Viral Infections

Human Herpes Viruses (HHV)


• H. simplex virus

HHV-1

• Cytomegalovirus

HHV-5

Type 1 (HSV-1)

(CMV)

• H. simplex virus

HHV-2

• Human herpes

HHV-6

Type 2 (HSV-2)

Virus type 6

• Varicella zoster

HHV-3

• Human herpes

HHV-7

Virus (VZV)

Virus type 7

• Epstein-Barr

HHV-4

• Human herpes

HHV-8

Virus (EBV)

Virus type 8


Viruses that are latent and which can also be found in “healthy” tissue usually are limited to ectodermal structures (skin, mucosa, retina etc). The primary infection usually occurs early in childhood through contact or droplet transfer. It can remain as a so-called latent infection throughout life.

The clinical manifestations of viruses in the oral mucosa are extraordinarily variable. Blisters, leukoplakic lesions on the tongue (“hairy leukoplakia”), localized and often expansive ulcerations and wart-like lesions have been described.


Human Herpes Viruses

316  Herpetic Stomatitis

Multiple blisters surrounded by erythema were caused by HSV-1 in this 40-year-old, HIV-positive homosexual patient. When the blisters burst, painful ulcerations remain.

Therapy: Topical analgesics and anti-inflammatory medicaments; systemic Aciclovir (e. g., Zovirax).

Left: Hairy leukoplakia on the lateral tongue border (Epstein-Barr virus, EBV).

317  Expansive Ulceration

Left: 28-year-old, HIV-positive homosexual with expansive ulceration and advanced attachment loss in the mandible.

Middle: After gross debridement of the soft tissue and extraction of 41 and 31. Despite treatment, the ulcer became larger. Suspicion of cytomegalovirus infection (CMV, smear).

Right: CMV infection confirmed. Extraction of tooth 42 and systemic therapy. Ulcer healed.

Human Papilloma Virus (HPV)

318 Verrucae (Wart)

Wart on the gingiva of a 42-year-old, HIV-positive homosexual, caused by HPV. This lesion was removed using the CO2 laser.

Left: Similar wart, caused by the same virus on the fingertip and nail bed.

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  • Category: Dental disease