口腔黏膜课件优秀课件.ppt

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1、口腔黏膜课件第1页，本讲稿共59页IntroductionBehets diseaseTraumatic Ulcer&Traumatic BullaRecurrent Aphthous UlcerSummary&QuestionsBACKReiters Syndrome 第2页，本讲稿共59页I.Introduction1.Ulcers are one of the most common types of lesions seen in oral mucosa.2.The difference between ulcer and erosion.NEXT第3页，本讲稿共59页ulcerero

2、sionNEXT第4页，本讲稿共59页ulcererosioncontinuity of epitheliumbroken severesuperficial basal cellsinvolvedfreeborderclearuncleardiseasesRAUBehcets diseaseSyphilis PemphigusHerpes simplex BACKComparison第5页，本讲稿共59页II.Recurrent Aphthous Ulcer1.Preface Name recurrent aphthous ulcer RAU recurrent aphthous stoma

3、titis RAS recurrent oral ulcer ROUNEXT第6页，本讲稿共59页 Typing Lehners classification minor aphthous ulcer（MiAU）major aphthous ulcer（MjAU）herpetiform ulcer（HU）Characteristic recidivity self-healing periodicityNEXT第7页，本讲稿共59页2.Etiology unknown immunity:cellular immunity,humoral immunity,complement,autoanti

4、body heritage infection：HSV environment:psychologyNEXT第8页，本讲稿共59页 denutrition：iron,copper,zinc,folic acid,Vit B12 hyperoxide dismutase microcirculation disturbance：lip,nail,apex linguae systemic factor：ulceration of stomach、hepatitis、colonitis、diarrhoeaNEXT第9页，本讲稿共59页3.Clinical features minor aphtho

5、us ulcer major aphthous ulcer herpetiform ulcerNEXT第10页，本讲稿共59页NEXTMiAUMjAUHUfeatureyellow red concave painful small(2-4mm)big(1-3cm)deep scarmultiple smallcourse7-10 days3-6 weeks7-10 daysnumber 1-51 10positionnonkeratinized oral mucosa soft palatetongue lip mouth floorsystemic symptomlymph nodes s

6、welling fever headache lymph nodes swelling 第11页，本讲稿共59页Minor aphthous ulcersNEXT第12页，本讲稿共59页NEXT第13页，本讲稿共59页NEXTMiAUMjAUHUfeatureyellow red concave painful small(2-4mm)big(1-3cm)deep scarmultiple smallcourse7-10 days3-6 weeks7-10 daysnumber 1-51 10positionnonkeratinized oral mucosa soft palatetongu

7、e lip mouth floorsystemic symptomlymph nodes swelling fever headache lymph nodes swelling 第14页，本讲稿共59页Major aphthous ulcers NEXT Periadenitis Mucosa Necrotica Recurrens 第15页，本讲稿共59页NEXTMajor aphthous ulcers 第16页，本讲稿共59页NEXTMiAUMjAUHUfeatureyellow red concave painful small(2-4mm)big(1-3cm)deep scarmu

8、ltiple smallcourse7-10 days3-6 weeks7-10 daysnumber 1-51 10positionnonkeratinized oral mucosa soft palatetongue lip mouth floorsystemic symptomlymph nodes swelling fever headache lymph nodes swelling 第17页，本讲稿共59页Herpetiform ulcers NEXT第18页，本讲稿共59页disease-process24h10d-14doutbreakNEXTintermissionheal

9、ingprodromal stageulcerative stage第19页，本讲稿共59页5.Diagnosis history clinical featureNEXT4.Pathology：nonspecific inflammation第20页，本讲稿共59页6.Differential diagnosisbenign ulcer&malignant ulcerNecrotizing sialadenometaplasia,Behets disease,herpes simplex,hand-foot-and-mouth disease NEXT第21页，本讲稿共59页benign u

10、lcermalignant ulcerageyouththe ageddepthdeepDeep or shallowself-healingyesnosystemic conditiongoodcachexypathologychronic inflammationcancerrecurrenceyesnoComparison NEXT第22页，本讲稿共59页7.Treatmentprinciple：symptomatic treatmentEvaluation of curative effectNEXT第23页，本讲稿共59页Topical application of a steroi

11、d ointment reduces discomfort and decreases the duration of the lesions.Topical anesthetics,antibiotics,mouthwashes,etc.,have been used.In severe cases,intralesional steroid injection or systemic steroids in a low dose(10-20 mg prednisone)for 5-10 days reduce the pain dramatically.BACK第24页，本讲稿共59页II

12、I.Behets disease1.Preface Hulusi Behet (1937)Behets disease is a chronic multisystemic inflammatory disorder of uncertain cause and prognosis.2.Etiology Unknown NEXT第25页，本讲稿共59页3.Clinical features 1)oral mucosa:minor aphthous ulcer 2)genital lesion:ulcer 3)skin lesions:erythema nodosum,epifolliculit

13、is,pustule after needling 4)ocular lesions:conjunctivitis,recurrent iritis 5)others systems:joint,digestive,cardiovascular,nervous,respiratory,urinaryNEXT第26页，本讲稿共59页Behets diseaseNEXT第27页，本讲稿共59页4.Pathology：Histopathologic changes consist of a perivascular mononuclear cellular infiltrate,endothelia

14、l cell swelling or necrosis,partial luminal obliteration and occasional fibrinoid necrosis of the vessels.NEXT第28页，本讲稿共59页5.Diagnosis 1)recurrent oral ulceration 2)recurrent genital ulceration 3)eye lesions 4)skin lesions 5)positive pathergy test To establish the diagnosis of Behets Disease,recurren

15、t oral ulceration plus any two of the other four major clinical criteria must be present.NEXT第29页，本讲稿共59页6.Differential diagnosisNEXTRAU Herpetic atomatitis Crohns diseaseReiters syndromeStevens-Johnson syndrome第30页，本讲稿共59页7.Treatment Symptomatic in mild cases.Systemic steroids,immunosuppressive dru

16、gs,colchicines,thalidomide,and dapsone are administered in severe cases.BACK第31页，本讲稿共59页IV.Traumatic Ulcer Traumatic Bulla1.Preface Because of the constant motion of the masticatory mucosa over the teeth and the introduction of hard objects into the oral cavity,traumatic ulcers are frequent.NEXT第32页

17、，本讲稿共59页2.Etiology Mechanical factors:a sharp or broken tooth,rough fillings,clumsy use of cutting dental instruments,hard foodstuffs,sharp foreign bodies,biting of the mucosa,and denture irritation etc.Physical factors:thermal burnsChemical factors:strong acid,strong base,As2O3,Ag(NO)3,iodophenolNE

18、XT第33页，本讲稿共59页3.Clinical feature1)Decubital ulcer mechanical irritating factors the ulcer conforms in area and linearity to the source of the irritating factorsNEXT第34页，本讲稿共59页NEXTtraumatic ulcer第35页，本讲稿共59页traumatic ulcerNEXT第36页，本讲稿共59页 infants,hard palate improper feedingNEXT2)Bednar ulcer第37页，本讲

19、稿共59页3)Rida-Fede ulcer infants lingual frenum ulcer secondary to inferior deciduous incisorNEXT第38页，本讲稿共59页4)Factitious ulcer mentally handicapped patients or those with serous emotional problems oral self-inflicted trauma by biting,fingernails,or by the use of a sharp object tongue,lower lip,gingiv

20、a slow to heal due to perpetuation of the injury by the patient local measures and psychiatric therapy NEXT第39页，本讲稿共59页5)Chemical burn the type of chemical utilized,its concentration,and the duration whitish surfacedesquamatingpainful erosion or ulcerbone damage healing within 1-2 weeksNEXT第40页，本讲稿共

21、59页NEXTchemical burn第41页，本讲稿共59页6)Thermal burn very hot foods,liquid,or hot metal objects palate,lips,floor of the mouth,tongue painful,red,undergoing desquamation,leaving erosions supportive treatment;self-healing in about a weekNEXT第42页，本讲稿共59页NEXTthermal burn第43页，本讲稿共59页7)Traumatic bulla&traumati

22、c hematoma caused by biting or prosthetic appliances buccal mucosa,soft palate,lips,tongue self-healing in 4-6 days NEXT第44页，本讲稿共59页traumatic bullaNEXT第45页，本讲稿共59页4.Diagnosis historyclinical featuresNEXTcarcinoma,syphilis,tubercular ulcer,major aphthous ulcerthrombocytopenia,thrombastheniapemphigus,

23、cicatricial pemphigoid 5.Differential diagnosis 第46页，本讲稿共59页malignant ulcerNEXT第47页，本讲稿共59页Traumatic ulcerMjAUmalignant ulcertubercular ulceretiologyfeature of ulcermorphology of ulcerpathology5.Differential diagnosisBACK第48页，本讲稿共59页6.Treatment Removal of the traumatic factorsTopical measures NEXT第4

24、9页，本讲稿共59页V.Reiters Syndrome1.PrefaceReiters syndrome is a disease of unknown cause that predominantly affects young men,20-30 years of age.NEXT2.Etiologyunknown第50页，本讲稿共59页3.Clinical feature Major symptoms:nongonococcal urethritis,conjunctivitis,arthritis Other symptoms:oral ulcer,circinate balanit

25、is,keratoderma blennorrhagicumNEXT第51页，本讲稿共59页NEXToral lesion第52页，本讲稿共59页4.Diagnosis history clinical criteriaNEXT第53页，本讲稿共59页5.Differential diagnosis The differential diagnosis the oral lesions includes erythema multiforme,Stevens-Johnson syndrome,psoriasis,Behets Disease,geographic tongue,and stom

26、atitis.NEXT第54页，本讲稿共59页6.Treatment It is nonspecific and symptomatic.Non-steroidal anti-inflammatory drugs,salicylates,and tetracyclines may be helpful,cyclosporin,azathioprine,methotrexate,and systemic steroid in severe case.BACK第55页，本讲稿共59页Summary 1.To compare the characteristics of major Aphthous

27、 ulcer,traumatic ulcer,carcinoma and tuberculous ulcer.(etiology,pathology,clinical feature,treatment,prognosis).2.To master the treatment principle of ulcerative diseases by taking RAU for example.NEXT第56页，本讲稿共59页3.To master the effect,usage,contraindication and side-effect of corticosteroid in tre

28、ating ulcerative diseases.4.To establish the conception of oral mucosal syndrome by means of learning Behets disease.NEXT第57页，本讲稿共59页Questions1.Which is the most common form of Recurrent Aphthous Ulcer?Whats the characteristic of its lesion?2.Whats the effect of corticosteroid in treating oral ulcer

29、ative diseases?3.Whats the primary treatment to traumatic ulcer?NEXT第58页，本讲稿共59页4.Taking major Aphthous ulcer and carcinoma for example,try to tell the difference between benign ulcer and malignant ulcer.5.What are the oral lesions of Behets Disease and Reiters Syndrome?What are their clinical systemic features?BACK第59页，本讲稿共59页