Color Atlas of Oral Diseases in Children and Adolescents. George Laskaris. Читать онлайн. Newlib. NEWLIB.NET

Автор: George Laskaris
Издательство: Ingram
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Жанр произведения: Медицина
Год издания: 0
isbn: 9783131604712
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      • The lesions may be mild or severe, and they usually have similar clinical features.

      • Clinically, the lesions present as white or erythematous wrinkled plaques, erosions or ulcerations, which are often covered by whitish pseudomembranes (Figs. 4.1–4.4).

      • The use of the rubber dam has significantly reduced iatrogenic burns.

      • The diagnosis is based on the history, the clinical features, and exclusion of other lesions or diseases.

       Differential diagnosis

      • Traumatic lesions

      • Thermal burns

      • Electric burn

      • Erosions seen in lichen planus and bullous diseases

       Treatment

      • Symptomatic. The lesions usually disappear within a week on removal of the chemical or the drug.

      • Topical and, rarely, systemic steroids in severe cases.

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      Fig. 4.1 Aspirin burn on the buccal mucosa and retromolar area

      

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      Fig. 4.2 Trichloroacetic acid burn on the lower labial mucosa

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      Fig. 4.3 Chlorine compound burn on the lower lip

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      Fig. 4.4 Severe and extensive erosions of the lips and tongue due to accidental contact with an agricultural compound

       Definition

      • Angioneurotic edema is a relatively common diffuse allergic reaction of the soft tissues. The disorder may be hereditary (rare) or acquired (common).

       Etioiogy

      • The acquired form may be caused by local anesthetics, drugs, foods, infections, emotional stress, etc.

      • The hereditary form is inherited as an autosomal dominant trait.

      • The great majority of angioneurotic edemas are idiopathic.

       Occurrence in children

      • Relatively rare.

       Localization

      • Oral mucosa (lips, tongue, soft palate, buccal mucosa).

      • Skin (face, hands, arms, legs, genitals).

      • Respiratory and gastrointestinal tract occur mainly in the hereditary form.

       Clinical features

      • Acute, painless soft-tissue swelling, with a smooth, shiny surface (Fig. 4.5).

      • The enlargement resolves within 24–72 hours.

      • The swelling may be solitary or multiple, and the size be up to several centimeters in diameter.

      • Edema of the epiglottis represents a severe complication that may result in death.

       Differential diagnosis

      • Glandular cheilitis

      • Cheilitis granulomatosa

      • Melkersson–Rosenthal syndrome

      • Lymphedema

      • Surgical emphysema

      • Acute abscess of the soft tissues

      • Traumatic swelling

       Treatment

      • Antihistamines, systemic corticosteroids.

      • In severe cases, intramuscular epinephrine.

      

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      Fig. 4.5 Acquired form of angioneurotic edema on the lower lip

      

      5 Foreign-Body Deposits

       Definition

      • Amalgam tattoo is a submucosal implantation of dental amalgam.

       Etioiogy

      • The most common ways that amalgam can be incorporated into the oral mucosa are: continuous contact between an amalgam filling and the oral soft tissues, and embedding of amalgam fragments into the oral tissues during dental filling or surgery.

       Occurrence in children

      • Relatively rare.

       Localization

      • The most common sites are the gingiva, alveolar mucosa, buccal mucosa, palate, and floor of the mouth.

       Clinical features

      • Clinically, amalgam tattoo presents as a black or dark-blue asymptomatic macule or plaque (Fig. 5.1). The borders of the lesion may be well defined or irregular, and the size varies from a few millimeters to several centimeters.

      • Adjacent teeth usually have amalgam restorations.

      • The diagnosis is usually based on the clinical features.

       Laboratory findings

      • Amalgam fragments may be visible on the radiograph as a densely radiopaque lesion.

      • Microscopically scattered dark-brown granules are seen in the connective tissue.

       Differential diagnosis

      • Pigmentation from other metals

      • Melanocytic nevus

      • Freckle and ephelis

      • Malignant melanoma

      • Pigmentation due to drugs

       Treatment

      • Treatment is not required.

      • Excisional biopsy is required only for diagnostic purposes.

       Definition

      • Incorporation of foreign body materials into the oral mucosa, such as silver, pencil graphite, metal dust, fish bone, wood pieces and other solid material.

       Occurrence in children

      • Common.

       Localization

      • Gingiva, alveolar mucosa, tongue, buccal mucosa, palate, lips.