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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      • Clinically, the lesions present as an asymptomatic, grayish or melanotic macule or plaque, or even as an inflammatory swelling (Figs. 5.2, 5.3).

      • The diagnosis is based on the history, clinical features, and occasionally on histopathological features.

       Laboratory tests

      • Radiographic examination.

      • Biopsy and histopathological examination.

       Differential diagnosis

      • Amalgam tattoo

      • Melanocytic nevus

      • Pyogenic granuloma

      • Soft-tissue abscess

       Treatment

      • Surgical excision of the foreign body.

      

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      Fig. 5.1 Amalgam tattoo on the palatal alveolar mucosa

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      Fig. 5.2 Fish bone implantation on the lateral border of the tongue, resulting in an inflammatory swelling

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      Fig. 5.3 Pencil graphite implantation into the dentogingival sulcus of the leteral incisor

       Definition

      • Materia alba is the result of necrotic epithelial cells, bacteria, and accumulation of food debris on the oral mucosa.

       Etiology

      • It is usually seen in patients with poor oral hygiene who neglect toothbrushing, or in cases in which painful oral lesions make oral hygiene difficult.

       Occurrence in children

      • Common.

       Localization

      • Dentogingival margins, attached gingiva, alveolar vestibular mucosa.

       Clinical features

      • Clinically, a white or yellow-whitish plaque is seen, which can be easily removed with slight rubbing, leaving an erythematous surface (Fig. 5.4).

      • The plaque is painless, and is usually accompanied by halitosis.

      • The diagnosis is based on the clinical features.

       Differential diagnosis

      • Candidiasis

      • Leukoplakia

      • Lichen planus

      • Chemical burn

       Treatment

      • Good oral hygiene.

      

Image

      Fig. 5.4 Materia alba on the attached lower gingiva

      

      6 Periodontal Diseases

       Definition

      • Gingivitis is an inflammatory disease of the marginal gingiva, either localized or generalized.

       Etiology

      • It is primarily caused by bacterial plaque accumulation due to inadequate oral hygiene.

      • Calculus, mechanical irritation, and irregularities in the position of the teeth may be contributory factors.

       Occurrence in children

      • Common.

       Localization

      • Free and interdental gingiva. Mainly observed during the mixed dentition, and more rarely in the primary dentition.

      • Sometimes in areas of tooth eruption (eruption gingivitis).

       Clinical features

      • Redness and edema, usually without pain (Fig. 6.1).

      • Gingival hyperplasia may sometimes be observed (Fig. 6.2).

      • Bleeding may occur spontaneously, or after light probing.

      • There is often halitosis.

      • The diagnosis is made clinically.

       Differential diagnosis

      • Desquamative gingivitis

      • Drug-induced gingival hyperplasia

      • Gingivitis due to mouth breathing

      • Acute leukemia

       Treatment

      • Plaque control and good oral hygiene.

      • Gingivectomy, in cases of severe gingival hyperplasia.

       Definition

      • Periodontitis is the result of progression of the inflammatory process from the gingiva to the deeper periodontal structures.

       Etiology

      • Bacterial plaque is important for the initiation of the disease.

      • The same factors as in chronic gingivitis, which usually evolve into periodontitis.

      • Systemic predisposing factors include: diabetes mellitus, human immunodeficiency virus (HIV) infection, immune diseases, metabolic diseases, etc.

      • Host factors are also important, and appear to be influenced by genetic and environmental factors such as smoking.

       Occurrence in children

      • Rare, mainly in adolescents.

       Localization

      • Localized or generalized.

       Clinical features

      • The consequences of periodontitis are alveolar bone resorption and loss of attachment, followed by periodontal pocket formation.

      • Inflammation and edema of the gingiva, pockets deeper than 3 mm (Fig. 6.3).

      • Bleeding and malodorous breath, teeth migration, tooth movement.

      • The diagnosis is usually made clinically.

       Radiographic features

      • Alveolar bone resorption.

       Differential diagnosis

      •