COLLEGE OF DENTISTRY
ORAL PATHOLOGY
[233 MDS]
DEPARTMENT OF MAXILLOFACIAL SURGERY & DIAGNOSTIC SCIENCES
[MDS]
STUDY GUIDE
1
Message from the Dean
Assalamu alaikum wa rahamatullahi wa barakatahu
It is my pleasure to welcome you to the College of Dentistry - Zulfi at Majmaah University,
Kingdom of Saudi Arabia. College of Dentistry aims to improve the dental health of the
people in Kingdom of Saudi Arabia through providing the students with excellent clinical
training, supporting research and learning environment. Towards this goal the Department of
Maxillofacial Surgery & Diagnostic Sciences has prepared a course handbook in Oral
Pathology for the benefit of the students.
I have read this handbook and would like to assure you that the team has done an
excellent job in addressing all the questions a student will have at the start of the course. This
handbook also contains all the schedule of lectures and practical classes. I would like to
congratulate the team for coming up with this handbook.
I am happy to be the Dean of the College of Dentistry and I am sure that the assurance
from the dedication of our energetic and benevolent faculty and staff prompts you to be
skilled and knowledgeable in attaining high standard of education.
Best wishes
Dr. Abdur Rahman Al Atram
2
Message from the members of the committee
Dear Students,
We are very happy to be faculty members of this College and teaching the Oral Pathology
course, I would like to introduce for you this handbook for Oral Pathology course that guides
you throughout the semester and finding the useful information that you need about the; course
name, detailed course contents, detailed objectives for each class, the proper and modern
methods and ways used for teaching in dental college, text books needed, and evaluation
systems.
The topics covered in this module are highly relevant and have clinical implications which will
be of great help in your professional life. This subject is one of the very important foundation
courses in dentistry and will help you to progress on to become a good dental surgeon. Hence we
the committee suggest you to use this handbook to prepare yourself during the course and gain
maximum benefit.
Best wishes & Good luck
3
APPROVAL FOR THE COURSE
This course has been reviewed, revised and approved by:



The Department of Maxillofacial Surgery and Diagnostic
College Curriculum Committee
College Council
4
TABLE OF CONTENTS
Page No
1
Message from the Dean
2
2
Message from the members of the committee
3
3
Approval of the course
4
4
General course information
6
5
Course description
7
6
General course objectives
8
7
Course contents
9
8
Detailed objectives of course contents
17
10
Student expected study hours and student support
21
11
Teaching and learning resources
22
12
Facilities required
25
13
Students Assessment
26
14
Course Evaluation & Improvement process
27
5
GENERAL COURSE INFORMATION
Course Title
Course Code
Course
components &
Credit hours
Oral Pathology
233 MDS
Theory
First semester
1
Practical
1
Total
2
Prerequisites
1
1
2
Second semester
General Anatomy, histology and embryology (ANA 113) Human physiology
Co-requisites
General Pathology (PATH213)
Year / Level
2nd year continous course in 1st and 2nd semester
6
COURSE DESCRIPTION
The course provides a basis for the clinical practice in which the students will be
engaged during the coming years and after graduation. The students will gain
sufficient knowledge to help them distinguish between oral tissues in health and
disease, identify diseases of the teeth, periodontium, maxilla and mandible
including the face, oral mucous membranes and associated soft tissues and
orofacial manifestations of systemic diseases. The causes of the various diseases
and the microscopic appearance of the developed lesions are emphasized. The
underlying basic pathological principles are also stressed, in addition to the
clinical appearance of the lesions, which is also studied to provide introductory
basis for clinical differential diagnosis.
7
GENERAL COURSE OBJECTIVES
The purpose of this course is for the students to understand and know how to
apply the following principles for each specific disease to be studied:
 The Etiology (cause)
 The Pathogenesis (how lesions are developed).

1.
2.
3.
4.
5.
6.
The clinical characteristics such as:
Age
Sex
Site
Color
Texture
Prevalence
 How to make differential diagnosis and the diagnostic aids used in
diagnosis.
 The clinical, microscopical and the radiographic appearance of lesions and
their differentiation from the normal tissue.
 The principles of treatment and prognosis
8
COURSE CONTENTS:
A - Lectures: 1st semester (14 lectures)
Lecture List of topic
no
1
Introduction
2-3
4-5
6-7
8-9
Detailed content
Definitions of oral pathology and its
field.
Normal orofacial structures.
Types of microscopes
Common stains used in oral
pathology
Developmental Anomalies of lip
abnormalities
Anomalies of tongue
of Jaw, lip and Syndromes associated with these
Tongue
defects
Abnormalities
of teeth
Orofacial
cysts
Odontogenic
tumors
Developmental alterations of teeth
Developmental alterations in the
number of teeth.
Developmental alterations in the size
of teeth.
Developmental alterations in the
shape of Teeth.
Developmental alterations in the
structure of teeth.
Odontogenic cysts –
Classification
Denti gerous cyst
Erup tion cyst.
Odontogenic kerato cyst.
Gingival Cyst of the Newborn.
Ging ival Cysl of the Adult.
Lateral Periodontal Cyst
Calcifying Odontogenic Cyst.
Tumors of odontogenic epithelium
Ameloblastoma,
Adenomatoid Odontogenic Tumor.
Calcifying Epithelial Odontogenic
Tumor.
Squamous Odontogenic Tumor.
Mixed odontogenic tumors
Ameloblastic Fibroma.
Odontoma.
No of
weeks
Contact
hours
1
1
2
2
2
2
2
2
2
2
Tumors of odontogenic mesenchyme
9
Central Odontogenic Fibroma.
Peri phe ral Odon togenic Fibroma.
Granular Cell Odontogenic Tumor.
Odon togenic Myxoma
Cementoblastoma.
10-11
12
13
14
Keratotic
lesions
Dental caries
Pulpal and
periapical
diseases
Leukoplakia
Hair tongue
White spone nevus
Smokers palate
Oral hairy leukoplakia
Lichen planus
Linea alba
Verrucus carcinoma
Definition
Classification of dental caries
Bacterial implicated in dental caries
Theories of Dental caries
Microscopic features of enamel and
dentin caries.
Pulpitls.
Periapical granuloma.
Periapical cyst.
Periapical abscess.
Osteomyelitis.
2
2
1
1
1
1
1
1
Revision
10
B. lectures 2nd semester (13 lectures)
Lecture
no
1-2
List of topic
Diseases of
salivary glands
Detailed content
Introduction
Benign salivary gland tumors
Pleomorphic adenoma
Canalicular adenoma
Basal cell adenoma
Warthins tumor
Malignant salivary gland tumors
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma
Polymorphous low grade
adenocarcinoma
No of
weeks
Contact
hours
2
2
2
2
1
1
1
1
Mucocele
Mucous retention cyst
Chronic sclerosing sialadenitis
Necrotizing sialometaplasia
Sjogren syndrome
3-4
5
6
Diseases &
tumors of
connective
tissue
Bacterial
infections
Viral and fungal
infections
Introduction
Tumors of fibrous tissue origin
Tumors of muscle tissue origin
Tumors of nerve tissue origin
Tumors of adipose tissue origin
Tumors of Vascular tissue origin
Introduction
Actinmycosis.
Impetigo.
Tonsillitis an pharyngitis.
Scarlet fever.
Syphilis.
Tuberculosis.
Introduction
Fungal infections
Pseudomembranous candidiasis
Erythematous
Pseudomembranous
Erythematous
Hyperplastic candidiasis
Denture stomatitis
Angular cheilitis
Median rhomboid glossitis
11
Herpes viruses
Paramyxovirus
Papovirus
Retroviruses
7-8
9-11
12
13
Diseases of
bone
Oral epithelial
tumors
Regressive
alterations
Forensic
odontology
14
Introduction
Bengin Fibro-Osseous lesions:
Paget disease
Osteopetrosis
Osteogenesis imperfecta
Cherubism
Introduction
Benign epithelial lesions
Malignant epithelial neoplasms
Premalignant lesions and conditions
Introduction
Abrasion
Attrition
Erosion
Abfraction
Resorption of teeth
Introduction
Terminologies
General overview
Revision
2
2
3
3
1
1
1
1
1
1
No of
weeks
Contact
hours
C – Practical (13)
Practical
no
1
2
List of topic
Detailed content
Introduction
Definitions of oral pathology and its
field.
Normal orofacial structures.
Types of microscopes
Common stains used in oral
pathology
Definition
Classification of dental caries
Bacterial implicated in dental caries
Role of plaque in dental caries
Stephan curve
Dental caries
1
1
1
1
12
Factors affecting plaque formation
Saliva and dental caries
Microscopic features of enamel and
dentin caries.
3-4
5-6
7
8-9
Developmental
abnormalities
of Jaw, lip and
Tongue
Orofacial Clefts.
Anomalies of lip
Anomalies of tongue
Syndromes associated with theses
defects
Abnormalities
of teeth
Enviornmental alterations of teeth
Environmental effects on tooth
structure development.
Postdevelopmental loss of tooth
structure
Environmental Discoloration of teeth.
Localized disturbances in eruption.
Pulpal and
periapical
diseases
Orofacial
cysts
Developmental alterations of teeth
Developmental alterations in the
number of teeth.
Developmental alterations in the size
of teeth.
Developmental alterations in the
shape of Teeth.
Developmental alterations in the
structure of teeth.
Pulpitls.
Secondary dentin
Pulpal calcifications.
Periapical granuloma.
Periapical cyst.
Periapical abscess.
Cellulitis.
Osteomyelitis.
Diffuse sclerosing osteomyelitis.
Condensing osteitis.
Odontogenic cysts
Denti gerous cyst
Erup tion cyst.
Primordial cyst.
Odontogenic kerato cyst.
Orthokeratinized odontogenic cyst.
Nevoid Basal Cell Carcinoma
Syndrome.
2
2
2
2
1
1
2
2
13
10-11
Odontogenic
tumors
Gingival Cyst of the Newborn.
Ging ival Cysl of the Adult.
Lateral Periodontal Cyst
Calcifying Odontogenic Cyst.
Gland ular Odontogenic Cyst.
Buccal Bifurcation Cyst.
Carcinoma Arisi ng in Odo ntogenic
Cysts.
Tumors of odontogenic epithelium
Ameloblastoma,
Malignant Ameloblastoma and
Ameloblastic Carcinoma
Clear Cell Odontogenic Carcinoma.
Adenomatoid Odontogenic Tumor.
Calcifying Epithelial Odontogenic
Tumor.
Squamous Odontogenic Tumor.
Mixed odontogenic tumors
Ameloblastic Fibroma.
Ame loblastic Fibro-Odontoma.
Ameloblastic Fibro sarcoma.
Odontoamelobla stoma.
Odontoma.
2
2
2
2
1
1
Tumors of odontogenic mesenchyme
Central Odontogenic Fibroma.
Peri phe ral Odon togenic Fibroma.
Granular Cell Odontogenic Tumor.
Odon togenic Myxoma
Cementoblastoma.
12-13
14
Keratotic
lesions
Leukoplakia
Hair tongue
White spone nevus
Smokers palate
Oral hairy leukoplakia
Lichen planus
Linea alba
Verrucus carcinoma
Revision
14
2nd Semesteer
Practical
no
1-2
List of topic
Diseases of
salivary glands
Detailed content
Introduction
Benign salivary gland tumors
Pleomorphic adenoma
Monomorphic adenoma
Papillary cysadenoma lymphatosum
Oncocytoma
Malignant salivary gland tumors
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma
Polymorphous low grade
adenocarcinoma
No of
weeks
Contact
hours
2
2
2
2
1
1
Mucocele
Mucous retention cyst
Chronic sclerosing sialadenitis
Necrotizing sialometaplasia
Sjogren syndrome
3-4
5
Diseases &
tumors of
connective
tissue
Bacterial
infections
Introduction
Tumors of fibrous tissue origin
Tumors of muscle tissue origin
Tumors of nerve tissue origin
Tumors of adipose tissue origin
Tumors of Vascular tissue origin
Introduction
Necrotizing ulcerative gingivitis.
Noma.
Actinmycosis.
Impetigo.
Tonsillitis an pharyngitis.
Scarlet fever.
Syphilis.
Tuberculosis.
15
6
Viral and fungal
infections
Introduction
Fungal infections
Pseudomembranous candidiasis
Erythematous
Pseudomembranous
Erythematous
Hyperplastic candidiasis
Denture stomatitis
Angular cheilitis
Median rhomboid glossitis
1
1
2
2
3
3
1
1
1
1
1
1
Herpes viruses
Paramyxovirus
Papovirus
Retroviruses
7-8
9-11
12
13
14
Diseases of
bone
Oral epithelial
tumors
Regressive
alterations
Forensic
odontology
Introduction
Bengin Fibro-Osseous lesions:
Paget disease
Osteopetrosis
Osteogenesis imperfecta
Osteoma
Ostoid osteoma and osteoblastoma
Introduction
Benign epithelial lesions
Malignant epithelial neoplasms
Premalignant lesions and conditions
Introduction
Abrasion
Attrition
Erosion
Abfraction
Resorption of teeth
Introduction
Terminologies
General overview
Revision
16
DETAILED OBJECTIVES OF THE CONTENTS:
LECTURES
Semester 1
Lecture 1: Oral Pathology Introduction
At the end of the lecture student should be able to –
 To enumerate the topics to be covered in the course
 To understand and explain the importance of the course
 To enlist the books used as learning resources in the course
Lecture 2-3: Developmental abnormalities of Jaw, lip and Tongue
At the end of the lecture student should be able to –
 To enumerate the Developmental abnormalities of Jaw, lip and Tongue
 To explain the process of formation of these anomalies.
 To understand the clinical importance of these anomalies
 To identify and enumerate the various syndromes associated with these anomalies.
Lecture 4-5: Developmental Abnormalities of teeth
At the end of the lecture student should be able to –
 To enumerate the Developmental abnormalities of Jaw, lip and Tongue
 To explain the process of formation of these anomalies.
 To understand the clinical importance of these anomalies
 To identify and enumerate the various syndromes associated with these anomalies.
Lecture 6-7: Orofacial cysts
At the end of the lecture student should be able to –
 To enumerate and classify Orofacial cysts
 To know the definition and types of cysts
 To enumerate and explain the clinical features, radiographic features, histologic features of all
cysts
Lecture 8-9: Odontogenic tumors
At the end of the lecture student should be able to –
17



To enumerate and classify odontogenic tumors
To know the clinical importance and general behavior of Odontogenic tumors
To enumerate and explain the clinical features, radiographic features, histologic features of the
common odontogenic tumors
Lecture 10-11: Keratotic lesions
At the end of the lecture student should be able to –
 To enumerate the keratotic lesions of oral cavity
 To know the difference between scrappable and nonscrappable lesions of the oral cavity
 To enumerate and explain the clinical features, histologic features and clinical importance of the
common keratotic lesions.
Lecture 12: Dental caries
At the end of the lecture student should be able to –
 To understand the importance and types of dental caries
 To enumerate and explain the theories of Caries formation
 To identify and explain the various zones of enamel and dentinal caries
Lecture 13: Pulpal and periapical diseases
At the end of the lecture student should be able to –
 To identify the signs and symptoms of reversible and irreversible pulpitis
 To understand and explain the sequelae of pulptis
 To describe in detail the various periapical lesions
 To classify and explain the types of osteomtelitis
Semester 2
Lecture 1-2: Diseases of salivary glands
At the end of the lecture student should be able –
 To enumerate and classify salivary gland tumors
 To know the clinical importance and general behavior of salivary gland tumors
 To enumerate and identify the common diseases and tumor like lesions of salivary glands
 To enumerate and explain the clinical features, radiographic features, histologic features of the
common salivary gland tumors and diseases.
18
Lecture 3-4: Diseases & tumors of connective tissue
At the end of the lecture student should be able To enumerate and know the common terminology of connective tissue tumors and diseases
 To identify and explain the features of common fibrous tissue tumors
 To identify and explain the features of common muscle tissue tumors
 To identify and explain the features of common nerve tissue tumors
 To identify and explain the features of common vascular tissue tumors
 To identify and explain the features of common adipose tissue tumors
Lecture 5: Bacterial infections
At the end of the lecture student should be able To identify and enumerate the common bacterial infections.
 To know the clinical features and importance of common bacterial infections of the oral cavity
 To know the clinical features and importance of common systemic bacterial infections with
manifestations in the oral cavity
Lecture 6: Viral and fungal infections
At the end of the lecture student should be able To identify and enumerate the common viral and fungal infections.
 To know the clinical features and importance of common viral infections of the oral cavity
 To know the clinical features and importance of common systemic viral infections with
manifestations in the oral cavity
 To know the clinical features and importance of types of candidiasis
Lecture 7-8: Diseases of bone
At the end of the lecture student should be able To enumerate the common diseases of bone affecting the oral cavity.
 To enumerate and describe in detail the fibro-osseous lesions
 To know the clinical features and importance of common diseases of bone with manifestations
in the oral cavity
Lecture 9-11: Oral epithelial tumors
At the end of the lecture student should be able-
19





To enumerate and know the common terminology of epithelial tumors.
To identify and explain the features of benign epithelial tumors of oral cavity
To identify and explain the features of premalignant lesions and conditions of oral cavity
To define and differentiate between premalignant lesions and premalignant conditions of oral
cavity
To identify and explain the features of malignant epithelial tumors of oral cavity
Lecture 12: Regressive Alterations
At the end of the lecture student should be able To define regressive alterations and enumerate the diseases.
 To identify and explain the features of attrition
 To identify and explain the features of abrasion
 To identify and explain the features of erosion
 To identify and explain the features of abfraction
 To be able to clinically differentiate between the lesions
 To identify and explain the features and types of resorption
Lecture 13: Forensic odontology
At the end of the lecture student should be able


To know the importance of Forensic odontology
To know the general scope of Forensic odontology
To identify the fields and situations in which forensic odontology can be applied
PRACTICALS
During the practical the students have to identify microscopic slides of the particular
topic and also answer the questions given in their practical manual.
20
Student additional private study hours per week & student support:
In Additional to the credit hours in the college hours the student is expected to put in 5 hours of private
study/learning hours per week. (This is an average for the semester not a specific requirement in each
week).
The students are encouraged to interact with the tutors of the course for any additional help required
during the course. The staff members are instructed to inform the students regarding the office hours
when they can approach the faculty for their help
After each class the faculty member allocates a few minutes to clear the doubts of the students if
needed
The power point presentation of each class is uploaded on the faculty members website from where
the students can easily retrieve it and come prepared for the lecture.
Group of three students are allotted to one faculty member, who is their mentor, the students can even
approach their respective mentors if they have any additional problems with the subject.
21
Teaching and learning resources:
Students will be shown power point presentations, quiz, and essay competition. During the practicals
students will be shown microscopic slides, models and casts to give them in depth knowledge and
understanding of the subject.
Use of more teaching aids during classes with special emphasis on the applied aspects of the structures,
impromptu questions asked during the class would also aid in developing cognitive skills. In addition we
would design quizzes and assignments in such a way that the students would have to correlate the various
topics and information given to them.
The students will be asked oral questions, debates, group discussions group tasks will be designed so that
the students learn to interact with their batchmates. In addition project work will be assigned to small
groups so that they learn to take up the responsibility and complete it.
ecommended text books:
Required textbooks
1. Shafer’s textbook of Oral pathology
R. Rajendran and S. Shivpathasundaram
ELSEVIER
6th edition
aa
2222222
a
2. Oral and Maxillofacial Pathology
Neville, Allan, Damn and Bouquot
SAUNDERS
3rd edition
22
3Textbook: Oral Pathology: Clinical - Pathologic Correlations
Author(s): Joseph A. Regezi ,James J. Sciubba and Richard C. K. Jordan
Publisher: ELSEVIER
Year: 2011
Edition: Third Edition
4. Textbook: Oral pathology
Author(s): J. V. Soames and J. C. Southam
Publisher: OXFORD
Year: 2005
23
Recommended books
Textbook: Color Atlas of Common Oral Diseases
Author(s): Robert P. Langlais, Craig S. Miller and Jill S. Nield-Gehrig
Publisher: Lippincott Williams & Wilkins; Fourth edition
Year : 2009
Lab Guide
Manual of Oral histology & Oral pathology
Author – Maji Jose; Publisher – CBS
Reference Material (Journals, Reports, etc)
Journal
Oral surgery oral medicine and oral pathology journal
Electronic Materials, Web Sites etc
Web sites
www.oralpath.com
www.pubmed.com
24
Facilities Required:
Theory:
1. A class room with a seating capacity of 30 students, equipped with a projector and smart board.
Practical:
1.
A well equipped laboratory with microscopes for conduction of practicals. Microscope with
an attached camera for projection and discussion of microscopic slides.
2. Microscopic slides and dental casts
25
Student Assessment:
Evaluation & assessment of students:
By Oral and Written examination, periodic assessment through assignments, evaluation of the projects
and group tasks.
Assessment of student communication skills will be through the seminars and term papers.
The oral skills will be tested in the oral exams.
1st and 2nd Semester
Assessment tools
In course assessments
60%
Final Written Exam
25%
Final Exam Practical
15%
Total
100%
Midterm exam
Midterm exam
practical
Behavior
Research
Presentation
Quiz
Oral Exam
Written
Identification of slides
and models
General
Activity
Oral
Written
Oral
Written
Identification of slides
and models
20%
15%
5%
4%
4%
2%
10%
The final marks obtained for the course will be decided by taking 50% marks from second semester and
50% from 1st semester.
26
SEMINARS
A. Guidelines for seminar sessions:
1. One seminar per student is scheduled during the semester.
2. Duration of each seminar will be of 5 minutes.
3. The students will be given the topics for seminar atleast two weeks in advance. The topics
will be selected randomly by the students by a picking a slip (lottery method).
4. The student is expected to prepare a powerpoint presentation for the seminar. They can
take the help of a staff member in preparing themselves for the presentation.
5. After each session group discussion will be allowed.
6. The tutor (faculty member incharge) will give his comments and feed back about the
presentation.
7. All the students are expected to be present during the seminars and also prepare
themselves by reading about the topic of presentation so as to have an active and
productive group discussion.
Course Evaluation and Improvement Process:
The students will be given a feedback form, which can be submitted to the course director or to the
dean which will help in improvement of the subject teaching.
The head of the department or the Dean has informal meetings with groups of students to discuss the
contents of the course, method of teaching to evaluate the course and the instructor.
Meetings will be conducted every week in the department to update the status of each student and the
difficulties felt by the colleague will be resolved accordingly. The dean randomly attends lectures to
assess the instructor. The power point presentation of each lecture is distributed to all the staff
members of the department for evaluation and suggestions for improvement.
Teachers will be subjected to go for up gradation of knowledge by attending the relevant conferences
and will be encouraged to carry on a self improvement.
Other staff members are invited to attend the seminar presentation of students to verify the standards
of student learning and their work.
27