Treatment of oral diseases: a concise textbook

221 Pages·2005·9.051 MB·English

by  George Laskaris

Thieme

Treatment of Oral Diseases
A Concise Textbook
George Laskaris, M.D., D.D.S., Ph.D.
Head of Oral Medicine, Department of
Dermatology, A. Sygros Hospital
Associate Professor of Oral Medicine
Medical School, University of Athens
Athens, Greece
Visiting Professor
University of London, UK
Thieme
Stuttgart • New York
IV
Library of Congress Cataloging-in-Publication Data Important note: Medicine is an ever-changing science un
dergoing continual development. Research and clinical ex
Laskaris, George. perience are continually expanding our knowledge, in par
Treatment of oral diseases : a concise textbook / Georg ticular our knowledge of proper treatment and drug therapy.
Laskaris ; with contributions by P. Angelakis ... [et al.]. p. ; Insofar as this book mentions any dosage or application,
cm. readers may rest assured that the authors, editors, and pub
Companion v. to: Color atlas of oral diseases / George Laska lishers have made every effort to ensure that such references
ris., 3rd ed., rev. and expanded. c2003. are in accordance with the state of knowledge at the time
Includes bibliographical references. of production of the book.
ISBN 3-13-130111-2 (GTV : alk. paper) - Nevertheless, this does not involve, imply, or express any
ISBN 1-58890-176-9 (TNY : alk. paper) guarantee or responsibility on the part of the publishers in
1. Mouth-Diseases. respect to any dosage instructions and forms of applications
[DNLM: 1. Mouth Diseases-diagnosis. 2. Mouth Diseases- stated in the book. Every user is requested to examine care
drug therapy. 3. Mouth Diseases-therapy. WU 166 L344t fully the manufacturers' leaflets accompanying each drug
2005] I. Angelakis, Philip. II. Laskaris, George. Enchromos at and to check, if necessary in consultation with a physician
las stomatologias. English. III. Title. or specialist, whether the dosage schedules mentioned
therein or the contraindications stated by the manufacturers
RC815.L3733 2005 differ from the statements made in the present book. Such
616.3*106-dc22 examination is particularly important with drugs that are
2004018493 either rarely used or have been newly released on the mar
ket. Every dosage schedule or every form of application used
is entirely at the user's own risk and responsibility. The
authors and publishers request every user to report to the
publishers any discrepancies or inaccuracies noticed.
Some of the product names, patents, and registered designs
referred to in this book are in fact registered trademarks or
proprietary names even though specific reference to this fact
is not always made in the text. Therefore, the appearance of
a name without designation as proprietary is not to be con
strued as a representation by the publisher that it is in the
public domain.
This book, including all parts thereof, is legally protected by
copyright. Any use, exploitation, or commercialization out
side the narrow limits set by copyright legislation, without
the publisher's consent, is illegal and liable to prosecution.
This applies in particular to photostat reproduction, copying,
mimeographing, preparation of microfilms, and electronic
data processing and storage.
© 2005 Georg Thieme Verlag,
Rüdigerstrasse 14, 70469 Stuttgart, Germany
http: //www.thieme.de
Thieme New York, 333 Seventh Avenue,
New York, NY 10001 USA
http://www.thieme.com
Cover design: Martina Berge, Erbach
Typesetting by Satzpunkt Ewert GmbH, Bayreuth
Printed in Germany by Druckhaus Götz, Ludwigsburg
ISBN 3-13-130111-2 (GTV)
ISBN 1-58890-176-9 (TNY) 12 3 4 5
V
Dedication
This book is dedicated to the brightest star,
my son Christos G. Laskaris,
whose memory leads my mind and life
VI
Preface
Oral medicine is an important discipline and the sician. Secondly, in complex problems, coope
diagnostic and therapeutic challenges faced by ration and consultation among the various
the stomatologist range from trivial, isolated, in subspecialties involved in the care of a patient,
nocuous oral lesions to the oral manifestations of with clearly defined roles and goals for all in
life-threatening systemic diseases. It requires a volved, are mandatory. Lastly, since the time of
thorough understanding of and a firm knowledge Hippocrates, therapeutic excess leading to harm
base in dentistry, oral pathology, otorhinolaryn- is to be avoided—in modern terms, the choice of
gology, dermatology, and internal medicine. a particular therapeutic approach should be
based on the available scientific evidence.
The diagnostic part of the practice of oral medi
cine is addressed in many excellent texts includ The book is divided into three parts: Part I
ing the Color Atlas of Oral Diseases by the author presents the definition and a brief summary of
of this volume. each disease—etiology, main clinical features, di
agnosis and differential diagnosis, and a detailed
This book aims to provide a concise, practical, multimodality treatment plan. For practical pur
and reliable guide to the management of oral poses, disease entities appear in alphabetical or
diseases. The field of therapeutics of oral diseas der in the contents. Part II provides information
es is progressing rapidly and every effort has regarding the main categories of drugs and the
been made to include evidence-based multimo- commonly used individual drugs within these
dality therapeutic regimens—drugs, surgery, and categories, which have proved useful in the
other therapeutic means—where appropriate. treatment of a particular disease. Part III provides
However, I ask the reader to keep in mind that a synopsis of the basic principles and oral appli
this book is not meant to be a substitute for a cations of lasers, which are making significant in
thorough knowledge base or the comprehensive roads in the field of oral therapeutics.
literature on each and every therapeutic compo
nent used in clinical practice. Nor is it aiming to It is my hope that stomatologists, oral surgeons,
present details of surgical techniques. dentists, dermatologists, otorhinolaryngolo-
gists, pediatricians, and internists alike will find
The emphasis is on formulating and implement the information in the book useful for the treat
ing a sound therapeutic plan, following an initial ment of oral diseases.
clinical evaluation, a comprehensive differential
diagnosis, and an accurate final diagnosis. Three Sincere thanks are due to the contributors of this
universal principles of therapeutics are high volume for sharing their experience and knowl
lighted. The first principle of management of edge of the treatment of specific oral diseases. I
oral disease is comprehensive and addresses the would also like to express my gratitude and
patient as a whole, not just a particular lesion. thanks to Dr Stathis S Papavasiliou, Associate
The time devoted to establishing a healthy and Professor of Internal Medicine, for his helpful
trusting relationship with the patient and his comments and corrections. Finally, my deepest
patient's family, alleviating anxiety, fear and gratitude goes to my family for their constant
other concerns, explaining the pros and cons of support and love.
various therapeutic strategies in simple terms, is
time well spent for both the patient and the phy Athens, September 2004 George Laskaris
VII
List of Contributors
Philip Angelakis, M.D., D.M.R.T., F.R.C.R. (UK) Gerassimos Pangalis, M.D., Ph.D.
Head Department of Radiation Oncology Professor of Hematology
Hygeia Hospital Medical School
Athens, Greece University of Athens
(Radiotherapy of Squamous Cell Carcinoma) Athens, Greece
(Treatment ofLeukemias and non-Hodgkin-Lym-
Nikos Choulis, Ph.D. (London) phomas)
Professor of Pharmacy
University of Athens George E. Romanos, D.D.S., D.M.D., Dr. med.
Athens, Greece dent, Ph.D.
(Drugs) Professor of Implant Dentistry
College of Dentistry
Eleni Gagari, D.M.D., D.M.Sc. New York University
Associate Professor of Oral and Maxillofacial New York, N.Y., U.S.A.
Pathology (Laser Therapy)
School of Dental Medicine
Tufts University George Stathopoulos, M.D., Ph.D.
Boston, MA, USA Medical Oncologist
(Chemical Burn, Thermal Burn, Drug-Related Mu Director of Oncology Clinic
cosal Pigmentation, Epulis Fissuratum, Metal Dep E. Dunant Hospital
osition, Nicotinic Stomatitis, Smoker's Melanosis, Athens, Greece
Smokeless Tobacco Keratosis) (Chemotherapy of Squamous Cell Carcinoma)
John Iatrou, D.D.S., M.D., Ph.D. George Vaiopoulus, M.D., Ph.D.
Associate Professor of Oral and Maxillofacial Professor of Internal Medicine
Surgery Medical School
Dental School University of Athens
University of Athens Athens, Greece
Athens, Greece (Treatment of Amyloidosis)
(Surgical Treatment of Squamous Cell Carcinoma)
Chrysostomos Melissinos, M.D., Ph.D.
Pneumonologist
Hygeia Hospital
Athens, Greece
(Treatment of Tuberculosis)
VIII
Contents
Part I: Diseases 1 Erythroplakia 68
Actinic Cheilitis 2 Exfoliative Cheilitis 69
Actinomycosis 4 Extramedullar Oral Plasmacytoma 70
Adenocarcinomas of the Salivary Glands 6
Agranulocytosis 8 FAPA Syndrome 71
Amalgam Tattoo 9 Fissured Tongue 72
Amyloidosis 10 Focal Epithelial Hyperplasia 73
Angina Bullosa Hemorrhagica 12 Furred Tongue 74
Angiocentric T-cell Lymphoma 13
Angular Cheilitis 14 Geographic Tongue 75
Aphthous Ulcers 15 Glossodynia 76
Ariboflavinosis 18 Gonococcal Stomatitis 77
Aspergillosis 19 Graft-Versus-Host Disease 78
Bacillary Angiomatosis 21 Hairy Leukoplakia 80
Behçet Disease 22 Hairy Tongue 81
Benign Tumors 25 Hand, Foot, and Mouth Disease 82
Buccal Cellulitis 26 Herpangina 83
Bullous Pemphigoid 27 Herpes Simplex Virus Infections 84
Burkitt Lymphoma 29 Herpes Zoster 86
Histoplasmosis 88
Candidiasis 30
Cheilitis Glandularis 33 Infectious Mononucleosis 90
Cheilitis Granulomatosa 34 Infectious Sialadenitis 91
Chemical Burns 35
Chronic Ulcerative Stomatitis 36 Kawasaki Syndrome 92
Cicatricial Pemphigoid 38
Cinnamon Contact Stomatitis 40 Langerhans Cell Histiocytosis 93
Coccidioidomycosis 41 Leishmaniasis 95
Condyloma Acuminatum 42 Leukemias 97
Contact Cheilitis 43 Leukoplakia 99
Crohn Disease 44 Lichen Planus 101
Cryptococcosis 46 Linear IgA Disease 103
Cyclic Neutropenia 48 Ludwig Angina 105
Cysts 50 Lupus Erythematosus 106
Dental Amalgam Contact Stomatitis 51 Malignant Melanoma 108
Denture Stomatitis 52 Median Lip Fissure 110
Dermatitis Herpetiformis 53 Median Rhomboid Glossitis Ill
Dermatomyositis 55 Melkersson-Rosenthal
Drug-Induced Gingival Overgrowth 57 Syndrome 112
Drug-Induced Oral Ulcerations 58 Metal Depositions 114
Drug-Related Mucosal Pigmentation 60 Mucormycosis 115
Dry Socket 61 Mumps 117
Eosinophilic Ulcer 62 Necrotizing Sialadenometaplasia 118
Epidermolysis Bullosa Acquisita 63 Necrotizing Ulcerative Gingivitis
Epulis Fissuratum 65 and Periodontitis 119
Erythema Multiforme 66 Nicotinic Stomatitis 121
Contents IX
Noma 122 Traumatic Ulcer 169
Non-Hodgkin Lymphomas 124 Trigeminal Neuralgia (Idiopathic) 170
Tuberculosis 172
Oral Malodor 126
Oral Soft-Tissue Abscess 128 Uremic Stomatitis 174
Oral Staphylococcal Infection 129
Oral Submucous Fibrosis 130 Verruca Vulgaris 175
Orofacial Granulomatosis 132 Verrucous Carcinoma 176
Paracoccidiomycosis 133 Wegener Granulomatosis 177
Pellagra 135
Pemphigoid Gestationis 136
Pemphigus 138 Part II: Drugs 179
Pericoronitis 141 Introduction 180
Peripheral Facial Nerve Paralysis 142 Antimicrobial Agents 180
Plasma Cell Cheilitis 143 Antifungal Agents 185
Plasminogen Deficiency: Gingival Antiviral Agents 186
Lesions 144 Corticosteroids 188
Pyostomatitis Vegetans 145 Immunosuppressive Agents 189
Nonsteroidal Anti-Inflammatory
Radiation-Induced Oral Mucositis 146 Agents 190
Antihistamines 190
Sarcoidosis 148 Other Drugs 191
Sarcomas 150
Scleroderma 152
Scurvy 154 Part III: Laser Therapy 193
Sjögren Syndrome 155 Laser Applications for the Treatment of
Smokeless Tobacco Keratosis 157 Oral Mucosal Lesions 194
Smoker's Melanosis 158 Introduction 194
Squamous Cell Carcinoma 159 Laser-Tissue Interactions 194
Streptococcal Gingivostomatitis 162 Laser Applications in Oral Medicine 195
Sweet Syndrome 163
Syphilis 165
Index 199
Thermal Burn 167
Toxic Epidermal Necrolysis 168