SEcTion 1: BaSicS

1. Oral Diseases—An Introduction 3Anil Ghom

2. Neoplasm 5Anil Ghom, Savita Ghom

Definition 5; Nomenclature 5; Normal Cell Cycle 5; Predisposing Epidemiologic Factors for the Development of Neoplasm 5; Acquired Preneoplastic Conditions 7; Carcinogenesis 7; Biology of Tumor Growth 9; Metastasis 11; Grading and Staging of Tumors 12

3. Infection Control in Dental Office 15Amina Sultan, Mandeep Kaur, Sukhdeep Singh

Transmission of Infections 15; Infections that can be Transmitted in a Dental Environment (by the Oral Cavity) 15; Standard Infection Control 16; Infection Control Protocol 16; Disinfections and Sterilization 18; Infection Control in Radiography 20

4. Case History 22Anil Ghom, Savita Ghom

Definition of Case History 23; Diagnostic Procedure 23; Personal Information 23; Taking and Recording History 27; Medical History 31; Examination 32; Establishing the Diagnosis 56

5. Investigations in Dentistry 60Anil Ghom, Savita Ghom

Diagnostic Test for Cancer Detection 60; Clinical Methods 61; Photodiagnosis 62; Histopathological Examination 62; Molecular Methods 66; Immunofluorescence Procedure 67; Caries Activity Tests 67; Hematological Investigation 70; Blood Chemistry 75; Radiological Investigations 77

SEcTion 2: DiSEaSES of oral STrucTurE

6. Teeth Anomalies 83Anil Ghom, Savita Ghom

Developmental Disturbances of Teeth 83; Environmental Alteration of Tooth 105

7. Developmental Defects of Craniofacial Structures 124Anil Ghom, Savita Ghom

Definitions 124; Developmental Disturbances of the Jaws 125

8. Keratotic and Non-keratotic Lesions 148Anil Ghom, Savita Ghom

Normal Variation 148; Non-keratotic White Lesions 151; Candidiasis 154; Oral Genodermatoses 163

9. Oral Premalignant Lesions and Conditions 169Anil Ghom, Savita Ghom

Concept of Precancer 169; Precancerous Lesions 169; Oral Lesions Associated with the Use of Tobacco 180; Premalignant Conditions 182

10. Cysts of Orofacial Region 203Anil Ghom, Savita Ghom

Definitions 203; General Diagnostic Features of Cysts 204; Theories of Cyst Enlargement 205; Classification 205; Epithelial Developmental Odontogenic Cyst 206; Inflammatory Cysts 217; Non-odontogenic Cysts 221; Nonepithelial Cysts 224; Cysts of Soft Tissues of the Face and Mouth 225; Syndromes Associated with Odontogenic Cysts 230; Treatment of Cysts 231

11. Odontogenic Tumors 235Anil Ghom, Savita Ghom

Classification 235; Benign Tumors 236; Malignant Tumor 258

Contents

xx

Text

book

of O

ral M

edic

ine

12. Benign Tumors of Orofacial Region 264Anil Ghom, Savita Ghom

Characteristics of Benign Tumor 265; Terminology 265; Classification 265; Tumors of Epithelial Origin 265; Tumors of Fibrous Connective Tissue Origin 269; Tumors of Cartilage Tissue Origin 274; Tumors of Adipose Tissue Origin 275; Bone Tumors 277; Tumors of Vascular Tissue Origin 283; Tumors of Neural Tissue Origin 293; Muscle Tumors 298; Giant Cell Neoplasm 300; Salivary Gland Tumor 303; Inflammatory Hyperplasia 303

13. Malignant Tumors of Orofacial Region 310Anil Ghom, Savita Ghom

Oral Carcinoma 310; Epithelial Tumors 312; Tumors of Fibrous Connective Tissues 325; Tumors of Adipose Tissues 328; Cartilage Tumors 328; Bone Tumors 330; Vascular Tumors 333; Tumors of Neural Tissues 333; Muscle Tumors 334; Tumors of Lymphoid Tissues 335; Myeloma 344; Malignant Tumors of Salivary Gland 346; Treatment Modalities of Oral Cancer 346

14. Vesicular, Bullous and Erosive Lesions 356Mandeep Kaur, Virender Gombra, Sukhdeep Singh

Classification of Ulcers 356; Ulcers Associated with Trauma 358; Ulcers Associated with Infection 359; Diseases of Unknown (Uncertain) Etiology 359; Ulcers Associated with Allergic Reactions 363; Ulcers Associated with Cutaneous Manifestation 367

15. Orofacial Pain 384Ajit Mishra, Savita Ghom

Types and Nature of Pain 385; Neurophysiology of Pain 385; Types of Nerve Cells 387; Sensory Receptors 387; Pain Conduction 387; Theories of Pain 388; Measurement of Pain Intensity 389; Classification of Orofacial Pain 390; Therapeutic Modalities of Pain Control 404

16. Infections of Oral Cavity 409Anil Ghom, Savita Ghom

Host Defense Mechanism 410; Oral Microflora 411; Spread of Infection 412; Diagnosis of Odontogenic Infection 413; Pathophysiology of Infection 413; Principles of Management of Odontogenic Infection 413; Sequelae of Pulpitis (Pulpoperiapical Abscess) 414; Radiographic Considerations 414; Etiology of Major Facial Infection 414; Acute and Chronic Infections of Oral Cavity 415; Osteomyelitis 428; Facial Space Infections 439; Fatal Complications of Oral Infection 445; Pulpal Infection 450; Focal Infection 451; Pits, Fistulae and Draining Sinus of Oral Cavity 452

17. Oral Pigmentation 455Amit Parate, Anil Ghom

Blue/Purple Vascular Lesions 457; Brown Melanotic Lesions 461; Brown Heme Associated Lesion 470; Exogenous Pigmentation 472; Pigmentation due to Drugs and Metals 473; Summary 476; Hypopigmentation in Oral Cavity 476

18. Dental Caries 480Raghvendra Shetty

Etiology 481; Pathogenesis 481; Theories of Cariogenesis 481; Classification 483; Diagnosis of Dental Caries 484; Types of Caries 487; Radiographic Differential Diagnosis of Dental Caries 496; Control of Dental Caries 498

19. Diseases of Tongue 501Anil Ghom, Savita Ghom

Embryology and Development of Tongue 501; Anatomy of Tongue 502; Functions of Tongue 503; Specialized Examination of the Tongue 504; Classification of Tongue Disorders 504; Congenital and Developmental Disorders 504; Local Tongue Disorders 510; Depapillation of the Tongue 514; Neurological Disorders 516; Premalignant Lesions and Conditions 518; Malignant Tumor 518

20. Diseases of Lip 523Anil Ghom, Savita Ghom

Classification of Lip Disorders 523; Development of Lip 523; Anatomy 523; Developmental Disorders of Lip 524; Cheilitis 529; Miscellaneous Disorders 535

21. Gingival and Periodontal Diseases 537Abhishek Soni, Anil Ghom

Normal Periodontium 537; Disease of Gingiva and Periodontium 539; Gingival Diseases 539; Drug-influenced Gingival Enlargements Dilantin Sodium 546; Non-plaque-induced Gingival Disease 550; Periodontal Diseases 554

22. Temporomandibular Joint Disorders 566Anil Ghom, Savita Ghom

Anatomy of TMJ 566; Functional Movement of TMJ 569; Diagnostic Studies 569; Classification of TMJ Disorders 569; Developmental Disorders of the TMJ 569; Degenerative Joint Diseases 574; Inflammatory Disorders of the Joint 576; Traumatic Disorders of TMJ 580; Metabolic Disorders 591; Neoplastic Disorders 592; Miscellaneous Disorders 593

xxi

Contents23. Salivary Gland Disorders 600

Anil Ghom, Savita Ghom

Development of Salivary Gland 601; Classification of Salivary Glands 601; Saliva 602; Examination of Salivary Glands 604; Diagnostic Tests of the Salivary Glands 604; Developmental Disorders of Salivary Gland 605;Functional Disorders of Salivary Gland 607; Obstructive Disorders 609; Cysts of Salivary Gland 614; Asymptomatic Enlargement of the Salivary Gland 617; Viral Infection 618; Bacterial Infection 619; Autoimmune Disorders 622;Tumors of Salivary Glands 625; Benign Tumors 626; Malignant Tumors 630

24. Disorders of Maxillary Sinus 638Anil Ghom, Shweta Tikekar (Singh)

Development of Maxillary Sinus 638; Anatomy of Maxillary Sinus 639; Functions of Maxillary Sinus 639; Examination and Investigation of Maxillary Sinus 639; Classification of Maxillary Sinus Disorders 640; Developmental Disorders 640; Inflammatory Disorders 641; Cysts 644; Benign Tumor 647; Malignant Tumor 648; Traumatic Injuries to the Paranasal Sinuses 651; Calcification 654

25. Traumatic Injuries of Oral Cavity 657Anil Ghom, Savita Ghom

Traumatic Injury of Soft Tissue 657; Fracture of Teeth 663; Complications of Healing 676

26. Soft Tissue Calcifications 679Anil Ghom, Savita Ghom

Definition 679; Classification of Calcification 679; Dystrophic Calcification 679; Idiopathic Calcification 682; Metastatic Calcification 684

SEcTion 3: SySTEmic DiSEaSES manifESTED in Jaw

27. Bacterial Infections 691Anil Ghom, Savita Ghom

Infections Caused by Bacteria 691

28. Viral Infections 713Anil Ghom, Mandeep Kaur

Definition 713; Classification 713; Infections Caused by Viruses 714; Herpes Simplex Virus Infections 714; Varicella Zoster Infections 718; Coxsackievirus Infection 723; Condyloma Acuminatum 726; Verruca Vulgaris (Common Wart) 726

29. Fungal Infections 731Anil Ghom, Savita Ghom

Infections Caused by Fungi 731; Protozoal Infections 738

30. Specific System Disorders 740Anil Ghom, Savita Ghom

Basic Life Support 741; Cardiovascular Diseases 742; Respiratory Disorders 750; Renal Disorders 752; Disordersof Gastrointestinal Tract 755; Neuromuscular Disorders 759; Granulomatous Disorders 764; Collagen Disorders 767; Skin Disorders 769; Muscle Disorders 774; Immunological Disorders 780; Miscellaneous Conditions 781

31. Diseases of Bone Manifested in Jaw 787Anil Ghom, Savita Ghom

Fibro-osseous Lesions 787; Fibro-osseous Lesions of Medullary Bone Origin 788; Fibro-osseous Lesions of Periodontal Origin 799; Other Lesions of Bone 804

32. Acquired Immunodeficiency Syndrome (AIDS) 818Anil Ghom, Savita Ghom

Definition 818; Prevalence and Epidemiology 819; Transmission 819; History of Nomenclature of Virus 819; Characteristics of the HIV Virus 819; Mechanism of Action 820; Classification 820; AIDS-related Complex 822; Oral Manifestations 822; Common Oral Manifestations in AIDS 823; Uncommon Oral Manifestation in AIDS 827; Guidelines to Prevent Transmission to Dentist 828; Prevention 828; Diagnostic Tests for AIDS 828; Management of AIDS 830

33. Endocrine Disorders 833Anil Ghom, Savita Ghom

Functions of the Endocrine System 833; Anatomy and Physiology 833; Diseases of Pituitary Gland 835; Diseases of Thyroid Gland 837; Diseases of Parathyroid Gland 840; Diseases of Pancreatic Gland 844; Diseases of Adrenal Gland 848; Diseases of Gonads 850

xxii

Text

book

of O

ral M

edic

ine

34. Blood Disorders 853Anil Ghom, Savita Ghom

Physiology of Blood 854; Composition 854; Blood Coagulation 855; Blood Group 856; Diseases of Red Blood Cells 856; Polycythemia 869; White Blood Cell Disorders 870; Quantitative Disorders 870; Qualitative Disordersof WBC 873; Platelet Disorders 874; Hemorrhagic Disorders 879

35. Vitamins 884Anil Ghom, Sarbani Deb Sikder

Causes of Vitamin Deficiency 884; Water Soluble Vitamins 884; Fat Soluble Vitamins 893

36. Metabolic Disorders 900Anil Ghom, Savita Ghom

Disturbances in Protein Metabolism 900; Disturbances in Lipid Metabolism 903; Disturbances in Carbohydrate Metabolism 906; Disturbances in Mineral Metabolism 907; Miscellaneous Disorders 910

SEcTion 4: DrugS uSED in DEnTiSTry

37. Antibiotics 915Pravin Lambade

Antibiotics Useful for Orofacial Infections 916; Routes of Drug Administration 916; Indications for Antibiotics 917; Principles of Prophylactic Antibiotics 917; Principles of Administration of Antibiotics 918; Effectiveness of Antibiotics 919; Interference with Cell Membrane Structure 922; Interference with Nucleic Acid Synthesis 922; Topical Antiseptic and Antibiotics 923; Classification of Local Antimicrobial Therapy 923

38. Analgesic and Anti-inflammatory Drugs 927Manjari Gandhi (Gupta)

Definition of Analgesic 927; Classification 927

39. Banned Drugs Used in Dentistry 936Manjari Gandhi (Gupta)

Reason for Banning a Drug 936; Reason for Sale and Purchase of Banned Drug in India 936

40. Anticancer Drugs 938Sachin Manglekar

Factors Affecting Chemotherapy 938; Kinetic Classification of Anticancer Drugs 938; Principles of Chemotherapy 939;Use of Anticancer Drugs 939; Pharmacology 942; Principles of Treatment 942

41. Antiviral Drugs 945Rajkumar Diwan

Classification of Antiviral Drugs 945; Antiherpes Drugs 945; Anti-hepatitis Drugs 947; Antiretroviral Drugs 947; Anti-HIV Drugs 948

42. Corticosteroids 952Anshul Khandelwal

Corticosteroid Action and its Regulation 952; Pharmacological Action 953; Mineralocorticoids 957

43. Immunomodulators 960Sonal Vahanwala

Immunosuppressants 960; Immunostimulants 960

44. Drugs Used in Pregnancy 965Mansi Tiwari

Pregnancy Trimesters 965; Pharmacokinetics in Pregnancy 965; Dental Management of Pregnant Patient 966; FDA Categories for Drug Use in Pregnancy 966; Commonly Used Drugs and their Categories 966; Guidelines for Prescribing Drugs in Pregnancy 968; Consideration in Lactation 968

45. Emergency Drugs Used in Dentistry 969Vikas Meshram

Emergency Management 969; Essential Emergency Drugs 970; Additional Emergency Drugs 971; Emergency Equipment 974; Maintenance of Emergency Kit 976

46. Antifungal Drugs 977Abhijeet Deoghare

Classification of Antifungal Agent 977; Polyenes 977; Azoles 978; Pyrimidine Analogs 980; Allylamines 980; Echinocandins 980; Antifungal Treatment in HIV Patients 981; Antifungal Treatment in Refractory Mucosal Candidiasis 981; Antifungal Combinations 981

xxiii

Contents47. Desensitizing Agents, Mouthwashes and Gum Paints 983

Vivek Thombre

Clinical Management of DH 986; Classification of Desensitizing Agents 987; Mouthwashes 989; Gum Paints 991

SEcTion 5: miScEllanEouS

48. Forensic Dentistry 995Anil Ghom, Smriti Goswami

Scope of Forensic Odontology 995; Record Management 995; Identification 996; Age Assessment 998; Bite Marks 998; Classification of Skin Wounds 1001; Medicolegal Aspects of Dentistry 1002 ;

49. Halitosis 1004Sonal Vahanwala

Normal Physiologic Odor 1004; Causes of Halitosis 1005; Investigations 1006; Treatment of Halitosis 1006

50. Controversial Diseases and Terminologies 1008Anil Ghom, Mansi Tiwari

Bowen’s Disease 1008; Leontiasis Ossea 1009; Previous or Former Cyst 1009; Primordial Cyst 1009; Globulomaxillary Cyst 1010; Median Mandibular Cyst 1011; Median Palatine Cyst 1011; AdenomatoidOdontogenic Tumor 1012; Cementoma 1013; True Cementoma 1013; Gigantiform Cementoma 1013;Reparative Giant Cell Granuloma 1013; Aneurysmal Bone Cyst 1014; Granular Cell Myoblastoma 1015;Eagle Syndrome 1015; Hand-Schuller-Christian Disease, Letterer Siwe Disease, Eosinophilic Granuloma andHistiocytosis X 1015; Traumatic Bone Cyst 1015; Neurilemmoma 1015

51. Syndromes of Oral Cavity 1016Ranit Chhabra, Barakha Nayak

Etiology of Syndromes 1018; Pattern of Inheritance 1018; Syndromes Associated with Oral and Paraoral Structures 1018

52. Geriatrics—Role of Oral Physician and Interdisciplinary Management 1030Shalu Rai

Definition 1030; Classification 1031; Age Changes Affecting the Structures in Oral Cavity 1031; Common Diseases Among Geriatric Patients 1031; Goal of Oral Physicians 1032

appEnDicES

Appendix 1: Causes and Classifications 1039Vivek Lath, Abhinav Singhal

Appendix 2: Glossary 1070Satish Chugani, Neha Dandwani

Appendix 3: Emergencies in Dental Office 1080Sachin Dev Sachdeva

Answers Key of MCQs 1085

Index 1089