
Flow Chart of Dental Caries includes:-
•Etiology
•Diagnosis
•Management
•Prevention
Source:- DCI WEBNEIR on Dental caries-30 Aug 2020.
Flow Chart of Dental Caries includes:-
•Etiology
•Diagnosis
•Management
•Prevention
Source:- DCI WEBNEIR on Dental caries-30 Aug 2020.
Clinical features:-
Oral manifestations:-
Histologic Features:-
1.Very similar to HSC; histiocytic proliferation with or without eosinophils.
2.These histiocytes do not contain significant amounts of cholesterol.
3.‘Foam cells’ not a feature.
Treatment & Prognosis:-
References:-
Shafer’s 8th edition
Clinical features:-
Oral manifestations:-
Radiological features:-
Histological features:-
Treatment & prognosis:-
Reference:
1.Faculty notes
2.Google
Clinical Features:-
References:-
1.Shafers’ 8th edition
2.Google images
3. For better understanding: https://youtu.be/2z3nSnBe8Vg
Clinical Features:-
Niemann-Pick disease type A begins in the individual’s first few months of life. Symptoms include the following:
◦Feeding difficulties
◦Abdominal enlargement within 3-6 months
◦Progressive loss of early motor skills
◦Rapid decline leading to death by the time the patient is aged 2-3 years
◦Abdominal enlargement may be detected in early childhood.
◦Respiratory infections recur.
◦No neurologic involvement is present.
Symptoms may include the following:
◦Unsteadiness of gait, clumsiness, problems in walking
◦Difficulty in posturing of the limbs
◦Slurred, irregular speech
◦Learning difficulties and progressive intellectual decline
◦Sudden loss of muscle tone, which may lead to falls
◦Seizures
Tremors accompanying movement.
Histologic features:-
Niemann – Pick cells are foamy, lipid – laden cells distributed throughout RES.
Positive for cholesterol & only weakly positive for ALP.
Affected cell becomes extremely large, enlarged secondary to distention of lysosomes.
Treatment:-
Enzyme replacement therapy currently being explored.
Current treatment symptomatic; consists mainly of antibiotic therapy for infections of pulmonary involvement.
Organ transplant (liver) also proposed
Overall prognosis poor.
References:-
Shafers’ 8th edition
Common LSD, characterized by deposition of gluco – cerebroside in cells of macrophage – monocyte system.
Results from mutation in gene or deficiency of enzyme that codes for glucosylceramidase.
Leads to accumulation of glucosylceramide in mononuclear phagocytic cells; transformed into “Gaucher cells“.
Five autosomal recessive variants exist resulting from distinct allelic mutations.
Three have been described in the literature.
Pathogenesis:-
These transit through blood as macromolecules; engulfed by phagocytic cells of the body.
Type I – Chronic nonneuronopathic form:-
Characterized by clinical or radiologic bone involvement.
Spleen enlarges massively filling the entire abdomen.
Type II – Infantile/acute neuronopathic form:-
Rapidly progressive neurovisceral involvement.
Symptoms start before 2 years of age, very severe.
Results in death in infancy.
Type III – Juvenile/ Norrbotnian form:-
Patients are juvenile presenting with systemic involvement.
(intermediate between type I and type II).
Progressive CNS involvement usually begins in teens or early twenties.
Histologic Features:-
Treatment & Prognosis:-
Prognosis of Type II is very poor; death within first year.
Less virulent form may persist till 6th decade.
Administration of purified glucocerebrosidase results in dramatic decrease in hepatic accumulations of glucocerebroside.
Enzyme replacement therapy available; effective but extremely expensive.
REFERENCES:-
Shafer’s 8th edition
Features of Mucopolysaccharidosis Syndromes– Hunter syndrome:-
Differs from Hurler’s syndrome in –
Clinical features :-
I- Type A is he severe form, which usually is diagnosed in children aged 18-36 months.
Symptoms in type A may include:
coarse facial features and short stature.
enlarged liver and spleen.
progressive and profound mental retardation.
ivory-colored skin lesions on the upper back and sides of the upper arms and thighs.skeletal changes, joint stiffness, short neck, broad chest, and too-large head.
progressive deafness.
atypical retinitis pigmentosa and visual impairment.
II.Type B Hunter syndrome is much milder than type A
Diagnosis:-
Treatment:-
References:-
1.SHAFERS 8th edition
2.NEVILLE ‘S 3rd edition
Features of Mucopolysaccharidosis Syndrome-HURLER’S SYNDROME(MPS I H, Gargoylism):
Chromosomal abnormality on chromosome arm 4p16.3
Characterized by increased levels of MPS in urine.
Clinical features:-
Histologic features:-
Oral Manifestations:-
Laboratory findings:-
Treatment:-
Corrective surgery may be necessary for patients with mucopolysaccharidosis type I (MPS I) who have joint contractures or foot and hand deformities.
Corneal transplants may be required if vision problems become severe.
Given the numerous mutations at this genetic locus, identification of which allele or alleles are involved requires referral to medical geneticists for diagnosis and genetic counseling.
References :-
1.SHAFERS’s 8th edition
2.NEVIELLE’S 3rd edition
Hematologic Diseases :-
• Hematologic diseases are disorders which
primarily affect the blood.
• Anemia is usually defined as a decrease
in the amount of red blood cells (RBCs) or
hemoglobin in the blood.
• Oral Manifestations:–
– folate and vit. B12 deficiency
– iron deficiency
– glossitis
• red colour
• athrophic papilae
• recurrent aphthae
– candidal infection
– angular stomatitis
– oral pain
• Leukemia is a group of cancers that
usually begins in the bone marrow and
results in high numbers of abnormal white
blood cells.
*Oral Manifestations:-
– gingival hypertrophy
– petechiae
– mucosal ulcers
– hemorrhage
Treatment of leukemia
– reactivation of herpes simplex virus – oral mucosistis.
References:-
1.Google- slideshare.
Careful examination of the oral cavity may
reveal findings indicative of an underlying
systemic condition, and allow for early diagnosis
and treatment. Examination should include
evaluation for mucosal changes, periodontal
inflammation and bleeding, and general
condition of the teeth.
I.GIT Diseases
• Gastrointestinal diseases refer to diseases involving
the gastrointestinal tract, namely the esophagus,
stomach, small intestine, large intestine and rectum,
and the accessory organs of digestions, the liver,
gallbladder, and pancreas.
• Crohn’s disease, also known as Crohn
syndrome and regional enteritis, is a type of
inflammatory bowel disease (IBD).
• Ulcerative colitis is a form of inflammatory
bowel disease (IBD) that causes inflammation
and ulcers in the colon.
• Gastroesophageal reflux is a chronic symptom
of mucosal damage caused by stomach acid
coming up from the stomach into the
esophagus.
• Chronic liver disease in the clinical context is a
disease process of the liver that involves a
process of progressive destruction and
regeneration of the liver parenchyma leading to
fibrosis and cirrhosis.
1. Crohn disease:–
– diffuse labial, gingival or mucosal swelling
– „cobblestoning“ of buccal mucosa and
gingiva
– aphtous ulcers
– mucosal tags
– angular cheilitis
– oral granulomas
2.Ulcerative colitis:-
– oral signs are present in periods of
exacerbation of disease
– aphtous ulceration or superficial
hemorrhagic ulcers
– angular stomatitis
– pyostomatitis vegetans, pyostomatitis
gangrenosum.
3.Gastroesophageal reflux:-
– reduction of the pH of the oral cavity below
5,5
– enamel damage
– damage of the dentin – higher sensitivity (to
temperature..), caries
4. Chronic liver diseases:-
– jaundice
– petechiae or gingival bleeding (hemostasis
disorder)
RREFERENCES:-
1.Google -slideshare
2.Davidson-22nd edition