precancerous condition
TRANSCRIPT
Dr ,V.RAMKUMARCONSULTANT DENTAL& FACIOMAXILLARY SURGEON
REGNO: 4118-TAMILNADU-INDIA(ASIA)
PRECANCEROUS LESION
• Morphologically altered tissue in which cancer is more likely to occur than with its apparently normal counter part
PRECANCEROUS CONDITION
• Generalized state associated significantly with significantly
• Increase risk of cancer.
• Leukoplakia
• Lichenplanus
• Oral submucous fibrosis
LEUKOPLAKIA
• Clinically raised white patchmore than 5mm in diameter which is unscrapable that cannot be diffentiated clinically or histopathologically unless tobacco is an etiology
HISTO PATHOLOGICAL FEATURES
• Abnormal keratinization
• Epithelial hyperplasia• Hyperkeratosis• Parakeratosis• Dyskeratosis• Acanthosis
TYPES OF LEUKOPLAKIA
• Speckled leukoplakia• Nodular leukoplakia• Homogenous leukoplakia• Erythroplakia
ERYTHROPLAKIA
• A malignant variant of leukoplakia which is red in colour and have a greater precancerous potential histopatholgically termed carcinoma insitu.
SMOOKERS KERATOSIS
• Site- cheek, palate floor of mouth• Etiology- heat, chemicals.• Increase product of keratin leads
inflammation, swellling reduction of salivary secretion
• The condition is reversible when the habit is stopped
• If the habit continues it leads to malignancy
MANAGEMENT
• MedicalTopical,systemic,intralesional
steroids.Ointments, paste.
SURGICAL MANAGEMENT
• Lasers
• Cryosurgery
• Surgical excision with cautery
ORAL LICHENPLANUS
• Chronic inflammatory immunological reactionin which epidermal or epithelial basal cell damageproduces mucocutaneous lesions of various types
• Etiology –associated with stress• Clinically-unilateral or bilateral• Types- erosive,bullous verucous• Clinical features virchams striae.
(radiating pattern)• Associated with diabetes known as
grispan syndrome
MANAGEMENT
• MedicalTopical,systemic,intralesional
steroids.Ointments, paste lozengesor mouth
wash.Topical flourinated corticosteroid5%mixture of LA
OTHER DRUGS
• Griseogulvin
• Cyclosporin• vitamin A and retinoids• Dapsone
RECENT ADVANCES
• Laser
• cryosurgery
PROTOCOL FOR MANAGEMENT OF LICHEN PLANUS
• Asymptomatic disease- No management reviewSymptomatic case• Antifungal agent• Ohi• Removal of local irritant• Topical steroid for 2 week• Steroid mouth wash .5mg in 10ml for5 min• Intralesional steroid triamcinolone 10mg• follow up 3 to 6 months
ORALSUBMUCOUSFIBROSIS
• It is a chronic insidous disease of the jaw and oral cavity usually associated with juxtra epithelial inflammatory cell.
CLINICAL FEATURES
• Difficulty- Speech
• - Swallowing
• -Mastication
• -Trismus
MEDICAL MANAGEMENT
• Antioxidant- Retinoid,B-carotene
• Vitamin E
• Vitamin A
SURGERY
• Surgical excision of fibrotic bands
• Flaps
RECENT ADVANCES
• LASER
• CRYOSURGERY