Textbook of Oral Medicine, Oral Diagnosis and Oral Radiology - E-Book

Cover Front matter Copyright Dedication Foreword I Foreword II List of Contributors Preface to theSecond Edition Preface to the First Edition Acknowledgments Contents SECTION 1 - Introduction and Approachto Diagnosis Chapter 1 - History and Scope of Oral Medicine and Oral Radiology History of Oral Medicine Mission Training and Scope of Practice Future Oral and Maxillofacial Radiology Oral Medicine and Radiology in India Course and Curriculum of Oral Medicine and Radiology Undergraduate Student Competencies as per Dental Council of India Regulations Scope and Future of Oral Medicine and Radiology in India SECTION 2 - Oral andMaxillofacialDisturbances Chapter 2 - Developmental Disturbances Fordyce's Granules (Fordyce's Spots/Disease) Lingual Tonsils Fissured Tongue Management Leukoedema Clinical features Histopathology and ultrastructural features Treatment Retrocuspid Papillae Histological features Prominent Palatal Rugae Classification of Palatine Rugae Based on Length Lingual Varices Etiopathogenesis Clinical features Histopathologic features Management Circumvallate Papillae or Vallate Papillae Parotid Papilla Racial Pigmentation/Physiological Pigmentation Clinical features Pathophyisology Management Hairy Tongue Clinical features Mlandibular and Maxillary Tori Exostoses Etiopathogenesis Clinical classification Torus/Tori Clinical classification of tori based on morphology Flat torus Lobular torus Nodular torus Spindle torus Torus palatinus Torus mandibularis Buccal exostoses Palatal Exostoses Reactive Subpontine Exostoses Radiographic findings Histopathologic features Clinical considerations Management and prognosis Soft Tissue Disturbances Developmental Disorders Affecting Tongue Aglossia/Lingual Agenesis/Aglossia Congenita Microglossia/Hypoglossia Macroglossia Clinical features Management Ankyloglossia/Tongue-tie Classification of ankyloglossia Clinical significance Cleft Tongue Fissured Tongue Geographic Tongue Etiopathogenesis and predisposing factors Clinical features Histopathologic features Management Lingual Varices Lingual Thyroid Tongue Pits Developmental Disorders Affecting the Lip Paramedian Lip Pits (Congenital Lip Pits) Commissural Lip Pits Double Lip Cleft Lip and Cleft Palate Cleft lip Cleft palate (Figure 28) Prenatal Diagnosis of Clefts Developmental Disorders Affecting Buccal Mucosa and Gingiva Oral Melanotic Macule Fordyce's Granules (Fordyce's Disease/Spots) Fibromatosis Gingivae Hard Tissue Disturbances (Jaws) Developmental Disturbances of the Jaws Agnathia Micrognathia Macrognathia Hemifacial Hyperplasia Etiology and clinical features Intraoral findings Radiographic features Management Hemifacial Atrophy (Parry Romberg Syndrome, Romberg Syndrome) Condylar Aplasia Condylar Hypoplasia Condylar Hyperplasia Clinical features Bifid/Trifid Condyle Coronoid Hyperplasia Exostoses/Tori Developmental Disturbances Affecting Teeth Developmental Disturbances Affecting Size of Teeth Microdontia Macrodontia Developmental Disturbances Affecting the Shape of the Teeth (Gemination, Fusion and Concrescence) Dilaceration Talon Cusp Etiopathogenesis Clinical classification of talon cusp Dens Invaginatus Dens Evaginatus Shovel-shaped incisors Taurodontism Ectopic Enamel Enamel Pearl (Enameloma) Cervical Enamel Extensions (Cervical Enamel Projections) Supernumerary Roots/Accessory Roots Supernumerary Cusps/Accessory Cusps Developmental Disturbances in Number of Teeth Hypodontia and oligodontia Hyperdontia Disturbances of Eruption of Teeth Premature eruption Etiopathogenesis Delayed eruption Eruption sequestrum Transposition of teeth Etiology Transmigration Classification of transmigrated canines Impacted Teeth Ankylosed Deciduous Teeth (Submerged Teeth) Developmental Disturbances in Structure of Teeth Developmental defects affecting the structure of enamel Overview of amelogenesis Genes associated with amelogenesis Environmental Enamel Hypoplasia Clinical features Local infection or trauma Irradiation Ingestion of fluoride Chemicals Nutritional deficiencies Exanthematous diseases/infections Congenital syphilis Birth-related injuries Metabolic disorders Celiac disease Amelogenesis Imperfecta Etiology Clinical features Classification Revision of the concepts of inheritance/ genetics The Lyonization effect/Lyon hypothesis/X chromosome inactivation Type I/Hypoplastic AI Clinical features Radiographic features Type II/Hypomaturation AI Clinical features Radiographic features Type III/Hypocalcified Type AI Clinical features Radiographic features Type IV Histological features of AI Diagnosis Differential diagnosis Management Association of AI with syndromes/conditions Developmental Defects Affecting the Structure of Dentin An overview of dentinogenesis Dentinogenesis Imperfecta Etiopathogenesis Classification Clinical features Radiographic appearance Histological features Management Dentin Dysplasia Etiopathogenesis Clinical features Type I/radicular dentin dysplasia Type II/coronal dentin dysplasia Radiographic appearance Type I/radicular dentin dysplasia Type II/coronal dentin dysplasia Histological features Type I/radicular dentin dysplasia Type II/coronal dentin dysplasia Differential diagnosis Management Regional Odontodysplasia Etiology Clinical features Radiographic appearance Histological features Differential diagnosis Management Chapter 3 - Orofacial Pigmentation Disorders Pigmented Lesions of Oral Mucosa Molecular and Pathologic Correlation of Pigmentation Metal Pigmentation Amalgam tattoo Mercury poisoning Arsenic Bismuth Lead Silver Diffuse and Multiple Pigmented Lesions Racial/physiologic pigmentation Drug-induced pigmentation Smoker's melanosis Endocrine disorders Café au lait pigmentation HIV infection Hemochromatosis Post inflammatory pigmentation Cyanosis Beta carotene Liver disease Focal/Localized Pigmented Lesions Hemangioma and vascular malformations Graphite Melanotic macule Pigmented nevi Malignant melanoma Clinical evaluation of pigmented lesions Pigmentation of Teeth Extrinsic Discoloration Classification of Extrinsic Stains Factors responsible for extrinsic discoloration Diet factors Oral hygiene related factors Habit related Drug related Occupation related Predisposing factors Intrinsic Discoloration Pre-eruptive causes of intrinsic discoloration (Table 6) Metabolic causes Disturbance during development of a tooth Genetic defects and hereditary diseases Medications Dental Fluorosis Post-eruptive Causes (Table 7) Dental conditions and caries Pulpal causes Dental Materials Diagnosis History Clinical examination Management Chapter 4 - Bacterial, Viral and Fungal Infections Bacterial Infections Scarlet Fever Clinical features Oral manifestations Management Diphtheria General clinical and oral manifestations Prevention and management Tularemia (Rabbit Fever, Deer-fly Fever, Francis' Disease, Tick-Borne Disease, Ohara's Disease) Clinical manifestations Oral manifestations Management Erysipelas Clinical features Management Impetigo Clinical features Non-bullous impetigo Bullous impetigo Melioidosis Risk factors Clinical features Diagnosis and management Tetanus Pathophysiology Clinical features Differential diagnosis Diagnosis Prevention and management Actinomycosis Clinical features Radiographic features Investigations Management Noma (Cancrum Oris, Gangrenous or Necrotizing Stomatitis) Clinical features Other variants of Noma Complications and management Botryomycosis (Bacterial Pseudomycosis) Clinical types and features Histopathologic features Management Rhinoscleroma (Respiratory Scleroma) Clinical stages Diagnosis Management Cat-Scratch Disease Clinical features Diagnosis Management Viral Infections Infectious Mononucleosis (Monoglandular Fever, Kissing Disease) Clinical features Syndrome association Diagnosis Management Acute Lymphonodular Pharyngitis Clinical features Management Measles (Rubeola) Clinical features Diagnosis Prevention and management German Measles (Rubella) Clinical features Oral manifestations Prevention and management HIV and AIDS Discovery of HIV Structure of the HIV-1 Virion Subtypes HIV-1 Virus Basic Genetics of HIV Stages of Infection (Figures 1â•fi17) Transmission Sexual contact Passage of the virus from infected mothers to the newborns Through blood and parenteral inoculation HIV and Saliva Acquired Immune Deficiency Syndrome Revised Classification System of HIV Disease (CDC, 1993) Category A Category B Category C (AIDS defining conditions) Cardinal findings Characteristic findings Associated findings Stages in HIV disease Correlation of CD4 cell count and AIDS complications Tuberculosis and HIV Oral manifestations Diagnostic criteria 1. Candidiasis 2. Periodontal disease 3. Hairy leukoplakia 4. Oral Kaposi's sarcoma Revised classification by the European Community Clearing House (1992) Group 1: Lesions strongly associated with HIV infection Group 2: Lesions less commonly associated with HIV infection Group 3: Lesions seen in HIV infection Laboratory diagnosis ELISA Test Management I. Fungal disease Candida albicans Herpes simplex virus-1 Varicella zoster virus Cytomegalovirus Human papilloma virus II. Bacterial disease III. Neoplasia Kaposi's sarcoma VI. Aphthous ulcers Universal precautions Sterilization Disinfection SINUSITIS Acute Sinusitis Clinical features Chronic Sinusitis Clinical and radiographic diagnosis Management Fungal Infections and Protozoal Diseases Histoplasmosis Pathogenesis Clinical features Acute Pulmonary Histoplasmosis Chronic Pulmonary Histoplasmosis Disseminated Histoplasmosis Diagnosis Prognosis and management Blastomycosis (Gilchrist Disease) Clinical manifestations Oral features Histologic findings Management Mucormycosis (Zygomycosis, Phycomycosis) Predisposing factors Clinical features Oral manifestations and radiographic features Diagnosis Management Aspergillosis Oral findings Diagnosis Management Cryptococcosis (European Blastomycosis, Torulosis, Busse-Buschke Disease) Types Clinical features Oral features Diagnosis Management Chapter 5 - Orofacial Pain Pain Physiology Common Terminologies Associated with Pain Properties of Pain Weber and Fechner's law Adaptation Pain localization Nociceptors Stimulation of nociceptors Sequelae of Pain Psychological sequelae Muscular sequelae Autonomic nervous system sequelae Reflex Dual Pain Pathways Neospinothalamic tract (for fast pain) Paleospinothalamic tract (for slow pain) Analgesia system or pain inhibitory pathway Gate Control Theory Concept of Referred Pain Characteristics of referred pain Classification of Orofacial Pain Types of Pain Acute pain Chronic pain Clinical Assessment of Pain Pain From Orodental Structures Pulpal Pain Clinical features Diagnosis Periodontal Pain Clinical features Diagnosis Barodontalgia Etiology Underwater Diving Paranasal Sinus-Related Pain Myofascial Pain Clinical features Management Neuralgias Trigeminal Neuralgia Clinical features Differential diagnosis Investigations Treatment Prognosis Glossopharyngeal Neuralgia Clinical features Differential diagnosis Investigations Treatment Prognosis Postherpetic Neuralgia Clinical features Management Nervus Intermedius (Geniculate) Neuralgia Occipital Neuralgia Atypical Odontalgia Clinical features Differential diagnosis Treatment Atypical Facial Pain Clinical features Diagnosis Management Burning Mouth Syndrome Clinical features Differential diagnosis Management SECTION 3 - MucocutaneousDisorders Chapter 6 - Red and White Lesions Color of Oral Mucosa Description of Red and White Lesions White Lesion Red Lesion Etiologic Classification of Red and White Lesions White Lesions of the Oral Cavity Frictional Keratosis/Traumatic Keratosis Management Chemical Burns and Thermal Burns Differential diagnosis Management Nicotine Stomatitis (Stomatitis Nicotine Palatinus, Smoker's Palate) Clinical features Differential diagnosis Leukoplakia Definition WHO definition of leukoplakia (1978) Axell et al definition of leukoplakia (1984) Axell et al definition of leukoplakia (1996) Pindborg et al definition of leukoplakia (1997) Epidemiology Classification and staging system for oral leukoplakia General guidelines for oral leukoplakia staging system Etiopathogenesis Tobacco (smoke/smokeless form) Alcohol Viral infection Leukoplakia and diabetes Candidiasis and leukoplakia Dietary factors Clinical features Clinical forms of leukoplakia Malignant transformation Investigations Differential diagnosis Treatment (Flowchart 1) General considerations Medical management of oral leukoplakia Chemoprevention Carotinoids and retinoids 13-cis retinoic acid Beta-carotene Fenretinide (n-4-hydroxy phenyl retinamide) Vitamin E Photodynamic therapy of oral leukoplakia Topical chemotherapy of oral leukoplakia Newer treatments Gene therapy Other alternative modalities of treatment Green tea Oral lycopene Surgical line of treatment Lichen Planus Definitions Etiopathogenesis Clinical features Skin involvement in lichen planus Oral manifestations Association of oral lichen planus with systemic illness Syndromes associated with OLP Differential diagnosis Investigations Malignant potential of OLP Prognosis Management (Flowchart 2) Immunosuppressive and immunomodulating agents Other treatment modalities Surgery Miscellaneous treatments Lichenoid drug reaction Agents causing lichenoid reactions Betel quid lichenoid lesion Candidiasis Epidemiology Etiology and pathogenesis Clinical presentation Acute pseudomembranous candidiasis Differential diagnosis Chronic hyperplastic candidiasis (candida leukoplakia) Chronic atrophic (erythematous) candidiasis Median rhomboid glossitis Angular cheilitis (perleche) Chronic multifocal oral candidiasis Chronic mucocutaneous candidiasis (CMC) Role of candida in oral carcinogenesis Investigations for candidiasis Smear examination Hematologic investigations Biopsy Microbiology Imprint culture technique Salivary culture technique Oral rinse technique Immunologic tests Rationale for treatment Topical versus systemic drugs Suggested medications for the treatment of candidiasis (Flowchart 3) Topical antifungal medications Treatment for chronic atropic candidiasis Complementary and alternative medicine Oral Submucous Fibrosis Epidemiology Etiopathogenesis Molecular pathogenesis of OSMF (Rajalalitha and Vali, 2005) Clinical features Staging of OSMF Group 1: Very early Group 2: Early cases Group 3: Moderately advanced Group 4: Advanced cases Group 5: Advance cases with premalignant and malignant changes Clinical Staging Functional Staging Malignant potential and oral submucous fibrosis Other diseases associated with OSMF Histopathologic changes Epithelial changes Connective tissue changes Histological staging of OSMF Group 1 Group 2 Group 3 Group 4 Investigations Differential diagnosis Treatment (Flowchart 4) Corticosteroids Placental extracts Hyaluronidase Interferon-gamma Complications Prognosis Psoriasis Hereditary Benign Intraepithelial Dyskeratosis (Witkop's Disease) Witkop-von Sallmann disease Differential diagnosis Focal Epithelial Hyperplasia (Heck's Disease) Clinical features Management Dyskeratosis Congenita White Sponge Nevus Etiopathogenesis Genetic basis Clinical features Differential diagnosis Histopathologic features Treatment Red Lesions of the Oral Cavity Classification of red lesionsâ•ficongenital and acquired Congenital red lesions Acquired red lesions Traumatic erythematous macules Reddish ulcers or ulcers with red halo Soft tissue odontogenic infection (cellulitis) Mucositis secondary to systemic diseases Macular hemangiomas and telangiectasias Polycythemia Lupus erythematosus Red Lesions of the Tongue Migratory Glossitis Median Rhomboid Glossitis Deficiency States Clinical features Foliate Papillitis Erythroplakia Definitions Incidence/prevalence Classification Clinical variations Microscopic variations Etiopathogenesis Clinical features Malignant transformation Differential diagnosis Treatment and recurrence rate Discoid Lupus Erythematosus Classification Etiopathogenesis Genetic factors Role of UV light Environmental factors Clinical features Skin lesions Early lesions Chronic lesions Mucosal or oral lesions Different types of DLE Laboratory findings Immunofluorescence studies Histological features Differential diagnosis Prognosis Management General measures Topical therapy Oral therapy Chapter 7 - Vesiculobullous Disorders Classification of Vesiculobullous Lesions Predominantly Vesicular Lesions Herpes Viruses Herpes Simplex Virus (HSV) Infections Etiology and pathogenesis Clinical features Primary HSV infection Herpetic Whitlow and Herpes Gladiatorum Investigations Recurrent Herpes Infections Herpetic Labialis Differential diagnosis Acute herpetic infections Secondary herpetic infections Treatment Prognosis Varicella Zoster Infections Clinical features Primary infection (chicken pox) Secondary infection (herpes zoster) Complications Associated with Herpes Zoster Investigations Differential diagnosis Treatment and prognosis Hand, Foot and Mouth Disease Etiology Clinical features Oral manifestations Management Herpangina Clinical features Oral manifestations Management Dermatitis Herpetiformis Clinical features Oral manifestations Investigations Management Predominantly Bullous Lesions Pemphigus Types of pemphigus Pemphigus Vulgaris Epidemiology Etiopathogenesis Immunogenetic aspects of etiology Clinical features Oral manifestations Differential diagnosis Investigations Cytology Histopathology Immunofluorescent studies Management Topical therapy Systemic therapy Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Clinical features Diagnostic criteria Histopathologic features and immunological studies Management and prognosis Bullous Pemphigoid Pathophysiology Clinical features Oral manifestations Histopathological and immunofluorescent studies Management and prognosis Mucous Membrane Pemphigoid or Cicatricial Pemphigoid Etiology and pathogenesis Clinical features Oral lesions Ocular findings Histopathology Differential diagnosis Treatment and prognosis Bullous Lichen Planus Histopathological findings Management Erythema Multiforme Etiopathogenesis Clinical features Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (Lyell's Syndrome) Etiopathogenesis Clinical features Histopathological and laboratory studies Management University of Florida management guidelines for TEN and SJS Bullous Impetigo Types Clinical features Management and prognosis Epidermolysis Bullosa Types of EB based on ultrastructural features General clinical features and oral manifestations Epidermolysis bullosa simplex Junctional epidermolysis bullosa Dystrophic epidermolysis bullosa Linear IgA Disease Clinical features Mucosal manifestations Drug-induced LABD Disease associations Management and prognosis Chapter 8 - Oral Ulcerative Diseases Classification Of Oral Ulcers Classification based on etiology Classification based on mode of onset and clinical presentation Traumatic Ulcers Types of Trauma Clinical features Diagnosis Differential diagnosis Histologic features Management Complications Prognosis Ulcers associated with infections (bacterial, viral and fungal infections) Primary Herpetic Gingivostomatitis Clinical features Diagnosis Differential diagnosis Treatment Symptomatic management Specific management Prognosis Recurrent Herpes Infection Precipitating Factors Clinical presentation Diagnosis Treatment Varicella Zoster Infection Chicken Pox Dermal lesions Oral lesions Management Herpes Zoster Clinical features Management Herpangina Clinical findings Hand, Foot and Mouth Disease Clinical features Skin lesions Oral lesions Management Prognosis Acute Necrotizing Ulcerative Gingivitis (Trench Mouth, Vincent's Disease, Vincent's Gingivostomatitis) Predisposing factors Clinical findings Management of ANUG Tuberculosis Oral manifestations Sites Typical lesion Differential diagnosis Management Syphilis Oral manifestations Chancre Mucous patches Gumma Diagnosis and management Deep Fungal Infections Aspergillosis Oral findings Histoplasmosis Mucormycosis Cryptococcosis North American Blastomycosis or Gilchrist's Disease Paracoccidiodomycosis or South American Blastomycosis Clinical features Drug-Induced Oral Ulcers Pathogenic basis of drug-induced stomatitis/oral ulceration Immune-mediated pathway Non-immune mediated pathway Stomatitis Medicamentosa Medications causing oral ulcers Management Stomatitis Venenata (Contact Stomatitis) Types of contact stomatitis Management Erythema Multiforme Blood Disorders Causing Oral Ulcers RBC Disorders WBC Disorders Immunologic Disorders Aphthous Ulcers (Recurrent Aphthous Stomatitis, Aphthae, Canker Sores) Etiopathogenesis Clinical features Types of recurrent aphthous stomatitis Minor aphthous ulcers (Mikulicz ulcer) Major aphthous ulcers (Sutton's ulcers; periadenitis mucosa necrotica recurrents) Herpetiform ulcers Diagnosis Management Dermatological Disorders Pemphigus Clinical features Diagnosis Management Pemphigoid Bullous Pemphigoid Cicatricial Pemphigoid Gastrointestinal Disorders Associated With Oral Ulcers Gastroesophageal Reflux Disease Clinical features Oral manifestations Crohn's Disease Clinical features Oral findings Ulcerative Colitis Clinical features Oral findings Celiac Disease Clinical features Oral findings Neoplastic Ulcers Ulcers Of Unknown Etiology Necrotizing Sialometaplasia Clinical features Diagnosis Syndromes Associated With Oral Ulcers PFAPA Syndrome (Marshall's Syndrome) Diagnostic criteria for PFAPA syndrome (proposed by Thomas et al) MAGIC Syndrome Reiter's Syndrome Behçet's Syndrome International Study Group Criteria for diagnosis of Behçet's syndrome O'Duffy criteria Oral ulcers Genital ulcers Ocular involvement Other clinical findings Stevensâ•fiJohnson Syndrome Clinical findings Diagnostic Protocol Chapter 9 - Dermatological Diseases Lichen Planus Etiopathogenesis Clinical features Investigations Differential diagnosis Management Epidermolysis Bullosa Classification Etiopathogenesis Clinical features Epidermolysis bullosa simplex Epidermolysis bullosa simplex with muscular dystrophy Epidermolysis bullosa atrophicans generalisata graves Epidermolysis bullosa dominant dystrophic/hypertrophic form Scarring epidermolysis bullosa with dermolytic vesicles Differential diagnosis Management Dental management Psoriasis Types Etiopathogenesis Clinical features Histopathology Management Psoriatic arthritis Ectodermal Dysplasia Etiopathogenesis Clinical features Oral manifestations Differential diagnosis Management Ehlersâ•fidanlos Syndrome Villefranche classification of EDS Etiopathogenesis Clinical features Symptoms Signs Oral manifestations Investigations Differential diagnosis Management Dental considerations Pachyonychia Congenita Etiopathogenesis Clinical features Oral manifestations Investigations Dyskeratosis Congenita Clinical features Mucocutaneous features Non-mucocutaneous features Oral manifestations Management Dental considerations Pityriasis Rosea Etiology Clinical features Differential diagnosis Treatment and prognosis Xeroderma Pigmentosum Etiology Clinical features Ocular symptoms Neurological symptoms Oral manifestations Diagnosis Treatment Acanthosis Nigricans Etiology Clinical features Types of AN Management Goltzâ•figorlin Syndrome Clinical features Skin manifestations Facial features Oral features Radiographic findings Treatment and prognosis Acrodermatitis Enteropathica Etiology Clinical features Differential diagnosis Diagnosis Treatment and prognosis Haileyâ•fiHailey Disease (Familial Benign Chronic Pemphigus) Etiology Clinical features Differential diagnosis Treatment and prognosis Darier's Disease (Keratosis Follicularis) Etiology Clinical features Treatment Reiter's Syndrome Etiology Clinical features Genitourinary tract involvement Arthritis Cutaneous lesions Ocular involvement Musculoskeletal features Oral manifestations Treatment and prognosis Incontinentia Pigmenti (Bloch-Sulzberger Syndrome) Clinical features Diagnostic criteria Major criteria Minor criteria (supportive evidence) Evidence of IP in a first degree female relative Differential diagnosis Treatment and prognosis Kawasaki Disease (Mucocutaneous Lymph Node Syndrome) Etiology Clinical features Complications Diagnosis Treatment Tuberous Sclerosis Complex (Epiloia, Bourneville's Disease) Etiopathogenesis Clinical features Major features Suggestive features requiring further investigation Skin lesions Mental deficiency Ocular signs Oral manifestations Treatment and prognosis Graft-Versus-Host Disease Etiology Clinical features Treatment and prognosis SECTION 4 - Diseases of Specific Structures Chapter 10 - Temporomandibular Disorders Components of Temporomandibular Joint Glenoid Fossa and Articular Eminence/Protuberance Mandibular Condyle Articular Capsule and Articular Disk Synovial Fluid Discal Ligaments Posterior Attachment or Retrodiscal Tissue or Bilaminar Zone Ligaments Associated with Temporomandibular Joint Muscles of Mastication Masseter muscle Temporalis muscle Medial pterygoid muscle Lateral pterygoid muscle Suprahyoid muscles Mandibular movements Forward movement or protraction Slight mouth opening Wide mouth opening Chewing movements/lateral excursions Arterial Supply, Venous Drainage and Sensory Innervation of TMJ Clinical Evaluation of Temporomandibular Joint Examination of Temporomandibular Joint Clinical Evaluation of Muscles of Mastication and Accessory/Cervical Muscles Temporalis Masseter Pterygoids Medial pterygoid Lateral pterygoid Digastric muscle Cervical Examination Sternocleidomastoid Posterior cervical muscles Trapezius Splenus capitis Occlusal Evaluation Imaging Protocol Disorders of TMJ Disorders Associated With Deviation/Alteration in the Form of Articular Surfaces Clinical features Articular Disk Defects Disk Thinning and Perforation Clinical features Adherence and Adhesions Clinical features Disk Displacement Disk Displacement with Reduction Clinical features Disk Displacement without Reduction Clinical features Displacement of Diskâ•fiCondyle Complex (Hypermobility and Dislocation) Clinical features Dislocation (Open Lock) Clinical features Types of dislocation Inflammatory Joint Disorders Synovitis or Capsulitis Clinical features Retrodiscitis Clinical features Degenerative Joint Diseases Osteoarthrosis Clinical and radiographic features Management Osteoarthritis Clinical features Radiographic features Juvenile Idiopathic Arthritis Clinical features Polyarthritides Traumatic Arthritis Infectious Arthritis/Septic Arthritis Rheumatoid Arthritis Clinical features Laboratory investigations Radiographic features Psoriatic Arthritis Clinical features Hyperuricemia Clinical features TMJ Ankylosis Etiopathology Trauma Local infections Systemic conditions Arthritis/inflammatory conditions Neoplasms Classification of ankylosis according to tissues involved and extent Classification of ankylosis by Topazian (1966) Grading of TMJ ankylosis Clinical features Clinical features of unilateral ankylosis Facial features Intraoral features Clinical features of bilateral ankylosis Facial features Intraoral features Radiographic features Management Masticatory Muscle Disorders Acute Disorders: Reflex Muscle Splinting Clinical features Management and prognosis Myositis Clinical features Muscle Spasm (Myospasm) Clinical features Chronic Conditions: Myofascial Pain Predisposing factors Pathophysiology Clinical features Primary finding Secondary findings Possible findings Referral pattern for myofascial pain Management Counseling Physiotherapy Trigger point therapy Medication Occlusal splint therapy Transcutaneous electric nerve stimulation (TENS) Muscular Hypertrophy Management Fibromyalgia Clinical features Official diagnostic criteria for fibromyalgia Management Congenital, Developmental and Acquired Disorders of the TMJ Neoplasms Affecting the TMJ Clinical features Benign tumors Malignant tumors Metastatic tumors Condylar Fractures Classification of Condylar Fractures I. Lindhal's classification of condylar fractures 1. Level of fracture (Figure 26) 2. Relationship of the fractured condylar segment to the mandible 3. Relationship of the condylar head to the glenoid fossa II. MacLennan's classification III. Classification of condylar neck fractures Clinical signs and symptoms of condylar fractures Chapter 11 - Diseases of Salivary Glands Developmental Disturbances Aplasia/Agenesis and Related Aberrancy of Salivary Glands Clinical features and diagnosis Diagnostic imaging Management Hyperplasia of Minor Salivary Glands Clinical features Histopathology Treatment Saliva, Xerostomia, Hyposalivation and Sialorrhea Saliva Hypofunction and Xerostomia Xerostomia and Salivary Gland Hypofunction due to Medications Xerostomia and Salivary Gland Hypofunction due to Radiation Therapy Sjögren's Syndrome Classification Etiopathogenesis Clinical features and diagnosis Laboratory diagnosis values Management Benign Lymphoepithelial Lesion (Mikulicz's Disease) Clinical features Diagnosis Treatment Sialorrhea Clinical features Treatment Inflammatory Conditions of Salivary Glands Mucocele Clinical features Histopathology Treatment Ranula Clinical features Histopathology Treatment Sialolithiasis, Salivary Duct Stone, Salivary Calculi Clinical features Diagnostic procedures Histopathology Treatment Sialadenitis Non-specific Sialadenitis Diagnostic imaging Histopathology Treatment Bacterial Sialadenitis Clinical features Histopathology Diagnosis Treatment Subacute Necrotizing Sialadenitis Clinical features Histopathology Treatment Cheilitis Glandularis Clinical features Histopathology Diagnosis Treatment Necrotizing Sialometaplasia Clinical features Diagnostic imaging Histopathology Treatment Chronic Sclerosing Sialadenitis (Kuttner Tumor) Clinical features Histopathology Diagnostic imaging Treatment Viral-Induced Salivary Gland Pathology Mumps Clinical features Prognosis and treatment Human Immunodeficiency Virus (HIV) Clinical features Histopathology Diagnostic imaging Treatment Non-Inflamm Cover Front matter Copyright Dedication Foreword I Foreword II List of Contributors Preface to theSecond Edition Preface to the First Edition Acknowledgments Contents SECTION 1 - Introduction and Approachto Diagnosis Chapter 1 - History and Scope of Oral Medicine and Oral Radiology History of Oral Medicine Mission Training and Scope of Practice Future Oral and Maxillofacial Radiology Oral Medicine and Radiology in India Course and Curriculum of Oral Medicine and Radiology Undergraduate Student Competencies as per Dental Council of India Regulations Scope and Future of Oral Medicine and Radiology in India SECTION 2 - Oral andMaxillofacialDisturbances Chapter 2 - Developmental Disturbances Fordyce's Granules (Fordyce's Spots/Disease) Lingual Tonsils Fissured Tongue Management Leukoedema Clinical features Histopathology and ultrastructural features Treatment Retrocuspid Papillae Histological features Prominent Palatal Rugae Classification of Palatine Rugae Based on Length Lingual Varices Etiopathogenesis Clinical features Histopathologic features Management Circumvallate Papillae or Vallate Papillae Parotid Papilla Racial Pigmentation/Physiological Pigmentation Clinical features Pathophyisology Management Hairy Tongue Clinical features Mlandibular and Maxillary Tori Exostoses Etiopathogenesis Clinical classification Torus/Tori Clinical classification of tori based on morphology Flat torus Lobular torus Nodular torus Spindle torus Torus palatinus Torus mandibularis Buccal exostoses Palatal Exostoses Reactive Subpontine Exostoses Radiographic findings Histopathologic features Clinical considerations Management and prognosis Soft Tissue Disturbances Developmental Disorders Affecting Tongue Aglossia/Lingual Agenesis/Aglossia Congenita Microglossia/Hypoglossia Macroglossia Clinical features Management Ankyloglossia/Tongue-tie Classification of ankyloglossia Clinical significance Cleft Tongue Fissured Tongue Geographic Tongue Etiopathogenesis and predisposing factors Clinical features Histopathologic features Management Lingual Varices Lingual Thyroid Tongue Pits Developmental Disorders Affecting the Lip Paramedian Lip Pits (Congenital Lip Pits) Commissural Lip Pits Double Lip Cleft Lip and Cleft Palate Cleft lip Cleft palate (Figure 28) Prenatal Diagnosis of Clefts Developmental Disorders Affecting Buccal Mucosa and Gingiva Oral Melanotic Macule Fordyce's Granules (Fordyce's Disease/Spots) Fibromatosis Gingivae Hard Tissue Disturbances (Jaws) Developmental Disturbances of the Jaws Agnathia Micrognathia Macrognathia Hemifacial Hyperplasia Etiology and clinical features Intraoral findings Radiographic features Management Hemifacial Atrophy (Parry Romberg Syndrome, Romberg Syndrome) Condylar Aplasia Condylar Hypoplasia Condylar Hyperplasia Clinical features Bifid/Trifid Condyle Coronoid Hyperplasia Exostoses/Tori Developmental Disturbances Affecting Teeth Developmental Disturbances Affecting Size of Teeth Microdontia Macrodontia Developmental Disturbances Affecting the Shape of the Teeth (Gemination, Fusion and Concrescence) Dilaceration Talon Cusp Etiopathogenesis Clinical classification of talon cusp Dens Invaginatus Dens Evaginatus Shovel-shaped incisors Taurodontism Ectopic Enamel Enamel Pearl (Enameloma) Cervical Enamel Extensions (Cervical Enamel Projections) Supernumerary Roots/Accessory Roots Supernumerary Cusps/Accessory Cusps Developmental Disturbances in Number of Teeth Hypodontia and oligodontia Hyperdontia Disturbances of Eruption of Teeth Premature eruption Etiopathogenesis Delayed eruption Eruption sequestrum Transposition of teeth Etiology Transmigration Classification of transmigrated canines Impacted Teeth Ankylosed Deciduous Teeth (Submerged Teeth) Developmental Disturbances in Structure of Teeth Developmental defects affecting the structure of enamel Overview of amelogenesis Genes associated with amelogenesis Environmental Enamel Hypoplasia Clinical features Local infection or trauma Irradiation Ingestion of fluoride Chemicals Nutritional deficiencies Exanthematous diseases/infections Congenital syphilis Birth-related injuries Metabolic disorders Celiac disease Amelogenesis Imperfecta Etiology Clinical features Classification Revision of the concepts of inheritance/ genetics The Lyonization effect/Lyon hypothesis/X chromosome inactivation Type I/Hypoplastic AI Clinical features Radiographic features Type II/Hypomaturation AI Clinical features Radiographic features Type III/Hypocalcified Type AI Clinical features Radiographic features Type IV Histological features of AI Diagnosis Differential diagnosis Management Association of AI with syndromes/conditions Developmental Defects Affecting the Structure of Dentin An overview of dentinogenesis Dentinogenesis Imperfecta Etiopathogenesis Classification Clinical features Radiographic appearance Histological features Management Dentin Dysplasia Etiopathogenesis Clinical features Type I/radicular dentin dysplasia Type II/coronal dentin dysplasia Radiographic appearance Type I/radicular dentin dysplasia Type II/coronal dentin dysplasia Histological features Type I/radicular dentin dysplasia Type II/coronal dentin dysplasia Differential diagnosis Management Regional Odontodysplasia Etiology Clinical features Radiographic appearance Histological features Differential diagnosis Management Chapter 3 - Orofacial Pigmentation Disorders Pigmented Lesions of Oral Mucosa Molecular and Pathologic Correlation of Pigmentation Metal Pigmentation Amalgam tattoo Mercury poisoning Arsenic Bismuth Lead Silver Diffuse and Multiple Pigmented Lesions Racial/physiologic pigmentation Drug-induced pigmentation Smoker's melanosis Endocrine disorders Café au lait pigmentation HIV infection Hemochromatosis Post inflammatory pigmentation Cyanosis Beta carotene Liver disease Focal/Localized Pigmented Lesions Hemangioma and vascular malformations Graphite Melanotic macule Pigmented nevi Malignant melanoma Clinical evaluation of pigmented lesions Pigmentation of Teeth Extrinsic Discoloration Classification of Extrinsic Stains Factors responsible for extrinsic discoloration Diet factors Oral hygiene related factors Habit related Drug related Occupation related Predisposing factors Intrinsic Discoloration Pre-eruptive causes of intrinsic discoloration (Table 6) Metabolic causes Disturbance during development of a tooth Genetic defects and hereditary diseases Medications Dental Fluorosis Post-eruptive Causes (Table 7) Dental conditions and caries Pulpal causes Dental Materials Diagnosis History Clinical examination Management Chapter 4 - Bacterial, Viral and Fungal Infections Bacterial Infections Scarlet Fever Clinical features Oral manifestations Management Diphtheria General clinical and oral manifestations Prevention and management Tularemia (Rabbit Fever, Deer-fly Fever, Francis' Disease, Tick-Borne Disease, Ohara's Disease) Clinical manifestations Oral manifestations Management Erysipelas Clinical features Management Impetigo Clinical features Non-bullous impetigo Bullous impetigo Melioidosis Risk factors Clinical features Diagnosis and management Tetanus Pathophysiology Clinical features Differential diagnosis Diagnosis Prevention and management Actinomycosis Clinical features Radiographic features Investigations Management Noma (Cancrum Oris, Gangrenous or Necrotizing Stomatitis) Clinical features Other variants of Noma Complications and management Botryomycosis (Bacterial Pseudomycosis) Clinical types and features Histopathologic features Management Rhinoscleroma (Respiratory Scleroma) Clinical stages Diagnosis Management Cat-Scratch Disease Clinical features Diagnosis Management Viral Infections Infectious Mononucleosis (Monoglandular Fever, Kissing Disease) Clinical features Syndrome association Diagnosis Management Acute Lymphonodular Pharyngitis Clinical features Management Measles (Rubeola) Clinical features Diagnosis Prevention and management German Measles (Rubella) Clinical features Oral manifestations Prevention and management HIV and AIDS Discovery of HIV Structure of the HIV-1 Virion Subtypes HIV-1 Virus Basic Genetics of HIV Stages of Infection (Figures 1â•fi17) Transmission Sexual contact Passage of the virus from infected mothers to the newborns Through blood and parenteral inoculation HIV and Saliva Acquired Immune Deficiency Syndrome Revised Classification System of HIV Disease (CDC, 1993) Category A Category B Category C (AIDS defining conditions) Cardinal findings Characteristic findings Associated findings Stages in HIV disease Correlation of CD4 cell count and AIDS complications Tuberculosis and HIV Oral manifestations Diagnostic criteria 1. Candidiasis 2. Periodontal disease 3. Hairy leukoplakia 4. Oral Kaposi's sarcoma Revised classification by the European Community Clearing House (1992) Group 1: Lesions strongly associated with HIV infection Group 2: Lesions less commonly associated with HIV infection Group 3: Lesions seen in HIV infection Laboratory diagnosis ELISA Test Management I. Fungal disease Candida albicans Herpes simplex virus-1 Varicella zoster virus Cytomegalovirus Human papilloma virus II. Bacterial disease III. Neoplasia Kaposi's sarcoma VI. Aphthous ulcers Universal precautions Sterilization Disinfection SINUSITIS Acute Sinusitis Clinical features Chronic Sinusitis Clinical and radiographic diagnosis Management Fungal Infections and Protozoal Diseases Histoplasmosis Pathogenesis Clinical features Acute Pulmonary Histoplasmosis Chronic Pulmonary Histoplasmosis Disseminated Histoplasmosis Diagnosis Prognosis and management Blastomycosis (Gilchrist Disease) Clinical manifestations Oral features Histologic findings Management Mucormycosis (Zygomycosis, Phycomycosis) Predisposing factors Clinical features Oral manifestations and radiographic features Diagnosis Management Aspergillosis Oral findings Diagnosis Management Cryptococcosis (European Blastomycosis, Torulosis, Busse-Buschke Disease) Types Clinical features Oral features Diagnosis Management Chapter 5 - Orofacial Pain Pain Physiology Common Terminologies Associated with Pain Properties of Pain Weber and Fechner's law Adaptation Pain localization Nociceptors Stimulation of nociceptors Sequelae of Pain Psychological sequelae Muscular sequelae Autonomic nervous system sequelae Reflex Dual Pain Pathways Neospinothalamic tract (for fast pain) Paleospinothalamic tract (for slow pain) Analgesia system or pain inhibitory pathway Gate Control Theory Concept of Referred Pain Characteristics of referred pain Classification of Orofacial Pain Types of Pain Acute pain Chronic pain Clinical Assessment of Pain Pain From Orodental Structures Pulpal Pain Clinical features Diagnosis Periodontal Pain Clinical features Diagnosis Barodontalgia Etiology Underwater Diving Paranasal Sinus-Related Pain Myofascial Pain Clinical features Management Neuralgias Trigeminal Neuralgia Clinical features Differential diagnosis Investigations Treatment Prognosis Glossopharyngeal Neuralgia Clinical features Differential diagnosis Investigations Treatment Prognosis Postherpetic Neuralgia Clinical features Management Nervus Intermedius (Geniculate) Neuralgia Occipital Neuralgia Atypical Odontalgia Clinical features Differential diagnosis Treatment Atypical Facial Pain Clinical features Diagnosis Management Burning Mouth Syndrome Clinical features Differential diagnosis Management SECTION 3 - MucocutaneousDisorders Chapter 6 - Red and White Lesions Color of Oral Mucosa Description of Red and White Lesions White Lesion Red Lesion Etiologic Classification of Red and White Lesions White Lesions of the Oral Cavity Frictional Keratosis/Traumatic Keratosis Management Chemical Burns and Thermal Burns Differential diagnosis Management Nicotine Stomatitis (Stomatitis Nicotine Palatinus, Smoker's Palate) Clinical features Differential diagnosis Leukoplakia Definition WHO definition of leukoplakia (1978) Axell et al definition of leukoplakia (1984) Axell et al definition of leukoplakia (1996) Pindborg et al definition of leukoplakia (1997) Epidemiology Classification and staging system for oral leukoplakia General guidelines for oral leukoplakia staging system Etiopathogenesis Tobacco (smoke/smokeless form) Alcohol Viral infection Leukoplakia and diabetes Candidiasis and leukoplakia Dietary factors Clinical features Clinical forms of leukoplakia Malignant transformation Investigations Differential diagnosis Treatment (Flowchart 1) General considerations Medical management of oral leukoplakia Chemoprevention Carotinoids and retinoids 13-cis retinoic acid Beta-carotene Fenretinide (n-4-hydroxy phenyl retinamide) Vitamin E Photodynamic therapy of oral leukoplakia Topical chemotherapy of oral leukoplakia Newer treatments Gene therapy Other alternative modalities of treatment Green tea Oral lycopene Surgical line of treatment Lichen Planus Definitions Etiopathogenesis Clinical features Skin involvement in lichen planus Oral manifestations Association of oral lichen planus with systemic illness Syndromes associated with OLP Differential diagnosis Investigations Malignant potential of OLP Prognosis Management (Flowchart 2) Immunosuppressive and immunomodulating agents Other treatment modalities Surgery Miscellaneous treatments Lichenoid drug reaction Agents causing lichenoid reactions Betel quid lichenoid lesion Candidiasis Epidemiology Etiology and pathogenesis Clinical presentation Acute pseudomembranous candidiasis Differential diagnosis Chronic hyperplastic candidiasis (candida leukoplakia) Chronic atrophic (erythematous) candidiasis Median rhomboid glossitis Angular cheilitis (perleche) Chronic multifocal oral candidiasis Chronic mucocutaneous candidiasis (CMC) Role of candida in oral carcinogenesis Investigations for candidiasis Smear examination Hematologic investigations Biopsy Microbiology Imprint culture technique Salivary culture technique Oral rinse technique Immunologic tests Rationale for treatment Topical versus systemic drugs Suggested medications for the treatment of candidiasis (Flowchart 3) Topical antifungal medications Treatment for chronic atropic candidiasis Complementary and alternative medicine Oral Submucous Fibrosis Epidemiology Etiopathogenesis Molecular pathogenesis of OSMF (Rajalalitha and Vali, 2005) Clinical features Staging of OSMF Group 1: Very early Group 2: Early cases Group 3: Moderately advanced Group 4: Advanced cases Group 5: Advance cases with premalignant and malignant changes Clinical Staging Functional Staging Malignant potential and oral submucous fibrosis Other diseases associated with OSMF Histopathologic changes Epithelial changes Connective tissue changes Histological staging of OSMF Group 1 Group 2 Group 3 Group 4 Investigations Differential diagnosis Treatment (Flowchart 4) Corticosteroids Placental extracts Hyaluronidase Interferon-gamma Complications Prognosis Psoriasis Hereditary Benign Intraepithelial Dyskeratosis (Witkop's Disease) Witkop-von Sallmann disease Differential diagnosis Focal Epithelial Hyperplasia (Heck's Disease) Clinical features Management Dyskeratosis Congenita White Sponge Nevus Etiopathogenesis Genetic basis Clinical features Differential diagnosis Histopathologic features Treatment Red Lesions of the Oral Cavity Classification of red lesionsâ•ficongenital and acquired Congenital red lesions Acquired red lesions Traumatic erythematous macules Reddish ulcers or ulcers with red halo Soft tissue odontogenic infection (cellulitis) Mucositis secondary to systemic diseases Macular hemangiomas and telangiectasias Polycythemia Lupus erythematosus Red Lesions of the Tongue Migratory Glossitis Median Rhomboid Glossitis Deficiency States Clinical features Foliate Papillitis Erythroplakia Definitions Incidence/prevalence Classification Clinical variations Microscopic variations Etiopathogenesis Clinical features Malignant transformation Differential diagnosis Treatment and recurrence rate Discoid Lupus Erythematosus Classification Etiopathogenesis Genetic factors Role of UV light Environmental factors Clinical features Skin lesions Early lesions Chronic lesions Mucosal or oral lesions Different types of DLE Laboratory findings Immunofluorescence studies Histological features Differential diagnosis Prognosis Management General measures Topical therapy Oral therapy Chapter 7 - Vesiculobullous Disorders Classification of Vesiculobullous Lesions Predominantly Vesicular Lesions Herpes Viruses Herpes Simplex Virus (HSV) Infections Etiology and pathogenesis Clinical features Primary HSV infection Herpetic Whitlow and Herpes Gladiatorum Investigations Recurrent Herpes Infections Herpetic Labialis Differential diagnosis Acute herpetic infections Secondary herpetic infections Treatment Prognosis Varicella Zoster Infections Clinical features Primary infection (chicken pox) Secondary infection (herpes zoster) Complications Associated with Herpes Zoster Investigations Differential diagnosis Treatment and prognosis Hand, Foot and Mouth Disease Etiology Clinical features Oral manifestations Management Herpangina Clinical features Oral manifestations Management Dermatitis Herpetiformis Clinical features Oral manifestations Investigations Management Predominantly Bullous Lesions Pemphigus Types of pemphigus Pemphigus Vulgaris Epidemiology Etiopathogenesis Immunogenetic aspects of etiology Clinical features Oral manifestations Differential diagnosis Investigations Cytology Histopathology Immunofluorescent studies Management Topical therapy Systemic therapy Paraneoplastic Pemphigus (Paraneoplastic Autoimmune Multiorgan Syndrome) Clinical features Diagnostic criteria Histopathologic features and immunological studies Management and prognosis Bullous Pemphigoid Pathophysiology Clinical features Oral manifestations Histopathological and immunofluorescent studies Management and prognosis Mucous Membrane Pemphigoid or Cicatricial Pemphigoid Etiology and pathogenesis Clinical features Oral lesions Ocular findings Histopathology Differential diagnosis Treatment and prognosis Bullous Lichen Planus Histopathological findings Management Erythema Multiforme Etiopathogenesis Clinical features Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (Lyell's Syndrome) Etiopathogenesis Clinical features Histopathological and laboratory studies Management University of Florida management guidelines for TEN and SJS Bullous Impetigo Types Clinical features Management and prognosis Epidermolysis Bullosa Types of EB based on ultrastructural features General clinical features and oral manifestations Epidermolysis bullosa simplex Junctional epidermolysis bullosa Dystrophic epidermolysis bullosa Linear IgA Disease Clinical features Mucosal manifestations Drug-induced LABD Disease associations Management and prognosis Chapter 8 - Oral Ulcerative Diseases Classification Of Oral Ulcers Classification based on etiology Classification based on mode of onset and clinical presentation Traumatic Ulcers Types of Trauma Clinical features Diagnosis Differential diagnosis Histologic features Management Complications Prognosis Ulcers associated with infections (bacterial, viral and fungal infections) Primary Herpetic Gingivostomatitis Clinical features Diagnosis Differential diagnosis Treatment Symptomatic management Specific management Prognosis Recurrent Herpes Infection Precipitating Factors Clinical presentation Diagnosis Treatment Varicella Zoster Infection Chicken Pox Dermal lesions Oral lesions Management Herpes Zoster Clinical features Management Herpangina Clinical findings Hand, Foot and Mouth Disease Clinical features Skin lesions Oral lesions Management Prognosis Acute Necrotizing Ulcerative Gingivitis (Trench Mouth, Vincent's Disease, Vincent's Gingivostomatitis) Predisposing factors Clinical findings Management of ANUG Tuberculosis Oral manifestations Sites Typical lesion Differential diagnosis Management Syphilis Oral manifestations Chancre Mucous patches Gumma Diagnosis and management Deep Fungal Infections Aspergillosis Oral findings Histoplasmosis Mucormycosis Cryptococcosis North American Blastomycosis or Gilchrist's Disease Paracoccidiodomycosis or South American Blastomycosis Clinical features Drug-Induced Oral Ulcers Pathogenic basis of drug-induced stomatitis/oral ulceration Immune-mediated pathway Non-immune mediated pathway Stomatitis Medicamentosa Medications causing oral ulcers Management Stomatitis Venenata (Contact Stomatitis) Types of contact stomatitis Management Erythema Multiforme Blood Disorders Causing Oral Ulcers RBC Disorders WBC Disorders Immunologic Disorders Aphthous Ulcers (Recurrent Aphthous Stomatitis, Aphthae, Canker Sores) Etiopathogenesis Clinical features Types of recurrent aphthous stomatitis Minor aphthous ulcers (Mikulicz ulcer) Major aphthous ulcers (Sutton's ulcers; periadenitis mucosa necrotica recurrents) Herpetiform ulcers Diagnosis Management Dermatological Disorders Pemphigus Clinical features Diagnosis Management Pemphigoid Bullous Pemphigoid Cicatricial Pemphigoid Gastrointestinal Disorders Associated With Oral Ulcers Gastroesophageal Reflux Disease Clinical features Oral manifestations Crohn's Disease Clinical features Oral findings Ulcerative Colitis Clinical features Oral findings Celiac Disease Clinical features Oral findings Neoplastic Ulcers Ulcers Of Unknown Etiology Necrotizing Sialometaplasia Clinical features Diagnosis Syndromes Associated With Oral Ulcers PFAPA Syndrome (Marshall's Syndrome) Diagnostic criteria for PFAPA syndrome (proposed by Thomas et al) MAGIC Syndrome Reiter's Syndrome Behçet's Syndrome International Study Group Criteria for diagnosis of Behçet's syndrome O'Duffy criteria Oral ulcers Genital ulcers Ocular involvement Other clinical findings Stevensâ•fiJohnson Syndrome Clinical findings Diagnostic Protocol Chapter 9 - Dermatological Diseases Lichen Planus Etiopathogenesis Clinical features Investigations Differential diagnosis Management Epidermolysis Bullosa Classification Etiopathogenesis Clinical features Epidermolysis bullosa simplex Epidermolysis bullosa simplex with muscular dystrophy Epidermolysis bullosa atrophicans generalisata graves Epidermolysis bullosa dominant dystrophic/hypertrophic form Scarring epidermolysis bullosa with dermolytic vesicles Differential diagnosis Management Dental management Psoriasis Types Etiopathogenesis Clinical features Histopathology Management Psoriatic arthritis Ectodermal Dysplasia Etiopathogenesis Clinical features Oral manifestations Differential diagnosis Management Ehlersâ•fidanlos Syndrome Villefranche classification of EDS Etiopathogenesis Clinical features Symptoms Signs Oral manifestations Investigations Differential diagnosis Management Dental considerations Pachyonychia Congenita Etiopathogenesis Clinical features Oral manifestations Investigations Dyskeratosis Congenita Clinical features Mucocutaneous features Non-mucocutaneous features Oral manifestations Management Dental considerations Pityriasis Rosea Etiology Clinical features Differential diagnosis Treatment and prognosis Xeroderma Pigmentosum Etiology Clinical features Ocular symptoms Neurological symptoms Oral manifestations Diagnosis Treatment Acanthosis Nigricans Etiology Clinical features Types of AN Management Goltzâ•figorlin Syndrome Clinical features Skin manifestations Facial features Oral features Radiographic findings Treatment and prognosis Acrodermatitis Enteropathica Etiology Clinical features Differential diagnosis Diagnosis Treatment and prognosis Haileyâ•fiHailey Disease (Familial Benign Chronic Pemphigus) Etiology Clinical features Differential diagnosis Treatment and prognosis Darier's Disease (Keratosis Follicularis) Etiology Clinical features Treatment Reiter's Syndrome Etiology Clinical features Genitourinary tract involvement Arthritis Cutaneous lesions Ocular involvement Musculoskeletal features Oral manifestations Treatment and prognosis Incontinentia Pigmenti (Bloch-Sulzberger Syndrome) Clinical features Diagnostic criteria Major criteria Minor criteria (supportive evidence) Evidence of IP in a first degree female relative Differential diagnosis Treatment and prognosis Kawasaki Disease (Mucocutaneous Lymph Node Syndrome) Etiology Clinical features Complications Diagnosis Treatment Tuberous Sclerosis Complex (Epiloia, Bourneville's Disease) Etiopathogenesis Clinical features Major features Suggestive features requiring further investigation Skin lesions Mental deficiency Ocular signs Oral manifestations Treatment and prognosis Graft-Versus-Host Disease Etiology Clinical features Treatment and prognosis SECTION 4 - Diseases of Specific Structures Chapter 10 - Temporomandibular Disorders Components of Temporomandibular Joint Glenoid Fossa and Articular Eminence/Protuberance Mandibular Condyle Articular Capsule and Articular Disk Synovial Fluid Discal Ligaments Posterior Attachment or Retrodiscal Tissue or Bilaminar Zone Ligaments Associated with Temporomandibular Joint Muscles of Mastication Masseter muscle Temporalis muscle Medial pterygoid muscle Lateral pterygoid muscle Suprahyoid muscles Mandibular movements Forward movement or protraction Slight mouth opening Wide mouth opening Chewing movements/lateral excursions Arterial Supply, Venous Drainage and Sensory Innervation of TMJ Clinical Evaluation of Temporomandibular Joint Examination of Temporomandibular Joint Clinical Evaluation of Muscles of Mastication and Accessory/Cervical Muscles Temporalis Masseter Pterygoids Medial pterygoid Lateral pterygoid Digastric muscle Cervical Examination Sternocleidomastoid Posterior cervical muscles Trapezius Splenus capitis Occlusal Evaluation Imaging Protocol Disorders of TMJ Disorders Associated With Deviation/Alteration in the Form of Articular Surfaces Clinical features Articular Disk Defects Disk Thinning and Perforation Clinical features Adherence and Adhesions Clinical features Disk Displacement Disk Displacement with Reduction Clinical features Disk Displacement without Reduction Clinical features Displacement of Diskâ•fiCondyle Complex (Hypermobility and Dislocation) Clinical features Dislocation (Open Lock) Clinical features Types of dislocation Inflammatory Joint Disorders Synovitis or Capsulitis Clinical features Retrodiscitis Clinical features Degenerative Joint Diseases Osteoarthrosis Clinical and radiographic features Management Osteoarthritis Clinical features Radiographic features Juvenile Idiopathic Arthritis Clinical features Polyarthritides Traumatic Arthritis Infectious Arthritis/Septic Arthritis Rheumatoid Arthritis Clinical features Laboratory investigations Radiographic features Psoriatic Arthritis Clinical features Hyperuricemia Clinical features TMJ Ankylosis Etiopathology Trauma Local infections Systemic conditions Arthritis/inflammatory conditions Neoplasms Classification of ankylosis according to tissues involved and extent Classification of ankylosis by Topazian (1966) Grading of TMJ ankylosis Clinical features Clinical features of unilateral ankylosis Facial features Intraoral features Clinical features of bilateral ankylosis Facial features Intraoral features Radiographic features Management Masticatory Muscle Disorders Acute Disorders: Reflex Muscle Splinting Clinical features Management and prognosis Myositis Clinical features Muscle Spasm (Myospasm) Clinical features Chronic Conditions: Myofascial Pain Predisposing factors Pathophysiology Clinical features Primary finding Secondary findings Possible findings Referral pattern for myofascial pain Management Counseling Physiotherapy Trigger point therapy Medication Occlusal splint therapy Transcutaneous electric nerve stimulation (TENS) Muscular Hypertrophy Management Fibromyalgia Clinical features Official diagnostic criteria for fibromyalgia Management Congenital, Developmental and Acquired Disorders of the TMJ Neoplasms Affecting the TMJ Clinical features Benign tumors Malignant tumors Metastatic tumors Condylar Fractures Classification of Condylar Fractures I. Lindhal's classification of condylar fractures 1. Level of fracture (Figure 26) 2. Relationship of the fractured condylar segment to the mandible 3. Relationship of the condylar head to the glenoid fossa II. MacLennan's classification III. Classification of condylar neck fractures Clinical signs and symptoms of condylar fractures Chapter 11 - Diseases of Salivary Glands Developmental Disturbances Aplasia/Agenesis and Related Aberrancy of Salivary Glands Clinical features and diagnosis Diagnostic imaging Management Hyperplasia of Minor Salivary Glands Clinical features Histopathology Treatment Saliva, Xerostomia, Hyposalivation and Sialorrhea Saliva Hypofunction and Xerostomia Xerostomia and Salivary Gland Hypofunction due to Medications Xerostomia and Salivary Gland Hypofunction due to Radiation Therapy Sjögren's Syndrome Classification Etiopathogenesis Clinical features and diagnosis Laboratory diagnosis values Management Benign Lymphoepithelial Lesion (Mikulicz's Disease) Clinical features Diagnosis Treatment Sialorrhea Clinical features Treatment Inflammatory Conditions of Salivary Glands Mucocele Clinical features Histopathology Treatment Ranula Clinical features Histopathology Treatment Sialolithiasis, Salivary Duct Stone, Salivary Calculi Clinical features Diagnostic procedures Histopathology Treatment Sialadenitis Non-specific Sialadenitis Diagnostic imaging Histopathology Treatment Bacterial Sialadenitis Clinical features Histopathology Diagnosis Treatment Subacute Necrotizing Sialadenitis Clinical features Histopathology Treatment Cheilitis Glandularis Clinical features Histopathology Diagnosis Treatment Necrotizing Sialometaplasia Clinical features Diagnostic imaging Histopathology Treatment Chronic Sclerosing Sialadenitis (Kuttner Tumor) Clinical features Histopathology Diagnostic imaging Treatment Viral-Induced Salivary Gland Pathology Mumps Clinical features Prognosis and treatment Human Immunodeficiency Virus (HIV) Clinical features Histopathology Diagnostic imaging Treatment Non-