Treatment of Oral Diseases. George Laskaris

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Treatment of Oral Diseases - George Laskaris

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rel="nofollow" href="#u8907146d-6b5a-5033-9c31-eb06cff3345f"> Part II: Drugs

       Introduction

       Antimicrobial Agents

       Antifungal Agents

       Antiviral Agents

       Corticosteroids

       Immunosuppressive Agents

       Nonsteroidal Anti-Inflammatory Agents

       Antihistamines

       Other Drugs

       Part III: User Therapy

       Laser Applications for the Treatment of Oral Mucosal Lesions

       Introduction

       Laser-Tissue Interactions

       Laser Applications in Oral Medicine

       Index

      Abbreviations

BP bullous pemphigoid
CT computed tomography
Dsg desmoglein
FAPA (periodic) fever, aphthous ulcers, pharyngitis, adenitis
GM-CSF Granulocyte-macrophage colony-stimulating factor
HCV hepatitis C virus
HIV human immune deficiency virus
HPV human papillomavirus
HSV herpes simplex virus
i. m. intramuscular
i.v. intravenous
MIC minimum inhibitory concentration
MIU million international units
MU million units
NSAIDs nonsteroidal anti-inflammatory drugs
PCR polymerase chain reaction
RAU recurrent aphthous ulcers
rhG-CSF recombinant human granulocyte colony-stimulating factor
s.c. subcutaneous
TNF tumor necrosis factor
U units
VSV varicella zoster virus

      Important Points

      •Before treatment an accurate diagnosis of each disease entity must be made.

      •Treatment without prior diagnosis is, as a rule, unsuccessful and may be dangerous for the patient.

      •Medicines must be prescribed only when they are necessary and when the benefits have been considered in relation to the risks involved.

      •For treatment to be successful the choice of the correct drug and the patient’s compliance with the physician’s instructions are necessary.

      •Clinicians must thoroughly understand, for every drug, the mechanism of action, clinical indications, interactions, side effects, formulations, and the dosage.

      •Almost all drugs have several side effects on multiple organ systems.

      •Physicians should choose the treatment with the optimal outcome and reasonable cost.

      •New drugs must be used with caution.

      •Stomatologists and dentists should avoid undertaking the treatment of the systemic diseases presenting with oral manifestations. The treatment of these diseases must be provided by the respective specialists.

      •Topical treatment of oral manifestations of systemic diseases must always be undertaken in collaboration with the patient’s physician.

      •Several serious oral diseases require hospital care.

      •There should be a good rapport or understanding between the physician and the patient—it is important for most therapeutic measures to be effective.

      This must always be in the mind of the physician before making decisions about diagnosis and treatment.

      Part I

      Diseases

      Actinic Cheilitis

      

Definition

      Actinic cheilitis is a relatively common precancerous disorder typically confined to the vermilion zone of the lower lip.

      

Etiology

      Fair-skinned individuals with high occupational or recreational sun exposure are more commonly affected.

      

Main Clinical Features

      •Chronic mild edema and erythema followed by dryness and fine scaling

      •The epithelium becomes progressively thin and atrophic with hyperkeratotic whitish papules or small plaques intermingled with red areas

      •Later the lip becomes very dry and scaly with erosions

      •Risk of development of leukoplakia and squamous cell carcinoma is increased

      

Diagnosis

      The clinical diagnosis should be confirmed by a biopsy and histopathologic examination.

      

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