Treatment of Oral Diseases. George Laskaris
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Introduction
Antimicrobial Agents
Antifungal Agents
Antiviral Agents
Corticosteroids
Immunosuppressive Agents
Nonsteroidal Anti-Inflammatory Agents
Antihistamines
Other Drugs
Laser Applications for the Treatment of Oral Mucosal Lesions
Introduction
Laser-Tissue Interactions
Laser Applications in Oral Medicine
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.