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7318795
Chemical Injuries & Physical
Descrição
Mapa Mental sobre Chemical Injuries & Physical, criado por Tabitha Lewis em 04-01-2017.
Mapa Mental por
Tabitha Lewis
, atualizado more than 1 year ago
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Tabitha Lewis
mais de 7 anos atrás
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Chemical Injuries & Physical
Epulis Fissuratum
single or multiple folds of hyperplastic tissue in alveolar vestibule
histopathologic
papillary hyperplasia and or pseudoepitheliomatous hyperplasis
Inflammatory Papillary Hyperplasia
Asymptomatic
pink or red pebbly mucosa
erythema suggests candidal infection
Histopathologic
may show pseudoepitheliomatous hyperplasia
Treatment and Prognosis
mild cases may resolve with removal denture
established cases require reclining refabricating denture foloowing excsion of hyperplastic tissue
antifungal therapy
traumatic ulcers
common oral pathology
traumatic ulcerative granuloma
not true granuloma
slow-healing, penetrating ulcer takes weeks to months to resolve
may be mistaken for malignancy
patients are immunocompetent
often white hyperkarkerotic rim
may help distinguish from aphthous ulcer or SCCA
histopathologic
numerous eosinophils
traumatic ulcerative granuloma with stromal eosinophilia
inflammation of skeletal muscle
granulation tissue
Verruciform xanthoma
can resemble squamous papillomas or early carcinomas
large macrophages with foamy cytoplasm
chemical injury facititial aspirin , mouthwashes mhyrdogen , peroxide
non infectios complications of antineoplastic therapy
complications of radiology
salivary gland hypofunction
treatment
pilocarpine, or cevimeline
topical fluoride
caphosol
mucositis occurs 1-2 weeks folllowing irradiation
desqaymation and ulceration
osteoradionecrosis radiation induced osteonecrosis
MANDIBLE AFFECTED
greater risk > 60 gy 6,500 radds
Complication
dental prosthesis intolerance due to xerostomia
treatment
debridement
antibiotics
hyperbaric oxygen?
prophylactic extrctions
saliva thickens at 1 week
hypofunction with/without xerostomia 1 month following therapeutic irradiation irreversible damge
treatment
increase of cerival cries hypogeeus.. classs 5
complications of chemotherapy
mucositis occurs within days
bone marrow suppression
thrombocytopenia
agranulocytosis
opportunistic infections
herpes simpples
candidiasis
osteonecrosis of the jaws
anti resoprive agents
bisphosphonates
relative potency
nitrogen containing
Pamidronate (Aredia) 100-1000 500-1000 100-1000 100-2000 Alendronate (Fosamax) Ibandronate (Boniva) Risedronate (Actonel) Zoledronic acid (Zometa) 1000-10000
indications
osteoporosis multiple myeloma
metastic carcinomas to bone
multiple myeloma
denosumab
prolia xgeva
AAOMS staging
Stage 0: non-exposed Stage 1: exposed asymptomatic Stage 2: exposed symptomatic Stage 3: extensive disease
MRONJ
Mandible affected more than maxilla, but discrepancy not as great as in osteoradionecrosis
Treatment
asymptomatic patients
chlorhexidine rinse
soft splint
smooth rough edges of exposed bone
symptomatic patients
systemic antibioti therapy and chlorehexidine
hyperabaric oxygen has not been beneficial
MRONJ definition
current or previous treatment with anti-resorptive OR anti angiogenic agents
exposed bone OR bone that can be probed through sinus tract persisting > 8 weeks
no h/o radiation or obvious metastis to jaws
lingual mandibular sequestration
Most often on lingual surface of the posterior mandible along the mylohyoid ridge
exfoliative cheiltitis
persistent scaling vermillion
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