Oral Pathology
Textbook of General Pathology for Dental Students 2023
This textbook is structured to meet the specific learning needs of dental students in general pathology and assist them in holistically formulating clinical decisions. It discusses pathology principles essential to understanding the disease process. The text is presented logically and designed to emphasise clinical relevance where necessary. Chapters on common systemic and orofacial diseases have also been included to highlight the fundamental relevance of pathology to clinical dentistry. Organised in 16 chapters, using a user-friendly writing style, this book covers core topics such as cellular pathology, inflammation, tissue repair, immunopathology, genetic disorders, infectious disease, neoplasia, nutritional and environmental pathology, pain, and pathology of organ systems relevant to the practice of dentistry. It is a must-have for undergraduate and postgraduate dental students.
Table of contents :
Foreword
Preface
Contents
1: Introduction to Pathology
1.1 Introduction
1.2 History of Pathology
1.3 Making a Diagnosis
1.4 Diagnostic Investigations in Pathology
1.4.1 Gross Pathology
1.4.2 Biopsy
1.4.3 Histopathology
1.4.4 Cytopathology
1.4.5 Haematopathology
1.4.6 Histochemistry
1.4.7 Immunohistochemistry (IHC)
1.4.8 Immunofluorescence (IF)
1.4.9 Molecular Pathology
1.4.10 Cytogenetics (Clinical Genetics)
1.4.11 Biochemical Methods
1.4.12 Medical Microbiology
1.4.13 Microbial Culture
1.4.14 Flow Cytometry
1.4.15 Electron Microscopy
1.4.16 Forensic Pathology/Autopsy
1.4.17 Oral and Maxillofacial Pathology
1.5 Summary
Bibliography
2: Homeostasis
2.1 Introduction
2.2 Homeostasis at the Cellular, Tissue, and Organ Levels
2.3 Regulation and Mechanisms of Homeostasis
2.4 Homeostatic Mechanisms (Feedback Mechanisms)
2.4.1 Positive Feedback
2.4.2 Negative feedback
2.5 Oral Homeostasis
2.6 Homeostasis and Ageing
2.7 Nutrition and Homeostasis
2.8 Environment and Homeostasis
2.9 Summary
Bibliography
3: Disease, Disorder, and Disability
3.1 Introduction
3.2 Disease: Definition and Characteristics
3.2.1 Aetiology
3.2.2 Pathogenesis
3.2.3 Morphological, Functional, and Clinical Manifestations
3.3 Epidemiology
3.4 Classification of the Disease
3.5 Numerical Disease-Coding Systems
3.6 Disorder (Medical Disorder)
3.6.1 Mental Disorder
3.6.2 Physical Disorder
3.6.3 Genetic Disorder
3.6.4 Emotional and Behavioural Disorders (EBDs)
3.7 Disability
3.8 Summary
Bibliography
4: Cell Structure and Function, Cell Division and Cell Cycle, Cell Types and Stem Cells
4.1 Introduction
4.2 Cell Structure and Function
4.2.1 The Plasma Membrane
4.2.2 Cytoplasm
4.2.2.1 Nucleus
4.2.2.2 Mitochondria
4.2.2.3 Ribosomes
4.2.2.4 Centrosome
4.2.2.5 Lysosomes
4.2.2.6 Endoplasmic Reticulum
4.2.2.7 Golgi Apparatus
4.2.2.8 Vacuoles and Vesicles
4.2.2.9 Peroxisomes
4.2.2.10 Cytoskeleton
4.3 Intercellular Junctions
4.3.1 Tight Junctions
4.3.2 Gap Junctions
4.3.3 Desmosomes/Hemidesmosomes
4.4 Cell Communication (Cell Signalling)
4.5 Signalling Pathways
4.5.1 Autocrine Signalling
4.5.2 Endocrine Signalling
4.5.3 Paracrine Signalling
4.5.4 Juxtacrine Signalling
4.6 Interaction with Extracellular Matrix
4.7 Cell Division and the Cell Cycle
4.7.1 Interphase
4.7.2 Mitotic Phase
4.8 Control and Regulation of the Cell Cycle
4.9 Cell Types in the Human Body
4.10 Stem Cells
4.10.1 Totipotent Stem Cells
4.10.2 Pluripotent Stem Cells (PSCs)
4.10.3 Multipotent Stem Cells
4.10.4 Unipotent Stem Cells
4.10.5 Oligopotent Stem Cells
4.11 Summary
Bibliography
5: Cellular Pathology
5.1 Introduction
5.2 Cell Injury
5.3 Causes of Cell Injury
5.3.1 Hypoxia (Oxygen Deprivation)
5.3.2 Mechanical Trauma
5.3.3 Extreme Heat (Thermal Burn)
5.3.4 Extreme Cold (Cryogenic Burn)
5.3.5 Ionising Radiation
5.3.6 Non-ionising Radiation
5.3.7 Electrical Shock
5.3.8 Chemical Injury
5.3.9 Therapeutic and Illicit Drug Injury
5.3.10 Injury Due to Infectious Agents
5.3.11 Nutritional Imbalances
5.3.12 Immunologically Mediated Cell Injury
5.3.13 Genetic and Metabolic Cell Injury
5.3.14 Injury from Free Radicals
5.4 Mechanisms of Cell Injury
5.4.1 Plasma Membrane Damage
5.4.2 Mitochondrial Damage
5.4.3 Adenosine Triphosphate (ATP) Depletion
5.4.4 Cytosolic Calcium Derangement
5.4.5 Nucleic Acid Damage
5.5 Responses to Cell Injury
5.5.1 Reversible Cell Injury
5.5.2 Irreversible Cell Injury
5.6 Cellular Adaptation
5.6.1 Hypertrophy
5.6.2 Hyperplasia
5.6.3 Atrophy
5.6.4 Metaplasia
5.6.5 Dysplasia
5.7 Cellular Degeneration
5.7.1 Hydropic Degeneration (Cloudy Swelling/Vacuolar Degeneration)
5.7.2 Fatty Change (Fatty Degeneration)
5.7.3 Hyaline Change
5.7.4 Mucoid Degeneration (Mucinous Degeneration, Myxomatous Degeneration)
5.7.5 Fibrinoid Degeneration (Fibrinoid Necrosis)
5.8 Cellular Accumulations and Pathologic Calcification
5.8.1 Abnormal Accumulations of Lipids
5.8.2 Abnormal Accumulation of Proteins
5.8.3 Accumulation of Glycogen
5.8.4 Accumulation of Pigments
5.8.5 Pathologic Calcification
5.9 Cell Death
5.9.1 Apoptosis
5.9.2 Necrosis
5.9.2.1 Coagulative Necrosis
5.9.2.2 Liquefactive Necrosis
5.9.2.3 Caseous Necrosis
5.9.2.4 Gangrenous Necrosis
5.9.2.5 Fibrinoid Necrosis
5.9.2.6 Fat Necrosis
5.10 Summary
Bibliography
6: Inflammation: An Overview
6.1 Introduction
6.2 Aetiology
6.3 Cardinal Signs of Inflammation
6.4 Cells of the inflammatory Response, Their Location, and Primary Role
6.5 Classification of Inflammation
6.5.1 Acute Inflammation
6.5.1.1 Early Vascular Response
6.5.1.2 Late Cellular Response
Stage 1
Stage 2
Transendothelial Migration (TEM) of Leukocytes
Stage 3
Chemotaxis of Neutrophils
Stage 4
Phagocytosis
Recognition and Attachment
Engulfment
Killing or Degradation
6.5.1.3 Cell-derived Inflammatory Mediators
6.5.1.4 Plasma-Derived Inflammatory Mediators
6.5.2 Chronic Inflammation
6.5.3 Types of Chronic Inflammation
6.5.3.1 Nonspecific Proliferative
6.5.3.2 Granulomatous Inflammation
6.6 Morphologic Patterns of Inflammation
6.6.1 Fibrinous Inflammation
6.6.2 Suppurative (Purulent) Inflammation
6.6.3 Serous Inflammation
6.6.4 Ulcerative Inflammation
6.6.5 Catarrhal Inflammation
6.6.6 Pseudomembranous Inflammation
6.6.7 Granulomatous Inflammation
6.7 Summary
Bibliography
7: Healing: Tissue Regeneration and Repair
7.1 Introduction
7.2 Types of Cells and Tissues Involved in the Healing Process
7.3 Healing by Regeneration
7.4 Healing by Repair
7.5 The Role of Cytokines, Growth Factors, and Extracellular Matrix
7.6 Wound Healing
7.7 Categories of Cutaneous Wound Healing
7.7.1 Healing by First intention (Primary Union)
7.7.2 Healing by Second Intention (Secondary Intention)
7.8 Healing of Oral Mucosal Wounds
7.9 Fracture Healing
7.9.1 Stages in Fracture Healing (Bone Regeneration) (Fig. 7.2)
7.10 Tooth Extraction Socket Healing
7.11 Factors that Influence Wound Healing
7.11.1 Local Factors
7.11.2 Systemic Factors
7.12 Complications of Wound Healing
7.13 Summary
Bibliography
8: Genetic and Developmental Pathology
8.1 Introduction
8.2 Chromosomes and Genes
8.3 Genotype and Phenotype
8.4 Inheritance Patterns
8.4.1 Single-Gene Inheritance (Mendelian Inheritance)
8.4.2 Sex-Linked Inheritance
8.4.3 Mitochondrial Inheritance.
8.4.4 Multifactorial Inheritance
8.5 Genetic Disorders
8.5.1 Monogenic Disorders
8.5.2 Polygenic Disorders (Multifactorial Inheritance Disorders)
8.5.3 Chromosomal Disorders (Cytogenetic Disorders)
8.6 Mutations
8.7 Congenital and Developmental Disorders
8.8 Summary
Bibliography
9: Infectious and Communicable Diseases: An Overview
9.1 Introduction
9.2 The Concept of Chain of Infection
9.3 Routes and Modes of Entry of Microbes
9.3.1 Direct Transmission
9.3.2 Indirect Transmission
9.4 Host Defences against Infection
9.5 Types of Infectious Agents and Mechanism of Infections
9.5.1 Bacteria
9.5.1.1 Mechanisms of Bacterial Injury
9.5.1.2 Examples of Bacterial Diseases
9.5.2 Viruses
9.5.2.1 Mechanism of Viral Infections
9.5.3 Fungi
9.5.3.1 Mechanism of Fungal Infections
9.5.3.2 Examples of Fungal Diseases
9.5.4 Protozoa
9.5.5 Helminths
9.5.6 Prions
9.6 Summary
Bibliography
10: An Introduction to Immunology and Immunopathology
10.1 Introduction
10.2 The Immune System: Innate and Adaptive Immunity.
10.2.1 Innate Immunity
10.2.2 Adaptive Immunity
10.2.3 T Cells and Antigen Presenting Cells(APCs)
10.2.4 B Cells
10.3 Antibody-Mediated versus Cell-Mediated Immunity
10.4 Passive vs. Active Immunisation
10.5 Immunopathology
10.5.1 Hypersensitivity Reactions
10.5.2 Autoimmunity
10.5.3 Immunodeficiency
10.6 Inflammation
10.7 Conclusions and Summary
Bibliography
11: Neoplasia and Carcinogenesis
11.1 Introduction
11.2 Classification of Neoplasms
11.2.1 Benign Neoplasms
11.2.2 Malignant Neoplasms
11.3 Other Tumour Terminologies
11.4 Non-Neoplastic Tumour-like Lesions
11.5 Epidemiology of Cancer
11.6 Aetiology of Cancer
11.6.1 Chemical Carcinogens
11.6.1.1 Mechanisms of Chemical Carcinogenesis.
11.6.2 Physical Carcinogens
11.6.2.1 Mechanism of Physical Carcinogenesis
11.6.3 Viral Carcinogens (Oncogenic Viruses)
11.6.3.1 Mechanism of Viral Carcinogenesis.
11.6.4 Bacteria, Fungi, and Parasites as Carcinogens
11.7 Role of Host Factors in Carcinogenesis
11.8 Clinical Effects of Neoplasms
11.9 Cancer Staging
11.9.1 Primary Tumour (T)
11.9.2 Regional Lymph Nodes (N)
11.9.3 Distant Metastasis (M)
11.10 Spread of Cancer: Metastasis
11.11 Cancer Diagnosis: Investigations
11.11.1 Histopathology and Cytopathology
11.11.2 Histological Grading of Cancer
11.11.3 Tumour Marker Tests
11.11.4 Histochemistry
11.11.5 Immunohistochemistry (IHC)
11.11.6 Flow Cytometry
11.11.7 Molecular Diagnosis
11.11.8 Imaging Tests
11.11.9 Diagnostic Surgery: Sentinel Node Mapping
11.12 Carcinogenesis
11.12.1 Host Defence Against Cancer
11.12.2 Stages of Cancer Development
11.12.3 Molecular and Genetic Basis of Cancer
11.12.4 Hallmarks of Carcinogenesis
11.12.5 Role of Tumour Suppressor Genes, Cellular Proto-Oncogenes, and Growth Factors in Carcinogenesis
11.13 Summary
Bibliography
12: Environmental and Nutritional Pathology
12.1 Introduction
12.2 Environmental Pollution
12.3 Effects of Tobacco, Alcohol, and Substance Abuse
12.4 Effects of Radiation
12.5 Nutrition and Malnutrition.
12.5.1 Nutritional Deficiencies
12.5.1.1 Caloric and Protein Deficit
12.5.1.2 Vitamin Deficiencies
12.5.1.3 Deficiency of Other Essential Micronutrients
12.5.2 Nutrient Excesses
12.5.2.1 Excesses of Carbohydrates, Proteins, and Fats
12.5.2.2 Overweight and Obesity
12.5.2.3 Hypervitaminosis
12.5.2.4 Iron Excess (Iron Toxicity)
12.6 Summary
Bibliography
13: Hemodynamic Disorders
13.1 Introduction
13.2 Hyperemia and Congestion
13.3 Haemorrhage
13.4 Haemostasis
13.5 Disorders of haemostasis
13.6 Laboratory diagnosis of haemostatic disorders
13.7 Thrombosis
13.8 Arterial or Venous Blood Stasis and Turbulence
13.9 Hypercoagulable State
13.10 Arterial Thrombosis
13.11 Disseminated Intravascular Coagulation (DIC)
13.12 Embolism
13.13 Pulmonary Embolism
13.14 Systemic Thromboembolism
13.15 Infarction
13.16 Oedema
13.17 Shock
13.18 Summary
Bibliography
14: Imbalances in Fluids and Electrolytes, Acids and Bases: An Overview
14.1 Introduction
14.2 Fluid Balance
14.3 Electrolyte Balance
14.4 Acid-Base Balance
14.5 Abnormalities in Acid-Base Balance
14.5.1 Alkalosis
14.6 Summary
Bibliography
15: Ageing
15.1 Introduction
15.2 Theories of Ageing
15.2.1 The Programmed Theories
15.2.2 The Error (Damage) Theory
15.3 Normal Ageing
15.4 Age-Related Diseases
15.5 Summary
Bibliography
16: Pain: Basic Concepts
16.1 Introduction
16.2 Pathophysiology of Pain
16.3 Classification of Pain
16.3.1 Nociceptive Pain
16.3.2 Neuropathic Pain
16.3.3 Mixed Pain
16.3.4 Psychogenic Pain
16.4 Conditions Associated with Peripheral and Central Neuropathic Pain
16.5 Summary
Bibliography
17: Dental, Oral, Maxillofacial and Salivary Gland Diseases: An Overview
17.1 Introduction
17.2 Common Developmental Disorders
17.3 Dental Caries and Pathology of the Dental Pulp
17.4 Other Acquired Dental Disorders
17.5 Periodontal Diseases
17.6 Mucosal Diseases
17.7 Diseases of the Jaw Bones
17.7.1 Jaw Cysts
17.7.2 Jaw Tumours
17.7.2.1 Giant Cell Tumours
17.7.2.2 Non-Odontogenic Tumours
17.7.3 Fibro-Osseous Lesions
17.8 Diseases of the Salivary Glands
17.8.1 Medication-Induced Hyposalivation and Xerostomia
17.9 Summary
Bibliography
18: Pathology of Organ Systems of the Body
18.1 Introduction
18.2 Gastrointestinal Diseases
18.2.1 Gastroesophageal Reflux Disease (GORD)
18.3 Liver Diseases
18.3.1 Viral Hepatitis
18.4 Cardiovascular Diseases
18.5 Respiratory Diseases
18.6 Diseases of the Blood and Blood-Forming Organs
18.6.1 Anaemias
18.6.2 Haemoglobinopathies (Sickle Cell Anaemia and Thalassemia)
18.6.3 Disorders of Coagulation
18.7 Disorders of the Immune System
18.7.1 Hypersensitivity Reactions
18.8 Diseases of the Renal System
18.9 Diseases of the Endocrine System and Metabolism
18.10 Diseases of the Nervous System
18.11 Diseases of Bone and Joints
18.12 Psychiatric Disorders
18.13 Summary
Bibliography
