DOCSLIB.ORG

Granulomatous Conditions in the Oral Cavity – a Review N

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Granulomatous Conditions in the Oral Cavity – a Review N Review Article Granulomatous conditions in the oral cavity – A review N. Vidulasri, M. P. Brundha* ABSTRACT Granulomatous diseases represent a unique form of the chronic inflammatory response with granulomatous diseases of the oral soft and hard tissues being an uncommon occurrence. When observed clinically, it presents a definite diagnostic dilemma due to the wide variety of possible etiologic diseases. Granulomatous diseases are also frequently observed due to a wide variety of infections. A granuloma is a distinct, compact microscopic structure composed of epithelioid-shaped macrophages typically surrounded by a rim of lymphocytes. Fibroblasts and collagen fibers are also seen immediately surrounding the lymphocytes. Granulomatous disorders comprise a large family of lesions that share a common histological feature: Granuloma formation. Therefore, an extensive clinical, microscopic, and laboratory evaluation is required to identify the source of the oral granulomatous disease. Therefore, the purpose of this article is to highlight the etiology, histopathological features, and differential diagnosis of various granulomatous diseases that affect the oral soft and hard tissues. KEY WORDS: Granuloma, Infectious disease, Inflammation, Macrophages, Oral lesions INTRODUCTION small, non-necrotizing or non-caseating granulomas with an aggregation of peripheral lymphocytes, A granuloma can be defined as a firm, tumor-like central epithelioid histiocytes, and presence of granulation with a compact collection of epithelioid multinucleated giant cells.[5,6] Granulomatous lesions cells and inflammatory cells formed as a reaction to present themselves as sessile, lobulated, moderately chronic inflammation due to foreign bodies, fungi, firm, and relatively non-tender nodules and papules [1] and bacteria. Oral granulomatous diseases are with normal coloration with little or no erythematous frequently observed due to a wide variety of infections. changes surrounding them.[7] The term granulomatous diseases include those conditions characterized by the histological presence Foreign substances such as endogenous and of granuloma resembling those of tuberculosis (TB) exogenous substances are the most common source of as well as condition without microscopic granuloma triggering localized granulomatous inflammation in formation but with the prominent proliferation of the oral cavity. These reactions present as non-descript granulation tissue.[2] Granulomas are normally the masses with the presence of erythema, localized or result of defensive mechanisms and form when generalized edema, pain, or even the presence of acute inflammatory processes are unable to destroy ulceration of the tissues.[8] On progression, some of invading agents and are believed to be the end the granulomas may ulcerate centrally and present result of a series of pathological events.[3] They as squamous cell carcinomas. The treatment of these possess a multifactorial etiology and may arise due conditions depends on the systemic cause. Localized to a reaction to environmental or genetic factors, lesions without systemic connection can be treated by infectious organisms, or may also be idiopathic, for conservative surgical removal.[9] The presence of signs which there is no trigger factor.[4] A wide variety of and symptoms may warrant additional clinical and granulomatous disorders can involve the orofacial laboratory testing to identify other possible sources of tissues. Such lesions of the oral cavity present as the inflammation, unless the foreign substance is not identified in microscopic sections, the granulomatous Access this article online inflammation generally presents a diagnostic dilemma for the clinicians. Often, the differential Website: jprsolutions.info ISSN: 0975-7619 diagnosis includes foreign body reactions, infection, Department of General Pathology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India *Corresponding author: Dr. M. P. Brundha, Department of General Pathology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 162, Poonamallee High Road, Chennai - 600 077, Tamil Nadu, India. Phone: +91-9884421482. E-mail: [email protected] Received on: 12-08-2019; Revised on: 08-09-2019; Accepted on: 17-10-2019 172 Drug Invention Today | Vol 13 • Issue 1 • 2020 N. Vidulasri and M. P. Brundha Crohn’s disease (CD), sarcoidosis, and orofacial involve other organs as well which are, respectively, granulomatosis (OFG).[10] Knowledge of the clinical classified as pulmonary and extra-pulmonary TB.[16] and histologic patterns of granulomatous diseases will Primary pulmonary disease results from initial allow easier interpretation for practitioners to provide infection with M. tuberculosis. Most individuals are a useful differential diagnosis, thus facilitating asymptomatic with lesions that heal spontaneously appropriate clinical management.[11] Therefore, the but which later becomes evident with the presence of aim of this article is to provide information regarding small calcified nodules known as Ghon’s complex. the histology and oral manifestation of granulomatous Secondary pulmonary TB is a post-primary disease conditions that commonly affect the oral cavity. due to the endogenous reactivation of latent infection which may be primarily due to immunosuppression.[17] CLASSIFICATION OF GRANULOMATOUS Histopathology [12,13] Tuberculous granulomas are characterized by the CONDITIONS presence of central caseous necrosis. The site is As there is great variation among the possible encircled by epithelioid cells, lymphocytes, histiocytes, [18] etiological factors, the classification of granulomatous fibroblasts, and occasionally Langhans giant cells. disorders may include many conditions. These In some instances, caseating granulomas may not comprise infections, vascular irregularities, be present but may show non-caseating granulomas. immunological upsets, leucocyte oxidase defects, A biopsy exhibiting granulomatous inflammation and hypersensitivity reactions, and neoplasia. Broadly microscopic evidence of mycobacterial organisms are these causes may be categorized as: often suggestive of TB. 1. Bacterial • TB Oral manifestation • Leprosy Oral TB may occur at any location on the oral mucous • Syphilis membrane with the tongue and gingiva being most • Cat-scratch disease commonly involved. Other sites include the palate, 2. Fungal lips, buccal mucosa, gingiva, palatine tonsil, and • Histoplasmosis floor of the mouth.[19] Other manifestations include • Blastomycosis it presents as a single or multiple painless ulcers and • Paracoccidioidomycosis usually appear as irregular, well-circumscribed with • Aspergillosis surrounding erythema, which usually extends from the 3. Reactive lesions (Trauma, and hypersensitivity) gingival margin to the depths of the adjacent vestibule • Pyogenic granuloma and is often associated with enlargement of cervical • Peripheral giant cell granuloma lymph nodes, localized masses, and swellings. In • Periapical granuloma rare cases, there is the involvement of the maxilla 4. Foreign bodies and mandible which usually results in tuberculous • Oral foreign body reactions osteomyelitis as a result of the penetration of gingival 5. Other causes (Unknown, autoimmune, and/or lesions into jaw bones.[20] vascular origin) • Sarcoidosis Leprosy • CD Leprosy is a slowly progressive infectious disease caused • Cheilitis granulomatosa by Mycobacterium leprae. The disease is presented as • Eosinophilic granuloma either lepromatous leprosy – a low resistance form • Wegener’s granulomatosis or tuberculoid leprosy, the highly resistant form. The initial event is a chronic mycobacterial infection that TB elicits a range of cellular immune responses followed TB is a chronic granulomatous disease caused by by the second response is a peripheral neuropathy that various strains of mycobacteria, usually attributed is initiated by the infection, followed by immunologic to the bacteria Mycobacterium tuberculosis. Among events. The conditions affect the skin and peripheral all infectious diseases, TB remains to be among the nerves, resulting in disabling deformities.[21] Mild world’s most notorious, contributing to high morbidity to moderate effects on other organs which include and mortality rates.[14] Although, oral manifestations systems such as the liver, kidneys, eyes, oral mucosa, of TB have a rare occurrence, it has been considered lymph nodes, bones, and joints and gonads. to account for 0.1–5% of all TB infections.[15] These lesions are usually secondarily inoculated with infected Histology sputum or due to hematogenous spread. The most The typical granulomatous nodule shows collections commonly affected organs are the lungs, but may also of epithelioid cells and lymphocytes in a fibrous Drug Invention Today | Vol 13 • Issue 1 • 2020 173 N. Vidulasri and M. P. Brundha stroma. Langhans type giant cells are variably present An indurate ulceration of the dorsum of the tongue, with vacuolated macrophages called lepra cells these hyperplasic foliate papillae, is the only clinical signs are scattered throughout the lesions and often contain of the disease. Erythema, edema, and petechial the bacilli.[21] hemorrhage with or without the presence of a chancre may occur in the soft palate. The asymmetry of the Oral manifestation uvula or tonsillar pillar can be noticed in the initial The oral lesions in leprosy
Load more

Recommended publications
  • ROLE of MAST CELL in ORAL PATHOLOGY Supriya Kheur Deepali Patekar Neeta Bagul Meena Kulkarni Samapika Routray 1 Varsha Dhas Department of Oral Pathology,Dr
    320 ROLE OF MAST CELL IN ORAL PATHOLOGY Supriya Kheur Deepali Patekar Neeta Bagul Meena Kulkarni Samapika Routray 1 Varsha Dhas Department of Oral Pathology,Dr. D.Y.Patil Dental College and Hospital, Pimpri, Pune-18, India 1Department of Oral Pathology, GITAM Dental College, Vishakhapattanam, India Corresponding Author: Supriya Kheur, Department of Oral Pathology,Dr. D.Y.Patil Dental College and Hospital, Pimpri, Pune-18, India. Ph -09970150760, Email : [email protected] Abstract Mast cells in oral tissues releases various pro-inflammatory cytokine tumor necrosis factor alpha (TNF-Ü) which promotes leukocyte infiltration in various inflammatory condition of oral cavity such as oral lichen planus (OLP), periapical lesions, gingivitis & periodontitis. T lymphocyte derived cytokines influences mast cell migration & mediator release. Mast cell secreted proteases, activates matrix-metalloprotinases-9 (MMP-9) which may contribute to alteration in basement membrane in inflammatory condition such as Lichen Planus. Hence by understanding the role of mast cells in the pathogenesis of various diseases; therapies should be targeted to enhance the prognosis of the diseases. Key Words: Mast cells, Degranulation, Cytokines, Tryptase, Chymase. Introduction chemotactins, cell activating & cell growth Mast cells (MC) are large spherical or factor. Tissue mast cells are not homogenous elliptical mononuclear cells found in a variety for eg. enzymes within granules of mucosal & of tissues including skin, submucosa or connective tissue mast cells are different from connective tissue of various organs & each other. The ranges of mast cell activity is (1) specialized for their anatomic location, as the mucosal epithelial tissues & also in dental granules are different for mucosal and pulp.
    [Show full text]
  • A Single Case Report of Granular Cell Tumor of the Tongue Successfully Treated Through 445 Nm Diode Laser
    healthcare Case Report A Single Case Report of Granular Cell Tumor of the Tongue Successfully Treated through 445 nm Diode Laser Maria Vittoria Viani 1,*, Luigi Corcione 1, Chiara Di Blasio 2, Ronell Bologna-Molina 3 , Paolo Vescovi 1 and Marco Meleti 1 1 Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; [email protected] (L.C.); [email protected] (P.V.); [email protected] (M.M.) 2 Private practice, Centro Medico Di Blasio, 43121 Parma; Italy; [email protected] 3 Faculty of Dentistry, University of the Republic, 14600 Montevideo, Uruguay; [email protected] * Correspondence: [email protected] Received: 10 June 2020; Accepted: 11 August 2020; Published: 13 August 2020 Abstract: Oral granular cell tumor (GCT) is a relatively rare, benign lesion that can easily be misdiagnosed. Particularly, the presence of pseudoepitheliomatous hyperplasia might, in some cases, lead to the hypothesis of squamous cell carcinoma. Surgical excision is the treatment of choice. Recurrence has been reported in up to 15% of cases treated with conventional surgery. Here, we reported a case of GCT of the tongue in a young female patient, which was successfully treated through 445 nm diode laser excision. Laser surgery might reduce bleeding and postoperative pain and may be associated with more rapid healing. Particularly, the vaporization effect on remnant tissues could eliminate GCT cells on the surgical bed, thus hypothetically leading to a lower rate of recurrence. In the present case, complete healing occurred in 1 week, and no recurrence was observed after 6 months. Laser surgery also allows the possibility to obtain second intention healing.
    [Show full text]
  • Download Download
    628 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 Tongue Lesions - A Review N.Anitha1, Dharini Jayachandran2 1Reader, Department of Oral Pathology and Microbiology,2Undergraduate Student, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research Abstract Tongue is a vital organ within the oral cavity that has varied function,and it may act as an index for the underlying systemic diseases.The investigation of the tongue diseases may begin with mere clinical examination .This review is to highlight the signs and symptoms of the various lesions that affects the tongue and especially to talk in brief about the benign and malignant tumours that affect the tongue along with other inherited and congenital abnormalities.Tongue lesions are categorized as tumours,infections, reactionary,congenital,developmental,acquired,autoimmune and potentially malignant disorders for easy understanding and to arrive at appropriate diagnosis.Tongue playing an important role in maintaining the harmony in the oral environment,it should be treated from diseases. Keywords: Tongue lesions,benign tumours,malignant tumours,diseases of tongue. CLASSIFICATION OF LESIONS ● Pyogenic granuloma AFFECTING THE TONGUE. ● Frictional keratosis BENIGN TUMOURS OF THE TONGUE INFECTIOUS LESIONS OF TONGUE ● Capillary hemangioma ● Oral squamous papilloma ● Fibroma ● Oral hairy leukoplakia ● Cavernous hemangioma ● Candidiasiis ● Giant cell granuloma ● Median rhomboid glossitis ● Lipoma ● Sublingual abcess ● Lymphangioma INHERITED,CONGENITAL,DEVELOPMENT ● Schwannoma AND ACQUIRED ABNORMALITIES OF TONGUE MALIGNANT TUMOURS OF TONGUE ● White sponge nevus ● Squamous cell carcinoma ● Foliate papillitis ● Veruccous carcinoma ● Angina bullosa hemorrhagica ● Non-Hodgkin’s lymphoma ● Geographic tongue TRAUMATIC/REACTIONARY LESIONS OF ● Fissured tongue THE TONGUE ● Median rhomboid glossitis ● Fibrous reactive hyperplasia ● Bifurcated/tetrafurcated tongue ● Traumatic ulcer Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol.
    [Show full text]
  • Pyogenic Granuloma on the Upper Lip: an Unusual Location
    www.scielo.br/jaos Pyogenic granuloma on the upper lip: an unusual location Eduardo Sanches GONÇALES1, José Humberto DAMANTE2, Cassia Maria FISCHER RUBIRA3, Luís Antônio de Assis Taveira4 1- DDS, PhD, Assistant Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil. 2- DDS, PhD, Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil. 3- DDS, PhD in Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil. 4- DDS, PhD, Associate Professor, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil. Corresponding address: Eduardo Sanches Gonçales - Faculdade de Odontologia de Bauru - USP - Departmento de Estomatologia - Al. Dr. Octavio Pinheiro Brisolla 9-75 - 17.012-901 - Bauru, SP - Brasil - Phone: 55 14 32358250 - e-mail:[email protected] Received: March 23, 2009 - Modification: September 16, 2009 - Accepted: October 11, 2009 ABSTRACT yogenic granuloma (PG) is a benign non-neoplastic mucocutaneous lesion. It is a Preactional response to constant minor trauma and might be related to hormonal changes. In the mouth, PG is manifested as a sessile or pedunculated, resilient, erythematous, exophytic and painful papule or nodule with a smooth or lobulated surface that bleeds easily. PG preferentially affects the gingiva, but may also occur on the lips, tongue, oral mucosa and palate. The most common treatment is surgical excision. This paper describes a mucocutaneous PG on the upper lip, analyzing the clinical characteristics and discussing the features that distinguish this lesion from other similar oral mucosa lesions. The diagnosis of oral lesions is complex and leads the dentist to consider distinct lesions with different diagnostic methods.
    [Show full text]
  • Vegetating Darier's Disease During Pregnancy
    Letters to the Editor 259 Vegetating Darier’s Disease During Pregnancy Daniel de la Rosa Carrillo Department of Dermatology, Ullevaal University Hospital, Oslo, Norway. E-mail: [email protected] Accepted December 12, 2005 Sir, She was discharged after 4 weeks. During that period she Darier’s disease is an autosomal dominant disorder cha- experienced improvement in the lesions on her abdomen, thumb, ears and feet. There was complete clearance of the lesion on her racterized by hyperkeratotic, crusted papules. Nails and cheek after 4 weeks. She continued topical treatment with clo- mucous membranes may also be involved. Histological betasol propionate 0.05% cream on the lesions on the abdomen examination shows suprabasal acantolhysis and overlying and thumb until clearance one month after discharge. dyskeratosis (1, 2). Both exacerbation and improvement of the disease during pregnancy have been described pre- viously, as have bacterial and viral secondary infections. DISCUSSION We present here a patient with exacerbation of Darier’s The condition was considered to be an exacerbation disease during pregnancy in a pattern that has not been of Darier’s disease during pregnancy, with concurrent described previously. bacterial infection and bilateral external otitis. Repeti- tive tests for virus, and especially herpes simplex and CASE REPORT varicella zoster, were all negative. Clinical differential A 37-year-old woman, para 1, gravida 2, 5 months pregnant, diagnoses were pemphigus vegetans of Hallopeau or with a known history of Darier’s disease since childhood, with pyogenic granuloma, but the negative direct immuno- intertriginous involvement, had been treated several times for fluorescence with acantholysis on histopathological pyoderma.
    [Show full text]
  • Multiple Large Peripheral Giant Cell Granuloma: a Case Report
    CASE REPORT BALIKESİR SAĞLIK BİLİMLERİ DERGİSİ / BALIKESIR HEALTH SCIENCES JOURNAL MULTIPLE LARGE PERIPHERAL GIANT CELL GRANULOMA: A CASE REPORT BÜYÜK BOYUTLARDA MULTİPL PERİFERAL DEV HÜCRELI GRANÜLOM: VAKA RAPORU Mustafa Gümüşok1 Murat Özle2 Begüm Okur2 Anıl Seçkin2 Farid Museyibov3 Özlem Üçok1 Sedat Çetiner2 1Gazi Üniversitesi Diş Hekimliği Fakültesi, ÖZET Ağız, Diş Ve Çene Radyolojisi Anabilim Dalı, Ankara Periferal dev hücreli granülom (PDHG) oral bölgenin sık izlenen dev hücreli bir lezyonudur. 2Gazi Üniversitesi Diş Hekimliği Fakültesi, PDHG’ler gerçek bir neoplazmı temsil etmezler. Etyolojileri çok açık olmayan bu lezyonların, Ağız, Diş Ve Çene Cerrahisi Anabilim Dalı, travma veya lokal irritasyonlara bağlı gelişen reaktif bir lezyon olduğu düşünülmektedir. Ankara PDHG’lere kadınlarda erkeklere oranla daha sık, mandibulada ise maksilladan daha fazla 3 Gazi Üniversitesi Diş Hekimliği Fakültesi, rastlanılır. Gingiva veya dişsiz alveolar kret üzerinde kırmızı, kırmızı-mavi nodüler kitle şeklinde Oral Patoloji Anabilim Dalı, Ankara görülürler. Bu olgu raporunda, 48 yaşında erkek hastada görülen, maksilla sol santral kesici - sağ kanin kesici dişler ve mandibula sağ santral kesici-sol kanin kesici dişler bölgesinde lokalize, Yazışma Adresi: yüzde asimetriye neden olan büyük boyutlu PDHG’ler sunulmuştur. Multipl PDHG vakasının Mustafa Gümüşok radyolojik, klinik, histopatolojik bulguları ile birlikte teşhis, tedavi ve 6 aylık takibi rapor Gazi Üniversitesi Diş Hekimliği Fakültesi Ağız edilmiştir. Diş Ve Çene Radyolojisi Asti Karşısı Emek Ankara Ankara – Türkiye Anahtar Kelimeler: Periferal dev hücreli granülom, mandibula, maksilla, multipl lezyon SUMMARY E posta: [email protected] Peripheral giant cell granuloma (PGCG) is the most common oral giant cell lesion. PGCG Kabul Tarihi: 25 Şubat 2015 presumably does not represent a true neoplasm. PGCG is believed to be stimulated by local irritation or trauma besides the causing of PGCG isn’t known exactly.
    [Show full text]
  • Peripheral Giant Cell Granuloma-A Rare Oral Entity
    Case Report Adv Dent & Oral Health Volume 6 Issue 4 - December 2017 Copyright © All rights are reserved by Karthikeyan Ramalingam DOI: 10.19080/ADOH.2017.06.555694 Peripheral Giant Cell Granuloma-A Rare Oral Entity Karthikeyan Ramalingam*, Sandeep Goyal and Sathya Sethuraman Department of Oral Pathology and Microbiology, Surendera Dental College and Research Institute, Rajasthan, India Submission: October 26, 2016; Published: December 04, 2017 *Corresponding author: Karthikeyan Ramalingam, Department of Oral Pathology and Microbiology, Surendera Dental College and Research Institute, Rajasthan, India, Email: Abstract Peripheral Giant Cell granuloma (PGCG) is one of the hyperplastic lesions of the oral cavity. It could arise from the periosteum or the periodontal membrane subsequent to chronic trauma or local irritation. It accounts for less than 10% of all hyperplastic gingival lesions, rarely exceeds 2cm in size and predominantly noted in females. We report a rare case of a large PGCG involving the right mandibular anterior gingiva stroma along with extravasated RBCs in histopathology. The lesion was surgically excised and the patient is remaining disease free on follow-up. in a 26-year-old male patient of Indian origin. It presented as a pinkish-red nodule which showed multinucleated giant cells in fibrous cellular Keywords: Peripheral giant cell granuloma; Mandibular gingival; Males; Anterior region Key Messages: We report the case of peripheral giant cell granuloma in the mandibular anterior gingiva in a male patient. This rare entity should be kept in mind on encountering such hyperplastic lesions in the oral cavity. Introduction multinucleated giant cells along with hemosiderin deposits and Peripheral giant cell granuloma (PGCG) is the infrequent, exophytic oral lesion that commonly contains giant cells.
    [Show full text]
  • Adverse Effects of Medicinal and Non-Medicinal Substances
    Benign? Not So Fast: Challenging Oral Diseases presented with DDX June 21st 2018 Dolphine Oda [email protected] Tel (206) 616-4748 COURSE OUTLINE: Five Topics: 1. Oral squamous cell carcinoma (SCC)-Variability in Etiology 2. Oral Ulcers: Spectrum of Diseases 3. Oral Swellings: Single & Multiple 4. Radiolucent Jaw Lesions: From Benign to Metastatic 5. Radiopaque Jaw Lesions: Benign & Other Oral SCC: Tobacco-Associated White lesions 1. Frictional white patches a. Tongue chewing b. Others 2. Contact white patches 3. Smoker’s white patches a. Smokeless tobacco b. Cigarette smoking 4. Idiopathic white patches Red, Speckled lesions 5. Erythroplakia 6. Georgraphic tongue 7. Median rhomboid glossitis Deep Single ulcers 8. Traumatic ulcer -TUGSE 9. Infectious Disease 10. Necrotizing sialometaplasia Oral Squamous Cell Carcinoma: Tobacco-associated If you suspect that a lesion is malignant, refer to an oral surgeon for a biopsy. It is the most common type of oral SCC, which accounts for over 75% of all malignant neoplasms of the oral cavity. Clinically, it is more common in men over 55 years of age, heavy smokers and heavy drinkers, more in males especially black males. However, it has been described in young white males, under the age of fifty non-smokers and non-drinkers. The latter group constitutes less than 5% of the patients and their SCCs tend to be in the posterior mouth (oropharynx and tosillar area) associated with HPV infection especially HPV type 16. The most common sites for the tobacco-associated are the lateral and ventral tongue, followed by the floor of mouth and soft palate area.
    [Show full text]
  • Case Report Low Laser Therapy As an Effective Treatment of Recurrent Aphtous Ulcers: a Clinical Case Reporting Two Locations
    Open Access Case report Low laser therapy as an effective treatment of recurrent aphtous ulcers: a clinical case reporting two locations Narjiss Akerzoul1,&, Saliha Chbicheb1 1Department of Oral Surgery, Faculty of Dentistry, Mohamed V University, Rabat, Morocco &Corresponding author: Narjiss Akerzoul, Department of Oral Surgery, Faculty of Dentistry, Mohamed V University, Rabat, Morocco Key words: Aphtous ulcers, oral ulcers, low level laser therapy, diode laser, pain relief Received: 12/04/2018 - Accepted: 22/06/2018 - Published: 10/07/2018 Abstract Apthous ulcers, commonly referred to as canker sores, are the most common ulcerative lesions of the oral mucosa. These are usually painful and are associated with redness and occasional bleeding from the affected area(s). Low Level Laser Therapy (LLLT) has shown excellent results in relieving the pain and complete remission of the oral ulcers. Through a clinical case, we report two locations of oral ulcers treated successfully with diode laser. Pan African Medical Journal. 2018; 30:205 doi:10.11604/pamj.2018.30.205.15779 This article is available online at: http://www.panafrican-med-journal.com/content/article/30/205/full/ © Narjiss Akerzoul et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pan African Medical Journal – ISSN: 1937- 8688 (www.panafrican-med-journal.com) Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net) Page number not for citation purposes 1 Introduction intraoral examination revealed ulcers on internal side of the lower lip and on the dorsal side of the tongue, and the ulcers were discrete and unique located on the lower lip region (Figure 1) and Aphthous ulcers, commonly known as canker sores, are the most the dorsal lingual mucosa (Figure 2).
    [Show full text]
  • Intralesional Corticosteroid Injection As an Effective Treatment Method for Oral Lesions: a Meta-Analysis
    Brazilian Journal of Pharmaceutical Sciences Review http://dx.doi.org/10.1590/s2175-97902019000418077 Intralesional corticosteroid injection as an effective treatment method for oral lesions: a meta-analysis Narges Gholizadeh1, Maryam-Sadat Sadrzadeh-Afshar 2, Nafiseh Sheykhbahaei3* 1Oral & Maxillofacial Medicine Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran, 2Oral & Maxillofacial Medicine Department, School of Dentistry, Aja University of Medical Sciences, Tehran, Iran, 3Oral & Maxillofacial Medicine Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Intralesional corticosteroid injection (ICSI) is known as one of the main methods used for treating a wide range of lesions. It also results in a high concentration of drugs at lesion sites, with minimal systemic absorption. Thus, this study aimed to provide a review of the intralesional corticosteroid injection (ICSI) indications in the treatment of oral lesions. To this end; relevant key words were searched in the databases of PubMed, Google Scholar, Scopus, ScienceDirect, and UpToDate in the present study. Accordingly, the results of a total number of 62 case reports or case series articles were used in this study and the positive therapeutic effects of intralesional corticosteroid injection (ICSI) in 23 common oral lesions were reported. The most common type of intralesional steroid in the treatment of oral lesions was triamcinolone. No significant difference was also observed in terms of pain in patients following the use of steroid alone or in combination with anesthetic agents; moreover, the reported side effects of this method were exceptionally rare and transient. It was concluded that the intralesional corticosteroid injection (ICSI) could be one of the effective therapeutic methods with no significant problems in many oral lesions such as inflammatory, immunologic, and vascular ones due to its higher therapeutic effects than other topical forms of steroids and fewer side effects than systemic corticosteroid.
    [Show full text]
  • Pyogenic Granuloma
    PYOGENIC GRANULOMA http://www.aocd.org Pyogenic granuloma is a relatively common skin growth. It is usually a small red, oozing and bleeding bump that looks like raw hamburger meat. It often seems to follows a minor injury and grows rapidly over a period of a few weeks to an average size of a half an inch. The head, neck, upper trunk and hands and feet are the most commonly sites. Pyogenic granuloma can occur at any age, but is least common in the very young and the very old. It is seen most often in children, pregnant women ("pregnancy tumor") and those taking the drugs Indinavir, Soriatane, Accutane and oral contraceptives. Pyogenic granulomas are always benign growths. Still there is always a concern that they could be cancerous, and rarely a cancer can mimic pyogenic granuloma. A sample is usually obtained for biopsy analysis. This is particularly important since as many as half of treated cases will recur (grow back) and need a second treatment. Those that appear on the upper back in young adults are more prone to recur. At times multiple smaller pyogenic granulomas form following a treatment (these are known as "satellites"). It appears that pieces of pyogenic granuloma may spread through local blood vessels. Pyogenic granulomas in pregnant women may go away after delivery on their own, and sometimes waiting is the best strategy in those cases. Most pyogenic granulomas are scraped off with an instrument called a curette and lightly cauterized to decrease the chance they will re-grow. An injection of local anesthesia is required (lidocaine is used-similar to Novocaine).
    [Show full text]
  • Generalized Gingival Pyogenic Granuloma in a 11 Years Old Female – a Diagnostic Challenge
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by ZENODO British Journal of Medicine & Medical Research 21(10): 1-5, 2017; Article no.BJMMR.33309 ISSN: 2231-0614, NLM ID: 101570965 Generalized Gingival Pyogenic Granuloma in a 11 Years Old Female – A Diagnostic Challenge J. Leelavathy 1, Shilpa K. Ramesh 2* and A. Winnifred Christy 1 1Department of Oral Medicine and Maxillofacial Radiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India. 2CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India. Authors’ contributions This work was carried out in collaboration between all authors. Author JL diagnosed the case, designed the manuscript. Author SKR prepared the manuscript and managed the literature searches, Author WC helped in reviewing and editing the manuscript. All authors read and approved the final manuscript . Article Information DOI: 10.9734/BJMMR/2017/33309 Editor(s): (1) Rodrigo Crespo Mosca, Department of Biotechnology, Institute of Energetic and Nuclear Research (IPEN-CNEN), University of Sao Paulo (USP), Brazil. Reviewers: (1) José López López, University of Barcelona, Spain. (2) Parag M. Khatri, Sri Aurobindo College of Dentistry, India. (3) Gowri Pendyala, Rural Dental College, Pravara Institute of Medical, India. Complete Peer review History: http://www.sciencedomain.org/review-history/19285 Received 9th April 2017 th Case Study Accepted 18 May 2017 st Published 1 June 2017 ABSTRACT Aims: To include pyogenic granuloma as one of the differential diagnosis of generalized gingival enlargements. Presentation of Case: In this article, we report a 11 years old female patient with generalized gingival enlargement, which on thorough clinical, histopathological and radiological examination concluded as a generalized gingival pyogenic granuloma.
    [Show full text]