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Rough or papillary lesions - Coggle Diagram
Rough or papillary lesions
Oral squamous papilloma
Etiology: HPV
Method of transmission: HPV is transmitted by direct contact between the virus and non-intact mucosa. The virus can also be spread by auto inoculation
Characteristics: the cauliflower like appearance suggests infection with HPV exophytic well circumscribed pedunculated and have finger or hair like projections
Dental implications: these lesions should be removed because of the association of some forms of HPV with oral malignancies and because the patient may be able to transmit the causal or viral agent
Treatment and prognosis: conservative surgical excision, cryotherapy, or electro desiccation usually suffices to treat this lesion
Condyloma
Etiology: 30 different types of HPV can infect the Anogenital tract
Method of transmission: HPV is transmitted by direct contact between the virus and mucous membranes
Characteristics: occur in those sites that are frequently traumatized during fellatio. Coalesce and become nodular, pink, exophytic growth
Dental implications: diagnosis and treatment of this condition will help prevent transmission of the virus this infection is more common in immuno suppressed patients and the clinician should carefully evaluate the patient’s assessment data for other indications that would suggest the need for a medical referral
Treatment and prognosis: removed surgically with a scalpel HPV 16 and these cancers correlates with a better overall survival rate
Multifactorial epithelial hyperplasia
Etiology: HPV 13 and 32
Method of transmission transmitted in a manner similar to that of other HPVs by surface contact with the virus through a break in the mucosal barrierCharacteristics: these lesions are more generalized within the oral cavity then other forms of HPV. These lesions display a pink to white some white translucent, surface that is only slightly cauliflower like
Characteristics: these lesions are more generalized within the oral cavity then other forms of HPV. These lesions display a pink to white some white translucent, surface that is only slightly cauliflower like
Dental implications: none
Treatment and prognosis: treatment is not always necessary. Conservative excision may be performed to establish a diagnosis these lesions will resolve spontaneously without any treatment malignant formation is unlikely
Papillary hyperplasia
Etiology: A reactive tissue proliferation due to mild, persistent trauma caused almost exclusively by the robbing of an ill fitting denture
Method of transmission: not applicable
Characteristics: this condition is almost always related to the presence of dentures or oral applications
Dental implications: treated with soft denture reline material prior to surgical removal of the lesion and fabrication of a new denture. They should also be educated on the proper use and care of their dentures including the fact that dentures may be removed from the mouth for a period of time every day
Treatment and prognosis: the lesions should not be surgically excised without the fabrication of a new denture since mechanical trauma related to functioning of an ill fitting denture will simply result in reoccurrence the prognosis is excellent
Keratoacanthoma
Etiology: unknown. Exposure of the affected area to sunlight is strongly associated with the development of the lesion
Method of transmission not applicable
Characteristics: the clinical appearance and location of the KA may help to differentiate it from other lesions. Typically arrives on the sun exposed skin of the face neck and upper extremities these are dome shaped nodules that display a smooth shiny service with a crater in the center
Dental implications: observation of a lesion with this general appearance during an extra oral examination should prompt a medical referral by the dental health care provider patients who developed KA are at a higher risk for developing a subsequent non-melanoma skin cancer‘s
Treatment and prognosis: surgical excision is a treatment of choice the prognosis is excellent with complete surgical removal
Verrucous carcinoma
Etiology: related to spit tobacco
Method of transmission: not thought to be contagious, although a variety of HPV types have been localized within them
Characteristics: the general appearance of this carcinoma coupled with a history of spit tobacco use suggests this lesion; however a biopsy must be performed for a definitive diagnosis
Dental implications: the dental hygienist is in a excellent position to educate patients about the effects of spit tobacco use and counseled them about tobacco cessation
Treatment and prognosis: surgical removal is the treatment of choice most patients have a good prognosis as metastasis is rare
Oropharyngeal cancer and tonsillar cancer
Etiology: some studies say that individuals engaging in oral sex and deep kissing are linked to this type of cancer.
Method of transmission not applicable
Characteristics obvious inflammatory tissue with a papillary appearance may be present. There is often cervical node involvement and mandibular lymph node involvement. A lesion in the throat or oral tissues that bleeds easily does not heal or a persistent patch, white or red, a lump or thickening, or a neck mass should cause alarm. Difficulty in moving the tongue and chewing difficulty are indications as well
Dental implications: tooth pain, ear pain, and difficulty in eating or swallowing may be reported. Careful palpation of cervical and mandibular lymph nodes is crucial
Treatment and prognosis: the prognosis of a patient who develops oral cancer that is HPV positive has a better prognosis than those who do not
RESOURCES
General and oral pathology for the dental hygienist by Leslie Delong and Nancy Burkhart Pg 378-389