DUST OF SNOW_BY ROBERT FROST_EDITED BY_ TANMOY MISHRA
Lecture xiii ju-oral pathology-lecture xiii-perio5
1. Oral Pathology
Periodontal Diseases
Sem IV- Lecture-XIII
By
Dr. Juma Alkhabuli
(BDS, MDentSci, PhD)
Associate Professor, Chair, Oral Biology Department
2. Non-
Non-Plaque induced gingival lesions
Gingival diseases of specific bacterial origin
Gingival diseases of viral origin
Gingival diseases of fungal origin
Gingival diseases of genetic origin
Gingival manifestations of systemic conditions
Traumatic lesions
Foreign body reactions
3. 1. Gingival disease of specific
bacteria origin
Streptococcal species
Rare
Usually starts as tonsolitis (A&B β-haemolytic
streptococci)
Treponema pallidum (Syphilitic gingivitis)
Extremely contagious
Of 3 phases (2nd/mucous patch + skin rash)
Neisseria gonorrhea associated lesions
5. 2. Gingival diseases of viral origin
A. Herpes virus infection:
Primary herpetic gingivostomatitis (HSV-1)
Recurrent herpes oral infection
* 1/3 of the primary infected pt. are affected
* Sunlight, trauma or stress may activate the
virus and the new lesions are called herpes
labialis (mucocutaneous) /cold sore
Varicella-zoster infection (V-Z-V; HHV-3)
* cause chickenpox and herpes zoster
B. Herpes papilloma virus (HPV)
9. 3. Gingival diseases associated with
fungal infections:
infections:
A. Candida-species infections:
Generalised gingival candidoses
Candida albicans (commensal organisms
of 40% of population)
* C. glabrata, C. tropicalis ,C. krusei,
C. parapsilosis
Opportunistic pathogens
Common in immunocompromised and
long-term broad spectrum antibiotic
hosts
10. Cont’d
A. Linear Gingival Erythema (HIV +ve)
B. Histoplasmosis- systemic fungal disease
caused by exposure to dust from animal
dropping)
12. 4. Gingival lesions of genetic origin
Hereditary Gingival Fibromatosis (rare
hereditary condition)-
Generalised or localised enlargement
May be associated with hypertrichosis,
epilepsy, mental retardation
Involves full width of the attached gingiva
23. Cont’d
Pemphigus vulgaris:
Auto-antibodies target the inter-epithelial
desmosomes
More common in Jews
4 types; vulgais, vegetans (affects oral
mucosa), erythematous and foliaceus
Affects gingiva + other parts of oral
mucosa and skin
Oral ulcerations, erosion are common
features
24. Cont’d
Ocular lesion may be present (bilateral
conjunctivitis)
50% of patients have oral lesions before
skin eruptions
positive Nikolsky sign [bulla can be
induced on normal-appearing skin if firm
lateral pressure is applied
26. Cont’d
Erythema multiforme:
Immunopathologic vascular injuries lead to
ischemic necrosis of skin and mucosa
Cause is unknown but allrgic to
sulfonamides, and herpes simplex viral
infection have been implicated
T "Target" lesions are characteristic
Oral lesions occur in 70% of cases may
become hemorrhagic, life-threatening in
the form of "Stevens-Johnson
Syndrome“[oral mucosa+skin +(ocular
/genital)]
28. Cont’d
lupus erythematosis
It is immunologically mediate connective
Tissue disease, affecting oral mucosa+skin
3 types; systemic (SLE):
Cutaneous (chronic
CLE, also called discoid)
Sub-acute cutaneous (CLE)
B lymphocytes + abnormal function of T
lymphocytes
Clinically appear similar to erosive LP