Developmental disturbances of LIP,PALATE and ORAL MUCOSA
- 1. DEVELOPMENTAL DISTURBANCES OF LIP,PALATE AND ORAL MUCOSA BY:SNEHA SURAPALLI 3RD YEAR BDS ORAL PATHOLOGY PRESENTATION
- 3. Congenital lip and commissural pits and fistula It is malformation of the lips ,often following a hereditary pattern. It may occur alone or in association with other developmental anomalies such as various oral clefts. 75-80% of all cases of congenital labial fistulas ,there is an associated cleft lip or cleft palate.
- 4. ETIOLOGY: Many theories have put up but none has been universally accepted. Notching of the lip. Fixation of the tissue at the base of the notch. C/F:
- 5. TREATMENT: Surgical excision However it is harmless and seldom manifest complications
- 6. VAN DER WOUDE SYNDROME It is an autosomal dominant syndrome typically consisting of cleft lip or cleft palate and distinctive pits of the lower lip ETIOLOGY: The most prominent feature is orofacial anomalies Caused due to abnormal fusion of palate and lip , at days 30-50 postconception
- 7. C/F: Occurences: affects about 1 in 100,000- 200,000. Sex: no sex prediliction Lesion: isolated ,usually medial Site : on the vermilion portion of lower lip
- 8. TREATMENT: Examination and genetic counseling by a pediatric geneticist. Surgical repair of clept lip and palate
- 9. CLEFT LIP AND CLEFT PALATE It is a common congenital malformation. Failure in the fusion of the nasal and maxillary prosses leads to cleft of primary palate ,can be unilateral or bilateral. Incidence of cleft of the lip and palate varies from 1 in 500 to 1 in 2500 depends on geographic origin.
- 10. ETIOLOGY: Heredity. Environmental factors Insufficent nutrition to pregnant women OTHER FACTORS: o Defective vascular supply o Size of the tongue prevent union of affected parts o Infections , certain alcohol ,drugs and toxins o Lack of inherent developmental force
- 11. C/F: Sex : male predilection Lesion: unilateral or bilateral anomaly Types : i. The cleft anterior to the incisive foramen is defined as cleft of primary palate. ii. The cleft posterior to the incisive foramen is defined as a cleft of secondary palate.
- 12. CLINICAL SIGNIFICANCE: Most cases can be surgically repaired with excellent cosmetic and functional results. Eating and drinking are difficult because of regurgitation of food and liquid through the nose. TREATMENT: Surgical treatment
- 17. CHELITIS GLANDULARIS Characterized by progressive enlargement and eversion of the lower labial mucosa that results in obliteration of the mucosal- vermillion interface.
- 18. Etiology : Chronic irritation. Lip enlargement is attributable to inflammation , hyperemia , edema and fibrosis. Surface keratosis , erosion,self-inflicted biting , factitial trauma , excessive wetting from compulsive licking , drying Chronic aggravating factor.
- 19. C/F: Lesion :enlargement of lip and loss of elasticty , asymptomatic lip swelling , burning discomfort, sensation of rawness Sex :male predilection. Age :4th -6th decade. Secretion: Mucopurulent exudates from ductal orifices of labial minor salivary glands.
- 20. Differential diagnosis: Actinic keratosis Atopic dermatitis Cheilitis granulomatosa Sarcoidosis Sqamous cell carcinoma Treatment: Antibiotic therapy.
- 22. CHEILITIS GRANULOMATOUS Cheilitis granulomatosa is a chronic swelling of the lip due to granulomatous inflammation. Etiology: Cause is unknown.
- 23. C/F: Non-tender swelling and enlargement one or more lips and cheeks. Enlarged lip appears cracked. Fissured with reddish brown discoloration and scaling.
- 24. Differential diagnosis: Insect bite Sarcoidosis Serum angiotensin-converting enzyme test Chest radiography Gallium Positron emission tomography
- 25. Histological feature: o Chronic inflammatory cell infiltrate o Shows peri and para vascular aggregations of lymphocytes ,plasma cells and histiocytes. o Formation with epitheloid cells and Langhans type giant cells.
- 26. Treatment : Intra lesional corticosteriods injections. Non steroidal anti-inflammatory agents . Mast cell stabilizers . Clofazimine. Tetracycline Surgery and radiation.
- 28. Hereditory intestinal polyposis syndrome It is an autosomal dominantly inheritant disorder characterized by intestinal hamaratomaous polyps in association with muco-cutaneous melanocytic macules. Etiology: The cause of the Peutz-Jeghers syndrome appears to be a germline mutation of the STK11 gene in most cases, located on band 19p13.3
- 29. Clinical feature: >Sex: M=F >Races: all races >Signs and symptoms: intestinal bleeding, menstrual irregularities, cutaneous pigmentation Histological features: >Extensive smooth muscle arborization throughout the polyp. Treatment: >surgical treatment
- 32. Labial and oral melanotic macule It shows a focal area of melanin deposition C/F: Sex:2:1 female predilection Age :23years Site: vermilion border of lip , buccal mucosa, gingiva and palate Lesion: well demarcated, uniformly tan to dark brown, asymptomatic ,round shaped
- 33. Histological feature: o Normal stratified squamous epithelium with abundant melanin deposits within the keratinicytes of basal and parabasal layers. TREATMENT: No treatment is required
- 35. ORAL MUCOSA
- 36. FORDYCES GRANULES It is a developmental anomaly characterized by heterotropic collections of sebaceous glands at various sites in the oral cavity C/F: Lesion :Small yellow spots. Sex/race: No gender and races predilection. Site: Tongue ,gingiva , frenum and palate
- 37. Histological feature: o Heterotopic collections of sebaceous gland. o The gland are usually superficial and may consist of only a few or a great many lobules o Shows keratin plugging. Treatment: Requires no treatment.
- 39. FOCAL EPITHELIAL HYPERPLASIA It is one of the most contagious of the oral papillary lesion. It is able to produce extreme acantosis or hyperplasia of the prickle cell layer of epithelium.
- 40. C/F: Age :children ,young and middle-aged. Sex : no predilection Site: labial , buccal and lingual mucosa , gingival. Lesion: papillary in nature , smooth surfaced, flat-topped ,pale or rarely white.
- 41. Histological features: o Focal acantosis of oral epithelium o Spinous layer show both cytoplasm and nuclei in cell Treatment: Treatment is unnecessary. Conservative excisional biopsy for proper diagnosis.