gingival lesions differential diagnosis
Definitive Diagnosis 11. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. Gingival enlargements are a common clinical finding and most represent a reactive hyperplasia as a direct result of plaque related inflammatory gingival disease. However, the ability to formulate a . The differential diagnosis of lesions or abnormalities of the oral cavity will help non-dental healthcare providers (HCPs) to refer at-risk patients to the appropriate provider so they can be re-examined more closely. Systemic disease or periodontal disease? Distinguishing ... It is considered that inflammation from local trauma can be exacerbated by poor plaque control and cause these lesions. Phenytoin-related gingival hyperplasia. Lesions of both HFM disease and herpangina may resemble primary herpetic gingivostomatitis. Surgical biopsy-‐ consideration 12. These generally respond to conservative tissue management and attention to plaque control. Cases 1 and 2 . 54 (2):313-324. racial pigmentation) to manifestations of systemic illnesses (e.g. Focal fibrous overgrowths: A case series and review of ... Emphasis is placed on the importance of obtaining a thorough . Peripheral odontogenic tumours (POT) are rare benign focal overgrowths of the oral soft tissue, usually occurring in the gingiva. Failure to carry out differential diagnosis of severe periodontal lesions has resulted in the instigation of periodontal therapy for many lesions of non-gingival origin. JORDI | Journal of Oral Diagnosis (PDF) Gingival enlargements: Differential diagnosis and ... Considerations in more generalised lesions include hereditary gingival fibromatosis, which may occur as an isolated lesion or as part of a syndrome. The diagnosis of these lesions is essential for their successful management and of the patient as a whole. Gingival Swellings Differential diagnosis Amer Ali College of dentistry, university of Kufa Powerpoint Templates Page 1 Infections • Gingival abscess • Periodontal abscess • Pericoronal abscess • Acute osteomyelitis • Acute herpetic gingivostomatitis Powerpoint Templates Page 2 Infection Gingival abscess Powerpoint Templates Page 3 infection Periodontal abscess Powerpoint Templates . Gingival pigmentation is a discoloration of the gingiva due to a variety of lesions and conditions associated with several endogenous and exogenous etiologic features . 6Benign Lesions of the Oral Cavity and the Jaws A. Ross Kerr, DDS, MSD Denise A. Trochesset, DDS VARIANTS OF NORMAL Tori/Exostoses Unencapsulated Lymphoid Aggregates Fordyce Spots BENIGN SOFT TISSU… Sridharan G. Epidemiology, control and prevention of tobacco induced oral mucosal lesions in India. 2014 Jan-Mar. The diagnosis of peripheral giant cell granuloma, a benign reactive gingival lesion, is confirmed by histopathologic examination. The differential diagnosis . Red lesions are a large, heterogeneous group of disorders of the oral mucosa. Failure to carry out differential diagnosis of severe periodontal lesions has resulted in the instigation of periodontal therapy for many lesions of non-gingival origin. The differential diagnosis of these lesions should be considered for accurate diagnosis Dr. Buket Acar, and . Diagnosis cannot be made on a clinical basis, when DG is the only clinical feature: histopathologic and immunopathologic studies are required. Apr 2010. While histopathologic assessment is often required for diagnosis, diascopy (as described above) can also be helpful in discriminating vascular processes from non . attached gingival, hard palate and dorsal tongue are seldom affected. Differential Diagnosis - "The 3 P's" . Differential Diagnosis Many of the lesions discussed in this chapter should be considered in the differential diagnosis: erythema from mechanical trauma, purpuric macule, cellulitis (nonpyogenic . TREATMENT AND PROGNOSIS Whenever severe localized lesions of the periodontium are detected, the differential diagnosis between pulpal and periodontal origins should be made. References. Stages for Evaluation of Oral Lesions 8. Differential Diagnoses. NPDs have three typical features: pain, bleeding, and ulceration of the gingival interdental papilla . 2014 National Primary Oral . The recommended treatment … Herpes simplex virus is the most common cause of genital ulcers in the . As . Annals of Dentistry, 01 Sep 1951, 10(3): 99-102 PMID: 14868993 . A biopsy is mandatory in gingival erythematous lesions with no obvious striae or papules to achieve a correct diagnosis [4,17]. Differential Diagnosis of Oral Masses Gingival Lesions. Herpes simplex virus is the most common cause of genital ulcers in the . However, typical and distinctive oral and/or skin lesions, sometimes with a characteristic location, can be observed and represent a valuable aid in guiding the differential diagnosis. Whenever severe localized lesions of the periodontium are detected, the differential diagnosis between pulpal and periodontal origins should be made. • Differential diagnosis: 1) Vascular neoplasm (e.g. Differential diagnoses include metastatic tumours in the oral cavity, angiosarcomas, gingival non-Hodgkin's lymphoma, Kaposi's sarcoma and haemangioma. 5th ed. VOGEL HB. Certain common oral lesions appear as masses, prompting concern about oral carcinoma. Differential Diagnoses of Oral Lesions. It may range from physiologic reasons (e.g. The differential diagnosis of the palatal mass includes the palatal abscess, benign and malignant salivary gland neoplasms, the benign neural tumors, and the traumatic or irritation fibroma. These pigmented lesions should be biopsied and carefully analyzed under the microscope to rule out a diagnosis of a malignant lesion such as melanoma. gingival inflammation.10 Other oral mucosal sites may also Differential diagnosis: The clinical features may be diagnostic of the typical reticular form of OLP. 3 Radiographic, . Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. 14 years. . There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. The differential diagnosis in such lesions should include PG, POF, metastatic cancer, fibroma, hyperplastic gingival inflammation, hemangioma and angiosarcoma. Treatment is excision. The differential diagnosis for purpura is broad, but it can be quickly narrowed by classifying the lesions based on their morphology, as well as other clinical and laboratory findings. . Tumours included peripheral odontogenic fibroma (2 patients), peripheral calcifying odontogenic cyst (2 patients), peripheral . The clinical differential diagnosis most often includes other reactive lesions of the gingiva including pyogenic granuloma and peripheral giant cell granuloma. Recognition of Oral Lesions 9. Differential Diagnosis 10. This case report highlights the important role of dentists to include oral melanoacanthoma in the differential diagnosis of diffuse gingival pigmented lesions. 1. Elapsed time between recurrences is extremely variable; some unfor-tunate patients have almost continuous disease whereas others go from months to years between episodes. Soft tissue lesions of the oral cavity in children may be normal/developmental findings or indicative of gingivitis, periodontal disease, local or systemic infection, benign tumors, or life-threatening systemic conditions ().The clinical features and management of common soft tissue lesions of the oral cavity in children will be reviewed here. However, lesions on the palms and soles are typical for HFM disease, and ulcers located only in the posterior oral cavity are typical for herpangina. Gingival lesions of pemphigus. The first part of this compendium covers immune-mediated and hereditary conditions as causes of gingival lesions, which can resemble those caused by dental plaque. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Differential Diagnosis. St Louis: Mosby-Year Book, Inc;1997. hemangioma, KS) ** Hemangiomas and PGs are likely related entities 2) Peripheral giant cell granuloma 3) Peripheral ossifying fibroma 4) Fibroma 5) Metastatic lesion Metastatic lesion Pyogenic granuloma • Histology: - vascular proliferation (granulation tissue) - mixed inflammatory infiltrate lesion with opacities. Gingival/Alveolar Ridge Masses • Parulis • Periodontal Abscess • Tori and Exostoses • Reactive Proliferations • Peripheral Odontogenic Cysts . White Lesions Rubbed away 1-‐ Infective Etiology: i. These characteristic components may be obvious in conjunction with plaque-like, erythematous, bullous, or ulcerative lesions. Signs and clinical symptoms of Final diagnosis often takes more than 5 months from the onset of disease. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized gingival enlargement. Sattari M, Haghighi AK, Tamijani HD. Core tip: In clinical dentistry, patients frequently report with isolated/regional or generalized gingival enlargements, which could fall under varied presentations. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional . Share this article Share with email Share . The lesions have many characteristics in common and may appear clinically indistinguishable. Oral lesions appear several months predating skin lesions [3, 27]. Gingival bleeding is rare. Multiple white lesions that do not rub off should be noted in patient records, including the location of the lesions. Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. 2 SCC of the oral cavity can mimic a variety of benign conditions occurring at multiple sites. Trope M. Treatment of the immature tooth with a non-vital pulp and apical periodontitis. Metastatic lesions in the oral cavity may be the first indication of an undiscovered malignancy at a distant site 32 . Gingival enlargement present predominantly in the interdental papillae. Addison's disease) to malignant neoplasms (e.g. Many are benign, although some (e.g., leukoplakia) may represent neoplasia or cancer. Case #2 •A 14 year old female presented with this lesion of the gingiva . [Medline]. In cases of PV, the form of the erosive gingival lesions differential diagnosis must be made with other entities, especially lichen planus and cicatricial pemphigoid, as well as lupus . Palatal and mandibular . Traumatic lesions, infections, developmental anomalies, allergic reactions, immunologically mediated diseases, premalignant lesions, malignant neoplasms, and systemic diseases are included in this group. The differential diagnosis includes pyogen-ic granuloma, peripheral giant cell granuloma, fi broma, peripheral odontogenic fi broma, fi - brosarcoma, and squamous cell carcinoma.1,3,5 A slowly growing mass on the interdental pa- . However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. 51(1):80-5. . Treatment 13. This article revises the existing knowledge of different types of enlargements and highlights some important diagnostic . Differential Diagnosis partially calcified odontoma, adenomatoid odontogenic tumor, ossifying fibroma; ameloblastic fibro-odontoma, calcifying epithelial odontogenic tumor. The lesion does not respond to plaque control measures or root planing and scaling. Pyogenic Granuloma (Lobular Capillary Hemangioma) Workup. Step 2. vi. Differential diagnosis should include mainly squamous papilloma, verruca vulgaris, spongiotic gingival hyperplasia, verrucous hyperplasia and early verrucous carcinoma and papillary squamous cell carcinoma 2-4,7,8. Whenever severe localized lesions of the periodontium are detected, the differential diagnosis between pulpal and periodontal origins should be made. Shklar G, Frim S, Flynn E. J Periodontol, 49(8):428-435, 01 Aug 1978 . D esquamative gingivitis is a clinical term used to describe an erythematous, erosive and ulcerated appearance of the gingiva. There are many oral lichen planus-like or "lichenoid" lesions which can confuse the diagnosis of OLP. REFERENCES. The etiology of these lesions is multifactorial, but the most prevalent cause is reactive hyperplasia and inflammation induced by dental plaque. Gingival enlargement is one of the frequent features of gingival diseases. Such lesions are easily distinguishable and categorized into diagnoses such as pyogenic granuloma, peripheral ossifying fibroma, etc. Gingival growths, barring a few are mostly reactive and seldom exhibit significant true neoplastic potential. In these cases, Nikolsky's sign test can be used to differentially diagnose benign mucous membrane pemphigoid. Classification of jaw cysts ODONTOGENIC CYSTS (arise from odontogenic . • Gingival lesions respond to oral hygiene measures frequent prophys • Sulca brush daily . Differential diagnosis of Jaw lesions GROUP 22 Differential diagnosis of Jaw lesions GROUP 22. Conclusions: In our study, neoplastic lesions were detected in 12.2% of patients and the risk of malignancy was determined as 5.5% in lesions presented by epulis. The goal of differential diagnosis is to determine the nature of the enlargement as a basis for formulating a rational treatment approach. The patient had a . REVIEW OF ORAL LESIONS ETIOLOGY, DIFFERENTIAL DIAGNOSIS AND TREATMENT AUGUST 20,2014 Disney's Coronado Springs Resort Lake Buena Vista, FL. along the margin of the gingiva and a punctate or diffuse erythema of the attached gingival. A clinical term defined as a predominantly white lesion of the oral mucosa that cannot be characterized clinically and pathologically as any other disease; a diagnosis of exclusion. The symptoms, growth rate, palpation characteristics, surface morphology, and lesion site allow for categorization of the soft tissue lesions into one of the five lesion groups as outlined in Case #1 . Early diagnosis of non plaque-related causes of gingival lesions can be vital for affected patients. Discuss diagnosis, testing, and treatment of desquamative gingival lesions. Dent Clin N Am.
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