DOCSLIB.ORG

Oral Medicine — Update for the Dental Practitioner Lumps and Swellings

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Oral Medicine — Update for the Dental Practitioner Lumps and Swellings IN BRIEF • Lumps have a variety of causes, benign and malignant. • Biopsy, imaging or other investigations are often indicated. 8 Oral Medicine — Update for the dental practitioner Lumps and swellings C. Scully1 and D. H. Felix2 This series provides an overview of current thinking in the more relevant areas of oral medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail. ORAL MEDICINE This article discusses neck lumps, salivary gland infection. Children and young adults are 1. Aphthous and other swellings, and lumps and swellings in the mouth. predominantly affected (Table 2). Enlarged cervi- common ulcers cal lymph nodes, especially in older people, may 2. Mouth ulcers of more NECK LUMPS also be related to malignant disease in the serious connotation The lymphoid system is the essential basis of drainage area (eg carcinoma) or may be a mani- 3. Dry mouth and disorders immune defences and comprises predominantly festation of systemic disease (eg HIV/AIDS). of salivation bone marrow, spleen, thymus and lymph nodes 4. Oral malodour too. Tissue fluid drains into lymph nodes which Examination of cervical lymph nodes act as ‘filters’ of antigens and, after processing in Inspection of the neck, looking particularly 5. Oral white patches the nodes, lymph containing various immuno- for swellings or sinuses, should be followed by 6. Oral red and cytes drains from the nodes, to lymph ducts and careful palpation of the thyroid gland and all hyperpigmented patches then to the circulation. A lymph node consists of the lymph nodes, searching for swelling or 7. Orofacial sensation and a cortex, paracortex and medulla and is enclosed tenderness. movement by a capsule. Lymphocytes and antigens (if pres- The examination of lymph nodes in the neck is 8. Orofacial swellings and ent) pass into the node through the afferent lym- an important part of every orofacial examination. lumps phatics, are ‘filtered’ and pass out from the About one third of all the lymph nodes in the 9. Oral cancer medulla through the efferent lymphatics. The body are in the neck and dental surgeons can 10. Orofacial pain cortex contains B cells aggregated into primary often detect serious disease through examining it. follicles; following stimulation by antigen these It is prudent to adopt a systematic and develop a focus of active proliferation (germinal methodical approach, examining different 1*Professor, Consultant, Dean, Eastman centre) and are termed secondary follicles. These lymph node groups in turn: Dental Institute for Oral Health Care follicles are in intimate contact with antigenpre- • Submental Sciences, 256 Gray’s Inn Road, UCL, University of London, London WC1X 8LD; senting dendritic cells. The paracortex contains T • Submandibular 2Consultant, Senior Lecturer, Glasgow cells, and the medulla contains T and B cells. • Pre-auricular/parotid Dental Hospital and School, 378 • Occipital Sauchiehall Street, Glasgow G2 3JZ / Associate Dean for Postgraduate Dental Causes of lymph node enlargement • Deep cervical chain. Education, NHS Education for Scotland, Many diseases can present with lesions in the 2nd Floor, Hanover Buildings, 66 Rose neck but the most common are lesions involving Both anterior and posterior cervical nodes Street, Edinburgh EH2 2NN *Correspondence to: Professor Crispian the lymph nodes (Table 1). should be examined as well as other nodes, liver Scully CBE Nodes enlarge in oral infections or local infec- and spleen if systemic disease is a possibility. Email: [email protected] tions in the drainage area (virtually anywhere in Most disease in lymph nodes is detected in the the head and neck). Most common is an enlarged anterior triangle of neck, which is bounded Refereed Paper © British Dental Journal 2005; 199: jugulo-digastric (tonsillar) lymph node, inflamed superiorly by the mandibular lower border, pos- 763–770 secondary to a viral upper respiratory tract teriorly and inferiorly by the sternomastoid BRITISH DENTAL JOURNAL VOLUME 199 NO. 12 DEC 24 2005 763 PRACTICE drainage and nodes are then often firm, discrete Table 1 Causes of cervical lymph node enlargement and tender, but are mobile (lymphadenitis). The Inflammatory Infective Local Bacterial Local infections in the focus of inflammation can usually be found in head and neck the drainage area which is anywhere on the face, Viral Viral respiratory infections scalp and nasal cavity, sinuses, ears, pharynx Herpes simplex and oral cavity. The local cause may not always Herpes zoster Herpangina be found despite a careful search. For example, children occasionally develop a Staphylococcus Systemic Bacterial Syphilis Tuberculosis aureus lymphadenitis (usually in a submandibu- Atypical mycobacterioses lar node) in the absence of any obvious portal of Cat scratch fever infection. Lymph nodes that are tender may be Brucellosis inflammatory, leukaemia or lymphoma; those Viral Glandular fever syndromes that are increasing in size and are hard may be (EBV, CMV, HIV, HHV-6) malignant. Rubella Lymph nodes may show reactive hyperplasia Protozoal Toxoplasmosis to a malignant tumour in the drainage area, or Others Mucocutaneous lymph node swelling because of metastatic infiltration. The syndrome (Kawasaki disease) latter may cause the node to feel distinctly hard, Non-infective Sarcoidosis and it may become bound down to adjacent Crohn’s disease tissues (‘fixed’), may not be discrete, and may Orofacial granulomatosis even, in advanced cases, ulcerate through the Connective tissue diseases skin. The neoplasms that frequently metastasise to cervical lymph nodes are oral squamous car- Malignancy Primary Leukaemias Lymphomas cinoma (Article 9), nasopharyngeal carcinoma, tonsillar cancer and thyroid tumours. Secondary Metastases Usually one or more anterior cervical nodes Other Drugs, eg phenytoin are involved, often unilaterally in oral neo- plasms anteriorly in the mouth, but otherwise not infrequently bilaterally. Table 2 Lymph node swellings at different ages More serious is the finding of an enlarged Decade Most common causes of swelling node suspected to be malignant but where the primary neoplasm cannot be found. Nasopha- First Lymphadenitis due to viral respiratory tract infection ryngeal or tonsillar carcinomas are classic causes of this and an ENT opinion should therefore be Second Lymphadenitis due to viral respiratory tract infection sought. Clinically unsuspected tonsillar cancer is Bacterial infection a common cause of metastasis in a cervical node Glandular fever syndromes of unidentified origin. Biopsy of the tonsil may HIV infection reveal a hitherto unsuspected malignancy. Toxoplasmosis Rare causes of cervical metastases include Third and fourth Lymphadenitis metastases from the stomach or even testicular Glandular fever syndromes tumours to lower cervical nodes. However, in HIV infection Malignancy some patients with a malignant cervical lymph node, the primary tumour is never located. After fourth Lymphadenitis Malignancy Generalised lymphadenopathy with or with- out enlargement of other lymphoid tissue such as liver and spleen (hepatosplenomegaly), sug- Table 3 Glandular fever syndromes gests a systemic cause. Lymph nodes may also swell when there are disorders involving the Features Adolescents and Sore throat, fever, immune system more generally, such as the young adults lymphadenopathy mainly glandular fever syndromes, HIV/AIDS and relat- ed syndromes, various other viral infections; Causal agents Epstein-Barr virus Cytomegalovirus Toxoplasma gondii Human immune (EBV) (CMV) deficiency viruses (HIV) bacterial infections such as syphilis and tubercu- losis; and parasites such as toxoplasmosis. In the Investigations Paul-Bunnell Test CMV antibodies Sabin-Feldman HIV antibody titres systemic infective disorders the nodes are usual- EBV antibody titres dye test Lymphopenia Specific IgM T4 (CD4) cell numbers ly firm, discrete, tender and mobile. Lymph antibodies nodes may also swell in non infective lesions such as sarcoidosis; mucocutaneous lymph node muscle, and anteriorly by the midline of the syndrome; and neoplasms such as lymphomas neck. Nodes in this site drain most of the head and leukaemias (Table 1). In the latter instances, and neck except the occiput and back of neck. and in the glandular fever syndromes (where Lymphadenopathy in the anterior triangle of the there is lymphadenopathy often together with neck alone is often due to local disease, especially sore throat and fever; Table 3), there is usually if the nodes are enlarged on only one side. enlargement of many or all
Load more

Recommended publications
  • Lumps and Swellings
    Clinical Oral medicine for the general practitioner: lumps and swellings Crispian Scully 1 his series of five papers summarises some of the most important oral medicine problems likely to be Tencountered by practitioners. Some are common, others rare. The practitioner cannot be expected to diagnose all, but has been trained to recognise oral health and disease, and should be competent to recognise normal variants, and common orofacial disorders. In any case of doubt, the practitioner is advised to seek a second opinion from a colleague. The series is not intended to be comprehensive in coverage either of the conditions encountered, or all aspects of Figure 1: Torus mandibularis. diagnosis or treatment: further details are available in standard texts, in the further reading section, or from the internet. The present article discusses aspects of lumps through fear, perhaps after hearing of someone with and swellings. ‘mouth cancer’. Thus some individuals discover and worry about normal anatomical features such as tori, the parotid Lumps and swellings papilla, foliate papillae on the tongue, or the pterygoid Lumps and swellings in the mouth are common, but of hamulus. The tongue often detects even a very small diverse aetiologies (Table 1), and some represent swelling, or the patient may first notice it because it is sore malignant neoplasms. Therefore, this article will discuss (Figure 1). In contrast, many oral cancers are diagnosed far lumps and swellings in general terms, but later focus on too late, often after being present several months, usually the particular problems of oral cancer and of orofacial because the patient ignores the swelling.
    [Show full text]
  • Review: Differential Diagnosis of Drug-Induced Gingival Hyperplasia and Other Oral Lesions
    ISSN: 2469-5734 Moshe. Int J Oral Dent Health 2020, 6:108 DOI: 10.23937/2469-5734/1510108 Volume 6 | Issue 2 International Journal of Open Access Oral and Dental Health REVIEW ARTICLE Review: Differential Diagnosis of Drug-Induced Gingival Hyper- plasia and Other Oral Lesions Einhorn Omer Moshe* Private Dental Office, Israel Check for *Corresponding author: Einhorn Omer Moshe, Private Dental Office, Dr. Einhorn, 89 Medinat Hayehudim updates street, Herzliya, Israel tooth discoloration, alteration of taste sensation and Abstract even appearance of lesions on the tissues of the oral Chronic medication usage is a major component of the cavity. Early recognition and diagnosis of these effects medical diagnosis of patients. Nowadays, some of the most common diseases such as cancer, hypertension, diabetes can largely assist in the prevention of further destruc- and etc., are treated with drugs which cause a variety of oral tive consequences in patients’ health status. As life ex- side-effects including gingival over growth and appearance pectancy increases, the number of elderly patients in of lesions on the tissues of the oral cavity. As such, drug-in- the dental practice also rises. Individuals of this popula- duced oral reactions are an ordinary sight in the dental prac- tice. This review will point out the main therapeutic agents tion are usually subjected to chronic medication intake causing gingival hyperplasia and other pathologic lesions which requires the clinician to be aware of the various in the oral cavity. Some frequently used medications, in side-effects accompanying these medications. This re- particular antihypertensives, nonsteroidal anti-inflammatory view will point out the main therapeutic agents causing drugs and even antibiotics, can lead to overgrowth of the gingival hyperplasia and other pathologic lesions in the gingiva and to the multiple unwanted conditions, namely: Lupus erythematosus, erythema multiforme, mucositis, oral oral cavity.
    [Show full text]
  • Orofacial Granulomatosis
    Al-Hamad, A; Porter, S; Fedele, S; (2015) Orofacial Granulomatosis. Dermatol Clin , 33 (3) pp. 433- 446. 10.1016/j.det.2015.03.008. Downloaded from UCL Discovery: http://discovery.ucl.ac.uk/1470143 ARTICLE Oro-facial Granulomatosis Arwa Al-Hamad1, 2, Stephen Porter1, Stefano Fedele1, 3 1 University College London, UCL Eastman Dental Institute, Oral Medicine Unit, 256 Gray’s Inn Road, WC1X 8LD, London UK. 2 Dental Services, King Abdulaziz Medical City-Riyadh, Ministry of National Guard, Riyadh, Saudi Arabia. 3 NIHR University College London Hospitals Biomedical Research Centre, London, UK. Acknowledgments: Part of this work was undertaken at University College London/University College London Hospital, which received a proportion of funding from the Department of Health’s National Institute for Health Research Biomedical Research Centre funding scheme. Conflicts of Interest: The authors declare that they have no affiliation with any organization with a financial interest, direct or indirect, in the subject matter or materials discussed in the manuscript that may affect the conduct or reporting of the work submitted. Authorship: all authors named above meet the following criteria of the International Committee of Medical Journal Editors: 1) Substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; 2) Drafting the article or revising it critically for important intellectual content; 3) Final approval of the version to be published. Corresponding author: Dr. Stefano Fedele DDS, PhD
    [Show full text]
  • Orofacial Granulomatosis Presenting As Gingival Enlargement – Report of Three Cases
    Open Access Journal of Dentistry & Oral Disorders Case Report Orofacial Granulomatosis Presenting as Gingival Enlargement – Report of Three Cases Savithri V*, Janardhanan M, Suresh R and Aravind T Abstract Department of Oral Pathology & Microbiology, Amrita Orofacial Granulomatosis (OFG) is an uncommon disease characterized School of Dentistry, Amrita VishwaVidyapeetham, Amrita by non-caseating granulomatous inflammation in the oral and maxillofacial University, India region. They present clinically as labial enlargement, perioral and/or mucosal *Corresponding author: Vindhya Savithri, swelling, angular cheilitis, mucosal tags, vertical fissures of lips, lingua plicata, Department of Oral Pathology & Microbiology, Amrita oral ulcerations and gingival enlargement. The term OFG was introduced by School of Dentistry, Amrita VishwaVidyapeetham, Amrita Wiesenfeld in 1985. The diagnosis of OFG is done by the clinical presentation University, India and histological picture and this may be further complicated by the fact that OFG may be the oral manifestation of a systemic condition, such as Crohn’s Received: October 16, 2017; Accepted: November 27, disease, sarcoidosis, or, more rarely, Wegener’s granulomatosis. In addition, 2017; Published: December 04, 2017 several conditions, including tuberculosis, leprosy, systemic fungal infections, and foreign body reactions may show granulomatous inflammation on histologic examination. They have to be excluded out by appropriate investigations. They have to be excluded out by appropriate investigations.
    [Show full text]
  • Chronic Inflammatory Gingival Enlargement and Treatment: a Case Report
    Case Report Adv Dent & Oral Health Volume 9 Issue 4- July 2018 Copyright © All rights are reserved by Mehmet Özgöz DOI: 10.19080/ADOH.2018.09.555766 Chronic Inflammatory Gingival Enlargement and Treatment: A Case Report Mehmet Özgöz1* and Taner Arabaci2 1Department of Periodontology, Akdeniz University, Turkey 2Department of Periodontology, Atatürk University, Turkey Submission: June 14, 2018; Published: July 18, 2018 *Corresponding author: Özgöz, Department of Periodontology, Akdeniz University Faculty of Dentistry, Antalya, Turkey, Fax:+902423106967; Email: Abstract Gingival enlargement is a common feature in gingival disease. If gingival enlargement isn’t treated, it may some aesthetic problems, plaque accumulation,Keywords: Gingival gingival enlargement; bleeding, and Periodontal periodontitis. treatments; In this paper, Etiological inflammatory factors; Plasma gingival cell enlargement gingivitis and treatment was presented. Introduction and retention include poor oral hygiene, abnormal relationship of Gingival enlargement is a common feature in gingival disease adjacent teeth, lack of tooth function, cervical cavities, improperly contoured dental restorations, food impaction, nasal obstruction, connection with etiological factors and pathological changes [3-5]. [1,2]. Many types of gingival enlargement can be classified in orthodontic therapy involving repositioning of the teeth, and habits such as mouth breathing and pressing the tongue against the gingival [18-20]. a)b) InflammatoryDrug-induced enlargement:enlargement [7-12]. chronic and acute [6]. c) Gingival enlargements associated with systemic diseases: patients to maintain oral hygiene [9,21]. Surgical correction of Overgrowth of the gingival tissue makes it more difficult for i. Conditioned enlargement (pregnancy, puberty, vitamin the gingival overgrowth is still the most frequent treatment. Such treatment is only advocated when the overgrowth is severe.
    [Show full text]
  • Herpes Simplex Virus Infection
    FUNGI VIRUS BACTERIA DISEASE The oral focal infection theory • A concept generally negleted for several decades, is controversial yet has gained renewed interest with progress in clasification and identification of oral microorganisms. • Additionally, recent evidence associating dental with artherosclerosis and other chronic disease has also helped resurrect the focal infection theory Pathways of infection arising from oral bacteria The three pathway that may link oral bacteria to secondary disease distant from the oral nidus are : 1. Metastatic infection attributable to transient bacteria in the blood 2. Metastatic immunologic injury 3. Metastatic toxic injury The scientific evidence weak a it is best supports of first pathway of transient bacteriemias of oral origin Mechanical prosthetic valve (arrow) Odontogenic infection Caries dental pulpitis Necrosis of the pulp pulp polyp Periapical abscess Periodontal infection Periodontal abscess Gingivitis ANUG Salivary infection Mucositis Recurent Apthous Stomatitis Minor RAS Mayor Fungal infection • Are oral fungal infections common ? • No, most are associated with an underlying systemic condition immunosuppression imunodeficiency syndrome cancer therapy anemia diabetes uremia leukemia • Patients who have conditions that modify the normal oral environment are at increased risk of fungal infection Among these individuals are patients with _ xerostomia _ have taken broad spectrum antibiotics Diagnosis of oral fungal infection based on : • History • Clinical appearance • Culture • Potassium hydroxide
    [Show full text]
  • Orofacial Granulomatosis: a Review
    DOI Number: 10.5958/0974-1283.2019.00181.6 Orofacial Granulomatosis: A Review Saloni Banga1, M K Sunil2, Hina Padaliya1 1Intern, 2Professor and Head of Department, Department of Oral Medicine & Radiology, Teerthanker Mahaveer Dental College & Research Center Moradabad Abstract Orofacial Granulomatosis (OFG) is an uncommon clinicopathological entity characterized clinically by the presence of persistent enlargement of the soft tissues of the oral and maxillofacial region and histologically by non-caseating and non-necrotizing granulomatous inflammation. The term ‘orofacial granulomatosis’ has been introduced to denote the group of various disorders, including Melkersson-Rosenthal syndrome and granulomatous cheilitis and has been noted to be associated with Crohn’s disease, Sarcoidosis and infectious diseases such as Tuberculosis. Although, various etiological agents such as dental materials, food additives and microbial agents have been recommended in the disease process. Treatment of orofacial granulomatosis is by corticosteroids but it’s not so efficient. It is more important to identify the pathogen first to specify the appropriate treatment line. Keywords— orofacial granulomatosis, Melkersson Rosenthal syndrome, crohn,s disease. Introduction Definition and its associated to other granulomatous disorders Orofacial granulomatosis term was introduced by Wiesenfeld in 19851. Granulomatosis is any condition Orofacial granulomatosis is an uncommon disorder1 characterized by the formation of multiple nodules or but is increasingly recognized. Orofacial granulomatosis granulomas in soft tissues. It encompasses Melkersson (as defined by Wiesenfeld in 1985) is the specific Rosenthal syndrome and Cheilitis granulomatosa1. histological finding of granulomas in mucosal or skin The true prevalence of this disease is unknown but is biopsies taken from the mouth or face in the absence suggested to be 0.8% (Mahler and Kiesewetter, 1996)3.
    [Show full text]
  • Generalized Aggressive Periodontitis Associated with Plasma Cell Gingivitis Lesion: a Case Report and Non-Surgical Treatment
    Clinical Advances in Periodontics; Copyright 2013 DOI: 10.1902/cap.2013.130050 Generalized Aggressive Periodontitis Associated With Plasma Cell Gingivitis Lesion: A Case Report and Non-Surgical Treatment * Andreas O. Parashis, Emmanouil Vardas, † Konstantinos Tosios, ‡ * Private practice limited to Periodontics, Athens, Greece; and, Department of Periodontology, School of Dental Medicine, Tufts University, Boston, MA, United States of America. †Clinic of Hospital Dentistry, Dental Oncology Unit, University of Athens, Greece. ‡ Private practice limited to Oral Pathology, Athens, Greece. Introduction: Plasma cell gingivitis (PCG) is an unusual inflammatory condition characterized by dense, band-like polyclonal plasmacytic infiltration of the lamina propria. Clinically, appears as gingival enlargement with erythema and swelling of the attached and free gingiva, and is not associated with any loss of attachment. The aim of this report is to present a rare case of severe generalized aggressive periodontitis (GAP) associated with a PCG lesion that was successfully treated and maintained non-surgically. Case presentation: A 32-year-old white male with a non-contributory medical history presented with gingival enlargement with diffuse erythema and edematous swelling, predominantly around teeth #5-8. Clinical and radiographic examination revealed generalized severe periodontal destruction. A complete blood count and biochemical tests were within normal limits. Histological and immunohistochemical examination were consistent with PCG. A diagnosis of severe GAP associated with a PCG lesion was assigned. Treatment included elimination of possible allergens and non- surgical periodontal treatment in combination with azithromycin. Clinical examination at re-evaluation revealed complete resolution of gingival enlargement, erythema and edema and localized residual probing depths 5 mm. One year post-treatment the clinical condition was stable.
    [Show full text]
  • Periodontal Health, Gingival Diseases and Conditions 99 Section 1 Periodontal Health
    CHAPTER Periodontal Health, Gingival Diseases 6 and Conditions Section 1 Periodontal Health 99 Section 2 Dental Plaque-Induced Gingival Conditions 101 Classification of Plaque-Induced Gingivitis and Modifying Factors Plaque-Induced Gingivitis Modifying Factors of Plaque-Induced Gingivitis Drug-Influenced Gingival Enlargements Section 3 Non–Plaque-Induced Gingival Diseases 111 Description of Selected Disease Disorders Description of Selected Inflammatory and Immune Conditions and Lesions Section 4 Focus on Patients 117 Clinical Patient Care Ethical Dilemma Clinical Application. Examination of the gingiva is part of every patient visit. In this context, a thorough clinical and radiographic assessment of the patient’s gingival tissues provides the dental practitioner with invaluable diagnostic information that is critical to determining the health status of the gingiva. The dental hygienist is often the first member of the dental team to be able to detect the early signs of periodontal disease. In 2017, the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) developed a new worldwide classification scheme for periodontal and peri-implant diseases and conditions. Included in the new classification scheme is the category called “periodontal health, gingival diseases/conditions.” Therefore, this chapter will first review the parameters that define periodontal health. Appreciating what constitutes as periodontal health serves as the basis for the dental provider to have a stronger understanding of the different categories of gingival diseases and conditions that are commonly encountered in clinical practice. Learning Objectives • Define periodontal health and be able to describe the clinical features that are consistent with signs of periodontal health. • List the two major subdivisions of gingival disease as established by the American Academy of Periodontology and the European Federation of Periodontology.
    [Show full text]
  • Gingival Diseases in Children and Adolescents
    8932 Indian Journal of Forensic Medicine & Toxicology, October-December 2020, Vol. 14, No. 4 Gingival Diseases in Children and Adolescents Sulagna Pradhan1, Sushant Mohanty2, Sonu Acharya3, Mrinali Shukla1, Sonali Bhuyan1 1Post Graduate Trainee, 2Professor & Head, 3Professor, Department of Paediatric and Preventive Dentistry, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be University), Bhubaneswar 751003, Odisha, India Abstract Gingival diseases are prevalent in both children and adolescents. These diseases may or may not be associated with plaques, maybe familial in some cases, or may coexist with systemic illness. However, gingiva and periodontium receive scant attention as the primary dentition does not last for a considerable duration. As gingival diseases result in the marked breakdown of periodontal tissue, and premature tooth loss affecting the nutrition and global development of a child/adolescent, precise identification and management of gingival diseases is of paramount importance. This article comprehensively discusses the nature, spectrum, and management of gingival diseases. Keywords: Gingival diseases; children and adolescents; spectrum, and management. Introduction reddish epithelium with mild keratinization may be misdiagnosed as inflammation. Lesser variability in the Children are more susceptible to several gingival width of the attached gingiva in the primary dentition diseases, paralleling to those observed in adults, though results in fewer mucogingival problems. The interdental vary in numerous aspects. Occasionally, natural variations papilla is broad buccolingual, and narrow mesiodistally. in the gingiva can masquerade as genuine pathology.1 The junctional epithelium associated with the deciduous On the contrary, a manifestation of a life-threatening dentition is thicker than the permanent dentition. underlying condition is misdiagnosed as normal gingiva.
    [Show full text]
  • Cinnamon Products As a Possible Etiologic Factor in Orofacial Granulomatosis
    Med Oral Patol Oral Cir Bucal. 2007 Oct 1;12(6):E440-4. Orofacial granulomatosis caused by cinnamon flavoring Med Oral Patol Oral Cir Bucal 2007;12:E440-4. Orofacial granulomatosis caused by cinnamon flavoring Cinnamon products as a possible etiologic factor in orofacial granulomatosis Hiroyasu Endo 1, Terry D. Rees 2 (1) Assistant Professor, Department of Periodontology, Nihon University, School of Dentistry at Matsudo, Japan (2) Professor and Former Chairman, Director of Stomatology, Department of Periodontics, Baylor College of Dentistry, Texas A&M University Health Science Center, Dallas, TX, USA Correspondence: Dr. Hiroyasu Endo Dept. of Periodontology Nihon University School of Dentistry at Matsudo 2-870-1 Sakaecho Nishi, Matsudo Chiba, Japan. 271-8587 E-mail: [email protected] Endo H, Rees TD. Cinnamon products as a possible etiologic factor Received: 17-09-2006 Accepted: 25-03-2007 in orofacial granulomatosis. Med Oral Patol Oral Cir Bucal. 2007 Oct 1;12(6):E440-4. © Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946 Indexed in: -Index Medicus / MEDLINE / PubMed -EMBASE, Excerpta Medica -SCOPUS -Indice Médico Español -IBECS ABStract Objectives: It has been reported that clinical changes due to hypersensitivity reactions to various foods, preservatives, and oral hygiene products may be consistent with the characteristic signs of orofacial granulomatosis (OFG). The ob- jective of this study was to examine 37 well-documented cases of cinnamon-induced contact stomatitis for clinical and histological features consistent with a diagnosis of OFG. Study design: We reviewed the records of the 37 cases to screen them for the clinical and histopathologic features of OFG.
    [Show full text]
  • A Concurrence of Periodontitis, Gingival Overgrowth and Plasma Cell Gingivitis: a Case Report
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 4 Ser.4 (April. 2020), PP 51-55 www.iosrjournals.org A Concurrence of Periodontitis, Gingival overgrowth and Plasma cell gingivitis: a case report Dr Yogesh Kumar Chanania1 Post Graduate Student, Dr C S Baiju2 MDS Professor & Head of Department, Dr Sumidha Bansal3 MDS Professor, Dr Karuna Joshi4 MDS Senior Lecturer 1(Department of Periodontics, Sudha Rustagi College of Dental Sciences & Research Faridabad, Pt. B. D. Sharma University of Health Sciences Rohtak, India) 2(Department of Periodontics, Sudha Rustagi College of Dental Sciences & Research Faridabad, Pt. B. D. Sharma University of Health Sciences Rohtak, India) 3(Department of Periodontics, Sudha Rustagi College of Dental Sciences & Research Faridabad, Pt. B. D. Sharma University of Health Sciences Rohtak, India) 4(Department of Periodontics, Sudha Rustagi College of Dental Sciences & Research Faridabad, Pt. B. D. Sharma University of Health Sciences Rohtak, India) Abstract: Periodontitis is inflammation of supporting tissues of the teeth, it causes destructive change that leads to loss of bone and periodontal ligament. Gingival overgrowth is increase in the size of gingiva. Gingival overgrowth may be associated with hormonal, nutritional imbalance or other local factors and systemic diseases. Plasma cell gingivitis is a condition that is clinically characterized by diffuse reddening and edematous swelling of gingiva. A non-smoker systemically healthy 35-year-old female patient reported with the chief complaint of swollen gums since 3 years. Clinically patient presented with generalized gingival overgrowth and was diagnosed as a stage IV grade ‘C’ periodontitis.
    [Show full text]