Oral path exam 3-3

changes that affect the oral flora so that organisms that are usually nonpathogenic are able to cause disease

most common affecting tissues of the oral cavity?

Infectious chronic granulomatous disease caused by Mycobacterium tuberculosis

when kidneys and liver become involved

involvement of the submandibular and cervical lymph nodes – swelled

-infection caused by a filamentous bacterium Actinomyces israelii
-formation of abscesses that tend to drain by the formation of sinus tracts

the colonies or organisms appear in the pus as tiny bright yellow grains

- caused by the spirochete Treponema pallidum
-transmitted by direct contact – sexual, also blood transfusion or transplacental inoculation

firm mass that eventually becomes an ulcer found on tongue and palate
- a destructive lesion that can perforate the palatal bone

-can be transmitted from infected mother to the fetus by crossing placental barrier
-causes serious/irreversible damage to the child (facial/dental abnormalities)
-Hutchinson’s incisors and Mulberry molars

- painful erythematous gingivitis in which there is necrosis of the interdental papillae
-caused by a fusiform bacillus and spirochete (Borrelia vincentii)
-gingival painful and erythematous – foul (fetid) odor
-cratering of interdental papillae
-Tx: débridement and ABC therapy – tetracycline

- inflammation of mucosa around the crown of a partially erupted, impacted tooth
-most common with mand. 3rd molar
- operculum – soft tissue flap covering partial eruption
-Tx: débridement, irrigation, ABC use, EXTRACTION

-acute inflammation of the bone and bone marrow
- most commonly a result of the extension of a PA abscess
-microscopic exam reveals:
nonviable bone
necrotic debris
acute inflammation
bacterial colonies in marrow spaces
Tx: drainage and ABC therapy

-long standing inflammation of bone
due to:
inadequately treated Acute Osteo
Paget’s Disease
Sickle cell disease
Bone irradiation
-bone is painful and swollen
-radiographically – diffuse, irregular (RL)
-when lesion becomes (RO)
Dx based on biopsy
Tx: Débridement and ABC Tx
Some cases require hyperbaric O2

Also called “thrush”Occurs as an overgrowth of the yeast-like fungus
Most common

- presents as an erythematous lesion with a white surface that is easily revived by rubbing with a 2x2
-commonly Tx: NYSTATIN

-most common type affecting oral mucosa
-also known as Denture Stomatitis – associated with denture or partial

white lesion that does not wipe off

-erythema/fissuring at labial commissures
-nutritional deficiency as well

-severe form occurring in patients who are severely immunocompromised (HIV)
-chronic oral and genital mucosal candidiasis

-histoplasmosis, coccidioidomycosis, blastomycosis, and cryptococcosis
all characterized by 1° involvement of the lungs
-oral lesions are chronic, non healing ulcers that can resemble Squamous cell
-Tx: antifungals – amphotericin B or ketoconazole

-rare fungal disease
-inhabitant organism from soil
-occurs in diabetic/debilitated patients
-involves nasal cavity, max. sinus, hard palate

Verruca Vulgaris, Condyloma Acuminatum, Focal Epithelial Hyperplasia:

1. papillary oral lesion caused by a papilloma virus
2. oral lesions are less common than skin lesions
3. lips are one of the most common intraoral sites
4. white, papillary, exophytic lesion resembling a papilloma
-biopsy
-Tx: excision of lesion surgically

1. a benign papillary lesion that is caused by another papillomavirus
2. transmitted by sexual contact
3. more common in anogenital region, transmitted to oral cavity via oral sex
4. lesions on tongue, buccal mucosa, palate, gingival, and alveolar ridge
-pink
-surgical excision

1. characterized by presence of multiple whitish to pink nodules distributed throughout oral mucosa
2. most common in children
3. asymptomatic and usually resolve on their own

what are the 2 forms of HERPES SIMPLEX INFECTION?

more contagious in vesicle stage
can affect fingers – herpetic whitlow
can also affect the eyes

highly contagious disease causing vesicular/pustular eruptions of the skin/mucous membrane

unilateral, painful eruption of vesicles along the distribution of a sensory nerve
-Adults, Occurs with immunodeficiencies and Hodgkin’s disease and Leukemia
-Affects branches of Trigeminal – V1, V2 or V3

named after the town in New York

Vesicles appear on the soft palate
Fever, malaise, sore throat, and difficulty swallowing (dysphagia)

Epidemics in children less than 5 years
Oral lesions with macules or papules on skin of feet, toes, hands and fingers
Resolves within 2 weeks
Usually no Tx

Highly contagious disease – for paramyxovirus?
Small erythematous macules with white necrotic centers?

Viral infection of parotid gland – paramyxovirus

- Infectious mononucleosis, nasopharyngeal carcinoma, Burkitt’s lymphoma, and hairy leukoplakia
-?? sore throat, fever, lymphadenopathy, enlarged spleen, malaise, fatigue
-palatal petechiae

-irregular, corrugated, white lesion most commonly occurring on lateral border of the tongue
-Immunocompromised patients – HIV