A child patient undergone pulpotomy in your clinic in1st primary molar. Next day the patient returned with ulcer on the right side of the lip.. traumatic ulcer
A child patient undergone pulpotomy in your clinic in1st primary molar. Next day the patient returned with ulcer on the right side of the lip... your diagnosis is:
a- Apthosis
b- Zonal herpes
c- traumatic ulcer***
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Traumatic ulcer:
Etiology:
As its name suggests, it is an acute or chronic trauma that can occur due to sharp food or accidental bites during chewing, excessive brushing, talking or even sleeping. They may remain for long periods of time, but most usually regenerate within a few days.
Clinical features:
they occur most often on the tongue, lips and jugal mucosa, which may be injured by teething. Gum, palate, and buccal groove bottom lesions may occur from other sources of irritation, such as excessive brushing. These are usually individual lesions with an erythematous area surrounding a removable, central, yellow, fibrinopurulent membrane. The lesion may develop a hyperkeratotic whitish hinge adjacent to the ulceration area.
Histopathological features:
traumatic ulcerations have a fibrinopurulent membrane that consists microscopically of fibrin mixed with neutrophils. Adjacent epithelium may be normal or mild hyperplasia with or without hyperkeratosis. The ulcer base consists of a granulation tissue that has lymphocytes, histiocytes, neutrophils, and occasionally plasma cells.
Treatment and prognosis:
For traumatic ulcerations that have an obvious source of injury, the cause should be removed. Diclonin hydrochloride or hydroxypropyl cellulose films may be applied for pain relief. If the cause is not obvious or if the patient does not respond to treatment, biopsy is indicated.
a- Apthosis
b- Zonal herpes
c- traumatic ulcer***
--------------------------------
Traumatic ulcer:
Etiology:
As its name suggests, it is an acute or chronic trauma that can occur due to sharp food or accidental bites during chewing, excessive brushing, talking or even sleeping. They may remain for long periods of time, but most usually regenerate within a few days.
Clinical features:
they occur most often on the tongue, lips and jugal mucosa, which may be injured by teething. Gum, palate, and buccal groove bottom lesions may occur from other sources of irritation, such as excessive brushing. These are usually individual lesions with an erythematous area surrounding a removable, central, yellow, fibrinopurulent membrane. The lesion may develop a hyperkeratotic whitish hinge adjacent to the ulceration area.
Histopathological features:
traumatic ulcerations have a fibrinopurulent membrane that consists microscopically of fibrin mixed with neutrophils. Adjacent epithelium may be normal or mild hyperplasia with or without hyperkeratosis. The ulcer base consists of a granulation tissue that has lymphocytes, histiocytes, neutrophils, and occasionally plasma cells.
Treatment and prognosis:
For traumatic ulcerations that have an obvious source of injury, the cause should be removed. Diclonin hydrochloride or hydroxypropyl cellulose films may be applied for pain relief. If the cause is not obvious or if the patient does not respond to treatment, biopsy is indicated.
