lesiputihppdgs08
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Transcript of lesiputihppdgs08
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Program Pendidikan S pesialis Dokter Gigi
Departemen Ilmu Penyakit Mulut FKGUI
Yuniardini S Wimardhani200
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LES I PUTIH !"#"DI$%#Y W!I$" &"S I'(
#"%)$I*"+I(F&%MM%$'#Y W!I$"&"SI'(
De,elopmental -hite les ion Gingi,al and palatal .yst o/ ne-orn and
adult Mis.ellaneous lesions
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HE R ED ITAR Y WHITE
LES ION
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Un.lear etiology (ormal ,ariation
Features1 ilateral3 u..al
mu.osa Faint3 -hite3 di//use3
/ilmy appearan.e3/olded-rinkling
mu.osa 4s.rapped o//3
/ade+disappear onstre.thing
%symptomati.3 no
malignant .hange
Mi.ros.opi.ally1 $hi.kening epith
parakeratosis "dema intra.ellular at
stratum spinosum
$reatment1 (o treatment
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#are autosomal disorder 5a//e.t non6.orni/ied epith Identi/ied at irth3 5 intense
at puerty #elated -ith K7 and K89
gene disturan.es
Features White lesion3 ele,ated3
irregular /issures pla:ue u..al mu.osa Dysphagia i/ esophagus
in,ol,ed DD+ -ith leukoplakia3
pla:ue type .andidias is
Mi.ros.opi.ally1 ',ious intra.elullar
edema o/ 55stratumspinosum
Pyknoti. nu.lei (o+mild in/iltration o/
in/lammation .ells
Management1(o treatment enign .ondt;n %ntiioti. in se,eral
studiesno .ons istentresults
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< Witkop;s disease #are autosomal
dominant disorderFeatures1 $hi.k3 .orrugated3
asymptomati. -hitespongy pla:ue o/u..al=laial mu.osa
Dete.ted at 8styear o/
li/e3 55intense untilteens
ular .on>u.ti,alesion
'..ular irritation3
photophoia3 lindness
Mi.ros.opi.ally1 Parakeratinised S tratum spinosum
thi.kening -ith
dyskeratoti. /eatures
Management1'ral les ion1 no treatment'..ular lesion
opthalmologist
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#are ?6linked Genodermatosis 'ral .hanges erythro+leukoplakia
Dysthropi. nails3 hyperpigmentation o/skin @/a.e3 ne.k3 .hestA
!aematologi. .hanges )ar.inoma in early adulthood
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R EA C TIVE /IN FLAM M ATORY
WHITE LES ION
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&inea ala3 /ri.tional keratosis3 .heek
.he-ing3 .hemi.al in>uries o/ oral mu.osa3
a.tini. keratos is3 smokeless toa..oindu.ed keratosis3 ni.otine stomatitis3
sanguinaria indu.ed leukoplakia
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a -hite horiBontal
streak on the u..al3
o..lusal plane asso.iated -ith
pressure3 /ri.tional
irritation3 su.king
trauma 5 in C o,er>et
Management1 (o treatment May disappear
spontaneously
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a -hite pla:ue3 rough
sur/a.e3related to
me.hani.al irritation
usually resol,e onelimination o/ the irritant
@rough or malad>usted
dentures3sharp .usps
and edges o/ roken
teethA DD+ leukoplakia
Mi.ros.opi.ally1 !yperkeratosis %.hantosis
Management1 " limination o/ irritant iopsy /or 2 -eeks non
healing les ion a/ter agent
remo,al
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.hroni. irritation su.king3
niling3 or .he-ing
thi.kened3 s.arred3 and
paler mu.osa stress or in psy.hologi.al
situationshaitual
.heek iting &ateral tongueDD+
'!& DD+WS (3 urns3
.andidiasis
Mi.ros.opi.ally1 hyperparakeratosis
and a.anthos is shaggy and ragged
keratin -+ adherent
a.terial
Manangement1 a plasti. o..lusal
night guard &a in,est'!&
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$rans ient non6
keratoti. -hite
les ions a result o/
.hemi.al in>uries
.austi. -hen
retained in the mouth
/or long periods
aspirin3 sil,er nitrate3
/ormo.resol3 sodium
hypo.hlorite3
para/ormaldehyde3
dental .a,ity
,arnishes3
a.idet.hing materials3and hydrogen
peroEide
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premalignantepithelial les ion
long6term sun
eEposure iopsieslesions
repeatedly ul.erate3.rust o,er3 -ith
thi.kened -hite area People -+outdoor
o..upations 3 and+or/air .ompleEions
Mi.ros.opi.ally1 %trophi. epithelium &amina propria1
elastos is+asophili.homogenousamorphous alterationo/ the .ollagen
Dysplasti. /eatures
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-hite mu.osal les ionin the area o/toa..o .onta.t
/ound in haitualusers o/ smokelesstoa..o
%nterior mandiular
posterior )essationnormal
mu.osal 862-eeks 58moiopsy
iopsy atypi.allesion1 ul.eration3erythroplakia3 intense
-hiteness3 or a,erru.oid or papillary
Malignanttrans/ormation 57E
/or .hroni. smokelesstoa..o users
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S anguinaria eEtra.t3
a miEture o/
enBophenanthridine
alkaloids @/rom
loodroot plant
S anguinaria
canadensis), used inoral rinses and
toothpaste sin.e
8H2 @eg *iadentA
Indu.ing dysplasti.
keratosis %,oid (o regression in
some *iadent6
indu.ed leukoplakias
months a/ter the.essation o/ *iadent
use
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D"*"&'PM"($%& W!I$"
&"SI'(
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)ysti. e.topi. lymphoid tissue @oral
lymphoepithelial .ystA 5posterior lateral order o/ the tongue @lingual
tons ilA and Waldeyer;s ring@ tonsillar tissue
1lingual3 pharyngeal3 palatine tonsilsA reddish yello- or -hite sumu.osal dome6
shaped nodules Diagnosed1.lini.al /eatures large enough to re:uire a iopsyso/t palate
irritation and it.hingremo,al
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multiple sessile dome shaped lesions 2 to
9 mm3 .halk -hite3 maEillary anterior
al,eolar ridge >ust lingual to the .rest posterior region o/ the >a- on the .rest o/
the ridge o..lusal to the .ro-ns o/ the
molar teeth seen in ne-orn or ,ery young in/ants
and disappear shortly a/ter irthJ originate
/rom remnants o/ the dental lamina
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.lini.al term
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slo-ly progressi,e .hroni. /iroti. diseaseo/ the oral .a,ity and oropharynE3 -+/iroelasti. .hange and in/lammation o/the mu.osaprogressi,e inaility to openthe mouth3 s-allo-3 or speak
*ery resistant to treatment
e a premalignant .ondition oral .an.er de,eloped in L o/ patientsmalignant trans/ormation rate -as 7 to89
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