Dr ,V.RAMKUMARCONSULTANT DENTAL& FACIOMAXILLARY SURGEON

REGNO: 4118-TAMILNADU-INDIA(ASIA)

PRECANCEROUS LESION

• Morphologically altered tissue in which cancer is more likely to occur than with its apparently normal counter part

PRECANCEROUS CONDITION

• Generalized state associated significantly with significantly

• Increase risk of cancer.

• Leukoplakia

• Lichenplanus

• Oral submucous fibrosis

LEUKOPLAKIA

• Clinically raised white patchmore than 5mm in diameter which is unscrapable that cannot be diffentiated clinically or histopathologically unless tobacco is an etiology

HISTO PATHOLOGICAL FEATURES

• Abnormal keratinization

• Epithelial hyperplasia• Hyperkeratosis• Parakeratosis• Dyskeratosis• Acanthosis

TYPES OF LEUKOPLAKIA

• Speckled leukoplakia• Nodular leukoplakia• Homogenous leukoplakia• Erythroplakia

ERYTHROPLAKIA

• A malignant variant of leukoplakia which is red in colour and have a greater precancerous potential histopatholgically termed carcinoma insitu.

SMOOKERS KERATOSIS

• Site- cheek, palate floor of mouth• Etiology- heat, chemicals.• Increase product of keratin leads

inflammation, swellling reduction of salivary secretion

• The condition is reversible when the habit is stopped

• If the habit continues it leads to malignancy

MANAGEMENT

• MedicalTopical,systemic,intralesional

steroids.Ointments, paste.

SURGICAL MANAGEMENT

• Lasers

• Cryosurgery

• Surgical excision with cautery

ORAL LICHENPLANUS

• Chronic inflammatory immunological reactionin which epidermal or epithelial basal cell damageproduces mucocutaneous lesions of various types

• Etiology –associated with stress• Clinically-unilateral or bilateral• Types- erosive,bullous verucous• Clinical features virchams striae.

(radiating pattern)• Associated with diabetes known as

grispan syndrome

MANAGEMENT

• MedicalTopical,systemic,intralesional

steroids.Ointments, paste lozengesor mouth

wash.Topical flourinated corticosteroid5%mixture of LA

OTHER DRUGS

• Griseogulvin

• Cyclosporin• vitamin A and retinoids• Dapsone

RECENT ADVANCES

• Laser

• cryosurgery

PROTOCOL FOR MANAGEMENT OF LICHEN PLANUS

• Asymptomatic disease- No management reviewSymptomatic case• Antifungal agent• Ohi• Removal of local irritant• Topical steroid for 2 week• Steroid mouth wash .5mg in 10ml for5 min• Intralesional steroid triamcinolone 10mg• follow up 3 to 6 months

ORALSUBMUCOUSFIBROSIS

• It is a chronic insidous disease of the jaw and oral cavity usually associated with juxtra epithelial inflammatory cell.

CLINICAL FEATURES

• Difficulty- Speech

• - Swallowing

• -Mastication

• -Trismus

MEDICAL MANAGEMENT

• Antioxidant- Retinoid,B-carotene

• Vitamin E

• Vitamin A

SURGERY

• Surgical excision of fibrotic bands

• Flaps

RECENT ADVANCES

• LASER

• CRYOSURGERY