Disorders of Oral Pigmentation



Oral pigmentation is a relatively common condition that may involve any portion of the oral cavity. Multiple causes are known, and they may range from simple iatrogenic mechanisms, such as implantation of dental amalgam, to complex medical disorders, such as Peutz-Jeghers syndrome. Local irritants, such as smoking, may also result in melanosis of varying degrees. Oral pigmented lesions result from cellular hyperplasia that can range from benign nevi to fatal oral melanoma.

Pigmented entities may arise from intrinsic and extrinsic sources. The color may range from light brown to blue-black. The color depends on the source of the pigment and the depth of the pigment from which the color is derived. Melanin is brown, yet it imparts a blue, green, or brown color to the eye. This effect is due to the physical properties of light absorption and reflection described by the Tyndall light phenomenon or effect.

Oral conditions associated with increased melanin are common; however, those due to melanocytic hyperplasias are rare. Clinicians must visually inspect the oral cavity, obtain clinical histories, and be willing to perform a biopsy for any condition that is not readily diagnosed. Patients with oral malignant melanoma often recall having an existing oral pigmentation months to years before diagnosis, and the condition may even have elicited prior comment from physicians or dentists.

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            Warna gingiva normal, mencerminkan kesehatan mulut dan mempunyai peranan penting dalam kedokteran gigi estetik. Jika terdapat kelainan warna, seperti gingiva yang kehitam-hitaman yang sering dikeluhkan pasien dapat merupakan suatu masalah1.

Pigmentasi gingiva dapat terjadi pada semua ras. Melanin adalah suatu pigmen berwarna coklat, sering timbul pada pigmentasi endogen gingiva yang merupakan tempat paling dominan dari mukosa. Pigmentasi gingiva ini merupakan hasil granula melanin yang diproduksi oleh melanoblas terletak diantara sel-sel epitel pada lapisan basal epitel gingiva.1 Pigmentasi melanin sering terjadi pada gingiva akibat deposisi abnormal dari melanin. Hiperpigmentasi gingiva disebabkan oleh deposisi berlebih dari melanin oleh melanosit.yang banyak terdapat di lapisan basal dan suprabasal epitel 2,3.




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Mandible Dislocation

Mandible dislocation is the displacement of the mandibular condyle from the articular groove in the temporal bone.  Most dislocations are managed and reduced in the emergency department with elective follow-up. However, some situations require immediate consultation with a facial surgeon. This article focuses primarily on the diagnosis and management of mandible dislocations in adults.

The management of temperomandibular joint dislocation depends on the underlying cause. Hypermobility or subluxation can be managed by the use of autologous blood, sclerosing agents, and capsulorrhaphy. Manual reduction is sufficient for acute dislocation; however, chronic protracted and chronic recurrent dislocations are among the most difficult to manage, and surgical intervention may be required to treat such cases.[1, 2, 3, 4]

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