Disease of Mouth & Salivary Glands PDF

Disease of mouth & salivary glands  Disease of mouth & salivary glands Disease of mouth & salivary glands Mouth lesions Stomatitis Definition: ▪ Inflammation of the mucosa of the oral cavity. Typ...

Disease of mouth & salivary glands  Disease of mouth & salivary glands Disease of mouth & salivary glands Mouth lesions Stomatitis Definition: ▪ Inflammation of the mucosa of the oral cavity. Types: 1) Catarrhal stomatitis. 2) Aphthous stomatitis. 3) Herpes virus Infection (Herpetic stomatitis). 4) Oral candidiasis (thrush). Catarrhal stomatitis 1) Hot and spicy food. 2) Excessive smoking. Causes 3) Lack of oral hygiene. 4) In the course of infectious fevers. N/E ▪ The mucosa is congested and may show vesicles or superficial ulcers. Aphthous stomatitis ▪ Rounded, superficial erosions, often covered with a gray-white exudate N/E and having an erythematous rim, painful, shallow. Behavior ▪ Tend to resolve spontaneously but may recur. 1) Stress or Fever. 2) Ingestion of certain foods. Triggers 3) Activation of inflammatory bowel disease. 1 Dr. Sh. H Disease of mouth & salivary glands Herpes virus Infection (Herpetic stomatitis) Cause ▪ Caused by herpes simplex virus (HSV). ▪ Primary infection is asymptomatic, but the virus persists in a dormant state within ganglia about the mouth (e.g., trigeminal ganglia). ▪ Reactivation of the virus caused by: Behavior 1) Fever. & Attacks 2) Cold exposure. 3) Respiratory tract infection. 4) Trauma. ▪ Solitary or multiple vesicles 50%). Salivary Gland Diseases Inflammation of The Salivary Glands (sialadenitis) Acute suppurative parotitis Predisposing 1) Lack of oral hygiene. factors 2) Diminished flow of saliva as in fevers. Cause ▪ Staphylococcal & streptococcal infection. Morphology ▪ The gland is hyperemic, swollen, and may show pus formation. 1) Retropharyngeal abscess. Complication 2) Pyemia. Mumps (epidemic parotitis) ▪ Systemic viral droplet infection in children mainly Definition affecting the parotid glands. Morphology ▪ Non-suppurative inflammation of parotid glands. ▪ They are rare including: 1) Orchitis especially in adults. Complication 2) Fibrosis may cause sterility. 3) Oophoritis, pancreatitis, mastitis and meningoencephalitis. 4 Dr. Sh. H  Disease of mouth & salivary glands Chronic sialadenitis ▪ Arises from ↓ production of saliva with subsequent inflammation. Cause ▪ The dominant cause is autoimmune sialadenitis, which is almost bilateral. ▪ This is seen in Sjögren syndrome. Sjögren syndrome: ▪ All of the salivary glands (major and minor), as well as the lacrimal Pathology glands, are affected in this disorder. Clinical ▪ Dry mouth (xerostomia). Picture ▪ Dry eyes (keratoconjunctivitis sicca). ▪ Intense lymphocytic and plasma cell infiltration with ductal epithelial hyperplasia. M/E ▪ Several lines of evidence suggest that it is an autoimmune disease caused by CD4+ T cell reactions against unknown antigens in the ductal epithelial cells of the exocrine glands. Pathogenesis 5 Dr. Sh. H Disease of mouth & salivary glands Salivary glands tumors Salivary Gland Tumors General Aspects ▪ About 80% of tumors occur within the parotid glands and most of the Incidence others in the submandibular glands. Sex ▪ Males and females are equally affected. ▪ In the parotids 70% to 80% of these tumors are benign. Type ▪ Generally, malignancy is less common in the parotid gland (15%) than in the submandibular glands (40%). Pleomorphic Adenoma (Mixed Tumor of Salivary Glands) Incidence ▪ Accounts for more than 90% of benign tumors of the salivary glands. N/E ▪ Slow-growing, well-demarcated, apparently encapsulated lesion. ▪ A heterogenous structure of: ✓ Epithelial elements form ducts, acini, tubules and sheets of cells. M/E ✓ Mesenchymal elements, myxoid tissue, chondroid matrix and rarely bone. Clinical ▪ Arising in the superficial parotid, it usually causes painless swelling at the Picture angle of the jaw. 6 Dr. Sh. H Disease of mouth & salivary glands ▪ Malignant transformation may occur, referred to then as a malignant mixed salivary gland tumor. Behavior ▪ Recurrence after surgical removal may occur because there are tiny tumor tissue extending beyond the capsule. TTT ▪ Adequate margins of resection are necessary to prevent recurrences. 7 Dr. Sh. H