal mucosa and excision of pre-aural appendages.

Ultrasound showing swollen left and normal right submandibular gland

Conventional Sialography of submandibular gland

(A) and parotid glands (B) showing ductal system

Snow Storm appearance (sjogren’s syndrome)

Scintigraphy

MRI

Sialendoscopy

Sialolithiasis

Bacterial sialdenitis

Acute parotitis

Viral sialadenitis (mumps)

Sialosis (Sialadenosis)

Necrotizing Sialometaplasia

Sarcodosis

Xerostomia

Sjogren’s syndrome (SS)

Schirmer Test (for SS)

Sialorrhea (Ptyalism)

Inflammatory Overgrowths

Fibrous epulis

Pyogenic granuloma

Pregnancy epulis

Peripheral giant cell granuloma

Fibroepithelial Polyp

Denture granuloma

Heck’s disease

Heamangioma

Lymphangioma

Lymphangioma on the palate A very unique case of congenital intra-oral lymphangioma

circumscriptum in a 10-year-old boy presented with a predominantly-unilateral, grouped, deep-seated vesicles

some of which were bloody, confined to the right posterior half of the hard palate.

White sponge naevus

White sponge naevus

Pachyonychia congenita

Benign Intraepithelial Dyskeratosis (Witkop’s)

Dyskeratoses congentia

Tylosis palmoplantar keratoderma

Darier’s disease

Squamous cell papilloma

Traumatic keratosis

Nicotinic stomatitis

Amalgam tattoos

Mucoctaneous Diseases I

Lichen planus

Lichen planus (Koebner phenomenon)

Non erosive LP

Erosive LP

Histopathlogy of LP

that show the lymphocytic band like infiltrate.

GVHD

Chronic ulcerative stomatitis

Pemphigus vulgaris

Pemphigus vegetants

Pemphigus foliaeous

Paraneoplastic pemphigus

Hailey-Hailey disease

Nikolsky sign

Histopathlogy for pemphegus A) Light microscopy studies of an early bulla reveal subepidermal

blistering with a superficial dermal inflammatory infiltrate rich in eosinophils. The cavity of the bulla contains nets of fibrin

andsome eosinophils and neutrophils. (B) Direct

immunofluorescence studies from 'perilesional' skin shows linear continuous deposits of IgG along the dermoepidermal

junction. (C) Indirect immunofluorescence studies using NaCl-

split skin shows autoantibodies that bind to the epidermal side of the separation.

Mucoctaneous Diseases II

Bullous pemphigoid

Mucosal membrane pemphigoid

Antiepiligrin cicatrical pemphigoid (AECP)

Erythema multiforme

Epidermolysis bullosa

Epithelial peeling

Oral blood blisters

Systemic lupus erythromatosus

Discoid lupus

Morphoea

Systemic sclerosis

Systemic sclerosis

Methods of Investigations

Primary hyperparathyroidism

(Salt and pepper appearance)

Paget’s disease

Multiple myeloma

(Punched-out appearance)

Microscopic image of direct immunoflurescence using an anti-IgG antibody. The tissue is skin from a patient with

Pemphigus vulgaris.

Microscopic image of direct immunoflurescence using an anti-IgG antibody. The tissue is skin from a patient with

Pemphigoid lesion

Incisional biopsy

Excisional biopsy

Pleomorphic adenoma

(Incisional biopsy)

Melanoma

(Excisional biopsy)

Warts

(Excisional biopsy)

Oral brush biopsy

THE END