Date post: | 12-Feb-2017 |
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Pathogenesis of Contact Stomatitis
Rahaf NajjarPediatric Dentistry Master (M2)
Lecture Outline:• Introduction.• Types of Allergic Stomatitis.• Pathogenesis.• Diagnosis.• Treatment.• Discussion.
Introduction:Stomatitis:- Inflammation of the soft tissue lining of any of the
oral cavity.- It can be caused by conditions occurs in the mouth: • Poor oral hygiene• Ill fitted dentures• Mouth burn from hot food or drinks• Systemic conditions that affect whole body as allergy,
infection or medications.
• Patient's complaints in adverse allergic reaction include signs and symptoms of stomatitis, burning sensation, cheilitis and lip swelling.
• Sometimes general symptoms and anaphylaxis may appear.
• Saliva play a protective role to the oral epithelium by:- washing away harmful substances- diluting allergenic substances entered the oral cavity.
• Saliva may, on the other hand, help in antigen presentation by providing small molecules of amino acids and small proteins, thereby accelerating sensitization.
Lecture Outline:• Introduction.• Types of Allergic Stomatitis.• Pathogenesis.• Diagnosis.• Treatment.• Discussion.
Types of Allergic Stomatitis1) Contact allergic stomatitis:• rarely occurs
• The high risk materials consider to cause contact allergic stomatitis are nickel sulfate, mercury-based products & gold.
• Cobalt chloride currently is considered the most common allergen in children.
prosthetic allergic stomatitis.• reaction of contact allergy to acrylate, denture metal
alloys, and cobalt-chromium pastes for denture fixation
• The pathologic changes appear on the locations where the prosthesis base comes in contact with the surrounding oral tissues.
• Erythema, edema, vesicles, bullae, erosions and ulcerations.
Types of Allergic Stomatitis
2) Stomatitis (cheilitis) venenata: • Contact allergic reaction caused by different
chemical and cosmetic substances that cause inflammation of the lips and inflammation of the entire oral mucosa.
• They are presented as inflammation with severe edema, followed by small erosions, and usually appear in multiple forms.
Types of Allergic Stomatitis
Lecture Outline:• Introduction.• Types of Allergic Stomatitis.• Pathogenesis.• Diagnosis.• Treatment.• Discussion.
Pathogenesis• Delayed type hypersensitivity reaction (Type IV
allergic reaction) is cellular immunity manifesting primarily by T- cells.
• Delayed hypersensitivity can occur mainly in patients who are previously have been in contact with a specific antigen and then the cells become sensitized.
No Inflammation
Edema and tissue damage
Lesion Regression due to PGE secretion
by macrophages
Lecture Outline:• Introduction.• Types of Allergic Stomatitis.• Pathogenesis.• Diagnosis.• Treatment.• Discussion.
Diagnosis:• The result of this test is
read tow times, at 48 h and 72 h
• painless and can be safely employed in older schoolchildren
• Patient should be informed not to take anti-allergic drugs
Patch (epicutaneous) Test
Lecture Outline:• Introduction.• Types of Allergic Stomatitis.• Pathogenesis.• Diagnosis.• Treatment.• Discussion.
Treatment• It is treated orally by local application of
corticosteroids and antiseptics
• Systemic administration of corticosteroids, non-steroid anti-inflammatory drugs and immunosuppressants.
Lecture Outline:• Introduction.• Types of Allergic Stomatitis.• Pathogenesis.• Diagnosis.• Treatment.• Discussion.
Discussion• Researchers reported that patients who suffer from
contact stomatitis are mainly middle-aged women, especially 50-60 years old.
• While dental patients exhibit different signs and symptoms, mainly on oral soft tissue, dental staff (dentists and assistants) commonly suffer from hands dermatitis
• Awareness of reactions that can occur with different dental materials in treatment is important to the dentists.
References1) Bakula A, Lugovi_c-Mihi_c L, _Situm M, Tur_cin J, _Sinkovi_c A (2011). Contact allergy in the mouth: diversity of clinical presentations and diagnosis of common allergens relevant to dental practice. Acta Clin Croat 50: 553–561.
2) Ahlgren C, Axell T, Moller H, Isaksson M, Liedholm R, Bruze M. Contact allergies to potential allergens in patients with oral lichen lesions. Clin Oral Investig. 2014;18(1):227-37
3) Joneja P. Contact allergic stomatitis in Orthodontics. International Journal of Dental Clinics. 2012;4(1):29-31
4) http://encyclopedia.thefreedictionary.com/