Jordan University of Science and Technology
Faculty of Dentistry
Department of Oral Medicine and Surgery
Third Year (Second Semester)
Course Title: Oral Pathology & Immunology
Course Code: Dent 352
Prerequisite: Head & Neck Anatomy
Oral Histology
General & Systemic Pathology
Course Coordinator:
Name: Dr. Huda Hammad
Office Phone: 23557
Office Hours: every other Thursday 10-12 am (depends on clinic)
Dental Health Centre
E-mail: hmhammad@just.edu.jo
Instructors: Drs. Huda Hammad, Rima Safadi
Time: 12:15-1:15 Sundays & Tuesdays (lectures), 10-12 Thursdays (lab)
Place: JUST
Prerequisite for:
Dent 353 Oral Pathology, Oral Medicine, Oral Surgery, Oral Radiology
Course Objectives: (few and broad)
1. To acquire a basic understanding of main diseases in the following topics:
a. Disorders of development of oral tissues.
b. Disorders of development of teeth.
c. Dental caries.
d. Other disorders of teeth.
e. Disorders of the dental pulp
f. Periapical periodontitis.
g. Cysts of the jaws and oral soft tissues.
h. Diseases of the periodontium.
i. Connective tissues hyperplasia, neoplasia, and related disorders.
j. Keratoses and related disorders of the oral mucosa.
k. Oral epithelial tumors and melanocytic lesions.
2. To be able to classify diseases according to the basic pathologic process.
3. To be familiar with the clinical, radiographic, and main histopathologic features of significant diseases
of the oral and maxillofacial region.
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4. To be able to make a differential diagnosis of oral lesions based on the knowledge received in the
above-mentioned topics.
5. To be aware of the relative significance and basic management of each disease process.
6. To acquire a basic understanding of immunology.
Learning Outcomes: (many and specific)
Successful completion of this theoretical course should lead to the following learning outcomes:
Knowledge and Understanding (student should)
- Be able to classify diseases according to the basic pathologic process.
- Be familiar with the clinical, radiographic, and main histopathologic features of significant diseases of
the oral and maxillofacial region.
- Be able to make a differential diagnosis of oral lesions based on the knowledge received in the abovementioned topics.
- Be aware of the relative significance and basic management of each disease process.
- Have a basic understanding of immunology and the range of immunological reaction which could
affect dental patients.
Skills (intellectual, and manual)
Successful completion of this clinical or lab course, the student should gain the following skills.
1. Be able to classify diseases according to the basic pathologic process.
2. Be able to make a differential diagnosis of oral lesions based on the knowledge of clinical and
radiographic features of significant diseases of the oral and maxillofacial region in the above-mentioned
topics.
3. Be aware of the relative significance and basic management of each disease process.
4. Have a basic understanding of immunology and the range of immunological reaction which could
affect dental patients.
Teaching methods:
 Duration: 14 weeks, (39 contact hours in total, including lab)
 Lectures: 29 hours, 2 hour per week ( including 1-hour midterm exam)
 clinical :
 Laboratory: 5 lab sessions, 2 hours each, given after lecture blocks according to
subject.
Modes of assessment:
The examination will comprise two formal written examinations in the form of:
1.
A midterm examination of multiple choice questions. The mark will be 40%, inclding 5 marks
for contiuous assessment based on participation and attendance.
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2.
Final exam of MCQs including lab material . The mark will be 60%.
Attendance policy:
Students are expected to attend more than 90% of lectures or labs.
Course Content & Weight:
Theory
No.
of
Lecture title
Material covered
lectures
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Disorders of development of oral soft Cleft lip and cleft palate
tissues and maxillofacial bones
Commissural & paramedian lip pits
Double lip and Ascher syndrome
Fordyce granules
Leukoedema
Miroglossia
Maroglossia
Ankyloglossia
Lingual thyroid nodule
Fissured tongue
Hairy tongue
Varicosities
Caliber-persistent artery
Lateral soft palate fistulas
Coronoid hyperplasia
Condylar hyperplasia
Codylar hypoplasia
Bifid condyle
Exostosis
Torus palatinus
Torus mandibularis
Eagle syndrome
Stafne defect
Palatal cysts of the newborn
Nasolabial cyst
Epidermoid cyst
Dermoid cyst
Thyroglossal duct cyst
Branchial cleft cyst
Oral lymphoepithelial cyst
Hemihyperplasia
Progressive hemifacial atrophy
Segmental odontomaxillary dysplasia
Crouzon syndrome
Apert syndrome
Mandibulofacial dysostosis
Disorders of development of teeth
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Disturbances in number of teeth:
hypodontia, anodontia, & related syndromes
hyperdontia
Disturbances in size of teeth:
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macrodonia and microdontia.
Disturbances in form of teeth:
Germination
Fusion
ontism
concrescence
accessory cusps
dens invaginatus
ectopic enamel
taurodontism
hypercementosis
accessory roots
dilaceration
Disturbances in structure of teeth:
-disturbances in structure of enamel:
localized causes (local infection or trauma,
enamel opacities)
generalized causes (chronological hypolasias,
congenital syphilis, fluorosis, amelogenesis
imperfecta)
- disturbances in structure of dentin:
dentinogenesis imperfecta
dentinal dysplasia
metabolic disturbances affecting dentinogenesis
regional odontodysplasia
Non-carious disorders of teeth
Disorders of eruption and shedding
Premature eruotion, natal, and neonatal teeth
Retarded eruption
Premature loss
Persistence of deciduous teeth
Impaction of teeth
Reimpaction of teeth
Non-bacterial loss of tooth substance
Attrition
Abrasion
Erosion
Abfraction
Resorption
Discoloration of teeth:
Extrinsic staining
Changes in structure or thickness of dental hard
tissues
Diffusion of pigments after formation of hard
tissues
Diffusion of pigments during formation of hard
tissues
Transplantation and reimplantation of teeth
Root fracture
Age changes
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Disorders of the dental pulp
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Pulpitis:
Clinical features
Etiology
Histopathology
Pulp polyp
Effects of cavity preparation and restorative materials
Healing of pulp
Pulp calcification
Pulp necrosis
Age changes in the pulp
Periapical periodontitis
Etiology
Acute periapical periodontitis
Chronic periapical periodontitis
(periapical granuloma)
sequelae
Acute periapical abscess and spread of
inflammation
Etiology and microbiology
Routes of spread
Cellulitis
Ludwig’s angina
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Cysts of the jaws and oral soft
tissues
Classification and incidence of cysts of the
jaws
Odontogenic cysts:definition and origins
Radicualr cysts
Dentigerous and eruption cysts
Odontogenic keratocysts
Gingival cyst
Lateral periodontal cyst\paradental cyst
Glandular odontogenic cyst
Non-odontogenic cysts
Nasopalatine duct cyst
Nasolabial cyst
Median cyst of the palate
Non-epithelialized primary bone cysts
Solitary bone cyst
Aneurysmal bone cyst
Stafne idiopathic bone cavity
Cysts of the soft tissues
Salivary mucoceles
Dermoid and epidermoid cysts
Lymphoepithelial cyst
Thyroglossal cyst
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Connective tissues hyperplasia,
neoplasia, and related disorders
Connective tissue hyperplasia
Epulides
Pyogenic granuloma
Fibroepithelial polyp
Denture irritation hyperplasia
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Papillary hyperplasia of the palate
Connective tissue neoplasms and allied
conditions
Tumors of fibrous tissue
Tumors of adipose tissue
Tumors of vascular tissue
Tumors of peripheral nerves
Tumors of muscle
The granular cell tumor
Lymphomas
Classification
Definition of histopathologic terms
Hereditary conditions
White sponge nevus
Leukoedema
Traumatic keratoses
Mechanical
Chemical
Thermal
Leukoplakia
Incidence
Clinical features etiological factors
Pathology, epithelial dysplasia
Prognosis
Dermatological causes of white patches
Lichen planus
Lupus erythematosus
Keratoses and related disorders of
the oral mucosa
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Oral epithelial tumors and
melanocytic lesions
Squamous cell papilloma and other benign
lesions associated with HPV
Squamous cell papilloma
Verruca vulgaris
Condyloma acuminatum
Squamous cell carcinoma
Epidemiology
Etiological factors
Oncogenes and tumor suppressor genes
Clinical presentation
Pathology
Prognosis
Verrucous carcinoma
Carcinoma in situ
Premalignant lesions and conditions
Exfoliative cytology
Basal cell carcinoma
Melanocytic nevi and melanoma
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Miscellaneous Disorders of the Oral
Mucosa
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Fordyce’s Granules
Sublingual Varices
Lingual Tonsil, Foliate Papillitis
Geographic Tongue (Migratory Glossitis)
Orofacial Granulomatosis
Crohn’s Disease
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Immunology
Sarcoidosis
Pyostomatitis Vegetans
Progressive Systemic Sclerosis (Scleroderma)
Verruciform Xanthoma
Oral Submucous Fibrosis
Amyloidosis
Oral Pigmentation
Superficial staining of the mucosa
Black hairy tongue
Foreign bodies
Amalgam tattoo Melanin pigmentation-developmental
causes
Heavy metal salts
Melanin pigmentation-acquired causes (Addison’s
disease, pulmonary disease, HIV infection, chronic
inflammation & lichen planus, drug-induced,
idiopathic oral melanotic macule, lentigo simplex)
sialadenitis
Neoplastic causes (melanoma in situ and melanoma)
Other endogenous pigments
Age Changes in the Oral Mucos
The immune system
The innate immune system
Complement
Cells of the immune system
The immune response
Antibodies
Cytokines
Antigen processing and presentation
T-helper subsets
Activation of macrophages
B-cell activation
Target cell killing
Regulation of the immune response
Immunological memory
Immunologic diseases:
Classification of immunologic diseases
Immune deficiency diseases
Allergy (hypersensitivity)
Autoimmunity
Allergic versus nonallergic reactions
Most frequent and serious problems
Atopic allergies: hay fever & asthma
Anaphylactic reactions, urticaria
Cytotoxic reactions: transfusion reactions,
erythroblastosis fetalis
Delayed hypersensitivity reaction: contact
dermatitis
Immune deficiencies
Symptoms, signs, and tests
Electrophoresis
Immunodiffusion
Skin tests
Coomb’s test
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Tissue immunofluorescence
Antinuclear antibody test
Specific diseases
Immune deficiency diseases:AIDS
Anaphylactic-atopic allergies (type I): allergic
rhinitis & asthma, urticaria, and angioedema,
systemic anaphylaxis, gastrointestinal food
allergies
Cytotoxic hypersensitivities (type II)
Erythroblastosis fetalis
Blood transfusion reactions
Autoimmune hemolytic anemia &
thrombocytopenia
Immune complex, or arthus type, hypersensitivities
(type III)
Arthus reaction
Serum sickness
Glomerulonephritis
Polyarteritis nodosa
Delayed, or cell-mediated, hypersensitivities (type IV)
Contact dermatitis
Infections manifest primarily as delayed
hypersensitivity reactions
Graft rejection
Autoimmune diseases
Systemic lupus erythematosus
Laboratory:
No. of
Practical requirement
Skills gained
labs
Developmental disorders
- To be familiar with the clinical, radiographic, and
main histopathologic features of some developmental
disorders of the oral and maxillofacial region and teeth.
- To be able to make a differential diagnosis of
developmental oral lesions.
- To be aware of the relative significance and basic
management of each developmental disease process.
Non-carious disorders of teeth,
disorders of dental pulp, periapical
periodontitis
- To be familiar with the clinical, radiographic, and
main histopathologic features of non-carious disorders
of teeth, disorders of the dental pulp, and periapical
periodontitis
- To be able to make a differential diagnosis of these
lesions.
- To be aware of the relative significance and basic
management of each disease process.
Cysts of the jaws and oral soft
tissues
- To be familiar with the clinical, radiographic, and
main histopathologic features of some cysts of the jaws
and oral soft tissues
- To be able to make a differential diagnosis of cysts of
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the jaws and oral soft tissues
- To be aware of the relative significance and basic
management of each cyst.
Connective tissue hyperplasia,
neoplasia, and related disorders
- To be familiar with the clinical and main
histopathologic features of oral connective tissue
hyperplasia, neoplasia, and related disorders
- To be able to make a differential diagnosis of these
lesions.
- To be aware of the relative significance and basic
management of each disease process.
Epithelial pathology
- To be familiar with the clinical, and main
histopathologic features of some epithelial disorders of
the oral and maxillofacial region.
- To be able to make a differential diagnosis of
epithelial oral lesions.
- To be aware of the relative significance and basic
management of each epithelial disease process.
Miscellaneous disorders
- To be familiar with the clinical, radiographic, and
main histopathologic features of some miscellaneous
disorders of the oral and maxillofacial region covered in
the lecture.
- To be able to make a differential diagnosis of
thesedisorders.
- To be aware of the relative significance and basic
management of each disorder.
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Feedback:
Concerns or complaints should be expressed in the first instance to the course instructor. If no resolution
is forthcoming then the issue should be brought to the attention of the Department Chair and if still
unresolved to the Dean. Questions about the material covered in the lecture, notes on the content of the
course, its teaching and assessment methods can be also sent by e-mail.
References and Supporting Material:
Textbook:
1. Oral Pathology by Soames & Southam, Oxford Uiversity Press, 3rd edition 1998, reprints 1999,
2001.
2. Oral Pathology by Soames & Southam, Oxford University Press, 4th edition 2005. Since this edition
was released after commencement of the course, students are given the option of using either edition
depending on availability in bookstores.
3. Oral and maxillofacial Pathology by Neville et al, Saunders, 2nd edition 2002, (Developmental
Disorders)
Useful websites:
http://www.dental.mu.edu/oralpath/opgloss.html
http://www.usc.edu/hsc/dental/opath/
http://www.forsyth.org/oralpathology/
http://www.library.vcu.edu/tml/oralpathology/
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http://www.mednet.gr/pim/oralpath.htm
http://www.uiowa.edu/~oprm/AtlasWIN/AtlasFrame.html
http://aaomp.org/
http://abomp.org/links.htm
http://www.lib.uiowa.edu/hardin/md/dent.html
http://www.usc.edu/hsc/dental/opfs/index.html
http://www.mic.ki.se/MEDIMAGES.html#DentistryandOralHealth
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