3 Lec 13 (Exam 3): Oral Manifestations of Systemic Diseases

K,A,D,E

of vitamins A, B, C, D, E and K, which ones are fat soluble?

B,C

of vitamins A, B, C, D, E and K, which ones are water soluble?

thiamine

what is the other name for vitamin B1?

niacin

what is the other name for vitamin B3?

retinol

what is the other name for vitamin A?

Vitamin B3 (Niacin)

deficiency in this vitamin is associated with pellagra, mouth inflammation (glossitis, angular stomatitis, cheilitis) and the 3 Ds:

•Dermatitis

•Diarrhea

•Dementia

Vitamin A (Retinol)

deficiency in this vitamin is associated with night blindness, xerophthalmia (dry eyes) and Bitot spots:

Vitamin B1 (Thiamine)

deficiency in this vitamin is associated with Beriberi, anorexia, irritability, and a decrease in short-term memory:

•Poor dietary intake due to lack of food

•Disproportionate reliance on highly processed

staple crops

•High-heat or long-duration cooking

what is the usual cause of a Vitamin B1 (Thiamine) deficiency?

Vitamin B12

the main functions of this vitamin include:

•DNA synthesis

•Methylation

•Mitochondrial metabolism

Deficiency is largely caused by gastric abnormalities/disorders that disrupt absorption:

GI abnormalities/diseases that impair absorption

what is the usual cause of a Vitamin B12 deficiency?

Vitamin B12

macro-ovaloctye changes in RBCs is associated with a deficiency in what vitamin?

Vitamin B12

Hypersegmentation of a neutrophil and abnormally large erythroid precursor cells are associated with a deficiency in what vitamin?

Vitamin B12

consequences of a deficiency in this vitamin can result in:

-megaloblastic anaemia or macrocytic anemia (due to impaired DNA synthesis)

-impaired sensory and peripheral nerve function

-increased melanin production

-fatigue

Vitamin B12

The following are oral manifestations of a deficiency in what vitamin?

•Glossodynia

•erythema and depapillation

of the tongue

•dry mouth

•angular cheilitis

Vitamin C (ascorbic acid)

deficiency in this vitamin is associated with Scurvy and impaired collagen synthesis

Vitamin C (ascorbic acid)

The following are oral manifestations of a deficiency in what vitamin?

-Petechiae

•Generalized gingival swelling

•Hemorrhage (petechiae, ecchymosis)

•Tooth mobility

•Ulceration

•Increased periodontal infection

•Delayed wound healing

Vitamin D

this vitamin and its metabolites are hormones and hormone precursors rather than vitamins, aids in calcium absorption in the body:

Vitamin D

deficiency in this vitamin is associated with Rickets in infants, leading to:

•Growth impairment

•Irritability

•Significant bowing of bones

•Hypomineralization of teeth

Vitamin D

deficiency in this vitamin is associated with Osteomalacia in adults, leading to:

•Diffuse skeletal pain

•Susceptible to fracture

Vitamin D

The following are oral manifestations of a deficiency in what vitamin?

•Severe early childhood caries

•Periodontal disease

•Enamel chronological hypoplasia

Vitamin K

the main functions of this vitamin include:

•Coagulation

•necessary for activation of clotting factors II, VII, IX, and X

•Activation of protein C and protein S (inhibiting excess generation of thrombin )

•bone formation (osteocalcin)

Coronary vascularcalcification

Acromegaly

An excess secretion of growth hormone

(GH) will cause what disorder?

Anterior pituitary adenoma

What is the most common cause of acromegaly?

Acromegaly

Clinical features of this disorder include:

•Coarse facial features

•Hypertrophy of soft palate tissues

•Mandibular prognathism

•Anterior open bite (Apertognathia)

•Diastema formation

•Macroglossia

Hypothyroidism

ID the pathology:

-signs/symptoms include: dry skin facial edema, hoarseness, enlargement of tongue

-can be caused by iodine excess or deficiency

Oral symptoms:

•Macroglossia

•Dysgeusia

•Poor periodontal health

•Burning mouth syndrome

•Dry mouth

•Effect on bone health

Hyperthyroidism

ID the pathology:

Classic symptoms

•heat intolerance

•Tremor

•Palpitations

•Anxiety

•weight loss despite a normal or increased

appetite

•Increased frequency of bowel movements

•shortness of breath

Graves disease

Most common cause of hyperthyroidism:

Graves disease

•Most common cause of hyperthyroidism

•Occurs at all ages but especially in women of reproductive age.

•Results from autoantibodies targeting TSHR

•Diffuse thyroid enlargement

hyperparathyroidism

Stones, bones, groans, with psychiatric overtones are associated with:

•Facial asymmetry/swelling

•Bone expansion

•Malocclusion

•Brown tumors (5%)

•Loss of lamina dura

•Pain/neuropathy

•Delayed eruption

•Hypoplastic enamel

•Root resorption

•Ground glass trabeculation pattern

•Thinning of the mandibular cortex

Orofacial manifestations of hyperparathyroidism:

Hypoparathyroidism

Clinical Features of this pathology:

•Pitting enamel hypoplasia if during tooth development

•Metabolic alkalosis, tetany

•Chvostek sign: upper lip twitches when facial nerve tapped below zygomatic process

diabetes mellitus

Oral complications of this disease includes:

•Periodontal disease

•Infections

•-Oral candidiasis

•-Mucormycosis

•Xerostomia and hyposalivation

•Tastes disturbance and BMS

•Delayed wound healing

diabetes mellitus

The most common risk factor for mucormycosis is:

Sickle cell anemia

•Hair-on-end radiographic feature is associated with:

Sickle cell anemia

ID the pathology:

•Hair-on-end radiographic feature

•BM hyperplasia; enlarged marrow spaces

•Widened bone trabeculations (stepladder configuration)

•Thickening of lamina dura

•Thinning of inferior border of mandible

•Pulpal necrosis, osteomyelitis

•Peripheral neuropathy

•Delayed eruption, hypoplasia

Thalassemia

ID the pathology:

•Disorder of hemoglobin synthesis

•A form of hemolytic anemia

•Reduced synthesis of alpha/beta

globin chains

•Prominent in the Mediterranean, Africa, India, Southeast Asia

•Red blood cells are microcytic and hypochromic

𝜷−Thalassemia

ID the pathology:

•Hepatosplenomegaly

•Bone abnormalities

•Osteopenia

•Pathological fractures

•Skin pigmentation

•Cardiomyopathy

•Liver fibrosis

Endocrine failure

Orofacial features:

-enlargement of upper jaw, (chipmunk face)

-migration. and spacing of upper anterior teeth

increase dental decay

-delayed dental development

Amyloidosis

ID the pathology:

•Condition causes deposition of extracellular proteinaceous material

•Amyloid- Beta pleated sheet configuration

•Occur in a specific organ or occur systemically

•Organ-Limited

Amyloidosis

ID the pathology:

Crohn disease

•Inflammatory condition primarily affecting distal small intestine and proximal colon (can be seen anywhere in the GI tract)

Crohn disease

ID the pathology:

•Orofacial granulomatosis

•Aphthous-like ulcerations

•Cobblestone appearance of mucosa

•Mucosal tags and soft tissue swellings resembling epulis fissuratum

•Linear ulcers in buccal vestibule