پنځم فصل د خولي د جوف ناروغى د خولي د جوف د غاښو ناروغى د ناړو د غدواتو ناروغى ناروغى (stratified non keratinized squamous epi) mucous Developmental anomalies (cleft upper lip) Facial clefts (cleft palate) facial processes Fordyce’s granules sebaceous (spots) Leukoedema leukoplakia mucosa macroglossia Macroglossia i amyloid haemangioma lymphangioma 270 پنځم فصل د خولي د جوف ناروغى aglossia Microglossia ii aglossia micoglossia Fissured tongue iii glossitis fissured tongue Bifid Tongue iv tongue tie fraenum Tongue Tie v Hairy Tongue vi hairy tongue filiform Mucocutaneuous Lesion mucosa Lichen Planus keratosis Vesicular lesions 271 پنځم فصل د خولي د جوف ناروغى pemphigus vugaris Pemphigus vulgaris i conjunctiva Pemphigoid ii pemphigoid pemphigoid Erythema Multiforme iii erythema multiforme Stevens-Johnson syndrome iv sulfa stomatitis Stomatitis Aphthous ulcer (canker sore) i stress inflammatory Bechet’s syndrome bowel disease Herpes simplex Herpetic stomatitis ii stress 272 پنځم فصل د خولي د جوف ناروغى cancrum oris Noma Necrotising Stomatitis iii Kwashiorkor stress marginal gangrene cheek cellulitis mucosa Mycotic infections iv Candidiasis actinomycosis (mandible) Cervicofacial actinomycosis candida albicans Candidiasis erythematous palate glossitis Glossitis Scarlet fever papillae papillae glossitis pernicious anaemia iron deficiency anaemia pellagra malnutrition papillae sprue congenital syphilis tertiary secondary primary Syphilitic Lesions primary syphilis i mucous patches Secondary syphilis ii 273 پنځم فصل د خولي د جوف ناروغى gummas tertiary syphilis iii fissures congenital syphilis iv Tuberculous lesions TB AIDS HIV Infection Hairy leukoplakia ٥-١ جدول.په AIDS کي د خولې ليژنونه . A. OPPORTUNISTIC INFECTIONS B. TUMOURS Fungal : Candidiasis (oral thrush) Kaposi’s sarcoma Histoplasmosis Squamous cell carcinoma Cryptococcosis Non-Hodgkin’s lymphoma Bacterial : Dental caries and periodontitis C. OTHERS Mycobacterial infections Hairy leukoplakia Viral : Herpetic stomatitis Recurrent aphthous ulcers Cytomegalovirus Human papillomavirus Pigmentary Lesions Melanotic pigmentation peutz-Jeghers Albright syndrome Addison’s disease malignant melanoma Haemochromatosis syndrome sufide exogenous pigmentation 274 پنځم فصل د خولي د جوف ناروغى Tumour ٥-٢ جدول. د خولې د ټيومورونو طبقه بندي او ټيومور ته ورته ليژنونه . A. TUMOUR-LIKE LESIONS 1. Fibrous growths C. PREMALIGNANT LESIONS (Fibroepithelial polyps, fibrous epulis, denture hyperplasia) 1. Hyperkeratotic leukoplakia 2. Pyogenic granuloma 2. Dysplastic leukoplakia 3. Mucocele D. MALIGNANT TUMOURS 4. Ranula 1. Squamous cell (Epidermoid) carcinoma 5. Dermoid cyst 2. Other malignant tumours B. BENIGN TUMOURS 1. Squamous papilloma 2. Haemangioma 3. Lymphangioma 4. Fibroma 5. Fibromatosis gingivae 6. Tumours of minor salivary glands (e.g. Pleomorphic adenoma) 7. Granular cell myoblastoma leukoplakia A Fibrous Growths 275 پنځم فصل د خولي د جوف ناروغى Fibroepithelial polyps i fibrous stratified squamous Fibrous epulis ii Giant cell epulis Denture Hyperplasia iii hyperplasia hyperplasia Pyogenic Granuloma Buccal mucosa fibrous epulis Vasoproliferative Mucocele mucous cyst (mucous glands) Ranula floor Mucocele 276 پنځم فصل د خولي د جوف ناروغى Dermoid cyst stratified squamous sebaceous Extravasated mucous Mucocele B mesodermal Squamous Papilloma Haemangioma haemangioma Capillary haemangioma macroglossia haemangioma cavernous macroglossia Lymphangioma macroglossia macrocheilia lymphoangioma Cystic hygroma macrocheilia 277 پنځم فصل د خولي د جوف ناروغى Cystic hygroma Fibroma fibroma Fibromatosis Gingivae Fibromatosis Gingivae pleomorphic adenoma Leukoplakia C Leukoplakia leukoplakia plaque leukoplakia leukoplakia 278 پنځم فصل د خولي د جوف ناروغى (incidence) floor mucosa leukoplakia AIDs Hairy leukoplakia leukoplakia Leukoplakia leukoplakia squamous epithelium Hyperkeratotic A hyperkeratosis hyperplasia Dysplastic pleomorphism dysplasia B 279 پنځم فصل د خولي د جوف ناروغى Hyperkeratosis A Leukoplakia Dysplastic B Basement membrane Malignant Tumours D Squamous cell (epidermoid) carcinoma 90% floor squamous cell carcinoma 280 پنځم فصل د خولي د جوف ناروغى i ii Human papilloma virus (HPV 16 ,18) iii Squamous cell carcinoma i fibrosis ii iii iv v Plummer vinson syndrome iv Squamous cell carcinoma Ulcerative i (wart) verrucous Papillary ii Nodular iii Scirrhous iv squamous well-differentiated 281 پنځم فصل د خولي د جوف ناروغى squamous carcinoma pleomorphism squamous cell carcinoma caries Periodontitis Abscess crown root dentine enamel cementum dental lamina gingiva primitive oral cavity 282 پنځم فصل د خولي د جوف ناروغى ectoderm dental lamina enamel ameloblasts enamel organ matrix dental mesoderm pulp papilla odontoblasts dental papilla dentin ameloblastic epithelium Enamel enamel enamel Dentin odontoblasts dentin osteocytes canaliculi 283 پنځم فصل د خولي د جوف ناروغى Cementum periodontal ligament cementum pulp Dentin Dental pulp Dental caries calcified dental caries acidogenic streptococci dentin dentin enamel decalcify proteolysis dentin plaques fluoride 284 پنځم فصل د خولي د جوف ناروغى caries premolars molar dentin enamel (pulititis) Caries pulpitis enamel Demtal caries pulpitis pulp pulpitis apical foramen pulpitis Apical granuloma granulation granuloma Apical abscess 285 پنځم فصل د خولي د جوف ناروغى Periodontal disease degeneration epulis fibrous hyperplasia scurvy leukemia periodontal Dilantin marginal gingivitis plaques marginal gingivitis periodontitis hyperplasia pyorrhea resorption alveolar developmental A dental cyst periodontal apical Radicular cyst dental pulp 286 پنځم فصل د خولي د جوف ناروغى odontogenic apical granuloma radicular cyst ٥-٤ جدول.د ژامي د اپتيليل سيسټونو طبقه بندي . A. INFLAMMATORY Radicular (apical, periodontal, dental) cyst B. DEVELOPMENTAL 1. Odontogenic cysts (i) Dentigerous (follicular) cyst (ii) Eruption cyst (iii) Gingival cyst (iv) Primordial cyst (odontogenic keratocyst) 2. Non-odontogenic and fissural cysts (i) Nasopalatine duct (Incisive canal, Median anterior maxillary) cyst (ii) Nasolabial (nasoalveolar) cyst (iii) Globulomaxillary cyst (iv) Dermoid cyst Developmental cysts B dentigerous Odontogenic cyst mandible enamel randicular canines maxilla molar 287 پنځم فصل د خولي د جوف ناروغى ameloblastoma Radicular fibrous dentigerous radicular dentigerous radicular Eruption cyst stratified squamous dentigerous Gingival cyst Dentigerous (follicular ) fibrous 288 پنځم فصل د خولي د جوف ناروغى Fissural Non-odontogenic B nasopalatine duct Nasopalatine duct cyst maxillary processes Nasolabial cyst ala Dermoid cyst globulomaxillary cyst Odontogenic tumours odontogenic WHO ٥-٥ جدول.دWHO په واسطه د Odontogenic ټيومورونو طبقه بندي . A. BENIGN B. MALIGNANT a) Epithelial origin a) Epithelial origin 1. Ameloblastoma 1. Malignant ameloblastoma 2. Adenomatoid odontogenic tumour (Adenoameloblastoma) 2. Ameloblastic carcinoma 3. Calcifying epithelial odontogenic tumour b) Mesenchymal origin b) Mesenchymal origin Ameloblastic fibrosarcoma 1. Odontogenic myxoma 2. Odontogenic fibroma 3. Cementoma c) Mixed epithelial-mesenchymal origin 1. Ameloblastic fibroma 2. Ameloblastic fibro-odontoma 3. Complex odontomas 289 پنځم فصل د خولي د جوف ناروغى A Ameloblastoma mandible enamel maxilla ramus multilocular Plexiform acnthomatous plexiform Ameloblastoma 290 پنځم فصل د خولي د جوف ناروغى Calcifying epithelial odontogenic Odontogenic Adenomatoid Cementoma Odontomas Odontogenic Myxoma B Odontogenic Carcinoma Ameloblastoma Malignant ameloblastoma i ameloblastic Ameloblastic Carcinoma ii primary intraosseous carcinoma iii odontogenic Odontogenic Sarcomas ameloblastic Ameloblastic fibrosarcoma fibroma 291 پنځم فصل د خولي د جوف ناروغى (submandibular) (sublingual ) paratiod parotid sublingual submandibular molar mucous tubuloalveolar serous paratoid serous acini mixed ptyalism Sialorrhoea Sialorrhoea(ptyalism) Shizophrenia (stomatitis) Sialosis xerostomia Xerostomia Mikulicz’s syndrome Mumps parotitis Sarcoidosis Sjogren’s syndrome antihistamines dehydration Megaloblastic anaemia Anti-depressants antihypertensive 292 پنځم فصل د خولي د جوف ناروغى Sialadenitis sialadenitis parotid mumps pancreatitis Orchitis- oophoritis mumps testis Cytomegalovirus mycotic sialadenitis parotitis acute sialadenitis i – a postoperative parotitis b c dehydration d chronic sialadenitis mumps 293 پنځم فصل د خولي د جوف ناروغى (sialolithiasis) a stricture b hyposalivation anti-depressants antihypertensives antihistamines mycoses actinomycosis TB c autoimmune disease (triat) Sjogren’s syndrome i rheumatoid arthritis (xyrostomia) keratoconjunctivitis sicca Lacrimal Mikulicz’ syndrome ii xerostomia tenderness purulent vacuolation parotid degeneration (fibrosis) fibrous 294 پنځم فصل د خولي د جوف ناروغى parotid 85% acini ٥-٦ جدول.د ناړو د غدواتو د ټيومورونو طبقه بندي . A. BENIGN B. MALIGNANT 1. Adenomas 1. Mucoepidermoid carcinoma (5-10%) i) Pleomorphic adenoma (Mixed tumour) (65-80%) 2. Malignant mixed tumour ii) Monomorphic adenoma i) Carcinoma in pleomorphic adenoma (2%) (a) Warthin’s tumour (Papillary cystadenoma ii) Carcinosarcoma (rare) lymphomatosum, Adenolymphoma) (5-10%) iii) Metastasising mixed salivary tumour (rare) (b) Oxyphil adenoma (Oncocytomas) (< 1%) 3. Adenoid cystic carcinoma (cylindroma) (3-10%) (c) Other types (Myoepithelioma, Basal cell 4. Acinic cell carcinoma (2-3%) adenoma, Clear cell adenoma) (uncommon) 5. Adenocarcinoma (1-3%) 2. Mesenchymal tumours (rare) 6. Epidermoid carcinoma (1-3%) 7. Undifferentiated carcinoma (< 1%) 8. Miscellaneous (rare) A Adenomas Adenoma monomorphic pleomorphic Mixed salivary