lesiputihppdgs08

8/13/2019 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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